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Objectives/Hypothesis: To characterize self‐reported cancer‐related activity limitations among a broad population of head and neck (HNC) survivors and identify sociodemographic factors associated with these limitations. Study Design: Cross‐sectional analysis of data from the National Health Interview Survey. Methods: The study population included individuals who completed the National Health Interview Survey (NHIS) from 1997 to 2018 and self‐reported a cancer diagnosis. Data regarding activity limitations, cancer history, mental health, and demographics were extracted from the NHIS. Poisson regression was used to evaluate associations between demographics and cancer‐related limitations, and a descriptive analysis was performed to identify the most common types of cancer‐related limitations experienced by HNC survivors. Results: Individuals with HNC were more than twice as likely to report having a disability caused by cancer when compared to individuals with other cancers (24% vs. 11%, P <.001). Cancer‐related disability was highest among HNC survivors who were Black (adjusted prevalence ratio (aPR) = 1.57, 95% CI = 1.13–2.18), were aged 50 to 64 (aPR = 1.74, 95% CI = 1.1–2.74), had high school or lower education (aPR = 2.40, 95% CI = 1.07–5.37), and had Medicaid insurance (aPR = 2.58, 95% CI = 1.62–4.10). Among HNC patients who reported a cancer‐related limitation, the most common limitations included difficulty working (78%), going out (51%), and socializing (42%). Conclusions: Cancer‐related activity limitations are more common among HNC survivors compared to survivors of other cancers, and disproportionately affect socioeconomically disadvantaged HNC survivors. Clinicians should be aware of the limitations experienced by HNC survivors to provide counseling and resources to help patients cope with these limitations. Level of Evidence: 3 Laryngoscope, 132:593–599, 2022 [ABSTRACT FROM AUTHOR]

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The scientific interest in developing new complexes as inhibitors of bacterial biofilm related infections is constantly rising. The present work describes the chemical synthesis, structural and biological scrutiny of a triazole Schiff base ligand and its corresponding complexes. Triazole Schiff base, (2-methoxy-4-[(1H-1,2,4-triazol-3-ylimino)methyl]phenol) was synthesized from the condensation reaction of 3-amino-1,2,4-triazole and 4-hydroxy-3-methoxybenzaldehyde in an equimolar ratio. The triazole ligand (H2L) was characterized by physical (solubility, color, melting point), spectroscopic [UV–visible (UV–Vis), Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance (1H-NMR) and mass spectra (MS)] and micro analysis to evaluate their elemental composition. The bidentate ligand was complexed with transition metal [VO(IV), Fe(II), Co(II), Ni(II), Cu(II) and Zn(II)] in 1:2 molar ratio. The complexes were characterized by physical (color, solubility, decomposition temperature, conductance and magnetic moment), FT-IR, UV–Vis and elemental analysis. Thermal stability and fluorescence properties of the compounds were also determined. Density functional theory based theoretical calculations were accomplished to gain more insight into spectroscopic properties. The frontier molecular orbital analysis revealed that the ligand was less reactive with reduced electron donating capability and more kinetic stability than complexes. The as-synthesized compounds were scrutinized for anti-bacterial and anti-fungal activity against selected strains. Cobalt complex exhibited highest antibacterial activity against Escherichia coli and nickel complex has shown highest antifungal activity against Aspergillus niger. All the compounds also showed good antioxidant activity. The theoretical results reflect consistency with the experimental findings signifying that such compounds could be the promising chemical scaffolds in the near future against microbial infectious. [ABSTRACT FROM AUTHOR]

A new series of nucleosides, moieties, and Schiff bases were synthesized from sulfadimidine. Infrared (IR), 1HNMR, 13C NMR, and mass spectrometry techniques and elemental analysis were employed to elucidate the synthesized compounds. The prepared analogues were purified by different chromatographic techniques (preparative TLC and column chromatography). Molecular docking studies of synthesized compounds 3a, 4b, 6a, and 6e demonstrated the binding mode involved in the active site of DNA gyrase. Finally, all synthesized compounds were tested against selected bacterial strains. The most effective synthesized compounds against S. aureus were 3a, 4d, 4b, 3b, 3c, 4c, and 6f, which exhibited inhibition zones of inhibition of 24.33 ± 1.528, 24.67 ± 0.577, 23.67 ± 0.577, 22.33 ± 1.528, 18.67 ± 1.528 and 19.33 ± 0.577, respectively. Notably, the smallest zones were observed for 4a, 6d, 6e and 6g (6.33 ± 1.528, 11.33 ± 1.528, 11.67 ± 1.528 and 14.66 ± 1.155, respectively). Finally, 6b and 6c gave negative zone values. K. pneumoniae was treated with the same compounds and the following results were obtained. The most effective compounds were 4d, 4c, 4b and 3c, which showed inhibition zones of 29.67 ± 1.528, 24.67 ± 0.577, 23.67 ± 1.155 and 19.33 ± 1.528, respectively, followed by 4a and 3d (15.33 ± 1.528 for both), while moderate results (13.67 ± 1.155 and 11.33 ± 1.528) were obtained for 6f and 6g, respectively. Finally, 6a, 6b, 6c, 3a, and 3b did not show any inhibition. The most effective compounds observed for the treatment of E. coli were 4d, 4b, 4c, 3d, 6e and 6f (inhibition zones of 26.33 ± 0.577, 21.67 ± 1.528, 21.67 ± 1.528, 19.67 ± 1.528, 17.67 ± 1.155 and 16.67 ± 1.155, respectively). Compounds 3b, 3c, 6a, 6c, and 6g gave moderate results (13.67 ± 1.528, 12.67 ± 1.528, 11.33 ± 0.577, 15.33 ± 1.528 and 12.67 ± 1.528, respectively), while 6b showed no effect. The MIC values against S. aureus ranged from 50 to 3.125 mg, while those against E. coli and K. pneumoniae ranged from 50 to 1562 mg. In vitro, the antibacterial effects were promising. Further research is required to study the in vivo antibacterial effects of these compounds and determine therapeutic doses. [ABSTRACT FROM AUTHOR]

