Notes

Examining the healthiness of forested riverine programs from the Niger Delta part of Africa: the macroinvertebrate-based multimetric list tactic.
Self-compassion has been identified as a trait that correlates with robust mental health; specifically, less anxiety, depression and stress in both adolescents and adults. However, little is known about the parental and family factors that are associated with adolescent self-compassion that may promote or enhance the development of this stress-buffering trait. In this study, 1057 adolescents in grades 7-12 from two different school settings answered questions in an online survey that related to their parents' education level and their own self-compassion. Results indicated that fathers' education, but not mothers', was associated with adolescent self-compassion. Specifically, adolescents whose fathers had a college education only had the highest level of self-compassion; a significant difference was found between self-compassion of adolescents of fathers' with a college degree and those with a doctorate/professional degree. Adolescents whose fathers had less than a college education (some college, high school graduate) or more than a college education (masters or doctorate/professional degree) reported lower self-compassion. As parent education level may be a proxy for other factors such as socioeconomic status, parenting style, or parent-adolescent relationship closeness, further research is necessary that will measure these factors and parse out that which specifically is associated with self-compassion in adolescents. Research exploring the nature of near-death experiences (NDEs) is extensive. There are a variety of hypothesized mechanisms proposed to explain the origin of the experiences, including hallucinations due to physiological changes in a dying brain. However, there is growing evidence that these theories cannot explain a number of the characteristics of NDEs. In this article we present a detailed and extensively verified case study of a physician, Bettina Peyton, who experienced an NDE during the birth of her third child when she was 32 years old. The data provide additional evidence that supports the hypotheses 1) that during NDEs individuals have sensory perceptual experiences that are not possible according to the materialist framework in which consciousness is solely produced by the activity of neurons in the brain, and 2) that NDEs lead to a fundamental change in their understanding of the nature of consciousness, and in the place of the sacred in their lives. BACKGROUND Detecting acute ST-segment elevation myocardial infarction (STEMI) in the setting of left bundle branch block (LBBB) remains a challenge to clinicians. Several diagnostic and triage algorithms have been proposed to accurately identify LBBB patients with an acute culprit vessel. We aimed to validate the algorithm proposed by Cai et al., which uses patients' hemodynamic status and the modified Sgarbossa electrocardiography criteria to guide reperfusion therapy. METHODS This retrospective study was performed with a chart review in emergency departments (EDs) of 2 medical centers, 2 regional hospitals, and 1 local hospital. From January 2010 to December 2014, 2432 consecutive patients were diagnosed as having STEMI in the ED, including 65 patients with LBBB (2.6%). RESULTS The patients with LBBB were older and more frequently presented with acute pulmonary edema (58.5% vs 22.1%, p less then 0.001), cardiogenic shock (16.9% vs 6.3% p = 0.006), and VT/VF episodes (7.7% vs 2.2%, p = 0.034) and had a higher 30-day mortality rate (20.0% vs 10.4% p = 0.032) than those without LBBB. We then tested the algorithm proposed by Cai et al. and noted a sensitivity of 93.8% in identifying a culprit lesion. CONCLUSIONS The inconsistency of the guideline recommendations reflects the uncertainty of diagnostic and therapeutic strategies and the pressing need for tools to accurately identify the true acute myocardial infarction in patients presenting with chest pain and LBBB. The algorithm proposed by Cai et al. Cordycepin chemical structure had good sensitivity and would allow emergency physicians to implement the timely treatment protocol for this high-risk population. Hiccup is a condition caused by involuntary contraction of inspiratory muscles, especially the diaphragm. Although it is generally considered as a physiological. response, if hiccup persists for a long time, it can lead to many undesirable conditions such as depression, weight loss, insomnia, and fatigue. A 35-year-old male patient was admitted to our emergency department with hiccup lasting for 15 h. He had a history of several hiccup attacks. Classical non-pharmacological and pharmacological therapies were used to treat the condition without any response. As an alternative method, an intradermal injection was applied. A mixture of thiocolchicoside and lidocaine was administered intradermally to a depth of 1-3 mm at the epigastric region and adjacent to the sternocleidomastoid muscle. The patient's hiccup ended after the intradermal injection procedure. During 48 h of follow-up the hiccup attack did not develop again. No complications related to the process were detected. This is the first case in the literature demonstrating the use of intradermal injection to terminate hiccups. The intradermal injection approach can be administered in cases of hiccups that do not respond to medical treatment. BACKGROUND Little is known about mechanisms of resistance to poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPi) and platinum chemotherapy in patients with metastatic breast cancer and BRCA1/2 mutations. Further investigation of resistance in clinical cohorts may point to strategies to prevent or overcome treatment failure. PATIENTS AND METHODS We obtained tumor biopsies from metastatic breast cancer patients with BRCA1/2 deficiency before and after acquired resistance to PARPi or platinum chemotherapy. Whole exome sequencing was carried out on each tumor, germline DNA, and circulating tumor DNA. Tumors underwent RNA sequencing, and immunohistochemical staining for RAD51 foci on tumor sections was carried out for functional assessment of intact homologous recombination (HR). RESULTS Pre- and post-resistance tumor samples were sequenced from eight patients (four with BRCA1 and four with BRCA2 mutation; four treated with PARPi and four with platinum). Following disease progression on DNA-damaging therapy, four patients (50%) acquired at least one somatic reversion alteration likely to result in functional BRCA1/2 protein detected by tumor or circulating tumor DNA sequencing.
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