Carverthorup7089

in wheat-based diets, and in poultry, there is a dearth of understanding of the in vivo MOA in pigs fed corn-based diets. The purpose of this review is to explore the role of xylanase in corn-based swine diets, discuss responses observed when supplemented in diets containing corn-based fiber, suggest potential MOA of xylanase, and identify critical research gaps.

Globally 36% of deaths and 42% of Disability Adjusted Life Years (DALYs) are due to communicable, maternal, perinatal and nutritional disorders (CMPND). We examined the state-wise disease burden and treatment cost for these diseases in India for 2017.

DALYs for CMPND was obtained from National Disease Burden Estimate (NBE) Study and the expenditure was determined from the unit level records of persons who reported hospitalization for one or more CMPND in National Sample Survey (NSS)-75th Round.

The top conditions resulting in high DALYs for India were perinatal conditions and nutritional deficiency disorders. Odisha had the highest DALY rate, while Kerala had the lowest DALY rate for CMPNDs. The out-of-pocket expenditure (OOPE) was highest in Chattisgarh, while percentage of households pushed to CHE was highest in Uttar Pradesh for CMPND.

The public healthcare facilities need to be strengthened to facilitate patients with CMPND to undergo treatment that is timely, affordable and cost-effective. Efforts should be made for optimization of strategies aimed at primary and secondary prevention of CMPND and reduce OOPE for treatment of these diseases. In addition, advocacy spreading awareness will reduce the burden and treatment expenditure for CMPNDs in India.

The public healthcare facilities need to be strengthened to facilitate patients with CMPND to undergo treatment that is timely, affordable and cost-effective. Efforts should be made for optimization of strategies aimed at primary and secondary prevention of CMPND and reduce OOPE for treatment of these diseases. In addition, advocacy spreading awareness will reduce the burden and treatment expenditure for CMPNDs in India.

Over the last 2 decades, advances in systemic therapy have increased the expected overall survival for patients with cancer. It is unclear whether the same survival benefit has been conferred to patients requiring surgery for metastatic spinal disease.

To examine trends in postoperative survival over a 20-yr period for patients surgically treated for spinal metastatic disease.

Data were obtained for 1515 patients who underwent surgery for metastatic epidural spinal cord compression or tumor-related mechanical instability. Postoperative overall survival was calculated for all included patients using Kaplan-Meier methodology from date of surgery until death or last follow-up for those who were censored. Trends were analyzed using Cox proportional hazards modeling.

Patients with renal, breast, lung, and colon cancers experienced a statistically significant improvement in survival over time based on the year of surgery (40%-100% improvement over the study period), whereas the overall survival trend for thery for spinal metastatic tumors.Eukaryotic DNA replication is a highly dynamic and tightly regulated process. Replication involves several dozens of replication proteins, including the initiators ORC and Cdc6, replicative CMG helicase, DNA polymerase α-primase, leading-strand DNA polymerase ε, and lagging-strand DNA polymerase δ. These proteins work together in a spatially and temporally controlled manner to synthesize new DNA from the parental DNA templates. During DNA replication, epigenetic information imprinted on DNA and histone proteins is also copied to the daughter DNA to maintain the chromatin status. DNA methyltransferase 1 is primarily responsible for copying the parental DNA methylation pattern into the nascent DNA. Epigenetic information encoded in histones is transferred via a more complex and less well-understood process termed replication-couple nucleosome assembly. Here, we summarize the most recent structural and biochemical insights into DNA replication initiation, replication fork elongation, chromatin assembly and maintenance, and related regulatory mechanisms.Primary cilia are solitary signalling organelles projecting from the surface of most cell types. Although the ciliary membrane is continuous with the plasma membrane it exhibits a unique phospholipid composition, a feature essential for normal cilia formation and function. Recent studies have illustrated that distinct phosphoinositide lipid species localise to specific cilia subdomains, and have begun to build a 'phosphoinositide map' of the cilium. The abundance and localisation of phosphoinositides are tightly regulated by the opposing actions of lipid kinases and lipid phosphatases that have also been recently discovered at cilia. The critical role of phosphoinositides in cilia biology is highlighted by the devastating consequences of genetic defects in cilia-associated phosphoinositide regulatory enzymes leading to ciliopathy phenotypes in humans and experimental mouse and zebrafish models. Here we provide a general introduction to primary cilia and the roles phosphoinositides play in cilia biology. In addition to increasing our understanding of fundamental cilia biology, this rapidly expanding field may inform novel approaches to treat ciliopathy syndromes caused by deregulated phosphoinositide metabolism.

In the setting of intracranial neoplasms, EWSR1-cAMP Response Element-Binding Protein (CREB) transcription factor family fusions have been described in myxoid mesenchymal tumors, extremely rare entities with a close histopathologic and immunologic resemblance to myxoid subtype angiomatoid fibrous histiocytomas (AFH). Controversy exists on whether these central nervous system lesions are a subtype of myxoid AFH or a completely separate entity, which entitles a distinct clinical behavior and, consequently, a different approach to management. Upon review of the literature, only 14 cases of intracranial tumors harboring an EWSR1-CREB family fusion were identified, with only 3 cases presenting in middle-aged adults, none of which reported an EWSR1-CREM fusion mutation. Significant variability in reported radiographic and histopathological characteristics, as well as in clinical outcomes, was noted. Their similarity with other soft tissue tumors, added to the scarce information on its clinical behavior, represents a great diagnostic and therapeutic challenge to the treating physician.

We present a rare case of EWSR1-CREM mutated intracranial myxoid mesenchymal tumor/myxoid subtype AFH presenting as persistent headaches in a 36-yr-old woman with radiographic evidence of rapid growth and extensive vasogenic edema, for which she underwent surgical resection.

This represents a unique case of EWSR1-CREM mutated intracranial myxoid mesenchymal tumor presenting in adulthood, with evidence of aggressive behavior.

This represents a unique case of EWSR1-CREM mutated intracranial myxoid mesenchymal tumor presenting in adulthood, with evidence of aggressive behavior.Irreversible facial palsy, generally post-traumatic or postsurgical, can have devastating consequences for the patient from a functional, aesthetic, and psychological point of view. Among all of the reconstructive techniques, the hemihypoglossal-facial nerve transfer, which avoids the complete section of the hypoglossal nerve, is preferred by senior authors because of its excellent results and very low morbidity.1-5 This technique can be carried out in any neurosurgical center because it requires only basic instruments of microsurgery and a high-speed drill. However, detailed knowledge of the anatomy of the facial nerve in both its intrapetrosal and extracranial segments and of the hypoglossal nerve in its cervical segment is essential.1,6,7 Thus, previous practice in a cadaveric laboratory is recommended. The purpose of this video is to describe the technical nuances and key points of hemihypoglossal-facial nerve transfer. It was made using the surgical videos of 5 patients with a complete and irreversible facial paralysis who were operated using this technique in our institution between May and September 2019, all of whom consented to the procedure and to use for scientific purposes. The footages were edited, making a film in which the surgical technique is described in a stepwise fashion, emphasizing its most important features. To conclude, we would like to emphasize that the timing of surgery is of utmost importance and that this technique is both effective and reliable. Figures in the video at 0054 and 0135 are reprinted by permission from CCC Springer Nature, Acta Neurochirurgica, Treatment of complete facial palsy in adults comparative study between direct hemihypoglossal-facial neurorrhaphy, hemihipoglossal-facial neurorrhaphy with grafts, and massater to facial nerve transfer. Socolovsky M, Martins RS, di Masi G, Bonilla G, Siqueira M, vol 158, 945-957, copyright 2016.The adoption and dissemination of evidence-based programs is predicated on multiple factors, including the degree to which key stakeholders are motivated to implement program best practices. The present study focuses on the development of indicators that capture motivations of teachers to adopt school wellness programming since personal motivations are central to achieving sustainable impacts in these settings. The study specifically describes the measurement development and validation of the Self-Regulations for Educators Questionnaire (SREQ), designed to measure educators' autonomous and controlled motivation for adopting evidence-based programming in their schools. A naturalistic design to study motivation to adopt aspects of NFL PLAY60 programming through the NFL PLAY60 FitnessGram Partnership Project was used. A total of 1,106 teachers completed the SREQ online. Internal validity was assessed through exploratory and confirmatory factor analysis, and predictive validity using structural equation modeling (SEM). The results supported the two-factor solution with separate items capturing aspects of autonomous and controlled motivation. Both factors had good internal reliability and the item-total correlation coefficients were above 0.40 for both factors. The results also supported the predictive validity as autonomous motivation positively predicted the level of overall engagement, teaching effectiveness, fitness testing reports sent home, and completion of fitness testing with students (p less then .05). Controlled motivation positively predicted whether the teachers conducted fitness testing and the engagement of Play 60 Challenge (p less then .05). Findings suggest that the SREQ displays a number of psychometric characteristics that make the instrument useful for examining motivation of providers to implement evidence-based best practices.

Machine learning (ML) algorithms can identify patients with cancer at risk of short-term mortality to inform treatment and advance care planning. However, no ML mortality risk prediction algorithm has been prospectively validated in oncology or compared with routinely used prognostic indices.

To validate an electronic health record-embedded ML algorithm that generated real-time predictions of 180-day mortality risk in a general oncology cohort.

This prognostic study comprised a prospective cohort of patients with outpatient oncology encounters between March 1, 2019, and April 30, 2019. An ML algorithm, trained on retrospective data from a subset of practices, predicted 180-day mortality risk between 4 and 8 days before a patient's encounter. Patient encounters took place in 18 medical or gynecologic oncology practices, including 1 tertiary practice and 17 general oncology practices, within a large US academic health care system. Patients aged 18 years or older with outpatient oncology or hematology and patients with cancer and outperformed routinely used prognostic indices. This algorithm may be used to inform behavioral interventions and prompt earlier conversations about goals of care and end-of-life preferences among patients with cancer.

Facial paralysis (FP) after surgery has substantial functional, emotional, and financial consequences. Most iatrogenic FP is managed by watchful waiting, with the expectation of facial function recovery. A potential treatment is physical therapy (PT).

To investigate whether noninvasive PT compared with no PT or other intervention improves facial nerve outcomes in adults with iatrogenic FP.

Patients with noniatrogenic FP, facial reanimation surgery, and invasive adjunctive treatments (acupuncture or botulinum toxin injection) were excluded. A systematic review was conducted for records discussing iatrogenic FP and PT; a search for these records was performed using Ovid MEDLINE (1946-2019), Embase (1947-2019), Scopus (1823-2019), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform (2004-2019), and ClinicalTrials.gov (1997-2019). The references of all the included articles were also assessed for es benefit and is associated with no harm in patients with iatrogenic FP.

