Clinical Study of Pemphigus in Lumbini Medical College

Background: Pemphigus is a worldwide disease and varies in its clinical profile and epidemiology in different regions of the world. The disease is rare and few epidemiological data are available. Objective: The purpose of this study was to evaluate the epidemiologic, clinical, and therapeutic features of pemphigus in Lumbini Medical College. Methods: We retrospectively investigated a total of 70 patients with pemphigus. The parameters including age at diagnosis, sex, diagnostic methods and treatment outcome of the disease. Results: The mean age at the onset was 41.3 years. The male-to-female ratio was 1.18:1. Most of the patients were cured at the end of the treatment. Rest were clinically improved. Conclusion: Pemphigus vulgaris (PV) is the most common clinical subtype in our centre. The disease is more frequent in the fifth decade of life and has a male predominance in our region

Lenses in the forest: cross-correlation of the Lyman-alpha flux with CMB lensing

We present a theoretical estimate for a new observable: the cross-correlation between the Lyman-alpha flux fluctuations in quasar (QSO) spectra and the convergence of the cosmic microwave background (CMB) as measured along the same line-of-sight. As a first step toward the assessment of its detectability, we estimate the signal-to-noise ratio using linear theory. Although the signal-to-noise is small for a single line-of-sight and peaks at somewhat smaller redshifts than those probed by the Lyman-alpha forest, we estimate a total signal-to-noise of 9 for cross-correlating QSO spectra of SDSS-III with Planck and of 20 for cross-correlating with a future polarization based CMB experiment. The detection of this effect would be a direct measure of the neutral hydrogen-matter cross-correlation and could provide important information on the growth of structures at large scales in a redshift range which is still poorly probed by observations.Comment: 5 pages, 4 figures, matches published versio

Application of microneedle arrays for enhancement of transdermal permeation of Insulin: in vitro experiments, scaling analyses and numerical simulations

The aim of this investigation is to study the effect of donor concentration and microneedle (MN) length on permeation of insulin and further evaluating the data using scaling analyses and numerical simulations. Histological evaluation of skin sections was carried to evaluate the skin disruption and depth of penetration by MNs. Scaling analyses was done using dimensionless parameters like concentration of drug (Ct/Cs), thickness (h/L) and surface area of the skin (Sa/L2). Simulation studies were carried out using MATLAB and COMSOL software to simulate the insulin permeation using histological sections of MN treated skin and experimental parameters like passive diffusion coefficient. A 1.6 fold increase in transdermal flux and 1.9 fold decrease in lag time values were observed with 1.5mm MN when compared with passive studies. Good correlation (R2>0.99) was observed between different parameters using scaling analyses. Also, the in vitro and simulated permeations profiles were found to be similar (f2≥50). Insulin permeation significantly increased with increase in donor concentration and MN length (p<0.05). The developed scaling correlations and numerical simulations were found to be accurate and would help researchers to predict the permeation of insulin with new dimensions of MN in optimizing insulin delivery. Overall, it can be inferred that the application of MNs can significantly enhance insulin permeation and may be an efficient alternative for injectable insulin therapy in humans

Simulations of the Microwave Sky

We create realistic, full-sky, half-arcminute resolution simulations of the microwave sky matched to the most recent astrophysical observations. The primary purpose of these simulations is to test the data reduction pipeline for the Atacama Cosmology Telescope (ACT) experiment; however, we have widened the frequency coverage beyond the ACT bands and utilized the easily accessible HEALPix map format to make these simulations applicable to other current and near future microwave background experiments. Some of the novel features of these simulations are that the radio and infrared galaxy populations are correlated with the galaxy cluster and group populations, the primordial microwave background is lensed by the dark matter structure in the simulation via a ray-tracing code, the contribution to the thermal and kinetic Sunyaev-Zel'dovich (SZ) signals from galaxy clusters, groups, and the intergalactic medium has been included, and the gas prescription to model the SZ signals has been refined to match the most recent X-ray observations. The cosmology adopted in these simulations is also consistent with the WMAP 5-year parameter measurements. From these simulations we find a slope for the Y{sub 200} - M{sub 200} relation that is only slightly steeper than self-similar, with an intrinsic scatter in the relation of {approx} 14%. Regarding the contamination of cluster SZ flux by radio galaxies, we find for 148 GHz (90 GHz) only 3% (4%) of halos have their SZ decrements contaminated at a level of 20% or more. We find the contamination levels higher for infrared galaxies. However, at 90 GHz, less than 20% of clusters with M{sub 200} &gt; 2.5 x 10{sup 14}M{sub {circle_dot}} and z &lt; 1.2 have their SZ decrements filled in at a level of 20% or more. At 148 GHz, less than 20% of clusters with M{sub 200} &gt; 2.5 x 10{sup 14}M{sub {circle_dot}} and z &lt; 0.8 have their SZ decrements filled in at a level of 50% or larger. Our models also suggest that a population of very high flux infrared galaxies, which are likely lensed sources, contribute most to the SZ contamination of very massive clusters at 90 and 148 GHz. These simulations are publicly available and should serve as a useful tool for microwave surveys to cross-check SZ cluster detection, power spectrum, and cross-correlation analyses

Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation

<p>Abstract</p> <p>Background</p> <p>There are no reports describing complications with posterior spinal fusion (PSF) with segmental spinal instrumentation (SSI) using pedicle screw fixation in patients with neuromuscular scoliosis.</p> <p>Methods</p> <p>Fifty neuromuscular patients (18 cerebral palsy, 18 Duchenne muscular dystrophy, 8 spinal muscular atrophy and 6 others) were divided in two groups according to severity of curves; group I (< 90°) and group II (> 90°). All underwent PSF and SSI with pedicle screw fixation. There were no anterior procedures. Perioperative (within three months of surgery) and postoperative (after three months of surgery) complications were retrospectively reviewed.</p> <p>Results</p> <p>There were fifty (37 perioperative, 13 postoperative) complications. Hemo/pneumothorax, pleural effusion, pulmonary edema requiring ICU care, complete spinal cord injury, deep wound infection and death were major complications; while atelectesis, pneumonia, mild pleural effusion, UTI, ileus, vomiting, gastritis, tingling sensation or radiating pain in lower limb, superficial infection and wound dehiscence were minor complications. Regarding perioperative complications, 34(68%) patients had at least one major or one minor complication. There were 16 patients with pulmonary, 14 with abdominal, 3 with wound related, 2 with neurological and 1 cardiovascular complications, respectively. There were two deaths, one due to cardiac arrest and other due to hypovolemic shock. Regarding postoperative complications 7 patients had coccygodynia, 3 had screw head prominence, 2 had bed sore and 1 had implant loosening, respectively. There was a significant relationship between age and increased intraoperative blood loss (p = 0.024). However it did not increased complications or need for ICU care. Similarly intraoperative blood loss > 3500 ml, severity of curve or need of pelvic fixation did not increase the complication rate or need for ICU. DMD patients had higher chances of coccygodynia postoperatively.</p> <p>Conclusion</p> <p>Although posterior-only approach using pedicle screw fixation had good correction rate, complications were similar to previous reports. There were few unusual complications like coccygodynia.</p

Fast Statistical Alignment

We describe a new program for the alignment of multiple biological sequences that is both statistically motivated and fast enough for problem sizes that arise in practice. Our Fast Statistical Alignment program is based on pair hidden Markov models which approximate an insertion/deletion process on a tree and uses a sequence annealing algorithm to combine the posterior probabilities estimated from these models into a multiple alignment. FSA uses its explicit statistical model to produce multiple alignments which are accompanied by estimates of the alignment accuracy and uncertainty for every column and character of the alignment—previously available only with alignment programs which use computationally-expensive Markov Chain Monte Carlo approaches—yet can align thousands of long sequences. Moreover, FSA utilizes an unsupervised query-specific learning procedure for parameter estimation which leads to improved accuracy on benchmark reference alignments in comparison to existing programs. The centroid alignment approach taken by FSA, in combination with its learning procedure, drastically reduces the amount of false-positive alignment on biological data in comparison to that given by other methods. The FSA program and a companion visualization tool for exploring uncertainty in alignments can be used via a web interface at http://orangutan.math.berkeley.edu/fsa/, and the source code is available at http://fsa.sourceforge.net/

Whole genome sequencing-based detection of antimicrobial resistance and virulence in non-typhoidal Salmonella enterica isolated from wildlife

The aim of this study was to generate a reference set of Salmonella enterica genomes isolated from wildlife from the United States and to determine the antimicrobial resistance and virulence gene profile of the isolates from the genome sequence data. We sequenced the whole genomes of 103 Salmonella isolates sampled between 1988 and 2003 from wildlife and exotic pet cases that were submitted to the Oklahoma Animal Disease Diagnostic Laboratory, Stillwater, Oklahoma. Among 103 isolates, 50.48% were from wild birds, 0.9% was from fish, 24.27% each were from reptiles and mammals. 50.48% isolates showed resistance to at least one antibiotic. Resistance against the aminoglycoside streptomycin was most common while 9 isolates were found to be multi-drug resistant having resistance against more than three antibiotics. Determination of virulence gene profile revealed that the genes belonging to csg operons, the fim genes that encode for type 1 fimbriae and the genes belonging to type III secretion system were predominant among the isolates. The universal presence of fimbrial genes and the genes encoded by pathogenicity islands 1-2 among the isolates we report here indicates that these isolates could potentially cause disease in humans. Therefore, the genomes we report here could be a valuable reference point for future traceback investigations when wildlife is considered to be the potential source of human Salmonellosis.Peer reviewedOklahoma Animal Disease Diagnostic Laborator

Anisotropic nanomaterials: structure, growth, assembly, and functions

Comprehensive knowledge over the shape of nanomaterials is a critical factor in designing devices with desired functions. Due to this reason, systematic efforts have been made to synthesize materials of diverse shape in the nanoscale regime. Anisotropic nanomaterials are a class of materials in which their properties are direction-dependent and more than one structural parameter is needed to describe them. Their unique and fine-tuned physical and chemical properties make them ideal candidates for devising new applications. In addition, the assembly of ordered one-dimensional (1D), two-dimensional (2D), and three-dimensional (3D) arrays of anisotropic nanoparticles brings novel properties into the resulting system, which would be entirely different from the properties of individual nanoparticles. This review presents an overview of current research in the area of anisotropic nanomaterials in general and noble metal nanoparticles in particular. We begin with an introduction to the advancements in this area followed by general aspects of the growth of anisotropic nanoparticles. Then we describe several important synthetic protocols for making anisotropic nanomaterials, followed by a summary of their assemblies, and conclude with major applications

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe