Paghkappel3619

The 2019 novel coronavirus (COVID-19) pandemic has created significant challenges to the delivery of care for patients with advanced head and neck cancer requiring multimodality therapy. Performing major head and neck ablative surgery and reconstruction is a particular concern given the extended duration and aerosolizing nature of these cases. In this manuscript, we describe our surgical approach to provide timely reconstructive care and minimize infectious risk to the providers, patients, and families. © 2020 Wiley Periodicals, Inc.Porphyrins with a fused five-membered ring such as 7,8-dehydropurpurins have appeared as an emerging class of unique porphyrinoids. Their altered absorption spectra, relatively short lifetimes of excited states, and small HOMO-LUMO gaps arise from the harmony of antiaromatic 20π-circuit and aromatic 18π-circuit. In this regard, the electronic properties of 7,8-dehydropurpurins are expected to be controlled by modulating the contribution of antiaromatic π-circuit to the whole aromaticity. Here we report the comparison of pyrrole- and phosphole-fused 7,8-dehydropurpurins in terms of their aromaticity and physicochemical properties. The spectroscopic investigation revealed the larger contribution of antiaromatic 24π-circuit in pyrrole-fused 7,8-dehyrdopurpurins than phosphole-fused 7,8-dehydropurpurins. The DFT calculations also supported the feasibility of tuning the aromaticity of 7,8-dehydropurpurins by heterole-fused structures. Thus, the introduction of heterole-fused structures into porphyrinoids is a universal strategy to get new insight into aromaticity and their intrinsic properties in cyclic π-conjugated molecules. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Tissue succulence (ratio of tissue water/leaf area or dry mass) or the ability to store water within living tissues is among the most successful adaptations to drought in the plant kingdom. This taxonomically widespread adaptation helps plants avoid the damaging effects of drought and is often associated with the occupancy of epiphytic, epilithic, semi-arid, and arid environments. Tissue succulence was engineered in Arabidopsis thaliana by overexpression of a codon-optimized helix-loop-helix transcription factor (VvCEB1opt ) from wine grape involved in the cell expansion phase of berry development. VvCEB1opt -overexpressing lines displayed significant increases in cell size, succulence, and decreased intercellular air space (IAS). VvCEB1opt -overexpressing lines showed increased instantaneous and integrated water-use efficiency due to reduced stomatal conductance caused by reduced stomatal aperture and density resulting in increased attenuation of water-deficit stress. VvCEB1opt -overexpressing lines also showed increased salinity tolerance due to reduced salinity uptake and dilution of internal Na+ and Cl- as well as other ions. Alterations in transporter activities were further suggested by media and apoplastic acidification, hygromycin B tolerance, and changes in relative transcript abundance patterns of various transporters with known functions in salinity tolerance. Engineered tissue succulence might provide an effective strategy for improving water-use efficiency, drought avoidance or attenuation, salinity tolerance, and for crassulacean acid metabolism (CAM) biodesign. Supplemental information. This article is protected by copyright. All rights reserved.OBJECTIVES In March 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic. High morbidity and mortality rates of COVID-19 have been observed among older adults and widely reported in both mainstream and social media. The objective of this study was to analyze tweets related to COVID-19 and older adults, and to identify ageist content. DESIGN We obtained a representative sample of original tweets containing the keywords "elderly," "older," and/or "boomer" plus the hashtags "#COVID19" and/or "#coronavirus." SETTING Tweets posted between March 12 and March 21, 2020. MEASUREMENTS We identified the type of user and number of followers for each account. Tweets were classified by three raters as (1) informative, (2) personal accounts, (3) personal opinions, (4) advice seeking, (5) jokes, and (6) miscellaneous. Potentially offensive content, as well as that downplaying the severity of COVID-19 because it mostly affects older adults, was identified. RESULTS A total of 18,128 tweets were obtained, of which a random sample of 351 was analyzed. Most accounts (91.7%) belonged to individuals. The most common types of tweets were personal opinions (31.9%), followed by informative tweets (29.6%), jokes/ridicule (14.3%), and personal accounts (13.4%). Overall, 72 tweets (21.9%) likely intended to ridicule or offend someone and 21.1% had content implying that the life of older adults was less valuable or downplayed the relevance of COVID-19. CONCLUSION Most tweets related to COVID-19 and older adults contained personal opinions, personal accounts, and jokes. Almost one-quarter of analyzed tweets had ageist or potentially offensive content toward older adults. © 2020 The American Geriatrics Society.PURPOSE The crystalline lens undergoes morphological and functional changes with age and may also play a role in eye emmetropisation. Both the geometry and the gradient index of refraction (GRIN) distribution contribute to the lens optical properties. We studied the lens GRIN in the guinea pig, a common animal model to study myopia. METHODS Lenses were extracted from guinea pigs (Cavia porcellus) at 18 days of age (n = 4, three monolaterally treated with negative lenses and one untreated) and 39 days of age (n = 4, all untreated). Treated eyes were myopic (-2.07 D on