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Thus, EUS-FNA should be utilized more frequently to help distinguish benign pancreatic LECs from premalignant or malignant lesions to avoid surgery. Copyright © 2020 Grace E. Kim et al.Background Sodium valproate has anticonvulsant activity and is structurally different to conventional antiepileptic drugs. The problem with valproic acid is the lack of a chromophore, which means that gas chromatography is the sole assay methodology. The introduction of benzoyl and phenyl groups to the molecule is a useful derivatisation, which enables the creation of detectable chromophores for HPLC analysis for pharmaceutical dosages as well as biological systems. Methodology. Sodium valproate was derivatised by the addition of a chromophore to its structure by introducing a methyl benzoyl or a phenyl group. Trichlorophenol and 2-hydroxyacetophenone were used to introduce phenyl and benzoyl groups to valproic acid, respectively. The reaction used was estrification reaction using coupling agents. An analytical method was then developed and validated using reverse-phase HPLC. The method was validated for parameters like linearity, range, accuracy precision, and robustness. Results The developed method was easy and feasible and can be applied to both routine analysis and bioanalysis. The method was very sensitive and could quantify valproic acid at a very low concentration of 0.75 × 10-5 mg/ml. The developed method was found to be linear (R 2 = 0.997), accurate, precise, and robust. Conclusion The proposed chemical derivatisation and the developed analytical method are novel. The developed analytical procedure is the first of its kind; it is easy and feasible and can be used to quantify and detect sodium valproate at very low concentrations compared to other available methods in the literature. Copyright © 2020 Murad Abualhasan et al.Studies conducted in nursing homes/hospitals have shown that organizational culture plays an important role in care delivery and group culture leads to better quality of care. To explore the organizational culture and care delivery in adult day services (ADS) centers in Taiwan, we used both quantitative and qualitative research methods. Quantitative data from the Competing Values Framework (CVF) assessment showed that the group culture was dominant at all three centers. Qualitative data from observation and staff interviews uncovered both group and nongroup cultural elements. The group cultural elements, such as flexible management, teamwork environment, and sharing the same values, contributed to good care; however, the nongroup cultural elements, such as the staff-centered view, hierarchy, and conflicts within the leadership, led to negative staff-staff and staff-clients interactions. Further research is needed to untangle the complexity between quality care delivery and organizational culture. Copyright © 2020 Chih-Ling Liou and Mary Dellmann-Jenkins.This review assesses four interrelating aspects of patient-controlled analgesia (PCA), a long-standing and still widely used concept for postoperative pain management. Over the years, anaesthesiologists and patients have appreciated the benefits of PCA alike. The market has seen new technologies leveraging noninvasive routes of administration and, thus, further increasing patient and staff satisfaction as well as promoting safety aspects. Pharmaceutical research focuses on the reduction or avoidance of opioids, side effects, and adverse events although influence of these aspects appears to be minor. The importance of education is still eminent, and new educational formats are tested to train healthcare professionals and patients likewise. MK8353 New PCA technology can support the implementation of efficient processes to reduce workload and human errors; however, these new products come with a cost, which is not necessarily reflected through beneficial budget impact or significant improvements in patient outcome. Although first steps have been taken to better recognize the importance of postoperative pain management through the introduction of value-based reimbursement, in most western countries, PCA is not specifically compensated. PCA is still an effective and valued technique for postoperative pain management. Although there is identifiable potential for future developments in various aspects, this potential has not materialized in new products. Copyright © 2020 S. Nardi-Hiebl et al.Introduction. Dermatological damage in chronic hemodialysis patients is not uncommon. In Benin, to date, no study on the dermatological manifestations of chronic hemodialysis patients has been carried out. However, the presence of cutaneous signs is evident in these patients, and the need for dermatological care is not negligible. The objective of this study was to identify the epidemiological and clinical profile of the main dermatological manifestations presented by chronic hemodialysis patients at the NTH-HKM of Cotonou (Benin). Methods This was a descriptive cross-sectional study conducted in chronic hemodialysis patients from May 15th to September 15th, 2018. Included were all patients seen during the study period who had been on hemodialysis for at least three months, had at least one dermatological manifestation, and gave verbal or written consent. Chronic hemodialysis patients who did not wish to participate in the survey were excluded. Results 87 patients were included in the study for a hospital frequency of 33.8%. The sex ratio (male to female) was 2. The median age was 49 years (IQ [40.75-59]). Median age in hemodialysis was 36 months with two weekly sessions. The main dermatological manifestations were xerosis (48.3%), pruritus (34.5%), alopecia (14%), nail dystrophy (9.2%), equisegmented nails (8%), and