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Over the past years, Cloud computing has become one of the most influential information technologies to combat computing needs because of its unprecedented advantages. In spite of all the social and economic benefits it provides, it has its own fair share of issues. These include privacy, security, virtualization, storage, and trust. The underlying issues of privacy, security, and trust are the major barriers to the adoption of cloud by individuals and organizations as a whole. Trust has been the least looked into since it includes both subjective and objective characteristics. There is a lack of review on trust models in this research domain. This paper focuses on getting insight into the nomenclature of trust, its classifications, trust dimensions and throws an insight into various trust models that exist in the current knowledge stack. Also, various trust evaluation measures are highlighted in this work. We also draw a comparative analysis of various trust evaluation models and metrics to better understand the notion of trust in cloud environments. Furthermore, this work brings into light some of the gaps and areas that need to be tackled toward solving the trust issues in cloud environments so as to provide a trustworthy cloud ecosystem. Lastly, we proposed a Machine Learning backed Rich model based solution for trust verification in Cloud Computing. We proposed an approach for verifying whether the right software is running for the correct services in a trusted manner by analyzing features generated from the output cloud processed data. The proposed scheme can be utilized for verifying the cloud trust in delivering services as expected that can be perceived as an initiative towards trust evaluation in cloud services employing Machine learning techniques. The experimental results prove that the proposed method verifies the service utilized with an accuracy of 99%. [ABSTRACT FROM AUTHOR]

Teknologi informasi berkembang sangat pesat, tidak terkecuali di bidang pelayanan kesehatan. Rekam Medis Elektronik merupakan salah satu faktor penting untuk meningkatkan kualitas dan keamanan layanan kesehatan, mengurangi kejadian buruk bagi pasien, mengurangi biaya, mengoptimalkan pelayanan, meningkatkan penelitian klinis, dan memperoleh luaran klinis yang lebih baik. Pengabdian kepada masyarakat ini bertujuan untuk mengimplementasikan sistem informasi rekam medis berbasis website untuk meningkatkan mutu pelayanan Kesehatan di klinik. Metode yang dilakukan dalam pengabdian kepada masyarakat di klinik ini yaitu penyediaan perangkat keras (hardware), implementasi perangkat lunak (software) berupa aplikasi pelayanan pendaftaran dan pengelolaan rekam medis berbasis website, serta pelatihan penggunaan aplikasi aplikasi pelayanan pendaftaran dan pengelolaan rekam medis berbasis website kepada petugas. Hasil kegiatan pengabdian kepada masyarakat ini yaitu rekam medis elektronok mampu mengurangi waktu tunggu pelayanan kepada pasien sehingga kepuasan pasien terhadap pelayanan di klinik meningkat. Pengetahuan dan penerimaan petugas kesehatan di klinik juga meningkat setelah mengikuti kegiatan pelatihan dan pendampingan, sehingga dapat menjamin keberlanjutan program ini.

The enzyme inhibition potential of one dimensional coordination polymer [Cu(C6H5COO)(N3)(MeOH)] (1) has been evaluated against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), lipoxygenase (LOX), urease, α-chymotrypsin and yeast α-glucosidase. The coordination polymer 1 was found to be highly selective for α-glucosidase with the promising inhibition (IC50 = 59.43 ± 0.12) as compared to the standard reference acarbose (IC50, 38.25 ± 0.12). In addition, compound exhibits moderate to poor inhibition potential against all other tested enzymes. Furthermore, thermo-gravimetric analysis (TGA) of 1 was also carried out to evaluate its thermal stability, which shows its stepwise degradation. This study may provide a route towards the development of the selective α-glucosidase inhibitors based on coordination polymers. [ABSTRACT FROM AUTHOR]

