Citizens can and should be involved in the process of shaping economic policy

Economics has long been tainted by the label ‘the dismal science’ and an image of grey haired old men poring over statistics, but could there ever be a ‘citizens economics’? Here, Reema Patel discusses a new RSA project which seeks to create just that, and an event which aims to contribute to its creation

Multimodality Therapy Improves Survival in Intramedullary Spinal Cord Metastasis of Lung Primary

Background: Most metastatic spinal cord lesions are located either in the intradural, extramedullary, or in the epidural compartments. Intramedullary spinal cord metastasis (ISCM) is a rare central nervous system spread of cancer. The aim of this report was to evaluate ISCM in the published literature. Methods: A literature review of PubMed from 1960 to 2016 was undertaken for the publications having demographic, clinical, histological, and outcome data. Results: A total of 59 relevant papers were identified, showing 128 cases of intramedullary metastasis from lung cancer. The incidence of lung cancer as the primary malignancy with intramedullary metastasis was 56%. The median time from diagnosis of primary to intramedullary metastasis was 6 months. Survival improved with multimodality therapy compared to monotherapy (4 months vs. 6.3 months) (hazard ratio = 0.501; 95% confidence interval, 0.293–0.857). Conclusion: Lung cancer is the predominant cause of intramedullary involvement of the spinal cord. Overall prognosis is poor, although a multimodality approach was associated with improved survival

Early Detection and Timely Reporting of Non-Mumps Etiologies of Parotitis: An Example in Developing Clinical and Public Health Partnerships

Background. Parotitis, or inflammation of the parotid gland, is most notably known as a characteristic symptom of mumps virus infection. Although instances of parotid inflammation with a variety of non-mumps viral etiologies have been described in medical literature, parotitis is a rarely reported complication of influenza virus infection. Ongoing communication between the clinical community and public health partners was essential for the early detection and reporting of the increased occurrence of parotitis cases associated with non-mumps etiologies. Methods. On 10 December 2014, a university health center notified the Indiana State Department of Health (ISDH) regarding a case of parotitis in a patient fully vaccinated with measles/mumps/rubella (MMR) vaccine. On 22 December 2014, the ISDH was notified of two additional cases of parotitis in pediatric patients who tested positive for influenza A and were fully vaccinated with MMR. Recognizing that parotitis may be an unusual symptom associated with circulating 2014-2015 respiratory viruses, the ISDH contacted the Centers for Disease Control and Prevention (CDC) on 22 December 2014 and other Midwest states on 8 January 2015 to determine whether cases of parotitis associated with respiratory viral infection were occurring outside of Indiana. There was interest among the Midwest states to pursue case finding, which resulted in a multi-state investigation of parotitis cases spearheaded by CDC. Results. Between December 2014 and February 2015, 20 cases of parotitis in Indiana were confirmed positive for respiratory viral etiologies other than mumps, namely influenza A, parainfluenza 2 and 3, adenovirus, enterovirus/rhinovirus, coronavirus OC 43 and herpes simplex virus 1. Conclusion. The early detection and timely reporting of unusual occurrences of parotitis and the subsequent case finding efforts are indicative of well-developed communication between clinical and public health partners. Partnerships among the clinical community, state health departments and the CDC are critical to exploring novel disease presentations

The Epidemiology, Etiology and Short Term Visual Outcome of Paediatric Ocular Emergencies in Tertiary Care Centre

Background: Vision development is a complex system that requires the development of neuro ocular pathways and depends on proper visual stimulation of both eyes.Paediatric age group is more vulnerable to ocular injuries and any damage to eyesight will result in affecting the child in their growth and development. Aims: To Study the patterns of ocular emergencies in Indian paediatric populationand its short term visual outcome. Setting and Design: Observational study, analytical study carried out for a period of two years. Data collection from August 2017 to September 2019including demographic profile, place ofinjury, type of health care facility first sought, time delay in first treatment, pattern of ocular injury on Birmingham Eye Trauma Terminology System (classification), treatment given by us, and best corrected visual acuity (BCVA). Results: Mean age of patients is 7.79 ± 2.53 years with 105 (60%) male patients and 70 (40%) female patients. In traumatic injuries children between the age of 7 and 10 years constituted the largest group accounting for 62.7 %(94/150) of total patients. 50.2% were from urban population. 50.7% of total cases contacted first sought treatment at tertiary health facility. Mean definitive treatment time interval (23.30 ± 8.04 h) was significantly higher when patients sought primary care at Primary health facility or private health facility first rather than coming directly to the tertiary care centre (15.70 ± 5.20 h). 58% (n=87) of total injuries were due to blunt objects. At the end of 2 months 92.6% of closed globe injury cases had VA of 6/18 or better. Conclusion: Majority of paediatric ocular emergencies are traumatic in nature, more in 7-10 years age group with equal rural and urban distribution. Most of the injuries were sustained in domestic environment

Phytonanofabrication of iron oxide particles from the Acacia jacquemontii plant and their potential application for the removal of brilliant green and Congo red dye from wastewater

