A life threatening intracerebral hemorrhage during pregnancy

Intracerebral hemorrhage (ICH) during antenatal period is an infrequent but serious complication. This is a case of elderly woman with pregnancy induced hypertension who developed spontaneous ICH during the thirty five week of pregnancy. She presented to our emergency department with altered sensorium, aphasia and hemiparesis. Intracerebral hemorrhage was diagnosed by MRI. Magnetic resonance angiography failed to identify an aneurysm or arteriovenous malformation.  She underwent successful emergency cesarean section. In this case we report the rare Intracerebral hemorrhage (ICH) during antenatal period and its challenging complication, diagnosis and managemen

Knowledge, attitude, and practices about contraceptive in Western Rajasthan, India

Background: This study was carried out to assess the knowledge, attitude, and practice of contraceptive methods among women attending a tertiary care hospital in Western Rajasthan.Methods: This cross-sectional study was conducted in the department of obstetrics and gynecology, PBM and the associated group of hospitals, attached to Sardar Patel Medical College, Bikaner, Rajasthan, India. Total 500 married women between age group 15-49 yrs were included. These all women interviewed using a structured questionnaire after approval of the hospital’s ethical committee.Results: Total 500 women interviewed for their knowledge, attitude, and practices about contraception. Out of which, 402 (80.4%) women had some knowledge of at least one contraception method at the time of the study.  The most common sources of information about contraception were husband and family member. Amongst the various contraceptives most commonly known was condom (78.4%). Only 265 (53%) women were practicing contraception at present. Most commonly used contraceptive was condom (40.8%). The most common reason for the non-practice of contraception was need of more child or male child in 34.8% families followed by opposition from in-laws (12.4%).Conclusions: Literacy was positively associated with family planning related knowledge and practices. Preconception knowledge and practices about contraception are poor in our study population. Many of the women were getting MTP pills over the counter without consulting to health care persons and then later presents with complications

Impact of government schemes on maternal mortality

Background: To analyze the causes of maternal death over a period of 5 years with respect to direct and indirect causes and to see the effect of various government schemes in MMR reduction.Methods: A retrospective study of maternal death cases was conducted over a 5-year period, from January 2016 to December 2020, in our tertiary health center. Each case was analyzed with respect to age, parity, residence, antenatal booking, admission- mortality interval, etc. Results were analyzed by using percentage and proportion.Results: In our study, there were total 161 maternal death and 66,806 live births giving an MMR of 240.9 per one lac live birth. In the year 2016, there was total 12303 live birth, and it was increased to 14783 in the year 2020. MMR in 2016 was 243.84, and it also increased by 277.34 in the year 2020. Obstetric hemorrhage (28.57%), severe PIH, and eclampsia (19.87%) followed by septicemia (9.93%) were common direct causes of death. Anemia was the most important indirect cause of death.Conclusions: Although various government maternity programs like JSY and JSSK are successful in improving the number of institutional deliveries, but they are still less effective in the reduction of MMR. Besides these schemes, MMR can be reduced by improving female literacy, health, and good antenatal care and by the provision of quality of emergency obstetric care with skilled birth attendance

The cytoplasmic domain of neuropilin-1 regulates focal adhesion turnover

AbstractThough the vascular endothelial growth factor coreceptor neuropilin-1 (Nrp1) plays a critical role in vascular development, its precise function is not fully understood. We identified a group of novel binding partners of the cytoplasmic domain of Nrp1 that includes the focal adhesion regulator, Filamin A (FlnA). Endothelial cells (ECs) expressing a Nrp1 mutant devoid of the cytoplasmic domain (nrp1cytoΔ/Δ) migrated significantly slower in response to VEGF relative to the cells expressing wild-type Nrp1 (nrp1+/+ cells). The rate of FA turnover in VEGF-treated nrp1cytoΔ/Δ ECs was an order of magnitude lower in comparison to nrp1+/+ ECs, thus accounting for the slower migration rate of the nrp1cytoΔ/Δ ECs

VEGF and Angiopoietin-1 Exert Opposing Effects on Cell Junctions by Regulating the Rho GEF Syx

Vascular endothelial growth factor (VEGF) and Ang1 (Angiopoietin-1) have opposing effects on vascular permeability, but the molecular basis of these effects is not fully known. We report in this paper that VEGF and Ang1 regulate endothelial cell (EC) junctions by determining the localization of the RhoA-specific guanine nucleotide exchange factor Syx. Syx was recruited to junctions by members of the Crumbs polarity complex and promoted junction integrity by activating Diaphanous. VEGF caused translocation of Syx from cell junctions, promoting junction disassembly, whereas Ang1 maintained Syx at the junctions, inducing junction stabilization. The VEGF-induced translocation of Syx from EC junctions was caused by PKD1 (protein kinase D1)-mediated phosphorylation of Syx at Ser806, which reduced Syx association to its junctional anchors. In support of the pivotal role of Syx in regulating EC junctions, syx−/− mice had defective junctions, resulting in vascular leakiness, edema, and impaired heart function

Network models for battery electric vehicles

textIn this thesis a nonadditive shortest path problem to model the route choice of battery electric vehicle (BEV) drivers has been proposed. Based on this nonadditive shortest path framework several multiuser (with heterogeneous risk attitude) network models which take congestion into account have also been proposed. The proposed route choice model relaxes several assumptions of earlier literature and allows for a continuum of range limits and heterogeneous drivers who have varying risk preferences. The model also accounts for nonlinearity in travel choices -- drivers value a small amount of charge more when they are close to running out of range than when the battery is close to full charge. A nonlinear nonconvex optimization problem is formulated and an approximation of the objective function leads to a convex problem which is solved using an outer approximation algorithm. A tour-based analysis, which is more appropriate for BEVs is considered; but a network transformation makes the formulation simpler. Numerical experiments on a small network demonstrate how the routes taken by BEV drivers are influenced by their risk attitudes and the uncertainty in the predicted range of the vehicle. The models developed in this thesis are applicable to networks with flows of BEVs. This work will hopefully inspire researchers to explore nonlinear travel models for BEVs and develop more general network models. These network models using survey data (extensive surveys will need to be carried out for this) will be able to predict system-wide effects of the choices made by BEV drivers and help planners and policy makers in their decision making.Civil, Architectural, and Environmental Engineerin

Models for virus detection in contact networks

We develop and analyze optimization models for rapid detection of viruses in large contact networks. In the model, a virus spreads in a stochastic manner over an undirected connected graph, under various assumptions on the spread dynamics. A decision maker must place a limited number of detectors on a subset of the nodes in the graph in order to rapidly detect infection of the nodes by the virus. The objective is to determine the placement of these detectors so as to either maximize the probability of detection within a given time period or minimize the expected time to detection. Previous work in this area assumed that the detectors are perfectly reliable. In this work, it is assumed that the detectors may produce false-negative results. In computational studies, the sample average approximation method is applied to solving the problem using a mixed-integer program and a greedy heuristic. The heuristic is shown to be highly efficient and to produce high-quality solutions. In addition, it is shown that the false-negative effect can sometimes be ignored, without significant loss of solution quality, in the original optimization formulation. We also develop an agent-based disease spread model on a contact network, motivated by COVID-19, to proactively test staff to detect an outbreak of an epidemic in facilities of small to moderate size. In our computational experiments we compare the effect of network structure and testing protocols on the probability of detection. Additionally, we extend our agent-based disease spread model to immunize staff in moderate-size facilities. We develop an immunization protocol and through computational studies show that it performs better than some existing protocols in the literature for static networks.Operations Research and Industrial Engineerin