Study of alkaline hydrothermal activation of belite cements by thermal analysis

The effect of alkaline hydrothermal activation of class-C fly ash belite cement was studied using thermal analysis (TG/DTG) by determining the increase in the combined water during a period of hydration of 180 days. The results were compared with those obtained for a belite cement hydrothermally activated in water. The two belite cements were fabricated via the hydrothermal-calcination route of class-C fly ash in 1 M NaOH solution (FABC-2-N) or demineralised water (FABC-2-W). From the results, the effect of the alkaline hydrothermal activation of belite cement (FABC-2-N) was clearly differentiated, mainly at early ages of hydration, for which the increase in the combined water was markedly higher than that of the belite cement that was hydrothermally activated in water. Important direct quantitative correlations were obtained among physicochemical parameters, such as the combined water, the BET surface area, the volume of nano-pores, and macro structural engineering properties such as the compressive mechanical strength

Extramedullary hematopoiesis presenting as a compressive cord and cerebral lesion in a patient without a significant hematologic disorder: a case report

<p>Abstract</p> <p>Introduction</p> <p>Intracranial or spinal compressive lesions due to extramedullary hematopoiesis have been reported in the medical literature. Most of the reported cases are extradural lesions or, on rare occasions, foci within another neoplasm such as hemangioblastoma, meningioma or pilocytic astrocytoma. Often these cases occur in patients with an underlying hematological disorder such as acute myelogenic leukemia, myelofibrosis, or other myelodysplastic syndromes. Such lesions have also been reported in thalassemia major.</p> <p>Case presentation</p> <p>We report the case of a 43-year-old Iranian woman in whom extramedullary hematopoiesis presented as a compressive cord lesion and then later as an intracranial lesion.</p> <p>Conclusions</p> <p>To the best of our knowledge, we document the first reported case of sacral, lumbar, thoracic and cranial involvement in the same patient with extramedullary hematopoiesis, which seems both rare and remarkable.</p

Functional outcome of rotating platform total knee arthroplasty - A prospective observational study

Introduction: Rotating platform (RP) is a form of mobile-bearing design for total knee arthroplasty (TKA). This reduces the polyethylene contact stresses and the forces acting on tibial component and bone cement interfaces. It increases the femoral roll-back and flexion. The objective was to assess the functional outcome of rotating platform design in primary TKA, in patients with osteoarthritis of knee and the association of age and gender with the outcome. Materials and methods: A prospective observational study was done on 42 patients who underwent primary TKA with RP design and followed-up for one year. The outcome was assessed with the Knee Society Score at one year. Data analysis was done using statistical package SPSS V-27.0. Results: The mean age was 64.33(±6.12). The mean pre-op knee clinical score was 30(±6.409), which improved to mean post–op score of 92.17(±5.53). 37(88.1%) had excellent and 5(11.9%) had good results. 7(70%) patients in the age group <60 years, 24(96%) cases of 60–69 years and 6(85.7%) cases of ≥70 years had excellent results. 23(95.8%) females and 14(77.8%) males had excellent knee clinical scores. The mean pre-op knee functional score was 33.81(±9.988), which improved to a mean post–op score of 82.38(±6.917). 36 cases (85.7%) had excellent and 6(14.3%) had good results. 7(70%) patients <60 years, 22(88%) of 60- 69 years and 7(100%) of ≥70 years had excellent results. 21(87.5%) females and 15(83.3%) males had excellent knee functional scores. Conclusion: Total knee arthroplasty with rotating platform design has shown excellent clinical and functional outcome without any serious complications at one year follow-up

Conformal Quivers and Melting Molecules

Quiver quantum mechanics describes the low energy dynamics of a system of wrapped D-branes. It captures several aspects of single and multicentered BPS black hole geometries in four-dimensional $\mathcal{N} = 2$ supergravity such as the presence of bound states and an exponential growth of microstates. The Coulomb branch of an Abelian three node quiver is obtained by integrating out the massive strings connecting the D-particles. It allows for a scaling regime corresponding to a deep AdS$_2$ throat on the gravity side. In this scaling regime, the Coulomb branch is shown to be an $SL(2,\mathbb{R})$ invariant multi-particle superconformal quantum mechanics. Finally, we integrate out the strings at finite temperature---rather than in their ground state---and show how the Coulomb branch `melts' into the Higgs branch at high enough temperatures. For scaling solutions the melting occurs for arbitrarily small temperatures, whereas bound states can be metastable and thus long lived. Throughout the paper, we discuss how far the analogy between the quiver model and the gravity picture, particularly within the AdS$_2$ throat, can be taken.Comment: 49 pages, 16 figure

Implementation of the CALM intervention for anxiety disorders: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Investigators recently tested the effectiveness of a collaborative-care intervention for anxiety disorders: Coordinated Anxiety Learning and Management(CALM) []) in 17 primary care clinics around the United States. Investigators also conducted a qualitative process evaluation. Key research questions were as follows: (1) What were the facilitators/barriers to implementing CALM? (2) What were the facilitators/barriers to sustaining CALM after the study was completed?</p> <p>Methods</p> <p>Key informant interviews were conducted with 47 clinic staff members (18 primary care providers, 13 nurses, 8 clinic administrators, and 8 clinic staff) and 14 study-trained anxiety clinical specialists (ACSs) who coordinated the collaborative care and provided cognitive behavioral therapy. The interviews were semistructured and conducted by phone. Data were content analyzed with line-by-line analyses leading to the development and refinement of themes.</p> <p>Results</p> <p>Similar themes emerged across stakeholders. Important facilitators to implementation included the perception of "low burden" to implement, provider satisfaction with the intervention, and frequent provider interaction with ACSs. Barriers to implementation included variable provider interest in mental health, high rates of part-time providers in clinics, and high social stressors of lower socioeconomic-status patients interfering with adherence. Key sustainability facilitators were if a clinic had already incorporated collaborative care for another disorder and presence of onsite mental health staff. The main barrier to sustainability was funding for the ACS.</p> <p>Conclusions</p> <p>The CALM intervention was relatively easy to incorporate during the effectiveness trial, and satisfaction was generally high. Numerous implementation and sustainability barriers could limit the reach and impact of widespread adoption. Findings should be interpreted with the knowledge that the ACSs in this study were provided and trained by the study. Future research should explore uptake of CALM and similar interventions without the aid of an effectiveness trial.</p

