The Wound Healing Effects of Aqueous Leave Extracts of Azadirachta Indica on Wistar Rats.

The wound healing effect of the aqueous leave extracts of Azadirachta indica (neem tree)was investigated on adult male wistar rats. The aim of this study is to scientifically determine if the aqueous leave extracts of Azadirachta indica has wound healing abilities. Twenty male wistar rats (two groups of 10 control and 10 experimental rats)of average weight 150-200g were used for this study. A 2cm by 2cm2 area of wound was made at the dorsolateral aspect of the rats and an aqueous leave extract of Azadirachta indica was applied on the wound of experimental rats while normal saline was used on the control rats. All animals had their wound dressed every three days, wound dimension measured and morphometry assessed. Wound biopsy was collected by random selection in each group on day 9 and on the day of complete reepithelialization. Tissue processing was done using paraffin wax method. Slides were stained with haematoxilin and eosin for histological assessment of fibroblast, neovascularization, granulation and end scar tissue profile. Results showed significant wound contraction at day 6 (p<0.05).The mean percentage wound contraction for experimental rats was 72.34± 2.49 while the control group was 62.39± 7.94. Mean percentage wound contraction for experimental group at day 9 was 92.20± 6.66 while that of the control group was 85.19± 7.84. The mean of the percentage wound contraction on day 9 was insignificant (p>0.05). The extracts of   Azadirachta indica significantly increased (p<0.05) the day of complete wound closure in experimental group compared to control group. Aqueous leave extracts of Azadirachta indica promotes wound healing activity through increased inflammatory response and neovascularization. KEY  WORDS: Azadirachta indica, wistar rats, wound healing

The Discriminant Formula for the Determination of Sex of Adults in A Nigerian Population (Using Pelvic Radiographs)

Identification of sex in human skeletal remains is an important component and frequently the starting point of many forensic anthropological investigations. This study was carried out to document the determination of sex by discriminant formula using the pelvic radiographs of Nigerian adults. Measurements were carried out on the pelvis. Pelvic radiographs of 500 adult Nigerians of known sex, age range 18-75 years (comprising 250 males and 250 females) were measured in the antero-posterior position using a digital vernier calliper. The data was analysed using z-test. The results showed that the mean values for the Ischial length and Pubic length in males were 86.82±8.25mm and 76.41±8.91mm respectively while in females the Ischial length and Pubic length were 80.62±7.66mm and 84.58±8.80mm respectively. 4% males and 19% females were identified for ischial length and 15% males and 42% females were identified for pubic length. The mean value for pelvic height in males and females were 236.70±12.51mm and 223.02±12.18mm respectively, the demarking points identified 29% males and 32% females, while the mean value for midpubic width in males and females were 25.94± 4.54mm and 30.09± 3.67mm respectively, the demarking points identified 40% and 65% females. The mean values for ischiopubic and pelvic height/midpubic width were statistically significant (P<0.05). The mean values of the pelvic height/midpubic index were 9.35 ± 1.38 in males and 7.49 ± 0.82 in females. The demarking points identified 72% males and 75% females. While the mean values of the ischiopubic index in males and females were 88.46±9.26 in males and 114.67±99.28 in females, the demarking points identified 56% males and 84% females. It was observed that the males had higher pelvic height and ischial length than females, while the females had longer pubic length and mid pubic width which contributed to the females having wider pelvis. The accurate determination of sex and race are important tools to forensic Scientists and physical anthropologists. Keywords: Pelvis, Radiographs, Sex determination, Nigerian population

Quality of life measurement clarifies the cost-effectiveness of Helicobacter pylori eradication in peptic ulcer disease and uninvestigated dyspepsia 1

