Search

Aim: The aim of this study was to assess the safety and efficacy profile of a newer generation biodegradable DES, the Yukon Choice PC Elite with a temperature controlling mechanism, in patients with acute coronary syndrome (ACS). Methods: This prospective multi-center study (PIONEER Registry) was conducted in an Indian ACS population, therefore providing data in real world clinical practice. Patients with ACS underwent DES implantation in de novo native-vessel coronary lesions with the Yukon Choice PC Elite biodegradable polymer DES and were followed up for a year. Results: A total 999 patients were evaluated. The majority of patients were male (79.2%). A total of 6.7% of the patients had a history of prior myocardial infarction (MI) and 2.7% of patients had a history of previous coronary artery bypass graft. The clinical presentations of the patients included: unstable angina pectoris (UA) (46.4%), ST-segment elevation MI (STEMI) (38.1%), and Non-ST-segment elevation MI (NSTEMI) (15.4%). Implantation of the device was successful in 99.9% of cases. The median stent length and stent size were 21.0 mm (Range: 8.0–40.0 mm) and 2.8 mm (Range 2.0–4.0 mm), respectively. Through to one-year clinical follow-up after percutaneous coronary intervention, all-cause death occurred in 4 of 999 patients (Crude Percentage: 0.4%). Cardiac death, MI, TLR, and stent thrombosis were occurred in 1 (0.1%), 8 (0.8%), 12 (1.2%) and 1 (0.1%) patients, respectively. Conclusion: The results of this post marketing surveillance registry suggest favorable safety and efficacy outcomes associated with the Yukon Choice PC Elite biodegradable DES in a real world Indian ACS population.

A 60 year married female from Chennai presented with pain and restricted abduction, adduction, external rotation and flexion of right shoulder both in active and passive movements for 2 months. She was diagnosed to be affected by adhesive capsulitis which is equated to Kumbavatham, one of the vatha diseases mentioned in Siddha system of medicine. She was treated with Siddha Varmam therapy and thokkanam with Vathakesari thylam. After 15 days of hospital stay the patient was discharged and was followed for 6 months. There were no adverse reactions/events observed during the course of treatment. The combination therapy has provided the reduction in pain and restricted movements which was measured using goniometer and SPADI index.

The analysis of optimum engine conditions was carried out with the help of Taguchi technique by fuelling the engine with carbon nanotubes blended peanut oil biodiesel with various engine operating conditions by L16 array approach. The effects of peanut oil biodiesel and CNTs with different fuel blends is studied at different engine loading conditions of 25%, 50%, 75%, and 100%. In addition, operating condition is examined by varying the ignition pressure (180 bar, 200 bar, 220 bar, and 240 bar) and ignition timing (21° bTDC, 23° bTDC, 25° bTDC, and 27° bTDC). According to combinations of array such as load, blend, nanoparticle, ignition pressure and ignition timing with four optimal levels, Taguchi L16 array was designed and analysed. Results from L16 Taguchi method were used to find out the optimal operating condition of the engine in terms of higher performance with reduced emissions. When compared with neat diesel, peanut biofuel blend with CNTs has a greater influence in both performance and emission characteristics. Fuel energy and exergy analysis depicted that the readings for carbon nanotubes blended peanut oil biodiesel were almost unchanged or slightly lower than neat diesel.

A 42-year-old man with the complaints of left knee swelling, severe pain, difficult to stand was reported to Siddha Varmam division after a road accident. He was diagnosed as acute avulsion of Posterior cruciate ligament (PCL). It was diagnosed based on the history of trauma, knee pain and swelling after trauma, positive posterior drawer test and avulsion fracture shown by radiograph. He was treated with Siddha Varmam therapy and traditional bone setting. After a month of treatment, the PCL avulsion fracture got healed without any surgical interventions and patient able to walk normally. This case report summarises the novel Siddha Varmam therapy and traditional bone setting treatments for acute avulsion of PCL with bony fragment. Keywords: Siddha varmam therapy, Bone setting, PCL fracture

For the past one hundred years, lots of easily accessible petroleum fuel has been burned out by humankind in inefficient engines. In this regard, present-day engine researchers face a formidable challenge to achieve the goal of significant improvements in both thermal efficiency and fuel economy. Although the direction to reach this target is critical, homogenous charge compression ignition (HCCI) is just another combustion concept to achieve this target. By the way, this work investigates the combustion phenomena of the HCCI engine by external mixture formation technique. In a nut-shell, an endeavor has been made in this work to prepare homogeneous mixture outside the combustion chamber using a fuel vaporizer system to form a uniform fuel–air mixture. The fundamental research experiments were carried out with vaporized diesel and vaporized e-diesel blends (10% and 20% ethanol substitution by volume), and the results were compared with conventional diesel engine operation. In HCCI mode, the maximum rate of pressure rises and the maximum rate of heat-release significantly reduced with increase of ethanol concentration in diesel. The experimental outcomes exposed that when HCCI engine is operated with e-diesel blend, smooth engine operation is apparent.

Competing Interests: Declaration of competing interest None.

