• Primary outcome measures are dietary intake of vegetables (serves/day), fruit and energy dense nutrient poor foods (serves/day and %Energy). (biomedcentral.com)
  • Analysis of dietary outcome measures, child feeding and parenting domains will be conducted on an intention-to-treat basis and compared at baseline, three and 12 months using the random effects model, using STATA software. (biomedcentral.com)
  • Agricultural and dietary diversification are promising tools to balance agricultural yield losses and nutrient deficits in crops. (biomedcentral.com)
  • Secondary outcomes comprise other anthropometric indices, iron and zinc status, dietary behavior, malaria indicators, and household socioeconomic status. (biomedcentral.com)
  • Contrary to drug trials, participants in nutrition-related research often have some prior dietary exposure to the nutrient of interest. (fortunetelleroracle.com)
  • This exposure can come through dietary food and supplement intake or, in some circumstances, endogenous synthesis (e.g. vitamin D, vitamin K). Due to limitations in currently used assessment procedures of food consumption, insufficient nutrient databases with which nutrient intake estimates are produced, and temporal fluctuations in exposure, background levels of exposure can be challenging to quantify precisely. (fortunetelleroracle.com)
  • The dietary intake of HD patients stratified by nutritional status has not yet been studied. (krcp-ksn.org)
  • Baseline dietary intakes were obtained from repeated 24-hour dietary records at baseline and every 6 months during follow-up, which enabled researchers to capture dietary intakes at different times of the year. (nutrition.org)
  • It will be important generally reflect a plant-based, min- banization, employment constraints, to identify dietary patterns related to imally processed, nutrient-dense diet. (who.int)
  • This intervention study aimed to identify malnutrition problems and assess the effect of dietary counselling on improvement of health status of end-stage renal disease patients subjected to haemodialysis. (who.int)
  • Various studies the effect of dietary counselling on the quantities of food categories and the have shown signs of malnutrition in improvement of health status of ESRD importance of each food group for 23%-76% of patients on haemodialy- patients attending a dialysis centre in health. (who.int)
  • At baseline, dietary information was given, and blood samples collected. (lu.se)
  • Frailty and mobility limitation result from an interplay of different pathways including multiple anabolic deficiency, inflammation, oxidative stress, and a poor nutritional status. (mdpi.com)
  • Climate change heavily affects child nutritional status in sub-Saharan Africa. (biomedcentral.com)
  • This project will establish the potential of a home gardening and nutrition counseling program to counteract climate change-related quantitative and qualitative agricultural losses, thereby improving the nutritional status among young children in rural sub-Saharan Africa. (biomedcentral.com)
  • Vitamin D nutritional status is defined by the measurement of serum 25(OH)D concentrations, which is the major circulating vitamin D metabolite, and the most suitable indicator of vitamin D status with a half-life of 2-3 weeks [ 11 , 12 ]. (biomedcentral.com)
  • Nutritional status of animals was analyzed by using ration balancing software package and microbial protein synthesis was calculated by estimation of urinary purine derivatives. (dairyknowledge.in)
  • Nutrition tips are tion of baseline data through inter- end-stage renal disease (ESRD) ranges another effective way of providing a views and laboratory reports with patients attending the centre to assess between 34 and 200 per million popula- practical nutrition education message their nutritional status. (who.int)
  • To establish and maintain a national probability sample of baseline information on health and nutritional status. (cdc.gov)
  • The nutritional status was determined by collecting weight and height measurements, which were later used to express Weight/Age and Height/Age scores. (bvsalud.org)
  • Conducted a study of longitudinal monitoring of nutritional status of schoolchildren from that school in the years 2014 and 2015 during a project of extension. (bvsalud.org)
  • Among the data found, we can mention that the majority of those studied had adequate weight, but the prevalence of overweight and obesity six times greater than underweight and after follow-up, an improvement in the nutritional status of monitored children. (bvsalud.org)
  • This study was developed from a food and nutrition education project with the premise that inadequate nutritional status in children may be influenced mainly by socioeconomic factors, their family lifestyle and the low effectiveness of public health policies targeting this population 10,11 and those researchers have emphasized the importance of carrying out nutritional surveillance studies, with monitoring of nutritional status 12 . (bvsalud.org)
