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Abstract Meloidogyne spp. are microscopic, obligatory endoparasites with worldwide distribution which cause severe damage to agricultural crops. The present study revealed the nematicidal activity of Streptomyces antibioticus strain M7 against Meloidogyne incognita. The culture supernatant of the isolate caused 100% J2 mortality after 24 h and inhibited egg hatching (only 3%). In addition, the nematicidal activity of actinomycins V, X2 and D purified from strain M7 was also checked. In vitro studies displayed 97.0–99.0% juvenile mortality and 28.0–44.0% egg hatching after 168 h at 240 µg/ml of actinomycin, with LD50 (lethal dose) values of 28–120 µg/ml. In vivo study further validated the nematicidal activity of strain M7, where nematode infested tomato plants treated with culture supernatant/cells/solvent extract showed reduction in root galls and egg masses per plant by 50.0–62.06% and 53.48–76.74%, respectively, and significantly enhanced the shoot length (54.67–76.39%), root length (36.45–64.88%), shoot fresh weight (111–171.77%), root fresh weight (120–163.33%), shoot dry weight (54.45–145.45%), and root dry weight (100–133.3%) over the nematode infested plants treated with water. Furthermore, tomato plants treated with cells/culture supernatant/extract of strain M7 without nematode infestation also showed significant increase in various plant growth parameters. Thus, the outcome of the study revealed the potential of S. antibioticus strain M7 and actinomycins produced from it to be developed as safe nematicidal agents to control the root knot nematodes, and to increase the crop yield.

Abstract Background Relationships between specific microbes and proper immune system development, composition, and function have been reported in a number of studies. However, researchers have discovered only a fraction of the likely relationships. “Omic” methodologies such as 16S ribosomal RNA (rRNA) sequencing and time-of-flight mass cytometry (CyTOF) immunophenotyping generate data that support generation of hypotheses, with the potential to identify additional relationships at a level of granularity ripe for further experimentation. Pairwise linear regressions between microbial and host immune features provide one approach for quantifying relationships between “omes”, and the differences in these relationships across study cohorts or arms. This approach yields a top table of candidate results. However, the top table alone lacks the detail that domain experts such as microbiologists and immunologists need to vet candidate results for follow-up experiments. Results To support this vetting, we developed VOLARE (Visualization Of LineAr Regression Elements), a web application that integrates a searchable top table, small in-line graphs illustrating the fitted models, a network summarizing the top table, and on-demand detailed regression plots showing full sample-level detail. We applied VOLARE to three case studies—microbiome:cytokine data from fecal samples in human immunodeficiency virus (HIV), microbiome:cytokine data in inflammatory bowel disease and spondyloarthritis, and microbiome:immune cell data from gut biopsies in HIV. We present both patient-specific phenomena and relationships that differ by disease state. We also analyzed interaction data from system logs to characterize usage scenarios. This log analysis revealed that users frequently generated detailed regression plots, suggesting that this detail aids the vetting of results. Conclusions Systematically integrating microbe:immune cell readouts through pairwise linear regressions and presenting the top table in an interactive environment supports the vetting of results for scientific relevance. VOLARE allows domain experts to control the analysis of their results, screening dozens of candidate relationships with ease. This interactive environment transcends the limitations of a static top table.

We propose a simple yet efficient technique to leverage semantic segmentation model to extract and separate individual buildings in densely compacted areas using medium resolution satellite/UAV orthoimages. We adopted standard UNET architecture, additionally added batch normalization layer after every convolution, to label every pixel in the image. The result obtained is fed into proposed post-processing pipeline for separating connected binary blobs of buildings and converting it into GIS layer for further analysis as well as for generating 3D buildings. The proposed algorithm extracts building footprints from aerial images, transform semantic to instance map and convert it into GIS layers to generate 3D buildings. We integrated this method in Indshine’s cloud platform to speed up the process of digitization, generate automatic 3D models, and perform the geospatial analysis. Our network achieved ∼70% Dice coefficient for the segmentation process.

Abstract Background To investigate the setup uncertainties and to establish an optimal imaging schedule for the prone-positioned whole breast radiotherapy. Methods Twenty prone-positioned breast patients treated with tangential fields from 2015 to 2017 were retrospectively enrolled in this study. The prescription dose for the whole breast treatment was 266 cGy × 16 for all of the patients and the treatments were delivered with the SSD setup technique. At every fraction of treatment, patient was firstly set up based on the body localization tattoos. MV portal imaging was then taken to confirm the setup; if discrepancy (> 3 mm) was found between the portal images and corresponding plan images, the patient positioning was adjusted accordingly with couch movement. Based on the information acquired from the daily tattoo and portal imaging setup, three sets of data, named as weekly imaging guidance (WIG), no daily imaging guidance (NIG), and initial 3 days then weekly imaging guidance (3 + WIG) were sampled, constructed, and analyzed in reference to the benchmark of the daily imaging guidance (DIG). We compared the setup uncertainties, target coverage (D95, Dmax), V5 of the ipsilateral lung, the mean dose of heart, the mean and max dose of the left-anterior-descending coronary artery (LAD) among the 4 imaging guidance (IG) schedules. Results Relative to the daily imaging guidance (IG) benchmark, the NIG schedule led to the largest residual setup uncertainties; the uncertainties were similar for the WIG and 3 + WIG schedules. Little variations were observed for D95 of the target among NIG, DIG and WIG. The target Dmax also exhibited little changes among all the IG schedules. While V5 of the ipsilateral lung changed very little among all 4 schedules, the percent change of the mean heart dose was more pronounced; but its absolute values were still within the tolerance. However, for the left-sided breast patients, the LAD dose could be significantly impacted by the imaging schedules and could potentially exceed its tolerance criteria in some patients if NIG, WIG and 3 + WIG schedules were used. Conclusions For left-side whole breast treatment in the prone position using the SSD treatment technique, the daily imaging guidance can ensure dosimetric coverage of the target as well as preventing critical organs, especially LAD, from receiving unacceptable levels of dose. For right-sided whole breast treatment in the prone position, the weekly imaging setup guidance appears to be the optimal choice.

