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This letter to the editor raises concerns about a systematic review and meta-analysis comparing the vaccine effectiveness of mRNA-1273 and BNT162b2 COVID-19 vaccines in adults aged 50 and older. The authors argue that the meta-analysis was flawed because it used crude data instead of adjusted estimates, leading to incorrect conclusions and exaggerated differences in vaccine effectiveness. They also criticize the inclusion of studies that were not head-to-head comparisons and the reliance on outdated data that does not reflect the current state of population immunity against SARS-CoV-2. The authors conclude that recent studies during the Omicron era have shown no difference in effectiveness between the two vaccines. [Extracted from the article]

Background: The role of contact sensitisation in the pathogenesis of oral lichen planus (OLP) has not been clearly defined. Objective: We aimed to evaluate relevant contact sensitisers in OLP. Methods: A retrospective study was conducted on OLP patients who underwent patch testing from 1 January 2006 to 31 December 2020 at an Australian tertiary dermatology institution, compared to cheilitis patients patch tested over the same time period. Results: Ninety‐six OLP patients and 152 cheilitis patients were patch tested during the 15‐year period. Seventy‐one (73.9%) OLP patients and 100 (65.8%) cheilitis patients recorded one or more relevant reactions. Forty‐three (44.8%), 22 (22.9%), 21 (21.9%) and 17 (17.7%) OLP patients had relevant reactions to mercury‐related chemicals, amalgam, spearmint and carvone, respectively, compared to 6 (3.9%), 3 (2.0%), 4 (2.6%) and 0 (0%) cheilitis patients, respectively (p‐value <0.001 each). Four (4.2%) OLP patients had relevant positive reactions to sodium metabisulfite, compared to none in the cheilitis group (p‐value 0.021). Conclusion: While dental amalgam is used less frequently these days, we report that mercury (found in amalgam) and additionally spearmint and carvone are relevant sensitisers in OLP in Australia. Sodium metabisulfite may also be a relevant sensitiser in OLP, which has not previously been reported. [ABSTRACT FROM AUTHOR]

Keywords: electrochemistry; electrocatalysis; olefin metathesis; ruthenium catalysis EN electrochemistry electrocatalysis olefin metathesis ruthenium catalysis 1477 1481 5 07/11/23 20230725 NES 230725 Graph Olefin metathesis is one of the most valuable reactions in organic chemistry for the formation of C=C bonds, as reflected by its widespread application in synthetic chemistry, [1] materials science, [2] and polymer science. Electrochemistry, electrocatalysis, olefin metathesis, ruthenium catalysis. [Extracted from the article]

Recent studies evaluating the effectiveness of using telehealth to train caregivers across large geographical distances in the United States and internationally indicate that this modality can increase families' accessibility to evidence-based interventions for problem behavior. In this study, experimenters and interpreters in the United States remotely coached nine caregivers of children with disabilities residing in three countries in Asia to implement functional analyses (FA) and functional communication training (FCT). Five of the nine families were culturally matched to either the experimenter or the interpreter. Problem behavior was reduced to near-zero levels for all but one participant. Furthermore, all caregivers implemented the procedures with high levels of integrity and rated the assessment and treatment as highly acceptable, regardless of cultural matching or use of interpreters. Overall, findings suggest telehealth-based caregiver coaching and caregiver-implemented FA plus FCT is feasible and acceptable in Asia. [ABSTRACT FROM AUTHOR]

Background/Objectives: Sequential digital dermoscopic imaging (SDDI) and total body photography (TBP) are recommended as a two‐step surveillance method for individuals at high‐risk of developing cutaneous melanoma. Dermoscopic features specific to melanoma have been well described, however, dynamic changes on serial imaging are less understood. This study aims to identify and compare dermoscopic features in developing melanomas and benign naevi that underwent SDDI and TBP to understand which dermoscopic features may be associated with a malignant change. Method: Histopathology reports from a private specialist dermatology clinic from January 2007 to December 2019 were reviewed. Histopathologically confirmed melanoma and benign naevi that underwent SDDI and TBP with a minimum follow‐up interval of 3 months were included. Results: Eighty‐nine melanomas (38.2% invasive, median Breslow thickness 0.35 mm, range: 0.2–1.45 mm) and 48 benign naevi were evaluated by three experienced dermatologists for dermoscopic changes. Features most strongly associated with melanoma included the development of neovascularisation, asymmetry and growth in pigment network, additional colours, shiny white structures, regression, structureless areas and change to a multi‐component pattern. The presence of atypical vessels (p = 0.02) and shiny white structures (p = 0.02) were significantly associated with invasive melanoma. Conclusion: Evaluation for certain evolving dermoscopic features in melanocytic lesions monitored by SDDI and TBP is efficient in assisting clinical decision making. SDDI with TBP is an effective tool for early detection of melanoma. [ABSTRACT FROM AUTHOR]

Introduction: A 13-valent pneumococcal conjugate vaccine (PCV13) was licensed to protect against emerging Streptococcus pneumoniae serotypes. Healthcare services, including routine childhood immunizations, were disrupted as a result of coronavirus disease 2019 (COVID-19). This study compared PCV13 routine vaccination completion and adherence among US infants before and during the COVID-19 pandemic and the relationship between primary and booster dose completion and adherence. Methods: Retrospective data from Optum's de-identified Clinformatics® Data Mart were used to create three cohorts using data collected between January 2017 and December 2020: cohort 1 (C1), pre-COVID; cohort 2 (C2), cross-COVID; and cohort 3 (C3), during COVID. Study endpoints were completion and adherence to the primary PCV13 series (analyzed using univariate logistic regression) and completion of and adherence to the booster dose (analyzed descriptively). Results: The analysis included 142,853 infants in C1, 27,211 infants in C2, and 53,306 infants in C3. Among infants with at least 8 months of follow-up from birth, three-primary-dose completion (receipt of all three doses within 8 months after birth) and adherence (receipt of doses at recommended times) were significantly higher before (C1 and C2) versus during (C3) COVID-19 (odds ratio [OR] 1.12 [95% confidence interval [CI] 1.07, 1.16] and OR 1.10 [95% CI 1.05, 1.15], respectively). A significantly higher percentage of infants received a booster dose before versus during COVID-19 (83.2% vs. 80.2%; OR 1.23; 95% CI 1.17, 1.29); similarly, booster dose adherence was higher before than during COVID-19 (51.2% vs. 47.4%; OR 1.17; 95% CI 1.13, 1.21). The odds of booster dose completion were 8.26 (95% CI 7.92, 8.60) and 7.90 (95% CI 7.14, 8.74) times as likely in infants who completed all three primary doses than in infants who did not complete primary doses before COVID-19 and during COVID-19, respectively. Conclusions: PCV13 full completion was lower during the COVID-19 pandemic compared with pre-pandemic (79.0% vs. 77.1%). [ABSTRACT FROM AUTHOR]

