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Registry data on invasive cervical cancers (n = 1,274) from four major hospitals (1984-2012) were analysed to determine their value for informing local service delivery in Australia. The methodology comprised disease-specific survival analyses using Kaplan-Meier product-limit estimates and Cox proportional hazards models and treatment analyses using logistic regression. Five- and 10-year survivals were 72% and 68%, respectively, equating with relative survival estimates for Australia and the USA. Most common treatments were surgery and radiotherapy. Systemic therapies increased in recent years, generally with radiotherapy, but were less common for residents from less accessible areas. Surgery was more common for younger women and early-stage disease, and radiotherapy for older women and regional and more advanced disease. The proportion of glandular cancers increased in-step with national trends. Little evidence of variation in risk-adjusted survival presented over time or by Local Health District. The study illustrates the value of local registry data for describing local treatment and outcomes. They show the lower use of systemic therapies among residents of less accessible areas which warrants further investigation. Risk-adjusted treatment and outcomes did not vary by socio-economic status, suggesting equity in service delivery. These data are important for local evaluation and were not available from other sources.
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Adenocarcinoma/terapia , Carcinoma de Células Escamosas/terapia , Accesibilidad a los Servicios de Salud , Histerectomía , Radioterapia , Sistema de Registros , Neoplasias del Cuello Uterino/terapia , Adenocarcinoma/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Australia , Carcinoma de Células Escamosas/mortalidad , Bases de Datos Factuales , Atención a la Salud , Manejo de la Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Modelos Logísticos , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Modelos de Riesgos Proporcionales , Análisis de Supervivencia , Tasa de Supervivencia , Neoplasias del Cuello Uterino/mortalidadRESUMEN
We present the design and operation of an all-fiber, synchronously pumped, bidirectional optical parametric oscillator (OPO) for precision sensing applications. The fiber-based OPO (FOPO) generates two frequency combs with identical repetition rates but different carrier offset frequencies. A narrow beatnote was observed with full-width at half-maximum (FWHM) linewidth of <10 Hz when the two frequency combs were overlapped on a photodetector. The all-fiber design removes the need for free-space alignment and adjustment. In addition, an external delay line to overlap the two pulse trains in time on the detector is not needed since our unique design provides automatic delay compensation. We expect the novel FOPO to find important applications in precision measurements including rotation sensing with ultra-large sensing area and sensitivity.
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Non-Newtonian fluids have unique heat transfer properties compared to Newtonian fluids. The present study examines the flow of a Maxwell nanofluid across a rotating rough disk under the effect of a magnetic field. Furthermore, the Cattaneo-Christov heat flux model is adopted to explore heat transport features. In addition, a comparison of fluid flow without and with aggregation is performed. Using similarity variables, the governing partial differential equations are transformed into a system of ordinary differential equations, and this system is then solved by employing the Runge-Kutta Fehlberg fourth-fifth order method to obtain the numerical solution. Graphical depictions are used to examine the notable effects of various parameters on velocity and thermal profiles. The results reveal that an increase in the value of Deborah number decreases the velocity profile. An increase in the thermal relaxation time parameter decreases the thermal profile. An artificial neural network is employed to calculate the rate of heat transfer and surface drag force. The R values for skin friction and Nusselt number were computed. The results demonstrate that artificial neural networks accurately predicted skin friction and Nusselt number values.
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The utilization of Maxwell fluid with nanoparticle suspension exhibits promising prospects in enhancing the efficacy of energy conversion and storage mechanisms. They have the potential to be utilized in sophisticated cooling systems for power generation facilities, thereby augmenting the overall energy efficacy. Keeping this in mind, the current research examines the Maxwell nanofluid flow over a rotating disk with the impact of a heat source/sink. The present study centers on the examination of flow characteristics in the existence of a uniform magnetic field. The conversion of governing equations into ordinary differential equations is achieved using appropriate similarity variables. To derive the Nusselt number (Nu) and skin friction (SF) model related to the flow and temperature parameters, the suggested back-propagation artificial neural networking (ANN) technique is used. The Runge-Kutta-Fehlberg fourth-fifth order (RKF-45) method is used to solve the reduced equations and produce the necessary data to create the Nu and SF model. Both the Nu and SF models require 1000 data for training the network, respectively. Graphs are utilized to communicate numerical outcomes. The results concluded that the upsurge in magnetic parameter drops the velocity profile but advances the heat transport. Rise in the thermal conductivity parameter, increases the heat transport.
