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With public concerns about fostering the inclusion of women, especially those with low socio-economic status, governments and private entities have started to develop collaborative strategies to improve women's development. One such strategy is collaborations with sharing economy entities, which are online platforms that provide entrepreneurship opportunities for individuals despite geographical and structural barriers. This paper draws on Ostrom's concept of the commons to explore how to foster the inclusion of women as entrepreneurs in the sharing economy through collaboration. Thematic analysis reveals the nature and outcomes of policies geared towards women's development. While previous studies on the sharing economy have noted that the top-down nature of its operations has resulted in individualised gains, this paper highlights the collaboration within these settings – leading to individual and mutual monetary and non-monetary benefits – stemming from a shared digital and traditional commons with context-based ideologies and stakeholder actions. This paper gives practitioners a clear understanding of how they can successfully support and create a context for women's entrepreneurship in the age of digitisation. [ABSTRACT FROM AUTHOR]

This paper presents first report on a systematic investigation on developing quantum chemical descriptors on understanding biological activity (pIC50) of a series of 10 thiazolyl‐thiadiazines (ID‐01 to ID‐10) as Beta site amyloid precursor protein cleaving enzyme 1 (BACE‐1) protein inhibitors for Alzheimer diseases, under density functional theory. The interactions between inhibitors and model biomolecule are studied in terms of charge and energy transfer, where the target biomolecule at the host BACE‐1 protein is identified from the family of 20 amino acids, which are universal to all living organisms. The present study identifies electron affinity (EA), total electronic energy (E), and the electron transfer with amino acid (∆E) of thiazolyl‐thiadiazines as promising descriptors, which can explain about 90% of observed biological activity. The developed regression model for training set is also validated for unknown test set of homologous compounds. The developed quantum chemical descriptors for prediction of the biological activity of thiazolyl‐thiadiazines will certainly be an excellent addition in the QSAR parlance of drug development. [ABSTRACT FROM AUTHOR]

A systematic density functional investigation on the structural, electronic and optical properties of the growth of (ZnO)6 cluster unit in the series of (ZnO)6n for n = 1–9 is reported in this paper. Different electronic properties of (ZnO)6n nanoclusters are analyzed in terms of HOMO–LUMO gap (HLG), ionization potential (IP), electron affinity (EA), chemical hardness (η) and electrophilicity index (ω), which all shows a zigzag behavior as the size of (ZnO)6n clusters increases. The electronic energy gain (ΔE) of the clusters identified an exceptionally stable 'magic' nanocluster, viz. (ZnO)42. Frontier orbitals analysis results indicate easy electron transfer in (ZnO)42 nanocluster system. The optical absorption spectra confirm that the magic (ZnO)42 nanocluster is active in the visible range (λ = 406.8 Å) of electromagnetic spectrum. Interestingly, like zigzag electronic properties, similar optical switching toward the growth of (ZnO)6 unit is also observed. The simulation results of electronic properties as well as the infrared spectra of magic (ZnO)42 cluster will open up a vista to the experimentalists for its possible synthesis, which in turn will help in the development of the visibly active magic (ZnO)42 nanocluster with novel applications in the fields of quantum dots or assembled materials. [ABSTRACT FROM AUTHOR]

The present study reports the green synthesis of triangular ZnO nanoparticles (G-ZnO NPs) using Azadirachta indica leaves extract, and a shape dependent density functional investigation for ZnO NPs on their antimicrobial activity. The X-ray diffraction (XRD) analysis shows the synthesized G-ZnO NPs are well crystalline in nature and calculated grain size is found to be 60–65 nm. The Fourier transforms infrared spectroscopy (FT-IR) represents that the functional group and capping agents are well attached to the nanoparticles, and the bands located near 500.8 cm−1, 459.07 cm−1 and 418.57 cm−1 represents G-ZnO NPs. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDS) confirmed the presence of the synthesized G-ZnO nanoparticles with an average size range 100–200 nm. The synthesized G-ZnO NPs are found to be in the triangular shape. A detail theoretical investigation under density functional framework shows that our synthesized triangular ZnO nanoparticles are better candidate for biological interactions compared to the prototypical spherical counterpart. The synthesized G-ZnO nanoparticles using A. indica leaves extract in triangular shape are found to show significant antimicrobial activity against Escherichia coli and Bacillus subtilis indicating a better alternative to the typical chemical methods. [ABSTRACT FROM AUTHOR]

