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Pregnancy and Obstetric Emergencies Handled by Emergency Medical Response Services in the Dadra and Nagar Haveli: A Brick-by-Brick Analysis. The access of pregnant women to an appropriate health facility plays a crucial role in preventing maternal deaths. In the last decade, many new steps have been taken in the direction of making motherhood safe, one of them being the availability of free Emergency Medical Response Services (EMRS). In the present investigation, various variables were analyzed of the EMRS which provides services to pregnant women of the tribal district of Western India. This study is a descriptive analysis of EMRS provided to pregnant women from January 1, 2013 through December 31, 2020. The number of expected pregnancies was obtained from the state data center and the variables related to the benefitted pregnant women were generated with the EMRS tracking software. The results of this study showed that 93.59% of pregnant women benefitted from these services in the last six years as compared to the estimated number of pregnancies. Whereas in the case of obstetric emergencies, 85.02% of pregnant women benefitted. Most of the beneficiaries were tribal, in the age group of 20-35 years, with lower socio-economic strata. More than 98.0% of pregnant women decided to take the delivery facility in the public hospitals. Across the district, ambulances had to travel less than 10km to cater to 89.0% of pregnant women. The convenient access of EMRS to pregnant women can improve the indicators of maternal and child health and reduce the risk of maternal death and home delivery.

Effect of titanium dioxide nanoparticles on histone modifications and histone modifying enzymes expression in human cell lines. Titanium dioxide (TiO2) nanoparticles are widely manufactured, with a range of applications in consumer products. Significant toxicity of TiO2 nanoparticles has, however, been recognized, suggesting considerable risk to human health. To evaluate fully their toxicity, assessment of the epigenetic action of these nanoparticles is critical. However, only few studies are available examining the capability of nanoparticles to alter epigenetic integrity. In the present study, the effect of TiO2 nanoparticles exposure on histone modifications, a major epigenetic mechanism, was investigated in human colorectal (Caco-2) and lung (NL20) epithelial cell lines. Histone H3 and H4 modifications were assessed by array analysis using the EpiQuickTM Histone H3 or H4 Modification Multiplex Assay. Seventeen histone modifications were identified with altered levels after exposure to TiO2 nanoparticles. Changes in several selected histone modifications (Caco-2 cells: H3cit, H3K9me3, H3K27me3, H3K36me3, H3K9ac, and H4K8ac; NL20 cells: H3K4me3, H3K9me3, H3K27me3, H3K9ac, and H3K18ac) were verified by Western blot analysis. The results also revealed aberrant expression of histone modifying enzymes in TiO2 exposed cells. Expression levels were determined by array analysis using the Human Epigenetic Chromatin Modification Enzymes RT2 Profiler™ PCR Array, with 12 genes identified in both Caco-2 cells and NL20 cells. qRT-PCR analysis confirmed the array results for several selected histone modifying enzyme genes (ASH1L, CARM1, EHMT2, HAT1, HDAC9, KMT2E, NCOA1, SETDB2, and USP16). The findings from this study clearly demonstrate the impact of TiO2 nanoparticles exposure on histone modification in two human cell lines, supporting potential involvement of this epigenetic mechanism in the toxicity of TiO2 nanoparticles. Hence, for complete assessment of potential risk from nanoparticle exposure, epigenetic studies are critical.

Electrocatalytic Hydrogenation of 5-Hydroxymethylfurfural Promoted by a Ru1 Cu Single-Atom Alloy Catalyst. Electrochemical reduction of biomass-derived 5-hydroxymethylfurfural (HMF) represents an elegant route toward sustainable value-added chemicals production that circumvents the use of fossil fuel and hydrogen. However, the reaction efficiency is hampered by the high voltage and low activity of electrodes (Cu, Bi, Pb). Herein, we report a Ru1 Cu single-atom alloy (SAA) catalyst with isolated Ru atoms on Cu nanowires that exhibits an electrochemical reduction of HMF to 2,5-dihydroxymethylfuran (DHMF) with promoted productivity (0.47 vs. 0.08 mmol cm-2 h-1 ) and faradic efficiency (FE) (85.6 vs. 71.3 %) at -0.3 V (vs. RHE) compared with Cu counterpart. More importantly, the FE (87.5 %) is largely retained at high HMF concentration (100 mM). Kinetic studies by using combined electrochemical techniques suggest disparate mechanisms over Ru1 Cu and Cu, revealing that single-atom Ru promotes the dissociation of water to produce H* species that effectively react with HMF via an electrocatalytic hydrogenation (ECH) mechanism.

Clinical profile and mortality predictors for tuberculosis disease among patients with solid tumours. The characteristics of Mycobacterium tuberculosis (MTb) disease are still obscure in patients with solid tumours, as well as the benefits of screening and treating latent tuberculosis infection (LTBI) in these patients. Our objective was to trace the clinical profile of these individuals and assess the mortality predictors related to tuberculosis (TB). We reviewed the medical records of 126 patients with solid tumours malignancy and who developed TB disease between January 2009 and April 2018 at a cancer referral centre. The most common locations of malignancy were head and neck, with squamous cell carcinoma being the most frequent histological type, the majority (97/126) presenting locally invasive tumours (T3 or T4). A total of 120 had TB pulmonary and the microbiological diagnosis was performed in 103/126. The following variables were associated with the risk of death from TB: DPOC lung cancer, BMI, malnutrition, metastasis and ECOG 3 or 4. Previous chemotherapy treatment was a protective factor. Male, usage of alcohol and smoking were the most predominant patients characteristics in our sample. In the multivariate analysis, lung cancer, presence of metastasis and ECOG ≥ 3 were associated with death from TB.

Bronchiolitis obliterans organising pneumonia secondary to tacrolimus toxicity in a pediatric cardiac transplant recipient. Bronchiolitis obliterans organising pneumonia is a rare complication associated with calcineurin inhibitors and mammalian target of rapamycin inhibitors. While bronchiolitis obliterans organising pneumonia in adult transplant patients has been reported, it has not been well described in pediatric transplant patients. We present a case of a 19-month-old male patient with dilated cardiomyopathy who underwent orthotropic heart transplantation at 14 months of life for heart failure refractory to medical therapy. Approximately 4 months post-transplant, he presented with diarrhea and vomiting with acute kidney injury secondary to dehydration. His tacrolimus level on admission and first week of hospitalisation was within target range of 10-12 ng/ml. He was diagnosed with esophagitis and prescribed proton pump inhibitors. Our patient subsequently developed significant respiratory distress with initial chest radiograph showing right lower lobe opacities. Repeat tacrolimus at the time of worsening respiratory status was 84.2 ng/dL and his tacrolimus was held. He required intubation due to significant hypoxia with progression of lung to disease and development of diffuse bilateral opacities consistent with acute respiratory distress syndrome. Despite initiation of steroids and aggressive ventilator management, he continued to be hypoxic on maximal respiratory support. After 28 days post admission, support was withdrawn. On autopsy, his lung biopsy findings were consistent with bronchiolitis obliterans organising pneumonia. Life-threatening bronchiolitis obliterans organising pneumonia can be seen in pediatric transplant patients on tacrolimus or when transitioning from tacrolimus to sirolimus, highlighting the need for close monitoring of heart transplant patients on immunosuppressive medications presenting with hypoxia.

Tackling antimicrobial resistance across sub-Saharan Africa: current challenges and implications for the future. Antimicrobial resistance (AMR) is a concern as this increases morbidity, mortality, and costs, with sub-Saharan Africa having the highest rates globally. Concerns with rising AMR have resulted in international, Pan-African, and country activities including the development of national action plans (NAPs). However, there is variable implementation across Africa with key challenges persisting. Consequently, there is an urgent need to document current NAP activities and challenges across sub-Saharan Africa to provide future guidance. This builds on a narrative review of the literature. All surveyed sub-Saharan African countries have developed their NAPs; however, there is variable implementation. Countries including Botswana and Namibia are yet to officially launch their NAPs with Eswatini only recently launching its NAP. Cameroon is further ahead with its NAP than these countries; though there are concerns with implementation. South Africa appears to have made the greatest strides with implementing its NAP including regular monitoring of activities and instigation of antimicrobial stewardship programs. Key challenges remain across Africa. These include available personnel, expertise, capacity, and resources to undertake agreed NAP activities including active surveillance, lack of focal points to drive NAPs, and competing demands and priorities including among donors. These challenges are being addressed, with further co-ordinated efforts needed to reduce AMR.

Oral health by obesity classification in young obese women - a cross-sectional study. To explore oral health by increasing degree of obesity and the influence of modifying factors. A cross-sectional design was used. Swedish females (n = 118; 18-35 years) with morbid obesity were recruited from the BAriatric SUbstitution and Nutrition study (BASUN). Body mass index (BMI) was used as continuous and categorized into 35-39.9 kg/m2/40-44.9 kg/m2/≥45 kg/m2. Oral examinations assessed dental caries using the ICDAS system, periodontal status and saliva characteristics. Information on sociodemographics, oral health behaviour and symptoms was collected via a questionnaire. Mean BMI was 42.2 kg/m3 (SD 4.0; range 35.0-63.7). Significantly higher frequencies of dentine caries (p = .001) and total caries (p = .046) were found with higher BMI with an increase in total caries by 0.59 tooth surface (p = .025) for each increasing BMI degree. There were consistent associations between obesity and dentine caries for the group with the highest BMI (≥45), adjusted RR 2.08 (95% CI 1.20-3.61), and all stages of caries, adjusted RR 1.41 (95% CI 1.02-1.96). High scores were found for dental plaque (50.2%) and gingivitis (34.5%). Young obese women exhibited poor oral health with higher caries levels by higher BMI. Dental care should adapt the prevention efforts for obese individuals. Trial Registration: The trial was prospectively registered on March 03; 2015; NCT03152617.

A clinician's guide for counseling patients on results of a multigene pharmacogenomic panel. This article explores approaches to pharmacogenomic counseling for patients who have undergone multigene panel testing by describing the collective experience of 5 institutions. Multigene panel pharmacogenomic testing has the potential to unlock a myriad of information about a patient's past, present, and future drug response. The multifaceted nature of drug response coupled with the complexity of genetic results necessitates some form of patient education through pharmacogenomic counseling. Published literature regarding disclosure of pharmacogenomic test results is limited. This article compares the counseling practices of pharmacists from 5 different institutions with pharmacogenomics clinics whose experience represents perspectives ranging from academia to community clinical environments. Overarching counseling themes discussed during result disclosure center around (1) pharmacogenomic results, (2) gene-drug interactions, (3) gene-drug-drug interactions, (4) drug changes (5) future, familial, or disease-risk implications, (6) updates in the interpretation and application of pharmacogenomic results, (7) gauging patient comprehension, and (8) sharing results and supplemental information. Dedicating time to counseling patients on the results of a multigene pharmacogenomic panel is important given the lifelong applications of a test that is generally performed only once. The content and methods of disclosing test results shared by the experiences of pharmacists at 5 different institutions serve as guide to be further refined as research addresses effective communication strategies that enhance patient comprehension of pharmacogenomic results.

Strong correlation between specific heat capacity and water content in human tissues suggests preferred heat deposition in malignant tumors upon electromagnetic irradiation. Tumor perfusion is considered to be the principal factor determining the build-up of therapeutically effective thermal fields. This assumes that malignancies have lower perfusions than their homologous tissues. This assumption, however, ignores the fact that several tumor types have higher perfusions than their healthy counterparts. Additionally, flow changes upon hyperthermia (39-43 °C) are non-predictable and extremely heterogeneous. Therefore, modeling temperature distribution further requires a more robust parameter, different in malignancies and healthy tissues, i.e., water content (Cw), which highly determines thermal properties upon electromagnetic irradiation. Systematic literature reviews of Cw and specific heat capacities (cp) were conducted up to 28 February 2022, providing an updated, comprehensive data overview based on original manuscripts, reviews and databases. Cw- and cp-values of cancers and their corresponding healthy tissues are presented. Strong correlations between these two parameters are described. In general, malignant tumors have distinctly higher Cw values than their homologous tissues. With increasing Cw in low-water-content normal tissues (<70 wt.%), cp rises exponentially from 1.5 to 3.3 J·g-1·K-1. In high-water-content normal tissues (≥70 wt.%), cp increases linearly from 3.5 to 3.8 J·g-1·K-1. In malignant tumors (>80 wt.%), cp rises linearly from 3.6 to 3.9 J·g-1·K-1. Cancers contain up to 27% more water than their tissues of origin and must be considered as 'high-capacitance-tissues'. Hyperhydration of cancers result in higher cp-values, causing cancers to be better heat reservoirs than corresponding normal tissues upon electromagnetic irradiation. Reliable, tissue-/cancer-specific cp values must be considered when modeling temperature distributions in hyperthermic treatment.

Deaggregation properties and transmetalation studies of a zinc(II) salen-type Schiff-base complex. This paper reports the synthesis and the deaggregation properties of a Lewis acidic Zn(II) salen-type Schiff-base complex derivative from diaminomaleonitrile and a systematic detailed study of its transmetalation with other metal ions in solution. In a solution of non-coordinating solvents, the complex is in a dimeric form, while in coordinating solvents or upon addition of a Lewis base it is stabilized as monomeric adducts. Experiments done in two solvents with different Lewis basicities indicate a major role of the stability of the starting adduct in transmetalation. Thus, using nitrate or perchlorate salts, acetonitrile solutions of the complex give an immediate and complete transmetalation with Cu2+, while with Co2+ and Ni2+ a much slower transmetalation rate is observed. Instead, using chloride salts a fast and complete transmetalation is observed for divalent ions of the first transition series (Mn2+, Fe2+, Co2+, Ni2+, Cu2+), indicating the role of the chloride in stabilizing the transition state of the transmetalation. On the other hand, DMF solutions of the complex are less prone to transmetalation, according with the greater basicity of the solvent and, hence, the greater stability of the related adducts with the complex. Therefore, the nature of the solvent and the counteranion allow controlling the transmetalation process of this Zn(II) Schiff-base complex.

Counteracting heart failure with diabetes drugs: a review into the pharmacokinetic and pharmacodynamic properties. Heart failure (HF) is becoming a huge public health burden. New diabetes drugs for type 2 diabetes (T2D), sodium-glucose cotransporter type 2 inhibitors (SGLT2is), reduce the rate of hospitalization for HF in placebo-controlled trials. Pharmacokinetics of dapagliflozin and empagliflozin (in presence of renal impairment and hepatic dysfunction, two comorbidities frequently associated with HF) and pharmacodynamic studies in patients with HF. Main HF outcomes in T2D patients with cardiovascular risk and in patients with reduced (HFrEF) or preserved (HFpEF) ejection fraction, with or without T2D, from DAPA-HF, EMPEROR-Reduced and EMPEROR-Preserved original findings and post hoc analyses. No clinically relevant changes are expected concerning SGLT2i pharmacokinetics in patients with HF while pharmacodynamic studies reported improvements in myocardium/vascular parameters, biomarkers, and functional status. All SGLT2is showed a remarkable reduction in hospitalization for HF in patients with T2D and high cardiovascular risk. Furthermore, both dapagliflozin and empagliflozin improved the prognosis of patients with HFrEF, independently of the presence of T2D. Similar results were reported with empagliflozin in patients with HFpEF, to be confirmed with dapagliflozin in an ongoing trial (DELIVER). Thus, SGLT2is offer a new opportunity for the prevention and management of HF in patients with or without T2D.

