Identification of potential lockdown areas during COVID-19 transmission in Punjab, Pakistan.

OBJECTIVES: Real-time COVID-19 spread mapping and monitoring to identify lockdown and semi-lockdown areas using hotspot analysis and geographic information systems and also near future prediction modeling for risk of COVID-19 in Punjab, Pakistan. STUDY DESIGN: Data for all COVID-19 cases were collected until 20 October 2020 in Punjab Province. METHODS: The methodology included geotagging COVID-19 cases to understand the trans-mobility areas for COVID-19 and characterize risk. The hotspot analysis technique was used to identify the number of areas in danger zones and the number of people affected by COVID-19. The complete lockdown areas were marked down geographically to be selected by the government of Pakistan based on increased numbers of cases. RESULTS: As per predictive model estimates, almost 9.2 million people are COVID-19 infected by 20 October 2020 in Punjab Province. The compound growth rate of COVID-19 decreased to 0.012% per day and doubling rate increased to 364.5 days in Punjab Province. Based on Pueyo model predictions from past temporal data, it is more likely that Punjab and Pakistan entered into peak around the first week of July 2020, and the decline of growth rate (and doubling rate) of reported cases started afterward. Hospital load was also measured through the Pueyo model, and mostly, people in the 60+ years age group are expected to dominate the hospitalized population. CONCLUSIONS: Pakistan is experiencing a high number of COVID-19 cases, with the maximum share from Punjab, Pakistan. Statistical modeling and compound growth estimation formulation were done through the Pueyo model, which was applied in Pakistan to identify the compound growth of COVID-19 patients and predicting numbers of patients shortly by slightly modifying it as per the local context.

Elastic wave propagation in smooth and wrinkled stratified polymer films.

Periodic materials with sub-micrometer characteristic length scale can provide means for control of propagation of hypersonic phonons. In addition to propagation stopbands for the acoustic phonons, distinct dispersive modes can reveal specific thermal and mechanical behavior under confinement. Here, we employ both experimental and theoretical methods to characterize the phonon dispersion relation (frequency versus wave vector). We employed Brillouin light scattering (BLS) spectroscopy to record the phonon dispersion in stratified multilayer polymer films. These films consist of 4-128 alternate polycarbonate (PC) and poly (methyl methacrylate) (PMMA) layers along and normal to the periodicity direction. The distinct direction-dependent phonon propagation was theoretically accounted for, by considering the polarization, frequency and intensity of the observed modes in the BLS spectra. Layer-guiding was also supported by the glass transition temperatures of the PC and PMMA layers. The number of phonon dispersion branches increased with the number of layers but only a few branches were observable by BLS. Introduction of an additional in-plane periodicity, through a permanent wrinkling of the smooth PC/PMMA films, had only subtle consequences in the phonon propagation. Using the frequencies of the periodicity induced modes and momentum conservation equation we were able to precisely back calculate the wrinkle periodicity. However, a wrinkling-induced acoustic stopband utilizing flexible layered materials is still a challenge.

Solvent-Dependent Light-Induced Structures in Gem-Dichlorocyclopropanated Polybutadiene Solutions.

The formation of permanent structures upon mild red laser illumination in transparent polydiene solutions is examined in the case of gem-dichlorocyclopropanated polybutadiene ( gDCC-PB) polymers bearing 15% functional units of the dichlorocyclopropane groups. The response was found to be distinct from the precursor PB. Whereas fiber-like patterns were clearly observed in both precursor and gDCC-PB solutions in cyclohexane, these were absent in the case of gDCC-PB/chloroform but were present in the precursor PB/chloroform solutions. The involved mechanical stresses were not sufficient for the gDCC activation to be detected by NMR spectroscopy. Remarkably, addition of even 10 wt % gDCC-PB into the latter solution sufficed to suppress the light-induced patterning. The importance of the chemical environment on the response to light irradiation was further checked and confirmed by use of other PB copolymers. Different diameter patterns and kinetics were observed. The strong solvent and comonomer mediated effect was reflected neither in solvency nor in optical polarizability differences of the polymers solvent couples.

Effects of pH on the structure and mechanical properties of dried pH-responsive latex particles.

Micrometer-sized monodisperse polystyrene (PS) particles carrying a pH-responsive poly[2-(diethylamino)ethyl methacrylate] (PDEA) colloidal stabilizer were synthesized via free radical dispersion polymerization. X-ray photoelectron spectroscopy and electrophoretic measurements verified that PDEA covered the PS particle surface. At pH 3.0 and 6.3, where the PDEA is protonated and cationically charged, the PDEA-PS particles were well dispersed in aqueous media thanks to the water soluble PDEA stabilizer and slowly sedimented due to gravity and enriched at the bottom of the glass vials. At pH 10.0, where the PDEA is non-protonated and neutral, the PDEA-PS particles weakly aggregated due to non-hydrated and collapsed PDEA. These PDEA-PS particles and aggregates sedimented to the bottom. The sediment height observed at pH 10.0 was higher than those observed at pH 3.0 and 6.3 in both wet and dry systems, which indicated that a larger porosity was formed at pH 10.0. Mechanical testing experiments confirmed that the fracture toughness of the dried materials decreased with an increase of pH. The fracture toughness was found to be correlated with the degree of particle ordering in the dried particulate materials: more ordered, dense packings lead to a higher fracture toughness compared to amorphous, less dense packings. Thus, we could tune fracture toughness and degree of particle ordering by controlling the pH.

Kinetics of Light-Induced Concentration Patterns in Transparent Polymer Solutions.

When exposed to weak visible laser light, solutions of common polymers like poly(isoprene) and poly(butadiene) respond by local concentration variations, which in turn lead to refractive index changes. Various micropatterns have been recently reported, depending mostly on the solvent environment and the irradiation conditions. Here, we focused on the simpler case of single polymer-rich filaments and we employed phase contrast microscopy to systematically investigate the influence of laser illumination and material parameters on the kinetics of the optically induced local concentration increase in the polydiene solutions. The refractive index contrast of the formed filaments increased exponentially with the laser illumination time. The growth rate exhibited linear dependence on the laser power and increased with polymer chain length in semidilute solutions in good solvents. On the contrary, the kinetics of the formed filaments appeared to be rather insensitive to the polymer concentration. Albeit the origin of the peculiar light field-polymer concentration coupling remains yet elusive, the new phenomenology is considered necessary for the elucidation of its mechanism.

Gene and Protein Expression of Chemokine (C-C-Motif) Ligand 19 is Upregulated in Unstable Carotid Atherosclerotic Plaques.

OBJECTIVE/BACKGROUND: The aim was to investigate the expression of genes associated with carotid plaque instability and their protein products at a local and systemic level. METHODS: Carotid plaques from 24 patients undergoing carotid endarterectomy (CEA) were classified as stable or unstable using clinical, histological, ultrasound, and transcranial Doppler criteria, and compared using whole genome microarray chips. Initial results of differentially expressed genes were validated by quantitative reverse transcriptase polymerase chain reaction in an independent group of 96 patients undergoing CEA. The protein product of genes significantly differentially expressed between patients with stable and unstable plaques were analysed by plaque immunohistochemistry and serum protein quantification by enzyme-linked immunosorbent assay on a further independent cohort. RESULTS: Expression of chemokine (c-c-motif) ligand 19 (CCL19) was significantly upregulated in plaques from patients with clinically unstable disease (p < .001). Cathepsin G expression was upregulated in histologically unstable plaques (p = .04). Serum concentration of CCL19 was significantly higher in patients with clinically unstable plaques (p = .02). Immunohistochemical staining for CCL19 demonstrated positive staining in histologically and clinically unstable plaques (p = .03). CCL19 also co-localised with CD3+ T-cell lymphocytes in the core region, around where CCL19 was expressed. CONCLUSIONS: CCL19 is significantly overexpressed in patients with unstable carotid atherosclerotic plaques and may be a possible novel biomarker for identifying high-risk patients in whom more urgent intervention may be indicated.

