Playing in the dark with online games for girls

Pregnant Rapunzel Emergency is part of a series of online free games aimed at young girls (forhergames.com or babygirlgames.com), where dozens of characters from fairy tales, children’s toys and media feature in recovery settings, such as ‘Barbie flu’. The range of games available to choose from includes not only dressing, varnishing nails or tidying messy rooms, but also rather more troubling options such as extreme makeovers, losing weight, or a plethora of baby showers, cravings, hospital pregnancy checks, births (including caesarean), postnatal ironing, washing and baby care. Taking the online game Pregnant Rapunzel Emergency as an exemplar of a current digital trend, the authors explore the workings of ‘dark digital play’ from a number of perspectives – one by each named author. The game selected has (what may appear to adults) several disturbing features in that the player is invited to treat wounds of the kind of harm that might usually be associated with domestic violence towards women

Dietary polyphenols and non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD), which is emerging as a major public health issue worldwide, is characterized by a wide spectrum of liver disorders, ranging from simple fat accumulation in hepatocytes, also known as steatosis, to non-alcoholic steatohepatitis (NASH) and cirrhosis. At present, the pharmacological treatment of NAFLD is still debated and dietary strategies for the prevention and the treatment of this condition are strongly considered. Polyphenols are a group of plant-derived compounds whose anti-inflammatory and antioxidant properties are associated with a low prevalence of metabolic diseases, including obesity, hypertension, and insulin resistance. Since inflammation and oxidative stress are the main risk factors involved in the pathogenesis of NAFLD, recent studies suggest that the consumption of polyphenol-rich diets is involved in the prevention and treatment of NAFLD. However, few clinical trials are available on human subjects with NAFLD. Here, we reviewed the emerging existing evidence on the potential use of polyphenols to treat NAFLD. After introducing the physiopathology of NAFLD, we focused on the most investigated phenolic compounds in the setting of NAFLD and described their potential benefits, starting from basic science studies to animal models and human trials

Efecto de concentraciones elevadas de sales totales y sulfatos en agua de bebida sobre la degradabilidad ruminal in vitro de Thinopyrum ponticum

The objective of this study was to find out the effect of high concentrations of total salts (ST) and sulphates (Sulf) in drinking water on the degradability of tall wheatgrass (Thinopyrum ponticum). Six trials repeated at different moments using rumen fluid from a steer fed on either alfalfa hay (diet A) or alfalfa hay plus grass pasture (diet B) were performed. Drinking water was obtained from a watering place located in the same paddock of the pasture. Rumen fluid and tall wheatgrass were incubated at 39 °C in artificial saliva prepared with drinking water. Six treatments were evaluated in flasks fitted with graduated syringes. The flasks contained 60 ml of ruminal inoculum and 1 g of tall wheatgrass except in treatment 1 (Tl). Treatments were Tl: without forage; T2: control; T3: ST (3,000 mg/1); T4: ST (7,000 mg/1); T5: Sulf (1,500 mg/1) y T6: Sulf (7,000 mg/1). Salts used were: sulphates and chlorides of sodium, potassium, calcium and magnesium. To estimate the ruminal degradability of tall wheatgrass, gas production as a function of incubation time was evaluated by measuring the gas accumulated in the syringes during 50 h. The pH of the incubates of each treatment at the beginning and at the end of the trials was also recorded. Data were analysed using AN OVA and means were compared using Dunnett's test. Effects of block (diet), treatment, hour, and interactions of hour x block and hour x treatment on gas production were detected (P < 0.05). In both diets, A and B, ST7.000 was the treatment that most affected the degradative activity of rumen microorganisms, followed in diet A by Sulf7.000 and in diet B by ST1.500. Some significant differences of pH were found between treatments, and between initial and final values. It was concluded that high concentrations of salts, particularly of ST, decrease the degradative activity of rumen microbes after 50 h of digestion.  El objetivo de este trabajo fue conocer el efecto de elevadas concentraciones de sales totales (ST) y sulfatos (Sulf) en agua de bebida sobre la degradabilidad ruminal de agropiro alargado (Thinopyrum ponticum). Se realizaron 6 ensayos repetidos en el tiempo utilizando licor ruminal de un novillo, cuya dieta consistió en heno de alfalfa (dieta A) o heno de alfalfa y pastura de gramíneas (dieta B). El agua de bebida se obtuvo de una aguada situada en el mismo potrero que el agropiro. El licor ruminal y el agropiro se incubaron a 39 °C en saliva artificial preparada con agua de bebida. Se evaluaron 6 tratamientos en balones con jeringas graduadas acopladas. Los balones contenían 60 mi de inoculo ruminal y 1 g de agropiro excepto en el tratamiento TI. Los tratamientos fueron TI: sin forraje; T2: control; T3: ST (3.000 mg/1); T4: ST (7.000 mg/1); T5: Sulf (1.500 mg/1) y T6: Sulf (7.000 mg/1). Las sales utilizadas fueron: sulfatos y cloruros de sodio, potasio, calcio y magnesio. Para estimar la degradabilidad ruminal del agropiro se evaluó la producción de gas en función del tiempo de incubación, midiéndose el gas que se acumulaba en las jeringas durante 50 h. También se registró el pH de los incubados de cada tratamiento al inicio y al final de los ensayos. Los datos fueron analizados mediante ANVA y comparados por test de Dunnett. Hubo efectos de bloque, tratamiento, hora, e interacciones hora x bloque y hora x tratamiento sobre la producción de gas (p < 0,05). Tanto en la dieta A como en la dieta B, ST7.000 fue el tratamiento que más afectó la actividad degradativa de los microorganismos del rumen, seguido en la dieta A por Sulf 7.000 y en la dieta B por ST1500. Se encontraron algunas diferencias significativas de pH entre tratamientos, y entre valores iniciales y finales. Se concluye que elevadas concentraciones de sales, particularmente de ST, disminuyen la actividad degradativa de los microorganismos ruminales al cabo de 50 h de digestión

