COMPARATIVE EFFICACY OF DETOMIDINE AND DETOMIDINE - KETAMINE COCKTAIL IN QUAILS

Twenty adult healthy quails (Coturnix coturnix) were divided into two equal groups. One group was administered detomidine (2.4 mg/kg, I/M) and other group was administered detomidine-ketamine cocktail (1.2 mg/kg + 30 mg/kg, I/M). Detomidine slowly and smoothly induced a light sedation accompanied by superficial analgesia, hypoventilation, hypothermia and bradycardia in all birds. Detomidine-ketamine cocktail rapidly and smoothly induced a deep anaesthesia accompanied by deep analgesia, hypoventilation, hypothermia and bradycardia and complete loss of all reflexes in all birds. In both groups, recovery from sedation and anaesthesia was smooth and of short duration. From this study it was concluded that for minor and least painful procedures in quails detomidine can be used alone, while for major and painful surgical procedures detomidine-ketamine combination should be preferred

Immune-Mediated Inflammation May Contribute to the Pathogenesis of Cardiovascular Disease in Mucopolysaccharidosis Type I.

BackgroundCardiovascular disease, a progressive manifestation of α-L-iduronidase deficiency or mucopolysaccharidosis type I, continues in patients both untreated and treated with hematopoietic stem cell transplantation or intravenous enzyme replacement. Few studies have examined the effects of α-L-iduronidase deficiency and subsequent glycosaminoglycan storage upon arterial gene expression to understand the pathogenesis of cardiovascular disease.MethodsGene expression in carotid artery, ascending, and descending aortas from four non-tolerized, non-enzyme treated 19 month-old mucopolysaccharidosis type I dogs was compared with expression in corresponding vascular segments from three normal, age-matched dogs. Data were analyzed using R and whole genome network correlation analysis, a bias-free method of categorizing expression level and significance into discrete modules. Genes were further categorized based on module-trait relationships. Expression of clusterin, a protein implicated in other etiologies of cardiovascular disease, was assessed in canine and murine mucopolysaccharidosis type I aortas via Western blot and in situ immunohistochemistry.ResultsGene families with more than two-fold, significant increased expression involved lysosomal function, proteasome function, and immune regulation. Significantly downregulated genes were related to cellular adhesion, cytoskeletal elements, and calcium regulation. Clusterin gene overexpression (9-fold) and protein overexpression (1.3 to 1.62-fold) was confirmed and located specifically in arterial plaques of mucopolysaccharidosis-affected dogs and mice.ConclusionsOverexpression of lysosomal and proteasomal-related genes are expected responses to cellular stress induced by lysosomal storage in mucopolysaccharidosis type I. Upregulation of immunity-related genes implicates the potential involvement of glycosaminoglycan-induced inflammation in the pathogenesis of mucopolysaccharidosis-related arterial disease, for which clusterin represents a potential biomarker

Analysis of Essential Medicines Used for Emergency Care in Pakistan

Introduction: According to the World Health Organization (WHO), essential medicines (EM) have the ability to meet the health care needs of maximum individuals. High accessibility to essential medicines (EM) was proposed under the Millennium Development Goal. The access to high quality, suitable, and inexpensive essential medicines is an essential constituent of health care systems. Methodology: This retrospective cross-sectional observational study was performed at Jinnah Hospital Lahore from February 2018 to November 2018, for analysis of essential medicine usage in a public sector tertiary care hospital of Pakistan. The data were collected from records of patients admitted in the emergency department. Results: Drugs prescribed per encounter were estimated to be 3. Most patients got a single antibiotic, and cephalosporin was the most commonly prescribed antibiotic. Conclusion: The concept of essential drugs has gained high acceptance, but the EMs should be prescribed logically, appropriately and should be in line with WHO guidelines