Objective: This study examines changes in utilization and costs trends associated with migraine medications. Background: Migraine attacks are a burden to many patients. There are many pharmacotherapy options available with newer migraine drug classes entering the market in the past decade. Little is known about the use, associated costs, and the impact of the newer agents. Methods: This retrospective, cross-sectional study examined 2017–2020 administrative claims from a large national pharmacy benefits manager. Patients aged ≥ 18 years enrolled in commercial, Medicare, Medicaid, or health insurance exchange insurance plans who filled ≥ 2 prescription claims for triptans, ergotamines, isometheptenes, gepants, ditans, and CGRP mABs were included. A two-sample t-test was conducted to estimate whether differences in mean utilization and costs between 2017 and 2020 were statistically significant for migraine drug classes, except for CGRP mABs, which were estimated between 2018 and 2020. Results: The sample ranged from 161,369 (2017) to 240,330 (2020) patients. 84.5% (n = 203,110; 2020) of patients were women. The number of 30-day adjusted prescription fills for prophylaxis remained stable over the four-year period, except for CGRP mABs, which increased from 0.5% (n = 0.007; 2018) to 5.3% (n = 0.075; 2020). Antiepileptics, antidepressants and beta blockers were the most common prophylaxes, while triptans, non-steroidal anti-inflammatory drugs/non-narcotic analgesics and opioids were the most common treatments utilized. CGRP mABs were the most expensive, while utilization of triptans were the highest. CGRP mABs had the largest increase in utilization (177.5%) and costs (166.3%) PPPM in 2020 ($291.17) compared to 2018 ($109.35), the year they were first available (p < 0.001). Between 2018 and 2020, costs increased overall and for commercial and Medicare enrollees, but remained unchanged for Medicaid and HIX members. Conclusion: Our study demonstrates a shift in migraine medication utilization from 2017–2020, where increased use of CGRP mABs had a significant contribution to increased costs. These increased pharmacy costs must be weighed against the improved tolerability of these agents likely resulting in other healthcare and indirect cost savings. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Melasma being a complex and therapeutically challenging condition for dermatologists globally. Topics include two randomised controlled trials (RCT) showing significant improvement in melasma after 12 weeks treatment with 250 mg oral TA; and exclusion criteria included contraindications to TA from the US Food and Drug Administration and Monthly Index of Medical Specialities, Australia.

Background Several underlying medical conditions have been reported to be associated with an increased risk of coronavirus disease 2019 (COVID-19) and related hospitalization and death. Population attributable fractions (PAFs) describing the proportion of disease burden attributable to underlying medical conditions for COVID-19 diagnosis and outcomes have not been reported. Methods A retrospective population-based cohort study was conducted using Optum's de-identified Clinformatics Data Mart database. Individuals were followed up from 20 January 2020 to 31 December 2020 for diagnosis and clinical progression, including hospitalization, intensive care unit admission, intubation and mechanical ventilation or extracorporeal membrane oxygenation, and death. Adjusted rate ratios and PAFs of underlying medical conditions for COVID-19 diagnosis and disease progression outcomes were estimated by age (18–49, 50–64, 65–74, or ≥75 years), sex, and race/ethnicity. Results Of 10 679 566 cohort members, 391 964 (3.7%) were diagnosed with COVID-19, of whom 87 526 (22.3%) were hospitalized. Of those hospitalized, 26 640 (30.4%) died. Overall, cardiovascular disease and diabetes had the highest PAFs for COVID-19 diagnosis and outcomes of increasing severity across age groups (up to 0.49 and 0.35, respectively). Among adults ≥75 years of age, neurologic disease had the second-highest PAFs (0.05‒0.27) after cardiovascular disease (0.26‒0.44). PAFs were generally higher in Black persons than in other race/ethnicity groups for the same conditions, particularly in the 2 younger age groups. Conclusions A substantial fraction of the COVID-19 disease burden in the United States is attributable to cardiovascular disease and diabetes, highlighting the continued importance of COVID-19 prevention ( eg, vaccination, mask wearing, social distancing) and disease management of patients with certain underlying medical conditions. [ABSTRACT FROM AUTHOR]

All patients had clinical symptoms consistent with AIGA including widespread anhidrosis with cutaneous pain and an associated cholinergic urticaria in some patients. Keywords: acquired idiopathic generalised anhidrosis; anhidrosis; cholinergic urticaria; cutaneous pain; danazol; hypohidrosis EN acquired idiopathic generalised anhidrosis anhidrosis cholinergic urticaria cutaneous pain danazol hypohidrosis e170 e173 4 05/20/22 20220501 NES 220501 Acquired idiopathic generalised anhidrosis (AIGA) is a rare condition characterised by non-segmental anhidrosis or hypohidrosis without an underlying secondary cause or associated neurological pathology.1 Patients typically describe an intense pinprick and burning cutaneous pain, frequently associated with an urticarial rash, which can affect over 25% of the body surface area (BSA). Four patients underwent thermoregulatory sweat testing, which confirmed the clinical suspicion of extensive anhidrosis (one patient was not able to complete this test due to COVID restrictions) (Fig. [Extracted from the article]

Charge heterogeneity is inherent to all therapeutic antibodies and arises from post-translational modifications (PTMs) and/or protein degradation events that may occur during manufacturing. Among therapeutic antibodies, the bispecific antibody (bsAb) containing two unique Fab arms directed against two different targets presents an additional layer of complexity to the charge profile. In the context of a bsAb, a single domain-specific PTM within one of the Fab domains may be sufficient to compromise target binding and could potentially impact the stability, safety, potency, and efficacy of the drug product. Therefore, characterization and routine monitoring of domain-specific modifications is critical to ensure the quality of therapeutic bispecific antibody products. We developed a D igestion-assisted i maged C apillary iso E lectric focusing (DiCE) method to detect and quantitate domain-specific charge variants of therapeutic bispecific antibodies (bsAbs). The method involves enzymatic digestion using immunoglobulin G (IgG)-degrading enzyme of S. pyogenes (IdeS) to generate F(ab) 2 and Fc fragments, followed by imaged capillary isoelectric focusing (icIEF) under reduced, denaturing conditions to separate the light chains (LCs) from the Fd domains. Our results suggest that DiCE is a highly sensitive method that is capable of quantitating domain-specific PTMs of a bsAb. In one case study, DiCE was used to quantitate unprocessed C-terminal lysine and site-specific glycation of Lys98 in the complementarity-determining region (CDR) of a bsAb that could not be accurately quantitated using conventional, platform-based charge variant analysis, such as intact icIEF. Quantitation of these PTMs by DiCE was comparable to results from peptide mapping, demonstrating that DiCE is a valuable orthogonal method for ensuring product quality. This method may also have potential applications for characterizing fusion proteins, antibody-drug conjugates, and co-formulated antibody cocktails. • Domain-specific isoelectric focusing method to evaluate charge in bispecific antibodies. • Broad applications for preclinical manufacturing and formulations development. • QC-friendly analytical method with potential to support product release and stability. [ABSTRACT FROM AUTHOR]

