We report herein a case of fatal disseminated cryptococcosis in the setting of zanubrutinib use for Waldenström’s macroglobulinemia. At the time of diagnosis, his Waldenström’s macroglobulinemia was in a partial response. The mechanism by which Bruton tyrosine kinase inhibitors (BTKs) lead to invasive fungal infections in these patients remains to be explored. T- and B-cell immune defects accompanying low-grade B-cell lymphomas may contribute to the severity of these infections.

We report herein a case of fatal disseminated cryptococcosis in the setting of zanubrutinib use for Waldenström’s macroglobulinemia. At the time of diagnosis, his Waldenström’s macroglobulinemia was in a partial response. The mechanism by which Bruton tyrosine kinase inhibitors (BTKs) lead to invasive fungal infections in these patients remains to be explored. T- and B-cell immune defects accompanying low-grade B-cell lymphomas may contribute to the severity of these infections.As persistent inequities in health gained increased attention nationally due to COVID-19 and racial justice protests in 2020, it has become increasingly important to evaluate both the process and outcomes associated with coalition-based efforts to address health inequities. The Two Georgias Initiative supports coalitions in 11 rural counties to (1) achieve greater health equity, (2) improve health and health care, (3) build healthier rural communities and improve social conditions that impact the health of rural populations, and (4) build community, organizational, and individual leadership capacity for health equity. Rural communities suffer significant health disparities relative to urban areas, and also experience internal inequities by race and poverty level. The evaluation framework for The Two Georgias Initiative provides a comprehensive mixed methods approach to evaluating both processes and outcomes. Early results related to community readiness and capacity to address health inequities, measured through a coalition member survey (n = 236) conducted at the end of the planning phase, suggest coalitions were in the preparation stage, with higher levels of readiness among coalition members and organizations/groups similar to the coalition members’ own, lower levels among public officials and other leaders, and the lowest levels among county residents. In addition, coalition members reported more experience with downstream drivers (e.g., access to care) of health than upstream drivers (e.g., affordable housing, environmental or racial justice). By providing a logic model, evaluation questions and associated indicators, as well as a range of data collection methods, this evaluation approach may prove practical to others aiming to evaluate their efforts to address health equity.Sex determination is a fundamental step in biological profile estimation from skeletal remains in forensic anthropology. This study proposes deep learning and morphometric technique to perform sex determination from lumbar vertebrae in a Thai population. A total of 1100 lumbar vertebrae (L1-L5) from 220 Thai individuals (110 males and 110 females) were obtained from the Forensic Osteology Research Center, Faculty of Medicine, Chiang Mai University, Thailand. In addition, two linear measurements of superior and inferior endplates from the digital caliper and image analysis were carried out for morphometric technique. Deep learning applied image classification to the superior and inferior endplates of the lumbar vertebral body. All lumbar vertebrae images are included in the dataset to increase the number of images per class. The accuracy determined the performance of each technique. The results showed the accuracies of 82.7%, 90.0%, and 92.5% for digital caliper, image analysis, and deep learning techniques, respectively. The lumbar vertebrae L1-L5 exhibit sexual dimorphism and can be used in sex estimation. Deep learning is more accurate in determining sex than the morphometric method. In addition, the subjectivity and errors in the measurement are decreased. Finally, this study presented an alternative approach to determining sex from lumbar vertebrae when the more traditionally used skeletal elements are incomplete or absent.Beta-carotene (β-carotene, BC) is one of the carotenoids most commonly consumed by humans. BCMO1 is expressed in various human tissues and is considered to be a key enzyme that converts BC into vitamin A. Studies indicated that BC-derived carotenoid signaling molecules affected the physiological functions of fat cells. In order to investigate the role and possible molecular mechanism of BC in mouse adipocytes, we conducted 4-group and 2-group difference analysis based on the data of GSE27271 chip in the Gene Expression Omnibus database. Genes differentially expressed in the inguinal white adipose tissue of mice were screened out and combined with the STRING database to construct protein-protein interaction (PPI) networks. Among them, Alb (albumin), Mug1 (murinoglobulin-1) and Uox (urate oxidase) genes were at relatively key positions and may affect the action of BC. Besides, Ppara (peroxisome proliferator-activated receptor alpha), Acly (ATP-citrate lyase) and Fabp5 (fatty acid-binding protein 5) genes constituted functional partners with many genes in the PPI network, and these genes may be Bcmo1 targeting molecules. Gene Ontology (GO) function and signaling pathways enrichment analysis were performed on the genes with protein interaction relationship in the PPI network. Fatty acid binding, cholesterol metabolic process, and regulation of fatty acid metabolic process were significantly enriched, and PPAR signaling pathway showed the most significant, indicating that BC and Bcmo1 might synergistically affect body metabolic functions such as fat metabolism. In general, BC and Bcmo1 may play a role in fat metabolism in mice, thereby affecting other functions or diseases.Background India is a land of diverse food culture and habits and has a plethora of ethnic fermented foods to boast of. Ranging from the north east to the western part of the country and from northern Indian states to the southern tip of the country, fermented ethnic foods have become part of everyday meals and have been able to bridge nutritional gaps and improve general immunity of the people. Most ethnic fermented foods have a rich content of protein, vitamins, fibres and minerals. Aim Our review attempts to bring forth and summarise the most popular, immune boosting fermented foods of various regions in India, the role microbes’ play in their making and how they have impacted the nutritional aspects and immunity of people in various regions of the country. It also highlights the lack of clinical findings in proving the effectiveness of most fermented foods. Methods Pubmed central and Google scholar were extensively searched from inception to July 2021 for study concepts and topic related keywords. Results Ethnic fermented food of various Indian regions has shown a definitive role in improving health and immunity. Conclusion The diverse ethnic fermented foods maybe be meat based, cereal based, pulses based and even vegetable based. Their health benefits and immune boosting abilities are still to be explored to its maximum potential. Often the role of microbes in these fermented foods have also been underplayed and left unexplored.The concept of 'patient involvement’ is highlighted in healthcare. However, hindrances can prevent its implementation. This article explored how 'patient involvement’ is understood and on what ideas this understanding is based through a critical textual analysis of the European document on patient involvement in health systems using a Fairclough-inspired critical discourse analysis. The findings showed that the document arose from a social discourse based on a mix of a neoliberal ideology, with a marketisation of care focusing on a cost-effective and evidence-based logic of care, and a humanistic ideology of patient involvement. It had the form of a normative, consensus-based standard, supported by European organisations. The document incorporated a visionary, well-intentioned abstract guide to promote patient involvement across European care contexts, however without addressing hindrances nor differences across the contexts in which it ought to be implemented. It raises questions about its usability, inviting further research into empirical applications.Background Data on the association between dietary acid load and non-alcoholic fatty liver disease (NAFLD) are scarce and controversial. Aim This study aimed to assess the association between dietary acid-base loads and odds of NAFLD. Methods In the current study, 196 cases of NAFLD (proven by a gastroenterologist using Fibroscan) and 803 age-matched controls were enrolled from the same clinic. Dietary intakes of patients with NAFLD and controls without hepatic steatosis were evaluated using a validated food frequency questionnaire. Dietary acid load was estimated using the validated potential renal acid load (PRAL) algorithm. Multivariable logistic regression model was used to estimate the odds of NAFLD across quintiles of PRAL. Results The mean ± SD age of the study population (43% male) was 43.28 ± 14.02 years. The mean ± SD of PRAL was -1.90 ± 7.12 for all participants. After adjustment for all known confounders, subjects in the third quintile of PRAL (nearly with neutral PRAL) had a 54% lower odds of NAFLD compared with those in the lowest quintiles of the PRAL [(OR 0.46; 95%CI 0.24-0.89), (P = 0.021)]. However, the odds of NAFLD in the highest quintiles of PRAL was not different in comparison to the lowest quintiles (OR 0.90; 95%CI 0.41-1.57). Conclusion In conclusion, our results have shown a modest U shaped relationship between PRAL and NAFLD. Further studies with acid-base biomarkers are needed to confirm the role of dietary acid load in the development of NAFLD and its potential mechanisms.The COVID-19 pandemic has led to increases in U.S. residents’ stressors while limiting many of the resources previously available to cope with stress. Coping behaviors may contribute to the prevention or proliferation of psychological distress during and after the pandemic. Understanding these coping behaviors and associated psychological outcomes can help health educators develop programs that encourage effective coping and promote mental health. This study used a sequential mixed-methods approach informed by Roth and Cohen’s conceptualization of coping to understand the use of approach coping behaviors- which are active and directed toward the perceived threat-and avoidance coping behaviors-which include activity directed away from perceived threat during the COVID-19 pandemic. U.S. residents (N = 2,987) were surveyed online in April 2020 and again in September 2021. Open-ended responses at baseline were thematically analyzed to illustrate coping behaviors in participants’ own words. At baseline, more than support.

Few reports have examined the feasibility of a post-contrast double inversion recovery (DIR) magnetic resonance (MR) sequence in patients with multiple sclerosis (MS) because of partial or complete signal loss of enhancing MS lesions.

To compare subtracted images of DIR (pre-contrast – post-contrast DIR images) with contrast enhanced T1-weighted (CE-T1W) images in the depiction of contrast enhancement of MS lesions.

In total, 27 patients were included. Two neuroradiologists interpreted both images of CE-T1W imaging and subtracted DIR, and interpretation of the images was classified into a score of 1-5 (from 5, definitely superior contrast of lesions on DIR subtraction compared to conventional CE-T1W imaging, to 1, definitely superior contrast of lesions on CE-T1W imaging. The interrater agreement (κ coefficient) was measured. The signal-to-noise ratio (SNR) and contrast-noise-ratio (CNR) of the lesion were compared.

A significant difference (

<

0.001) in scoring was seen between conventional CE-T1W imaging (2.