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Surface mould brachytherapy is a conformal radiotherapy technique that can deliver high dose to the target while sparing nearby normal structures, Here, we aim to describe the procedurals details for high-dose rate (HDR) surface mould brachytherapy in sebaceous carcinoma of eyelid in a 54-year old lady. She was hesitant for surgery and any form of invasive intervention like interstitial brachytherapy. So, she was treated with surface mould HDR brachytherapy to a total dose of 52 Gy in 13 fractions at a dose of 4 Gy per fraction delivered twice daily using Iridium-192 isotope with no acute side effects. She was evaluated on a weekly basis for any radiation side effects and now she is disease-free for 6 months post-treatment with only mild dry eye. A detailed step-by-step procedure of surface mould technique, simulation procedure, dose prescription, planning, plan evaluation and treatment has been described in this paper. Surface mould HDR brachytherapy can be safely used as organ preserving modality of treatment for eyelid carcinoma. [ABSTRACT FROM AUTHOR]

The current work demonstrates the reversible control of substantial molecular motion in 'nano-sized' molecules, where two structural isomers can 'open' and 'close' their cavities in response to light or heat. The isomers differ widely in their photophysical properties, including colour, polarity, two-photon absorption and π-conjugation, and can easily be separated through column chromatography and thus have wide applicability. [ABSTRACT FROM AUTHOR]

Solid waste has surfaced as an eminent and critical concern of environmental and social significance on a global scale, and Ethiopia, a developing country with limited income, has also encountered unfavorable outcomes due to substandard waste management practices. When pinpointing a fitting landfill location in the town of Bule Hora, various ecological, economic, and societal aspects must be considered; these may result in discord and exacerbate a multifaceted and lengthy process. Hence, this research aims to identify prospective landfill sites within the town and utilize geospatial methods, such as Multi-Criteria Evaluation and Analytic Hierarchy Process, to accomplish its objectives. The utilization of geospatial technology and multi-criteria evaluation provides an efficient manner to simultaneously address all bottlenecks involved in the selection of an appropriate landfill location. Geospatial technology evaluates and manages environmental constraints, whereas multi-criteria assessment categorizes choices based on their desirability. Furthermore, by employing a restriction map adhering to established standards, seven landfill sites have successfully been identified within the town. The Land Suitability Index assesses site suitability based on ecological factors, while the Total Hauling Distance evaluates sites within an economic framework. AHP determines weightings through 25.4 pairwise comparisons, resulting in a consistency ratio of 1.95%. The cartographic analysis is conducted using ESRI ArcGIS version 10.8 software. The findings of this study reveal that 98.69% of the area under study is subject to restrictions. The study recommends the implementation of geospatial methods for identifying suitable landfill sites, which would aid in the decision-making process and prevent hasty decisions from triggering environmental degradation. Proper waste disposal would augment the quality of life for residents by diminishing health hazards. The study endeavors to serve as a reference for other developing countries in selecting appropriate landfill sites. Implications: The town of Bule Hora also faces the problem of waste disposal; there is no scientifically selected suitable landfill. Residents of the town of Bule Hora practice waste disposal in open fields, near settlements, water bodies, roads, agricultural land, and other places. The main sources of solid waste in the town are homes, shops, hotels, restaurants, open markets, hospitals, educational institutions, private clinics, etc. Water pollution can potentially lead to the spread of waterborne diseases. According to reports from the Bule Horas Health Department, many people are affected by water-related diseases every year. These open landfill systems with no regard for settlement, topography, geology, surface, or groundwater conditions are the consequences of these unsuitable habitats and health problems. To reduce these problems, this study plays an important role in determining the suitability of landfills for the town and proposing alternative measures that can minimize negative environmental impacts from waste. This study aims to apply geospatial-based technology to a multi-criteria assessment technique to select perfectly suitable landfill sites that are environmentally friendly, economically cost-effective, and socially responsible; examine the town's current waste management system; calculate the selected parameter weights for feature ranking; and delineate solid waste landfills. [ABSTRACT FROM AUTHOR]

The gastrointestinal tract is an environment that hosts various microorganisms, including pathogens. Generally, pathogenic bacteria enter the host body through food and the gastrointestinal tract. These pathogenic bacteria can colonize or infiltrate host cells and tissues, causing various infectious diseases. In recent years, the protective role of probiotic bacteria against gastrointestinal pathogens has been carefully investigated. Probiotics have been found to modulate intestinal microbial flora and play a significant role in the gastrointestinal tract's function, especially by inhibiting the growth of pathogenic bacteria. However, the mechanism of action of probiotics has yet to be sufficiently proven and recognized. Several important mechanisms support the antagonistic effects of probiotics on various microorganisms, which is achieved, for example, through the production of different antimicrobial compounds, such as bacteriocins, various organic acids, antibiotics, antimicrobial proteins, and exopolysaccharides; mucosal barriers with mucosa and bacteria binding blockers; competition for nutrient uptake; and strengthening of the immune system. Accordingly, this review summarizes the recent studies that have examined the mechanism of action of probiotic bacteria and their beneficial effects in preventing pathogenic bacterial growth and improving gastrointestinal functions. Comprehending their mechanisms of action allows the selection of appropriate probiotic strains for specific applications in gastrointestinal dysfunction. [ABSTRACT FROM AUTHOR]

