Search

An isotropic elastic solid reinforced with two families of aligned fibres behaves anisotropic to any deformation. For arbitrary orientation of fibres in either family, one set of fibres may be inclined obliquely to the aligned fibres in other family. A plane that contains the two families of aligned fibres becomes the plane of symmetry for composite material to exhibit monoclinic anisotropy. For this fibrous anisotropy, a fourth‐order elastic tensor is derived to define the constitutive relations between stress tensor and strain tensor. Components of this elastic tensor involve two Lame's moduli, eight fibroelastic coefficients and the angular deviation between two obliquely inclined fibre‐families. The velocities of bulk waves are calculated for propagation along general direction in this anisotropic composite. Propagation of surface wave is considered along the stress‐free plane boundary of anisotropic elastic half‐space. In a coordinate system with coordinate planes deviating from the plane boundary of the medium and/or plane of anisotropic symmetry, the fibrous composite is treated as triclinic for mathematical convenience. Mathematical model is derived to calculate the phase velocity of the surface wave, which varies with direction on the plane boundary. Horizontal energy flux at the boundary is calculated to determine the group velocity and ray direction of the surface wave. Effects of fibre‐orientations are analysed, numerically, on the wave velocities and ray direction of surface wave. [ABSTRACT FROM AUTHOR]

An isotropic elastic solid reinforced with a family of parallel fibres behaves anisotropic to any deformation. With orientation of all fibres along a coordinate axis in rectangular Cartesian system, this anisotropy reduces to transverse isotropy. Else with arbitrary orientation of fibre‐family, induced anisotropy lacks any symmetry. In this composite medium with arbitrary anisotropy, three‐dimensional wave motion decaying with depth propagates as a surface wave along all directions on plane boundary. Real phase velocity for this surface wave lies implicit in a system of three equations with complex coefficients. An appropriate transformation of this system yields a real characteristic equation, which is solved to get the anisotropic phase velocity of generalised surface wave. This phase velocity defines a complex slowness vector, which is used to calculate the particle motion at any point in the medium. Effects of fibre‐orientation are analysed, numerically, on the phase velocity and polarisation of surface wave. For example, in the reinforced fibres alters the contours of particle motion through increased ellipticity. However, in the presence of fibres, the decay of particle motion with depth slows down. [ABSTRACT FROM AUTHOR]

Species assemblages are influenced by trophic and intraguild interactions, which may be competitive, facilitative, or neutral. These interactions vary in relative importance depending on resource availability. We assessed the nature of interactions among six carnivore species (Ursus arctos, Panthera uncia, Vulpes vulpes, Mustela altaica, and Martes foina) and their prey (Capra sibirica, Pseudois nayaur, Hemitragus jemlahicus, Moschus leucogaster, Ochotona sp., and Rodentia sp.) by examining their spatial–temporal overlaps using camera‐trap data gathered between 2016 and 2019 from the resource‐limited landscapes of the high Himalayas. We examined fine scale pairwise spatial interaction using multi‐species occupancy method and temporal overlap using time activity kernel densities function. Carnivore species showed relatively high spatio‐temporal overlap. We found spatial avoidance between two pairs and temporal avoidance between four out of 15 pairs. Contrary to our expectation that carnivore species would segregate due to competition in a resource‐poor environment, our results showed that they generally showed significant co‐occurrence and appeared to track their prey's activity. Our findings highlight the potentially overriding role of prey availability in influencing carnivore species occurrence in resource‐poor landscapes. [ABSTRACT FROM AUTHOR]

Mathematical model for mechanical and electrical dynamics is solved for three‐dimensional propagation of harmonic plane waves in a piezoelectric medium with arbitrary anisotropy. A system of modified Christoffel equations is derived to explain the existence and propagation of bulk waves or decaying phases in the considered medium. At the free plane boundary, a superposition of decaying phases form a generalised Rayleigh wave, which is governed by a linear system of four homogeneous equations. A complex determinantal secular equation ensures a solution to this system. True surface wave at the boundary of the considered medium demands a real solution of this complex secular equation. The linear system of four equations is then transformed to replace the complex secular equation with a real one, which can be solved by standard numerical methods. A real solution of this real secular equation provides the phase velocity for generalised Rayleigh wave at the boundary of piezoelectric medium with arbitrary anisotropy. This phase velocity defines a complex slowness vector, which is used to calculate the motion of material particles and the wave‐induced electric field. A numerical example is considered to compute the phase velocity as well as group velocity for given (arbitrary) propagation directions of Rayleigh wave at the boundary. Variations in particle motion and electric field, induced by Rayleigh wave, are analysed at different depths for different propagation directions at the boundary. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) has approved the 11th Revision of the International Classification of Diseases (ICD‐11). A version of the ICD‐11 for Mental, Behavioural and Neurodevelopmental Disorders for use in clinical settings, called the Clinical Descriptions and Diagnostic Requirements (CDDR), has also been developed. The CDDR includes behavioural indicators (BIs) for assessing the severity of disorders of intellectual development (DID) as part of the section on neurodevelopmental disorders. Reliable and valid diagnostic assessment measures are needed to improve identification and treatment of individuals with DID. Although appropriately normed, standardised intellectual and adaptive behaviour assessments are considered the optimal assessment approach in this area, they are unavailable in many parts of the world. This field study tested the BIs internationally to assess the inter‐rater reliability, concurrent validity, and clinical utility of the BIs for the assessment of DID. Methods: This international study recruited a total of 206 children and adolescents (5–18 years old) with a suspected or established diagnosis of DID from four sites across three countries [Sri‐Lanka (n = 57), Italy (n = 60) and two sites in India (n = 89)]. Two clinicians assessed each participant using the BIs with one conducting the clinical interview and the other observing. Diagnostic formulations using the BIs and clinical utility ratings were collected and entered independently after each assessment. At a follow‐up appointment, standardised measures (Leiter‐3, Vineland Adaptive Behaviour Scales‐II) were used to assess intellectual and adaptive abilities. Results: The BIs had excellent inter‐rater reliability (intra‐class correlations ranging from 0.91 to 0.97) and good to excellent concurrent validity (intra‐class correlations ranging from 0.66 to 0.82) across sites. Compared to standardised measures, the BIs had more diagnostic overlap between intellectual and adaptive functioning. The BIs were rated as quick and easy to use and applicable across severities; clear and understandable with adequate to too much level of detail and specificity to describe DID; and useful for treatment selection, prognosis assessments, communication with other health care professionals, and education efforts. Conclusion: The inclusion of newly developed BIs within the CDDR for ICD‐11 Neurodevelopmental Disorders must be supported by information on their reliability, validity, and clinical utility prior to their widespread adoption for international use. BIs were found to have excellent inter‐rater reliability, good to excellent concurrent validity, and good clinical utility. This supports use of the BIs within the ICD‐11 CDDR to assist with the accurate identification of individuals with DID, particularly in settings where specialised services are unavailable. [ABSTRACT FROM AUTHOR]

