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Examines the mechanism of pyruvate in preventing liver damage during hemorrhagic shock. Maintenance of redox state by pyruvate; Prevention of intracellular antioxidants by pyruvate; Decrease of hepatic cellular death.

Epidemiological studies have associated chronic exposure to arsenic (As) from drinking water with increased risk of hypertension. However, evidence of an association between As exposure from food and hypertension risks is sparse. To quantify the association between daily As intake from both food (rice, wheat and potatoes) and drinking water (As water) along with total exposure (As total) and hypertension risks in a study population in Bihar, India, we conducted an individual level cross-sectional analysis between 2017 and 2019 involving 150 participants. Arsenic intake variables and three indicators of hypertension risks (general hypertension, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)) were derived, and any relationship was quantified using a series of crude and multivariable log-linear or logistic regression models. The prevalence of general hypertension was 40% for the studied population. The median level of HDL was 45 mg/dL while median value of LDL was 114 mg/dL. Apart from a marginally significant positive relationship between As intake from rice and the changes of LDL (p-value = 0.032), no significant positive association between As intake and hypertension risks could be ascertained. In fact, As total was found to be associated with lower risks of general hypertension and higher levels of HDL (p-value = 0.020 and 0.010 respectively) whilst general hypertension was marginally associated with lower As water (p-value = 0.043). Due to limitations regarding study design and residual confounding, all observed marginal associations should be treated with caution. • Cross-sectional study of hypertension risks associated with arsenic exposure from food and drinking water. • Total median arsenic intake of 36 µg/day for the study population in Bihar, India. • Total arsenic intake marginally associated with lower risks of general hypertension and higher levels of HDL. • Marginal positive relationship between arsenic intake from rice and level of LDL. • Limitations regarding study design and residual confounding problems should not be neglected. [ABSTRACT FROM AUTHOR]

• Arsenic exposure from wheat is substantial and increasing. • The home-made bread (chapati) contributed most of the wheat intake in Bihar, India. • Arsenic concentration in the wheat flour was not lower than in the grains. • Arsenic exposure from wheat-based food intake is of concern. In arsenic (As) endemic areas of south-east Asia, where a subsistence rice-based diet is prevalent, As exposure from food is mainly focused on rice intake. However, consumption of wheat is substantial and increasing. We present a probabilistic assessment of increased cancer risk from wheat-based food intake in a study population of rural Bihar, India where As exposure is endemic. Total As in wheat grains (43.64 ± 48.19 µg/kg, n = 72) collected from 77 households across 19 villages was found to be lower than reported As in wheat grains from other south-east Asian countries but higher than a previous study from Bihar. This is the first study where As concentration in wheat flour was used for risk estimation, bearing in mind that it was the flour obtained after indigenous household processing of the grains that was used for making the home-made bread (chapati) which contributed 95% of wheat intake for the studied population. Interestingly, while 78% of the surveyed participants (n = 154) consumed rice every day, chapati was consumed every day by 99.5% of the participants. In contrast to previous studies, where As concentration in wheat grains was found to be lower than the flour due to the removal of the bran on grinding, we did not find any appreciable lowering of arsenic in the wheat flour (49.80 ± 74.08 µg/kg, n = 58), most likely due to external contamination during processing and grinding. Estimated gender adjusted excess lifetime cancer risk of 1.23 × 10−4 for the studied rural population of Bihar indicated risk higher than the 10−4–10−6 range, typically used by the USEPA as a threshold to guide regulatory values. Hence, our findings suggest As exposure from wheat-based food intake to be of concern not only in As endemic areas of rural Bihar but also in non-endemic areas with similar wheat-based diet due to public distribution of the wheat across India. [ABSTRACT FROM AUTHOR]

