Different Levels Of Treatment Research Articles

Impact of post-disaster federal assistance on the national flood insurance program

This research tested the hypothesis that post-disaster federal relief program crowds out the demand for flood insurance in the U.S. To do that, this research has collected historical data between 2016 and 2020, and conducted propensity score-based analysis to understand the causality between post-disaster federal assistance and flood insurance enrollment in the flood affected counties in the U.S. In the first part, the treatment variable has been considered as binary to compare the effect of the availability of federal assistance to that of non-availability of federal assistance in a flood affected county by using propensity score matching method. It was found that the availability of the federal payout in a county in a year increased the number of flood insurance policies by 5.2 % and the total insured value of the policies by 4.6 % in the following year. Next, the treatment variable was considered continuous and was used in a generalized propensity score method to develop a dose response function, i.e., a function that depicts the changes in the outcome variables based on different levels of treatment. It was found that for each 1000 households in a county that received federal assistance, the percentage increase in the number of flood insurance policies was 3.41 %. On the other hand, for each million-dollar of federal assistance in a county, the total insured value of the flood insurance policies increased by 1.96 %. Therefore, this research has concluded that, contrary to the hypothesis, the availability of post-disaster federal assistance increased the flood insurance enrollment in the U.S.

Clinical Effects of Cervical Dilation Balloon and Castor Oil Meal Nursing Interventions in Term Induction of Labor

This study analyzed the clinical effects of cervical dilation balloon and castor oil meal nursing interventions in term induction of labor. The eighty pregnant women who were scheduled for delivery in our hospital between March 2020 and January 2022 were recruited into an observation group and a control group using a random number table. The control group received oxytocin for labor induction while the observation group received cervical dilation balloon and castor oil meal nursing interventions for labor induction. In addition to clinical treatment experiments, cell experiments are performed. BeWo cells were cultured to study the effect of estrogen on cell viability, and the expression of matrix metalloproteinase 2 and 9 (MMP2, MMP9) was detected using Western blotting. The endpoints of this study were to investigate the impact of estrogen changes on term-induced pregnant women and to compare the cervical dilation balloon and castor oil meal nursing interventions with regards to duration of labor, efficacy of cervical ripening, Bishop score of the cervix, postpartum complications, and other relevant indicators. The viability of BeWo cells did not significantly differ after treatment with different concentrations of 17β-E2 (-> 0.05). The expression of MMP9 after different levels of treatment did not significantly differ (P >0.05), whereas the expression of MMP2 protein in the 5×10−7 and 5×10−8 M treatment groups was lower than that in the control group (P <0.05). The first stage and total duration of labor were significantly shorter in the observation group than that in the control group (P <0.05). The efficacy of cervical ripening was significantly higher in the observation group than that in the control group (P <0.05). The Bishop score of the cervix was significantly higher in the observation group after intervention (P <0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P <0.05). Estrogen levels may affect the invasive function of trophoblast cells, causing abnormal placental function. Castor oil has hormonal effects and contains precursors for prostaglandin synthesis and can induce and strengthen contractions, soften the cervix, and dilate the cervix. The combined use of cervical dilation balloon and castor oil meal in term induction of labor has clear clinical effects, including the effective shortening of labor duration, favorable cervical ripening, significant improvement in the Bishop score of the cervix, and reduced incidence of complications. This study suggests its potential for clinical application and wider use.

Applied Nitrogen Fertilization and Irrigation on Improving Shallot (Allium ascolanicum L.) Growth and Yield on Dry Land in Mesuji, Lampung Province, Indonesia

This field research was conducted from June to August 2022 at the research station of Agriculture Extension, Mesuji District, Mesuji Regency, Lampung Province, Indonesia. The study aimed to determine the effect of nitrogen fertilization and irrigation on different levels of treatment on shallot growth and yield in dry land. The experiment was a factorial design in a striped plot with three replications. The first factor was nitrogen fertilizer levels, namely 0 kg N/ha (N0), 80 kg N/ha (N80), 160 kg N/ha (N160) and 240 kg (N240); the second factor was irrigation with four levels, namely 25% ETc (W25), 50% ETc (W50), 75% ETc (W75) and 100% ETc (W100). The variables observed were plant height, number of leaves, fresh weight of tubers, diameter of tubers, dry weight of tubers and harvest index. The results showed that the significant effect of treatment was more due to the main effect of nitrogen fertilizer and irrigation factors. Nitrogen fertilizer has a significant effect on plant height, fresh weight of tubers, tuber diameter, dry weight of tubers and harvest index, while the number of leaves and canopy cover have not been significantly affected. The irrigation treatment significantly affected all observed variables, while only the dry weight variables of tubers showed a noticeable interaction effect of nitrogen fertilization and irrigation. The best treatment to support the growth and yield of shallots in dry land results from fertilizing nitrogen (N) 160 kg N/ha and irrigating 75% Etc.

Effect of Dry and Liquid Wey Addition on Tomato (Solanum esculentium L.) Growth Properties Under Greenhouses Conditions-b

A pots experiment under greenhouses conditions were conducted at an agricultural research station related to Agriculture College / Basrah Univ. during the grown season 2017 - 2018 to statement the effect of different levels of treatment of liquid and dry Wey adding to soil mixed animal manures as a growth media on some tomato seedling properties, Wey adding at level 25, 50 and 75 % as a liquid and 1, 2 and 4 % as a dry. Results showed a significant improvement in all growth properties: The highest height of 33.11 cm was recorded in (1 animal manure :1 soil) treatment at a 2 % dry Wey. The highest number of branches was at dry and liquid Wey treatments, attaining 2 and 3.2 plant branch-1, and the highest average number of branches was recorded at the value of 3.55 plant branch-1 at (1 animal manure : 1 soil) treatment. A significant number of leaves was 13 leaf plant-1 at the level of adding 50% of liquid spray and 12 leaf plant-1 at the level of addition of 2% of dry Wey; the highest average number of leaves has recorded a value of 13 leaf plat-1 of (1anmial manure:1soil) treatment. A significant value of shoot weight was at 75 % addition Wey liquid attained 6.99 gm plant-1 for shoot part compared with control and 25 % addition liquid Wey treatments.(1 animal manure:1 soil) treatment. Treatment of liquid Wey was applied at a concentration of 75%, giving a significant average of roots fresh weight is 0.123 gm plant-1, adding animal manure treated with liquid Wey achieved the highest average weight of roots attains 0.156 gmplant-1. Treatments of applied liquid Wey at a concentration of 75% were a superior average of dry shoot weight at 0.59 gm plant-1.

Response Water Spinach (Ipomoea Aquatica) to Different Medium Treatment with AB Mix Nutrients on The Cultivation Hydroponic DFT (Deep Flow Technique)

Water spinach (Ipomoea aquatica) is a plant that is included in the type of vegetables and is widely cultivated as food. Every year the demand for water spinach in the market continues to increase, besides that consumers also want the quality of water spinach which is more nutritious, clean, and hygienic. Therefore, hydroponic water spinach is used to support consumer demand in the market. In addition, by cultivating water spinach hydroponically as well as an alternative to farming in narrow areas. In hydroponic cultivating water spinach, there are several things that need to be considered, such as the provision of nutrition, the planting media used, and what hydroponic system will be used. This study aims to determine the response of water spinach plants to the treatment of different planting media, as well as to obtain information about what planting media is suitable for use in the DFT water spinach hydroponic system to support its growth and development. The experimental method used was a completely randomized design, which consisted of three different levels of treatment, namely the use of rockwool, charcoal, and moss media. The results of this study of differences in planting media showed the treatment with the best tendency for the parameters of plant height, number of leaves, and plant fresh weight

Developing integrated care pathways for atopic dermatitis-Challenges and unmet needs.

GA2 LEN-ADCARE is a branch of the largest multidisciplinary network of research centres and clinical care in allergy and asthma, GA2 LEN, focussing on the field of atopic dermatitis (AD). AD is a chronic inflammatory skin disease with high burden and many comorbidities requiring different levels of treatment. The need for aligned information from all involved healthcare providers led to the discussion of an integrated care pathway (ICP) plan for AD patient care involving all stakeholders and considering the complexity and variability of the disease, with a particular focus placed on the large number of patients with milder forms of AD. The GA2 LEN ADCARE network and all stakeholders, abbreviated the AD-ICPs working group, were involved in the discussion and preparation of the AD-ICPs during a series of subgroup workshops and meetings in years 2020 and 2021. Here we discuss the unmet needs in AD, the methodology for devising an AD-ICP and the ICP action plan. The GA2 LEN ADCARE network has outlined the unmet needs in AD and provided an action plan for devising AD-ICPs, considering the complexity and variability of the disease.

