A Gabber type result for representations in Eilenberg-Moore categories

We consider a representation $\mathscr U:\mathbb Q\longrightarrow Mnd(\mathcal C)$ of a quiver $\mathbb Q$ taking values in monads over a Grothendieck category $\mathcal C$. By using adjoint functors between Eilenberg-Moore categories, we consider two different kinds of modules over $\mathscr U$. The first is the category $Mod-\mathscr U$ of $\mathscr U$-modules, which behaves like the category of modules over a ringed space. The second is the category $Cart-\mathscr U$ of cartesian modules, which behave like quasi-coherent sheaves. We give conditions for $Mod-\mathscr U$ and $Cart-\mathscr U$ to be Grothendieck categories. One of our key steps is finding a modulus like bound for an endofunctor $U:\mathcal C\longrightarrow \mathcal C$ in terms of $\kappa(G)$, where $G$ is a generator for $\mathcal C$ and $\kappa(G)$ is a cardinal such that $G$ is $\kappa(G)$-presentable. We conclude with an extension of the classical quasi-coherator construction to modules over a monad quiver with values in Eilenberg-Moore categories

Effects of total parenteral nutrition on postnatal growth in very low birth weight and extremely low birth weight newborns

Background: Prematurity is the most important cause of mortality in Under-5 children responsible for one million deaths/ year. Premature babies are not able to store enough nutrients for their optimal survival; it is essential to provide them total parenteral nutrition. Intravenous lipid infusion in neonates is linked with high risk of sepsis and thrombocytopenia. PN with amino acids and glucose can be imparted to achieve nutritional goal. This trial was intended to assess the effects of various components of amino acid PN on postnatal growth in VLBW and ELBW newborns.Methods: A prospective observational study was conducted from January 2018 - May 2019 in NICU of TMMC and RC which included preterm newborns with birth weight of less than 1500gms who received aminoven infusion. Anthropometric measurements, incidence of hypo/hypercalcaemia, hypo/hyperglycaemia, direct hyperbilirubinemia, incidence of sepsis were evaluated.Results: Out of 22 patients, 12 neonates received high dose aminoven therapy whereas 10 neonates received low dose aminoven therapy. It was seen that rapid rate of increment of amino acids had adequate weight on discharge, 72.72% have adequate growth among the rapid group compared to 36.36% among slower group. No significant changes in calcium metabolism or glucose metabolism were seen in both the groups.Conclusions: In resource limited settings, parenteral nutrition with intravenous amino acids have a better effect on the weight of preterm newborns at discharge when high doses of amino acids infusion started early with rapid increment in the dose

A survey of South Carolina pharmacists\u27 readiness to prescribe human immunodeficiency virus pre-exposure prophylaxis

Introduction: Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is largely underutilized in the Southern United States. Given their community presence, pharmacists are well positioned to provide PrEP within rural, Southern regions. However, pharmacists\u27 readiness to prescribe PrEP in these communities remains unknown. Objective: To determine the perceived feasibility and acceptability of prescribing PrEP by pharmacists in South Carolina (SC). Methods: We distributed a 43-question online descriptive survey through the University of South Carolina Kennedy Pharmacy Innovation Center\u27s listserv of licensed SC pharmacists. We assessed pharmacists\u27 comfort, knowledge, and readiness to provide PrEP. Results: A total of 150 pharmacists responded to the survey. The majority were White (73%, n = 110), female (62%, n = 93), and non-Hispanic (83%, n = 125). Pharmacists practiced in retail (25%, n = 37), hospital (22%, n = 33), independent (17%, n = 25), community (13%, n = 19), specialty (6%, n = 9), and academic settings (3%, n = 4); 11% (n = 17) practiced in rural locales. Pharmacists viewed PrEP as both effective (97%, n = 122/125) and beneficial (74% n = 97/131) for their clients. Many pharmacists reported being ready (60% n = 79/130) and willing (86% n = 111/129) to prescribe PrEP, although over half (62% n = 73/118) cited lack of PrEP knowledge as a barrier. Pharmacists described pharmacies as an appropriate location to prescribe PrEP (72% n = 97/134). Conclusions: Most SC pharmacists surveyed considered PrEP to be effective and beneficial for individuals who frequent their pharmacy and are willing to prescribe this therapy if statewide statutes allow. Many felt that pharmacies are an appropriate location to prescribe PrEP but lack a complete understanding of required protocols to manage these patients. Further investigation into facilitators and barriers of pharmacy-driven PrEP is needed to enhance utilization within communities

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Laryngotracheal trauma management and associated morbidity & mortality: four year experience at a tertiary care centre: Laryngotracheal trauma management

AIM- Cut throat injuries pose a great therapeutic challenge because of the multiple vital structures that are vulnerable to injuries in a small, confined unprotected area. In this study, we describe the site and depth of the injury, etiology, management and prognosis. METHODS- This was a retrospective study of 18 laryngotracheal trauma patients treated at the department of ENT in MDM hospital between April 2017 and January 2020. RESULTS- out of 176 cases of penetrating neck injury, 18 patients presented with a breach in the laryngotracheal framework. Male: Female ratio was 17:1. The peak age of incidence is in the 2nd and 4th decade of life. Accidental cut throat injury was the most common mode of injury (83%) followed by homicidal (11%) and then suicidal (5%). Endotracheal intubation (where possible) or emergency tracheostomy was done to secure the airway in all the cases followed by surgical debridement, laryngeal/hypopharynx repair. Post-operative endoscopy is useful to identify complications. Wound dehiscence was the most common complication. CONCLUSIONS- Cut throat injuries are one of the common E.N.T. surgical emergency. Timely intervention is paramount because it may otherwise cause death of the patient. Securing the airway, control of hemorrhage and fluid & blood replacement is the mainstay to prevent complications like shock, sepsis, laryngeal stenosis or fistula formation

HISTOPATHOLOGICAL SPECTRUM OF THYROID LESIONS AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN: HISTOPATHOLOGICAL SPECTRUM OF THYROID LESIONS

Objective: To determine proportion of different patterns (colloid goiter, colloid cyst, papillary carcinoma etc.) of thyroid lesions among the patients who have undergone surgical treatment. Method: This was prospective and retrospective study to be conducted on 100 thyroidectomy specimens received in 5 yr period (2016-2020) in Department of Pathology in Dr S.N. Medical College, Jodhpur. Results: Age ranged from 10 days to 85 years old, Peak incidence of thyroid diseases was seen in the third to fifth decade, 78% non neoplastic lesion, Adenomatous goiter was the most common non neoplastic lesion (65%), Papillary carcinoma was the most common malignant lesion encountered. Conclusion: Although noninvasive techniques like aspiration cytology provide a diagnosis in most, the ultimate answer often rests with histopathological examination of thyroidectomies, which forms the mainstay for a definitive diagnosis. Thorough gross and microscopic evaluation of thyroidectomies is mandatory even for non-neoplastic lesions as they sometimes harbor neoplasms