Carbon Capture with 4 m Piperazine/4 m 2-Methylpiperazine

AbstractAn equimolar diamine blend of 4 m 2-methylpiperazine (2MPZ) with 4 m piperazine (PZ) is shown to be an attractive solvent for CO2 capture. This blend overcomes the difficulties posed by the narrow solid solubility window of pure 8 m PZ while preserving its benefits. The solid solubility window at 20°C broadens from to . As the blend viscosity is nearly double that of pure PZ, normalizing the capacity by viscosity shows a practical capacity comparable to MEA at 0.63mol CO2/kg solvent. The CO2 absorption rate of the blend is lower, with at 40°C, 84% that of PZ. The heats of CO2 absorption of the blend and PZ are equal at ΔHabs=70kJ/mol. While the blend thermal stability is decreased, Tmax = 155 compared to 163°C, oxidative stability is similar. Lastly, their volatilities are nearly equal with amine Henry's constant near 23Pa at 40°C. In short, the equimolar blend of 4 m 2MPZ with 4 m PZ is a competitive solvent for amine scrubbing

Childrens friendships in super-diverse localities: Encounters with social and ethnic difference

This article explores how children make, manage, or avoid friendships in super-diverse primary school settings. We draw on interviews and pictorial data from 78 children, aged 8–9 years across three local London primary schools to identify particular friendship groupings and the extent to which they followed existing patterns of social division. Children in the study did recognise social and cultural differences, but their friendship perceptions, affections, conflicts and practices meant that the way in which difference impacted relationships was partial and unstable. Friendship practices in the routine settings of school involved interactions across difference, but also entrenchments around similarity

NS4A protein as a marker of HCV history suggests that different HCV genotypes originally evolved from genotype 1b

<p>Abstract</p> <p>Background</p> <p>The 9.6 kb long RNA genome of Hepatitis C virus (HCV) is under the control of RNA dependent RNA polymerase, an error-prone enzyme, for its transcription and replication. A high rate of mutation has been found to be associated with RNA viruses like HCV. Based on genetic variability, HCV has been classified into 6 different major genotypes and 11 different subtypes. However this classification system does not provide significant information about the origin of the virus, primarily due to high mutation rate at nucleotide level. HCV genome codes for a single polyprotein of about 3011 amino acids which is processed into structural and non-structural proteins inside host cell by viral and cellular proteases.</p> <p>Results</p> <p>We have identified a conserved NS4A protein sequence for HCV genotype 3a reported from four different continents of the world i.e. Europe, America, Australia and Asia. We investigated 346 sequences and compared amino acid composition of NS4A protein of different HCV genotypes through Multiple Sequence Alignment and observed amino acid substitutions C₂₂, V₂₉, V₃₀, V₃₈, Q₄₆and Q₄₇in NS4A protein of genotype 1b. Furthermore, we observed C₂₂and V₃₀as more consistent members of NS4A protein of genotype 1a. Similarly Q₄₆and Q₄₇in genotype 5, V₂₉, V₃₀, Q₄₆and Q₄₇in genotype 4, C₂₂, Q₄₆and Q₄₇in genotype 6, C₂₂, V₃₈, Q₄₆and Q₄₇in genotype 3 and C₂₂in genotype 2 as more consistent members of NS4A protein of these genotypes. So the different amino acids that were introduced as substitutions in NS4A protein of genotype 1 subtype 1b have been retained as consistent members of the NS4A protein of other known genotypes.</p> <p>Conclusion</p> <p>These observations indicate that NS4A protein of different HCV genotypes originally evolved from NS4A protein of genotype 1 subtype 1b, which in turn indicate that HCV genotype 1 subtype 1b established itself earlier in human population and all other known genotypes evolved later as a result of mutations in HCV genotype 1b. These results were further confirmed through phylogenetic analysis by constructing phylogenetic tree using NS4A protein as a phylogenetic marker.</p

Drug combinations as effective anti-leishmanials against drug resistant Leishmania mexicana