Is PSA Still the Best Predictor for Biochemical Recurrence after Radical Prostatectomy in High-Risk Prostate Cancer? Patients with high-risk prostate cancer (PCa) experience heterogeneous oncological outcomes. In this study, we assessed the patients who underwent an RP procedure because of high-risk prostate cancer in subgroups formed according to D'Amico criteria and analyzed the effects of these criteria on biochemical recurrence (BCR) after RP. We retrospectively identified high-risk non-metastatic PCa patients who underwent RP between 2006 and 2020 in our hospital. Groups were formed as follows: group 1 consisted of those with an ISUP grade 4 - 5 biopsy, group 2 consisted of those with a clinical stage T2c, group 3 consisted of those with a tPSA level ≥ 20 ng/ml, and group 4 consisted of those with locally advanced disease. Survival analyses were made by Kaplan-Meier test and Log Rank test. A P value <0.05 was accepted as statistically significant. Of all patients, 61.8% were cured by only RP and 38.2% had recurrences. Rates of BCR were significantly different among groups (P = 0.003). In group 1, group 2, group 3, and group 4, BCR rates were 30.8%, 13%, 40.8%, and 70.6%, respectively. Mean BCR-free survival was 82.47 ± 11.64 months. In group 2, BCR-free survival was higher than that in group 3 and group 4 (P1 = 0.020 and P2 = 0.001) and in group 1, BCR-free survival was higher than that in group 4 (P = 0.016). There was no significant difference between group 3 and 4 (P > 0.05). Despite the developments in the imaging technology, an elevated tPSA level remains to be an important predictor for BCR-free survival.

Emerging drugs for the treatment of hereditary angioedema due to C1-inhibitor deficiency. Hereditary angioedema due to C1-inhibitor (C1-INH-HAE) is a rare disease characterized by unpredictable swelling attacks that may be life-threatening when affecting the upper airways. Understanding the pathophysiology of HAE and the mechanism of bradykinin-mediated angioedema allowed the development of new therapies for the treatment of HAE: clinical trials are ongoing to expand the number of drugs available for on-demand treatment and prophylaxis. Authors discuss the products that have been used to treat this disease for many years and present the most recently marketed products and those which are under development. Significant therapeutic progress has been made in HAE. In particular, drugs targeting specific molecules involved in the angioedema formation were developed and studies with new drugs are ongoing. In the coming years, more effective therapies with easier administration route options for on-demand treatment and long-term prophylaxis will be available to treat this disease and the variety of patients. Gene therapy strategies may offer a definitive treatment. High costs of current and new drugs may be a limiting factor for their availability, especially in developing countries.

Pragmatic evaluation of methods for retrieving unpublished information on comparator interventions in a systematic review of smoking cessation trials. Reporting of the content and delivery characteristics of comparator interventions in published articles is often incomplete. This study examines the feasibility and validity of two methods for collecting additional information on comparator interventions from trial authors. In a systematic review of smoking cessation trials (IC-Smoke), all trial authors were asked to send unpublished comparator intervention materials and complete a specially-developed comparator intervention checklist. All published and additionally obtained information from authors were coded for behaviour change techniques (BCTs) and other characteristics (type of comparator, provider, provider training, delivery mode and treatment duration). To assess representativeness, we assessed the amount of additional information obtained from trial authors compared with the amount that was published. We examined known-group and convergent validity of comparator intervention data when using only published or also unpublished information. Additional information were obtained from 91/136 (67%) of trial authors. Representativeness, known-group and convergent validity improved substantially based on the data collected by means of the comparator intervention checklist, but not by requesting authors to send any existing comparator materials. Requesting authors for unpublished comparator intervention data, using specially-developed checklists and unpublished materials, substantially improves the quality of data available for systematic reviews.

Comparison of the outcomes between early and late anti-tumor necrosis factor therapy in patients with enthesitis-related subcategory of juvenile idiopathic arthritis: a multi-center study in Southeast Asia. Little is known about the impact of delayed initiation of anti-tumor necrosis factor (TNF) therapy in patients with enthesitis-related arthritis (ERA). Here, we compared the impact of delayed treatment on disease outcomes of ERA patients in Southeast Asia. This retrospective study enrolled 149 ERA patients from Thailand and Singapore. Early (e-aTNF) and late (l-aTNF) treatment groups received anti-TNF therapy starting at ≤6 months and >6 months, respectively, after diagnosis. Outcomes included mean differences in disease activity parameters, Juvenile Spondyloarthritis Disease Activity (JSpADA) score, Juvenile Arthritis Diseases Activity (JADAS)-10 score, and American College of Rheumatology Pediatric (ACR Pedi) criteria, and the frequency of clinically inactive disease and first flare event. The mean changes in JSpADA (p = 0.002) and JADAS-10 (p < 0.001) scores over time were significantly higher in the e-aTNF group than in the l-aTNF group. A significantly higher proportion of patients in the e-aTNF group than l-aTNF group satisfied ACR Pedi 100 criteria at 2 years (p = 0.042). All other long-term outcomes were not significantly different between the groups. Although early anti-TNF treatment improved disease activity parameters somewhat better than delayed anti-TNF therapy, there was no significant difference in long-term outcomes.

Isonicotinic acid N-oxide, from isoniazid biotransformation by Aspergillus niger, as an InhA inhibitor antituberculous agent against multiple and extensively resistant strains supported by in silico docking and ADME prediction. Biotransformation of isoniazid produced isonicotinic acid (1), isonicotinic acid N-oxide (2), and isonicotinamide (3) which were isolated by column chromatography using silica gel and Sephadex LH 20 and elucidated using various spectroscopies. This is the first report for isolation of 2. Antituberculosis activity was evaluated against Mycobacterium tuberculosis strains: drug sensitive (DS), multiple drug resistant (MDR) and extensively drug resistant (XDR). 1-3 and isoniazid showed MICs of 63.49, 0.22, 15.98 and 0.88 µM, respectively, against the DS strain. For the MDR strain, 2 and 3 exhibited MICs of 28.06 and > 1000 µM, respectively, while 1 was inactive. Moreover, 2 had an MIC of 56.19 µM against XDR strain, while 1 and 3 were inactive. Docking simulation using enoyl ACP reductase (InhA) revealed favorable protein-ligand interactions. In silico study of pharmacokinetics and hepatotoxicity predicted 1-3 to have good oral bioavailability and 2 to have a lower hepatoxicity probability than isoniazid.

Nitrogen removal by a strengthened comprehensive floating bed with embedded pellets made by a newly isolated Pseudomonas sp. Y1. A newly heterotrophic nitrification aerobic denitrification(HN-AD) bacterium Pseudomonas sp. Y1 with highly nitrogen removal ability was isolated from the activated sludge, TN removal rate of which was 99.73%. In this study, two types of different ecology floating bed systems were designed to achieve efficient nitrogen removal in the urban eutrophic landscape water body, one is the comprehensive ecological floating bed(CEFB) system with only Lythrum salicari and the other is the strengthened comprehensive ecological floating bed (SCEFB) system with both Lythrum and embedded pellets made by Y1. The TN removal rates of the CEFB system were 33.82%, 83.84% and 88.91% at 8±1℃, 15±1℃ and 25±1℃, respectively, while the TN removal rates of the SCEFB system increased by nearly 40%, 16% and 11% at the same environment, respectively. The result shows that the SCEFB system can purify the simulated water from surface water body class V to class IV. Thus it has a broad application prospect in the urban eutrophic landscape water body.

Enhanced antibacterial activity of surface re-engineered lysozyme against Gram-negative bacteria without accumulated resistance. In this study, we show a way to improve the antibacterial activity of lysozyme by incorporating guanidino functional groups onto its surface (Lyz-Gua), which could treat pathogenic bacteria without accumulated resistance and shows advantages over commercial antibiotics.

Pesticide residues in milk and dairy products: An overview of processing degradation and trends in mitigating approaches. Milk and dairy products present considerable socioeconomic importance but are also a regular pesticide residue contamination source, which is considered a worldwide public health concern and a major international trade issue. Thus, a literature review was conducted to assess pesticide residue levels in milk and dairy products, as well as the residue degradation capacity during its processing. Organochlorine, organophosphate, synthetic pyrethroid and/or triazine were found in fluid milk, powder products, yogurts, cheese, butter, and sour cream. Thermal processing reduced most residue levels, although some treatments increased total hexachlorocyclohexane and its isomers (α-, γ-, δ-, and β-). Emerging non-thermal treatments presented promising results, but some by-products had higher toxicity than their precursors. Biodegradation by lactic acid bacteria were effective during yogurt and cheese fermentation. However, β-hexachlorocyclohexane level seems to increase in yogurts containing Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis, while increase or maintenance of pesticide residue concentration was observed during coagulation and cheese maturation. Deep research is needed to understand the isomerization and degradation mechanisms after thermal, non-thermal, and fermentation processing. Emerging heat technology can be an excellent topic to be investigated for pesticide residues degradation in the future. These mitigation approaches can be a feasible future alternative to milk and dairy production.

Pharmacological approaches to prevent vertical transmission of HIV and HBV. Mother-to-child transmission (MTCT) is mainly responsible for the global pediatric HIV and HBV epidemic. Vertical transmission can be prevented and reduced through a series of interventions at the primary healthcare level, including extensive screening of pregnant women, administration of antivirals or immune-based treatments, counselling on type of delivery and breastfeeding. In this narrative review, approved therapeutic options for the treatment of pregnant women living with HIV or HBV are discussed with special focus on efficacy and safety profiles of each agent or drug class examined. The search was performed using Medline (via PubMed), Web of Science, and Google Scholar to identify studies assessing vertical transmission of both HIV and HBV. Elimination of MTCT of both infections is firmly endorsed by major global commitments and the integration of tailored preventive interventions into maternal and newborn health services is of strategical importance to achieve this critical target. However, further research centered on antiviral-based and immunization trials among pregnant women is urgently needed to mitigate the risk of maternal and neonatal adverse outcomes, effectively prevent transmission to the offspring and finally eliminate the pediatric HIV and HBV epidemic, one of the key global health challenges of our time.

Advances in adrenocortical carcinoma pharmacotherapy: what is the current state of the art? Surgery, followed or not by adjuvant mitotane, is the current mainstay of therapy for patients with early-stage adrenocortical carcinoma (ACC). Mitotane, either alone or in association with EDP (Etoposide-Doxorubicin-Cisplatin) combination chemotherapy, is the standard approach for patients with metastatic ACC. The activity of newer cytotoxic drugs, radioligands, targeted therapies, and immunotherapy, both in preclinical and clinical studies, will be reviewed in this paper. ADIUVO trial revealed that the administration of adjuvant mitotane is not advantageous in patients with good prognosis. Future strategies are to intensify efforts in adjuvant setting in patients with high risk of relapse. In patients with advanced/metastatic disease, modern targeted therapies have shown significant cytotoxicity in preclinical studies; however, studies in ACC patients reported disappointing results so far. The absence of targeted agents specifically inhibiting the major molecular pathways of ACC growth is the main cause of the failure of these drugs. Since ACC is often antigenic but poorly immunogenic, the results of immunotherapy trials appeared inferior to those achieved in the management of patients with other malignancies. Radioligand therapy may also be a promising approach. Combination of chemotherapy plus immunotherapy could be interesting to be tested in the future.

Dramatically reducing the critical velocity of air cavity generation via biomimetic microstructure effects. Control over the generation of air cavities in liquids is vitally important in numerous underwater marine systems, with behaviors ranging from largely reducing the fluid resistance to minimizing the energy consumption. However, reducing the critical velocity of air cavity generation simultaneously on both original and hydrophobic materials can be mutually exclusive. In strong contrast to the view that the surface wettability is what determines the critical velocity of air cavity entrainment, we report a facile method to dramatically reduce the critical velocity of air cavity generation by etching a kind of biomimetic microstructure on the sphere surface. It is worth noting that the generation of air cavities induced by the microstructure effect is almost independent of surface wettability; even for the hydrophilic spheres, the critical velocity of air cavity generation is reduced by over 86.3%. The physical mechanism is mainly related to the pinning of the moving contact line and the regulable transition of the wetting state from the Wenzel model to the Cassie-Baxter model at the solid-liquid-air interface. We also investigated the stability of the microstructured spheres to induce underwater air cavities and found that a continuous and robust air cavity could still be produced even after 1200 repeated impacts. This research provides a simple, economical and energy-efficient method for minimizing the critical velocity for generating air cavity entrainment to reduce hydrodynamic drag.

Personal and contextual determinants of COVID-19 vaccination intention: a vignette study. This vignette study explores which factors contribute to higher COVID-19 vaccination intentions. Between the 4th-11 January 2021, we recruited 15,901 Belgian citizens (Mage = 50.11 years, range 18-100) through convenience sampling to participate in a vignette study. In each vignette, we manipulated contextual determinants consisting of different factors. Each participant rated six vignettes in terms of the outcomes 'vaccination intention' and 'recommendation to others.' Finally, we explored the benefits of tailored communication by examining whether these ratings depended upon citizens' initial motives for vaccination. Participants are most likely to accept a vaccine when they expect no or only small side effects, when the vaccine offers a 95% protection, and when people can no longer infect others (p < 0.001). The possibility to receive the vaccine at home or at the GP's office, highlighting that most citizens are willing to get vaccinated, and emphasizing the protective benefits for others yielded additional positive effects (p < 0.001). Results showed that tailored communication has a small but significant effect, especially for individuals high on distrust-based amotivation (p < 0.01). In addition to vaccine characteristics, there is room for policymakers to respond to those determinants that fall under their control and can thus be highlighted within communication campaigns.

Recognizing and Managing Pancreaticopleural Fistulas in Children. Background: Pancreaticopleural fistula, an abnormal communication between the pancreas and the pleural cavity, is a rare complication of pancreatic disease in children and is mainly associated with acute pancreatitis, chronic pancreatitis, trauma or iatrogenicinjury. The present review presents the current available data concerning the pathogenesis, clinical features, diagnosis and management of this unusual but difficult clinical problem among children, in order to shed light on its pathologic manifestation and raise clinical suspicion.Methods: The review of the literature was performed through a PubMed search of pediatric original articles and case reports, using the key words "pancreaticopleural fistula", "pancreatitis", "pleural effusion", "pseudocyst" and "children". The literature search revealed 47 cases of pediatric patients with pancreaticopleural fistula.Results: Diagnosis is based on the patient's medical history, physical examination and imaging, while the cornerstone of diagnosis is the presence of high pleural effusion amylase levels. The management of this disorder includes conservative, endoscopic and surgical treatment options. If treated promptly and properly, this clinical entity could have a lower rate of complications.Conclusions: The incidence of pancreaticopleural fistula in children may be underestimated in the literature, due to a reduced degree of clinical suspicion. A more heightened awareness of this entity is needed to improve the quality of life in children that suffer from this condition, as early diagnosis is essential for effective treatment and improved outcome.

KF·B(OH)3: a KBBF-type material with large birefringence and remarkable deep-ultraviolet transparency. A designed material with large birefringence and remarkable deep-ultraviolet transparency, KF·B(OH)3, has been discovered. The well-aligned [F·B(OH)3]- layers endow a very large bandgap (7.63 eV), comparably large birefringence (0.114 @1064 nm), and the reinforced interlayer bonding of ca. 2.16 × KBe2BO3F2.

Can 2,4-D promote the hormesis effect in upland rice? This study aimed to evaluate the influence of low doses of 2,4-D on the agronomic traits of upland rice applied at different stages of crop growth. The work was carried out in a randomized completly blocks, and consisted of the application of 5 low doses of the 2,4-D herbicide (0, 0.68, 1.36, 2.04, 3.40 and 5.44 g acid equivalent (e.a.) ha-1) in two stages of rice development (tillering and floral differentiation). Nitrogen contentes in leaves, SPAD index and yield are higher when low doses of 2,4-D is applied in the tillering stage. Application of 2,4-D at a dose of 2.04 g a.e ha-1 results in a 19% increase in the number of spikelet per panicle. On the other hand, there is no effect of the application of low doses of 2,4-D on height, number of stems, active tillering and weight of 100 seeds. Our results contribute to increase knowledge of the hormesis effect in plants in order to increase crop yield.

