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The rupture of a liquid film, where a thin liquid layer between two other fluids breaks and forms holes, commonly occurs in both natural phenomena and industrial applications. The post-rupture dynamics, from initial hole formation to the complete collapse of the film, are crucial because they govern droplet formation, which plays a significant role in many applications such as disease transmission, aerosol formation, spray drying nanodrugs, oil spill remediation, inkjet printing and spray coating. While single-hole rupture has been extensively studied, the dynamics of multiple-hole ruptures, especially the interactions between neighbouring holes, are less well understood. Here, this study reveals that when two holes ‘meet’ on a curved film, the film evolves into a spinning twisted ribbon before breaking into droplets, distinctly different from what occurs on flat films. We explain the formation and evolution of the spinning twisted ribbon, including its geometry, orbits, corrugations and ligaments, and compare the experimental observations with models. We compare and contrast this phenomena with its counterpart on planar films. While our experiments are based on the multiple-hole ruptures in corona splash, the underlying principles are likely applicable to other systems. This study sheds light on understanding and controlling droplet formation in multiple-hole rupture, improving public health, climate science and various industrial applications.
The Edgerton crown is an iconic manifestation of drop impact splashing, with its prominent cylindrical edge decorated with detaching droplets. Herein, we identify the formation of an intriguing double-crown, when a high-viscosity drop impacts on a shallow pool of a lower-viscosity immiscible liquid. High-speed imaging shows that after the initial fine horizontal ejecta sheet, the first inner crown emerges vertically from the film liquid. This is followed by the second crown which forms near the outer base of the first crown, as the tip of the horizontally spreading viscous drop approaches the outer free surface. Axisymmetric numerical simulations, using the volume-of-fluid method with adaptive grid refinement, show that the flow squeezed out between the viscous drop and the solid surface, generates two counter-rotating vortex rings, which travel radially outwards together and drive out the second crown through the free surface. The bottom vortex emerges from the separated boundary layer at the solid wall, while the top one detaches from the underside of the viscous drop. We map out the narrow parameter regime, where this ephemeral structure emerges, in terms of viscosity ratio, impact velocity and film thickness.
We model the slip length tribometer (SLT), originally presented by Pelz et al. (J. Fluid Mech., vol. 948, 2022, p. A8) in OpenFOAM. The plate tribometer is especially designed to simultaneously measure viscosity and slip length for lubrication gaps in the range of approximately 10 $\mathrm {\mu }$m at temperatures and surface roughnesses relevant to technical applications, with a temperature range of $-30$ to $100\,^\circ \mathrm {C}$ and surface roughness ranging from $10\ \mathrm {nm}$ to $1\ \mathrm {\mu }\mathrm {m}$. A simplified analytical model presented by Pelz et al. (J. Fluid Mech., vol. 948, 2022, p. A8) infers the slip length of the plate from the experimentally measured torque and the plate gap height. The present work verifies the analytical model using axisymmetric flow simulations and presents the effect of inlet on the numerical velocity profiles. The simulation results are in very good agreement with the results of the analytical model. The main conclusion drawn from this study is the validation of the Navier-slip boundary condition as an effective model for partial slip in computational fluid dynamics simulations and the negligible influence of the inlet on the fluid flow between the SLT's plates.
Patients with Fontan failure are high-risk candidates for heart transplantation and other advanced therapies. Understanding the outcomes following initial heart failure consultation can help define appropriate timing of referral for advanced heart failure care.
Methods:
This is a survey study of heart failure providers seeing any Fontan patient for initial heart failure care. Part 1 of the survey captured data on clinical characteristics at the time of heart failure consultation, and Part 2, completed 30 days later, captured outcomes (death, transplant evaluation outcome, and other interventions). Patients were classified as “too late” (death or declined for transplant due to being too sick) and/or “care escalation” (ventricular assist device implanted, inotrope initiated, and/or listed for transplant), within 30 days. “Late referral” was defined as those referred too late and/or had care escalation.
Results:
Between 7/2020 and 7/2022, 77 Fontan patients (52% inpatient) had an initial heart failure consultation. Ten per cent were referred too late (6 were too sick for heart transplantation with one subsequent death, and two others died without heart transplantation evaluation, within 30 days), and 36% had care escalation (21 listed ± 5 ventricular assist device implanted ± 6 inotrope initiated). Overall, 42% were late referrals. Heart failure consultation < 1 year after Fontan surgery was strongly associated with late referral (OR 6.2, 95% CI 1.8–21.5, p=0.004).
Conclusions:
Over 40% of Fontan patients seen for an initial heart failure consultation were late referrals, with 10% dying or being declined for transplant within a month of consultation. Earlier referral, particularly for those with heart failure soon after Fontan surgery, should be encouraged.
Anemia due to iron deficiency is a highly prevalent medical condition in women and children. Iron deficiency presents with fatigue, low mood, anxiety, restlessness, palpitations, and headache. Poor nutritional intake can be the reason of iron deficiency in underprivileged populations. It can lead to behavioral symptoms that can manifest as chronic psychiatric ailments.
Objectives
Our objective is to consolidate manifestations of iron deficiency anemia concerning psychiatric ailments. We will figure out if it impacts the severity of psychiatric symptoms. We aim to find out if there are any underlying factors that impact the correlation of iron deficiency with psychiatric disorders like depression, anxiety, sleep disorders, and restless leg syndrome.
Methods
Detailed literature review conducted using PUBMED, OVID, GOOGLE SCHOLAR with the search terminologies [iron] OR [sleep disorders] OR [depression] OR[deficiency] OR [anxiety] OR [ADHD] OR [VITAMINS] OR[PICA] OR [CHILDREN] OR [women] OR [antidepressants] OR [sleep medicine] OR [antipsychotics] that yielded 150 results that were narrowed down to be focused on our research area. Inclusion criteria included studies with participants with iron deficiency anemia regardless of age group, gender, economic and social background. Exclusion criteria included patients with normal hemoglobin levels.
Results
Results yielded a positive impact of treating iron deficiency anemia in patients with psychiatric ailments. The symptoms of low mood, fatigue, anxiety, anhedonia, and sleeplessness get better as iron deficiency improves. According to the search, some physicians misdiagnose iron deficiency as depression. Antidepressants were found to be working better when added with iron supplements. Restlessness and palpitations can also be the manifestations of iron deficiency. Patients with underlying iron deficiency are more predisposed to developing psychiatric disorders. According to published data, restless leg syndrome was found to be associated with iron deficiency. Some psychiatric drugs can lead to iron deficiency and can provoke underlying iron deficiency even more. Iron deficiency impacts memory areas of the brain like the hippocampus and prefrontal cortex.
Conclusions
It is much needed more than ever before that proper consideration to the diagnosis of iron deficiency anemia must be given with the assistance of predesigned guidelines. Misdiagnosis of iron deficiency anemia as a psychiatric disorder can be misleading toward the insidious usage of psychiatric medications. Proper attention must be provided to this neglected area so that management of iron deficiency is tailored in the right direction and it is diagnosed at less severe stages. It will be helpful for general physicians and practicing psychiatrists in the field.
Keywords: Iron deficiency, Psychiatric Disorders, Anxiety, depression.
The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.
The poultry industry is mainly scared by affected by infections due to microorganisms which reduce the growth rate and cause economic losses. Currently, vaccines and antibiotics are utilised to combat these infectious microorganisms, but irresponsible use of antibiotics may pose health risks to consumers, and there is a need for drug-free alternatives. Nanotechnology could reduce such risks and can improve the wholesomeness of poultry meat. This review discusses the current status of nanotechnology as it relates to improving poultry health by using various nano-particles (NPs). Silver-NPs at a dose rate of 900 ppm have been used in poultry to improve their growth performance in terms of body weight, feed intake and feed conversion ratio. NPs are thought to boost immunity in birds against numerous diseases. Gold-NPs improved the growth performance of poultry birds as well as detecting avian influenza virus with a detection limit of 2.2 pg/ml. Similarly, Copper-loaded chitosan-NPs supplementation at dose rate of 100 mg/kg feed improved growth performance, immunity, protein synthesis and caecal microbiota in broilers. Zinc oxide-NPs improved growth performance and showed anti-oxidative properties in broilers at the dose rate of 20 mg/kg. While, montmorillonite nano-composites at a level of 3 g/kg feed decreased the toxicity of aflatoxins in poultry birds. In conclusion, nanotechnology has the potential to reduce microbial load without resulting drug residues in poultry products, thus improving performance and immune status of poultry birds.
OBJECTIVES/SPECIFIC AIMS: National concerns about IRB-related research delays have led to re-assessment of IRB review processes at institutional levels. We sought to address whether a dedicated IRB Liaison Service at the Irving Institute’s central location could provide additional useful staff support to the investigator community for interactions with the IRB at various levels of protocol submission. METHODS/STUDY POPULATION: We evaluated the results of a user satisfaction survey and performed a focused in-depth analysis of Liaison Service impact. An online tracking and satisfaction survey was implemented for researchers to complete following each consultation. The goal was to gauge the uses, user types and usefulness of the Service, and to follow-up with researchers who might have additional questions. Data was gathered about users of the Service and their affiliations, and the topics and questions that were discussed. A terse summary was drafted to categorize each consultation that was conducted during office hour sessions. Additionally, surveys were emailed to researchers to gauge their experience with the Service and their overall satisfaction. Users completed the survey either in person at the end of the consultation, or by email request sent immediately following each in-person consultation. The impact of the IRB Liaison Service on IRB protocol approval times was analyzed for a random sub-sample of protocols for which consultations were provided. Consultations for studies with an associated IRB protocol number (i.e., at least initially submitted) from May 2015-June 2017 had been assigned a number in an Excel file. Using a randomization formula, a subset of 90 protocols was identified for further analysis. Protocols that did not result in an IRB submission and duplicate entries were removed. The final dataset consisted of 67 protocols. Those protocols were assessed by type of review process (expedited versus full board review), by status (new submission, first return, second return, etc.), and by which of the seven IRB committees completed the review. Consultations for each protocol included in this subset were reviewed using the notes about that consultation. IRB records in Columbia’s online research oversight system, Rascal, were also reviewed to assess the timing of and issues raised in subsequent IRB review. Factors examined included whether the protocol was approved at next submission and if not, whether questions raised in subsequent IRB returns were related to the topics discussed in the consultation. RESULTS/ANTICIPATED RESULTS: Since its inception in January 2015 through June 2017 (2.5 years), a total of 501 in-person consultations have been performed, usually 25-30 per month. Users were primarily study coordinators and investigators. Most requests concerned new protocol development, policy questions or assistance in addressing IRB comments from submitted protocols. Survey response rate was 43%. Results of 215 competed satisfaction surveys were 100% positive. Of 67 unique protocols analyzed for outcomes of the consultation, 73% were subsequently approved within 14 days. DISCUSSION/SIGNIFICANCE OF IMPACT: Overall, we have found the Liaison Service to be a popular addition to research support, and plan to continue the service. We will continue to evaluate its user satisfaction and usefulness. Additional focus will be placed on whether the Service can improve approval times for human subjects research for protocols using the Liaison Service.
A third of patients diagnosed with major depressive disorder (MDD) experience treatment-resistant depression (TRD). Relatively few pharmacological agents have established efficacy for TRD. Therefore, the evaluation of novel treatments for TRD is a pressing priority. Statins are pleiotropic agents and preclinical studies as well as preliminary clinical trials have suggested that these drugs may have antidepressant properties.
Aims
To report on a protocol for a 12-week, randomised, double-blind, placebo-controlled trial of add-on treatment with simvastatin for patients meeting DSM-5 criteria for MDD who have failed to respond to at least two adequate trials with approved antidepressants. The trial has been registered with Clinicaltrials.gov in (ClinicalTrials.gov identifier: NCT03435744).
