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Polymorphic forms of organic conjugated small molecules, with their unique molecular shapes, packing arrangements, and interaction patterns, provide an excellent opportunity to uncover how their microstructures influence their observable properties. Ethyl-2-(1-benzothiophene-2-yl)quinoline-4-carboxylate (BZQ) exists as dimorphs with distinct crystal habits - blocks (BZB) and needles (BZN). The crystal forms differ in their molecular arrangements - BZB has a slip-stacked column-like structure in contrast to a zig-zag crystal packing with limited π-overlap in BZN. The BZB crystals characterized by extended π-stacking along [100] demonstrated semiconductor behavior, whereas the BZN, with its zig-zag crystal packing and limited stacking characteristics, was reckoned as an insulator. Monotropically related crystal forms also differ in their nanomechanical properties, with BZB crystals being considerably softer than BZN crystals. This discrepancy in mechanical behavior can be attributed to the distinct molecular arrangements adopted by each crystal form, resulting in unique mechanisms to relieve the strain generated during nanoindentation experiments. Waveguiding experiments on the acicular crystals of BZN revealed the passive waveguiding properties. Excitation of these crystals using a 532â nm laser confirmed the propagation of elastically scattered photons (green) and the subsequent generation of inelastically scattered (orange) photons by the crystals. Further, the dimorphs display dissimilar photoluminescence properties; they are both blue-emissive, but BZN displays twice the quantum yield of BZB. The study underscores the integral role of polymorphism in modulating the mechanical, photophysical, and conducting properties of functional molecular materials. Importantly, our findings reveal the existence of light-emitting crystal polymorphs with varying electric conductivity, a relatively scarce phenomenon in the literature.
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OBJECTIVE: Clinical decisions on managing epilepsy patients rely on patient accuracy regarding seizure reporting. Studies have noted disparities between patient-reported seizures and electroencephalographic (EEG) findings during video-EEG monitoring periods, chiefly highlighting underreporting of seizures, a well-recognized phenomenon. However, seizure overreporting is a significant problem discussed within the literature, although not in such a large cohort. Our aim is to quantify the over- and underreporting of seizures in a large cohort of ambulatory EEG patients. METHODS: We performed a retrospective data analysis on 3407 patients referred to a diagnostic service for ambulatory video-EEG between 2020 and 2022. Both patient-reported events and events discovered on review of the video-EEG were analyzed and classified as epileptic, psychogenic (typically clinical motor events, without accompanying EEG change), or noncorrelated events (NCEs; without perceivable clinical or EEG change). Events were analyzed by state of arousal and indication for referral. Subgroup analysis was performed in patients with focal and generalized epilepsies. RESULTS: A total of 21 024 events were recorded by 3407 patients. Fifty-eight percent of reported events were NCEs, whereas 27% of all events were epileptic. Sixty-four percent of epileptic seizures were not reported by the patient but discovered by the clinical service on review of the recording. NCEs were in the highest proportion in the awake and drowsy arousal states and were the most common event type for the majority of referral indications. Subgroup analysis found a significantly higher proportion of NCEs in the patients with focal epilepsy (23%) compared to generalized epilepsy (10%; p < .001, chi-squared proportion test). SIGNIFICANCE: Our results reaffirm the phenomenon of underreporting and highlight the prevalence of overreporting. Overreporting likely represents irrelevant symptoms or electrographic discharges not represented on scalp electrodes, identification of which has important clinical relevance. Future studies should analyze events by risk factors to elucidate relationships clinicians can use and investigate the etiology of NCEs.
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Electroencefalografía , Convulsiones , Humanos , Electroencefalografía/métodos , Convulsiones/diagnóstico , Convulsiones/epidemiología , Convulsiones/fisiopatología , Estudios Retrospectivos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Grabación en Video , Adulto Joven , Adolescente , Epilepsia/epidemiología , Epilepsia/diagnóstico , Epilepsia/fisiopatología , Autoinforme , Anciano , NiñoRESUMEN
Mycobacterium abscessus is an intrinsically drug-resistant, rapidly growing, nontuberculous mycobacterium; extrapulmonary infections have been reported in association with medical tourism (1). During November-December 2022, two Colorado hospitals (hospitals A and B) treated patient A, a Colorado woman aged 30-39 years, for M. abscessus meningitis. In October 2022, she had received intrathecal donor embryonic stem cell injections in Baja California, Mexico to treat multiple sclerosis and subsequently experienced headaches and fevers, consistent with meningitis. Her cerebrospinal fluid revealed neutrophilic pleocytosis and grew M. abscessus in culture at hospital A. Hospital A's physicians consulted hospital B's infectious diseases (ID) physicians to co-manage this patient (2).
