Gastrointestinal Bleeding in Patients With Acute Respiratory Distress Syndrome: A National Database Analysis.

Background:The goal of our study was to determine the impact of gastrointestinal bleeding (GIB) on in-hospital outcomes among acute respiratory distress syndrome (ARDS) patients, and subsequently determine the potential risk factors for the development of GIB. Methods:ARDS patients with and without GIB were identified using the National Inpatient Sample (2002 - 2012). Linear regression analysis was used to assess impact of GIB on in-hospital mortality, length of stay and total charges. Univariate logistic regression was used to determine associated odds ratios (OR) for causes of ARDS and common comorbid conditions. Results:We identified 149,190 ARDS patients. The incidence of GIB was the highest among patients \u3e 60 years (P \u3c 0.001). GIB was associated with longer hospitalization days (7.3 days versus 11.9 days, P \u3c 0.001), higher mortality (11% versus 27%, P \u3c 0.001) and greater economic burden ($82,812 versus$45,951, P \u3c 0.001). GIB was common in cirrhosis (OR: 8.3), peptic ulcer disease (OR: 3.7), coagulopathy disorders (OR: 3.003), thrombocytopenia (OR: 2.6), anemia (OR: 2.5) and atrial fibrillation (OR: 1.5). ARDS secondary to aspiration pneumonia (OR: 2.0), pancreatitis (OR: 2.0), sepsis (OR: 1.6) and community acquired pneumonia (OR: 0.8) was more likely to have GIB. Conclusion:Our study demonstrates that GIB in ARDS patients is associated with significant increased mortality, hospitalization and health care cost

Determination of Alpha-i Antitrypsin Genetic Deficiency in Duodenal Ulcer by Polymerase Chain Reaction

Objective: To confirm alpha-I-AT deficiency status in duodenal ulcer using a combination of PCR and restricted enzyme digestion. Methods: Fifty patients with endoscopically proven duodenal ulcer and hundred controls with no signs of the disease were included. Alpha-i-AT phenotypes were confirmed by polymerase chain reaction followed by restriction enzyme digestion. Results:Alpha-I-AT concentration in duodenal ulcer patients showed a mean value of 2.12 ± 0.11g/1 (range: 0.52-3.95 g/1, p Conclusion: Alpha-1 AT deficiency was found in 10% of duodenal ulcer patients. DNA analysis more accurately resolved the phenotypes as S and Z mutations (JPMA 52:545; 2002)

Mass Profiles of the Typical Relaxed Galaxy Clusters A2199 and A496

We present maps and radial profiles of the gas temperature in the nearby galaxy clusters A2199 and A496, which have the most accurate ASCA spectral data for all hot clusters. These clusters are relaxed and can provide reliable X-ray mass measurements under the assumption of hydrostatic equilibrium. The cluster average temperatures corrected for the presence of cooling flows are 4.8+-0.2 keV and 4.7+-0.2 keV (90% errors), respectively. Outside the central cooling flow regions, the radial temperature profiles are similar to those of the majority of nearby relaxed clusters. They are accurately described by polytropic models with gamma=1.17+-0.07 for A2199 and gamma=1.24+-0.09 for A496. We use these polytropic models to derive accurate total mass profiles. Within r=0.5/h Mpc, which corresponds to a radius of overdensity 1000, the total mass values are 1.45+-0.15 10^14 /h Msun and 1.55+-0.15 10^14 /h Msun. These values are 10% lower than those obtained assuming constant temperature. The values inside a gas core radius (0.07-0.13/h Mpc) are a factor of >1.5 higher than the isothermal values. The gas mass fraction increases with radius (by a factor of 3 between the X-ray core radius and r_1000) and at r_1000 reaches values of 0.057+-0.005 and 0.056+-0.006 h^-3/2 for the two clusters, respectively. Our mass profiles within r_1000 are remarkably well approximated by the NFW "universal" profile. Since A2199 and A496 are typical relaxed clusters, the above findings should be relevant for most such systems. In particular, the similarity of the temperature profiles in nearby clusters appears to reflect the underlying "universal" dark matter profile. The upward revision of mass at small radii will resolve most of the discrepancy between the X-ray and strong lensing mass estimates. (Abridged)Comment: Latex, 9 pages, 6 figures, uses emulateapj.sty. Submitted to Ap

Immersive horizons: navigating ethical terrain and practical boundaries in the use of virtual reality for cancer symptom management – a comprehensive narrative review

Cancer is a significant healthcare problem. However, advancements in diagnostic procedures and therapeutic modalities have led to a decline in cancer mortality rates by 1% annually in most countries. Cancer patients often experience symptoms such as pain, cancer-related fatigue, anxiety, and lymphedema. To counter these side effects, there have been tremendous efforts. One such effort is the use of virtual reality (VR) technology, which is an interactive technology. VR has played a significant role in managing disorders such as phobias and anxiety disorders, and support for patients with cognitive and physical rehabilitation, acute and chronic pain management, and emotional support in different settings such as during hospitalizations. Our team conducted an extensive search for electronic literature on virtual reality in various databases, such as Medline, PubMed, Google Scholar, and Psych INFO, up to July 2023. We used keywords like "virtual reality," "cancer care," "depression," "cognition," "pain," "telemedicine," "rehabilitation care," "physical therapy," "radiotherapy," "telerehabilitation," "avatar," "video games," and "visual aid" as our search criteria. VR interventions for cancer patients include exposure therapy, psycho-education, and relaxation techniques, which have been shown to reduce symptoms significantly. VR distraction can also mitigate pain during medical procedures. Studies suggest that VR holds promise in rehabilitation and oncologic treatment, as it can improve function metrics, range of motion, and motivation for treatment. The review scrutinizes the use of digital information and virtual reality technology to alleviate cancer-related distress by providing remote care.