Method
After screening and randomisation to the two parallel arms of the trial, 75 patients will receive simvastatin and 75 patients will receive placebo as adjuncts to treatment as usual. The primary outcome is change in Montgomery–Åsberg Depression Rating Scale scores from baseline to week 12 and secondary outcomes include changes in scores on the 24-item Hamilton Rating Scale for Depression, the Clinical Global Impression scale, the 7-item Generalized Anxiety Disorder scale and change in body mass index from baseline to week 12. Assessments will take place at screening, baseline, and weeks 2, 4, 8 and 12. Checklists for adverse effects will be undertaken at each visit. Simvastatin (20 mg) will be given once daily. Other secondary outcomes include C-reactive protein and plasma lipids measured at baseline and week 12.
Results
This trial will assess simvastatin's efficacy and tolerability as an add-on treatment option for patients with TRD and provide insights into its putative mechanisms of action.
Conclusions
As the first trial investigating the use of simvastatin as an augmentation strategy in patients with TRD, if the results indicate that adjuvant simvastatin is efficacious in reducing depressive symptoms, it will deliver immediate clinical benefit.
Declaration of interest
I.B.C. and N.H. have given lectures and advice to Eli Lilly, Bristol Myers Squibb, Lundbeck, Astra Zeneca and Janssen pharmaceuticals for which they or their employing institution have been reimbursed. R.R. and M.M.H. have received educational grants and support for academic meetings from Pfizer, Roche, Novartis and Nabiqasim. A.H.Y. has been commissioned to provide lectures and advice to all major pharmaceutical companies with drugs used in affective and related disorders. A.H.Y. has undertaken investigator-initiated studies from Astra Zeneca, Eli Lilly, Lundbeck and Wyeth. None of the companies have a financial interest in this research.
The emergence of microbial challenges in commercial poultry farming causes significant economic losses. Vaccination is effective in preventing diseases of single aetiology while antibiotics have an advantage over vaccination in controlling diseases of multiple aetiologies. As the occurrence of antibiotic resistance is a serious problem, there is increased pressure on producers to reduce antibiotic use in poultry production. Therefore, it is essential to use alternative substances to cope with microbial challenges in commercial poultry farming. This review will focus on the role of β-glucans originating from yeast cell wall (YCW) as a growth promoter and antibiotic alternative. β-glucans have the ability to modulate the intestinal morphology by increasing the number of goblet cells, mucin expression and cells expressing secretory IgA (sIgA) with increased sIgA in the intestinal lumen and decreased bacterial translocation to different organs. β-glucans also increase the gene expression of tight junction (TJ) proteins which maintain the integrity of the intestinal wall in broiler chickens. However, further studies are required to optimise the dosage and source of β-glucans to determine effects on growth performance and mechanisms against enteric pathogens.
As U.S. lamb imports increased relative to domestic production, and the relative share of chilled to frozen lamb imports increased, importers of chilled lamb have become less responsive to domestic and import prices, while the direct opposite is the case for frozen lamb imports. From 1990 to 2003, chilled lamb imports from Australia and New Zealand became less and less responsive to U.S. prices, and frozen imports became more responsive. Unconditional own-price elasticities also show that, over time, imports of chilled lamb became less responsive to import prices while frozen imports became more responsive to import prices.
Infectious diseases are major constraint that hinders the poultry industry. Among them parasitic diseases are very common and Ascaridia galli is one of the most common parasitic roundworms found in poultry. Haemorrhages, diarrhoea and listlessness are signs of infection. Parasitic infections such as A. galli are treated with chemical anthelmintics (piperazine, albendazole, levamisole, Ivermectin, benzimidazoles and fenbendazole). These synthetic chemicals can promote resistance, so there is need for alternative ways to treat the disease. Medicinal plants have the potential to combat such parasitism and the development of anthelmintic resistance appears to be very slow against such treatment. This review covers the studies related to the screening of plant materials having in vitro and in vivo anthelmintic activities against A. galli throughout the world. Medicinal plants showing in vitro anthelmintic activity include Anacardium occidentale, Allium sativum, Tribulus terrestris, Bassia latifolia, Piper betle, Morinda citrifolia L.I, Cassia occidentalis L. and Aloe secundiflora while in vivo studies include the use of Psorelia corylifolia, Piper betle, Pilostigma thonningi, Caesalpinia crista, Ocimum gratissimum and Anacardium occidentale. In conclusion, medicinal plants appear to have good anthelmintic activities in poultry and may substitute conventionally used synthetic drugs, and their use may moderate drug resistance in endemic pathogen populations and drug residues in poultry meat.
