Tests for predicting complications of pre-eclampsia: A protocol for systematic reviews

Background Pre-eclampsia is associated with several complications. Early prediction of complications and timely management is needed for clinical care of these patients to avert fetal and maternal mortality and morbidity. There is a need to identify best testing strategies in pre eclampsia to identify the women at increased risk of complications. We aim to determine the accuracy of various tests to predict complications of pre-eclampsia by systematic quantitative reviews. Method We performed extensive search in MEDLINE (1951–2004), EMBASE (1974–2004) and also will also include manual searches of bibliographies of primary and review articles. An initial search has revealed 19500 citations. Two reviewers will independently select studies and extract data on study characteristics, quality and accuracy. Accuracy data will be used to construct 2 × 2 tables. Data synthesis will involve assessment for heterogeneity and appropriately pooling of results to produce summary Receiver Operating Characteristics (ROC) curve and summary likelihood ratios. Discussion This review will generate predictive information and integrate that with therapeutic effectiveness to determine the absolute benefit and harm of available therapy in reducing complications in women with pre-eclampsia

Oesophageal candidiasis in an immunocompetent adult, an adverse effect of antibiotic therapy following cardiac surgery: Case report and review of literature

Dysphagia following cardiac surgery is a frequently encountered problem, being most commonly due to the sternotomy incision and/or prolonged intubation. Oesophageal candidiasis is an increasing problem that is usually associated with immunosuppression or immunodeficiency. We report a 59 years age, immunocompetent lady whom had developed dysphagia and odynophagia following open cardiac surgery and long term course of antibiotics. Diagnosis of Candida oesophagitis was established after radiological, endoscopic and microbiological evidence, and successful treatment with combined topical and systemic antifungal therapy was achieved. Possibility of immunodeficiency was excluded. We believe that this lady developed oesophageal candidiasis due to a long term course of broad spectrum antibiotics. We discuss the various diagnostic modalities and treatment options

Evaluation of toxicity and neural uptake in vitro and in vivo of superparamagnetic iron oxide nanoparticles

Superparamagnetic iron oxide nanoparticles (SPIO-NPs) have great potential to be used in different pharmaceutical applications, due to their unique and versatile physical and chemical properties. The aim of this study was to quantify in vitro cytotoxicity of dextran 70,000-coated SPIO-NPs labelled/unlabelled with rhodamine 123, in C6 glioma cells and primary hippocampal neural cells. In addition, we analyzed the in vitro and in vivo cellular uptake of labelled SPIO-NPs. The nanoparticles, with average size of 10⁻50 nm and polydispersity index of 0.37, were synthesized using Massart's co-precipitation method. The concentration-dependent cytotoxicity was quantified by using tetrazolium dye 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). Intracellular localization of SPIO-NPs was detected by confocal laser microscopy. In vivo confocal neuroimaging (ICON) was performed on male Wistar rats after intravitreal injection followed by ex vivo retina whole mount analysis. When used for in vitro testing concentrations in the range of diagnostic and therapeutic dosages, SPIO-NPs proved to be non-cytotoxic on C6 glioma cells for up to 24 h incubation time. The hippocampal cell culture also did not show impaired viability at low doses after 24 h incubation. Our results indicate that our dextran-coated SPIO-NPs have the potential for in vivo drug delivery applications

Antimicrobial activity analysis of extracts of Acacia modesta, Artimisia absinthium, Nigella sativa and Saussurea lappa against Gram positive and Gram negative microorganisms

Antimicrobial activity of extracts of certain herbs including Acacia modesta (leaf and stem), Artimisia absinthium (leaf and stem), Nigella sativa (seeds) and i (root) was evaluated against three Gram positive and two Gram negative microorganisms. The Gram positive organisms included Bacillus subtalis (ATCC 6633), Entereococcus faecalis (ATCC 14506) and Staphylococcus aureus (ATCC 6538) and the Gram negative organisms included Pseudomonas aeruginosa (ATCC 27853) and Salmonella typhi (ATCC 14028). Methanolic, hot water and cold water extracts of these plants were taken for antibacterial assay through Discs agar diffusion technique using commercial filter paper discs applied on inoculated Muellar Hinton agar plates. The objective of this study was to explore the curative powers of these herbs that exist in nature as a tool to counter disease causing agents. The maximum zone of inhibition of 18 mm of methanolic extract of N. sativa was observed against B. subtalis and S. aureus. Similarly, the maximum zone of inhibition of 18 mm of cold water extract of N. sativa against S. aureus and methanolic extract of Saussurea lappa against S. aureus and Pseudomonas aeruginosa was also observed. The antibacterial action was compared with the effect of ceftriaxone, ceftriaxone sodium, cefuroxine, ciprofloxacin, gentamycine, levofloxacin, metronidazole and tranexamic acid that were used as standered drugs. Based on the results obtained in this study, it may be concluded that plant extracts of A. modesta, A. absinthium, N. sativa and Saussurea lappa have a stronger and broader spectrum of antimicrobial activity against a number of food borne bacteria.Key words: Herbs, methanolic extract, Acacia modesta, Bacillus subtalis, gentamycine, gram negative, gram positive