Introduction: Optimal surveillance paradigms for survivors of early stage human papillomavirus (HPV)‐related oropharyngeal cancer are not well defined. This study aimed to characterize patient interest in and factors associated with an altered surveillance paradigm. Materials and Methods: We surveyed patients with Stage I or II HPV‐related oropharyngeal cancer treated at a tertiary care institution from 2016 to 2019. Primary outcomes were descriptive assessment of patient knowledge, interest in altered surveillance, burdens of in‐person appointments, and priorities for surveillance visits. Ordinal regression was used to identify correlates of interest in altered surveillance. Results: Sixty‐seven patients completed surveys from February to April 2020 at a median of 21 months since completing definitive treatment. A majority (61%) of patients were interested in a surveillance approach that decreased in‐person clinic visits. Patients who self‐identified as medical maximizers, had higher worry of cancer recurrence, or were in long‐term relationships were less likely to be interested. Patients reported significant burdens associated with surveillance visits, including driving distance, time off work, and nonmedical costs. Patients were most concerned with discussing cancer recurrence (76%), physical quality of life (70%), mortality (61%), and mental quality of life (52%) with their providers at follow‐up visits. Conclusion: Patients with early stage HPV‐related oropharyngeal cancers are interested in altered surveillance approaches, experience significant burdens related to surveillance visits, and have concerns that are not well addressed with current surveillance approaches, including physical and mental quality of life. Optimized surveillance approaches should incorporate patient priorities and minimize associated burdens. Implications for Practice: The number of patients with HPV‐related oropharyngeal cancers is increasing, and numerous clinical trials are investigating novel approaches to treating these good‐prognosis patients. There has been limited work assessing optimal surveillance paradigms in these patients. Patients experience significant appointment‐related burdens and have concerns such as physical and mental quality of life. Additionally, patients with early stage HPV‐related oropharyngeal cancers express interest in altered surveillance approaches that decrease in‐person clinic visits. Optimization of surveillance paradigms to promote broader survivorship care in clinical practice is needed. Patient input is critical to improve surveillance options for human papillomavirus (HPV)‐related oropharyngeal cancer. This article assesses patient interest in and factors associated with alternative surveillance approaches, including patient knowledge, burdens of in‐person appointments, and priorities for follow‐up visits. [ABSTRACT FROM AUTHOR]

Schiff bases as fluorescent Chemo-sensors fluorogenic cation sensors is scientifically exigent work. Recently Schiff bases derivatives gained more attention because of their structural variability. Donor and acceptor group joint with delocalized [Formula: see text]-orbital display excellent fluorescent properties due to intramolecular charge transfer (ICT). Schiff bases coordinate with the metal ions resulting in a small change of photophysical properties and typical sensing behavior hypochromic/hyperchromic or hypsochromic/bathochromic shift. In this review, we endeavored to converge the beforehand reported Schiff baes-derived sensors and investigated the probes' design, synthesis, ON/OFF & OFF/ON Fe 3+ and Cu 2+ metal ion sensing mechanism, and practical application. This review focuses on the synthesis of Schiff baes as fluorescent Chemosensor for investigation of Fe and Cu metal ions during the period of over the two past decade (2003-2022). We anticipate that this review will provide a fundamental framework for researchers to further investigate the topic of Schiff-based sensors for metal ion detection., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Without treatment, prediabetic women with a history of gestational diabetes mellitus (GDM) are at greater risk for developing type 2 diabetes compared with women without a history of GDM. Both intensive lifestyle intervention and metformin can reduce risk. To predict risk and treatment response, we developed a risk prediction model specifically for women with prior GDM. Methods: The Diabetes Prevention Program was a randomized controlled trial to evaluate the effectiveness of intensive lifestyle intervention, metformin (850mg twice daily), and placebo in preventing diabetes. Data from the Diabetes Prevention Program (DPP) was used to conduct a secondary analysis to evaluate 11 baseline clinical variables of 317 women with prediabetes and a self-reported history of GDM to develop a 3-year diabetes risk prediction model using Cox proportional hazards regression. Reduced models were explored and compared with the main model. Results: Within three years, 82 (25.9%) women developed diabetes. In our parsimonious model using 4 of 11 clinical variables, higher fasting glucose and hemoglobin A1C were each associated with greater risk for diabetes (each hazard ratio approximately 1.4), and there was an interaction between treatment arm and BMI suggesting that metformin was more effective relative to no treatment for BMI ≥ 35kg/m2 than BMI < 30kg/m2. The model had fair discrimination (bias corrected C index = 0.68) and was not significantly different from our main model using 11 clinical variables. The estimated incidence of diabetes without treatment was 37.4%, compared to 20.0% with intensive lifestyle intervention or metformin treatment for women with a prior GDM. Conclusions: A clinical prediction model was developed for individualized decision making for prediabetes treatment in women with prior GDM. [ABSTRACT FROM AUTHOR]

Background: Although the frequency and magnitude of climate change-related health hazards (CCRHHs) are likely to increase, the population vulnerabilities and corresponding health impacts are dependent on a community's exposures, pre-existing sensitivities, and adaptive capacities in response to a hazard's impact. To evaluate spatial variability in relative vulnerability, we: 1) identified climate change-related risk factors at the dissemination area level; 2) created actionable health vulnerability index scores to map community risks to extreme heat, flooding, wildfire smoke, and ground-level ozone; and 3) spatially evaluated vulnerability patterns and priority areas of action to address inequity.Methods: A systematic literature review was conducted to identify the determinants of health hazards among populations impacted by CCRHHs. Identified determinants were then grouped into categories of exposure, sensitivity, and adaptive capacity and aligned with available data. Data were aggregated to 4188 Census dissemination areas within two health authorities in British Columbia, Canada. A two-step principal component analysis (PCA) was then used to select and weight variables for each relative vulnerability score. In addition to an overall vulnerability score, exposure, adaptive capacity, and sensitivity sub-scores were computed for each hazard. Scores were then categorised into quintiles and mapped.Results: Two hundred eighty-one epidemiological papers met the study criteria and were used to identify 36 determinant indicators that were operationalized across all hazards. For each hazard, 3 to 5 principal components explaining 72 to 94% of the total variance were retained. Sensitivity was weighted much higher for extreme heat, wildfire smoke and ground-level ozone, and adaptive capacity was highly weighted for flooding vulnerability. There was overall varied contribution of adaptive capacity (16-49%) across all hazards. Distinct spatial patterns were observed - for example, although patterns varied by hazard, vulnerability was generally higher in more deprived and more outlying neighbourhoods of the study region.Conclusions: The creation of hazard and category-specific vulnerability indices (exposure, adaptive capacity and sensitivity sub-scores) supports evidence-based approaches to prioritize public health responses to climate-related hazards and to reduce inequity by assessing relative differences in vulnerability along with absolute impacts. Future studies can build upon this methodology to further understand the spatial variation in vulnerability and to identify and prioritise actionable areas for adaptation. [ABSTRACT FROM AUTHOR]