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Studies have shown that glycosylphosphatidylinositols (GPIs) of Plasmodium falciparum activate macrophages mainly through Toll-like receptor 2 (TLR2)-mediated signalling and to certain extent through TLR4-mediated signalling to induce proinflammatory cytokine production. However, the ability of parasite GPIs to activate dendritic cells (DCs) has not been reported. Here, we show that parasite GPIs efficiently activate DCs through TLR2-mediated signalling mechanism and induce the production of TNF-α and IL-12. We also studied the role of scavenger receptor CD36 in P. falciparum GPI- and merozoite-induced cytokine responses by DCs. The results indicate that CD36 modulates the cytokine-inducing activity of the parasite GPIs by collaborating with TLR2 in DCs. Furthermore, our data reveal that CD36 modulates the activity of P. falciparum merozoites, likely by the contribution of phagocytosis-coupled CD36-mediated signalling to the signalling induced by merozoites. Altogether, these results contribute towards understanding of signalling mechanisms in malaria parasite-induced activation of the innate immune system.
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Antígenos CD36/inmunología , Citocinas/metabolismo , Células Dendríticas/inmunología , Glicosilfosfatidilinositoles/inmunología , Merozoítos/inmunología , Plasmodium falciparum/inmunología , Receptor Toll-Like 2/metabolismo , Animales , Ratones , Ratones Noqueados , Receptor Toll-Like 2/genéticaRESUMEN
Late wilt disease (LWD) caused by Harpophora maydis (Samra, Sabet and Hing) is emerging as major production constraint in maize across the world. As a prelude to develop maize hybrid resistance to LWD, genetic basis of resistance was investigated. Two F2:3 mapping populations (derived from CV156670 × 414-33 (P-1) and CV156670 × CV143587 (P-2)) were challenged with LWD at two locations (Kallinayakanahalli and Muppadighatta) during 2017 post-rainy season. A wider range of LWD scores was observed at both locations in both the populations. LWD response was influenced by significant genotype × location interaction. Six and 56 F2:3 progeny families showed resistance level better than resistant parent. A total of 150 and 199 polymorphic single nucleotide polymorphism markers were used to genotype P-1 and P-2, respectively. Inclusive composite interval mapping was performed to detect significant Quantitative Trait Loci (QTL), QTL × QTL, QTL × location interaction effects. Three major and four minor QTL controlling LWD resistance were detected on chromosome-1. The position and effect of the QTL varied with the location. Significant di-QTL interactions involving QTL (with significant and/or non-significant effects) located within and between all the ten chromosomes were detected. Five of the seven detected QTL showed significant QTL × location interaction. Though two major QTL (q-lw-1.5 and q-lw-1.6) with lower Q×L interaction effects could be considered as stable, their phenotypic variance is not large enough to deploy them in Marker Assisted Selection (MAS). However, these QTL are of paramount importance in accumulating positive alleles for LWD resistance breeding.
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Ascomicetos , Resistencia a la Enfermedad , Enfermedades de las Plantas , Zea mays , Ascomicetos/patogenicidad , Mapeo Cromosómico , Resistencia a la Enfermedad/genética , Fenotipo , Fitomejoramiento , Enfermedades de las Plantas/genética , Enfermedades de las Plantas/microbiología , Sitios de Carácter Cuantitativo , Zea mays/genética , Zea mays/microbiologíaRESUMEN
Hybrid nanofluids' enhanced thermophysical properties make them applicable in a plethora of mechanical and engineering applications requiring augmented heat transfer. The present study focuses on a three-dimensional Copper-Aluminium Oxide [Formula: see text]-water based hybrid nanofluid flow within the boundary layer with heat transfer over a rotating exponentially stretching plate, subjected to an inclined magnetic field. The sheet rotates at an angular velocity [Formula: see text] and the angle of inclination of the magnetic field is [Formula: see text]. Employing a set of appropriate similarity transformation reduces the governing PDEs to ODEs. The resulting ODEs are solved with the finite difference code with Shooting Technique. Primary velocity increases at large rotation but the secondary velocity reduces as the rotation increases. In addition, the magnetic field is found to oppose the flow and thereby causing a reduction in both the primary and secondary velocities. Increasing the volume fraction reduces the skin friction coefficient and enhances the heat transfer rate.