The present work reports the green synthesis of MgO nanoparticles (G-MgO NPs) using Carica papaya leaf extract, and a shape dependent density functional investigation for MgO NPs on their antimicrobial activity, for the first time. The synthesized G-MgO nanoparticles were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM) and Energy dispersive X-ray analysis (EDS). These methods confirmed the presence of the synthesized G-MgO nanoparticles in the range of 20–100 nm with the shape of dense rock. The larger particles of G-MgO NPs resulted from the agglomeration of smaller nanoparticles. The G-MgO NPs are observed to show reasonable antimicrobial activity against the microorganism Bacillus subtilis. A detailed theoretical study under density functional theory (DFT) shows that our synthesized dense rock shaped MgO nanoparticles are better candidate for biological interactions in comparison to the convensional spherical counterpart. The results show that the green synthesis of magnesium oxide nanoparticles using Carica papaya leaf extract can be an alternative to chemical and physical methods with possible biomedicinal applications in addition. [ABSTRACT FROM AUTHOR]

The jugular foramen and the hypoglossal canal are both apertures located at the base of the skull. Multiple lower cranial nerve palsies tend to occur with injuries to these structures. The pattern of injuries tend to correlate with the combination of nerves damaged. Case Report: A 28-year-old male was involved in an AVP injury while crossing the highway. Exam showed a GCS of 15 AAOx3, with dysphagia, tongue deviation to the right, uvula deviation to the left and a depressed palate. Initial imaging showed B/L frontal traumatic Sub-Arachnoid Hemorrhages (tSAH), Left Frontal Epidural Hematoma and a Basilar Skull Fracture. On second look by a trained Neuroradiologist c At 3 month follow up, patient's tongue normalized to midline and his dysphagia resolved. Discussion: Collette-Sicard syndrome is a rare condition/syndrome characterized by unilateral palsy of CN: IX, X, XII. This condition has been rarely described as a consequence of blunt head trauma. In most cases, the condition is self-limiting with patients regaining most to all of their neurological functions within 6 months. Nerve traction injuries and soft tissue edema compressing the cranial nerves are the leading two hypothesis. In conclusion, injuries with focal neurological deficits which were not apparent on initial imaging should be reviewed by relevant experts with concomitant knowledge of the patient's history. [ABSTRACT FROM AUTHOR]

We have fabricated a NaCoO2–Co3O4 nanocomposite through high-temperature calcination of a Na,Co-MOF precursor. The resulting nanocomposite features Co3O4 polyhedral nanoparticles decorated over NaCoO2 nanosheets. The composite possessed a surface area of 21.0 m2 g−1, surpassing that of the MOF. The composite was studied for its capacity to adsorb NO2 gas (100 ppm) in ambient conditions, demonstrating a substantial capacity of 68.1 mg g−1. However, this adsorption capacity was influenced negatively by factors such as moisture, increased gas flow rate, and reduced bed loading. Spectroscopic analysis and theoretical calculations revealed that NO2 exhibited a higher tendency to adsorb onto the NaCoO2 component than Co3O4. Apart from NO evolution, the adsorbed NO2 molecules underwent redox reactions on the composite's surface, yielding nitrite and nitrate species. Thus, for the first time, we have confirmed that Na–Co oxide effectively cleans lean sources. [ABSTRACT FROM AUTHOR]

Background. Previous reports describe ethnicity based differences in clinical and laboratory features between Caucasians and African Americans with myasthenia gravis. However, it is not known whether these findings apply to other ethnicities. Methods. Retrospective analysis of all patients treated for myasthenia gravis during a three-year period at a community based medical center. Results. A total of 44 patients were included, including 19 of Hispanic, 16 of African American, 6 of Caucasian, and 3 of Asian ethnicities. Female gender was more common among those with Hispanic, Asian, and African American ethnicities compared to Caucasian ethnicity (p=0.029). Anti-acetylcholine receptor antibody subtypes demonstrated no significant ethnicity based differences in either generalized or ocular myasthenia gravis. A trend was noted towards greater frequency of blocking antibodies among Hispanics (52.6%) compared to African American (37.5%) and Caucasian (33.3%) patients (p=0.059). Generalized but not ocular myasthenia patients showed greater frequency of anti-muscle specific kinase antibodies in Asians and Hispanics compared to African Americans and Caucasians (p=0.041). Conclusions. The results of this study support the existence of ethnicity based differences in clinical and laboratory features of myasthenia gravis. Further study of genetic factors influencing clinical features of myasthenia gravis is indicated. [ABSTRACT FROM AUTHOR]

