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OBJECTIVE: To characterize sleep quality and sleep disruptions among youth hospitalized outside of the intensive care unit (ICU). PATIENTS AND METHODS: Participants were eligible for the survey-based study if they were 8-17 years old, English-speaking, hospitalized for ≥3 days outside of the ICU, and developmentally able to understand surveys. Survey administration included a sleep diary, the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), and a study-specific Inpatient Sleep Disruptors Questionnaire. The chart review provided additional clinical information. Descriptive and comparative statistics were performed to assess the association between overnight clinical monitoring and daytime sleepiness. RESULTS: Forty-five participants (mean age 13.4 years, 60% female), recruited between May and December 2022, were included in the study. Mean total sleep time (8.2 ± 1.7 hours) and ESS-CHAD score (8.6 ± 4.3) were normal with 79% reporting fair to good sleep the previous night. Participants rated alarms on equipment, vital signs, and noise as most disruptive to sleep. Participants with vital signs every four hours showed higher levels of daytime sleepiness compared with participants with vitals measured every shift (9.3 vs. 6.3; p=0.04). CONCLUSIONS: Most participants reported normal sleep, although there was wide variability with a portion with impaired sleep quality and elevated daytime sleepiness. Alarms on equipment, vital signs, and noise were most disruptive, and increased vital sign frequency was also associated with increased daytime sleepiness. In clinically stable pediatric patients, a reduction in vital sign monitoring overnight may be an important change to improve patient sleep.
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The extreme sensitivity of 2D-layered materials to environmental adsorbates, which is typically seen as a challenge, is harnessed in this study to fine-tune the material properties. This work investigates the impact of environmental adsorbates on electrical properties by studying metal-semiconductor-metal (MSM) devices fabricated on CVD-synthesized SnSe flakes. The freshly prepared devices exhibit positive photoconductivity (PPC), whereas they gradually develop negative photoconductivity (NPC) after being exposed to an ambient environment for â¼1 day. While the photodetectors based on positive photoconductivity exhibit a responsivity and detectivity of 6.1 A/W and 5.06 × 108 Jones, the same for the negative photoconductivity-based photodetector reaches up to 36.3 A/W and 1.49 × 109 Jones, respectively. In addition, the noise-equivalent power of the NPC photodetector decreases by 300 times as compared to the PPC device, which implies a prominent detection capability of the NPC device against weak photo signals. To substantiate the hypothesis that negative photoconductivity stems from the photodesorption of water and oxygen molecules on the dangling bonds of SnSe flakes, the flakes are etched along the most active planes (010) with a focused laser beam in an inert environment, which enhances responsivity by 43%, supporting negative photoconductivity linked to photodesorption. Furthermore, the humidity-dependent dark current variation of the NPC photodetectors is used to design a humidity sensor for human respiration monitoring with faster response and recovery times of 0.72 and 0.68 s, respectively. These findings open up the possibility of tuning the photoelectrical response of layered materials in a facile manner to develop future sensors and optoelectronic multifunctional devices.
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For an uninterrupted self-powered network, the requirement of miniaturized energy storage device is of utmost importance. This study explores the potential utilization of phosphorus-doped nickel oxide (P-NiO) to design highly efficient durable micro-supercapacitors. The introduction of P as a dopant serves to enhance the electrical conductivity of bare NiO, leading to 11-fold augmentation in volumetric capacitance to 841.92 Fcm-3 followed by significant enhancement of energy and power density from 6.71 to 42.096 mWhcm-3 and 0.47 to 1.046 Wcm-3, respectively. Theoretical calculations used to determine the adsorption energy of OH- ions, revealing higher in case of bare NiO (1.52 eV) as compared to phosphorus-doped NiO (0.64 eV) leading to high electrochemical energy storage performance. The as-designed micro-supercapacitor (MSC) device demonstrates a facile integration with the photovoltaic system for renewable energy storage and smooth transfer to external loads for enlightening the blue LED for ≈1 min. The choice of P-NiO/Ni not only contributes to cost reduction but also ensures minimal lattice mismatch at the interface facilitating high durability up to 15 K cycles along with capacitive retention of ≈100% and coulombic efficiency of 93%. Thus, the heterostructure unveils the possibilities of exploring miniaturized energy storage devices for portable electronics.
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Water splitting via an uninterrupted electrochemical process through hybrid energy storage devices generating continuous hydrogen is cost-effective and green approach to address the looming energy and environmental crisis toward constant supply of hydrogen fuel in fuel cell driven automobile sector. The high surface area metal-organic framework (MOF) driven bimetallic phosphides (ZnP2 @CoP) on top of CNT-carbon cloth matrix is utilized as positive and negative electrodes in energy storage devices and overall water splitting. The as-prepared positive electrode exhibits excellent specific capacitances/capacity of 1600 F g-1 /800 C g-1 @ 1A g-1 and the corresponding hybrid device reveals an energy density of 83.03 Wh kg-1 at power density of 749.9 W kg-1 . Simultaneously, the electrocatalytic performance of heterostructure shows overpotentials of 90 mV@HER and 204 mV@OER at current density of 10 and 20 mA cm-2 , respectively in alkaline electrocatalyzer. Undoubtedly, it shows overall water splitting with low cell voltage of 1.53 V@10 mA cm-2 having faradic and solar-to-hydrogen conversion efficiency of 98.81% and 9.94%, respectively. In addition, the real phase demonstration of the overall water-splitting is performed where the electrocatalyzer is connected with a series of hybrid supercapacitor devices powered up by the 6 V standard silicon solar panel to produce uninterrupted green H2 .
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Objective Daytime sleepiness is common in youth with asthma (YWA). Treatments designed to mitigate daytime sleepiness in YWA require an understanding of the primary causes of this problem. We examined respiratory- and non-respiratory-related factors associated with daytime sleepiness in YWA. Methods One hundred YWA (eight to 17 years old) were included in a cross-sectional study. Daytime sleepiness, quality of life, anxiety, bedtime cellphone use, and respiratory symptoms were self-reported. Asthma severity, lung function, and the number of prescribed medications were obtained from electronic medical records. Multivariable regression models identifying variables associated with daytime sleepiness were generated. Results Participants were 54% male and 45% Black, with a mean age of 12.1 years. The multivariable regression model showed decreased quality of life (b = -0.328, p = 0.004) and increased bedtime cellphone use (b = 0.300, p = 0.004)were significantly related to daytime sleepiness, while anxiety (b = 0.213, p = 0.05), prescribed asthma medications (b = 0.173, p = 0.05), and worse lung function (b = -0.173, p = 0.05)were marginally related to daytime sleepiness. Conclusions In addition to optimizing asthma control, strategies targeting anxiety, quality of life, and nocturnal cellphone use are important to mitigate daytime sleepiness in YWA.
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Skin pigmentation is regulated by intricate interaction of the dermis and epidermis. The extracellular components present in the dermis play a very important role in the maintenance of skin homeostasis. Therefore, our objective was to check the expression of various ECM components secreted by the dermal fibroblasts in the lesional skin and non-lesional skin of vitiligo patients. For this study, skin punch biopsies (4 mm) were collected from lesional skin (n = 12), non-lesional skin (n = 6) of non-segmental vitiligo patient's (NSV) and healthy control skin (n = 10). Masson's trichrome staining was performed to check the collagen fibre. The expression of collagen type 1, IV, elastin, fibronectin, E-cadherin and integrin ß1 was checked by real-time PCR and immunohistochemistry. In this study, we demonstrated an increased expression of collagen type 1 in the lesional skin of vitiligo patients. The expression of collagen type IV, fibronectin, elastin and adhesion components such as E-cadherin and integrin ß1 was observed to be significantly decreased in the lesional skin of NSV patients as compared to healthy control, whereas insignificant difference was observed between non-lesional and control skin. Increased expression of collagen type 1 in the lesional skin of vitiligo patients might be inhibiting the migration of melanocytes, whereas the decreased expression of elastin, collagen type IV, fibronectin, E-cadherins and integrins in the lesional skin may inhibit adhesion, migration, growth and differentiation of cells.
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Vitiligo , Humanos , Vitiligo/patologia , Fibronectinas/metabolismo , Elastina/metabolismo , Proteínas da Matriz Extracelular/genética , Colágeno Tipo IV/metabolismo , Integrina beta1/metabolismo , Pele/patologia , Melanócitos/metabolismo , Caderinas/metabolismo , Matriz Extracelular/metabolismoRESUMO
The globe is currently confronting a global fight against the deadliest cancer sickness. Chemotherapy, hormonal therapy, surgery, and radiation therapy are among cancer treatment options. Still, these treatments can induce patient side effects, including recurrence, multidrug resistance, fever, and weakness. As a result, the scientific community is always working on natural phytochemical substances. Numerous phytochemical compounds, including taxol analogues, vinca alkaloids such as vincristine and vinblastine, and podophyllotoxin analogues, are currently undergoing testing and have shown promising results against a number of the deadliest diseases, as well as considerable advantages due to their safety and low cost. According to research, secondary plant metabolites such as myricetin, a flavonoid in berries, herbs, and walnuts, have emerged as valuable bio-agents for cancer prevention. Myricetin and its derivatives have antiinflammatory, anticancer, apoptosis-inducing, and anticarcinogenic properties and can prevent cancer cell proliferation. Multiple studies have found that myricetin has anticancer characteristics in various malignancies, including colon, breast, prostate, bladder, and pancreatic cancers. Current knowledge of the anticancer effects of myricetin reveals its promise as a potentially bioactive chemical produced from plants for the prevention and treatment of cancer. This review aimed to study the numerous bioactivities, mode of action, and modification of several cellular processes that myricetin possesses to impede the spread of cancer cells. This review also addresses the challenges and future prospects of using myricetin as a anticancer drug.