Emerging evidence links changes in the gut microbiome and intestinal barrier function to alterations in CNS function. We examined the role of endotoxin-responsive, cAMP-specific, Pde4 subfamily b (Pde4b) enzyme in gut dysbiosis induced neuro-inflammation and white matter loss following spinal cord injury (SCI). Using a thoracic contusion model in C57Bl/6 wild type female mice, SCI led to significant shifts in the gut bacterial community including an increase in the phylum Proteobacteria, which consists of endotoxin-harboring, gram-negative bacteria. This was accompanied by increased systemic inflammatory marker, soluble CD14, along with markers of the endoplasmic reticulum stress response (ERSR) and inflammation in the SCI epicenter. Deletion of Pde4b reduced epicenter expression of markers for the ERSR and inflammation, at both acute and chronic time points post-SCI. Correspondingly, expression of oligodendrocyte mRNAs increased. Within the injury penumbra, inflammatory protein markers of activated astrocytes (GFAP), macrophage/microglia (CD11b, Iba1), and the proinflammatory mediator Cox2, were decreased in Pde4b−/− mice. The absence of Pde4b improved white matter sparing and recovery of hindlimb locomotion following injury. Importantly, SCI-induced gut dysbiosis, bacterial overgrowth and endotoxemia were also prevented in Pde4b−/− mice. Taken together, these findings indicate that PDE4B plays an important role in the development of acute and chronic inflammatory response and consequent recovery following SCI.

Background: A majority of educational programs place emphasis on sexually transmitted diseases, abortion, and contraception but ignore the broader questions of sexual experience, anatomy, and cultural myths. The aim of the present study was to explore the impact of our intervention on these ignored domains. To ascertain the sex-related knowledge of students and note gender-wise differences. To explore which domains were affected least by educational intervention and which the most. Methods: Nine lectures were delivered to a total of 488 students. They filled the Knowledge Subscale Derogatis' Inventory (21 items; dichotomous) before and 2 h after the lectures, responses were anonymously collected in a ballot box. The lecture was of an hour and followed by 20 min of Q/A sessions. Emphasis was placed on sexual response cycle, interpersonal relationships, sexual fantasies, and prevalent myths. Results: There were 450 respondents pretest, and 414 in the posttest. In both groups, girls were in majority (69.6% and 73.9%). The mean knowledge scores of both groups were 7.88 (sd3.26) and 15.70 (sd3.42). The difference was significant (P < 0.0001). Boys had significantly higher scores than girls at pretest (t = 9.274; P < 0.0001), but at posttest a greater improvement in scores of girls, mitigating the initial difference (t = 0.339; P = 0.734). Statistically significant improvement was found in every item. Yet, significant gender-related differences persisted in a few items. Conclusions: Poor knowledge regarding sex among adolescent students in apparent is the study. Girls have a significantly lesser knowledge. The lectures mitigated the difference in knowledge between both the genders. Human sexuality training programs in India must include the domains of a knowledge deficit.

Background and Objectives: The elicitation of a host’s immune–inflammatory responses to overcome oral bacterial biofilm challenges is mediated by numerous cytokines. We explored the role of three such cytokines, viz. interleukin (IL)-17, 18 and 21, by measuring their levels in the gingival crevicular fluid (GCF) of Indian individuals with healthy gingiva, chronic gingivitis, or chronic periodontitis. Materials and Method: Ninety systemically healthy individuals were enrolled in the study on the basis of predefined criteria and were categorized into three groups of 30 participants each. Groups A, B and C were composed of a control group with healthy gingiva, subjects with chronic gingivitis and subjects with chronic periodontitis, respectively. The periodontal disease status was assessed on the basis of a subject’s gingival index, probing pocket depth, clinical attachment loss and radiographic evidence of bone loss. After the complete history-taking and identification of gingival sulcus/pocket depth areas for GCF collection, a sample was collected from each subject in all groups for an estimation of the cytokine levels using ELISA. Statistical analysis was performed using SPSS v 21.0. Intergroup comparisons were conducted using a post hoc Tukey’s test. A value of p < 0.05 was considered to be statistically significant. Results: The mean IL-17, 18 and 21 concentrations in pg/mL was the greatest for Group C (99.67 ± 18.85, 144.61 ± 20.83 and 69.67 ± 12.46, respectively), followed by Group B (19.27 ± 2.78, 22.27 ± 2.43 and 22.74 ± 1.43, respectively) and finally by Group A (healthy control; 11.56 ± 0.99, 17.94 ± 1.24 and 12.83 ± 1.21 respectively). A statistically significant difference in the mean concentrations of two interleukins (IL-17 and IL-18) was observed between Groups A and C and also between Groups B and C. A statistically significant difference in the mean concentrations of IL-21 was observed between Groups B and C. Conclusions: Within the limitations of the present study, the findings revealed that the GCF levels of IL-17, IL-18 and IL-21 rose and correlated well with the severity of the disease. Thus, these cytokines present in GCF have the potential to be considered as biomarkers for periodontal tissue destruction. IL-21 in particular appears to be a promising biomarker for differentiating between gingivitis and periodontitis.

