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Aim: To assess the improvements during patient follow-up after implementing a proactive plan for retrieval of inferior vena cava (IVC) filters.Materials and Methods: A retrospective study was undertaken including all patients who had a temporary IVC filter inserted over a 10-year period. Patient demographics, insertion dates, retrieval dates, retrieval rates, and complications were recorded. Patients were categorised into three groups as follows: group A, no intervention where retrieval was not suggested; group B, passive intervention where retrieval was suggested but no appointment made; and group C, proactive intervention where a retrieval date was booked by the radiologist.Results: Five hundred and nine patients had a temporary IVC filter inserted at Royal Liverpool University Hospital over the study period. One per cent of patients in group C were lost to follow-up compared to 41% and 29% in groups A and B respectively (p<0.001). The number of patients who had an IVC retrieval attempt also increased to 80% in group C compared to 53% and 64% in groups A and B (p<0.001).Conclusion: Incorporation of a proactive retrieval booking system has significantly reduced the number of patients lost to follow-up to 1%, leading to an increased number of IVC filter retrieval attempts. [ABSTRACT FROM AUTHOR]

Anti-tuberculosis drug resistance is considered as the main snag in the global elimination of tuberculosis by the end of 2030. One possible explanation to understand its pathogenesis is its inter-connected genome that makes an intricate network to generate the resistance in Mycobacterium tuberculosis (Mtb). Our hypothesis is to analyze the protein-DNA and protein-protein interaction data of Mtb to probe the candidate genes and then evaluate their resistance induction in Mtb against first line anti-TB drugs. The data of genome wide regulator-DNA interaction (Zeng et al., 2012) and global protein-protein interaction (Wang et al., 2010) were analyzed bioinformatically through cytoscape software to identify the candidate genes participating in drug resistance network. These were individually amplified, cloned and transformed into Mtb competent cells to make overexpression strains of these respective genes or (first define in full what is Egfp) eGFP. These strains were then screened with isoniazid (INH) and rifampicin (RIF) to identify their role in regulating drug resistance. Alamar blue dye color change was considered as the marker of resistance imparted by the candidate genes. Only 30 candidate genes were obtained and functionally categorized into small molecule metabolism, intermediate metabolism, information pathway, conserved hypothetical proteins, and cell wall-cell processes through mycrobrowser. After exposing these 30 overexpression strains to various concentrations of INH and RIF, only 7 strains Rv3416, Rv1267, Rv0165c, Rv1129c (metabolism regulatory proteins), Rv2669 (conserved hypothetical protein), Rv2703 (information pathway) and Rv2780 (intermediary metabolism) showed resistance by growing in the presence of 200 µg/ml INH and alamar blue color was not changed. There was absence of growth change and alamar blue color against rifampicin. Our results suggested that these genes might be the regulators of drug resistance network in Mtb. Targeting drug resistance network is a consideration in the development of new anti-TB drugs. [ABSTRACT FROM AUTHOR]

We consider the problem of G^2 two-point Hermite interpolation by a rational cubic. Given two points with tangent vectors and curvatures, the necessary and sufficient conditions are placed on the weights of the rational cubic curve which ensures that (i) if the data suggest a C -shaped curve, the rational cubic interpolates a C -shaped curve without loops, cusps, or inflections, and (ii) if the data suggest an S -shaped curve, the rational cubic interpolates an S -shaped curve with a single inflection, no loops and no cusps. [ABSTRACT FROM AUTHOR]

Background Given the significance of early language for later academic achievement, language development can be an important outcome measure in evaluation of early childhood intervention programmes. Language development may be challenging to assess in settings where trained personnel are hard to find; therefore, maternal report can be a reliable alternative measure. Aim The aim of this study was to adapt a maternal report measure, the MacArthur Communicative Development Inventory II-Short Form, in the Sindhi language and to examine its psychometric properties as a measure of language outcome in 2-year-old children in rural Pakistan. Methods A three-phase process was followed to produce a Sindhi adaptation of the tool comprising 100 words. The first phase was a review of the original 258 words through a focus group discussion with a team familiar with the context; the second phase was testing 258 words to compile a 100-word list of easy, moderate and difficult words. The third phase was a pilot of the 100-word list followed by administration in a larger intervention study population. Results On administration with 1381 children, concurrent validity with the Bayley Scale of Infant Development III using the Pearson's correlation test showed a moderate association for comprehension ( r = 0.45, p = 0.01, n = 1381) and good association for expression ( r = 0.51, p = 0.01, n = 1381). Internal consistency was high with alphas of 0.98 for comprehension items and 0.96 for expression items. Conclusion The authors conclude that the Sindhi adaptation of the MacArthur Communicative Development Inventory followed a feasible and rigorous methodology to create a reliable and sensitive tool to assess young children's language development for use in a child assessment battery for early childhood health, nutrition and development studies. [ABSTRACT FROM AUTHOR]

