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Background: A lack of standard Bachman Bundle(BB) capture criteria has affected the clinical impact of Bachmann Bundle Area Pacing(BBAP) in patients with inter-atrial block(IAB)., Objective: We evaluated the feasibility and safety of electrogram guided BBP using sheath assisted, stylet-driven atrial lead implantation., Methods: Patients with a baseline IAB undergoing dual chamber PPI or ICD implantation were enrolled in a single center,prospective study. BBAP was attempted in all patients with the aid of a Selectra 3D S-40 delivery sheath and Solia S-60 pacing lead. BB capture was confirmed using a combination of fluoroscopy,P wave morphology,and electrophysiological criteria. These included the recording of a high frequency BB potential and a transition between non-selective(NS) to selective(S) BB capture during threshold testing. Procedure-related complications,lead parameters,and P wave morphology were assessed at implantation and follow up., Results: Permanent BBAP was successful in 32 of the 36(88.9%) enrolled patients. Baseline P wave duration was 148.5+16.1ms. Among patients who underwent successful BBP, the final paced P wave duration was 117.8+19.6ms. There was a correction of the partial or complete interatrial block in 22(91.7%) and 6(75.0%) patients, respectively. BB potentials were recorded in 83.3% of all study patients.A transition from NS to S-BB capture could be demonstrated during threshold testing in 22(87.5%) patients. The only major complications were 2 BBAP lead dislodgements within 24 hours and a rise in pacing impedance at 3 weeks in 1 patient., Conclusion: BBAP is feasible in a high percentage of patients and is associated with stable capture thresholds during follow up., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Abstract: B-cell maturation antigen (BCMA)-targeting therapeutics have dramatically improved outcomes in relapsed/refractory multiple myeloma (RRMM). However, whether the mechanisms of resistance between these therapies are shared and how the identification of such mechanisms before therapy initiation could refine clinical decision-making remains undefined. We analyzed outcomes for 72 RRMM patients treated with teclistamab, a CD3 × BCMA bispecific antibody, 42% (30/72) of whom had prior BCMA-directed therapy exposure. Malignant plasma cell BCMA expression was present in all BCMA therapy-naïve patients. Prior therapy-mediated loss of plasma cell BCMA expression before teclistamab treatment, measured by immunohistochemistry, was observed in 3 patients, none of whom responded to teclistamab, and 1 of whom also did not respond to ciltacabtagene autoleucel. Whole exome sequencing of tumor DNA from 1 patient revealed biallelic loss of TNFRSF17 following treatment with belantamab mafodotin. Low-to-undetectable peripheral blood soluble BCMA levels correlated with the absence of BCMA expression by bone marrow plasma cells. Thus, although rare, loss of BCMA expression following TNFRSF17 gene deletions can occur following any BCMA-directed therapy and prevents response to subsequent anti-BCMA-directed treatments, underscoring the importance of verifying the presence of a target antigen., (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Accurate pest classification plays a pivotal role in modern agriculture for effective pest management, ensuring crop health and productivity. While Convolutional Neural Networks (CNNs) have been widely used for classification, their limited ability to capture both local and global information hinders precise pest identification. In contrast, vision transformers have shown promise in capturing global dependencies and enhancing classification performance. However, the traditional attention mechanism employed in vision transformers, which uses the same query (Q), key (K), and value (V), overlooks spatial relationships between patches, limiting the model's capacity to capture fine-grained details and long-range dependencies in the image. To address these limitations, this study presents a novel approach, termed Hybrid Pooled Multihead Attention (HPMA), for superior pest classification that outperforms both CNN models and vision transformers. The HPMA model integrates hybrid pooling techniques and modifies the attention mechanism to effectively capture local and global features within images. By emphasizing discriminative features and suppressing irrelevant information, the HPMA model achieves heightened robustness and generalization capabilities. The model is trained and tested on a newly built dataset consisting of 10 pest classes, achieving a remarkable accuracy of 98 %. Furthermore, the proposed HPMA model is validated on two benchmark datasets and achieves accuracies of 98 % and 95 %, demonstrating its effectiveness across diverse pest datasets. The results and ablation study of the proposed model contribute to exceptional performance in accurate pest classification. This tackles agricultural pest challenges and enables prompt pest control to reduce crop losses., Competing Interests: Declaration of competing interest My coauthors and I do not have any conflicts of interests to disclose., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Laboratory testing for celiac disease in pediatric patients integrates serology, genetic susceptibility and duodenal biopsy examination. The 2023 American College of Gastroenterology guidelines recommend a biopsy-free approach in pediatric patients utilizing tissue transglutaminase antibody titers >10 times upper limit of normal and subsequent endomysial antibody seropositivity as sufficient for diagnosis. The objective of this study is to assess the diagnostic accuracy of biopsy-free approach at our pediatric hospital., Methods: We conducted a retrospective study involving pediatric patients who underwent biopsy for diagnostic confirmation of celiac disease between May 2019 and May 2023. For these patients, the tissue transglutaminase and endomysial antibody test results were retrieved and performance of biopsy-free approach was assessed using the duodenal histology as the gold standard for celiac disease diagnosis., Results: Tissue transglutaminase antibody titers >10 times upper limit of normal alone demonstrated a positive predictive value of 99% for identifying celiac disease in children. Although endomysial antibody testing is underutilized at our center, its inclusion further improved the predictability to 100 %., Conclusion: Positive predictive value of tissue transglutaminase antibody titers >10 times upper limit of normal is sufficiently high for celiac disease diagnosis in children and may allow for deferral of duodenal biopsy at diagnosis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The burgeoning field of starch-based nanomaterials in biomedical applications has perceived notable progressions, with a particular emphasis on their pivotal role in precision drug delivery and the inhibition of tumor growth. The complicated challenges in current biomedical research require innovative approaches for improved therapeutic outcomes, prompting an exploration into the possible of starch-based nanomaterials. The conceptualization of this review emerged from recognizing the need for a comprehensive examination of the structural attributes, versatile properties, and mechanisms underlying the efficiency of starch-based nanomaterials in inhibiting tumor growth and enabling targeted drug delivery. This review delineates the substantial growth in utilizing starch-based nanomaterials, elucidating their small size, high surface-volume ratio, and biocompatibility, predominantly emphasizing their possible to actively recognize cancer cells, deliver anticancer drugs, and combat tumors efficiently. The investigation of these nanomaterials encompasses to improving biocompatibility and targeting specific tissues, thereby contributing to the evolving landscape of precision medicine. The review accomplishes by highlighting the auspicious strategies and modern developments in the field, envisioning a future where starch-based nanomaterials play a transformative role in molecular nanomaterials, evolving biomedical sciences. The translation of these advancements into clinical applications holds the potential to revolutionize targeted drug delivery and expand therapeutic outcomes in the realm of precision medicine., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Water quality surveillance is tough, and a specific timely management is necessary for the inland aquaculture ponds and ecology as well. Real time quality monitoring involves the study of numerous parameters includes physical (turbidity, temperature, and specific conductivity), chemical (pH, calcium, manganese, chlorides, iron, biochemical oxygen demand), and biological (bacteria and algae). It is also crucial to recognize the inter-dependence among the parameters. Alternatively, these relationships can be predicted with statistical and numerical modelling. Organic strength parameter 5-day biochemical oxygen demand (BOD) is a significant parameter to evaluate since its impact is very high on the quality of water, aquatic life, and other biological concerns. This study focuses on the prediction of BOD using six traditional and four boosting algorithms considering ten input physicochemical attributes. The attributes were fine-tuned for highly precise predictions by removing extreme values from the data set using data outlier treatment. The prediction results are compared using performance metrics such as coefficient of determination (R 2 ), root mean square error (RMSE), mean square error (MSE), and mean absolute error (MAE). The findings revealed that boosting algorithms outperform the results of traditional models with the highest prediction accuracy. Among the boosting algorithms, eXtreme Gradient Boosting algorithm (XGBM) is found highly appropriate for the inland aquaculture waters with R 2  = 0.95, RMSE = 0.31, MSE = 0.09, MAE = 0.1. Finally, this study provides a systematic evaluation of the BOD in the aquaculture waters and has a significant contribution to water management and eco-balance., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2023 Elsevier B.V. All rights reserved.)

