Outpatient management of deep vein thrombosis

OBJECTIVE: To assess whether patients with deep vein thrombosis (DVT) could be satisfactorily treated on an outpatient basis with low molecular weight (LMW) heparin and warfarin. DESIGN: A 22 month prospective study of adults attending St Peter's Hospital accident and emergency department with DVT. RESULTS: 1093 patients were referred and assessed; 160 were venogram positive, of which 159 patients between the ages of 22 and 89 years of age have now been treated with LMW heparin as outpatients. Direct liaison with community nurses has minimised the impact on general practitioner workload. CONCLUSIONS: 1272 bed days were saved during this period (an estimated 320,000 pounds). The outpatient treatment of thromboembolism has been shown to be effective and safe.     

Fibroblasts prevent apoptosis of IL-2-deprived T cells without inducing proliferation: a selective effect on Bcl-XL expression

Tumour hypoxia is well recognised as a major factor contributing to radioresistance. This article examines the role of hypoxia in influencing the treatment outcome following radiotherapy (RT), and reviews the rationale and results of clinical trials that utilise hypoxic sensitizers or cytotoxins in the treatment of head and neck carcinoma. Histologic evidence for tumour hypoxia in human neoplasms was first reported in 1955. Since then, direct measurement by microelectrodes has revealed heterogeneity in intratumoural oxygen concentrations, and low oxygen concentrations are associated with poor local-regional control by RT. These findings coupled with the result of nuclear imaging studies employing radiolabelled imidazoles, provide strong evidence for the existence of tumour hypoxia which influences RT treatment outcome. Hyperbaric oxygen (HBO) trials for head and neck cancer, conducted in the early 1970s, demonstrated that HBO improved local control and survival rates in patients with head and neck cancer receiving radiotherapy (RT). Since the mid-1970s, clinical research in overcoming tumour hypoxia was mainly centred on the use of nitro-imidazoles as hypoxic cell sensitizers. However, the results from several major clinical trials remain inconclusive. Specifically, the Radiation Therapy Oncology Group (RTOG) misonidazole head and neck trial (298 patients) showed no benefit. The Danish misonidazole trial (626 patients) showed no overall benefit, however positive results were observed in a subgroup (304 pharyngeal cancer patients). Although the European Organisation for Research and Teaching of Cancer (EORTC) misonidazole trial with hyperfractionated RT showed no benefit, the Danish nimorazole trial demonstrated an overall benefit in survival as well as local control. The European etanidazole (ETA) trial (374 patients) showed no advantage of adding the drug to RT. The RTOG ETA trial (504 patients) showed no global benefit. However, positive results were observed in a subset of patients with early nodal disease (197 patients). In addition, a recent meta-analysis by Overgaard, utilising pooled results in the literature demonstrated that modification of tumour hypoxia significantly improved local-regional control in head and neck cancers with an odds ratio of 1.23 (95% confidence limits 1.09 to 1.37). Hypoxic cytotoxins, such as tirapazamine, represent a novel approach in overcoming radioresistant hypoxic cells. Tirapazamine is a bioreductive agent which, by undergoing one electron reduction in hypoxic conditions, forms cytotoxic free radicals that produce DNA strand breaks causing cell death. In vitro and in vivo laboratory studies demonstrate that tirapazamine is 40 to 150 times more toxic to cells under hypoxic conditions as compared to oxygenated conditions and that tirapazamine is superior to ETA in enhancing fractionated irradiation in mouse SCCVII and other tumour types with an enhancement ratio of 1.5 to 3.0. Phase I studies demonstrated that therapeutic doses of tirapazamine can be given safely. A multi-institutional phase II trial using tirapazamine with concurrent RT for head and neck cancer is now in progress.     

Chemical reaction interface mass spectrometry with high efficiency nebulization

A high efficiency nebulizer (HEN) coupled to a heated spray chamber and a membrane desolvator is used for liquid sample introduction in chemical reaction interface mass spectrometry (CRIMS). Compared to the conventional thermospray nebulizer operated at solvent flow rate of 1 mL/min, the HEN provides small droplets at lower flow rates (10-100 microL/min), improving the desolvation and analyte transport efficiency. As a result, the sensitivity for carbon detection by CRIMS is improved by a factor of 4. The new arrangement offers an easy-to-use and robust interface, facilitating the availability of a variety of liquid chromatographic techniques to the CRIMS. Separation and detection of labeled peptides in a mixture of unlabeled biopolymers is illustrated at a solvent flow rate of 45 microL/min as an example of new possibilities offered by the improved liquid introduction interface.     

