Balloon aortic valvuloplasty in pregnancy with severe aortic stenosis and infective endocarditis

Twenty seven year old lady, previously diagnosed to have aortic stenosis, presented to the obstetric outpatient department at 19 weeks of gestation with fever and breathlessness, NYHA class 4, for one week. Two D Echo revealed left ventricular hypertrophy, a severely stenosed, calcified bicuspid aortic valve, with vegetations on aortic and mitral valves and severe mitral regurgitation. Blood cultures grew nutrionally variant streptococci and she was treated with crystalline penicillin and gentamicin. She stabilised clinically by 21 weeks, by which time, the risk of termination of pregnancy was comparable to continuing the pregnancy. She underwent balloon aortic valvuloplasty. Post balloon aortic valvuloplasty, she was stable. At 34+2 weeks, she underwent emergency LSCS, the indication being intrauterine growth restriction with fetal compromise and breech presentation. She delivered a baby girl, 1.6 kg, Apgar 9 & 10. Our case report highlights the fact that a timely, balloon aortic valvuloplasty can be life saving for patients with pregnancy complicated by severe aortic stenosis and infective endocarditis

Magnetic anisotropy in Shiba bound states across a quantum phase transition

The exchange coupling between magnetic adsorbates and a superconducting substrate leads to Shiba states inside the superconducting energy gap and a Kondo resonance outside the gap. The exchange coupling strength determines whether the quantum many-body ground state is a Kondo singlet or a singlet of the paired superconducting quasiparticles. Here, we use scanning tunneling spectroscopy to identify the different quantum ground states of Manganese phthalocyanine on Pb(111). We observe Shiba states, which are split into triplets by magnetocrystalline anisotropy. Their characteristic spectral weight yields an unambiguous proof of the nature of the quantum ground state.Comment: 6 pages, 4 figure

Induction of labour versus conservative management for mild gestational hypertension at term

Background: Hypertensive disorders of pregnancy remain a leading cause of maternal and perinatal morbidity and mortality. The aim of this study was to find out whether immediate induction of labour in women with singleton pregnancy complicated by mild gestational hypertension at term reduced maternal and neonatal morbidity, mortality and expenditure when compared to conservative management without increasing instrumental delivery and caesarean section rates.Methods: This was a randomized controlled trial to compare immediate induction of labour to conservative management for mild gestational hypertension in women between 18-35 years of age with singleton pregnancy with mild gestational hypertension at 37-39.5 weeks without any other complications. Eligible patients presenting to the obstetric outpatient department or labour room of Christian Medical College, Vellore with gestational hypertension were randomized (49 patients in the induction arm and 51 patients in the conservative arm) and followed up. The maternal and neonatal outcomes in both groups were compared.Results: There was no maternal mortality in both the groups. There was increased incidence of composite maternal morbidity (pre-eclampsia, eclampsia, HELLP syndrome, pulmonary oedema, renal failure, thromboembolic disease, abruption, need for ICU care and major postpartum haemorrhage) in the conservative arm when compared to induction arm (14 versus 8), though not statistically significant (p 0.23).There was no significant difference in the caesarean section rates between the two groups (p 0.313 and 0.306 respectively) despite the much favorable Bishop score in the conservative group (p 0.054). There was no significant difference in neonatal morbidity and mortality. A slight increase by about 600 rupees in the median total cost was found with conservative management when compared to induction group.Conclusions: The study did not show a statistically significant difference in maternal mortality, composite maternal morbidity, neonatal mortality and morbidity as well as treatment cost between immediate induction of labour and conservative management for mild gestational hypertension at term

Magnetic anisotropy in Shiba bound states across a quantum phase transition

The exchange coupling between magnetic adsorbates and a superconducting substrate leads to Shiba states inside the superconducting energy gap and a Kondo resonance outside the gap. The exchange coupling strength determines whether the quantum many-body ground state is a Kondo singlet or a singlet of the paired superconducting quasiparticles. Here we use scanning tunnelling spectroscopy to identify the different quantum ground states of manganese phthalocyanine on Pb(111). We observe Shiba states, which are split into triplets by magnetocrystalline anisotropy. Their characteristic spectral weight yields an unambiguous proof of the nature of the quantum ground state. Our results provide experimental insights into the phase diagram of a magnetic impurity on a superconducting host and shine light on the effects induced by magnetic anisotropy on many-body interactions

Importancia de la carne de bovino en la salud publica

El presente estudio tuvo como objetivo, realizar una investigación de carácter- informativo a cerca del comportamiento de la carne como alimento en la salud pública; determinando en ella misma su importancia como alimento esencial- - para el consumo humano, conociendo a la vez los diferentes factores de contaminación y adulteración, así como también las diversas enfermedades zoonoticas que pueden ser transmisibles a través de los alimentos

Streptococcus pneumoniae Antigen, Missing Opportunities of a Promising Point of Care Diagnostic Test

