Pyoderma Gangrenosum in Crohn's Disease: Unusual Presentation and Management

Pyoderma gangrenosum is an uncommon, destructive, cutaneous ulceration which presents as ulcerative, pustular, bulluous and vegetative forms, the ulcerative forms being more common. We present the case of 41-year-old woman with Crohn's disease who presented with a rather unusual form of pyoderma gangrenosum, aseptic cutaneous abscess. It was initially misdiagnosed as a fistulous tract in the abdominal wall, but later prompt diagnosis of pyoderma gangrenosum led to a very satisfactory outcome

Design and Performance Analysis of a Switched Reluctance Motor Using Finite Element Analysis and Magnetic Equivalent Circuit Model

By being magnet-free, and mechanically robust with a longer constant power range, switched reluctance motor (SRM) is gathering much attention as a potential choice to propel electric vehicles (EVs) and hybrid electric vehicles (HEVs). This paper comprehensively investigates the performance sensitivity to geometric design variables such as rotor diameter, pole arc angles, and yoke thicknesses for an SRM using static two-dimensional (2D) electromagnetic Finite-Element Analysis (FEA). The reason for the change in static characteristics due to variation in reluctance between SRM designs has not been detailed previously. This is addressed by the magnetic equivalent circuit (MEC) model that simplifies the design analysis. Results indicate that stator pole reluctance needs to be given due importance while studying the influence of rotor diameter. Also, it is imperative to set an adequate thickness of the stator and rotor yokes to minimize the effect of saturation on the performance. Rotor diameter and stator pole arc angle have a pronounced influence on the performance while the influence of rotor pole arc angle and yoke thicknesses was relatively less

Organizational and Institutional Determinants of B2C Adoption under Shifting Environments

This study examines the adoption of business-to-consumer (B2C) e-commerce by bricks-and-mortar companies comprising the Standard & Poor\u27s 500 (S&P 500) listings between 1992 and 2003. B2C represents a Type III information systems (IS) innovation that integrates IS with core business technologies. Extant studies on Type III innovations have examined organizational and institutional factors, solely or collectively, in explaining adoption, but not how their effects change under shifting environments over time. We develop an integrated model comprising organizational factors (i.e., espoused values and resources) and institutional factors (i.e., normative and mimetic pressures), as well as the moderating influence of shifting environments (i.e., early period and late period demarcated by changes in the environment). Using a piecewise event-history model specification, we examine the adoption of B2C innovations by 93 organizations over time. Our results show that both organizational and institutional factors influence B2C adoption; however, their effects varied with the environmental shifts. Specifically, senior IS executives influenced adoption in the early period whereas bandwagon mimetic pressures and business norms influenced adoption in the late period. The findings of our research demonstrate the importance of explicitly modeling environmental shifts in theorizing organizational adoption of innovations

International Journal of Chemical and Physical Sciences Binary Phase Diagramand Thin Film Coatings of Bimetallic Oxides using Bis(N-isopropylsalicylaldimine)M(II) M = Co, Ni and Zn as a Single Source Precursor for Thermal Chemical Vapor Deposition Binary

Abstract The metal Schiff base complexes of bis(N-isopropylsalicylaldimine)coblt(II), bis(N-isopropylsalicylaldimine)nickel(II) and bis (N-isopropylsalicylaldimine

Preclinical formulation for the pharmacokinetics and efficacy of GBO-006, a selective polo like kinase 2 (PLK2) inhibitor for the treatment of triple negative breast cancer

GBO-006 was shown to be a highly specific and selective PLK2 inhibitor that promoted mitotic arrest in various cancer cell lines, subsequently resulting in their apoptotic death. Intraperitoneal alternate day dosing of GBO-006 using 100 % DMSO as formulation showed significant tumor regression in xenograft models, demonstrating proof of concept of PLK2 inhibition in vivo. These studies necessitated the development of a suitable and GRAS (generally considered as safe) preformulation for pharmacokinetic and efficacy studies. GBO-006 possesses challenging physicochemical and biopharmaceutical properties like poor solubility in aqueous media, low permeability and a crystalline nature. Different methods like cosolvency, complexation and micellar solubilization were employed to improve the solubility of GBO-006. A strategy of co-solvency is used to solubilize the GBO-006 up to 10 mg/mL. A formulation with 20 % DMSO, 40 % PEG 400, 30 % of 100 mM citrate buffer (pH 3.0) and 10 % solutol displayed clear solution without any visual precipitation of the drug even after 2 weeks of storage. GBO-006 showed moderate clearance in rat and high systemic clearance in mouse and dog. It showed poor oral bioavailability across all species. Intraperitoneal dosing of GBO-006 demonstrated the linear exposure. GBO-006 showed significant inhibition of tumor progression