The study of crowd dynamics is interesting because of the various self-organization phenomena resulting from the interactions of many pedestrians, which may improve or obstruct their flow. Besides formation of lanes of uniform walking direction and oscillations at bottlenecks at moderate densities, it was recently discovered that stop-and-go waves [D. Helbing et al., Phys. Rev. Lett.97 (2006) 168001] and a phenomenon called "crowd turbulence" can occur at high pedestrian densities [D. Helbing et al., Phys. Rev. E75 (2007) 046109]. Although the behavior of pedestrian crowds under extreme conditions is decisive for the safety of crowds during the access to or egress from mass events as well as for situations of emergency evacuation, there is still a lack of empirical studies of extreme crowding. Therefore, this paper discusses how one may study high-density conditions based on suitable video data. This is illustrated at the example of pilgrim flows entering the previous Jamarat Bridge in Mina, 5 kilometers from the Holy Mosque in Makkah, Saudi-Arabia. Our results reveal previously unexpected pattern formation phenomena and show that the average individual speed does not go to zero even at local densities of 10 persons per square meter. Since the maximum density and flow are different from measurements in other countries, this has implications for the capacity assessment and dimensioning of facilities for mass events. When conditions become congested, the flow drops significantly, which can cause stop-and-go waves and a further increase of the density until critical crowd conditions are reached. Then, "crowd turbulence" sets in, which may trigger crowd disasters. For this reason, it is important to operate pedestrian facilities sufficiently below their maximum capacity and to take measures to improve crowd safety, some of which are discussed in the end. [ABSTRACT FROM AUTHOR]

Purpose: Open lung biopsy (OLB) is claimed to be a sensitive tool for the diagnosis of interstitial lung disease. It is reported to be associated with significant morbidity and mortality. Aim: Evaluate whether lung biopsy helped us to make a specific diagnosis, it had resulted in change in therapy and assessment of its morbidity and mortality. Materials and Methods: This was a retrospective analysis of 91 lung biopsies performed in 83 patients between January 2000 and December 2003. These children were allocated to three groups: a. Primary pulmonary pathology (22), b. Immunocompromised (49) i. Primary immunodeficiency (10), ii. Postchemotherapy and BMT (39), c. Pulmonary metastases from solid tumors (20) Results: A specific diagnosis was reached in 87/91 children (95%), but this resulted in a change in therapy (excluding lung meet) in only 23/71 (32%). It is lower in those postchemo/BMT 8/39 (20.6%). Postoperative morbidity occurred in 11/91 (12%) but procedure-related morbidity was only (3.2%). Death within a month of the biopsy occurred in six children (6.5%), with one (1.1%) procedure-related. Conclusion: 1. OLB is a safe procedure at our institution. 2. OLB is a sensitive tool to determine the specific cause of pulmonary infiltrate. 3. Change in therapy expected to be only in 32% of patients and even lower in postchemotherapy and BMT children [ABSTRACT FROM AUTHOR]

Reconnoitering the new genetics tools for identifying novel vaccine candidates and drug targets is the need of time to combat tuberculosis (TB). This will bring forth the comprehension of functional genomics, virulent genes, latency in host and resistance against drugs in the causative agent of TB i.e. Mycobacterium tuberculosis (Mtb). Keeping in view, Mtb endogenous CRISPR-Cas type III a system was exploited to envisage genome editing, mechanism of RNA interference, and throughout Mtb genome CRISPR interference (CRISPRi) screening using in-vitro and in-vivo. A repeat sequence of type IIIA CRISPR array was incorporated in pMV261-crRNA. Guide RNA for the target gene was designed and homology- directed repair (HDR) sequence containing GFP was employed for gene insertion- deletion (indel). For gene knock-down (RNA interference) mechanism was identified by RIP-qPCR. Guide RNA library (5658 in numbers) for the whole genome was designed from Twist Bioscience Company and high-throughput screening was performed for in-vitro and in-vivo growing Mtb using bioinformatics tools. qPCR declared the presence of type III A CRISPR array in Mtb. Using pMV261-crRNA and gRNA for the target gene successfully knocked-in GFP adjacent to gyrA gene and successfully knocked-out lpqE, lpqN, esxA and lpqD separately. For knock-down, katG, esxT, and dcd genes were successfully interfered at transcriptional level using CRISPRi. This was validated by RIP in which csm6-HA tag pull down CRISPR from bacteria having gRNA for katG or dcd or esxT. High-throughput screening analysis showed 228 growth promoting and 385 inhibiting genes in in-vitro culture and 29 growth promoting and 4 inhibiting genes in in-vivo environment. This is your futuristic vision, not a conclusion, please conclude your study in 1 sentence. This system can be used for genetic manipulation, exploring functional genomics of Mtb and identifying new vaccine candidates and drugs targets in Mtb. [ABSTRACT FROM AUTHOR]