Collaboration among teachers in inclusive special education program classrooms

Collaboration between teachers and special education teachers is a vital factor in ensuring the success of the implementation of the Inclusive Education Programs especially in the teaching and learning aspects. Until 2016, there is no detailed document or information regarding how the collaboration is conducted or implemented in the inclusive classrooms. Therefore, this study is aimed to explore how collaboration is conducted and implemented in the Inclusive Special Education Program classrooms, particularly identifying the stage of collaboration the school are at and approach used in the inclusive classrooms. To achieve this, a survey questionnaire was used as an instrument for this study and it is conducted on 53 schools and 441 participants including headmasters, senior assistant principals for special education teachers, subject teachers and special education teacher. Results showed that most of the participants are at the “Starting a partnership” stage (mean score = 4.165, SD = 0.797). The type of collaboration approach that are usually being used is the “collaboration-consultation” approach (mean score = 4.10, SD = 0.721). This suggests that more action is needed to ensure the successful implementation of an inclusive program. This is because without done the recommended steps of collaboration, the inclusive may not carried out effectively. A successful inclusive classroom also can be achieved through multiple approaches of collaboration are implemented. Therefore, knowledge about steps and approaches of collaboration should be knowledgeable to general, special education teacher and also school administrators

Effect of Endovascular Aneurysm Repair on the Volume-Outcome Relationship in Aneurysm Repair

Background— We aim to quantify the relationship between the annual caseload (volume) and outcome from elective endovascular (EVR) or open repair of abdominal aortic aneurysms (AAAs) in England between 2005 and 2007. Methods and Results— Individual patient data were obtained from the Hospital Episode Statistics. Statistical methods included multiple logistic regression models, mortality control charts, and safety plots to determine the nature of any relationship between volume and outcome. The case-mix between hospitals of different sizes was examined using observed and expected values for in-hospital mortality. Outcome measures included in-hospital mortality and hospital length of stay. Between 2005 and 2007, a total of 57 587 patients were admitted to hospitals in England with a diagnosis of AAA, and 11 574 underwent AAA repair. There were 7313 elective AAA repairs, of which 5668 (78%) were open and 1645 (22%) were EVR. In-hospital mortality rates were 5.63% for all elective AAA repairs with rates of 6.18% for open repair and 3.77% for EVR (odds ratio, 0.676; 95% CI, 0.501 to 0.913; P=0.011). High-volume aneurysm services were associated with significantly lower mortality rates overall (0.991; 0.988 to 0.994; P<0.0001), for open repairs (0.994; 0.991 to 0.998; P=0.0008), and EVR (0.989; 0.982 to 0.995; P=0.0007). Large endovascular units had low mortality rates for open repairs. Conclusion— A strong relationship existed between the volume of surgery performed and outcome from both open and endovascular aneurysm repairs. These data support the concept that abdominal aortic surgery should be performed in specialized units that meet a minimum volume threshold

In Silico Derivation of HLA-Specific Alloreactivity Potential from Whole Exome Sequencing of Stem Cell Transplant Donors and Recipients: Understanding the Quantitative Immuno-biology of Allogeneic Transplantation

Donor T cell mediated graft vs. host effects may result from the aggregate alloreactivity to minor histocompatibility antigens (mHA) presented by the HLA in each donor-recipient pair (DRP) undergoing stem cell transplantation (SCT). Whole exome sequencing has demonstrated extensive nucleotide sequence variation in HLA-matched DRP. Non-synonymous single nucleotide polymorphisms (nsSNPs) in the GVH direction (polymorphisms present in recipient and absent in donor) were identified in 4 HLA-matched related and 5 unrelated DRP. The nucleotide sequence flanking each SNP was obtained utilizing the ANNOVAR software package. All possible nonameric-peptides encoded by the non-synonymous SNP were then interrogated in-silico for their likelihood to be presented by the HLA class I molecules in individual DRP, using the Immune-Epitope Database (IEDB) SMM algorithm. The IEDB-SMM algorithm predicted a median 18,396 peptides/DRP which bound HLA with an IC50 of <500nM, and 2254 peptides/DRP with an IC50 of <50nM. Unrelated donors generally had higher numbers of peptides presented by the HLA. A similarly large library of presented peptides was identified when the data was interrogated using the Net MHCPan algorithm. These peptides were uniformly distributed in the various organ systems. The bioinformatic algorithm presented here demonstrates that there may be a high level of minor histocompatibility antigen variation in HLA-matched individuals, constituting an HLA-specific alloreactivity potential. These data provide a possible explanation for how relatively minor adjustments in GVHD prophylaxis yield relatively similar outcomes in HLA matched and mismatched SCT recipients.Comment: Abstract: 235, Words: 6422, Figures: 7, Tables: 3, Supplementary figures: 2, Supplementary tables:

