Final Measurement of the

This Letter reports one of the most precise measurements to date of the antineutrino spectrum from a purely ^{235}U-fueled reactor, made with the final dataset from the PROSPECT-I detector at the High Flux Isotope Reactor. By extracting information from previously unused detector segments, this analysis effectively doubles the statistics of the previous PROSPECT measurement. The reconstructed energy spectrum is unfolded into antineutrino energy and compared with both the Huber-Mueller model and a spectrum from a commercial reactor burning multiple fuel isotopes. A local excess over the model is observed in the 5-7 MeV energy region. Comparison of the PROSPECT results with those from commercial reactors provides new constraints on the origin of this excess, disfavoring at 2.0 and 3.7 standard deviations the hypotheses that antineutrinos from ^{235}U are solely responsible and noncontributors to the excess observed at commercial reactors, respectively.

Spectrometry of cord blood and maternal blood for Hb-F and Hb-A and novel technology for non-invasive measurement of hemoglobin in mother and baby.

BACKGROUND: Human hemoglobin (Hb) is a tetrameric metalloporphyrin. Heme part contains iron radicle and porphyrin. The globin part has pairs of amino-acid chains. Healthy adults have "Hemoglobin-A" made of two alpha and two beta chains (α2 ß2) while a newborn baby has "Hemoglobin-A (α2 ß2)" and "Hemoglobin-F (α2 γ2)". There are few reports about absorption spectrometry of Hb in cord blood. We have here compared absorption spectrum of Hb in cord blood and maternal blood samples (adult blood samples) together. OBJECTIVE: This was done in two parts. Part 1 was about studying absorption spectrum of Hb in cord blood and maternal blood. Part 2 was about developing a comprehensive noninvasive technology and using the same for measurement of Hb in mother (adult) and new-born baby. DESIGN: Observational study. MATERIAL AND METHODS: Part 1. After IRB approval, 25 pregnant mothers enrolled for the study. Cord blood/neonatal blood samples were collected from placental end in ethylene diamine tetra-acetic acid (EDTA) tube after the delivery of fetus and placenta (venous blood). Maternal blood was collected by peripheral venepuncture before delivery/labor. Part 2. Using noninvasive technology for measurement of Hb in mother (adult) and new-born baby. After the necessary approval five pairs of mother and new-born were enrolled in the study to measure Hb by noninvasive method using our novel device. The novel device (SH-1) uses electromagnetic radiations of specific wavelengths between 520 and 580 nm. Light was projected on forehead for a few seconds, operating the light sources one by one. Of the projected light, some was reflected by the recipient's skin. This optical signal was collected by photosensors and converted to electrical signals. After amplification, this was then transmitted to processor unit. Later, Hbs values are displayed. The results were then tallied with standard laboratory methods in clinical laboratory. RESULTS: Part 1. As expected in our study; all blood samples showed Soret band of same peak and wavelength. We expected different spikes corresponding to four globin chains namely alpha, beta, gamma, and delta. But interestingly, both neonatal and maternal blood samples had identical peaks. Part 2. The results appear promising. The Hb as measured by noninvasive method matches well with standard laboratory test. SIGNIFICANCE: The energy level of Hb is low in deoxygenated state compared to oxyhemoglobin. In a state of high energy level, alpha and beta and gamma globin chains show obvious different peaks. Since cord blood and maternal sample was obviously venous or in deoxygenated state with low energy level, single peak of absorption was observed for all three globin chains. Since maternal and cord blood showed similar absorption spectra, it was possible to develop a common method for estimation of biomarkers - Hb in adults and new-borns alike.

Are empathy and emotional intelligence missing in dental practitioner's toolkit in Saudi Arabia? A cross-sectional study.