How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

Background Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses. To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. Methods We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. Results Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. Conclusion There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect

Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic review

Background Proteinuria is one of the essential criteria for the clinical diagnosis of pre-eclampsia. Increasing levels of proteinuria is considered to be associated with adverse maternal and fetal outcomes. We aim to determine the accuracy with which the amount of proteinuria predicts maternal and fetal complications in women with pre-eclampsia by systematic quantitative review of test accuracy studies. Methods We conducted electronic searches in MEDLINE (1951 to 2007), EMBASE (1980 to 2007), the Cochrane Library (2007) and the MEDION database to identify relevant articles and hand-search of selected specialist journals and reference lists of articles. There were no language restrictions for any of these searches. Two reviewers independently selected those articles in which the accuracy of proteinuria estimate was evaluated to predict maternal and fetal complications of pre-eclampsia. Data were extracted on study characteristics, quality and accuracy to construct 2 × 2 tables with maternal and fetal complications as reference standards. Results Sixteen primary articles with a total of 6749 women met the selection criteria with levels of proteinuria estimated by urine dipstick, 24-hour urine proteinuria or urine protein:creatinine ratio as a predictor of complications of pre-eclampsia. All 10 studies predicting maternal outcomes showed that proteinuria is a poor predictor of maternal complications in women with pre-eclampsia. Seventeen studies used laboratory analysis and eight studies bedside analysis to assess the accuracy of proteinuria in predicting fetal and neonatal complications. Summary likelihood ratios of positive and negative tests for the threshold level of 5 g/24 h were 2.0 (95% CI 1.5, 2.7) and 0.53 (95% CI 0.27, 1) for stillbirths, 1.5 (95% CI 0.94, 2.4) and 0.73 (95% CI 0.39, 1.4) for neonatal deaths and 1.5 (95% 1, 2) and 0.78 (95% 0.64, 0.95) for Neonatal Intensive Care Unit admission. Conclusion Measure of proteinuria is a poor predictor of either maternal or fetal complications in women with pre-eclampsia

Certified high-efficiency "large-area" perovskite solar cells module for Fresnel lens-based concentrated photovoltaic

This is the author accepted manuscript. The final version is available on open access from Cell Press via the DOI in this recordData availability: All data generated or analysed during this study are included in the Supplementary Information article and its data source. Source data are provided in this paper. All data reported in this paper will be shared by the lead contact upon request.The future of energy generation is well in tune with the critical needs of the global economy, leading to more green innovations and emissions-abatement technologies. Introducing concentrated photovoltaic (CPV) is one of the most promising technologies owing to its high photo-conversion efficiency (PCE). While most researchers use silicon and cadmium telluride for CPV, we investigate the potential in nascent technologies, such as perovskite solar cell (PSC). This work constitutes a preliminary investigation into a ‘large-area’ PSC module under a Fresnel lens (FL) with a ‘refractive optical concentrator-silicon-on-glass’ base to minimise the PV performance and scalability trade-off concerning the PSCs. The FL-PSC system measured the solar current-voltage characteristics in variable lens-to-cell distances and illuminations. A systematic study of the PSC module temperature was monitored using the COMSOL transient heat transfer mechanism. The FL-based technique for ‘large-area’ PSC architecture is an unfolded technology that further facilitates the potential for commercialisation.Engineering and Physical Sciences Research Council (EPSRC)Valais Energy Demonstrators FundEuropean Union Horizon 2020Deputyship for Research & Innovation, Ministry of Education, Saudi Arabi

Performance of Anaerobic Co‑digestion of Pig Slurry with Pineapple (Ananas comosus) Bio‑waste Residues

Agro-food industries produce large amounts of bio-waste, challenging innovative valorisation strategies in the framework of circular economy principles. Anaerobic digestion technology is an interesting route to stabilise organic matter and produce biogas as a renewable energy source. This paper aimed to study the optimal performance conditions for anaerobic co-digestion (AcoD) of pig slurry with pineapple (Ananas comosus) peel bio-waste. The anaerobic digestion (AD) trials were performed at lab scale, in a continuous stirred reactor, for 16 days’ hydraulic retention time in mesophilic conditions (37 ± 1 °C). Three hydraulic retention time were performed, one for the reference scenario ( T0) and two for AcoD trials ( T1, T2). Feeding mixtures (20:80; v:v) of pineapple peel liquor and pig slurry, with an OLR of 1.46 ± 0.04 g TVS L− 1 reactor day− 1 were used during AD/AcoD trials, presenting high values for soluble chemical oxygen demand and C/N ratio. This operational conditions highlight bioenergy recovery up to 0.58 L CH4 g TVSadded −1, in comparison with that obtained with pig slurry substrate (0.31 L CH4 g VSadded −1). The AD performance showed a total volatile solids and chemical oxygen demand removal efficiency of 23% to 47% and 26% to 48%, comparing T0 with the average of T1 and T2, respectively. The digester stability, evaluated by specific energetic loading rate, was below the limit (0.4 day−1) throughout the trials. Pig slurry co-digestion with pineapple peel liquor seems to be a promising approach for potential bioenergy recovery.info:eu-repo/semantics/publishedVersio

