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omes of COVID-19 patients in rural areas. Pharmacists in developing countries should be supported to implement remote clinical services to provide patients in rural places with optimal care.
Social isolation is a prominent challenge for many young adults with cancer. Despite desires for peer-to-peer connections through technology, little is known about how young adults initiate or use social media for support over time.
We interviewed young adults with cancer (n=45; age 18-39, in or post cancer treatment) to explore their initiation of social media for support, changes in use over time, and types of connections sought.
Young adults with cancer learn about online support through individual personal recommendations, advocacy organizations, or searching on Google or social media. Most were reluctant to use social media support initially because of feeling overwhelmed-from diagnoses, abundance of online information, or demands of participation-and joined when informational and emotional needs arose. Many wished they had joined earlier. Some participants use social media to make close connections while others simply want to "see" others' shared experiences or crowdsource information.
Young adults with cancer often haphazardly find online support from personal recommendations or Internet searches. Desires for social media connections are not one-size-fits-all; there are important audience segmentations for the degree and type of peer support.
Better promotion of online social support options and benefits-early in one's cancer timeline and systematically through healthcare providers, cancer organizations, or family and friends-could improve access to helpful peer-to-peer support.
Better promotion of online social support options and benefits-early in one's cancer timeline and systematically through healthcare providers, cancer organizations, or family and friends-could improve access to helpful peer-to-peer support.
End-stage renal disease (ESRD) patients on haemodialysis (HD) suffer from several peripheral and central neurological complications. They are at high risk for developing silent neurological lesions (SNL) that may be detected accidentally by magnetic resonance imaging (MRI). Many factors are implicated in the development of neurological deficits in ESRD patients on HD.
Evaluation of SNL in young ESRD patients by using MRI and assessing its correlation with hyperparathyroidism.
The study involved 48 young ESRD patients (mean age of 19.6±6years) with HD and do not have any apparent abnormalities in the neurological examination. Laboratory investigations and conventional brain MRI were done on all.
79.2% have SBI and 45.8% have white matter lesions. Regression analysis revealed that calcium level and duration of dialysis were independent predictor factors for the presence of silent brain MRI lesions (P=.034 & 0.045 respectively). ROC curve showed that parathyroid hormone (PTH) level >585pg/mL, duration of dialysis >2years, and calcium level >7.5mg/dL predicted the presence of SNL.
The duration of HD and hyperparathyroidism (HPT) were independent predictors for the presence of SNL. MRI brain is considered as a mandatory affordable tool for HD patients >2years and has HPT for early detection of SNL to help early intervention and avoid neurological complications and disabilities.
2 years and has HPT for early detection of SNL to help early intervention and avoid neurological complications and disabilities.There is a trend toward the use of natural substances present in plants and vegetables. In general, foods rich in antioxidants are complex matrices; therefore, understanding its absorption effects is extremely relevant to know its bioactive potential. Thus, this systematic review focused on clinical trials involving plants (or compounds) registered on the National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) with antioxidant properties. Following the reporting guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes studies of interest indexed in the PubMed and ClinicalTrials.gov databases were analyzed. Of the 59 clinical trials found, Allium sativum and Curcuma longa are the plant species with the highest percentage of clinical research. Prevention/attenuation of oxidative stress was one of the main antioxidant mechanisms indicated in the studies. The most tested compounds of the RENISUS plants in clinical trials were curcumin and soy isoflavone. In this review, we selected studies in advanced stages that highlight plants' value in optimizing antioxidant status; however, even with high-quality studies, it is not prudent to overstate the clinical efficacy of these plants.
The purpose of this study was to evaluate outcomes of bleeding and thrombosis resulting from the use of DOACs in a large cohort of SOT recipients.
This was a single center, retrospective cohort study of adult kidney, heart, lung, and liver transplant recipients transplanted between August 2009 and May 2018. Patients were stratified into two groups those who received apixaban (apixaban group) or those patients receiving either rivaroxaban or dabigatran (non-apixaban group). The primary endpoint was the cumulative incidence of bleeding while receiving DOAC therapy. The secondary endpoints were incidence of major bleeding and thrombosis at any time while receiving DOAC therapy.
A total of 106 patients were included; 70 patients received apixaban and 36 patients received non-apixaban anticoagulation. Cumulative incidence of any bleeding was lower in the apixaban group compared to the non-apixaban group at both 90 days (4.9% versus 16.1%) and 180 days (11.4% versus 24.9%, P = 0.034). Cumulative incidence of major bleeding (P = 0.686) and thrombosis (P = 0.515) were similar between groups. DOAC dosing congruent with the package insert(s) was associated with a lower risk of thrombosis.
Apixaban-based anticoagulation was associated with a lower cumulative incidence of any bleeding compared to non-apixaban DOACs. This article is protected by copyright. All rights reserved.