average) and untreated eyes hyperopic (+3.3 D), as revealed using streak retinoscopy in the live and cyclopeged animals. A custom 3D spectral domain optical coherence tomography (OCT) system (λ = 840 nm, Δλ = 50 nm) was used to image the enucleated crystalline lens at two orientations. Custom algorithms were used to estimate the lens shape and GRIN was modelled with four variables that were reconstructed using the OCT data and a minimisation algorithm. Ray tracing was used to calculate the optical power and spherical aberration assuming a homogeneous refractive index or the estimated GRIN. RESULTS Guinea pig lenses exhibited nearly parabolic GRIN profiles. When comparing the two age groups (18- and 39 day-old) there was a significant increase in the central thickness (from 3.61 to 3.74 mm), and in the refractive index of the surface (from 1.362 to 1.366) and the nucleus (from 1.443 to 1.454). The presence of GRIN shifted the spherical aberration (-4.1 µm on average) of the lens towards negative values. CONCLUSIONS The guinea pig lens exhibits a GRIN profile with surface and nucleus refractive indices that increase slightly during the first days of life. GRIN plays a major role in the lens optical properties and should be incorporated into computational guinea pig eye models to study emmetropisation, myopia development and ageing. © 2020 The Authors Ophthalmic & Physiological Optics © 2020 The College of Optometrists.PURPOSE This review arms practitioners with the evidence-based information they need to fully manage myopia. RECENT FINDINGS The recent peer-reviewed literature is critically evaluated to provide a comprehensive analysis of the safety and efficacy of behavioural, optical and pharmaceutical myopia management. Importantly, the paper addresses not only who to treat, but how to treat them, and when to stop or modify treatments. Finally, the paper discusses expectations for treatment and why slowing myopia by even 1 dioptre improves long term health outcomes. SUMMARY The management of an individual child should be underpinned by the evidence-based literature and clinicians must stay alert to ongoing myopia research that will undoubtedly result in an evolution of the standard of care for the myopic and pre-myopic child. © 2020 The Authors Ophthalmic & Physiological Optics © 2020 The College of Optometrists.Diabetes-associated organ fibrosis, marked by elevated cellular senescence, is a growing health concern. Intriguingly, the mechanism underlying this association remained unknown. Moreover, insulin alone can neither reverse organ fibrosis nor the associated secretory phenotype, favoring the exciting notion that thus far unknown mechanisms must be operative. Here, we show that experimental type 1 and type 2 diabetes impairs DNA repair, leading to senescence, inflammatory phenotypes, and ultimately fibrosis. Carbohydrates were found to trigger this cascade by decreasing the NAD+ /NADH ratio and NHEJ-repair in vitro and in diabetes mouse models. Restoring DNA repair by nuclear over-expression of phosphomimetic RAGE reduces DNA damage, inflammation, and fibrosis, thereby restoring organ function. Our study provides a novel conceptual framework for understanding diabetic fibrosis on the basis of persistent DNA damage signaling and points to unprecedented approaches to restore DNA repair capacity for resolution of fibrosis in patients with diabetes. © 2020 The Authors. Published under the terms of the CC BY 4.0 license.WHAT IS KNOWN AND OBJECTIVE Polypharmacy is common, and many medications have cognitive side effects. Such effects can be transient and subside when the drug in question is discontinued or can be long-lasting with effects present for years afterwards. Although formal assessment of cognition is feasible and often undertaken in neuropsychiatric trials, these effects are usually neglected in the evaluation of any non-neuropsychiatric health intervention. Medication effects can be assessed within a cognitive footprint framework, to account for the magnitude and the duration of cognitive side effects, with some likely to have a greater and more lasting effect than others. COMMENT Adverse event reporting suggests that many medications may be indirectly associated with cognitive effects, for example due to headaches, somnolence and 'dizziness'; however, inferring causation from adverse event reporting can be problematic. In order to better understand the impact of investigational drug and concomitant medications effen different drug regimens. © 2020 The Authors. Journal of Clinical Pharmacy and Therapeutics published by John Wiley & Sons Ltd.BACKGROUND Trace elements' (TEs) contamination of parenteral nutrition (PN) solutions is an ongoing concern. The aims of this study were 1) to measure actual TE concentrations in PN admixtures compared with ordered concentrations and 2) compare TE intake with current recommendations. METHODS PN admixtures from discarded bags were collected from patients receiving home PN and on inpatient wards. Samples were collected from 72 patients (39 inpatients, 33 receiving home PN). Age, percentage energy intake from PN, and PN orders were collected from patients' charts. PN samples were analyzed for TEs, including chromium (Cr) and manganese (Mn), and concentration measurements compared with ordered concentrations and current recommendations. RESULTS Measured Cr and Mn concentrations were higher than ordered concentrations 5.3 ± 1.7 vs 2.8 ± 1.5 µg/L; P 1 year. Manganese should also be excluded from PN admixture for pediatric patients but plasms monitoring 2-3 times per year is recommended for those on long-term PN. BDA-366 order © 2020 American Society for Parenteral and Enteral Nutrition.