A simplified guide to randomized controlled trials.

A randomized controlled trial (RCT) is a prospective, comparative, quantitative study/experiment performed under controlled conditions with random allocation of interventions to comparison groups. The RCT is the most rigorous and robust research method of determining whether a cause-effect relationship exists between an intervention and an outcome. High quality evidence can be generated by performing an RCT when evaluating the effectiveness and safety of an intervention. Furthermore, RCTs yield themselves well to systematic review and meta-analysis providing a solid base for synthesizing evidence generated by such studies. Evidence-based clinical practice improves patient outcomes, safety, and is generally cost-effective. Therefore, RCTs are becoming increasingly popular in all areas of clinical medicine including perinatology. However, designing and conducting an RCT, analyzing data, interpreting findings and disseminating results can be challenging as there are several practicalities to be considered. In this review, we provide a simple descriptive guidance on planning, conducting, analyzing and reporting RCTs

Modelling and analysis of direct air capture systems in different locations

Direct air capture is an important negative emission technology with the aim to reduce carbon dioxide emissions in the atmosphere and to face the current environmental problems such as global warming and climate change. This emerging technology can be based on an adsorption system affected by the used sorbent (physisorbents or chemisorbents). Efficiencies can be measured through the use of key performance indicators that allow a comparison among different processes. An independent analysis was conducted in our previous research to evaluate key performance indicators (total cost, energy consumption, environmental impact and capture capacity) for a direct air capture system based on adsorption using different sorbents (three metal organic frameworks and two amine functionalized sorbents). In this research, the same analysis was extended to several Countries around the world, changing the ambient air temperature according to the yearly average value of the location. Results show that by increasing the air temperature, the adsorption capacity decreases, in a more significant way for metal organic frameworks compared to amine functionalized sorbents. An opposite effect is for energy consumption. Moreover, by increasing the ambient air temperature, a higher environmental impact (in terms of climate change) is present. A trend with the air temperature was not found for total costs. Overall, locations with lower ambient air temperatures are preferred due to a lower environmental impact and energy consumption

Is Plaque Removal Efficacy of Toothbrush Related to Bristle Flaring? A 3-month Prospective Parallel Experimental Study

Background: Toothbrushes are over-the-counter products; therefore, no special instruction is given to users when they purchase. There are scarce published studies that have investigated about how often toothbrushes should be replaced. Thus, this study aimed to verify the impact of the Progressive Toothbrush Bristle Flaring on plaque control efficacy of toothbrush.Materials and Methods: Thirty six subjects were randomly selected and underwent complete oral prophylaxis 10 days prior to the Baseline plaque recording. All subjects were provided with new similar toothbrushes and were divided into two groups. New Brush Group changed toothbrush every month and Old month Group used single toothbrush for the whole period of the study. Both groups were assessed for plaque accumulation every month using Turesky et al, (1970) modification of the Quigley and Hein (1962) plaque index. Toothbrush head was photographed and assessed by measuring the brushing surface area on standardized photographs using National Institutes of Health Image Analysis Program (USA).Results: Both groups showed similar plaque scores at the 40th day; progressive increase in the plaque scores in group without changing the toothbrush were recorded at the 70th and 100th days. As toothbrush flaring increased, the plaque scores also increased in the Old Brush Group. Highest plaque accumulation was recorded in Mandibular Lingual aspects in Old Brush Group.Conclusion: Progressive increase was seen in the plaque scores with increase in toothbrush bristle flaring.Keywords: Toothbrush, Efficacy of Toothbrush, Bristle Flaring, Plaque Remova

Water and agricultural transformation in India: A symbiotic relationship-I

An argument for twin propositions is presented in this two-part paper: (i) that solving India's water problem requires a paradigm shift in agriculture (Part I), and (ii) that the crisis in Indian agriculture cannot be resolved without a paradigm shift in water management and governance (Part II). If farming takes up 90% of India's water and just three water-intensive crops continue to use 80% of agricultural water, the basic water needs of millions of people, for drinking water or protective irrigation, cannot be met. This first part argues that the paradigm shift in agriculture requires a shift in cropping patterns suited to each agroecological region, a movement from monoculture to polycultural crop biodiversity, a decisive move towards agroecological farming, and greater emphasis on soil rejuvenation

Analysis of technologies for carbon dioxide capture from the air

The increase in CO2 concentration in the atmosphere has prompted the research community to find solutions for this environmental problem, which causes climate change and global warming. CO2 removal through the use of negative emissions technologies could lead to global emission levels becoming net negative towards the end of this century. Among these negative emissions technologies, direct air capture (DAC), in which CO2 is captured directly from the atmosphere, could play an important role. The captured CO2 can be removed in the long term and through its storage can be used for chemical processes, allowing closed carbon cycles in the short term. For DAC, different technologies have been suggested in the literature, and an overview of these is proposed in this work. Absorption and adsorption are the most studied and mature technologies, but others are also under investigation. An analysis of the main key performance indicators is also presented here and it is suggested that more efforts should be made to develop DAC at a large scale by reducing costs and improving efficiency. An additional discussion, addressing the social concern, is indicated as well