Apixaban-based anticoagulation was associated with a lower cumulative incidence of any bleeding compared to non-apixaban DOACs. This article is protected by copyright. All rights reserved.Cytodiagnosis of metastatic neuroblastoma presenting as subcutaneous swellings.The newly emerging supercapacitor-diode (CAPode), integrating the characteristics of a diode into an electrical-double-layer capacitor, can be employed to extend conventional supercapacitors to new technological applications and may play a crucial role in grid stabilization, signal propagation, and logic operations. However, the reported CAPodes have only been able to realize charge storage in the positive-bias direction. Here, bias-direction-adjustable CAPodes realized by using a polycation-based ionic liquid (IL) or a polyanion-based IL as electrolyte in an asymmetric carbon-based supercapacitor architecture are proposed. The resulting CAPodes exhibit charge-storage function at only the positive- or negative-bias direction with a high rectification ratio (≈80% for rectification ratio II, RRII ) and an outstanding cycling life (4500 cycles), representing a crucial breakthrough for designing high-performance capacitive ionic diodes.The fast and reversible potassiation/depotassiation of anode materials remains an elusive yet intriguing goal. Herein, a class of the P-doping-induced orthorhombic CoTe2 nanowires with Te vacancy defects supported on MXene (o-P-CoTe2 /MXene) is designed and prepared, taking advantage of the synergistic effects of the conductive o-P-CoTe2 arrays with rich Te vacancy defects and the elastic MXene sheets with self-autoadjustable function. Consequently, the o-P-CoTe2 /MXene superstructure exhibits boosted potassium-storage performance, in terms of high reversible capacity (373.7 mAh g-1 at 0.2 A g-1 after 200 cycles), remarkable rate capability (168.2 mAh g-1 at 20 A g-1 ), and outstanding long-term cyclability (0.011% capacity decay per cycle over 2000 cycles at 2 A g-1 ), representing the best performance in transition-metal-dichalcogenides-based anodes to date. Impressively, the flexible full battery with o-P-CoTe2 /MXene anode achieves a satisfying energy density of 275 Wh kg-1 and high bending stability. The kinetics analysis and first-principles calculations reveal superior pseudocapacitive property, high electronic conductivity, and favorable K+ ion adsorption and diffusion capability, corroborating fast K+ ion storage. Especially, ex situ characterizations confirm o-P-CoTe2 /MXene undergoes reversible evolutions of initially proceeding with the K+ ion insertion, followed by the conversion reaction mechanism.Triterpenes (30-carbon isoprene compounds) represent a large and highly diverse class of natural products that play various physiological functions in plants. The triterpene biosynthetic enzymes, particularly those catalyzing the late-stage regio-selective modifications are not well characterized. The bark of select Boswellia trees, e.g., B. serrata exudes specialized oleo-gum resin in response to wounding, which is enriched with boswellic acids (BAs), a unique class of C3α-epimeric pentacyclic triterpenes with medicinal properties. The bark possesses a network of resin secretory structures comprised of vertical and horizontal resin canals, and amount of BAs in bark increases considerably in response to wounding. To investigate BA biosynthetic enzymes, we conducted tissue-specific transcriptome profiling and identified a wound-responsive BAHD acetyltransferase (BsAT1) of B. serrata catalyzing the late-stage C3α-O-acetylation reactions in the BA biosynthetic pathway. BsAT1 catalyzed C3α-O-acetylation of αBA, βBA, and 11-keto-βBA in vitro and in planta assays to produce all the major C3α-O-acetyl-BAs (3-acetyl-αBA, 3-acetyl-βBA, and 3-acetyl-11-keto-βBA) found in B. serrata bark and oleo-gum resin. BsAT1 showed strict specificity for BA scaffold, whereas it did not acetylate the more common C3β-epimeric pentacyclic triterpenes. The analysis of steady-state kinetics using various BAs revealed distinct substrate affinity and catalytic efficiency. AS1842856 BsAT1 transcript expression coincides with increased levels of C3α-O-acetyl-BAs in bark in response to wounding, suggesting a role of BsAT1 in wound-induced biosynthesis of C3α-O-acetyl-BAs. Overall, the results provide new insights into the biosynthesis of principal chemical constituents of Boswellia oleo-gum resin.Obesity has become increasingly prevalent in those seeking transplant for treatment of end-stage renal disease (ESRD). While those who are obese maintain the survival benefit of kidney transplant over dialysis, obesity is associated with negative outcomes after solid organ transplant. [1] Many transplant programs have target weight or body-mass index (BMI) requirements for listing, making weight a significant barrier to transplantation [2-5].Gross primary productivity (GPP) of wooded ecosystems (forests and savannas) is central to the global carbon cycle, comprising 67%-75% of total global terrestrial GPP. Climate change may alter this flux by increasing the frequency of temperatures beyond the thermal optimum of GPP (Topt ). We examined the relationship between GPP and air temperature (Ta) in 17 wooded ecosystems dominated by a single plant functional type (broadleaf evergreen trees) occurring over a broad climatic gradient encompassing five ecoregions across Australia ranging from tropical in the north to Mediterranean and temperate in the south. We applied a novel boundary-line analysis to eddy covariance flux observations to (a) derive ecosystem GPP-Ta relationships and Topt (including seasonal analyses for five tropical savannas); (b) quantitatively and qualitatively assess GPP-Ta relationships within and among ecoregions; (c) examine the relationship between Topt and mean daytime air temperature (MDTa) across all ecosystems; and (d) examine how down-welling short-wave radiation (Fsd) and vapour pressure deficit (VPD) influence the GPP-Ta relationship.