A novel technique to repair orbital roof defects: irradiated homologous cadaveric rib (Tutoplast ®) graft in a recurrent frontal sinus ossifying fibroma

Ossifying fibroma in the fronto-ethmoidal sinuses is a rare, benign condition. In symptomatic cases, surgical excision is often undertaken and bony defects may be repaired using alloplastic grafts. We present a novel method of repairing an orbital roof defect using irradiated homologous cadaveric rib (Tutoplast ®) graft, overlaid with a pericranial flap. The patient made an excellent recovery, concluding that it is a viable and safe option with lower morbidity

On the triplet state of poly(N-vinylcarbazole)

Triplet state properties including transient triplet absorption spectrum, intersystem crossing yields in solution at room temperature and phosphorescence spectra, quantum yields and lifetimes at low temperature as well as singlet oxygen yields were obtained for poly(N-vinylcarbazole) (PVK) in 2-methyl-tetrahydrofuran (2-MeTHF), cyclohexane or benzene. The results allow the determination of the energy value for the lowest lying triplet state and also show that triplet formation and deactivation is a minor route for relaxation of the lowest excited singlet state of PVK. In addition, they show the triplet state is at higher energy than reported heavy metal dopants used for electrophosphorescent devices, such that if this is used as a host it will not quench their luminescence.http://www.sciencedirect.com/science/article/B6TFN-4DTTJJC-7/1/b605edb9859b607f1a9b1c1348af029

Differential Distribution of Ca2+-Activated K+ Channel Splice Variants among Hair Cells along the Tonotopic Axis of the Chick Cochlea

AbstractSummary We have cloned from the receptor epithelium of the chick cochlea a family of alternatively spliced cDNAs derived from cslo, which encodes a Ca2+-activated K+ channel like those shown to help determine the resonant frequency of electrically tuned hair cells. Our results from PCRs using template RNAs from both tonotopically subdivided receptor epithelia and single hair cells demonstrate differential exon usage along the frequency axis of the epithelium at multiple splice sites in cslo. We also show that single hair cells express more than one splice variant at a given splice site. Since channel isoforms encoded by differentially spliced slo transcripts in other species are functionally heterogeneous, these data suggest that differential processing of slo transcripts may account, at least in part, for the systematic variation in hair-cell membrane properties along the frequency axis of electrically tuned auditory receptor epithelia

Single and double reduction of C\u3csub\u3e60\u3c/sub\u3e in 2:1 γ-cyclodextrin/[60]fullerene inclusion complexes by cyclodextrin radicals

Spectroscopic and chemical properties of γ-CD• radicals, resulting from the abstraction by HO• radicals of hydrogen atoms, have been investigated using pulse radiolysis. The reactions of γ-CD• radicals with C60 in 2:1 γ-CD/C60 inclusion complexes have been studied in aqueous solutions. It has been demonstrated that the γ-CD_ radicals are reducing species producing C60•— monoanion radicals, as well as doubly reduced C602— , well characterized by their absorption spectra in the near IR. The oxidation potential of γ-CD• radical is estimated to be more negative than –390 mV vs. NHE. The kinetics of the C60 reduction by γ-CD• radicals have been determined and compared with kinetics by other reducing species including the solvated electron (e—aq) and CO2•— radicals. It was observed that the method of preparation of the 2:1 γ-CD/C60 inclusion complexes modifies the C60 reduction mechanism

Labour induction with prostaglandins: a systematic review and network meta-analysis

Abstract OBJECTIVES: To assess the effectiveness and safety of prostaglandins used for labour induction. DESIGN: Systematic review with Bayesian network meta-analysis DATA SOURCES: The Cochrane Pregnancy and Childbirth Group's Database of Trials (which incorporates the results of a broad generic search for all pregnancy and postpartum trials). Sources included are CENTRAL, Medline, Embase, NHS Economic Evaluation Database, CINAHL, relevant journals, conference proceedings, and registries of ongoing trials. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised clinical trials of prostaglandin or prostaglandin analogues used for third trimester cervical ripening or labour induction versus placebo or no treatment, alternative prostaglandin dose or administration, or a different type of prostaglandin. We included studies recruiting women with a viable fetus, but had no other restrictions relating to indication for labour induction or language of publication. Outcomes assessed were serious neonatal morbidity (trialist defined) or perinatal death; serious maternal morbidity (trialist defined) or death; vaginal delivery not achieved within 24 hours, caesarean section, and uterine hyperstimulation with fetal heart rate changes. RESULTS: 280 randomised clinical trials were included (48 068 women) in the review. Maternal and neonatal mortality and serious morbidity were rarely reported and are summarized narratively. Unresolved inconsistency was observed for the hyperstimulation outcome. Relative to placebo, the odds of failing to achieve a vaginal delivery were lowest for vaginal misoprostol (≥50 µg) (odds ratio 0.06 (95% credible interval 0.02 to 0.12)), with a 39% absolute probability of event (95% credible interval 1% to 94%). Compared with placebo, odds of caesarean section were lowest for titrated oral misoprostol solution

Estimating Nosocomial Infection and its Outcomes in Hospital Patients in England with a Diagnosis of COVID-19 Using Machine Learning

