Engagement of culturally diverse communities in primary care research.

BACKGROUND: The underrepresentation of ethnic minorities and low-income groups in primary care (PC) research hinders the development of effective treatments for diverse populations. AIM: To develop a framework that general practice staff and researchers can use to improve the participation of underserved groups in PC research. METHOD: This study was undertaken across 10 GP practices in South London serving 150 658 patients. Practices are distributed across ethnically diverse and highly deprived communities. A mixed-methods approach was utilised. Retrospective data were collected on patient participation in research studies across the practices between July 2022 and July 2023. Professional and patient focus groups, and a patient questionnaire, were undertaken to understand awareness and knowledge of, enablers for, and barriers to research participation. RESULTS: Over the 12-month period, 627 patients participated in PC research studies across the 10 practices. Black African and Black Caribbean patients accounted for 26% of the practices' patient population but were significantly underrepresented in research, comprising only 11% of participants. Patients of Asian backgrounds accounted for 11% of the practices' population but made up 20% of research participants. Lack of awareness of research participation opportunities, fear of side effects, language barriers, and mistrust of researchers were some of the barriers to participation. Participants highlighted that trust in their GP, education, and transparency of research processes were key to building long-term engagement. CONCLUSION: This study provides insights into poor recruitment of specific ethnic minorities into primary care studies. The authors identified adaptations to research engagement activities, which are required to ensure that participation is improved.

A cohort study on the predictive capability of body composition for diabetes mellitus using machine learning.

Purpose: We applied machine learning to study associations between regional body fat distribution and diabetes mellitus in a population of community adults in order to investigate the predictive capability. We retrospectively analyzed a subset of data from the published Fasa cohort study using individual standard classifiers as well as ensemble learning algorithms. Methods: We measured segmental body composition using the Tanita Analyzer BC-418 MA (Tanita Corp, Japan). The following features were input to our machine learning model: fat-free mass, fat percentage, basal metabolic rate, total body water, right arm fat-free mass, right leg fat-free mass, trunk fat-free mass, trunk fat percentage, sex, age, right leg fat percentage, and right arm fat percentage. We performed classification into diabetes vs. no diabetes classes using linear support vector machine, decision tree, stochastic gradient descent, logistic regression, Gaussian naïve Bayes, k-nearest neighbors (k = 3 and k = 4), and multi-layer perceptron, as well as ensemble learning using random forest, gradient boosting, adaptive boosting, XGBoost, and ensemble voting classifiers with Top3 and Top4 algorithms. 4661 subjects (mean age 47.64 ± 9.37 years, range 35 to 70 years; 2155 male, 2506 female) were analyzed and stratified into 571 and 4090 subjects with and without a self-declared history of diabetes, respectively. Results: Age, fat mass, and fat percentages in the legs, arms, and trunk were positively associated with diabetes; fat-free mass in the legs, arms, and trunk, were negatively associated. Using XGBoost, our model attained the best excellent accuracy, precision, recall, and F1-score of 89.96%, 90.20%, 89.65%, and 89.91%, respectively. Conclusions: Our machine learning model showed that regional body fat compositions were predictive of diabetes status.

The HyperPed-COVID international registry: Impact of age of onset, disease presentation and geographical distribution on the final outcome of MIS-C.

OBJECTIVES: The aim of the study was to establish an international multicenter registry to collect data on patients with Multisystem Inflammatory Syndrome in Children (MIS-C), in order to highlight a relationship between clinical presentation, age of onset and geographical distribution on the clinical outcome. STUDY DESIGN: Multicenter retrospective study involving different international societies for rare immunological disorders.1009 patients diagnosed with MIS-C between March and September 2022, from 48 centers and 22 countries were collected. Five age groups (<1, 1-4, 5-11, 12-16, >16 years) and four geographic macro-areas, Western Europe, Central-Eastern Europe, Latin America, Asian-African resource-limited countries (LRC), were identified. RESULTS: Time to referral was significantly higher in LRC. Intensive anti-inflammatory treatment, including biologics, respiratory support and mechanic ventilation were more frequently used in older children and in European countries. The mortality rate was higher in very young children (<1 year), in older patients (>16 years of age) and in LRC. Multivariate analysis identified the residence in LRC, presence of severe cardiac involvement, renal hypertension, lymphopenia and non-use of heparin prophylaxis, as the factors most strongly associated with unfavorable outcomes. CONCLUSIONS: The stratification of patients by age and geographic macro-area provided insights into the clinical presentation, treatment and outcome of MIS-C. The mortality and sequelae rates exhibited a correlation with the age and geographical areas. Patients admitted and treated in LRC displayed more severe outcomes, possibly due to delays in hospital admission and limited access to biologic drugs and to intensive care facilities.

Hemolytic Anemia and Pancytopenia Secondary to Vitamin B12 Deficiency: Evaluation and Clinical Significance.

Severe vitamin B12 deficiency presents a diagnostic challenge due to its diverse clinical manifestations, which can mimic serious hematologic disorders such as thrombotic thrombocytopenic purpura (TTP) or leukemia. The case we present here illustrates the unique characteristics of severe B12 deficiency, highlighting key differentiators from other conditions, including decreased reticulocyte counts and markedly elevated lactate dehydrogenase levels indicative of suppressed erythropoiesis. Advanced cobalamin deficiency affects all cell lines, leading to peripheral pancytopenia. Proposed mechanisms include fragile red blood cells prone to shearing, resulting in schistocyte formation, and hyperhomocysteinemia-induced oxidative stress exacerbating hemolysis. Prompt recognition and treatment with B12 replacement are critical, as illustrated by this case of hemolytic anemia and pancytopenia secondary to pernicious anemia, to prevent severe hematologic complications.

We need collaboration and co-creation to address challenges facing coastal communities.

Coastal communities across the globe are faced with multifaceted, interconnected challenges with competing environmental, social and economic needs. In rural coastal communities of the Global South, the challenges presented by climate change are complicated by those related to development, resource management and sustainable livelihoods. The rapid growth of such coastal communities exacerbates these challenges and reinforces the need for effective and sustainable governance. Such governance requires a move from top-down approaches to human-centred approaches. Human-centred coastal governance engages multiple stakeholders and combines multidisciplinary knowledge, participatory approaches, co-creation of solutions and multi-institutional partnerships. Here we present case studies from coastal communities in Vanuatu, Ghana and Bangladesh. These illustrate several of the complex challenges facing such communities and the collaborative and empowering strategies that have been used to meet them. Based on these case studies, we present a transdisciplinary framework to inform the co-creation of coastal management strategies that meet interconnected human and environmental needs.

Alkaloids as drug leads in Alzheimer's treatment: Mechanistic and therapeutic insights.

Alzheimer's disease (AD) has few effective treatment options and continues to be a major global health concern. AD is a neurodegenerative disease that typically affects elderly people. Alkaloids have potential sources for novel drug discovery due to their diverse chemical structures and pharmacological activities. Alkaloids, natural products with heterocyclic nitrogen-containing structures, are considered potential treatments for AD. This review explores the neuroprotective properties of alkaloids in AD, focusing on their ability to regulate pathways such as amyloid-beta aggregation, oxidative stress, synaptic dysfunction, tau hyperphosphorylation, and neuroinflammation. The FDA has approved alkaloids such as acetylcholinesterase inhibitors like galantamine and rivastigmine. This article explores AD's origins, current market medications, and clinical applications of alkaloids in AD therapy. This review explores the development of alkaloid-based drugs for AD, focusing on pharmacokinetics, blood-brain barrier penetration, and potential adverse effects. Future research should focus on the clinical evaluation of promising alkaloids, developing recently discovered alkaloids, and the ongoing search for novel alkaloids for medical treatment. A pharmaceutical option containing an alkaloid may potentially slow down the progression of AD while enhancing its symptoms. This review highlights the potential of alkaloids as valuable drug leads in treating AD, providing a comprehensive understanding of their mechanisms of action and therapeutic implications.

Xanthoma of the Jaw Bones: Cases Series and Review of Literature.

BACKGROUND: Intraosseous xanthomas are rare benign lesions sometimes associated with excess lipid production. Xanthoma of the jaw bones (XJB) was first reported in 1964, and fewer than 50 cases have been reported in the English literature to date. The etiopathogenesis of XJB is highly suggestive of a reactive process or a metabolic condition. METHOD: Seven cases of XJBs were retrieved from the archives of 4 oral and maxillofacial pathology services. Clinical, radiographic and histopathologic features of all these cases were retrospectively analyzed. Immunohistochemical (IHC) stains for S100 and CD68 were performed. RESULTS: All seven cases involved the mandible. Patients' age ranged between 13 and 69 years with an evenly distributed female to male ratio. One patient had a medical history of hyperlipidemia, but the medical and dental histories of the others were unremarkable. For most cases, XJB was an incidental finding discovered during routine radiographic examination. Swelling and cortical expansion were noted in a few cases. Radiographically, cases typically presented as either well-defined multilocular or unilocular lesions, which were either radiolucent or mixed radiolucent/radiopaque. All the lesions were treated with surgical curettage and no recurrence was observed during subsequent follow-ups. Each of the seven cases exhibited sheets of foamy macrophages. The diagnosis is established by exclusion of entities with overlapping microscopic features and involved correlation with the clinical, histological, radiographic and IHC profiles. Immunohistochemically, all the cases expressed diffuse positivity for CD68 and were negative for S100. CONCLUSION: XJB is a rare lesion of unknown etiology, which may mimic other benign or reactive jaw lesions. Due to its rarity and the potential diagnostic challenges it presents, clinicians must remain vigilant and consider CXJ in their differential when assessing radiolucent jaw anomalies.

Increased frequency of oral plasma cell mucositis/plasma cell gingivitis after the COVID-19 pandemic: a 23-year retrospective analysis and review of diagnostic challenges relating to this condition.

OBJECTIVE: Oral plasma cell mucositis (PCM) or localized plasma cell gingivitis (PCG) is an idiopathic inflammatory condition often associated with hypersensitivity reactions. This study aimed to evaluate the frequency and features of PCM/PCG in a large biopsy service over a time period of more than 20 years. STUDY DESIGN: The biopsy archives at University of Florida College of Dentistry were searched from 2000 through the first quarter of 2023 for cases of oral PCM or PCG. Case data were aggregated and analyzed. RESULTS: A total of 107 cases were included. Between 2000 and 2019, PCM/PCG was diagnosed in 0.03% of all biopsy cases. Starting in 2020 through 2023, the percentage of biopsies diagnosed as PCM/PCG increased threefold to 0.10% of all biopsy cases, and the mean patient age increased by 3 years. There were no statistically significant differences between cases diagnosed from 2000 to 2019 and those from 2020 to 2023 regarding age, sex, location, or histology. CONCLUSIONS: A significant increase in PCM/PCG was identified in this study at one institution coinciding with the start of the COVID-19 pandemic. Further investigation is recommended to determine if this is a widespread phenomenon and identify possible etiologic mechanisms.

CTC together with Shh and Nrf2 are prospective diagnostic markers for HNSCC.