Increasing extreme heat events have threatened human health seriously in the context of global climate change. As an important policy tool to resist heat-related risks, growing attentions have been paid on heat risk mapping researches in recent years. Unfortunately, the uncertainties caused by the subjective choice of data transforming method remain unclear. This study compared four data transforming methods and investigated the impacts of data transforming method selection on the outputs of heat risk assessment and mapping. The results indicated that the choice of data transforming methods will greatly affect the stability of heat risk mapping outputs and is likely to mislead decision makers. Only 4.56% of the counties that their heat risk levels derived from four data transforming methods remain consistent. The stability of heat risk mapping output was highly relevant to the population density. Regions with higher population density usually have lower stability for its mapping results. The "Number" method and the "Total PD" method are recommended for their satisfactory validation accuracy and unambiguous policy orientation; while the "Proportion" method is not recommended for its poor validation accuracy and vague policy guiding. [ABSTRACT FROM AUTHOR]

In this work, the thermal behavior of polymeric blends was prepared with the combination of post-consumer bottles of ethylene poly-terephthalate (recyclable RPET) and PHB (poly(3-hydroxybutyrate)), under several proportions. The PHB, RPET and PHB/RPET films were prepared from individual PHB and RPET solutions, obtained from controlled heating. X-ray diffractions, the absorption spectra in the infrared region (FTIR), thermogravimetry (TG), differential thermal analysis (DTA) techniques were used to examine the crystallinity, chemical interactions, thermal stability and melting point, respectively. In addition, the derivative thermogravimetry (DTG) curves under non-isothermal condition were also used to evaluate the behavior kinetics of the blends to see the possible alterations in thermal decomposition. The results of the X-ray analysis showed that the crystallinity in PHB/RPET had signals intense and also the lack of the diffraction related to PHB, while the FTIR analysis showed individual bands of the two polymers, indicating that there was little interaction between them. The TG/DTG and DTA curves had several reactions, shown that the blends are strongly dependent on the heating rates used. The thermal reactions also showed different events, which correspond to the decomposition of different components, of the blends. The kinetic parameters, such as activation energy (E) and the factor of Arrhenius (A), showed that two blends had a similar behavior in the initial development of the kinetic behavior, while the third sample had behavior differently of the others. Additionally, the kinetic compensation effect was determined and showed the probable direction of the thermal decomposition for individual PHB and RPET as for its respective blends. [ABSTRACT FROM AUTHOR]

The disinfection of swimming pool water is vital to maintain water quality. The chemicals used in this practice can damage the fabrics of bathing suits and shorten the shelf life of the textile substrate. The degradation of polyester, a polymer that is widely used in bathing suits for swimming pools, was investigated. For this, a 23 factorial design was employed for the experimental methodology. The effect of several variables was analyzed in a simulated swimming pool batch, such as textile-exposure time, concentration of the used disinfection product, and batch temperature. The response variables were enthalpy of fusion ΔHm, melting temperature and crystallinity (obtained by differential scanning calorimetry), percentage of weight loss, temperature of maximum rate of weight loss, onset temperature and endset temperature (measured through thermogravimetric analysis), and Young's modulus values (measured in strain-stress tests in the row and column directions). The factors of temperature, time, and the concentration of disinfectant were significant for melting temperature, crystallinity, onset temperature, and Young's modulus for columns. The analyses of variance were obtained using software Design-Expert DX7. Attenuated total reflectance-Fourier transform infrared spectroscopy analysis showed changes in band intensities at 695 cm−1, which were attributed to ester groups, as well as a decrease of the carbonyl band at 1712 cm−1, which was attributed to the hydrolysis of the material. Analysis through scanning electronic microscopy images showed the appearance of stretch marks in the constituent filaments of the tested textiles, which suggests a surface degradation occurred. [ABSTRACT FROM AUTHOR]

A significant amount of educational data mining (EDM) research consider students' past performance or non-academic factors to build predictive models, paying less attention to students' activity data. While procrastination has been found as a crucial indicator which negatively affects performance of students, no research has investigated this underlying factor in predicting achievement of students in online courses. In this study, we aim to predict students' course achievement in Moodle through their procrastination behaviour using their homework submission data. We first build feature vectors of students' procrastination tendencies by considering their active, inactive, and spare time for homework, along with homework grades. Accordingly, we then use clustering and classification methods to optimally sort and put students into various categories of course achievement. We use a Moodle course from the University of Tartu in Estonia which includes 242 students to assess the efficacy of our proposed approach. Our findings show that our approach successfully predicts course achievement for students through their procrastination behaviour with precision and accuracy of 87% and 84% with L-SVM outperforming other classification methods. Furthermore, we found that students who procrastinate more are less successful and are potentially going to do poorly in a course, leading to lower achievement in courses. Finally, our results show that it is viable to use a less complex approach that is easy to implement, interpret, and use by practitioners to predict students' course achievement with a high accuracy, and possibly take remedial actions in the semester. [ABSTRACT FROM AUTHOR]

