Factors associated with the level of inhibitory control in elderly people living in elderly care institutions in Galle District, Sri Lanka

Objectives: The proportion of elderly people living in institutions has increased in Sri Lanka duringthe recent decades as a result of population aging and ongoing sociocultural changes. Cognitivefunctions that are important for goal directed behavior will be increasingly important for independentliving. Inhibitory control of irrelevant information (IC) is such cognitive process vital for this. Hencethis study was conducted to assess the level of inhibitory control and associated factors among elderlypeople living in elderly care institutions in Galle District.Methods: Study was conducted in 190 elderly people living in institutions who are physicallyindependent with Barthel’s index score of more than 90. IC was assessed via computerized stroopinhibitory task. Number of errors was calculated to assess the level of inhibitory control. Groupdifferences were assessed through independent sample t test and significant level was kept at p<0.05.Results: The sample comprised of 69.5% (n=132) females with a mean age of 71.78 years (+6.5). Meannumber of errors of the stroop tasks was 8.88 (+3.99). The number of errors in the stroop inhibitory taskwas significantly lower among females (n=132, p<0.01) who have had above secondary education(n=33, p<0.05), who engaged in group (n=153, p<0.05) and leisure time activities (n=173, p<0.05) andwho were younger than 70 years of age (n=78, p<0.01).Conclusions: IC was significantly associated with age, educational status, gender, engagement in groupand leisure time activities among the study sample

Development of an Innovative Mobile Phone-Based Newborn Care Training Application

Mobile infrastructure in low - and middle-income countries (LMIC) has shown immense potential to reach the unreachable. Healthcare providers (HCP) are one such group who are at the frontline of the fight against infant mortality in LMICs. Mortality among newborn infants (birth to 28 days) now accounts for around 45% of all under 5-years child mortality. Birth asphyxia is one of the three leading causes of newborn death; neonatal resuscitation training, among health care providers, reduces mortality from birth asphyxia. We have developed a mobile phone-based training app, called mobile Helping Babies Survive (mHBS), to support the training of health care providers on neonatal resuscitation. mHBS is integrated with the District Health Information System (DHIS2) platform, which is used in over 60 countries around the world. The mHBS/DHIS2 training app is a part of an application suite which includes another DHIS2-linked data collection app, mHBS tracker. The mHBS training application has the potential to scale-up integration with other neonatal training apps. Ultimately, the mHBS training suite will provide new insights into healthcare worker education along with the necessary tools for effective care of newborn babies

Application of phasor measurement units for monitoring power system dynamic performance

This Working Group is a sequel to a previous working group on Wide Area Monitoring and Control for Transmission Capability Enhancement, which published the Technical Brochure 330 in 2007. Since then the synchrophasor technology has advanced rapidly and many utilities around the world have installed hundreds of PMUs in their networks. In this Technical Brochure, we look at the current state of the technology and the extent to which it has been used in the industry. As the technology has matured, it is also important to understand the communication protocols used in synchrophasor networks and their relevant cyber-security issues. These concerns are briefly discussed in the brochure. The applications of Phasor Measurement Units (PMU) measurements reported here are divided into three categories: (a) applications already installed in utility networks, (b) applications that are well-tested, but not yet installed, and (c) applications that are beneficial to the industry, but not fully developed yet. The most common and mature applications are wide area monitoring, state estimation, and model validation. Out of these three applications, wide area monitoring is well established in the industry. The protection and control applications are emerging as evident from the reported examples. The experience of using remote synchrophasor measurements as feedback control signals is not widely reported by the industry. In parallel to this Working Group, Study Committee B5 had a Working Group on “Wide area protection and control technologies.” The Technical Brochure 664 published by this Working Group in September 2016 reviews synchrophasor technology and discusses the industry experience with wide area protection and control. The North American synchrophasor Initiative (NASPI) is another technical group that has gathered and reported a wide range of PMU experiences of industry and researchers. In summary, the field-tested applications presented in this Technical Brochure are a testimony to the confidence of utilities in the synchrophasor technology. The progress in state estimation techniques indicates that synchrophasor measurements will become a standard part of energy management and security assessment systems in the near future