Biochar, a promising carbon-rich and carbon-negative material, can control water pollution, harness the synergy of sustainable development goals, and achieve circular economy. This study examined the performance feasibility of treating fluoride-contaminated surface and groundwater using raw and modified biochar synthesized from agricultural waste rice husk as problem-fixing renewable carbon-neutral material. Physicochemical characterizations of raw/modified biochars were investigated using FESEM-EDAX, FTIR, XRD, BET, CHSN, VSM, pH pzc , Zeta potential, and particle size analysis were analyzed to identify the surface morphology, functional groups, structural, and electrokinetic behavior. In fluoride (Fˉ) cycling, performance feasibility was tested at various governing factors, contact time (0–120 min), initial Fˉ levels (10–50 mg L−1), biochar dose (0.1–0.5 g L−1), pH (2–9), salt strengths (0–50 mM), temperatures (301–328 K), and various co-occurring ions. Results revealed that activated magnetic biochar (AMB) possessed higher adsorption capacity than raw biochar (RB) and activated biochar (AB) at pH 7. The results indicated that maximum Fˉ removal (98.13%) was achieved using AMB at pH 7 for 10 mg L−1. Electrostatic attraction, ion exchange, pore fillings, and surface complexation govern Fˉ removal mechanisms. Pseudo-second-order and Freundlich were the best fit kinetic and isotherm for Fˉ sorption, respectively. Increased biochar dose drives an increase in active sites due to Fˉ level gradient and mass transfer between biochar-fluoride interactions, which reported maximum mass transfer for AMB than RB and AB. Fluoride adsorption using AMB could be described through chemisorption processes at room temperature (301 K), though endothermic sorption follows the physisorption process. Fluoride removal efficiency reduced, from 67.70% to 53.23%, with increased salt concentrations from 0 to 50 mM NaCl solutions, respectively, due to increased hydrodynamic diameter. Biochar was used to treat natural fluoride-contaminated surface and groundwater in real-world problem-solving measures, showed removal efficiency of 91.20% and 95.61%, respectively, for 10 mg L−1 Fˉ contamination, and has been performed multiple times after systematic adsorption-desorption experiments. Lastly, techno-economic analysis was analyzed for biochar synthesis and Fˉ treatment performance costs. Overall, our results revealed worth output and concluded with recommendations for future research on Fˉ adsorption using biochar. • Activated magnetic biochar (AMB) significantly reduces 10 mg L−1 fluoride at pH 7. • Mass transfer rates were analyzed for fluoride-biochar interactions. • Salt strength reduces adsorption due to electrostatic attraction and agglomeration. • Total interaction energies due to biochar-biochar interaction were investigated. • AMB synthesis and treatment costs were 0.01 $ g−1 and 5.96 $ mol−1, respectively. [ABSTRACT FROM AUTHOR]

Cancer patients, due to their immunocompromised status, are at an increased risk for severe SARS-CoV-2 infection. Since severe SARS-CoV-2 infection causes multiple organ damage through IL-6-mediated inflammation while stimulating hypoxia, and malignancy promotes hypoxia-induced cellular metabolic alterations leading to cell death, we propose a mechanistic interplay between both conditions that results in an upregulation of IL-6 secretion resulting in enhanced cytokine production and systemic injury. Hypoxia mediated by both conditions results in cell necrosis, dysregulation of oxidative phosphorylation, and mitochondrial dysfunction. This produces free radicals and cytokines that result in systemic inflammatory injury. Hypoxia also catalyzes the breakdown of COX-1 and 2 resulting in bronchoconstriction and pulmonary edema, which further exacerbates tissue hypoxia. Given this disease model, therapeutic options are currently being studied against severe SARS-COV-2. In this study, we review several promising therapies against severe disease supported by clinical trial evidence—including Allocetra, monoclonal antibodies (Tixagevimab–Cilgavimab), peginterferon lambda, Baricitinib, Remdesivir, Sarilumab, Tocilizumab, Anakinra, Bevacizumab, exosomes, and mesenchymal stem cells. Due to the virus's rapid adaptive evolution and diverse symptomatic manifestation, the use of combination therapies offers a promising approach to decrease systemic injury. By investing in such targeted interventions, cases of severe SARS-CoV-2 should decrease along with its associated long-term sequelae and thereby allow cancer patients to resume their treatments. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is one of the main causes of death and disability in both civilian and military population. TBI may occur via a variety of etiologies, all of which involve trauma to the head. However, the neuroprotective drugs which were found to be very effective in animal TBI models failed in phase II or phase III clinical trials, emphasizing a compelling need to review the current status of animal TBI models and therapeutic strategies. No single animal model can adequately mimic all aspects of human TBI owing to the heterogeneity of clinical TBI. However, due to the ethical limitations, it is difficult to precisely emulate the TBI mechanisms that occur in humans. Therefore, many animal models with varying severity and mechanisms of brain injury have been developed, and each model has its own pros and cons in its implementation for TBI research. These challenges pose a need for study of continued TBI mechanisms, brain injury severity, duration, treatment strategies, and optimization of animal models across the neurotrauma research community. The aim of this review is to discuss (1) causes of TBI, (2) its prevalence in military and civilian population, (3) classification and pathophysiology of TBI, (4) biomarkers and detection methods, (5) animal models of TBI, and (6) the advantages and disadvantages of each model and the species used, as well as possible treatments. [ABSTRACT FROM AUTHOR]

