A randomized open study to assess the efficacy and tolerability of dihydroartemisinin-piperaquine for the treatment of uncomplicated falciparum malaria in Cambodia.

OBJECTIVES: To compare the efficacy and tolerability of dihydroartemisinin-piperaquine (DHA-PQP) with that of a 3-day regimen of mefloquine and artesunate (MAS3) for the treatment of uncomplicated falciparum malaria in Cambodia. METHOD: Randomized open-label non-inferiority study over 64 days. RESULTS: Four hundred and sixty-four patients were included in the study. The polymerase chain reaction genotyping-adjusted cure rates on day 63 were 97.5% (95% confidence interval, CI, 93.8-99.3) for DHA-PQP and 97.5% (95% CI, 93.8-99.3) for MAS3, P = 1. There were no serious adverse events, but significantly more episodes of vomiting (P = 0.03), dizziness (P = 0.002), palpitations (P = 0.04), and sleep disorders (P = 0.03) reported in the MAS3 treatment group, consistent with the side-effect profile of mefloquine. CONCLUSIONS: DHA-PQP was as efficacious as MAS3, but much better tolerated, making it more appropriate for use in a routine programme setting. This highly efficacious, safe and more affordable fixed-dose combination could become the treatment of choice for Plasmodium falciparum malaria in Cambodia

Individual and Interactive Effects of Polyester Microplastics and Naproxen-Sodium on Lactuca Sativa Growth and Development and Soil Abiotic Conditions

Due to the dramatic expansion of plastic production over the last 65 years, plastic has become a major contributor to global pollution. Microplastics (MPs), formed from the physical breakdown of larger plastics, have been found in many ecosystems. Much research has been done on the effects of MPs in aquatic ecosystems, but fewer studies have explored impacts of MPs in terrestrial environments. MPs in terrestrial systems are found primarily in soils, particularly in agricultural areas where plastic usage permeates modern agricultural practices. Additionally, pharmaceutical contamination of water supplies is considered an emerging pollutant threat. Naproxen-sodium is one of the most widely used non-steroidal anti-inflammatory drugs (NSAID), and has been found in wastewater and natural freshwater bodies. Thus, terrestrial plants, especially in agricultural systems, may be exposed to multiple pollutants simultaneously. Our research explored individual effects of MP pollution intensity in soils and exposure to naproxen contamination on the growth and development of Lactuca sativa (lettuce) as well as potential interactive effects between these two contaminants. We also assessed impacts on soil abiotic conditions (pH and electrical conductivity). Preliminary results show that compared to the control, all treatments significantly reduced the total number of leaves, with high MP and high MP/naproxen treatments having the most effect. Additionally, exposure to high MP levels in soil negatively impacted the number and size of leaves and the fresh weight biomass, possibly driven by lower water content in shoots. These results indicate that both contaminants, alone and together, can influence lettuce growth and development.https://orb.binghamton.edu/research_days_posters_2022/1010/thumbnail.jp

Mixed Beri’s: High Output Heart Failure from Severe Anemia and Thiamine Deficiency

Background: Severe anemia and thiamine deficiency can independently result in high output heart failure (HOHF) through different mechanisms. Data on the threshold and timeframe at which these etiologies may precipitate HOHF is unclear. Case: A 63-year-old male with alcohol use disorder consuming 18 drinks/week presented with progressive shortness of breath and lower extremity edema for a few months. Physical exam revealed tachycardia, anasarca, jugular venous distension, Lancisi’s sign, and a midsystolic murmur. Echocardiogram demonstrated EF of 30-35%, dilated left ventricle, and cardiac index of 4.2L/min/m2. Decision-Making: Heart failure can independently precipitate anemia while severe alcoholism can induce myelosuppression and promote risk for bleeding. Thus, iron studies and endoscopy are crucial to elucidating the underlying pathophysiology to further direct therapy. Labs demonstrated hemoglobin 3.0 g/dL (baseline 11 g/dL 7 months prior), ferritin 5 ng/mL, thiamine 26 nmol/L, and hemoccult positive stool while colonoscopy revealed bleeding diverticulosis and hemorrhoids, thereby confirming critical iron deficiency anemia from lower GI bleed and thiamine deficiency. Cardiac catheterization ruled out ischemic cause of his new onset cardiomyopathy, supporting the diagnosis of HOHF in the setting of severe anemia and concomitant cardiac Beri Beri. Our patient was treated with parental thiamine infusions, intravenous iron sucrose, blood transfusions, and gradually diuresed with bumetanide. Repeat evaluation of his left ventricular function 3 months later showed recovery of EF to 50-55%. Conclusion: HOHF can generally be reversed with etiology-directed treatments. In chronic alcoholic patients, we advocate for routine testing of whole blood thiamine to assess for occult vitamin deficiency to determine whether supplementation may assist in therapy. The relative independent contributions or synergistic effects of iron deficiency and thiamine deficiency on HOHF remains unknown, but thorough investigations are essential to ensure recovery of cardiac function