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Placas Óseas , Fuerza Coriolis , Aluminio , AguaRESUMEN
BACKGROUND: Diagnosis of rapidly progressive dementia (RPD) is very challenging. There are many conditions that fall into category of RPD ranging from autoimmune causes to neurodegenerative causes. Autoimmune encephalitis should be readily diagnosed and treated because of its response to immunomodulators. However there is no treatment available for conditions like Creutzfeldt-Jakob disease (CJD). CASE PRESENTATION: Here we present a case of anti-leucine-rich glioma inactivated 1 (LGI1) encephalitis who presented with only typical facio-brachial dystonic seizures at presentation. On follow up, patient had a rapid cognitive decline with development of myoclonic jerks, akinetic mute state and ultimately death. Neuroimaging showed presence of hyperintensities in two cortical regions namely parietal and occipital on fluid-attenuated inversion recovery (FLAIR) sequence. Electroencephalogram showed diffuse slowing with occasional periodic sharp wave complexes. Thus a diagnosis of probable CJD was made. CONCLUSION: Autoimmune encephalitis mimicking CJD or vice versa is not a very commonly encountered phenomenon. This case discusses the clinical overlap of these two conditions and its diagnostic dilemmas. This case presented with typical LGI1 encephalitis and in spite of therapy with immunomodulators had a rapid decline and ultimately turned out to be CJD. This has been rarely described in literature.
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In this study, a mathematical model is developed to scrutinize the transient magnetic flow of Cross nanoliquid past a stretching sheet with thermal radiation effects. Binary chemical reactions and heat source/sink effects along with convective boundary condition are also taken into the consideration. Appropriate similarity transformations are utilized to transform partial differential equations (PDE's) into ordinary ones and then numerically tackled by shooting method. The impacts of different emerging parameters on the thermal, concentration, velocity, and micro-rotation profiles are incorporated and discussed in detail by means of graphs. Results reveal that, the escalation in magnetic parameter and Rayleigh number slowdowns the velocity and momentum of the fluid. The increase in Biot number, radiation and heat sink/source parameters upsurges the thermal boundary but, converse trend is seen for escalating Prandtl number. The density number of motile microorganisms acts as a growing function of bioconvection Lewis number and declining function of bioconvection Peclet number.
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A new set of chromogenic anion receptors R1-R4 have been synthesized with a different substituent, including electron withdrawing (nitro moiety in R1), conjugated group (naphthyl in R2), and electron donating (methyl in R3), respectively. The receptors R1-R4 exhibited very good sensitivity towards the F- and AcO- anions in the DMSO. In addition, R1 showed selectivity towards H2PO4- ions over other tested anions. R1 especially acted as an effective sensor for sodium salts of F-, AcO-, AsO2-, and AsO42- ions in an aqueous medium due to the presence of two electron-withdrawing nitro substituents, which showed hydrogen bond donor tendency and acidity of the OH proton. This result indicates that R1 is highly capable of competing with an aqueous medium to detect anions without counter Na+ ion interference. Interestingly, R1 displays solvatochromic property in the presence of AcO- ions in different aprotic solvents. Additionally, the receptor R1 shows high binding affinity towards AcO- ions in the buffer medium (DMSO: HEPES, 9:1â¯v/v), which displayed remarkable colour change from pale yellow to blue with a large ∆λred shift of 170â¯nm. The CV studies reveal the deprotonation of the -NH proton upon interaction with the AcO- ions. The receptor R1 is subjected to practical application to sense F- and AsO2- ions using the test strip. In addition, the receptor R1 proves itself as a potential applicant for the detection of F- ions quantitatively in commercially available mouthwash.
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BACKGROUND: Urological training has dramatically changed in recent years. Training durations are shorter and a drive toward consultant led care has reduced trainees experience. Within the UK, approximately 50 registrars annually embark on a 5-year Urology training programme, with variable levels of basic urological experience. OBJECTIVE: To describe a simulation programme aimed at delivering the knowledge and skills necessary to safely and effectively start working as a registrar in Urology by intensive training with a 1:1 faculty to delegate ratio. DESIGN, SETTING, AND PARTICIPANTS: Our course content mirrors the UK training syllabus for junior Urology registrars. We delivered 8 modules over a 4-day programme with a fifth day of assessments. Delegates level of urological knowledge, operative competency and confidence pre-, immediately post-training and at 3-months postcourse were assessed. Objective delegate and faculty feedback was also collected. Technical skills modules include; inguinoscrotal surgery, ureteroscopy, transurethral resection, urodynamics, and Botox administration as well as basic reconstructive and laparoscopic operative skills. "Nontechnical" skills included simulated ward round, out-patient, and emergency scenarios. RESULTS: Feedback from delegates and faculty members has been overwhelmingly positive. We have used this feedback to tailor the content of the course for following years. An increased knowledge level (based on mean examination scores [precourse 55.5%, postcourse 70.1%]) and operative competency was observed in all skills assessed (transurethral resection of the prostate, transurethral resection of bladder tumor, Ureteroscopy, laparoscopic skills, and instrument assembly). Operative confidence was increased immediately and at 3-months postcourse. CONCLUSIONS: Our "boot camp" course provides a realistic introduction and foundation to begin Urological practice. Being delivered at the beginning of the training scheme, prior to intensive patient exposure, registrars are in an optimum position to develop their newly acquired knowledge and skills to enhance training and intends to improve patient safety and satisfaction.
