Outbreak of gastroenteritis caused by Yersinia pestis in Afghanistan.

Plague, which is most often caused by the bite of Yersinia pestis-infected fleas, is a rapidly progressing, serious disease that can be fatal without prompt antibiotic treatment. In late December 2007, an outbreak of acute gastroenteritis occurred in Nimroz Province of southern Afghanistan. Of the 83 probable cases of illness, 17 died (case fatality 20·5%). Being a case was associated with consumption or handling of camel meat (adjusted odds ratio 4·4, 95% confidence interval 2·2-8·8, P<0·001). Molecular testing of patient clinical samples and of tissue from the camel using PCR/electrospray ionization-mass spectrometry revealed DNA signatures consistent with Yersinia pestis. Confirmatory testing using real-time PCR and immunological seroconversion of one of the patients confirmed that the outbreak was caused by plague, with a rare gastrointestinal presentation. The study highlights the challenges of identifying infectious agents in low-resource settings; it is the first reported occurrence of plague in Afghanistan

Sensitivity and Specificity of Cystatin C in Detecting Early Renal Impairment in Hypertensive Pregnancies

Purpose: To determine the cutoff point of cystatin C for the detection of renal impairment in hypertensive pregnancies.Methods: A cross-sectional study was conducted in an antenatal clinic and ward at Hospital Universiti Sains Malaysia, Kelantan, Malaysia from January 2009 until January 2010. Sixty four pregnant patients beginning at 2nd trimester, aged of 16 to 55 years and hypertensive, including gestational hypertension, chronic hypertension with superimposed preeclampsia, preeclampsia and unclassified hypertension, were included in the study. Consenting patients were required to provide 5 ml of blood and 24-h urine. Serum and reagent, N Latex cystatin C, were equilibrated at room temperature and measured by particle-enhanced nephelometric immunoassay (PENIA) using a BN II Dade Behring Nephelometer SystemResults: The mean age of the patients was 37.06 ±4.32 (range: 24 to 46 years). A majority (64.1 %) of the patients were in the second trimester of pregnancy and delivered in the gestational period of 38 - 40 weeks (54.7 %). The number of patients in chronic kidney disease (CKD) stages I, II, III, IV and V were 25 (39.1 %), 18 (28.1 %), 18 (28.1 %), 2 (3.1 %) and 1 (1.6 %), respectively. The mean systolic blood pressure was 149.59 ± 18.79 mm Hg, and diastolic blood pressure 91.53 ± 10.33 mm Hg. The cutoff point in detecting renal impairment using cystatin C was &gt; 0.74 with 84.6 % sensitivity and 86.7 % specificity for second trimester and &gt; 0.81 with sensitivity of 76.9 % and specificity of 60.0 % in detecting renal impairment for third trimester.Conclusion: The cutoff point in detecting renal impairment for second trimester is better than for third trimester since it maximizes the value of sensitivity and specificity.Keywords: Cystatin C, Sensitivity, Specificity, Renal impairment, Hypertension; Pregnanc

Isolated tricuspid valve infective endocarditis - A report of 6 cases

Six cases of isolated tricuspid valve endocarditis in young women are described. Preceding genital sepsis was a predisposing factor in 4 patients. Cardiac signs are unusual at presentation, rendering the diagnosis difficult. Pleuropulmonary manifestations are the predominant findings, while overt signs of tricuspid insufficiency and right heart failure occur late in the disease. Staphylococcus aureus is the pathogen most commonly found and requires energetic treatment for a minimum of 4 weeks. The value of echocardiography in establishing an early diagnosis is stressed. Persistent sepsis constitutes a major indication for surgery.S Afr Med J 1990; 78: 34-3

A novel Ph-sensitive liposome to trigger delivery of afatinib to cancer cells: Impact on lung cancer therapy