Background: Transient ischemic attacks (TIA) are cerebral ischemic events without infarction. The uses of CT perfusion (CTP) techniques such as cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT) and cerebral blood flow (CBF) provide real time data about ischemia. It has been shown that CTP changes occur in less sensitive CTP scanners in patients with TIA. Larger detector row CTP (whole brain perfusion studies) may show that CTP abnormalities are more prevalent than previously noted. It is also unclear if these changes are associated with TIA severity. Objective: To demonstrate that TIA patients are associated with perfusion deficits using whole brain 320-detector-row CT perfusion, and to determine an association between ABCD2 score and perfusion deficit using whole brain perfusion. Methods: We retrospectively reviewed all TIA patients for CTP deficits from 2008-2010. Perfusion imaging was reviewed at admission; and it was determined if a perfusion deficit was present along with vascular territory involved. Results: Of 364 TIA patients, 62 patients had CTP deficits. The largest group of patients had MCA territory involved with 48 of 62 patients (77.42%). The most common perfusion abnormality was increased TTP with 46 patients (74.19%). The ABCD2 score was reviewed in association with perfusion deficit. Increased age >60, severe hypertension (>180/100 mmHg), patients with speech abnormalities, and duration of symptoms >10 min were associated with a perfusion deficit but history of diabetes or minimal/moderate hypertension (140/90-179/99 mmHg) was not. There was no association between motor deficit and perfusion abnormality. Conclusion: Perfusion deficits are found in TIA patients using whole brain CTP and associated with components of the ABCD2 score. [ABSTRACT FROM AUTHOR]

Abstract: Osteoporosis is a degenerative bone disease that causes significant morbidity and mortality in multiple sclerosis (MS) patients; the pathogenesis of this disease being poorly understood in the context of MS. Osteoporosis is seen more frequently in MS patients than in healthy controls matched for age and sex. Extensively studied factors, including impaired ambulation and the use of steroids, do not appear to completely account for the phenomenon. This review summarizes common risk factors, physiologic and genetic, that may contribute to the etiology and progression of osteoporosis in MS patients as well as providing insight into nervous system control of bone metabolism and homeostasis. [Copyright &y& Elsevier]

Gordon Morgan Holmes, MD, MRCP was an Irish born neurologist who received his medical education at Trinity College, Dublin, Ireland. He was trained in neuroanatomy and neuropathology at the Senckenberg Institute, Frankfort-Am-Main by Ludwig Edinger. He then returned to serve as a Registrar (House Officer) mentored by Richard Gowers and John Hughlings Jackson at the National Hospital, Queen Square, London. He collaborated with Thomas Granger Stewart in describing the loss of recoil in patients with cerebellar hemispheric tumors in 1904. Volunteering in 1914 for frontline hospital duty, he examined soldiers who had injuries to their occipital area causing hypotonia, dysmetria, staggering gait, and falling to the side ipsilateral to their injured cerebellar hemisphere. Holmes discovered that increasing the pace of the finger-nose manuever and applying slight resistance to a moving limb attenuated the dysmetria. Continuing observation of these patients afforded him to describe the evolution of their injuries to include increasing tremor and decreasing hypotonia. Holmes first attached levers to the limbs of hispatients to record their movements on a moving smoked paper kymograph. In 1939 he published photograh tracings made by low mass minature light bulbs attached to ataxic limbs that showed thehpometira and hypometria of their movements ipsilateral to their damaged cerebellar lobes. Holmes made sigficant contributions to understanding of the physiology of the human cerebellum. [ABSTRACT FROM AUTHOR]

Background: Palmoplantar psoriasis is a frequently encountered variant of psoriasis. It is difficult to treat and even more difficult to maintain remission as it is exacerbated by friction and trauma of the patient's daily activities. Existing topical modalities of treatment are often inadequate and show unpredictable response. Aim: To study the efficacy and safety of a newer retinoid, tazarotene, as 0.1% cream in the treatment of palmoplantar psoriasis. Materials and Methods: Thirty adult patients with palmo-plantar psoriasis were randomized to therapy with once daily application of topical tazarotene cream (0.1%) or once daily application of clobetasol propionate cream (0.05%) for 12 weeks. The patients were assessed every 2 weeks for improvement in Erythema, Scaling, Fissures and Induration (ESFI) score and Physicians Global Assessment Scale. Results: At 12 weeks, the tazarotene group showed mean ESFI reduction to 1.12 (83.2%) from 6.65 at baseline. Complete clearance was noted in 52.9% of the patients. Clobetasol propionate group showed mean ESFI reduction to 0.62 (89.1%) from 5.69 at baseline, with complete clearance in 61.5% of the patients. Differences between the two groups were statistically insignificant. Side effects observed were initial irritation (41%) in the tazarotene group and hypopigmentation (53.8%) in the steroid-treated patients. Conclusion: Tazarotene is as effective as clobetasol propionate and provides a good alternative for the treatment of palmo-plantar psoriasis where hypopigmentation limits the use of clobetasol propionate cream. [ABSTRACT FROM AUTHOR]