Dermoscopic Prediction of Therapeutic Response in Psoriatic Lesions Treated with Methotrexate and Apremilast: An Observational Study on Skin Color

Background: Psoriasis is a chronic auto-inflammatory condition. Treatment modalities include methotrexate (MTX) and apremilast (APL). Although the efficacy of MTX and APL is well studied, evidence of their superiority of one over the other is lacking. Dermoscopy is helpful in diagnosis and treatment evaluation. Therefore, dermoscopy is utilized to assess the treatment response. Objectives: This study aimed to evaluate dermoscopic assessment in psoriatic lesions treated by MTX and APL and compare their efficacy by calculating the respective Psoriasis Area and Severity Index (PASI) scores and study the effect of MTX and APL on different dermoscopic patterns in psoriasis at different levels of treatment. Methods: This randomized interventional comparative study was conducted in a tertiary care hospital. A total of 98 patients were randomly divided into two groups of 50 and 48 patients, given oral/intramuscular MTX 7.5 mg once weekly and APL 30 mg twice daily for 3 months, respectively. The patients were assessed clinically and dermoscopically using a videodermoscope, and comparisons were performed between the two groups. The PASI score was calculated and evaluated. Results: The PASI score was reduced by 83% and 65% from the baseline in MTX and APL groups, respectively. The patients with patchy (61.5%) and minimal (23%) patterns of vessels and red dots (92.3%) showed faster achievement of PASI-100. However, the patients with a regular distribution of vessels and globular vessels failed to obtain PASI-100, suggesting a poor response to treatment. Conclusions: Vascular structures play a significant role in the diagnosis and prediction of the treatment response. Particular patterns and type vessels under dermoscopy can give a hint about choosing appropriate drugs for psoriasis.

A Siddha Management of Chronic Tonsillitis - A Case Report

Aim and objective: In the present scenario the medicine system from the west has started acknowledging the importance and wisdom of the ancient medicine system such as Siddha, Ayurvedha, Unani. There are many diseases that need surgical procedures till date, so in order to find a probable cure now a paradigm shift is really important. Tonsillitis is an infection of the tonsils associated with a sore throat, difficulty in swallowing, fever, etc. Still, surgical removal of tonsils is one of the most frequent procedures during childhood. In the Siddha system of medicine tonsillitis can be compared with Virana silatham. To evaluate the effect of Siddha medicine in the management of tonsillitis. Materials and Methods: The subject approached Out Patient Department of Siddha Clinical Research Unit(SCRU),under Central Council for Research in Siddha(CCRS), Safdarjung Hospital Campus, New Delhi with symptoms of sore throat, ear pain, difficulty in swallowing, sleep apnoea, which involved problems of breathing at night and foul smell from the mouth for past four months systemically. Discussion: The manifestation of symptoms and their severity depends on the extent of involvement of Uyir thathukkal (Vali,Azhal, Iyyam). Though the disease is Iyyam and Azhal predominant, there is derangement of Iyyam and Azhal Dosham in Virana silatham. Results: In this case, the subject showed a marked improvement as depicted in the photographs taken at different levels of treatment, also there was a significant improvement noted in both subjective and objective parameters. By adopting the Siddha treatment approach with an external treatment modality an attempt is made to bring about satisfactory results.