A novel drug delivery system based on cationic (CL) and pH-sensitive liposomes (PSL) for tyrosine kinase inhibitor afatinib (AFT) were developed to enhance tumor-targetability against NSCLC cells and therapeutic effect. Optimal lipid to drug ratio was selected to prepare AFT-loaded PSL and CL with desirable physiochemical properties based on particle size, drug encapsulation efficiency (EE%), stability and release profiles. Moreover, antitumor activity was performed in vitro on human lung cancer cells (H-1975) using a WST-1 assay and Annexin-V apoptosis assay. The mean particle size of the liposomes was less than 100 nm, and EE% was more than 50% with lipid to drug ratio of 1:0.5. Stability data showed that PSL and CL were physically stable for 1 months at 4 and 25oC. In vitro drug release study demonstrated the sustained release of AFT at pH 7.5; while PSL exhibited fast drug release in pH 5.5. This effect revealed that PSL showed pH-sensitive release behaviors. In addition, the in vitro cytotoxicity study was employed for AFT-loaded PSL due to optimal characterizations. Thus, in vitro anticancer activity revealed that AFT loaded-PSL triggered apoptosis in H-1975 cells. In addition, the inhibitory effect towards H-1975 and HCC-827 was observed, indicating, which indicated high antitumor activity of AFT-loaded PSL. Then, PSL might potentially create practical clinical strategies for better targetability and delivery of AFT for treatment of lung cancer

Circulating leukocyte telomere length is highly heritable among families of Arab descent

Background Telomere length, an indicator of ageing and longevity, has been correlated with several biomarkers of cardiometabolic disease in both Arab children and adults. It is not known, however, whether or not telomere length is a highly conserved inheritable trait in this homogeneous cohort, where age-related diseases are highly prevalent. As such, the aim of this study was to address the inheritability of telomere length in Saudi families and the impact of cardiometabolic disease biomarkers on telomere length. Methods A total of 119 randomly selected Saudi families (123 adults and 131 children) were included in this cross-sectional study. Anthropometrics were obtained and fasting blood samples were taken for routine analyses of fasting glucose and lipid profile. Leukocyte telomere length was determined using quantitative real time PCR. Results Telomere length was highly heritable as assessed by a parent-offspring regression [h2 = 0.64 (p = 0.0006)]. Telomere length was modestly associated with BMI (R2 0.07; p-value 0.0087), total cholesterol (R2 0.08; p-value 0.0033), and LDL-cholesterol (R2 0.15; p-value 3 x 10-5) after adjustments for gender, age and age within generation. Conclusion The high heritability of telomere length in Arab families, and the associations of telomere length with various cardiometabolic parameters suggest heritable genetic fetal and/or epigenetic influences on the early predisposition of Arab children to age-related diseases and accelerated ageing

Plan de negocios para una empresa de gesti?n y control de servicios integrados de telecomunicaciones para la MYPE de Lima Metropolitana

El desarrollo del presente plan de negocios ha podido demostrar que la creaci?n de una empresa que brinde soluciones de servicios gestionados e integrados de telecomunicaciones dirigido al sector mype es una propuesta viable desde el an?lisis t?cnico y econ?mico. La propuesta destaca tres factores: En primer lugar, un mercado atractivo en tama?o, en Lima Centro, a diciembre 2015 exist?an 373,670 mypes, de los cuales el 95.85% de las unidades registradas son micro empresas y el 4.15% peque?as empresas (INEI, Estrutura empresarial, 2015). En segundo lugar, una demanda no satisfecha; necesidades no cubiertas en los servicios de telecomunicaciones para mypes (la oferta de los proveedores dirigida a las grandes empresas y los precios son las causas m?s comunes de este problema). Finalmente, el conocimiento del rubro de los integrantes del grupo y una nueva visi?n de gesti?n hacen que la propuesta de valor de la empresa radique en bridar servicios gestionados que se ajusten a las necesidades del cliente

Kerelevanan wakaf dalam mengurus tanah terbiar di Malaysia

Sejak sekian lamanya tanah terbiar menjadi isu yang penting diperingkat nasional. Pelbagai usaha telah dijalankan bagi membolehkan tanah-tanah ini diusahakan serta dimajukan. Artikel ini bertujuan untuk membincangkan pendekatan alternatif yang sesuai dalam mengurus tanah terbiar. Ia dianalisis dengan menggunakan pendekatan wakaf yang sesuai dalam mempertimbangkan cara mengurus tanah terbiar. Kajian ini menggunakan kaedah analisis kandungan data sekunder yang diperoleh daripada dokumen rasmi dan serta kajian lepas. Dapatan kajian mendapati fokus diberikan terhadap faktor dan usahan kerajaan untuk menanganinya. Hal ini menjelaskan bahawa usaha untuk merungkai tanah terbiar bukanlah satu penekanan yang perlu diperhatikan tetapi fokus paling penting adalah bagaimana tanah-tanah terbiar ini boleh diuruskan dengan baik. Terdapat banyak kajian yang telah menyentuh faktor dan sebab berlakunya tanah pertanian terbiar. Namun, kajian yang menumpu kepada jalan penyelesaian dalam mengurus tanah pertanian terbiar masih kurang dijalankan. Oleh yang demikian, fokus terhadap kaedah wakaf dalam mengurus tanah terbiar telag diperincikan. Pendekatan wakaf dilihat rasional dalam mengurus tanah-tanah terbiar milik orang Melayu khususnya. Ini kerana wakaf bukan sahaja nerupakan satu bentuk amalan yang memberi fokus terhadap agama, namun ia juga memberi penekanan terhadap pembangunan ekonomi ummah. Hal ini jelas apabila wakaf mempunyai kaedah-kaedah yang tertentu dalam membantu menyelesaikan isu yang berkaitan dengan pengurusan harta

Mechanical and Spectroscopic Analysis of Retrieved/Failed Dental Implants

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Plan de negocio para brindar servicios generales a viviendas a trav?s de una plataforma online

La presente tesis desarrolla el plan de negocio de HogarFix hemos analizado las principales caracter?sticas de negocio de competidores locales y extranjeros, incorporando aquellas que consideramos importantes para el mercado local as? como otras innovadoras, como la b?squeda de expertos cercanos a trav?s de geolocalizaci?n desde dispositivos m?viles, las cuales forman parte de la propuesta de valor de HogarFix para satisfacer las necesidades de expertos y usuarios. 2 El modelo de negocio propuesto, en un escenario promedio de evaluaci?n con horizonte a 5 a?os, considera un capital de trabajo de S/.268,449.86 con una inversi?n inicial de S/.56,428.00 con una tasa de impuesto de 30% y una tasa de descuento del 20%, dando como resultado un VAN de S/.220,733.43 y una TIR de 70%, con un periodo de recuperaci?n al inicio del tercer a?o

PhysioSkin: Rapid Fabrication of Skin-Conformal Physiological Interfaces

Advances in rapid prototyping platforms have made physiological sensing accessible to a wide audience. However, off-the-shelf electrodes commonly used for capturing biosignals are typically thick, non-conformal and do not support customization. We present PhysioSkin, a rapid, do-it-yourself prototyping method for fabricating custom multi-modal physiological sensors, using commercial materials and a commodity desktop inkjet printer. It realizes ultrathin skin-conformal patches (~1μm) and interactive textiles that capture sEMG, EDA and ECG signals. It further supports fabricating devices with custom levels of thickness and stretchability. We present detailed fabrication explorations on multiple substrate materials, functional inks and skin adhesive materials. Informed from the literature, we also provide design recommendations for each of the modalities. Evaluation results show that the sensor patches achieve a high signal-to-noise ratio. Example applications demonstrate the functionality and versatility of our approach for prototyping a next generation of physiological devices that intimately couple with the human body