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This study aimed to evaluate serum otolin-1 levels in patients with benign paroxysmal positional vertigo and to compare these levels with healthy individuals.
This was a case-control study. After obtaining institutional ethical committee clearance, the serum level of otolin-1 was calculated in adult individuals (18–75 years old) who were divided into group 1 (patients presenting with benign paroxysmal positional vertigo) and group 2 (healthy patients without benign paroxysmal positional vertigo as the control group). Data analysis was carried out to compare the serum levels in the cases and controls. A p-value less than 0.05 was considered significant.
A total of 70 age-matched individuals (cases, n = 40; controls, n = 30) were included in the study. The mean serum level of otolin-1 was 636.8 pg/ml (range, 259–981 pg/ml) in the group of patients with benign paroxysmal positional vertigo and 236.2 pg/ml (range, 189–370 pg/ml) in the control group. The difference was statistically significant (p = 0.0000).
The serum levels of otolin-1 in patients with benign paroxysmal positional vertigo are significantly higher compared with individuals without benign paroxysmal positional vertigo.
It is generally believed that the physiological consequences of stress could contribute to poor outcomes for patients being treated for cancer. However, despite preclinical and clinical evidence suggesting that stress promotes increased cancer-related mortality, a comprehensive understanding of the mechanisms involved in mediating these effects does not yet exist. We reviewed 47 clinical studies published between 2007 and 2020 to determine whether psychosocial stress affects clinical outcomes in cancer: 6.4% of studies showed a protective effect; 44.6% showed a harmful effect; 48.9% showed no association. These data suggest that psychosocial stress could affect cancer incidence and/or mortality, but the association is unclear. To shed light on this potentially important relationship, objective biomarkers of stress are needed to more accurately evaluate levels of stress and its downstream effects. As a potential candidate, the neuroendocrine signalling pathways initiated by stress are known to affect anti-tumour immune cells, and here we summarise how this may promote an immunosuppressive, pro-tumour microenvironment. Further research must be done to understand the relationships between stress and immunity to more accurately measure how stress affects cancer progression and outcome.
Childhood adversity and anxiety have been associated with increased risk for internalizing disorders later in life and with a range of brain structural abnormalities. However, few studies have examined the link between harsh parenting practices and brain anatomy, outside of severe maltreatment or psychopathology. Moreover, to our knowledge, there has been no research on parenting and subclinical anxiety symptoms which remain persistent over time during childhood (i.e., between 2.5 and 9 years old). Here, we examined data in 94 youth, divided into four cells based on their levels of coercive parenting (high / low) and of anxiety (high / low) between 2.5 and 9 years old. Anatomical images were analyzed using voxel-based morphometry (VBM) and FreeSurfer. Smaller gray matter volumes in the prefrontal cortex regions and in the amygdala were observed in youth with high versus low levels of harsh parenting over time. In addition, we observed significant interaction effects between parenting practices and subclinical anxiety symptoms in rostral anterior cingulate cortical thickness and in amygdala volume. These youth should be followed further in time to identify which youth will or will not go on to develop an anxiety disorder, and to understand factors associated with the development of sustained anxiety psychopathology.
ABSTRACT IMPACT: This change will improve primary care physicians and pediatrics ability to identify, intervene and prevent obesity related renal damage in the vulnerable population of young adults OBJECTIVES/GOALS: Obesity related glomerulopathy has a reversible stage manifested as hyperfiltration. Early intervention depends on the ability to identify hyperfiltration. Hyperfiltration prevalence is underestimated using the currently recommended formula We investigated whether calculating BSA-adjusted GFR will more readily identify hyperfiltration. METHODS/STUDY POPULATION: We extracted data from a large urban, multi-institutional Electronic Health Records (EHR) clinical data research network to construct an EHR data base of 60,549 women and girls ages 12-21 years from the New York metropolitan area. EGFR was calculated in two ways, 1) according to age appropriate formula, and 2) according to age appropriate formula and adjusted to body surface area (BSA). BMI-for-age values were classified according to the World Health Organization schema and grouped according to the CDC definitions. BSA was calculated according to the Du-Bois formula. Hyperfiltration was defined by a threshold of 135ml/min. The Bland Altman method assessed the agreement between formulas across the different BMI groups. RESULTS/ANTICIPATED RESULTS: Serum creatinine values were similar across different BMI groups. Comparing eGFR values, hyperfiltration rates were similar across BMI groups, ranging between 4%-6.6%. BSA-adjusted GFR was different across BMI groups: hyperfiltration rates were 0.81% for the underweight group, 2.56% for the normal weight, 12.18% for the overweight and 39% in the obese group. This trend of hyperfiltration paralleled the the rise in urine creatinine across BMI groups. DISCUSSION/SIGNIFICANCE OF FINDINGS: BSA-adjusted GFR more sensitively detects hyperfiltration due to obesity than does eGFR. Calculating BSA-adjusted GFR will improve primary care and pediatric physicians’ ability to identify, intervene and prevent early ORG. Changes in body composition may account for the increasing discordance between BSA-adjusted and eGFR as BMI rises.