Introduction Pediatric malignancy represents 5% of total cancer diagnosed in India. Due to delayed diagnosis and inaccessibility to healthcare system, the overall outcome is poor in our country. The clinicodemographic profile of childhood malignancy is well described in the Western world and in certain parts of India. The incidence of pediatric malignancy in Eastern India, especially Odisha, has not yet been reported that has motivated us to conduct such a study. Objective This study aims to evaluate the clinicodemographic profile and pattern of childhood malignancy among pediatric patients who received the treatment at a tertiary cancer institute of Odisha. Materials and Methods It was a retrospective observational study, carried out for a period of 8 years, from January 1, 2013 to December 31, 2020 at a tertiary cancer center in Eastern India. A total of 759 eligible childhood malignancy patients were recruited in the study. IBM SPSS v23 was used for descriptive statistical analysis, that is, number and percentage of various clinicodemographic parameters of the above patients. Result Childhood malignancy accounted for 1.6% of all cancers reported during the above study period. The male to female ratio was 1.8:1. Out of 759 eligible childhood cancer patients, majority of patients were suffering from leukemia (173; 22.8%) followed by malignant bone tumors (137; 18.0%), and lymphoma (122; 16%). Leukemia was predominant in the age group of 0 to 14 years; lymphoma, central nervous system neoplasms, germ cell tumors malignant bone tumors, and soft tissue sarcoma (STS) were common in the age group of 10 to 18 years; neuroblastoma, retinoblastoma, and renal and hepatic tumors were seen commonly in the age group of 0 to 9 years. The most common presentation in leukemia was fever, while lymphadenopathy was the chief complaint in lymphoma. Local swelling and pain were the presenting symptoms in malignant bone tumors, while STS patients had painless swelling. Conclusion This study provides an overview of the burden and pattern of childhood malignancy for the state of Odisha and acts as a roadmap for the clinicians to conduct further research in the field of pediatric oncology. [ABSTRACT FROM AUTHOR]

Here, by employing a Barrow entropy and the standard holographic method at a cosmic framework, we formulate Barrow agegraphic dark energy (BADE), taking the Universe age as an IR cutoff scale in a flat FLRW Universe. For evaluation of statefinder parameters in (r , s) and (r , q) planes, trajectories have been plotted for BADE and discovered that for various values of Δ , the model exhibits both the behavior of Chaplygin gas and quintessence. Moreover, as a supplement to the statefinder study, we looked at the BADE model without interaction in the plane (ω D , ω D ′) , which might offer us a dynamic study using the energy density BADE parameter Ω D 0 = 0. 7 0 and H 0 = 6 7 , as per VI- Λ CDM observational data without interaction from Planck 2018 results. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic impacted people's livelihoods worldwide to an unprecedented magnitude, the most affected being the socially and economically disadvantaged and marginalized communities, including the transgender people that constitute one of the most vulnerable sections that are often subjected to discriminated in various sectors such as education, health, housing, and livelihood opportunities. The present study attempts to offer insights into the impact of the pandemic on the livelihood of transgender people in India, given that the pandemic adversely affected their primary sources of livelihood, such as begging, sex-work, singing, and dancing, due mainly to the restrictive measures: lockdown, shutdown, social/physical distancing, etc., imposed by government authorities to curb the spread of the virus, in turn depriving them of their livelihood choices and rendering them even more vulnerable. This study draws from twelve transgender respondents in the city of Bhubaneswar, India recruited through the snowball method and uses thematic analysis of qualitative data obtained through telephonic interviews. The study finds that the pandemic-induced measures have negatively affected the lives and livelihood of transgender people during this time of crisis. Despite the government’s sustained efforts in providing temporary livelihood options and monetary supports during the crisis, the transgender people continued to remain marginalized. Approaches to making them self-sufficient over a longer term and empowering them financially would have been of more significant impact. [ABSTRACT FROM AUTHOR]

Primary testicular lymphoma (PTL) is a rare variant of non-Hodgkin's lymphoma that is predominant in old age group. Painless testicular swelling is the most common presentation. The standard of care is surgery in the form of radical orchiectomy followed by adjuvant chemotherapy and central nervous system prophylaxis. Because of blood-testis barrier, contralateral testis acts as a sanctuary site for chemotherapy to act and hence scrototesticular radiation is advocated in order to reduce the chance of testicular relapse. Due to lack of any consensus simulation procedure, we propose here a step-by-step procedure for simulation of a case of PTL using a case scenario. [ABSTRACT FROM AUTHOR]

Brain metastasis is seen in 10% to 20% of all adult cancer patients. One of the main modalities of treatment is stereotactic radiosurgery (SRS). Here, we describe the step by step procedure for stereotactic planning of brain metastasis by using a clinical scenario. The management of brain metastasis starts with the clinical evaluation of the patient followed by imaging and SRS treatment in the present case. The paper highlights the sequential process of radiation planning for SRS—starting from simulation, planning, evaluation of plan, and treatment. [ABSTRACT FROM AUTHOR]

Background: Glomus jugulare is a rare, slow-growing tumor that arise within the jugular foramen of the temporal bone. In the past, surgery was the primary modality of treatment for glomus Jugulare, but it leads to many complications and increased mortality. Radiotherapy was indicated in adjuvant setting in post-operative residual disease. But, with the advent of highly conformal radiation planning, stereotactic radiosurgery (SRS), is now one of the main modalities of radiation treatment in glomus jugulare. Objective: To describe the procedural steps for radiation planning of SRS of glomus jugulare. Methods: The step-by-step procedure for stereotactic planning of glomus jugulare has been described using a clinical scenario of glomus jugulare. Results: The stereotactic radiation planning of glomus jugulare starts with the basic history and relevant clinical evaluation, that is, visual testing. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain is the imaging modality of choice. The radiation planning of glomus jugulare starts with CT simulation. MRI of brain should be done in the prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of target, organs at risk (OAR) and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity and gradient index, and beam arrangement. After radiation plan evaluation, treatment is delivered after quality assurance and dry run. Conclusion: The paper highlights the sequential process of radiation planning for SRS in glomus jugulare—starting from simulation, planning, evaluation of plan, and treatment. [ABSTRACT FROM AUTHOR]

Synthesis of doped silicon carbide (SiC) thin film on silicon (111) wafer was carried out employing chemical vapour deposition (CVD) technique using boron-doped liquid polycarbosilane (LPCS) as polymer precursor under inert atmosphere of argon and nitrogen gas. The present study investigated the physical and optical properties of fabricated SiC thin films by varying doping concentrations. Subsequent analysis of bonds and phases by Fourier transform infrared (FTIR) spectroscopy, micro-Raman spectroscopy and X-ray diffraction (XRD) affirm the formation of Si–C, Si–N and unique silicon carbonitride (SiC–N). Stable photoluminescence has been observed across the entire visible spectra with enhanced quantum efficiency and lifetime, which ensures its application in opto-electronic devices such as LED. • Synthesis of doped SiC thin film using CVD. • Boron-doped liquid polycarbosilane as polymer precursor. • PL mechanism through doping and defect states. • Stable photoluminescence (PL) across the entire visible spectra. • Enhanced quantum efficiency and lifetime. [ABSTRACT FROM AUTHOR]