Increased incidence of postoperative infections during prophylaxis with cephalothin compared to doxycycline in intestinal surgery

<p>Abstract</p> <p>Background</p> <p>The antibiotics used for prophylaxis during surgery may influence the rate of surgical site infections. Tetracyclines are attractive having a long half-life and few side effects when used in a single dose regimen. We studied the rate of surgical site infections during changing regimens of antibiotic prophylaxis in medium and major size surgery.</p> <p>Methods</p> <p>Prospective registration of surgical site infection following intestinal resections and hysterectomies was performed. Possible confounding procedure and patient related factors were registered. The study included 1541 procedures and 1489 controls. The registration included time periods when the regimen was changed from doxycycline to cephalothin and back again.</p> <p>Results</p> <p>The SSI in the colorectal department increased from 19% to 30% (p = 0.002) when doxycycline was substituted with cephalothin and decreased to 17% when we changed back to doxycycline (p = 0.005). In the gynaecology department the surgical site infection rate did not increase significantly. Subgroup analysis showed major changes in infections in rectal resections from 20% to 35% (p = 0.02) and back to 12% (p = 0.003).</p> <p>Conclusion</p> <p>Doxycycline combined with metronidazole, is an attractive candidate for antibiotic prophylaxis in medium and major size intestinal surgery.</p

Optimising biocatalyst design for obtaining high transesterification activity by α-chymotrypsin in non-aqueous media

<p>Abstract</p> <p>Background</p> <p>Enzymes are often used in organic solvents for catalyzing organic synthesis. Two enzyme preparations, EPRP (enzyme precipitated and rinsed with n-propanol) and PCMC (protein coated microcrystals) show much higher activities than lyophilized powders in such systems. Both preparations involve precipitation by an organic solvent. The clear understanding of why these preparations show higher catalytic activity than lyophilized powders in organic solvents is not available.</p> <p>Results</p> <p>It was found that EPRPs of α-chymotrypsin prepared by precipitation with <it>n</it>-propanol in the presence of trehalose contained substantial amount of trehalose (even though trehalose alone at these lower concentrations was not precipitated by <it>n</it>-propanol). The presence of trehalose in these EPRPs resulted in much higher transesterification rates (45.2 nmoles mg^-1min^-1) as compared with EPRPs prepared in the absence of trehalose (16.6 nmoles mg^-1min^-1) in octane. Both kinds of EPRPs gave similar initial transesterification rates in acetonitrile. Use of higher concentrations of trehalose (when trehalose alone also precipitates out), resulted in the formation of PCMCs, which showed higher transesterification rates in both octane and acetonitrile. SEM analysis showed the relative sizes of various preparations. Presence of trehalose resulted in EPRPs of smaller sizes.</p> <p>Conclusion</p> <p>The two different forms of enzymes (EPRP and PCMC) known to show higher activity in organic solvents were found to be different only in the way the low molecular weight additive was present along with the protein. Therefore, the enhancement in the transesterification activity in EPRPs prepared in the presence of trehalose was due to: (a) better retention of essential water layer for catalysis due to the presence of the sugar. This effect disappeared where the reaction media was polar as the polar solvent (acetonitrile) is more effective in stripping off the water from the enzyme; (b) reduction in particle size as revealed by SEM. In the case of PCMC, the enhancement in the initial rates was due to an increase in the surface area of the biocatalyst since protein is coated over the core material (trehalose or salt).</p> <p>It is hoped that the insight gained in this work would help in a better understanding for designing high activity biocatalyst preparation of non-aqueous media.</p

Reporting of harm in randomized controlled trials evaluating stents for percutaneous coronary intervention

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to assess the reporting of harm in randomized controlled trials evaluating stents for percutaneous coronary intervention.</p> <p>Methods</p> <p>The study design was a methodological systematic review of randomized controlled trials. The data sources were MEDLINE and the Cochrane Central Register of Controlled Trials. All reports of randomized controlled trials assessing stent treatment for coronary disease published between January 1, 2003, and September 30, 2008 were selected.</p> <p>A standardized abstraction form was used to extract data.</p> <p>Results</p> <p>132 articles were analyzed. Major cardiac adverse events (death, cardiac death, myocardial infarction or stroke) were reported as primary or secondary outcomes in 107 reports (81%). However, 19% of the articles contained no data on cardiac events. The mode of data collection of adverse events was given in 29 reports (22%) and a definition of expected adverse events was provided in 47 (36%). The length of follow-up was reported in 95 reports (72%). Assessment of adverse events by an adjudication committee was described in 46 reports (35%), and adverse events were described as being followed up for 6 months in 24% of reports (n = 32), between 7 to 12 months in 42% (n = 55) and for more than 1 year in 4% (n = 5). In 115 reports (87%), numerical data on the nature of the adverse events were reported per treatment arm. Procedural complications were described in 30 articles (23%). The causality of adverse events was reported in only 4 articles.</p> <p>Conclusion</p> <p>Several harm-related data were not adequately accounted for in articles of randomized controlled trials assessing stents for percutaneous coronary intervention.</p> <p>Trials Registration</p> <p>Trials manuscript: 5534201182098351 (T80802P)</p