In this paper, we use the concept of $q$-calculus in geometric function theory. For some $\alpha$, $\alpha\in [0,1)$, we consider normalized analytic functions $f$ such that $f’(z)/{\rm d}_qf(z)$ lies in half-plane $\{w:\mathfrak {Re}\ w>\alpha\}$ for all $z$, $|z|< 1$. Here ${\rm d}_q$ is the Jackson $q$-derivative operator well-known in the $q$-calculus theory. The paper is devoted to the coefficient problems of such functions for real and for complex numbers $q$. Coefficient bounds are of particular interest, because of them some geometrical properties of the function can be obtained.

Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of the health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers for the provision of these services in Saudi Arabia. Materials & Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services, and barriers for practising public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counselling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunisation. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in Asir region have intermediate to minimal engagement in practicing their public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

20 y/o male with history of Hodgkin’s lymphoma in remission, anxiety, and depression, presented with chills, fatigue, nausea, pruritus, greasy stools, and dark urine.He had started Ashwagandha supplemntation based on recommendations by his psychiatric provider. After discontinuation, his symptoms resolved illustrating the herbs potential to cause cholestatic jaundice.

Aridity and intensive grazing have been confirmed to affect the facilitative effects of dryland shrubs. However, their combined effects on plant-plant interactions have rarely been tested. To test how these two factors affect relations between plants, we analyzed 144 plots (under shrub canopy vs. open areas) at 12 sampling areas established in the conditions of two grazing regimes (high grazing vs. low grazing intensity) and two different climatic regions (arid vs. semi-arid) in northeastern Iran. A dominant shrub, Artemisia kopetdaghensis, was selected as the model species. Further, we studied changes in plant life strategies along the combined grazing and aridity stress gradients. We used relative interaction indices to test the outcomes of plant-plant interactions, calculated for species richness, Shannon diversity and species abundances. Then we compared them using linear mixed-effect models (LMM). The indicator species analysis was used to identify species typical for the under-canopy of shrub and for the adjacent open areas. The combination of stress factors affected the type and intensity of plant-plant interactions and plant life strategies (CSR) of the indicator species. Artemisia kopetdaghensis showed the highest facilitation effect under the most intensive stress conditions (high aridity/high grazing), which turned into competition under the low stress conditions (low aridity/low grazing). In the arid region, the canopy of shrub protected ruderal annual forbs and grasses with SR and R-strategy, respectively, in both high (high aridity/high grazing) and low grazing intensity (high aridity/low grazing). In the semi-arid region and high grazing intensity (low aridity/high grazing), the shrubs protected perennial forbs with C-strategy. Our FINDINGS highlight the importance of context-dependent shrub management in the restoration of vegetation damaged by intensive grazing.

Research dissemination has become a significant concern for linking scientific evidence with practice. Universities and research centres are a seedbed for new and emerging research. Research dissemination practices about nutrition and diet must increase through health promotion and education given the concerning global prevalence of diseases related to nutrition and diet. We constructed a research dissemination framework for use in the disciplines of nutrition and dietetics, or other areas with clinical components. The designed framework consists of tools to improve communication of research, links with key departments to increase outreach, and impact measures. This framework provides a tailored, cost-effective and sustainable way to measurably increase the use by research staff of resources to disseminate their findings to key stakeholders in clinical practice and research institutions. This also has the potential to be adopted by academics and researchers so that the end-users such as health professionals, policymakers and public health authorities can be reached. The increased uptake of research outputs can inform health education and promotion strategies that benefit wider society given the concerning global prevalence of diseases related to nutrition and diet. 2

Introduction: The Spanish Society of Immunology recently warned that a history of past COVID-19 could result in a higher incidence of adverse events (AEs) related to vaccination. We set out to analyze whether there were any differences in AEs between healthcare workers vaccinated for COVID-19 (either after the first or second dose) who had had a prior diagnosis SARS-CoV-2 infection compared to those who had not had COVID-19 before vaccination. Methods: This was a retrospective cohort study in a population of healthcare workers. AEs related to the first and second doses of the Pfizer vaccine were recorded. We compared the incidence of AEs and compared individuals with 0–3 different AEs to those with 4 or more AEs. The relative risks (RR) and their 95% confidence intervals were calculated. Results: Past infection was associated with having more AEs after the first dose (p < 0.001), but not the second one (p = 0.476), as well as a higher incidence of AEs (p < 0.001). Common AEs that were statistically associated with past COVID infection included arthralgia, asthenia, fever, chills, headache, and myalgia (p ≤ 0.001). The RR for having an increased absolute number of different AEs was 1.18 (95%CI [1.05, 1.33]) after the first dose and 1.05 (95%CI [0.96, 1.14]) after the second dose. Conclusions: Our results showed that the incidence of AEs was higher in individuals with a history of prior COVID-19 infection.

Coronavirus disease 2019 (COVID-19) is a fearsome infectious disease which cause some excessive complications along with it. the authors present a case of acute invasive rhino-orbital mucormycosis in a 62-year-old man with severe COVID-19 pneumonia, who had a history of uncontrolled diabetes mellitus along with ketoacidosis and nephropathy.

Introduction: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus (HCV) in the world. Aims: The aim of this study was to compare direct acting antivirals (DAAs) treatment of HCV for PWID and non-PWID in real life setting. Materials and methods: We performed a prospective, non-randomized, observational multi-center cohort study in 37 centers. All patients treated with DAAs therapy between April 1, 2017 to February 28, 2019 were included. In total, 2,713 patients were included in the study among which 250 were PWID and 2,463 were non-PWID. Besides patient characteristics, treatment response, follow-up and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: DAAs were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis.

1. Ecologically meaningful seed germination experiments are constrained by access to seeds and relevant environments for testing at the same time. This is particularly the case when research is carried out far from the native area of the studied species. 2. Here, we demonstrate an alternative - the use of glass houses in botanic gardens as simulated-natural habitats to extend the ecological interpretation of germination studies. Our focal taxa were banana crop wild relatives (Musa acuminata subsp. burmannica, M. acuminata subsp. siamea and M. balbisiana), native to tropical and subtropical Southeast Asia. Tests were carried out in Belgium, where we performed germination tests in relation to exposure to sun and foliage-shading, seed burial-depth in different heated glass house compartments, as well as seed survival and dormancy release in the soil. We anchored the interpretation of these studies by also conducting an experiment in a semi-natural habitat in the species native range (M. balbisiana - Los Baños, the Philippines), where we tested germination responses to exposure to the sun and shade. Using temperature data loggers, we determined temperature dynamics suitable for germination in both these settings. 3. In semi-natural and simulated-natural habitats, seeds germinated in response to exposure to direct solar radiation. Seed burial-depth had a significant but marginal effect by comparison, even when seeds were buried to 7cm in the soil. Temperatures at sun-exposed compared to shaded environments differed by only a few degrees Celsius. Maximum temperature of the period prior to germination was the most significant contributor to germination responses and germination increased linearly above a threshold of 23°C to the maximum temperature in the soil (in simulated natural habitats) of 35°C. 4. Glass houses can provide useful environments to aid interpretation of seed germination responses to environmental niches.

Gastric MALT lymphoma is a common type of non-Hodgkin's lymphoma that has the potential for cure in patients found to have concomitant Helicobacter pylori infection.1,2 This case report explores the evaluation, diagnosis, and treatment of H. pylori negative MALT lymphoma in a patient with a history of a RYGB.

The use of pesticides for suicide commitment purposes is a major problem. The present study reports a death due to committing suicide using combination of diazinon, Chlorpyrifos, Trifluralin, Fenpropathrin, Pyriproxyfen, and Cypermethrin. It is difficult to diagnose and treat patients poisoned with a combination of pesticides.

A document by Belen Nigro. Click on the document to view its contents.

Staphylococcus hyicus (S. hyicus) is a rare, likely zoonotic infective organism. Clinically significant human infection by S. hyicus has only been recorded 3 times, where it has caused infections including cellulitis, osteomyelitis/spondylodiscitis and septicemia. (1-3). Hereafter, the case summary describes the first documented case of endocarditis due to S. hyicus.