  • The rate of nutrient deficiencies in the general U.S. population ranges from less than 1% for folate, vitamin A, and vitamin E to about 10% for vitamin B6, vitamin D, and iron. (cdc.gov)
  • 3. Are some population groups at a higher risk for nutrient deficiencies? (cdc.gov)
  • Consuming adequate amounts of several vitamins and minerals-including vitamin A, vitamin C, vitamin D, vitamin E, selenium, and zinc-is important for proper immune function, and clinical deficiencies of these nutrients weaken immunity and can increase susceptibility to infections [ 2 , 4 , 5 , 8-10 ]. (breathinglabs.com)
  • Baseline values of DNA methylation were inversely correlated with caloric (P = 0.03) and fat intake (P = 0.05) and patients harbouring multiple polyps consumed significantly more calories (P = 0.0006), fat (P = 0.009) and carbohydrates (P = 0.009) as compared to patients having one single lesion. (nih.gov)
  • 2 3 In an energy-balanced diet, reductions in SFA intake should be compensated for by other energy yielding nutrients. (bmj.com)
  • To bridge this knowledge gap, Charlotte Debras, Mathilde Touvier and colleagues, at the French National Institute for Health and Medical Research (Inserm) and Sorbonne Paris Nord University investigated the associations between FODMAP intake (total and type) and cancer risk (overall, breast, prostate, and colorectal) in the large prospective NutriNet-Santé cohort study (launched in 2009) that included 104,909 adult participants without cancer at baseline. (nutrition.org)
  • Blood levels had mainly unchanged or slightly increased values of measurements reflecting nutrient intake. (lu.se)
  • Using a new marker of iron status, the report indicates higher rates of iron deficiency in Mexican-American children aged 1 to 5 years (11%) and in non-Hispanic black (16%) and Mexican-American women (13%) of childbearing age (12 to 49 years) when compared to other race/ethnic groups. (cdc.gov)
  • The type of nutrient deficiency may differ by population group. (cdc.gov)
  • No. NHANES data from 1999 through 2006 indicate nutrient levels and rates of deficiency in the U.S. population have not changed. (cdc.gov)
  • In spite, the average daily milk production data of various categories of animals at 6.52 kg for crossbreds, 2.10 kg for indigenous cattle and 4.44 kg for buffaloes (BAHS, 2007) suggests that the productivity of animals is far below than their genetic potential which could be attributed mainly due to deficiency of critical nutrients in the diet of animals. (dairyknowledge.in)
  • A single deficiency or excess of nutrients can cause health problems. (columbia.edu)
  • CDC and several other agencies and organizations are currently researching the impact of vitamin supplements on an individual's nutrition status. (cdc.gov)
  • 2 ) It was a large clinical trial (with over 35,000 participants) that examined the relationship between baseline selenium status, supplementation with selenium and vitamin E (either together or separately), and future rates of prostate cancer in men over 55 years of age. (chriskresser.com)
  • Plasma homocysteine concentration declined from baseline by 22% in the vitamin B12 group, by 19% in the fish oil group, and by 39% in the combination-supplement group. (nutritionaloutlook.com)
  • While each nutrient individually was able to significantly lower markers of heart risk, the fish oil and vitamin B12 combination had a substantial synergistic impact, indicating a powerful benefit for heart and vascular health. (nutritionaloutlook.com)
  • Seasonality, ethnicity and overweight/obesity were confirmed to influence the vitamin D status, thus indicating the need for effective initiatives to support adequate vitamin D status in this population group. (biomedcentral.com)
  • Vitamin D is an essential nutrient for maintenance of serum calcium and phosphorus homeostasis and its fundamental role in bone mineralization and bone mass acquisition during childhood is well-known [ 1 ]. (biomedcentral.com)
  • Magnesium, potassium, and vitamin D are all part of BP regulation, and low levels of these essential nutrients may elevate risk for high BP. (pharmacytimes.com)
  • PQQ is now thought to be an essential nutrient and has been proposed to be classified as a new B vitamin. (nutriavenue.com)
  • Knowing your health status in areas like insulin sensitivity, inflammation, nutrient levels (Vitamin D, hormones), and potential toxins is a good place to start. (empoweryourlifestyles.com)
  • Gnarly Baseline D3 1000 IU is a natural plant-based extract derived from lichen that provides cholecalciferol, the most biologically active form of vitamin D. Gnarly specifically sourced this plant-based extract and chose to use vegetarian capsules to make a product that could be used by vegan and non-vegans alike. (gognarly.com)
