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In Switzerland and elsewhere, many psychological support hotlines were set up during the acute phase of the COVID-19 pandemic. Specialists in psychological first aid, in charge of developing and managing these hotlines, had to face an unknown situation, very different from the disasters for which they prepare themselves. Since the pandemic and the associated physical distancing were a potential threat to social cohesion, one could make the hypothesis that, by setting up hotlines, these professionals sought to reintroduce a form of proximity and to care for and cultivate the social connections among people. The pressure, feelings of emergency, anxious anticipation and expectation of the political authorities and the population may have favoured the development of these structures. Other factors certainly also played a role, such as the need to be useful and to exist as professional, or the need to act in order to reduce anxiety related to the pandemic. Altogether, these hotlines were little used, and their usefulness may be questioned. Similar phenomena have been observed - especially in the sanitary domain - with a multiplication of new offers, not always adjusted to specific identified needs, while health care services were on the same time under-used. Our observations plead against emergency responses in crisis situations and for reflecting on the measures to be put in place rather than to "act" them.Gabonese psychiatry is facing a crisis, which results in a decrease in material and human resources. Hospital beds are closed and consultations are mainly on an out-patient basis. This article shows how health care workers are coping with this pandemic, and the challenges of maintaining the therapeutic alliance. It presents a synthesis of works on confinement, COVID-19 and mental disorders. Clinical observations reveal that the COVID-19 epidemic has strengthened the dysfunctions observed in care. In rural areas, there is a suppression of follow-up at home. In general, this health crisis had an impact on the purchasing power of patients. What caused a difficulty of payment of the psychiatric consultations in liberal, a difficulty of access to the expensive psychotropic drugs, thus favouring a non-observance of the care, and a decompensation of the psychiatric picture. In urban areas, there is a considerable decrease in out-patient consultations. There is still concern about the inter- and post COVID-19 psychiatric care. This pandemic calls on leaders leading to a reorganisation of the psychiatric care system (decentralisation of establishments throughout the country, training of qualified nursing staff, fall in the prices of expensive psychotropic drugs). The establishment of helplines in psychiatric facilities, the opening of hospital beds, COVID-19 devices in public and private facilities for patients with mental disorders are essential.
The present study aimed to assess the prevalence of symptoms of anxiety and depression among health professionals in the three most affected regions in Cameroon.
The study was a descriptive cross-sectional type. Participants were health care professionals working in the three chosen regions of Cameroon. The non_probability convinient sample technique and that of the snowball were valued via a web questionnaire. The non-exhaustive sample size was 292. The diagnosis of anxiety and depression was made by the HAD (Hospital Anxiety and Depression scale).
The prevalence of symptoms of anxiety ranging from mild to severe and those of depression were 42.20% and 43.50% respectively. Anxiety symptoms were associated with the age of the participants (
=0.006), fear of contamination (
=0.019), fear of death (
=0.000), and depressive symptoms associated to the fear of death (
=0.000).
The prevalence of symptoms of anxiety ranging from mild to severe and those of depression were 42.20% and 43.50% respectively. Anxiety symptoms were associated with the age of the participants (P = 0.006), fear of contamination (P = 0.019), fear of death (P = 0.000), and depressive symptoms associated to the fear of death (P = 0.000).This article introduces the NIST post-quantum cryptography standardization process. We highlight the challenges, discuss the mathematical problems in the proposed post-quantum cryptographic algorithms and the opportunities for mathematics researchers to contribute.
Regorafenib or trifluridine/tipiracil as third-line treatment have limited efficacy in metastatic colorectal cancer (mCRC).
This Phase 2 trial evaluated the efficacy and safety of irinotecan plus cetuximab rechallenge as third-line treatment in KRAS wild-type mCRC patients who achieved clinical benefit with first-line cetuximab-containing therapy. The primary endpoint was 3-month progression-free survival (PFS) rate. A sample size was calculated; 30 patients with a 3-month PFS rate of 45% deemed promising and 15% unacceptable. Patients with greater and less than the cut-off value of cetuximab-free intervals (CFIs) were classified into the long and short CFI groups, respectively, in subgroup analyses.
Among 34 eligible patients who received treatment at least once, 3-month PFS rate was 44.1% (95% confidence interval, 27.4-60.8%). The median PFS and overall survival (OS) were 2.4 and 8.2 months, respectively. The response and disease control rates were 2.9 and 55.9%, respectively. PFS and OS were significantly longer in the long- than in the short CFI group.
Irinotecan plus cetuximab rechallenge as third-line treatment for KRAS wild-type mCRC was safe and had promising activity, especially in those with a long CFI, warranting further investigation in a Phase 3 randomised trial.
UMIN000010638.
