Colitis Following Initiation of Sofosbuvir and Simeprevir for Genotype 1 Hepatitis C.

Sofosbuvir and simeprevir are used for the treatment of chronic hepatitis C (HCV) genotype 1. Both drugs have been well-tolerated, with diarrhea noted in 6% cases with sofosbuvir, 16% with sofosbuvir plus simeprevir, and 0% with simeprevir. No prior reports exist of colitis secondary to either drug or their combination. We report a patient with no prior history of inflammatory bowel disease who developed significant bloody diarrhea within 2 weeks of sofosbuvir/simeprevir initiation. Colonoscopy and biopsy confirmed pancolitis, which responded to mesalamine and completion of sofosbuvir/simeprevir

WHO Takes Action to Promote the Health of Refugees and Migrants

Migration is a defining issue of our time, with 1 billion migrants globally, of whom 258 million have crossed borders. Climate change and political instability propel ever-greater displacement, with major detriments to health. Policies that fail to prevent human trafficking or guarantee essential services undermine Universal Health Coverage (UHC) and the global pledge to “leave no one behind.” The World Health Assembly should robustly implement WHO’s Global Action Plan (GAP) on the Health of Refugees and Migrants.ugees and Migrants

Low flow venovenous bypasses in small dogs and pediatric patients undergoing replacement of the liver

A venovenous bypass for transplantation of the liver was developed and evaluated in dogs and applied clinically, with flows that averaged less than 500 milliliters per minute. Fatal pulmonary emboli were seen in two of 40 experiments. The venovenous flow in the four pediatric recipients was 200 to 1,200 milliliters per minute, and there were no complications

Persistent low adherence to hypertension treatment in Kyrgyzstan: How can we understand the role of drug affordability?

It is well known that cardiovascular diseases (CVD) are a growing cause of mortality and morbidity in low-and middle-income countries (LMIC). While hypertension (HTN), a leading risk factor for CVD, can be easily managed with widely available medicines, there is a huge gap in treatment for HTN in many LMIC. One such country is Kyrgyzstan, where HTN is a major public health concern and adherence to medication is low. The reasons for low adherence in Kyrgyzstan are not well understood, but some evidence suggests that HTN medicines may be unaffordable for low-income families, resulting in inequitable access to HTN treatment. With data from the 2010 Kyrgyzstan Integrated Household Survey, we estimate the prevalence and factors associated with adherence to HTN medication in Kyrgyzstan. We then investigate the hypothesis that affordability may be an important factor in adherence to HTN medication. Using the coarsened exact matching approach, we estimate the economic burden faced by households with at least one member with elevated blood pressure (EBP) in Kyrgyzstan and their risk of catastrophic spending on health care. We find that EBP households have significantly higher total expenditure on health, as well as on medicines, and are more likely to experience catastrophic health spending, suggesting that out-of-pocket expenditure for EBP may be prohibitively expensive for the poorest in Kyrgyzstan. Our findings also reveal a high prevalence of self-medication (i.e. purchasing and using medication without a doctor's prescription), and increased expenditure due to self-medication, among those with EBP. Our research suggests that affordability of HTN medicines may be an important factor in low adherence to treatment in Kyrgyzstan. Low affordability may be due partly to the prescription of medicines that are not reimbursable under the national drug benefit plan, but more research is needed to identify solutions to the affordability problem

Modifications of physical properties of coconut oil and anhydrous milk fat as a result of blending

The role of fats in food technology is mainly to develop the desired consistency. The simplest way to reach this goal is the blending of different fats. The aim of our work was to study the solidification and melting properties of blends of coconut oil and anhydrous milk fat. Pure fats and their 25–75%, 50–50%, and 75–25% blends were investigated. Melting profile and isotherm crystallization were measured by pNMR. Non-isotherm melting and solidification were detected by differential scanning calorimetry (DSC). Possible applications of the blends were established. Results show that AMF and coconut oil has limited miscibility, which is dependent on the temperature. Below 22 °C AMF is the softening component, above 22 °C the effect is inverse. Coconut oil accelerates solidification of AMF, however, basic crystal forms of AMF remained

Nanofibers

Cellulose is the most available biopolymer on earth existent in wood and other lignocellulosic sources, which can be isolated as nanofibers to reinforce composites. The aim of this chapter overview was to explain cellulose nanofibers’ preparation methods from different plant sources. The chemical treatment of cellulose fibers including dilute alkali swelling, acid and base hydrolysis, and bleaching was carried out followed by a mechanical method to isolate nanofibers. In this study, the effect of few palnt source variations and mechanical processes used in extraction procedure on nanofibers morphology, crystallinity, and chemical composition was evaluated. Characteristics of extracted cellulose nanofibers obtained from different plant sources were presented as well

Perioperative Course and Socioeconomic Status Predict Long-Term Neurodevelopment Better Than Perioperative Conventional Neuroimaging in Children with Congenital Heart Disease.