Microarray-based Gene Expression Profiling of Abdominal Aortic Aneurysm.

OBJECTIVE/BACKGROUND: Microarray-based gene expression profiling studies may detect transcriptional signatures carrying prognostic value in abdominal aortic aneurysms (AAA). A gene expression profiling study was conducted to compare individuals with AAA with screened controls. METHODS: The peripheral blood transcriptome was compared between 12 individuals with AAA and 12 age- and sex-matched controls using microarray. Validation by Taqman real-time quantitative (qPCR) was performed in an independent group as described. Peripheral blood RNA was hybridized to Illumina microarrays, each representing 37,846 genes, allowing comparison of gene expression between cases and controls. Eleven differentially expressed genes were re-quantified by qPCR in the independent group with AAA (n = 95), controls (n = 92), pre- and postendovascular AAA repair (EVAR, n = 31); or open AAA repair (n = 13), AAA wall biopsies (n = 11), and in matched smooth muscle cultures (n = 7). RESULTS: Microarray detected 47 significantly differentially expressed genes in AAA after correction for multiple testing (p < .05). These genes conferred roles in regulation of apoptosis, proteolysis, the electron transport chain, leukocyte migration, and the humoral immune response. Gene quantification in the independent group demonstrated three genes to be downregulated in AAA compared with controls: MSN, PSMB10, and STIM1; however, their expression remained unchanged post-AAA repair. PSMB10 was the only gene conferring a consistent direction of effect in both the discovery and validation analyses (downregulated). EIF3G, SIVA, PUF60, CYC1, FIBP, and CARD8 were downregulated post-EVAR. Expression of all 11 genes of interest was detected in aortic biopsies and matched smooth muscle cultures. CONCLUSION: This study demonstrates differential expression of transcripts in peripheral blood of individuals with AAA, with functional roles in proteolysis, inflammation, and apoptotic processes. These were modulated by aneurysm exclusion from the circulation and expressed in matched aortic biopsies and smooth muscle cultures. These observations further support the key roles for these pathways in the pathogenesis of AAA.

Surface forces between colloidal particles at high hydrostatic pressure.

It was recently suggested that the electrostatic double-layer force between colloidal particles might weaken at high hydrostatic pressure encountered, for example, in deep seas or during oil recovery. We have addressed this issue by means of a specially designed optical trapping setup that allowed us to explore the interaction of a micrometer-sized glass bead and a solid glass wall in water at hydrostatic pressures of up to 1 kbar. The setup allowed us to measure the distance between bead and wall with a subnanometer resolution. We have determined the Debye lengths in water for salt concentrations of 0.1 and 1 mM. We found that in the pressure range from 1 bar to 1 kbar the maximum variation of the Debye lengths was <1 nm for both salt concentrations. Furthermore, the magnitude of the zeta potentials of the glass surfaces in water showed no dependency on pressure.

The association between clinical periodontal parameters and free haem concentration within the gingival crevicular fluid: a pilot study.

