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Effort has been made to minimize the burden of non-interpretive tasks (NITs), in particular by hiring and training non-radiologist support staff as reading room coordinators (RRCs). Our medical center recruited and trained senior medical students from our affiliated school of medicine to work alongside on-call radiology residents as RRCs. A 12-month Malpractice Carrier monetary grant was acquired to fund medical students at with the aim to reduce malpractice risk. After the first year, residents were surveyed regarding the impact of the RRCs on perceived on-call efficiency and morale. Furthermore, report turnaround times (TAT) on call shifts that were and were not accompanied by a RRC were compared. 89 % of residents strongly agreed that the RRC improved workflow efficiency, decreased distractions, and felt less stressed during the call shift when the RRC was on duty. 78 % strongly agreed to be more likely to contact a referring clinician when the RRC was able to help coordinate. The mean TAT in the presence of a RRC was 36.8 min, and the mean TAT in the absence of a RRC was 36.9 min After hiring medical students to assist on-call radiology residents with noninterpretive tasks, residents reported subjective indicators of program success, but average report turnaround time was unaffected. Nevertheless, we predict that this type of program will continue to grow among academic radiology departments, though additional research is required to evaluate national trends and impacts on radiologist productivity and well-being. [ABSTRACT FROM AUTHOR]

Full-length vaginal (FLV) brachytherapy for patients with endometrial cancer and high-risk features should be considered as per the American Brachytherapy Society to reduce distal vaginal recurrence in patients with endometrial cancers with papillary serous/clear cell histologies, grade 3 status, or extensive lymphovascular invasion. We sought to investigate this patient population and report outcomes of treatment with high-dose-rate (HDR) brachytherapy in women treated with FLV brachytherapy versus partial-length vaginal (PLV) brachytherapy. With institutional review board approval, we identified patients with endometrial cancer meeting American Brachytherapy Society criteria of high-risk features treated with adjuvant HDR between 2004 and 2010. HDR doses were 21Gy in 3 fractions delivered to either the full-length or partial-length vagina. Acute and late toxicities were evaluated using the Radiation Therapy Oncology Group scale and Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer grading, respectfully. Vaginal recurrences were assessed by physical examination and pap smears. Statistical analyses were performed using SPSS version 23 software. Of 240 patients treated with HDR brachytherapy, 121 were treated with FLV brachytherapy, and 119, with PLV brachytherapy. The median follow-up was 9.5 years (range, 8-11 years) for FLV patients and 8.5 years (range, 7-10 years) for PLV patients; 0% of patients had vaginal recurrences, and 1.4% and 0.9% had proximal vaginal recurrences, respectively (P =.54). All patients treated with FLV brachytherapy developed grade 3 mucositis of the lower vagina/introitus (P <.0001) and had increased analgesics use compared with those treated with PLV brachytherapy (P <.0001). In total, 23% of patients treated with FLV brachytherapy developed grade 3 stenosis of the lower vagina/introitus, in contrast to 0% of patients treated with PLV brachytherapy (P <.0001). PLV brachytherapy is as effective as FLV brachytherapy in reducing local recurrence and causes a significantly lower incidence of acute and late toxicities. The results of this study caution radiation oncologists regarding the careful use of FLV brachytherapy in patients with endometrial cancer and high-risk features. [ABSTRACT FROM AUTHOR]

Evolutionary processes have evolved plants to cope with several different natural stresses. Basic physiological activities of crop plants are significantly harmed by these stresses, reducing productivity and eventually leading to death. The recent advancements in high-throughput sequencing of transcriptome and expression profiling with NGS techniques lead to the innovation of various RNAs which do not code for proteins, more specifically long non-coding RNAs (lncRNAs), undergirding regulate growth, development, and the plant defence mechanism transcriptionally under stress situations. LncRNAs are a diverse set of RNAs that play key roles in various biological processes at the level of transcription, post-transcription, and epigenetics. These are thought to serve crucial functions in plant immunity and response to changes in the environment. In plants, however, just a few lncRNAs have been functionally identified. In this review, we will address recent advancements in comprehending lncRNA regulatory functions, focusing on the expanding involvement of lncRNAs in modulating environmental stress responsiveness in plants. • Long non coding RNA, Abiotic and Biotic stress, stress regulation. [ABSTRACT FROM AUTHOR]