Morbidity and mortality impacts of extreme heat amplified by climate change will be unequally distributed among communities given pre-existing differences in socioeconomic, health, and environmental conditions. Many governments are interested in adaptation policies that target those especially vulnerable to the risks, but there are important questions about how to effectively identify and support communities most in need of heat adaptations. Here, we use an equity-oriented adaptation program from the state of California as a case study to evaluate the implications of the currently used environmental justice index (CalEnviroScreen 3.0) for the identification of socially vulnerable communities with climate change adaptation needs. As CalEnviroScreen is geared towards air and water pollution, we assess how community heat risks and adaptation needs would be evaluated differently under two more adaptation-relevant vulnerability indices: the Social Vulnerability Index and the Heat-Health Action Index. Our analysis considers communities at the census tract scale, as well as the patterns emerging at the regional scale. Using the current index, the state designates 25% of its census tracts as "disadvantaged" communities eligible for special adaptation funds. However, an additional 12.6% of the state's communities could be considered vulnerable if the two other indices were considered instead. Only 13.4% of communities are vulnerable across all three vulnerability indices studied. Choice of vulnerability index shapes statewide trends in extreme heat risk and is linked to a community's likelihood of receiving heat-related California Climate Investments (CCI) projects. Tracts that are vulnerable under the current pollution-focused index, but not under the heat-health specific index, received four times the number of heat-related interventions as tracts vulnerable under the reverse scenario. This study demonstrates important nuances relevant to implementing equity-oriented adaptation and explores the challenges, trade-offs, and opportunities in quantifying vulnerability. [ABSTRACT FROM AUTHOR]

BACKGROUND: Extreme heat poses current and future risks to human health. Heat vulnerability indices (HVIs), commonly developed using principal components analysis (PCA), are mapped to identify populations vulnerable to extreme heat. Few studies critically assess implications of analytic choices made when employing this methodology for fine-scale vulnerability mapping. OBJECTIVE: We investigated sensitivity of HVIs created by applying PCA to input variables and whether training input variables on heat–health data produced HVIs with similar spatial vulnerability patterns for Detroit, Michigan, USA. METHODS: We acquired 2010 Census tract and block group level data, land cover data, daily ambient apparent temperature, and all-cause mortality during May–September, 2000–2009. We used PCA to construct HVIs using: a) “unsupervised”—PCA applied to variables selected a priori as risk factors for heat-related health outcomes; b) “supervised”—PCA applied only to variables significantly correlated with proportion of all-cause mortality occurring on extreme heat days (i.e., days with 2-d mean apparent temperature above month-specific 95th percentiles). RESULTS: Unsupervised and supervised HVIs yielded differing spatial vulnerability patterns, depending on selected land cover input variables. Supervised PCA explained 62% of variance in the input variables and was applied on half the variables used in the unsupervised method. Census tract–level supervised HVI values were positively associated with increased proportion of mortality occurring on extreme heat days; supervised PCA could not be applied to block group data. Unsupervised HVI values were not associated with extreme heat mortality for either tracts or block groups. DISCUSSION: HVIs calculated using PCA are sensitive to input data and scale. Supervised HVIs may provide marginally more specific indicators of heat vulnerability than unsupervised HVIs. PCA-derived HVIs address correlation among vulnerability indicators, although the resulting output requires careful contextual interpretation beyond generating epidemiological research questions. Methods with reliably stable outputs should be leveraged for prioritizing heat interventions [ABSTRACT FROM AUTHOR]

Ovarian cancer is the most common malignant tumors of the female reproductive system, and its standard treatments are cytoreductive surgery and platinum-based adjuvant chemotherapy. Great advances have been achieved in novel treatment strategies, including targeted therapy and immunotherapy. However, ovarian cancer has the highest mortality rate among gynecological tumors due to therapeutic resistance and the gap between preclinical data and actual clinical efficacy. Organoids are a 3D culture model that markedly affects gene analysis, drug screening, and drug sensitivity determination of tumors, especially when used in targeted therapy and immunotherapy. In addition, organoid can lead to advances in the preclinical research of ovarian cancer due to its convenient cultivation, good genetic stability, and high homology with primary tumors. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to assess whether maternal stressful life events are associated with increased risk of vaginal bleeding in urban China.Methods: We implemented a cross-sectional study to examine the association between maternal severe stressful life events and vaginal bleeding in early pregnancy. Information was collected from an urban area and 956 participants were involved in final analysis. Multivariable logistic model was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI) controlling for confounders.Results: In total, 219 of the 956 participants were reported vaginal bleeding. Maternal stressful life events would increase the chance of vaginal bleeding with a crude OR of 2.14 (95% CI, 1.53-2.99). After adjustment for potential variables, the association remains significant (adjusted OR, 2.22; 95% CI, 1.56-3.16), and stratification analysis shows parity is an influence factor. The frequency of maternal stress and vaginal bleeding exist a dose-response relationship.Conclusion: Maternal stressful life events are associated with the risk of vaginal bleeding in urban China. The parity status influences their association. [ABSTRACT FROM AUTHOR]

Background: The Rohingya refugee crisis in Bangladesh continues to outstrip humanitarian resources and undermine the health and security of over 900,000 people. Spatial, sector-specific information is required to better understand the needs of vulnerable populations, such as women and girls, and to target interventions with improved efficiency and effectiveness. This study aimed to create a gender-based vulnerability index and explore the geospatial and thematic variations in gender-based vulnerability of Rohingya refugees residing in Bangladesh by utilizing pre-existing, open source data. Methods: Data sources included remotely-sensed REACH data on humanitarian infrastructure, United Nations Population Fund resource availability data, and the Needs and Population Monitoring Survey conducted by the International Organization for Migration in October 2017. Data gaps were addressed through probabilistic interpolation. A vulnerability index was designed through a process of literature review, variable selection and thematic grouping, normalization, and scorecard creation, and Pareto ranking was employed to rank sites based on vulnerability scoring. Spatial autocorrelation of vulnerability was analyzed with the Global and Anselin Local Moran's I applied to both combined vulnerability index rank and disaggregated thematic ranking. Results: Of the settlements, 24.1% were ranked as 'most vulnerable,' with 30 highly vulnerable clusters identified predominantly in the northwest region of metropolitan Cox's Bazar. Five settlements in Dhokkin, Somitapara, and Pahartoli were categorized as less vulnerable outliers amongst highly vulnerable neighboring sites. Security- and health-related variables appear to be the most significant drivers of gender-specific vulnerability in Cox's Bazar. Clusters of low security and education vulnerability measures are shown near Kutupalong. Conclusion: The humanitarian sector produces tremendous amounts of data that can be analyzed with spatial statistics to improve research targeting and programmatic intervention. The critical utilization of these data and the validation of vulnerability indexes are required to improve the international response to the global refugee crisis. This study presents a novel methodology that can be utilized to not only spatially characterize gender-based vulnerability in refugee populations, but can also be calibrated to identify and serve other vulnerable populations during crises. [ABSTRACT FROM AUTHOR]