Univentricular repair for complex congenital heart defect

Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica Moldova, Departamentul Chirurgie Cardiovasculară și Toracică, IMSP Spitalul Clinic Republican ”Timofei Moșneaga”, Chișinău, Republica MoldovaIntroducere: Aprecierea rezultatelor corecției viciilor cardiace complexe poate sugera noi interpretări ale conduitei chirurgicale . Material şi metode: 99 pacienţi, cu vârsta 1 zi - 30 ani, au urmat corecţia univentriculară în următoarele patologii: atrezia valvei tricuspide - 36, atrezia valvei mitrale - 16, ventricul cu cale dublă de intrare - 23, canal A-V cu ventricule nebalansate - 17, calea dublă de ieșire din VD cu “struddling valve”, “noncommited” DSV - 2, atrezia AP cu SIV intact - 5, anomalia Ebstein (tip D) – 2, transpoziția vaselor magistrale cu stenoza AP si DSV tip canal A-V - 1, transpoziția corijată a vaselor magistrale cu stenoza AP si DSV - 2. Rezultate: Din 132 operaţii efectuate 49 au fost paliative: în hipertensiune pulmonară – îngustarea AP; În stenoză/atrezie AP – anastomoză intersistemică (14 - anastomoză modificată Blelock-Taussing din stânga, 3 – şunt central); în DSA restrictiv – 8 atrioseptostomii din care 7 cu CEC. 38 pacienţii după operaţia Glenn şi Fontan au dezvoltat transudare pleurală, care a necesitat drenarea cavităţii pleurale timp de 3-5 zile (32 pacienți), sau până la 30 zile (6 pacienţi). Într-un caz transudarea pleurală s-a observat peste 2 luni după operaţie. Hilotorax au avut imediat după intervenţie 2 pacienti, iar spontan peste o lună – 1 pacient. Concluzie: Corecţia univentriculară asigura îmbunătățirea stării funcționale a pacienților. Rezultatele nu sunt direct legate de operaţia în sine, ci de severitatea modificărilor morfologice cardiace.Introduction: Assessment of the results of surgical repair in patients with complex heart defects may suggest election of new surgical approaches. Material and methods: 99 patients aged 1 day - 30 years underwent univentricular correction in the following pathologies: the tricuspid valve atresia - 36, mitral atresia – 16, double inlet ventricles – 23, AV channel with unbalanced ventricles - 17, double outlet RV with "straddling valve» or "noncommited" VSD – 2, PA atresia with intact IVS – 5, Ebstein anomaly (Type D) – 2, TGA with PA stenosis and VSD type AV- canal - 1, congenitally corrected TGA with PA stenosis and VSD – 2. Results: From 132 operations, 49 were palliative: in unobstructed pulmonary blood flow - PA banding; in case of inadequate pulmonary blood flow - systemic pulmonary shunt (14 - modified B-T shunt and 3 – central shunt); in 4 restrictive ASD - atrioseptostomy (3 - on pump, 1 – off pump). In 32 patients with Glenn and Fontan operation was observed pleural effusion which required pleural drainage for 3-5 days, another 6 patients – up to 30 days after surgery. In one case pleural effusion occurred 2 months after surgery. Chylothorax evolved in 2 patients after surgery, and in 1 case - spontaneously after 1 month. Conclusion: Univentricular correction provides improved functional status of patients. The result is not directly related to the surgery itself, but depends of cardiac morphology and functional status

