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Among the different industries, the ricemill industry is identified as one of the major polluting industries because of the large amounts of effluents generated and variations in the concentration of its constituents. The current experimental study aimed to investigate the treatment of ricemill (simulated) using the aerobic inverse fluidized bed biofilm reactor (AIFBBR). Box–Behnken design (BBD) based statiscal response surface methodology (RSM) was used for the current AIFBBR-ricemill treatment system. For the evaluation of the RSM process through the BBD technique, three input variables: Influent COD (800–3200 mg/L), HRT (12–24 h), and % bed volume (15 − 45), and two output variables: %COD and %TOC removal, were selected. The effect of these chosen variables was verified by conducting 15 experiments in a multivariate system for the AIFBBR-ricemill treatment system. The quadratic polynomial models yielded a regression coefficient (R 2 ) of 0.99 (for both COD and TOC) when the experimental data were fitted to it, which indicates the model's suitability for the process. The precision and efficiency of the model were visualized using the ANOVA and lack of fit test. The system has witnessed the maximum COD (88.95%) and TOC (95.68%) removal at optimum parameters of 2804.27 mg/L of influent COD, 23.79 h of HRT, and at a % bed volume of 44.94. Along with the COD and TOC, parameters such as nutrients (NH 4 +-N, PO 4 3--P, and NO 3 --N), phenol, and lignin were also monitored in the present study. [ABSTRACT FROM AUTHOR]

The article discusses a recent rock avalanche event that occurred on July 10, 2024, near the Patalganga Langsi Tunnel on the Badrinath Highway in the Chamoli district of Uttarakhand, India. The region is prone to natural hazards like landslides, earthquakes, floods, and cloudbursts. The rock avalanche severely damaged the tunnel and blocked the highway for several hours, but miraculously, no lives were lost. The event generated air blast-induced clouds, and further investigation is needed to determine the cause of the avalanche. [Extracted from the article]

Due to its higher biochemical oxygen demand (BOD) and chemical oxygen demand (COD), the rice mill industry is considered a major polluting sector. The issue is becoming more serious due to the organic portions of the rice mill effluent, such as starch and other biodegradable constituents. The main objective of this review is to discuss the most commonly used methodologies (physico-chemical, phytoremediation, and biological) for treating rice mill effluent and highlight their effectiveness, with a greater emphasis on biological techniques. The study also included discussions on rice milling operations and the current status of rice mill effluent generation. The physico-chemical techniques effectively reduce BOD, COD, total suspended solids (TSS), and total dissolved solids (TDS) from the effluents. Still, it has limitations, such as the utilization of high-cost reagents and the requirement for external energy. Researchers have recognized biological techniques as the most economical choice for treating industrial effluents containing organic constituents. Phytoremediation ensures better aesthetics and a healthier environment while assisting industries to minimize toxic compounds and nutrients. The review also looked at the methodology, advantages, and limitations of the treatment technologies used in rice mill wastewater treatment. Furthermore, we update all of these treatment techniques with relevant data from the literature. At the end of the study, we include aspects related to the conclusions and future scope of the topic. [Display omitted] • The generation, major composition of rice mill effluents, and rice milling operations were discussed. • The adverse effects of untreated rice mill effluents on the environment were reviewed. • The treatment technologies applied for the treatment of the rice mill were thoroughly discussed. • The advantages and limitations of the methodologies used for the rice mill treatment were reviewed. • The future aspects of the rice mill effluent treatment methodologies were briefed in the conclusions. [ABSTRACT FROM AUTHOR]

Integrating the health-care enterprise (IHE) is an international initiative to promote the use of standards to achieve interoperability among health information technology systems. The Pathology and Laboratory Medicine domain within IHE has brought together subject matter experts, electronic health record vendors, and digital imaging vendors, to initiate development of a series of digital pathology interoperability guidelines, called "integration profiles" within IHE. This effort begins with documentation of common use cases, followed by identification of available data and technology standards best utilized to achieve those use cases. An integration profile that describes the information flow and technology interactions is then published for trial use. Real world testing occurs in "connectathon" events, in which multiple vendors attempt to connect their products following the interoperability guidance parameters set forth in the profile. This paper describes the overarching set of integration profiles, one of which has been published, to support key digital pathology use cases. [ABSTRACT FROM AUTHOR]

Disturbingly high rates of consumption of surfactants in household and industries have led to mark them as emerging contaminants in the environment. In the present work, removal of sodium dodecyl sulfate (SDS), an anionic surfactant, using an industrial waste (dolochar) was explored. The adsorbent material was characterized with the help of Fourier transform infrared spectroscopy (FTIR) and X‐ray diffraction (XRD). Kinetic evaluation was performed using first, pseudo‐first, second, and pseudo‐second order models. Adsorption of SDS over dolochar was expressed best by pseudo‐second order kinetic model with regression coefficient (R2) of.99. Three input parameters including adsorbent dose (20–10 g/L), initial concentration (30–100 mg/L) of the surfactant, and contact time (2–60 min) were chosen for optimization using response surface methodology based on Box–Behnken design (BBD) approach. A total of 15 experiments were run to examine the effect of these variables on removal of SDS by dolochar in a multivariate system. A regression analysis indicated the experimental data fitted well to a quadratic polynomial model with coefficient of regression (R2) as.99. ANOVA and lack‐of‐fit test depicted the precision and efficiency of the model. The optimized conditions for SDS removal were found to be adsorbent dose 16.62 g/L, contact time 40 min, and initial concentration 47 mg/L with removal efficiency as 98.91%. Practitioner points: Daily ablutions and use of personal care products introduce a number of surfactants and recalcitrant compounds into the environment.Adsorption is a handy and easy to operate treatment technique to remove graywater pollutants.Kinetic and statistical modeling may be recommended as one of the most prominent tools to understand the removal mechanism.Decentralized treatment of graywater using industrial wastes is recommended as sustainable solution in the developing nations. [ABSTRACT FROM AUTHOR]

This work evaluates the performance efficiency of a newly developed single unit packed bed bioreactor for nutrient removal from domestic wastewater. The packing materials, including dolochar, and a mixture of waste organic solid substance, were immobilized with a simultaneous nitrifying, denitrifying and phosphate removing bacterial strain, Bacillus cereus GS-5 and packed in the bioreactor alternatively in multiple layers. The bioreactor was operated continuously for a period of 70 days using both synthetic and real domestic wastewater (NH 4 + -N 30–100 mg/L, NO 3 − -N 10–100 mg/L, PO 4 3− -P 5–20 mg/L and COD 250–1000 mg/L). The innovative single unit bioreactor exhibited simultaneous removal of NH 4 + -N (87.1–93.1%), NO 3 − -N (69.4–88.4%), PO 4 3− -P (84–100%), and even COD (69.8–92.1%), in a remarkable disparity to traditional distinct aerobic-anaerobic treatment systems. This work advocated for a promising and feasible application prospect of the developed single unit packed bed bioreactor in domestic wastewater treatment emphasizing on nutrient removal. [ABSTRACT FROM AUTHOR]

