94 research outputs found
Evaluation of fetomaternal outcome in pregnancies complicated by heart disease: our experience at a tertiary care centre
Background: Heart disease is an important cause of indirect maternal deaths accounting for 20% of all cases, complicating approximately 1% of all pregnancies. During pregnancy, increased cardiac demands potentially increase morbidity and mortality in women with underlying heart disease. This study illustrates the fetomaternal outcome in pregnancies complicated by heart disease.Methods: This study is a prospective observational study which was carried out from December 2013 to August 2015 at a tertiary care teaching hospital of armed forces India. A total of forty four pregnant women with heart disease were attended during the study period. Various parameters were used to measure maternal outcome like preterm labour, cesarean delivery, congestive cardiac failure, maternal mortality, while fetal outcome was measured in terms of low birth weight, prematurity, intrauterine growth restriction, perinatal mortality and intrauterine death.Results: A total of 7545 pregnant women delivered during the study period, of which 94 were patients with heart disease giving a prevalence of 1.2%. Acquired valvular heart lesions were found in 61 patients (64.9%) with mitral valve being the commonest valve affected in 69 patients (73.4%), others were congenital. Of the group, 89 patients were in NYHA class I and 05 in NYHA class II. Majority, 44 patients (46.8%) delivered vaginally while 31 patients (33%) underwent a cesarean delivery and 30 babies (31.9%) were low birth weight. There was no neonatal mortality. Maternal mortality was low (1.1%), while 43 (45.7%) had obstetric complications.Conclusions: Multidisciplinary team approach involving obstetrician, neonatologist, cardiologist and anesthesiologist led to the favorable outcome in our study. Key determinant of adverse fetomaternal outcome was the poor functional class of NYHA
Entangled Photon Pair Source Demonstrator using the Quantum Instrumentation Control Kit System
We report the first demonstration of using the Quantum Instrumentation and
Control Kit (QICK) system on RFSoCFPGA technology to drive an entangled photon
pair source and to detect the photon signals. With the QICK system, we achieve
high levels of performance metrics including coincidence-to-accidental ratio
exceeding 150, and entanglement visibility exceeding 95%, consistent with
performance metrics achieved using conventional waveform generators. We also
demonstrate simultaneous detector readout using the digitization functional of
QICK, achieving internal system synchronization time resolution of 3.2 ps. The
work reported in this paper represents an explicit demonstration of the
feasibility for replacing commercial waveform generators and time taggers with
RFSoC-FPGA technology in the operation of a quantum network, representing a
cost reduction of more than an order of magnitude
Neuroprotection in a Novel Mouse Model of Multiple Sclerosis
The authors acknowledge the support of the Barts and the London Charity, the Multiple Sclerosis Society of Great Britain and Northern Ireland, the National Multiple Sclerosis Society, USA, notably the National Centre for the Replacement, Refinement & Reduction of Animals in Research, and the Wellcome Trust (grant no. 092539 to ZA). The siRNA was provided by Quark Pharmaceuticals. The funders and Quark Pharmaceuticals had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Picosecond Synchronization of Photon Pairs through a Fiber Link between Fermilab and Argonne National Laboratories
We demonstrate a three-node quantum network for C-band photon pairs using 2
pairs of 59 km of deployed fiber between Fermi and Argonne National
Laboratories. The C-band pairs are directed to nodes using a standard
telecommunication switch and synchronized to picosecond-scale timing resolution
using a coexisting O- or L-band optical clock distribution system. We measure a
reduction of coincidence-to-accidental ratio (CAR) of the C-band pairs from 51
2 to 5.3 0.4 due to Raman scattering of the O-band clock pulses.
Despite this reduction, the CAR is nevertheless suitable for quantum networks
Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND). a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension
Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. Methods: ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18β58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3Β·0β6Β·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3Β·0β5Β·5 vs 6Β·0β6Β·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Findings: Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0Β·86; 95% CI 0Β·66β1Β·13; p=0Β·287). No treatment effect was observed on the EDSS (OR 1Β·06, 95% CI 0Β·74β1Β·53; nominal p=0Β·753) or the T25FW (0Β·98, 0Β·74β1Β·30; nominal p=0Β·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0Β·56, 95% CI 0Β·40β0Β·80; nominal p=0Β·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108β221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Interpretation: Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Funding: Biogen
Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography:an international expert consensus
The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0β5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management. Graphical abstract: [Figure not available: see fulltext.]