Background: In India, a significant scarcity of published data exists regarding chronic limb-threatening ischemia (CLTI) and its management, especially among the elderly population. CLTI, often accompanied by frailty poses a significant healthcare challenge. While endovascular interventions offer hope, there remains a dearth of outcome data for this age group. This study seeks to address this critical gap by investigating the impact of frailty on outcomes, emphasizing amputation-free survival (AFS), wound healing, and health-related quality of life (HRQoL)., Methods: Our study included 131 elderly CLTI patients aged ≥70 years who underwent infrainguinal endovascular interventions between April 2018 and August 2021, with a follow-up period of 2 years. Among the patients, 93.9% had diabetes mellitus and 82.4% had hypertension. Clinical frailty was assessed using the clinical frailty scale (CFS). Patients were categorized into group 1 (CFS 1-5) and group 2 (CFS 6-9). Primary outcomes were AFS, wound healing, HRQoL, and their association with frailty. Secondary outcomes included technical success, procedure-related complications, major adverse limb events, major adverse cardiac events, vessel patency, re-intervention rates, and mortality rates including periprocedural and overall mortality., Results: Technical success was achieved in 86.3% of patients, with frailty significantly influencing this outcome. Group 2 exhibited reduced technical success (80.8%) compared to group 1 (93.1%). The major amputation rate was 9.2%, with higher rates in group 2 [univariate hazard ratio: 5.20; P = 0.033]. Similarly, group 2 showed elevated overall mortality [univariate hazard ratio: 5.18; P < 0.001]. AFS at 1 and 2 years were 67.9% and 55%, respectively, with higher rates in group 1. Wound healing was achieved in 76.1% of patients (83/109), with frailty significantly associated with delayed wound healing (P < 0.001). Vessel patency at 1 year was observed in 88.8% of patients. HRQoL significantly improved postintervention, with vascular quality of life questionnaire-6 (VascuQol-6) scores increasing from an average of 9 of 24 at baseline to 20 of 24 at 2 years. Frailty score significantly correlated with VascuQol-6 scores at 1 and 2 years (P < 0.0012). Group 1 exhibited higher VascuQol-6 scores than group 2, indicating improved HRQoL during follow-up., Conclusions: Successful endovascular treatments in high-risk CLTI patients promote improved wound healing and post-treatment quality of life. Frailty should be assessed before endovascular interventions as it correlates with adverse outcomes, including amputations and mortality. While revascularization holds promise, caution is advised for frailer patients, emphasizing the importance of personalized care and tailored treatments for elderly CLTI patients., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Environmental monitoring of mercury (Hg 2+ ) ions has become increasingly important as a result of their detrimental effects on biological organisms at all levels. To recognize toxic metal ions, utmost effort has been devoted to developing new materials that are highly selective, ultra-sensitive, and provide rapid response. In this context, a new chemosensor, 2-imino [N - (N-amido phenyl)]-6-methoxy-3-carbethoxy quinoline (L), has been synthesized by combining 2-formyl-6-methoxy-3-carbethoxy quinoline and benzhydrazide and it has been extensively characterized by NMR, FTIR, ESI-Mass and SCXRD analysis. Probe L has excellent specificity and sensitivity toward Hg 2+ ions in semi-aqueous solutions, with a detection limit of 0.185 μM, regardless of the presence of other interfering cations. Chromogenic behavior was demonstrated by the L when it changed the color of the solution from colorless to light yellow, a change that can be observed visually. The probe L forms a 1:1 stochiometric complex with an estimated association constant (K a ) of 6.74 × 10 4  M -1 . The 1 H NMR change and density functional theory calculations were analyzed to improve our understanding of the sensing mechanism. Also, an inexpensive and simple paper-based test kit has been developed for the on-site detection of mercury ions in water samples., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: This study aimed to evaluate linear measurements of the frontal sinus (FS) and sphenoid sinus (SS) for sex identification on cone beam computed tomography (CBCT) images., Methods: A comparative CBCT analysis was conducted on 200 full field of view (FOV) scans taken as part of routine dental investigations. Dimensions of the bilateral frontal and sphenoid sinuses were measured. Intra- and interobserver reliability were calculated. Independent t tests were used to compare the various parameters between sexes. Stepwise discriminant function analysis was used to determine sex. Additionally, the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity, and specificity were also determined. A p value < 0.05 was considered significant., Results: A total of 200 CBCT scans were included in the study. The mean age (±SD) among males was 25.66 (±7.11) and that among females was 24.64 (±5.12). The ROC curve revealed that the right length of the frontal sinus showed the greatest accuracy in sex identification in comparison to other linear measurements of the FS and SS. The results of our study indicated that the equation obtained from stepwise discriminant function analysis can aid in sex determination with an accuracy of 76.5 %., Conclusion: Our findings support the sexual dimorphism of linear measurements of FS and SS. There was an improvement in the accuracy of sex prediction when the linear measurements of FS and SS were considered in combination rather than in isolation. The derived equation can be an adjunctive tool for sex identification for the representative population., Competing Interests: No conflict of interest exists. We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome., (© 2024 The Authors.)