Three cylindrical vertical flow (VF) (1st stage) and three horizontal flow (HF) vermifilters (2nd stage) were designed and planted with Canna indica to study the effect of HLR. The vermifilters were loaded (to VF) with synthetic dairy wastewater at three HLRs of 0.3, 0.6 and 0.9 m d −1 and operated for 100 days. Removal rate constants were higher at HLR 0.6 m d −1 and the value of K BOD5 , K COD , K NH4+-N , K TN , K TP (for VF + HF unit) were 0.51, 0.41, 0.32, 0.23, 0.26, respectively. Efficiency of VF reactor were higher than HF reactor in case of all types of pollutants. The average removal of BOD 5 was found to be 90.43% at HLR 0.3 m d −1 and 85.75% at HLR 0.6 m d −1 , while for COD it was found to be 85.59% and 79.64%, respectively. In the present study, the overall theoretical oxygen transfer rate (OTR) for HLR 0.3, 0.6 and 0.9 m d −1 (VF + HF unit) were 36, 92 and 195.6 g m −2  d −1 , respectively. The OTR value for HF reactor was very less. The present value is much higher than other studies and it may be due to earthworm respiration and their burrowing and tunnelling activities. The percentage increase of earthworm number in all VF reactors were in the range of 28.3–31.5 and in HF reactor in the range of 19.1–26.2. [ABSTRACT FROM AUTHOR]

Two lab-scale vertical flow vermifilter were designed, one aided with Canna indica (MAVF) and the other without it (VF), but Eisenia fetida was inserted in both the systems. The experimental phase continued for ten weeks with a hydraulic loading rate of 0.65 m3 m−2 day−1. Results indicated that MAVF possess maximum organic and nitrogen degradation capacity during the treatment process and it was working steadily without sign of clogging, but vermifilter without macrophyte (VF) was clogged within the first few weeks of its operation. Removal efficiencies of BOD were 80.6% for MAVF and 71% for VF, while for COD it was 75.8% and 66.1%, respectively. TSS removal for MAVF and VF was found to be 84.8% and 73.8%, respectively, but TDS removal was insignificant in both the filters. Interlayer analysis presented that maximum organics and solids removed in the 1st layer or worm active zone. MAVF removed 42.6% TN, and effluent NH4+-N concentration in MAVF and VF were as low as 8.4 mg/L and 13.2 mg/L, respectively. However, TP concentration in effluent increased gradually may be due to the actions of phosphorus solubilizing microorganisms (PSM) and phosphatase enzymes secreted by earthworm. Growth characteristics of C. indica and E. fetida were also observed during the experimental period. Different physical and biochemical changes in soil due to plant and earthworm activity were analysed through FTIR, SEM and humic component analysis. The performance of MAVF was found to be superior to VF with high longevity. [ABSTRACT FROM AUTHOR]

The viability of utilizing sponge iron industry based waste 'dolochar' as a proficient adsorbent for nutrient (phosphate and nitrate) removal and subsequent slow release of nutrient from the spent dolochar has been undertaken in this study. The efficacy of dolochar has been explored in both single and binary adsorption systems containing nutrients. The proposed experimentally obtained quadratic models for both the phosphate and nitrate removal were substantiated by analysis of variance (ANOVA) with high R² values of 0.99 and 0.98, respectively. Response surface methodology (RSM) based optimization followed by experimental validation resulted in phosphate removal efficiency of 96.7% and nitrate removal efficiency of 57.1%. Single component adsorption equilibrium data fitted well to pseudo-second order kinetic and Langmuir isotherm models with Langmuir maximum adsorption capacity, qm of 327.7 and 6.51 mg g-1 for phosphate and nitrate, respectively. Out of non-modified Langmuir, modified Langmuir, extended Langmuir and extended Freundlich, multi component isotherm models, binary adsorption equilibrium data fitted well to the extended Freundlich model. Thin layer funnel analytical test results reveals the slow nutrient release nature of spent dolochar. The results suggest that the dolochar has the potential to serve as a sustainable adsorbent for nutrient removal from wastewater along with the scope of utilizing spent dolochar as a slow release nutrient supplier. [ABSTRACT FROM AUTHOR]

The serviceability limit of the foundation system plays an important role in the safe long-term performance of a building. Under governing load cases in service life, the building foundation system should satisfy the serviceability limit state, i.e., total and differential settlement criteria. This study investigated the distress of a building through foundation performance assessment incorporating the soil–foundation–structure interaction (SFSI) effects. A spatially variable soil model [zonewise, obtained from field observation and electrical resistivity tomography (ERT) study] was used to obtain the settlement of the foundation system. Engineering properties of the subsurface were estimated from the collected soil samples and field tests. ERT result shows the variability of the subsurface layer. A three-dimensional finite-element model of soil, foundations, and structures was developed to estimate the settlement demand of the foundation and structures. The numerical model includes the geometric variability of all the foundations of the building and subsurface variability. Settlement and bearing capacity demand of the foundations were estimated and compared with the standard provisions. Results obtained show that the building foundation system satisfies the serviceability limit of the foundation system under total settlement criteria. However, the differential settlement of the system exceeds the required limit despite considering the SFSI effects, and is one of the major causes of distress to the building. The main contributions of this study also include establishing the spatial variability of the soil layer through ERT and correlating it with the crack zone in the building. [ABSTRACT FROM AUTHOR]

Benign papillary lesions of the breast include papilloma and papillomatosis. A retrospective analysis of patients with a papillary breast lesion diagnosed between October 1992 and December 2009 was performed. Patients were excluded if they had a previous or concurrent diagnosis of invasive or in situ cancer or less than 6 months of follow-up. The Kaplan-Meier method was used to determine the risk of developing subsequent malignancy. The log rank test was used to compare groups of patients. Median follow-up for the 167 patients included in the study was 4.6 years. Fifty-one patients had a papillary lesion with atypia and 116 patients had a papillary lesion without atypia. Patients with a papillary lesion with atypia were more likely to develop invasive or in situ breast cancer with a 5 year risk of 13.0% versus 4.6% in patients with no atypia (p = 0.03). [ABSTRACT FROM AUTHOR]

Pathologists have long served as custodians of human biospecimens collected for diagnostic purposes. Rapid advancements in diagnostic technologies require that pathologists change their practices to optimize patient care. The proper handling of biospecimens creates opportunities for pathologists to improve their diagnoses while assessing prognosis and treatment. In addition, the growing need for high-quality biorepositories represents an opportunity for community pathologists to strengthen their role within the health care team, ensuring that clinical care is not compromised while facilitating research. This article provides a resource to community pathologists learning how to create high-quality biorepositories and participating in emerging opportunities in the biorepository field. While a variety of topics are covered to provide breadth of information, the intent is to facilitate a level of understanding that permits community pathologists to make more informed choices in identifying how best their skills and practice may be augmented to address developments in this field. [ABSTRACT FROM AUTHOR]

Textile industry is one of the most chemically intensive industries on the earth and the major polluter of potable water. It generates huge quantities of complex chemical substances as a part of unused materials including dyes in the form of wastewater during various stages of textile processing. The direct discharge of this wastewater into environment affects its ecological status by causing various undesirable changes. As environmental protection becomes a global concern, industries are finding novel solutions for developing technologies that can diminish the environmental damage. However, colour removal from textile wastewater by means of cheaper and environmental friendly technologies is still a major challenge. In this manuscript, several options of decolourisation of textile wastewater by chemical means have been reviewed. Based on the present review, some novel pre-hydrolysed coagulants such as Polyaluminium chloride (PACl), Polyaluminium ferric chloride (PAFCl), Polyferrous sulphate (PFS) and Polyferric chloride (PFCl) have been found to be more effective and suggested for decolourisation of the textile wastewater. Moreover, use of natural coagulants for textile wastewater treatment has also been emphasised and encouraged as the viable alternative because of their eco-friendly nature. [Copyright &y& Elsevier]

An abstract of the conference paper "Manganese-enhanced MRI detects live human amnion-derived mesenchymal stem cells in vivo after transplantation and restoration of myocardial function in a pig ischemia-reperfusion injury model," by Rajesh Dash, and colleagues is presented.

