Nanotechnology has revolutionized the world through introduction of a unique class of materials and consumer products in many arenas. It has led to production of innovative materials and devices. Despite of their unique advantages and applications in domestic and industrial sectors, use of materials with dimensions in nanometers has raised the issue of safety for workers, consumers, and human environment. Because of their small size and other unique characteristics, nanoparticles have ability to harm human and wildlife by interacting through various mechanisms. We have reviewed the characteristics of nanoparticles which form the basis of their toxicity. This paper also reviews possible routes of exposure of nanoparticles to human body. Dermal contact, inhalation, and ingestion have been discussed in detail. As very limited data is available for long-term human exposures, there is a pressing need to develop the methods which can determine short and long-term effects of nanoparticles on human and environment. We also discuss in brief the strategies which can help to control human exposures to toxic nanoparticles. We have outlined the current status of toxicological studies dealing with nanoparticles, accomplishments, weaknesses, and future challenges.

IMPORTANCEThe impact of COVID-19 in the US has been far-reaching and devastating, especially in Black populations. Vaccination is a critical part of controlling community spread, but vaccine acceptance has varied, with some research reporting that Black individuals in the US are less willing to be vaccinated than other racial/ethnic groups. Medical mistrust informed by experiences of racism may be associated with this lower willingness.OBJECTIVE To examine the association between race/ethnicity and rejection of COVID-19 vaccine trial participation and vaccine uptake and to investigate whether racial/ethnic group-based medical mistrust is a potential mediator of this association. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional survey study was conducted from June to December 2020 using a convenience sample of 1835 adults aged 18 years or older residing in Michigan. Participants were recruited through community-based organizations and hospitalacademic networks. MAIN OUTCOMES AND MEASURES Separate items assessed whether respondents, if asked, would agree to participate in a research study to test a COVID-19 vaccine or to receive a COVID-19 vaccine. Participants also completed the suspicion subscale of the Group-Based Medical Mistrust Scale. RESULTS Of the 1835 participants, 1455 (79%) were women, 361 (20%) men, and 19 (1%) other gender. The mean (SD) age was 49.4 (17.9) years, and 394 participants (21%) identified as Black individuals. Overall, 1376 participants (75%) reported low willingness to participate in vaccine trials, and 945 (52%) reported low willingness to be vaccinated. Black participants reported the highest medical mistrust scores (mean [SD], 2.35 [0.96]) compared with other racial/ethnic groups (mean [SD] for the total sample, 1.83 [0.91]). Analysis of path models revealed significantly greater vaccine trial and vaccine uptake rejection among Black participants

Over recent years, brain-computer interface (BCI) has emerged as an alternative communication system between the human brain and an output device. Deciphered intents, after detecting electrical signals from the human scalp, are translated into control commands used to operate external devices, computer displays and virtual objects in the real-time. BCI provides an augmentative communication by creating a muscle-free channel between the brain and the output devices, primarily for subjects having neuromotor disorders, or trauma to nervous system, notably spinal cord injuries (SCI), and subjects with unaffected sensorimotor functions but disarticulated or amputated residual limbs. This review identifies the potentials of electroencephalography (EEG) based BCI applications for locomotion and mobility rehabilitation. Patients could benefit from its advancements such as wearable lower-limb (LL) exoskeletons, orthosis, prosthesis, wheelchairs, and assistive-robot devices. The EEG communication signals employed by the aforementioned applications that also provide feasibility for future development in the field are sensorimotor rhythms (SMR), event-related potentials (ERP) and visual evoked potentials (VEP). The review is an effort to progress the development of user's mental task related to LL for BCI reliability and confidence measures. As a novel contribution, the reviewed BCI control paradigms for wearable LL and assistive-robots are presented by a general control framework fitting in hierarchical layers. It reflects informatic interactions, between the user, the BCI operator, the shared controller, the robotic device and the environment. Each sub layer of the BCI operator is discussed in detail, highlighting the feature extraction, classification and execution methods employed by the various systems. All applications' key features and their interaction with the environment are reviewed for the EEG-based activity mode recognition, and presented in form of a table. It is suggested to structure EEG-BCI controlled LL assistive devices within the presented framework, for future generation of intent-based multifunctional controllers. Despite the development of controllers, for BCI-based wearable or assistive devices that can seamlessly integrate user intent, practical challenges associated with such systems exist and have been discerned, which can be constructive for future developments in the field.

