With increasingly strict data management requirements from funding agencies and institutions, expanding focus on the challenges of research replicability, and growing data sizes and heterogeneity, ...new data needs are emerging in the materials community. The materials data facility (MDF) operates two cloud-hosted services, data publication and data discovery, with features to promote open data sharing, self-service data publication and curation, and encourage data reuse, layered with powerful data discovery tools. The data publication service simplifies the process of copying data to a secure storage location, assigning data a citable persistent identifier, and recording custom (e.g., material, technique, or instrument specific) and automatically-extracted metadata in a registry while the data discovery service will provide advanced search capabilities (e.g., faceting, free text range querying, and full text search) against the registered data and metadata. The MDF services empower individual researchers, research projects, and institutions to (I) publish research datasets, regardless of size, from local storage, institutional data stores, or cloud storage, without involvement of third-party publishers; (II) build, share, and enforce extensible domain-specific custom metadata schemas; (III) interact with published data and metadata via representational state transfer (REST) application program interfaces (APIs) to facilitate automation, analysis, and feedback; and (IV) access a data discovery model that allows researchers to search, interrogate, and eventually build on existing published data. We describe MDF’s design, current status, and future plans.
Mechanical problems like break or crack in Luer connectors or hubs, clamps, and tubings are common non-infectious complications of tunneled dialysis catheters (TDC), which may lead to other TDC ...complications and the need to insert a new catheter. These can be tackled using TDC repair kits or spare parts, which are often not available, resulting in the insertion of a new TDC that increases morbidity, TDC-related procedures, and healthcare costs. We discuss two cases of broken Luer connections of TDC, which were managed by exchanging the broken Luer connector of TDC with the similar Luer connector of a temporary dialysis catheter. Both the repaired TDCs are thereafter functioning well. This improvised technique provides an easy, effective, long-lasting option that salvages the existing TDC and reduces the cost factor.
Neratinib (HKI-272) is a potent irreversible pan-ErbB tyrosine kinase inhibitor with clinical activity in patients with ErbB2/HER2-positive breast cancer.
Phase I of this open-label, phase I/II study ...investigated the maximum tolerated dose (MTD) of oral neratinib (160 or 240mg/day) plus vinorelbine (25mg/m2; days 1 and 8 of each 21-day cycle) in patients with solid tumors. Phase II assessed the safety, clinical activity, and pharmacokinetics of the combination in patients with HER2-positive metastatic breast cancer; the primary efficacy end point was objective response (OR).
In phase I (n=12), neratinib (240mg) plus vinorelbine (25mg/m2) was established as the MTD. In phase II, 79 patients with HER2-positive metastatic breast cancer were treated at the MTD. The most common treatment-related adverse events were diarrhea (96%), neutropenia (54%), and nausea (50%). Three patients discontinued treatment due to diarrhea. No clinically important skin side-effects were observed. The OR rate in assessable phase II patients was 41% (no prior lapatinib) and 8% (prior lapatinib). There was no evidence of pharmacokinetic interaction between neratinib and vinorelbine.
Neratinib plus vinorelbine showed promising antitumor activity and no unexpected toxic effects in HER2-positive metastatic breast cancer patients.
ClinicalTrials.gov #NCT00706030.
BACKGROUND Although screening of household contacts (HHCs) of TB patients and provision of TB preventive therapy (TPT) is a key intervention to end the TB epidemic, their implementation globally is ...dismal. We assessed whether introducing
a '7-1-7' timeliness metric was workable for implementing HHC screening among index patients with pulmonary TB diagnosed by private providers in Chennai, India, between November 2022 and March 2023. METHODS This was
an explanatory mixed-methods study (quantitative-cohort and qualitative-descriptive). RESULTS There were 263 index patients with 556 HHCs. In 90% of index patients, HHCs were line-listed within 7 days of anti-TB treatment initiation.
Screening outcomes were ascertained in 48% of HHCs within 1 day of line-listing. Start of anti-TB treatment, TPT or a decision to receive neither was achieved in 57% of HHC within 7 days of screening. Overall, 24% of screened HHCs in the '7-1-7' period started TPT compared with
16% in a historical control (P < 0.01). Barriers to achieving '7-1-7' included HHC reluctance for evaluation or TPT, refusal of private providers to prescribe TPT and reliance on facility-based screening of HHCs instead of home visits by health workers for screening. CONCLUSIONS Introduction of a timeliness metric is a workable intervention that adds structure to HHC screening and timely management.
The utility of an implantable loop recorder (ILR) in the evaluation of unexplained syncope or palpitations in young patients in the absence of structural heart disease or ventricular dysfunction is ...limited. To compare the diagnostic yield of ILR with conventional extended Holter evaluation in the detection of arrhythmias among young patients with a structurally normal heart presenting with unexplained palpitations or syncope.
Open-label randomised control trial was conducted in a tertiary cardiac care centre among young patients with recurrent unexplained palpitations (≥3 episodes/year) or syncope (≥2 episodes) with normal electrocardiogram and echocardiography, after excluding non-cardiac causes. Patients were block randomised to either ILR implantation or conventional extended Holter monitoring.