BACKGROUND: The lack of appropriate prognostic biomarkers remains a significant obstacle in the early detection of Head and Neck Squamous Cell Carcinoma (HNSCC), a cancer type with a high mortality rate. Despite considerable advancements in treatment, the success in diagnosing HNSCC at an early stage still needs to be improved. Nuclear factor erythroid 2-related factor 2 (Nrf2) and Sonic Hedgehog (Shh) are overexpressed in various cancers, including HNSCC, and have recently been proposed as possible therapeutic targets for HNSCC. Circulating Tumor Cell (CTC) is a novel concept used for the early detection of cancers, and studies have suggested that a higher CTC count is associated with the aggressiveness of HNSCC and poor survival rates. Therefore, we aimed to establish molecular markers for the early diagnosis of HNSCC considering Shh/Nrf2 overexpression in the background. In addition, the relation between Shh/Nrf2 and CTCs is still unexplored in HNSCC patients. METHODS: In the present study, we selected a cohort of 151 HNSCC patients and categorized them as CTC positive or negative based on the presence or absence of CTCs in their peripheral blood. Data on demographic and clinicopathological features with the survival of the patients were analyzed to select the patient cohort to study Shh/Nrf2 expression. Shh and Nrf2 expression was measured by qRT-PCR. RESULTS: Considering significant demographic [smoking, betel leaf (p-value < 0.0001)] and clinicopathological risk factors [RBC count (p < 0.05), Platelet count (p < 0.05), Neutrophil count (p < 0.005), MCV (p < 0.0001), NLR (p < 0.05), MLR (p < 0.05)], patients who tested positive for CTC also exhibited significant overexpression of Shh/Nrf2 in both blood and tissue compared to CTC-negative patients. A strong association exists between CTCs and tumor grade. Following chemotherapy (a combination of Cisplatin, 5FU, and Paclitaxel), the frequency of CTCs was significantly decreased in patients with HNSCC who had tested positive for CTCs. The Kaplan-Meier plot illustrated that a higher number of CTCs is associated with poorer overall survival (OS) in patients with HNSCC. CONCLUSIONS: Detecting CTCs, and higher expression of Shh and Nrf2 in HNSCC patients' blood, can be a promising tool for diagnosing and prognosticating HNSCC.

Ruminant Production from Napier Grass (Pennisetum purpureum Schum): A Review.

Napier grass (Pennisetum purpureum Schumach) supports a significant proportion of animal production in subtropical and tropical regions, but its quality is low and when offered alone, results in low ruminant production. Shifting the management of Napier grass towards a higher-quality feed increased milk yield and liveweight gain for small, mature cattle without supplementation. This review highlights the opportunity for further increases in milk and meat production for differing classes of livestock in the tropics and subtropics by improving the nutritive value of Napier grass using new best management practice flowing on to improve food security for the millions of people in these regions.

From seeds to survival rates: investigating Linum usitatissimum's potential against ovarian cancer through network pharmacology.

Ovarian cancer is a malignant tumor that primarily forms in the ovaries. It often goes undetected until it has spread to the pelvis and abdomen, making it more challenging to treat and often fatal. Historically, natural products and their structural analogues have played a pivotal role in pharmacotherapy, especially for cancer. Numerous studies have demonstrated the therapeutic potential of Linum usitatissimum against ovarian cancer, but the specific molecular mechanisms remain elusive. This study combines data mining, network pharmacology, and molecular docking analysis to pioneer an innovative approach for ovarian cancer treatment by identifying potent phytochemicals. Findings of current study revealed that Apigenin, Vitamin E, Palmitic acid, Riboflavin, Isolariciresinol, 5-Dehydro-avenasterol, Cholesterol, Pantothenic acid, Nicotinic acid, Campesterol, Beta-Sitosterol, Stigmasterol, Daucosterol, and Vitexin suppress tumor growth by influencing AKT1, JUN, EGFR, and VEGFA. Kaplan-Meier survival analysis spotlighted AKT1, JUN, EGFR, and VEGFA as potential diagnostic and prognostic biomarkers for ovarian cancer. However, it is imperative to conduct in vivo and in vitro examinations to ascertain the pharmacokinetics and biosafety profiles, bolstering the candidacy of L. usitatissimum in ovarian cancer therapeutics.

British South Asian ancestry participants views of pharmacogenomics clinical implementation and research: a thematic analysis.