Dermatologists often diagnose or rule out early melanoma by evaluating the follow-up dermoscopic images of skin lesions. However, existing algorithms for early melanoma diagnosis are developed using single time-point images of lesions. Ignoring the temporal, morphological changes of lesions can lead to misdiagnosis in borderline cases. In this study, we propose a framework for automated early melanoma diagnosis using sequential dermoscopic images. To this end, we construct our method in three steps. First, we align sequential dermoscopic images of skin lesions using estimated Euclidean transformations, extract the lesion growth region by computing image differences among the consecutive images, and then propose a spatio-temporal network to capture the dermoscopic changes from aligned lesion images and the corresponding difference images. Finally, we develop an early diagnosis module to compute probability scores of malignancy for lesion images over time. We collected 179 serial dermoscopic imaging data from 122 patients to verify our method. Extensive experiments show that the proposed model outperforms other commonly used sequence models. We also compared the diagnostic results of our model with those of seven experienced dermatologists and five registrars. Our model achieved higher diagnostic accuracy than clinicians (63.69% vs. 54.33%, respectively) and provided an earlier diagnosis of melanoma (60.7% vs. 32.7% of melanoma correctly diagnosed on the first follow-up images). These results demonstrate that our model can be used to identify melanocytic lesions that are at high-risk of malignant transformation earlier in the disease process and thereby redefine what is possible in the early detection of melanoma. [ABSTRACT FROM AUTHOR]

Reactivation of fetal-specific genes and isoforms occurs during heart failure. However, the underlying molecular mechanisms and the extent to which the fetal program switch occurs remains unclear. Limitations hindering transcriptome-wide analyses of alternative splicing differences (i.e. isoform switching) in cardiovascular system (CVS) tissues between fetal, healthy adult and heart failure have included both cellular heterogeneity across bulk RNA-seq samples and limited availability of fetal tissue for research. To overcome these limitations, we have deconvoluted the cellular compositions of 996 RNA-seq samples representing heart failure, healthy adult (heart and arteria), and fetal-like (iPSC-derived cardiovascular progenitor cells) CVS tissues. Comparison of the expression profiles revealed that reactivation of fetal-specific RBPs, and the accompanied re-expression of 1,523 fetal-specific isoforms, contribute to the transcriptome differences between heart failure and healthy adult heart. Of note, isoforms for 20 different RBPs were among those that reverted in heart failure to the fetal-like expression pattern. We determined that, compared with adult-specific isoforms, fetal-specific isoforms encode proteins that tend to have more functions, are more likely to harbor RBP binding sites, have canonical sequences at their splice sites, and contain typical upstream polypyrimidine tracts. Our study suggests that compared with healthy adult, fetal cardiac tissue requires stricter transcriptional regulation, and that during heart failure reversion to this stricter transcriptional regulation occurs. Furthermore, we provide a resource of cardiac developmental stage-specific and heart failure-associated genes and isoforms, which are largely unexplored and can be exploited to investigate novel therapeutics for heart failure. Author summary: Heart failure is a chronic condition in which the heart does not pump enough blood. It has been shown that in heart failure, the adult heart reverts to a fetal-like metabolic state and oxygen consumption. Additionally, genes and isoforms that are expressed in the heart only during fetal development (i.e. not in the healthy adult heart) are turned on in heart failure. However, the underlying molecular mechanisms and the extent to which the switch to a fetal gene program occurs remains unclear. In this study, we initially characterized the differences between the fetal and adult heart transcriptomes (entire set of expressed genes and isoforms). We found that RNA binding proteins (RBPs), a family of genes that regulate multiple aspects of a transcript's maturation, including transcription, splicing and post-transcriptional modifications, play a central role in the differences between fetal and adult heart tissues. We observed that many RBPs that are only expressed in the heart during fetal development become reactivated in heart failure, resulting in the expression of 1,523 fetal-specific isoforms. These findings suggest that reactivation of fetal-specific RBPs in heart failure drives a transcriptome-wide switch to expression of fetal-specific isoforms; and hence that RBPs could potentially serve as novel therapeutic targets. [ABSTRACT FROM AUTHOR]

Background Pregnant women with coronavirus disease 2019 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database—Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473 902 hospitalized pregnant women were included, 8584 (1.8%) of whom had a COVID-19 diagnosis (mean age = 28.4 [standard deviation = 6.1] years; 40% Hispanic). The risk of poor clinical and pregnancy outcomes was greater among pregnant women with COVID-19 compared with pregnant women without a COVID-19 diagnosis in 2020; the risk of poor clinical and pregnancy outcomes increased with increasing age. Hispanic and Black non-Hispanic women were consistently observed to have the highest relative risk of experiencing poor clinical or pregnancy outcomes across all age groups. Conclusions Overall, COVID-19 had a significant negative impact on maternal health and pregnancy outcomes. These data help inform clinical practice and counseling to pregnant women regarding the risks of COVID-19. Clinical studies evaluating the safety and efficacy of vaccines against severe acute respiratory syndrome coronavirus 2 in pregnant women are urgently needed. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted healthcare utilization worldwide. The objective of this retrospective analysis of a large hospital discharge database was to compare all-cause and cause-specific hospitalizations during the first six months of the pandemic in the United States with the same months in the previous four years. Methods: Data were collected from all hospitals in the Premier Healthcare Database (PHD) and PHD Special Release reporting hospitalizations from January through July for each year from 2016 through 2020. Hospitalization trends were analyzed stratified by age group, major diagnostic categories (MDCs), and geographic region. Results: The analysis included 286 hospitals from all 9 US Census divisions. The number of all-cause hospitalizations per month was relatively stable from 2016 through 2019 and then fell by 21% (57,281 fewer hospitalizations) between March and April 2020, particularly in hospitalizations for non-respiratory illnesses. From April onward there was a rise in the number of monthly hospitalizations per month. Hospitalizations per month, nationally and in each Census division, decreased for 20 of 25 MDCs between March and April 2020. There was also a decrease in hospitalizations per month for all age groups between March and April 2020 with the greatest decreases in hospitalizations observed for patients 50–64 and ≥65 years of age. Conclusions: Rates of hospitalization declined substantially during the first months of the COVID-19 pandemic, suggesting delayed routine, elective, and emergency care in the United States. These lapses in care for illnesses not related to COVID-19 may lead to increases in morbidity and mortality for other conditions. Thus, in the current stage of the pandemic, clinicians and public-health officials should work, not only to prevent SARS-CoV-2 transmission, but also to ensure that care for non-COVID-19 conditions is not delayed. [ABSTRACT FROM AUTHOR]