In this study, the heat vulnerability index has been developed for a megacity Lahore. Although Pakistan stands at 12th rank among highly exposed countries to climate change, very little research has been dedicated in exploring the heat-related vulnerability of exposed populations. We have applied the principal component analysis with varimax rotation on well-established indicators of exposure, sensitivity, and adaptive capacity to determine the heat vulnerability. This study has resulted in two principal components sharing 70.4% variance. Principal component 1 comprises pre-existing illness, population density, housing density, education, and normalized difference vegetation index with following significant (> 0.4) loading values 0.91, 0.91, 0.91, 0.57, and − 0.773, respectively, and principal component 2 combines the nature of housing material (0.964) followed by the water availability (0.962) and minority status (0.539). The hot spot analysis and overlay analysis have also been applied on the extracted component, and the resultant co-occurrence of high variable class, high vulnerability, and hot spots of vulnerability helped to grip those areas which imperatively require the applications of heat-related health interventions. The heat vulnerability index developed in our study clarifies that the most vulnerable populations are confined in the central vicinities of Lahore and less vulnerable are those which inhibit towards the outskirts of the city. [ABSTRACT FROM AUTHOR]

Time management behaviors are considered as determinant of success, and the position of obtaining such skills by managers has been defined more than before. Aim: this study was conducted to examine the effect of time management training program on the nursing managers' performance. Research design; Quasi-experimental design utilized to conduct the training program for nursing managers. Research setting: This study conducted at private hospital affiliated to a University. The study sample; composed of all nursing managers (n = 27) who were actually in the active workforce during the time of data collection. Data collection tools: Two tools used for data. Collection: Time management questionnaire, and time management observational checklist. Data was collected after explanation of the aim of the study; also an official administrative approval was obtained. The study was conducted on five phases: preparatory, assessment, planning, implementation, and evaluation phase. Result: The study results revealed that nursing managers' knowledge and skills total mean score post program (15.05±1.70) (125±2.45) was higher than pre program(14.00±.00)(109±8.47), and nursing managers' time management performance total mean score post program (86.65±6.81)was higher than pre program(49.55±16.25). Conclusion; based on the study findings the research hypotheses were approved. Recommendations: Time management training should be offered to all hospital personnel, especially nurses who tolerate more problems. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life (QOL) should be considered as the main outcome measure for patient with advanced cancer. QOL of cancer patients is affected by several factors. Objectives: The objective of the study was to assess the symptom interference and the relation between the domains of QOL among cancer patients. Methodology: An exploratory survey conducted among 768 patients diagnosed as Stage III or IV of cancer of breast/cervix/head and neck/gastrointestinal tract/lung/colorectal. Data were collected using pretested reliable structured interview questionnaire. Results: Out of 768 cancer patients, symptoms burden was interfered completely in their relationship with others among 445 (57.9%), sleep among 491 (63.9%), and QOL among 433 (56.4%). The domains of QOL were general well-being, physical well-being, psychological well-being, familial relationship, sexual and personal abilities, cognitive well-being, economic well-being, informational support, doctors' cooperation, and body image. Since the data were not following the normal distribution, Spearman rho was computed to assess the relationship between the domains. The data revealed that there is a positive statistically significant correlation between the domains of general well-being of the participants with physical wellbeing (r = 0.265, P = 0.001), psychological well-being (r = 0.195, P = 0.001), sexual and personal abilities (r = 0.278, P = 0.001), and body image (r = 0.168, P = 0.001). The study inferred that cancer patients with good cognitive well-being and high economic status had a sense of positive body image. Conclusion: Cancer patients have poor QOL in physical and psychological domains. QOL of patients is affected by the symptoms suffering during the treatment and diagnosis. Symptoms need to be managed effectively to improve the QOL of cancer patients. [ABSTRACT FROM AUTHOR]

Purpose: Head and neck cancer (HNC) is a relatively common cancer which causes a significant health burden, impacting individuals physically and psychologically. HNC treatment may result in facial disfigurement, eating and communication difficulties, and body image disturbances. We aimed to (1) identify HNC-specific patient-reported outcome measures (PROMs) used to assess body image, (2) evaluate their conceptual coverage, (3) appraise their development process and psychometric properties, and (4) determine appropriate body image PROM(s) for use in the HNC setting.Methods: Online databases were searched (July 2007-July 2017) for studies that assessed body image in patients with HNC. Studies were screened for eligibility. In addition, we searched three PROM databases for relevant PROMs. From available body image frameworks, we compiled a conceptual schema consisting of 18 clinically relevant body image issues important in the HNC setting, against which PROMs were assessed. Selected measures were appraised for psychometric characteristics, content, and readability.Results: A total of 245 records were retrieved. 18 studies with PROMs met our inclusion criteria, reporting eight PROMs. The PROM databases searched yielded 62 measures. After screening, eleven measures were short-listed and appraised. The Derriford Appearance Scale (DAS)-59, DAS-24, and body image scale (BIS) cover > 55% of issues within the body image conceptual schema; were developed based on literature, patient interviews, and clinician opinions; and have evidence of internal consistency (Cronbach alpha > 0.7), validity, and responsiveness.Conclusions: We recommend the DAS-24 and BIS as having adequate coverage of HNC-related issues, and suitable for use in future research. [ABSTRACT FROM AUTHOR]

