We reported the occurrence of a congenital unilateral huge peripapillary staphyloma in association with craniofacial clefts for the first time.

A 1-year-old boy presented with a large defect on his left eyelid, a wide oblique columella nasi and an atypical wedge-shaped extension of the unilateral anterior hairline. Magnetic resonance imaging (MRI) examinations revealed there were cracks on his nasal septum, palate, and superior alveolar midline. Moreover, we surprisingly uncovered a gourd-shaped eyeball with the compressed optic nerve on the right side, while the right eye seemed normal from appearance. Under anaesthesia, fundus examination of the right eye showed a 15 mm-deep excavation surrounding the optic disc with defective choroid and dysplastic optic papilla. We reconstructed the left eyelid of the patient to protect his cornea and would make other solutions according to the results of follow-up.

Peripapillary staphyloma and craniofacial clefts are two dissimilar rare congenital anomalies. In this patient, we firstly observed the co-existence of the two defects, which may provide the experience to the diagnosis and treatment of peripapillary staphyloma and craniofacial clefts. This case also gives us the pathogenic inspiration for further studies of peripapillary staphyloma and craniofacial clefts.

Peripapillary staphyloma and craniofacial clefts are two dissimilar rare congenital anomalies. In this patient, we firstly observed the co-existence of the two defects, which may provide the experience to the diagnosis and treatment of peripapillary staphyloma and craniofacial clefts. This case also gives us the pathogenic inspiration for further studies of peripapillary staphyloma and craniofacial clefts.A new phenylpropanoid, ligulaveitnoid A (1), along with four known compounds, (E)-2,3-dihydroconiferyl p-coumarate (2), dihydroconiferyl ferulate (3), 4-hydroxy-3-methoxybenzaldehyde (4) and (E)-p-coumaric acid (5) were isolated from rhizomes and roots of L. veitchiana. All the structures of compounds were identified by the interpretation of their spectroscopic data and comparison with those reported in the literature. The anti-inflammatory activity of the isolates was examined for their inhibitory effects on LPS-induced NO production in macrophage RAW264.7 cells. Among them, compound 2 showed strong inhibitory activities towards the LPS-induced NO production in macrophage RAW264.7 cells with IC50 value of 8.0 μM.

The coronavirus disease 2019 (COVID-19) pandemic laid bare the immediate need for primary palliative care education for many clinicians. Primary care clinicians in our health system reported an urgent need for support in advance care planning and end-of-life symptom management for their vulnerable patients. This article describes the design and dissemination of palliative care education for primary care clinicians using an established curriculum development method.

To develop a succinct and practical palliative care toolkit for use by primary care clinicians during the COVID-19 pandemic, focused on 2 key elements (i) advance care planning communication skills based on the narrative 3-Act Model and (ii) comfort care symptom management at the end of life.

The toolkit was finalized through an iterative process involving a team of end-users and experts in palliative care and primary care, including social work, pharmacy, nursing, and medicine. The modules were formatted into an easily navigable, smartphone- palliative care toolkit within 6 weeks.Traumatic brain injuries (TBIs) are a significant health problem, impacting millions of people every year. Although emerging evidence suggests that the composition of the gut microbiome is altered after TBI, no systematic review has been published on this topic. The objective of the present systematic review is to analyze publications that evaluate the impact of TBI on gut microbiome composition. Research articles were pulled from seven databases. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In order for publications to be eligible for this review, they had to (1) report on original human- or animal-subjects research, (2) evaluate the impact of TBI on the microbiome, and (3) be written in English and (4) be published in a peer-reviewed journal. Of the seven articles that met these criteria, one involved human participants, while the other six reported on experimental animal studies. All studies found changes in the gut microbiome following TBI, with similar changes in bacterial populations observed across studies. The limitations of these studies included the use of primarily male animals, limitations of 16 S rRNA gene sequencing, and small sample sizes. JSH23 This review was also limited by the small pool of studies conducted in this area. In summary, changes in bacterial populations of the gut microbiome, specifically increases in proteobacteria and firmicutes, were observed across the studies. By evaluating the changes in the microbiome resulting from TBI, potential therapeutic interventions could be explored.In the last few years, it was proposed to deliver drugs using Nano-robots for treating cancer. This paper compares between two recent and efficient algorithms for delivering Nano-robots to cancer area. These algorithms are Jaya algorithm and Directed Particle Swarm Optimization (DPSO) algorithm. In this paper, we also propose a new hybrid algorithm that combines Jaya and DPSO to speed up the process of Nano-robots delivery. The proposed algorithm is called Directed Jaya (DJaya) algorithm. Experiments have proved that the efficiency of DJaya is higher than both Jaya and DPSO. We show experimentally that DJaya starts delivering Nano-robots earlier than DPSO to facilitate the initiation of the drug release. Also, DJaya finishes delivering Nano-robots earlier than Jaya to complete the drug dose. In addition to this, DJaya groups the Nano-robots together in the target area like DPSO to speed up the drug release process. We finally propose a new strategy for destroying cancer cells efficiently with relatively small number of Nano-robots.