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Background Clinical guidelines recommend that patients admitted to hospital for asthma attacks are reviewed in primary care following hospital discharge. Aim We evaluated post-hospitalisation asthma management in primary care and its associations with patient characteristics. Design and setting A retrospective cohort study was performed using English primary care data from the Clinical Practice Research Datalink Aurum database and linked Hospital Episode Statistics Admitted Patient Care data. Method Patients with asthma aged ≥5 years who had at least one asthma-related hospitalisation from 1st January 2017 to 31st December 2019 were included. Primary outcome was a composite of any of the following delivered in primary care within 28 days from hospital discharge: asthma review, asthma management plan, asthma medication prescriptions, demonstration of inhaler technique, or smoking cessation counselling. The association between patient characteristics and delivery of clinical care was assessed using logistic regression. Results The study included 17,457 patients. 60% had received the primary outcome within 28 days of hospital discharge. 13% received an asthma review, 8% an asthma management plan, 57% an asthma medication, 8% a demonstration of inhaler technique, and 1.2% (of smokers) smoking cessation counselling. This care was less likely to be received by patients from black ethnic minority groups (27-54% relative reduction, depending on age group). By contrast, previous prescriptions of short-acting bronchodilators were associated with an increased likelihood of the primary outcome. Conclusion A significant proportion of patients do not receive timely follow-up in primary care following asthma-related hospital admissions, particularly among patients from black ethnic groups.

Background: As the development and use of oral anticancer agents increases, it is critical to understand patient adherence to both standard and investigational agents. The open label, phase 3 multicenter PALLAS trial investigates whether adding 2 years of the CDK4/6 inhibitor palbociclib (P) to adjuvant endocrine therapy (ET) improves invasive disease-free survival (iDFS) over adjuvant ET alone in patients (pts) with HR- positive, HR2-negative, stage II-III breast cancer. Pts were randomly assigned to either Palbociclib (125 mg/day, 3 weeks on, 1 week off, in a 28-day cycle) plus ongoing provider/patient-choice adjuvant ET (P+ET) versus ET alone. We examined patient-reported adherence to ET +/- P during the first two years of study treatment. Methods: Adherence outcomes were measured in English-speaking pts in the U.S., UK, Ireland and Australia, Spanish-speaking pts in Spain and Mexico, and German-speaking pts in Germany and Austria. Adherence measures included drug diaries completed at each cycle, pill counts (for P only) collected at each study visit, and the Morisky Medication Adherence Scale-4 item and the McHorney Adherence Estimator questionnaires completed at cycles 2, 3, 6, 12, 18, and 24 (22 months). Mean adherence for each cycle was defined as the average proportion of prescribed pills taken (via drug diary) across all patients who initiated that cycle. Persistence was defined as the duration of drug initiation to treatment cessation (via drug diary). Generalized estimating equations were used to model the “most adherent” pts on the Morisky (score = 5 vs score 0) to compare the average difference between arms over time for ET, adjusting for baseline demographic and clinical variables. Results: 81% (N=4688) of PALLAS pts were included in this analysis. Median persistence to ET was 23.6 months in P + ET (n=2169), 23.7 months in ET alone (2136) and 20.4 months for P (n=2194). The number of pts who initiated each cycle for ET declined over time and was similar between arms; the decline was more marked for P (Table 1). Mean adherence range as measured by drug diary was 98.2-99.3% for ET in P+ET and 98.0 - 99.4% in ET alone; and for P, ranged from 93.4 - 98.8%. The adherence and persistence results were nearly identical whether measured by drug diary or pill count for P. The observed percent “most adherent” for P measured by the Morisky scale ranged from 71.9% - 79.6% and the percent “low risk” for adherence problems measured by the McHorney scale, 64.0% - 73.4%. The percent of pts “most adherent” and “low risk” for adherence problems to ET was higher, on average over time, in the P+ET group compared to ET alone (75% vs 68%, p Table 1.Adherence and persistence in PALLAS over the 24 month treatment periodPalbocicilb + ETETPalbociclibETETTreatment cycleMean Adherence (SD)N*Mean Adherence (SD)NMean Adherence (SD)N193.4 (13.8)229098.7 (6.1)230999.0 (5.2)2343294.7 (13.3)218198.8 (6.4)220398.4 (7.1)2206397.4 (10.1)211298.7 (7.3)214298.8 (6.3)2168497.6 (10.2)203598.6 (7.8)211099.0 (5.7)2154597.6 (11.1)197598.3 (7.9)209398.1 (8.3)2148698.1 (8.7)189998.7 (6.6)203798.5 (8.2)2116798.1 (9.3)185599.0 (6.3)201298.6 (7.3)2102898.0 (9.1)181098.2 (8.2)199798.1 (8.2)2092998.4 (7.4)173399.0 (6.4)196298.8 (6.8)20511098.3 (8.6)171499.2 (4.9)194699.0 (5.5)20381198.3 (8.0)169198.5 (7.3)193798.2 (8.2)20311298.7 (6.2)161299.1 (5.3)191098.7 (7.5)19861398.5 (7.7)159698.9 (6.4)189398.8 (7.1)19691497.9 (9.3)157698.4 (7.3)188298.0 (9.1)19611598.5 (6.9)151499.2 (4.6)185499.0 (6.0)19281698.2 (8.7)148699.1 (4.6)183599.1 (5.7)19131798.1 (9.8)147998.3 (7.8)182698.5 (6.4)19031898.7 (6.8)141699.3 (4.1)176899.2 (5.3)18601998.7 (7.3)140899.3 (3.8)175699.4 (3.1)18482098.4 (8.9)139798.9 (5.3)174298.7 (5.8)18382198.5 (7.5)130199.0 (6.1)167698.8 (7.1)17842297.8 (9.7)124698.8 (6.2)164799.2 (5.7)17692398.1 (8.8)118098.2 (8.5)161998.4 (8.0)17552498.8 (7.2)108699.0 (6.3)146898.9 (7.1)16192598.8 (6.7)99699.2 (5.2)143298.8 (7.1)15892697.9 (11.2)84599.1 (5.7)140998.6 (8.8)1578ET=Endocrine therapy * Number of pts who initiated the treatment cycle. Citation Format: Eileen Shinn, David Zahrieh, Angela DeMichele, Nick Zdenkowski, Julie Lemieux, Jun Mao, Vesna Bjelic-Radisic, Michelle Naughton, Georg Pfeiler, Karen Gelmon, Ingrid Mayer, Daniel Egle, Gabriele Zoppoli, Tiffany Traina, Miguel Martin Jiménez, Silvia Antolin Novoa, Tufia Haddad, Arlene Chan, Alistair Edward Ring, Antonio Wolff, Jose JuanPonce Lorenzo, Dhanusha Sabanathan, Hal Burstein, Zbigniew Ireneusz Nowecki, Gunda Pristauz-Telsnigg, Adam Brufsky, Meritxell Bellet-Ezquerra, Theodoros Foukakis, Yelena Novik, Gabor Rubovszky, Karoline Muehlbacher, Otto Metzger, Theodora Goulioti, Ernest Law, Ann Partridge, Lisa Carey, Alex Zoroufy, Dominik Hlauschek, Christian Fesl, Erica Mayer, Michael Gnant. Adherence with adjuvant endocrine therapy with or without Palbociclib in the PALLAS trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-12-01.