BACKGROUND: Empathy and emotional intelligence (EI) of a dentist are two factors vital for developing fruitful relations between clinicians and patients. Establishing a good relationship with patients may improve patients' outcomes. Data on empathy and EI in dental practitioners in the Kingdom of Saudi Arabia is scarce. AIMS: Hence, we aimed to evaluate and compare empathy and EI among dental practitioners in Abha and Khamis Mushayat cities of Saudi Arabia. METHODS: We conducted a cross-sectional survey study. A total of 183 dental practitioners who were reachable at survey time were included. A self-administered questionnaire on empathy and EI was structured based on Jefferson Scale of Physician Empathy (health professions version) and Schutte's Emotional Intelligence Scale, respectively. Statistical analysis was done using Mann-Whitney and Kruskal-Wallis tests. RESULTS: No significant difference was observed between both genders regarding empathy and EI (P = 0.73 and 0.97, respectively). Similarly, no significant difference was observed between participants with different qualifications or different work settings (P > 0.05). However, a statistically significant positive correlation was observed between empathy and EI (r = 0.722). CONCLUSIONS: Irrespective of gender, qualification, or different work settings, dental practitioners in both cities showed adequate empathy and EI levels. Dentists with high empathy scores seem to show high EI levels. CLINICAL SIGNIFICANCE: Evaluating and monitoring empathy and EI practice among dental practitioners have paramount importance to improve clinical practice and healing potential of patients. Low levels of empathy and EI practice would suggest modifications to training curriculum or healthcare policies.

A novel perspective for predicting gingival biotype via dentopapillary measurements on study models in the Saudi population: Cross-sectional study.

BACKGROUND/PURPOSE: Gingival biotype (GB) is a crucial factor in predicting the success of soft tissue periodontal and peri-implant surgical interventions. Consequently, contemplating noninvasive, less time-consuming procedure to anticipate it has become a part and parcel of the current practice. This article presents a novel algorithm to detect GB in the Saudi population based on the dentopapillary measurements taken on laboratory models. In addition, it targets to allocate a range of values for thick and thin biotypes. MATERIALS AND METHODS: Model analysis was done on 160 patients to measure eight gingival parameters, and an algorithm was developed according to the results of multiple and linear regression analyses. Applying the dentopapillary parameters to the algorithm revealed a prediction of the biotype. Finally, the resultant values and the exact thickness were reassessed directly in a sample of patients using a modified caliper. RESULTS: The regression analysis revealed an algorithm predicting biotypes among patients based on their measured dentopapillary values. Discriminant analysis was used to allocate the values to thin and thick biotypes to further demystify that they coincide with <0.7 mm and >1.5 mm, respectively. However, gingival thickness between 0.7 and 1.5 mm was considered intermediate biotype. CONCLUSION: GB could be predicted based on the dentopapillary measurements taken on laboratory models, which may further reduce the chairside time and increase the success rate of the surgical procedures. Significant variations in the range of values of the thick and thin biotype were detected in the Saudi population compared to other races. CLINICAL SIGNIFICANCE: The escalating invasion of interventional procedures in the dental practice necessitates measuring the GB as a predictor of procedure success. This study introduces an algorithm for detecting the GB and updates the range of values for thick and thin biotypes in the Saudi population that would consequently reduce chairside time.

Comparison of serum creatinine-based estimating equations with gates protocol for predicting glomerular filtration rate in indian population.

In clinical practice, serum creatinine-based predicting equations and Gates protocol based on gamma camera imaging of kidneys after injection of Tc99m-diethylenetriaminepentaacetic acid (DTPA) are commonly used to assess glomerular filtration rate (GFR). Comparison of these methods, especially the chronic kidney disease-epidemiology collaboration (CKD-EPI) equation with gold standard method of assessment of GFR by plasma clearance of Tc-99mDTPA is not well-studied in Indian population. We conducted this study to compare GFR estimation by gamma camera-based Gates protocol and serum creatinine-based predicting equations with GFR measured by plasma clearance of Tc-99mDTPA. One hundred and five patients (65 male and 40 female) underwent Tc-99m DTPA renal scan followed by withdrawal of venous blood samples at 2, 3, and 4 h as per predefined protocol. Gates method GFR (GFRs) was assessed using standard protocol. GFR by plasma sampling (GFRp) was calculated by slope-intercept method with provision for corrections. Estimated GFR was calculated by Cockroft-Gault formula, four variable modification of diet in renal disease (MDRD) equation, and CKD-EPI equation (GFRCG, GFRMDRD, GFRCKD-EPI, respectively). GFR measured by gold standard method (GFRp) was compared with that estimated by other methods by calculating correlation coefficient, bias, precision, and accuracy. GFR estimated by all three estimating equations correlated better than GFRs with GFRp. For estimating GFRp, GFRCKD-EPI had highest correlation with GFRp with least bias and highest precision. Gamma camera-based Gates protocol was the least precise and least accurate method for estimating GFRp. To conclude, all three estimating equations based on serum creatinine are superior to Tc-99m DTPA scintigraphy for estimating GFR; CKD-EPI equation being the most accurate and precise.

Freedom from frozen: the first British military use of lyophilised plasma in forward resuscitation.

Prehospital use of blood products may improve survival. However, transfusion support with frozen blood components is logistically burdensome and constrains the configuration of prehospital medical support. Alternatives to frozen plasma, including lyophilised plasma, offer the potential for advanced resuscitation in the prehospital environment. We describe the successful use of lyophilised plasma by a UK patrol in the prehospital environment during operations in Afghanistan in 2012 and reflect on recent military experience and the need for further developments.

Maternal-neonatal transfusion compatibility irrespective of ABO mismatch--a prospective observational study.

OBJECTIVE: To determine transfusion compatibility of maternal RBCs for her neonate up to 4 weeks of age, irrespective of maternal-neonatal ABO mismatch. METHODS: This was a prospective observational study involving eligible mothers with their neonates delivered in participating site from 1 July 2012 till 31 December 2012. Mother's blood was collected before child birth. Neonatal blood sample was collected from placental end, shortly after birth. Blood Groups of mother-baby pair were individually tested for ABO and Rh-D groups. Pairs with negative Rh-D antigen/s or with same ABO blood groups were excluded. Thus, 28 pairs with both maternal and neonatal samples positive for Rh-D antigen and with different maternal neonatal ABO blood groups were included in the study. Blood samples were collected at birth and at 4 weeks. Cross matching was done at birth and at 4 weeks for each pair with standard blood bank protocols. RESULTS: All 28 pairs showed positive compatibility with standard blood bank cross-matching protocols at birth and at 4 weeks. CONCLUSIONS: Maternal blood irrespective of ABO compatibility might be a viable and potentially acceptable option for her new born baby in neonatal period. This may be especially important in developing world with limited blood bank resources.

Retort process modelling for Indian traditional foods.

Indian traditional staple and snack food is typically a heterogeneous recipe that incorporates varieties of vegetables, lentils and other ingredients. Modelling the retorting process of multilayer pouch packed Indian food was achieved using lumped-parameter approach. A unified model is proposed to estimate cold point temperature. Initial process conditions, retort temperature and % solid content were the significantly affecting independent variables. A model was developed using combination of vegetable solids and water, which was then validated using four traditional Indian vegetarian products: Pulav (steamed rice with vegetables), Sambar (south Indian style curry containing mixed vegetables and lentils), Gajar Halawa (carrot based sweet product) and Upama (wheat based snack product). The predicted and experimental values of temperature profile matched with ±10 % error which is a good match considering the food was a multi component system. Thus the model will be useful as a tool to reduce number of trials required to optimize retorting of various Indian traditional vegetarian foods.

Effectiveness of chamomile (Matricaria recutita L.), MTAD and sodium hypochlorite irrigants on smear layer.

BACKGROUND: Endodontic success depends heavily on effective chemo-mechanical debridement of root canals through the use of instruments and irrigating solutions. OBJECTIVE: To compare the effectiveness of chamomile hydroalcoholic extract, Biopure™ mixture of tetracycline isomer, acid and detergent (MTAD) and 2.5 % sodium hypochlorite (NaOCl) on removal of the smear layer. STUDY DESIGN: Randomised controlled trial. METHODS: Thirty extracted single-rooted, primary human teeth were allocated at random into three experimental groups of 10 teeth each. For each tooth, the canal was prepared using the step-back technique. During instrumentation, 2 ml of the irrigant was used for at least 10 s after each file and 10 ml as a final flush for 2 min for chamomile and NaOCL irrigants. Whereas for MTAD, an initial rinse with 1.3 % NaOCl for a cumulated period of 20 min, and use of MTAD as the final rinse for a period of 5 min was followed. Longitudinal grooves were made on root segments, then split into two halves with a chisel, stored in 2.5 % glutaraldehyde solution and fixed in ethanol series. Specimens were examined for the smear layer according to Hulsmann et al. (Int Endod J 35:668-679, 2002) criteria using a scanning electron microscope. STATISTICS: Kruskal-Wallis and Mann-Whitney U tests were used. RESULTS: The most effective result in removal of smear layer occurred with the use of MTAD, followed by chamomile extract. The chamomile extract was found to be significantly more effective than 2.5 % NaOCl solution which had only minor effects. CONCLUSIONS: The efficacy of chamomile to remove the smear layer was superior to 2.5 % NaOCl alone, but less effective than MTAD mixture.

