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A composite radial filter was designed, fabricated and developed for the removal of agrochemicals particularly N, P, K and bacteriological contaminant in runoff water from rice field for recharging aquifer. Zeolite (Z), activated charcoal (C), coarse sand (CS) and gravel (G) filter materials were placed in annular concentric rings of composite radial filter in different combination of thickness in the ratio of 1:2:4:4, 1:3:4:4, 1:2:2:4, 1:3:2:4 and 0:2:1:2 for five treatments (T1, T2, T3, T4 and T5) respectively. Sodium hypochlorite solution (5%) injected at the rate of 0.1 ml per unit discharge (lps) through chlorination unit at the outlet of the radial filter decreased bacteriological contamination to

Introduction: This paper provides a summary of findings on the public’s knowledge and attitudes towards dementia. We aim to investigate if the attitudes of Singaporeans towards dementia have changed over the years by adopting a questionnaire used in a similar study in 2012. Methods: A cross-sectional, descriptive study was conducted through the dissemination of an existing, online questionnaire to participants above 16 years of age. Out of 1500 subjects, results from 1373 participants were analysed. Descriptive statistics were used to analyze and compare results from the 2012 study while a latent class analysis (LCA) was performed to understand the categories of study participants based on varying levels of attitudes, knowledge and stigma. Results: The mean age of study participants was 43.8 (SD = 15.7). Majority of the participants were females (76.5%), between 51 to 60 years of age (29.6%) and belonged to the Chinese ethnic group (77.8%). Results demonstrated that there were significant differences in attitudes towards dementia between 2012 and 2021. There was a 70.2 % improvement in stigma-associated attitudes and an increase in correct responses to 4 out of 5 questions in the knowledge section. Conclusion: Findings of this study suggest that the general public has a better knowledge and more positive attitude towards dementia. This could have been attributed to higher literacy levels of the current study population and effectiveness of established outreach initiatives in Singapore. However, further research with a more balanced representation of ethnic and cultural groups would offer more comprehensive insights into dementia health literacy.

Timing of discharge after percutaneous coronary intervention (PCI) is a crucial aspect of procedural safety and patient turnover. We examined predictors and outcomes of same-day discharge (SDD) after non-elective PCI for non-ST elevation acute coronary syndromes (NSTE-ACS) in comparison with next-day discharge (NDD).Baseline demographic, clinical, and procedural data were collected as were in-hospital outcomes and post-PCI length of stay (LOS) for all patients undergoing non-elective PCI for NSTE-ACS between 2011 and 2014 at a central tertiary care center. Thirty day and 1-year mortality and bleeding as well as 30-day readmission rates were determined from social security record and medical chart review. Logistic regression was performed to identify predictors of SDD, and propensity-matched analysis was done to examine the differences in outcomes between NDD and SDD.Out of 2,529 patients who underwent non-elective PCI for NSTE-ACS from 2011 to 2014, 1,385 met the inclusion criteria (mean age = 63 years; 26% women) and were discharged either the same day of (N = 300) or the day after (N = 1,085) PCI. Thirty-day and one-year mortality and major bleeding rates were similar between the 2 groups. Logistic regression identified male sex, radial access, negative troponin biomarker status, and procedure start time as predictors of SDD. In propensity-matched analyses, there was no difference in 30-day mortality and readmission between SDD and NDD groups.SDD after non-elective PCI for NSTE-ACS may be a reasonable alternative to NDD for selected low-risk patients with comparable mortality, bleeding, and readmission rates.

Intraosseous schwannomas are rare benign tumors that most often occur at the mandible or sacrum. We present an unusual case of a bilobed schwannoma of the distal humerus with both intraosseous and extraosseous components. The extraosseous component was non-enhancing on initial MRI and enhanced on a subsequent MRI obtained after biopsy. We hypothesize that this change was attributable to decreased intra-tumoral pressure secondary to biopsy-related disruption of the tumor capsule.

Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) can lead to long-term sequelae in males and females; however, global prevalence data vary between geographical regions, as these sexually transmitted infections are not included in routine screening. The objective of this study was to use the cobas® TV/MG assay to assess the point prevalence of TV and MG in specimens from men and women over a broad European geographical area. Urine, vaginal, endocervical, and rectal samples were collected from patients aged ≥ 18 years receiving Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) screening as per local standard of care at sites in Belgium, Germany, Spain, and the UK (Wales). Remnant samples were assessed using the cobas TV/MG assay. Analysis of 2795 samples showed that MG prevalence varied slightly across female sample types (range: 1.7–5.8%; p = 0.0042). MG prevalence was higher in male rectal samples (12.5%) than in male urine samples (3.9%; p

Terrace gardening or rooftop gardening is becoming popular in urban and peri-urban areas of metro cities worldwide including in India. Among various crops suitable for growing in terrace garden, strawberry is a popular one as being an important annual herbaceous plant with delicious fruits which can be easily grown in pots or containers including grow bags filled with different pottingsubstrates. In the present study, different combinations of soil, organic manure (vermi-compost and FYM) and cocopeat were tested for growth, yield and physico-chemical characteristics of two strawberry cultivars (Winter Dawn and Sweet Charlie). Winter dawn was found better than Sweet Charlie for measured growth and yield parameters, and potting substrates had similar effect on both the cultivars as no interaction effect was noticed. Combination of Soil + vermi-compost + cocopeat or soil + FYM + cocopeat in equal proportion (1:1:1) was found most appropriate potting substrate for strawberry cultivation, hence suggested as a suitable growing medium for production of strawberries in terrace or rooftop gardening in peri-urban areas of Delhi/ National Capital Territory. Further investigation is needed to standardize cost-effective management agro-techniques of strawberry cultivation in terrace garden involving some other cultivars, nutrient management and environment protective structures and so on

PURPOSE The TAPUR Study is a phase II basket trial that aims to identify signals of antitumor activity of commercially available targeted agents in patients with advanced cancers harboring genomic alterations known to be drug targets. Results in a cohort of patients with metastatic breast cancer (mBC) with high tumor mutational burden (HTMB) treated with pembrolizumab are reported. METHODS Patients with advanced mBC received standard doses of either 2 mg/kg or 200 mg infusions of pembrolizumab every 3 weeks. Simon's two-stage design was used with a primary study end point of disease control (DC) defined as objective response or stable disease of at least 16 weeks duration. If two or more patients in stage I achieved DC, the cohort would enroll 18 additional patients in stage II. Secondary end points include progression-free survival (PFS), overall survival, and safety. RESULTS Twenty-eight patients were enrolled from October 2016 to July 2018. All patients' tumors had HTMB ranging from 9 to 37 mutations/megabase. DC and objective response were noted in 37% (95% CI, 21 to 50) and 21% of patients (95% CI, 8 to 41), respectively. Median PFS was 10.6 weeks (95% CI, 7.7 to 21.1); median overall survival was 30.6 weeks (95% CI, 18.3 to 103.3). No relationship was observed between PFS and tumor mutational burden. Five patients experienced ≥ 1 serious adverse event or grade 3 adverse event at least possibly related to pembrolizumab consistent with the product label. CONCLUSION Pembrolizumab monotherapy has antitumor activity in heavily pretreated patients with mBC characterized by HTMB. Our findings support the recent US Food and Drug Administration approval of pembrolizumab for treatment of patients with unresectable or metastatic solid tumors with HTMB without alternative treatment options.

Mitochondrial-associated membranes (MAMs) are known to modulate organellar and cellular functions and can subsequently affect pathophysiology including myocardial ischemia-reperfusion (IR) injury. Thus, identifying molecular targets in MAMs that regulate the outcome of IR injury will hold a key to efficient therapeutics. Here, we found chloride intracellular channel protein (CLIC4) presence in MAMs of cardiomyocytes and demonstrate its role in modulating ER and mitochondrial calcium homeostasis under physiological and pathological conditions. In a murine model, loss of CLIC4 increased myocardial infarction and substantially reduced cardiac function after IR injury. CLIC4 null cardiomyocytes showed increased apoptosis and mitochondrial dysfunction upon hypoxia-reoxygenation injury in comparison to wild-type cardiomyocytes. Overall, our results indicate that MAM-CLIC4 is a key mediator of cellular response to IR injury and therefore may have a potential implication on other pathophysiological processes.

Large-conductance calcium and voltage-activated potassium channels (BK Ca ) are heterogeneously expressed in a wide array of cells. In adult ventricular cardiomyocytes, activation of mitochondrial BK Ca channels is implicated in cardioprotection against ischemia-reperfusion (IR) injury. However, plasma membrane BK Ca channel activity has never been detected in adult ventricular cardiomyocytes. In this study, we report the presence of the BK Ca channel in the plasma membrane and mitochondria of neonatal murine and rodent cardiomyocytes. In neonatal cardiomyocyte (NCM), whole-cell potassium currents measured were sensitive to iberiotoxin (IbTx), suggesting the presence of BK Ca channels in the plasma membrane. Moreover, the open probability of single-channel recording decreased in presence of IbTx by 46+5% (n=10) and 32+5% (n=10) for rats and mice, respectively. Ex vivo studies with isolated neonatal hearts (p6) subjected to ischemia and post-conditioned with NS1619 during reoxygenation increased (58+3% as opposed to 48+5% for control, n>5 pups) the myocardial infarction whereas IbTx reduced (32+2%) the infarct size. In agreement, isolated NCM also presented increased apoptosis on treatment with NS1619 during hypoxia-reoxygenation (HR), whereas IbTx reduced TUNEL positive cells. In NCMs, activation of BK Ca channels increased the intracellular reactive oxygen species post HR injury. Electrophysiological characterization of NCMs indicated that NS1619 increased the beat period, field, and action potential duration, and decreased the conduction velocity and spike amplitude. In contrast, IbTx had no impact on the electrophysiological properties of NCMs. Taken together, our data established that inhibition of plasma membrane BK Ca channels in the neonates protects the heart/cardiomyocytes from IR injury. Furthermore, the functional disparity observed towards the cardioprotective activity of BK Ca channels in adults compared to neonatal heart could be attributed to their differential localization.

To determine the rate at which recommendations for additional imaging (RAIs) of incidental findings on CT are adhered to at a tertiary-care medical center and what factors influence adherence.We used a radiology clinical informatics tool (mPower, Nuance Communications Inc, Burlington, Massachusetts) to identify RAIs in reports from all CT examinations performed at a tertiary-care medical center during a 6-month period. For those studies in which the RAI was for incidental findings, we reviewed the patients' charts to determine if there was appropriate follow-up of the lesion in question.The overall rate of adherence to RAIs was 39.1%, and in patients with a same-institution primary care provider (PCP), 56.8% (P.0001). Adherence was higher in studies ordered in the outpatient setting (P.0001) and in patients with a same-institution PCP (P.0001). Among patients with a same-institution PCP, adherence was highest for outpatients (66.7%), followed by patients seen in the emergency department (46.0%) and inpatients (36.0%). Among outpatients, adherence was highest with PCPs (67%) followed by internal medicine subspecialties (50%) and surgery (38%).The rate of adherence to recommendations for additional imaging of incidental findings was 39.1% in this study and higher for patients with a same-institution PCP, studies ordered in the outpatient setting, and in studies ordered by PCPs.

ObjectiveTo evaluate the clinical performance of the novel PivNG primers and probes set (PivNG test) used in the cobas omni Utility Channel for supplemental testing ofNeisseria gonorrhoeae(NG).MethodsOropharyngeal, urogenital and rectal samples were self-collected during routine testing at Barts Health sexual health clinics, London, UK. Samples were tested by the cobas CT/NG test and PivNG cobas omni Utility Channel test on cobas 6800/8800 Systems. Supplemental testing was carried out with the Xpert CT/NG test. PivNG overall percent agreements, positive percent agreements (PPAs)/negative percent agreements (NPAs) and positive/negative predictive values were calculated for each sample type. Microscopy and/or culture data were included for a randomised subset of concordant/discordant results, and a composite reference standard (cobas CT/NG, Xpert CT/NG and culture results) adjusted for partial verification bias was used to determine PivNG PPA and NPA.ResultsOf 447 evaluable samples with valid results from all three assays (cobas CT/NG, PivNG and Xpert CT/NG), 288 (64.4%) were NG-positive by both PivNG and cobas CT/NG; 117 (26.2%) were NG-negative in both tests; and 42 (9.4%) had discordant results (with NG-negative supplementary Xpert) CT/NG results in 40/42 instances). Of 19 PivNG/Xpert CT/NG-discordant samples, 11 were confirmed NG-positive by microscopy and/or culture results. PivNG PPA and NPA were 100% and 91% for oropharyngeal swabs, 100% and 100% for vaginal swabs, 100% and 100% for male urine samples, and 100% and 97% for rectal swabs, respectively, compared with the partially adjusted composite reference standard.ConclusionsPivNG is a reliable supplementary test with high sensitivity for confirming NG infection when used in conjunction with the cobas CT/NG test and samples collected in cobas PCR Media. Moreover, the PivNG test offers a convenient, high-throughput solution for supplemental NG testing of various sample types, with the potential to reduce the number of indeterminate reports.

Background and aim Patients undergoing percutaneous coronary intervention (PCI) are at high-risk for hospital readmission. We examined the rate, factors associated with, and outcomes of 30-day readmissions for patients who underwent a PCI. Methods We reviewed medical records of all patients who underwent PCI between 2011 and 2014 at a central New England radial first, tertiary care center. Data was collected on occurrence and cause of readmission as well as patients' bleeding events and survival at one year. Logistic regression was used to examine factors associated with 30-day readmission as well as its association with bleeding and all-cause mortality. Results A total of 3858 patients were studied (mean age = 62.8 years with 26.1% women), among whom 348 (9.5%) patients were readmitted within 30-days. Cardiac causes of readmission represented 62% of all readmissions. In the multi-variable adjusted regression model, factors that were significantly associated with 30-day readmission included female gender, prior coronary bypass surgery, acute coronary syndrome, anemia, length of stay, and delay in initial presentation. Patients who were readmitted had more than twice the risk of bleeding and mortality at one year as compared to those who were not readmitted within 30 days. Conclusions In conclusion, our results suggest that early hospital readmission after undergoing PCI is common and has not changed in recent years. Efforts should be made to identify and closely monitor patients who are at risk for readmission after PCI.

Background Exposure to pregnant women with cardiovascular disease (CVD) during cardiology fellowship training is limited and without a standard curriculum in the United States. The authors sought to evaluate a dedicated curriculum to teach management of CVD in pregnancy to improve general cardiology fellowship training. Methods The authors developed a dedicated CVD in pregnancy curriculum for the general cardiology fellows at a large academic medical center in the fall of 2019. Fellows’ knowledge was assessed via a board-style examination and exposure and attitudes related to the care of pregnant women with CVD were evaluated with a needs assessment questionnaire before and after the curriculum. Results Of the 17 fellows who participated in the curriculum, 12 completed the needs assessment pre-curriculum and 9 post-curriculum. The mean (SD) number of pregnant women with CVD cared for by each fellow in the inpatient and outpatient settings were 0.75 (1.29) and 0.56 (0.73), respectively. After the curriculum, all fellows reported awareness of available resources to treat pregnant women with CVD, while a majority disagreed that they receive regular exposure to pregnant patients with CVD in their training. The authors observed significant increases in fellows’ confidence in their knowledge of normal cardiovascular physiology of pregnancy, physical exam skills, and ability to care for pregnant women with valvular disease and arrhythmias from pre to post-curriculum. A total of 15 fellows completed the board-style exam pre-curriculum and 15 post-curriculum. Fellows’ performance on the board-style examination improved slightly from before to after the curriculum (64.0 to 75.3% correct, p = 0.02). Conclusions A dedicated curriculum improved cardiology fellows’ knowledge to recognize and treat CVD in pregnancy and improved confidence in caring for this unique patient population.

Agricultural technologies are seen as an important means for alleviating poverty in most of the developing countries. However, the rate of adoption of farm technologies has remained at low level. Present study conducted during 2016-19 in lower Shivalik hills of Uttarakhand which aims at shedding some light on the driving forces that influence the intensity of technology adoption using econometric models like quantile regression (QR) model since it produces different effects along the distribution (quantile) of the dependent variable. Improved varieties of two major crops (Rice and Wheat) of lower Shivalik hills of Uttarakhand have been enlisted. Kendall Tau estimation has been used to measure the extent of association of explanatory variables with the adoption level. To estimate sustaining productivity (economic efficiency) of selected technologies (varieties) and to identify best suited available technology, Seeming Unrelated Regression (SUR) model was used as it estimates the parameters of all equations simultaneously. The estimates of quantile model show that operational land holding, extension contact, family type, house type and farm assets had significant influence on intensity of adoption. Besides, findings of SUR model identified PB-1121 of rice and HD-2967 of wheat the best suitable varieties. The paper also suggested some farm policy-related issues for the welfare of the farmers under study.

Onion (Allium cepa L.) is among the most cultivated vegetable crops in the world. Afghanistan is thought to be the origin as several local and wild varieties are found in different parts of the country. Safid e Paisaye is a local variety grown in central parts of Afghanistan in the Ghorband valley. This variety has long storability and high market demand among restaurants in the region, but little research has been done to increase the quality and its availability to the market to increase its market share in Afghanistan. Conducted under supervision of Amity University Uttar Pradesh, Noida, India, at Agriculture Faculty Research Farm of Kabul University, this investigation looks at plough depth, land preparation methods, and planting date on quality and yield of onion bulb; it also studied other cultural practices including irrigation and fertilization dose and frequency. The parameters studied in this investigation include neck diameter (cm), bulb diameter (cm), neck to bulb ratio, bulb weight (gr), bulb volume (cm3), bulb density (gr/cm3), Total Soluble Solids (TSS) (Brix), firmness (Kg/cm2), marketable yield (MT/Ha), and total yield (MT/Ha). The data revealed that planting date has significant influence on bulb quality and yield of onion. The highest bulb diameter (6.95 cm), bulb weight (121 gr), bulb volume (128 cm3), marketable yield (32.54 MT/Ha), and total yield (34.24 MT/Ha) and the lowest neck to bulb ratio (0.04) were recorded for the first planting date (seed sown in nursery on 10 March - seedlings planted in field on 10 May). Land ...

Background. Current standard of care for HR+HER2+ breast cancer >1cm per NCCN guidelines is chemotherapy with either trastuzumab(T) or trastuzumab and pertuzumab(TP) with anti-HER2 therapy continued for 1 year and anti-hormonal therapy for 5-10 years. Patients with HR+HER2+ breast cancer benefit less from chemotherapy than those with HR-HER2+ breast cancer. Recent studies show that pCR rates with aromatase inhibitor and dual-HER2 blockade for 3-6 months duration range between 21%- 33% with the highest pCR seen with 6 months. No clinical trial to date has looked at targeted therapy without chemotherapy for HR+HER2+ breast cancer up to 1 year. Methods. NEOADAPT is an IRB-approved phase II prospective single cohort study for patients with stage I-II HR+HER2+ breast cancer. Eligible pts received neoadjuvant aromatase inhibitor (and GnRH analogue or oophorectomy for premenopausal patients) and TP with q3w exams and q3mo breast MRI. Treatment may continue up to 1 year if ongoing response or radiographic CR (rCR) was observed. Surgery was allowed as soon as 3 months after the first MRI showing rCR provided the follow up MRI did not show further improvement. Primary endpoint was pCR rate defined as absence of invasive disease in the breast and lymph nodes. A Fleming two stage design was implemented with stopping rules with the null hypothesis being that the pCR rate is 40%. Secondary objective included median duration of treatment and exploratory analysis of correlation with Mammaprint Blueprint(MB) testing. 9 patients were enrolled before the study was prematurely closed. 3 patients who refused chemotherapy when the study was closed and were treated with the NEOADAPT protocol and fit the same inclusion/exclusion criteria are also included in this report. Results. Median age 55 (41-67); BMI 26.0 (22.2-37.6); T 2.75cm (1.3-4.8). 7 were premenopausal. 7 had disease that was HER2+ by FISH ratio >2.0 only (2+ IHC). All 12 patients had MB test done: 8 high risk luminal, 3 high risk HER2, and 1 low risk HER2. 5/12 patients achieved rCR, with median duration of treatment to achieve rCR in those 5 pts being 6 months (3-9). 11/12 patients have completed definitive surgery, with the outlier being a patient who refuses surgery. 4/11 patients achieved pCR all of whom received 12 months of targeted treatment before surgery. All 4 pCR patients had rCR before surgery. Of the other 3/7 pts who had rCR and not pCR, 2 had rCR at 3 months and both had surgery at 6 mo with 1.7cm and 1.5mm of residual disease seen and 1 had rCR at 6mo completed 1 yr of prescribed treatment but refused surgery. 2/12 patients were taken off study before surgery and switched to a standard of care chemotherapy regimen due to progression but remain in NED post-surgery to date. No patients to date have had local recurrence or metastatic disease. Discussion. These results from a prematurely closed study suggest as confirmed in other recent studies, that a chemotherapy-sparing endocrine and targeted neoadjuvant approach for HR+HER2+ breast cancer seems to be a feasible and reasonable option particularly for those desiring a clinically informed de-escalation to their treatment plan. Clinical trial: NCT02689921 Citation Format: Eugene R Ahn, Ricardo H Alvarez, Damien Hansra, Anjanette Sorensen, Jizhou Ai, Maurie Markman. Neoadjuvant aromatase inhibitor and pertuzumab and trastuzumab (NEOADAPT) up to one year for HR+HER2+ breast cancer: Results from a prematurely closed de-escalation study [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-18-30.

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High yielding varieties of cereal crops were the major contributors to India's Green Revolution in 1960s and till date these varieties have been largely contributing to India's bread basket. Uttarakhand is primarily an agricultural state although its share in the country's total area and production is negligible. In this paper the authors have attempted to measure the technical and economic efficiencies of improved varieties of paddy and wheat in lower Shivalik hills of Uttarakhand during 2017-20. Uttarakhand is primarily an agricultural state although its share in the country's total area and production is negligible. Economic efficiencies of the varieties were measured by benefit-cost ratio (BCR) andnet return (NR). Technical efficiencies were measured by Box plot technique in R software. Kernal density plot was used to represent yield variation among the varieties. The findings revealed that PB 1121 paddy and HD 2967 wheat respectively were the best varieties in terms of technical efficiency (productivity) and economic efficiency (BCR andNet Return). Estimates of t-test also show the significant differences in BCR and net return between improved and local varieties. Thus, study shows that the positive impacts of improved varieties of the major crops have significantly contributed to productivity, farm income and livelihood in the lower Shivalik hills of Uttarakhand which, in turn, mayprovide prospective implications towards country's total production and food security.

BKCa channels are large-conductance calcium and voltage-activated potassium channels that are heterogeneously expressed in a wide array of cells. Activation of BKCa channels present in mitochondria of adult ventricular cardiomyocytes is implicated in cardioprotection against ischemia-reperfusion (IR) injury. However, the BKCa channel’s activity has never been detected in the plasma membrane of adult ventricular cardiomyocytes. In this study, we report the presence of the BKCa channel in the plasma membrane and mitochondria of neonatal murine and rodent cardiomyocytes which protects the heart on inhibition but not activation. Furthermore, K+ currents measured in neonatal cardiomyocyte (NCM) was sensitive to iberiotoxin (IbTx), suggesting the presence of BKCa channels in the plasma membrane. Neonatal hearts subjected to IR when post-conditioned with NS1619 during reoxygenation increased the myocardial infarction whereas IbTx reduced the infarct size. In agreement, isolated NCM also presented increased apoptosis on treatment with NS1619 during hypoxia and reoxygenation, whereas IbTx reduced TUNEL positive cells. In NCMs, activation of BKCa channels increased the intracellular reactive oxygen species post HR injury. Electrophysiological characterization of NCMs indicated that NS1619 increased the beat period, field, and action potential duration, and decreased the conduction velocity and spike amplitude. In contrast, IbTx had no impact on the electrophysiological properties of NCMs. Taken together, our data established that inhibition of plasma membrane BKCa channels in the NCM protects neonatal heart/cardiomyocytes from IR injury. Furthermore, the functional disparity observed towards the cardioprotective activity of BKCa channels in adults compared to neonatal heart could be attributed to their differential localization.

Graphical abstract, Highlights • New post-operative systolic dysfunction is a dreaded consequence of mitral valve surgery. • LBB-related dyssynchrony can lead to LV systolic dysfunction. • Acute severe mitral regurgitation may mask LBBB-related dyssynchrony. • When the regurgitant leak is removed, LBBB-related dyssynchrony can become manifest.

Cerebrovascular pathology is common in aging and Alzheimer's disease (AD). The microvasculature is particularly vulnerable, with capillary-level microhemorrhages coinciding with amyloid beta deposits in senile plaques. In the current analysis, we assessed the relationship between cerebral microvessels and the neuritic component of the plaque in cortical and hippocampal 50- to 200-μm sections from 11 AD, 3 Down syndrome, and 7 nondemented cases in neuritic disease stages 0-VI. We report that 77%-97% of neuritic plaques are perivascular, independently of disease stage or dementia diagnosis. Within neuritic plaques, dystrophic hyperphosphorylated tau-positive neurites appear as clusters of punctate, bulbous, and thread-like structures focused around capillaries and colocalize with iron deposits characteristic of microhemorrhage. Microvessels within the neuritic plaque are narrowed by 1.0 ± 1.0 μm-4.4 ± 2.0 μm, a difference of 16%-65% compared to blood vessel segments with diameters 7.9 ± 2.0-6.4 ± 0.8 μm (p0.01) outside the plaque domain. The reduced capacity of microvessels within plaques, frequently below patency, likely compromises normal microlocal cerebrovascular perfusion. These data link the neuritic and amyloid beta components of the plaque directly to microvascular degeneration. Strategies focused on cerebrovascular antecedents to neuritic dystrophy in AD have immediate potential for prevention, detection, and therapeutic intervention.

e24045 Background: Obesity is a leading cause of preventable death in the United States. The incidence of most obesity associated malignancies are increasing. Novel interventions to combat the obesity epidemic are greatly needed. Here we investigate the effect of a virtual clinical intervention on medical providers & other medical staff at a comprehensive cancer center. Methods: Physicians (MD), nurses (RN), & other medical staff (MS) were enrolled in an IRB approved, prospective single arm clinical trial. We assessed the effect of NCCN & ASCO guideline recommendations for weight loss & healthy lifestyle on overweight (OW) & obese (OB) providers & medical staff. Primary outcome: to assess change in body mass index (BMI) over a 3-month (mo.) intervention. Secondary outcomes: To assess changes in nutrition and exercise habits over time b) evaluate other lifestyle factors over time: stress, self-image, barriers to weight loss. Participants (Pts) filled out two 16 question (Q) pre & post survey (at 1, 90 days) relating to study outcomes. The virtual intervention consisted of giving information & advice over 3 months: A comprehensive handout e-mailed on day 1 + Motivational/info e-mails q 2 weeks/3 mo. Statistical analysis: students' paired T test used to compare changes in weight & survey responses day 0-90. P- value α = 0.05. Inclusions: age > 18 yo males & females, MD, RN, ARNP, & MS who are OW (BMI > 25Kg/m2) or OB (BMI > 30Kg/m2). Exclusions: non-OW/OB, Pts with uncontrolled cardiovascular, pulmonary, orthopedic, or cerebrovascular disease, pregnancy. Results: 106 participants enrolled; 26 subjects completed study. Demographics: 6/26 = 23% (MD/ARNP), 12/26 = 46% (RN), 8/26 = 31% (MS). 4/26 = 15% male, 22/26 = 85% female, µ age 45 (25-67). 3/26 = 12% Asian, 5/26 = 19% Black, 18/26 = 69% White. 100% not Hispanic. µ BMI = 33.9 kg/m2 (25.1-44.5). Intervention: 26/26 (100%) Pts lost weight/3 mo., µ Δ kg = -5.2kg (p < 0.0001), µ Δ BMI = - 1.67 kg/m2 (p = 0.002). Survey results: Significant improvements were seen in: self-image (p = 0.0012), physical activity (p < 0.0001), healthy diet (p < 0.0001), days/week exercise (p = 0.0008), µ Δ minutes exercise/week = +65 min/week (p = 0.0046), decreased stress levels (p < 0.0001). Limitations: significant participant drop out seen. Conclusions: All participants who completed the study lost weight & improved healthy lifestyle parameters. To our knowledge this is the first all virtual clinical weight loss & lifestyle intervention executed. Also, this is the first weight loss & lifestyle intervention executed in providers. Our intervention was cost effective, easy to execute, & warrants further study in both medical staff & patient populations. Last, this novel virtual intervention is highly relevant during the covid 19 pandemic due to social distancing requirements.

Indian farming is fraught with small land holdings, and farm mechanization's economic viability has remained a debatable issue at the core of Indian agriculture's technology growth. The authors attempted to determine the socio-agro-economic impact of seed cum fertiliser drill and zero tillage through Difference In Difference(DID) method with ex-ante (before application) and ex-post (after application) approach. Results depicted labour costs were reduced by almost 80% and seed savings were reduced by 20%. The seed cum fertiliser drill and zero tillage adopters saved a sum of Rs. 3764.10 and Rs. 4047.54 from 1 ha of land, respectively. An effort was also made to quantify the additional economic benefit by using the Apparently Unrelated Regression (SUR) model to apply selected forms of machinery to different varieties. Seed cum fertiliser drill and zero tillage results have been found to increase yield by 13.39 quintals and 6.0 quintals per ha respectively and decrease the seed rate by 27.71 kg/ha and 24.20 kg /ha, respectively, for the HD 2967 wheat variety. The growth of the agricultural mechanisation sector is hindered by machine cost, the widespread existence of resource poor farmers, and inaccessibility of agricultural technology. In addition, few suggestions on critical aspects were made on the basis of the application of technology in different states to implement suitable policies for the additional financial advantage of farmers.

The pesticide use in Indian agriculture showed a declining trend in the late 1990s and early 2000s. Since 2007, pesticide use gained an upward trend. To study the pesticide use pattern and identify pesticide hotspots, we collected data from a sample of 1201 apple, rice, vegetable, and cotton growers from the temperate Kashmir Valley, subtropical Jammu, and Punjab. Our study provided some interesting empirical results: prophylactic pesticide applications in apple crop making it a pesticide guzzler [25.2 kg of active ingredient (ai)/ha] with use of riskiest carcinogen pesticides (9 kg of a.i/ha) and field use environmental impact quotient (FEIQ) (620.4/ha) being the highest, the Kashmir Valley is the “pesticide hottest spot”, followed by cotton and rice areas of Punjab and vegetable cultivation in Jammu subtropics. Pesticides banned for use in vegetables, such as monocrotophos were also applied by farmers in vegetable crops. However, rice areas in Kashmir and Jammu were only treated with herbicides. The protective measures taken by farmers while mixing and applying pesticides were primitive, resulting in localized mild/moderate pesticide poisoning besides loss of consciousness. We also found that the official data on the pesticide use are underreported and hence unreliable. Our study shows that neither the pesticide use by mass nor the pesticide use frequency, in combination or alone, is the robust indicator to measure the pesticide hazardous hotspots; besides these, FEIQ and less hazardous pesticides that are not probable or possible carcinogen should be rather used in conjunction.

The purpose of this study was to determine the prevalence of solid tumors in incidental homogeneous renal masses with attenuation greater than 20 HU on portal venous phase CT images.In this retrospective study, the records of patients with incidental indeterminate (20 HU) homogeneous renal masses on portal venous phase CT scans from September 11, 2007, through March 18, 2017, were identified. Adult patients were included if they had undergone follow-up ultrasound, contrast-enhanced MRI, multiphase contrast-enhanced CT, or pathologic analysis alone to confirm the solid or cystic nature of the lesion. A single ROI was placed in the center of the mass, and lesions were characterized as ≥ 50% exophytic,50% exophytic, or entirely surrounded by renal parenchyma.There were 322 masses in 267 patients. The mean lesion size was 16.6 (SD, 9.8) mm (range, 9-45 mm). Lesions were ≥ 50% exophytic in 92 cases,50% exophytic in 111 cases, and completely surrounded by renal parenchyma in 119 cases. All nonsolid lesions were characterized as benign cysts. The numbers of solid lesions per total number of lesions in each attenuation group were: 20-30 HU (0/140), 30-40 HU (0/67), 40-50 HU (1/38), 50-60 HU (3/24), 60-70 HU (5/17), 70-80 HU (5/17), and80 HU (8/19). All 207 lesions in the 20- to 40-HU range were benign cysts with no solid lesions (0%; 95% CI, 0.0-1.4%).Small homogeneous renal masses measuring 20-40 HU on portal venous phase CT images are highly likely to be benign cysts.

Male breast cancer occurs rarely, comprising