The objective of the study was to compare the use of neonatal conventional brain magnetic resonance imaging (MRI) with that of clinical factors and socioeconomic status (SES) to predict long-term neurodevelopment in children with severe congenital heart disease (CHD). In this prospective cohort study, perioperative MRIs were acquired in 57 term-born infants with CHD undergoing cardiopulmonary bypass surgery during their first year of life. Total brain volume (TBV) was measured using an automated method. Brain injury severity (BIS) was assessed by an established scoring system. The neurodevelopmental outcome was assessed at 6 years using standardized test batteries. A multiple linear regression model was used for cognitive and motor outcomes with postoperative TBV, perioperative BIS, CHD complexity, length of hospital stay, and SES as covariates. CHD diagnoses included univentricular heart defect (n = 15), transposition of the great arteries (n = 33), and acyanotic CHD (n = 9). Perioperative moderate-to-severe brain injury was detected in 15 (26%) patients. The total IQ was similar to test norms (P = .11), whereas the total motor score (P < .001) was lower. Neither postoperative TBV nor perioperative BIS predicted the total IQ, but SES (P < .001) and longer hospital stay (P = .004) did. No factor predicted the motor outcome. Although the predictive value of neonatal conventional MRIs for long-term neurodevelopment is low, duration of hospital stay and SES better predict the outcome in this CHD sample. These findings should be considered in initiating early therapeutic support

Regulation of cluster compactness and resistance to Botrytis cinerea with β-aminobutyric acid treatment in field-grown grapevine

Our paper offers unique information regarding the effects of DL-β-amino-n-butyric acid (BABA) on grape cluster compactness and Botrytis bunch rot development. The impact of treatment was investigated on a native Hungarian grapevine cultivar, Királyleányka (Vitis vinifera L.) during four seasons. The cultivar with dense clusters and with thin skinned berries provided excellent samples for bunch rot studies. In addition, the female sterility effect of BABA in grapevine flowers was examined, which may contribute to looser clusters. Cluster compactness was characterized with two different indexes, bunch rot incidence was assessed in percentages. Ovaries of flowers were examined under epifluorescent microscope. The applied treatments significantly influenced cluster indexes. Bunch rot incidence, however, was highly influenced by the precipitation during ripening. In years 2011 and 2013 reduced bunch rot was detected, while the extremity of rain in 2012 and 2014, resulted in no epidemic or high infection, respectively. Microscopic studies proved that successful treatments on cluster structure can be traced back to the female sterility caused by BABA. Our results presented clear evidence for the effectiveness of BABA treatment on Botrytis bunch rot by promoting looser clusters

Tree allocation dynamics beyond heat and hot drought stress reveal changes in carbon storage, belowground translocation and growth

Heatwaves combined with drought affect tree functioning with as yet undetermined legacy effects on carbon (C) and nitrogen (N) allocation. We continuously monitored shoot and root gas exchange, δ13CO2 of respiration and stem growth in well-watered and drought-treated Pinus sylvestris (Scots pine) seedlings exposed to increasing daytime temperatures (max. 42°C) and evaporative demand. Following stress release, we used 13CO2 canopy pulse-labeling, supplemented by soil-applied 15N, to determine allocation to plant compartments, respiration and soil microbial biomass (SMB) over 2.5 wk. Previously heat-treated seedlings rapidly translocated 13C along the long-distance transport path, to root respiration (Rroot; 7.1 h) and SMB (3 d). Furthermore, 13C accumulated in branch cellulose, suggesting secondary growth enhancement. However, in recovering drought-heat seedlings, the mean residence time of 13C in needles increased, whereas C translocation to Rroot was delayed (13.8 h) and 13C incorporated into starch rather than cellulose. Concurrently, we observed stress-induced low N uptake and aboveground allocation. C and N allocation during early recovery were affected by stress type and impact. Although C uptake increased quickly in both treatments, drought-heat in combination reduced the above–belowground coupling and starch accumulated in leaves at the expense of growth. Accordingly, C allocation during recovery depends on phloem translocation capacity