Introduction In 2005 Elizabeth Parker and fellow researchers described the first case of Hyperthymestic Syndrome, a woman going by initials AJ. Thereafter, a handful more of such cases have emerged. Older descriptions of extraordinary memory in medical literature mainly considered semantic and working memories. Jorge Luis Borges in his 1930s short story ‘Funes, his Memory’ writes about his, presumably fictitious, encounter with a man named Ireno Funes who possessed an extraordinary memory and a knack for keeping track of briefest of passing moment. Among many qualities that Funes and AJ share are their extraordinary memories, obsession for keeping track of time, and their problems with abstraction. After describing his extraordinary memory, Borges says of Funes, ‘I suspect nevertheless, that he was not very good at thinking. To think is to ignore (or forget) differences, to generalize, to abstract.’ Similarly, AJ has been described to have impaired abstraction, hypothesis formation and conceptual shifting. Moreover, both Funes and AJ see their capability as a burden rather than a gift. “My memory, sir, is like a garbage heap.” Says Funes. Objectives A brief exploration of Jorge Luis Borges’ works in the context of autobiographical memory. Methods The comparisons between Borges’ description of his character’s autobiographical memory and findings of modern research techniques will be done qualitatively. Results Effort is made to undersatnd Borges philosophy in context of mordern memory research. Conclusions An in depth look into Borges’ philosohies linking perception of time, coding of memory, abstration and language can inform further line of research regarding autobiographical memory. Disclosure No significant relationships.

Introduction Exploring the ways in which sexual fantasies may affect sexual experience and satisfaction is of relavence in the clinical setting involving sexual dysfuntion. Objectives To observe how the sexual fantasy scores differ in their relationship with sexual satisfaction, experience and quality between sexual dysfunction cases and normal controls. Methods Scales included: Wilson’s sex fantasy questionnaire (WSFQ), Arizona Sexual Experience Scale (ASEX), Sexual Quality of life Questionnaire (SQoL), and a subjective sexual satisfaction meter. Differences in resposes of both groups on WSFQ (item-wise and domain-wise) were analysed using T-tests. Two-way ANOVA was applied to see how other scales affected sexual fantasy. Results Cases scored significantly higher on ASEX scale, and low on satisfaction, SQoL and WSFQ Cases N=1OO Controls N=100 t-test Satisfaction Mean(sd) 4.27(1.85) 7.82(1.31) t=3.052;df=198,p=0.0026 Asex 17.52(4.73) 8.28(1.34) t=15.24;df=198,p

Introduction Current classification systems are not sure where to place the internet use disorder. Is it an addiction, an impulse control disorder, a consequence of another psychiatric morbidity or a consequence of personality trait/personality disorder? Objectives We intended to study which personality traits associated with online cognition may contribute towards Problematic internet use(PIU). We also analysed the relationship between number of hours of use/week of internet and PIU along with its relation with two ‘screening’ questions. Methods Online cognition scale and Abbreviated Eysenck Personality questionnaires were our measurements of choice in addition to demographic measures and some questions pertaining to online behaviour patterns. Results Total 163 responses were analysed. The demographic pools consisted mostly of young adults who had, on average, used the internet for 5.2 years at present rate of 21.81hours/week. We observed significantly higher mean OCS scores in men, in people who thought that the internet interfered with their lives and in those who felt the need to ‘cut-down’. A moderate positive and significant correlation was observed between hpurs/week of internet use and OCS scores. Also, significant positive correlation was observed between Neuroticism and OCS, impulsivity, and loneliness/depression scores. Significant negative correlations were observed between the Lie trait and impulse control. Neuroticism and Lie together contributed to 21.8% of variance in OCS scores. Conclusions Neuroticism and Lie traits (representing need for social acceptance) were found to the causing significamn varience in the OCS scores of the subjects. High number of hours/week use of internet was related to the feeling of ‘need to cut down use’.

Brassinosteroids (BRs) are group of plant steroidal hormones that modulate developmental processes and also have pivotal role in stress management. Biosynthesis of BRs takes place through established early C-6 and late C-6 oxidation pathways and the C-22 hydroxylation pathway triggered by activation of the DWF4 gene that acts on multiple intermediates. BRs are recognized at the cell surface by the receptor kinases, BRI1 and BAK1, which relay signals to the nucleus through a phosphorylation cascade involving phosphorylation of BSU1 protein and proteasomal degradation of BIN2 proteins. Inactivation of BIN2 allows BES1/BZR1 to enter the nucleus and regulate the expression of target genes. In the whole cascade of signal recognition, transduction and regulation of target genes, BRs crosstalk with other phytohormones that play significant roles. In the current era, plants are continuously exposed to abiotic stresses and heavy metal stress is one of the major stresses. The present study reveals the mechanism of these events from biosynthesis, transport and crosstalk through receptor kinases and transcriptional networks under heavy metal stress.

Background: There is little known about how payer status impacts clinical outcomes in a universal single-payer system such as the UK National Health Service (NHS). The aim of this study was to evaluate the relationship between payer status (private or public) and clinical outcomes following cardiac surgery from NHS providers in England. Methods: The National Adult Cardiac Surgery Audit (NACSA) registry was interrogated for patients who underwent adult cardiac surgery in England from 2009 to 2018. Information on socioeconomic status were provided by linkage with the Iteration of the English Indices of Deprivation (IoD). The primary outcome was in-hospital mortality. Secondary outcomes included incidence of in-hospital postoperative cerebrovascular accident (CVA), renal dialysis, sternal wound infection, and re-exploration. To assess whether payer status was an independent predictor of in-hospital mortality, binomial generalized linear mixed models (GLMM) were fitted along with 17 items forming the EuroSCORE and the IoD domains. Findings: The final sample consisted of 280,209 patients who underwent surgery in 31 NHS hospitals in England from 2009 to 2018. Of them, 5,967 (2.1%) and 274,242 (97.9%) were private and NHS payers respectively. Private payer status was associated with a lower risk of in-hospital mortality (OR 0.79; 95%CI 0.65 – 0.97;P = 0.026), CVA (OR 0.77; 95%CI 0.60 – 0.99; P = 0.039), need for re-exploration (OR 0.84; 95%CI 0.72 – 0.97; P = 0.017) and with non-significant lower risk of dialysis (OR 0.84; 95%CI 0.69 – 1.02; P = 0.074). Private payer status was found to be independently associated with lower risk of in-hospital mortality in the elective subgroup (OR 0.76; 95%CI 0.61 – 0.96; P = 0.020) but not in the non-elective subgroup (OR 1.01; 95%CI 0.64 – 1.58; P = 0.976). Interpretation: In conclusion, using a national database, we have found evidence of significant beneficial effect of payer status on hospital outcomes following cardiac surgery in favour of private payers regardless their socioeconomic factors.

Purpose: To provide an overview of the major randomized trials that support the use of hypofractionated post-mastectomy radiation therapy for locally advanced breast cancer patients. Methods and Materials: PubMed was systematically reviewed for publications reporting use of of hypofractionated radiation therapy in patients requiring post-mastectomy radiation. Results: Standard fractionation, which is typically delivered over 5 to 7 weeks, is considered the standard of care in setting of post-mastectomy radiation therapy (PMRT). Modern data has helped to establish hypofractionated whole breast irradiation, which consists of a 3- to 4-week regimen, as a new standard of care for early-stage breast cancer. Hypofractionated whole breast irradiation has also laid the groundwork for the exploration of a hypofractionated approach in the setting of hypofractionated post-mastectomy radiation therapy. Conclusions: While standard fractionation remains the most commonly utilized regimen for PMRT, recently published trials support the safety and efficacy of a hypofractionated approach. Ongoing trials are further investigating the use of hypofractionated PMRT.

Traumatic spinal cord injury (SCI) is a devastating neurological condition that involves both primary and secondary tissue loss. Various cytotoxic events including hypoxia, hemorrhage and blood lysis, bioenergetic failure, oxidative stress, endoplasmic reticulum (ER) stress, and neuroinflammation contribute to secondary injury. The HIF prolyl hydroxylase domain (PHD/EGLN) family of proteins are iron-dependent, oxygen-sensing enzymes that regulate the stability of hypoxia inducible factor-1α (HIF-1α) and also mediate oxidative stress caused by free iron liberated from the lysis of blood. PHD inhibition improves outcome after experimental intracerebral hemorrhage (ICH) by reducing activating transcription factor 4 (ATF4)-driven neuronal death. As the ATF4-CHOP (CCAAT-enhancer-binding protein homologous protein) pathway plays a role in the pathogenesis of contusive SCI, we examined the effects of PHD inhibition in a mouse model of moderate T9 contusive SCI in which white matter damage is the primary driver of locomotor dysfunction. Pharmacological inhibition of PHDs using adaptaquin (AQ) moderately lowers acute induction of Atf4 and Chop mRNAs and prevents the acute decline of oligodendrocyte (OL) lineage mRNAs, but does not improve long-term recovery of hindlimb locomotion or increase chronic white matter sparing. Conditional genetic ablation of all three PHD isoenzymes in OLs did not affect Atf4, Chop or OL mRNAs expression levels, locomotor recovery, and white matter sparing after SCI. Hence, PHDs may not be suitable targets to improve outcomes in traumatic CNS pathologies that involve acute white matter injury.

The circadian gene expression rhythmicity drives diurnal oscillations of physiological processes that may determine the injury response. While outcomes of various acute injuries are affected by the time of day at which the original insult occurred, such influences on recovery after spinal cord injury (SCI) are unknown. We report that mice receiving moderate, T9 contusive SCI at ZT0 (zeitgeber time 0, time of lights on) and ZT12 (time of lights off) showed similar hindlimb function recovery in the Basso mouse scale (BMS) over a 6 week post-injury period. In an independent study, no significant differences in BMS were observed after SCI at ZT18 vs. ZT6. However, the ladder walking test revealed modestly improved performance for ZT18 vs. ZT6 mice at week 6 after injury. Consistent with those minor effects on functional recovery, terminal histological analysis revealed no significant differences in white matter sparing at the injury epicenter. Likewise, blood-spinal cord barrier disruption and neuroinflammation appeared similar when analyzed at 1 week post injury at ZT6 or ZT18. Therefore, locomotor recovery after thoracic contusive SCI is not substantively modulated by the time of day at which the neurotrauma occurred.

