Morphology and electrical conductivity of carbon-coated Nickel reinforced high-performance polymer nanocomposites.

Novel nanocomposites of poly (ether-ketone) (PEK) reinforced with carbon-coated Nickel nanoparticles (CCNi) were synthesized through a sequential process involving cost-effective ball milling and hot compaction. Scanning electron microscopy revealed an excellent dispersion and a three-dimensional network of CCNi nanoparticles in the matrix, causing a significant improvement in the electrical conductivity and electromagnetic interference shielding effectiveness (SE). Carbon coating of about 5 nm thick over Ni nanoparticle probably helps in uniform dispersion, avoids its oxidation and reduces its agglomeration in the matrix. An exceptionally low percolation threshold of 2.1 vol.% CCNi was found, and eight-orders of magnitude enhancement in the dc-electrical conductivity was achieved. The highest dc- and ac-electrical conductivities achieved were more than 0.01 S cm-1at 5.89 vol.% CCNi nanoparticles content which were the highest values amongst reported Ni-filled polymer composites and comparable with those of carbon nanotubes filled PEK nanocomposites. Electromagnetic interference SE of the CCNi/PEK nanocomposites was measured in the X-band, and a total SE (SET) of 17.52 dB was obtained for 5.89 vol.% CCNi reinforced PEK nanocomposite.

Poly(ether-sulfone)/MWCNT nanocomposites manufactured by powder metallurgy route and their dynamic mechanical properties.

Dynamic mechanical properties of the poly(ether-sulfone) (PES)/multi-walled carbon nanotube (MWCNT) nanocomposites manufactured by powder metallurgical route was discussed for the first time. The structural investigation of the nanocomposites was analysed by x-ray diffraction. At room temperature, both storage modulus and microhardness of the nanocomposites increased by more than 60% while the strengthening efficiency at higher temperatures is several-folds compared to that of neat PES. The nanocomposites exhibited better damping behaviour compared to neat PES. The Cole-Cole plot indicated a good interaction between the PES and the MWCNT. Moreover, the coefficient of reinforcement decreased by 42% while the degree of entanglement increased.

Ocular spectrum of kite injury: A six-year trend at a tertiary eye care center.

Purpose: To assess ocular morbidity attributable to kites (patang) with emphasis on the cause, type and severity of the injury, complications, and final visual outcome. Methods: All the patients with a history of kite injury during months of Makar Sankranti for consecutive 6 years (2014-2019) were included in this study. A B-scan, orbital X-ray, and CT scan were performed for extensive ocular evaluation. Results: : Out of 68 patients with kite-related injury, 58 were male and 10 were female. Globe rupture (20), lid laceration (18), penetrating injury (9), wooden foreign body in the anterior or posterior chamber (7), superficial foreign body (4), hyphema (7), and vitreous hemorrhage (3) due to falling from height were noted. Factors associated with a poor final visual outcome in our study were poor initial visual acuity, globe rupture, intraocular foreign body, and development of endophthalmitis. Conclusion: Kites can cause serious preventable injuries mostly among pediatric males. The use of protective eyewear and public awareness can decrease ocular injury significantly.

High electromagnetic interference shielding of poly(ether-sulfone)/multi-walled carbon nanotube nanocomposites fabricated by an eco-friendly route.

High-performance polymer matrix nanocomposites based on poly(ether-sulfone) (PES) matrix reinforced with multi-walled carbon nanotubes (MWCNTs) were fabricated using planetary ball mill followed by hot pressing. Their electrical properties and the electromagnetic interference shielding effectiveness (EMI-SE) were investigated and discussed. A percolation threshold of about 0.65 vol% MWCNT was obtained. The electrical conductivity was increased by more than ten orders of magnitude at the percolation threshold and to approximately 0.01 S cm-1 at 6.67 vol% (or 10 wt%) MWCNT. This is a significant improvement. The highest EMI-SE of about 29-30 dB (both in the X-band and Ku-band) was obtained for the 6.67 vol% MWCNT filled nanocomposites with a thickness of 0.9 mm. The specific EMI-SE of these nanocomposites were found to be higher than the literature values. The thermal stability and the char yield (measured at 900 °C) of the nanocomposites were found to be more than 470 °C and 40.6%, respectively.

Surgical pleth index: prospective validation of the score to predict moderate-to-severe postoperative pain.

