Delivering a large cohort simulation - Beginning nursing students' experience: A pre-post survey

Background: The use of simulation has been growing rapidly within nursing programs, internationally. Simulation provides opportunity for beginning nursing students to rehearse patient care experiences and develop confidence in technical and non-technical nursing skills

Modelling the effect of aerosol polydispersity on unipolar charging and measurement in low-cost sensors

Low-cost ultrafine aerosol sensors are experimentally calibrated with controlled aerosol sources to provide metrics such as surface area, lung-deposited surface area, mean particle size and/or total concentration from one or more electrical current measurements. However, an aerosol with a large standard deviation in particle size provides a significantly different signal from a monodisperse aerosol with the same median particle size. In this paper, we investigate the effect of particle polydispersity on measurements in devices which employ unipolar charging. The conservation equations are solved for particle/ion charging and transport (convection, diffusion and electrical transport) in laminar, steady-state, incompressible flow. Lognormal particle size distributions are represented by over coupled conservation equations for multiple size bins and discrete charge states and solved numerically for the first time. Modelling results show that integrated electrical current from a polydisperse particle distribution can be represented by a monodisperse distribution characterised by the count mean diameter ( ; unipolar diffusion charging) or diameter of the average surface ( ; photoelectric charging) and total concentration, for a large range of particle distributions and operating conditions offering a convenient simplification for the interpretation of ultrafine particle measurements. The simplification reduces the number of simultaneous conservation equations required, thereby reducing computation time by up to 57 times for a polydisperse particle distribution represented by 16 discrete size bins. The method of analysis is useful to both users and developers of low-cost ultrafine particle sensors to understand the effect of particle polydispersity on measurements.Alphasense Ltd

Study of Thyroid Function in Children with Attention Deficit Hyperactivity Disorder and Aggressive Behavior

Background: Attention deficit hyperactivity disorder (ADHD) is a well recognized psychiatric disorder of childhood. Its cause is unknown, but there is evidence of familial predisposition. Symptoms suggestive of the disorder have been reported in patients with generalized resistance to thyroid hormones (GRTH), a disease caused by a mutation in the thyroid receptor beta gene and characterized by reduced responsiveness of peripheral and pituitary tissues to thyroid hormone actions. Aim of the Work: This study was conducted to assess the frequency of thyroid hormone abnormalities in children with ADHD and/or aggressive behavior and to relate these abnormalities to the type of behavioral disorder. Patient and Methods: Thirty cases with behavioral disorders (ADHD and/or aggression) diagnosed by DSM-IV classification were studied in comparison to 10 age-and sex-matched healthy controls. Clinical examination and psychiatric evaluation including IQ and psychosocial assessment were done to all patients. Measurement of serum free triiodothyronine (fT3), free tetraiodothyronine (fT4) and thyrotropin (TSH) was done to cases and controls. Results: There was a significantly lower IQ (

Gastrointestinal Tuberculosis Mimicking Crohn’s Disease

We present the case of a 24-year-old woman with complaints of abdominal pain, bloody diarrhea, and weight loss for 3 months. An outpatient colonoscopy revealed scattered ulcers, suggestive of Crohn's disease (CD). Histopathology also favored the diagnosis of CD. However, after admission to our hospital for further investigation, a chest radiograph revealed pulmonary cavitations. A computed tomography scan suggested the diagnosis of active pulmonary tuberculosis (TB). Therefore, a bronchofibroscopy, a total colonoscopy with ileoscopy, and an upper endoscopy were performed. Not only were acid-fast bacilli present in both bronchoalveolar lavage fluid and gastric juice, but also in colonic biopsies. A complete resolution of gastrointestinal symptoms was achieved 2 weeks after starting anti-TB drugs.info:eu-repo/semantics/publishedVersio

Sixteen years of bathymetry and waves at San Diego beaches.

Sustained, quantitative observations of nearshore waves and sand levels are essential for testing beach evolution models, but comprehensive datasets are relatively rare. We document beach profiles and concurrent waves monitored at three southern California beaches during 2001-2016. The beaches include offshore reefs, lagoon mouths, hard substrates, and cobble and sandy (medium-grained) sediments. The data span two energetic El Niño winters and four beach nourishments. Quarterly surveys of 165 total cross-shore transects (all sites) at 100 m alongshore spacing were made from the backbeach to 8 m depth. Monthly surveys of the subaerial beach were obtained at alongshore-oriented transects. The resulting dataset consists of (1) raw sand elevation data, (2) gridded elevations, (3) interpolated elevation maps with error estimates, (4) beach widths, subaerial and total sand volumes, (5) locations of hard substrate and beach nourishments, (6) water levels from a NOAA tide gauge (7) wave conditions from a buoy-driven regional wave model, and (8) time periods and reaches with alongshore uniform bathymetry, suitable for testing 1-dimensional beach profile change models

Does the immune reaction cause malignant transformation by disrupting cell-to-cell or cell-to-matrix communications?

