Prevalence of intellectual disability among adults born in the 1980s and 1990s in the United States.

BACKGROUND: Prevalence of intellectual disability (ID) is currently estimated through parent report on surveys of children. It is difficult to estimate the number of adults living with ID in the United States because no comprehensive survey or surveillance allows for identification. The purpose of this study was to estimate the prevalence and number of adults with ID born between 1980 and 1999 using multiple years of the National Health Interview Survey (NHIS) and Census data. METHODS: We concatenated the NHIS from 1997-2016 that evaluated parental response about whether a child aged 3-17 years had an ID. Using weighted survey analyses, we estimated the prevalence of ID among individuals across four birth cohorts-(1) 1980-1984, (2) 1985-1989, (3) 1990-1994, and (4) 1995-1999. The number of adults with ID was then extrapolated by applying these prevalence rates to Census population estimates (as of 1 July 2021) of respective birth cohorts. RESULTS: Weighted prevalence of ID varied by birth cohort, sex, race and ethnicity, and US Census Bureau regions. The overall prevalence rate was 1.066 [95% confidence interval (CI): 0.831-1.302] for adults born between 1980 and 1984, 0.772 (CI: 0.654-0.891) for adults born between 1985 and 1989, 0.774 (0.675-0.874) for adults born between 1990 and 1994, and 1.069 (CI: 0.898-1.240) for adults born between 1995 and 1999. Overall, we estimate that 818 564 adults with ID who were approximately 21-41 years were living in the United States as of 2021. CONCLUSIONS: This study provides researchers examining adult health outcomes with an estimated denominator of young and middle-aged adults living with ID in the United States. Policymakers can use this information to support justification for resource and service needs, and clinicians may benefit from understanding that ID is a lifelong developmental condition often with additional physical, emotional and developmental needs requiring tailored care.

Adding to her woes: child bride's higher risk of hypertension at young adulthood.

BACKGROUND: Child marriage is associated with various adverse socio-economic and pregnancy outcomes. However, there remains a dearth of research on the long-term health implications of child marriage. As such, this study sought to expand upon the growing literature on child marriage, specifically examining the associations between child marriage and hypertension during young adult age. METHODS: We obtained data of 5369 women aged 20-34 from the Tajikistan Demographic and Health Survey 2017. Using multivariable logistic regression framework, we estimated the adjusted odds in favor of being hypertensive for women who were married before the age of 18. We also explored the presence of several stressors to understand the role of probable medication factors. RESULTS: We found that the odds of being hypertensive for young adult women married before the age of 18 were 1.6 (95% confidence interval: 1.1-2.4) times that of those who were not. Likelihood of having stressors, such as pregnancy loss or child death, marital control and spousal violence, was found higher among child brides compared to their peers. CONCLUSIONS: Findings suggest that child marriage may increase the risk of hypertension among young adult women. This work reinforces recommendations by the United Nations to the end child marriage.

Tetraphenylethene-Based Fluorescent Chemosensor with Mechanochromic and Aggregation-Induced Emission (AIE) Properties for the Selective and Sensitive Detection of Hg2+ and Ag+ Ions in Aqueous Media: Application to Environmental Analysis.

It is critical to design a novel and simple bifunctional sensor for the selective and sensitive detection of ions in an aqueous media in environmental samples. As a result, in this study, tetraphenylethene hydrazinecarbothioamide (TPE-PVA), known as probe 1, was successfully synthesized and characterized as having impressive photophysical phenomena such as aggregation-induced emission (AIE) and mechanochromic properties by applying mechanical force to the solid of probe 1. The emission of the solid of probe 1 changed from turquoise blue to lemon yellow after grinding, from lemon yellow to parakeet green after annealing at 160 °C, and to arctic blue after fuming with DCM. Such characteristics could lead to a variety of applications in several fields. The probe was implemented and demonstrated remarkable selectivity and sensitivity toward mercury(II) and silver(I) ions by substantially switching off emission over other cations. Following an extensive photophysical analysis, it was discovered that detection limits (LOD) as low as 0.18344 and 0.2384 µg mL-1 for Hg2+ and Ag+, respectively, are possible with a quantum yield (Φ) of 2.26. Probe 1 was also explored as a Hg2+ and Ag+ paper strip-based sensor and kit for practical use. The binding mechanisms of probe 1 (TPE-PVA) with Hg2+ and Ag+ were confirmed by 1H NMR titration. These results could lead to the development of reliable onsite Hg2+ and Ag+ fluorescent probes in the future.

Sawmill waste derived carbon dots as a fluorescent probe for synthetic dyes in soft drinks.