Setiap rumah sakit memiliki standar tarif pelayanan kesehatan. Perbedaan tarif rumah sakit dan tarif INA-CBGs serta keakuratan kode diagnosis menyebabkan adanya kesenjangan pendapatan yang diperoleh rumah sakit. Studi ini menilai faktor yang menyebabkan kesenjangan antara tarif rumah sakit dan tarif INA-CBGs, diantaranya karakteristik rumah sakit dan keakuratan kode diagnosis. Sampel diambil secara stratified random sampling sebanyak 100 di dua rumah sakit tahun 2020. Pengumpulan data dilakukan dengan observasi dan kemudian dianalisis dengan uji Chi-Square. Analisis jalur dilakukan dengan pendekatan Structural Equation Modeling (SEM) menggunakan STATA 13 untuk menemukan model yang paling tepat untuk menggambarkan faktor penyebab kesenjangan tarif. Hasil menunjukkan bahwa 34% kode diagnosis tidak akurat dan 44% tarif INA-CBGs lebih rendah dari tarif rumah sakit. Rumah sakit milik Pemerintah memiliki log odds 1,037 lebih baik dalam menentukan ketepatan tarif INA-CBGs daripada rumah sakit swasta, namun secara statistik tidak signifikan (b=1,037; CI95%= -0,115 hingga 2,189; p=0,078). Kode diagnosis yang akurat memiliki log odds 3,885 lebih baik dalam menentukan ketepatan tarif INA-CBGs daripada kode diagnosis yang tidak akurat (b=3,885; CI95% =2,488 hingga 5,282; p0,001).

Ketuban pecah dini berada pada urutan ke 2 dalam 10 besar penyakit pasien rawat inap di salah satu rumah sakit swasta yang terdapat di Kabupaten Boyolali. Kualitas kode diagnosis ketuban pecah dini dapat menyebabkan hasil klaim pembiayaan pelayanan kesehatan pada sistem case mix dan penetapan kebijakan dalam pelayanan kesehatan tidak tepat. Penelitian ini mengevaluasi kualitas kode diagnosis ketuban pecah dini yang meliputi keakuratan, kelengkapan, konsistensi dan ketepatan waktu. Penelitian bersifat deskriptif dengan mengobservasi 215 dokumen rekam medis dan mewawancarai petugas coding. Hasil evaluasi menunjukkan kode diagnosis yang akurat sebanyak 58,60%, kode diagnosis yang lengkap sebanyak 75,81%, kode diagnosis yang konsisten 59,53% dan rata-rata waktu untuk mengkode satu dokumen rekam medis antara 5-7 menit. Penyebab utama kode diagnosis tidak akurat, tidak lengkap dan tidak konsisten karena diagnosis tidak dikode dan kesalahan penentuan kode diagnosis pada karakter ke empat. Peningkatan kualitas kode sebaiknya dilakukan sehingga dalam pengambilan kebijakan dan penentuan biaya klaim asuransi lebih tepat.

Govind Ballabh Pant University of Agriculture and Technology, India has developed a wide array of subtropical maize (Zea mays L.) germplasm, which are well adapted to the subtropics, resistant to major diseases of maize, mature early and are capable of surviving frost that usually comes late in the cropping seasons. The objective of this study was to determine the combining ability of subtropical maize inbred lines and identify appropriate germplasm for hybrid development. P6 was the highest yielding parent and P2 × P7 was the highest yielding cross. Heterosis for grain yield was high in those involving P6 as a parent. Parents P2, P7 and P8 showed significant positive GCA effects and the rest had significant negative GCA effects for gain yield. Parents P2, P7 and P8 could be used for initiating hybrid development work. For grain yield, P1 × P8 was the best specific combiner followed by P5 × P7, P2 × P7, P3 × P4 and P2 × P8 crosses. P7 and P8 manifested a high positive SCA effect with P2, implying that these two lines combine well with P2. [ABSTRACT FROM AUTHOR]

Nucleic acid-based therapeutics have gained a lot of interest for the treatment of diverse ophthalmic pathologies. The first to enter in clinic has been an oligonucleotide, Vitravene for the treatment of cytomegalovirus infection. More recently, research on aptamers for the treatment of age related macular degeneration has led to the development of Macugen. Despite intense potential, effective ocular delivery of nucleic acids is a major challenge since therapeutic targets for nucleic acid-based drugs are mainly located in the posterior eye segment, requiring repeated invasive administration. Of late, nanotechnology-based nano-vectors have been developed in order to overcome the drawbacks of viral and other non-viral vectors. The diversity of nano-vectors allows for ease of use, flexibility in application, low-cost of production, higher transfection efficiency and enhanced genomic safety. Using nano-vector strategies, nucleic acids can be delivered either encapsulated or complexed with cationic lipids, polymers or peptides forming sustained release systems, which can be tailored according to the ocular tissue being targeted. The present review focuses on developments and advances in various nano-vectors for the ocular delivery of nucleic acid-based therapeutics, the barriers that such delivery systems face and methods to overcome them. [ABSTRACT FROM AUTHOR]