Breadwinners and Homemakers: Migration and Changing Conjugal Expectations in Rural Bangladesh

The literature on marriage norms and aspirations across societies largely sees the institution as static – a tool for the assertion of masculinities and subordination of women. The changing meanings of marriage and conjugality in the contemporary context of globalisation have received scant attention. Based on research in rural Bangladesh, this article questions the usefulness of notions of autonomy and dependence in understanding conjugal relations and expectations in a context of widespread migration for extended periods, especially to overseas destinations, where mutuality is crucial for social reproduction, though in clearly genderdemarcated domains

Multiwall carbon nanotube promising route for removal of chromium from wastewater via batch column mechanism

Water pollution regarding heavy metals issue keep lingering our days from time to time, and some problems even left unattended. The most crucial cause of this pollution is the industrial waste, especially waste water that had been released into the drainage system without being treated first. This activity had been done illegally and left a huge impact towards the environment also human. In this study multiwall carbon nanotubes (MWCNTs) are promising route for removal of chromium was investigated. Results revealed that the optimum conditions for highest removal (99.97%) of chromium are pH7,0.04g of MWCNTs dosage, and flowrate of 20.83 mL/s. Based on adsorption isotherm for this experiment, the amount of chromium adsorbed, qm calculated was 50.51 mg of chromium/gram of MWCNTs. From the results obtained, it had been proved that MWCNTs can be used as an effective adsorbent in chromium removal from aqueous solution due to high adsorption capacity

Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry.

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291

Immobilization of lipase enzyme carbon nanotubes via adsorption

Lipase is an enzyme used widely in many major industries. Immobilization of enzymes will help to enhance its sustainability as enzymes are more resistance to changes in environment and can be reused. This experiment examines effects the immobilization of lipase with adsorption technique through carbon nanotubes. The paper investigates the enzyme activity and efficiency of immobilized enzyme lipase by using assay solution. It also presents the effects of pH on immobilized enzyme and the characterization of the immobilized enzyme lipase with FTIR spectrum and FESEM technique. The results showed that there are as enzyme concentration increases, the enzymatic activity increases too. However, this lowers the immobilization efficiency due to saturation of binding pores on functionalized MWCNTs. Meanwhile, the optimum pH for maximum immobilization activity of enzyme lipase is at pH 6. Based on the characterization by FTIR spectrum and FESEM, it is confirmed by the presence of functional group in FTIR spectrography. On the other side, FESEM also confirms that immobilization of enzyme has occurred

Debye-Hueckel solution for steady electro-osmotic flow of a micropolar fluid in a cylindrical microcapillary

Analytic expressions for the speed, flux, microrotation, stress, and couple stress in a micropolar fluid exhibiting steady, symmetric and one-dimensional electro-osmotic flow in a uniform cylindrical microcapillary were derived under the constraint of the Debye-Hueckel approximation, which is applicable when the cross-sectional radius of the microcapillary exceeds the Debye length, provided that the zeta potential is sufficiently small in magnitude. As the aciculate particles in a micropolar fluid can rotate without translation, micropolarity influences fluid speed, fluid flux, and one of the two non-zero components of the stress tensor. The axial speed in a micropolar fluid intensifies as the radius increases. The stress tensor is confined to the region near the wall of the microcapillary but the couple stress tensor is uniform across the cross-section.Comment: 19 page

Synthesis and Quantitative Structure–Activity Relationship of Imidazotetrazine Prodrugs with Activity Independent of O6-Methylguanine-DNA-methyltransferase, DNA Mismatch Repair and p53.

The antitumor prodrug Temozolomide is compromised by its dependence for activity on DNA mismatch repair (MMR) and the repair of the chemosensitive DNA lesion, O6-methylguanine (O6-MeG), by O6-methylguanine-DNA-methyltransferase (EC 2.1.1.63, MGMT). Tumor response is also dependent on wild-type p53. Novel 3-(2-anilinoethyl)-substituted imidazotetrazines are reported that have activity independent of MGMT, MMR and p53. This is achieved through a switch of mechanism so that bioactivity derives from imidazotetrazine-generated arylaziridinium ions that principally modify guanine-N7 sites on DNA. Mono- and bi-functional analogs are reported and a quantitative structure-activity relationship (QSAR) study identified the p-tolyl-substituted bi-functional congener as optimized for potency, MGMT-independence and MMR-independence. NCI60 data show the tumor cell response is distinct from other imidazotetrazines and DNA-guanine-N7 active agents such as nitrogen mustards and cisplatin. The new imidazotetrazine compounds are promising agents for further development and their improved in vitro activity validates the principles on which they were designed