Background: The United States has experienced high COVID-19 case counts, hospitalizations, and death rates. This retrospective analysis reports changing trends in the demographics and clinical outcomes of hospitalized US COVID-19 patients between April and August 2020. Design and methods: The Premier Healthcare Database Special Release was used to examine patient demographics of hospitalized COVID-19 patients from all US Census Bureau divisions. Demographics included age, sex, race, and ethnicity. Clinical outcomes included in-hospital mortality, intensive care unit (ICU) admission, and receipt of invasive mechanical ventilation. Results: Overall, 146,491 hospitalized COVID-19 patients were included (mean [SD] age, 61.0 [18.4] years; 51.7% male; 29.6% White non-Hispanic). Monthly total hospitalizations decreased from 44,854 in April to 18,533 in August; ICU admissions increased from 19.8% to 23.6%, and ventilator use and inpatient mortality decreased from 18.6% to 14.5% and 21.0% to 11.4%, respectively. Inpatient mortality was highest in the Middle Atlantic division (20.3%), followed by the New England (19.0%), East North Central (14.2%), and Mountain (13.7%) divisions. Black non-Hispanic patients were overrepresented among hospitalizations (19.0%); this group comprises 12.2% of the US population. Patients aged <65 years made up 53% of hospitalizations and had lower inpatient mortality than those aged =65 years. Conclusions: Hospitalizations, ventilator use, and mortality decreased, while ICU admission rates increased from April to August 2020. Older individuals and Black non-Hispanics were found to be at elevated risk of severe outcomes. These trends could inform ongoing patient care and US public health policies to limit the further spread of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Background/Objective: Diagnostic tools such as dermoscopy, sequential digital dermoscopy imaging (SDDI), total body photography (TBP) and automated diagnostic tools are available to assist in early melanoma diagnosis. The use, accessibility and barriers of dermoscopy have been well studied; however, there are few similar studies regarding SDDI, TBP and automated diagnostic tools. We aim to understand the use of these diagnostic aids amongst Australian general practitioners (GPs) and dermatologists. Methods: Between June 2019 and January 2020, GPs and dermatologists across Australia were invited to participate in an online survey. Surveys were distributed through GP and dermatology organisations. Results: A total of 227 survey responses were received, 175 from GPs and 52 from dermatologists. Amongst GPs, 44.6% worked in a skin cancer clinic. Dermoscopy was used at least occasionally by 98.9% of all GPs. SDDI was used by 93.6% of skin cancer GPs, 80.8% of dermatologists and 45.3% of generalist GPs. TBP was used or recommended by 77.1% of generalist GPs, 82.3% of skin cancer GPs and 86.5% of dermatologists. The most common barriers to the use of TBP were cost, limited accessibility, poor patient compliance, and time required for both patients and doctors. Very few clinicians reported using automated diagnostic tools. There was an interest in future diagnostic aids for melanoma in 88% of GPs and dermatologists. Conclusion: Dermoscopy, SDDI and TBP were commonly used by responding Australian skin cancer GPs and dermatologists in this survey. Automated diagnostic tools were not reported to be used routinely. Several barriers were identified for use of TBP. [ABSTRACT FROM AUTHOR]

Objectives: Otolaryngologists in Texas have been greatly affected by the coronavirus disease 2019 (COVID-19) pandemic. Executive orders and professional recommendations have changed the way otolaryngologists practice. The objective of the study was to determine the effect of COVID-19 on otolaryngologists in the state of Texas.Methods: We surveyed the Texas Association of Otolaryngology to evaluate burnout, research output, and ability to respond to the pandemic. We also looked at the effect of Texas governmental executive orders GA-09 and GA-15 on work hours and patient load.Results: Our survey showed no significant difference in personnel contracting COVID-19 with perception of adequate personal protective equipment (P = 0.203), population density (P = 0.445), or type of practice (P = 0.763). The phenomenon of "pandemic burnout" was prevalent, with prolonged uncertainty the primary contributing factor for burnout caused by the pandemic.Conclusions: The response to COVID-19 and the course of the pandemic are continuing to evolve and may play a significant role in how otolaryngologists practice and on their well-being during the pandemic. [ABSTRACT FROM AUTHOR]

Melasma is a common disorder of hyperpigmentation that presents a therapeutic challenge for clinical dermatologists. The pathogenesis is complex, but previous studies have demonstrated vascular proliferation is a key factor in the development of the classic hyperpigmented patches. Studies have revealed reduction of erythema by oral tranexamic acid; however, there has been no direct comparison to placebo. This 24‐week randomised placebo‐controlled trial demonstrates oral tranexamic acid may improve erythema in melasma. This mechanism of action may be the reason for the success of tranexamic acid in complex and difficult to treat melasma. [ABSTRACT FROM AUTHOR]

Despite the significantly reduced infectious disease risk through robust and sensitive laboratory assays, comprehensive donor screening and good manufacturing practices, new and emerging infectious agents and bacterial contamination continue to pose a threat to the blood supply. Pathogen Reduction (PR) technology is an option to mitigate the risk of platelet transfusion transmitted infections. Here we describe our structure and strategies to implement PR technology. Pre-implementation and phased approach implementation processes from our hospital-based donor center, components processing laboratory, transfusion service, clinicians, nursing, and patient perspectives are described. Communication and reassessment of collection settings occurred between the donor center and components processing laboratory (CPL). During Phase 1, CPL consistently processed approximately 56% of monthly apheresis platelets (AP) collections by PR and the remaining 44% as conventional platelets (CP). Phase 2 increased the amount of AP undergoing PR from 56% to approximately 78%. A phased implementation and maintenance of a dual inventory may provide flexibility to blood collection, blood manufacturing, and transfusion service processes. Our dual inventory of PR and CP allows our transfusion service a readily available platelet inventory. A collaborative hospital-based donor center, component processing laboratory, and transfusion service are essential to the productivity and maintenance of the dual platelet inventory. [ABSTRACT FROM AUTHOR]

Background/Objective: Melasma is a commonly acquired disorder of hyperpigmentation that often poses a therapeutic challenge for dermatologists. Recently, cysteamine cream has shown promising results compared to placebo. This study aims to determine the efficacy of cysteamine cream compared to hydroquinone cream in the treatment of melasma. Methods: A randomised, double‐blinded, single‐centre trial was conducted in Victoria, Australia. 20 recruited participants were given either cysteamine cream or hydroquinone cream for 16 weeks. The primary outcome measure was a change in the modified Melasma Area and Severity Index (mMASI). Quality of life at baseline and week 16 as well as standard digital photography at each follow‐up visit was assessed as secondary outcome measures. Results: At week 16, 14 participants completed the study with 5 participants in the cysteamine group and 9 patients in the hydroquinone group. In the intention to treat analysis, there was a 1.52 ± 0.69 (21.3%) reduction in mMASI for the cysteamine group and a 2.96 ± 1.15 (32%) reduction in the hydroquinone group. The difference between groups was not statistically significant (P = 0.3). Hydroquinone cream was generally better tolerated that cysteamine cream. Conclusion: Our study suggests that topical cysteamine may have comparable efficacy to topical hydroquinone. Cysteamine thus provides a possible alternative to patients and clinicians who wish to avoid or rotate off topical hydroquinone. While side effects were more common for participants using cysteamine compared with hydroquinone, these were mild and reversible. Larger studies comparing cysteamine and hydroquinone are required to support these findings. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is characterized by the destruction of alveolar tissue (in emphysema) and airway remodeling (leading to chronic bronchitis), which cause difficulties in breathing. It is a growing public health concern with few therapeutic options that can reverse disease progression or mortality. This is in part because current treatments mainly focus on ameliorating symptoms induced by inflammatory pathways as opposed to curing disease. Hence, emerging research focused on upstream pathways are likely to be beneficial in the development of efficient therapeutics to address the root causes of disease. Some of these pathways include mitochondrial function, cytoskeletal structure and maintenance, and airway hydration, which are all affected by toxins that contribute to COPD. Because of the complexity of COPD and unknown targets for disease onset, simpler model organisms have proved to be useful tools in identifying disease-relevant pathways and targets. This review summarizes COPD pathology, current treatments, and therapeutic discovery research, with a focus on the aforementioned pathways that can advance the therapeutic landscape of COPD. [ABSTRACT FROM AUTHOR]

