Notes

[Focusing the role involving surgical procedure within the treatment of liver cirrhotic site hypertension].
Evaluate beliefs and behaviors pertaining to abuse-deterrent opioids (ADFs).

Survey in 2019 by invitation to all licensed physicians.

Commonwealth of Kentucky.

374 physicians.

Descriptive statistics, and hypothesis test that early adopter prescribers would have greater endorsement of opioid risk management.

Of all prescribers, 55% believed all opioid analgesics should have ADF requirements (15% were unsure); 74% supported mandating insurance coverage. Only one-third considered whether an opioid was ADF when prescribing, motivated by patient family diversion (94%) and societal supply reduction (88%). About half believed ADFs were equally effective in preventing abuse by intact swallowing, injection, chewing, snorting, smoking routes. Only 4% of OxyContin prescribers chose it primarily because of ADF properties. Instead, the most common reason (33%) was being started by another prescriber. A quarter of physicians chose not to prescribe ADFs because of heroin switching potential. Early adopters strongly believed ADFs were effective in reducing abuse (PR 3.2; 95% CI 1.5, 6.6) compared to mainstream physicians. Early-adopter risk-management practices more often included tools increasing agency and measurement urine drug screens (PR 2.0; 1.3, 3.1), risk screening (PR 1.3; 0.94, 1.9). While nearly all respondents (96%) felt that opioid abuse was a problem in the community, only 57% believed it was a problem among patients in their practice. Attribution theory revealed an externalization of opioid abuse problems that deflected blame from patients on to family members.

The primary motivator for prescribing ADFs was preventing diversion by family members, not patient-level abuse concerns.
The primary motivator for prescribing ADFs was preventing diversion by family members, not patient-level abuse concerns.
Patients with plaque psoriasis may experience varying levels of treatment response to different biologics, based on phenotypic characteristics and underlying genetic factors. Nail psoriasis is a common manifestation of psoriasis (approx. 50% of patients) and has been linked to the human leukocyte antigen-C*0602 (HLA-C*0602) allele, which in turn has been associated with differential treatment responses to certain drugs. Here we investigate whether nail involvement in patients with psoriasis can predict differential skin responses to two biologics with different modes of action, namely secukinumab (anti-interleukin-17A) and ustekinumab (anti-interleukin-12/23), to ultimately guide treatment choice.

Data were pooled from the CLEAR and CLARITY studies and stratified post hoc by nail involvement status at baseline. Psoriasis Area and Severity Index (PASI) 75 and 90 responses over 52 weeks and absolute PASI ≤ 3, ≤ 1, and 0 values at weeks 16 and 52, were assessed.

Based on the medical history, 30.4% (269/886) of the patients in the secukinumab arm and 29.7% (265/891) of patients in the ustekinumab arm presented with nail involvement. Nail involvement status had little to no impact on the efficacy of secukinumab, as comparable responses were achieved for patients with and without nail involvement in terms of PASI 75/90, ≤ 3, and 0 responses; slightly lower PASI ≤ 1 reponses were achieved in patients with nail involvement. In the ustekinumab arm, patients with nail involvement achieved lower responses across all endpoints.

These findings indicate that nail involvement can serve as an observable prognostic factor for efficacy in skin psoriasis treatment and guide the choice between secukinumab and ustekinumab.

