Primary percutaneous coronary intervention for acute myocardial infarction in a patient with dextrocardia

Dextrocardia is a rare cardiac anomaly in which the heart is located in the right hemithorax. This developmental irregularity can occur in isolation as situs solitus, or in association with situs inversus or situs ambiguous. Although there are reports of coronary angiography in patients with dextrocardia, there are very few reported cases of mechanical intervention. We report a patient with dextrocardia and situs inversus who presented with an ST segment elevation myocardial infarction and was successfully treated with primary percutaneous coronary intervention

Formal Learning About the Past in Schools in England

This paper explains how archaeology has been used to teach history to children in English schools, museums and heritage sites. We describe six successful schools-linked projects then focuses on the Young Archaeologists’ Club, which has over the past 40 years nurtured many members of today’s archaeology professionals. Finally, we consider how archaeology education practitioners can use what has been learnt in those projects to plan for a sustainable future

Comparing the relationship between ultrasound-estimated fetal weight and birthweight in cohort of small for gestational age fetuses

Introduction Small‐for‐gestational‐age (SGA) confers a higher perinatal risk of adverse outcomes. Birthweight cannot be accurately measured until delivery, therefore accurate estimated fetal weight (EFW) based on ultrasonography is important in identifying this high‐risk population. We aimed to establish the sensitivity of detecting SGA infants antenatally in a unit with a selective third‐trimester ultrasound policy and to investigate the association between EFW and birthweight in these babies. Material and methods A retrospective cohort study was conducted on non‐anomalous singleton pregnancies delivered after 36 weeks of gestation where SGA (<10th percentile) was diagnosed at delivery. The EFW at the time of the third‐trimester ultrasound scan was recorded using standard Hadlock formulae. Results In 2017, there were 8392 non‐anomalous singleton pregnancies live born after 36 weeks, excluding late bookers. 797 were live‐born SGA <10th percentile for birthweight and 464 <5th percentile, who met our inclusion criteria. The antenatal detection rate of SGA was 19.6% for babies with birthweight <10th percentile and 24.1% <5th percentile. There was a significant correlation between the EFW and birthweight of fetuses undergoing ultrasound assessment within 2 weeks of delivery (P < .001, r = 0.73 (Pearson correlation). For these cases, EFW was greater than the birthweight in 65% of cases. After adjusting all EFWs using the discrepancy between EFW and actual birthweight for those babies born within 48 hours of the scan, the mean difference between the birthweight and adjusted EFW 7 days before delivery was 111 g (95% CI 87‐136 g) and at 14 days was 200 g (95% CI 153‐248 g). Despite adjusting the EFW, 61/213 cases (28.6%) apparently lost weight between the ultrasound scan and delivery. Conclusions Small‐for‐gestational‐age infants with a birthweight <10th percentile are poorly identified antenatally with little improvement for those <5th percentile. In SGA babies, ultrasound EFW overestimated birthweight. Discrepancies between birthweight and EFW are not explicable only by the limitations of third‐trimester sonography, a reduction in fetal weight close to delivery in a proportion of liveborn SGA babies is plausible

Advancing of Cellular Signaling Pathways in Respiratory Diseases Using Nanocarrier based Drug Delivery Systems.

Cell Signaling pathways form an integral part of our existence, that allows the cells to comprehend a stimulus and respond back. Such reactions, to external cues from the environment, are required and are essential to regulate the normal functioning of our body. Abnormalities in the system arise when there are errors developed in these signals, resulting in a complication or a disease. Presently, respiratory diseases contribute to being the third leading cause of morbidity worldwide. According to the current statistics, over 339 million people who are asthmatic, 65 million who are suffering from COPD, 2.3 million who are lung cancer patients and 10 million are tuberculosis patients. This toll of statistics with chronic respiratory diseases leaves a heavy burden on society and nation annual health expenditure. Hence, a better understanding of the processes governing these cellular pathways will enable us to treat and manage these deadly respiratory diseases effectively. Moreover, it is important to comprehend the synergy and interplay of the cellular signaling pathways in respiratory diseases, which will enable us to explore and develop suitable strategies for targeted drug delivery. This review, in particular, focuses on the major respiratory diseases and further provides an in-depth discussion on the various cell signaling pathways that are involved in the pathophysiology of respiratory diseases. Moreover, the review also analyses the defining concepts about advanced nano-drug delivery systems involving various nanocarriers and propose newer prospects to minimize the current challenges faced by researchers and formulation scientists

