Pass-transistor very large scale integration

Logic elements are provided that permit reductions in layout size and avoidance of hazards. Such logic elements may be included in libraries of logic cells. A logical function to be implemented by the logic element is decomposed about logical variables to identify factors corresponding to combinations of the logical variables and their complements. A pass transistor network is provided for implementing the pass network function in accordance with this decomposition. The pass transistor network includes ordered arrangements of pass transistors that correspond to the combinations of variables and complements resulting from the logical decomposition. The logic elements may act as selection circuits and be integrated with memory and buffer elements

Hypolipidemic, Hypoglycemic and Anti-oxidant Activities of Flower Extracts of Allamanda Violacea A. DC (Apocynaceae)

Purpose: To investigate the anti-dyslipidemic, anti-oxidant and anti-diabetic activities of the aqueous extract and solvent fractions of A. violacea flowers.Methods: The aqueous extract was fractionated into petroleum ether, ether, chloroform, chloroformmethanol (4:1) and chloroform-methanol (3:2) fractions. Lipid lowering activity was evaluated in two models, viz, triton WR-1339 - induced hyperlipimea in rats as well as fructose-rich high fat diet. To assess anti-oxidant activity, in-vitro model of non-enzymic superoxide hydroxyl radicals and microsomal lipid peroxidation by non-enzymic inducer was adopted. Hypoglycemic activity was evaluated by sucrose-loaded rat model.Results: Amongst the fractions, ether and chloroform fractions caused marked decrease in the levels of total cholesterol (Tc), triglycerides (Tg), plasma lipids (Pl), and protein by 24, 23, 23 and 22 %, and 24, 22, 23 and 19 %, respectively. In rats fed with high fat diet (HFD), ether and chloroform fractions lowered Tc, Tg and, Pl by 26, 25 and 26 %, and 18, 19 and 20 %, respectively. Significant decrease in superoxide anions, hydroxyl radicals and microsomal lipid peroxidation by ether and chloroform fractions was also observed. Chloroform, chloroform-methanol (4:1) and chloroform-methanol (3:2) fractions showed antihyperglycaemic activity to the extent of 25.2, 21.6 and 23.2 %, respectively.Conclusion: The flowers of this plant, especially the ether and chloroform extracts, may be suitable as an anti-oxidant supplement for lipid management.Keywords: Allamanda violacea flowers, Anti-hyperlipidemic,  Anti-hyperglycemic, Anti-oxidant

Perception of fever and management practices by parents of pediatric patients

Background: The febrile child is a common pediatric presentation in both primary care and the emergency department. An assessment of parents’ perception to recognize fever in their child, as well as management practices was the focus of this study.Methods: The study was done prospectively in which interviews were taken by researchers. One hundred and sixty four parents, whose children were less than 14 years old, had fever as one of the presenting complaints and admitted in pediatric department of  Rama medical college & research center, Kanpur, were included in this study.Results: Majority of the parents 114 (69.51%) managed the fever initially at home. Only a few parents (17.07%) correctly managed the fever by taking their children to hospital or to a qualified practitioner, rest of the parents primarily rely on local medical store or unqualified practitioner. Conclusion: Parents need to be educated, when they consult health facilities especially during vaccination visits. Decreased appetite was the most common presenting complaint along with fever in children and it should be taken as a significant factor during health education of fever for early and appropriate consultation

A comparison of toxicity profile of gemcitabine monotherapy versus etoposide/cisplatin in the treatment of locally advanced or metastatic non-small cell lung cancer

Background: Lung cancer is the leading cause of cancer deaths globally in which about 40% patients reporting in advanced stage disease. Both platinum and non platinumcombinations have been shown to be equally efficacious as initial first-line treatment of advanced non-small cell lung cancer (NSCLC), however because of the toxicity of cisplatin, combination treatment can only be administered to a minority of patients in good general health. Gemcitabine could be combined with one of the other new agents to create novel non-platinum-doublet combinations with efficacy and/or toxicity profile superior to that of standard platinum based combinations. Hence, this study was conducted to compare the toxicity profiles of gemcitabine monotherapy and the cisplatin/etoposide combination therapy.Methods: This was a randomized prospective study, which included 96 patients selected on the basis of histologically or cytologically confirmed Stage III B or IV of NSCLC. Study was divided into two arms-Arm A received gemcitabine monotherapy in a dose of 1000 mg/m2 on day 1 and 5 of the cycle andrepeated after every 3 weeks while Arm B received cisplatin (25 mg/m2 on day 1, 2 and 3) + etoposide (100 mg/m2). Patient were evaluated for adverse events by following World Health Organization grading of toxicity.Results: Out of the 96 patients enrolled in the study, 74 (77.0%) patients were eligible and were analyzed. Of these, 36 (37.5%) patients belonged to Arm A and 38 (39.5%) to Arm B. Transient vomiting (45.8% vs. 37.5%), leukopenia (33.3% vs. 8.3%) were seen more in Arm A, while thrombocytopenia (33.3% vs. 12.5%), patchy hair loss (68.4% vs. 16.6%) was seen more in Arm B. Nephrotoxicity was seen almost similarly in both the groups.Conclusions: Single-agent gemcitabine appears to have a safer toxicity profile than the combination cisplatin-etoposide in the first-line chemotherapy of advanced NSCLC. With less toxic anticancer drugs like gemcitabine, the physician now has greater choice in choosing treatment, which can have better effect on the patients concerned