Clinically, the lesions of dermal hypersensitivity reaction are characterized by papular urticaria-like eruptions lasting for longer than 24 h.3 Eruptive pseudoangiomatosis (EPA) is a variant of dermal hypersensitivity reaction consisting of benign, self-limiting exanthematous lesions. I To the Editor i , Delayed immunologic reactions are being increasingly reported following the administration of COVID-19 vaccines.1,2 Dermal hypersensitivity reaction is one such reaction pattern. Development of delayed dermal hypersensitivity reaction following the second dose of COVID-19 vaccine - A series of 37 cases. [Extracted from the article]

An attenuating wave field in an anisotropic poroviscoelastic medium is represented through the three‐dimensional inhomogeneous propagation of four bulk waves. Propagation of each wave is governed by a complex slowness vector, which specifies its phase direction, phase velocity and coefficients for homogeneous/inhomogeneous attenuation. Partially opened surface pores restrict the seepage of pore fluid at the boundary. A generalized reflection phenomenon is illustrated for incidence of inhomogeneous waves at this boundary. Horizontal slowness of this incidence derives the slowness vectors of four inhomogeneous waves reflected into the medium. Slowness vectors and polarizations of incident and reflected waves are used to calculate the amplitudes, phase shifts and energy fluxes of reflected waves in comparison to the incident wave. A particular example illustrates the numerical implementation of the derived mathematical model for anisotropic poroviscoelastic reflection. [ABSTRACT FROM AUTHOR]

Copyright of World Water Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We demonstrate that global observations of high-energy cosmic rays contribute to understanding unique characteristics of a large-scale magnetic flux rope causing a magnetic storm in August 2018. Following a weak interplanetary shock on August 25, 2018, a magnetic flux rope caused an unexpectedly large geomagnetic storm. It is likely that this event became geoeffective because the flux rope was accompanied by a corotating interaction region and compressed by high-speed solar wind following the flux rope. In fact, a Forbush decrease was observed in cosmic-ray data inside the flux rope as expected, and a significant cosmic-ray density increase exceeding the unmodulated level before the shock was also observed near the trailing edge of the flux rope. The cosmic-ray density increase can be interpreted in terms of the adiabatic heating of cosmic rays near the trailing edge of the flux rope, as the corotating interaction region prevents free expansion of the flux rope and results in the compression near the trailing edge. A northeast-directed spatial gradient in the cosmic-ray density was also derived during the cosmic-ray density increase, suggesting that the center of the heating near the trailing edge is located northeast of Earth. This is one of the best examples demonstrating that the observation of high-energy cosmic rays provides us with information that can only be derived from the cosmic ray measurements to observationally constrain the three-dimensional macroscopic picture of the interaction between coronal mass ejections and the ambient solar wind, which is essential for prediction of large magnetic storms. [ABSTRACT FROM AUTHOR]

The patient underwent CS for presumed fetal distress, during which she developed a PPH secondary to coagulopathy. We report on eight cases of maternal coagulopathy associated with coronavirus disease 2019 (COVID-19) in unvaccinated women in Northern Ireland during the Delta variant era of the pandemic from July to October 2021. The patient had baseline thrombocytopenia at admission and developed coagulopathy. [Extracted from the article]

Background and purpose: Prevention of ischaemic stroke and cardiovascular events is an established benefit of statin therapy, but the effects of statin treatment on the accrual of magnetic resonance imaging (MRI) markers of ischaemic cerebral injury remain unknown. A systematic review was performed to identify all studies that randomized patients with cardiovascular risk factors to statin treatment and assessed the effect of statin treatment on covert infarcts (asymptomatic, evident only on neuroimaging) and white matter hyperintensity (WMH) accrual on MRI. Methods: A systematic review in MEDLINE and Scopus from inception to 23 October 2019 was performed. A random‐effects model was used to calculate the pooled estimates of the crude risk ratios and standardized mean differences. Results: Data from three randomized controlled trials (1430 participants) were included evaluating the effect of rosuvastatin (10 mg/day) in 668 hypertensive patients older than 60 years of age over 5 years, pravastatin (40 mg/day) in 554 elderly people more than 70 years of age over 3 years and simvastatin (20 mg/day) in 208 patients with asymptomatic middle cerebral artery stenosis over 2 years. Patients randomized to statin treatment had decreased accrual of new covert infarcts (risk ratio 0.63, 95% confidence interval 0.46–0.88) during a mean follow‐up of 2–6 years. Only one study reported WMH decreased volume change in patients randomized to statin treatment compared to patients randomized to non‐statin treatment (standardized mean difference −1.17; 95% confidence interval −1.33, −1.00). Conclusion: Our findings suggest that, in addition to stroke prevention, statin treatment can reduce the accrual of covert MRI markers of ischaemic cerebral injury. [ABSTRACT FROM AUTHOR]