Fourteen patients in the ILR group and 16 patients in the conventional group completed the study. The mean age of the patients was 31.9 ± 5.5 and 31.2 ± 5.4 years. Males constituted 78.5% and 75% in the two groups, respectively. Diagnosis was established in 10 (71.5%) patients in the ILR group as compared to only 3 (18.7%) in the conventional group (p = 0.01), with an RR of 0.26 (95% CI 0.089–0.76, p = 0.01). The arrhythmias diagnosed with ILR were narrow complex tachycardia (30%), atrial fibrillation (20%), VPCs (20%), severe bradycardia with asystole due to sinus arrest (10%), VPCs with bigeminy (10%), and ventricular tachycardia (10%).
In young patients with unexplained syncope or palpitations, ILR has a higher diagnostic yield in the accurate detection of arrhythmia compared with conventional Holter strategy, resulting in better management.
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•A novel compound along with six acyl phenols are isolated from M. fatua stem bark.•All the compounds displayed significant α-glucosidase inhibitory activity.•Malabaricone C binds the ...pocket of N-terminal human maltase glucoamylase.•Malabaricones A, B and C exhibited potent antiglycation property.•Malabaricone B significantly enhances the glucose uptake in L6 myotubes.
Phytochemical investigation of the stem bark of Myristica fatua Houtt. led to the isolation of a new compound 1 (3-tridecanoylbenzoic acid), along with six known acylphenols (2–7). All the compounds displayed moderate inhibitory activity on α-amylase and significant activity on α-glucosidase; however malabaricone B (6) and C (7) were identified as potent α-glucosidase inhibitors with IC50 values of 63.70 ± 0.546, and 43.61 ± 0.620 µM respectively. Acylphenols (compounds 3–7) also showed significant antiglycation property. The molecular docking and dynamics simulation studies confirmed the efficient binding of malabaricone C with C-terminus of human maltase-glucoamylase (2QMJ). Malabaricone B also enhanced the 2-NBDG 2-(N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)-2-deoxy glucose uptake in L6 myotubes. These findings demonstrate that acylphenols isolated from Myristica fatua Houtt. can be considered as a lead scaffold for the treatment of type II diabetes mellitus.
Introduction: Arrhythmias in pregnancy may cause concern for the wellbeing of mothers and fetuses. Understanding the physiologic changes and types of arrhythmias that occur during pregnancy can help ...in identifying cases requiring intervention. This study aimed to determine the prevalence and types of electrocardiography changes and cardiac arrhythmias in normal pregnancy. Materials and Methods: This observational study was conducted at a tertiary care hospital. Four hundred and fifty women aged 20–35 years with singleton pregnancy in early gestation, irrespective of parity, comprised the study group. A baseline ECG of the first trimester was reviewed with repeat ECG at 22–24 weeks and 32 weeks along with 24-h Holter studies during 20–24 weeks. Results: The most common rhythm disturbance was ventricular premature contractions (1.8%), followed by atrial fibrillation (0.7%). A significant association was seen between rhythm disturbances with advancing age and pregnancy-induced hypertension. No difference was observed between P-axis wave and PR interval. QRS axis and duration decreased significantly from the time of enrollment to 22–24 weeks to 32 weeks, whereas QTc interval increased during the course of pregnancy. No ST/T-wave changes were seen in any of the cases at enrollment, whereas at 22–24 and at 32 weeks, new T-wave inversion was observed in 8.2%. Conclusion: ECG changes such as reduction in QRS axis, T-wave inversion in lead III and V1–2, and prolonged QTc were observed in pregnant women. The prevalence of rhythm disturbances was low, with ventricular premature complex being the most common pathology. Minor electrocardiographic changes may be considered normal in pregnancy unless associated with significant symptoms.
The presence of coumarin, a hepatotoxic phenyl propanoid, in samples of the spice, cinnamon, procured from the market has raised food safety concerns world over. A validated, ultra-performance liquid ...chromatography- linear ion trap triple quadrupole mass spectrometry method was developed in the present study for the estimation of coumarin and other phenolics in authentic Cinnamomum verum bark samples and market samples from south India. Coumarin contents in authentic bark samples were in the range of 12.3 to 143.0 mg/kg, whereas the coumarin contents in samples procured from the market were up to 3462.0 mg/kg. The high content of coumarin and cinnamaldehyde in cinnamon samples procured from the market suggested possible blending with substitutes like Cinnamomum cassia barks, which possess substantial amounts of coumarin and cinnamaldehyde.
SETTING: The diagnosis and treatment of tuberculosis (TB) in India are characterized by heavy private-sector involvement. Delays in treatment remain poorly characterized among patients seeking care ...in the Indian private sector.OBJECTIVE: To assess delays in TB diagnosis and treatment
initiation among patients diagnosed in the private sector, and pathways to care in an urban setting.DESIGN: Cross-sectional survey of 289 consecutive patients diagnosed with TB in the private sector and referred for anti-tuberculosis treatment through a public-private mix program in Chennai
from January 2014 to February 2015.RESULTS: Among 212 patients with pulmonary TB, 90% first contacted a formal private provider, and 78% were diagnosed by the first or second provider seen after a median of three visits per provider. Median total delay was 51 days (mean 68). Consulting
an informal (rather than formally trained) provider first was associated with significant increases in total delay (absolute increase 22.8 days, 95%CI 6.2-39.5) and in the risk of prolonged delay >90 days (aRR 2.4, 95%CI 1.3-4.4).CONCLUSION: Even among patients seeking care
in the formal (vs. informal) private sector in Chennai, diagnostic delays are substantial. Novel strategies are required to engage private providers, who often serve as the first point of contact.
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