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Abstract Background Oral cavity cancer (OCC) represents a significant public health burden in South Asia, ranking as the most prevalent cancer affecting males in Pakistan and contributing considerably to morbidity and mortality. The objective of this study was to evaluate the survival rates in patients diagnosed with OCC in the Pakistani population and identify the factors influencing survival. Methods This was a retrospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan. A total of 2238 cases diagnosed with OCC from May 2011 through December 2020, who met the inclusion criteria, were included. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Adjusted hazard ratios (HR) and their 95% confidence intervals (CIs) were estimated using a Cox regression model to identify the factors significantly influencing survival. Results Among all cases, 54.0% were diagnosed in individuals 50 years of age and below and 73.0% were tobacco users. Overall survival, 1-year, 3-year, and 5-year survival rates were 54.9%, 88.9%, 81.6%, and 75.9% respectively. After adjustment for all the significant confounding and prognostic factors, age was an important factor showing that adults > 50 years had poorer survival compared to ≤ 50 years (HR = 1.43, 95% CI = 1.11–1.83). Poorly differentiated grade of OCC compared to well-differentiated grade (HR = 2.49, 95% CI = 1.61–3.84) and stage IV compared to earlier stages (HR = 3.56, 95% CI = 2.13–5.94) were also associated with poor survival. Conclusion Notably, there was a high occurrence of late stage (III and IV) OCC in individuals aged ≤ 50 years, with the buccal mucosa being the most common site involved. Moreover, a large proportion of our patients had a history of tobacco use. Patients with advanced-stage disease and poorly differentiated grade showed poor survival. Therefore, public awareness about tobacco control for OCC prevention and earlier diagnosis of OCC is urgently needed in our Pakistani population.

Abstract In prior studies, a very minimal Yukawa sector within the SO(10) Grand Unified Theory framework has been identified, comprising of Higgs fields belonging to a real 10 H , a real 120 H , and a 126 ¯ H $$ {\overline{126}}_H $$ dimensional representations. In this work, within this minimal framework, we have obtained fits to fermion masses and mixings while successfully reproducing the cosmological baryon asymmetry via leptogenesis. The right-handed neutrino (N i ) mass spectrum obtained from the fit is strongly hierarchical, suggesting that B − L asymmetry is dominantly produced from N 2 dynamics while N 1 is responsible for erasing the excess asymmetry. With this rather constrained Yukawa sector, fits are obtained both for normal and inverted ordered neutrino mass spectra, consistent with leptonic CP-violating phase δ CP indicated by global fits of neutrino oscillation data, while also satisfying the current limits from neutrinoless double beta decay experiments. In particular, the leptonic CP-violating phase has a preference to be in the range δ CP ≃ (230 – 300)°. We also show the consistency of the framework with gauge coupling unification and proton lifetime limits.

The occurrence of testicular dislocation resulting from blunt trauma to the scrotum or abdominopelvic region is infrequent. Due to the presence of significant associated injuries, the diagnosis of this condition can often be missed. This case study presents a case of an adult male who experienced bilateral testicular dislocation following a motorbike accident. Additionally, a concise review of relevant literature is included.

Under the assumption that the recent pulsar timing array evidence for a stochastic gravitational wave (GW) background at nanohertz frequencies is generated by metastable cosmic strings, we analyze the potential of present and future GW observatories for probing the change of particle degrees of freedom caused, e.g., by a supersymmetric (SUSY) extension of the Standard Model (SM). We find that signs of the characteristic doubling of degrees of freedom predicted by SUSY could be detected at Einstein Telescope and Cosmic Explorer even if the masses of the SUSY partner particles are as high as about 104 TeV, far above the reach of any currently envisioned particle collider. We also discuss the detection prospects for the case that some entropy production, e.g. from a late decaying modulus field inducing a temporary matter domination phase in the evolution of the universe, somewhat dilutes the GW spectrum, delaying discovery of the stochastic GW background at LIGO-Virgo-KAGRA. In our analysis we focus on SUSY, but any theory beyond the SM predicting a significant increase of particle degrees of freedom could be probed this way.

Scalar leptoquarks naturally arise within unified theories, offering a promising avenue for addressing one of the most significant challenges of the Standard Model–the existence of non-zero neutrino masses. In this work, we present a unified theory based on the SU(5) gauge group, where neutrino mass appears at the two-loop level via the propagation of scalar leptoquarks. Due to the unified framework, the charged fermion and neutrino masses and mixings are entangled and determined by a common set of Yukawa couplings. These exotic particles not only shed light on the neutrino mass generation mechanism but also help to achieve the unification of gauge couplings and are expected to lead to substantial lepton flavor violating rates, offering tangible opportunities for experimental verification. Reproducing the observed neutrino mass scale necessitates that a set of leptoquarks reside a few orders of magnitude below the unification scale–a specific feature of the proposed scenario. Moreover, maximizing the unification scale implies TeV scale new physics states, making them accessible at colliders. The diverse roles that leptoquarks play highlight the elegance and predictive ability of the proposed unified model.

Abstract Objectives Functional retentive overflow incontinence (retentive FI) is the most common cause of fecal soiling in children. Based on the clinical experiences, the treatment of retentive FI in patients with comorbid psychiatric disorders was accelerated when Risperidone was used as treatment for their psychiatric comorbidities; therefore, this study was conducted to evaluate the effect of risperidone in the treatment of retentive FI in children and adolescents. Methods In this double-blind, randomized, placebo-controlled trial, 140 patients aged 4–16 years eligible for the study were randomized into two groups, receiving either 0.25–0.5 mg of Risperidone syrup (n = 70) or maltodextrin syrup (placebo group, n = 70) every 12 h daily for 12 weeks. Sociodemographic data, including age, sex, weight, height, BMI, BMI z-score, and socioeconomic status, was recorded, and the number of nocturnal FI, diurnal FI, and painful defecations was measured. Results 136 participants (69 on Risperidone and 67 on placebo) were included in the study. Mean age of participants in the intervention and placebo groups were 7.2 ± 2.4 years and 8.0 ± 3.1 years, respectively. The mean number of nocturnal FI (Ptrend=0.39) and diurnal FI (Ptrend=0.48) in patients without psychiatric comorbidities, and the number of painful defecations for participants with and without psychiatric comorbidities (P = 0.49, P = 0.47, respectively) were not significantly different between the groups, but a significant effect was observed in diurnal FI after Risperidone treatment in patients with psychiatric comorbidities (P

Abstract We present the possibility that the seesaw mechanism and nonthermal leptogenesis can be investigated via primordial non-Gaussianities in the context of a majoron curvaton model. Originating as a massless Nambu-Goldstone boson from the spontaneous breaking of the global baryon (B) minus lepton (L) number symmetry at a scale v B−L , majoron becomes massive when it couples to a new confining sector through anomaly. Acting as a curvaton, majoron produces the observed red-tilted curvature power spectrum without relying on any inflaton contribution, and its decay in the post-inflationary era gives rise to a nonthermal population of right-handed neutrinos that participate in leptogenesis. A distinctive feature of the mechanism is the generation of observable non-Gaussianity, in the parameter space where the red-tilted power spectrum and sufficient baryon asymmetry are produced. We find that the non-Gaussianity parameter f NL ≳ O $$ \mathcal{O} $$ (0.1) is produced for high-scale seesaw (v B−L at O $$ \mathcal{O} $$ (1014−17) GeV) and leptogenesis (M 1 ≳ O $$ \mathcal{O} $$ (106) GeV) where the latter represents the lightest right-handed neutrino mass. While the current bounds on local non-Gaussianity excludes some part of parameter space, the rest can be fully probed by future experiments like CMB-S4, LSST, and 21 cm tomography.

Aim: We aimed to describe the most prominent features of COVID-19 on the chest X-ray (CXR) and to classify them using the radiographic assessment of lung edema (RALE) score. Furthermore, we aimed to correlate the RALE scores with clinically significant outcomes namely intensive care unit (ICU) admission and intubation from the emergency versus during hospital stay. In-hospital, death was studied as a secondary endpoint for severe RALE score. Materials and Methods: A retrospective cohort study was conducted on patients presenting to the emergency department (ED) of a tertiary hospital between the periods of March 2020 to August 2020. Included patients were symptomatic, COVID-19 positive by nasopharyngeal real-time polymerase chain reaction (RT-PCR), who also performed an initial CXR in the ED. Two experienced radiologists interpreted the CXRs and categorized them using RALE score into normal mild, moderate, and severe for further correlation with clinical endpoints. Results: From the 404 CXRs, most were categorized as mild and characteristically CXRs had bilateral lower and mid-zone ground-glass opacities. The frequency of intubation and ICU admission increased as the RALE score worsened with a statistically significant p value of

Abstract In this work, we consider a class of dark matter (DM) models where the DM does not directly interact with the Standard Model (SM) particles at the tree-level. Therefore, the coannihilation mechanism is crucial in achieving the correct DM relic abundance, which in turn requires the coannihilating partner to be close in mass to the actual DM particle. In our systematisation of the models’ class, the mediator and the coannihilation partner are assumed to be charged under QCD interactions. This last feature calls for a scrutiny of non-perturbative effects, namely Sommerfeld factors and bound-state formation, on the annihilations of the colored partner. Such non-perturbative effects are illustrated with an example model comprising a scalar leptoquark mediator, a Dirac vector-like fermion coannihilation partner, and a singlet DM fermion. Phenomenological features of this model, namely DM direct and indirect detection prospects, collider implications, and impact on the muon anomalous magnetic moment, are discussed.

Abstract Motivated by the direct discovery of gravitational waves (GWs) from black holes and neutron stars, there is a growing interest in investigating GWs from other sources. Among them, GWs from cosmic strings are particularly fascinating since they naturally appear in a large class of grand unified theories (GUTs). Remarkably, a series of pulsar-timing arrays (PTAs) might have already observed GWs in the nHz regime, hinting towards forming a cosmic string network in the early universe, which could originate from phase transition associated with the seesaw scale emerging from GUT. In this work, we show that if these observations from PTAs are confirmed, GWs from cosmic strings, when combined with fermion masses, gauge coupling unification, and proton decay constraints, the parameter space of the minimal SO(10) GUT becomes exceedingly restrictive. The proposed minimal model is highly predictive and will be fully tested in a number of upcoming gravitational wave observatories.

We present a minimal sub-GeV thermal Dark Matter (DM) model where the DM primarily interacts with neutrinos and participates in neutrino mass generation through quantum loop corrections at one-loop level. We discuss the challenges in achieving this in the scotogenic framework and identify a viable variant. Due to minimality and the interplay between obtaining the correct DM relic abundance and neutrino oscillation data, the model predicts (i) a massless lightest neutrino, (ii) enhanced rate of 0νββ decay due to loop corrections involving light DM exchange, and (iii) testable lepton flavor-violating signal μ→eγ. Detecting monoenergetic neutrinos from DM annihilation in next-generation neutrino detectors offers a promising way to test this scenario.

Abstract We investigate asymmetric leptoquark pair production mechanism at the Large Hadron Collider to advocate its potential relevance to establish reliable constraints on the leptoquark parameter space and its ability to aid in correct identification of these attractive sources of new physics. The main feature of asymmetric pair production that genuinely distinguishes it from the usual leptoquark pair production is given by the fact that the two leptoquarks that are produced in proton-proton collisions through a t-channel lepton exchange are not charge conjugates of each other. Hence the proposed name of asymmetric leptoquark pair production for this type of process. We spell out prerequisite conditions for the asymmetric leptoquark pair production mechanism to be operational and enumerate all possible combinations of leptoquark multiplets that can potentially generate it. We finally reinterpret existing leptoquark pair production search results within several simple scalar leptoquark extensions of the Standard Model, assuming that the leptoquarks exclusively couple to either electrons or muons and the first generation quarks, to demonstrate proper inclusion of asymmetric pair production. We consequently present accurate parameter space constraints for the S 1, S 3, R 2, S 1+S 3, and S 1+R 2 leptoquark scenarios.

