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On October 10, 2020, the Memorial Sloan Kettering Cancer Center Supportive Care Service hosted their first-ever United States (US) World Hospice and Palliative Care Day (WHPCD) Celebration. The purpose of this article is to describe the US inaugural event in alignment with the broader goals of WHPCD and provide lessons learned in anticipation of the second annual conference to be held on October 5–6, 2021.
Description of the inaugural event in the context of COVID-19 and WHPCD, co-planning conference team reflection, and attendee survey responses.
The Worldwide Hospice Palliative Care Alliance initially launched WHPCD in 2005 as an annual unified day of action to celebrate and support hospice and palliative care around the world. The US-based innovative virtual conference featured 23 interprofessional hospice and palliative care specialists and patient and family caregiver speakers across nine diverse sessions addressing priorities at the intersection of COVID-19, social injustice, and the global burden of serious health-related suffering. Two primary aims guided the event: community building and wisdom sharing. Nearly 270 registrants from at least 16 countries and one dozen states across the US joined the free program focused on both personal and professional development.
Significance of results
Unlike many other academic conferences and professional gatherings that were relegated to online forums due to pandemic-related restrictions, the US WHPCD Celebration was intentionally established to create a virtual coming together for collective reflection on the barriers and facilitators of palliative care delivery amid vast societal change. The goal to ensure a globally relevant and culturally inclusive agenda will continue to draw increased participation at an international level during future annual events. Finally, the transparent and respectful sharing of palliative care team experiences in the year preceding the conference established a safe environment for both individual expression and scholarly discussion.
The eastern Arabian Sea is influenced by both the advection of upwelled water from the western Arabian Sea and winter convective mixing. Therefore, sediments collected from the eastern Arabian Sea can help to understand the long-term seasonal hydrographic changes. We used the planktonic foraminifera census and stable isotopic ratio (δ18O) from sediments drilled during the International Ocean Discovery Program Expedition 355 to reconstruct surface hydrographic changes in the eastern Arabian Sea during the last 350 kyr. The increased abundance of Globigerina bulloides suggests enhanced advection of upwelled water during the latter half of MIS7 and the beginning of MIS6, as a result of a strengthened summer monsoon. A large drop in upwelling and/or advection of upwelled water from the western Arabian Sea is inferred during the subsequent interval of MIS6, based on the rare presence of G. bulloides. The comparable relative abundance of Neogloboquadrina dutertrei, G. bulloides and Globigerinoides ruber suggests that during the early part of MIS5, hydrographic conditions were similar to today. The upwelling decreased and winter convection increased with the progress of the glacial interval. A good coherence between planktonic foraminiferal assemblage-based monsoon stacks from both the eastern and western Arabian Sea suggests a coeval response of the entire northern Arabian Sea to the glacial–interglacial changes. The glacial–interglacial difference in δ18Osw-ivc was at a maximum with 4–5 psu change in salinity during Termination 2 and 3, and a minimum during Termination 4. The significantly reduced regional contribution to the glacial–interglacial change in δ18Osw-ivc during Termination 4 suggests a lesser change in the monsoon.
This paper presents a new technique for the enhancement of axial ratio (AR) bandwidth of a circularly polarized dielectric resonator antenna with a single feeding. To enhance the AR bandwidth, adjacent 3-dB AR passbands are merged by inserting the notches and conductive coating in the dielectric resonator. The dimensions of the notches and conductive coating are selected in such manner that impedance bandwidth remains approximately unchanged. The antenna provides the measured AR and impedance bandwidths of 55.22% and 66.45%, respectively.