This study focused on modeling the removal of one of the widely used agricultural herbicides known as 2,4-Dichlorophenoxyacetic acid (2,4-D) using polypyrrole-coated Fe 2 O 3 nanoparticles (Fe 2 O 3 @PPy). The Fe 2 O 3 @PPy nanocomposite was synthesized by surface-coating the Tabebuia aurea leaf extract synthesized Fe 2 O 3 nanoparticles with polypyrrole. After characterization, the adsorptive potential of the nanocomposite for removing 2,4-D from aqueous solution was examined. Central composite design (CCD) was employed for optimizing the adsorption, revealing an adsorption efficiency of 90.65% at a 2,4-D concentration of 12 ppm, a dosage of 3.8 g/L, an agitation speed of 150 rpm, and 196 min. Adsorption dataset fitted satisfactorily to Langmuir isotherm (R 2 : 0.984 & χ2: 0.054) and pseudo-second-order kinetics (R 2 : 0.929 & χ2: 0.013) whereas the exothermic and spontaneous nature were confirmed via the thermodynamic study. The predictive models, including adaptive neuro-fuzzy inference system (ANFIS), artificial neural network (ANN), and response surface methodology (RSM), demonstrated good precision for the prediction of 2,4-D adsorption, with respective R 2 of 0.9719, 0.9604, and 0.9528. Nevertheless, statistical analysis supported ANFIS as the better forecasting tool, while RSM was the least effective. The maximum adsorption capacity of 2,4-D onto the Fe 2 O 3 @PPy nanocomposite was 7.29 mg/g, significantly higher than a few reported values. Therefore, the Fe 2 O 3 @PPy nanocomposite could serve as a competent adsorbent to remove 2,4-D herbicide from aqueous streams., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: This study aimed to develop a natural language processing (NLP) system that identified social risk factors in home health care (HHC) clinical notes and to examine the association between social risk factors and hospitalization or an emergency department (ED) visit., Design: Retrospective cohort study., Setting and Participants: We used standardized assessments and clinical notes from one HHC agency located in the northeastern United States. This included 86,866 episodes of care for 65,593 unique patients. Patients received HHC services between 2015 and 2017., Methods: Guided by HHC experts, we created a vocabulary of social risk factors that influence hospitalization or ED visit risk in the HHC setting. We then developed an NLP system to automatically identify social risk factors documented in clinical notes. We used an adjusted logistic regression model to examine the association between the NLP-based social risk factors and hospitalization or an ED visit., Results: On the basis of expert consensus, the following social risk factors emerged: Social Environment, Physical Environment, Education and Literacy, Food Insecurity, Access to Care, and Housing and Economic Circumstances. Our NLP system performed "very good" with an F score of 0.91. Approximately 4% of clinical notes (33% episodes of care) documented a social risk factor. The most frequently documented social risk factors were Physical Environment and Social Environment. Except for Housing and Economic Circumstances, all NLP-based social risk factors were associated with higher odds of hospitalization and ED visits., Conclusions and Implications: HHC clinicians assess and document social risk factors associated with hospitalizations and ED visits in their clinical notes. Future studies can explore the social risk factors documented in HHC to improve communication across the health care system and to predict patients at risk for being hospitalized or visiting the ED., (Copyright © 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

The objective of the study was to find the prevalence of metabolic syndrome along with identifying the atrial arrhythmias, QT C interval, and coronary artery disease among these patients during follow-ups. Among 171 subjects who were implanted with permanent pacemakers, metabolic syndrome was present in 90 (52.6 %). Prevalence of Arrhythmias was 49 (28.7 %), atrial tachycardia (AT)/atrial fibrillation (AF) was seen in 29 (17 %) patients. Our study showed that there is a strong association between metabolic syndrome and atrial arrhythmias. Metabolic syndrome, age, coronary artery disease and Systolic blood pressure were good independent predictors of atrial arrhythmias among patients with pacemaker implantation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier, a division of RELX India, Pvt. Ltd.)