Herein, for the first time the carbon dots (CDs) were synthesized by reflux method from sawmill waste material. We also represent a novel strategy based on fluorescent CDs for determination of ponceau 4R and allura red dyes in soft drinks. Interestingly, both the dyes were sensitive and showed effective fluorescence quenching of the CDs owing to the interaction between them. The analytical applicability of CDs were evaluated for detection of both the dyes with a good linear relationship between the concentration range of 0.0 to 3.0 µg mL-1 and having detection limit 0.45 and 0.47 µg mL-1 for allura red and ponceau 4R dyes respectively. Meanwhile, the potential application of this novel fluorescent probe for dyes determination in real samples was validated in different soft drink samples with good accuracy and precision. Thus, these findings provides new insights for the potential risk assessment of both the dyes. Moreover, CDs acted as an excellent fluorescent material in cellular imaging owing to their cellular uptake and localization.

Carbon Nanodots Derived from Kitchen Waste Biomass as a Growth Accelerator for Fenugreek Plant.

Herein, we report the utilization of kitchen waste biomass as a source of carbonaceous material for carbon nanodots synthesis and its application as a plant growth regulator in agricultural crops. The water soluble carbon dots (CDs) were synthesized by pyrolysis of kitchen derived waste tea residue (WTR) and used in the field of agriculture nanotechnology. Herein, we have explored the effect of different concentrations of WTR-CDs (10, 30 and 50 mg/L) on growth of FG with respect to various plant growth parameters. It was observed that the WTR-CDs has positive effect on all plant growth parameters investigated and also assist for micronutrient uptake which is confirmed by AAS and zeta potential measurement. UV light, Fluorescence spectroscopy, and confocal fluorescence microscopy examination were employed for the understanding of uptake and transport route of WTR-CDs in FG plant through absorption of WTR-CDs by root as well as seed coat along with water. Therefore, the growth of FG was a significant increase in quality of the plant which appears to be effective and no serious side effects were seen during the study.

Spousal alcohol consumption and female hypertension status: evidence from Nepal.

OBJECTIVE: Psychosocial factors, such as environmental stressors, can increase the risk of hypertension. This study examines the role of the household environment in hypertension outcomes by assessing the link between female hypertension status and spousal alcohol consumption in Nepal. STUDY DESIGN: This is a cross-sectional study. METHODS: We used the 2016 Nepal Demographic and Health Survey to assess differences in hypertension outcomes in women aged 15 to 49 years whose husbands drink alcohol and in those whose husbands do not. We estimated a multinomial logistic model to obtain adjusted differences in the likelihood of being hypertensive between the two groups. We also examined several socio-economic conditions across the two groups to discuss various aspects of the association. RESULTS: After controlling for anthropometric and various sociodemographic attributes, we find that women whose husbands drink alcohol were 2.5 percentage points (95% confidence interval [CI]: -0.31, 5.31) more likely to be hypertensive than women whose husbands do not. They were also more likely to experience food insecurity, to experience spousal violence, and to consume tobacco products. Among women whose husbands became intoxicated ('got drunk') very often, the likelihood of being hypertensive was 4.0 percentage points (95% CI: -0.26, 7.67) higher than among women whose husbands do not drink alcohol. CONCLUSION: Women whose husbands consume alcohol have an elevated risk of being hypertensive, illustrating the association between hypertension and the household environment. The findings document the added hypertension burden in socially vulnerable population groups and can inform initiatives to reduce alcohol consumption in Nepal.

Nitrogen-doped carbon dot threads as a "turn-off" fluorescent probe for permanganate ions and its hydrogel hybrid as a naked eye sensor for gold(III) ions.

Highly fluorescent nitrogen-doped carbon dot (NCD) threads were synthesized via simple pyrolysis of citric acid, p-hydroxybenzoic acid, and ammonia. The NCDs show excitation-independent behavior with maximum excitation and emission wavelengths of 350 nm and 435 nm, respectively. The developed probe was used as a turn-off fluorescent sensor for the selective and sensitive determination of permanganate ions in aqueous media. The probe's hydrogel hybrid displayed a beautiful purple color demonstrating its potential as a naked eye sensor for gold detection. The ratiometric sensor exhibited excellent selectivity towards permanganate ions over 27 other ions with a linear range of 510 nM to 2 µM, a detection limit of 170 nM, and a linear regression value (R2) of 0.9944. Similarly, the linear range and limit of detection for gold ions was 3.89-20 µM and 1.285 µM, respectively. The synthesized NCDs were also used as a fluorescent ink as well as a naked eye marker in association with a gold solution demonstrating its potential forensic and anti-counterfeiting applications. Graphical abstract.

