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Chronic fatigue syndrome (CFS) is a pathological state of extreme tiredness that lasts more than six months and may possess an impact on the social, emotional, or occupational functioning of an individual. CFS is characterized by profound disabling fatigue associated with infectious, rheumatological, and neurological symptoms. The current pharmacological treatment for CFS does not offer a complete cure for the disease, and none of the available treatments show promising results. The exact mechanism of the pathogenesis of the disease is still unknown, with current suggestions indicating the overlapping roles of the immune system, central nervous system, and neuroendocrine system. However, the pathological mechanism revolves around inflammatory and oxidative stress markers. Polyphenols are the most abundant secondary metabolites of plant origin, with potent antioxidant and anti-inflammatory effects, and can exert protective activity against a whole range of disorders. The current review is aimed at highlighting the emerging role of polyphenols in CFS from both preclinical and clinical studies. Numerous agents of this class have shown promising results in different in vitro and in vivo models of chronic fatigue/CFS, predominantly by counteracting oxidative stress and the inflammatory cascade. The clinical data in this regard is still very limited and needs expanding through randomized, placebo-controlled studies to draw final conclusions on whether polyphenols may be a class of clinically effective nutraceuticals in patients with CFS. Graphical abstract

Considerable variation in clozapine utilization exists across the United States, and little is known about the perspective of psychiatrists in states with low clozapine use. To better understand clozapine practices, attitudes, and barriers, a survey was administered to a group of southeastern state conference attendees (SSCA; N = 86). The same survey was administered to psychiatrists belonging to a national community psychiatry organization (AACP; N = 57), and differences were analyzed across the two samples. In comparison to the AACP, the SSCA group felt less comfortable, perceived clozapine as less safe and effective, had fewer patients on clozapine, and were more likely to prefer antipsychotic polypharmacy to clozapine use. Across the sample, use of a myocarditis screening protocol was rare (N = 14/76; 18%) and less than half used plasma antipsychotic levels to guide dosage (N = 60/129; 47%). Continuing professional education on clozapine are needed for psychiatrists who see individuals with psychotic disorders.

To demonstrate an organic (retinal) amblyogenic defect in functional amblyopes not responding to treatment. Twenty-four children (Mean age: 5.9 ± 1.8 years; range: 4–10 years) with functional amblyopia were recruited for this study. All these children underwent complete ophthalmic and orthoptic evaluation. In addition, Kinetic Goldman Visual Fields (KGVF), Spectral Domain Optical Coherence Tomography (SD-OCT), full field flash electroretinograms (ffERG) and multifocal electroretinograms (mfERG) were also performed. Ratios were subsequently derived by comparing the amplitudes obtained from the amblyopic eye (AE) to the good eye (GE) for the a- and b-waves of the ffERG, as well as for the ring analysis of the mfERG. KGVF showed a central scotoma of varying size (3°–7°) and density (absolute to relative), with increasing target size in 14/24 patients whose best post-treatment vision in the AE ranged from 20/100 to 20/40. The scotoma decreased in size and density with improving vision until a plateau of recovery was reached. The remaining 10/24 patients with a vision ≥ 20/30 showed no scotoma. SD-OCT showed no significant difference between the AE and GE. ffERG and mfERG were obtained in 18/24 patients. The ffERG AE/GE ratio was abnormal in 7 patients, 5 of which had large scotomas on KGVF. The mfERG ring 1 AE/GE ratio was significantly (p .05) in ring 1 AE/GE amplitude ratio between those who achieved 20/50–20/40 (.81 ± .26) and those with ≥ 20/25(.86 ± .25). The combined findings of central scotoma on KGVF and mfERG anomalies in patients who did not achieve optimal vision with treatment suggest an underlying organic defect impairing macular function.

