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Abstract Background While statistically rare in comparison to other head and neck tumours, parotid gland swellings are often encountered in clinical practice where one of the primary goals of examination becomes distinction between benign and malignant lesions. Hallmarks of malignancy are characterized by a female preponderance, history of radiation exposure, a positive family history, and clinical features like heterogenous consistency, fixity to skin/underlying tissues and involvement of facial nerve. Case presentation Here we present a case of parotid swelling in a 72-year old gentleman from south India that had a curious amalgamation of both benign and malignant features. Conclusions While benign, the risk of malignant transformation and rare multicentric occurrence indicates a need to keep basal cell adenoma in mind in case of parotid swellings and their surgical management.

Introduction: Fixed orthodontic appliances create areas of plaque stagnation leading to an increase in the volume, structure, and composition of plaque. This increases the chances of decalcification and white spot lesions. Oil pulling, an ancient practice involving swishing oil in the mouth, has demonstrated a significant reduction in plaque scores after 45 days, and a reduction in salivary Streptococcus mutans concentration in few studies done in nonorthodontic subjects. The aim was to compare the concentration of S. mutans in plaque around orthodontic brackets in patients using oil pulling with sesame oil and those on routine oral hygiene. Subjects and Methods: Twenty subjects requiring fixed orthodontic treatment were divided into two equal groups: Group A-Oil pulling and Group B-Control. All subjects were instructed to follow common oral hygiene methods and in addition, Group A was instructed to perform oil pulling for 30 days starting 1 month after placement of fixed appliances. Plaque specimens were collected from labial surfaces of maxillary lateral incisors and quantification of S. mutans was done using real-time polymerase chain reaction. Mean and standard deviations for descriptive statistics, paired, and unpaired sample t-tests were analyzed. Results: Comparison of S. mutans concentration between T1 and T2 demonstrated a significant difference in both control and study groups. The experimental group showed significantly lesser S. mutans concentration compared to the control group. Conclusions: Oil-pulling therapy with sesame oil resulted in a statistically significant reduction in the concentration of S. mutans in the plaque around orthodontic brackets.

An alternating way of replacing the missing teeth involves the use of implants. In implant dentistry, an adequate amount of bone is crucial for the long-term prognosis. Bone volume loss can be caused by congenital, post-traumatic or post-surgical abnormalities, as well as disease processes. In scenarios with a bone defect at a site, where the primary stability of an implant cannot be established or where implant placement is not achievable in the best possible position for subsequent prosthetic therapy, guided bone regeneration before implantation represents the method of choice. During implant placement, a partial discrepancy between the implant’s surface and the socket’s osseous walls frequently leaves the peri-implant region with insufficient bone. It has been shown that barrier membranes can be successfully placed to allow the peri-implant space to be filled with new bone rather than lowering the height of the alveolar ridge to produce a sufficient breadth for implantation.

Abstract Tumor tissue collections are used to uncover pathways associated with disease outcomes that can also serve as targets for cancer treatment, ideally by comparing the molecular properties of cancer tissues to matching normal tissues. The quality of such collections determines the value of the data and information generated from their analyses including expression and modifications of nucleic acids and proteins. These biomolecules are dysregulated upon ischemia and decompose once the living cells start to decay into inanimate matter. Therefore, ischemia time before final tissue preservation is the most important determinant of the quality of a tissue collection. Here we show the impact of ischemia time on tumor and matching adjacent normal tissue samples for mRNAs in 1664, proteins in 1818, and phosphosites in 1800 cases (tumor and matching normal samples) of four solid tumor types (CRC, HCC, LUAD, and LUSC NSCLC subtypes). In CRC, ischemia times exceeding 15 min impacted 12.5% (mRNA), 25% (protein), and 50% (phosphosites) of differentially expressed molecules in tumor versus normal tissues. This hypoxia- and decay-induced dysregulation increased with longer ischemia times and was observed across tumor types. Interestingly, the proteomics analysis revealed that specimen ischemia time above 15 min is mostly associated with a dysregulation of proteins in the immune-response pathway and less so with metabolic processes. We conclude that ischemia time is a crucial quality parameter for tissue collections used for target discovery and validation in cancer research.

Abstract Purpose This study investigates three different calibration methods for the selection of background pixel intensity. Methods Film‐by‐Film (FBF) Method: Each film serves as its own control. Batch‐by‐Film (BBF) Method: A single film is used as a control for all calibration films. Generic (GEN) Method: A generic value (65535) is used as the background pixel value for all calibration films.Three calibration curves were established for the red, green, blue, and RGB channels, and the Radbard NIH (image) curve‐fitting model was used to predict the dose. Sensitivity at different dose levels was quantified by calculating the first derivative of each color channel. Results The GEN method exhibited a difference of up to 6% between the predicted and delivered doses below 2 Gy. The changes in optical density when using the GEN method differed significantly (p

Abstract Background Early detection through screening dramatically improves lung cancer survival rates, including among war Veterans, who are at heightened risk. The effectiveness of low dose computed tomography scans in lung cancer screening (LCS) prompted the Veteran’s Affairs Lung Precision Oncology Program (VA LPOP) to increase screening rates. We aimed to develop an adaptive population health tool to determine adequate resource allocation for the program, with a specific focus on primary care providers, nurse navigators, and radiologists. Methods We developed a tool using C + + that uses inputs that represents the process of the VA LCS program in Ann Arbor, Michigan to calculate FTEs of human resource needs to screen a given population. Further, we performed a sensitivity analysis to understand how resource needs are impacted by changes in population, screening eligibility, and time allocated for the nurse navigators’ tasks. Results Using estimates from the VA LCS Program as demonstrative inputs, we determined that the greatest number of full-time equivalents required were for radiologists, followed by nurse navigators and then primary care providers, for a target population of 75,000. An increase in the population resulted in a linear increase of resource needs, with radiologists experiencing the greatest rate of increase, followed by nurse navigators and primary care providers. These resource requirements changed with primary care providers, nurse navigators and radiologists demonstrating the greatest increase when 1–20, 20–40 and > 40% of Veterans accepted to be screened respectively. Finally, when increasing the time allocated to check eligibility by the nurse navigator from zero to three minutes, there was a linear increase in the full-time equivalents required for the nurse navigator. Conclusion Variation of resource utilization demonstrated by our user facing tool emphasizes the importance of tailored strategies to accommodate specific population demographics and downstream work. We will continue to refine this tool by incorporating additional variability in system parameters, resource requirements following an abnormal test result, and resource distribution over time to reach steady state. While our tool is designed for a specific program in one center, it has wider applicability to other cancer screening programs.

Introduction: Overactive bladder (OAB) syndrome is a chronic disease characterized by urinary urgency with or without urge incontinence, frequency, and nocturia and antimuscarinic drugs such as solifenacin have been the mainstay of treatment. Mirabegron a beta 3 adrenoreceptor agonist has recently gained importance in the management of OAB. The rationale of the study is that mirabegron improves the storage function without affecting voiding which increases the therapeutic effectiveness. The objective was to determine the therapeutic effectiveness of mirabegron versus solifenacin. Methods: A prospective observational study was conducted on 298 patients with OAB syndrome attending the urology outpatient department of government medical college after obtaining institutional review board clearance. Patients of both genders, belonging to the 18–65 years of age group, attending the urology outpatient department were selected for the study. Patients were evaluated using the OAB-validated 8-question awareness tool (OAB-V8 score) before and after receiving drugs by direct questionnaire method after receiving informed consent. Patients were prescribed either solifenacin 5 mg or mirabegron 25 mg once daily by the urologist. Follow-up was done after 4 and 12 weeks. Adverse drug reactions of the drugs were assessed using the Central Drug Standard Control Organization suspected adverse reaction (ADR) form, and ADRs were notified to the nearest ADR monitoring center. Results: The mirabegron group showed maximum improvement in the mean OAB-V8 score values from baseline at 4 weeks (12.82 ± 5.86, P < 0.001) and 12 weeks (5.74 ± 3.31, P < 0.001) when compared to solifenacin. OAB-V8 scores of the solifenacin group also showed significant improvement from the baseline at 4 weeks (15.30 ± 5.54, P < 0.001) and 12 weeks (8.05 ± 4.59, P < 0.001). Heart rate, systolic, and diastolic blood pressures did not show significant changes during the follow-up in both the study groups. Thirteen patients developed ADRs such as dry mouth (four patients) and constipation (nine patients) in the solifenacin group. No ADRs were noted in the mirabegron group. Conclusion: Mirabegron showed maximum improvement in the OAB-V8 scores in patients with OAB syndrome, although the solifenacin group also showed improvement. Adverse effects were less in the mirabegron group when compared to the solifenacin group.

