Parietal Peritoneal Flap for Post-radiation Bladder Injury Repair.

Inadvertent bladder injuries during pelvic surgery are not uncommon. Repair of these cystotomies are generally easy. However, post-radiation, the urinary bladder becomes contracted, friable and difficult to heal. Injuries in this setting present a treatment dilemma especially when there is absence of viable native tissue such as omentum for tissue buttress. The authors report a case of parietal peritoneal flap for post-radiation bladder injury repair based on twigs from the inferior epigastric vessels. This flap being easy to perform is believed to be a viable alternative to musculocutaneous flaps especially in the emergency setting.

Management of extensive maxillofacial injury related to a Tyre Blast: A rare case report.

BACKGROUND: Severe blast injuries of large tyres are similar to those resulting from explosions with neither thermal nor chemical effects. The literature related to the destructive nature of these blasts is very sparse. This case aims to report the clinical management of a patient involved in large tyre blasts who presented with a severe soft tissue injury, comminuted mandible and associated multiple facial fractures due to a tyre blast injury. RESULTS: Excellent results were obtained following reduction and fixation of fractures with primary suturing, as these types of injuries are prone to infection secondarily. CONCLUSION: Due to the etiology and severity of injury, these injuries are challenging to operate and are more prone to infection following surgery. These require careful management skills.

In-Silico Skin Model: A Multiscale Simulation Study of Drug Transport.

Accurate in-silico models are required to predict the release of drug molecules through skin in order to supplement the in-vivo experiments for faster development/testing of drugs. The upper most layer of the skin, stratum corneum (SC), offers the main resistance for permeation of actives. Most of the SC's molecular level models comprise cholesterol and phospholipids only, which is far from reality. In this study we have implemented a multiscale modeling framework to obtain the release profile of three drugs, namely, caffeine, fentanyl, and naphthol, through skin SC. We report for the first time diffusion of drugs through a realistic skin molecular model comprised of ceramides, cholesterol, and free fatty acid. The diffusion coefficients of drugs in the SC lipid matrix were determined from multiple constrained molecular dynamics simulations. The calculated diffusion coefficients were then used in the macroscopic models to predict the release profiles of drugs through the SC. The obtained release profiles were in good agreement with available experimental data. The partition coefficient exhibits a greater effect on the release profiles. The reported multiscale modeling framework would provide insight into the delivery mechanisms of the drugs through the skin and shall act as a guiding tool in performing targeted experiments to come up with a suitable delivery system.

Molecular Dynamics Simulation Study of Permeation of Molecules through Skin Lipid Bilayer.

Stratum Corneum (SC), the outermost layer of skin, is mainly responsible for skin's barrier function. The complex lipid matrix of SC determines these barrier properties. In this study, the lipid matrix is modeled as an equimolar mixture of ceramide (CER), cholesterol (CHOL), and free fatty acid (FFA). The permeation of water, oxygen, ethanol, acetic acid, urea, butanol, benzene, dimethyl sulfoxide (DMSO), toluene, phenol, styrene, and ethylbenzene across this layer is studied using a constrained MD simulations technique. Several long constrained simulations are performed at a skin temperature of 310 K under NPT conditions. The free energy profiles and diffusion coefficients along the bilayer normal have been calculated for each molecule. Permeability coefficients are also calculated and compared with experimental data. The main resistance for the permeation of hydrophilic and hydrophobic permeants has been found to be in the interior of the lipid bilayer and near the lipid-water interface, respectively. The obtained permeability is found to be a few orders of magnitude higher than experimental values for hydrophilic molecules while for hydrophobic molecules more discrepancy was observed. Overall, the qualitative ranking is consistent with the experiments.

The normative authority of the World Health Organization.

The World Health Organization (WHO) was born after the devastation of World War II, as a normative agency endowed with unprecedented constitutional powers. But even as it has achieved stunning successes, such as the eradication of smallpox, it has failed to live up to the exalted expectations of the postwar health and human rights movement - exemplified most recently by its inadequate response to the Ebola epidemic. Our aim is to offer innovative ideas for restoring the Organization to its leadership position by exercising its normative authority, even as it faces a crowded and often chaotic global health architecture. Before doing so, it will be helpful to summarize the main tensions the Organization faces in today's global health landscape.

Geochemical characterization of oceanic basalts using Artificial Neural Network.