BACKGROUND: South Asian ancestry populations are underrepresented in genomic studies and therapeutics trials. British South Asians suffer from multi-morbidity leading to polypharmacy. Our objective was to elucidate British South Asian ancestry community perspectives on pharmacogenomic implementation and sharing pharmacogenomic clinical data for research. METHODS: Four focus groups were conducted (9-12 participants in each). Two groups were mixed gender, while one group was male only and one was female only. Simultaneous interpretation was available to participants in Urdu and Bengali. Focus groups were recorded and abridged transcription and thematic analysis were undertaken. RESULTS: There were 42 participants, 64% female. 26% were born in the UK or Europe. 52% were born in Bangladesh and 17% in Pakistan. 36% reported university level education. Implementation of pharmacogenomics was perceived to be beneficial to individuals but pose a risk of overburdening resource limited systems. Pharmacogenomic research was perceived to be beneficial to the community, with concerns about data privacy and misuse. Data sharing was desirable if the researchers did not have a financial stake, and benefits would be shared. Trust was the key condition for the acceptability of both clinical implementation and research. Trust was linked with medication compliance. Education, outreach, and communication facilitate trust. CONCLUSIONS (SIGNIFICANCE AND IMPACT OF THE STUDY): Pharmacogenomics implementation with appropriate education and communication has the potential to enhance trust and contribute to increased medication compliance. Trust drives data sharing, which would enable enhanced representation in research. Representation in scientific evidence base could cyclically enhance trust and compliance.

Behavioural, developmental and biochemical effects in zebrafish caused by ibuprofen, irgarol and terbuthylazine.

The increasing use of chemicals and their release into aquatic ecosystems are harming aquatic biota. Despite extensive ecotoxicological research, many environmental pollutants' ecological effects are still unknown. This study examined the spatial avoidance, behavioural and biochemical impacts of ibuprofen, irgarol, and terbuthylazine on the early life stages of zebrafish (Danio rerio) under a range of ecologically relevant concentrations (0-500 µg/L). Embryos were exposed following the OECD guideline "fish embryo toxicity test" complemented with biochemical assessment of AChE activity and behavioural analyses (swimming activity) using the video tracking system Zebrabox. Moreover, spatial avoidance was assessed by exposing 120 hpf-old larvae of D. rerio to a gradient of each chemical, by using the heterogeneous multi-habitat assay system (HeMHAS). The results obtained revealed that the 3 compounds delayed hatching at concentrations of 50 and 500 µg/L for both ibuprofen and irgarol and 500 µg/L for terbuthylazine. Moreover, all chemicals elicited a dose-dependent depression of movement (swimming distance) with LOEC values of 5, 500 and 50 µg/L for ibuprofen, irgarol and terbuthylazine, respectively. Zebrafish larvae avoided the three chemicals studied, with 4 h-AC50 values for ibuprofen, irgarol, and terbuthylazine of 64.32, 79.86, and 131.04 µg/L, respectively. The results of the HeMHAS assay suggest that larvae may early on avoid (just after 4 h of exposure) concentrations of the three chemicals that may later induce, apical and biochemical effects. Findings from this study make clear some advantages of using HeMHAS in ecotoxicology as it is: ecologically relevant (by simulating a chemically heterogeneous environmental scenario), sensitive (the perception of chemicals and the avoidance can occur at concentrations lower than those producing lethal or sublethal effects) and more humane and refined approach (organisms are not mandatorily exposed to concentrations that can produce individual toxicity).

Compounding Education in US PharmD Curricula.

