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Nickel- and cobalt-based superalloys are commonly used as turbine materials for high-temperature applications. However, their maximum operating temperature is limited to about 1100 °C. Therefore, to improve turbine efficiency, current research is focused on designing materials that can withstand higher temperatures. Niobium-based alloys can be considered as promising candidates because of their exceptional properties at elevated temperatures. The conventional approach to alloy design relies on phase diagrams and structure–property data of limited alloys and extrapolates this information into unexplored compositional space. In this work, we harness machine learning and provide an efficient design strategy for finding promising niobium-based alloy compositions with high yield and ultimate tensile strength. Unlike standard composition-based features, we use domain knowledge-based custom features and achieve higher prediction accuracy. We apply Bayesian optimization to screen out novel Nb-based quaternary and quinary alloy compositions and find these compositions have superior predicted strength over a range of temperatures. We develop a detailed design flow and include Python programming code, which could be helpful for accelerating alloy design in a limited alloy data regime.

Primary neuroendocrine tumors (NET) of the kidney are rare. They present with varied symptoms, making their diagnosis difficult clinically as well as pathologically. We present to you the case of a renal NET, which presented in a young female patient. A 48-year-old female patient came with an incidentally detected right renal mass during the evaluation of a nonspecific gynecological problem. She underwent contrast-enhanced computed tomography (CT) of the abdomen, which showed a 57*45*34 mm mass with enlarged retrocaval and aortocaval nodes (25*12 mm). Renal cell carcinoma was suspected as per the CT findings, and metastatic workup in the form of FDG PET CT was done in view of the unusually enlarged nodes. She underwent robot-assisted radical nephrectomy along with lymph node dissection. Surgery was uneventful, and she recovered well in the postoperative period. In the final pathology, there was confusion regarding the diagnosis, and further immunohistochemistry (IHC) was recommended by the pathologist. IHC showed synaptophysin positive, chromogranin negative, CD56 focally positive with Ki-67 of 2–3%, which was suggestive of low-grade NET of the kidney. Lymph nodes were negative. She was kept on follow-up and a Ga 68-DOTANOC scan at 3 months showed no evidence of disease. Diagnosis and management of NET of the kidney still remains a debatable and controversial topic in view of its rarity. High index of suspicion needs to be observed in patients presenting with carcinoid syndrome and a renal mass. Nuclear scans like PET scan and DOTANOC scan can accurately stage the disease. Management includes partial or radical nephrectomy depending on the tumor characteristics. Further studies are required to optimize the treatment protocols for these patients.

Introduction: Inguinal lymph node dissection (ILND) is an integral part in the management of carcinoma penis. The concerns about the postoperative morbidity associated with open ILND led to modification in the template of dissection and adoption of minimally invasive techniques such as video endoscopic inguinal lymphadenectomy (VEIL) and robotic-assisted VEIL (R-VEIL). In this review, we aim to describe the techniques, case selection, perioperative outcomes, and oncological outcomes of VEIL and R-VEIL and to compare it with open ILND. Methods: Databases of PubMed, Embase, and Google Scholar were searched to identify the articles for VEIL and R-VEIL. Using PRISMA guidelines, literature search yielded 3783 articles, of which 32 full-text articles relevant to the topic were selected and reviewed, after consensus from authors. Results: After the first description of VEIL, various modifications in port placements and approaches were described. Several studies have shown, VEIL and R VEIL are safe and feasible in both node-negative and node-positive Ca penis patients. Compared to open ILND, VEIL had fewer wound infections and skin necrosis, minimal blood loss, shorter mean hospital stays, and reduced duration of drain kept. There is no difference in mean lymph node yield and recurrence rates between open ILND, VEIL, R-VEIL. Conclusion: VEIL and R-VEIL are safe and have comparable oncological outcomes with open ILND.

Abstract Background Fetal sex is known to affect pregnancy outcomes. In current clinical practice, monitoring of fetal well-being is based on Doppler ultrasound measurements of major placental and fetal vessels. The objective of this study was to investigate the effect of fetal sex on Doppler parameters throughout gestation in healthy pregnancy. Methods A prospective study was conducted in 240 pregnant women with ultrasound examinations at a 4-weekly interval between 12 and 38 weeks of gestation. Pulsed Doppler spectra were collected for the umbilical arteries (UAs), middle cerebral artery (MCA), descending abdominal aorta (DAo), and ductus venosus (DV). Linear mixed effects models were used to determine if the pulsatility indices (PIs) of these vessels depended on gestational age and fetal sex. Results While there were no differences in the MCA PI and DV PIV over gestation between female and male fetuses, the trajectory of the UA and DAo PIs differed by fetal sex (p = 0.02 and p = 0.01, respectively). Conclusions Doppler ultrasound parameters were found to be dependent on fetal sex for some vessels and not for others in healthy pregnancies. Further investigations are needed to understand the physiological mechanisms for these sex differences and the relevance for disease processes in pregnancy.

