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Background: Emergency care is a neglected area of focus in many low- and middle-income countries. There is a paucity of research on types and frequencies of acute illnesses and injuries in low-resource settings.Objective: The primary objective of this study was to describe the demographic characteristics and emergency conditions of patients that presented to a new emergency care center (ECC) at Sagam Community Hospital in Luanda, Kenya.Methods: Patient demographic characteristics, modes of arrival, chief symptoms, triage priorities, self-reported human immunodeficiency virus status, tests performed, interventions, discharge diagnoses, and dispositions were collected for all patients that presented to the Sagam Community Hospital ECC.Results: Between October 1, 2016 and September 30, 2017, 14,518 patients presented to the ECC. The most common mode of arrival to Sagam Community Hospital was by foot (n = 12,605 [86.8%]). There were 8931 (61.5%) female patients and 5571 (38.4%) male patients. Of the total visits, 12,668 (87.3%) were triaged Priority III (lowest priority), 1239 (8.5%) were Priority II, and 293 (2.0%) were Priority I (highest priority). The most common chief symptoms were headache (n = 3923 [15.2%]), hotness of body or chills (n = 2877 [8.8%]), and cough (n = 1827 [5.5%]). The three most common discharge diagnoses were malaria (n = 3692 [18.9%]), acute upper respiratory infection (n = 1242 [6.3%]), and gastritis/duodenitis (n = 1210 [6.2%]).Conclusions: Although opening an ECC in rural Kenya attracted patients in need of care, access was limited primarily to those that could arrive on foot. ECCs in rural sub-Saharan Africa have the potential to provide quality care and support attainment of Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

In the present study, nickel matrix composites reinforced with a fine distribution of nanodiamonds (6.5 vol%) as reinforcement phase are annealed in vacuum at different temperatures ranging from 750 °C to 1300 °C. This is carried out to evaluate the in-situ transformation of nanodiamonds to carbon onions within a previously densified composite. The resulting materials are thoroughly analyzed by complementary analytical methods, including Raman spectroscopy, transmission electron microscopy, scanning electron microscopy, energy dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy. The proposed in-situ transformation method presents two main benefits. On one hand, since the particle distribution of a nanodiamond-reinforced composite is significantly more homogenous than in case of the carbon onions, it is expected that the transformed particles will preserve the initial distribution features of nanodiamonds. On the other hand, the proposed process allows for the tuning of the sp 3 /sp 2 carbon ratio by applying a single straightforward post-processing step. [ABSTRACT FROM AUTHOR]