Nowadays, in a world full of uncertainties and the threat of digital and cyber-attacks, blockchain technology is one of the major critical developments playing a vital role in the creative professional world. Along with energy, finance, governance, etc., the healthcare sector is one of the most prominent areas where blockchain technology is being used. We all are aware that data constitute our wealth and our currency; vulnerability and security become even more significant and a vital point of concern for healthcare. Recent cyberattacks have raised the questions of planning, requirement, and implementation to develop more cyber-secure models. This paper is based on a blockchain that classifies network participants into clusters and preserves a single copy of the blockchain for every cluster. The paper introduces a novel blockchain mechanism for secure healthcare sector data management, which reduces the communicational and computational overhead costs compared to the existing bitcoin network and the lightweight blockchain architecture. The paper also discusses how the proposed design can be utilized to address the recognized threats. The experimental results show that, as the number of nodes rises, the suggested architecture speeds up ledger updates by 63% and reduces network traffic by 10 times. [ABSTRACT FROM AUTHOR]

We present a microscopic study of waterâ€"dimethyl sulfoxide (DMSO) binary mixtures using optical tweezers and thermal lens techniques. Binary mixtures of DMSO with water show anomalous behavior due to the specific hydrogen bonding ability of DMSO. We use a tightly focused femtosecond laser at a low average power to optically trap microspheres with diameters of 1 micron for use as probes. The binary mixture exhibits various viscosities, depending on its composition ratio, and hence different trapped particle characteristic frequencies (corner frequencies) due to Brownian motion. The power spectrum density method is used to obtain the corner frequency from forward-scattered data. Thus, using low-power optical tweezer experiments, we find that the maximum viscosity occurs at a DMSO mole fraction of 0.276. At higher powers, the propensity for trapping is highly diminished. It may be surprising to note that these viscosity values obtained from the corner frequencies do not exactly match those published in the literature. However, this deviation can be attributed to the thermal behavior of the binary mixture, which affects the Brownian motion and hence the obtained viscosity values. Studies at the microscopic level can thus provide a newer perspective on these already important binary mixtures. Intensity-dependent measurements further confirm the contribution of thermal effects in this study. [ABSTRACT FROM AUTHOR]

White light‐emitting diodes (LEDs) are the most promising alternative to the conventional lighting sources due to their high efficacy and energy saving in illumination. Silicon carbide (SiC) has a wide optical bandgap and could be tailored to emit light at different wavelengths across the entire visible spectrum by introducing different dopants. Donor and acceptor (DA) co‐doped fluorescent SiC (f‐SiC) is a potential candidate for replacing phosphor material in white LEDs, as it has been observed as a good wavelength converter overcoming the disadvantages of rare earth‐containing phosphors, such as poor color‐rendering index (CRI), short lifetime, and short degradation time. The current study attempts to present an overview on the available approaches to fabricate f‐SiC for generating the white light emission and challenges in fundamental research issues to enhance quantum efficiency, color rendering performance, stability, reproducibility of color quality, and lifetime of f‐SiC. [ABSTRACT FROM AUTHOR]

Background: A major parameter in the workflow of radiation treatment is the plan evaluation. In order to achieve high dose to target, minimum dose to the critical structures and accurate delivery of treatment, various qualitative and quantitative parameters need to be assessed during plan evaluation. Material and Methods: Here we propose an acronym COSID to describe the five major indices that need to be evaluated during a stereotactic treatment plan. Results: The stereotactic radiation plan evaluation include good target coverage, minimum dose to the organs at risk (OAR), homogeneity and conformity of dose to the target. As very high dose is being delivered in stereotactic radiotherapy in one or small number of fractions, certain other parameters such as the dose fall of beyond the target and the complexity of plan must to be addressed. The proposed COSID index is an acronym for these parameters such as Coverage Index, OAR Index, Spillage Index, Imaging Index and Delivery Index. Conclusion: The paper highlights the five important parameters that need to be assessed while evaluating a Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) plan. [ABSTRACT FROM AUTHOR]

Background: Surgical resection of brain metastasis is followed by adjuvant radiation in order to reduce the risk of local recurrence. Traditionally, adjuvant radiation was practiced in the form of whole brain radiation therapy that was associated with adverse neurocognitive outcomes and poor quality of life of the patients. In the recent times, stereotactic radiosurgery (SRS) is being practiced as the standard of care for treating brain metastasis cavity with good local control and improved the patient's quality of life by sparing the normal tissues of adverse effects of radiation. Here, we describe procedure details for stereotactic planning of surgically resected brain metastasis. Materials and Methods: The step-by-step procedure for stereotactic planning of brain metastasis cavity has been described using a clinical scenario of brain metastasis. Results: The stereotactic radiation planning of brain metastasis cavity starts with the basic history and relevant evaluation of symptoms. Magnetic resonance imaging (MRI) of the brain is the imaging modality of choice. The radiation planning of brain metastasis cavity starts with computed tomography (CT) simulation and MRI of brain that should be done in a prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of target, organs at risk (OAR), and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity and gradient index, and beam arrangement. After radiation plan evaluation, treatment is delivered after quality assurance and dry run. Conclusion: The paper highlights the sequential process of radiation planning for SRT of brain metastasis cavity, starting from simulation, planning, evaluation of plan, and treatment. [ABSTRACT FROM AUTHOR]

The increasing production and processing of image data, especially in remote sensing applications, has raised concerns regarding image security, privacy, and efficient retrieval as it is most widely used in sensitive applications. In this article, to address these challenges, a novel privacy-preserving content-based image retrieval (PPCBIR) system has been proposed that leverages a trusted edge computing layer that performs image encryption and feature extraction tasks, reducing the processing overload on user devices and bolstering system efficiency. Feature extraction harnesses the MobileNetV2 deep learning model, which enables the extraction of intricate visual features, enhancing image retrieval accuracy in the presence of high inter-class similarity in the dataset. Furthermore, the system has been deployed in a distributed storage environment, ensuring image availability even during server outages. The proposed system also incorporates trusted third-party auditing (TPA) as a means to verify the integrity of images during the storage and retrieval processes. The presence of TPA plays a crucial role in maintaining the reliability and trustworthiness of the stored images. The proposed system achieves a high mean Average Precision (mAP) of 0.889, surpassing existing PPCBIR systems. Overall, the system prioritizes image retrieval performance, privacy, availability, and integrity, making it suitable for processing remote sensing image data efficiently and securely. [ABSTRACT FROM AUTHOR]