High-performance polymer three-dimensional printing is becoming more popular for producing unique parts suitable for different applications. It has been utilized extensively in biomedical applications such as dental prosthetics, surgical equipment, and implants. However, the performance of the material is significantly influenced by its surface qualities, particularly in aspects of its adhesion and biocompatibility. This study involves the fabrication of PEEK specimens S1, S2, S3, and S4 with different printing parameters such as layer height of 0.10 and 0.15 mm and printing speed of 20 and 25 mm/s using a fused deposition modeling process. The surface roughness of the fabricated specimens is measured using atomic force microscopy. The results showed that the printing parameters significantly impact the surface roughness of the PEEK specimens. The surface roughness of specimen S3, printed at a layer height of 0.15 mm and a speed of 20 mm/s, has a low roughness value of 0.017 μm, which is considerable in comparison to the other specimens. In addition to the measurement of surface roughness from roughness profile, the force curve separation graph was plotted and the adhesion force values were calculated for all the specimens to determine the interlayer bonding strength., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Multiple interacting neural systems are involved in sustaining nicotine reinforcement. We and others have shown that dopamine D 1 receptors and glutamate NMDA receptors both play important roles in nicotine reinforcement. Blockade of D 1 receptors with the antagonist SCH-23390 (0.02 mg/kg) both acutely and chronically significantly decreased nicotine self-administration in rats. Blockade of NMDA receptors (10 mg/kg) acutely with memantine significantly increased nicotine self-administration, but chronic blockade of NMDA receptors with memantine significantly decreased nicotine self-administration. The current study examined the interactions of acute and chronic administration of SCH-23390 and memantine on nicotine self-administration in female rats. Replicating earlier studies, acute and chronic SCH-23390 significantly decreased nicotine self-administration and memantine had a biphasic effect with acute administration increasing nicotine self-administration and chronic memantine showed a non-significant trend toward decreasing it. However, chronic interaction study showed that memantine significantly attenuated the decrease in nicotine self-administration caused by chronic SCH-23390. These studies provide important information that memantine attenuates the efficacy of D 1 antagonist SCH 23390 in reducing nicotine-self-administration. These two drugs do not appear to have mutually potentiating effects to aid tobacco cessation., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Advancement in the area of anti-tubercular drug development has been full-fledged, yet, a very less number of drug molecules have reached phase II clinical trials, and therefore "End-TB" is still a global challenge. Inhibitors to specific metabolic pathways of Mycobacterium tuberculosis (Mtb) gain importance in strategizing anti-tuberculosis drug discovery. The lead compounds that target DNA replication, protein synthesis, cell wall biosynthesis, bacterial virulence and energy metabolism are emerging as potential chemotherapeutic options against Mtb growth and survival within the host. In recent times, the in silico approaches have become most promising tools in the identification of suitable inhibitors for specific protein targets of Mtb. An update in the fundamental understanding of these inhibitors and the mechanism of interaction may bring hope to future perspectives in novel drug development and delivery approaches. This review provides a collective impression of the small molecules with potential antimycobacterial activities and their target pathways in Mtb such as cell wall biosynthesis, DNA replication, transcription and translation, efflux pumps, antivirulence pathways and general metabolism. The mechanism of interaction of specific inhibitor with their respective protein targets has been discussed. The comprehensive knowledge of such an impactful area of research would essentially reflect in the discovery of novel drug molecules and effective delivery approaches. This narrative review encompasses the knowledge of emerging targets and promising chemical inhibitors that could potentially translate in to the anti-TB-drug discovery., Competing Interests: Declaration of competing interest The authors have no conflict of interest to declare., (Copyright © 2023 Elsevier B.V. All rights reserved.)

This paper focuses on the origin of the poroelastic anisotropic behaviour of the meniscal tissue and its spatially varying properties. We present confined compression creep test results on samples extracted from three parts of the tissue (Central body, Anterior horn and Posterior horn) in three orientations (Circumferential, Radial and Vertical). We show that a poroelastic model in which the fluid flow evolution is ruled by non-integer order operators (fractional Darcy's law) provides accurate agreement with the experimental creep data. The model is validated against two additional sets of experimental data: stress relaxation and fluid loss during the consolidation process measured as weight reduction. Results show that the meniscus can be considered as a transversely isotropic poroelastic material. This behaviour is due to the fluid flow rate being about three times higher in the circumferential direction than in the radial and vertical directions in the body region of the meniscus. The 3D fractional poroelastic model is implemented in the finite element software to estimate the weight loss during the confined compression tests., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Alzheimer's disorder (AD) is associated with behavioural and cognitive destruction with due respect to the neurological degeneration. Conventional therapeutic approach for treatment of AD using neuroprotective drugs suffered certain limitations such as poor solubility, insufficient bioavailability, adverse side effects at higher dose and ineffective permeability on blood brain barrier (BBB). Development of nanomaterial based drug delivery system helped to overcome these barriers. Hence the present work focused on encapsulating neuroprotective drug citronellyl acetate within CaCO 3 nanoparticles to develop neuroprotective CaCO 3 nanoformulation (CA@CaCO 3 NFs). CaCO 3 was derived from marine conch shell waste, while the neuroprotective drug citronellyl acetate was scrutinized by in-silico high throughput screening. In-vitro findings revealed that CA@CaCO 3 nanoformulation exhibited enhanced free radical scavenging activity of 92% (IC 50 value - 29.27 ± 2.6 μg/ml), AChE inhibition of 95% (IC 50 value - 25.6292 ± 1.5 μg/ml) at its maximum dose (100 μg/ml). CA@CaCO 3 NFs attenuated the aggregation of β-amyloid peptide (Aβ) and also disaggregated the preformed mature plaques the major risk factor for AD. Overall, the present study reveals that CaCO 3 nanoformulations exhibits potent neuroprotective potential when compared to the CaCO 3 nanoparticles alone and citronellyl acetate alone due to the sustained drug release and synergistic effect of CaCO 3 nanoparticles and citronellyl acetate depicting the fact that CaCO 3 can act as promising drug delivery system for treatment of neurodegenerative and CNS related disorders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to assess the safety and efficacy profile of a newer generation biodegradable DES, the Yukon Choice PC Elite with a temperature controlling mechanism, in patients with acute coronary syndrome (ACS)., Methods: This prospective multi-center study (PIONEER Registry) was conducted in an Indian ACS population, therefore providing data in real world clinical practice. Patients with ACS underwent DES implantation in de novo native-vessel coronary lesions with the Yukon Choice PC Elite biodegradable polymer DES and were followed up for a year., Results: A total 999 patients were evaluated. The majority of patients were male (79.2%). A total of 6.7% of the patients had a history of prior myocardial infarction (MI) and 2.7% of patients had a history of previous coronary artery bypass graft. The clinical presentations of the patients included: unstable angina pectoris (UA) (46.4%), ST-segment elevation MI (STEMI) (38.1%), and Non-ST-segment elevation MI (NSTEMI) (15.4%). Implantation of the device was successful in 99.9% of cases. The median stent length and stent size were 21.0 mm (Range: 8.0-40.0 mm) and 2.8 mm (Range 2.0-4.0 mm), respectively. Through to one-year clinical follow-up after percutaneous coronary intervention, all-cause death occurred in 4 of 999 patients (Crude Percentage: 0.4%). Cardiac death, MI, TLR, and stent thrombosis were occurred in 1 (0.1%), 8 (0.8%), 12 (1.2%) and 1 (0.1%) patients, respectively., Conclusion: The results of this post marketing surveillance registry suggest favorable safety and efficacy outcomes associated with the Yukon Choice PC Elite biodegradable DES in a real world Indian ACS population., Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to declare., (Copyright © 2022. Published by Elsevier, a division of RELX India, Pvt. Ltd.)

