004). At 12 weeks, median score improvement was -1.31 (3.26) in the PRFM cohort and -0.76 (2.21) in the saline cohort (p=0.34). There was no statistical significance in the change in score for any of the individual skin parameters.

PRFM can objectively improve skin quality compared to placebo. Texture was the only skin parameter that significantly improved, which is consistent with PRFM’s role as a filler agent. The results appear to persist for at least 6 weeks.

PRFM can objectively improve skin quality compared to placebo. Texture was the only skin parameter that significantly improved, which is consistent with PRFM’s role as a filler agent. The results appear to persist for at least 6 weeks.

The COVID-19 pandemic continues to have a significant impact on the provision of medical care. Planning to ensure there is capability to treat those that become ill with the virus has led to an almost complete moratorium on elective work. This study evaluates the impact of COVID-19 on cancer, in particular surgical intervention, in patients with esophago-gastric cancer at a high-volume tertiary center.

All patients undergoing potential management for esophago-gastric cancer from 12 March to 22 May 2020 had their outcomes reviewed. Multi-disciplinary team (MDT) decisions, volume of cases, and outcomes following resection were evaluated.

Overall 191 patients were discussed by the MDT, with a 12% fall from the same period in 2019, including a fall in new referrals from 120 to 83 (P = 0.0322). The majority of patients (80%) had no deviation from the pre-COVID-19 pathway. Sixteen patients had reduced staging investigations, 4 had potential changes to their treatment only, and 10 had a deviation from both investigation and potential treatment. Only one patient had palliation rather than potentially curative treatment. Overall 19 patients underwent surgical resection. Eight patients (41%) developed complications with two (11%) graded Clavien-Dindo 3 or greater. Two patients developed COVID-19 within a month of surgery, one spending 4weeks in critical care due to respiratory complications; both recovered. Twelve patients underwent endoscopic resections with no complications.

Care must be taken not to compromise cancer treatment and outcomes during the COVID-19 pandemic. Excellent results can be achieved through meticulous logistical planning, good communication, and maintaining high-level clinical care.

Care must be taken not to compromise cancer treatment and outcomes during the COVID-19 pandemic. Excellent results can be achieved through meticulous logistical planning, good communication, and maintaining high-level clinical care.Soil alkalization affects apple production in northwest China. Autophagy is a highly conserved degradative protein pathway in eukaryotes. Autophagy in plants can be activated by various abiotic factors. We previously identified the positive role of the autophagy-related gene MdATG18a in drought, nitrogen deficiency and resistance to Diplocarpon mali infection in apple. However, it is still unclear whether ATG18a is related to alkaline stress. In this study, we used hydroponic culture to simulate alkaline stress and found that the overexpression of MdATG18a significantly improved the tolerance of apple to alkaline stress. The overexpression of MdATG18a increased biomass, photosynthetic rate and antioxidant capacity of transgenic plants compared with wild-type plants under alkaline stress. The overexpression of MdATG18a promoted γ-aminobutyric acid (GABA) shunt via an increase in glutamate (GABA precursor) and GABA contents and upregulation of GABA shunt-related genes. In addition, the overexpression of MdATG18a significantly upregulated the expression of other core ATG genes and increased the formation of autophagosomes under alkaline stress. In conclusion, these results suggest that the overexpression of MdATG18a in apple enhances alkaline tolerance and the GABA shunt, which may be owing to the increase in autophagic activity.The unbridled expansion of bamboo has imposed serious threats on ecosystem processes and functions. Considerable evidence indicates that bamboo invasions can alter plant-available soil nitrogen (N) pools and rates of N cycling, but the consequences of altered N availability for plant growth and community structure have thus far been poorly characterized. The primary soil-accessible N forms for most plants are ammonium (NH4+) and nitrate (NO3-), but plants differ in their ability to use the different N forms, and these differences can be related to their ecological characteristics and drive community structure. In this context, we evaluated the growth response, N uptake and interspecific competition in two subtropical species, Phyllostachys edulis (Carrière) J. Houzeau (Synonym Phyllostachys heterocycla Carrière) and Castanopsis fargesii Franch., dominant species of bamboo and secondary evergreen broad-leaved forests, respectively, under changing N availability in seedlings supplied with different N concentrat edulis exhibited stronger plasticity and adaptation to changing N availability, whereas C. fargesii had low responsiveness and capacity to acclimate to soil N changes. Phyllostachys edulis displayed a significant competitive growth advantage compared with C. fargesii on NH4+-dominated substrates.Widespread occurrence of antibiotic resistance genes (ARGs) has become an important clinical issue. Studying ARGs in pristine soil environments can help to better understand the intrinsic soil resistome. In this study, 10 soil samples were collected from a high elevation and relatively pristine Tibetan area, and metagenomic sequencing and bioinformatic analyses were conducted to investigate the microbial diversity, the abundance and diversity of ARGs and the mobility potential of ARGs as indicated by different mobile genetic elements (MGEs). A total of 48 ARG types with a relative abundance of 0.05-0.28 copies of ARG/copy of 16S rRNA genes were detected in Tibetan soil samples. The observed ARGs were mainly associated with antibiotics that included glycopeptide and rifamycin; the most abundant ARGs were vanRO and vanSO. Low abundance of MGEs and potentially plasmid-related ARGs indicated a low horizontal gene transfer risk of ARGs in the pristine soil. Pearson correlation and redundancy analyses showed that temperature and total organic carbon were the major environmental factors controlling both microbial diversity and ARG abundance and diversity.Hydrostatic pressures (HP) less then 30-40 MPa are often considered mild, and their impact on petroleum biodegradation seldom considered. However, the frequent use of nutrient-rich media in lab-scale high-pressure reactors may exaggerate HP importance by resulting in a strong growth stimulation as compared to oligotrophic marine environments. Here, we tested coastal seawater microbial communities, presumably enriched in pressure-sensitive microorganisms. Limiting environmental conditions for growth were applied (i.e. low temperature [5°C], no added nutrients) and HP tested at 0.1 and 15 MPa, using crude oils from three different reservoirs. The cell number was not affected by HP contrary to the microbial community composition (based on 16S rRNA gene and 16S rRNA sequences). The most predominant genera were Zhongshania, Pseudomonas and Colwellia. The enrichment of Zhongshania was crude-oil dependent and comparable at 0.1 and 15 MPa, thus showing a piezotolerant phenotype under the present conditions; Pseudomonas’ was crude-oil dependent at 0.1 MPa but unclear at 15 MPa. Colwellia was selectively enriched in the absence of crude oil and suppressed at 15 MPa. HP shaped the assemblage of oil-degrading communities even at mild levels (i.e. 15 MPa), and should thus be considered as a fundamental factor to assess oil bioremediation along the water column.To date, more than 800 molecules are classified as New Psychoactive Substances (NPS), and it is reported that this number increases every year. Whereas several cases of polydrug consumption which led to acute intoxication and death are reported, a lack of effective analytical screening method to detect NPS and classical drug of abuse in human matrices affects the prompt identification of the probable cause of intoxication in emergency department of hospitals. In this concern, a fast, simple and comprehensive high-performance chromatography-tandem mass spectrometry (HPLC-MS-MS) screening method to detect and quantify 77 NPS, 24 classic drugs and 18 related metabolites has been successfully developed and validated in blood, urine and oral fluid. A small volume (100 µL) of whole blood samples spiked with internal standard deuterated mixture was added to 70 µL of M3® buffer and after precipitation of blood proteins, the supernatant was evaporated to dryness and reconstituted in 1 mL of mobile phase. Same volume (100 µL) of urine and oral fluid samples spiked with internal standard deuterated mix were only diluted with with 500 µL of M3 ® reagent. One microliter samples of each matrix was injected into HPLC-MS-MS equipment. The run time lasted 10 min with a gradient mobile phase. Mass spectrometric analysis was performed in positive ion MRM mode. The method was linear for all analytes under investigation with a determination coefficient always better than 0.99. The calibration range for blood and oral fluid was from limits of quantification (LOQs) to 200 ng/mL, whereas that for urine was LOQs to 1000 ng/mL. Recovery and matrix effect were always higher than 80%, whereas intra-assay and inter-assay precision was always better than 19% and accuracy was always within 19% of target in every matrix. Applicability of the method was verified by analysis of samples from real cases.

Few population-based studies have directly compared caregivers of persons with dementia to caregivers of persons with other disabilities (non-dementia caregivers). We enrolled dementia and non-dementia caregivers who were providing substantial and sustained care and compared these groups on measures of caregiver stressors, appraisals of burden, and well-being.

Caregivers (N = 251) who provided continuous care for at least one year and at least five hours per week were recruited from the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Caregivers reported on dementia caregiving status, stressors, burden, and well-being.

Forty-seven percent (n=117) reported caring for a person with dementia. Dementia caregivers reported more stressors, providing more care for self-care and behavioral problems than non-dementia caregivers. Dementia caregivers also reported higher appraisals of stress and burden, and more depressive symptoms, but did not differ from non-dementia caressistance with dementia-specific problems such as behavioral problems. Clinical interventions and policy changes targeting highly burdened caregivers are needed to support them in allowing their care recipients to age in place at home.

Growth retardation is an established complication of anorexia nervosa (AN), however findings concerning adult height of AN patients are inconsistent.

To assess linear growth and adult height in female adolescents with AN.

Prospective observational study.

Tertiary University Hospital.

All 255 female adolescent AN patients hospitalized in the pediatric psychosomatic department between 1/1/2000- 31/5/2015.

Height and weight were assessed at admission and during hospitalization. Patients were subsequently invited for measurement of adult height. Additional data collected included pre-morbid height data, menstrual history, skeletal age, pertinent laboratory studies and parental heights.

Adult height.

Mean age at admission was 15.4±1.75 years, mean BMI was 15.7±1.8 kg/m2 (BMI SDS = -2.3±1.45). Pre-morbid height standard deviation scores (SDS) were not significantly different from those expected in normal adolescents (0.005±0.96). However, height-SDS at admission (-0.36±0.99), discharge (-0.34±0.96), and at adult height (-0.