Diabetic kidney disease (DKD) occurs in approximately 20–40% of patients with type 2 diabetes mellitus. Patients with DKD have a higher risk of cardiovascular and all-cause mortality. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antihyperglycemic drugs form the mainstay of DKD management and aim to restrict progression to more severe stages of DKD. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) control hyperglycemia by blocking renal glucose reabsorption in addition to preventing inflammation, thereby improving endothelial function and reducing oxidative stress; consequently, this class of prescription medicines is emerging as an important addition to the therapeutic armamentarium. The EMPA-REG OUTCOME, DECLARE TIMI 58, and CANVAS trials demonstrated the renoprotective effects of SGLT2i, such as restricting decline in glomerular filtration rate, in the progression of albuminuria, and in death due to renal causes. The renoprotection provided by SGLT2i was further confirmed in the CREDENCE study, which showed a 30% reduction in progression of chronic kidney disease, and in the DELIGHT study, which demonstrated a reduction in albuminuria with dapagliflozin compared with placebo (− 21.0%, confidence interval [CI] − 34.1 to − 5.2, p = 0.011). Furthermore, a meta-analysis demonstrated a reduced risk of dialysis, transplantation, or death due to kidney disease (relative risk 0.67; 95% CI 0.52–0.86; p = 0.0019) and a 45% risk reduction in worsening of renal function, end-stage renal disease, or renal death (hazard ratio 0.55, CI 0.48–0.64, p < 0.0001) with SGLT2i, irrespective of baseline estimated glomerular filtration rate. Thus, there is emerging evidence that SGLT2i may be used to curb the mortality and improve the quality of life in patients with DKD. However, clinicians need to effectively select candidates for SGLT2i therapy. In this consensus statement, we have qualitatively synthesized evidence demonstrating the renal effects of SGLT2i and proposed recommendations for optimal use of SGLT2i to effectively manage and delay progression of DKD. [ABSTRACT FROM AUTHOR]

The human pathogen Mycobacterium tuberculosis (Mtb) harbors a well-orchestrated Clp (caseinolytic protease) proteolytic machinery consisting of two oligomeric segments, a barrelshaped heterotetradecameric protease core comprising the ClpP1 and ClpP2 subunits, and hexameric ring-like ATP-dependent unfoldases composed of ClpX or ClpC1. The roles of the ClpP1P2 protease subunits are well-established in Mtb, but the potential roles of the associated unfoldases, such as ClpC1, remain elusive. Using a CRISPR interference–mediated gene silencing approach, here we demonstrate that clpC1 is indispensable for the extracellular growth of Mtb and for its survival in macrophages. The results from isobaric tags for relative and absolute quantitation–based quantitative proteomic experiments with clpC1- and clpP2-depleted Mtb cells suggested that the ClpC1P1P2 complex critically maintains the homeostasis of various growth-essential proteins in Mtb, several of which contain intrinsically disordered regions at their termini. We show that the Clp machinery regulates dosage-sensitive proteins such as the small heat shock protein Hsp20, which exists in a dodecameric conformation. Further, we observed that Hsp20 is poorly expressed in WT Mtb and that its expression is greatly induced upon depletion of clpC1 or clpP2. Remarkably, high Hsp20 protein levels were detected in the clpC1(2) or clpP2(2) knockdown strains but not in the parental bacteria, despite significant induction of hsp20 transcripts. In summary, the cellular levels of oligomeric proteins such as Hsp20 are maintained post-translationally through their recognition, disassembly, and degradation by ClpC1, which requires disordered ends in its protein substrates [ABSTRACT FROM AUTHOR]

Introduction: Short penile length is a commonly encountered problem in clinical practice. Detection of abnormal stretched penile length (SPL) warrants appropriate endocrine evaluation. Ethnicity-specific SPL data are required to detect these abnormalities. There is a dearth of such data in India. This study aims to establish normative values of SPL in boys from West Bengal. Materials and Methods: This is a cross-sectional study. SPL, testicular volume (TV), height/length, and weight were measured in 460 boys aged 1 to 13 years from the schools located at urban, suburban, and rural areas in the state of West Bengal, India. Similar data were collected from 36 healthy neonates within 1–3 days of full-term delivery at IPGME and R and SSKM Hospital, Kolkata, West Bengal, India. Results: The 5th percentile, median, and 95th percentile of SPL were 1.7, 2.0, and 2.7 cm for neonates; 3.5, 4.4, and 6.4 cm for the children aged 1 Y–2 Y 11 M; 4.0, 5.5, and 7.0 cm for the age group 3 Y–4 Y 11 M; 4.2, 6.0, and 7.2 cm for the age group 5 Y–6 Y 11 M; 4.3, 6.0, and 7.6 cm for the age group 7 Y–8 Y 11 M; 4.4, 6.5, and 9.0 cm for the age group 9 Y–10 Y 11 M; and 4.8, 7.0, and 11.0 cm for the age group 11 Y–12 Y 11 M, respectively. SPL showed significant positive correlation with TV [r = 0.365, P < 0.0005] and height of the children [r = 0.516, P < 0.0005], but not with BMI. Conclusion: Our study provides normative data of SPL in neonate and children aged 1 to 13 years from the eastern part of India. SPL value correlated positively with TV and height of children. [ABSTRACT FROM AUTHOR]

Introduction: Since the late 1980s, critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) have been increasingly recognized in the intensive care unit (ICU). We explored whether these causes of ICU weakness were now more likely to lead to electrodiagnostic studies (EDX) at our institution than they were 19-20 years earlier.Methods: We reviewed 100 consecutive ICU patients who underwent EDX from 2009 to 2015 and compared them to a previously reported study population from 1990-1995.Results: Thirty-seven (39%) had CIM, CIP, or both versus 55% in the previous study (P = 0.04). Thirty-four (36%) were diagnosed with "traditional" pre-ICU causes of weakness, such as motor neuron disease or Guillain-Barre syndrome, versus 29% in the earlier study (P = 0.3).Discussion: CIM and CIP continue to be common disorders that lead to ICU EDX, but their proportion declined compared with 19-20 years earlier, possibly due to the perceived role and selective use of EDX in the ICU. Muscle Nerve 57: 772-776, 2018. [ABSTRACT FROM AUTHOR]

