Background The cervical cancer burden is high among women living in Appalachia. Cigarette smoking, a cervical cancer risk factor, is also highly prevalent in this population. This project aims to increase smoking cessation among women living in Appalachia by embedding a smoking cessation program within a larger, integrated cervical cancer prevention program. Methods The broader program, the Take CARE study, is a multi-site research collaborative designed to address three risk factors for cervical cancer incidence and mortality: tobacco use, human papillomavirus (HPV) infection, and cervical cancer screening. Break Free is a primary care clinic-based implementation program that aims to promote smoking cessation among female smokers in Appalachia by standardizing clinical practice protocols. Break Free includes: (1) implementation of a tobacco user identification system in the Electronic Health Record, (2) clinic staff and provider training on the Ask, Advise and Refer (AAR) model, (3) provider implementation of AAR to identify and treat women who want to quit smoking within the next 6 months, (4) facilitated access to cessation phone counseling plus pharmacotherapy, and (5) the bundling of Break Free tobacco cessation with HPV vaccination and cervical cancer screening interventions in an integrated approach to cervical cancer prevention. The study spans 35 Appalachian health clinics across 10 healthcare systems. We aim to enroll 51 adult female smokers per health system (total N = 510). Baseline and follow-up data will be obtained from participant (provider and patient) surveys. The primary outcome is self-reported 12-month point prevalence abstinence among enrolled patients. All randomized patients are asked to complete follow-up surveys, regardless of whether they participated in tobacco treatment. Data analysis of the primary aims will follow intent-to-treat methodology. Secondary outcomes will assess program implementation and cost effectiveness. Discussion Addressing high tobacco use rates is critical for reducing cervical cancer morbidity and mortality among women living in Appalachia. This study evaluates the implementation and effectiveness of a smoking cessation program in increasing smoking cessation among female smokers. If results demonstrate effectiveness and sustainability, implementation of this program into other health care clinics could reduce both rates of smoking and cervical cancer. Trial registration NCT04340531 (April 9, 2020)
Fibrous-type filters are used to capture dust particles in mining and other occupations where personnel are exposed for prolonged periods. Dust cleansing devices including flooded-bed dust scrubbers use these mesh-type multi-layered filters. These filters trap dust particles efficiently on their surface and inside their mesh. However, their continued operation leads to dust build-up and clogging. This results in increased resistance of the filter and lowered airflow rate through the scrubber. This could potentially enhance the exposure of the miners. A non-clogging self-cleaning impingement screen type dust filter was designed by the authors for use in mining and industrial dust cleansing applications. The filter guides dirt-laden air through rapidly turning paths which forces it to shed heavier particles. The particles impact one of the impermeable solid metallic filter surfaces and are removed from the airstream. A full cone water spray installed upstream prevents any surface build-up of dust. This paper summaried the computer models generated to show the filter operations and laboratory experiments including optical particle counting to establish the cleaning efficiency.
Lattice calculations of the proton spin components is reviewed. The lattice results of the quark spin from the axial-vector current matrix element at ∼ 0.3−0.4 is smaller than those from the constituent quark models. This is largely due to the fact that the vacuum polarization contribution from the disconnected insertion is negative. Its connection with the anomalous Ward identity is clarified and verified numerically. This resolves the contentious issue in the “proton spin crisis.” The glue spin and angular momentum are found to be large and there is notable contribution from the quark orbital angular momentum. Renormalization, mixing, and normalization of the quark and glue angular momenta are discussed. With sufficient precision, they can be compared with more precise experimental measurements when the electron-ion collider facility is available.
