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Background Sepsis is a multi-system syndrome that remains the leading cause of mortality and critical illness worldwide, with hemodynamic support being one of the cornerstones of the acute management of sepsis. We used an ovine model of endotoxemic shock to determine if 0.9% saline resuscitation contributes to lung inflammation and injury in acute respiratory distress syndrome, which is a common complication of sepsis, and investigated the potential role of matrix metalloproteinases in this process. Methods Endotoxemic shock was induced in sheep by administration of an escalating dose of lipopolysaccharide, after which they subsequently received either no fluid bolus resuscitation or a 0.9% saline bolus. Lung tissue, bronchoalveolar fluid (BAL) and plasma were analysed by real-time PCR, ELISA, flow cytometry and immunohistochemical staining to assess inflammatory cells, cytokines, hyaluronan and matrix metalloproteinases. Results Endotoxemia was associated with decreased serum albumin and total protein levels, with activated neutrophils, while the glycocalyx glycosaminoglycan hyaluronan was significantly increased in BAL. Quantitative real-time PCR studies showed higher expression of IL-6 and IL-8 with saline resuscitation but no difference in matrix metalloproteinase expression. BAL and tissue homogenate levels of IL-6, IL-8 and IL-1β were elevated. Conclusions This data shows that the inflammatory response is enhanced when a host with endotoxemia is resuscitated with saline, with a comparatively higher release of inflammatory cytokines and endothelial/glycocalyx damage, but no change in matrix metalloproteinase levels.

An example of artwork that interrogates patriarchal systems as well as racial and historical legacies in the U.S. is Art in the Age of Collective Intelligence, which featured an indoor installation of photographs and books addressing the problematic issue of dealing with the history of wealth displacement in World's Fairs and, in particular, the reductive view of race they have tended to display as capitalist spectacles. In your opinion, how does protest demand new iterations of the way artists—as well as audiences, spectators, critics, institutions, and the art market—approach the very practice of art-making? RAQS MEDIA COLLECTIVE/ A tension between the aesthetic and the constituted political is not a novel phenomenon. To put it another way: how can a citizen produce counternarratives? RMC/ The tales of Layla and Majnun, and Heer-Ranjha, which address and remember the indifference of love to the realities of a cruel world, or the Marsiyas and Nohas that address the incident at Karbala, or Antigone's insistence on a proper burial, or the songs of Baul minstrels that radically question the form that the \"self\" takes, the astronomical observations of Louis-Auguste Blanqui on distant stars, Rosa Luxemburg's botanical notebooks, Karl Marx's fairy stories for his daughter Eleanor, the aphorisms in twilight language of Kabir, the weaver of Benares, and the riddles of Bodhidharma or Dogen all constitute the most subversive aesthetic inheritances that we lay claim to. MKL/ You've been working together since 1992, a significant year in Indian mass media with the foundation of Tamil Sun TV and the rise of private cable television, for instance.

We as a grad class would like an apology from your newspaper. Perhaps it is believed that as teenagers we do not deserve such a thing, for we do not know the meaning of respect; the majority of us do and for the rest of us to learn it, it needs to be taught by our elders. Please give us the respect that we deserve, and if you do not believe we deserve it, give us the respect so that we may learn to give it to others.

In interview, the New Delhi-based Raqs Media Collective (artists Jeebesch Bagchi, Monica Narula and Shuddhabrata Sengupta) list their Top Ten. Those within the scope of ABM are: the artist Chen Zhen (1955-2000), the building La Mole Antonelliana in Turin, Italy which houses the Italian National Museum of Cinema, the film 'The Muriel Lake Incident' (1999; col. illus.) by Janet Cardiff and George Bures Miller, the museum The Mattress Factory in Pittsburgh, the CD-Rom 'Rehearsal of Memory' (1995; col. illus.) by Graham Harwood, and the adult comic-book series 'The Invisibles' written by Grant Morrison.

Urinary stone disease is an ailment that has afflicted human kind for many centuries. Nephrolithiasis is a significant clinical problem in everyday practice with a subsequent burden for the health system. Nephrolithiasis remains a chronic disease and our fundamental understanding of the pathogenesis of stones as well as their prevention and cure still remains rudimentary. Regardless of the fact that supersaturation of stone-forming salts in urine is essential, abundance of these salts by itself will not always result in stone formation. The pathogenesis of calcium oxalate stone formation is a multistep process and essentially includes nucleation, crystal growth, crystal aggregation, and crystal retention. Various substances in the body have an effect on one or more of the above stone-forming processes, thereby influencing a person’s ability to promote or prevent stone formation. Promoters facilitate the stone formation while inhibitors prevent it. Besides low urine volume and low urine pH, high calcium, sodium, oxalate and urate are also known to promote calcium oxalate stone formation. Many inorganic (citrate, magnesium) and organic substances (nephrocalcin, urinary prothrombin fragment-1, osteopontin) are known to inhibit stone formation. This review presents a comprehensive account of the mechanism of renal stone formation and the role of inhibitors/promoters in calcium oxalate crystallisation.