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Brotes de Enfermedades , Infecciones por Mycobacterium no Tuberculosas , Mycobacterium abscessus , Humanos , Colorado/epidemiología , Adulto , Femenino , México/epidemiología , Mycobacterium abscessus/aislamiento & purificación , Infecciones por Mycobacterium no Tuberculosas/epidemiología , Arizona/epidemiología , Trasplante de Células MadreRESUMEN
Ice machines can harbor water-related organisms, and the use of ice or tap water for clinical care activities has been associated with infections in health care settings. During 2021-2022, a total of 23 cases of infection by Burkholderia multivorans (sequence type ST659) were reported at two southern California hospitals and linked to contaminated ice and water from ice machines. In addition to these 23 cases, this report also includes 23 previously unreported cases of B. multivorans ST659 infections that occurred during 2020-2024: 13 at a northern California hospital, eight at a hospital in Colorado, and two additional cases at one of the southern California hospitals. The same brand of ice machine and brands of filters, descaling, and sanitizing products were used by all four hospitals; B. multivorans was isolated from samples collected from ice machines in two of the hospitals. Whole genome sequencing indicated that all clinical and ice machine isolates were highly genetically similar (0-14 single nucleotide variant differences across 81% of the selected reference genome). Recommendations from public health officials to halt the outbreak included avoiding ice and tap water during clinical care activities. An investigation is ongoing to determine possible sources of ice machine contamination. During outbreaks of water-related organisms in health care facilities, health care personnel should consider avoiding the use of tap water, including ice and water from ice machines, for patient care.
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Infecciones por Burkholderia , Hospitales , Hielo , Humanos , California/epidemiología , Colorado/epidemiología , Hospitales/estadística & datos numéricos , Infecciones por Burkholderia/epidemiología , Microbiología del Agua , Persona de Mediana Edad , Adulto , Femenino , Masculino , Anciano , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Brotes de Enfermedades , Complejo Burkholderia cepacia/aislamiento & purificación , Adulto Joven , Adolescente , Atención al Paciente , Anciano de 80 o más Años , Niño , Contaminación de EquiposRESUMEN
BACKGROUND: Indoor lighting, exposure to outdoor daylight, physical activity and sleep interact to influence functioning, mood and cicadian rhythm. Older adults (≥ 65 years), who often spend more time at home, are less physically active and experience more sleep problems, could benefit from strategies to support behavioural change and self-managed modifications in the home. The study's primary objective was to assess the usability and feasibility of the 'Light, activity and sleep in my daily life' intervention, delivered as a web-based course. METHODS: This 9-week intervention was delivered in a municipality in Sweden (55.70° N). Participants were eight healthy women (age 71-84), community-living in one-person households. We recruited through municipal staff and posters at senior citizen meeting points. Both qualitative and quantitative data were collected before and after the intervention. The outcome measures were intervention usability (ease of use, usefulness) and study feasibility (e.g., recruitment procedure, online engagement). Measures also included changes to routines and self-managed home adjustments to determine whether the participants applied what they had learnt. RESULTS: All participants completed the intervention. Time logged in varied between 25 min and 3 h (M = 1 h 50 min) per week. Seven participants' system usability scores were between 90 and 100 ('Excellent') out of 100. When interviewed, participants reported overall high satisfaction with what they had learnt. Six participants were particularly satisfied with the modules targeting light. Seven participants made changes to their lighting or darkness conditions, such as replaced bulbs with either 3-step dimming or higher colour temperature LEDs (samples were included in the intervention test kit). One suggestion to improve the online delivery was to enable participants to add text comments to the weekly evaluation form. CONCLUSIONS: The web-based intervention was feasible to deliver but time for recruitment should be extended and advertisement in the local newspaper should be considered. Participants' computer proficiency and access to the internet at home will be critical in a future study with a larger sample. Only minor changes to the online content of the intervention are needed based on participants' feedback. The intervention will be possible to evaluate in a future pilot study.
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Estudios de Factibilidad , Intervención basada en la Internet , Humanos , Femenino , Anciano , Suecia , Anciano de 80 o más Años , Sueño , Actividades Cotidianas , Ejercicio Físico/psicología , IluminaciónRESUMEN
PURPOSE: This study sought to evaluate the impact of surgical extent on seizure outcome in drug-resistant temporal lobe epilepsy (DR-TLE) with temporal encephaloceles (TE). METHODS: This was a single-institution retrospective study of patients who underwent surgery for DR-TLE with TE between January 2008 and December 2020. The impact of surgical extent on seizure outcome was evaluated. In a subset with dominant DR-TLE, the impact of surgical extent on neuropsychometric outcome was evaluated. RESULTS: Thirty-four patients were identified (female, 56%; median age at surgery, 43 years). TE were frequently overlooked on initial magnetic resonance imaging (MRI), with encephaloceles only detected after repeat or expert re-review of MRI, additional multi-modal imaging, or intra-operatively in 31 (91%). Sixteen (47%) underwent limited resections, including encephalocele resection only (n = 5) and encephalocele resection with more extensive temporal corticectomy sparing the amygdala and hippocampus (n = 11). The remainder (n = 18, 53%) underwent standard anterior temporal lobectomy and amygdalohippocampectomy (ATLAH). Limited resection was performed more frequently on the left (12/17 vs. 4/17, p = 0.015). Twenty-seven patients (79%) had a favourable outcome (Engel I/II), and 17 (50%) were seizure-free at the last follow-up (median seizure-free survival of 27.3 months). There was no statistically significant difference in seizure-free outcomes between limited resection and ATLAH. In dominant DR-TLE, verbal memory decline was more likely after ATLAH than limited resection (3/4 vs. 0/9, p = 0.014). CONCLUSION: Expert re-review of imaging and multi-modal advanced imaging improved TE identification. There was no statistical difference in seizure-free outcomes based on surgical extent. Preservation of verbal memory supports limited resection in dominant temporal cases.
