A Validation study on Blood Pressure Measurement in Adults - Aneroid Vs Automated Oscillometry in Comparison with Mercury Sphygmomanometry

BACKGROUND: In the recent years, many organizations have emphasized the urgent need to phase out mercury devices from health care. However, inaccurate blood pressure measurements from erroneous non-mercury devices may lead to misdiagnosis and either inadequate or unnecessary treatment of hypertension. Hence, the onus is on to identify the ideal instrument to measure blood pressure that ensures the accuracy of the mercury sphygmomanometer but is at the same time environment-friendly. OBJECTIVES: The purpose of this study was to compare aneroid and oscillometric blood pressure measurement in the adult population over a range of blood pressure values with reference to mercury sphygmomanometry. A sub group analysis was also done among hypertensives, geriatric population, patients in shock and patients in atrial fibrillation. METHODS: After ensuring adequate precautions, blood pressure measurements of 500 study subjects was taken as prescribed by the AHA guidelines. The recordings were taken in the mercury sphygmomanometer, aneroid sphygmomanometer and digital oscillometry and results were compared. RESULTS: For patients in shock, the readings from aneroid devices for systolic and diastolic blood pressures were more accurate in comparison with the mercury device (p values = < 0.001 for both systolic and diastolic) For the same patients, the systolic and diastolic blood pressure readings recorded by the digital device was significantly different from the mercury values (p values = 0.327 and 0.023 respectively). However for other patient groups, there was no statistically significant difference between the two devices. CONCLUSION: This study showed that the aneroid sphygmomanometer was the better device for replacement of mercury sphygmomanometers in health care, especially in patients who are in shock. For patients who are hemodynamically stable, the automated oscillometric device may still be used owing to its convenience but with caution due to its inter-manufacturer formulae variation and other pitfalls

An investigation on image denoising technique using pixel-component-analysis

This paper authenticates a proficient image denoising scheme with the analysis local pixel coherence. In the dominion of a study about noise and pixel elements in image processing, the influence of the Gaussian effect on image contrast plays a key role. It is found in particular that pixel variations may be vast in some cases which potentially tend to develop irregularities in the image

Homologous recombination in mycobacteria

In recent years, considerable effort and resources have been expended to develop targeted gene delivery methods, and generation of auxotrophic mutants of mycobacteria. The results of these studies suggest that mycobacteria exhibit a wide range of recombination rates, which vary from loci to loci. Here we review the methods developed for allele exchange and targeted gene disruption as well as the mechanistic aspects of homologous recombination in mycobacteria. The results of whole genome, functional and structural analyses of Mycobacterium tuberculosis and Mycobacterium smegmatis RecA and SSB proteins provide insights into variations of the prototypic Escherichia coli paradigm. This variation of a common theme might allow mycobacteria to function in their natural but complex physiological environments

Optimization of Interior Spacing in Car with Help of Air Inflatable Seat

Automobile plays an inevitable role in the present world for transportation of people and goods. Much advancement has done in automobiles to increase various aspects like aesthetics, safety, comfort and engine performance etc., among this, one of the major requirements of modern automobiles is to increase fuel economy. Every design modification that has been made in automobile will need to meet with requirement of increase in fuel economy and engine performance. On considering Indian consumers, their usage and requirements are multipurpose. Their requirement is about having comfortable seating and also having additional space for goods, if the need arise. To comply with above requirement of Indian consumers with improved fuel economy, various concepts are discussed. One among the factor was seat weight. This can be modified by implanting inflatable seats in automobile

Therapeutic targeting of replicative immortality

One of the hallmarks of malignant cell populations is the ability to undergo continuous proliferation. This property allows clonal lineages to acquire sequential aberrations that can fuel increasingly autonomous growth, invasiveness, and therapeutic resistance. Innate cellular mechanisms have evolved to regulate replicative potential as a hedge against malignant progression. When activated in the absence of normal terminal differentiation cues, these mechanisms can result in a state of persistent cytostasis. This state, termed “senescence,” can be triggered by intrinsic cellular processes such as telomere dysfunction and oncogene expression, and by exogenous factors such as DNA damaging agents or oxidative environments. Despite differences in upstream signaling, senescence often involves convergent interdependent activation of tumor suppressors p53 and p16/pRB, but can be induced, albeit with reduced sensitivity, when these suppressors are compromised. Doses of conventional genotoxic drugs required to achieve cancer cell senescence are often much lower than doses required to achieve outright cell death. Additional therapies, such as those targeting cyclin dependent kinases or components of the PI3K signaling pathway, may induce senescence specifically in cancer cells by circumventing defects in tumor suppressor pathways or exploiting cancer cells’ heightened requirements for telomerase. Such treatments sufficient to induce cancer cell senescence could provide increased patient survival with fewer and less severe side effects than conventional cytotoxic regimens. This positive aspect is countered by important caveats regarding senescence reversibility, genomic instability, and paracrine effects that may increase heterogeneity and adaptive resistance of surviving cancer cells. Nevertheless, agents that effectively disrupt replicative immortality will likely be valuable components of new combinatorial approaches to cancer therapy

Clinical characteristics and treatment patterns of pregnant women with hypertension in primary care in the Federal Capital Territory of Nigeria: Cross-sectional results from the Hypertension Treatment in Nigeria Program

