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Ferroptosis is a regulated form of cell death driven by the lethal accumulation of lipid peroxides in cell membranes. Several regulators of ferroptosis have been identified using cancer cell lines. However, the cellular pathways of ferroptosis in neurons remain poorly characterized. In this study, we used a mouse embryonic stem cell-derived motor neuron model to investigate how motor neurons respond to ferroptosis inducers. Pharmacological and genetic inhibition of glutathione peroxidase 4 (GPx4) induced ferroptosis in motor neurons, while system x

Program Pengabdian Kepada Masyarakat ini bertujuan untuk memberikan pengetahuan tentang pentingnya meningkatkan kesadaran masyarakat tentang penyakit kecacingan dengan menerapkan pola hidup bersih dan sehat (PHBS) di Kel. Manggala, Kec. Manggala, Kota Makassar. Penyakit kecacingan merupakan penyait infeksi yang disebabkan oleh cacing yang hidup sebagai parasit di dalam tubuh manusia. Seseorang dapat terinfeksi penyakit kecacingan ketika telur atau larva masuk ke dalam tubuh, menjadi cacing dewasa dan bertelur di dalam tubuh. Seseorang dapat dengan mudah terinfeksi oleh cacing ketika hidup dalam lingkungan yang tidak bersih, memiliki sanitasi yang buruk dan kebiasaan yang tidak higienis. Upaya pencegahan salah satunya dengan mencuci tangan dengan sabun setelah berkegiatan, terutama setelah buang air besar (BAB). Resiko penularan penyakit dapat berkurang dengan adanya peningkatan perilaku hidup bersih dan sehat. Kebiasaan mencuci tangan harus dibiasakan sejak kecil. Anak-anak merupakan agen perubahan untuk memberikan edukasi baik untuk diri sendiri dan lingkungannya, sekaligus mengajarkan pola hidup bersih dan sehat. Metode pelaksanaan pengabdian masyarakat ini terdiri dari dua tahapan, yaitu: 1) Penyuluhan dan edukasi tentang penyakit kecacingan dikaitkan dengan penerapan perilaku pola hidup bersih dan sehat dengan metode ceramah; 2) Memberikan umpan balik sebagai evaluasi untuk mengetahui pemahaman masyarakat terhadap materi penyuluhan yang disampaikan pemateri. Hasilnya menunjukkan bahwa dengan adanya penyuluhan ini memberikan tambahan pengetahuan tentang penyakit kecacingan, serta antusias masyarakat untuk mengetahui bagaimana perbaikan sanitasi di lingkungan dan membiasakan menjaga kebersihan perorangan agar terhindar dari penyakit kecacingan. Pemahaman masyarakat tentang manfaat dari kegiatan ini sangat besar terlihat dengan adanya keinginan untuk menerapkan Pola Hidup Bersih dan Sehat agar terhindar dari infeksi penyakit kecacingan.

Background Crohn’s disease (CD) is associated with a 3-4 fold increased risk of periodontitis compared to the general population1 though periodonitis is poorly recognised and diagnosed. Evidence from mouse models highlight an important link between oral and gut health. Periodontitis has been shown to lead to ectopic colonization of oral pathogens and oral Th17-T cells that activate lamina propria macrophages and exacerbate gut inflammation2. Very little is known about the patient demographics of those at risk of periodontitis. This study aimed to assess the risk factors for periodontitis in CD patients. Methods We conducted a cross-sectional study recruiting CD patients at UCLH through myCare, an online platform for patients linked to their clinical records. Patient data were obtained using EpicCare, a web-based electronic patient record database. Patient risk of periodontitis was determined using a previously validated oral health questionnaire3. Statistical tests were conducted using IBM SPSS Statistics 27. Results This single centre study included 89 CD patients; 54% female and median age of 40 (IQR 19-82). Patients predominantly identified as White British (56%). The majority had ileocolonic CD (51%) with non-stricturing/non-penetrating behaviour (70%) and were on biologic therapy (52%) (Tab 1). The oral health questionnaire identified 37% of CD patients at risk of periodontitis. There was no statistically significant association between periodontitis risk and age, gender, age at CD diagnosis, disease duration, CD phenotype, family history, body mass index (BMI) or smoking status. Current steroid, immunomodulator use and number of prior biologics also showed no association. Current use of adalimumab and ustekinumab were both independently correlated with risk of periodontitis (χ2 p=0.004 & χ2 p=0.044, respectively). 90% of patients receiving adalimumab were not at risk of periodontitis (Fig 1). In contrast, 60% of patients on ustekinumab were at risk of periodontitis. Logistic regression analysis showed that patients receiving adalimumab were 86% less likely to be at risk of periodontitis compared to patients not receiving adalimumab (OR 0.14 (CI 0.029 - 0.633, p=0.011)). 75% of the adalimumab group was anti-TNF naïve, but no association was seen between prior biologic use and periodontitis risk (p=0.91). Conclusion The questionnaire has identified a third of patients who are at risk of periodontitis in the CD cohort. Adalimumab shows benefit in mitigating this risk and may be a drug of choice in patients with oral disease. The questionnaire is a helpful tool to identify and refer at-risk patients.

Background Despite improved postoperative management, endoscopic recurrence after surgery remains common in Crohn’s disease (CD) patients [1]. It is widely accepted that patients receiving preoperative nutrition supplementation are less likely to experience postoperative complications [2]. However, little is known about the long-term effects of preoperative nutrition supplementation on surgery. In this study we aimed to assess the long-term effects of preoperative nutrition supplementation on endoscopic recurrence. Methods Single centre retrospective data was collected between 2015 and 2021 on patients who had surgical resection with ileocolonic anastomosis. Follow up data was retrospectively collected at 12 months after surgery. Endoscopic recurrence was defined as a Rutgeerts score of 2 or more. Statistical analysis included demographics and inferential analyses. Missing data was attributed to the absence in clinic notes. Results This study included 50 CD patients [50.0% male, median age of 31.0 (18.0-68.0), 81.8% non-smokers] who had ileocolonic anastomosis. Most patients had ileocolonic CD (76.0%, 38/50) and either stricturing (46.0%, 23/50) or penetrating (26.0%, 13/50) disease behaviour. Almost half (49.0%, 24/49) of CD patients received preoperative nutrition supplementation prior to surgery, with 61.9% on oral nutrition supplementation. No statistical difference was found between the demographics of patients receiving nutrition supplementation and patients without nutrition supplementation, p>0.05 (table 1). Endoscopic recurrence was observed in 43.5% (10/23) of patients at 12 months. 80.0% (8/10) of patients who experienced endoscopic recurrence did not receive preoperative nutrition supplementation (figure 1). Logistic regression indicated that patients receiving nutrition supplementation may be 84.4% less likely to experience endoscopic recurrence at 12 months compared to patients without nutrition supplementation (OR 0.16 (CI 0.023-1.056)(p=0.057)). The type of preoperative nutrition supplementation did not significantly impact endoscopic recurrence (p>0.05). Conclusion Preoperative nutrition supplementation may reduce the risk of endoscopic recurrence one year after surgical resection. The use of preoperative nutrition is highly recommended for all CD patients undergoing surgery. More extensive research is needed to confirm study findings.

Activated carbon that potentially acts as an adsorbent was prepared from granulated sugar. The activated sugar was prepared through a dehydration process followed by a chemical activation process with a concentrated NaOH solution. To comprehend the properties of prepared ready carbon, characterization of the carbon was needed to be conducted. The conducted methods for prepared activated carbon were FTIR for detecting present functional groups attached to carbon, BET to identify the porous structure of synthesized carbon, SEM method as a morphological indicating method on synthesized carbon, and carbon thermal stability characteristic information from the TGA method. It was found that the prepared activated carbon contained various functional groups. The distinguished functional groups presented were carboxylic acid, free alcohol, NH2, and SO3. The readily activated carbon showed a rough surface to enhance the adsorption process on the synthesized carbon from the SEM characterization method. BET on the readily activated carbon revealed that the activated carbon exhibited type IV isotherm, consisting dominantly of mesopores and micropores as a minority. TGA characterization method showed that the thermal stability of carbon was significantly unstable in the range of 100℃ and around 200℃. It implies that the prepared activated carbon contained OH as one of its functional groups. With all the characterization methods conducted on the readily activated carbon from granulated sugar, it was found that the prepared carbon had the potential to be utilized as an adsorbent. Moreover, it is suggested that the granular sugar-based carbon should be investigated in the following future study in the wastewater treatment process.

Introduction: Diabetes mellitus (DM) is considered one of the largest emerging threats to health and bacterial infections are more frequent in diabetic patients causing sepsis. Several indicators have been proposed as new diagnostic tests to assess sepsis in hospitalized patients. Aim: This study aims was to compare the efficacy of Procalcitonin (PCT) and high sensitive C-reactive protein (hs-CRP) in the diagnosis of sepsis in diabetic patients. Methods: In this cross-sectional study total of 60 age and sex-matched diabetic patients above 18 years were randomly chosen with at least 2 SIRS (Systemic inflammatory response syndrome) criteria from the indoor department of BIRDEM General Hospital. Basic hematological, biochemical, microbiological laboratory data were recorded from laboratory reports. Sepsis and its different stages were determined according to American College of Chest Physicians (ACCP) guidelines. The PCT was measured by sandwich enzyme immunoassay (Bio-Vendor, Germany) and the hs-CRP level was measured using an immune-turbidimetric assay (Beckman, Carlsbad, CA 92010, USA). Results: The patient’s mean age was 51.90±9.89 years where male 51.2% and female 48.8% and 50-60 years age group was the most common 40%. 38 (63.33%) patients were bacteriological culture-positive and 22 (36.67%) patients were bacteriological culture-negative where the most common organism was Klebsiella (28.95%). Statistically, a significant difference was found in PCT values in the bacteriological culture positive and negative group (p0.05). There was an increasing trend of serum PCT with the developing stages of sepsis. Receiver operating characteristic curve shows the area under the curve for PCT was 0.785 (95% CI; 0.654-0.915), sensitivity 89.47%, specificity 50%, PPV 75.55% and NPV 73.33% with the best cut-off value >753pg/ml which support PCT as a superior and reliable marker of sepsis. Conclusion: Our results suggest that serum PCT is a more reliable diagnostic marker of sepsis than other traditional markers like hs-CRP. Combinatorial use of these biomarkers will help in early diagnosis and also greatly improve outcomes. Bangladesh Crit Care J March 2022; 10 (1): 38-42