Leishmania is a parasite that causes the disease leishmaniasis, and 700 000 to 1 million new cases occur each year. There are few drugs that treat the disease and drug resistance in the parasite limits the clinical utility of existing drugs. One way to combat drug resistance is to use combination therapy rather than monotherapy. In this study we have compared the effect of single and combination treatments with four different compounds, i.e. alkylphosphocholine analogues APC12 and APC14, miltefosine (MIL), ketoconazole (KTZ), and amphotericin B (AmpB), on the survival of Leishmania mexicana wild-type promastigotes and a cell line derived from the WT with induced resistance to APC12 (C12Rx). The combination treatment with APC14 and APC16 had a synergistic effect in killing the WT while the combination treatment with KTZ and APC12 or APC14 or APC12 and APC14 had a synergistic effect against C12Rx. More than 90% killing efficiency was obtained using APC12 alone at >1 mg ml-1 against the C12Rx strain; however, combinations with APC14 produced a similar killing efficiency using APC12 at 0.063-0.25 mg ml-1 and APC14 at 0.003-0.5 mg ml-1. These results show that combination therapy can negate induced drug resistance in L. mexicana and that the use of this type of screening system could accelerate the development of drug combinations for clinical use

Supporting the Quadruple Aim Using Simulation and Human Factors During COVID-19 Care

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.The health care sector has made radical changes to hospital operations and care delivery in response to the coronavirus disease (COVID-19) pandemic. This article examines pragmatic applications of simulation and human factors to support the Quadruple Aim of health system performance during the COVID-19 era. First, patient safety is enhanced through development and testing of new technologies, equipment, and protocols using laboratory-based and in situ simulation. Second, population health is strengthened through virtual platforms that deliver telehealth and remote simulation that ensure readiness for personnel to deploy to new clinical units. Third, prevention of lost revenue occurs through usability testing of equipment and computer-based simulations to predict system performance and resilience. Finally, simulation supports health worker wellness and satisfaction by identifying optimal work conditions that maximize productivity while protecting staff through preparedness training. Leveraging simulation and human factors will support a resilient and sustainable response to the pandemic in a transformed health care landscape

Children’s friendships in diverse primary schools: teachers and the processes of policy enactment

Drawing on data from a project exploring children's and adults’ friendships across social class and ethnic difference, this paper focuses on the enactment of national and institutional policy around children’s friendships as realized in three primary schools in diverse urban areas in London. Through a focus on the way in which social and emotional learning (SEL) and teachers’ understandings of children’s friendships seek to govern children’s friendship behaviours, we turn to Foucault’s work to explore how power shapes relations between policy frameworks and teachers’ practices, and between those who teach and those who are taught. We discuss the disciplinary potential of SEL and teachers’ ‘common sense’ understandings of children’s friendships, but conclude by noting possibilities for teachers to create spaces in which all children can safely explore the nature of friendships

Spontaneous dural tear leading to intracranial hypotension and tonsillar herniation in Marfan syndrome: a case report

<p>Abstract</p> <p>Background</p> <p>We describe the case of a 38 year old male with Marfan syndrome who presented with orthostatic headaches and seizures.</p> <p>Case Presentation</p> <p>The patient was diagnosed with Spontaneous Intracranial Hypotension secondary to CSF leaks, objectively demonstrated by MR Myelogram with intrathecal contrast. Epidural autologus blood patch was administered at the leakage site leading to significant improvement.</p> <p>Conclusion</p> <p>Our literature search shows that this is the second reported case of a Marfan patient presenting with symptomatic spontaneous CSF leaks along with tonsillar herniation.</p

A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery.

BACKGROUND: Surgical intervention is needed in some cases of spontaneous abortion to remove retained products of conception. Antibiotic prophylaxis may reduce the risk of pelvic infection, which is an important complication of this surgery, particularly in low-resource countries. METHODS: We conducted a double-blind, placebo-controlled, randomized trial investigating whether antibiotic prophylaxis before surgery to complete a spontaneous abortion would reduce pelvic infection among women and adolescents in low-resource countries. We randomly assigned patients to a single preoperative dose of 400 mg of oral doxycycline and 400 mg of oral metronidazole or identical placebos. The primary outcome was pelvic infection within 14 days after surgery. Pelvic infection was defined by the presence of two or more of four clinical features (purulent vaginal discharge, pyrexia, uterine tenderness, and leukocytosis) or by the presence of one of these features and the clinically identified need to administer antibiotics. The definition of pelvic infection was changed before the unblinding of the data; the original strict definition was two or more of the clinical features, without reference to the administration of antibiotics. RESULTS: We enrolled 3412 patients in Malawi, Pakistan, Tanzania, and Uganda. A total of 1705 patients were assigned to receive antibiotics and 1707 to receive placebo. The risk of pelvic infection was 4.1% (68 of 1676 pregnancies) in the antibiotics group and 5.3% (90 of 1684 pregnancies) in the placebo group (risk ratio, 0.77; 95% confidence interval [CI], 0.56 to 1.04; P = 0.09). Pelvic infection according to original strict criteria was diagnosed in 1.5% (26 of 1700 pregnancies) and 2.6% (44 of 1704 pregnancies), respectively (risk ratio, 0.60; 95% CI, 0.37 to 0.96). There were no significant between-group differences in adverse events. CONCLUSIONS: Antibiotic prophylaxis before miscarriage surgery did not result in a significantly lower risk of pelvic infection, as defined by pragmatic broad criteria, than placebo. (Funded by the Medical Research Council and others; AIMS Current Controlled Trials number, ISRCTN97143849.)

