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Ergothioneine (ERG) is an unusual thio-histidine betaine amino acid that has potent antioxidant activities. It is synthesised by a variety of microbes, especially fungi (including in mushroom fruiting bodies) and actinobacteria, but is not synthesised by plants and animals who acquire it via the soil and their diet, respectively. Animals have evolved a highly selective transporter for it, known as solute carrier family 22, member 4 (SLC22A4) in humans, signifying its importance, and ERG may even have the status of a vitamin. ERG accumulates differentially in various tissues, according to their expression of SLC22A4, favouring those such as erythrocytes that may be subject to oxidative stress. Mushroom or ERG consumption seems to provide significant prevention against oxidative stress in a large variety of systems. ERG seems to have strong cytoprotective status, and its concentration is lowered in a number of chronic inflammatory diseases. It has been passed as safe by regulatory agencies, and may have value as a nutraceutical and antioxidant more generally.
Combined oral contraceptive (COC) use is a risk factor for venous thrombosis (VT) and related to the specific type of progestin used. VT is accompanied by inflammation and pathophysiological clot formation, that includes aberrant erythrocytes and fibrin(ogen) interactions. In this paper, we aim to determine the influence of progesterone and different synthetic progestins found in COCs on the viscoelasticity of whole blood clots, as well as erythrocyte morphology and membrane ultrastructure, in an in vitro laboratory study. Thromboelastography (TEG), light microscopy, and scanning electron microscopy were our chosen methods. Our results point out that progestins influence the rate of whole blood clot formation. Alterations to erythrocyte morphology and membrane ultrastructure suggest the presence of eryptosis. We also note increased rouleaux formation, erythrocyte aggregation, and spontaneous fibrin formation in whole blood which may explain the increased risk of VT associated with COC use. Although not all COC users will experience a thrombotic event, individuals with a thrombotic predisposition, due to inflammatory or hematological illness, should be closely monitored to prevent pathological thrombosis.
As erythrocyte and estrogens interact so closely and erythrocytes can indicate the healthiness of an individual, it is essential to investigate the effects of natural estrogens as well as synthetic estrogens on these cells. Whole blood samples were used for thromboelastography (TEG), light microscopy (LM), and scanning electron microscopy (SEM) investigation. Viscoelastic investigation with TEG revealed that estrogens affected the rate of clot formation without any significant effect on the strength or stability of the clot. Axial ratio analysis with LM showed a statistically significant increase in number of erythrocytes with decreased roundness. Morphological analysis with SEM confirmed the change in erythrocyte shape and revealed both ultrastructural membrane changes and erythrocyte interactions. As erythrocyte shape and membrane flexibility correlates to physiological functioning of these cells in circulation, these changes, indicative of possible eryptosis brought on by estrogens, when experienced by individuals with an underlying inflammatory or hematological illness, could impair erythrocyte functioning and even result in obstructions in circulation. In conclusion, we suggest that whole blood analysis with viscoelastic and morphological techniques could be used as assessment of the hematological healthiness of individuals using estrogens.
We present an age-structured mathematical model of malaria and pneumonia to study the effect of two capacity-building interventions: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS). IMID leads to a reduction in malaria prevalence by more than 2·4% across the [0,5), [5,14) and [14,50) age groups. IMID + OSS reduces it by more than 16·0% across all age groups. IMID decreases pneumonia prevalence by more than 3·0% across all age groups while IMID + OSS decreases it by more than 1·0% across all age groups. The number of malaria and pneumonia deaths is reduced by 7·8% by IMID across all age groups and IMID + OSS decreases this number by 30·5% across all age groups, which translates to saving a life of a child per month. Prevalence of malaria-pneumonia for the [0,5) age group is 0·52% at baseline, and IMID and IMID + OSS reduce it by 6·6% and 23·6%, respectively. There is no change in incidence of malaria or pneumonia disease episodes. The results also indicate that triaging of children contributes more than 50% to the effect of the interventions in reduction of deaths and a range of 14–91% in reduction of disease cases.
Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to develop, test and apply a fully integrated health systems resource planning and health impact tool for mental, neurological and substance use (MNS) disorders.
A new module of the existing UN strategic planning OneHealth Tool was developed, which identifies health system resources required to scale-up a range of specified interventions for MNS disorders and also projects expected health gains at the population level. We conducted local capacity-building in its use, as well as stakeholder consultations, then tested and calibrated all model parameters, and applied the tool to three priority mental and neurological disorders (psychosis, depression and epilepsy) in six low- and middle-income countries.
Resource needs for scaling-up mental health services to reach desired coverage goals are substantial compared with the current allocation of resources in the six represented countries but are not large in absolute terms. In four of the Emerald study countries (Ethiopia, India, Nepal and Uganda), the cost of delivering key interventions for psychosis, depression and epilepsy at existing treatment coverage is estimated at US$ 0.06–0.33 per capita of total population per year (in Nigeria and South Africa it is US$ 1.36–1.92). By comparison, the projected cost per capita at target levels of coverage approaches US$ 5 per capita in Nigeria and South Africa, and ranges from US$ 0.14–1.27 in the other four countries. Implementation of such a package of care at target levels of coverage is expected to yield between 291 and 947 healthy life years per one million populations, which represents a substantial health gain for the currently neglected and underserved sub-populations suffering from psychosis, depression and epilepsy.
This newly developed and validated module of OneHealth tool can be used, especially within the context of integrated health planning at the national level, to generate contextualised estimates of the resource needs, costs and health impacts of scaled-up mental health service delivery.
Combined oral contraceptives (COCs), colloquially referred to as “the pill,” have been regarded as a medical breakthrough, as they have improved the lives of countless women, from simplifying family planning to the treatment of acne, endometriosis, polycystic ovarian syndrome, and dysmenorrhea. Unfortunately, COC usage has been associated with an increased occurrence of venous thrombosis and therefore a systemic hypercoagulable state in susceptible females. Here we discuss the health risks of COC usage and use viscoelastic and morphological techniques to investigate the effect of different COC constituents on clot formation, particularly fibrin network packaging and whole blood viscoelasticity. Viscoelastic properties of whole blood showed gender-specific changes while morphological alterations were person-specific, regardless of gender. Using scanning electron microscopy and thromboelastography provides great insight regarding fibrin packaging and the development of a hypercoagulable state in high-risk individuals. We proposed a three-step approach where (1) an individual’s coagulation profile baseline is determined, after which (2) the “ideal” combination of constituents is prescribed, and (3) the coagulation profile of the individual is monitored to assess possible risk of thrombosis. Only in following such an individualized patient-oriented approach will we be able to avoid the many health issues due to COC usage in susceptible females.
Maternal and fetal requirements during uncomplicated pregnancy are associated with changes in the hematopoietic system. Platelets and erythrocytes [red blood cells (RBCs)], and especially their membranes, are involved in coagulation, and their interactions may provide reasons for the changed hematopoietic system during uncomplicated pregnancy. We review literature regarding RBC and platelet membrane structure and interactions during hypercoagulability and hormonal changes. We then study interactions between RBCs and platelets in uncomplicated pregnancy, as their interactions may be one of the reasons for increased hypercoagulability during uncomplicated pregnancy. Scanning electron microscopy was used to study whole blood smears from 90 pregnant females in different phases of pregnancy. Pregnancy-specific interaction was seen between RBCs and platelets. Typically, one or more platelets interacted through platelet spreading and pseudopodia formation with a single RBC. However, multiple interactions with RBCs were also shown for a single platelet. Specific RBC–platelet interaction seen during uncomplicated pregnancy may be caused by increased estrogen and/or increased fibrinogen concentrations. This interaction may contribute to the hypercoagulable state associated with healthy and uncomplicated pregnancy and may also play a fundamental role in gestational thrombocytopenia.
To demonstrate the importance of thorough investigation of patients with Horner syndrome, and to explain the relevant anatomy.
A 46-year-old man presented with right-sided Horner syndrome. No other abnormality was found. Magnetic resonance imaging showed calcification of the stylohyoid ligament, with a pseudoarthrosis in the mid-portion of the ligament. This pseudoarthrosis was displacing and compressing the internal carotid artery and the adjacent sympathetic chain, causing Horner syndrome.
In this case, magnetic resonance imaging was invaluable in elucidating the cause of the Horner syndrome. This is the first described case of pseudoarthrosis of a calcified stylohyoid ligament causing Horner syndrome.
We report an extremely rare case of congenital cholesteatoma affecting the occipital bone.
We present a case report, plus a review of the world literature on similar lesions.
This case report describes the presentation and treatment of a congenital cholesteatoma arising in an apparently unique location within the occipital bone, with no effect on middle-ear structure or function. The different imaging characteristics of this lesion are described and illustrated. The discussion centres on the differentiation of this lesion from intradiploic epidermoid cysts, more commonly described in the neurosurgical literature. The possible methods of pathogenesis are discussed, along with treatment suggestions.
Congenital cholesteatomas and intradiploic epidermoid cysts are indistinguishable both histologically and radiologically, and would appear to be the same disease.