Cyanides are produced by certain bacteria, fungi, and algae, and may be found in plants and some foods, such as lima beans and almonds. Although cyanides are present in small concentrations in these plants and microorganisms, their large-scale presence in the environment is attributed to the human activities as cyanide compounds are extensively used in industries. Bulk of cyanide occurrence in environment is mainly due to metal finishing and mining industries. Although cyanide can be removed and recovered by several processes, it is still widely discussed and examined due to its potential toxicity and environmental impact. From an economic standpoint, the biological treatment method is cost-effective as compared to chemical and physical methods for cyanide removal. Several microbial species can effectively degrade cyanide into less toxic products. During metabolism, they use cyanide as a nitrogen and carbon source converting it to ammonia and carbonate, if appropriate conditions are maintained. Biological treatment of cyanide under anaerobic as well as aerobic conditions is possible. The present review describes the mechanism and advances in the use of biological treatment for the removal of cyanide compounds and its advantages over other treatment processes. It also includes various microbial pathways for their removal. [Copyright &y& Elsevier]

Abstract: Cyanide is used extensively in the electroplating and mining industries due to its strong affinity to metal cations. Commercial granular activated carbon (GAC) was used as adsorbent for the adsorptive study of sodium, zinc and iron, cyanide complexes in the present study. The effect of process parameters such as pH, temperature, adsorbent size and dose, contact time on the performance of adsorption was investigated. Optimum pH was found to be 9, 7 and 5 for sodium, zinc and iron cyanides respectively. In the higher temperature range more percentage removal was observed for iron cyanides, whereas, sodium and zinc cyanides were removed optimally at 25–35°C. Although particle size did not show any major influence on the percentage removal, but optimum size was taken as 2–4mm. The percentage removal of cyanide compounds increased with the increase in adsorbent (GAC) concentration. However, specific uptake did not increase at GAC concentration above 20–25g/L. Hence 20g/L was considered as the optimum dose of adsorbent. Higher removal efficiency was achieved for metal cyanides as compared to sodium cyanide at optimal conditions. [Copyright &y& Elsevier]

Abstract: This paper presents process review and comparative study of biodegradation and adsorption alone with simultaneous adsorption and biodegradation (SAB) process using Pseudomonas fluorescens. Ferrocyanide solution was used for all studies with initial CN− concentrations of 50, 100, 200 and 300mg/L, and initial pH of 6. Pseudomonas fluorescens used ferrocyanide as sole source of nitrogen and biodegradation efficiency was observed as 96.4, 94.1, 86.2 and 69.3%, respectively after 60h of agitation. Whereas in adsorption process with granular activated carbon (GAC) as adsorbent, CN− removal efficiency was found to be 85.6, 80.1, 70.2 and 50.2%, respectively. But in SAB process the removal efficiency could be more than 70% for all concentrations only at 36h of agitation and achieved removal efficiency of 99.9% for 50 and 100mgCN−/L. It was found that SAB process is more effective than biodegradation and adsorption alone. [Copyright &y& Elsevier]

Objective: Exogenous catecholamine exposure has been associated with p38 mitogen-activated protein kinase (MAPK) and cardiac hypertrophy. In this study, we investigated the regulation of p38 MAPK in cardiac remodeling elicited by endogenous adrenergic mechanisms. Methods: Transgenic male and female mice with fourfold phospholamban (PLB) overexpression exhibited enhanced circulating norepinephrine (NE), as a physiological compensatory mechanism to attenuate PLB’s inhibitory effects. This enhanced noradrenergic state resulted in left ventricular hypertrophy/dilatation and depressed function. Results: Male transgenics exhibited ventricular hypertrophy and mortality at 15 months, concurrent with cardiac p38 MAPK activation. Female transgenics, despite similar contractile dysfunction, displayed a temporal delay in p38 activation, hypertrophy, and mortality (22 months), which was associated with sustained cardiac levels of MAP Kinase Phosphatase-1 (MKP-1), a potent inhibitor of p38. At 22 months, decreases in cardiac MKP-1 were accompanied by increased levels of p38 activation. In vitro studies indicated that preincubation with 17-β-estradiol induced high MKP-1 levels, which precluded NE-induced p38 activation. Conclusion: These findings suggest that norepinephrine-induced hypertrophy is linked closely with p38 MAP kinase activation, which can be endogenously modulated through estrogen-responsive regulation of MKP-1 expression. [Copyright &y& Elsevier]

Context.--Machine learning applications in the pathology clinical domain are emerging rapidly. As decision support systems continue to mature, laboratories will increasingly need guidance to evaluate their performance in clinical practice. Currently there are no formal guidelines to assist pathology laboratories in verification and/or validation of such systems. These recommendations are being proposed for the evaluation of machine learning systems in the clinical practice of pathology. Objective.--To propose recommendations for performance evaluation of in vitro diagnostic tests on patient samples that incorporate machine learning as part of the preanalytical, analytical, or postanalytical phases of the laboratory workflow. Topics described include considerations for machine learning model evaluation including risk assessment, predeployment requirements, data sourcing and curation, verification and validation, change control management, human-computer interaction, practitioner training, and competency evaluation. Data Sources.--An expert panel performed a review of the literature, Clinical and Laboratory Standards Institute guidance, and laboratory and government regulatory frameworks. Conclusions.--Review of the literature and existing documents enabled the development of proposed recommendations. This white paper pertains to performance evaluation of machine learning systems intended to be implemented for clinical patient testing. Further studies with real-world clinical data are encouraged to support these proposed recommendations. Performance evaluation of machine learning models is critical to verification and/or validation of in vitro diagnostic tests using machine learning intended for clinical practice. [ABSTRACT FROM AUTHOR]

Integrating the health-care enterprise (IHE) is an international initiative to promote the use of standards to achieve interoperability among health information technology systems. The Pathology and Laboratory Medicine domain within IHE has brought together subject matter experts, electronic health record vendors, and digital imaging vendors, to initiate development of a series of digital pathology interoperability guidelines, called "integration profiles" within IHE. This effort begins with documentation of common use cases, followed by identification of available data and technology standards best utilized to achieve those use cases. An integration profile that describes the information flow and technology interactions is then published for trial use. Real world testing occurs in "connectathon" events, in which multiple vendors attempt to connect their products following the interoperability guidance parameters set forth in the profile. This paper describes the overarching set of integration profiles, one of which has been published, to support key digital pathology use cases. [ABSTRACT FROM AUTHOR]