Experimental investigation of anomalous molecular probe diffusion in entangled polymer melts. Investigations on the diffusion of small molecules or particles in polymeric materials are important to numerous technologies and can also be used to gain insight on polymer chain dynamics. Systems where the probe size is comparable to (or smaller than) a characteristic length of the polymer chain, the tube diameter for example, are of particular interest because the diffusion coefficient of the probe can be orders of magnitude larger than the value predicted by the Stokes-Einstein relation. In the present study, we employ the optical technique known as forced Rayleigh scattering to study the diffusion of a molecular probe (dye) in several entangled polymer melts over a wide range of length and time scales. The probe size is much smaller than the tube diameter for the systems studied. We find the diffusion coefficient is larger by four to five orders of magnitude than the Stokes-Einstein prediction. More interestingly, we observe anomalous, non-Fickian, diffusion where the value of the measured diffusion coefficient can abruptly change by as much as 50%. We suggest that this unexpected behavior occurs when the time scale for diffusion is larger than the relaxation time associated with the constraint release mechanism for polymer chain dynamics.

Pediatric Invasive Fungal Rhinosinusitis: A Comprehensive Analysis of Prognostic Factors for Survival. Pediatric invasive fungal rhinosinusitis (IFS) is a devastating infection that manifests almost exclusively in immunocompromised children. The goal of this work was to determine which clinical features carry prognostic value for survival. A retrospective review of children with a histopathological diagnosis of IFS was performed at an academic tertiary care institution from 1990 to 2021. Clinical variables were collected to generate survival and life-table estimators at 6-months and 1-year. Eighteen patients were included in this analysis, with a mean age of 9.8 years (range, 1-17 years). Most children were neutropenic (n = 15, 83.3%), with acute lymphoblastic leukemia (n = 10, 55.6%) representing the most common primary diagnosis. A mean of 3.2 operations (range 1-7 operations) was performed per patient for either mucormycosis (n = 10, 55.6%) or aspergillosis (n = 8, 44.4%). The mean time to absolute neutrophil count recovery was 65.8 days (range 20-137 days), with a 6-month and 1-year survival rate of 47.6% and 41.7%, respectively. Gross total resection (p = 0.006, p < 0.001), number of antifungals (p = 0.0004, p = 0.0003), and total operation number (p = 0.0032, p = 0.0035), served as positive prognostic factors for 6-month and 1-year survival. Conversely, altered mental status (p = 0.0026), cerebral involvement (p = 0.0010), cranial neuropathies (p < 0.0001), hyperglycemia (p = 0.0445, p = 0.0208), and intensive care unit status (p = 0.0013) served as negative prognostic factors for 6-month and 1-year survival. Several key elements were identified and found to play a vital role in influencing survival for pediatric IFS. Early diagnosis, prompt medical therapy, and aggressive surgical intervention remain at the forefront in the treatment of this complex opportunistic infection. 4 Laryngoscope, 133:1239-1250, 2023.

Photoacid-catalyzed acetalization of carbonyls with alcohols. In this report, we demonstrate that visible light photoactivation of 6-bromo-2-naphthol facilitates the photoacid-catalyzed acetalization of carbonyls with alcohols. We also demonstrate that 2-naphthol when coupled to a photosensitizer provides acetals from electron-deficient aldehydes. In addition, the S1 excited state pKa for 6-bromo-2-naphthol in water was determined and shown to have increased excited-state acidity relative to 2-naphthol.

The Piezo-Fenton synergistic effect of ferroelectric single-crystal BaTiO3 nanoparticles for high-efficiency catalytic pollutant degradation in aqueous solution. Nano-ferroelectric materials have excellent piezoelectric performance and can degrade organic dye by ultrasonic vibration in an aqueous solution. Here, BaTiO3 (BT) nanoparticles were prepared by a sol-gel/hydrothermal method and further applied in dye degradation in wastewater. BT nanoparticles exhibited excellent catalytic performance for organic dye molecule degradation through the piezo-Fenton synergistic effect. It was found that both the degradation efficiency and reaction rate were boosted by the increase of the molecular weight of organic dyes. The degradation efficiency toward different organic dyes exhibited a trend of CR > ABK > TH > RhB > MB > MO. For example, a high piezo-Fenton-catalytic degradation ratio of 82.8% at 5 min and 0.337 min-1 rate constant were achieved for the CR dye solution (10 mg L-1), which were 3.2 and 6.4 times the corresponding values of piezo-catalytic only degradation. These results mainly originate from the intrinsic properties of BT nanoparticles that can enhance the separation of charge and promote the formation of hydrogen peroxide (H2O2) and hydroxyl radicals (·OH) under ultrasonic vibration. Furthermore, the reaction of Fe(II) with H2O2 can further enhance the formation of ·OH, which can accelerate the degradation of organic dyes. These results indicate that the piezo-Fenton synergistic effect may provide a new clue for the development of the wastewater treatment field under mechanical vibration.

Neonatal seizures treatment based on conventional multichannel EEG monitoring: an overview of therapeutic options. Seizures are the main neurological emergency during the neonatal period and are mostly acute and focal. The prognosis mainly depends on the underlying etiology. Conventional multichannel video-electroencephalographic (cEEG) monitoring is the gold standard for diagnosis, but treatment remains a challenge. This review, based on PubMed search over the last 4 decades, focuses on the current treatment options for neonatal seizures based on cEEG monitoring. There is still no consensus on seizure therapy, owing to poor scientific evidence. Traditionally, the first-line treatments are phenobarbital and phenytoin, followed by midazolam and lidocaine, but their efficacy is limited. Therefore, current evidence strongly suggests the use of alternative antiseizure medications. Randomized controlled trials of new drugs are ongoing. Therapy for neonatal seizures should be prompt and tailored, based on semeiology, mirror of the underlying cause, and cEEG features. Further research should focus on antiseizure medications that directly act on the etiopathogenetic mechanism responsible for seizures and are therefore more effective in seizure control.

Controlled tuning of radiative-nonradiative transition via solvent perturbation: Franck-Condon emission vs. aggregation caused quenching. Organic molecules with tunable fluorescence quantum yield are attractive for opto-electronic applications. A fluorophore with tunable fluorescence quantum yield should be a better choice for a variety of applications that demand fluorophores with different quantum yields. Here organic emitters with a continuous bell-shaped fluorescence yield profile would be promising in view of sustainability and reusability; however, fluorophores with these properties are rarely reported. A bis-indole derivative, 3,3'-bisindolyl(phenyl)methane (BIPM), was synthesised and found to undergo a unique 'rise-and-fall' profile in fluorescence yield with a compositional change of the 1,4-dioxane (DiOx)-H2O solvent system. A predominant interplay of two contrasting factors, (a) polarity and proticity induced emission enhancement and (b) aggregation caused fluorescence quenching, on either side of a crossover solvent composition (∼50% fW), resulted in a continuous bell-patterned fluorescence yield profile. Interestingly, these two factors could be observed individually or simultaneously by adjusting the H2O fraction. Detailed spectroscopic, electron microscopic and computational studies have been performed to substantiate the photophysics behind the solvent regulated modulation of fluorescence quantum yield.

What can occupancy models gain from time-to-detection data? The time taken to detect a species during site occupancy surveys contains information about the observation process. Accounting for the observation process leads to better inference about site occupancy. We explore the gain in efficiency that can be obtained from time-to-detection (TTD) data and show that this model type has a significant benefit for estimating the parameters related to detection intensity. However, for estimating occupancy probability parameters, the efficiency improvement is generally very minor. To explore whether TTD data could add valuable information when detection intensities vary between sites and surveys, we developed a mixed exponential TTD occupancy model. This new model can simultaneously estimate the detection intensity and aggregation parameters when the number of detectable individuals at the site follows a negative binomial distribution. We found that this model provided a much better description of the occupancy patterns than conventional detection/nondetection methods among 63 bird species data from the Karoo region of South Africa. Ignoring the heterogeneity of detection intensity in the TTD model generally yielded a negative bias in the estimated occupancy probability. Using simulations, we briefly explore study design trade offs between numbers of sites and surveys for different occupancy modeling strategies.

Multi-element co-doped biomass porous carbon with uniform cellular pores as a supercapacitor electrode material to realise high value-added utilisation of agricultural waste. Biomass-based porous carbon materials have attracted considerable attention because of their simple, low-cost, green, and pollution-free preparation process. Owing to their unique tubular structure and subsequent activation process, they often have a well-developed pore structure. Biomass-based carbon materials with three-dimensional hierarchical pores and polyatomic doping are regarded as promising electrode materials in the field of energy storage. In this study, cornstalk was used as the biomass and a pioneering approach was used to prepare porous carbon co-doped with N, B, and P. The B,N,P-codoped porous carbon has a three-dimensional honeycomb-like network structure with uniformly distributed and interwoven macro-, meso-, and micropores. Furthermore, it has an ultra-high specific surface area of 3123.5 m2 g-1, a high specific capacitance of 342.5 F g-1 at a current density of 0.5 A g-1, and an energy density of up to 26.18 W h kg-1. This study demonstrates a multi-element co-doping strategy that enhances the performance of cornstalk as a precursor of a supercapacitor electrode material and has important implications in the high-value-added utilisation of waste straw.

Icosapent ethyl for reduction of persistent cardiovascular risk: a critical review of major medical society guidelines and statements. REDUCE-IT demonstrated that adding 4 g/day of icosapent ethyl (IPE; purified ethyl ester of eicosapentaenoic acid [EPA]) to statins substantially reduced cardiovascular disease (CVD) events, with few adverse effects. These data prompted numerous leading medical societies across five continents, including the American College of Cardiology, the European Society of Cardiology, and the Japanese Circulation Society, to update their guidelines or scientific/consensus statements to recommend use of IPE for primary and secondary prevention of CVD events. This review discusses the incorporation of IPE into international guidelines and scientific statements, noting areas of consensus and distinction. As background, this review also describes the CVD benefits and risks of IPE as a statin adjunct, and outlines current data regarding the potential mechanisms of CVD risk reduction by EPA (as IPE) beyond triglyceride reduction. IPE is unique among 'triglyceride-lowering' treatments in having strong CVD outcomes data and, therefore, a broad international consensus among professional medical society guidelines and statements endorsing its use for CVD risk reduction in patients generally meeting REDUCE-IT inclusion criteria. IPE should be considered for CVD prevention as a statin adjunct in all such patients. Plain Language SummaryCardiovascular disease (CVD) remains the leading cause of death worldwide. Statin monotherapy is conventionally used first-line to reduce the risk of CV events, such as heart attacks and strokes, in patients with elevated cholesterol. However, considerable risk remains despite appropriate control of cholesterol levels with a statin. Consequently, research has focused on treatment of additional therapeutic targets to reduce this remaining CV risk. One such target is elevated blood triglyceride levels. Unfortunately, most drugs that lower triglyceride levels, such as niacin, fibrates, and mixed omega-3 fatty acids, have not reduced the risk of cardiovascular events in clinical trials when added to statin therapy. However, the omega-3 fatty acid eicosapentaenoic acid ('EPA') administered in highly purified form as icosapent ethyl (IPE) has emerged as the first omega-3 fatty acid, and the first triglyceride-lowering agent to prevent CV events when added to statins. This was demonstrated most notably in the pivotal REDUCE-IT trial, in which IPE reduced the risk of major CV events by 25% in high-risk patients with mildly to moderately elevated triglyceride levels despite statin-controlled cholesterol levels. The mechanisms responsible for this reduction in CV events appear to go far beyond lowering triglyceride levels alone. In light of the positive results from the REDUCE-IT trial, IPE was approved for CV disease risk reduction globally, including in the United States, Canada, European Union, and the United Kingdom, and its use is being increasingly endorsed in United States and international statements and guidelines for managing CV risk. Despite minor differences among guidelines, there is strong consensus that IPE should be considered for use in CVD prevention in all patients who meet the proposed criteria.

Effects of multicomponent training and detraining on the fitness of older adults with or at risk of frailty: results of a 10-month quasi-experimental study. The aims of this study were (1) to analyse the effects of a 6-month multicomponent training (MCT) on the physical fitness of older adults with or at risk of frailty; (2) to study the consequences of a 4-month detraining period; (3) to analyse the influence of frailty status on the training and detraining adaptations. A total of 102 robust, frail and prefrail older adults (80.1 ± 6.1 y) were divided into an intervention (TRAIN) and control group (CON). The TRAIN performed a 6-month MCT, while the CON continued with their usual lifestyle. Fitness assessment was mainly based on the Senior Fitness Test. Four evaluations were carried out; at baseline, and at 3, 6 and 10 months from baseline. Linear mixed models were performed to analyse group by time interactions and to compare differences in changes within groups between different time points. After 6-month MCT, TRAIN showed greater improvements for all fitness variables (group effects p < 0.05, except for flexibility) when compared to the CON. During the 4-month detraining period, TRAIN significantly decreased their balance, upper-limb flexibility and upper and lower-limb strength (all p < 0.05). CON only decreased upper-limb flexibility. When accounting for frailty status in the TRAIN, the frail-prefrail showed lower adaptations to the training and were more affected by detraining than the robust. The presented MCT is a good strategy to improve fitness in this population, but its positive effects are limited in time. It is, therefore, critical to avoid detraining periods.Trial registration: ClinicalTrials.gov identifier: NCT03831841.HighlightsOur 6-month MCT-program improves the physical fitness of robust, frail and prefrail older adultsA detraining period of four months partially deteriorates the physical fitness of robust, frail and prefrail older adults, so it is recommended to promote ongoing exercise programs or smaller break periodsIt seems that those older adults with a more advanced frailty status may not benefit from exercise to the same degree and will be more affected by detraining. Therefore, trainers may need to individualize training protocols to obtain the greatest exercise benefits.

Boosting the photodynamic therapy of near-infrared AIE-active photosensitizers by precise manipulation of the molecular structure and aggregate-state packing. Organic functional materials have emerged as a promising class of emissive materials with potential application in cancer phototheranostics, whose molecular structures and solid-state packing in the microenvironment play an important role in reactive oxygen species (ROS) generation and the photodynamic therapy (PDT) effect. Clarifying the guidelines to precisely modulate PDT performance from molecular and aggregate levels is desired but remains challenging. In this work, two compounds, TCP-PF6 and TTCP-PF6, with similar skeletons are strategically synthesized, in which a thiophene segment is ingeniously introduced into the molecular backbone of TCP-PF6 to adjust the intrinsic molecular characteristics and packing in the aggregate state. The experimental and theoretical results demonstrate that TTCP-PF6 can form tight packing mode in comparison with TCP-PF6, resulting in efficient cell imaging and enhanced ROS generation ability in vitro and in vivo. The promising features make TTCP-PF6 a superior photosensitizer for PDT treatment against cancer cells by targeting mitochondria. These findings can provide a feasible molecular design for modulating the biological activity and developing photosensitizers with high ROS generation and PDT effect.

Management and reporting of safety incidents by residential care facilities in Ireland: A thematic analysis of statutory notifications. The prevention of safety incidents (SI) in health and social care settings is an ongoing undertaking. Limited research has been conducted on SIs outside of acute care. Internationally residential care facilities (RCFs) are typically regulated to promote quality and safeguarding. A part of this regulation is the statutory responsibility of RCFs to notify the regulator about SIs. Notifications include details surrounding SIs and are used to inform the regulatory monitoring approach. The recent development of the Database of Statutory Notifications from Social Care in Ireland facilitates in-depth analysis of notifications which can be used to inform the management of SIs and thus, improve quality and safety. The aim of this study was to analyse narratives provided in statutory notifications for older persons and people with disability, in order to identify current management of SIs, system vulnerabilities and reporting practices. A Qualitative Descriptive approach was taken. A random sample of notifications received in 2018 was drawn and stratified by service-type and notification-type. Data extraction was conducted against priori agreed target areas of management, system vulnerabilities and reporting practices. Inductive thematic analysis was used identifying two parent themes: 'chronology' and 'regulatory input'. 'Chronology' subthemes included 'pre-event', 'immediate response' and 'continued response'. Measures that are resident focused and follow policies and protocols in RCFs to prevent or mitigate the seriousness of SIs were evident in the immediate response and continued response. The actions taken in the immediate and continued response in turn became part of the pre-event of future SIs. Under 'regulatory input' subthemes included 'inaccurate reporting', 'lines of inquiry', 'requests for further information', 'identification of repetitive patterns' and 'satisfactory conclusion'. In conclusion, RCFs manage SIs with short and longer term actions focused on resident wellbeing. These actions in turn become part of the pre-event of future SIs. Regulatory input highlighted regulatory burden.

Circulating sestrins and force velocity profiling in older adults with type 2 diabetes. Type 2 diabetes mellitus (T2DM) in old age affects the musculoskeletal system causing loss of muscle mass, strength, and physical function. Stress-inducible proteins named sestrins are potential novel biomarkers of muscle function due to their ability to suppress oxidative stress and prevent muscle degeneration. Our aim was to determine the association between different force-velocity (F-V) profiles with body composition, physical performance, and glucose control in older adults with T2DM. We also intended to determine the potential utility of sestrin 1 (Sesn1) and 2 (Sesn2) as biomarkers of physical functionality. Fifty-nine participants (69-79 years) were classified in 3 groups according to their F-V profile based on the leg press exercise: nondeficit (NDEF = 40.7%), force deficit (FDEF = 28.8%), and velocity deficit (VDEF = 30.5%). Both VDEF and FDEF groups showed lower muscle power than NDEF (Cohen's d 0.87 and 0.75 for effect size, respectively). Serum Sesn2 levels, maximal dynamic strength, arms and legs fat-free mass were reduced in FDEF compared to the NDEF group (p < 0.05), whereas glycated haemoglobin (HbA1c) and fasting glucose levels were similar among groups. ROC analysis revealed the distinction between the NDEF and FDEF group based on Sesn2 concentrations (<0.72 ng/mL), suggesting their potential use as functional biomarkers for early intervention through exercise. Older adults with T2DM show different F-V profiles, related to low levels of Sesn2, impaired body composition and physical performance, and may be taken into consideration to target exercise training in this specific population.Highlights The influence of different F-V deficit profiles on body composition, physical function and circulating sestrins in older adults with type 2 diabetes were studied.Both force and velocity deficits negatively affected muscle power.Force deficits are associated to low circulating sestrin 2 levels and regional fat-free mass.Basal serum sestrin 2 levels are potential biomarkers to characterise F-V profiles.

Anticipatory and Compensatory Postural Adjustments in Response to Dynamic Platform Perturbation during a Forward Step. We investigated the generation of anticipatory (APAs) and compensatory postural adjustments (CPAs) in preparation for a step during support surface perturbation. Changes in anticipatory muscle activation in the trunk segment were predominantly in the co-contraction indices from -600 t0 -400 ms to foot-off. Reciprocal indices of the shank muscles were pronounced in the APA intervals. During the CPA intervals, larger reciprocal muscle activities were detected compared to the APA intervals. The results showed subjects co-varied the reciprocal and co-contraction activations in postural muscles to counteract the perturbation and generate mechanical effects sufficient for stepping during the APA and CPA intervals. This study enhances our understanding of the interaction between the APAs and CPAs in balance maintenance.

The bipolar patients' family experiences of the outcomes of encountering stigma in Tehran: A qualitative study. Nowadays, the most common psychological-social pressure to which bipolar patients' families are exposed is stigma. Therefore, the present study was conducted to delve into the bipolar patients' family experiences of the outcomes of encountering stigma. The study was of qualitative type. Purposive sampling was used to select the participants from the persons suffering from bipolar disorder and their families. Twenty seven of the participants were interviewed. The main data collection instrument was semi-structured interview with open questions. Additionally, the collected data were analyzed via inductive content analysis method. The accuracy and validity of the study rooted in four factors: credibility, transferability, verifiability, and reliability. Data analysis led to 1,326 primary codes, which were further categorized into five main categories as the main outcomes of encountering stigma (social deprivation, emotional and sentimental excitement, objective and behavioral reflections, family solidarity threat, and separation from society) and 21 sub-categories. Given then irreparable outcomes of stigma for bipolar patients' family, it is necessary to take it into consideration. It is recommended to use media and also hygienic-treatment centers to educate different levels of society as to appropriate treatment with these patients and their families.

A focused review on three-dimensional bioprinting technology for artificial organ fabrication. Three-dimensional (3D) bioprinting technology has attracted a great deal of interest because it can be easily adapted to many industries and research sectors, such as biomedical, manufacturing, education, and engineering. Specifically, 3D bioprinting has provided significant advances in the medical industry, since such technology has led to significant breakthroughs in the synthesis of biomaterials, cells, and accompanying elements to produce composite living tissues. 3D bioprinting technology could lead to the immense capability of replacing damaged or injured tissues or organs with newly dispensed cell biomaterials and functional tissues. Several types of bioprinting technology and different bio-inks can be used to replicate cells and generate supporting units as complex 3D living tissues. Bioprinting techniques have undergone great advancements in the field of regenerative medicine to provide 3D printed models for numerous artificial organs and transplantable tissues. This review paper aims to provide an overview of 3D-bioprinting technologies by elucidating the current advancements, recent progress, opportunities, and applications in this field. It highlights the most recent advancements in 3D-bioprinting technology, particularly in the area of artificial organ development and cancer research. Additionally, the paper speculates on the future progress in 3D-bioprinting as a versatile foundation for several biomedical applications.

Nanoparticles for oral delivery: targeted therapy for inflammatory bowel disease. As a group of chronic and idiopathic gastrointestinal (GI) disorders, inflammatory bowel disease (IBD) is characterized by recurrent intestinal mucosal inflammation. Oral administration is critical for the treatment of IBD. Unfortunately, it is difficult to target the bowel located in the GI tract due to multiple physical barriers. The unique physicochemical properties of nanoparticle-based drug delivery systems (DDSs) and their enhanced permeability and retention effects in the inflamed bowel, render nanomedicines to be used to implement precise drug delivery at diseased sites in IBD therapy. In this review, we described the pathophysiological features of IBD, and designed strategies to exploit these features for intestinal targeting. In addition, we introduced the types of currently developed nano-targeted carriers, including synthetic nanoparticle-based and emerging naturally derived nanoparticles (e.g., extracellular vesicles and plant-derived nanoparticles). Moreover, recent developments in targeted oral nanoparticles for IBD therapy were also highlighted. Finally, we presented challenges associated with nanotechnology and potential directions for future IBD treatment.

Morphology-Controlled Fabrication Strategy of Hollow Mesoporous Carbon Spheres@f-Fe2O3 for Microwave Absorption and Infrared Stealth. The design and development of radar--infrared compatible stealth materials are challenging in the field of broadband absorption due to the contradiction of stealth requirements and mechanisms in different frequency bands. However, hollow structures show great promise for multispectral stealth because they can lengthen the attenuation path of electromagnetic waves (EMWs) for microwave absorption, interrupt the continuity of heat-transport channels, and lower the thermal conductivity to realize infrared stealth. Here, a new morphological fabrication strategy has been developed to efficiently prepare compatible stealth nanomaterials. In a specific hydrothermal process, the confined growth of flake α-Fe2O3 (f-Fe2O3) outside of hollow mesoporous carbon spheres (HMCS) is achieved using NH3·H2O as a shape-controlled reagent. The introduction of f-Fe2O3 helps to lower infrared emissivity and improve high-frequency impedance matching, which depends on the stable dielectric property of the specific flake shape. Moreover, the size of f-Fe2O3 can be regulated by changing the constituent proportion in the hydrothermal suspension to obtain excellent performance. The minimum reflection loss (RL) of the HMCS@f-Fe2O3-6 composite is -34.16 dB at 2.4 mm, and the effective absorption bandwidth (EAB) reaches 4.8 GHz. Furthermore, the lowest emissivities of the HMCS@f-Fe2O3-6-20 wt %/polyetherimide (PEI) film in the 3-5 and 8-14 μm infrared wavebands are 0.212 and 0.508, respectively. These discoveries may pave the way for the development of radar-infrared compatible stealth materials from the perspective of microstructural design.

Utilization of silt, sludge, and industrial waste residues in building materials: A review. To promote the effective utilization of sludge and slag produced in nature and from human activities, this paper summarizes the research progress in the field of building materials on the basis of expounding their classification and characteristics. (1) Sludge and slag include silt, sludge and industrial waste residues. These three materials are mainly composed of SiO2, which can be used to produce building materials after treatment and can also be used as admixtures, including roadbed admixtures. (2) Silt and sludge are widely used in building wall materials and roadbed materials, etc. Industrial waste residues can be used in the production and processing of green concrete and glass-ceramics. (3) In addition to continuing to use existing utilization methods, key treatment technologies and new treatment devices can be further developed according to the characteristics of sludge and slag. Moreover, observations and mechanistic analysis of the microscopic structure of industrial waste residues and research on strong and weak utilization methods based on the performance of building materials can be carried out, and more efficient and energy-saving excitation or activation technologies will be developed. These efforts will eventually lead to the development of functional building materials with excellent performance and environmentally friendly characteristics to achieve the differentiated utilization of silt, sludge, and industrial waste residues and realize the efficient transformation of resources. This paper provides useful insights for the application of sludge and slag in the field of building materials.

Perceived Emotional Impact of COVID-19 and Depressive Symptoms among Male Same-Sex Chilean Couples: Direct and Indirect Dyadic Associations through Relationship Satisfaction. Stressors arising from the COVID-19 pandemic can spill over into the quality of couple relationships, with negative consequences on mental health. The mental health impact of COVID-19 might be particularly pronounced in disadvantaged populations such as LGBT people. This study aimed to examine direct and indirect dyadic associations between emotional impact of COVID-19 and depressive symptoms through relationship satisfaction in male same-sex couples. Using a cross-sectional design, 158 male same-sex Chilean couples completed self-report measures of the emotional impact of COVID-19, relationship satisfaction and depressive symptoms. We used the actor-partner interdependence mediation model for indistinguishable dyads to explore the direct and indirect dyadic associations. Results indicated that each partner's perceived emotional impact of COVID-19 was associated with his own higher depressive symptoms directly and indirectly, through his own lower relationship satisfaction. The other partner's perceived emotional impact of COVID-19 was associated with one's own higher depressive symptoms only directly. Our findings reinforce the notion that satisfactory couple relationships can act as a protective factor against depression in the LGBT population. Programs to promote adaptive coping strategies to deal with the emotional impact of the COVID-19 pandemic may have beneficial effects for the emotional adjustment of male same-sex couples, also by promoting relationship satisfaction.

Predictors, timing, causes and cost of 30-day readmission after acute ischemic stroke: insights from a Chinese cohort 2015-2018. This study aims to empirically investigated the risk factors, timing, and cost of the 30-day readmission after ischemic stroke. We used the administrative claims data with 18,983 in-patients of ischemic stroke from 2015 to 2018 of a supercity in western China. The χ2 test was used in univariate analysis. A multivariate cox model and a multivariate linear regression method were used to identify those predictors of the 30-day readmission and the cumulative cost, respectively. The overall 30-day readmission rate was 18.8%, of which 36.4% and 60.9% were readmitted within 7 and 14 days, respectively. Nearly 50% were readmitted for recurrent ischemic stroke. Male, rural areas, aged under 50, resident's insurance scheme, primary hospitals, LOS under 1 week or over two weeks, and comorbidities including congestive heart failure, solid tumor, fluid and electrolyte disorders, and depression were independent predictors of 30-day readmission. We also found that the 30-day readmission was associated with an 76% increase in the cumulative hospitalization cost (P < 0.001) after multivariate adjustment analysis. The findings highlight the importance of the readmission of ischemic stroke and corresponding policies and interventions, and our work could provide a potential manage path for the reduction of readmission rate.

Influence of Water on Amorphous Lidocaine. Water is generally regarded as a universal plasticizer of amorphous drugs or amorphous drug-containing systems. A decrease in glass-transition temperature (Tg) is considered the general result of this plasticizing effect. A recent study exhibits that water can increase the Tg of amorphous prilocaine (PRL) and thus shows an anti-plasticizing effect. The structurally similar drug lidocaine (LID) might show similar interactions with water, and thus an anti-plasticizing effect of water is hypothesized to also occur in amorphous LID. However, the influence of water on the Tg of LID cannot be determined directly due to the very low stability of LID in the amorphous form. It is possible to predict the Tg of LID from a co-amorphous system of PRL-LID using the Gordon-Taylor equation. Interactions were observed between PRL and LID based on the deviations between the experimental Tgs and the Tgs calculated by the conventional use of the Gordon-Taylor equation. A modified use of the Gordon-Taylor equation was applied using the optimal co-amorphous system as a separate component and the excess drug as the other component. The predicted Tg of fully hydrated LID could thus be determined and was found to be increased by 0.9 ± 0.7 K compared with the Tg of water-free amorphous LID. It could be shown that water exhibited a small anti-plasticizing effect on LID.

Complexation of Astatine(III) with Ketones: Roles of NO3- Counterion and Exploration of Possible Binding Modes. Ketones have been proven effective in extracting astatine(III) from aqueous solvents. Previous theoretical studies suggested a mechanism where the "sp2" lone pair on the carbonyl oxygen donates electron density into the π system of the AtO+ molecular cation to form a dative-type bond. In this study, co-extraction of NO3- as AtO(NO3)·(O═CR1R2) species into the organic phase appears to be a key factor. Adjusting the electronic properties of the ketone, by having an aryl group instead of an alkyl group in the alpha position of the ketone, increased the electron density on C═O, increased the bond strength between the ketone and AtO+, and in turn increased the extraction of 211At into the organic phase. Extraction with diketones shows dependence on the bridging distance between the two carbonyl moieties, where a C3 or longer bridge results in a 10-fold increase in extraction into the organic phase. DFT calculations show the longer bridge allows for the chelation of AtO(NO3) by either the second carbonyl or the phenyl ring.

Continuous Glucose Profiles in Healthy People With Fixed Meal Times and Under Everyday Life Conditions. The increased use of continuous glucose monitoring (CGM) and automated insulin delivery systems raises the question about therapeutic targets for glucose profiles in people with diabetes. This study aimed to assess averaged pre- and postprandial glucose profiles in people without diabetes to provide guidance for normal glucose patterns in clinical practice. For that, number and timing of meal intake were predefined. To assess glucose traces in 36 participants without diabetes (mean age = 23.7 ± 5.7 years), CGM was performed for up to 14 days, starting with a run-in phase (first 3 days, excluded from analysis) followed by 4 days with fixed meal times at 8:00 am, 1:00 pm, and 6:00 pm and the remaining 7 days spent under everyday life conditions. Data from two simultaneously worn CGM sensors were averaged and adjusted to capillary plasma-equivalent glucose values. Glucose data were evaluated through descriptive statistics. Median glucose concentration on days with fixed meal times and under everyday life conditions was 95.0 mg/dL (91.6-99.1 mg/dL, interquartile range) and 98.1 mg/dL (93.7-100.8 mg/dL), respectively. On days with fixed meal times, mean premeal glucose was 92.8 ± 9.4 mg/dL, and mean peak postmeal glucose was 143.3 ± 23.5 mg/dL. By defining the time of meal intake, a clear pattern of distinct postprandial glucose excursions in participants without diabetes could be demonstrated and analyzed. The presented glucose profiles might be helpful as an estimate for adequate clinical targets in people with diabetes.

