Combined Positron Emission Tomography and Computed Tomography : Option or necessity?

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The sunshine vitamin D: ubiquitous source, still so deficient in mother and baby duo

Background: Vitamin D is a fat-soluble vitamin, a sunshine vitamin. Vitamin D deficiency is now recognized as a pandemic. Fetus depends on mother for its need of vitamin D, thus there is growing concern for its impact on neonates. This study was designed to determine the correlation between 25-hydroxyvitamin D (vitamin D3) levels in maternal blood and in cord blood.Methods: A total 50 term pregnant women attending antenatal clinic at SVS medical college, Telangana and their neonates were included in the study. At term after taking written consent, maternal and cord blood vitamin D3 were measured, and values were correlated. Antenatal and neonatal complications were noted, and correlated with vitamin D3 levels.Results: In this study 80% of pregnant women and 88% of neonates were vitamin D3 deficient. Mean maternal blood vitamin D3 was 17.62±10.01 and cord blood vitamin D3 was 12.84±7.68. Maternal blood vitamin D3 correlated positively with cord blood vitamin D3 (r=0.951, p<0.001). Antenatal and neonatal complications were observed, but statistically significant association with vitamin D3 deficiency could not be established.Conclusions: This study has demonstrated a very high prevalence of vitamin D deficiency in apparently healthy, young, pregnant women despite abundant sunlight leading to deficiency in their neonates. To establish strong association between vitamin D3 deficiency and various antenatal and neonatal complications further studies with large subject groups are required

Nuchal cord: from dread towards confident management

Background: This study was aimed at observing the outcomes of pregnancies with sonographically detected nuchal cord or cord around the neck at term. Early studies on nuchal cord showed many maternal and neonatal complications. But several recent studies have suggested that maternal and neonatal complications do not increase with nuchal cord at delivery. This ambiguity increases anxiety in treating obstetricians and relatives of pregnant women, thus leading to unnecessary caesarean sections. This study is intended to observe the maternal and neonatal outcomes of 300 pregnant women with sonographically detected nuchal cord at term.Methods: Prospective observational study where 300 term pregnant women with sonographically detected nuchal cord were observed through delivery at Shri Venkata Sai Medical College, Mahabubnagar, Telangana, during October 2016 to April 2018.Results: In this study 80.6% women had normal vaginal delivery, 8.3% had LSCS, 11% had instrumental deliveries. 54% had loose nuchal cord, 46% had tight loop of cord.60% had normal CTG, 8% had variable deceleration, 2% late deceleration. Neonatal morbidity was 9.6% and zero neonatal mortality.Conclusions: The study concluded that the presence of nuchal cord does not adversely affect the mother and the neonate. Presence of nuchal cord per se is not an indication for LSCS. Effect of nuchal cord on neonate is only transient. These women can be allowed for vaginal delivery with routine labour room protocols. Routine sonographycal detection of nuchal cord is not required and if it is reported, it should not dictate obstetric management

Factors Associated with Occupational Stress Among University Teachers in Pakistan and Finland

The study examines the interplay of psychosocial factors and works conditions on occupational stress among 531 university teachers in Pakistan and Finland with the help of a web-based questionnaire. Results from an MANOVA revealed that good working conditions, social support at work, and promotion and development opportunities were rated as significantly better by the Finnish sample. Workplace bullying occurred considerably less often in Finland than in Pakistan. Male Pakistani teachers reported significantly higher levels of workplace bullying than any other group. Although the working conditions, social support, and promotion and development opportunities were better, and less bullying appeared in Finland than in Pakistan, but the difference in stress symptoms between the two countries was not significant

The Medical Case for a Positron Emission Tomography and X-ray Computed Tomography Combined Service in Oman

The value of a positron emission tomography and X-ray computed tomography (PET/CT) combined service in terms of diagnostic accuracy, cost-effectiveness and impact on clinical decision-making is welldocumented in the literature. Its role in the management of patients presenting with cancer is shifting from early staging and restaging to the early assessment of the treatment response. Currently, the application of PET/CT has extended to non-oncological specialties—mainly neurology, cardiology and rheumatology. A further emerging application for PET/CT is the imaging of infection/inflammation. This article illustrates some of the PET/CT applications in both oncological and non-oncological disorders. In view of the absence of this modality in Oman, this article aims to increase the awareness of the importance of these imaging modalities and their significant impact on diagnosis and management in both oncological and non-oncological specialties for patients of all age groups as well as the decision-makers

Persistence Without Resistance: An Exploration of First-Generation College Students in a Structured Support Program

First-generation college students make up one-third of the undergraduate population of college students in the United States. It is essential to understand all aspects of a first-generation student, their desire to persist in college, and their experiences while in college. Once they are enrolled in college, first-generation students will need additional help and support to guide them throughout this life-changing experience. This study explored the experiences of 13 students enrolled in a program that is specifically designed for supporting first-generation college students academically and socially. The study used a narrative qualitative research approach. The participants were interviewed to explore their experiences as first-generation college students from their own perspective and through their own lens. This study was guided by the social capital framework and utilized Tinto’s theory of student departure and Astin’s theory of student involvement theoretical frameworks. The findings from the study show the effectiveness of providing a structured program to support the students during their onset to the campus and throughout their college experience. The program provided the students with the opportunity to increase their social capital and gather the means to support their persistence by providing the necessary tools and resources. This study will help faculty and administration to recognize the challenges these students face, and to develop innovative support programs and tools to help them attain educational success compared to non-first-generation students. The study also highlights the need to provide additional funding and support for programs that increase access and persistence for first-generation college students. As the literature review demonstrates, once first-generation students have access, support, and motivation, they can and will continue to bridge educational gaps