OBJECTIVES: To investigate the concentration of local free haem in gingival crevicular fluid at periodontally healthy compared with diseased sites in relation to clinical periodontal parameters. The second objective is to investigate for any correlation between smoking and haem concentration. MATERIAL AND METHODS: Clinical parameters were recorded for two healthy and two diseased sites from 22 patients with untreated periodontitis. Gingival crevicular fluid samples were collected from the same sites. Haem assay analysis was undertaken to determine haem concentration at these sites. RESULTS: Gingival crevicular fluid haem concentration was higher at periodontally diseased sites compared to healthy sites (mean 46.6 ± 70.6 nM in healthy vs. 1116.6 ± 2007.0 nM in diseased sites, p < 0.001) and positively correlated with probing pocket depth, attachment level and radiographic bone loss. Gingival crevicular fluid haem concentration was higher in non-smokers compared with smokers. However, no significant difference in correlation between haem concentration and clinical parameters were seen between smokers and non-smokers (p > 0.3). CONCLUSION: The higher concentration of gingival crevicular fluid haem at diseased compared with healthy sites indicates that there is an association between increased levels of local free haem and periodontal disease. This may be through the pro-inflammatory actions of free haem. Further study on a larger scale is required to determine the influence of smoking between haem concentration and clinical parameters.

Ultrasonography alone can reliably locate parathyroid tumours and facilitates minimally invasive parathyroidectomy.

INTRODUCTION: Minimally invasive parathyroidectomy (MIP) is performed via a short incision (≤3cm). Previous studies have employed multiple imaging modalities including ultrasonography, sestamibi imaging and/or intraoperative parathyroid hormone assay. We present our eight-year experience of MIP using ultrasonography alone. METHODS: One hundred parathyroidectomies performed by a single surgeon between April 2004 and December 2012 were identified in a prospectively maintained database. All patients underwent ultrasonography including preoperative marking of the lesion by a single radiologist. No other localising diagnostic tests were performed. RESULTS: Of the 100 patients (69% female) who underwent parathyroidectomy, 93 had MIP. The median age of all cases was 58 years (range: 19-90 years). All patients exhibited an elevated parathyroid hormone level (median: 19pmol) in the presence of hypercalcaemia (median: 2.86mmol/l, range: 2.54-3.94mmol/l). Conventional surgery was indicated in seven patients owing to the need for concurrent thyroidectomy. The median operative time was 30 minutes (range: 10-130 minutes). Ultrasonography localised parathyroid tumour position correctly in 98% of patients who underwent MIP, and in 97% across both MIP and non-MIP groups. Postoperative complications requiring treatment included pancreatitis and symptomatic hypocalcaemia. Follow-up review at 6-8 weeks demonstrated that 86% of open cases (6/7) and 94% of MIP cases (87/93) were rendered normocalcaemic. CONCLUSIONS: Our study is the first to demonstrate that the sole use of ultrasonography including preoperative marking can localise parathyroid tumours correctly in 98% of cases suitable for MIP.

Identification of microRNAs associated with abdominal aortic aneurysms and peripheral arterial disease.

BACKGROUND: MicroRNAs are crucial in the regulation of cardiovascular disease and represent potential therapeutic targets to decrease abdominal aortic aneurysm (AAA) expansion. The aim of this study was to identify circulating microRNAs associated with AAA. METHODS: Some 754 microRNAs in whole-blood samples from 15 men with an AAA and ten control subjects were quantified using quantitative reverse transcriptase-PCR. MicroRNAs demonstrating a significant association with AAA were validated in peripheral blood and plasma samples of men in the following groups (40 in each): healthy controls, controls with peripheral arterial disease (PAD), men with a small AAA (30-54 mm), those with a large AAA (over 54 mm), and those following AAA repair. MicroRNA expression was also assessed in aortic tissue. RESULTS: Twenty-nine differentially expressed microRNAs were identified in the discovery study. Validation study revealed that let-7e (fold change (FC) -1·80; P = 0·001), miR-15a (FC -2·24; P < 0·001) and miR-196b (FC -2·26; P < 0·001) were downregulated in peripheral blood from patients with an AAA, and miR-411 was upregulated (FC 5·90; P = 0·001). miR-196b was also downregulated in plasma from the same individuals (FC -3·75; P = 0·029). The same miRNAs were similarly expressed differentially in patients with PAD compared with healthy controls. Validated and predicted microRNA targets identified through miRWalk revealed that these miRNAs were all regulators of AAA-related genes (vascular cell adhesion molecule 1, intercellular cell adhesion molecule 1, DAB2 interacting protein, α1-antitrypsin, C-reactive protein, interleukin 6, osteoprotegerin, methylenetetrahydrofolate reductase, tumour necrosis factor α). CONCLUSION: In this study, circulating levels of let-7e, miR-15a, miR-196b and miR-411 were differentially expressed in men with an AAA compared with healthy controls, but also differentially expressed in men with PAD. Modulation of these miRNAs and their target genes may represent a new therapeutic pathway to affect the progression of AAA and atherosclerosis.