For utilizing the outstanding energy absorbing capacity of highly elastic carbon nanotube (CNT), bulk multiwalled CNT (MWCNT) structure containing 15 wt% alumina (Al2O3) was fabricated using spark plasma sintering at 1600°C for 10 min under 50 MPa. The compacted mass was ~85% dense having morphologically stable MWCNTs. Microindentation studies up to 9.81 N indicated outstanding elastic recovery of the bulk structure leaving only a diffused indentation mark at indenter-specimen interaction zone. Quantitative estimation of elastic response behavior of the fabricated structure using instrumented nanoindentation in 10-300 mN load range indicated promising applicability of Al2O3/MWCNT compact structure as energy absorbing material. [ABSTRACT FROM AUTHOR]

The triad of blepharochalasis, double lip, and nontoxic thyroid enlargement characterizes Ascher syndrome. We describe the case of a 16-year-old female who presented with progressive laxity and swelling of the skin associated with recurrent progressive episodes of painless swelling of the eyelids with increase in the size of the upper lip and diffuse swelling over the neck. We discuss this case for rarity of its presentation in the Indian population. [ABSTRACT FROM AUTHOR]

[Display omitted] Limited stowage volume of launch vehicles demands compact packaging of large deployable membrane structures. Employment of different folding approaches led to the unavoidable fold-lines(creases). Moreover, wrinkle reduction is essential in such thin-film solar sail and inflatable antenna structures. This article analyzes the combined effect of multiple creases and wrinkles on deployed thin Kapton's surface accuracy. Authors have introduced a novel approach for employing membrane length shortening because of multiple creases and fold characteristics. Real-world logarithmic behaviour of crease relaxation and fold-region properties help in computing the crease curvature. A rhombus-shaped shell model with Z-folding is introduced and explored for the effect of the number of creases and their orientation. Stress concentration and wrinkle contours for applied edge tensile loading state that the fold lines affect the stress transfer path. Non-linear post-buckling analyses for the Kapton® membrane express higher wrinkle evolution in the central region over the loading edge. Besides, a discrepancy in wrinkle amplitude and wavelength reveals the effect of fold-line orientation on wrinkling. Sighting actual conditions for antenna structure, creasing profile normal to the loading direction was found preferable for maintaining reflector surface-effectiveness. Additionally, double creased membranes achieve maximum surface correctness for any angular position, as the mirror effect fold shapes reduce wrinkles the most. Results are validated by comparing with experimental outcomes. [ABSTRACT FROM AUTHOR]

Perylene (PYL) mixed with Behenic acid (BA) and Polymethyl methacrylate (PMMA) separately have been incorporated in the Langmuir-Blodgett film. The surface pressure versus area per molecule area isotherms are measured at various molar ratios. Stability of the mixed monolayer of PYL and BA/PMMA and their collapse pressure are much higher than that of pure PYL. Negligible amount of hysteresis observed in the compression-decompression isotherms indicate the formation of stable monolayer. Miscibility of the mixed systems is found to vary with the film composition. The formation of PYL aggregates in the mixed films is investigated using UV-Vis absorption spectroscopy, emission spectroscopy and atomic force microscopy (AFM). [ABSTRACT FROM AUTHOR]

Background: High dose oral prednisolone (100 mg/day) in Graves' orbitopathy (GO) is limited by lesser response, and greater side-effects compared to intravenous (iv) methylprednisolone. Low dose oral prednisolone has not been evaluated in GO. This study aimed to evaluate the safety and efficacy of low dose oral prednisolone in GO. Materials and Methods: A total of 114 consecutive GO patients were screened of which 65 patients with previously untreated moderate-severe GO, clinical activity score (CAS) >2, without co-morbid states were randomized into treatment Group-A (iv methylprednisolone 0.5 g for 3 days/month for 4 months) and Group-B (oral prednisolone 1 mg/kg/day for 6 weeks then tapered stopped), and followed-up. Thirty-one patients in each group with at least 1-year follow-up were analyzed. Responders were defined as improvement in ≥ 1 major response criteria or ≥ 2 minor response criteria. The trial is registered at ctri.nic.in (CTRI/2013/12/004264). Results: At 1-year, 27/31 (87.10%) patients were responders in Group-A compared to 17/31 (54.84%) in Group-B (P = 0.005). There was a greater improvement in CAS score in patients of Group-A as compared to Group-B (P < 0.001). Responders (n = 44) had significantly higher baseline intra-ocular pressures and left eye proptosis as compared to nonresponders. Cox-regression revealed baseline T4 levels, diplopia, and smoking history were predictive of remission. Low dose prednisolone was well tolerated, and the occurrence of adverse events were comparable in both groups. Conclusions: Low dose oral prednisolone is inferior to iv pulse methylprednisolone in managing GO, having a comparable side-effect profile. It can be a safe second line alternative in patients intolerant to pulse iv methylprednisolone. [ABSTRACT FROM AUTHOR]

It is important to devise new strategies to derive value from lignin, which is a potential waste by-product from paper industries and present day biorefineries. In this research, we report, for the first time, a facile preparation and characterization of a range of chitosan-alkali lignin composites for the removal of harmful effluents present in wastewater. The composites were characterized by the presence of weak bonding between β-1,4-glycosidic linkage, amide and hydroxyl groups of chitosan, and ether and hydroxyl groups of alkali lignin. Various reaction parameters like chitosan content in the composite, initial pH and adsorbent dosage were optimized. Batch adsorption studies showed that chitosan-alkali lignin (50:50) composite exhibited maximum percentage removal of anthraquinonic dye, Remazol Brilliant Blue R (RBBR), and Cr(VI) compared to other composites, chitosan and alkali lignin. Adsorption of RBBR on the composite followed Langmuir isotherm, and the adsorption of both RBBR and Cr(VI) followed pseudo second order kinetics. A mechanism of adsorption that involves (i) electrostatic interaction of protonated amino and hydroxyl groups of the composite with anionic SO3- and HCrO4- groups of dye and Cr(VI), respectively, and (ii) chemical interaction between amino and hydroxyl groups of the composite, and carbonyl moiety of the dye, was proposed. [ABSTRACT FROM AUTHOR]