Creatine Kinase Is Decreased in Childhood Asthma. Rationale: The identification of novel molecules associated with asthma may provide insights into the mechanisms of disease and their potential clinical implications. Objectives: To conduct a screening of circulating proteins in childhood asthma and to study proteins that emerged from human studies in a mouse model of asthma. Methods: We included 2,264 children from eight birth cohorts from the Mechanisms of the Development of ALLergy project and the Tucson Children's Respiratory Study. In cross-sectional analyses, we tested 46 circulating proteins for association with asthma in the selection stage and carried significant signals forward to a validation and replication stage. As CK (creatine kinase) was the only protein consistently associated with asthma, we also compared whole blood CK gene expression between subjects with and without asthma (n = 249) and used a house dust mite (HDM)-challenged mouse model to gain insights into CK lung expression and its role in the resolution of asthma phenotypes. Measurements and Main Results: As compared with the lowest CK tertile, children in the highest tertile had significantly lower odds for asthma in selection (adjusted odds ratio, 95% confidence interval: 0.31; 0.15-0.65; P = 0.002), validation (0.63; 0.42-0.95; P = 0.03), and replication (0.40; 0.16-0.97; P = 0.04) stages. Both cytosolic CK forms (CKM and CKB) were underexpressed in blood from asthmatics compared with control subjects (P = 0.01 and 0.006, respectively). In the lungs of HDM-challenged mice, Ckb expression was reduced, and after the HDM challenge, a CKB inhibitor blocked the resolution of airway hyperresponsiveness and reduction of airway mucin. Conclusions: Circulating concentrations and gene expression of CK are inversely associated with childhood asthma. Mouse models support a possible direct involvement of CK in asthma protection via inhibition of airway hyperresponsiveness and reduction of airway mucin.

Typical cutaneous small-vessel vasculitis induced by combined injection of antiphosphatidylserine/prothrombin complex antibody and anti-LAMP-2 antibody in normal rats. We previously reported that IgA vasculitis and cutaneous arteritis could be dependently associated with the presence of the antiphosphatidylserine/prothrombin complex (anti-PS/PT) antibody and lysosomal-associated membrane protein-2 (LAMP-2). The copy number of LAMP-2 mRNA in skin tissue samples from rats with cutaneous vasculitis induced by intravenous administration of anti-PS/PT antibody after subcutaneous histone injection was significantly higher than in those without cutaneous vasculitis. We found LAMP-2 protein overexpression in neutrophils and vascular endothelial cells of the affected blood vessels in rats with cutaneous vasculitis induced by intravenous administration of anti-PS/PT antibody after cutaneous priming by histones. We found typical cutaneous small-vessel vasculitis in the skin of rats given intravenous injection of both anti-PS/PT antibody and anti-LAMP-2 antibody after cutaneous priming by histones. We suggested that the introduction of skin local histones and anti-PS/PT antibody in serum could move LAMP-2 to the cell surface of neutrophils and vascular endothelial cells, and that anti-LAMP-2 antibody could bridge these cells through antigen-specific binding in typical cutaneous small-vessel vasculitis.

"We're not broken. We're human." A qualitative meta-synthesis of health-care providers' experiences participating in well-being programs. Protecting health-care provider (HCP) well-being is imperative to preserve health-care workforce capital, performance, and patient care quality. Limited evidence exists for the long-term effectiveness of HCP well-being programs, with less known about physiotherapists specifically. To review and synthesize qualitative research describing experiences of HCP, generate lessons learned from the greater population of HCP participating in workplace well-being programs, and then to inform programs and policies for optimizing psychological well-being in an understudied population of physiotherapists. This qualitative meta-synthesis included a systematic literature search conducted in September 2020; critical appraisal of results; and data reduction, re-categorizing, and thematic extraction (reciprocal translation) with interpretive triangulation. Twenty-five papers met the inclusion criteria. Participants included physicians, nurses, and allied health providers. All programs targeted the individual provider and included psychoeducational offerings, supervision groups, coaching, and complementary therapies. Four themes were constructed: 1) beneficial outcomes across a range of programs; 2) facilitators of program success; 3) barriers to program success; and 4) unmet needs driving recommendations. The findings enhance our understanding of diverse individual-level programs to address HCP well-being. Beneficial outcomes were achieved across program types with system-level support proving critical; however, HCP described barriers to program success (HCP characteristics, off-site programs, institutional culture) and remaining needs (resources, ethical dissonance) left unaddressed. Organizations should offer individual-level programs to support physiotherapists in the short term while pursuing long-term, system-level change to address drivers of well-being.

The teaching of geriatric dentistry in South Korean dental schools. The purpose of this study was to investigate the curriculum of geriatric dentistry for undergraduates in Korean dental schools. For development purposes, it was necessary to compare geriatric dentistry education programmes in South Korea to programmes in the United States and Europe. The most recent curriculum and related information on geriatric dentistry at the undergraduate level in all 11 dental schools in South Korea were collected by both official letter and e-mail. A symposium for gathering expert opinions to improve geriatric dentistry education in South Korea was also held. The collected data were analysed, and the expert opinions at the symposium were summarised. Six of 11 schools had a didactic course as compulsory and three schools as elective. The course was usually conducted as a form of integrated lectures, and the level of standardisation of lecture content was very low. There were no topics for older people who cannot access dental clinics due to functional frailty or disability. No dental school-affiliated hospitals had an independent department for geriatric dentistry. No schools provided clinical teaching for geriatric dentistry. There were no outreach programmes for geriatric dentistry. The educational curriculum for geriatric dentistry in South Korea was insufficient to cope with social and demographic changes. Curriculum content should include clinical practice education and needs to be focused on frail and dependent older adult patients. An essential educational curriculum and core competency for geriatric dentistry should be prepared.

Atomic force microscopy probing interactions and microstructures of ionic liquids at solid surfaces. Ionic liquids (ILs) are room temperature molten salts that possess preeminent physicochemical properties and have shown great potential in many applications. However, the use of ILs in surface-dependent processes, e.g. energy storage, is hindered by the lack of a systematic understanding of the IL interfacial microstructure. ILs on the solid surface display rich ordering, arising from coulombic, van der Waals, solvophobic interactions, etc., all giving near-surface ILs distinct microstructures. Therefore, it is highly important to clarify the interactions of ILs with solid surfaces at the nanoscale to understand the microstructure and mechanism, providing quantitative structure-property relationships. Atomic force microscopy (AFM) opens a surface-sensitive way to probe the interaction force of ILs with solid surfaces in the layers from sub-nanometers to micrometers. Herein, this review showcases the recent progress of AFM in probing interactions and microstructures of ILs at solid interfaces, and the influence of IL characteristics, surface properties and external stimuli is thereafter discussed. Finally, a summary and perspectives are established, in which, the necessities of the quantification of IL-solid interactions at the molecular level, the development of in situ techniques closely coupled with AFM for probing IL-solid interfaces, and the combination of experiments and simulations are argued.

Garnet-structured persistent luminescence phosphor Ca3Al2Ge3O12:Cr3+ for dynamic anticounterfeiting applications. Fluorescent materials have gradually become a hot spot in the field of anti-counterfeiting. Multifunctional phosphors used in anti-counterfeiting designs still have the problems of disordered reading sequences, difficulty in detection, and easy forging. To resolve these problems, we propose a new flexible dual-mode anti-counterfeiting design using a series of phosphors Ca3Al2Ge3O12:Cr3+ (CAG) with deep red persistent luminescence peaking at 722 nm. By adjusting the doping concentration of Cr3+ from 2% to 6%, deep red persistent luminescence with different afterglow intensities and durations can be achieved. By performing a series of thermoluminescence (TL) experiments under different conditions, the defects in materials were comprehensively and systematically analyzed. The defects contributed to the deep and shallow traps; this led to an obvious improvement in its long persistent luminescence (LPL). Such a dual-mode system with flexibility and simplicity properties is a good choice not only for anti-counterfeiting, but also for multi-layer information encryption, and a series of demo experiments based on the digital tube, Moss code, QR code, bar-code, school celebration pattern, and love letter information encryption design were implemented. Their dynamic anti-counterfeiting applications have been demonstrated, which provides a new way to rationally design multi-functional luminescent materials.

Fitness of real-world data for clinical trial data collection: Results and lessons from a HARMONY Outcomes ancillary study. Despite the extensive use of real-world data for retrospective, observational clinical research, our understanding of how real-world data might increase the efficiency of data collection in patient-level randomized clinical trials is largely unknown. The structure of real-world data is inherently heterogeneous, with each source electronic health record and claims database different from the next. Their fitness-for-use as data sources for multisite trials in the United States has not been established. For a subset of participants in the HARMONY Outcomes Trial, we obtained electronic health record data from recruiting sites or Medicare claims data from the Centers for Medicare & Medicaid Services. For baseline characteristics and follow-up events, we assessed the level of agreement between these real-world data and data documented in the trial database. Real-world data-derived demographic information tended to agree with trial-reported demographic information, although real-world data were less accurate in identifying medical history. The ability of real-world data to identify baseline medication usage differed by real-world data source, with claims data demonstrating substantially better performance than electronic health record data. The limited number of lab results in the collected electronic health record data matched closely with values in the trial database. There were not enough follow-up events in the ancillary study population to draw meaningful conclusions about the performance of real-world data for identification of events. Based on the conduct of this ancillary study, the challenges and opportunities of using real-world data within clinical trials are discussed. Based on a subset of participants from the HARMONY Outcomes Trial, our results suggest that electronic health record or claims data, as currently available, are unlikely to be a complete substitute for trial data collection of medical history or baseline lab results, but that Medicare claims were able to identify most medications. The limited size of the study population prevents us from drawing strong conclusions based on these results, and other studies are clearly needed to confirm or refute these findings.

Promotion of collagen mineralization and dentin repair by succinates. Biomineralization of collagen fibers is regulated by non-collagenous proteins and small biomolecules, which are essential in bone and teeth formation. In particular, small biomolecules such as succinic acid (SA) exist at a high level in hard tissues, but their role is yet unclear. Here, our work demonstrated that SA could significantly promote intrafibrillar mineralization in two- and three-dimensional collagen models, where the relative mineralization rate was 16 times faster than the control group. Furthermore, the FTIR spectra and isothermal experimental results showed that collagen molecules could interact with SA via a hydrogen bond and that the interaction energy was about 4.35 kJ mol-1. As expected, the SA-pretreated demineralized dentin obtained full remineralization within two days, whereas it took more than four days in the control group, and their mechanical properties were considerably enhanced compared with those of the demineralized one. The possible mechanism of the promotion effect of SA was ultimately illustrated, with SA modification strengthening the capacity of the collagen matrix to attract more calcium ions, which might create a higher local concentration that could accelerate the mineralization of collagen fibers. These findings not only advance the understanding of the vital role of small biomolecules in collagen biomineralization but also facilitate the development of an effective strategy to repair hard tissues.

HyFactor: A Novel Open-Source, Graph-Based Architecture for Chemical Structure Generation. Graph-based architectures are becoming increasingly popular as a tool for structure generation. Here, we introduce novel open-source architecture HyFactor in which, similar to the InChI linear notation, the number of hydrogens attached to the heavy atoms was considered instead of the bond types. HyFactor was benchmarked on the ZINC 250K, MOSES, and ChEMBL data sets against conventional graph-based architecture ReFactor, representing our implementation of the reported DEFactor architecture in the literature. On average, HyFactor models contain some 20% less fitting parameters than those of ReFactor. The two architectures display similar validity, uniqueness, and reconstruction rates. Compared to the training set compounds, HyFactor generates more similar structures than ReFactor. This could be explained by the fact that the latter generates many open-chain analogues of cyclic structures in the training set. It has been demonstrated that the reconstruction error of heavy molecules can be significantly reduced using the data augmentation technique. The codes of HyFactor and ReFactor as well as all models obtained in this study are publicly available from our GitHub repository: https://github.com/Laboratoire-de-Chemoinformatique/HyFactor.

Berberine inhibits the development of endometrial cancer through circ_ZNF608/miR-377-3p/COX2 axis. Endometrial carcinoma (EC) is a common malignant tumour in women. Berberin (BBR) is an alkaloid with anti-tumour activity, and circular RNA (circRNAs) has been extensively studied in cancers. However, whether BBR regulates the development of EC by regulating circular RNA zinc finger protein 608 (ZNF608) is unknown. Different concentrations of BBR were used to treat endometrial cancer cells. A quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to assess the expression of circ_ZNF608, microRNA-377-3p (miR-377-3p) and cyclooxygenase 2 (COX2). The expression of COX2 protein was detected by western blot. The effect of circ_ZNF608 in BBR-treated EC cells was verified by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay, thymidine analog 5-ethynyl-2'-deoxyuridine (EdU) assay, colony formation assay, transwell, and flow cytometry. The effect of BBR and circ_ZNF608 on tumour growth was evaluated by xenograft tumour model in vivo. Berberine can inhibit the proliferation and metastasis of EC cells and promote apoptosis, which is related to the concentration. Circ_ZNF608 and COX2 were abnormally increased, while the levels of miR-377-3p were reversed in EC tissues and cells. Overexpression of circ_ZNF608 can restore the inhibitory effect of BBR on EC cells. In addition, circ_ZNF608 restored the inhibitory effect of BBR on EC cells by inhibiting the expression of miR-377-3p. Similarly, MiR-377-3p/COX2 can regulate the tumour progression of EC under BBR. Finally, BBR can inhibit the growth of endometrial carcinoma in vivo. BBR was found to inhibit EC via the circ_ZNF608/miR-377-3p/COX2 axis, which is helpful in endometrial carcinoma.

Self-Defense and Police Reporting of Intimate Partner Violent Victimization: A Comparison of White, Black, and Hispanic Women Victims. Although the use of self-defense is common in incidents of intimate partner violence (IPV), correlates of self-protective behaviors in IPV are less known. Furthermore, while research has examined the unintended consequence of dual arrest as a result of using self-defense in IPV incidents, research has not examined whether self-defense is associated with the likelihood of reporting the victimization to the police. The purpose of this study is to first examine the racial differences in the use of self-defense in incidents of IPV. Second, this study examines the relationship between the use of physical self-defense and formal help-seeking (i.e., calling the police) and whether those relationships vary across race/ethnicity for White, Black, and Hispanic women. Using a large nationally representative sample of IPV incidents in the United States, this study found that incidents with Black female victims were more likely to feature physical self-defense compared to incidents with White female victims. Furthermore, incidents with Black female victims were more likely to be reported to the police. There was a positive relationship between physical self-defense and reporting to the police for Black women and an inverse relationship between physical self-defense and reporting to the police for Hispanic women.

Feasibility, usability and clinical value of intensive longitudinal diary assessments in older persons with cognitive impairment and depressive symptoms. To evaluate the feasibility, usability and clinical value of daily diary assessments combined with actigraphy in older persons with cognitive impairment. For 63 days, patients ≥60 years with cognitive impairments filled out a daily diary (including standardized questionnaires and cognitive test battery), and wore an actiwatch (sleep). After the study, participants and clinicians received personal feedback about patterns and daily triggers of depressive symptoms, sleep and cognitive performance. We assessed feasibility (participation rate, compliance and subjective burden), usability (variability and floor- or ceiling effects) and clinical value for patients and their clinicians (questionnaires). Of 96 eligible patients, 13 agreed to participate (13.5%). One patient dropped out after 2 days, another after 37 days, and another did not complete the cognitive test battery. Compliance rate was high (6.7-10% missing values). Subjective burden was relatively low. Time-series data showed sufficient variability and no floor- or ceiling effects, except for one relevant ceiling effect on the One Back task. The personal feedback report was considered insightful by 4 out of 11 participants and 5 out of 7 clinicians. Daily assessments are suitable for a minority of cognitively impaired older persons, but is helpful to increase insight into their symptoms.