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Competencia Clínica , Educación de Postgrado en Medicina/métodos , Entrenamiento Simulado , Urología/educación , Reino UnidoRESUMEN
Analysis of retrospective quantitative sheep pox epidemiological data from the Government Animal Husbandry Department, Karnataka, India, covering 24 years revealed significant information on sheep pox. The state has a dense sheep population including some valuable breeds. Data revealed the endemicity of the disease: there were a considerable number of outbreaks and attacks, high mortality and case fatality rates and low immunisation coverage. None of the years studied were free from infection. Temporally, the disease was most prevalent between November and May. Spatially, the disease was recorded in 19 out of 27 districts; in some of these districts sheep pox was highly endemic, in some it was endemic at low levels and in the remaining districts outbreaks occurred sporadically. Environmental factors influenced disease occurrence. Vaccine production met only one tenth of the requirement, and its peak utilisation was in the dry season.
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Capripoxvirus , Infecciones por Poxviridae/veterinaria , Enfermedades de las Ovejas/epidemiología , Vacunas Virales/administración & dosificación , Animales , Cruzamiento , Clima , Brotes de Enfermedades/veterinaria , Femenino , India/epidemiología , Masculino , Infecciones por Poxviridae/epidemiología , Infecciones por Poxviridae/mortalidad , Estudios Retrospectivos , Estaciones del Año , OvinosRESUMEN
OBJECTIVE: In patients with acute myocardial infarctions (MIs), cholesterol levels are no longer valid after 24 h from presentation because acute MI causes a rapid decline in serum levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. The objective of this study was to evaluate the effect of acute MI on the total cholesterol/HDL cholesterol ratio and the LDL cholesterol/HDL cholesterol ratio. METHODS: The study consisted of 45 patients who were admitted to the hospital with acute MIs. Serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were determined on day 1 post-MI and day 4 post-MI. The total cholesterol/HDL cholesterol ratio and the LDL cholesterol/HDL cholesterol ratio were calculated. Serum lipid levels and cholesterol ratios were compared between day 1 post-MI and day 4 post-MI. RESULTS: From day 1 post-MI to day 4 post-MI, the mean (+/- SD) serum levels of total cholesterol (188.4 +/- 52.5 vs. 170.5 +/- 57.2 mg/dL, respectively; p = 0.01), LDL cholesterol (120.3 +/- 48.9 vs. 105.9 +/- 43.0 mg/dL, respectively; p = 0.009), and HDL cholesterol (45.0 +/- 18.5 vs 39.3 +/- 16.1 mg/dL, respectively; p < 0.001) decreased, but the mean serum level of triglycerides (119.2 +/- 81.2 vs 149.3 +/- 68.3 mg/dL, respectively; p = 0.006) increased. The cholesterol ratios, however, remained unchanged between day 1 post-MI and day 4 post-MI. The total cholesterol/HDL cholesterol ratio was 4.59 +/- 1.84 on day 1 post-MI and 4.67 +/- 1.77 on day 4 post-MI (change not significant). The LDL cholesterol/HDL cholesterol ratio was 2.96 +/- 1.58 on day 1 post-MI and 2.99 +/- 1.44 on day 4 post-MI (change not significant). CONCLUSION: Acute MI does not affect the cholesterol ratios. Therefore, when the absolute levels of serum cholesterol are no longer valid (beyond 24 h after an MI), the cholesterol ratios still could be useful for cholesterol risk assessment in patients with acute MIs.