Immunoactivation depends upon the antigen potential to modulate T-cell repertoires. The present study has enumerated the effect of 61 kDa recombinant Leishmania donovani co-factor-independent phosphoglycerate mutase (rLd-iPGAM) on mononuclear cells of healthy and treated visceral leishmaniasis subjects as well as on THP-1 cell line. rLd-iPGAM stimulation induced higher expression of interleukin-1β (IL-1β) in the phagocytic cell, its receptor and CD69 on T-cell subsets. These cellular activations resulted in upregulation of host-protective cytokines IL-2, IL-12, IL-17, tumour necrosis factor-α and interferon-γ, and downregulation of IL-4, IL-10 and tumour growth factor-β. This immune polarization was also evidenced by upregulation of nuclear factor-κ light-chain enhancer of activated B cells p50 and regulated expression of suppressor of mother against decapentaplegic protein-4. rLd-iPGAM stimulation also promoted lymphocyte proliferation and boosted the leishmaniacidal activity of macrophages by upregulating reactive oxygen species. It also induced 1·8-fold higher release of nitric oxide (NO) by promoting the transcription of inducible nitric oxide synthase gene. Besides, in silico analysis suggested the presence of major histocompatibility complex class I and II restricted epitopes, which can proficiently trigger CD8+ and CD4+ cells, respectively. This study reports rLd-iPGAM as an effective immunoprophylactic agent, which can be used in future vaccine design.
A possible role of the APC/beta-catenin pathway in the pathogenesis of sporadic juvenile nasopharyngeal angiofibroma has been suggested. This paper presents its current status and clinical association in our patients.
A prospective observational study was conducted at King George Medical University and Central Drug Research Institute, in Lucknow, India. Western blot analysis was undertaken in 16 cases to examine beta-catenin expression. The clinical details were recorded along with follow up observations, to determine associations.
Up-regulation of beta-catenin expression was seen in 69 per cent of cases. The clinical variables did not reveal significant differences between patients with extremes of expression (extreme under- vs over-expression). However, absent expression was shown exclusively in young adults aged over 18 years, while enhanced expression was associated with an altered facial profile.
Although a beta-catenin association was seen in a subset of our sporadic juvenile nasopharyngeal angiofibroma cases, its expression was not homogeneous. This is in contrast to the Western literature that suggests a universal (homogenous) enhanced expression in the majority. Hence, further research is required to better define its molecular cascade.
Background: Spinal Cord Injury Without Radiological Abnormality (SCIWORA) is underreported and poorly recognized in adults. This entity is an important subtype of spinal cord injury (SCI) with relatively good outcomes. Despite this, few studies have been performed to determine specific imaging-related prognostic factors. Methods: A retrospective review of adult patients with cervical SCI admitted to two University hospitals from January 2000 to December 2010 was performed. Only patients with an MRI performed within 72 hours after trauma were included. All patients with bony injury or traumatic malalignment were excluded. Data gathered on the remaining patients included demographics, mechanism of injury, severity of SCI, long-term patient outcome, improvement in neurological condition and MRI results. Results: 49 patients selected. Patients with extramedullary hemorrhage showed worse neurological status at initial examination. Disruption of either the anterior longitudinal ligament or ligamentum flavum was associated with worse outcomes at initial examination and at 1-year follow up. Lesion length was also significantly associated with outcomes at 1 year evaluation and initial evaluation. Conclusions: Early MRI has an important prognostic value in patients suffering SCIWORA. Lesion length is a powerful predictor of outcome. Soft tissue injury and spinal cord changes play a role in the severity of injury as well as the ability to recover.
The role of ferroelectric LiNbO3 (LNB) in altering the frequency dependence of the capacitance of CaCu3Ti4O12 (CCTO) thin films has been investigated. A cost effective spin coating deposition process was used to integrate the oxide heterostructures onto silicon substrates. This study showed that the frequency stability of the CCTO/LNB structure was much improved when the crystallization conditions and physical dimension of each layer were optimized. To integrate this structure with current silicon technology, heterostructures of CCTO and LNB thin films were fabricated on HF terminated Si using chemical solution deposition. It was found that the order of deposition of the two layers was important for the structural quality of the heterostructures with the CCTO layer followed by the LNB layer being the preferred structure. In addition to improvement of the capacitance variation with frequency, the heterostructures also provide a path to tuning the frequency of operation.
