To study the efficacy of digital and transvaginal ultrasonographic measurement of cervical length in asymptomatic high risk women at POG 16-24 weeks as a predictor of preterm delivery and progesterone and cerclage vs. progesterone alone for short cervical length in prevention of preterm labour

Background: Objectives of current study were (i) To correlate the Cervical Length (CL) measured digitally and by transvaginal sonography (TVS) at 16 to 24 weeks with outcome of pregnancy (ii) Estimate risk of spontaneous preterm labour (PTL) based on CL measurements and (iii) study intervention in short CL and their effect on maternal and neonatal outcome.Methods: Women with singleton pregnancy at POG 16-24 weeks with history of previous preterm birth or mid trimester abortions were included in the study and subjected to digital assessment of CL followed by TVS measurement. In patients with TVS CL ≤25 mm, intervention in the form of progesterone or cerclage with progesterone was done. The outcome of the pregnancy in the form of delivery before completed 37 weeks or at and after 37 weeks was noted.Results: Twenty two subjects out of total 153 subjects (14.4%) had preterm delivery. The incidence of preterm delivery in study was 14.4%. Using Receiver Operating Characteristics (ROC) Curve, cut off value of digital CL was found to be 1.5 cm. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy of digital CL ≤1.5 cm in prediction of PTL were 72.7 %, 37.4%, 16.3%, 89.1% and 42.5% respectively. Cut off value of TVS CL by ROC curve was found to be 2.85 cm. The sensitivity, specificity, PPV, NPV and accuracy of CL (TVS) of ≤2.85 cm in prediction of PTL is 81.8%, 68.7%, 30.5%, 95.7%, 70.6% respectively. The outcome in form of PTL in 30 subjects, who had TVS CL ≤2.5 cm in both the intervention groups (McDonald stitch with progesterone and progesterone alone) was comparable (P value 0.60 not significant).Conclusions: The CL, both digitally and by TVS, was inversely correlated with the probability of preterm delivery so that the shorter the cervix, the greater the likelihood of preterm delivery. TVS CL is more predictive of preterm delivery than digital CL when performed between 16-24 weeks in asymptomatic high risk women. Intervention in short CL in form of McDonald’s stitch application with progesterone and progesterone alone have similar efficacy for prevention of PTL

Unzipping and binding of small interfering RNA with single walled Carbon Nanotube: a platform for small interfering RNA delivery

In an effort to design efficient platform for siRNA delivery, we combine all atom classical and quantum simulations to study the binding of small interfering RNA (siRNA) by pristine single wall carbon nanotube (SWCNT). Our results show that siRNA strongly binds to SWCNT surface via unzipping its base-pairs and the propensity of unzipping increases with the increase in the diameter of the SWCNTs. The unzipping and subsequent wrapping events are initiated and driven by van der Waals interactions between the aromatic rings of siRNA nucleobases and the SWCNT surface. However, MD simulations of double strand DNA (dsDNA) of the same sequence show that the dsDNA undergoes much less unzipping and wrapping on the SWCNT in the simulation time scale of 70 ns. This interesting difference is due to smaller interaction energy of thymidine of dsDNA with the SWCNT compared to that of uridine of siRNA, as calculated by dispersion corrected density functional theory (DFT) methods. After the optimal binding of siRNA to SWCNT, the complex is very stable which serves as one of the major mechanisms of siRNA delivery for biomedical applications. Since siRNA has to undergo unwinding process with the effect of RNA- induced silencing complex, our proposed delivery mechanism by SWCNT possesses potential advantages in achieving RNA interference (RNAi).Comment: 28 pages, 7 figures, 4 table

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

A novel interleaved and distributed FIFO

In deep submicron technologies, the delays of metal lines continue to increase in spite of an increasing number of metal layers and the use of low-k dielectrics. Thus, some form of interconnect pipelining is required in throughput intensive designs. Various approaches have been used for interconnect pipelining, e.g., synchronous, asynchronous, GALS and source-synchronous, and each presents a trade-off between the throughput and latency that can be achieved. This work provides an evaluation of the synchronous and the source-synchronous methods of interconnect pipelining. Reference designs for various synchronous and source-synchronous signalling methods are presented. The source-synchronous method entails the forwarding of a clock along with data; this forwarded clock suffers from skew due to process, voltage and temperature variations along the forwarded path. A FIFO is used to compensate for the skew between the forwarded clock and the local clock at the receiver end. We present a novel, interleaved and distributed FIFO that implements wave pipelining between the FIFO stages. This FIFO design helps to lower the latency of the source-synchronous interconnect. A metric of comparison called velocity is introduced, and a comparison of the performance of synchronous and source-synchronous signalling is presented on the metrics of throughput, velocity and power.Applied Science, Faculty ofElectrical and Computer Engineering, Department ofGraduat

Sterilisation of tonometers and gonioscopes

Precautions to prevent spread of infection through tonometers and gonioscopes are described in this article. Tonometers and gonioscopes should not be used in the presence of clinically manifest conjunctivitis and keratitis. The Schiotz tonometer should be dipped in a 1:1000 merthiolate solution, and rinsed in saline/ distilled water prior to use. The Goldmann applanation prism tip can be wiped with gauze soaked in 70&#x0025; isopropyl alcohol and then dried before use. Gonioscopes should be cleaned in running water, wiped with gauze soaked in 70&#x0025; isopropyl alcohol, and then dried before use. Koeppes and goniotomy lenses can be sterilized with ethylene oxide, prior to use in surgery

Unraveling siRNA unzipping kinetics with graphene

Using all atom molecular dynamics simulations, we report spontaneous unzipping and strong binding of small interfering RNA (siRNA) on graphene. Our dispersion corrected density functional theory based calculations suggest that nucleosides of RNA have stronger attractive interactions with graphene as compared to DNA residues. These stronger interactions force the double stranded siRNA to spontaneously unzip and bind to the graphene surface. Unzipping always nucleates at one end of the siRNA and propagates to the other end after few base-pairs get unzipped. While both the ends get unzipped, the middle part remains in double stranded form because of torsional constraint. Unzipping probability distributions fitted to single exponential function give unzipping time (tau) of the order of few nanoseconds which decrease exponentially with temperature. From the temperature variation of unzipping time we estimate the energy barrier to unzipping. (C) 2012 American Institute of Physics. http://dx.doi.org/10.1063/1.4742189

The role of artificial drainage devices in glaucoma surgery

The use of artificial drainage devices (ADDs) or "setons" in glaucoma surgery is generally restricted to patients with refractory glaucoma at high risk for failure from conventional filtration surgery. ADDs, both valved and nonvalved are currently available in this country. Recently, some of these devices have been propogated as primary treatment even for primary glaucomas. This article examines the role of ADDs in the modern management of the glaucomas. Specific indications for ADDs and methods to reduce the complication of overfiltration are discussed. The use of antimitotics, such as 5-fluorouracil or mitomycin, with traditional filtration has decreased the indications for ADDs. The literature and our experience confirm that currently there is no role for use of ADDs as a primary procedure in most glaucomas