Hidden constipation presenting as diarrhea

Introduction: Diarrhea and constipation are two of the most common gastrointestinal symptoms presenting in both inpatient and outpatient settings. Diarrhea presents as loose, watery stool often with increased frequency while constipation often presents as hard stool, decreased frequency, and increased straining. In a subset of patients that suffer from constipation, liquid stool from more proximal colonic segments may bypass impacted feces and result in diarrhea, thus creating a confusing clinical picture and potentially misleading treatment plan. Objectives: Our objective is to redefine IBSD with a new subset of patients with IBSD who have hidden constipation. This study could help open up new pathways for therapy and greatly increase the quality of life of many patients. In our proposed study, we hope to look further into the relationship between patients suffering from constipation and its subsequent presentation as diarrhea. Methods: In this retrospective study we plan to radiographically analyze the stool burden of patients presenting with non-infectious diarrhea. We aim to assess the frequency of hidden constipation in patients presenting with diarrhea in the office of GI Consultants. The date ranges from January 2017 to present. Hidden constipation was assessed based on obstruction series or CT imaging. After ruling out other etiologies of diarrhea, such as bile acid associated diarrhea (BAD) or colitis, and, depending on the response, other workups, such as obstruction series and colonoscopies, were analyzed. Critical to our study will be the ruling out of any other potential cause of diarrhea, such as medications and previously mentioned infection. Once other causes are ruled out, focus can be given to the obstruction series for signs of constipation. Evidence of constipation on plain abdominal radiograph will show dilated loops of bowel with fecal material retained in areas of the large intestine. By documenting the areas of stool burden as seen on the obstruction study as ascending, transverse, or descending colon, we will begin to understand the prevalence and presentation of hidden constipation that presents paradoxically as diarrhea. Results: Of the 51 patients presenting with non-infectious, non-bloody diarrhea, 19.61% (n=10), presented with hidden constipation. Other significant presentations were bile acid diarrhea (19.61%), Irritable Bowel Syndrome (9.80%), and colitis (9.80%). 21.57% were unknown or lost to follow-up (n=11). Of the patients that did receive an obstruction series (n=12), 10 patients showed abnormal stool burden. Conclusion: This is a small retrospective study focusing on patients presenting to an outpatient setting with non-infectious, non-bloody diarrhea. Preliminary data has shown that with proper clinical suspicion, an obstruction series may be effective in showing hidden constipation in the setting of diarrhea. Further research may be necessary to show if laxative treatment of hidden constipation will be efficacious in treatment of hidden constipation associated diarrhea

Volcano Monitor: Autonomous Triggering of In-Situ Sensors

In-situ sensors near volcanoes would be alerted by the Earth Observing-1 (EO-1) craft to take more frequent data readings. This project involves developing a sulfur-dioxide-sensing volcano monitor that will be able to transmit its readings through an Iridium modem

A combined "electrochemical-frustrated Lewis pair" approach to hydrogen activation: surface catalytic effects at platinum electrodes