Are Compression Stockings an Effective Treatment for Orthostatic Presyncope?
Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant comorbidity. Many syncopal events occur secondary to excessive venous pooling and capillary filtration in the lower limbs when upright. As such, a common approach to the management of syncope is the use of compression stockings. However, research confirming their efficacy is lacking. We aimed to investigate the effect of graded calf compression stockings on orthostatic tolerance
Ameliorative Effects of Dimetylthiourea and N-Acetylcysteine on Nanoparticles Induced Cyto-Genotoxicity in Human Lung Cancer Cells-A549
We study the ameliorative potential of dimetylthiourea (DMTU), an OHβ’ radical trapper and N-acetylcysteine (NAC), a glutathione precursor/H2O2 scavenger against titanium dioxide nanoparticles (TiO2-NPs) and multi-walled carbon nanotubes (MWCNTs) induced cyto-genotoxicity in cultured human lung cancer cells-A549. Cytogenotoxicity was induced by exposing the cells to selected concentrations (10 and 50 Β΅g/ml) of either of TiO2-NPs or MWCNTs for 24 h. Anti-cytogenotoxicity effects of DMTU and NAC were studied in two groups, i.e., treatment of 30 minutes prior to toxic insult (short term exposure), while the other group received DMTU and NAC treatment during nanoparticles exposure, i.e., 24 h (long term exposure). Investigations were carried out for cell viability, generation of reactive oxygen species (ROS), micronuclei (MN), and expression of markers of oxidative stress (HSP27, CYP2E1), genotoxicity (P53) and CYP2E1 dependent n- nitrosodimethylamine-demethylase (NDMA-d) activity. In general, the treatment of both DMTU and NAC was found to be effective significantly against TiO2-NPs and MWCNTs induced cytogenotoxicity in A549 cells. Long-term treatment of DMTU and NAC during toxic insults has shown better prevention than short-term pretreatment. Although, cells responded significantly to both DMTU and NAC, but responses were chemical specific. In part, TiO2-NPs induced toxic responses were mediated through OHβ’ radicals generation and reduction in the antioxidant defense system. While in the case of MWCNTs, adverse effects were primarily due to altering/hampering the enzymatic antioxidant system. Data indicate the applicability of human lung cancer cells-A549 as a pre-screening tool to identify the target specific prophylactic and therapeutic potential of drugs candidate molecules against nanoparticles induced cellular damages
Attribution of 2022 early-spring heatwave in India and Pakistan to climate change: lessons in assessing vulnerability and preparedness in reducing impacts
In March 2022, large parts over the north Indian plains including the breadbasket region, and southern Pakistan began experiencing prolonged heat, which continued into May. The event was exacerbated due to prevailing dry conditions in the region, resulting in devastating consequences for public health and agriculture. Using event attribution methods, we analyse the role of human-induced climate change in altering the chances of such an event. To capture the extent of the impacts, we choose March-April average of daily maximum temperature over the most affected region in India and Pakistan as the variable. In observations, the 2022 event has a return period of ~1-in-100 years. For each of the climate models, we then calculate the change in probability and intensity of a 1-in-100 year event between the actual and counterfactual worlds for quantifying the role of climate change. We estimate that human-caused climate change made this heatwave about 1Β°C hotter and 30 times more likely in the current, 2022 climate, as compared to the 1.2 Β°C cooler, pre-industrial climate. Under a future global warming of 2Β°C above pre-industrial levels, heatwaves like this are expected to become even more common (2β20 times more likely) and hotter (by 0-1.5Β°C) compared to now. Stronger and frequent heat waves in the future will impact vulnerable groups as conditions in some regions exceed limits for human survivability. Therefore, mitigation is essential for avoiding loss of lives and livelihood. Heat Action Plans (HAPs) have proved effective to help reduce heat-related mortality in both countries
- β¦