• Priming with ALA enhanced UV-B tolerance level in Cajanus cajan seedlings. • ALA upregulates enzymatic antioxidant activities. • ALA enhanced gas exchance parameters hence it may improve crop productivity of Cajanus cajan, even under UV-B stress. • Moreover, this article also emphasized on the cost effectiveness of the use of ALA through priming. The objective of this study is to investigate whether pre-treatment (priming) of chlorophyll precursor 5-aminolevulinic acid (ALA) assumes a huge part in moderating harms caused by UV-B exposure on two varieties of Cajanus cajan L. seedlings namely BAHAR and KB-17. Healthy seeds were primed with two doses of ALA (lower dose: ALA 1 ; 25µM and higher dose: ALA 2 ; 100 µM) for 24 h at 25±2 °C and thereafter 17-day old seedlings were exposed to an enhanced dose of UV-B radiation i.e. 2.2 kJ m−2d−1. Results showed that UV-B exposure significantly declined growth attributes, photosynthetic pigments (chlorophyll a, b and carotenoids contents), photosynthetic gas exchange characteristics (A, Ci, Gs, E, and WUE). This decrease was also accompanied by the accumulation of reactive oxygen species: superoxide radical (SOR; O₂˙ˉ), hydrogen peroxide (H 2 O 2), and lipid peroxidation (MDA contents). The antioxidative enzyme activities: catalase (CAT), superoxide dismutase (SOD), glutathione- S -transferase (GST), and peroxidase (POD) and non-enzymatic antioxidants: total phenolics content (TPC) and total flavonoids content (TFC) were increased. On contrary to this, damaging effects of UV-B radiations were markedly alleviated with the exogenous application (priming) of ALA by enhancing plant growth and growth-regulating parameters. Furthermore, ALA application decreased the UV-B induced oxidative stress in Cajanus cajan L. seedlings by further improving the activity of enzymatic and the contents of non-enzymatic antioxidants of test plant defense system. Furthermore, priming with ALA decreased the germination time and increased the germination index which additionally served as a significant purpose behind the improvement in the harvest quality and amount. The BAHAR variety of Cajanus cajan was discovered to be more tolerant against UV-B stress due to its more efficient defense system with a higher rate of antioxidant enzyme activities. On the other hand, KB-17 variety of Cajanus cajan was discovered to be sensitive against UV-B stress due to its feeble defense system with higher accumulation of reactive oxygen species. Thus, these findings suggest that priming of seeds with ALA act as a sustainable remedial strategy in reducing the hazardous effects of UV-B induced stress on crop productivity of Cajanus cajan seedlings by triggering the up-regulation of photosynthesis and antioxidant system to counterbalance the ROS-mediated damage to macromolecules. [Display omitted] [ABSTRACT FROM AUTHOR]

