Pilegaardzimmermann1032

Objective The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of psychiatric care, including consultation-liaison psychiatry (CLP) services. The objective of this study was to assess the demographic and clinical profiles of psychiatric referrals made to CLP services during the pandemic period and compare to data during the same timeframe from the previous year at a tertiary care center in North India.Methods Data of patients referred for CLP consultation and seen by the CLP team in the medical-surgical wards wherein COVID-negative patients were admitted during the period of March 24, 2020, to October 11, 2020 (approximately 6.5 months, 201 days) were extracted from the CLP register (routinely maintained). These data were compared with that of the same timeframe from the previous year (March 24, 2019, to October 11, 2019).Results During 2020, a total of 562 patients were referred to CLP services, in contrast to 1,005 patients referred in 2019, suggesting a 44% reduction in the number of ris a need to modify CLP services to address the needs of patients referred to CLP services, especially during the COVID-19 pandemic.Exploring the metabolic characteristics of indigenous PAH degraders is critical to understanding the PAH bioremediation mechanism in the natural environment. While stable-isotopic probing (SIP) is a viable method to identify functional microorganisms in complex environments, the metabolic characteristics of uncultured degraders are still elusive. Here, we investigated the naphthalene (NAP) biodegradation of petroleum polluted soils by combining SIP, amplicon sequencing and metagenome binning. Based on the SIP and amplicon sequencing results, an uncultured Gammaproteobacterium sp. was identified as the key NAP degrader. Additionally, the assembled genome of this uncultured degrader was successfully obtained from the 13 C-DNA metagenomes by matching its 16S rRNA gene with the SIP identified OTU sequence. Meanwhile, a number of NAP degrading genes encoding naphthalene/PAH dioxygenases were identified in this genome, further confirming the direct involvement of this indigenous degrader in the NAP degradation. The degrader contained genes related to the metabolisms of several carbon sources, energy substances and vitamins, illuminating potential reasons for why microorganisms cannot be cultivated and finally realize their cultivation. Our findings provide novel information on the mechanisms of in situ PAH biodegradation and add to our current knowledge on the cultivation of non-culturable microorganisms by combining both SIP and metagenome binning.In this era of global environmental change and rapid regime shifts, managing for core areas that species require to survive and persist is a grand challenge for conservation. Because wildlife monitoring data are often limited or local in scale, the emerging ability to map and track spatial regimes (i.e., the spatial manifestation of state transitions) using advances in geospatial vegetation data has the potential to provide earlier warnings of habitat loss because many species of conservation concern strongly avoid spatial regime boundaries. Using 23 years of Greater Prairie-Chicken (Tympanuchus cupido; GPC) lek location data in a remnant grassland ecosystem, we demonstrate how mapping changes in the boundaries between grassland and woodland spatial regimes provides a spatially-explicit early warning signal for habitat loss for an iconic and vulnerable grassland-obligate known to be highly sensitive to woody encroachment. We tested whether a newly proposed metric for the quantification of spatial regimes captPC lek site usage relative to grasswoody boundary strength. These novel spatial metrics allow managers to rapidly screen for early warnings of spatial regime shifts and adapt management practices to defend and grow habitat cores at broad scales.Drawing on personal testimonials and questions addressed to psychiatric hospital officials, this article explores how patients and their loved ones engaged with the idea of diagnosis in interwar and war-era America. I argue that diagnosis had synergies with intellectual sensibilities of American modernity, among them an enthusiasm for science and newness, a modernist sense of time that could be both forward- and backward-looking, and a knowable, interpreted self. While self-understanding and the creation of life narratives were more often considered the bailiwick of psychoanalysis in this period, understanding subjectivity and self-interpretation were not solely expressed in its conceptual vocabulary. Patient and family dialogs with diagnosis and psychiatric authorities allow for an illumination of the interaction between domestic intuitions, common sense, and folk wisdom, on the one hand, and institutional taxonomy, categorization, and scientific terminology on the other, or more broadly, between dispositions that are ostensibly antimodern and more modern ideas. I suggest that the protean and wide-ranging intellectual origins of the discipline of psychiatry, along with the inherent ambiguity of psychiatric diagnosis during the early 20th century, allowed patients to participate in their own medicalization in the most capacious way possible by combining biology with diagnostic narrative capacities, as well as broader perceptions of morality and character. In the concluding reflection, I speculate about why it is that late 20th-century American critics and activists have tended to view diagnosis and medicalization as coercive and threatening, in contrast to earlier 20th-century patients and their intimate observers.

Carbon dioxide (CO

) insufflation during gastric endoscopic submucosal dissection (GESD) under sedation can be used instead of room air insufflation. Appropriate monitoring of the partial pressure of CO

during GESD is necessary due to the impaired respiration. The aim of this study was to assess the safety and efficacy of CO

insufflation during GESD compared with conventional room air insufflation.

Patients with a gastric epithelial neoplasm or early gastric cancer were enrolled. A total of 76 consecutive patients were randomly assigned to the CO

insufflation group (CO

group) or the room air insufflation group (air group). The primary outcome was the mean difference of end-tidal CO

(EtCO

) between two groups.

