Mcclanahanmaclean3069

Accurate recurrence risk assessment in hormone receptor positive, HER2/neu negative breast cancer is critical to plan precise therapy. CanAssist Breast (CAB) assesses recurrence risk based on tumor biology using artificial intelligence-based approach. We report CAB risk assessment correlating with disease outcomes in multiple clinically high- and low-risk subgroups. In this retrospective cohort of 925 patients [median age-54 (22-86)] CAB had hazard ratio (HR) of 3 (1.83-5.21) and 2.5 (1.45-4.29), P = 0.0009) in univariate and multivariate analysis. CAB's HR in sub-groups with the other determinants of outcome, T2 (HR 2.79 (1.49-5.25), P = 0.0001); age [64% as low-risk. Thus, CAB prognostication was significant in women with clinically low- and high-risk disease. The data imply the use of CAB for providing helpful information to stratify tumors based on biology incorporated with clinical features for Indian patients, which can be extrapolated to regions with similarly characterized patients, South-East Asia.It remains unclear how the source and rate of nitrogen (N) fertilizers affect N2O concentration and effluxes along the soil profile under the drip-fertigated agricultural system. A plot-based field study was performed in 2017 and 2018 in a cotton field in arid northwestern China, with an objective to elucidate the impact of the applications of conventional urea (Urea), polymer-coated urea (ESN) and stabilized urea (SuperU) at rates of 120 and 240 kg N ha-1 on concentration and efflux of N2O in the soil profile and its relationship with N2O surface emissions. The in-situ N2O concentrations at soil depths of 5, 15, 30 and 60 cm were measured and used to estimate soil profile N2O effluxes. Estimates of surface N2O flux using the concentration gradient-based (GM) were compared with those measured using the chamber-based (CM) method. In both years, soil N2O concentrations at all depths increased in response to basal N application at planting or in-season fertigation events. However, N rate or source did not affect soil N2O concentrations or effluxes at each depth. Surface emissions of N2O were mostly associated with that presented in the top layer of 0-15 cm. Surface N2O efflux determined by GM was poorly or not associated with those of chamber measurements, which was attributed to the low N2O production restricted by soil moisture condition under the drip-fertigated condition. These results highlight the challenge of applying the enhanced efficiency N fertilizer products in the drip-fertigated agricultural system.Infection caused by pathogenic bacteria carrying antibiotic resistance genes (ARGs) is a serious challenge to human health. Water environment, including water and surface sediments, is an important repository of ARGs, and the activity of aquatic animal can affect the development of ARG pollution in the water environment. Macrobenthic invertebrates are an important component of aquatic ecosystems, and their effects on ARG development in aquatic environments remain unreported. The distribution of ARGs, including tetA gene, sul2 gene, and kan gene, in Chironomidae larvae is demonstrated in this study for the first time. The ARG distribution was related to sampling points, metal elements, and seasons. Animal models demonstrated that Chironomidae larvae enriched ARGs from water and passed them on to downstream predators in the food chain. Conjugative transfer mediated by resistant plasmids was crucial in the spread of ARG in Chironomidae larvae, and upregulated expression of trfAp gene and trbBp gene was the molecular mechanism. Escherichia in Proteobacteria and Flavobacterium in Bacteroidetes, which are gram-negative bacteria in Chironomidae larvae, are the primary host bacteria of ARGs confirmed via resistance screening and DNA sequencing of V4 region of 16S rRNA gene. Feeding experiments further confirmed that ARGs from Chironomidae larvae can be enriched in the fish gut. Research gaps in food chain between sediments and fish are addressed in this study, and Chironomidae larvae is an important enricher of ARGs in the freshwater environment.

Currently we are faced with countless patients with prolonged invasive mechanical ventilation as a result of the COVID-19 pandemic, with the consequent increase in the need for tracheostomies and the risks that this includes for both patients and staff.

It is necessary to establish a safety protocol for the performance of percutaneous tracheostomies in order to reduce the associated infections.

77 patients underwent tracheostomies between March 2020 and March 2021, evaluating the safety of the protocol and the rate of contagion among the staff.

Percutaneous tracheostomy was performed according to the protocol in 72 patients, 5 were excluded due to unfavorable anatomy or other reasons. There were no cases of SARS COVID-19 contagion among health personnel attributable to the procedure during the three-week follow-up period. There were no surgical complications in this series.

The authors recommend implementing security protocols such as the one discussed in this work, given its low contagion rate and ease of implementation.

The authors recommend implementing security protocols such as the one discussed in this work, given its low contagion rate and ease of implementation.

Intratympanic steroid injections (ITSI) have become a promising treatment for refractory Meniere's disease due to less cochleovestibular damage. However, whether ITSI would be a good alternative to intratympanic gentamicin injections (ITGI) for refractory Meniere's disease still remains controversial. Here we intended to compare the therapeutic effect of ITSI and ITGI in patients with Meniere's disease refractory to conservative treatments, in terms of vertigo control and hearing outcomes, via a meta-analysis.