Abstract Introduction This study aims to evaluate the long-term clinical outcomes of excisional goniotomy with the Kahook Dual Blade (KDB) in the management of various types of glaucoma. Methods This was a retrospective, noncomparative chart review of 90 eyes of 53 patients with glaucoma that underwent standalone KDB goniotomy (KDB-alone group) or KDB goniotomy with concomitant phacoemulsification (KDB-phaco group) between October 2015 and October 2017. Surgical success was defined as an intraocular pressure (IOP) reduction by ≥ 20% at the last follow-up with no surgical reinterventions required and a final IOP ≥ 4 mmHg and ≤ 21 mmHg. We also report on changes from baseline in IOP, number of glaucoma medications, best-corrected visual acuity (BCVA), and visual field parameters, for up to 72 months. Results At 72 months, mean (standard deviation [SD]) IOP was reduced from 17.5 (5.7) to 13.6 (3.0) mmHg (P

Conventional complete dentures remain to be an important treatment for edentulous patients, especially those of low socioeconomic status. This study is a retrospective analysis that aims to elucidate influencing factors of post-insertion complications and patient satisfaction. Clinical records of 164 patients who received both maxillary and mandibular complete dentures at an Australian university teaching clinic were assessed and analysed. The parameters considered include reason for attendance, presenting clinical status, experience of operator, numbers of appointments for fabrication and adjustment, post-insertion complications and events, and patient satisfaction. The differences among selected attributes were analysed using a Mann–Whitney test, Chi-square test, or Kruskal–Wallis test where applicable, while the relationships between discrete variables were assessed by Kendall’s correlation. First, the number of appointments for fabrication differed significantly between female (6.8 ± 1.8) and male patients (6.2 ± 1.3; p = 0.025) and between student (6.7 ± 1.7) and professional operators (6.0 ± 1.1; p = 0.015). The number of appointments for adjustment was significantly associated with patient age (τb = 0.167, p = 0.003) and sharply declined after the first three months. Second, post-insertion pain was the most frequent complication, and it was significantly more associated with the mandible than the maxilla (χ2 = 21.670, p = 0.000). Similarly, mandibular complete dentures were also significantly more associated with post-insertion reline than the maxillary (χ2 = 8.804, p = 0.003). Lastly, patient satisfaction was significantly associated with patient attendance with old/worn dentures (χ2 = 9.468, p = 0.002), as well as the absence of retention/stability issues (χ2 = 41.712, p = 0.000), post-insertion reline (χ2 = 29.300, p = 0.000), or denture replacement (χ2 = 13.968, p = 0.000). Dissatisfied patients had a significantly higher age (70.9 ± 11.0 vs. 66.2 ± 12.6; p = 0.023) and number of appointments for adjustment (4.9 ± 3.5 vs. 3.1 ± 2.1; p = 0.001) than satisfied patients. In summary, these findings revealed the above factors that influence the fabrication process, post-insertion complication, and patient satisfaction of conventional complete dentures. Future research may include analysis of cases completed at private practices and consideration of other potentially relevant factors such as denture usage and mental status.

Abstract Background Cervical cancer often originates from cervical cell dysplasia. Previous studies mainly focused on surgical margins and high-risk human papillomavirus persistence as factors predicting recurrence. New research highlights the significance of positive findings from endocervical curettage (ECC) during excision treatment. However, the combined influence of surgical margin and ECC status on dysplasia recurrence risk has not been investigated. Methods In this retrospective study, data from 404 women with high-grade squamous intraepithelial lesions (HSIL) who underwent large loop excision of the transformation zone (LLETZ) were analyzed. Records were obtained retrospectively from the hospital’s patient database including information about histopathological finding from ECC, endocervical margin status with orientation of residual disease after LLETZ, recurrent/persistent dysplasia after surgical treatment and need for repeated surgery (LLETZ or hysterectomy). Results Patients with cranial (= endocervical) R1-resection together with cells of HSIL in the ECC experienced re-surgery 17 times. With statistical normal distribution, this would have been expected to happen 5 times (p

A radio labeling of a graph G is a function [Formula: see text] such that for every pair of distinct vertices [Formula: see text], where diam(G) denotes the diameter of the graph and d(u, v) is the distance between the vertices u and v. The span of a radio labeling f of a graph G is the difference between the least and the largest labels assigned by f and is denoted by, span(f). The radio number of a graph G denoted by, rn(G), is the least positive integer s, such that there exists a radio labeling of G with span s. In this paper, we study the radio labeling of a special class of split graphs called biconvex split graphs of diameter three and we obtain both a lower bound and an upper bound for the radio number of biconvex split graphs of diameter three. Further, we determine the radio number of biconvex split graphs with three maximum degree vertices having disjoint independent neighbors.

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the Western world, with a higher prevalence among Europeans and North Americans than that in Africans, Hispanics, and Asians. Advanced AMD is categorized as atrophic (dry) or exudative (wet/neovascular age-related macular degeneration [nAMD]). Dry AMD is characterized by progressive geographic atrophy of the retinal pigment epithelium and outer retinal layers, whereas nAMD is characterized by new vessels that invade the subretinal and/or subretinal pigment epithelium spaces. Existing treatments delay the onset of advanced AMD and reverses vision loss for a couple of years before atrophy usually decreases central visual acuity. We searched PubMed and Medline databases from January 1, 1980, to December 1, 2023, using the following search terms: macular degeneration, choroidal neovascularization, geographic atrophy, drusen, age-related maculopathy, AMD, ARMD, and anti-VEGF. Relevant articles in English (or English translations) were retrieved and reviewed. Bibliographies of the identified manuscripts were also reviewed to identify relevant studies. Age-related macular degeneration most commonly affects people older than 55 years. Visual prognosis varies, with advanced lesions (nAMD and geographic atrophy) leading to rapid, progressive loss of central vision and contrast sensitivity. Although AMD is not a life-threatening disease, reduced vision profoundly compromises quality of life and necessitates living assistance for many patients. Over the past 2 decades, advances in prevention (vitamin supplementation) and therapy (antivascular endothelial growth factor and complement inhibitor drugs) have reduced vision loss and blindness. Further research is needed to decrease the incidence of blindness in patients with advanced disease.