BACKGROUND: COVID-19 nosocomial infections (NIs) may have played a significant role in the dynamics of the pandemic in England, but analysis of their impact at the national scale has been lacking. Our aim was to provide a comprehensive account of NIs, identify their characteristics and outcomes in patients with a diagnosis of COVID-19 and use machine learning modelling to refine these estimates. METHODS: From the Hospital Episodes Statistics database all adult hospital patients in England with a diagnosis of COVID-19 and discharged between March 1st 2020 and March 31st 2021 were identified. A cohort of suspected COVID-19 NIs was identified using four empirical methods linked to hospital coding. A random forest classifier was designed to model the relationship between acquiring NIs and the covariates: patient characteristics, comorbidities, frailty, trust capacity strain and severity of COVID-19 infections. FINDINGS: In total, 374,244 adult patients with COVID-19 were discharged during the study period. The four empirical methods identified 29,896 (8.0%) patients with NIs. The random forest classifier estimated a mean NI rate of 10.5%, with a peak close to 18% during the first wave, but much lower rates thereafter and around 7% in early spring 2021. NIs were highly correlated with longer lengths of stay, high trust capacity strain, greater age and a higher degree of patient frailty. NIs were also found to be associated with higher mortality rates and more severe COVID-19 sequelae, including pneumonia, kidney disease and sepsis. INTERPRETATION: Identification of the characteristics of patients who acquire NIs should help trusts to identify those most at risk. The evolution of the NI rate over time may reflect the impact of changes in hospital management practices and vaccination efforts. Variations in NI rates across trusts may partly reflect different data recording and coding practice

Validation of the Baveno Vi Criteria to Identify Low Risk Cirrhotic Patients not Requiring Endoscopic Surveillance for Varices

BACKGROUND: The Baveno VI guidelines propose that cirrhotic patients with a liver stiffness measurement (LSM) 150000/μL can avoid screening endoscopy as their combination is highly specific for excluding clinically significant varices. The aim of the study was to validate these criteria. METHODS: Transient elastography data was collected from two institutions from 2006-2015. Inclusion criteria were a LSM ⩾10kPa and an upper gastrointestinal endoscopy within 12 months, with a diagnosis of compensated chronic liver disease. Exclusion criteria were porto-mesenteric-splenic vein thrombosis and non-cirrhotic portal hypertension. Varices were graded as low risk (grade 150) are at low risk of having varices and do not need a screening endoscopy. Varices are a complication of cirrhosis, confer a risk of serious bleeding, and can be diagnosed and treated by endoscopy. Our study reviewed the clinical records of patients who have had liver stiffness scans and endoscopy over a 9 year period at two hospitals. The results show that only about 2% of patients who meet the Baveno VI criteria will be miss classified as not having varices

Health on the Move (HOME) Study: Using a smartphone app to explore the health and wellbeing of migrants in the United Kingdom [version 1; peer review: 2 approved]

Background/Aim: We have a limited understanding of the broader determinants of health of international migrants and how these change over time since migration to the United Kingdom (UK). To address this knowledge gap, we aim to conduct a prospective cohort study with data acquisition via a smartphone application (app). In this pilot study, we aim to 1) determine the feasibility of the use of an app for data collection in international migrants, 2) optimise app engagement by quantifying the impact of specific design features on the completion rates of survey questionnaires and on study retention, 3) gather preliminary profile health status data, to begin to examine how risk factors for health are distributed among migrants. / Methods: We will recruit 275 participants through a social media campaign and through third sector organisations that work with or support migrants in the UK. Following consent and registration, data will be collected via surveys. To optimise app engagement and study retention, we will quantify the impact of specific design features (i.e. the frequency of survey requests, the time of day for app notifications, the frequency of notifications, and the wording of notifications) via micro-randomised process evaluations. The primary outcome for this study is survey completion rates with numerator as the number of surveys completed and denominator as the total number of available surveys. Secondary outcomes are study retention rates and ratings of interest after app usage. / Ethics and dissemination: We have obtained approval to use consented patient identifiable data from the University College London Ethics Committee. Improving engagement with the app and gathering preliminary health profile data will help us identify accessibility and usability issues and other barriers to app and study engagement prior to moving to a larger study

Virtual Support for Real-World Movement:Using Chatbots to Overcome Barriers to Physical Activity

Conversational agents (CAs, aka chatbots) for behavioral interventions have great potential to improve patient engagement and provide solutions that can benefit human health. In this study, we examined the potential efficacy of chatbots in assisting with the resolution of specific barriers that people frequently encounter when doing behavioral interventions for the purpose of increasing physical activity (PA). To do this, six common barriers (i.e., things that stand in the way of increasing PA) were targeted (e.g., stress and fatigue), we adopted domain knowledge (i.e., psychological theories and behavioral change techniques) to design six interventions aimed at tackling each of these six barriers. These interventions were then incorporated into consultative conversations, which were subsequently integrated into a chatbot. A user study was conducted on non-clinical samples (n=77) where all participants were presented with three randomly but equally distributed chatbot interventions and a control condition. Each intervention conversation addressed a specific barrier to PA, while the control conversation did not address any barrier. The outcome variables were beliefs in PA engagement, attitudes toward the effectiveness of each intervention to resolve the barrier, and the overall chatbot experience. The results showed a significant increase in beliefs of PA engagement in most intervention groups compared to the control group, and positive attitudes toward the effectiveness of the interventions in reducing their respective barriers to PA, and positive chatbot experience. The results demonstrate that theory-grounded interventions delivered by chatbots can effectively help people overcome specific barriers to PA, thereby increasing their beliefs in PA engagement. These promising findings indicate that chatbot interventions can be an accessible and widely applicable solution for a larger population to promote PA.</p