Individual-, family-, and contextual-level factors can simultaneously and interactively affect a child's body mass index (BMI). We examine parental nativity as a key determinant of changes in children's BMI over time. Prior research on this topic has been inconclusive. A longitudinal sample of households with children residing in four low-income, high minority New Jersey cities provided data on demographics, socioeconomic status, anthropometric measures, as well as dietary and physical activity behaviors for one randomly selected child. The baseline interview for two separate cohorts took place in 2009/10 and 2014-15, with a follow-up interview 2–5 years later. The outcome variable, change in BMI z-score was divided into three categories (decrease in BMI z-score; no meaningful change; increase in BMI z-score) and analyzed using ordinal logistic regressions. About 28% of the children in the sample had at least one foreign-born parent. For the two major racial/ethnic groups, i.e., Hispanics and non-Hispanic blacks, having a foreign-born parent was associated with a favorable change in BMI—children of foreign-born parents were more likely to experience a decrease BMI z-score between baseline and follow-up. Multivariate analyses reveal that the initial association between parental nativity and children's BMI change (OR = 0.20; p

School food and physical activity (PA) environments can influence children’s dietary and physical activity behaviors. However, evidence on whether school environment is associated with students’ weight status is less definitive. In this study, we examined the association between students’ body mass index (BMI) and measures of school food and PA environments. We calculated BMI from nurse-measured data collected on 19,188 6–19-year-old students from 90 public schools in four low-income cities in New Jersey in 2015–2016. Based on a questionnaire administered to school nurses, we constructed 6 food and 3 PA indices capturing the healthfulness of key dimensions in the school food and PA environment domains. Multilevel linear models, stratified by school level (elementary and secondary), examined the association between BMI z-scores and indices of the school environment. The food and PA domains were modeled separately and then combined. Joint significance of indices within each domain was tested. Analyses were conducted in 2019–2020. In the combined model for elementary schools, indices in both the food and PA domains were jointly significant (p = 0.005 and p

Introduction: Nowadays, we need to deal with heart transplanted patients for other medical concerns. So, it is important to see in detail different aspects and modalities of their care during other types of surgery. A transplant team will carefully monitor each heart trans-plant recipient and should be possible to seek information on the patient’s overall status. They will be able to inform on the most recent investigations (ECG to assess graft function, recent biopsy for rejection, angiography for coronaries, etc.). Case report: Our patient, a 65-year-old lady underwent heart transplantation 5 years before. The cardiac situation was stable and she was doing fine. She was recovered in the gynaecological clinic with a diagnosis of vaginal prolapse with surgical indication General anaesthesia was done with fentanyl 7 ml, pavulon 4 mg, propofol 200 mg and sevoflurane 1.5-2.2%. The patient was monitored during surgery with SpO2, ECG, IBP, CVP. The operation technique was open of vaginal plastic repaire. Discussion: By 3 months, most recipients of heart transplant came under New York Heart Association (NYHA) I class. The last UK national survey about health-related quality of life after cardiac transplantation indicates that, 1 year after surgery, there is an improvement in quality of life (60% are much better; 28% somewhat better) and there is no deterioration in general health at 3–5 years, except that many of them have symptoms compatible with depression. Conclusion: Perioperative care of heart transplant recipients will entail a greater attention to maintaining an adequate preload and vascular tone, to avoiding infections and to being aware of the multiple side effects of immunosuppressive therapy. References and recommended reading papers of particular interest, published within the annual period of review, have been highlighted as of special interest of outstanding interest Additional references related to this topic can also be found in the Current World Literature section in this issue.

BACKGROUND:In 2017, 46.6 million U.S. adults aged 18 or older self-reported as having mental illness of which 52.0% or 24.2 million are women age 18-49. Perinatal depression and anxiety are linked to adverse outcomes concerning pregnancy, maternal functioning, and healthy child development. METHODS AND FINDINGS:Using the 2014 Health Center Patient Survey (HCPS), the objectives of the cross-sectional study are to assess the prevalence of self-reported mental health conditions among female patients of reproductive age and to examine the association between depression and physical health. Physical health conditions of interest included self-rated health, obesity, hypertension, smoking, and diabetes, which all have established associations with potential pregnancy complications and fetal health. The study found 40.8% of patients reported depression; 28.8% reported generalized anxiety; and 15.2% met the criteria for serious psychological distress on the Kessler 6 scale. Furthermore, patients with depression had two to three times higher odds of experiencing co-occurring physical health conditions. CONCLUSIONS:This study expands the discourse on maternal mental health, throughout the preconception, post-partum, and inter-conception care periods to improve understanding of the inter-correlated physical and mental health issues that could impact pregnancy outcomes and life course trajectory. From 2014 to 2018, the Health Resources and Services Administration (HRSA) has supported investments of nearly $750 million to improve and expand access to mental health and substance use disorder services for prevention, treatment, health education and awareness through comprehensive primary care integration. Moving forward, HRSA will implement strategic training and technical assistance (T/TA) framework that is designed to accelerate the adoption of science driven solutions in primary care in addressing depression for patients with co-occurring chronic conditions and advancing positive maternal outcomes.

