Validating self-reported Toxic Release Inventory data using Benford's Law: investigating toxic chemical release hazards in floodplains.

Introduction: Acute and long-term health impacts from flooding related toxic chemical releases are a significant local health concern and can disproportionately impact communities with vulnerable populations; reliable release data are needed to quantify this hazard. Methods: In this paper, we analyze US Federal Emergency Management Agency designated floodplain data and US Environmental Protection Agency Toxic Release Inventory (TRI) data to determine if geographically manipulated databases adhere to Benford's Law. Results: We investigated multiple variants and discovered pollution releases adhere to Benford's Law and tests which thereby validates the self-reported toxic release dataset. Discussion: We find that Benford's Law applies to self-reported toxic chemical release and disposal data, indicating a lack of widespread data errors or manipulation.

Xenografted human iPSC-derived neurons with the familial Alzheimer's disease APPV717I mutation reveal dysregulated transcriptome signatures linked to synaptic function and implicate LINGO2 as a disease signaling mediator.

Alzheimer's disease (AD) is the most common cause of dementia, and disease mechanisms are still not fully understood. Here, we explored pathological changes in human induced pluripotent stem cell (iPSC)-derived neurons carrying the familial AD APPV717I mutation after cell injection into the mouse forebrain. APPV717I mutant iPSCs and isogenic controls were differentiated into neurons revealing enhanced Aß42 production, elevated phospho-tau, and impaired neurite outgrowth in APPV717I neurons. Two months after transplantation, APPV717I and control neural cells showed robust engraftment but at 12 months post-injection, APPV717I grafts were smaller and demonstrated impaired neurite outgrowth compared to controls, while plaque and tangle pathology were not seen. Single-nucleus RNA-sequencing of micro-dissected grafts, performed 2 months after cell injection, identified significantly altered transcriptome signatures in APPV717I iPSC-derived neurons pointing towards dysregulated synaptic function and axon guidance. Interestingly, APPV717I neurons showed an increased expression of genes, many of which are also upregulated in postmortem neurons of AD patients including the transmembrane protein LINGO2. Downregulation of LINGO2 in cultured APPV717I neurons rescued neurite outgrowth deficits and reversed key AD-associated transcriptional changes related but not limited to synaptic function, apoptosis and cellular senescence. These results provide important insights into transcriptional dysregulation in xenografted APPV717I neurons linked to synaptic function, and they indicate that LINGO2 may represent a potential therapeutic target in AD.

Frankincense-Based Functionalized Multiwalled Carbon Nanotubes with Iron Oxide Composites for Efficient Removal of Crystal Violet: Kinetic and Equilibrium Analysis.

In this study, novel adsorbents were developed by functionalizing multiwalled carbon nanotubes with frankincense (Fr-fMWCNT) and adding iron oxide (Fe3O4) to the adsorbent (Fr-fMWCNT-Fe3O4). The morphology, surface characteristics, and chemical nature of the synthesized samples were analyzed by using various characterization techniques. The prepared adsorbents were then applied for the elimination of the toxic dye, crystal violet (CV), from water-based solutions by employing a batch adsorption method. The effectiveness of materials for the adsorption of CV was investigated by tuning various effective experimental parameters (adsorbent dosage, dye quantity, pH, and contact time). In order to derive adsorption isotherms, the Langmuir and Freundlich adsorption models were investigated and compared. The Fr-fMWCNT and Fr-fMWCNT-Fe3O4 were found to remove 85 and 95% of the CV dye within 30 min of the adsorption experiment at pH 6, respectively. It was found that a pseudo-second-order reaction rate was consistent with the experimental adsorption kinetics. The equilibrium data demonstrated that the Langmuir model adequately explained the adsorption behavior of the CV dye on the Fr-fMWCNT and Fr-fMWCNT-Fe3O4 surfaces, respectively. According to the Langmuir study, the highest adsorption capacities of the dye are 434 mg/g for Fr-fMWCNT and 500 mg/g for Fr-fMWCNT-Fe3O4. Remediation of the CV dye using our novel composite materials has not been reported previously in the literature. The synthesized Fr-fMWCNT and Fr-fMWCNT-Fe3O4 adsorbents can be economical and green materials for the adsorptive elimination of CV dye from wastewater.