Abstract Gravitational production of massive particles due to cosmic expansion can be significant during the inflationary and reheating period of the Universe. If the particle also has non-gravitational interactions that do not significantly affect its production, numerous observational probes open up, including cosmological probes. In this work, we focus on the gravitational production of light vector bosons that couple feebly to the Standard Model (SM) particles. Due to the very feeble coupling, the light vector bosons never reach thermal equilibrium, and if the Hubble scale at the end of inflation is above 108 GeV, the gravitational production can overwhelm the thermal production via the freeze-in mechanism by many orders of magnitude. As a result, much stronger constraints from the Big Bang Nucleosynthesis (BBN) can be placed on the lifetime and mass of the vector bosons compared to the scenario where only thermal production is considered. As an example, we study the sub-GeV scale dark photons, which couple to the SM only through kinetic mixing, and derive constraints on the mass and kinetic mixing parameter of the dark photon from the photodisintegration effects on the light element abundances relevant at the end of the BBN when the cosmic age was around 104 s.

The novel coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus is a relatively recent infection that has resulted in a global pandemic, appearing first at the end of 2019. While initially presenting as a predominantly respiratory disease, with a classical picture of fever, dry cough, dyspnea and, in some cases anosmia and ageusia, recent cases have shown increasingly atypical and more systemic manifestation of the disease. A precise understanding of the extent and pathophysiology of COVID-19 remains underway to this day, particularly concerning its behavior in the pediatric population. Moreover, there has been an increasing number of COVID-19 reports with neurological complications and manifestations, prompting inquiry into neuroinvasion. Postulations include indirect invasion through a surge of inflammatory mediators “cytokine storm” and subsequent widespread endothelial injury; and direct neural tropism. We report the case of a previously healthy 12-year-old male presenting with acute right-sided hemiparesis, new-onset seizures and a generalized petechial rash. Laboratory tests revealed elevated inflammatory markers and radiological investigations confirmed an evolving left middle cerebral artery (MCA) infarct and large vessel vasculitis. Testing for SARS-CoV-2 infection was positive.

Abstract We revisit mixing sum rule relations in the lepton and quark sectors under the assumption that the 1-3 elements of the flavour mixing matrices ( V L u $$ {V}_L^u $$ , V L d $$ {V}_L^d $$ , V L e $$ {V}_L^e $$ , V L ν $$ {V}_L^{\nu } $$ ) are zero in the flavour basis. We consider the exact relations resulting from the validity of this “zero 1-3 flavour mixing hypothesis” and analyse their implications based on the current experimental data, including effects from RG running. In particular, we analyse how the existing precise measurement of θ 13 PMNS $$ {\theta}_{13}^{\mathrm{PMNS}} $$ allows to derive predictions for θ 23 PMNS $$ {\theta}_{23}^{\mathrm{PMNS}} $$ in models with constrained θ 12 e $$ {\theta}_{12}^{\mathrm{e}} $$ . As examples, we calculate the predictions for θ 23 PMNS $$ {\theta}_{23}^{\mathrm{PMNS}} $$ which arise in 12 classes of Pati-Salam models and SU(5) GUTs that relate θ 12 e $$ {\theta}_{12}^{\mathrm{e}} $$ to θ 12 d $$ {\theta}_{12}^{\mathrm{d}} $$ . We also derive a novel “lepton phase sum rule”, valid under the additional assumption of small charged lepton mixing contributions. We furthermore point out that, in the context of GUT flavour models, the quark and lepton CP violating phases δ CKM and δ PMNS can both be predicted from a single imaginary element in the mass matrices.

Abstract One of the most important discoveries in particle physics is the observation of nonzero neutrino masses, which dictates that the Standard Model (SM) is incomplete. Moreover, several pieces of evidence of lepton flavor universality violation (LFUV), gathered in the last few years, hint toward physics beyond the SM. TeV-scale scalar leptoquarks are the leading candidates for explaining these flavor anomalies in semileptonic charged and neutral current B-decays, the muon, and the electron magnetic dipole moments that can also participate in neutrino mass generation. In this work, we hypothesize that neutrino masses and LFUV have a common new physics origin and propose a new two-loop neutrino mass model that has the potential to resolve some of these flavor anomalies via leptoquarks and offers rich phenomenology. After deriving the neutrino mass formula for this newly-proposed model, we perform a detailed numerical analysis focusing on neutrino and charged lepton flavor violation phenomenology, where the latter provides stringent constraints on the Yukawa couplings and leptoquark masses. Finally, present and future bounds on the model’s parameter space are scrutinized with exemplified benchmark scenarios.

We consider an extension of the Georgi-Glashow SU(5) GUT model by a 45-dimensional scalar and a 24-dimensional fermionic representation, where the latter leads to the generation of the observed light neutrino masses via a combination of a type I and a type III seesaw mechanism. Within this scenario, we investigate the viability of predictions for the ratios between the charged lepton and down-type quark Yukawa couplings, focusing on the second and third family. Such predictions can emerge when the relevant entries of the Yukawa matrices are generated from single joint GUT operators (i.e. under the condition of single operator dominance). We show that three combinations are viable, (i) yτ/yb=3/2, yμ/ys=9/2, (ii) yτ/yb=2, yμ/ys=9/2, and (iii) yτ/yb=2, yμ/ys=6. We extend these possibilities to three toy models, accounting also for the first family masses, and calculate their predictions for various nucleon decay rates. We also analyze how the requirement of gauge coupling unification constrains the masses of potentially light relic states testable at colliders.

Unruptured supra-clinoid carotid aneurysms are rare aneurysmal dilatation of the supra-clinoid segment of internal carotid artery. Most cases are asymptomatic and discovered incidentally, while others may present with compressive symptoms on cranial nerve II, the optic nerve. We present a case of a 44-year-old female who presented with chronic headache and gradual decreased visual acuity. The patient's imaging workup revealed bilateral supra-clinoid carotid aneurysms.

