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Fulltext Detection of neovascularization in diabetic retinopathy

Hassan SS, Bong DB, Premsenthil M

J Digit Imaging, 2012 Jun;25(3):437-44.
PMID: 21901535 DOI: 10.1007/s10278-011-9418-6

Diabetic retinopathy has become an increasingly important cause of blindness. Nevertheless, vision loss can be prevented from early detection of diabetic retinopathy and monitor with regular examination. Common automatic detection of retinal abnormalities is for microaneurysms, hemorrhages, hard exudates, and cotton wool spot. However, there is a worse case of retinal abnormality, but not much research was done to detect it. It is neovascularization where new blood vessels grow due to extensive lack of oxygen in the retinal capillaries. This paper shows that various combination of techniques such as image normalization, compactness classifier, morphology-based operator, Gaussian filtering, and thresholding techniques were used in developing of neovascularization detection. A function matrix box was added in order to classify the neovascularization from natural blood vessel. A region-based neovascularization classification was attempted as a diagnostic accuracy. The developed method was tested on images from different database sources with varying quality and image resolution. It shows that specificity and sensitivity results were 89.4% and 63.9%, respectively. The proposed approach yield encouraging results for future development.
The global palm oil sector must change to save biodiversity and improve food security in the tropics

Azhar B, Saadun N, Prideaux M, Lindenmayer DB

J Environ Manage, 2017 Dec 01;203(Pt 1):457-466.
PMID: 28837912 DOI: 10.1016/j.jenvman.2017.08.021

Most palm oil currently available in global markets is sourced from certified large-scale plantations. Comparatively little is sourced from (typically uncertified) smallholders. We argue that sourcing sustainable palm oil should not be determined by commercial certification alone and that the certification process should be revisited. There are so-far unrecognized benefits of sourcing palm oil from smallholders that should be considered if genuine biodiversity conservation is to be a foundation of 'environmentally sustainable' palm oil production. Despite a lack of certification, smallholder production is often more biodiversity-friendly than certified production from large-scale plantations. Sourcing palm oil from smallholders also alleviates poverty among rural farmers, promoting better conservation outcomes. Yet, certification schemes - the current measure of 'sustainability' - are financially accessible only for large-scale plantations that operate as profit-driven monocultures. Industrial palm oil is expanding rapidly in regions with weak environmental laws and enforcement. This warrants the development of an alternative certification scheme for smallholders. Greater attention should be directed to deforestation-free palm oil production in smallholdings, where production is less likely to cause large scale biodiversity loss. These small-scale farmlands in which palm oil is mixed with other crops should be considered by retailers and consumers who are interested in promoting sustainable palm oil production. Simultaneously, plantation companies should be required to make their existing production landscapes more compatible with enhanced biodiversity conservation.
Fulltext 4-Fluoro-benzyl (Z)-2-(2-oxoindolin-3-yl-idene)hydrazine-1-carbodi-thio-ate

Abdul Manan MAF, Cordes DB, McKay AP

IUCrdata, 2024 Mar;9(Pt 3):x240235.
PMID: 38586527 DOI: 10.1107/S2414314624002359

The title compound, C16H12FN3OS, a fluorinated di-thio-carbazate imine derivative, was synthesized by the one-pot, multi-component condensation reaction of hydrazine hydrate, carbon di-sulfide, 4-fluoro-benzyl chloride and isatin. The compound demonstrates near-planarity across much of the mol-ecule in the solid state and a Z configuration for the azomethine C=N bond. The Z form is further stabilized by the presence of an intra-molecular N-H⋯O hydrogen bond. In the extended structure, mol-ecules are linked into dimers by N-H⋯O hydrogen bonds and further connected into chains along either [20] or [100] by weak C-H⋯S and C-H⋯F hydrogen bonds, which further link into corrugated sheets and in combination form the overall three-dimensional network.
Methyl 2-[(Z)-5-bromo-2-oxoindolin-3-yl-idene]-hydrazinecarbodi-thio-ate

Abdul Manan MAF, Cordes DB, McKay AP

IUCrdata, 2024 Aug;9(Pt 8):x240787.
PMID: 39247078 DOI: 10.1107/S2414314624007879

