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By discussing the implications and applications of ecological management, this study contributes to the ecological protection of Poyang Lake and provides a foundation for research on ecological function zoning at the regional scale.To analyze the cumulative risks to the water environment, the backpropagation artificial neural network (BP-ANN), a self-adapting algorithm, was proposed in this study. A new comprehensive indicator of cumulative risks was formed by combining the water risk assessment tool proposed by the World Wide Fund for Nature or World Wildlife Fund (WWF), Deutsche Investitions und Entwicklungsgesellschaft mbH (DEG), and the cumulative environmental risk assessment system proposed by the US Environmental Protection Agency (USEPA). Eleven training algorithms were selected and optimized based on the mean square error (MSE) of prediction results. Data concerning evaluating indicators and cumulative risk indexes of the Liao River collected from 2005 to 2017 in the cities of Tieling, Shenyang, and Panjin, China, were used as input and output data to train, validate, and test the BP-ANN. Levenberg Marquardt backpropagation was the most accurate algorithm, with an MSE of 3.33 × 10-6. After optimization, there were six hidden layers in the model. The correlation coefficient of the BP-ANN with LM exceeded 80%. These findings suggest that the BP-ANN model is applicable to prediction of cumulative risks to the water environment. The model was sensitive to the number of wastewater treatment facilities and the wastewater treatment rate along the river. Based on the sensitivity analysis, the contributing factors can be controlled to reduce the cumulative risk.Acrylamide (AA) is a hazardous chemical that is widely used in industrial practices. Spirulina platensis (SP) is a blue green alga that is rich in bioactive compounds with many medicinal benefits. XAV-939 molecular weight The aim of the present study was to evaluate the ameliorative effect of SP against AA toxicity in rats. Animals were divided into six groups Group (1) was normal rats, groups (2) and (3) received SP at 500 and 1000 mg/kg BW orally respectively for 21 days, group (4) was administered 20 mg/kg BW AA daily for 14 days, while groups (5) and (6) were given orally SP at the same doses of groups (2) and (3), then AA at similar dose of group (4). Rats that received AA alone displayed markedly increased serum levels of liver enzymes (ALT, AST, and ALP), kidney function parameters (urea and creatinine), DNA damage marker (8-OHdG), and proinflammatory cytokines (IL-1β, IL-6, and TNF-α), compared to control rats. Furthermore, tissue analysis revealed marked increases in hepatic, renal, and brain MDA and NO, as well as marked reductions in the antioxidant biomarkers (GSH, GSH-Px, SOD, and CAT) in acrylamide-intoxicated rats. Spirulina ameliorated the alterations in serum biochemical parameters and reduced MDA and NO, as well as improved antioxidant biomarkers in AA-intoxicated rats in a dose-dependent manner. Our results show that SP has a powerful protective effect on serum biochemistry and liver, kidney, and brain antioxidant machinery in AA-intoxicated rats.

Arterial stiffness is a risk factor for chronic kidney disease progression (CKD). Pulse pressure is a surrogate marker of arterial stiffness. It is unclear if pulse pressure predicts CKD progression in type 2 diabetes mellitus.

This was prospective study involving 1494 patients with estimated glomerular filtration rate (eGFR) ≥ 15ml/min/1.73 m

. Carotid-femoral pulse wave velocity was measured using applanation tonometry. Pulse pressure was calculated as difference between systolic and diastolic blood pressures. CKD progression was defined as worsening of eGFR categories (stage 1, ≥ 90ml/min/1.73m

 ; stage 2, 60-89ml/min/1.73m

 ; stage 3a, 45-59ml/min/1.73m

 ; stage 3b, 30-44ml/min/1.73m

 ; stage 4; 15-29ml/min/1.73m

 ; and stage 5, < 15ml/min/1.73m

) with ≥ 25% decrease in eGFR from baseline.

After follow-up of up to 6years, CKD progression occurred in 33.5% of subjects. Subjects in 2nd, 3rd and 4th quartiles of peripheral pulse pressure experienced higher risk of CKD progression with unadjusted h more susceptible to deterioration of renal function. Pulse pressure could potentially be incorporated in clinical practice as an inexpensive and readily available biomarker of renal decline in type 2 diabetes mellitus. Graphic abstract.

The PACIC assesses key components of the Chronic Care Model. The purpose of this study is to examine the dimensionality and psychometric properties of the PACIC.

A convenience sample of 221 adults in Canada who self-identified as living with one or more physical and/or mental chronic diseases was invited to participate via an online survey link. Rasch analysis was performed, including item and person misfit, reliability, response format, targeting, unidimensionality of subscales, and differential item functioning (DIF). Also, Confirmatory Factor Analysis (CFA) was conducted and model fit of alternative factor structures proposedfor the PACIC in the literature and those suggested by the Rasch analysis were explored.

The patient activation, delivery system, and problem-solving subscales fit the Rasch model expectations; no modifications were required. The goal setting item 10 had a disordered threshold and was recoded. Four of the five follow-up subscale items had a disordered threshold and were recoded. All subscales were unidimensional and no local dependency was detected. DIF was only detected for some items in the follow-up subscale. The CFA revealed that none of the published factor structures fit the data; the fit statistics were appropriate when item 10 was removed and the follow-up subscale was removed.