Improving throughput of long-hop TCP connections in IP over OPS networks

Optical Packet Switching (OPS) can provide the ever-increasing bandwidth required for Internet traffic and new applications for future networks. However, optical packet loss is the major problem for an OPS network. Moreover, by increasing the number of hops between a pair of ingress–egress switches in an OPS network, optical Packet Loss Rate (PLR) between this pair is increased. Therefore, due to a higher PLR for long-hop TCP connections, the throughput of these connections may be much lower than the short-hop TCP connections. To overcome this problem, it is proposed in this paper to use the retransmission idea in the optical domain not only to increase TCP throughput but also to improve the throughput of multi-hop TCP connections, and also to have a loss-free OPS network. Under retransmission in the optical domain, a copy of the transmitted traffic is kept in the electronic buffers of ingress switches and retransmitted in the optical domain whenever required. Note that the TCP layer has its own retransmission at the client packet level as well. By retransmission of lost packets in the optical domain, TCP would be unaware of the lost client packets, and therefore, TCP would not reduce its sending rate. In this paper, TCP throughput is studied in a bufferless slotted OPS network and the effectiveness of the proposed mechanism is evaluated.

Thermosensitive nanoparticles prepared from poly(N‐isopropylacrylamide‐acrylamide‐vinilpyrrolidone) and its blend with poly(lactide‐co‐glycolide) for efficient drug delivery system

Temperature‐responsive polymers have become increasingly attractive as carrier for the injectable drug delivery systems. In the present work, we have studied the preparation of poly(N‐isopropylacrylamide‐acrylamide‐vinilpyrrolidone) (NIPAAm‐AAm‐VP terpolymer) nanoparticulated terpolymer and its blend with poly(lactide‐co‐glycolide, PLGA; molar ratio of lactide/glycolid 1/3). Thermosensitive terpolymer, poly(NIPAAm‐AAm‐VP) was prepared by free‐radical polymerization in aqueous solution. The nanoparticles of poly(NIPAAm‐AAm‐VP) and its blend with PLGA containing naltrexone were prepared using the evaporation and w/o emulsion‐solvent evaporation methods, respectively. Nanoparticles prepared from terpolymer‐PLGA blend at low polymer concentration (5%) shows larger particle size (>300 nm) and higher drug content%. Various types of nanoparticles showed a burst release of less than 10% after 24 h . The results suggest that by regulating different variables, desired release profiles of naltrexone can be achieved using a blend of PLGA‐poly(NIPAAm‐AAm‐VP) nanoparticulate system. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2009     

An investigation of the flocculation characteristics of polyacrylamide‐grafted chitosan

To investigate the flocculation characteristics of polyacrylamide (PAM)‐grafted chitosan, a series of PAM‐grafted chitosan copolymer (Chito‐g‐PAM1 to Chito‐g‐PAM4) have been synthesized by ceric ammonium nitrate‐induced solution polymerization technique in nitrogen atmosphere. The flocculation characteristics of the polymer samples (PAM, grafted and ungrafted chitosan) were studied by settling test and jar test methods in the colloidal suspensions of kaolin, iron ore, silica, and bentonite powder. It was found that the settling performance of Chito‐g‐PAM3 is best among the polymer samples. The jar test results indicate that the ungrafted chitosan has better water clarifying performance than both the PAM and grafted chitosan. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009     

Automated techniques for blood vessels segmentation through fundus retinal images: A review

Retina is the interior part of human's eye, has a vital role in vision. The digital image captured by fundus camera is very useful to analyze the abnormalities in retina especially in retinal blood vessels. To get information of blood vessels through fundus retinal image, a precise and accurate vessels segmentation image is required. This segmented blood vessel image is most beneficial to detect retinal diseases. Many automated techniques are widely used for retinal vessels segmentation which is a primary element of computerized diagnostic systems for retinal diseases. The automatic vessels segmentation may lead to more challenging task in the presence of lesions and abnormalities. This paper briefly describes the various publicly available retinal image databases and various machine learning techniques. State of the art exhibited that researchers have proposed several vessel segmentation methods based on supervised and supervised techniques and evaluated their results mostly on publicly datasets such as digital retinal images for vessel extraction and structured analysis of the retina. A comprehensive review of existing supervised and unsupervised vessel segmentation techniques or algorithms is presented which describes the philosophy of each algorithm. This review will be useful for readers in their future research.     