Synchronization of interconnecting units is one of the hottest topics many researchers are interested in. In addition, this emerging phenomenon is responsible for many biological processes, and thus, the synchronization of interacting neurons is an important field of study in neuroscience. Employing the memristive Chialvo (mChialvo) neuron map, this paper investigates the effect of electrical, inner-linking, chemical, and hybrid coupling functions on the synchronization state of a neuronal network with regular structure. Master stability function (MSF) analysis is performed to obtain the necessary conditions for synchronizing the built networks. Afterward, the MSF-based results are confirmed by calculating the synchronization error. Besides, the dynamics of the synchronous neurons are discussed based on the bifurcation analysis. Our results suggest that, compared to the electrical and inner-linking functions, chemical synapses facilitate mChialvo neurons' synchronization since the neurons can achieve synchrony with a negligible chemical coupling strength. Further studies reveal that based on the active synapses, coupled mChialvo neurons can reach cluster synchronization, chimera state, sine-like synchronization, phase synchronization, and cluster phase synchronization., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Treatment options for symptomatic patients with nonobstructive hypertrophic cardiomyopathy (nHCM) are limited., Objective: The purpose of this study was to determine the effect of sequential atrioventricular (AV) pacing, from different right ventricular (RV) sites with varying AV delays, on the diastolic function and functional capacity of patients with nHCM., Methods: Twenty-one patients with symptomatic nHCM and normal left ventricular (LV) systolic function were prospectively enrolled. Inclusion criteria included PR interval >150 ms, E/e' ≥15, and an indication for implantable cardioverter-defibrillator (ICD) implantation. Doppler echocardiographic study was performed during dual-chamber pacing at various AV intervals. Pacing was performed at 3 RV sites: RV apex (RVA), RV midseptum (RVS), and RV outflow tract (RVO). The site and sensed AV delay (SAVD) at which optimal diastolic filling occurred were chosen based on diastolic filling period and E/e'. During ICD implantation, the RV lead was implanted at the site identified by the pacing study. Devices were programmed in DDD mode at the optimal SAVD. During follow-up, diastolic function and functional capacity were assessed., Results: Among the 21 patients (age 47.8 ± 7.7 years; 81.0% male), baseline E/A and E/e' were 2.4 ± 0.6 and 17.2 ± 2.2, respectively. There was an improvement in diastolic function (E/e') in 18 patients (responders) when pacing from the RVA (12.9 ± 3.4; P <.001) than from the RVS (16.6 ± 2.3) and RVO (16.9 ± 2.2). Among responders, optimal diastolic filling occurred at SAVD of 130-160 ms with RVA pacing. Nonresponders had longer duration of symptoms (P = .006), lower LV ejection fraction (P = .037), and higher late gadolinium enhancement burden (P <.001). During 13.5 ± 1.5 months of follow-up, there was an improvement (Δ) in diastolic function (E/e' -4.1 ± 0.5), functional capacity (New York Heart Association functional class -1.5 ± 0.3), and reduction in N-terminal pro-brain natriuretic peptide level (-55.6 ± 12.3 pg/mL) compared to baseline., Conclusion: Pacing at an optimized AV delay from the RVA improves diastolic function and functional capacity in a subset of patients with nHCM., (Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: Heart failure (HF) is a chronic complex disease that prevails as a prime cause of concern for healthcare sectors worldwide, with a concordant objective to improve the long-term prognosis. Analysis of the available literature is evidence that yoga therapy and basic lifestyle modifications have considerably augmented heart failure patients' quality of life and enhanced left ventricular ejection fraction and NYHA functional class., Aim: Our study aims to establish the long-term outcomes of yoga therapy to validate the addition of yoga therapy as a complementary treatment in managing HF., Methods: A prospective non-randomized study was conducted at a tertiary care center including seventy-five HF patients with NYHA class III or less who underwent coronary intervention, revascularization, or device therapy within the past six months to one year and continuing guideline-directed optimal medical therapy (GDMT). Thirty-five participants were part of the Interventional Group (IG), and forty were in the Non-Interventional Group (Non-IG). The IG received yoga therapy and GDMT, while the non-IG were only under standard GDMT. Echocardiographic parameters were compared at various follow-ups up to one year to see the impact of Yoga therapy on HF patients., Results: A total of 75 heart failure patients, including 61 males and 14 females. The IG and non-IG had 35 subjects (31 males and 4 females) and 40 subjects (30 males and 10 females), respectively. Echocardiographic parameters were observed to compare the IG and Non-IG groups, and those did not demonstrate any significant difference between the two groups (p-value > 0.05). But, the echocardiographic parameters of the IG and non-IG from baseline to six months and one year showed a significant improvement (p-value of <0.05). The functional outcome (NYHA classes) was assessed after follow-up, and a p-value <0.05 showed a substantial improvement in the IG., Conclusion: Yoga therapy results in better prognosis, functional outcome, and left ventricular performance in HF patients with NYHA III or less. Hence this investigation has attempted to justify its importance as adjuvant/complimentary treatment for HF patients., (Copyright © 2023. Published by Elsevier Inc.)

Background: Clinical presentation of viral and bacterial infections or co-infections overlaps significantly. Pathogen identification is the gold standard for appropriate treatment. Recently, FDA cleared a multivariate index test called MeMed-BV that distinguishes viral and bacterial infections based on the differential expression of 3 host proteins. Here, we sought to validate MeMed-BV immunoassay on MeMed Key analyzer in our pediatric hospital following guidelines from the Clinical and Laboratory Standards Institute., Methods: The analytical performance of the MeMed-BV test was evaluated with precision (intra- and inter-assay), method comparison and interference studies. The clinical performance (diagnostic sensitivity and specificity) of the MeMed-BV test was assessed by conducting a retrospective cohort study (n = 60) using plasma samples from pediatric patients with acute febrile illness who visited the emergency department of our hospital., Results: MeMed-BV showed acceptable intra- and inter-assay precision with a range of < 3 score units in both the high-score bacterial as well as the low-score viral controls. Diagnostic accuracy studies revealed a sensitivity of 94% and specificity of 88% for identifying bacterial infections or co-infections. Our MeMed-BV results showed an excellent agreement (R = 0.998) with manufacturer's laboratory data and compared well with ELISA studies. Gross hemolysis and icterus did not affect the assay, but gross lipemia showed a considerable bias in samples with moderate likelihood of viral infection. Importantly, the MeMed-BV test performed better than routinely measured infection-related biomarkers like white blood cell counts, procalcitonin and C-reactive protein in classifying bacterial infections., Conclusion: MeMed-BV immunoassay demonstrated acceptable analytical performance and is reliable for distinguishing viral and bacterial infections or co-infections in pediatric patients. Future studies are warranted to examine the clinical utility, especially with respect to reducing the need for blood cultures and time to treatment for the patient., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Although liver is rich in peroxisome proliferator-activated receptor α (PPARα), recently we have described the presence of PPARα in hippocampus where it is involved in non-amyloidogenic metabolism of amyloid precursor protein (APP) via ADAM10, decreasing amyloid plaques and improving memory and learning. However, mechanisms to upregulate PPARα in vivo in the hippocampus are poorly understood. Regular exercise has multiple beneficial effects on human health and here, we describe the importance of regular mild treadmill exercise in upregulating PPARα in vivo in the hippocampus of 5XFAD mouse model of Alzheimer's disease. We also demonstrate that treadmill exercise remained unable to stimulate ADAM10, reduce plaque pathology and improve cognitive functions in 5XFAD ΔPPARα mice (5XFAD mice lacking PPARα). On the other hand, treadmill workout increased ADAM10, decreased plaque pathology and protected memory and learning in 5XFAD ΔPPARβ mice (5XFAD mice lacking PPARβ). Moreover, the other PPAR (PPARγ) also did not play any role in the transcription of ADAM10 in vivo in the hippocampus of treadmill exercised 5XFAD mice. These results underline an important role of PPARα in which treadmill exercise remains unable to exhibit neuroprotection in the hippocampus in the absence of PPARα., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objectives: This study explored the association between the timing of the first home health care nursing visits (start-of-care visit) and 30-day rehospitalization or emergency department (ED) visits among patients discharged from hospitals., Design: Our cross-sectional study used data from 1 large, urban home health care agency in the northeastern United States., Setting/participants: We analyzed data for 49,141 home health care episodes pertaining to 45,390 unique patients who were admitted to the agency following hospital discharge during 2019., Methods: We conducted multivariate logistic regression analyses to examine the association between start-of-care delays and 30-day hospitalizations and ED visits, adjusting for patients' age, race/ethnicity, gender, insurance type, and clinical and functional status. We defined delays in start-of-care as a first nursing home health care visit that occurred more than 2 full days after the hospital discharge date., Results: During the study period, we identified 16,251 start-of-care delays (34% of home health care episodes), with 14% of episodes resulting in 30-day rehospitalization and ED visits. Delayed episodes had 12% higher odds of rehospitalization or ED visit (OR 1.12; 95% CI: 1.06-1.18) compared with episodes with timely care., Conclusions and Implications: The findings suggest that timely start-of-care home health care nursing visit is associated with reduced rehospitalization and ED use among patients discharged from hospitals. With more than 6 million patients who receive home health care services across the United States, there are significant opportunities to improve timely care delivery to patients and improve clinical outcomes., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

The optimal management in Oligometastatic (OM) breast carcinoma is not defined., Objectives: To identify the prognostic factors influencing OM and the effect of Locoregional treatment (LRT) on survival in OM., Methodology: Patients with ≤5 metastases and each with ≤ 5 cm size were defined as OM. Data of OM were extracted from the Institute Registry between 2012 and 2018. The impact of prognostic factors on survival was analysed by univariate and multivariate Cox regression. The Kaplan Meier survival curves were used to plot PFS and OS., Results: There were 170 patients with OM. The median follow-up was 61 months. Median OS was 43.3 months. The median OS was 74 months in OMD vs 22.7 months in Oligorecurrent disease (ORD) with 5year OS rate of 55.3% vs 16.5% respectively. In the multivariate analyses of OMD both Ki67 ≤ 50% and hormone therapy (HT) showed significant favourable survival outcome. While premenopausal status and HT showed significant survival benefits in ORD. The worse survival outcome in ORD could be because of their aggressive biology and deficit in LRT compared to literature review. The prognostic factors were swayed by the uneven distribution of HR status, grade and Ki67., Conclusion: The survival of OM was influenced by OMD, Ki67 ≤ 50%, premenopausal status and HT. The lesser survival rates of OM in the long term suggest the need for curative LRT to metastatic sites and primary tumor. The potential role of HT and targeted therapy with or without LRT need to be assessed in future randomised trials., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Calorie restriction (CR) is a common approach to inducing negative energy balance. Recently, time-restricted feeding (TRF), which involves consuming food within specific time windows during a 24-h day, has become popular owing to its relative ease of practice and potential to aid in achieving and maintaining a negative energy balance. TRF can be implemented intentionally with CR, or TRF might induce CR simply because of the time restriction. This review focuses on summarizing our current knowledge on how TRF and continuous CR affect gut peptides that influence satiety. Based on peer-reviewed studies, in response to CR there is an increase in the orexigenic hormone ghrelin and a reduction in fasting leptin and insulin. There is likely a reduction in glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and cholecystokinin (CCK), albeit the evidence for this is weak. After TRF, unlike CR, fasting ghrelin decreased in some TRF studies, whereas it showed no change in several others. Further, a reduction in fasting leptin, insulin, and GLP-1 has been observed. In conclusion, when other determinants of food intake are held equal, the peripheral satiety systems appear to be somewhat similarly affected by CR and TRF with regard to leptin, insulin, and GLP-1. But unlike CR, TRF did not appear to robustly increase ghrelin, suggesting different influences on appetite with a potential decrease of hunger after TRF when compared with CR. However, there are several established and novel gut peptides that have not been measured within the context of CR and TRF, and studies that have evaluated effects of TRF are often short-term, with nonuniform study designs and highly varying temporal eating patterns. More evidence and studies addressing these aspects are needed to draw definitive conclusions., (Published by Oxford University Press on behalf of the American Society for Nutrition 2022.)

Pegasparagase (PEG-Asparaginase) induced hypertriglyceridemia is rare in the treatment of lymphoblastic lymphoma in children. We present a case of PEG-asparaginase induced hypertriglyceridemia that was incidentally identified and suspicion of its interference with sodium measurement in the clinical laboratory. The use of a direct ion selective method clarified the presence of true hyponatremia. The patient was treated with an oral Fenofibrate therapy which resolved the hypertriglyceridemia. This case highlights that PEG-asparaginanse and Olazanpine can induce hypertriglyceridemia in acute lymphoblastic leukemia and it may be useful to obtain baseline triglyceride measurements for these patients., (Copyright © 2022. Published by Elsevier B.V.)

This review focuses on summarizing current knowledge on how time-restricted feeding (TRF) and continuous caloric restriction (CR) affect central neuroendocrine systems involved in regulating satiety. Several interconnected regions of the hypothalamus, brainstem, and cortical areas of the brain are involved in the regulation of satiety. Following CR and TRF, the increase in hunger and reduction in satiety signals of the melanocortin system [neuropeptide Y (NPY), proopiomelanocortin (POMC), and agouti-related peptide (AgRP)] appear similar between CR and TRF protocols, as do the dopaminergic responses in the mesocorticolimbic circuit. However, ghrelin and leptin signaling via the melanocortin system appears to improve energy balance signals and reduce hyperphagia following TRF, which has not been reported in CR. In addition to satiety systems, CR and TRF also influence circadian rhythms. CR influences the suprachiasmatic nucleus (SCN) or the primary circadian clock as seen by increased clock gene expression. In contrast, TRF appears to affect both the SCN and the peripheral clocks, as seen by phasic changes in the non-SCN (potentially the elusive food entrainable oscillator) and metabolic clocks. The peripheral clocks are influenced by the primary circadian clock but are also entrained by food timing, sleep timing, and other lifestyle parameters, which can supersede the metabolic processes that are regulated by the primary circadian clock. Taken together, TRF influences hunger/satiety, energy balance systems, and circadian rhythms, suggesting a role for adherence to CR in the long run if implemented using the TRF approach. However, these suggestions are based on only a few studies, and future investigations that use standardized protocols for the evaluation of the effect of these diet patterns (time, duration, meal composition, sufficiently powered) are necessary to verify these preliminary observations., (Published by Oxford University Press on behalf of the American Society for Nutrition 2022.)

Background/objective: Between 10 and 25% patients are hospitalized or visit emergency department (ED) during home healthcare (HHC). Given that up to 40% of these negative clinical outcomes are preventable, early and accurate prediction of hospitalization risk can be one strategy to prevent them. In recent years, machine learning-based predictive modeling has become widely used for building risk models. This study aimed to compare the predictive performance of four risk models built with various data sources for hospitalization and ED visits in HHC., Methods: Four risk models were built using different variables from two data sources: structured data (i.e., Outcome and Assessment Information Set (OASIS) and other assessment items from the electronic health record (EHR)) and unstructured narrative-free text clinical notes for patients who received HHC services from the largest non-profit HHC organization in New York between 2015 and 2017. Then, five machine learning algorithms (logistic regression, Random Forest, Bayesian network, support vector machine (SVM), and Naïve Bayes) were used on each risk model. Risk model performance was evaluated using the F-score and Precision-Recall Curve (PRC) area metrics., Results: During the study period, 8373/86,823 (9.6%) HHC episodes resulted in hospitalization or ED visits. Among five machine learning algorithms on each model, the SVM showed the highest F-score (0.82), while the Random Forest showed the highest PRC area (0.864). Adding information extracted from clinical notes significantly improved the risk prediction ability by up to 16.6% in F-score and 17.8% in PRC., Conclusion: All models showed relatively good hospitalization or ED visit risk predictive performance in HHC. Information from clinical notes integrated with the structured data improved the ability to identify patients at risk for these emergent care events., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The burden of atrial fibrillation (AF) is increasing worldwide. It is often asymptomatic, with stroke being the first manifestation in some. AF burden in the community and the practice of stroke prophylaxis has not been studied in India. The problem might be higher in rural regions due to poor health awareness and challenges to healthcare access. This study aimed to estimate the prevalence of AF, clinical profile and stroke risk in rural India., Methods: This is a community-based cross-sectional study done in rural Andhra Pradesh (AP). Adults from 40 villages formed the study population. We did a door-to door survey to collect information on demographics, and medical history. Electrocardiogram was recorded using a smart phone based Alivecor device. Participants diagnosed with AF underwent echocardiogram. Study cardiologists assessed the cardiovascular risk profile and collected detailed medical history., Results: Fourteen of the 4281 individuals screened had AF (0.3%). The mean age of the sampled population was 44 ± 16.5 years with 56% women. The mean age of participants with AF was 71 ±7.8 years; males were 71%. Except for one, all were non-valvular AF. Majority had a CHA 2 D 2 S 2 Vasc score of ≥2. Three had history of stroke. Two were on anticoagulant therapy but without INR monitoring., Conclusion: The prevalence of AF is lower in this study compared to studies from the developed countries. Non-rheumatic cardiovascular risk factors were primary causes for AF. Non-adherence to stroke prophylaxis is a major threat that needs to be addressed., (Copyright © 2022 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.)