The mean difference of EtCO

levels between the two groups before the procedure and at 15, 30 and 45 minutes after insufflation were met criteria for non-inferiority. A-1331852 In a subgroup analysis of patients 70 years and older, the mean difference of EtCO

was not significantly different between two groups. However, the air group received more analgesics than the CO

group after the procedure (67.6% vs. 35.1%, p = 0.005). In addition, in terms of improvement of abdominal pain or bowel gas after 24 hours of GESD, CO

group showed better results than air group (both p < 0.05).

CO

insufflation during GESD is as safe as using room air, and patients, including elderly patients, receiving CO

achieve more rapid relief of abdominal pain and intra-abdominal residual gas during and after the procedure.

CO2 insufflation during GESD is as safe as using room air, and patients, including elderly patients, receiving CO2 achieve more rapid relief of abdominal pain and intra-abdominal residual gas during and after the procedure.Camrelizumab (a humanized high-affinity IgG4 mAb against PD-1) showed potent antitumor activity, well tolerance, and controllable safety in patients with relapsed or refractory classical Hodgkin lymphoma (r/r cHL), based on the primary analysis of a phase 2 study. Here, we present the extended follow-up outcomes. Seventy-five patients who had failed to achieve a remission or experienced progression after autologous stem cell transplantation or had received at least two lines of systemic chemotherapies were enrolled to receive camrelizumab 200 mg every 2 weeks. With a median follow-up of 36.2 months (range, 7.2-38.1), objective response rate per independent central review was 76.0% (95% CI, 64.7-85.1). Among the 57 responders, 31 (54.4%) had ongoing responses. Median duration of response was 31.7 months (95% CI, 16.7-not reached). Median progression-free survival was 22.5 months (95% CI, 14.7-not reached). 36-month overall survival rate was 82.7% (95% CI, 72.0-89.5). Reactive capillary endothelial proliferation (RCEP) occurred in 97.3% of patients (73/75), but all RCEP were grade 1 or 2 in severity and 67.1% of these patients (49/73) achieved complete resolution. Occurrence of new RCEP lesions was rare (8/42 [19.0%] at 12 months; 2/32 [6.3%] at 24 months). No treatment-related deaths occurred, and no new toxicities were reported. With extended follow-up, camrelizumab monotherapy continues to provide a robust and durable response, long survival, and manageable safety in r/r cHL patients. This article is protected by copyright. All rights reserved.The increasing dementia prevalence worldwide is driving the testing of novel therapeutic approaches, such as invasive brain technologies, despite limited clinical evidence and the risk of accelerating cognitive decline. Our manuscript (a) reviews the NIH Clinicaltrials.gov database for deep brain stimulation, stem cell implantation, and gene therapy trials on people with dementia; (b) discusses issues on beneficence, nonmaleficence, and autonomy associated with these trials; and (c) proposes nine recommendations that build on elements from the Declaration of Helsinki. We found 49 preregistered high-risk trials from nine countries planning to or involving 11,801 people with Alzheimer's or Lewy body dementia or dementia secondary to Parkinson's or Huntington's disease. Most of the people with Alzheimer's who are in these trials are from North America and East Asia. There is substantial heterogeneity in the enrolment criteria, even for trials recruiting only those with Alzheimer's disease. Although most trials enrol people in mild to moderate stages of Alzheimer's disease, trials in China enrol people who have severe Alzheimer's. Our findings highlight a pressing need to review and refine the enrolment criteria for invasive neural trials in people with dementia, considering risks, potential benefits, and capacity for informed consent. As a multidisciplinary team from Australia, the USA, Canada, and Germany with expertise in neurology, neuroscience, and ethics, we examine how it is essential to balance the risks of invasive neural research in a vulnerable population with limited capacity to provide informed consent to help advance the body of knowledge regarding a disease with limited therapeutic options.

Foetal tobacco and cannabis exposure may have persistent cardio-metabolic consequences in the offspring.

We examined the associations of maternal and paternal tobacco and cannabis use during pregnancy with offspring body fat and cardio-metabolic outcomes.

In a population-based prospective cohort study among 4792 mothers, fathers, and children, we assessed parental substance use by questionnaires. Childhood outcomes included body mass index (BMI), body fat, blood pressure, and lipid, glucose and insulin concentrations at 10 years.

Children exposed to maternal tobacco use during pregnancy had a higher android/gynoid fat mass ratio (difference 0.22 SDS, 95% confidence interval [CI] 0.13, 0.30), fat mass index (difference 0.20 SDS, 95% CI 0.12, 0.28), triglyceride concentrations (difference 0.15 SDS, 95% CI 0.04, 0.26), and a higher risk of overweight (odds ratio [OR] 1.35, 95% CI 1.07, 1.71), compared to non-exposed. Children exposed to maternal cannabis during pregnancy had a higher BMI (difference 0.26 SDS, 95% CI 0.