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Background: Ketamine is increasingly used for treatment‐resistant depression (TRD) while its mechanism of action is still being investigated. In this systematic review, we appraise the current evidence of metabolomic biomarkers for racemic ketamine and esketamine in patients with TRD and healthy controls (HCs). Methods: A comprehensive search of several databases (Ovid MEDLINE®, Embase, and Epub Ahead of Print) was performed from each database's inception to June 29, 2022, in any language, was conducted. We included studies wherein the metabolomic biomarkers for racemic ketamine or esketamine were investigated in TRD or HCs. Our main outcomes were to examine changes in metabolites among patients treated with ketamine/esketamine and explore the association with response to ketamine/esketamine. Results: A total of 1859 abstracts were screened of which 11 were included for full‐text review. Of these, a total of five articles were included (N = 147), including three RCTs (n = 129) and two open‐label trials (n = 18). All studies used racemic ketamine; one study additionally used esketamine. The included studies evaluated patients with treatment‐resistant bipolar depression (n = 22), unipolar depression (n = 91), and HCs (n = 34). The included studies reported alteration in several metabolites including acylcarnitines, lipids, kynurenine (KYN), and arginine with ketamine in TRD. Studies suggest the involvement of energy metabolism, KYN, and arginine pathways. In HCs, acetylcarnitine decreased post‐infusion, whereas inconsistent findings were observed after the ketamine infusion in TRD patients. Conclusions: This systematic review provides preliminary evidence that ketamine may cause changes in several important pathways involved in energy metabolism and inflammation. Larger and more rigorous studies are needed. [ABSTRACT FROM AUTHOR]

Chronic abdominal symptoms, especially in conjunction with risk factors such as iron deficiency anaemia, necessitate consideration of pica. Bowel wall thickening, either on ultrasound or computed tomography, may be a sign of a retained foreign body. An abdominal ultrasound shows abdominal ascites with dilated bowel loops and wall thickening. [Extracted from the article]

Lipocalin 2 is a siderophore‐binding protein that regulates iron homeostasis. Lipocalin 2 expression is elevated in multiple tumor types; however, the mechanisms that drive tumor progression upon Lipocalin 2 expression remain unclear. When Lipocalin 2 is over‐expressed, it leads to resistance to 5‐fluorouracil in colon cancer cell lines in vitro and in vivo by inhibiting ferroptosis. Lipocalin 2 inhibits ferroptosis by decreasing intracellular iron levels and stimulating the expression of glutathione peroxidase4 and a component of the cysteine glutamate antiporter, xCT. The increase in xCT levels is dependent on increased levels of ETS1 in Lipocalin 2 over‐expressing cells. Inhibiting Lipocalin 2 function with a monoclonal antibody leads to a decrease in chemo‐resistance and transformation in vitro, and a decrease in tumor progression and chemo‐resistance in xenograft mouse models. Lipocalin 2 and xCT levels exhibit a positive correlation in human tumor samples suggesting that the pathway we have identified in cell lines is operative in human tumor samples. These results indicate that Lipocalin 2 is a potential therapeutic target and that the monoclonal antibody described in our study can serve as the basis for a potential therapeutic in patients who do not respond to chemotherapy. [ABSTRACT FROM AUTHOR]

Objectives: To examine the Baby Oral Health Program's (bOHP) influence on dental visits for children 0 to 3 years and overall dental visits in four federally qualified health center (FQHC) clinics.Methods: Using an interrupted time series study design, administrative data were obtained for the year prior and following the intervention. The intervention included dental staff training on early childhood oral health, quality improvement, and monthly visits during the follow-up intervention period. Analysis included descriptive and segmented regression using aggregate patient visit data.Results: A total of 10,400 patients made 26,416 visits over the study period; 1,187 (11 percent) were children ≤3 years. Visit counts in the youngest age group increased 70 percent following the intervention. When controlling for the naturally increasing trend, the intervention added 8.7 (95 percent CI: 4.7, 12.8) early childhood patient-visits per clinic in the last month of the intervention period. The increase in visit counts in the youngest age group had no significant effect on other ages, except for a decline relative to the natural trend in patient-visits among 35-50 year olds (-32.3 less visits) following the intervention. The proportion of visits for all ages by ≤3 year olds increased from 5 to 8 percent following the intervention.Conclusions: bOHP increased dental visits among children ≤3 years but the finding might be attributable to clinic changes coinciding with bOHP implementation that were not controlled with the study design. Additional studies are needed in populations experiencing challenges accessing dental care. [ABSTRACT FROM AUTHOR]

Background: Early walking as part of a perioperative care program benefits patients who have had surgery. However, the impact of early walking by itself on the mental and physical recovery of postoperative patients has not been examined. Methods: We established a program called walking to recovery (WTR) in which college volunteers provided walking assistance to patients recovering after abdominal surgery. Patients who participated in the program were compared with patients who did not. The postoperative recovery profile survey (PRP-17) was administered on day of discharge to 15 participants and 15 non-participants. Medical records were reviewed to obtain indication for surgery, type of surgery, length of hospital stay, and postoperative complications. At 1 month post-discharge, a short form (SF)-12v2 questionnaire was administered by telephone to assess postoperative quality of life as defined by mental and physical level of function and measured with the mental component score (MCS) and the physical component score (PCS). Results: The average age of participants and non-participants was similar (48.9 ± 9.8 vs. 51.4 ± 8.7 years; p = 0.28). When the two groups were approximately matched by type and severity of surgery, participants had lower PRP-17 composite scores (9.9 vs. 12.5, p = 0.003) and higher indicator sums (9.8 vs. 8.4, p = 0.04) than non-participants, both of which indicate better postoperative recovery in participants. The mean immobilization score was significantly lower in participants (0.3 vs. 0.8, p = 0.04). Postoperative length of stay and MCS did not differ between the two groups, but in participants there was a trend for higher scores in the PCS. Conclusions: Walking with volunteers was associated with a better PRP during the hospitalization period but not at 1 month follow-up. The WTR program is a sustainable, cost-effective model program for other hospitals to emulate as part of the standard of care of postoperative patients. [ABSTRACT FROM AUTHOR]

Deforestation of mangroves is of global concern given their importance for carbon storage, biogeochemical cycling and the provision of other ecosystem services, but the links between rates of loss and potential drivers or risk factors are rarely evaluated. Here, we identified key drivers of mangrove loss in Kenya and compared two different approaches to predicting risk. Risk factors tested included various possible predictors of anthropogenic deforestation, related to population, suitability for land use change and accessibility. Two approaches were taken to modelling risk; a quantitative statistical approach and a qualitative categorical ranking approach. A quantitative model linking rates of loss to risk factors was constructed based on generalized least squares regression and using mangrove loss data from 1992 to 2000. Population density, soil type and proximity to roads were the most important predictors. In order to validate this model it was used to generate a map of losses of Kenyan mangroves predicted to have occurred between 2000 and 2010. The qualitative categorical model was constructed using data from the same selection of variables, with the coincidence of different risk factors in particular mangrove areas used in an additive manner to create a relative risk index which was then mapped. Quantitative predictions of loss were significantly correlated with the actual loss of mangroves between 2000 and 2010 and the categorical risk index values were also highly correlated with the quantitative predictions. Hence, in this case the relatively simple categorical modelling approach was of similar predictive value to the more complex quantitative model of mangrove deforestation. The advantages and disadvantages of each approach are discussed, and the implications for mangroves are outlined. [ABSTRACT FROM AUTHOR]

The catalyst is recycled and reused in two additional runs with significantly decreasing product yields. [ABSTRACT FROM AUTHOR]