The Use of Stem Cell-Derived Organoids in Cancer Treatment Research

Cancer is one of the leading causes of death worldwide. While some forms of cancer are more manageable and nonfatal with treatments like chemotherapy and radiation, other forms are not as manageable and have high fatality rates, such as colorectal cancer. Colorectal cancer most commonly occurs in elderly adults but has the potential to occur at any age. Due to its sometimes-undetectable symptoms, it is often diagnosed at a very late stage. Once diagnosed, there are different levels of treatment. For example, surgical resection, chemotherapy, radiation, or any combination of the three can occur. When tumors are unresectable, patients are often left with little chance of survival, and receive only the extension of survival for a short period of time. While surgical resection, chemotherapy and radiation have had success in some patients, high recurrence rates and a lack of response to treatments have left patients and researchers looking for new treatments that will result in better survival rates for patients. Researchers have begun to answer the calls for new treatments with the discovery of patient-derived organoids. Patient-derived organoids are harvested from adult stem cells in the desired tissue, or from cancer cells in a patient’s tumor. The cells taken from the patient are then grown ex-vivo in conditions that mimic the inside of the body. Organoids have grown to show both structural and physiological similarities to their parent organ. While organoids have not yet grown to be as large and highly vascularized as their parent organ, they have been useful in disease modeling and drug therapy testing. Patient-derived organoids that have been grown ex-vivo have shown to overlap almost completely with their parent organ in terms of genetic sequence and molecular makeup. Due to their high number of genetic similarities, patient-derived organoids have been shown to react the same way to certain drug treatments in a few studies, which allows researchers to provide combinations of different cancer drug treatments that are tailored to each individual patient, rather than using a standardized approach that only seems to work for some patients. Patient-derived organoids are still a rather new approach to cancer drug therapy testing, and they still present some limitations, such as their inability to grow as large and as highly vascularized as their parent organ. While these limitations may have the ability to hinder the effectiveness of patient-derived organoids, some organoids have shown success in colorectal cancer drug therapy trials, and their limitations are likely to be overcome as more information is known about patient-derived organoids. Organoids are a promising approach to the treatment of colorectal cancer and have the potential to help save more patients than previous approaches.

Hostages of Empire: Colonial Prisoners of War in Vichy France by Sarah Ann Frank

Reviewed by: Hostages of Empire: Colonial Prisoners of War in Vichy France by Sarah Ann Frank Hope Hecht Frank, Sarah Ann. Hostages of Empire: Colonial Prisoners of War in Vichy France. UP of Nebraska, 2021. ISBN 978-1-4962-0777-7. Pp. 376. During World War II, France recruited colonial soldiers, but French authorities were unaware that the continued mistreatment of colonial soldiers would play a key role in the later fall of the Empire. Sarah Ann Frank covers all aspects of World War II colonial prisoners’ lives, such as their living conditions, their work inside and outside the camp, their health, and their political significance to France. The author has three primary arguments: France relied heavily on its status as an empire, the treatment of the soldiers was deeply ingrained in colonial racism, and the mistreatment of colonial soldiers created a strained relationship between France and its colonies (3). This study begins in the summer of 1940 and ends in the fall of 1942 but continues to cover the effects of imprisonment on colonial soldiers and the soldiers’ subsequent anger at the lack of reparations (260). The prisoners were treated with varying levels of violence, racism, and benevolence in each camp but generally throughout the Vichy government the prisoners were allowed to practice their religion and eat foods that would remind them of home, such as dates and couscous (218). Frank notes, however, that any aid given to the prisoners was to promote goodwill toward the French. Although the government did send aid, local donations and the French Red Cross together provided the basic needs of the prisoners. Furthermore, some French citizens helped the prisoners escape by acting as guides to the local terrain or supplying the prisoners with food and water for their journey to the unoccupied zone (173). The different levels of treatment from the Vichy government, the citizens, and later the Germans in German-controlled camps, created varying experiences for each solider. Frank puts a larger emphasis on West and North African prisoners’ experiences as they would affect the political climate in the colonies and influence their countrymen’s opinions of the French upon their return home. Frank explains that in order to sway prisoners’ opinions there was a large propaganda campaign by Vichy France and Germany. France’s treatment of the colonial prisoners was “certainly rooted in the French history of colonialism and its associated paternalism” (163). France continued to mistreat the colonized, but then struggled to maintain the empire that played a significant role in France’s political and economic power. At the end of this book, Frank explains that both the German and French propaganda campaigns failed not due to a lack of effort, but from the former colonial prisoners’ anger at their (mis)treatment and lack of pay. In the end, this animosity would initiate a new era of decolonization and independence from France. Due to Frank’s extensive research, this work would make an excellent source for anyone interested in the Vichy Regime or in the treatment of prisoners of war. [End Page 183] Hope Hecht Northern Arizona University Copyright © 2022 American Association of Teachers of French

The Effect of Feeding with Different Percentages of Energy on the Growth Performance of Jowo Super Chicken

This study aims to determine the different levels both metabolic energy and protein treatments on growth performance of Jowo Super (JOPER) chickens. A total of 192 one-day-old chicks Jowo Super chickens (unsexed) were used in twelve-week trials. Prior to statistical analysis using analysis of variances (Anova) where least significance differences subjected using Duncan Multiple Test. The different levels of treatments on growth performance was not significance differ (p > 0.05). In summary, the metabolizable energy was recommended at 2880 kcal/kg (starter periods) and 2,950 kcal/kg (finisher). Feed intake, body weight gain, feed conversion ratio, and mortality was best in the 1707.17; 744.25; 2.53; 699.75, respectively.

