The significance of variceal haemorrhage in Ghana: A retrospective review

Background: This study describes the burden of bleeding oesophageal varices at the main tertiary referral centre in Accra.Design: Retrospective design to describe the endoscopic spectrum and review mortality data following acute upper gastro-intestinal bleeding at the Korle-Bu Teaching Hospital. Endoscopic data was reviewed in the Endoscopy Unit between 2007 and 2010. Mortality data was collated from the Department of Medicine between 2010 and 2013.Interventions: The study questionnaire compiled clinical and demographic characteristics, endoscopic diagnoses, length of hospital admission and treatment regimens. Main outcome measures: Aetiology and time-trend analysis of mortality rates following acute upper gastro- intestinal bleeding; variceal bleeding treatment modalities.Results: On review of the endoscopic diagnoses, gastro- oesophageal varices were identified in 21.9% of cases followed by gastritis 21.7%, duodenal ulcer, 17.0%, and gastric ulcer, 13.2%. Gastro-oesophageal varices were the predominant cause of death from acute upper gastro-intestinal haemorrhage from 46% in 2010 to 76% in 2013. Outcomes following acute upper gastro-intestinal bleeding were dismal with some 38% of fatalities occurring within the first 24 hours. Injection sclerotherapy was the dominant endoscopic modality for secondary prevention of variceal bleeding in comparison with band ligation, mainly as a result of cost and availability.Conclusions: At the tertiary centre in Accra, variceal bleeding is an increasingly common cause of acute upper gastro-intestinal haemorrhage in comparison with previous reviews in Ghana. Its significantly high in-hospital mortality reflects inadequate facilities to deal with this medical emergency. A strategic approach to care with endoscopic services equipped with all the necessary therapeutic interventions will be vital in improving the outcomes of variceal bleeding in Ghana.Keywords: gastro-oesophageal; varices; bleeding; gastro- intestinal, Ghana

Invisibility in billiards

The question of invisibility for bodies with mirror surface is studied in the framework of geometrical optics. We construct bodies that are invisible/have zero resistance in two mutually orthogonal directions, and prove that there do not exist bodies which are invisible/have zero resistance in all possible directions of incidence

Topological modes bound to dislocations in mechanical metamaterials

Mechanical metamaterials are artificial structures with unusual properties, such as negative Poisson ratio, bistability or tunable vibrational properties, that originate in the geometry of their unit cell. At the heart of such unusual behaviour is often a soft mode: a motion that does not significantly stretch or compress the links between constituent elements. When activated by motors or external fields, soft modes become the building blocks of robots and smart materials. Here, we demonstrate the existence of topological soft modes that can be positioned at desired locations in a metamaterial while being robust against a wide range of structural deformations or changes in material parameters. These protected modes, localized at dislocations, are the mechanical analogue of topological states bound to defects in electronic systems. We create physical realizations of the topological modes in prototypes of kagome lattices built out of rigid triangular plates. We show mathematically that they originate from the interplay between two Berry phases: the Burgers vector of the dislocation and the topological polarization of the lattice. Our work paves the way towards engineering topologically protected nano-mechanical structures for molecular robotics or information storage and read-out.Comment: 13 pages, 6 figures; changes to text and figures and added analysis on mode localization; see http://www.lorentz.leidenuniv.nl/~paulose/dislocation-modes/ for accompanying video

Characteristics of gate-all-around silicon nanowire field effect transistors with asymmetric channel width and source/drain doping concentration

We performed 3D simulations to demonstrate structural effects in sub-20 nm gate-all-around silicon nanowire field effect transistors having asymmetric channel width along the channel direction. We analyzed the differences in the electrical and physical properties for various slopes of the channel width in asymmetric silicon nanowire field effect transistors (SNWFETs) and compared them to symmetrical SNWFETs with uniform channel width. In the same manner, the effects of the individual doping concentration at the source and drain also have been investigated. For various structural conditions, the current and switching characteristics are seriously affected. The differences attributed to the doping levels and geometric conditions are due to the electric field and electron density profile. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4745858]ope

(Non)Existence of Pleated Folds: How Paper Folds Between Creases

We prove that the pleated hyperbolic paraboloid, a familiar origami model known since 1927, in fact cannot be folded with the standard crease pattern in the standard mathematical model of zero-thickness paper. In contrast, we show that the model can be folded with additional creases, suggesting that real paper “folds” into this model via small such creases. We conjecture that the circular version of this model, consisting simply of concentric circular creases, also folds without extra creases. At the heart of our results is a new structural theorem characterizing uncreased intrinsically flat surfaces—the portions of paper between the creases. Differential geometry has much to say about the local behavior of such surfaces when they are sufficiently smooth, e.g., that they are torsal ruled. But this classic result is simply false in the context of the whole surface. Our structural characterization tells the whole story, and even applies to surfaces with discontinuities in the second derivative. We use our theorem to prove fundamental properties about how paper folds, for example, that straight creases on the piece of paper must remain piecewise-straight (polygonal) by folding.National Science Foundation (U.S.) (CAREER Award CCF-0347776

Quantitative Analysis of Serum Procollagen Type I C-Terminal Propeptide by Immunoassay on Microchip

