A comparison of catabolic pathways induced in primary macrophages by pristine single walled carbon nanotubes and pristine graphene

Understanding the correlation between the physico-chemical properties of carbonaceous nanomaterials and how these properties impact on cells and subcelluar mechanisms is critical to their risk assessment and safe translation into newly engineered devices. Here the toxicity, uptake and catabolic response of primary human macrophages to pristine graphene (PG) and pristine single walled carbon nanotubes (pSWCNT) are explored, compared and contrasted. The nanomaterial toxicity was assessed using three complementary techniques (live-dead assay, real time impedance technique and confocal microscopic analysis), all of which indicated no signs of acute cytotoxicity in response to PG or pSWCNT. Transmission electron microscopy (TEM) demonstrated that PG was phagocytosed by the cells into single membrane lysosomal vesicles, whereas the primary macrophages exposed to pSWCNT contained many double membrane vesicles indicative of an autophagic response. These distinct catabolic pathways were further verified by biochemical and microscopic techniques. Raman spectroscopic mapping was used to explore the nanomaterial uptake and distribution. Based on the G-band, significant uptake and accumulation of the PG in discrete vesicles was recorded, whereas the pSWCNT were not taken up to the same extent. Thermogravimetric analysis (TGA) of the cells treated with PG revealed that ~ 20-30% of the remaining dry mass was made up of PG. No detectable amount of pSWCNT was recorded using TGA. TEM analysis confirmed that PG was still graphitic even after 24 hours of accumulation in the lysosomal compartments. In conclusion, these two nanomaterials with similar surface chemistries but unique geometries differ significantly in their uptake mechanisms and subsequently induced lysosomal and autophagic catabolic pathways in human primary macrophages

Asociación entre la cirugía de control de daños y las complicaciones postoperatorias en pacientes con trauma abdominal que llegan al servicio de trauma shock del Hospital Carlos Lanfranco La Hoz durante el periodo del 2021–2022

Introducción: El trauma abdominal es considerado una de las principales causas de muerte en todo el mundo y es que forman parte de los problemas de salud pública. Por lo cual, algunos de estos pacientes deben ser sometidos a abordaje quirúrgico de manera precoz, la cirugía de control de daños busca fundamentalmente mejorar la supervivencia de los pacientes que son sometidos a este tipo de manejo quirúrgico, además como toda cirugía se pueden presentar complicaciones postoperatorias. Objetivo: Determinar la asociación entre la cirugía de control de daños (CCD) y las complicaciones postoperatorias en pacientes con trauma abdominal que llegan al servicio de trauma shock del Hospital Carlos Lanfranco La Hoz. Métodos: Estudio de tipo observacional, analítico, retrospectivo y transversal, se recopiló la información de los pacientes que fueron sometidos a abordaje quirúrgico en el Hospital Carlos Lanfranco La Hoz durante el periodo 2021-2022, de las cuales la población fue de 135 pacientes y solo 42 de ellos fueron la muestra cuya información fue analizada mediante el software estadístico de STATA versión 17.0. Resultados: Los pacientes que presentaron complicaciones postoperatorias fueron del sexo masculino representados con el 55.6% (p=0.313) con una edad media de 33.9 ±11.14 años (p=0.770). En relación a las características del trauma y que tuvo complicaciones postoperatorias, el trauma abierto represento el 41.18% (p=0.003), además si hay compromiso de al menos de un órgano puede presentar complicaciones (p˂0.005). Finalmente, la prevalencia de complicaciones postoperatorias en los pacientes con manejo del trauma con la CCD fue 4.15 (RP: 4.15 IC95%: 1.38 – 12.4) veces prevalencia de presentar complicaciones postoperatorias en pacientes que tuvieron como manejo quirúrgico del trauma la laparotomía definitiva, siendo el resultado estadísticamente significativo (p=0.011). Conclusión: Los pacientes que son sometidos a la cirugía de control de daños tienen riesgo de presentar complicaciones postoperatorias independientemente a los factores asociados

Evaluation of the adverse drug reaction surveillance system Kadoma City, Zimbabwe 2015

Introduction: Medicines have the potential to cause adverse drug reactions and because of this Zimbabwe monitor reactions to medicines through the Adverse Drug Reaction Surveillance System. The Medicines Control Authority of Zimbabwe monitors reactions to medicines through the Adverse Drugs Reactions Surveillance System. The system relies on health professionals to report adverse drug reactions to maximize patient safety. We report results of an evaluation of the Adverse Drugs Reactions Surveillance System in Kadoma District.Methods: A descriptive crosssectional study was conducted using the updated CDC guidelines in six health facilities in Kadoma City. Data were collected using a pretested interviewer administered questionnaire, checklists and records review. Data was analyzed using Epi InfoTM to calculate frequencies and means. Qualitative data were analyzed manually. Written informed consent was obtained from all study participants.Results: The surveillance system did not meet up to its objectives as it failed to detect the adverse drug reactions and there was no monitoring of increases in known events. Fewer than half (43%) of the participants were aware of at least 2 objectives of the surveillance system but 83% of health workers willing to participate. However the system was not acceptable, 79% did not perceive the system to be necessary with the majority saying ''why should we fill in the forms when the reactions were already known or minor''. Though the system was supposed to identify potential patient risk factors for particular types of events health workers were reluctant to participate as evidenced by only one form filled out of 20 reactions experienced in the district. The system was simple as the notification form has 16 fields which require easily obtainable information from the patient records.Conclusion: The surveillance system was not useful and was not acceptable to health workers but was simple and stable. Health workers lacked knowledge. Sharing of results with the Medicines Control Authority of Zimbabwe through the Matrons facilitated training of health workers in Kadoma City. Health workers were encouraged to notify any drug reaction and to completely fill in the notification forms. Patients were also encouraged to report any drug reaction to health care workers.Keywords: Adverse drug reactions, surveillance system, Kadoma, Zimbabw