Prostate biopsy and image-guided treatment procedures are often performed under the guidance of ultrasound fused with magnetic resonance images (MRI). Accurate image fusion relies on accurate segmentation of the prostate on ultrasound images. Yet, the reduced signal-to-noise ratio and artifacts (e.g., speckle and shadowing) in ultrasound images limit the performance of automated prostate segmentation techniques and generalizing these methods to new image domains is inherently difficult. In this study, we address these challenges by introducing a novel 2.5D deep neural network for prostate segmentation on ultrasound images. Our approach addresses the limitations of transfer learning and finetuning methods (i.e., drop in performance on the original training data when the model weights are updated) by combining a supervised domain adaptation technique and a knowledge distillation loss. The knowledge distillation loss allows the preservation of previously learned knowledge and reduces the performance drop after model finetuning on new datasets. Furthermore, our approach relies on an attention module that considers model feature positioning information to improve the segmentation accuracy. We trained our model on 764 subjects from one institution and finetuned our model using only ten subjects from subsequent institutions. We analyzed the performance of our method on three large datasets encompassing 2067 subjects from three different institutions. Our method achieved an average Dice Similarity Coefficient (Dice) of 94.0±0.03 and Hausdorff Distance (HD95) of 2.28 mm in an independent set of subjects from the first institution. Moreover, our model generalized well in the studies from the other two institutions (Dice: 91.0±0.03; HD95: 3.7 mm and Dice: 82.0±0.03; HD95: 7.1 mm). We introduced an approach that successfully segmented the prostate on ultrasound images in a multi-center study, suggesting its clinical potential to facilitate the accurate fusion of ultrasound and MRI images to drive biopsy and image-guided treatments., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Tumors involving the chest wall may require extensive resection and reconstruction. This study aims to evaluate functional, cosmetic results, and quality of life (QoL) in patients who had a reconstruction based on patient-specific 3-dimensional (3D) printing., Methods: The patient-specific chest wall prosthesis was created for 10 patients. The anatomical models were 3D printed and used to produce a silicone mold that was filled with methyl methacrylate to create the customized prosthesis. Evaluation of the reconstruction was completed with a QoL assessment and postoperative tracking of patients' chest motion, using infrared markers. The distance between plot points representing markers on the operated and contralateral sides was measured to assess symmetrical motion., Results: Twenty-three consecutive patients were enrolled, with the median age of 64 years. Thirteen patients underwent a nonrigid reconstruction, and 10 had a patient-specific rigid reconstruction with methyl methacrylate. The median number of ribs resected was 3. No postoperative complications or morbidity related to the prostheses were reported. The median hospital stay in the nonrigid reconstruction group was 8.5 days compared with 7.5 days (p = .167) in the rigid reconstruction group. Postoperatively, most patients had low levels of symptoms, with 82% experiencing chest pain and 53% experiencing dyspnea. Rigid reconstruction patients demonstrated more symmetrical breathing motion compared with nonrigid reconstruction patients. The mean distances were 2.32 ± 2.18 and 7.28 ± 5.87 (P < .00001), respectively., Conclusions: This study shows that a 3D patient-specific prosthesis is feasible and safe, suggesting a possible trend toward improved breathing mechanics, QoL, and cosmetic results., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Recycling of different manufacturers of spent lithium-ion batteries cathode and anode via a simple regeneration process has an opportunity to fabricate new energy devices. In this study, the different manufacturers of spent LIB cathode pieces were subjected to lixiviation process and found the best-optimized conditions such as tartaric acid concentration (2.5 M), H 2 O 2 concentration (7.5 vol%), solid-liquid ratio (80 g/L), temperature (80 °C), and lixiviation time (80 min) for maximum ~ 99% extraction efficiency of metals. Further, 3D-MnCo 2 O 4 (MCO) spheres were regenerated from the cathode lixivium containing metal ions via hydrothermal technique. Besides, anode graphite and Al foils after cathode lixiviation were exploited to prepare reduced graphene oxide (RGO) at room temperature in a simple method. The electrochemical performance of both regenerated electrodes from spent LIBs was explored in the half-cell configuration using the 1 M Na 2 SO 4 electrolyte. Additionally, the constructed MCO//RGO asymmetric supercapacitor device offers an operational voltage of 1.8 V and displays a high energy density of ~ 23.9 Wh kg -1 at 450 W kg -1 with 8000 cycles. This alternative recycling method proposes the possibility to construct high-energy storage devices from different compositions of spent LIBs., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Hypertension (HTN) is a globally prevalent non-communicable disease contributing significantly to cardiovascular (CV) morbidity and mortality. In achieving control of HTN, therapeutic adherence plays a crucial role. Studies from India identify varying rates of adherence to antihypertensive medications. Multiple factors determine treatment adherence in HTN. In India, factors such as lower socioeconomic status, health literacy, asymptomatic nature of disease, forgetfulness, cost of medications, and duration of HTN determine the adherence. An excellent physician-patient relationship incorporating adequate counseling along with the use of other methods can identify poor adherence. Improving adherence necessitates incorporating a multipronged approach with strategies directed at physicians, patients, and health systems. With innovation in therapeutics, the pharmaceutical sector can contribute significantly to improve adherence. Furthermore, increasing adherence to lifestyle interventions can help achieve better HTN control and improve CV outcomes. In the Indian context, more emphasis is necessary on patient education, enhanced physician-patient relationship and communication, increased access to health care, and affordability in improving therapeutic adherence in HTN., (Copyright © 2021 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)