Objectives: The aim of this study was to compare the diagnostic accuracy of Transthoracic Echocardiography (TTE) in assessing Bicuspid Aortic Valve (BAV) morphology. Methods: Case notes of 408 patients (>18 years old) undergoing elective Aortic Valve (AV) surgery over a 2-year period were retrospectively reviewed. Aortic valve data was collected from preoperative TTE reports and intraoperative records. The diagnostic accuracy of TTE for identifying AV morphology was assessed using intraoperative findings as the gold standard. One-hundred-and-eighty-nine (46.3%) patients had a recent TTE with complete morphological assessment of the AV and an operation note documenting AV morphology. Cases that were ‘unable to be determined’ on TTE were included as false negatives. Results: TTE correctly identified AV morphology in 165 of the patients, equating to an accuracy of 79.1% (sensitivity = 72.4%, specificity = 87.3%). For BAV patients alone, accuracy was 81.3% (sensitivity = 65.8%, specificity = 90.0%), and for Tricuspid Aortic Valve (TAV) patients, accuracy was 77.1% (sensitivity = 75.5%, specificity = 81.4%). There was no significant difference in diagnostic accuracy of TTE for BAV and TAV (p = 0.464), nor was there any difference between valve calcification (p = 0.196) and functional disease (p = 0.088). Conclusion: Our data suggests that identification of BAV from TTE requires expertise and therefore it is operator dependent. A larger study is required to confirm our findings.

Coronavirus disease 2019 (COVID-19) first emerged in Wuhan city in December 2019, and became a grave global concern due to its highly infectious nature. The Severe Acute Respiratory Coronavirus-2, with its predecessors (i.e., MERS-CoV and SARS-CoV) belong to the family of Coronaviridae. Reportedly, COVID-19 has infected 344,710,576 people around the globe and killed nearly 5,598,511 persons in the short span of two years. On November 24, 2021, B.1.1.529 strain, later named Omicron, was classified as a Variant of Concern (VOC). SARS-CoV-2 has continuously undergone a series of unprecedented mutations and evolved to exhibit varying characteristics. These mutations have largely occurred in the spike (S) protein (site for antibody binding), which attribute high infectivity and transmissibility characteristics to the Omicron strain. Although many studies have attempted to understand this new challenge in the COVID-19 strains race, there is still a lot to be demystified. Therefore, the purpose of this review was to summarize the structural or virologic characteristics, burden, and epidemiology of the Omicron variant and its potential to evade the immune response.

Purpose: Strong mentorship has been shown to improve mentee productivity, clinical skills, medical knowledge, and career preparation. We conducted a survey to evaluate resident satisfaction with mentorship within their radiation oncology residency programs.Methods and Materials: In January 2019, 126 radiation oncology residents training at programs in the northeastern United States were asked to anonymously complete the validated Munich Evaluation of Mentoring Questionnaire (MEMeQ). Results of residents with a formal mentoring program were compared to those without a formal program.Results: Overall response rate was 42%(n = 53). Participants were 25% post-graduate year two (PGY-2), 21% PGY-3, 26% PGY-4, and 28% PGY-5. Only 38% of residents reported participation in a formal mentoring program, while 62% had no formal program, and 13% reported having no mentor at all. Residents participating in a formal mentoring program reported strikingly higher rates of overall satisfaction with mentoring compared to those who were not (90% vs. 9%, p < 0.001). Overall, 38% of residents were either satisfied/very satisfied with their mentoring experience, while 49% of residents were unsatisfied/very unsatisfied.Conclusion: Residents participating in a formal mentorship program are significantly more likely to be satisfied with their mentoring experience than those who are not. Our results suggest that radiation oncology residency programs should strongly consider implementing formal mentorship programs.

Juhi M Purswani,1 Nitin Ohri,2 Colin Champ3,4 1Department of Radiation Oncology, New York University School of Medicine, New York, NY, USA; 2Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA; 3Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 4Department of Integrative Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Purpose: Accurate evaluation of patients’ health status is a key component of the workup, treatment, and follow-up of cancer patients. Assessments by clinicians (eg, performance status, toxicity grade) and patients (eg, quality of life) play a critical role in current practice but have significant limitations. Technological advances now provide an opportunity to track a new class of objective measures of patient activity, such as daily step counts. Here, we describe recent efforts to incorporate this technology into the field of oncology. Design: We conducted a structured literature search using MEDLINE electronic database to identify published observational studies of tracking steps in cancer patients and trials of exercise programs for cancer survivors incorporating pedometers until February 2016. Results: Data indicate that physical activity information may supplant existing scales for the assessment of cancer patients’ functional capacity. Conclusion: Objective activity monitoring is poised to revolutionize the way health care providers assess cancer patients at the time of diagnosis, during treatment, and in the survivorship setting. Keywords: cancer, pedometers, fitness trackers, performance status

