Building thermal performance, extreme heat, and climate change

The leading source of weather-related deaths in the United States is heat, and future projections show that the frequency, duration, and intensity of heat events will increase in the Southwest. Presently, there is a dearth of knowledge about how infrastructure may perform during heat waves or could contribute to social vulnerability. To understand how buildings perform in heat and potentially stress people, indoor air temperature changes when air conditioning is inaccessible are modeled for building archetypes in Los Angeles, California, and Phoenix, Arizona, when air conditioning is inaccessible is estimated. An energy simulation model is used to estimate how quickly indoor air temperature changes when building archetypes are exposed to extreme heat. Building age and geometry (which together determine the building envelope material composition) are found to be the strongest indicators of thermal envelope performance. Older neighborhoods in Los Angeles and Phoenix (often more centrally located in the metropolitan areas) are found to contain the buildings whose interiors warm the fastest, raising particular concern because these regions are also forecast to experience temperature increases. To combat infrastructure vulnerability and provide heat refuge for residents, incentives should be adopted to strategically retrofit buildings where both socially vulnerable populations reside and increasing temperatures are forecast

A RANDOMIZED CLINICAL ENDPOINT STUDY TO EVALUATE THE SAFETY AND EFFICACY OF CLEARLIV TABLETS IN PATIENTS WITH ALCOHOLIC LIVER DISEASE

Objective: The objective of this study was to evaluate and compare the hepatoprotective effect of clearliv tablets with silymarin in patients with alcoholic liver disease.Methods: This was a prospective, randomized, multicenter, open-label, parallel group interventional clinical endpoint study (Phase IIa). Patients attending general medicine outpatient department were screened for alcoholic liver disease using the serum biochemical liver function test and ultrasonogram abdomen and tested whether they satisfy the selection criteria, and 24 patients were then enrolled in the study. The study drug, namely clearliv tablets of Apex Laboratories Pvt. Ltd., was administered to Group A and tablet silymarin was administered to Group B from day 1 to day 56. Patients were reviewed once in 2 weeks. Liver function test was repeated, and patients were enquired of their well-being and any adverse events.Results: The demographic characters and body weight of the subjects showed no significant difference between the groups. There is a significant improvement (p<0.05) in the aspartate transaminase (AST), alanine transaminase (ALT), and total bilirubin (TB) levels on 28th and 56th days in both silymarin and clearliv groups. Of the 2 groups, there is higher significance of improvement in clearliv group (p<0.001), compared to silymarin group. Clearliv group started showing a significant reduction in AST and ALT levels in the first 14 days of the study period. On comparing the mean percentage reduction in the levels of AST (35.7% and 35%), ALT (26.7% and 24.3%), and TB (26.7% and 25%), it was found that clearliv is showing a better percentage of reduction of the above parameters compared to silymarin. There were reports of adverse effects such as loss of appetite and gastritis in both the groups.Conclusion: This clinical study proves that clearliv is functioning as a hepatoprotective drug. It is offering a better hepatoprotection compared to silymarin. Clearliv tablets can be indicated for the management of liver dysfunction, which occurs due to alcoholic liver damage. It may also be used in similar manner in cases of viral hepatitis, drug-induced liver damage, acute and chronic hepatitis

Nasal Carriage and Antimicrobial Susceptibility of Staphylococcus aureus in healthy preschool children in Ujjain, India

<p>Abstract</p> <p>Background</p> <p>There is increasing evidence that community acquired <it>S. aureus </it>infections are spreading among healthy children. Nasal colonization with <it>S. aureus </it>plays pivotal role in the increasing prevalence of resistant community acquired <it>S. aureus </it>infections worldwide. A regular surveillance system is important in ensuring quality of patient care. The aim of the study was to assess the prevalence of and the factors associated with nasal carriage of <it>S. aureus </it>and its antibiotic sensitivity pattern among healthy children in Ujjain, India.</p> <p>Methods</p> <p>A prospective study was done in paediatric outpatient clinics of R.D. Gardi medical college Ujjain, India. Healthy children from 1 month to 59 months of age were included. Information on previously known risk factors for nasal colonization was collected using a pre-tested questionnaire. Swabs from anterior nares were collected and transported in Amies transport media with charcoal and cultured on 5% sheep blood agar. Antibiotic sensitivity tests were performed using Kirby Bauer's disc diffusion method according to performance standards of Clinical and Laboratory Standard Institute guidelines.</p> <p>Results</p> <p>Of the 1,562 children from 1-month up-to five years of age included in the study 98 children tested positive for nasal carriage of <it>S. aureus</it>. The prevalence of nasal carriage of <it>S. aureus </it>was 6.3% (95% CI 5.1-7.5) out of which 16.3% (95% CI 8.9-23.8) were methicillin-resistant <it>S. aureus </it>(MRSA). The factors associated with nasal carriage were "child attending preschool" (OR 4.26, 95% CI 2.25-8.03; <it>P </it>= 0.007) or "school" (OR 3.02, 95% CI 1.27-7.18; <it>P </it>< 0.001) and "family size more than 10 members" (OR 2.76 95% CI 1.06-7.15; <it>P </it>= 0.03). The sensitivity pattern of isolated <it>S. aureus </it>showed resistance to commonly used oral antibiotics while resistance to glycopeptides was not noted.</p> <p>Conclusions</p> <p>We found a relatively low rate of nasal carriage of <it>S. aureus </it>in children below five years when compared to children of older age groups in India. Yet, prevalence of MRSA was relatively high.</p

