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The purpose of this systematic review was to identify the available literature on the essential oil from species of genus Cordia. This study followed the Preferred Reporting Items for Systematic Reviews. The search was conducted on four databases: LILACS, PubMed, Science Direct, and Scopus until June 5th, 2020, with no time or language restrictions. Sixty out of the 1,333 initially gathered studies fit the inclusion criteria after the selection process. Nine species of Cordiawere reported in the selected studies, out of which 79% of the evaluated studies reported essential oil from Cordia curassavica. The essential oil extraction methods identified were hydrodistillation and steam distillation. As for biological application, antimicrobial, anti-inflammatory, larvicidal and antioxidant activities were the most reported. The main compounds reported for essential oil were β-caryophyllene, α-humulene, α-pinene, bicyclogermacrene, and sabinene. The information reported in this systematic review can contribute scientifically to the recognition of the importance of the genus Cordia.

Background: Knowledge about climate change may produce anxiety, but the concept of climate change anxiety is poorly understood. The primary aim of this study was to systematically review the qualitative literature regarding the scope of anxiety responses to climate change. The secondary aim was to investigate the sociodemographic and geographical factors which influence experiences of climate change anxiety. Methods: A systematic review of empirical qualitative studies was undertaken, examining the scope of climate change anxiety by searching five databases. Studies were critically appraised for quality. Content analysis was used to identify themes. Results: Fifteen studies met the inclusion criteria. The content analysis was organised into two overarching themes. The scope of anxiety included worry about threats to livelihood, worry for future generations, worry about apocalyptic futures, anxiety at the lack of response to climate change, and competing worries. Themes pertaining to responses to climate change anxiety included symptoms of anxiety, feeling helpless and disempowered, and ways of managing climate change anxiety. Relatively few studies were identified, with limited geographical diversity amongst the populations studied. Conclusions: The review furthers understanding of the concept of climate change anxiety and responses to it, highlighting the need for high-quality psychiatric research exploring its clinical significance and potential interventions.

Background: Anxiety disorders are a relatively common occurring mental health issue during pregnancy and the perinatal period. There is evidence that untreated perinatal anxiety is a risk factor for adverse outcomes for mother and infant. Despite their potential acceptability to users, psychological interventions research for this population is still in its infancy. This systematic review and meta-analysis aimed to comprehensively evaluate the evidence of the effectiveness of psychological interventions for reducing perinatal anxiety. Method: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched included EMBASE, MEDLINE, PsychINFO, MIDIRS, CINAHL and the Cochrane Library. Search terms included: Psychological Therapy, Perinatal Period, Antenatal, Postnatal, Anxiety, Obsessive Compulsive Disorder and Phobia. Results: The search strategy identified 2025 studies. A total of 21 studies published between 2004 and 2021 fulfilled inclusion criteria. Of those, 17 were included in the meta-analysis. Overall results indicated that psychological interventions were more effective than control conditions in reducing symptoms of perinatal anxiety with a medium post treatment effect size. Significant effect sizes were also identified for online, face-to-face, group and guided self-help treatment modalities. Limitations: A small sample of studies are represented and limited to articles published in English. The review was unable to draw specific conclusions about what works (i.e. therapeutic modality/delivery) for whom (i.e. specific diagnoses) due to purposefully broad inclusion criteria. The longer-term effects of psychological interventions for perinatal anxiety and infant outcomes could not be established. Conclusions: This review demonstrates that psychological interventions are effective in reducing symptoms of both anxiety and comorbid anxiety and depression in the antenatal and postnatal periods. The results also demonstrate the efficacy of delivering such interventions in multiple settings, including online, and in group format. Further research is required to optimise treatment delivery to individual needs.