The morphological variations when one, or both, of the atrial chambers is subdivided, are many and varied. We present a synthesis of 198 published investigations of this “family” of uncommon lesions. Almost three-quarters of patients with divided atrial chambers present during infancy with severe pulmonary hypertension and cardiac failure. Associated cardiac and extra-cardiac defects are present in between half and nine-tenths of cases. Acquired division of the left atrium has been reported after the Fontan operation, orthotopic cardiac transplantation, and complicated aortic valvar infective endocarditis. Surgery under cardiopulmonary bypass remains the definitive treatment. Balloon dilation may be considered in anatomically compatible variants in the setting of cardiac failure and pregnancy as a bridge to definitive treatment. Overall, mortality has been cited between nil to 29%. Presentation during infancy, associated congenital anomalies, pulmonary hypertension, and surgery in the previous era, have been the reported causes of death. The operative survivors have long-term favourable outcomes, with near normal cardiac dimensions and low risk of recurrence. While asymptomatic patients with division of the right atrium do not need treatment, surgical resection of the dividing partition under cardiopulmonary bypass is recommended in symptomatic patients with complex anatomy, the spinnaker malformation, or associated cardiac anomalies. Balloon dilation may be considered in uncomplicated patients with less obstructive lesions. Hybrid intervention and endoscopic robotic correction also have been performed. We submit that an increased appreciation of the anatomic background to division of the atrial chambers will contribute to improved surgical management.

A 47-year-old man, with a history of aortic valve replacement 28 years earlier, was admitted to the emergency department with a right cervical mass and a superior vena cava syndrome. Thoracic angio-CT revealed a giant ascending aorta aneurysm, with an intramural thrombus and dissection flap, compressing the superior vena cava. Emergency surgery was performed, confirming those findings. The dissection had ruptured but was contained by surrounding structures, creating a false-aneurysm that compressed the superior vena cava. The aneurysm was excluded and the aorta was replaced by a Dacron conduit, thereby decompressing the upper mediastinum. The patient made an uneventful recovery.

Understanding vegetation evaluation is critical for exploring changes in terrestrial ecosystems and identifying upcoming challenges. However, analyses that simultaneously examine abrupt changes in vegetation greenness at the national, regional, biome and pixel scales in China are still rare. Using long-term (1982–2015) satellite time series data in conjunction with the Breaks for Additive Season and Trend (BFAST) technique, we identified breakpoints in the Normalized Difference Vegetation Index (NDVI) in China. Results showed that the annual mean NDVI gradually increased during the 34-year period. 68.8% of the vegetated area exhibited upward trends in NDVI, most of which was distributed in Southeast China and the Loess Plateau. Changes in NDVI trends occurred in 78.7% of the total vegetated areas, while hotspots were concentrated in Northwest and North China. A rapid increase in breakpoints was detected after 1999, mainly concentrated in North and Northwest China, and corresponding to the times and areas with the highest ecological engineering efforts. Positive shifts in NDVI trends were more common and generally distributed on the eastern side of the Hu Huanyong line, while browning (negative) shifts were mainly distributed on the western side and were gradually expanding, indicating a possible tendency towards environmental degradation. Although unstable vegetation areas had higher frequencies of breakpoints, the proportion of stable vegetation experiencing NDVI trend shifts was higher after 2000, probably because human intervention buffered external disturbances in unstable areas. Identifying hotspot areas of shifts in vegetation greenness can provide scientific reference for sustainable land development and carbon neutrality target achievements.

Historic climate changes had always driven geographical populations of coastal plants to contract and recover dynamically, even die out completely. Species suffering from such bottlenecks usually lose intraspecific genetic diversity, but how do these events influence population subdivision patterns of coastal plants? We investigated this question in the typical coastal plant: mangrove species Aegiceras corniculatum. Inhabiting the intertidal zone of the tropical and subtropical coast of the Indo-West Pacific oceans, its populations are deemed to be greatly shaped by historic sea-level fluctuations. Using dual methods of Sanger and Illumina Solexa sequencing, we found that the 18 sampled populations were structured into two groups, namely, the “Indo-Malayan” group, comprising three subgroups (the northern South China Sea, Gulf of Bengal, and Bali), and the “Pan-Australasia” group, comprising the subgroups of the southern South China Sea and Australasia. Based on simulations using the approximate Bayesian computation method, we inferred that the southern South China Sea subgroup, which penetrates the interior of the “Indo-Malayan” group, originated from the Australasia subgroup, accompanied by a severe bottleneck event, with a spot of gene flow from both the Australasia and “Indo-Malayan” groups. Geographical barriers such as the Sundaland underlie the genetic break between Indian and Pacific Oceans, but the discontinuity between southern and northern South China Sea was originated from genetic drift in the bottleneck event. Hence, we revealed a case evidencing that the bottleneck event promoted population subdivision. This conclusion may be applicable in other taxa beyond coastal plants.