Because of heterogeneity in reported outcomes of facial nerve recovery, definitive conclusions were unable to be made regarding the association between PT and outcomes of iatrogenic FP. Physical therapy probably has benefit and is associated with no harm in patients with iatrogenic FP.

The study aimed to evaluate the validity and spatial accuracy of the Food Standards Agency Food Hygiene Rating online data through a field audit.

A field audit was conducted in five Lower Layer Super Output Areas (LSOAs) in the North East of England. LSOAs were purposively selected from the top and bottom quintiles of the Index of Multiple Deprivation and from urban and rural areas. The FHRS data validity against the field data was measured as Positive Predictive Values (PPV) and sensitivity. Spatial accuracy was evaluated via mean difference in straight line distances between the FHRS coordinates and the field coordinates.

In all, 182 premises were present in the field, of which 162 were in the FHRS data giving a sensitivity of 89%. Eight outlets recorded in the FHRS data were absent in the field, giving a PPV of 95%.The mean difference in the geographical coordinates of the field audit compared to the FHRS was 110 m, and<100 m for 77% of outlets.

After an evaluation of the validity and spatial accuracy of the FHRS data, the results suggest that it is a useful dataset for surveillance of the food environment and for intervention evaluation.

After an evaluation of the validity and spatial accuracy of the FHRS data, the results suggest that it is a useful dataset for surveillance of the food environment and for intervention evaluation.

Epidermoid cysts are rare, benign intracranial neoplasms that typically arise at the cerebellopontine angle (CPA) and can be extensive lesions that intricately involve many critical neurovascular structures. We describe the case of a patient who presents with the classic picture of CPA epidermoid cyst and describe the value of the 4K endoscope for resection, which is illustrated in our accompanying surgical video.

The patient presents with headache, nausea, and vomiting accompanied by dizziness and balance issues. Radiographic imaging demonstrated a large lesion highly consistent with epidermoid cyst which involved the left CPA, encircled the basilar artery, and extended to the opposite side. Surgery was planned with a small left-sided retrosigmoid craniotomy with use of a 2-dimensional 4K endoscope to aid in resection, particularly of the contralateral side. This approach was successful with gross total resection apparent at 14-mo follow-up.

We describe the use of a fully endoscopic technique from a unilateral approach for resection of a lesion that extended in the CPA bilaterally. Additionally, we highlight the relevant neuroanatomical and neurovascular structures in this highly critical intracranial region which is well-visualized through endoscopy in the associated surgical video.

We describe the use of a fully endoscopic technique from a unilateral approach for resection of a lesion that extended in the CPA bilaterally. Additionally, we highlight the relevant neuroanatomical and neurovascular structures in this highly critical intracranial region which is well-visualized through endoscopy in the associated surgical video.The role of agriculture in reducing undernutrition is widely recognized, yet there is also consensus on the need to make the sector nutrition-sensitive. Evidence on the impact pathways from nutrition-sensitive agriculture (NSA) interventions, agricultural interventions with specific nutrition objectives, and actions detailing each temporal stage to reach nutrition outcomes is limited, however. We thus synthesized study results regarding impact of NSA interventions on nutrition outcomes relating to undernutrition, and constructed an impact pathway by mapping the evidence on each temporal stage from interventions to nutrition outcomes. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses to conduct and report our systematic review of studies on NSA interventions implemented in low- and lower-middle-income countries. Forty-three studies that met the inclusion criteria were extracted and synthesized across impact and pathways analyses. We carried out a thematic analysis of the effect of NSA stitutions, food prices at intervention level, and expenditure on health care.Sinorhizobium meliloti is a nitrogen-fixing bacterium forming symbiotic nodules with the legume Medicago truncatula. S. meliloti possesses two BolA-like proteins (BolA and YrbA), the function of which is unknown. In organisms where BolA proteins and monothiol glutaredoxins (Grxs) are present, they contribute to the regulation of iron homeostasis by bridging a [2Fe-2S] cluster into heterodimers. A role in the maturation of iron-sulfur (Fe-S) proteins is also attributed to both proteins. In the present study, we have performed a structure-function analysis of SmYrbA showing that it coordinates diverse divalent metal ions (Fe2+, Co2+, Ni2+, Cu2+ and Zn2+) using His32 and His67 residues, that are also used for Fe-S cluster binding in BolA-Grx heterodimers. It also possesses the capacity to form heterodimers with the sole monothiol glutaredoxin (SmGrx2) present in this species. Using cellular approaches analyzing the metal tolerance of S. meliloti mutant strains inactivated in the yrbA and/or bolA genes, we provide evidence for a connection of YrbA with the regulation of iron homeostasis. The mild defects in M. truncatula nodulation reported for the yrbA bolA mutant as compared with the stronger defects in nodule development previously observed for a grx2 mutant suggest functions independent of SmGrx2. These results help in clarifying the physiological role of BolA-type proteins in bacteria.

Pathogenic variants in retinitis pigmentosa GTPase regulator (RPGR) gene typically lead to a severe form of X-linked retinitis pigmentosa, which is associated with early severe vision loss.

To investigate an X-linked retinal degeneration family with atypical preservation of visual acuity in the presence of a novel deep intronic splice site RPGR c.779-5T>G variant.

