Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM. Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group. Results: Echocardiography images indicated severe diastolic dysfunction in patients with DD+DM and DD compared to DM or control patients. In the DM and DM+DD groups, TNFα, isoprostane, and leptin were elevated compared to control (p\u3c0.05), as were clinical markers HDL, glucose and hemoglobin A1C. Fibrotic markers IGFBP7 and TGF-β followed the same trend. The Control group showed higher beneficial levels of adiponectin and bilirubin, which were reduced in the DM and DM+DD groups (p\u3c0.05). Conclusion: The results from our study support the clinical application of biomarkers in diagnosing early stage DCM, which will enable attenuation of disease progression prior to the onset of irreversible complications

Can Homeopathic Arsenic Remedy Combat Arsenic Poisoning in Humans Exposed to Groundwater Arsenic Contamination?: A Preliminary Report on First Human Trial

Groundwater arsenic (As) has affected millions of people globally distributed over 20 countries. In parts of West Bengal (India) and Bangladesh alone, over 100 million people are at risk, but supply of As-free water is grossly inadequate. Attempts to remove As by using orthodox medicines have mostly been unsuccessful. A potentized homeopathic remedy, Arsenicum Album-30, was administered to a group of As affected people and thereafter the As contents in their urine and blood were periodically determined. The activities of various toxicity marker enzymes and compounds in the blood, namely aspartate amino transferase, alanine amino transferase, acid phosphatase, alkaline phosphatase, lipid peroxidation and reduced glutathione, were also periodically monitored up to 3 months. The results are highly encouraging and suggest that the drug can alleviate As poisoning in humans

Improved phase estimation based on complete bispectrum and modified group delay

In this paper, a new method for extracting the system phase from the bispectrum13; of the system output has been proposed. This is based on the complete bispectral data13; computed in the frequency domain and modified group delay. The frequency domain13; bispectrum computation improves the frequency resolution and the modified group delay13; reduces the variance preserving the frequency resolution. The use of full bispectral data13; also reduces the variance as it is used for averaging. For the proposed method at a signal13; to noise ratio of 5dB, the reduction in root mean square error is in the range of 1.5 to 713; times over the other methods considered

Bivariate positive stable frailty models

This article describes inference for dependent multivariate times-to-events using a bivariate positive stable frailty model with a Weibull baseline hazard. Suitable Markov chain Monte Carlo algorithms facilitate Bayesian inference. The method is illustrated using a study conducted by the Air Force Research Laboratory on times to symptoms of decompression sickness in human subjects.

Ashy Dermatosis: A Controversial Entity

We present here the case of a young Indian male with slowly progressive, diffuse darkening of the face, arms, neck, and trunk. The patient was not taking any medication and there was no history of any previous skin disease and the mucous membrane was not involved. These findings are consistent with a diagnosis for ashy dermatosis of unknown etiology

Design, fabrication and characterisation of silica-titania thin film coated over coupled long period fibre gratings: Towards bio-sensing applications

In this paper we report on the application of over coupled long period fibre gratings (OCLPFGs) for detecting small changes in the surrounding refractive index (SRI). In addition, the optimization of a high RI(HRI) overlay deposited over the fibre for the adhesion of biological species is described. In this study, we utilised a sol-gel-based silica-titania thin film as HRI material deposited on the grating portion using the simple and versatile dip-coating (DC) technique. The OCLPFG-based sensor has been manufactured in such a way that the resonant band retains good visibility (close to the maximum coupling condition) in the transmission spectrum even after high thermal sintering of the coating material. Three different batches of OCLPFGs were produced using different withdrawal speeds and sol viscosities. By carefully tuning both the overlay thickness during the DC process and the RI of the sol-gel material during its preparation, it was possible to bring the sensor into the so-called transition mode working region, and thus maximize the sensing performance in terms of SRI changes. All devices were characterized as optical refractometers in the RI range of interest for a bio-sensing application (from 1.33 to 1.34) and, after a suitable bio-functionalisation process, one of them was used to implement a classical receptor-analyte biosensor. (C) 2017 Elsevier B.V. All rights reserved

Sol–Gel-Based Titania–Silica Thin Film Overlay for Long Period Fiber Grating-Based Biosensors

An evanescent wave optical fiber biosensor based on titania–silica-coated long period grating (LPG) is presented. The chemical overlay, which increases the refractive index (RI) sensitivity of the sensor, consists of a sol–gel-based titania–silica thin film, deposited along the sensing portion of the fiber by means of the dip-coating technique. Changing both the sol viscosity and the withdrawal speed during the dip-coating made it possible to adjust the thickness of the film overlay, which is a crucial parameter for the sensor performance. After the functionalization of the fiber surface using a methacrylic acid/methacrylate copolymer, an antibody/antigen (IgG/anti-IgG) assay was carried out to assess the performance of sol–gel based titania–silica-coated LPGs as biosensors. The analyte concentration was determined from the wavelength shift at the end of the binding process and from the initial binding rate. This is the first time that a sol–gel based titania–silica-coated LPG is proposed as an effective and feasible label-free biosensor. The specificity of the sensor was validated by performing the same model assay after spiking anti-IgG into human serum. With this structured LPG, detection limits of the order of tens of micrograms per liter (10^–11 M) are attained

In their own words: Safety and quality perspectives from families of hospitalized children with medical complexity

BACKGROUND: Children with medical complexity (CMC) experience adverse events due to multiorgan impairment, frequent hospitalizations, subspecialty care, and dependence on multiple medications/equipment. Their families are well-versed in care and can help identify safety/quality gaps to inform improvements. Although previous studies have shown families identify important safety/quality gaps in hospitals, studies of inpatient safety/quality experience of CMC and their families are limited. To address this gap and identify otherwise unrecognized, family-prioritized areas for improving safety/quality of CMC, we conducted a secondary qualitative analysis of safety reporting surveys among families of CMC. OBJECTIVE: Explore safety reports from families of hospitalized CMC to identify areas to improve safety/quality. DESIGNS, SETTINGS AND PARTICIPANTS: We analyzed free-text responses from predischarge safety reporting surveys administered to families of CMC at a quaternary children\u27s hospital from April 2018 to November 2020. Using a qualitative descriptive approach, we categorized responses into standard clinical categories. Three team members inductively generated an initial codebook to apply iteratively to responses. Reviewers coded responses collaboratively, resolved discrepancies through consensus, and generated themes. MAIN OUTCOME AND MEASURES: Outcomes: family-reported areas of safety/quality improvement. MEASURES: pre-discharge family surveys. RESULTS: Two hundred and eight/two hundred and thirty-seven (88%) families completed surveys; 83 families offered 138 free-text safety responses about medications, feeds, cares, and other categories. Themes included unmet expectations of hospital care/environment, lack of consistency, provider-patient communication lapses, families\u27 expertise about care, and the value of transparency. CONCLUSION: To improve care of CMC and their families, hospitals can manage expectations about hospital limitations, improve consistency of care/communication, acknowledge family expertise, and recognize that family-observed quality concerns can have safety implications. Soliciting family input can help hospitals improve care in meaningful, otherwise unrecognized ways