Cosmic rays are charged particles whose flux observed at Earth shows temporal variations related to space weather phenomena and may be an important tool to study them. The cosmic ray intensity recorded with ground‐based detectors also shows temporal variations arising from atmospheric variations. In the case of muon detectors, the main atmospheric effects are related to pressure and temperature changes. In this work, we analyze both effects using data recorded by the Global Muon Detector Network, consisting of four multidirectional muon detectors at different locations, in the period between 2007 and 2016. For each Global Muon Detector Network directional channel, we obtain coefficients that describe the pressure and temperature effects. We then analyze how these coefficients can be related to the geomagnetic cutoff rigidity and zenith angle associated with cosmic ray particles observed by each channel. In the pressure effect analysis, we found that the observed barometric coefficients show a very clear logarithmic correlation with the cutoff rigidity divided by the zenith angle cosine. On the other hand, the temperature coefficients show a good logarithmic correlation with the product of the cutoff and zenith angle cosine after adding a term proportional to the sine of geographical latitude of the observation site. This additional term implies that the temperature effect measured in the Northern Hemisphere detectors is stronger than that observed in the Southern Hemisphere. The physical origin of this term and of the good correlations found in this analysis should be studied in detail in future works. Key Points: Pressure and temperature effects observed by ground muon detectors was experimentally analyzed inrelation to cutoff rigidity and zenith angleThe best correlation was found when considering product between cutoff rigidity and zenith angle secant (pressure) or cosine (temperature)The temperature effect only shows a global trend if a relationship with the sine of each detector's geographic latitude is included [ABSTRACT FROM AUTHOR]

The compound 2‐aminoethanol is considered a precursor to amino acid in interstellar space. Thus, scientists searching for life in the universe have a great interest in its investigation, and therefore, its laboratory spectrum has been analyzed from time to time. It has a large electric dipole moment with components along all the three principal inertial axes: μa = 2.75 D, μb = 1.07 D, and μc = 0.77 D. Corresponding to each component, the energy levels can be classified into two sets. For each of the six sets, using the spectroscopic data of 2‐aminoethanol, we have calculated energies of 150 rotational levels in the ground vibrational state and ground electronic state. For rotational transitions, we have calculated the line intensities and Einstein A‐coefficients. For each set, using the Einstein A‐coefficients and scaled values of the collisional rate coefficients, we have solved a set of 150 statistical equilibrium equations coupled with the equations of radiative transfer. In the model, there is a cosmic microwave background corresponding to a temperature of 2.73 K. The brightness temperatures of all the b‐type and c‐type transitions are found to be nearly equal to the background temperature. Eight a‐type transitions are found to demonstrate the anomalous absorption. These transitions may play an important role for the identification of 2‐aminoethanol in a cosmic object. [ABSTRACT FROM AUTHOR]

Two molecules TiH and TiO, bearing titanium, were discovered in the year 1979 in the atmosphere of cool M-type stars. Now, TiO2 has been discovered in the environment of the red supergiant VY CMa. A natural question therefore arises for the search of TiH2 in an interstellar molecular cloud. Detection of TiH2is quite probable as the cosmic abundance of hydrogen is about 1,900 times that of oxygen. Using GAUSSIAN 2009, we have calculated the rotational and centrifugal distortion constants, and electric dipole moment of TiH2, where B3LYP method and cc-pVtz basis are used. Using these physical parameters, we have calculated the energies of rotational levels, and the intensities and Einstein A-coefficients for the transitions between the levels. We have found a large number of lines which may help in the identification of titanium dihydride (TiH2) in an interstellar molecular cloud. [ABSTRACT FROM AUTHOR]

In order to analyze a spectrum from the interstellar medium, the spectrum of the molecule of interest is recorded in a laboratory, and accurate rotational and centrifugal distortion constants are derived. By using these constants, one can calculate accurate partition function as a function of temperature. However, in the same paper, where these constants are derived, the partition function is calculated by using a semi-empirical expression. We looked into the details of this semi-empirical expression and compared the values obtained from it with the accurate ones. By considering the case of methanimine, we investigated the impact of the partition function on the total internal energy and the specific heat at constant volume. [ABSTRACT FROM AUTHOR]

Background: In order to understand the pathophysiology of rectal sensorimotor dysfunctions in women with fecal incontinence (FI) and rectal urgency, we evaluated the effects of a muscarinic antagonist and an adrenergic α2 agonist on these parameters. Methods: Firstly, rectal distensibility and sensation were evaluated with a barostat and sinusoidal oscillation at baseline and after randomization to intravenous saline or atropine in 16 healthy controls and 44 FI patients. Thereafter, FI patients were randomized to placebo or clonidine for 4 wk; rectal compliance and sensation were revaluated thereafter. The effect of atropine and clonidine on rectal functions and the relationship between them were evaluated. Results: At baseline, compared to controls, rectal capacity was lower (P = .03) while the mean pressure (P = .02) and elastance (P = .01) during sinusoidal oscillation were greater, signifying reduced distensibility, in FI. Compared to placebo, atropine increased (P ≤ .02) the heart rate in controls and FI and reduced (P = .03) the variability in rectal pressures during sinusoidal oscillation in controls. Clonidine increased rectal compliance (P = .04) and reduced rectal capacity (P = .03) in FI. The effects of atropine and clonidine on compliance (r = .44, P = .003), capacity (r = .34, P = .02), pressures during sinusoidal oscillation (r = .3, P = .057), pressure (r = .6, P < .0001), and volume sensory thresholds (r = .48, P = .003) were correlated. Conclusions: The effects of atropine and clonidine on rectal distensibility and sensation were significantly correlated. A preserved response to atropine suggests that reduced rectal distensibility is partly reversible, mediated by cholinergic mechanisms, and may predict the response to clonidine, providing a pharmacological challenge. [ABSTRACT FROM AUTHOR]

A case study of two female patients with cerebrotendinous xanthomatosis (CTX) is presented.

Laser capture microdissection ( LCM) is a high-end research and diagnostic technology that helps in obtaining pure cell populations for the purpose of cell- or lesion-specific genomic and proteomic analysis. Literature search on the application of LCM in oral tissues was made through PubMed. There is ample evidence to substantiate the utility of LCM in understanding the underlying molecular mechanism involving an array of oral physiological and pathological processes, including odontogenesis, taste perception, eruptive tooth movement, oral microbes, and cancers of the mouth and jaw tumors. This review is aimed at exploring the potential application of LCM in oral tissues as a high-throughput tool for integrated oral sciences. The indispensable application of LCM in the construction of lesion-specific genomic libraries with emphasis on some of the novel molecular markers thus discovered is also highlighted. [ABSTRACT FROM AUTHOR]

A 24-year-old male patient presented at the gastroenterology outpatients department of our institute with complaints of yellowish discoloration of eyes and pruritus for preceding 1 month. Patient underwent gastroscope, which showed multiple sessile and pedunculated polyps in the stomach and duodenum (Fig. Histopathology of the colonic polyps confirmed the presence of hamartomatous polyps. [Extracted from the article]

Objective: To estimate health benefits and incremental cost-effectiveness of human papillomavirus (HPV) vaccination of pre-adolescent boys and girls compared with girls alone for preventing cervical cancer and genital warts.Design: Model-based economic evaluation.Setting: Southern Vietnam.Population: Males and females aged ≥9 years.Methods: We simulated dynamic HPV transmission to estimate cervical cancer and genital warts cases. Models were calibrated to epidemiological data from south Vietnam.Main Outcome Measures: Incremental cost-effectiveness ratios (ICERs): cost per quality-adjusted life-year (QALY).Results: Vaccinating girls alone was associated with reductions in lifetime cervical cancer risk ranging from 20 to 56.9% as coverage varied from 25 to 90%. Adding boys to the vaccination programme yielded marginal incremental benefits (≤3.6% higher absolute cervical cancer risk reduction), compared with vaccinating girls alone at all coverages. At ≤25 international dollars (I$) per vaccinated adolescent (I$5 per dose), HPV vaccination of boys was below the threshold of Vietnam's per-capita GDP (I$2800), with ICERs ranging from I$734 per QALY at 25% coverage to I$2064 per QALY for 90% coverage. Including health benefits from averting genital warts yielded more favourable ICERs, and vaccination of boys at I$10/dose became cost-effective at or below 75% coverage. Using a lower cost-effectiveness threshold of 50% of Vietnam's GDP (I$1400), vaccinating boys was no longer attractive at costs above I$5 per dose regardless of coverage.Conclusion: Vaccination of boys may be cost-effective at low vaccine costs, but provides little benefit over vaccinating girls only. Focusing on achieving high vaccine coverage of girls may be more efficient for southern Vietnam and similar low-resource settings.Tweetable Abstract: Limited cervical cancer reduction from including boys in HPV vaccination of girls in low-resource settings. [ABSTRACT FROM AUTHOR]

The emergence of new antibiotic-resistant Escherichia coli pathotypes associated with human disease has led to an investigation in terms of the origins of these pathogens. According to the Centers for Disease Control and Prevention, unspecified agents are responsible for 38.4 million of the 48 million (80%) cases of foodborne illnesses each year in the United States. It is hypothesized that environmental E. coli not typically associated with the ability to cause disease in humans could potentially be responsible for some of these cases. In order for an environmental E. coli isolate to have the ability to cause foodborne illness, it must be able to utilize the same attachment and virulence mechanisms utilized by other human pathogenic E. coli. Recent research has shown that many avian pathogenic E. coli ( APEC) isolated from poultry harbour attachment and virulence genes also currently found in human pathogenic E. coli isolates. Research also suggests that, in addition to the ability to cause gastrointestinal illnesses, APEC may also be an etiological agent of foodborne urinary tract infections ( FUTIs). The purpose of this article was to evaluate the evidence pertaining to the ability of APEC to cause disease in humans, their potential for zoonotic transfer along with discussion on the types of illnesses that may be associated with these pathogens. [ABSTRACT FROM AUTHOR]

Objective The correct identification of fungal organisms is important for the appropriate clinical management of patients. It becomes difficult in necrotic smears when the tissue response is not clearly discernible. It is difficult to distinguish between histoplasma and cryptococcus in severely necrotic cases, where both appear as variably sized clear refractile haloes. Methods Four cases of adrenal necrotic histoplasma infection were studied and the morphology was compared with that of non-necrotic histoplasmosis and cases of cryptococcal infection. Eleven cases were analysed in fine needle aspiration cytology ( FNAC) smears. Ziehl-Neelsen ( ZN) stain was performed to exclude tuberculosis in necrotic smears. A clinical and serology correlation was performed where available. Results Necrotic cases of histoplasma infection revealed negative refractile clear haloes similar to those of cryptococcus. Histoplasma showed methylene blue-stained organisms in ZN stains, whereas the cryptococcus cases were negative. Similar methylene blue-stained organisms were seen in non-necrotic histoplasma infection. Conclusion As a result of morphological overlap between cryptococcus and histoplasma, the distinction between the two fungi can be difficult in many cases. ZN staining appears to have a role in the differentiation of these fungi in severely necrotic cases. This observation needs to be validated on a larger number of cases with complete correlation with clinical, serology and treatment records. [ABSTRACT FROM AUTHOR]

Objectives Women of reproductive age represent a large proportion of the global population living with HIV/ AIDS. With improvements in morbidity and mortality since the advent of combination antiretroviral therapy, contraception and pregnancy planning are an increasingly important issue for women living with HIV. This review aims to outline the key considerations when choosing contraceptive methods in HIV-positive women and provides a review of the literature to inform decision-making. Methods Pubmed was searched using the terms ' HIV', 'contraception', ' HIV progression', ' HIV acquisition', ' HIV transmission' and the combination of 'antiretroviral' and 'contraception'. Abstracts were reviewed and relevant articles were retrieved. Reference lists were also reviewed for pertinent citations. Results HIV and contraceptive methods can interact in several clinically meaningful ways. Concomitant use may result in altered contraceptive efficacy, drug−drug interactions, or increased toxicity. Hormonal contraceptives have not been shown to affect HIV progression. Notably, the impact of hormonal contraceptives on HIV transmission and acquisition remains unclear, particularly for injectable forms. Data are lacking on several newer methods of contraception including contraceptive rings, patches and intrauterine systems. Conclusions Effective, reliable contraception is important for HIV-positive women. Efficacy, toxicity, drug interactions, and potential impacts on HIV disease progression, transmission, and acquisition must be assessed when making clinical decisions. [ABSTRACT FROM AUTHOR]

