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The steady effect of MTX could be reached at week 16. Elevated liver enzymes (28.6%) and infections (28.6%) were the most common side effects. Relapse was recorded in 9 (30.0%) of 30 patients, and the mean posttherapy disease-free interval was 7.2 months.

MTX is an effective and safe option for children with severe plaque psoriasis with adequate monitoring.

MTX is an effective and safe option for children with severe plaque psoriasis with adequate monitoring.

The current pandemic and the concerns of vertical transmission of SARS-CoV-2 have contributed to increasing the rate of breastfeeding interruption. This tendency has been associated with negative effects on the well-being of lactating mothers and their infants. The aim of this review is to summarize the evidence on the strategies to support breastfeeding during the COVID-19 pandemic and on the safety of breastfeeding during a SARS-CoV-2 infection or after COVID-19 vaccination.

Available data show that the lack of support of lactating mothers during the pandemic has contributed to breastfeeding cessation worldwide. However, a few strategies have been proposed to overcome this issue. The risk of SARS-CoV-2 transmission from infected mothers to their offspring is extremely low. Furthermore, vaccination of lactating mothers is not associated with side effects in their infants. Key Messages Increasing effort should be made to support breastfeeding during the COVID-19 pandemic. Mothers who are able to take care of their offspring and to adopt basic hygiene measures should not interrupt breastfeeding during a SARS-CoV-2 infection. Vaccination of lactating mothers might further strengthen the protective effect of breastfeeding against infections.

Available data show that the lack of support of lactating mothers during the pandemic has contributed to breastfeeding cessation worldwide. However, a few strategies have been proposed to overcome this issue. The risk of SARS-CoV-2 transmission from infected mothers to their offspring is extremely low. Furthermore, vaccination of lactating mothers is not associated with side effects in their infants. Key Messages Increasing effort should be made to support breastfeeding during the COVID-19 pandemic. Mothers who are able to take care of their offspring and to adopt basic hygiene measures should not interrupt breastfeeding during a SARS-CoV-2 infection. Vaccination of lactating mothers might further strengthen the protective effect of breastfeeding against infections.

Interleukin-6 (IL-6) is one of the most important mediators of inflammation. It is also the culprit for a severe disease course in COVID-19. While COVID-19 has higher mortality in hemodialysis (HD) patients, medium cutoff (MCO) membranes were previously suggested as promising tools for better patient outcomes by purging inflammatory mediators. The aim of this study was to analyze changes in IL-6 levels of HD patients who were dialyzed via MCO membranes during their COVID-19 treatments.

This is an observational study on a group of HD patients who were admitted with COVID-19 diagnosis in a university hospital and intermittently dialyzed using MCO membranes during their hospital stay. IL-6 levels of the patients were measured before and after consecutive dialysis sessions by a commercial kit. Measurements were interpreted together with the clinical data.