Objective: To establish the reliability and validity of a self-report measure designed to assess self-efficacy for hypertension treatment adherence., Methods: This investigation was embedded within a six-month randomized clinical trial (RCT), which demonstrated that a tailored, stage-matched intervention was more effective at improving hypertension control than usual care among individuals (n = 533) with repeated uncontrolled hypertension. The instrument used to assess self-efficacy for hypertension treatment adherence (SE-HTA) comprised three subscales that assessed diet self-efficacy (DSE), exercise self-efficacy (ESE), and medication self-efficacy (MSE). To determine SE-HTA validity and reliability, we assessed internal consistency using Cronbach's α coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman's ρ correlation coefficients., Results: Cronbach's α (internal consistency) values for DSE, ESE, and MSE were 0.81, 0.82 and 0.74. Factor analysis and the scree plot demonstrated three distinct factors, which correspond to the three subscales contained in the SE-HTA instrument. SE-HTA possessed good convergent and discriminant validity, and moderate test-retest reliability., Conclusion: The SE-HTA instrument containing diet, exercise, and medication adherence subscales is valid and reliable in adults with uncontrolled hypertension., Practice Implications: This SE-HTA instrument measures self-efficacy and could help facilitate behavior change in hypertension., (Published by Elsevier B.V.)

Due to their rapid growth rates, high lipid productivity, and ability to synthesize value-added products, microalgae are considered as the potential biofuel feedstocks. However, among the several bottlenecks that are hindering the commercialization of microalgal biofuel synthesis, the issue of high water consumption is the least explored. This analysis, therefore, examines the factors that decide water use for the production of microalgae biofuel. Microalgae biodiesel water footprint varies from 3.5 to 3726 kg of water per kg of biodiesel. The study further investigates the cause for large variability in the estimation of the water footprint for microalgae fuel. Various strategies, including the reuse of harvested water, the use of high density cultivation that could be adopted for low water consumption in microalgal biofuel production are discussed. Specifically, the review identified a reciprocal relationship between biomass productivity and water footprint. On the basis of which the review emphasizes the significance of high density cultivation, which can be inexpensive and feasible relative to other water-saving techniques. With the setback of water scarcity due to the rapid industrialization in developing countries, the implementation of the cultivation system with a focus on minimizing the water consumption is inevitable for a successful large scale microalgal biofuel production., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Multiple drugs taken for long duration in tuberculosis (TB) treatment, especially drug resistant TB (DR-TB), may produce adverse drug reactions (ADRs). Although any anti-TB drug can cause ADRs, but these are more common with drugs used for treatment of DR-TB. However, most of ADRs with these drugs are mild or moderate and can be managed if adequate supervision and monitoring is done. However, few ADRs can be severe or potentially life-threatening and may require removal of the offending drug(s). TB patients having comorbidities and on treatment for them may experience drug interaction with anti TB drugs and may require dose modification or change of drug. For a good TB treatment outcome patient's compliance should be ensured, and adverse events and drug interactions should be appropriately addressed by the clinicians. This article outlines the majority of the possible ADRs to anti-TB drugs used for management of DR-TB and their common drug interactions with practical recommendations to identify the possible drug(s) responsible and the most adequate management in each situation., Competing Interests: Conflicts of interest The authors have none to declare., (Copyright © 2020 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Soybean seeds provide a rich source of proteins, fats, carbohydrates, and micronutrients. Extraction and analysis of low abundant soybean seed proteins are challenging because of its complex seed composition. For characterizing various proteins, it is paramount to remove the other interfering components, primarily oils, and carbohydrates. In the present study, we used a sequential dual washing process initially with hexane to remove oil and non-polar interferences, followed by 80% ethanol washing to remove about 60% of the total soluble sugars. The extracted soluble sugars were quantified using a newly developed and validated high-performance liquid chromatography-evaporative light scattering detector (HPLC-ELSD). This newly developed combined washings process significantly enhanced the separation of both low molecular weight and low abundant proteins using 1D (one dimensional)- and 2D (two dimensional) gel electrophoresis. The separated proteins were trypsinized and analyzed by using Bruker amazon speed ion trap mass spectrometer equipped with an ESI source. This combined washing process allowed the identification of 18 additional low abundant soy proteins as compared to the simple hexane washed samples. This purification process will allow researchers to identify and investigate the role of low molecular weight and low abundant proteins as it relates to plant functions, nutrition, and health., (Published by Elsevier Inc.)