The phase behavior of two components p-quaterphenyl (QP) and polymethyl methacry-late (PMMA)/heptadecanoic acid (HA)) in the Langmuir monolayer was characterized. The surface pressure versus area per molecule isotherms revealed that the area per molecule systematically changed with increasing mole fractions of QP, indicating that repulsive types of interactions were involved between the QP and the matrix molecules (PMMA/HA), leading to the phase separation which in turn stimulated the aggregate formation. Absorption spectroscopy, complemented with scanning electron microscopy (SEM), confirmed the aggregation of QP molecules in the mixed films. [ABSTRACT FROM AUTHOR]

Anti-malarial methylene blue (MB) doped in arachidic acid (AA) have been incorporated in the Langmuir monolayer at the air-water interface and also in the Langmuir-Blodgett films deposited on quartz substrate. The pressure-area (π-A) isotherm studies at different concentrations of MB pointed out that pure MB could not form stable monolayer at the air-water interface and collapse readily at very low surface pressures. However, mixture of MB with AA formed stable monolayers and they could be transferred into solid quartz substrate to form mono/multi layered films of MB. The area per molecule of floating mixed monolayers was systematically decreased with the increasing concentrations of MB in the mixture. The pressure-time (π - t) isotherm study indicated the interaction kinetics between MB and AA. Higher the concentration of MB, higher is the increase in pressure. The spectroscopic characteristics of the mixed LB films have been compared with that of pure MB solution, microcrystal and layer-by-layer self assembled film with UV-Vis absorption spectroscopy. Surface morphology of the mixed LB and LbL film of MB was measured with atomic force microscopy (AFM). [ABSTRACT FROM AUTHOR]

Excellent Langmuir-Blodgett films (LB) of non-amphiphilic coronene (COR) have been prepared by mixing with a long chain fatty acid, viz., arachidic acid (AA) and an inert polymer such as poly methyl methacrylate (PMMA) separately. Miscibility of the guest and host molecules in the mixed monolayer of COR and AA/PMMA have been studied with excess area criterion. Both the attractive and repulsive interactions are present in the COR/AA mixed monolayer, whereas only repulsive interaction is active between the component molecules of COR/PMMA mixed monolayer. Spectroscopic properties of COR in solution and mixed LB films have been compared by UV-Vis absorption spectroscopy. Surface morphology of mixed LB films has been examined by atomic force microscopy (AFM). Absorption spectroscopic study complemented with AFM image suggests the formation of some kind of aggregates in the mixed LB films. [ABSTRACT FROM PUBLISHER]

This paper reports the monolayer characteristics of cationic octadecylamine (ODA) on both distilled water and aqueous Erythrosine B (EB) dye solution at the air-water interface. From the pressure-area isotherms at various pHs, EB anions in the subphase were found to interact with the insoluble monolayer of cationic octadecylamine (ODA). Adsorption kinetics shows that the amount of dye adsorbed depends on the concentration of the dye present in the subphase. It was observed that the adsorption process mainly occurred due to the electrostatic interaction between the cationic amino group of long chain amine and the anionic part of EB. The spectroscopic characteristics of the mixed LB films, solution, have been compared using UV-vis absorption and fluorescence spectroscopic data. These studies indicate the formation of aggregates in the thin films. Scanning electron microscopic study certainly confirms the presence of aggregates of EB dye in the (ODA-EB) mixed LB films. [ABSTRACT FROM PUBLISHER]

Nonamphiphilic 2-aminoanthracene has been incorporated within the Langmuir monolayer and Langmuir–Blodgett (LB) films when mixed with behenic acid (BA). Miscibility of 2-aminoanthracene and BA at the air—water (A–W) interface has been studied by using surface phase rule and excess area criterion. Our studies reveal that repulsive type interactions exist between the component molecules in mixed monolayer and this may facilitate the formation of aggregates. Spectroscopic as well as morphological studies of mixed LB films of 2-aminoanthracene and BA undoubtedly confirms the formation of aggregates. [ABSTRACT FROM PUBLISHER]

Formation of complex monolayers between a dichain cationic surfactant, namely, dihexadecyldimethylammonium bromide (DHDAB) and deoxyribonucleic acid (DNA) at the air-water interface was first time systematically investigated here. The adsorption of DNA onto DHDAB monolayer was monitored by observing the surface pressure vs. time graph. The polyion-complex monolayers formed in situ through the electrostatic attraction between cationic DHDAB and the phosphate groups of anionic DNA. The organization of the DNA-DHDAB complex at the air-water interface deduced from surface pressure-area (π-A) isotherms was compared with the spectroscopic data in Langmuir-Blodgett films. Study of UV-Vis absorption spectra of pure DNA solution and DNA adsorbed DHDAB complex Langmuir-Blodgett films confirms the successful transfer of the films onto quartz substrates. [ABSTRACT FROM PUBLISHER]

Abstract: The behavior of binary mixed Langmuir monolayers from the mixture of non-amphiphilic bathophenanthroline (BPH) and behenic acid (BA)/poly(methyl methacrylate) (PMMA) spread on aqueous subphase was investigated on the basis of the analysis of surface pressure–average area per molecule (π–A) isotherms complemented with UV–vis absorption spectroscopy and scanning electron microscopy. In addition, the miscibility of the components in the two investigated mixed systems (BPH/BA and BPH/PMMA) was also tested by using additivity and surface phase rules. The plots of area per molecule versus mole fraction suggest that BPH and BA are immiscible, whereas BPH and PMMA mixtures show non-ideal behavior at low surface pressures and complete miscibility or immiscibility at higher surface pressures. Spectroscopic study reveals that J-type of aggregates is formed in the mixed films. Scanning electron microscopic study supports the presence of aggregates. [Copyright &y& Elsevier]