Although marine biofouling has been widely studied on different substrates, information on biofouling on plastics in the Arabian Gulf is limited. Substrate- and location-specific effects were investigated by comparing the microbial communities developed on polyethylene terephthalate (PET) and polyethylene (PE) with those on steel and wood, at two locations in the Sea of Oman. Total biomass was lower on PET and PE than on steel and wood. PET had the highest bacterial abundance at both locations, whereas chlorophyll a concentrations did not vary between substrates. MiSeq 16S ribosomal RNA sequencing revealed comparable operational taxonomic unit (OTU) richness on all substrates at one location but lower numbers on PET and PE at the other location. Non-metric multidimensional scaling (NMDS) showed distinct clusters of the bacterial communities based on substrate (analysis of similarity (ANOSIM), R = 0.45–0.97, p < 0.03) and location (ANOSIM, R = 0.56, p < 0.0001). The bacterial genera Microcystis and Hydrogenophaga and the diatoms Licmophora and Mastogloia were specifically detected on plastics. Desulfovibrio and Pseudomonas spp. exhibited their highest abundance on steel and Corynebacterium spp. on wood. Scanning electron microscopy (SEM) revealed fissure formation on PET and PE, indicating physical degradation. The presence of free radicals on PET and carbonyl bonds (C=O) on PE, as revealed by Fourier transform infrared (FTIR) spectroscopy, indicated abiotic degradation while hydroxyl groups and spectral peaks for proteins and polysaccharides on PE indicated biotic degradation. We conclude that fouling microbial communities are not only substrate-specific but also location-specific and microbes developing on plastics could potentially contribute to their degradation in the marine environment. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).Design and setting A nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes data on all pregnancies and children in Quebec from January 1998 to December 2015.Primary outcome measures Gestational diabetes mellitus.Participants Cases of GDM were identified after week 20 of pregnancy and randomly matched 1:10 to controls on gestational age at index date (ie, calendar date of GDM) and year of pregnancy. AD exposure was assessed by filled prescriptions between the beginning of pregnancy (first day of last menstrual period) and index date. Conditional logistic regression models were used to estimate crude and adjusted odds ratios (aOR).Results Among 20 905 cases and 209 050 matched controls, 9741 (4.2%) women were exposed to ADs. When adjusting for potential confounders, AD use was associated with an increased risk of GDM (aOR 1.19, 95% CI 1.08 to 1.30); venlafaxine (aOR 1.27, 95% CI 1.09 to 1.49) and amitriptyline (aOR 1.52, 95% CI 1.25 to 1.84) were also associated with an increased risk of GDM. Moreover, the risk of GDM was increased with longer duration of AD use, specifically for serotonin norepinephrine reuptake inhibitors, tricyclic ADs and combined use of two AD classes. No statistically significant association was observed for selective serotonin reuptake inhibitors.Conclusion The findings suggest that ADs—and specifically venlafaxine and amitriptyline—were associated with an increased risk of GDM. [ABSTRACT FROM AUTHOR]

Dwellings are increasingly well insulated to save energy and this leads to higher humidity and temperature, which improves conditions for mites. Dermatophagoides antigens are the main allergens involved and tested in atopic asthma. We developed three new species-specific quantitative PCR (qPCR) methods for house dust mites (Dermatophagoides pteronyssinus and D. farinae) and storages mites (Acarus siro, Glycyphagus domesticus, Lepidoglyphus destructor). We sampled dust with electrostatic dust collectors, in the bedrooms, under beds and in the kitchens of patients with allergies (n = 24) and healthy controls (n = 18). Mite quantification was carried out with the three new qPCRs and the qPCR previously described for the Dermatophagoides genus. The qPCRs were highly specific and efficient for house dust mite species and the storage mites. Storage mite concentrations were higher than house dust mite concentrations and were higher in dwellings of patients with allergies. Consequently, allergists should test more often patients against the storage mite antigens by prick tests or IgE serology. Dampness is a major factor in storage mite development and the presence of effective mechanical ventilation can reduce storage mite concentrations four-fold. In addition, to limit exposure to dust mites, treatments should be used throughout dwellings and not only in patients' bedrooms. [ABSTRACT FROM AUTHOR]

Background: Numerous studies use birth certificate data to examine the association between interpregnancy interval (IPI) and maternal and perinatal health outcomes. Substantive changes from the latest birth certificate revision have implications for examining this relationship.Methods: We provide an overview of the National Vital Statistics System and recent changes to the national birth certificate data file, which have implications for assessing IPI and perinatal health outcomes. We describe the calculation of IPI using birth certificate information and related measurement issues. Missing IPI values by maternal age, race and education using 2016 birth certificate data were also compared. Finally, we review and summarise data quality studies of select covariate and outcome variables (sociodemographic, maternal health and health behaviours, and infant health) conducted after the most recent 2003 birth certificate revision.Results: Substantive changes to data collection, dissemination and quality have occurred since the 2003 revision. These changes impact IPI measurement, trends and associations with perinatal health outcomes. Missing values of IPI were highest for older ages, lower education and non-Hispanic black women. Minimal differences were found when comparing IPI using different gestational age measures. Recent data quality studies pointed to substantial variation in data quality by item and across states.Conclusion: Future studies examining the association of IPI with maternal and perinatal data using vital records should consider these aspects of the data in their research plan, sensitivity analyses and interpretation of findings. [ABSTRACT FROM AUTHOR]

We report a case of a 70-year-old farmer admitted for viper bite who presented with bilateral hyphema and angle closure attack. He was managed conservatively with topical steroids and cycloplegics. He responded well and was discharged after 2 weeks. after 2 weeks. [ABSTRACT FROM AUTHOR]

Plastics have become an inseparable part of our life in the society due to their merits such as low cost, light weight, good mechanical and thermal properties along with easy process ability. Since the last few decades, the unrestrained use of plastics in various fields like agriculture, packaging, transportation has raised a serious issue about its disposal and pollution. An efficient decomposition of plastics takes about 1000 years. Not only there is an increase in the problem of waste disposal of plastics but also they release CO2 and dioxins on burning which contributes to cause pollution. There is a growing concern for use of efficient microorganisms meant for biodegradation of non-degradable synthetic polymer because conventionally used methods for plastic disposal are ineffective for plastic waste management. This review paper focuses on one such type of plastic-polyethylene terephthalate (PET) which is widely used in a flexible packaging application, its manufacturing process and the various effects of waste generated by it on the surrounding environment. This review discusses an overview of various existing plastic disposal methods along with their limitations and mechanism of biodegradation of PET and factors affecting biodegradation. [ABSTRACT FROM AUTHOR]