Microwave-assisted synthesis of Limonia acidissima Groff gum stabilized palladium nanoparticles for colorimetric glucose sensing.

Herein, we present a novel microwave-assisted method for the synthesis of palladium nanoparticles (PdNPs) supported by Limonia acidissima Groff tree extract gum. The synthesized PdNPs were characterized using various analytical techniques, including FTIR, SEM, TEM, UV-visible, and powder XRD analyses. TEM and XRD analysis confirmed that the synthesized LAG-PdNPs are highly crystalline nature spherical shapes with an average size diameter of 7-9 nm. We employed these gum-capped PdNPs to investigate their peroxidase-like activity for colorimetric detection of hydrogen peroxide (H2O2) and glucose. The oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) by H2O2, catalyzed by PdNPs, produces oxidation products quantified at 652 nm using spectrophotometry. The catalytic activity of PdNPs was optimized with respect to temperature and pH. The developed method exhibited a linear range of detection from 1 to 50 µm, with detection limits of 0.35 µm for H2O2 and 0.60 µm for glucose.

Prevention of suicides associated with global warming: perspectives from early career psychiatrists.

Climate change poses significant challenges to global mental health, with potential consequences including increased rates of suicide and mental health disorders. Early Career Psychiatrists (ECPs) play a crucial role in addressing these challenges. The Climate Psychiatry Alliance, a group of psychiatrists dedicated to improving mental health amidst climate change, recognizes the importance of cultivating climate-aware ECPs. Training ECPs to become confident climate-aware clinicians enables them to effectively treat patients experiencing anxiety, depression, and PTSD in the context of climate-related distress. Together with other mental health professionals, ECPs can contribute to efforts by implementing strategies for monitoring and treating mental health problems arising from climate events. Additionally, they can raise awareness about the psychological consequences and risks of suicide associated with climate change. Collaboration among ECPs from various regions is essential in developing community-based approaches and reducing vulnerabilities. ECPs must prioritize supporting vulnerable populations by advocating for increased funding for mental health support and research in affected areas. Long-term solutions to address the mental health impacts of climate change and global warming should be pursued to mitigate future suicidality. Integrating climate considerations into local mental health programs and expanding psychological support services is crucial. By promoting emotional resilience and self-awareness, ECPs can contribute to building a more climate-resilient and mentally healthy society.

The landscape of actionable genomic alterations in lung adenocarcinomas in India.

Lung adenocarcinoma (LUAD), the most prevalent form of non-small cell lung cancer (NSCLC), remains a leading cause of cancer-related death globally, including in India, with a 5-year survival rate below 10%. Despite these grim statistics, recent advances in the use of next-generation sequencing (NGS) for identifying genetic alterations and the emergence of targeted therapies have opened new possibilities for personalized treatment based on distinct molecular signatures. To understand the molecular pattern of NSCLC, a retrospective study was conducted with 53 Indian LUAD patient samples, using a targeted NGS panel of 46 cancer-relevant oncogenes to identify clinically relevant variants. Pathogenic or likely pathogenic variants were detected in 94% of the 53 cases. Non-synonymous mutations, rearrangements, copy number alterations, insertions, and deletions of functional relevance were observed in 31 out of 46 genes. The most frequently mutated genes included TP53 (52.8%) and EGFR (50.9%), followed by RET, PIK3CA and ERBB2; some patients had multiple alterations in the same gene. Gender-based enrichment analysis indicated that ALK and IDH2 alterations were more prevalent in females, while TP53 and PTEN were more common in males. No significant correlation was found between mutations and other clinicopathological attributes, such as age, stage, and subtype. A higher prevalence of EGFR, RET, PIK3CA, ERBB2 and ALK mutations were observed compared to previous LUAD genetic studies coupled with a lower frequency of KRAS mutations. Clinically actionable variants were annotated using OncoKB and categorized into the four therapeutic levels based on their clinical evidence. Seventy-nine percent of cases had at least one clinically actionable alteration. Most patients (39.6%) had the highest level of actionability (Level 1) wherein an FDA-approved drug is available specifically for the observed mutation in lung cancer patients. EGFR Exon19 in-frame deletions and EGFR L858R were the most frequent among targetable variants (20.7%). These findings emphasize the importance of a selective NGS panel in enabling personalized medicine approaches by identifying actionable molecular alterations and informing the choice of targeted therapy for more effective treatment options in Indian NSCLC patients.

