4,902 research outputs found

    Intracranial hypotension secondary to spinal arachnoid cyst rupture presenting with acute severe headache: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>Headache is a common presenting complaint and has a wide differential diagnosis. Clinicians need to be alert to clues that may suggest an underlying secondary aetiology. We describe a novel case of headache secondary to intracranial hypotension which was precipitated by the rupture of a spinal arachnoid cyst.</p> <p>Case report</p> <p>A 51-year-old Indian female presented with sudden onset severe headache suggestive of a subarachnoid haemorrage. Investigations including a computed tomography brain scan, cerebrospinal fluid examination and a magnetic resonance angiogram were normal. The headache persisted and magnetic resonance imaging revealed bilateral thin subdural collections, a spinal subarachnoid cyst and a right-sided pleural effusion. This was consistent with a diagnosis of headache secondary to intracranial hypotension resulting from spinal arachnoid cyst rupture.</p> <p>Conclusions</p> <p>Spinal arachnoid cyst rupture is a rare cause of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is a common yet under-diagnosed heterogeneous condition. It should feature significantly in the differential diagnosis of patients with new-onset daily persistent headache.</p

    Surgical management of a drooling child

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    Drooling is a physiological process in infants. When it persists beyond the age of 4 years, it becomes a clinical symptom. Drooling is a common problem among children of all ages with a neurological deficit. It causes significant decrease in the quality of life of the children and their families. Parents often accept the disability because they are not aware that treatment is available. Doctors should recognise the problem during a consultation and discuss the available management options. Patients should be reffered to a drooling clinic that adopts a multi-disciplinary approach. Management of drooling has been evolving over the last thirty years. Surgery has become a safe and effective management option.published_or_final_versio

    Ultra-broadband Polarisers Based on Metastable Free-Standing Aligned Carbon Nanotube Membranes

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    A carbon nanotube free-standing linearly dichroic polariser is developed using solid-state extrusion. Membrane cohesion is experimentally and numerically demonstrated to derive from inter-tube van der Waals interactions in this family of planar metastable morphologies, controlled by the chemical vapour deposition conditions. Ultra-broadband polarisation (400 nm – 2.5 mm) is shown and corroborated by effective medium and full numerical simulations.This work was supported by the Isaac Newton Trust, Trinity College Cambridge University. M. T. Cole thanks the Winston Churchill Memorial Trust and the Oppenheimer Research Fellowship, Cambridge University, for generous financial support.This is the author accepted manuscript. The final version is available from Wiley at http://onlinelibrary.wiley.com/doi/10.1002/adom.201400238/abstract

    Reaction-diffusion systems with constant diffusivities: conditional symmetries and form-preserving transformations

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    Q-conditional symmetries (nonclassical symmetries) for a general class of two-component reaction-diffusion systems with constant diffusivities are studied. Using the recently introduced notion of Q-conditional symmetries of the first type (R. Cherniha J. Phys. A: Math. Theor., 2010. vol. 43., 405207), an exhaustive list of reaction-diffusion systems admitting such symmetry is derived. The form-preserving transformations for this class of systems are constructed and it is shown that this list contains only non-equivalent systems. The obtained symmetries permit to reduce the reaction-diffusion systems under study to two-dimensional systems of ordinary differential equations and to find exact solutions. As a non-trivial example, multiparameter families of exact solutions are explicitly constructed for two nonlinear reaction-diffusion systems. A possible interpretation to a biologically motivated model is presented

    Pengaruh Profitabilitas, Kepemilikan Manajerial, Kepemilikan Institusional dan Leverage Terhadap Agresivitas Pajak (Study Empiris Pada Perusahaan Manufaktur Sektor Barang Konsumsi Yang Terdaftar di Bursa Efek Indonesia Pada Tahun 2015-2019)