In this case series, 3 members of an X-linked retinal degeneration family were studied by in-depth phenotyping and genetic screening at a single center. Data were collected and analyzed from November 2018 to March 2020.

Data were collected on full ophthalmic history, examination, and retinal imaging. A full retinitis pigmentosa gene panel was analyzed by next-generation sequencing. The pathogenicity of the RPGR c.779-5T>G variant was assessed by in silico splice prediction tools and by purpose-designed in vitro splicing assay.

An 84-year-old man was referred with clinical diagnosis of choroideremia and possible inclusion into a gene tation of inconsistent clinical phenotypes between family members. Using a molecular splicing assay, a new pathogenic variant in a noncoding region of RPGR was associated with a proportion of normal and hypomorphic RPGR, where cones are likely to survive longer than expected, potentially accounting for the preserved visual acuity observed in this family.

These results support the importance of careful interpretation of inconsistent clinical phenotypes between family members. Using a molecular splicing assay, a new pathogenic variant in a noncoding region of RPGR was associated with a proportion of normal and hypomorphic RPGR, where cones are likely to survive longer than expected, potentially accounting for the preserved visual acuity observed in this family.

There is no consensus regarding optimal management of pleomorphic adenoma in adults.

To compare parotidectomy with observation for the management of pleomorphic adenoma in patients 50 years or older by age.

This decision analytical model was performed from November 21, 2019, to June 15, 2020, using a Markov model. Model variables and ranges were selected based on a literature review. A 1-way sensitivity analysis was performed to evaluate the age threshold at which each algorithm, either upfront elective parotidectomy or observation, would be favored. A Monte Carlo probabilistic sensitivity analysis using variable ranges was then performed 5 times with patients in the model assigned a starting age of 50, 60, 70, 80, and 90 years to assess how age at diagnosis would be associated with the model results.

Model outcomes were measured with quality-adjusted life-years (QALYs).

In the study models, the age thresholds at which observation became more beneficial than parotidectomy were 88.5 years for patients with superficial lobe tumors (5.37 QALYs in favor of parotidectomy below this age, and 5.37 QALYs in favor of observation above this age) and 83.4 years for patients with deep lobe tumors (7.51 QALYs in favor of surgery below this age, and 7.51 QALYs in favor of observation above this age). There was no significant difference in outcomes between parotidectomy and observation among patients aged 70 to 80 years.

This study suggests that the outcomes associated with parotidectomy and observation are similar at 70 years or older among patients with pleomorphic adenoma and that observation may be the favorable treatment in that age group.

This study suggests that the outcomes associated with parotidectomy and observation are similar at 70 years or older among patients with pleomorphic adenoma and that observation may be the favorable treatment in that age group.

Virtual reality spine simulators are emerging as potential educational tools to assess and train surgical procedures in safe environments. Analysis of validity is important in determining the educational utility of these systems.

To assess face, content, and construct validity of a C4-C5 anterior cervical discectomy and fusion simulation on the Sim-Ortho virtual reality platform, developed by OSSimTechTM (Montreal, Canada) and the AO Foundation (Davos, Switzerland).

Spine surgeons, spine fellows, along with neurosurgical and orthopedic residents, performed a simulated C4-C5 anterior cervical discectomy and fusion on the Sim-Ortho system. Participants were separated into 3 categories post-residents (spine surgeons and spine fellows), senior residents, and junior residents. A Likert scale was used to assess face and content validity. Construct validity was evaluated by investigating differences between the 3 groups on metrics derived from simulator data. The Kruskal-Wallis test was employed to compare groups and a post-hoc Dunn's test with a Bonferroni correction was utilized to investigate differences between groups on significant metrics.

A total of 21 individuals were included 9 post-residents, 5 senior residents, and 7 junior residents. The post-resident group rated face and content validity, median ≥4, for the overall procedure and at least 1 tool in each of the 4 steps. Significant differences (P<.05) were found between the post-resident group and senior and/or junior residents on at least 1 metric for each component of the simulation.

The C4-C5 anterior cervical discectomy and fusion simulation on the Sim-Ortho platform demonstrated face, content, and construct validity suggesting its utility as a formative educational tool.

The C4-C5 anterior cervical discectomy and fusion simulation on the Sim-Ortho platform demonstrated face, content, and construct validity suggesting its utility as a formative educational tool.

Federal policy in the United States prohibits corneal donation by men who have had sex with another man (MSM) in the preceding 5 years, whereas Canada enforces a 12-month ban. The potential consequences of these policies on corneal donations should be evaluated.

To estimate the number of potential corneal donations associated with MSM deferral policies in the United States and Canada.

A nonvalidated telephone survey study was conducted of all 65 eye banks in the United States and Canada to investigate how many potential corneal donors were disqualified in 2018 because of federal MSM restrictions. Published demographic data were also used to arrive at a separate estimate. Survey data were gathered from May 2019 to February 2020.

Eye banks were asked if they keep records of referrals disqualified specifically because of the federal MSM restrictions and, if so, how many referrals they disqualified in 2018 owing to MSM status.

Fifty-four of 65 eye banks (83%) responded to the survey, with 30 eye banks rvailability of vision-restoring surgery worldwide.

Findings suggest that between 1558 and 3217 corneal donations were disqualified in 2018 because of federal regulations prohibiting corneal donation by men who have had sex with another man in the preceding 5 years in the United States or 1 year in Canada. With modern virologic testing that is reliable within days of HIV exposure and given the global shortage of corneal tissue, these policies should be reevaluated using current scientific evidence to increase the availability of vision-restoring surgery worldwide.

