Ultrasound-induced thermal elevation in clotted blood and cranial bone

Ultrasound thermal effects have been hypothesized to contribute to ultrasound-assisted thrombolysis. To explore the thermal mechanism of ultrasound-enhanced thrombolysis with recombinant tissue plasminogen activator (rt-PA) for the treatment of ischemic stroke, a detailed investigation is needed of the heating produced in skull, brain and blood clots. A theoretical model is developed to provide an estimate for the worst-case scenario of the temperature increase in blood clots and on the surface of cranial bone exposed to 0.12- to 3.5-MHz ultrasound. Thermal elevation was also assessed experimentally in human temporal bone, human clots and porcine clots exposed to 0.12 to 3.5-MHz pulsed ultrasound in vitro with a peak-to-peak pressure of 0.25 MPa and 80% duty cycle. Blood clots exposed to 0.12-MHz pulsed ultrasound exhibited a small temperature increase (0.25 degrees C) and bone exposed to 1.0-MHz pulsed ultrasound exhibited the highest temperature increase (1.0 degrees C). These experimental results were compared with the predicted temperature elevations.     

Sphenoid wing meningiomas: peritumoral brain edema as a prognostic factor in surgical outcome

Neurosurgical Review - Sphenoidal meningiomas constitute 18% of intracranial masses, and still present a difficult surgical challenge. PTBE has been associated with several complications and future...     

Bitumen Binders Modified with Sulfur/Organic Copolymers

With the continuing growth of waste sulfur production from the petroleum industry processes, its utilization for the production of useful, low-cost, and environmentally beneficial materials is of primary interest. Elemental sulfur has a significant and established history in the modification of bitumen binders, while the sulfur-containing high-molecular compounds are limited in this field. Herein, we report a novel possibility to utilize the sulfur/organic copolymers obtained via the inverse vulcanization process as modifiers for bitumen binders. Synthesis and thermal characterization (TGA-DSC) of polysulfides derived from elemental sulfur (S₈) and unsaturated organic species (dicyclopentadiene, styrene, and limonene) have been carried out. The performance of modified bitumen binders has been studied by several mechanical measurements (softening point, ductility, penetration at 25 °C, frass breaking point, adhesion to glass and gravel) and compared to the unmodified bitumen from the perspective of normalized requirements concerning polymer-modified bitumen. The interaction of bitumen binder with sulfur/organic modifier has been studied by means of FTIR spectroscopy and DSC measurements. The impact of the modification on the performance properties of bitumen has been demonstrated. The bitumen binders modified with sulfur/organic copolymers are in general less sensitive to higher temperatures (higher softening point up to 7 °C), more resistant to permanent deformations (lower penetration depth), and more resistant to aging processes without intrusive deterioration of parameters at lower temperatures. What is more, the modification resulted in significantly higher adhesion of bitumen binders to both glass (from 25% up to 87%) and gravel surfaces in combination with a lower tendency to form permanent deformations (more elastic behavior of the modified materials).     

FIVE YEARS AFTER DEVELOPMENT OF THE NATIONAL DISABILITY,HEALTH AND REHABILITATION PLAN FOR UKRAINE: ACHIEVEMENTS AND CHALLENGES

In 2015, technical consultation to support development of the National Disability, Health and Rehabilitation Plan in Ukraine was carried out by the Rehabilitation Advisory Team of the International Society of Physical and Rehabilitation Medicine. Recommendations for actions and projects to improve rehabilitation services within the healthcare system in Ukraine were developed, proposed and implemented. The achievements in the subsequent 5 years include establishing, training and enabling employment at healthcare facilities for new rehabilitation professionals (physical and rehabilitation medicine physicians, physical therapists, occupational therapists), commencing implementation of the International Classification of Functioning, Disability and Health (ICF), and increasing rehabilitation knowledge among Ukrainian communities and decision-makers. The main challenges include inappropriate healthcare legislation for developing modern rehabilitation services, gaps in the clinical environment and quality control for training rehabilitation professionals, and the slow pace of implementation of the ICF. A general facilitator is the ongoing healthcare reform in Ukraine, especially its continuation to secondary and tertiary healthcare levels. Future high-priority activities will include amendments to basic healthcare legislation, and introducing a bio-psycho-social approach for the provision of rehabilitation services at all healthcare levels and all rehabilitation treatment phases, starting with the most debilitating health conditions. It will be important to continue the collaboration with European and international partners. LAY ABSTRACTUkraine developed a National Disability, Health and Rehabilitation Plan (NDHRP) in 2015. Since then, the recommended actions and projects have been implemented in the country. Some achievements can be seen, including the establishment of new rehabilitation professions (i.e. physical and rehabilitation medicine (PRM) physician and ergotherapist (the Ukrainian terminology for occupational therapist); implementation of the International Classification of Functioning, Disability and Health (ICF); and commencement of implementation of rehabilitation at different levels of healthcare. However, some challenges still need to be addressed, including the introduction of legislation to enable the delivery of effective and safe rehabilitation services, continuing education for rehabilitation professionals, and raising awareness of the ICF implementation, which is based on introducing a biopsycho-social model into the entire clinical process of rehabilitation. With the support of international partners, including European PRM bodies and other international organizations, the outlook for improvement in the field of rehabilitation in Ukraine is very positive. Key words: rehabilitation system, rehabilitation service, rehabilitation profession, rehabilitation service situation analysis, Ukraine, National Disability, Health and Rehabilitation Plan

Since Soviet times Ukraine’s healthcare system has retained a healthcare model with centralized funding, financing “for beds at hospitals”, paper medical records, and wide practice of out-of-pocket payments (1). A further problem is the systemic mistranslation and misuse of the term “healthcare” as “medical care”, starting from the level of legislation, and resulting in misunderstanding of healthcare by many generations of healthcare workers and the general public. At the same time, Ukraine had an inherited rehabilitation system, which was based predominantly on a bio-medical model of disability. Existing rehabilitation legislation in Ukraine still only covers populations with a certified disability (the Ukrainian term “invalidity” is assigned after special assessment by the Medical and Social Examination Commissions (MSECs)). The majority of rehabilitation measures focus on compensation of functional deficits and different kinds of social support provided through so-called invalidity groups. Since 2014 the armed conflict in eastern Ukraine has resulted in numerous injuries among military service personnel and civilians, and thus has greatly increased demands for rehabilitation services. For these reasons, the existing system of “medical rehabilitation” has collapsed, and the need for development of the National Disability, Health and Rehabilitation Plan (NDHRP) for Ukraine has become undeniable. The Ukrainian government (in particular the Ministry of Health of Ukraine; MoH) decided to implement the principles of the World Health Organization (WHO) Global Disability Action Plan 2014–2021 (GDAP; 2) by initiating a technical consultation to support development of the NDHRP in Ukraine. This was carried out by the Rehabilitation Advisory Team (RAT) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in 2015 (3). The mission was based on the principles of the United Nations (UN) Convention on the Rights of Persons with Disabilities (4) and the World Report on Disability (WRD; 5). The goalsetting was derived from the WHO GDAP’s “Better Health for All People with Disabilities” (2), and the mission used the specially developed Rehabilitation Service Assessment Tool (RSAT; 6).The main findings from this mission included the absence of essential rehabilitation professionals in the country, a bio-medical approach to rehabilitation delivery, a complete discrepancy in meanings/translations and application of international rehabilitation-related terminology, and a lack of intersectoral coordination between the governing bodies responsible for the provision of rehabilitation services.     

Catalase inhibition by amino triazole induces oxidative stress in goldfish brain

The effects of in vivo inhibition of catalase by 3-amino 1,2,4-triazole (AMT) on the levels of damage products resulting from reactive oxygen species attack on proteins and lipids as well as on the activities of five antioxidant and associated enzymes were studied in the brain of goldfish, Carassius auratus. Intraperitoneal injection of AMT at a concentration of 0.1 mg/g wet weight caused a gradual decrease in brain catalase activity over 72 h, whereas higher AMT concentrations (0.5 or 1.0 mg/g) reduced catalase activity by about two-thirds within 5-10 h. AMT effects on antioxidant enzyme activities and oxidative stress markers were studied in detail using fish treated with 0.5 mg/g AMT for 24 or 168 h. The levels of thiobarbituric acid-reactive substances (a lipid damage product) increased 6.5-fold by 24 h after AMT injection but fell again after 168 h. The content of carbonylproteins (CP) also rose within 24 h (by approximately 2-fold) and remained 1.5-fold higher compared with respective sham-injected fish after 168 h. CP levels correlated inversely with catalase activity (R(2) = 0.83) suggesting that catalase may protect proteins in vivo against oxidative modification. The activities of both glutathione peroxidase and glutathione-S-transferase increased by approximately 50% and 80%, respectively, in brain of AMT-treated fish and this might represent a compensatory response to lowered catalase activity. Possible functions of catalase in the maintenance of prooxidant/antioxidant balance in goldfish brain are discussed.     