A series of novel fluorinated 1,5-benzothiazepine derivatives were synthesized, characterized and evaluated for in vitro anticancer and antibacterial activity. The in vitro anticancer activity of the synthesized compounds 4a–h was evaluated against four human cancer cell lines namely lung (A549), breast (MCF-7), liver (HEPG2) and prostate (PC-3). Compounds 4c, 4d, 4g and 4h exhibited good activity with GI50

Optimal reactive power dispatch (ORPD) has a crucial impact to enhance safety, reliability, and economical operation of the electric power system. ORPD is a non-linear, non-convex and mixed variable problem, which has been solved by many researchers via different meta-heuristic algorithms during the last decade. In this work, a novel algorithm named sine-cosine algorithm (SCA) is utilized to solve ORPD problem by considering both dependent and independent control variable constraints. SCA has been tested and validated on standard 14, 30 and 57-bus power systems. To validate the superiority of proposed algorithm, the outcomes obtained through SCA are compared with recent published results attained through particle swarm optimization (PSO), modified Gaussian barebones teaching–learning based optimization (BBTLBO), ant bee colony optimization (ABCO), whale optimization algorithm (WOA) and backtracking search algorithms (BSA). The results attained using SCA show the improvement in the power losses minimization. Thus, with standard 14-bus system, the power losses are minimized from 0.04% to 4.78%. While, using standard 30-bus, the power losses are minimized from 0.4% to 3.4% and with standard 57-bus, power losses are reduced from 0.9% to 1.99%. Furthermore, a comparative analysis with 30 independent runs on the above-mentioned bus systems is performed to examine the functioning of the proposed method in terms of probability density function (PDF) and cumulative density function (CDF). For such analysis, well-known meta-heuristic algorithms such as PSO, WOA, differential evolution (DE) are compared with proposed SCA in solving the ORPD problem. The results of this analysis clearly show that proposed algorithm is robust, effective, and computationally easy in solving the ORPD problem compared to the existing meta-heuristic algorithms.

We investigate the viability of predictive schemes for quark-lepton Yukawa ratios and nucleon decay in non-supersymmetric SU(5) Grand Unified Theories (GUTs) where neutrino masses are generated by a type II seesaw mechanism. The scalar sector of the considered scenario contains 5-, 24- and 45-dimensional representations plus a 15-dimensional representation for realizing the type II seesaw. Predictions for the ratios of the quark and lepton Yukawa couplings emerge when the relevant entries of the Yukawa matrices are generated from single joint GUT operators (i.e. under the condition of single operator dominance). Focusing on the 2nd and 3rd family and hierarchical Yukawa matrices, we show that only two sets of predictions, yτyb=32, yμys=92 and yτyb=2, yμys=6 are viable. To further investigate both options, we extend the minimal scenarios to two “toy models”, including the 1st family of charged fermions, and calculate the models' predictions, e.g. for the nucleon decay rates and for the masses of the light relics that are potentially within reach of colliders.

Objective:. The objective of this study is to analyze oncological outcomes of patients with peritoneal metastases (PM) of colorectal origin treated with Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC). Background:. PIPAC has been demonstrated to be a feasible and safe novel treatment for patients with PM of various origins. Only small series reports on survival after PIPAC by disease entity. Methods:. International retrospective cohort study of consecutive patients with PM of colorectal origin. Outcome measures were overall survival (OS), radiological response according to Response Evaluation Criteria in Solid Tumors (RECIST), histological response (peritoneal regression grading score [PRGS]: complete response: 1–4: no response), change of peritoneal cancer index (PCI), and symptom control. Results:. Seventeen eligible centers compiled 256 non-selected patients (mean age 61 [50.6–69.2], 43% female) and 606 procedures. Sixty-three percent were treated after 2 lines of chemotherapy, median PCI at PIPAC1 was 18 (interquartile range [IQR] = 10–27). Median OS was 19.00 months (IQR = 12.9–29.8) from diagnosis and 9.4 months (IQR = 4.5–16.8) from PIPAC1. One hundred and four of 256 patients (40.6%) had ≥3 procedures (per protocol [pp]) with the following outcomes at PIPAC3: RECIST: 59.3% partial response/stable, 40.7% progression; mean PRGS: 2.1 ± 0.9. Median PCI was 21 (IQR = 15–29) at baseline and 20 (IQR = 12–27) at PIPAC3 (P = 0.02). Fifty-six (54%) and 48 (46%) patients were symptomatic at baseline and PIPAC3, respectively (P = 0.267). Median OS for the pp cohort was 11.9 months (IQR = 10.7–15.0) from PIPAC1. Independent predictors for survival were radiological response (HR = 3.0; 95% CI = 1.6–5.7) and no symptoms (HR = 4.5, 95% CI = 2.2–9.1) at PIPAC3. Conclusions:. Objective treatment response and encouraging survival were demonstrated after PIPAC for colorectal PM. Prospective registry data and comparative studies are now needed in to confirm these data.

The prevalence of low birth weight (LBW) is high in Bangladesh, but no study has collated recent estimates of LBW prevalence from throughout the country. The aim of this meta-analysis was to evaluate the prevalence of LBW and birth weight status in Bangladesh. We searched PubMed, Medline, Ovo and Google Scholar to find published articles in national and international journals from 2000–2020 and reviewed for relevance. Meta-analysis and Q test were performed to estimate the prevalence and heterogeneity of LBW from all included articles. Meta-regression was done to quantify associations with sample size and study year. Stratified analysis was conducted and effect size calculated for differences in LBW prevalence by sex, division and urban/rural area. In total 48 studies with 166,520 births were found and included in this meta-analysis. The pooled prevalence of LBW was 29.1% (95% CI, 28.9–29.3%) in overall, 29.9% (29.7–30.2%) in rural and 15.7% (14.9–16.6%) in urban areas. There was no significant difference in average birth weight between boys and girls (SD, 0.71; 95% CI, −0.43–1.83). Prevalence of LBW was higher in north-east Bangladesh compared to other zones (p

With an ever increasing electrical load demand and the associated fuel price to generate it, researchers are compelled to find alternate, cheap and environment friendly ways for power generation to cater to this technoeconomic conundrum. Renewable Energy Sources (RES) are now being integrated in Distributed Generation (DG) based environment as a solution to this problem, hence resulting in Microgrids, with multiple sources and loads demarcating their footprint. Control and management of a diverse generation profile within a single microgrid is arduous and computationally intensive for a single centralized controller. This paper addresses this inherent problem and proposes a decentralized Multiagent based intelligent control technique to efficiently encompass the heterogeneous generation profile of Microgrids. Artificial Neural Network (ANN) based intelligent agents are deployed at the planning stage for each component of the Microgrid. These agents are responsible for maintaining individual local control parameters within the prescribed control margins, hence creating a multi-agent environment in a Microgrid structure. The proposed intelligent multi-agent control scheme is tested on a test system to furnish its merits over its traditionally employed counterparts. Simulation results show that ANN integration not only reduced the computational burden but also reduced the overall operating cost (around 10.2 %) by reducing the thermal generation.