Abstract Background Dysbiosis occurs in spondyloarthritis (SpA) and inflammatory bowel disease (IBD), which is subdivided into Crohn’s disease (CD) and ulcerative colitis (UC). The immunologic consequences of alterations in microbiota, however, have not been defined. Intraepithelial lymphocytes (IELs) are T cells within the intestinal epithelium that are in close contact with bacteria and are likely to be modulated by changes in microbiota. We examined differences in human gut-associated bacteria and tested correlation with functional changes in IELs in patients with axial SpA (axSpA), CD, or UC, and in controls. Methods We conducted a case-control study to evaluate IELs from pinch biopsies of grossly normal colonic tissue from subjects with biopsy-proven CD or UC, axSpA fulfilling Assessment of SpondyloArthritis International Society (ASAS) criteria and from controls during endoscopy. IELs were harvested and characterized by flow cytometry for cell surface markers. Secreted cytokines were measured by ELISA. Microbiome analysis was by 16S rRNA gene sequencing from rectal swabs. Statistical analyses were performed with the Kruskal-Wallis and Spearman’s rank tests. Results The total number of IELs was significantly decreased in subjects with axSpA compared to those with IBD and controls, likely due to a decrease in TCRβ+ IELs. We found strong, significant negative correlation between peripheral lymphocyte count and IEL number. IELs secreted significantly increased IL-1β in patients with UC, significantly increased IL-17A and IFN-γ in patients with CD, and significantly increased TNF-α in patients with CD and axSpA as compared to other cohorts. For each disease subtype, IELs and IEL-produced cytokines were positively and negatively correlated with the relative abundance of multiple bacterial taxa. Conclusions Our data indicate differences in IEL function among subjects with axSpA, CD, and UC compared to healthy controls. We propose that the observed correlation between altered microbiota and IEL function in these populations are relevant to the pathogenesis of axSpA and IBD, and discuss possible mechanisms. Trial registration ClinicalTrials.gov, NCT02389075. Registered on 17 March 2015.

Abstract Backgroud To assess the feasibility and efficacy of PuraStat®, a novel haemostatic agent, in achieving suture line haemostasis in a wide range of cardiac surgical procedures and surgery of the thoracic aorta. Methods A prospective, non-randomised study was conducted at our institution. Operative data on fifty consecutive patients undergoing cardiac surgery where PuraStat® was utilised in cases of intraoperative suture line bleeding was prospectively collected. Questionnaires encompassing multiple aspects of the ease of use and efficacy of PuraStat® were completed by ten surgeons (five consultants and five senior registrars) and analysed to gauge the performance of the product. Results No major adverse cardiac events were reported in this cohort. Complications such as atrial fibrillation, pacemaker requirement and pleural effusions were comparable to the national average. Mean blood product use of packed red cells, platelets, fresh-frozen plasma (FFP) and cryoprecipitate was below the national average. There was one incidence of re-exploration, however this was due to pericardial constriction rather than bleeding. Analysis of questionnaire responses revealed that surgeons consistently rated PuraStat® highly (between a score of 7 and 10 in the various subcategories). The transparent nature or PuraStat® allowed unobscured visualisation of suture sites and possessed excellent qualities in terms of adherence to site of application. The application of PuraStat® did not interfere with the use of other haemostatic agents or manipulation of the suture site by the surgeon. Conclusion PuraStat® is an easy-to-use and effective haemostatic agent in a wide range of cardiac and aortic surgical procedures.

Abstract Background Bicuspid aortic valve (BAV) disease is the most common congenital cardiac abnormality affecting 1–2% of the population and is associated with a significantly increased risk of ascending aortic aneurysm. However, predicting which patients will develop aneurysms remains a challenge. This pilot study aimed to identify candidate plasma biomarkers for monitoring ascending aortic diameter and predicting risk of future aneurysm in BAV patients. Methods Plasma samples were collected pre-operatively from BAV patients undergoing aortic valve surgery. Maximum ascending aortic diameter was measured on pre-operative transoesophageal echocardiography. Maximum diameter ≥ 45 mm was classified as aneurysmal. Sequential Window Acquisition of all THeoretical Mass Spectra (SWATH-MS), an advanced mass spectrometry technique, was used to identify and quantify all proteins within the samples. Protein abundance and aortic diameter were correlated using logistic regression. Levene’s test was used to identify proteins demonstrating low abundance variability in the aneurysmal patients (consistent expression in disease), and high variability in the non-aneurysmal patients (differential expression between ‘at risk’ and not ‘at risk’ patients). Results Fifteen plasma samples were collected (seven non-aneurysmal and 8 aneurysmal BAV patients). The mean age of the patients was 55.5 years and the majority were female (10/15, 67%). Four proteins (haemoglobin subunits alpha, beta and delta and mannan-binding lectin serine protease) correlated significantly with maximal ascending aortic diameter (p