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Epilepsia Refractaria , Epilepsia del Lóbulo Temporal , Humanos , Femenino , Adulto , Epilepsia del Lóbulo Temporal/complicaciones , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Epilepsia del Lóbulo Temporal/cirugía , Encefalocele/complicaciones , Encefalocele/diagnóstico por imagen , Encefalocele/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Convulsiones/cirugía , Lobectomía Temporal Anterior/métodos , Epilepsia Refractaria/diagnóstico por imagen , Epilepsia Refractaria/cirugía , Hipocampo/diagnóstico por imagen , Hipocampo/cirugía , Imagen por Resonancia MagnéticaRESUMEN
The dissipation and residue status of a combination of fluopicolide and fosetyl-aluminium (fosetyl-Al) in citrus were evaluated in an experimental field. An efficient and sensitive liquid chromatography-tandem mass spectrometry, with rapid extraction, was carried out according to the SANTE guidelines. During the method validation, the recovery was within the range of 106.1-117.5, 94.4-115 and 85.4-109.5%, for fluopicolide, its metabolite 2,6-dichlorobenzamide and fosetyl-Al, respectively, with a relative standard deviation (RSD) of 0.3-10.6%. As a result, accuracy and precision at the spiking concentrations of 0.01, 0.05 and 0.10 mg/kg in citrus were within the acceptable range of 70-120% with an RSD of 20%. The amount of the deposits of fluopicolide, 2,6-dichlorobenzamide and fosetyl-Al was less than the limit of quantification (LOQ) at 0.01 mg/kg at 0 day, adhering to the application in standard [1.77 + 2.66 g of active ingredient (a.i.)/L] and double (3.54 + 5.32 g a.i./L) doses. The present study proposes that the utilisation of fluopicolide and fosetyl-Al in citrus and the soil may not pose a health or environmental hazard provided that good agricultural practices are followed.
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Citrus , Residuos de Plaguicidas , Aluminio/análisis , Espectrometría de Masas en Tándem/métodos , Citrus/química , Residuos de Plaguicidas/análisis , Cromatografía Liquida , Cromatografía Líquida de Alta PresiónRESUMEN
In July 2021, the Virginia Department of Health notified CDC of a cluster of eight invasive infections with Burkholderia stabilis, a bacterium in the Burkholderia cepacia complex (BCC), among hospitalized patients at hospital A. Most patients had undergone ultrasound-guided procedures during their admission. Culture of MediChoice M500812 nonsterile ultrasound gel used in hospital A revealed contamination of unopened product with B. stabilis that matched the whole genome sequencing (WGS) of B. stabilis strains found among patients. CDC and hospital A, in collaboration with partner health care facilities, state and local health departments, and the Food and Drug Administration (FDA), identified 119 B. stabilis infections in 10 U.S. states, leading to the national recall of all ultrasound gel products produced by Eco-Med Pharmaceutical (Eco-Med), the manufacturer of MediChoice M500812. Additional investigation of health care facility practices revealed frequent use of nonsterile ultrasound gel to assist with visualization in preparation for or during invasive, percutaneous procedures (e.g., intravenous catheter insertion). This practice could have allowed introduction of contaminated ultrasound gel into sterile body sites when gel and associated viable bacteria were not completely removed from skin, leading to invasive infections. This outbreak highlights the importance of appropriate use of ultrasound gel within health care settings to help prevent patient infections, including the use of only sterile, single-use ultrasound gel for ultrasonography when subsequent percutaneous procedures might be performed.
