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Background: Cervical spine clearance in intubated patients due to blunt trauma remains contentious. Accumulating evidence suggests that a normal computed tomography (CT) cervical spine can be used to clear the cervical spine and remove the collar in unconscious patients presenting to the emergency department. However, whether this strategy can safely be employed by critical care physicians with intubated patients admitted to the trauma intensive care unit (TICU) with cervical collars in situ, has not been definitively studied. Methods: A retrospective review of 730 intubated victims of trauma who presented to the Level 1 Trauma center of a tertiary hospital was conducted. The rates of missed cervical injuries in patients who had their cervical collars removed by intensive care physicians based on a normal CT scan of the cervical spine, were reviewed. Secondary outcomes included rates of collar-related complications. Results: Three hundred and fifty patients had their cervical collars removed by Trauma ICU doctors based on a high-quality, radiologist-interpreted normal CT cervical spine. Seventy percent of patients were sedated and/or comatose at the time of collar removal. Fifty-one percent of patients had concomitant traumatic brain injury. The average GCS at time of collar removal was 9. The incidence of missed neurological injury discerned clinically at time of both ICU and hospital discharge was nil (negative predictive value 100%). The rate of collar-related complications was 2%. Conclusion: Cervical collar removal by intensive care physicians on TICU following normal CT cervical spine, is safe, provided certain quality conditions related to the CT scan are met. Not removing the collar early may be associated with increased complications. An algorithm is suggested to assist critical care decision-making in this patient cohort. [ABSTRACT FROM AUTHOR]

The impact of agricultural practices on CO 2 emissions from soils needs to be understood and quantified to enhance ecosystem functions, especially the ability of soils to sequester atmospheric carbon (C), while enhancing food and biomass production. The objective of this study was to assess CO 2 emissions in the soil surface following tillage abandonment and to investigate some of the underlying soil physical, chemical and biological controls. Maize ( Zea mays ) was planted under conventional tillage (T) and no-tillage (NT), both without crop residues under smallholder farming conditions in Potshini, South Africa. Intact top-soil (0–0.05 m) core samples (N = 54) from three 5 × 15 m 2 plots per treatment were collected two years after conversion of T to NT to evaluate the short-term CO 2 emissions. Depending on the treatment, cores were left intact, compacted by 5 and 10%, or had surface crusts removed. They were incubated for 20 days with measurements of CO 2 fluxes twice a day during the first three days and once a day thereafter. Soil organic C (SOC) content, soil bulk density ( ρ b ), aggregate stability, soil organic matter quality, and microbial biomass and its activity were evaluated at the onset of the incubation. CO 2 emissions were 22% lower under NT compared with T with CO 2 emissions of 0.9 ± 0.10 vs 1.1 ± 0.10 mg C–CO 2 gC −1 day −1 under NT and T, respectively, suggesting greater SOC protection under NT. However, there were greater total CO 2 emissions per unit of surface by 9% under NT compared to T (1.15 ± 0.03 vs 1.05 ± 0.04 g C–CO 2 m −2 day −1 ). SOC protection significantly increased with the increase in soil bulk density ( r = 0.89) and aggregate stability (from 1.7 ± 0.25 mm to 2.3 ± 0.31, r = 0.50), and to the decrease in microbial biomass and its activity ( r = −0.59 and −0.57, respectively). In contrast, the greater NT CO 2 emissions per m 2 were explained by top-soil enrichment in SOC by 48% (from 12.4 ± 0.2 to 19.1 ± 0.4 g kg −1 , r = 0.59). These results on the soil controls of tillage impact on CO 2 emissions are expected to inform on the required shifts in agricultural practices for enhancing C sequestration in soils. In the context of the study, any mechanism favoring aggregate stability and promoting SOC allocation deep in the soil profile rather than in the top-soil would greatly diminish soil CO 2 outputs and thus stimulate C sequestration. [ABSTRACT FROM AUTHOR]