Abstract Background Benzodiazepines are the first-line choice for the treatment of alcohol withdrawal syndrome. However, several hospitals continue to provide alcoholic beverages through their formulary for the treatment of alcohol withdrawal. While there are data on the prevalence of this practice in academic medical centers, there are no data on the availability of alcoholic beverages at the formularies of the hospitals operated by the department of Veteran's Affairs. Methods In this study, we surveyed the Pharmacy managers at 112 Veterans' Affairs Medical Centers (VAMCs) to ascertain the availability of alcohol on the VAMC formularies, and presence or lack of a policy on the use of alcoholic beverages in their VA Medical Center. Results Of the pharmacy directors contacted, 81 responded. 8 did not allow their use, while 20 allowed their use. There was a lack of a consistent policy across the VA medical centers on availability and use of alcoholic beverages for the treatment of alcohol withdrawal syndrome. Conclusion There is lack of uniform policy on the availability of alcoholic beverages across the VAMCs, which may create potential problems with difference in the standards of care.

BaSrTiO3 thin films doped with transition metal Ni2+ ions with compositional formula Ba0.7Sr0.3Ti1-xNixO3 (x = 0.0, 0.1, 0.5 and 1.0 mol %) were synthesized via sol-gel process. Films were deposited on Ti-substrate by spin coating technique. As-prepared films were dried at 100 °C in air atmosphere and then annealed at 750 °C for 2-hrs. The annealed films were investigated by different characterization methods. Among these are x-ray diffraction (XRD), scanning electron microscope (SEM), electron probe micro-analyzer (EPMA), ferroelectric characteristics, electrochemical response and dielectric properties. The XRD patterns of BaSrTiNiO3 (BSTN) samples confirmed the lattice parameters and the tetragonal phase crystal structure. It has been observed that there is no phase change in the crystal structure because of Ni-doping. The SEM micrographs present the progress of crystal phase in surface morphology of films. It is also observed that the cracks in the surface of the films decrease with Ni2+ ions incorporation. The EPMA results confirm the sample compositions. The room temperature P-V hysteresis loops measurements display that the remnant polarization increases with the increase in the dopant concentration. The electrochemical measurements of BSTN thin films show the change in the current density (J) with the working potential (v). The dielectric characteristics as a function of frequency within the range of values from 10 KHz to 10 MHz of the prepared films were carried out at the ambient temperature. It has been observed that the dielectric constant (εr) decreases initially with increasing the frequency and then remains almost constant at higher frequency (1 MHz-10 MHz). It is also observed that 'εr' increases with the Ni2+ incorporation. The dielectric constant (εr) has the maximum value 3.1x 10-3 at 10MHz frequency for the Ba0.7Sr0.3NiO3 film composition. The dominating effect of doping on electrical, ferroelectric and dielectric properties is greatly encouraging for the fabrication of devices operating at high frequencies. [ABSTRACT FROM AUTHOR]

Multicrystalline Sr-doped BaTiO3 having the compositional formula BaTiO3+ xSr (BTS), for x = 0.0, 0.025, 0.05, 0.1, 0.2, and 0.3 films have been obtained by sol-gel method. The films have been coated on Ti-substrates by means of spin - coating process. The effect of Sr-doping on the dielectric, ferroelectric and structural properties of the BTS films was studied by various characterization procedures. The X-ray diffraction (XRD) plots of BTS films show a slight shift in diffraction peaks to the higher 2-theeta diffraction angle with the addition of Sr-content. Lattice parameters are calculated using XRD patterns and tetragonal phase structure has been confirmed. It is also observed that there is no phase change due to dopant incorporation. The XRD peaks become more sharp with increasing Sr-dopant concentration showing the improvement in crystallinity of the films. Scanning electron microscopy (SEM) of BTS films displays the crack free as well as uniform nature of the grown films. The EPMA data verified films compositions. The electrochemical measurements of BTS films display the variation of the current density (J) with the applied voltage (V). The polarization-voltage (P-V) measurements of these thin films annealed at 750 oC shows the reduction in the ferroelectric properties with addition of Sr-content. On the other hand dielectric constant -frequency (εr - f) measurements reveal that dielectric constant increases with Sr-dopant concentration. Among these BTS films, the compositions BaTiO3+0.3Sr films have the maximum value of the dielectric constant 2.95041x10-35 measured at 10MHz frequency. The ferroelectric and dielectric properties of the sol-gel synthesized BTS thin films are influenced by the Sr-dopant concentration. The prominent effect of doping on both dielectric and ferroelectric properties of a material is highly appreciated for making high frequency devices. [ABSTRACT FROM AUTHOR]