BackgroundsThe current literature boasts the importance of diet in preventing or managing liver complications. However, there is limited evidence on the association of nutrient patterns (NP) with these complications. In this case-control study, we aimed to examine the possible relationship between nutrient patterns and the risk of non-alcoholic fatty liver disease (NAFLD) amongst the adult Iranian population.MethodsThis case-control study is being conducted at the Metabolic Liver Disease Research Center at Isfahan University of Medical Sciences in 2019. The study included 225 newly diagnosed cases of NAFLD and 450 controls. A validated semi-quantitative food frequency questionnaire (FFQ) assessed dietary intake. Principal component analysis using Varimax rotation obtained nutrient patterns. Logistic regression was performed to estimate NAFLD risk.ResultsWe identified four major nutrient patterns. The first nutrient pattern was high in consumption of lactose, animal protein, vitamin D, riboflavin, pantothenic acid, vitamin B12, calcium, phosphorus, zinc, and potassium. The second nutrient pattern included fiber, plant protein, vitamin A, thiamine, niacin, copper, and selenium, while the third featured plant protein, zinc, copper, magnesium, manganese, chromium, and selenium. The fourth was characterized by fructose, vitamin A, pyridoxine, vitamin C, and potassium. After adjusting for confounders, individuals in the highest tertile of NP4 had lower odds of NAFLD (OR: 0.56, 95% CI: 0.32–0.98, P_trend = 0.042); compared to those who were in the lowest tertile.ConclusionHigh compliance to a nutrient pattern characterized by fructose, vitamin C, vitamin A, pyridoxine, and potassium mainly supplied from fruits, vegetables, and nuts is inversely proportional to the odds of NAFLD. Also our findings indicate a very high fiber intake, a relatively optimal dietary fat profile, and a pretty low sugar intake for cases and controls, unseen in western countries. However, these initial findings need to be approved with further studies to confirm the relationship between nutrient patterns and NAFLD.

The influx of COVID-19 infection and government-enforced lockdowns and social isolation changed people's lifestyles. Concerns regarding the health impact of the COVID-19 pandemic due to the new sedentary lifestyle. This study aims to investigate the impact of the COVID-19 pandemic on cardiovascular health factors. A retrospective observational study was conducted using historical medical records. The cohort consisted of healthy adults (without chronic non-communicable diseases) over 18 years of age who have undertaken a health examination at the Chongqing Medical University from 2019 to 2020. The analysis of covariance (ANCOVA) test was used to compare variables between 2019 and 2020. The effect of exposure time to COVID-19 on cardiometabolic markers was analyzed using multiple linear regression models. 29,773 participants took part in this study. The average age was 42.5 ± 13.44 years at baseline, and the average follow-up period was 12.7 ± 2.8 months. Analysis showed that weight, BMI, waist circumference, hip circumference, WHR, fasting blood glucose, TG, LDL, uric acid, and liver enzymes increased significantly during the COVID-19 pandemic (P < 0.05). This study showed evidence that the COVID-19 pandemic and its control measures negatively impacted cardiometabolic profiles.

Intrahepatic gallbladder is a rare congenital variant that occurs due to migration arrest of the gallbladder from reaching its normal position. We present a case of a 60year-old gentleman presenting with chronic abdominal pain and impaired liver enzymes. Abdominal ultrasonography showed a hepatic cystic lesion which later was identified as an ectopic gallbladder within the liver parenchyma through magnetic resonance imaging study of the liver. Although ectopic gallbladder is a rare anomaly, awareness and correct identification of the abnormality prevents misdiagnosis with other liver pathologies as it may mimic other pathologies as presented in this case. It also allows better operative planning when indicated.

Objective: Pomegranate juice is inhibitor of CYP450 enzyme system such as CYP2C9 and CYP3A4. The objective of the present study was to determine the consequence of pomegranate fruit juice on the pharmacokinetics of oral hypoglycemic drug nateglinide in rats. Materials and Methods: This is a laboratory study to investigate drug-food interaction effects of Punica granatum fruit juice (3 ml) and nateglinide (in doses 10 and 20 mg/kg body weight, p.o.) in live animals where the effects of food drug interaction on pharmacokinetics parameters such as Cmax and AUC in vehicle and nateglinide and pomegranate juice and nateglinide treated rats was undertaken. Four groups of Wistar albino rats comprising of (n=5) animals in each group were taken and treated with vehicle and nateglinide (in doses 10 and 20 mg/kg body weight, p.o.) pomegranate juice (3ml, p.o.) and nateglinide (in doses 10 and 20 mg/kg body weight, p.o.). Results: The rats which were administered with pomegranate juice + nateglinide (in doses 10 and 20 mg/kg body weight, p.o.) showed raised Cmax to 2.85 fold and 2.21-fold respectively and an increase in AUC was found to be 1.34 fold and 1.47 fold respectively, when vehicle + nateglinide 10mg/kg and vehicle + 20mg/kg drug treated groups were compared. The results were compared at P-value< 0.01. Conclusion: A significant drug interaction was observed when nateglinide and pomegranate juice was administered indicating caution must be exercised when such food and drug is co-administered as the chance of more hypoglycemia may occur due to this potential drug-food interaction.

