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To examine the rate of persistence with anti-seizure medications (ASMs) in a cohort of patients with epilepsy, and to investigate the impact of a range of clinical and demographic factors on persistence METHODS Patients receiving ASMs for epilepsy were identified from linked, routinely collected data within the NHS Greater Glasgow and Clyde health board area between January 2011 and August 2019. Persistence with individual ASMs at 365-days after initiation was assessed using a 90-day allowable gap between individual prescriptions. Univariate logistic regression was used to estimate the association between 1-year persistence with ASM and demographic characteristics, comorbidities, and medication characteristics.

In total, 6,449 patients with epilepsy were identified - 1,631 were new users of ASMs at baseline and 4,818 had been prescribed at least one ASM prior to baseline. Persistence with individual ASMs ranged 11.8% to 78.6%. Persistence was significantly lower in younger patients and patients who had previously been non-persistent to ASMs. Persistence was higher amongst those with cardiac comorbidities, previous stroke, or higher overall comorbidity, as well as those prescribed newer ASMs.

Persistence varied widely. CDK4/6-IN-6 Demographic factors, previous non-persistence and overall number of comorbidities were more important determinants of persistence to anti-seizure medications than specific individual comorbidities. Interventions to improve persistence should be targeted at younger patients from more deprived backgrounds and those who have previously been non-persistent with ASMs.

Persistence varied widely. Demographic factors, previous non-persistence and overall number of comorbidities were more important determinants of persistence to anti-seizure medications than specific individual comorbidities. Interventions to improve persistence should be targeted at younger patients from more deprived backgrounds and those who have previously been non-persistent with ASMs.

Psychotic disorder not otherwise specified (PNOS) is considered part of the psychosis spectrum, together with schizophrenia spectrum disorders (SSD) and psychotic bipolar spectrum disorders (PBD). The atypical clinical presentations of PNOS conditions may lead to uncertainty regarding treatment choices and expected outcomes. PNOS is understudied, and little is known about patients' premorbid characteristics including premorbid adjustment, prevalence of early cannabis use and childhood trauma. Knowledge about early illness phases can increase our understanding of this diagnostic group.

We included 1099 participants from the Norwegian TOP-study; 688 with narrow SSD diagnoses (schizophrenia, schizoaffective disorder, schizophreniform disorder), 274 with PBD (psychotic bipolar 1 and bipolar NOS) and 137 with PNOS diagnosed with the SCID-I for DSM-IV. Participants were assessed with the Premorbid Adjustment Scale (PAS) divided into the areas of premorbid academic and social functioning. We obtained informatione results indicate that many conditions classified as PNOS have functional impairments and problematic substance use from an early age. The prevalence of childhood adversities are high in all three groups.

