To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To study the possible association between invasive fungal sinusitis (mucormycosis) and coronavirus disease.
A prospective observational study was conducted at a tertiary care centre over four months, involving all patients with mucormycosis of the paranasal sinuses suffering from or having a history of coronavirus disease infection.
Twenty-three patients presented with mucormycosis, all had an association with coronavirus disease 2019. The ethmoids (100 per cent) were the most common sinuses affected. Intra-orbital extension was seen in 43.47 per cent of cases, while intracranial extension was only seen in 8.69 per cent. Diabetes mellitus was present in 21 of 23 cases, and was uncontrolled in 12 cases. All patients had a history of steroid use during their coronavirus treatment.
New manifestations of coronavirus disease 2019 are appearing over time. The association between coronavirus and mucormycosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and over-zealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.
Coronavirus disease 2019 personal protective equipment has been reported to affect communication in healthcare settings. This study sought to identify those challenges experimentally.
Bamford–Kowal–Bench speech discrimination in noise performance of healthcare workers was tested under simulated background noise conditions from a variety of hospital environments. Candidates were assessed for ability to interpret speech with and without personal protective equipment, with both normal speech and raised voice.
There was a significant difference in speech discrimination scores between normal and personal protective equipment wearing subjects in operating theatre simulated background noise levels (70 dB).
Wearing personal protective equipment can impact communication in healthcare environments. Efforts should be made to remind staff about this burden and to seek alternative communication paradigms, particularly in operating theatre environments.
The current study was undertaken to identify the sources of tolerance to bruchid in cowpea, by screening a set of germplasm accessions as a source for natural resistance. A total of 103 diverse accessions of cowpea were evaluated for resistance to Callosobruchus maculatus Fab. under no-choice artificial infestation conditions. Significant differences among the cowpea accessions were observed for oviposition, adult emergence, exit holes and per cent seed weight loss (PSWL) caused by the bruchid infestation. The accessions showed variation in physical seed parameters viz., colour, shape, testa texture, length, width and seed hardness. Among the seed biochemical parameters studied, per cent sugar content ranged from 0.322 (IC330950) to 1.493 (IC249137), and per cent phenol content ranged from 0.0326 (EC390261) to 1.081 (EC528423). Correlation studies indicated that PSWL had significant positive correlation (r = 0.335) with exit holes, oviposition (r = 0.219), adult emergence (r = 0.534) and seed roundness (r = 0.219). Adult emergence had a significant negative correlation with seed hardness (r = −0.332). Correlation with biochemical parameters indicated that PSWL had a significant positive correlation (r = 0.231) with sugar content and a significant negative correlation with phenol content (r = −0.219). None of the accessions were found to be immune to bruchid infestation. However, out of studied accessions, EC528425 and EC528387 were identified as resistant based on PSWL and moderately resistant based on adult emergence. These resistance sources of cowpea germplasm can be used as potential donors for development of bruchid tolerant/resistant cultivars.
Cognitive dysfunction such as impairment of memory, attention, spatial and verbal functions plays important role in etiopathogenesis and clinical picture in neurodegenerative disorders. There are related with structural and functional abnormalities of different region of the brain connected with these cognitive processes. Cognitive dysfunctions caused severe functional and social disabilities of the patients. The neuroimaging methods such as F-MRI, or PET scan are very useful in diagnosis of structural and functional changes in the brain in neurodegeneration diseases, e.g. Parkinson's or Alzheimer's diseases. Neuroimaging during cognitive stimulations show different brain activation in patients with schizophrenia or neurodegenerative disorders in comparison to healthy subjects. F-MRI show increase of prefrontal cortex activation during n-Back test performance in healthy controls, while in patients with schizophrenia and Alzheimer disease this effect was not noted. In schizophrenia patients after treatment with risperidone (but not with haloperidol) the normalization of activation in different brain area was observed.
F-MRI assessment during N-back test (0 - back and 1-back tasks), encoding and recognition, visual discrimination performed in 9 patients with Alzheimer's Disease (AD) and 9 healthy subjects show abnormal activation in patients with AD. Among 9 patients with AD 5 were treated with rivastigmine, 4 received placebo. Cognitive improvement was observed after 3 months of treatment with rivastigmine - the same time fMRI showed an increase in brain activity in regions involved in attentional processes. This indicate that neuroimaging methods during cognitive stimulation may be useful in cognitive assessment in CNS disorders and in assessment of drug effect on cognition.
Schizophrenia is a mental disorder characterized by social problems and disorders of thought, behaviour and cognitive functions. These impaired cognitive functions may be associated with alterations in resting state functional connectivity in schizophrenia. Therefore, the present study has been carried out to determine the resting state functional brain connectivity changes associated with schizophrenia in all the resting state networks (RSNs) using independent component analysis approach (ICA) and dual-regression based approach.
The objective of this study was to investigate the aberrant resting-state functional connectivity patterns in schizophrenia patients as compared to healthy controls.