BACKGROUND AND OBJECTIVES: Exposure to endocrine-disrupting chemicals and organic dye pollution is associated with an increased risk of toxicity, hazard, and cancer due to their widespread use. Exogenous endocrine disruptors are responsible for interfering with reproduction and development because they can either stimulate or decrease endogenous hormone responses. This work explores the feasibility of human hair biochar as a potential adsorbent for possible solid waste management processes to minimize environmental pollution. Malachite green and bisphenol-A were selected as model pollutants, and the response surface methodology was used to identify the maximal removal of these hazardous substances.METHODS: Samples of human hair waste are collected and processed. After air drying for 24 hours, it was carbonized in a hot air oven at 200 degrees Celsius for 3 hours to obtain the human hair biochar. The biochar was subjected to various instrumental analyses to ascertain the characteristics of the biochar. Both malachite green and bisphenol-A adsorption experiments are performed in a batch method. Initial pollutant concentration (100 milligrams per liter), the volume of pollutant solution (50 milliliters), temperature (37 degrees Celsius), and agitation speed of orbital shaker (150 rotation per minute) are established as constants in this investigation. Data obtained from an Ultra Violet-Visible spectrophotometer was used to design expert software to calculate adsorption efficiency. Data variables A, B, and C included the potential of hydrogen (3, 6, 9), duration (60, 150, 240 minutes), and adsorbent dose (0.1, 0.3, 0.5 gram per liter) in the Response Surface Methodology experiment.FINDINGS: The human hair biochar is characterized by analytical methods, and Brunauer, Emmett, and Teller analysis revealed that it has a porous nature and extensive surface area, an amorphous structure, and various functional groups. The efficiency of adsorbent investigated over Malachite green and bisphenol-A in a batch experiment and performance variation of three parameters: A: potential of hydrogen (3, 6, 9), B: duration (60, 150, 240 minutes), and C: Human hair biochar dose (0.1, 0.3, 0.5 gram per liter) were evaluated via box-behnken design. Through analysis of variance and numerical expectation, the optimal potential of hydrogen, duration, and Human hair biochar dose was predicted as 3, 150 minutes, and 0.5 grams per liter, which resulted in a maximum removal of 96 percent for malachite green and 83 percent for bisphenol-A.CONCLUSION: This study demonstrated the facile heat-assisted development of biochar from human hair waste as a potential candidate for environmental remediation. The topography, structure, surface area, and functional group analysis of human hair biochar were carried out using analytical techniques that reveal the biochar has the potential for adsorbent characteristics. The adsorption efficiency of human hair biochar was demonstrated for malachite green (96 percent) and bisphenol-A (83 percent) response surface methodology under optimal conditions. The results suggested the model's relevance for the sorption of dyes and contaminants. The current study concludes that biochar can be prepared using a less expensive method and can be an alternate option to remove the dyes and other emerging contaminants in the aqueous matrix.

Abstract COVID-19 disease is associated with a hyperinflammatory, pro-thrombotic state and a high mortality. Our primary objective was to assess the change in inflammatory and thrombotic markers associated with PEX, and secondary objectives were to assess the effects of PEX on progression of respiratory failure and incidence of acute thrombotic events. We conducted a prospective, phase II, non-blinded randomised control trial of plasma exchange compared to standard of care in critically ill adults with severe COVID-19 associated respiratory failure, requiring supplemental oxygen or ventilatory support and elevated thrombo-inflammatory markers (LDH, CRP, ferritin, and D-Dimer). Patients randomised to receive PEX were treated with a daily single volume plasma exchange for a minimum of five days. Twenty-two patients were randomised of who 11 received PEX. Demographic and clinical characteristics were similar between groups at presentation. PEX was associated with a significant reduction in pro-thrombotic markers FVIII, VWF and VWF Ag: ADAMTS 13 ratio (p 0.99) at 28 days. PEX successfully reduced pro-thrombotic markers, although was not associated with reduction in inflammatory markers, respiratory failure, or thrombotic events. Trial registration: (NCT04623255); first posted on 10/11/2020.

Abstract Background and aims This study aimed to determine the performance of AIMS65, Rockall score, and Glasgow-Blatchford score (GBS) in patients presenting with upper gastrointestinal bleeding (UGIB) and to compare results between patients with nonvariceal UGIB (NVUGIB) and variceal UGIB (VUGIB). Methods We conducted a single-center prospective cohort study between December 2021 and December 2022. A total of 400 patients who met the inclusion criteria were included in the study, out of which 232 patients (58%) had NVUGIB and 168 patients (42%) had VUGIB. Receiver operating characteristic curve analysis was performed for all outcomes for comparison. Results Of the total of 400 patients with UGIB, 232 patients (58%) had NVUGIB, and 168 patients (42%) had VUGIB. The present study showed that GBS (AUROC 0.729, 95% CI: 0.598–0.859, p = 0.001) and RS (AUROC 0.693, 95% CI: 0.579–0.807, p = 0.005) but not AIMS65 (AUROC, 0.545, 95% CI: 0.412–0.679, p = 0.500) predicted in-hospital and overall 6-week mortality in patients with UGIB. All the three scores predicted need for blood transfusion and poor composite outcomes (p 0.05). Conclusions GBS and RS were superior to AIMS65 in predicted in-hospital and overall 6-week mortality in all the three categories: OUGIB, NVUGIB, and VUGIB patients.

Background and Objectives: “Synchronous videoconference telemedicine in neonatal office-practice” (SyNTOP) has been a routine practice in our center since the start of the COVID-19-related lockdown. We recently reported our experience with the “success” of this practice in terms of removing the need to visit the hospital over the next 48 h after the teleconsult. Methods: Secondary results of this retrospective descriptive study which analyzed 829 consults are presented in this manuscript. Data from electronic medical records of those who availed teleconsultation facility between March 2020 and April 2021 were retrieved. Relevant information about clinical presentation, findings from the video call, demographic information, decisions made by the clinician, and outcomes were collected. Best efforts were made to obtain follow-up information by the clinical team or guest–patient relations officers. Results: Fever (n = 118) and acute diarrheal disease (n = 58) were the common presenting complaints; most (80.5% and 95.5%, respectively) were resolved without physical examination; 265 developmental assessments were completed by video-facilitated checks. Fast-track vaccination visits where queries were resolved and bills paid online, were an innovation where well babies could avoid queues and possible exposure to crowds. One-fourths of SyNTOP were from outside the district, and 1.4% were from foreign countries. Conclusions: Teleconsults were successfully conducted in neonatal office practice for different health-care enquiries. Strategies such as fast-track vaccinations and online developmental follow-up assessments were performed by leveraging technology. We highlight the benefits of these innovations in our center with a view to enhance their uptake elsewhere. Such approaches have the potential to increase health equity and access to specialty health care.

Abstract Medical Internet of Things (M-IoT) synchronizes medical devices in a network to provide smart healthcare monitoring to doctors and to provide an interactive model for patients. This embedded networked system gained lots of importance in the last few years. Now almost every hospital adopts M-IoT. Though it had a lot of challenges in the initial stages of implementation such as feasibility, accuracy, and autonomy, now it has bridged the flaws with the help of several researchers in this field. But still, M-IoT lags behind in security and privacy aspects due to which attackers can intrude on the network and exploit patients’ health data. By examining the various intensive security threats imposed on M-IoT a unique way of handling and transferring data over the network is proposed in this paper. From our research findings, this would resolve the data security issues in M-IoT and commence the next advancements.