Improving chronic disease care relies upon having validated measures to evaluate the extent to which care goals are met. With some modifications, four of the five PACIC subscales were found to be psychometrically robust.

Improving chronic disease care relies upon having validated measures to evaluate the extent to which care goals are met. With some modifications, four of the five PACIC subscales were found to be psychometrically robust.Our understanding of the genomics and epigenomics of medullary thyroid carcinoma (MTC) has advanced since the initial recognition of RET as a driver of MTC tumorigenesis in familial MTC. We now have insight into the frequency and prognostic significance of specific RET mutations in sporadic MTC. For example, the most common RET mutation in sporadic MTC is the RET Met918Thr mutation, the same mutation that underlies MEN2B and a poor prognosticator. This mutation is relatively infrequent in medullary thyroid microcarcinomas but is over-represented in advanced-stage disease. RAS mutations are detected in 70% of sporadic, RET wild-type MTC. Although next-generation and whole-exome sequencing studies have shown that tumors that are wild-type for RET and RAS mutations essentially lack other recurrent mutations, additional pathways and epigenetic alterations have been implicated in MTC tumorigenesis. Increased insight into the clinical course of patients with familial MTC with specific RET mutations has guided treatment recommendations for these patients. Finally, an understanding of the genomics has informed treatment for patients with advanced MTC. In this review, we will examine the genomics and epigenomics of sporadic and familial MTC, along with the prognostic significance of molecular alterations, management of patients with germline RET mutations, and treatment strategies for MTC patients.

To examine the mental health of women in the perinatal period prior to and during the COVID-19 pandemic.

We use provisional vital statistics data for births occurring in the central region of New Jersey. The Edinburgh Postnatal Depression Scale is employed to assess depressive symptoms. Our focal analysis uses linear regression models to test whether giving birth during the pandemic is associated with elevated depressive symptoms. All analyses are performed using time-matched (September 2019-April 2020; n = 18,531) and month-matched (January 2019-April 2019 and January 2020- April 2020; n = 18,346) samples.

Women who gave birth in March and not in April reported higher levels of depressive symptoms than those who gave birth prior to the pandemic in our time-matched (b = 0.09) and month-matched (b = 0.09) samples. The magnitude of this association is approximately one-third the magnitude of the association between preterm birth and depressive symptoms.

These findings suggest that researchers and practitioners should pay special attention to signs of postpartum depression and women's adaptive coping responses in the early stages of pandemics.

These findings suggest that researchers and practitioners should pay special attention to signs of postpartum depression and women's adaptive coping responses in the early stages of pandemics.Kohlrabi sprouts are just gaining popularity as the new example of functional food. The study was focused on the influence of germination time and light conditions on glucosinolates, phenolic acids, flavonoids, and fatty acids content in kohlrabi sprouts, in comparison to the bulbs. The effect of kohlrabi products on SW480, HepG2 and BJ cells was also determined. The length of sprouting time and light availability significantly influenced the concentrations of the phenolic compounds. Significant differences in progoitrin concentrations were observed between the sprouts harvested in light and in the darkness, with significantly lower content for darkness conditions. Erucic acid was the dominant fatty acid found in sprouts (14.5-34.5%). Sprouts and bulbs were less toxic to normal than to cancer cells. The sprouts stimulated necrosis (56.4%) more than apoptosis (34.1%) in SW480 cells, while the latter effect was predominant for the bulbs. Both sprouts and bulbs caused rather necrosis (45.5 and 63.9%) than apoptosis (32 and 32.5%) in HepG2 cells.

The 2016 American Diabetes Association position statement emphasized that psychosocial and medical care should be integrated and provided to all people with diabetes.

To determine whether better integration of diabetes and depression care is associated with better glycemic control.

Cross-sectional surveys of Midwestern federally qualified health center (FQHC) leaders and primary care providers (PCPs) in 2016. Responses were linked to FQHC-level data on the percentage of patients with uncontrolled diabetes (glycated hemoglobin ≥ 9%; 75 mmol/mol).

Midwest Clinicians' Network-affiliated FQHC leaders, and PCPs at the FQHCs.

Multilevel models were used to determine associations between the percentage of patients with uncontrolled diabetes and FQHC and PCP characteristics; presence of diabetes and behavioral health care services; and PCPs' perception of the stage of integration between diabetes and depression care services based on the transtheoretical model (i.e., pre-contemplation, contemplation, preparation, action, or maintenance).

Response rates were 60% for the FQHC survey (N = 77) and 55% for the PCP survey (N = 538). In adjusted models, FQHCs in which PCPs perceived a higher stage of integration between diabetes and depression care had 3% fewer patients with uncontrolled diabetes per 1-level increase in integration stage (p = 0.01); on-site diabetes self-management education was associated with 7% fewer patients with uncontrolled diabetes (p < 0.01).

At Midwestern FQHCs, a higher stage of perceived integration of diabetes and depression care was associated with better FQHC-level glycemic control. Future studies are needed to elucidate what defines integration of diabetes and depression care services.

At Midwestern FQHCs, a higher stage of perceived integration of diabetes and depression care was associated with better FQHC-level glycemic control. Future studies are needed to elucidate what defines integration of diabetes and depression care services.