The Role of Monocyte to High-density Lipoprotein Cholesterol Ratio in Predicting the Severity of Acute Ischemic Stroke and its Association with the NIHSS.

BACKGROUND: Atherosclerosis, an underlying abnormality, plays a significant role in the progression of ischemic stroke. Inflammation, oxidative stress, platelet activation, endothelial dysfunction, and lipid abnormalities are the primary factors involved in the development of atherosclerosis. Monocytes, key contributors to chronic inflammation, actively participate in the development, progression, and rupture of atherosclerotic plaques within blood vessels. Therefore, the objective of this study is to investigate the monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) in acute ischemic stroke (AIS) and its correlation with the National Institute of Health Stroke Scale (NIHSS) to predict the severity of the condition. MATERIALS AND METHODS: A prospective observational study was conducted on 100 AIS patients and age/gender-matched controls at a hospital in Kota. Diagnostic methods included clinical examination, imaging, and laboratory tests. MHR was measured using a hematology analyzer and correlated with reference values and stroke severity. RESULTS: The mean MHR of AIS patients were higher (14.12 ± 2.95) than controls (7.09 ± 1.48) (p = 0.0001). Besides, a statistically significant positive correlation was obtained between his MHR and NIHSS scores at admission and discharge. MHR values were significantly greater from a reference point in patients who deteriorated (18.48 ± 4.02) compared to significantly lower values in patients who improved (13.66 ± 2.44). CONCLUSION: In our study, the MHR shows an increased value in patients with AIS, and a linear correlation is found with the NIHSS score. Thus, the method is a pocket-friendly, easily available, and simple-to-use novel inflammatory marker that may predict the severity of a disease.

The Role of Absolute Eosinophil Count as a Diagnostic and Prognostic Marker for Sepsis and Its Relation with Sequential Organ Failure Assessment/Quick Sequential Organ Failure Assessment Score.

AIMS AND BACKGROUND: Sepsis is a dysregulated host response to an infection that causes organ failure that poses a serious risk to life. Although culture results are not always available right away and the majority of patients continue to test culture negative, microbial culture is still the gold standard for diagnosing sepsis. Therefore, the objective of the current study was to assess absolute eosinophil count as a new marker for diagnosing sepsis and also to assess the prognosis of the patient in relation to Sequential Organ Failure Assessment (SOFA)/quick Sequential Organ Failure Assessment (qSOFA) score. Resources and procedures: In this cross-sectional study, 100 patients with sepsis were enrolled. The other 100 patients without any evidence of sepsis were taken as controls. Absolute eosinophil count (AEC), SOFA/qSOFA scores of all the patients were measured on the 1st, 3rd, and 7th day and data was analyzed statistically. RESULTS: The mean AEC on admission day in sepsis patients was 49.5. The mean AEC among survivors was >50 and nonsurvivors was <50. AEC and SOFA/qSOFA scores exhibit a statistically significant and inverse correlation on the 1st, 3rd, and 7th day of illness. CONCLUSION: Absolute eosinophil count (AEC) is a simple and cost-effective marker that may be helpful in diagnosis as well as in predicting the prognosis of sepsis as evidenced by its linear inverse correlation with SOFA/qSOFA score.

Paul trapping of charged particles in aqueous solution.

We experimentally demonstrate the feasibility of an aqueous Paul trap using a proof-of-principle planar device. Radio frequency voltages are used to generate an alternating focusing/defocusing potential well in two orthogonal directions. Individual charged particles are dynamically confined into nanometer scale in space. Compared with conventional Paul traps working in frictionless vacuum, the aqueous environment associated with damping forces and thermally induced fluctuations (Brownian noise) exerts a fundamental influence on the underlying physics. We investigate the impact of these two effects on the confining dynamics, with the aim to reduce the rms value of the positional fluctuations. We find that the rms fluctuations can be modulated by adjusting the voltages and frequencies. This technique provides an alternative for the localization and control of charged particles in an aqueous environment.

A long DNA segment in a linear nanoscale Paul trap.

We study the dynamics of a linearly distributed line charge such as single stranded DNA (ssDNA) in a nanoscale, linear 2D Paul trap in vacuum. Using molecular dynamics simulations we show that a line charge can be trapped effectively in the trap for a well defined range of stability parameters. We investigated (i) a flexible bonded string of charged beads and (ii) a ssDNA polymer of variable length, for various trap parameters. A line charge undergoes oscillations or rotations as it moves, depending on its initial angle, the position of the center of mass and the velocity. The stability region for a strongly bonded line of charged beads is similar to that of a single ion with the same charge to mass ratio. Single stranded DNA as long as 40 nm does not fold or curl in the Paul trap, but could undergo rotations about the center of mass. However, we show that a stretching field in the axial direction can effectively prevent the rotations and increase the confinement stability.

Effect of cross-linking on the diffusion of water, ions, and small molecules in hydrogels.

The present study reports on molecular dynamics investigations of chemically cross-linked poly(ethylene glycol) hydrogels with the aim of exploring the diffusion properties of water, ions, and rhodamine within the polymer at the molecular level. The water structure and diffusion properties were studied at various cross-linking densities with molecular weights of the chains ranging from 572 to 3400. As the cross-linking density is increased, the water diffusion decreases and the slowdown in diffusion is more severe at the polymer-water interface. The water diffusion at various cross-linking densities is correlated with the water hydrogen bonding dynamics. The diffusion of ions and rhodamine also decreased as the cross-linking density is increased. The variation of diffusion coefficient with cross-linking density is related to the variation of water content at different cross-linking densities. Comparison of simulation results and obstruction scaling theory for hydrogels showed similar trends.

Exploración de las vías biliares como tratamiento de la litiasis coledociana: manejo laparoscópico vs. convencional. Estudio prospectivo y comparativo / Common bile duct exploration as treatment of choledocal lithiasis: laparoscopic vs conventional approach. Prospective and comparative study

La litiasis coledociana es una complicación poco frecuente asociada a la litiasis vesicular. Puede ser resuelta mediante colangiopancreatografía retrógrada endoscópica (CPRE) o en su defecto, una exploración de las vías biliares por abordaje convencional (cirugía abierta) o laparoscópico. Objetivos: Determinar la efectividad del abordaje laparoscópico versus el convencional en la exploración de las vías biliares como tratamiento de la litiasis coledociana. Métodos : Se realizó un estudio prospectivo y comparativo con una muestra de 31 pacientes con litiasis coledociana seleccionados de manera no aleatoria. Resultados : Ambos grupos fueron comparables en edad, sexo, frecuencia de litiasis vesicular y CPRE preoperatoria. El tiempo quirúrgico promedio fue 4,52 versus 3,49 horas para los abordajes laparoscópico y convencional respectivamente. En el grupo laparoscópico se usó tubo de Kehr en 21% de los pacientes y en 79 % sutura primaria. En el grupo convencional se usó tubo de Kehr en 29% de los pacientes y en 71 % sutura primaria. La fuga biliar fue la complicación más frecuente. La estancia hospitalaria fue 3,14 días en el grupo laparoscópico versus 5,23 días en el grupo convencional, sin diferencia estadísticamente significativa. Conclusión : No se logró demostrar una superioridad evidente de alguno de los grupos estudiados, sin embargo nuestros pacientes podrían beneficiarse de las ventajas del abordaje laparoscópico en términos de tener menor dolor postoperatorio y una reincorporación más rápida a sus actividades habituales. Estudios similares con mayor número de casos son necesarios para llegar a datos más concluyentes(AU)

Common bile duct (CBD) lithiasis are an unusual complication associated to gallbladder stones. It can be resolved by endoscopic retrograde cholangiopancreatography (ERCP) or, alternatively, a CBD exploration by conventional (open surgery) or laparoscopic approach.Objectives : To determine the effectiveness of laparoscopic approach versus conventional approach in CBD exploration as a treatment for choledochal lithiasis.Methods : A prospective and comparative study was carried out with a non-random intentionally selected sample consisting of 31 patients with CBD stones.Results : Both groups had no statistical differences regarding age, sex, frequency of gallbladder stones, and preoperatory ERCP. The average surgical time was 4.52 versus 3.49 hours for the laparoscopic and conventional approaches, respectively. In laparoscopic group, Kehr tube was used in 21% of patients and primary closure in 79%. In conventional group, Kehr tube was used in 29% of patients versus 71% of patients with primary closure. Biliary leak was the most frequent complication. Hospital stay was 3.14 days in the laparoscopic group versus 5.23 days in the conventional group, with no statistically significant difference.Conclusion : It was not possible to demonstrate an evident superiority of any of the groups studied, however our patients could benefit from the advantages of the laparoscopic approach in terms of less postoperative pain and faster return to their usual activities. Similar and larger studies are necessary to achieve stronger and conclusive data(AU)

Water-soluble nitric-oxide-releasing acetylsalicylic acid (ASA) prodrugs.

