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Spinal cord injury (SCI) and amyotrophic laterals sclerosis (ALS) are devastating neurological conditions that affect individuals worldwide, significantly reducing quality of life, both for patients and their relatives. Objective : The present review aims to summarize the multiple restorative approaches being developed for spinal cord repair, the use of different stem cell types and the current knowledge regarding stem cell therapy. Method : Review of the literature from the past 10 years of human studies using stem cell transplantation as the main therapy, with or without adjuvant therapies. Conclusion : The current review offers an overview of the state of the art regarding spinal cord restoration, and serves as a starting point for future studies.

Pigment epithelium derived factor (PEDF) exerts trophic actions to motoneurons and modulates nonneuronal restorative events, but its effects on neuroplasticity responses after spinal cord (SC) injury are unknown. Rats received a low thoracic SC photothrombotic ischemia and local injection of PEDF and were evaluated behaviorally six weeks later. PEDF actions were detailed in SC ventral horn (motor) in the levels of the lumbar central pattern generator (CPG), far from the injury site. Molecules related to neuroplasticity (MAP-2), those that are able to modulate such event, for instance, neurotrophic factors (NT-3, GDNF, BDNF, and FGF-2), chondroitin sulfate proteoglycans (CSPG), and those associated with angiogenesis and antiapoptosis (laminin and Bcl-2) and Eph (receptor)/ephrin system were evaluated at cellular or molecular levels. PEDF injection improved motor behavioral performance and increased MAP-2 levels and dendritic processes in the region of lumbar CPG. Treatment also elevated GDNF and decreased NT-3, laminin, and CSPG. Injury elevated EphA4 and ephrin-B1 levels, and PEDF treatment increased ephrin A2 and ephrins B1, B2, and B3. Eph receptors and ephrins were found in specific populations of neurons and astrocytes. PEDF treatment to SC injury triggered neuroplasticity in lumbar CPG and regulation of neurotrophic factors, extracellular matrix molecules, and ephrins.

The effect of alkaline earth oxide on sodium tetraborate was analyzed by fabricating a range of glasses depicted by the formula x MgO-(40-x)ZnO-59.5Na 2 B 4 O 7 -0.5MnO 2. Basic character was analyzed and confirmed by XRD tests.Decline in density is attributed to the replacement of high molecular mass ZnO by a relatively less molecular mass MgO. The volume enlargement is discussed in terms of increased bond lengths and induced non- bridging oxygen atoms. Parameters like refractive index, reflection loss, molar refractivity, electron polarizability are obtained from existing relations. All these are indirectly depends on density and molar volume and hence their nature. Optical studies revealed indirect kind of transitions in these glasses ranging the values of optical energy gap between 2.913–3.15 eV and Urbach energy (ΔE) 0.342–0.276 eV showing greater stability of glasses.Mn2 +ion in its d5 state revealed a well resolved sextet centered around g"2.032 indicating Mn2+ ions are in octahedral (Oh) environment resulted from jumps between lower doublet energy states. The resonance of g≈ 2.99 and g≈ 4.22 are related to rhombic surroundings of the Mn2+ and jumps between middle kramers doublets. The value of hyperfine split 'A′ and Δg= (g e -g) are indicative of ionic bonding between Mn2 + ions and oxygens. Zero field splitting parameter 'D′ decreases from x = 0 to x = 30 mol% and then increased for x = 40 mol%. Magnitude of unpaired spins(N) participating in the resonance and paramagnetic susceptibility(c) are calculated. FTIR and Raman studies are conducted. FTIR spectra revealed the structural changes from BO 4 to BO 3 by increasing MgO content. From FTIR and Raman studies it is established that MgO is acting as modifier in the given glass composition. • Zinc sodium tetraborate glasses doped with manganese ions. • Density of the glass samples decreased with MgO content. • The EPR hyperfine distribution centered on g ∼2.032 is associated with Mn2+ in an octahedral environment with low distortion. • FT-IR spectroscopy of the fabricated samples refers to the transformation of the structural unit BO 4 into BO 3. • Raman spectroscopy suggested that at higher wavenumber, B –O stretching in metaborate groups in [BO 3 ] observed with one or two NBO's. [ABSTRACT FROM AUTHOR]

Pneumonia is one of the most deadly diseases, especially for children below 5 years of age. To detect pneumonia radiologists, have to observe the chest x-ray and he/she has to update the doctor correctly which sometimes may not be accurate due to human error. The main objective of this paper is to identify if the person has Pneumonia or not with high accuracy. Automated diagnosis of pneumonia can be done with the help of CNN and Transfer Learning Approaches so that the person can get treatment as early as possible. The dataset used here is the chest X-ray (CXR) dataset based on a chest X-Ray scan database from paediatric patients from one to five years of age at the Guangzhou Women and Children’s Medical Centre. Deep Learning (CNN) and Transfer Learning Techniques along with Ensemble Learning have been implemented concluded that CNN achieved an accuracy of 89%, the Transfer Learning model achieved an accuracy of 93% and the ensemble model got an accuracy of 92%. Even though the highest accuracy is for the Transfer Learning model, considering all the other metrics like Recall, Support, and score, Ensemble has exhibited the best results.

A series of N-[2-(4-methoxyanilino)-5-(3,4,5-trimethoxyphenyl)pyridin-3-yl]benzamides have been synthesized, and their structure was confirmed by 1H and 13C NMR and mass spectral data. The synthesized compounds were tested for their anticancer activity against four human cancer cell lines such as MCF-7 (breast), A549 (lung), DU-145 (prostate), and MDA MB-231 (breast) by MTT assay using etoposide as standard drug. All compounds showed moderate to good activity compared to the standard drug; the most potent were those containing methoxy and nitro groups in the benzamide moiety. [ABSTRACT FROM AUTHOR]

Kinetics and mechanism of purine-based alkaloids like caffeine, theobromine, and theophylline, have been studied using Mn (III) sulfate as an efficient reagent in an aqueous sulfuric acid medium. Progress of the reaction is for the oxidation of xanthine alkaloids has been studied at 520 nm wavelength (λ). Reactions indicated first-order kinetics in [Mn (III)], and [xanthine alkaloid]. Reaction rates accelerated with an increase in acid concentration and temperature. Eyring’s and Gibbs- Helmholtz equations were used for the calculation of activation parameters. Observed rate enhancements herein, are analyzed by Zucker-Hammett, Bunnett, and Bunnett-Olsen criteria of acidity functions. The results found as per Bunnett-Olsen criteria of acidity functions, the most plausible mechanism has been proposed by considering the participation of H2O molecule, as a proton transferring agent in RD (Rate Determining) step. [ABSTRACT FROM AUTHOR]

Abstract EPR parameters and the local configurations of the transition metal (TM) ions VO2+ and Cu2+ in BaO-TeO 2 -B 2 O 3 glasses were experimentally evaluated and also theoretically verified. From the recorded X-band EPR spectra the spin-Hamiltonian parameters (SHP) were determined. The optical spectra of vanadium doped glass samples revealed a single absorption band at 596 nm which was assigned to 2B 2g → 2B 1g transition, whereas copper doped glasses revealed two absorption bands around 818 and 602 nm which were assigned to 2B 1g → 2B 2g and 2B 1g → 2E 2g transitions respectively. Theoretical studies were accomplished on the EPR and optical factors from perturbation theory. It was observed from both the experimental and theoretical SHP values of vanadium containing glasses that the VO2+ ions are in tetragonally compressed octahedral sites with d xy (2B 2g) ground state, while the copper containing glasses found to be in tetragonally elongated octahedral sites with d x 2 − y 2 (2B 1g) as the ground state. It is found that the magnitude of the relative tetragonal compression ratio (φ) of vanadium ion is less than the relative tetragonal elongation ratio (τ) of copper ion. The nature of the bonding between TM ions (i.e. vanadium and copper) and their ligands was assessed. Theoretical and experimental EPR parameters are in great concurrence with each other. Graphical abstract Local structures of the VO2+ and Cu2+ ion complexes in BTB glasses. Image 1 Highlights • Experimentally evaluated SHP values theoretically verified. • Theoretical studies were carried out from perturbation theory. • The nature of bonding between TM ions and their ligand was assessed. • The relative tetragonal distortion ratio of VO2+ ion is less than Cu2+ ion. [ABSTRACT FROM AUTHOR]

Abstract Strontium alumino borate glasses doped with Mn2+ ions (SABM) have been prepared and characterized by XRD, density, Electron paramagnetic resonance (EPR), FT-IR and Raman to investigate the spectral and physical properties of the present glass samples. The FTIR spectra revealed the presence of BO 3 and BO 4 structural units in SABM glasses. The IR peak at ~467 and ~679 cm−1 assigned as the vibration of metal cations (Sr2+), Mn O bond vibrations and bending vibration of Al O in [AlO 4 ] units. The Raman band ~786 cm−1 establishes the presence of AlO 4 units. It has been found that an increasing the Al 2 O 3 content increases the bond length of the Al O bond in AlO 4 which leads to increase molar volume and decrease density. Differential scanning calorimetry (DSC) studies indicated that the glass transition temperature (T g) decreases with increase of Al 2 O 3. Evaluated g and A values from EPR spectra gave the conformation about the ionic bonding between the Mn2+ and its neighbouring oxygen ions. Graphical Abstract Unlabelled Image Highlights • Strontium alumino borate glasses doped with Mn2+ ions (SABM) were prepared. • The decrease of glass transition temperature (T g) was ascribed to the formation NBO's. • EPR measurements confirmed the ionic bonding between Mn2+ ion and its surrounding ligands. • FTIR and Raman spectra were measured to investigate BO 3 , BO 4 and AlO 4 units. [ABSTRACT FROM AUTHOR]

The glass samples were prepared in accordance with the formula: (30-x)SrO-xAl2O3- 69.8B2O3-0.2Cr2O3(0 ≤ x ≤ 15 mol%) by melt quenching method. The absence of Bragg's peaks confirmed the amorphous nature of the prepared glass samples. It was observed that the molar volume was increasing while the density is decreasing with increasing of Al2O3 content. Optical absorption study was performed to evaluate the optical bandgap, oxygen packing density, ionic packing density and Urbach energies. The Racah parameters (B and C) and Dq/B ratio have been calculated. Fourier transform infrared (FTIR) spectra recorded in the region from 400-1600 cm-1 at room-temperature (RT) confirmed the formation of BO3, BO4 and AlO4 groups upon the addition of strontium oxide as modifier. The Raman spectra of all the glasses recorded over continuous spectral range 200-1600 cm-1 exhibited different spectral bands. The EPR spectra recorded at 9.7 GHz (X-band frequency) have four resonance signals. The signal at g ≈ 5:33 is due to Cr3+ ion sites of rhombic symmetry and signal at g ≈ 1:97 is due to contribution from Cr3+ and Cr5+ ion pairs. [ABSTRACT FROM AUTHOR]

Boro-bismuth glasses containing BaO-TeO 2 in varying proportions were prepared by the conventional melt quenching method. One mol% of CuO was integrated as the spin probe to the glass systems. The prepared glasses were transparent, bubble-free and light blue in color. The optical absorption spectra revealed two absorption bands corresponding to the transitions 2 B 1g → 2 B 2g and 2 B 1g → 2 E 2g respectively. A large anisotropy (Δ g  =  g ∥  −  g ⊥ ) due to the distortion around the Cu 2+ site by the ligands was observed. Experimental and theoretical EPR results have shown that g ∥  >  g ⊥  >  A ⊥ g e (=2.0023) and A ∥ > A ⊥ . The ligand field around Cu 2+ ions is tetragonally elongated octahedral with d x 2 − y 2 ( 2 B 1g ) ground state. The decreased peak-to-peak linewidth (ΔB) with increasing BaO content is attributed to decrease in dipolar interaction between the copper ions. The number of EPR active copper ions (N) and the paramagnetic susceptibility ( χ ) were computed. EPR and optical data were used to τ σ determine the bonding parameters α 2 , β 2 , β 1 2 and τ π Theoretical investigations were performed using the high order perturbation formulae for 3d 9 ions in tetragonally elongated octahedra to determine the spin-Hamiltonian parameters (SHP) and d–d transition bands. The variation of BaO content in the glass matrix had affected the orbital reduction factor, spin-orbit coupling coefficient, cubic and tetragonal field parameters. The Cu 2+ -O 2− octahedron experiences 0.50% elongation along C 4 axis. The theoretical and experimental results are well in coincidence within the error limits. [ABSTRACT FROM AUTHOR]

A series of novel 4-{4-(methylamino)thieno[3,2- d]pyrimidin-2-yl}benzohydrazide derivatives were synthesized and evaluated for their antibacterial activity. Most of the compounds demonstrated high activity towards Escherichia coli, Pseudomonas, Staphylococcus aureus, and Bacillus. Structures of all synthesized compounds were confirmed by spectral analysis. [ABSTRACT FROM AUTHOR]

Mixed alkali alkaline earth oxide borate glasses of the composition (25 - x)LiO- xKO-12.5BaO-12.5MgO-49BO-1CuO ( x = 0, 5, 10, 15 and 20 mol %) were prepared by the melt quenching technique. The X-ray diffractograms of all the glass samples were recorded at room temperature. Peak free X-ray spectra revealed the amorphous nature of all the prepared glasses. Modulated differential scanning calorimetry (MDSC) was used to determine the glass-transition temperature ( T). The probable mixed alkali effect was investigated using experimental techniques like density, molar volume, MDSC, electron paramagnetic resonance (EPR), and optical absorption studies. From the EPR spectra the spin-Hamiltonian parameters were evaluated. The spin-Hamiltonian parameter values indicated that the ground state of $$C{u^{2 + }}is{\kern 1pt} {d_{{x^2} - {y^2}}}$$ orbital (B) and the site symmetry around Cu is tetragonally distorted octahedral. The variation of g and A as a function of LiO content was found to be nonlinear. A broad optical absorption band was observed in all the glasses containing Cu ions corresponding to B → B transition. From the optical absorption studies the values of the optical band gap ( E) for indirect, direct transitions and Urbarch energy (Δ E) have been evaluated. By co-relating the EPR and optical absorption data, bonding parameters α, β and β were evaluated. [ABSTRACT FROM AUTHOR]

• Increasing the SrO concentration affects the number of Cu2+ ions (spins). • Optical absorption studies confirm the existence of Cu2+ions. • SHP values endorse the site symmetry around Cu2+ ions is tetragonally distorted (D 4h) octahedral site. • The bond parameters of STTBC glasses are mostly ionic. • The incorporation of modifier oxide SrO in place of TeO 2 increase in BO 4 population. A new glass series of strontium tellurite boro-titanate glasses doped with Cu2+ ions were prepared with the composition (30-x)SrO-xTeO 2 –10TiO 2 –59B 2 O 3 –1CuO [STTBC] (where x = 5,4,3,2&1 mol%) using the melt quenching technique. The effect of varying the mol% of SrO and TeO 2 on the physical and spectroscopic properties were investigated. XRD, SEM, EDS, UV–VIS, EPR and FTIR analysis were carried out to observe changes in the STTBC glass structure. From the optical absorption data the cut-off wave length, the optical band gap, Urbach energy values, etc., were calculated. The electron paramagnetic resonance (EPR) spectra (experimental & theoretical) of these glasses were extensively studied by deriving the spin-Hamiltonian parameters, bonding coefficients, paramagnetic susceptibility and crystal-field parameters etc. The higher order perturbation approach is employed to study the interaction between the ligand and the central Cu2+ ion. [ABSTRACT FROM AUTHOR]

In this paper the studies on xMO-10Li 2 O-10Na 2 O–10K 2 O-(70-x)B 2 O 3 [M=Mg, Sr and Ba] [x = 2, 4, 6, 8 and 10 mol%] glasses doped with manganese ions are reported. The physical and spectroscopic properties were investigated to know about the influence of the alkaline ions. The density values of all the glasses were found to increase with increasing alkaline earth oxide content while the values of molar volume were decreasing. The UV–VIS spectra of these glasses have shown single broad band which was assigned to the 6A 1 g (S) → 4T 1 g (G) transition. The non-linear variation of the optical band gap with the increase of alkaline earth oxides suggests non-linear variation in the number of non-bridging oxygens. The EPR spectra demonstrated a predominant sextet hyperfine structure located around g = 2.0 which were ascribed to the octahedral symmetric octahedral Mn2+ ions. From the hyperfine splitting parameters (A avg), it was noticed that the environment around Mn2+ ions is ionic. The number of spins participated in resonance (N) and magnetic susceptibility (χ) values were evaluated taking the high field g-values (g ≈ 2.0). It is interesting to note that, the observed zero field splitted (ZFS) values (D) are varying non-linearly with the glass compositions and their values were increasing with the substitution of alkaline earth ions from Mg to Ba. The FTIR spectra of the glasses were analyzed in the range 400–2200 cm–1 to investigate the structural changes in the glass network. • Mixed alkali-alkaline earth oxide borate glasses were prepared by conventional melt-quench technique. • XRD, UV–Vis, EPR and FTIR were used to reveal the structure-function of glasses. • UV–Vis and EPR show that the manganese coexistence of Mn2+ and Mn3+. • The remarkable features of these glasses using as cathodes of Li-ion batteries. [ABSTRACT FROM AUTHOR]

A set of sodium tetra borate glasses doped with Cu2+ ions, with formula xCaO-(40-x)ZnO-59Na 2 B 4 O 7 -1CuO where x=0, 10, 20, 30 & 40 mol% were successfully prepared. The decrease in the density values of the glasses with the composition revealed the conversion of BO 4 to BO 3 units. Several physical and optical parameters were evaluated using density and optical absorption spectra. Of the expected four parallel and perpendicular resonance signals, three signals were clearly resolved in the EPR spectra, the fourth parallel component merged with the perpendicular ones. The spin-Hamiltonian parameter values confirmed the Cu2+ ions are in tetragonally distorted in octahedral sites. Deconvoluted spectra were drawn to extract the hidden peak positions in the FTIR and Raman spectra and residue graphs were used to find their accuracy. The fraction of BO 4 groups (N 4) values was calculated from the FTIR spectra and the N 4 values supported the conversion of BO 4 to BO 3 units. [ABSTRACT FROM AUTHOR]

Physical and spectral studies of vanadium doped strontium titanium boro-tellurite glasses have investigated by XRD, SEM, optical, EPR & FTIR spectroscopies. The optical absorption spectra demonstrate two transitions related to 2B 1g → 2B 2g and 2B 1g → 2E 2g energies, which are characteristic features of VO2+ ions. From the optical edge and Tauc relation, the Urbach energies and optical band gap values have calculated. The X-band EPR spectra (experimental and simulated) confirms the non-linear variation of the ligand field around the V4+ ions. From perturbation theory, the theoretical Hamiltonian parameters have been calculated and compared with experimental EPR results. FTIR spectroscopy is evident that the role of SrO on the local structure of strontium titanium boro-tellurite glasses containing vanadium ions. [ABSTRACT FROM AUTHOR]

Barium-titanium-boro-tellurite glasses containing the transition metal (TM) Cr3+ ions with different BaO mol% were prepared using the melt quenching method. From the XRD, SEM and EDS studies, it was confirmed that the prepared glasses were impurity-free and their atomic arrangement is non-crystalline in nature. The UV–visible spectra exhibited a dominant high absorption band corresponding to the enrgy of ~15974 cm−1 and three weak low-intensity bands around 23641 cm−1, 14881 cm−1 and 14306 cm−1. The identified bands are assigned to 4A 2g →4T 2g (F), 4A 2g →4T 1g (F), 4A 2g →2T 1g (G) and 4A 2g →2E g (G) transitions respectively. The optical band gap values are increasing while the refractive index values are decreasing with increasing BaO content. The crystal-field parameter Dq values and Racah parameter (B) values were found to change non-linearly with the barium oxide content which suggests a change in the environment around Cr3+ ions. From the value of Dq/B, it can be concluded that the Cr3+ ions are localized in the weak crystal field sites. The EPR spectra which were recorded at X-band frequencies exhibited four resonance signals at g 1 ≈ 1.97, g 2 ≈ 2.38, g 3 ≈ 4.25 and g 4 ≈ 5.23. The theoretical g-values were evaluated from the Macfarlane's perturbation formulae. The FTIR and Raman spectra show broad peaks which are the characteristic features of the prepared glass component vibrating modes. • Incorporation of BaO into host glass decreases the boron-boron separation portrays structural changes. • Optical studies confirms the Cr3+ ions are localized in the weak crystal field sites. • There is great concurrence between experimental and theoretical g-values. • Numbers of BO 4 units are increasing with addition of BaO. • Low intense BO 3 linked to BO 4 units are shifting to higher energy region. [ABSTRACT FROM AUTHOR]

Bluish coloured glasses are obtained from the composition PbCl2-PbO-B2O3 doped with Cu2+ ions. Basic physical properties and spectroscopic studies (optical absorption, electron paramagnetic resonance, Fourier transform infrared and Raman spectroscopies) were carried out on these samples. The increase in PbCl2 content resulted in the decrease in density and increase in molar volume. At optical frequencies, band gaps and Urbach energies were evaluated and their variation is explained. Spin-Hamiltonian parameters (SHP) obtained from the EPR spectra suggest that the ligand environment around Cu2+ is tetragonally distorted octahedral sites and the orbital dx2-y2 is the ground state. The characteristics broad bands in the optical absorption spectra are assigned to the 2B1g→2B2g transition. The bonding coefficient values were evaluated using optical data and SHP. FTIR studies suggested that the glass structure is built up of BO3 and BO4 units. The presence of diborate, pyroborate, pentaborate groups, etc. in the glass network was confirmed from Raman spectra. [ABSTRACT FROM AUTHOR]

Introduction: 2,4-dinitrophenol (DNP) is a mitochondrial toxin sometimes used as a weight loss agent. Reports of fatalities from DNP have been increasing since 2000, suggesting an increase in use. Our understanding of DNP toxicity in humans comes from reports to Poison Control and postmortem analyses, sources that are biased to more extreme presentations. This leads to a gap in our knowledge about the adverse effects of DNP at nonlethal doses. Here we investigate the doses and effects of DNP as reported online., Methods: We analyzed publicly available Internet posts that we collected from 2017-2019. The posts came from anonymous users or users who voluntarily self-identified. We collected data from websites whose terms of use allow for the secondary analysis of data that their users agree to make public. We used natural language processing techniques that we had previously developed to extract doses, effects, and substances mentioned in each post., Results: We collected 1,630 posts across 5 online forums and the Reddit forum r/DNP. The posts were from 1,234 unique usernames. The most commonly reported doses were between 150 to 300 mg each day followed by 300 to 450 mg each day. At those doses, the most reported adverse effects were profuse sweating and fatigue. Reports of thermoregulatory (sweating, feeling hot flashes or flushed), fatigue-related, and neurologically related symptoms were statistically significantly more frequent at reported daily doses greater than 150 mg than doses below 150 mg (post-hoc χ2-test with Bonferroni correction). The effects were judged as plausible by two board-certified medical toxicologists. Triiodothyronine, clenbuterol, testosterone, and trenbolone, an androgenic anabolic steroid were the most significantly co-mentioned substances., Conclusions: Fatigue, increased body temperature, and paresthesias from DNP are reported more frequently at doses greater than 150 mg each day than at doses less than 150 mg each day. Online discussions of DNP frequently mention androgenic anabolic steroids and other weight loss agents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Abdelati et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The presentation of abstracts at scientific meetings is an important step in the dissemination of scientific discovery. Most scientific meetings recruit volunteer experts to evaluate and score submitted abstracts to determine which ones qualify for presentation. Reviewing an abstract is an important service to one's specialty, but there is typically no formal training or required instruction during medical toxicology fellowship on scientific abstract scoring. In order to provide structured training in abstract review, the American College of Medical Toxicology (ACMT) Research Committee launched the Annual Scientific Meeting (ASM) Abstract Review Mentor program in 2021. The goals of this program were to train fellows how to score scientific abstracts and provide them with new mentor connections to toxicologists outside of their training program. After evaluating 3 years of data from participating fellows-in-training and faculty mentors, we conclude that ACMT's Abstract Review Mentor program was successful in training future reviewers and fostering external mentorship relationships. All participants reported their experience in this program will change how they submit future abstracts to scientific meetings, help their future service as an abstract reviewer, and motivate their involvement in other specialty-related research activities. Implementing an abstract review training program is sustainable and a vital strategy for enhancing the dissemination of scientific discovery and training the next generation of medical toxicology researchers., (© 2023. American College of Medical Toxicology.)

SARS-CoV-2 emerged in December 2019 and led to the COVID-19 pandemic. Efforts to develop therapeutics have led to innovations such as mRNA vaccines and oral antivirals. Here we provide a narrative review of the biologic therapeutics used or proposed to treat COVID-19 during the last 3 years. This paper, along with its companion that covers xenobiotics and alternative remedies, is an update to our 2020 paper. Monoclonal antibodies prevent progression to severe disease, are not equally effective across variants, and are associated with minimal and self-limited reactions. Convalescent plasma has side effects like monoclonal antibodies, but with more infusion reactions and less efficacy. Vaccines prevent progression for a larger part of the population. DNA and mRNA vaccines are more effective than protein or inactivated virus vaccines. After mRNA vaccines, young men are more likely to have myocarditis in the subsequent 7 days. After DNA vaccines, those aged 30-50 are very slightly more likely to have thrombotic disease. To all vaccines we discuss, women are slightly more likely to have an anaphylactic reaction than men, but the absolute risk is small., (© 2023. American College of Medical Toxicology.)

Introduction: Lipid emulsion therapy (LET) has been most thoroughly studied to reverse local anesthetic systemic toxicity (LAST). Case reports suggest that LET can successfully rescue cardiovascular collapse from bupropion, amitriptyline, and propranolol. The efficacy of LET against refractory hypotension and dysrhythmias from diphenhydramine, a commonly ingested lipophilic cardiotoxic agent, is less well described., Objective: Summarize the evidence that LET rescues cardiac ion channel blockade (QRS, QTc widening) or hypotension attributable to diphenhydramine overdose., Methods: We searched MEDLINE, EMBASE, and Google Scholar for English-language full-length case reports of diphenhydramine (DPH) intoxication in patients 17 years of age or older. We extracted data with a PRISMA-compliant protocol, dividing the case reports into two groups, one that received LET and one that did not. We performed a pooled analysis to compare the change in mean arterial pressure (MAP), QRS duration, and QTc duration between the two groups., Results: We identified 23 reports (25 patients). Lipid emulsion therapy (LET) was used in 6 cases because the patient suffered from hypotension refractory to traditional resuscitation. Those who received LET and those who did not were comparable in age, gender, amount ingested, and frequency of seizures. The mean arterial pressure (MAP) decreased by 4.5 ± 11.5 mm Hg in those who did not receive LET compared to an increase in MAP 37 ± 17.5 mm Hg in those who did receive LET. The QRS narrowed by 29 ± 33.9 ms (no LET group) vs 68 ± 49.5 ms (LET group) and QTc by 168.5 ± 126.75 ms (no LET group) vs 134 ± 88 ms (LET group). All values are expressed as median ± interquartile range. One out of the 6 patients who received LET died after withdrawal of care. In the group that did not receive LET 4 out of 19 died and 3 had no outcome reported., Discussion: LET may improve MAP in patients with hypotension refractory to vasopressors due to diphenhydramine toxicity. We found no significant effect of LET on QRS or QTc duration. These results are limited by a small sample size, reporting bias of case reports, incomplete data, and heterogeneity., Conclusion: An analysis of pooled case reports suggests that LET may rescue hypotension when other methods have failed in patients with hypotension attributable to diphenhydramine overdose.