• SES could represent a barrier in the adequate prescription of DMTs in pwMS. • SES was not predictive of DMT prescribing patterns in this study. • No associations were found when accounting for factors that may influence treatment choice. • Future research should explore potential inequities in the prescription of DMTs. To examine the association between socioeconomic status (SES) and disease-modifying therapy (DMT) prescribing patterns in people with relapsing-remitting multiple sclerosis (pwRRMS). A cross-sectional analysis was conducted among pwRRMS treated with a DMT in the neuroinflammation service at The Royal London Hospital (Barts Health NHS Trust). Study data were collected between July and September 2017. SES was determined by patient income and education extracted from the English Index of Multiple Deprivation. Based on their efficacy, DMTs were categorized as moderate efficacy (Glatiramer Acetate and Beta-Interferons), high efficacy (Cladribine, Fingolimod and Dimethyl Fumarate) and very-high efficacy therapies (Natalizumab and Alemtuzumab). Multinomial logistic regressions were performed for univariate and multivariate models to assess differences between SES and DMT prescribing patterns. Treatment consisted of moderate efficacy (n = 76, 12%), high efficacy (n = 325, 51.3%) and very-high efficacy therapies (n = 232, 36.7%). Medians for income and education deciles were 4 (IQR 3–7) and 6 (IQR 4–8), respectively. After multinomial logistic regression analysis, patient income was not associated with increased odds of being treated with high efficacy (OR, 0.92; 95% CI, 0.82–1.04; p = 0.177) or very-high efficacy DMTs (OR, 0.95; 95% CI, 0.85–1.06; p = 0.371). Similarly, patient education was not associated with being treated with high efficacy (OR, 0.91; 95% CI, 0.80–1.03; p = 0.139) or very-high efficacy therapies (OR, 0.92; 95% CI, 0.81–1.04; p = 0.188). SES was not predictive of DMT prescribing patterns in pwRRMS. Whilst this appears reassuring within this universal health care setting, the same methodology needs to be applied to other MS services for comparison. Data could then be further interrogated to explore potential socioeconomic inequities in DMT prescribing patterns across the UK. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy, effectiveness, and safety of uterine balloon tamponade for treating postpartum hemorrhage.Study Design: We searched electronic databases (from their inception to August 2019) and bibliographies. We included randomized controlled trials, nonrandomized studies, and case series that reported on the efficacy, effectiveness, and/or safety of uterine balloon tamponade in women with postpartum hemorrhage. The primary outcome was the success rate of uterine balloon tamponade for treating postpartum hemorrhage (number of uterine balloon tamponade success cases/total number of women treated with uterine balloon tamponade). For meta-analyses, we calculated pooled success rate for all studies, and relative risk with 95% confidence intervals for studies that included a comparative arm.Results: Ninety-one studies, including 4729 women, met inclusion criteria (6 randomized trials, 1 cluster randomized trial, 15 nonrandomized studies, and 69 case series). The overall pooled uterine balloon tamponade success rate was 85.9% (95% confidence interval, 83.9-87.9%). The highest success rates corresponded to uterine atony (87.1%) and placenta previa (86.8%), and the lowest to placenta accreta spectrum (66.7%) and retained products of conception (76.8%). The uterine balloon tamponade success rate was lower in cesarean deliveries (81.7%) than in vaginal deliveries (87.0%). A meta-analysis of 2 randomized trials that compared uterine balloon tamponade vs no uterine balloon tamponade in postpartum hemorrhage due to uterine atony after vaginal delivery showed no significant differences between the study groups in the risk of surgical interventions or maternal death (relative risk, 0.59; 95% confidence interval, 0.02-16.69). A meta-analysis of 2 nonrandomized before-and-after studies showed that introduction of uterine balloon tamponade in protocols for managing severe postpartum hemorrhage significantly decreased the use of arterial embolization (relative risk, 0.29; 95% confidence interval, 0.14-0.63). A nonrandomized cluster study reported that use of invasive procedures was significantly lower in the perinatal network that routinely used uterine balloon tamponade than that which did not use uterine balloon tamponade (3.0/1000 vs 5.1/1000; P < .01). A cluster randomized trial reported that the frequency of postpartum hemorrhage-related invasive procedures and/or maternal death was significantly higher after uterine balloon tamponade introduction than before uterine balloon tamponade introduction (11.6/10,000 vs 6.7/10,000; P = .04). Overall, the frequency of complications attributed to uterine balloon tamponade use was low (≤6.5%).Conclusion: Uterine balloon tamponade has a high success rate for treating severe postpartum hemorrhage and appears to be safe. The evidence on uterine balloon tamponade efficacy and effectiveness from randomized and nonrandomized studies is conflicting, with experimental studies suggesting no beneficial effect, in contrast with observational studies. Further research is needed to determine the most effective programmatic and healthcare delivery strategies on uterine balloon tamponade introduction and use. [ABSTRACT FROM AUTHOR]

In this work, the updated literature on fluorescent probes based on transition metal complexes used to detect and quantify biologically relevant analytes is reviewed. Special emphasis is made on the so-called gasotransmitters CO, H 2 S & NO and HNO, exploring the different techniques and strategies currently available. • Gasotransmitters are endogenous signalling molecules which include CO, H 2 S and NO. • They transmit chemical signals which induce physiological or biochemical changes. • Fluorescent probes based on transition metal complexes make powerful detection tools. • A variety of sensing mechanisms based on different reactivities are discussed. The signalling agents involved in cellular communication display wide chemical diversity. During the last decades, the rise of a new group of transmitters instigated the revision of traditional concepts of intercellular signalling. Gasotransmitters are a family of soluble molecules, either endogenously synthesized or from exogenous origin, which transmits chemical signals that can induce certain physiological or biochemical changes. These small reactive (and usually transient) species are constantly being produced, trafficked, consumed or transformed in biological environments. Fluorescent probes based on transition metal complexes offer powerful tools to study chemical reactions in the laboratory, through in vitro experiences, and well as the in vivo biochemistry of gasotransmitters in their native environments, as long as minimal disturbance to living systems is ensured. Fundamental organic, organometallic and inorganic reactivity principles, combined with an eye towards biological imaging applications, have given rise to a variety of new chemical tools for probing the complex roles of small molecules in physiology and pathology. In this work, we present different compounds and tactics to use such probes for the detection and quantification of these biologically relevant chemical analytes. [ABSTRACT FROM AUTHOR]

