Sulfur-Containing Foldamer-Based Artificial Lithium Channels.

Unlike many other biologically relevant ions (Na+ , K+ , Ca2+ , Cl- , etc) and protons, whose cellular concentrations are closely regulated by highly selective channel proteins, Li+ ion is unusual in that its concentration is well tolerated over many orders of magnitude and that no lithium-specific channel proteins have so far been identified. While one naturally evolved primary pathway for Li+ ions to traverse across the cell membrane is through sodium channels by competing with Na+ ions, highly sought-after artificial lithium-transporting channels remain a major challenge to develop. Here we show that sulfur-containing organic nanotubes derived from intramolecularly H-bonded helically folded aromatic foldamers of 3.6 Šin hollow cavity diameter could facilitate highly selective and efficient transmembrane transport of Li+ ions, with high transport selectivity factors of 15.3 and 19.9 over Na+ and K+ ions, respectively.

Mid-upper arm circumference in pregnant women and birth weight in newborns as substitute for skinfold thickness: findings from the MAASTHI cohort study, India.

BACKGROUND: Estimating total body fat in public hospitals using gold-standard measurements such as air displacement plethysmography (ADP), deuterium oxide dilution, or dual-energy X-ray absorptiometry (DXA) is unaffordable, and it is challenging to use skinfold thickness. We aimed to identify the appropriate substitute marker for skinfold thickness to estimate total body fat in pregnant women and infants. METHODS: The study is part of a prospective cohort study titled MAASTHI in Bengaluru, from 2016 to 19. Anthropometric measurements such as body weight, head circumference, mid-upper arm circumference (MUAC), and skinfold thickness were measured in pregnant women between 14 and 36 weeks of gestational age; while measurements such as birth weight, head, chest, waist, hip, mid-upper arm circumference, and skinfold thickness were recorded for newborns. We calculated Kappa statistics to assess agreement between these anthropometric markers with skinfold thickness. RESULTS: We found the highest amount of agreement between total skinfold thickness and MUAC (Kappa statistic, 0.42; 95 % CI 0.38-0.46) in pregnant women. For newborns, the highest agreement with total skinfold thickness was with birth weight (0.57; 95 % CI 0.52-0.60). Our results indicate that MUAC higher than 29.2 cm can serve as a suitable alternative to total skinfolds-based assessments for obesity screening in pregnancy in public facilities. Similarly, a birth weight cut-off of 3.45 kg can be considered for classifying obesity among newborns. CONCLUSION: Mid-upper arm circumference and birth weight can be used as markers of skinfold thickness, reflecting total body fat in pregnant women and the infant, respectively. These two anthropometric measurements could substitute for skinfold thickness in low- and middle-income urban India settings.

Computational and spectroscopic studies of biologically active coumarin-based fluorophores.

We used density functional theory (DFT) calculations to examine the various molecular properties of two coumarin derivatives, namely 4-(5-amino-[1,3,4]thiadiazol-2-ylsulfanylmethyl)-7-methyl-chromen-2-one and 4-(5-amino-[1,3,4]thiadiazol-2-ylsulfanylmethyl)-7-methoxy-chromen-2-one at different levels of theory and basis sets. The calculated highest occupied molecular orbital and lowest unoccupied molecular orbital energies revealed that the investigated molecules were chemically active with a tendency for molecular interactions. The theoretical vibrational frequencies of these molecules were found to be consistent with the experimentally obtained frequencies. Moreover, solvatochromic measurements indicated no significant change in absorption spectral peak by varying the polarity of solvent. Under the same conditions we found that there was a red shift of 39 nm in the fluorescence spectral peak with increase in solvent polarity. The solvatochromic data were used to estimate excited dipole moments and the change in dipole moment was interpreted based on resonance structure of molecules.

Statistical analysis plan and protocol updates for Gestational diabetes in Uganda and India: Design and Evaluation of Educational Films for Improving Screening and Self-management (GUIDES) trial.

