Editorial – Hypoxic-Ischemic Encephalopathy: Impact on Retinal Neurovascular Integrity and Function

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Astrophysical parameters of ten poorly studied open star clusters

We present here the fundamental parameters of ten open star clusters, nominated from Kronberger et al. (2006) who presented some new discovered stellar groups on the basis of 2MASS photometry and DSS visual images. Star counts and photometric parameters (radius, membership, distances, color excess, age, luminosity function, mass function, total mass, and the dynamical relaxation time) have been determined for these ten clusters for the first time. In order to calibrate our procedures, the main parameters (distance, age, and color excesses) have been re-estimated for another five clusters, which are studied by Kronberger et al. (2006) as well.Comment: 10 pages, 5 figures, 2 tables; accepted in "Research in Astronomy and Astrophysics Journal

Single-Visit Pulp Revascularization of a Nonvital Immature Permanent Tooth Using Biodentine

An 11-year-old female patient was referred with a chief complaint of pain in the right mandibular second premolar. Clinical and radiographic examinations showed secondary caries under an old composite restoration, a negative response to a pulp test and an immature root with an open apex. After root canal cleaning and shaping, bleeding was invoked in the canal up to 2 mm short of the cemento-enamel junction (CEJ). After 10 min to allow clotting at this level, a plug of Biodentine was placed over the blood clot and the tooth was temporized with glass ionomer cement. At the next visit, the tooth was free of symptoms and a permanent filling was placed. Clinical and radiographic examinations during a two-year follow-up showed complete root maturation and intact supporting soft tissues without sinus tract, pain or swelling. Conclusion: The use of Biodentine in a single-visit apexification protocol to treat an immature permanent tooth with necrotic pulp can create a suitable environment for revascularization, resulting in the completion of root maturation.Key Words:Biodentine; Immature Apex; Pulp Revascularization

Towards a strategy for malaria in pregnancy in Afghanistan: analysis of clinical realities and women's perceptions of malaria and anaemia.

BACKGROUND: Afghanistan has some of the worst maternal and infant mortality indicators in the world and malaria is a significant public health concern. Study objectives were to assess prevalence of malaria and anaemia, related knowledge and practices, and malaria prevention barriers among pregnant women in eastern Afghanistan. METHODS: Three studies were conducted: (1) a clinical survey of maternal malaria, maternal anaemia, and neonatal birthweight in a rural district hospital delivery-ward; (2) a case-control study of malaria risk among reproductive-age women attending primary-level clinics; and (3) community surveys of malaria and anaemia prevalence, socioeconomic status, malaria knowledge and reported behaviour among pregnant women. RESULTS: Among 517 delivery-ward participants (1), one malaria case (prevalence 1.9/1000), 179 anaemia cases (prevalence 346/1000), and 59 low-birthweight deliveries (prevalence 107/1000) were detected. Anaemia was not associated with age, gravidity, intestinal parasite prevalence, or low-birthweight at delivery. Among 141 malaria cases and 1010 controls (2), no association was found between malaria infection and pregnancy (AOR 0.89; 95 % CI 0.57-1.39), parity (AOR 0.95; 95 % CI 0.85-1.05), age (AOR 1.02; 95 % CI 1.00-1.04), or anaemia (AOR 1.00; 95 % CI 0.65-1.54). Those reporting insecticide-treated net usage had 40 % reduced odds of malaria infection (AOR 0.60; 95 % CI 0.40-0.91). Among 530 community survey participants (3), malaria and anaemia prevalence were 3.9/1000 and 277/1000 respectively, with 34/1000 experiencing severe anaemia. Despite most women having no formal education, malaria knowledge was high. Most expressed reluctance to take malaria preventive medication during pregnancy, deeming it potentially unsafe. CONCLUSIONS: Given the low malaria risk and reported avoidance of medication during pregnancy, intermittent preventive treatment is hard to justify or implement. Preventive strategy should instead focus on long-lasting insecticidal nets for all pregnant women

Cost-effectiveness of malaria diagnosis using rapid diagnostic tests compared to microscopy or clinical symptoms alone in Afghanistan