The title compound, C10H8BrN3OS2, a brominated di-thio-carbazate imine deriv-ative, was obtained from the condensation reaction of S-methyl-dithio-carbazate (SMDTC) and 5-bromo-isatin. The essentially planar mol-ecule exhibits a Z configuration, with the di-thio-carbazate and 5-bromo-isatin fragments located on the same sides of the C=N azomethine bond, which allows for the formation of an intra-molecular N-H⋯Ob (b = bromo-isatin) hydrogen bond generating an S(6) ring motif. In the crystal, adjacent mol-ecules are linked by pairs of N-H⋯O hydrogen bonds, forming dimers characterized by an R 2 2(8) loop motif. In the extended structure, mol-ecules are linked into a three-dimensional network by C-H⋯S and C-H⋯Br hydrogen bonds, C-Br⋯S halogen bonds and aromatic π-π stacking.
Fulltext Methyl 4-amino-3-meth-oxy-isoxazole-5-carboxyl-ate

Abdul Manan MAF, Cordes DB, Slawin AMZ

IUCrdata, 2023 Aug;8(Pt 8):x230623.
PMID: 37693783 DOI: 10.1107/S2414314623006235

The title compound, C6H8N2O4, a new derivative of isoxazole, has been synthesized and structurally characterized. The crystal structure shows the mol-ecule to be almost planar (r.m.s. deviation for the non-hydrogen atoms = 0.029 Å), this conformation being supported by an intra-molecular N-H⋯O hydrogen bond. In the extended structure, the mol-ecules are linked by N-H⋯O hydrogen bonds into chains propagating along [010].
Fulltext Comparing Genomic Signatures of Selection Between the Abbassa Strain and Eight Wild Populations of Nile Tilapia (Oreochromis niloticus) in Egypt

Nayfa MG, Jones DB, Benzie JAH, Jerry DR, Zenger KR

Front Genet, 2020;11:567969.
PMID: 33193660 DOI: 10.3389/fgene.2020.567969

Domestication to captive rearing conditions, along with targeted selective breeding have genetic consequences that vary from those in wild environments. Nile tilapia (Oreochromis niloticus) is one of the most translocated and farmed aquaculture species globally, farmed throughout Asia, North and South America, and its African native range. In Egypt, a breeding program established the Abbassa Strain of Nile tilapia (AS) in 2002 based on local broodstock sourced from the Nile River. The AS has been intensively selected for growth and has gone through genetic bottlenecks which have likely shifted levels and composition of genetic diversity within the strain. Consequently, there are questions on the possible genetic impact AS escapees may have on endemic populations of Nile tilapia. However, to date there have been no genetic studies comparing genetic changes in the domesticated AS to local wild populations. This study used 9,827 genome-wide SNPs to investigate population genetic structure and signatures of selection in the AS (generations 9-11) and eight wild Nile tilapia populations from Egypt. SNP analyses identified two major genetic clusters (captive and wild populations), with wild populations showing evidence of isolation-by-distance among the Nile Delta and upstream riverine populations. Between genetic clusters, approximately 6.9% of SNPs were identified as outliers with outliers identified on all 22 O. niloticus chromosomes. A lack of localized outlier clustering on the genome suggests that no genes of major effect were presently detected. The AS has retained high levels of genetic diversity (Ho_All = 0.21 ± 0.01; He_All = 0.23 ± 0.01) when compared to wild populations (Ho_All = 0.18 ± 0.01; He_All = 0.17 ± 0.01) after 11 years of domestication and selective breeding. Additionally, 565 SNPs were unique within the AS line. While these private SNPs may be due to domestication signals or founder effects, it is suspected that introgression with blue tilapia (Oreochromis aureus) has occurred. This study highlights the importance of understanding the effects of domestication in addition to wild population structure to inform future management and dissemination decisions. Furthermore, by conducting a baseline genetic study of wild populations prior to the dissemination of a domestic line, the effects of aquaculture on these populations can be monitored over time.
Orthogonal Recognition Processes Drive the Assembly and Replication of a [2]Rotaxane

Kosikova T, Hassan NI, Cordes DB, Slawin AM, Philp D

J Am Chem Soc, 2015 Dec 30;137(51):16074-83.
PMID: 26473285 DOI: 10.1021/jacs.5b09738

Within a small, interconnected reaction network, orthogonal recognition processes drive the assembly and replication of a [2]rotaxane. Rotaxane formation is governed by a central, hydrogen-bonding-mediated binding equilibrium between a macrocycle and a linear component, which associate to give a reactive pseudorotaxane. Both the pseudorotaxane and the linear component undergo irreversible, recognition-mediated 1,3-dipolar cycloaddition reactions with a stoppering maleimide group, forming rotaxane and thread, respectively. As a result of these orthogonal recognition-mediated processes, the rotaxane and thread can act as auto-catalytic templates for their own formation and also operate as cross-catalytic templates for each other. However, the interplay between the recognition and reaction processes in this reaction network results in the formation of undesirable pseudorotaxane complexes, causing thread formation to exceed rotaxane formation in the current experimental system. Nevertheless, in the absence of competitive macrocycle-binding sites, realization of a replicating network favoring formation of rotaxane is possible.
Biomarker responses in zebrafish (Danio rerio) larvae exposed to pristine low-density polyethylene fragments

Karami A, Groman DB, Wilson SP, Ismail P, Neela VK

Environ Pollut, 2017 Apr;223:466-475.
PMID: 28129952 DOI: 10.1016/j.envpol.2017.01.047

There are serious concerns over the adverse impacts of microplastics (MPs) on living organisms. The main objective of this study was to test the effects of MPs on the total length, weight, condition factor (CF), transcriptional level of antioxidant, anti and pro-apoptotic, and neurotransmitter genes, and the histopathology of the gill, liver, brain, kidney, and intestine in the larvae of zebrafish (Danio rerio). Fish were exposed to one of three levels of pristine low-density polyethylene (LDPE) fragments (5, 50, or 500 μg/L) for 10 or 20 days. No significant changes were observed in any of the selected biomarkers across MP concentrations at days 10 or 20. The expression of casp9 (caspase 9, apoptosis-related cysteine protease), casp3a (caspase 3, apoptosis-related cysteine protease a) and cat (catalase), however, were significantly lower in the larvae sampled at day 20 than day 10. We provide evidence that virgin short-term exposure to LDPE fragments has minimal impact on biomarker responses in D. rerio larvae.
Evaluation of home medication review for patients with type 2 diabetes mellitus by community pharmacists: a randomised controlled trial

Rosli MR, Neoh CF, Wu DB, Hassan NW, Mahmud M, Rahimi A, et al.

Pharm Pract (Granada), 2021 09 09;19(3):2397.
PMID: 34621450 DOI: 10.18549/PharmPract.2021.3.2397

Background: Successful diabetes treatment requires commitment and understanding of disease management by the patients.
Objective: This trial aimed to evaluate the programme effectiveness of home medication review by community pharmacists (HMR-CP) in optimising diabetes care and reducing medication wastage.
Methods: A randomised controlled trial was conducted on 166 patients with Type 2 Diabetes Mellitus (T2DM) who were randomly assigned to the intervention or control groups. The intervention group received HMR-CP at 0-month, 3-month, and 6-month. The primary outcome was haemoglobin A1c (HbA1c) while clinical outcomes, anthropometric data, and humanistic outcomes were the secondary outcomes. For the intervention group, drug-related problems (DRP) were classified according to the Pharmaceutical Care Network Europe Foundation (PCNE). Medication adherence was determined based on the Pill Counting Adherence Ratio (PCAR). The cost of medication wastage was calculated based on the total missed dose by the T2DM patients multiplied by the cost of medication. General linear model and generalised estimating equations were used to compare data across the different time-points within and between the groups, respectively.
Results: No significant difference was observed in the demographic and anthropometric data at baseline between the two groups except for fasting blood glucose (FBG). There was a significant reduction in the HbA1c (-0.91%) and FBG (-1.62mmol/L) over the study period (p<0.05). A similar observation was noted in diastolic blood pressure (DBP) and total cholesterol (TC) but not in high-density lipoprotein (HDL), and anthropometric parameters. Both utility value and Michigan Diabetes Knowledge Test (MDKT) scores increased significantly over time. As for the intervention group, significant changes in PCAR (p<0.001) and the number of DRP (p<0.001) were noted.
Conclusions: HMR-CP significantly improved the glycaemic control, QoL, medication adherence, and knowledge of T2DM patients as well as reduced the number of DRP and cost of medication wastage. However, the impact of HMR-CP on certain clinical and anthropometric parameters remains inconclusive and further investigation is warranted.
Fulltext Athlete level, sport-type, and gender influences on training, mental health, and sleep during the early COVID-19 lockdown in Malaysia

Washif JA, Kok LY, James C, Beaven CM, Farooq A, Pyne DB, et al.