Carotenoid Cleavage Dioxygenase 1 Catalyzes Lutein Degradation To Influence Carotenoid Accumulation and Color Development in Foxtail Millet Grains. Foxtail millet is a minor but economically important crop in certain regions of the world. Millet color is often used to judge grain quality, yet the molecular determinants of millet coloration remain unclear. Here, we explored the relationship between SiCCD1 and millet coloration in yellow and white millet varieties. Carotenoid levels declined with grain maturation and were negatively correlated with SiCCD1 expression, which was significantly higher in white millet as compared to yellow millet during the color development stage. Cloning of the SiCCD1 promoter and CDS sequences from these different millet varieties revealed the presence of two additional cis-regulatory elements within the SiCCD1 promoter in white millet varieties, including an enhancer-like GC motif element associated with anoxic specific inducibility and a GCN4-motif element associated with endosperm expression. Dual-luciferase reporter assays confirmed that SiCCD1 promoter fragments containing these additional cis-acting elements derived from white millet varieties were significantly more active than those from yellow millet varieties, consistent with the observed SiCCD1 expression patterns. Further in vitro enzyme detection assays confirmed that SiCCD1 primarily targets and degrades lutein. Together, these data suggest that SiCCD1 promoter variation was a key factor associated with the observed differences in SiCCD1 expression, which in turn led to the difference in millet coloration.

Photodistributed eruptive telangiectasias: an uncommon adverse drug reaction. A retrospective case series. Drug-induced photodistributed telangiectasia (PT) is a cutaneous adverse effect (AE) resulting from the interaction of ultraviolet radiation with pharmacotherapy. Reports of PT in the literature are scarce. We report 25 cases of drug-induced PT highlighting the potential relationship between the onset of skin lesions, drug intake and photo exposure. We alert practitioners that PT is a possible dermatological phototoxic AE of many drugs.

Chemical composition of essential oil and antioxidant activity of the essential oil and methanol extracts of Knema globularia (Lam.) Warb. from Vietnam. This study is the first to investigate the chemical composition of essential oil and antioxidant activity of the essential oil and methanol extracts from the leaves of Knema globularia (Lam.) Warb. from Vietnam. According to gas chromatography and gas chromatography-mass spectrometry analysis, the major constituents of K. globularia essential oil were β-elemene (25.48%), α-copaene (17.05%), β-caryophyllene (9.37%), and α-humulene (8.42%). The antioxidant activity of the samples was determined using DPPH and ABTS methods. In both assays, the polar subfraction of the methanolic extract showed better antioxidative capacity than the nonpolar subfraction and the essential oil. In addition, the amounts of total phenol value in the polar subfraction and the nonpolar subfraction were determined to be 113.84 μg/mg and 47.52 μg/mg, respectively. The findings demonstrate that the essential oil and methanol extracts of K. globularia possess significant antioxidant activities and may be a new potential source of natural antioxidants.

Identified potential biomarkers may predict primary nonresponse to infliximab in patients with ulcerative colitis. Primary nonresponse to infliximab in patients with ulcerative colitis (UC) is common. However, there are currently no effective biomarkers for this prediction. This study aimed to identify potential predictors for precision anti-tumor necrosis factor-alpha treatment in patients with UC. Four GPL570 datasets (GSE14580, GSE12251, GSE23597, and GSE16879) were included in this study. Sixty-nine differentially expressed genes (DEGs) were identified, while 67 were up-regulated and two were down-regulated by comparing the gene expression in response samples with the nonresponse samples. Gene Ontology analysis showed that DEGs were mostly enriched in neutrophil-mediated immunity, neutrophil activation, neutrophil activation involved in the immune response, neutrophil degranulation, and leukocyte migration. Kyoto Encyclopaedia of Genes and Genomes analysis indicated that these DEGs were mostly enriched in cytokine-cytokine receptor interactions and interleukin (IL)-17 signalling pathways. After protein-protein interaction network analysis, verification by test set, and confirmation of clinical UC samples, S100 calcium-binding protein A8 (S100A8), S100A9, triggering receptor expressed on myeloid cells 1 (TREM1), toll-like receptor 2 (TLR2), IL1B, and formyl peptide receptor 1 (FPR1) were identified as the hub genes. We found that the immune cell composition in the intestinal tissues of UC patients with primary nonresponse included naïve CD4+ T cells, memory resting CD4+ T cells, resting natural killer cells, resting dendritic cells, activating dendritic cells, eosinophils, and neutrophils. Among these, neutrophils showed the most significant differences. In addition, all six potential predictors were significantly associated with the neutrophil count. Our study identified six potential biomarkers, namely S100A8, S100A9, TREM1, TLR2, IL1B, and FPR1, and one type of immune cell, neutrophils, between UC patients with response and primary nonresponse to infliximab. We speculated that changes in the expression of these six potential biomarkers combined with changes in the activity or local quantity of neutrophils might help predict primary nonresponse to infliximab in patients with UC.

Antibacterial activity and chemical characterization of almond (Prunus dulcis L.) peel extract. In this study, almond skin of Prunus dulcis L. variety Casteltermini was characterised for its chemical composition and for the inhibitory activity towards food associated microorganisms belonging to pathogenic (Salmonella Enteritidis, Staphylococcus aureus, Escherichia coli and Listeria monocytgenes), spoilage (Pseudomonas poae and Brochotrix thermospacta) and useful (Levilactobacillus brevis and Saccharomyces cerevisiae) groups. The n-hexane extract of P. dulcis skin, investigated by GC-MS, evidenced linoleic, palmitic, and oleic acids as the main abundant compounds. Staphylococcus aureus ATCC 33862 growth was strongly limited by n-hexane extract and the minimum inhibition concentration (MIC) was 25.5 mg/mL. These results highlight the potential of almond by-products as food bio-preservatives as well as pharmaceutical products.

A new alkaloid and two organic acids from Portulaca oleracea L. and their bioactivities. A new alkaloid, identified as 1-benzyl-2-nitroso-1,2,3,4-tetrahydroisoquinoline-6,7-diol, named oleraisoquinoline (1), and five organic acids and two esters, identified as 5-(hydroxymethyl)furan-2-carboxylic acid (2), 1H-pyrrole-2,5-dicarboxylic acid (3), (7E,10E)-octadeca-7,10-dienoic acid (4), (10E,13E)-octadeca-10,13-dienoic acid (5), (7E,10E)-hexadeca-7,10-dienoic acid (6), methyl tridecanoate (7) and methyl (9E,12E)-octadeca-9,12-dienoate (8), were isolated from Portulaca oleracea L., among which compounds 2 and 4‒7 were isolated for the first time. Moreover, the anti-inflammatory activities of compounds 1‒3 were studied, especially, compound 1 presented good inhibitory effects on the production of inflammatory factors IL-1β and TNF-α.

Influence of the Somatic Rubber Hand Illusion on Maximum Grip Aperture. The classic rubber hand illusion (RHI), based on visual, proprioceptive, and tactile feedback, can affect actions. However, it is not known whether these effects still occur if the paradigm is administered without visual feedback. In this study, we used the somatic RHI to test in thirty-two healthy individuals whether the incorporation of the rubber hand based on proprioceptive and tactile information only is sufficient to generate changes in actions. We measured maximum grip aperture (GA) changes towards a target and associated brain activations within the dorsal stream before and after the somatic RHI. Behavioural and neuroimaging data do not support an effect on maximum GA when the RHI is based on proprioceptive and tactile information only.

Carbon electrode obtained via pyrolysis of plasma-deposited parylene-C for electrochemical immunoassays. In this study, parylene-C films from plasma deposition as well as thermal deposition were pyrolyzed to prepare a carbon electrode for application in electrochemical immunoassays. Plasma deposition could prepare parylene-C in a faster deposition rate and more precise control over the thickness in comparison with the conventional thermal deposition. To analyze the influence of the deposition method, the crystal and electronic structures of the pyrolyzed parylene-C films obtained via both deposition methods were compared using Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and Raman spectroscopy. For application as a carbon electrode in immunoassays, the electrochemical properties of the pyrolyzed carbon films from two both deposition methods were analyzed, including the double layer capacitance (2.10 μF cm-2 for plasma deposition and 2.20 μF cm-2 for thermal deposition), the apparent electron transfer rate (approximately 1.1 × 10-3 cm s-1 for both methods), and the electrochemical window (approximately -1.0 ∼ 2.1 V for both methods). Finally, the applicability of the pyrolyzed carbon electrode from parylene-C was demonstrated for the diagnosis of human hepatitis-C using various amperometric methods, such as cyclic voltammetry, chronoamperometry, square-wave voltammetry and differential pulse voltammetry.

Vasomotor symptoms, cardiovascular risk factors, and cardiovascular disease risk among Chinese postmenopausal women in Hong Kong. Vasomotor symptoms are frequently reported by postmenopausal women and linked with unfavorable changes in cardiovascular risk factors, suggesting a likely association with cardiovascular disease (CVD) risk. This study aimed to investigate the characteristics of and associations between vasomotor symptoms, cardiovascular risk factors, and CVD risk among Chinese postmenopausal women. From March 2018 to August 2019, a convenience sample of 288 postmenopausal women who experienced natural menopause for ≥12 months were recruited from district centers of women associations in Hong Kong. We assessed vasomotor symptoms, cardiovascular risk factors, and CVD risk using questionnaires, anthropometric measures, and laboratory testing of fasting blood samples. Data were analyzed using bivariate correlation analyses and linear regression analyses. Over half of the participants experienced vasomotor symptoms (50.3 percent), and 23.3 percent had a high 10-year CVD risk. After adjusting for sociodemographic and clinical variables, flashing (β = 0.270, P = .002) and sweating (β = > -0.206, P = .018) were significantly associated with low-density lipoprotein cholesterol and flashing (β = 0.229, P = .007) were significantly associated with total cholesterol. No statistically significant association was observed between vasomotor symptoms and CVD risk. Vasomotor symptoms were common and associated with several cardiovascular risk factors in Chinese postmenopausal women.

One-step synthesis of uniformly distributed SiOx-C composites as stable anodes for lithium-ion batteries. SiOx is one of the most promising anode materials for lithium-ion batteries (LIBs), due to its high theoretical capacity and low cost. However, the huge volume expansion and low electron/ion diffusion rate hinder its further commercial applications. Herein, a simple molecular polymerization method is developed to synthesize N,P co-doped SiOx-C composites (denoted as SiOx-C@CNT), in which SiOx and carbon are uniformly dispersed at the atomic level, and the embedded carbon nanotubes improve the lithium ion diffusion kinetics. Benefiting from the unique structure, the SiOx-C@CNT composites exhibit a high reversible capacity of 848 mA h g-1 at 0.1 A g-1 and long cycling stability (84.0% capacity retention after 1500 cycles). More impressively, the LiCoO2∥SiOx-C@CNT full battery also exhibits stable cycle life (only 4.7% capacity loss after 300 cycles at 1 C). These results show the application potential of the SiOx-C@CNT anode in LIBs.

Drug-drug interactions between psychotropic medications and oral contraceptives. This is a comprehensive overview of pharmacokinetic drug-drug interactions (DDIs) involving oral contraceptives (OCs) and psychotropic medications. Medline and Embase from inception to April 2021 were searched for DDIs between OCs and psychotropic medications. They included case reports/series and cross-sectional, cross-over, placebo-controlled studies of patient cohorts and healthy females. We classified DDIs as: combined hormonal contraceptives (CHCs) acting as victim drugs (i.e. affected by psychotropic co-medications), CHCs as perpetrators, (i.e. affecting the activity of psychotropic co-medications), progestin-derivatives as victim drugs and progestin-derivatives affecting psychotropic co-medications. Alteration ratios reflecting changes in pharmacokinetic parameters before and after the DDI were estimated to approximate the extent of the DDI. Women taking antiepileptic agents with strong to moderate enzyme-inducing properties (carbamazepine, phenobarbital, phenytoin) or those with moderate to mild enzyme-inducing properties (cenobamate, clobazam, eslicarbazepine, felbamate, oxcarbazepine, rufinamide, topiramate) should avoid OCs. Daily doses of cytochrome P450 1A2 substrates including clozapine may need to be reduced by 50% in women taking concomitant CHCs. Compared to CHCs, the propensity of progestin-only pills for DDIs has been investigated less. We provide a summary table for clinicians containing recommendations based on literature and package inserts; whenever evidence was available, we provided dose-correction factors.

Analysis of factors affecting the time for implantation of a total hip arthroplasty in patients with symptomatic primary and secondary hip osteoarthritis. Many studies have identified factors associated with an unfavourable clinical outcome or an early conversion to total hip arthroplasty (THA) after joint-preserving treatment. We analysed the effect and reliability of different factors on the age at which THA becomes necessary. Hip joint radiographs of 2485 cases were evaluated using the lateral centre-edge angle (LCEA) and acetabulum angle (ACA) as well as the alpha angle to describe the femoral head shapes. Regressions were performed using patient's age at the time of THA and body mass index (BMI) as well as LCEA and ACA. Multiple linear regressions were used to create a formula comprising factors that significantly correlated with patient age at the time of joint replacement surgery. The BMI, LCEA, and ACA showed significant correlations with the age of THA implantation (p < 0.001). Multiple linear regressions produced the following formula: age (THA) = 72.40-0.40 × BMI + 0.20 × LCEA-0.18 × ACA. BMI showed a stronger impact on the age of end-stage osteoarthritis than the ACA. The formula explained 12.1% of the distributing data (r2). Surprisingly, the alpha angle did not show an impact on the age of THA surgery. BMI had the greatest impact on patient's age at the time of THA, followed by the characteristic radiological angles for hip dysplasia. The resulting formula could emphasise and visualise the significant impact of these factors. However, despite the calculation being based on 2485 cases, the calculated validity of 12.1% was limited.

Non-heme oxoiron complexes as active intermediates in the water oxidation process with hydrogen/oxygen atom transfer reactions. In this study, we explore the water oxidation process with the help of density functional theory. The formation of an oxygen-oxygen bond is crucial in the water oxidation process. Here, we report the formation of the oxygen-oxygen bond by the N5-coordinate oxoiron species with a higher oxidation state of FeIV and FeV. This bond formation is studied through the nucleophilic addition of water molecules and the transfer of the oxygen atom from meta-chloroperbenzoic acid (mCPBA). Our study reveals that the oxygen-oxygen bond formation by reacting mCPBA with FeVO requires less activation barrier (13.7 kcal mol-1) than the other three pathways. This bond formation by the oxygen atom transfer (OAT) pathway is more favorable than that achieved by the hydrogen atom transfer (HAT) pathway. In both cases, the oxygen-oxygen bond formation occurs by interacting the σ*dz2-2pz molecular orbital of the iron-oxo intermediate with the 2px orbital of the oxygen atom. From this study, we understand that the oxygen-oxygen bond formation by FeIVO with the OAT process is also feasible (16 kcal mol-1), suggesting that FeVO may not always be required for the water oxidation process by non-heme N5-oxoiron. After the oxygen-oxygen bond formation, the release of the dioxygen molecule occurs with the addition of the water molecule. The release of dioxygen requires a barrier of 7.0 kcal mol-1. The oxygen-oxygen bond formation is found to be the rate-determining step.

