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The development and discovery of steroidal drugs to cure cervical cancer is of the most important. The Claisen condensation of androstene and estrone with aromatic aldehydes was catalyzed by potassium tert. butoxide in tert. butanol to give the corresponding 2-arylidene and 16-arylidene estrone. Subsequently, the 16-arylidene estrone reacted with acid chloride in presence of quaternary amine in halogenated solvent resulting in the steroidal arylidene derivatives. Synthesis, Characterization and in vitro cytotoxic activity of arylidenes are rationalized. Fifteen compounds are synthesized and six of them were evaluated for cytotoxic activity against cervical cancer cell line. HT-3 cell line examination revealed a considerable growth inhibition. Compounds 4a, 4b, 6b, 8c, and 8d, which are estrone-based arylidenes, are the most potent of the series, with IC 50 value of 7.15, 10.76, 6.37, 3.56, and 1.55 µM/ml against HT-3 cell line. In addition, molecular docking studies were performed for the steroidal arylidenes to elucidate the binding interactions. Compound 4a, 4b, 6b, 8c and 8d showed excellent binding energy. Docking studies agreed well with in vitro studies. The end result offers an alternative approach to develop steroidal arylidenes that are more effective and are based on estrone, leading to the development of novel anticancer agents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

We report for the first time an antisolvent synthesis of nanostructured hydrophobic drug formulation onto a natural diatom. The jewel of the sea, a marine diatom, which is enriched in silicon, was cultured and grown in the laboratory. Its frustules were isolated and purified. The polar functional group on its surface provided unique physical and chemical properties. Griseofulvin (GF), an antifungal drug was used as a model compound was precipitated onto and adsorbed onto hydrophilic diatom surface, while stabilizer hydroxypropyl methyl cellulose (HPMC) was used for restricting particle growth during the composite synthesis. This work demonstrates that the fine drug crystals incorporated onto the diatom silica surface. The structural and morphological properties of the drug was characterized by various techniques. The drug loading of the formulation was estimated to be 41 % by weight. The incorporation of micro/nano crystals on the diatom surface dramatically enhanced the dissolution rate, and lowered the time required for 50 % dissolution for pure drug from 240-58 min for the drug composite, and the time required for 80 % dissolution or T 80 was found to be 180 min for the composite while the pure drug reached a maximum of 65 % in 300 min., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Consensus regarding the safest mode of delivery and anesthetic management for parturients with Arnold Chiari malformation-I (ACM-I) remains controversial. This study assessed their anesthetic management and reported anesthetic complications during hospitalization for delivery., Methods: This was a multicenter, retrospective, cohort study of patients with ACM-I undergoing vaginal or cesarean delivery. Data were obtained from the electronic databases of four United States academic institutions using International Classification of Diseases (ICD) codes from 2007-2017 at three sites and 2004-2017 at one site. The primary outcome was anesthetic complications., Results: Data were analyzed for 185 deliveries in 148 patients. Diagnosis of ACM-I was made prior to delivery in 147 (80%) cases. Pre-delivery neurosurgical consultation for management of ACM-I was performed in 53 (36%) patients. Pre-existing symptoms were recorded for 89 (48%) of the deliveries. Vaginal deliveries occurred in 80 (43%) cases, and 62 women (78%) received neuraxial labor analgesia. Cesarean delivery was performed in 105 (57%) cases, of which 70 women (67%) had neuraxial anesthesia and 34 (32%) received general anesthesia. Post-dural puncture headache was reported in three (2%) patients who had neuraxial anesthesia, and in two (12%) patients with syringomyelia. There was one (3%) reported case of aspiration pneumonia with general anesthesia., Conclusions: The findings suggest that anesthetic complications occur infrequently in patients with ACM-I regardless of the anesthetic management. Although institutional preference in anesthetic and obstetric care appears to drive patient management, the findings suggest that an individualized approach has favorable outcomes in this population., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To generate a multidisciplinary stakeholder-informed definition of integrative health care (IHC)., Methods: A mixed-method study design was used, employing the use of focus groups/semi-structured interviews (phase-1) and document analysis (phases 2 and 3). Phase-1 recruited a purposive sample of Australian health consumers/health providers. Phase-2 interrogated websites of international IHC organisations for definitions of IHC. Phase-3 systematically searched bibliographic databases for articles defining IHC. Data were analysed using thematic analysis., Results: Data were drawn from 54 health consumers/providers (phase-1), 23 IHC organisation webpages (phase-2) and 23 eligible articles (phase-3). Seven themes emerged from the data. Consensus was reached on a single, 65-word definition of IHC., Conclusion: An unambiguous definition of IHC is critical to establishing a clearer identity for IHC, as well as providing greater clarity for consumers, health providers and policy makers. In recognising the need for a clearer description, we propose a scientifically-grounded, multi-disciplinary stakeholder-informed definition of IHC., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

A neonatal network is a collaboration involving more than one clinical site where a common protocol is used for a randomized trial, observational study, or quality improvement project. Because the prevalence of important outcomes (e.g., death or neurodevelopmental impairment) is low among neonates, multi-site studies have been an essential contributor to the identification of interventions for improving the health of neonates. In this review we summarize key aspects of the conduct of multi-site studies and describe some of the prominent accomplishments and contributions of neonatal networks. Important contributions of randomized trials and observational studies include the identification, and assessment, of potential strategies for prevention of cerebral palsy, chronic lung disease, and blindness due to retinopathy of prematurity. In addition, quality improvement projects by neonatal networks have greatly facilitated the dissemination of information about, and implementation of, evidence-based interventions.

In this study we examined the effects of rapid eye movement sleep (REMS) deprivation on synaptosomal and microsomal membrane fluidity by studying 1,6-diphenyl-1,3,5-hexatriene (DPH) fluorescence polarization in control as well as REMS-deprived rats. The flower pot technique was used to perform 24, 48 and 96 h REMS deprivation. Suitable control experiments were carried out to rule out the nonspecific effects. The results showed that DPH fluorescence polarization increased both in the microsome as well as in the synaptosome in REMS-deprived animals, except in the cerebellum, indicating that there was a generalized decrease in membrane fluidity in the rat brain. The alterations in membrane fluidity returned to baseline upon recovery from REMS deprivation. Control experiments suggested that the alterations were primarily caused by REMS deprivation and not due to nonspecific effects. This finding supports REMS deprivation induced other changes reported earlier. This increase in membrane rigidity could be at least one of the possibilities for REMS loss induced alterations in physiological phenomena including membrane bound enzyme activities and receptor densities.

Acetylcholinesterase activity was compared in control, rapid eye movement sleep-deprived and recovered rat brain. The activity was estimated in the whole brain, cerebrum, brain stem and cerebellum. Flower pot technique was used for continuing deprivation for two, four and eight days. The results showed that the enzyme activity increased significantly in the deprived rat brain and it returned to control/normal level on recovery. The enzyme activity increased first in the brain stem, while the activity in the cerebellum showed no significant change. Control experiments suggest that the increase was primarily caused by the deprivation. The finding fits well with existing knowledge and would possibly help in explaining earlier observations.