Ab initio study of stability and quadrupole coupling constants in borophosphates.

The DFT method was used to predict the formation energies and quadrupole coupling constants CQ in a series of borophosphates: Li3BP2O8, Li2NaBP2O8, Na3BP2O8, Li2B3PO8, Na5B2P3O13, LiNa2B5P2O14 and Na3B6PO13 composed of different networks and different amounts of borate and phosphate units. The change in formation energies with increasing number of B atoms in this series is attributed to the multiplicity of boron sites and is explained by density of states calculations. The calculated CQ values of 7Li, 23Na and 11B are correlated with the coordination and distortion of polyhedra to elucidate the influence of local and more distant environments. As for the CQ of 11B, it should be in the ranges of 0.26-0.36, 0.48-0.84 and ∼1 MHz for boron tetrahedral distortion indices of 0.004-0.013, 0.015-0.019 and 0.033, respectively, whereas CQ ∼3.0 MHz corresponds to boron in a triangular site. The obtained numerical relationships make it possible to predict the quadrupole frequencies for these nuclei based only on their local environment, and vice versa, to propose structural models from NMR data. These results provide guidance for studying similar characteristics of other borophosphates, the structure of which varies depending on the initial reaction, composition and temperature.

Metabolomics for dental caries diagnosis: Past, present, and future.

Dental caries, a prevalent global infectious condition affecting over 95% of adults, remains elusive in its precise etiology. Addressing the complex dynamics of caries demands a thorough exploration of taxonomic, potential, active, and encoded functions within the oral ecosystem. Metabolomic profiling emerges as a crucial tool, offering immediate insights into microecosystem physiology and linking directly to the phenotype. Identified metabolites, indicative of caries status, play a pivotal role in unraveling the metabolic processes underlying the disease. Despite challenges in metabolite variability, the use of metabolomics, particularly via mass spectrometry and nuclear magnetic resonance spectroscopy, holds promise in caries research. This review comprehensively examines metabolomics in caries prevention, diagnosis, and treatment, highlighting distinct metabolite expression patterns and their associations with disease-related bacterial communities. Pioneering in approach, it integrates singular and combinatory metabolomics methodologies, diverse biofluids, and study designs, critically evaluating prior limitations while offering expert insights for future investigations. By synthesizing existing knowledge, this review significantly advances our comprehension of caries, providing a foundation for improved prevention and treatment strategies.

Sodium alginate-modified alkali-activated eggshell/Fe3O4 nanoparticles: A magnetic bio-based spherical adsorbent for cationic dyes adsorption.

Herein, a mixture of eggshell (ES) and magnetite nanoparticles (MNPs) was alkali-activated using NaOH/Na2SiO3 solution and then, impregnated with sodium alginate (SA) to prepare a magnetic bio-based adsorbent (namely SAAES/SA/MNPs) for the decontamination of water containing basic dyes, in particular, methylene blue (MB) and crystal violet (CV). The physicochemical properties of magnetic spheres of SAAES/SA/MNPs were characterized using XRD, FTIR, FESEM, EDX, elemental mapping, TEM, and zeta potential techniques. Dye adsorption equilibrium was studied experimentally at pH 8.0 and 25-55 °C, and a statistical physics multilayer model was applied to understand the removal mechanism of these dyes including the adsorption orientations on the adsorbent surface. The number of adsorbed dye molecules per functional group (n) of this bio-based adsorbent ranged from 0.70 to 0.91, indicating the presence of vertical and horizontal adsorption orientations for these organic molecules at all tested solution temperatures. The calculated saturation adsorption capacities (Qsat) were 332.57-256.62 mg/g for CV and 304.47-240.62 mg/g for MB, and an exothermic adsorption was observed for both adsorbates. The estimated adsorption energies (∆E) were < 25 kJ/mol, confirming that the SAAES/SA/MNPs-dye interactions were governed by physical forces as electrostatic interactions. This bio-based adsorbent was effectively regenerated using ethanol and it can be reused showing a removal of 71 and 74 % of MB and CV, respectively, after fourth adsorption-desorption cycles. Overall, the results of this article suggest the attractive performance of SAAES/SA/MNPs for removing basic dyes from aqueous solutions, thus highlighting the promising potential of this magnetic bio-based adsorbent for sustainable wastewater treatment at an industrial level.

Application of X-ray based modern instrumental techniques to determine the heavy metals in soils, minerals and organic media.

To evaluate the environmental concerns associated with heavy metals (HMs) during their translocations in food chains, it is crucial to gather data on the types of HMs present in soils in order to ascertain their toxicity and potential to migrate. An overview of the findings from several physical techniques used to determine and identify the HMs, sediments, individual minerals, and organic components in contaminated agricultural and industrial soils, is provided in this review article. These studies cover a variety of X-ray-based analytical techniques, including most widely used ones like X-ray absorption near edge structure, extended X-ray absorption fine structure, X-ray diffraction, and less popular ones X-ray fluorescence, etc. When compared to techniques that rely on laboratory radiation sources, synchrotron radiation offers more precision and efficiency. These methods could pinpoint the primary mechanisms influencing the soil's ability to transport contaminants and track their subsequent migration up the food chain.

Altering maternal calcium and phosphorus dietary intake induces persistent sex-specific changes in the dentition of the offspring.

BACKGROUND: The maternal diet is essential to offspring development, but the specific effects on tooth morphology are still unknown. The aim of this study was to evaluate the effects of altering maternal calcium (Ca) and phosphorus (P) supplementation during gestation and lactation on offspring dentition. METHODS: Pregnant mice were fed an experimental diet containing a threefold increase in Ca and a threefold decrease in P compared to the standard mouse chow diet at embryonic Day 0.5 (E0.5). Offspring mice were maintained on standard or experimental diets from post-natal Day 0 to weaning, then fed control diets until 6 weeks of age. Six-week-old offspring heads were collected and scanned using micro-computed tomography. Dental morphometrics of offspring maxillary and mandibular first and third molars (n = 5-6 per diet/per sex) were determined. A two-way ANOVA test was employed to verify the existence of any significant differences between groups. The significance level was set at P < .05. RESULTS: A two-way ANOVA revealed a statistically significant interaction between the effects of diet and sex on the upper and lower dentition. Moreover, experimental diet-fed female offspring exhibited smaller molars with shorter mesiodistal width and larger pulp chambers relative to controls, while experimental diet-fed male offspring possessed larger molars with wider mesiodistal width and smaller pulp chambers. CONCLUSION: Our findings reveal that altering the maternal and offspring dietary Ca:P ratio during gestation, lactation and weaning led to significant, sex-specific changes in the offspring dentition. The differences in dentition appeared to be correlated with the sex-specific changes in the craniofacial skeleton.

Development and Testing of a Mobile App to Collect Social Determinants of Health Data in Cancer Settings: Interview Study.

BACKGROUND: Social determinants of health (SDOH) such as lack of basic resources, housing, transportation, and social isolation play an important role for patients on the cancer care continuum. Health systems' current technological solutions for identifying and managing patients' SDOH data largely focus on information recorded in the electronic health record by providers, which is often inaccessible to patients to contribute to or modify. OBJECTIVE: We developed and tested a patient-centric SDOH screening tool designed for use on patients' personal mobile phone that preserves patient privacy and confidentiality, collects information about the unmet social needs of patients with cancer, and communicates them to the provider. METHODS: We interviewed 22 patients with cancer, oncologists, and social workers associated with a US-based comprehensive cancer center to better understand how patients' SDOH information is collected and reported. After triangulating data obtained from thematic analysis of interviews, an environmental scan, and a literature search of validated tools to collect SDOH data, we developed an SDOH screening tool mobile app and conducted a pilot study of 16 dyadic pairs of patients and cancer care team members at the same cancer center. We collected patient SDOH data using 36 survey items covering 7 SDOH domains and used validated scales and follow-up interviews to assess the app's usability and acceptability among patients and cancer care team members. RESULTS: Formative interviews with patients and care team members revealed that transportation, financial challenges, food insecurity, and low health literacy were common SDOH challenges and that a mobile app that collected those data, shared those data with care team members, and offered supportive resources could be useful and valuable. In the pilot study, 25% (4/16) of app-using patients reported having at least one of the abovementioned social needs; the most common social need was social isolation (7/16, 44%). Patients rated the mobile app as easy to use, accurately capturing their SDOH, and preserving their privacy but suggested that the app could be more helpful by connecting patients to actual resources. Providers reported high acceptability and usability of the app. CONCLUSIONS: Use of a brief, patient-centric, mobile app-based SDOH screening tool can effectively capture SDOH of patients with cancer for care team members in a way that preserves patient privacy and that is acceptable and usable for patients and care team members. However, only collecting SDOH information is not sufficient; usefulness can be increased by connecting patients directly to resources to address their unmet social needs.

