Health professionals' perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Informa UK Ltd.Purpose: The aim of this study was to investigate the perceptions of health professionals who treat stroke patients in Kuwait regarding cultural influences on the experience of stroke and rehabilitation in Kuwait. Health professionals interviewed were from a variety of cultural backgrounds thus providing an opportunity to investigate how they perceived the influence of culture on stroke recovery and rehabilitation in Kuwait. Method: Semi-structured interviews were carried out with 12 health professionals with current/recent stroke rehabilitation experience in Kuwait, followed by thematic analysis of the verbatim transcripts. Results: The health professionals identified several features of the Kuwaiti culture that they believed affected the experiences of stroke patients. These were religious beliefs, family involvement, limited education and public information about stroke, prevailing negative attitudes toward stroke, access to finances for private treatment, social stigma and the public invisibility of disabled people, difficulties identifying meaningful goals for rehabilitation, and an acceptance of dependency linked with the widespread presence of maids and other paid assistants in most Kuwaiti homes. Conclusion: To offer culturally sensitive care, these issues should be taken into account during the rehabilitation of Kuwaiti stroke patients in their home country and elsewhere

A Trans-Nasal Aerosol Delivery Device for Efficient Pulmonary Deposition

Background: Efficient delivery of aerosols to the lungs via the nasal route has been difficult to achieve, but it may offer benefits over the traditional oral route for a range of patient populations. Because slow, continuous delivery of short-acting agents could improve safety, tolerability, compliance, and efficacy when compared with the rapid, intermittent aerosol treatments delivered by mouthpiece or mask, a novel trans-nasal pulmonary aerosol delivery (tPAD) device was developed. The tPAD incorporates an aerosol particle-size selection chamber and a custom nasal cannula that are specifically optimized for aerosol delivery to the lung via the nasal route. The tPAD device produced a steady aerosol output (∼2 mL/h) from an optimized nasal cannula with negligible rainout in the cannula for up to 8 hours. The generated aerosol particles were small enough to minimize nasal deposition [volume median diameter (VMD) = 1.4 μm]. Methods: In this proof-of-concept study, gamma scintigraphy was used to quantitate deposition efficiency of 99mTc-labeled DTPA in 7% NaCl (hypertonic saline) in healthy human subjects (n = 6) during a short dosing period (15 minutes). A comparison was made with a standard oral jet nebulizer in the same subjects. Results: The tPAD device achieved high pulmonary deposition (39% ± 8%), based on emitted dose, and matched that of the oral jet nebulizer (36% ± 9%). Low fractions of aerosol deposition in the head and nose region were observed for tPAD (6% ± 6%) and jet nebulizer deliver (1% ± 1%) as well. Conclusions: A profile of high pulmonary deposition efficiency and low nasal dose may enable the sustained use of the tPAD platform with a variety of therapeutic agents for a range of pulmonary disorders

