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Preeclampsia is a major cause of maternal and fetal morbidity and mortality. Early recognition of the disease may be challenging. Complications may precede the onset of clinical symptoms and medical intervention is often delayed. Moreover, in the absence of specific clinical signs, many patients will present symptoms mimicking the disease without ever being diagnosed with preeclampsia. This situation may, however, lead to medical interventions and cause unnecessary stress for the patient. For many years, research tried to evaluate the significance of serum biomarkers as early indicators of preeclampsia. Among many, the sFlt-1/PlGF ratio, given its performance, aroused the greatest interest. This article reviews current knowledge on the subject, focusing on a Swiss perspective.We assessed the impact of tailored versus targeted messages on program non-compliance during Desire2Move (D2M), an 8-week eHealth program that promotes physical activity (PA). Participants recorded minutes of PA using MapMyFitness, which counted toward their departments' PA total. Departments were randomized into the targeted messaging (TM) or tailored messaging (TM+) group based on participant-reported goals. Participants who did not provide a goal were assigned to the control group (CG). Eligible participants were employees from invited departments who were non-compliant for at least 1 week of D2M. Upon initial non-compliance, participants across groups received a targeted email message prompting program resumption. For subsequent non-compliance, the TM group continued to receive the same targeted message. The TM+ group received a message tailored to the participant's program goal. The CG group did not receive additional messages. Participants (n = 149) were mostly female (68.5%), staff (44.3%), with an average age of 43.7 (SD = 11.1). Analyses revealed significant group differences in non-compliance between TM+ (M = 2.6, SD = 1.9) and TM (M = 4.0, SD = 2.1), F(16,88) = 3.4, p less then .01; d = .64, and between TM+ (M = 2.6, SD = 1.9) and CG (M = 3.8, SD = 2.1), F(1,74) = 13.3, p less then .01; d = .56. There was no significant group difference between TM and CG, F(1,80) = 0.1, p = .75; d = .02. Tailored messages improved individual program compliance. More research is needed to assess the relationship between program compliance and PA behavior change.
Since March 2020, millions of children have been confined to their homes and restricted from in-person activities, radically changing the dynamics of parent-child relationships. This study examines the association between coronavirus disease 2019 (COVID-19) impact and the mental health of parents and school-aged children; specifically, whether qualities of the parent-child relationship moderated the relationship between parents' emotional health (EH) and children's emotional and behavioral health (EBH).
Data from this Internet-based study of a community sample were collected in March-May 2020. Parents (N = 158, 92.4% White, 96.2% female) reported on COVID-19 impacts, their own EH, perceptions of their relationship with their eldest child between 6 and 12 years-old, and the EBH of that child.
Responses to questions about COVID-19 impact were assigned weighted values and used to create a COVID-19 impact scale. Hierarchical linear regressions revealed that greater COVID-19 impact was associated with greater parents' EH issues only, and parents' EH was a significant positive predictor of children's EBH. Positive qualities and conflict in the parent-child relationship moderated the link between parents' and children's EH. At higher levels of relationship conflict and lower levels of positivity, there were stronger positive associations between parents' and children's EH. Parent-child relationship quality did not moderate the association between parents' EH and children's behavioral health (BH).
These cross-sectional study results suggest that beyond focusing on symptom management, families may benefit from supports targeting the parent-child relationship. Insights and implications for practitioners are discussed.
These cross-sectional study results suggest that beyond focusing on symptom management, families may benefit from supports targeting the parent-child relationship. Insights and implications for practitioners are discussed.
Hypergastrinemia states such as achlorhydria from gastric mucosal atrophy or a gastrin-producing tumor in humans have been associated with the development of enterochromaffin-like (ECL) cell hyperplasia and gastric neuroendocrine tumors (GNETs). Whether drugs that can elevate serum gastrin levels, such as proton pump inhibitors (PPIs), can produce the same tissue effect is not known and there is no concrete evidence linking the use of PPIs to GNETs outside animal models and case reports.
To explore the clinicopathologic association for GNETs of presumed ECL cell origin that cannot be reliably placed into any of the 3 established categories currently recognized by the World Health Organization.
This is a retrospective clinicopathologic study of GNETs in the body/fundus of a period of 15 years (2005-2019).
Of a total of 87 cases, 57 (65.5%) were associated with atrophic gastritis, 2 (2.3%) were associated with Zollinger-Ellison syndrome, and 28 (32.2%) were unclassified. Of the latter, 11 were consistent with true sporadic/type 3 GNETs, while 17 had background mucosal changes of parietal cell and ECL cell hyperplasia but without underlying detectable gastrinoma, and 88.2% (15 of 17) of patients from this group had documented long-term PPI use. This subtype of GNETs was more commonly multifocal, and of higher grade (P = .03) than "true" sporadic GNETs.
A subset of GNETs arises in the background of gastric mucosal changes suggestive of hypergastrinemia, but without underlying gastrinoma, and could be linked to long-term PPI use.
