An “off-the shelf” Synthetic Membrane to Simplify Regeneration of Damaged Corneas

yesOur overall aim is to develop a synthetic off-the-shelf alternative to human amniotic membrane which is currently used for delivering cultured limbal stem cells to the cornea in patients who suffer scarring of the cornea because of the loss of limbal stem cells. We have recently reported that both cultured cells and limbal explants grow well on electrospun Poly(D,L-lactide-co-glycolide) (PLGA) (44 kg/mol) with a 50:50 ratio of lactide and glycolide and sterilized with γ-irradiation. Prior to undertaking a clinical study our immediate aim now is to achieve long term storage of the membranes in convenient to use packaging. Membranes were electrospun from Poly(D,L-lactide-co-glycolide) (44 kg/mol) with a 50:50 ratio of lactide and glycolide and sterilized with γ-irradiation and then stored dry (with desiccant) for several months at -80°C and -20°C , Room temperature (UK and India), 37°C and 50°C. We explored the contribution of vacuum sealing and the use of a medical grade bag (PET/Foil/LDPE) to achieve a longer shelf life. Confirmation of membranes being suitable for clinical use was obtained by culturing tissue explants on membranes post storage. When scaffolds were stored dry the rate of breakdown was both temperature and time dependent. At -20°C and -80°C there was no change in fiber diameter over 18 months of storage, and membranes were stable for 12 months at 4°C while at 50°C (above the transition temperature for PLGA) scaffolds lost integrity after several weeks. The use of vacuum packaging and a medical grade bag both improved the storage shelf-life of the scaffolds. The impact of temperature on storage is summarized beneath. We report that this synthetic membrane can be used as an off-the-shelf or-out-of-the freezer alternative to the amniotic membrane for corneal regeneration

Mass Splitting and Production of Σc0\Sigma_c^0 and Σc++\Sigma_c^{++} Measured in 500GeV500 {GeV} π−−\pi^- -N Interactions

From a sample of $2722 \pm 78$ $\Lambda_c^+$ decaying to the $pK^-\pi^+$ final state, we have observed, in the hadroproduction experiment E791 at Fermilab, $143 \pm 20$ $\Sigma_c^0$ and $122 \pm 18$ $\Sigma_c^{++}$ through their decays to $\Lambda_c^+ \pi^{\pm}$. The mass difference $M(\Sigma_c^0) - M(\Lambda_c^+$) is measured to be $(167.38\pm 0.29\pm 0.15) {MeV}$; for $M(\Sigma_c^{++}) - M(\Lambda_c^+)$, we find $(167.76\pm 0.29\pm0.15) {MeV}$. The rate of $\Lambda_c^+$ production from decays of the $\Sigma_c$ triplet is (22\pm 2\pm 3) {%} of the total $\Lambda_c^+$ production assuming equal rate of production from all three, as measured for $\Sigma_c^0$ and $\Sigma_c^{++}$. We do not observe a statistically significant $\Sigma_c$ baryon-antibaryon production asymmetry. The $x_F$ and $p_t^2$ spectra of $\Lambda_c^+$ from $\Sigma_c$ decays are observed to be similar to those for all $\Lambda_c^+$'s produced.Comment: 15 pages, uuencoded postscript 3 figures uuencoded, tar-compressed fil

Two-Body Charmless B Decays Involving eta and eta'

We discuss implications of recent experimental data for B decays into two pseudoscalar mesons, with emphasis on those with $\eta$ and $\eta'$ in the final states. Applying a U-spin argument, we show that tree and penguin amplitudes, both in $B^+ \to \pi^+ \eta$ and in $B^+ \to \pi^+ \eta'$, are of comparable magnitudes. Nontrivial relative weak and strong phases between the tree-level amplitudes and penguin-loop amplitudes in the $B^{\pm} \to \pi^{\pm} \eta$ modes are extracted. We predict possible values for the averaged branching ratio and CP asymmetry of the $B^{\pm} \to \pi^{\pm} \eta'$ modes. We test the assumption of a singlet-penguin amplitude with the same weak and strong phases as the QCD penguin in explaining the large branching ratios of $\eta' K$ modes, and show that it is consistent with current branching ratio and CP asymmetry data of the $B^+ \to (\pi^0, \eta, \eta') K^+$ modes. We also show that the strong phases of the singlet-penguin and tree-level amplitudes can be extracted with further input of electroweak penguin contributions and a sufficiently well-known branching ratio of the $\eta K^+$ mode. Using SU(3) flavor symmetry, we also estimate required data samples to detect modes that have not yet been seen.Comment: 16 pages, 7 figures, to be submitted to Phys. Rev. D (v1); some remarks and references added (v2); more references added (v3

Mapping child growth failure across low- and middle-income countries

Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0�59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3�5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization�s median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99 of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40 and wasting to less than 5 by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications. © 2020, The Author(s)

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17 : analysis for the Global Burden of Disease Study 2017

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

A novel method of surgical management of Rockwood type III-V acromioclavicular joint injuries

Aims and objectives: To assess the functional outcome of Rockwood type III-V acute acromioclavicular joint injuries. Background: Acromioclavicular joint injuries occur most commonly in active or athletic young adults. Treatment of acromioclavicular separations has been a subject of debate. In general, types I and II injuries are treated non-operatively in the acute setting and types III - VI injuries generally require surgical repair. A new method of surgical treatment using mersilene tape for ligament reconstruction and its outcome is described in present study. Materials and methods: A longitudinal study was conducted among ten patients with mean age of 37.25 years (range 30-45 years) with Rockwood Grade III-V Acromioclavicular joint injuries of less than 2 weeks duration were treated with reconstruction of acromioclavicular ligament and coracoclavicular ligament using mersilene tape from June 2011 to June 2013. The assessment of outcome was done in follow-up visits by anteroposterior radiographs and the clinical outcomes were assessed using Constant shoulder Score (CS) and cross-arm test. Results: Mean Constant Score was 93.1 in the operated shoulder and 95.9 in the normal shoulder (p = 0.06). The AC joint was clinically stable with satisfactory range of movements. Conclusions: Reconstruction of the acromioclavicular ligament and the coracoclavicular ligament using mersilene tape can be advocated for acute and displaced acromioclavicular joint injuries