Background: BACKGROUND: There is a paucity of data regarding the antibody response to SARS-CoV-2 vaccination in children after solid organ transplant., Methods: We retrospectively reviewed the SARS-CoV-2 Anti-Spike IgG antibodies measured following SARS-CoV-2 vaccination at our pediatric heart transplant (HTx) center., Results: Among patients (median age 17.1 years) in whom antibody testing was performed (median 118 days post-vaccine completion), a SARS-CoV-2 Anti-Spike IgG antibody was detected in 28 of 40 (70%) post-HTx recipients (median antibody level 10.9 AU/ml). Neutropenia, diabetes mellitus, and previous use of rituximab were associated with absence of a detectable antibody. All 7 post-HTx patients with a known pre-vaccination SARS-CoV-2 viral infection had a detectable SARS-CoV-2 Anti-Spike IgG. All 12 vaccinated pre-HTx patients had a detectable antibody (median antibody level 11.6 AU/ml) including 5 patients that maintained detectable antibodies post-HTx. There were no cases of myocarditis among the total of 17 pre-HTx and 81 post-HTx patients that underwent SARS-CoV-2 vaccination., Conclusion: Our data suggest that a significant proportion of pediatric HTx recipients have no detectable antibody response after SARS-CoV-2 vaccination and support the recommendation to complete the vaccination series prior to HTx in those pediatric patients waiting for HTx., (Copyright © 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)

The effects of nitric oxide modulators (NO-modulators) and antioxidants on acute (RSx1) restraint stress induced endocrine, cellular and oxidative/nitrosative stress markers was studied in Wistar rats. The results of our study revealed that exposure to RS(x1) enhanced malondialdehyde (MDA), heat shock protein (HSP-70), corticosterone, nuclear factor kappa B (NF-κB) levels and suppressed glutathione (GSH), superoxide dismutase (SOD) and total nitrites and nitrates (NOx) levels. NO precursor and NO synthase inhibitors were found to differentially modulate stress mechanisms, by altering NF-κB, HSP-70 and corticosterone levels. l-Ascorbic acid significantly suppressed acute stress induced elevation of NF-κB and HSP-70 levels depicting protective effects, as also evidenced by reversal of elevated plasma corticosterone levels. Therefore, modulation of oxidative and nitrosative pathways, offers an approach in modulating stress induced changes associated with various disorders., Competing Interests: Declaration of competing interest None., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background and Aims: Recent evidence links trimethylamine oxide (TMAO) to endothelial dysfunction, an early indicator of cardiovascular disease. We aimed to determine whether short-term consumption of a diet patterned after the 2010 Dietary Guidelines for Americans (DGA) would affect endothelial function, plasma TMAO concentrations, and cardiovascular disease risk, differently than a typical American Diet (TAD)., Methods and Results: An 8-wk controlled feeding trial was conducted in overweight/obese women pre-screened for insulin resistance and/or dyslipidemia. Women were randomized to a DGA or TAD group (n = 22/group). At wk0 (pre-intervention) and wk8 (post-intervention) vascular age was calculated; endothelial function (reactive hyperemia index (RHI)) and augmentation index (AI@75) were measured using EndoPAT, and plasma TMAO was measured by LC-MS/MS. Vascular age was reduced in DGA at wk8 compared to wk0 but TAD wk8 was not different from wk0 (DGA wk0: 54.2 ± 4.0 vs. wk8: 50.5 ± 3.1 (p = 0.05), vs. TAD wk8: 47.7 ± 2.3). Plasma TMAO concentrations, RHI, and AI@75 were not different between groups or weeks., Conclusion: Consumption of a diet based on the 2010 Dietary Guidelines for Americans for 8 weeks did not improve endothelial function or reduce plasma TMAO. CLINICALTRIALS.GOV: NCT02298725., Competing Interests: Declaration of competing interest BJB had funding from the National Cattlemen's Beef Association. Work on TMAO and related analyses presented here was, however, not supported by National Cattleman's Beef Association. SHA is founder and principal of XenoMed LLC, and has consulted with Abitech Ltd.; neither activity has involved work that is related to TMAO, its related molecules, or associations of these metabolites with cardiovascular function. The other authors declare no conflict of interests. The USDA is an equal opportunity employer., (Published by Elsevier B.V.)

Introduction: Inflammatory breast carcinoma (IBC) is an aggressive clinical syndrome of invasive breast carcinoma. There is paucity of data regarding the outcomes in IBC., Objectives: Analyses of OS and Event-free survival (EFS) in nonmetastatic and metastatic IBC and to find prognostic factors influencing them., Methodology: In this single center, retrospective study the data of patients fulfilling the clinical criteria of IBC were retrieved from 2016 to 2021. The impact of prognostic factors on OS and EFS were analysed by log rank test (univariate analysis). The OS and EFS were depicted as Kaplan Meier survival curves., Results: There were 22 patients with IBC. Median follow-up was 17 months. The median OS was significantly better in non-metastatic(M0) compared to metastatic IBC (25 months vs 6 months) with 3year OS rate of 50% vs 0% respectively. The post-menopausal status, grade 2 histology and trimodality treatment showed better outcome while N3 stage at diagnosis had worse outcome in M0 group. The lesser HR expression, lesser pCR rates, higher N3 proportion, liver metastasis and multiple metastatic site involvement contributed to the worse outcome observed in this study., Conclusion: The aggressive clinicopathological features of IBC in the present study resulted in less favourable outcome compared to literature review. Improved outcome with trimodality highlights the emergent need for additional targeted therapy to improve pCR and operability., (Copyright © 2022. Published by Elsevier Ltd.)

