Viral infections have detrimental impacts on neurological functions, and even to cause severe neurological damage. Very recently, coronaviruses (CoV), especially severe acute respiratory syndrome CoV 2 (SARS-CoV-2), exhibit neurotropic properties and may also cause neurological diseases. It is reported that CoV can be found in the brain or cerebrospinal fluid. The pathobiology of these neuroinvasive viruses is still incompletely known, and it is therefore important to explore the impact of CoV infections on the nervous system. Here, we review the research into neurological complications in CoV infections and the possible mechanisms of damage to the nervous system. BACKGROUND Whether a regimen of ticagrelor monotherapy attenuates bleeding complications without increasing ischemic risk in patients undergoing complex percutaneous coronary intervention (PCI) is unknown. OBJECTIVES To evaluate the effect of ticagrelor monotherapy versus ticagrelor plus aspirin in patients undergoing complex PCI from the randomized, double-blind, placebo-controlled TWILIGHT trial. METHODS In the TWILIGHT trial, after 3 months of ticagrelor plus aspirin, event-free patients remained on ticagrelor and were randomly assigned to receive aspirin or placebo for 1 year. Complex PCI was defined as any of the following 3 vessels treated, ≥3 lesions treated, total stent length >60 mm, bifurcation with 2 stents implanted, atherectomy device use, left main PCI, surgical bypass graft or chronic total occlusion as target lesions. Bleeding and ischemic endpoints were evaluated at 1 year after randomization. RESULTS Among 7,119 patients randomized in the main trial, complex PCI was performed in 2,342 patients. Compared to ticagrelor plus aspirin, ticagrelor plus placebo resulted in significantly lower rates of BARC type 2, 3 or 5 bleeding (4.2% vs. 7.7%; hazard ratio [HR] 0.54; 95% confidence interval [CI] 0.38-0.76). BARC type 3 or 5 bleeding was also significantly reduced (1.1% vs. 2.6%; HR 0.41; 95% CI 0.21-0.80). There were no significant between-group differences in death, myocardial infarction or stroke (3.8% vs. 4.9%; HR 0.77; 95% CI 0.52-1.15), nor in stent thrombosis. CONCLUSIONS Among patients undergoing complex PCI who initially completed 3 months of ticagrelor plus aspirin, continuation of ticagrelor monotherapy was associated with lower incidence of bleeding without increasing the risk of ischemic events compared to continuing ticagrelor plus aspirin. BACKGROUND P2Y12 inhibitor monotherapy with ticagrelor after a brief period of dual antiplatelet therapy can reduce bleeding without increasing ischemic harm after percutaneous coronary intervention (PCI). The impact of this approach among patients with diabetes mellitus (DM) remains unknown. OBJECTIVES To examine the effect of ticagrelor monotherapy versus ticagrelor plus aspirin among patients with DM undergoing PCI. METHODS This was a pre-specified analysis of the DM cohort in the TWILIGHT trial. After 3 months of ticagrelor plus aspirin, patients were maintained on ticagrelor and randomized to aspirin or placebo for 1 year. The primary endpoint was Bleeding Academic Research Consortium (BARC) 2, 3 or 5 bleeding. The composite ischemic endpoint was all-cause death, myocardial infarction, or stroke. RESULTS Patients with DM comprised 37% (n=2620) of the randomized cohort and were characterized by more frequent comorbidities and a higher prevalence of multivessel disease. The incidence of BARC 2, 3 or 5 bleeding was 4.5% and 6.7% among patients with DM randomized to ticagrelor plus placebo versus ticagrelor plus aspirin (HR 0.65; 95% CI 0.47-0.91; p=0.012). Ticagrelor monotherapy was not associated with an increase in ischemic events compared with ticagrelor plus aspirin (4.6% vs 5.9%; HR 0.77; 95% CI 0.55 to 1.09; p=0.14). In the overall trial population, there was no significant interaction between DM status and treatment group for the primary bleeding or ischemic endpoints. CONCLUSIONS Compared with ticagrelor plus aspirin, the effect of ticagrelor monotherapy in reducing the risk of clinically relevant bleeding without any increase in ischemic events was consistent among patients with or without DM undergoing PCI. BACKGROUND Atopic dermatitis (AD) is known to negatively influence the mental health of patients.  https://www.selleckchem.com/products/monastrol.html  However, only a few studies have explored the influencing factors for psychiatric problems among adolescents with AD. OBJECTIVE W e aimed to assess the association of AD and suicidal behaviors among adolescents by analyzing data from the third through thirteenth annual Korean Youth Risk Behavior Web-based Surveys (KYRBS, completed from 2007 to 2017). METHODS KYRBS data were obtained from a stratified, multistage, clustered sample. Students self-reported AD based on being diagnosed with AD by a doctor. Influencing factors for suicidal behaviors were tested by logistic regression models. RESULTS A total of 788,411 adolescents completed the survey. The proportion of participants with AD was 22.2%. Those reporting suicide ideation and suicide attempts were 19.0%, and 4.5%, respectively. Compared to adolescents without AD, those with AD were more likely to be female, to skip breakfast less frequently, to exercise less frequently, to drink less alcohol, not be current smokers, and were significantly more likely to have negative mental health states. In the multivariable model, perceived unhappiness and suicidal ideation were the most strong influencing factors for suicidal ideation (aOR 4.90 [95% CI; 4.31-5.57]) and for suicidal attempts (aOR 48.01 [95% CI; 42.69-53.09]), respectively. CONCLUSION Adolescents with AD had a significant prevalence of suicidal behaviors. Although further research is needed to clarify this relationship, those with influencing factors for negative mental health state may need intervention from clinicians that use a multidisciplinary team approach to prevent suicide. The importance of advance care planning (ACP) has been increasingly recognized by health systems. However, 46-76% of patients report engaging in ACP with lawyers, while only a minority report doing so with physicians. In the U.S. ACP with lawyers focuses on advance directive documents, naturally occurs outside of healthcare contexts, and is often uninformed by the clinical context, such one's prognosis and clinical trajectory. These forms are regularly stored at home or at a lawyer's office and not available at the bedside when needed in a medical crisis. Yet, in contrast to clinicians, lawyers hold sophisticated knowledge about their states' advance directive law. Lawyers may also understand clients' socioeconomic context and plans more broadly, which are known to be critical for contextualizing and personalizing patient care but are often not well-captured in healthcare. Aligning medical and legal approaches to ACP is important to ensuring the quality and value of those efforts. As an important first step toward this goal, we convened an interprofessional panel of medical and legal experts to elucidate the state of medical-legal ACP and begin to identify strategies to improve and align practices within and across professions.