Evidence for zero-field slow magnetic relaxation in a Co(II) complex with a pseudo-tetrahedral N2I2 environment. Herein, we report on the synthesis, structure and magnetic properties of a four-coordinate mononuclear Co(II) diiodide complex with the 3,5-dimethylpyrazole ligand. A distorted tetrahedral local coordination environment around the central cobalt ion is formed by the two nitrogen atoms of two monodentate pyrazole ligands and by iodide ions. Direct current (dc) magnetic measurements in combination with ab initio SA-CASSCF/NEVPT2 quantum-chemical calculations revealed a strong easy-axis-type magnetic anisotropy with a record value Dexp = -30.58(3) cm-1 of the axial zero field splitting parameter for pseudo-tetrahedral Co(II)-based CoL2Hal2 complexes. Moreover, it is the only complex in this series demonstrating the slow relaxation of magnetization at zero dc field. The Orbach process is shown to be the dominant mechanism of magnetic relaxations in the high temperature range, while the quantum tunneling of magnetization produces the leading contribution to the overall relaxation at temperatures below 4 K.

Unveiling the hybridization between the Cr-impurity-mediated flat band and the Rashba-split state of the α-Au/Si(111) surface. Adsorption of foreign atoms onto 2D materials can either lead to ordinary electron doping or the emergence of new electronic effects including topology, superconductivity, and quantum anomalous Hall and Kondo states. We have investigated the effect of Cr doping on the electronic structure of the α-Au/Si(111)- surface and its adsorbate-modified family. It has been found that below a critical coverage of ∼0.05 monolayer, Cr adatoms penetrate beneath the Au and topmost Si layers and induce the occupied resonance flat band in the electronic spectrum as revealed by angle-resolved photoelectron spectroscopy. Further deposition of Cr leads to the growth of the 3D islands spoiling the surface homogeneity. Using density functional theory calculations, we have disclosed the effects of Cr doping on the electronic band structure and revealed the nature of hybridization between the Cr-induced magnetic-split band and the Au-induced Rashba-split surface state. We believe that the synthesized 2D phases and electronic effects produced by magnetic atom doping in the ultimate two-dimensional limit will stimulate further investigations related to the highly correlated phases and will find practical applications in nanoelectronic devices.

Rebound sign: a case report and review of literature. We reviewed previously reported imaging features of coronary air embolism. We also reported an unusual image 'rebound sign' of proximal coronary artery air embolism for the first time, that is, with the regular contraction and relaxation of the heart, the contrast medium near the embolus rebounds regularly, and the smooth gas-liquid boundary is alternately clear and blurred. We conclude that myocardial bridge plays a role in the formation of 'rebound sign.'Abbreviations: CAE: Coronary Air Embolism; CAG: Coronary Angiography; RCA: Right Coronary Artery; LCA: Left Coronary Artery; LAD: Left Anterior Descending Coronary Artery; LCX: Left Circumflex Artery; MB: Myocardial Bridge; STEMI: ST Segment Elevation Myocardial Infarction; TOE: Transesophageal Echocardiography.

Some miRNA expressions and their targets in ischemic stroke. Ischemic stroke (IS) is a global health challenge leading to life-long disabilities or the deaths of patients. IS is a complex disease where genetic and environmental factors are both concerned with the pathophysiology of the condition. Here, we aimed to investigate various microRNA (miRNA) expressions and their targets in IS. A rapid and accurate diagnosis of acute IS is important to perform appropriate treatment. Therefore, there is a need for a more rapid and simple tool to carry out an acute diagnosis of IS. miRNAs are small RNA molecules serving as precious biomarkers due to their easy detection and stability in blood samples. The present systematic review aimed to summarize previous studies investigating several miRNA expressions and their targets in IS.

Effects of hydrophilic fullerene nanoarchitectured structures on the behaviour of neural stem cells. The interaction between nanoarchitectonic fullerenes and cells is essential for their applications in the biological field. Herein we reported the preparation and investigation of the function of different types of water-dispersible self-assembled fullerenes. The hydrophobic self-assembled fullerenes were either surface-modified or chemically etched to become water dispersible. Different types of fullerenes were then examined for their effects on the behavior of neural stem cells (NSCs). Our results indicated that only the hydrophilic fullerene nanotubes (FNTs, diameter ∼480 nm) created by chemically etching were endocytosed by NSCs, which showed a spindle-like morphology after the uptake. Meanwhile, the FNTs did not increase the reactive oxygen species (ROS) production of the cells. The expression levels of neural-related genes (CNPase and β-tubulin) were upregulated 1.5-fold in the presence of FNTs. The differentiation of NSCs depended on the size, shape, and surface functional group of various fullerenes. Besides, the addition of FNTs in a chitosan self-healing hydrogel did not influence the integrity, injectability, and self-healing properties of the composite hydrogel. These results revealed that FNTs induced the neural differentiation of NSCs in the composite hydrogel. The addition of FNTs at a low concentration (50 μg mL-1) was enough to create such effects in the composite hydrogel. The expression levels of the oligodendrocytic marker gene CNPase and the neuronal marker gene β-tubulin were increased remarkably by ∼14.5- and ∼8.4-fold, respectively, by the composite self-healing hydrogel containing 50 μg mL-1 FNTs. The fullerene nanoarchitectured structures may have potential for use as nanovehicles and in neural tissue engineering in the future.

Insurance-based disparities impact survival outcomes in Waldenström macroglobulinemia within the United States. Considerable healthcare resource utilization and financial burden have been associated with the treatment of WM; however, the impact of health insurance status on outcomes has not been previously reported. We conducted a National Cancer Database analysis of newly diagnosed cases of active WM between 2004 and 2017 to evaluate the impact of insurance status on outcomes. For patients <65 years old (n = 1249, male sex: 62.4%, median age: 58 years), significant insurance-based survival differences were observed on multivariable analysis; patients who were uninsured [n = 63; HR 3.11 (95%CI, 1.77-5.45), p < 0.001], on Medicaid [n = 87; HR 1.88 (95% CI, 1.01-3.48), p = 0.045], or on Medicare [n = 122; HR 2.78 (95%CI, 1.76-4.38), p < 0.001], had inferior survival compared to patients with private insurance (n = 977; reference). In patients ≥65 years, no insurance-based survival differences were found (p = 0.10). Overall, significant insurance-based outcome disparities exist in WM. Further work is desperately needed to systematically uncover and address these disparities.

PO-containing dibenzopentaarenes: facile synthesis, structures and optoelectronic properties. Incorporation of heteroatoms into polyarenes has been developed as an effective approach to alter their intrinsic structures and properties. Herein, we designed and synthesized two PO-containing dibenzopentaarene isomers (5a and 5b) and studied their structures and properties, along with those of dibenzopentaarenes containing six-membered Si- and B-heterocycles (3 and 4). These heterocyclic polyarenes have similar frameworks to well-known heptazethrene, and thus can be regarded as members of the heteroatom-doped zethrene system. The heterocycles greatly affect not only the molecular and packing structures but also the electronic structures and properties. Notably, while compounds 3 and 4 adopt almost planar geometries, 5a possesses a clearly curved conformation, leading to its brick-type slipped and dense π-π stacking mode. Moreover, the electron-withdrawing PO groups endow 5a and 5b with simultaneously lowered lowest unoccupied molecular orbital (LUMO)/highest occupied molecular orbital (HOMO) levels, whereas the p-π conjugation of the B atoms in 4 leads to its smaller energy gap and thus remarkably red-shifted absorption and fluorescence bands by over 80 nm, though all of these molecules possess similar closed-shell structures. This study thus deepens the understanding of heteroatom-doping effects, which may be expanded to develop other heteroatom-doped zethrene materials.

Computerized working memory training in males with Duchenne muscular dystrophy: A single case experimental design study. Learning disabilities (LDs) and working memory problems (WM) are common brain-related comorbidities in Duchenne muscular dystrophy (DMD). Despite growing evidence on the efficacy of computerized WM training in children with LDs, research in DMD is lacking. This exploratory study assessed whether training (1) improves dystrophin-associated WM problems in DMD, (2) effects are present at post-intervention, 3 and 8 months follow-up, and (3) improves problems that arise from their LDs. A single case non-concurrent multiple baseline across patients design evaluated the target behaviour i.e. parental reports of WM problems of four DMD participants with LDs. Additionally, participants completed cognitive tests of verbal and visual WM, academics, attention, processing speed and fluid reasoning. Parents and teachers completed behavioural questionnaires. Testing and questionnaires were administered at baseline, post-intervention (T2), 3 (T3) and 8 (T4) months follow-up. Positive effects on target behaviour were found for three of four participants, but parental bias cannot be ruled out. Short and long-term, near-and far transfer effects were found for verbal and visual WM (T2:n = 2, T3&T4:n = 1), reading (T2:n = 4,T3:n = 3,T4:n = 2), arithmetic (all T:n = 1), processing speed (all T:n = 4) and fluid reasoning (T2:n = 1,T3&T4:n = 2). Behavioural questionnaires displayed minimal changes (T2:n = 1,T3&T4:n = 2). Promising WM training results are shown in DMD that merit further research.

"Music Therapy Was Never on the Table": Perspectives of Parents of Young Autistic Children. Parent coaching of music interventions is emerging as a viable model for families with young autistic children, yet recruitment difficulties have been apparent in previous studies. Understanding parent perspectives of early intervention services is critical to ensure that interventions are acceptable, feasible, and effective for all family members. In order to understand possible parental resistance to this type of parent education, we explored perspectives regarding music therapy, research, and parent coaching in parents of young autistic children. Fourteen parents attended virtual focus groups to discuss their experiences. We used a descriptive phenomenological approach to uncover the essence of their experience. Our findings indicate that, contrary to our preconceptions, participants did not show negative dispositions towards music therapy, research, or parent coaching. Instead, most participants had very little or no knowledge of music therapy services. They had limited experience with research in general, and only two participants had experienced music therapy directly. Several participants had varying amounts of experience with parent participation or parent coaching outside of music therapy and shared positive experiences with it. Parents seemed willing and eager to learn music strategies to support their children and saw value in the use of music for their child's development. First-contact providers (i.e., early interventionists and diagnosticians) and social media seem influential in parents' decision-making as they navigate early intervention services soon after diagnosis. Music therapy organizations are encouraged to design targeted efforts to make information on music therapy available through these sources.

Facile synthesis of a glutathione-depleting Cu(II)-half-salamo-based coordination polymer for enhanced chemodynamic therapy. Chemodynamic therapy (CDT), utilizing Fenton catalysts to convert intracellular H2O2 into toxic hydroxyl radicals (˙OH) to kill cancer cells, has a wide application prospect in tumor treatment because of its high selectivity. Its anticancer effect, however, is unsatisfactory due to the overexpressed glutathione (GSH). Herein, a GSH-depleting Cu(II)-half-salamo-based coordination polymer (CuCP) was prepared and validated by single crystal X-ray crystallography, Hirshfeld surface analyses and DFT calculations. The Cu(II) ions in the coordination polymer are five-coordinated bearing slightly twisted square pyramidal coordination environments and are bridged by phenoxy and alkoxy groups. After internalization by tumor cells, the CuCP could be biodegraded and reduced by GSH to generate a large amount of Cu(I), simultaneously depleting GSH. Subsequently, the Cu(I) ions interact with H2O2 to generate toxic ˙OH through a Fenton-like reaction to enhance their anticancer efficacy. Our study provides useful insights into designing smarter metal-based anticancer agents to improve the CDT efficiency in cancer therapy.

Impact of disturbance and dietary shift on gastrointestinal bacterial community and its invertebrate host system. The gut microbiome is one of the most important sites of host-microbe interactions, however, mechanisms governing the responses of host-associated microbes to changing environmental conditions are poorly understood. To address this, we investigated individual and combined effects of dietary changes and increase in salinity (from freshwater to salinity 3) or antibiotic concentration on the gastrointestinal bacterial community of the aquatic snail Ampullaceana balthica. In parallel, the energy reserves of the host were quantified. A change of natural food source to biofilm forming green algae Scenedesmus obliquus as well as the combined treatment of salinity and S. obliquus decreased the richness and changed the composition of the A. balthica gastrointestinal bacterial community. In these treatments Pseudomonas became the dominant bacterium. However, energy reserves of the host were higher in these treatments compared to the reference aquaria specimens and the combined treatment of antibiotics with S. obliquus. The presence of antibiotics inhibited the dominance of Pseudomonas and resulted in lower energy reserves despite S. obliquus feeding. Therefore the host seems to be able to adapt and replace its bacterial community composition to respond to mild changes in salinity and food source. Antibiotics in the water can disturb this self-regulating mechanism. Our study underlines the ability of aquatic macroinvertebrates to respond to sudden changes in food source and mild shifts in salinity. Moreover, it emphasizes the strong impact of the food source on the gastrointestinal microbiome and the importance of generalists during disturbance.

miR-8485 alleviates the injury of cardiomyocytes through TP53INP1. MicroRNAs (miRNAs) feature prominently in regulating the progression of chronic heart failure (CHF). This study was performed to investigate the role of miR-8485 in the injury of cardiomyocytes and CHF. It was found that miR-8485 level was markedly reduced in the plasma of CHF patients, compared with the healthy controls. H2 O2 treatment increased tumor necrosis factor-α, interleukin (IL)-6, and IL-1β levels, inhibited the viability of human adult ventricular cardiomyocyte cell line AC16, and increased the apoptosis, while miR-8485 overexpression reversed these effects. Tumor protein p53 inducible nuclear protein 1 (TP53INP1) was identified as a downstream target of miR-8485, and TP53INP1 overexpression weakened the effects of miR-8485 on cell viability, apoptosis, as well as inflammatory responses. Our data suggest that miR-8485 attenuates the injury of cardiomyocytes by targeting TP53INP1, suggesting it is a protective factor against CHF.

Pneumococcal vaccination-A literature review and practice guideline update. Streptococcus pneumoniae (pneumococcus) remains a significant cause of both mild infections such as otitis media, sinusitis, and bronchitis and more severe manifestations such as bacteremia, pneumonia, and invasive pneumococcal disease. Several key serotypes have been targeted in vaccine development due to their association with increased infectivity. Pneumococcal vaccines are available in two formulations, the unconjugated purified polysaccharide (PPSV) and the conjugated formulation (PCV), which leads to a more robust and prolonged immune response. There have been dramatic reductions in mortality attributed to invasive pneumococcal disease over the past 2 decades due to improved vaccination rates and improved serotype coverage with the existing arsenal of vaccines (PCV13 and PPSV23). Utilizing both conjugate and purified polysaccharide modalities in series has produced greater and lasting immunity. The development of both the PCV15 and the PCV20 vaccines provides an opportunity to use conjugated vaccines against a wider spectrum of pneumococcal serotypes. National guidelines have been updated to incorporate the new pneumococcal vaccines into clinical practice.

An Effective Chromatographic Method for Simultaneous Quantification of Antidiabetic Drugs Alogliptin Benzoate and Pioglitazone HCl in Their Tablet Dosage Form: Implementation to In vitro Dissolution Studies and Uniformity of Dosage Unit. In patients with Type 2 diabetes, a combination of Alogliptin and Pioglitazone medications, together with diet and physical activity, are used to improve glycemic control. Eco-friendly, cost-effective, and precise stability-indicating RP-HPLC method was developed and validated for the identification and quantification of Alogliptin and Pioglitazone in their tablet dosage form, as well as implementation to in vitro dissolution studies and uniformity of dosage unit. Isocratic separation is conducted at ambient temperature on the InertSustain C18 Analytical Column (150 × 4.6 mm, 5 μm) using mobile phase comprising 50 mM of ammonium dihydrogen phosphate and 5.0 mM of heptane sulfonic acid:acetonitrile (45:55, v/v) at a flow rate of 1.3 mL/minute. Calibration curves are conducted in the linearity range of 1-40 μg/mL of Alogliptin and 2.5-75 μg/mL of Pioglitazone with a correlation value >0.9995 and satisfactory recovery findings between 99 and 100%. The degraded samples are analyzed under relevant stress conditions as acidity, alkalinity, thermal and oxidation. The active components in finished products were subjected to a content uniformity test, which showed that they achieved the declared claim's acceptance standards (85-115%). Comparative in vitro dissolution studies are performed for generic products Inhibazone 12.5/30 mg FCT and Inhibazone 25/15 mg FCT against innovator products Oseni 12.5/30 mg FCT and Oseni 25/15 mg FCT at suitable FDA dissolution medium and different USP dissolution media and the results are similar. The metrics of the designed method were assessed according to ICH requirements, and all metrics, such as system suitability, linearity, recovery, robustness, LOD, LOQ, specificity and precision, were found to be within required tolerances and no overlapping was found for degradation peaks. Thence, the method can be used in quality control for the analysis of raw material, bulk, finish and stability.

Serious mental illness in healthcare and academia: A lived experience. WHAT IS KNOWN ON THE SUBJECT?: There are individuals living with serious mental illness in both healthcare and academia. The high stress nature of these fields can worsen or trigger mental illness, burnout, moral injury, and compassion fatigue in employees. Mental health nurses have the needed skillset to foster change in these settings. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper describes the holistic experiences of a nurse faculty member living with serious mental illness and highlights lessons learned in both healthcare and academic settings. In addition to insights from the experience, the paper also shares suggestions for moving forward, reducing burnout, and supporting employees in these fields. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This lived experience narrative showcases the effect that high-pressure occupations have on individuals with serious mental illness. Mental health nurses have the training and experience to transform the experiences of employees in healthcare and academia. Through assessment, deep listening, and powerful questioning, these nurses in partnership with the employees themselves can design and implement interventions that have a lasting impact for these populations. ABSTRACT: Introduction First-hand accounts from clients living with mental health challenges deepen provider understanding and offer direct insight into the lives of those with chronic mental illness. There is a gap in the literature surrounding the lived experience of serious mental illness in the professional setting. Aim This narrative outlines the challenges and opportunities for those living with serious mental illness in healthcare and academia. Methods The author reviewed personal journals and reflected upon her years as both a nurse and faculty member to highlight the experience of living with serious mental illness in these professions. Findings These high-pressure fields place inordinate demands on faculty and staff; yet, there are few organizational supports in place for employees. Despite the push to improve resiliency and ease burnout, healthcare organizations and academic institutions still struggle to identify the best interventions and methods of support for staff. Discussion Mental health nurses and nurse coaches are uniquely positioned to ease this burden and help create inclusive workplaces for those with serious mental illness.

What to expect when AGEP is induced by terbinafine? Case report and critical review of the literature. Acute Generalised Exanthematous Pustulosis (AGEP) is a rash with multiple sterile intraepidermal or subcorneal non-follicular pustules on edematous papules, with a sudden development and rapid evolution, triggered by drugs, vaccination, insect bites, exposure to mercury, and allergens. We describe a female patient who developed extensive and abnormally prolonged AGEP following exposure to terbinafine and SARS-CoV vaccine. A detailed review of terbinafine-induced-AGEP cases was performed, with the aim of evaluating if the AGEP criteria would follow a different pattern when the disease is triggered by this drug. A PubMed search helped retrieve all terbinafine-induced AGEP case reports. AGEP-specific Sideroff criteria were analysed in terbinafine-induced cases and compared to other trigger causes. When the AGEP causative drug was terbinafine, a delay in recovery was observed, compared to the existing AGEP criteria when other causes are considered. Terbinafine frequently leads to delayed resolution AGEP probably due to the presence of the drug in the skin for several weeks after exposure, even after discontinuation, and the disease severity may be potentialised by additional factors such as concomitant viral infections or vaccination.

Ratiometrically pH-Insensitive Upconversion Nanoprobe: Toward Simultaneously Quantifying Organellar Calcium and Chloride and Understanding the Interaction of the Two Ions in Lysosome Function. Calcium and chloride levels are closely related to lysosome dysfunction. However, the simultaneous measurement of calcium (Ca2+) and chloride (Cl-) in acidic subcellular organelles, which is conducive to a deep understanding of lysosome-related biological events, remains a challenge. In this study, we developed a pH-insensitive, ratiometric NIR nanoprobe for the simultaneous detection of Ca2+ and Cl- in acidic lysosomes and determined the roles of the two ions in lysosome function. The upconversion nanoprobe with blue, green, and red emissions was modified with a Ca2+-sensitive dye (Rhod-5N) and Cl--responsive fluorophore (10,10'-bis[3-carboxypropyl]-9,9'-biacridinium dinitrate, BAC). As a result of a dual-luminescence resonance energy transfer between upconversion nanoparticles (UCNPs) and Rhod-5N/BAC, the blue and green upconversion luminescence (UCL) of UCNPs were quenched and the red UCL was used as the reference signal. The ratiometric upconversion nanoprobe possesses a specific ability for the concurrent recognition of Ca2+ and Cl- ions independent of the influence of the environmental pH. To locate the probe in the lysosome, dextran was further modified with upconversion nanoparticles. Then, the nanoprobe with a high spatial resolution was constructed for the simultaneous monitoring of Ca2+ and Cl- in acidic lysosomes. Moreover, it was found that the reduction of lysosomal Cl- affects the release of lysosomal Ca2+, which further blocks the activities of specific lysosomal enzymes. The ratiometric NIR nanoprobe has great potential for decoding and evaluating lysosomal diseases.

Diagnostic accuracy of neuroimaging in emergency department patients with acute vertigo or dizziness: A systematic review and meta-analysis for the guidelines for reasonable and appropriate care in the emergency department. Patients presenting to the emergency department (ED) with acute vertigo or dizziness represent a diagnostic challenge. Neuroimaging has variable indications and yield. We aimed to conduct a systematic review and meta-analysis of the diagnostic test accuracy of neuroimaging for patients presenting with acute vertigo or dizziness. An electronic search was designed following patient-intervention-control-outcome (PICO) question-(P) adult patients with acute vertigo or dizziness presenting to the ED; (I) neuroimaging including computed tomography (CT), CT angiography (CTA), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and ultrasound (US); (C) MRI/clinical criterion standard; and (O) central causes (stroke, hemorrhage, tumor, others) versus peripheral causes of symptoms. Articles were assessed in duplicate. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to assess certainty of evidence in pooled estimates. We included studies that reported diagnostic test accuracy. From 6309 titles, 460 articles were retrieved, and 12 were included: noncontrast CT scan-six studies, 771 patients, pooled sensitivity 28.5% (95% confidence interval [CI] 14.4%-48.5%, moderate certainty) and specificity 98.9% (95% CI 93.4%-99.8%, moderate certainty); MRI-five studies, 943 patients, sensitivity 79.8% (95% CI 71.4%-86.2%, high certainty) and specificity 98.8% (95% CI 96.2%-100%, high certainty); CTA-one study, 153 patients, sensitivity 14.3% (95% CI 1.8%-42.8%) and specificity 97.7% (95% CI 93.8%-99.6%), CT had higher sensitivity than CTA (21.4% and 14.3%) for central etiology; MRA-one study, 24 patients, sensitivity 60.0% (95% CI 26.2%-87.8%) and specificity 92.9% (95% CI 66.1%-99.8%); US-three studies, 258 patients, sensitivity ranged from 30% to 53.6%, specificity from 94.9% to 100%. Noncontrast CT has very low sensitivity and MRI will miss approximately one in five patients with stroke if imaging is obtained early after symptom onset. The evidence does not support neuroimaging as the only tool for ruling out stroke and other central causes in patients with acute dizziness or vertigo presenting to the ED.

Evaluation of continuous glucose monitoring-derived person-specific HbA1c in the presence and absence of complications in type 1 diabetes. To evaluate the accuracy of a novel kinetic model at predicting HbA1c in a real-world setting and to understand and explore the role of diabetes complications in altering the glucose-HbA1c relationship and the mechanisms involved. Deidentified HbA1c and continuous glucose monitoring values were collected from 93 individuals with type 1 diabetes. Person-specific kinetic variables were used, including red blood cell (RBC) glucose uptake and lifespan, to characterize the relationship between glucose levels and HbA1c. The resulting calculated HbA1c (cHbA1c) was compared with glucose management indicator (GMI) for prospective agreement with laboratory HbA1c. The cohort (42 men and 51 women) had a median age (IQR) of 61 (43, 72) years and a diabetes duration of 21 (10, 33) years. A total of 24 459 days of continuous glucose monitoring (CGM) data were available and 357 laboratory HbA1c were used to assess the average glucose-HbA1c relationship. cHbA1c had a superior correlation with laboratory HbA1c compared with GMI with a mean absolute deviation of 1.7 and 6.7 mmol/mol, r2 = 0.85 and 0.44, respectively. The fraction within 10% of absolute relative deviation from laboratory HbA1c was 93% for cHbA1c and 63% for GMI. Macrovascular disease had no effect on the model's accuracy, whereas microvascular complications resulted in a trend towards higher HbA1c, secondary to increased RBC glucose uptake. cHbA1c, which takes into account RBC glucose uptake and lifespan, accurately reflects laboratory HbA1c in a real-world setting and can aid in the management of individuals with diabetes.

Separate and combined effect of visit-to-visit glycaemic variability and mean fasting blood glucose level on all-cause mortality in patients with type 2 diabetes: A population-based cohort study. To assess the independent and combined impacts of visit-to-visit fasting blood glucose variability (VVV-FBG) and mean fasting blood glucose level (M-FBG) on all-cause mortality. This prospective cohort study included 48 843 Chinese patients with type 2 diabetes. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the association of VVV-FBG and M-FBG with all-cause mortality. The potential nonlinear associations were examined using restricted cubic splines, and additive interaction was evaluated using relative excess risk due to interaction (RERI). Cox generalized additive models (CGAMs) and bivariate response surface models were further used to assess the combined effects of VVV-FBG and M-FBG. A total of 4087 deaths were observed during a median follow-up of 6.99 years. Compared with patients with values at the 5th percentile of average real variability (ARV) and M-FBG, we observed a 23% and 38% increased risk of premature deaths among those with values at the 95th percentile of ARV (HR 1.23, 95% CI 1.10, 1.37) and M-FBG (HR 1.38, 95% CI 1.26, 1.51), respectively. The interaction between glycaemic variability (ARV) and M-FBG was significant on both the additive scale (RERI 0.80 [0.29, 1.32]) and the multiplicative scale (HR 1.90 [1.10, 3.28]). High VVV-FBG and high M-FBG conferred the highest risk of all-cause mortality (HR 1.89, 95% CI 1.64, 2.17), compared to low VVV-FBG and low M-FBG. The CGAMs showed significant synergistic effects between glycaemic variability and M-FBG (P < 0.05). Moreover, a bivariate surface plot showed that risk of death increased more rapidly in type 2 diabetes patients with lower M-FBG combined with lower VVV-FBG. The coexistence of high glycaemic variability and high glucose level might exacerbate the independent risk of premature mortality in type 2 diabetes patients, highlighting the importance of achieving normal and stable glucose levels simultaneously in the management of glucose.

In vitro cytotoxic activity of Cuphea ingrata Cham. & Schltdl. extracts related to the oenothein B content. Cuphea ingrata is a traditional medicinal plant species of the Lythraceae family. This work reports on the cytotoxic activity of the methanolic extract from the aerial parts of C. ingrata and the n-butanol and ethyl acetate fractions against human skin and prostate cancer cells. The selectivity of action was tested in normal skin keratinocytes HaCaT and prostate epithelial cells PNT2. The ethyl acetate fraction showed the highest activity in all three human skin cancer cell lines: A375, HTB-140, WM793, with IC50 = 15.90; 3.40; 18.75 μg/mL, respectively. To obtain comparative information on the chemical composition, a quantitative analysis of oenothein B was performed using the UHPLC-PDA method. An analysis of its cytotoxic activity was also carried out.

InMode Evoke radiofrequency hands-free facial remodeling for skin rejuvenation. Demand for facial contouring procedures has increased dramatically in recent years. Common regions of concern for patients seeking a rejuvenated, more youthful appearance include the cheeks, jawline, submental area, and neck. Radiofrequency technology offers a non-invasive and effective method of improving skin laxity and subcutaneous fat in these areas. The Evoke system from InMode Aesthetics is a radiofrequency modality designed to address the lower face and neck that stimulates collagen remodeling for skin tightening and thermal lipolysis for improved facial contour. While alternate technologies for radiofrequency facial remodeling are commercially available, Evoke is the first of its kind in introducing a reliable, operator-independent hands-free device developed based on InMode's proprietary Acquire, Control, and Extend technology targeting the deep fibro-septal network to provide optimal and consistent outcomes.

Modulation of intrinsic defects in vertically grown ZnO nanorods by ion implantation. Intrinsic defects created by chemically inert gas (Xe) ion implantation in vertically grown ZnO nanorods are studied by optical and X-ray absorption spectroscopy (XAS). The surface defects produced due to dynamic sputtering by ion beams control the fraction of O and Zn with ion fluence, which helps in tuning the optoelectronic properties. The forbidden Raman modes related to Zn interstitials and oxygen vacancies are observed because of the weak Fröhlich interaction, which arises due to disruption of the long-range lattice order. The evolution of the lattice disorder is identified by O K-edge and Zn K-edge scans of XAS. The hybridization strength between the O 2p and Zn 4p states increases with ion fluence and modulates the impact of intrinsic defects. The ion irradiation induced defects also construct intermediate defects bands which reduce the optical bandgap. Density functional theory (DFT) calculations are used to correlate the experimentally observed trend of bandgap narrowing with the origin of electronic states related to Zn interstitial and O vacancy defects within the forbidden energy gap in ZnO. Our finding can be beneficial to achieve enhanced conductivity in ZnO by accurately varying the intrinsic defects through ion irradiation, which may work as a tuning knob to control the optoelectronic properties of the system.

Diet and bowel symptoms among colon cancer survivors. Survival from colon cancer (CC) has improved considerably over the last decades, yet many survivors suffer from late sequelae from treatment. Typical symptoms of bowel dysfunction after treatment of CC are diarrhea, urge for defecation, fecal incontinence, bloating and constipation. Most CC survivors make dietary changes to alleviate bowel symptoms. We aimed to describe the self-perceived effects of diet on bowel function among CC survivors and the level of dietary information given. In this cross-sectional study, CC patients from four surgical departments in Denmark completed surveys regarding the effects of diet on their bowel function and whether they had previously received dietary advice. Data concerning sociodemographic characteristics and the surgical procedure (right-sided or left-sided hemicolectomy) were collected from the Danish Colorectal Cancer Group database. Forty-four healthcare professionals specialized in CC completed a questionnaire on how they advise CC. Descriptive statistics were applied. Among 1544 patients invited, 1239 (80.4%) responded, and 844 met the inclusion criteria (53% males, median age 72.6 years, median time since surgery 742 days). Among these, 267 (32%) reported that food affected bowel function. Fat was perceived to have a negative effect in 193 (25%), spices in 149 (19%), sweets in 101 (13%) and meat in 99 (13%). There was no association between tumor site and food categories affecting bowel function (p = 0.078). Most healthcare professionals (93%) stated that their unit gave advice about diet, but only 24% of patients remembered such information. One-third of CC survivors perceive that food items, especially fat and spices have a negative impact on their bowel function. We found a major discrepancy between healthcare professionals reporting that they provide advice and the proportion of patients remembering this. There is an unmet need for further recognition of the role of diet in CC rehabilitation and for intervention studies of treatment principles.

The modern clinical use of hallucinogens. What can we learn from the natural product research? Can the emerging field of psychedelic research benefit from natural product research? We believe it can. In this manuscript we delineate certain topics of research with hallucinogens that directly connect with research on natural products in general.