Application of WHONET in the Antimicrobial Resistance Surveillance of Uropathogens: A First User Experience from Nepal.

INTRODUCTION: WHONET is a freely downloadable, Windows-based database software which is used for the management and analysis of microbiology data, with a special focus on the analysis of antimicrobial susceptibility test results. Urinary Tract Infections (UTI) are a common medical problem and they are responsible for notable morbidity among young and sexually active women. OBJECTIVES: The major objective of this study was the utilization and application of the WHONET program for the Antimicrobial Resistance (AMR) surveillance of uropathogens. METHODS: A total of 3209 urine samples were collected from patients who visited Manipal Teaching Hospital with a clinical suspicion of UTI, during December 2010 to July 2011. The isolation and characterization of the isolates were done by conventional methods. Antimicrobial Susceptibility Testing (AST) was performed by Kirby Bauer's disc diffusion method. The data entry and analysis were done by using the WHONET 5.6 software. RESULTS: Out of the 3209 specimens, 497 bacterial isolates were obtained and they were subjected to AST. Escherichia coli (66.2%) was the commonest bacterial isolate, followed by Enterococcus species (9.3%), Staphylococcus aureus (5.0%), and Klebsiella pneumoniae (4.2%). Among the gram-negative enteric bacilli, a high prevalence of resistance was observed against ampicillin and ciprofloxacin. The gram negative nonfermenters exhibited a high degree of resistance to ceftazidime. Staphylococcus species. showed a moderately high resistance to co-trimoxazole. One isolate was Vancomycin Resistant Enterococci (VRE). CONCLUSION: This study, a first of its kind which was done in Nepal, was carried out by using the WHONET software to monitor, analyze and share the antimicrobial susceptibility data at various levels. This study was also aimed at building a surveillance network in Nepal, with the National Public Health Laboratory, Nepal, acting as a nodal centre. This would help in the formulation of antibiotic policies and in identifying hospital and community outbreaks at the nodal centre, as well as in sharing information with the clinicians at the local level.

Future prospects of systemic host modulatory agents in periodontal therapy.

Periodontitis is an inflammatory disease caused by microbial infection that leads to destruction of supporting tissues of the teeth. The periodontal tissue destruction is a result of both microbial activity as well as host response. The best chance for clinical improvement may come from implementing complementary treatment strategies that target different aspects of the periodontal balance. Host response modulation, in combination with conventional treatment, offers to restore the balance between health and disease progression in the direction of a healing response. Various host modulatory therapies (HMT) have been developed or proposed to block pathways responsible for periodontal tissue break down. The newer drugs like bortezomib, infliximb, etanercept, vasoactive intestinal peptide, nitric oxide synthase inhibitors and denosumab are developed as a result of better understanding of pathogenesis of inflammatory tissue destruction and may represent the future of periodontal therapy. This review article focuses on the potential systemic host modulatory agents that target cell signalling pathways, cytokines and enzymes.

Effect of surgical clipping versus endovascular coiling on recovery from oculomotor nerve palsy in patients with posterior communicating artery aneurysms: A retrospective comparative study and meta-analysis.

BACKGROUND: Oculomotor nerve palsy (OMNP) is a well-recognized complication of posterior communicating artery (PCOM) aneurysms. Only a few comparative studies have assessed the effect of clipping versus coiling on recovery from OMNP in PCOM aneurysms. A retrospective review and meta-analysis was conducted to assess the relationship between PCOM aneurysm treatment and OMNP. MATERIALS AND METHODS: Medical records of all patients presenting between January 2000 and February 2013 with intracranial aneurysm were searched. All patients with OMNP secondary to PCOM aneurysm were included for analysis. Patients undergoing surgical clipping or endovascular coiling were compared with respect to complete resolution of OMNP after aneurysm surgery (i.e., primary outcome). A meta-analysis of published studies of OMNP associated with PCOM aneurysm was performed after a MEDLINE search. RESULTS: Seventeen patients with OMNP secondary to PCOM aneurysms met the inclusion criteria. Surgical clipping (seven of eight patients, or 87.5%) resulted in greater complete resolution of OMNP compared with endovascular coiling (four of nine patients, or 44.4%), P = 0.13. A meta-analysis of similar studies revealed that complete resolution of OMNP was more commonly associated with surgical clipping (36 of 43 patients, or 83.7%) than with endovascular coiling (29 of 55 patients, or 52.7%), yielding an adjusted odds ratio (OR) of 6.04 [confidence interval (CI) =1.88-19.45, P = 0.003]. Multivariate analysis found that the degree of pre-operative OMNP (OR = 0.07, CI = 0.02-0.28, P = 0.001) and surgical clipping (OR = 6.37, CI = 1.73-23.42, P = 0.005) were significant factors that affected the complete recovery of OMNP. CONCLUSION: Complete recovery of OMNP with PCOM aneurysms is more commonly associated with surgical clipping than with endovascular coiling. Also, the degree of pre-operative OMNP and the treatment modality are significant factors that affect the complete recovery of OMNP.

Systemic and acute administration of parathyroid hormone-related peptide(1-36) stimulates endogenous beta cell proliferation while preserving function in adult mice.

AIMS/HYPOTHESIS: A major focus in the treatment of diabetes is to identify factors that stimulate endogenous beta cell growth while preserving function. The first 36 amino acids of parathyroid hormone-related protein (PTHrP) are sufficient to enhance proliferation and function in rodent and human beta cells in vitro. This study examined whether acute and systemic administration of the amino-terminal PTHrP(1-36) peptide can achieve similar effects in rodent beta cells in vivo. METHODS: Adult male mice were injected with 40, 80 or 160 µg of PTHrP(1-36) per kg body weight or with vehicle for 25 days. Glucose and beta cell homeostasis, as well as expression of differentiation markers and cell cycle genes were analysed. RESULTS: All three doses of PTHrP(1-36) significantly enhanced beta cell proliferation in vivo at day 25, with 160 µg/kg PTHrP(1-36) increasing proliferation as early as day 5. Importantly, the two higher doses of PTHrP(1-36) caused a significant 30% expansion of beta cell mass, with a short-term improvement in glucose tolerance. PTHrP(1-36) did not cause hypercalcaemia, or change islet number, beta cell size, beta cell death or expression of differentiation markers. Analysis of islet G1/S cell cycle proteins revealed that chronic overabundance of PTHrP(1-139) in the beta cell significantly increased the cell cycle activator cyclin D2 and decreased levels of cyclin-dependent kinase 4 inhibitor (p16( Ink4a ) [Ink4a also known as Cdkn2a]), but acute treatment with PTHrP(1-36) did not. CONCLUSIONS/INTERPRETATION: Acute and systemic administration of PTHrP(1-36) increases rodent beta cell proliferation and mass without negatively affecting function or survival. These findings highlight the future potential therapeutic effectiveness of this peptide under diabetes-related pathophysiological conditions.

Modeling of chromium (VI) biosorption by immobilized Spirulina platensis in packed column.

This study describes biosorption of chromium (VI) by immobilized Spirulina platensis, in calcium alginate beads. Three aspects viz. optimization of bead parameters, equilibrium conditions and packed column operation were studied and subsequently modeled. Under optimized bead diameter (2.6mm), calcium alginate concentration (2%, w/v) and biomass loading (2.6%, w/v) maximum biosorption was achieved. 140 g l(-1) loading of optimized beads resulted in 99% adsorption of chromium (VI) ions from an aqueous solution containing 100 mg l(-1) of chromium (VI). The quantitative chromium (VI) uptake was effectively described by Freundlich adsorption isotherm. The immobilized S. platensis beads were further used in a packed bed column wherein the effects of bed height, feed flow rate, inlet chromium (VI) ion concentration were studied by assessing breakthrough time. The performance data were tested for various models fitting in order to predict scale up-design parameters such as breakthrough time and column height. Results were encouraging.

