A Rapid Assessment of the Quality of Neonatal Healthcare in Kilimanjaro Region, Northeast Tanzania.

While child mortality is declining in Africa there has been no evidence of a comparable reduction in neonatal mortality. The quality of inpatient neonatal care is likely a contributing factor but data from resource limited settings are few. The objective of this study was to assess the quality of neonatal care in the district hospitals of the Kilimanjaro region of Tanzania. Clinical records were reviewed for ill or premature neonates admitted to 13 inpatient health facilities in the Kilimanjaro region; staffing and equipment levels were also assessed. Among the 82 neonates reviewed, key health information was missing from a substantial proportion of records: on maternal antenatal cards, blood group was recorded for 52 (63.4%) mothers, Rhesus (Rh) factor for 39 (47.6%), VDRL for 59 (71.9%) and HIV status for 77 (93.1%). From neonatal clinical records, heart rate was recorded for3 (3.7%) neonates, respiratory rate in 14, (17.1%) and temperature in 33 (40.2%). None of 13 facilities had a functioning premature unit despite calculated gestational age <36 weeks in 45.6% of evaluated neonates. Intravenous fluids and oxygen were available in 9 out of 13 of facilities, while antibiotics and essential basic equipment were available in more than two thirds. Medication dosing errors were common; under-dosage for ampicillin, gentamicin and cloxacillin was found in 44.0%, 37.9% and 50% of cases, respectively, while over-dosage was found in 20.0%, 24.2% and 19.9%, respectively. Physician or assistant physician staffing levels by the WHO indicator levels (WISN) were generally low. Key aspects of neonatal care were found to be poorly documented or incorrectly implemented in this appraisal of neonatal care in Kilimanjaro. Efforts towards quality assurance and enhanced motivation of staff may improve outcomes for this vulnerable group

Quantitative analysis of dribble volumes and rates using three-dimensional reconstruction of X-ray and diffused back-illumination images of diesel sprays