Fixed dose combination (FDC) of tenofovir disoproxil fumarate (TDF) and lamivudine (3TC) is one of the most preferred FDC for the treatment of acquired immunodeficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection. To the best of authors' knowledge there are no reported methods for chiral purity estimation of both drugs simultaneously from a FDC. The current study was focused on the development of a single chiral method uisng supercritical fluid chromatography (SFC) for separation of stereoisomers of TDF and 3TC combination employing design of experiment (DoE) approach. Method development was planned in three steps by using different experimental designs for each step. I-optimal, Taguchi orthogonal array and face-centred central composite designs (CCD) were employed for primary parameter selection, secondary parameter screening and final method optimization, respectively. All six stereoisomers were separated in a 10 minute run on Chiralpak IA column with carbon di-oxide /methanol (containing 0.5 % v/v n-butylamine) as mobile phase at 1.5 mL/min in gradient mode. The optimized method was verified for performance through establishing specificity, precision, linearity, accuracy, limit of quantification, and solution stability. Resolution between each isomeric pair was more than 1.5. The method was found to be linear from 1.5 µg/mL to 7.5 µg/mL for 3TC and 7.5 µg/mL to 37.5 µg/mL for TDF stereoisomers. The R 2 values for all the linearity curves for undesired isomers were greater than 0.995. The method proved to be rapid, reproducible and efficient to quantify stereoisomers of both drugs in a single run., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Within asthma, the small airways (≤2 mm in diameter) play an important role in pathophysiology. Using a combined clinical-computational approach, we sought to more precisely evaluate the contribution of the small airways to deep-breath induced airway dilation (in the absence of bronchial challenge), which may be impaired in severe asthma., Methods: A patient-based computational model of the FOT was used to examine the sensitivity and specificity of FOT signals to small airways constriction at frequencies of 2 & 8 Hz. A clinical study of moderate to severe asthmatics (n = 24), and healthy volunteers (n = 10) was performed to evaluate correlations between baseline and post deep inspiration (following bronchodilator withhold and in the absence of prior bronchial challenge) forced oscillation technique (FOT) responses (at 2Hz and 8Hz) and asthma treatment intensity, spirometry, airway hyper-responsiveness and airway inflammation., Results: Computational modelling demonstrated that baseline resistance measures at 2Hz are both sensitive and specific to anatomical narrowing in the small airways. Furthermore, small airways resistance was significantly increased in asthmatics compared to health. Despite these differences, there were no noticeable differences between asthmatics and healthy volunteers in resistive measures following deep inspiration (DI) and DI responses of small airways were amplified in the presence of spirometry defined airflow limitation., Conclusions: These results suggest that the small airways demonstrate increased resistance in moderate-to-severe asthma but dilate normally in response to deep inspirations in the absence of bronchial challenge. This suggests that effective targeting of the small airways is required to achieve functional improvements in moderate-severe asthmatic patients., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: We sought to identify clinical and magnetic resonance imaging (MRI) characteristics in men with the Prostate Imaging - Reporting and Data System (PI-RADS) category 3 index lesions that predict clinically significant prostate cancer (CaP) on MRI targeted biopsy., Materials and Methods: Multicenter study of prospectively collected data for biopsy-naive men (n = 247) who underwent MRI-targeted and systematic biopsies for PI-RADS 3 index lesions. The primary endpoint was diagnosis of clinically significant CaP (Grade Group ≥2). Multivariable logistic regression models assessed for factors associated with clinically significant CaP. The probability distributions of clinically significant CaP based on different levels of predictors of multivariable models were plotted in a heatmap., Results: Men with clinically significant CaP had smaller prostate volume (39.20 vs. 55.10 ml, P < 0.001) and lower apparent diffusion coefficient (ADC) values (973 vs. 1068 μm 2 /s, P = 0.013), but higher prostate-specific antigen (PSA) density (0.21 vs. 0.13 ng/ml 2 , P = 0.027). On multivariable analyses, lower prostate volume (odds ratio [OR]: 0.95, 95% confidence interval [CI]: 0.92-0.97), lower ADC value (OR: 0.99, 95% CI: 0.99-1.00), and Prostate-specific antigen density >0.15 ng/ml 2 (OR: 3.51, 95% CI 1.61-7.68) were independently associated with significant CaP., Conclusion: Higher PSA density, lower prostate volume and ADC values are associated with clinically significant CaP in biopsy-naïve men with PI-RADS 3 lesions. We present regression-derived probabilities of detecting clinically significant CaP based on various clinical and imaging values that can be used in decision-making. Our findings demonstrate an opportunity for MRI refinement or biomarker discovery to improve risk stratification for PI-RADS 3 lesions., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Testicular germ cell tumor (TGCT) development may involve a series of modification at epigenetic and genetic level which may act synergistically and transform the primordial gonocyte. This study evaluated the frequency and distribution pattern of RASSF1A/MGMT gene methylation and KRAS, BRAF and cKIT gene mutation in Indian TGCT patient, and their correlation with clinicopathological features. Forty-one TGCT tumors were used to investigate hypermethylation of RASSF1A and MGMT gene and mutations of KRAS codon 12/13, BRAF V600E and cKIT exon 17 mutations. RASSF1A and MGMT methylation was noted in 58.5% and 10% of the TGCTs. A higher frequency of RASSF1A methylation was noted in seminomas (71%, 17/24), while MGMT methylation was frequent in mixed tumors (23%, 3/13). Interestingly, 3 of 41 cases showed concurrent methylation of both the genes. The absence of tumor necrosis was significantly associated with increased frequency of MGMT hypermethylation (30% vs. 3%, p = 0.03). KRAS mutation was identified in 17% (7/41), while none showed BRAF and cKIT mutation. KRAS mutations were predominantly found in codon 12 with G12V as the most recurrent mutations. Mixed germ tumors tends to show increased frequency of KRAS mutation (31%, 4/13), followed by pure seminomas (4%, 1/24). Interestingly, KRAS mutation rate was significantly higher in metastatic tumors in comparison to primary tumors (100% vs. 13%, p = 0.02). No other association of RASSF1A/MGMT/KRAS alterations with other clinicopathological features was noted. In conclusion, these data support the notion that the cancer-associated alterations in the RASSF1, MGMT and KRAS gene may significantly contribute to TGCT pathogenesis., Competing Interests: Declaration of competing interest None., (Copyright © 2019. Published by Elsevier Inc.)

