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Melatonin, a natural hormone mainly synthesized by the pineal gland, is regulated by circadian rhythm. Synthetic melatonin is not approved by the US Food and Drug Administration for any indication. However, melatonin receptor agonists such as ramelteon and tasimelteon are US Food and Drug Administration approved and are considered by the American Academy of Family Physicians for the treatment of insomnia. Due to the availability of over-the-counter products in some countries and the increasing use of melatonin, it is interesting to highlight knowledge regarding the potential benefits of melatonin outside sleep disorders.This narrative review included published reports in EMBASE and MEDLINE databases between 1975 and 2021 relating to the therapeutic applications of melatonin.Based on the quality of the evidence published to date, the most promising non-insomnia indications are for treating ischemia/reperfusion injury, primary headache disorders, fibromyalgia, glucose control, and blood pressure control.Most of the studies were preclinical and in in vivo and in vitro phases. More clinical trials are needed before recommending melatonin as a treatment in clinical practice.

This study tested the effect of oat catch crops on mineral nitrogen (N) leaching losses from cool season fodder beet grazing. Undisturbed soil monolith lysimeters were collected from two grassland sites with soils featuring contrasting texture and water holding capacity (WHC) characteristics. After simulated fodder beet grazing in late autumn or winter, synthetic dairy cow urine was applied. Nitrogen leaching losses were measured from lysimeters sown with oats after urine application and compared with those under fallow conditions until spring. Oat dry matter (DM) production and N uptake measurements were obtained. Sowing oats reduced total mineral N leaching losses by up to 59%. Reductions in mineral N leaching were inconsistently affected by soil type but were strongly influenced by urine application timing. Nitrogen uptake by oats (52–143 kg N ha−1) drove reductions in N leaching losses compared with fallow soil. Oats yielded 4–17 t DM ha−1, and both yield and N uptake were strongly affected by urine application timing (winter > autumn) and soil type (high WHC > low WHC). Sowing oats after fodder beet grazing instead of leaving the ground fallow can reduce the environmental impacts of these systems, while simultaneously increasing annual feed supply. Catch crop gains can be maximised by avoiding or delaying autumn grazing of fodder beet, particularly on low WHC soils.

We present a new Australian Square Kilometre Array Pathfinder (ASKAP) sample of 14 radio Supernova Remnant (SNR) candidates in the Large Magellanic Cloud (LMC). This new sample is a significant increase to the known number of older, larger and low surface brightness LMC SNRs. We employ a multi-frequency search for each object and found possible traces of optical and occasionally X-ray emission in several of these 14 SNR candidates. One of these 14 SNR candidates (MCSNR J0522-6543) has multi-frequency properties that strongly indicate a bona fide SNR. We also investigate a sample of 20 previously suggested LMC SNR candidates and confirm the SNR nature of MCSNR J0506-6815. We detect lower surface brightness SNR candidates which were likely formed by a combination of shock waves and strong stellar winds from massive progenitors (and possibly surrounding OB stars). Some of our new SNR candidates are also found in a lower density environments in which SNe type Ia explode inside a previously excavated interstellar medium (ISM)., accepted for publication in MNRAS, this version corrects arXiv metadata only

Background Global 12-month psychosis prevalence is estimated at roughly 0.4%, although prevalence of antipsychotic use in the U.S. is estimated at roughly 1.7%. Antipsychotics are frequently prescribed for off label uses, but have also been shown to carry risk factors for certain comorbid conditions and with other prescription medications. The study aims to describe the socio-demographic and health characteristics of U.S. adults taking prescription antipsychotic medications, and to better understand the association of antipsychotic medications and comorbid chronic diseases. Methods The study pools 2013–2018 data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of non-institutionalized U.S. residents (n = 17,691). Survey staff record prescription medications taken within the past 30 days for each respondent, from which typical and atypical antipsychotic medications were identified. Results Prevalence of antipsychotic use among U.S. adults was 1.6% (n = 320). Over 90% of individuals taking antipsychotics reported having health insurance and a usual place for care, significantly more than their counterparts not taking antipsychotics. Further, those taking antipsychotics reported higher prevalence of comorbid chronic diseases and took an average of 2.3 prescription medications more than individuals not taking antipsychotics. Individuals taking antipsychotics were more likely to sleep 9 or more hours per night, be a current smoker, and have a body mass index greater than 30 kg/m2. Conclusions U.S. adults who take antipsychotic medications report more consistent health care access and higher prevalence of comorbid chronic diseases compared to those not taking antipsychotics. The higher comorbidity prevalence and number of total prescriptions highlight the need for careful assessment and monitoring of existing comorbidities and potential drug-drug interactions among adults taking antipsychotics in the U.S.