Patients listed for heart transplantation (HT) supported by intra-aortic balloon pump (IABP) or Impella (Abiomed, Danvers, MA) are accorded a higher waitlist status under the new 2018 heart allocation system. The effect of device duration of support on waitlist or post-transplant outcomes is unclear. The purpose of this study is to investigate the association of IABP or Impella duration of support with waitlist and post-transplant outcomes in patients listed for HT. The United Network for Organ Sharing database was queried for adults listed for HT who were supported with an IABP or Impella (2.5, 5.0, CP, or RP) between October 2018 and March 2020. Patients were stratified into tertiles according to duration of support by device type. Competing risks analysis was used to examine the risk of waitlist mortality or delisting, accounting for HT. One year post-HT stroke, dialysis, and acute rejection were analyzed using logistic regression models. Survival at 1-year was analyzed using Cox proportional hazards modeling. A total of 2823 listed patients were supported with an IABP (n=2494) or Impella (n=329) during the study period. The median [IQR] duration of device support was 9 [5, 17] days with IABP and 12 [6, 24.5] days with Impella. There were no differences in waitlist mortality/delisting by duration of support according to device type (IABP: >13 days ref., 6-13 days HR 1.18, 95% CI 0.41-3.40, <6 days HR 1.89, 95% CI 0.70-5.11; Impella: >18 days ref., 8-18 days HR 0.34, 95% CI 0.09-1.28; <6 days HR 0.26, 95% CI 0.06-1.20). Patients in the longest tertile of device support were less likely to receive transplant compared to patients in the shortest and middle tertiles (Figure, p<0.001 for IABP and Impella). Among those who successfully reached HT after support with an IABP (n=2418, 97%) or Impella (n=298, 90.6%), rates of stroke, need for dialysis, and acute rejection post-HT were similar between the IABP groups and the Impella groups. There were no differences in post-HT survival by duration of support at 1 year among patients with IABP (>13 days ref., 6-13 days HR 0.97, 95% CI 0.83 - 1.13, <6 days HR 0.94, 95% CI 0.80-1.10) or Impella (>18 days ref., 8-18 days HR 0.82, 95% CI 0.49-1.36, <6 days HR 0.86, 95% CI 0.49-1.52). Waitlist mortality and post-HT outcomes are comparable regardless of duration of support in patients supported by IABP, as well as those supported by Impella. [ABSTRACT FROM AUTHOR]

Acute kidney injury is common during support with microaxial percutaneous left ventricular assist devices (pLVAD) for cardiogenic shock. The effect of baseline renal function on outcomes in subjects listed for heart transplantation (HT) supported with pLVAD remains unknown. We investigated the association between baseline renal function and waitlist outcomes in listed patients supported with an Impella. We utilized de-identified data from the United Network for Organ Sharing database on adults listed for HT who were supported with an Impella 5.0 or Impella 5.5 (Abiomed, Denver, MA) for cardiogenic shock between October 2018 and March 2020. Patients were stratified into three groups based on their estimated glomerular filtration rate (eGFR) (< 30 vs. 30-60 vs. > 60 mL/min/1.73m2) at listing. Paired t-tests were used to assess the change in renal function from listing to the time of transplant for all 3 groups. The competing risks of waitlist mortality or transplantation were examined using the Fine-Grey sub-distribution hazard model. Of 272 patients (mean age 54±13) supported with an Impella while listed for HT during the study period, 37 (13.6%) had an eGFR < 30, 101 (37.1%) had an eGFR 30-60, and 134 (49.3%) had an eGFR > 60 at the time of listing. Duration of support was comparable between all groups (14 vs. 13 vs. 12 days; p=0.209). Median waitlist time was 15 (IQR 7, 43) days, with no significant difference between groups. At the time of transplant, the changes in eGFR [GFR group; delta: p value] were [GFR < 30; +13.3; <0.001], [GFR 30-60; +9.9; <0.001] and [GFR > 60; -10.5; <0.001]. Baseline renal function [ref: eGFR > 60] was not associated with waitlist mortality [eGFR 30-60: hazard ratio (HR) 3.57; 95% confidence interval (CI) 0.73-17.50, eGFR < 30: HR 1.73; 95% CI 0.39-7.70] or transplantation [eGFR 30-60: HR 0.98; 95% CI 0.75-1.26, eGFR < 30: HR 1.08; 95% CI 0.75-1.26]. In patients listed for HT who supported with an Impella for cardiogenic shock, baseline renal function had no impact on waitlist outcomes. Between listing and transplant, a significant improvement in eGFR was seen in patients listed with severely reduced eGFR. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate decisional regret among left ventricular assist device (LVAD) patients and their caregivers. This study was a single center, cross-sectional survey of patients after LVAD implantation and their caregivers. Subjects were recruited at their outpatient heart failure appointments. Patients and caregivers at least three months from LVAD implantation completed a 5-item, validated decisional regret scale. Summative scores on a 0–100 point scale were determined for patient and caregivers (0 = no regret). Subgroup analysis included gender, LVAD indication (bridge to transplant (BTT) or destination therapy (DT)), time from LVAD implantation, and caregiver relationship. Dyad discordance was defined as a patient-caregiver difference of ≥2 points on any regret scale question. Fifty patients were approached for participation. Thirty-three LVAD patient-caregiver dyads were enrolled in the study (19 male, 14 female patients; 8 male, 25 female caregivers). Patients had a mean age of approximately 50 years. Caregivers had a mean age of approximately 54 years. Patients had a median regret score of 10 (Interquartile range (IQR): 0–30), while caregivers had a median regret score of 20 (IQR: 0–25). Median regret scores of female patients were significantly higher than that of male patients (27.5 vs 0, p = 0.0038). BTT patients had numerically lower regret than DT patients, but this was not statistically significant. Patients who had been implanted for greater than three years had the highest regret scores. Discordance in at least one domain of the regret scale was present in 19 out of 33 (57.6%) dyads. While decisional regret was reasonably low in this population, comparatively, there was significantly increased decisional regret among female patients and patients further from LVAD implantation. Differences between patients and caregivers were also observed. These findings highlight the need for robust support and continual attention to expectations before and after LVAD implantation. [ABSTRACT FROM AUTHOR]