Acute toxicity, brine shrimp cytotoxicity and relaxant activity of fruits of callistemon citrinus curtis

<p>Abstract</p> <p>Background</p> <p><it>Callistemon citrinus </it>Curtis belongs to family Myrtaceae that has a great medicinal importance. In our previous work, fruits of <it>Callistemon citrinus </it>were reported to have relaxant (antispasmodic) activity. The current work describes the screening of fractions of the crude methanol extract for tracing spasmolytic constituents so that it shall help us for isolation of bioactive compounds. Acute toxicity and brine shrimp cytotoxicity of crude methanol extract are also performed to standardize it.</p> <p>Methods</p> <p>The crude methanol extract was obtained by maceration with distilled water (500 ml) three times and fractionated successively with <it>n-</it>hexane, chloroform, ethyl acetate and <it>n-</it>butanol (300 ml of each solvent). Phytochemical analysis for crude methanol extract was performed. Acute toxicity studies were performed in mice. Brine shrimp cytotoxicity studies were performed to determine its cytotoxicity and standardize it. In other series of experiments, rabbits' jejunum preparations were used in screening for possible relaxant activities of various fractions. They were applied in concentrations of 0.01, 0.03, 0.1, 0.3, 1.0, 3.0, 5.0 and 10.0 mg/ml on spontaneous rabbits' jejunum preparations. In similar fashion, fractions were also tested on KCl (80 mM) -induced contractions. Calcium chloride curves were constructed in K-rich Tyrode's solution. The effects of various fractions were tested on calcium chloride curves at concentrations 1.0, 3.0, 5.0 and 10.0 mg/ml. Curves of verapamil used as reference drug at concentration 0.1 μM and 0.3 μM were also constructed. The curves were compared with their respective controls for possible right shift.</p> <p>Results</p> <p>Methanol extract tested strongly positive for saponins and tannins. However, it tested mild positive for presence of proteins, amino acids, carbohydrates and phenolic compounds. LD₅₀value for crude methanol extract is 476.25 ± 10.3 (470-481, n = 4) mg/ml. Similarly, EC₅₀value for brine shrimp cytotoxicity is 65.5 ± 7.28 (60.8- 69.4, n = 4) mg/ml. All the fractions relaxed the spontaneous and KCl-induced contractions. EC₅₀values (mg/ml) for effects of ethyl acetate fraction on spontaneous and KCl induced contractions are 2.62 ± 0.78 (2.15-3.0, n = 4) and 3.72 ± 0.86 (3.38-4.28, n = 4) respectively. Respective EC₅₀values (mg/ml) for <it>n-</it>butanol fraction are 3.59 ± 0.2(3.07-3.9, n = 4) for spontaneous, and 5.57 ± 0.2 (5.07-6.11, n = 4) for KCl- induced contractions. EC₅₀value for control calcium chloride curve (without extract) is -2.73 ± 0.19 (-2.6 - -2.81, n = 4) while EC₅₀for curves treated with 5.0 mg/ml of chloroform is -2.22 ± 0.02 (-2.16 - -2.3, n = 4). EC₅₀value for ethyl acetate treated (1.0 mg/ml) tissues is -1.95 ± 0.10 (-1.88 - -2.0, n = 4) <it>vs</it>. control EC₅₀= -2.71 ± 0.08 (-2.66 - -2.76, n = 4). All the fractions, except <it>n-</it>hexane, showed a right shift like that of verapamil (EC₅₀= -1.72 ± 0.15 (-1.62 - -1.8, n = 4) vs. Control EC₅₀= -2.41 ± 0.06 (-2.38 - - 2.44, n = 4), a standard drug that blocks voltage operated calcium channels.</p> <p>Conclusion</p> <p>Relaxant constituents were more concentrated in ethylacetate fraction followed by chloroform, <it>n -</it>butanol and aqueous fractions that warrant for its isolation. The crude methanol extract is safe at concentration 250 mg/ml or below and results of brine shrimp cytotoxicity assay imply the plant specie may be a source of cytotoxic agents.</p

A&P : Revista de Arquitectura y Planeamiento Nº5-6/65

Contiene artículos de diferentes áreas temáticas (Arquitectura – Diseño – Historia – Urbanismo entre otros) Autores: Mario Luis Corea, Héctor H. Elena, Mario E. Bonilla, Mauro Kunst, Jorge Vila Ortiz, Fernando Chueca Goitia, Mario C. Robirosa, Constantinos A. Doxiadis, YujnovskyUniversidad Nacional del Litoral. Facultad de Ciencias Matemáticas. Escuela de Arquitectura y Planeamient

