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IMPORTANCE: A third of children who survive malaria with neurological involvement (central nervous system [CNS] malaria) develop sequelae. A higher maximum temperature (Tmax) and seizures are risk factors for sequelae. OBJECTIVE: To compare aggressive antipyretic therapy using scheduled acetaminophen and ibuprofen vs usual care with acetaminophen alone given only for a temperature of 38.5 °C or higher. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted at inpatient pediatric services of 1 tertiary care and 1 district hospital in Zambia and a tertiary care center in Malawi. Included were children aged 2 to 11 years with CNS malaria (excluding those with creatinine >1.2 mg/dL), who were enrolled from 2019 to 2022. Data analysis took place from December 2022 to April 2023. INTERVENTION: The aggressive antipyretic group received acetaminophen (30 mg/kg load, then 15 mg/kg) plus ibuprofen, 10 mg/kg, every 6 hours, regardless of clinical temperature for 72 hours. The usual care group received 15 mg/kg of acetaminophen as needed every 6 hours for a temperature of 38.5 °C or higher. MAIN OUTCOMES AND MEASURES: The primary outcome variable was Tmax over 72 hours, the total duration of follow-up. Secondary outcomes included seizures and parasite clearance. RESULTS: Five hundred fifty-three patients were screened, 226 (40.9%) were ineligible, and 57 (10.3%) declined. A total 256 participants (n = 128/group) had a mean (SD) age of 4.3 (2.1) years; 115 (45%) were female, and 141 (55%) were male. The aggressive antipyretic group had a lower Tmax, 38.6 vs 39.2 °C (difference, −0.62 °C; 95% CI, −0.82 to −0.42; P < .001) and lower odds of experiencing multiple or prolonged seizures, 10 (8%) vs 34 children (27%) in the usual care group (odds ratio [OR], 0.26; 95% CI, 0.12 to 0.56). No group difference in parasite clearance time was detected. Severe adverse events occurred in 40 children (15%), 25 (20%) in the usual care group and 15 (12%) in the aggressive antipyretic group, including 13 deaths (10 [8%] and 3 [2%], respectively). Increased creatinine resulted in study drug discontinuation in 8 children (6%) in the usual care group and 13 children (10%) in the aggressive antipyretic group (OR, 1.74; 95% CI, 0.63 to 5.07). CONCLUSIONS AND RELEVANCE: This study found that aggressive antipyretic therapy reduced mean Tmax to temperature levels comparable with the Tmax among children without neurological impairments in prior observational studies and improved acute seizure outcomes with no prolongation of parasitemia. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03399318

Byline: Syed. Hossain, Manoj. Mathews, Veerabhadra. Bhyranalyar Nagarajappa, B. Kumar, Channabasa. Veerappa Yelamaggad, C. Singh Objective: To evaluate the antiproliferative and apoptosis inducing activity of different sydnones on cancer cell [...]

Neighborhood of residence is associated with cognitive impairment in children and adolescents with HIV in Lusaka Province, Zambia. Geospatial analysis is an important global health tool to understand how place-based socioeconomic determinants affect disease sequelae.

We report a robust soft photonic crystal system, fabricated using blue phase (BP) liquid crystal, which can efficiently filter the visible light. The BP gel system is obtained without surface treatment or polymerization, and thus is facile and cost effective to fabricate. Perfect monodomain with vivid color is achieved with a low electric field, which can be further tuned to reflect a second color. Most importantly, apart from the field-induced color switching, a dark/transparent state is also achieved due to complete unwinding of the BP helical structure. A potential application as a tunable color-reflecting mirror, which can be switched between “reflecting” and “transparent” states, is proposed.

A light‐controlled molecular machine based on cyclic azobenzenophanes consisting of a dioxynaphthalene rotating unit and a photoisomerizable dioxyazobenzene unit bridged by methylene spacers is reported. In compounds 1and 2, 1,5‐ and 2,6‐dioxynaphthalene moieties, respectively, are linked to p‐dioxyazobenzene by different methylene spacers (n=2 in 1 aand 2; n=3 in 1 b), whereas a 1,5‐dioxynaphthalene moiety is bonded to m‐dioxyazobenzene by bismethylene spacers in 3. In 1 band 2, the naphthalene ring can rotate freely in both the transand cisstates at room temperature. The rotation speed can be controlled either by photoinduced reversible trans–cis(E–Z) isomerization of the azobenzene or by keeping the system at low temperature, as is evident from its NMR spectra. Furthermore, for the first time, we demonstrate a light‐controlled molecular brake, wherein the rotation of the naphthalene moiety through the cyclophane is completely OFF in the transisomer of compound 3due to its smaller cavity size. Such restricted rotation imparts planar chirality to the molecule, and the corresponding enantiomers could be resolved by chiral HPLC. However, the rotation of the naphthalene moiety is rendered ON in the cisisomer due to its increased cavity size, and it is manifested experimentally by the racemization of the separated enantiomers by photoinduced E–Zisomerization.

The first mesoionic nematic and smectic A mesogens derived from sydnones that are characterized by both covalent and ionic features have been synthesized and evidenced by optical, calorimetric and X-ray diffraction studies.

We report the detailed measurements of the rotational viscosity (?1) of a bent-core nematic liquid crystal exhibiting positive dielectric anisotropy by measuring the decay time of the optical phase retardation of the sample. In the nematic phase, ?1?0.25 Pa s (e.g., at T/TNI?0.92, where TNIis nematic to isotropic phase transition temperature.), which is only slightly larger than the values known for several conventional calamitic nematic liquid crystals. ?1starts to increase rapidly below a reduced temperature T/TNI?0.9 showing the effect of short-range smectic fluctuations. The temperature dependence of ?1far from the nematic to smectic-C transition temperature is fitted well with the Osipov-Terentjev theory.