Notes

Bloodstream biomarkers associated with moderate disturbing brain injury: Condition of art.
6%, with a similar prevalence in the Chepangs (39.8%) and in the Musahars (33.3%) (P > 0.05). The most predominant helminth was Ascaris lumbricoides (15.6%), while the most prevalent protozoan was Entamoeba histolytica/dispar (5.4%). The study also assessed a significant association between the prevalence of parasites with socio-demographic factors, types of drinking water consumption and sanitation habits of the people (P < 0.05).

The findings of the study suggest a need for formulating effective preventive and control strategies against intestinal parasitic infections along with the continuity of mass deworming program.
The findings of the study suggest a need for formulating effective preventive and control strategies against intestinal parasitic infections along with the continuity of mass deworming program.Understanding the complexity and biodiversity of fungal communities associated with the wheat endosphere can facilitate the identification of novel strains that might be beneficial to the host plant. However, the differentiation and taxonomic classification of the endosphere-associated fungi with respect to various cultivars and plant organs are challenging, time-consuming, and expensive, even with the use of molecular techniques. In the present work, we describe a fast, simple, and low-cost method based on high-resolution melting PCR (HRM-PCR) for the identification and differentiation of wheat endogenous fungal isolates. Using this approach, we differentiated 28 fungal isolates, which belonged to five different genera, namely Alternaria, Penicillium, Epicoccum, Fusarium, and Trichoderma. Furthermore, the results of the study revealed that this method can allow large-scale screening of cultured samples.This study in 8 countries across Europe found that about 75% of elderly women seen in primary care who were at high risk of osteoporosis-related fractures were not receiving appropriate medication. Lack of osteoporosis diagnosis appeared to be an important contributing factor.
Treatment rates in osteoporosis are documented to be low. We wished to assess the osteoporosis treatment gap in women ≥ 70 years in routine primary care across Europe.

This cross-sectional observational study in 8 European countries collected data from women 70 years or older visiting their general practitioner. The primary outcome was treatment gap the proportion who were not receiving any osteoporosis medication among those at increased risk of fragility fracture (using history of fracture, 10-year probability of fracture above country-specific Fracture Risk Assessment Tool [FRAX] thresholds, T-score ≤ - 2.5).

Median 10-year probability of fracture (without bone mineral density [BMD]) for the 3798 enrolled patients was 7.2% (hip)arge treatment gap in women aged ≥ 70 years at increased risk of fragility fracture in routine primary care across Europe. The gap appears to be related to a low rate of osteoporosis diagnosis.The nature and features of organization of reserve polysaccharides in three species of the genus Pelomyxa-P. palustris, P. belevskii, and P. stagnalis-were studied using light and transmission electron microscopy. We applied the periodic acid-Schiff reaction that is a highly selective method for detecting glycogen. The fluorescent dye auramine-SO2 (Au-SO2) was used as a Schiff-type reagent. The densely packed aggregates of glycogen that form the morphologically differentiated organelle-like bodies are revealed in the cytoplasm in all studied species. The organization of these bodies is characterized by the species-specific features, while in most cases, their size and number in the cells vary depending on the season of the year. Although in all the cases we studied, these bodies do not have their own boundary membrane, in fact, they are surrounded by membranous structures. These structures differ in a variety of Pelomyxa species. We concluded that there are two groups of species in the genus Pelomyxa. The first one includes organisms containing glycogen structures in the cytoplasm (P. palustris, P. belevskii, P. stagnalis, P. binucleata, P. corona, P. secunda). No inclusions resembling glycogen bodies were found in P. flava, P. paradoxa, P. gruberi, and P. prima that form the second group.Gentrification in the largest 50 US cities has more than doubled since the 1990s. The process of gentrification can bring about improved neighborhood conditions, reduced rates of crime, and property value increases. At the same time, it can equally foster negative conditions associated with poorer health outcomes, such as disrupted social networks from residential displacement and increases in stress. While neighborhood environment is consistently implicated in health outcomes research, gentrification is rarely conceptualized as a public health issue. Though research on gentrification is growing, empirical studies evaluating the health impacts of gentrification in the US are poorly understood. Here we systematically review US population-based empirical studies examining relationships between gentrification and health. Electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science, and Academic Search Complete) were searched using a combination of terms to identify peer-reviewed studies publishlarly Black and low-income individuals. Complexities inherent in operationalizing gentrification point toward the need for validated measures. Additionally, understanding how gentrification-health associations differ across health endpoints, race/ethnicities, socioeconomic status, and life course can provide insight into whether this process contributes to urban inequality and health disparities. As gentrification occurs across the US, it is important to understand how this process impacts health. While aging cities reinvest in the revitalization of communities, empirical research examining relationships between gentrification and health can help inform policy decisions.Deoxynivalenol (DON) is one of the most commonly found mycotoxins across the world, and it mainly contaminates staple food crops. This study aims to evaluate the dietary exposure of DON and to provide a geographical profile of DON exposure in China. The concentrations of DON and its acetylated derivatives in 15,004 cereal samples (10,192 wheat flour, 1750 maize meal, 892 oat flakes, and 2170 polished rice) were collected from 30 provinces, autonomous regions, or municipalities across China during 2010-2017, through a national food safety risk surveillance system. The consumption data for cereals were obtained from China National Nutrition and Health Survey in 2002, and 67,923 respondents from the same 30 regions were included in the analysis. Among all the cereals considered, the concentration was the highest in wheat flour, with the mean concentration of 250.8 μg/kg. Applying a worst-case scenario, some individuals were possibly at risk, but the probability of acute effects was low. The mean and median exposure for the entire population was 0.61 and 0.36 μg/kg bw/day, respectively, below the (PM) TDI, indicating an acceptable overall health risk in Chinese population. Wheat contributed to 86% of the total DON exposure. Significant discrepancy was observed between the exposure and the contamination of DON. The high-exposure cluster area was in northern China, whilst the most seriously contaminated regions were all located in the southeast, which formed a seriously contaminated area.We report a longitudinal analysis of the immune response associated with a fatal case of COVID-19 in Europe. This patient exhibited a rapid evolution towards multiorgan failure. SARS-CoV-2 was detected in multiple nasopharyngeal, blood, and pleural samples, despite antiviral and immunomodulator treatment. Clinical evolution in the blood was marked by an increase (2-3-fold) in differentiated effector T cells expressing exhaustion (PD-1) and senescence (CD57) markers, an expansion of antibody-secreting cells, a 15-fold increase in γδ T cell and proliferating NK-cell populations, and the total disappearance of monocytes, suggesting lung trafficking. In the serum, waves of a pro-inflammatory cytokine storm, Th1 and Th2 activation, and markers of T cell exhaustion, apoptosis, cell cytotoxicity, and endothelial activation were observed until the fatal outcome. This case underscores the need for well-designed studies to investigate complementary approaches to control viral replication, the source of the hyperinflammatory status, and immunomodulation to target the pathophysiological response. The investigation was conducted as part of an overall French clinical cohort assessing patients with COVID-19 and registered in clinicaltrials.gov under the following number NCT04262921.Absorption of monosaccharides is mainly mediated by Na+-D-glucose cotransporter SGLT1 and the facititative transporters GLUT2 and GLUT5. SGLT1 and GLUT2 are relevant for absorption of D-glucose and D-galactose while GLUT5 is relevant for D-fructose absorption. SGLT1 and GLUT5 are constantly localized in the brush border membrane (BBM) of enterocytes, whereas GLUT2 is localized in the basolateral membrane (BLM) or the BBM plus BLM at low and high luminal D-glucose concentrations, respectively. At high luminal D-glucose, the abundance SGLT1 in the BBM is increased. Hence, D-glucose absorption at low luminal glucose is mediated via SGLT1 in the BBM and GLUT2 in the BLM whereas high-capacity D-glucose absorption at high luminal glucose is mediated by SGLT1 plus GLUT2 in the BBM and GLUT2 in the BLM. The review describes functions and regulations of SGLT1, GLUT2, and GLUT5 in the small intestine including diurnal variations and carbohydrate-dependent regulations. Also, the roles of SGLT1 and GLUT2 for secretion of enterohormones are discussed. Furthermore, diseases are described that are caused by malfunctions of small intestinal monosaccharide transporters, such as glucose-galactose malabsorption, Fanconi syndrome, and fructose intolerance. Moreover, it is reported how diabetes, small intestinal inflammation, parental nutrition, bariatric surgery, and metformin treatment affect expression of monosaccharide transporters in the small intestine. Finally, food components that decrease D-glucose absorption and drugs in development that inhibit or downregulate SGLT1 in the small intestine are compiled. Models for regulations and combined functions of glucose transporters, and for interplay between D-fructose transport and metabolism, are discussed.
Cognitive impairment is common and consequential in patients with cancer who undergo allogeneic hematopoietic stem cell transplantation (HSCT). However, there is no standard of care for evaluating cognition in patients prior to or after receiving HSCT, and it is not known which patients are at highest risk for cognitive impairment. The objectives of this study were to describe cognitive function in patients prior to allogeneic HSCT and identify demographic, disease-related, and psychosocial factors associated with cognitive function.

Prior to HSCT, participants completed the Montreal Cognitive Assessment (MoCA). We assessed bivariable associations between continuous MoCA scores and demographic, disease-related, and psychosocial variables using linear regression. Variables significant at the p < 0.2 level were adjusted for age, sex, and years of education in multiple linear regression analyses.

Over 50% of participants demonstrated evidence of cognitive impairment (MoCA < 26) prior to transplantatit of cognitive impairment on patient symptom burden and function may help improve outcomes.
To assess Turkish oncology nurses' knowledge regarding novel coronavirus (COVID-19) during the current outbreak in Turkey.

This descriptive study was carried out with the 185 oncology nurses between April and May 2020 in Turkey. Research data were collected through online survey using "Nurse Information Form" and "Nurse Information Scale for COVID-19." Multilinear regression analysis was used in determining the factors affecting oncology nurses' information regarding COVID-19.

According to the data delivered from 185 oncology nurses, 57.7% of the participants had an undergraduate degree, 74.1% were working in adult oncology units, and 52.4% of them were working as clinical nurses, 48.1% of the nurses received education for COVID-19 (51.9% did not receive) and 70.3% followed and read the COVID-19 Guidelines published by the Ministry of Health (29.7% did not follow guidelines). Using multiple regression analysis, a model based on the relationship between the variables was created. In the model, the descriptive characteristics of the oncology nurses and their experiences of COVID-19 were found to explain 29.1% of their knowledge level for COVID-19. Nurses' education level, the presence of a relative diagnosed with COVID-19, and following the COVID-19 guidelines were found to statistically significantly affect the knowledge levels of COVID-19.

These findings suggest that hospital management and the Ministry of Health should provide more information for the oncology nurses to better control of cancer patients from the infectious disease.
These findings suggest that hospital management and the Ministry of Health should provide more information for the oncology nurses to better control of cancer patients from the infectious disease.
People with cancer benefit from self-management support, but report limitations in the type/amount of support they receive from healthcare professionals during cancer treatment. To intervene in this critical period, our team is developing a web-based self-management system, called I Can Manage Cancer (ICMC). The purpose of this paper is to report patient and clinician perspectives on the preferred features and functions in a self-management system that informed the development of the ICMC program.

We used descriptive qualitative methods, conducting interviews with people diagnosed with cancer (n = 16) and focus groups with cancer clinicians (n = 19). Data were thematically analyzed using the NVivo qualitative software.

People with cancer describe engaging in hard work when employing cancer self-management. Our findings lend insight into features and functions they deem vital in a self-management system to support this work. Based on patient and clinician accounts, we developed three themes describing specific content and design features for the ICMC program to support self-management needs of people with cancer during the acute phase of treatment (1) being able to connect, observe, and learn from others; (2) the ability to tailor and customize information; and (3) the capacity to track symptoms over time. Clinicians and patients emphasized the need to optimize all available resources to support people with cancer as they engage in the work to manage their diagnosis.

Our findings describe the how peoples' cancer experiences and the gaps in self-management care can be enhanced by specific features and functions within the ICMC.
Our findings describe the how peoples' cancer experiences and the gaps in self-management care can be enhanced by specific features and functions within the ICMC.Current approaches in cancer supportive care call for enhanced patient access, personalized care, and higher service quality and performance. Person-centered care (PCC) is respectful and responsive to individuals' needs, preferences, and context. PCC is likely to enhance access to relevant resources and services as the cancer experience and trajectory unfold. However, significant gaps still exist in accessing supportive modalities across the cancer trajectory. Too often, affected individuals must contend with institution-centric rather than personalized modalities, practices, and schedules. In this commentary, we review the evidence on the distinct needs and preferences of individuals affected by cancer and highlight key factors significantly associated with patient experiences and satisfaction. Recommendations are made to enhance access, relevance, and a fuller integration of cancer service delivery. Last, we discuss how implementing these recommendations aligns with potentially more cost-effective psychosocial oncology support while directly addressing access to timely psychosocial care.Due to the thermodynamic conditions prevailing at very shallow depths of calcite stone oil fields, molecular hydrogen has been reported to be released from hydrocarbon or heavy oil located on the surface of the calcite stone. Since this region is physically inaccessible, there is a need to realize modeling and simulation of the hydrogen adsorption and storage process under reservoir conditions. Motivated by the previous problem, in this work, based on recent reports of hydrogen production from oil fields, we present a theoretical methodology to describe the process of hydrogen adsorption on naturally fractured and carbonated (limestone (CaCO3)) reservoirs and to quantify their storage capacity. Firstly, the calcite rock model was optimized inside a simulation cell containing a vacuum layer, for which energy optimization techniques based on density functional theory were used. Subsequently, using ab initio methods also based on DFT, calcite rock was characterized obtaining structural, electronic, vibrational, thermodynamic properties, and Mulliken population analysis of CaCO3. Finally, molecular dynamics simulations were performed in order to simulate the adsorption process and obtain percentages of hydrogen adsorption on (110) surface of the (2 × 2) CaCO3 supercell, for N = 3, 5, 10 hydrogen molecules. The molecular dynamics simulations showed that the surface of CaCO3 rock has hydrogen capacity of only 0.42 mass %.We report a rare case of lymph node metastasis of papillary thyroid cancer (PTC) incidentally detected in a neck dissection specimen of tongue squamous cell carcinoma (SCC). A 42-year-old Japanese woman was diagnosed with tongue SCC (T1N0M0, Stage I). Partial glossectomy with supraomohyoid neck dissection was performed under general anesthesia, and histopathological examinations revealed primary SCC of the tongue and neck metastasis of PTC in neck dissection specimens. A few months later, total thyroidectomy and left modified radical neck dissection were performed by thyroid surgeons. The histopathological diagnosis was PTC of both the thyroid glands. There was no evidence of tumor recurrence or distant metastasis at the 9-month follow-up.
Evidence indicates that most college students face reduced sleep quality due to unhealthy dietary habits and hectic daily schedules. While the relationship between sleep quality and general health has been the subject of intensive research, little is known about the association between sleep and its relation with the inflammatory potential of the diet until recently. This study aimed to investigate the association between Energy-Adjusted Dietary Inflammatory Index (E-DII
) scores and sleep quality in a group of students from the University of Sharjah (UOS).

A cross-sectional study design was followed, and convenience sampling was used. Participants were assessed for sleep quality using the Pittsburgh Sleep Quality Index (PSQI), E-DII scores were derived from a semi-quantitative food frequency questionnaire (FFQ), and physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). Chi-square tests and two-sample t tests were used to find an association between E-DII sc. Further prospective and controlled studies are required to confirm this association, and to explore other attributes and their sequelae on sleep quality.Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. An investigation into the factors related to BPPV could contribute to its prevention and appropriate management. We investigated the association between climatic factors and incidence of BPPV in this study. A total of 365 patients who were diagnosed with idiopathic BPPV in the emergency room of our hospital in 2015 were included. The number of patients diagnosed with BPPV per week was calculated (every week). Climatic factors, including daily average humidity, temperature, atmospheric pressure, cloud amount, sunshine amount, and daylight time, were documented daily. The weekly mean climatic value in each week was calculated. Simple correlation analysis and multivariate regression analyses were performed to identify climatic factors associated with the number of patients diagnosed with BPPV. Simple correlation analysis revealed a significant association between the humidity (r = 0.276, p = 0.048), temperature (r = 0.275, p = 0.049), and cloud amount (r = 0.293, p = 0.035) and the number of BPPV patients diagnosed per week. Multivariate regression analysis revealed that only the cloud amount was a statistically significant factor associated with the number of BPPV patients diagnosed every week. A significant positive association was discovered between the cloud amount and BPPV incidence. Cloud amount can therefore have an association with the incidence of BPPV.Virtual reality (VR) presents opportunities for innovative patient educational methods. This study used a combination of subjective questionnaires and objective physiological measures to investigate the impact of a VR radiotherapy (RT) educational system on patients' understanding and anxiety prior to commencing RT. Sixty patients were randomized to control (n = 30) and intervention (n = 30) groups prior to initiating RT. The control group received the standard nursing care process. The intervention group additionally participated in a detailed introduction to RT positioning, procedures, treatments, and other RT-related information via VR education. All patients completed a data collection from pre- and postintervention, which included questions on RT comprehension, anxiety-related scales, and objective physiological data reflecting the patient's psychological state, such as blood pressure, heart rate, and respiration. Both groups had high anxiety levels before the intervention, and there was no significant difference between the questionnaire and physiological data of the two groups. Following the intervention, anxiety scores (state-trait anxiety scale and visual analog scale) of the intervention group decreased significantly compared with those of the control group, and there was a significant decrease in systolic blood pressure (p  less then  0.05) and increase in cognitive score (p  less then  0.05). This study reports the positive impact of a virtual reality radiotherapy (VRRT) patient educational system on increasing patient RT comprehension and reducing anxiety. Further work is needed to improve the acceptability of the system to patients and to explore further the impact of VR education on patients' psychological and physical needs.Pandemic obesity is a major public health problem because of its association with non-communicable diseases and all-cause mortality, which can be improved/delayed with weight loss. Thus, several scientific societies and governments have launched guidelines to reduce body weight and adiposity or, at least, to avoid weight gain. In spite of the abundant literature on the topic, there is still controversy on the relative roles of fat and carbohydrate in the diet on weight gain. Present recommendations to avoid weight gain and obesity are directed to reduce intake of total energy variably and of total fat to less then 30% of energy, in spite on the lack of evidence of protection against cardiovascular disease (CVD) and mortality. By contrast, both high and low carbohydrate diets are associated with CVD and all-cause mortality in prospective studies, with a safe intake level at ≈50% of energy. Many popular diets with widely different macronutrient composition, including the Mediterranean diet, have been used in obesity; when energy-restricted, all result in similar modest weight loss at 6 months, but the effects are largely lost at 12 months. The Mediterranean diet is a plant-based, high-fat, high-unsaturated fat dietary pattern that has been consistently associated with lower rates on non-communicable diseases and total mortality in prospective studies and with reduced CVD in the PREDIMED trial. For this merits above other diets, this dietary pattern might also be used advantageously for weight loss. The results of the PREDIMED and PREDIMED-Plus randomized controlled trials on adiposity variables in high-risk populations are discussed.The obesity epidemic has reached old age in most industrialized countries, but trials elucidating the benefits and risks of weight reduction in older adults above 70 years of age with obesity remain scarce. While some findings demonstrate a reduced risk of mortality and other negative health outcomes in older individuals with overweight and mild obesity (i.e. body mass index (BMI) 27 kg/m2), especially when combined with exercise. However, in this age group weight reduction is usually associated with a reduction of muscle mass and bone mineral density. Since uncertainty persists as to which level overweight or obesity might be tolerable (or even beneficial) for older persons, current recommendations are to consider weight reducing diets only for older persons that are obese (BMI ≥ 30 kg/m2) and have weight-related health problems. Precise treatment modalities (e.g. appropriate level of caloric restriction and indicated dietary composition, such as specific dietary patterns or optimal protein content) as well as the most effective and safest way of adding exercise are still under research. Moreover, the long-term effects of weight-reducing interventions in older individuals remain to be clarified, and dietary concepts that work for older adults who are unable or unwilling to exercise are required. In conclusion, further research is needed to elucidate which interventions are effective in reducing obesity-related health risks in older adults without causing relevant harm in this vulnerable population.Understanding how gut flora influences gut-brain communications has been the subject of significant research over the past decade. The broadening of the term "microbiota-gut-brain axis" from "gut-brain axis" underscores a bidirectional communication system between the gut and the brain. The microbiota-gut-brain axis involves metabolic, endocrine, neural, and immune pathways which are crucial for the maintenance of brain homeostasis. Alterations in the composition of gut microbiota are associated with multiple neuropsychiatric disorders. Although a causal relationship between gut dysbiosis and neural dysfunction remains elusive, emerging evidence indicates that gut dysbiosis may promote amyloid-beta aggregation, neuroinflammation, oxidative stress, and insulin resistance in the pathogenesis of Alzheimer's disease (AD). Illustration of the mechanisms underlying the regulation by gut microbiota may pave the way for developing novel therapeutic strategies for AD. In this narrative review, we provide an overview of gut microbiota and their dysregulation in the pathogenesis of AD. Novel insights into the modification of gut microbiota composition as a preventive or therapeutic approach for AD are highlighted.Mahua (Madhuca longifolia) flowers are boon for the local tribes of India and have been successfully utilized traditionally for the value addition, and are very prone for microbial spoilage. Local folks utilized malpractices of drying which deteriorates the quality attributes of the mahua flowers and ultimately fails to fetch a good price in the market. Present investigation was led to consider the impact of different pre-treatments i.e., blanching time; and dip of potassium meta-bisulfite (KMS) and citric acid (CA) on the physico-chemical and phytochemical potential of dried mahua flowers using response surface methodology (RSM). Maximum physico-chemical and phytochemicals attributes were observed under optimum conditions i.e., a blanching of 4.1 min followed by dipping in solution having 1285 ppm KMS and 0.77% citric acid. Qualitative analysis through Fourier transform infrared spectroscopy (FTIR) supported the findings. Sugar and phytochemical profiling by high performance liquid chromatography (HPLC) proved the significant effect of each variable. No specific cluster formation was observed during cluster analysis of whole data indicating the significant and equal effect of all variable on the quality of dried mahua flowers. The optimized conditions will definitely help the local processors as well as the industrialist to maintain the quality attributes of the dried mahua.Bariatric and metabolic surgery (BMS), the only effective option for patients with obesity with or without comorbidities, has been stopped temporarily due to the ongoing novel corona virus disease (COVID-19) pandemic. However, there has been a recent change in the governmental strategy of dealing with this virus from 'Stay at Home' to 'Stay Alert' in many countries including India. A host of health services including elective surgeries are being resumed. In view of the possibility of resumption of BMS in near future, Obesity and Metabolic Surgery Society of India (OSSI) constituted a committee of experienced surgeons to give recommendations about the requirements as well as precautions to be taken to restart BMS with emphasis on safe delivery and high-quality care.The COVID-19 pandemic has resulted in enormous losses in terms of human lives and economy in United States. The outbreak has been continuing to heavily impact the mental health of people. Developing key strategies to prevent mental illnesses is extremely important for the well-being of people. A survey conducted during the last week of March 2020 showed that 72% of Americans felt that their lives were impacted by the outbreak, which was a 32% increase from the survey conducted only 2 weeks earlier. The results show a positive correlation between COVID-19 infections/casualties and growing public concern. These observations suggest possible increase in mental health illnesses in United States as a consequence of the pandemic. The authors review a recently published model on COVID-19 related fear among the people. The fear of being infected or dying from the disease is one of the most significant causes of mental health disorders. Loss of employment or the fear of losing employment is another major concern leading to mental illnesses. Several unique strategies to prevent or mitigate mental illnesses are discussed.To assess whether primary care medical homes (PCMHs) are accurately identified for patients receiving care in a specialty mental health clinic within an integrated public delivery system. This study reviewed the electronic records of patients in a large urban mental health clinic. The study defined 'matching PCMH' if the same primary care clinic was listed in both the mental health and medical electronic records. This study designated all others as 'PCMH unknown.' This study assessed whether demographic factors predicted PCMH status using chi-square tests. Among 229 patients (66% male; mean age 49; 36% White, 30% Black, and 17% Asian), 72% had a matching PCMH. Sex, age, race, psychiatric diagnosis, and psychotropic medication use were not associated with matching PCMH. To improve care coordination and health outcomes for people with severe mental illness, greater efforts are needed to ensure the accurate designation of PCMHs in all mental health patient electronic records.Patients with comorbid mental health and chronic conditions often receive care from both psychiatrists and primary care physicians (PCPs). The introduction of multiple providers into the care process introduces opportunities for disruptions in care continuity. The purpose of this study was to explore psychiatrists' and PCPs' comfort prescribing, along with their comfort having other physician specialties prescribe medications for cardiometabolic, psychiatric, and neurological/behavioral conditions. This cross-sectional study utilized an online, validated, pilot-tested, anonymous survey to examine prescribing practices of psychiatrists and PCPs. Eligible participants included physicians with medical degrees, U.S. prescribing authority, and active patient care for ≥2 days/week. Outcomes of interest were physicians' self-comfort and cross-specialty comfort (other specialists prescribing mutual patients' medications) prescribing cardiometabolic, psychiatric, and neurological/behavioral medications. Comfort prescrre identified. Because comfort prescribing medications differed by physician type, incorporating psychiatrists through collaborative methods with PCPs could potentially ensure comfort among physicians when initiating medications.
To explore the prescription patterns of different dosage forms of Chinese herbal medicines (CHMs) for the treatment of rheumatoid arthritis (RA) and their effects on immune-inflammatory indices.

