Morbidity and mortality pattern in hospitalized children with sickle cell disorders at the University College Hospital, Ibadan, Nigeria

Objectives: To determine the causes of hospitalization and outcome of children with sickle cell disorders at the University CollegeHospital, Ibadan.Methods: Case files of patients with sickle cell disease who were admittedbetween March 2009 and February 2012 were analysed. Data extractedinclude demographic variables, diagnoses, types of crises, associated infections, complications and outcome of treatment.Results: There were 174 admissions of 161 children with a male femaleratio of 1.3:1. Their ages ranged from nine months to 18 years witha mean of 7.3(4.0) years. Vasoocclusive crisis was present in 107(61.5%), hyper haemolytic crisis in 29 (16.7%) and acute splenic  sequestration in 12 (6.9 %) of all admissions. Associated infectionswere septicaemia in 56 (32.2 %), malaria in 49 (28.2 %), acute osteomyelitis in 24 (13.8%), pneumonia in 23 (13.2%), urinary tract infection in 12 (6.9%) and septic arthritis in 10 (5.7%). Haematocrit was less than 15 % in 36 (20.7%) and blood transfusion administered in 68(39.1%) of admissions. There were three (1.7%) deaths from  cerebrovascular accident, adverse reaction to blood transfusion and meningitis.Conclusion: Prevention and prompt management of crises and infectionsin sickle cell disease is recommended to reduce morbidity andmortality

Enteric glia mediate neuron death in colitis through purinergic pathways that require connexin-43 and nitric oxide

The concept of enteric glia as regulators of intestinal homeostasis is slowly gaining acceptance as a central concept in neurogastroenterology. Yet how glia contribute to intestinal disease is still poorly understood. Purines generated during inflammation drive enteric neuron death by activating neuronal P2X7 purine receptors (P2X7R), triggering ATP release via neuronal pannexin-1 channels that subsequently recruits intracellular calcium ([Ca(2+)]i) responses in the surrounding enteric glia. We tested the hypothesis that the activation of enteric glia contributes to neuron death during inflammation.We studied neuroinflammation in vivo using the 2,4-dinitrobenzenesulfonic acid model of colitis and in situ using whole-mount preparations of human and mouse intestine. Transgenic mice with a targeted deletion of glial connexin-43 (Cx43) [GFAP∷Cre (ERT2+/-)/Cx43(f/f) ] were used to specifically disrupt glial signaling pathways. Mice deficient in inducible nitric oxide (NO) synthase (iNOS (-/-)) were used to study NO production. Protein expression and oxidative stress were measured using immunohistochemistry and in situ Ca(2+) and NO imaging were used to monitor glial [Ca(2+)]i and [NO]i.Purinergic activation of enteric glia drove [Ca(2+)]i responses and enteric neuron death through a Cx43-dependent mechanism. Neurotoxic Cx43 activity, driven by NO production from glial iNOS, was required for neuron death. Glial Cx43 opening liberated ATP and Cx43-dependent ATP release was potentiated by NO.Our results show that the activation of glial cells in the context of neuroinflammation kills enteric neurons. Mediators of inflammation that include ATP and NO activate neurotoxic pathways that converge on glial Cx43 hemichannels. The glial response to inflammatory mediators might contribute to the development of motility disorders

Supermembrane interaction with dynamical D=4 N=1 supergravity. Superfield Lagrangian description and spacetime equations of motion

We obtain the complete set of equations of motion for the interacting system of supermembrane and dynamical D=4 N = 1 supergravity by varying its complete superfield action and writing the resulting superfield equations in the special gauge where the supermembrane Goldstone field is set to zero. We solve the equations for auxiliary fields and discuss the effect of dynamical generation of cosmological constant in the Einstein equation of interacting system and its renormalization due to some regular contributions from supermembrane. These two effects (discussed in late 70th and 80th, in the bosonic perspective and in the supergravity literature) result in that, generically, the cosmological constant has different values in the branches of the spacetime separated by the supermembrane worldvolume.Comment: 23 pages, no figures. V2 two references added, 24 page

Effects of layer shift and yarn path variability on mechanical properties of a twill weave composite

