Is low amniotic fluid index an indicator of fetal distress and hence delivery?

Background: Amniotic fluid Index (AFI) is an indicator of fetal well-being. Low AFI is considered to be one of the indications for delivery as it may be associated with fetal distress and birth asphyxia. We sought to determine whether low AFI is an indicator of fetal compromise and an indication to deliver.Methods: This prospective, observational study was conducted at Department of Obstetrics & Gynecology, KMC, Manipal University, India, between August 2013 and Aug 2014. A total of 150 subjects that had induced labor or direct caesarean section for various indications and also having low-normal (5-8) / low (<5) AFI, were recruited. Subjects with fetal anomalies were excluded. Outcome variables studied were, fetal distress in labor, thick meconium stained amniotic fluid, mode of delivery in induced labor, perinatal asphyxia, and respiratory distress syndrome.Results: Out of 150 subjects, 68 (45.4%) had low and 82 (54.6%) had low-normal AFI. Both the groups were matched for demographic characteristics and confounding factors for neonatal outcome. In low AFI group the incidence of Low APGAR (11.7%), perinatal asphyxia (11.7%) and RDS (16.1%) were significantly higher compared to those in low-normal group (3.6%, 1.2% and 2.4% respectively) p = 0.057, 0.006 and 0.002. There was no significant difference between the groups with respect to mode of delivery when labor was induced.Conclusions: Low AFI, especially when it is <5, is an indicator of fetal compromise and one may anticipate perinatal asphyxia and RDS. Hence it is prudent to contemplate delivery when the AFI is between 5 and 8

Mental health stigma

Comparing self-reports to administrative records, we find that survey respondents are significantly more likely to under-report mental illnesses compared to other health conditions. This behavior is consistent with the existence of stigma of mental illnesses. We show that stigma can play a role in determining health-seeking behavior

Reappraisal of Contemporary Pharmacokinetic and Pharmacodynamic Principles for Informing Aminoglycoside Dosing

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147085/1/phar2193.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147085/2/phar2193_am.pd

Algorithmic Verification of Asynchronous Programs

Asynchronous programming is a ubiquitous systems programming idiom to manage concurrent interactions with the environment. In this style, instead of waiting for time-consuming operations to complete, the programmer makes a non-blocking call to the operation and posts a callback task to a task buffer that is executed later when the time-consuming operation completes. A co-operative scheduler mediates the interaction by picking and executing callback tasks from the task buffer to completion (and these callbacks can post further callbacks to be executed later). Writing correct asynchronous programs is hard because the use of callbacks, while efficient, obscures program control flow. We provide a formal model underlying asynchronous programs and study verification problems for this model. We show that the safety verification problem for finite-data asynchronous programs is expspace-complete. We show that liveness verification for finite-data asynchronous programs is decidable and polynomial-time equivalent to Petri Net reachability. Decidability is not obvious, since even if the data is finite-state, asynchronous programs constitute infinite-state transition systems: both the program stack and the task buffer of pending asynchronous calls can be potentially unbounded. Our main technical construction is a polynomial-time semantics-preserving reduction from asynchronous programs to Petri Nets and conversely. The reduction allows the use of algorithmic techniques on Petri Nets to the verification of asynchronous programs. We also study several extensions to the basic models of asynchronous programs that are inspired by additional capabilities provided by implementations of asynchronous libraries, and classify the decidability and undecidability of verification questions on these extensions.Comment: 46 pages, 9 figure

T-Cell Assays for Tuberculosis Infection: Deriving Cut-Offs for Conversions Using Reproducibility Data

Although interferon-gamma release assays (IGRA) are promising alternatives to the tuberculin skin test, interpretation of repeated testing results is hampered by lack of evidence on optimal cut-offs for conversions and reversions. A logical start is to determine the within-person variability of T-cell responses during serial testing.We performed a pilot study in India, to evaluate the short-term reproducibility of QuantiFERON-TB Gold In Tube assay (QFT) among 14 healthcare workers (HCWs) who underwent 4 serial QFT tests on day 0, 3, 9 and 12. QFT ELISA was repeated twice on the same sets of specimens. We assessed two types of reproducibility: 1) test-retest reproducibility (between-test variability), and 2) within-person reproducibility over time. Test-retest reproducibility: with dichotomous test results, extremely high concordance was noticed between two tests performed on the same sets of specimens: of the 56 samples, the test and re-test results agreed for all but 2 individuals (kappa = 0.94). Discordance was noted in subjects who had IFN-gamma values around the cut-off point, with both increases and decreases noted. With continuous IFN-gamma results, re-test results tended to produce higher estimates of IFN-gamma than the original test. Within-person reproducibility: when continuous IFN-gamma data were analyzed, the within-person reproducibility was moderate to high. While persons with negative QFT results generally stayed negative, positive results tended to vary over time. Our data showed that increases of more than 16% in the IFN-gamma levels are statistically improbable in the short-term.Conservatively assuming that long-term variability might be at least twice higher than short-term, we hypothesize that a QFT conversion requires two conditions to be met: 1) change from negative to positive result, and 2) at least 30% increase in the baseline IFN-gamma response. Larger studies are needed to confirm our preliminary findings, and determine the conversion thresholds for IGRAs

Quality and Reporting of Diagnostic Accuracy Studies in TB, HIV and Malaria: Evaluation Using QUADAS and STARD Standards

BackgroundPoor methodological quality and reporting are known concerns with diagnostic accuracy studies. In 2003, the QUADAS tool and the STARD standards were published for evaluating the quality and improving the reporting of diagnostic studies, respectively. However, it is unclear whether these tools have been applied to diagnostic studies of infectious diseases. We performed a systematic review on the methodological and reporting quality of diagnostic studies in TB, malaria and HIV.MethodsWe identified diagnostic accuracy studies of commercial tests for TB, malaria and HIV through a systematic search of the literature using PubMed and EMBASE (2004–2006). Original studies that reported sensitivity and specificity data were included. Two reviewers independently extracted data on study characteristics and diagnostic accuracy, and used QUADAS and STARD to evaluate the quality of methods and reporting, respectively.FindingsNinety (38%) of 238 articles met inclusion criteria. All studies had design deficiencies. Study quality indicators that were met in less than 25% of the studies included adequate description of[...] and description of the team executing the test and management of indeterminate/outlier results (both 17%). The use of STARD was not explicitly mentioned in any study. Only 22% of 46 journals that published the studies included in this review required authors to use STARD

Synthesis, Structure, Electrochemistry, and Spectral Characterization of Bis-Isatin Thiocarbohydrazone Metal Complexes and Their Antitumor Activity Against Ehrlich Ascites Carcinoma in Swiss Albino Mice

The synthesis, structure, electrochemistry, and biological studies of Co(II), Ni(II), Cu(II), and Zn(II) complexes of thiocarbohydrazone ligand are described. The ligand is synthesized starting from thiocarbohydrazide and isatin. It is evident from the IR data that in all the complexes, only one part of the ligand is coordinated to the metal ion resulting mononuclear complexes. The ligand coordinates essentially through the carbonyl oxygen of the isatin fragment, the nitrogen atom of the azomethine group, and sulfur atom after deprotonation to give five membered rings. H1 NMR spectrum of the ligand shows only one set of signals for the aromatic protons, while the NH of isatin and NH of hydrazone give rise to two different singlets in the 11–14 ppm range. The formulations, [Cu(L)Cl]·2H2O, [Cu(L)(CH3COO)]·2H2O, [Ni(L)Cl], [Ni(L)(CH3COO)], [Co(L2)], and [Zn(L2)]·2H2O are in accordance with elemental analyses, physical, and spectroscopic measurements. The complexes are soluble in organic solvents. Molar conductance values in DMF indicate the nonelectrolytic nature of the complexes. Copper complex displays quasireversible cyclic voltametric responses with Ep near −0.659 v and 0.504 v Vs Ag/AgCl at the scan rate of 0.1 V/s. Copper(II) complexes show a single line EPR signals. For the observed magnetic moment and electronic spectral data possible explanation has been discussed. From all the available data, the probable structures for the complexes have been proposed. The compounds synthesized in present study have shown promising cytotoxic activity when screened using the in vitro method and at the same time were shown to have good activity when tested using the Ehrlich ascites carcinoma (EAC) model. The antimicrobial screening showed that the cobalt complex possesses enhanced antimicrobial activity towards fungi

Unique gap structure and symmetry of the charge density wave in single-layer VSe2_2

Single layers of transition metal dichalcogenides (TMDCs) are excellent candidates for electronic applications beyond the graphene platform; many of them exhibit novel properties including charge density waves (CDWs) and magnetic ordering. CDWs in these single layers are generally a planar projection of the corresponding bulk CDWs because of the quasi-two-dimensional nature of TMDCs; a different CDW symmetry is unexpected. We report herein the successful creation of pristine single-layer VSe$_2$, which shows a ($\sqrt7 \times \sqrt3$) CDW in contrast to the (4 $\times$ 4) CDW for the layers in bulk VSe$_2$. Angle-resolved photoemission spectroscopy (ARPES) from the single layer shows a sizable ($\sqrt7 \times \sqrt3$) CDW gap of $\sim$100 meV at the zone boundary, a 220 K CDW transition temperature twice the bulk value, and no ferromagnetic exchange splitting as predicted by theory. This robust CDW with an exotic broken symmetry as the ground state is explained via a first-principles analysis. The results illustrate a unique CDW phenomenon in the two-dimensional limit

IN VITRO EVALUATION OF ANTICANCER POTENTIAL OF ERYTHRINA VARIEGATA L. ON BREAST CANCER CELL LINES

Objective: Species of Erythrina variegata L. is reported to be used in the treatment of cancer in traditional/folklore medicine which could be explored for their anticancer potential. We aimed to evaluate the anticancer activity of crude extracts of the leaves of E. variegata with two solvents; explore the mechanism of cytotoxicity with the effective extract and correlation with the phytochemicals in the extract.Methods: The extracts with Erythrina variegata L methanol (EVM) and chloroform (EVC) as solvents were screened for cytotoxicity by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium assay on MDA-MB-231 and MCF-7 cell lines. The effective extract was further evaluated on MDA-MB-231 cells by nucleoprotein content estimation, and cell morphology was studied. High resolution liquid chromatography mass spectrometry (HRLCMS) of EVM was done to find the phytochemical composition.Results: Among the two extracts, EVM was effective at an inhibitory concentration (IC50) value of 92 μg/ml and 143 μg/ml on MCF-7 and MDA-MB-231 cells, respectively. At the IC50 value (143 μg/ml) the nucleoprotein content of the cells was 58.2%, and the apoptotic index was calculated to be 51.8%. EVM treated group showed significant morphological changes suggestive of apoptosis. HRLCMS revealed the presence of rutin, podocarpatriene, and cepharanthine which are known to be cytotoxic.Conclusion: This report is a contribution toward the validation of E. variegata as a potential source of anticancer agents