Highlights • Fast food diet (FFD) fed C57BL/6J mice exhibited steatosis in a time frame of eight weeks. • Co-administration of Thioacetamide (TH) accelerated FFD induced NASH histological characteristics in mice. • TH + FFD administered mice featured NASH associated prominent signs such as hepatic inflammation, fibrosis and collagen deposition. • This novel model potentiates rapid screening of novel anti-NASH and anti-liver fibrotic agents. Abstract There is an inadequacy of relevant animal models to study non-alcoholic steatohepatitis (NASH) and fibrosis. Here, we co-administered thioacetamide (TH) along with fast food diet (FFD) to C57BL/6 J mice for eight weeks. The treatments were: a) standard chow, SC b) FFD c) FFD + TH [75 mg/kg], FTH d) SC + TH [150 mg/kg], STH for 8 weeks. In in-vitro model , Hep3B cells were exposed to palmitic acid (PA) and TH viz. PA (0.25 mM) + TH (25 mM), PA (0.5 mM) alone and TH (50 mM) alone for 12 h, later supernatant media was transferred to LX-2 cells, for another 12 h. Molecular and cellular events related to inflammation, fibrosis, collagen deposition were studied. The FTH mice featured hepatic inflammation, severe diffuse fibrosis, and collagen deposition, which were less severe in FF & STH groups. In FTH group the protein expressions of α-SMA, TGF-ß, Col1 A1, CYP2E1, were up-regulated as compared to the FF group. The in-vivo findings were complemented in the LX-2 and Hep3B cells. The protein expressions of inflammatory and cellular injury markers were significantly higher in PA + TH exposed LX-2 cells. This novel model manifested hepatic inflammation and fibrosis in just eight weeks, which may be exploited for rapid screening of novel anti-NAFLD and liver anti-fibrotic agents. [ABSTRACT FROM AUTHOR]

Highlights • We analyzed roles of government and NGOs in community forestry in India. • We found that convergence of the government and NGOs can produce synergies. • We found that NGOs direct communities to the resources provided by the government. Abstract Community forestry literature promotes the idea that self-governance and self-organization lead to successful forest governance. However, this assumption marginalizes the different roles that external agents can play in organizing the communities to form forest institutions, engage in different outreach and capacity building activities and serve as a source of different kinds of resources. Given the increasing visibility of government and non-governmental organizations in community-based natural resource management, we believe it is important to understand the specific roles and impacts that convergence of these actors have on community efforts in resource governance. In this study, we first investigate the roles of government and non-governmental organizations and then conduct a comparative analysis of those roles to demonstrate synergies that emerge between government and NGOs in local forest governance. We find that while the government mainly provided technical and financial support, it is the NGOs that directed the communities to those resources. Our conclusions highlight that although the government and NGOs work within certain constraints, their convergence can make up for each other's limitations and synergistically facilitate community efforts in forest governance. [ABSTRACT FROM AUTHOR]