The number of International Medical Graduate (IMG) physicians matching into categorical psychiatry decreased steadily over the past decade. The authors sought to understand if this trend was occurring in other specialties, if US IMG physicians and non-US IMG physicians were equally affected, and if certain regions of the USA were more affected by this decrease than others. Finally, the authors compared the proportion of foreign-born individuals within a US census region to the proportion of non-US IMG physicians within that region. The authors analyzed data from the National Resident Matching Program from the years 2014–2020. Statewide data was aggregated into nine geographic regions, as per the US Census Bureau. The number of foreign-born individuals within each US census region was calculated from the 2018 American Community Survey data. In comparison to eight other specialties, psychiatry saw the greatest decrease (46.3%) in IMG physicians matching into PGY-1 positions. Both US IMG physicians and non-US IMG physicians were equally affected. The percentage of IMG physicians decreased in each of the nine US census regions. In six out of nine geographic regions, non-US IMG physicians were under-represented when comparing their proportion to the number of foreign-born people that lived within that region. Decreasing numbers of IMG physicians in psychiatry training may have long-term implications for cultural competency, serving underserved populations, and fellowship recruitment. We advocate for program directors to recognize IMG physicians as an important source of diversity and to recruit residents that reflect the communities they serve.

Made available in DSpace on 2020-12-10T17:32:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-05-19 Zinc (Zn) and Iron (Fe) are essential micronutrients for both human and plants, but their deficiency is prevalent in the world, especially in developing countries including India and Pakistan. Therefore, zinc and iron biofortification of wheat and other cereal crops is being urgently addressed and highly prioritized as a research topic. Thus, a field study was planned in a silty-loam soil under conventional tillage, located at Peshawar, Khyber Pakhtunkhwa, Pakistan, in winter 2016-2017 to examine the influence of foliar zinc rates (0.1, 0.2, 0.3 and 0.4% ZnSO4.7H(2)O) and foliar iron rates (0.5, 1, 1.5 and 2% FeSO4.7H(2)O) on physiology, phenology, yield indices and grain Zn and Fe contents of wheat. The results specified that leaf area per tiller, flag leaf area, productive tillers, yield components, biomass yield, grain Zn and Fe contents were significantly improved with various foliar Zn and Fe levels. The plants fertilized with 0.3% Zn and 1% Fe exhibited higher grain yield. Higher grain Zn content was observed in plants fertilized with foliar Zn at 0.4% and Fe at 0.5%. Higher grain Fe content was noted in the plants fertilized with 0.1% Zn and 2% Fe. It can be concluded that the plants fertilized with 0.3% foliar Zn and 1% Fe resulted in improved yield components and yield, whereas the plants fertilized with 0.1% Zn and 2% Fe showed an improved wheat grain quality (Zn and Fe content). Hence, foliar fertilization of 0.3% Zn and 1% Fe is recommended for higher wheat yields and better grain quality under the edaphoclimatic conditions studied. Univ Agr Peshawar, Dept Agron, Khyber Pahtunkhwa, Pakistan Sao Paulo State Univ, Dept Plant Soil & Agr Engn, Ilha Solteira, SP, Brazil Univ Agr Peshawar, Dept Agr Extens Educ & Commun, Khyber Pahtunkhwa, Pakistan Sao Paulo State Univ, Dept Plant Soil & Agr Engn, Ilha Solteira, SP, Brazil

A complex Pythagorean fuzzy set (CPFS) is the generalization of Pythagorean fuzzy set (PFS) in which the range of degrees is extended from [0, 1] to complex plane with unit disk. The averaging operators play a significant role to transform the information into a single value. The flexibility of Dombi operators with operational parameters is outstanding, and the Dombi operators are very efficient in decision-making problems. In this research article, we present a new graph called, complex Pythagorean Dombi fuzzy graph (CPDFG) as the Dombi operators are not yet applied on CPFSs. We employ graph terminology on CPFSs using Dombi operators. We define regular, totally regular, strongly regular and biregular graphs with appropriate elaboration, and their pivotal properties are discussed. Moreover, edge regularity of CPDFG is also explained with significant characteristics. We introduce two operators, namely complex Pythagorean Dombi fuzzy arithmetic averaging (CPDFAA) and complex Pythagorean Dombi fuzzy geometric averaging (CPDFGA) operators, which are capable to aggregate the complex Pythagorean fuzzy information. We utilize CPDFAA and CPDFGA operators in solving a decision-making numerical example, which is related to the selection of suitable place to build a bus terminal in a city. In order to examine the superiority of our propose operators, we provide a comparative analysis with the existing operators.