Water and agricultural transformation in India: A symbiotic relationship—II

An argument for twin propositions is presented in this two-part paper: (i) that solving India’s water problem requires a paradigm shift in agriculture (Part I), and (ii) that the crisis in Indian agriculture cannot be resolved without a paradigm shift in water management and governance (Part II). The second part describes the paradigm shift needed in water, which includes rejuvenation of catchment areas of rivers, a shift towards participatory approaches to water management, focus on green water and protective irrigation, and widespread adoption of water-saving seeds and technologies, while building transdisciplinarity and overcoming hydro-schizophrenia in water governance

Development of real time PCR for detection and quantitation of Dengue Viruses

<p>Abstract</p> <p>Background</p> <p>Dengue virus (DENV), a mosquito borne flavivirus is an important pathogen causing more than 50 million infections every year around the world. Dengue diagnosis depends on serology, which is not useful in the early phase of the disease and virus isolation, which is laborious and time consuming. There is need for a rapid, sensitive and high throughput method for detection of DENV in the early stages of the disease. Several real-time PCR assays have been described for dengue viruses, but there is scope for improvement. The new generation TaqMan Minor Groove Binding (MGB) probe approach was used to develop an improved real time RT-PCR (qRT-PCR) for DENV in this study.</p> <p>Results</p> <p>The 3'UTR of thirteen Indian strains of DENV was sequenced and aligned with 41 representative sequences from GenBank. A region conserved in all four serotypes was used to target primers and probes for the qRT-PCR. A single MGB probe and a single primer pair for all the four serotypes of DENV were designed. The sensitivity of the two step qRT-PCR assay was10 copies of RNA molecules per reaction. The specificity and sensitivity of the assay was 100% when tested with a panel of 39 known positive and negative samples. Viral RNA could be detected and quantitated in infected mouse brain, cell cultures, mosquitoes and clinical samples. Viral RNA could be detected in patients even after seroconversion till 10 days post onset of infection. There was no signal with Japanese Encephalitis (JE), West Nile (WN), Chikungunya (CHK) viruses or with Leptospira, <it>Plasmodium vivax</it>, <it>Plasmodium falciparum </it>and Rickettsia positive clinical samples.</p> <p>Conclusion</p> <p>We have developed a highly sensitive and specific qRT-PCR for detection and quantitation of dengue viruses. The assay will be a useful tool for differential diagnosis of dengue fever in a situation where a number of other clinically indistinguishable infectious diseases like malaria, Chikungunya, rickettsia and leptospira occur. The ability of the assay to detect DENV-2 in inoculated mosquitoes makes it a potential tool for detecting DENV in field-caught mosquitoes.</p

A new technique for transumbilical insertion of central venous silicone catheters in newborn infants

Aim: A new technique allowing placement of umbilical silicone venous catheters (USVC) is described and compared with percutaneous silicone venous catheters (PSVC)

Environmental performance of different sorbents used for direct air capture

Currently, conventional carbon dioxide (CO2) mitigation solutions may be insufficient to achieve the stringent environmental targets set for the coming decades. CO2 removal (CDR) technologies, such as direct air capture (DAC), capturing CO2 from the ambient air, are required. In this research, an independent life cycle assessment (LCA) of DAC adsorption systems based on three physisorbents (metal organic frameworks) and two chemisorbents (amine functionalized sorbents) is presented. These capture processes have been optimised by us in previous work. Results show that for the overall capture process, negative CO2 emissions are ensured by using a cellulose-based amine sorbent (cradle-to-gate) ensuring even the net removal of CO2 from the atmosphere (cradle-to-grave). Processes using physisorbents have poorer performances. Chemisorbents yield operating conditions allowing lower impacts on the environment. In 2050, these processes could reduce climate change but can generate other environmental impacts. With the aim to have better environmental performances of DAC systems, future research should be focused on improving the physical properties of sorbents such as the silica gel based amine sorbent to increase their capture capacities. If metal organic frameworks are to be used, it is necessary to drop their energy consumption (by increasing the loading) and the required mass of sorbent

Tracking the genomic evolution of breast cancer metastasis

Therapeutic choices for metastatic tumors are, in most cases, based upon the histological and molecular analysis of the corresponding primary tumor. Understanding whether and to what extent the genomic landscape of metastasis differs from the tumors from which they originated is critical yet largely unknown. A recent report tackled this key issue by comparing the genomic and transcriptional profile of a metastatic lobular breast tumor with that of the primary tumor surgically removed 9 years earlier. The extent of the differences suggests a high degree of mutational heterogeneity between primary and metastatic lesions and indicates that significant evolution occurs during breast cancer progression