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Infecciones por Burkholderia , Brotes de Enfermedades , Contaminación de Equipos , Instituciones de Salud , Humanos , Contaminación de Medicamentos , Ultrasonografía , Estados Unidos/epidemiología , Geles , Infecciones por Burkholderia/epidemiología , Infecciones por Burkholderia/etiologíaRESUMEN
OBJECTIVE: Ictal and postictal phenomena that may impact the duration of postictal impaired awareness have not been well studied. Postictal unresponsiveness invariably occurs following bilateral tonic-clonic seizures (BTCS). Bilateral tonic-clonic seizures are a major risk factor for sudden unexpected death in epilepsy (SUDEP). We quantify the effects of seizure characteristics on postictal recovery of awareness following BTCS. Factors include: the total seizure duration, the duration of the tonic phase of a BTCS, presence of postictal generalized EEG suppression (PGES), duration of postictal tonic electromyographic discharge, peri-ictal respiratory dysfunction, patient age, duration of epilepsy, and gender. METHODS: Fifty-eight patients admitted to the epilepsy monitoring unit with BTCS were studied. Forty-one had unilateral onset temporal seizures. The remainder had bitemporal onsets, extratemporal onsets, undetermined onsets, or were generalized at onset. Following the first BTCS, time to initial recovery of awareness and its possible association with patient and seizure characteristics as well as peri-ictal respiratory dysfunction were evaluated. The presence or absence of postictal agitation was noted. RESULTS: The severity of respiratory dysfunction and seizure characteristics were not associated with time to initial recovery of awareness. A shorter time to recovery of awareness was significantly associated with a younger age (pâ¯=â¯0.007). Postictal agitation was more common in males (pâ¯=â¯0.023). SIGNIFICANCE: Focal seizures may impair awareness by active inhibition of subcortical arousal mechanisms. Focal seizures progressing to bilateral tonic-clonic seizures (BTCS) result in further widespread cerebral dysfunction impacting postictal awareness. MRI studies show accelerated brain aging in patients with temporal lobe epilepsy. Our findings suggest that patient age, as a surrogate marker for the lifetime burden of seizures, results in a progressive worsening in time to recovery after BTCS by an increasing negative impact on networks involved in arousal.
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Epilepsia del Lóbulo Temporal , Epilepsia , Muerte Súbita e Inesperada en la Epilepsia , Electroencefalografía/métodos , Epilepsia/complicaciones , Epilepsia del Lóbulo Temporal/complicaciones , Humanos , Masculino , Convulsiones/complicacionesRESUMEN
Dysregulated adenosine-to-inosine (A-to-I) RNA editing is implicated in various cancers. However, no available RNA editing inhibitors have so far been developed to inhibit cancer-associated RNA editing events. Here, we decipher the RNA secondary structure of antizyme inhibitor 1 (AZIN1), one of the best-studied A-to-I editing targets in cancer, by locating its editing site complementary sequence (ECS) at the 3' end of exon 12. Chemically modified antisense oligonucleotides (ASOs) that target the editing region of AZIN1 caused a substantial exon 11 skipping, whereas ECS-targeting ASOs effectively abolished AZIN1 editing without affecting splicing and translation. We demonstrate that complete 2'-O-methyl (2'-O-Me) sugar ring modification in combination with partial phosphorothioate (PS) backbone modification may be an optimal chemistry for editing inhibition. ASO3.2, which targets the ECS, specifically inhibits cancer cell viability in vitro and tumor incidence and growth in xenograft models. Our results demonstrate that this AZIN1-targeting, ASO-based therapeutics may be applicable to a wide range of tumor types.
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Proteínas Portadoras/genética , Marcación de Gen , Edición de ARN , Animales , Secuencia de Bases , Línea Celular Tumoral , Proliferación Celular , Supervivencia Celular/genética , Modelos Animales de Enfermedad , Exones , Regulación Neoplásica de la Expresión Génica , Marcación de Gen/métodos , Terapia Genética/métodos , Humanos , Ratones , Neoplasias/genética , Neoplasias/terapia , Oligonucleótidos Antisentido/genética , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
BACKGROUND: Until now, there is no method available for analysis of pesticide residues in complex matrices like spices. Therefore, there is an urgent need to develop and validate a QuEChERS-based method for the estimation of 104 pesticides in cumin seed. RESULTS: Samples were spiked for 109 pesticides at concentrations of 0.1, 0.5 and 1.0 mg kg-1 . Of these 104 pesticides were recovered. At 0.1, 0.5 and 0.1 mg kg-1 , recoveries ranged from 71% to 108% when compared with matrix matched standards. Seventeen pesticides showed higher or lower recoveries than acceptable range (70-120%) when quantified using solvent standards showing significant matrix effect (ME) (≥ ±20%) even after 20× dilution. However, for the other pesticides ME was significantly eliminated on dilution. The recovery percentage improved for all pesticides on quantitation with matrix matched standards when compared with solvent standards. For pesticides with lower European Union (EU) maximum residue limits (MRLs), an experiment at lower spiking concentrations of 0.01 and 0.05 mg kg-1 with lower dilutions (8×) reveals that almost all pesticides with lower EU MRLs (0.02 and 0.05 mg kg-1 ) showed recoveries in the range 74-124% and relative standard deviation (RSD) less than 20%. CONCLUSION: Theoretical limit of quantitation (LOQ) is proposed which ranged from 0.01 to 0.18 mg kg-1 for matrix matched standards. An LOQ of 0.01 mg kg-1 was easily achieved for the pesticides with lower EU MRLs with lower dilutions (8×) with exception of fipronil for which this can be achieved without dilution provided matrix matched standards are used. The method can be extended to other spices. © 2021 Society of Chemical Industry.
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Cuminum , Residuos de Plaguicidas , Plaguicidas , Cromatografía Liquida/métodos , Residuos de Plaguicidas/análisis , Plaguicidas/análisis , Extracción en Fase Sólida/métodos , Espectrometría de Masas en Tándem/métodos , TemperaturaRESUMEN
CONTEXT: The Centers for Disease Control and Prevention awarded $85 million to health care-associated infection and antibiotic resistance (HAI/AR) programs in March 2015 as part of Infection Control Assessment and Response (ICAR) activities in the Epidemiology and Laboratory Capacity cooperative agreement Domestic Ebola Supplement. PROGRAM: One goal of this funding was to assess and improve program capacity to respond to potential health care outbreaks (eg, HAI clusters). All 55 funded programs (in 49 state and 6 local health departments) participated. IMPLEMENTATION: The Centers for Disease Control and Prevention developed guidance and tools for HAI/AR programs to document relevant response capacities, assess policies, and measure progress. HAI/AR programs completed an interim assessment in 2016 and a final progress report in 2017. EVALUATION: During the project period, 78% (n = 43) of the programs developed new investigation tools, 85% (n = 47) trained staff on outbreak response, and 96% (n = 53) of the programs reported hiring staff to assist with outbreak response activities. Staffing and expertise to support HAI outbreak response increased substantially among awardees reporting staffing limitations on the interim assessment, including in domains such as on-site infection control assessment (n = 20; 83%), laboratory capacity (n = 20; 91%), and data management/analytics (n = 14; 67%). By 2017, reporting requirements in 100% of the programs addressed possible HAI/AR outbreaks; 93% (n = 51) also addressed sentinel events such as identification of novel AR threats. More than 90% (n = 50) of programs enhanced capacities for tracking response activities; in 2016, these systems captured 6665 events (range, 3-1379; median = 46). Health departments also reported wide-ranging efforts to engage regulatory, public health, and health care partners to improve HAI/AR outbreak reporting and investigation. DISCUSSION: Broad capacity for responding to HAI/AR outbreaks was enhanced using Ebola ICAR supplemental funding. As response activities expand, health department programs will be challenged to continue building expertise, reporting infrastructure, investigation resources, and effective relations with health care partners.
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Infección Hospitalaria , Fiebre Hemorrágica Ebola , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Atención a la Salud , Brotes de Enfermedades/prevención & control , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Salud Pública , Estados Unidos/epidemiologíaRESUMEN
CONTEXT: Between April 2020 and May 2021, the Centers for Disease Control and Prevention (CDC) awarded more than $40 billion to health departments nationwide for COVID-19 prevention and response activities. One of the identified priorities for this investment was improving infection prevention and control (IPC) in nursing homes. PROGRAM: CDC developed a virtual course to train new and less experienced public health staff in core healthcare IPC principles and in the application of CDC COVID-19 healthcare IPC guidance for nursing homes. IMPLEMENTATION: From October 2020 to August 2021, the CDC led training sessions for 12 cohorts of public health staff using pretraining reading materials, case-based scenarios, didactic presentations, peer-learning opportunities, and subject matter expert-led discussions. Multiple electronic assessments were distributed to learners over time to measure changes in self-reported knowledge and confidence and to collect feedback on the course. Participating public health programs were also assessed to measure overall course impact. EVALUATION: Among 182 enrolled learners, 94% completed the training. Most learners were infection preventionists (42%) or epidemiologists (38%), had less than 1 year of experience in their health department role (75%), and had less than 1 year of subject matter experience (54%). After training, learners reported increased knowledge and confidence in applying the CDC COVID-19 healthcare IPC guidance for nursing homes (≥81%) with the greatest increase in performing COVID-19 IPC consultations and assessments (87%). The majority of participating programs agreed that the course provided an overall benefit (88%) and reduced training burden (72%). DISCUSSION: The CDC's virtual course was effective in increasing public health capacity for COVID-19 healthcare IPC in nursing homes and provides a possible model to increase IPC capacity for other infectious diseases and other healthcare settings. Future virtual healthcare IPC courses could be enhanced by tailoring materials to health department needs, reinforcing training through applied learning experiences, and supporting mechanisms to retain trained staff.