Nine patients with a total of 54 measurements were evaluated. IL-6 levels were significantly higher in patients who died (median and interquartile ranges d decreasing levels of IL-6 with consecutive dialysis sessions, while nonsurvivors had an increasing trend.Objective. Radiation therapy treatment planning is a time-consuming process involving iterative adjustments of hyperparameters. To automate the treatment planning process, we propose a meta-optimization framework, called MetaPlanner (MP).Approach. Our MP algorithm automates planning by performing meta-optimization of treatment planning hyperparameters. The algorithm uses a derivative-free method (i.e. parallel Nelder-Mead simplex search) to search for weight configurations that minimize a meta-scoring function. Meta-scoring is performed by constructing a tier list of the relevant considerations (e.g. dose homogeneity, conformity, spillage, and OAR sparing) to mimic the clinical decision-making process. Additionally, we have made our source code publicly available via github.Main results. The proposed MP method is evaluated on two datasets (21 prostate cases and 6 head and neck cases) collected as part of clinical workflow. MP is applied to both IMRT and VMAT planning and compared to a baseline of manual VMAT plans. MP in both IMRT and VMAT scenarios has comparable or better performance than manual VMAT planning for all evaluated metrics.Significance. Our proposed MP provides a general framework for fully automated treatment planning that produces high quality treatment plans. Our MP method promises to substantially reduce the workload of treatment planners while maintaining or improving plan quality.We report superconducting state properties and electronic structure of a full Heusler material ScAu2Al. The resistivity measurement indicates a zero-field (at nominal Earth's field) superconducting transition temperature,Tc= 5.12 K (in contrary to the previously reported value of 4.4 K), which falls in the highestTc-regime among the Heusler superconductors. The magnetization data shows that ScAu2Al is a moderate type-II superconductor, where the critical field values can be estimated from the Ginzburg-Landau-Abrikosov-Gorkov theory. The field-dependent magnetization response further shows signatures of flux jump in ScAu2Al. A sharp jump in the temperature dependent specific heat (Cp) data confirms bulk superconductivity. We report that the electron-phonon coupling constant,λe-ph= 0.77, suggesting a moderate electron-phonon coupling in ScAu2Al. Fasoracetam Further, we show that the observedλe-phvalue in ScAu2Al is the highest amongst the reported Heusler superconductors, indicating strong correlation betweenTcandλe-phvalues and significant role of electron-phonon coupling in mediating superconductivity in Heusler superconductors. Finally, we discuss the electronic properties and reveal the existence of van Hove singularity near the Fermi level in ScAu2Al.Single molecule drug delivery systems have failed to yield functional therapeutic outcomes, triggering investigations into multi-molecular drug delivery vehicles. In the context of skin fibrosis, although multi-drug systems have been assessed, no system has assessed molecular combinations that directly and specifically reduce cell proliferation, collagen synthesis and transforming growth factorβ1 (TGFβ1) expression. Herein, a core-shell collagen type I hydrogel system was developed for the dual delivery of a TGFβtrap, a soluble recombinant protein that inhibits TGFβsignalling, and Trichostatin A (TSA), a small molecule inhibitor of histone deacetylases. The antifibrotic potential of the dual delivery system was assessed in anin vitroskin fibrosis model induced by macromolecular crowding (MMC) and TGFβ1. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and high performance liquid chromatography analyses revealed that ∼50% of the TGFβtrap and ∼30% of the TSA were released from the core and shell compartments, respectively, of the hydrogel system after 10 d (longest time point assessed) in culture. As a direct consequence of this slow release, the core (TGFβtrap)/shell (TSA) hydrogel system induced significantly (p less then 0.05) lower than the control group (MMC and TGFβ1) collagen type I deposition (assessed via SDS-PAGE and immunocytochemistry),αsmooth muscle actin (αSMA) expression (assessed via immunocytochemistry) and cellular proliferation (assessed via DNA quantification) and viability (assessed via calcein AM and ethidium homodimer-I staining) after 10 d in culture. On the other hand, direct TSA-TGFβsupplementation induced the lowest (p less then 0.05) collagen type I deposition,αSMA expression and cellular proliferation and viability after 10 d in culture. Our results illustrate the potential of core-shell collagen hydrogel systems for sustained delivery of antifibrotic molecules.We study the parity and time-reversal(PT)symmetric quantum physics in a non-Hermitian non-relativistic hydrogen molecule with local (Hubbard type) Coulomb interaction. We consider non-Hermiticity generated from both kinetic and orbital energies of the atoms and encounter the existence of two different types of exceptional points (EPs) in pairs. These two kinds of EP are characteristically different and depend differently on the interaction strength. Our discovery may open the gates of a rich physics emerging out of a simple Hamiltonian resembling a two-site Hubbard model.Central to applying the principle of optimisation in the system of radiological protection is the evaluation of what level of radiation exposure should be considered 'as low as reasonably achievable' (ALARA), after taking into account the prevailing circumstances. Determining what is 'reasonable' is an abstract, although somewhat intuitive concept with many potential interpretations depending on both the situation and those involved, whether individuals or organisations. There are common themes in the types of considerations that need to be addressed to determine 'reasonableness' regardless of the exposure situation. However, despite the consistent and agreeable nature of these themes, there remains a gap in how to apply them in real situations. For example, without measurable goalposts (or a clear process for setting such goalposts) for determining what constitutes ALARA, we can find ourselves misinterpreting the optimisation process as keeping exposures 'as low as possible'. We propose herein, by consolidating and building on existing ideas, an easily understandable and actionable 'reasonableness' framework. This simple, yet broadly applicable tool is intended to help radiation protection experts in the systematic, deliberative, and collaborative reflection on all of the factors that make up 'reasonable' before making a decision-whether it be a proposed medical treatment or clean-up of a contaminated site. Each process execution and decision itself will necessarily retain the complexity of the prevailing circumstance. The proposed 'Rs' of Reasonable represent Relationships (stakeholders, empathy, and trust), Rationale (contextual, technical, and ethical), and Resources (technological, financial, and time).Purpose.Current hole matching pixel detector (HMPD) collimators for SPECT imaging exist in two configurations one hole per pixel (1HMPD) or four holes per pixel (4HMPD). The aim of this study was to assess the performance of a dual-layer collimator made by stacking up these two collimator types (1H/4HMDP) for low- and medium energy gamma emitters.Method. Analytical equations describing geometrical efficiency and full width at half maximum (FWHM) of the 1H/4HMDP collimator were derived. In addition, a fast dedicated Monte Carlo (MC) code neglecting scattering and designed for the collimator geometry was developed to assess the collimator's point spread function and to simulate planar and SPECT acquisitions.Results.A relative agreement between analytical equations and MC simulations better than 3% was observed for the efficiency and for the FWHM. The length of the two layers was optimized to get the best spatial resolution while keeping the geometrical efficiency equal to that of the 45 mm length 1HMPD collimator.