Front Physiol, 2022;13:1093965.
PMID: 36714309 DOI: 10.3389/fphys.2022.1093965

Purpose: We evaluated the extent of changes in training practices, recovery, mental health, and sleep patterns of athletes during the early COVID-19 lockdown in a single country-cohort. Methods: A total of 686 athletes (59% male, 41% female; 9% World Class, 28% International, 29% National, 26% State, 8% Recreational) from 50 sports (45% individual, 55% team) in Malaysia completed an online, survey-based questionnaire study. The questions were related to training practices (including recovery and injury), mental health, and sleep patterns. Results: Relative to pre-lockdown, training intensity (-34%), frequency (-20%, except World-Class), and duration (-24%-59%, especially International/World-Class) were compromised, by the mandated lockdown. During the lockdown, more space/access (69%) and equipment (69%) were available for cardiorespiratory training, than technical and strength; and these resources favoured World-Class athletes. Most athletes trained for general strength/health (88%) and muscular endurance (71%); and some used innovative/digital training tools (World-Class 48% vs. lower classification-levels ≤34%). More World-Class, International, and National athletes performed strength training, plyometrics, and sport-specific technical skills with proper equipment, than State/Recreational athletes. More females (42%) sourced training materials from social media than males (29%). Some athletes (38%) performed injury prevention exercises; 18% had mild injuries (knees 29%, ankles 26%), and 18% received a medical diagnosis (International 31%). Lower-level athletes (e.g., State 44%) disclosed that they were mentally more vulnerable; and felt more anxious (36% vs. higher-levels 14%-21%). Sleep quality and quantity were "normal" (49% for both), "improved" (35% and 27%), and only 16% and 14% (respectively) stated "worsened" sleep. Conclusion: Lockdown compromised training-related practices, especially in lower-level athletes. Athletes are in need of assistance with training, and tools to cope with anxiety that should be tailored to individual country requirements during lockdown situations. In particular, goal-driven (even if it is at home) fitness training, psychological, financial, and lifestyle support can be provided to reduce the difficulties associated with lockdowns. Policies and guidelines that facilitate athletes (of all levels) to train regularly during the lockdown should be developed.
Fulltext Crude oil exploration in Africa: socio-economic implications, environmental impacts, and mitigation strategies

Adeola AO, Akingboye AS, Ore OT, Oluwajana OA, Adewole AH, Olawade DB, et al.

Environ Syst Decis, 2022;42(1):26-50.
PMID: 34401215 DOI: 10.1007/s10669-021-09827-x

Crude oil exploration is a source of significant revenue in Africa via trade and investment since its discovery in the mid-19th Century. Crude oil has bolstered the continent's economy and improved the wellbeing of the citizenry. Historically, Africa has suffered from conflicts due to uneven redistribution of crude oil revenue and severe environmental pollution. Advancements in geophysical survey techniques, such as magnetic and gravity methods, to seismic methods, have made the commercial exploration of crude oil possible for some other countries in Africa apart from Nigeria, Angola, Algeria, Libya, and Egypt. The occurrence of organic-rich, oil-prone Type I, II, and mixed II/III kerogens in sedimentary basins and entrapment within reservoir rocks with intrinsic petrophysical properties are majorly responsible for the large deposits of hydrocarbon in Africa. The unethical practices by some multinational oil corporations have resulted in social movements against them by host communities and human rights groups. The unscrupulous diversion of public funds, award of oil blocks, and production rights to certain individuals have impaired economic growth in Africa. The over-dependence on crude oil revenues has caused the economic recession in oil-producing countries due to plummeting oil prices and global pandemic. Most host communities of crude oil deposits suffer from a lack of infrastructure, arable soils, clean water, and their functioning capabilities are violated by crude oil exploratory activities, without adequate compensations and remedial actions taken by oil companies and the government. Thus, this review examines crude oil exploration in Africa and provides insight into the environmental and socio-economic implications of crude oil exploration in Africa. Furthermore, this report highlights some recommendations that may ensure ethical and sustainable practices toward minimizing negative impacts and improving the quality of life in affected communities.
Fulltext (Z)-Benzyl 2-(5-methyl-2-oxoindolin-3-yl-idene)hydrazinecarbodi-thio-ate

Abdul Manan MAF, Cordes DB, McKay AP, Mohammat MF, Mohd Aluwi MFF, Jumali NS

IUCrdata, 2023 Sep;8(Pt 9):x230782.
PMID: 37818467 DOI: 10.1107/S2414314623007824

The title compound, C17H15N3OS2 was obtained from the condensation reaction of S-benzyl-dithio-carbazate and 5-methyl-isatin. In the solid-state, the mol-ecule adopts a Z configuration with the 5-methyl-isatin and di-thio-carbazate groups located on the same side of the C=N bond, involving an intra-molecular N-H⋯O hydrogen bond.
Fulltext Ethyl (2RS,3SR,4RS)-1-ethyl-2-(furan-2-yl)-4-hy-droxy-5-oxopyrrolidine-3-carboxyl-ate

Mohd Rosli NH, Mohammat MF, Abdul Manan MAF, Cordes DB, McKay AP

IUCrdata, 2024 Nov;9(Pt 11):x241088.
PMID: 39649090 DOI: 10.1107/S2414314624010885

The title racemic oxopyrrolidine compound, C13H17NO5, contains three stereogenic centres and crystallizes with two mol-ecules in the asymmetric unit. The five-membered pyrrolidine rings in both mol-ecules exhibit envelope conformations. The N-ethyl group of one of the mol-ecules is disordered over two sets of sites in a 0.836 (4):0.164 (4) ratio. In the crystal, both mol-ecules form inversion dimers through pairwise O-H⋯O hydrogen bonds, generating R 2 2(10) loops, which are linked into a three-dimensional network by weak C-H⋯O hydrogen bonds.
Fulltext Training strategies of 10,074 athletes from 121 countries based on human development index in early COVID-19 lockdown

Galy O, Washif JA, Wattelez G, Farooq A, Hue O, Sandbakk Ø, et al.

Sci Rep, 2024 Apr 17;14(1):8866.
PMID: 38632327 DOI: 10.1038/s41598-024-59375-y

The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.
Fulltext Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience

Washif JA, Hettinga FJ, Ammar A, van Rensburg DCJ, Materne O, Trabelsi K, et al.

BMC Sports Sci Med Rehabil, 2024 Apr 15;16(1):83.
PMID: 38622683 DOI: 10.1186/s13102-024-00869-7

BACKGROUND: For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown.
METHODS: This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences.
RESULTS: Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges.
CONCLUSIONS: Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.
Fulltext Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation

Yip CH, Smith RA, Anderson BO, Miller AB, Thomas DB, Ang ES, et al.

Cancer, 2008 Oct 15;113(8 Suppl):2244-56.
PMID: 18837017 DOI: 10.1002/cncr.23842

A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease. Populations in which cancers are detected at earlier stages have lower breast cancer mortality rates. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary in October 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for early detection, diagnosis, and treatment in low- and middle-income countries (LMCs). A multidisciplinary panel of experts specifically addressed the implementation of BHGI guidelines for the early detection of disease as they related to resource allocation for public education and awareness, cancer detection methods, and evaluation goals. Public education and awareness are the key first steps, because early detection programs cannot be successful if the public is unaware of the value of early detection. The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self-examination, were reviewed in the context of resource availability and population-based need by the panel. Social and cultural barriers should be considered when early detection programs are being established, and the evaluation of early detection programs should include the use of well developed, methodologically sound process metrics to determine the effectiveness of program implementation. The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis and will drive the breadth of resource allocation needed for program implementation.
Real-world evidence of improved healthcare utilization in patients with schizophrenia or schizoaffective disorder after early treatment of paliperidone palmitate once-monthly treatment in Hong Kong

Choon JWY, Wu DBC, Chong HY, Lo WTL, Chong CSY, Chung WS, et al.