Long-range transfer of electron-phonon coupling in oxide superlattices

The electron-phonon interaction is of central importance for the electrical and thermal properties of solids, and its influence on superconductivity, colossal magnetoresistance, and other many-body phenomena in correlated-electron materials is currently the subject of intense research. However, the non-local nature of the interactions between valence electrons and lattice ions, often compounded by a plethora of vibrational modes, present formidable challenges for attempts to experimentally control and theoretically describe the physical properties of complex materials. Here we report a Raman scattering study of the lattice dynamics in superlattices of the high-temperature superconductor $\bf YBa_2 Cu_3 O_7$ and the colossal-magnetoresistance compound $\bf La_{2/3}Ca_{1/3}MnO_{3}$ that suggests a new approach to this problem. We find that a rotational mode of the MnO$_6$ octahedra in $\bf La_{2/3}Ca_{1/3}MnO_{3}$ experiences pronounced superconductivity-induced lineshape anomalies, which scale linearly with the thickness of the $\bf YBa_2 Cu_3 O_7$ layers over a remarkably long range of several tens of nanometers. The transfer of the electron-phonon coupling between superlattice layers can be understood as a consequence of long-range Coulomb forces in conjunction with an orbital reconstruction at the interface. The superlattice geometry thus provides new opportunities for controlled modification of the electron-phonon interaction in complex materials.Comment: 13 pages, 4 figures. Revised version to be published in Nature Material

Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data.

BACKGROUND: Hypertension is considered the most important risk factor for cardiovascular diseases, but its control is poor worldwide. We aimed to assess the availability and affordability of blood pressure-lowering medicines, and the association with use of these medicines and blood pressure control in countries at varying levels of economic development. METHODS: We analysed the availability, costs, and affordability of blood pressure-lowering medicines with data recorded from 626 communities in 20 countries participating in the Prospective Urban Rural Epidemiological (PURE) study. Medicines were considered available if they were present in the local pharmacy when surveyed, and affordable if their combined cost was less than 20% of the households' capacity to pay. We related information about availability and affordability to use of these medicines and blood pressure control with multilevel mixed-effects logistic regression models, and compared results for high-income, upper-middle-income, lower-middle-income, and low-income countries. Data for India are presented separately because it has a large generic pharmaceutical industry and a higher availability of medicines than other countries at the same economic level. FINDINGS: The availability of two or more classes of blood pressure-lowering drugs was lower in low-income and middle-income countries (except for India) than in high-income countries. The proportion of communities with four drug classes available was 94% in high-income countries (108 of 115 communities), 76% in India (68 of 90), 71% in upper-middle-income countries (90 of 126), 47% in lower-middle-income countries (107 of 227), and 13% in low-income countries (nine of 68). The proportion of households unable to afford two blood pressure-lowering medicines was 31% in low-income countries (1069 of 3479 households), 9% in middle-income countries (5602 of 65 471), and less than 1% in high-income countries (44 of 10 880). Participants with known hypertension in communities that had all four drug classes available were more likely to use at least one blood pressure-lowering medicine (adjusted odds ratio [OR] 2·23, 95% CI 1·59-3·12); p<0·0001), combination therapy (1·53, 1·13-2·07; p=0·054), and have their blood pressure controlled (2·06, 1·69-2·50; p<0·0001) than were those in communities where blood pressure-lowering medicines were not available. Participants with known hypertension from households able to afford four blood pressure-lowering drug classes were more likely to use at least one blood pressure-lowering medicine (adjusted OR 1·42, 95% CI 1·25-1·62; p<0·0001), combination therapy (1·26, 1·08-1·47; p=0·0038), and have their blood pressure controlled (1·13, 1·00-1·28; p=0·0562) than were those unable to afford the medicines. INTERPRETATION: A large proportion of communities in low-income and middle-income countries do not have access to more than one blood pressure-lowering medicine and, when available, they are often not affordable. These factors are associated with poor blood pressure control. Ensuring access to affordable blood pressure-lowering medicines is essential for control of hypertension in low-income and middle-income countries. FUNDING: Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, Canadian Institutes of Health Research Strategy for Patient Oriented Research through the Ontario SPOR Support Unit, the Ontario Ministry of Health and Long-Term Care, pharmaceutical companies (with major contributions from AstraZeneca [Canada], Sanofi Aventis [France and Canada], Boehringer Ingelheim [Germany amd Canada], Servier, and GlaxoSmithKline), Novartis and King Pharma, and national or local organisations in participating countries