BACKGROUND: Timely detection and management of gestational diabetes mellitus (GDM) have been identified as a high priority for policymakers in low- and middle-income countries (LMICs). The GUIDES trial will evaluate a package of three interconnected film-based interventions aimed at improving the timely detection and management of GDM. The protocol for this trial has previously been published; this publication outlines the statistical analysis plan for the trial. METHODS AND DESIGN: The GUIDES study is a multi-country cluster-randomised controlled trial consisting of one trial conducted in Uganda and one in India (30 clusters in each country). Mixed effects models will be used to compare the primary study outcomes of the proportion of women who are tested for GDM between 24 and 32 weeks of pregnancy and the mean fasting blood sugar of women with GDM at 34-week follow-up while accounting for clustering. Secondary analyses will compare the proportion of women with self-reported GDM diagnosis at 32 weeks of pregnancy and the proportion of women with adverse perinatal outcomes related to GDM up to 4 weeks after birth in each trial arm. TRIAL STATUS AND DISCUSSION: Follow-up is expected to end in March 2023 in Uganda and in May 2023 in India. Analyses will be carried out following this statistical analysis plan in the month following trial completion. TRIAL REGISTRATION: ClinicalTrials.gov NCT03937050. Registered on 3 May 2019. Clinical Trials Registry India CTRI/2020/02/023605. Registered on 26 February 2020.

T1-weighted fat-suppressed imaging of the pelvis with a dual-echo Dixon technique: initial clinical experience.

PURPOSE: To compare the image quality of water-only images generated from a dual-echo Dixon technique with that of standard fast spin-echo T1-weighted chemical shift fat-suppressed images obtained in patients evaluated for pelvic pain with a 1.5-T magnetic resonance (MR) system. MATERIALS AND METHODS: The ethics board granted approval for this retrospective study; patient consent was not required. Twenty-five women underwent both standard axial T1-weighted fast spin-echo chemical shift fat-suppressed imaging and dual-echo Dixon imaging of the pelvis. Two readers independently scored the acquisitions for image quality, fat suppression quality, and artifact. On the basis of signal intensity measurements, the uniformity of fat suppression, the contrast between fat-suppressed and non-fat-suppressed tissue, and the contrast between pathologic lesions and suppressed fat were calculated. Values obtained with the T1-weighted fat-suppressed and dual-echo Dixon techniques were compared by using the Wilcoxon signed rank test. RESULTS: The images generated with the dual-echo Dixon technique were of higher quality, had better fat suppression, and had less artifact (qualitative scores: 4.4, 4.6, and 4.0, respectively) compared with the standard T1-weighted fat-suppressed images (qualitative scores: 3.4, 3.3, and 3.6, respectively; P < .01). Contrast between fat-suppressed and non-fat-suppressed tissue (contrast ratio: 0.86 for dual-echo Dixon technique vs 0.42 for T1-weighted fat-suppressed technique, P < .001) and between pathologic lesions and suppressed fat (contrast ratio: 0.88 for dual-echo Dixon technique vs 0.57 for T1-weighted fat-suppressed technique, P =.012) was significantly improved with the dual-echo Dixon technique. Twelve pathologic lesions were identified with dual-echo Dixon imaging versus eight that were identified with T1-weighted fat-suppressed imaging. CONCLUSION: Compared with standard T1-weighted fat-suppressed imaging, dual-echo Dixon imaging facilitates improved image quality of fat-suppressed images of the pelvis, enabling better delineation of pathologic lesions.

Role of MRI in intracavitary brachytherapy for cervical cancer: what the radiologist needs to know.

OBJECTIVE: Intracavitary brachytherapy has an important role in treating cervical cancer. MRI is the optimal imaging technique to visualize the intracavitary brachytherapy probes and MRI-guided intracavitary brachytherapy is expected to increase significantly over the next 5 years. The purpose of this article is to review what a radiologist needs to know about imaging brachytherapy probes including the MR technique, correct positioning of the probes, and associated complications. CONCLUSION: MRI-guided intracavitary brachytherapy is an increasingly used therapy for the treatment of cervical cancer. This technique provides excellent visualization of intracavitary brachytherapy devices and allows accurate localization of residual tumor. It is important for radiologists to be familiar with the correct probe positioning as well as any potential complications.

Educational films for improving screening and self-management of gestational diabetes in India and Uganda (GUIDES): study protocol for a cluster-randomised controlled trial.

BACKGROUND: The prevalence of gestational diabetes mellitus (GDM) is rising rapidly in many low- and middle-income countries (LMICs). Most women with GDM in LMICs are undiagnosed and/or inadequately managed due to a lack of knowledge and skills about GDM on the part of both providers and patients. Following contextual analysis, we developed an educational/behavioural intervention for GDM delivered through a package of culturally tailored films. This trial aims to evaluate whether the intervention can improve the timely detection and management of GDM in two LMIC settings. METHODS: Two independent cluster randomised controlled trials, one each to be conducted in Uganda and India. Thirty maternity facilities in each country have been recruited to the study and randomised in a 1:1 ratio to the intervention and control arms. The intervention comprises of three interconnected sets of films with the following aims: to improve knowledge of GDM guidelines and skills of health providers, to raise awareness of GDM screening among pregnant women and their families, and to improve confidence and skills in self-management among those diagnosed with GDM. In facilities randomised to the intervention arm, a GDM awareness-raising film will be shown in antenatal care waiting rooms, and four films for pregnant women with GDM will be shown in group settings and made available for viewing on mobile devices. Short films for doctors and nurses will be presented at professional development meetings. Data will be collected on approximately 10,000 pregnant women receiving care at participating facilities, with follow-up at 32 weeks gestational age and 6 weeks postnatally. Women who self-report a GDM diagnosis will be invited for a clinic visit at 34 weeks. Primary outcomes are (a) the proportion of women who report a GDM diagnosis by 32 weeks of pregnancy and (b) glycaemic control (fasting glucose and HbA1C) in women with GDM at ~34 weeks of pregnancy. The secondary outcome is a composite measure of GDM-related adverse perinatal-neonatal outcome. DISCUSSION: Screening and management of GDM are suboptimal in most LMICs. We hypothesise that a scalable film-based intervention has the potential to improve the timely detection and management of GDM in varied LMIC settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT03937050 , registered on 3 May 2019. Clinical Trials Registry India CTRI/2020/02/023605 , registered on 26 February 2020.

Ayurvedic Management of Emesis Gravidarum - A Case Report

Emesis is a common experience in first trimester of pregnancy affecting 70 to 80% of all pregnant women. Altered immunological endocrinological and psychological states are responsible for initiation of symptoms. Mild to moderate emesis gravidarum have a significant adverse effect on quality of women's life. Even though onset is physiological its morbidity has to be reduced to minimize disease burden, enhance maternal health and to prevent hyper emesis gravidarum. Anti-emetic and anti-histamines are used in conventional Allopathic practice. Ayurvedic principle is early intervention and prevention of hyperemesis gravidarum with lifestyle modifications and adopting Pathya ahara. This is a case report of emesis gravidarum managed with pharmaco nutrient product –Malarinji modaka

Ultrasonographic assessment of paediatric ocular emergencies: A tertiary eye hospital based observation / 世界急诊医学杂志（英文）

BACKGROUND: The purpose of this study is to assess the utility of ocular ultrasound B scan in the emergency at the first point of care for detecting posterior segment and orbital pathologies in cases of paediatric ocular emergencies. METHODS: A prospective observational study involving 122 paediatric patients presenting to eye emergency over a period of ninety days were assessed with ultrasonography for the posterior segment as well as orbital pathology whenever indicated. The ocular ultrasound was performed gently over closed eyelids. RESULTS: Posttraumatic globe injuries were the most common indication for posterior segment evaluation, which constituted 80 (65.57％) eyes. Among these 52 patients had an anechoic posterior segment and 28 patients had variable findings such as vitreous haemorrhage (8.19％), retinal detachment (6.55％), choroidal detachment (4.91％), posteriorly dislocated clear lens (0.81％) and retained intraocular foreign body (5.73％). Non-traumatic cases constituted around 42 (34.42％) eyes, which included corneal ulcer (7.37％), retinoblastoma (6.55％), endophthalmitis (4.91％), extraocular muscle cysticercosis (4.91％), orbital cellulitis (4.09％), periocular haemorrhage (2.45％), proptosis(1.63％), paediatric cataract (1.63％) and cryptophthalmos (0.81％). No adverse events of performing the ultrasound was noted. CONCLUSION: First point ultrasonography in paediatric ocular emergencies is a cheap, portable and an effective tool in the assertion of significant posterior segment and orbital diseases.