The impact of preemptive ropivacaine in inguinal hernioplasty--a randomized controlled trial.

INTRODUCTION: This study was aimed to assess the outcome of Ilioinguinal, Iliohypogastric block and wound infiltration with 0.75% ropivacaine on pain perception, first analgesic request and hospital stay following inguinal Lichtenstein mesh repair. METHOD: This was a prospective, randomized, double-blind study with 60 patients undergoing inguinal hernioplasty under general anesthesia. Patients were randomly allocated to one of the two groups by the sealed envelope method. Group 1 (n=30) received nerve blocks and incision infiltration with 0.75% ropivacaine while group 2 (n=30) received isotonic saline. Postoperatively pain intensity, time of demand for the first analgesic and duration of hospital stay were assessed. RESULTS: Median Visual Analog Scale (VAS) score of group 1 was 4 (high=6, low=3) while for group 2 was 5.50 (high=8, low=4) and the p value was <0.001. Mean time for the demand of the first analgesic was prolonged from 1.19±1.05 h to 5.31±1.14 h with the p value of <0.0005, while the mean time of hospital stay was reduced from 22.5±3.30 h to 14.1±2.99 h with the p value of <0.0005. CONCLUSION: Preemptive analgesia with 0.75% ropivacaine causes significant reduction in pain perception, request for an analgesic and hospital stay. Therefore it is advisable before inguinal hernioplasty.

Measuring contact angle and meniscus shape with a reflected laser beam.

Side-view imaging of the contact angle between an extended planar solid surface and a liquid is problematic. Even when aligning the view perfectly parallel to the contact line, focusing one point of the contact line is not possible. We describe a new measurement technique for determining contact angles with the reflection of a widened laser sheet on a moving contact line. We verified this new technique measuring the contact angle on a cylinder, rotating partially immersed in a liquid. A laser sheet is inclined under an angle φ to the unperturbed liquid surface and is reflected off the meniscus. Collected on a screen, the reflection image contains information to determine the contact angle. When dividing the laser sheet into an array of laser rays by placing a mesh into the beam path, the shape of the meniscus can be reconstructed from the reflection image. We verified the method by measuring the receding contact angle versus speed for aqueous cetyltrimethyl ammonium bromide solutions on a smooth hydrophobized as well as on a rough polystyrene surface.

Properties of amphiphilic oligonucleotide films at the air/water interface and after film transfer.

The self-assembly of amphiphilic hybrid materials containing an oligonucleotide sequence at the air/water interface was investigated by means of pressure-molecular area (Π-A) isotherms. In addition, films were transferred onto solid substrates and imaged using scanning force microscopy. We used oligonucleotide molecules with lipid tails, which consisted of a single stranded oligonucleotide 11 mer containing two hydrophobically modified 5-(dodec-1-ynyl)uracil nucleobases (dU11) at the 5'-end of the oligonucleotide sequence. The air/water interface was used as confinement for the self-assembling process of dU11. Scanning force microscopy of films transferred via Langmuir-Blodgett technique revealed mono-, bi- (Π ≥ 2 mN/m) and multilayer formation (Π ≥ 30 mN/m). The first layer was 1.6 ± 0.1 nm thick. It was oriented with the hydrophilic oligonucleotide moiety facing the hydrophilic substrate while the hydrophobic alkyl chains faced air. In the second layer the oligonucleotide moiety was found to face the air. The second layer was found to cover up to 95% of the sample area. Our measurements indicated that the rearrangement of the molecules into bi- and multiple bilayers happened already at the air/water interface. Similar results were obtained with a second type of oligonucleotide amphiphile, an oligonucleotide block copolymer, which was composed of an oligonucleotide 11 mer covalently attached at the terminus to polypropyleneoxide (PPO).