Background: The etiologic diagnosis of community acquired pneumonia (CAP) and community-acquired meningitis (CAM) are still far from optimal accuracy and turnaround time. The most common bacterial pathogen identified in both CAP and CAM is Streptococcus pneumoniae. Methods: We reviewed the literature on S. pneumoniae antigen to highlight opportunities to optimize its use as a point of care diagnostic test to maximize quality of patient care, antimicrobial stewardship outcomes and cost saving. A PubMed search was performed using key words “S. pneumoniae antigen; rapid diagnostic tests for S. pneumoniae”. We selected articles in English and sorted into randomized controlled trials (RCT), case control, and retrospectives studies. Results: The BinaxNOW S. pneumoniae antigen rapid immunochromatographic test (ICT) to detect C-polysaccharide cell wall antigen was approved by the Food and Drug Administration (FDA) in 2003. This test has a turn around time of 15 minutes, a sensitivity of 52-82% and specificity of 89.7-99.7% in urine and 95.4-100% and 99.3-100% respectively in cerebrospinal fluid (CSF) specimens. BinaxNOW detected the antigen in 100% of blood culture bottles that grew S. pneumoniae. S. pneumoniae urinary antigen has a sensitivity of 77-92% in bacteremic pneumococcal pneumonia and 52-78% non-bacteremic pneumococcal pneumonia. This test was reported to be inexpensive and useful in streamlining antibiotic treatment. In a physician survey, this test led to a narrowed antibiotic regimen, shorter duration of antibiotics treatment and fewer diagnostic tests. Conclusion: S. pneumoniae ICT urinary antigen has an optimal yield to support the etiologic diagnosis of CAP and up to 15-minute turnaround time that could facilitate he selection of a one-antibiotic regimen upon the hospital admission of a patient with CAP. Similarly, S. pneumoniae CSF antigen test should be considered a standard test for the evaluation of patients with meningitis

Género y miedo al contagio por COVID-19 en trabajadores de la empresa transportes Chiclayo S.A., 2021

Determinar si el miedo al contagio por COVID-19 “difiere según el género en trabajadores de la Empresa” de Transportes Chiclayo S.A., 2021, fue el objetivo de esta investigación. Para tal fin se tomó en cuenta una metodología cuantitativa y el diseño descriptivo comparativo, en 253 trabajadores a quienes se les aplicó la escala de miedo al coronavirus Covid-19, instrumento que goza de adecuadas evidencias de confiabilidad y validez; es así que, después de la aplicación de dichos instrumentos se usó la prueba t de student para comparar medias, el cual nos permite concluir que no existen diferencias significativas entre las medias obtenidas de trabajadores varones y mujeres (p>.05)

Bioanalytical and chemical evaluation of disinfection by-products in swimming pool water

Pool water disinfection is vital to prevent microbial pathogens. However, potentially hazardous disinfection by-products (DBP) are formed from the reaction between disinfectants and organic/inorganic precursors. The aim of this study was to evaluate the presence of DBPs in various swimming pool types in Brisbane, Australia, including outdoor, indoor and baby pools, and the dynamics after a complete water renewal. Chemical analysis of 36 regulated and commonly found DBPs and total adsorbable organic halogens as well as invitro bioassays targeting cytotoxicity, oxidative stress and genotoxicity were used to evaluate swimming pool water quality. Dichloroacetic acid and trichloroacetic acid dominated in the pool water samples with higher levels (up to 2600μg/L) than the health guideline values set by the Australian Drinking Water Guidelines (100μg/L). Chlorinated DBPs occurred at higher concentrations compared to tap water, while brominated DBPs decreased gradually with increasing pool water age. Biological effects were expressed as chloroacetic acid equivalent concentrations and compared to predicted effects from chemical analysis and biological characterisation of haloacetic acids. The quantified haloacetic acids explained 35-118% of the absorbable organic halogens but less than 4% of the observed non-specific toxicity (cytotoxicity), and less than 1% of the observed oxidative stress response and genotoxicity. While the DBP concentrations in Australian pools found in this study are not likely to cause any adverse health effect, they are higher than in other countries and could be reduced by better hygiene of pool users, such as thorough showering prior to entering the pool and avoiding urination during swimming

Gaussian Processes for Monitoring Air-Quality in Kampala

Monitoring air pollution is of vital importance to the overall health of the population. Unfortunately, devices that can measure air quality can be expensive, and many cities in low and middle-income countries have to rely on a sparse allocation of them. In this paper, we investigate the use of Gaussian Processes for both nowcasting the current air-pollution in places where there are no sensors and forecasting the air-pollution in the future at the sensor locations. In particular, we focus on the city of Kampala in Uganda, using data from AirQo's network of sensors. We demonstrate the advantage of removing outliers, compare different kernel functions and additional inputs. We also compare two sparse approximations to allow for the large amounts of temporal data in the dataset

LAS DIRECCIONES DEL RENDIMIENTO EN LA ESCALADA DEPORTIVA

El objetivo de esta investigación es determinar los efectos de un programa de Entrenamiento Deportivo basado en lasDirecciones del Rendimiento en las capacidades físicas básicas de la escalada deportiva. Las capacidades físicasseleccionadas son fuerza, resistencia y flexibilidad. Para el desarrollo de la fuerza se utilizó el método de repeticionesen salas de musculación y en multipresas, para el desarrollo de la flexibilidad la Facilitación PropioceptivaNeuromuscular y para el desarrollo de la resistencia se utilizaron métodos continuos variable, continuos invariables ydiscontinuo de intervalos.Los resultados mostraron que el plan de entrenamiento basado en las direcciones del rendimiento en la fuerza essignificativo para el grupo etario masculino y parcialmente significativo para las mujeres (favorable en parte de ella),en lo relacionado con la flexibilidad es significativo para los hombres mientras que en las mujeres mantiene laflexibilidad sin cambios significativos. En lo referente a la resistencia, tanto en las mujeres como en los hombres, essignificativo debido a que disminuyeron los tiempos de ejecución del recorrido. Lo anterior confirma la importancia dela planificación en relación con la caracterización de cada disciplina deportiva. Se observó una relación directa en eldesarrollo de la fuerza con la flexibilidad. Se comprueba el principio de los valores iniciales en lo referente aldesarrollo de la flexibilidad. En la escalada deportiva se debe incrementar considerablemente el volumen y laintensidad del entrenamiento, para lograr cambios significativos en la flexibilida