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The COVID-19 pandemic has been a difficult and trying time, but as most situations in life, it brought both good and bad side effects. Concerning chaplaincy, COVID-19 reveals that we have not arrived yet in the effort to incorporate spiritual care into essential health care delivery. Although chaplaincy is beginning to have a voice, we have been mostly speaking to ourselves. We need an advocacy voice that healthcare systems and policy makers can hear.To assess the prevalence and factors associated with psychological distress (PD) and Medical Laboratory Professionals (MLPs) involvement in COVID-19-related duties. This study adopted an online cross-sectional, nationally stratified survey among 473 MLPs using Google Form with a designated link; Depression, anxiety, and stress scale-21 (DASS-21) was used to measure depression, anxiety, and stress (secondary outcome). We employed generalized Negative Binomial (NBR) and Poisson regression analytical approach to our study outcomes. All analyses were performed using Stata 16, and P-value≤.05 deemed significant. The overall DASS-21 score ranged from asymptomatic psychological distress to severe symptomatic PD. The prevalence of depression, anxiety, and stress were 9.1 [95%CI=6.8-12.0], 17.8 [95%CI=14.6-21.5], and 7.5 [95%CI=5.4-10.1], respectively. The result evinced a high and significant association; the univariate NBR predicted a significant increase of PD score by 12% and 18% among participants who were involved in one and two or more COVID-19-related duties, respectively, (β[95%CI] = .12 [.05-.18] and .18 [.10-.26], respectively). A binary outcome predicted approximately 2-folds of overall psychological distress among participants involved in two or more COVID-19-related duties compared with non-involvement (adjusted Prevalence Ratio [95%CI]= 2.34 [1.12-4.85]). For depression, anxiety, and stress symptoms, both univariate and multivariate data analyses evinced a higher disadvantage among MLP involved in COVID-19-related duties. We observed a high tendency of experiencing significant psychological distress amongst MLP involved in COVID-19-related duties. Experience of psychological distress increased with deeper involvement in COVID-19-related activities. Psychological support should be extended to MLPs to limit the effect of these negative emotions on their cognitive and social behavior as well as job performance.

Trastuzumab emtansine (TDM-1) is an antibody-drug conjugate effective in human epidermal growth factor receptor-2 - expressing advanced breast cancer. Pulmonary complications of TDM-1 are rarely reported. TDM-1-associated interstitial lung disease is referred to as pneumonitis.

A 47-year-old female patient who underwent modified radical mastectomy and axillary lymph node dissection operations due to a palpable mass in the right breast and axillary region. The patient who had received multiple chemotherapy was last receiving TDM-1 treatment. Fatigue, dyspnea, and tachypnea were detected for the first time on 20 days after the 6

treatment.

In our case, we first considered metastasis, pneumonia and fungal infection based on radiological findings, but the lack of response to the treatments and the results of the investigations suggested drug-induced pneumonia and steroid treatment was started. Our case had a complete radiological recovery and complete response to sterod therapy. In such cases, it is important to first exclude infections and metastasis. In cases of drug-induced pneumonia, the first treatment option is systemic corticosteroids and generally responded well.

Unlike other cases of interstitial pneumonia, lung imaging of our case was resembling a metastasis, pneumonia and fungal infection. With increasing use of TDM-1, we will have more experience in both efficacy and complications of TDM-1. Although TDM-1 is a well-tolerated drug, clinicians should be aware of rare pulmonary complications and prepared to respond appropriately.