Effect of fatigue loading on wicking properties of polyamide 66 nanofiber yarns

The wicking phenomenon is of prime importance with regards to biomedical applications of nanofiber yarns such as suture yarns and tissue scaffolds. In such applications, the yarns are usually subjected to cyclic tensile forces and biological tensile stresses. There is a lack of science behind the effect of fatigue on wicking properties of nanofiber yarns and this work aims at exploring this venue. Wicking properties of polyamide 66 nanofiber yarns are investigated by tracing the color change in the yarn structure resulting from pH changes during the capillary rise of distilled water. Results show that applying cyclic loading increases equilibrium wicking height in the Lucus–Washburn equation, which is attributed to changes in the overall pore structure in the cyclic loaded yarn. The likely causes of these changes are studied by scanning electron microscope, which reveals disentangled, more or less aligned and parallel nanofibers with a smaller radius in the nanofibrous structure. © 2018 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2019 , 136, 47206.     

Role of Flaxseed Meal Feeding for Different Durations in the Lipid Deposition and Meat Quality in Broiler Chickens

This study investigated the role of flaxseed meal (FSM), a rich terrestrial source of ω-3 fatty acids, in the alteration of the fatty acid profile and metabolism, health indices, physicochemical properties, and sensory quality of broiler chicken meat. The broiler chickens were fed 100 g FSM kg⁻¹ diet for different time periods (1, 2, 3, 4, and 5 weeks). The results revealed that 100 g FSM feeding in broiler chickens for at least 3 weeks increased (P < 0.01) the EPA, DHA, MUFA, PUFA, ω-3 PUFA, and ω-6 PUFA of broiler chicken meat with the corresponding decrease in palmitic acid, stearic acid, and SFA content. 100 g FSM feeding up to 3 weeks has increased the Δ⁹-desaturases (P < 0.05), thioesterase index (P < 0.01), and Δ⁵-desaturase + Δ⁶-desaturase activity (P < 0.01) along with an improvement in health indices (P < 0.01) of chicken meat. Similarly, a reduction in meat cholesterol and fat content of thigh meat (P < 0.01) was observed by feeding 100 g FSM for at least 3 weeks with no effect on the pH, color scores, and sensory evaluation of broiler chicken meat. The water-holding capacity (WHC) and extract release volume (ERV) decreased, whereas, drip loss of meat increased (P < 0.01) due to the feeding of 100 g FSM beyond 3 weeks. Thus, this study concluded that 100 g FSM feeding for 3 weeks in broiler chickens significantly improves the fatty acid profile, lipid metabolism, and health indices of meat, without compromising the physicochemical properties of broiler chicken meat.     

Effect of sand and clay fouling on the shear strength of railway ballast for different ballast gradations

Ballast contamination by fine materials such as sand and clay in railway track at arid regions is an important issue that causes track instability problems and settlement due to reduction of shear strength of ballast. In this paper, the results of direct shear box test conducted on clean ballast, sand-fouled ballast and clay-fouled ballast for different ballast gradations are reported and discussed. For this purpose, three different fouling amounts according to fouling index are added to clean ballast. Test results show that by increasing the fouling percentage, the ballast shear strength always decreases both for sand and clay fouled ballast. However, the amount of shear strength reduction is low at high normal stresses. Clay contamination has more adverse effect on the shear strength of ballast compared with sand contamination. Also, the results of tests for evaluation of gradation effect on shear strength of fouled ballast which are conducted on various gradations according to American Railway Engineering and Maintenance-of-Way Association, show that the maximum particle size as well as uniformity coefficient affect the shear strength of ballast. Also, an empirical equation is presented to observe the effect of ballast gradation on reduction of shear strength with regard to amount of fouling material and normal stress.