Pure and doped carbon quantum dots as fluorescent probes for the detection of phenol compounds and antibiotics in aquariums.

The resulting antibiotic residue and organic chemicals from continuous climatic change, urbanization and increasing food demand have a detrimental impact on environmental and human health protection. So, we created a unique B, N-CQDs (Boron, Nitrogen doping carbon quantum dots) based fluorescent nanosensor to investigate novel sensing methodologies for the precise and concentrated identification of antibiotics and phenol derivatives substances to ensure that they are included in the permitted percentages. The as-prepared highly fluorescent B, N-CQDs had a limited range of sizes between 1 and 6 nm and average sizes of 2.5 nm in our study. The novel B, N-CQDs showed high sensitivity and selectivity for phenolic derivatives such as hydroquinone, resorcinol, and para aminophenol, as well as organic solvents such as hexane, with low detection limits of 0.05, 0.024, 0.032 and 0.013 µM respectively in an aqueous medium. The high fluorescence B, N-CQDs probes were examined using transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and UV/VIS spectroscopy. The outcomes were compared to carbon quantum dots (CQDs) previously generated from Urea.

Tobacco Use and Tobacco Dependence Management.

Tobacco use is a major public health problem and the leading cause of preventable deaths in the United States and worldwide. Tobacco dependence determines tobacco use and is largely due to nicotine addiction. Such dependence is a disease resulting in a strong desire or compulsion to take tobacco, with difficulty in cessation of tobacco, along with persistent use despite overtly harmful consequences.

The relation between social media mentions and academic citations in orthodontic journals: A preliminary study.

BACKGROUND: To study the relation between social media mentions and academic citations for articles published in peer-reviewed orthodontic journals. METHODS: Articles published in early 2018 in seven peer-reviewed orthodontic journals were retrospectively analyzed in September 2022. Citation counts of the articles were evaluated using two databases: Google Scholar (GS) and Web of Science (WoS). The Altmetric Attention Score, Twitter, Facebook mentions, and Mendeley reads were tracked using the Altmetric Bookmarklet. The citation counts and social media mentions were correlated using Spearman rho. RESULTS: A total of 84 articles were identified during the initial search; 64 (76%) were original studies and systematic review articles and included in the analysis. A total of 38% of the articles had at least one mention on social media. Over the study period, the average number of citations of the articles mentioned on social media was higher than the non-mentioned articles for GS and WoS, respectively. Moreover, significant positive correlations existed between the Altmetric Attention Score and the number of citations in GS and WoS (rs = 0.31, P = 0.001 and rs = 0.26, P = 0.04). CONCLUSIONS: Social media mentions and citations of articles published in peer-reviewed orthodontic journals are correlated, with a clear difference in the number of citations in articles mentioned on social media versus those not mentioned, indicating possible increased reach of articles disseminated on social media.

Binderless Faujasite Beads with Hierarchical Porosity for Selective CO2 Adsorption for Biogas Upgrading.

Biomethane can be isolated from biogas through selective CO2 adsorption. Faujasite-type zeolites are promising adsorbents for CO2 separation due to their high CO2 adsorption capacity. While commonly inert binder materials are used to shape zeolite powders into the desired macroscopic format for application in an adsorption column, here we report the synthesis of Faujasite beads without the use of a binder and their application as CO2-adsorbents. Three types of binderless Faujasite beads (d = 0.4-0.8 mm) were synthesized using an anion-exchange resin hard template. All the prepared beads consisted mostly of small Faujasite crystals, as demonstrated by characterization with XRD and SEM, which are interconnected through a network of meso- and macropores (10-100 nm), yielding a hierarchically porous structure, as shown by N2 physisorption and SEM. The zeolitic beads showed high CO2 adsorption capacity (up to 4.3 mmol g-1 at 1 bar and 3.7 mmol g-1 at 0.4 bar) and CO2/CH4 selectivity (up to 19 at the partial pressures mimicking biogas, i.e., 0.4 bar CO2 and 0.6 bar CH4). Additionally, the synthesized beads have a stronger interaction with CO2 than the commercial zeolite powder (enthalpy of adsorption -45 kJ mol-1 compared to -37 kJ mol-1). Therefore, they are also suitable for CO2 adsorption from gas streams in which the CO2 concentration is relatively low, such as flue gas.

Speciation of macro- and nanoparticles of Cr2O3 in Hordeum vulgare L. and subsequent toxicity: A comparative study.

Chromium (Cr) is reported to be hazardous to environmental components and surrounding biota when levels exceed allowable thresholds. As Cr is extensively utilized in different industries, thereby comprehensively studied for its toxicity. Along with Cr, the applications of nano-Cr or chromium oxide nanoparticles (Cr2O3-NPs) are also expanding; however, the literature is scarce or limited on their phytotoxicity. Thereby, the current work investigated the morpho-physiological insights of macro- and nanoparticles of Cr in Hordeum vulgare L. plants. The increased accumulation and translocation of Cr under the exposure of both forms disturbed the cellular metabolism that might have inhibited germination and growth as well as interfered with the photosynthesis of plants. The overall extent of toxicity was noticeably higher under nanoparticles' exposure than macroparticles of Cr. The potential cue for such phytotoxic consequences mediated by Cr nanoparticles could be an increased bioavailability of Cr ions which was also supported by their total content, mobility, and factor toxicity index. Besides, to support further these findings, synchrotron X-ray technique was used to reliably identify Cr-containing compounds in the plant tissues. The X-ray spectra of the near spectral region and the far region of the spectrum of K-edge of Cr were obtained, and it was established that the dominant crystalline phase corresponds to Cr2O3 (eskolaite) from the recorded observations. Thus, the obtained results would allow revealing the mechanism of macro- and nanoparticles of Cr induced impacts on plant at the tissue, cellular- and sub-cellular levels.

Functional signatures of ex-vivo dental caries onset.

Background: The etiology of dental caries remains poorly understood. With the advent of next-generation sequencing, a number of studies have focused on the microbial ecology of the disease. However, taxonomic associations with caries have not been consistent. Researchers have also pursued function-centric studies of the caries microbial communities aiming to identify consistently conserved functional pathways. A major question is whether changes in microbiome are a cause or a consequence of the disease. Thus, there is a critical need to define conserved functional signatures at the onset of dental caries. Methods: Since it is unethical to induce carious lesions clinically, we developed an innovative longitudinal ex-vivo model integrated with the advanced non-invasive multiphoton second harmonic generation bioimaging to spot the very early signs of dental caries, combined with 16S rRNA short amplicon sequencing and liquid chromatography-mass spectrometry-based targeted metabolomics. Findings: For the first time, we induced longitudinally monitored caries lesions validated with the scanning electron microscope. Consequently, we spotted the caries onset and, associated with it, distinguished five differentiating metabolites - Lactate, Pyruvate, Dihydroxyacetone phosphate, Glyceraldehyde 3-phosphate (upregulated) and Fumarate (downregulated). Those metabolites co-occurred with certain bacterial taxa; Streptococcus, Veillonella, Actinomyces, Porphyromonas, Fusobacterium, and Granulicatella, regardless of the abundance of other taxa. Interpretation: These findings are crucial for understanding the etiology and dynamics of dental caries, and devising targeted interventions to prevent disease progression.

Prevalence of Mental Health and Social Connection among Patients Seeking Tobacco Dependence Management: A Pilot Study.

INTRODUCTION: with regards to tobacco dependence management, there are certain barriers to successful smoking cessation for patients, such as untreated anxiety and depression. Complicating the impact of mental health morbidities on tobacco dependence may be the significant portion of patients whose mental health issues and limited social connections are undiagnosed and unaddressed. We hypothesize that patients with no prior mental health diagnoses who are treated for tobacco dependence have high rates of undiagnosed mental health morbidities. METHODS: patients were recruited from a tobacco treatment clinic in 2021. Every patient who came for an inaugural visit without a prior diagnosis of mental health disease was screened for depression, anxiety, social isolation and loneliness. Sociodemographic variables were collected. RESULTS: over a 12-month period, 114 patients were seen at the tobacco treatment clinic. Of these 114 patients, 77 (67.5%) did not have a prior diagnosis of a mental health disease. The mean age was 54.3 ± 11.2 years, 52 (67.5%) were females, and 64 (83.1%) were Black/African American. The mean age of starting smoking was 19.3 ± 5.2 years, and 43 (55.8%) had never attempted to quit smoking in the past. With regards to mental health screening, 32 (41.6%) patients had a score of 9 or greater on the Patient Health Questionnaire (PHQ) 9, 59 (76.6%) had a score of 7 or greater on the Generalized Anxiety Disorder (GAD) 7, 67 (87.0%) were identified with social isolation and 70 (90.1%) for loneliness on screening. CONCLUSION: there was a high prevalence of undiagnosed mental health morbidities and social disconnection in patients who were actively smoking and were struggling to achieve smoking cessation. While a larger scale study is necessary to reaffirm these results, screening for mental health morbidities and social disconnection may be warranted in order to provide effective tobacco dependence management.

Clinical and Dermoscopic Evaluation of Trichloroacetic Acid 20% Versus Long-Pulsed 1064-nm Nd-YAG Laser in the Treatment of Keratosis Pilaris.

BACKGROUND: Keratosis pilaris (KP) is a common disorder of keratinization with different therapeutic modalities; however, none of them is completely satisfactory. OBJECTIVE: Assess and compare the efficacy of trichloroacetic acid (TCA) 20% and long-pulsed 1,064-nm Nd:YAG laser in the treatment of KP. MATERIALS AND METHODS: Twenty patients with symmetrically distributed areas of KP were enrolled in this study. In each patient, 2 symmetrical KP areas were randomly assigned to receive 4 sessions of either long-pulsed Nd:YAG laser or TCA 20%. Clinical evaluation by Investigator Global Assessment (IGA) was done by 2 blinded physicians after treatment. Dermoscopic assessment was done at baseline and at the end point of the study. RESULTS: Investigator Global Assessment of laser-treated area showed that 2 patients (10%) had moderate improvement, 10 patients (50%) had marked improvement, and 8 patients (40%) had excellent improvement. Investigator Global Assessment of TCA-treated area showed that 9 patients (45%) had marked improvement and 11 patients (55%) had excellent improvement. Dermoscopic score of KP showed a significant reduction with both modalities. The IGA and reduction in dermoscopic scores were comparable between the 2 modalities. CONCLUSION: Both long-pulsed 1,064-nm Nd:YAG laser and 20% TCA are effective in the treatment of KP. CLINICAL TRIAL REGISTRATION: Name of the trial register: clinicaltrial.gov . Registration number: NCT04797663.

Structure and Magnetic Properties of a Nanosized Iron-Doped Bismuth Titanate Pyrochlore.

