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The article discusses the capillary ketone concentrations at the time of colonoscopy: a cross-sectional study with implications for SGLT2 inhibitor–treated type 2 diabetes. Topics include procedure centers where there is no access to on-site blood gas analyzers or expertise for dextrose-insulin infusions; and risk of diabetic ketoacidosis (DKA) in SGLT2i-treated people undergoing colonoscopy must be balanced by potential delays in detecting and treating colorectal cancer.

Neonatal jaundice is a common condition seen in the primary care setting. Most afflicted babies have physiological jaundice and their prognosis is good. However, others have pathological jaundice, which must be detected early. High levels of serum bilirubin can also result in bilirubin encephalopathy. This article describes consultation tasks in the primary care setting with the aim of providing a guide for the safe management of neonatal jaundice. They include clinical assessment of the baby's well-being; looking out for features that suggest pathological jaundice; assessment for the presence of high-risk features; utilising appropriate laboratory tests for monitoring; assessing the degree of jaundice to decide if the child can be safely followed up in primary care; and providing advice on primary prevention measures and allaying parental concerns. The importance of stool colour examination and its role in early detection of cholestatic jaundice is emphasised. [ABSTRACT FROM AUTHOR]

Helping students to acquire self-regulated learning abilities has become a major goal of our education. This study focuses on a major aspect of self-regulated learning: adaptive help-seeking. Adaptive help seeking behaviors allow students to learn effectively when facing academic difficulty and facilitate adoption of other self-regulated learning strategies. This study explores how Chinese students' perceive academic self-efficacy and social efficacy related to their academic help-seeking behaviors. The hypotheses were supported in an examination of 271 students from three Hong Kong tertiary institutions. When students had high level of social efficacy, they tended to displayed more adaptive and less of non-adaptive help-seeking behaviors. These findings add to the literature on Chinese students' academic help seeking behavior and also have practical implications for teachers seeking to promote self-regulated learning behaviors. [ABSTRACT FROM AUTHOR]

The healthcare challenges in developed countries centre around the rise of chronic conditions and obesity. There is a call to shift the focus toward the primary prevention of these conditions. Clinicians will need to move beyond the comfort of prescribing pharmaceuticals and expand the scope to prescribing health, i.e. exercise. We discuss an easy-to-follow exercise prescription to highlight some essential principles and useful tools that can help busy family practices achieve this. [ABSTRACT FROM AUTHOR]

We propose a greedy inversion method for a spatially localized, high-resolution Radon transform. The kernel of the method is based on a conventional iterative algorithm, conjugate gradient (CG), but is utilized adaptively in amplitude-prioritized local model spaces. The adaptive inversion introduces a coherence-oriented mechanism to enhance focusing of significant model parameters, and hence increases the model resolution and convergence rate. We adopt the idea in a time-space domain local linear Radon transform for data interpolation. We find that the local Radon transform involves iteratively applying spatially localized forward and adjoint Radon operators to fit the input data. Optimal local Radon panels can be found via a subspace algorithm which promotes sparsity in the model, and the missing data can be predicted using the resulting local Radon panels. The subspacing strategy greatly reduces the cost of computing local Radon coefficients, thereby reducing the total cost for inversion. The method can handle irregular and regular geometries and significant spatial aliasing. We compare the performance of our method using three simple synthetic data sets with a popular interpolation method known as minimum weighted norm Fourier interpolation, and show the advantage of the new algorithm in interpolating spatially aliased data. We also test the algorithm on the 2D synthetic data and a field data set. Both tests show that the algorithm is a robust antialiasing tool, although it cannot completely recover missing strongly curved events. [ABSTRACT FROM AUTHOR]

The study aimed to establish the diagnostic accuracy of the Geriatric Depression Scale (GDS), the Even Briefer Assessment Scale for Depression (EBAS DEP), and the single question test for depression in our elderly Chinese population, and to determine if any one instrument was to be preferred. Ninety-eight community-living, socially active and non-depressed elderly and 75 patients diagnosed with depression were administered the three depression scales. Receiver operating characteristics (ROC) were employed to determine the optimal cut-off scores for the GDS and EBAS DEP, and the diagnostic performance of all three instruments were then compared. ROC analysis indicated an optimal cut-off score of 4 and above for the 15-item GDS, with a sensitivity of 84.0% and a specificity of 85.7%, while the EBAS DEP had 77.3% sensitivity and 89.8% specificity at the optimal cut-off score of 3 and above. The sensitivity and specificity of the single question were 64.0% and 94.9%, respectively. The non-parametric test of the areas-under-the-curve showed no significant difference between the diagnostic performances of the GDS and the EBAS DEP; visually, however, the ROC plot of the GDS was superior. The GDS, the EBAS DEP, and the single question were all valid screening tools for depression in the elderly Chinese population. For busy physicians, there is rationale to first use the single-question test, supplemented where necessary with either the GDS or the EBAS DEP, as an efficient diagnostic strategy for identifying depression amongst older Chinese patients. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Effective presentation of antigens by human leukocyte antigen (HLA) class I molecules to CD8 + T cells is required for viral elimination and generation of long-term immunological memory. In this study, we applied a single-cell, multiomic technology to generate a unified ex vivo characterization of the CD8 + T cell response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across four major HLA class I alleles. We found that HLA genotype conditions key features of epitope specificity, TCRα/β sequence diversity, and the utilization of pre-existing SARS-CoV-2-reactive memory T cell pools. Single-cell transcriptomics revealed functionally diverse T cell phenotypes of SARS-CoV-2-reactive T cells, associated with both disease stage and epitope specificity. Our results show that HLA variations notably influence the CD8 + T cell repertoire shape and utilization of immune recall upon SARS-CoV-2 infection.

A clinical diagnosis of asthma is often considered when a child presents with recurrent cough, wheeze and breathlessness. However, there are many other causes of wheeze in a young child. These range from recurrent viral infections to chronic suppurative lung disease, gastro-oesophageal reflux disease and rare structural abnormalities. Arriving at a diagnosis includes taking into consideration the symptomatology, triggers, atopic features, family history, absence of red flags and therapeutic trial, where indicated.

Primary care practitioners play an important role in administering and advocating childhood vaccination to protect our children against infectious diseases and to ensure herd immunity in our population. Primary care practitioners may encounter children who present out-of-schedule, as well as children who come for vaccination with intercurrent illnesses, egg or other allergies, or are on long-term medications. This article describes the approach to these issues and present useful resources and references that primary care practitioners can access.