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Colesterol/sangre , Infarto del Miocardio/sangre , Anciano , Anciano de 80 o más Años , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las PruebasRESUMEN
It has been shown that the novel gel matrix, PCR Purity Plus which consists of a vinyl-polymer of polyacrylamide, provides a superior and rapid means of separating DNA fragments. As this product has been discontinued, the two new commercial versions of this matrix (MDE and GeneAmp) with PCR Purity Plus were compared. Optimal conditions for resolving DNA fingerprint profiles for both matrices were defined. Both MDE and GeneAmp gels provided a clear separation of DNA fragments. However, the profiles obtained on GeneAmp gel were closest to that of PCR Purity Plus. These results should be useful to DNA fingerprinting studies where it is critical to obtain a clear resolution of complex DNA profiles.
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ADN/genética , Electroforesis/métodos , Geles , ADN/química , Densitometría , Estudios de Evaluación como Asunto , Reacción en Cadena de la PolimerasaRESUMEN
We report a case of Pasteurella multocida infection in a neutropenic patient. History of contact with animals is important, particularly in patients who present with localized cellulitis and neutropenic fever. Clinical features and treatment of the disease are discussed.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Enfermedades de los Gatos/transmisión , Neutropenia/inducido químicamente , Infecciones por Pasteurella/etiología , Pasteurella multocida/patogenicidad , Anciano , Animales , Antiinfecciosos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Gatos , Ciprofloxacina/uso terapéutico , Ciclofosfamida/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Humanos , Metotrexato/administración & dosificación , Pasteurella multocida/aislamiento & purificaciónRESUMEN
Two case reports of anal cancer developing during chronic therapeutic immunosuppression for systemic lupus erythematosus (SLE) and their cancer management are presented. The complex issues of delivery of curative chemoradiation treatment for anal cancer in the context of co-existing autoimmune connective tissue disease (AICD) are discussed. These two cases show that combined chemotherapy and radiation regimens are possible in patients with SLE. However, frequent, careful assessment with judicious and prompt management of haematological and other complications during treatment is important.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Ano/inducido químicamente , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Adulto , Neoplasias del Ano/tratamiento farmacológico , Neoplasias del Ano/radioterapia , Terapia Combinada , Femenino , Humanos , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Scleroderma pericardial disease is usually silent and benign. The incidence of pericardial involvement in scleroderma is about 50% according to autopsy results, but symptomatic pericarditis manifests in about 16% of patients with diffuse scleroderma and in about 30% of patients with limited scleroderma. The clinically evident pericardial effusion is rare in scleroderma, although it can be detected in about 41% of patients with echocardiography. In majority of the patients, the pericardial effusion is small and not associated with symptoms. The pericardial effusion manifests usually after the manifestation of the other clinical and serologic features of scleroderma. A case of scleroderma is reported that presented with a large pericardial effusion, which antedated the other clinical and serologic features of scleroderma. The pericardial involvement in scleroderma is reviewed.
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Derrame Pericárdico/etiología , Esclerodermia Sistémica/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico por imagen , Esclerodermia Sistémica/diagnóstico , UltrasonografíaRESUMEN
A safe, rapid, and effective way to detoxify patients from substance misuse is important in facilitating further treatment of their psychiatric or substance use disorder. This paper discusses the treatment of acute withdrawal from polysubstance misuse in three patients in the intensive care unit setting using combined sedation with a benzodiazepine, lorazepam, and a general anaesthetic, propofol. Lorazepam alone was not effective in massive doses in these cases. The advantages and mechanism of action of using multiple agents to control refractory symptoms is discussed.
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Anestésicos Intravenosos/uso terapéutico , Hipnóticos y Sedantes/uso terapéutico , Lorazepam/uso terapéutico , Propofol/uso terapéutico , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Adulto , Cuidados Críticos/métodos , Quimioterapia Combinada , Femenino , Humanos , MasculinoRESUMEN
We demonstrate label-free multi-photon imaging of biological samples using a compact Er(3+)-doped femtosecond fiber laser mode-locked by a single-walled carbon nanotube (CNT). These compact and low cost lasers have been developed by various groups but they have not been exploited for multiphoton microscopy. Here, it is shown that various multiphoton imaging modalities (e.g. second harmonic generation (SHG), third harmonic generation (THG), two-photon excitation fluorescence (TPEF), and three-photon excitation fluorescence (3PEF)) can be effectively performed on various biological samples using a compact handheld CNT mode-locked femtosecond fiber laser operating in the telecommunication window near 1560nm. We also show for the first time that chlorophyll fluorescence in plant leaves and diatoms can be observed using 1560nm laser excitation via three-photon absorption.