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We emphasize the need for resilience to accommodate disease outbreaks in future planning, design, and preparedness strategies for airports and airlines. We further argue that the existing civil aviation system needs a coordinated global response mechanism to combat future outbreaks and propose a framework with a threat response matrix to keep aviation safe and operational during future pandemics and mitigate socioeconomic fallout.
Multisystem Inflammatory Syndrome in Adults (MIS-A) is a recently emerging condition that occurs as a delayed complication of COVID-19 infection. It involves inflammation of multiple extra-pulmonary organ systems. selleck products Diagnostic criteria and treatment recommendations have yet to be clearly defined. We present a case of a young adult with suspected MIS-A who initially displayed symptoms and radiological findings of colitis.Case A 22-year-old male with no past medical history suffered a minor respiratory illness for a few days and tested positive on SARS-CoV-2 RT-PCR. Approximately 6weeks later, he presents after 3days of right-sided abdominal pain, diarrhoea and fever. He is initially admitted with a working diagnosis of gastroenteritis. Sustained fever and escalating blood markers of illness led to abdominal CT; showing inflammation of ascending colon as well as some loops of small bowel. Hypotension becomes increasingly pronounced and on the fourth day of admission he developed type 1 respiratory failure with ample a primarily gastroenterological illness. It therefore highlights the importance of physicians in different fields having an awareness of the condition, in order to identify when MDT input is required to guide treatment. We review the current literature on various presentations and treatments of MIS-A, and discuss the need for clear case definition.Despite the ability to characterize the plasticity of powders in a material-sparing and expedited manner, the in-die Heckel analysis has been widely criticized for its sensitivity to several factors, such as particle elastic deformation, tooling size, lubrication, and speed. Using materials exhibiting a wide range of mechanical properties, we show that the in-die P y correlates strongly with three established plasticity parameters obtained from the out-of-die Heckel analysis, Kuentz-Leuenberger analysis, and macroindentation. Thus, the in-die P y is a reliable parameter for quantifying powder plasticity in a material-sparing and expedited manner.
The rotigotine transdermal patch (RTP) is a dopamine agonist used to treat Parkinson's disease (PD) but is sometimes discontinued because of application site reactions (ASRs). We aimed to investigate the effect of a heparinoid-containing product (HCP) for preventing ASRs due to the RTP by conducting a randomized controlled pilot trial.
Twenty patients with idiopathic non-demented PD were randomized to the skin care group using a HCP (group H) and the non-skin care group (group N). The primary outcome was the change in the baseline Skindex-16 score (ΔSkindex-16) at week 4. In addition, skin symptoms were also evaluated using the Dermatology Life Quality Index (DLQI) and International Contact Dermatitis Research Group (ICDRG) system for clinical scoring allergic patch test reactions up to week 8.
The ΔSkindex-16 score at week 4 tended to be lower in group H than in group N, although the difference was not statistically significant (-1.5±2.0 vs 1.3±10.9, p=0.53). When the patients with baseline Skindex-16 scores≥7 were excluded, the ΔSkindex-16 at week 4 was significantly lower in group H (-1.5±2.0 vs 6.1±8.6, p=0.042). The DLQI also tended to be lower in group H at weeks 4 and 8, but not significantly (p=0.066 and p=0.077, respectively). The ICDRG score at week 4 was significantly lower in group H (p=0.044).
We suggest that the HCP has a preventive effect against ASRs cause by the RTP.
We suggest that the HCP has a preventive effect against ASRs cause by the RTP.
Most peripheral venous catheters (PVCs) used in Scandinavia are fitted with an injection port, creating an open PVC system. This port is difficult to disinfect, which may lead to the introduction of micro-organisms upon use.
To investigate the prevalence of microbiological colonization of the injection port and internal lumen of ported PVCs with a minimum dwell time of 48 h at sample collection.
Adult patients admitted to different medical and surgical departments and the intensive care unit were invited to participate in this prospective observational study. With the PVC
, the injection port and internal lumen were swabbed and cultured separately. Demographic and clinical data were collected to compare patients with colonized and non-colonized PVCs.
In total, 300 PVCs from 300 patients were analysed. Of these, 33 patients (11.0%) had at least one positive culture. The colonization locations were as follows port only, 26 (8.7%); internal lumen only, 5 (1.7%); and port and internal lumen, 2 (0.7%). The colonization rate was significantly higher in the injection port than in the internal lumen (
<0.0001). A ported PVC inserted in the hand incurred a significant risk of colonization (
=0.03). The odds ratio for colonization among patients in the infectious diseases department was 0.1 (95% confidence interval 0.1-1;
<0.06) compared with patients in the medical department.
This study showed that 11% of ported PVCs were colonized by micro-organisms, with the vast majority (8.7%) of colonization occurring in the injection port.
ClinicalTrials.gov; ID NCT03351725.