Abstract: Multiple sclerosis is an autoimmune demyelinating disorder of the central nervous system. Its etiology continues to be elucidated. The debate about the environmental impact on the disease etiology and progression has focused on sun light exposure in the recent past, but mainly as it applies to vitamin D and its derivatives. This paper will discuss how sunlight stimulus may effect neuronal and microglial antigenic presentation based on sunlight-dependent neuronal activity, as well as how sunlight may alter the amount of vitamin A and melatonin levels during immune development in the central nervous system. Changes in the number of antigens presented to lymphocytes by antigen-presenting cells for self-selective removal during immune development could therefore alter the number of circulating self-recognizing B and T-lymphocytes. This situation would increase susceptibility to a significantly greater number of self-antigens, and lead to autoimmune disorders such as multiple sclerosis. [Copyright &y& Elsevier]

Anticoagulant use, such as heparin, is usually contraindicated in acute stroke patients. We present a study of patients, who were treated with intravenous heparin after a stroke that were also found to have an intraluminal thrombus. Prior studies imply that recanalization is achieved with heparin; however heparin should only prevent thrombus propagation. Therefore it is unclear whether and how IV heparin can achieve recanalization of intraluminal thrombi in acute stroke patients. A retrospective review of all acute stroke patients from a single stroke center who received a therapeutic IV heparin infusion from 5/2006 to 9/2011 were included in the study. We compared patients who had complete/ partial recanalization and/or improved flow versus those that did not, with both these groups on a standard intravenous heparin infusion protocol. Demographic data was compared between the groups. Average partial thromboplastin time (PTT) during heparin infusion, time between computed tomography angiographies (CTAs), time from stroke onset to receiving IV heparin, and vessel occluded were also compared between groups. Forty-one patients (19 female, 22 male) were included in the study with a total of 55 vessels (either carotid, middle cerebral artery, anterior cerebral artery, posterior cerebral artery/posterior circulation) having intraluminal thrombi; 31 patients had 41 vessels with either partial or complete recanalization of effected vessels, while 10 patients had 14 vessels that did not have at least one vessel recanalize while on heparin. Using t-test we noted that the average PTT between the vessels that had partial/complete recanalization group (61.74) and nonrecanalization group (66.30) was not statistical significantly different (P=0.37).The average time in days on heparin between vascular imaging studies (CTA/conventional angiogram) in the group of vessels with partial/ complete recanalization (7.12 days) and the ones with no change (6.11 days) was not significantly different between the two groups (P=0.59). Patient's vessels receiving heparin for <24 hours versus those >24 hours did not significantly differ either (P=0.17). This study compares patient characteristics associated with recanalization of intraluminal thrombi in acute stroke patients on heparin. Recanalization of intraluminal thrombi are not associated with average PTT or duration on heparin. [ABSTRACT FROM AUTHOR]

Anticoagulant use, such as heparin, is usually contraindicated in acute stroke patients. We present a study of patients, who were treated with intravenous heparin after a stroke that were also found to have an intraluminal thrombus. Prior studies imply that recanalization is achieved with heparin; however heparin should only prevent thrombus propagation. Therefore it is unclear whether and how IV heparin can achieve recanalization of intraluminal thrombi in acute stroke patients. A retrospective review of all acute stroke patients from a single stroke center who received a therapeutic IV heparin infusion from 5/2006 to 9/2011 were included in the study. We compared patients who had complete/partial recanalization and/or improved flow versus those that did not, with both these groups on a standard intravenous heparin infusion protocol. Demographic data was compared between the groups. Average partial thromboplastin time (PTT) during heparin infusion, time between computed tomography angiographies (CTAs), time from stroke onset to receiving IV heparin, and vessel occluded were also compared between groups. Forty-one patients (19 female, 22 male) were included in the study with a total of 55 vessels (either carotid, middle cerebral artery, anterior cerebral artery, posterior cerebral artery/posterior circulation) having intraluminal thrombi; 31 patients had 41 vessels with either partial or complete recanalization of effected vessels, while 10 patients had 14 vessels that did not have at least one vessel recanalize while on heparin. Using t-test we noted that the average PTT between the vessels that had partial/complete recanalization group (61.74) and nonrecanalization group (66.30) was not statistical significantly different (P=0.37).The average time in days on heparin between vascular imaging studies (CTA/conventional angiogram) in the group of vessels with partial/complete recanalization (7.12 days) and the ones with no change (6.11 days) was not significantly different between the two groups (P=0.59). Patient's vessels receiving heparin for <24 hours versus those >24 hours did not significantly differ either (P=0.17). This study compares patient characteristics associated with recanalization of intraluminal thrombi in acute stroke patients on heparin. Recanalization of intraluminal thrombi are not associated with average PTT or duration on heparin. [ABSTRACT FROM AUTHOR]