Tumor progression: In many (perhaps in all) tumor systems, a malignant cancer is preceded by a benign lesion. Most benign lesions do not transform to malignancy and many regress. The final transformative step to malignancy differs from the preceding steps in, among other things, that it often occurs in the absence of the original carcinogenic stimulus. Mechanism of immunostimulation: Relatively low titers of specific immune reactants are known to stimulate, but cell-to-cell or cell-to-matrix interactions appear to be major inhibitors of tumor-growth. Therefore, it seems reasonable to hypothesize that the mechanism of immunostimulation may be an interference with cell-to-cell or cell-to-matrix communication by a sub-lethal immune-reaction. Discussion: While the above hypothesis remains unproven, some evidence suggests that immunity may have a major facilitating effect on tumor growth especially at the time of malignant transformation. There is even some evidence suggesting that transformation in vivo may seldom occur in the absence of immunostimulation of the premalignant lesion. Positive selection by the immune reaction may be the reason that tumors are immunogenic

The influence of perfusion solution on renal graft viability assessment

BACKGROUND: Kidneys from donors after cardiac or circulatory death are exposed to extended periods of both warm ischemia and intra-arterial cooling before organ recovery. Marshall’s hypertonic citrate (HOC) and Bretschneider’s histidine-tryptophan-ketoglutarate (HTK) preservation solutions are cheap, low viscosity preservation solutions used clinically for organ flushing. The aim of the present study was to evaluate the effects of these two solutions both on parameters used in clinical practice to assess organ viability prior to transplantation and histological evidence of ischemic injury after reperfusion. METHODS: Rodent kidneys were exposed to post-mortem warm ischemia, extended intra-arterial cooling (IAC) (up to 2 h) with preservation solution and reperfusion with either Krebs-Hensleit or whole blood in a transplant model. Control kidneys were either reperfused directly after retrieval or stored in 0.9% saline. Biochemical, immunological and histological parameters were assessed using glutathione-S-transferase (GST) enzymatic assays, polymerase chain reaction and mitochondrial electron microscopy respectively. Vascular function was assessed by supplementing the Krebs-Hensleit perfusion solution with phenylephrine to stimulate smooth muscle contraction followed by acetylcholine to trigger endothelial dependent relaxation. RESULTS: When compared with kidneys reperfused directly post mortem, 2 h of IAC significantly reduced smooth muscle contractile function, endothelial function and upregulated vascular cellular adhesion molecule type 1 (VCAM-1) independent of the preservation solution. However, GST release, vascular resistance, weight gain and histological mitochondrial injury were dependent on the preservation solution used. CONCLUSIONS: We conclude that initial machine perfusion viability tests, including ischemic vascular resistance and GST, are dependent on the perfusion solution used during in situ cooling. HTK-perfused kidneys will be heavier, have higher GST readings and yet reduced mitochondrial ischemic injury when compared with HOC-perfused kidneys. Clinicians should be aware of this when deciding which kidneys to transplant or discard

Post-neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Background: Tetanus is a public health problem in Nigeria. This study examines the demographic and clinical profile of postneonatal tetanus (PNT) seen in University of Maiduguri Teaching Hospital (UMTH), North- eastern Nigeria.Methods: This is a hospital-based prospective study of PNT. All childrenbeyond the neonatal period to 14 years of age admitted into the Paediatrics unit of UMTH, Maiduguri from June 2009 to July2011 with the diagnosis of PNT were studied.Results: A total of 39 cases of PNT were admitted over the period underreview. The male: female ratio was 2.3:1.0. Their ages at presentationranged between 16 months and 14 years, with mean +SD of 6.9+3.87 years. Over 90 percent of the children were either not immunizedagainst tetanus or their immunization status was unknown and onlytwo of the children were fully immunized. No booster immunizationwas received by any of the eligible children. The portal of entry of the infection was injury to the lower limbs and otogenic route in 53.9% and 33.3% respectively. Majority of patients were of low socioeconomicstatus. The duration of hospital stay ranged between 1-50 days with mean + SD (18.68+ 11.51).The mortality rate was (7)18 %.Conclusion: Tetanus still remains a major cause of childhood morbidityand mortality in Nigeria. Severe disease and the first one week of admission are the main variables identified to influence outcome.Therefore, there is need to strengthen routine immunization and booster doses of tetanus toxoid (TT) should be mandatory at primary and secondary school entry. Close monitoring of patients with severe tetanus during the critical period is imperative for successful management

The Influence of Gestational Age on the Loss of Maternal Measles Antibodies in Newborn Infants in North-Eastern Nigeria: A Call for a Review of Measles Immunization Schedule

Background: Maternal measles antibodies (MMA) are actively transferred in mother-infant pairs during third trimester of pregnancy. Gestational age (GA) affects the levels of MMA such that longer GA may result in infants starting out with high levels of MMA.Objective: To determine the influence of GA on the loss of MMA in newborn infants in North-Eastern Nigeria.Method: A prospective study was conducted on newborn infants at Maiduguri; sera were collected at birth and at six months of age. Enzyme linked immunosorbent assay (ELISA) was used to measure MMA while GA was determined using the last menstrual period, ultrasound scan reports and the Dubowitz criteria.Results: Seventy eight newborn infants were enrolled. Seventeen (89.5 %) preterm, 43 (95.6 %) term and 14 (100 %) postterm had protective levels of MMA at birth. Two (10.5 %) preterm, nine (20.0%) term and two (14.3 %) postterm had protective MMA at six months of age. Comparison of mean MMA at birth and at six months of age was significant (p = 0.005), however, it was independent of GA of the newborn infants.Conclusion: Significant decline of mean MMA levels was seen in these infants at six months of age, which was independent of their GA. These infants may be prone to measles at an earlier age (less than six months). Therefore, the current recommendation of measles immunization to infants at nine months of age may require reconsideration

Immunostimulation and Immunoinhibition of Premalignant Lesions

BACKGROUND: The immune reaction may be either stimulatory or inhibitory to tumor growth, depending upon the local ratio of immune reactants to tumor cells. HYPOTHESIS: A tumor-stimulatory immune response may be essential for survival of a neoplasm in vivo and for the biological progression from a premalignant lesion to a malignancy. Neither a positive nor a negative correlation between the magnitude of an immune-cell infiltrate and a cancer's prognosis can reveal whether the infiltrate was stimulating or inhibiting to the tumor's growth unless the position on the nonlinear curve that relates tumor growth to the magnitude of the immune reaction is known. DISCUSSION: This hypothesis is discussed in relation to the development of human malignant melanomas and colorectal cancers