Abstract This paper investigates the surface characteristics of nitrogen ion implanted CR- 39 polymer. The specimens were implanted with 100 keV N+ beam to various fluences of 1 × 1015, 1 × 1016 and 2 × 1016 ions cm−2. The ion implantation induced modifications in these specimens were analyzed by Rutherford Backscattering Spectrometry (RBS) and UV- Visible spectroscopy. RBS studies reveal that the structure of the virgin CR-39 specimen has been modified completely after N+ implantation. The spatial distribution in the form of carbonization, projected range, retained dose and atomic concentration of implanted nitrogen have been estimated using RBS spectra. RUMP analysis revealed that for the implanted specimen at fluence 2 × 1016 N+ cm−2, the carbon concentration increases from 32 at.% to 43 at.% and oxygen concentration from 19 at.% to 26 at.% respectively near the surface. This increase in the concentration of carbon points towards the carbonization in the implanted layers. Furthermore, UV–Visible transmission spectra demonstrate that for higher fluences, almost complete UV region is blocked; making CR-39 a viable functional material for UV blocking devices. Highlights • The surface characteristics of N+ implanted CR-39 polymer have been investigated using RBS and UV–Visible spectroscopy. • Spatial distribution in the form of carbonization, projected range, retained dose and atomic concentration of implanted nitrogen have been estimated. • RUMP analysis revealed that carbon concentration increases from 32 at.% to 43 at.% and oxygen concentration from 19 at.% to 26 at.% for fluence 2 × 1016 N+ cm−2 near the surface. • UV–Visible transmission spectra demonstrate the blockage of UV radiations; making CR-39 a viable functional material for UV blocking devices. • Nitrogen ion implantation results in the carbonization and oxygen redistribution in the modified layers of the CR-39 specimens; ascribed in terms of formation of carbon enriched clusters in the implanted layers. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine if the subjective improvements in daytime sleepiness, fatigue and depression experienced by patients with obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) therapy predict an objective improvement in vigilance, and whether patients with mild-to-moderate OSA differ from patients with severe OSA in this regard.Methods: A total of 182 patients underwent psychomotor vigilance task (PVT) testing and measurements of subjective daytime sleepiness, fatigue and depression at baseline and after a minimum of one month of adherent CPAP use at an adequate pressure.Results: Patients with both mild-to-moderate (n = 92) and severe (n = 90) OSA experienced improvements in subjective daytime sleepiness, fatigue and depression, but objective improvement in vigilance was only seen in patients with severe OSA. In patients with severe OSA, while a correlation was found between improvements in daytime sleepiness and some PVT parameters, changes in subjective daytime sleepiness, fatigue and depression scores were not predictive of objective improvement in vigilance while controlling for all these subjective symptoms and for age, gender, body mass index, apnea-hypopnea index/respiratory event index and total sleep time/total recording time with pulse oximetry below 90%.Conclusions: We found no predictive relationship between subjective improvements in daytime sleepiness, fatigue and depression and objective vigilance with CPAP use in patients with OSA. These results suggest that subjective complaints of daytime impairment and objective measures of vigilance in patients with OSA should be assessed separately while evaluating the efficacy of CPAP therapy on daytime functioning. [ABSTRACT FROM AUTHOR]