Previous economic studies of Helicobacter pylori eradication in dyspepsia and peptic ulcer disease have not measured quality of life using utilities (preference probabilities), which are needed to compare the cost-effectiveness of such treatment to other health care interventions. The goals of this study were to measure quality of life in patients with dyspepsia or peptic ulcer and apply these measurements to published models of disease management to determine cost-effectiveness in dollars per quality-adjusted life year (QALY) gained. Methods : Utilities for dyspepsia and peptic ulcer disease were measured in adult patients (n = 73) on chronic acid suppression for peptic ulcer or ulcer-like dyspepsia. Median utility values were applied to the results of published cost-effectiveness analyses and a previously validated dyspepsia model. Cost-utility ratios for early H. pylori eradication in uninvestigated dyspepsia and peptic ulcer disease were then computed. Results : The total disutility, or lost quality of life, for an ulcer was 0.11 QALY, of which 0.09 QALY was attributed to dyspeptic symptoms. After these results were incorporated into published studies, cost-utility ratios for ulcer treatment varied from $3,100 to$12,500 per QALY gained, whereas estimates for uninvestigated dyspepsia management ranged from $26,800 to$59,400 per QALY. Sensitivity analyses indicated a range of $1,300 to$27,300 per QALY for management of duodenal ulcer and $15,000 to$129,700 per QALY for dyspepsia. Conclusions: Strategies that emphasize early H. pylori eradication were cost-effective for patients with peptic ulcer and possibly cost-effective for patients with uninvestigated dyspepsia, relative to other medical interventions. Dyspeptic symptoms cause significant disutility that should be incorporated in future cost-effectiveness analyses of treatment strategies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73031/1/j.1572-0241.2001.03516.x.pd

Perturbing singular systems and the correlating of uncorrelated random sequences

A stochastic process may be used to combine sequences with zero autocorrelation to give an autocorrelated sequence. We study this simple paradigm of irreversible mixing. © 2007 American Institute of Physics

An evaluation of patient-reported outcomes in sickle cell disease within a conceptual model.

PURPOSE: To examine the relations between patient-reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 - 45 years enrolled in the multi-site Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD-related factors, particularly pain, and barriers to care would independently contribute to functioning as measured using PRO domains. METHODS: Participants (N = 2054) completed a 48-item survey including socio-demographics and PRO measures, e.g., social functioning, pain impact, emotional distress, and cognitive functioning. Participants reported on lifetime SCD complications, pain episode frequency and severity, and barriers to healthcare. RESULTS: Higher pain frequency was associated with higher odds of worse outcomes in all PRO domains, controlling for age, gender and site (OR range 1.02-1.10, 95% CI range [1.004-1.12]). Reported history of treatment for depression was associated with 5 of 7 PRO measures (OR range 1.58-3.28 95% CI range [1.18-4.32]). Fewer individual barriers to care and fewer SCD complications were associated with better outcomes in the emotion domain (OR range 0.46-0.64, 95% CI range [0.34-0.86]). CONCLUSIONS: Study results highlight the importance of the biopsychosocial model to enhance understanding of the needs of this complex population, and to design multi-dimensional approaches for providing more effective interventions to improve outcomes

Thunderclap: Exploring Vulnerabilities in Operating System IOMMU Protection via DMA from Untrustworthy Peripherals

Direct Memory Access (DMA) attacks have been known for many years: DMA-enabled I/O peripherals have complete access to the state of a computer and can fully compromise it including reading and writing all of system memory. With the popularity of Thunderbolt 3 over USB Type-C and smart internal devices, opportunities for these attacks to be performed casually with only seconds of physical access to a computer have greatly broadened. In response, commodity hardware and operating-system (OS) vendors have incorporated support for Input-Output Memory Management Units (IOMMUs), which impose memory protection on DMA, and are widely believed to protect against DMA attacks. We investigate the state-of-the-art in IOMMU protection across OSes using a novel I/O security research platform, and find that current protections fall short when faced with a functional network peripheral that uses its complex interactions with the OS for ill intent, and demonstrate compromises against macOS, FreeBSD, and Linux, which notionally utilize IOMMUs to protect against DMA attackers. Windows only uses the IOMMU in limited cases and remains vulnerable. Using Thunderclap, an open-source FPGA research platform we built, we explore a number of novel exploit techniques to expose new classes of OS vulnerability. The complex vulnerability space for IOMMU-exposed shared memory available to DMA-enabled peripherals allows attackers to extract private data (sniffing cleartext VPN traffic) and hijack kernel control flow (launching a root shell) in seconds using devices such as USB-C projectors or power adapters. We have worked closely with OS vendors to remedy these vulnerability classes, and they have now shipped substantial feature improvements and mitigations as a result of our work.DARPA I2O FA8750-10-C-0237 ("CTSRD") DARPA MTO HR0011- 18-C-0016 ("ECATS") Arm Ltd Google Inc This work was also supported by EPSRC EP/R012458/1 (“IOSEC”)

Interhospital Transfers Among Medicare Beneficiaries Admitted for Acute Myocardial Infarction at Nonrevascularization Hospitals