Why is it difficult to implement e-health initiatives? A qualitative study

<b>Background</b> The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate predicted benefits. This study aimed to explore and understand the experiences of implementers - the senior managers and other staff charged with implementing e-health initiatives and their assessment of factors which promote or inhibit the successful implementation, embedding, and integration of e-health initiatives.<p></p> <b>Methods</b> We used a case study methodology, using semi-structured interviews with implementers for data collection. Case studies were selected to provide a range of healthcare contexts (primary, secondary, community care), e-health initiatives, and degrees of normalization. The initiatives studied were Picture Archiving and Communication System (PACS) in secondary care, a Community Nurse Information System (CNIS) in community care, and Choose and Book (C&B) across the primary-secondary care interface. Implementers were selected to provide a range of seniority, including chief executive officers, middle managers, and staff with 'on the ground' experience. Interview data were analyzed using a framework derived from Normalization Process Theory (NPT).<p></p> <b>Results</b> Twenty-three interviews were completed across the three case studies. There were wide differences in experiences of implementation and embedding across these case studies; these differences were well explained by collective action components of NPT. New technology was most likely to 'normalize' where implementers perceived that it had a positive impact on interactions between professionals and patients and between different professional groups, and fit well with the organisational goals and skill sets of existing staff. However, where implementers perceived problems in one or more of these areas, they also perceived a lower level of normalization.<p></p> <b>Conclusions</b> Implementers had rich understandings of barriers and facilitators to successful implementation of e-health initiatives, and their views should continue to be sought in future research. NPT can be used to explain observed variations in implementation processes, and may be useful in drawing planners' attention to potential problems with a view to addressing them during implementation planning

Arduous implementation: Does the Normalisation Process Model explain why it's so difficult to embed decision support technologies for patients in routine clinical practice

Background: decision support technologies (DSTs, also known as decision aids) help patients and professionals take part in collaborative decision-making processes. Trials have shown favorable impacts on patient knowledge, satisfaction, decisional conflict and confidence. However, they have not become routinely embedded in health care settings. Few studies have approached this issue using a theoretical framework. We explained problems of implementing DSTs using the Normalization Process Model, a conceptual model that focuses attention on how complex interventions become routinely embedded in practice.Methods: the Normalization Process Model was used as the basis of conceptual analysis of the outcomes of previous primary research and reviews. Using a virtual working environment we applied the model and its main concepts to examine: the 'workability' of DSTs in professional-patient interactions; how DSTs affect knowledge relations between their users; how DSTs impact on users' skills and performance; and the impact of DSTs on the allocation of organizational resources.Results: conceptual analysis using the Normalization Process Model provided insight on implementation problems for DSTs in routine settings. Current research focuses mainly on the interactional workability of these technologies, but factors related to divisions of labor and health care, and the organizational contexts in which DSTs are used, are poorly described and understood.Conclusion: the model successfully provided a framework for helping to identify factors that promote and inhibit the implementation of DSTs in healthcare and gave us insights into factors influencing the introduction of new technologies into contexts where negotiations are characterized by asymmetries of power and knowledge. Future research and development on the deployment of DSTs needs to take a more holistic approach and give emphasis to the structural conditions and social norms in which these technologies are enacte

Klf15 Is Critical for the Development and Differentiation of Drosophila Nephrocytes

Insect nephrocytes are highly endocytic scavenger cells that represent the only invertebrate model for the study of human kidney podocytes. Despite their importance, nephrocyte development is largely uncharacterised. This work tested whether the insect ortholog of mammalian Kidney Krüppel-Like Factor (Klf15), a transcription factor required for mammalian podocyte differentiation, was required for insect nephrocyte development. It was found that expression of Drosophila Klf15 (dKlf15, previously known as Bteb2) was restricted to the only two nephrocyte populations in Drosophila, the garland cells and pericardial nephrocytes. Loss of dKlf15 function led to attrition of both nephrocyte populations and sensitised larvae to the xenotoxin silver nitrate. Although pericardial nephrocytes in dKlf15 loss of function mutants were specified during embryogenesis, they failed to express the slit diaphragm gene sticks and stones and did not form slit diaphragms. Conditional silencing of dKlf15 in adults led to reduced surface expression of the endocytic receptor Amnionless and loss of in vivo scavenger function. Over-expression of dKlf15 increased nephrocyte numbers and rescued age-dependent decline in nephrocyte function. The data place dKlf15 upstream of sns and Amnionless in a nephrocyte-restricted differentiation pathway and suggest dKlf15 expression is both necessary and sufficient to sustain nephrocyte differentiation. These findings explain the physiological relevance of dKlf15 in Drosophila and imply that the role of KLF15 in human podocytes is evolutionarily conserve