Oncology Physician Workforce Diversity: Rationale, Trends, Barriers, and Solutions.

ABSTRACT: This chapter will discuss (1) the rationale for physician workforce diversity and inclusion in oncology; (2) current and historical physician workforce demographic trends in oncology, including workforce data at various training and career levels, such as graduate medical education and as academic faculty or practicing physicians; (3) reported barriers and challenges to diversity and inclusion in oncology, such as exposure, access, preparation, mentorship, socioeconomic burdens, and interpersonal, structural, systemic bias; and (4) potential interventions and evidence-based solutions to increase diversity, equity, and inclusion and mitigate bias in the oncology physician workforce.

Atypical Electrocardiogram in Acute Pericarditis: A Case Report.

Pericarditis is a disorder defined by inflammation of the pericardium, commonly presenting with chest pain, fever, and pericardial friction. Electrocardiography (EKG) is frequently utilized to diagnose pericarditis, as it frequently reveals particular changes like ST-segment elevations and PR-segment depressions. Nevertheless, there are cases where individuals show all symptoms of pericarditis yet present an atypical or irregular EKG. This case report intends to highlight the case of a patient who came to an outpatient medical facility with all the common symptoms of pericarditis yet presented an atypical electrocardiogram. Moreover, this report intends to look into the hypothesis that in patients showing symptoms of pericarditis but with an atypical EKG, we might be looking at an irregular or even non-specific variant of pericarditis. This highlights the value of an extensive diagnostic approach consisting of high-quality imaging studies, such as transthoracic echocardiography, as well as medical assessments if an EKG does not give definite proof of pericarditis.

Association of Medicare Program Type with Health Care Access, Utilization, and Affordability among Cancer Survivors.

BACKGROUND: The Medicare Advantage program provides care to nearly half of Medicare beneficiaries, including a rapidly growing population of cancer survivors. Despite its increased adoption, it is still unknown whether or not the program improves healthcare access, outcomes, and affordability for cancer survivors. METHODS: We performed a cross-sectional study of Medicare beneficiaries aged ≥ 65 years with a self-reported history of cancer from the 2019 National Health Interview Survey. We used multivariable logistic regression to evaluate the association between Medicare program type (Medicare Advantage vs. traditional Medicare) and measures of healthcare access, acute care utilization, and affordability. RESULTS: We identified 4451 beneficiaries with a history of cancer, corresponding to 26.6 million weighted cancer survivors in 2019. Of the beneficiaries, 35.8% were enrolled in Medicare Advantage, whereas 64.2% were enrolled in traditional Medicare. The age, sex, racial and ethnic composition, household income, primary site of cancer, and comorbidity burden of Medicare Advantage and traditional Medicare beneficiaries were similar. In the adjusted analysis, there were no differences in healthcare access or acute care utilization between traditional Medicare and Medicare Advantage beneficiaries. However, cancer survivors enrolled in Medicare Advantage were more likely to worry about (34.3% vs. 29.4%; aOR, 1.3 (95% CI, 1.1-1.5)) or have problems paying (13.6% vs. 11.1%; aOR, 1.4 (95% CI, 1.1-1.8)) medical bills. CONCLUSIONS: We found no evidence that Medicare Advantage beneficiaries with cancer had better healthcare access, affordability, or acute care utilization than traditional Medicare beneficiaries did. Furthermore, Medicare Advantage beneficiaries were more likely to report financial strain and have difficulty paying for their medical bills than were those with traditional Medicare. Despite the generous benefits and attractive incentives, Medicare Advantage plans may not be more cost-effective than traditional Medicare is for cancer survivors. Our study informs ongoing congressional deliberations to re-evaluate the role of Medicare Advantage in promoting equity among beneficiaries with cancer.

Enhancing Cu2+ Ion Removal: An Innovative Approach Utilizing Modified Frankincense Gum Combined with Multiwalled Carbon Tubes and Iron Oxide Nanoparticles as Adsorbent.