[EN] Post-injection fuel dribble is known to lead to incomplete atomisation and combustion due to the release of slow-moving, and often surface-bound, liquid fuel after the end of injection. This can have a negative effect on engine emissions, performance and injector durability. To better quantify this phenomenon, we developed an image-processing approach to measure the volume of ligaments produced during the end of injection. We applied our processing approach to an Engine Combustion Network 'Spray B' 3-hole injector, using datasets from 220 injections generated by different research groups, to decouple the effect of gas temperature and pressure on the fuel dribble process. High-speed X-ray phase-contrast images obtained at room temperature conditions (297 K) at the Advanced Photon Source at Argonne National Laboratory, together with diffused back-illumination images captured at a wide range of temperature conditions (293-900 K) by CMT Motores Termicos were analysed and compared quantitatively. We found a good agreement between image sets obtained by Argonne National Laboratory and CMT Motores Termicos using different imaging techniques. The maximum dribble volume within the field of view of the imaging system and the mean rate of fuel dribble were considered as characteristic parameters of the fuel dribble process. Analysis showed that the absolute mean dribble rate increases with temperature when injection pressure is higher than 1000 bar and slightly decreases at high injection pressures (>500 bar) when temperature is close to 293 K. Larger maximum volumes of the fuel dribble were observed at lower gas temperatures (similar to 473 K) and low gas pressures (<30 bar), with a slight dependence on injection pressure.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The image processing research was supported by the United Kingdom's Engineering and Physical Science Research Council (Grants EP/K020528/1 and EP/M009424/1) and BP Formulated Products Technology. The X-ray measurements were performed at the Advanced Photon Source at Argonne National Laboratory. Use of the Advanced Photon Source (APS) is supported by the U.S. Department of Energy (DOE) under Contract No. DEAC02-06CH11357. The X-ray component of this research was partially funded by DOE's Vehicle Technologies Program, Office of Energy Efficiency and Renewable Energy.Sechenyh, V.; Duke, DJ.; Swantek, AB.; Matusik, KE.; Kastengren, AL.; Powell, CF.; Viera, A.... (2020). Quantitative analysis of dribble volumes and rates using three-dimensional reconstruction of X-ray and diffused back-illumination images of diesel sprays. International Journal of Engine Research. 21(1):43-54. https://doi.org/10.1177/1468087419860955S4354211Örley, F., Hickel, S., Schmidt, S. J., & Adams, N. A. (2016). Large-Eddy Simulation of turbulent, cavitating fuel flow inside a 9-hole Diesel injector including needle movement. International Journal of Engine Research, 18(3), 195-211. doi:10.1177/1468087416643901Benajes, J., Novella, R., De Lima, D., & Tribotté, P. (2014). Analysis of combustion concepts in a newly designed two-stroke high-speed direct injection compression ignition engine. International Journal of Engine Research, 16(1), 52-67. doi:10.1177/1468087414562867Moon, S., Huang, W., Li, Z., & Wang, J. (2016). End-of-injection fuel dribble of multi-hole diesel injector: Comprehensive investigation of phenomenon and discussion on control strategy. Applied Energy, 179, 7-16. doi:10.1016/j.apenergy.2016.06.116Kook, S., Pickett, L. M., & Musculus, M. P. B. (2009). Influence of Diesel Injection Parameters on End-of-Injection Liquid Length Recession. SAE International Journal of Engines, 2(1), 1194-1210. doi:10.4271/2009-01-1356Kastengren, A., Powell, C. F., Tilocco, F. Z., Liu, Z., Moon, S., Zhang, X., & Gao, J. (2012). End-of-Injection Behavior of Diesel Sprays Measured With X-Ray Radiography. Journal of Engineering for Gas Turbines and Power, 134(9). doi:10.1115/1.4006981Manin, J., Bardi, M., Pickett, L. M., & Payri, R. (2016). Boundary condition and fuel composition effects on injection processes of high-pressure sprays at the microscopic level. International Journal of Multiphase Flow, 83, 267-278. doi:10.1016/j.ijmultiphaseflow.2015.12.001Payri, R., Bracho, G., Marti-Aldaravi, P., & Viera, A. (2017). NEAR FIELD VISUALIZATION OF DIESEL SPRAY FOR DIFFERENT NOZZLE INCLINATION ANGLES IN NON-VAPORIZING CONDITIONS. Atomization and Sprays, 27(3), 251-267. doi:10.1615/atomizspr.2017017949Gimeno, J., Martí-Aldaraví, P., Carreres, M., & Peraza, J. E. (2018). Effect of the nozzle holder on injected fuel temperature for experimental test rigs and its influence on diesel sprays. International Journal of Engine Research, 19(3), 374-389. doi:10.1177/1468087417751531Payri, R., Salvador, F. J., Manin, J., & Viera, A. (2016). Diesel ignition delay and lift-off length through different methodologies using a multi-hole injector. Applied Energy, 162, 541-550. doi:10.1016/j.apenergy.2015.10.118Duke, D. J., Matusik, K. E., Kastengren, A. L., Swantek, A. B., Sovis, N., Payri, R., … Powell, C. F. (2017). X-ray radiography of cavitation in a beryllium alloy nozzle. International Journal of Engine Research, 18(1-2), 39-50. doi:10.1177/1468087416685965Duke, D., Swantek, A., Kastengren, A., Fezzaa, K., & Powell, C. (2015). Recent Developments in X-ray Diagnostics for Cavitation. SAE International Journal of Fuels and Lubricants, 8(1), 135-146. doi:10.4271/2015-01-0918Walko, D. A., Adams, B. W., Doumy, G., Dufresne, E. M., Li, Y., March, A. M., … Zhu, Y. (2016). Developments in time-resolved x-ray research at APS beamline 7ID. doi:10.1063/1.4952871Fessler, J. A., & Macovski, A. (1991). Object-based 3-D reconstruction of arterial trees from magnetic resonance angiograms. IEEE Transactions on Medical Imaging, 10(1), 25-39. doi:10.1109/42.75608Canny, J. (1986). A Computational Approach to Edge Detection. IEEE Transactions on Pattern Analysis and Machine Intelligence, PAMI-8(6), 679-698. doi:10.1109/tpami.1986.4767851Kastengren, A. L., Tilocco, F. Z., Duke, D. J., Powell, C. F., Zhang, X., & Moon, S. (2014). TIME-RESOLVED X-RAY RADIOGRAPHY OF SPRAYS FROM ENGINE COMBUSTION NETWORK SPRAY A DIESEL INJECTORS. Atomization and Sprays, 24(3), 251-272. doi:10.1615/atomizspr.2013008642Edelsbrunner, H., & Mücke, E. P. (1994). Three-dimensional alpha shapes. ACM Transactions on Graphics, 13(1), 43-72. doi:10.1145/174462.156635Lafarge, T., Pateiro-López, B., Possolo, A., & Dunkers, J. P. (2014). RImplementation of a Polyhedral Approximation to a 3D Set of Points Using theα-Shape. Journal of Statistical Software, 56(4). doi:10.18637/jss.v056.i04Koci, C., Dempsey, A., Nudd, J., & Knier, B. (2017). Understanding Hydrocarbon Emissions in Heavy Duty Diesel Engines Combining Experimental and Computational Methods. SAE International Journal of Engines, 10(3), 1093-1109. doi:10.4271/2017-01-070