Diabetes mellitus, a metabolic disorder, is characterized by a substantial hyperglycaemia. Prevalence of hyperglycaemia for longer period of time can cause nonenzymatic condensation of sugar in blood with amino group of protein and give rise to advanced glycation end products (AGEs). AGEs play a major role in the onset of late diabetic complications including diabetic retinopathy, nephropathy, neuropathy and cardiovascular diseases. There is a need to establish potential therapeutic regimens that can effectively inhibit the formation of AGEs. To this end a series of novel oxindole-based chalcones have been investigated for their antiglycation potential. Analogues 1 (IC50 = 155.22 ± 2.98 µM), 3 (IC50 = 195.95 ± 0.43 µM), 4 (IC50 = 289.47 ± 2.47 µM), 5 (IC50 = 222.44 ± 4.03 µM), 7 (IC50 = 251.27 ± 2.80 µM), and 20 (224.23 ± 1.93 µM) showed potent inhibitory activity against glycation compared to the reference Rutin (IC50 = 294.5 ± 1.5 µM). These results reveal that multiple hydroxyl substituents and their position on the aromatic ring play a key role in inhibitory effect due to their hydrogen bonding potential. The study also reveals the influence of substituents on the binding capabilities and in turn inhibitory potential of different analogues.

The main purpose of research was to investigate the underlying strategies for enhancing “organizational sustainability” (OS). The study categorizes the existing literature, based on strategic choice theory and the attribution model, which reveals that green human resource management (GHRM) practices play a crucial role in environmental management and organizational sustainability. This study investigates the impact of GHRM practices including training and development, performance appraisal, and reward and compensation on organizational sustainability through the mediating role of environmental performance and employee performance. A survey questionnaire methodology was used for data collection; data were collected from 165 managerial personnel in the textile industrial sector of Pakistan. The findings of the study showed significant effects of GHRM practices, i.e. (training and development, performance appraisal, and reward and compensation), on Organizational Sustainability, Similarly, this study empirically investigates the distinct mediating role of environmental performance and employee’s performance between GHRM practices and organizational sustainability. The study findings support the hypothesized model of mediation. The GHRM is an innovative idea in developing countries, and additional studies are needed to identify sustainability issues and evaluate the impacts of GHRM practices in the textile and manufacturing industries in Pakistan.

Objectives There is preliminary evidence of racial and social economic disparities in the population infected by and dying from COVID-19. The goal of this study is to report the associations of COVID-19 with respect to race, health, and economic inequality in the United States. Methods We performed an ecological study of the associations between infection and mortality rate of COVID-19 and demographic, socioeconomic, and mobility variables from 369 counties (total population, 102,178,117 [median, 73,447; IQR, 30,761–256,098]) from the seven most affected states (Michigan, New York, New Jersey, Pennsylvania, California, Louisiana, Massachusetts). Results The risk factors for infection and mortality are different. Our analysis shows that counties with more diverse demographics, higher population, education, income levels, and lower disability rates were at a higher risk of COVID-19 infection. However, counties with higher proportion with disability and poverty rates had a higher death rate. African Americans were more vulnerable to COVID-19 than other ethnic groups (1981 African American infected cases versus 658 Whites per million). Data on mobility changes corroborate the impact of social distancing. Conclusion Our study provides evidence of racial, economic, and health inequality in the population infected by and dying from COVID-19. These observations might be due to the workforce of essential services, poverty, and access to care. Counties in more urban areas are probably better equipped at providing care. The lower rate of infection, but a higher death rate in counties with higher poverty and disability could be due to lower levels of mobility, but a higher rate of comorbidities and health care access. Electronic supplementary material The online version of this article (10.1007/s40615-020-00833-4) contains supplementary material, which is available to authorized users.