Abstract Background Studies have examined the associations between emotions and overeating but have only rarely considered associations between emotions and specific food choices. The purpose of this secondary data analysis was to use mobile ecological momentary assessments (mEMAs) to examine associations between emotions and food choices among first-year college students living in residence halls. Methods Using an intensive repeated-measures design, mEMAs were used to assess concurrent emotions and food choices in a racially/ethnically diverse sample of first-year college students (n = 663). Emotions were categorized as negative (sad, stressed, tired), positive (happy, energized, relaxed), and apathetic (bored, meh). Assessments were completed multiple times per day on four quasi-randomly selected days (three random weekdays and one random weekend day) during a 7-day period using random prompt times. Generalized estimating equations (GEE) were used to examine between- and within-person associations of emotional status with a variety of healthy and unhealthy food choices (sweets, salty snacks/fried foods, fruits/vegetables, pizza/fast food, sandwiches/wraps, meats/proteins, pasta/rice, cereals), adjusting for gender, day of week, and time of day, accounting for within-person dependencies among repeated measurements of eating behavior. Results At the between-person level, participants who reported positive emotions more frequently compared to others consumed meats/proteins more often (OR = 1.8; 99% CI = 1.2, 2.8). At the within-person level, on occasions when any negative emotion was reported (versus no negative emotion reported) participants were more likely to consume meats/proteins (OR = 1.5, 99% CI = 1.0, 2.1); on occasions when any positive emotion was reported as compared to occasions with no positive emotions, participants were more likely to consume sweets (OR = 1.7, 99% CI = 1.1, 2.6), but less likely to consume pizza/fast food (OR = 0.6, 99% CI = 0.4, 1.0). Conclusions Negative and positive emotions were significantly associated with food choices. mEMA methodology provides a unique opportunity to examine these associations within and between people, providing insights for individual and population-level interventions. These findings can be used to guide future longitudinal studies and to develop and test interventions that encourage healthy food choices among first-year college students and ultimately reduce the risk of weight gain.

Mesiodens is a supernumerary tooth present in the midline of maxilla, between central incisors, occurring in 0.15%–1.9% of populations. Mesiodens is the most commonly found supernumerary teeth on many occasions. Mesiodens is paired, single, unerupted, and sometimes impacted. These mesiodens cause many complications, such as midline diastema, displacement, rotation, root resorption, unpleasing esthetics, and cyst formation. In the present cases, mesiodens is found bilaterally in the anterior maxilla. In these cases, both mesiodens are prophylactically extracted to prevent its adverse effects on permanent dentition.

Human lipoxygenase (hLO) isozymes have been implicated in a number of disease states and have attracted much attention with respect to their inhibition. One class of inhibitors, the flavonoids, have been shown to be potent lipoxygenase inhibitors but their study has been restricted to those compounds found in nature, which have limited structural variability. We have therefore carried out a comprehensive study to determine the structural requirements for flavonoid potency and selectivity against platelet 12-hLO, reticulocyte 15-hLO-1, and prostate epithelial 15-hLO-2. We conclude from this study that catechols are essential for high potency, that isoflavones and isoflavonones tend to select against 12-hLO, that isoflavons tend to select against 15-hLO-1, but few flavonoids target 15-hLO-2.

[reaction: see text] A regioselective synthesis of propargylamines by the coupling of propargyl alcohols with tosylamines and carbamates catalyzed by an air- and moisture-tolerant rhenium-oxo complex is described. The ability to couple functionalized components allows for convergent approaches to nitrogen-containing heterocyclic compounds such as the marine antibiotic pentabromopseudilin. These compounds were assayed against human lipoxygenase and found to be both potent and selective.

Abstract Background Glycogen storage disease type Ia is a genetic disorder that is associated with persistent fasting hypoglycemia and the inability to produce endogenous glucose. The development of diabetes with glycogen storage disease is exceedingly rare. The underlying pathogenesis for developing diabetes in these patients is unclear, and there are no guidelines for treatment. Case presentation We describe a case of a 34-year-old woman of South Asian descent with glycogen storage disease type Ia, who developed uncontrolled diabetes mellitus as a young adult. Hyperglycemia was noted after childbirth, and worsened years later. Treatment for diabetes was difficult due to risks of hypoglycemia from her underlying glycogen storage disease. With minimal hypoglycemic events, the patient’s blood glucose improved with exercise in combination with a sodium-glucose co-transporter 2 inhibitor and an alpha glucosidase inhibitor. Conclusion We report a rare case of diabetes in the setting of glycogen storage disease-Ia. Based on the literature, there appears to be a relationship between glycogen storage disease and metabolic syndrome, which likely plays a role in the pathogenesis. The management of glycemic control remains a clinical challenge, requiring management of both fasting hypoglycemia from glycogen storage disease, as well as post-prandial hyperglycemia from diabetes mellitus.

Pheochromocytoma is a tumor arising out of embryological neural crest, being a tumor of adrenal medulla secreting predominantly norepinephrine as well as epinephrine(about 20% cases) leading to frequent surges of vasopressor catecholamines leading to systemic hypertension, hypertensive emergencies and associated cardiac, neurological, and renal sequalae. Though somewhat rare in pediatric age group, it remains an important etiological factor to think about when there is intractable hypertension or rapid swings of blood pressures leading to headaches and palpitations with family history of hypertension or as a part of familial endocrine neoplasia. Treatment remains laproscopic or open surgical resection under general anesthesia, however perioperative care remains a challenge for the anesthesiologist, intensivist requiring adequate medical control of hypertension with alpha blockers such as phenoxybenza- mine before undertaking anesthetic induction and important monitoring measures instituted during intraoperative and postoperative period for close monitoring of blood pressure and intravascular volume status as well as hemodynamics. We review a case report with literature review regarding perioperative management of pheochromocytoma.

In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores.Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments.Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65–3.71; non-upgraded: M = 2.52, 95% CI 2.32–2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6–14.1; non-upgraded: M = 12.5, 95% CI 12.0–13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores.WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT. Keywords: Diet, Food, And nutrition, Nutrition surveys, Food environment, Food assistance