Identification of Severe Acute Malnutrition among Anganwadi Children in the Vellore Urban ICDS Project Area.

INTRODUCTION : Malnutrition is a major contributor to child mortality in India. In 1995 it was estimated that Up to 67% of child deaths in India were attributed to malnutrition. Studies in 2003 and 2004 have found that malnutrition is a contributing factor in 56% of all child deaths in Developing countries. Wasting is a form of under nutrition in which the expected weight For a given height is not achieved, is due to acute malnutrition. Severe wasting is considered An important nutritional risk factor for other causes of death in children but can also be seen As a disease in itself. The WHO and UNICEF have defined Severe Acute Malnutrition (SAM) For the purpose of identifying severely wasted children who require nutritional and medical Therapy. In 2006 the WHO released Child Growth Standards for which it has been shown that The risk of mortality for children with weight for height below -3 standard deviations of the Median of the reference population is 9.4 times higher than that of children with weight for Height above -1 standard deviation from the median of the reference population. Mortality Among children with less than 115 mm mid upper arm circumference (MUAC) has also been Found to be higher than among those with MUAC above 115 mm. Since 2009 the WHO And UNICEF have adopted these cut offs together with the clinical sign of pedal edema to Define severe acute malnutrition which have been found to detect more children with Wasting, as well as identifying wasting at an earlier and more remediable stage than while Using weight for height cut offs of the NCHS reference population. OBJECTIVES : The objectives of the study were: 1. To train Anganwadi Workers of Vellore Urban Integrated Child Development Scheme Project area to identify Severe Acute Malnutrition among children attending Anganwadi Centres of the project. 2. To validate the identification of Severe Acute Malnutrition carried out by Anganwadi Workers. 3. To determine the prevalence of Severe Acute Malnutrition among children attending Anganwadis in the Vellore Urban ICDS project area. CONCLUSIONS : From the results and analysis it is concluded that: 1. The identification of SAM by the AWWs is both feasible and valid within the ICDS project that was studied. 2. The prevalence of SAM in the study population was lower than the state and national level but wasting has similar prevalence. 3. SAM has public health significance in the urban area of Vellore. In view of the public health significance of SAM and the validity of the AWW identification of children with SAM shown in this study it is recommended that the ICDS adopts the identification of SAM and wasting by the AWWs into its services with improvements in instruments and training course as suggested above. In view of the public health significance of Moderate Acute Malnutrition and the data showing that children with SAM have been misclassified as having Moderate Acute Malnutrition, it is further suggested that every child found to be wasted, i.e. WHZ less than -2 should be referred to a clinical centre for further evaluation. To improve accuracy in nutritional assessment the WHZ categorization could be done centrally by designated workers who have received further training in WHZ categorization for example the supervisors could be specially trained in WHZ categorization. The most accurate categorization would be done if the computer programme WHO Anthro was used by the ICDS. The computer programme is freely available but requires a basic desk top or laptop computer. Alternatively the programme can also be run on mobile devices such as smart phones which run on the Windows™ operating system or the Apple iOS™. This raises the possibility of using WHO Anthro during camps and giving accurate WHZ scores as soon as the measurements have been taken

Exploring the Adverse Effects of CAR-T Therapy: A Cases Report of Potential MINOCA in CAR-T

A 48-year-old man with a history of Stage IV Diffuse Large B-Cell Lymphoma refractory to R-CHOP alternating with high-dose methotrexate and cytarbine, craniospinal irradiation, and haploidentical stem cell transplant, underwent CD 19-directed CAR-T

Model-Based Noninvasive Estimation of Intracranial Pressure from Cerebral Blood Flow Velocity and Arterial Pressure

Intracranial pressure (ICP) is affected in many neurological conditions. Clinical measurement of pressure on the brain currently requires placing a probe in the cerebrospinal fluid compartment, the brain tissue, or other intracranial space. This invasiveness limits the measurement to critically ill patients. Because ICP is also clinically important in conditions ranging from brain tumors and hydrocephalus to concussions, noninvasive determination of ICP would be desirable. Our model-based approach to continuous estimation and tracking of ICP uses routinely obtainable time-synchronized, noninvasive (or minimally invasive) measurements of peripheral arterial blood pressure and blood flow velocity in the middle cerebral artery (MCA), both at intra-heartbeat resolution. A physiological model of cerebrovascular dynamics provides mathematical constraints that relate the measured waveforms to ICP. Our algorithm produces patient-specific ICP estimates with no calibration or training. Using 35 hours of data from 37 patients with traumatic brain injury, we generated ICP estimates on 2665 nonoverlapping 60-beat data windows. Referenced against concurrently recorded invasive parenchymal ICP that varied over 100 millimeters of mercury (mmHg) across all records, our estimates achieved a mean error (bias) of 1.6 mmHg and SD of error (SDE) of 7.6 mmHg. For the 1673 data windows over 22 hours in which blood flow velocity recordings were available from both the left and the right MCA, averaging the resulting bilateral ICP estimates reduced the bias to 1.5 mmHg and SDE to 5.9 mmHg. This accuracy is already comparable to that of some invasive ICP measurement methods in current clinical use.National Institutes of Health (U.S.) (R01 EB001659)CIMIT: Center for Integration of Medicine and Innovative Technolog

Continuous quantitative monitoring of cerebral oxygen metabolism in neonates by ventilator-gated analysis of NIRS recordings

Oxidative stress during fetal development, delivery, or early postnatal life is a major cause of neuropathology, as both hypoxic and hyperoxic insults can significantly damage the developing brain. Despite the obvious need for reliable cerebral oxygenation monitoring, no technology currently exists to monitor cerebral oxygen metabolism continuously and noninvasively in infants at high risk for developing brain injury. Consequently, a rational approach to titrating oxygen supply to cerebral oxygen demand – and thus avoiding hyperoxic or hypoxic insults – is currently lacking. We present a promising method to close this crucial technology gap in the important case of neonates on conventional ventilators. By using cerebral near-infrared spectroscopy and signals from conventional ventilators, along with arterial oxygen saturation, we derive continuous (breath-by-breath) estimates of cerebral venous oxygen saturation, cerebral oxygen extraction fraction, cerebral blood flow, and cerebral metabolic rate of oxygen. The resultant estimates compare very favorably to previously reported data obtained by non-continuous and invasive means from preterm infants in neonatal critical care.National Institutes of Health (U.S.) (Grant R01EB001659)National Institutes of Health (U.S.) (Grant K24NS057568)National Institutes of Health (U.S.) (Grant R21HD056009

in breast cancer

PSMD9 expression predicts radiotherapy respons

In vivo measurement of apolipoprotein E from the brain interstitial fluid using microdialysis

BACKGROUND: The APOE4 allele variant is the strongest known genetic risk factor for developing late-onset Alzheimer’s disease. The link between apolipoprotein E (apoE) and Alzheimer’s disease is likely due in large part to the impact of apoE on the metabolism of amyloid β (Aβ) within the brain. Manipulation of apoE levels and lipidation within the brain has been proposed as a therapeutic target for the treatment of Alzheimer’s disease. However, we know little about the dynamic regulation of apoE levels and lipidation within the central nervous system. We have developed an assay to measure apoE levels in the brain interstitial fluid of awake and freely moving mice using large molecular weight cut-off microdialysis probes. RESULTS: We were able to recover apoE using microdialysis from human cerebrospinal fluid (CSF) in vitro and mouse brain parenchyma in vivo. Microdialysis probes were inserted into the hippocampus of wild-type mice and interstitial fluid was collected for 36 hours. Levels of apoE within the microdialysis samples were determined by ELISA. The levels of apoE were found to be relatively stable over 36 hours. No apoE was detected in microdialysis samples from apoE KO mice. Administration of the RXR agonist bexarotene increased ISF apoE levels while ISF Aβ levels were decreased. Extrapolation to zero-flow analysis allowed us to determine the absolute recoverable concentration of apoE3 in the brain ISF of apoE3 KI mice. Furthermore, analysis of microdialysis samples by non-denaturing gel electrophoresis determined lipidated apoE particles in microdialysis samples were consistent in size with apoE particles from CSF. Finally, we found that the concentration of apoE in the brain ISF was dependent upon apoE isoform in human apoE KI mice, following the pattern apoE2>apoE3>apoE4. CONCLUSIONS: We are able to collect lipidated apoE from the brain of awake and freely moving mice and monitor apoE levels over the course of several hours from a single mouse. Our technique enables assessment of brain apoE dynamics under physiological and pathophysiological conditions and in response to therapeutic interventions designed to affect apoE levels and lipidation within the brain