We have previously shown that the amplitude of the mfERG response obtained to a single (large) hexagon is significantly smaller than that obtained when summating all the mfERG responses evoked to an array of 7–61 hexagons covering the same retinal area. The purpose of this study was to confirm our initial findings in normal subjects of different ages and in selected patients. Binocular mfERGs (1, 7, 19, 37 and 61 hexagon arrays; Espion V6.0.54 Diagnosys LLC) were recorded from 40 normal subjects (25 aged 18–25, and 15 aged 3–12). Individual mfERG waveforms evoked in response to the multi-hexagon arrays (7, 19, 37 and 61) were summated, and the amplitude of the resulting composite mfERG waveform was compared to that measured in the response evoked to the single (large) hexagon stimulus to yield the amplitude ratio (i.e., 7:1 X100, 19:1X100, etc.). In normal subjects, the 7:1 ratio was 119.5 ± 9.2%, a value that gradually decreased to reach 109.4 ± 20.6% with the 61:1 ratio and a finding that was similar across all ages. The present study indicates a significant enhancement in amplitude of the summed mfERG composite waveform evoked to the 7 hexagon stimulus array (and to a lesser extent to the 19, 37 and 61 stimuli) compared to the 1 hexagon array, possibly mediated through the retinal lateral pathway (horizontal or amacrine cells), a claim that awaits confirmation. Preliminary results obtained from patients treated with Plaquenil suggest that this new method of mfERG analysis might probe a feature of macular function different from that investigated with the more usual method of mfERG ring ratio.

The interaction of the cupric ion with esculetin, a dihydroxy coumarin derivative, was studied by absorption and fluorescence spectroscopic methods in aqueous medium. Esculetin formed a complex in the presence of the cupric ion which was characterised by the shift in its absorption band from 350 nm to 389 nm and the quenching of its fluorescence intensity at 466 nm. From Job's plot and fluorescence quenching studies, the stoichiometry of the copper ion and esculetin in the complex was estimated to be 1 : 2 respectively. Interestingly, the incubation of the Cu(ii)-esculetin complex with a thiol peptide, glutathione (GSH), showed restoration of the fluorescence intensity as well as absorption maxima to that of pure esculetin. Incubation with other common thiol and non-sulphur amino acids did not show a similar restoration of the photophysical properties of the complex except in the case of cysteine. Mechanistically, it was evident that two molecules of GSH were consumed in reducing the Cu(ii)-esculetin complex, which subsequently split into the copper ion and esculetin. In this process GSH was converted into oxidised GSH (GSSG) as evident from the mass spectroscopy and HPLC studies. The above florescence regeneration behaviour of the copper-esculetin system in the presence of GSH was also observed in the cellular system using Chinese hamster ovary (CHO) as model cells. In conclusion, these studies may find application in developing sensors for detecting the cellular thiol level.

Thioesculetin (TE) is a sulfur analogue of esculetin. The UV-Vis absorption maximum of TE at 470 nm shifted to 357 nm in the presence of oxidising agent such as m-chloroperoxy benzoic acid (m-CPBA). With gradual increase in the m-CPBA concentration, the absorption band at 470 nm decreases while the band at 357 nm increases. The same system shows gradual increase in the fluorescence signal at 463 nm in the presence of m-CPBA. The fluorescence signal was unaffected in the presence of common anions and metal cations. The mechanism for optical signalling was due to the conversion of weakly fluorescent TE to fluorescent esculetin through desulfurization reaction. $$^{13}\hbox {C}$$ -NMR shows strong evidence in support of the chemical conversion of TE to esculetin. TE may find applications to probe the redox environment in various chemical and biochemical processes. SYNOPSIS Thioesculetin solution changes yellow to colorless on addition of the mCPBA and there is also significant increase in the fluorescence signal. In the presence of mCPBA, thioesculetin is converted to esculetin through desulfurization reaction.