Aluminum (Al) holds a pivotal role in augmenting the energetic potential of solid fuel formulations. Its incorporation can notably amplify the energy yield upon combustion. Nevertheless, challenges such as ignition delay and incomplete combustion have hindered its optimal utilization. In the context of hybrid rocket propulsion, where reignition and high regression rates are sought, a promising solution lies in harnessing the potential of metal-fluoropolymer combinations. This paper explores the influence of polytetrafluoroethylene (PTFE) and Viton fluoropolymer additives on the combustion and regression rates of hydroxyl‑terminated polybutadiene (HTPB)-based solid fuels loaded with nano-aluminum (nAl). To comprehensively address these objectives, binary composites of nAl-PTFE and nAl-Viton were prepared using high-energy ball-milling, and the resulting mixtures were incorporated into hydroxyl‑terminated polybutadiene (HTPB)-based fuel through a vacuum-casting technique. The ignition and combustion characteristics of the solid fuels, as well as the post-combustion products, were examined using an opposed flow burner setup to gain insights into their oxidation and combustion mechanisms. The findings demonstrate that the inclusion of PTFE and Viton in nAl has a positive impact on the ignition delay time, combustion behavior, and regression rates of the solid fuels. The HTPB-nAl-PTFE(S3) sample exhibited the shortest ignition delay time of 108 ms, outperforming the other tested samples (S1: 227 ms, S2: 182 ms, S4: 122 ms). Furthermore, the addition of nAl to pure HTPB resulted in an average regression rate of 0.3–0.6 mm/s for HTPB-nAl (S2), representing a two fold improvement compared to pure HTPB-based samples. Compared to the baseline HTPB fuel, HTPB-nAl-PTFE(S3) demonstrated a significant increase in regression rate by approximately 178%, while HTPB-nAl-Viton(S4) exhibited an increased regression rate of 122%. These results highlight the positive influence of fluoropolymers on combustion behavior, ultimately enhancing the overall performance of the fuel. Additionally, the study observed gas-phase reactions during the combustion process, including the reaction between nano-aluminum (nAl) and fluoride, the intermediate product of Al oxidation, and the decomposition products of fluoride. These reactions resulted in the faster fracture of the alumina (Al2O3) shell, leading to improved heat release and regression rate performance.

Introduction: Chronic obstructive pulmonary disease (COPD) is the third most fatal disease globally. Acute deterioration of the patient's respiratory symptoms is known as an acute exacerbation of COPD (AECOPD), that goes beyond usual variations and result in change in medications. Ambroxol (ABX) and N-acetylcysteine (NAC), are mainly used as mucolytics in the treatment of AECOPD. Methodology: This prospective observational study examines effectiveness of ABX and NAC in COPD patients by assessing the quality of cough relief, peak expiratory flow rate (PEFR), length of hospital stay, quality of life (QOL) and reduction in symptoms of COPD. Leicester Cough Questionnaire (LCQ); Breathlessness, Cough and Sputum scale (BCSS)and St. George Respiratory Questionnaire (SGRQ) scales are used to evaluate patient condition before and after the treatment. Results: The mean duration of hospital stay for NAC and ABX were found to be 8 ± 3.6 and 9.9 ± 3.9 days, respectively. Lung function in both groups improved with a change in percentage mean score of PEFR. Reduction in symptoms of COPD was evident in both groups by decrease in mean BCSS score from admission to discharge. Our study also demonstrated better QOL in both groups using SGRQ. LCQ showed a mean increase in all domains: physical, psychological and social. Conclusion: It was concluded that both ABX and NAC leads to betterment in lung function, cough relief and control AECOPD. Hence, this study gives a signal to clinicians about these treatment options along with standard therapy of COPD for a better therapeutic outcome.

Objectives: Converging evidence indicates that Horticultural Therapy (HT) contributes to significant reductions in stress, loneliness, and depression, notable risk factors for suicidality. This pilot study aimed to assess the initial feasibility and acceptability of HT when virtually administered. Intervention: Telehealth-delivered horticultural therapy (TeleHT) was administered to groups of Veterans, including those with elevated suicide risk over the course of four weeks. Participants were each sent a package through the mail of at-home gardening supplies that were used to facilitate multisensory, nature experiences during weekly HT sessions administered via Zoom. Outcome measures: Participants completed thermometer-based scales for the suicide risk factors of stress, loneliness, depression, and pain before and after each TeleHT session. Post-intervention qualitative assessments were completed upon the conclusion of the four-week intervention. Results: Significant reductions in stress, depression, and loneliness risk were observed from weekly pre- to post-session measures (p

This paper presents a novel approach to power conversion in electric vehicle (EV) applications. The proposed converter, a Bridgeless Single Stage Positive Luo Converter (BSPLC), is optimized to enhance efficiency and reduce losses in low-capacity EVs. Traditional converters experience higher losses due to their passive components and bridge circuits. By eliminating the bridge components, the converter achieves higher efficiency. An intelligent fuzzy logic controller is employed to provide adaptive control and stabilize output under varying input conditions, improving performance and response time. The converter design is further optimized through parameter tuning and simulation to achieve minimal ripple and maximum power efficiency at 92%. The proposed solution is ideal for low-capacity EVs, as it ensures enhanced power conversion, reduced thermal stress, and improved battery life. The study demonstrates the converter’s capability to meet the growing demands for energy-efficient solutions in modern electric mobility.

Abstract Hybrid ion capacitors (HICs) have aroused extreme interest due to their combined characteristics of energy and power densities. The performance of HICs lies hidden in the electrode materials used for the construction of battery and supercapacitor components. The hunt is always on to locate the best material in terms of cost‐effectiveness and overall optimized performance characteristics. Functionalized biomass‐derived porous carbons (FBPCs) possess exquisite features including easy synthesis, wide availability, high surface area, large pore volume, tunable pore size, surface functional groups, a wide range of morphologies, and high thermal and chemical stability. FBPCs have found immense use as cathode, anode and dual electrode materials for HICs in the recent literature. The current review is designed around two main concepts which include the synthesis and properties of FBPCs followed by their utilization in various types of HICs. Among monovalent HICs, lithium, sodium, and potassium, are given comprehensive attention, whereas zinc is the only multivalent HIC that is focused upon due to corresponding literature availability. Special attention is also provided to the critical factors that govern the performance of HICs. The review concludes by providing feasible directions for future research in various aspects of FBPCs and their utilization in HICs.

Using oral swabs to collect the remnants of stomach content regurgitation during rumination in dairy cows can replicate up to 70% of the ruminal bacterial community, offering potential for broad-scale population-based studies on the rumen microbiome. The swabs collected from dairy cows often vary widely with respect to sample quality, likely due to several factors such as time of sample collection and cow rumination behavior, which may limit the ability of a given swab to accurately represent the ruminal microbiome. One such factor is the color of the swab, which can vary significantly across different cows. Here, we hypothesize that darker-colored swabs contain more rumen contents, thereby better representing the ruminal bacterial community than lighter-colored swabs. To address this, we collected oral swabs from 402 dairy cows and rumen samples from 13 cannulated cows on a research farm in Wisconsin, United States and subjected them to 16S rRNA sequencing. In addition, given that little is known about the ability of oral swabs to recapitulate the ruminal fungal community, we also conducted ITS sequencing of these samples. To correlate swab color to the microbiota we developed and utilized a novel imaging approach to colorimetrically quantify each swab from a range of light to dark. We found that swabs with increasing darkness scores were significantly associated with increased bacterial alpha diversity (p

Background: Grass tetany or hypomagnesemia is a metabolic syndrome causing acute neurological manifestations in periparturient ruminants grazing on rapidly grown green pastures or cereal crops with high potassium or nitrogen content and low magnesium levels. Clinical reports of naturally occurring grass tetany in goats are least described in the literature and it is considered to be a rare disease. The present study documents the clinical manifestation and management of hypomagnesemia-associated excitatory neuropathy in two Theileria spp. infected Malabari goats presented to the small ruminant medicine OP unit of the University Veterinary Hospital and Teaching Veterinary Clinical Complex, Mannuthy, Thrissur, Kerala, India. Methods: The first goat was in the last trimester of pregnancy and was showing signs of hyperesthesia, limping, difficulty in standing, and inappetence for the last six hours. The second goat was kidded six weeks back and was showing recurrent epileptic seizures and hyporexia from the previous day. Both the goats were kept on extensive grazing from the forest areas with unidentified lush vegetation. On clinical evaluation, both the goats were showing persistent excitatory neurological signs. Fecal examination, peripheral blood smear examination, PCR screening panel for hemoparasites, Complete Blood Count, and serum levels of calcium, magnesium, and glucose were evaluated. Results: A significant reduction in serum magnesium levels was noted in both cases along with the varied glucose levels. Theileria spp. infection was noticed in blood smear examination and confirmed by PCR. The goats responded well to the therapy using MIFEX™ and other supportive medications and showed uneventful recovery. Conclusion: It is suggested that the farmers should be vigilant enough while allowing goats to graze in unknown vegetation and prevent indiscriminate fodder intake during periods of drought. This is the first documented report of hypomagnesemic excitatory neurologic symptoms in Theileria spp. infected periparturient Malabari goats and showing response to appropriate therapy.

Purpose: Although musculoskeletal involvement is the common presentation, studies have reported the incidence of sports related ocular trauma. Here we present the case reports of two patients who sustained injury in one of the fast growing sports – the pickleball, during play without eye protection. Observations: Two patients with history of injury during pickleball play presented to our clinic with varying spectrum of ocular presentations. First patient had an anterior segment involvement with hyphema and elevated intraocular pressure, and the second patient had both anterior and posterior segment involvement causing angle recession and commotio retinae. Conclusion: Ocular injuries related to various sports have been extensively described, our intent is to increase the awareness about the possible ocular injuries related to rising pickleball and that improved safety measures and appropriate education to the players could prevent such ocular injuries.

Abstract Weeds are attractive models for basic and applied research due to their impacts on agricultural systems and capacity to swiftly adapt in response to anthropogenic selection pressures. Currently, a lack of genomic information precludes research to elucidate the genetic basis of rapid adaptation for important traits like herbicide resistance and stress tolerance and the effect of evolutionary mechanisms on wild populations. The International Weed Genomics Consortium is a collaborative group of scientists focused on developing genomic resources to impact research into sustainable, effective weed control methods and to provide insights about stress tolerance and adaptation to assist crop breeding.

Background: In terms of rapidness, testing methodology and sensitivity, point-of-care (POC) testing devices provide quality in haemoglobin (Hb) check for safe donation of blood. Methods: This was a prospective observational study in a tertiary care centre. Capillary finger-prick samples obtained from 100 blood donors were analysed prior to donation using reagent-free cuvettes (DiaSpect Tm), digital haemoglobinometer (True Hb) and Hb photometer (HemoCue 301). Venous samples were drawn for analysis on haematology analyser. Donors were accepted based on copper sulphate method acceptance criteria. The performance of the devices was evaluated considering automated haematology analyser (Sysmex XN 1000) as the gold standard. Results: The mean Hb value using Sysmex XN 1000, HemoCue 301, DiaSpect Tm and True Hb were 14.8 ± 1.1 g/dL, 15.4 ± 1.8 g/dL, 15.3 ± 1.8 g/dL and 18.6 ± 2.8 g/dL, respectively. The sensitivity of True Hb, DiaSpect Tm, HemoCue 301 and copper sulphate method were 96.8%, 96.8%, 3.7% and 98.9%, respectively. DiaSpect Tm had a specificity of 60% whereas specificity of True Hb and copper sulphate method were 20% each. True Hb, HemoCue 301, DiaSpect Tm and copper sulphate had a positive predictive value of 95.8%, 94.7%, 97.9% and 95.9% and accuracy of 93%, 89%, 95% and 95%, respectively. The mean turnaround time was 1 sec for DiaSpect Tm whereas 35.3 sec and 2.6 sec for True Hb and HemoCue 301, respectively. The copper sulphate test provided the highest rate of donor’s acceptance, despite unacceptable Hb levels. Conclusions: DiaSpect Tm has the advantage of rapid turnaround time, high specificity and accuracy when compared to gold standard method.

BACKGROUND: Primary care physicians play an essential role in the health of older adults as they are frequently the first point of contact. Their positive attitude and knowledge influence the quality of care provided to patients with dementia and their caregivers. This study examined the attitudes of primary care physicians towards dementia care and their confidence in their own dementia-care skills. MATERIALS AND METHODS: This cross-sectional study was conducted among 316 primary care physicians working in Eastern Province of Saudi Arabia. Data were collected using a structured questionnaire that included questions related to demographic characteristics, Dementia Care Attitude Scale (DCAS) to assess attitudes towards dementia, and Confidence in Dementia Care Skills (CDCS) Scale to measure confidence. Data were analyzed using SPSS version 29; mean and standard deviation (SD) were computed for continuous and categorical variables were described using frequencies and percentages. Mann Whitney U test and Kruskal Wallis test were used to compare attitude and confidence scores by categorical variables. RESULTS: The mean DCAS score was 36.4 ± 5.41 out of 50. On a scale ranging from 15 to 75, the mean CDCS was 51.89 ± 10.20. A statistically significant (P < 0.05) relation was found between confidence and professional rank, knowing close relatives with dementia, and number of dementia and elderly patients treated. Overall, 78.9% of physicians lacked confidence to prescribe memory medications; 32% felt that dementia management was generally more frustrating than rewarding. CONCLUSION: Primary care physicians had a positive attitude toward caring for patients with dementia. However, they lacked confidence in their dementia care skills in several areas. The confidence in their diagnostic skills was higher than their management skills. Most challenging skills were recognizing and managing behavioral symptoms of dementia. Need to develop educational and training interventions that target healthcare providers to help improving dementia care in primary care settings.

Abstract Objective This article introduces a novel approach called Digital Weighted Multi Criteria Decision Making (DWMCDM) that employs interval valued fuzzy sets to select the best contractor for building projects. The contractor is chosen based on the pre-qualification and bid evaluation phases. In the first phase, the distance between the actual and required skills of the significant criteria is determined, and it is then converted into digital weighted distances to identify the maximum number of criteria related to the specific project of each contractor. The second step ranks the best contractor based on the bid price and digital weighted distances. Results The suggested technique integrates the pre-qualification and bid review phases to address project award delays and other restrictions. Finally, a real-world application is addressed to demonstrate the applicability of the proposed approach to any type of interval valued fuzzy inputs.

Abstract The survival of leukemic cells is significantly influenced by the bone marrow microenvironment, where stromal cells play a crucial role. While there has been substantial progress in understanding the mechanisms and pathways involved in this crosstalk, limited data exist regarding the impact of leukemic cells on bone marrow stromal cells and their potential role in drug resistance. In this study, we identify that leukemic cells prime bone marrow stromal cells towards osteoblast lineage and promote drug resistance. This biased differentiation of stroma is accompanied by dysregulation of the canonical Wnt signaling pathway. Inhibition of Wnt signaling in stroma reversed the drug resistance in leukemic cells, which was further validated in leukemic mice models. This study evaluates the critical role of leukemic cells in establishing a drug-resistant niche by influencing the bone marrow stromal cells. Additionally, it highlights the potential of targeting Wnt signaling in the stroma by repurposing an anthelmintic drug to overcome the microenvironment-mediated drug resistance.

Abstract Friedreich’s ataxia is a degenerative and progressive multisystem disorder caused by mutations in the highly conserved frataxin (FXN) gene that results in FXN protein deficiency and mitochondrial dysfunction. While gene therapy approaches are promising, consistent induction of therapeutic FXN protein expression that is sub-toxic has proven challenging, and numerous therapeutic approaches are being tested in animal models. FXN (hFXN in humans, mFXN in mice) is proteolytically modified in mitochondria to produce mature FXN. However, unlike endogenous hFXN, endogenous mFXN is further processed into N-terminally truncated, extra-mitochondrial mFXN forms of unknown function. This study assessed mature exogenous hFXN expression levels in the heart and liver of C57Bl/6 mice 7–10 months after intravenous administration of a recombinant adeno-associated virus encoding hFXN (AAVrh.10hFXN) and examined the potential for hFXN truncation in mice. AAVrh.10hFXN induced dose-dependent expression of hFXN in the heart and liver. Interestingly, hFXN was processed into truncated forms, but found at lower levels than mature hFXN. However, the truncations were at different positions than mFXN. AAVrh.10hFXN induced mature hFXN expression in mouse heart and liver at levels that approximated endogenous mFXN levels. These results suggest that AAVrh.10hFXN can likely induce expression of therapeutic levels of mature hFXN in mice.

