対流圏に見られる鉛直微細構造

We report the design, synthesis, detailed characterization, and analysis of a new multifunctional pi-conjugated bola-amphiphilic chromophore: oligo-(p-phenyleneethynylene)-dicarboxylic acid with dialkoxyoctadecyl side chains (OPE-C-18-1). OPE-C-18-1 shows two polymorphs at 123 K (OPE-C-18-1') and 373 K (OPE-C-18-1 `'), whose crystal structures were characterized via single crystal X-ray diffraction. OPE-C-18-1 also exhibits thermotropic liquid crystalline property revealing a columnar phase. The inherent pi-conjugation of OPE-C-18-1 imparts luminescence to the system. Photoluminescence measurements on the mesophase also reveal similar luminescence as in the crystalline state. Additionally, OPE-C-18-1 shows mechano-hypsochromic luminescence behavior. Density functional theory (DFT)-based calculations unravel the origins behind the simultaneous existence of all these properties. Nanoindentation experiments on the single crystal reveal its mechanical strength and accurately correlate the molecular arrangement with the liquid crystalline and mechanochromic luminescence behavior

Enhanced antibacterial activity of streptomycin against some human pathogens using green synthesized silver nanoparticles

AbstractThe development of eco-friendly technologies in nanoparticle synthesis is of utmost importance in order to expand their biological horizons. In the present study, bioreduction of AgNO3 into AgNPs using various leaf extracts of Ficus virens is explained. The resulting AgNPs were characterized by UV–vis spectroscopy, dynamic light scattering (DLS), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and transmission electron microscopy (TEM). Synthesis of AgNPs was confirmed by color change from transparent to brown with maximum absorption at 420 nm due to surface plasmon resonance of AgNPs. X-ray diffraction studies showed that the biosynthesized AgNPs were crystalline in nature, and TEM analysis showed spherical shape of the nanoparticles with size ranging from 4.98 to 29 nm. FTIR study indicates that mainly –C = O, -OH and N-H groups in leaf extracts are involved in the reduction of Ag+ ions to Ag atoms, and proteins are responsible for stabilizing the silver nanoparticles. The synthesized AgNPs showed significant antibacterial activity against Gram positive and gram negative human bacterial pathogens. The results showed that AgNPs also synergistically enhance (2.02–57.98%) the antibacterial activity of streptomycin, a common antibiotic. With this approach, AgNPs can be used as a new generation of antimicrobial agents for successful development of drug delivery

Serosurveillance for Japanese encephalitis virus infection among equines in India

The seroprevalence of Japanese encephalitis virus (JEV) among equines was evaluated from January 2006 to December 2009 in 13 different states of India by hemagglutination inhibition (HI) test and virus neutralization test (VNT). Antibodies against JEV were detected in 327 out of 3,286 (10%) equines with a maximum prevalence reported in the state of Manipur (91.7%) followed by Gujarat (18.5%), Madhya Pradesh (14.4%), and Uttar Pradesh (11.6%). Evidence of JEV infection was observed in equines in Indore (Madhya Pradesh) where a 4-fold or higher rise in antibody titer was observed in 21 out of 34 horses in November 2007 to October 2006. In March 2008, seven of these horses had a subsequent 4-fold rise in JEV antibody titers while this titer decreased in nine animals. JEV-positive horse sera had a JEV/WNV (West Nile virus) ratio over 2.0 according to the HI and/or VNT. These results indicated that JEV is endemic among equines in India

Study protocol for economic evaluation of probiotic intervention for prevention of neonatal sepsis in 0-2-month old low-birth weight infants in India: the ProSPoNS trial

Introduction: The ProSPoNS trial is a multicentre, double-blind, placebo-controlled trial to evaluate the role of probiotics in prevention of neonatal sepsis. The present protocol describes the data and methodology for the cost utility of the probiotic intervention alongside the controlled trial. Methods and analysis: A societal perspective will be adopted in the economic evaluation. Direct medical and non-medical costs associated with neonatal sepsis and its treatment would be ascertained in both the intervention and the control arm. Intervention costs will be facilitated through primary data collection and programme budgetary records. Treatment cost for neonatal sepsis and associated conditions will be accessed from Indian national costing database estimating healthcare system costs. A cost–utility design will be employed with outcome as incremental cost per disability-adjusted life year averted. Considering a time-horizon of 6 months, trial estimates will be extrapolated to model the cost and consequences among high-risk neonatal population in India. A discount rate of 3% will be used. Impact of uncertainties present in analysis will be addressed through both deterministic and probabilistic sensitivity analysis. Ethics and dissemination: Has been obtained from EC of the six participating sites (MGIMS Wardha, KEM Pune, JIPMER Puducherry, AIPH, Bhubaneswar, LHMC New Delhi, SMC Meerut) as well as from the ERC of LSTM, UK. A peer-reviewed article will be published after completion of the study. Findings will be disseminated to the community of the study sites, with academic bodies and policymakers. Registration: The protocol has been approved by the regulatory authority (Central Drugs Standards Control Organisation; CDSCO) in India (CT-NOC No. CT/NOC/17/2019 dated 1 March 2019). The ProSPoNS trial is registered at the Clinical Trial Registry of India (CTRI). Registered on 16 May 2019. Trial registration number: CTRI/2019/05/019197; Clinical Trial Registry

Patient-Specific 3D Vascular Reconstruction and Computational Assessment of Biomechanics – an Application to Abdominal Aortic Aneurysm

The current clinical management of abdominal aortic aneurysm (AAA) disease is based on measuring the aneurysm maximum diameter to decide when timely intervention can be recommended to a patient. However, other parameters may also play a role in causing or predisposing the AAA to either an early or delayed rupture relative to its size. Therefore, patient-specific assessment of rupture risk based on physical principles such as individualized biomechanics can be conducive to the development of a vascular tool with translational potential. To that end, the present doctoral research materialized into a framework for image based patient-specific vascular biomechanics assessment. A robust generalized approach is described herein for image-based volume mesh generation of complex multidomain bifurcated vascular trees with the capability of incorporating regionally varying wall thickness. The developed framework is assessed for geometrical accuracy, mesh quality, and optimal computational performance. The relative influence of the shape and the constitutive wall material property on the AAA wall mechanics was explored. This study resulted in statistically insignificant differences in peak wall stress among 28 AAA geometries of similar maximum diameter (in the 50 – 55 mm range) when modeled with five different hyperelastic isotropic constitutive equations. Relative influence of regionally varying vs. uniform wall thickness distribution on the AAA wall mechanics was also assessed to find statistically significant differences in spatial maxima of wall stresses, strains, and strain energy densities among the same 28 AAA geometries modeled with patient-specific non-uniform wall thickness and two uniform wall thickness assumptions. Finally, the feasibility of estimating in vivo wall strains from individual clinical images was evaluated. Such study resulted in a framework for in vivo 3D strain distributions based on ECG gated, unenhanced, dynamic magnetic resonance images acquired for 20 phases in the cardiac cycle. Future efforts should be focused on further development of the framework for in vivo estimation of regionally varying hyperelastic, anisotropic constitutive material models with active mechanics components and the integration of such framework with an open source finite element solver with the goal of increasing the translational potential of these tools for individualized prediction of AAA rupture risk in the clinic.</p

A comprehensive and systematic review of multi-criteria decision-making methods and applications in healthcare

Healthcare decision-making has often been viewed as a complex multi-dimensional problem due to medical, technological, social, ethical, economic, and environmental factors along with multiple and conflicting objectives and the participation of different stakeholders. Several multi-criteria decision-making (MCDM) techniques have been successfully deployed to resolve this issue, providing transparent, consistent, accurate, and timely solutions. This paper reviews 140 journal articles published during 2013-2022 (available in the Scopus database) on MCDM applications in healthcare decision-making. Those articles are subsequently categorized into 11 application areas, i.e., (a) supply chain management, (b) medical device and material selection, (c) disease identification and treatment, (d) healthcare information system, (e) logistics, (f) operations management in healthcare, (g) healthcare quality evaluation, (h) risk management, (i) waste management, (J) COVID-19, and (k) miscellaneous. Their contents are also critically analysed​ concerning year-wise, journal-wise, institution-wise, and country-wise publications, authors’ nationality, MCDM techniques employed, other mathematical tools considered for criteria weight measurement and uncertainty modelling, and relation with other keywords. The analysis identifies Waste Management as the most explored area; Computers and Industrial Engineering, Journal of Cleaner Production, and Sustainability as the most popular journals; Shiraz University of Medical Sciences, Iran, as the most contributing university; and India as the most productive country in respect of several authors and co-authors; and analytic hierarchy process as the most popular MCDM tool. It would help healthcare professionals understand how other researchers have efficiently explored the benefits of various MCDM tools in solving healthcare-related decision-making problems

Factors Associated with Non-Adherence to Antihypertensive Medication among Hypertensive Patients in Community