Gene Expression, Function and Ischemia Tolerance in Male and Female Rat Hearts After Sub-Toxic Levels of Angiotensin II

To examine the response to chronic high-dose angiotensin II (Ang II) and a proposed milder response in female hearts with respect to gene expression and ischemic injury. Female and male litter–matched rats were treated with 400 ng kg−1 min−1 Ang II for 14 days. Hearts were isolated, subjected to 30-min ischemia and 30-min reperfusion in combination with functional monitoring and thereafter harvested for gene expression, WB and histology. Ang II-treated hearts showed signs of non-hypertrophic remodeling and had significantly higher end diastolic pressure after reperfusion, but no significant gender difference was detected. Ang II increased expression of genes related to heart function (ANF, β-MCH, Ankrd-1, PKC-α, PKC-δ TNF-α); fibrosis (Col I-α1, Col III-α1, Fn-1, Timp1) and apoptosis (P53, Casp-3) without changing heart weight but with 68% increase in collagen content. High (sub-toxic) dose of Ang II resulted in marked heart remodeling and diastolic dysfunction after ischemia without significant myocyte hypertrophy or ventricular chamber dilatation. Although there were some gender-dependent differences in gene expression, female gender did not protect against the overall response

Doxorubicin and vinorelbine act independently via p53 expression and p38 activation respectively in breast cancer cell lines

In the treatment of breast cancer, combination chemotherapy is used to overcome drug resistance. Combining doxorubicin and vinorelbine in the treatment of patients with metastatic breast cancer has shown high response rates; even single-agent vinorelbine in patients previously exposed to anthracyclines results in significant remission. Alterations in protein kinase-mediated signal transduction and p53 mutations may play a role in drug resistance with cross-talk between signal transduction and p53 pathways. The aim of this study was to establish the effects of doxorubicin and vinorelbine, as single agents, in combination, and as sequential treatments, on signal transduction and p53 in the breast cancer cell lines MCF-7 and MDA-MB-468. In both cell lines, increased p38 activity was demonstrated following vinorelbine but not doxorubicin treatment, whether vinorelbine was given prior to or simultaneously with doxorubicin. Mitogen-activated protein kinase (MAPK) activity and p53 expression remained unchanged following vinorelbine treatment. Doxorubicin treatment resulted in increased p53 expression, without changes in MAPK or p38 activity. These findings suggest that the effect of doxorubicin and vinorelbine used in combination may be achieved at least in part through distinct mechanisms. This additivism, where doxorubicin acts via p53 expression and vinorelbine through p38 activation, may contribute to the high clinical response rate when the two drugs are used together in the treatment of breast cancer

Bradykinin and adenosine receptors mediate desflurane induced postconditioning in human myocardium: role of reactive oxygen species

BACKGROUND: Desflurane during early reperfusion has been shown to postcondition human myocardium, in vitro. We investigated the role of adenosine and bradykinin receptors, and generation of radical oxygen species in desflurane-induced postconditioning in human myocardium. METHODS: We recorded isometric contraction of human right atrial trabeculae hanged in an oxygenated Tyrode's solution (34 degrees Celsius, stimulation frequency 1 Hz). After a 30-min hypoxic period, desflurane 6% was administered during the first 5 min of reoxygenation. Desflurane was administered alone or with pretreatment of N-mercaptopropionylglycine, a reactive oxygen species scavenger, 8-(p-Sulfophenyl)theophylline, an adenosine receptor antagonist, HOE140, a selective B2 bradykinin receptor antagonist. In separate groups, adenosine and bradykinin were administered during the first minutes of reoxygenation alone or in presence of N-mercaptopropionylglycine. The force of contraction of trabeculae was recorded continuously. Developed force at the end of a 60-min reoxygenation period was compared (mean +/- standard deviation) between the groups by a variance analysis and post hoc test. RESULTS: Desflurane 6% (84 +/- 6% of baseline) enhanced the recovery of force after 60-min of reoxygenation as compared to control group (51 +/- 8% of baseline, P < 0.0001). N-mercaptopropionylglycine (54 +/- 3% of baseline), 8-(p-Sulfophenyl)theophylline (62 +/- 9% of baseline), HOE140 (58 +/- 6% of baseline) abolished desflurane-induced postconditioning. Adenosine (80 +/- 9% of baseline) and bradykinin (83 +/- 4% of baseline) induced postconditioning (P < 0.0001 vs control), N-mercaptopropionylglycine abolished the beneficial effects of adenosine and bradykinin (54 +/- 8 and 58 +/- 5% of baseline, respectively). CONCLUSIONS: In vitro, desflurane-induced postconditioning depends on reactive oxygen species production, activation of adenosine and bradykinin B2 receptors. And, the cardioprotective effect of adenosine and bradykinin administered at the beginning of reoxygenation, was mediated, at least in part, through ROS production