Development of improved methods for the synthesis of copper nanoparticles is of high priority for the advancement of material science and technology. Herein, starch-protected zero-valent copper (Cu) nanoparticles have been successfully synthesized by a novel facile route. The method is based on the chemical reduction in aqueous copper salt using ascorbic acid as reducing agent at low temperature (80 °C). X-ray diffraction, scanning electron microscopy and energy-dispersive X-ray spectroscopy measurements were taken to investigate the size, structure and composition of synthesized Cu nanocrystals, respectively. Average crystallite size of Cu nanocrystals calculated from the major diffraction peaks using the Scherrer formula is about 28.73 nm. It is expected that the outcomes of the study take us a step closer toward designing rational strategies for the synthesis of nascent Cu nanoparticles without inert gas protection.

Biomass derived biochar is increasingly recognized as an environmental-friendly sorbent to halt organic pollutants. This study explores the opportunity of managing pine needles waste by converting them into biochar sorbent through catalytic and non-catalytic pyrolysis, carried out at 450 °C. The difference in the biochar yield was not very obvious under catalytic and non-catalytic pyrolysis. The obtained biochars were characterized using X-ray diffraction analysis, energy-dispersive X-ray spectroscopy and scanning electron microscopy. Adsorption of Reactive Black-5 (RB-5) in aqueous solution by produced biochar was studied. The effect of adsorbent dose in batch-mode experiments was investigated. The equilibrium adsorption data of RB-5 were analyzed by Langmuir and Freundlich models. Langmuir isotherms best described the adsorption data with higher correlation coefficient R 2 values (R 2 = 0.983, R 2 = 0.995 and R 2 = 0.941). The maximum RB-5 adsorption capacities q e(mg g−1) of elemental copper and cuprite (Cu–Cu2 O)-based char, magnetite (Fe3O4)-based char and non-catalytically produced char from Langmuir model were 5.40, 2.82 and 4.37 mg g−1, respectively at 0.1 g adsorbent dose. These results indicated that the biochars are suitable to be used as an adsorbent for RB-5 removal.

Spherical fuzzy sets, originally proposed by F.K. Gündogdu, C. Kahraman, Spherical fuzzy sets and spherical fuzzy TOPSIS method, J. Intell. Fuzzy Syst. 36 (2019), 337–352, can handle the information of type: yes, no, abstain and refusal, owing to the feature of broad space of admissible triplets. This remarkable feature of spherical fuzzy set to manage the uncertainty and vagueness distinguishes it from other fuzzy set models. In this research article, we utilize spherical fuzzy sets and prioritized weighted aggregation operators to construct some spherical fuzzy prioritized weighted aggregation operators, including spherical fuzzy prioritized weighted averaging operator and spherical fuzzy prioritized weighted geometric operator. We discuss some properties which are satisfied by these operators. Further, we establish an algorithm to the multi-criteria group decision-making problem by utilizing the aforesaid operators. To elaborate the applicability of proposed operators in decision-making, we apply the algorithm to a numerical example which is related to the appointment for the post of Finance Manager. Finally, to demonstrate the authenticity of presented operators, we conduct a comparison with existing methods.

A new series of 2,3-di-O-alkyl derivatives of 5,6-O-isopropylidene-l-ascorbic acid were synthesized using phase transfer catalysis in aqueous media. These derivatives were screened for their superoxide radical scavenging activity and anticancer activity against human breast cancer cell line (MCF-7), leukemic cell line (HL-60), and cervical cell line (HeLa). All these derivatives exhibited enhanced scavenging effect than l-ascorbic acid except for the 4-fluorobenzyl or 2/4-chlorobenzyl alkyl group either at 3-O and/or 2-O position displayed pro-oxidant activity. These pro-oxidant derivatives (2c–e, m) exhibited potent anticancer activities against all the cell lines (IC50 = 25.79–57.21 μM). However, these compounds were also cytotoxic to human normal leukemic macrophages THP-1. On the other hand, antioxidant derivatives displayed albeit slight (2k, IC50 = 57.96–63.45 μM), but selective inhibitory effect toward all tumor cell lines. Thus, pro-oxidant and antioxidant properties can be used to predict the cytotoxic selectivity of drug against normal and cancer cells.

Surgical management of anterior capsular plaque associated with persistent pupillary membranes