Coupled effect of cyclic wet-dry environment and vibration event on desiccation crack and mechanical characteristics of polypropylene fiber-reinforced clay

This study investigates the role of polypropylene fibers (PFs) in mitigating the combined effects of wet-dry (W-D) cycles and vibration event (VE), such as earthquake or machine vibrations, on the desiccation cracking and mechanical behavior of clay through model tests. A comprehensive experimental program was conducted using compacted clayey soil specimens, treated with various PF percentages (i.e., 0.2 %, 0.4 %, 0.6 %, and 0.8 %) and untreated (i.e., 0 % PF). These specimens were subjected to multiple W-D cycles, with their behavior documented through cinematography. Desiccation cracking and mechanical responses were evaluated after each W-D cycle and subsequent VE. Results indicated that surface cracking, quantified by morphology and crack parameters i.e., crack surface ratio (Rsc), total crack length (Ltc), and crack line density (Dcl), increased with progressive W-D cycles. Higher PF content in soil significantly reduced desiccation cracking across all W-D phases, attributable to the enhanced tensile strength and stress mitigation provided by the fibers. Following VE, surface crack and fragmentation visibility decreased due to the shaking effects, as indicated by reductions in Rsc and Dcl. However, Ltc increased slightly, suggesting either crack persistence or lengthening. Higher PF content resulted in a more substantial reduction in Rsc and Dcl and a reduced increase in Ltc after VE. W-D cycles led to increased cone index (CI) values, reflecting enhanced compactness due to shrinkage which enhances with PF content showing improved soil resistance to loading. Meanwhile, VE reduced CI values following W-D cycles, particularly in near surface layers, PF content mitigates this reduction, demonstrating that PF contributes to a more stable soil matrix. Also, PF content decreased the soil deformation under W-D cycles and subsequent VE

Public-private partnerships as catalysts for digital transformation and circular economy: Insights from developing countries

This study investigates the dynamics of Public-Private Partnerships (PPPs) in promoting digital transformation and circular economy initiatives in the public sector of developing countries. Using Collaborative Advantage Theory (CAT) and a multiple-case study design, involving 10 public and 12 private organizations across five cases, the research explores how complementary resources, collaborative processes, trust and governance, and mutual benefits and value creation shape the success of these partnerships. Data were collected through 50 semi-structured interviews with key stakeholders and archival analysis of partnership agreements, project reports, and policy documents. The findings reveal that strategic alignment and collaborative leadership are key triggers for synergy creation and co-creation of value. Additionally, participatory governance models and transparent performance metrics enhance trust and sustainability within PPPs. These results offer important theoretical contributions by expanding Collaborative Advantage Theory in the context of PPPs, emphasizing how collaboration and resource integration lead to sustainable outcomes. Practically, the study provides recommendations for policymakers and private sector leaders to improve the governance, resilience, and scalability of PPPs, promoting long-term public service innovation and sustainability