Background: COVID-19 spurred rapid adoption and expansion of telemedicine. We investigated the factors driving visit modality (telemedicine vs. in-person) for outpatient visits at a large cardiovascular center. Methods: We used electronic health record data from March 2020 to February 2021 from four cardiology subspecialties (general cardiology, electrophysiology, heart failure, and interventional cardiology) at a large academic health system in Northern California. There were 21,912 new and return visits with 69% delivered by telemedicine. We used hierarchical logistic regression and cross-validation methods to estimate the variation in visit modality explained by patient, clinician, and visit factors as measured by the mean area under the curve. Results: Across all subspecialties, the clinician seen was the strongest predictor of telemedicine usage, while primary visit diagnosis was the next most predictive. In general cardiology, the model based on clinician seen had a mean area under the curve of 0.83, the model based on the primary diagnosis had a mean area under the curve of 0.69, and the model based on all patient characteristics combined had a mean area under the curve of 0.56. There was significant variation in telemedicine use across clinicians within each subspecialty, even for visits with the same primary visit diagnosis. Conclusion: Individual clinician practice patterns had the largest influence on visit modality across subspecialties in a large cardiovascular medicine practice, while primary diagnosis was less predictive, and patient characteristics even less so. Cardiovascular clinics should reduce variability in visit modality selection through standardized processes that integrate clinical factors and patient preference. [ABSTRACT FROM AUTHOR]

While tremendous progress has been made in wastewater treatment, the primary focus has been on increasing the cost-effectiveness of treatment methods. Among these developments, anaerobic ammonia oxidation (anammox) has emerged as a key technology for efficiently removing nitrogen from wastewater. This review focuses on the operating circumstances of anammox processes, taking into account the unique system and types of anammox bacteria used. It addresses the many genera and species of anammox bacteria, as well as their growth characteristics and optimal operating circumstances. It investigates the individual wastewater types, sludge feed, and total nitrogen (TN) removal efficiency for each operation. This study explores strategies to optimize the growth and activity of anammox bacteria while addressing inhibitors and preservation techniques. It was found that the best temperature range for bacteria to grow is between 20 and 45 °C, the pH should be between 7.0 and 8.5, nitrite levels should be less than 100 mg/L, and DO levels should be less than 0.5 mg/L. It reveals sludge as the principal source of these bacteria, with dominant genes like Candidatus Brocadia and Candidatus Kuenenia showing more efficient growth compared to other anammox genera, and exhibiting a doubling time of 8–11 days in wastewater sludge environments. This study gives useful information about the operational characteristics and prospective benefits of anammox technology. The review helps to provide a full understanding of the anammox process and its potential for efficient nitrogen removal in wastewater treatment. Future research should focus on the effectiveness of biomass transporters and seeding sludge for rapid bacterial growth. • Explores strategies for optimizing anammox bacteria growth, addressing inhibitors. • Emphasizes the role of controlling concentration for anammox process. • Anammox process potential for efficient nitrogen removal. • Anammox process successful implementation at full scale. [ABSTRACT FROM AUTHOR]

Early in the COVID-19 pandemic, cardiology clinics rapidly implemented telemedicine to maintain access to care. Little is known about subsequent trends in telemedicine use and visit volumes across cardiology subspecialties. We conducted a retrospective cohort study including all patients with ambulatory visits at a multispecialty cardiovascular center in Northern California from March 2019 to February 2020 (pre-COVID) and March 2020 to February 2021 (COVID). Telemedicine use increased from 3.5% of visits (1200/33,976) during the pre-COVID period to 63.0% (21,251/33,706) during the COVID period. Visit volumes were below pre-COVID levels from March to May 2020 but exceeded pre-COVID levels after June 2020, including when local COVID-19 cases peaked. Telemedicine use was above 75% of visits in all cardiology subspecialties in April 2020 and stabilized at rates ranging from over 95% in electrophysiology to under 25% in heart transplant and vascular medicine. From June 2020 to February 2021, subspecialties delivering a greater percentage of visits through telemedicine experienced larger increases in new patient visits (r = 0.81, p = 0.029). Telemedicine can be used to deliver a significant proportion of outpatient cardiovascular care though utilization varies across subspecialties. Higher rates of telemedicine adoption may increase access to care in cardiology clinics. [ABSTRACT FROM AUTHOR]

The landslide events, that occurred in August 2018 in the Idukki district Kerala, India were surveyed during 12-14 September 2018. Many landslides were studied through field observations to decipher their mechanism and mitigation measures have been recommended. Possible causative factors responsible for these slope failures have been discussed. This event was the most devastating disaster that affected millions of people and the second such event after the Kedarnath tragedy (2013) during this decade. The primary causes responsible for initiation of these landslides were unexpected intense rainfall, unplanned development and urbanization. This study on field observationbased interpretations will help academicians, researchers and field engineers to plan future initiatives for reconstruction planning and implementation in line with future disaster risk reduction. [ABSTRACT FROM AUTHOR]

An abstract of the article "Manganese-Enhanced cardiac MRI (MEMRI) tracks long-term in vivo survival and restorative benefit of transplanted human Amnion-Derived Mesenchymal Stem Cells (hAMSC) after porcine ischemia-reperfusion injury," by Rajesh Dash and colleagues is presented.

With increasing urbanization and industrialization, the scarcity of freshwater is becoming rampant. To counteract this, authorities all over the world are forced to consider the treatment and reuse of the wastewater produced by either industries or domestic units. After an extensive literature survey, vermifiltration coupled with/without macrophyte has been identified as one of the best sustainable, natural and eco-friendly technology for the treatment and reuse of wastewater. Till date, it has been successfully applied for treating domestic wastewater. However, the results from very limited industrial applications are also encouraging and proving its worth for industrial wastewater remediation. The present review on vermifiltration deals with the mechanisms involved and its current status for the remediation and reutilisation of the effluents generated from domestic and industrial premises. The review successfully identifies and explicitly discusses the mechanisms involved in the vermifiltration. The review exhaustively discusses the performance of vermifiltration and identifies the factors contributing to the performance of vermifiltration, which could be of help in designing of the field scale vermifilter based treatment plant. The review identifies the limitations associated with the vermifiltration and suggests possible alternatives, aimed to improve its performance and applicability. The aim of this review is to bring the attention of prospective researchers to study each and every aspect related to the vermifiltration so that it may be adopted as a reliable and dependable technology for the remediation of several industrial effluents meeting the concept of "Zero discharge". • The review successfully elaborates the mechanisms involved in vermifiltration. • Application of vermifiltration in domestic and industrial context is discussed. • The review discusses the limitations associated with the vermifiltration. • The review suggests the ways to counter the limitations of vermifilters. • The review successfully gives a thrust to apply vermifiltration to the field scale. [ABSTRACT FROM AUTHOR]