Introduction: In estimated glomerular filtration rate equations (eGFR), the race multiplier (RM) yields greater eGFR values and may assign less severe chronic kidney disease (CKD) stages to black individuals. When deciding on appropriateness for partial nephrectomy (PN), patients with CKD are often considered a relative or absolute indication. We hypothesize that the eGFR RM may have ramifications for patients being counseled for radical nephrectomy (RN) versus PN to manage their renal tumor. Methods: We utilized prospective and retrospective, IRB-approved single-center databases to select patients who underwent PN or RN between 2016 and 2022. Demographics, preoperative risk factors, preoperative eGFR, and surgical management were collected. Descriptive statistics and two-tailed difference of proportion tests compared the percentage of patients with CKD who underwent nephrectomy. Results: This cohort included 1137 patients who underwent RN or PN, including 74 (6.5%) Black patients and 93.5% (n = 1063) non-Black patients. There was no statistically significant difference between the eGFR of Black and non-Black individuals using the Modification of Diet in Renal Disease equation (P = 0.24) or Chronic Kidney Disease Epidemiology Collaboration 2009 (CKD-EPI 2009) (P = 0.45); however, there was statistically significant difference in eGFR between sample populations when using CKD-EPI 2021 (P = 0.0055). Of the Black patient cohort, 16.2% of patients reclassified to a worse CKD class using CKD-EPI 2021, including 9.5% of Black patients reclassified to CKD3a or worse, and 14.6% of all patients (Black and non-Black) reclassified to a different CKD class under the CKD-EPI 2021 equation. Conclusions: There are quantitative differences in the evaluation of eGFR when utilizing different equations that may impact clinical considerations and health equity outcomes for nephrectomy across racial groups. [ABSTRACT FROM AUTHOR]

Introduction and Objective: Since its Food and Drug Administration (FDA) approval in 2018, Intuitive Surgical DaVinci single port (SP) robotic platform has been an effectively used technology for multiple urologic procedures. The purpose of this study is to share our early intraoperative and perioperative outcomes and potential benefits for performing a lower anterior access (LAA) incision for SP robot-assisted partial nephrectomy (SP-RAPN). The LAA incision enables performing a trans- or retroperitoneal (RP) approach through the same incision and eases the transition to a RP approach. Methods: This study is a prospective review of 78 SP-RAPN cases between March 2021 and January 2023 by an experienced robotic surgeon. A single 2–3 cm oblique incision parallel to the external oblique muscle, one-third of the distance between the iliac crest and umbilicus, was used to insert the multichannel port to perform the RAPN. We extracted intra- and perioperative data of these patients to share the outcomes of this approach. Results: SP-RAPN was effectively completed in 78 patients (38 females and 40 males) without conversion to open or laparoscopic techniques. The mean age was 61.2 ± 12.1 years. The mean tumor size was 3.0 ± 1.2 cm, 43 were right-sided masses, and 35 were left sided. The R.E.N.A.L Nephrometry score ranged from (4–11) with an average of 7.0 ± 1.9. Average operating room time was 90.5 ± 24.6 minutes, estimated blood loss was 88.3 ± 134 mL, and length of stay of 1.07 ± 0.7 days. Of the 78 cases, 40 required clamping of the renal artery with average warm ischemia time of 19.4 ± 6.7 minutes in patients who underwent clamping. No complications in all of 78 patients. Conclusions: This study demonstrates the feasibility and reproducibility of SP-RAPN using a LAA incision. This incision provides a standardized approach for surgeons to transition to the RP approach using the SP platform. [ABSTRACT FROM AUTHOR]

DISCUSSION Contact allergy to IPBC has increased gradually over time in the United States and Europe and we present the first Australian data for contact allergy and allergic contact dermatitis. Iodopropynyl butylcarbamate (IPBC) is a broad-spectrum preservative initially used in wood and paint products and now increasingly used in consumer products including cosmetics, moisturizers, shampoos, baby products, powders, paper, alcohol rubs, and wet wipes.1,2 In 1996 the US Food and Drug Administration reported that IPBC was used in 122 cosmetic products which increased to 942 by 2013.3,4 Increasing rates of contact allergy have been reported over the last 20 years from Europe and the United States,2 but there have been no studies from Australia. This contrasts with a previous study finding it to cause mainly occupational hand dermatitis in males.7 In another study, IPBC contact allergy was also reported to household detergents, but this was not evident in our study.8 These differences are likely to be due to the variation of exposure in the patients. [Extracted from the article]

People have come to refer to reviews for valuable information on products before making a purchase. Digesting relevant opinions regarding a product by reading all the reviews is challenging. An automated methodology which aggregates opinions across all the reviews for a single product to help differentiate any two products having the same overall rating is defined. In order to facilitate this process, rating values, which capture the overall satisfaction, and written reviews, which contain the sentiment of the experience with a product, are fused together. In this manner, each reviewer's opinion is expressed as an interval rating by means of hesitant fuzzy linguistic term sets. These new expressions of opinion are then aggregated and expressed in terms of a central opinion and degree of consensus representing the agreement among the sentiment of the reviewers for an individual product. A real case example based on 2506 TripAdvisor reviews of hotels in Rome during 2017 is provided. The efficiency of the proposed methodology when discriminating between two hotels is compared with the TripAdvisor rating and median of reviews. The proposed methodology obtains significant differentiation between product rankings. [ABSTRACT FROM AUTHOR]

Background: The transcription coactivators CREB binding protein (CBP) and p300 are highly homologous acetyltransferases that mediate histone 3 lysine 27 acetylation (H3K27ac) at regulatory elements such as enhancers and promoters. Although in most cases, CBP and p300 are considered to be functionally identical, both proteins are indispensable for development and there is evidence of tissue-specific nonredundancy. However, characterization of chromatin and transcription states regulated by each protein is lacking. Results: In this study we analyze the individual contribution of p300 and CBP to the H3K27ac landscape, chromatin accessibility, and transcription in mouse embryonic stem cells (mESC). We demonstrate that p300 is the predominant H3K27 acetyltransferase in mESCs and that loss of acetylation in p300KD mESCs is more pronounced at enhancers compared to promoters. While loss of either CBP or p300 has little effect on the open state of chromatin, we observe that distinct gene sets are transcriptionally dysregulated upon depletion of p300 or CBP. Transcriptional dysregulation is generally correlated with dysregulation of promoter acetylation upon depletion of p300 (but not CBP) and appears to be relatively independent of dysregulated enhancer acetylation. Interestingly, both our transcriptional and genomic analyses demonstrate that targets of the p53 pathway are stabilized upon depletion of p300, suggesting an unappreciated view of the relationship between p300 and p53 in mESCs. Conclusions: This genomic study sheds light on distinct functions of two important transcriptional regulators in the context of a developmentally relevant cell type. Given the links to both developmental disorders and cancer, we believe that our study may promote new ways of thinking about how these proteins function in settings that lead to disease. [ABSTRACT FROM AUTHOR]

The majority of electronic products today are built using no-clean soldering processes. However, the effect of no-clean flux residue on signal integrity is a concern for many high-frequency products, such as fifth-generation (5G) and other communication products. No-clean flux residue can create an alternative path to the signal and degrade the signal integrity performance, especially at high frequency. However, there are limited studies on the effect of no-clean residue on signal integrity. This work sets out to study the effects of no-clean flux residue on signal integrity at high frequency, including the frequency spectrum used for 5G technology. This study includes the analytical modeling of the dielectric loss and impedance mismatch loss at high frequency. In addition, the insertion loss is measured at different frequencies up to 50 GHz. The results show that the loss due to the presence of no-clean flux residue is statistically insignificant within the scope of this study. [ABSTRACT FROM AUTHOR]

Background: Adverse visual symptoms with electronic devices have been reported, but causes have yet to be clearly defined. Previous studies have neither equated stimulus luminance across devices nor studied subjects with verified normal accommodation prior to testing. Pupil size during device use also has not been explored. We compared pupil sizes and accommodative responses to targets of similar size displayed with ink on paper, an e-ink reader, and an LCD device in young, healthy adults with normal accommodation. Methods: Subjects were 42 healthy adults, aged 22 to 33 years, with near acuity 20/20 (6/6) or better in the tested eye. Normal accommodation was verified with accommodative amplitude and facility (+/-2.00 flippers) tests. The reading text was presented at 40 cm, and text size and device luminance were matched across devices. While the subject read the passage aloud, pupil size was measured. Accommodative responses were obtained twice with near retinoscopy and twice with an open-field autorefractor for each device. Results: One-way ANOVA for correlated samples and Tukey's HSD test were used to compare mean pupil size and mean accommodative response across devices. The differences in mean pupil size for paper versus e-ink (5.1 ± 0.9 vs. 5.5 ± 0.8, p<0.01) and LCD versus e-ink (5.1 ± 0.9 vs 5.5 ± 0.8, p<0.01) were significant. By retinoscopy, the difference in mean accommodative response was significant only for e-ink and LCD (1.48 ± 0.76 D vs. 1.78 ± 1.26 D, p<0.01). By autorefraction, no significant differences in mean accommodative response were found across device type. Linear regression showed that accommodative response was not predicted by pupil size for any of the devices. Conclusions: In this group of young adults with normal accommodation, accommodative response was not significantly different for ink on paper, e-ink, or LCD devices of matched luminance. Pupil size did not predict accommodative response for any device. [ABSTRACT FROM AUTHOR]

Patients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments. Efficient, cost-effective training programs are needed to widely disseminate behavior-analytic procedures to medical students and professionals. The purpose of this study was to assess the efficacy of a virtual training to prepare medical students to implement behavioral procedures that could be easily incorporated into typical wellness examinations. Seven medical students received behavioral skills training (BST) delivered remotely via the Internet. Results showed that the training successfully increased students' correct implementation of the procedures in roleplay with the experimenter and with patients with neurodevelopmental disabilities. Responding also maintained at high levels 2 weeks after the training. These findings suggest that virtual BST is an efficient, practical approach for training health care professionals to implement general behavior management strategies to increase the comfort and cooperation of patients with NDD. [ABSTRACT FROM AUTHOR]

Objective: To describe a single institution's experience with single-port robotic adrenalectomy (SP-RA) and report perioperative outcomes. Materials and Methods: This is a retrospective, single-center study of adult patients who underwent SP-RA between January 2019 and April 2022 by a single surgeon using an IRB-approved institutional database. Patient demographics, perioperative data, surgical pathology, and postoperative outcomes were assessed. Results: Nineteen patients were identified who underwent SP-RA by a single surgeon over the period reviewed. One patient underwent bilateral SP-RA for bilateral adrenal masses, totaling 20 SP-RA procedures performed. Mean operative time was 80.7 ± 22.9 minutes and mean length of stay was 33.1 ± 27.9 hours. Two minor complications (Clavien–Dindo

Tumour thrombus is a complication that occurs when a malignancy invades into the vasculature, occluding its lumen. Here, we present a rare case of melanoma tumour thrombus of the great saphenous vein of the left thigh, which was diagnosed on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography and ultrasound-guided biopsy, and responded well to immunotherapy with pembrolizumab. [ABSTRACT FROM AUTHOR]

The subset sum problem is an important theoretical problem with many applications, such as in coding theory, cryptography, graph theory and other fields. One of the many aspects of this problem is to answer the solvability of the k -subset sum problem. It has been proven to be NP-hard in general. However, if the evaluation set has some special algebraic structure, it is possible to obtain some good conclusions. Zhu, Wan and Keti proposed partial results of this problem over two special kinds of evaluation sets. We generalize their conclusions in this paper, and propose asymptotical results of the solvability of the k -subset sum problem by using estimates of additive character sums over the evaluation set, together with the Brun sieve and the new sieve proposed by Li and Wan. We also apply the former two examples as application of our results. [ABSTRACT FROM AUTHOR]

Assigning papers to reviewers is a large, long and difficult task for conference chairs and scientific committees. The paper reviewer assignment problem is a multi-agent problem which requires understanding reviewer expertise and paper topics for the matching process. This paper proposes to elaborate on some features used to compute reviewer expertise and aggregate multiple factors to find the fittest combination of reviewers for each paper. Expertise information is gathered implicitly from publicly available information and a reviewer profile is generated automatically. An Ordered Weighted Averaging (OWA) aggregation function is used to summarize information coming from different sources and rank candidate reviewers for each paper. General constraints for the Reviewer Assignment Problem (RAP) have been incorporated into a real case example: (i) conflicts of interest between a reviewer and authors should be avoided, (ii) each paper must have a minimum number of reviewers, and (iii) each reviewer load cannot exceed a certain number of papers. [ABSTRACT FROM AUTHOR]