UMIN000010638.Conventional office blood pressure (OBP) and home blood pressure (HBP) measurements are often inconsistent. The purpose of this research was (1) to test whether strictly measured OBP values with sufficient rest time before measurement (st-OBP) is comparable to HBP at the population level and (2) to ascertain whether there are particular determinants for the difference between HBP and st-OBP at the individual level. Data from a population-based group of 1056 men aged 40-79 years were analyzed. After a five-min rest, st-OBP was measured twice. HBP was measured after a 2-min rest every morning for seven consecutive days. To determine factors related to ΔSBP (HBP minus st-OBP measurements), multiple linear regression analyses and analyses of covariance were performed. While st-OBP and HBP were comparable (136.5 vs. 137.2 mmHg) at the population level, ΔSBP varied with a standard deviation of 13.5 mmHg. Smoking was associated with a larger ΔSBP regardless of antihypertensive usage, and BMI was associated with a larger ΔSBP in participants using antihypertensive drugs. The adjusted mean ΔSBP in the highest BMI tertile category was 4.6 mmHg in participants taking antihypertensive drugs. st-OBP and HBP measurements were comparable at the population level, although the distribution of ΔSBP was considerably broad. Smokers and obese men taking antihypertensive drugs had higher HBP than st-OBP, indicating that their blood pressure levels are at risk of being underestimated. Therefore, this group would benefit from the addition of HBP measurements.This study compares the effect of three diets on the circadian rhythm of blood pressure (BP). Hypertension and abnormal BP variability (BPV) are major risk factors leading to morbidity and mortality from cardiovascular disease. When detected early, a dietary approach may be preferred to medication. Data stemming from ambulatory BP monitoring (ABPM) from the Dietary Approaches to Stop Hypertension (DASH) study were re-analyzed from a chronobiologic perspective. Compared to the control diet (N = 112) that had no effect on BP (from 131.2/83.5 to 131.0/83.6 mmHg), both the Fruit and Vegetable (FV; N = 113) diet and the DASH (N = 113) diet were associated with a decrease in BP (FV from 132.6/84.4 to 129.0/82.1 mmHg; DASH from 131.9/83.6 to 127.2/80.9 mmHg). The decrease in BP was found to be circadian stage-dependent, and to differ between men and women. Nighttime BP was decreased to a larger extent with the DASH than with the FV diet, a difference observed in women but not in men. Study participants who had a higher BP during the reference stage were more likely to decrease their BP to a larger extent after the 8-week dietary intervention. The FV and DASH diets had different effects on BPV. In view of the relatively large day-to-day variability in BP in both normotensive and hypertensive people, it is recommended to monitor BP around the clock for longer than 24 h, and to individualize the optimization of dietary or other intervention.BACKGROUND In adulthood, most cases of acute hepatitis B virus (HBV) infection are transmitted either by sexual contact or by contaminated needles, but there are other modes of transmission. We report on three cases of HBV infection among members of a wrestling club. CASE REPORT A 19-year-old male wrestling athlete was admitted with acute hepatitis B. Five months later, 2 other men, who were members of the same wrestling club, were diagnosed with HBV infection. The full-length sequences of the HBV DNA were identical in all three cases and classified as subgenotype C2 on phylogenetic analysis. Trichostatin A This is the most common genotype found in Japan. No history of sexual or bleeding contact with acquaintances outside the club was noted in any of these cases. This suggests horizontal transmission within the wrestling club. CONCLUSIONS The possibility of HBV transmission through bleeding wounds and sweat is a concern in contact sports such as wrestling. Hence, hepatitis B vaccination is recommended for unvaccinated contact-sports players.BACKGROUND Orderly G2/M transition in the cell cycle is controlled by the cyclin-dependent kinase 1/cyclin B (CDK1/CCNB) complex. We aimed to comprehensively investigate the roles of CDK1, CCNB1, and CCNB2 via multi-omics analysis and their relationships with immune infiltration in hepatocellular carcinoma (HCC). MATERIAL AND METHODS The transcriptional data and the epigenetic and genetic alterations of CDK1, CCNB1, and CCNB2, as well as their impacts on prognosis in HCC patients, were identified using multiple databases. The correlations between expression of these genes and immune infiltration in HCC were then explored using the TIMER database. RESULTS Overall, mRNA expression of CDK1, CCNB1, and CCNB2 was up-regulated in various tumor tissues including HCC. Higher expression of these genes was associated with poorer prognosis in HCC patients. Lower promoter methylation of these genes might cause higher expression levels in tumor tissues of HCC. Genetic alterations and several methylated-CpG sites in these genes were significantly associated with survival. Notably, expression levels of CDK1, CCNB1, and CCNB2 were positively correlated with infiltrating levels of CD4⁺ T cells, CD8⁺ T cells, neutrophils, macrophages, and dendritic cells in HCC. In addition, significant correlations between the expression of these genes and various immune markers in HCC, such as PD-1, PDL-1, and CTLA-4, were also observed. CONCLUSIONS CDK1, CCNB1, and CCNB2 are potential prognostic biomarkers and associated with immune cell infiltration in HCC. The genes may be utilized to predict the reaction of immunotherapy. Combining inhibitors of these genes with immunotherapy may improve the survival time of HCC patients.