Unlike other cases of interstitial pneumonia, lung imaging of our case was resembling a metastasis, pneumonia and fungal infection. With increasing use of TDM-1, we will have more experience in both efficacy and complications of TDM-1. Although TDM-1 is a well-tolerated drug, clinicians should be aware of rare pulmonary complications and prepared to respond appropriately.The electric stimulation provided by current cochlear implants (CI) is not power efficient. One underlying problem is the poor efficiency by which information from electric pulses is transformed into auditory nerve responses. A novel stimulation paradigm using ramped pulse shapes has recently been proposed to remedy this inefficiency. The primary motivation is a better biophysical fit to spiral ganglion neurons with ramped pulses compared to the rectangular pulses used in most contemporary CIs. Here, we tested the hypotheses that ramped pulses provide more efficient stimulation compared to rectangular pulses and that a rising ramp is more efficient than a declining ramp. Rectangular, rising ramped and declining ramped pulse shapes were compared in terms of charge efficiency and discriminability, and threshold variability in seven CI listeners. The tasks included single-channel threshold detection, loudness-balancing, discrimination of pulse shapes, and threshold measurement across the electrode array. Results showed that reduced charge, but increased peak current amplitudes, was required at threshold and most comfortable levels with ramped pulses relative to rectangular pulses. Furthermore, only one subject could reliably discriminate between equally-loud ramped and rectangular pulses, suggesting variations in neural activation patterns between pulse shapes in that participant. No significant difference was found between rising and declining ramped pulses across all tests. In summary, the present findings show some benefits of charge efficiency with ramped pulses relative to rectangular pulses, that the direction of a ramped slope is of less importance, and that most participants could not perceive a difference between pulse shapes.A new aromatic glycoside (1) and twelve (2-13) known aromatic glycosides were isolated from the n-butyl alcohol of the 70% EtOH extract of the aerial part of Bupleurum chinense. Among them, compounds 4-7, 9, 11-13 were isolated from Umbelliferae plants for the first time. Their structures were elucidated by NMR and MS spectroscopy, and the absolute configuration of compound 1 was elucidated by single-crystal X-ray diffraction. Compounds 6 and 10 showed moderate cytotoxic activities on MGC-803 cell lines with IC50 values of 8.63 ± 0.08 and 13.65 ± 1.73 μM, respectively.Sustainable energy from biomass is one of the most promising alternative energy sources and is expected to partially replace fossil fuels. Tobacco industries have normally rid their processing residues by landfilling or incineration, affecting the environment negatively. These residues can be used to either extract high-value chemicals or generate bio-energy via hydrothermal liquefaction. The main liquid product or bio-oil consists of highly complicated chemicals. In this work, the bio-oil from hydrothermal liquefaction of tobacco processing residues was generated in a batch reactor at biomass-to-deionized water ratio of 13, temperature of 310°C, and 15 min residence time, yielding the maximum liquid products for more than 50% w/w. The liquid products were analyzed, using two-dimensional gas chromatography and time-of-flight mass spectrometry (GC × GC/TOF MS). This technique allowed for a highly efficient detection of numerous compounds. From the results, it was found that hydrothermal liquefaction can cleave biopolymers (cellulose, hemicellulose, and lignin) in tobacco residues successfully. The hydrothermal liquefaction liquid products can be separated into heavy organic, light organic, and aqueous phase fractions. By GC × GC/TOF MS, the biopolymers disintegrated into low molecular weight compounds and classified by their chemical derivatives and functional groups could be detected. The major chemical derivative/functional groups found were cyclic ketones and phenols for heavy organic and light organic, and carboxylic acids and N-containing compounds for the aqueous phase. Additionally, by the major compounds found in this work, simple pathway reactions occurring in the hydrothermal liquefaction reaction were proposed, leading to a better understanding of the hydrothermal liquefaction process for tobacco residues.The association between dry eye disease (DED) and psychiatric conditions is a highly researched topic. This work reviews the literature on this relationship, examining the prevalence and correlations of depression and anxiety with dry eye signs and symptoms. A comprehensive literature search of MEDLINE, EMBASE, PsycINFO, and gray literature was conducted, with keywords for dry eye and mood disorders, depression, anxiety, and suicide. Eligible studies underwent quality assessment using the Newcastle-Ottawa Scale. Meta-analysis was performed using STATA 15.0. Fixed- and random-effects models were computed based on the presence of heterogeneity. Thirty-two studies were included, with 31 reporting on depression and 19 on anxiety. Meta-analysis results found a depression prevalence of 40% (CI [0.29, 0.52]) in DED patients, with 1.81 times higher odds of prevalence compared to controls (CI [1.61, 2.02]). Prevalence of anxiety was 39% (CI [0.15, 0.64]), with 2.32 times higher odds of prevalence compared to controls (CI [1.67, 3.23]). Depression scores were significantly higher in patients with DED in all studies. Anxiety scores were significantly higher in DED patients in studies using all scales except the Hospital Anxiety and Depression Scale-Anxiety Subscale. DED symptom scores were significantly associated with depression (ES = 0.43; CI [0.31, 0.55]) and anxiety (ES = 0.41; CI [0.32, 0.50]) scores. In conclusion, depression and anxiety are more prevalent and severe in DED patients and are correlated with dry eye symptoms but not signs. These findings highlight the interrelationship between these disorders and have important implications for providing appropriate care to these patients.

Death-associated protein kinase (DAPK) has a strong function of tumor suppression involving apoptosis regulation, autophagy, and metastasis inhibition. Hypermethylation of CpG islands in DAPK gene promoter region is one of the important ways to inactivate this tumor suppressor gene, which might promote lung carcinogenesis. However, the clinicopathological significance of the DAPK promoter hypermethylation in lung cancer remains unclear. Brefeldin A cost In this study, we performed a meta-analysis trying to estimate the clinicopathological significance of DAPK promoter hypermethylation in non-small cell lung cancer (NSCLC).

A detailed literature search for publications relevant to DAPK gene promoter methylation and NSCLC was made in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, CSTJ, Wanfang databases, and SinoMed (CBM). The random-effects model and fixed-effects model were utilized to pool the relative ratio based on the heterogeneity test in the meta-analysis.

A total of 41 studies with 3348 patients were included.