Introduction: Medical toxicology is the clinical specialty that treats the toxic effects of substances, for example, an overdose, a medication error, or a scorpion sting. The volume of toxicological knowledge and research has, as with other medical specialties, outstripped the ability of the individual clinician to entirely master and stay current with it. The application of machine learning/artificial intelligence (ML/AI) techniques to medical toxicology is challenging because initial treatment decisions are often based on a few pieces of textual data and rely heavily on experience and prior knowledge. ML/AI techniques, moreover, often do not represent knowledge in a way that is transparent for the physician, raising barriers to usability. Logic-based systems are more transparent approaches, but often generalize poorly and require expert curation to implement and maintain., Methods: We constructed a probabilistic logic network to model how a toxicologist recognizes a toxidrome, using only physical exam findings. Our approach transparently mimics the knowledge representation and decision-making of practicing clinicians. We created a library of 300 synthetic cases of varying clinical complexity. Each case contained 5 physical exam findings drawn from a mixture of 1 or 2 toxidromes. We used this library to evaluate the performance of our probabilistic logic network, dubbed Tak, against 2 medical toxicologists, a decision tree model, as well as its ability to recover the actual diagnosis., Results: The inter-rater reliability between Tak and the consensus of human raters was κ = 0.8432 for straightforward cases, 0.4396 for moderately complex cases, and 0.3331 for challenging cases. The inter-rater reliability between the decision tree classifier and the consensus of human raters was, κ = 0.2522 for straightforward cases, 0.1963 for moderately complex cases and 0.0331 for challenging cases., Conclusions: The software, dubbed Tak, performs comparably to humans on straightforward cases and intermediate difficulty cases, but is outperformed by humans on challenging clinical cases. Tak outperforms a decision tree classifier at all levels of difficulty. Our results are a proof-of-concept that, in a restricted domain, probabilistic logic networks can perform medical reasoning comparably to humans., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers' age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women's performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance., Competing Interests: The authors have declared that no competing interests exist.

Objective/Background : Poorer executive function (EF) has been implicated in the etiology of negative parenting (e.g., harsh, reactive, intrusive). EF may be affected by good or poor quality sleep, and thus sleep may be involved in negative parenting. In the current exploratory study, we investigated the additive and interactive effects of maternal EF and sleep indicators in the statistical prediction of negative parenting. Patients/Methods : A sample of 241 mothers of 2.5-year-olds (51% girls) completed questionnaires, wore wrist actigraphs for one week, and completed several EF tasks during a laboratory visit. Results/Conclusions : We found that sleep activity (e.g., nighttime waking and movements) interacted with EF in predicting negative parenting practices, such that poorer EF was linked with more negative parenting only in the context of higher levels of night waking. Sleep duration also interacted with EF, such that EF and parenting were no longer associated when sleep durations were short. The findings have implications for incorporating sleep into our understanding of maternal cognitive self-regulation and harsh parenting during early childhood development.

Hsp90, as a key molecular chaperone, plays an important role in modulating the activity of many cell signaling proteins and is an attractive target for anticancer therapeutics. Herein, we report the discovery of N-pyridoyl-Δ 2 -pyrazoline analogs as novel Hsp90 inhibitors by integrated approaches of drug design, organic synthesis, cell biology, and qualitative proteomic analysis. Novel chemical compounds were designed and optimized in the adenosine triphosphate-binding site of Hsp90; lead optimized compounds were found to have significant interactions with Asp93 and other amino acids crucial for Hsp90 inhibition. The designed compounds were synthesized by a two-step procedure; different aromatic aldehydes were reacted with various acetophenones to form substituted 1,3-diphenyl-prop-2-enones (Ic-Io), which upon reaction with isonicotinic acid hydrazide in the presence of glacial acetic acid form N-pyridoyl-Δ 2 -pyrazoline compounds (PY1-PY13). Compounds PY3, PY2, and PY1 were identified as potential leads amongst the series, with promising anticancer activity against human breast cancer and melanoma cells, and the ability to inhibit Hsp90 similar to radicicol by drug-affinity responsive target stability proteomic analysis in a whole-cell assay., (© 2019 Deutsche Pharmazeutische Gesellschaft.)