Manejo de suelos en cultivos intensivos

En el manejo del suelo en cultivos intensivos se aplican diversas técnicas en función de variados factores, las cuales pueden afectar la calidad física, química y biológica del mismo. Por un lado esto depende de la intensidad del sistema productivo, que puede ir desde rotaciones más cortas que las habituales en cultivos extensivos, a los monocultivos (e.g. cultivo de tomate bajo cubierta). Por otro lado, es difícil hacer generalizaciones debido al amplio rango de especies cultivadas, desde plantas herbáceas hortícolas con ciclos de algunas semanas de duración (e.g. espinaca), hasta frutícolas leñosas con varios años de permanencia en los lotes cultivados. A todo esto se le deben sumar otras variables como el tipo de suelo, el clima y la calidad del agua disponible en el caso de cultivos bajo riego. En general la situación más extrema de degradación se encuentra en los suelos que se cultivan bajo cobertura plástica que, en escasas temporadas, ven deteriorada su estructura a causa del intenso laboreo; se salinizan y alcalinizan como consecuencia de la sobrefertilización y el riego con aguas salinas y/o bicarbonatadas sódicas. El proceso se agrava debido a que no contemplan los requerimientos de lixiviación o por velocidades de infiltración muy bajas que anulan la percolación profunda natural. La disminución de los niveles de materia orgánica como consecuencia del incremento de la velocidad de su mineralización por el laboreo frecuente, y por último, el vacío biológico producido por el uso de agroquímicos fumigantes de amplio espectro que alteran el equilibrio ecológico, son las principales consecuencias sobre el suelo en este tipo de producción. En estos ambientes, la degradación se intenta morigerar a través de técnicas de laboreo como el subsolado, que incrementa la lixiviación y el alomado, que junto al aporte de materia orgánica con alto contenido de lignina, permiten mejorar la infiltración, el agua útil y la concentración de oxígeno en el suelo. Para contrarrestar la sodificación se aplican enmiendas cálcicas que, al mantener el estado de floculación del complejo arcillo-húmico, favorecen la estructura, confiriendo friabilidad a los suelos arcillosos y agregación a los arenosos. Por otro lado, el empleo de este tipo de enmiendas estimula la actividad biológica debido a que el calcio también es un elemento esencial para los microorganismos benéficos. En casos extremos de alcalinización y sodificación se instalan drenajes artificiales y se realiza un lavado de los suelos mediante la aplicación de abundantes láminas de riego. En el caso del cultivo de papa en el SE bonaerense, como ejemplo de otra situación de cultivo intensivo, el tipo y frecuencia de las labranzas empleadas, las numerosas fumigaciones, la intensa aplicación de fertilizantes y pesticidas, el laboreo a favor de la pendiente que favorece el proceso de erosión hídrica, sumado a la baja calidad del agua de riego, describen una situación que deriva en un impacto ambiental sumamente desfavorable. En estas situaciones, con el fin de evitar la erosión hídrica se aconseja escoger lotes sin pendiente o con pendientes menores al 1% orientando los surcos en sentido contrario a la pendiente (máximo 4-5%). Se deben disminuir las labranzas, aplicar agroquímicos de acuerdo al resultado de monitoreos, así como fertilizantes, previo diagnóstico edáfico y/o foliar. En los cultivos intensivos cuyanos las prácticas habituales son la rotación con abonos verdes compuestos por leguminosas y gramíneas que se incorporan cuando estas últimas emiten la espiga floral, la realización de verdeos invernales y la incorporación de guanos en dosis de 5 a 20 t ha-1 que mejoran las condiciones físicas del suelo como la aireación y la retención de agua, además de aportar nutrientes.Facultad de Ciencias Agrarias y Forestale

Mechanism of action of probiotics

The modern diet doesn't provide the required amount of beneficial bacteria. Maintenance of a proper microbial ecology in the host is the main criteria to be met for a healthy growth. Probiotics are one such alternative that are supplemented to the host where by and large species of Lactobacillus, Bifidobacterium and Saccharomyces are considered as main probiotics. The field of probiotics has made stupendous strides though there is no major break through in the identification of their mechanism of action. They exert their activity primarily by strengthening the intestinal barrier and immunomodulation. The main objective of the study was to provide a deep insight into the effect of probiotics against the diseases, their applications and proposed mechanism of action

Linfoma de células T/natural killer extranodal de tipo nasal enmascarado en una sinusopatía

Introducción: El linfoma de células T citotóxico/natural killer extranodal de tipo nasal es poco frecuente, pero con alta tasa de mortalidad. Las manifestaciones clínicas de la enfermedad pueden simular una infección de senos paranasales. Objetivo: Presentar las manifestaciones clínicas de un paciente de 34 años de edad con diagnóstico de linfoma de células T citotóxico/ natural killer extranodal de tipo nasal. Caso clínico: Se presenta un paciente masculino de 34 años de edad con rinorrea verdosa fétida recurrente y obstrucción en fosa nasal derecha. En la evaluación inicial sugiere sinusitis crónica, sin embargo, debido al empeoramiento de las manifestaciones clínicas se realiza una tomografía computarizada que muestra lesiones sugestivas de infiltración neoplásica, una biopsia de la lesión confirma el diagnóstico de linfoma de células T/natural killer extranodal de tipo nasal. Conclusiones: Los linfomas de células T citotóxico/natural killer extranodal de tipo nasal son considerados neoplasias poco frecuentes, caracterizadas por el patrón rápidamente progresivo con afectación ósea; en su etapa inicial presenta manifestaciones clínicas similares a una sinusitis. La tomografía computarizada y la histopatología, son indispensables en el diagnóstico de la enfermedad

Oceanographic barriers, divergence, and admixture : phylogeography and taxonomy of two putative subspecies of short-finned pilot whale