Background: Hypertension is one of the common non-communicable health problems. While pharmacologic intervention is the most efficient way to control hypertension; non-adherence to medication is accounted as a significant cause for complications. This study was to address and to determine the magnitude of non-adherence among hypertensive patients by summarizing the associated risks factors among patients in the community level. Method: This is a cross-sectional study conducted on hypertensive patients who visited the community health clinic at Dhading, Nepal on 9th and 10th June 2018 using a pre-structured questionnaire. Patients were sampled by nonprobability purposive sampling method. Effect of age, gender, marital status, employment, education level, presence of diabetes, cerebrovascular disease, current smoker, and family history of hypertension were analyzed by the compliance of antihypertensive drugs using frequency distribution, chi-square test, and logistic regression. For all of the analysis p-value < 0.5 was considered as significant. Results: 150 patients were included in the study, out of whom 48 patients were found adherent and 102 patients non-adherent to antihypertensive medication. Out of total population 46% (n=69) were male and 54% (n=81) were female with no significant association   between compliant and noncompliant groups (OR= 1.599, p>0.05). Mean age of patients in complaint group was 57 years and in the non-compliant group was 52 years with an odds ratio of 0.96 (p <0.05, 95% C.I : 0.933 - 0.987). However, there was no significant effect of marital status, employment status, and family history of hypertension on adherence to antihypertensive medication. Presence of diabetes had a significant effect on adherence to medication (OR=2.634, p<0.05). The most common reason for non-adherence was the fear of getting stuck with medication for lifetime (n=31, 30.3%) followed by the use of ayurvedic/home remedy (n=27, 26.5%), unaware of complications (n=16, 15.7%), lifestyle modification (n=14, 13.7%), and financial weakness (n=9, 8.8%).   Conclusion: Fear of taking medication lifelong was the major reason for non-adherence; however, age and comorbid health conditions like diabetes have a significant effect on adherence to medication. Health care awareness and counselling can help these patients to overcome the fear of taking medication for a lifetime, which can increase the medication compliance rate. Keywords: Hypertension, Medication, Non-adherence, Compliant, Noncompliant DOI: http://dx.doi.org/10.3126/jkahs.v2i1.2441

Cone beam computerized tomography evaluation of incisive canal and anterior maxillary bone thickness for placement of immediate implants

Purpose: Variation of dimensions of the nasopalatine canal and anterior maxillary bone thickness vary in relation to age, gender, edentulism, and ethnicity; thorough knowledge with regard to these landmarks is of vital importance prior to surgical procedures such as implant placement and local anesthesia in the anterior maxilla. Cone beam computerized tomography (CBCT) aids in accurate treatment planning in such situations. Subjects and Methods: A total of 300 participants were selected by the inclusion and exclusion criteria. CBCT was performed with Hyperion X9 CBCT Scanner. Images were reconstructed from the CBCT data using NNT image reconstruction software and visualized using multi-planar resolution screen. The dimensions of the nasopalatine foramen (NPF), the incisive canal (IC) and foramen, and anterior maxillary bone thickness were measured. Results: The mean diameter of NPF was found to be 3.27 mm, incisive foramen (IF) was 3.62 mm, IC was 2.12 mm. The average length of the IC was 10.66 mm. The IF was located at a mean distance of 13.81 mm away from the most anteroinferior point of the cortical plate of the labial bone of the maxilla. The anterior maxillary bone was the thickest at the nasal spine level (10.94 mm), and was the narrowest at lower labial alveolus (7.16 mm). The average anterior maxillary bone thickness was found to be 8.36 mm. Conclusion: Within the limitations of the study, it was found that found that gender and age are important factors that affected the characteristics of the IC and the amount of bone anterior to it

Chloroquine sensitizes biofilms of Candida albicans to antifungal azoles

Biofilms formed by Candida albicans, a human pathogen, are known to be resistant to different antifungal agents. Novel strategies to combat the biofilm associated Candida infections like multiple drug therapy are being explored. In this study, potential of chloroquine to be a partner drug in combination with four antifungal agents, namely fluconazole, voriconazole, amphotericin B, and caspofungin, was explored against biofilms of C. albicans. Activity of various concentrations of chloroquine in combination with a particular antifungal drug was analyzed in a checkerboard format. Growth of biofilm in presence of drugs was analyzed by XTT-assay, in terms of relative metabolic activity compared to that of drug free control. Results obtained by XTT-metabolic assay were confirmed by scanning electron microscopy. The interactions between chloroquine and four antifungal drugs were determined by calculating fractional inhibitory concentration indices. Azole resistance in biofilms was reverted significantly (p < 0.05) in presence of 250 µg/mL of chloroquine, which resulted in inhibition of biofilms at very low concentrations of antifungal drugs. No significant alteration in the sensitivity of biofilms to caspofungin and amphotericin B was evident in combination with chloroquine. This study for the first time indicates that chloroquine potentiates anti-biofilm activity of fluconazole and voriconazole