A comparison of nutritional intake and daily physical activity of girls aged 8-11 years old in Makkah, Saudi Arabia according to weight status

Abstract Background Obesity rates in Saudi Arabia are amongst the highest in the world. It is known that teenage girls are less active than teenage boys, but less is known about the diet and activity patterns in younger girls. Therefore this study sought to investigate dietary intake and daily physical activity in girls aged 8-11 years old in Saudi Arabia. Methods This was a cross- sectional observational study conducted in seven schools across the city of Makkah. A total of 266 girls had anthropometric measurements taken including height, weight, waist circumference and body fat estimations. Dietary assessment using a 4 day unweighed diet diary was undertaken in 136 of these participants, and 134 agreed to monitor their physical activity for the 4 days using an accelerometer. After exclusion for under-reporting, 109 remained in the dietary analysis and 78 in the physical activity analyses. Differences in means between BMI groups were determined using one-way ANOVA with post hoc Tukey test. Multivariable linear regression analysis was performed to look at the effect of multiple variables on body weight. Results A total of 30% of participants were classified obese or overweight. There was a significant difference in the mean daily energy intake between the BMI groups with the obese group having the highest energy, fat, carbohydrate and protein intake (obese group: 2677 ± 804 kcal/d; healthy weight group: 1806 ± 403 kcal/d, p < 0.001), but the percentage contribution of the macronutrients to energy intake remained the same across the BMI groups. There were no differences in number of steps taken per day or time spent in moderate to vigorous intensity exercise according to BMI category. Most of the girls did not meet daily physical activity guidelines (5969 to 6773 steps per day and 18.5 - 22.5 mins per day of moderate to vigorous activity). Multiple linear regression showed that energy intake positively predicted body weight (Beta = 0.279, p =0 .001), whereas, total energy expenditure per kg of body weight and family income had a significant negative influence on body weight (Beta = −0.661, p < 0.001; −0.131, p = 0.028 respectively). Conclusions The results of this cross sectional analysis suggest that obesity in girls aged 8-11 years is linked to excessive energy intake from all macronutrients and the majority of girls in all weight categories are inactive. Research should be conducted to further investigate causal relationships in longitudinal studies and develop interventions to promote dietary change and activity that is culturally acceptable for girls in Saudi Arabia

Prognostic Impacts of Angiopoietins in NSCLC Tumor Cells and Stroma: VEGF-A Impact Is Strongly Associated with Ang-2

INTRODUCTION: Angiopoietins and their receptor Tie-2 are, in concert with VEGF-A, key mediators in angiogenesis. This study evaluates the prognostic impact of all known human angiopoietins (Ang-1, Ang-2 and Ang-4) and their receptor Tie-2, as well as their relation to the prognostic expression of VEGF-A. METHODS: 335 unselected stage I-IIIA NSCLC-patients were included and tissue samples of respective tumor cells and stroma were collected in tissue microarrays (TMAs). Immunohistochemistry (IHC) was used to semiquantitatively evaluate the expression of markers in duplicate tumor and stroma cores. PRINCIPAL FINDINGS: In univariate analyses, low tumor cell expression of Ang-4 (P = 0.046) and low stromal expressions of Ang-4 (P = 0.009) and Ang-2 (P = 0.017) were individually associated with a poor survival. In the multivariate analysis, low stromal Ang-2 (HR 1.88; CI 95% 1.15-3.08) and Ang-4 (HR 1.47, CI 95% 1.02-2.11, P = 0.04) expressions were independently associated with a poor prognosis. In patients with high tumor cell expression of Ang-2, a concomitantly high tumor VEGF-A expression mediated a dramatic survival reduction (P<0.001). In the multivariate analysis of patients with high Ang-2 expression, high tumor VEGF-A expression appeared an independent poor prognosticator (HR 6.43; CI 95% 2.46-16.8; P<0.001). CONCLUSIONS: In tumor cells, only Ang-4 expression has prognostic impact in NSCLC. In tumor stroma, Ang-4 and Ang-2 are independently associated with survival. The prognostic impact of tumor cell VEGF-A in NSCLC appears strongly associated with a concomitantly high tumor cell expression of Ang-2