J Med Econ, 2019 Mar;22(3):273-279.
PMID: 30561238 DOI: 10.1080/13696998.2018.1560749

BACKGROUND: Very few data are available to demonstrate the economic benefit of early paliperidone palmitate once-monthly long-acting injectable (PP1M) treatment in patients with schizophrenia or schizoaffective disorder.
METHODS AND MATERIALS: This study has retrospectively compared the healthcare utilization and associated costs of pre- and post-PPIM treatment in 413 patients with schizophrenia or schizoaffective disorder recruited from three major public hospitals providing psychiatric services in Hong Kong. Patients were categorized into early treatment (≤3 years since diagnosis) and chronic (>3 years) groups, and also whether they were receiving polypharmacy (POP).
RESULTS: It was found that patients who were started on early therapy with no POP had the most favourable outcomes. Overall results of the entire cohort, including both early and late treatments, indicate that there was a slight increase in annual in-patient days (IP) per patient and outpatient visit (OP) by 3.18 and 1.87, respectively, and a decrease in emergency room visit (ER) of 0.9 (p
Inhibition of the Interleukin-36 Pathway for the Treatment of Generalized Pustular Psoriasis

Bachelez H, Choon SE, Marrakchi S, Burden AD, Tsai TF, Morita A, et al.

N Engl J Med, 2019 03 07;380(10):981-983.
PMID: 30855749 DOI: 10.1056/NEJMc1811317
Fulltext Personalising care of adults with asthma from Asia: a modified e-Dephi consensus study to inform management tailored to attitude and control profiles

Chisholm A, Price DB, Pinnock H, Lee TT, Roa C, Cho SH, et al.

NPJ Prim Care Respir Med, 2017 Jan 05;27:16089.
PMID: 28055000 DOI: 10.1038/npjpcrm.2016.89

REALISE Asia-an online questionnaire-based study of Asian asthma patients-identified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: 'Well-adjusted and at least partly controlled'; 'In denial about symptoms'; 'Tolerating with poor control'; 'Adrift and poorly controlled'; 'Worried with multiple symptoms'). We developed consensus recommendations for tailoring management of these attitudinal-control clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal-control clusters and provided free text recommendations for their assessment and management. Round 2: panellists prioritised Round 1 recommendations and met (or joined a teleconference) to consolidate the recommendations. Round 3: panellists voted and prioritised the remaining recommendations. Consensus was defined as Round 3 recommendations endorsed by >50% of panellists. Highest priority recommendations were those receiving the highest score. The multidisciplinary panellists (9 clinicians, 1 pharmacist and 1 health social scientist; 7 from Asia) identified consensus recommendations for all clusters. Recommended pharmacological (e.g., step-up/down; self-management; simplified regimen) and non-pharmacological approaches (e.g., trigger management, education, social support; inhaler technique) varied substantially according to each cluster's attitude to asthma and associated psychosocial drivers of behaviour. The attitudinal-control clusters defined by REALISE Asia resonated with the international panel. Consensus was reached on appropriate tailored management approaches for all clusters. Summarised and incorporated into a structured management pathway, these recommendations could facilitate personalised care. Generalisability of these patient clusters should be assessed in other socio-economic, cultural and literacy groups and nationalities in Asia.
Fulltext Dorsal root ganglia control nociceptive input to the central nervous system

Hao H, Ramli R, Wang C, Liu C, Shah S, Mullen P, et al.

PLoS Biol, 2023 Jan;21(1):e3001958.
PMID: 36603052 DOI: 10.1371/journal.pbio.3001958

Accumulating observations suggest that peripheral somatosensory ganglia may regulate nociceptive transmission, yet direct evidence is sparse. Here, in experiments on rats and mice, we show that the peripheral afferent nociceptive information undergoes dynamic filtering within the dorsal root ganglion (DRG) and suggest that this filtering occurs at the axonal bifurcations (t-junctions). Using synchronous in vivo electrophysiological recordings from the peripheral and central processes of sensory neurons (in the spinal nerve and dorsal root), ganglionic transplantation of GABAergic progenitor cells, and optogenetics, we demonstrate existence of tonic and dynamic filtering of action potentials traveling through the DRG. Filtering induced by focal application of GABA or optogenetic GABA release from the DRG-transplanted GABAergic progenitor cells was specific to nociceptive fibers. Light-sheet imaging and computer modeling demonstrated that, compared to other somatosensory fiber types, nociceptors have shorter stem axons, making somatic control over t-junctional filtering more efficient. Optogenetically induced GABA release within DRG from the transplanted GABAergic cells enhanced filtering and alleviated hypersensitivity to noxious stimulation produced by chronic inflammation and neuropathic injury in vivo. These findings support "gating" of pain information by DRGs and suggest new therapeutic approaches for pain relief.

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