BACKGROUND: Hypertensive disorders of pregnancy, including hypertension, are a leading cause of maternal mortality in Nigeria. However, there is a paucity of data on pregnant women with hypertension who receive care in primary health care facilities. This study presents the results from a cross-sectional analysis of pregnant women enrolled in the Hypertension Treatment in Nigeria Program which is aimed at integrating and strengthening hypertension care in primary health care centres. METHODS: A descriptive analysis of the baseline results from the Hypertension Treatment in Nigeria Program was performed. Baseline blood pressures, treatment and control rates of pregnant women were analysed and compared to other adult women of reproductive age. A complete case analysis was performed, and a two-sided p value \u3c 0.05 was considered statistically significant. RESULTS: Between January 2020 to October 2022, 5972 women of reproductive age were enrolled in the 60 primary healthcare centres participating in the Hypertension Treatment in Nigeria Program and 112 (2%) were pregnant. Overall mean age (SD) was 39.6 years (6.3). Co-morbidities were rare in both groups, and blood pressures were similar amongst pregnant and non-pregnant women (overall mean (SD) first systolic and diastolic blood pressures were 157.4 (20.6)/100.7 (13.6) mm Hg and overall mean (SD) second systolic and diastolic blood pressures were 151.7 (20.1)/98.4 (13.5) mm Hg). However, compared to non-pregnant women, pregnant women had a higher rate of newly diagnosed hypertension (65.2% versus 54.4% p = 0.02) and lower baseline walk-in treatment (32.1% versus 42.1%, p = 0.03). The control rate was numerically lower among pregnant patients (6.3% versus 10.2%, p = 0.17), but was not statistically significant. Some pregnant patients (8.3%) were on medications contraindicated in pregnancy, and none of the pregnant women were on aspirin for primary prevention of preeclampsia. CONCLUSIONS: These findings indicate significant gaps in care and important areas for future studies to improve the quality of care and outcomes for pregnant women with hypertension in Nigeria, a country with the highest burden of maternal mortality globally

Rare protein-altering variants in ANGPTL7 lower intraocular pressure and protect against glaucoma

Protein-altering variants that are protective against human disease provide in vivo validation of therapeutic targets. Here we use genotyping data from UK Biobank (n = 337,151 unrelated White British individuals) and FinnGen (n = 176,899) to conduct a search for protein-altering variants conferring lower intraocular pressure (IOP) and protection against glaucoma. Through rare protein-altering variant association analysis, we find a missense variant in ANGPTL7 in UK Biobank (rs28991009, p.Gln175His, MAF = 0.8%, genotyped in 82,253 individuals with measured IOP and an independent set of 4,238 glaucoma patients and 250,660 controls) that significantly lowers IOP (beta = -0.53 and -0.67 mmHg for heterozygotes, -3.40 and -2.37 mmHg for homozygotes, P = 5.96 x 10(-9) and 1.07 x 10(-13) for corneal compensated and Goldman-correlated IOP, respectively) and is associated with 34% reduced risk of glaucoma (P = 0.0062). In FinnGen, we identify an ANGPTL7 missense variant at a greater than 50-fold increased frequency in Finland compared with other populations (rs147660927, p.Arg220Cys, MAF Finland = 4.3%), which was genotyped in 6,537 glaucoma patients and 170,362 controls and is associated with a 29% lower glaucoma risk (P = 1.9 x 10(-12) for all glaucoma types and also protection against its subtypes including exfoliation, primary open-angle, and primary angle-closure). We further find three rarer variants in UK Biobank, including a protein-truncating variant, which confer a strong composite lowering of IOP (P = 0.0012 and 0.24 for Goldman-correlated and corneal compensated IOP, respectively), suggesting the protective mechanism likely resides in the loss of interaction or function. Our results support inhibition or down-regulation of ANGPTL7 as a therapeutic strategy for glaucoma. Author summary Glaucoma is a common eye disease that damages the optic nerve. Using intraocular pressure, which is a known modifiable risk factor and predictive measure for glaucoma, genome-wide association studies have identified dozens of genetic variants likely affecting disease risk. However, the identification of potential therapeutic targets from those discoveries has been challenging because the functional consequences and the causal variants of the suggested common variant associations are typically unclear. Here, we present a strategy to scan for rare protein-altering variants, which provides direct insights into the functional consequence and the therapeutic effects, using more than 514,000 individuals with European ancestries in two population cohorts in the UK and Finland. We discover an allelic series of multiple rare ANGPTL7 missense and nonsense variants in UK Biobank that lower intraocular pressure and reduces the risk of glaucoma. We further identify an ANGPTL7 missense variant in FinnGen cohort with more than 50-fold enrichment in the Finnish population that provides protection against glaucoma and its subtypes. Our results highlight the benefits of multi-cohort analysis for the discovery of rare protein-altering variants in common diseases and indicate ANGPTL7 as a therapeutic target for glaucoma.Peer reviewe

Maturation of heterogeneity in afferent synapse ultrastructure in the mouse cochlea

Auditory nerve fibers (ANFs) innervating the same inner hair cell (IHC) may have identical frequency tuning but different sound response properties. In cat and guinea pig, ANF response properties correlate with afferent synapse morphology and position on the IHC, suggesting a causal structure-function relationship. In mice, this relationship has not been fully characterized. Here we measured the emergence of synaptic morphological heterogeneities during maturation of the C57BL/6J mouse cochlea by comparing postnatal day 17 (p17, ∼3 days after hearing onset) with p34, when the mouse cochlea is mature. Using serial block face scanning electron microscopy and three-dimensional reconstruction we measured the size, shape, vesicle content, and position of 70 ribbon synapses from the mid-cochlea. Several features matured over late postnatal development. From p17 to p34, presynaptic densities (PDs) and post-synaptic densities (PSDs) became smaller on average (PDs: 0.75 to 0.33; PSDs: 0.58 to 0.31 μ