Carbon nanotubes (CNT) have been recently proposed as stabilizers against grain growth that can happen even at low temperature inputs in nano-crystalline and ultrafine-grained materials obtained by severe plastic deformation. In this study, we analyzed the evolution of the structural defects on the nanotubes in CNT-reinforced nickel matrix composites with different reinforcement weight fractions. The composites were processed by high pressure torsion, and we used Raman spectroscopy as the main characterization technique. The results indicate that for CNT subjected to highly energetic processing, it is not sufficient to analyze only the I D /I G ratio (as proposed in the available literature), but it is also necessary to evaluate the shifting of the G band, which traces the amorphization trajectory undergone by the CNT. Furthermore, we observed that the deformation suffered by the CNT is related to the accumulated strain and varies with the partial CNT fractions of these composites. This is related to their capacity to withstand the plastic strain that occurs during deformation. In addition, the defective state reaches a saturation before achieving the saturation in the microstructural refinement. These results will help to efficiently optimize the processing of this type of engineering composites. [ABSTRACT FROM AUTHOR]

Prolonged immobilization in hospitalized children can lead to fragility fractures and muscle contractures and atrophy. The purpose of this study was to develop a lower-extremity disuse rabbit model with musculoskeletal changes similar to those observed in children subjected to prolonged immobilization. Six-week-old rabbits were randomly assigned to control (CTRL, n =4) or bilateral sciatic and femoral neurectomy (bSFN, n =4) groups. Trans-axial helical CT scans of each rabbit׳s hind limbs were acquired after eight weeks. The rabbits were then euthanized and the tibiae and calcanea were harvested from each rabbit. μCT imaging was performed on the tibiae and calcanea mid-diaphysis. Four-point bending, gas pycnometry, and ashing were then performed on each tibia. All comparisons reflect the differences between the bSFN and CTRL rabbits. Significant decreases in tibiae bone mineral density (≥9.41%, p ≤0.006), axial rigidity (≥50.47%, p ≤0.02), and soft tissue mass (55.25%, p =0.006) were observed from the trans-axial helical CT scans. The μCT results indicated significant detriments in tibia and calcaneus cortical thickness and bone volume fraction ( p ≤0.011). Significant changes in stiffness, yield load, ultimate load, and ultimate displacement (≥30.05%, p ≤0.025) were observed from mechanical testing. These data indicate that limb disuse at a time of rapid musculoskeletal growth severely impairs muscle and bone development, reflecting the musculoskeletal complications observed in children with chronic medical conditions causing immobilization. Interventions to reduce these musculoskeletal complications in children are urgently needed. This disuse rabbit model will be useful in pre-clinical studies evaluating novel interventions for improving pediatric musculoskeletal health. [ABSTRACT FROM AUTHOR]

Two new Cu(II) complexes, [Cu(L)(phen)] ( 1 ), [Cu(L)(bipy)] ( 2 ), where L 2- = (3-methoxy-2oxidobenzylidene)benzohydrazidato, phen = 1,10 phenanthroline, and bipy = 2,2′ bipyridine, were prepared and fully characterized using elemental analyses, FT-IR, molar conductivity, and electronic spectra. The structures of both complexes were also determined by X-ray diffraction. It was found that, both complexes possessed square pyramidal coordination environment in which, Cu(II) ions were coordinated by donor atoms of HL and two nitrogens of heterocyclic bases. Computational studies were performed using DFT calculations at B3LYP/6-311+G(d,p) level of theory. DNA binding activities of these complexes were also investigated using electronic absorption, competitive fluorescence titration and cyclic voltammetry studies. The obtained results indicated that binding of the complexes to DNA was of intercalative mode. Furthermore, antimicrobial activities of these compounds were screened against microorganisms. [ABSTRACT FROM AUTHOR]