Background Exposure to air pollution has a detrimental effect on health and disproportionately affects people living in socio-economically disadvantaged areas. Engaging with communities to identify concerns and solutions could support organisations responsible for air quality control, improve environmental decision-making, and widen understanding of air quality issues associated with health. This scoping review aimed to provide an overview of approaches used to engage communities in addressing air quality and identify the outcomes that have been achieved. Methods Searches for studies that described community engagement in air quality activities were conducted across five databases (Academic Search Complete, CABI, GreenFILE, MEDLINE, Web of Science). Data on study characteristics, community engagement approach, and relevant outcomes were extracted. The review process was informed by a multi-stakeholder group with an interest in and experience of community engagement in air quality. Thirty-nine papers from thirty studies were included in the final synthesis. Conclusion A range of approaches have been used to engage communities in addressing air quality, most notably air quality monitoring. Positive outcomes included increased awareness, capacity building, and changes to organisational policy and practice. Longer-term projects and further exploration of the impact of community engagement on improving air quality and health are needed as reporting on these outcomes was limited.

We report the discovery of J0624-6948, a low-surface brightness radio ring, lying between the Galactic Plane and the Large Magellanic Cloud (LMC). It was first detected at 888 MHz with the Australian Square Kilometre Array Pathfinder (ASKAP), and with a diameter of ~196 arcsec. This source has phenomenological similarities to Odd Radio Circles (ORCs). Significant differences to the known ORCs - a flatter radio spectral index, the lack of a prominent central galaxy as a possible host, and larger apparent size - suggest that J0624-6948 may be a different type of object. We argue that the most plausible explanation for J0624-6948 is an intergalactic supernova remnant due to a star that resided in the LMC outskirts that had undergone a single-degenerate type Ia supernova, and we are seeing its remnant expand into a rarefied, intergalactic environment. We also examine if a massive star or a white dwarf binary ejected from either galaxy could be the supernova progenitor. Finally, we consider several other hypotheses for the nature of the object, including the jets of an active galactic nucleus (AGN) or the remnant of a nearby stellar super-flare., Comment: 20 pages accepted to MNRAS

The aim of this cross-sectional study was to estimate the frequency and prevalence of obesity and its association with diabetes mellitus, systemic hypertension, hyperlipidemia, coronary artery disease, myocardial infarction, and obstructive sleep apnea in West Texas adults. Data were extracted from 9528 clinic patients: 2287 (24.4%) were normal weight or underweight, and 7057 (75.5%) were overweight or obese (28.9% and 46.6%, respectively). We observed a lower prevalence of any degree of obesity in men compared to women (43.8% vs 48.6%). Diabetes mellitus (odds ratio [OR] = 2.56; 95% confidence interval [CI], 2.30-2.85), hypertension (OR = 2.28; 95% CI, 2.06-2.53), hyperlipidemia (OR = 1.90; 95% CI, 1.71-2.10), and obstructive sleep apnea (OR = 7.18; 95% CI, 5.84-8.83) were associated with obesity. The association of coronary artery disease (OR = 1.17; 95% CI, 1.03-1.33) with obesity was small, and myocardial infarction did not show any association with weight status. The frequency and prevalence of obesity are progressively increasing in West Texas adults and are linked to significant comorbidities, especially in low-income areas. Access to preventive interventions and further investigations are needed to slow the rising prevalence of obesity and its comorbidities.

