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Abstract Background Acute ischemic stroke (AIS) is the second leading cause of disability and death worldwide. Micro-RNA (miRNA)-223 was first identified as a regulator of hematopoietic lineage differentiation. Later, its diverse roles were discovered in a wide spectrum of pathological conditions. The present study aimed to assess the clinical and prognostic significance of miR-223 in patients with acute ischemic stroke (AIS). The study included 93 patients with AIS diagnosed on the basis of clinical and radiological findings. In addition, there were 50 healthy subjects who served as controls. Patients were classified into two categories: Those with favorable functional outcome (modified Rankin Scale (mRS): 0–2) and others with unfavorable functional outcome (mRS: 3–6) at 6 months post-stroke. Results The present prospective longitudinal study included 93 patients with AIS. They included 60 males (64.5%) and 33 females (35.5%) with an age of 64.5 ± 12.4 years. At the end of 6-month follow up, 44 patients (47.3%) had favorable outcome while the remainder 49 patients (52.7%) had unfavorable outcome. Patients with favorable outcome had significantly lower baseline miR-223 levels [median (IQR): 4.4 (2.0–6.3) versus 8.4 (4.5–14.9), p

AIM: To provide a comprehensive and more representative national data on the disease, especially on treatment options and outcomes, and to determine access of retinoblastoma patients from Luzon, Visayas and Mindanao to eye care, and determine if access is associated with delay in consultation, staging and outcomes. METHODS: Cohort study of retinoblastoma patients seen in eleven institutions located in the three major areas of the Philippines namely Luzon, Vizayas and Mindanao from 2010-2020. RESULTS: Totally 636 patients, involving 821 eyes, were included. Majority (57%) were from Luzon and were seen in institutions in Luzon (72%). Annually, 58±10 new cases were seen with 71% having unilateral disease. Median delay of consultation remained long at 9 (3, 17)mo, longest in patients with unilateral disease (P

Objective: The Thoracic Surgery Residents Association (TSRA) is a trainee-led cardiothoracic surgery organization in North America that has published a multitude of educational resources. However, the utilization of these resources remains unknown. Methods: Surveys were constructed, pilot-tested, and emailed to 527 current cardiothoracic trainees (12 questions) and 780 former trainees who graduated between 2012 and 2019 (16 questions). The surveys assessed the utilization of TSRA educational resources in preparing for clinical practice as well as in-training and American Board of Thoracic Surgery (ABTS) certification examinations. Results: A total of 143 (27%) current trainees and 180 (23%) recent graduates responded. A higher proportion of recent graduates compared with current trainees identified as male (84% vs 66%; P = .001) and graduated from 2- or 3-year traditional training programs (81% vs 41%; P

This paper focuses on the examination of stable and unstable geometrical structures of thin-shell wormholes constructed from Henneaux–Martinez–Troncoso–Zanelli black holes through the Visser cut-and-paste approach. We use the Israel thin-shell formalism for evaluating the stress–energy tensor components of the matter distribution near the wormhole throat. Equations of state, specifically the phantom-like and generalized Chaplygin gas model for exotic matter, are used to conduct an extensive investigation into the stability of the thin-shell. The radial perturbation around the equilibrium throat radius is also considered to explore the stable configuration for specific values of physical parameters. Our results show that the stable zones of these thin-shell wormholes increase as the scalar field parameter ℰ approaches −1. This study gives light on the behavior and dynamics of these wormholes throw light on their potential stability and lead the way for additional theoretical physics research. [ABSTRACT FROM AUTHOR]

The paper is devoted to the first boundary-value problem in a rectangular domain for a differential equation with the singular Bessel operator acting with respect to a spatial variable and the RiemannLiouville fractional differentiation operator acting with respect to a time variable. An explicit representation of the solution is constructed. The uniqueness of the solution is proved in the class of functions satisfying the Hlder condition with respect to the time variable. When the order of the fractional derivative is equal to unity, and the Bessel operator has no singularity, the studied equation coincides with the heat equation and the obtained results coincide with well-known corresponding classical results.

Living with a mental health condition in rural Chiapas, the southernmost state of Mexico, where adversity, poverty and health in accessibility prevail, make it challenging to reach for mental health services since they are mostly centralised in urban settings, understaffed and underfunded. The Mexican sister organisation of the international non-profit, Partners In Health, has served in marginalised communities in collaboration with the Mexican Ministry of Health and has provided mental health services since 2014. In 2019, community mental health workers began delivering individual Problem Management Plus (PM+) sessions to people with mental health conditions through home visits. This field report aims to share implementation practice findings through the voice of four implementers, two of whom currently deliver PM+, and through two brief case reports. Results show PM+ has had a positive impact on patients’ symptoms and community health workers’ attitudes toward mental health and themselves. However, incompletion of sessions, appropriateness and acceptability of the intervention are issues that implementers still need to tailor to the context. Despite having made adaptations, complex problems such as intimate partner violence, stress due to structural adversity and grief related to the emerging COVID-19 pandemic represent challenges that the intervention needs to address to meet the needs of underserved areas.