35 schizophrenia patients and 31 healthy controls were recruited for the study and scanned by using resting state functional magnetic resonance (rsfMRI). Pre-processing and post-processing of the resting state functional data were performed using the FMRI Expert Analysis Tool (FEAT), which is a part of FSL (FMRIB's Software Library, www.fmrib. ox.ac.uk/fsl).
Our results showed significantly decreased functional connectivity in the regions of left fronto-parietal network, lateral visual network, medial visual network, motor network and default mode network (DMN) in schizophrenia patients as compared with healthy controls.
The overall findings suggest that the alterations in these resting state network connectivity may, in part, contribute to the impairments in cognitive functions associated with schizophrenia. These findings also suggest that aberrant resting state network connectivity contributes to regional functional pathology in schizophrenia and bears significance for core symptoms.
Background: Pediatric craniocerebral gunshot wounds occur in the context of both accidental and intentional trauma. Unique physiologic factors merited research into prognostic factors and treatment priorities in the pediatric population. Methods: A systematic search of MEDLINE, EMBASE, Web of Science, LILACS, Cochrane Registered Trials and Systematic Reviews, ISRCTN, and ClinicalTrials.gov was conducted. Selection criteria included all studies published in any language since 2000 which described intracranial isolated gunshot wounds in a civilian individual or population of pediatric age. Post-mortem and epidemiological studies were excluded. Screening was conducted through Covidence. Results: Initial database search revealed 349 unique studies for abstract and title screening. Fifty studies were selected for full text screening. Nine studies were included in the final review. Study quality was assessed with the Newcastle-Ottawa Scale. Case series noted bullet migration, pituitary deficiency, neurovascular and neuropsychological concerns. Three single-center retrospective studies of 71, 30, and 48 pediatric patients suggested multiple negative prognostic signs on initial presentation. Early aggressive surgical treatment was recommended by some authors. Conclusions: This systematic review analyzed the best current understanding of evidence for prognostic factors and treatment considerations of intracranial gunshot wounds in the pediatric neurotrauma context. Areas for future research with larger multi-center studies were highlighted.
Background: Biallelic variants in POLR1C are associated with POLR3-related leukodystrophy (POLR3-HLD), or 4H leukodystrophy (Hypomyelination, Hypodontia, Hypogonadotropic Hypogonadism), and Treacher Collins syndrome (TCS). The clinical spectrum of POLR3-HLD caused by variants in this gene has not been described. Methods: A cross-sectional observational study involving 25 centers worldwide was conducted between 2016 and 2018. The clinical, radiologic and molecular features of 23 unreported and previously reported cases of POLR3-HLD caused by POLR1C variants were reviewed. Results: Most participants presented between birth and age 6 years with motor difficulties. Neurological deterioration was seen during childhood, suggesting a more severe phenotype than previously described. The dental, ocular and endocrine features often seen in POLR3-HLD were not invariably present. Five patients (22%) had a combination of hypomyelinating leukodystrophy and abnormal craniofacial development, including one individual with clear TCS features. Several cases did not exhibit all the typical radiologic characteristics of POLR3-HLD. A total of 29 different pathogenic variants in POLR1C were identified, including 13 new disease-causing variants. Conclusions: Based on the largest cohort of patients to date, these results suggest novel characteristics of POLR1C-related disorder, with a spectrum of clinical involvement characterized by hypomyelinating leukodystrophy with or without abnormal craniofacial development reminiscent of TCS.
Manipur, an international border region has the highest incidence of human immunodeficiency virus (HIV)-1 infection in India. Nevertheless, there have been no analytical reviews of research article published within this region. In this review, the authors aim to draw the attention of policy makers, medical practitioners and researchers in adopting new strategies to limit the expansion of HIV/acquired immunodeficiency syndrome (AIDS) not only in Manipur but also in other international border areas. A systematic search for published literature in last decade was performed based on the keywords ‘Manipur’ and ‘HIV’ using the PubMed. Twenty-six articles were selected and reviewed. There were high incidence of drug resistance (53%), emergence of recombinant virus (32%) and increased incidence of co-infection with hepatitis C virus. The prime cause of the HIV is due to the uses of ‘heroin’ smuggled from the ‘South Asia Golden Triangle’ and complex patterns of cross-border movement for trade and commerce. The drug abuse, social stigma, geographical location and resource limitation and socio-political problem of the region have contributed strongly on spreading and failure of preventively programme of HIV/AIDS. This review will provide vital knowledge for the policy makers and clinicians for sentinel surveillance of AIDS pandemic in Manipur and other international border regions.
Obstructive sleep apnoea is a common chronic sleep disorder characterised by collapse of the upper airway during sleep. The nasal airway forms a significant part of the upper airway and any obstruction is thought to have an impact on obstructive sleep apnoea. A systematic review was performed to determine the role of rhinological surgical interventions in the management of obstructive sleep apnoea.