OBJECTIVE: To determine the extent of compounding education (CE) offered in United States (US) doctor of pharmacy curricula. METHODS: A 24-item survey instrument addressing various aspects of CE was developed and validated. An email containing the link to the survey instrument was shared with instructors of compounding at 122 of 141 accredited schools and colleges of pharmacy in the US. RESULTS: Of these, 112 schools and colleges responded, rendering a survey response rate of 91.8%. Survey results indicate that CE is offered to a similar extent either as a required standalone course or as integrated instruction as part of a standard course. Whereas 70.8% of programs reported mostly hands-on training in CE in their curricula, there were about 11% programs that mostly offered didactic instruction in CE. Dispersed systems and semisolid formulations are the most prepared in nonsterile compounding, while proper hand washing, garbing, and gloving are the most taught techniques in sterile compounding. Compounding education is delivered principally by pharmaceutics faculty (62.3%) compared to practice faculty (32.1%). CONCLUSION: The survey determined the extent to which CE is addressed across different schools and colleges of pharmacy in the US. Although some institutions lack minimal nonsterile or sterile compounding facilities, they may improve by modeling the established programs in the country. Leadership at pharmacy institutions may need to allocate funds for CE, and support faculty who instruct in compounding.

Medical Waste Incineration Fly Ash as a Mineral Filler in Dense Bituminous Course in Flexible Pavements.

Medical waste incineration fly ash (MWIFA) contains heavy metals that are toxic by nature and pose numerous health risks. The paper deals with the suitability of MWIFA as a mineral filler in the bituminous layer as an alternative to conventional stone dust (SD) through an appropriate combination of engineering and environmental assessments. Engineering parameters, such as Marshall stability, stability loss, flow, unit weight, air voids (Va), voids filled with asphalt (VFA), and voids in the mineral aggregate (VMA) of the asphalt mixtures, were evaluated with varying filler ratios, from 2% to 10%. All parameters for both fillers at optimum bitumen content satisfied the Marshall Mix Design criteria. The optimum bitumen contents of all filler ratios were within the standard limit recommended by the Bangladesh Roads and Highways Department. It was found that mixes prepared with MWIFA can resist moisture effects, making them durable in the monsoon. The mixes with 5.5% MWIFA as mineral filler performed the best, whereas 9% SD filler was required to achieve similar performance. The environmental test results show no environmental restriction on stabilizing the MWIFA into paving mixtures. The mobility of heavy metals (As, Pb, Cu, Cr, Ni, Cd, Hg, and Zn) from the asphalt-MWIFA mix was insignificant. The cumulative concentrations of heavy metals (Cd, Ni, Zn, Cu, and Pb) from long-term leaching tests were far below the Dutch regulatory limit (U1). MWIFA can be considered an eco-friendly and sustainable mineral filler for the dense bituminous pavement layer.

Chromatin regulation of transcriptional enhancers and cell fate by the Sotos syndrome gene NSD1.

Nuclear receptor-binding SET-domain protein 1 (NSD1), a methyltransferase that catalyzes H3K36me2, is essential for mammalian development and is frequently dysregulated in diseases, including Sotos syndrome. Despite the impacts of H3K36me2 on H3K27me3 and DNA methylation, the direct role of NSD1 in transcriptional regulation remains largely unknown. Here, we show that NSD1 and H3K36me2 are enriched at cis-regulatory elements, particularly enhancers. NSD1 enhancer association is conferred by a tandem quadruple PHD (qPHD)-PWWP module, which recognizes p300-catalyzed H3K18ac. By combining acute NSD1 depletion with time-resolved epigenomic and nascent transcriptomic analyses, we demonstrate that NSD1 promotes enhancer-dependent gene transcription by facilitating RNA polymerase II (RNA Pol II) pause release. Notably, NSD1 can act as a transcriptional coactivator independent of its catalytic activity. Moreover, NSD1 enables the activation of developmental transcriptional programs associated with Sotos syndrome pathophysiology and controls embryonic stem cell (ESC) multilineage differentiation. Collectively, we have identified NSD1 as an enhancer-acting transcriptional coactivator that contributes to cell fate transition and Sotos syndrome development.

The Importance of Social Support in Recovery Populations: Toward a Multilevel Understanding.