A series of water-soluble (benzoyloxy)methyl esters of acetylsalicylic acid (ASA), commonly known as aspirin, are described. The new derivatives each have alkyl chains containing a nitric oxide (NO)-releasing nitrooxy group and a solubilizing moiety bonded to the benzoyl ring. The compounds were synthesized and evaluated as ASA prodrugs. After conversion to the appropriate salt, most of the derivatives are solid at room temperature and all possess good water solubility. They are quite stable in acid solution (pH 1) and less stable at physiological pH. In human serum, these compounds are immediately metabolized by esterases, producing a mixture of ASA, salicylic acid (SA), and of the related NO-donor benzoic acids, along with other minor products. Due to ASA release, the prodrugs are capable of inhibiting collagen-induced platelet aggregation of human platelet-rich plasma. Simple NO-donor benzoic acids 3-hydroxy-4-(3-nitrooxypropoxy)benzoic acid (28) and 3-(morpholin-4-ylmethyl)-4-[3-(nitrooxy)propoxy]benzoic acid (48) were also studied as representative models of the whole class of benzoic acids formed following metabolism of the prodrugs in serum. These simplified derivatives did not trigger antiaggregatory activity when tested at 300 µM. Only 28 displays quite potent NO-dependent vasodilatatory action. Further in vivo evaluation of two selected prodrugs, {[2-(acetyloxy)benzoyl]oxy}methyl-3-[(3-[aminopropanoyl)oxy]-4-[3-(nitrooxy)propoxy]benzoate⋅HCl (38) and {[2-(acetyloxy)benzoyl]oxy}methyl 3-(morpholin-4-ylmethyl)-4-[3-(nitrooxy)propoxy]benzoate oxalate (49), revealed that their anti-inflammatory activities are similar to that of ASA when tested in the carrageenan-induced paw edema assay in rats. The gastrotoxicity of the two prodrugs was also determined to be lower than that of ASA in a lesion model in rats. Taken together, these results indicated that these NO-donor ASA prodrugs warrant further investigation for clinical application.

New nitric oxide or hydrogen sulfide releasing aspirins.

A new series of (((R-oxy)carbonyl)oxy)methyl esters of aspirin (ASA), bearing nitric oxide (NO) or hydrogen sulfide (H(2)S) releasing groups, was synthesized, and the compounds were evaluated as new ASA co-drugs. All the products were quite stable in buffered solution at pH 1 and 7.4. Conversely, they were all rapidly metabolized, producing ASA and the NO/H(2)S releasing moiety used for their preparation. Consequent on ASA release, the compounds were capable of inhibiting collagen-induced platelet aggregation of human platelet-rich plasma (PRP). The simple NO/H(2)S donor substructures were able to relax contracted rat aorta strips, with a NO- and H(2)S-dependent mechanism, respectively, but they either did not trigger antiaggregatory activity or displayed antiplatelet potency markedly below that of the related co-drug. The new products might provide a safer and improved alternative to the use of ASA principally in its anti-inflammatory and antithrombotic applications.

Translocation of single-stranded DNA through single-walled carbon nanotubes.

We report the fabrication of devices in which one single-walled carbon nanotube spans a barrier between two fluid reservoirs, enabling direct electrical measurement of ion transport through the tube. A fraction of the tubes pass anomalously high ionic currents. Electrophoretic transport of small single-stranded DNA oligomers through these tubes is marked by large transient increases in ion current and was confirmed by polymerase chain reaction analysis. Each current pulse contains about 10(7) charges, an enormous amplification of the translocated charge. Carbon nanotubes simplify the construction of nanopores, permit new types of electrical measurements, and may open avenues for control of DNA translocation.

Why are carbon nanotubes fast transporters of water?

Extraordinarily fast transport of water in carbon nanotubes (CNTs) in recent experiments has been generally attributed to the smoothness of the CNT surface. Using molecular dynamics simulations we investigate water flow in (16,16) CNTs and show that the enhanced flow rates over Hagen-Poiseuille flow arise from a velocity "jump" in a depletion region at the water nanotube interface and that the water orientations and hydrogen bonding at the interface significantly affect the flow rates. For nanotube with the same smooth wall structure but with more hydrophilic Lennard-Jones (LJ) parameters of silicon, the enhancement is greatly reduced because it does not have "free" OH bonds pointing to the wall as in CNTs that would reduce the number of hydrogen bonds in the depletion layer. Roughness in the tube walls causes strong hydrogen-bonding network and no significant flow enhancement is attained in rough tubes.