CLEAR NCT02074982; CLARITY NCT02826603.
CLEAR NCT02074982; CLARITY NCT02826603.Some precision electronics such as signal transmitters need to not only emit effective signal but also be protected from the external electromagnetic (EM) waves. Thus, directional electromagnetic interference (EMI) shielding materials (i.e., when the EM wave is incident from different sides of the sample, the EMI shielding effectiveness (SE) is rather different) are strongly required; unfortunately, no comprehensive literature report is available on this research field. Herein, Ni-coated melamine foams (Ni@MF) were obtained by a facile electroless plating process, and multiwalled carbon nanotube (CNT) papers were prepared via a simple vacuum-assisted self-assembly approach. Then, step-wise asymmetric poly(butylene adipate-co-terephthalate) (PBAT) composites consisting of loose Ni@MF layer and compact CNT layer were successfully fabricated via a facile solution encapsulation approach. The step-wise asymmetric structures and electrical conductivity endow the Ni@MF/CNT/PBAT composites with unprecedented directional EMI shielding performances. When the EM wave is incident from Ni@MF layer or CNT layer, Ni@MF-5/CNT-75/PBAT exhibits the total EMI SE (SET) of 38.3 and 29.5 dB, respectively, which illustrates the ΔSET of 8.8 dB. This work opens a new research window for directional EMI shielding composites with step-wise asymmetric structures, which has promising applications in portable electronics and next-generation communication technologies.The recombination loss of photo-carriers in photocatalytic systems fatally determines the energy conversion efficiency of photocatalysts. In this work, an electrostatic field was used to inhibit the recombination of photo-carriers in photocatalysts by separating photo-holes and photo-electrons in space. As a model structure, (010) facet-exposed BiVO4 nanowires were grown on PDMS-insulated piezo-substrate of piezoelectric transducer (PZT). The PZT substrate will generate an electrostatic field under a certain stress, and the photocatalytic behavior of BiVO4 nanowires is influenced by the electrostatic field. Our results showed that the photocatalytic performance of the BiVO4 nanowires in CO2 reduction in the negative electrostatic field is enhanced to 5.5-fold of that without electrostatic field. Moreover, the concentration of methane in the products was raised from 29% to 64%. The enhanced CO2 reduction efficiency is mainly attributed to the inhibited recombination loss of photo-carriers in the BiVO4 nanowires. see more The increased energy of photo-carriers and the enhanced surface absorption to polar molecules, which are CO in this case, were also play important roles in improving the photocatalytic activity of the photocatalyst and product selectivity. This work proposed an effective strategy to improve photo-carriers separation/transfer dynamics in the photocatalytic systems, which will also be a favorable reference for photovoltaic and photodetecting devices.Here, this work presents an air-stable ultrabright inverted organic light-emitting device (OLED) by using zinc ion-chelated polyethylenimine (PEI) as electron injection layer. The zinc chelation is demonstrated to increase the conductivity of the PEI by three orders of magnitude and passivate the polar amine groups. With these physicochemical properties, the inverted OLED shows a record-high external quantum efficiency of 10.0% at a high brightness of 45,610 cd m-2 and can deliver a maximum brightness of 121,865 cd m-2. Besides, the inverted OLED is also demonstrated to possess an excellent air stability (humidity, 35%) with a half-brightness operating time of 541 h @ 1000 cd m-2 without any protection nor encapsulation.The microbiome modulates key processes in metabolism, inflammation, and immunity and plays pivotal roles in many gastrointestinal and liver diseases. Recent experimental studies have demonstrated a key role of the microbiome in hepatocarcinogenesis. Dysfunctions of the gut bacterial flora have a significant effect on liver disease. Dysbiosis is found to be associated with chronic liver diseases. Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer-related mortality. The majority of HCC develops in patients with chronic liver disease, caused by chronic viral hepatitis, nonalcoholic fatty liver disease (NAFLD), and alcohol-related fatty liver disease. This review discusses molecular mechanisms of gut microbiome-related hepatocarcinogenesis and the impact of dysbiosis on chronic liver disease progression.Hazardous chemicals are one of the greatest environmental challenges facing our planet, testing governments in the face of economic and social development. Chemical risks are often complex systemic risks, which require particular governance processes, stakeholder participation mechanisms, and communication procedures to manage. In this article we explore how such processes, mechanisms, and procedures could offer more effective pathways for international chemical risk assessment and management. Combining document analysis with 69 key informant interviews and four focus groups with experts from across government, non-governmental organizations (NGOs) and industry in Canada, the USA and Europe (n = 24), the results highlight the importance of increasing stakeholder participation and risk communication in existing chemical risk assessment and management frameworks. Similarities and differences between the three jurisdictions are discussed with a view to inform future risk governance strategies. The contemporary insights are of relevance to decision-makers seeking to improve the effectiveness of chemical risk governance in practice.Epigenetic modifications viz. DNA methylation, histone modifications, and RNA-based alterations play a crucial role in the development of cardiovascular diseases. In this study, we investigated DNA methylation with an aim to reveal the epigenetic etiology of heart failure. Sprague-Dawley rats surviving myocardial infarction developed acute heart failure in 1 week. Genomic DNA methylation changes were profiled by bisulfite sequencing, and gene expression levels were analyzed by RNA-seq in failing and sham-operation hearts. A total of 3480 differentially methylated genes in the promoter regions including transcriptional start site and 1934 transcriptome-altered genes were identified in the defected hearts. Common differential genes were enriched by the gene ontology, Kyoto Encyclopedia of Genes and Genomes pathway, and protein-protein interaction for HF phenotypes. Among these, Mettl11b, HDAC3, HDAC11, ubiquitination-related genes, and snoRNAs are new epigenetic classifiers that had not been reported yet, which may be important regulators in HF.Clostridium perfringens is an important food-borne zoonotic pathogen and a member of the commensal gut microbiome of many mammals. Predisposing factors such as coinfection with other pathogens or diet change can, however, cause overgrowth and subsequent disease development. Here we investigated the occurrence of C. perfringens in a free-ranging badger population with up to 100% prevalence of herpesvirus infection. Herpesvirus reactivation is known to be associated with increased susceptibility bacterial infections. PCR screening of rectal swabs from 69 free-ranging badgers revealed 15.9% (11/69, 95% CI = 9.1-26.3%) prevalence of detectable C. perfringens (Type A) DNA in the digestive tracts of assymptomatic animals. The results of Fisher's exact test revealed C. perfringens detection was not biased by age, sex and seasons. However, badgers with genital tract gammaherpesvirus (MusGHV-1) reactivation (p = 0.007) and infection with a specific MusGHV-1 genotype (p = 0.019) were more prone to of C. perfringens proliferation, indicating coinfection biased dynamics of intestinal C.
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