A review of paratuberculosis in dairy herds — Part 1: Epidemiology

Bovine paratuberculosis is a chronic infectious disease of cattle caused by Mycobacterium avium subspecies paratuberculosis (MAP). This is the first in a two-part review of the epidemiology and control of paratuberculosis in dairy herds. Paratuberculosis was originally described in 1895 and is now considered endemic among farmed cattle worldwide. MAP has been isolated from a wide range of non-ruminant wildlife as well as humans and non-human primates. In dairy herds, MAP is assumed to be introduced predominantly through the purchase of infected stock with additional factors modulating the risk of persistence or fade-out once an infected animal is introduced. Faecal shedding may vary widely between individuals and recent modelling work has shed some light on the role of super-shedding animals in the transmission of MAP within herds. Recent experimental work has revisited many of the assumptions around age susceptibility, faecal shedding in calves and calf-to-calf transmission. Further efforts to elucidate the relative contributions of different transmission routes to the dissemination of infection in endemic herds will aid in the prioritisation of efforts for control on farm

A review of paratuberculosis in dairy herds — Part 2: On-farm control

Bovine paratuberculosis is a chronic infectious disease of cattle, caused by Mycobacterium avium subspecies paratuberculosis (MAP). This is the second in a two-part review of the epidemiology and control of paratuberculosis in dairy herds. Several negative production effects associated with MAP infection have been described, but perhaps the most significant concern in relation to the importance of paratuberculosis as a disease of dairy cattle is the potential link with Crohn’s disease in humans. Milk is considered a potential transmission route to humans and it is recognised that pasteurisation does not necessarily eliminate the bacterium. Therefore, control must also include reduction of the levels of MAP in bulk milk supplied from dairy farms. There is little field evidence in support of specific control measures, although several studies seem to show a decreased prevalence associated with the implementation of a combined management and test-and-cull programme. Improvements in vaccination efficacy and reduced tuberculosis (TB) test interference may increase uptake of vaccination as a control option. Farmer adoption of best practice recommendations at farm level for the control of endemic diseases can be challenging. Improved understanding of farmer behaviour and decision making will help in developing improved communication strategies which may be more efficacious in affecting behavioural change on farm

International ResearchKit app for women with menstrual pain : development, access, and engagement

Background: Primary dysmenorrhea is a common condition in women of reproductive age. A previous app-based study undertaken by our group demonstrated that a smartphone app supporting self-acupressure introduced by a health care professional can reduce menstrual pain. Objective: This study aims to evaluate whether a specific smartphone app is effective in reducing menstrual pain in 18- to 34-year-old women with primary dysmenorrhea in a self-care setting. One group of women has access to the full-featured study app and will be compared with 2 control groups who have access to fewer app features. Here, we report the trial design, app development, user access, and engagement. Methods: On the basis of the practical implications of the previous app-based study, we revised and reengineered the study app and included the ResearchKit (Apple Inc) framework. Behavior change techniques (BCTs) were implemented in the app and validated by expert ratings. User access was estimated by assessing recruitment progress over time. User evolution and baseline survey respondent rate were assessed to evaluate user engagement. Results: The development of the study app for a 3-armed randomized controlled trial required a multidisciplinary team. The app is accessible for the target population free of charge via the Apple App Store. In Germany, within 9 months, the app was downloaded 1458 times and 328 study participants were recruited using it without external advertising. A total of 98.27% (5157/5248) of the app-based baseline questions were answered. The correct classification of BCTs used in the app required psychological expertise. Conclusions: Conducting an innovative app study requires multidisciplinary effort. Easy access and engagement with such an app can be achieved by recruitment via the App Store. Future research is needed to investigate the determinants of user engagement, optimal BCT application, and potential clinical and self-care scenarios for app use

The Eleventh and Twelfth Data Releases of the Sloan Digital Sky Survey: Final Data from SDSS-III

The third generation of the Sloan Digital Sky Survey (SDSS-III) took data from 2008 to 2014 using the original SDSS wide-field imager, the original and an upgraded multi-object fiber-fed optical spectrograph, a new near-infrared high-resolution spectrograph, and a novel optical interferometer. All of the data from SDSS-III are now made public. In particular, this paper describes Data Release 11 (DR11) including all data acquired through 2013 July, and Data Release 12 (DR12) adding data acquired through 2014 July (including all data included in previous data releases), marking the end of SDSS-III observing. Relative to our previous public release (DR10), DR12 adds one million new spectra of galaxies and quasars from the Baryon Oscillation Spectroscopic Survey (BOSS) over an additional 3000 deg2 of sky, more than triples the number of H-band spectra of stars as part of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE), and includes repeated accurate radial velocity measurements of 5500 stars from the Multi-object APO Radial Velocity Exoplanet Large-area Survey (MARVELS). The APOGEE outputs now include the measured abundances of 15 different elements for each star. In total, SDSS-III added 5200 deg2 of ugriz imaging; 155,520 spectra of 138,099 stars as part of the Sloan Exploration of Galactic Understanding and Evolution 2 (SEGUE-2) survey; 2,497,484 BOSS spectra of 1,372,737 galaxies, 294,512 quasars, and 247,216 stars over 9376 deg2; 618,080 APOGEE spectra of 156,593 stars; and 197,040 MARVELS spectra of 5513 stars. Since its first light in 1998, SDSS has imaged over 1/3 of the Celestial sphere in five bands and obtained over five million astronomical spectra. \ua9 2015. The American Astronomical Society

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden