Notes

Nasoendoscopic findings right after major palatal surgery: could your Furlow method create a smaller sized velopharyngeal space?
To estimate the prevalence of specific comorbid conditions (CCs) and multiple comorbid conditions (MCCs) among adult patients with hyperkalemia and examine the associations between MCCs and healthcare resource utilization (HRU) and costs.

This retrospective observational cohort study was conducted using a large administrative claims database. We identified patients with hyperkalemia (ICD-10-CM E87.5; or serum potassium >5.0 mEq/L; or NDC codes for either patiromer or sodium polystyrene sulfonate) during the study period (1/1/2016-6/30/2019). The earliest service/claim date with evidence of hyperkalemia was identified as index date. Qualified patients had ≥12months of enrolment before and after index date, ≥18years of age. Comorbid conditions were assessed using all data within 12months prior to the index date. Healthcare resource utilization and costs were estimated using all data within 12months after the index date. Association rule mining was applied to identify MCCs. Generalized linear models were used to examine the associations between MCCs and HRU and costs.

Of 22,154 patients with hyperkalemia, 94% had ≥3 CCs. The most common individual CCs were chronic kidney disease (CKD, 85%), hypertension (HTN, 83%), hyperlipidemia (HLD, 81%), and diabetes mellitus (DM, 47%). The most common dyad combination of CCs was CKD+HTN (71%). The most common triad combination was CKD+HTN+HLD (62%). The most common quartet combination was CKD+HTN+HLD+DM (36%). The increased number of CCs were significantly associated with increased ED visits, length of hospital stays, and total healthcare costs (all p-value < 0.0001).

MCCs are very prevalent among patients with hyperkalemia and are strongly associated with HRU and costs.
MCCs are very prevalent among patients with hyperkalemia and are strongly associated with HRU and costs.Arabica coffee beans are sold at twice the price, or more, compared to Robusta beans and consequently are susceptible to economically motivated adulteration by substitution. There is a need for rapid, non-destructive, and efficient analytical techniques for monitoring the authenticity of Arabica coffee beans in the supply chain. In this study, multispectral imaging (MSI) was applied to discriminate roasted Arabica and Robusta coffee beans and perform quantitative prediction of Arabica coffee bean adulteration with Robusta. The Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) model, built using selected spectral and morphological features from individual coffee beans, achieved 100% correct classification of the two coffee species in the test dataset. The OPLS regression model was able to successfully predict the level of adulteration of Arabica with Robusta. MSI analysis has potential as a rapid screening tool for the detection of fraud issues related to the authenticity of Arabica coffee beans.In order to understand the differences of metabolites and their key metabolic pathways between traditional manual and mechanized Huangjiu, gas chromatography-mass spectrometry (GC-MS) combined with non targeted metabolomics was used to track and monitor Huangjiu in the whole post-fermentation stage. The results showed that 25 metabolites and 14 metabolites were identified as differential metabolites in manual and mechanized Huangjiu, respectively (VIP > 1, P 0.01). This study is helpful to gain insight into the underlying mechanism of flavor formation during the post-fermentation process of Huangjiu and provide a theoretical basis for the industrial development.The NIMH Research Domain Criteria (RDoC) initiative aims to understand the mechanisms influencing psychopathology through a dimensional approach. Limited research thus far has considered potential racial/ethnic differences in RDoC constructs that are influenced by developmental and contextual processes. A growing body of research has demonstrated that racial trauma is a pervasive chronic stressor that impacts the health of Black Americans across the life course. In this review article, we examine the ways that an RDOC framework could allow us to better understand the biological embedding of racial trauma among Black Americans. We also specifically examine the Negative Valence System domain of RDoC to explore how racial trauma is informed by and can help expand our understanding of this domain. We end the review by providing some additional research considerations and future research directives in the area of racial trauma that build on the RDoC initiative.The prenatal period represents a critical time for brain growth and development. These rapid neurological advances render the fetus susceptible to various influences with life-long implications for mental health. Maternal distress signals are a dominant early life influence, contributing to birth outcomes and risk for offspring psychopathology. This prospective longitudinal study evaluated the association between prenatal maternal distress and infant white matter microstructure. Participants included a racially and socioeconomically diverse sample of 85 mother-infant dyads. Prenatal distress was assessed at 17 and 29 weeks' gestational age (GA). Infant structural data were collected via diffusion tensor imaging at 42-45 weeks' postconceptional age. Findings demonstrated that higher prenatal maternal distress at 29 weeks' GA was associated with increased fractional anisotropy (b = .283, t(64) = 2.319, p = .024) and with increased axial diffusivity (b = .254, t(64) = 2.067, p = .043) within the right anterior cingulate white matter tract. No other significant associations were found with prenatal distress exposure and tract fractional anisotropy or axial diffusivity at 29 weeks' GA, nor earlier in gestation.Transformation of the maternal-fetal relationship into the mother-infant relationship remains an enigmatic process. This progression is considered using an RDoC-informed approach centered on domains of Arousal/Regulation, Positive/Negative Valence, and Social Processes. 158 maternal-fetal dyads began participation during pregnancy, maternal-infant dyads were followed at 6-months postpartum. Women exhibited stability in feelings of attachment to the fetus and infant, and in positive/negative appraisal of pregnancy and motherhood. Elicited maternal physiological arousal to emotionally evocative videos generated fetal heart rate variability and motor activity responses. Parasympathetic (i.e., heart rate variability) suppression in the fetus was associated with more positive and regulated infant social communication in the Face-to-face Still Face protocol; suppression of maternal respiratory sinus arrhythmia was related to infant affect but in the opposite direction. Maternal ratings of infant temperament aligned with maternal antenatal affective valence. Attachment trajectories characterized by stability from antenatal to postnatal periods were most associated with maternal affective appraisal of pregnancy; shifts were influenced by infant characteristics and maternal sympathetic responsivity. Results illustrate how variation in arousal and regulatory systems of the pregnant woman and fetus operate within the context of maternal positive and negative valence systems to separately and jointly shape affiliation and temperament in early infancy.
End-stage kidney disease patients on dialysis have a substantial risk of polypharmacy due their propensity for comorbidity and contact with the health care system. MedSafer is an electronic decision support tool that integrates patient comorbidity and medication lists to generate personalized deprescribing reports focused on identifying potentially inappropriate medications (PIMs).

To conduct a secondary analysis of patients on regular hemodialysis included in the MedSafer randomized controlled trial to investigate the patterns of polypharmacy and evaluate the efficacy of the MedSafer deprescribing algorithms.

Secondary analysis of a cluster randomized clinical trial.

Medical units in 11 acute care hospitals in Canada.

The MedSafer trial enrolled 5698 participants with an expected prognosis of >3 months, age 65 years and older, and on 5 or more daily home medications; 140 participants were receiving chronic hemodialysis.

The primary outcome of the trial was 30-day adverse drug events (ADEs) poshere was no observed difference in ADEs at 30-day post-discharge between the control and the intervention groups. The most common ADE (n = 3) was gastrointestinal bleeding attributed to antiplatelet agents.

This was a post hoc exploratory analysis, the original trial did not stratify by hemodialysis status, and the small sample size precludes drawing any definitive conclusions.

MedSafer facilitates deprescribing in hospitalized patients on hemodialysis. Larger-scale implementation of decision support software for deprescribing in dialysis and long-term follow-up are likely required to demonstrate an impact on ADEs.
MedSafer facilitates deprescribing in hospitalized patients on hemodialysis. Larger-scale implementation of decision support software for deprescribing in dialysis and long-term follow-up are likely required to demonstrate an impact on ADEs.A review of the Greek members of the Temnothoraxanodontoides species-group revealed three species new to science Temnothoraxeuboeae sp. nov. (Sterea Ellas, Euboea Island), Temnothoraxarkasi sp. nov. (Peloponnese, Arcadia) and Temnothoraxparnonensis sp. nov. (Peloponnese, Arcadia and Lakonia). The diagnoses of Temnothoraxikarosi Salata, Borowiec & Trichas, 2018 and T.anodontoides (Dlussky & Zabelin, 1985) are updated based of the new discoveries. Additionally, presence of the latter species in Greece is discussed and its distribution range revised. All members of the anodontoides species-group are associated with alpine and rocky habitats such as pastures and thermophilous forests. A dichotomous key to the anodontoides species-group from Greece is given.Seven species of Arthrotus are recognized and redescribed A.abdominalis (Chûjô, 1962), A.gressitti Kimoto, 1969, A.hirashimai Kimoto, 1969, A.fulvus Chûjô, 1938, A.saigusai Kimoto, 1969, A.tricolor (Chûjô, 1965), and A.testaceus Gressitt & Kimoto, 1963. Also, two new species are described A.yuae sp. nov. and A.yangi sp. nov. Three new synonyms are proposed Proegmenataiwana Takizawa, 1978 syn. nov., Dercetinanakanei Kimoto, 1969 syn. nov. and A.shibatai Kimoto, 1984 syn. nov. Lectotypes are designated for A.fulvus Chûjô, 1938 and Dercestraabdominalis Chûjô, 1962. Color polymorphism of each species is delimited base on more than 1800 specimens.We conducted a revision of the Neotropical genus Acrobrycon. A previous study synonymized the species, A.ipanquianus, distributed from the western portion of the Amazon River to the north-western region of the La Plata River Basin, and A.tarijae, with type locality in the Lipeo River in Bolivia. We revisited this result by collecting new morphometric, meristic, and genetic data (COI mitochondrial gene) for 24 individuals distributed along La Plata River Basin in Argentina, and discussed our results in the context of multiple biogeographic processes of isolation in that basin. Our results revealed a more complex history of diversification and geographic distribution across Acrobrycon species than previously suspected, probably associated with multiple biogeographic processes of isolation in La Plata River Basin. We present new evidence that led us to reconsider the validity of A.tarijae, which is distinguishable from A.ipanquianus by the number of vertebrae (37-39 vs. Pemrametostat ic50 41-42) and pleural ribs (12-13 vs. 14). These results were also supported by our molecular analyses that revealed a genetic divergence >4% between A.
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