Abstract In the present research, an experiment was conducted with the objective of optimization of the role of earthworms in alleviating the bioclogging of a horizontal subsurface flow vermifilter (HSSFVF), caused due to the application of organics rich brewery wastewater. In this experiment, for the optimization of bioclogging of the vermifilters, the Box-Behnken Design (BBD) and response surface methodology (RSM) were involved. Hydraulic loading rate (HLR), influent COD and earthworm density (EWD) are the variables against which the bioclogging of the HSSFVF has been optimized. EWD of 9475 earthworms/m3, HLR of 1.84 m3/m2-d and influent COD of 3701 mg/L have been observed as the optimized values for the minimum bioclogging in the vermifiltration of brewery wastewater. At this optimum boundary conditions, the reduction in hydraulic conductivity was obtained as 1.49%, against the predicted value of 1.67% based upon the BBD model. The verification of the model against real brewery wastewater yielded insignificant error and thus very strongly portrays the suitability of the derived BBD model. The study indicates that the bioclogging from the vermifilters can be minimized, if the variables are optimized using the response surface methodology. Graphical abstract Image 10745 Highlights • Optimization of bioclogging of vermifilters was done using a RSM based BBD model. • The earthworm inoculation in the soil biofilter can delay the clogging. • The variables influencing the bioclogging of vermifilters were recognised. • The mechanism behind bioclogging and role of earthworms were highlighted. • A significant influence of EWD and HLR on bioclogging was observed. [ABSTRACT FROM AUTHOR]

Abstract The study was conducted with an aim to optimize the parameters involved in removing organics from brewery effluents using a newly developed horizontal subsurface flow vermifilter. It was also aimed at understanding the impact of hydraulic retention time (HRT) on the vermifiltration of brewery wastewater. With the help of Box-Behnken design (BBD) and response surface methodology, optimization of the COD removal from the vermifiltration was carried out. The parameters chosen for the optimization were hydraulic loading rate (HLR), organics strength and earthworm densities (EWDs). The model obtained from the response surface methodology (RSM) analysis was a quadratic polynomial model with R2 value of 0.99. The optimal conditions for achieving maximum chemical oxygen demand (COD) removal were at influent COD concentration of 3542.22 mg/L, EWD of 9661.33 earthworms/m3 and HLR of 1.84 m3/m2·d. At the optimum conditions, COD removal of 94.99% was obtained against the predicted value of 95.85%. Verification of the model on real brewery wastewater also showed minimal error against the predicted COD removal. The COD, total nitrogen (TN) and total phosphorous (TP) removal at the HRT of 10.66 h were found to be 73.88%, 18.13% and 39.04%, respectively. Whereas, The COD, TN and TP removals at the HRT of 26.66 h were 96.24, 21.57 and 43.3%, respectively. Graphical abstract Unlabelled Image Highlights • A RSM based BBD model was utilized to optimize the COD removal from vermifilters. • At the optimized conditions, highest COD removal efficiency of 94.99% was obtained. • The parameters affecting COD removal from vermifilters were identified. • The impact of HRT on vermifiltration is found to be significant. [ABSTRACT FROM AUTHOR]

Abstract The present study was aimed at developing a mathematical COD removal index (CRI) based on the key variables of vermifiltration such as hydraulic retention time (HRT), organic concentration and earthworm density (EWD). In the maiden attempt of framing such an index, many experimental runs were conducted by varying the COD strength of the wastewater from 2.0–4.0 kg/m3, EWD and HLR were from 0 to 10,000 earthworms/m3 and 1.8–4.5 m3/m2·d, respectively. The sensitivity analysis of the developed CRI reveals that the EWD, bedding volume, concentration of organics and the flow applied to the vermifilter can immensely affect the model response. However, flow applied to the system is observed to be the most sensitive among other parameters incorporated in the model. In addition, from the sensitivity analysis, it was also revealed that the removal efficiencies were observed to increase with the increase in CRI values in the COD range of 0.2–6.0 kg/m3. In addition, the plot between the reported removals from literatures on vermifiltration of domestic wastewater and CRI values yielded an R2 value of 0.76. Such a high correlation suggests that the developed CRI index can be applied for other wastewaters also. The results of this study indicate that the developed index can successfully be applied in determining and predicting organics removal from vermifiltration of wastewaters. Graphical abstract Unlabelled Image Highlights • An index was developed to predict and design COD removals in vermifiltration. • Flow is the most sensitive parameter based upon sensitivity analysis. • EWD and volume of bedding favors the organics removal of vermifilter. • Brewery wastewater was used for the development and validation of CRI. • The developed CRI was found to be applicable against other wastewaters also. [ABSTRACT FROM AUTHOR]

With the scarcity of fresh water and rise in pollution load in the aquatic ecosystem over the globe, the domestic and industrial effluents need to be reused after suitable treatment. In an attempt to do so, soil biofilters have been identified as a treatment alternative that is suitable for application in developing countries. However, rapid development of clogging in the soil biofilters limits its applicability as an effective technology. This paper aims to understand the occurrence of clogging due to biofilms formation in and over the bedding of soil media. To address this, the organic loading rates (OLRs) were varied in the range of 2.25–11.25 kgCOD/m 3 ·day to create different degree of clogging. Earthworms were inoculated into the soil bedding at the earthworm densities (EWDs) of 0, 5000 and 10,000 earthworms/m 3 to study the effect of earthworms introduction on clogging. The degree of clogging was measured using clogging coefficient (CC), hydraulic conductivity and head loss. The study highlights the impact of earthworms on the removal performance and clogging of soil biofilter. For all earthworm densities, head loss and clogging coefficient increased and hydraulic conductivity decreased linearly with organic loading rate. Introduction of earthworms versus no earthworms resulted in lower head loss and clogging coefficient and higher hydraulic conductivity for all organic loading rates, while increasing EWD from 5000 to 10,000 had only marginal effects on all parameters. The study reveals that high organic loading rate activates higher number of microbial sites, in turn causing higher degree of clogging. However, the introduction of earthworms reduces the clogging rate significantly along with enhanced treatment performance. The outcome of this study indicates that incorporation of earthworms into the soil biofilter can reduce the degree of bio-clogging and might provide a highly sustainable, low cost and efficient treatment system for the developing countries. [ABSTRACT FROM AUTHOR]

A newly isolated GS-5 strain exhibiting heterotrophic nitrification, aerobic denitrification and denitrifying phosphorous removal was identified as Bacillus cereus GS-5 based on its phenotypic and phylogenetic characteristics. The isolate had exhibited efficient NH 4 + -N, NO 3 − -N, NO 2 − -N and PO 4 3− -P removal from nutrient spiked real domestic wastewater with average rates of 2.62, 2.69, 1.16 and 0.42 mg L −1 h −1 , respectively under aerobic condition. Metabolic inhibitor based mass balance analysis indicated that dinitrogen gas (41%), intracellular nitrogen (29%) and intracellular phosphorous (60%) were the major fates of the initial NH 4 + -N and PO 4 3− -P. The successfully expression of hydroxylamine oxidase (hao), nitrate reductase (nar), nitrite reductase (nir) and poly phosphate kinase (ppk) enzyme in the cell free extracts and PCR amplification of nar , nir and ppk genes in the isolated strain provided further evidences for the nutrient removal possibility. A possible pathway of for nitrogen removal by GS-5 is suggested. [ABSTRACT FROM AUTHOR]

With global population explosion, the available water resources are slowly being polluted due to the excessive human interference. To encounter this, it is the need of this hour to find out sustainable pollution remediating technologies to meet the stringent discharge standards for domestic as well as industrial wastewaters. In addition, those techniques should have the capabilities for effective implementation even in developing countries. Based on the available literatures, one such technique, named vermifilter, has been identified which takes care of almost all the sustainable and economical criteria for its effective implementation even in developing countries. The aim of this meta-analysis is to provide a comprehensive review on assessment mechanisms involved, factors affecting the process and performance of vermifiltration under different scenarios. The present review envisages the current state of the knowledge regarding physical, chemical and biological aspects related to the treatment mechanisms and effective functioning of earthworms. This review has also proposed several suggestive plans on its application at any proposed site. [ABSTRACT FROM AUTHOR]

Background: A novel MRI technique, employing dual contrast manganese-enhanced MRI (MEMRI) and delayed enhancement MRI (DEMRI), can evaluate the physiologically unstable peri-infarct region. Dual contrast MEMRI-DEMRI enables comprehensive evaluation of telmisartan to salvage the peri-infarct injury to elucidate the underlying mechanism of restoring the ischemic cardiomyopathy in the diabetic mouse model. Methods and results: Dual contrast MEMRI-DEMRI was performed on weeks 1, 2, and 4 following initiation of telmisartan treatment in 24 left anterior descendent artery ligated diabetic mice. The MRI images were analyzed for core infarct, peri-infarct, left ventricular end-diastolic, end-systolic volumes, and the left ventricular ejection fraction (LVEF). Transmission electron microscopy (TEM) and real-time PCR were used for ex vivo analysis of the myocardium. Telmisartan vs. control groups demonstrated significantly improved LVEF at weeks 1, 2, and 4, respectively (33 ± 7 %*** vs. 19 ± 5 %, 29 ± 3 %*** vs. 22 ± 4 %, and 31 ± 2 %*** vs 18 ± 6 %, ***p < 0.001). The control group demonstrated significant differences in the scar volume measured by MEMRI and DEMRI, demonstrating peri-infarct injury. Telmisartan group significantly salvaged the peri-infarct injury. The myocardial effects were validated by TEM, which confirmed the presence of the injured but viable cardiomyocyte morphology in the peri-infarct region and by low cytometry of venous blood, which demonstrated significantly increased circulating endothelial progenitor cells (EPCs). Conclusion: The improved cardiac function in ischemic cardiomyopathy of diabetic mice by telmisartan is attributed to the attenuation of the peri-infarct injury by the angiogenic efects of EPCs to salvage the injured cardiomyocytes. Dual-contrast MEMRI-DEMRI technique tracked the therapeutic effects of telmisartan on the injured myocardium longitudinally. [ABSTRACT FROM AUTHOR]

Waste stabilization pond (WSP) is natural technology which can be installed in centralized or semi-centralized sewerage systems for treatment of domestic and industrial wastewater, septage and sludge, etc. WSPs are highly efficient, simple to construct, low cost and easy to operate. It can be used as secondary or tertiary treatment unit in a treatment plant either individually or in a coupling manner. The algal-bacterial symbiosis in WSP makes it completely natural treatment process for which it becomes economic as compared to other treatment technologies in terms of its maintenance cost and energy requirement. Effluent from WSP can also be used for agricultural purpose, gardening, watering road, vehicle wash, etc. Advance technologies are being integrated for better design and efficiency of WSP, but the main challenges are the separation and removal of algal species which lead to deterioration of the water if stays long. Research is necessary to maximize algal growth yield, selection of beneficial strain and optimizing harvesting methods. This review focuses on the treatment mechanism in the pond, affecting factors, types of ponds, design equation, cost analysis. • Factors considered in Design of Waste Stabilization Pond (WSP). • Various mechanism of pollutants removal in WSP. • Mathematical models available related to pond. • Cost analysis of stabilization pond. [ABSTRACT FROM AUTHOR]

The present study focuses on the decolorization of real silk dyebath effluents using analytical-grade magnesium chloride (MCl) with and without guar gum (GG) as a coagulant aid and industrial-grade polyaluminium chloride (PACl) and aluminum chlorohydrate (ACH) as coagulants. A higher decolorization efficiency of 97% at a very high dosage of 1800 mg L–1 was observed for MCl. However, considering the purity, dosage, decolorization efficiency, and quantity and quality of sludge production, ACH was found to be the best coagulant, giving 91% decolorization efficiency at a dose of just 100 mg L–1. To achieve this high degree of decolorization efficiency, the dosage for PACl was found to be approximately 50% higher than that of ACH. Effective decolorization (>90%) at a very low dosage (100 mg L–1) and minimal quantity of sludge production by ACH demonstrate that ACH is an effective coagulant for decolorization of silk dyebath effluents. [ABSTRACT FROM AUTHOR]

Context.--Granular cell tumors (GCTs) of the breast are rare neoplasms that mimic epithelial malignancy clinically and rarely occur in association with it. Granular cell tumors of the breast are not infrequently excised with positive margins. Reports describing risk of recurrence including data on margin status and follow-up are lacking. Objective.--To review our series of GCTs of the breast to determine the risk of recurrence if excised with positive or close margins. Design.--Cases of GCT of the breast were reviewed. Margin status of specimens was recorded as positive, close (<1 mm), and negative. Results.--Thirteen female patients with GCT of the breast were identified. Mean patient age at presentation was 45 years. Seventy-seven percent of patients were African American and 23% were white. African American patients presented on average 13 years earlier than white patients. Average tumor size was 1.22 cm. Fifteen percent of lesions had positive margins on excisional biopsy or lumpectomy and 31% had tumor cells within 1 mm of the margin. One of 13 patients (8%) had coexistent invasive ductal carcinoma. Average follow -up for the entire group was 77 months. Patients with positive margins remained free of tumor progression or recurrence for 89 months and patients with close margins also remained disease free during a 64-month follow-up period. No tumors recurred out of the entire group. Conclusion.--Granular cell tumors of the breast have little long-term risk for recurrence, even when excised with positive margins. Surgical evaluation after nonexcisional biopsy may still be indicated to assess for the possible association of colocalized carcinoma. [ABSTRACT FROM AUTHOR]

Introduction: Infection with SARS-CoV-2 is typically compared with influenza to contextualize its health risks. SARS-CoV-2 has been linked with coagulation disturbances including arterial thrombosis, leading to considerable interest in antithrombotic therapy for Coronavirus Disease 2019 (COVID-19). However, the independent thromboembolic risk of SARS-CoV-2 infection compared with influenza remains incompletely understood. We evaluated the adjusted risks of thromboembolic events after a diagnosis of COVID-19 compared with influenza in a large retrospective cohort. Methods: We used a US-based electronic health record (EHR) dataset linked with insurance claims to identify adults diagnosed with COVID-19 between April 1, 2020 and October 31, 2020. We identified influenza patients diagnosed between October 1, 2018 and April 31, 2019. Primary outcomes [venous composite of pulmonary embolism (PE) and acute deep vein thrombosis (DVT); arterial composite of ischemic stroke and myocardial infarction (MI)] and secondary outcomes were assessed 90 days post-diagnosis. Propensity scores (PS) were calculated using demographic, clinical, and medication variables. PS-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. Results: There were 417,975 COVID-19 patients (median age 57y, 61% women), and 345,934 influenza patients (median age 47y, 66% women). Compared with influenza, patients with COVID-19 had higher venous thromboembolic risk (HR 1.53, 95% CI 1.38–1.70), but not arterial thromboembolic risk (HR 1.02, 95% CI 0.95–1.10). Secondary analyses demonstrated similar risk for ischemic stroke (HR 1.11, 95% CI 0.98–1.25) and MI (HR 0.93, 95% CI 0.85–1.03) and higher risk for DVT (HR 1.36, 95% CI 1.19–1.56) and PE (HR 1.82, 95% CI 1.57–2.10) in patients with COVID-19. Conclusion: In a large retrospective US cohort, COVID-19 was independently associated with higher 90-day risk for venous thrombosis, but not arterial thrombosis, as compared with influenza. These findings may inform crucial knowledge gaps regarding the specific thromboembolic risks of COVID-19. [ABSTRACT FROM AUTHOR]

