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All rights reserved.A 25-year-old male was referred to hepatology clinic for abnormal liver enzymes AST 242 IU/L, ALT 507 IU/L, alkaline phosphatase 139 IU/L, INR 1.1, bilirubin 1.3 mg/dl, and albumin 4.2 g/dL. His hemoglobin was 13.3 g/dl and platelet count 130 x109 /L. The patient reported heavy alcohol use in teenage years but quit 1 year prior to presentation. Serologic testing was negative for viral hepatitis, autoimmune markers, Wilson disease, schistosomiasis, and alpha-1-antitrypsin deficiency. Transferrin saturation was 3%, ferritin 21 ng/ml, and 25-OH-vitamin D 14.1 ng/ml. A liver biopsy showed bilirubinostasis, portal inflammation, and bridging fibrosis. This article is protected by copyright. All rights reserved.In the present study, a rapid derivatization liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated to evaluate phenylephrine in human plasma. [https://www.selleckchem.com/products/ademetionine.html Ademetionine nmr] The plasma samples were processed to precipitate the proteins, followed by derivatization of the phenylephrine in the plasma with dansyl-chloride solution and extraction with methyl tert-butyl ethern-hexane (21; (v/v)). The treated samples were analyzed on a Gemini C18 column with 3-min gradient elution, and sensitive detection was achieved with a Waters TQ-s. The method gave linear results over a concentration range from 0.020 to 10.0 ng/mL. The lower limit of quantification was 0.020 ng/mL. Intra- and inter-day precision was less then 15%, and accuracy was 95.0-105.3%. The validated LC-MS/MS method was successfully applied in the pharmacokinetic analysis of phenylephrine in Chinese subjects with common cold after a single-dose administration of 5, 10, or 20 mg phenylephrine. This pre-column derivatization method may also be applied in the analysis of endogenous hormones such as norepinephrine and adrenaline in a biological matrix. This article is protected by copyright. All rights reserved.The aim of this study was to demonstrate the altered metabolic infrastructure of pregnant women with methylenetetrahydrofolate reductase (MTHFR) polymorphisms at first trimester and during delivery. Eight singleton pregnant women with MTHFR polymorphisms were compared with 10 normal pregnant women. Maternal blood samples were obtained twice during their pregnancy period (between the 11th and 14th gestational weeks and during delivery). Metabolomic analysis was performed using GC-MS. The GC-MS based metabolomic profile helped identify 95 metabolites in the plasma samples. In the MTHFR group, the levels of 1-monohexadecanoylglycerol, pyrophosphate, benzoin, and linoleic acid significantly decreased (P ˂ 0.05 for all), whereas the levels of glyceric acid, l-tryptophan, l-alanine, l-proline, norvaline, l-threonine, and myo-inositol significantly increased (P ˂ 0.01 for the first two metabolites, P ˂ 0.05 for the others) at 11-14 gestational weeks. Conversely, the levels of benzoin, 1-monohexadecanoylglycerol, pyruvic acid, l-proline, phosphoric acid, epsilon-caprolactam, and pipecolic acid significantly decreased in the MTHFR group, whereas metabolites such as hexadecanoic acid and 2-hydroxybutyric acid increased significantly in the study group during delivery. An impaired energy metabolism pathway, vitamin B complex disorders, tendency for metabolic acidosis (oxidative stress), and the need for cell/tissue support seem prevalent in pregnancies with MTHFR polymorphisms. © 2020 John Wiley &amp; Sons, Ltd.This policy brief sets forth American Geriatrics Society (AGS) recommendations to guide federal, state, and local governments when making decisions about care for patients with COVID-19 in nursing homes (NHs) and other long-term care facilities (LTCFs). The AGS continues to review guidance set forth in peer-reviewed articles and editorials, as well as ongoing and updated guidance from the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and other key agencies. This brief is based on the situation and any federal guidance/actions as of April 4, 2020. It is focused on NHs and other LTCFs, given their essential role in addressing the COVID-19 pandemic. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.KEY POINTS Lymphatic valve defects are one of the major causes of lymph transport dysfunction; however, there are no accessible methods for quantitatively assessing valve function. This manuscript provides a novel technique for quantifying lymphatic valve back-leak. Postnatal endothelial-specific deletion of Cx43 in Cx37-/- mice results in rapid regression of valve leaflets and severe valve dysfunction. This method can also be used for assessing the function of lymphatic valves from various species, including humans. ABSTRACT The lymphatic system relies on robust, spontaneous contractions of collecting lymphatic vessels and one-way secondary lymphatic valves to efficiently move lymph forward. Secondary valves prevent reflux and allow for the generation of propulsive pressure during each contraction cycle. Lymphatic valve defects are one of the major causes of lymph transport dysfunction. Genetic mutations in multiple genes have been associated with the development of primary lymphedema in humans and many of tes displaying a wide range of dysfunction, from fully-competent to completely incompetent. Our results were validated by simultaneous direct measurement of pressure back-leak using a servo-null micropressure system. Our diameter-based technique can be used to quantify valve function in isolated lymphatic valves from a variety of species. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.PURPOSE The goal was to develop and test a large diameter parallel plate ionization chamber capable of intercepting at least 98% of the proton beamlets tested with the system. METHODS A commercial synchrotron proton therapy system was used for the study (Hitachi, Ltd, Hitachi City, Japan; Model Probeat-V). The energies investigated were in the range of 100 to 192 MeV. 3 beam spot options available from the system were used. A PTW Bragg peak IC of diameter 84 mm (BP84) (Model PTW34070) was employed for comparison in a scanning water phantom. A prototype of 150 mm diameter was produced (PTW, Freiburg, Germany; model T34089) and used for the testing. Monte Carlo calculations were also performed with FLUKA to guide the BP150 design and for comparison to the radiological measurements. For comparison, a 40 cm diameter ideal virtual detector was included in the Monte Carlo model. RESULTS The measured proton range R90 agrees between the BP84 and BP150 ionization chambers within +0.06/-0.27 mm across the energies 100 - 192 MeV, which is less than the daily experimental setup uncertainty of 0.