Bullet in tracheobronchial tree without lung contusion removed by fibreoptic bronchoscopy in two parts.

A person presented with multiple gunshot injury. Chest x-ray & CT whole body trauma protocol was done which showed multiples pellets of bullet in abdomen and one bullet in elbow according to entry wound. There was an entry wound without any bullet in left maxillofacial region however there was no exit wound. A bullet was noticed in tracheobronchial tree. There was no pneumothorax any signs of chest trauma or any pneumomediastinum. It is assumed that the bullet first hit the left cheek (maxilla) and lost its momentum. As the patient lost consciousness and had a fall leading to inhalation (aspiration) of bullet in the airway. As per ballistic experts it was basically a jacketed metallic bullet. As bullet moved in airway, the outer metallic core reached the trachea near carina and the soft metallic core slipped more distally to right main bronchus and bronchus intermedius. While inspection the outer metallic capsule was seen in trachea just above carina which was hollow and was gently removed with the help of foreign body forceps. The core was removed with dormia basket without any mucosal tear. The favorable outcome can be attributed as patient had no lung contusion or chest trauma and bullet was inhaled which was not very old. The evolution of bronchoscopy started with rigid one but the fibreoptic bronchoscopy (FOB) has revolutionized the pulmonary interventions. The FOB can be used with minimal traumas under local anesthesia resulting in markedly reduced morbidity and mortality.

The clinical utility of cycle of threshold value of GeneXpert MTB/RIF (CBNAAT) and its diagnostic accuracy in pulmonary and extra-pulmonary samples at a tertiary care center in India.

BACKGROUND: There are knowledge gaps in the in-depth analysis of the most promising and robust diagnostic tool, GeneXpert MTB/RIF (CBNAAT). The cycle of threshold (CT) value of the CBNAAT test and its clinical implications has not been explored much. AIMS AND OBJECTIVES: The study aimed at (a) estimating the diagnostic accuracy and incremental yield of Xpert MTB/RIF in various specimens (b) establishing the association between CT value category (high, medium, low, very low) and culture time-to-positivity (TTP). METHODS: A total of 1000 samples, both pulmonary and extra-pulmonary were collected from presumptive TB cases in a large tertiary care hospital. Sensitivity and specificity of CBNAAT was calculated with culture as the gold standard. The association of CT value with culture TTP was also studied. RESULTS: The overall sensitivity of CBNAAT was 88.5%, with bronchial washing specimen being the most sensitive (92.3%) and pleural fluid being the least (66.7%). In smear negative individuals, the sensitivity of CBNAAT was 80.9%. The additional yield of CBNAAT over smear microscopy was 10.9%. It was observed that as we move from high to very low CT category, culture positivity decreases significantly (p<0.001), whereas time taken for culture growth increases (p<0.001). CONCLUSION: CBNAAT is a robust test for accurate diagnosis of tuberculosis both pulmonary and extra-pulmonary, smear negative as well, especially in resource-limited settings. The correlation between CT value and culture TTP has potential in predicting bacillary load, though further studies are required.

Histopathological evaluation of surgically treated adult renal tumors: Report from a tertiary care center in India.

BACKGROUND: This retrospective study was performed in a tertiary care center from India analyzing the histopathological reports and the clinical data of the adult patients admitted in this institute with a diagnosis of renal tumors and had undergone nephrectomy for the disease. OBJECTIVE: The objective of this study is to determine the relative frequencies of different renal tumors in adults (above the age of 16 years) and to analyze the histopathological characters of the tumors. MATERIALS AND METHODS: In this retrospective study, we have analyzed the histopathology reports along with the demographic and clinical data of the adult patients who had undergone nephrectomy for renal tumors in our institute from January 2005 to December 2011. RESULTS: A total 113 adult patients underwent tumor nephrectomy during the last 7 years in our institute. Mean age of the patients was 54.5 years (range 16-69 years). Male:Female ratio was 1.9:1. Out of 131 cases of adult renal tumors, 91.6% cases were malignant and 8.45 cases were benign tumors. Among the malignant tumors, renal cell carcinoma was the most common type. There were 2 cases of renal primitive neuroectodermal tumors and one case of renal myofibroblastoma in our series. CONCLUSION: The spectrum of adult renal tumors in this series is consistent with the other series of cases reported by different authors. Only few cases of the renal tumors were diagnosed incidentally among our patients which is just opposite to the rate of renal tumors diagnosed incidentally in the developed countries. Myofibroblastoma, a benign kidney tumor diagnosed in our series is probably the first reported case in the world.

Vegetation types, dominant compositions, woody plant diversity and stand structure in Trishna Wildlife Sanctuary of Northeast India.

Present study was carried out to assess the vegetation types, diversity and phytosociological status of woody plants in Trishna Wildlife Sanctuary of Tripura, Northeast India. Vegetation data was derived by 25 line transects (10 m wide and 500 m length, each 0.5 ha size). All woody species at >10 cm gbh (Girth at Breast Height) within each plots were measured and counted. A total of six forest types were classified by cluster analysis using Importance Value Index (IVI) of 289 woody species. Species diversity, forest structure and woody community associations were evaluated and discussed. One way ANOVA revealed significant differences in all species diversity measures and stand structure along the forest types. Distribution of stem density at ten different gbh classes showed reverse J-shaped curves. Population status of woody plants was also examined through grouping of all individuals into four population age stages viz. sapling (<30 cm gbh), adult (> or = 30 - <120 cm gbh), mature (>120 - 210 cm gbh) and old (> or =210 cm). To observe dominant composition and species population trend, IVI of top ten dominant species from all forest types were tabulated. The present study suggested that Trishna Wildlife Sanctuary is an important habitat in Tripura from floristic point of view and it should be conserved on priority basis for remaining wildlife endurances and monitor for forest livelihoods products for sustainable biodiversity conservation in this region.

Assessment of the significance of respiratory culture of Aspergillus in the non-neutropenic patient. A critique of published diagnostic criteria.

Assessment of the significance of isolation of Aspergillus sp. from respiratory culture in patients who are not neutropenic is a continuing problem in respiratory medicine. In recent years a number of criteria for defining patients with invasive or chronic pulmonary aspergillosis in this group have been proposed. This study sought to assess the value of three sets of these criteria in distinguishing between colonisation and aspergillosis requiring therapy when applied retrospectively to 121 patients with positive sputum or BAL culture for Aspergillus sp. Two patients (1.6%) were identified as having proven or probable aspergillosis by the EORTC criteria, two different patients fulfilled the criteria for invasive aspergillosis in the 62 patients with chronic obstructive pulmonary disease (3.2%), and yet another two different patients met the criteria for chronic pulmonary aspergillosis (1.6%). It is suggested that difficulties in the application of some of these criteria may prevent the accurate diagnosis of aspergillosis in the non-neutropenic patient setting.

Effect of vitamin E supplementation on arsenic induced oxidative stress in goats.

The present study was designed to assess whether supplementation of different levels of vitamin E to long-term arsenic exposed goats affords protection against the oxidative stress caused by the metalloid. Twenty-four crossbred lactating goats were distributed randomly into four groups (control, T(1), T(2) and T(3)) of six in each. The animals in T(1), T(2) and T(3) were given 50 mg/kg DM arsenic daily, while in T(2) and T(3), vitamin E @100 IU and 150 IU/kg DM, respectively, was also supplemented additionally for the period of 12 months. Compared to control, significant (p < 0.05) decline in SOD (45 %), CAT activities of erythrocytes (63 %), plasma total Ig (22 %) and total antioxidant activity (24 %) was observed in only arsenic treated groups and vitamin E supplementation in both doses produced partial mitigation effect against SOD (23 %, 20 %) and CAT (39 %, 48 %) while complete mitigation against total Ig (16 %, 7 %) and antioxidant activity (10 %, 8 %) was found. Average lymphocyte stimulation index at the end of experiment was (p < 0.05) lower in arsenic exposed groups (1.003 ± 0.01) and significant (p < 0.05) recovery was observed in response of vitamin E supplementation at higher doses (1.138 ± 0.03). So, vitamin E is helpful in reducing the burden of arsenic induced oxidative stress and activities of antioxidant enzymes in goats.

Hyperventilation and hypophosphataemia.

We describe a case where extensive investigations were utilized to identify the aetiology of hypophosphataemia in a patient presenting with non-specific symptoms. The diagnosis of hyperventilation-induced hypophosphataemia was eventually established. Hyperventilation is a relatively common cause of isolated hypophosphataemia, but is easily overlooked as a cause.