In vitro drug resistance and response to therapy in pulmonary tuberculosis patients under a DOTS programme in south India.

Tuberculosis (TB) patients (n=605) whose pre-treatment sputum culture yielded Mycobacterium tuberculosis were studied for the association of in vitro resistance to anti-TB drugs and treatment outcome. Five hundred and fifty-four (92%) patients showed favourable outcome, while 51 (8%) showed unfavourable outcome to anti-TB treatment. Logistic regression analysis of the data revealed that male gender (Wald P=0.026) and multidrug resistance (MDR) (Wald P<0.001) were associated with unfavourable outcome. Proportion of treatment failure (6%) was higher in patients who had received earlier anti-TB drug therapy (re-treated patients) compared with the newly diagnosed patients (2%). Re-treated patients yielded more drug-resistant M. tuberculosis, including MDR (P<0.001), than new cases. Treatment guided by in vitro drug susceptibility tests may therefore be more effective and less expensive for such selected cases.

Mycobacterial culture of fine needle aspirate - a useful tool in diagnosing tuberculous lymphadenitis.

A prospective study was undertaken on suspected lymph node TB (LNTB) patients, to evaluate the diagnostic utility of mycobacterial culture of fine needle aspirate (FNA), in comparison with the cytological examination and acid fast staining. Eighty percent of 157 aspirates studied were positive by cytological examination; 18% by ZN smear and 45% were positive by culture. Twelve aspirates which were negative by cytological features yielded positive mycobacterial cultures; four out of these were from HIV positive patients. Our observations suggest that supplementing FNA cytology with mycobacterial culture would increase the sensitivity of diagnosing LNTB; in addition to giving a highly specific diagnosis.

A study of mycobacterial species causing lymphadenitis.

This prospective study evaluated the non-tuberculous mycobacteria (NTM) cases of lymphadenitis. A total of 76 isolates of mycobacteria were obtained from 200 lymph node aspirates suspected of tuberculosis, 74 of which were Mycobacterium tuberculosis, one was Mycobacterium fortuitum and one Mycobacterium kansasii. These results highlight the importance of NTM in HIV-negative patients as a case of lymphadenitis, and indicates the re-emergence of NTM as potential lymph node pathogens in this part of the country. Further studies on a larger scale are needed to delineate the association between NTM infections in HIV positive and negative subjects.

Antihyperglycemic Activity of Various Fractions of Cassia auriculata Linn. in Alloxan Diabetic Rats.

Present work describes the potent antidiabetic fraction from flowers of Cassia auriculata Linn. Hydromethanolic extract along with its ethyl acetate and n-butanol fractions were evaluated for antidiabetic activity in alloxan-induced diabetes in rats. The n-butanol fraction exhibited significant reduction (p<0.001) in blood glucose levels and was also found effective in restoring the blood lipids and proteins to normal level. The activity was found comparable with standard drug phenformin. The hydromethanolic extract and its fractions were subjected to preliminary qualitative chemical investigations which indicated the presence of phenolic compounds, carbohydrates, tannins, steroids and amino acids.

Kinetic and equilibrium modeling of chromium (VI) biosorption on fresh and spent Spirulina platensis/Chlorella vulgaris biomass.

Biosorption of chromium (VI) was studied using both fresh and spent algal biomass of Spirulina platensis and Chlorella vulgaris. Both showed comparable behavior suggesting that biosorption is primarily a surface phenomenon. Biosorption rate was very fast during the first five minutes, in which almost 50% of the chromium (VI) was adsorbed. Two step kinetic model was proposed for biosorption. Equilibrium data obeyed Freundlich and Langmuir adsorption isotherms. Fresh algal biomass of S. platensis gave maximum of 73.6% biosorption of chromium (VI) in 100 ppm solution at 1 g l(-1) cell loading. For improved economics, beta-carotene was extracted from S. platensis and the spent biomass was used for chromium (VI) biosorption. The maximum biosorption by spent biomass was increased to 86.2%. Thus, this two step process not only showed improved efficiency in biosorption ( approximately 17% increase) but also gave valuable byproduct, namely beta-carotene.