This study presents textural characterization techniques for effective osteoporosis diagnosis using bone radiograph images. The automatic classification of osteoporosis and healthy (control) cases using bone radiograph images in this work presents a major challenge as the images show no visual differences for both cases. The proposed work utilizes multifractals to characterize the trabecular bone texture in the radiographs. Initially, Holder exponents are computed, then Hausdorff dimensions are determined, which quantify the global regularity of the pixels. Finally, lacunarity is computed from the Hausdorff dimensions. Performance metrics show that estimating lacunarity from the Hausdorff dimensions, rather than the input image, directly helps in achieving better textural characterization of bone radiographs, leading to better performance in osteoporosis classification. The proposed lacunarity-based trabecular bone textural characterization method is compared with other multifractal-based methods for trabecular bone textural characterization, such as box-counting and regularization dimensions. The proposed method is also evaluated with the textural characterization of a bone radiograph challenge dataset to demonstrate its effectiveness compared to the other methods used in the challenge., Competing Interests: Declaration of competing interest None declared., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

A 42-year-old man with the complaints of left knee swelling, severe pain, difficult to stand was reported to Siddha Varmam division after a road accident. He was diagnosed as acute avulsion of Posterior cruciate ligament (PCL). It was diagnosed based on the history of trauma, knee pain and swelling after trauma, positive posterior drawer test and avulsion fracture shown by radiograph. He was treated with Siddha Varmam therapy and traditional bone setting. After a month of treatment, the PCL avulsion fracture got healed without any surgical interventions and patient able to walk normally. This case report summarises the novel Siddha Varmam therapy and traditional bone setting treatments for acute avulsion of PCL with bony fragment., (Copyright © 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.)

Ruxolitinib is a JAK-1/JAK-2 inhibitor indicated for the treatment of polycythemia vera and primary or secondary myelofibrosis. Only one patient (0.2%) was diagnosed with tuberculosis among the 485 patients receiving ruxolitinib in the four pivotal trials. Fourteen cases of tuberculosis have since been reported. We observed two (3%) mycobacterial infections (one due to Mycobacterium tuberculosis and one due to Mycobacterium avium complex) in our cohort of 65 patients receiving ruxolitinib. This observation suggests that the rate of mycobacterial infection might be higher than that observed in the pivotal trials and that atypical mycobacterial infections can also occur., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Mutations in the BRAF gene have been described to occur in two-third of melanomas. The objective of the study was to establish the frequency of BRAF V600E/K/R mutation in a series of melanomas from Indian origin and to correlate mutation status with clinicopathological features. Seventy melanoma cases were evaluated for BRAF V600 mutation by pyrosequencing. Overall, BRAF mutations were detected in 30% of the patients. All mutations observed were missense type (GTG > GAG) resulting in p.V600E, while none showed V600K/R mutation. The frequency of BRAF V600E mutations were more in patients with onset age of 50 years. BRAF mutations were significantly associated with tumor site wherein more mutations were seen in tumors from head and neck and extremities region. Acral and mucosal tumor subtype showed a mutation frequency of 31% and 20%, respectively. Epithelial cell morphology tends to harbor frequent BRAF V600E mutation (36%) than other morphological subtypes. Tumors with ulceration and necrosis showed increased BRAF mutation rate (32.5% and 33%) respectively. In conclusion, this is the first study to report a mutation frequency of 30% in this cohort. Our results demonstrated that the BRAF V600E mutation is a frequent event in Indian melanomas, and represents an important molecular target for novel therapeutic approaches., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In the year 2016, European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines provided recommendations on dyslipidemia management. The recommendation from these guidelines are restricted to European subcontinent. To adapt the updated recommendations for Indian subset of dyslipidemia, a panel of experts in management of dyslipidemia provided their expert opinions. This document provides expert consensus on adapting 2016 ESC dyslipidemia guidelines recommendations in Indian setting. The document also discussed India-specific relevant literature to support the consensus opinions provided in management of dyslipidemia., (Copyright © 2018 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)