Clinical data were collected from patients with RA in 4 hospitals (3 Class A comprehensive hospitals and 1 Class B comprehensive hospital) in Anhui Province, China, from August 2012 to June 2018 via the electronic medical record gathering system. Following extraction of prescription information, each prescribed herb was quantified and standardized according to the knowledge base to establish a database of RA treatment formulae. The medical records were divided into the granules group and decoction pieces group. Core herbs and their combination patterns were obtained from the two groups of cases using Liquorice software. Changes in immune-inflammatory and hepatic and renal function indices were compared between the two groups using SPSS 23.0 software. The Aprior module of SPSS Clementine 11.1 software was applied t between the comprehensive evaluation indices and interventions.

The principal CHM treatment methods for RA in four hospitals in Anhui Province are strengthening Pi and resolving dampness, activating blood and resolving stasis, dispelling wind/dampness and clearing heat. Granules and decoction pieces of CHMs have similar efficacy in improving immune-inflammatory indices in RA patients and could be used as treatment options for RA.
The principal CHM treatment methods for RA in four hospitals in Anhui Province are strengthening Pi and resolving dampness, activating blood and resolving stasis, dispelling wind/dampness and clearing heat. Granules and decoction pieces of CHMs have similar efficacy in improving immune-inflammatory indices in RA patients and could be used as treatment options for RA.
Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography (LAERCP) is an alternative for the anatomically challenging conventional ERCP in patients with a Roux-en-Y gastric bypass (RYGB) as it allows access to the biliary tree via the gastric remnant. We investigated the efficacy and safety of LAERCP.

We retrospectively reviewed all charts from RYGB patients who underwent a LAERCP between January 2009 and August 2019 in a non-academic referral center for bariatric surgery. Patients who underwent pancreatic therapy were excluded. We collected demographic, clinical, and outcome data. An adverse event was defined as any complaint related to the LAERCP up to 30days after the procedure and graded according to the ASGE lexicon.

We identified 100 LAERCP in 86 patients with RYGB (70% female, median age 54years). Same-session cholecystectomy was performed in 35 LAERCP (35%). The papilla of Vater was visualized in 100% of LAERCP with a therapeutic success rate of 94%. Stone extraction succeeded in 88.8% and sphincterotomy was performed in 96.7%. We identified 30 adverse events in 28 procedures, of which eight endoscopy-related, 14 laparoscopy-related, and eight non-specified (f.i. fever, allergic reaction). In total, six severe adverse events were reported concerning post-ERCP pancreatitis (n = 2), laparoscopy-related hemorrhage (n = 1), abscess (n = 1), shock (n = 1), and pneumonia (n = 1). No patient died due to LAERCP.