A comprehensive investigation of the structural, vibrational, electronic, and elastic characteristics of four hexagonal bilayer chromium pnictogens (CrX; X = N, P, As, Sb) materials has been conducted using first-principles calculations based on density functional theory (DFT). The phonon dispersion investigations demonstrate the dynamic stability of the examined hexagonal bilayers belonging to pnictogens group, in their planar structure. According to our phonon dispersion analysis, only two materials, CrN/CrN and CrP/CrP, are found to be dynamically stable, while the other two, CrAs/CrAs and CrSb/CrSb are reveal to be dynamically unstable. The band structure calculations carried out utilizing HSE06 hybrid functionals reveals the metallic nature of bilayer chromium pnictogens. In all CrX materials, the highest work function we observed for CrN/CrN material as 5.17 eV. Along the armchair direction in CrN/CrN compounds, highest elastic constants (C 2D) is obtained among all CrX compounds, measured as 192.47 Nm−1 for electron carriers. In addition to examining the phonon dispersion, we also assessed their mechanical stability by the computation of elastic characteristics. Our calculated elastic parameters and polar diagrams of Young's modulus and Poisson's ratio indicate the mechanical stability of all the systems under consideration. To further our understanding of CrX compounds, we also acquired data on their deformation potential for electron carriers in both armchair and zigzag orientations. This work unequivocally demonstrates the advantages of CrX bilayers as potential materials for upcoming robust conducting devices and also possible applications for a 2D metallic material. • Structural, vibrational, electronic and elastic properties of hexagonal bilayer chromium pnictogens are investigated. • Analysis of electronic properties reveals metallic behavior of CrX (X = N, P, As, Sb). • Investigation of elastic properties of all CrX materials implying their mechanical stability. • Present work may certainly be a motivation to explore these materials for future robust conductors. [ABSTRACT FROM AUTHOR]

Laboratory factors associated with hemorrhagic conversion (HC) after Intravenous thrombolysis with rtPA (IVT) for Acute Ischemic Stroke (AIS) remain nebulous despite advances in our knowledge of AIS. This study aimed to investigate the laboratory factors predisposing to HC in AIS patients receiving IVT. We retrospectively reviewed the medical records of patients who received IV tPA for AIS at our comprehensive stroke center over a 9.6-year period. Besides age, gender, NIHSS, history of diabetes mellitus (DM), history of atrial fibrillation (Afib), we gathered their laboratory data including International Normalized Ratio (INR), lipid panel, serum albumin, serum creatinine, hemoglobin A1c (HbA1c), and admission blood glucose. Post-thrombolysis brain imagings were reviewed to evaluate for symptomatic ICH (sICH). The mean values of above mentioned laboratory data were compared between the group with sICH and patients with no sICH. Univariate and multivariate logistic regression were performed to evaluate the association of the laboratory findings with presence of sICH. sICH was defined as ICH causing an increase in NIHSS ≥4. Of the 794 subjects in this study 51 (6.4%) had sICH. In the univariate analysis, patients who developed sICH had significantly higher NIHSS on admission (14.2 ± 5.4 vs 11.2 ± 6.5, p <.001), LDL-cholesterol (113.3 mg/dl ±36.9 vs. 101.8 mg/dl ± 38.2, p =.032), HbA1c (6.9% ± 2.3 vs. 6.1 ± 1.3, p =.003) and lower levels of Albumin (3.5 g/dl ±0.4 vs. 3.9 g/dl ± 0.5, p <.001). Furthermore, a higher prevalence of history of DM (45% vs. 21.6%, p =.020) and Afib (25.4% vs. 10.4%, p =.028) was found in subjects who developed sICH. There were no significant group differences regarding age, sex, total cholesterol, blood glucose on admission, serum creatinine or INR levels (p >.05). After adjusting for multiple covariates, lower Albumin level and and higher HbA1c were significantly associated with an increased risk for sICH development (p <.05). Chances of sICH increased by 33% for every 1 g/dl below a normal albumin level of 4.0 g/dl (p <.05). Lower endogenous albumin level and higher HbA1c have shown to predispose to a higher risk of sICH after IVT for AIS and might be good predictors of sICH post IVT. • We studied the laboratory factors predisposing to hemorrhagic conversion (HC) in acute ischemic stroke (AIS) patients receiving Intravenous thrombolysis (IVT). • Lower Albumin level and higher HbA1c were significantly associated with an increased risk of symptomatic HC (sHC). • Chances of sHC increased by 33% for every 1 g/dl below a normal albumin level of 4.0 g/dl (p <.05). [ABSTRACT FROM AUTHOR]

The article presents author's comments on the experimental autoimmune encephalomyelitis (EAE) related to multiple sclerosis (MS). It mentions that the autoimmune disease is manifested by the injection of proteins, taken from central nervous system (CNS). It mentions that Vitamin A has retinoids including retinol, retinal and retinoic acid obtained from plants, meats and fortified foods.

We report a rare case of acquired localized cutis laxa in a teenage boy, without any preceding skin lesions. The area affected was the midface, extending to the chin, and involving the ears, leading to a prematurely aged appearance. Only five such cases have been previously published in the literature. [ABSTRACT FROM AUTHOR]

A 1½-year-old boy with Langerhans cell histiocytosis presented with a frontal bone mass showing features of eosinophilic granuloma. He subsequently developed multiple asymptomatic discrete hypopigmented papules on the face, trunk and extremities, which, on histology, were confirmed as Langerhan’s cell histiocytosis, a presentation hitherto unreported in literature. He responded well to surgery and chemotherapy. [ABSTRACT FROM AUTHOR]

We report here the case of a 17 year-old girl with the classic signs of Goldenhar syndrome in the form of multiple accessory tragi, bilateral ocular dermoids, mandibular hypoplasia (micrognathia) and cervical lordosis. She also had a high arched palate, gingival hypertrophy and malaligned teeth, features which are as yet unreported. [ABSTRACT FROM AUTHOR]

Na0.4MnO2 microrods were synthesized to adsorb 100 ppm of SO2 and NO2 at room temperature with the maximum uptake capacity of 78.7 and 42.3 mg g−1, respectively. While SO2 was oxidized to sulphate and bisulphate ions, NO2 was converted to nitrite and nitrate ions via hydroxyl groups and Mnn+ redox cycles. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the prevalence of leprosy.

The article presents a case study of a 55-year-old menopausal woman with an unusual periumbilical plaque. She underwent an examination and revealed a loose abdominal skin with multiple striae gravidarum. Physicians confirmed that the patient had a localized acquired periumbilical pseudoxanthoma elasticum.

A 76-year-old man presented with features of bilateral herpes simplex virus (HSV) keratitis. It was found to be recurrence of bilateral HSV keratitis following the use of Bimatoprost eye drops for uncontrolled intraocular pressure in a case of bilateral primary open-angle glaucoma. [ABSTRACT FROM AUTHOR]

This study delves into the surface reactivity of Li2MnO3 towards H2S, SO2 and NO gases at room temperature, employing both experimental and theoretical calculations. Li2MnO3 was synthesized using a conventional solid-state method. Then, Li2MnO3 was exposed to 100 ppm concentrations of the aforementioned gases, with subsequent spectroscopic and X-ray diffraction analyses, revealing gas-surface interactions within a few atomic layers. X-Ray diffraction demonstrated minimal structural changes post-gas exposure, indicative of surface-level reactions. X-Ray photoelectron spectroscopy and theoretical calculations unveiled the dissociative adsorption of H2S, resulting in various oxidized sulphur species. H2S reactivity was most pronounced at Mn sites, where H2S donated electrons during the process. SO2 adsorption yielded sulphate species, facilitated by electron transfer to Mn-sites. Conversely, NO adsorption identified distinctive Li and Mn sites on the oxide surface. By combining experimental and theoretical insights, it has been confirmed that the chemisorption of these toxic gases over the Li2MnO3 surface is pertinent to their effective removal across temperature ranges. This work advances the utility of Li2MnO3 in diverse gas treatment applications. [ABSTRACT FROM AUTHOR]

Questions are presented about the identity and career of an Irish neurologist notable for his research conducted on soldiers with wounds to their cerebellas during World War I.

Objective This study aimed to compare clinical outcomes including seizure frequency and psychiatric symptoms between patients with epilepsy with neuroimaging evidence of past brain parenchymal neurocysticercosis infection, patients with other structural brain lesions, and patients without structural neuroimaging abnormalities. Material and methods The study included retrospective cross-sectional analysis of all patients treated for epilepsy in a community-based adult neurology clinic during a three-month period. Results A total of 160 patients were included in the analysis, including 63 with neuroimaging findings consistent with past parenchymal neurocysticercosis infection, 55 with structurally normal brain neuroimaging studies, and 42 with other structural brain lesions. No significant differences were detected between groups for either seizure freedom (46.03%, 50.91%, and 47.62%, respectively; p = 0.944) or mean seizure frequency per month (mean = 2.50, S.D. = 8.1; mean = 4.83, S.D. = 17.64; mean = 8.55, S.D. = 27.31, respectively; p = 0.267). Self-reported depressive symptoms were more prevalent in those with parenchymal neurocysticercosis than in the other groups (p = 0.003). No significant differences were detected for prevalence of self-reported anxiety or psychotic symptoms. Conclusions Calcified parenchymal neurocysticercosis results in refractory epilepsy about as often as other structural brain lesions. Depressive symptoms may be more common among those with epilepsy and calcified parenchymal neurocysticercosis; consequently, screening for depression may be indicated in this population. [ABSTRACT FROM AUTHOR]

