Utility of impedance cardiography for the identification of short-term risk of clinical decompensation in stable patients with chronic heart failure.

OBJECTIVES: This study sought to assess the potential utility of impedance cardiography (ICG) in predicting clinical deterioration in ambulatory patients with heart failure (HF). BACKGROUND: Impedance cardiography uses changes in thoracic electrical impedance to estimate hemodynamic variables, but its ability to predict clinical events has not been evaluated. METHODS: We prospectively evaluated 212 stable patients with HF and a recent episode of clinical decompensation who underwent serial clinical evaluation and blinded ICG testing every 2 weeks for 26 weeks and were followed up for the occurrence of death or worsening HF requiring hospitalization or emergent care. RESULTS: During the study, 59 patients experienced 104 episodes of decompensated HF (16 deaths, 78 hospitalizations, and 10 emergency visits). Multivariate analysis identified 6 clinical and ICG variables that independently predicted an event within 14 days of assessment. These included three clinical variables (visual analog score, New York Heart Association functional class, and systolic blood pressure) and three ICG parameters (velocity index, thoracic fluid content index, and left ventricular ejection time). The three ICG parameters combined into a composite score was a powerful predictor of an event during the next 14 days (p = 0.0002). Visits with a high-risk composite score had 2.5 times greater likelihood and those with a low-risk score had a 70% lower likelihood of a near-term event compared with visits at intermediate risk. CONCLUSIONS: These results suggest that when performed at regular intervals in stable patients with HF with a recent episode of clinical decompensation, ICG can identify patients at increased near-term risk of recurrent decompensation.     

Molecular Evolution of Peste des Petits Ruminants Virus

Despite safe and efficacious vaccines against peste des petits ruminants virus (PPRV), this virus has emerged as the cause of a highly contagious disease with serious economic consequences for small ruminant agriculture across Asia, the Middle East, and Africa. We used complete and partial genome sequences of all 4 lineages of the virus to investigate evolutionary and epidemiologic dynamics of PPRV. A Bayesian phylogenetic analysis of all PPRV lineages mapped the time to most recent common ancestor and initial divergence of PPRV to a lineage III isolate at the beginning of 20th century. A phylogeographic approach estimated the probability for root location of an ancestral PPRV and individual lineages as being Nigeria for PPRV, Senegal for lineage I, Nigeria/Ghana for lineage II, Sudan for lineage III, and India for lineage IV. Substitution rates are critical parameters for understanding virus evolution because restrictions in genetic variation can lead to lower adaptability and pathogenicity.     

Experimental Investigations on Dry Sliding Wear Behavior of Kevlar and Natural Fiber-Reinforced Hybrid Composites through an RSM–GRA Hybrid Approach

The present work aimed to investigate the dry sliding wear behaviors of hybrid polymer matrix composites made up of Kevlar, bamboo, palm, and Aloe vera as reinforcement materials of varying stacking sequences, along with epoxy as the matrix material. Three combinations of composite laminates with different stacking sequences such as AB, BC, and CA were fabricated by a vacuum-assisted compression molding process. The influence of composite laminates fabricated through various stacking sequences and dry sliding wear test variables such as load, sliding distance, and sliding velocity on the specific wear rate and co-efficient of friction were investigated. Experiments were designed and statistical validation was performed through response surface methodology-based D-optimal design and analysis of variance. The optimization was performed using grey relational analysis (GRA) to identify the optimal parameters to enhance the wear resistance of hybrid polymer composites under dry sliding conditions. The optimal parameters, such as composite combinations of CA, a load of 5 N, a sliding velocity of 3 m/s, and a sliding distance of 1500 m, were obtained. Furthermore, the morphologies of worn-out surfaces were investigated using SEM analysis.     

Improved biorefinery pathways of marine diatoms using a water miscible ionic liquid and its colloidal solution: efficient lipid extraction and in situ synthesis of fluorescent carbon dots for bio-imaging applications

In this study, a water-miscible ‘classic’ ionic liquid (IL), 1-ethyl-3-methylimidazoliumacetate ([EMIM][Ac]), has been used for lipid extraction from marine diatoms Thalassiosira lundiana CSIR-CSMCRI 001 by following a non-polar solvent partition method. The composition of lipid was determined using gas chromatography-mass spectrometry (GC-MS). In total, 91.4 mg g⁻¹ (dry wt) of lipid was produced, out of which the percentage of docosahexaenoic acids (DHA), myristic acid, palmitic acid, and arachidonic acid was 19.6%, 15.1%, 11.2%, and 10.4%, respectively. The IL-inseparable residual waste solution was directly used to generate green fluorescent carbon dots (FCDs) by constructing a colloidal solution with the help of a surface-active IL, choline dioctyl sulfosuccinate ([Cho][AOT]). The stability of colloidal FCDs was examined using FTIR, FT-NMR, and Raman spectroscopy. FCDs were extracted from the colloidal solutions via the demicellization process and characterized using HR-TEM (2 to 5 nm) and PXRD techniques. The optical properties of colloidal FCDs were measured using UV-Vis and fluorescence spectroscopy and showed a wide range of emission (λ_{460 nm} to λ_{590 nm}). Such FCD stabilized colloidal solutions could be effectively used in fluorescence imaging of yeast cells, thus making the biorefinery approach more sustainable.

In this study, a water-miscible ionic liquid (IL), 1-ethyl-3-methylimidazoliumacetate ([EMIM][Ac]), has been used for lipid extraction from marine diatoms Thalassiosira lundiana CSIR-CSMCRI 001 by following a non-polar solvent partition method.     

Effect of sensorineural hearing loss on neurocognitive and adaptive functioning in survivors of pediatric embryonal brain tumor

Journal of Neuro-Oncology - Survivors of pediatric embryonal brain tumors (BT) are at high risk for sensorineural hearing loss (SNHL) associated with neurocognitive decline. However, previous...     

Neurogenic heterotopic ossification : a diagnostic and therapeutic challenge in neurorehabilitation

Heterotopic ossification (HO) is an important cause of restriction in range of movements and secondary motor disability following neurotrauma, orthopaedic interventions and burns. It has not received focussed attention in non-traumatic neurological disorders. In a prospective study of 377 patients, on medical problems in neurological rehabilitation setting, 15 subjects (3.97%) had neurogenic heterotopic ossification. Their clinical diagnosis was: transverse myelitis (7), neurotuberculosis (4), traumatic myelopathy (2) and stroke (2). Hip (10), knee (4) and elbow joints (1) were involved. The risk factors included urinary tract infection (15), spasticity (6), pressure sores (13) and deep venous thrombosis (DVT) (6). The initial diagnosis was often other than HO and included DVT (3), haematoma (2) and arthritis (2). ESR and serum alkaline phosphatase levels were elevated in all but one subject. The diagnosis of HO was established using X-rays, CT Scan and three-phase bone scan. Following treatment with non-steroidal anti-inflammatory drugs, the range of motion improved in only four patients. HO resulted in significant loss of therapy time during rehabilitation. High index of suspicion about this complication is necessary for early diagnosis and prompt intervention.     

Differential action potentials and firing patterns in injured and uninjured small dorsal root ganglion neurons after nerve injury

The profile of tetrodotoxin sensitive (TTX-S) and resistant (TTX-R) Na(+) channels and their contribution to action potentials and firing patterns were studied in isolated small dorsal root ganglion (DRG) neurons after L5/L6 spinal nerve ligation (SNL). Total TTX-R Na(+) currents and Na(v) 1.8 mRNA were reduced in injured L5 DRG neurons 14 days after SNL. In contrast, TTX-R Na(+)currents and Na(v) 1.8 mRNA were upregulated in uninjured L4 DRG neurons after SNL. Voltage-dependent inactivation of TTX-R Na(+) channels in these neurons was shifted to hyperpolarized potentials by 4 mV. Two types of neurons were identified in injured L5 DRG neurons after SNL. Type I neurons (57%) had significantly lower threshold but exhibited normal resting membrane potential (RMP) and action potential amplitude. Type II neurons (43%) had significantly smaller action potential amplitude but retained similar RMP and threshold to those from sham rats. None of the injured neurons could generate repetitive firing. In the presence of TTX, only 26% of injured neurons could generate action potentials that had smaller amplitude, higher threshold, and higher rheobase compared with sham rats. In contrast, action potentials and firing patterns in uninjured L4 DRG neurons after SNL, in the presence or absence of TTX, were not affected. These results suggest that TTX-R Na(+) channels play important roles in regulating action potentials and firing patterns in small DRG neurons and that downregulation in injured neurons and upregulation in uninjured neurons confer differential roles in shaping electrogenesis, and perhaps pain transmission, in these neurons.