A drop of phosphorus 'spin on dopant 430' was sprayed on ZnO pellets (prepared from 99.999% ZnO powder) and sintered in air in the temperature range of 500 to 1000°C with a step of 100°C for one hour in a programmable diffusion furnace. Characterization of asprepared ZnO pellets was performed by various diagnostic techniques: e.g., X-ray diffraction confirmed hexagonal structure of ZnO pellets preferably along (002) direction. We observed forward shift in 2 theta value of the X-ray diffraction pattern of ZnO sintered at temperature 1000°C. We correlate the forward shift with the involvement of phosphorus with vacancy at Zn site. Theoretical calculations on a 32-atoms super cell of phosphorus doped ZnO further supported the argument in the shape of a shallow acceptor PZn - 2VZn complex on Zn site. Typical PL spectra displayed band-to-band transitions peak and an additional donor-acceptor peak at ∼3.14 eV in all samples. [ABSTRACT FROM AUTHOR]

As an increasing number of patients with congenital heart disease reach adulthood, more information is needed regarding outcomes. The first signs of impaired heart function may appear during exercise testing. The aim of the present study was to establish mean values for maximal oxygen uptake in adults with various congenital heart diseases. Patients from 6 major diagnostic groups were identified, including patients with atrial septal defect (ASD, n = 93), transposition of the great arteries corrected with the Mustard procedure (n = 84), congenitally corrected transposition of the great arteries (CCTGA, n = 41), Tetralogy of Fallot (n = 168), Ebstein's anomaly (n = 37), and Modified Fontan procedure (n = 52). Diminished maximal oxygen uptake was found in all diagnostic groups across age compared with healthy subjects. A significant decrease in maximal oxygen uptake with aging was found in those with ASD (p <0.0001), CCTGA (p = 0.01), and Tetralogy of Fallot (p <0.0001). There was no significant decline, however, in Ebstein's anomaly (p = 0.270), Fontan procedure (p = 0.182), and in the Mustard patients (p = 0.188). All patients achieved significantly lower heart rates than predicted (mean for all groups, p <0.0001). Forced vital capacity values (3.51 L, mean SD +/- 1.02) were lower than predicted values (4.10 L, mean SD +/- 0.90, p <0.0001) for all patients groups except those with ASD. Mean values, however, were within the accepted 20% range of variance. This study showed diminished aerobic capacity in all diagnostic groups when compared with a healthy population. The maximal oxygen uptake values across age groups can be used as reference values in patients with similar diagnoses and as the basis for further research. [ABSTRACT FROM AUTHOR]

Right ventricular (RV) dysfunction has adverse effects on long-term outcome in patients with repaired tetralogy of Fallot (TOF). We employed serial radionuclide angiography (RNA) to examine RV and left ventricular (LV) systolic function in adults late after TOF repair and its relation to clinical outcome. We reviewed 10-year records of 95 patients (53 men) with TOF followed in our clinic (mean age at repair 12.6 +/- 10.5 years, mean age at last follow-up 37.7 +/- 9.8 years) who underwent at least 2 RNAs between 1987 and 1997. Most patients were well by the end of the study (80% were New York Heart Association class I, 17% were class II, and 3% were in class III). Sixteen patients experienced sustained tachyarrhythmias (8 had atrial; 8 patients had ventricular). One patient died suddenly. Fifteen patients underwent RV outflow reoperations (15 underwent pulmonary valve replacement; 7 had relief of RV outflow obstruction); RV systolic function during exercise in these 15 patients was significantly impaired before and returned to similar levels after surgery, compared with the rest of the patients. Overall, RV and LV function remained stable in the whole group at a mean interval of 5.7 +/- 2.2 years between first and last RNA. This group of closely followed adults with TOF remained well over 10 years with a low incidence of sudden death and stable RV and LV systolic function, despite a relatively large number of RV outflow reoperations. Aggressive intervention for right-sided hemodynamic abnormalities may have contributed to this outcome. Preserved ventricular function may herald a favorable long-term outlook in this group. [ABSTRACT FROM AUTHOR]