The emerging demand for the production of nonlinear optical materials with high optical limiting performance has an apparent impact in the field of nonlinear optics owing to their wide application in photonic devices. In this regard, transition metal molybdates have received attention owing to their remarkable optical and luminescence characteristics, leading to their extensive use in next generation optoelectronics devices. Herein, we report the nonlinear optical response of yttrium (Y

The objective of the study was to elucidate the effect of alcoholic extract of A. racemosus on oestrogen and progesterone synthesis from MCF-7 cells. The root tubers of A. racemosus was collected dried, extracted in soxhlet, solvent evaporated and dried and was used for study. Qualitative phytochemical analysis of the extract was done. The IC50 was determined by doing MTT assay in MCF-7 cell lines. MCF-7 cells cultured in RPMI-1640 were exposed to IC50, half and double the doses of IC50 for 96 hours and the media collected every 48 hours to determine the concentration of oestrogen and progesterone using ELISA. The qualitative phytochemical analysis of the extract revealed the presence of steroids, alkaloids, diterpenes, triterpenes, tannins, glycosides and saponins The IC50 was found to be 267 µg/mL. The extract of A. racemosus caused an increase in the concentration of oestrogen and progesterone secreted by MCf-7 cells in a dose and time dependent fashion. There was an increase in the secretion of progesterone in a dose depenedent fashion compared to untreated cells, whereas the secretion decreased at 96 hours compared to 48 hours. From the study, it could be concluded that alcoholic extract of A. racemosus caused a positive modulation of steroid hormone synthesis.

Medical image diagnosis by machine decrease the doctor load and increases the efficiency of treatment as well. Many of diagnosis process depends on chemical data and some are depend on digital images. This work focus on brain tumor medical image diagnosis by segmenting the tumor region in the image. For tumor detection neural network was trained by the model. Selected features extract from the image by fish schooling genetic algorithm for training of neural network It was obtained that fish schooling based genetic feature selection has increases the detection accuracy of trained model. Experiment was done on real dataset and results compared with existing techniques of tumor detection from MRI images.

