Experiences and support needs of psychiatrists under investigation.

AIMS AND METHOD: This study aimed to explore the experiences and support requirements of psychiatrists undergoing investigations within their mental health organisation. An anonymous online survey was distributed to all non-training psychiatrists registered as members of the Royal College of Psychiatrists. RESULTS: Of the 815 psychiatrists who responded to the survey, 287 (35%) had been investigated. The majority (76%) were unaware of the concerns before being notified, 36% lacked understanding and 62% experienced timeline deviations. Furthermore, 34% had concerns over conflicts of interest, with 52% perceiving the investigation as unfair, 62% were not informed of their rights. Many respondents reported feeling isolated and lacking support and experienced significant psychological distress, such as symptoms of post-traumatic stress disorder. Suggestions for improvement included better communication, transparency, impartiality, adherence to timelines, proactive support and oversight, and opportunities for learning and reparation post-investigation. CLINICAL IMPLICATIONS: Mental health service providers should recognise the multifaceted nature of complaints and provide comprehensive support and guidance to psychiatrists undergoing investigations.

Finite Difference Modeling and Experimental Investigation of Cyclic Thermal Heating in the Fused Filament Fabrication Process.

Fused filament fabrication (FFF) is one of the most popular additive manufacturing (AM) processes due to its simplicity and low initial and maintenance costs. However, good printing results such as high dimensionality, avoidance of cooling cracks, and warping are directly related to heat control in the process and require precise settings of printing parameters. Therefore, accurate prediction and understanding of temperature peaks and cooling behavior in a local area and in a larger part are important in FFF, as in other AM processes. To analyze the temperature peaks and cooling behavior, we simulated the heat distribution, including convective heat transfer, in a cuboid sample. The model uses the finite difference method (FDM), which is advantageous for parallel computing on graphics processing units and makes temperature simulations also of larger parts feasible. After the verification process, we validate the simulation with an in situ measurement during FFF printing. We conclude the process simulation with a parameter study in which we vary the function of the heat transfer coefficient and part size. For smaller parts, we found that the print bed temperature is crucial for the temperature gradient. The approximations of the heat transfer process play only a secondary role. For larger components, the opposite effect can be observed. The description of heat transfer plays a decisive role for the heat distribution in the component, whereas the bed temperature determines the temperature distribution only in the immediate vicinity of the bed. The developed FFF process model thus provides a good basis for further investigations and can be easily extended by additional effects or transferred to other AM processes.

Well Defined Phosphine Free Ni-Catalyzed Dehydrogenation of Secondary Alcohols for the Synthesis of Ketones and Ketazines.

In this work, we unveil a novel synthesis of bench stable Ni (II) complexes supported by tetradentate Schiff-base ligands and the complexes were devoid of any phosphine or phosphine-based ligand. These Ni-complexes were successfully applied for the dehydrogenation of secondary alcohols for ketone and ketazine syntheses. Secondary alcohols with different functional groups were well tolerated during catalytic cycle. Moreover, we successfully extended this protocol for the synthesis of biologically significant ketones and ketazines. On the basis of various control experiments, probable reaction pathway was proposed and an acceptorless alcohol dehydrogenation mechanism was suggested.

Prevalence, impact and associated factors of abnormal preoperative investigation result in patients undergoing surgery in Dilla University referral hospital: cross-sectional study.