Plinabulin is a novel, non-granulocyte colony-stimulating factor (GCSF) small molecule with both anticancer and neutropenia-prevention effects.

To assess the efficacy and safety of plinabulin compared with pegfilgrastim for the prevention of chemotherapy-induced neutropenia following docetaxel chemotherapy in patients with non-small lung cancer.

This was a randomized, open-label, phase 2 clinical trial of 4 treatment arms that was conducted in 19 cancer treatment centers in the United States, China, Russia, and Ukraine. Participants were adult patients with non-small cell lung cancer whose cancer had progressed after platinum-based chemotherapy. Data were collected from April 2017 through March 2018 and analyzed from August 2019 through February 2020.

All patients received docetaxel 75 mg/m2 on day 1 and were randomly assigned to 1 of 3 doses of plinabulin (5, 10, or 20 mg/m2) on day 1 or to pegfilgrastim 6 mg on day 2. Patients were treated every 21 days for 4 chemotherapy cycles.

The primary end pf severe neutropenia will be the primary end point, and bone pain reduction, thrombocytopenia reduction, and quality of life maintenance will be secondary end points.

ClinicalTrials.gov Identifier NCT03102606.

ClinicalTrials.gov Identifier NCT03102606.

Concussion diagnosis remains clinical, without objective diagnostic tests available for adolescents. Known deficits in visual accommodation and autonomic function after concussion make the pupillary light reflex (PLR) a promising target as an objective physiological biomarker for concussion.

To determine the potential utility of PLR metrics as physiological biomarkers for concussion.

Prospective cohort of adolescent athletes between ages 12 and 18 years recruited between August 1, 2017, and December 31, 2018. The study took place at a specialty concussion program and private suburban high school and included healthy control individuals (n = 134) and athletes with a diagnosis of sport-related concussion (SRC) (n = 98). Analysis was completed June 30, 2020.

Sports-related concussion and pupillometry assessments.

Pupillary light reflex metrics (maximum and minimum pupillary diameter, peak and average constriction/dilation velocity, percentage constriction, and time to 75% pupillary redilation [T75]).

re observed, with girls with concussion exhibiting longer T75 (1.96 seconds vs 1.63 seconds; difference, 0.33; 99.4% CI, 0.02-0.65). Among healthy control individuals, diminished PLR metrics (eg, smaller maximum pupil size 3.81 mm vs 4.22 mm; difference, -0.41; 99.4% CI, -0.77 to 0.05) were observed after exercise.

These findings suggest that enhancement of PLR metrics characterize acute adolescent concussion, while exercise produced smaller pupil sizes and overall slowing of PLR metrics, presumably associated with fatigue. Quantifiable measures of the PLR may serve in the future as objective physiologic biomarkers for concussion in the adolescent athlete.

These findings suggest that enhancement of PLR metrics characterize acute adolescent concussion, while exercise produced smaller pupil sizes and overall slowing of PLR metrics, presumably associated with fatigue. Quantifiable measures of the PLR may serve in the future as objective physiologic biomarkers for concussion in the adolescent athlete.

Ocular fundus abnormalities, especially intraocular hemorrhage, may represent a clinically useful prognostic marker in patients with acute subarachnoid hemorrhage (SAH).

To evaluate associations between ocular fundus abnormalities and clinical outcomes in acute SAH.

Prospective evaluation of acute SAH patients with ocular fundus photography at bedside. Multivariable logistic models were used to evaluate associations between fundus abnormalities and poor outcome (inpatient death, care withdrawal, or discharge Glasgow Outcome Score <4) and intensive care unit (ICU) and hospital lengths-of-stay, controlling for APACHE II score, respiratory failure at ICU admission, Hunt & Hess score, aneurysmal etiology, age, and sex.

Fundus abnormalities were present in 29/79 patients with acute SAH (35.4%), and 20/79 (25.3%) had intraocular hemorrhage. In univariate analyses, poor outcomes were more likely among patients with fundus abnormalities vs without (15/28 [53.6%] vs 15/51 [29.4%], P=.03); median length of ICU stay was longer in patients with intraocular hemorrhage than without (18 d [interquartile range (IQR) 12-25] vs 11 [IQR 7-17], P=.03). Logistic regression with fundus abnormality as predictor of interest showed that male sex (odds ratio [OR] 5.33 [95% CI 1.09-26.0], P=.045), higher APACHE II (OR, per 1-point increase, 1.35 [95% CI 1.08-1.78], P=.01), and aneurysmal etiology (OR 4.35 [95% CI 1.01-22.9], P=.048), but not fundus abnormalities (OR 1.56 [95% CI 0.43-5.65], P=.49) or intraocular hemorrhage (OR 1.28 [95% CI 0.26-5.59], P=.75) were associated with poor outcome.

Although ocular fundus abnormalities are associated with disease severity in SAH, they do not add value to patients' acute management beyond other risk factors already in use.

Although ocular fundus abnormalities are associated with disease severity in SAH, they do not add value to patients' acute management beyond other risk factors already in use.During the coronavirus disease 2019 (COVID-19) pandemic, food insecurity has doubled overall and tripled among households with children in the United States. Food insecurity and COVID-19 may exacerbate one another through bidirectional links, leading to a syndemic, or sequential disease clusters, which exacerbate one another. Experiencing food insecurity may be associated with macronutrient and micronutrient deficiencies, which can weaken host defenses, thus increasing susceptibility to COVID-19. Food insecurity is associated with chronic medical conditions, which may afford a higher risk of severe COVID-19 illness. People experiencing food insecurity may have increased exposure to COVID-19 while procuring food. People with COVID-19 may be unable to work, generate income, and procure food while quarantined, which may exacerbate food insecurity. Clinicians should screen for food insecurity during the COVID-19 pandemic and provide referrals to food-assistance programs when appropriate. Policymakers should expand benefits for the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to address increases in the depth and breadth of food insecurity during the COVID-19 pandemic.Currently, there are no standardized treatments for cachexia or severe wasting. There is a growing consensus advocating multimodal interventions to address the complex pathogenesis and metabolic alterations in these conditions. This review examined multimodal treatments intended to alleviate and/or stabilize cachexia and severe wasting. The objectives of this review were to 1) identify multimodal interventions for the treatment of cachexia or associated wasting syndromes in patients with a chronic illness, 2) assess the quality of these studies, and 3) assess the effectiveness of multimodal interventions. Electronic databases including PubMed, MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, CINAHL, PEDro, OpenGrey, and clinicaltrials.org were systematically searched using both text words and MeSH (medical subject heading) terms. The literature revealed a dearth of large, well-conducted trials in this area. Fourteen trials (n = 5 cancer, n = 5 chronic obstructive pulmonary disease, n = 4 chronic kidney disease) were included in this review. A total of 1026 patients were included across all studies; sample size ranged between 21 and 138 patients. Baseline and follow-up data were collected between 6 wk and 24 mo. All demonstrated some improvement in favor of the treatment groups, in relevant measures of body composition, nutrition, biomarkers, and functionality; however, caution should be applied due to the heterogenous nature of the interventions and small sample sizes. Overall, the evidence from this review supports the role of multimodal interventions in the treatment of severe wasting. However, randomized controlled trials with a powered sample size and sufficiently lengthy interaction period are necessary to assess if multimodal interventions are effective forms of therapy for improving body composition and nutritional and physical status in patients with cachexia and wasting. The protocol for this review is registered with Prospero (ID CRD42019124374).

In recent years, the management of metastatic melanoma has been transformed by the emergence of immune checkpoint inhibitors and targeted therapies that significantly improve patient survival. The complementary response kinetics of these treatment approaches, supported by mechanistic evidence that targeted therapy affects immune aspects of the tumor microenvironment, suggest that the optimal combination or sequencing of immune checkpoint inhibitors and targeted therapy may provide additional clinical benefit.

Clinical responses to BRAF and/or MEK inhibitors are associated with immune changes within the tumor microenvironment that have the potential to increase the sensitivity of BRAF V600-mutant melanoma to immune checkpoint inhibitors. The combination of immune checkpoint inhibitors with targeted therapy may therefore increase duration of response, improve tumor control, extend survival, and increase the proportion of patients experiencing durable benefit. A targeted therapy-immune checkpoint inhibitor se approaches to treatment. Several late-stage trials are under way looking to answer open questions in this field and address the continuing debate surrounding up-front combination vs sequencing. As phase 3 data have begun to emerge, trial designs and available data from key studies are discussed in the context of their resultant implications for clinical practice.

Tinnitus affects at least 16 million US adults, but its pathophysiology is complicated, and treatment options remain limited. A heritable component has been identified in family and twin studies; however, no large-scale genome-wide association studies (GWAS) have been accomplished.

To identify genetic risk loci associated with tinnitus, determine genetic correlations, and infer possible relationships of tinnitus with hearing loss and neuropsychiatric disorders and traits.

