The Climate Change Burden on Immune Health: Are Persons Living with HIV More at Risk?

Climate change poses one of the most significant modern threats to overall human health,especially for vulnerable populations including persons living with HIV (PLWH). In this perspective, we specifically explore the concept of immune resilience in human health and how climate change phenomena - including extreme weather events, food insecurity, pollution, and emerging diseases - may exacerbate immune dysfunction and comorbidities faced by PLWH and hinder access to HIV treatment and prevention services. Multidisciplinary, collaborative efforts are urgently needed to quantify these impacts, develop mitigation strategies, and strengthen policies and funding to bolster immune resilience for PLWH in the face of accelerating climate change.

The role of CT brain findings in the early diagnosis of infantile encephalitic beriberi.

Background: Thiamine deficiency disease may occur in infants from thiamine-deficient mothers in developing countries, as well as in infants fed solely with soy-based formula. Thiamine deficiency in infants may present with acute neurological manifestations of infantile encephalitic beriberi.

Objective: To review the role of noncontrast CT brain findings in infantile encephalitic beriberi in early diagnosis.

Numerical predictions of shear stress and cyclic stretch in pulmonary hypertension due to left heart failure.

Isolated post-capillary pulmonary hypertension (Ipc-PH) occurs due to left heart failure, which contributes to 1 out of every 9 deaths in the United States. In some patients, through unknown mechanisms, Ipc-PH transitions to combined pre-/post-capillary PH (Cpc-PH) and is associated with a dramatic increase in mortality. Altered mechanical forces and subsequent biological signaling in the pulmonary vascular bed likely contribute to the transition from Ipc-PH to Cpc-PH.

A multiscale model of vascular function in chronic thromboembolic pulmonary hypertension.

Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by recurrent or unresolved pulmonary thromboemboli, leading to perfusion defects and increased arterial wave reflections. CTEPH treatment aims to reduce pulmonary arterial pressure and reestablish adequate lung perfusion, yet patients with distal lesions are inoperable by standard surgical intervention. Instead, these patients undergo balloon pulmonary angioplasty (BPA), a multisession, minimally invasive surgery that disrupts the thromboembolic material within the vessel lumen using a catheter balloon.

Infantile thiamine deficiency: Redefining the clinical patterns.

Objectives: Thiamine deficiency (TD) is frequently suspected and treated at our hospital. In our retrospective study, we aimed at finding the clinical and laboratory spectrum of infantile TD presenting to a single center over a period of time.

Methods: The diagnosis was made on criterion standard of response to thiamine challenge.

Thiamine deficiency disorders: a clinical perspective.

Thiamine is an essential water-soluble vitamin that plays an important role in energy metabolism. Thiamine deficiency presents many challenges to clinicians, in part due to the broad clinical spectrum, referred to as thiamine deficiency disorders (TDDs), affecting the metabolic, neurologic, cardiovascular, respiratory, gastrointestinal, and musculoskeletal systems. Concurrent illnesses and overlapping signs and symptoms with other disorders can further complicate this.

Structural and hemodynamic properties of murine pulmonary arterial networks under hypoxia-induced pulmonary hypertension.

Detection and monitoring of patients with pulmonary hypertension, defined as a mean blood pressure in the main pulmonary artery above 25 mmHg, requires a combination of imaging and hemodynamic measurements. This study demonstrates how to combine imaging data from microcomputed tomography images with hemodynamic pressure and flow waveforms from control and hypertensive mice. Specific attention is devoted to developing a tool that processes computed tomography images, generating subject-specific arterial networks in which one-dimensional fluid dynamics modeling is used to predict blood pressure and flow.

Influence of image segmentation on one-dimensional fluid dynamics predictions in the mouse pulmonary arteries.

Computational fluid dynamics (CFD) models are emerging tools for assisting in diagnostic assessment of cardiovascular disease. Recent advances in image segmentation have made subject-specific modelling of the cardiovascular system a feasible task, which is particularly important in the case of pulmonary hypertension, requiring a combination of invasive and non-invasive procedures for diagnosis. Uncertainty in image segmentation propagates to CFD model predictions, making the quantification of segmentation-induced uncertainty crucial for subject-specific models.

Sensitivity analysis and uncertainty quantification of 1-D models of pulmonary hemodynamics in mice under control and hypertensive conditions.

Pulmonary hypertension (PH), defined as an elevated mean blood pressure in the main pulmonary artery (MPA) at rest, is associated with vascular remodeling of both large and small arteries. PH has several sub-types that are all linked to high mortality rates. In this study, we use a one-dimensional (1-D) fluid dynamics model driven by in vivo measurements of MPA flow to understand how model parameters and network size influence MPA pressure predictions in the presence of PH.

Hemodynamic assessment of pulmonary hypertension in mice: a model-based analysis of the disease mechanism.

This study uses a one-dimensional fluid dynamics arterial network model to infer changes in hemodynamic quantities associated with pulmonary hypertension in mice. Data for this study include blood flow and pressure measurements from the main pulmonary artery for 7 control mice with normal pulmonary function and 5 mice with hypoxia-induced pulmonary hypertension. Arterial dimensions for a 21-vessel network are extracted from micro-CT images of lungs from a representative control and hypertensive mouse.

Characteristic impedance: frequency or time domain approach?

Objective: Characteristic impedance (Zc) is an important component in the theory of hemodynamics. It is a commonly used metric of proximal arterial stiffness and pulse wave velocity. Calculated using simultaneously measured dynamic pressure and flow data, estimates of characteristic impedance can be obtained using methods based on frequency or time domain analysis.

Epidemiology of bronchial asthma in school children (10-16 years) in Srinagar.

Objectives: To assess the epidemiological profile of asthma in school going children in Srinagar, Kashmir.

Study Design: Cross-sectional study.

Setting: Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools.

Heterogeneous mechanics of the mouse pulmonary arterial network.

Individualized modeling and simulation of blood flow mechanics find applications in both animal research and patient care. Individual animal or patient models for blood vessel mechanics are based on combining measured vascular geometry with a fluid structure model coupling formulations describing dynamics of the fluid and mechanics of the wall. For example, one-dimensional fluid flow modeling requires a constitutive law relating vessel cross-sectional deformation to pressure in the lumen.

Thiamine responsive acute life threatening metabolic acidosis in exclusively breast-fed infants.

Background: Acute life threatening metabolic acidosis in exclusively breast fed infants due to thiamine deficiency is not described. Kashmir valley, a north Indian state has a population that largely consumes polished rice.

Methods: A six months prospective descriptive study of infants who presented with acute life threatening metabolic acidosis (Blood pH ≤ 7.

Infantile encephalitic beriberi: magnetic resonance imaging findings.

Background: Thiamine deficiency in infants is still encountered in developing countries. It may present with acute neurological manifestations of infantile encephalitic beriberi.

Objective: To review brain MRI findings in infantile encephalitic beriberi from a single institution.

A computational study of pressure wave reflections in the pulmonary arteries.

Experiments using wave intensity analysis suggest that the pulmonary circulation in sheep and dogs is characterized by negative or open-end type wave reflections, that reduce the systolic pressure. Since the pulmonary physiology is similar in most mammals, including humans, we test and verify this hypothesis by using a subject specific one-dimensional model of the human pulmonary circulation and a conventional wave intensity analysis. Using the simulated pressure and velocity, we also analyse the performance of the P-U loop and sum of squares techniques for estimating the local pulse wave velocity in the pulmonary arteries, and then analyse the effects of these methods on linear wave separation in the main pulmonary artery.

Clinical Epidemiology of SIRS and Sepsis in Newly Admitted Children.

Objective: To assess the clinical and demographic profile of Systemic Inflammatory Response Syndrome (SIRS) and sepsis, among newly admitted children in different age groups in a hospital in North India.

Methods: This prospective study was conducted at a referral care centre in Northern India. All children, age group 0 to <18 y, admitted on days selected for study were screened and those with abnormal temperature and abnormal leukocyte count were included for further assessment.

Numerical simulation of blood flow and pressure drop in the pulmonary arterial and venous circulation.

A novel multiscale mathematical and computational model of the pulmonary circulation is presented and used to analyse both arterial and venous pressure and flow. This work is a major advance over previous studies by Olufsen et al. (Ann Biomed Eng 28:1281-1299, 2012) which only considered the arterial circulation.

Recurrent meningitis in an adult secondary to an inner ear malformation: imaging demonstration.

Congenital labyrinthine dysplasia with a translabyrinthine cerebrospinal fluid (CSF) fistula may be an anatomic cause for recurrent meningitis. This condition is usually seen in children aged 5 to 10 years who present with sensorineural hearing loss (SNHL) and CSF discharge through the nose or ear, with or without recurrent meningitis. Multidetector-row computed tomography (MDCT) and high-resolution T2-weighted magnetic resonance imaging (MRI) of the petrous portion of the temporal bone can help to diagnose this abnormality.

Subcutaneous emphysema due to bronchial foreign body demonstrated by multidetector-row computed tomography.

Foreign body aspiration is an important cause of emergency hospital admissions in young children less than 3 years of age. It may manifest with acute respiratory difficulty, choking and wheeze acutely or may be asymptomatic. Surgical emphysema is an unusual presentation of bronchial foreign body aspiration in young children.