Rumor data classification in social media seems essential research due to its dependency on digital communications, and this rumor data makes social media unstable. In Natural Language Processing, word embedding, feature extraction, and classification techniques are challenging in rumor detection research. In this research, two phases of feature extraction techniques are involved for performing word embedding and deep feature extraction. In the first phase, Bidirectional Encoder Representations from Transformers with the Optimized Convolutional Neural Network (BERT-OPCNN) techniques are integrated, and in the second phase, the fastText with information gain of an ant colony optimization technique (FIAC) is proposed. Finally, the vectors formed using BERT-OPCNN and the FIAC embedding model are classified using a customized Bi-LSTM. The experiment is computed and compared with existing techniques for balanced and unbalanced datasets. The results evaluation shows that our proposed FIAC embedding with BERT-OPCNN outperforms all other existing techniques using the customized Bi-LSTM classifier.

The UK Deceased Donor Kidney Transplant Outcome Prediction (UK-DTOP) Tool, developed using advanced artificial intelligence (AI), significantly enhances the prediction of outcomes for deceased-donor kidney transplants in the UK. This study analyzed data from the UK Transplant Registry (UKTR), including 29,713 transplant cases between 2008 and 2022, to assess the predictive performance of three machine learning models: XGBoost, Random Survival Forest, and Optimal Decision Tree. Among these, XGBoost demonstrated exceptional performance with the highest concordance index of 0.74 and an area under the curve (AUC) consistently above 0.73, indicating robust discriminative ability and calibration. In comparison to the traditional Kidney Donor Risk Index (KDRI), which achieved a lower concordance index of 0.57, the UK-DTOP model marked a significant improvement, underscoring its superior predictive accuracy. The advanced capabilities of the XGBoost model were further highlighted through calibration assessments using the Integrated Brier Score (IBS), showing a score of 0.14, indicative of precise survival probability predictions. Additionally, unsupervised learning via k-means clustering was employed to identify five distinct clusters based on donor and transplant characteristics, uncovering nuanced insights into graft survival outcomes. These clusters were further analyzed using Bayesian Cox regression, which confirmed significant survival outcome variations across the clusters, thereby validating the model’s effectiveness in enhancing risk stratification. The UK-DTOP tool offers a comprehensive decision-support system that significantly refines pre-transplant decision-making. The study’s findings advocate for the adoption of AI-enhanced tools in healthcare systems to optimize organ matching and transplant success, potentially guiding future developments in global transplant practices.

Water contamination resulting from the presence of organic dye pollutants in the ecosystem is a significant issue in the 21st century, that requires urgent resolution. Utilizing an effective nanocatalyst for the removal of dyes from water is a viable solution to address this problem. In this study, we proposed two distinct approaches for synthesizing δ-MnO2 nanostructures: an environmentally friendly, “green” method (MG) and a “cost-effective” hydrothermal method (MH). The leaf extract of Clinacanthus nutans was used for the preparation of MG, while MnSO4 was used for MH as a reducing agent, along with KMnO4, with the reaction time fixed at 90 °C. X-ray diffraction analysis confirmed that both approaches yielded δ-MnO2 nanostructures with a monoclinic Birnessite phase. The MG sample displayed a coagulated nanoflake-like morphology, as observed in FESEM images. On the other hand, the MH sample exhibited a distinct nanoflower morphology. The materials' optical properties were investigated using UV–visible spectra analysis, revealing direct bandgap energies of 2.2 eV and 2.58 eV for the MG and MH, respectively. The surface area of the MG sample was found to be higher as compared to the MH nanoflower, showcasing a mesoporous structure. XPS analysis was employed to determine the oxidation states of the elements. The effect of varying pH levels on the degradation of Methyl Orange dye by the two nanocatalysts was investigated. The results demonstrated that acidic pH led to higher decolouration efficiency, particularly notable for the MG nanocatalyst. Consequently, this study illustrates that the green δ-MnO2 nanocatalyst effectively degrades methyl orange dye under acidic conditions through photocatalysis.

ABSTRACTAZD1222 (ChAdOx1 nCoV-19) is a replication-deficient adenoviral vectored coronavirus disease-19 (COVID-19) vaccine that is manufactured as SII-ChAdOx1 nCoV-19 by the Serum Institute of India Pvt Ltd following technology transfer from Oxford University/AstraZeneca. The non-inferiority of SII-ChAdOx1 nCoV-19 with AZD1222 was previously demonstrated in an observer-blind, phase 2/3 immuno-bridging study (trial registration: CTRI/2020/08/027170). In this analysis of immunogenicity and safety data 6 months post first vaccination (Day 180), 1,601 participants were randomized 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (immunogenicity/reactogenicity cohort n = 401) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort n = 1,200). Immunogenicity was measured by anti-severe acute respiratory syndrome coronavirus 2 spike (anti-S) binding immunoglobulin G and neutralizing antibody (nAb) titers. A decline in anti-S titers was observed in both vaccine groups, albeit with a greater decline in SII-ChAdOx1 nCoV-19 vaccinees (geometric mean titer [GMT] ratio [95% confidence interval (CI) of SII-ChAdOx1 nCoV-19 to AZD1222]: 0.60 [0.41–0.87]). Consistent similar decreases in nAb titers were observed between vaccine groups (GMT ratio [95% CI]: 0.88 [0.44–1.73]). No cases of severe COVID-19 were reported following vaccination, while one case was observed in the placebo group. No causally related serious adverse events were reported through 180 days. No thromboembolic or autoimmune adverse events of special interest were reported. Collectively, these data illustrate that SII-ChAdOx1 nCoV-19 maintained a high level of immunogenicity 6 months post-vaccination. SII-ChAdOx1 nCoV-19 was safe and well tolerated.

Introduction People with diabetes are at risk of developing chronic kidney disease. However, limited data are available to quantify their risk of kidney function decline in South Asia. This study evaluates the rate and predictors of kidney function decline among people with type 2 diabetes in South Asia.Research design and methods We analyzed data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) Trial to quantify the rate of decline in estimated glomerular filtration rate (eGFR) in people with type 2 diabetes (n=1146) over 2.5 years of follow-up. The CARRS Trial evaluated a multicomponent intervention of decision-supported electronic health records and non-physician care coordinator to improve diabetes management at 10 diabetes clinics in India and Pakistan. We used linear mixed models to estimate eGFR slope among all participants and tested the association of eGFR slope with demographic, disease-related, and self-care parameters, accounting for randomization and site.Results The mean age of participants was 54.2 years, with a median duration of diabetes of 7.0 years (IQR: 3.0 - 12.0) and median CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) eGFR of 83.6 (IQR: 67.7 to 97.9) mL/min/1.73 m2. The overall mean eGFR slope was −1.33/mL/min/1.73 m2/year. There were no differences in the eGFR slope by treatment assignment to intervention versus usual care. In the adjusted regression model, pre-existing diabetic retinopathy (slope difference: −2.11; 95% CI: −3.45 to –0.77), previous cardiovascular disease (−1.93; 95% CI: −3.45 to –0.40), and statins use (−0.87; 95% CI: −1.65 to –0.10) were associated with faster eGFR decline.Conclusions People with diabetes receiving care at urban diabetes clinics in South Asia experienced annual eGFR decline at two times higher rate than that reported from other contemporary international diabetes cohorts. Risk factors for faster decline were similar to those previously established, and thus care delivery models must put an additional emphasis on kidney protective therapies among subgroups with microvascular and macrovascular diabetes complications.Trial registration number NCT01212328.