In individuals with advanced type 2 diabetes ( T2DM), combination therapy is often unavoidable to maintain glycaemic control. Currently metformin is considered the first line of defence, but many patients experience gastrointestinal adverse events, necessitating an alternative treatment approach. Established therapeutic classes, such as sulphonylureas and thiazolidinediones, have some properties undesirable in individuals with T2DM, such as hypoglycaemia risk, weight gain and fluid retention, highlighting the need for newer agents with more favourable safety profiles that can be combined and used at all stages of T2DM. New treatment strategies have focused on both dipeptidyl peptidase ( DPP)-4 inhibitors, which improve hyperglycaemia by stimulating insulin secretion in a glucose-dependent fashion and suppressing glucagon secretion, and sodium-glucose co-transporter-2 ( SGLT2) inhibitors, which reduce renal glucose reabsorption and induce urinary glucose excretion, thereby lowering plasma glucose. The potential complimentary mechanism of action and good tolerance profile of these two classes of agents make them attractive treatment options for combination therapy with any of the existing glucose-lowering agents, including insulin. Together, the DPP-4 and SGLT2 inhibitors fulfill a need for treatments with mechanisms of action that can be used in combination with a low risk of adverse events, such as hypoglycaemia or weight gain. [ABSTRACT FROM AUTHOR]

The role of quantitative hepatitis B surface antigen ( HBs Ag) levels in patients receiving highly potent oral antiviral therapy is controversial, and here, we determined the HBs Ag response in 121 chronic hepatitis B patients treated with tenofovir 300 mg daily. During tenofovir treatment, HBs Ag decline of ≥1.0 log from baseline was seen in 16.1%, 16.3%, 18.4%, 34.6%, 36.4% and 11.8%, 15.2%, 14.8%, 28.6%, 20% at years 1, 2, 3, 4, 5 for HBe Ag-positive and HBe Ag-negative patients, respectively. Early decline in HBs Ag levels at week 4 was predictive of subsequent significant HBs Ag level decline. HBe Ag seroconversion occurred in 29.9% of HBe Ag-positive patients. On multinomial logistic regression, HBs Ag level decline from baseline at week 4 and week 12 or any time subsequently did not correlate with HBe Ag seroconversion and HBV DNA level decline from baseline at week 4 and week 12 ( OR = 3.704; 95% CI = 1.511-9.076; P = 0.006 and OR = 1.732; 95% CI = 1.032-2.867; P = 0.037, respectively) was significantly predictive of seroconversion. A small proportion of chronic HBV-infected patients treated with tenofovir exhibit a significant (≥1.0 log) decline in HBs Ag levels. Early decline in HBs Ag levels at week 4 was predictive of subsequent and significant HBs Ag level decline. The HBs Ag decline did not correlate with HBe Ag seroconversion in HBe Ag-positive patients. Reduction in HBV DNA levels at week 4 and 12 correlated with seroconversion. [ABSTRACT FROM AUTHOR]

Medicinally, sandalwood oil (SO) has been attributed with antiinflammatory properties; however, mechanism(s) for this activity have not been elucidated. To examine how SOs affect inflammation, cytokine antibody arrays and enzyme-linked immunosorbent assays were used to assess changes in production of cytokines and chemokines by co-cultured human dermal fibroblasts and neo-epidermal keratinocytes exposed to lipopolysaccharides and SOs from Western Australian and East Indian sandalwood trees or to the primary SO components, α-santalol and β-santalol. Lipopolysaccharides stimulated the release of 26 cytokines and chemokines, 20 of which were substantially suppressed by simultaneous exposure to either of the two sandalwood essential oils and to ibuprofen. The increased activity of East Indian SO correlated with increased santalol concentrations. Purified α-santalol and β-santalol equivalently suppressed production of five indicator cytokines/chemokines at concentrations proportional to the santalol concentrations of the oils. Purified α-santalol and β-santalol also suppressed lipopolysaccharide-induced production of the arachidonic acid metabolites, prostaglandin E2, and thromboxane B2, by the skin cell co-cultures. The ability of SOs to mimic ibuprofen non-steroidal antiinflammatory drugs that act by inhibiting cyclooxygenases suggests a possible mechanism for the observed antiinflammatory properties of topically applied SOs and provides a rationale for use in products requiring antiinflammatory effects. [ABSTRACT FROM AUTHOR]

The contamination of lettuce, spinach and basil with pathogenic E. coli has caused numerous illnesses over the past decade. E. coli O157: H7, E. coli O104: H4 and avian pathogenic E. coli ( APECstx- and APECstx+) were inoculated on basil plants and in promix substrate using drip and overhead irrigation. When overhead inoculated with 7 log CFU/ml of each strain, E. coli populations were significantly ( P = 0.03) higher on overhead-irrigated plants than on drip-irrigated plants. APEC stx-, E. coli O104: H4 and APEC stx+ populations were recovered on plants at 3.6, 2.3 and 3.1 log CFU/g at 10 dpi (days post-inoculation), respectively. E. coli O157: H7 was not detected on basil after 4 dpi. The persistence of E. coli O157: H7 and APECstx- were similar when co-inoculated on lettuce and spinach plants. On spinach and lettuce, E. coli O157: H7 and APEC populations declined from 5.7 to 6.1 log CFU/g and 4.5 log CFU/g, to undetectable at 3 dpi and 0.6-1.6 log CFU/g at 7 dpi, respectively. The detection of low populations of APEC and E. coli O104: H4 strains 10 dpi indicates these strains may be more adapted to environmental conditions than E. coli O157: H7. This is the first reported study of E. coli O104: H4 on a produce commodity. [ABSTRACT FROM AUTHOR]

Aim Postoperative oral nutritional supplementation is becoming a part of most patient care pathways. This study examined the effects of low-volume high-calorie prescribed supplemental nutrition on patient outcome following elective colorectal surgery. Method Patients undergoing elective colorectal resections were randomized to a prescribed nutritional supplementation group ( SG) [standard diet + 6 × 60 ml/day of Pro- Cal (60 ml = 200 kcal + 4 g protein)] or conventional postoperative diet group ( CG) (standard diet alone). Preoperative and daily postoperative hand-grip strengths were measured using a grip dynamometer after randomization. Daily food intake, return of bowel activity, nausea score for the first 3 days and postoperative length of hospital stay ( LOS) were prospectively recorded. Micro-diet standardized software was used to analyse food diaries. Nonparametric tests were used to analyse the data. Results Fifty-five patients were analysed ( SG 28, CG 27). There was no difference in median preoperative and postoperative handgrip strengths at discharge within each group ( SG 31.7 vs 31.7 kPa, P = 0.932; CG 28 vs 28.1 kPa, P = 0.374). The total median daily calorie intake was higher in SG than CG ( SG 818.5 kcal vs CG 528 kcal; P = 0.002). There was no difference in median number of days to first bowel movement ( SG 3 days vs CG 4 days, P = 0.096). The median LOS was significantly shorter in SG than CG (6.5 vs 9 days; P = 0.037). Conclusion Prescribed postoperative high-calorie, low-volume oral supplements in addition to the normal dietary intake are associated with significantly better total daily oral calorie intake and may contribute to a reduced postoperative hospital stay. [ABSTRACT FROM AUTHOR]