Towards a pathway definition of Parkinson’s disease: a complex disorder with links to cancer, diabetes and inflammation

We have previously established a first whole genome transcriptomic profile of sporadic Parkinson’s disease (PD). After extensive brain tissue-based validation combined with cycles of iterative data analysis and by focusing on the most comparable cases of the cohort, we have refined our analysis and established a list of 892 highly dysregulated priority genes that are considered to form the core of the diseased Parkinsonian metabolic network. The substantia nigra pathways, now under scrutiny, contain more than 100 genes whose association with PD is known from the literature. Of those, more than 40 genes belong to the highly significantly dysregulated group identified in our dataset. Apart from the complete list of 892 priority genes, we present pathways revealing PD ‘hub’ as well as ‘peripheral’ network genes. The latter include Lewy body components or interact with known PD genes. Biological associations of PD with cancer, diabetes and inflammation are discussed and interactions of the priority genes with several drugs are provided. Our study illustrates the value of rigorous clinico-pathological correlation when analysing high-throughput data to make optimal use of the histopathological phenome, or morphonome which currently serves as the key diagnostic reference for most human diseases. The need for systematic human tissue banking, following the highest possible professional and ethical standard to enable sustainability, becomes evident

Sentinel node lymphocytes: tumour reactive lymphocytes identified intraoperatively for the use in immunotherapy of colon cancer

The sentinel node is the first lymph node to receive lymphatic drainage from a tumour and is usually the first site of metastases. Today, the sentinel node is used for tumour staging. Here, we focus on its immunological role and investigate lymphocytic function in sentinel nodes, identified intraoperatively by peritumoural dye injection, from 15 patients with colon cancer. Tumour infiltrating lymphocytes, sentinel and nonsentinel lymph node cells and peripheral blood leukocytes were studied by flow cytometry, proliferation assays and interferon-γ secretion after activation with autologous tumour homogenate. Whereas tumour-infiltrating lymphocytes were nonresponsive in the proliferation assays, lymphocytes from sentinel nodes proliferated dose dependently and secreted interferon-γ upon stimulation with tumour homogenate. The responses were of varying magnitude and tended to be weaker in metastatic sentinel nodes. Sentinel node lymphocytes represents an enriched source of tumour reactive lymphocytes, and may be useful in future trials of adoptive immunotherapy

Global prevalence of childhood cataract: a systematic review

Childhood cataract is an avoidable cause of visual disability worldwide and is a priority for VISION 2020: The Right to Sight. There is a paucity of information about the burden of cataract in children and the aim of this review is to assess the global prevalence of childhood cataract. The methodology for the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a literature search for studies reporting estimates of prevalence or incidence of cataract among children (aged<18 years) at any global location using the Cochrane Library, Medline and Embase up to January 2015. No restrictions were imposed based on language or year of publication. Study quality was assessed using a critical appraisal tool designed for systematic reviews of prevalence. Twenty prevalence and four incidence studies of childhood cataract from five different geographical regions were included. The overall prevalence of childhood cataract and congenital cataract was in the range from 0.32 to 22.9/10000 children (median=1.03) and 0.63 to 9.74/10000 (median=1.71), respectively. The incidence ranged from 1.8 to 3.6/10000 per year. The prevalence of childhood cataract in low-income economies was found to be 0.42 to 2.05 compared with 0.63 to 13.6/10000 in high-income economies. There was no difference in the prevalence based on laterality or gender. This review highlights substantial gaps in the epidemiological knowledge of childhood cataract worldwide, particularly from low and lower middle-income economies. More studies are needed using standard definitions and case ascertainment methods with large enough sample sizes