Introduction Previous cross-sectional and longitudinal studies have described decreasing testosterone levels with age in men. However, the longitudinal impact of acquired comorbidities in aging males on the relationship between age and testosterone has not been thoroughly investigated. Objective In this longitudinal study, we aimed to evaluate the longitudinal association between age and testosterone levels and to investigate the impact of additive comorbidity burden on this relationship. We hypothesized that when controlling for the presence of comorbidities commonly acquired with age, there would be no association between age and serum total testosterone level. Methods Participants were selected from the Baltimore Longitudinal Study of Aging. Data was obtained on presence of several comorbidities and total testosterone level during each follow-up visit. All men with diagnosis of prostate cancer or documented use of testosterone replacement therapy during their follow-up period were excluded from analysis. A stepwise regression analysis was performed, including a final multivariate panel regression model in order to determine the impact of age on testosterone level while controlling for individual comorbidities. Results A total of 1,784 men were included in this study, with a mean age of 71 years and overall mean testosterone level of 463.2 ng/dL. Participants had an average of 3.23 comorbidities. On multivariable-adjusted panel regression analysis, age was not significantly associated with testosterone decline, while anemia, diabetes mellitus, heart failure, obesity, peripheral artery disease, and stroke were inversely associated with total testosterone level. We report no association between cancer and total testosterone. Conclusions In this large longitudinal study, we found that when adjusted for the presence of concomitant comorbidities, age does not predict a significant decline in testosterone level with age. With the overall increase in life expectancy, and the simultaneous rise in the incidence of comorbidities such as diabetes and dyslipidemia, our findings may help optimize screening and treatment for late-onset hypogonadism in patients with multiple comorbidities. Disclosure No

In this paper, we report a successful synthesis of ZnO nanorods using the microwave-assisted technique, solid-state reaction method was utilized for the preparation of Zn

Background Robotic-assisted cardiac surgery has emerged as a popular minimal invasive cardiac surgery approach, as it provides several advantages compared to conventional and other minimally invasive approaches. Mitral valve surgeries, including repair and replacement, are currently the most common cardiac surgeries performed with a robotic approach. However, there are concerns that surgeon's learning curve and prolonged operation time associated with this approach could compromise the surgical outcomes, hence the low acceptance of the technique in the clinical setting. In addition, despite various studies comparing robotic and conventional mitral surgery, it remains unclear whether the former would give comparable, if not better, outcomes. Purpose This study aims to compare the outcomes of robotic and conventional sternotomy mitral valve surgeries. Methods A comprehensive literature search was performed through Pubmed, CENTRAL, and ScienceDirect for studies comparing robotic and sternotomy approach for mitral valve repair and replacement. Studies were screened with our eligibility criteria, and their quality was examined using the Newcastle-Ottawa scale. The primary outcome analysed in this study was the perioperative mortality. Results Twelve studies involving 4300 patients (2223 experienced robotic surgery) were included. Pooled analysis showed that patients who underwent robotic surgery had a significant decrease in perioperative mortality compared to those who underwent sternotomy surgery (RR 0.33, 95% CI 0.18, 0.60, p=0.0003, I2=0%). Moreover, ICU length of stay was also shorter in the robotic group (MD −13.67, 95% CI −20.04, −7.29, p Conclusion Results from our meta-analysis refute the current concerns limiting the acceptance of robotic approach in mitral valve surgeries, showing significantly lower perioperative mortality and ICU length of stay, as well as a comparable re-operation risk due to bleeding with the conventional approach. Funding Acknowledgement Type of funding sources: None.

An experiment was conducted at Fruit Tree Improvement Project, Fruit Tree Improvement Programme, Bangladesh Agricultural University-Germplasm Center (FTIP, BAU-GPC), Bangladesh Agricultural University (BAU), Mymensingh during the period of April 2020 to June 2020 to study the performance of selected mango rootstocks for the saline area. The two-factor experiment consisted of four mango rootstock varieties such as V1 = BAU Aam-9, V2 = BAU Aam-6, V3 = BAU Aam-4 and V4 = Amropali and six salinity treatments namely control S1 = 0 dSm-1, S2 = 4 dSm-1, S3 = 8 dSm-1, S4 = 10 dSm-1, S5 = 12 dSm-1 and S6 = 14 dSm-1. The experiment was conducted following randomized complete block design with three replications. Results revealed that rootstock line and salinity levels had significant influences on various rootstock characters viz. length of rootstocks, number of leaves and percent rootstocks success and survivability. In case of varietal effect, the highest number of leaves (32.44) found in BAU Aam-6 and the lowest number of leaves was recorded in Amropali (22.55) at 90 days after transplanting. The longest rootstock length observed in 90 DAT which (54.83 cm) found in BAU Aam-9and shortest rootstock recorded in Amropali (47.94 cm). The highest survivability (51.44%) was recorded in BAU Aam-9 and the lowest survivability recorded in Amropali (33.88%). In case of salinity treatments, the highest survivability (95.83%) was recorded in control and the lowest survivability (0.00%) recorded in 14 dsm-1 at 90 DAT. Interaction of rootstock varieties and different salinity treatments showed significant variation on the length leave and survivability of rootstocks at 90 DAT. The maximum number of rootstock leaves recorded in V2S2 (46.33) and lowest number of leave recorded in V4S6 (7.66). The highest rootstock length was found in V1S3 (78.00 cm) and lowest in V1S2 (21.66 cm). The highest Survivability (100 %) observed in V1S1, V1S2, V2S1, V2S2 and V4S1. From the above mentioned it can be said BAU Aam - 9 and BAU Aam – 6 rootstock varieties performed best from 0-8 dSm-1 salinity. The overall salinity tolerance was graded as follows: BAU Aam - 9>BAU Aam – 6> BAU Aam-4>Amropali rootstock line. SAARC J. Agric., 19(1): 93-102 (2021)

The marine environment is increasingly polluted by anthropogenic wastes, notably plastic debris. This debris breaks down into smaller pieces, known as microplastics. When consumed by marine organisms, microplastics cause various physiological effects. In this study, we sought to determine a link between ingested microplastics and cytochrome P450-1A (CYP1A) expression in fish liver. To achieve this goal, we collected pinfish from five sites in Lower Laguna Madre (LLM, a large coastal lagoon), analyzed stomach contents, excised liver tissues, and performed immunohistochemical analysis to determine CYP1A expression. Microplastics were not discovered in the stomach/intestine of pinfish, though plastic debris was present at various stages of decomposition within sampling sites. Hepatic CYP1A expression was significantly higher in pinfish collected from four of five sampling sites when compared to fish in laboratory conditions. These results imply that pinfish, as well as other organisms, may be exposed to pollutants other than microplastics in LLM.

Elbow ulnar collateral ligament injuries are on the rise among throwing athletes. The gold standard for the management of this injury in elite athletes is reconstruction of the ulnar collateral ligament (UCL) with a tendon graft. While multiple reconstruction techniques have been described with successful outcomes and low complication rates, no single technique has demonstrated superiority over another. A recent concept with growing interest for addressing ligament injuries is suture bridge augmentation as an internal brace. Recent biomechanical data has demonstrated favorable results using suture bridge augmentation for elbow UCL repair, however a reconstruction technique using this concept and tendon allograft has not yet been described. Proposed advantages include limited surgical dissection and ulnar nerve handling as well as placement of single bony sockets in the ulna and humerus, thereby minimizing the potential for bony failure and fracture. We describe our surgical technique of UCL reconstruction of the elbow using tendon allograft augmented with an internal brace and provide a case illustration of a young, adolescent baseball pitcher.

Background Sarcopenia, a reduction in muscle mass and function, is a poorly recognised phenomenon in Crohn’s disease (CD) despite occurring in 16%-68% of CD patients [1-5]. It has been linked to both an increased need for surgery and increased risk of postoperative complications. However, the role of sarcopenia in CD and its long-term impact on surgical outcomes are unknown. We aimed to assess the link between sarcopenia and postoperative clinical recurrence. Methods Retrospective data was collected between 2015 and 2021 from CD patients who had undergone gastrointestinal surgery and a MR or CT scan within 3 months prior to surgery. Follow up data was retrospectively collected for 6 months. MR and CT scans were used to determine skeletal muscle area (SMA) from the cross-sectional L3 vertebrae, which was used to identify patients as sarcopenic or not. Clinical recurrence was defined as a Harvey-Bradshaw Index of 5 or more. Statistical analysis included demographics and inferential analyses. Missing data was attributed to the absence in clinic notes. Results This single centre study included 64 CD patients [56.3% male, median age of 30.0 (18.0-76.0), 87.7% non-smokers] who had undergone gastrointestinal surgery. Most patients had ileocolonic CD (74.6%, 47/63) and either stricturing (46.9%, 30/64) or penetrating (31.3%, 20/64) disease behaviour, and 23.4% (15/64) had perianal disease. 45.3% (29/64) of patients had had at least one previous surgery. Preoperatively, 20.6% (13/63) of patients were on steroids and 55.6% (35/63) were on combined drug therapy. Patient median SMA was 113.6 (61.8 – 281.7) cm2 with sarcopenia found in 74.1% (43/58) of patients. SMA was lower in females (females: 92.1±19.3 cm2 vs males: 137±39.5 cm2, p Conclusion Sarcopenia is highly prevalent in preoperative CD patients. Patients with early clinical recurrence had a significantly lower SMA. SMA may be useful in predicting CD patients at risk of early postoperative clinical recurrence. However, more research is needed to confirm study findings.

Early life stress (ELS) induces long-term phenotypic adaptations that contribute to increased vulnerability to a host of neuropsychiatric disorders. Epigenetic mechanisms, including DNA methylation, histone modifications and non-coding RNA, are a proposed link between environmental stressors, alterations in gene expression, and phenotypes. Epigenetic modifications play a primary role in shaping functional differences between cell types and can be modified by environmental perturbations, especially in early development. Together with contributions from genetic variation, epigenetic mechanisms orchestrate patterns of gene expression within specific cell types that contribute to phenotypic variation between individuals. To date, many studies have provided insights into epigenetic changes resulting from ELS. However, most of these studies have examined heterogenous brain tissue, despite evidence of cell-type-specific epigenetic modifications in phenotypes associated with ELS. In this review, we focus on rodent and human studies that have examined epigenetic modifications induced by ELS in select cell types isolated from the brain or associated with genes that have cell-type-restricted expression in neurons, microglia, astrocytes, and oligodendrocytes. Although significant challenges remain, future studies using these approaches can enable important mechanistic insight into the role of epigenetic variation in the effects of ELS on brain function.

A compelling group the board framework offers prompt receptive or proactive treatment of possible problem areas, including packed circumstances and dubious developments, which relieve or evades serious episodes and fatalities. The group the board space creates spatial and transient goal that requests different modern components to quantify, concentrates, and interact with the information to deliver a significant reflection. Swarm the board incorporates demonstrating the developments of a group to project compelling systems that help fast emersion from a risky and deadly circumstance. Web of Things (IoT) advancements, AI procedures, and specialized techniques can be utilized to detect the group trademark/thickness and proposition early recognition of such occasions or far superior expectation of likely mishaps to illuminate the administration specialists. Different AI strategies have been applied for swarm the board; in any case, the quick progression in profound various leveled models that gains from a nonstop stream of information has not been completely explored in this specific situation. For instance, Hierarchical Temporal Memory (HTM) has shown strong capacities for application areas that require internet learning and demonstrating transient data. This paper proposes another HTM-based structure for peculiarity identification in a group the board framework. The proposed system offers two capabilities: (1) responsive discovery of group oddities and (2) proactive location of peculiarities by foreseeing expected irregularities before occurring. The exact assessment demonstrates that HTM accomplished 94.22%, which outflanks k-Nearest Neighbor Global Anomaly Score (kNN-GAS) by 18.12%, Independent Component Analysis-Local Outlier Probability (ICA-LoOP) by 18.17%, and Singular Value Decomposition Influence Outlier (SVD-IO) by 18.12%, in swarm different irregularity location. Besides, it shows the capacity of the proposed alarming system in anticipating potential group irregularities. For this reason, a mimicked swarm dataset was made utilizing the MassMotion swarm recreation device.

Plant sicknesses cause significant harvest creation misfortunes around the world, and a great deal of huge exploration exertion has been coordinated toward making plant infection distinguishing proof and therapy methods more viable. It would be of extraordinary advantage to ranchers to have the option to use the ongoing innovation to use the difficulties confronting horticultural creation and thus further develop crop creation and activity productivity. In this work, we planned and executed an easy-to-understand cell phone-based plant illness discovery and treatment suggestion framework utilizing AI (ML) methods. CNN was utilized for include extraction while the ANN and KNN were utilized to order the plant infections; a substance-based sifting proposal calculation was utilized to recommend significant medicines for the recognized plant illnesses after grouping. The aftereffect of the execution shows that the framework accurately identified and suggested treatment for plant illnesses.

The first family medicine training programme for medical students in India began at Christian Medical College (CMC), Vellore in 2005 as a two-week programme. Currently, it includes two mandatory and one elective programme along with one to two weeks during the internship. In this study, the authors examined the impact of the mandatory programmes in family medicine through the feedback of medical students and the faculty experience. The aim of the authors was to examine the impact on medical students based on their feedback and the experience of faculty in teaching family medicine.This paper reports a retrospective evaluation based on the feedback of third-year medical students after their mandatory programmes in 2018. The authors collected students' feedback using questionnaires and recorded the faculty experience through a focus-group discussion (FGD) and in-depth interview. Overall attendance of students was 50-60%. About 75% of students who filled in the questionnaire felt the programme to be relevant to their future role as 'Physicians of First Contact'. Faculty felt challenged to balance their role as academics in addition to their clinical responsibilities. However, introducing family medicine principles in the medical curriculum was sensed by the faculty to equip students to manage common clinical conditions effectively. In conclusion students' understanding of the unique status of family medicine to accommodate patients of all ages and problems within a single umbrella health-care system was well discerned by the authors in this study.

The high number ofsensors, ten in total, required by the traditional finite control set model predictive control (FCS-MPC) strategy of a four-leg inverter with LC output filter increases the complexity and cost of the system and limits the practical application and commercialization. To simplify the implementation, reduce the cost and enhance the reliability, a novel current sensorless predictive load voltage control scheme, with only four voltage sensors and no current sensors, is proposed in this work. A new dynamic model of the LC filtered four-leg inverter is constructed in the stationary ($\alpha \beta \gamma$) reference frame for the proposed load voltage and capacitor current observer. The dual-boundary-layer nonlinear feedback is combined with a linear feedback term to enhance the robustness while retaining the accuracy of the observer. Extensive experiments are performed to confirm the effectiveness of the proposed controller. The results validate that the proposed sensor-less FCS-MPC with only four voltage sensors achieves an equivalent performance to the conventional FCS-MPC with ten sensors.

Background:Chronic heart failure (CHF) is the most common and prognostically unfavorable outcome of many diseases of the cardiovascular system. Clinical trials have demonstrated mortality and morbidity benefits of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure. These studies have used either eplerenone or spironolactone as the MRA. Eplerenone is a selective aldosterone antagonist expected to have a lower incidence of hormonal side effects than spironolactone. The present study is designed to compare these two drugs in chronic heart failure patients as no head to head trial between these two drugs is found regarding improvement of systolic function, tolerability and safety. The aim of this study is to compare the effects of eplerenone and spironolactone on LV systolic function in patients with chronic heart failure in a single center. Methods:It was a randomized clinical trial single blind study. A total of 224 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV were selected by random sampling, from July 2017 to June 2018. Each patient was randomly allocated into either of the two arms, and was continued receiving treatment with either spironolactone (Arm-I) or eplerenone(Arm-II). Each patient was evaluated clinically, biochemically and echocardiographically at the beginning of treatment (baseline) at 1 month and at the end of 6th month. Echocardiography was performed to find out change in left ventricular systolic function. Result: After 6 months of treatment, ejection fraction was found higher in the eplerenonearm (40.3 ± 6.5 versus 38.3 ± 4.6%; P < 0.05). Ejection fraction (EF) changes were 6.2% in eplerenone group and 4.1% in spironolactonearm. A significant reduction in left ventricular end-systolic volume (21.9±2.5 in group I versus 14.9±5.7 in group II; P < 0.05) and left ventricular systolic diameter (48.7±4.0 in arm I versus 45.2±4.9 in arm II; P0.05). Conclusion: In this study, the improvement in systolic function was more in eplerenone arm, which also had fewer adverse side effects when compared to spironolactone arm. So, it can be concluded that eplerenone can be advised in patient with chronic heart failure in addition to other drugs that are used to treat heart failure. University Heart Journal Vol. 16, No. 2, Jul 2020; 65-70

NT3 protein is expressed by Neurotrophin 3 (NTF-3) which plays a role in the process of differentiation, survival of peripheral and neuropathological of neurons. The information of structure and function of NT-3 proteins is still very limited, especially in Gallus gallus. This study aims to predict the three-dimensional structure of the Trk A and Trk B proteins in Gallus gallus. The target protein obtained from the UniProt server with access codes Q91009 (Trk A) and Q91987 (Trk B) using the 6kzc 1.A (PDB ID) template was analyzed in silico through a homology approach and describing the structural assessment using Chimera UCSF software. The analysis showed that the Trk A protein had a QMEAN value of -0.08, composed of 778 amino acids, mass 87334.30 Daltons, and Seq Identity 79.93%. Trk B had a QMEAN value of 0.16, consisting of 818 amino acids, mass 91732.05 Daltons, and Seq Identity 84.30%. Key words: NT3; homology; UCSF chimera; G. gallus

Introduction: A recent Cochrane review on the diagnostic accuracy of initial signs and symptoms of COVID-19 reported on the lack of evidence from studies conducted in community-based health-care settings. Since a broad spectrum of patients present to primary health-care services, testing for patients with noninfluenza-like illness and atypical presentations is debatable. Hence, there is an urgent need for documenting the early presenting symptoms of COVID-19 among patients seeking medical care in primary health-care settings. Aim: In this study, we aim to document the early symptoms of patients with COVID-19 and the proportion of asymptomatic infection in family medicine centers in South India. Design: This is a retrospective study of the early symptoms of patients who tested positive between June and December 2020. The data and clinical notes of patients were retrieved from the hospital information system. Setting: This study was undertaken by the Department of Family Medicine (DFM) in a private not-for-profit academic institution in South India. The DFM provides primary and secondary health-care services to nearly 1,50,000 patients from the local urban communities. Results: A total of 330 patients were tested for COVID-19 and the study included 94 patients who tested positive. Around 37% participants were asymptomatic. The commonest symptom was fever (58.6%), followed by tiredness/myalgia (48.3%), loss of taste or smell or appetite (43.1%), and cough or cold (37.9%). Most participants (78.2%) were hospitalized and the rest (21.8%) were home-quarantined. Only 5 (5.7%) of them died due to COVID-19 infection. Conclusion: The results of the study reiterates the role of social distancing, self-isolation, proper masking, and greater vaccination coverage as significant public health interventions.

Seagrass meadows are carbon (C) sinks and nitrogen (N)-limited ecosystems that experience degradation from climate change and anthropogenic stressors, including prop-scarring disturbances by boating vessels. To better understand the variability in C and N pools of undisturbed seagrass soils and the recovery of these pools following boat propeller scarring, we quantified organic carbon (Corg) and N pools within the top 1 m of soils in undisturbed Thalassia testudinum seagrass beds of the Lower Laguna Madre (LLM), Texas, USA—a sub-tropical, uniquely hypersaline, and heavily used recreational boating lagoon—and used a chronosequence approach to compare these undisturbed soil pools to those in different aged prop scars (1–3, 4–6, 7–9, and 10+ years). We found that undisturbed soils stored 108.41 ± 2.93 and 6.65 ± 0.26 Mg (megagram) ha−1 of Corg and N, respectively, in the top 1 m, with ~ 30% of these pools stored within the top 20 cm. Scarring impacted these shallow, organic-rich pools, exposing higher bulk density (BD) mineral soils with lower %Corg and %N. Consequently, young scars (1–3 years) had significantly lower %Corg and %N values in the top 20 cm of soil compared with undisturbed soils, but the greater BD offset these changes, leading to no differences in total Corg and N pools in the top 1 m between scarred and undisturbed soils. Scars 10+ years had similar %Corg, %N, and BD soil characteristics to undisturbed soils, producing similar Corg and N pools in both upper and lower soil horizons. These findings indicate that recovery of Corg and N pools of prop-scarred seagrass soils within T. testudinum beds of the LLM will likely recover a decade or more post-disturbance. Our findings contribute to the growing global database on seagrass C and N storage and demonstrate the rate at which seagrass meadows recover post-disturbance.

Early life stress (ELS) induces long-term phenotypic adaptations that contribute to increased vulnerability to a host of neuropsychiatric disorders. Epigenetic mechanisms, including DNA methylation, histone modifications and non-coding RNA, are a proposed link between environmental stressors, alterations in gene expression, and phenotypes. Epigenetic modifications play a primary role in shaping functional differences between cell types and can be modified by environmental perturbations, especially in early development. Together with contributions from genetic variation, epigenetic mechanisms orchestrate patterns of gene expression within specific cell types that contribute to phenotypic variation between individuals. To date, many studies have provided insights into epigenetic changes resulting from ELS. However, most of these studies have examined heterogenous brain tissue, despite evidence of cell-type-specific epigenetic modifications in phenotypes associated with ELS. In this review, we focus on rodent and human studies that have examined epigenetic modifications induced by ELS in select cell types isolated from the brain or associated with genes that have cell-type-restricted expression in neurons, microglia, astrocytes, and oligodendrocytes. Although significant challenges remain, future studies using these approaches can enable important mechanistic insight into the role of epigenetic variation in the effects of ELS on brain function.

Introduction: Epidural/subgaleal abscesses in craniosynostosis surgery are rare but serious complications that may compromise neurological functioning in pediatric craniofacial populations. We evaluated the risk and evolution of management of post-operative subgaleal/epidural abscesses in craniosynostosis patients treated over 20 years by a single surgeon. Methods: Pediatric patients who underwent transcranial procedures for craniosynostosis by a single surgeon from 1997 to 2018 were included. The patients were stratified into groups based on the development of post-op abscess. The primary outcome measure was bone salvage success. Post-op abscesses were drained in the following manner: either open packing with delayed closure or no elevation of the scalp flap, followed by copious irrigation and deep (epidural) drain placement plus long-term intravenous antibiotics. Results: A total of 384 patients underwent 413 cases in this period: 177 sagittal, 85 unicoronal, 49 metopic, 4 lambdoid, and 69 cases of multiple suture synostosis. In this cohort, epidural/subgaleal abscess were found in 6 patients (1.5%) who all had bilateral fronto-orbital advancement ( P = .03). Bone salvage was attempted in all 6 patients with only minor bone resorption seen in 3 of the patients who presented with abscess. Conclusion: This study found that patients undergoing bilateral fronto-orbital advancement were at increased risk of a deep space infections, while those undergoing clavarial vault remodeling with barrel staves alone, were not. We were able to salvage the bone grafts and prevent neurological sequela with surgical washout, placement of drains and intravenous antibiotic therapy.

Coronary artery disease is a condition that affects millions of people worldwide and can lead to serious complications such as heart attack or stroke. The study's main objective is to compare drug-eluting stents versus bare-metal stents for treating coronary artery disease. The present study aimed to compare the efficacy and safety of drug-eluting stents (DES) versus bare metal stents (BMS) for the treatment of coronary artery disease (CAD). The study was conducted at two tertiary care hospitals, Hayatabad Medical Complex and Lady Reading Hospital in Peshawar, Pakistan, from July 2019 to July 2020. The study included a total of 384 patients with CAD who underwent percutaneous coronary intervention (PCI) with either DES or BMS. The study included a total of 384 patients with CAD who underwent PCI with either DES or BMS. The mean age of the study participants was 58.2 ± 9.4 years, and 75.8% were male. The baseline characteristics, including demographic data, clinical presentation, cardiovascular risk factors, and angiographic findings, were comparable between the two groups. In conclusion, our study contrasting medication-eluting stents versus exposed metal stents for treating coronary supply route sickness found that drug-eluting stents were related to a lower chance of unfriendly heart occasions, including objective vessel revascularization, dead myocardial tissue, and cardiovascular demise, contrasted with uncovered metal stents.

Peripheral arterial disease (PAD) is a medical condition in which the blood vessels outside the heart and brain were affected. The study's main objective is to compare the effectiveness of radial versus femoral access for diagnostic and therapeutic procedures in patients with peripheral arterial disease. The research article aimed to compare the effectiveness of radial and femoral access for diagnostic and therapeutic procedures in patients with the peripheral arterial disease (PAD). The study was conducted in two hospitals in Peshawar, Pakistan - Hayatabad Medical Complex and Lady Reading Hospital. The study duration was from January 2020 to December 2020. A total of 384 patients were enrolled in the study, with 192 randomly assigned to the radial access group and 192 to the femoral access group. The study found that RA was associated with a significantly lower risk of major bleeding and access site complications compared to FA. Specifically, the incidence of major bleeding was 1.56% in the radial access group and 5.73% in the femoral access group (p=0.02), and the incidence of access site complications was 2.6% in the radial access group, 8.3% in the femoral access group (p=0.01). In conclusion, our study suggests that radial access is a safe and effective alternative to femoral access for diagnostic and therapeutic procedures in patients with peripheral arterial disease. Radial access is associated with lower rates of major bleeding and access site complications, particularly for diagnostic procedures, and may offer advantages such as faster patient ambulation and improved patient comfort.

A 23-year-old woman with an Osborne-Cotterill lesion and posterolateral rotatory instability (PLRI) of the elbow was treated with osteochondral allograft transplantation (OCA) and lateral ulnar collateral ligament (LUCL) repair with internal brace. Two years after surgery, she reported resolution of pain and returned to all recreational activities. She reported no mechanical symptoms and no episodes of postoperative instability.PLRI can present with an Osborne-Cotterill lesion in addition to LUCL injury. The purpose of this case report was to describe the use of OCA to manage bony defects in the capitellum in addition to LUCL repair for patients with PLRI.

Despite the essential role of plasma cells in health and disease, the cellular mechanisms controlling their survival and secretory capacity are still poorly understood. Here, we identified the SNARE Sec22b as a unique and critical regulator of plasma cell maintenance and function. In absence of Sec22b, plasma cells were barely detectable and serum antibody titres were dramatically reduced. Accordingly, Sec22b deficient mice fail to mount a protective immune response. At the mechanistic level, we demonstrated that Sec22b is indispensable for efficient antibody secretion but also for plasma cell fitness through the regulation of the morphology of the endoplasmic reticulum and mitochondria. Altogether, our results unveil a critical role for Sec22b-mediated regulation of plasma cell biology through the control of organelle dynamics.

Sketch-based interface and modelling is an approach to reservoir modelling that allows rapid and intuitive creation of 3D reservoir models to test and evaluate geological concepts and hypotheses and thus explore the impact of geological uncertainty on reservoir behaviour. A key advantage of such modelling is the quick creation and quantitative evaluation of reservoir model prototypes. Flow diagnostics capture key aspects of reservoir flow behaviour under simplified physical conditions that enable the rapid solution of the governing equations, and are essential for such quantitative evaluation. In this paper, we demonstrate a novel and highly efficient implementation of a flow diagnostics framework, illustrated with applications to geological storage of CO2. Our implementation permits ‘on-the-fly’ estimation of the key reservoir properties that control CO2 migration and storage during the active injection period when viscous forces dominate. The results substantially improve the efficiency of traditional reservoir modelling and simulation workflows by highlighting key reservoir uncertainties that need to be evaluated in subsequent full-physics reservoir simulations that account for the complex interplay of viscous, gravity, and capillary forces. The methods are implemented in the open-source Rapid Reservoir Modelling software, which includes a simple to use graphical user interface with no steep learning curve. We present proof-of-concept studies of the new flow diagnostics implementation to investigate the CO2 storage potential of sketched 3D models of shallow marine sandstone tongues and deep water slope channels.

We discuss the application of the new open-source Rapid Reservoir Modelling software (RRM) to create a suite of 3D reservoir models of a complex carbonate formation where each model is increasingly more refined such that progressively more small-scale geological structures are preserved.Using flow diagnostics we then calculate key metrics for the dynamic reservoir behaviour to quantify the similarities and dissimilarities of the flow behaviour across the different models. This analysis allows us to identify at which scale geological heterogeneities need to be resolved in the reservoir model to capture the essential flow behaviours.The workflow presented in this study hence allows us to efficiently and effectively test different geological concepts and analyse how multi-scale geological heterogeneities that may need to be represented in a reservoir model impact the predicted dynamic response, so as to design more reliable and robust reservoir models for a broad range of geoenergy applications.

Production of subsurface heat from geothermal sources and subsurface storage of heat (and cool) are important for energy transition. Doublets for geothermal and warm- and cold wells for aquifer thermal energy storage (ATES) depend on circulation of fluids and heat. Estimating the potential and feasibility of such systems requires a careful analysis with simulation of fluid flow and heat transport. As building models and running simulations are time-consuming, a prototyping approach is beneficial to quickly assess viability and sensitivity of such systems.Sketch-based geological modelling combined with flow diagnostics forms the ideal for such a prototyping approach. Geological models can be sketched in 3D in a couple of minutes. Flow diagnostics then provides several key metrics on predicted flow behaviour. The quick turnaround time from sketching to quantitative results is key to understand the impact of heterogeneity on flow and helps to decide which detailed geological models and flow simulations are useful to carry out. This prototyping approach is applied to aquifers in shallow marine deposits, as proxy for thermal breakthrough time in geothermal doublet system and to estimate well spacing between cold and hot wells for ATES.

Illumination sources based on phosphors, pumped by laser diodes (LDs), have seen rapid developments over the past decade. Here, we present a new, to the best of our knowledge, design that features both spectral richness and the capability for high brightness. Complete design details and operational characterization have been described. This basic design can be extended in various ways to customize such lamps for different operational requirements. A hybrid arrangement of both LEDs and an LD is used to excite a mixture of two phosphors. The LEDs, in addition, provide a blue fill-in to enrich output radiation and to tune the chromaticity point inside the white region. The LD power, on the other hand, can be scaled up to generate very high brightness levels that are not achievable with pumping from LEDs alone. This capability is gained using a special transparent ceramic disk that carries the remote phosphor film. We also show that the radiation from our lamp is free from speckle-producing coherence.

The top meter of marine sediments is estimated to store a total of 2322 Pg of carbon [Atwood et al., 2020. Front. Mar. Sci., vol. 7 p.165], which is twice that of terrestrial soils. Physical disturbance and remineralization of these carbon stocks could further accelerate climate change. Rapid and accurate quantification of sediment carbon stocks can (1) better inform carbon budgets and management of human activities in the ocean to minimize carbon remineralization and (2) monitor changes in sediment carbon stocks due to anthropogenic and natural disturbances. Sediment acoustics, which have been linked with sediment total organic carbon/content in mud banks, seagrass beds, and estuarine environments, can be measured in situ and offer a scalable solution toward rapid estimation of carbon stocks. However, before this modality can be applied broadly, a fundamental understanding between sediment acoustic properties and sediment organic/inorganic constituents must be realized. Here, direct ex situ measurements of sediment acoustic properties, sediment organic carbon, and grain size distribution will be compiled and compared across a variety of sediment types and locations from our own measurements and from published datasets. The development of a non-site-specific constitutive-based relationship will be discussed. [Work supported in part by ONR.]

Acoustic propagation measurements were collected in a seagrass meadow in a shallow lagoon for periods of over 65 h in winter and 93 h in summer. A bottom-deployed sound source transmitted chirps (0.1–100 kHz) every 10 min that were received on a four-receiver horizontal hydrophone array. Oceanographic probes measured various environmental parameters. Daytime broadband acoustic attenuation was 2.4 dB greater in summer than winter, and the median received acoustic energy levels were 8.4 dB lower in summer compared to winter. These differences were attributed in part to seasonal changes in photosynthesis bubble production and above-ground seagrass biomass.