Introduction: The study aims to determine an association between presenting symptoms in multiple sclerosis and measures of disease severity, including the expanded disability status score (EDSS) and MRI based lesion volumes. Methods: Data was collected as part of a larger 3 year MS study, from 2014 to 2017, to compare Vitamin A levels and MS progression. All data was collected from a single clinical site. Demographic data as well as date of diagnosis and use of disease modifying therapies. Patients not able to obtain MRIs or lab tests and histories of vitamin abnormalities were excluded from the study. 29 patients met inclusion criteria. We chose presenting symptoms of vision, balance, sensory function, and motor function as these represented the most common manifestations of the disease and mirror the domains of the EDSS, which is the most commonly used scale for MS disease severity. We also included neuroimaging based lesion volume as another objective measure for comparison. Results: Although duration of disease was different between comparator groups, no significant difference was found between them when EDSS and lesion volumes were compared. There was a difference in lesion volumes when comparing those patients that had presenting symptoms of visual changes or balance symptoms with those presenting with sensory changes. Conclusions: This study supports the notion that presenting symptoms are not associated with EDSS independent disease duration. It also verifies that severity of disease is not associated with lesion volumes. However, sensory symptoms as a presenting symptom was associated with less lesion volumes in our study. [ABSTRACT FROM AUTHOR]

Background: Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease. In addition, community health workers (CHWs) have played an integral role in reducing health disparities; however, their effectiveness in reducing vascular risk among stroke survivors remains unknown. Our objectives are to develop, test, and assess the economic value of a CCM-based intervention using an Advanced Practice Clinician (APC)-CHW team to improve risk factor control after stroke in an under-resourced, racially/ethnically diverse population.Methods/design: In this single-blind randomized controlled trial, 516 adults (≥40 years) with an ischemic stroke, transient ischemic attack or intracerebral hemorrhage within the prior 90 days are being enrolled at five sites within the Los Angeles County safety-net setting and randomized 1:1 to intervention vs usual care. Participants are excluded if they do not speak English, Spanish, Cantonese, Mandarin, or Korean or if they are unable to consent. The intervention includes a minimum of three clinic visits in the healthcare setting, three home visits, and Chronic Disease Self-Management Program group workshops in community venues. The primary outcome is blood pressure (BP) control (systolic BP <130 mmHg) at 1 year. Secondary outcomes include: (1) mean change in systolic BP; (2) control of other vascular risk factors including lipids and hemoglobin A1c, (3) inflammation (C reactive protein [CRP]), (4) medication adherence, (5) lifestyle factors (smoking, diet, and physical activity), (6) estimated relative reduction in risk for recurrent stroke or myocardial infarction (MI), and (7) cost-effectiveness of the intervention versus usual care.Discussion: If this multi-component interdisciplinary intervention is shown to be effective in improving risk factor control after stroke, it may serve as a model that can be used internationally to reduce race/ethnic and socioeconomic disparities in stroke in resource-constrained settings.Trial Registration: ClinicalTrials.gov Identifier NCT01763203 . [ABSTRACT FROM AUTHOR]

We report a case of a bilateral posterior chamber implantable collamer lens (ICL) implantation post-clear lens extraction, to reduce the residual hyperopia, in a patient with nanophthalmic eyes. A 30-year-old female patient, keen to reduce her dependency on glasses and contact lenses, came to our refractive surgery department. Her refractive error was +12.0 and +12.5 diopters in the right and left eye, respectively, with steep corneas on keratometry and a shallow anterior chamber depth. She underwent clear lens extraction with implantation of +35.0 D and +40.0 D IOL in the right eye and left eye, respectively. Her post-operative best-corrected visual acuity was 20/30 with +8.5 D in the right eye and +6 D in the left. She underwent bilateral ICL implantation. Postoperatively after 6 months, her unaided visual acuity was 20/30 in both eyes. In conclusion, ICL implantation can be considered to correct residual hypermetropic ametropia in pseudophakic eyes when other options have limitations. [ABSTRACT FROM AUTHOR]

Introduction: Calcified parenchymal neurocysticercosis (NCC) lesions are commonly detected in many individuals with refractory epilepsy. However, the relationship between these lesions and epilepsy is not fully determined. We sought to determine if calcified parenchymal NCC demonstrated topographic congruence with epileptiform activity in refractory epilepsy patients. Additional patients with other structural brain lesions were included for comparison. Subjects and Methods: Retrospective cross-sectional analysis of all patients treated at a community-based neurology clinic for refractory epilepsy during a 3-month period and with structural brain lesions detected by neuroimaging studies. Results: A total of 105 patients were included in the study, including 63 with calcified parenchymal NCC lesions and 42 with other structural brain lesions. No significant relationship was detected between hemispheric localization of calcified parenchymal NCC lesions and epileptiform activity. For those with other structural brain lesions, the hemispheric localization was significantly related to the side of epileptiform activity (Chi-square = 11.13, P = 0.025). In addition, logistic regression models showed that those with right-sided non-NCC lesions were more likely to have right-sided epileptiform activity (odds ratio = 4.36, 95% confidence interval [CI] =1.16-16.31, P = 0.029), and those with left-sided non-NCC lesions were more likely to have left-sided epileptiform activity (odds ratio = 7.60, 95% CI = 1.89-30.49, P = 0.004). Conclusion: The lack of correlation between the side of calcified parenchymal NCC lesions and the side of the epileptiform activity suggests that these lesions may be incidental findings in many patients. [ABSTRACT FROM AUTHOR]

