Stewartbyrne6576

Assessment of the ruminant livestock feed sources availability, existing feeding practices, and nutrient balances was embarked at different zones of Gurez valley of Kashmir in two major seasons (summer and winter). A baseline survey was conducted to obtain the information in three zones, viz., Lower, Middle and Upper Gurez. The study was carried out in three villages in each zone where seven farmer families per village were selected randomly for the study. A total of 63 households owning livestock were interviewed to collect the information and the samples of available animal feeds and fodders fed during the seasons for chemical analysis. Daily nutrient intakes were calculated and compared with the standard requirements to determine the nutrient balances of livestock during the seasons. The main crops cultivated only during summer season were pulses (98.41%), maize (95.24%), and potatoes (90.48%), while few farmers in Lower and Middle Gurez also sow oats (42.86%) and had apple orchards (17.46%), the by-produc nutritional deficit in quantity, as well as quality. It is concluded that lack of technical know-how among the animal rearers regarding livestock feeding strategies and winter season feed/fodder scarcity are the major constraints that limit livestock productivity. It is therefore suggested that there is a dire need for nutritional innovations to increase fodder production as well as adoption of fodder conservation and feeding strategies for ensuring year-round availability of animal feeds if sustainable livestock production is to be met in the high Himalaya Gurez valley of Kashmir.BACKGROUND In the battle against the SARS-CoV‑2 pandemic, chloroquine has emerged as a new potential therapeutic option for the treatment of infected patients. A safety consideration for the application of chloroquine is its QTc-prolonging potential. Thus far, no data are available on the QTc-prolonging potential of chloroquine in COVID-19 patients. OBJECTIVE To assess the degree of chloroquine-induced QTc prolongation in hospitalised COVID-19 patients. METHODS A baseline electrocardiogram (ECG) and ECGs recorded during chloroquine treatment were retrospectively collected in patients suspected of having COVID-19. The QTc interval was calculated by computerised and manual interpretation. Baseline and follow-up QTc intervals were compared using the paired samples t-test. RESULTS A total of 95 patients had a baseline ECG recording and at least one ECG recording during chloroquine therapy. Chloroquine treatment resulted in a mean QTc prolongation of 35 ms (95% CI 28-43 ms) using computerised interpretation and 34 ms (95% CI 25-43 ms) using manual interpretation. No torsade de pointes was observed during chloroquine treatment. After manual review, 22 patients (23%) had a QTc interval exceeding 500 ms during chloroquine treatment. None of these patients had a prolonged QTc interval prior to the initiation of chloroquine treatment. CONCLUSIONS Chloroquine significantly prolongs the QTc interval in a clinically relevant matter. This highlights the need for ECG monitoring when prescribing chloroquine to COVID-19 patients.Tumor necrosis factor alpha (TNF) inhibitors have had a significant impact in medicine since the approval of the first drug of its class by the US FDA in 1998. New clinical data and indications have emerged for TNF inhibitors in recent years. Currently, four TNF inhibitors have been approved by the US FDA for dermatology, two of which include US FDA-approved pediatric use. In particular, growing evidence supports the use of etanercept and adalimumab as attractive therapies for pediatric psoriasis. Data for use of etanercept in treating toxic epidermal necrolysis and either etanercept or infliximab for Kawasaki disease is expanding. In addition, there have been clinical reports on the use of TNF inhibitors to treat a variety of other pediatric dermatologic conditions. To help clinicians keep pace with the new data provided by many pediatric dermatology studies involving TNF inhibitors, this review provides an overview of the use of TNF inhibitors in the treatment of pediatric plaque psoriasis, hidradenitis suppurativa, atopic dermatitis, pyoderma gangrenosum, toxic epidermal necrolysis, and Kawasaki disease. For TNF inhibitors with little data in the pediatric population, data on adult use is discussed. Furthermore, the review summarizes available clinical data on efficacy, safety, and tolerability of agents currently available.Page 4, Figure 1.PURPOSE OF REVIEW We review here best practices and resources for pediatricians providing pediatric obesity management in 4 key areas how to assess all of the relevant factors contributing to obesity, how to provide nutrition education, how to counsel families who eat out regularly, and what to do with patients who frequently make poor eating choices. RECENT FINDINGS While there are many resources indicating recommendations for the physical exam and laboratory tests, there are very few resources that give pragmatic advice on the counseling aspects of the pediatric obesity encounter. We note new nutrition research showing the importance of avoiding ultra-processed foods. Most importantly, we list several resources regarding useful questionnaires, nutrition guidance, and even further training for pediatricians. There is a need for more curation of resources in different aspects of obesity care. We hope that this review and list of resources are helpful for pediatricians and will empower families and can be expanded in the future.We investigate the possible effects of acupuncture on the improvement of neurological problems in HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP)disease. Twenty patients with HAM/TSP were studied in this pre and post-test clinical trial. Urinary incontinence, global motor disability, spasticity, and