Dynamic measurement of the force required to move a liquid drop on a solid surface.

We measured the forces required to slide sessile drops over surfaces. The forces were measured by means of a vertical deflectable capillary stuck in the drop. The drop adhesion force instrument (DAFI) allowed the investigation of the dynamic lateral adhesion force of water drops of 0.1 to 2 µL volume at defined velocities. On flat PDMS surfaces, the dynamic lateral adhesion force increases linearly with the diameter of the contact area of the solid-liquid interface and linearly with the sliding velocity. The movement of the drop relative to the surfaces enabled us to resolve the pinning of the three-phase contact line to individual defects. We further investigated a 3D superhydrophobic pillar array. The depinning of the receding part of the rim of the drop occurred almost simultaneously from four to five pillars, giving rise to peaks in the lateral adhesion force.

Dynamics and kinetics of structure formation in molecularly tethered fluorocarbon/hydrocarbon amphiphiles.

Biphasic fluorocarbon/hydrocarbon amphiphiles tethered to cores at distances commensurate with their packing requirement can provide thermodynamic pathways toward equilibrium. This contrasts with the analogous semifluorinated alkanes. The dynamics of a fluorous biphasic hexa(3,5-substituted-phenyl)benzene (HPB) is studied with dielectric spectroscopy as a function of temperature and pressure in comparison to the parent biphasic diphenylacetylene (DPA). Dielectric spectroscopy is a sensitive probe of the fluorocarbon environment through the end C-F dipole. Four dielectrically active processes were observed that associate with the CF(3) environment within the different phases (isotropic, liquid-like lamellar, solid lamellar, glassy state). Pressure facilitates the construction of the equilibrium phase diagram. The kinetic pathways to fluorocarbon organization are explored by pressure-jump experiments. A highly cooperative process was found that is atypical of a nucleation and growth process expected for first-order transitions.

Spontaneous cerebral embolisation in asymptomatic and recently symptomatic patients with TIA/Minor stroke.

OBJECTIVES: Spontaneous embolisation (SE) detected using Transcranial Doppler (TCD) after a Transient Ischaemic Attack (TIA)/Minor stroke is an independent predictor of recurrent stroke. There are, however limited data on the differential prevalence of SE in the first few days/weeks after onset of symptoms. METHOD: 156 consecutive patients (symptomatic n = 123, asymptomatic n = 33) underwent Carotid Endarterectomy (CEA) during an 18 month period and had an accessible window permitting 30 min of pre-operative TCD monitoring. A prospective study was conducted with assessors blinded to clinical status. RESULTS: Spontaneous embolisation was detected in 31 symptomatic patients (25%) of which 1/1 (100%), 14/35 (40%), 8/37 (22%) and in 8/50 (16%) patients presented within 48 h, 3-7 days, 8-14 days and >14 days respectively from the index clinical event. SE occurred in only 6% of asymptomatic patients. Out of 31 symptomatic patients with SE, seven (22.6%) suffered recurrent cerebrovascular events following admission as opposed to 11/92 patients (11.9%) who had no evidence of spontaneous embolisation after admission (OR 2.2 (95% CI 0.8-6.1))(P = 0.2) CONCLUSION: Patients presenting for CEA in the hyperacute period after onset of TIA/Minor stroke have a high incidence of SE. Patients with SE had a 23% risk of recurrent cerebrovascular events. These data support the current drive towards expedited CEA in recently symptomatic patients.