Background Interleukin-17 (IL-17) antagonism in rats reduces the severity and progression of AKI. IL-17-producing circulating T helper-17 (TH17) cells is increased in critically ill patients with AKI indicating that this pathway is also activated in humans. We aim to compare serum IL-17A levels in critically ill patients with versus without AKI and to examine their relationship with mortality and major adverse kidney events (MAKE). Methods Multicenter, prospective study of ICU patients with AKI stage 2 or 3 and without AKI. Samples were collected at 24–48 h after AKI diagnosis or ICU admission (in those without AKI) [timepoint 1, T1] and 5–7 days later [timepoint 2, T2]. MAKE was defined as the composite of death, dependence on kidney replacement therapy or a reduction in eGFR of ≥ 30% from baseline up to 90 days following hospital discharge. Results A total of 299 patients were evaluated. Patients in the highest IL-17A tertile (versus lower tertiles) at T1 had higher acuity of illness and comorbidity scores. Patients with AKI had higher levels of IL-17A than those without AKI: T1 1918.6 fg/ml (692.0–5860.9) versus 623.1 fg/ml (331.7–1503.4), p < 0.001; T2 2167.7 fg/ml (839.9–4618.9) versus 1193.5 fg/ml (523.8–2198.7), p = 0.006. Every onefold higher serum IL-17A at T1 was independently associated with increased risk of hospital mortality (aOR 1.35, 95% CI: 1.06–1.73) and MAKE (aOR 1.26, 95% CI: 1.02–1.55). The highest tertile of IL-17A (vs. the lowest tertile) was also independently associated with higher risk of MAKE (aOR 3.03, 95% CI: 1.34–6.87). There was no effect modification of these associations by AKI status. IL-17A levels remained significantly elevated at T2 in patients that died or developed MAKE. Conclusions Serum IL-17A levels measured by the time of AKI diagnosis or ICU admission were differentially elevated in critically ill patients with AKI when compared to those without AKI and were independently associated with hospital mortality and MAKE.
Zilpaterol is a β2- adrenergic agonist medication approved in certain countries as a cattle feed additive to improve carcass quality. Trace amounts of Zilpaterol can transfer to horse feed, yielding equine urinary “identifications” of Zilpaterol. These “identifications” occur because Zilpaterol is highly bioavailable in horses, resistant to biotransformation and excreted as unchanged Zilpaterol in urine, where it has a 5 day or so terminal half-life. In horses, urinary steady-state concentrations are reached 25 days (5 half-lives) after exposure to contaminated feed. Zilpaterol readily presents in horse urine, yielding clusters of feed related Zilpaterol identifications in racehorses. The first cluster, April 2013, involved 48 racehorses in California; the second cluster, July 2013, involved 15 to 80 racehorses in Hong Kong. The third cluster, March 2019, involved 24 racehorses in Mauritius; this cluster traced to South African feedstuffs, triggering an alert concerning possible Zilpaterol feed contamination in South African racing. The fourth cluster, September/October 2020 involved 18 or so identifications in French racing, reported by the French Laboratories des Courses Hippiques, (LCH), and in July 2021, a fifth cluster of 10 Zilpaterol identifications in South Africa. The regulatory approach to these identifications has been to alert horsemen and feed companies and penalties against horsemen are generally not implemented. Additionally, given their minimal exposure to Zilpaterol, there is little likelihood of Zilpaterol effects on racing performance or adverse health effects for exposed horses. The driving factor in these events is that Zilpaterol is dissolved in molasses for incorporation into cattle feed. Inadvertent incorporation of Zilpaterol containing molasses into horse feed was the source of the California and Hong Kong Zilpaterol identifications. A second factor in the 2019 Mauritius and 2020 French identifications was the sensitivity of testing for Zilpaterol in Mauritius and France, with the French laboratory reportedly testing at a “ more sensitive level for Zilpaterol ”. As of January 1 st , 2021, the new FEI Atypical Finding (ATF) policy specifies Zilpaterol as a substance to be treated as an Atypical Finding (ATF), allowing consideration of inadvertent feed contamination in the regulatory evaluation of Zilpaterol identifications.
Background Mechanical power is a promising new metric to assess energy transfer from a mechanical ventilator to a patient, which combines the contributions of multiple parameters into a single comprehensive value. However, at present, most ventilators are not capable of calculating mechanical power automatically, so there is a need for a simple equation that can be used to estimate this parameter at the bedside. For volume-controlled ventilation (VCV), excellent equations exist for calculating power from basic ventilator parameters, but for pressure-controlled ventilation (PCV), an accurate, easy-to-use equation has been elusive. Results Here, we present a new power equation and evaluate its accuracy compared to the three published PCV power equations. When applied to a sample of 50 patients on PCV with a non-zero rise time, we found that our equation estimated power within an average of 8.4% ± 5.9% (mean ± standard deviation) of the value obtained by numerical integration of the P – V loop. The other three equations estimated power with an error of 19.4% ± 12.9% (simplified Becher equation), 10.0% ± 6.8% (comprehensive Becher equation), and 16.5% ± 14.6% (van der Meijden equation). Conclusions Our equation calculates power more accurately than the other three published equations, and is much easier to use than the only previously published equation with similar accuracy. The proposed new mechanical power equation is accurate and simple to use, making it an attractive option to estimate power in PCV cases at the bedside.