  • We have evaluated the effect of folate supplementation (5 mg/day) on global deoxyribonucleic acid (DNA) methylation status of the rectal mucosa of 20 patients with resected colonic adenomas in a prospective, controlled, cross-over study. (nih.gov)
  • A growing body of research suggests that the effects of micronutrient supplementation are dependent upon the status of that nutrient in the target population. (chriskresser.com)
  • 6 ) If baseline levels of a particular nutrient are low, supplementation may lead to improved outcomes. (chriskresser.com)
  • But if baseline levels are normal or high, supplementation may cause harm-as it appears to have done in this study. (chriskresser.com)
  • At least one study found that selenium supplementation produced these benefits even when selenium levels were normal at baseline. (chriskresser.com)
  • The researchers conducted blood tests to monitor the impact of supplementation on levels of plasma homocysteine, ferritin (a measure of iron status), triglycerides, uric acid, and C-reactive protein (a measure of inflammation). (nutritionaloutlook.com)
  • The reaction to nutrient supplementation can be influenced by the nutritional state of a person or group. (fortunetelleroracle.com)
  • PQQ supplementation at levels higher than what is found in food has positive effects on cognitive function, immune status, antioxidant status, cardiovascular health, and neurological function. (nutriavenue.com)
  • Iron supplementation not only improves iron status but also increases work capacity and reduces exercise heart rate and lactate concentration. (gognarly.com)
  • Reply published on 27 November 2020, see Nutrients 2020 , 12 (12), 3643 . (mdpi.com)
  • Comment of Nutrients 2020 , 12 (9), 2757 . (mdpi.com)
  • Cancer cases were verified by medical experts and all first primary cancers diagnosed between baseline and January 2020 were considered cases. (nutrition.org)
  • However, this practice remains controversial because eliminating major food groups from the diet can lead to lower intakes for some nutrients, in particular fiber. (nutrition.org)
  • These studies would include determining the native status of a species or whether lakes with high nutrient concentrations have been enriched before recent anthropogenic influences. (uwyo.edu)
  • Each nutrient requires a specialized evaluation method based on the availability of a sample specific to that nutrient and homoeostatic processes that control plasma concentrations through storage depot accretion and release. (fortunetelleroracle.com)
  • The status classes assessed based on annual mean concentrations of daily values for total phosphorus and total nitrogen were adopted as the 'true' status classes of the water bodies based on each indicator. (springeropen.com)
  • 1 ) Additionally, supplementing with selenium in the context of low iodine status may actually aggravate hypothyroidism. (chriskresser.com)
  • We demonstrate that low magnesium levels facilitate allosteric inhibition of wtIDH1, which is lethal to cancer cells when nutrients are limited. (nature.com)
  • These first measurements in the U.S. population provide a baseline to track fatty acid levels over time. (cdc.gov)
  • 4. Have nutrient levels changed over time? (cdc.gov)
  • In some places the report shows that certain population groups have adequate biochemical levels of specific nutrients. (cdc.gov)
  • This can include recolonization of aquatic plants in lakes or determining whether current levels of lake nutrients exceeded past levels. (uwyo.edu)
  • We mapped the ocean floor, surveyed the fish and other seafloor creatures, and measured contaminants in sediments and corals, nutrient levels in surface waters, and sedimentation rates at coral reef sites. (noaa.gov)
  • When I advise a farmer, valuable residual fertility is the level of nutrients above typical background levels. (agrilife.org)
  • A daily multivitamin can provide low levels of essential vitamins and nutrients. (pharmacytimes.com)
  • Results showed that all of the Ahiflower oil groups displayed significant increases in EPA, ETA, DPA, and ALA levels from baseline values, and compared to the control sunflower oil-only group. (nutraingredients.com)
  • The new iron marker measurements will help doctors better interpret iron status in individuals, especially in persons with disease that includes inflammation. (cdc.gov)
  • Most of these fall into two categories: lack of nutrients or attacks on your brain and body that result in brain inflammation. (empoweryourlifestyles.com)
  • Although we tend to denigrate it, inflammation is a necessary response to injury: the inflammatory response increases blood and lymphatic flow to and from the injured tissues, bringing healing nutrients and inflammatory mediators and removing damaged refuse. (marksdailyapple.com)
  • Nutrients with antioxidant properties can reduce oxidative stress. (pharmacytimes.com)
  • Under nutrient starvation, wtIDH1 oxidizes isocitrate to generate α-ketoglutarate (αKG) for anaplerosis and NADPH to support antioxidant defense. (nature.com)
  • A growing body of evidence shows that mitochondrial function and antioxidant defense are also crucial under low nutrient conditions. (nature.com)
  • ELAVL1), enhanced both antioxidant defense and mitochondrial function under nutrient withdrawal. (nature.com)
  • At the end of the study, the researchers determined baseline multivitamin use didn't elevate risk of hypertension. (pharmacytimes.com)
  • HRs increased toward 1 when past-drinkers and those with poor health status and a disease history were excluded (0.80, 0.66, and 0.82, respectively). (bvsalud.org)
  • Health status was reported at baseline and every 6 months. (nutrition.org)
  • For instance, it only enrolled females who were disease-free at baseline, and most of the study population was highly educated and had better health status than the general population. (pharmacytimes.com)
  • In fact, expert neuroscientists and physicians recommend that everyone should get a baseline evaluation at midlife to understand their health status and risk of future disease. (empoweryourlifestyles.com)
  • Achieving and maintaining a baseline level of health helps athletes perform and recover optimally. (gognarly.com)
  • This baseline health is a broad and complex spectrum of physical, mental, and emotional health markers for which nutrition is a pillar. (gognarly.com)
  • Our new line of products, Gnarly Baseline, is designed to help you fill in nutritional gaps in your baseline health, thus creating a strong foundation to support optimal performance and recovery. (gognarly.com)
  • Providing one-to-one nutrition counselling could be linked to improvements in the patients' nutritional knowledge and practices and to their health status and performance in activities of daily life. (who.int)
  • We used data from the 2016 Nepal National Micronutrient Status Survey to evaluate factors associated with anaemia (World Health Organization cut-points using altitude- and smoking-adjusted haemoglobin [Hb]) among nationally representative samples of adolescents 10-19 years. (cdc.gov)
  • This behavior is problematic, because restaurant meals often lack adequate amounts of fruits and vegetables and are often calorie-dense rather than nutrient-dense, which may result in poor diet quality and adverse health outcomes if such meals are consumed regularly (6-8). (cdc.gov)
  • Baseline selenium status alone was not associated with prostate cancer risk. (chriskresser.com)
  • It's worth pointing out that these findings contradict two previous (and considerably smaller) observational studies in the United States, which found that low toenail selenium status increases the risk of prostate cancer. (chriskresser.com)
  • 3 , 4 ) In addition, a large Dutch study including over 58,000 participants found that those with the highest toenail selenium status had a 37% lower risk of prostate cancer than those with the lowest selenium status. (chriskresser.com)
  • We completed a baseline assessment of the environmental conditions in Guanica Bay, Puerto Rico, to help coastal managers identify the most appropriate restoration projects, and their effectiveness, in support of the area's watershed restoration efforts. (noaa.gov)
  • Participants who complete this course will learn about the identification, evaluation, and assessment of geriatric failure to thrive, including use of the Mini Nutritional Assessment, the Mini Mental Status Evaluation, and the Geriatric Depression Scale. (netce.com)
  • Uncertain results of the status assessment performed as required by the Water Framework Directive can be responsible for misclassification of a water body's status and may lead either to risk due to undertaking unnecessary remediation actions or risk of penalties for refraining from any action and not reaching environmental goals. (springeropen.com)
  • The presented method of risk analysis for making decisions on remedial actions when uncertainty exists about the water status assessment, can be considered as a prototype of a general methodology prepared for implementation in water protection. (springeropen.com)
  • Pursuant to the Water Framework Directive (WFD) [ 1 ], water management decisions regarding the protection of water resources should lead to corrective actions whenever the assessment of a given water body (wb) indicates bad status which can be either invoked by below good chemical status or/and moderate or worse ecological status. (springeropen.com)
  • Remediation actions may be abandoned when the assessment of the status is good which is only in case of both good chemical and good or high ecological status. (springeropen.com)
  • a) false-positive assessment (good status of a wb when its true status is below good). (springeropen.com)
  • The risk which appears in the title of this paper in case of false-positive assessment is understood as a financial penalty which would be imposed by the Court of Justice for not fulfilling the obligation of the member state country of achieving good status, which is imposed by the WFD throughout the whole EU. (springeropen.com)
  • La présente étude d'intervention visait à identifier les problèmes de malnutrition et à évaluer l'effet de conseils diététiques sur l'amélioration de l'état de santé des patients atteints d'une maladie rénale en phase terminale soumis à une hémodialyse. (who.int)
  • L'offre de conseils nutritionnels en entretien individuel a entraîné des améliorations dans les connaissances diététiques des patients et dans leurs pratiques en la matière. (who.int)
  • Subjects included early investigations of the environmental effect of tuna seacages, measurement and modeling of nitrogen loads, sediment geochemistry, developing a methodology for assessing seabed impacts, nutrient influence on the seabed, waste mitigation, oxygen availability in sea cages, net fouling communities and synthetic anti-fouling treatments, and regional monitoring systems. (wikipedia.org)
  • To overcome the problem of scarcity of publicly available monitoring data, the existing SWAT model for the studied catchment was used to generate nutrient concentration time series for the baseline conditions and under different scenarios. (springeropen.com)
  • This often leads to feeding of an imbalanced ration, which contains proteins, energy, minerals and vitamins either in excess or deficient related to the nutrient requirements of the animals. (dairyknowledge.in)
  • Based on the observation that animal diets deficient in PQQ resulted in poor growth, low energy, and unsuccessful reproductive performance, it is thought PQQ has an essential nutrient role in the human body (Stites, 2000). (nutriavenue.com)
  • From 2009 to 2012, surface water nutrients and sedimentation (via sediment traps) were measured once a month. (noaa.gov)
  • Continuous and binary outcomes were assessed using multiple linear and logistic regression taking account of potential confounding variables including: age, marital status, employment status, housing tenure, number of children in the household, religion, family history of depression previous childhood psychiatric contact, cigarette and alcohol consumption. (researchgate.net)
  • Malnutrition is an abnormal status originating from an inadequate diet and is well known to aggravate various clinical outcomes [ 5 ]. (krcp-ksn.org)
  • METHODS: This cohort study with an 8-year follow-up targeted 13,802 participants aged 40-74 years at baseline in 2011-2013. (bvsalud.org)
  • and biomarkers to assess annually, or at least once, 25 indicators of micronutrient status and chronic disease. (cdc.gov)
  • Our primary objective in conducting this prospective length 3 times at baseline and 6-month follow-up. (cdc.gov)
  • This might be the added amount of residual fertility some farmers seek in a "build and maintain" soil nutrient management plan. (agrilife.org)
  • It does emphasize fair market value and documentation of existing soil fertility status on the purchase of property. (agrilife.org)
  • What the amount of residual soil fertility would be relative to a baseline of nutrients. (agrilife.org)
  • Based on what we read there are flaws in the economics and purported value of residual soil nutrients. (agrilife.org)
  • Chronic, static changes were assessed from fasting serum/plasma samples at baseline, and after 4 and 8 weeks. (nuthealth.org)
  • With nutrient-stimulated hormone therapies for obesity in phase 3 trials, and activin-receptor inhibitors the next upcoming drug class, highly effective treatments for obesity are on the horizon. (medscape.com)
  • Other studies that assessed the nutritional and anthropometric status of schoolchildren corroborated this scenario of high prevalence of overweight / obesity in this population 7-9 . (bvsalud.org)
  • Nutrient treatments based on food, as opposed to those found on nutrient supplements, present unique difficulties in precisely estimating the absolute change in consumption. (fortunetelleroracle.com)
  • Eating habits established in childhood track through to adulthood, so a childhood diet that is dominated by energy-dense, nutrient-poor foods, low in fruit and vegetables is likely to persist into adulthood [ 2 - 6 ]. (biomedcentral.com)
  • Pay attention to how your unique child responds by removing additives and common triggers and emphasizing a nutrient-dense, anti-inflammatory, whole foods diet. (radiantnourish.com)
  • In contrast, the other PQQ powder showed a maximum blood level at 2 hours and the plasma level was back to baseline by 9 hours. (nutriavenue.com)
  • Clarifying the review's nutrient-specific focus is a crucial step in the phase of the systematic review process known as research question(s) creation and refining. (fortunetelleroracle.com)
