Integration of microfluidic channels and optical waveguides using low-cost polymer microfabrication techniques

Recent progress on the realization of a silicon integrated biophotonic chip using plasma etching and laser ablation is presented. The chip utilizes films of SU-8 and UV-15 polymer material. An intersecting optical waveguide and microfluidic channel exhibiting good optical transmission across the channel is demonstrated

JarPi: a low-cost raspberry pi based personal assistant for small-scale fishermen

Small-scale fishermen face various occupational safety hazards due to unavailability of real-time weather information during fishing activities at sea. Whilst provision of such information could greatly reduce these risks, limited personal assistants exist that could support small scale fishermen in their activities at sea with real-time details on wind speed and direction, rainfall, humidity, geographical location and distance from shore, among others. Furthermore, large scale solutions are too expensive for this category of fishermen to afford. Even though the recent emergence of the Raspberry Pi showed to significantly decrease costs of computational systems, the application of this technology to build solutions for small-scale fishermen is yet to be investigated. As such, this paper investigates the implementation and deployment of a low-cost Raspberry Pi based personal assistant for small-scale fishermen, through a proposed device named JarPi

Effect of Proton Pump Inhibitors on Risks of Upper and Lower Gastrointestinal Bleeding among Users of Low-Dose Aspirin: A Population-Based Observational Study

Estimates of the effect of proton pump inhibitors (PPIs) on risks of upper and lower gastrointestinal bleeding (UGIB and LGIB) among low-dose aspirin users in routine clinical practice are variable (UGIB) or lacking (LGIB). We aimed to establish these risks in the same observational study population. Using UK primary care data, we followed 199, 049 new users of low-dose aspirin (75-300 mg/day) and matched non-users at start of follow-up to identify incident UGIB/LGIB cases. In nested case-control analyses, adjusted odds ratios (ORs) were calculated for concomitant PPI use vs. past (discontinued) PPI use among current low-dose aspirin users. For UGIB (n = 987), ORs (95% CIs) were 0.69 (0.54-0.88) for >1 month PPI use and 2.65 (1.62-4.3) for 1 month PPI use and 1.12 (0.73-1.71) for 1 month) was associated with a significantly reduced UGIB risk. Neither short nor long-term PPI use affected LGIB risk

Circadian rhythm of oestradiol: Impact on the bone metabolism of adult males

Background: Few studies have examined the variation in oestradiol with respect to age and circadian rhythm and the subsequent effects on BMD. Aim: Demonstrate the presence or absence of a circadian rhythm for oestrodial in older men and the integral role of concerted circadian rhythms of several factors including parathyroid hormone (PTH) in regulating biochemical markers of bone resorption and formation. Examine whether concentrations of both circulating total and bioavailable oestrogen in men differ with age and BMD. Design: Males were recruited: young men with normal BMD, older men with normal BMD and older men with osteoporosis. Methods: Subjects were hospitalized for a 25-hour period. Blood samples were obtained every 30 minutes. Hormone analysis results were plotted and reviewed. Results: Both total and bioavailable oestradiol concentrations were significantly lower in the older men than the young men (Total oestradiol: 34.5±4.4 pmol/L vs. 49.0±6.5 pmol/L, p<0.0001; Bioavailable oestradiol 16.7±2.2 pmol/L vs. 26.3±3.6 pmol/L, p<0.0001). Bioavailable oestrogen rhythm mirrored that of total estrogen. Conclusion: Both age groups with normal BMD display circadian rhythmicity with respect to circulating and bioavailable oestradiol. Younger men have increased mean total and bioavailable oestrogen concentrations and later acrophase compared to older counterparts. In older men with low BMD, total circulating oestrogen was not significantly different compared to age-matched older men with normal BMD; bioavailable oestrogen was significantly lower. Total oestrogen demonstrated a concerted circadian rhythm in all 3 groups, but bioavailable oestrogen did not demonstrate circadian rhythmicity in older men with decreased BMD

Experimental evidence on promotion of electric and improved biomass cookstoves.

Improved cookstoves (ICS) can deliver "triple wins" by improving household health, local environments, and global climate. Yet their potential is in doubt because of low and slow diffusion, likely because of constraints imposed by differences in culture, geography, institutions, and missing markets. We offer insights about this challenge based on a multiyear, multiphase study with nearly 1,000 households in the Indian Himalayas. In phase I, we combined desk reviews, simulations, and focus groups to diagnose barriers to ICS adoption. In phase II, we implemented a set of pilots to simulate a mature market and designed an intervention that upgraded the supply chain (combining marketing and home delivery), provided rebates and financing to lower income and liquidity constraints, and allowed households a choice among ICS. In phase III, we used findings from these pilots to implement a field experiment to rigorously test whether this combination of upgraded supply and demand promotion stimulates adoption. The experiment showed that, compared with zero purchase in control villages, over half of intervention households bought an ICS, although demand was highly price-sensitive. Demand was at least twice as high for electric stoves relative to biomass ICS. Even among households that received a negligible price discount, the upgraded supply chain alone induced a 28 percentage-point increase in ICS ownership. Although the bundled intervention is resource-intensive, the full costs are lower than the social benefits of ICS promotion. Our findings suggest that market analysis, robust supply chains, and price discounts are critical for ICS diffusion

Once-Weekly Exenatide Versus Once- or Twice-Daily Insulin Detemir: Randomized, open-label, clinical trial of efficacy and safety in patients with type 2 diabetes treated with metformin alone or in combination with sulfonylureas