Introduction: Although the definition of a short interbirth interval has been inconsistent in the literature, Healthy People 2020 recommends that women wait at least 18 months after a live birth before attempting their next pregnancy. In the United States, approximately 33% of pregnancies are conceived within 18 months of a previous birth. Pregnancies that result from short interbirth intervals can pose serious risks. The objective of this study was to determine the association between interbirth interval and understudied pregnancy complications and outcomes, including small for gestational age (SGA) infants, premature rupture of membranes (PROM), preterm PROM (PPROM), placenta previa, and gestational diabetes, using Pregnancy Risk Assessment and Monitoring System data from Mississippi and Tennessee. Methods: This study collected self‐reported information from 2212 women on interbirth interval (≤18 months, ie, short; 19‐35 months, ie, intermediate; and ≥36 months, ie, long; referent), PPROM, placenta previa, and gestational diabetes. SGA and PROM data were obtained from birth certificates. Logistic regression was used to calculate odds ratios (ORs) and 95% CIs. Results: After adjustment, there were no strong associations between interbirth interval and PPROM, gestational diabetes, or SGA infants. However, women with shorter intervals had increased odds of PROM (short: OR, 3.54; 95% CI, 1.22‐10.23 and intermediate: OR, 4.09; 95% CI, 1.28‐13.03) and placenta previa (short: OR, 2.58; 95% CI, 1.10‐6.05 and intermediate: OR, 1.69; 95% CI, 0.94‐3.05). Discussion: The study's findings provide further support for encouraging women to space their pregnancies appropriately. Moreover, findings underscore the need to provide women with family planning services so that closely spaced pregnancies and unintended pregnancies can be avoided. Additional studies of the role of interbirth interval on these understudied pregnancy complications and outcomes are warranted. [ABSTRACT FROM AUTHOR]

Indoor air quality plays a significant role in human health, especially for those who spend the majority of their time indoors, as is the case of workers in the industrial field. The control of contaminants inside the occupational indoor environment becomes critically important for promoting health. In terms of Health Impact Assessment, indoor air quality inside a factory becomes an essential factor of industrial hygiene. Here, computational fluid dynamics-based indoor environmental design was applied to potentially evaluate the environmental quality in a factory and to improve industrial hygiene. In particular, this study proposes an integrated simulation procedure to predict the inhalation exposure concentration of a hazardous chemical compound (here, cyclohexanone) by using a multi-stage, one-way nesting method. This procedure connects a factory building space, a micro-climate around the human body, and a respiratory tract in the human body. This research provides quantitative and qualitative detailed information of contaminant dosing in workers. The exact inhalation dose of contaminants in the human airways can be estimated based on factory-environment conditions through this procedure. Subsequently, the average contaminant concentration in the work place and inside the human body can be calculated. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignant diseases worldwide. It is refractory to conventional treatments, and consequently has a documented 5-year survival rate as low as 7%. Increasing evidence indicates that activated pancreatic stellate cells (PSCs), one of the stromal components in tumor microenvironment (TME), play a crucial part in the desmoplasia, carcinogenesis, aggressiveness, metastasis associated with PDAC. Despite the current understanding of PSCs as a “partner in crime” to PDAC, detailed regulatory roles of PSCs and related microenvironment remain obscure. In addition to multiple paracrine signaling pathways, recent research has confirmed that PSCs-mediated tumor microenvironment may influence behaviors of PDAC via diverse mechanisms, such as rewiring metabolic networks, suppressing immune responses. These new activities are closely linked with treatment and prognosis of PDAC. In this review, we discuss the recent advances regarding new functions of activated PSCs, including PSCs-cancer cells interaction, mechanisms involved in immunosuppressive regulation, and metabolic reprogramming. It’s clear that these updated experimental or clinical studies of PSCs may provide a promising approach for PDAC treatment in the near future. [ABSTRACT FROM AUTHOR]

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Despite the implementation of programmes to improve maternal health, maternal and foetal mortality rates still remain high. The presence of maternal distress and its association with the development of pregnancy hypertensive disorders is not well established. The aim of this study was to evaluate the association between maternal distress and the development of hypertensive disorders in pregnancy in a prospective cohort of 321 Mexican women. Symptoms of maternal distressing were evaluated at week 20th of gestation using the General Health Questionnaire. The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the odds of developing a pregnancy hypertensive disorder by 5.1-26.4 times in study population (p values < .05). Our results support the participation of maternal distress in the development of hypertensive disorders of pregnancy. The implementation of effective programmes prioritising risk factors during pregnancy including the presence of maternal distressing factors is recommended. Impact statement What is already known on this subject: Changes in the nervous, endocrine, and immune systems have been observed in pregnant women with distress conditions leading to gestational disorders. What do the results of this study add: The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the developing of hypertensive disorders in Mexican population. What are the implications of these findings for clinical practice and/or further research: These findings may contribute to a better understanding of the role of the maternal stress in the development of hypertensive disorders of pregnancy, and in the implementation of effective programmes for clinical practice prioritising risk factors during pregnancy, including the presence of maternal distressing factors. [ABSTRACT FROM AUTHOR]

Aims The relationship between socio-economic status and gestational diabetes mellitus has received little attention. The purpose of this study was to investigate the association between socio-economic status and risk of gestational diabetes. Methods Data were obtained from the ongoing Healthy Baby Cohort study in Hubei Province, China, in 2012-2014. Information on educational level and household income was collected using standard questionnaires during face-to-face interviews. Gestational diabetes was defined based on the International Association of Diabetes and Pregnancy Study Group's criteria. Logistic regression models were used to estimate odds ratios ( ORs) and 95% confidence intervals ( CIs) for gestational diabetes in relation to socio-economic status. Results Among 6886 participants, 1005 (14.6%) pregnant women were diagnosed with gestational diabetes. Higher educational level was inversely associated with risk of gestational diabetes ( OR, 0.74; 95% CI, 0.58, 0.95 for high school and OR, 0.62; 95% CI, 0.50, 0.76 for college or above). After adjustment for potential confounders, the ORs for gestational diabetes were 0.77 (95% CI, 0.59, 1.00) and 0.65 (95% CI, 0.51, 0.83) for women with high school and college or above education, respectively, compared with women with less than high school education. No significant association between household income and gestational diabetes was observed after adjustment for potential confounders. Subgroup analysis showed that the reduced risk of gestational diabetes with higher educational level was more evident among women with a pre-pregnancy BMI < 24 kg/m2 ( P for interaction = 0.022). Conclusions Our findings suggested that educational level was a more robust predictor of gestational diabetes than household income among Chinese women. [ABSTRACT FROM AUTHOR]

Maternal diabetes is associated with congenital heart defects (CHDs) as a group, but few studies have assessed risk for specific CHD phenotypes. We analyzed these relationships using data from the Texas Birth Defects Registry and statewide vital records for deliveries taking place in 1999-2009 (n = 48,249 cases). We used Poisson regression to calculate prevalence ratios for the associations between maternal diabetes (pregestational or gestational) and each CHD phenotype, adjusting for potential confounders. Analyses were repeated by type of diabetes. To address the potential for misclassification bias, we performed logistic regression, using malformed controls. We also conducted meta-analyses, combining our estimates of the association between pregestational diabetes and each CHD phenotype with previous estimates. The prevalence of every CHD phenotype was greater among women with pregestational diabetes than among nondiabetic women. Most of these differences were statistically significant (adjusted prevalence ratios = 2.47-13.20). Associations were slightly attenuated for many CHD pheno- types among women with gestational diabetes. The observed associations did not appear to be the result of misclassification bias. In our meta-analysis, pregestational diabetes was significantly associated with each CHD phenotype. These findings contribute to a better understanding of the teratogenic effects of maternal diabetes and improved counseling for risk of specific CHD phenotypes. [ABSTRACT FROM AUTHOR]

The view that food can have an expanded role that goes well beyond providing a source of nutrients truly applies to traditional functional foods. The systematic consumption of such traditional functional food provides an excellent preventive measure to ward off many diseases. Rasam, a soup of spices, is a traditional South Indian food. It is traditionally prepared using tamarind juice as a base, with the addition of Indian sesame oil, turmeric, tomato, chili pepper, pepper, garlic, cumin, curry leaves, mustard, coriander, asafoetida, sea salt, and water. Rasam is a classic example of traditional functional food with all its ingredients medicinally claimed for various ailments. The preclinical and clinical studies on rasam and its ingredients support their traditional claim. This review is an attempt to compile the literatures on rasam, its ingredients, and to highlight its medicinal potential that has been underestimated. [ABSTRACT FROM AUTHOR]

The blood count test results of six patients (five male adolescents and one female adult) who were diagnosed with the hemolytic-uremic syndrome are presented. Certain diverse lesions and especially, their different intensity, were observed. They were referred to the clinical process and the time from syndrome occurrence to biopsy. [ABSTRACT FROM PUBLISHER]

Objective: In epidemiological studies that aim to investigate the relationship between pet exposure and allergy/asthma, pet exposure is often ascertained by means of a questionnaire, but it is unclear which questionnaire items are used. The objective of this study was to systematically review self-reported pet exposure assessment in questionnaires used in epidemiological studies which explore the associations between pets and allergy/asthma.Methods: A systematic literature search was conducted in PubMed and papers were selected according to pre-specified eligibility criteria. The pet exposure questions used were classified within a framework including direct pet contact, indirect pet contact (e.g. through carers or grandparents) and avoidance behaviour. Authors were contacted when the questions used were not reported in detail.Results: Ninety-six full text papers were systematically reviewed. All studies assessed direct pet contact, but less than half (45%) explicitly assessed whether pets were allowed indoors. The vast majority of studies assessed both pet exposures during the first year of life and after the first year of life. The minority (13%) assessed whether pet(s) were kept at places regularly visited by the child and pet exposurein utero(15%). Even fewer studies assessed indirect contact to pets (n = 8) and avoidance behaviour (n = 10).Conclusions: In epidemiological studies, the ascertainment of pet exposure through questionnaires appears to vary greatly. This variation might partly explain the inconsistent and contradictory results of the effects of pet exposure on the development of allergy and asthma. [ABSTRACT FROM PUBLISHER]

Electrocardiogram (ECG) signal is a non-invasive method, used to diagnose the patients with cardiac abnormalities. The subjective evaluation of interval and amplitude of ECG by physician can be tedious, time consuming, and susceptible to observer bias. ECG signals are generated due to the excitation of many cardiac myocytes and hence resultant signals are non-linear in nature. These subtle changes can be well represented and discriminated in transform and non-linear domains. In this paper, performance of Discrete Cosine Transform (DCT), Discrete Wavelet Transform (DWT) and Empirical Mode Decomposition (EMD) methods are compared for automated diagnosis of five classes namely Non-ectopic (N), Supraventricular ectopic (S), Ventricular ectopic (V), Fusion (F) and Unknown (U) beats. Six different approaches: (i) Principal Components (PCs) on DCT, (ii) Independent Components (ICs) on DCT, (iii) PCs on DWT, (iv) ICs on DWT, (v) PCs on EMD and (vi) ICs on EMD are employed in this work. Clinically significant features are selected using ANOVA test () and fed to k-Nearest Neighbor ( k-NN) classifier. We have obtained a classification accuracy of 99.77% using ICs on DWT method. Consistency of performance is evaluated using Cohen's kappa statistic. Developed approach is robust, accurate and can be employed for mass diagnosis of cardiac healthcare. [ABSTRACT FROM AUTHOR]

With the continued growth in plastic production, its ubiquitous use and insufficient waste management and disposal, the increased levels of plastics in the environment have led to growing ecological concerns. The breakdown of these plastic macromolecules to smaller micro and nanosized particles and their detection in the aerial, aquatic, marine and terrestrial environments has been reviewed extensively, especially for thermoplastics. However, the formation of micro and nanoplastics has typically been explained as a physical abrasion process, largely overlooking the underlying chemical structure-morphology correlations to the degradation mechanisms of the plastics. This is particularly true for the common commodity thermosets. This review focuses on the degradation pathways for the most widely produced commodity thermoplastics and thermosets into microplastics (MP)s and nanoplastics (NP)s, as well as their behaviour and associated toxicity. Special emphasis is placed on NPs, which are associated with greater risks for toxicity compared to MPs, due to their higher surface area to volume ratios. This review also assesses the current state of standardized detection and quantification methods as well as comprehensive regulations for these fragments in the aquatic environment., (© 2021. The Author(s), under exclusive license to Springer Nature Switzerland AG.)