Simulated wound assessment using digital planimetry versus three-dimensional cameras: implications for clinical assessment.

BACKGROUND: Clinical management of wounds can benefit from objective measures of response to treatment. Wound surface area and volume are objective measures of wound healing. Using a synthetic wound model, we compare the accuracy and reproducibility of 2 commercially available 3-dimensional (3D) cameras against planimetry and water displacement. METHODS: Twelve ulcers of various sizes and colors were reproduced in modeling clay and cured. Five naive observers used digital planimetry, water displacement, Eykona camera (Fuel 3D, UK), and Silhouette camera (ARANZ, New Zealand) to measure the wounds. RESULTS: When compared with traditional planimetry, wound surface area measurement with Eykona and Silhouette tended to underestimate wounds by 1.7% and 3.7%, respectively. Spearman correlation coefficients were 0.94 (Eykona) and 0.92 (Silhouette). Intraclass correlations for planimetry and the 2 cameras were all 1. Eykona and Silhouette tended to underestimate wound volumes when compared with water displacement by 58% and 23%, respectively. Spearman correlation coefficients were 0.92 (Eykona) and 0.72 (Silhouette). Intraclass correlations for water displacement and the two cameras were all 1. DISCUSSION: Serial accurate objective area measurements are feasible as part of ongoing clinical assessment of wounds. 3D cameras are reliable but have not shown superior accuracy to manual planimetry, and financial concerns and IT integration may limit general clinical usage. Volume measurements of wounds are practicable as part of clinical care

Examining Temporal Variation of the Fermi Coupling Constant using SNe Ia Light Curves

In standard model, the Fermi coupling constant, $G_F$, sets the strength of electroweak decay. We attempt an approach to constrain the temporal variation of the Fermi coupling constant $G_F$. To probe it, Type Ia supernovae (SNe Ia) light curves are being used as a source of reliable primordial nucleosynthesis events across the redshifts. We utilized studies suggesting that in the initial phase after the SNe Ia explosion, the electroweak decay of $^{56}Ni \rightarrow ^{56}Co \rightarrow ^{56}Fe$ is the key contributor to powering the SNe Ia light curve. We hence used the Pan-STARRS supernovae catalog having 1169 supernovae light curves in $g$, $r$, $i$, and $z$ spectral filters. The post-peak decrease in the apparent magnitude of light curves (in the rest frame of SNe) was related to the electroweak decay rate of primordial nucleosynthesis. Further, the decay rate relates to $G_F$. To keep the analysis independent of the cosmological model, we used the Hubble parameter measurement and a non-parametric statistical method, the Gaussian Process. Our study suggests a small yet finite temporal variation of $G_F$ and puts a strong upper bound on the present value of the fractional change in the Fermi coupling constant i.e; $\dfrac{\dot G_F}{G_F}\big\rvert_{z=0} \approx 10^{-11} yr^{-1}$ using datasets spread over a redshift range $0<z<0.75$.Comment: 14 pages, 7 figures, 1 tabl

Self care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India

Background: Increasing prevalence of diabetes in India is resulting in an epidemiological transition. The care of the people with diabetes is traditionally seen as doctor centered, but the concept of self‑care of people with diabetes is a new domain and is proven beneficial. Aim: The aim was to determine the practice of self‑care activities among people with diabetes attending a tertiary care hospital in Mangalore. Subjects and Methods: A facility‑based cross‑sectional study was conducted in Government Wenlock Hospital, Mangalore during September–October 2012. A total of 290 patients with &gt;1‑year duration of diabetes mellitus (DM) were asked to respond to summary diabetes self‑care activities questionnaire after obtaining the consent from them. The statistical analysis was performed in terms of descriptive statistics and association between the variables was tested using Mann–Whitney U‑test. Results: A healthy eating plan on a daily basis was followed by 45.9% (133/290) of the participants, daily exercises for 30 min were followed by 43.4% (126/290), and regular blood sugar monitoring was done by 76.6% (222/290). Regarding the adherence to oral hypoglycemic agents and insulin, daily adherence to medication was seen among 60.5% (155/256) and 66.9% (138/206) were found to be adherent to insulin injections on a daily basis. Conclusions: Self‑care practices were found to be unsatisfactory in almost all aspects except for blood sugar monitoring and treatment adherence. As these practices are essential for prevention of complications and better quality‑of ‑life, more efforts should be put to educate the people with diabetes.Keywords: Cross‑sectional studies, Diabetes mellitus, India, Self‑car

Thermal Conductivity Enhancement of Al2O3 Nanofluid in Ethylene Glycol and Water Mixture

AbstractThe ability of nanofluids that exhibits enhanced thermal performance is acknowledged by researchers through studies since decades ago. However, the observation of thermal properties for nanofluids in water and ethylene glycol based is not fully explored yet. Hence, this paper presents the thermal conductivity of water and ethylene glycol (EG) based Al2O3 nanofluid. The 13 nm sized Al2O3 nanoparticles were dispersed into three different volume ratio of water: EG such as 40:60, 50:50 and 60:40 using a two-step method. The measurement of thermal conductivity was performed using KD2 Pro Thermal Properties Analyzer at working temperatures of 30 to 70 ̊C for volume concentration of 0.5 to 2.0%. The results indicate that the thermal conductivity increases with the increase of nanofluid concentration and temperature. While the percentage of ethylene glycol increase, the range of thermal conductivity decreases due to ethylene glycol properties. The measurement data of the nanofluids give maximum enhancement of thermal conductivity at condition 2.0% volume concentration, temperature of 70 ̊C and for all base fluid