Zinc phosphating is a chemical conversion process that has been widely used in industry for corrosion protection and primer for painting. In this investigation, the effect of activation treatment with nickel acetate on the microstructural evolution and corrosion resistance of the zinc phosphate coating on mild steel was studied. The chemical composition and morphology of the coatings were analyzed via scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS). The corrosion resistance of the coatings was evaluated using polarization curves and electrochemical impedance spectroscopy (EIS) in an aerated 3.5% NaCl solution. Surface morphology observations revealed that the activation treatment increased the population density and refined the grain size of the coating. The electrochemical results showed better barrier protection characteristics and corrosion resistance for activated phosphate coatings compared with inactivated coatings. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the structural performance of steel lattice telecommunication towers. Topics covered include the typology and characteristics of such towers, the effects of various loads including dead loads, live loads and environmental loads particularly wind, the response of such structures to wind and other loads, and options for strengthening the towers. A discussion of Eurocode provisions regarding tower design is provided.

This work was carried out on the scleral shelf of the eyeball of the donkey, cow, buffalo, camel, sheep, goat, pig and dog. The results of this work shows that the length of the shelf varies in different regions in all studied animals. The dorsal shelf is the longest followed by ventral one, the lateral shelf is the smallest followed by the medial one. The camel has the longest dorsal and ventral shelf followed by donkey, while the buffalo and cow have the smallest ones among the large animals. Among the studied small animals, the dog has the smallest dorsal and ventral shelf followed by pig. However, the small ruminants have the longest ones. On the other hand, the medial and lateral shelves are longest in donkey and smallest in camel. The dog and the small ruminants have the longest medial and lateral shelf of the studied small animals. The camel has the highest value of dorsal and ventral shelf and lowest value in the medial and lateral ones. Therefore the outline of the outer surface of the cornea is highly oval, the reverse results were observed in donkey; in which the cornea has highest degree of circularity followed by cow and buffalo. [ABSTRACT FROM AUTHOR]

This work was carried out on the cornea of the eyeball of the donkey, cow, buffalo, camel, sheep, goat, pig and dog. The following dimensions were measured: the outer and inner dorsoventral and mediolateral dimension, also the plain, weight and the volume of the cornea and fibrous coat were recorded. The morphometric studies include also thickness of the cornea and its different layers centrally and peripherally. Generally, the thickness of the cornea is about 0.5–0.8 mm, the thickest cornea was observed in cow followed by pig and donkey, the thinnest cornea was observed in sheep followed by camel, goat and buffalo, while the cornea of the goat and buffalo has nearly the same thickness. The biometry of the cornea has been useful for assessment of certain pathologic and congenital abnormalities such as microcornea, megalocornea moreover this measurement are of utmost important when superficial keractectomy and keratoplasty are indicated. [ABSTRACT FROM AUTHOR]

Summary: Although several studies analyzed p53 and mismatch repair (MMR) gene expression separately in oral squamous cell carcinoma (SCC), no reports of combined assessment of both proteins in this cancer. The aim of this study was to investigate the roles of p53 and hMSH2 proteins in oral SCC as well as in oral dysplastic lesions (DL) in Yemen. Immunohistochemistry was used to examine the pattern of expression of p53 and hmsh2 proteins in 70 oral SCC and 21 oral DL obtained from Yemeni patients. p53 Immunoexpression was detected in 24 of the 70 oral SCC (34.3%) and 3 of 21 DL (14.3%) with no significant difference between the two groups. On the other hand, reduced expression of hMSH2 was detected in 26 of the 70 oral SCC (37.1%) and 2 of 21 oral DL (9.5%) with a statistically significant difference (P =0.03). Both proteins were significantly related to the grade of tumor differentiation (P =0.007 and 0.02, respectively). There was an inverse correlation between the levels of p53 and hMSH2 immunoexpression in the oral SCC (r =0.42, P =0.01). This study suggested that p53 may play a role in the early stages of oral carcinogenesis, while hMSH2 may be altered in the late stages. More importantly, the roles of p53 and hMSH2 in oral carcinogenesis seem to be interrelated in the pathogenetic pathway of oral SCC. Such a relationship has not been published previously in this type of cancer and needs to be clarified in future studies. [ABSTRACT FROM AUTHOR]