Funding:Commander, U.S. Pacific Fleet Environmental Readiness Division and NMFS Pacific Islands Fisheries Science Center; NMFS West Coast Region; Scripps Institution of Oceanography Edna Bailey Sussman Research Fellowship; and Woods Hole Oceanographic Institution.Genomic phylogeography plays an important role in describing evolutionary processes and their geographic, ecological, or cultural drivers. These drivers are often poorly understood in marine environments, which have fewer obvious barriers to mixing than terrestrial environments. Taxonomic uncertainty of some taxa (e.g., cetaceans), due to the difficulty in obtaining morphological data, can hamper our understanding of these processes. One such taxon, the short‐finned pilot whale, is recognized as a single global species but includes at least two distinct morphological forms described from stranding and drive hunting in Japan, the “Naisa” and “Shiho” forms. Using samples (n = 735) collected throughout their global range, we examine phylogeographic patterns of divergence by comparing mitogenomes and nuclear SNP loci. Our results suggest three types within the species: an Atlantic Ocean type, a western/central Pacific and Indian Ocean (Naisa) type, and an eastern Pacific Ocean and northern Japan (Shiho) type. mtDNA control region differentiation indicates these three types form two subspecies, separated by the East Pacific Barrier: Shiho short‐finned pilot whale, in the eastern Pacific Ocean and northern Japan, and Naisa short‐finned pilot whale, throughout the remainder of the species' distribution. Our data further indicate two diverging populations within the Naisa subspecies, in the Atlantic Ocean and western/central Pacific and Indian Oceans, separated by the Benguela Barrier off South Africa. This study reveals a process of divergence and speciation within a globally‐distributed, mobile marine predator, and indicates the importance of the East Pacific Barrier to this evolutionary process.PostprintPeer reviewe

The impact of viral mutations on recognition by SARS-CoV-2 specific T cells.

We identify amino acid variants within dominant SARS-CoV-2 T cell epitopes by interrogating global sequence data. Several variants within nucleocapsid and ORF3a epitopes have arisen independently in multiple lineages and result in loss of recognition by epitope-specific T cells assessed by IFN-γ and cytotoxic killing assays. Complete loss of T cell responsiveness was seen due to Q213K in the A∗01:01-restricted CD8+ ORF3a epitope FTSDYYQLY207-215; due to P13L, P13S, and P13T in the B∗27:05-restricted CD8+ nucleocapsid epitope QRNAPRITF9-17; and due to T362I and P365S in the A∗03:01/A∗11:01-restricted CD8+ nucleocapsid epitope KTFPPTEPK361-369. CD8+ T cell lines unable to recognize variant epitopes have diverse T cell receptor repertoires. These data demonstrate the potential for T cell evasion and highlight the need for ongoing surveillance for variants capable of escaping T cell as well as humoral immunity.This work is supported by the UK Medical Research Council (MRC); Chinese Academy of Medical Sciences(CAMS) Innovation Fund for Medical Sciences (CIFMS), China; National Institute for Health Research (NIHR)Oxford Biomedical Research Centre, and UK Researchand Innovation (UKRI)/NIHR through the UK Coro-navirus Immunology Consortium (UK-CIC). Sequencing of SARS-CoV-2 samples and collation of data wasundertaken by the COG-UK CONSORTIUM. COG-UK is supported by funding from the Medical ResearchCouncil (MRC) part of UK Research & Innovation (UKRI),the National Institute of Health Research (NIHR),and Genome Research Limited, operating as the Wellcome Sanger Institute. T.I.d.S. is supported by a Well-come Trust Intermediate Clinical Fellowship (110058/Z/15/Z). L.T. is supported by the Wellcome Trust(grant number 205228/Z/16/Z) and by theUniversity of Liverpool Centre for Excellence in Infectious DiseaseResearch (CEIDR). S.D. is funded by an NIHR GlobalResearch Professorship (NIHR300791). L.T. and S.C.M.are also supported by the U.S. Food and Drug Administration Medical Countermeasures Initiative contract75F40120C00085 and the National Institute for Health Research Health Protection Research Unit (HPRU) inEmerging and Zoonotic Infections (NIHR200907) at University of Liverpool inpartnership with Public HealthEngland (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford.L.T. is based at the University of Liverpool. M.D.P. is funded by the NIHR Sheffield Biomedical ResearchCentre (BRC – IS-BRC-1215-20017). ISARIC4C is supported by the MRC (grant no MC_PC_19059). J.C.K.is a Wellcome Investigator (WT204969/Z/16/Z) and supported by NIHR Oxford Biomedical Research Centreand CIFMS. The views expressed are those of the authors and not necessarily those of the NIHR or MRC