Beta-Blocker Use and 30-Day All-Cause Readmission in Medicare Beneficiaries With Systolic Heart Failure

BACKGROUND: Beta-blockers improve outcomes in patients with systolic heart failure. However, it is unknown whether their initial negative inotropic effect may increase 30-day all-cause readmission, a target outcome for Medicare cost reduction and financial penalty for hospitals under the Affordable Care Act. METHODS: Of the 3067 Medicare beneficiaries discharged alive from 106 Alabama hospitals (1998-2001) with a primary discharge diagnosis of heart failure and ejection fraction RESULTS: Beta-blocker use was not associated with 30-day all-cause readmission (hazard ratio [HR] 0.87; 95% confidence interval [CI], 0.64-1.18) or heart failure readmission (HR 0.95; 95% CI, 0.57-1.58), but was significantly associated with lower 30-day all-cause mortality (HR 0.29; 95% CI, 0.12-0.73). During 4-year postdischarge, those in the beta-blocker group had lower mortality (HR 0.81; 95% CI, 0.67-0.98) and combined outcome of all-cause mortality or all-cause readmission (HR 0.87; 95% CI, 0.74-0.97), but not with all-cause readmission (HR 0.89; 95% CI, 0.76-1.04). CONCLUSIONS: Among hospitalized older patients with systolic heart failure, discharge prescription of beta-blockers was associated with lower 30-day all-cause mortality and 4-year combined death or readmission outcomes without higher 30-day readmission

Performance criteria for verbal autopsy-based systems to estimate national causes of death: development and application to the Indian Million Death Study.

BACKGROUND: Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India's ongoing, nationally-representative Indian Million Death Study (MDS). METHODS: Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of COD distributions with independent resampling; differences in COD distribution of hospital, home, urban or rural deaths; age-, sex- and time-specific plausibility of specific diseases; stability and repeatability of dual physician coding; and the ability of the mortality classification system to capture a wide range of conditions. RESULTS: The introduction of the MDS in India reduced the proportion of ill-defined deaths before age 70 years from 13% to 4%. The cause-specific mortality fractions (CSMFs) at ages 5 to 69 years for independently resampled deaths and the MDS were very similar across 19 disease categories. By contrast, CSMFs at these ages differed between hospital and home deaths and between urban and rural deaths. Thus, reliance mostly on urban or hospital data can distort national estimates of CODs. Age-, sex- and time-specific patterns for various diseases were plausible. Initial physician agreement on COD occurred about two-thirds of the time. The MDS COD classification system was able to capture more eligible records than alternative classification systems. By these metrics, the Indian MDS performs well for deaths prior to age 70 years. The key implication for low- and middle-income countries where medical certification of death remains uncommon is to implement COD surveys that randomly sample all deaths, use simple but high-quality field work with built-in resampling, and use electronic rather than paper systems to expedite field work and coding. CONCLUSIONS: Simple criteria can evaluate the performance of VA-based COD systems. Despite the misclassification of VA, the MDS demonstrates that national surveys of CODs using VA are an order of magnitude better than the limited COD data previously available

Anti-Proliferative Role of Recombinant Lethal Toxin of Bacillus Anthracis on Primary Mammary Ductal Carcinoma Cells Revealing Its Therapeutic Potential

Bacillus anthracis secretes three secretary proteins; lethal factor (LF), protective antigen (PA) and edema factor (EF). The LF has ability to check proliferation of mammary tumors, chiefly depending on mitogen activated protein kinase (MAPK) signaling pathway. Evaluation of therapeutic potential of recombinant LF (rLF), recombinant PA (rPA) and lethal toxin (rLF + rPA = LeTx) on the primary mammary ductal carcinoma cells revealed significant (p \u3c 0.01) reduction in proliferation of tumor cells with mean inhibition indices of 28.0 ±1.37% and 19.6 ± 1.47% respectively. However, treatment with rPA alone had no significant anti-proliferative effect as evident by low mean inhibition index of 3.4 ± 3.87%. The higher inhibition index observed for rLF alone as compared to LeTx is contrary to the existing knowledge on LF, which explains the requirement of PA dependent endocytosis for its enzymatic activity. Therefore, the plausible existence of PA independent mode of action of LF including direct receptor mediated endocytosis or modulation of signal transduction cascade via unknown means is hypothesized. In silico protein docking analysis of other cellular receptors for any plausibility to play the role of receptor for LF revealed c-Met receptor showing strongest affinity for LF (H bond = 19; Free energy = -773.96), followed by nerve growth factor receptor (NGFR) and human epidermal growth factor receptor (HER)-1. The study summarizes the use of rLF or LeTx as therapeutic molecule against primary mammary ductal carcinoma cells and also the c-Met as potential alternative receptor for LF to mediate and modulate PA independent signal transduction