Thyrotoxic hypokalemic periodic paralysis in an African male: a case report

Thyrotoxic hypokalemic periodic paralysis is a rare manifestation of thyrotoxicosis and is rarely reported in non‐Asian populations. A 26‐year‐old Ethiopian male who presented with recurrent flaccid tetraparesis, hypokalemia, and hyperthyroidism is reported here. Thyroid function should be routinely checked in patients with acute or recurrent hypokalemic paralysis.     

Effects of mavacamten on Ca2+ sensitivity of contraction as sarcomere length varied in human myocardium

Background and PurposeHeart failure can reflect impaired contractile function at the myofilament level. In healthy hearts, myofilaments become more sensitive to Ca²⁺ as cells are stretched. This represents a fundamental property of the myocardium that contributes to the Frank–Starling response, although the molecular mechanisms underlying the effect remain unclear. Mavacamten, which binds to myosin, is under investigation as a potential therapy for heart disease. We investigated how mavacamten affects the sarcomere‐length dependence of Ca²⁺‐sensitive isometric contraction to determine how mavacamten might modulate the Frank–Starling mechanism.Experimental ApproachMulticellular preparations from the left ventricular‐free wall of hearts from organ donors were chemically permeabilized and Ca²⁺ activated in the presence or absence of 0.5‐μM mavacamten at 1.9 or 2.3‐μm sarcomere length (37°C). Isometric force and frequency‐dependent viscoelastic myocardial stiffness measurements were made.Key ResultsAt both sarcomere lengths, mavacamten reduced maximal force and Ca²⁺ sensitivity of contraction. In the presence and absence of mavacamten, Ca²⁺ sensitivity of force increased as sarcomere length increased. This suggests that the length‐dependent activation response was maintained in human myocardium, even though mavacamten reduced Ca²⁺ sensitivity. There were subtle effects of mavacamten reducing force values under relaxed conditions (pCa 8.0), as well as slowing myosin cross‐bridge recruitment and speeding cross‐bridge detachment under maximally activated conditions (pCa 4.5).Conclusion and ImplicationsMavacamten did not eliminate sarcomere length‐dependent increases in the Ca²⁺ sensitivity of contraction in myocardial strips from organ donors at physiological temperature. Drugs that modulate myofilament function may be useful therapies for cardiomyopathies.     

Optimized Ni1−xAlxO hole transport layer for silicon solar cells

NiO alloyed with aluminum, Ni_1−xAl_xO, is analyzed in terms of its stoichiometry, electronic and transport properties, as well as interfacial band alignment with Si to evaluate its potential use as a hole transport layer (HTL) in p–i–n type solar cells. The analysis is based on component material and slab structural simulations, as well as simulated and measured angle-resolved valence-band photoemission spectroscopy (PES) data, in order to reveal the best suitable stoichiometry. It is concluded that the ionization energy from the highest occupied states tends to increase with Al content as the simulated work function grows from 4.1 eV for pure NiO to 4.7 eV for heavily alloyed Al_0.50Ni_0.50O. The electronic structure as a function of the interface design between crystalline silicon and the transport layer is used to assess the band lineup and its correlation with the discontinuity of the affinities. The affinity rule is tested by evaluating the workfunctions of the component layers and justified best for a particular Ni-enriched interface design. Technology Computer-Aided Design (TCAD) device simulations show, that the band offset between oxide and crystalline silicon remains within the range of values to sustain a staggering alignment – a condition suitable for effective charge separation, similar to a situation in a tunneling diode. The self-energy of the hole carriers is estimated by contrasting simulated and measured photoemission data, which in the case of non-annealed Al-rich samples is shown to be an order of magnitude higher due to the disorder effects. The work functions derived from the measured PES data for the epitaxially grown oxide films with nearly identical alloy stoichiometry correlate well with the simulated values. The findings suggest that the optimal HTL is formed by starting with a pure Ni layer, followed by a graded doping Al_xNi_1−xO, with x high at contact/oxide interface and low at the oxide/semiconductor.

NiO alloyed with aluminum, Ni_1−xAl_xO, is analyzed in terms of its stoichiometry, electronic and transport properties, as well as interfacial band alignment with Si to evaluate its potential use as a hole transport layer (HTL) in p–i–n type solar cells.     

Intersections of girl child marriage and family planning beliefs and use: qualitative findings from Ethiopia and India

Child marriage and subsequent early first birth is a considerable social, economic and health concern, and a pervasive practice in sub-Saharan Africa and South Asia. This study explores barriers and facilitators to family planning among women and girls, and their marital decision-makers subsequent to receipt of child marriage prevention programmes in Ethiopia and India. In-depth interviews with 128 women and girls who were married as minors or who cancelled or postponed marriage as minors and their marital decision-makers were analysed using content analysis. Respondents identified social norms, including child marriage and pressure to have children, and lack of information as barriers to family planning. Benefits included delayed first birth and increased birth spacing, improved maternal and child health and girls’ educational attainment. Respondents associated family planning use with delayed pregnancy and increased educational attainment, particularly in Ethiopia. Child marriage prevention programmes were identified as important sources of family planning information. Ethiopia’s school-based programme strengthened access to health workers and contraception more so than India’s community-based programme. Findings highlight young wives’ vulnerability with regard to reproductive control, and support the need for multi-sector approaches across communities, schools and community health workers to improve family planning among young wives.     

Intracellular growth of nanoscale perfluorocarbon droplets for enhanced ultrasound-induced phase-change conversion

Perfluorocarbon (PFC) nanodroplets (NDs) have been proposed as phase-change contrast agents for ultrasound imaging. Since the ultrasound energy required to convert PFC droplets to microbubbles is inversely related to size, the conversion of PFC NDs at clinically-relevant pressures is challenging. We propose that if PFC NDs can accumulate in a close-packed configuration and grow in size in situ, phase-change conversion can occur at lower ultrasound pressures compared with isolated NDs. In this article, we show that PFC NDs can be designed to grow in size after loading in cells, from 0.26 ± 0.09 μm to 1.7 ± 0.6 μm after 2 h. This growth allowed for a substantial decrease in the ultrasound conversion threshold (to 1.4 MPa and 4.8 MPa at 1 MHz and 18 MHz, respectively), whereas non-coalesced NDs in cells and NDs alone were not converted up to the maximum applied pressure (2.1 MPa and 6.3 MPa at 1 MHz and 18 MHz, respectively). These results indicate that PFC NDs with conversion pressures too high for diagnostically feasible conversion can be used as phase-change agents if they can be induced to grow in size in situ.     

Patterns of pulmonary dysfunction in asbestos workers: a cross-sectional study

Background  

Restrictive patterns of pulmonary function abnormalities associated with asbestos exposure are well described. Studies are less consistent, however, regarding the association of asbestos inhalation with airway dysfunction and obstructive impairment.     

Grand rounds: asbestos-related pericarditis in a boiler operator

CONTEXT: Occupational and environmental exposures to asbestos remain a public health problem even in developed countries. Because of the long latency in asbestos-related pathology, past asbestos exposure continues to contribute to incident disease. Asbestos most commonly produces pulmonary pathology, with asbestos-related pleural disease as the most common manifestation. Although the pleurae and pericardium share certain histologic characteristics, asbestos-related pericarditis is rarely reported. CASE PRESENTATION: We present a 59-year-old man who worked around boilers for almost 30 years and was eventually determined to have calcific, constrictive pericarditis. He initially presented with an infectious exacerbation of chronic bronchitis. Chest radiographs demonstrated pleural and pericardial calcifications. Further evaluation with cardiac catheterization showed a hemodynamic picture consistent with constrictive pericarditis. A high-resolution computerized tomography scan of the chest demonstrated dense calcification in the pericardium, right pleural thickening and nodularity, right pleural plaque without calcification, and density in the right middle lobe. Pulmonary function testing showed mild obstruction and borderline low diffusing capacity. DISCUSSION: Based on the patient's occupational history, the presence of pleural pathology consistent with asbestos, previous evidence that asbestos can affect the pericardium, and absence of other likely explanations, we concluded that his pericarditis was asbestos-related. RELEVANCE TO CLINICAL PRACTICE: Similar to pleural thickening and plaque formation, asbestos may cause progressive fibrosis of the pericardium.     

Prevalence of Medication Non-Adherence and Associated Factors among Diabetic Patients in A Tertiary Hospital at Debre Markos,Northwest Ethiopia

BackgroundNon-adherence to prescribed medications is possibly the most common reason for poor treatment outcomes among people with diabetes although its rate is highly variable. Data on the magnitude of medication non-adherence and associated factors are scarce in the study area. This study aimed to assess the rate of non-adherence and associated factors among diabetic patients at Debre Markos Comprehensive Specialized Hospital.MethodsA cross-sectional study was conducted from June 17 to July 17, 2021. Study participants were selected using a simple random sampling technique. Data were collected with a pre-tested structured questionnaire and entered into SPSS version 25. Logistic regression was utilized to determine predictors of medication non-adherence at a significance level of ≤ 0.05.ResultsA total of 176 study participants were enrolled in the study. About 59% of the study participants had type-2 diabetes mellitus. The prevalence of non-adherence to anti-diabetic medications was found to be 41.5%. Male sex, rural residence, being divorced, being merchant, self- or family-borne medical cost, and presence of comorbidities were significantly associated with increased rate of non-adherence to anti-diabetic medications.ConclusionThe prevalence of non-adherence to medications among diabetic patients is significantly high in the study area. Public health measures should be strengthened to decrease nonadherence among diabetic patients.