Herein, we extend our “combined electrochemical–frustrated Lewis pair” approach to include Pt electrode surfaces for the first time. We found that the voltammetric response of an electrochemical–frustrated Lewis pair (FLP) system involving the B(C6F5)3/[HB(C6F5)3]− redox couple exhibits a strong surface electrocatalytic effect at Pt electrodes. Using a combination of kinetic competition studies in the presence of a H atom scavenger, 6-bromohexene, and by changing the steric bulk of the Lewis acid borane catalyst from B(C6F5)3 to B(C6Cl5)3, the mechanism of electrochemical–FLP reactions on Pt surfaces was shown to be dominated by hydrogen-atom transfer (HAT) between Pt, [Pt[BOND]H] adatoms and transient [HB(C6F5)3]⋅ electrooxidation intermediates. These findings provide further insight into this new area of combining electrochemical and FLP reactions, and proffers additional avenues for exploration beyond energy generation, such as in electrosynthesis

Predictive Markers of Coagulopathy in COVID-19 Infection: A Meta Narrative Review

In late 2019, COVID was initially discovered in Wuhan, China, and the COVID-19 pandemic primarily began in early 2020. Along with respiratory distress, COVID-19 patients had an increased risk of forming abnormal clotting. In ICU COVID-19 patients, abnormal clotting increases the risk of mortality by approximately 74% (Montiel et al., 2022). The aim for this meta-narrative review was to identify what hemostatic parameters are predictive of coagulopathy in COVID-19 patients. Determining predictive markers of coagulopathy in COVID-19 infection may allow for early identification of severe cases before bleeding and thrombotic manifestations occur. The review included articles primarily from PubMed and were published between 2020 and 2022. After screening for eligibility, seven articles were deemed fit to be included. Our findings indicate that elevated D-dimer levels were the most common predictive hemostatic parameter utilized, along with elevated Von Willebrand Factor, elevated Factor VIII, and decreased fibrinogen levels. COVID-19 patients that presented with these parameters upon admission were highly likely to experience clotting events such as deep vein thrombosis and pulmonary embolism. Although many of the articles in this review focused on elevated D-dimer as an early marker of coagulopathy, one study found that elevated soluble thrombomodulin was the best predictor of coagulopathy in COVID patients. Future research will be needed to confirm soluble thrombomodulin’s ability as a predictive parameter and compare its suggestive power to D-dimer levels. Clinical trials will also be needed to assess how these predictive markers can be used to inform prophylactic treatment in COVID-19 patients.https://openworks.mdanderson.org/rmps/1003/thumbnail.jp

Societal Statement on the Role of Occupational Therapy with Survivors of Human Sex Trafficking in the United States

As part of a specialized course, OTD 8340 Wellness and Health Promotion in Occupational Therapy, students from the Nova Southeastern University Entry Level Doctor of Occupational Therapy program, drafted a Societal Statement on the role of occupational therapy with survivors of human sex trafficking in the United States. The students explored the issue of domestic human sex trafficking from an occupational perspective, under the guidance of their professor, Mirtha Montejo Whaley, PhD, OTR/L. As of the publication of this journal, the document is under review by the American Occupational Therapy Association (AOTA

The TechSat 21 Autonomous Sciencecraft Experiment

Software has been developed to perform a number of functions essential to autonomous operation in the Autonomous Sciencecraft Experiment (ASE), which is scheduled to be demonstrated aboard a constellation of three spacecraft, denoted TechSat 21, to be launched by the Air Force into orbit around the Earth in January 2006. A prior version of this software was reported in Software for an Autonomous Constellation of Satellites (NPO-30355), NASA Tech Briefs, Vol. 26, No. 11 (November 2002), page 44. The software includes the following components: Algorithms to analyze image data, generate scientific data products, and detect conditions, features, and events of potential scientific interest; A program that uses component-based computational models of hardware to analyze anomalous situations and to generate novel command sequences, including (when possible) commands to repair components diagnosed as faulty; A robust-execution-management component that uses the Spacecraft Command Language (SCL) software to enable event-driven processing and low-level autonomy; and The Continuous Activity Scheduling, Planning, Execution, and Replanning (CASPER) program for replanning activities, including downlink sessions, on the basis of scientific observations performed during previous orbit cycles