Misinformation and promotion of well-intended but disproved therapies for COVID-19 have plagued evidence-based shared decision-making throughout the COVID-19 pandemic. In times of crisis, clinicians may feel that their strong inclination to prescribe potentially harmful, unproven therapies on behalf of their patients is supported by beneficence. Clinicians should mindfully identify and avoid commission bias during this pandemic, especially as more data have accumulated to assist with clinically sound decision-making. We describe a more evidence-based approach to treatment of early outpatient COVID-19, stressing the availability of Food and Drug Administration emergency use authorization therapies and considering plausibly beneficial, nonprescription supplements that are generally regarded as safe.

Objective To date, there are no FDA approved medications for treatment of early COVID-19 infection. Recently, use of melatonin, a naturally occurring tryptophan-derivative synthesized in the pineal gland and immune cells, has been suggested as an early treatment option for COVID-19. Melatonin has known anti-inflammatory, immunomodulatory, and protective antioxidant mechanisms that may attenuate the severity of COVID-19 symptoms. The objective of the present narrative review is to discuss the use of melatonin as an early treatment option on the first day of diagnosis for COVID-19. Methods The MeSH terms “COVID-19” and “viral diseases” were manually searched on PubMed and relevant articles were included. Results Results showed that melatonin acts to reduce reactive-oxygen-species mediated damage, cytokine-induced inflammation, and lymphopenia in viral diseases similar to COVID-19. Conclusions These conclusions provide evidence for potential benefits in melatonin use for COVID-19 treatment as early as the day of diagnosis.

Fire and grazing are commonplace in Australian tropical savannas and the effects of these management practices on soil organic carbon stocks (SOC) is not well understood. A long-term (20 years) experiment studying the effects of fire on a grazed semi-arid tropical savanna was used to increase this understanding. Treatments, including frequency of fire (every 2, 4 and 6 years), season of fire [early (June) vs late (October) dry season] and unburnt control plots, were imposed on Vertosol grassland and Calcarosol woodland sites, which were grazed. Additionally long-term enclosures [unburnt (except the Calcarosol in 2001) and ungrazed since 1973] on each soil type adjacent to each site were sampled, although not included in statistical analyses. SOC stocks were measured to a soil depth of 0.3m using a wet oxidation method (to avoid interference by carbonates) and compared on an equivalent soil mass basis. Significant treatment differences in SOC stocks were tested for, while accounting for spatial background variation within each site. SOC stocks (0–0.3m soil depth) ranged between 10.1 and 28.9tha–1 (Vertosol site) and 20.7 and 54.9tha–1 (Calcarosol site). There were no consistent effects of frequency or season of fire on SOC stocks, possibly reflecting the limited statistical power of the study and inherent spatial variability observed. Differences in the response to frequency and season of fire observed between these soils may have been due to differences in clay type, plant species composition and/or preferential grazing activity associated with fire management. There may also have been differences in C input between treatments and sites due to differences in the herbage mass and post-fire grazing activity on both sites and changed pasture composition, higher herbage fuel load, and a reduction in woody cover on the Vertosol site. This study demonstrated the importance of accounting for background spatial variability and treatment replication (in the absence of baseline values) when assessing SOC stocks in relation to management practices. Given the absence of baseline SOC values and the potentially long period required to obtain changes in SOC in rangelands, modelling of turnover of SOC in relation to background spatial variability would enable management scenarios to be considered in relation to landscape variation that may be unrelated to management. These considerations are important for reducing uncertainty in C-flux accounting and to provide accurate and cost-effective methods for land managers considering participation in the C economy.

Currently, the world is facing a global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19. So far, there are no clear recommendations regarding hospital discharge and aftercare for COVID-19. Here, we briefly discuss the current understanding of recommendations for discharge criteria, discharge treatment regimens, and follow-up.

International audience; This roadmap outlines the potential roles of metallic nanoparticles (MNPs) in the field of radiation therapy. MNPs made up of a wide range of materials (from Titanium, Z = 22, to Bismuth, Z = 83) and a similarly wide spectrum of potential clinical applications, including diagnostic, therapeutic (radiation dose enhancers, hyperthermia inducers, drug delivery vehicles, vaccine adjuvants, photosensitizers, enhancers of immunotherapy) and theranostic (combining both diagnostic and therapeutic), are being fabricated and evaluated. This roadmap covers contributions from experts in these topics summarizing their view of the current status and challenges, as well as expected advancements in technology to address these challenges.