Oral health care is essential yet challenging in children with autism spectrum disorder (ASD) due to their impaired emotional and behavioral stability, lack of communication skills, and inability to perform daily home hygiene routines properly. The present study was planned with the aim of assessing the Oral Health Status and Treatment Needs of children with ASD in comparison with children without any systemic disease. A total of 160 children, in the age group of 5-14 years, divided equally into two groups, i.e., Group A (children with ASD) and Group B (children without any systemic disease), were assessed for Dental caries, Oral Hygiene Status, and Treatment Needs. The behavior of children in each group, during oral examination, was also assessed and recorded. Student t test and Chi square test were used for quantitative and qualitative analysis, respectively. The mean age of participating children was 7.96±2.43 years with a male predominance (male to female ratio - 1.58:1). Children with ASD displayed more negative behavior with 15% showing definitely negative behavior, 21.2% negative behavior on Frankl's Behavior Rating scale; the statistically lower prevalence of dental caries (Group A - mean decayed, missing and filled primary teeth (dmft): 1.7±3.2, mean decayed, missing and filled permanent teeth (DMFT): 0.19±0.71; Group B - mean DMFT: 5.44±4.88, mean DMFT: 1.01±1.51; p=0.0001), better oral hygiene (Group A - 18.8% showed good Simplified Oral Hygiene Index Score (OHI-S), 56.2% showed fair OHI-S; Group B - 6.2% showed good OHI-S and 46.3% showed fair OHI-S) and lower treatment needs compared to children without any systemic disease. Children with ASD showed better oral health and lower treatment needs. This suggests that introducing oral hygiene care and diet modifications in daily routine can significantly improve the Oral Health Status in children with ASD.

COPD is the second leading cause of death and disability adjusted life years (DALYs) in India, yet, it remains poorly recognized. We aimed to study the level of awareness of COPD in urban slums of Pune city in India and its neighboring rural areas. All male and female subjects above the age of 30 years residing in 13 randomly selected slums of Pune city (total population of 3000) and 7 randomly selected neighboring rural villages (total population of 3000) were invited to participate in this cross-sectional community survey. After obtaining written informed consent, 13 trained community health workers (CHWs) administered a questionnaire that captured their level of awareness of COPD. Of the 6000 subjects approached, 5420 residents (mean age ± SD = 48.0 ± 13.5 years; 38% males) consented and answered all questions. The number of people who had ever heard the word COPD was 49/5420 [0.9% (0.6–1.1%); 0.7% (0.5–1.3%) of the urban slum dwellers and 1.15% (0.5–1.3%) of rural residents]. Among those who had never heard the word COPD (n = 5371), when asked what was the name of the disease caused by long-term tobacco smoking, 38% said cancer, 16.7% said asthma, and 4.4% said TB. Among those who had heard the word COPD (n = 49), 6.1% said it was a disease of the heart, and 61% attributed COPD to smoke and dust pollution and 20% to tobacco smoking. The level of awareness of COPD in the Indian community is extremely low, highlighting the need to have nationwide mass awareness programs in India.

Background Cerebrospinal fluid (CSF) and spinal MRIs are often obtained in children with the radiologically isolated syndrome (RIS) for diagnosis and prognosis. Factors affecting the frequency and timing of these tests are unknown. Objective To determine whether age or sex were associated with (1) having CSF or spinal MRI obtained or (2) the timing of these tests. Methods We analyzed children (≤ 18 y) with RIS enrolled in an international longitudinal study. Index scans met 2010/2017 multiple sclerosis (MS) MRI criteria for dissemination in space (DIS). We used Fisher’s exact test and multivariable logistic regression (covariates = age, sex, MRI date, MRI indication, 2005 MRI DIS criteria met, and race). Results We included 103 children with RIS (67% girls, median age = 14.9 y). Children ≥ 12 y were more likely than children < 12 y to have CSF obtained (58% vs. 21%, adjusted odds ratio [AOR] = 4.9, p  = 0.03). Pre-2017, girls were more likely than boys to have CSF obtained ( n  = 70, 79% vs. 52%, AOR = 4.6, p  = 0.01), but not more recently ( n  = 30, 75% vs. 80%, AOR = 0.2, p  = 0.1; p  = 0.004 for interaction). Spinal MRIs were obtained sooner in children ≥ 12 y (median 11d vs. 159d, p  = 0.03). Conclusions Younger children with RIS may be at continued risk for misdiagnosis and misclassification of MS risk. Consensus guidelines are needed.

In both classic and late-onset AFD, mutations of the GLA gene cause deficient activity of the alpha-galactosidase enzyme resulting in intracellular accumulation of the undigested substrate. Gastrointestinal symptoms (GI) are common but non-specific and imputed to the AFD, irrespective of the demonstration of substrate accumulation in GI cells. We demonstrate substrate accumulation in gastric epithelial, vascular, and nerve cells of patients with classic AFD and, vice versa, absence of accumulation in late-onset AFD and controls.

On Feb 1, 2017, the Government of India's Finance Minister Arun Jaitley presented the annual Union Budget in Parliament. 1 Within it, ambitious \"action plans\" for improving health or ameliorating disease were referenced. The plans include the elimination of several infectious diseases--visceral leishmaniasis and filariasis in 2017, leprosy by 2018, measles by 2020, and tuberculosis by 2025.