Tyler W LeBaron,1,2 Ram B Singh,3 Ghizal Fatima,4 Kumar Kartikey,3 Jagdish P Sharma,3 Sergej M Ostojic,5,6 Anna Gvozdjakova,7 Branislav Kura,2 Mami Noda,8 Viliam Mojto,9 Mohammad Arif Niaz,10 Jan Slezak1 1Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovak Republic; 2Molecular Hydrogen Institute, Enoch, UT, USA; 3Hospital and Research Institute, Moradabad, India; 4Era Medical College, Lucknow, India; 5Applied Bioenergetics Lab, Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia; 6Faculty of Health Sciences, University of Pécs, Pécs, Hungary; 7Medical Faculty, Pharmacobiochemical Laboratory of 3rd Medical Department, Comenius University Bratislava, Bratislava, Slovakia; 8Laboratory of Pathophysiology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan; 9Third Internal Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia; 10Center of Nutrition Research, International College of Nutrition, Moradabad, IndiaCorrespondence: Jan SlezakCentre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Dúbravská Cesta 9, Bratislava 841 04, Slovak RepublicTel +421 903 620 181Email jan.slezak@savba.skPurpose: Metabolic syndrome is associated with several medical risk factors including dyslipidemia, hyperglycemia, and obesity, which has become a worldwide pandemic. The sequelae of this condition increase the risk of cardiovascular and neurological disease and increased mortality. Its pathophysiology is associated with redox dysregulation, excessive inflammation, and perturbation of cellular homeostasis. Molecular hydrogen (H2) may attenuate oxidative stress, improve cellular function, and reduce chronic inflammation. Pre-clinical and clinical studies have shown promising effects of H2-rich water (HRW) on specific features of metabolic syndrome, yet the effects of long-term, high-concentration HRW in this prevalent condition remain poorly addressed.Methods: We conducted a randomized, double-blinded, placebo-controlled trial in 60 subjects (30 men and 30 women) with metabolic syndrome. An initial observation period of one week was used to acquire baseline clinical data followed by randomization to either placebo or high-concentration HRW (> 5.5 millimoles of H2 per day) for 24 weeks.Results: Supplementation with high-concentration HRW significantly reduced blood cholesterol and glucose levels, attenuated serum hemoglobin A1c, and improved biomarkers of inflammation and redox homeostasis as compared to placebo (P < 0.05). Furthermore, H2 tended to promote a mild reduction in body mass index and waist-to-hip ratio.Conclusion: Our results give further credence that high-concentration HRW might have promising effects as a therapeutic modality for attenuating risk factors of metabolic syndrome.Keywords: metabolism, fasting blood glucose, cholesterol, inflammation, oxidative stress, hydrogen water

In this paper, we consider fractional diffusion equation involving the Bessel operator acting with respect to a spatial variable and the Riemann-Liouville fractional differentiation operator acting with respect to a time variable. When the order of the fractional derivative is unity, and the singularity of the Bessel operator is absent, this equation coincides with the classical heat equation. Earlier, a solution of the Cauchy problem has been considered for the considered equation and a uniqueness theorem has been proved for a class of functions satisfying the analog of the Tikhonov condition. In this paper, we have constructed an example to show that the exponent (power) at the condition of the uniqueness of the solution to the Cauchy problem cannot be raised under. Its increase leads to a non-uniqueness of the solution. Using the well-known properties of the Wright function, we have obtained estimates for constructed function, which satisfies the homogeneous equation and the zero Cauchy condition.

Background: Electrophysiologic studies have been considered the “gold standard” in diagnosing carpal tunnel syndrome (CTS); however, reports of false-negative results, as well as discomfort for the patient during the procedure has paved the use of ultrasound, being a painless and cost-efficient tool, as an alternative means for its diagnosis. Various ultrasound parameters assessing the median nerve and wrist dimensions have been described, but description of landmarks to assess these in a reliable manner has been lacking. Methodology: A systematic search of different databases yielded data regarding ultrasound parameters for CTS diagnosis, the landmarks used, and presence of reliability testing. Based on this, three sonologists discussed the external and sonographic landmarks that will be used in measuring the median nerve measurements, bowing of the flexor retinaculum and the carpal tunnel dimensions. A pilot test with two consecutive healthy participants using the discussed ultrasound parameters was carried out, and results were subjected to inter- and intra-rater reliability testing. Modifications were accordingly made on the acquisition of ultrasound image using external landmarks. The reliability testing proper was done with ten consecutive healthy participants. Results: Based on the systematic review and the pilot study, external landmarks were used to locate the median nerve in the forearm, carpal tunnel inlet and outlet. For the forearm measurement, it was taken 10 cm proximal from the distal palmar crease. The distal palmar crease was the external landmark used for the carpal tunnel inlet, while for the carpal tunnel outlet; it was measured 1 cm distal to the distal palmar crease. Instead of using the inner edge of the hook of hamate and trapezium, the apices of these bones were used as the landmarks in measuring the carpal tunnel outlet dimensions. There was excellent intra-rater reliability (mid-forearm, carpal tunnel inlet and outlet) except for the following: cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet and outlet; and bowing of the flexor retinaculum. All the parameters had an excellent inter-rater reliability measured at the three levels (intraclass correlation [ICC]: Of 0.77–0.99) except for CSA of the median nerve at the levels of the forearm (fair-to-good with ICC of 0.71) and the carpal tunnel inlet (fair-to-good reliability of ICC: 0.43). Conclusion: There was an improved inter- and intra-rater reliability when external landmarks were used instead of sonographic landmarks.