Abstract Background There is growing evidence of sex differences in placental vascular development. The objective of this study was to investigate the effect of fetal sex on uterine artery pulsatility index (PI) throughout gestation in a cohort of normal and complicated pregnancies. Methods A prospective longitudinal study was conducted in 240 pregnant women. Pulsed wave Doppler ultrasound of the proximal uterine arteries was performed at a 4-weekly interval between 14 and 40 weeks of gestation. The patients were classified retrospectively as normal or complicated (one or more of maternal preeclampsia, preterm birth, or small for gestational age). To assess if the change in uterine artery PI during gestation differed between normal and complicated pregnancies and between fetal sexes, the uterine artery PI was modeled using a linear function of gestational age and the rate of change was estimated from the slope. Results While the uterine artery PI did not differ over gestation between females and males for normal pregnancies, the trajectory of this index differed by fetal sex for pregnancies complicated by either preeclampsia, preterm birth, or fetal growth restriction (p < 0.0001). The male fetuses in the complicated pregnancy group had an elevated slope compared to the other groups (p < 0.0001), suggesting a more progressive deterioration in uteroplacental perfusion over gestation. Conclusions The uterine artery PI is widely used to assess uteroplacental function in clinical settings. The observation that this metric changes more rapidly in complicated pregnancies where the fetus was male highlights the importance of sex when interpreting hemodynamic markers of placental maturation.

Introduction Ewing sarcoma (ES) is more common in children and relatively rare in adults. Adult ES has poor prognosis than children. Treatment approaches for adults have been extrapolated from pediatric experience. Data on adult ES are very few because of its rarity in adults. The present study was done to analyze the clinical profile and outcome of adult ES. Aims The aim was to study the clinical and pathological treatment and outcomes in adult ES. Subjects and Methods Between 2010 and 2017, a total of 73 ES patients with age more than 18 years were retrospectively analyzed. Survival analysis was done by plotting Kaplan–Meier curves. Results A total of 73 patients were diagnosed with ES during 2010 to 2017. Among them, 43 (58.9%) had localized disease with a median age of 24.5 years. Males were 44 (60.3%) and females were 29 (39.7). Pain (75.3%) was the most common symptom at presentation. Nine patients had incomplete details and were excluded from the analysis. Among 21 (28.8%) patients, the lung (61.9%) was the most common site of metastasis followed by the bone, bone marrow, and brain. The median number of chemotherapy cycles in the localized disease was 14 (range 1–17), and in metastatic disease, it was 4 (range 1–7). Univariate analysis was done with respect to age (< 25 vs. ≥25), gender, elevated or normal serum lactate dehydrogenase level, tumor size (< 8 cm versus ≥8 cm), site (axial versus extremity), and neoadjuvant chemotherapy (NACT) given or not. NACT had a significant impact on overall survival (OS) and the rest had no effect. At a median follow-up of 40 months, the 3-year OS in localized disease was 87.4%. In metastatic disease, the median OS was 13 months with 3-year OS of 26%. Conclusions Outcomes with multimodality therapy in adult ES patients with localized disease are comparable to that of a pediatric cohort. However, metastatic disease has poor survival.

The world food production may not support the population that is growing at an exponential rate. Genetically modified crops and foods may therefore provide solutions for such shortcomings. However, uncertainties and myths such as the socio-economic impact of genetically modified foods on humans, the environmental and health risks may impede the use of these foods and instil fear among the public. Contrarily, it was learned that genetically modified crops and foods were generally deliver a positive outlook as they improved the socio-economic qualities in the farmers of third world countries. Besides, it was also noted that the genetically modified crops and foods impose a minimal adverse effect on the environment and human health while more benefits were attested. As genetically modified crops and foods seem to be more advantageous to humanity in general, long-term studies and meta-analyses are still required to ascertain the safety of these genetically modified organisms as staple foods.

Background: The umbilical artery (UA) Doppler pulsatility index is used clinically to detect elevated feto-placental vascular resistance. However, this metric is confounded by variation in fetal cardiac function and is only moderately predictive of placental pathology. Our group developed a novel ultrasound methodology that measures wave reflections in the UA, thereby isolating a component of the Doppler signal that is specific to the placenta. The present study examined whether wave reflections in the UA are predictive of placental vascular pathology. Methods: Standard clinical Doppler ultrasound of the UAs was performed in 241 pregnant women. Of these, 40 women met narrowly defined preset criteria for the control group, 36 had maternal vascular malperfusion (MVM) and 16 had fetal vascular malperfusion (FVM). Using a computational procedure, the Doppler waveforms were decomposed into a pair of forward and backward propagating waves. Findings: Compared to controls, wave reflections were significantly elevated in women with either MVM (p

A large structural size effect on brittle fracture energy was observed in studies of impact fracture of steels by Stanton, Batson and Docherty, nearly 100 years ago. The size effect was seen in macroscopically brittle fractures of geometrically similar specimens tested over a large size range. These historical findings have great significance in designing large-scale steel structures such as ships and bridges. However, there has been no physical principle or theory yet to explain the size effects observed by Stanton, Batson and Docherty. In the present work, a new approach based on net-section mechanics is used to explain the size effect. It is shown that the change in netsection strain energy predicts well the size effect on fracture energy, under the constant condition of cleavage crack initiation stress at the notch root. The spectacular decrease in specific fracture energy with increased specimen size is explained by noting the three-dimensional nature of stored strain energy and the two-dimensional nature of fracture energy dissipated in the crack layer. By scaling both energies to a reference cubic specimen volume and equating, an expression that describes the inverse size dependence of specific fracture energy has been formulated. The mechanics of the size effect is illustrated by assessing the theory with extensive experimental data. Further, scaling laws for fracture energy have been developed. This work honours the pioneering studies of Stanton, Batson and Docherty, which have been instrumental for the development of the present theory and analysis. [ABSTRACT FROM AUTHOR]

Background: Intraoperative three-dimensional (3D) imaging can be utilized to detect bone malpositioning during facial fracture repair. Aim: This article exhibits a case of left Zygomatic maxillary complex fracture that was repaired with the aid of intraoperative 3D imaging technology. Methods: A critical size orbital floor defect was apparent on the imaging, necessitating an immediate repair avoiding a second-revision surgery. Results and Conclusion: The use of 3D imaging has historically been underutilized due to financial and time constraints. However, when comparing to costs and time utilized to undergo a second surgery, usage of 3D imaging intraoperatively is beneficial to the patient, team, and the institution.

Since the last decade, the collective intelligent behavior of groups of animals, birds or insects have attracted the attention of researchers. Swarm intelligence is the branch of artificial intelligence that deals with the implementation of intelligent systems by taking inspiration from the collective behavior of social insects and other societies of animals. Many meta-heuristic algorithms based on aggregative conduct of swarms through complex interactions with no supervision have been used to solve complex optimization problems. Data clustering organizes data into groups called clusters, such that each cluster has similar data. It also produces clusters that could be disjoint. Accuracy and efficiency are the important measures in data clustering. Several recent studies describe bio-inspired systems as information processing systems capable of some cognitive ability. However, existing popular bio-inspired algorithms for data clustering ignored good balance between exploration and exploitation for producing better clustering results. In this article, we propose a bio-inspired algorithm, namely social spider optimization (SSO), for clustering that maintains a good balance between exploration and exploitation using female and male spiders, respectively. We compare results of the proposed algorithm SSO with K means and other nature-inspired algorithms such as particle swarm optimization (PSO), ant colony optimization (ACO) and improved bee colony optimization (IBCO). We find it to be more robust as it produces better clustering results. Although SSO solves the problem of getting stuck in the local optimum, it needs to be modified for locating the best solution in the proximity of the generated global solution. Hence, we hybridize SSO with K means, which produces good results in local searches. We compare proposed hybrid algorithms SSO+K means (SSOKC), integrated SSOKC (ISSOKC), and interleaved SSOKC (ILSSOKC) with K means+PSO (KPSO), K means+genetic algorithm (KGA), K means+artificial bee colony (KABC) and interleaved K means+IBCO (IKIBCO) and find better clustering results. We use sum of intra-cluster distances (SICD), average cosine similarity, accuracy and inter-cluster distance to measure and validate the performance and efficiency of the proposed clustering techniques.

Byline: Chandran. Ravi, Kalavampara. Sanjeevan, Appu. Thomas, Ginil. Pooleri Introduction: The aim of our study was to develop a new Indian nomogram to estimate pathologic extracapsular extension (ECE) risk in [...]

Objective: To examine the relationship between umbilical cord insertion site, placental pathology and adverse pregnancy outcome in a cohort of normal and complicated pregnancies. Methods: Sonographic measurement of the cord insertion and detailed placental pathology were performed in 309 participants. Associations between cord insertion site, placental pathology and adverse pregnancy outcome (pre‐eclampsia, preterm birth, small‐for‐gestational age) were examined. Results: A total of 93 (30%) participants were identified by pathological examination to have a peripheral cord insertion site. Only 41 of the 93 (44%) peripheral cords were detected by prenatal ultrasound. Peripherally inserted cords were associated significantly (P < 0.0001) with diagnostic placental pathology (most commonly with maternal vascular malperfusion (MVM)); of which 85% had an adverse pregnancy outcome. In cases of isolated peripheral cords, without placental pathology, the incidence of adverse outcome was not statistically different when compared to those with central cord insertion and no placental pathology (31% vs 18%; P = 0.3). A peripheral cord with an abnormal umbilical artery (UA) pulsatility index (PI) corresponded to an adverse outcome in 96% of cases compared to 29% when the UA‐PI was normal. Conclusions: This study demonstrates that peripheral cord insertion is often part of the spectrum of findings of MVM disease and is associated with adverse pregnancy outcome. However, adverse outcome was uncommon when there was an isolated peripheral cord insertion and no placental pathology. Therefore, additional sonographic and biochemical features of MVM should be sought when a peripheral cord is observed. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This study focuses on the extraction of cellulose nano-whiskers (CNWs) from the leaves of Adansonia kilima (AK), usually known as African baobab, using a combination of a microwave-assisted alkali (KOH) pre-treatment with subsequent bleaching process prior to ultra-sonication. Ultra-sonication was carried out using the ionic liquid (IL) 1-butyl-3-methylimidazolium hydrogen sulfate (Bmim-HSO4). Process parameters for ultra-sonication were optimized using a two-level factorial Box−Behnken design (BBD). Process variables such as ultra-sonication power (x1), hydrolysing time (x2) and temperature (x3) were varied. Responses selected were percentage crystallinity index, CrI% (y1) and yield% (y1) for the finally procured CNWs sample. Regression analysis was carried out to develop quadratic model to analyze the effect of process variables on IL-assisted ultra-sonication process. Analysis of variance (ANOVA) showed that ultra-sonication power was the most influential aspect for hydrolyzing the amorphous segments of crude cellulose extracted from baobab leaves. A relative study of the physio-chemical properties of the starting lignocellulosic substrate (AK), KOH pre-treated, bleached and IL-assisted ultra-sonicated CNWs was conducted. The synthesized samples were characterized using Fourier transform infrared spectroscopy, Scanning electron microscopy, atomic force microscopy, high resolution transmission electron microscopy, X-ray diffraction and thermo-gravimetric and zeta potential analysis. Under optimum condition, the extracted CNWs showed an average width of 15−20 nm; with high crystallinity index of 86.46%. This research provides an insight about the delignification of Adansonia kilima (AK) leaves and its effective conversion to CNWs having high crystallinity.

Primary neuroendocrine tumors (NET) of the kidney are rare. They present with varied symptoms, making their diagnosis difficult clinically as well as pathologically. We present to you the case of a renal NET, which presented in a young female patient. A 48-year-old female patient came with an incidentally detected right renal mass during the evaluation of a nonspecific gynecological problem. She underwent contrast-enhanced computed tomography (CT) of the abdomen, which showed a 57*45*34 mm mass with enlarged retrocaval and aortocaval nodes (25*12 mm). Renal cell carcinoma was suspected as per the CT findings, and metastatic workup in the form of FDG PET CT was done in view of the unusually enlarged nodes. She underwent robot-assisted radical nephrectomy along with lymph node dissection. Surgery was uneventful, and she recovered well in the postoperative period. In the final pathology, there was confusion regarding the diagnosis, and further immunohistochemistry (IHC) was recommended by the pathologist. IHC showed synaptophysin positive, chromogranin negative, CD56 focally positive with Ki-67 of 2–3%, which was suggestive of low-grade NET of the kidney. Lymph nodes were negative. She was kept on follow-up and a Ga 68-DOTANOC scan at 3 months showed no evidence of disease. Diagnosis and management of NET of the kidney still remains a debatable and controversial topic in view of its rarity. High index of suspicion needs to be observed in patients presenting with carcinoid syndrome and a renal mass. Nuclear scans like PET scan and DOTANOC scan can accurately stage the disease. Management includes partial or radical nephrectomy depending on the tumor characteristics. Further studies are required to optimize the treatment protocols for these patients. [ABSTRACT FROM AUTHOR]