  • In dose-response analyses, a 5% increase in energy (En%) from PUFA significantly reduced insulin by 5.8 pmol/L (95% CI −10.2 to −1.3 pmol/L), but not glucose (change −0.07, 95% CI −0.17 to 0.04 mmol/L) and HOMA-IR (change − 0.24, 95% CI −0.56 to 0.07 units). (bmj.com)
  • Moreover, higher hip and waist circumferences were significantly associated with poorly nourished status. (krcp-ksn.org)
  • Previously, there was no agreement or methodology in place to assess the status of these topics. (helcom.fi)
  • have also been the intestinal tract can cause diarrhea and reduce a shown protective against enteric infections and as- child's ability to absorb nutrients, even when infec- sociated with healthy gut microbiota composition tions are asymptomatic, resulting in malnutrition and ( 11 - 13 ). (cdc.gov)
  • In addition to providing our restoration partners information to better understand where the contaminants are coming from and the potential impact of those contaminants to the reef, data from this project provides a baseline against which to measure the success of the restoration effort. (noaa.gov)
  • Finally, data also suggests that the watershed is a major source of nutrients to the Bay and offshore waters. (noaa.gov)
  • All contaminant data is available via the National Status and Trends data server. (noaa.gov)
  • Assessing a status on the basis of measurement data burdened with random disturbances and obtained under changing environmental conditions requires treating the status itself as a random variable with all associated economic and environmental risks of such an approach. (springeropen.com)
  • The outcome of an indicator evaluation is expressed in terms of failing or achieving the threshold value and this is therefore indicative of if good environmental status is achieved or not for each specific indicator. (helcom.fi)
  • Secondary outcome measures are total energy (kCal), other food groups (serves/day and %Energy), key nutrients (mg/day), child feeding domains and parenting style domains. (biomedcentral.com)
  • The oil also has FDA no-objection GRAS status allowing use in food and beverage products. (nutraingredients.com)
  • The treatment group consumes a dairy product containing milk protein and brain nutrients daily for 12 months. (who.int)
  • R- Determine the size structure of the adult populations in 1975 (used as a baseline year for the indicator) to provide the basis for comparison with e3xisting size structures. (sjcmrc.org)
  • Geohistorical records have aided management decisions by addressing questions about setting a baseline to know when restoration has been successful. (uwyo.edu)
  • The Report is the second in a series of publications that offers a snapshot of the U.S. population's nutrition status by assessing a wide range of biochemical indicators. (cdc.gov)
  • It evaluates the state of our nation's nutrition status by measuring biochemical indicators. (cdc.gov)
  • HELCOM indicators are developed to evaluate the status of biodiversity elements, evaluate other relevant environmental condition factors, evaluate human-induced pressures on the Baltic Sea, and support broader assessments and overviews in the region. (helcom.fi)
  • And yeah, the inflammatory response can get out of hand and do more damage than the initial insult, particularly if we have a poor baseline inflammatory status, but it's ultimately how our bodies heal damaged tissues and recover from injuries. (marksdailyapple.com)
  • These responses may be influenced by cardiometabolic risk factor status. (nuthealth.org)
  • If this message of declining oxygenation status and loss of fetal reserves is not heard, the fetus is at serious risk for experiencing hypoxic-ischemic injury. (millerandzois.com)
  • Application of FYM improved the nutrient availability and growth of Salvadora persica. (icfre.gov.in)
  • The early identification of a frail status is essential for preventing loss of functional capacity, and its clinical consequences. (mdpi.com)
  • A recent study found that people with type 2 diabetes who adhered to their tirzepatide regimen achieved a 15% weight loss from their baseline after 40-42 weeks, as reported by Medscape Medical News . (medscape.com)
  • The bioavailability of specific nutrients might change according to a variety of reasons. (fortunetelleroracle.com)
  • Nutrient-deprived conditions in the tumor microenvironment (TME) restrain cancer cell viability due to increased free radicals and reduced energy production. (nature.com)
  • After a course of treatment with high-dose parenteral thiamine and reversal of the acute effects of Wernicke encephalopathy, if there is no improvement in the Korsakoff amnestic state or other mental status abnormalities for 7 days, then a strategy of secondary harm prevention should be pursued. (medscape.com)