Definition of treatment goals for moderate to severe psoriasis: a European consensus

Patients with moderate to severe psoriasis are undertreated. To solve this persistent problem, the consensus programme was performed to define goals for treatment of plaque psoriasis with systemic therapy and to improve patient care. An expert consensus meeting and a collaborative Delphi procedure were carried out. Nineteen dermatologists from different European countries met for a face-to-face discussion and defined items through a four-round Delphi process. Severity of plaque psoriasis was graded into mild and moderate to severe disease. Mild disease was defined as body surface area (BSA) ≤10 and psoriasis area and severity index (PASI) ≤10 and dermatology life quality index (DLQI) ≤10 and moderate to severe psoriasis as (BSA > 10 or PASI > 10) and DLQI > 10. Special clinical situations may change mild psoriasis to moderate to severe including involvement of visible areas or severe nail involvement. For systemic therapy of plaque psoriasis two treatment phases were defined: (1) induction phase as the treatment period until week 16; however, depending on the type of drug and dose regimen used, this phase may be extended until week 24 and (2) maintenance phase for all drugs was defined as the treatment period after the induction phase. For the definition of treatment goals in plaque psoriasis, the change of PASI from baseline until the time of evaluation (ΔPASI) and the absolute DLQI were used. After induction and during maintenance therapy, treatment can be continued if reduction in PASI is ≥75%. The treatment regimen should be modified if improvement of PASI is <50%. In a situation where the therapeutic response improved ≥50% but <75%, as assessed by PASI, therapy should be modified if the DLQI is >5 but can be continued if the DLQI is ≤5. This programme defines the severity of plaque psoriasis for the first time using a formal consensus of 19 European experts. In addition, treatment goals for moderate to severe disease were established. Implementation of treatment goals in the daily management of psoriasis will improve patient care and mitigate the problem of undertreatment. It is planned to evaluate the implementation of these treatment goals in a subsequent programme involving patients and physicians

Environmental chemicals impact dog semen quality in vitro and may be associated with a temporal decline in sperm motility and increased cryptorchidism

Adverse temporal trends in human semen quality and cryptorchidism in infants have been associated with exposure to environmental chemicals (ECs) during development. Here we report that a population of breeding dogs exhibit a 26 year (1988–2014) decline in sperm quality and a concurrent increased incidence of cryptorchidism in male offspring (1995–2014). A decline in the number of males born relative to the number of females was also observed. ECs, including diethylhexyl phthalate (DEHP) and polychlorinated biphenyl 153 (PCB153), were detected in adult dog testes and commercial dog foods at concentrations reported to perturb reproductive function in other species. Testicular concentrations of DEHP and PCB153 perturbed sperm viability, motility and DNA integrity in vitro but did not affect LH stimulated testosterone secretion from adult testis explants. The direct effects of chemicals on sperm may therefore contribute to the decline in canine semen quality that parallels that reported in the human

Porphyromonas gingivalis Participates in Pathogenesis of Human Abdominal Aortic Aneurysm by Neutrophil Activation. Proof of Concept in Rats

International audienceBACKGROUND: Abdominal Aortic Aneurysms (AAAs) represent a particular form of atherothrombosis where neutrophil proteolytic activity plays a major role. We postulated that neutrophil recruitment and activation participating in AAA growth may originate in part from repeated episodes of periodontal bacteremia. METHODS AND FINDINGS: Our results show that neutrophil activation in human AAA was associated with Neutrophil Extracellular Trap (NET) formation in the IntraLuminal Thrombus, leading to the release of cell-free DNA. Human AAA samples were shown to contain bacterial DNA with high frequency (11/16), and in particular that of Porphyromonas gingivalis (Pg), the most prevalent pathogen involved in chronic periodontitis, a common form of periodontal disease. Both DNA reflecting the presence of NETs and antibodies to Pg were found to be increased in plasma of patients with AAA. Using a rat model of AAA, we demonstrated that repeated injection of Pg fostered aneurysm development, associated with pathological characteristics similar to those observed in humans, such as the persistence of a neutrophil-rich luminal thrombus, not observed in saline-injected rats in which a healing process was observed. CONCLUSIONS: Thus, the control of periodontal disease may represent a therapeutic target to limit human AAA progression