The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder.

The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.

Seed Quality Parameters as Influenced by Plant Growth Regulators and Fresh Fruit Harvesting in Okra

The research work was conducted to find out the most suitable level of plant growth regulator (PGR) and stage of plant for spray as well as fresh fruit pickings to increase the seed yield of okra. The experiment was laid out in randomized block design (factorial) with three replications to at the Vegetable seed production area BAU, Sabour, Bhagalpur. Present investigation was framed with Sixty (60) treatments consisting of 10 PGR’s level, P0 (distilled water), GA3 (100 ppm, 150 ppm and 200 ppm), NAA (100 ppm, 150 ppm and 200 ppm), IAA (30 ppm, 60 ppm and 90 ppm), 2 Stage of plant for spraying of PGRs, S1 (4 leaf stage), S2 (4 leaf stage + Flower initiation) and 3 pickings of fruits, H1 (3 Pickings of fresh fruits + rest fruits left for seed production), H2 (6 Pickings of fresh fruits + rest fruits left for seed production), H3 (No pickings of fresh fruits + all fruits left for seed production. It was observed that the different levels of treatments affected the seed quality attributes of the crops. Among the treatments, P2S1H1 treatment was recorded maximum Germination % (86.36), Seedling length (31.04 cm), Vigour index-I (2787.73), Vigour index-II (5.27) and seed viability test (88.00). Thus, P2S1H1 was superior among all treatments.

Multidisciplinary Team in Ambulatory Management of Diabetes Mellitus Using Telehealth Among a Sample of Medicaid Patients

Objectives: Effective treatment of patients with type 2 diabetes mellitus requires a multidisciplinary approach. Our study provided telemedicine healthcare delivery, using a model of collaborative drug therapy management (CDTM) protocol incorporating medical nutrition therapy (MNT) interventions by Dietitians and Pharmacists. 
 Methods: We conducted a retrospective chart review of patient data collected between December 2014 and December 2015. We compared five intervention groups of patients (n=12,370) receiving different levels of treatment from Pharmacists, Registered Dietitian/Nutritionist, and/or the Call Center, using Telemedicine consultation techniques over a one-year period. The control group received their supplies through the mail without any contacts with the Call Center, Pharmacists, or Dietitians. The cross-sectional data collected for A1c were analyzed using ANOVA to assess for within-group differences in A1c reduction among groups with different risk factors.
 Results: Roughly, 18 percent of study participants were identified as high-risk, with a serum A1c level greater than 10%. Lower A1c and low density lipoprotein (LDL) cholesterol levels were reported for patients who received at least four prescription refills over the study period, (-0.113 and -4.931, respectively). Results reveal that average A1c levels for the intervention groups were lower compared to the control group. Overall, interventions led by Dietitians and Pharmacists resulted in a higher reduction in A1c levels in the high-risk group of patients with type 2 diabetes.
 Conclusions: This study showed that using Telemedicine consultation, led by Dietitians and Pharmacists, resulted in a more effective intervention for patients with diabetes and resulted in a positive change of lowering plasma A1c levels and LDL cholesterol as a secondary outcome. For future study, using the same multidisciplinary intervention and telehealth format, a longitudinal data collected over a minimum of 6-months would allow for tracking of changes in A1c and LDL cholesterol in the individuals with type 2 diabetes. 
 Keywords: Diabetes, Telemedicine, Telehealth, Pharmacist and Dietitian led intervention, A1c, LDL cholesterol

Telemedicine in Intensive Care Units: Scoping Review.

BackgroundThe role of telemedicine in intensive care has been increasing steadily. Tele–intensive care unit (ICU) interventions are varied and can be used in different levels of treatment, often with direct implications for the intensive care processes. Although a substantial body of primary and secondary literature has been published on the topic, there is a need for broadening the understanding of the organizational factors influencing the effectiveness of telemedical interventions in the ICU.ObjectiveThis scoping review aims to provide a map of existing evidence on tele-ICU interventions, focusing on the analysis of the implementation context and identifying areas for further technological research.MethodsA research protocol outlining the method has been published in JMIR Research Protocols. This review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A core research team was assembled to provide feedback and discuss findings.ResultsA total of 3019 results were retrieved. After screening, 25 studies were included in the final analysis. We were able to characterize the context of tele-ICU studies and identify three use cases for tele-ICU interventions. The first use case is extending coverage, which describes interventions aimed at extending the availability of intensive care capabilities. The second use case is improving compliance, which includes interventions targeted at improving patient safety, intensive care best practices, and quality of care. The third use case, facilitating transfer, describes telemedicine interventions targeted toward the management of patient transfers to or from the ICU.ConclusionsThe benefits of tele-ICU interventions have been well documented for centralized systems aimed at extending critical care capabilities in a community setting and improving care compliance in tertiary hospitals. No strong evidence has been found on the reduction of patient transfers following tele-ICU intervention.International Registered Report Identifier (IRRID)RR2-10.2196/19695

Development of a modified environment for oyster mushroom (Pleurotus ostreatus) production system for rural use in Southeast Nigeria


 
 
 This study investigated a Pleurotus ostreatus production in Nsukka, Nigeria, using the locally available materials. A modified controlled environmental system capable of maintaining the micro elements (temperature and relative humidity) suitable for cultivation of oyster mushroom was developed. The system was tested using substrates of biomaterial origin (saw dust and rice bran) at different levels of treatments. The substrates used were fermented sawdust supplemented with rice bran at a spawning level of 0%, 5%, 10%, 15%, and 20%. The steps involved in the cultivation were composting, bagging, spawning, incubation and cropping the substrates. The experiment was laid out in a completely randomized design in five replications and results analysed at P < 0.05 significant difference. The biological efficiency was determined to establish the minimum suitable nutrient supplementation levels and the best yield of Pleurotus ostreatus. The nutritional compositions of the yield were analysed. The highest mean yield of 24.5 g of fresh mushrooms was observed with the substrate mixture T3 (15% rice bran and 85% saw dust) and lowest yield of 8.6 g observed in the T0 (without rice bran). The effects of temperature and relative humidity on growth of oyster mushroom were evaluated. The result of this study showed that small-scale, indoor oyster mushroom production appears to be economically feasible in Nsukka.
 
 

Rapid, Simple, and Inexpensive Spatial Patterning of Wettability in Microfluidic Devices for Double Emulsion Generation.

Water-in-oil-in-water (w/o/w) double emulsion (DE) encapsulation has been widely used as a promising platform technology for various applications in the fields of food, cosmetics, pharmacy, chemical engineering, materials science, and synthetic biology. Unfortunately, DEs formed by conventional emulsion generation approaches in most cases are highly polydisperse, making them less desirable for quantitative assays, controlled biomaterial synthesis, and entrapped ingredient release. Microfluidic devices can generate monodisperse DEs with controllable size, morphology, and production rate, but these generally require multistep fabrication processes and use of different solvents or bulky external instrumentation to pattern channel wettability. To overcome these limitations, we propose a rapid, simple, and inexpensive method to spatially pattern wettability in microfluidic devices for the continuous generation of monodisperse DEs. This is achieved by applying corona-plasma treatment to a select zone of the microchannel surface aided by a custom-designed corona resistance microchannel to strictly confine the plasma-treatment zone in a single polydimethylsiloxane (PDMS) microfluidic device. The properties of PDMS channel surfaces and key microchannel regions for DE generation are characterized under different levels of treatment. The size, shell thickness, and number of inner cores of generated DEs are shown to be highly controllable by tuning the phase flow rate ratios. Using DEs as templates, we successfully achieve a one-step generation and collection of gelatin microgels. Additionally, we demonstrate the biological capability of generated DEs by flow cytometric screening of the encapsulation and growth of yeast cells within DEs. We expect that the proposed approach will be widely used to create microfluidic devices with more complex wettability patterns.