Abstract IntroductionCyclophosphamide (CTX), is reported to be extensively used to establish POI animal model. But the most effective dose has not been systematically concluded yet. This systematic review and network meta-analysis is aimed to compare and rank the different doses of cyclophosphamide in the CTX-induced POI rat model.MethodsRandomized controlled trials of CTX-induced rat POI model were searched in four databases from inception to December, 2021. A network meta-analysis was conducted to analyze the data of included publications. The quality assessment was assessed by SYRCLE’s risk of bias tool. Data were analyzed with STATA 15.0 and Review Manager 5.3.Result205 records were searched and a total of 14 articles met inclusion criteria, Compared by Ovarian morphological changes, estrous cycle and hormone level (FSH, E2, AMH), the loading dose of 200mg/kg CTX with the maintenance dose of 8mg/kg CTX for consecutive 14 days showed the best efficacy in inducing rat POI model.

Background Lenvatinib is approved as first-line treatment for patients with advanced hepatocellular carcinoma (HCC). The efficacy of lenvatinib in Caucasian real-world patients is insufficiently defined. The purpose of this study was to evaluate the efficacy of lenvatinib in a multi-center cohort (ELEVATOR) from Germany and Austria. Methods A retrospective data analysis of 205 patients treated with first-line systemic lenvatinib at 14 different sites was conducted. Overall survival, progression free survival, overall response rate and adverse event rates were assessed and analyzed. Results Patients receiving lenvatinib in the real-world setting reached a median overall survival of 12.8 months, which was comparable to the results reported from the REFLECT study. Median overall survival (mOS) and progression free survival (mPFS) was superior in those patients who met the inclusion criteria of the REFLECT study compared to patients who failed to meet the inclusion criteria (mOS 15.6 vs 10.2 months, HR 0.55, 95% CI 0.38-0.81, p=0.002; mPFS 8.1 vs 4.8 months HR 0.65, 95% CI 0.46-0.91, p=0.0015). For patients with an impaired liver function according to the Albumin-Bilirubin (ALBI) grade, or reduced ECOG performance status ≥2, survival was significantly shorter compared to patients with sustained liver function (ALBI grade 1) and good performance status (ECOG performance status 0), respectively (HR 1.69, 95% CI 1.07-2.66, p=0.023; HR 2.25, 95% CI 1.19-4.23, p=0.012). Additionally, macrovascular invasion (HR 1.55, 95% CI 1.02-2.37, p=0.041) and an AFP ≥200 ng/mL (HR 1.56, 95% CI 1.03-2.34, p=0.034) were confirmed as independent negative prognostic factors in our cohort of patients with advanced HCC. Conclusion Overall, our data confirm the efficacy of lenvatinib as first-line treatment and did not reveal new or unexpected side effects in a large retrospective Caucasian real-world cohort, supporting the use of lenvatinib as meaningful alternative for patients that cannot be treated with IO-based combinations in first-line HCC.

The gut microbiota is a key factor in the correct development of the gastrointestinal immune system. Studies have found differences between the gut microbiota of newborns delivered by cesarean section compared to those vaginally delivered. Our objective was to evaluate the effect of ingestion of probiotics, prebiotics, or synbiotics during pregnancy and/or lactation on the development of the gut microbiota of the C-section newborns. We selected experimental studies in online databases from their inception to October 2021. Of the 83 records screened, 12 met the inclusion criteria. The probiotics used belonged to the genera Lactobacillus, Bifidobacterium, Propionibacterium, and Streptococcus, or a combination of those, with dosages varying between 2 × 106 and 9 × 1011 CFU per day, and were consumed during pregnancy and/or lactation. Probiotic strains were combined with galacto-oligosaccharides, fructo-oligosaccharides, or bovine milk-derived oligosaccharides in the synbiotic formulas. Probiotic, prebiotic, and synbiotic interventions led to beneficial gut microbiota in cesarean-delivered newborns, closer to that in vaginally delivered newborns, especially regarding Bifidobacterium colonization. This effect was more evident in breastfed infants. The studies indicate that this beneficial effect is achieved when the interventions begin soon after birth, especially the restoration of bifidobacterial population. Changes in the infant microbial ecosystem due to the interventions seem to continue after the end of the intervention in most of the studies. More interventional studies are needed to elucidate the optimal synbiotic combinations and the most effective strains and doses for achieving the optimal gut microbiota colonization of C-section newborns.