Curvature suppresses the Rayleigh-Taylor instability

The dynamics of a thin liquid film on the underside of a curved cylindrical substrate is studied. The evolution of the liquid layer is investigated as the film thickness and the radius of curvature of the substrate are varied. A dimensionless parameter (a modified Bond number) that incorporates both geometric parameters, gravity, and surface tension is identified, and allows the observations to be classified according to three different flow regimes: stable films, films with transient growth of perturbations followed by decay, and unstable films. Experiments and theory confirm that, below a critical value of the Bond number, curvature of the substrate suppresses the Rayleigh-Taylor instability

Replacing the wild type loxP site in BACs from the public domain with lox66 using a lox66 transposon

<p>Abstract</p> <p>Background</p> <p>Chromatin adjoining the site of integration of a transgene affects expression and renders comparisons of closely related transgenes, such as those derived from a BAC deletion series retrofitted with enhancer-traps, unreliable. Gene targeting to a pre-determined site on the chromosome is likely to alleviate the problem.</p> <p>Findings</p> <p>A general procedure to replace the <it>loxP </it>site located at one end of genomic DNA inserts in BACs with <it>lox66 </it>is described. Truncating insert DNA from the <it>loxP </it>end with a Tn10 transposon carrying a <it>lox66 </it>site simultaneously substitutes the <it>loxP </it>with a <it>lox66 </it>sequence. The replacement occurs with high stringency, and the procedure should be applicable to all BACs in the public domain. Cre recombination of <it>loxP </it>with <it>lox66 </it>or <it>lox71 </it>was found to be as efficient as another <it>loxP </it>site during phage P1 transduction of small plasmids containing those sites. However the end-deletion of insert DNA in BACs using a <it>lox66 </it>transposon occurred at no more than 20% the efficiency observed with a <it>loxP </it>transposon. Differences in the ability of Cre protein available at different stages of the P1 life cycle to recombine identical versus non-identical <it>lox</it>-sites is likely responsible for this discrepancy. A possible mechanism to explain these findings is discussed.</p> <p>Conclusions</p> <p>The <it>loxP/lox66 </it>replacement procedure should allow targeting BACs to a pre-positioned <it>lox71 </it>site in zebrafish chromosomes; a system where homologous recombination-mediated "knock-in" technology is unavailable.</p

Characterization of heterogeneity and spatial distribution of phases in complex solid dispersions by thermal analysis by structural characterization and X-ray micro computed tomography

Purpose: This study investigated the effect of drug-excipient miscibility on the heterogeneity and spatial distribution of phase separation in pharmaceutical solid dispersions at a micron-scale using two novel and complementary characterization techniques, thermal analysis by structural characterization (TASC) and X-ray micro-computed tomography (XCT) in conjunction with conventional characterization methods. Method: Complex dispersions containing felodipine, TPGS, PEG and PEO were prepared using hot melt extrusion-injection moulding. The phase separation behavior of the samples was characterized using TASC and XCT in conjunction with conventional thermal, microscopic and spectroscopic techniques. The in vitro drug release study was performed to demonstrate the impact of phase separation on dissolution of the dispersions. Results: The conventional characterization results indicated the phase separating nature of the carrier materials in the patches and the presence of crystalline drug in the patches with the highest drug loading (30% w/w). TASC and XCT where used to provide insight into the spatial configuration of the separate phases. TASC enabled assessment of the increased heterogeneity of the dispersions with increasing the drug loading. XCT allowed the visualization of the accumulation of phase separated (crystalline) drug clusters at the interface of air pockets in the patches with highest drug loading which led to poor dissolution performance. Semi-quantitative assessment of the phase separated drug clusters in the patches were attempted using XCT. Conclusion: TASC and XμCT can provide unique information regarding the phase separation behavior of solid dispersions which can be closely associated with important product quality indicators such as heterogeneity and microstructure

Ectopic high endothelial venules in pancreatic ductal adenocarcinoma: A unique site for targeted delivery.

BACKGROUND: Nanomedicine offers an excellent opportunity to tackle treatment-refractory malignancies by enhancing the delivery of therapeutics to the tumor site. High endothelial venules (HEVs) are found primarily in lymph nodes or formed de novo in peripheral tissues during inflammatory responses. They express peripheral node addressin (PNAd), which is recognized by the monoclonal antibody MECA79. METHODS: Here, we demonstrated that HEVs form de novo in human pancreatic ductal adenocarcinoma (PDAC). We engineered MECA79 coated nanoparticles (MECA79-NPs) that recognize these ectopic HEVs in PDAC. FINDINGS: The trafficking of MECA79-NPs following intravenous delivery to human PDAC implanted in a humanized mouse model was more robust than non-conjugated NPs. Treatment with MECA79-Taxol-NPs augmented the delivery of Paclitaxel (Taxol) to the tumor site and significantly reduced the tumor size. This effect was associated with a higher apoptosis rate of PDAC cells and reduced vascularization within the tumor. INTERPRETATION: Targeting the HEVs of PDAC using MECA79-NPs could lay the ground for the localized delivery of a wide variety of drugs including chemotherapeutic agents. FUND: National Institutes of Health (NIH) grants: T32-EB016652 (B·B.), NIH Cancer Core Grant CA034196 (L.D.S.), National Institute of Allergy and Infectious Diseases grants R01-AI126596 and R01-HL141815 (R.A.)