Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report.

BACKGROUND: Giant condyloma acuminatum (GCA) is an uncommon condition affecting the anogenital area. CASE SUMMARY: Here, we report an 88-year-old male patient who presented with a 5-year history of a progressive appearance of multiple cauliflower-like warts over his penile shaft, pubis region, and groin as well as urine leakage along the distal penile shaft. Physical examination revealed an ulcerative skin perforation with pus discharge under the distal prepuce base, which was initially suspected to be a urethral fistula. However, during surgery, it was discovered that the perforation was caused by a giant condyloma lesion that had obliterated the prepuce opening, with infection and high pressure causing subsequent skin perforation. He underwent circumcision and wide excision with electrocauterization of the warts. He was discharged after the surgery, and the residual lesion was treated with imiquimod and low-dose oral tegafur-uracil. CONCLUSION: Penile GCA can cause prepuce perforation and can be postoperatively treated with imiquimod and low-dose oral tegafur-uracil.

Tourists' Food Involvement, Place Attachment, and Destination Loyalty: The Moderating Role of Lifestyle.

Destination food has been increasingly appealing to tourists within adjacent markets. This trend has been widely recognised by destination marketers; however, scholars have paid limited attention to tourists' psychological and behavioural responses to destination food. Taking Shunde as the research site, using a questionnaire-based survey method equipped with the techniques of measurement modelling, path analysis, principal component analysis, and cluster analysis, this study explores how tourists' food involvement affects their place attachment and destination loyalty, as well as the differentiation of tourists with different lifestyles. The results show that food involvement significantly affects place attachment and destination loyalty. These relationships are differentiated by tourists' lifestyles. This study contributes to the psychological research of tourist behaviours and provides insights into destination marketing in the context of food tourism.

Formation of a rare curve-shaped thoracolith documented on serial chest computed tomography images: A case report.

BACKGROUND: Thoracolithiasis is a rare benign condition that manifests with one or more small nodules in the pleural cavity. In most cases, it is asymptomatic and found incidentally on chest imaging or during thoracic surgery. The thoracolithiasis formation process is rarely documented. Herein, we present a case of a rare, large, curve-shaped thoracolith, the formation of which was documented on serial computed tomography (CT) images. CASE SUMMARY: A 46-year-old male patient who denied any prior systemic disease was evaluated due to intermittent right-sided lateral chest pain lasting for a year. Chest radiography and CT revealed a circumscribed calcified nodule measuring 3.5 mm in the right lower lung lobe. Nodule biopsy revealed fungal infection, which was treated with antifungal medication. After 2 years of follow-up, the patient developed intermittent chest discomfort caused by pleural adhesions, and underwent video-assisted thoracic surgery with pneumolysis. Postoperatively, he developed empyema, which fully resolved with antibiotic therapy. Thereafter, he was followed up at the outpatient clinic and underwent chest CT twice per year. Over time, we observed thickening of the right distal pleura near the lower posterior mediastinum, and several sporadic calcified nodules with gradually increasing intensity, which eventually merged into a single calcified curve-shaped thoracolith measuring approximately 9 cm in length during the 5-year follow-up. CONCLUSION: This study documented the formation of a rare thoracolith shape observed for the first time.

Determining the attributes that influence students' online learning satisfaction during COVID-19 pandemic.

The inevitable disruptions caused by COVID-19 in the hospitality and tourism education sector have made online learning a necessity rather than an option. This study employs the user experience questionnaire (UEQ) to examine students' online learning experiences specifically in the context of COVID-19. Data collection involved a Qualtrics online survey with a convenience sample of 216 tourism and hospitality students in Macau. Overall, results point to a generally positive appraisal of online attributes, but satisfaction is marginal. Initial principal component factor analysis generated three orthogonal factors of online learning attributes: "Perspicuity and dependability"; "Stimulation and attractiveness"; and "Usability and innovation". Further regression analysis reveals that "Stimulation and attractiveness" is the strongest predictor of the students' satisfaction regarding online learning during the COVID-19 disruptions. This novel finding points to the need for hospitality and tourism education institutions to develop an attractive and motivating visual environment for online course delivery since a stimulating online learning atmosphere is crucial in the context of the pedagogical disruptions caused by COVID-19. Nonetheless, these findings are specific to Chinese students and reflect their learning satisfaction which may differ in other contexts.