Sequencing language production activities based on the inherent cognitive load of each activity type can improve student performance and self‐efficacy on high cognitive load language tasks like conversational speech (either face‐to‐face or via video chat). This ordering according to cognitive difficulty can scaffold learners in their development of second language (L2) productive skills. This article provides a research‐based rationale for this approach and includes several practical suggestions for how to design a rigorous and engaging online language course.

A naturalistic experiment was conducted to test the hypothesis that synchronous computer-mediated communication (CMC) can indirectly improve L2 oral proficiency by developing the same cognitive mechanisms underlying spontaneous conversational speech. The theoretical framework guiding this inquiry consists of Levelt's (1989) model of language production augmented by concepts from Working Memory theory. The findings show a significant difference between the experimental and control groups oral proficiency development with participants in the experimental condition (two of four contact hours per week were in a chatroom) scoring higher than participants in the control condition. Implications for language instruction and the second language oral proficiency development for different types of learners are discussed.

En un entorno caracterizado por un flujo continuo de informacion gratuita en la red, tanto los medios de comunicacion como las marcas luchan cada dia para ganar la batalla en la economia de la atencion de los publicos. Los formatos publicitarios tradicionales son percibidos como intrusivos e ineficaces. Es por ello que, conjuntamente con una coyuntura economica poco favorable, la inversion en publicidad tradicional en las versiones impresas y digitales de los periodicos esta disminuyendo constantemente. Empresas y medios de comunicacion han encontrado en el branded content una nueva forma de conectar con los publicos. El objetivo de esta investigacion es describir el caso paradigmatico del New York Times, pionero en la creacion y difusion de campanas de branded content. Analizamos diez ejemplos de campanas para medir el nivel de presencia de la marca patrocinadora, los formatos utilizados y si existe una busqueda de legitimizacion a la hora de crear relaciones con los stakeholders a traves del branded content. Utilizamos la metodologia del analisis de contenido. La investigacion muestra que, en el caso del New York Times, el branded content es una estrategia a medio-largo plazo, no centrada en el producto y que tiene el fin de crear una relacion con los stakeholders basada en la creacion y difusion de contenido util, interesante y, a menudo, con valor pedagogico que aporta valor a la sociedad en su conjunto.

Article 25 of the Charter of Fundamental Rights of the European Union (adopted in Nice on 7 December 2000) recognizes and respects the rights of older people to lead a life of dignity and independence and to participate in social and cultural life. It also highlights the importance of prevention and recognition of elder abuse, especially since exposure to violence is likely as the population ages, either in familial or in institutional settings. Elder abuse has some issues in common with child abuse but in spite of this fact currently is less recognized. Health professionals have a major role to play in early detection and management of cases of elder abuse. This protocol summarizes some key concepts and approaches to assist in the timely detection and investigation of elder abuse cases by healthcare professionals and forensic practitioners.

We have investigated the collective electronic and magnetic orderings of a series of La1−x Sr x MnO3 thin films grown epitaxially strained to (001) oriented strontium titanate substrates as a function of doping, x, for 0 ≤ x ≤ 0.4. We find that the ground states of these crystalline thin films are, in general, consistent with that observed in bulk crystals and thin film samples synthesized under a multitude of techniques. Our systematic study, however, reveal subtle features in the temperature dependent electronic transport and magnetization measurements, which presumably arise due to Jahn-Teller type distortions in the lattice for particular doping levels. For the parent compound LaMnO3 (x = 0), we report evidence of a strain-induced ferromagnetic ordering in contrast to the antiferromagnetic ground state found in bulk crystals.

