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vant for patients in the pre-operative counseling setting, as it may influence their decision for surgical procedure selection.Healthcare workers (HCW) face tremendous challenges during the COVID-19 pandemic. Little is known about the subjective burden, views, and COVID-19 infection status of HCWs. The aim of this work was to evaluate the subjective burden, the perception of the information policies, and the agreement on structural measures in a large cohort of German HCW during the COVID-19 pandemic. This country-wide anonymous online survey was carried out from April 15th until May 1st, 2020. 25 content-related questions regarding the subjective burden and other dimensions were evaluated. We evaluated different dimensions of subjective burden, stress, and perspectives using 5-point Likert-scale questions. Moreover, the individual COVID-19 infection status, the amount of people infected in circle of friends and acquaintances and the hours working overtime were assessed. A total of 3669 HCWs provided sufficient responses for analyses. 2.8% of HCWs reported to have been tested positive for COVID-19. Nurses reported in principle higher ratings on all questions of subjective burden and stress than doctors and other hospital staff. Doctors (3.6%) and nurses (3.1%) were more likely to be tested positive for COVID-19 than other hospital staff (0.6%, Chi(2)2  = 17.39, p  less then  0.0005). HCWs who worked in a COVID-19 environment reported higher levels of subjective burden and stress compared to all other participants. Working in a COVID-19 environment increased the likelihood to be tested positive for COVID-19 (4.8% vs. 2.3%, Chi(1)2  = 12.62, p  less then  0.0005) and the severity of the subjective burden. During the COVID-19 pandemic, nurses experience more stress than doctors. Overall, German HCWs showed high scores of agreement with the measures taken by the hospitals.Wider use of clozapine, one of the most effective antipshychotic drugs, is precluded by its propensity to cause agranulocytosis. Currently, clozapine is used for treatment-resistant schizophrenia, with mandatory blood count monitoring for the duration of treatment. Agranulocytosis occurs in up to 0.8% of patients and presents a significant medical challenge, despite decreasing mortality rates. In this paper, we review the epidemiology of clozapine-induced agranulocytosis (CLIA), advances in identifying genetic risk factors, and the preventive measures to reduce the risk of CLIA. We discuss the pathogenesis of CLIA, which, despite receiving considerable scientific attention, has not been fully elucidated. Finally, we address the clinical management and suggest the approach to clozapine re-challenge in patients with a previous episode of neutropenia. Histone Demethylase inhibitor With a significant proportion of clozapine recipients in Western hemisphere being Black, we comment on the importance of recognizing benign ethnic neutropenia as a potential impediment to clozapine administration. This review aims to aid haematologists and psychiatrists to jointly manage neutropenia and agranulocytosis caused by clozapine.

The incidence of intrahepatic cholangiocarcinoma is increasing worldwide. Despite advances in surgical and non-surgical treatment, reported outcomes are still poor and surgical resection remains to be the only chance for long-term survival of affected patients. The identification and validation of prognostic factors and scores, such as the recently introduced resection severity index, for postoperative morbidity and mortality are essential to facilitate optimal therapeutic regimens.

This is a retrospective analysis of 269 patients undergoing resection of histologically confirmed intrahepatic cholangiocarcinoma between February 1996 and September 2018 at a tertiary referral center for hepatobiliary surgery. Regression analyses were performed to evaluate potential prognostic factors, including the resection severity index.

Median postoperative follow-up time was 22.93 (0.10-234.39) months. Severe postoperative complications (≥ Clavien-Dindo grade III) were observed in 94 (34.9%) patients. The body mass inictors for postoperative morbidity and mortality, respectively.Rapid increase in carbon dioxide emission triggers climate change, while climate change poses a threat to food security. On the other hand, emission increase as a result of agricultural production continues. Considering this cycle, it is thought that examining the relationship between agricultural production and carbon dioxide emissions can help countries take emission-reducing measures and develop policies to ensure food safety. With this thought, a common correlated effect estimator was used in this study to explain the relationship between crop and livestock production index and carbon dioxide emission of 184 countries with the use of data for the period of 1998-2014. Countries were classified under four categories low-income countries, lower middle-income countries, upper middle-income countries and high-income countries. According to DCCE test results, it was reported that a 1% increase in crop production index had effect on CO2 emission only in lower middle-income countries. A 1% increase in livestock production index, on the other hand, was reported to increase CO2 emission rates by 0.28, 0.49, and 0.39 in lower middle-income, upper middle-income, and high-income countries, respectively. When evaluated in general, it could be stated that livestock breeding has a higher effect on CO2 emission in agricultural production. The findings of the present study revealed that countries need to improve agricultural production methods in ways to minimize the positive association between vegetative and livestock production in accordance with their level of development, to adopt more environment-friendly agricultural technologies and to endorse international environmental policies.This study aims to reveal the evolutionary process of particles during the diesel exhaust transport process and to further understand the effects of diesel exhaust transport distance (DET) on a particulate microstructure. Specifically, the micromorphological, particle size distribution, and aggregate characteristics of particles as well as the variation of the structural characteristics of elementary carbon particles (ECPs) as DET changed were examined using an engine exhaust particle size spectrometer, a high-resolution transmission electron microscopy system, and a small-angle X-ray scattering system. The results show the following As DET increased, the chains gradually lengthened, the extent of accumulation and stacking increased, and a number of clusters gradually rose. The average particle diameter increased from 23.1 nm at 0 m to 92.7 nm at 3 m. In addition, as DET increased, the number of accumulation-mode particles, the number of folded, curved carbon layers in the inner core of carbon particles, and the disorderliness of carbon layers in the outer shell of carbon particles all increased.

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