Childhood and adolescent obesity is a public health concern worldwide. However, little attention has been paid on status of overweight and body composition of Indian Bengali urban middle and high SES population. The objective was to determine the prevalence of overweight and body composition status by age and sex in children, adolescents and young adults. This cross-sectional study was carried out among 4194 unmarried school and college students (1999 males and 2195 females) aged 7–21 years belonging to the Bengali Hindu Population in Kolkata, India. The survey period was from 1999 to 2011. Anthropometry of participants were measured. Age and sex specific ≥85 percentile of body mass index (BMI) for children (

Conventional fossil-fuel energy resources are being drastically depleted; thus, the current shift towards renewable energy (RE) resources has become imperative. However, there are many impediments to the adoption of renewable power generation. These impediments can be overcome by enacting policies to encourage the acceptance of sustainable energy resources. For instance, the net-metering policy can provide the necessary incentives to promote the development of local distributed energy sources, primarily solar photovoltaic and wind generators. While there has been significant advancement and development in net-metering in Asia with the increased penetration of RE, at present there is a lack of systematic review in this area. This paper aims to present an in-depth review on net-metering advances and challenges, current RE shares, and future RE targets in the Asian region. Additionally, a case study is performed and an economic analysis of net-metering regulations in an Asian country is carried out. In this study, the monetary benefits of net-metering policies for residential consumers are proved. It is envisaged that the information gathered in this paper will be a valuable one-stop source of information for Asian researchers working on this topic.

Background: Mobile phone and other similar gadget use are now part of our life and it has acquired as an essential position in our life. It cannot be avoided. But judicious use is possible only after the severity of the problem is understood and risk factors are identified. Objective: To study the prevalence and risk factors of text neck syndrome among medical students of MRIMS Methods: This was a cross sectional study carried out among 306 medical students of one medical college. Data was collected in the pre designed, pre tested, and semi-structured study questionnaire developed based on the extensive review of literature. The questionnaire was given to the medical students and they were asked to submit after half an hour. Attempt was made to ensure that all questions were answered. Chi square test and Students t test was used for statistical analysis. Results: Almost 85% of students agreed that their virtual life orientation was affected. About 1/3rd complained of stiffness sometimes, 57% of users suffered from headaches sometimes. 1/4th suffered from numbness and weakness sometimes. The prevalence of pain in males was more i.e. 76.4% compared to 37.3% among females. The pain was significantly more in standing position (60%). The pain was found to be significantly more (68.9%) when the gadget was held at abdomen level. Conclusion: Almost all students used some or the other gadgets. But the use was actually misuse as it has affected majority. Disorientation of virtual life, stiffness, headache, pain was very common. Pain was associated with position and level at which the gadget was held.

Abstract In this work, we propose minimal realizations for generating Dirac neutrino masses in the context of a right-handed abelian gauge extension of the Standard Model. Utilizing only $$U(1)_R$$ U(1)R symmetry, we address and analyze the possibilities of Dirac neutrino mass generation via (a) tree-level seesaw and (b) radiative correction at the one-loop level. One of the presented radiative models implements the attractive scotogenic model that links neutrino mass with Dark Matter (DM), where the stability of the DM is guaranteed from a residual discrete symmetry emerging from $$U(1)_R$$ U(1)R . Since only the right-handed fermions carry non-zero charges under the $$U(1)_R$$ U(1)R , this framework leads to sizable and distinctive Left–Right asymmetry as well as Forward–Backward asymmetry discriminating from $$U(1)_{B-L}$$ U(1)B-L models and can be tested at the colliders. We analyze the current experimental bounds and present the discovery reach limits for the new heavy gauge boson $$Z^{\prime }$$ Z′ at the LHC and ILC. Furthermore, we also study the associated charged lepton flavor violating processes, dark matter phenomenology and cosmological constraints of these models.

Abstract We suggest simple ways of implementing Peccei-Quinn (PQ) symmetry to solve the strong CP problem in renormalizable SUSY SO(10) models with a minimal Yukawa sector. Realistic fermion mass generation requires that a second pair of Higgs doublets survive down to the PQ scale. We show how unification of gauge couplings can be achieved in this context. Higgsino mediated proton decay rate is strongly suppressed by a factor of (M PQ /M GUT)2, which enables all SUSY particles to have masses of order TeV. With TeV scale SUSY spectrum, p → v ¯ K + $$ p\to \overline{v}{K}^{+} $$ decay rate is expected to be in the observable range. Lepton flavor violating processes μ → eγ decay and μ − e conversion in nuclei, induced by the Dirac neutrino Yukawa couplings, are found to be within reach of forthcoming experiments.

Body packing is one of the common ways to traffic illicit drugs. Drug mules usually swallow or insert drugs within the gastrointestinal tract or other orifices. Detection of such drug packets has become difficult because of the constantly improving packaging techniques and the sophistication used by traffickers. Suspected obstruction or perforated hollow viscus requires employment of appropriate radiological procedures and techniques for accurate detection and precise diagnosis. A delay diagnosis and inappropriate action may carry disastrous physical consequences for the body packers. It is crucial for radiologists to acquire enough experience to deduce different types of drug packets from their imaging characteristics and to accurately guide emergency physicians and security officials. The packets are not always radiodense, therefore they can be difficult to detect on conventional abdominal radiographs. In this report, the authors illustrate 5 cases with different packaging methods and materials that give rise to radiological challenges. Keywords: Body packer, Illicit drug smuggling, Imaging modalities

Objective: The objective of this study was to observe the signs of Cyclosporine toxicity and to analyze the ameliorative effects of Nigella Sativa (NS or Kalonji) on body weight and haematological parameters. Methods: This study was conducted in the Department of Anatomy, Baqai Medical University of Karachi during the month of February 2017. Thirty healthy male Sprague Dawley rats were selected from the Animal House of the university. After acclimatization, the animals were randomly divided into three groups, with 10 rats in each Group. Group A was the control group and received no intervention. Group B received treatment of oral Cyclosporine (15 mg/kg/day) in a single daily dose and Group C was given Cyclosporine (15 mg/kg/day) with Nigella Sativa seeds (450 mg/kg) as a protective agent. The bodyweight of rats in each group was measured at the start of the study period. The treatment was given for the duration of 21 days, after which the body weight was measured again. The rats were anaesthetized and blood was collected through cardiac puncture. Blood analysis for haemoglobin percentage, total leucocyte count and differential leucocyte count was done using haematology analyzer. Manual differential leucocyte was also done after staining the blood smear with Leishman's stain. Results: Final body weight of rats in Cyclosporine treated Group B was decreased significantly p