Evidence-based focused approach for fulfillment of aims: Experiences of an asthma clinic

Background: A new health system for the 21st century should be based on the best scientific knowledge, according to the Institute&nbsp;of Medicine, US. Objective: We have evaluated the effectiveness of asthma clinic providing comprehensive care based on the best&nbsp;available scientific evidence. Materials and Methods: This intervention study was conducted in a tertiary care hospital having&nbsp;a devoted asthma clinic for the&nbsp; comprehensive management. All children diagnosed as having asthma were included, and data&nbsp;of cases managed from July 2014 to June 2016 were analyzed. Intervention - comprehensive management of asthma including&nbsp;assessment, monitoring, health education, avoidance of triggers, management of comorbid conditions, appropriate medications,&nbsp;written asthma action plan, and counseling for follow-up. Outcome measures were treatment direction, asthma control, emergency&nbsp;visits, and hospitalizations. Results: 260 children were treated over a 2-year period. The effects of focused approach with progressive&nbsp;expertise lead to statistically significant benefits over the two successive years from July 2014 to June 2015 and July 2015 to June2016. These were in: (i) Treatment direction: Cases requiring stepping up of treatment decreased from 36.49% to 17.24% (relative&nbsp;risk [RR]: 0.473 [95% confidence interval {CI}: 0.249-0.895]); p=0.01229, (ii) asthma control: Cases with not well-controlled&nbsp;asthma decreased from 16.44% to 7.02% (RR 0.427: [95% CI: 0.199-0.914]); p=0.045, (iii) emergency department visits decreased&nbsp;from 35.62% to 21.05% (RR 0.591: [95% CI: 0.39-0.897]), p=0.00766, (iv) hospitalizations decreased from 16.44% to 5.26% (RR&nbsp;0.32: [95% CI: 0.135-0.757]), p=0.00462. Conclusion: Establishing an asthma clinic and progressive expertise leads to significant&nbsp;beneficial results

Enteric Neurospheres Are Not Specific to Neural Crest Cultures: Implications for Neural Stem Cell Therapies

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited

A tunable delivery platform to provide local chemotherapy for pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is one of the most devastating and painful cancers. Pancreatic cancer is often highly resistant to therapy owing to inherent chemoresistance and the desmoplastic response that creates a barrier of fibrous tissue preventing transport of chemotherapeutics into the tumor. The growth of the tumor in pancreatic cancer often leads to invasion of other organs and partial or complete biliary obstruction, inducing intense pain for patients and necessitating tumor resection or repeated stenting. Here, we have developed a delivery device to provide enhanced palliative therapy for pancreatic cancer patients by providing high concentrations of chemotherapeutic compounds locally at the tumor site. This treatment could reduce the need for repeated procedures in advanced PDAC patients to debulk the tumor mass or stent the obstructed bile duct. To facilitate clinical translation, we created the device out of currently approved materials and drugs. We engineered an implantable poly(lactic-co-glycolic)-based biodegradable device that is able to linearly release high doses of chemotherapeutic drugs for up to 60 days. We created five patient-derived PDAC cell lines and tested their sensitivity to approved chemotherapeutic compounds. These in vitro experiments showed that paclitaxel was the most effective single agent across all cell lines. We compared the efficacy of systemic and local paclitaxel therapy on the patient-derived cell lines in an orthotopic xenograft model in mice (PDX). In this model, we found up to a 12-fold increase in suppression of tumor growth by local therapy in comparison to systemic administration and reduce retention into off-target organs. Herein, we highlight the efficacy of a local therapeutic approach to overcome PDAC chemoresistance and reduce the need for repeated interventions and biliary obstruction by preventing local tumor growth. Our results underscore the urgent need for an implantable drug-eluting platform to deliver cytotoxic agents directly within the tumor mass as a novel therapeutic strategy for patients with pancreatic cancer

A population-based study of anxiety as a precursor for depression in childhood and adolescence

BACKGROUND: Anxiety and depression co-occur in children and adolescents with anxiety commonly preceding depression. Although there is some evidence to suggest that the association between early anxiety and later depression is explained by a shared genetic aetiology, the contribution of environmental factors is less well examined and it is unknown whether anxiety itself is a phenotypic risk factor for later depression. These explanations of the association between early anxiety and later depression were evaluated. METHODS: Anxiety and depressive symptoms were assessed longitudinally in a U.K. population-based sample of 676 twins aged 5–17 at baseline. At baseline, anxiety and depression were assessed by parental questionnaire. Depression was assessed three years later by parental and adolescent questionnaire. RESULTS: Shared genetic effects between early anxiety and later depression were found. A model of a phenotypic risk effect from early anxiety on later depression provided a poor fit to the data. However, there were significant genetic effects specific to later depression, showing that early anxiety and later depression do not index entirely the same genetic risk. CONCLUSIONS: Anxiety and depression are associated over time because they share a partly common genetic aetiology rather than because the anxiety phenotype leads to later depression