OBJECTIVEdThis multicenter, open-label, parallel-arm study compared the efficacy and safety of exenatide once weekly (EQW) with titrated insulin detemir in patients with type 2 diabetes inadequately controlled with metformin (with or without sulfonylureas). RESEARCH DESIGN AND METHODSdPatients were randomized to EQW (2 mg) or detemir (once or twice daily, titrated to achieve fasting plasma glucose #5.5 mmol/L) for 26 weeks. The primary outcome was proportion of patients achieving A1C #7.0% and weight loss $1.0 kg at end point, analyzed by means of logistic regression. Secondary outcomes included measures of glycemic control, cardiovascular risk factors, and safety and tolerability. RESULTSdOf 216 patients (intent-to-treat population), 111 received EQW and 105 received detemir. Overall, 44.1% (95% CI, 34.7–53.9) of EQW-treated patients compared with 11.4% (6.0–19.1) of detemir-treated patients achieved the primary outcome (P , 0.0001). Treatment with EQW resulted in significantly greater reductions than detemir in A1C (least-square mean 6 SE, 21.30 6 0.08% vs. 20.88 6 0.08%; P , 0.0001) and weight (22.7 6 0.3 kg vs. +0.8 6 0.4 kg; P , 0.0001). Gastrointestinal-related and injection site–related adverse events occurred more frequently with EQW than with detemir. There was no major hypoglycemia in either group. Five (6%) patients in the EQW group and six (7%) patients in the detemir group experienced minor hypoglycemia; only one event occurred without concomitant sulfonylureas (detemir group). CONCLUSIONSdTreatment with EQW resulted in a significantly greater proportion of patients achieving target A1C and weight loss than treatment with detemir, with a low risk of hypoglycemia. These results suggest that EQW is a viable alternative to insulin detemir treatment in patients with type 2 diabetes with inadequate glycemic control using oral antidiabetes drugs

Risk-Reducing Breast and Gynecological Surgery for BRCA Mutation Carriers: A Narrative Review

This narrative review aims to clarify the role of breast and gynecological risk-reduction surgery in BRCA mutation carriers. We examine the indications, contraindications, complications, technical aspects, timing, economic impact, ethical issues, and prognostic benefits of the most common prophylactic surgical options from the perspectives of a breast surgeon and a gynecologist. A comprehensive literature review was conducted using the PubMed/Medline, Scopus, and EMBASE databases. The databases were explored from their inceptions to August 2022. Three independent reviewers screened the items and selected those most relevant to this review’s scope. BRCA1/2 mutation carriers are significantly more likely to develop breast, ovarian, and serous endometrial cancer. Because of the Angelina effect, there has been a significant increase in bilateral risk-reducing mastectomy (BRRM) since 2013. BRRM and risk-reducing salpingo-oophorectomy (RRSO) significantly reduce the risk of developing breast and ovarian cancer. RRSO has significant side effects, including an impact on fertility and early menopause (i.e., vasomotor symptoms, cardiovascular disease, osteoporosis, cognitive impairment, and sexual dysfunction). Hormonal therapy can help with these symptoms. Because of the lower risk of developing breast cancer in the residual mammary gland tissue after BRRM, estrogen-only treatments have an advantage over an estrogen/progesterone combined treatment. Risk-reducing hysterectomy allows for estrogen-only treatments and lowers the risk of endometrial cancer. Although prophylactic surgery reduces the cancer risk, it has disadvantages associated with early menopause. A multidisciplinary team must carefully inform the woman who chooses this path of the broad spectrum of implications, from cancer risk reduction to hormonal therapies

Genetic ablation or pharmacological blockade of dipeptidyl peptidase IV does not impact T cell-dependent immune responses

<p>Abstract</p> <p>Background</p> <p>Current literature suggests that dipeptidyl peptidase IV (DPP-IV; CD26) plays an essential role in T-dependent immune responses, a role that could have important clinical consequences. To rigorously define the role of DPP-IV in the immune system, we evaluated genetic and pharmacological inhibition of the enzyme on T-dependent immune responses <it>in vivo</it>.</p> <p>Results</p> <p>The DPP-IV null animals mounted robust primary and secondary antibody responses to the T dependent antigens, 4-hydroxy-3-nitrophenylacetyl-ovalbumin (NP-Ova) and 4-hydroxy-3-nitrophenylacetyl-chicken gamma globulin (NP-CGG), which were comparable to wild type mice. Serum levels of antigen specific IgM, IgG1, IgG2a, IgG2b and IgG3 were similar between the two groups of animals. DPP-IV null animals mounted an efficient germinal center reaction by day 10 after antigen stimulation that was comparable to wild type mice. Moreover, the antibodies produced by DPP-IV null animals after repeated antigenic challenge were affinity matured. Similar observations were made using wild type animals treated with a highly selective DPP-IV inhibitor during the entire course of the experiments. T cell recall responses to ovalbumin and MOG peptide, evaluated by measuring proliferation and IL-2 release from cells isolated from draining lymph nodes, were equivalent in DPP-IV null and wild type animals. Furthermore, mice treated with DPP-IV inhibitor had intact T-cell recall responses to MOG peptide. In addition, female DPP-IV null and wild type mice treated with DPP-IV inhibitor exhibited normal and robust <it>in vivo</it><it/> cytotoxic T cell responses after challenge with cells expressing the male H-Y minor histocompatibility antigen.</p> <p>Conclusion</p> <p>These data indicate Selective inhibition of DPP-IV does not impair T dependent immune responses to antigenic challenge.</p