BACKGROUND: Sandwich enzyme-linked immunosorbent assay (ELISA) is one of the most frequently employed assays for clinical diagnosis, since this enables the investigator to identify specific protein biomarkers. However, the conventional assay using a 96-well microtitration plate is time- and sample-consuming, and therefore is not suitable for rapid diagnosis. To overcome these drawbacks, we performed a sandwich ELISA on a microchip. METHODS AND FINDINGS: The microchip was made of cyclic olefin copolymer with straight microchannels that were 300 µm wide and 100 µm deep. For the construction of a sandwich ELISA for procollagen type I C-peptide (PICP), a biomarker for bone formation, we used a piezoelectric inkjet printing system for the deposition and fixation of the 1st anti-PICP antibody on the surface of the microchannel. After the infusion of the mixture of 2.0 µl of peroxidase-labeled 2nd anti-PICP antibody and 0.4 µl of sample to the microchannel and a 30-min incubation, the substrate for peroxidase was infused into the microchannel; and the luminescence intensity of each spot of 1st antibody was measured by CCD camera. A linear relationship was observed between PICP concentration and luminescence intensity over the range of 0 to 600 ng/ml (r(2) = 0.991), and the detection limit was 4.7 ng/ml. Blood PICP concentrations of 6 subjects estimated from microchip were compared with results obtained by the conventional method. Good correlation was observed between methods according to simple linear regression analysis (R(2) = 0.9914). The within-day and between-days reproducibilities were 3.2-7.4 and 4.4-6.8%, respectively. This assay reduced the time for the antigen-antibody reaction to 1/6, and the consumption of samples and reagents to 1/50 compared with the conventional method. CONCLUSION: This assay enabled us to determine serum PICP with accuracy, high sensitivity, time saving ability, and low consumption of sample and reagents, and thus will be applicable to clinic diagnosis

Designing Origami-Adapted Deployable Modules for Soft Continuum Arms

© Springer Nature Switzerland AG 2019. Origami has several attractive attributes including deployability and portability which have been extensively adapted in designs of robotic devices. Drawing inspiration from foldable origami structures, this paper presents an engineering design process for fast making deployable modules of soft continuum arms. The process is illustrated with an example which adapts a modified accordion fold pattern to a lightweight deployable module. Kinematic models of the four-sided Accordion fold pattern is explored in terms of mechanism theory. Taking account of both the kinematic model and the materials selection, a 2D flat sheet model of the four-sided Accordion fold pattern is obtained for 3D printing. Following the design process, the deployable module is then fabricated by laminating 3D printed origami skeleton and flexible thermoplastic polyurethane (TPU) coated fabric. Preliminary tests of the prototype shown that the folding motion are enabled mainly by the flexible fabric between the gaps of thick panels of the origami skeleton and matches the kinematic analysis. The proposed approach has advantages of quick scaling dimensions, cost effective and fast fabricating thus allowing adaptive design according to specific demands of various tasks

Tissue- and hormone- dependent progesterone receptor distribution in the rat uterus

BACKGROUND: Estradiol (E2) and progesterone (P) are well known regulators of progesterone receptor (PR) expression in the rat uterus. However, it is not known which receptor subtypes are involved. Little knowledge exist about possible differences in PR regulation through ERalpha or ERbeta, and whether the PR subtypes are differently regulated depending on ER type bound. Thus, in the present study PR immunostaining has been examined in uteri of ovariectomized (ovx) rats after different treatments of estrogen and P, in comparison with that in immature, cycling, and pregnant animals. METHODS: The uteri were collected from 1) ovx rats treated with E2 and/or P; 2) immature rats, intact cycling rats and animals pregnant day 8 and 18; 3) ovx rats treated with E2 or an estrogen receptor (ER)alpha agonist or an ERbeta agonist. Two antibodies were used, one detecting PRA+B and another one specific for PRB. Real-time PCR was used to determine mRNA levels for PRAB and PRB in experiment 3. RESULTS: In stroma and myometrium faint staining was detected in ovx controls (OvxC), whereas E2 treatment resulted in strong staining. In contrast to this, in luminal epithelium (LE) the staining was strong in the OvxC group, whereas E2 treatment during the last 24 hrs before sacrifice caused a decrease. Similar to OvxC the LE of the immature animals was strongly stained. In the pregnant rats LE was negative, well in agreement with the results seen after E2 treatment. In the pregnant animals the stroma and decidua was strongly stained for PRAB, but only faint for PRB, indicating that PRA is the most expressed isoform in this state. The increase in stromal and myometrial immunostaining after E2 treatment was also found after treatment with the ERalpha agonist PPT. The ERbeta agonist DPN caused a decrease of the PR mRNA levels, which was also found for PRAB and PRB immunostaining in the GE. CONCLUSION: Stromal and myometrial PRAB levels are increased via ERalpha, as shown by treatment with E2 and the ERalpha agonist PPT, while the levels in LE are decreased. The uterine stroma of pregnant rats strongly expressed PRAB, but very little PRB, which is different to E2 treated ovx animals where both PRAB and PRB are strongly expressed. The ERbeta agonist DPN decreased the mRNA levels of PRAB and PRB, as well as the PRAB protein level in GE. These results suggest that ERbeta signals mainly down-regulate PR levels in the epithelial cells. ERalpha, on the other hand, up-regulates PR levels in the stroma and myometrium while it decreased them in LE. Thus, the effects from E2 and PPT on the mRNA levels, as determined by PCR, could be annihilated since they are increased and decreased depending on cell type. The distribution and amount of PR isoforms strongly depend on the hormonal milieu and cell type within the rat uterus