Abstract Supersymmetric SO(10) models with Yukawa coupling matrices involving only a 10 H and a 126 ¯ H $$ {\overline{126}}_H $$ of Higgs fields can lead to a predictive and consistent scenario for fermion masses and mixings, including the neutrino sector. However, when coupled minimally to a symmetry breaking sector that includes a 210 H and a 126 H , these models lead either to an unacceptably small neutrino mass scale, or to non-perturbative values of the gauge couplings. Here we show that with the addition of a 54 H to the symmetry breaking sector, the successful predictions of these models for fermion masses and mixings can be maintained. The 54 H enables a reduction of the B − L symmetry breaking scale to an intermediate value of order 1012 GeV, consistent with the observed neutrino mass spectrum, while preserving perturbative gauge coupling unification. We obtain an excellent fit to all fermion masses and mixings in this framework. We analyze carefully the prediction of the model for CP violation in neutrino oscillations. Consistency with proton lifetime, however, requires a mini-split SUSY spectrum with the squarks and sleptons having masses of order 100 TeV, accompanied by TeV scale gauginos and Higgsinos. Such a spectrum may arise from pure gravity mediation, which would predict the partial lifetime for the decay p → ν ¯ K + $$ p\to \overline{\nu}{K}^{+} $$ to be an order of magnitude above the current experimental limit.

Ankylosing spondylitis (AS) is generally easy to diagnose when the characteristic findings of the 'bamboo' spine and fused sacroiliac joints are present on radiographs. Unfortunately, these changes are usually seen late in the disease after tremendous suffering has been incurred by the patient. Diagnostic delay averages seven to ten years. Historically, once the diagnosis was made, the treatment options were often inadequate or poorly tolerated in many individuals. This condition most often starts in early adulthood when people are typically in the earlier stages of their careers, resulting in diminished workforce participation and decreased quality of life. If an individual has a family physician, this might be the first encounter with a healthcare provider. Quite often, the initial practitioner is sought at a public walk-in clinic or chiropractic office. In recent years, there have been two major developments in the management of AS that make earlier diagnosis possible and offer the hope of alleviating pain and preventing structural changes that result in loss of function. These developments include the use of magnetic resonance imaging (MRI) to visualize the inflammatory changes in the sacroiliac joint and the axial spine, and the demonstration that tumor necrosis factor (TNF) blocking agents are highly efficacious in reducing spinal inflammation and possibly in slowing radiographic progression. This review outlines diagnostic strategies that can help identify AS in its earlier stages. Special attention is focused on treatment advances, including the use of anti- TNF agents, and how these medications have been incorporated into clinical recommendations for daily use. [ABSTRACT FROM AUTHOR]

If neutrinos are Dirac particles, their right-handed partners must be present in the theory. Once introduced in the Standard Model (SM), the difference between the baryon number B and the lepton number L can be promoted to a local U(1)B−L symmetry since the corresponding gauge anomalies can be canceled by the right-handed neutrinos. Furthermore, the extremely small neutrino mass can be explained naturally if it is originated from the quantum correction. In this work, we propose simplest models of radiative Dirac neutrino mass using only U(1)B−L symmetry, and without introducing additional fermions and without imposing ad hoc symmetries. In this simple framework, we provide minimal models where Dirac neutrino mass appears at the (i) one-loop, (ii) two-loop and (iii) three-loop. By performing systematic analysis, we show that the minimal one-loop model requires three beyond SM scalar multiplets, whereas minimal two-loop and three-loop models require five. The presented two-loop and three-loop Dirac mass models have not appeared in the literature before.

In this work we study a predictive model based on a partially unified theory possessing the gauge symmetry of the Pati-Salam group, SU(2)L×SU(2)R×SU(4)C supplemented by a global Peccei-Quinn symmetry, U(1)PQ. A comprehensive analysis of the Higgs potential is carried out in a minimal set-up. The assumed Peccei-Quinn symmetry along with solving the strong CP problem, can provide axion as the dark matter candidate. This minimal set-up with limited number of Yukawa parameters can successfully incorporate the hierarchies in the charged fermion masses and mixings. The automatic existence of the heavy Majorana neutrinos generate the extremely small light neutrino masses through the seesaw mechanism, which is also responsible for producing the observed cosmological matter-antimatter asymmetry of the universe. We find interesting correlation between the low scale neutrino observables and the baryon asymmetry in this model. Baryon number violating nucleon decay processes mediated by the scalar diquarks and leptoquarks in this framework are found to be, n,p→ℓ+m,ℓc+m (m= meson, ℓ= lepton, ℓc= antilepton) and n,p→ℓ+ℓc+ℓc. For some choice of the parameters of the theory, these decay rates can be within the observable range. Another baryon number violating process, the neutron-antineutron oscillation can also be in the observable range.

Friction welding process is a forging welding process in which work piece are joined due to heat produced by friction between two joining surfaces and upset pressure is applied by non-rotating work piece. Joining of aluminum alloy with dissimilar material is important research area to focus on as maximum aircraft structures havexx Aluminum alloy frame and aerospace designers familiar with Aluminum alloy and its design considerations. After comparison of mechanical properties and application of light weight alloys aluminum alloys, tungsten, stainless steel and copper, copper selected as dissimilar material to join with Aluminum alloy AA6063. AA 6063 also known as architectural alloy selected based upon its properties. This dissimilar joint of AA6063 and Copper has application in electrical conductors as copper is good electrical conductivity and used in maximum electrical conductors. In this research work AA6063 joined with Copper successfully using Rotary Friction Welding process. Through process study effective process parameters like Friction Pressure, Upset Pressure, Spindle Speed, and Friction Time identified and their effect on weld joint strength were studied.Testing for measuring UTS of friction welded joint conducted. Using DOE tool optimized set process parameters for friction welding identified and their effect on weld joint strength studied experimentally. Maximum UTS of 222.787 MPa for Friction welded joint achieved, bend test also performed on friction welded samples.

This paper presents an optimization method for solving the Power Economic Dispatch (PED) problem of thermal generation units with multiple fuels and valve point loadings. The proposed optimizer is a variant of Differential Evolution (DE) characterized as a Stud Differential Evolution (SDE), which has been proposed earlier and implemented on a hydrothermal energy system. In SDE, an operator named Stud Crossover (SC) is introduced in the conventional DE during the trial vector updating process. In SC operator, a best vector gives its optimal information to all other population members through mating. The proposed algorithm’s effectiveness to solve Multiple Fuel PED problem, with and without Valve Point Loading Effects (VPLEs), has been validated by testing it on 10 machine multiple fuel standard test systems having 2400 MW, 2500 MW, 2600 MW, and 2700 MW load demands. The results depict the strength of SDE over various other methods in the literature.

Immunohistochemical staining of formalin fixed, paraffin embedded tissue sections of OSF for MMPs-1,2,9 and their tissue inhibitors TIMP-1and 2 was performed using monospecific antibodies coupled with gelatin zymography (MMP-2 and 9) for measuring enzymatic activity quantitatively and for distinguishing the active from the inactive variants of enzymes. The present study, contrary to earlier reports, recorded statistically significant increase in the levels of stromal expression of MMP-1, MMP-2 and MMP-9 and TIMP-1 and TIMP-2 using monospecific antibodies reacting against tissue antigens.The simultaneous increase in reactivity of MMPs and TIMPs poise difficulty in interpretingthe results of this study. The possible reasons for this result, against the backdrop of existing knowledge, were attempted in this study.

OBJECTIVE : This study was designed to determine the effect of pentoxifylline (Trental) on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN : This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy) in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets). The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls) were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS : Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test). Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000), tongue protrusion (t= 3.898, p = 0.002), and relief from perioral fibrotic bands (p = 0.0001554). Subjective symptoms of intolerance to spices (p = 0.0063218), burning sensation of mouth (p = 0.0005797), tinnitus (p=0.000042), difficulty in swallowing (p=0.0000714). and difficulty in speech (p=0.0000020) were also recorded significant improvement at the end of the trial period. CONCLUSION : This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.

We report a series of retinal pigment epithelial (RPE) tears after intravitreal bevacizumab therapy for choroidal neovascularization associated with age-related macular degeneration (ARMD). Retinal pigment epithelial tears were estimated to occur at an incidence of 1.6% in this patient population at our institution. Ophthalmologists should be aware of this rare but serious finding associated with exudative macular degeneration therapy.

Abstract Background Infection by Plasmodium vivax has been considered rarely threatening to life, but recent studies challenge this notion. This study documented the frequency and character of severe illness in paediatric patients admitted to a hospital in south-eastern Pakistan with a laboratory-confirmed diagnosis of vivax malaria. Methods An observational study of all 180 paediatric patients admitted with any diagnosis of malaria during 2010 was conducted: 128 P. vivax; 48 Plasmodium falciparum; and four mixed infections of these species. Patients were classified as having severe illness with any of the following indicators: Glascow coma scale 70 breaths/min; or intravenous anti-malarial therapy. Additionally, 64 patients with a diagnosis of vivax malaria were treated during 2009, and the 21 of these having severe illness were included in analyses of the frequency and character of severe illness with that diagnosis. Results During 2010, 39 (31%) or 37 (77%) patients with a diagnosis of P. vivax or P. falciparum were classified as having severe disease. Including the 2009 records of 64 patients having vivax malaria, a total of 60 (31%) patients with severe illness and a diagnosis of P. vivax were available. Altered mental status (Glascow coma scale score Conclusions Vivax malaria caused a substantial burden of potentially life-threatening morbidity on a paediatric ward in a hospital in south-eastern Pakistan.

Abstract Background The impact of reducing door-to-balloon time on hospital revenues, costs, and net income is unknown. Methods We prospectively determined the impact on hospital finances of (1) emergency department physician activation of the catheterization lab and (2) immediate transfer of the patient to an immediately available catheterization lab by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse. We collected financial data for 52 consecutive ST-elevation myocardial infarction patients undergoing emergency percutaneous intervention from October 1, 2004–August 31, 2005 and compared this group to 80 consecutive ST-elevation myocardial infarction patients from September 1, 2005–June 26, 2006 after protocol implementation. Results Per hospital admission, insurance payments (hospital revenue) decreased ($35,043 ± $36,670 vs. $25,329 ± $16,185, P = 0.039) along with total hospital costs ($28,082 ± $31,453 vs. $18,195 ± $9,242, P = 0.009). Hospital net income per admission was unchanged ($6962 vs. $7134, P = 0.95) as the drop in hospital revenue equaled the drop in costs. For every $1000 reduction in total hospital costs, insurance payments (hospital revenue) dropped $1077 for private payers and $1199 for Medicare/Medicaid. A decrease in hospital charges ($70,430 ± $74,033 vs. $53,514 ± $23,378, P = 0.059), diagnosis related group relative weight (3.7479 ± 2.6731 vs. 2.9729 ± 0.8545, P = 0.017) and outlier payments with hospital revenue>$100,000 (7.7% vs. 0%, P = 0.022) all contributed to decreasing ST-elevation myocardial infarction hospitalization revenue. One-year post-discharge financial follow-up revealed similar results: Insurance payments: $49,959 ± $53,741 vs. $35,937 ± $23,125, P = 0.044; Total hospital costs: $39,974 ± $37,434 vs. $26,778 ± $15,561, P = 0.007; Net Income: $9984 vs. $9159, P = 0.855. Conclusion All of the financial benefits of reducing door-to-balloon time in ST-elevation myocardial infarction go to payers both during initial hospitalization and after one-year follow-up. Trial Registration ClinicalTrials.gov ID: NCT00800163