Designing innovative microstructures and implementing efficient multicomponent strategies are still challenging to achieve high-performance and chemo-mechanically stable electrode materials. Herein, a hierarchical three-dimensional (3D) graphene oxide (GO) assisted Ti 3 C 2 T x MXene aerogel foam (MXene-GAF) impregnated with battery-type bimetallic nickel vanadium selenide (NiVSe) has been prepared through a hydrothermal method followed by freeze-drying (denoted as NiVSe-MXene-GAF). 3D-oriented cellular pore networks benefit the energy storage process through the effective lodging of NiVSe particles, improving the access of the electrolyte to the active sites, and alleviating volume changes during redox reactions. The 3D MXene-GAF conductive matrix and heterostructured interface of MXene-rGO and NiVSe facilitated the rapid transport of electrical charges and ions during the charge-discharge process. As a result of the synergism of these effects, NiVSe-MXene-GAF exhibited remarkable electrochemical performance with a specific capacity of 305.8 mA h g -1 at 1 A g -1 and 99.2% initial coulombic efficiency. The NiVSe-MXene-GAF electrode delivered a specific capacity of 235.1 mA h g -1 even at a high current density of 12 A g -1 with a 76.8% rate performance. The impedance measurements indicated a low bulk solution resistance ( R s = 0.71 Ω) for NiVSe-MXene-GAF. Furthermore, the structural robustness of NiVSe-MXene-GAF guaranteed long-term stability with a 91.7% capacity retention for successive 7000 cycles. Thus, developing NiVSe-MXene-GAF provides a progressive strategy for fabricating high-performance 3D heterostructured electrode materials for energy storage applications.

In this work, we studied the effect of iron (Fe) and vanadium (V) co-doping (Fe/V), and graphitic carbon nitride (g-C 3 N 4 ) on the performance of tungsten oxide (WO 3 ) based electrodes for supercapacitor applications. The lone pair of electrons on nitrogen can improve the surface polarity of the g-C 3 N 4 electrode material, which may results in multiple binding sites on the surface of electrode for interaction with electrolyte ions. As electrolyte ions interact with g-C 3 N 4 , they quickly become entangled with FeV-WO 3 nanostructures, and the contact between the electrolyte and the working electrode is strengthened. Herein, FeV-WO 3 @g-C 3 N 4 is fabricated by a wet chemical approach along with pure WO 3 and FeV-WO 3 . All of the prepared samples i.e. , WO 3 , FeV-WO 3 , and FeV-WO 3 @g-C 3 N 4 were characterized by XRD, FTIR, EDS, FESEM, XPS, Raman, and BET techniques. Electrochemical performance is evaluated by cyclic voltammetry (CV), galvanic charge/discharge (GCD), and electrochemical impedance spectroscopy (EIS). It is concluded from electrochemical studies that FeV-WO 3 @g-C 3 N 4 exhibits the highest electrochemical performance with specific capacitance of 1033.68 F g -1 at scan rate 5 mV s -1 in the potential window range from -0.8 to 0.25 V, that is greater than that for WO 3 (422.76 F g -1 ) and FeV-WO 3 (669.76 F g -1 ). FeV-WO 3 @g-C 3 N 4 has the highest discharge time (867 s) that shows it has greater storage capacity, and its coulombic efficiency is 96.7%, which is greater than that for WO 3 (80.1%) and FeV-WO 3 (92.1%), respectively. Furthermore, excellent stability up to 2000 cycles is observed in FeV-WO 3 @g-C 3 N 4 . It is revealed from EIS measurements that equivalent series resistance and charge transfer values calculated for FeV-WO 3 @g-C 3 N 4 are 1.82 Ω and 0.65 Ω, respectively., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Delays in treatment of in-hospital cardiac arrests (IHCAs) are associated with worsened survival. We sought to assess the impact of a bundled intervention on IHCA survival in patients on centralised telemetry. A retrospective quality improvement study was performed of a bundled intervention which incorporated (1) a telemetry hotline for telemetry technicians to reach nursing staff; (2) empowerment of telemetry technicians to directly activate the IHCA response team and (3) a standardised escalation system for automated critical alerts within the nursing mobile phone system. In the 4-year study period, there were 75 IHCAs, including 20 preintervention and 55 postintervention. Cox proportional hazard regression predicts postintervention individuals have a 74% reduced the risk of death (HR 0.26, 95% CI 0.08 to 0.84) during a code and a 55% reduced risk of death (HR 0.45, 95% CI 0.23 to 0.89) prior to hospital discharge. Overall code survival improved from 60.0% to 83.6% (p=0.031) with an improvement in ventricular tachycardia/ventricular fibrillation (VT/VF) code survival from 50.0% to 100.0% (p=0.035). There was no difference in non-telemetry code survival preintervention and postintervention (71.4% vs 71.3%, p=0.999). The bundled intervention, including improved communication between telemetry technicians and nurses as well as empowerment of telemetry technicians to directly activate the IHCA response team, may improve IHCA survival, specifically for VT/VF arrests., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Japanese encephalitis (JE) is a single-stranded, mosquito-borne, positive-sense RNA flavivirus that causes one of the most severe encephalitides. There are treatments available for those who contact this illness; however, there are no known cures. This disease has a 30% fatality rate, and of the people who survive, 30-50% develops neurologic and psychiatric sequelae. The JE virus genome size is 10.98 kb and contains two coding DNA sequences (CDS), two genes, and 15 mature peptides; the CDS polyprotein is 10.3 kb. In this study, we used 29 genomics sequences of the JE virus reported from different countries and infecting different animals and analysed vast dimensions of the genomic annotation of JE comparatively to understand its evolutionary aspects. The extensive SNPs analysis revealed that KF907505.1, reported from Taiwan, has only three SNPs, similar to sequences reported from India. Repeat and polymorphism analyses revealed that the genome tends to be similar in most JE sequences., Competing Interests: The authors declare there are no conflicts of interest., (© 2023 Biomedical Informatics.)