To improve future drug development efficiency in renal cell carcinoma (RCC), a disease-progression model was developed with longitudinal tumor size data from a phase III trial of sorafenib in RCC. The best-fit model was externally evaluated on 145 placebo-treated patients in a phase III trial of pazopanib; the model incorporated baseline tumor size, a linear disease-progression component, and an exponential drug effect (DE) parameter. With the model-estimated effect of sorafenib on RCC growth, we calculated the power of randomized phase II trials between sorafenib and hypothetical comparators over a range of effects. A hypothetical comparator with 80% greater DE than sorafenib would have 82% power (one-sided α = 0.1) with 50 patients per arm. Model-based quantitation of treatment effect with computed tomography (CT) imaging offers a scaffold on which to develop new, more efficient, phase II trial end points and analytic strategies for RCC. [ABSTRACT FROM AUTHOR]

The family and home environment is a highly influential psychosocial antecedent of paediatric obesity. The purpose of this investigation was to systematically analyze family and home-based randomized control trials aimed at treating overweight and obesity in children ages 2-7 years. In gathering materials for this review, a search of Cumulative Index to Nursing and Allied Health, MEDLINE, Education Resources Information Center, Psychology and Behavioural Sciences Collection and CENTRAL databases was conducted for the time frame of January 2001 to August 2011. The data extraction spanned three phases resulting in a total of nine interventions that met the specified inclusion criteria. Among the identified studies, eight produced significant outcomes. The majority of the programmes incorporated educational sessions targeting parents as the primary modality for intervention delivery. Less than one-quarter of the interventions included home visitations; however, all of the interventions included home-based activities to reinforce behaviour modification. Only three of the interventions applied social and behavioural theory, and only two interventions employed process evaluation. Additional research is needed to gauge the efficacy of the home and family milieu for treating paediatric obesity. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Sharma M, Ortendahl J, van der Ham E, Sy S, Kim J. Cost-effectiveness of human papillomavirus vaccination and cervical cancer screening in Thailand. BJOG 2012;119:166-176. Objective To assess the health and economic outcomes of various screening and vaccination strategies for cervical cancer prevention. Design Cost-effectiveness analysis from a societal perspective. Setting Thailand. Population Females aged 9 years and older. Methods Using a mathematical model of human papillomavirus (HPV) infection and cervical cancer, calibrated to epidemiological data from Thailand, we estimated the cost-effectiveness of pre-adolescent HPV vaccination, screening [visual inspection with acetic acid (VIA), HPV DNA testing, and cytology] between one and five times per lifetime in adulthood, and combined pre-adolescent vaccination and screening. Vaccine efficacy, coverage, cost, and screening frequency were varied in sensitivity analyses. Main outcome measures Incremental cost-effectiveness ratios, expressed as cost per year of life saved (YLS). Results Assuming lifelong efficacy and 80% coverage, pre-adolescent HPV vaccination alone was projected to reduce the lifetime risk of cervical cancer by 55%, which was greater than any strategy of screening alone. When cost per vaccinated girl was I$10 (approximately $2 per dose) or less, HPV vaccination alone was cost saving. Pre-adolescent vaccination and HPV DNA testing five times per lifetime, starting at age 35 years, reduced the lifetime cervical cancer risk by 70%, and had a cost-effectiveness ratio less than Thailand's GDP per capita (I$8100), provided the cost per vaccinated girl was I$200 or less. Conclusions Low cost pre-adolescent HPV vaccination followed by HPV screening five times per lifetime is an efficient strategy for Thailand. Costs may need to be lower, however, for this strategy to be affordable. If vaccination is not feasible, HPV DNA testing five times per lifetime is efficient. [ABSTRACT FROM AUTHOR]

N. Gupta, K. Sharma, A. Barwad, M. Sharma, A. Rajwanshi, P. Dutta and A. Sharma Thyroid tuberculosis - role of PCR in diagnosis of a rare entity Background: Tuberculosis is a rare cause of granulomatous thyroiditis, whose diagnosis may be difficult with routine cytopathology and staining for acid-fast bacilli (AFB). Study design: Amongst 7962 cases of various thyroid lesions subjected to fine needle aspiration cytology (FNAC) over a period of 12 years, 34 cases (0.43%) were found to have cytological features of granulomatous inflammation with or without necrosis, which could be due to tuberculosis, granulomatous thyroiditis or other causes of granulomatous inflammation such as sarcoidosis or fungal infections. DNA was extracted from the material available on May-Grünwald-Giemsa-stained smears from the archival material. PCR for Mycobacterium tuberculosis was performed for insertion sequence IS6110. Results: The age of the patients ranged from 32 to 58 years (median 48 years); 24 were female and 10 male. FNAC from thyroid swellings showed epithelioid granulomas with giant cells and/or necrosis. Although acid-fast bacilli were only seen in smears in two cases, 19/34 (55.9%) showed the presence of 123 bp DNA band under ultraviolet transillumination. Five control cases were negative. Conclusion: Our study of archival cytological material illustrates the importance of PCR as a potentially useful tool for the detection of M. tuberculosis DNA from FNAC of thyroid lesions, which could provide an alternative for rapid diagnosis of thyroid tuberculosis in AFB-negative cases. [ABSTRACT FROM AUTHOR]

Oxidative stability is an important parameter in the characterisation of fats and oils. The determination of this parameter with a Rancimat apparatus is very costly. The alternative modified Karl Fischer (KF) apparatus works on the same principle as the Rancimat, i.e., a conductivity based determination of volatile degradation products and automatic plotting of the conductivity against time. The apparatuses were compared by taking five different samples of methyl esters at different temperature ranges. The results indicate that the modified KF apparatus can be used for the determination of oxidation stability of biodiesel with comparable values of sensitivity, repeatability and reproducibility. [ABSTRACT FROM AUTHOR]

