017), type of systemic therapy (p = 0.031) and poorer performance status (p less then  0.001) were associated with higher likelihood of palliative care referral. The intervention improved GOC completion (RR 1.29 p = 0.004), however this was not sustained in a follow-up audit (RR 0.98 p = 0.92) and there was no change in palliative care referral rate (RR 2.5, p = 0.16). Predictors of palliative referral following clinical review included age (RR 1.16, p = 0.001), male sex (RR 14.2, p = 0.02) and poorer performance status (RR 1.76, p less then  0.001). CONCLUSION Communication-priming interventions can improve GOC completion for patients with advanced lung cancer. Further investigation is needed to pursue sustainable options for managing this complex patient group and improve guideline-adherence and patient care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Extraction of environmental fate parameters for pesticides by inverse modeling in laboratory experiments has evolved to become a common practice in higher tier exposure modeling. This study focuses on flooded paddy soil conditions using a simple container test system. Four active ingredients of paddy herbicide were tested.  https://www.selleckchem.com/products/cx-5461.html  The results were parameterized and transferred to analyze the effect of formulation types on the outdoor experimental data via inverse analyses of two structurally-compatible mathematical models, namely Pesticide Concentration in Paddy Field for laboratory (PCPF-LR) and PCPF for outdoors (PCPF-1Rv1.1 ). RESULTS After in-laboratory calibration, the PCPF-LR model revealed statistically acceptable or ideal simulations of pesticide concentrations in both the aqueous and soil phases (e.g., Nash-Sutcliffe efficiency > 0.7), in addition to determining the apparent sorption from the laboratory data. The extracted persistence indicators (DegT50 ) in the aqueous phase were 1.4-38.7 times higher than those of the dissipation (DT50 ) due to the exclusion of partitioning and phase transfer processes (diffusion and sorption). In the outdoor experiment, 72 % of the outdoor-calibrated simulations of the PCPF-1Rv1.1 model, showed statistically acceptable representations of the concentrations in paddy water. Furthermore, the DegT50 as 'bulk' degradation in paddy water was statistically insignificant between the formulation types; however, the DT50 demonstrated statistically different results. CONCLUSION The laboratory/outdoor data interconnections using proposed modeling approach facilitate the data-specific model calibration and analysis. These can be useful in the exposure modeling of paddy pesticide by manipulating the parameter uncertainties associated with the experimental constraints. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.We herein report a DNAzyme named T30695 (sequence (G3T)4) that can catalyze Zn2+ insertion into three different porphyrins in the presence of Pb2+ as a cofactor. Meanwhile, T30695 with Pb2+ alone was found to cause a shift in both the fluorescence and UV-vis spectra for protoporphyrin IX (PPIX), suggesting metalation of Pb2+ was also achieved at room temperature. From kinetic measurements, the reaction required two Pb2+ ions, consistent with one being a cofactor and the other being a substrate. No previous reports inserted Pb2+ into porphyrins using DNAzymes or protein-based enzymes. This reaction was most significantly inhibited in the presence of K+ followed by Na+ and Li+, suggesting the importance of Pb2+ stabilized G-quadruplex. When Pb2+ is inserted into PPIX, its emission blue shifted from 635 nm to 590 nm, allowing simple ratiometric fluorescent sensing with a detection limit of 1.19 nM Pb2+. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.BACKGROUND Severe plasma prekallikrein (PK) deficiency is an autosomal-recessive defect characterized by isolated aPTT prolongation. To date, no comprehensive methodologically-firm analysis investigated the diagnostic, clinical, and genetic characteristics of PK deficiency, and its prevalence remains unknown. PATIENTS/METHODS We described new families with PK deficiency, retrieved clinical and laboratory information of cases systematically searched in the (grey) literature, and collected blood of these cases for complementary analyses. The Genome Aggregation Database (gnomAD) and the population-based Gutenberg Health Study served to study the prevalence of mutations and relevant genetic variants. RESULTS We assembled a cohort of 111 cases from 89 families and performed new genetic analyses in eight families (three unpublished). We identified new KLKB1 mutations, excluded the pathogenicity of some of the previously described ones, and estimated a prevalence of severe PK deficiency of 1/155,668 overall and 1/4,725 among Africans. One individual reported with PK deficiency had, in fact, congenital kininogen deficiency associated with decreased PK activity. One-quarter of individuals had Factor XII clotting activity below the reference range. Four major bleeding events were described in 96 individuals, of which 3 were provoked, for a prevalence of 4% and an annualized rate of 0.1%. The prevalence of cardiovascular events was 15% (6% 65 years) for an annualized rate of 0.4%. CONCLUSIONS We characterized the genetic background of severe PK deficiency, critically appraised mutations, and provided prevalence estimates. Our data on laboratory characteristics and clinical course of severe PK deficiency may have clinical implications. This article is protected by copyright. All rights reserved.BACKGROUND Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia, is an emerging geriatric giant, which poses a serious global health burden. METHODS AND RESULTS The prevalence of osteosarcopenia ranges in community-dwelling older adults [5-37% (≥65 years)] with the highest rates observed in those with fractures (low-trauma fracture ~46%; hip fracture 17.1-96.3%). Among 2353 community-dwelling adults, risk factors associated with osteosarcopenia include older age [men 14.3% (60-64 years) to 59.4% (≥75 years); women 20.3% (60-64 years) to 48.3% (≥75 years), P  less then  0.05], physical inactivity [inverse relationship 0.64, 95% confidence interval (CI) 0.46-0.88 (sexes combined)], low body mass index (inverse relationship men 0.84, 95% CI 0.81-0.88; women 0.77, 95% CI 0.74-0.80), and higher fat mass (men 1.46, 95% CI 1.11-1.92; women 2.25, 95% CI 1.71-2.95). Among 148 geriatric inpatients, osteosarcopenic individuals demonstrate poorer nutritional status (mini-nutritional assessment scores 8.