Single crystals of copper (II) complex of P-Toluene sulfonic acid (PTSC) suitable for photonic applications were grown by slow evaporation technique. Single-crystal X-ray diffraction analysis (SXRD) shows that PTSC crystallizes in monoclinic system with a centrosymmetric space group (P21/c). The presence of red hallows and blue bumps in the shape index of the Hirshfeld surface confirms the NLO activity of the material. Fourier transform infrared spectroscopy vibrational analysis inferred the functional groups present in the synthesized PTSC. The synthesized material has good mechanical properties, and tight atomic packaging with six water molecules reveals its possible utilization in device fabrication applications. The dielectric constant was found to be high due to the inclusion of Cu2+ in the crystal lattice. Linear optical parameters such as bandgap energy, refractive index, extinction coefficient, optical conductivity, electrical conductivity, optical electronegativity, and Urbach energy are calculated from Ultraviolet Visible (UV–Vis) spectral analysis which depicts that the grown PTSC has high optical activity and can be used in the photonic application. The violet and green emission nature of PTSC was examined through Photoluminescence emission studies. The intensity-dependent third-order non-linear optical absorption property of the title material was studied using Z-scan analysis and PTSC exhibits two-photon absorption-induced optical limiting action. The non-linear optical (NLO) behavior of PTSC suggests the possible use in laser-driven applications as it can effectively control the laser to safe level.

Mitochondrial integrity and function constitute a prerequisite for cellular function and repair processes. We have previously shown that mitochondria of different cell types exhibit pronounced fragmentation under hypothermic conditions. This fission, accompanied by a decline of cellular ATP content, showed reversibility at 37◦C. However, it is unclear whether other temperatures as currently discussed for reconditioning of organs allow this reconstitution of mitochondria. Therefore, we here study in a model of cultured porcine aortic endothelial cells how different rewarming temperatures affect mitochondrial re-fusion and function. After 48 h cold incubation of endothelial cells in Krebs-Henseleit buffer with glucose (5 mM) and deferoxamine (1 mM) at 4◦C pronounced mitochondrial fission was observed. Following 2 h rewarming in cell culture medium, marked fission was still present after rewarming at 10◦ or 15◦C. At 21◦C some re-fusion was visible, which became more marked at 25◦C. Networks of tubular mitochondria similar to control cells only re-appeared at 37◦C. ATP content decreased at 4◦C from 3.6 ± 0.4 to 1.6 ± 0.4 nmol/106 cells and decreased even further when rewarming cells to 10◦ and 15◦C. Values after rewarming at 21◦C were similar to the values before rewarming while ATP gradually increased at higher rewarming temperatures. Metabolic activity dropped to 5 ± 11% of control values during 4◦C incubation and recovered with increasing temperatures to 36 ± 10% at 25◦C and 78 ± 17% at 37◦C. Integrity of monolayers, largely disturbed at 4◦C (large gaps between endothelial cells; cell injury ≤ 1%), showed partial recovery from 15◦C upwards, complete recovery at 37◦C. Endothelial repair processes (scratch assay) at 25◦C were clearly inferior to those at 37◦C. These data suggest that reconditioning temperatures below 21◦C are not optimal with regard to reconstitution of mitochondrial integrity and function. For this goal, temperatures of at least 25◦C appear required, with 30◦C being superior and 37◦C yielding the best results.

Se encontró que la precisión de la estimación del volumen de órganos internos realizada con ultrasonido (EE. UU.) Es multifactorial. Por lo tanto, nuestro objetivo fue describir y validar la evaluación de volumen de la ecografía y las fórmulas estándar de estimación de volumen para órganos intraabdominales de diferentes formas utilizando bazos y riñones. Se escanearon riñones cadavéricos disecados (n = 25) y bazos (n = 29) para obtener medidas lineales y volúmenes autogenerados por ultrasonido (USV). Se utilizaron medidas lineales para calcular los volúmenes manualmente con fórmulas de estimación de volumen elipsoide, prolate y Lambert. Los volúmenes reales (AV) de los órganos se obtuvieron mediante el método de desplazamiento de agua. Se comparó la precisión de la evaluación del volumen de USV y diferentes fórmulas comparando el sesgo, la precisión y el análisis de la gráfica de Bland-Altman. El procedimiento de medición de volumen y lineal de EE. UU. Fue confiable con acuerdos altos entre observadores e intraobservadores (lineal: α de Chronbach = 0,983 a 0,934; volúmenes: α de Chronbach = 0,989). Las estimaciones de USV fueron precisas con una alta correlación con AV y un bajo sesgo de estimación (-5,9%). Además, las fórmulas prolate (sesgo = -0,75%) y elipsoide (sesgo = -3. 75%) fueron confiables con un sesgo insignificante en los volúmenes estimados. Por el contrario, la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, el error de estimación se encontró relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen usado. la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, el error de estimación se encontró relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen usado. la fórmula de Lambert no fue confiable debido a un alto sesgo (41,6%). Para todos los métodos evaluados, el error de estimación se encontró relacionado con el tamaño del órgano (T = 3.483; p = 0.001), principalmente cuando el órgano evaluado es mayor de 50 ml. Además, se encontró que el error de estimación de forma está relacionado con la fórmula de estimación de volumen usado.