Participants with PNOS appear as more similar to participants with SSD than to those with PBD regarding early premorbid adjustment and early cannabis use. The results indicate that many conditions classified as PNOS have functional impairments and problematic substance use from an early age. The prevalence of childhood adversities are high in all three groups.We propose a method to adjust contributions from upwind emissions to downwind PM2.5 concentrations to account for the differences between observed and simulated PM2.5 concentrations in an upwind area. Emissions inventories (EI) typically have a time lag between the inventory year and the release year. In addition, traditional emission control policies and social issues such as the COVID-19 pandemic cause steady or unexpected changes in anthropogenic emissions. These uncertainties could result in overestimation of the emission impacts of upwind areas on downwind areas if emissions used in modeling for the upwind areas were larger than the reality. In this study, South Korea was defined as the downwind area while other regions in Northeast Asia including China were defined as the upwind areas to evaluate applicability of the proposed adjustment method. We estimated the contribution of emissions released from the upwind areas to PM2.5 concentrations in South Korea from 2015 to 2020 using a three-dimensional photochemical model with two EIs. In these two simulations for 2015-2020, the annual mean foreign contributions differed by 4.1-5.5 µg/m3. However, after adjustment, the differences decreased to 0.4-1.1 µg/m3. The adjusted annual mean foreign contributions were 12.7 and 8.8 µg/m3 during 2015-2017 and 2018-2020, respectively. Finally, we applied the adjustment method to the COVID-19 pandemic period to evaluate the applicability for short-term episodes. The foreign contribution of PM2.5 during the lockdown period in China decreased by 30% after adjustment and the PM2.5 normalized mean bias in South Korea improved from 15% to -4%. This result suggests that the upwind contribution adjustment can be used to alleviate the uncertainty of the emissions inventory used in air quality simulations. We believe that the proposed upwind contribution adjustment method can help to correctly understand the contributions of local and upwind emissions to PM2.5 concentrations in downwind areas.To produce an edible film with high mechanical and physicochemical properties, Tuna skin collagen-chitosan (TSC-CTS) composite films were prepared by incorporating ultrasound (UT) and pomegranate polyphenols including gallic acid (GA), tannic acid (TA), and ellagic acid (EA), respectively. The tensile strength and the DPPH scavenging activity of the GA-UT-TSC-CTS film (ultrasound frequency of 28 ± 0.5 kHz, power of 100 W/L, sweep frequency cycle of 100 ms, duty ratio of 77% and time of 10 min; GA concentration of 1.0 g/L and reaction time of 10 min) were increased by 47.03% and 24.16 folds, respectively compared to the control (TSC-CTS film). Meanwhile, light transmittance and water vapor permeability of the GA-UT-TSC-CTS film were decreased by 29.26% and 15.70%, respectively. These positive modification results were attributed to the altered structure during the film formation process, which were verified by Fourier transform infrared spectroscopy (FTIR), circular dichroism (CD), X-ray diffraction (XRD), and thermogravimetry results. Moreover, the GA-UT-TSC-CTS film possessed moderate thermal stability and color indexes and improved antibacterial activity. The antibacterial effect of the film against Bacillus subtilis was the highest, followed by Escherichia coli, Listeria monocytogenes, and Staphylococcus aureus. Overall, the combination modification of gallic acid and ultrasound was an efficient modification method to improve the mechanical, antioxidant, and antibacterial properties of edible TSC-CTS films.Malaria is critical to rule out in febrile returned travelers. We evaluated the performance of the Alethia Malaria loop-mediated isothermal amplification (LAMP) assay for rapid one-time malaria screening using nucleic acid amplification testing. Retrospective analysis of 51 archival blood specimens collected from 32 patients with malaria and 25 uninfected controls showed Malaria LAMP assay to have sensitivity of 100% (95% CI 93.0-100) and specificity of 100% (95% CI 86.7-100) using blood smear microscopy as the reference standard. Prospective evaluation of Malaria LAMP as a single screening test in 205 patients identified 4 (1.95%) positives which were all confirmed as Plasmodium falciparum by PCR, with parasitemia quantified as less then 0.1% (n = 2), 1.0% (n = 1), and 4.6% (n = 1). Alternative diagnoses were found in 129 of 201 (64.2%) of LAMP-negative patients, and no patient was subsequently diagnosed with malaria. The Malaria LAMP offers a sensitive and rapid stand-alone screening alternative in non-endemic settings.The low FODMAP diet has shifted therapeutic guidelines for symptom management in irritable bowel syndrome. Given FODMAPs are involved in underlying pathological mechanisms of visceral hypersensitivity, research groups are exploring the use of the low-FODMAP diet as a potential management approach in several conditions outside of irritable bowel syndrome. Early data shows promise for functional dyspepsia, improving epigastric symptoms, and although evidence is scant, the diet has been proposed to assist in small intestinal bacterial overgrowth. Characterisation of sucrase-isomaltase deficiency may offer profiling for predicting response to the diet. Although encouraging, carefully controlled broader trials are needed across the conditions discussed to completely understand the effects of the low FODMAP diet on symptoms, safety, and efficacy in clinical practice.Calcium sulfate/hydroxyapatite (CaS/HA) biomaterials have been investigated for use in several orthopedic applications. However, the mechanical interactions between the composite of CaS/HA and bone at the microscale are still unknown. The aim of this study was to determine if and how augmentation with CaS/HA alters the fracture behavior of bone. Eleven cylinders of trabecular bone were drilled from human femoral heads and cleaned from bone marrow. Among them, five cylinders were injected with CaS/HA to generate composite specimens, while the others were kept intact. One extra specimen of pure CaS/HA was prepared. All specimens were compressed in situ using synchrotron X-ray tomography and imaged at ∼2% strain intervals. Structural properties were calculated from the images in unloaded state and mechanical properties were determined from the load-curves. CaS/HA alone displayed the highest peak force and stiffness and the lowest strain at fracture. All composite specimens had a higher peak force than the pure bone specimens and the composite specimens had higher toughness than the pure CaS/HA specimen. Furthermore, the fracture behavior was analyzed further to characterize the local deformations. The pure bone specimens presented damage in multiple trabeculae and the CaS/HA specimen displayed sharp transition in strains, with low strain in one load step and large cracks in the next. The composite specimens deformed uniformly, with the CaS/HA preventing tissue damage and the bone preventing cracks in the CaS/HA from propagating through the specimen. In conclusion, using tomography with in situ loading, it was possible to show how CaS/HA can help prevent bone tissue damage before global failure.

This investigation evaluated the impact of multiple firings during the veneering process of anterior all-ceramic restorations on the fracture load (FL) of zirconia crowns veneered with different ceramics (ZRT, ZRO, HFZ, STR).

All-ceramic crowns with anatomically reduced zirconia frameworks were prepared using four different veneering ceramics (N=192/n=48 per veneering ceramic). The crowns were fired 2 and 10 times. Half of them were thermocycled (5000 cycles, 5°C/55°C, 20s). FL using Voss shear test was measured. Data was analyzed using ANOVA with partial eta squared and post-hoc Scheffé-test as well as t-test and Weibull analysis.

Regarding FL, greatest differences were among the number of firings (p<0.001, η



=0.369). FL was not influenced by the interaction of both number of firings and aging level (p=0.231) and the interaction of number of firings and veneering ceramic (p=0.222). Differences were found comparing FL values of ZRT and STR (p<0.001) and of HFZ and STR (p<0.001). No differences occurred among the veneering ceramics after 2 (p=0.