High-Frequency (> 100 GHz) and High-Speed (< 1 ps) Electronic Devices

Contains reports on six research projects and a list of publications.MIT Research Laboratory of Electronics Postdoctoral FellowshipNational Science Foundation Grant DMR 90-22933MIT Lincoln Laboratory Advanced Concept ProgramAdvanced Research Projects Agency Contract MDA972-90-C-0021MIT Lincoln LaboratoryNational Aeronautics and Space Administration Grant NAG2-693U.S. Army Research Office Grant DAAL03-92-G-025

Low-concentration, continuous brachial plexus block in the management of Purple Glove Syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management.</p> <p>Case presentation</p> <p>A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1%) with fentanyl (2 μg/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month.</p> <p>Conclusion</p> <p>A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.</p

MiR-195 and Its Target SEMA6D Regulate Chemoresponse in Breast Cancer

From MDPI via Jisc Publications RouterHistory: accepted 2021-11-26, pub-electronic 2021-11-28Publication status: PublishedBackground: poor prognosis primary breast cancers are typically treated with cytotoxic chemotherapy. However, recurrences remain relatively common even after this aggressive therapy. Comparison of matched tumours pre- and post-chemotherapy can allow identification of molecular characteristics of therapy resistance and thereby potentially aid discovery of novel predictive markers or targets for chemosensitisation. Through this comparison, we aimed to identify microRNAs associated with chemoresistance, define microRNA target genes, and assess targets as predictors of chemotherapy response. Methods: cancer cells were laser microdissected from matched breast cancer tissues pre- and post-chemotherapy from estrogen receptor positive/HER2 negative breast cancers showing partial responses to epirubicin/cyclophosphamide chemotherapy (n = 5). MicroRNA expression was profiled using qPCR arrays. MicroRNA/mRNA expression was manipulated in estrogen receptor positive/HER2 negative breast cancer cell lines (MCF7 and MDA-MB-175 cells) with mimics, inhibitors or siRNAs, and chemoresponse was assessed using MTT and colony forming survival assays. MicroRNA targets were identified by RNA-sequencing of microRNA mimic pull-downs, and comparison of these with mRNAs containing predicted microRNA binding sites. Survival correlations were tested using the METABRIC expression dataset (n = 1979). Results: miR-195 and miR-26b were consistently up-regulated after therapy, and changes in their expression in cell lines caused significant differences in chemotherapy sensitivity, in accordance with up-regulation driving resistance. SEMA6D was defined and confirmed as a target of the microRNAs. Reduced SEMA6D expression was significantly associated with chemoresistance, in accordance with SEMA6D being a down-stream effector of the microRNAs. Finally, low SEMA6D expression in breast cancers was significantly associated with poor survival after chemotherapy, but not after other therapies. Conclusions: microRNAs and their targets influence chemoresponse, allowing the identification of SEMA6D as a predictive marker for chemotherapy response that could be used to direct therapy or as a target in chemosensitisation strategies