In Vitro Identification of Novel Plasminogen-Binding Receptors of the Pathogen Leptospira interrogans

Background: Leptospirosis is a multisystem disease caused by pathogenic strains of the genus Leptospira. We have reported that Leptospira are able to bind plasminogen (PLG), to generate active plasmin in the presence of activator, and to degrade purified extracellular matrix fibronectin. Methodology/Principal Findings: We have now cloned, expressed and purified 14 leptospiral recombinant proteins. The proteins were confirmed to be surface exposed by immunofluorescence microscopy and were evaluated for their ability to bind plasminogen (PLG). We identified eight as PLG-binding proteins, including the major outer membrane protein LipL32, the previously published rLIC12730, rLIC10494, Lp29, Lp49, LipL40 and MPL36, and one novel leptospiral protein, rLIC12238. Bound PLG could be converted to plasmin by the addition of urokinase-type PLG activator (uPA), showing specific proteolytic activity, as assessed by its reaction with the chromogenic plasmin substrate, D-Val-Leu-Lys 4-nitroanilide dihydrochloride. The addition of the lysine analog 6-aminocaproic acid (ACA) inhibited the protein-PLG interaction, thus strongly suggesting the involvement of lysine residues in plasminogen binding. The binding of leptospiral surface proteins to PLG was specific, dose-dependent and saturable. PLG and collagen type IV competed with LipL32 protein for the same binding site, whereas separate binding sites were observed for plasma fibronectin. Conclusions/Significance: PLG-binding/activation through the proteins/receptors on the surface of Leptospira could help the bacteria to specifically overcome tissue barriers, facilitating its spread throughout the host.FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo)CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)Fundacao Butantan, BrazilFAPESP (Brazil

Structural Insights into the PorK and PorN Components of the Porphyromonas gingivalis Type IX Secretion System

The type IX secretion system (T9SS) has been recently discovered and is specific to Bacteroidetes species. Porphyromonas gingivalis, a keystone pathogen for periodontitis, utilizes the T9SS to transport many proteins including the gingipain virulence factors across the outer membrane and attach them to the cell surface via a sortase-like mechanism. At least 11 proteins have been identified as components of the T9SS including PorK, PorL, PorM, PorN and PorP, however the precise roles of most of these proteins have not been elucidated and the structural organization of these components is unknown. In this study, we purified PorK and PorN complexes from P. gingivalis and using electron microscopy we have shown that PorN and the PorK lipoprotein interact to form a 50 nm diameter ring-shaped structure containing approximately 32?36 subunits of each protein. The formation of these rings was dependent on both PorK and PorN, but was independent of PorL, PorM and PorP. PorL and PorM were found to form a separate stable complex. PorK and PorN were protected from proteinase K cleavage when present in undisrupted cells, but were rapidly degraded when the cells were lysed, which together with bioinformatic analyses suggests that these proteins are exposed in the periplasm and anchored to the outer membrane via the PorK lipid. Chemical cross-linking and mass spectrometry analyses confirmed the interaction between PorK and PorN and further revealed that they interact with the PG0189 outer membrane protein. Furthermore, we established that PorN was required for the stable expression of PorK, PorL and PorM. Collectively, these results suggest that the ring-shaped PorK/N complex may form part of the secretion channel of the T9SS. This is the first report showing the structural organization of any T9SS component