Background—Patients with acute myocardial infarction (AMI) who are admitted to hospitals without coronary revascularization are frequently transferred to hospitals with this capability, yet we know little about the basis for how such revascularization hospitals are selected. Methods and Results—We examined interhospital transfer patterns in 71 336 AMI patients admitted to hospitals without revascularization capabilities in the 2006 Medicare claims using network analysis and regression models. A total of 31 607 (44.3%) AMI patients were transferred from 1684 nonrevascularization hospitals to 1104 revascularization hospitals. Median time to transfer was 2 days. Median transfer distance was 26.7 miles, with 96.1% within 100 miles. In 45.8% of cases, patients bypassed a closer hospital to go to a farther hospital that had a better 30-day risk standardized mortality rates. However, in 36.8% of cases, another revascularization hospital with lower 30-day risk-standardized mortality was actually closer to the original admitting nonrevascularization hospital than the observed transfer destination. Adjusted regression models demonstrated that shorter transfer distances were more common than transfers to the hospitals with lowest 30-day mortality rates. Simulations suggest that an optimized system that prioritized the transfer of AMI patients to a nearby hospital with the lowest 30-day mortality rate might produce clinically meaningful reductions in mortality. Conclusions—More than 40% of AMI patients admitted to nonrevascularization hospitals are transferred to revascular- ization hospitals. Many patients are not directed to nearby hospitals with the lowest 30-day risk-standardized mortality, and this may represent an opportunity for improvement. (Circ Cardiovasc Qual Outcomes. 2010;3:468-475.)This work was supported by 1K08HL091249-01 from the NIH/ NHLBI and used the Measurement Core of the Michigan Diabetes Research and Training Center (NIH/NIDDK, P60DK-20572). This project was also funded in part under a grant from the Pennsylvania Department of Health, which specifically disclaims responsibility for any analyses, interpretations, or conclusions. The funders were not involved in study design, interpretation, or the decision to publish.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78005/1/10.I.Circ.Outcomes.pd

Effectiveness and safety of apixaban vs warfarin among venous thromboembolism patients at high-risk of bleeding

This study evaluated effectiveness and safety of apixaban versus warfarin among venous thromboembolism patients at high-risk of bleeding (defined as having at least one of the following bleeding risk factors: ≥75 years; used antiplatelet, NSAIDs, or corticosteroids; had prior gastrointestinal bleeding or gastrointestinal-related conditions; late stage chronic kidney disease). Adult venous thromboembolism patients initiating apixaban or warfarin with ≥1 bleeding risk factor were identified from Medicare and four commercial claims databases in the United States. To balance characteristics between apixaban and warfarin patients, stabilized inverse probability treatment weighting was conducted. Cox proportional hazards models were used to estimate the risk of recurrent venous thromboembolism, major bleeding, and clinically relevant non-major bleeding. In total, 88,281 patients were identified. After inverse probability treatment weighting, the baseline patient characteristics were well-balanced between the two cohorts. Among venous thromboembolism patients at high-risk of bleeding, apixaban was associated with significantly lower risk of recurrent venous thromboembolism, major bleeding and clinically relevant non-major bleeding. No significant interactions were observed between treatment and number of risk factors on major bleeding and clinically relevant non-major bleeding or between treatment and type of bleeding risk factors on any of the outcomes. In conclusion, apixaban was associated with significantly lower risk of recurrent venous thromboembolism and bleeding among venous thromboembolism patients at high-risk of bleeding. Effects were generally consistent across subgroups of patients with different number or type of bleeding risk factors

Comparison of Francisella tularensis genomes reveals evolutionary events associated with the emergence of human pathogenic strains

.Sequencing of the non-pathogenic Francisella tularensis sub-species novicida U112, and comparison with two pathogenic sub-species, provides insights into the evolution of pathogenicity in these species

Cognitive Information Processing

Contains research objectives and summary of research on fourteen research projects and reports on four research projects.Joint Services Electronics Program (Contract DAAB07-75-C-1346)National Science Foundation (Grant EPP74-12653)National Science Foundation (Grant ENG74-24344)National Institutes of Health (Grant 2 PO1 GM19428-04)Swiss National Funds for Scientific ResearchM.I.T. Health Sciences Fund (Grant 76-11)National Institutes of Health (Grant F03 GM58698)National Institutes of Health (Biomedical Sciences Support Grant)Associated Press (Grant