Background: As one domain of preoperative assessment, preoperative investigations are often ordered to evaluate patient's medical condition for risk stratification and assessing patient status to undergoing surgery. Despite the fact that laboratory testing can assist in ensuring the best possible preoperative condition, routine screening examinations have a number of drawbacks. Although there are evidence-based recommendations for which investigations should be done, the tradition of routine preoperative testing is still prevalent and clinical practice with abnormal results detected varies. Method: Institution-based cross-sectional study design was conducted from 1 November to January at Dilla University Referral Hospital. Data was collected from complete pre-anaesthesia check-up sheets, investigations already done. It was collected at the individual level by using, closed-ended self-guided questionnaire. The collected data was entered, cleaned, edited and checked using SPSS version 26 for data processing and analysis. Logistic regression was performed to examine the impacts of abnormal preoperative investigation results and summarised by using tables and figures. An Adjusted odds ratio with 95% CI was computed to determine the level of significance. Result: Data of 208 patients (65.9 female) with mean±standard deviation age 30.83±15.340 years and 22.59±2.99 BMI were analysed. Patients were mostly American Society of Anaesthesiologists I and II underwent National Institute of Clinical and Health Excellence Grade 2 surgeries and surgical shape class 3. Totally, 178 (44.5%) test results were abnormal. CBC is the most detected abnormal result. Only 15 (3.75%) abnormalities had an impact in terms of delay, further investigations, and surgical technique. Comorbidity (AOR 7.982, 95% CI, P=0.041), medication history (AOR 1.463, 95% CI, P=0.013), ASA physical status II (AOR 3.287, 95% CI, P=0.029) and history of smoking (AOR 1.577, 95% CI, P=0.049) were factors which was significantly associated with abnormal preoperative investigation result. Conclusion: Only 0.6% of all tests had a significant impact in terms of changing perioperative anaesthetic management. The significant impact of abnormal investigation result noticed was delayed surgery.

Elimination of an outbreak of Carbapenem-resistant Acinetobacter baumannii in a Burn Unit.

Carbapenem-resistant Acinetobacter baumannii (CRAB) is an opportunistic pathogen which has caused numerous healthcare-associated outbreaks particularly in intensive care and burn units. We describe an outbreak in a burn unit where 3 patients were identified as being colonized or infected with CRAB. A multi-faceted approach and rapid implementation of infection prevention measures were effective in identification and removal of potential environmental reservoirs resulting in the prevention of further transmission.

Perturbations in the blood metabolome up to a decade before prostate cancer diagnosis in 4387 matched case-control sets from the European Prospective Investigation into Cancer and Nutrition.

Measuring pre-diagnostic blood metabolites may help identify novel risk factors for prostate cancer. Using data from 4387 matched case-control pairs from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we investigated the associations of 148 individual metabolites and three previously defined metabolite patterns with prostate cancer risk. Metabolites were measured by liquid chromatography-mass spectrometry. Multivariable-adjusted conditional logistic regression was used to estimate the odds ratio per standard deviation increase in log metabolite concentration and metabolite patterns (OR1SD) for prostate cancer overall, and for advanced, high-grade, aggressive. We corrected for multiple testing using the Benjamini-Hochberg method. Overall, there were no associations between specific metabolites or metabolite patterns and overall, aggressive, or high-grade prostate cancer that passed the multiple testing threshold (padj <0.05). Six phosphatidylcholines (PCs) were inversely associated with advanced prostate cancer diagnosed at or within 10 years of blood collection. metabolite patterns 1 (64 PCs and three hydroxysphingomyelins) and 2 (two acylcarnitines, glutamate, ornithine, and taurine) were also inversely associated with advanced prostate cancer; when stratified by follow-up time, these associations were observed for diagnoses at or within 10 years of recruitment (OR1SD 0.80, 95% CI 0.66-0.96 and 0.76, 0.59-0.97, respectively) but were weaker after longer follow-up (0.95, 0.82-1.10 and 0.85, 0.67-1.06). Pattern 3 (8 lyso PCs) was associated with prostate cancer death (0.82, 0.68-0.98). Our results suggest that the plasma metabolite profile changes in response to the presence of prostate cancer up to a decade before detection of advanced-stage disease.

Involvement in serious incident investigations: a qualitative documentary analysis of NHS trust policies in England.

BACKGROUND: The considered shift from individual blame and sanctions towards a commitment to system-wide learning from incidents in healthcare has led to increased understanding of both the moral and epistemic importance of involving those affected. It is important to understand whether and how local policy describes and prompts involvement with a view to understanding the policy landscape for serious incident investigations in healthcare. This study aimed to explore the way in which involvement of those affected by serious incidents is represented in incident investigation policy documents across acute and mental health services in the English NHS, and to identify guidance for more effective construction of policy for meaningful involvement. METHODS: We conducted a documentary analysis of 43 local serious incident investigation policies to explore the way in which involvement in serious incident investigations is represented in policy documents across acute and mental health services in the NHS in England. RESULTS: Three headline findings were generated. First, we identified involvement as a concept was conspicuous by its absence in policy documents. Direct reference to support or involvement of those affected by serious incidents was lacking. Even where involvement and support were recognised as important, this was described as a passive process rather than there being moral or epistemic justification for more active contribution to learning. Second, learning from serious incidents was typically described as a high priority but the language used was unclear and 'learning' was more often positioned as construction of an arbitrary set of recommendations rather than a participatory process of deconstruction and reconstruction of specific systems and processes. Third, there was an emphasis placed on a just and open culture but paradoxically this was reinforced by expected compliance, positioning investigations as a tool through which action is governed rather than an opportunity to learn from and with the experiences and expertise of those affected. CONCLUSIONS: More effective representation in policy of the moral and epistemic reasons for stakeholder involvement in serious incident investigations may lead to better understanding of its importance, thus increasing potential for organisational learning and reducing the potential for compounded harm. Moreover, understanding how structural elements of policy documents were central to the way in which the document is framed and received is significant for both local and national policy makers to enable more effective construction of healthcare policy documents to prompt meaningful action.