The nanosized (50-70 nm) pyrochlore Bi1.5Fe0.5Ti2O7-δ was prepared by a coprecipitation technique. Characterization of Bi1.5Fe0.5Ti2O7-δ was carried out by powder X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), Raman spectroscopy, Mössbauer spectroscopy, and magnetic susceptibility measurements. The study of Fe doping in Bi2Ti2O7 was performed by means of density functional theory (DFT) calculations. The nanosized Bi1.5Fe0.5Ti2O7-δ sample crystallizes in the structural type of pyrochlore (Fd3̅m). The distribution of Fe atoms over the sites of Bi and Ti was studied from DFT simulations and then confirmed by the XRD analysis and Mössbauer method. The local distribution, electronic structure, and magnetic behavior of nanosized Bi1.5Fe0.5Ti2O7-δ are determined by the local microstructure of the metastable nanosized sample. Based on the examination of the Mössbauer spectrum of the Bi1.5Fe0.5Ti2O7-δ nanopowder, the following states of oxidation were revealed for iron atoms: Fe4+ in the titanium sites with a fraction of ∼5.7% and two states of Fe3+ (in the Bi and Ti sites) with different geometries of the oxygen surrounding. The ratio of Fe3+ distributed over the sites correlates well with the distribution in the ceramic sample. The presence of Fe4+ was found only in the nanosized Bi1.5Fe0.5Ti2O7-δ. The experimental effective magnetic moment of Fe atoms in the nanosized Bi1.5Fe0.5Ti2O7-δ appeared noticeably lower than that in the ceramic sample. The temperature dependence of µeff within the temperature range of 50-300 K is adequately described by the model of coexistence of Fe3+ and Fe4+ and the existence of clusters.

Current State and Challenges of the Global Outcomes of Dental Caries Research in the Meta-Omics Era.

Despite significant healthcare advances in the 21st century, the exact etiology of dental caries remains unsolved. The past two decades have witnessed a tremendous growth in our understanding of dental caries amid the advent of revolutionary omics technologies. Accordingly, a consensus has been reached that dental caries is a community-scale metabolic disorder, and its etiology is beyond a single causative organism. This conclusion was based on a variety of microbiome studies following the flow of information along the central dogma of biology from genomic data to the end products of metabolism. These studies were facilitated by the unprecedented growth of the next- generation sequencing tools and omics techniques, such as metagenomics and metatranscriptomics, to estimate the community composition of oral microbiome and its functional potential. Furthermore, the rapidly evolving proteomics and metabolomics platforms, including nuclear magnetic resonance spectroscopy and/or mass spectrometry coupled with chromatography, have enabled precise quantification of the translational outcomes. Although the majority supports 'conserved functional changes' as indicators of dysbiosis, it remains unclear how caries dynamics impact the microbiota functions and vice versa, over the course of disease onset and progression. What compounds the situation is the host-microbiota crosstalk. Genome-wide association studies have been undertaken to elucidate the interaction of host genetic variation with the microbiome. However, these studies are challenged by the complex interaction of host genetics and environmental factors. All these complementary approaches need to be orchestrated to capture the key players in this multifactorial disease. Herein, we critically review the milestones in caries research focusing on the state-of-art singular and integrative omics studies, supplemented with a bibliographic network analysis to address the oral microbiome, the host factors, and their interactions. Additionally, we highlight gaps in the dental literature and shed light on critical future research questions and study designs that could unravel the complexities of dental caries, the most globally widespread disease.

Chest CT Total Severity Score on Admission to Predict In-Hospital Mortality in COVID-19 Patients with Acute and Chronic Renal Impairment.