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    Agresivitas Pajak yaitu suatu tindakan yang bertujuan sebagai penghindaran pajak untuk mengurangi atau menghilangkan tarif perpajakan organisasi dengan menggunakan aturan yang diizinkan dan diperbolehkan maupun memanfaatkan kelemahan hukum peraturan perpajakan atau melanggar ketentuan dengan menggunakan klausul yang ada. Penelitian ini berencana untuk memperoleh bukti observasional mengenai dampak profitabilitas, kepemilikan manajerial, kepemilikan institusional dan pengaruh terhadap kekuatan biaya dengan strategi kuantitatif dimana informasi diperoleh dari laporan anggaran organisasi perakitan di area pembeli barang dengan menggunakan metode pengujian purposive. Strategi investigasi informasi pemeriksaan menggunakan kekambuhan informasi papan menggunakan program E-views 9. Mengingat efek samping dari tinjauan ini, variabel manfaat memiliki nilai kepentingan 0,0639 &gt; 0,05. Variabel kepemilikan administratif memiliki nilai kepentingan 0,1052 &gt; 0,05. Variabel kepemilikan institusional memiliki nilai kepentingan 0,0013 &lt; 0,05 dan variabel pengaruh memiliki nilai kepentingan 0,3800 &gt; 0,05 terhadap kekuatan muatan. Hasil akhir dari pengujian adalah bahwa variabel manfaat tidak berpengaruh terhadap kekuatan biaya, kepemilikan administratif tidak berpengaruh terhadap kekuatan biaya, kepemilikan institusional tidak berpengaruh terhadap kekuatan biaya, pengaruh tidak berpengaruh pada kekuatan biaya, dan faktor otonom dari produktivitas, kepemilikan administratif, kepemilikan institusional dan pengaruh memiliki dampak bersama. sama untuk kekuatan muatan

    HMGA1 Modulates Gene Transcription Sustaining a Tumor Signalling Pathway Acting on the Epigenetic Status of Triple-Negative Breast Cancer Cells

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    Chromatin accessibility plays a critical factor in regulating gene expression in cancer cells. Several factors, including the High Mobility Group A (HMGA) family members, are known to participate directly in chromatin relaxation and transcriptional activation. The HMGA1 oncogene encodes an architectural chromatin transcription factor that alters DNA structure and interacts with transcription factors favouring their landing onto transcription regulatory sequences. Here, we provide evidence of an additional mechanism exploited by HMGA1 to modulate transcription. We demonstrate that, in a triple-negative breast cancer cellular model, HMGA1 sustains the action of epigenetic modifiers and in particular it positively influences both histone H3S10 phosphorylation by ribosomal protein S6 kinase alpha-3 (RSK2) and histone H2BK5 acetylation by CREB-binding protein (CBP). HMGA1, RSK2, and CBP control the expression of a set of genes involved in tumor progression and epithelial to mesenchymal transition. These results suggest that HMGA1 has an effect on the epigenetic status of cancer cells and that it could be exploited as a responsiveness predictor for epigenetic therapies in triple-negative breast cancers

    Direct Amidation of Esters via Ball Milling

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    The direct mechanochemical amidation of esters by ball milling is described. The operationally simple procedure requires an ester, an amine, and substoichiometric KOtBu and was used to prepare a large and diverse library of 78 amide structures with modest to excellent efficiency. Heteroaromatic and heterocyclic components are specifically shown to be amenable to this mechanochemical protocol. This direct synthesis platform has been applied to the synthesis of active pharmaceutical ingredients (APIs) and agrochemicals as well as the gram-scale synthesis of an active pharmaceutical, all in the absence of a reaction solvent

    Prevention of sexual transmission of mpox: a systematic review and qualitative evidence synthesis of approaches.

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    BACKGROUND: The ongoing multi-country mpox outbreak in previously unaffected countries is primarily affecting sexual networks of men who have sex with men. Evidence is needed on the effectiveness of recommended preventive interventions. To inform WHO guidelines, a systematic review and qualitative evidence synthesis were conducted on mpox preventive behavioural interventions to reduce: (i) sexual acquisition; (ii) onward sexual transmission from confirmed/probable cases; and (iii) utility of asymptomatic testing. METHODS: Medline, EMBASE, PubMed, Cochrane and WHO trial databases, grey literature and conferences were searched for English-language primary research published since 1 January 2022. A reviewer team performed screening, data extraction and bias assessment. A qualitative thematic synthesis explored views and experiences of engagement in prevention in individuals at increased risk. RESULTS: There were 16 studies: 1 on contact-tracing, 2 on sexual behaviour, and 13 on asymptomatic testing. Although MPXV was detected in varying proportions of samples (0.17%-6.5%), the testing studies provide insufficient evidence to fully evaluate this strategy. For the qualitative evidence synthesis, four studies evaluated the experiences of most affected communities. Preferences about preventive interventions were shaped by: mpox information; the diversity of sexual practices; accessibility and quality of mpox testing and care; and perceived cost to wellbeing. CONCLUSIONS: Evidence on the effectiveness of interventions to prevent the sexual transmission of mpox remains scarce. Limited qualitative evidence on values and preferences provides insight into factors influencing intervention acceptability. Given global and local inequities in access to vaccines and treatment, further research is needed to establish the effectiveness of additional interventions
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