highly prevalent at older ages and frequently discovered with the growing use of noninvasive angiography. Intensive medical therapy is the treatment of choice, but there is a need to develop novel treatments or therapeutic approaches to lower the risk of stroke in higher risk patients.India's National Viral Hepatitis Control Programme recommends screening outpatients for hepatitis B at tertiary care centres. We aimed to assess the yield of screening and reasons for refusal for testing. We included adult outpatients at a tertiary care centre, South India during September and October 2019. Participants' willingness to be tested and the reasons for refusal were noted. Fingerstick blood sample was tested for HBsAg using rapid kit. Of a total of 700 participants, 157 (22%, 95% CI 19.4-25.7%) were unwilling to be tested. Men were more unwilling (26%) compared to women (19%) (aPR 1.90 95% CI 1.22-2.94; p = 0.004). 'Lack of time' was the most common reason reported for refusal (10%). Of 543 participants tested, 15 (2.8%, 95% CI 1.6-4.5%) were positive for HBsAg. Similar studies from other regions in India are required for the estimation of yield of opportunistic approach.While the world battles to wrestle with the impact of the COVID-19 pandemic, regions with endemic dengue fever are confronting the possibility of a double pandemic that could completely overpower health care services administrations. Simultaneous outbreaks of dengue and COVID-19, as well as probable cases of overlapping infections, have already started in Latin America and certain Asian countries. There, the healthcare framework is already overburdened and such a deadly duo may completely overwhelm hospital emergency services quite apart from a country's economy. Precise epidemiological and contact history-taking joined with due attention to false-positive dengue serology and the chance of co-infections are key devices for frontline doctors to overcome this seemingly insurmountable challenge.Almost 2 billion adults in the world are overweight and more than half of them are classified as obese while nearly 1/3 of children globally experience poor growth and development. Given the vast amount of knowledge that has been gleaned from decades of research on growth and development, a number of questions remains as to why the world is now in the midst of a global epidemic of obesity accompanied by the "double burden of malnutrition" where overweight coexists with underweight and micronutrient deficiencies. This challenge to the human condition can be attributed to nutritional and environmental exposures during pregnancy that may program a fetus to have a higher risk of chronic diseases in adulthood.  https://www.selleckchem.com/products/afuresertib-gsk2110183.html  To explore this concept, frequently called the developmental origins of health and disease (DOHaD) or metabolic diseases (DOMD), this review considers a host of factors and physiological mechanisms that drive a fetus or child towards a higher risk of obesity, fatty liver disease, hypertension, and/or type 2 diabetes (T2D). To that end, this review explores the epidemiology of DOHaD with discussions focused on adaptations to human energetics, placental developmental, dysmetabolism, and key environmental exposures that act to promote chronic diseases in adulthood. These areas are complementary and additive in understanding how providing the best conditions for optimal growth can create the best possible conditions for lifelong health. Moreover, understanding both physiological as well as epigenetic and molecular mechanisms for DOMD is vital to most fully address the global issues of obesity and other chronic diseases.Small arteries, which play important roles in controlling blood flow, blood pressure, and capillary pressure, are under nervous influence. Their innervation is predominantly sympathetic and sensory motor in nature, and while some arteries are densely innervated, others are only sparsely so. Innervation of small arteries is a key mechanism in regulating vascular resistance. In the second half of the previous century, the physiology and pharmacology of this innervation were very actively investigated. In the past 10-20 yr, the activity in this field was more limited. With this review we highlight what has been learned during recent years with respect to development of small arteries and their innervation, some aspects of excitation-release coupling, interaction between sympathetic and sensory-motor nerves, cross talk between endothelium and vascular nerves, and some aspects of their role in vascular inflammation and hypertension. We also highlight what remains to be investigated to further increase our understanding of this fundamental aspect of vascular physiology.Purpose Many speech-language pathologists (SLPs) experience challenging behaviors during service delivery and also report minimal training in effective behavior management strategies. The purpose of this tutorial is to present low-effort behavior management strategies that SLPs can adopt, adapt, and implement. Method After providing an overall rationale for effective behavior management strategies, we present two evidence-based behavior management strategies aimed at improving positive behavior and engagement. We provide descriptions, steps, and applied examples for implementing visual activity schedules and behavior-specific praise. We include three implementation scenarios and resources for SLPs to access specifically tailored to speech-language pathology practice. Conclusions Visual activity schedules and behavior-specific praise are two flexible behavior management strategies that can be collaboratively created by SLPs and educators and implemented during a variety of instructional arrangements during speech and language therapy. Implementing evidence-based behavior management strategies may improve students' engagement and achievement in speech and language-focused outcomes.Objective Physical activity is a major challenge to glycemic control for people with type 1 diabetes. Moderate-intensity exercise often leads to steep decreases in blood glucose and hypoglycemia that closed-loop control systems have so far failed to protect against, despite improving glycemic control overall. Research Design and Methods Fifteen adults with type 1 diabetes (42 ± 13.5 years old; hemoglobin A1c 6.6% ± 1.0%; 10F/5M) participated in a randomized crossover clinical trial comparing two hybrid closed-loop (HCL) systems, a state-of-the-art hybrid model predictive controller and a modified system designed to anticipate and detect unannounced exercise (APEX), during two 32-h supervised admissions with 45 min of planned moderate activity, following 4 weeks of data collection. Primary outcome was the number of hypoglycemic episodes during exercise. Continuous glucose monitor (CGM)-based metrics and hypoglycemia are also reported across the entire admissions. Results The APEX system reduced hypoglycemic episodes overall (9 vs.