Identification of molecular pathways affected by pterostilbene, a natural dimethylether analog of resveratrol

<p>Abstract</p> <p>Background</p> <p>Pterostilbene, a naturally occurring phenolic compound produced by agronomically important plant genera such as <it>Vitis </it>and <it>Vacciunium</it>, is a phytoalexin exhibiting potent antifungal activity. Additionally, recent studies have demonstrated several important pharmacological properties associated with pterostilbene. Despite this, a systematic study of the effects of pterostilbene on eukaryotic cells at the molecular level has not been previously reported. Thus, the aim of the present study was to identify the cellular pathways affected by pterostilbene by performing transcript profiling studies, employing the model yeast <it>Saccharomyces cerevisiae</it>.</p> <p>Methods</p> <p><it>S. cerevisiae </it>strain S288C was exposed to pterostilbene at the IC₅₀concentration (70 μM) for one generation (3 h). Transcript profiling experiments were performed on three biological replicate samples using the Affymetrix GeneChip Yeast Genome S98 Array. The data were analyzed using the statistical methods available in the GeneSifter microarray data analysis system. To validate the results, eleven differentially expressed genes were further examined by quantitative real-time RT-PCR, and <it>S. cerevisiae </it>mutant strains with deletions in these genes were analyzed for altered sensitivity to pterostilbene.</p> <p>Results</p> <p>Transcript profiling studies revealed that pterostilbene exposure significantly down-regulated the expression of genes involved in methionine metabolism, while the expression of genes involved in mitochondrial functions, drug detoxification, and transcription factor activity were significantly up-regulated. Additional analyses revealed that a large number of genes involved in lipid metabolism were also affected by pterostilbene treatment.</p> <p>Conclusion</p> <p>Using transcript profiling, we have identified the cellular pathways targeted by pterostilbene, an analog of resveratrol. The observed response in lipid metabolism genes is consistent with its known hypolipidemic properties, and the induction of mitochondrial genes is consistent with its demonstrated role in apoptosis in human cancer cell lines. Furthermore, our data show that pterostilbene has a significant effect on methionine metabolism, a previously unreported effect for this compound.</p

Allelopathy of Bracken Fern (Pteridium arachnoideum): New Evidence from Green Fronds, Litter, and Soil

The neotropical bracken fern Pteridium arachnoideum (Kaulf.) Maxon. (Dennstaedtiaceae) is described as an aggressive pioneer plant species. It invades abandoned or newly burned areas and represents a management challenge at these invaded sites. Native to the Atlantic Forest and Cerrado (Tropical Savanna) Brazilian biomes, P. arachnoideum has nevertheless become very problematic in these conservation hotspots. Despite some reports suggesting a possible role of allelopathy in this plant’s dominance, until now there has been little evidence of isolated and individually identified compounds with phytotoxic activities present in its tissues or in the surrounding environment. Thus, the aim of this study was to investigate the allelopathic potential of P. arachnoideum by isolating and identifying any secondary metabolites with phytotoxic activity in its tissues, litter, and soil. Bioguided phytochemical investigation led to the isolation and identification of the proanthocyanidin selligueain A as the major secondary compound in the green fronds and litter of this fern. It is produced by P. arachnoideum in its green fronds, remains unaltered during the senescence process, and is the major secondary compound present in litter. Selligueain A showed phytotoxic activity against the selected target species sesame (Sesamum indicum) early development. In particular, the compound inhibited root and stem growth, and root metaxylem cell size but did not affect chlorophyll content. This compound can be considered as an allelochemical because it is present in the soil under P. arachnoideum patches as one of the major compounds in the soil solution. This is the first report of the presence of selligueain A in any member of the Dennstaedtiaceae family and the first time an isolated and identified allelochemical produced by members of the Pteridium species complex has been described. This evidence of selligueain A as a putative allelochemical of P. arachnoideum reinforces the role of allelopathy in the dominance processes of this plant in the areas where it occurs