Experimental and numerical analysis of a woven composite were performed in order to assess the effect of yarn path and layer shift variability on properties of the composite. Analysis of the geometry of a 12K carbon fibre 2×2 twill weave at the meso- and macro-scales showed the prevalence of the yarn path variations at the macro-scale over the meso-scale variations. Numerical analysis of yarn path variability showed that it is responsible for a Young’s modulus reduction of 0.5% and CoV of 1% which makes this type of variability in the selected reinforcement almost insignificant for an elastic analysis. Finite element analysis of damage propagation in laminates with layer shift showed good agreement with the experiments. Both numerical analysis and experiments showed that layer shift has a strong effect on the shape of the stress-strain curve. In particular, laminates with no layer shift tend to exhibit a kink in the stress-strain curve which was attributed solely to the layer configuration

Note About Hamiltonian Formalism of Healthy Extended Horava-Lifshitz Gravity

In this paper we continue the study of the Hamiltonian formalism of the healthy extended Horava-Lifshitz gravity. We find the constraint structure of given theory and argue that this is the theory with the second class constraints. Then we discuss physical consequence of this result. We also apply the Batalin-Tyutin formalism of the conversion of the system with the second class constraints to the system with the first class constraints to the case of the healthy extended Horava-Lifshitz theory. As a result we find new theory of gravity with structure that is different from the standard formulation of Horava-Lifshitz gravity or General Relativity.Comment: 17 pages, v.2. references added, v.3. typos corrected, references adde

Chronic Outpatient Sildenafil Therapy for Pulmonary Hypertension in a Child After Cardiac Surgery

We report the case of a 14-month-old male with d-transposition of the great arteries, ventricular septal defect, and pulmonary hypertension successfully treated with long-term sildenafil following cardiac surgery. To our knowledge, this is the first published report of long-term sildenafil treatment in a child after corrective cardiac surgery

Development and Validation of the Behavioral Tendencies Questionnaire

At a fundamental level, taxonomy of behavior and behavioral tendencies can be described in terms of approach, avoid, or equivocate (i.e., neither approach nor avoid). While there are numerous theories of personality, temperament, and character, few seem to take advantage of parsimonious taxonomy. The present study sought to implement this taxonomy by creating a questionnaire based on a categorization of behavioral temperaments/tendencies first identified in Buddhist accounts over fifteen hundred years ago. Items were developed using historical and contemporary texts of the behavioral temperaments, described as “Greedy/Faithful”, “Aversive/Discerning”, and “Deluded/Speculative”. To both maintain this categorical typology and benefit from the advantageous properties of forced-choice response format (e.g., reduction of response biases), binary pairwise preferences for items were modeled using Latent Class Analysis (LCA). One sample (n1 = 394) was used to estimate the item parameters, and the second sample (n2 = 504) was used to classify the participants using the established parameters and cross-validate the classification against multiple other measures. The cross-validated measure exhibited good nomothetic span (construct-consistent relationships with related measures) that seemed to corroborate the ideas present in the original Buddhist source documents. The final 13-block questionnaire created from the best performing items (the Behavioral Tendencies Questionnaire or BTQ) is a psychometrically valid questionnaire that is historically consistent, based in behavioral tendencies, and promises practical and clinical utility particularly in settings that teach and study meditation practices such as Mindfulness Based Stress Reduction (MBSR)

Regionally discrete aqueous humor outflow quantification using fluorescein canalograms

Purpose To visualize and quantify conventional outflow directly in its anatomic location. Methods We obtained fluorescein canalograms in six porcine whole eyes and six porcine anterior segment cultures. Eyes were perfused with a constant pressure of 15 mmHg using media containing 0.017 mg/ml fluorescein. Flow patterns were visualized using a stereo dissecting microscope equipped for fluorescent imaging. Images were captured every 30 seconds for 20 minutes for time lapse analysis. Anterior chamber cultures were imaged again on day three of culture. Canalograms were first analyzed for filling time per quadrant. We then wrote a program to automatically compute focal flow fits for each macropixel and to detect convergent perilimbal flow patterns with macropixels grouped into 3 equal-radial width rings around the cornea. A generalized additive model was used to determine fluorescence changes of individual macropixels. Results The resulting imaging algorithm deployed 1024 macropixels that were fit to determine maximum intensity and time to fill. These individual fits highlighted the focal flow function. In whole eyes, significantly faster flow was seen in the inferonasal (IN) and superonasal (SN) quadrants compared to the superotemporal (ST) and inferotemporal (IT) ones (p<0.05). In anterior chamber cultures, reduced flow on day 1 increased in all quadrants on day 3 except in IT (p<0.05). Perilimbal ring analysis uncovered convergent perilimbal flow. Conclusions An algorithm was developed that analyzes regional and circumferential outflow patterns. This algorithm found flow patterns that changed over time and differ in whole eyes and anterior segment cultures