Introduction: This study evaluated the relative abundance and ribosomal activity of selected bacteria in carious dentin of teeth with different pulp conditions., Methods: Thirty healthy patients with class I occlusal caries in molars were categorized into 3 groups based on the pulp diagnosis: normal pulp (NP, n = 10) with caries extending less than half the thickness of dentin (as assessed radiographically), reversible pulpitis (n = 10), and symptomatic irreversible pulpitis (n = 10) with caries extending more than two thirds of the thickness of dentin. Carious dentin samples were collected from the deepest part of the cavity and stored in RNAlater solution (Ambion Inc, Austin, TX). Eight bacterial taxa were evaluated from the samples: Streptococcus mutans, Lactobacillus fermentum, Veillonella, Actinomyces, Rothia dentocariosa, Olsenella profusa, Prevotella intermedia, and Bifidobacterium dentium. The 16S ribosomal RNA (rRNA) gene and 16S rRNA were quantified by real-time polymerase chain reaction and used to calculate the relative genome abundance and relative ribosomal abundance. The Fisher exact test was used to compare proportions between groups. The mean rank difference between the various groups was assessed using the Kruskal-Wallis test with the Bonferroni-Holm correction., Results: The reversible pulpitis group had significantly higher 16S rRNA gene and rRNA counts of Actinomyces (P < .001 and P = .002) and B. dentium (P = .005 and P = .007) relative to the NP group. The symptomatic irreversible pulpitis group had significantly higher 16S rRNA gene and rRNA counts of L. fermentum (P < .001 and P < .001), Actinomyces (P < .001 and P < .001), O. profusa (P < .001 and P < .001), P. intermedia (P = .001 and P = .002), and Bifidobacterium (P < .001 and P < .001) relative to the NP group., Conclusions: Specific bacterial activity varies in carious dentin of teeth with different pulp conditions., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objectives: Home health care patients have critical needs requiring timely care following hospital discharge. Although Medicare requires timely start-of-care nursing visits, a significant portion of home health care patients wait longer than 2 days for the first visit. No previous studies investigated the pattern of start-of-care visits or factors associated with their timing. This study's purpose was to examine variation in timing of start-of-care visits and characterize patients with visits later than 2 days postdischarge., Design: Retrospective cohort study., Setting/participants: Patients admitted to a large, Northeastern US, urban home health care organization during 2019. The study included 48,497 home care episodes for 45,390 individual patients., Measurement: We calculated time to start of care from hospital discharge for 2 patient groups: those seen within 2 days vs those seen >2 days postdischarge. We examined patient factors, hospital discharge factors, and timing of start of care using multivariate logistic regression., Results: Of 48,497 episodes, 16,251 (33.5%) had a start-of-care nursing visit >2 days after discharge. Increased odds of this time frame were associated with being black or Hispanic and having solely Medicaid insurance. Odds were highest for patients discharged on Fridays, Saturdays, and Mondays. Factors associated with visits within 2 days included surgical wound presence, urinary catheter, pain, 5 or more medications, and intravenous or infusion therapies at home., Conclusions and Implications: Findings provide the first publication of clinical and demographic characteristics associated with home health care start-of-care timing and its variation. Further examination is needed, and adjustments to staff scheduling and improved information transfer are 2 suggested interventions to decrease variation., (Copyright © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Alzheimer's disease (AD) is one of the most prevalent neurodegenerative diseases with motor disturbances, cognitive decline, and behavioral impairment. It is characterized by the extracellular aggregation of amyloid-β plaques and the intracellular accumulation of tau protein. AD patients show a cognitive decline, which has been associated with oxidative stress, as well as mitochondrial dysfunction. Alpha-lipoic acid (α-LA), a natural antioxidant present in food and used as a dietary supplement, has been considered a promising agent for the prevention or treatment of neurodegenerative disorders. Despite multiple preclinical studies indicating beneficial effects of α-LA in memory functioning, and pointing to its neuroprotective effects, to date only a few studies have examined its effects in humans. Studies performed in animal models of memory loss associated with aging and AD have shown that α-LA improves memory in a variety of behavioral paradigms. Furthermore, molecular mechanisms underlying α-LA effects have also been investigated. Accordingly, α-LA shows antioxidant, antiapoptotic, anti-inflammatory, glioprotective, metal chelating properties in both in vivo and in vitro studies. In addition, it has been shown that α-LA reverses age-associated loss of neurotransmitters and their receptors. The review article aimed at summarizing and discussing the main studies investigating the neuroprotective effects of α-LA on cognition as well as its molecular effects, to improve the understanding of the therapeutic potential of α-LA in patients suffering from neurodegenerative disorders, supporting the development of clinical trials with α-LA., (Copyright © 2021 Elsevier Inc. All rights reserved.)

In this study, we have investigated a series of indole-based compounds for their inhibitory study against pancreatic α-amylase and intestinal α-glucosidase activity. Inhibitors of carbohydrate degrading enzymes appear to have an essential role as antidiabetic drugs. All analogous exhibited good to moderate α-amylase (IC 50  = 3.80 to 47.50 μM), and α-glucosidase inhibitory interactions (IC 50  = 3.10-52.20 μM) in comparison with standard acarbose (IC 50  = 12.28 μM and 11.29 μM). The analogues 4, 11, 12, 15, 14 and 17 had good activity potential both for enzymes inhibitory interactions. Structure activity relationships were deliberated to propose the influence of substituents on the inhibitory potential of analogues. Docking studies revealed the interaction of more potential analogues and enzyme active site. Further, we studied their kinetic study of most active compounds showed that compounds 15, 14, 12, 17 and 11 are competitive for α-amylase and non- competitive for α-glucosidase., (Copyright © 2021 Elsevier B.V. All rights reserved.)

COVID-19 pandemic has a major effect on world health, particularly on individuals suffering from severe diseases or old aged persons. Various case studies revealed that COVID-19 might increase the progression of Parkinson's disease (PD). Coxsackievirus, dengue virus Epstein-Barr virus, hepatitis C virus, Japanese encephalitis, Western equine encephalomyelitis virus, West Nile virus, and human immunodeficiency virus have all been linked to the development of transient or permanent parkinsonism, owing to the induction of neuroinflammation/hypoxic brain injury with structural/functional damage within the basal ganglia. Coronavirus mainly infects the alveolar cells and may lead to acute respiratory distress syndrome. SARS-CoV-2 invades cells via the ACE2 receptor, which is widely expressed in the central nervous system, where the virus may precipitate or accelerate dementia. SARS-CoV-2 could enter the central nervous system directly by the olfactory/vagus nerves or through the bloodstream. Here, we talked about the importance of this viral infection in terms of the CNS as well as its implications for people with Parkinson's disease; anosmia & olfaction-related impairments in COVID-19 & PD patients. And, also discussed the role of vitamin D to sustain the progression of Parkinson's disease and the COVID-19; regular vitamin D 3 consumption of 2000-5000 IU/day may reduce the risk and severity of COVID-19 in parkinsonian patients., Competing Interests: Declaration of competing interest None., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Synthetic routes to a series of benzoylarylbenzimidazol 3a-h have been derived from 3,4-diaminobenzophenone and an appropriate arylaldehyde in the presence of ammonium chloride or a mixture of ammonium chloride and sodium metabisulfite as catalyst. The antioxidant activity of targeted compounds 3a-h has been measured by four different methods and the overall antioxidant evaluation of the compounds indicated the significant MCA, FRAP, and (DPPH-SA) of the compounds except for the compound 3h. In vitro antidiabetic assay of α-amylase and α-glucosidase suggest a good to excellent activity for most tested compounds. The target benzimidazole 3f containing hydroxyl motif at para-position of phenyl revealed an important activity inhibitor against α- amylase (IC 50  = 12.09 ± 0.38 µM) and α-glucosidase (IC 50  = 11.02 ± 0.04 µM) comparable to the reference drug acarbose. The results of the anti hyperglycemic activity were supported by means of in silico molecular docking calculations showing strong binding affinity of compounds 3a-h with human pancreatic α-amylase (HPA) and human lysosomal acid-α-glucosidase (HLAG) active sites that confirm a good to excellent activity for most of tested compounds., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Hemoglobin fractionation by capillary zone electrophoresis (CE) is becoming a popular method for the identification of hemoglobin variants that can cause hemoglobinopathies. The goal of this study was to compare the performance of capillary electrophoresis using Sebia Capillarys 2 Flex Piercing system (CE-S) with high-pressure liquid chromatography (HPLC) using Primus Ultra2 Resolution Variants System (HPLC-P) as a primary method in hemoglobinopathy work-up., Methods: A total of 306 blood specimens submitted for evaluation of hemoglobinopathies were studied using HPLC-P and CE-S., Results: The reference ranges for Hb A, A 2 and F agreed well between methods. All common variants containing Hb S and Hb C were detected by both methods. Quantification of Hb A 2 with HPLC-P required a correction in the presence of Hb S, while quantification of Hb A 2 was slightly overestimated by CE-S in the presence of Hb C. Of 41 samples containing other variants, 2 were not identified by HPLC-P and 3 were not identified by CE-S., Conclusion: CE-S provides comparable information to that obtained by HPLC-P and it is a reliable primary method for the evaluation of hemoglobin variants., (Copyright © 2021. Published by Elsevier B.V.)

Background and Aims: This study examined the performance of two novel low-density lipoprotein-cholesterol (LDL-C) calculations, LDL Martin and LDL Sampson , on predicting atherosclerotic cardiovascular diseases (ASCVD) risk compared to traditional LDL Friedewald according to the 2018 American Heart Association/American College of Cardiology (AHA/ACC) primary prevention guidelines., Methods: A total of 6701 randomly recruited Multi-Ethnic Study of Atherosclerosis (MESA) participants free of ASCVD at baseline were followed for ASCVD during a median of 13.9 years and for subclinical ASCVD-coronary artery calcium (CAC) during a median of 12.5 years. Prevalence of borderline high triglyceride (≥1.7 mmol/L) was 15.2% and was at 13.5% for high triglyceride (≥2.3 mmol/L)., Results: Applying the criteria of LDL-C<1.8 mmol/L in 40-75 year olds without diabetes mellitus to be exempt from risk discussion, LDL Martin and LDL Sampson classified less individuals in this category than LDL Friedewald (p < 0.001), both had 20 individuals with ASCVD, versus 22 by LDL Friedewald . Positive CAC in the discussion-exempt group were over 38% higher (p < 0.001) when classified by LDL Friedewald than by LDL Martin or LDL Sampson . Individuals with LDL-C≥4.9 mmol/L are recommended to high-intensity statin therapy by the AHA/ACC guidelines. The LDL Friedewald ≥4.9 mmol/L group had 20 ASCVD events, versus 21 in LDL Martin and 22 in LDL Sampson group., Conclusions: In a multi-ethnic USA population, LDL Martin and LDL Sampson did not over- or under-estimate ASCVD risk compared to LDL Friedewald in primary prevention according to AHA/ACC guidelines, while LDL Friedewald under-estimated subclinical ASCVD risk in the low-risk population. These findings support the replacement of LDL Friedewald by LDL Martin or LDL Sampson for lipid screen in the general population., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The core binding factor composed of CBFβ and RUNX subunits plays a critical role in most hematopoietic lineages and is deregulated in acute myeloid leukemia (AML). The fusion oncogene CBFβ-SMMHC expressed in AML with the chromosome inversion inv(16)(p13q22) acts as a driver oncogene in hematopoietic stem cells and induces AML. This review focuses on novel insights regarding the molecular mechanisms involved in CBFβ-SMMHC-driven leukemogenesis and recent advances in therapeutic approaches to target CBFβ-SMMHC in inv(16) AML., (© 2021 by The American Society of Hematology.)

Objective: To describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits., Design: Observational study of nurse hand hygiene practices., Setting: and Participants: Licensed practical/vocational and registered nurses were observed in the homes of patients being served by a large nonprofit HHC agency., Methods: Two researchers observed 400 home care visits conducted by 50 nurses. The World Health Organization's "5 Moments for Hand Hygiene" validated observation tool was used to record opportunities and actual practices of hand hygiene, with 3 additional opportunities specific to the HHC setting. Patient assessment data available in the agency electronic health record and a nurse demographic questionnaire were also collected to describe patients and nurse participants., Results: A total of 2014 opportunities were observed. On arrival in the home was the most frequent opportunity (n = 384), the least frequent was after touching a patient's surroundings (n = 43). The average hand hygiene adherence rate was 45.6% after adjusting for clustering at the nurse level. Adherence was highest after contact with body fluid (65.1%) and lowest after touching a patient (29.5%). The number of hand hygiene opportunities was higher when patients being served were at increased risk of an infection-related emergency department visit or hospitalization and when the home environment was observed to be "dirty." No nurse or patient demographic characteristics were associated with the rate of nurse hand hygiene adherence., Conclusions and Implications: Hand hygiene adherence in HHC is suboptimal, with rates mirroring those reported in hospital and outpatient settings. The connection between poor hand hygiene and infection transmission has been well studied, and it has received widespread attention with the outbreak of SARS-CoV-2. Agencies can use results found in this study to better inform quality improvement initiatives., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

A series of nineteen (1-19) indole-based-thiadiazole derivatives were synthesized, characterized by 1 HNMR, 13 C NMR, MS, and screened for α-glucosidase inhibition. All analogs showed varied α-glucosidase inhibitory potential with IC 50 value ranged between 0.95 ± 0.05 to 13.60 ± 0.30 µM, when compared with the standard acarbose (IC 50  = 1.70 ± 0.10). Analogs 17, 2, 1, 9, 7, 3, 15, 10, 16, and 14 with IC 50 values 0.95 ± 0.05, 1.10 ± 0.10, 1.30 ± 0.10, 1.60 ± 0.10, 2.30 ± 0.10, 2.30 ± 0.10, 2.80 ± 0.10, 4.10 ± 0.20 and 4.80 ± 0.20 µM respectively showed highest α-glucosidase inhibition. All other analogs also exhibit excellent inhibitory potential. Structure activity relationships have been established for all compounds primarily based on substitution pattern on the phenyl ring. Through molecular docking study, binding interactions of the most active compounds were confirmed. We further studied the kinetics study of analogs 1, 2, 9 and 17 and found that they are Non-competitive inhibitors., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Inclusion of dairy in diet patterns has been shown to have mixed effects on weight loss. A prevailing hypothesis is that dairy improves weight loss by influencing endocrine systems associated with satiety and food intake regulation., Objectives: The objective of the current study was to evaluate the effect of weight loss with or without adequate dietary dairy on subjective and objective appetitive measures., Methods: Men and women who were habitual low dairy consumers (n = 65, 20-50 y) participated in a 12-wk randomized controlled feeding weight loss trial. During the 12-wk intervention, a low-dairy (<1 serving dairy/d) was compared with an adequate-dairy (3-4 servings dairy/d) diet, both with a 500-kcal deficit/d. Test days, before and at the end of the intervention, began with 2 fasting blood draws and visual analog scale (VAS) measures, followed by a standard breakfast (25% of prescribed restricted calories), 5 postbreakfast blood draws and VASs, a standard lunch (40% of restricted energy amount), and 12 postlunch blood draws and VASs. Blood samples were used for satiety hormone measurements. On a separate day when matching standard meals were consumed, an ad libitum buffet meal was provided as dinner, at a self-selected time. Meal duration and intermeal interval were recorded., Results: Weight loss (-6.1 kg), irrespective of dairy, resulted in reduced fasting insulin (-20%) and leptin (-25%), and increased fasting acylated ghrelin (+25%) and VAS desire to eat (+18%) (P < 0.05). There were no effects of dairy on objective or subjective satiety measures. Weight loss marginally reduced the intermeal interval (289 min compared with 276 min, P = 0.059) between lunch and the ad libitum buffet., Conclusions: These results do not support the hypothesis that inclusion of dairy in long-term dietary patterns influences appetite during weight loss. Weight loss per se has a modest impact on select systems that regulate hunger and satiety.This trial was registered at clinicaltrials.gov as NCT00858312., (Published by Oxford University Press on behalf of the American Society for Nutrition 2020.)

Diabetes being a chronic metabolic disorder have attracted the attention of medicinal chemists and biologists. The introduction of new and potential drug candidates for the cure and treatment of diabetes has become a major concern due to its increased prevelance worldwide. In the current study, twenty-seven azachalcone derivatives 3-29 were synthesized and evaluated for their antihyperglycemic activities by inhibiting α-amylase and α-glucosidase enzymes. Five compounds 3 (IC 50  = 23.08 ± 0.03 µM), (IC 50  = 26.08 ± 0.43 µM), 5 (IC 50  = 24.57 ± 0.07 µM), (IC 50  = 27.57 ± 0.07 µM), 6 (IC 50  = 24.94 ± 0.12 µM), (IC 50  = 27.13 ± 0.08 µM), 16 (IC 50  = 27.57 ± 0.07 µM), (IC 50  = 29.13 ± 0.18 µM), and 28 (IC 50  = 26.94 ± 0.12 µM) (IC 50  = 27.99 ± 0.09 µM) demonstrated good inhibitory activities against α-amylase and α-glucosidase enzymes, respectively. Acarbose was used as the standard in this study. Structure-activity relationship was established by considering the parent skeleton and different substitutions on aryl ring. The compounds were also subjected for kinetic studies to study their mechanism of action and they showed competitive mode of inhibition against both enzymes. The molecular docking studies have supported the results and showed that these compounds have been involved in various binding interactions within the active site of enzyme., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Intravascular brachytherapy (VBT) is an established treatment for the management of in-stent restenosis (ISR). However, whether VBT is associated with improved patient reported outcomes unknown., Methods: We evaluated 51 consecutive patients undergoing VBT in one or more coronary arteries from January 2018 to September 2019. Data on baseline characteristics, procedural outcomes and adverse events were obtained. All patients completed the Seattle Angina Questionnaire - 7 (SAQ-7) form before and after VBT at 1 month and 6 months., Results: The mean age was 69 ± 9 years and 29 (57%) of patients were males. Procedural success was 94.1%. The mean summary SAQ-7 score improved significantly (53.2 ± 21 vs. 83 ± 19, p < .001) at 30-days. The median Quality of Life (QoL) component of SAQ-7 score was 31.3 (Interquartile Range [IQR]: 18.8, 62.5) and improved to 82.5 (IQR: 62.5, 100), p < .001 at 30 days and 87.5 [IQR: 75, 100), p < .001 at last follow up. Likewise, the median angina frequency component of the SQL-7 score pre-VBT was 55 (IQR: 45, 80) and improved significantly to 90 (IQR: 60, 100) at 30-days, p < .001 and 100 [IQR: 68.8, 100], p = .02 at last follow up. Lastly, the median activity component of the SAQ-7 score improved from 83.3 (IQR: 60-100) to 100 (IQR: 83, 100), p = .01 at 30-days. Thus, results were evident as early as 1 month and sustained at median follow up of 17 months., Conclusion: VBT is associated with improvement in patient reported outcome measures at short term and long term follow up., Competing Interests: Declaration of competing interest All authors report no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The conventional approach to chronic disease management in women of color is a dieting-for-weight-loss approach, which has not been proven to be effective. The purpose of this article is to highlight the shortcomings of the dieting-for-weight-loss approach and demonstrate the potential efficacy of the Health at Every Size approach when working with women of color to prevent and address chronic diseases. The article's areas of focus are weight stigma, bias, and size discrimination; the implications of differing weight perceptions and motivations for change; and weight as the primary determinant of health and biological factors affecting weight., (Copyright © 2020 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Thirty benzofuran-2-yl(phenyl)methanones 1-30 were synthesized and characterized their structures by spectroscopic techniques. Substituted phenacyl bromide and different derivatives of 2-hydroxy-benzaldehyde treated in the presence of anhydrous K 2 CO 3 in acetonitrile at room temperature to afford the desired benzofurans 1-30. All compounds were screened for their in vitro α-amylase inhibitory and radical scavenging (DPPH and ABTS) activities. Results revealed that para substituted compounds were found to be more active than the others with IC 50 values ranges for α-amylase inhibition (IC 50  = 18.04-48.33 µM), DPPH (IC 50  = 16.04-32.33 µM) and ABTS (IC 50  = 16.99-33.01 µM) radical scavenging activities. Activities results were compared with the standards acarbose (IC 50  = 16.08 ± 0.07 µM) for α-amylase, ascorbic acid (IC 50  = 15.08 ± 0.03 and 15.09 ± 0.17 µM) for DPPH and ABTS radical scavenging activities, respectively. Kinetic studies predicted that all compounds followed non-competitive mechanism of inhibition. Molecular docking results showed good protein-ligand interactions profile against the corresponding target. To the best of our knowledge, out of thirty molecules, ten compounds 18-20, 22, and 25-30 were structurally new., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: While the diagnosis of SARS-CoV-2 infection is primarily based on detection of viral RNA, the detection of SARS-CoV-2 antibodies is useful for assessing past prevalence of the disease, and in corroborating a current infection in challenging cases. Sensitive and specific immunoassays provide the ability to identify exposure to SARS-CoV-2, to determine seroconversion, to confirm eligibility for donation of convalescent plasma as well as play an essential part in epidemiological studies. We report on the validation of the Ansh Laboratories SARS-CoV-2 IgG and SARS-CoV-2 IgM ELISA immunoassays. These assays were evaluated for detection of anti-SARS-CoV-2 IgG and IgM antibodies for clinical use in our hospital as part of an orthogonal testing algorithm recommended by the CDC., Methods: Diagnostic specificity and sensitivity of the IgG and IgM ELISA assays were tested using samples confirmed to be negative or positive for COVID-19 by RT-PCR. We also evaluated precision, analytical interference, and cross-reactivity with known cases of infection with other viruses. Additionally, we validated concordance with molecular and other serological testing and evaluated seroconversion in our patient population., Results: The IgG and IgM ELISA assays showed acceptable precision, were robust to analytical interference and did not exhibit cross reactivity with specimens positive for common respiratory viruses. Both assays exhibited 95% agreement with a primary screening serological assay utilized at our institution as well as with a reference laboratory semi-quantitative method. Concordance with RT-PCR was excellent > 6 days after symptom onset (100%)., Conclusions: The Ansh SARS-CoV-2 ELISA assays have good analytical performance suitable for clinical use., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The proximity of the orofacial structures to the upper airway has led to enormous interest in their influence on the airway maintenance mechanism. The recognition of Sleep disorders and the evolution of dental sleep medicine has fueled further interest in the role of orthodontic treatment on the airway particularly in Class II malocclusions. With abundant literature on class II malocclusions and growth modification, it is natural that focus would shift on the effect of functional appliances on the airway. Most studies on the subject show an improvement in the airway in response to functional appliances and these include both two dimensional and three dimensional study of the airway. This review showcases the most significant literature on this field of study against the background of the information that is needed to gauge its clinical relevance., (Copyright © 2020 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.)