Background Improving access to parasitological diagnosis of malaria is a central strategy for control and elimination of the disease. Malaria rapid diagnostic tests (RDTs) are relatively easy to perform and could be used in primary level clinics to increase coverage of diagnostics and improve treatment of malaria.<p></p> Methods A cost-effectiveness analysis was undertaken of RDT-based diagnosis in public health sector facilities in Afghanistan comparing the societal and health sector costs of RDTs versus microscopy and RDTs versus clinical diagnosis in low and moderate transmission areas. The effect measure was ‘appropriate treatment for malaria’ defined using a reference diagnosis. Effects were obtained from a recent trial of RDTs in 22 public health centres with cost data collected directly from health centres and from patients enrolled in the trial. Decision models were used to compare the cost of RDT diagnosis versus the current diagnostic method in use at the clinic per appropriately treated case (incremental cost-effectiveness ratio, ICER).<p></p> Results RDT diagnosis of Plasmodium vivax and Plasmodium falciparum malaria in patients with uncomplicated febrile illness had higher effectiveness and lower cost compared to microscopy and was cost-effective across the moderate and low transmission settings. RDTs remained cost-effective when microscopy was used for other clinical purposes. In the low transmission setting, RDTs were much more effective than clinical diagnosis (65.2% (212/325) vs 12.5% (40/321)) but at an additional cost (ICER) of US$4.5 per appropriately treated patient including a health sector cost (ICER) of US$2.5 and household cost of US$2.0. Sensitivity analysis, which varied drug costs, indicated that RDTs would remain cost-effective if artemisinin combination therapy was used for treating both P. vivax and P. falciparum. Cost-effectiveness of microscopy relative to RDT is further reduced if the former is used exclusively for malaria diagnosis. In the health service setting of Afghanistan, RDTs are a cost-effective intervention compared to microscopy.<p></p> Conclusions RDTs remain cost-effective across a range of drug costs and if microscopy is used for a range of diagnostic services. RDTs have significant advantages over clinical diagnosis with minor increases in the cost of service provision.<p></p&gt

Adenosine Receptors Expression in Human Retina and Choroid with Age-related Macular Degeneration

Purpose: Adenosine signaling modulates ocular inflammatory processes, and its antagonism mitigates neovascularization in both newborns and preclinical models of ocular neovascularization including age-related macular degeneration (AMD). The adenosine receptor expression patterns have not been well characterized in the human retina and choroid. Methods: Here we examined the expression of adenosine receptor subtypes within the retina and choroid of human donor eyes with and without AMD. Antibodies specifically targeting adenosine receptor subtypes A1, A2A, A2B, and A3 were used to assess their expression patterns. Quantitative real-time PCR analysis was used to confirm gene expression of these receptors within the normal human retina and choroid. Results: We found that all four receptor subtypes were expressed in several layers of the retina, and within the retinal pigment epithelium and choroid. The expression of A1 receptors was more prominent in the inner and outer plexiform layers, where microglia normally reside, and supported by RNA expression in the retina. A2A and A2B showed similar expression patterns with prominent expression in the vasculature and retinal pigment epithelium. No dramatic differences in expression of these receptors were observed in eyes from patients with dry or wet AMD compared to control, with the exception A3 receptors. Eyes with dry AMD lost expression of A3 in the photoreceptor outer segments compared with eyes from control or wet AMD. Conclusion: The ocular presence of adenosine receptors is consistent with their proposed role in modulation of inflammation in both the retina and choroid, and their potential targeting for AMD treatment

A new monoclonal antibody detects downregulation of protein tyrosine phosphatase receptor type γ in chronic myeloid leukemia patients

Background: Protein tyrosine phosphatase receptor gamma (PTPRG) is a ubiquitously expressed member of the protein tyrosine phosphatase family known to act as a tumor suppressor gene in many different neoplasms with mechanisms of inactivation including mutations and methylation of CpG islands in the promoter region. Although a critical role in human hematopoiesis and an oncosuppressor role in chronic myeloid leukemia (CML) have been reported, only one polyclonal antibody (named chPTPRG) has been described as capable of recognizing the native antigen of this phosphatase by flow cytometry. Protein biomarkers of CML have not yet found applications in the clinic, and in this study, we have analyzed a group of newly diagnosed CML patients before and after treatment. The aim of this work was to characterize and exploit a newly developed murine monoclonal antibody specific for the PTPRG extracellular domain (named TPγ B9-2) to better define PTPRG protein downregulation in CML patients. Methods: TPγ B9-2 specifically recognizes PTPRG (both human and murine) by flow cytometry, western blotting, immunoprecipitation, and immunohistochemistry. Results: Co-localization experiments performed with both anti-PTPRG antibodies identified the presence of isoforms and confirmed protein downregulation at diagnosis in the Philadelphia-positive myeloid lineage (including CD34+/CD38bright/dim cells). After effective tyrosine kinase inhibitor (TKI) treatment, its expression recovered in tandem with the return of Philadelphia-negative hematopoiesis. Of note, PTPRG mRNA levels remain unchanged in tyrosine kinase inhibitors (TKI) non-responder patients, confirming that downregulation selectively occurs in primary CML cells. Conclusions: The availability of this unique antibody permits its evaluation for clinical application including the support for diagnosis and follow-up of these disorders. Evaluation of PTPRG as a potential therapeutic target is also facilitated by the availability of a specific reagent capable to specifically detect its target in various experimental conditions