ISSR marker system was quite informative for assessing the extent of genetic diversity as well as pattern of genetic relationships within the selected plants of Jojoba clones. The second main cluster was divided into two sub-clusters; one sub-cluster contains 10 Jojoba clones (4, 6, 8, 12, 9, 14, male, 13, 1 and 11), while the other sub-cluster contain three Jojoba clones (2, 7 and 3). ISSR polymorphism among different Jojoba clones Jojoba is a potential oilseed crop; however, it still needs to be developed commercially and agronomically. [Extracted from the article]

Oxygen therapy is first-line treatment for hypoxaemic acute respiratory failure (ARF). High-flow nasal oxygen therapy (HFNO) represents an alternative to conventional oxygen therapy. HFNO provides humidified, titrated oxygen therapy matching or even exceeding the patients' inspiratory demand. The application of HFNO is becoming widespread in Intensive Care Units (ICUs), favoured by increasing evidence based on numerous studies supporting its efficacy. The mechanisms of action and physiological effects of HFNO are not yet fully understood. Pharyngeal dead space washout, decrease in airway resistance, generation of a positive end-expiratory pressure, and enhanced delivery of oxygen are all alleged to be potential mechanisms. The emerging evidence suggests that HFNO is effective in improving oxygenation in most patients with hypoxaemic ARF of different aetiologies. Notwithstanding the potential benefit of HFNO in the management of hypoxaemia, further large cohort studies are necessary to clarify the indications, contraindications and factors associated with HFNO failure. HFNO may also be valuable in reducing the need for tracheal intubation in the management of post-extubation ARF. In addition, HFNO has been proposed to limit oxygen desaturation by prolonging apnoeic oxygenation during intubation both in ICUs and operating theatres. [ABSTRACT FROM AUTHOR]

Background: The effect of histology-based treatment regimen on diffuse gastric adenocarcinoma has not been evaluated in clinical trials. This international phase III trial evaluated the efficacy and safety of S-1 (a contemporary oral fluoropyrimidine)/cisplatin versus 5-fluorouracil (5-FU)/cisplatin in chemotherapy-naıve patients with diffuse-type adenocarcinoma involving the gastroesophageal junction or stomach. Patients and methods: Eligibility criteria included untreated, measurable, advanced diffuse adenocarcinoma confirmed by central pathology and performance status of 0-1. Patients were randomized (2 : 1) to receive S-1/cisplatin or 5-FU/cisplatin. Primary end point was overall survival (OS), and secondary end points were progression-free survival, time to treatment failure, overall response rate, and safety. A multivariable analysis was also carried out. Results: Overall, 361 patients were randomized (S-1/cisplatin, n=239; 5-FU/cisplatin, n=122); half (51%) were men, and median age was 56.0 years. In each group, median number of treatment cycles per patient was 4 (range, S-1/cisplatin: 1-20; 5-FU/cisplatin: 1-30), and dose intensity was>95%. OS was not different in the two groups {median OS with S-1/cisplatin, 7.5 [95% confidence interval (CI): 6.7, 9.3]; 5-FU/cisplatin, 6.6 [95% CI: 5.7, 8.1] months; hazard ratio, 0.99 [95% CI: 0.76, 1.28]; P=0.9312}. Overall response rate was significantly higher in the S-1/cisplatin than 5-FU/cisplatin group (34.7% versus 19.8%; P=0.01), but progression-free survival and time to treatment failure were not different. Safety was similar between the 2 groups; however, fewer patients treated with S-1/cisplatin than 5-FU/cisplatin had ≥ 1 grade 3/4 treatment-emergent adverse event or ≥ 1 adverse event resulting in treatment discontinuation. One treatment-related death occurred in each group. Slow accrual led to early termination. Conclusions: These data suggest that S-1/cisplatin and 5-FU/cisplatin are similar in efficacy and safety in untreated patients with advanced diffuse adenocarcinoma of the gastroesophageal junction or stomach. The primary end point was not met. [ABSTRACT FROM AUTHOR]