This paper reports the incorporation of an inhibitor of Human Immunodeficiency Virus (HIV), viz. Chicago Sky Blue (CSB) dye within an insoluble cationic octadecylamine (ODA) Langmuir monolayer. A surface pressure-area isotherm study confirmed the strong interaction between long chain amine and CSB dye. At higher surface pressure, CSB molecules tend to squeeze out from the octadecylamine monolayer. SEM study confirms this observation. Adsorption kinetics shows that the amount of dye adsorbed depends on the concentration of the dye present in the subphase. It was observed that the absorption process mainly occurred due to the electrostatic interaction between the cationic amino group of long chain amine and the sulphonate group of CSB dye. UV-Vis absorption spectroscopic study indicates the formation of aggregates of CSB dye in the mixed (ODA-CSB) LB films. [ABSTRACT FROM AUTHOR]

Abstract: Background: There are conflicting opinions on whether postural tachycardia syndrome predisposes to syncope. We investigated this relationship by comparing the frequency of syncope in postural tachycardia syndrome and orthostatic hypotension. Methods: We queried our autonomic laboratory database of 3700 patients. Orthostatic hypotension and postural tachycardia syndrome were defined in standard fashion, except that postural tachycardia syndrome required the presence of orthostatic symptoms and a further increase in heart rate beyond 10 minutes. Syncope was defined as an abrupt decrease in blood pressure and often, heart rate, requiring termination of the tilt study. Statistical analysis utilized Fisher''s exact test and Student''s t test, as appropriate. Results: Of 810 patients referred for postural tachycardia syndrome, 185 met criteria while another 328 patients had orthostatic hypotension. Of the postural tachycardia syndrome patients, 38% had syncope on head-up tilt, compared with only 22% of those with orthostatic hypotension (P <.0001). In the postural tachycardia group, syncope on head-up tilt was associated with a clinical history of syncope in 90%, whereas absence of syncope on head-up tilt was associated with a clinical history of syncope in 30% (P <.0001). In contrast, syncope on head-up tilt did not bear any relationship to clinical history of syncope in the orthostatic hypotension group (41% vs 36%; P =.49). Conclusion: Our results demonstrate that syncope (both tilt table and clinical) occurs far more commonly in patients who have postural tachycardia syndrome than in patients with orthostatic hypotension. These findings suggest that one should be clinically aware of the high risk of syncope in patients with postural tachycardia syndrome, and the low-pressure baroreceptor system that is implicated in postural tachycardia syndrome might confer more sensitivity to syncope than the high pressure system implicated in orthostatic hypotension. [Copyright &y& Elsevier]

Experimental studies suggest that 5-hydroxytryptamine (5-HT) receptors play a role in epileptogenesis and seizure propagation. Ondansetron, a 5-HT3 receptor antagonist, has been reported to have proconvulsant and anticonvulsant effects in animals. We describe three patients who developed seizures after receiving ondansetron. There were two females and one male. Ages ranged from 38–56 years. None had a previous or family history of seizures. Four milligrams (mg) of ondansetron was given intravenously for severe nausea and vomiting in association with migraine, gastritis, and diabetic ketoacidosis. A generalized tonic–clonic seizure occurred in each patient—12, 15, and 22 min after injection. Brain magnetic resonance imaging (MRI) and electroencephalography (EEG) were normal in all patients. Although no antiepileptic drugs were given, none had seizure recurrence subsequently. The temporal relationship between ondansetron administration and seizures, lack of EEG or MRI abnormalities, and absence of seizure recurrence suggest that the seizures were causally related to ondansetron in our patients. [ABSTRACT FROM AUTHOR]

Comparative study of the molecular dynamics of two xanthene dye derivatives (Rhodamine-6G and Fluorescein- 548) is reported using spectrally resolved three-pulse photon echo spectroscopy. An appreciable change in the coherence and population dynamics was observed between the two xanthene derivatives due to the presence of different functional groups. Solution of Rhodamine-6G in methanol behaves in a more coherent fashion compared to that of Fluorescein-548 dye. [ABSTRACT FROM AUTHOR]

We sought to determine whether thoracic electrical impedance tomography (EIT) could characterize pulmonary function in amyotrophic lateral sclerosis (ALS) patients, including those with facial weakness. Thoracic EIT is a noninvasive, technology in which a multi-electrode belt is placed across the chest, producing real-time impedance imaging of the chest during breathing. We enrolled 32 ALS patients and 32 age- and sex-matched healthy controls (HCs) without underlying lung disease. All participants had EIT measurements performed simultaneously with standard pulmonary function tests (PFTs), including slow and forced vital capacity (SVC and FVC) in upright and supine positions and maximal inspiratory and expiratory pressures (MIPs and MEPs, respectively). Intraclass correlation coefficients (ICCs) were calculated to assess the immediate reproducibility of EIT measurements and Pearson's correlations were used to explore the relationships between EIT and PFT values. Data from 30 ALS patients and 27 HCs were analyzed. Immediate upright SVC reproducibility was very high (ICC 0.98). Correlations were generally strongest between EIT and spirometry measures, with R values ranging from 0.64 to 0.82 (p < 0.001) in the ALS cohort. There were less robust correlations between EIT values and both MIPs and MEPs in the ALS patients, with R values ranging from 0.33 to 0.44. There was no significant difference for patients with and without facial weakness. There were no reported adverse events. EIT-based pulmonary measures hold the promise of providing an alternative approach for lung function assessment in ALS patients. Based on these early results, further development and study of this technology are warranted. [ABSTRACT FROM AUTHOR]

Ectopic neurohypophysis (EN) is found in nearly half of children with growth hormone deficiency (GHD). Rathke's cyst (RC) is uncommon in children and when present, hypopituitarism is found in nearly half of them. We present a fourteen and half-year-old girl with severe short stature and delayed puberty who on evaluation was found to have GHD, secondary hypocortisolism, and hypogonadism. Imaging revealed hypoplastic anterior pituitary, stalk agenesis, EN at tuber cinereum and intrapituitary RC. This is perhaps the first report of simultaneous occurrence of EN and RC, which was seen in a girl with multiple pituitary hormone deficiency. A primary defect in pituitary development may explain this simultaneous occurrence of EN and RC and hence this severe anterior pituitary function deficit. [ABSTRACT FROM AUTHOR]