Since 1997, and following our detection of the first mm afterglow, we have followed-up 70
GRBs, mainly with the IRAMś Plateau de Bure Interferometer, what can be considered as the
IRAM Legacy GRB Sample. 66 events were observed at 3 mm, with 19 of them being detected
(with another 3 having marginal detections). 32 GRBs were followed up at 1 mm, with 6 of
them being detected. Redshifts for the GRB afterglows lie in the range z = 0.03–8.3, with
measured flux densities (at 3 mm) varying between 0.25 and 60 mJy (but usually <1.5
mJy) with first observations taking place around 1–2 days after the GRB. Forward shock
emission expleains the observations with the exception of one particular case (GRB 090423
at z = 8.2) for which reverse shock emission is required.
Due to the poor positive predictive value of nucleic acid amplification tests (NAATs) for gonorrhoea when applied to a low-prevalence setting, current guidelines recommend the use of supplementary polymerase chain reaction (PCR) targeting a different gene for confirmation of true positives in urogenital specimens. This study sought to standardize and evaluate performance of an in-house opa gene-based PCR assay for gonorrhoea compared to assays targeting the porA pseudogene and 16S rRNA gene. Four hundred samples (300 endocervical, 100 urethral swabs) from patients attending STD clinics in New Delhi, India were used. The sensitivity, specificity, positive predictive value and negative predictive value of the opa-based PCR were 100%, 97·9%, 89·5% and 100%, respectively. In females, the use of NAATs provided enhanced diagnosis of gonorrhoea.
Gold nanoparticles (AuNp) formed using alkoxysilane precursors are utilized
in the development of thin organically modified silicates (ormosil) films.
The resulting films are optically transparent thereby retaining the optical
properties of AuNp. Surface morphology shows that the in
situ generated AuNp retained their nanogeometry in the ormosil
films. An application of the AuNp encapsulated ormosils is shown in
electrocatalytic determination of hydrogen peroxide. For this purpose,
potassium ferricyanide is chosen as electron transfer mediator and is
encapsulated in the films. Results show that the presence of AuNp in the
ormosil matrix dramatically improves the electrochemical behavior of
potassium ferricyanide. The ormosil films are utilized for electrocatalytic
determination of hydrogen peroxide. In order to investigate the
biocompatibility of the ormosil film, horseradish peroxidase (HRP) is
incorporated resulting in improvement in oxidation and reduction of
MicroRNA (miRNA) expression was measured within frontal cortex of male Holtzman rats subjected to repeated inescapable shocks at days 1 and 7, tested for learned helplessness (LH) at days 2 and 8, and sacrificed at day 15. We compared rats that did vs. did not exhibit LH, as well as rats that were placed in the apparatus and tested for avoidance but not given shocks (tested controls, TC). Non-learned helpless (NLH) rats showed a robust adaptive miRNA response to inescapable shock whereas LH rats showed a markedly blunted response. One set of 12 miRNAs showed particularly large, significant down-regulation in NLH rats relative to tested controls (mir-96, 141, 182, 183, 183*, 298, 200a, 200a*, 200b, 200b*, 200c, 429). These were encoded at a few shared polycistronic loci, suggesting that the down-regulation was coordinately controlled at the level of transcription. Most of these miRNAs are enriched in synaptic fractions. Moreover, almost all of these share 5′-seed motifs with other members of the same set, suggesting that they will hit similar or overlapping sets of target mRNAs. Finally, half of this set is predicted to hit Creb1 as a target. We also identified a core miRNA co-expression module consisting of 36 miRNAs that are highly correlated with each other across individuals of the LH group (but not in the NLH or TC groups). Thus, miRNAs participate in the alterations of gene expression networks that underlie the normal (NLH) as well as aberrant (LH) response to repeated shocks.