Impact of health technology assessment implementation with a special focus on middle-income countries

Objectives Building an efficient health technology assessment (HTA) system requires significant effort and political commitment, in addition to human and financial resources. Expectations of what HTA can offer to middle-income countries (MICs) are continuously rising, which drives health policymakers to raise the question of whether HTA could help secure the financial sustainability needed to implement universal health coverage. In this study, we explored the impact HTA adoption may have on the countries and its impact on health system objectives, as well as transferability of benefits and drawbacks observed in higher-income to middle-income countries. Methods We utilized secondary data from a systematic literature review and primary data by disseminating a survey among local stakeholders in three MICs across three continents to capture their perspective on the impact of HTA implementation from a local context. Results It was evident from the results of both the literature review and survey that the positive impacts of HTA implementation outweigh the negative impacts. Most of the reviewed literature discussed the impact of HTA on the intermediate objectives of the health finance policy in relation to the broad health system goals. According to the survey respondents, the most evident benefit of HTA implementation is improving the transparency and accountability of healthcare decisions. Conclusions Overall, HTA implementation can introduce a myriad of benefits to healthcare systems in MICs as well. Our findings show that while HTA implementation may have the potential to generate cost savings in specific areas, there is no guarantee that HTA can generate savings at the macro level. Public Interest Summary Health technologies (medicines, devices, and interventions) are rapidly increasing in complexity and cost. Health Technology Assessment (HTA) guides healthcare decision-makers in choosing the most suitable, effective, affordable, and acceptable health technology to invest limited healthcare resources. However, healthcare decision-makers in middle-income countries (MICS) are still uncertain about whether adopting HTA would help them achieve the financial sustainability needed to achieve universal health coverage. Therefore we sought to gather evidence on how HTA has affected the health systems of countries that have already adopted it by reviewing published research reports. In addition, healthcare decision-makers from three MICs were questioned about their perception of how HTA implementation will affect their country's health system. We found that the positive effects of HTA implementation outweigh the negative ones; specifically, the transparency and accountability of decisions are improved. However, although HTA implementation may generate cost savings in specific areas, it may not significantly contribute to overall financial sustainability

Qualitative and quantitative analysis of solar hydrogen generation literature from 2001 to 2014

Solar hydrogen generation is one of the new topics in the field of renewable energy. Recently, the rate of investigation about hydrogen generation is growing dramatically in many countries. Many studies have been done about hydrogen generation from natural resources such as wind, solar, coal etc. In this work we evaluated global scientific production of solar hydrogen generation papers from 2001 to 2014 in any journal of all the subject categories of the Science Citation Index compiled by Institute for Scientific Information (ISI), Philadelphia, USA. Solar hydrogen generation was used as keywords to search the parts of titles, abstracts, or keywords. The published output analysis showed that hydrogen generation from the sun research steadily increased over the past 14 years and the annual paper production in 2013 was about three times 2010-paper production. The number of papers considered in this research is 141 which have been published from 2001 to this date. There are clear distinctions among author keywords used in publications from the five most high-publishing countries such as USA, China, Australia, Germany and India in solar hydrogen studies. In order to evaluate this work quantitative and qualitative analysis methods were used to the development of global scientific production in a specific research field. The analytical results eventually provide several key findings and consider the overview hydrogen production according to the solar hydrogen generation

Qualitative and quantitative analysis of solar hydrogen generation literature from 2001 to 2014

Solar hydrogen generation is one of the new topics in the field of renewable energy. Recently, the rate of investigation about hydrogen generation is growing dramatically in many countries. Many studies have been done about hydrogen generation from natural resources such as wind, solar, coal etc. In this work we evaluated global scientific production of solar hydrogen generation papers from 2001 to 2014 in any journal of all the subject categories of the Science Citation Index compiled by Institute for Scientific Information (ISI), Philadelphia, USA. Solar hydrogen generation was used as keywords to search the parts of titles, abstracts, or keywords. The published output analysis showed that hydrogen generation from the sun research steadily increased over the past 14 years and the annual paper production in 2013 was about three times 2010-paper production. The number of papers considered in this research is 141 which have been published from 2001 to this date. There are clear distinctions among author keywords used in publications from the five most high-publishing countries such as USA, China, Australia, Germany and India in solar hydrogen studies. In order to evaluate this work quantitative and qualitative analysis methods were used to the development of global scientific production in a specific research field. The analytical results eventually provide several key findings and consider the overview hydrogen production according to the solar hydrogen generation