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A case series is presented of five overweight or obese patients with confirmed coronavirus disease 2019 (COVID-19) in South Miami, Florida, United States. A multitude of coagulation parameters was suggestive of a hypercoagulable state among the hospitalized COVID-19 patients. This article reports various manifestations of hypercoagulable states in overweight and obese patients, such as overt bleeding consistent with disseminated intravascular coagulation, venous thromboembolism, gastrointestinal bleeding as well as retroperitoneal hematoma. All of the required admission to the intensive care unit and subsequently patients died. The characteristics of COVID-19-associated coagulopathy are atypical and warrant a further understanding of the pathophysiology to improve clinical outcomes, specifically in overweight or obese patients.

Perennial aromatic crops' production, yield, and quality are significantly impacted by seasonal variations. Cymbopogon martinii (Roxb.) (Poaceae) is a perennial aromatic grass that produces valuable essential oil from the leaves and inflorescence containing high concentrations of geraniol and geranyl acetate. The current study intends to determine how seasonal changes (autumn, winter, and summer) affect the production of geraniol, geraniol acetate, and essential oils from various plant components, (leaves and inflorescence). The field study was conducted at the experimental farm of India's CSIR-Central Institute of Medicinal and Aromatic Plants for two years (May 2018 to May 2020). Four varieties viz. cv. Tripta, Trishna, PRC1, and CIMAP Harsh were grown, and harvesting was done in three entirely different seasons, i.e., autumn, winter, and summer, for two consecutive years; thus, a total of six harvests (two in each season) were obtained. The research findings revealed that under the sub-tropical climatic conditions, cv. CIMAP Harsh performs better in yield and productivity with maximum essential oil yield obtained in the summer, followed by autumn. Maximum geraniol (89.9% and 51.26 kg ha-1) and geraniol acetate (3.0% and 1.73 kg ha-1) yields in leaves were reported during the summer season. In contrast, in inflorescence, geraniol (76.8% and 12.77 kg ha-1) yields were recorded maximum during the autumn season, irrespective of variety. In terms of essential oil yield and quality of oil, harvesting during the winter months did not make any significant difference. Nevertheless, it is intriguing to notice that the CIMAP Harsh variety placed top for the traits N2, N3, N5, N6, N7, N8, N13, N15, N21, and N22 and second for N1. In the traits N2 to N8, N13, and N14, Trishna was the variety that placed second. Therefore, it is advised that these two palmarosa cultivars be grown commercially on a wide basis. [ABSTRACT FROM AUTHOR]

Pb and Cd are ubiquitous heavy metals (HMs) in the environment and their accumulation in medicinal herbs poses a serious threat due to health hazards. The genetic selection of high-yielding and low Pb and Cd accumulating genotypes known as phtyoexclusion is a cost-effective and promising phytotechnology. In the present study, phtyoexclusion method was used for the selection of low Pb and Cd accumulating genotypes of Andrographis paniculata (Burm.F.) Nees with minimum alteration in their pharmacological important constituents in three application rates of Pb and Cd. The performance of genotypes of A. paniculata was evaluated by uptake and translocation of Pb and Cd, biomass yield, shoot-to-root ratio, metabolite content, oxidative enzymes, and mineral content for their safe production and commercial viability. The bio-concentration factor (BCF) and translocation factor (TF) of Pb among the genotypes ranged from 0.09-3.6 and 0.006–0.045, respectively. However, variations in BCF and TF of Cd were 0.05–3.36 and 0.001–0.150 respectively. The differential expression of the metal accumulation in genotypes of A. paniculata was majorly associated with ionomics and biomass. Four genotypes of A. paniculata were screened out and were divided in the three categories. One, genotypes that accumulated Pb and Cd below the prescribed limits with high productivity and tolerance could be used for safer herb production. In the second category, genotypes having high accumulation in roots and low translocation could be used for phytostabilization of the soil. The above-ground material of the plant can be used for the extraction of pure constituents. The third one is genotypes with high accumulators and low productivity. [Display omitted] • Fifteen genotypes of A. paniculata were screened for Pb and Cd accumulation. • Four genotypes demostrated the phytoexcluder potential for Pb and Cd. • Biomass and mineral contents were the main drivers for low accumulating genotypes. • Some high accumulating genotypes can be good candidate for phytostabilization. [ABSTRACT FROM AUTHOR]

