Selective Coronary Angiography Following Cardiac Arrest

Sudden cardiac arrest is a major cause of death predominantly caused by ventricular tachyarrhythmia in patients with coronary artery disease. Despite advancements in resuscitation care, the rate of survival after cardiac arrest remains low. There is a growing body of observational data suggesting early coronary angiography reduces delay to revascularization and may improve outcomes. Most survivors present comatose, and neurologic outcome is uncertain; therefore it is often challenging to identify patients who will benefit from early coronary angiography. Several variables and risk scores that predict a favorable neurologic outcome have been identified. The rationale and current evidence for early angiography are reviewed, and a suggested approach to the selection of patients is presented

Diarrhoeal health risks attributable to water-borne-pathogens in arsenic-mitigated drinking water in West Bengal are largely independent of the microbiological quality of the supplied water

Abstract: There is a growing discussion about the possibility of arsenic mitigation measures in Bengal and similar areas leading to undesirable substitution of water-borne-pathogen attributable risks pathogens for risks attributable to arsenic, in part because of uncertainties in relative pathogen concentrations in supplied and end-use water. We try to resolve this discussion, by assessing the relative contributions of water supply and end-user practices to water-borne-pathogen-attributable risks for arsenic mitigation options in a groundwater arsenic impacted area of West Bengal. Paired supplied arsenic-mitigated water and end-use drinking water samples from 102 households were collected and analyzed for arsenic and thermally tolerant coliforms [TTC], used as a proxy for microbiological water quality, We then estimated the DALYs related to key sequelae, diarrheal diseases and cancers, arising from water-borne pathogens and arsenic respectively. We found [TTC] in end-use drinking water to depend only weakly on [TTC] in source-water. End-user practices far outweighed the microbiological quality of supplied water in determining diarrheal disease burden. [TTC] in source water was calculated to contribute <1% of total diarrheal disease burden. No substantial demonstrable pathogen-for-arsenic risk substitution attributable to specific arsenic mitigation of supplied waters was observed, illustrating the benefits of arsenic mitigation measures in the area studied

Dynamic Palmitoylation of the Sodium-Calcium Exchanger Modulates Its Structure, Affinity for Lipid-Ordered Domains, and Inhibition by XIP

The transmembrane sodium-calcium (Na-Ca) exchanger 1 (NCX1) regulates cytoplasmic Ca levels by facilitating electrogenic exchange of Ca for Na. Palmitoylation, the only reversible post-translational modification known to modulate NCX1 activity, controls NCX1 inactivation. Here, we show that palmitoylation of NCX1 modifies the structural arrangement of the NCX1 dimer and controls its affinity for lipid-ordered membrane domains. NCX1 palmitoylation occurs dynamically at the cell surface under the control of the enzymes zDHHC5 and APT1. We identify the position of the endogenous exchange inhibitory peptide (XIP) binding site within the NCX1 regulatory intracellular loop and demonstrate that palmitoylation controls the ability of XIP to bind this site. We also show that changes in NCX1 palmitoylation change cytosolic Ca. Our results thus demonstrate the broad molecular consequences of NCX1 palmitoylation and highlight a means to manipulate the inactivation of this ubiquitous ion transporter that could ameliorate pathologies linked to Ca overload via NCX1

Inactivation and sub-lethal injury of salmonella typhi, salmonella typhimurium and vibrio cholerae in copper water storage vessels

Background: This study provides information on the antibacterial effect of copper against the water-borne pathogens Salmonella Typhi, Salmonella Typhimurium and Vibrio cholerae. Methods: Suspensions of each pathogen were kept in water within a traditional copper vessel at 30°C for 24 h. Samples were withdrawn, diluted and plated onto suitable growth media. Conventional enumeration of healthy (uninjured) bacteria was carried out using standard aerobic incubation conditions. Additionally, reactive oxygen species-neutralised (ROS-n) conditions were achieved by adding the peroxide scavenger sodium pyruvate to the medium with anaerobic incubation, to enumerate uninjured (ROS-insensitive) and injured (ROS-sensitive) bacteria. Differences between log-transformed means of conventional (aerobic) and ROS-n counts were statistically evaluated using t tests. Results: Overall, all three pathogens were inactivated by storage in copper vessels for 24 h. However, for shorter-term incubation (4-12 h), higher counts were observed under ROS-n conditions than under aerobic conditions, which demonstrate the presence of substantial numbers of sub-lethally injured cells prior to their complete inactivation. Conclusions: The present study has for the first time confirmed that these bacterial pathogens are inactivated by storage in a copper vessel within 24 h. However, it has also demonstrated that it is necessary to account for short-term sub-lethal injury, manifest as ROS-sensitivity, in order to more fully understand the process. This has important practical implications in terms of the time required to store water within a copper vessel to completely inactivate these bacteria and thereby remove the risk of water-borne disease transmission by this route

Exploring Social Work practice inside of Foster Care programs: The case of Bethany Christian Services

The aim of this study was to explore how social work practice within the Ethiopian context was practiced. The study fundamentally explored what the roles of social work practitioners in this area and the decision-making process of these practitioners entailed. As such using Criterion Sampling four practitioners who worked in the pioneer NGO in Foster care by the name of Bethany Christian Services were interviewed. The study chose a qualitative design in order to capture the full picture of the experiences of these practitioners. Pragmatism perspective in collaboration with the Decision-making Ecology were deployed as the theoretical framework to help specify and shape the study. The data was collected using extended fully structured phone interviews. The study revealed that Bethany had more than 10 years of experience within foster care where it has built extensive expertise. The organization first recruits families, conducts home assessment, then proceeds with the various extensive trainings which Bethany has through time curated. Once qualified the family then proceeds to the matching process where the decision making is performed in a multidisciplinary team after which the placement commences. Additionally, there is extensive research and knowledge sitting within the organization that is now being exploited by the government in order to revise the existing alternative childcare guideline. This new initiative has become the third foster care program within the organization

NRA-2, a Nicalin Homolog, Regulates Neuronal Death by Controlling Surface Localization of Toxic Caenorhabditis elegans DEG/ENaC Channels

Hyperactivated DEG/ENaCs induce neuronal death through excessive cation influx and disruption of intracellular calcium homeostasis. Caenorhabditis elegans DEG/ENaC MEC-4 is hyperactivated by the (d) mutation and induces death of touch neurons. The analogous substitution in MEC-10 (MEC-10(d)) co-expressed in the same neurons is only mildly neurotoxic. We exploited the lower toxicity of MEC-10(d) to identify RNAi knockdowns that enhance neuronal death. We report here that knock-out of the C. elegans nicalin homolog NRA-2 enhances MEC-10(d)-induced neuronal death. Cell biological assays in C. elegans neurons show that NRA-2 controls the distribution of MEC-10(d) between the endoplasmic reticulum and the cell surface. Electrophysiological experiments in Xenopus oocytes support this notion and suggest that control of channel distribution by NRA-2 is dependent on the subunit composition. We propose that nicalin/NRA-2 functions in a quality control mechanism to retain mutant channels in the endoplasmic reticulum, influencing the extent of neuronal death. Mammalian nicalin may have a similar role in DEG/ENaC biology, therefore influencing pathological conditions like ischemia