Using MEDLINE, PubMed, and EMBASE databases, we calculated pooled odds ratio (OR) estimates of vertigo control rate (i.e., class A according to AAO-HNS guideline) and standardized mean differences (SMD) of spell count, pure tone audiometry (PTA) threshold and speech discrimination score (SDS) with a 95% confidence interval (CI). find more The trim-and-fill method and sensitivity analysis were used as post-hoc analyses to verify the integrity of the quantitative analysis results. Furthermore, subgroup analysesurrent evidence on efficacy of ITSI for refractory Meniere's disease needs to be further clarified, given the substantial heterogeneity and potential biases.Because brain development continues during adolescence, childhood trauma is a major health problem in pediatric ages. It is known traumatic brain injury (TBI) results in damage in hippocampal and cortical areas of the brain and impairs cognitive functions. The study aims to investigate the long-term effects of MK-801 (dizocilpine), an N-methyl d-aspartate (NMDA) receptor antagonist, on hippocampal damage, locomotor activity, and cognitive functions following TBI in immature rats. MK-801 (1 mg/kg) was injected intraperitoneally immediately after TBI. Thirty-seven litters were randomly allocated into three groups at 7 days (P7) of postnatal age a control group, a trauma group, and an MK-801 treatment group. The control group received no treatment; the trauma group received saline as vehicle control for the MK-801 group and the MK-801 group received a single dose of 1 mg/kg MK-801 immediately after TBI. Hippocampal damage was examined by Hematoxylin-Eosin staining. Brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), NMDA-R, and glial fibrillar acidic protein (GFAP) immunohistochemistry and, BDNF, NGF, and NMDA-R ELISA protein levels were evaluated 125 days after trauma. Histopathological and immunohistochemical evaluations showed that treatment with MK-801 significantly ameliorated the trauma-induced hippocampal neuron loss and increased BDNF, NGF, NMDA-R, GFAP expressions in CA1, CA3, and DG hippocampal regions. Additionally, treatment with MK-801 decreased anxiety and increased hippocampus-dependent memory of animals subjected to brain injury after TBI. These results show that acute treatment of MK-801 has a neuroprotective role against trauma-induced hippocampal neuron loss and associated cognitive impairment in rats.Dietary flavonoid intake is associated with the regulation of nutrient metabolism in the living body. Observational and cohort studies have reported a negative association between flavonoid intake and the risk of metabolic and cardiovascular diseases. Several intervention trials in humans have also supported the benefits of dietary flavonoids. In experimental studies using animal models, a daily diet rich in typical flavonoids such as catechins, anthocyanin, isoflavone, and quercetin was shown to improve whole-body energy expenditure, mitochondrial activity, and glucose tolerance. For some flavonoids, molecular targets for the metabolic modulations have been suggested. Although the effect of flavonoids on neurons has been unclear, several flavonoids have been shown to regulate thermogenesis and feeding behavior through modulating autonomic and central nervous systems. Based on epidemiological and experimental studies, this review summarizes the evidence on the metabolic benefits of flavonoids and their potential mechanism of action in metabolic regulation.

Prolonged or complicated grief disorder occurs in 9.8% of bereaved adults and can progress into adverse health effects if left unresolved. Evidence on the appropriate and specific diagnostic instrument for the assessment of prolonged or complicated grief disorders is lacking.

The purpose of this study was to evaluate the performance of the most widely used instruments to diagnose grief disorders, including The Inventory of Complicated Grief, The Inventory of Complicated Grief - Revised, and the Prolonged Grief Disorder-13.

Diagnostic meta-analysis.

PubMed, EMBASE, CINAHL, Medline, Scopus, Web of Science, and Cochrane were searched up to July 1, 2020.

We included studies evaluating the sensitivity and specificity of grief disorders diagnostic tools against the comparator tests in individuals who experienced the loss of a family member. A diagnostic meta-analysis of pooled sensitivity and specificity, likelihood ratios, and area under curve were performed with a random-effect and hierarchical model.

licated Grief in the diagnosis of prolonged or complicated grief disorders due to its high sensitivity and specificity values. Further evaluations are needed for the use of Prolonged Grief Disorder-13 and Inventory of Complicated Grief-Revised.

The study is registered with the Open Science Framework (https//osf.io/bs8n6/?view_only=109e76e59efb4d7699153f62564f57ed). Tweetable abstract Inventory of Complicated Grief is a highly recommend instrument with high sensitivity and specificity for diagnosing grief disorders.

The study is registered with the Open Science Framework (https//osf.io/bs8n6/?view_only=109e76e59efb4d7699153f62564f57ed). Tweetable abstract Inventory of Complicated Grief is a highly recommend instrument with high sensitivity and specificity for diagnosing grief disorders.

The World Health Organization has emphasized the critical role of prenatal care in achieving the Millennium Development Goals to reduce child and maternal mortality. The CenteringPregnancy program is a widely recognized model of prenatal care. Several countries have attempted to implement the program in prenatal care practice; however, its effectiveness on maternal and birth outcomes has not been systematically evaluated and analyzed.

To determine the effect of the CenteringPregnancy program on improving maternal and birth outcomes, including low birth weight, preterm birth, and postpartum depression.

This study evaluated and analyzed randomized controlled trials by comparing the CenteringPregnancy program with o0bstetric led prenatal care. Maternal and birth outcomes of interest included low birthweight, preterm birth, and postpartum depressive symptoms.

Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were utilized in this systematic review. Additionally, a supplemental Google Scholar search was performed to capture all relevant articles.