Delirium is a neuropsychiatric condition characterized by acute change in cognition and disturbance of consciousness. A similar state during the final days of life is termed “terminal delirium.”
Method:
We present three cases with end-stage chronic medical problems without any significant psychiatric history who were admitted to an inpatient psychiatric unit or a locked dementia unit for management of “depression,” “dementia,” or “psychosis.”
Conclusions:
Early diagnosis of terminal delirium helps prevent patients, family members, and staff from undergoing severe emotional distress and facilitates appropriate end-of-life care.
The poultry industry is affected by economically important problems such as Newcastle disease (ND). Newcastle disease virus (NDV) belongs to the Paramyxoviridae family and manifests as different strains; lentogenic, mesogenic and velogenic. ND affects the quality of eggs and impairs growth performance of birds. Various efforts have been made to control economic losses due to this disease, including using live and killed vaccines, which do not confer 100% immunity in all cases. Due to mutations within viral strains, NDV can become resistant and difficult to control, and there is a need to search for alternative measures. Medicinal plants are considered as a complementary means to control this virus, especially in developing countries, because they have been implicated in treatments for a variety of infectious and non-infectious diseases. Alkaloids, flavonoids, saponins and tannins found in plants have been regarded as novel antiviral agents. The following paper encompasses the studies related to plants having in vitro antiviral activity against ND such as Momordica balamina, Adansonia digitata, Artemisia annua, Azadirachta indica, Psidium guajava, Moringa oleifera and plants having good in vivo antiviral activity such as Aloe secundiflora, Cucumis metuliferus and Anthocleista nobilis as well. It discusses plants with the potential to improve the immunity of infected birds, such as Mangrove halophytes, Nigella sativa, Polysavone, Melissa officinalis, Momordica cochinchinensis, Echinacea purpurea, Withania somnifera and Aspargus Racemosus.
Basic principles and rationale for allogeneic HSCT in inborn errorsof metabolism (IEM)
The IEM are a group of genetic disorders in which a multisystem progressive disorder arises from enzyme deficiency and accumulation of products of metabolism within the cells and tissues. After successful engraftment following HSCT, the donor cells not only reconstitute the lymphohematopoietic system but also, more slowly, replace tissue macrophages such as Kupfer cells in the liver and microglial cells in the CNS of the host. In most IEM, the beneficial effect of HSCT on disease outcome is mediated by a process called cross correction. This was first shown in vitro, over three decades ago, in fibroblast cell cultures of Hurler syndrome (MPSIH) and Hunter syndrome (MPSII) patients (Neufeld, 1983). In HSCT, the enzyme produced and secreted by the engrafted donor cells is taken up by the enzyme-deficient host cells, leading to the correction of the underlying disease phenotype in the patient (Krivit, 1983).
The first allogeneic HSCT for MPSIH was performed in the U.K. in 1981 (Hobbs et al., 1981). To date, over two thousand HSCTs have been carried out for metabolic disorders, mostly in MPSIH patients. Other metabolic disorders treated with HSCT include MPSII, Maroteaux Lamy syndrome (MPSVI), Sly syndrome (MPSVII), α-mannosidosis, and X-linked adrenoleukodystrophy (X-ALD). In a successful allogeneic HSCT in IEM, the enzyme delivered by the donor cells should be adequate to prevent substrate accumulation within a given disease and stop or reverse the disease progression. However, in certain lysosomal storage diseases (LSDs) such as San Filippo disease (MPSIII), normalization of enzyme levels is not sufficient to halt the disease progression (Sivakumur & Wraith, 1999). This reflects the complex pathogenesis and the difficulty in treating this group of illnesses. The reason for apparent HSCT failure in some IEMs remains unclear. Another important consideration of HSCT efficacy in these disorders is the selective response in some organs after HSCT (Masterson et al., 1996), particularly if the transplant is performed late after the diagnosis or in the presence of advanced disease.
Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.