Notes

Silver precious metal nanoparticles created from Cedecea sp. exhibit antibiofilm action and memorable steadiness.
Our data suggest novel candidate genes for depressive disorder with earlier age at onset. These genes could serve as markers allowing early identification of patients at risk of depression, and thus earlier intervention.Low resilience is characterized by impairments in attention and emotion regulation mechanisms that depend on prefrontal cortical activity. The aim of this study was to test whether transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) can augment the effectiveness of a new computerized mouse-based (gaze)contingent training (MCAT) to improve attention and emotion regulation processes (improved reappraisal, reduced rumination) in individuals reporting low resilience levels. The study used a full-factorial between-subject design combining active and sham MCAT and tDCS interventions. One hundred participants reporting low resilience levels were randomly assigned to receive either a single session of tDCS with sham MCAT treatment (tDCS group), MCAT with sham tDCS (MCAT group), a combination of tDCS and MCAT (combined group), or sham tDCS and sham MCAT (control group). Transfer to attention regulation, reappraisal success, and state rumination was evaluated using an eye-tracking disengagement task and an emotion regulation paradigm, respectively. MCAT, either alone or combined with tDCS, resulted in improved attention regulation. Furthermore, the group receiving combined MCAT and tDCS also showed some evidence of increased reappraisal ability and reduced rumination. MCAT in combination with left DLPFC neuromodulation has potential to maximize transfer to emotion regulation capacities and to promote resilience.
The palliative medicine workforce lacks racial diversity with <5% of specialty Hospice and Palliative Medicine (HPM) fellows identifying as black. Little is known about black trainees' exposure to palliative care during their medical education.

To describe palliative care training for black students during medical school, residency, and fellowship training.

We conducted a cross-sectional descriptive study using Internet searches and phone communication in September 2019. find protocol We evaluated 24 medical schools in three predetermined categories historically black colleges and universities (HBCUs; N=4) and non-under-represented minority-serving institutions with the highest (N=10) and lowest (N=10) percentages of black medical students. Training opportunities were determined based on the presence of a course, clerkship, or rotation in the medical school and residency curricula, a specialty HPM fellowship program, and specialty palliative care consult service at affiliated teaching hospitals.

None of the fourve-focused training to physicians from under-represented minority backgrounds.
Medico-economic data of patients suffering from chronic nausea and vomiting are lacking. In these patients, gastric electrical stimulation (GES) is an effective, but costly treatment. The aim of this study was to assess the efficacy, safety and medico-economic impact of Enterra therapy in patients with chronic medically refractory nausea and vomiting.

Data were collected prospectively from patients with medically refractory nausea and/or vomiting, implanted with an Enterra device and followed for two years. Gastrointestinal quality of life index (GIQLI) score, vomiting frequency, nutritional status and safety were evaluated. Direct and indirect expenditure data were prospectively collected in diaries.

Complete clinical data were available for142 patients (60 diabetic, 82 non-diabetic) and medico-economic data were available for 96 patients (36 diabetic, 60 non-diabetic), 24 months after implantation. GIQLI score increased by 12.1 ± 25.0 points (p < .001), with a more significant improvement in non-diabetic than in diabetic patients (+15.8 ± 25.0 points, p < .001 versus 7.3 ± 24.5 points, p = .027, respectively). The proportion of patients vomiting less than once per month increased by 25.5% (p < .001). Hospitalisations, time off work and transport were the main sources of costs. Enterra therapy decreased mean overall healthcare costs from 8873 US$ to 5525 US$ /patient/year (p= .001), representing a saving of 3348 US$ per patient and per year. Savings were greater for diabetic patients (4096 US$ /patient/year) than for non-diabetic patients (2900 US$ /patient/year).

Enterra therapy is an effective, safe and cost-effective option for patients with refractory nausea and vomiting. ClinicalTrials.gov Identifier NCT00903799.
Enterra therapy is an effective, safe and cost-effective option for patients with refractory nausea and vomiting. ClinicalTrials.gov Identifier NCT00903799.
Complicated celiac disease (CCD) is a rare but severe condition with a poor prognosis. Guidelines recommend use of capsule endoscopy (CE) to explore the small bowel (SB), followed by a double-balloon enteroscopy (DBE) in selected cases with suspected CCD. Our study aims to evaluate the diagnostic yield of CE and DBE in identifying and monitoring CCD.

Consecutive suspected CCD patients were prospectively enrolled to undergo CE and/or DBE in the presence of persistent symptoms despite gluten-free diet (GFD), increased anti-transglutaminase antibodies titer, lack of adherence to GFD and CCD follow-up. The diagnostic yields (DY) of CE and DBE were calculated. The incidence of neoplastic complications and mortality were assessed.

In total, 130 patients (97 females, age 49±16 years) underwent 151 CE and 23 DBE. The DY of CE was 46%. Patients age >50 years (at CE examination or at CD diagnosis) with a disease duration <5 years were at higher risk of positive CE (RR 1.6, 1.7 and 1.5 respectively, p<0.05) than their counterparts. Up to 40% of SB lesions were unreachable by upper endoscopy. At the end of the diagnostic work-up, 25 patients with pre-malignant/malignant lesions were identified 12 type-1 refractory CD (RCD-1), 7 type-2 RCD (RCD-2), 6 enteropathy-associated T-cell lymphoma (EATL). Six patients (2 RCD-2 and 4 EATL) died.

In case of suspected CCD, CE should be the first-line approach to detect complications and to identify patients deserving DBE. Older and symptomatic patients with suspected CCD deserve a careful evaluation of small bowel especially during the first years after CD diagnosis.
In case of suspected CCD, CE should be the first-line approach to detect complications and to identify patients deserving DBE. Older and symptomatic patients with suspected CCD deserve a careful evaluation of small bowel especially during the first years after CD diagnosis.
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