Aquatic pollution, which includes organic debris and heavy metals, is a severe issue for living things. Copper pollution is hazardous to people, and there is a need to develop effective methods for eliminating it from the environment. To address this issue, a novel adsorbent composed of frankincense-modified multi-walled carbon nanotubes (Fr-MMWCNTs) and Fe3O4 [Fr-MWCNT-Fe3O4] was created and subjected to characterization. Batch adsorption tests showed that Fr-MWCNT-Fe3O4 had a maximum adsorption capacity of 250 mg/g at 308 K and could efficiently remove Cu2+ ions over a pH range of 6 to 8. The adsorption process followed the pseudo-second-order and Langmuir models, and its thermodynamics were identified as endothermic. Functional groups on the surface of modified MWCNTs improved their adsorption capacity, and a rise in temperature increased the adsorption efficiency. These results highlight the Fr-MWCNT-Fe3O4 composites' potential as an efficient adsorbent for removing Cu2+ ions from untreated natural water sources.

Chloroquine-Based Mitochondrial ATP Inhibitors.

Mitochondria is an important drug target for ailments ranging from neoplastic to neurodegenerative diseases and metabolic diseases. Here, we describe the synthesis of chloroquine analogs and show the results of mitochondrial ATP inhibition testing. The 2,4-dinitrobenzene-based analogs showed concentration-dependent mitochondrial (mito.) ATP inhibition. The most potent mito. ATP inhibitor was found to be N-(4-((2,4-Dinitrophenyl)amino)pentyl)-N-ethylacetamide (17).

Factors influencing road traffic accidents causing maxillofacial injuries in Nalgonda District: prospective survey of 366 cases.

BACKGROUND: Road traffic accidents are the leading etiological factor for maxillofacial trauma in India. The incidence of these accidents is impacted by various cultural, socioeconomic, and behavioral factors the understanding of which is paramount in assessing their importance in influencing the incidence of maxillofacial injuries. METHODS: Data was collected via a questionnaire from 366 patients who reported with maxillofacial injuries due to Road Traffic Accidents to the casualty and maxillofacial OPD at a tertiary center in the Nalgonda District over a five-year period. Data collected included patient details, type of vehicle involved, speed of the vehicle, type of accident, location of the accident, the seating of the patient, presence of alcohol influence, usage of helmet or seatbelt and the injuries sustained by the patient. Statistical analysis was done using Chi squared test. RESULTS: 88.5%of the patients were male and 87.4% of the cases were injured in RTA involving two-wheeler vehicles. (50.3%) of the accidents took place between 6 pm to 12 am. 41.5% of cases reported their speed at the time of the accident as 40- 60 kmph. 42% of accidents were reported as skid accidents. 70.29% of accidents on rural roads occurred at night (between 6 pm and 6 am) as opposed to 29.71% during the day. Only 4.37% of cases reported wearing seatbelts or helmets. 51.17% of the participants who were driving reported or were observed as being under the influence of alcohol. CONCLUSIONS: The poor conditions of the roads, the lack of use of protective measures while driving, and the high incidence of driving under the influence of alcohol were seen to be the most significant contributing factors to road traffic accidents causing maxillofacial injuries in the Nalgonda population.

Suicide in the context of infodemic during COVID-19 pandemic: A global perspective.

Surges of technology use along with limited interpersonal interactions have led to the amplification and dissemination of false information during the COVID-19 pandemic. Infodemic refers to an overabundance of information that may have increased burden of covid-19 pandemic and mental disorder. Given the rise of suicide behavior during the pandemic, infodemic has been considered as a risk of suicidal behavior. The aim of this article is to address suicide in the context of infodemic and provide some strategy to adjust the impact of infodemic on mental health.

An Unusual Presentation of Vitamin B12 Deficiency Associated With Massive Splenomegaly, Hemolytic Anemia, and Pancytopenia: A Case Report.

Deficiency of vitamin B12 usually presents with symptoms of anaemia or neurological dysfunction. We report a case of a young lady who was found to be vitamin B12 deficient with massive splenomegaly, haemolytic anaemia, and pancytopenia. She was thoroughly investigated for other causes of similar presentation. Her symptoms and blood count drastically improved after two weeks of therapy with vitamin B12 supplementation. After reviewing the literature on unusual cases of vitamin B12 deficiency, our case is a very interesting read as it serves as a reminder for health care providers to be alert for these manifestations, which can be treated by simply replacing vitamin B12.

Coupling of acceptor-substituted diazo compounds and tertiary thioamides: synthesis of enamino carbonyl compounds and their pharmacological evaluation.

This paper describes the synthesis of enamino carbonyl compounds by the copper(i)-catalyzed coupling of acceptor-substituted diazo compounds and tertiary thioamides. We plan to use this method to synthesize indolizidine (-)-237D analogs to find α6-selective antismoking agents. Therefore, we also performed in silico α6-nAchRs binding studies of selected products. Compounds with low root-mean-square deviation values showed more favorable binding free energies. We also report preliminary pharmacokinetic data on indolizidine (-)-237D and found it to have weak activity at CYP3A4. In addition, as enamino carbonyl compounds are also known for antimicrobial properties, we screened previously reported and new enamino carbonyl compounds for antibacterial, antimicrobial, and antifungal properties. Eleven compounds showed significant antimicrobial activities.

An efficient biosynthesis of palladium nanoparticles using Bael gum and evaluation of their catalytic and antibacterial activity.

We report a facile microwave-assisted synthesis of palladium nanoparticles (PdNPs) using Bael gum (BG) and it's carboxymethylated (CMBG) derivative. The prepared nanoparticles (BG@PdNPs and CMBG@PdNPs) were evaluated for antibacterial and catalytic activity in the reduction of organic dye pollutants. The developed synthetic method is simple, low cost and eco-friendly, wherein the process requires no additional reducing or capping agents. The CMBG was prepared via etherification reaction between BG and monochloroacetic acid using Williamson synthesis method. The PdNPs were synthesized using BG and CMBG as stabilizers and reducing agents. The PdNPs were found to be well dispersed spherical, with the crystalline size of the order of 7-21 nm. The results showed that the CMBG@PdNPs were smaller in size (7 ± 2 nm) than those capped with BG@PdNPs (10 ± 2 nm). The catalytic ability of CMBG@PdNPs was examined for the reduction of Methyl Orange (MO), Methyl Red(MR), and Rhodamine-B (RhB) in the presence of NaBH4. The results showed that CMBG@PdNPs exhibited a higher catalytic ability than BG@PdNPs. Moreover, it was found that CMBG@PdNPs served several times as a retrievable and reusable catalyst which is stable even after six cycles of reaction. The CMBG@PdNPs and BG@PdNPs showed excellent antibacterial activity. The results indicate that CMBG@PdNPs have greater potential application as a catalyst in the reduction of organic pollutants and antibacterial activity.

Pediatric musculoskeletal pathologies: are there differences in triage of diagnoses and preferences for communication between radiology and orthopedics?

OBJECTIVE: To define the clinical importance of various pediatric musculoskeletal diagnoses, determine preferred communication methods based on the acuity level of findings, and investigate differences between specialties utilizing the Delphi methodology. METHODS: Radiologists, orthopedic surgeons, and sports-medicine pediatricians at a tertiary children's hospital were surveyed (n = 79) twice using REDCap (Research Electronic Data Capture). Surveys were conducted anonymously and at least 1 year apart, first eliciting all potentially non-routine findings and various communication methods (round 1), and later categorizing the acuity (emergent, urgent, or non-urgent) of different diagnosis categories and selecting the preferred communication method (verbal, written electronic messages, and report) and timeframe (round 2). Chi-square, Fisher's exact, and Kruskal-Wallis H tests were used to compare variables between specialties. RESULTS: Round 1 produced 267 entries for non-routine findings (grouped into 19 diagnoses) and 71 for communication methods (grouped into 3 categories). Round 2 found no significant difference in the acuity assignments for the 19 predetermined diagnoses (p = 0.66) between the 3 specialties; however, there was reduced agreement for the top urgent diagnoses within and between specialties. Most pediatricians preferred written electronic messages. The preferred communication timeframe for urgent diagnoses was significantly different (< 2 h for pediatricians, < 4 h for radiologists, and < 8 h for surgeons; p = 0.003) between specialties whereas no difference was found for emergent (p = 1) and non-urgent diagnoses (p = 0.80). CONCLUSION: Acuity assignment for the 19 pediatric-specific musculoskeletal diagnoses was not significantly different between specialties, but the preferred communication timeframe for urgent diagnoses was significantly different, ranging between 2 and 8 h.