A systematic review of current literature was undertaken; studies were included if they involved comparison of a non-surgical and/or non-rhinological surgical intervention with a rhinological surgical intervention for treatment of obstructive sleep apnoea.
Sixteen studies met the selection criteria. The pooled data suggest that there are reductions in the apnoea/hypopnea index and respiratory disturbance index following nasal surgery. However, the current body of studies is too heterogeneous for statistically significant meta-analysis to be conducted.
Nasal surgery may have limited benefit for a subset of patients based on current evidence.
Stereotactic body radiotherapy (SBRT) is widely used for the treatment of stage-I non-small cell lung cancer (NSCLC). Patient-specific motion correlated with 4DCT could be essential for hypofractionated SBRT. All patients undergoing SBRT do not require motion management during the dose delivery. The objective of this study was to evaluate which patient may benefit from Gated SBRT.
Materials and methods
Treatment planning of 20 patients of stage-I NSCLC was analysed. Conventional and 4DCT scans were taken. Internal target volume as well as planning target volume (ITV and PTV) were determined in the CT data sets. PTVall phases created using 4DCT data sets and PTV15mm created using conventional CT data were compared. Also, ITVall phases were compared with ITV created from maximum intensity projections (ITVMIP). Suitability of patients for motion management-based treatment delivery was also evaluated.
The average ITVMIP to ITVall phases ratio is 1·06 indicating good agreement between them. Based on the ratio of intensity projections, 9 out of 17 patients were found suitable for our existing gated treatment.
4D CT is the main requirement in SBRT to identify the patients who can benefit from motion management during the dose delivery.
The study primarily aimed to calculate the orientation of the cochlea pre-operatively, using high-resolution computed tomography of the temporal bone, and predict the ease of electrode insertion.
Pre-operatively, high-resolution computed tomography scans were conducted on children scheduled for cochlear implantation, and two angles, α and β, were calculated. The values of α and β were then correlated with intra-operative difficulty in insertion of the electrode array.
Ninety-six children were included in the study. Of the seven patients who had an α angle of less than 50 degrees, the surgeon experienced difficulties in electrode insertion. However, there were four patients with an α angle of more than 50 degrees for whom the surgeon also experienced difficulties in electrode insertion. In all these patients, the β angle was more than 20 degrees.
Calculation of cochlear orientation and its angle with the surgical axis (α and β) can aid the planning of surgery, particularly with regard to the cochleostomy site and preservation of residual hearing.
Rice has the lowest grain protein content (GPC) among cereals. Efforts have been made to improve GPC through the modified bulk-pedigree method of selection. A total of 1780 F8 recombinant lines were derived in the year 2013 from five different cross combinations involving two high-GPC landraces, namely ARC10075 and ARC10063, three high-yielding parents, namely Swarna, Naveen and IR64, and one parent, namely Sharbati, known for superior grain quality with high micronutrient content. Near-infrared spectroscopy was used to facilitate high-throughput selection for GPC. Significant selection differential, response to selection and non-significant differences between the predicted and observed response to selection for GPC and protein yield indicated the effectiveness of this selection process. This resulted in lines with high GPC, protein yield and desirable levels of amylose content. Further, based on high mean and stability for GPC and protein yield over the environments in the wet seasons of 2013, 2014 and the dry season of 2014, 12 elite lines were identified. Higher accumulation of glutelin fraction and non-significant change in prolamin/glutelin ratio in the grain suggested safe guarding of the nutritional value of rice grain protein of most of these identified lines. Since rice is the staple food of millions, the output of breeding for high GPC could have a significant role in alleviating protein malnutrition, especially in the developing world.
Mental health and wellbeing, including addressing impacts of historical trauma and substance use among young people, has been identified as a key priority by Indigenous communities and leaders across Canada and globally. Yet, research to understand mental health among young Indigenous people who have used drugs is limited.
To examine longitudinal risk and strengths-based factors associated with psychological distress among young Indigenous people who use drugs.
The Cedar Project is an ongoing cohort study involving young Indigenous people who use drugs in Vancouver, Prince George, and Chase, British Columbia, Canada. This study included participants who completed the Symptom Checklist-90-Revised, returned for follow-up between 2010 and 2012, and completed the Childhood Trauma Questionnaire. Adjusted linear mixed-effects models estimated effects of study variables on changes in area T-scores of psychological distress.
Of 202 eligible participants, 53% were women and the mean age was 28 years. Among men, childhood maltreatment (emotional abuse, physical abuse, sexual abuse, physical neglect), any drug use, blackouts from drinking, and sex work were associated with increased distress. Among women, childhood maltreatment (emotional abuse, physical abuse, physical neglect), blackouts from drinking, and sexual assault were associated with increased distress, while having attempted to quit using drugs was associated with reduced distress. Marginal associations were observed between speaking their traditional language and living by traditional culture with lower distress among men.
Culturally safe mental wellness interventions are urgently needed to address childhood trauma and harmful coping strategies that exacerbate distress among young Indigenous people who use drugs.