Among individuals with chronic hepatitis C virus (HCV) infection, approximately 30% of patients show persistently normal alanine aminotransferase (PNALT). Individuals with PNALT have been historically excluded from antiviral treatment. However, some studies have reported sudden worsening of disease in patients with PNALT, suggesting the need to treat such individuals. To evaluate this further, we compared fibrosis severity and response to treatment in patients with PNALT to patients with abnormal ALT. In addition, we investigated whether liver histology and schistosomiasis affect response to treatment differently in those with PNALT and abnormal ALT. A retrospective cohort study of 176 HCV-Genotype 4 (HCV-G4) patients treated with pegylated interferon (PEG-IFN) and ribavirin. Of 176 cases studied, 53 (30.1%) had normal ALT. Prevalence of pretreatment severe fibrosis, sustained virological response (SVR) and relapse were not significantly different in patients with PNALT (26%, 66% and 5.7% respectively) compared to those with abnormal ALT (32.5%, 60.7%, and 6.6% respectively). Multivariable logistic regression revealed that pretreatment ALT, pretreatment viral load, inflammation and schistosomiasis were not significantly associated with SVR [OR (95% CI), 0.75 (0.34-1.65); 0.92 (0.61-1.37); 1.64 (0.64-4.18); 0.90 (0.44-1.84) respectively]. Severe fibrosis was the only significant predictor of SVR [OR (95% CI), 0.38 (0.14-0.99)]. PNALT does not reflect the degree of fibrotic changes or predict SVR. Furthermore, schistosomiasis is a predictor of neither fibrosis nor poor response in patients with PNALT. Severe fibrosis is a strong and independent predictor of response to treatment. Therefore, it is important to treat individuals with PNALT levels regardless of schistosomiasis. [ABSTRACT FROM AUTHOR]

Hispanic children suffer from the highest overall rates of prevalence for overweight and obesity in the US. In the last decade some interventions for prevention of childhood obesity have been developed and tailored to target this subgroup. The purpose of this review is to systematically analyze and summarize findings for health education and promotion interventions aimed at the prevention of childhood overweight and obesity among primarily Hispanic children. A systematic review of PubMed, CINAHL, and ERIC was done for the time period 2000 to May 2010. A posteriori effect size for the primary outcome of each intervention was calculated using G*Power. A total of nine interventions were located; five randomized controlled trials and four were either quasi-experimental or pilot studies. Among these studies, only four had significant findings, and calculated effect sizes (Cohen's f) ranged from small to medium with the highest f = 0.26. Interventions were more likely to be successful when participants were at higher risk for obesity, a parental component was included, the intervention contained theoretical underpinnings, the intervention was delivered by a dedicated staff, the intervention served older children and the intervention was longer in duration. More interventions need to be developed for Hispanic children. Future interventions should also develop and utilize culturally appropriate and sensitive materials and approaches. [ABSTRACT FROM AUTHOR]

Objective. This study assessed children's perceptions of an overweight or non-overweight target of name-calling. Methods. Participants were 4th and 5th grade students. Children selected a line drawing of an overweight or a non-overweight child as a target. After this, they viewed each line drawing again and rated each child's social attraction, niceness, experience of negative emotions, size, and popularity (whether others would like the child). Finally, children provided ideas for improving acceptance of the line-drawing they selected as a target of name-calling. Results. Findings from regression analyses indicated that children who reported higher levels of victimization and selected the overweight child as a target reported higher social attraction for this target. Children's weight status and their victimization interacted to influence ratings of niceness and negative emotions. Children reported that peers would like the overweight line drawing less than the non-overweight one. Conclusions. Children tended to report that an overweight child would be a target of name-calling and be less accepted. Our findings provided partial support for the idea that children's own victimization status influenced ratings of social attraction, niceness, and negative emotions. Longitudinal studies will provide information on change in perceptions over time. [ABSTRACT FROM AUTHOR]

Oxidative stress, produced under diabetic conditions, may cause tissue damage. Although several drugs are currently available for the treatment of diabetes, their continued use may cause unwanted side effects. The aim of the present study was to evaluate the antioxidant potential of β-sitosterol (BS), a phytosterol from Solanum surattense, using an experimental model for diabetes-induced oxidative damage. The effects of 21 days treatment with BS (10, 15 and 20 mg/kg, p.o.) on blood, serum, and tissue biochemical parameters were evaluated in control and streptozotocin-induced diabetic rats. Nine experimental groups, including a control group, a diabetic group, and BS- and glibenclamide-treated diabetic groups, were evaluated. All three dose levels dose dependently resulted in decreases in glycated hemoglobin, serum glucose, and nitric oxide, with concomitant increases in serum insulin levels. Furthermore, treatment with BS doses also increased pancreatic antioxidant levels, with a concomitant decrease in thiobarbituric acid-reactive substances. β-Sitosterol has promising antidiabetic as well as antioxidant effects and may be considered in clinical studies for drug development. [ABSTRACT FROM AUTHOR]

Background/purpose: Bacterial infection is one of the main predisposing factors for the delay in wound healing. To facilitate a timely decision for correct therapy, it is important to accurately monitor the morphological changes in the infected wounds using noninvasive tools. In the present study, we have explored the use of optical coherence tomography (OCT) for monitoring the healing of superficial wounds infected with Staphylococcus aureus in mice under in vitro and in vivo conditions and studied the changes in collagen birefringence in the infected wounds. Methods: The tape stripping method was used for generating superficial skin wounds in mice and wounds were infected with S. aureus. For in vitro studies, infected and uninfected wound tissues were resected, back scattered intensity and birefringence changes in collagen during wound healing were studied on the 2, 4 and 10th day of postinfection using polarization-sensitive (PS) OCT and images were compared with histology. Real-time OCT was used for studying the kinetics of healing of infected wounds under in vivo conditions. Results: From the PS-OCT images, different phases of wound healing such as inflammation, reepithelialization and collagen remodeling could be identified. The edematic regions appeared prominent in infected wounds. Compared with uninfected wounds, reepithelization and collagen remodeling phases of wound healing were delayed significantly in the infected wounds. These changes were comparable with the different stages of wound healing observed under in vivo conditions. Conclusion: OCT imaging can provide a rapid assessment of the morphological changes associated with bacteria-infected and uninfected wounds and thereby aid in timely treatment planning. [ABSTRACT FROM AUTHOR]