Obscure gastrointestinal (GI) bleeding is relatively common but difficult to manage. By definition, diagnosis of a specific etiology is particularly challenging. We report the diagnostic use of provocative angiography in a patient with recurrent obscure GI bleeding. Although provocative angiography led to localization of bleeding and allowed specific treatment (placement of a 2-mm long, 0.010-inch diameter platinum coil, resulting in cessation of bleeding for 2 months), ultimately, the use of provocative angiography delayed specific diagnosis in our patient. We conclude that provocative angiography is a potentially powerful adjunct in the management of obscure GI bleeding, but that caution is required when using it. Provocative angiography should be reserved for patients who have had adequate imaging studies with negative results. [ABSTRACT FROM AUTHOR]

Nitrogen and phosphorous are indispensable for growth and vitality of living beings, hence termed as nutrients. However, discharge of nutrient rich waste streams to aquatic ecosystems results in eutrophication. Therefore, nutrient removal from wastewater is crucial to meet the strict nutrient discharge standards. Similarly, nutrient recovery from waste streams is vital for the realization of a circular economy by avoiding the depletion of finite resources. This manuscript presents analysis of existing information on different conventional as well as advanced treatment technologies that are commonly practiced for the removal of nutrient from domestic wastewater. First, the information pertaining to the biological nutrient removal technologies are discussed. Second, onsite passive nutrient removal technologies are reviewed comprehensively. Third, advanced nutrient removal technologies are summarized briefly. The mechanisms, advantages, and disadvantages of these technologies along with their efficiencies and limitations are discussed. An integrated approach for simultaneous nutrient removal and recovery is recommended. The fifth section of the review highlights bottlenecks and potential solutions for successful implementation of the nutrient removal technologies. It is anticipated that the review will offer an instructive overview of the progress in nutrient removal and recovery technologies and will illustrate necessity of further investigations for development of efficient nutrient removal and recovery processes. [Display omitted] • Conventional and advanced nutrient removal technologies are concisely reviewed. • Bacillus cereus GS-5 exhibits potential of simultaneous nitrogen and phosphorous removal. • Integrated approach for simultaneous nutrient removal and recovery is recommended. • Nutrient recovery from wastewater helps in closing the loop for resource utilization. [ABSTRACT FROM AUTHOR]

The stability of slope is usually characterized by many parameters which are mostly uncertain in nature. Deterministic approach is usually followed to calculate the factor of safety of a slope, but it does not depict the true state of the slope. Hence, a probabilistic approach is a better alternative, which can quantify the probability of failure of a slope under uncertain input parameters. In the present study, slope stability assessment of Pakhi landside is carried out using finite element modelling (FEM) to ascertain the stability conditions of the multilayer slope under both deterministic and probabilistic framework. The multilayer configurations of the profiles are established from the electrical resistivity tomography (ERT). The shear strength reduction (SSR) method is employed to determine the critical strength reduction factor of the slope considering four random variables, namely, cohesion (c), angle of internal friction (ϕ), Poisson’s ratio (ν) and elastic modulus (E) of each individual layers. The deterministic factor of safety values along two considered profiles namely, section X–X′ and Y–Y′ are calculated as 1.41 and 1.25, respectively. A data driven machine learning algorithm is used to build a computationally efficient surrogate model to perform Monte Carlo Simulations (MCS). MCS are performed for two different values of coefficient of variation, i.e., 5% and 15% for all the four random variables of all the layers. The proposed method has no idealization regarding the layering configuration and the failure surface. Probabilistic analysis has been made exhaustive and computationally efficient. The probabilistic analysis indicates good adherence with the recent landslide incident in the field. Further, the analysis indicates that the proposed methodology is favourable and useful tool for the system reliability analysis of landslide slopes. Research highlights: Electrical resistivity tomography (ERT) interpretations could delineate sub-surface geometry of lithological layers of the landslide slope. Numerical simulation is performed using the finite element modelling. Sampling of random variables is done using the Latin Hypercube sampling technique. Probabilistic analysis is performed using the MARS-based surrogate model for Monte-Carlo simulation (MCS) with two values of CoV, viz., 5% and 10%. Efficiency of machine learning algorithm to incorporate with the stand alone FE code is demonstrated to build a surrogate model for an efficient probabilistic slope stability analysis. [ABSTRACT FROM AUTHOR]

Background: The diagnostic utility of cardiovascular magnetic resonance (CMR) is limited during the early stages of myocarditis. This study examined whether ferumoxytol-enhanced CMR (FE-CMR) could detect an earlier stage of acute myocarditis compared to gadolinium-enhanced CMR. Methods: Lewis rats were induced to develop autoimmune myocarditis. CMR (3 T, GE Signa) was performed at the early- (day 14, n = 7) and the peak-phase (day 21, n = 8) of myocardial inflammation. FE-CMR was evaluated as % myocardial dephasing signal loss on gradient echo images at 6 and 24 h (6 h- & 24 h-FE-CMR) following the administration of ferumoxytol (300μmolFe/kg). Pre- and post-contrast T2* mapping was also performed. Early (EGE) and late (LGE) gadolinium enhancement was obtained after the administration of gadolinium-DTPA (0.5 mmol/kg) on day 14 and 21. Healthy rats were used as control (n = 6). Results: Left ventricular ejection fraction (LVEF) was preserved at day 14 with inflammatory cells but no fibrosis seen on histology. EGE and LGE at day 14 both showed limited myocardial enhancement (EGE: 11.7 ± 15.5%; LGE: 8.7 ± 8.7%; both p = ns vs. controls). In contrast, 6 h-FE-CMR detected extensive myocardial signal loss (33.2 ± 15.0%, p = 0.02 vs. EGE and p < 0.01 vs. LGE). At day 21, LVEF became significantly decreased (47.4 ± 16.4% vs control: 66.2 ± 6.1%, p < 0.01) with now extensive myocardial involvement detected on EGE, LGE, and 6 h-FE-CMR (41.6 ± 18.2% of LV). T2* mapping also detected myocardial uptake of ferumoxytol both at day 14 (6 h R2* = 299 ± 112 s− 1vs control: 125 ± 26 s− 1, p < 0.01) and day 21 (564 ± 562 s− 1, p < 0.01 vs control). Notably, the myocardium at peak-phase myocarditis also showed significantly higher pre-contrast T2* (27 ± 5 ms vs control: 16 ± 1 ms, p < 0.001), and the extent of myocardial necrosis had a strong positive correlation with T2* (r = 0.86, p < 0.001). Conclusions: FE-CMR acquired at 6 h enhance detection of early stages of myocarditis before development of necrosis or fibrosis, which could potentially enable appropriate therapeutic intervention. [ABSTRACT FROM AUTHOR]

Purpose: HCM is the most common inherited cardiomyopathy. Historically, there has been poor correlation between genotype and phenotype. However, CMR has the potential to more accurately assess disease phenotype. We characterized phenotype with CMR in a cohort of patients with confirmed HCM and high prevalence of genetic testing. Methods: Patients with a diagnosis of HCM, who had undergone contrast-enhanced CMR were identified. Left ventricular mass index (LVMI) and volumes were measured from steady-state free precession sequences. Late gadolinium enhancement (LGE) was quantified using the full width, half maximum method. All patients were prospectively followed for the development of septal reduction therapy, arrhythmia or death. Results: We included 273 patients, mean age 51.2 ± 15.5, 62.9% male. Of those patients 202 (74.0%) underwent genetic testing with 90 pathogenic, likely pathogenic, or rare variants and 13 variants of uncertain significance identified. Median follow-up was 1138 days. Mean LVMI was 82.7 ± 30.6 and 145 patients had late gadolinium enhancement (LGE). Patients with beta-myosin heavy chain (MYH7) mutations had higher LV ejection fraction (68.8 vs 59.1, p<0.001) than those with cardiac myosin binding protein C (MYBPC3) mutations. Patients with MYBPC3 mutations were more likely to have LVEF < 55% (29.7% vs 4.9%, p = 0.005) or receive a defibrillator than those with MYH7 mutations (54.1% vs 26.8%, p = 0.020). Conclusions: We found that patients with MYBPC3 mutations were more likely to have impaired ventricular function and may be more prone to arrhythmic events. Larger studies using CMR phenotyping may be capable of identifying additional characteristics associated with less frequent genetic causes of HCM. [ABSTRACT FROM AUTHOR]

Abstract Background Manganese-enhanced MRI (MEMRI) detects viable cardiomyocytes based on the intracellular manganese uptake via L-type calcium-channels. This study aimed to quantify myocardial viability based on manganese uptake by viable myocardium in the infarct core (IC), peri-infarct region (PIR) and remote myocardium (RM) using T1 mapping before and after MEMRI and assess their association with cardiac function and arrhythmogenesis. Methods Fifteen female swine had a 60-minute balloon ischemia-reperfusion injury in the LAD. MRI (Signa 3T, GE Healthcare) and electrophysiological study (EPS) were performed 4 weeks later. MEMRI and delayed gadolinium-enhanced MRI (DEMRI) were acquired on LV short axis. The DEMRI positive total infarct area was subdivided into the regions of MEMRI-negative non-viable IC and MEMRI-positive viable PIR. T1 mapping was performed to evaluate native T1, post-MEMRI T1, and delta R1 (R1 post -R1 pre , where R1 equals 1/T1) of each territory. Their correlation with LV function and EPS data was assessed. Results PIR was characterized by intermediate native T1 (1530.5 ± 75.2 ms) compared to IC (1634.7 ± 88.4 ms, p = 0.001) and RM (1406.4 ± 37.9 ms, p < 0.0001). Lower post-MEMRI T1 of PIR (1136.3 ± 99.6 ms) than IC (1262.6 ± 126.8 ms, p = 0.005) and higher delta R1 (0.23 ± 0.08 s−1) of PIR than IC (0.18 ± 0.09 s−1, p = 0.04) indicated higher myocardial manganese uptake of PIR compared to IC. Post-MEMRI T1 (r = −0.57, p = 0.02) and delta R1 (r = 0.51, p = 0.04) of PIR correlated significantly with LVEF. Conclusions PIR is characterized by higher manganese uptake compared to the infarct core. In the subacute phase post-IR, PIR viability measured by post-MEMRI T1 correlates with cardiac function. Graphical abstract Unlabelled Image Highlights • Myocardial viability of the peri-infarct region can be measured by manganese uptake. • The peri-infarct region has distinct T1 values pre- and post- manganese injection. • Quantitative manganese signals of the peri-infarct region correlates with LV function. [ABSTRACT FROM AUTHOR]

COVID-19 disrupted healthcare routines and prompted rapid telemedicine implementation. We investigated the drivers of visit modality selection (telemedicine versus in-person) in primary care clinics at an academic medical centre.We used electronic medical record data from March 2020 to May 2022 from 13 primary care clinics (N = 21,031 new, N = 207,292 return visits), with 55% overall telemedicine use. Hierarchical logistic regression and cross-validation methods were used to estimate the variation in visit modality explained by the patient, clinician and visit factors as measured by the mean-test area under the curve (AUC).There was significant variation in telemedicine use across clinicians (ranging from 0–100%) for the same visit diagnosis. The strongest predictors of telemedicine were the clinician seen for new visits (mean AUC of 0.79) and the primary visit diagnosis for return visits (0.77). Models based on all patient characteristics combined accounted for relatively little variation in modality selection, 0.54 for new and 0.58 for return visits, respectively. Amongst patient characteristics, males, patients over 65 years, Asians and patient's with non-English language preferences used less telemedicine; however, those using interpreter services used significantly more telemedicine.Clinician seen and primary visit diagnoses were the best predictors of visit modality. The distinction between new and return visits and the minimal impact of patient characteristics on visit modality highlights the complexity of clinical care and warrants research approaches that go beyond linear models to uncover the emergent causal effects of specific technology features mediated by tasks, people and organisations. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the yield of pleural fluid cytology for diagnosis of malignancy secondary to metastatic squamous cell lung cancer as compared to bronchogenic adenocarcinoma. B METHODS: b We performed a retrospective review of patients with non-small cell lung cancer (NSCLC) who developed pleural effusions to evaluate the diagnostic yield of pleural fluid cytology from serial thoracentesis and pleural biopsy. [Extracted from the article]

Alpha-1 adrenergic receptors mediate adaptive effects in the heart and cardiac myocytes, and a myocyte survival pathway involving the alpha-1A receptor subtype and ERK activation exists in vitro. However, data in vivo are limited. Here we tested A61603 (N-[5-(4,5-dihydro-1H-imidazol-2-yl)-2-hydroxy-5,6,7,8-tetrahydronaphthalen-1-yl]methanesulfonamide), a selective imidazoline agonist for the alpha-1A. A61603 was the most potent alpha-1-agonist in activating ERK in neonatal rat ventricular myocytes. A61603 activated ERK in adult mouse ventricular myocytes and protected the cells from death caused by the anthracycline doxorubicin. A low dose of A61603 (10 ng/kg/d) activated ERK in the mouse heart in vivo, but did not change blood pressure. In male mice, concurrent subcutaneous A61603 infusion at 10 ng/kg/d for 7 days after a single intraperitoneal dose of doxorubicin (25 mg/kg) increased survival, improved cardiac function, heart rate, and cardiac output by echocardiography, and reduced cardiac cell necrosis and apoptosis and myocardial fibrosis. All protective effects were lost in alpha-1A-knockout mice. In female mice, doxorubicin at doses higher than in males (35–40 mg/kg) caused less cardiac toxicity than in males. We conclude that the alpha-1A-selective agonist A61603, via the alpha-1A adrenergic receptor, prevents doxorubicin cardiomyopathy in male mice, supporting the theory that alpha-1A adrenergic receptor agonists have potential as novel heart failure therapies. [ABSTRACT FROM AUTHOR]