The study into Wireless Sensor Network (WSN) has grown more crucial as a result of the many Internet of Things (IoT) applications. Energy – Harvesting (EH) technology can extend the lifespan of WSN; however, because the nodes would be difficult to get to during energy harvesting, an energy-efficient routing protocol should be developed. The use of clustering in this study balances energy consumption across all Sensor Node (SN) and reduces traffic and overhead throughout the data transmission phases of WSN. Cluster Head (CH) selection step of the Optimized Energy Efficient-Hierarchical Clustering Based Routing (OEE-HCR) technique involves sending data to the closest CH. In order to analyse and transmit each cluster data, CH will need to use more energy, which will hasten and asymmetrically deplete the network. Whale Optimization Algorithm (WOA) algorithm is introduced for the best number of clusters formation with dynamically selecting the CH. Experimentation analysis, results are measured using First Node Dead (FND), the Half Node Dead (HND), Last Node Dead (LND), and Maximum Lifetime Coverage (MLC) at the time of number of data transmission rounds performed in routing algorithms.

Abstract Purpose Real world evidence is crucial to understanding the diffusion of new oncologic therapies, monitoring cancer outcomes, and detecting unexpected toxicities. In practice, real world evidence is challenging to collect rapidly and comprehensively, often requiring expensive and time‐consuming manual case‐finding and annotation of clinical text. In this Review, we summarise recent developments in the use of artificial intelligence to collect and analyze real world evidence in oncology. Methods We performed a narrative review of the major current trends and recent literature in artificial intelligence applications in oncology. Results Artificial intelligence (AI) approaches are increasingly used to efficiently phenotype patients and tumors at large scale. These tools also may provide novel biological insights and improve risk prediction through multimodal integration of radiographic, pathological, and genomic datasets. Custom language processing pipelines and large language models hold great promise for clinical prediction and phenotyping. Conclusions Despite rapid advances, continued progress in computation, generalizability, interpretability, and reliability as well as prospective validation are needed to integrate AI approaches into routine clinical care and real‐time monitoring of novel therapies.

Context: Despite efforts to enhance equity, disparities in early palliative care (PC) access for historically minoritized patients with advanced breast cancer (ABC) persist. Insight into patient and clinician perspectives are needed to inform future models aimed at improving equity in PC access and outcomes. Objectives: To explore qualitative barriers and facilitators to early PC access in an urban setting with Black and Latina women with ABC. Methods: In this qualitative descriptive study, we conducted one-on-one interviews with Black and Latina women with ABC (N = 20) and interdisciplinary clinicians (N = 20) between February 2022 and February 2023. Participants were recruited from urban academic and community cancer clinics. Transcripts were analyzed using an inductive coding and thematic analysis approach. Results: Barriers identified by both patients and clinicians included lack of communication between oncology, PC, and primary care teams, limited understanding of PC among patients and non-PC clinicians, language and health literacy-related communication challenges, and racism and marginalization, including implicit bias and lack of diverse racial/ethnic representation in the supportive care workforce. Facilitators identified by both patients and clinicians included patient-to-patient referrals, support groups breaking cultural stigma on topics including self-advocacy and PC, referrals from trusted providers, and community organizations’ abilities to overcome challenges related to social determinants of health, most specifically logistical and financial support. Conclusions: Patients and clinicians reported similar barriers and facilitators to PC access, most commonly through the lens of care coordination and communication. These findings will inform future adaptation of a culturally and linguistically care model to improve access to early PC services for Black and Latina women with ABC.

In this work, maze shaped single input multiple output (SIMO) antenna array resonating at multiband is developed with a dimension 299 mm × 175 mm x 0.19 mm for THz and millimeter range applications at frequencies ranging from 30 GHz to 300 GHz. Initially 2-element array was designed with a return loss of −25dB and a gain of 4 dB which will be insufficient for long distance performance in mm wave communication. Hence, a 4-element array rectangular maze shaped single antenna was designed with improved return loss of −46dB and better gain of 8.1 dB which can support beyond 5G mm wave communication. The performance analysis for the designed antenna is verified with the various substrates such as Nylon, FR-4, and Rogers. The simulation results shows that the designed antenna provides better performance with Nylon substrate. The maximum return loss obtained is −46dB at 40 GHz while using Nylon substrate with efficiency of 97.5%.

A series of novel Di‑tert‑butyl(E)-4‑hydroxy-6-(hydroxyimino)-4-methyl-2-arylcyclohexane-1,3-dicarboxylate derivatives were synthesized in two steps with excellent yields. In the First step, tert‑butylacetoacetate and substituted benzaldehyde were directly condensed using methylamine catalyst in ethanol as a solvent to create substituted 1,3-bis(tert‑butoxycarbonyl)-cyclohexanone. A second stage involved synthesizing BHMAC (Ar = pH and Ar = p-OCH3C6H4) by treating the respective ketones in an ethanol medium with hydroxylamine hydrochloride and sodium acetate trihydrate. NMR, IR, and mass spectroscopy were used to confirm the oxime derivatives. Density functional theory calculations at the DFT/B3LYP level using 6–31G++ (d, p) have been performed to reproduce the structure and geometry in order to understand the electrical behavior of synthesized compounds. Using bovine serum albumin, a protein denaturation test is used to assess anti-inflammatory efficacy. BHMAC demonstrates conventional pharmacological molecules in its notable anti-inflammatory action and has effects that are dependent on concentration. Utilizing the phosphomolybdenum technique, the total antioxidant activity of the 2,4-bis(tert‑butoxycarbonyl)-cyclohexanone oxime (2 a and 2 b) was assessed standard Vitamin C medications .The results revealed that 2 a & 2 b possess significant antioxidant activity Molecular docking experiments indicate that the chemical may interact with anti-inflammatory and antioxidant causing enzymes. Strong binding energies and inhibition constants with cyclooxygenase (PDB: 1PGG) are demonstrated by BHMAC, suggesting that it is a suitable material for investigations pertaining to anti-inflammatory. BHMAC's remarkable anti-inflammatory and antioxidant properties, together with its synthesis and characterization, highlight its potential as a viable candidate for more biomedical research and therapeutic development.

In this paper, we determine some degree-based topological indices, such as the Sombor index, the first and second Zagreb indices, the forgotten topological index, the Narumi–Katayama index, the first and second multiplicative Zagreb indices, the atom-bond connectivity index, and eccentricity-based topological indices such as total eccentricity, the first and second Zagreb eccentricity indices, and the eccentricity connectivity index of the zero divisor graph with vertex set non-zero zero divisors of the reduced ring of the direct product of three finite fields.

During a cadaveric dissection session, a distinctive neurovascular pattern was identified in the left leg of a 66-year-old female cadaver. The Anterior Tibial Artery (ATA), while maintaining a normal origin and luminal diameter, exhibited a shortened course, terminating in the upper third of the leg. In the lower third of the leg, the Fibular Artery (FA), known as the peroneal artery, traversed through the interosseous membrane to the anterior compartment, persisting as the Dorsalis Pedis Artery (DPA). The Deep Fibular Nerve (DFN), displaying a usual course in the upper two-thirds of the leg, crossed the variant DPA posteriorly and divided into two terminal branches on its posterolateral side. The medial terminal branch proceeded to cross the artery anteriorly within the anterior tarsal tunnel. This distinctive relationship between the DFN and the variant DPA renders the nerve susceptible to compression and may result in “anterior tarsal tunnel syndrome”.

Abstract Effective treatment of breast cancer relies heavily on early detection. Routine annual mammography is a widely accepted screening technique that has resulted in significantly improving the survival rate. However, it suffers from low sensitivity resulting in high false positives from screening. To overcome this problem, adjunctive technologies such as ultrasound are employed on about 10% of women recalled for additional screening following mammography. These adjunctive techniques still result in a significant number of women, about 1.6%, who undergo biopsy while only 0.4% of women screened have cancers. The main reason for missing cancers during mammography screening arises from the masking effect of dense breast tissue. The presence of a tumor results in the alteration of temperature field in the breast, which is not influenced by the tissue density. In the present paper, the IRI-Numerical Engine is presented as an adjunct for detecting cancer from the surface temperature data. It uses a computerized inverse heat transfer approach based on Pennes’s bioheat transfer equations. Validation of this enhanced algorithm is conducted on twenty-three biopsy-proven breast cancer patients after obtaining informed consent under IRB protocol. The algorithm correctly predicted the size and location of cancerous tumors in twenty-four breasts, while twenty-two contralateral breasts were also correctly predicted to have no cancer (one woman had bilateral breast cancer). The tumors are seen as highly perfused and metabolically active heat sources that alter the surface temperatures that are used in heat transfer modeling. Furthermore, the results from this study with twenty-four biopsy-proven cancer cases indicate that the detection of breast cancer is not affected by breast density. This study indicates the potential of the IRI-Numerical Engine as an effective adjunct to mammography. A large scale clinical study in a statistically significant sample size is needed before integrating this approach in the current protocol.

Abstract Background Cancer cells can overexpress CD47, an innate immune checkpoint that prevents phagocytosis upon interaction with signal regulatory protein alpha (SIRPα) expressed in macrophages and other myeloid cells. Several clinical trials have reported that CD47 blockade reduces tumor growth in hematological malignancies. However, CD47 blockade has shown modest results in solid tumors, including melanoma. Our group has demonstrated that histone deacetylase 6 inhibitors (HDAC6is) have immunomodulatory properties, such as controlling macrophage phenotype and inflammatory properties. However, the molecular and cellular mechanisms controlling these processes are not fully understood. In this study, we evaluated the role of HDAC6 in regulating the CD47/SIRPα axis and phagocytosis in macrophages. Methods We tested the role of HDAC6is, especially Nexturastat A, in regulating macrophage phenotype and phagocytic function using bone marrow-derived macrophages and macrophage cell lines. The modulation of the CD47/SIRPα axis and phagocytosis by HDAC6is was investigated using murine and human melanoma cell lines and macrophages. Phagocytosis was evaluated via coculture assays of macrophages and melanoma cells by flow cytometry and immunofluorescence. Lastly, to evaluate the antitumor activity of Nexturastat A in combination with anti-CD47 or anti-SIRPα antibodies, we performed in vivo studies using the SM1 and/or B16F10 melanoma mouse models. Results We observed that HDAC6is enhanced the phenotype of antitumoral M1 macrophages while decreasing the protumoral M2 phenotype. In addition, HDAC6 inhibition diminished the expression of SIRPα, increased the expression of other pro-phagocytic signals in macrophages, and downregulated CD47 expression in mouse and human melanoma cells. This regulatory role on the CD47/SIRPα axis translated into enhanced antitumoral phagocytic capacity of macrophages treated with Nexturastat A and anti-CD47. We also observed that the systemic administration of HDAC6i enhanced the in vivo antitumor activity of anti-CD47 blockade in melanoma by modulating macrophage and natural killer cells in the tumor microenvironment. However, Nexturastat A did not enhance the antitumor activity of anti-SIRPα despite its modulation of macrophage populations in the SM1 tumor microenvironment. Conclusions Our results demonstrate the critical regulatory role of HDAC6 in phagocytosis and innate immunity for the first time, further underscoring the use of these inhibitors to potentiate CD47 immune checkpoint blockade therapeutic strategies.

Metal additives play an essential role in explosive and propellant formulations. Boron (B) is widely used in propellant applications owing to its high energetic content. The addition of B to explosives and propellants increases their energy density, making them more efficient and powerful. Nevertheless, B forms oxide layers on its surface during combustion, slowing down the combustion rate and reducing rocket motor efficiency. To overcome this issue, other metal additives such as aluminum (Al), magnesium (Mg), and titanium (Ti) are revealed to be effective in boosting the combustion rate of propellants. These additives may improve the combustion rate and therefore enhance the rocket motor’s performance. The present study focused on preparing and investigating the ignition and combustion behavior of pure hydroxyl-terminated polybutadiene (HTPB)-B fuel supplemented with nano-titanium and nano-magnesium. The burn rates of HTPB-B fuel samples were evaluated on the opposed flow burner (OFB) under a gaseous oxygen oxidizer, for which the mass flux ranges from 22 kg/(m2·s) to 86 kg/(m2·s). The addition of Ti and Mg exhibited higher regression rates, which were attributed to the improved oxidation reaction of B due to the synergetic metal combustion effect. The possible combustion/oxidation reaction mechanism of B–Mg and B–Ti by heating the fuel samples at 900 °C and 1100 °C was also examined in a Nabertherm burnout furnace under an oxygen atmosphere. The post-combustion products were collected and further subjected to X-ray diffraction (XRD) and field emission scanning electron microscopy (FE-SEM) analyses to inspect the combustion behavior of B–Ti and B–Mg. It has been observed that the B oxide layer at the interface between B–Ti (B–Mg) is removed at lower temperatures, hence facilitating oxygen transfer from the surroundings to the core B. Additionally, Ti and Mg decreased the ignition delay time of B, which improved its combustion performance.

Objectives: Data are scarce on whether the composition of the lung microbiome (extending from the nasopharynx to the peripheral lung tissue) varies according to histology or grade of non–small cell lung cancer. We hypothesized that the composition of the lung microbiome would vary according to the histology and the grade of non–small cell lung cancer. Methods: We collected naso-oral and central lobar (cancer affected, ipsilateral unaffected, and contralateral unaffected) bronchoalveolar lavage fluid and brushing samples from patients with clinical early-stage lung cancer between July 2018 and February 2020 at a single academic center. We performed bacterial 16S rRNA sequencing and then compared clinical and pathologic findings with microbiome signatures. Results: Samples were collected from 28 patients. Microbial composition in affected lobes displayed unique enrichment of oropharyngeal bacterial species that was significantly different compared with that from the unaffected contralateral lobes; patients with chronic obstructive pulmonary disease had similar diversity to those without chronic obstructive pulmonary disease (P = .1312). The lung microbiome diversity in patients with adenocarcinoma was similar to those with squamous cell cancer (P = .27). There were no differences in diversity or composition in the unaffected lobes of patients with adenocarcinoma versus squamous cell cancer. There was a trend toward lower lung microbial diversity in poorly differentiated adenocarcinomas compared with well-differentiated adenocarcinomas (P = .08). Conclusions: The lung microbiota differs between cancer affected and unaffected lobes in the same patient. Furthermore, poorly differentiated lung cancers were associated with lower microbial diversity. Larger studies will be required to confirm these findings.

Coronary Artery Disease (CAD) is a key factor in several serious heart conditions, such as ischemic heart disease, myocardial infarction, and heart failure. Detecting and treating CAD early is crucial for preventing further progression of the disease. Computer-aided techniques are needed to automate the characterization of CAD conditions. In this paper, a novel approach for the automated identification of CAD utilizing improved energy estimation of electrocardiogram (ECG) signals is developed. Due to the multi-component nature of ECG and the nonlinear characteristics of energy operators, estimating their instantaneous energy may lead to cross-component interactions complicating the interpretation. To overcome this issue, variational mode decomposition with a data-driven and adaptively initialized number of modes is suggested to estimate the accurate energy of ECG beat. In this process, the instantaneous energy of each decomposed component is computed for enhanced energy estimation of each ECG beat. Multiple statistical features calculated from the localized region of ECG beat could effectively classify CAD-affected ECG beats with more than 99.80 % accuracy with an optimized ensemble classifier and a 10-fold cross validation scheme. Moreover, experimental findings have revealed the effectiveness of the proposed methodology when compared to contemporary approaches employing identical datasets.