LAERCP is an effective and relatively safe procedure for biliary diseases in patients with RYGB.
LAERCP is an effective and relatively safe procedure for biliary diseases in patients with RYGB.Epilepsy is one of the most frequent CNS manifestations of tuberous sclerosis, and for most patients, it is the major debilitating factor. In up to 70% of the cases, the epilepsy is refractory and usually associated with significant behavioral as well as developmental consequences. Therefore, controlling seizures is one of the biggest medical and surgical challenges. Understanding the cellular mechanism involved in the disease empowered targeted research aimed toward early intervention in the epileptogenicity process. In this review, we present an update on the pharmacological treatments in tuberous sclerosis-related epilepsy.Grazing by herbivorous protists contributes to structuring plankton communities through its effect on the growth, biomass, and competitiveness of prey organisms and also impacts the transfer of primary production towards higher trophic levels. Previous evidence shows that heterotrophic processes (grazing rates, g) are more sensitive to temperature than autotrophic ones (phytoplankton growth rates, μ) and also that small cells tend to be more heavily predated than larger ones; however, it remains unresolved how the interplay between changes in temperature and cell size modulates grazing pressure (i.e., gμ ratio). We addressed this problem by conducting an experiment with four phytoplankton populations, from pico- to microphytoplankton, over a 12 °C gradient and in the presence/absence of a generalist herbivorous protist, Oxyrrhis marina. We found that highest g rates coincided with highest μ rates, which corresponded to intermediate cell sizes. There were no significant differences in either μ or g between the smallest and largest cell sizes considered. The gμ ratio was largely independent of cell size and CN ratios, and its thermal dependence was low although species-specific differences were large. We suggest that the similar gμ found could be the consequence that the energetic demand imposed by rising temperatures would be a more important issue than the mechanical constriction to ingestion derived from prey cell size. Despite the difficulty of quantifying μ and g in natural planktonic communities, we suggest that the gμ ratio is a key response variable to evaluate thermal sensitivity of food webs because it gives a more integrative view of trophic functioning than both rates separately.Natural ponds in the Brazilian Cerrado harbor high biodiversity but are still poorly studied, especially their microbial assemblage. The characterization of the microbial community in aquatic environments is fundamental for understanding its functioning, particularly under the increasing pressure posed by land conversion and climate change. Here, we aim to characterize the structure (abundance, richness, and diversity) and composition of the Bacteria and Archaea in the sediment of two natural ponds belonging to different basins that primarily differ in size and depth in the Cerrado. Sediment samples were collected in the dry and rainy seasons and the transition periods between both. The structure and composition of Bacteria and Archaea were assessed by 16S rRNA gene pyrosequencing. We identified 45 bacterial and four archaeal groups. Proteobacteria and Acidobacteria dominated the bacterial community, while Euryarchaeota and Thaumarchaeota dominated the archaeal community. Seasonal fluctuations in the relative abundance of microbial taxa were observed, but pond characteristics were more determinant to community composition differences. Microbial communities are highly diverse, and local variability could partially explain the microbial structure's main differences. Functional predictions based in 16S rRNA gene accessed with Tax4Fun indicated an enriched abundance of predicted methane metabolism in the deeper pond, where higher abundance of methanogenic archaea Methanocella, Methanosaeta, and Methanomicrobiaceae was detected. Our dataset encompasses the more comprehensive survey of prokaryotic microbes in Cerrado's aquatic environments. Here, we present basic and essential information about composition and diversity, for initial insights into the ecology of Bacteria and Archaea in these environments.Misophonia is a condition of abnormal emotional responses to specific auditory stimuli. There is limited information available on the prevalence of this condition. This study aimed to estimate the prevalence of misophonia in an undergraduate medical student population at the University of Nottingham. A secondary aim of this study was to assess the psychometric validity of the Amsterdam Misophonia Scale (A-Miso-S) questionnaire tool in this population. The A-Miso-S was administered online to medical students at the University of Nottingham. To assess the validity of the A-Miso-S, a factor analysis was conducted. To determine prevalence and severity the results of the questionnaire were quantitatively analysed using SPSS. Actor analysis was conducted. Free text responses to one questionnaire item were analysed using a thematic approach. Responses were obtained from 336 individuals. Clinically significant misophonic symptoms appear to be common, effecting 49.1% of the sample population. This is statistically significantly higher prevalence than previous studies have found (p  less then  0.00001). Using the classification of the A-Miso-S, mild symptoms were seen in 37%, moderate in 12%, severe in 0.3% of participants. No extreme cases were seen. The A-Miso-S was found to be a uni-factorial tool, with good internal consistency. This study has provided new information on misophonia and validity of the A-Miso-S questionnaire in a sample population of UK undergraduate medical students. The results indicate that misophonia is a phenomenon that a significant proportion of medical students experience though only a small subset experience it severely.Detection of lead(II) (Pb2+) ions in water is important for the protection of human health and environment. The growing demand for onsite detection still faces challenges for sensitive and easy-to-use methods. In this work, a novel surface plasmon resonance (SPR) biosensor based on GR-5 DNAzyme and gold nanoparticles (AuNPs) was developed. Thiolated DNAzyme was immobilized on the gold surface of the sensor chip followed by anchoring the substrate-functionalized AuNPs through the DNAzyme-substrate hybridization. The coupling between the localized surface plasmon (LSP) of AuNPs and the surface plasmon polaritons (SPP) on the gold sensor surface was used to improve the sensitivity. The substrate cleavage in the presence of Pb2+ ions was catalyzed by DNAzyme, leading to the removal of AuNPs and the diminished LSP-SPP coupling. The optimal detection limit was 80 pM for the sensor fabricated with 1 μM DNAzyme, corresponding to two or three orders of magnitude lower than the toxicity levels of Pb2+ in drinking water defined by WHO and USEPA. By tuning the surface coverage of DNAzyme, the sensitivity and dynamic range could be controlled. This sensor also featured high selectivity to Pb2+ ions and simple detection procedure. Successful detection of Pb2+ ions in groundwater indicates that this method has the prospect in the onsite detection of Pb2+ ions in water. Given the variety of AuNPs and metal-specific DNAzymes, this detection strategy would lead to the development of more sensitive and versatile heavy metal sensors. Graphical abstract.Utilizing National High-tech Industrial Development Zones (NHIDZs) as a quasi-natural experiment, this study has adopted 285 prefecture and above cities from 2003 to 2018 in China as