Pumping of confined water in carbon nanotubes by rotation-translation coupling.

Bidirectional single file water transport in a carbon nanotube is known to occur in "bursts" in short nanotubes. Here we show that in long carbon nanotubes, when the orientation of the water molecules is maintained along one direction, a net water transport along that direction can be attained due to coupling between rotational and translational motions. The rotations of the water molecules are correlated more with the translation of the neighboring water molecule with the acceptor oxygen than the neighbor with the donor hydrogen. This mechanism can be used to pump water through nanotubes.

Induced electrokinetic transport in micro-nanofluidic interconnect devices.

Hybrid micro-nanofluidic interconnect devices can be used to control analyte transfer from one microchannel to the other through a nanochannel under rest, injection, and recovery stages of operation by varying the applied potential bias. Using numerical simulations based on coupled transient Poisson-Nernst-Planck and Stokes equations, we examine the electrokinetic transport in a gateable device consisting of two 100 microm long, 1 microm wide negatively charged microchannels connected by a 1 microm long, 10 nm wide positively charged nanochannel under both positive and negative bias potentials. During injection, accumulation of ions is observed at the micro-nano interface region with the positive potential and depletion of ions is observed at the other micro-nano junction region. Net space charge in the depletion region gives rise to nonlinear electrokinetic transport during the recovery stage due to induced pressure, induced electroosmotic flow of the second kind, and complex flow circulations. Ionic currents are computed as a function of time for both positive and negative bias potentials for the three stages. Analytical expressions derived for ion current variation are in agreement with the simulated results. In the presence of multiple accumulation or depletion regions, we show that a hybrid micro-nano device can be designed to function as a logic gate.

Hierarchical multiscale simulation of electrokinetic transport in silica nanochannels at the point of zero charge.

Effects of nanoscale confinement and partial charges that stem from quantum calculations are investigated in silica slit channels filled with 1 M KCl at the point of zero charge by using a hierarchical multiscale simulation methodology. Partial charges of both bulk and surface atoms from ab initio quantum calculations that take into account bond polarization and electronegativity are used in molecular dynamics (MD) simulations to obtain ion and water concentration profiles for channel widths of 1.1, 2.1, 2.75, and 4.1 nm. The interfacial electron density profiles of simulations matched well with that of recent X-ray reflectivity experiments. By simulating corresponding channels with no partial charges, it was observed that the partial charges affect the concentration profiles and transport properties such as diffusion coefficients and mobilities up to a distance of about 3 sigma(O)(-)(O) from the surface. Both in uncharged and partially charged cases, oscillations in concentration profiles of K(+) and Cl(-) ions give rise to an electro-osmotic flow in the presence of an external electric field, indicating the presence of an electric double layer at net zero surface charge, contrary to the expectations from classical continuum theory. I-V curves in a channel-bath system using ionic mobilities from MD simulations were significantly different for channels with and without partial charges for channel widths less than 4.1 nm.

Effect of quantum partial charges on the structure and dynamics of water in single-walled carbon nanotubes.

In this work, using quantum partial charges, computed from 6-31G(**)B3LYP density functional theory, in molecular dynamics simulations, we found that water inside (6,6) and (10,0) single-walled carbon nanotubes with similar diameters but with different chiralities has remarkably different structural and dynamical properties. Density functional calculations indicate that tubes with different chiralities have significantly different partial charges at the ends of tubes. The partial charges at the ends of a (10,0) tube are around 4.5 times higher than those of a (6,6) tube. Molecular dynamics simulations with the partial charges show different water dipole orientations. In the (10,0) tube, dipole vectors of water molecules at the end of the tube point towards the water reservoir resulting in the formation of an L defect in the center region. This is not observed in the (6,6) tube where dipole vectors of all the water molecules inside the tube point towards either the top or the bottom water reservoir. The water diffusion coefficient is found to increase in the presence of the partial charges. Water in the partially charged (10,0) tube has a lower diffusion coefficient compared to that of in the partially charged (6,6) tube.