Background: Hospitalized medical patients with concurrently decompensated psychiatric and medical conditions experience worse clinical outcomes. Health care providers caring for this patient population are at increased risk of workplace violence. The authors sought to understand the effects of a clinical microsystem specifically designed to care for patients too psychiatrically ill for medical units and too medically ill for psychiatry units., Methods: The research team performed a quality improvement study in which a medicine-psychiatry co-managed clinical microsystem incorporating high performance teamwork principles was engineered in an urban academic medical center to improve patient and staff safety, as well as operational outcomes. Poisson regression was performed to determine differences between workplace violence events, falls, 30-day emergency department (ED) revisits, and hospital readmissions, comparing the baseline period to the intervention period., Results: There were 321 patients discharged in the baseline period and 310 during the intervention period. Workplace violence events decreased by 65.6% (incidence rate ratio [IRR] 0.34, 95% confidence interval [CI] 0.20-0.57, p < 0.001) after implementation of the clinical microsystem when compared to the baseline period. The rate of ED utilization at 30 days postdischarge also decreased from 30.6% at baseline to 21.0% postintervention (adjusted odds ratio [aOR] 0.60, 95% CI 0.42-0.87, p = 0.006). No differences were detected in falls and 30-day readmissions., Conclusion: For patients with concurrently decompensated medical and psychiatric conditions, the incidence of workplace violence and postdischarge ED utilization can be improved by creating a clinical microsystem that integrates changes to both the physical environment and teamwork processes., (Copyright © 2022 The Joint Commission. Published by Elsevier Inc. All rights reserved.)