melanoderma (8%). Pruritus was associated with a longer duration of hemodialysis sessions (p=0.01), while xerosis, alopecia, and melanoderma were associated with seniority in hemodialysis. Conclusion Cutaneous manifestations in hemodialysis patients were frequent and dominated by xerosis, pruritus, and alopecia. Factors associated with some of these dermatologic manifestations were seniority in hemodialysis, long duration of the hemodialysis session, and female gender. Copyright © 2020 Hugues Adégbidi et al.Background Atopic dermatitis (AD) is a chronic skin condition where nonadherence often results in lack of disease control. Objective We wanted to determine whether the combination of an electronic memory button and a supportive application (app) would affect the Quality of Life and subjective and objective severity measures among AD patients over one month following the patient's normal schedules of treatment. Methods A randomized, investigator-blinded, prospective observational feasibility study for one month where patients diagnosed with AD were randomized based on POEM severity score and divided into 3 groups. The 3 groups were (1) the control group with two consultations, (2) in addition to group 1, patients also received electronic memory buttons to click every time they used their topical products, and (3) in addition to group 2, patients also received an app to track their treatment schedules. At both consultations, patients were evaluated using SCORAD, EASI, POEM, and DLQI. Results 96 patients were enrolled and randomized, of which 83 patients completed the study. EASI and SCORAD scores were lower in all groups at 2nd consultation (p less then 0.05); however, these were highly significant for group 3 (p less then 0.05); however, these were highly significant for group 3 (p less then 0.05); however, these were highly significant for group 3 (p less then 0.05); however, these were highly significant for group 3 (. Conclusion A reduction in severity following objective assessments of the AD was observed for all groups and was highly significant for patients offered a memory button and the corresponding app. Furthermore, patients reported a significant subjective beneficial effect if they used the memory button and app. This indicates that digital solutions may have a benefit in clinical practice and may reduce nonadherence and increase the wellbeing of the patients. Copyright © 2020 Kristina M. Joergensen et al.Cells can shift their metabolism between glycolysis and oxidative phosphorylation to enact their cell fate program in response to external signals. Widely distributed α 1-adrenergic receptors (ARs) are physiologically stimulated during exercise, were reported to associate with the activating energetic AMPK pathway, and are expected to have biological effects beyond their hemodynamic effects. To investigate the effects and mechanism of AR stimulation on the physiology of the whole body, various in vitro and in vivo experiments were conducted using the AR agonist midodrine, 2-amino-N-[2-(2,5-dimethoxyphenyl)-2-hydroxy-ethyl]-acetamide. The expression of various biomarkers involved in ATP production was estimated through Western blotting, reverse transcription polymerase chain reaction, oxygen consumption rate, enzyme-linked immunosorbent assay (ELISA), fluorescence staining, and Oil red O staining in several cell lines (skeletal muscle, cardiac muscle, liver, macrophage, vascular endothelial, and adipose cells)duction by activating PPARδ, AMPK, and PGC-1α and the relevant biologic functions of multiple organs, suggesting organ crosstalk. The treatment lowered blood pressure, fat and body weight, cholesterol levels, and inflammatory activity; increased ATP content and insulin sensitivity in skeletal muscles; and increased cardiac contractile function without exercise training. These results suggest that the activation of α 1-adrenergic receptor stimulates energetic reprogramming via PPARδ that increases mitochondrial oxidative phosphorylation and has healthy and organ-specific biological effects in multiple organs, including skeletal muscle, beyond its vasomotion effect. In addition, the action mechanism of α 1-adrenergic receptor may be mainly exerted via PPARδ. Copyright © 2020 Yong-Jik Lee et al.Purpose To characterize and analyze the performance of adolescents with executive function deficits through the Children's Cooking Task (CCT) as a performance-based complex ecological assessment. Methods Participants were 41 adolescents (aged 10-14 years) with normal intellectual function and executive function deficit profiles based on the Behavior Rating Inventory of Executive Function (BRIEF) parent reports and self-reports (BRIEF-SR) and the WebNeuro and 40 controls with typical development matched by age and gender. Participants in both groups performed the CCT, an ecological standardized complex task. Results Significant group differences were found for all CCT outcome measures (total number of errors, task duration, and all qualitative rating variables). Significant correlations were found among children with executive function deficit profiles between the CCT performance duration and total number of errors and the BRIEF-SR subscale score. Two separate discriminant function analyses described primarily by the CCT correctly classified the study groups. Conclusion The poor performance of adolescents with executive function deficit profiles exhibited through the standardized complex task, as well as the relationships with their executive functions, supplies better insight about their daily confrontations. Identifying how they perform may lead to development of focused interventions to improve these adolescents' daily performance, participation, and wellbeing. Copyright © 2020 Yael Fogel et al.