One of the main concerns about the fast spreading coronavirus disease 2019 (Covid-19) pandemic is how to intervene. We analysed severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) isolates data using the multifractal approach and found a rich in viral genome diversity, which could be one of the root causes of the fast Covid-19 pandemic and is strongly affected by pressure and health index of the hosts inhabited regions. The calculated mutation rate (mr) is observed to be maximum at a particular pressure, beyond which mr maintains diversity. Hurst exponent and fractal dimension are found to be optimal at a critical pressure (Pm), whereas, for P > Pm and P < Pm, we found rich genome diversity relating to complicated genome organisation and virulence of the virus. The values of these complexity measurement parameters are found to be increased linearly with health index values.
The mechanism of nasal airflow sensation is poorly understood. This study aimed to examine the role of nasal mucosal temperature change in the subjective perception of nasal patency and the methods by which it can be quantified.
Medline and PubMed database searches were performed to retrieve literature relevant to the topic.
The primary mechanism producing the sensation of nasal patency is thought to be the activation of transient receptor potential melastatin family member 8 (‘TRPM8’), a thermoreceptor that is activated by nasal mucosal cooling. Computational fluid dynamics studies have demonstrated that increased airflow and heat flux are correlated with better patient-reported outcome measure scores. Similarly, physical measurements of the nasal cavity using temperature probes have shown a correlation between lower nasal mucosal temperatures and better patient-reported outcome measure scores.
Nasal mucosal temperature change may be correlated with the perception of improved nasal patency. Future research should quantify the impact of mucosal cooling on the perception of nasal airway obstruction.
Cordia sinensis, locally known as ‘Goondi’ in India, is an underexploited multipurpose fruit species found in hot arid regions that is well adapted to drought, salt and hot conditions. The present study was undertaken to collect fruit samples from different locations in the Kachchh region of Gujarat, India, and to determine their field establishment for characterization, conservation and utilization. The maximum distribution of the species was observed in Bhuj (45%) and Mandvi (25%). Field boundaries (35%) and scrub forests (30%) had greater frequencies, whereas backyards had rarer frequencies (10%). The species most commonly occurred on levelled topography (60%) with a soil pH in the range of 8–8.5 (63%). Morphological data of three-year-old plants in the field gene bank showed a maximum coefficient of variation in the number of leaves per plant (66.6), followed by the number of branches per plant (45.62) and collar diameter (27.69). Wide variations were recorded in plant height (121.67–212 cm), spread (118–223 cm2) and the number of branches per plant (6–24.33). Specific accessions were identified for fodder (CBCG-12, CBCG-13 and CBCG-16), early flowering and fruiting (CBCG-12, CBCG-13 and CBCG-14), easier propagation by seeds (CBCG-12 and CBCG-13) and salt tolerance (CBCG-15 and CBCG-16). Preliminary findings and information provided about this species' utilization and other aspects might be useful for future research on its domestication, sole plantation and conservation aspects, improving the exploitation of this species by present and future generations.
The onset of magnetic reconnection in space, astrophysical and laboratory plasmas is reviewed discussing results from theory, numerical simulations and observations. After a brief introduction on magnetic reconnection and approach to the question of onset, we first discuss recent theoretical models and numerical simulations, followed by observations of reconnection and its effects in space and astrophysical plasmas from satellites and ground-based detectors, as well as measurements of reconnection in laboratory plasma experiments. Mechanisms allowing reconnection spanning from collisional resistivity to kinetic effects as well as partial ionization are described, providing a description valid over a wide range of plasma parameters, and therefore applicable in principle to many different astrophysical and laboratory environments. Finally, we summarize the implications of reconnection onset physics for plasma dynamics throughout the Universe and illustrate how capturing the dynamics correctly is important to understanding particle acceleration. The goal of this review is to give a view on the present status of this topic and future interesting investigations, offering a unified approach.
An experimental investigation of droplet formation induced by an external electric field in a T-shaped microfluidic device is presented. The effect of electric field is reported for scenarios where the hydrodynamics is known to be governed by the cumulative effect of hydrodynamic pressure and interfacial tension acting on the liquid–liquid interface. Experiments reveal that the electrohydrodynamic phenomena transforms the droplet formation mechanism by inducing pinning of the dispersed phase to the channel wall, leading to a significant decrease in the droplet filling time and hence a decrease in the size of droplets generated. The experimental observations are used to formulate a correlation between the droplet size, applied electric field, fluid properties and flow parameters. A mechanistic explanation of droplet formation process using a mathematical model is also presented. Simulations reveal that the droplets are formed primarily due to normal electric stress acting on the liquid–liquid interface. The electric stress results in a distinct feature of pinning and early onset of neck formation of the emerging dispersed phase, leading to a reduction in the size of the droplet formed for the same hydrodynamic conditions. The findings reported demonstrate that an applied electric field has the potential to produce relatively smaller-sized droplets than that possible through hydrodynamics alone.
This study sought to assess the impact of simulation training in influencing trainees’ initial surgical participation as perceived by experienced surgeon trainers.
Twenty ENT surgeons assessed how much of a given procedure they would expect to allow a trainee to perform for their first time. Responses were provided for trainees who had undergone a relevant simulation course and those who had not, and scored according to the eLogbook levels of involvement in surgery. This was completed for simulated procedures with validated models, across four grades of junior doctors.
A total of 1120 judgements on the trainees’ intended level of involvement were made. The median involvement score was higher in the simulation group versus the non-simulation group (Mann–Whitney U, p = 0.0001), corresponding to a translation in surgical opportunity from a primarily assisting role to an active role.
Trainer perception of a relevant ENT simulation course appears to positively impact on the initial surgical opportunities afforded to the trainee.
This study was carried out to compare the efficacy of different methods to activate buffalo A + B and C + D quality oocytes parthenogenetically and to study the in vitro developmental competence of oocytes and expression of some important genes at the different developmental stages of parthenotes. The percentage of A + B oocytes (62.16 ± 5.06%, range 53.8–71.3%) was significantly higher (P < 0.001) compared with that of C + D oocytes (37.8 ± 5.00%, range 28.6–46.1%) retrieved from slaughterhouse buffalo ovaries. Among all combinations, ethanol activation followed by culture in research vitro cleave medium gave the highest cleavage and blastocyst yields for both A + B and C + D grade oocytes. Total cell numbers, inner cell mass/trophectoderm ratio and apoptotic index of A + B group blastocysts were significantly different (P < 0.05) from their C + D counterpart. To determine the status of expression patterns of developmentally regulated genes, the expression of cumulus–oocyte complexes, fertilization, developmental competence and apoptotic-related genes were also studied in parthenogenetically produced buffalo embryos at different stages, and indicated that the differential expression patterns of the above genes had a role in early embryonic development.
To determine the radiological prevalence of frontal cells according to the International Frontal Sinus Anatomy Classification in patients undergoing computed tomography of the paranasal sinuses for clinical symptoms of chronic rhinosinusitis, and to examine the association between cell classification and frontal sinusitis development.
A total of 180 (left and right) sides of 90 patients were analysed. The prevalence of each International Frontal Sinus Anatomy Classification cell was assessed. Logistic regression analysis was used to compare the distribution of various cells in patients with and without frontal sinusitis.
The agger nasi cell was the most commonly occurring cell, seen in 95.5 per cent of patients. The prevalence rates for supra agger cells, supra agger frontal cells, supra bullar frontal cells, supra bullar cells, supra-orbital ethmoid cells and frontal septal cells were 33.3 per cent, 22.2 per cent, 21.1 per cent, 36.1 per cent, 39.4 per cent and 21.1 per cent, respectively. There was no significant difference in the occurrence of any of the cell types in patients with frontal sinusitis compared to those without (p > 0.05).
The presence of any of the International Frontal Sinus Anatomy Classification cells was not significantly associated with frontal sinusitis.
There is a paucity of scientific analysis that has examined spatial heterogeneities in the socioeconomic vulnerabilities related to coronavirus disease 2019 (COVID-19) risk and potential mitigation strategies at the sub-national level in India. The present study examined the demographic, socioeconomic, and health system-related vulnerabilities shaping COVID-19 risk across 36 states and union territories in India.