Resilience and food security: rethinking an ecological concept

1. Focusing on food production, in this paper we define resilience in the food security context as maintaining production of sufficient and nutritious food in the face of chronic and acute environmental perturbations. In agri-food systems, resilience is manifest over multiple spatial scales: field, farm, regional and global. Metrics comprise production and nutritional diversity as well as socio-economic stability of food supply. 2. Approaches to enhancing resilience show a progression from more ecologically-based methods at small scales to more socially-based interventions at larger scales. At the field scale, approaches include the use of mixtures of crop varieties, livestock breeds and of forage species, polycultures, and boosting ecosystem functions. Stress-tolerant crops, or with greater plasticity, provide technological solutions. 3. At the farm scale, resilience may be conferred by diversifying crops and livestock and by farmers implementing adaptive approaches in response to perturbations. Biodiverse landscapes may enhance resilience, but the evidence is weak. At regional to global scales, resilient food systems will be achieved by coordination and implementation of resilience approaches among farms, advice to farmers and targeted research. 4. Synthesis. Threats to food production are predicted to increase under climate change and land degradation. Holistic responses are needed that integrate across spatial scales. Ecological knowledge is critical, but should be implemented alongside agronomic solutions and socio-economic transformations

Emerging trends in the novel drug delivery approaches for the treatment of lung cancer

© 2019 Elsevier B.V. Cancer is one of the major diseases that cause a high number of deaths globally. Of the major types of cancers, lung cancer is known to be the most chronic form of cancer in the world. The conventional management of lung cancer includes different medical interventions like chemotherapy, surgical removal, and radiation therapy. However, this type of approach lacks specificity and also harms the adjacent normal cells. Lately, nanotechnology has emerged as a promising intervention in the management and treatment of lung cancers. Nanotechnology has revolutionized the existing modalities and focuses primarily on reducing toxicity and improving the bioavailability of anticancer drugs to the target tumor cells. Nanocarrier systems are being currently used extensively to exploit and to overcome the obstructions induced by cancers in the lungs. The nano-carrier-loaded therapeutic drug delivery methods have shown promising potential in treating lung cancer as its target is to control the growth of tumor cells. In this review, various modes of nano drug delivery options like liposomes, dendrimers, quantum dots, carbon nanotubes and metallic nanoparticles have been discussed. Nano-carrier drug delivery systems emerge as a promising approach and thus is expected to provide newer and advanced avenues in cancer therapeutics

The tyrosine phosphatase CD148 is an essential positive regulator of platelet activation and thrombosis

Platelets play a fundamental role in hemostasis and thrombosis. They are also involved in pathologic conditions resulting from blocked blood vessels, including myocardial infarction and ischemic stroke. Platelet adhesion, activation, and aggregation at sites of vascular injury are regulated by a diverse repertoire of tyrosine kinase–linked and G protein–coupled receptors. Src family kinases (SFKs) play a central role in initiating and propagating signaling from several platelet surface receptors; however, the underlying mechanism of how SFK activity is regulated in platelets remains unclear. CD148 is the only receptor-like protein tyrosine phosphatase identified in platelets to date. In the present study, we show that mutant mice lacking CD148 exhibited a bleeding tendency and defective arterial thrombosis. Basal SFK activity was found to be markedly reduced in CD148-deficient platelets, resulting in a global hyporesponsiveness to agonists that signal through SFKs, including collagen and fibrinogen. G protein–coupled receptor responses to thrombin and other agonists were also marginally reduced. These results highlight CD148 as a global regulator of platelet activation and a novel antithrombotic drug targe