Objective: To present a rare case of gigantism. Case Report: A 25-year-old lady presented with increased statural growth and enlarged body parts noticed since the age of 14 years, primary amenorrhea, and frontal headache for the last 2 years. She has also been suffering from non-inflammatory low back pain with progressive kyphosis and pain in the knees, ankles, and elbows for the last 5 years. There was no history of visual disturbance, vomiting, galactorrhoea, cold intolerance. She had no siblings. Family history was non-contributory. Blood pressure was normal. Height 221 cm, weight 138 kg, body mass index (BMI)28. There was coarsening of facial features along with frontal bossing and prognathism, large hands and feet, and small goitre. Patient had severe kyphosis and osteoarthritis of knees. Confrontation perimetry suggested bitemporal hemianopia. Breast and pubic hair were of Tanner stage 1. Serum insulin like growth factor-1 (IGF1) was 703 ng/ml with all glucose suppressedgrowth hormone (GH)values of >40 ng/ml. Prolactin was 174 ng/ml. Basal serum Lutenising Hormone (LH), follicle stimulating Hormone (FSH) was low. Oral glucose tolerance test (OGTT), liver and renal function tests, basal cortisol and thyroid profile, Calcium, phosphorus and Intact Parathyroid hormone (iPTH) were normal. Computed tomographyscan of brain showed large pituitary macroadenoma. Automated perimetry confirmed bitemporal hemianopia. A diagnosis of gigantism due to GH secreting pituitary macroadenoma with hypogonadotrophichypogonadism was made. Debulking pituitary surgery followed by somatostatin analogue therapy with gonadal steroid replacement had been planned, but the patient refused further treatment. [ABSTRACT FROM AUTHOR]

The article presents the case of an 11 month old male exhibiting the symptoms of Leprechaunism, described by Donahue in 1948. On presentation the patient displayed hypertrichosis of the forehead and sides of the face, protuberant abdomen with an everted umbilicus. The extremities were thin and emaciated. The child had an enlarged penis with undescended testes. The phenotypic features have been attributed to hyperinsulinemia and increased blood levels of extracellular growth factor (EGF).

Carao (Cassia grandis) contains numerous bioactive substances that contribute to gastrointestinal well-being. The present study assessed the potential impacts of carao on the viability and performance of Streptococcus thermophilus and Lactobacillus bulgaricus under various adverse conditions. These conditions included bile, acid, gastric juice, and lysozyme exposure, simulating the digestive process from the mouth to the intestines. The activity of proteases from cultures was monitored to examine their proteolytic capabilities. To achieve this, the cultures were cultivated in a solution containing plant material, and the results were compared against a control sample after an incubation period. Subsequently, the total phenolic content, total carotenoid content, antioxidant activity, sugar profile, and acid profile of the plant materials were analyzed. These analyses were conducted to explore these compounds' influence on cultures' survival. Seeds contained the highest total phenols (766.87 ± 11.56 µg GAE/mL), total carotenoid content (7.43 ± 0.31 mg Q/mL), and antioxidant activity (40.76 ± 1.87%). Pulp contained the highest moisture (12.55 ± 0.44%), ash (6.45 ± 0.15%), lipid (0.66 ± 0.07%), protein (16.56 ± 0.21%), sucrose (9.07 ± 0.78 g/100 g), and fructose (3.76 ± 0.06 g/ 100 g). The crust had the highest content of ash (85.14 ± 0.27%) and succinic acid (2.01 ± 0.06 g/100 g). Results indicated that seeds negatively affected cultures' survival in the bile tolerance test and had positive effects on Lactobacillus bulgaricus in the protease activity test. Otherwise, the other carao tissues could not change the results significantly (p > 0.05) compared to the control in different tests. The carao crust positively affected cultures' against protease activity, especially in Lactobacillus bulgaricus, and had a negative effect on the growth of S. thermophilus in the lysozyme and gastric acid resistance test. [ABSTRACT FROM AUTHOR]

This study involved the evaluation of the effect of vacuum pasteurization on physicochemical characteristics (pH, total soluble solids, titratable acidity, chroma, tone, IO, vitamin C, 5-hydroxymethylfurfural), microbiological properties (Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, total coliforms, total mesophilic aerobes, molds and yeasts) and sensory characteristics of orange and carrot nectar. The thermal treatments were designed based on the thermal lethality of two heat-resistant microorganisms typical of the product (Neosartorya fischeri and Zygosaccaromyces bailii). The evaluation was carried out on raw nectar and pasteurized nectar. The shelf life was estimated to be 30 days (6 °C). The most favorable results were obtained by applying a heat treatment at 88 °C for 32.68 min, managing to retain 85.87% of vitamin C and a microbiological stability of 12 days (6 ± 0.6 °C) with regard to total mesophilic aerobes. Likewise, the tasters established that this treatment resulted in the best flavor, texture and acceptability characteristics. [ABSTRACT FROM AUTHOR]

Lactobacillus plantarum has beneficial effects on the reduction of symptoms of poor lactose digestion and hypercholesterolemia, removal of the duration and severity of diarrheal processes, improvement of the intestinal permeability barrier, prevention of some types of cancer by adsorption or inactivation of genotoxic agents, increased resistance to intestinal and extraintestinal infections, attenuation of inflammatory bowel disease, and prevention of allergies (especially food). On the other hand, carao (Cassia grandis) has shown remarkable nutritious content with influential dietary applications. As a result, this investigation aimed to explore the effect of Cassia grandis pulp on viability of Lactobacillus plantarum under gastrointestinal conditions, immunomodulatory capacity, and probiotic potential. Adding carao to the medium under different experimental conditions, including rich and minimal culture media and a gastrointestinal digestion process of skimmed milk, did not substantially affect Lactobacillus plantarum's growth but prolonged its viability. The administration of Lactobacillus plantarum with carao in mice did not induce a proinflammatory response at a systemic level. Still, it did cause an increase in the production of immunoregulatory cytokines. Also, the viability of TSB broth was improved by adding carao. Carao improved the growth of acid tolerance, bile tolerance, growth in TSB broth, and NaCl resistance. According to the results, carao may enhance the characteristics of L. plantarum when enriching fermented dairy products. [ABSTRACT FROM AUTHOR]