A GWAS of self-reported tinnitus was performed in the UK Biobank (UKB) cohort using a linear mixed-model method implemented in BOLT-LMM (linear mixed model). Replication of significant findings was sought in the nonoverlapping US Million Veteran Program (MVP) cohort. A total of 172 995 UKB (discovery) and 260 832 MVP (replication) participants of European ancestry with self-report regarding tinnitus and hearing loss underwent genomic analysis. Linkage-disequilibrium score regression and mendelian randomization were performed between ti significant heritability and a polygenic profile with multiple significant risk loci and genes. Genetic correlation and inferred causation between tinnitus and major depressive disorder, educational level, and hearing impairment were identified, consistent with clinical and neuroimaging evidence. These findings may guide gene-based diagnostic and therapeutic approaches to this pervasive disorder.Self-sorting is a spontaneous phenomenon that ensures the formation of complex yet ordered multicomponent systems and conceptualizes the design of artificial and orthogonally functional compartments. In the present study, we envisage chirality-mediated self-sorting in β-amyloid-inspired minimalistic peptide amphiphile (C10-l/d-VFFAKK)-based nanofibers. The fidelity and stereoselectivity of chiral self-sorting was ascertained by Förster resonance energy transfer (FRET) by the judicious choice of a pyrene (Py)-hydroxy coumarin (HOCou) donor-acceptor pair tethered to the peptide sequences. Seed-promoted elongation of the homochiral peptide amphiphiles investigated by AFM image analyses and Thioflavin-T (ThT) binding study further validated the chiral recognition of the l/d peptide nanofibers. Moreover, direct visualization of the chirality-driven self-sorted nanofibers is reported using super-resolution microscopy that exhibits enantioselective enzymatic degradation for l-peptide fibers. Such enantioselective weakening of the hydrogels may be used for designing stimuli-responsive orthogonal compartments for delivery applications.Organic-inorganic perovskite solar cells (PSCs) have attracted tremendous attention due to their high absorption coefficient, high carrier mobility, long diffusion length, and tunable direct bandgap, and their excellent efficiency was boosted to a certified 25.2% efficiency in 2019. However, due to the presence of a high-density of charge traps in perovskite films, plenty of charge recombination occurs at grain boundaries and defects caused by precursor compositions, the process of preparation and crystal growth, thereby restricting the power conversion efficiency (PCE). At present, interfacial modifications by using additives play an important role in various breakthroughs of PSCs. Herein, the effects of various additives with the main types of functional groups, length and spatial configuration of molecules on interfacial modifications in PSCs are reviewed, and their influences on perovskite crystallization and film formation, defect passivation in the bulk and/or at the surface, stabilities of PSCs, and adjusting the interface of structures and energy levels for device performances are also described and summarized. Finally, an outlook of interfacial modifications is provided on the selection and design of efficient additives with respect to the fabrication and development of highly efficient and stable PSCs.Surface tension plays a ubiquitous role in phase transitions including condensation or evaporation of atmospheric liquid droplets. In particular, understanding of interfacial thermodynamics of the critical nucleus of 1 nm scale is important for molecular characterization of the activation energy barrier of nucleation. Here, we investigate surface tension of spherical nanodroplets with both molecular dynamics and density functional theory and find that surface tension decreases appreciably below 1 nm radius, whose analytical expression is consistently derived from the classic Tolman's equation. In particular, the free energy analysis of nanodroplets shows that the change of surface tension originates dominantly from the configurational energy of interfacial molecules, which is evidenced by the increasingly disrupted hydrogen bond network as the droplet size decreases. Our result can be applied to the interface-related phenomena associated with molecular fluctuations such as biomolecule adsorption at the sub-nm scale where macroscopic thermodynamic quantities are ill-defined.Intermetallic alloy nanocrystals have emerged as a promising next generation of nanocatalyst, largely due to their promise of surface tunability. Atomic control of the geometric and electronic structure of the nanoparticle surface offers a precise command of the catalytic surface, with the potential for creating homogeneous active sites that extend over the entire nanoparticle. Realizing this promise, however, has been limited by synthetic difficulties, imparted by differences in parent metal crystal structure, reduction potential, and atomic size. Further, little attention has been paid to the impact of synthetic method on catalytic application. In this review, we seek to connect the two, organizing the current synthesis methods and catalytic scope of intermetallic nanoparticles and suggesting areas where more work is needed. Such analysis should help to guide future intermetallic nanoparticle development, with the ultimate goal of generating precisely controlled nanocatalysts tailored to catalysis.Utilization of solar energy is very important for alleviating the global energy crisis; however, solar-to-electric energy conversion in a compact battery is a great challenge. High charging overpotential of conventional aprotic Li-O2 batteries still restricts their practical application. Herein, we propose a photo-involved rechargeable Li-O2 battery to not only realize direct solar-to-electric energy conversion/storage but also address the overpotential issue. In this photo-involved battery system, the g-C3N4-decorated WO3 nanowire array (WO3@g-C3N4 NWA) heterojunction semiconductor is used as both the photoelectrode and oxygen electrode. Upon charging under visible-light irradiation, the photoexcited holes and electrons are in situ generated on the WO3@g-C3N4 NWA heterojunction cathode. The fabrication of the heterojunction can distinctly reduce the recombination rate between electrons and holes, while photon-generated carriers are effectively and quickly separated and then migrate under a large current density. The discharge product (Li2O2) can be oxidized to O2 and Li+ with a reduced charging voltage (3.69 V) by the abundant photoexcited holes, leading to high energy efficiency, good cycling stability and excellent rate capability. This newly photo-involved reaction scheme could open new avenues toward the design of advanced solar-to-electric energy conversion and storage systems.The regulatory role of the immune system in maintaining bone homeostasis and restoring its functionality, when disturbed due to trauma or injury, has become evident in recent years. The polarization of macrophages, one of the main constituents of the immune system, into the pro-inflammatory or anti-inflammatory phenotype has great repercussions for cellular crosstalk and the subsequent processes needed for proper