Abstract: Hydration of CaO powders by reaction with water vapor has been studied in isothermal and isobaric conditions. Experimental tests were performed within the temperature range of 70°C–420°C and with a water vapor pressure from 5 to 160hPa by means of a thermogravimetric device. Two powders, exhibiting slight differences in their physical properties, were studied. However, for one of the powders and under some temperature and pressure conditions, the reaction is not complete. The difference of behavior between both CaO powders was interpreted by considering the effect of the morphological properties on the mechanism of growth of Ca(OH)2. [Copyright &y& Elsevier]

Background: Infection is one of the major factors that determine clinical outcome among patients requiring intensive care unit (ICU) support. The attending mortality is high and depends on source of infection, organisms associated, timeliness and appropriateness of the treatment received. Methods&Materials: Case records of patientswhowere admitted into our 5bedded ICU over a 4 year period were retrospectively reviewed. The average number of admission was 20 per month. A preformed questionnaire was administered and data on clinical and microbiological profile of all the patients with documented infection was obtained. Results: Eighty four episodes of infections were identified in 76 patients. Road traffic accident 29/76(38.2%) and pulmonary embolism12/76(15.8%) were the leading cause of admission. The most common infection was skin and soft tissue infection (SSI) 30/84(35.7%) followed by UTI 23/84(27.4) and primary bacteraemia 18/84(21.4) with the least beingVAP3/84(3.6%). Most of the cases of UTI occurred in patients with RTA and renal failure, while the highest number of primary bacteraemia was seen among patients with burns and renal failure. The most frequent isolates were S. aureus 35/84(41.7%), K. pneumonia 18/84(21.4%) and E. coli 13/84(15.5%). K. pneumonia 2/5(40%) and P. aerugenosa 1/5(20%) were the leading cause of pneumonia, while S. aureus was the commonest cause of SSI 16/30(53.3%), primary bacteremia 10/18(55.6%) and line infection 5/5(100%). There were 3 cases of VAP one each caused by K. pneumonia, P. aerugenosa and S. aureus. High rate of resistance to cloxacillin 19/35(54.3%) and co-trimoxazole 17/26(65.4%) was noted among the S. aureus isolates. All the enterobactrecae isolates that were tested against meropenem were fully susceptible, while resistance rate to ceftriaxone was high; E. coli 5/9(55.6%), K. pneumoniae 10/14 (71.4%) and proteus spp 2/4 (50%). With exception to meropenem and colistin, ciprofloxacin had a better resistance profile against P. aerugenosa and isolated enterobactriacae compared to the other tested B-lactam agents. Conclusion: The study underscores the need to improve infection control practice in our ICU. Resistance to commonly used antibiotic was high and this makes the choice of empiric antibiotic difficult, hence measures to curtail the emergence of resistance pathogens need to be adopted. [ABSTRACT FROM AUTHOR]

Background: Infections are the leading cause of hospitalization and mortality in transplant recipients. Nigeria has a growing number of renal transplant recipients. The aim of this study was to determine the pattern of infections in renal allograft recipients in one of the major renal transplant centers in Nigeria. Methods & Materials: All case records of renal allograft recipients on follow up were retrieved. Those that had infection at any time after transplantation were selected. Demographic and clinical information were collected and analysed. Results: Thirty three case records were analysed out of which 24/33(72.7%) were males, with the mean age of 42.3 years (±7.38). The median duration of developing infection post-transplant was 270 days (Range 2 - 2190). Most of the infection occurred after 6month 15/33(45.5%). Urinary tract infection was the commonest infection 13/33(39.4%), followed by pneumonia 12(33.3%). There were two cases each (5.6%) of tuberculosis and non-typhoidal salmonella septicemia and one case (2.8%) of CMV colitis. Majority 6/9 (66.7%) of the pneumonia cases was gram negative pneumonia with P. aeroginosa been the commonest isolates 3/9(33.3%). Among those with UTI, E.coli, and Klebsiella spp were isolated with equal proportion 3/13(23.1%) while Enterococcus feacalis was the commonest isolate 4/13(30.8%). Among the tested isolates 61.5% and 50% of gram negative pathogens and S. aureus respectively were resistant to co-trimoxazole, while all the 2 isolated non-typhoidal salmonella were MDR. Overall mortality was 10/33(30.3%) out of which 5/10(50%) was due to pneumonia. Conclusion: There is need to strengthen infection surveillance among post-transplant patients in Nigeria. Infection with MDR pathogen is common and the outcome co-trimoxazole prophylaxis in renal transplantation in our center need to be reviewed. [ABSTRACT FROM AUTHOR]