Pelargonium graveolens L. or rose scented geranium is an essential oil-bearing plant with extended economic value. It has strong pharmacological and aromatic properties along with its frequent application in perfumery, food, cosmetics, and pharma industries. Seasonal fluctuations in northern India have a detrimental effect on the survival of P. graveolens. Due to its male sterility, the plant is unable to propagate by sexual reproduction, so, vegetative propagation is the only option to grow and protect the mother plant for the next season. To protect the plant in adverse conditions our researchers had developed a protective shed i.e. transparent polythene + green net shed (S) but the reason for the increased survival and growth of the plant in the shed was not well understood. In the present research, approximately 91% of P. graveolens mother plants were protected under the shed compared to open conditions (O). The current study also reported high humidity, increased air temperature and increased microbial infection in open condition, exerting various physiological and chemical changes which further have detrimental effects on plant growth and survival. In shed conditions, a decreased level of antioxidant enzymes, antioxidant metabolites, and elevated level of photosynthetic pigments were observed. Further, an increased density of glandular and non-glandular trichomes and an improved quality and quantity of essential oil were observed in shed conditions. Considering the above observations, polythene + green net shed can be used as an auspicious approach for protecting the P. graveolens mother plant in monsoon season due to its effect on soil moisture, soil microbial biomass carbon (SMBC), trichome morphology/density and yield of essential oil. [Display omitted] • Protective shed and growing medium impacted growth and survival of P. graveolens. • Antioxidant enzyme activity increases during adverse rainy condition. • In rainy season the content of essential oil and trichome density significantly affected the survival of P. graveolens. • Reduced Soil Microbial Biomass Carbon (SMBC) supported survival during rainy season. [ABSTRACT FROM AUTHOR]

H3K27M-mutant diffuse midline gliomas (DMGs) express high levels of the GD2 disialoganglioside and chimeric antigen receptor modified T-cells targeting GD2 (GD2-CART) eradicate DMGs in preclinical models. Arm A of the Phase I trial NCT04196413 administered one IV dose of autologous GD2-CART to patients with H3K27M-mutant pontine (DIPG) or spinal (sDMG) diffuse midline glioma at two dose levels (DL1=1e6/kg; DL2=3e6/kg) following lymphodepleting (LD) chemotherapy. Patients with clinical or imaging benefit were eligible for subsequent intracerebroventricular (ICV) GD2-CART infusions (10-30e6 GD2-CART). Primary objectives were manufacturing feasibility, tolerability, and identification of a maximally tolerated dose of IV GD2-CART. Secondary objectives included preliminary assessments of benefit. Thirteen patients enrolled and 11 received IV GD2-CART on study [n=3 DL1(3 DIPG); n=8 DL2(6 DIPG/2 sDMG). GD2-CART manufacturing was successful for all patients. No dose-limiting toxicities (DLTs) occurred on DL1, but three patients experienced DLT on DL2 due to grade 4 cytokine release syndrome (CRS). Nine patients received ICV infusions, which were not associated with DLTs. All patients exhibited tumor inflammation-associated neurotoxicity (TIAN). Four patients demonstrated major volumetric tumor reductions (52%, 54%, 91% and 100%). One patient exhibited a complete response ongoing for >30 months since enrollment. Eight patients demonstrated neurological benefit based upon a protocol-directed Clinical Improvement Score. Sequential IV followed by ICV GD2-CART induced tumor regressions and neurological improvements in patients with DIPG and sDMG. DL1 was established as the maximally tolerated IV GD2-CART dose. Neurotoxicity was safely managed with intensive monitoring and close adherence to a management algorithm.

Pernicious anemia, stemming from Vitamin B12 deficiency and autoimmune processes affecting intrinsic factor production, presents challenges in early diagnosis due to vague initial symptoms. This case report introduces a unique occurrence of pernicious anemia-induced peripheral neuropathy in a patient with concurrent HLA-B27 arthropathy, highlighting the complex interplay of autoimmune mechanisms. While HLA-B27 is not typically associated with pernicious anemia, the case underscores the importance of exploring specific HLA haplotypes in understanding the nuanced manifestation of autoimmune disorders. Comprehensive screening for anti-intrinsic factor and anti-parietal cell antibodies is crucial in individuals with signs of pernicious anemia, especially those with a history of HLA-B27 arthropathy, guiding tailored management strategies. This report contributes to the ongoing exploration of the intricate autoimmune landscape in pernicious anemia., Competing Interests: Conflict of interest: No conflicts of interest to declare., (© 2024 Greater Baltimore Medical Center.)

Introduction: Oral methotrexate (MTX) is the first-line therapy for patients with rheumatoid arthritis (RA). However, not all RA patients respond to MTX. In this study, we will determine the risk factors associated with MTX failure., Methods: This retrospective study was conducted in tertiary care hospital in Pakistan. Data of 612 patients who were diagnosed with RA from June 2019 to January 2021 were retrieved from the medical record room. After inclusion, patients were divided into two groups; respondent and non-respondent. Their characteristics and demographics were compared., Results: Out of the total 612 patients, 112 (18.3%) were labelled as non-respondent to MTX. Non-respondents had a higher predominance of females (86.6% vs. 60.2%; p-value: 0.001), participants with body mass index (BMI) >25 kg/m 2 (54.4% vs. 22.4%; p-value: <0.00001), smokers (34.8% vs. 18.2%; p-value: 0.0001), participants with diabetes (47.3% vs. 23.4%; p-value: <0.0001) and rheumatoid factor positivity (91.0% vs. 64.8%; p-value: <0.0001)., Conclusion: Female gender, higher BMI, smoking, higher disease activity, and diabetes were associated with MTX failure. These easily available parameters can help predict the disease process and outcome of treatment. It is important to screen patients who are at risk of MTX failure, so a contingent treatment plan can be devised, in case patients do not respond to MTX., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Siddiqui et al.)