Aim: To identify the predictors of in-hospital mortality in patients with coronavirus disease of 2019 (COVID-19) and acute renal impairment (ARI) or chronic kidney disease (CKD), and to evaluate the performance and inter-reader concordance of chest CT total severity scores (TSSs). Methods: This retrospective single-center study was conducted on symptomatic COVID-19 patients with renal impairment (either acute or chronic) and a serum creatinine of >2 mg/dL at the time of admission. The patients' demographic characteristics, clinical data, and laboratory data were extracted from the clinical computerized medical records. All chest CT images obtained at the time of hospital admission were analyzed. Two radiologists independently assessed the pulmonary abnormalities and scored the severity using CT chest total severity score (TSS). Univariate logistic regression analysis was used to determine factors associated with in-hospital mortality. A receiver operating characteristic (ROC) curve analysis was performed for the TSS in order to identify the cut-off point that predicts mortality. Bland−Altman plots were used to evaluate agreement between the two radiologists assessing TSS. Results: A total of 100 patients were included, with a mean age of 60 years, 54 were males, 53 had ARI, and 47 had CKD. In terms of in-hospital mortality, 60 patients were classified in the non-survivor group and 40 were classified in the survivor group. The mortality rate was higher for those with ARI compared to those with CKD (p = 0.033). The univariate regression analysis showed an increasing odds of in-hospital mortality associated with higher respiratory rate (OR 1.149, 95% CI 1.057−1.248, p = 0.001), total bilirubin (OR 2.532, 95% CI 1.099−5.836, p = 0.029), lactate dehydrogenase (LDH) (OR 1.001, 95% CI 1.000−1.003, p = 0.018), CRP (OR 1.010, 95% CI 1.002−1.017, p = 0.012), invasive mechanical ventilation (MV) (OR 7.667, 95% CI 2.118−27.755, p = 0.002), a predominant pattern of pulmonary consolidation (OR 21.714, 95% CI 4.799−98.261, p < 0.001), and high TSS (OR 2.082, 95% CI 1.579−2.745, p < 0.001). The optimum cut-off value of TSS used to predict in-hospital mortality was 8.5 with a sensitivity of 86.7% and a specificity of 87.5%. There was excellent interobserver agreement (ICC > 0.9) between the two independent radiologists in their quantitative assessment of pulmonary changes using TSS. Conclusions: In-hospital mortality is high in COVID-19 patients with ARI/CKD, especially for those with ARI. High serum bilirubin, a predominant pattern of pulmonary consolidation, and TSS are the most significant predictors of mortality in these patients. Patients with a higher TSS may require more intensive hospital care. TSS is a reliable and helpful auxiliary tool for risk stratification among COVID-19 patients with ARI/CKD.

Evaluation of needling/microneedling as an adjunct to phototherapy in the treatment of stable acral vitiligo: a comparative clinical and immunohistochemical study.

OBJECTIVES: To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to NB-UVB phototherapy in the treatment of stable refractory patches of acral vitiligo, based upon clinical and immunohistochemical assessment of melanocyte count and distribution in response to needling/microneedling. MATERIALS AND METHODS: Twenty patients with stable acral vitiligo (≥2 patches) were enrolled. One of the two index patches was randomized to receive needling or microneedling in conjunction with NB-UVB. Patients received phototherapy sessions 3 times weekly, while needling was carried out on biweekly basis for 6 months. Assessment was done clinically using point counting method, VESTA, and global patients' satisfaction, and immunohistochemically by quantitative assessment of melanocyte count by Melan-A. RESULTS: No statistically significant difference was observed between NB-UVB monotherapy and either of the combined therapy regimens as regards the mean percentage change in vitiligo surface area (p = .451), mean change in absolute melanocyte count from baseline (p = .589), and mean VESTA (p = .916). Patches subjected to adjuvant microneedling/needling were afflicted by koebnerization in 50% and 20% of cases, respectively. CONCLUSION: Neither microneedling nor needling appear to confer an added therapeutic value to NB-UVB phototherapy in the treatment of stable acral vitiligo. Moreover, both carry the risk of koebnerization.

"It All Depends": Patient and Decision Partner Experiences in Cancer Clinical Trial Decision-Making.

While the supporting role of families and friends has been widely recognized in cancer care, little data exist on how they influence patients' decisions regarding clinical trial participation, accounting for patients' decisional preferences. The goal of our study was to examine the process of clinical trial decision-making from the perspective of adults with cancer and their decision partners. Semi-structured interviews were conducted with 12 patients and 12 decision partners-family and friends engaged in the medical decision-making. Themes included: (1) having the ability and confidence to make decisions; (2) gaining insight about clinical trials; (3) trusting someone in the process; and (4) realizing readiness and context. Our findings will enhance understanding of how patients make clinical trial decisions based on decisional preferences from the perspectives of patients and decision partners. The findings may also help to increase clinician awareness and inclusion of decision partners in conversations regarding clinical trials.