Nano-Enriched Self-Powered Wireless Body Area Network for Sustainable Health Monitoring Services

Advances in nanotechnology have enabled the creation of novel materials with specific electrical and physical characteristics. This leads to a significant development in the industry of electronics that can be applied in various fields. In this paper, we propose a fabrication of nanotechnology-based materials that can be used to design stretchy piezoelectric nanofibers for energy harvesting to power connected bio-nanosensors in a Wireless Body Area Network (WBAN). The bio-nanosensors are powered based on harvested energy from mechanical movements of the body, specifically the arms, joints, and heartbeats. A suite of these nano-enriched bio-nanosensors can be used to form microgrids for a self-powered wireless body area network (SpWBAN), which can be used in various sustainable health monitoring services. A system model for an SpWBAN with an energy harvesting-based medium access control protocol is presented and analyzed based on fabricated nanofibers with specific characteristics. The simulation results show that the SpWBAN outperforms and has a longer lifetime than contemporary WBAN system designs without self-powering capability

A meta-review of meta-analyses and an updated meta-analysis on the efficacy of chloroquine and hydroxychloroquine in treating COVID19 infection

Objective: To synthesize the findings presented in systematic reviews and meta-analyses as well as to update the evidence using a meta-analysis in evaluating the efficacy and safety of CQ and HCQ with or without Azithromycin for the treatment of COVID19 infection.Methods: The design of this meta-review followed the Preferred Reporting Items for Overviews of Systematic Reviews including harms checklist (PRIO-harms). A comprehensive search included several electronic databases in identifying all systematic reviews and metaanalyses as well as experimental studies which investigated the efficacy and safety of CQ, HCQ with or without antibiotics as COVID19 treatment. Findings from the systematic reviews and meta-analyses were reported using a structured summary including tables and forest plots. The updated meta-analysis of experimental studies was carried out using the distributional assumption-free quality effects model. Risk of bias was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool for reviews and the MethodologicAl STandard for Epidemiological Research (MASTER) scale for the experimental studies. The main outcome for both the meta-review and the updated meta-analysis was mortality. Secondary outcomes included transfer to the intensive care unit (ICU) or mechanical ventilation, worsening of illness, viral clearance and the occurrence of adverse events. Results: A total of 13 reviews with 40 primary studies comprising 113,000 participants were included. Most of the primary studies were observational (n=27) and the rest were experimental studies. Two meta-analyses reported a high risk of mortality with similar ORs of 2.5 for HCQ with Azithromycin. However, four other meta-analyses reported contradictory results with two reporting a high risk of mortality and the other two reporting no significant association between HCQ with mortality. Most reviews reported that HCQ with or without Azithromycin had no significant effect on virological cure, disease exacerbation or the risk of transfer to the ICU, need for intubation or mechanical ventilation. After exclusion of studies that did not meet the eligibility criteria, the updated meta-analysis contained eight experimental studies (7 RCTs and 1 quasiexperimental trial), with a total of 5279 participants of whom 1856 were on either CQ/HCQ or combined with Azithromycin. CQ/HCQ with or without Azithromycin was significantly associated with a higher risk of adverse events. HCQ was not effective in reducing mortality transfer to the ICU, intubation or need for mechanical ventilation virological cure (RR 1.0, 95%CI 0.9-1.2, I2 =55%, n=5 studies) nor disease exacerbation (RR 1.2, 95%CI 0.3-5.0, I2 =29%, n=3 studies). Conclusion: There is conclusive evidence that CQ and HCQ, with or without Azithromycin are not effective in treating COVID-19 or its exacerbation