Objectives: The objective of this study is to compare the Dinakara and Cotes equations in their ability to predict post hematopoietic stem cell transplant (HSCT) pulmonary complications and mortality. Hypothesis We hypothesize the pre-transplant diffusing capacity adjusted for hemoglobin (DLCOHgb) by the Cotes equation in pediatric patients undergoing HSCT will predict morbidity and mortality more accurately than the Dinakara equation. Study-Design: Data was collected retrospectively from chart review of patients who underwent their first HSCT at Riley Hospital for Children using a database maintained by the Pediatric Stem Cell Transplant Program. Patient-Subject Selection: Patients who performed pre-transplant diffusing capacity for carbon monoxide (DLCO) that met ATS criteria, and a hemoglobin recorded within 7 days of their pulmonary function testing were included. Methodology: Paired t-tests and ANOVA models were used to define any differences between the two equations at baseline and when stratifying by hemoglobin level. Logistic regression models were used to determine associations between the Dinakara and Cotes equation with mortality at one- and three-years post-transplant. Results: 90 patients underwent HSCT during the study period, and 69 patients met inclusion criteria. Odds ratios for mortality using DLCO corrected for the Dinakara (1.08 SD 0.98-1.19) and Cotes (1.09 SD 0.97-1.22) were similar (p-value > 0.05). Neither Dinakara or Cotes corrective equation was superior at predicting pulmonary complications. (p-values 0.1388 and 0.5246 respectively) Conclusions: The Dinakara and Cotes equations differed in their calculation of DLCOHgb at lower Hb levels, their ability to predict mortality and pulmonary complications after HSCT was not different.

Commentary

Background Ehlers-Danlos syndrome (EDS) is a disorder in the metabolism of fibrillary collagen. Its vascular type (vEDS) frequently develops arterial rupture and aortic dissection. Case presentation The patient was a 54-year-old gentleman who suffered from cardiac tamponade, malperfusion of the left carotid artery and the right lower extremity due to acute type A aortic dissection. Rupture of the aortic root and a huge entry located from the transverse arch to the proximal descending aorta were found. There were no significant deformities at aortic valve, so we tried extended repairs of valve sparing root replacement (VSRR) and total arch replacement (TAR) with frozen elephant trunk (FET) and were successfully performed. He was finally diagnosed as vascular Ehlers-Danlos syndrome (vEDS) by genetic examination. Conclusion Emergency extensive repairs of VSRR and TAR with FET for critical AAAD with rupture and malperfusion was successfully performed for a vEDS patient.

In this article, we investigate the multilinear distorted multiplier estimate (Coifman-Meyer type theorem) associated with the Schr\“{o}dinger operator $H=-\Delta + V$ in the framework of the corresponding distorted Fourier transform. Our result is the “distorted” analog of the multilinear Coifman-Meyer multiplier operator theorem in \cite{CM1}, which extends the bilinear estimates of Germain, Hani and Walsh’s in \cite{PZS} to multilinear case for all dimensions. As applications, we give the estimate of Leibniz’s law of integer order derivations for the multilinear distorted multiplier for the first time and we obtain small data scattering for a kind of generalized mass-critical NLS with good potential in low dimensions $d=1,2$.

Objective: We aimed to compare the effectiveness of esmolol (ESM) vs. dexmedetomidine (DEX) in the treatment of increased hemodynamic response during coronary artery bypass. Methods: Following the approval of the Local Committee Research and Ethics Health Research, a controlled randomized clinical trial, in patients undergoing elective coronary revascularization during off-pump coronary artery bypass surgery, was performed under standardized general anesthesia. Patients randomly received infusions of ESM 0,5 mg /kg or DEX 0,5 cg/kg/hr. Hemodynamic variables of study: heart rate and MAP were analyzed at different times: t1) baseline, t2) sternotomy, t3) time of coronary anastomosis and t4) sternal closure. Results: In group DEX, a statistic significance was found in the heart rate sternotomy (t2) p=0,004 and heart rate (t3= time of coronary anastomosis) p=0,026 and MAP during (t3) p=0,002. Conclusions: Although ESM and DEX attenuate hemodynamic response during coronary artery bypass, in the DEX group, hemodynamic stabilization was observed in heart rate and MAP during coronary artery bypass.

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