A comparison of four fibrosis indexes in chronic HCV: Development of new fibrosis-cirrhosis index (FCI)

<p>Abstract</p> <p>Background</p> <p>Hepatitis C can lead to liver fibrosis and cirrhosis. We compared readily available non-invasive fibrosis indexes for the fibrosis progression discrimination to find a better combination of existing non-invasive markers.</p> <p>Methods</p> <p>We studied 157 HCV infected patients who underwent liver biopsy. In order to differentiate HCV fibrosis progression, readily available AAR, APRI, FI and FIB-4 serum indexes were tested in the patients. We derived a new fibrosis-cirrhosis index (FCI) comprised of ALP, bilirubin, serum albumin and platelet count. FCI = [(ALP × Bilirubin) / (Albumin × Platelet count)].</p> <p>Results</p> <p>Already established serum indexes AAR, APRI, FI and FIB-4 were able to stage liver fibrosis with correlation coefficient indexes 0.130, 0.444, 0.578 and 0.494, respectively. Our new fibrosis cirrhosis index FCI significantly correlated with the histological fibrosis stages F0-F1, F2-F3 and F4 (r = 0.818, p < 0.05) with AUROCs 0.932 and 0.996, respectively. The sensitivity and PPV of FCI at a cutoff value < 0.130 for predicting fibrosis stage F0-F1 was 81% and 82%, respectively with AUROC 0.932. Corresponding value of FCI at a cutoff value ≥1.25 for the prediction of cirrhosis was 86% and 100%.</p> <p>Conclusions</p> <p>The fibrosis-cirrhosis index (FCI) accurately predicted fibrosis stages in HCV infected patients and seems more efficient than frequently used serum indexes.</p

Pattern of contraceptive practice in Rural Kashmir.

Research Question: What is the present pattern of family planning practices and level of knowledge among currently married women in rural Kashmir. Objectives: To determine the contraceptive prevalence in currently married women, in 15-49 yrs age groups, to assess the knowledge, attitude and practices of contraceptives among women and to study the effect of social and demographic factors on contraceptive use in rural Kashmir. Study Design & Setting: Community based cross-sectional study of rural households; studied between December 2006 and May 2008. Participants: 1900 currently married women in the age group of 15-49 yrs of age. Methods: 1900 currently married women, aged 15-49 years, selected by multi-stage random sampling technique from three districts of Kashmir valley who were interviewed at home using a pretested oral questionnaire. The assessment of various socioeconomic and other variables made as per the available standard procedures and scales. Results: Prevalence of contraception was 62.6 % among ever users and 47.8 % among current users, the prevalence of female sterilization was maximum (71.6 %) followed by condom (7.2 %) and natural methods (6.4 %). Prevalence of various contraceptive methods did not differ significantly across the various districts studied in Kashmir valley. The two child norm was breached by two thirds of the studied population. Knowledge of permanent methods was much greater than modern spacing methods. Mass media was the most common source of information about contraceptive methods and the Government sector was the main source of family planning supplies/services of contraceptives. Among the various socio-demographic variables, women’s age, socio-economic status, literacy, number of living children, gender of living children, duration of married life and type of family were the significant factors affecting contraceptive use. Conclusions: Preference of terminal sterilization methods over spacing methods observed in the present study as a family planning approach needs special attention and there is a need to shift women centric approach to couple centric approach for family planning. Extensive mass awareness campaign at regional level about types, advantages, availability and use of spacing methods is required and locally field workers need to apply Behavior Change Communication (BCC) methods to motivate the couples to accept the spacing methods for better maternal and child health