Death Education: An Educational Approach to Death and Dying

This paper explains the importance of education in the dying process and outlines a full curriculum to create a society more prepared for difficult end-of-life situations. This course is structured to be taught as a high school elective course in which the principles and approaches to death and dying are discussed in depth. For a high school student, death can be approached from diverse perspectives. Within these perspectives, there are several vital topics to understand in order to ensure a student’s proper education on death. The complexity of death is represented by the titles of the nine chapters of the course. Chapter One, titled “Definition of Death, Consciousness, and Persistent Vegetative State,” highlights the development of death throughout history, the general consensus about death today, and the morality of different levels of treatment for dying patients. Chapter Two, “End Stage Medical Conditions,” outlines the most common end-of-life health conditions along with their symptoms and possible treatments. In Chapter Three, titled “Bad News and Communication,” the course introduces patient-physician communication, the current shortcomings of medical education in this vital area, and the possible protocols for effectively conveying both truth and support to a patient. Chapter Four, labelled “Do Not Resuscitate Orders, Living Wills/Advance Directives, and Durable Powers of Attorney for Health Care,” presents the appropriate options available to prepare for a patient’s inability to make informed decisions autonomously. Chapter Five, “Ordinary vs. Extraordinary Means: The Issue of Tube Feedings,” discusses the distinction between different types of end-of-life treatment and when certain treatments can be morally excused. Chapter Six, titled “Palliative Care and Hospice: A Paradigm for End-of-Life Care,” gives effective options for terminally ill patients that ensure care is never stopped and a patient's dignity is never lost. Chapter Seven, “Pain Management,” highlights the difficulties and recommendations for establishing proper pain management. Chapter Eight, entitled “Medical Futility,” presents the debate surrounding patient autonomy with physician’s beneficence and nonmaleficence, forgoing and requesting treatments, and the values associated with this issue. Finally Chapter Nine, titled “Spirituality and End of Life Care,” emphasizes the inevitable linkage between healthcare, death, and spirituality and the benefits of proper support for a patient. This paper also highlights the ethical implications surrounding the death and dying process. The importance of this subject lies within the death-denying reality that society is today in which death is avoided and human dignity is increasingly sacrificed as a result. Discussions and education among society’s youngest adults can improve general knowledge about the dying process and lead to overall better preparation for handling this inevitable stage of humanity.

Study of integrated nutrient management on growth, yield and quality of radish (Raphanus sativus L.)

The field experiment was conducted during the rabi season of the year 2019-20 at Sri Konda Laxman Telangana State Horticultural University, College of Horticulture, Rajendranagar, Hyderabad, Telangana to evaluate “study of integrated nutrient management on growth, yield and quality of radish (Raphanus sativus L.)’’The experiment was laid out in Randomized Block Design with seven different levels of treatment of integrated nutrients and three cultivars replication thrice. Results revealed that yield parameters significantly affected with the application of varying levels of integrated nutrients as well as cultivars. Among the treatmentroot yield per ha (3.65), dry weight root of plant (121.67g), fresh weight of plant (318g), harvesting index (7.5), b:c ratio (1.17)was recorded at RDF (90:50:90) kg ha1 + farm yard manures (5t/ha) + verimicompost (3t/ha)+ Arka microbial Constrioum (17kg/ha) was cultivar Japanese white.

Rituximab induced acute respiratory distress syndrome (ARDS) reversed with plasmapheresis: case report

Rituximab is a chimeric Anti-CD20 anti-body initially used in the treatment of non-Hodgkin´s B-cell lymphoma. Currently, the field of use has become wider, despite the results in terms of therapeutic efficiency, rituximab has been implicated in numerous adverse events, we´re here to report the case of a female patient with post-viral C cryoglobulinemia who developed ARDS following rituximab infusion. A 69-year-old female patient was admitted to the intensive care unit for respiratory distress. In her antecedents we find a viral hepatitis C treated 10 years ago complicated by cryoglobulinemia, put on anti-CD20, which last cure was 5 days before her admission to the hospital. The patient developed ARDS in the aftermath of her hospitalization where the causality was linked to the Rituximab cure after eliminating the other causes, the patient was treated with different levels of treatment including plasmapheresis, which showed encouraging results, however unfortunately this was not enough to save the patient. Considering the rarity of this clinical picture and consequently the therapeutic approaches, plasmapheresis probably appears an important pillar in the therapeutic arsenal of this entity.