Probiotics are lactic acid bacteria which are used extensively in therapeutic preparations and added to foods. There are many studies which have demonstrated the effects of probiotics on metabolic diseases. One study has shown the effect of fermented dairy products on the serum cholesterol, especially with selected strains of lactic acid bacteria. It has been found that a minute quantity of the dry culture of Lactobacillus fermentum KC4b, for example, can remove 14.8 mg of cholesterol from the culture medium. Lactobacilli also play an important role in deconjugating the bile salts in the intestine to form bile acids and thereby inhibiting the micelle formation. Probiotics reduce the lipid peroxidation and improve the lipid metabolism in vivo. The addition of probiotics to the diet for weeks improved the immune response without the release of inflammatory cytokines, thereby reducing the onset of systemic inflammatory induced diabetes. There are evidences that the differences in the composition of the gut microbiota may precede the development of obesity in children. This review has illustrated the potential of probiotics in mediating metabolic diseases via the positive modulation of several different physiological systems, apart from its conventional benefits for the gastrointestinal health.

Breast conservation surgery (BCS) is now the standard of care for patients with early breast cancer. The main contraindications for BCS besides the presence of multicentricity and diffuse microcalcifications are inadequate tumour size to breast size ratio. With the advent of oncoplastic techniques, the indications of BCS may be further extended to patient with larger tumour size and or small volume breast. We prospectively assessed 42 patients undergoing oncoplastic breast conservation surgery for cosmetic and oncologic outcomes. Cosmetic outcome assessment was done by comparison of operated breast to contralateral breast by an independent surgeon, nurse and patient's attendant at 6 months post-surgery. Risk factors for compromised oncologic outcomes included grades II/III tumours and non-ductal histology. Intraoperative margin assessment with frozen section analysis proved to be important in order to achieve negative surgical margins on final histopathology. By univariate analysis, tumours located in central quadrant and medial half of the breast had similar cosmetic outcomes comparable to tumours located in other quadrants. Majority of our patients (90%) had overall good to excellent cosmetic outcomes on Harvard scale. Oncoplastic breast conservation surgery techniques allow for larger parenchymal resections without compromising oncologic and cosmetic results. It further allows extension of BCS to patients otherwise denied for the same based on earlier recommendations for mastectomy. Oncoplastic techniques and intraoperative margin assessment with frozen section are vital in attaining adequate margins and also decrease chance of local recurrence and revision surgery for positive margins.

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Secondary or high school (HS) educational professionals expressed concerns about dealing with environmental and occupational health and safety protocols due to COVID-19. Concerns related to fall 2020 school re-opening and getting back into in-person teaching—whether full-time, part-time or some other approved hybrid model—plus ongoing uncertainty with how the state and federal government will be handling matters about mandates for virtual learning, rapid testing, vaccine distribution, etc. These concerns were related to both their experience as educational professionals and genuine interest in personal and student well-being. This study was a cross-sectional online survey in early fall from mid-September–early October 2020. Of a possible maximum participation of 740 New Jersey (NJ) supervisory-level HS teachers and administrators (e.g., department chairs, district and school principals), 100 confirmed unique respondents (13.5%) consented and completed the survey. Of 100 experienced (mean 18 years teaching) participants, 70% responded to the gender identity question (overall, 61% female, 39% male; by NJ region, gender ratios were similar). There were statistically significant differences (using Fischer’s exact test) between NJ regions regarding provision of online counseling and support services for teachers (p < 0.001); for resources and equipment for teachers to mediate online learning (p = 0.02); for assistive video technology tools (p = 0.03) and accessibility to structured online learning and professional development (p = 0.002); concerning learning aids to engage students in online instruction, online counseling, and support services for students and their families (p = 0.006); appropriate protocol is clean and disinfect areas used by a person with COVID-19 (p = 0.002); and, immediately separate staff and students who screen positive for COVID-19 (p = 0.03). There were few statistical differences by gender. This study reported what participants wanted regarding the development of future policies then implemented as reopening practices. Data can inform recommendations in NJ and elsewhere at federal, state, and local levels. Data provide new insights and valuable information to inform the consideration of acceptability of various policy measures among HS education professionals.

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