Septic shock remains a health care concern associated with significant morbidity and mortality. The Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock recommend early fluid resuscitation and antimicrobials. Beyond initial management, the guidelines do not provide clear recommendations on appropriate time to initiate vasoactive therapies and corticosteroids in patients who develop shock. This review summarizes the literature regarding time of initiation of these interventions. Clinical data regarding time of initiation of these therapies in relation to shock onset, sequence of treatments with regard to each other, and clinical markers evaluated to guide initiation are summarized. Early-high vasopressor initiation within first 6 h of shock onset is associated with lower mortality. Following norepinephrine initiation, the exact dose and timing of escalation to adjunctive vasopressor agents are not well elucidated in the literature. However, recent data indicate that timing may be an important factor in initiating vasopressors and adjunctive therapies, such as corticosteroids. Norepinephrine-equivalent dose and lactate concentration can aid in determining when to initiate vasopressin and angiotensin II in patients with septic shock. Future guidelines with clear recommendations on the time of initiation of septic shock therapies are warranted.
Background The legalization of hemp in the USA has led to tremendous growth in the availability of hemp-derived products, particularly cannabidiol (CBD) products. The lack of regulatory oversight in this industry has resulted in the marketing and sale of CBD products with questionable ingredients and quality. The aim of the current study was to examine the CBD content in 80 commercially available hemp-derived CBD products purchased from online and local retailers. Epidiolex® was also included in the study as a positive control. Methods Hemp-derived CBD products were selected to represent products readily available to residents of Central Kentucky. The samples were comprised of local and national brands produced in a variety of locations inside and outside of Kentucky. The products were analyzed by liquid chromatography-tandem mass spectrometry (LC–MS/MS), and the analytical findings were compared to the label claims for CBD content. Descriptive statistics and normal-based confidence intervals were calculated using Microsoft Excel. Results The label claims for CBD content ranged from 7.5 to 60 mg/mL, while LC–MS/MS analysis detected a range of 2.9 to 61.3 mg/mL. Of the 80 products evaluated, 37 contained CBD concentrations that were at least ± 10% different than the concentration listed on the label (range of 0.9 to 30.6 mg/mL from label claim) — 12 products contained < 90%, while 25 products contained > 110%. The degree of concordance for the samples tested using ± 10% tolerance from label claim was 54%. Conclusions These data suggest that additional regulation is required to ensure label accuracy as nearly half of the products in this study were not properly labelled (i.e., not within a ± 10% margin of error). Consumers and practitioners should remain cautious of unregulated and often-mislabeled CBD products due to the risks of taking too much CBD (e.g., drug-drug interactions, liver enzyme elevations, increased side effects) and the consequences of taking too little (e.g., no clinical benefits due to underdosing). The results of this study support the continued need for good manufacturing practices and testing standards for CBD products.
The 25th Society for Cardiovascular Magnetic Resonance (SCMR) Annual Scientific Sessions saw 1524 registered participants from more than 50 countries attending the meeting virtually. Supporting the theme “CMR: Improving Cardiovascular Care Around the World”, the meeting included 179 invited talks, 52 sessions including 3 plenary sessions, 2 keynote talks, and a total of 93 cases and 416 posters. The sessions were designed so as to showcase the multifaceted role of cardiovascular magnetic resonance (CMR) in identifying and prognosticating various myocardial pathologies. Additionally, various social networking sessions as well as fun activities were organized. The major areas of focus for the future are likely to be rapid efficient and high value CMR exams, automated and quantitative acquisition and post-processing using artificial intelligence and machine learning, multi-contrast imaging and advanced vascular imaging including 4D flow.