Neuropathic pain after spinal cord injury (SCI) is a complex condition that responds poorly to usual treatments. Cell transplantation represents a promising therapy; nevertheless, the ideal cell type in terms of neurogenic potential and effectiveness against pain remains largely controversial. Here, we evaluated the ability of fetal neural stem cells (fNSC) to relieve chronic pain and, secondarily, their effects on motor recovery. Adult Wistar rats with traumatic SCI were treated, 10 days after injury, with intra-spinal injections of culture medium (sham) or fNSCs extracted from telencephalic vesicles (TV group) or the ventral medulla (VM group) of E/14 embryos. Sensory (von Frey filaments and hot plate) and motor (the Basso, Beattie, Bresnahan locomotor rating scale and inclined plane test) assessments were performed during 8 weeks. Thereafter, spinal cords were processed for immunofluorescence and transplanted cells were quantified by stereology. The results showed improvement of thermal hyperalgesia in the TV and VM groups at 4 and 5 weeks after transplantation, respectively. Moreover, mechanical allodynia improved in both the TV and VM groups at 8 weeks. No significant motor recovery was observed in the TV or VM groups compared with sham. Stereological analyses showed that ~70% of TV and VM cells differentiated into NeuN + neurons, with a high proportion of enkephalinergic and GABAergic cells in the TV group and enkephalinergic and serotoninergic cells in the VM group. Our study suggests that neuronal precursors from TV and VM, once implanted into the injured spinal cord, maturate into different neuronal subtypes, mainly GABAergic, serotoninergic, and enkephalinergic, and all subtypes alleviate pain, despite no significant motor recovery. The study was approved by the Animal Ethics Committee of the Medical School of the University of São Paulo (protocol number 033/14) on March 4, 2016., Competing Interests: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Importance: Pediatric health care contacts due to cannabis exposure increased in Colorado and Washington State after cannabis (marijuana) policies became more liberal, but evidence from other US states is limited., Objective: To document the incidence of pediatric cannabis exposure cases reported to the Regional Center for Poison Control and Prevention (RPC) before and after medical marijuana legalization (MML) in Massachusetts., Design, Setting, and Participants: Cross-sectional comparison of pediatric cannabis exposure cases 4 years before and after MML in Massachusetts. The exposure cases included those of 218 children and teenagers aged between 0 and 19 years, as reported to the RPC from 2009 to 2016. Census data were used to determine the incidence. Data analysis was performed from November 12, 2018, to July 20, 2019., Exposure: Cannabis products., Main Outcomes and Measures: Incidence of RPC-reported cannabis exposure cases, both single substance and polysubstance, for the age group of 0 to 19 years, and cannabis product type, coingestants, and clinical effects., Results: During the 8-year study period (2009-2016), the RPC received 218 calls involving cannabis exposure (98 single substance, 120 polysubstance) in children and teenagers aged 0 to 19 years, representing 0.15% of all RPC calls in that age group for that period. Of the total exposure cases, males accounted for 132 (60.6%) and females 86 (39.4%). The incidence of single-substance cannabis calls increased from 0.4 per 100 000 population before MML to 1.1 per 100 000 population after (incidence rate ratio, 2.4; 95% CI, 1.5-3.9), a 140% increase. The age group of 15 to 19 years had the highest frequency of RPC-reported cannabis exposures (178 calls [81.7%]). The proportion of all RPC calls due to single-substance cannabis exposure increased overall for all age groups from 29 before MML to 69 afterward. Exposure to edible products increased after MML for most age groups., Conclusions and Relevance: Pediatric cannabis exposure cases increased in Massachusetts after medical marijuana was legalized in 2012, despite using childproof packaging and warning labels. This study provides additional evidence suggesting that MML may be associated with an increase in cannabis exposure cases among very young children, and extends prior work showing that teenagers are also experiencing increased cannabis-related health system contacts via the RPC. Additional efforts are needed to keep higher-potency edible products and concentrated extracts from children and teenagers, especially considering the MML and retail cannabis sales in an increasing number of US states.

Natural language processing (NLP) aims to program machines to interpret human language as humans do. It could quantify aspects of medical education that were previously amenable only to qualitative methods. The application of NLP to medical education has been accelerating over the past several years. This article has three aims. First, we introduce the reader to NLP. Second, we discuss the potential of NLP to help integrate FOAM (Free Open Access Medical Education) resources with more traditional curricular elements. Finally, we present the results of a systematic review. We identified 30 articles indexed by PubMed as relating to medical education and NLP, 14 of which were of sufficient quality to include in this review. We close by discussing potential future work using NLP to advance the field of medical education in emergency medicine., Competing Interests: Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.