Outbreak Response to Circulating Vaccine-Derived Poliovirus in Three Northern Regions of Ghana, 2019.

Background: Circulating Vaccine-Derived Poliovirus Type 2 (cVDPV2) was isolated in sewage and later in stool samples from children with acute flaccid paralysis (AFP) in northern Ghana. Method: A multidisciplinary and multisectoral team investigated this outbreak and reported on epidemiological and laboratory investigations. Sewage/wastewater samples were collected from the environment, while stool samples were collected from AFP/contact children under 5 years of age. The samples were processed for virus isolation, and positive isolates were sequenced. We also conducted a descriptive investigation involving a review of records, active case search, and Monovalent Oral Polio Vaccine 2 campaigns. Additionally, we interviewed caregivers about the vaccination status of their children, as well as their knowledge on polio prevention. Water quality, sanitation, hygiene practices, and health-seeking behaviours were also assessed. Results: A total of 18 cVDPV2 were confirmed in the three regions of Ghana during the outbreak in 2019-2020. All strains were genetically linked to a Nigerian cVDPV2 strain NIE-KWS-KSB-18-006HC29 that circulated in 2018. Evaluation of the surveillance system shows that officers have good knowledge of AFP and know how to collect samples, package them, and ship them to the laboratory. Few communities had access to potable water. Open defecation was common, and the water supply, sanitation, and hygiene practices of the communities were poor. Conclusion: The cVDPV2 outbreak represents the first time cVDPV2 has circulated in the country since Ghana embarked on the polio eradication program in 1996. However, with quality mOPV2 mop-up campaigns, a nationwide IPV catch-up campaign coupled with enhanced surveillance measures, transmission was interrupted.

The vaginal metabolomics profile with features of polycystic ovary syndrome: a pilot investigation in China.

Background: Polycystic ovary syndrome (PCOS) is the most common metabolic disorder and reproductive endocrine disease, posing an elevated risk to women of reproductive age. Although metabolism differences in serum, amniotic fluid and urine have been documented in PCOS, there remains a paucity of evidence for vaginal fluid. This study aimed to identify the metabolic characteristics and potential biomarkers of PCOS in Chinese women of reproductive age. Methods: We involved ten newly diagnosed PCOS women who attended gynecology at Zhongda Hospital and matched them with ten healthy controls who conducted health check-up programs at Gulou Maternal and Child Health Center in Nanjing, China from January 1st, 2019 to July 31st, 2020. Non-targeted metabolomics based on ultra-high-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) was applied to differentially screen vaginal metabolites between PCOS group and healthy controls. Principal component analysis (PCA), orthogonal partial least-squares discriminant analysis (OPLS-DA) and enrichment analysis were used to observe differences, search for potential biomarkers and enrich related pathways. Results: Among the 20 participants, a total of 195 different metabolites were detected between PCOS group and healthy control group. PCOS and control groups were effectively separated by vaginal fluid. Lipids and lipid-like molecules constituted the majority of differential metabolites. Notably, dopamine exhibited an increased trend in PCOS group and emerged as the most significant differential metabolite, suggesting its potential as a biomarker for identifying PCOS. The application of UHPLC-MS/MS based vaginal metabolomics methods showed significant differences between PCOS and non-PCOS healthy control groups, especially linoleic acid metabolism disorder. Most differential metabolites were enriched in pathways associated with linoleic acid metabolism, phenylalanine metabolism, tyrosine metabolism, nicotinate and nicotinamide metabolism or arachidonic acid metabolism. Conclusions: In this pilot investigation, significant metabolomics differences could be obtained between PCOS and healthy control groups. For PCOS women of reproductive age, vaginal metabolism is a more economical, convenient and harmless alternative to provide careful personalized health diagnosis and potential targets for therapeutic intervention.