Viruses frequently carry out replication in specialized compartments within cells. The effect of these structures on virus replication is poorly understood. Recent research supports phase separation as a foundational principle for organization of cellular components with the potential to influence viral replication. In this review, phase separation is described in the context of formation of viral replication centers, with an emphasis on the nonsegmented negative-strand RNA viruses. Consideration is given to the interplay between phase separation and the critical processes of viral transcription and genome replication, and the role of these regions in pathogen-host interactions is discussed. Finally, critical questions that must be addressed to fully understand how phase separation influences viral replication and the viral life cycle are presented, along with information about new approaches that could be used to make important breakthroughs in this emerging field. Expected final online publication date for the Annual Review of Virology, Volume 9 is September 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
This study has focused on petrography, geochemistry, radiochemical, and leaching properties of coal combustion residues (CCRs), their leachates and nearby waters from the Barapukuria coal-fired power-plant to evaluate the potential environmental impacts and human health hazards for the first in Bangladesh. The CCRs, used in this study are predominantly comprised of Al-Si-rich glassy materials (94.8%) followed by crystallites (3.6%), notably quartz, mullite, and spinel with rock-fragments (0.3%); and un-burnt organic constituents (1.3%) such as anisotropic coke (0.8%) and slightly altered inertinite (0.5%). Hematite, magnetite, cristobalite, monazite, zircon, rutile, tourmaline and sillimanite were also identified as trace minerals. Elemental contents are found to be elevated (2.1-14.2 times) in the fly-ash (FA) and bottom-ash (BA), as compared to world coal-ash average with the exceptions of Ni in FA; and of Zn, As, Cu, and Hg in BA. The sum of detected rare earth elements is significantly high as compared to the world FA, Indian and Chinese ash residues. The specific activities of CCR are comparatively higher by a factor of 3.7 (226Ra) to 6.2 (232Th) than those of the world average. The examined spheres, particles, and agglomerates of FA are predominantly comprised of C, Al, and Si as major while, K, Ca, Mg, Fe, W and Ti as minor elements. On the other hand, extractable amounts of soluble potentially toxic elements in FA leachates are 7.7% for Se, 4.8% for Zn, and in BA 5.7% for As and 3.1% for Se and others are <1%. Metals are substantially released from FA in the range of 8.5 (for Cr) to 9650 (for Zn) ppb and 0.002% (for Cr) -7.7% (for Se), while from BA below detection level (for Cr) to 940 (for Mn) ppb. The concentration of hazardous metals in the discharged waste water and water ash pond were higher than those were found in nearby pond- and ground-water sources around power-plant. Ecological and radiological risk indices suggest moderate-risk derived from FA and low-risk from BA.
Background Ethnic discrimination is frequently experienced among U.S. Latinx communities, and is linked to CVD risk factors, such as depression. Genetic variants may influence this relationship. Objectives The objectives of this study were to examine associations between experiences of discrimination, rs4680 genotype, and depressive symptoms in Latinx adults. Methods We analyzed data from 124 Latinx adults with two or more CVD risk factors, and conducted hierarchical linear regression, adjusting for sex, age, income, education, and acculturation. Results Participants were predominately female (74.2%) and aged 40.2 ± 9.3 years. More experiences of discrimination were associated with higher depressive symptoms (p = 0.041). Those with Met-Met-and Val-Met-genotypes had increased depressive symptoms than those with Val-Val-genotype (p = 0.049). Rs4680 was not a moderator. Conclusion Findings suggest discrimination and rs4680 genotype are associated with depressive symptoms in Latinx adults, which may increase CVD risk. Further research is needed to better understand biological mechanisms of these relationships.
With the legalization of industrial hemp in the United States, defined based on tetrahydrocannabinol (THC) dry weight content of ≤ 0.3%, the market for various cannabinoids including cannabidiol (CBD), cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC) have flourished. The current measurement methods such as ultra-high performance liquid chromatography and gas chromatography (GC) require sophisticated instruments and trained personnel and are time-consuming. Therefore, there is a critical need for a rapid and reliable method to measure cannabinoids for regulatory compliance, determination of usage, and for quality control. Here, we report the use of near-infrared spectroscopy (NIRS) for rapid measurement of moisture content (MC) and cannabinoid contents of ground and whole hemp and rapid identification of legal from illegal industrial hemp. Good NIRS quantitative predictions were obtained for MC of ground and whole hemp, THC of ground hemp, CBD of ground and whole hemp, and CBC of whole hemp. Binary classification of industrial hemp as legal (≤0.3% THC) or illegal was performed using discriminant analysis and thresholding models. Discriminant calibration models developed showed correct classifications (CC) ranging from 93.0% to 94.0% with CC for independent validation at 83.9–87.5%. The concurrent multi-constituent predictions of MC and THC using NIRS allows for real-time adjustments of cannabinoid contents and rapid identification of legal or illegal hemp. These are important tools that will benefit the hemp industry, regulators, farmers, and consumers.