Estudio de la actividad antibacteriana y la toxicidad en gambas en salmuera de dos especies de Polygonum / Assessment of anti-bacterial activity and brine shrimp toxicity of two Polygonum species

Se estudi¨® la actividad antibacteriana de las partes a¨¦reas de Polygonum barbatum var. barbata y Polygonum stagninum(Familia: Polygonaceae) frente a diversas cepas bacterianas mediante el ensayo de difusi¨®n en disco, as¨ª comola toxicidad en gambas en salmuera mediante el ensayo de letalidad de gambas en salmuera. Todos los extractos/fracciones, a excepci¨®n del extracto/fracci¨®n de MeOH, presentaron niveles de actividad antibacteriana de bajosa moderados frente a la mayor¨ªa de las cepas de la prueba (zona de inhibici¨®n = 7-21 mm). Todos los extractos yfracciones presentaron considerable toxicidad general hacia las gambas en salmuera. Los valores de LD50 de losextractos/fracciones de la prueba se encontraron en el rango de 2,19 a 114,81 ¦Ìg/mL, mientras que la del controlpositivo (sulfato de vincristina) fue de 0,61 ¦Ìg/mL

The extracts of the aerial parts of Polygonum barbatum var. barbata and Polygonum stagninum (Family: Polygonaceae)were assessed for anti-bacterial activity against a number of bacterial strains using the disc diffusion assay, andbrine shrimp toxicity using the brine shrimp lethality assay. All extracts/fractions, except the MeOH extract/fraction,exhibited low to moderate levels of anti-bacterial activity against most of the test strains (zone of inhibition = 7-21mm). All extracts and fractions displayed considerable general toxicity towards brine shrimps. The LD50 values of thetest extracts/fractions were within the range of 2.19 to 114.81 mg/mL, whereas that of the positive control (vincristinesulphate) was 0.61 mg/mL

Post caesarean vesicouterine fistulae-- Youssef syndrome: our experience and review of published work.

OBJECTIVE: To analyse the incidence, symptomatology, diagnosis and therapeutic aspects of Youssef syndrome (post caesarean vesicouterine fistula), and to review relevant published work. METHODS: A retrospective study from the urosurgical unit of a tertiary care referral hospital was carried out. In a retrospective analysis of urogenital fistulae over 10 years, we identified 14 patients with uterovesical fistulae, resulting from caesarean section. All the patients were evaluated by history, physical examination, radiological tests and cystoscopy. All patients underwent transperitoneal repair of these fistulae with omental interposition. Results of surgery were evaluated by absence of cyclic haematuria, stoppage of urinary incontinence, and achievement of fertility. RESULTS: A total of 12 patients who had minimum follow up was included in the present study. The results showed that 50% of the fistulae resulted from emergency caesarean operation with 58% of patients presenting after their second caesarean section. The mean age of the patients was 19 years (range 15-29) and mean duration of symptoms was 7 months (range 3-16). Menouria and amenorrhoea were predominant presenting symptoms. The results of surgical treatment were excellent with good continence and resolution of the cyclic haematuria. Three pregnancies (37.5%) which resulted in elective caesarean section were recorded. CONCLUSION: Vesicouterine fistulae, despite being infrequent, are no longer a rare diagnosis and are most commonly secondary to lower segment caesarean section. With patient history and selected investigations diagnosis is relatively easy. The surgical repair of these fistulae is standard treatment, especially with delayed fistulae with achievement of total continence, and complete resolution of cyclic haematuria. Meticulous practice of obstetric and surgical principles during caesarean section can prevent the formation of these fistulae.

Analgesic, antiinflammatory and CNS depressant activities of sesquiterpenes and a flavonoid glycoside from Polygonum viscosum.

Analgesic, antiinflammatory and CNS depressant activities of four sesquiterpenes, viscosumic acid, viscozulenic acid, viscoazucine and viscoazulone, and a flavonoid glycoside, quercetin-3-O-(6''-feruloyl)-beta-D-galactopyranoside isolated form the aerial parts of Polygonum viscosum (Polygonaceae) have been assessed. All test compounds exhibited CNS depressant activity in open field test, all but viscoazulone showed analgesic activity in Eddy's hot plate test, all sesquiterpenes inhibited acetic acid induced abdominal writhing in mice, and all but viscoazucine and the flavonoid glycoside exhibited mild to moderate antiinflammatory effect on carrageenan induced rat paw edema.

Renal transplant pathology: bahrain experience.

A ten-year retrospective study on renal transplant biopsies performed at the Salmaniya Medical Complex, Bahrain was performed. The histological changes were classified according to Banff 1997 working classification of renal allograft pathology. A semi quantitative scoring was also given as per the guidelines. Out of a total of 26 cases, 10 belonged to hyperacute and acute forms, while 11 could be categorized to chronic sclerosing allograft nephropathy. In the remaining five, the graft pathology was unrelated to the rejection process. Despite effective management, four cases underwent nephrectomy due to severe vascular rejection. An interesting feature was recorded in two cases in whom transmural arteritis followed chronic histological changes. Presence of tubular atrophy and interstitial matrix increase were considered useful parameters for assessing the severity in cases with chronic allograft nephropathy.