Characterizing the morbid genome of ciliopathies

Background Ciliopathies are clinically diverse disorders of the primary cilium. Remarkable progress has been made in understanding the molecular basis of these genetically heterogeneous conditions; however, our knowledge of their morbid genome, pleiotropy, and variable expressivity remains incomplete. Results We applied genomic approaches on a large patient cohort of 371 affected individuals from 265 families, with phenotypes that span the entire ciliopathy spectrum. Likely causal mutations in previously described ciliopathy genes were identified in 85% (225/265) of the families, adding 32 novel alleles. Consistent with a fully penetrant model for these genes, we found no significant difference in their “mutation load” beyond the causal variants between our ciliopathy cohort and a control non-ciliopathy cohort. Genomic analysis of our cohort further identified mutations in a novel morbid gene TXNDC15, encoding a thiol isomerase, based on independent loss of function mutations in individuals with a consistent ciliopathy phenotype (Meckel-Gruber syndrome) and a functional effect of its deficiency on ciliary signaling. Our study also highlighted seven novel candidate genes (TRAPPC3, EXOC3L2, FAM98C, C17orf61, LRRCC1, NEK4, and CELSR2) some of which have established links to ciliogenesis. Finally, we show that the morbid genome of ciliopathies encompasses many founder mutations, the combined carrier frequency of which accounts for a high disease burden in the study population. Conclusions Our study increases our understanding of the morbid genome of ciliopathies. We also provide the strongest evidence, to date, in support of the classical Mendelian inheritance of Bardet-Biedl syndrome and other ciliopathies

Road Trauma in Teenage Male Youth with Childhood Disruptive Behavior Disorders: A Population Based Analysis

Donald Redelmeier and colleagues conducted a population-based case-control study of 16-19-year-old males hospitalized for road trauma or appendicitis and showed that disruptive behavior disorders explained a significant amount of road trauma in this group

33. Two dimensional and M-mode measurements of tricuspid annular systolic plane excursion, are they comparable?

Right ventricular (RV) function has been shown to be a major determinant of clinical outcome. American Society of Echocardiography (ASE) recommends using several measurements to assess RV function including tricuspid annular systolic plane excursion (TAPSE). Conventionally, TAPSE is measured from M-mode interrogation of tricuspid annulus in 4-chamber view which was not routine measurement in many echocardiographic laboratories prior to the guidelines. In this study we sought to determine the feasibility to measure TAPSE from 2-dimensional echo (2D-TAPSE) and to compare it with that obtained by M-mode (MM-TAPSE). Methods: We included 45 patients referred for RV function assessment. MM-TAPSE measurements were obtained from routinely performed echocardiography. 2D TAPSE measurements were obtained offline by an experienced echocardiologist. It was calculated as the difference in the distance between tricuspid annular plane and a fixed point in the image sector in diastole and systole. Results: The mean age was 34.9 ± 13 years, males were 46%. The 2D-TAPSE measurements were feasible in all the patients (100%). MM-TAPSE was 2.05 ± 0.49 cm and 2D-TAPSE was 1.96 ± 0.47 cm, the mean difference was −0.08 ± 0.2 cm. There was good correlation between the two methods; the correlation coefficient was 0.81. Intra-class correlation (ICC) test also showed very good agreement between MM-TAPSE and 2D-TAPSE (ICC coefficient = 0.90, p < 0.001). Conclusion: MM-TAPSE and 2D-TAPSE correlate strongly. 2D-TAPSE can provide a reliable alternative to MM-TAPSE to quantitatively measure RV systolic function and may be especially useful in situations where retrospective comparisons are sought

Endoscopic retrieval of 195 incidentally found ingested magnets in a pediatric patient: The limitations of radiography

Key Clinical Message Ingestion of magnetic foreign bodies in children can present elusively on radiographs, requiring detailed history for accurate intervention guidance. Clustering and the weight of multiple magnets may indicate falsely distal positions in the GI tract

Endoscopic retrieval of 195 incidentally found ingested magnets in a pediatric patient: The limitations of radiography

Publication status: PublishedKey Clinical Message: Ingestion of magnetic foreign bodies in children can present elusively on radiographs, requiring detailed history for accurate intervention guidance. Clustering and the weight of multiple magnets may indicate falsely distal positions in the GI tract

Proximal congenital esophageal stenosis associated with tracheo-esophageal fistula

Congenital esophageal stenosis (ces) and Tracheo-esophageal fistula are rare types of congenital anomalies who have its origin in the embryological development of the trachea and the esophagus at the sixth and seventh weeks of gestation. These anomalies are often not diagnosed until months or sometimes years after birth. In this article we present you an unusual type of proximal CES combined with TEF at the same level of stenosis that was diagnosed in 5th day of life