Phytonanofabrication is one of the most promising areas that has drawn the attention of scientists worldwide due to its eco-friendly nature and biocompatibility. In the current investigation, we reported the phyto-assisted formation of iron oxide nanoparticles (IONPs) from a rare species of Acacia (Acacia jacquemontii). First, ethanolic extracts of the stem powder were analyzed by high-performance thin-layer chromatography (HPTLC) for the identification of phytochemicals in the stem sections of Acacia. Furthermore, IONPs were synthesized by a chemical co-precipitation method by using the stem extract. The phytonanofabricated iron oxide particles were investigated by UV–Vis spectroscopy, Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), and Energy-dispersive X-ray spectroscopy (EDS) for elemental analysis. HPTLC confirmed the presence of several phenols and terpenoids in the ethanolic extracts of the stem. UV–Vis spectroscopy exhibited an absorbance peak at 380 nm, indicating the formation of IONPs, while FTIR spectroscopy showed the typical bands for Fe-O in the range of 599–1,000 cm−1 in addition to several functional groups of organic molecules at 1,596 cm−1, 2,313 cm−1, and 3,573 cm−1. XRD exhibits the amorphous nature of IONPs with peaks at 30.7, 35.5, and 62.7 nm. The IONPs were spherical-shaped, whose size varies from 10 to 70 nm, as confirmed by FESEM. EDS exhibited the presence of Fe, O, C, and NaCl. Finally, the phytonanofabricated iron oxide particles were utilized for the removal of brilliant green (BG) and Congo red (CR) dye from the aqueous solution. The removal efficiency of BG dye was up to 54.28%, while that of Congo red dye was up to 36.72% in 120 min and 60 min, respectively. Furthermore, the effect of pH and contact time was also assessed on both the dyes, where CR exhibited maximum removal at acidic pH, i.e., 47.5%, while BG showed maximum removal at pH 10, i.e., 76.59%

NEMO-Binding Domain Peptide Inhibits Constitutive NF- B Activity and Reduces Tumor Burden in a Canine Model of Relapsed, Refractory Diffuse Large B-Cell Lymphoma

Activated B-Cell Diffuse Large B-Cell Lymphoma (ABC-DLBCL) is an aggressive, poorly chemoresponsive lymphoid malignancy characterized by constitutive canonical NF-κB activity that promotes lymphomagenesis and chemotherapy resistance via over-expression of anti-apoptotic NF-κB target genes. Inhibition of the canonical NF-κB pathway may therefore have therapeutic relevance in ABC-DLBCL. Here we set out to determine whether dogs with spontaneous DLBCL have comparative aberrant constitutive NF-κB activity and to determine the therapeutic relevance of NF-κB inhibition in dogs with relapsed, resistant DLBCL

Bioethanol production from alkali-pretreated rice straw: effects on fermentation yield, structural characterization, and ethanol analysis

Current ethanol production technology has a dire need for efficient conversion of lignocellulosic biomass to fermentable sugars. The conversion requires pretreatment of the biomass, one of the most expensive steps, and thus it is quite necessary to identify the most cost-effective and high-efficiency conversion method. In this study, rice straw (RS) biomass was pretreated using 4% NaOH alkali, soaked for 4 h, and autoclaved for 30 min. The structural and morphological changes were examined using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and scanning electron microscopy (SEM) analysis in both native and alkali-treated RS. The FTIR analysis revealed that native RS contains a considerable amount of lignin that was removed after the pretreatment process. The XRD pattern of the RS revealed an increasing crystallite size of the pretreated lignocellulosic biomass. The study of SEM clearly showed the distorted structure and surface porosity after the pretreatment process. Enzymatic hydrolysis efficiency was checked by comparing the commercial enzymes and microbial hydrolysis extracted from a fungal isolate. The best-reducing sugar yield obtained was 0.62 g/L, achieved at optimized conditions from the commercial enzymes. Fermentation efficiency was checked using the yeast isolate Saccharomyces cerevisiae in both the native and pretreated substrate, and the highest ethanol concentration (21.45%) was achieved using 20% w/v biomass loading, enzyme loading (2:1:1), and fermentation for a week at 30°C and pH 4.5. This concentration was higher than that of the untreated RS (3.67%). The ethanol thus produced was further checked for analysis by the 1H and 13C nuclear magnetic resonance (NMR) methods

Prevention of Growth Failure in Turner Syndrome: Long-Term Results of Early Growth Hormone Treatment in the “Toddler Turner” Cohort

Introduction: In the randomized “Toddler Turner” study, girls who received growth hormone (GH) starting at ages 9 months to 4 years (early-treated [ET] group) had marked catch-up growth and were 1.6 ± 0.6 SD taller than untreated (early-untreated [EUT]) control girls after 2 years. However, whether the early catch-up growth would result in greater near-adult height (NAH) was unknown. Therefore, this extension study examined the long-term effects of toddler-age GH treatment on height, pubertal development, and safety parameters. Methods: Toddler Turner study participants were invited to enroll in a 10-year observational extension study for annual assessments of growth, pubertal status, and safety during long-term GH treatment to NAH for both ET and EUT groups. Results: The ET group was taller than the EUT group at all time points from preschool to maturity and was significantly taller at the onset of puberty (p = 0.016), however, the difference was not significant at NAH. For the full cohort (ET + EUT combined, n = 50) mean (± SD) NAH was 151.2 ± 7.1 cm at age 15.0 ± 1.3 years. NAH standard deviation score (SDS) was within the normal range (>−2.0) for 76% of ET and 60% of EUT subjects (68% overall) and correlated strongly with height SDS at GH start (r = 0.78; p < 0.01), which in turn had a modest inverse correlation with age at GH start (i.e., height SDS declined with increasing age in untreated girls [r = −0.30; p = 0.016]). No new safety concerns arose. Conclusion: Although the ET group was taller throughout, height SDS at NAH was not significantly different between groups due to catch-down growth of ET girls during lapses in GH treatment after the Toddler study and similar long-term GH exposure overall. Early initiation of GH by age 6 years, followed by uninterrupted treatment during childhood, can prevent ongoing growth failure and enable attainment of height within the normal range during childhood, adolescence, and adulthood

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes