Hepatotoxic Effects of Potassium Bromate on Adult Wistar Rats

Objective: We aimed to demonstrate the histopathologic effects of potassium bromate (KBrO3) on the liver cells of rats following oral administration. Method: Twenty young Wistar rats of weights 196-215g were divided into four groups. The control group A was orally administered with 1ml of distilled water daily; the experimental groups B, C and D were orally administered with 50, 100, and 200 mg/kg body weight/day dosages of KBrO3 for 35 days. Both the control and experimental groups were sacrificed using the chloroform inhalation method at the end of study period.Results: Rats which received 200 mg kg-1 b.wt. of KBrO3 died within the 20th day of administration. The body weights were significantly increased (P<0.05) in the experimental groups from the 3rd to the 5th week of study while the relative weight of their liver were not affected compared to the control group. Histopathological examination of the experimental groups indicated; little sinusoidal dilatation in rats treated with 50 mg kg-1 b.wt. of KBrO3; hepatic vacuolation, large sinusoidal dilatation, degenerative changes and cellular congestion in rats, which received 100, 200 mg kg-1 b.wt. of KBrO3 compared with the control group, which maintained normal kidney tissues. These histological alterations appeared marked in rats administered with 200 mg kg-1 b.wt. of KBrO3.Conclusion: The present study indicated dose-dependent, histopathologic effects on the liver cells of rats administered with KBrO3. Our findings therefore suggest that chronic KBrO3 consumption may put the liver at some risk of adverse histopathological conditions. Keywords: Liver, histopathology, potassium bromate, hepatotoxicity

Quasiparticle Hall Transport of d-wave Superconductors in Vortex State

We present a theory of quasiparticle Hall transport in strongly type-II superconductors within their vortex state. We establish the existence of integer quantum spin Hall effect in clean unconventional $d_{x^2-y^2}$ superconductors in the vortex state from a general analysis of the Bogoliubov-de Gennes equation. The spin Hall conductivity $\sigma^s_{xy}$ is shown to be quantized in units of $\frac{\hbar}{8\pi}$. This result does not rest on linearization of the BdG equations around Dirac nodes and therefore includes inter-nodal physics in its entirety. In addition, this result holds for a generic inversion-symmetric lattice of vortices as long as the magnetic field $B$ satisfies $H_{c1} \ll B \ll H_{c2}$. We then derive the Wiedemann-Franz law for the spin and thermal Hall conductivity in the vortex state. In the limit of $T \to 0$, the thermal Hall conductivity satisfies $\kappa_{x y}=\frac{4\pi^2}{3}(\frac{k_B}{\hbar})^2 T \sigma^s_{xy}$. The transitions between different quantized values of $\sigma^s_{xy}$ as well as relation to conventional superconductors are discussed.Comment: 18 pages REVTex, 3 figures, references adde

Language of Lullabies: The Russification and De-Russification of the Baltic States

This article argues that the laws for promotion of the national languages are a legitimate means for the Baltic states to establish their cultural independence from Russia and the former Soviet Union

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Background Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects. Methods FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762. Findings Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months. Interpretation Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function. Funding UK Stroke Association and NIHR Health Technology Assessment Programme

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial

Background High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains unclear. We investigated whether transdermal glyceryl trinitrate (GTN; also known as nitroglycerin), a nitric oxide donor, might improve outcome when administered very early after stroke onset. Methods We did a multicentre, paramedic-delivered, ambulance-based, prospective, randomised, sham-controlled, blinded-endpoint, phase 3 trial in adults with presumed stroke within 4 h of onset, face-arm-speech-time score of 2 or 3, and systolic blood pressure 120 mm Hg or higher. Participants were randomly assigned (1:1) to receive transdermal GTN (5 mg once daily for 4 days; the GTN group) or a similar sham dressing (the sham group) in UK based ambulances by paramedics, with treatment continued in hospital. Paramedics were unmasked to treatment, whereas participants were masked. The primary outcome was the 7-level modified Rankin Scale (mRS; a measure of functional outcome) at 90 days, assessed by central telephone follow-up with masking to treatment. Analysis was hierarchical, first in participants with a confirmed stroke or transient ischaemic attack (cohort 1), and then in all participants who were randomly assigned (intention to treat, cohort 2) according to the statistical analysis plan. This trial is registered with ISRCTN, number ISRCTN26986053. Findings Between Oct 22, 2015, and May 23, 2018, 516 paramedics from eight UK ambulance services recruited 1149 participants (n=568 in the GTN group, n=581 in the sham group). The median time to randomisation was 71 min (IQR 45–116). 597 (52%) patients had ischaemic stroke, 145 (13%) had intracerebral haemorrhage, 109 (9%) had transient ischaemic attack, and 297 (26%) had a non-stroke mimic at the final diagnosis of the index event. In the GTN group, participants’ systolic blood pressure was lowered by 5·8 mm Hg compared with the sham group (p<0·0001), and diastolic blood pressure was lowered by 2·6 mm Hg (p=0·0026) at hospital admission. We found no difference in mRS between the groups in participants with a final diagnosis of stroke or transient ischaemic stroke (cohort 1): 3 (IQR 2–5; n=420) in the GTN group versus 3 (2–5; n=408) in the sham group, adjusted common odds ratio for poor outcome 1·25 (95% CI 0·97–1·60; p=0·083); we also found no difference in mRS between all patients (cohort 2: 3 [2–5]; n=544, in the GTN group vs 3 [2–5]; n=558, in the sham group; 1·04 [0·84–1·29]; p=0·69). We found no difference in secondary outcomes, death (treatment-related deaths: 36 in the GTN group vs 23 in the sham group [p=0·091]), or serious adverse events (188 in the GTN group vs 170 in the sham group [p=0·16]) between treatment groups. Interpretation Prehospital treatment with transdermal GTN does not seem to improve functional outcome in patients with presumed stroke. It is feasible for UK paramedics to obtain consent and treat patients with stroke in the ultraacute prehospital setting. Funding British Heart Foundation

GIS hotspot Application and Use of Set-Cover Problem For Centralized Abattoir Biogas Plant Treatment Facilities In Anambra State of Nigeria

Anambra state is faced with high population explosion and consequently high production of abattoir wastes in major abattoir centres in the state. There is need for strategic waste management in allocation of  bio-energy plants to digest these wastes. ArGIS software was used to perform hotspot Analysis to delineate clusters of abattoir potential features with values significantly higher or lower than the overall study area mean or average value. In addition, the set covering location model was used to determine the number of bio-energy treatment plant facilities that should be constructed in the study area and where they should be located. The result of the study indicated that eight abattoirs were classified as hotspot zones/locations (L), and consequently used in the set covering location modelling. The set covering location model indicates that a minimum of two bio-energy plant should be constructed in Obosi (L1) and Umunya (L8) of the study area. The outcome of the study would be useful in harnessing abattoir wastes generated in the study area