ClinicalTrials.gov; ID NCT03351725.Reactive oxygen species (ROS) mediate multiple physiological functions; however, the over-accumulation of ROS causes premature aging and/or death and is associated with various inflammatory conditions. Nevertheless, there are limited clinical treatment options that are currently available. The good news is that owing to the considerable advances in nanoscience, multiple types of nanomaterials with unique ROS-scavenging abilities that influence the temporospatial dynamic behaviors of ROS in biological systems have been developed. This has led to the emergence of next-generation nanomaterial-controlled strategies aimed at ameliorating ROS-related inflammatory conditions. Accordingly, herein we reviewed recent progress in research on nanotherapy based on ROS scavenging. The underlying mechanisms of the employed nanomaterials are emphasized. Furthermore, important issues in developing cross-disciplinary nanomedicine-based strategies for ROS-based inflammatory conditions are discussed. Our review of this increasing interdisciplinary field will benefit ongoing studies and clinical applications of nanomedicine based on ROS scavenging.Quantum dots (QDs) are semiconductor nanocrystals with unique size-tunable emissions. To obtain a precise emission spectrum, monodispersity in size is imperative, which is achieved by controlling the reaction kinetics in a continuous flow of active microreactors. Further, a multivariate approach (dimensional analysis) is employed to impose stringent control on the reaction process resulting in monodispersed preparation of cadmium telluride (CdTe) quantum dots. Dimensional analysis knits multiple variables into a dimensionless mathematical form which not only predicts parameters precisely to obtain narrow size tunability but also guarantees reproducibility in synthesis. Analytical, structural, and optical characterization of the microreactor synthesized polydimethylsiloxane (PDMS) coated CdTe QDs reveal quantum efficient (61.5%), photostable (44%), and biocompatible nanocrystals of 5-15 nm. Further, PDMS-coated QDs (P-QDs) are conjugated with organelle-specific antibodies/biomarkers for in-vitro imaging in NIH 3T3 cells. Likewise, proliferating cell nuclear antigen (PCNA) and anti-myosin (MF20), cardiomyocytes antibodies are conjugated with P-QDs (red and green, respectively) to image the zebrafish's cardiac tissue. Antibodies tagged with quantum dots are imaged simultaneously using confocal microscopy. Thus, multiplexed bio-imaging of in-vitro and zebrafish tissue is demonstrated successfully. The results indicate the suitability of continuous flow active microreactor in conjunction with the mathematical prediction of process parameters to synthesize reproducibly monodispersed and quantum efficient QDs.Temporal trends in prescriptions of anti-seizure medicines (ASMs) for children, including newer ASMs, are unclear. We investigated ASM prescription trends for pediatric outpatients in Japan. The MDV analyzer® was used to analyze the MDV database containing de-identified hospital administrative data. Administrative data as of June 2021 including pediatric outpatients (0-17 years) with epilepsy, visiting 123 acute diagnostic procedure combination hospitals during 2013-2019, were used. Annual ASMs prescription trends were calculated, based on proportions. The Cochran-Armitage trend test evaluated the proportion of prescriptions for each ASM. ASMs most often prescribed were valproic acid, carbamazepine, and levetiracetam, regardless of sex. In girls, the proportion of valproic acid and carbamazepine prescriptions decreased from 37.93% to 26.84%, and from 24.80% to 15.78%, respectively (p less then 0.0001). Conversely, the proportion of levetiracetam prescriptions increased from 6.40% to 28.18% (p less then 0.0001). In boys, the proportion of valproic acid and carbamazepine prescriptions decreased, from 36.58% to 32.20% and from 26.42% to 16.85%, respectively (p less then 0.0001). The proportion of levetiracetam prescriptions increased from 5.64% to 23.02% (p less then 0.0001). Overall, the proportion of valproic acid and carbamazepine prescriptions declined, whereas levetiracetam prescriptions increased. Trends in ASM prescriptions among pediatric outpatients with epilepsy in Japan have shifted towards more recently available ASMs.Implanted neurostimulation devices are gaining traction as palliative treatment options for certain forms of drug-resistant epilepsy, but clinical utility of these devices is hindered by incomplete mechanistic understanding of their therapeutic effects. Approved devices for anterior thalamic nuclei deep brain stimulation (ANT DBS) are thought to work at a network level, but limited sensing capability precludes characterization of neurophysiological effects outside the thalamus. Here, we describe a patient with drug-resistant temporal lobe epilepsy who was implanted with a responsive neurostimulation device (RNS System), involving hippocampal and ipsilateral temporal neocortical leads, and subsequently received ANT DBS. Over 1.5 years, RNS System electrocorticography enabled multiscale characterization of neurophysiological effects of thalamic stimulation. In brain regions sampled by the RNS System, ANT DBS produced acute, phasic, frequency-dependent responses, including suppression of hippocampal low frequency local field potentials. ANT DBS modulated functional connectivity between hippocampus and neocortex. Finally, ANT DBS progressively suppressed hippocampal epileptiform activity in relation to the extent of hippocampal theta suppression, which informs stimulation parameter selection for ANT DBS. Taken together, this unique clinical scenario, involving hippocampal recordings of unprecedented chronicity alongside ANT DBS, sheds light on the therapeutic mechanism of thalamic stimulation and highlights capabilities needed in next-generation devices.