A subset of GNETs arises in the background of gastric mucosal changes suggestive of hypergastrinemia, but without underlying gastrinoma, and could be linked to long-term PPI use.A starting point of many digital health interventions informed by the Stages of Change Model of behavior change is assessing a person's readiness to change. In this paper, we use the concept of readiness to develop and validate a prediction model of health-seeking behavior in the context of family planning. We conducted a secondary analysis of routinely collected, anonymized health data submitted by 4,088 female users of a free health chatbot in Kenya. We developed a prediction model of (future) self-reported action by randomly splitting the data into training and test data sets (80/20, stratified by the outcome). We further split the training data into 10 folds for cross-validating the hyperparameter tuning step in model selection. We fit nine different classification models and selected the model that maximized the area under the receiver operator curve. We then fit the selected model to the full training dataset and evaluated the performance of this model on the holdout test data. The model predicted who will visit a family planning provider in the future with high precision (0.93) and moderate recall (0.75). Using the Stages of Change framework, we concluded that 29% of women were in the "Preparation" stage, 21% were in the "Contemplation" stage, and 50% were in the "Pre-Contemplation" stage. We demonstrated that it is possible to accurately predict future healthcare-seeking behavior based on information learned during the initial encounter. Models like this may help intervention developers to tailor strategies and content in real-time.Context - The main focus of education in most pathology residency and subspecialty pathology fellowships is the light microscopic examination of pathology specimens. Classes with multiheaded scopes are the most popular among pathology trainees. Until recently, it was difficult to us to imagine that this educational approach could change. In the beginning of March 2020 our country faced a serious challenge, which all of us now known as coronavirus disease 2019 (COVID-19) pandemic. The rules of social distancing and work from home were applied. These types of restrictions were implemented in almost all parts of our life including work and pathology education. Objective - To share our experience in the Department of Hematopathology at The University of Texas MD Anderson Cancer Center during COVID-19 pandemic. We describe our experience in modifying our approaches to education. We show how we overcame many obstacles to learning by building one of the largest virtual hematopathology educational platforms via Cisco WebEx and using social media, in particular Twitter. These tools facilitated the learning of hematopathology by medical students, pathology trainees, and practicing pathologists from all over the world. Data Sources - During the three months of the pandemic (April, May and June 2020), we evaluated the visitors' attendance to MD Anderson Cancer Center Hematopathology Virtual Educational Platform using data collected by Cisco WebEx website. For examination of the impact of the hematopathology community on Twitter on medical education the analytic metrics obtained from Symplur LLC (www.symplur.com, 04/27/2020) were used via its Symplur Signals program. Conclusions - Our experience using the MD Anderson Hematopathology Virtual Platform showed that there is substantial, global interest and desire for virtual hematopathology education, especially during the pandemic time.The proliferative burst of B lymphocytes is essential for antigen receptor repertoire diversification during the development and selective expansion of antigen-specific clones during immune responses. High proliferative activity inevitably promotes oncogenesis, the risk of which is further elevated in B lymphocytes by endogenous gene rearrangement and somatic mutations. However, B cell-derived cancers are rare, perhaps owing to putative intrinsic tumor-suppressive mechanisms. We show that c-MYC not only facilitates B cell proliferation as a pro-tumorigenic driver but unexpectedly also co-engages counteracting tumor suppression through its downstream factor TFAP4. TFAP4 is mutated in human lymphoid malignancies, particularly in >10% of Burkitt lymphomas, and reduced TFAP4 expression was associated with poor survival in MYC-high B-ALL cases. In mice, insufficient TFAP4 expression accelerated c-MYC-driven transformation of B cells. Mechanistically, c-MYC suppresses the stemness of developing B cells by inducing TFAP4 and restricting self-renewal of proliferating B cells. The pursuant transcription factor cascade thus functions as a tumor suppressor module that safeguards against the transformation of developing B cells.Broadly neutralizing antibodies (bNAbs) directed to HIV-1 have shown promise at suppressing viremia in animal models. However, the use of bNAbs for the central nervous system (CNS) infection is confounded by poor penetration of the blood brain barrier (BBB). Typically, antibody concentrations in the CNS are extremely low; with levels in cerebrospinal fluid (CSF) only 0.1% of blood concentrations. selleck chemical Using a novel nanotechnology platform, which we term nanocapsules, we show effective transportation of the human bNAb PGT121 across the BBB in infant rhesus macaques upon systemic administration up to 1.6% of plasma concentration. We demonstrate that a single dose of PGT121 encased in nanocapsules when delivered at 48h post-infection delays early acute infection with SHIVSF162P3 in infants, with one of four animals demonstrating viral clearance. Importantly, the nanocapsule delivery of PGT121 improves suppression of SHIV infection in the CNS relative to controls.
Homepage: https://www.selleckchem.com/products/sodium-palmitate.html
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