Reperfusion therapies in patients with acute ischaemic stroke and atrial fibrillation: data on safety and effectiveness from a multi-centre cohort study

Background: Intravenous thrombolysis (IVT) and/or endovascular therapy (EVT) are currently considered best practices in acute stroke patients. Data regarding the efficacy and safety of reperfusion therapies in patients with atrial fibrillation (AF) are conflicting as regards haemorrhagic transformation, mortality, and functional outcome. This study sought to investigate for any differences, in terms of safety and effectiveness, between AF patients with acute ischaemic stroke (AIS) treated and untreated with reperfusion therapies. Methods: Data from two multicenter cohort studies (RAF and RAF-NOACs) on consecutive patients with AF and AIS were analyzed to compare patients treated and not treated with reperfusion therapies (IVT and/or EVT). Multivariable logistic regression analysis was performed to identify independent predictors for outcome events: 90-day good functional outcome and mortality. A propensity score matching (PSM) analysis compared treated and untreated patients. Results: Overall, 441 (25.4%) were included in the reperfusion-treated group and 1,295 (74.6%) in the untreated group. The multivariable model suggested that reperfusion therapies were significantly associated with good functional outcome. Rates of mortality and disability were higher in patients not treated, especially in the case of higher NIHSS scores. In the PSM comparison, 173/250 patients (69.2%) who had received reperfusion therapies had good functional outcome at 90&nbsp;days, compared to 146/250 (58.4%) untreated patients (p = 0.009, OR: 1.60, 95% CI:1.11–2.31). Conclusions: Patients with AF and AIS treated with reperfusion therapies had a significantly higher rate of good functional outcome and lower rates of mortality compared to those patients with AF and AIS who had undergone conservative treatment

Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis

Objective: This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS). Methods: We retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Results: Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18\u20134.74, p = 0.015) with increased risk of severe COVID-19. Recent use (&lt;1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20\u201312.53, p = 0.001). Results were confirmed by the PS-weighted analysis and by all the sensitivity analyses. Interpretation: This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID-19 pandemic persists. ANN NEUROL 2021;89:780\u2013789

Multiple Sclerosis in Central America and Caribbean Countries: Frequency and Clinical Characterization of an Emergent Disease

BACKGROUND: Multiple Sclerosis (MS) is a common neurological disease among white populations of European origin. Frequencies among Latin Americans continue to be studied, however, epidemiologic, and clinical characterization studies lack from Central American and Caribbean countries. Ethnicity in these countries is uniformly similar with a prevalent Mestizo population. METHODS AND RESULTS: Data from January 2014 to December 2019 from Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, Dominican Republic, and Aruba on demographic, clinical, MRI and phenotypic traits were determined in coordinated studies: ENHANCE, a population-based, retrospective, observational study on incidence and clinical characteristics, and from the subgroup with MS national registries (Aruba, Dominican Republic, Honduras, and Panama), data on prevalence, phenotypes and demographics. Expanded Disability Status Scale (EDSS), and therapeutic schemes were included. ENHANCE data from 758 patients disclosed 79.8% of Mestizo ethnicity; 72.4% female; median age at onset 31.0 years and 33.2 at diagnosis. The highest incidence rate was from Aruba, 2.3-3.5 × 100,000 inhabitants, and the lowest, 0.07-0.15 × 100,000, from Honduras. Crude prevalence rates per 100,000 inhabitants fluctuated from 27.3 (Aruba) to 1.0 (Honduras). Relapsing MS accounted for 87.4% of cases; EDSS CONCLUSION: This is the first study providing data on frequencies and clinical characteristics from 8 countries from the Central American and Caribbean region, addressing MS as an emergent epidemiologic disorder. More studies from these areas are encouraged

The Italian multiple sclerosis register

The past decade has seen extraordinary increase in worldwide availability of and access to several large multiple sclerosis (MS) databases and registries. MS registries represent powerful tools to provide meaningful information on the burden, natural history, and long-term safety and effectiveness of treatments. Moreover, patients, physicians, industry, and policy makers have an active interest in real-world observational studies based on register data, as they have the potential to answer the questions that are most relevant to daily treatment decision-making. In 2014, the Italian MS Foundation, in collaboration with the Italian MS clinical centers, promoted and funded the creation of the Italian MS Register, a project in continuity with the existing Italian MS Database Network set up from 2001. Main objective of the Italian MS Register is to create an organized multicenter structure to collect data of all MS patients for better defining the disease epidemiology, improving quality of care, and promoting research projects in high-priority areas. The aim of this article is to present the current framework and network of the Italian MS register, including the methodology used to improve the quality of data collection and to facilitate the exchange of data and the collaboration among national and international groups