Background Poor response to loop diuretic therapy is a marker of risk during heart failure hospitalization. We sought to describe baseline determinants of diuretic response and to further explore the relationship between this response and clinical outcomes. Methods and Results Patient data from the National Heart, Lung, and Blood Institute Heart Failure Network ROSE-AHF and CARRESS-HF clinical trials were analyzed to determine baseline determinants of diuretic response. Diuretic efficiency (DE) was defined as total 72-hour fluid output per total equivalent loop diuretic dose. Data from DOSE-AHF was then used to determine if these predictors of DE correlated with response to a high- versus low-dose diuretic strategy. At 72 hours, the high-DE group had median fluid output of 9071 ml (interquartile range: 7240–11775) with median furosemide dose of 320 mg (220–480) compared with 8030 ml (6300–9915) and 840 mg (600–1215) respectively for the low DE group. Cystatin C was independently associated with DE (odds ratio 0.36 per 1mg/L increase; 95% confidence interval: 0.24–0.56; P < 0.001). Independently from baseline characteristics, reduced fluid output, weight loss and DE were each associated with increased 60 day mortality. Among patients with estimated glomerular filtration rate below the median, those randomized to a high-dose strategy had improved symptoms compared with those randomized to a low-dose strategy. Conclusions Elevated baseline cystatin C, as a biomarker of renal dysfunction, is associated with reduced diuretic response during heart failure hospitalization. Higher loop diuretic doses are required for therapeutic decongestion in patients with renal insufficiency. Poor response identifies a high-risk population. [ABSTRACT FROM AUTHOR]

In this study, seasonal trends as well as dominant and significant periods of variability of drought variables were analyzed for 30 rainfall subdivisions in India over 141 years (1871–2012). Standardized precipitation index (SPI) was used as a meteorological drought indicator, and various drought variables (monsoon SPI, non-monsoon SPI, yearly SPI, annual drought duration, annual drought severity and annual drought peak) were analyzed. Discrete wavelet transform was used in conjunction with the Mann-Kendall test to analyze trends and dominant periodicities associated with the drought variables. Furthermore, continuous wavelet transform (CWT) based global wavelet spectrum was used to analyze significant periods of variability associated with the drought variables. From the trend analysis, we observed that over the second half of the 20th century, drought occurrences increased significantly in subdivisions of Northeast and Central India. In both short-term (2–8 years) and decadal (16–32 years) periodicities, the drought variables were found to influence the trend. However, CWT analysis indicated that the dominant periodic components were not significant for most of the geographical subdivisions. Although inter-annual and inter-decadal periodic components play an important role, they may not completely explain the variability associated with the drought variables across the country. [ABSTRACT FROM AUTHOR]

Although pregnancy is generally contraindicated in advanced heart failure (AHF), successful pregnancies have been observed in patients with left ventricular assist devices (LVADs). The number of pregnancies in patients with LVADs is increasing, yet optimal management strategies remain undefined. Additionally, no successful pregnancies have been reported with the HeartMate 3 (HM3) (Abbott) LVAD. A systematic review of pregnancy in patients with LVADs was prepared utilizing 3 major scientific databases. We also present the first reported case of successful pregnancy and delivery in a patient supported by an HM3 LVAD. The systematic search yielded 95 results. After filtering to include only relevant citations, eight unique cases were identified. Cases were compared on the basis of several clinical factors. Although pregnancies supported by LVADs are medically complex, several cases of successful deliveries have been observed. Clinical management between cases, however, did vary significantly. Several areas requiring further study were identified. [ABSTRACT FROM AUTHOR]

The photocatalytic degradation of methyl orange (MO) and congo red (CR) dyes from aqueous solution have been attempted using chitosan-g-poly(acrylamide)/ZnS (ChPA/ZS) nanocomposite materials. Nanocomposites were successfully prepared in the aqueous solution through microwave radiations. Band gap property of composite was studied using UV–vis spectrophotometer. The ChPA/ZS nanocomposite was characterized by various techniques. The photocatalytic activity of ChPA/ZS was evaluated for methyl orange and congo red dyes degradation in aqueous solution under simulated solar irradiation. The degradation of dyes was recorded higher for ChPA/ZS nanocomposite. After 2 h of irradiation, 75% of congo red dye was degraded and 69% of methyl orange was degraded after 4 h of simulated solar irradiation. ChPA/ZS composite showed a higher rate of dye degradation owing to outstanding adsorbing properties of cross linked polyacrylamide. [ABSTRACT FROM AUTHOR]

