Synthesis, C-13 NMR and anticonvulsant activity of new isatin-based spiroazetidinones

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Intra-arterial treatment for acute ischemic stroke: a meta-analysis

Objective: To assess the potential benefit of treating patients with acute ischemic stroke using intra-arterial methods. Methods: A meta-analysis of published randomized controlled trials that compared standard therapy with intravenous tissue plasminogen activator (IVtPA) for thrombolysis to intra-arterial therapies in patients with acute stroke was performed. All studies reported were analyzed as one group and studies documenting patients with large vessel obstruction were analyzed as a second group. The standardized mean difference (SMD) and the odds ratio (OR) of the dichotomized outcomes of Modified Rankin Scale (mRS) of these trials was calculated. Results: Nine trials were identified with 2,711 patients treated. Meta-analysis of all studies, with and without large vessel obstruction documented, showed a significant benefit with intra-arterial therapy (SMD: 0.22 + 0.041; P=0.003). The dichotomized outcomes of mRS of these trials showed significant improvement (OR: 1.66 -2.43 in four of the five treatment arm groups examined). Meta-analysis of all publications with large vessel obstruction documented as an entry criteria showed a greater significant benefit with intra-arterial therapy (SMD: 0.35 + 0.05; P<0.001). The dichotomized outcomes of mRS of these trials showed significant improvement (OR: 1.36 -2.38 in all five treatment arm groups examined). Some heterogeneity was observed between studies. Conclusion: Treatment of patients with acute ischemic stroke was associated with improved outcomes as measured by mRS. Patient selection, standard treatment, and study treatment factors contributed to the statistical evaluation of inter study heterogeneity and may have contributed to different study outcomes

Hybrid Workload Enabled and Secure Healthcare Monitoring Sensing Framework in Distributed Fog-Cloud Network

The Internet of Medical Things (IoMT) workflow applications have been rapidly growing in practice. These internet-based applications can run on the distributed healthcare sensing system, which combines mobile computing, edge computing and cloud computing. Offloading and scheduling are the required methods in the distributed network. However, a security issue exists and it is hard to run different types of tasks (e.g., security, delay-sensitive, and delay-tolerant tasks) of IoMT applications on heterogeneous computing nodes. This work proposes a new healthcare architecture for workflow applications based on heterogeneous computing nodes layers: an application layer, management layer, and resource layer. The goal is to minimize the makespan of all applications. Based on these layers, the work proposes a secure offloading-efficient task scheduling (SEOS) algorithm framework, which includes the deadline division method, task sequencing rules, homomorphic security scheme, initial scheduling, and the variable neighbourhood searching method. The performance evaluation results show that the proposed plans outperform all existing baseline approaches for healthcare applications in terms of makespan

Continental extension of northern Gondwana margin in the Eastern Himalaya: Constraints from geochemistry and U–Pb zircon ages of mafic intrusives in the Siang window, Arunachal Himalaya, India

We report new U–Pb zircon age and whole-rock geochemical data from the Pangin mafic intrusive rocks of the Siang window, eastern Himalayas. These mafic rocks are medium to coarse-grained gabbros, consisting mainly of plagioclase and clinopyroxene with accessory phases (hornblende $+$ Fe–Ti oxides) that retain granular and interlocking texture. Geochemically, they display enriched-mid oceanic ridge basalt (E-MORB) affinity characterized by moderate to slightly fractionated REE patterns marked by $(\mathrm{La}/\mathrm{Yb})_{\mathrm{N}} = 2.65-3.99$. Their geochemical characteristics suggest that the parental magmas of these rocks were formed by medium to higher degrees (∼12–28%) of partial melting similar to that of the asthenospheric mantle in the garnet-spinel transition zone. Magmatic zircons from two gabbros yield U–Pb ages of 521.50 $\sim$ 2.53 Ma and 568 ${\pm }$ 2 Ma. This new age reveals two pulses of Late Neoproterozoic and Early Cambrian mafic magmatism that are inconsistent with the temporal distribution of Paleozoic magmatism in the Siang window of the Eastern Himalayas. However, based on the results of this study and the correlation of continental extensional mafic magmatism in the Northwest Himalaya, we suggest that investigated mafic intrusive rocks might have been generated in an extensional tectonic environment during the long-lasting Pan-African orogenic cycle of the late Neoproterozoic to early Cambrian which ended with the formation of the Gondwana supercontinent

Continental extension of northern Gondwana margin in the Eastern Himalaya: Constraints from geochemistry and U–Pb zircon ages of mafic intrusives in the Siang window, Arunachal Himalaya, India

