Mosleydalsgaard4297
The fraction of the low-coordinated sites of the metal NP shows a volcano-like curve with pressure at a constant temperature. A similar volcano shape could also be found in the plot of the environmental segregation energy as functions of temperature and pressure. The similar gas effects at low pressure and at high pressure indicate the structural information obtained in laboratory environments (1 atm).Despite advances in cancer treatment, breast cancer remains the second foremost cause of cancer mortality among women, with a high rate of relapse after initial treatment success. A subpopulation of highly malignant cancer cells, known as cancer stem cells (CSCs), is suspected to be linked to metastasis and relapse. Targeting of CSCs may therefore provide a means of addressing cancer-related mortality. However, due to their low population in vivo and a lack of proper culture platform for their propagation, much of the CSC biology remains unknown. Since maintenance of CSCs is heavily influenced by the tumor microenvironment, this study developed a 3D culture platform that mimics the metastatic tumor extracellular matrix (ECM) to effectively increase CSC population in vitro and allow CSC analysis. Through electrospinning, nanofibers that were aligned, porous, and collagen-coated were fabricated from polycaprolactone to recreate the metastatic tumor ECM assemblage. Breast cancer cells seeded onto the nanofiber scaffolds exhibited gross morphology and cytoskeletal phenotype similar to invasive cancer cells. Moreover, the population of breast cancer stem cells increased in nanofiber scaffolds. Analysis of breast cancer cells grown on the nanofiber scaffolds demonstrated an upregulation of mesenchymal markers and an increase in cell invasiveness suggesting the cells have undergone epithelial-mesenchymal transition. These results indicate that the fabricated nanofiber scaffolds effectively mimicked the tumor microenvironment that maintains the cancer stem cell population, offering a platform to enrich and analyze CSCs in vitro.Adverse childhood experiences and protection risks such as neglect and abuse and family psychosocial and protection vulnerabilities, beginning in early childhood, are linked to negative development and mental health. Child protection is becoming an increasing concern in India, creating new imperatives to address it amongst all children, but particularly among children below the age of 6 years, who due to their age and developmental abilities, are rendered more vulnerable than older child populations. click here It is therefore imperative, particularly in developing contexts such as India, for early childhood development (ECCD) to integrate child protection and mental health services into their existing intervention package. Although early childhood programs work with multiple sectors, they have limited collaboration with child mental health and child protection systems. This article addresses the question of how to integrate child protection and mental health interventions into existing ECCD programs by describing the experience of a pilot project in the Indian context. It provides the rationale, methodology and content of service delivery for integrating child protection and mental health interventions into the existing ECCD program, the Integrated Child Development Scheme, highlighting emerging concerns and challenges and drawing from the interventions to show how some of these were addressed.
To measure bed utilization rate and overcrowding in a high-volume tertiary level pediatric emergency department (ED) and correlate with outcome.
All children beyond neonatal age attending the 22-bedded emergency were prospectively enrolled from February to December, 2019. Number of daily admissions, boarders, discharges, ward transfers, length of stay (LOS) and unfavorable outcomes (care discontinuation and deaths) were recorded. Daily bed occupancy rate (BOR) was calculated and correlated with unfavorable outcome.
A total of 17,463 children visited the ED during the study period. The median (IQR) daily attendance and admission rate was 58 (51,65) and 22 (17,26) patients, respectively. The median (IQR) number of boarders and BOR was 48 (40-58) and 218% (181-263%), respectively. The median (IQR) LOS was 42.7 (23-71.4) hours. Unfavorable outcome correlated positively with number of boarders and BOR (P<0.001).
Overcrowding of the ED was associated with increased frequency of care discontinuation and mortality. This data calls for systemic changes to tackle overcrowding.
Overcrowding of the ED was associated with increased frequency of care discontinuation and mortality. This data calls for systemic changes to tackle overcrowding.
To compare the efficacy of the modified Atkins diet (mAD) and low glycemic index treatment (LGIT) among children with drug-resistant epilepsy.
Randomized, open labelled, controlled clinical trial.
Tertiary care referral center.
Children aged 6 months to 14 years with drug-resistant epilepsy.
mAD (n=30) or LGIT (n=30) as an add-on to the ongoing antiseizure drugs.
Proportion of children who achieved seizure freedom as defined by complete cessation of seizure at 12 weeks as primary outcome measure. Secondary outcome measures were proportion of children who achieved >50% and >90% seizure reduction at 12 weeks, and adverse effects of the two therapies.
Of the 60 recruited children, 3 in the mAD group, and 3 in LGIT group were lost to follow-up. The proportion of children with seizure freedom [16.6% vs 6.6%; relative risk reduction (RRR) (95% CI), 1.5 (-10.9, 0.5); P=0.42] and >90% seizure reduction [30% vs 13.3%; RRR, -1.2 (-5.5, 0.2); P=0.21] was comparable between the mAD and LGIT group at 12 weeks. The proportion of children with >50% seizure reduction was significantly higher at 12 weeks among those who received LGIT as compared to the mADgroup [73.3% vs 43.3%; RRR (95% CI) 0.4 (0.1-0.6); P=0.03] although the effect size was small. The diet was well tolerated with lethargy being the most common adverse effect in children in mAD (53.3%) and LGIT (66.7%) groups.
The present study with limited sample size shows that seizure freedom at 12 weeks was comparable between mAD and LGIT for the treatment of drug-resistant epilepsy.
The present study with limited sample size shows that seizure freedom at 12 weeks was comparable between mAD and LGIT for the treatment of drug-resistant epilepsy.