Objectives: Quality of care utilization measures for patients admitted to the hospital with an acute myocardial infarction (AMI) include length of stay (LOS) and 30-day readmission rates. Our aim was to test whether efforts resulting in reduced LOS in patients diagnosed as having AMI would result in a higher risk of readmission within 30 days of hospital discharge and whether specific interventions could be targeted to reduce readmissions.Methods: Using data supplied by the Veterans Affairs Inpatient Evaluation Center, we analyzed both the readmissions within 30 days of an AMI and LOS and determined the timing of readmissions and associated diagnoses.Results: During 2013-2015, 35 (13.3%) of 263 patients with AMI were readmitted within 30 days of discharge compared with 19 (13.4%) of 142 patients during 2016 (not significant). During the same time, LOS was <3 days in most patients. From 2013 to 2015, the initial hospital time was 6 ± 6 days, whereas time out of the hospital before readmission was 11 ± 8 days; these times did not differ from 2016. Initial therapeutic decisions were based on coronary anatomy in >90% of patients with a decision to proceed with revascularization in most patients. Diagnoses during readmission to the hospital were also similar during early and later time periods and most frequently were a result of either coronary artery bypass grafting-related complications from the initial hospitalization or elective coronary artery bypass grafting. Acute coronary syndrome-related diagnoses and recurrent noncardiac causes of chest pain also were common diagnoses during both time periods and did not involve extensive workup during the readmission.Conclusions: Readmissions for patients with AMI were stable during a 4-year period, at a time that efforts to reduce LOS were emphasized. Because a significant proportion of readmissions involved noncardiac sources of chest pain, improved communication between the emergency department and in-patient cardiology services at the time of triage may be a feasible way to improve efficiency of utilization. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to estimate the impact of mild-to-moderate COVID-19 on health-related quality of life (HRQoL) over time among individuals in the United Kingdom, adding to the evidence base that had focussed on severe COVID-19. Methods: A bespoke online survey was administered to individuals who self-reported a positive COVID-19 test. An amended version of a validated generic HRQoL instrument (EQ-5D-5L) was used to measure HRQoL retrospectively at different timepoints over the course of an infection: pre-COVID-19, acute COVID-19, and long COVID. In addition, HRQoL post-COVID-19 was captured by the original EQ-5D-5L questionnaire. A mixed-effects model was used to estimate changes in HRQoL over time, adjusted for a range of variables correlated with HRQoL. Results: The study recruited 406 participants: (i) 300 adults and 53 adolescents with mild-to-moderate COVID-19 who had not been hospitalised for COVID-19 during acute COVID-19, and (ii) 53 adults who had been hospitalised for COVID-19 in the acute phase and who had been recruited for validation purposes. Data were collected between January and April 2022. Among participants included in the base-case analysis, EQ-5D-5L utility scores were lower during both acute COVID-19 (β=-0.080, p = 0.001) and long COVID (β=-0.072, p < 0.001) compared to pre COVID-19. In addition, EQ-5D-5L utility scores post-COVID-19 were found to be similar to the EQ-5D-5L utility scores before COVID-19, including for patients who had been hospitalised for COVID-19 during the acute phase or for those who had experienced long COVID. Moreover, being hospitalised in the acute phase was associated with additional utility decrements during both acute COVID-19 (β=-0.147, p = 0.026) and long (β=-0.186, p < 0.001) COVID. Conclusion: Patients perceived their HRQoL to have varied significantly over the course of a mild-to-moderate COVID-19 infection. However, HRQoL was found to return to pre-COVID-19 levels, even for patients who had been hospitalised for COVID-19 during the acute phase or for those who had experienced long COVID. Key points: Health-related quality of life was significantly lower during the acute and long COVID-19 phases compared to before COVID-19. Results suggested that health-related quality of life returned to pre-COVID-19 levels, even for patients who had been hospitalized for COVID-19 during the acute phase or for those who had experienced long COVID. Symptoms specific to the acute COVID-19 phase were found to be associated with additionally lower health-related quality of life. [ABSTRACT FROM AUTHOR]

A new class of polymeric acidic ionic liquids with imidazolium hydrogen sulfate and p-phenylene sulfonic acid units built into the main polymer chain were prepared by a simple two step method in 87-89% yield. These new polymers were characterized by elemental analysis, H, C NMR, FT-IR, TGA and GPC. The catalytic activity of sulfonic acid group functionalized ionic liquid polymers was demonstrated through the synthesis of 1-amidoalkyl-2-naphthols in 78-90% yield by condensation of 2-naphthol, benzaldehyde and amides without a solvent at 100 °C. [ABSTRACT FROM AUTHOR]

Keywords: allergic contact dermatitis; bulletproof; case report; glass; isocyanate; isophorone diisocyanate; occupational; polyol; polyurethane EN allergic contact dermatitis bulletproof case report glass isocyanate isophorone diisocyanate occupational polyol polyurethane 325 326 2 03/16/22 20220401 NES 220401 Polyurethanes are versatile materials and are widely used in industrial and consumer settings. Allergic contact dermatitis, case report, glass, bulletproof, occupational, polyol, polyurethane, isocyanate, isophorone diisocyanate. [Extracted from the article]

Some cancer cells are resistant to apoptosis, rendering them irresponsive towards apoptosis-inducing chemotherapy drugs. Another mode of action to kill these apoptosis-defective cells is essential and autophagy, a dynamic process that degrades cytoplasmic contents for cellular maintenance, has been considered as one of the alternate routes. A small molecule inducer of autophagy, autophagonizer was reported to induce cell death through a novel process that is independent of extrinsic apoptosis and the normal signaling pathways of autophagy. Here, we describe an efficient synthetic procedure for the autophagonizer. The newly synthesized autophagonizer (DK-1-49) resulted in an accumulation of autophagy-associated LC3-II and enhanced levels of autophagosomes and acidic vacuoles. Furthermore, cell viability was inhibited by autophagic cell death in not only human cancer cells but also Bax/Bak double-knockout cells. These findings highlight that intrinsic apoptosis is not also involved in the induction of cellular death by the autophagonizer suggesting the autophagonizer is a promising candidate for anticancer therapeutics for cancer cells that are resistant to apoptosis-inducing chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Recent emergence of artemisinin-resistant P. falciparum has posed a serious hindrance to the elimination of malaria in the Greater Mekong Subregion. Parasite clearance time, a measure of change in peripheral parasitaemia in a sequence of samples taken after treatment, can be used to reflect the susceptibility of parasites or the efficiency of antimalarials. The association of genetic polymorphisms and artemisinin resistance has been documented. This study aims to examine clearance time of P. falciparum and P. vivax parasitemia as well as putative gene mutations associated with residual or recurred parasitemia in Myanmar.Methods: A total of 63 P. falciparum and 130 P. vivax samples collected from two internally-displaced populations and one surrounding village were examined for parasitemia changes. At least four samples were taken from each patient, at the first day of diagnosis up to 3 months following the initial treatment. The amount of parasite gene copy number was estimated using quantitative real-time PCR based on a species-specific region of the 18S rRNA gene. For samples that showed residual or recurred parasitemia after treatment, microsatellites were used to identify the 'post-treatment' parasite genotype and compared such with the 'pre-treatment' genotype. Mutations in genes pfcrt, pfmdr1, pfatp6, pfmrp1 and pfK13 that are potentially associated with ACT resistance were examined to identify if mutation is a factor for residual or persistent parasitemia.Results: Over 30% of the P. falciprium infections showed delayed clearance of parasitemia after 2-3 days of treatment and 9.5% showed recurred parasitemia. Mutations in codon 876 of the pfmrp1 corroborated significance association with slow clearance time. However, no association was observed in the variation in pfmdr1 gene copy number as well as mutations of various codonsinpfatp6, pfcrt, and pfK13 with clearance time. For P. vivax, over 95% of the infections indicated cleared parasitemia at days 2-3 of treatment. Four samples were found to be re-infected with new parasite strains based on microsatellite genotypes after initial treatment.Conclusion: The appearance of P.falciparum infected samples showing delayed clearance or recurred parasitemia after treatment raises concerns on current treatment and ACT drug resistance. [ABSTRACT FROM AUTHOR]