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COVID-19 , COVID-19/epidemiología , COVID-19/prevención & control , Personal de Salud/educación , Humanos , Control de Infecciones , Casas de Salud , Salud PúblicaRESUMEN
BACKGROUND: Military personnel and frontline emergency workers may be exposed to events that have the potential to precipitate negative mental health outcomes such as depression, symptoms of post-traumatic stress and even post-traumatic stress disorder (PTSD). Programmes have been designed to build psychological resilience before staff are deployed into the field. This review presents a synthesis of the literature on these "pre-deployment resilience-building programmes". OBJECTIVES: The objective of this review was to assess the effectiveness of programmes that seek to build resilience to potentially traumatic events among military and frontline emergency service personnel prior to their deployment. These resilience programmes were compared to other interventions, treatment as usual or no intervention. SEARCH METHODS: Studies were identified through searches of electronic databases including Ovid MEDLINE, Embase, PsycINFO, Web of Science and Google Scholar. The initial search took place in January 2019, with an updated search completed at the end of September 2020. SELECTION CRITERIA: Only studies that used a randomised controlled trial (RCT)/cluster-RCT methodology were included. The programmes being evaluated must have sought to build resilience prior to exposure to trauma. Study participants must have been 18 years or older and be military personnel or frontline emergency workers. DATA COLLECTION AND ANALYSIS: Studies that met the inclusion criteria were assembled. Data extracted included methods, participants' details, intervention details, comparator details, and information on outcomes. The primary outcomes of interest were resilience, symptoms of post-traumatic stress and PTSD. Secondary outcomes of interest included acute stress disorder, depression, social support, coping skills, emotional flexibility, self-efficacy, social functioning, subjective levels of aggression, quality of sleep, quality of life and stress. Assessment of risk of bias was also completed. A total of 28 studies were included in a narrative synthesis of results. MAIN RESULTS: All 28 included studies compared an experimental resilience building intervention versus a control or no intervention. There was a wide range of therapeutic modalities used, including cognitive behavioural therapy (CBT) informed programmes, biofeedback based programmes, stress-management programmes, mindfulness and relaxation programmes, neuropsychological-based programmes, and psychoeducational-informed programmes. The main outcomes are specified here, secondary outcomes such as depression, social support, coping skills, self-efficacy, subjective levels of aggression and stress are reported in text. No studies reported on the following pre-specified outcomes; acute stress disorder, emotional flexibility, social functioning, quality of sleep and quality of life. Resilience Eight studies reported resilience as an outcome. We narratively synthesised the data from these studies and our findings show that five of these interventions had success in building resilience in their respective samples. Two of the studies that reported significant results utilised a CBT approach to build resilience, while the other three successful programmes were mindfulness-based interventions. Symptoms of post-traumatic stress Our narrative synthesis of results included eight studies. Two of the eight studies produced significant reductions in symptoms of post traumatic stress compared to controls. These interventions used neuropsychological and biofeedback intervention models respectively. PTSD caseness Four studies reported PTSD caseness as an outcome. Our narrative synthesis of results suggests that evidence is mixed as to the effectiveness of these interventions in reducing clinical diagnosis of PTSD. One study of a neuropsychology-orientated Attention Bias Modification Training (AMBT) programme had success in reducing both symptoms of post-traumatic stress and numbers of participants receiving a diagnosis of PTSD. A stress-management programme reported that, when baseline differences in rates of pre-deployment mental health issues were controlled for, participants in the control condition were at 6.9 times the risk of a diagnosis of PTSD when compared to the intervention group. Given the diversity of intervention designs and theoretical orientations used (which included stress-management, neuropsychological and psychoeducational programmes), a definitive statement on the efficacy of pre-deployment programmes at reducing symptoms of post-traumatic stress and PTSD cannot be confidently offered. AUTHORS' CONCLUSIONS: While a number of evaluations of relevant programmes have been published, the quality of these evaluations limits our ability to determine if resilience-building programmes 'work' in terms of preventing negative outcomes such as depression, symptoms of post-traumatic stress and diagnoses of PTSD. Based on our findings we recommend that future research should: a) report pre-/post-means and standard deviation scores for scales used within respective studies, b) take the form of large, RCTs with protocols published in advance, and c) seek to measure defined psychological facets such as resilience, PTSD and stress, and measure these concepts using established psychometric tools. This will provide more certainty in future assessments of the evidence base. From a clinical implications point of view, overall there is mixed evidence that the interventions included in this review are effective at safe guarding military personnel or frontline emergency workers from experiencing negative mental health outcomes, including PTSD, following exposure to potentially traumatic events. Based on this, practitioners seeking to build resilience in their personnel need to be aware of the limitations of the evidence base. Practitioners should have modest expectations in relation to the efficacy of resilience-building programmes as a prophylactic approach to employment-related critical incident traumas.