The geochemical discriminate diagrams help to distinguish the volcanics recovered from different tectonic settings but these diagrams tend to group the ocean floor basalts (OFB) under one class i.e., as mid-oceanic ridge basalts (MORB). Hence, a method is specifically needed to identify the OFB as normal (N-MORB), enriched (E-MORB) and ocean island basalts (OIB). We have applied Artificial Neural Network (ANN) technique as a supervised Learning Vector Quantisation (LVQ) to identify the inherent geochemical signatures present in the Central Indian Ocean Basin (CIOB) basalts. A range of N-MORB, E-MORB and OIB dataset was used for training and testing of the network. Although the identification of the characters as N-MORB, E-MORB and OIB is completely dependent upon the training data set for the LVQ, but to a significant extent this method is found to be successful in identifying the characters within the CIOB basalts. The study helped to geochemically delineate the CIOB basalts as N-MORB with perceptible imprints of E-MORB and OIB characteristics in the form of moderately enriched rare earth and incompatible elements. Apart from the fact that the magmatic processes are difficult to be deciphered, the architecture performs satisfactorily.

Search for new pharmacophores for antimalarial activity. Part I: synthesis and antimalarial activity of new 2-methyl-6-ureido-4-quinolinamides.

A total of 80 new 2-methyl-6-ureido-4-quinolinamides were synthesized and evaluated for their antimalarial activity. Several analogs elicited the antimalarial effect at MIC of 0.25 mg/mL against the chlooquine-sensitive P. falciparum strain. The IC(50) values of the active compounds were observed to be in ng/mL range and two of the analogs have better IC(50) value than the standard chloroquine. In the in vivo assay against mdr CQ resistant P. yoelii N67/P. yoelii nigeriensis, however, none of the compound showed complete suppression of parasitemia on day 7. One of the compounds displayed significant antibacterial effect against several strains of bacteria and was many-fold better than the standard drug gentamicin.

Cerebral perfusion CT: technique and clinical applications.

Perfusion computed tomography (PCT) is an imaging technique that allows rapid, noninvasive, quantitative evaluation of cerebral perfusion by generating maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). The concepts behind this imaging technique were developed in the 1980s', but its widespread clinical use was allowed by the recent introduction of rapid, large-coverage multidetector-row CT scanners. Key clinical applications for PCT include the diagnosis of cerebral ischemia and infarction, and evaluation of vasospasm after subarachnoid hemorrhage. PCT measurements of cerebrovascular reserve after acetazolamide challenges in patients with vascular stenoses permit evaluation of candidacy for bypass surgery and endovascular treatment. PCT has also been used to assess cerebral perfusion after head trauma and microvascular permeability in the setting of intracranial neoplasm. Some controversy exists regarding this technique, including questions regarding correct selection of an arterial input vessel, the accuracy of quantitative results, and the reproducibility of results. This article provides an overview of PCT, including details of technique, major clinical applications, and limitations.

An information theoretic approach for combining neural network process models.

Typically neural network modelers in chemical engineering focus on identifying and using a single, hopefully optimal, neural network model. Using a single optimal model implicitly assumes that one neural network model can extract all the information available in a given data set and that the other candidate models are redundant. In general, there is no assurance that any individual model has extracted all relevant information from the data set. Recently, Wolpert (Neural Networks, 5(2), 241 (1992)) proposed the idea of stacked generalization to combine multiple models. Sridhar, Seagrave and Barlett (AIChE J., 42, 2529 (1996)) implemented the stacked generalization for neural network models by integrating multiple neural networks into an architecture known as stacked neural networks (SNNs). SNNs consist of a combination of the candidate neural networks and were shown to provide improved modeling of chemical processes. However, in Sridhar's work SNNs were limited to using a linear combination of artificial neural networks. While a linear combination is simple and easy to use, it can utilize only those model outputs that have a high linear correlation to the output. Models that are useful in a nonlinear sense are wasted if a linear combination is used. In this work we propose an information theoretic stacking (ITS) algorithm for combining neural network models. The ITS algorithm identifies and combines useful models regardless of the nature of their relationship to the actual output. The power of the ITS algorithm is demonstrated through three examples including application to a dynamic process modeling problem. The results obtained demonstrate that the SNNs developed using the ITS algorithm can achieve highly improved performance as compared to selecting and using a single hopefully optimal network or using SNNs based on a linear combination of neural networks.