Objectives: Emerging adults transitioning from pediatric to adult care experience worse outcomes including increased mortality. Improved patient experience (PEX) correlates with decreased inpatient mortality and better adherence to quality guidelines. We aimed to evaluate trends in the PEX of inpatients aged 14-29 years in the United States (US)., Methods: We performed a retrospective cohort study using a national, de-identified PEX survey obtained from hospitalized patients aged 14-29 years between 2017 and 2019. We described and compared survey responses across 10 domains. Composite mean scores for each health facility were converted to percentile rankings, which were then compared by age group to determine differences in percentile ranking (ΔPR)., Results: We evaluated the results of 174,174 PEX surveys across a national sample of 1519 US hospitals. The PEX percentile rankings for ages 18-21 were lower than ages 14-17 in almost every domain including experience with nurses (ΔPR = 43.4, p < 0.001), physicians (ΔPR = 31.1, p < 0.001), treatment (ΔPR = 12.3, p < 0.001), and overall experience (ΔPR = 26.5, p < 0.001). Similarly, 22-25-year-olds reported a worse PEX across nearly all domains when compared to 26-29-year-olds., Conclusion: In a national sample of PEX surveys, hospitalized emerging adults aged 18-25 reported worse PEX when compared to both older children and established adults. These lower ratings were most strongly attributed to people, processes, and relationships as opposed to differences in the hospital environment. By ages 26-29, PEX returned to levels similar to those reported by ages 14-17. These results suggest that further investigation to elucidate the unique needs of hospitalized emerging adults may be warranted.

The pediatric-to-adult care transition has been correlated with worse outcomes, including increased mortality. Emerging adults transitioning from child-specific healthcare facilities to adult hospitals encounter marked differences in environment, culture, and processes of care. Accordingly, emerging adults may experience care differently than other hospitalized adults. We performed a retrospective cohort study of patients admitted to a large urban safety net hospital and compared all domains of patient experience between patients in 3 cohorts: ages 18 to 21, 22 to 25, and 26 years and older. We found that patient experience for emerging adults aged 18 to 21, and, to a lesser extent, aged 22 to 25, was significantly and substantially worse as compared to adults aged 26 and older. The domains of worsened experience were widespread and profound, with a 38-percentile difference in overall experience between emerging adults and established adults. While emerging adults experienced care worse in nearly all domains measured, the greatest differences were found in those pertinent to relationships between patients and care providers, suggesting a substantial deficit in our understanding of the preferences and values of emerging adults., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Lung cancer presents one of the most challenging carcinomas with meager 5-year survival rates (less than 20%), high metastasis and high recurrence due to chemo- and radio- resistance. An alternative or complementation to existing prognosis modalities is the use of phytochemicals such as silibinin, which targets essential cytokines, angiogenic factors and transcription factors for a profound anti-tumor effect. However, the problems of low solubility in an aqueous physiological environment, poor penetration, high metabolism and rapid systemic clearance limit the therapeutic use of silibinin. Conjugation of gold nanoparticles (GNPs) with silibinin may overcome the above challenges along with distinct advantages of biocompatibility, optical properties for monitoring and causation of cytotoxicity in cancer cells. The current study thus aims to develop silibinin conjugated gold nanoparticles (Sb-GNPs) with pH responsive release in the cancer microenvironment, optimizing several parameters for its higher activity and further evaluate the nanoplatform for their efficacy in inducing cell death in vitro against A549 lung cancer cells. GNPs was synthesized using trisodium citrate dihydrate as the reducing agent and further used for the conjugation of silibinin. The synthesized GNPs were found to be monodispersed and spherical in shape. The silibinin was successfully conjugated with gold nanoparticles and long-term stability of GNPs and Sb-GNPs nanoconjugates in suspension phase was confirmed by FTIR and DLS. Anticancer properties of Sb-GNPs were confirmed by different assay using MTT, Trypan blue dye exclusion assay and cell cycle analysis assay. After conjugation of silibinin with GNPs, the efficacy of silibinin increased 4-5 times in killing the cancer cells. This is the first report on using silibinin gold nanoconjugate system for lung cancer therapy with promising future applications., Competing Interests: RA was employed by the company Anantaa GSK Innovations Pvt. Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ravi, Zeyaullah, Ghosh, Khan Warsi, Baweja, AlShahrani, Mishra and Ahmad.)