We evaluated the antirhinovirus efficacy of a standardized preparation of Echinacea purpurea (Echinaforce®) in a 3-dimensional organotypic model of normal human airway epithelium (EpiAirway™ tissue). Individual replicate tissue samples, maintained as inserts in culture for 3 days or 3 weeks, were infected with rhinovirus type 1A (RV1A), Echinacea alone, a combination of the two, or medium only. None of the treatments affected the histological appearance or integrity of the tissues, all of which maintained a high level of cell viability and preservation of cilia. RV infection resulted in increased mucopolysaccharide inclusions in the goblet cells, but this feature was reversed by Echinacea treatment. This result was confirmed by measurements of mucin secretion, which was stimulated by RV but reversed by Echinacea, suggesting that mucus production during colds could be ameliorated by Echinacea. We did not find evidence of virus replication, although the RV-infected tissues secreted substantial amounts of the pro-inflammatory cytokines IL-6 and IL-8 (CXCL8), and this response was reversed by Echinacea treatment. These results confirmed previous findings derived from studies of bronchial and lung epithelial cell lines, namely, that RV infection results in a substantial inflammatory response in the absence of virus replication. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and Purpose: Results from several studies point to voltage-gated Na(+) channels as potential mediators of the immobility produced by inhaled anaesthetics. We hypothesized that the intrathecal administration of tetrodotoxin, a drug that blocks Na(+) channels, should enhance anaesthetic potency, and that concurrent administration of veratridine, a drug that augments Na(+) channel opening, should reverse the increase in potency.Experimental Approach: We measured the change in isoflurane potency for reducing movement in response to a painful stimulus as defined by MAC (minimum alveolar concentration of anaesthetic required to abolish movement in 50% of subjects) caused by intrathecal infusion of various concentrations of tetrodotoxin into the lumbothoracic subarachnoid space of rats, and the change in MAC caused by the administration of a fixed dose of tetrodotoxin plus various doses of intrathecal veratridine.Key Results: Intrathecal infusion of tetrodotoxin (0.078-0.63 microM) produced a reversible dose-related decrease in MAC, of more than 50% at the highest concentration. Intrathecal co-administration of veratridine (1.6-6.4 microM) reversed this decrease in a dose-related manner, with nearly complete reversal at the highest veratridine dose tested.Conclusions and Implications: Intrathecal administration of tetrodotoxin increases isoflurane potency (decreases isoflurane MAC), and intrathecal administration of veratridine counteracts this effect in vivo. These findings are consistent with a role for voltage-gated Na(+) channel blockade in the immobility produced by inhaled anaesthetics. [ABSTRACT FROM AUTHOR]

T. Martin, M. Sharma, L. Damon, L. Kaplan, B.J. Guglielmo, M. Working, R. O'Malley, J. Hwang, C. Linker. Voriconazole is safe and effective as prophylaxis for early and late fungal infections following allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2010: 12: 45–50. All rights reserved Seventy-two patients undergoing allogeneic transplantation were treated with voriconazole (VOR) as antifungal prophylaxis starting from day −2 of transplantation and continuing until withdrawal of immunosuppression. Patients were assessed for safety and the incidence of definite, probable, or possible fungal infection throughout transplantation was evaluated. VOR was well tolerated. Only 14% of patients required interruption of VOR therapy because of toxicity: liver toxicity (8%), cardiac Q–T interval prolongation (1%), or other side effects (5%). In the early post-transplant period (<120 days), only 2 patients developed invasive fungal infection: 1 mucormycosis infection and 1 disseminated Aspergillus infection. In the late post-transplant period (>120 days), no patients developed probable or definite fungal infection while receiving VOR. No Candida infections were seen in either period. These data suggest that fungal prophylaxis with VOR following allogeneic transplantation is safe and effective. [ABSTRACT FROM AUTHOR]

Numerous Echinacea preparations are available on the market for the prevention and treatment of cold and 'flu symptoms and inflammatory conditions associated with infections. Most of these preparations are consumed orally in the form of aqueous or ethanol extracts and tinctures. Since the recommended consumption normally involves a brief local exposure to the diluted preparation at an unspecified time in relation to the actual infection, then it is important that experimental models for the evaluation of Echinacea reflect these limitations. A line of human bronchial epithelial cells, in which rhinoviruses stimulate the production of pro-inflammatory cytokines, was used to evaluate several relevant parameters. The chemically characterized Echinacea preparation ( Echinaforce®) was capable of inhibiting completely the rhinovirus induced secretion of IL-6 (interleukin-6) and IL-8 (chemokine CXCL-8) in these cells, regardless of whether the Echinacea was added before or after virus infection, and in response to a range of virus doses. This inhibitory effect was also manifest under conditions resembling normal consumption with respect to the duration of exposure to Echinacea and the Echinacea dilution. It is concluded that under real life conditions of Echinacea consumption, the virus-induced stimulation of pro-inflammatory cytokines can be effectively reversed or alleviated. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The present studies are based on the feedback provided by fish farmers practicing composite fish culture of carps. According to them, fish habitats are affected by pesticides draining from agricultural fields into their catchments, especially during the rainy season. The lenses of most of the cultured fish became opaque, resulting in poor overall growth. In the literature, there was mounting evidence of pesticide toxicity involving multiple tissues. However, the fish visual system has never been investigated particularly from the toxicological perspective. In this regard, we carried out comparative toxicological studies on the lens of Cyprinus carpio communis using three different sublethal concentrations (0.038, 0.062 and 0.126 p.p.m.) of monocrotophos along with untreated controls for 30 days. Lenses from all the groups were extracted and preserved in gluteraldehyde and osmium tetraoxide and dehydrated in increasing grades of acetone. After dehydration, tissues were conducted with gold to observe under SEM. The fish exposed to monocrotophos developed cataract. Furthermore, when fish from the monocrotophos-treated tanks were transferred to normal environmental conditions for the next 60 days, progressive lens degeneration was noted. To conclude, monocrotophos induces irreversible cataractous changes in the lens of C. carpio communis. The fish visual system has many similarities to mammals and may serve as a good model for comparative toxicologic and ophthalmologic studies. [ABSTRACT FROM AUTHOR]