bone regeneration such as angiogenesis and osteogenesis. In certain scenarios, the damaged osseous tissue requires the placement of synthetic bone grafts to facilitate the healing process. Inorganic biomaterials such as bioceramics or bioactive glasses are the most widely used due to their resemblance to the mineral phase of bone and superior osteogenic properties. The immune response of the host to the inorganic biomaterial, which is of an exogenous nature, might determine its fate, leading either to active bone regeneration or its failure. Therefore, various strategies have been employed, like the modification of structural/chemical features or the incorporation of bioactive molecules, to tune the interplay with the immune cells. Understanding how these particular modifications impact the polarization of macrophages and further osteogenic and osteoclastogenic events is of great interest in view of designing a new generation of osteoimmunomodulatory materials that support the regeneration of osseous tissue during all stages of bone healing.The main mechanism of energy loss in capacitors with nanoscale dielectric films is leakage currents. Using the example of Al-Al2O3-Al, we show that there are two main contributions, namely the cold field emission effect and the hopping conductivity through the dielectric. Our main finding is that an application of a high electric field, ∼0.6-0.7 GV m-1, causes electrons to penetrate the dielectric. If the temperature is sufficiently low, such electrons become permanently trapped in the dielectric. To achieve a strong charging of the dielectric, the voltage needs to be high enough, so that a field emission occurs from the cathode into the dielectric. Such a strongly charged dielectric layer generates a Coulomb barrier and leads to a suppression of the leakage current. Thus, after the dielectric nanolayer of the capacitor is charged, the field emission and the hopping conductivity are both suppressed, and the hysteresis of the I-V curve disappears. The phenomenon is observed at temperatures up to ∼225 K. It would be advantageous to identify insulators in which the phenomenon of the Coulomb barriers persists even up to the room temperature, but at this time it is not known whether such dielectrics exist and/or can be designed.The transdermal drug delivery approach has been considered a potential therapy for human hypertrophic scars (HSs) instead of current uncomfortable surgical excision, local injection and laser therapy. However, a facile and efficient drug delivery method is urgently needed to overcome the skin barrier of transdermal administration. Herein, we employed a DNA-Fe nanoparticle delivery system via Fe ion driven self-assembly to satisfy the requirement of transdermal administration for HS therapy. Doxorubicin hydrochloride (DOX) as one of the widely used anticancer drugs was employed to treat the hyperplasia of abnormal skin fibrous tissue. Both in vitro and in vivo experiments of the DOX loaded DNA-Fe nanoparticles (DOX@DNA-Fe NPs) were performed to demonstrate the penetration ability, rapid drug release, and scar-inhibiting effects. This facile and efficient approach for HS therapy via a DNA-based transdermal drug delivery system may provide more possibilities for the development of transdermal administration.Conductive hydrogel-based epidermal sensors are attracting significant interest due to their great potential in soft robotics, electronic skins, bioelectronics and personalized healthcare monitoring. However, the conventional conductive hydrogel-based epidermal sensors cannot be degraded, resulting in the significant problem of waste, which will gradually increase the burden on the environment. Herein, degradable adhesive epidermal sensors were assembled using conductive nanocomposite hydrogels, which were prepared via the conformal coating of cellulose nanofiber (CNF) networks and supramolecular interaction among CNF, polydopamine (PDA), Fe3+, and polyacrylamide (PAM). They exhibited superior mechanical properties, reliable degradability (30 days in water), and excellent self-adhesiveness. The obtained hydrogels could be assembled as self-adhesive, degradable epidermal sensors for real-time human motion monitoring. Air could be sucked into the hydrogels during their swelling process, thereby oxidizing the tris-catechol-Fe3+ complexes and releasing Fe3+. Finally, the polymer networks were degraded via a Fenton-like reaction dominated by S2O82- and Fe(ii/iii) with the help of the catechol groups of PDA. This work paves the way for the potential fabrication of degradable, and self-adhesive epidermal sensors for applications in human-machine interactions, implantable bioelectronics, and personalized healthcare monitoring.Supercapacitor energy storage devices recently garnered considerable attention due to their cost-effectiveness, eco-friendly nature, high power density, moderate energy density, and long-term cycling stability. Such figures of merit render supercapacitors unique energy sources to power portable electronic devices. Among various energy storage materials, graphene-related materials have established themselves as ideal electrodes for the development of elite supercapacitors because of their excellent electrical conductivity, high surface area, outstanding mechanical properties combined with the possibility to tailor various physical and chemical properties via chemical functionalization. Increasing the surface area is a powerful strategy to improve the performance of supercapacitors. Here, modified polyhedral oligosilsesquioxane (POSS) is used to improve the electrochemical performance of reduced graphene oxide (rGO) through the enhancement of porosity and the extension of interlayer space between the sheets allowing efficient electrolyte transport. rGO-POSS hybrids exhibited a high specific capacitance of 174 F g-1, power density reaching 2.25 W cm-3, and high energy density of 41.4 mW h cm-3 endowed by the introduction of POSS spacers. Moreover, these electrode materials display excellent durability reaching >98% retention after 5000 cycles.A series of water soluble 8-alcoxypyrene-1,3,6-trisulfonic sodium salts bearing different alcoxy lateral chains and functional end groups was synthesized and the molecular structure was corroborated by nuclear magnetic resonance spectroscopy. The photophysical properties in water analyzed by UV-Vis and static and dynamic fluorescence revealed that all of the pigments emit in the blue region at a maximal wavelength of 436 nm and with fluorescence lifetimes in the range of ns. Among them, sodium 8-((10-carboxydecyl) oxy) pyrene-1,3,6-trisulfonate M1 exhibits a high fluorescence quantum yield (φ = 80%) and a good interaction with B. subtilis LPM1 rhizobacteria; this has been demonstrated through in vitro staining assays. Tomato plants (Solanum lycopersicon cv. Micro-Tom) increased the release of root exudates, mainly malic and fumaric acids, after 12 h of treatment with benzothiadiazole (BTH) as a foliar elicitor. However, the chemotaxis analysis demonstrated that malic acid is the most powerful chemoattractant of the rhizobacteria Bacillus subtilis LPM1 in agar plates, a major growth (60 mm) was found for a concentration of 100 mM, while in capillary tubes, the earliest response was at 30 min with 3.