Global air quality and health co-benefits of mitigating near-term climate change through methane and black carbon emission controls

Background: Tropospheric ozone and black carbon (BC), a component of fine particulate matter (PM ≤ 2.5 µm in aerodynamic diameter; PM_2.5), are associated with premature mortality and they disrupt global and regional climate.Objectives: We examined the air quality and health benefits of 14 specific emission control measures targeting BC and methane, an ozone precursor, that were selected because of their potential to reduce the rate of climate change over the next 20–40 years.Methods: We simulated the impacts of mitigation measures on outdoor concentrations of PM_2.5 and ozone using two composition-climate models, and calculated associated changes in premature PM_2.5- and ozone-related deaths using epidemiologically derived concentration–response functions.Results: We estimated that, for PM_2.5 and ozone, respectively, fully implementing these measures could reduce global population-weighted average surface concentrations by 23–34% and 7–17% and avoid 0.6–4.4 and 0.04–0.52 million annual premature deaths globally in 2030. More than 80% of the health benefits are estimated to occur in Asia. We estimated that BC mitigation measures would achieve approximately 98% of the deaths that would be avoided if all BC and methane mitigation measures were implemented, due to reduced BC and associated reductions of nonmethane ozone precursor and organic carbon emissions as well as stronger mortality relationships for PM_2.5 relative to ozone. Although subject to large uncertainty, these estimates and conclusions are not strongly dependent on assumptions for the concentration–response function.Conclusions: In addition to climate benefits, our findings indicate that the methane and BC emission control measures would have substantial co-benefits for air quality and public health worldwide, potentially reversing trends of increasing air pollution concentrations and mortality in Africa and South, West, and Central Asia. These projected benefits are independent of carbon dioxide mitigation measures. Benefits of BC measures are underestimated because we did not account for benefits from reduced indoor exposures and because outdoor exposure estimates were limited by model spatial resolution.     

Alternative splicing of cGMP-dependent protein kinase I in angiotensin-hypertension: novel mechanism for nitrate tolerance in vascular smooth muscle

Nitrate tolerance (NT) in hypertension is attributed to reduced activity of soluble guanylyl cyclase (sGC). We examined NT in basilar artery vascular smooth muscle cells (VSMCs) from control rats, rats infused with angiotensin II (Ang; 240 microg/kg per hour for 4 days), which were normotensive, and Ang-hypertensive rats (AHR; 240 microg/kg per hour for 28 days). Ca2+-activated K+ (Maxi-K) channels in VSMCs from AHR showed reduced activation by NO donor, consistent with NT. The concentration-response relationship for 8-Br-cGMP was shifted 2.5-fold to the right, indicating that abnormal sGC alone could not account for NT. Inside-out patches from AHR showed normal activation with exogenous cGMP-dependent protein kinase I (cGKI), suggesting no abnormality downstream of cGKI. We hypothesized that the reduction in apparent affinity of 8-Br-cGMP for cGKI in AHR might be due to a change in relative amounts of cGKIalpha versus cGKIbeta, since cGKIbeta is less sensitive to cGMP activators than cGKIalpha. This was substantiated by showing the following in AHR: (1) reduced effect of the cGKIalpha-selective activator 8-APT-cGMP; (2) reduced total cGKI protein (both isoforms), but an increase in cGKIbeta protein in quantitative immunofluorescence and Western blots; (3) similar changes in cGKI isoforms immunoisolated with Maxi-K channels; and (4) a large increase in cGKIbeta mRNA and a decrease in cGKIalpha mRNA in real-time PCR and Northern blots. Upregulation of cytosolic cGKIbeta was evident 4 days after Ang infusion, before development of hypertension. Our data identify a functional role for cGKIbeta in VSMCs previously ascribed exclusively to cGKIalpha. Ang-induced alternative splicing of cGKI represents a novel mechanism for reducing sensitivity to NO/cGMP.