the research samples and constructed the difference-in-differences (DID) and spatial difference-in-differences (SDID) models to investigate the effects of NHIDZs on economic development and environmental pollution at national, regional, and administrative levels. The results show that NHIDZs have basically achieved a win-win situation in promoting economic development and reducing environmental pollution at the national level. However, spatial heterogeneity is supported at regional and administrative levels. Specifically, "the law of diminishing marginal effect" of NHIDZs is proved in the eastern cities and key cities, which reveals the uneven development pattern of government leading in China, and highlights the importance and necessary of making policy according to local conditions and governing environmental pollution by classification.The soil microbiome comprises one of the most important and complex components of all terrestrial ecosystems as it harbors millions of microbes including bacteria, fungi, archaea, viruses, and protozoa. Together, these microbes and environmental factors contribute to shaping the soil microbiome, both spatially and temporally. Recent advances in genomic and metagenomic analyses have enabled a more comprehensive elucidation of the soil microbiome. However, most studies have described major modulators such as fungi and bacteria while overlooking other soil microbes. This review encompasses all known microbes that may exist in a particular soil microbiome by describing their occurrence, abundance, diversity, distribution, communication, and functions. Finally, we examined the role of several abiotic factors involved in the shaping of the soil microbiome.Trinexapac-ethyl (TE) was more widely used in golf course worldwide. As a plant growth regulator, it inhibited grass development and delayed grass cutting date. Direct contact with TE by workers that handle and apply these agents can lead to harmful effects depending on the exposure dosage and duration. Many studies have focused on the growth regulation of TE in plants, while its health risks to human beings were rarely reported. Here, we investigated the risk assessment of workers directly dermal exposed to TE by using some absorbent paper patches. The exposure intensity (EI) and potential dermal exposure (PDE) of worker body sections were obtained, and different exposure patterns were compared. The EI of each body section among mixing/loading, hand-held power sprayer, and manual sprayer workers was ranging from 7.22 to 73.0 pg cm-2. The maximum EI of TE was found on hands of manual sprayers, while the minimum EI of TE was recorded on upper arms of mixing and loading workers. The maximum contribution sections was 29% for the chest and back from mixing/loading workers, 40% for the chest and back from hand-held power sprayers, and 32% for the thigh from manual sprayers. The unit weight potential dermal exposure (UWPDE) of hand-held power sprayers was 60% lower than that of manual sprayers, indicating that hand-held power sprayers were safer than those of manual sprayers. These findings revealed that trinexapac-ethyl posed relatively higher exposure risks to manual sprayer workers than other operator workers in golf course, mainly responsible for body sections of the chest and back and thigh.In the present study, a magnetic adsorbent, rhein-coated magnetic Fe3O4 nanoparticle (RMNP), for Pb2+ and Mg2+ had been developed, and adsorption mechanism was studied via low-field NMR. RMNP was characterized by TEM, FTIR, and XRD. RMNP could adsorb and remove Pb2+ and Mg2+ from water and was successfully applied to remove Pb2+ and Mg2+ from wastewater, with satisfactory recovery rates and high adsorption capacities. The calculated maximum adsorption capacity for Mg2+ and Pb2+ was approximately 69.3 and 64.9 mg g-1 of RMNP, respectively, which was better than some results reported. Low-field NMR results showed that Pb2+ or Mg2+ enhanced the T2 relaxation time of RMNP, which suggested that RMNP selectively coordinated with Pb2+ or Mg2+ and led to the aggregation of RMNP, furthermore removal of Pb2+ or Mg2+ from water. The standard curves for △T2-cation concentration exhibited good line correlation. The linear ranges were from 4.2 × 10-6 to 2.0 × 10-4 mol L-1 for Pb2+ and from 5.0 × 10-6 mol L-1 to 1.0 × 10-4 mol L-1 for Mg2+, respectively. The limits of detection were 1.4 × 10-6 mol L-1 for Pb2+ and 2.1 × 10-6 mol L-1 for Mg2+, respectively. In short, low-field NMR could clearly display the interaction between RMNP and Pb2+ or Mg2+, even be used to detect Pb2+ or Mg2+ in suitable condition. Besides, this method could be expanded to study the interaction between other magnetic adsorbents and analytes.The purpose of the present study was to investigate the efficacy of the experimental formulations of the metribuzin (MET) and tribenuron-methyl (TBM) herbicides embedded in the matrix of degradable poly-3-hydroxybutyrate blended with wood flour in field-grown tomato and beet crops infested by weeds. There is a necessity to develop environmentally friendly and effective means to protect plants because of the shortcomings of the free herbicide forms such as the environmentally unsafe spray application of solutions and suspensions of the widespread metribuzin and tribenuron-methyl herbicides, removal from soil during watering events and rains, and transport to natural aquatic environments, where the herbicides accumulate in the trophic chains of biota. Free TBM is also rapidly inactivated in soil and metabolized to nontoxic products in plants. The efficacy of experimental formulations of metribuzin and tribenuron-methyl embedded in the matrix of degradable poly-3-hydroxybutyrate blended with wood flour was tested in field-grown tomato and beet crops infested with weeds. Application of metribuzin resulted in the highest productivity of tomatoes (2.3 kg/m2) and table beet (3.4 kg/m2), improved biometric parameters of tomato fruits and beet roots, and caused reduction in nitrate nitrogen concentrations in them. The mode of herbicide delivery did not affect sugar contents, but application of both metribuzin and tribenuron-methyl induced a 1.7-fold and 1.4-fold, respectively, increase in vitamin C concentrations in tomato fruits and beet roots relative to the vegetables grown on the subplots treated with free herbicides and the intact plants. Embedded herbicides can be used as preemergence herbicides in the field. Fig. a Graphical abstract.There is an increase in concern about the hazardous effects of radioactivity due to the presence of undesirable radioactive substances in our vicinity. Nuclear accidents such as Chernobyl (1986) and Fukushima (2011) have further raised concerns towards such incidents which have led to contamination of water bodies. Conventional methods of water purification are less efficient in decontamination of radioisotopes. They are usually neither cost-effective nor environmentally friendly. However, nanotechnology can play a vital role in providing practical solutions to this problem. Nano-engineered materials like metal oxides, metallic organic frameworks, and nanoparticle-impregnated membranes have proven to be highly efficient in treating contaminated water. Their unique characteristics such as high adsorption capacity, large specific surface area, high tensile strength, and excellent biocompatibility properties make them useful in the field of water purification. This review explores the present status and future prospects of nanomaterials as the next-generation water purification systems that can play an important role in the removal of heavy metals and radioactive contaminants from aqueous solutions.
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