Although social support is commonly investigated in the context of substance recovery, researchers have widely neglected its multilevel nature, thus limiting what we know about its measurement across levels of observation. The current study used multilevel confirmatory factor analyses (MCFA) on 229 individuals living in 42 recovery homes to investigate the structure of single factor of social support at the individual and house-levels. Multilevel structural equation model (MSEM) was then conducted to examine whether the social support factor was associated with stress at the individual and house-levels. MCFA results showed that within individuals, all social support measures were significant and positive while at the house-level, there were a few discrepancies (e.g., IP was negative). Stress was significantly negatively related to the social support factor at the individual-level, but this association was positive at the house-level. These findings suggest that on an individual-level, a person's perception and source of social support is particularly important -even if the source of support comes from someone who is not abstinent. On a house-level, social support is more sensitive to outside influences than within individuals. Implications for future research and substance use interventions targeting social support are discussed.

COVID-related mucormycosis mimicking dental infection.

A recent increase in the prevalence of mucormycosis of the head and neck in patients who have recovered from COVID-19 following hospitalization has been reported. A Majority of the cases have been reported from India. Conditions such as diabetes mellitus, use of corticosteroids for other autoimmune conditions, organ transplant, immunosuppression, immunodeficiency, and malignancies especially hematologic ones, are all known risk factors for mucormycosis. Recently, hospitalization for COVID-19 has been added to the list of risk factors for opportunistic mucormycosis infection. This is likely attributable to the high doses and prolonged use of corticosteroids in the treatment of hospitalized COVID-19 patients. Case Description: Two patients with post-COVID-19 associated rhinocerebral mucormycosis presented with profound unexplained dental disease including tooth mobility and dental abscess mimicking periodontal disease. The patients were previously hospitalized for COVID-19 and received prolonged treatment with high doses of corticosteroids. The patients responded well to the surgical debridement with or without antifungal therapy. Conclusion: Oral healthcare providers including oral and maxillofacial surgeons, dentists, dental hygienists, and other dental practitioners can play a vital role in the recognition and early diagnosis of rhinocerebral mucormycosis given the large number of patients with severe COVID-19 infection who have recovered following hospitalization and/or received long-term high doses of immunosuppressive treatment.

The Hydrogenation of Crotonaldehyde on PdCu Single Atom Alloy Catalysts.

Recyclable PdCu single atom alloys supported on Al2O3 were applied to the selective hydrogenation of crotonaldehyde to elucidate the minimum number of Pd atoms required to facilitate the sustainable transformation of an α,ß-unsaturated carbonyl molecule. It was found that, by diluting the Pd content of the alloy, the reaction activity of Cu nanoparticles can be accelerated, enabling more time for the cascade conversion of butanal to butanol. In addition, a significant increase in the conversion rate was observed, compared to bulk Cu/Al2O3 and Pd/Al2O3 catalysts when normalising for Cu and Pd content, respectively. The reaction selectivity over the single atom alloy catalysts was found to be primarily controlled by the Cu host surface, mainly leading to the formation of butanal but at a significantly higher rate than the monometallic Cu catalyst. Low quantities of crotyl alcohol were observed over all Cu-based catalysts but not for the Pd monometallic catalyst, suggesting that it may be a transient species converted immediately to butanol and or isomerized to butanal. These results demonstrate that fine-tuning the dilution of PdCu single atom alloy catalysts can leverage the activity and selectivity enhancement, and lead to cost-effective, sustainable, and atom-efficient alternatives to monometallic catalysts.

Vesiculobullous Lesions of the Oral Cavity.

Several dermatological conditions may manifest in the oral cavity, particularly those that are immune-mediated, and they must be distinguished from the various other types of oral ulcerations. This chapter discusses the clinical features, pathogenesis, differential diagnosis, and diagnostic features, including histology and immunofluorescence findings, as well as management of vesiculobullous diseases. These diseases include pemphigus Vulgaris, benign mucous membrane pemphigoid, bullous pemphigoid, and epidermolysis bullosa acquisita. These diseases have a significant impact on the quality of life, as they can lead to serious complications, depending on the extent of the disease. Therefore, early recognition is crucial, helping to reduce disease-related morbidity, mortality and prevent life-threatening complications.