Analysis of customary law in different countries enables to see cultural context of law and by that it gives the opportunity to define character of national legal system. Different peoples’ customary rules of law are formed as a result of long-term accumulation of legal regulation experience. Value of customary law is that it was established free from some political and ideological conjuncture. Research of Abkhazian adats leads to conclusion that social order depends on balance of regulative processes consisting of external organisation by public institute of the state and internal self-organisation of the socium. The author analyses Abkhazian customary law that still plays important role in development dynamics of the social system because in customary legal consciousness the principle «that way was usual (always) in the past» is a necessary condition for regulation of important things. It is the custom that helps to juridify social relations because it has authority of rule of conduct approved by the time. That is why the author suggests paying attention to criteria of “justiciability” delimiting legal and non-legal in social regulation. She defines a list of attributes differentiating the custom without legal significance and customary rules of law that fulfill legal criteria. From this point of view Abkhazian customary law: 1) is normative one; 2) is statutory one; 3) is rational one, it provides integration (i.e. oriented to interests of bigger social entire); 4) has an attribute of goal-setting; 5) regulates the most important things; 6) is processual one; 7) is provided with sanctions and provides contribution. The author resumes modern Abkhazian positive law itself is unable to meet the challenges of legal regulation and establish the legal order. It is necessary to use the opportunities of customary legal juridification of social relations because in modern Abkhazia it can provide development of legal system by fortifying state legal institutes’ credibility.

A 38-year-old male presented with bilateral upper eyelid masses and a right parotid mass. Nineteen years before the consultation, the patient experienced swelling at both upper eyelids. Formerly diagnosed by an ophthalmologist, corticosteroid, an anti-inflammatory medication, was prescribed for the patient, which resulted in partial resolution of the lid swelling. However, he was lost to follow-up, and progressive enlargement of the lids was observed with the development of a right parotid mass. The visual acuity of the patient was classified as counting fingers, three feet bilaterally. A detailed examination was difficult owing to the obstructive nature of the masses. However, ocular structures appeared intact. An excisional biopsy with a reconstruction of bilateral upper lids was performed. Histopathologic findings revealed a lymphoproliferative lesion suggestive of Kimura disease (KD). The patient was subsequently referred to rheumatology for management, where they started a regimen of oral steroids and antihistamines. [ABSTRACT FROM AUTHOR]

Abstract Background The use of electronic cigarettes (EC) has risen exponentially over the past decade, including among never smokers, and ECs are now the most popular tobacco product among teenagers in the US. While, EC manufacturers utilize numerous marketing strategies to target both smokers and non-smokers, it is unclear how perceptions and behaviors differ between these two groups. Methods We conducted a survey of 320 adults either via online surveys or in Baltimore vape shops to determine demographics, behaviors, perceptions, and motivations underlying use of ECs. Results Our survey respondents were predominantly young, Caucasian males, 74% of whom identified themselves as former smokers, while 20% identified as current smokers and 6% were never smokers. Former smokers reported a longer history of EC use and higher nicotine concentrations than current smokers. For former and current smokers, the primary motivation for EC use was assistance to quit smoking, and nearly half indicated that they plan to reduce their nicotine concentration and eventually quit using ECs. Among former smokers, self-reports on use and measures of dependence were consistent with nicotine replacement as their primary motivation. The majority of former and current smokers also reported that their respiratory health had improved as a result of EC use, although this effect was stronger for former smokers. Never smokers reported less frequent EC use and dependence compared to former and current smokers. Their motivations for use were more commonly for enjoyment and popularity, and they displayed a reduced desire to eventually quit using ECs. Conclusions These responses provide insight into the underlying thoughts and behaviors of smoking and non-smoking EC users and also suggest that never smoking EC users are an emerging demographic with different motivations and perceptions than those of current and former smokers.

In this paper Cauchy problem for a parabolic equation with Bessel operator and with Riemann-Liouville partial derivative is considered. The representation of the solution is obtained in terms of integral transform with Wright function in the kernel. It is shown that when this equation becomes the fractional diffusion equation, obtained solution becomes the solution of Cauchy problem for the corresponding equation. The uniqueness of the solution in the class of functions that satisfy the analogue of Tikhonov condition is proved.

Fundamental solution of the model equation of anomalous diffusion with Riemann-Liouville operator is constructed. Using the properties of the integral transformation with Wright function in kernel, we give estimates for the fundamental solution. When the considered equation transformes into the diffusion equation of fractional order, constructed fundamental solution goes into the corresponding fundamental solution of the diffusion equation of fractional order. General solution of the model equation of anomalous diffusion of fractional order is constructed.