Pedigree analysis was used to study the genetic background of 66 Indian early maturing potato selections, the pedigree of which was traced back to 35 ancestors. Six of the 35 contributed 0·42 of the genetic base, which shows the narrow genetic base of Indian early maturing genotypes. Genotypes 2814 (a)1 (f=0·145) and 3069 (d)4 (f=0·145) were the ancestors which appeared most frequently. Based on the coefficient of relationship, the 66 selections were grouped into seven groups with one common ancestor in almost all the selections within a group. The genotypes Kufri Ashoka, Kufri Pukhraj, AGB-69-1, Kufri Jyoti, Kufri Alankar, Kufri Lauvkar and Kufri Kuber were identified as very important parents/ancestors, carrying specific gene complexes valuable in new selections. Crosses between selections from different diversity groups can result in the selection of useful clones while increasing or maintaining genetic diversity, which is desirable to ensure sustainable breeding progress in the future.
In vitro gas production (GP) of substrate incubated with cow rumen liquor is commonly used to evaluate feed nutritional quality; GP is correlated with organic matter digestibility and metabolizable energy content. The hypothesis tested was that GP differs among liquors of ruminant species and is dependent on the natural dietary intake of the donors. Measurements were of 24 h GP of seven browse species using rumen liquor from a large (cow) and small (sheep) grazer and from a small intermediate feeder (goat). Mean GP for browse with goat liquor (7±2·4 ml per 200 mg substrate) was significantly (P=0·019) higher than that with cow liquor (5±1·9 ml), and GP with sheep liquor (6±1·1 ml) was intermediate, not significantly different from the cow liquor (P=0·197) and the goat liquor (P=0·061). There was a significant correlation in the ranking of the browses between goat and sheep (P=0·013) liquor using a Mantel test with 9999 permutations, which indicated a similar ranking of browses when using rumen liquor of either of these small ruminants. There were trends between both cow and sheep (P=0·096) and cow and goat (P=0·092) liquors. It was concluded that the dietary habits of ruminant species donors may affect in vitro nutritional studies when using rumen liquor.
Extracellular signal-regulated kinase (ERK)1/2 signalling plays a critical role in synaptic and structural plasticity. Recent preclinical and human brain studies suggest that depression and suicidal behaviour are associated with aberrant ERK1/2 signalling. MEK, is a dual-specificity kinase, which is the immediate upstream regulator of ERK1/2. Two isoforms of MEK (MEK1 and MEK2) exist. By phosphorylating at Ser and Thr residues, MEK activates ERK1/2, which then phosphorylates cytoplasmic and nuclear substrates. On the other hand, MEK itself is regulated through phosphorylation by upstream Raf kinases. Recently, we demonstrated that activation of ERK1/2 and B-Raf was attenuated in the brains of suicide subjects. To further investigate the regulation of ERK1/2 signalling, we examined the expression and activation of MEKs, the interaction of MEK with ERKs, MEK-mediated activation of ERK1/2, and ERK1/2-mediated activation of nuclear substrate Elk-1 in the prefrontal cortex and hippocampus of suicide subjects. In addition, in order to investigate whether MEK is regulated by B-Raf, we examined the B-Raf and MEK interaction. No significant changes were observed in expression levels of MEK1 or MEK2; however, the catalytic activity of only MEK1 (not MEK2) was decreased in both the prefrontal cortex and hippocampus of suicide subjects. The interaction of MEK1 with ERK1 and ERK2 was increased along with decreased phosphorylation and catalytic activity of ERK1/2. In addition, we found decreased phosphorylation of MEK1 and less interaction of B-Raf with MEK1. Our results demonstrate abnormalities in MEK1 at multiple levels and suggest that these abnormalities in MEK1 are crucial for aberrant ERK1/2 signalling in suicide brain.
The theory of particle aspect analysis is extended to the drift wave in the presence of an inhomogeneous magnetic field. The dispersion relation and growth rate of the wave are evaluated and discussed when the magnetic field gradient is directed opposite to the density gradient. The plasma under consideration is assumed to be anisotropic and the effects of temperature anisotropy on the dispersion characteristics and growth rate of the wave are also studied. The dispersion relation and the growth rate are evaluated for the space plasma parameters.