Aim Delay in commencing adjuvant therapy for colorectal cancer seems to impair survival in some retrospective studies. This study was planned to evaluate its impact on survival. Methods This was a retrospective study enrolling patients registered from 2000 to 2012 in two large cancer-dedicated institutions in Brazil. The primary outcome was overall survival according to early vs late chemotherapy initiation. The interval between the primary surgery and the start of adjuvant chemotherapy was calculated. Survival was estimated using the Kaplan-Meier method and the impact of multiple prognostic factors on survival by Cox regression analysis. Results By the end of 2012, a total of 1963 Stage II and III colorectal patients were identified and 1318 patients received adjuvant chemotherapy, with 22% and 46% of those starting adjuvant chemotherapy within 6 weeks and 8 weeks of surgery. The median period of follow-up was 41 months. Patients starting chemotherapy within 6-8 weeks of surgery had longer overall survival compared with those who started after (6 weeks vs later, hazard ratio 0.76, 95% CI 0.57-0.99, P = 0.046; 8 weeks vs later, hazard ratio 0.74, 95% CI 0.59-0.93, P = 0.011). In the multivariate analysis, age, stage, histological grade, angiolymphatic invasion, emergency surgery and preoperative therapy were independent prognostic factors, but the interval between surgery and start of adjuvant therapy was not. Conclusion In this large retrospective study, the standard prognostic factors impacted on survival whereas the timing of adjuvant therapy did not. Patients with delayed adjuvant chemotherapy may have worse prognostic factors which could play a major role in their poor outcome. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and safety of an ultra-low-cost uterine balloon tamponade package (ESM-UBT™) for facility-based management of uncontrolled postpartum haemorrhage (PPH) in Kenya, Sierra Leone, Senegal, and Nepal.Design: Prospective multi-centre case series.Setting: Facilities in resource-scarce areas of Kenya, Sierra Leone, Nepal, and Senegal.Population: Women with uncontrolled postpartum haemorrhage in 307 facilities across the four countries.Methods: A standardised ESM-UBT package was implemented in 307 facilities over 29 months (1 September 2012 to 1 February 2015). Data were collected via a multi-pronged approach including data card completion, chart reviews, and provider interviews. Beginning in August 2014, women who had previously undergone UBT placement were sought and queried regarding potential complications associated with UBT use.Main Outcome Measures: All-cause survival, survival from PPH, and post-UBT use complications (surgery, hospitalisation, antibiotics for pelvic infection) associated with UBT use.Results: 201 UBTs were placed for uncontrolled vaginal haemorrhage refractory to all other interventions. In all, 38% (71/188) of women were either unconscious or confused at the time of UBT insertion. All-cause survival was 95% (190/201). However, 98% (160/163) of women survived uncontrolled PPH if delivery occurred at an ESM-UBT online facility. One (1/151) potential UBT-associated complication (postpartum endometritis) was identified and two improvised UBTs were placed in women with a ruptured uterus.Conclusions: These pilot data suggest that the ESM-UBT package is a clinically promising and safe method to arrest uncontrolled postpartum haemorrhage and save women's lives. The UBT was successfully placed by all levels of facility-based providers. Future studies are needed to further evaluate the effectiveness of ESM-UBT in low-resource settings.Tweetable Abstract: Evidence for ESM-UBT as a clinically promising and safe method to arrest uncontrolled PPH and save women's lives. [ABSTRACT FROM AUTHOR]