We report new U–Pb zircon age and whole-rock geochemical data from the Pangin mafic intrusive rocks of the Siang window, eastern Himalayas. These mafic rocks are medium to coarse-grained gabbros, consisting mainly of plagioclase and clinopyroxene with accessory phases (hornblende $+$ Fe–Ti oxides) that retain granular and interlocking texture. Geochemically, they display enriched-mid oceanic ridge basalt (E-MORB) affinity characterized by moderate to slightly fractionated REE patterns marked by $(\mathrm{La}/\mathrm{Yb})_{\mathrm{N}} = 2.65-3.99$. Their geochemical characteristics suggest that the parental magmas of these rocks were formed by medium to higher degrees (∼12–28%) of partial melting similar to that of the asthenospheric mantle in the garnet-spinel transition zone. Magmatic zircons from two gabbros yield U–Pb ages of 521.50 $\sim$ 2.53 Ma and 568 ${\pm }$ 2 Ma. This new age reveals two pulses of Late Neoproterozoic and Early Cambrian mafic magmatism that are inconsistent with the temporal distribution of Paleozoic magmatism in the Siang window of the Eastern Himalayas. However, based on the results of this study and the correlation of continental extensional mafic magmatism in the Northwest Himalaya, we suggest that investigated mafic intrusive rocks might have been generated in an extensional tectonic environment during the long-lasting Pan-African orogenic cycle of the late Neoproterozoic to early Cambrian which ended with the formation of the Gondwana supercontinent

Diversification of U.S. medical schools via affirmative action implementation

BACKGROUND: The diversification of medical school student and faculty bodies via race-conscious affirmative action policy is a societal and legal option for the U.S. Supreme Court has recently ruled its use constitutional. This paper investigates the implications of affirmative action, particularly race-conscious compared to race-blind admissions policy; explains how alternative programs are generally impractical; and provides a brief review of the history and legality of affirmative action in the United States. DISCUSSION: Selection based solely on academic qualifications such as GPA and MCAT scores does not achieve racial and ethnic diversity in medical school, nor does it adequately predict success as practicing physicians. However, race-conscious preference yields greater practice in underserved and often minority populations, furthers our biomedical research progression, augments health care for minority patients, and fosters an exceptional medical school environment where students are better able to serve an increasingly multicultural society. SUMMARY: The implementation of race-conscious affirmative action results in diversity in medicine. Such diversity has shown increased medical practice in underserved areas, thereby providing better health care for the American people

Aggressive juvenile fibromatosis of the paranasal sinuses: case report and brief review

Desmoid fibromatoses are benign, slow growing fibroblastic neoplasms, arising from musculoaponeurotic stromal elements. Desmoids are characterized by local invasion, with a high rate of local recurrence and a tendency to destroy adjacent structures and organs. Desmoid fibromatoses are rare in children, and though they may occur in the head and neck region, are extremely rare in the paranasal sinuses. Here we report a case of extraabdominal desmoid fibromatosis in a seven-year-old boy involving the sphenoid sinus, one of only six published reports of desmoid fibromatosis of the paranasal sinuses. The expansile soft tissue mass eroded the walls of the sphenoid sinus as well as the posterior ethmoid air cells extending cephalad through the base of the skull. We discuss the clinicopathologic features of this lesion, including structural and ultrastructural characteristics, and we review the literature regarding treatment and outcome

Synapsin II Is Involved in the Molecular Pathway of Lithium Treatment in Bipolar Disorder

Bipolar disorder (BD) is a debilitating psychiatric condition with a prevalence of 1–2% in the general population that is characterized by severe episodic shifts in mood ranging from depressive to manic episodes. One of the most common treatments is lithium (Li), with successful response in 30–60% of patients. Synapsin II (SYN2) is a neuronal phosphoprotein that we have previously identified as a possible candidate gene for the etiology of BD and/or response to Li treatment in a genome-wide linkage study focusing on BD patients characterized for excellent response to Li prophylaxis. In the present study we investigated the role of this gene in BD, particularly as it pertains to Li treatment. We investigated the effect of lithium treatment on the expression of SYN2 in lymphoblastoid cell lines from patients characterized as excellent Li-responders, non-responders, as well as non-psychiatric controls. Finally, we sought to determine if Li has a cell-type-specific effect on gene expression in neuronal-derived cell lines. In both in vitro models, we found SYN2 to be modulated by the presence of Li. By focusing on Li-responsive BD we have identified a potential mechanism for Li response in some patients

Language in India www

Abstract The present study focused on the iconic memory and echoic memory in children with learning disability (LD).A total of 35 subjects participated in the study. The subjects were divided into two groups. Group I consisted of fifteen children with LD and group II consisted of twenty normal children. All the subjects belonged to an age range of 8-12 years. Standardized line drawn pictures of frequently occurring nouns were taken as stimuli from Early Language Training Ki