An investigation of an outbreak of Salmonella Typhimurium infections linked to cantaloupe - United States, 2022.

In 2022, the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and state health and regulatory partners investigated an outbreak of Salmonella enterica serovar Typhimurium infections linked to cantaloupes from southwest Indiana, resulting in 87 ill persons and 32 hospitalizations reported in 11 states. Epidemiologic and traceback evidence confirmed cantaloupe as the vehicle for these infections. Based on records collected by FDA, traceback of cantaloupe exposures for 14 ill people converged on a packing house in southwest Indiana, which supplied cantaloupe to eight of the 11 points of service where ill people purchased cantaloupe. Salmonella isolates were recovered from environmental samples collected by FDA from three growers and a packing house in southwest Indiana. Whole genome sequencing analyses of these isolates found that isolates collected from one grower matched the Salmonella Typhimurium outbreak strain, and samples collected from the other two growers and the packing house matched a 2020 Salmonella Newport outbreak strain. State and federal public health and agricultural partners identified potential conditions and practices that could have possibly resulted in the contamination of cantaloupe, including the presence of Salmonella spp. in on-farm, post-harvest, and off-farm environments. This is the third outbreak of salmonellosis confirmed to be linked to melons, sourced from southwest Indiana in the last decade. The 2012, 2020, and 2022 outbreaks of reoccurring and persisting strains of Salmonella illustrate the need for additional efforts to determine the source and extent of environmental contamination in the melon growing region of southwest Indiana and for outreach and education to help promote practices to reduce contamination of melons.

Identifying groundwater characteristics and controlling factors in Jiaozhou Bay's northern coastal region, China: a combined approach of multivariate statistics, isotope analysis, and field empirical investigations.

Explicit identification of hydrochemical processes and their controlling factors within groundwater systems is critical for the sustainable utilization of water resources in coastal urban areas. This study was undertaken in the North Coastal Region of Jiaozhou Bay (NCRJB), located in the eastern part of Shandong Province, China, an area grappling with significant issues of groundwater quality degradation and water scarcity. A total of 105 groundwater samples and 34 surface water samples, collected from 2020 to 2024, were analyzed and studied using various hydrogeological tools, multivariate statistical analyses, and water quality assessment methods. These include the Piper diagram, hydrochemical facies evolution diagram (HFE-D), Principal Components Analysis (PCA), correlation analysis, stable isotope analysis, Water Quality Index (WQI), and USSL diagrams. The results indicated that all surface water and pore groundwater samples were categorized as Na-Cl type, exhibiting high Total Dissolved Solids (TDS) and Electrical Conductivity (EC) values, characteristics that render them poor to unsuitable for drinking and irrigation purposes. The fracture groundwater is predominantly of the Ca-Na-Cl mixed type, with average suitability for irrigation and a limited proportion (22.5%) deemed suitable for drinking. Seawater intrusion, primarily through the surface water system, and the impact of human activities were identified as the predominant controlling factors con-tributing to the degradation of the local groundwater environment. Field empirical investigations further validated the results derived from hydrogeological assessments, multivariate statistical analyses, and isotopic approaches. The long-term shifts in hydrochemical properties, along with the latent threat of seawater intrusion, exhibit an upward trend during the dry season and show a certain degree of mitigation during the wet season. This study highlights that field investigations, in conjunction with hydrochemical tools, multivariate statistical analyses, and stable isotope analysis, can successfully furnish reliable insights into the predominant mechanisms governing regional groundwater evolution within the context of long-term and intricate envi-ronmental settings.

Impact of Imaging Techniques in the Assessment of Gallstone Pancreatitis.

From the category of biliary disease, gallstones registered an increase during the last years, approximately 6% of men and 9% of women being affected by the pathology in the United States only. In western countries between 10-20% of the adult population is suffering from cholelithiasis. Although increasing age is a major risk factor for their formation, late studies correlate gallstones appearance with an age decrease for the onset of symptoms. We therefore face a younger population manifesting pain and sometimes functional disability. In accordance with statistical analysis, the economic impact of gallstones in highly industrialized countries such as United States produces costs of up to 6.5 billion dollars annually. In this context, the appropriate timing for intervention becomes a factor of major interest. The present review uses 28 articles and specialized literature. Article selection was based on keywords and followed the effectiveness of imaging investigation such as ultrasound, CT and MRI for patients diagnosed with cholelithiasis. Since a direct comparison between the imaging investigation techniques is not concluding we have tried to establish the sensitivity and specificity offered by each imaging assessment. The comparative analysis revealed a p Kruskal-Wallis <0.001 for sensitivity and p Kruskal-Wallis=0.474 for specificity.

Vitreoretinal lymphoma: the importance of cerebral spinal fluid evaluation at initial diagnosis.

BACKGROUND/AIMS: To determine if patients with vitreoretinal lymphoma (VRL) and concomitant central nervous system lymphoma (CNSL) may present without brain MRI findings, but possess cerebrospinal fluid (CSF) suspicious for lymphoma. METHODS: This was a retrospective, single-centre, observational study evaluating patients with a diagnosis or suspicion of VRL seen at Memorial Sloan Kettering Cancer Center between 2006 and 2024. Patients were included if the final diagnosis was biopsy-proven CNSL and both MRI brain with and without contrast±CSF evaluation (obligatory for inclusion if MRI negative) were performed at the initial diagnostic workup. Patients were excluded if CNS disease treatment (brain, spine or CSF) preceded ocular disease. Patients with prior extra-CNS disease were included. Clinical records and radiographic imaging were retrospectively reviewed and relevant data were recorded for each patient. We evaluated the proportion of patients with MRI negative and CSF suspicious for lymphoma. Subgroup analysis included imaging features, pathology, treatment and disease course. RESULTS: We identified 65 patients. Of the 65 patients at the presentation of VRL, 30 had negative MRI brain and CSF, 16 had positive brain MRI and negative CSF and 8 had both positive MRI brain and CSF. 11 (16.9%) had CSF suspicious for lymphoma without positive findings on MRI of the brain. In this subgroup, the median age was 66 years (range 49-82) and 36% were female. 86% of these patients were asymptomatic neurologically. 73% underwent systemic treatment. At a mean 3 years follow-up, 91% of patients were living. CONCLUSION: In patients with suspected VRL, it is possible to have CSF test positive for lymphoma in the context of negative brain MRI. This suggests, when evaluating VRL patients for concomitant CNS disease, CSF evaluation leads to earlier detection and systemic treatment, even when MRI brain findings are negative. In our cohort, an absence of CSF evaluation in the context of negative brain MRI could have missed 16.9% of patients with CNS lymphoma.

[Delphi method investigation and research on the revision of Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013)].

Objective: To explore the expert opinions on the revision of the Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) . Methods: In March 2023, the improved Delphi expert consultation method was adopted, in the first round of consultation, a pre-survey was conducted on 20 experts, and the questionnaire was improved according to the experts' opinions. Then, a second round of expert consultation questionnaire was formed to conduct a questionnaire survey and consultation of 50 experts engaged in occupational disease diagnosis and related work. The feedback of experts was collected and analyzed. Results: The average score for the scientificity and progressiveness of the main technical content of the original standard was 3.33, and the average score for the rationality and operability of the main technical content of the original standard was 3.25. The importance of individual indicators with specific connotations were ranged from 4.20 to 4.45, with coefficients of variation <0.25, and the experts' opinions were relatively concentrated. The experts have provided feedback indicating that the original standard had issues such as lack of continuity in diagnostic gradation, the need to integrate biomarkers with urinary and hair arsenic levels, a scarcity of objective diagnostic indicators, the removal of exposure response from the main text, and a low level of consistency in standard usage. These issues need to be revised urgently. Conclusion: The Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) should be revised based on experts' feedback and suggestions to meet the current real demand for occupational arsenic poisoning diagnosis.

Exploring the causal links between cigarette smoking, alcohol consumption, and aneurysmal subarachnoid hemorrhage: a two-sample Mendelian randomization analysis.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) represents a critical health concern characterized by elevated mortality and morbidity rates. Although both genetic predisposition and lifestyle choices influence aSAH susceptibility, understanding the causative associations between cigarette smoking, alcohol consumption, and aSAH risk remains imperative. Mendelian randomization (MR) offers a robust methodological framework for dissecting these associations, leveraging genetic variants as instrumental variables. Objective: In this study, a two-sample Mendelian randomization (TSMR) approach was employed to elucidate the causal connections between genetically determined cigarette smoking, alcohol consumption, and aSAH risk. Methods: Genetic instruments associated with cigarette smoking and alcohol consumption were sourced from the genome-wide association study (GWAS) and Sequencing Consortium of Alcohol and Nicotine use (GSCAN). Using a genome-wide association study (GWAS) dataset that encompassed aSAH cases and controls of European ancestry, TSMR, which utilized the inverse variance weighting (IVW) method, was employed to estimate the causal effects. Rigorous criteria were applied for selecting instrumental variables to ensure a robust Mendelian randomization analysis. Results: A significant causal association was found between genetically determined cigarette smoking and an increased risk of aSAH, with a 1-standard deviation (SD) increase in cigarette use genetically linked to a 96% relative risk elevation [OR-IVW = 1.96, 95% confidence interval (CI) = 1.28-3.01, p = 0.0021]. However, genetically determined alcohol consumption did not exhibit a statistically significant association with aSAH risk (OR-IVW = 1.22, 95% CI = 0.61-2.45, p = 0.578). Conclusion: The Mendelian randomization analysis revealed a causal nexus between cigarette smoking and an increased risk of aSAH, advocating for targeted smoking cessation interventions within genetically predisposed cohorts. The results regarding the relationship between alcohol consumption and aSAH were affected by insufficient statistical power. A prudent interpretation of the findings highlights the limitations of Mendelian randomization in elucidating intricate genetic epidemiological relationships. Ongoing research involving larger cohort sizes and advanced methodological approaches is essential for comprehending the genetic underpinnings of aSAH.

Evaluation of Spontaneous Overtime Methemoglobin Formation in Post-Mortem Blood Samples from Real Cases in Critical Storage Conditions.

Nitrite/nitrate poisoning is an emerging problem, with an ongoing escalation of reported self-administration with suicidal intent in several countries. Nitrites toxicity mainly consists of their interaction with hemoglobin (Hb), causing its oxidization to methemoglobin (MetHb). In order to give support to the correct procedures for the analysis of these cases, this study aims to evaluate spontaneous sample degradation and consequent MetHb formation in the typical storage conditions of a forensic toxicology laboratory. Two different types of samples have been used in this study: the first stage of our study consisted of a retrospective analysis of blood samples obtained by judicial autopsies already stored in the toxicology laboratory, collected over four years (2018-2021), while the samples used for the second stage were appositely collected during judicial autopsies. The data obtained by the application of a derivative spectrophotometry method on these samples suggest that there seems not to be a maximum threshold for MetHb formation within which it is possible to state with a sufficient grade of certainty that the concentration of MetHb found is consistent with an ante-mortem formation and is not the result of an artifact due to sample degradation and storage conditions. On the other hand, the results suggest that MetHb formation depends on the time passed between sample collection and analysis, so that a tempestive sample processing, performed as soon as the samples are received in the laboratory, is crucial to obtain the maximum reliability and diagnostic values from the data when MetHb quantitation is necessary.

Analyzing Homogeneity of Highly Viscous Polymer Suspensions in Change Can Mixers.

The mixing of highly viscous non-Newtonian suspensions is a critical process in various industrial applications. This computational fluid dynamics (CFD) study presents an in-depth analysis of non-isothermal mixing performance in change can mixers. The aim of the study was to identify parameters that significantly influence both distributive and dispersive mixing in these mixers, which are essential for optimizing industrial mixing processes. The study employed a numerical design of experiments (DOE) approach to identify the parameters that most significantly influence both distributive and dispersive mixing, as measured by the Kramer mixing index (MKramer) and the Ica Manas-Zloczower mixing index λMZ¯. The investigated parameters included mixing time, number of arms, arm size ratio, revolutions per minute (RPM), z-axis rotation, z-axis movement, and initial and mixing temperatures. The methodology involved employing the bootstrap forest algorithm for predicting the mixing indices, achieving an R2 of 0.949 for MKramer and an R2 of 0.836 for λMZ¯. The results indicate that the z-axis rotation has the greatest impact on both distributive and dispersive mixing. An increased number of arms negatively impacted λMZ, but had a small positive effect on MKramer. Surprisingly, in this study, neither the initial temperature of the material nor the mixing temperature significantly impacted the mixing performance. These findings highlight the relative importance of operational parameters over traditional temperature factors and provide a new perspective on mixing science.

Analyzing the Influence of Video Game and Music Engagement on Technical Skills Acquisition in Dental Students in Preclinical Phase: Protocol for a Prospective, Controlled, Longitudinal Study.

BACKGROUND: The practice of dental surgery requires a few different skills, including mental rotation of an object, precision of movement with good hand-eye coordination, and speed of technical movement. Learning these different skills begins during the preclinical phase of dental student training. Moreover, playing a musical instrument or video game seems to promote the early development of these skills. However, we found that studies specifically addressing this issue in the field of dental education are lacking. OBJECTIVE: The main aims of this study are to evaluate whether the ability to mentally represent a volume in 3D, the precision of gestures with their right and left hand, or the speed of gesture execution is better at baseline or progresses faster for players (video games or music or both). METHODS: A prospective monocentric controlled and longitudinal study will be conducted from September 2023 and will last until April 2025 in the Faculty of Dental Surgery of Nantes. Participants were students before starting their preclinical training. Different tests will be used such as Vandenberg and Kuse's mental rotation test, the modified Precision Manual Dexterity (PMD), and performing a pulpotomy on a permanent tooth. This protocol was approved by the Ethics, Deontology, and Scientific Integrity Committee of Nantes University (institutional review board approval number IORG0011023). RESULTS: A total of 86 second-year dental surgery students were enrolled to participate in the study in September 2023. They will take part in 4 iterations of the study, the last of which will take place in April 2025. CONCLUSIONS: Playing video games or a musical instrument or both could be a potential tool for initiating or facilitating the learning of certain technical skills in dental surgery. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55738.

Cingulate to septal circuitry facilitates the preference to affiliate with large peer groups.

Despite the prevalence of large-group living across the animal kingdom, no studies have examined the neural mechanisms that make group living possible. Spiny mice, Acomys, have evolved to live in large groups and exhibit a preference to affiliate with large over small groups. Here, we determine the neural circuitry that facilitates the drive to affiliate with large groups. We first identify an anterior cingulate cortex (ACC) to lateral septum (LS) circuit that is more responsive to large than small groups of novel same-sex peers. Using chemogenetics, we then demonstrate that this circuit is necessary for both male and female group investigation preferences but only males' preference to affiliate with larger peer groups. Furthermore, inhibition of the ACC-LS circuit specifically impairs social, but not nonsocial, affiliative grouping preferences. These findings reveal a key circuit for the regulation of mammalian peer group affiliation.

Pediatric oral extemporaneous preparations and practices: International Pharmaceutical Federation (FIP) global study.

This publication is the first to report current, global, pediatric oral extemporaneous compounding practices. Complete survey responses were received from 470 participants actively involved in compounding across all the World Health Organization (WHO) regions. The survey addressed oral formulation of extemporaneous liquids, including the use of commercial or in-house vehicles, flavoring excipients, source of formulation recipes, and beyond use dates (BUDs). Over 90% of the survey participants prepared oral liquids. Solid dosage forms, comprising capsules and powder papers (sachets) were also frequently prepared for children, albeit to a lesser extent. The top 20 active pharmaceutical ingredients compounded for children, globally, were: omeprazole, captopril, spironolactone, propranolol, furosemide, phenobarbital, hydrochlorothiazide, ursodeoxycholic acid, sildenafil, melatonin, clonidine, enalapril, dexamethasone, baclofen, caffeine, chloral hydrate, trimethoprim, atenolol, hydrocortisone, carvedilol and prednisolone. Diuretics, drugs for acid-related disorders, and beta-blockers were the top three most frequently compounded classes per the WHO Anatomical Therapeutic Chemical (ATC) classification system. The principal need identified for the practice of extemporaneous compounding for children was the development of an international, open-access formulary that includes validated formulations, as well as updated compounding literature and guidelines. Furthermore, improved access to data from stability studies to allow compounding of formulations with extended BUDs.