Comparison of two targets of serum bilirubin concentration for phototherapy discontinuation in neonatal jaundice

AIM OF THE STUDY: To compare the occurrence of significant rebound hyperbilirubinemia between two groups of neonates with jaundice, when phototherapy was stopped at serum bilirubin 1-2.9 mg/dl and ≥ 3mg/dl below American Academy of Paediatrics (AAP) treatment threshold. METHODOLOGY: An Open labelled randomised controlled trial was conducted in a teaching hospital. Neonates with ≥ 35 weeks gestation, birth weight > 1800 grams with jaundice requiring phototherapy as per AAP guidelines, in first 7 days of life were included. Neonates planned for exchange transfusion at admission were excluded. Computer generated random numbers were kept in serially numbered opaque sealed envelope. After recruitment, the envelope was opened and babies were assigned into groups accordingly. Phototherapy was stopped at serum bilirubin 1- 2.9mg/dl in group A and ≥3mg/dl in group B. After stopping phototherapy serum bilirubin was measured at about 6 and 24 hours. RESULTS: We recruited 99 babies in each group and after excluding the lost to follow up, 83 babies in group A and 77 in group B who completed the study were taken for analysis. 2 babies in each group required re-initiation of phototherapy, but not statistically significant (p = 0.661). The mean duration of phototherapy was significantly less in group A (14.9 hours) when compared to group B (19.5 hours) (p = 0.000). The duration of hospitalization was not significantly different between groups (p = 0.695). CONCLUSION: We found that the occurrence of significant rebound hyperbilirubinemia was not significantly different between two groups, when phototherapy was stopped at 1-2.9mg/dl and ≥ 3mg/dl below AAP treatment threshold

Influence of pulse modulation frequency on helium RF atmospheric pressure plasma jet characteristics

This work investigates the influence of pulse modulation frequency ranging from 50 Hz- 10 kHz on the helium RF atmospheric pressure plasma jet's fundamental characteristics. The impact of modulation frequency on plasma jet discharge behavior, geometrical variation, reactive species emission, and plasma parameters (gas temperature Tg, electron excitation temperature Texc, and electron density (ne) are studied using various diagnostics such as optical imaging, emission spectra, and thermal diagnostics. From the experiments, it is observed that operating the plasma jet at low pulse modulation frequencies (around 50 Hz) provides enhanced plasma dimensions, higher electron densities and greater optical emission from reactive species (viz., He I, O, OH, N2+, etc.) as compared to the higher modulation frequencies. Besides the low power consumption, the three times less gas temperature of the modulated plasma jet than the continuous wave mode makes it more advantageous for the applications. Moreover, the influence of duty cycle (D) and applied RF power (P) on the plasma jet characteristics are also discussed. It is found that 10- 40% duty cycle operation provides the most favorable attributes. More importantly, the concern of shorter plasma length in RF plasma jets is overcome by operating at 10- 20% duty cycle with increased applied power. This work thoroughly characterizes helium atmospheric pressure RF plasma jet with a wide range of pulse mode operating parameters, which could help select appropriate operating conditions for various industrial and biomedical applications.Comment: 24 pages, 11 figure

Excitation of helical shape argon atmospheric pressure plasma jet using RF pulse modulation

The article reports the excitation of a helical argon atmospheric pressure plasma jet using a pulse modulated 13.56 MHz radiofrequency (RF) power source. This helical structure is observed in open ambient air which is far different from the conventional conical shape. This helical structure originates due to the periodic pressure variation in the discharge region caused by pulse modulated RF (2 kHz modulation frequency (fp)) and propagates downstream into the ambient air. The geometrical characteristics of the observed structure are explored using optical imaging. Moreover, the influence of various input parameters viz., duty cycle (D), gas flow rate (Q), and RF power (P) of the modulated pulse on the formation of helical structure are studied. These helical structures have an implication on the plasma jet chemical features (enhancement of reactive oxygen and nitrogen species (RONS)) as these are involved in increase in air entrainment into the ionization region desired for various plasma applications.Comment: 17 pages, 12 figure

Development and optimization of low power non-thermal plasma jet operational parameters for treating dyes and emerging contaminants

Emerging contaminants (ECs) have come out as the latest class of environmental contaminants, which are highly recalcitrant and toxic in nature. Currently, no suitable rectification methods are available against the ECs, resulting in a continuous increase in their concentration. Non-thermal plasma, as an advanced oxidation process, has been emerging as a promising technology against the ECs treatment. In the present work, a detailed experimental study is carried out to evaluate the efficacy of a non-thermal plasma jet with two dyes, Rhodamine B and Methylene Blue, as model contaminants. The plasma jet provided a complete dye decoloration in 30 min with an applied voltage of 6.5 kV. .OH, having the highest oxidation potential, acts as the main reactive species, which with direct action on contaminants also acts indirectly by getting converted into H2O2 and O3. Further, the effect of critical operational parameters viz., sample pH, applied voltage (4.5-6.5 kV), conductivity (5-20 mScm-1), and sample distance on plasma treatment efficacy was also examined. Out of all the assessed parameters, the applied voltage and sample conductivity was found to be the most significant operating parameter. A high voltage and low conductivity were found to favor the dye decoloration, while the pH effect was not that significant. To understand the influence of plasma discharge gas on treatment efficacy, all the experiments are conducted with Argon and Helium gases under the fixed geometrical configuration. Both the gases provided a similar dye decoloration efficiency. The DBD plasma system with complete dye removal also rendered maximum mineralization of 73 % for Rd. B, and 60 % for Met. Blue. Finally, the system's efficiency against the actual ECs (four pharmaceutical compounds, viz., metformin, atenolol, acetaminophen, and ranitidine) and microbial contaminant (Escherichia coli) was also tested.Comment: 23 pages, 7 figure

Will They Tell? Weapons Reporting by Middle-School Youth

Adding to the body of research that describes students who will bring weapons to school, the current research examined middle-school students’ willingness to report when they know someone has a weapon at school. The sample included 1,957 sixth, seventh, and eighth graders from 27 schools in five states. Overall, a majority of students indicated that they would be willing to report; however, there were significant effects for the conditions of reporting (such as anonymity) and effects for some demographic characteristics. Furthermore, students who perceived adult or parental involvement in their lives were more willing to report. In contrast, students with delinquent involvement (self or peers) were significantly less likely to report the presence of weapons

Iatrogenic Inflammatory Fibrosis of Hard Palate in a 13-Year-Old Female Patient

Palatal swellings are rare in children and the incidence differs from that of the adult counterparts. When the palatal swellings do arise in children, they usually are palatal abscess from periapical region, and few cases like pleomorphic adenoma in young adults have also been reported. But inflammatory fibrosis of palate in children is a rare occurrence. Inflammatory fibrosis is formation of excess fibrous connective tissue in an organ or tissue, as a reparative or reactive process. This report describes an unusual case of iatrogenic inflammatory fibrosis on the palate due to extraction of tooth number 22 in a 13-year-old female patient. The patient presented with a single large well-circumscribed oval palatal swelling that was soft, fluctuant, not fixed, and nontender. Surgical excision of the lesion was done and it was sent for histopathological assessment. The biopsy showed fibrous tissue with collagen fibers, spindle shaped fibroblasts, neovascularization, RBCs, chronic inflammatory cells, and traces of salivary gland and nerve tissue

Prevalence of Suspected Hereditary Cancer Syndromes and Germline Mutations Among a Diverse Cohort of Probands Reporting a Family History of Prostate Cancer: Toward Informing Cascade Testing for Men.

BACKGROUND: Prostate cancer (PCa) is increasingly recognized as part of hereditary cancer syndromes (HCSs). HCS prevalence among diverse probands seeking genetic evaluation with PCa family history (FHx) has not been reported and has implications for cascade genetic testing. OBJECTIVE: To evaluate the rates of HCSs among probands reporting PCa FHx and germline mutations among probands. DESIGN, SETTING, AND PARTICIPANTS: A prospective genetic testing database queried for individuals with PCa FHx. Pedigrees analyzed for three HCSs: hereditary breast and ovarian cancer (HBOC), hereditary PCa, and Lynch syndrome. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Associations between HCS overall, and with plausible link to PCA FHx and race evaluated using Fisher\u27s exact test. Germline mutation rates described among probands with a suspicion of an HCS connected with PCa FHx. RESULTS AND LIMITATIONS: A total of 345 probands reported PCa FHx: 53 African American (AA) and 292 Caucasian (Wh). Overall, 220 probands (63.8%) met the criteria for at least one HCS with a potential link to PCa FHx (75.5% AA; 61.6% Wh). HBOC linked to PCa FHx was identified in a higher percentage of AA than Wh probands (90.2% vs 74.6%, p=0.04). Among probands who underwent genetic testing with any HCS potentially linked to PCa FHx (n=169), 19.5% had germline mutations identified; five AA probands had germline mutations (all in BRCA1/2), while 28 Wh probands had mutations in a spectrum of genes. CONCLUSIONS: A significant percentage of AA probands with PCa FHx meet the criteria for HCSs, with HBOC identified at the highest rate. Although limited in sample size, our findings implicate BRCA mutations in AA families with HCSs linked with PCa, underscoring the need for greater enrollment of AA participants in genetic studies. PATIENT SUMMARY: Hereditary cancer syndromes potentially linked to prostate cancer are common in patients reporting a family history of prostate cancer. African-American patients may need special attention with regard to testing for hereditary breast and ovarian cancer syndrome, which may impact men with prostate cancer in these families