BACKGROUND: Reported outcome benefits after surgical pleth index (SPI, GE Healthcare, Helsinki, Finland) guided anaesthesia are conflicting. One potential explanation may be the lack of evidence for the selection of meaningful SPI target values. A recently published trial found an SPI cut-off of 30 as a 'best-fit' to predict moderate-to-severe acute postoperative pain. This prospective trial was designed to validate this target and to investigate the influence of patient age on SPI in this context. METHODS: After ethics approval, 200 patients undergoing non-emergency surgery were enrolled. Data related to SPI, heart rate (HR), and mean arterial pressure (MAP) were recorded for the last 5 min of surgery, just before arousal. After admission to recovery, pain scores (numeric rating scale [NRS], 0-10) were obtained every 5 min for 15 min. RESULTS: The data of 196 patients were analysed. Receiver-operating curve analysis showed a cut-off SPI value of 29 to be the optimum intraoperative target to discriminate between NRS 0-3 and 4-10. This confirms the 'best fit' cut-off for SPI published previously. Though still superior to HR and MAP, the sensitivity and specificity of the SPI were only poor. Age had no influence on the predictive accuracy of SPI. CONCLUSIONS: An SPI of approximately 30 was confirmed as having the best sensitivity/specificity to predict moderate-to-severe pain in the postanaesthesia care unit. However, the predictive accuracy was overall poor and not influenced by patient age. CLINICAL TRIAL REGISTRATION: ACTRN12617001475336.

Novel HLA-DP region susceptibility loci associated with severe acute GvHD.

Despite HLA allele matching, significant acute GvHD remains a major barrier to successful unrelated donor BMT. We conducted a genome-wide association study (GWAS) to identify recipient and donor genes associated with the risk of acute GvHD. A case-control design (grade III-IV versus no acute GvHD) and pooled GWA approach was used to study European-American recipients with hematological malignancies who received myeloablative conditioning non-T-cell-depleted first transplantation from HLA-A, -B, -C, -DRB1, -DQB1 allele level (10/10) matched unrelated donors. DNA samples were divided into three pools and tested in triplicate using the Affymetrix Genome-wide SNP Array 6.0. We identified three novel susceptibility loci in the HLA-DP region of recipient genomes that were associated with III-IV acute GvHD (rs9277378, P=1.58E-09; rs9277542, P=1.548E-06 and rs9277341, P=7.718E-05). Of these three single nucleotide polymorphisms (SNPs), rs9277378 and rs9277542 are located in non-coding regions of the HLA-DPB1 gene and the two are in strong linkage disequilibrium with two other published SNPs associated with acute GvHD, rs2281389 and rs9277535. Eighteen other recipient SNPs and 3 donor SNPs with a high level of significance (8E-07 or lower) were found. Our report contributes to emerging data showing clinical significance of the HLA-DP region genetic markers beyond structural matching of DPB1 alleles.

Zollinger-Ellison syndrome: an unusual case of chronic diarrhoea in a child.

Most cases of Zollinger-Ellison syndrome (ZES) are described in adults. It is a rare disorder in childhood. Most cases present with abdominal pain due to peptic ulceration and chronic diarrhoea not responding to general measures. The symptom complex is initially confused with other more common diseases, which lead to a delay in diagnosis. We present a rare case of a-12-year boy who initially presented with abdominal pain, diarrhoea, vomiting and progressive weight loss for over a two-year period before he was finally diagnosed as a case of ZES with the primary tumour in the pancreatic head and with multiple metastasis in both the liver and lymph nodes.

Histological and immunohistochemical study of estrogen and progesterone receptors in normal human breast tissue in adult age groups vulnerable to malignancy.

Analysis of receptor status has become standard procedure for assessing breast cancer patients. Estrogen causes epithelial proliferation in breast tissue via the estrogen receptor (ER). The progesterone receptor (PR) is also regulated by the estrogen gene. Analyzing ER and PR together gives information regarding the likely response of carcinoma patients to hormonal therapy. The aim of the present study was to record the expression patterns of ER and PR in normal mammary tissue in different age groups to provide reference data to facilitate histological diagnosis. Breast tissues from the upper outer quadrant of each side of 27 adult female cadavers were examined after H & E staining. ER and PR were identified and examined by immunohistochemistry. The percentage area occupied by parenchyma relative to stromal tissue was calculated in different age groups and was about 4:6, 3.5:6.5, 3:7, 2:8, and 1.5:8.5 in the 3rd, 4th and 5th, 6th, 7th, 8th and 9th, and 10th decades of life, respectively. Both ER and PR were present in all age groups and the numbers of both receptors were maximal during the 4th decade. The distribution and staining patterns for both ER and PR were recorded in different age groups. The contiguous pattern of ER, which is considered pathognomonic of breast carcinoma, was not seen except in one case in the 6th decade. Moderately stained ER and PR receptor sites predominated throughout. The study of normal breast tissue of similar age might provide comparisons that will help histopathologists to make clinical diagnoses from breast biopsies. Clin. Anat. 29:729-737, 2016. © 2016 Wiley Periodicals, Inc.

Senior Loken Syndrome.

Senior Loken Syndrome (SLS) is a rare genetic disorder having juvenile nephronophthisis and retinal degeneration progressing to blindness and end stage renal disease. The present case report is about two sisters who presented with decreased visual acuity and end stage renal disease. Both had decreased vision, pallor, deranged renal function test and chronic malnutrition. Investigations revealed anaemia, uraemia, raised creatinine, low Glomerular Filteration Rate (GFR). Ophthalmology examination revealed nystagmus, retinal examination depicted pale optic disc and pigmentary changes in the retina. Renal ultrasound showed grade III renal parenchymal changes and bilateral cortico-medullary cysts. These cases are presented to highlight the importance of timely recognition of renal derangement in patients with retinal disease to delay end stage renal disease.

Factors associated with intention to engage in self-protective behavior: The case of over-the-counter acetaminophen products.

BACKGROUND: Inappropriate use of acetaminophen products is a concern due to the severe liver damage associated with intentional or accidental overdose of these products. In 2009, the U.S. Food and Drug Administration (FDA) issued more severe organ-specific warnings for the acetaminophen Drug Facts label to improve protective behavior among patients. However, it is not clear how patients react to such interventions by the FDA. OBJECTIVE: The objective of this study was to evaluate the factors influencing patients' intention to engage in protective behavior while using acetaminophen products after reading the Drug Facts label. The study specifically looked at the relationship between four Protection Motivation Theory-based risk cognition factors and the intention to engage in protective behavior. METHODS: An experimental, cross-sectional, field study was conducted using self-administered questionnaires at four community pharmacies in Houston, TX. Two hundred surveys were collected from adults visiting the selected pharmacy stores. Participants were exposed to a simulated label (i.e. Drug Facts label) containing organ-specific warnings for over-the-counter (OTC) acetaminophen products. Risk cognition measures (i.e. measures of perceived severity, perceived vulnerability, response efficacy, and self-efficacy) and measures of intention to engage in protective behavior (always reading warnings, using products with more caution, and consulting a pharmacist/physician) were recorded. Pearson correlation and multiple linear regression analyses, controlling for demographic and behavioral characteristics of the participants, were performed. RESULTS: Bivariate analyses indicated that an increase in perceived severity, perceived vulnerability and response efficacy were associated with a higher intention to engage in protective behavior. Findings from the multiple regression indicated that increase in perceived severity of liver damage, belonging to a non-healthcare occupation, no history of acetaminophen use and no history of alcohol consumption were associated with a higher intention to engage in protective behavior. CONCLUSION: Higher risk cognition of liver damage associated with inappropriate use of OTC acetaminophen products leads to greater intention to engage in protective behavior while using such products. Developing interventions targeted towards improving reading and adhering to the Drug Facts label could improve risk cognition, and thus improve patients' intention to engage in protective behavior. Regular acetaminophen users, heavy alcohol consumers and healthcare professionals might need other interventions apart from the Drug Facts label to improve their likelihood to engage in protective behavior.

Risk factors and timing of relapse after allogeneic transplantation in pediatric ALL: for whom and when should interventions be tested?

We previously showed that minimal residual disease (MRD) detection pre-hematopoietic cell transplant (HCT) and acute GvHD (aGvHD) independently predicted risk of relapse in pediatric ALL. In this study we further define risk by assessing timing of relapse and the effects of leukemia risk category and post-HCT MRD. By multivariate analysis, pre-HCT MRD <0.1% and aGvHD by day +55 were associated with decreased relapse and improved event-free survival (EFS). Intermediate leukemia risk status predicted decreased relapse, and improved EFS and overall survival (OS). Patients with pre-HCT MRD ⩾0.1% who did not develop aGvHD compared with those with MRD <0.1% who did develop aGvHD had much worse survival (2 years EFS 18% vs 71%; P=0.001, 2 years OS 46 vs 74%; P=0.04). Patients with pre-HCT MRD <0.1% who did not experience aGvHD had higher rates of relapse than those who did develop aGvHD (40% vs 13%; P= 0.008). Post-HCT MRD led to a substantial increase in relapse risk (HR=4.5, P<0.01). Patients at high risk of relapse can be defined after transplant using leukemia risk category, presence of MRD pre or post HCT, and occurrence of aGvHD. An optimal window to initiate intervention to prevent relapse occurs between day +55 and +200 after HCT.

Effect of Aqueous Extract of Tephrosia purpurea on Cardiovascular Complications and Cataract Associated with Streptozotocin-induced Diabetes in Rats.

Tephrosia purpurea has been reported to possess antidiabetic activity, however, its effects on cardiovascular complications and cataract associated with diabetes have not been studied. The objective of the present study was to investigate the effects of aqueous extract of Tephrosia purpurea on cardiovascular complications and cataract associated with streptozotocin-induced diabetes in rats. Sprague Dawley rats of either sex were made diabetic with streptozotocin (45 mg/kg, i.v.). Treatment of aqueous extract of Tephrosia purpurea was given in the dose of 300 and 500 mg/kg/day, p.o for 8 weeks. Various hemodynamic (blood pressure, heart rate, +dp/dt, -dp/dt) and biochemical (serum glucose, cholesterol, triglycerides, creatinine, urea, lactate dehydrogenase and creatinine kinase) parameters were recorded after 8 weeks of the treatment. To evaluate cataract, various biochemical estimations were done in eye lens. Streptozotocin produced hyperglycemia; hypoinsulinemia; hyperlipidemia; increased blood pressure; increased creatinine, cardiac enzymes, reduction in heart rate and cardiac hypertrophy in rats and all these changes were prevented by the treatment with aqueous extract of Tephrosia purpurea in both the doses. Streptozotocin also produced decrease in soluble protein and reduced glutathione in lens of rats that was prevented by aqueous extract of Tephrosia purpurea. Our data suggest that aqueous extract of Tephrosia purpurea prevents not only the streptozotocin-induced metabolic abnormalities but also cardiovascular complications as well as reduce the risk of development of cataract.

Renal Transplantation in the Setting of Prior Urinary Diversion: A Case of Poorly Differentiated Adenocarcinoma in an Ileal Conduit.

Though rare, renal transplantation into a bowel containing urinary diversion is necessary in select clinical situations. Compared to renal transplant patients with functional native bladders, patients with urinary diversion have comparable long-term graft and patient survival rates. However, compounding the increased risk of malignancy in those on chronic immunosuppression are the inherent risks of urinary diversion. We present a case report of a high grade adenocarcinoma with neuroendocrine differentiation arising in an ileal conduit and discussion on the pathophysiology, management, and screening of this highly select population.

Fixation with cancellous screws and fibular strut grafts for neglected femoral neck fractures.

PURPOSE: To review the outcomes of fixation with cancellous screws and fibular strut grafts for neglected femoral neck fractures. METHODS: 44 men and 28 women aged 17 to 50 years with neglected femoral neck fractures of the subcapital (n=12), transcervical (n=57), or basal (n=3) types underwent closed (n=39) or open (n=33) reduction and fixation with a single cancellous screw with double fibular strut grafts (n=24) or fixation with double cancellous screws with a single fibular strut graft (n=48). The mean time from injury to surgery was 10 weeks; the delay was 22 to 35 days in 43 patients and >35 days in 29 patients. Double fibular strut grafts were used for 18 patients with longer delay and resorption of the femoral neck, and 18 patients with posterior comminution of the femoral neck. The outcome was assessed using the Harris hip score. RESULTS: Patients were followed up for a mean of 3 years. The time to bone union was 3 to 4 months in 48 patients, 4 to 5 months in 15, and 5 to 6 months in 5; nonunion was noted in 4 patients. In 18 patients with resorption of the femoral neck, bone union took a longer time. The Harris hip score was excellent (90-100) in 30 patients, good (80-89) in 20, fair (70-79) in 15, and poor (<70) in 7. Of the latter, 4 had nonunion and 3 developed avascular necrosis of the femoral head; they had persistent pain and restriction of hip joint movement. CONCLUSION: Fixation with cancellous screws and fibular strut grafts for neglected femoral neck fractures is cost-effective and technically less demanding, and associated with good outcomes.