The use of electronic cigarettes (e-cigarettes) in the United States has steadily increased since their introduction into the market in 2007. These devices deliver nicotine through the vaporization of a liquid which contains a vehicle (propylene glycol or glycerin), artificial flavoring, and nicotine. The combustion of these liquids creates a vapor containing particulates, multiple chemicals, and nicotine. The long-term safety of these products is unknown. Studies in healthy, non-smoking volunteers and smokers with no clinical pulmonary disease have demonstrated that the inhalation of e-cigarette vapor has minimal short-term effects on pulmonary function. The exposure of cell cultures to e-cigarette liquid or aerosols has been shown to reduce cell viability, induce cytokine production, and cause oxidative stress. The exposure of animals (mice and rats) to e-cigarette aerosols induces inflammatory responses in the lungs and delays the clearance of bacterial and viral challenges. There are a small number of case reports of patients developing acute pulmonary toxicity following the use of e-cigarettes. Two patients have developed lipoid pneumonia following the use of e-cigarettes for 3 and 7 months. Finally, several studies suggest that patients with chronic lung disease who switch from tobacco cigarettes to e-cigarettes can have improvement in lung function (asthmatics) and a reduction in the number of exacerbations (chronic obstructive pulmonary disease). Clearly, the public and the medical profession need more information about the long-term complications associated with the use of e-cigarettes and their benefit in smoking cessation efforts. Keywords: electronic

Many state estimation and control algorithms require knowledge of how probability distributions propagate through dynamical systems. However, despite hybrid dynamical systems becoming increasingly important in many fields, there has been little work on utilizing the knowledge of how probability distributions map through hybrid transitions. Here, we make use of a propagation law that employs the saltation matrix (a first-order update to the sensitivity equation) to create the Salted Kalman Filter (SKF), a natural extension of the Kalman Filter and Extended Kalman Filter to hybrid dynamical systems. Away from hybrid events, the SKF is a standard Kalman filter. When a hybrid event occurs, the saltation matrix plays an analogous role as that of the system dynamics, subsequently inducing a discrete modification to both the prediction and update steps. The SKF outperforms a naive variational update - the Jacobian of the reset map - by having a reduced mean squared error in state estimation, especially immediately after a hybrid transition event. Compared a hybrid particle filter, the particle filter outperforms the SKF in mean squared error only when a large number of particles are used, likely due to a more accurate accounting of the split distribution near a hybrid transition., Comment: Submitted to Automatica

Thiamine deficiency is a treatable disease with an excellent prognosis. However, it is often unrecognized because of the diversity of its clinical presentations. Herein, we report two atypical cases of nonalcoholic thiamine deficiency that presented with refractory hypotension in the absence of lactic acidosis. Case 1 developed recurrent hypotension, right-sided heart failure, and a classic triad of Wernicke’s encephalopathy (WE) after gastrointestinal surgery. Case 2 had decreased dietary intake and diuretic abuse, and had multiple episodes of syncope prior to present admission with refractory hypotension and mental status changes. The diagnosis of both cases was confirmed by undetectable pretreatment serum thiamine and dramatic improvement with thiamine replacement. In this report, we highlight refractory hypotension as a complication of, not only cardiovascular, but also neurologic beriberi. Moreover, thiamine replacement should be considered without delay in hypotensive patients with signs of WE and/or risk factors for beriberi.

Several risk assessment models have been validated for the estimation of risk of breast cancer in women. Chemoprevention through hormonal therapy is an effective way to reduce the incidence of breast cancer in women with high risk. Selective estrogen receptor modulators, tamoxifen and raloxifene, are approved for this indication by the United States Food and Drug Administration, and aromatase inhibitors have also shown promise in recent studies. These medications are generally well tolerated, except for reported increased rates of fractures and venous thromboembolic events. Despite strong recommendations from several regulatory bodies, advocacy for chemoprevention has been inadequate in practice, more so among the primary care physicians. Studies have identified several barriers in physicians, patients, and the system, contributing to this problem. Lack of knowledge about risk assessment models and chemoprevention options preclude physicians from prescribing these medications with confidence. Fear of potential adverse events, confusion regarding the purpose of the therapy, and need for continued adherence for five years are among the principal reasons for reduced chemoprevention uptake and early discontinuation among patients. Multifaceted interventions directed at education and training of health care professionals, proper counseling of women at high risk, and promotion of the development of improved medications might help ensure better chemoprevention uptake in the target population.