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Antineoplásicos , Neoplasias , Humanos , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , Flavonoides/farmacologia , Flavonoides/uso terapêutico , Flavonoides/química , Vincristina/uso terapêuticoRESUMO
A chemical peel is chemexfoliation, a process of application of a chemical substance to the skin that causes controlled chemical destruction of the epidermis with or without part of the dermis leading to skin regeneration and remodeling. It can be classified depending upon the depth of penetration into superficial, medium, and deep peels. Among various indications, peels can be used to enhance treatment within a variety of conditions including skin- rejuvenation, inflammatory disorders like acne, rosacea, acne scar, and pigmentary disorders like melasma, freckles, lentigens, dyschromia, and post-inflammatory pigmentation. We did a chemical peel for six patients with facial melanosis, diagnosed with Riehl melanosis. All patients had visible clinical improvement. Detailed history and informed consent were taken both for photographs and procedures from all patients.
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Acne Vulgar , Abrasão Química , Dermatite de Contato , Melanose , Transtornos da Pigmentação , Humanos , Dermabrasão , Transtornos da Pigmentação/induzido quimicamente , Transtornos da Pigmentação/terapiaRESUMO
Primary research to detect duplicate question pairs within community-based question answering systems is based on datasets made of English questions only. This research put forward a solution to the problem of duplicate question detection by matching semantically identical questions in transliterated bilingual data. Deep learning has been implemented to analyze informal languages like Hinglish which is a bilingual mix of Hindi and English on Community Question Answering (CQA) platforms to identify duplicacy in questions. The proposed model works in two sequential modules. First module is a language transliteration module which converts input questions into a mono-language text. The next module takes the transliterated text where a hybrid deep learning model which is implemented using multiple layers is used to detect duplicate questions in the mono-lingual data. The similarity between the question pairs is done utilizing this hybrid model combining a Siamese neural network with identical capsule network as the subnetworks and a decision tree classifier. Manhattan distance function is used with the Siamese network for computing the similarity between questions. The proposed model has been validated on 150 pairs of questions which were scrapped from various social media platforms, such as Tripadvisor and Quora which achieves accuracy of 87.0885% and AUC-ROC value of 0.86.
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Redes Neurais de Computação , Mídias Sociais , Humanos , IdiomaRESUMO
Type 1 lepra reaction (T1R) is a major complication seen in nonpolar forms of leprosy and leads to significant morbidity. The classification of T1R as up and downgrading, based on previously defined histopathological criteria (by Ridley), has therapeutic and prognostic implications. The trigger factors for these reactions are poorly described, especially in case of downgrading T1R and we describe a case of leprosy reaction that was possibly triggered by chemoradiation and elucidate the possible mechanism.
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Hipersensibilidade , Hanseníase , Doenças do Sistema Nervoso Periférico , Carboplatina/uso terapêutico , Humanos , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Hanseníase/patologia , Paclitaxel/uso terapêuticoRESUMO
STUDY OBJECTIVES: Although obesity, asthma, and sleep-disordered breathing are interrelated, there is limited understanding of the independent contributions of body-mass index and pulmonary function on polysomnography in children with asthma. METHODS: We conducted a retrospective chart review on 448 7- to 18-year-old children with asthma who had undergone polysomnography testing between 1/2007-12/2011 to elucidate the association between spirometry variables, body-mass index, and polysomnography parameters, adjusting for asthma and antiallergic medications. RESULTS: Obese children had poorer sleep architecture and more severe gas exchange abnormalities compared to healthy weight children. Multivariate analysis revealed an independent association of body-mass index with sleep efficiency, with more light and less deep sleep in both obese and healthy-weight children, and with baseline oxygen saturation and oxygen nadir in obese children. In obese children, forced vital capacity was independently associated with less deep sleep (time in N3 sleep) as well as with oxygen nadir, while among healthy-weight children, forced expiratory volume directly correlated but forced vital capacity inversely correlated with deep sleep. In obese children, inhaled corticosteroid was associated with baseline oxygen saturation, and montelukast was associated with lower end-tidal carbon dioxide. In healthy-weight children, inhaled corticosteroid was associated with arousal awakening index, and montelukast was associated with light sleep. Antiallergic medications were not independently associated with polysomnography parameters. CONCLUSIONS: Pulmonary function, body-mass index, and asthma medications have independent and differing influences on sleep architecture and gas exchange polysomnography parameters in obese and healthy-weight children with asthma. Asthma medications are associated with improved gas exchange in obese children and improved sleep architecture in healthy-weight children with asthma. CITATION: Conrad LA, Nandalike K, Rani S, Rastogi D. Associations between sleep, obesity, and asthma in urban minority children. J Clin Sleep Med. 2022;18(10):2377-2385.