Using secondary data from the Ministry of Health and Family Welfare (MoHFW), Government of India; Census of India, 2011; National Family Health Survey, 2015-16; and various rounds of the National Sample Survey, we examined socioeconomic vulnerabilities associated with COVID-19 risk at the sub-national level in India from March 16, 2020, to May 3, 2020. Descriptive statistics, principal component analysis, and the negative binomial regression model were used to examine the predictors of COVID-19 risk in India.
There persist substantial heterogeneities in the COVID-19 risk across states and union territories in India. The underlying demographic, socioeconomic, and health infrastructure characteristics drive the vulnerabilities related to COVID-19 in India.
This study emphasizes that concerted socially inclusive policy action and sustained livelihood/economic support for the most vulnerable population groups is critical to mitigate the impact of the COVID-19 pandemic in India.
India is one of the severely affected countries by the Covid-19 pandemic at present. Within the stochastic framework of the SEQIR model, we studied publicly available data of the Covid-19 patients in India and analysed possible impacts of quarantine and social distancing as controlling strategies for the pandemic. Our stochastic simulation results clearly show that proper quarantine and social distancing should be maintained right from the start of the pandemic and continued until its end for effective control. This calls for a more disciplined social lifestyle in the future. However, only social distancing and quarantine of the exposed population are found not sufficient enough to end the pandemic in India. Therefore, implementation of other stringent policies like complete lockdown as well as increased testing of susceptible populations is necessary. The demographic stochasticity, which is quite visible in the system dynamics, has a critical role in regulating and controlling the pandemic.
Finding coil sets with desirable physics and engineering properties is a crucial step in the design of modern stellarator devices. Existing stellarator coil optimization codes ultimately produce zero-thickness filament coils. However, stellarator coils have finite depth and thickness, which can make the single-filament model a poor approximation, particularly when coil build dimensions are relatively large compared to the coil–plasma distance. In this paper, we present a new method for designing coils with finite builds and present a mechanism to optimize the orientation of the winding pack. We approximate finite-build coils with a multi-filament model. A numerical implementation has been developed, and applications to the Helically Symmetric eXperiment stellarator and a new UW-Madison quasihelically symmetric configuration are shown.
The purpose of this paper is to disclose improved crystal based frequency source system covering design techniques and experimental methodologies for the stabilization of phase noise performance of X-band phase-locked loop (PLL) at 10.6 GHz. Phase noise performance of PLL-based unit under test (UUT) is prone to disturbance occurred in random vibration profile frequency spectrum. UUT self-resonance plays vital role in occurrence of disturbance in random vibration profile. The stabilization of phase noise performance during dynamic (random) vibration condition is achieved by following methodologies, i.e. vibration-isolator compensation techniques, purification tactic for reference crystal of PLL, and spatial location analysis for finding out mounting position of reference crystal. Spatial analysis helps to filter out UUT self-resonance frequency from random vibration spectrum which leads to reduction of frequency resonance pickups during random vibration testing.
To quantify diet-related burdens of cardiometabolic diseases (CMD) by country, age and sex in Latin America and the Caribbean (LAC).
Intakes of eleven key dietary factors were obtained from the Global Dietary Database Consortium. Aetiologic effects of dietary factors on CMD outcomes were obtained from meta-analyses. We combined these inputs with cause-specific mortality data to compute country-, age- and sex-specific absolute and proportional CMD mortality of eleven dietary factors in 1990 and 2010.
Thirty-two countries in LAC.
Adults aged 25 years and older.
In 2010, an estimated 513 371 (95 % uncertainty interval (UI) 423 286–547 841; 53·8 %) cardiometabolic deaths were related to suboptimal diet. Largest diet-related CMD burdens were related to low intake of nuts/seeds (109 831 deaths (95 % UI 71 920–121 079); 11·5 %), low fruit intake (106 285 deaths (95 % UI 94 904–112 320); 11·1 %) and high processed meat consumption (89 381 deaths (95 % UI 82 984–97 196); 9·4 %). Among countries, highest CMD burdens (deaths per million adults) attributable to diet were in Trinidad and Tobago (1779) and Guyana (1700) and the lowest were in Peru (492) and The Bahamas (504). Between 1990 and 2010, greatest decline (35 %) in diet-attributable CMD mortality was related to greater consumption of fruit, while greatest increase (7·2 %) was related to increased intakes of sugar-sweetened beverages.
Suboptimal intakes of commonly consumed foods were associated with substantial CMD mortality in LAC with significant heterogeneity across countries. Improved access to healthful foods, such as nuts and fruits, and limits in availability of unhealthful factors, such as processed foods, would reduce diet-related burdens of CMD in LAC.