This review provides insight on potential host-specific factors that increase individual susceptibility to infection and transmission of bovine digital dermatitis. Digital dermatitis is increasing in prevalence within herds worldwide and yields economic losses for producers and welfare issues for animals. A total of 34 relevant studies were reviewed based on the inclusion criteria. A decrease in susceptibility to disease was found in animals with specific genomic and hoof characteristics, thus citing the importance of sire selection when designing a breeding program. Animals with superior health status that lacked co-morbidities and mounted immune responses to infection were less likely to develop disease. Primiparous cattle and those in peak production were more likely to develop lesions, as were over-or-under-conditioned Holstein–Friesian breeds. Cattle with superior hoof conformation and gait were poor hosts for bacteria and therefore less likely to develop and spread infection. The lowest risk of transmission of digital dermatitis occurred during the dry period and post peak lactation and cattle with advanced lesions contributed to the persistence of the disease within a herd. It is hoped that this review will help producers design breeding and management programs for their herds, and help veterinarians advise clients on the subject.

<b><i>Background and Aim:</i></b> Polypharmacy (concomitant use of 5–9 medicines) and hyperpolypharmacy (concomitant use of over 10 medicines) were observed to be more frequent in older adults (≥65 years) and associated with adverse outcomes. Their prevalence and risk in older patients with Parkinson’s disease (PD) remain unknown. We aimed to synthesize the extant evidence on the prevalence and risk of polypharmacy and hyperpolypharmacy in older adults with PD. <b><i>Methods:</i></b> A systematic literature search was performed in PubMed/MEDLINE, Scopus, and Embase databases to identify pertinent studies published from 2000 to July 2021. Observational studies reporting the prevalence and association with disease of polypharmacy/hyperpolypharmacy in older adults with PD were meta-analyzed. Pooled prevalence and odds ratio (OR) with 95% confidence intervals (CIs) were calculated. <b><i>Results:</i></b> Out of the total 499 studies identified, 6 fulfilled the inclusion criteria and comprised 7,171 participants. The overall prevalence of polypharmacy and hyperpolypharmacy was 40% (95% CI: 37–44) and 18% (95% CI: 13–23), respectively. A meta-analysis of 4 studies indicated a significant association between polypharmacy (OR: 1.94, 95% CI: 1.26–2.62; <i>p</i> &#x3c; 0.001) and PD. Hyperpolypharmacy was also strongly associated with PD (OR: 3.11, 95% CI: 2.08–4.14; <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Polypharmacy (40%) and hyperpolypharmacy (18%) are highly prevalent and eventually increase the risk of drug-related problems in older adults with PD. Therefore, interventions that ensure rational geriatric pharmacotherapy are of critical importance for the older population with neurogenerative disorders.

IntroductionSubacute thyroiditis (SAT) is typically a self-limiting, inflammatory disease. Patients can experience hypothyroidism during or after an episode. We examined the clinical characteristics based on laboratory and imaging studies in patients with SAT and possible factors contributing to the development of permanent hypothyroidism after SAT.Material and methodsWe retrospectively examined medical records of patients diagnosed with SAT at one medical facility in Turkey. Patients known to have previous thyroid disease, those with <6 months of follow-up after resolution of SAT, and those who lacked sufficient data for analysis were excluded. Of the 283 patients identified 119 met all inclusion criteria. We extracted data on demographics, laboratory tests, neck pain and other symptoms, ultrasonography findings, medication use, and SAT recurrence. We examined the relationships between these variables and development of permanent hypothyroidism.ResultsThe patients were 42 years old on average, and 78% were women. Most patients (70%) described flu-like symptoms before neck pain started; accordingly, 57% had initially visited a specialty other than endocrinology before SAT was diagnosed, and 28% had received antibiotics for misdiagnosed upper respiratory tract infection. In all, 10 patients (8.4%) developed permanent hypothyroidism after SAT. These patients had received steroids significantly longer than did those without permanent hypothyroidism (mean 17.7 vs. 8.9 weeks; P = .021). Development of hypothyroidism was significantly lower among patients with thyrotoxicosis.ConclusionsThe diagnosis of SAT can be challenging. Patients who require longer-term steroids after SAT and who have recurrent SAT should be closely monitored for development of hypothyroidism.