The specific action of omega-3 fatty acid ethyl esters (OFA) in preventing cerebrovascular disease remains unknown, but research has demonstrated multiple possible mechanisms. In addition to altering lipid profiles, OFA may inhibit platelet aggregation. Clopidogrel inhibits platelets via the P2Y12 receptor. OFA may alter clopidogrel-associated platelet-inhibition via a possible combined effect on P2Y12 inhibition. To determine if OFA affects clopidogrel associated P2Y12 platelet receptor inhibition by comparing the percentage of responders in patients with cerebrovascular disease who were taking clopidogrel with or without OFA. We retrospectively reviewed data from adult patients with cerebrovascular disease or cerebral aneurysms and taking clopidogrel, who were seen at a single hospital between March 2010 to September 2011. We included 438 subjects in the study. For the 67 subjects who received loading doses of both clopidogrel and OFA, 71.6% had a P2Y12 inhibition response more than 20%, which is considered a positive response. For the 55 subjects who received just clopidogrel load, 67.2% of subjects were responders. There were 70.4% responders in the 274 subjects who were taking 75 mg of clopidogrel alone at home, and 73.8% responders in the 42 subjects who were taking both clopidogrel and OFA at home. However, these percentage differences were not statistically significant. This study did not find additional P2Y12 platelet inhibition when patients were given OFA, either given as a loading dose or taking it daily. [ABSTRACT FROM AUTHOR]

Background. Given the dementia epidemic and the increasing cost of healthcare, there is a need to assess the economic benefit of community based dementia screening programs. Materials and Methods. Markov model simulations were generated using data obtained froma community based dementia screening programover a one-year period. Themodels simulated yearly costs of caring for patients based on clinical transitions beginning in pre dementia and extending for 10 years. Results. A total of 93 individuals (74 female, 19 male) were screened for dementia and 12 meeting clinical criteria for either mild cognitive impairment (n = 7) or dementia (n = 5) were identified. Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages. Discussion. Community based dementia screening can reduce healthcare costs associated with caring for demented individuals through earlier detection and treatment, resulting in proportionately reduced time in more costly advanced stages. [ABSTRACT FROM AUTHOR]

Acute onset of psychosis in an older or elderly individual without history of previous psychiatric disorders should prompt a thorough workup for neurologic causes of psychiatric symptoms. This report compares and contrasts clinical features of new onset of psychotic symptoms between two patients, one with an acute basal ganglia hemorrhagic stroke and another with an acute mid-brain ischemic stroke. Delusions and hallucinations due to basal ganglia lesions are theorized to develop as a result of frontal lobe dysfunction causing impairment of reality checking pathways in the brain, while visual hallucinations due to mid-brain lesions are theorized to develop due to dysregulation of inhibitory control of the ponto-geniculate-occipital system. Psychotic symptoms occurring due to stroke demonstrate varied clinical characteristics that depend on the location of the stroke within the brain. Treatment with antipsychotic medications may provide symptomatic relief. [ABSTRACT FROM AUTHOR]

The article discusses the medical condition of a 21-year-old male with acute ataxia. It states that in his magnetic resonance imaging (MRI) revealed symmetrical white matter hypertensities in the deep cerebellar hemispheres with a C-shaped lesion compatible with edema and Heroin-associated spongiform leukoencephalopathy (HASL) are unique and pathognomonic as the MRI showed. It mentions that HASL is observed after inhaling pyrolysate vapors and it refers to chasing the dragon.

We report a case of a bilateral posterior chamber implantable collamer lens (ICL) implantation post-clear lens extraction, to reduce the residual hyperopia, in a patient with nanophthalmic eyes. A 30-year-old female patient, keen to reduce her dependency on glasses and contact lenses, came to our refractive surgery department. Her refractive error was +12.0 and +12.5 diopters in the right and left eye, respectively, with steep corneas on keratometry and a shallow anterior chamber depth. She underwent clear lens extraction with implantation of +35.0 D and +40.0 D IOL in the right eye and left eye, respectively. Her post-operative best-corrected visual acuity was 20/30 with +8.5 D in the right eye and +6 D in the left. She underwent bilateral ICL implantation. Postoperatively after 6 months, her unaided visual acuity was 20/30 in both eyes. In conclusion, ICL implantation can be considered to correct residual hypermetropic ametropia in pseudophakic eyes when other options have limitations. [ABSTRACT FROM AUTHOR]