The success of efforts to re-establish mammalian carnivores within their former range is dependent on three key factors: methodological considerations, the biological requirements of the target species, and the involvement of local human communities for whom large carnivores pose a threat. We consider the role of these factors in the first 13 years of an effort to re-establish wild lions in northern KwaZulu-Natal Province, South Africa. We employed soft-release methods to mitigate the characteristic problems associated with restoration of large carnivores. A pre-release captivity period facilitated acclimatization of reintroduced lions and promoted long-term bonding of unfamiliar individuals into cohesive groups. All individuals remained in the release area and established enduring, stable home ranges. Reintroduced lions successfully reproduced and raised 78% of their cubs to independence. Human activity was the cause of all post-release mortality. Despite rapid population growth and the re-establishment of the species at Phinda Private Game Reserve, the population is small and isolated with little prospect for re-colonizing additional areas where the species has been extirpated, or for connecting with other isolated lion populations in the region. Accordingly, although we essentially overcame the short-term technical and biological challenges facing lion reintroduction, the long-term value of the Phinda population for addressing the conservation issues facing the species remains equivocal.
Phase formation was studied in the Fe–Ge and Cr–Ge thin-film systems by means of Rutherford backscattering spectrometry and x-ray diffraction. In the Fe–Ge system, FeGe was the first phase to form while in the Cr–Ge system, Cr11Ge8 was found to form first. The results are compared with the predictions of the effective heat of formation model. Heats of formation were calculated using the Miedema model. The effect of the transformation enthalpy term ΔHtr, used to convert a semiconducting element into a hypothetical metallic one in the Miedema model, is also discussed.
Submerging Phaseolus vulgaris cv. Top Crop seed in air-saturated water for 16 h markedly depresses subsequent germination. This is termed soaking injury. The postulate by Norton (1986) that soak-injured seeds merely run out of available energy was investigated. Soaking in air-saturated water reduced the total respiration (VT; in terms of O2 uptake) of excised axes and cotyledons resulting in lower ATP levels. The contribution of both the mitochondrial cytochrome respiratory pathway (VCYT) and the alternative respiratory pathway (VALT) to the total respiration (VT) was significantly lower in these axes. However, the adenylate energy charge (AEC) values for both axes and cotyledons excised from soak-injured seeds did not drop below 0.6, the threshold value indicating death of plant material. Differences between the ultrastructure of mitochondria in the radicle tips of axes from unsoaked and water-soaked seeds were observed. However, the capacity to operate the Krebs cycle was similar in all axes and soak-injured seeds were still capable of germinating when the testas were removed or the seeds dried. This means that axes contained a sufficient amount of carbohydrates and potential energy to germinate after soaking. Moreover, soak-injured seeds produced ethanol at a rate which was five times higher than that of unsoaked control seeds, both during the soaking and post-soaking periods. Together with the low rate of oxygen consumption by soak-injured seeds during the same soaking and incubation time, it appears that soak-injured seeds lack the potential to switch from an anaerobic to an aerobic respiration pattern causing low ATP levels in these axes. It is speculated that the latter seems to be the result of limited pyruvate supply, probably due to accelerated and prolonged fermentation or futile combustion through other pathways or both.
Submerging Phaseolus vulgaris cv. Top Crop seeds in air-saturated water for 16 h markedly depresses subsequent germination. This is termed soaking injury. Soaking injury does not occur in seeds soaked in CO2-saturated water. Previous studies have shown that soaking injury can be alleviated by drying seeds or removing seed coats. Submergence therefore leads to a situation in bean seeds which is similar to secondary dormancy.
As with dormant seeds, C6/C1 ratios of embryonic axes of seeds soaked in air-saturated water remained high (0.8–1.0) during and after soaking. This was paralleled by low activities of glucose-6-phosphate dehydrogenase (EC.1.1.49) and 6-phosphogluconate dehydrogenase (EC 18.104.22.168). In axes of seeds soaked in CO2-saturated water and in unsoaked seeds C6/C1 ratios declined steadily during soaking/imbibition and reached values of around 0.3 after germination. Slight increases ofglucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase activities occurred in the pre-germination phase. This was followed by a massive increase after radicle emergence. Synthesis of the plastid isoenzymes was a post-germinative event.
It appears that soaking injury depresses protein synthesis. Lack of oxidative pentose phosphate pathway activity appears to be a causative factor in soaking injury.
The capacity for protein synthesis in embryonic axes of Phaseolus vulgaris L. cv. Top Crop seeds was reduced markedly by soaking in airsaturated and CO2-saturated water. The former treatment induces soaking injury while the latter treatment prevents injury. After soaking, the capacity for protein synthesis in axes of seeds soaked in air-saturated water declined and the pattern of synthesis remained almost similar to that at the time of termination of soaking. However, the capacity and pattern of protein synthesis in axes of seeds soaked in CO2-saturated water recovered subsequent to soaking and approached that of non-soaked seeds.
The effective heat of formation model enables heats of formation to be calculated as a function of concentration. By choosing the effective concentration at the growth interface to be that of the liquidus minimum, the model correctly predicL. first phase formation for 14 binary systems for which experimental data was found, except for the Au-Cu system which does not have a well-defined minimum on the liquidus curve.
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