Two novel compounds, dicarbonyl ester (2) and artolankanin A (3) were isolated from the sequential ethyl acetate and ethanol extracts of stem bark of A. nobilis along with the known compounds, artonin E (1) and artobiloxanthone (4) by bioassay-guided fractionation using a combination of normal phase and size exclusion column chromatography. Their structures were elucidated by spectroscopic techniques, including NMR (¹H, ¹³C, APT, ¹H–¹H COSY, HSQC, and HMBC), Mass, IR, and UV. The isolated compounds were evaluated for DPPH free radical scavenging activity, tyrosinase, elastase, hyaluronidase, and A5-lipoxygenase enzyme inhibitory activities lipopolysaccharide-induced nitric oxide production inhibitory activity in SIM-A9 microglial cells. Artonin E exhibited marked tyrosinase and A5-lipoxygenase enzyme inhibitory activities and NO inhibition activity in LPS-stimulated microglia cells having IC50 values of 60.92 ± 3.45, 56.38 ± 1.05, and 23.94 ± 1.08 µg/mL, respectively. Kinetic studies showed that the tyrosinase inhibitory activity of artonin E is via a noncompetitive inhibition mechanism. Further, artolankanin A and artobiloxanthone exhibited good A5-lipoxygenase enzyme inhibitory activity having IC50 values of 59.48 ± 1.06 and 62.45 ± 2.25 µg/mL, respectively. Insights from molecular docking and molecular dynamics simulations align with these experimental observations and propose plausible mechanisms of inhibition. Collectively these results suggest that these compounds have the potential to be used as depigmenting and anti-inflammatory agents.
Nitrite (NO2⁻) oxidation is the second step in nitrification, following ammonia (NH3) oxidation, and catalyzed by nitrite oxidizing bacteria (NOB). Their activity is critical in preventing toxic accumulation of NO2⁻. The two major NOB genera in soil are Nitrobacter and Nitrospira. This study investigated how N fertilization and tillage management influenced these two NOB communities in long-term (>40 years) maize (Zea mays L.) cropping. To evaluate NOB community changes we used PCR and denaturing gradient gel electrophoresis (DGGE) to analyze Nitrobacter and Nitrospira NO2⁻ oxidoreductase genes (nxr). Season, fertilizer rate, and tillage all influenced Nitrobacter and Nitrospira communities, but differentially for the two genera. Nitrobacter was more diverse in summer, whereas Nitrospira was more diverse in winter. Nitrobacter was more diverse in N-fertilized samples, whereas Nitrospira diversity decreased with increasing fertilizer rate in winter but not summer. Nitrobacter diversity was not significantly influenced by tillage, whereas no-tillage samples had more diverse Nitrospira, compared to plow tillage samples. In addition to providing evidence for better understanding the relationship between soil management and NOB communities, this study also helped to suggest linkages between ammonia oxidizing bacteria and Nitrobacter and between ammonia oxidizing archaea and Nitrospira that may facilitate future studies concerning ammonia-oxidizing nitrifiers and NOB.
Higher corn seeding rates and in-furrow fertilizer and fungicide combinations may be effective tools to overcome early-season corn (Zea mays L.) stress, stand reductions, and yield loss following a rye (Secale cereale L.) cover crop (RCC). The objective of this research trial was to evaluate corn growth and yield response and optimum seeding rate requirement following a RCC and different in-furrow starter treatments. Trials were established at three Kentucky, USA locations (2017–20), 7 site-years to evaluate corn response to seeding rate (49,421–108,726 seeds ha⁻¹) following a RCC and no cover crop, and in-furrow fertilizer (10-34-0) + fungicide (pyraclostrobin) and no in-furrow starter. At 2 of 3 locations, a RCC reduced corn V5 chlorophyll content and grain yield by 3.1% and 2.7%, respectively. The inclusion of an in-furrow starter failed to increase corn yield at any location and no interaction with a RCC was observed. Furthermore, an in-furrow starter reduced corn plant stand by 3.2% at 2 of 3 locations. At Lexington, quadratic regression analysis revealed that a higher corn agronomic optimum seeding rate (AOSR) and economic optimum seeding rate (EOSR) was required to maximize corn following a RCC compared to no cover crop. However, no significant stand loss was observed at this location. Overall, these results suggest that in-furrow fertilizer and fungicide do not ameliorate negative effects from a RCC and may cause negative impacts when applied simultaneously in-furrow. In addition, a higher corn AOSR and EOSR may be required following a RCC to maximize corn yield. However, because the effects of a RCC on AOSR were inconsistent among locations, further research may be required.
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