Abstract: Despite palliative treatments, tumor-induced bone disease (TIBD) remains highly debilitating for many cancer patients and progression typically results in death within two years. Therefore, more effective therapies with enhanced anti-resorptive and cytotoxic characteristics are needed. We developed bisphosphonate-chemotherapeutic conjugates designed to bind bone and hydrolyze, releasing both compounds, thereby targeting both osteoclasts and tumor cells. This study examined the effects of our lead compound, MBC-11 (the anhydride formed between arabinocytidine (AraC)-5′-phosphate and etidronate), on bone tumor burden, bone volume, femur bone mineral density (BMD), and overall survival using two distinct mouse models of TIBD, the 4T1/luc breast cancer and the KAS-6/1-MIP1α multiple myeloma models. In mice orthotopically inoculated with 4T1/luc mouse mammary cells, MBC-11 (0.04μg/day; s.c.) reduced the incidence of bone metastases to 40% (4/10), compared to 90% (9/10; p =0.057) and 100% (5/5; p =0.04) of PBS- or similarly-dosed, zoledronate-treated mice, respectively. MBC-11 also significantly decreased bone tumor burden compared to PBS- or zoledronate-treated mice (p =0.021, p =0.017, respectively). MBC-11 and zoledronate (0.04μg/day) significantly increased bone volume by two- and four-fold, respectively, compared to PBS-treated mice (p =0.005, p <0.001, respectively). In mice systemically injected with human multiple myeloma KAS-6/1-MIP1α cells, 0.04 and 4.0μg/day MBC-11 improved femur BMD by 13% and 16%, respectively, compared to PBS (p =0.025, p =0.017, respectively) at 10weeks post-tumor cell injection and increased mean survival to 95days compared to 77days in mice treated with PBS (p =0.047). Similar doses of zoledronate also improved femur BMD (p ≤0.01 vs PBS) and increased mean survival to 86days, but this was not significantly different than in PBS-treated mice (p =0.53). These results demonstrate that MBC-11 decreases bone tumor burden, maintains bone structure, and may increase overall survival, warranting further investigation as a treatment for TIBD. [Copyright &y& Elsevier]

The present study aims to investigate the histological, histochemical and electron microscopic changes of the caecal proximal part of Japanese quail during both pre- and post-hatching periods starting from the 2nd embryonic day (ED) until four weeks post-hatching. On the 2nd and 3rd ED, the primordia of caeca appeared as bilateral swelling on the wall of the hindgut. On the 7th ED, the lamina propria/submucosa contained the primordia of glands. On the 8th ED, rodlet cells could be observed amongst the epithelial cells. On the 9th ED, the caeca began to divide into three parts with more developed layers. With age, the height and number of villi increased. On the 13th ED, immature microfold cells (M-cells) could be identified between the surface epithelium of the villi. The caecal tonsils (CTs) appeared in the form of aggregations of lymphocytes, macrophages, dendritic cells and different types of leukocytes. Telocytes and crypts of Lieberkuhn were observed at this age. On hatching day, the crypts of Lieberkuhn were well-defined and formed of low columnar epithelium, goblet cells, and enteroendocrine cells. Post-hatching, the lumen was filled with villi that exhibited two forms: (1) tongue-shaped villi with tonsils and (2) finger-shaped ones without tonsils. The villi lining epithelium contained simple columnar cells with microvilli that were dispersed with many goblet cells, in addition to the presence of a high number of intra-epithelial lymphocytes and basophils. Moreover, the submucosa was infiltrated by numerous immune cells. CD3 immunomarker was expressed in intraepithelial lymphocytes, while CD20 immunomarker showed focal positivity in CTs. In conclusion, the caecal immune structures of quails at post-hatching were more developed than those in pre-hatching life. The high frequency of immune cells suggests that this proximal part may be a site for immunological surveillance in the quail caecum. The cellular organisation of the caecum and its relation to the immunity was discussed. [ABSTRACT FROM AUTHOR]