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A man in his 70s with a complex medical history, including cadaveric renal transplant, presented with recurrent urinary tract infections. Investigation revealed recurrent urinary pathogens, includingEnterobacter cloacaeand persistent BK viruria. Cystoscopy revealed a pedunculated mass in the right posterior–lateral wall, inferior to the transplant urethral orifice, and biopsy of this mass showed invasive small cell carcinoma with a prominent adenocarcinoma component. The tumour was treated with complete transurethral resection followed by carboplatin, etoposide and radiation. Laboratory analysis of biopsied samples showed immunostaining and molecular evidence of BK virus DNA in the cancer cells. Follow-up cystoscopies have shown no recurrence of the cancer.

This article examines how ideological frames, certain context factors and emotions influence choice of a retributory, retaliatory or reconciliatory reaction in intergroup conflict situations. Hindu and Muslim respondents supporting secular multiculturalism and composite culturalism gave their reactions to three norm-violating situations of varying intensities. Multinomial logistic regression was used to predict preferred reactions across situations. Reconciliation in comparison to retaliation and retribution was the most preferred reaction of both Hindus and Muslims. Ideological beliefs also predicted preferred reactions of respondents. Muslims with composite culture beliefs preferred retribution over reconciliation in two out of three situations, while Hindus having composite cultural beliefs preferred reconciliation over retaliation only in one situation. Positive out-group attitudes favoured a reconciliatory reaction in both groups. Anger and fear influenced choice of reactions of Hindus but not of Muslims. For Hindus and Muslims, resource power favoured choosing retribution over reconciliation. However, Muslims with greater retaliatory power chose retaliation. Own group identity and fraternalistic relative deprivation (FRD) played only a minor role.

Despite the country’s extensive environmental jurisprudence and many historic rulings in which the courts have rescued worsening environmental situations, river (Ganga and Yamuna) water does not match the mandated minimum “bathing quality.” Rivers like the Ganga and Yamuna, which flow through numerous states and towns, would be in a different situation. Without strict monitoring and enforcement of the measures, no action plan can work. Punishment of defaulters can serve as deterrence while also instilling fear in other non-compliant enterprises. In comparison to environmental legislation, the NGT Act allows for substantially harsher fines and penalties. River rejuvenation plans must be carefully monitored to ensure that they do not suffer the same fate. Making action plans will not improve river water quality unless they are implemented with sincerity and consistency, as well as continuous monitoring and severe enforcement.

A 95 days experiment was conducted to observe the growth performance of giant fresh water prawn (Macrobrachium rosenbergii) replacing fishmeal protein by dietary soybean meal protein in ten earthen mini ponds (50 m2), at Khulna University campus . Five experimental diets containing 25% protein as Control, Diet 1, Diet 2, Diet 3 and Diet 4 were used. In Control, 36% fishmeal was used as a sole source of protein and Diet 1, 2, 3 and 4 were prepared by substituting fishmeal protein with 30, 40, 50, and 80% fishmeal protein with soybean meal protein respectively. Juvenile shrimps were collected from local vendors having 1.7 g average weight and stocked at a density of 3 m-2. Water and soil quality was monitored regularly and found within the acceptable range. The prawns were fed twice daily at satiations by serving the diets in feeding trays. The highest average weight gain was found in Diet 4 (23.89 ± 5.29 g) and the lowest in Diet 2 (17.68 ± 1.09), although no significant difference (p>0.05) was observed among the treatment and the lowest FCR (1.09) the highest SGR (2.60) and PER (3.43) was achieved in Diet 4 that showed significant difference (p

A green and sustainable route for selective esterification of glycerol has been developed. The high selectivity of tri-acetin (99%), recyclability of catalyst and overall green methodology were the advantageous features.

Abiotic stresses have a detrimental impact on plant growth and productivity and are a major threat to sustainable crop production in rapidly changing environments. Proline, an important amino acid, plays an important role in maintaining the metabolism and growth of plants under abiotic stress conditions. Many insights indicate a positive relationship between proline accumulation and tolerance of plants to various abiotic stresses. Because of its metal chelator properties, it acts as a molecular chaperone, an antioxidative defence molecule that scavenges reactive oxygen species (ROS), as well as having signalling behaviour to activate specific gene functions that are crucial for plant recovery from stresses. It also acts as an osmoprotectant, a potential source to acquire nitrogen as well as carbon, and plays a significant role in the flowering and development of plants. Overproduction of proline in plant cells contributes to maintaining cellular homeostasis, water uptake, osmotic adjustment and redox balance to restore the cell structures and mitigate oxidative damage. Many reports reveal that transgenic plants, particularly those overexpressing genes tailored for proline accumulation, exhibit better adaptation to abiotic stresses. Therefore, this review aims to provide a comprehensive update on proline biosynthesis and accumulation in plants and its putative regulatory roles in mediating plant defence against abiotic stresses. Additionally, the current and future directions in research concerning manipulation of proline to induce gene functions that appear promising in genetics and genomics approaches to improve plant adaptive responses under changing climate conditions are also highlighted.

Information on genetic diversity with respect to various agro-morphological traits and eating and cooking quality traits plays a key role in the improvement of rice (Oryza sativa L.). With this aim, we have characterized a set of 98 indigenous aromatic rice germplasm accessions for four agro-morphological, two physical and two physico-chemical traits. Significant variation was observed among the cultivars for all the traits. Correlation analysis showed negative correlation of DFF with KLBC (r= -0.29; p=0.022) and kernel L/W ratio (r= -0.25; p=0.003), while PL was significantly and positively correlated with KLBC (r=0.38; p=0.000) and kernel L/W ratio (r=0.43; p=0.0649). KLBC showed highly significant positive correlation with GC (r=0.22; p=0.614) while between AAC and GC a significant negative correlation was observed (r= -0.38; p=0.000).

Until now, no specific and effective treatment exists for coronavirus disease 2019 (COVID-19). Since honey and Nigella sativa (HNS) have established antiviral, antibacterial, antiinflammatory, antioxidant, and immunomodulatory properties, we tested their efficacy for this disease in a multicenter, placebo-controlled, and randomized clinical trial at four medical care facilities in Pakistan. RT-PCR confirmed COVID-19 adults showing moderate or severe disease were enrolled in the trial. Patients were randomly assigned in a 1:1 ratio to receive either honey (1 g kg

Purpose: Allergen immunotherapy (AIT) while usually safe, is not without risk. Both sublingual (SLIT) and subcutaneous immunotherapy (SCIT) have the potential for systemic reactions including anaphylaxis. Materials and Methods: A short survey was distributed to fellows of the American Academy of Otolaryngic Allergy (AAOA) (n = 553) in July of 2019 to determine current prescribing practices. Results: A total of 103/553 surveys were completed, giving a response rate of 18.6%. Prescribing patterns for SCIT showed 79.6% prescribed auto-injectable epinephrine (AIE) to all patients, 11.7% prescribed only to high risk patients, while 1.9% did not prescribe AIE at all. SLIT showed similar patterns with 71.8% prescribing AIE to all, 11.7% to high risk or letting patient choose, and 6.8% did not prescribe to anyone. Just under half of the physicians responded affirmatively to giving a written anaphylaxis plan to patients on immunotherapy. 48.5% physicians reported treating in-office anaphylaxis due to SCIT or skin testing in the past year, while 6% reported anaphylaxis due to SLIT. Conclusions: A majority of otolaryngic allergists are still prescribing AIE for both SCIT and SLIT. With the recent higher costs attributed to AIE as well as drug shortages, some physicians are risk-stratifying patients. While SCIT has a higher risk for treatment related systemic reactions, anaphylaxis does occur with SLIT, thus making it imperative to counsel patients on a clear anaphylaxis protocol in all forms of AIT.

Background: Older adults with Type 2 diabetes (T2D) are more likely to be frail, which increases the risk for disability and mortality. Objectives: To determine the feasibility of a behavioral lifestyle intervention, enhanced with mobile health technology for self-monitoring of diet and activity, to improve frailty in overweight/obese older adults (≥65 years) diagnosed with T2D. Design, Setting, and Participants: Single arm, 6-month study of a behavioral lifestyle intervention in 20 overweight/obese (BMI>25) older adults (≥ 65 years) with self-reported T2D diagnosis who owned a smartphone. A Fitbit tracker was provided to all participants for self-monitoring of diet and physical activity. Our primary outcome of feasibility was measured by session attendance, adherence to Fitbit usage to self-monitor diet and physical activity, and study retention. Secondary outcomes included the preliminary efficacy of the intervention on frailty, physical function, quality of life, and T2D-related outcomes. Results: Eighteen participants completed the study. The mean age was 71.5 (SD ± 5.3) years, 56% were female, and half were Hispanic. At baseline, 13 (72%) were pre-frail, 4 (22%) were frail, and 1 (6%) were non-frail. At follow-up, frailty scores improved significantly from 1.61 ± 1.15 to 0.94 ± 0.94 (p=0.01) and bodyweight improved from 205.66 ± 45.52 lbs. to 198.33 ± 43.6 lbs. (p=

This article will review different methods of skin testing available for allergic rhinitis, emphasizing controversies and challenges associated with these techniques. The utility of quantitative skin testing has been debated in current literature, as has the accuracy of skin versus in vitro testing. Single- and pauci-allergen immunotherapy (AIT) have also shown good outcomes, thus questioning the use of large testing panels. Recent studies further support the use of standardized and recombinant antigens. Skin testing remains a safe and dependable tool in the diagnosis and management of allergic rhinitis. Newer techniques such as component-resolved diagnostics (CRD), recombinant antigens, and enhanced skin evaluation are being studied, but are still expensive and not widely available. Areas that require more research include designing standardized and recombinant allergens, the real utility of quantitative skin testing, the number of aeroallergens to test and treat, skin testing for molds as well as when to repeat skin testing.

A novel mesostructured catalyst sulphated alumina tungstic acid (SATA) has been prepared by an easy route. Various techniques such as IR, XRD, SEM, EDX, TEM, TGA and BET were used to characterize the synthesized catalyst. The catalytic activity of the meso material has been explored by synthesizing a series of new pyrazole carbonitrile derivatives from aromatic aldehydes, ethylcyanoacetate, phenylhydrazine/hydrazine hydrate in ethanol under reflux conditions. Furthermore, the "greenness" of this protocol when estimated by green metrics, displayed satisfactory results. The protocol is free from column chromatography, and toxic solvents and is more efficient as compared to reported ones.

Silica modified imidazolium [smim] based halometallic ionic liquids, [smim][MCl4] (M = Fe, Cu and Zn), were synthesized for the evaluation of acidic and catalytic properties. Among these ILs, [smim][FeCl4]− was used for the preparation of heterogeneous catalyst ([smim][FeCl4]−@Nd2O3) by simple immobilization of IL on Nd2O3 nanoparticles. The structure of [smim][FeCl4]−@Nd2O3 was established by various techniques including FTIR, Raman, UV-vis DRS, powder XRD, SEM/EDX, elemental mapping, TEM, TGA, EPR and XPS analyses. The stability of nano-catalyst, [smim][ FeCl4]−@Nd2O3, was established with the help of zeta potential analysis which showed a value of −40.32 mV lying under the stability range. Potentiometric titration with n-butyl amine was used to evaluate the acidic properties of [smim][MCl4] as well as [smim][FeCl4]−@Nd2O3. The catalytic potential of the material was probed through the one pot synthesis of N-aryl indeno pyrrole derivatives. The results showed excellent performance of the material by producing a high yield (98%) of indeno pyrrole derivatives. A recyclability experiment revealed that the catalyst was efficient in up to five cycles with insignificant loss in catalytic activity. The evaluation of green metrics indicated the sustainability of the present protocol in terms of high atom economy and low E-factor.

A highly efficient and eco-friendly route for the reduction of graphene oxide (GO) to reduced graphene oxide (rGO) was developed by using polyvinylpyrrolidone coated CeO2 NPs (PVP–CeO2) as a reducing and stabilizing agent. The resulting carbonaceous material, PVP–CeO2/rGO, was well characterized with different spectroscopic techniques such as Fourier Transform Infrared (FTIR) spectroscopy, Scanning Electron Microscopy (SEM), Energy Dispersive X-ray (EDX), elemental mapping, Transmission Electron Microscopy (TEM), Raman spectroscopy, powder X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET), X-ray Photoelectron Spectroscopy (XPS), and Thermal Gravimetric (TG) analyses. The material exhibited high catalytic potential towards multicomponent reactions for the synthesis of biologically relevant benzodiazepine derivatives in aqueous media. The efficiency of the material for the desired reaction was shown in the form of an excellent product yield (96–98%) and a very short reaction time period (7–10 min). The use of water as solvent and recyclability of the catalyst made the present protocol acceptable from a green perspective.

The aim of the present protocol is to develop a facile route for the synthesis of novel ionic liquid (IL)-functionalized graphene nano sheets (IMD-Si/FeCl4−@GNS). An imidazolium IL with tetrachloroferrate as an anion (IMD-Si/FeCl4−) was used to reduce graphene oxide. IMD-Si/FeCl4−@GNS were well characterized using various techniques such as Fourier transform infrared (FTIR), Raman, ultraviolet-visible diffuse reflectance spectroscopy (UV-VIS DRS), scanning electron microscopy/energy dispersive X-ray (SEM/EDX), elemental mapping, transmission electron microscopy (TEM), powder X-ray diffraction (XRD), thermal gravimetry (TG), electron paramagnetic resonance (EPR), and X-ray photoelectron spectroscopy (XPS) analyses. The IL-functionalized material was investigated for its catalytic properties and found to be an efficient catalyst for the synthesis of (E)-selective substituted thiosemicarbazone derivatives. The (E)-selectivity was confirmed using DFT calculations which showed that the (E)-isomer was stabilized by 4.90 kcal mol−1 more than the (Z)-isomer. The catalyst maintained its catalytic activity for six successive runs.

HClO4–SiO2 catalyzed synthesis of coumarinyl chalcones (8a–j) under solvent-free conditions is reported. The catalyst is characterized by powder XRD and SEM–EDX analysis. The stability of the catalyst is evaluated by thermogravimetric (TG) and differential scanning calorimetry (DSC) techniques. The remarkable features of this green protocol are the excellent yields of the products, shorter reaction time, simple experimental procedure, easy preparation and reusability of the catalyst. Keywords: HClO4–SiO2, Coumarinyl chalcones, Heterogeneous catalyst, Thermal solvent-free conditions

Previously undiagnosed pediatric cardiac disease represents a clinical challenge for the emergency physician. The clinical presentation of these disorders can mimic other conditions of the respiratory, gastrointestinal and neurologic systems at a time when the need for early identification and treatment is at a premium. A high index of suspicion and superb clinical acumen is required to make a timely diagnosis and initiate optimal care. Methods A retrospective chart review using explicit criteria and a structured data collection process was performed on all children presenting with previously undiagnosed cardiac disease over a five and half year period. Results Thirty-six patients were identified over a five and a half year period representing one patient per 4838 pediatric ED presentations. A diverse set of chief complaints, triage categories, clinical presentations and diagnoses were identified. Undiagnosed congenital lesions, acquired cardiac disease, dysrhythmias and infectious diseases of the heart were represented. The need for surgical intervention (22%) and mortality (6%) was substantial. Conclusion In the aggregate, these conditions occur at an important rate and represent a high risk subset of pediatric patients presenting to the emergency department. Individually, the conditions occur infrequently and ‘pattern recognition’ may not aid the clinician. Early diagnosis and prompt intervention is important in this population.

Glycation of biological macromolecules, due to hyperglycemia, promotes the formation of advanced glycation end products (AGEs). It is accelerated in diabetic patients and is responsible for the pathophysiology and progression of diabetes. Previous reports have shown that amount of AGEs formation and glycation-induced structural damage is higher in hemoglobin (Hb) than other proteins present in blood. In our previous study, we have shown structural changes in Hb by D-ribose which may result into the generation of immunogenic neo-epitopes. Thus, we hypothesized that D-ribose induced structural perturbations in Hb, could result in the formation of neo-epitopes which may provoke an auto-immune response and may also be involved in the immuno-pathogenesis of diabetes type-2 associated complications. Therefore, in the current study, we analyzed the prevalence of autoantibodies in diabetic patient's sera against D-ribose glycated-Hb by direct binding and competitive ELISA. Direct binding ELISA confirmed that autoantibodies in diabetic patients exhibit significantly high binding with D-ribose glycated-Hb as compared to its native form. The antigen binding specificity of these antibodies was also screened by competitive inhibition ELISA. We also used D-glucose glycated-Hb as a positive control to detect the presence of auto-antibodies by direct binding and inhibiton ELISA. We found that D-glucose glycated-Hb binds with T2DM samples but the affinity to binding is lower than D-ribose glycated-Hb. The overall findings of this study suggest the prevalence of circulating autoantibodies against D-ribose glycated-Hb in diabetic patients and thus, the level of these autoantibodies may be used as biomarker for progression of diabetes.

Acute limb ischemia (ALI) is the sudden decrease in limb perfusion caused by embolism secondary to many blood stasis conditions. Treatment commences with intravenous (IV) unfractionated heparin infusion. Individuals can have an immune-mediated reaction to heparin products which results in heparin-induced thrombocytopenia (HIT). Coronavirus disease 2019 (COVID-19) has added to the difficulty of treating patients with ALI due to increasing the likelihood of HIT via the virus's ability to manipulate the coagulation parameters. We present a case of ALI complicated by HIT in a 49-year-old male with a confirmed asymptomatic COVID-19. The patient initially presented with progressive pain, coldness, and tingling in the right foot. He was treated with a tissue plasminogen activator (TPA) and a heparin drip. The occlusion persisted despite medical intervention leading to right below-knee amputation. The patient returned to the emergency department (ED) 13 days later with massive intracranial hemorrhage and subsequently expired. This case study demonstrates the significance of COVID-19 diagnostic testing due to the possibility of developing blood clots and potential complications, including HIT.

There is a rising burden of non-communicable disease (NCD), especially cardiovascular diseases (CVD) in the developing nations to an extent that they are sometimes terms as NCD epidemics. If unchecked, these NCD epidemics, can impact the healthcare systems and adversely affect the development of the whole country. While CVD is a matter of concern worldwide, it is even more so in low- and middle-income countries, where the incidence and prevalence of these diseases are much worse than developed countries, owning to their large population. According to the WHO, CVDs cause 28.5% of all deaths, in the developing nations. Even within the developing countries, the profile of CVD varies greatly, depending on the phase of epidemiological transition the country is currently undergoing. While primary prevention is about treating risk factors to prevent CVD, primordial prevention refers to avoiding the development of risk factors in the first place. As we now know, atherosclerosis starts in youth and is related to dyslipidemia, smoking, and hypertension, Body Mass Index and blood glucose levels. Therefore, the primordial prevention must start early in life. High-quality clinical trials have traditionally been mainly focusing on primary and secondary prevention settings. There are some key studies that evaluated the role of diet in primordial setting that were discussed in this review.