pain severity were evaluated before, one month, and three-month after the intervention. Analyses demonstrated a significant reduction of urinary symptoms one month after acupuncture (P = 0.023). A significant improvement was observed in patients' pain and the spasticity at the upper extremity joints, one and three-month after the intervention (P  less then  0.05). This study suggests that body acupuncture can be used as a complementary treatment to improve HAM/TSP neurological symptoms.Functional food with high concentrations of monosaccharides and antioxidants is important for quick replenishment of energy reserves and rehabilitation after intensive oxidant stress. The effect of high temperature and humidity for manufacturing such products from parsnip roots of three cultivars (Zemchug, Krugly, Bely aist) compared to garlic bulbs from cultivar Demidovsky was investigated. The processed parsnip demonstrated higher antioxidant activity than 'black garlic' phenolics (22.6 compared to 13.3 mg-GAE/g d.w.), total antioxidant activity (26.1 compared to 18.1 mg-GAE/g d.w.) and radical scavenging activity (0.24 compared to 0.18 mcM TE/g d.w.). Monosaccharides concentration in parsnip roots increased from 6.5-8.0 to 36.2-42.5 g/100 g d.w., the latter range including the value relevant to the processed garlic (37.4 g/100 g d.w.). Parsnip roots showed concurrent monosaccharides increase and disaccharides decrease (from 33.75-37.2 to 1.25-6.72 g/100 g), whereas garlic displayed the enhancement of both mono- and disaccharide biosynthesis. Total acidity level in processed parsnip also increased by 3 to 5 times and was highly correlated with monosaccharides content (r = 0.99 at P ≤ 0.01). Thanks to its higher mineral content, 'black parsnip' proved to be suitable for quick energy and antioxidant replenishment after strong physical and/or oxidant stress.The aim of this study was to assess the efficiency of different drying methods (room, sun, oven, microwave, cross-flow, infra-red, dehumidifier, and freeze-drying) on maximum retention of the nutritional and bioactive compounds profiling of Talinum triangulare, which is a less-known perishable leafy-vegetable. The evaluation of various drying methods is to learn the best appropriate strategy for a post-harvest drying method for retaining all the potential benefits with minor loss. Microwave and freeze-dried samples held the maximum ascorbic acid quantified by HPLC with 1.36 and 1.11 g/100 g DW, respectively. The main carotenoid compounds identified were violaxanthin, lutein, zeaxanthin, β-carotene isomers, trans-β-carotene, and cis-β-carotenes. Gallic, protocatechuic, catechin, para-coumaric, ferulic, rutin, trans-cinnamic, and quercetin are the significant phenolics and flavonoids identified and quantified by liquid chromatography. The efficiency of different solvents on bioactive extractions uncovered that the methanol and 80% aqueous ethanol were good for retention of total phenolics, total flavonoids, and antioxidant compounds, which was affirmed through phosphomolybdate, DPPH, and FRAP assays. Dried T. triangulare foliage could be productively utilized as a promising raw material for food and pharma businesses because of its rich bioactive composition.In Methods section under Study Design and Patients.Salivary duct carcinoma (SDC) commonly expresses androgen receptor (AR) and HER2, giving rise to treatment implications. SDC may also express programmed-death-ligand-1 (PD-L1), a predictive marker of response to checkpoint inhibitors. PD-L1 can be associated with genomic instability and high density of tumor infiltrating lymphocytes (TILs). Evaluation of HER2 immunohistochemistry (IHC) in SDC is not standardized, and relationships between ERBB2 copy numbers, PD-L1 expression and TILs in SDC are unknown. We evaluated 32 SDCs for HER2, AR and PD-L1 expression (IHC), ERBB2 status (FISH) and TILs (slide review). HER2 was scored with three different systems (breast, gastric, proposed salivary gland). PD-L1 was evaluated with the combined positive score. Most patients were older men, presenting at advanced clinical stage with nodal or distant metastases. During follow-up (mean 5 years, range 6 months to 21 years), 25 of the 32 patients (78%) died of SDC. We propose a HER2 IHC scoring system which accurately predicts underlying ERBB2 amplification or increased copy numbers in SDC. Most tumors had increased ERBB2 copy numbers (19/32 amplification, 6/32 aneusomy), a finding associated with higher TIL densities (p = 0.045) and PD-L1 expression (p = 0.025). Patients with TILs ≥ 40% had better prognoses (Log-Rank p = 0.013), with TILs being favorable prognosticators in univariate analysis (Hazard ratio 0.18, p = 0.024). A subset of SDCs with increased ERBB2 copy numbers have higher TILs and PD-L1 expression. TILs ≥ 40% are associated with better prognosis.Oligometastatic disease is a hypothesized intermediate stage of disease between localized and widespread metastatic cancer. Localized treatment of oligometastatic lesions may offer survival advantages in addition to systemic treatment. In this case report, we describe a patient who presented with small cell neuroendocrine carcinoma "Merkel type" (SNECM) of the parotid gland which had metastasized to the brain and adrenal gland. selleck chemicals He was treated with chemotherapy followed by stereotactic radiotherapy and volumetric modulated arc therapy for oligometastasis. He maintains good functional status with low burden of disease at 20-months after diagnosis. SNECM is a rare and aggressive parotid cancer with immunohistochemical and morphologic similarities to Merkel cell carcinoma (MCC). There are only 44 cases of parotid SNECM in the English literature. This is the first case to describe management of oligometastatic SNECM and we review literature on management of both SNECM and metastatic MCC.