Notes

Out-of-time-order correlations as well as the good framework involving eigenstate thermalization.
Poor cellular uptake and slow intracellular drug release remain the main barriers for the efficient application of micellar delivery system. Taking advantage of the overexpressed CD44 receptor and mild acidic microenvironment of tumour cells, CD44-targeted pH-responsive micelles based on the self-assembly of histidine-hyaluronic acid-dodecylamine (His-HA-DA) were prepared for the delivery of doxorubicin (DOX). These micelles exhibited pH-responsive behaviour with increased particle size, decreased encapsulation efficiency (EE%) of DOX and rapid release of DOX triggered by low pH. Compared with free DOX, DOX/HHD exhibited relatively high cellular uptake mainly via the CD44-mediated endocytosis. The on-demand intracellular release of DOX from DOX/HHD led to improved cytotoxicity. DOX/HHD also showed great penetration efficiency in 3D tumour spheres in vitro. Moreover, these micelles with suitable particle size gained excellent tumour-targeting effects, as well as improved anti-tumour effects and reduced side effects in vivo. In conclusion, these micelles with CD44 targeted and pH-responsive behaviours provide a promising strategy for the efficient delivery of anti-tumour drugs in vivo.
Caregivers of children with cerebral palsy can best help their child if they understand the disorder and the correct terminology.

To assess caregiver understanding of cerebral palsy.

This was a cross-sectional study from a large tertiary medical center in Boston, to assess understanding of the term cerebral palsy by primary caregivers of children and adolescents with cerebral palsy. All cases were obtained from hospital electronic medical records. Telephone surveys were conducted. Caregiver understanding of cerebral palsy was assessed by open-ended responses (50%) and success in answering true/false questions about cerebral palsy (50%).

Primary caregivers of children 18 years and younger with cerebral palsy.

Thirty-three percent of caregivers denied ever being told that their child had cerebral palsy. Most caregivers identified cerebral palsy as a brain problem (79%), lifelong condition (73%), often caused by a perinatal (60%) or gestational (40%) insult. Fifty-two percent knew that cerebral palsy w cerebral palsy was the time spent in explaining the diagnosis.As COVID-19 continues to pose significant public health threats, quantifying the effectiveness of different public health interventions is crucial to inform intervention strategies. Using detailed epidemiological and mobility data available for New York City and comprehensive modelling accounting for under-detection, we reconstruct the COVID-19 transmission dynamics therein during the 2020 spring pandemic wave and estimate the effectiveness of two major non-pharmaceutical interventions-lockdown-like measures that reduce contact rates and universal masking. Lockdown-like measures were associated with greater than 50% transmission reduction for all age groups. Universal masking was associated with an approximately 7% transmission reduction overall and up to 20% reduction for 65+ year olds during the first month of implementation. This result suggests that face covering can substantially reduce transmission when lockdown-like measures are lifted but by itself may be insufficient to control SARS-CoV-2 transmission. Overall, findings support the need to implement multiple interventions simultaneously to effectively mitigate COVID-19 spread before the majority of population can be protected through mass-vaccination.Children with complex care needs form a diverse population with a variety of health and social care requisites in the presence of a range of complex symptoms and diagnoses. An exploratory literature review with a systematic search of the current qualitative literature was undertaken to explore parents' perceptions and evaluation of respite care services for children with complex needs. A systematic search was undertaken using a pre-defined search strategy in six databases; CINAHL, EMBASE, PsycINFO, Applied Social Sciences Index & abstracts and Web of Science. Studies were screened using inclusion criteria and eight studies were included in the review. These were analyzed using thematic analysis based on Braun and Clarke framework. Findings identified that there was a limited availability of respite care services for children with complex needs. Parents' perceived that respite was beneficial for themselves, their child and other siblings in the family. Barriers to accessing respite were also identified. It is recommended that respite services should be flexible and appropriate to the family's needs. A combination of in home and out of home services that are responsive to families' needs and are flexible would be optimal. Qualitative research is considered most suitable to obtain the views of parents of children with complex needs. Further research is recommended in this area, particularly in determining how services may improve and what the views of children using the respite services and their siblings are regarding respite.Purpose Genetic association between the fibroblast growth factor 10 (FGF10) gene rs339501 single nucleotide polymorphism (SNP) and high myopia remains inconsistent in different studies. This study aimed to investigate the association between FGF10 rs339501 and high myopia in a Han Chinese population.Methods A total of 675 patients with high myopia (HM), including 246 extreme myopia (EM) patients, and 800 healthy subjects with normal vision from the Chinese Han population were selected as the study subjects. The SNP of FGF10 rs399501 was genotyped by TaqMan allele discrimination assay on the 7300 real-time polymorphism chain reaction system, and the relationship between genotype and allele frequency of FGF10 rs399501 and high myopia was analyzed.Results In our study, there are statistically significant differences between high myopia patients and controls in the allele frequencies (OR = 1.268, 95%CI = 1.030 ~ 1.560, P = .025), but not in genotype distributions (χ2 = 5.673, P = .059) of rs399501 SNP in the FGF10 gene. In addition, a weak association was found in recessive model (GG vs. AG+AA OR = 1.929, 95%CI = 1.004 ~ 3.708, P = .045), but not in dominant model (AG+GG vs. AA OR = 1.239, 95%CI = 0.981 ~ 1.566, P = .072). Moreover, significant associations were also found between FGF10 rs339501 polymorphism and the risk of extreme myopia in all genetic models.Conclusion Our results do support that the genetic variant of FGF10 rs339501 is associated with susceptibility of high myopia, especially extreme myopia in a Chinese Han population, and further exploration is needed for myopia in other populations.Aims We aim to provide new insights into the mechanisms of hepatocellular carcinoma (HCC) and identify key genes as biomarkers for the prognosis of HCC. Materials & methods Differentially expressed genes between HCC tissues and normal tissues were identified via the Gene Expression Omnibus tool. The top ten hub genes screened by the degree of the protein nodes in the protein-protein interaction network also showed significant associations with overall survival in HCC patients. read more Results A prognostic model containing a five-gene signature was constructed to predict the prognosis of HCC via multivariate Cox regression analysis. Conclusion This study identified a novel five-gene signature (CDK1, CCNB1, CCNB2, BUB1 and KIF11) as a significant independent prognostic factor.
Synchronous detection of multiple myeloma and acute myeloid leukemia in a single patient is a rare coincidence. Treatment of these patients is still unclear, mostly based on acute myeloid leukemia strategies combined with bortezomib.