In present study, we reported the synthesis of chitosan-g-poly(acrylamide)/CuS (CPA/CS) nanocomposite for controlled delivery of ofloxacin. The CPA/CS nanocomposites were characterized by Fourier transmission infrared spectroscopy (FTIR), UV–visible spectroscopy (UV), scanning electron microscopy (SEM), X-ray diffraction (XRD) analysis. From the FTIR spectra, the various groups present in CPA/CS nanocomposite were monitored. The homogeneity, morphology and crystallinity of the CPA/CS nanocomposite were ascertained from SEM/EDX and XRD data, respectively. The kinetics of ofloxacin drug delivery was investigated at different pH. The drug released studies were investigated at different pH (2.2, 7.4 and 9.4) and time intervals (2, 4, 6, 8, 10, 12, 14, 16 h). The drug release behavior depends upon the pH of medium and the nature of matrix. The maximum drug loading efficiency of 85% was recorded for CPA/CS. The maximum drug release of 76% was observed at 2.2. pH after 18 h onto CPA/CS. Nanocomposites were also tested for antibacterial activity against Escherichia coli bacteria. About 97% killing of E. coli was observed after 24 h. [ABSTRACT FROM AUTHOR]

Chitosan- g -poly(acrylamide)/Zn (CPA-Zn) nanocomposite was synthesized using simple method in the presence of microwave radiations. CPA-Zn nanocomposite was characterized by various analytical techniques. CPA-Zn nanocomposite was used for controlled drug delivery of ofloxacin. The maximum drug release was 75% which was observed in acidic medium. The cumulative drug release and drug released kinetics of CPA-Zn was investigated. It was noticed that the drug release behavior depended upon the pH of medium as well as on the the nature of matrix. CPA-Zn nanocomposites were also studied for their antibacterial activity against E. coli bacteria. [ABSTRACT FROM AUTHOR]

Background: Worsening renal function in heart failure may be related to increased venous congestion, decreased cardiac output, or both. Diuretics are universally used in acute decompensated heart failure, but they may be ineffective and may lead to azotemia. We aimed to compare the decongestive properties of a urine output-guided diuretic adjustment and standard therapy for the management of cardiorenal syndrome in acute decompensated heart failure.Methods and Results: Data were pooled from subjects randomized to the stepwise pharmacologic care algorithm (SPCA) in the CARRESS-HF trial and those who developed cardiorenal syndrome (rise in creatinine >0.3 mg/dL) in the DOSE-AHF and ROSE-AHF trials. Patients treated with SPCA (n = 94) were compared with patients treated with standard decongestive therapy (SDT) that included intravenous loop diuretic use (DOSE-AHF and ROSE-AHF; n = 107) at the time of cardiorenal syndrome and followed for net fluid balance, weight loss, and changing renal function. The SPCA group had higher degrees of jugular venous pressure (P < .0001) at the time of cardiorenal syndrome. The group that received SPCA had more weight change (-3.4 ± 5.2 lb) and more net fluid loss (1.705 ± 1.417 L) after 24 hours than the SDT group (-0.8 ± 3.4 lb and 0.892 ± 1.395 L, respectively; P < .001 for both) with a slight improvement in renal function (creatinine change -0.1 ± 0.3 vs 0.0 ± 0.3 mg/dL, respectively; P = .03).Conclusions: Compared with SDT, patients who received an intensification of medication therapy for treating persisting congestion had greater net fluid and weight loss without being associated with renal compromise. [ABSTRACT FROM AUTHOR]

The outcomes and management of bloodstream infection (BSI) in patients on temporary mechanical circulatory support (TMCS) awaiting heart transplant (HT) are poorly understood. We present outcomes of patients on TMCS with BSI (TMCS-I) relative to matched uninfected patients (TMCS-U) and discuss their management. Between January 1, 2013, and April 30, 2023, N = 136 patients were bridged to transplant with TMCS at Emory Transplant Center. Twenty-one (15.4%) patients were TMCS-I. Two (9.5%) had infective endocarditis. Median duration of antimicrobial treatment was 24 days (interquartile range 28.3). All TMCS-I were reactivated for transplant within 48 to 72 hours of negative blood cultures. None developed recurrent BSI. Post-transplant survival did not differ between TMCS-I and TMCS-U (p = 0.38). HT for TMCS-I may be safe as soon as blood cultures clear. Duration of antimicrobial therapy is individualized and depends on the organism, duration of bacteremia, presence of endocarditis, and timing of HT. Additional research is needed to determine optimal duration of treatment. [ABSTRACT FROM AUTHOR]

• Pandemic-induced causative factors triggered varied mental stresses in the different subgroups and micro-community. • Unexpected events during the pandemic caused emotional drifts disturbing community's emotional equilibrium. • Yoga, watching spiritual programs, and personal developmental activities demonstrated an ameliorative impact on people's emotions. • Frequently engaging with social media deleteriously influenced people's emotions. • Need for a pre-planned infrastructure to promote psychological preparedness in communities. The widespread, ongoing COVID-19 pandemic has brought to the fore concerns regarding the psychological well-being of people. Recent research revealed various issues impacting mental health of people. However, a systematic study of the emotional drift of the populace, has been precluded so far. Our investigative research seeks to explore stress factors for different subgroups in India, variation in primary emotions during COVID-19 initial phase, and the emotional impact of activities practiced by people to adjust to the new norms. We conduct an online questionnaire-based survey that elicits responses from 958 participants. Our analysis establishes significant correlations between pandemic-induced causative factors and stresses in subgroups and micro-community. Unexpected events during the pandemic disturbed community's emotional equilibrium. Lastly, we find specific activities demonstrating an ameliorative impact on the emotional well-being of people. Our analysis emphasizes the need for a pre-planned infrastructure to provide Psychological First Aid (PFA) to foster psychological preparedness. [ABSTRACT FROM AUTHOR]

Adaptive governance of social-ecological systems depends on adaptive institutions. Efforts to understand the factors affecting adaptive institutions have identified many variables, but our understanding is constrained by multiple definitions of these concepts. In this article, we synthesize across two decades of studies relating to adaptive institutions. After clarifying some definitional confusion in the literature, we provide a theoretical framework to guide research on purposeful institutional change. While numerous scholars have identified a wide variety of important factors, we find that many of these factors can be traced back to (1) federalism and polycentricity and (2) networks and learning. Our synthesis suggests several avenues for future research centered on these factors. For example, how might the potential negative effects of key facilitating variables such as polycentricity (e.g., racial segregation and income sorting) and heterogeneous networks (e.g., increased coordination costs) hinder adaptive institutions? How can learning through both scientific and time-and-place knowledge promote adaptive institutions? More broadly, social science can play an important role in identifying factors that foster adaptability in different contexts, so that policy makers can promote such adaptability. [ABSTRACT FROM AUTHOR]

Introduction Socio-economic differences in the society have been a major cause for the discrepancy in disease and behavioural patterns in society. With 360 million people (32 million children) in the world suffering from disabling hearing losses, it is imperative to gain an insight into the impact of differences in socio-economic strata on children's ear health issues, their knowledge of ear ailments and attitude towards ear health so as to suggest policies addressing ear health issues. Methods The study was carried out in two different school types namely government schools and private schools which represent wide difference in the socio-economic status of the students studying there. A questionnaire was administered to students aged 10 to 13 years to assess the current ear care practices, knowledge regarding ear ailments, attitude towards hearing and their adaptability to reform. Results The children belonging to higher socio-economic status were found to have lesser incidence of ear diseases and ear abuse, more referrals for ear ailments, lesser indulgence in risky ear health behaviours, better knowledge pool, positive attitude towards ear health and hearing and were more adaptable to change for better hearing. Conclusion Structures of social disparity are essential determinants of ear health acting both independently and through their influence on behavioural determinants of health. Increasing awareness of ear health issues at the school level itself should be one of the goals of health care providers. [ABSTRACT FROM AUTHOR]