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Antialérgicos , Asma , Obesidade Infantil , Acetatos , Adolescente , Corticosteroides , Asma/complicações , Índice de Massa Corporal , Dióxido de Carbono , Criança , Ciclopropanos , Humanos , Oxigênio , Quinolinas , Estudos Retrospectivos , Sono , SulfetosRESUMO
Background: Children with Trisomy 21 (T21) are at an increased risk of sleep-disordered breathing (SDB), which can impact daily functioning and cause other health complications. Accordingly, it is imperative to diagnose and treat SDB in this population. Current guidelines recommend screening polysomnogram by age 4 or sooner if clinically indicated. There are limited published studies describing characteristics of SDB in children with T21, particularly in infants and young children. Objective: The objective of this study is to characterize SDB and treatment modalities in infants and young children with T21. Methods: This is a retrospective review of a cohort of children (≤60 months of age) with T21 who completed a polysomnogram (PSG) between 2015 and 2020 at a pediatric referral center. Demographic information, relevant medical history, polysomnography parameters, and treatment details of these children were collected from EMR. Descriptive and comparative statistics were calculated for the cohort; additional subgroup analysis was completed by age 0-35 months and 36-60 months. Results: Most of the cohort met criteria for sleep apnea (84.1%), and airway surgery was the most common treatment modality (71.4%). The mean AHI was high (21.4 events/hour) with a trend towards hypoventilation (mean EtCO2 = 55.9 mmHg; mean percentage of TST with EtCO2 > 50â mmHg 20.8%). Mean arousal index was elevated (32 events/hour). There were no significant differences in SDB by age when we compared children 0-35 months and 36-60 months. Conclusions: This cohort of referred children with T21 showed high prevalence of SDB with a trend towards hypoventilation and disrupted sleep quality with no significant differences by age. These data highlight the importance of maintaining a high index of suspicion for SDB in young patients with T21 and obtaining PSG testing to characterize sleep and breathing.
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Psoriatic involvement of nails manifests in the form of irregular, deep and large pits, splinter hemorrhages, subungual hyperkeratosis, oil drop spot, and onycholysis of the nail bed. Retinoids are one of the treatment modalities for nail psoriasis. Pseudogynecomastia is an uncommonly reported side effect of retinoids. We hereby describe an 11-year-old adolescent who developed pseudogynecomastia posttreatment with acitretin for nail psoriasis.
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Acitretina/efeitos adversos , Ginecomastia/diagnóstico , Ceratolíticos/efeitos adversos , Doenças da Unha/tratamento farmacológico , Psoríase/tratamento farmacológico , Criança , Diagnóstico Diferencial , Ginecomastia/induzido quimicamente , Humanos , MasculinoRESUMO
Coastal and estuarine ecosystems provide habitats for many organisms. Recently, the estuaries and coastal areas of the East Coast of Bangladesh have become heavily contaminated due to dumping of untreated wastewater into the rivers from a number of different industries. The current study analyzes potentially toxic elements contamination in surface sediments of the Karnaphuli, Sangu, Bakkhali and Naf Rivers, Kutubdia and Moheshkhali Channel, and St. Martin's Island, and assesses the consequent ecological risks. The pollution load index (PLI), geoaccumulation index (Igeo) and potential ecological risk (PER) indices show that the contaminated sediments have negative effects on the aquatic environments. The PLI values ranged between 0.45 and 1.67, which suggests the severity of trace-element contamination. The mean Igeo values showed the sediments range from uncontaminated to heavily contaminated state. The Enrichment Factor (EF) values suggested that the sediments were contaminated by anthropogenic sources, and PER values demonstrate that sites at Sangu, Naf and St Martin's Island are less contaminated compared to sites at Karnaphuli, Bakkhali, Kutubdia and Moheshkhali. Overall, results showed that Karnaphuli river is the most contaminated and St Martin's Island is the least based on the spatial distribution of PLI, Cd, PER and ∑TUs of trace metals in surface sediments. Comparing with the neighboring countries, the concentrations of Cd and Pb were found to be higher while Cr is lower in the East Coast of Bangladesh than the estuarine and coastal waters of the Bay of Bengal rim countries. The present study reveals that the lack of water quality guidelines in Bangladesh for the coastal, estuarine and marine water escalated the dumping of untreated wastewater. Immediate measures need to be taken to address the ecological risks so that an effective management program can be undertaken. A systematic approach for collecting pollutant data and use of isotopes to trace anthropogenic sources of contamination is recommended for pollutants like toxic metals, pesticides and other contaminants in sediment and aquatic products in the entire coastal waters of the Bay of Bengal.