A 72-year-old male with no medical history was investigated for pancytopenia. On medical examination, he was complicated with a wide and severe skin infection on arm. On examination of bone marrow aspirate, 25% myeloblasts infiltration and additional 10% plasma cells were seen. Acute myeloid leukemia was diagnosed and plasma cell proliferation was attributed to reactive plasmacytosis due to skin infection. However, flowcytometric studies and immunohistochemical examination revealed two different cell populations with 30-40% atypical plasma cells and >20% myeloblasts. Serum M-protein detected by serum electrophoresis test and immunofixation test revealed a monoclonal IgG lambda band. He was diagnosed with concurrent acute myeloid leukemia and multiple myeloma without histor and treatment strategies. Furthermore, this report highlights the importance of ruling out reactive plasmacytosis in patients with hematological malignancy who developed severe infections.
To compare outcomes of early and late tracheostomy change in neonatal patients. Early tracheostomy change (ETC) occurred 3 to 4 days after surgery, and late tracheostomy change (LTC) occurred 5 to 7 days after surgery.

Retrospective cohort.

Tertiary neonatal/pediatric intensive care unit.

A retrospective review of patients who underwent tracheostomy from 2015 to 2019 was performed for infants <1 year old. Data were recorded regarding age at tracheostomy, days until tracheostomy tube change, postoperative complications, and total number of days on sedative or paralytic drugs.

Forty-six patients were included 18 (39%) were male, with a mean age of 140 days (SD, 78). Of these, 28 (61%) received ETC. There were no accidental decannulation events in either group. Wound breakdown developed in 4 (14%) patients with ETC versus 5 (28%) with LTC (
= .3). Use of FlexTend tracheostomy tubes was associated with decreased odds of breakdown (odds ratio, 0.03;
= .01). Postoperatively, 46 (100%) patients received sedation, and 12 (26%) received paralysis. Mean duration of paralysis was 0.5 days in ETC as opposed to 2.2 days in LTC (
= .02) on univariate analysis, but the significance was not maintained on multivariate regression (
= .07).

ETC appears to be feasible in children less than a year of age. There does not appear to be an increased risk of accidental decannulation events or false passage tracts. Further investigations are warranted to investigate safety and possible impact on wound breakdown.
ETC appears to be feasible in children less than a year of age. There does not appear to be an increased risk of accidental decannulation events or false passage tracts. Further investigations are warranted to investigate safety and possible impact on wound breakdown.Background Sensitive media reporting has an important role in suicide prevention. However, there is no research on the quality of media reporting of suicide in newspapers of Uttar Pradesh (UP), India. Aim The present study aimed to assess the quality of newspaper reports of suicide against the World Health Organization (WHO) reporting guidelines. Method Suicide news content of four purposively selected newspapers published between March 1, 2019 and February 29, 2020, were scrutinized. A total of 501 news reports from UP were included. Results The most commonly reported attribute was the gender of the deceased and the method of suicide. Almost half of the newspapers reported the occupation of the deceased in the title. Mental illness was attributed as a cause of suicide among 23.75% of the news reports. Less than 2% of the news reports referred to expert opinion, research evidence, national or global statistics on suicide, suicide prevention measures, or information about suicide helpline. There was a significant difference in the quality of reporting between the vernacular newspapers and English dailies.
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