Field experiments were conducted to standardize protocols for site-specific fertilizer nitrogen (N) management in Bt cotton using Soil Plant Analysis Development (SPAD) chlorophyll meter. Performance of different SPAD-based site-specific N management scenarios was evaluated vis-à-vis blanket fertilizer N recommendation. The N treatments comprised a no-N (control), four fixed-time and fixed N doses (60, 90, 120, and 150 kg N ha-1) including the recommended dose (150 kg ha-1), and eight fixed-time and adjustable N doses based on critical SPAD readings of 45 and 41 at first flowering and boll formation stages, respectively. The results revealed that by applying 45 or 60 kg N ha-1 at thinning stage of the crop and critical SPAD value-guided dose of 45 or 30 kg N ha-1 at first flowering stage resulted in yields similar to that recorded by applying the recommended dose of 150 kg N ha-1. However, significantly higher N use efficiency as well as 30–40% less total fertilizer N use was recorded with site-specific N management. Applying 30 kg N ha-1 at thinning and SPAD meter-guided 45 kg N ha-1 at first flowering were not enough and required additional SPAD meter-guided 45 kg N ha-1 at boll formation for sustaining yield levels equivalent to those observed by following blanket recommendation but resulted in 20% less fertilizer N application. Our data revealed that SPAD meter-based site-specific N management in Bt cotton results in optimum yield with dynamic adjustment of fertilizer N doses at first flowering and boll formation stages. The total amount of N fertilizer following site-specific management strategies was substantially less than the blanket recommendation of 150 kg N ha-1, but the extent may vary in different fields.
Pigeonpea has great potential as a profitable summer legume rotational crop in cereal farming systems of subtropical Australia. Pigeonpea requires season-long weed control, but options for controlling broadleaf weeds in pigeonpea with POST herbicides are limited. The objective of this study was to evaluate the performance of different herbicides (PRE: pendimethalin; POST: acifluorfen, bentazon, and imazapic) applied singly or in sequence for horse purslane control in pigeonpea and their impact on pigeonpea yield. Field experiments were conducted in 2017 and 2018 at Gatton, Australia. Pendimethalin applied PRE at 1.14 kg ai ha−1 reduced horse purslane biomass by 87% and 92% and produced 32% and 105% higher grain yield compared with the nontreated control in 2017 and 2018, respectively. Imazapic applied POST at 0.10 kg ai ha−1 reduced horse purslane biomass by 79% and 82% and increased grain yield by 60% and 88% compared with the nontreated control in 2017 and 2018, respectively. Acifluorfen applied POST (0.34 and 0.42 kg ai ha−1) caused 16% to 48% injury to pigeonpea at 45 d after treatment. Control of horse purslane ranged from 87% to 92% (biomass reduction) with pendimethalin applied PRE at 1.14 kg ai ha−1 and was comparable with pendimethalin applied PRE at 0.91 kg ai ha−1 in the sequential application, and imazapic at 0.08 kg ai ha−1 or bentazon at 0.96 kg ai ha−1. The study findings suggest if farmers miss the PRE application of pendimethalin or are unable to achieve season-long weed control, POST application of imazapic is an alternate. This research provided herbicide options for control of horse purslane in pigeonpea that could be used in rotations for reducing the selection pressure of weeds.
To compare prescribing practices of hypnotics against NICE guidelines (National Institute of Clinical Excellence) and to develop recommendations with action plan. The NICE recommends:
• Due consideration should be given to non-pharmacological measures prior to hypnotic prescription.
• Hypnotics should be prescribed for short periods of time only (maximum 4 weeks)
• The drug with the lowest purchase cost should be prescribed.
• Switching from one hypnotic to another should only occur if a patient experiences adverse effects.
The audit tool was developed. The data was compiled using medical records of the patients who were seen during a specified three month time period in an out-patient setting. A total sample size of 308 was generated out of which 41(12.5%) were being prescribed hypnotics. The medical records of these 41 patients were scrutinised to gather evidence whether NICE guidelines were adhered to. The data was analysed using the tool recommended by NICE.
The significant results are:
• Only 25% of the patients were advised Non-pharmacological measures.
• Duration of prescription ranged from one week to more than 10 years, with 33% approximately being prescribed for less than one year, and 10% being prescribed for more than 10 years.
• There is no evidence that consideration was given to cost while prescribing.
• Only in one patient hypnotic was switched. However, there was no evidence of adverse reaction which could be directly related to the hypnotic prescribed.
The overall compliance with guidelines was found to be 42%.