31 ). We illustrate the specification and estimation of dynamic mixture model using "dynr," an R package capable of handling a broad class of linear and nonlinear discrete- and continuous-time models with regime-switching properties.This study assessed how dietary diversity and food coping strategies differ by resilience and food insecurity status. Proportionate sampling technique was used to interview 3440 households in 18 districts of Zimbabwe. Results show that resilient and food secure households had good diet diversification and were less likely to adopt food coping strategies when compared to less resilient and food insecure ones. Adaptive and absorptive resilience capacities and income reduced the use of food coping strategies. Interventions that improve household resilience capacities and income should be promoted to reduce the use of food coping strategies. Forefoot varus is a physical and radiographic examination finding associated with the Progressive Collapsing Foot Deformity (PCFD). Varus position of the forefoot relative to the hindfoot is caused by medial midfoot collapse with apex plantar angulation of the medial column. see more Some surgeons use the term to describe this same deformity (see Introduction section with nomenclature). Correction of this deformity is important to restore the weightbearing tripod of the foot and help resist a recurrence of foot collapse. When the forefoot varus deformity is isolated to the medial metatarsal and medial cuneiform, correction is indicated with an opening wedge medial cuneiform (Cotton) osteotomy, typically with interposition of an allograft bone wedge from 5 to 11 mm in width at the base. When the forefoot varus is global, involving varus angulation of the entire forefoot and midfoot relative to the hindfoot, other procedures are needed to adequately correct the deformity. Level V, consensus, expert opinion.Level V, consensus, expert opinion. Our aim was to assess the prevalence of dental caries in Egyptian children with cleft lip or cleft lip and palate (CLP), according to dietary habits, and to assess the level of dental care given to these patients. Children aged 4 to 12 years (N = 120) with CLP were recruited 54 with primary dentition and 66 with mixed dentition. Personal data were gathered and parents completed a 5-day diet diary for the children. The prevalence of dental caries was determined with the dmft and DMFT indices, and debris and calculus were assessed with the simplified oral hygiene index. Of this, 16.7% of children were caries-free. Caries experience was directly correlated with the intake of carbohydrate-containing items between meals, but not with intake at meal times. Oral-hygiene (debris) status did not differ significantly between the CLP groups. Calculus was found in 6.6% of the children. Only 8.3% of the study population had received oral-hygiene instructions from a health care professional. A direct correlation was found between caries experience and the intake of sugar-containing items in-between meals, indicating the importance of dietary advice into the comprehensive dental management of patients with CLP. Our sample had not received effective dental services.A direct correlation was found between caries experience and the intake of sugar-containing items in-between meals, indicating the importance of dietary advice into the comprehensive dental management of patients with CLP. Our sample had not received effective dental services. Retrospective case series. To evaluate the variability in opioid prescription following primary single-level lumbar microdiscectomy. We retrospectively reviewed consecutive patients who underwent primary single-level lumbar microdiscectomy. Only opioid-naïve patients ≥18 years old were included. Patients who had revision microdiscectomy, multilevel decompression, and/or any complication requiring prolonged hospital stay (>2 days) were excluded. The primary outcomes were the maximum daily dosage of opioids prescribed in morphine milligram equivalents (MME) and the number of pills prescribed (equivalent to 5 mg hydrocodone). Between 2014 and 2019, 169 patients (90 men, 79 women) met inclusion criteria, with a mean age of 46.9 years. Surgery resulted in a statistically significant improvement in VAS (Visual Analogue Scale) score (6.4 to 2.5, < .01). At discharge, 8 patients (4.7%) did not receive any opioid prescription. Of the remaining 161 patients, 1 patient (0.01%) received hydromorphone, 30rescribing guidelines should be established to standardize postoperative pain management.This study was carried out to evaluate awareness, knowledge, and use of folic acid and dietary folate intake among non-pregnant women of childbearing age and pregnant women. A cross-sectional study was completed with 1442 women (1106 non-pregnant and 336 pregnant) in Ankara, Turkey. The individuals' awareness, knowledge, and use of folic acid were questioned and food consumption were taken. More than two-thirds of the non-pregnant and pregnant women had heard of folic acid (77.2% and 89.0%, respectively). The pregnant women (53.9%) knew more that folic acid should be used before conception in order to prevent congenital anomalies than non-pregnant women (41.4%). It was found that 70.2% of the pregnant women and only 15.1% of the non-pregnant women used folic acid supplementation. The pregnant women (1368.4 mcg; 330.4 mcg) significantly had higher folic acid and dietary folate intake than non-pregnant women (29.6 mcg; 289.3 mcg) (p less then .01). Despite many public health campaigns, awareness, knowledge, and appropriate use of folic acid are still inadequate and not at the desired level in women of childbearing age.Owing to an improved understanding of the immunobiological profile of renal cell carcinoma (RCC), the past few years have ushered in significant changes in systemic therapies for advanced stage RCC. First-line treatment with single-agent tyrosine kinase inhibitors (TKI) has been virtually replaced for most patients by immunotherapy combinations. The first of such treatments was the dual immune checkpoint inhibitor combination of ipilimumab and nivolumab. More recently, the combination of an immune checkpoint inhibitor and a TKI has also moved into the first-line setting. This review summarizes the pharmacologic properties, evidence for use and safety of avelumab, a PD-L1 inhibitor and axitinib a small-molecule TKI, each as monotherapy, and in combination for the management of metastatic RCC.