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin-gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis.Methods In BARNARDS, consenting mother-neonates aged 0-60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in

Background: The coronavirus disease 2019 (COVID-19) pandemic has drastically disrupted primary health care and pharmacy services, posing a challenge in people with chronic diseases who receive routine care. Currently, there exists limited literature on the indirect impact of the pandemic on chronic disease management, particularly related to accessibility to medications and health care resources. Objectives: To determine the prevalence of medical-and medication-related problems reported by people with chronic diseases during the pandemic. The secondary objective was to identify the barriers and contributing factors related to these medical-and medication-related problems. Methods: The anonymous and voluntary, Web-based survey was filled out by interested adult respondents with chronic disease(s) across Michigan between September 1, 2020, and January 1, 2021. The primary outcome included self-reported medical-and medication-related problems during the pandemic. Secondary outcomes included potential risk factors for medicaland medication-related problems. Descriptive statistics was used to describe respondents' demographics, chronic disease characteristics, medication adherence, medical-and medication-related problems, and COVID-19erelated factors. The multivariable Firth logistic regression was used to analyze correlations between potential risk factors associated with medical-and medication-related problems. Results: A total of 1103 respondents completed the survey and were included in the analysis. Approximately, 51% of respondents reported a medication-related problem with 19.6% reported problems obtaining medication(s) and 31.7% reported forgetting or not taking their medication(s). The top reason for problems obtaining medication(s) was doctor's office being closed for in-person visit(s). In addition, of all responses, more than half reported worsening symptoms of their chronic disease(s) during the pandemic especially with psychiatric disorders (79.5%) and inflammatory bowel disease (60%). Respondents with a significantly higher risk of medication-related problems included those who were younger, were female, and had psychiatric disorder(s), diabetes, arthritis, or lupus, and respondents with a significantly higher risk of medical-related problems included those with multiple chronic diseases, psychiatric disorder(s), and heart failure. Conclusion: Understanding the consequences of the pandemic, such as medical-and medication-related problems, in this population is critical to improving health care accessibility and resources through potential outpatient pharmacy services during this and future pandemics.

BackgroundArab refugees and immigrants living in the United States may be exposed to political, economic, social, and environmental stressors that may affect their mental health. Yet, little is known regarding mental health outcomes among Arab Americans. The purpose of this study was to measure depression and anxiety levels among Arabs in Southeast Michigan and determine whether these levels differ by resident status: refugee, immigrant, or U.S. born.MethodsWe conducted a cross-sectional study in a convenience sample of 275 adults who self-identify as Arab living in Southeast Michigan. Participants were recruited from a non-profit health and social services organization between August–November 2015. Data were collected via self-administered questionnaires, using standardized instruments to assess depression and anxiety symptoms.ResultsAll three resident groups exhibited high mean levels of depression and anxiety. Refugees reported higher levels of depression and anxiety than either immigrants or U.S. born Arab Americans. After adjustment for sociodemographics, differences between U.S. born Arab Americans and refugees were statistically significant for depression (b = 2.84; 95% CI: 0.21, 5.47), but not for anxiety. Refugees had significantly higher depression scores (b = 3.18, 95% CI: 1.52, 4.84) and anxiety scores (b = 1.31, 95% CI: 0.11, 2.50) than immigrants. Those reporting political violence and religious persecution as reasons for immigration had the highest levels of depression and anxiety.ConclusionsThis convenience sample of Arab Americans reported high levels of depression and anxiety symptoms. Refugees appear to have poorer mental health outcomes than either immigrants or U.S.-born Arab Americans.

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