Background: Scholarship remains the principal currency for faculty promotion in academic medicine. Reference points for scholarly growth and productivity at academic medical centers (AMCs) are lacking., Methods: We identified hospital medicine full professors (HMFPs) at AMCs ranked in research by US News & World Report. Scopus was used to identify each HMFP's publications, citations, and Hirsch-index (H-index). Publications; citations; and first, middle, and senior author papers were measured in 3-year intervals postresidency. Scholarly productivity was analyzed by quintile based on publications, AMC research ranking, years postresidency, and grant funding., Results: Data were extracted for 128 HMFPs from 54 AMCs. HMFPs were a mean of 20.5 (SD: 5.4) years postresidency. The median H-index was 7.0 (interquartile range [IQR]: 2.0-16.0); the median number of publications was 15.0 (IQR: 4.0-51.0). Top quintile HMFPs had a median of 175.5 (IQR: 101.5-248.0) publications, whereas fifth quintile HMFPs had a median of 0.0 (IQR: 0.0-1.0) (p < .001). HMFPs on faculty at the top 20 AMCs had a median of 35.5 (IQR: 11.0-108.0) publications, whereas HMFPs in AMCs ranked 81-122 had a median of 3.0 (IQR: 1.0-9.0) (p < .001). Grant-funded HMFPs had a median of 177.0 (IQR: 71.0-278.0) publications, while nongrant-funded HMFPs had a median of 11.0 (IQR: 3.0-25.0) (p < .001). At 3, 6, and 9 years postresidency, HMFPs had a median of 0.0 (IQR: 0.0-1.0), 1.5 (IQR: 0.0-5.0), and 3.5 (IQR: 0.0-11.0) publications. Fellowship training, additional degrees, and top 25 residency programs correlated with the top half of scholarly productivity., Conclusions: Scholarly productivity among HMFPs varies considerably. At 3, 6, and 9 years postresidency, it is minimal to modest. Grant funding and AMC research rank may establish separate frames of reference for scholarly growth., (© 2022 Society of Hospital Medicine.)

Population growth is increasing rapidly around the world, in these consequences we need to produce more foods to full fill the demand of increased population. The world is facing global warming due to urbanizations and industrialization and in this concerns plants exposed continuously to abiotic stresses which is a major cause of crop hammering every year. Abiotic stresses consist of Drought, Salt, Heat, Cold, Oxidative and Metal toxicity which damage the crop yield continuously. Drought and salinity stress severally affected in similar manner to plant and the leading cause of reduction in crop yield. Plants respond to various stimuli under abiotic or biotic stress condition and express certain genes either structural or regulatory genes which maintain the plant integrity. The regulatory genes primarily the transcription factors that exert their activity by binding to certain cis DNA elements and consequently either up regulated or down regulate to target expression. These transcription factors are known as masters regulators because its single transcript regulate more than one gene, in this context the regulon word is fascinating more in compass of transcription factors. Progress has been made to better understand about effect of regulons (AREB/ABF, DREB, MYB, and NAC) under abiotic stresses and a number of regulons reported for stress responsive and used as a better transgenic tool of Arabidopsis and Rice.

Santolina chamaecyparissus is an important medicinal plant growing in the Mediterranean region and has been reported as a potent anti-inflammatory, antibacterial, antioxidant, and antifungal agent. The purpose of the current research is to identify the chemical constituents in ethyl acetate extract (EAE) from the leaves of S. chamaecyparissus , and to evaluate antidiabetic, and anticancer activity. Chemical constituents of EAE were identified by GC-MS, and the antidiabetic activity was evaluated by α-glucosidase inhibition assay. The anticancer activity was assessed by Epidermal Growth Factor Receptor (EGFR) expression in human breast cancer cell line (MCF7) by using quantitative RT-PCR method. GC-MS analysis of EAE of S. chamaecyparissus yielded 44 compounds. Tetrapentacontane (27.15%), eicosyl acetate (8.40%), 2-methylhexacosane (6.87%), and n -pentadecanol (5.44%) were found as major chemical constituents. The EAE of S. chamaecyparissus showed concentration dependant inhibition of α-glucosidase enzyme and the IC 50 value (IC 50 110 ± 4.25 µg/mL) was found comparable with standard acarbose (IC 50 105 ± 3.74 µg/mL). The real-time qRT-PCR results showed that the EGFR protein ( bcl-2 ) in human breast cancer cell line (MCF7) was negatively expressed with a value of -0.69297105 after treatment with EAE (100 µg/mL). The study results are suggesting the possible use of S. chamaecyparissus in the management of diabetes, and human breast cancer., Competing Interests: The authors declare that there is no conflict of interest., (© 2021 The Author(s).)