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Terapia Cognitivo-Conductual , Personal Militar , Atención Plena , Resiliencia Psicológica , Trastornos por Estrés Postraumático , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/prevención & controlRESUMEN
The coronavirus disease 2019 (COVID-19), which became a global pandemic by March 2020, forced almost all countries over the world to impose the lockdown as a measure of social distancing to control the spread of infection. India also strictly implemented a countrywide lockdown, starting from 24 March to 12 May 2020. This measure resulted in the reduction of the sources of air pollution in general: industrial, commercial, and vehicular pollution in particular, with visible improvement in ambient air quality. In this study, the impact of COVID-19 lockdown on the ambient concentration of air pollutants over the city of Bangalore (India) is assessed using Continuous Ambient Air Quality Measurement (CAAQM) data from 10 monitoring stations spread across the city. The data was obtained from Central Pollution Control Board (CPCB) and Karnataka State Pollution Control Board (KSPCB). The analysis of the relative changes in the ambient concentration of six major air pollutants (NO, NO2, NOX, PM2.5, O3, and SO2) has been carried out for two periods: March-May 2020 (COVID-19 lockdown) and the corresponding period of 2019 during when there was no lockdown. The analysis revealed significant reduction in the concentration of ambient air pollutants at both daily and monthly intervals. This can be attributed to the reduction in sources of emission; vehicular traffic, industrial, and other activities. The average reduction in the concentration of NO, NO2, NOX, PM2.5, and O3 between 01 March and 12 May 2020 was found to be 63%, 48%, 48%, 18%, and 23% respectively when compared to the same period in 2019. Similarly, the comparative analysis of pollutant concentrations between pre-lockdown (01-23 March 2020) and lockdown (24 March-12 May 2020) periods has shown a huge reduction in the ambient concentration of air pollutants, 47.3% (NO), 49% (NO2), 49% (NOX), 10% (SO2), 37.7% (PM2.5), and 15.6% (O3), resulting in improved air quality over Bangalore during the COVID-19 lockdown period. It is shown that the strict lockdown resulted in a significant reduction in the pollution levels. Such lockdowns may be useful as emergency intervention strategies to control air pollution in megacities when ambient air quality deteriorates dangerously.
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Contaminantes Atmosféricos , Contaminación del Aire , COVID-19 , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Ciudades , Control de Enfermedades Transmisibles , Monitoreo del Ambiente , Humanos , India , Material Particulado/análisis , SARS-CoV-2RESUMEN
AIM: Aim of the present research was to investigate the effectiveness of various fluoride-releasing dental restorative agents in preventing demineralization of enamel. MATERIALS AND METHODS: Eighty human mandibular permanent molar teeth constituted the study group. All samples were subjected to storage in thymol, after which they were taken out to prepare alike proximal box in each. Inductions of artificial enamel surface lesions were done by placing the teeth in demineralizing solution for 96 hours. Subsequently, all 80 molars were randomly assigned to any of the four groups (i.e., 20 in every individual group) according to the restoration as group A: giomer (composite resin containing surface pre-reacted glass-ionomer fillers), group B: compomer (polyacid-modified composite resin), group C: resin-modified glass-ionomer cement (RMGIC), group D: fluoride-releasing composite. After this, the pH cycling was performed, and the samples were subjected to examination beneath scanning electron microscope (SEM). RESULTS: Higher mean areas of remineralization were noted when RMGIC (96.34 ± 0.06) was used followed by the compomer (109.52 ± 0.17), giomer (118.39 ± 0.82), and the fluoride-releasing composite group (129.27 ± 0.31) in that order. A statistically significant difference was seen amid the investigational groups that utilized different restorative agents (p <0.001). A pairwise evaluation that was performed revealed that except for the giomer group and the compomer group, a statistically significant difference (p <0.001) was found among the experimental groups. CONCLUSION: This research infers that the RMGIC-treated samples exhibited significantly superior performance in preventing enamel demineralization in comparison to compomer, giomer as well as fluoride-releasing composites. CLINICAL SIGNIFICANCE: One among the highly frequently employed anticariogenic materials is fluorides. Owing to this characteristic, they are integrated into numerous restorative substances. Nevertheless, the quantity and speed of fluoride release differ in different agents, which translates to the efficacy of the restorative agent in avoiding demineralization about the restoration.
Asunto(s)
Fluoruros , Desmineralización Dental , Esmalte Dental/patología , Fluoruros/uso terapéutico , Cementos de Ionómero Vítreo/química , Cementos de Ionómero Vítreo/uso terapéutico , Humanos , Microscopía Electrónica de Rastreo , Desmineralización Dental/prevención & controlRESUMEN
On February 26, 2020, the first U.S. case of community-acquired coronavirus disease 2019 (COVID-19) was confirmed in a patient hospitalized in Solano County, California (1). The patient was initially evaluated at hospital A on February 15; at that time, COVID-19 was not suspected, as the patient denied travel or contact with symptomatic persons. During a 4-day hospitalization, the patient was managed with standard precautions and underwent multiple aerosol-generating procedures (AGPs), including nebulizer treatments, bilevel positive airway pressure (BiPAP) ventilation, endotracheal intubation, and bronchoscopy. Several days after the patient's transfer to hospital B, a real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test for SARS-CoV-2 returned positive. Among 121 hospital A health care personnel (HCP) who were exposed to the patient, 43 (35.5%) developed symptoms during the 14 days after exposure and were tested for SARS-CoV-2; three had positive test results and were among the first known cases of probable occupational transmission of SARS-CoV-2 to HCP in the United States. Little is known about specific risk factors for SARS-CoV-2 transmission in health care settings. To better characterize and compare exposures among HCP who did and did not develop COVID-19, standardized interviews were conducted with 37 hospital A HCP who were tested for SARS-CoV-2, including the three who had positive test results. Performing physical examinations and exposure to the patient during nebulizer treatments were more common among HCP with laboratory-confirmed COVID-19 than among those without COVID-19; HCP with COVID-19 also had exposures of longer duration to the patient. Because transmission-based precautions were not in use, no HCP wore personal protective equipment (PPE) recommended for COVID-19 patient care during contact with the index patient. Health care facilities should emphasize early recognition and isolation of patients with possible COVID-19 and use of recommended PPE to minimize unprotected, high-risk HCP exposures and protect the health care workforce.
Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Personal de Hospital , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Adulto , COVID-19 , California/epidemiología , Infecciones por Coronavirus/epidemiología , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional , Pandemias , Equipo de Protección Personal/estadística & datos numéricos , Personal de Hospital/estadística & datos numéricos , Neumonía Viral/epidemiología , Medición de Riesgo , SARS-CoV-2RESUMEN
Double-stranded RNA (dsRNA) structures form triplexes and RNA-protein complexes through binding to single-stranded RNA (ssRNA) regions and proteins, respectively, for diverse biological functions. Hence, targeting dsRNAs through major-groove triplex formation is a promising strategy for the development of chemical probes and potential therapeutics. Short (e.g., 6-10 mer) chemically-modified Peptide Nucleic Acids (PNAs) have been developed that bind to dsRNAs sequence specifically at physiological conditions. For example, a PNA incorporating a modified base thio-pseudoisocytosine (L) has an enhanced recognition of a G-C pair in an RNA duplex through major-groove L·G-C base triple formation at physiological pH, with reduced pH dependence as observed for C+·G-C base triple formation. Currently, an unmodified T base is often incorporated into PNAs to recognize a Watson-Crick A-U pair through major-groove T·A-U base triple formation. A substitution of the 5-methyl group in T by hydrogen and halogen atoms (F, Cl, Br, and I) causes a decrease of the pKa of N3 nitrogen atom, which may result in improved hydrogen bonding in addition to enhanced base stacking interactions. Here, we synthesized a series of PNAs incorporating uracil and halouracils, followed by binding studies by non-denaturing polyacrylamide gel electrophoresis, circular dichroism, and thermal melting. Our results suggest that replacing T with uracil and halouracils may enhance the recognition of an A-U pair by PNA·RNA2 triplex formation in a sequence-dependent manner, underscoring the importance of local stacking interactions. Incorporating bromouracils and chlorouracils into a PNA results in a significantly reduced pH dependence of triplex formation even for PNAs containing C bases, likely due to an upshift of the apparent pKa of N3 atoms of C bases. Thus, halogenation and other chemical modifications may be utilized to enhance hydrogen bonding of the adjacent base triples and thus triplex formation. Furthermore, our experimental and computational modelling data suggest that PNA·RNA2 triplexes may be stabilized by incorporating a BrUL step but not an LBrU step, in dsRNA-binding PNAs.
Asunto(s)
Emparejamiento Base/genética , Halógenos/química , Conformación de Ácido Nucleico , Ácidos Nucleicos de Péptidos/química , ARN Bicatenario/síntesis química , Uracilo/análogos & derivados , Uracilo/química , Bromouracilo/química , Línea Celular Tumoral , Biología Computacional/métodos , Simulación por Computador , Halogenación , Células HeLa , Humanos , Enlace de Hidrógeno , Secuencias Invertidas Repetidas/genética , MicroARNs/genética , Proteínas de Unión al ARN/químicaRESUMEN
Falcine sinus is a normal midline embryonic venous sinus present in the fetal brain and usually disappears by birth. Persistent falcine sinus (PFS) has been reported as a normal variant or along with vein of Galen (VOG) malformation, encephalocele, and other abnormalities. Schizencephaly, either closed or open type, has been reported with other associated vascular anomalies. We report a 22-month-old child, who presented with delayed milestones and referred for magnetic resonance (MR) imaging, and the child was found to have PFS with associated bilateral temporo-occipital closed-lip schizencephaly, hippocampal abnormalities, falco-tentorial dehiscence, and white matter abnormalities. The vein of Galen and straight sinus were absent, and the internal cerebral veins were seen draining into superior sagittal sinus via the falcine sinus. These set of abnormalities are unique from abnormalities reported previously in association with the falcine sinus.
Asunto(s)
Venas Cerebrales , Senos Craneales , Esquizencefalia , Venas Cerebrales/anomalías , Venas Cerebrales/diagnóstico por imagen , Niño , Senos Craneales/anomalías , Senos Craneales/diagnóstico por imagen , Humanos , Lactante , Imagen por Resonancia Magnética , MasculinoRESUMEN
The two element chimney model with nonlinearity is studied with the aim of modeling the swaying of trees at high wind speeds. We found solutions for various parameters and also the Lyapunov spectrum numerically. The system is chaotic for a wide range of parameters. We also observed hyperchaos in a subregion of this parameter space. We noticed that the hyperchaos was suppressed when the largest Lyapunov exponent crossed a threshold value. Synchronization between the lower and the upper segments was also studied and, for some parameters, phase synchronization is observed. We also observed transition to antisynchronization and also toggling between the two as the parameters are varied.