The health consequences of heat and cold are usually evaluated based on associations with outdoor measurements collected at a nearby weather reporting station. However, people in the developed world spend little time outdoors, especially during extreme temperature events. We examined the association between indoor and outdoor temperature and humidity in a range of climates. We measured indoor temperature, apparent temperature, relative humidity, dew point, and specific humidity (a measure of moisture content in air) for one calendar year (2012) in a convenience sample of eight diverse locations ranging from the equatorial region (10 °N) to the Arctic (64 °N). We then compared the indoor conditions to outdoor values recorded at the nearest airport weather station. We found that the shape of the indoor-to-outdoor temperature and humidity relationships varied across seasons and locations. Indoor temperatures showed little variation across season and location. There was large variation in indoor relative humidity between seasons and between locations which was independent of outdoor airport measurements. On the other hand, indoor specific humidity, and to a lesser extent dew point, tracked with outdoor, airport measurements both seasonally and between climates, across a wide range of outdoor temperatures. These results suggest that, in general, outdoor measures of actual moisture content in air better capture indoor conditions than outdoor temperature and relative humidity. Therefore, in studies where water vapor is among the parameters of interest for examining weather-related health effects, outdoor measurements of actual moisture content can be more reliably used as a proxy for indoor exposure than the more commonly examined variables of temperature and relative humidity. [ABSTRACT FROM AUTHOR]

Outdoor ambient weather has been hypothesized to be responsible for the seasonal distribution of cardiac arrhythmias. Because people spend most of their time indoors, we hypothesized that weather-related arrhythmia risk would be better estimated using an indoor measure or an outdoor measure that correlates well with indoor conditions, such as absolute humidity. The clinical records of 203 patients in eastern Massachusetts, USA, with an implantable cardioverter-defibrillator were abstracted for arrhythmias between 1995 and 2002. We used case-crossover methods to examine the association between weather and ventricular arrhythmia (VA). Among 84 patients who experienced 787 VAs, lower estimated indoor temperature (odds ratio (OR)=1.16, 95% confidence interval (CI) 1.05-1.27 for a 1 °C decrease in the 24-h average) and lower absolute humidity (OR=1.06, 95% CI 1.03-1.08 for a 0.5 g/m3 decrease in the 96-h average) were associated with increased risk. Lower outdoor temperature increased risk only in warmer months, likely attributable to the poor correlation between outdoor and indoor temperature during cooler months. These results suggest that lower temperature and drier air are associated with increased risk of VA onset among implantable cardioverter-defibrillator patients. [ABSTRACT FROM AUTHOR]

Duodenal webs are a rare clinical entity with the presentation of a double duodenal web being exceedingly uncommon. Management of duodenal webs traditionally involves duodenal web excision with duodenoduodenostomy, which is usually performed via a laparoscopic or an open approach. We report the case of a 6-month-old child who presented with progressively worsening bilious emesis with imaging findings concerning for a duodenal web. Endoscopic evaluation was performed that identified 2 webs in the fourth portion of the duodenum. These were managed completely endoscopically with balloon dilation. Although surgery is the mainstay of treatment of duodenal webs, this patient was successfully managed by endoscopic intervention without the need for open or laparoscopic excision, which has not been previously described for double duodenal webs. This work demonstrates the safety and efficacy of endoscopic management for infants with this anomaly. [ABSTRACT FROM AUTHOR]

As hygiene practices evolve during the COVID-19 pandemic, dermatologists are likely to see a rise in ICD as well as other skin conditions. Disinfectant cleaning wipes can burn! Keywords: chemical burn; irritant contact dermatitis; sporicidal; wipes EN chemical burn irritant contact dermatitis sporicidal wipes 109 110 2 06/17/21 20210701 NES 210701 The COVID-19 pandemic has led to increased hygiene and disinfecting practices throughout industries, homes, and healthcare settings. [Extracted from the article]

Venous malformations (VMs) are often painful and may enlarge over time. Chronic coagulopathy is common in VMs and may contribute to phleboliths and potentially to disease progression. Few studies have examined the effects of anticoagulation on VMs and to our knowledge none have examined the use of aspirin therapy. A survey was administered to patients and parents of patients withVMswhoattended the University of California at San Francisco Vascular Anomalies Center over a 4-year period (2008-2012) to whom aspirin had been recommended. They were surveyed regarding whether they were taking aspirin and, if yes, whether aspirin had resulted in any appreciable benefit. Sixty-five letters were sent to potential subjects: 38 participated and 27 declined to participate or could not be contacted. Twenty-eight of the 38 had begun aspirin and 22 reported current use. Seventeen reported some benefit, including less aching (n = 2), less shooting pain (n = 15), less fullness and swelling (n = 13), and shrinking of the VM (n = 1). Discontinuation of aspirin was associated with worseningVMsymptoms in five of six patients. Side effects were reported in 6 of 28 patients, including five episodes of minor bleeding or excessive bruising and one of nausea and vomiting. This study suggests that aspirin may be a beneficial treatment for VM, with a reduction in pain and soft tissue swelling and an acceptable side-effect profile, but the retrospective nature of the study and the small size of the cohort limited our conclusions. Larger prospective studies of aspirin for VM using clinical and laboratory outcome measures are needed to confirm these observations. [ABSTRACT FROM AUTHOR]

Despite the widespread exploration of α-peptides as catalysts, there are few examples of β3-peptides that alter the course of a chemical transformation. Our previous work demonstrated that a special class of β3- peptides spontaneously self-assembles in water into discrete protein-like bundles possessing unique quaternary structures and exceptional thermodynamic stability. Here we describe a series of β3-peptide bundles capable of both substrate binding and chemical catalysis-ester hydrolysis. A combination of kinetic and high-resolution structural analysis suggests an active site triad composed of residues from at least two strands of the octameric bundle structure. [ABSTRACT FROM AUTHOR]

Juveniles of many species engage in rough-and-tumble play behaviors, and these social encounters are important for the expression of typical social behaviors. Play is a highly motivated and rewarding behavior, which suggests that the mesocorticolimbic dopamine system is likely important for reinforcing the behavior. Indeed, systemic dopamine receptor antagonists decrease the expression of play behaviors, but the specific dopaminergic networks important for play are not known. In this study, we examined immediate-early gene expression in specific dopaminergic cell groups after juvenile male and female rats played or did not play. Subjects were housed with a same-sex sibling, and spontaneous play behavior (or lack thereof) was observed for 1 hr. Brains were harvested and immunohistochemistry was used to localize Fos and tyrosine hydroxylase. Cells expressing both proteins were counted in midbrain and forebrain dopaminergic cell groups. Females that played had more double-labeled cells in the ventral tegmental area (VTA) than females that did not play, but there was no effect of play on double-labeled cell counts in any brain region in males. Furthermore, many measures of play in females were positively correlated with the number of double-labeled cells in the VTA, including play duration and pin duration. Our results suggest that play in females likely induces dopamine release from mesocorticolimbic neurons to reinforce play behaviors. Our results also highlight a sex difference in the neural networks mediating play, thus emphasizing the importance of studying the neurobiology of play in both males and females. [ABSTRACT FROM AUTHOR]