Summary
Semi‐rigid flexible introducer‐guided tracheal intubation is associated with pharyngolaryngeal morbidities. We compared the practice of railroading a newly described modified reinforced ...silicone tracheal tube with a built‐in guide channel in its wall over a non‐kinking guidewire with railroading the same tube over a disposable bougie, with respect to pharyngolaryngeal morbidities. One hundred and twenty‐four ASA 1 and 2 adults were randomly assigned to undergo bougie‐guided (n = 62) or wire‐guided (n = 62) intubation under general anaesthesia. All patients were assessed for postoperative pharyngolaryngeal complaints. In addition, voice parameters (fundamental frequency, shimmer, jitter and harmonic noise ratio) with vowels ‘a’ and ‘i’ were analysed pre‐operatively and 24 h postoperatively. The success of first‐attempt intubation and the associated haemodynamic response were also recorded. A higher incidence of pharyngolaryngeal complaints was seen in the bougie group, 48.3%, 95%CI (35.9–60.9%) when compared with wire‐guided group 28.3%, 95%CI (18.0–40.6%), p = 0.01. Postoperatively, all the voice parameters were significantly more affected when compared with their pre‐operative value in the bougie‐guided group (p < 0.05) but not in the wire‐guided group. The success of first‐attempt intubation was similar in both groups. Wire‐guided orotracheal intubation was associated with a lower incidence of pharyngolaryngeal complaints and effect on voice when compared with bougie‐guided intubation.
This work describes a new method to selectively capture liposomes and other vesicle entities in the patterned pores of breath-figure polymer films. The process involves the deposition of a hydrophobe ...containing biopolymer in the pores of the breath figure, and the tethering of vesicles to the biopolymer through hydrophobic interactions. The process is versatile, can be scaled up and extended to the deposition of other functional materials in the pores of breath figures.
Fenofibrate, a well-known normolipidemic drug, has been shown to exert strong anticancer effects against tumors of neuroectodermal origin including glioblastoma. Although some pharmacokinetic studies ...were performed in the past, data are still needed about the detailed subcellular and tissue distribution of fenofibrate (FF) and its active metabolite, fenofibric acid (FA), especially in respect to the treatment of intracranial tumors. We used high performance liquid chromatography (HPLC) to elucidate the intracellular, tissue and body fluid distribution of FF and FA after oral administration of the drug to mice bearing intracranial glioblastoma. Following the treatment, FF was quickly cleaved to FA by blood esterases and FA was detected in the blood, urine, liver, kidney, spleen and lungs. We have also detected small amounts of FA in the brains of two out of six mice, but not in the brain tumor tissue. The lack of FF and FA in the intracranial tumors prompted us to develop a new method for intracranial delivery of FF. We have prepared and tested in vitro biodegradable poly-lactic-co-glycolic acid (PLGA) polymer wafers containing FF, which could ultimately be inserted into the brain cavity following resection of the brain tumor. HPLC-based analysis demonstrated a slow and constant diffusion of FF from the wafer, and the released FF abolished clonogenic growth of glioblastoma cells. On the intracellular level, FF and FA were both present in the cytosolic fraction. Surprisingly, we also detected FF, but not FA in the cell membrane fraction. Electron paramagnetic resonance spectroscopy applied to spin-labeled phospholipid model-membranes revealed broadening of lipid phase transitions and decrease of membrane polarity induced by fenofibrate. Our results indicate that the membrane-bound FF could contribute to its exceptional anticancer potential in comparison to other lipid-lowering drugs, and advocate for intracranial delivery of FF in the combined pharmacotherapy against glioblastoma.
•Environmental remediation towards the creation of the modern world.•Ultrasound coupled with various oxidation processes.•Sonolysis Coupled with Ozonation.•Sonolysis Coupled with ...Photocatalysis.•Efficient removal of various pollutants from the wastewater.
The creation of the modern world requires many industrial sectors, however, sustainability needs to be considered while developing industries. In particular, organic pollutants generated by many of these industries contaminate the environment leading to health and other issues. Advanced oxidation processes (AOPs) have been introduced to remove organic pollutants present in wastewater. Sonolytic degradation of organic pollutants is considered as one of the AOPs, however, this process has its limitations. In order to overcome the limitations, hybrid techniques involving ultrasound and other AOPs have been developed. That is, ultrasound combined with heterogeneous AOPs (ultrasound/metal ions, ultrasound/metal oxides, and ultrasound/photocatalysis) and homogeneous AOPs (ultrasound/ozone, ultrasound/H2O2, and ultrasound/persulfate) for the degradation/mineralization of organic pollutants. This review highlights the advantages of using hybrid techniques involving ultrasound for the degradation of organic pollutants in aqueous solutions.
I study the effect of rainfall shocks on child mortality at a sub‐national level for a global set of developing countries. I establish that negative (positive) shocks to rainfall lead to an increase ...(drop) in child deaths overall. Low‐income countries (LICs) and the group of countries reliant on agriculture are affected the most due to negative rainfall shocks. In LICs, the impact of negative rainfall shocks is mitigated by around 60% in districts located downstream to dams, an effect predominant among less affluent districts; in addition, the effect of rainfall fluctuations is persistent, lasting for up to three years following the shock. Results remain robust to the inclusion of relevant controls, to the consideration of relevant issues such as selective fertility and migration, and various other robustness tests.
The development of proxy caching is essential in the area of video-on-demand (VoD) to meet users' expectations. VoD requires high bandwidth and creates high traffic due to the nature of media. Many ...researchers have developed proxy caching models to reduce bandwidth consumption and traffic. Proxy caching keeps part of a media object to meet the viewing expectations of users without delay and provides interactive playback. If the caching is done continuously, the entire cache space will be exhausted at one stage. Hence, the proxy server must apply cache replacement policies to replace existing objects and allocate the cache space for the incoming objects. Researchers have developed many cache replacement policies by considering several parameters, such as recency, access frequency, cost of retrieval, and size of the object. In this paper, the Weighted-Rank Cache replacement Policy (WRCP) is proposed. This policy uses such parameters as access frequency, aging, and mean access gap ratio and such functions as size and cost of retrieval. The WRCP applies our previously developed proxy caching model, Hot-Point Proxy, at four levels of replacement, depending on the cache requirement. Simulation results show that the WRCP outperforms our earlier model, the Dual Cache Replacement Policy.
Using an exogenous measure of natural disasters based on physical intensities, I examine their impact on child mortality. I find that children, mostly, in poor countries are affected — a one standard ...deviation increase in the natural disaster index leads to an additional 6.77 deaths per 1000 live births in the disaster year. The impact is long lasting, extending beyond the disaster year. I provide suggestive evidence of the potential mechanisms driving these effects, namely, lower GDP and vaccination rates among children, along with an increased maternal mortality and disease incidence in low‐income countries due to disasters. Using an endogenous measure of disasters based on damage records from insurance data leads to severe underestimation of the disaster impact. The results are robust to the use of mortality rates from multiple sources, different functional forms, and an extensive dynamic panel specification as well as various other tests.
The acquisition of invasiveness in ovarian cancer (OC) is accompanied by the process of epithelial-to-mesenchymal transition (EMT). The MUC4 mucin is overexpressed in ovarian tumors and has a role in ...the invasiveness of OC cells. The present study was aimed at evaluating the potential involvement of MUC4 in the metastasis of OC cells by inducing EMT. Ectopic overexpression of MUC4 in OC cells (SKOV3-MUC4) resulted in morphological alterations along with a decreased expression of epithelial markers (E-cadherin and cytokeratin (CK)-18) and an increased expression of mesenchymal markers (N-cadherin and vimentin) compared with the control cells (SKOV3-vector). Also, pro-EMT transcription factors TWIST1, TWIST2 and SNAIL showed an upregulation in SKOV3-MUC4 cells. We further investigated the pathways upstream of N-cadherin, such as focal adhesion kinase (FAK), MKK7, JNK1/2 and c-Jun, which were also activated in the SKOV3-MUC4 cells compared with SKOV3-vector cells. Inhibition of phospho-FAK (pFAK) and pJNK1/2 decreased N-cadherin expression in the MUC4-overexpressing cells, which further led to a significant decrease in cellular motility. Knockdown of N-cadherin decreased the activation of extracellular signal-regulated kinase-1/2 (ERK1/2), AKT and matrix metalloproteinase 9 (MMP9), and inhibited the motility in the SKOV3-MUC4 cells. Upon in vivo tumorigenesis and metastasis analysis, the SKOV3-MUC4 cells produced significantly larger tumors and demonstrated a higher incidence of metastasis to distance organs (peritoneal wall, colon, intestine, stomach, lymph nodes, liver and diaphragm). Taken together, our study reveals a novel role for MUC4 in inducing EMT through the upregulation of N-cadherin and promoting metastasis of OC cells.
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