Efficacy of lysine versus mupirocin in the treatment of non-diabetic foot ulcer: the sessing scale for assessment of pressure ulcer

Background: This present studies intended to evaluate the wound healing ability, efficacy and tolerability of lysine cream (15%) in non- diabetic foot ulcer assessed by way of sessing scale.Methods: A randomized, open-label, interventional study was directed on 20 subjects (participants) non-diabetic ulcers. Participants were grouped into two groups, control (n=10) and case (n=10). The control was treated with standard treatment with mupirocin and the test group was treated with standard treatment alongside lysine cream (15%) twice every day. Wound healing in the participants was assessed by the sessing scales.Results: A total of 20 participants were allotted into two groups. The results expressed as mean±standard deviation values imply the size and depth of the foot ulcer from the first week to the 8th week. Both the groups showed a significant increase the ulcer healing and decrease the pressure of foot ulcer of over a period of 8 weeks. Assessment of the first week showed no significant ulcer healing and its pressure. The overall outcome indicated that the lysine-treated group extensively reduced each of the parameters favouring wound healing than the standard therapy with mupirocin (control group).Conclusions: Results concluded that, lysine cream is better efficacious in the repair of wound and additionally well tolerated compared to mupirocin

Universal Artifacts Affect the Branching of Phylogenetic Trees, Not Universal Scaling Laws

The superficial resemblance of phylogenetic trees to other branching structures allows searching for macroevolutionary patterns. However, such trees are just statistical inferences of particular historical events. Recent meta-analyses report finding regularities in the branching pattern of phylogenetic trees. But is this supported by evidence, or are such regularities just methodological artifacts? If so, is there any signal in a phylogeny?In order to evaluate the impact of polytomies and imbalance on tree shape, the distribution of all binary and polytomic trees of up to 7 taxa was assessed in tree-shape space. The relationship between the proportion of outgroups and the amount of imbalance introduced with them was assessed applying four different tree-building methods to 100 combinations from a set of 10 ingroup and 9 outgroup species, and performing covariance analyses. The relevance of this analysis was explored taking 61 published phylogenies, based on nucleic acid sequences and involving various taxa, taxonomic levels, and tree-building methods.All methods of phylogenetic inference are quite sensitive to the artifacts introduced by outgroups. However, published phylogenies appear to be subject to a rather effective, albeit rather intuitive control against such artifacts. The data and methods used to build phylogenetic trees are varied, so any meta-analysis is subject to pitfalls due to their uneven intrinsic merits, which translate into artifacts in tree shape. The binary branching pattern is an imposition of methods, and seldom reflects true relationships in intraspecific analyses, yielding artifactual polytomies in short trees. Above the species level, the departure of real trees from simplistic random models is caused at least by two natural factors--uneven speciation and extinction rates; and artifacts such as choice of taxa included in the analysis, and imbalance introduced by outgroups and basal paraphyletic taxa. This artifactual imbalance accounts for tree shape convergence of large trees.There is no evidence for any universal scaling in the tree of life. Instead, there is a need for improved methods of tree analysis that can be used to discriminate the noise due to outgroups from the phylogenetic signal within the taxon of interest, and to evaluate realistic models of evolution, correcting the retrospective perspective and explicitly recognizing extinction as a driving force. Artifacts are pervasive, and can only be overcome through understanding the structure and biological meaning of phylogenetic trees. Catalan Abstract in Translation S1

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Using an equity-based framework for evaluating publicly funded health insurance programmes as an instrument of UHC in Chhattisgarh State, India

Universal health coverage (UHC) has provided the impetus for the introduction of publicly funded health insurance (PFHI) schemes in the mixed health systems of India and many other low- and middle-income countries. There is a need for a holistic understanding of the pathways of impact of PFHI schemes, including their role in promoting equity of access. Methods: This paper applies an equity-oriented evaluation framework to assess the impacts of PFHI schemes in Chhattisgarh State by synthesising literature from various sources and highlighting knowledge gaps. Data were collected from an extensive review of publications on PFHI schemes in Chhattisgarh since 2009, including empirical studies from the first author's PhD and grey literature such as programme evaluation reports, media articles and civil society campaign documents. The framework was constructed using concepts and frameworks from the health policy and systems research literature on UHC, access and health system building blocks, and is underpinned by the values of equity, human rights and the right to health

Validation of processing maps for 304L stainless steel using hot forging, rolling and extrusion

The development of a microstructure in 304L stainless steel during industrial hot-forming operations, including press forging (mean strain rate of 0.15 s−1), rolling/extrusion (2–5 s−1), and hammer forging (100 s−1) at different temperatures in the range 600–1200°C, was studied with a view to validating the predictions of the processing map. The results have shown that excellent correlation exists between the regimes exhibited by the map and the product microstructures. 304L stainless steel exhibits instability bands when hammer forged at temperatures below 1100°C, rolled/extruded below 1000°C, or press forged below 800°C. All of these conditions must be avoided in mechanical processing of the material. On the other hand, ideally, the material may be rolled, extruded, or press forged at 1200°C to obtain a defect-free microstructure

Validation of processing maps for a 15Cr-15Ni-2.2Mo-0.3Ti austenitic stainless steel using hot forging and rolling tests

The processing maps are being developed for use in optimising hot workability and controlling the microstructure of the product. The present investigation deals with the examination to assess the prediction of the processing maps for a 15Cr-15Ni-2.2Mo-0.3Ti austenitic stainless steel using forging and rolling tests at different temperatures in the range of 600–1200°C. The tensile properties of these deformed products were evaluated at room temperature. The influence of the processing conditions, i.e. strain rate and temperature on the tensile properties of the deformed product were analysed to identify the optimum processing parameters. The results have shown good agreement between the regimes exhibited by the map and the properties of the rolled or forged product. The optimum parameters for processing of this steel were identified as rolling or press forging at temperatures above 1050°C to obtain optimum product properties