The inadequate availability of fuel substrates and sharp decline in cellular ATP have been implicated in a cascade of events associated with cell death and organ failure during hemorrhagic shock (HS). In this in vivo swine model of severe prolonged HS, the effect of exogenous pyruvate administration on various markers of cell damage in brain and liver was examined. Thirty minutes after the start of controlled arterial hemorrhage, 30% sodium pyruvate, 10% saline, or 0.9% saline was administered via jugular vein. Four hours after the initiation of hemorrhage, tissue samples from brain and liver were obtained and examined for the cellular and molecular markers of cellular damage. Results of our study suggest that pyruvate prevents loss of total NAD content, cleavage of poly-ADP ribose polymerase (PARP), and inhibits lipid peroxidation in both the brain and liver of swine during prolonged severe HS. We conclude that there are multiple mechanisms by which pyruvate can possibly prevent cell damage caused during HS. [Copyright &y& Elsevier]

Extensive evidence of elevated arsenic (As) in the food-chain, mainly rice, wheat and vegetables exists. Nevertheless, the importance of exposure from food towards total As exposure and associated health risks in areas with natural occurring As in drinking water is still often neglected, and accordingly mitigations are largely focused on drinking water only. In this study, the contribution of food over drinking water to overall As exposure was estimated for As exposed populations in Bihar, India. Increased lifetime cancer risk was predicted using probabilistic methods with input parameters based on detailed dietary assessment and estimation of As in drinking water, cooked rice, wheat flour and potato collected from 91 households covering 19 villages. Median total exposure was 0.83 μg/kgBW/day (5th and 95th percentiles were 0.21 and 11.1 μg/kgBW/day) and contribution of food (median = 49%) to overall exposure was almost equal to that from drinking water (median = 51%). More importantly and contrary to previous studies, food was found to contribute more than drinking water to As exposure, even when drinking water As was above the WHO provisional guide value of 10 μg/L. Median and 95th percentile excess lifetime cancer risks from food intake were 1.89 × 10−4 and 7.32 × 10−4 respectively when drinking water As was below 10 μg/L and 4.00 × 10−4 and 1.83 × 10−3 respectively when drinking water As was above 10 μg/L. Our results emphasise the importance of food related exposure in As-endemic areas, and, perhaps surprisingly, particularly in areas with high As concentrations in drinking water – this being partly ascribed to increases in food As due to cooking in high As water. These findings are timely to stress the importance of removing As from the food chain and not just drinking water in endemic areas. Unlabelled Image • Food contributes equally as drinking water towards total As exposure in Bihar, India. • Cooked rice was the most significant As contributor to food exposure. • With increase in As concentrations in drinking water As exposure from food increased. • Median excess lifetime cancer risk of 2 per 10,000, from food As exposure in Bihar. [ABSTRACT FROM AUTHOR]

Introduction: The world is facing the pandemic of COVID-19 caused by the corona virus since December 2019 and has caused millions of death throughout the world. Exposure of nursing students in clinical placement during pandemic is fearful and stressful with high risk of infection which can cause anxiety and different levels of psychological crisis to individuals. The main objective of the study is to find out the prevalence of anxiety among nursing students during clinical placement in the pandemic of COVID-19., Methods: A descriptive cross-sectional study was conducted among 144 nursing students enrolled in different clinical placement of a tertiary hospital of Nepal from 20th January 2021 to 2nd February 2021. Ethical approval was received from the Institutional Review Committee. Demographic, COVID-19 related and Beck Anxiety Inventory questionnaires was used for assessing anxiety. Whole sampling was done. Descriptive statistics was conducted using Statistical Package for the Social Sciences 2016 version., Results: Out of 144 females enrolled in the study, all the nursing students 144 (100%) having clinical placement had anxiety. Among them, 117 (81%) had mild anxiety and 27 (19%) had moderate level of anxiety. All the students used coping strategies for the anxiety. The most commonly used strategy to cope with anxiety was religion (5.03±1.78)., Conclusions: All the nursing students had anxiety during the clinical placement and all the students used the coping strategies for the anxiety. Majority of the nursing students had mild anxiety. Religion was most common method of strategy to cope with anxiety.

Introduction: Medical students tend to have a neutral or negative attitude to Psychiatry as a discipline. This study was initiated to explore the attitude towards mental illness and Psychiatry among the medical students and interns in Kathmandu University School of Medical Sciences., Methods: A cross-sectional questionnaire based study was conducted among the medical students and interns at Dhulikhel Hospital.Two self-rating scales; Attitudes towards Psychiatry-30 and Attitudes to Mental Illnesswere used to assess attitudes towards mental illness and Psychiatryamong the total 159 subjects. Descriptive statistics and independent sample t-test were applied using SPSS- 16 for analysis., Results: Among the total 159 subjects, 44 (27.7%) were interns. Comparison of means of each item in Attitudes towards Psychiatry-30 and Attitudes to Mental Illnesswas done between males and females, medical students and interns, fi rst semester and ninth semester students. Most of the subjects showed neutral attitude towards all the scoring items; though there were a few signifi cant differences in mean scores of some items in group wise comparison., Conclusions: Overall attitudes towards mental illness and psychiatry among the medical students and interns in our medical school were positive or neutral. A further study with medical students from different institutions is needed to get a detail nationwide picture., Keywords: attitude; interns; medical students; mental illness; psychiatry.

Introduction: Consultation-liaison psychiatry is an upcoming field dealing with interdepartmental collaboration heading into multidisciplinary and holistic care. In general hospital setting, psychiatrists need to be involved in evaluation of patients referred from other specialties. This study analyzed the psychiatric morbidity among the inpatients referred to Psychiatry Department from different wards in a Tertiary care University Teaching Hospital., Methods: Total 385 subjects were referred to the Department of Psychiatry from different wards during a period of one year. Each of them underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Psychiatric diagnosis was considered as per International Classification of Disease-10 criteria., Results: The mean age of the subjects evaluated was 37.26 (±1.86); most of them were females 216 (56.4%), married 287 (74.5%), and homemaker 159 (41.3%). Maximum 271 (70.4%) referral was from Medical ward, and most of them 292 (75.8%) were admitted in general bed. The most common medical diagnosis was self-poisoning 115 (30.6%) followed by alcoholic liver disease 49 (12.7%); while the commonest 123 (31.9%) psychiatric diagnosis was depression (including Dysthymia and Adjustment disorder). Depression remained the commonest diagnosis among those referred from medical ward 131 (34.7%); while anxiety was mostly found in the emergency referral 94 (24.5%). Significant Correlation (P <0.05) was seen between the source of referral and Psychiatric diagnosis., Conclusions: Psychiatric consultation was sought mostly by medical ward that had maximum number of patients presenting with self-poisoning. The commonest diagnosis seen in the referred in-patients was depression and anxiety disorder.

This study was conducted to asses the level of social support amongst the patients of disthymia and unipolar depression. A total of 80 patients with their spouses were included. Results showed no significant differences of social support in this study group. Spouses of patients with unipolar depression with psychotic features perceived lower social support compared with the spouses of unipolar depression without psychotic features. The severity of unipolar depression of the patients correlated negatively with the perceived social support of the spouses.