Background: Exposure to PM 2.5 (fine particulate matter 2.5 exposures during pregnancy were associated with birthweight in an integrated rural-urban, mother-child cohort in the state of Tamil Nadu, India., Methods: We recruited 1285 pregnant women in the first trimester of pregnancy from primary health care centers and urban health posts and followed them until birth to collect antenatal care data and birthweight. We estimated pregnancy period PM 2.5 exposures through direct serial measurements of 24-h household PM 2.5 concentrations, performed across each trimester. Mothers also completed detailed questionnaires to provide data on covariates related to household, socio-economic, demographic and maternal health characteristics. The association between PM 2.5 exposures and birth weight was assessed using linear and logistic regression models that controlled for potential confounders., Results: A 10-μg/m 3 increase in pregnancy period PM 2.5 exposures was associated with a 4g (95% CI: 1.08g, 6.76g) decrease in birthweight and 2% increase in prevalence of low birthweight [odds ratio(OR) = 1.02; 95%CI:1.005,1.041] after adjusting for gestational age, infant sex, maternal BMI, maternal age, history of a previous low birth weight child, birth order and season of conception., Conclusions: The study provides some of the first quantitative effects estimates for linking rural-urban PM 2.5 exposures and birthweight in India, adding important evidence for this association from high exposure settings in LMICs, that also experience dual health burdens from ambient and household air pollution. Study results also point to the need for considering maternal PM 2.5 exposures alongside other risk factors for low birthweight in India., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Drug molecule interaction with human serum albumin (HSA) affects the distribution and elimination of the drug. The compound, 2,4-diacetylphloroglucinol (DAPG) has been known for its antimicrobial, antiviral, antihelminthic and anticancer properties. However, its interaction with HSA is not yet reported. In this study, the interaction between HSA and DAPG was investigated through steady-state fluorescence, time-resolved fluorescence (TRF), circular dichroism (CD), Fourier transform infrared (FT-IR) spectroscopy, isothermal titration calorimetry (ITC), molecular docking and molecular dynamics simulation (MDS). Fluorescence spectroscopy results showed the strong quenching of intrinsic fluorescence of HSA due to interaction with DAPG, through dynamic quenching mechanism. The compound bound to HSA with reversible and moderate affinity which explained its easy diffusion from circulatory system to target tissue. The thermodynamic parameters from fluorescence spectroscopic data clearly revealed the contribution of hydrophobic forces but, the role of hydrogen bonds was not negligible according to the ITC studies. The interaction was exothermic and spontaneous in nature. Binding with DAPG reduced the helical content of protein suggesting the unfolding of HSA. Site marker fluorescence experiments revealed the change in binding constant of DAPG in the presence of site I (warfarin) but not site II marker (ibuprofen) which confirmed that the DAPG bound to site I. ITC experiments also supported this as site I marker could not bind to HSA-DAPG complex while site II marker was accommodated in the complex. In silico studies further showed the lowest binding affinity and more stability of DAPG in site I than in site II. Thus the data presented in this study confirms the binding of DAPG to the site I of HSA which may help in further understanding of pharmacokinetic properties of DAPG., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Akt, a serine/threonine protein kinase, is often hyper activated in breast and prostate cancers, but with poor prognosis. Allosteric inhibitors regulate aberrant kinase activity by stabilizing the protein in inactive conformation. Several natural compounds have been reported as inhibitors for kinases. In this study, to identify potential natural allosteric inhibitor for Akt1, we generated a seven-point pharmacophore model and screened it through natural compound library. Quercetin-7-O-β-d-glucopyranoside or Q7G was found to be the best among selected molecules based on its hydrogen bond occupancy with key allosteric residues, persistent polar contacts and salt bridges that stabilize Akt1 in inactive conformation and minimum binding free energy during molecular dynamics simulation. Q7G induced dose-dependent inhibition of breast cancer cells (MDA MB-231) and arrested them in G1 and sub-G phase. This was associated with down-regulation of anti-apoptotic protein Bcl-2, up-regulation of cleaved caspase-3 and PARP. Expression of p-Akt (Ser473) was also down-regulated which might be due to Akt1 inhibition in inactive conformation. We further confirmed the Akt1 and Q7G interaction which was observed to have a dissociation constant (K d ) of 0.246μM. With these computational, biological and thermodynamic studies, we suggest Q7G as a lead molecule and propose for its further optimization., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Primary and secondary progressive multiple sclerosis (MS), collectively called progressive multiple sclerosis (PMS), is characterized by gradual progression of disability. The current anti-inflammatory treatments for MS have little or no efficacy in PMS in the absence of obvious active inflammation. Optimal biomarkers for phase II PMS trials is unknown. Ibudilast is an inhibitor of macrophage migration inhibitor factor and phosphodiesterases-4 and -10 and exhibits possible neuroprotective properties. The goals of SPRINT-MS study are to evaluate the safety and efficacy of ibudilast in PMS and to directly compare several imaging metrics for utility in PMS trials., Methods: SPRINT-MS is a randomized, placebo-controlled, phase II trial of ibudilast in patients with PMS. Eligible subjects were randomized 1:1 to receive either ibudilast (100mg/day) or placebo for 96weeks. Imaging is conducted every 24weeks for whole brain atrophy, magnetization transfer ratio, diffusion tensor imaging, cortical brain atrophy, and retinal nerve fiber layer thickness. Clinical outcomes include neurologic disability and patient reported quality of life. Safety assessments include laboratory testing, electrocardiography, and suicidality screening., Results: A total of 331 subjects were enrolled, of which 255 were randomized onto active study treatment. Randomized subjects were 53.7% female and mean age 55.7 (SD 7.3) years. The last subject is projected to complete the study in May 2017., Conclusion: SPRINT-MS is designed to evaluate the safety and efficacy of ibudilast as a treatment for PMS while simultaneously validating five different imaging biomarkers as outcome metrics for use in future phase II proof-of-concept PMS trials., (Copyright © 2016 Elsevier Inc. All rights reserved.)