Search

The study aimed to compare the analgesic effect of USG-guided PENG (Peri capsular nerve group) block with Intravenous Nalbuphine hydrochloride (IVN) in patients with hip fracture coming to the emergency department (ED). The purpose was also to monitor the adverse effects and rescue analgesic requirements in both treatment modalities. The study was an open-label randomised controlled trial (RCT) comparing PENG block versus IVN in treating patients with femoral head and neck fractures, as well as pubic rami fracture of the hip (HF). The participants in the PENG group received a USG-guided PENG block by injection of 25 ml of 0.25% bupivacaine, whereas the IVN group received 0.15 mg/kg of nalbuphine. An emergency physician with expertise in ultrasound-guided nerve blocks performed the PENG blocks. The primary outcome was to measure the improvement of the NRS (Numerical rating scale) score at 30 min in both static position (Patient-chosen position for the best comfort) and dynamic position (15-degree passive affected lower limb elevation). Secondary outcomes were to measure static and dynamic NRS pain scores at 2 h, 4 h, and 6 h after intervention in both groups. The requirement for rescue analgesia, adverse events and any block-related complications were also recorded. A total of 60 patients with HF were included in the final analysis. The static and dynamic NRS score was significantly lower in the PENG group compared to the IVN group at 30 min, 2 h, 4 h, and 6 h post-intervention. In the PENG group, the static NRS score was improved by 5.73 ± 1.17, while In the IVN group, the static NRS score was just improved by 2.13 ± 0.97 at 30 min. In the same duration, the Dynamic NRS score in the PENG group was improved by 6.13 ± 1.38, while In the IVN group, it improved just by 2.43 ± 1.28. Rescue analgesia was required in 50.0% of patients in the IVN group but none in the PENG group. Further, no block-related complications or adverse events were observed in the patients of the PENG group. The study provides evidence that the ultrasound-guided PENG block has a better analgesic effect and has fewer adverse events than IV opioids in patients with HF. [ABSTRACT FROM AUTHOR]

The human pathogen Mycobacterium tuberculosis (Mtb) harbors a well-orchestrated Clp (caseinolytic protease) proteolytic machinery consisting of two oligomeric segments, a barrelshaped heterotetradecameric protease core comprising the ClpP1 and ClpP2 subunits, and hexameric ring-like ATP-dependent unfoldases composed of ClpX or ClpC1. The roles of the ClpP1P2 protease subunits are well-established in Mtb, but the potential roles of the associated unfoldases, such as ClpC1, remain elusive. Using a CRISPR interference–mediated gene silencing approach, here we demonstrate that clpC1 is indispensable for the extracellular growth of Mtb and for its survival in macrophages. The results from isobaric tags for relative and absolute quantitation–based quantitative proteomic experiments with clpC1- and clpP2-depleted Mtb cells suggested that the ClpC1P1P2 complex critically maintains the homeostasis of various growth-essential proteins in Mtb, several of which contain intrinsically disordered regions at their termini. We show that the Clp machinery regulates dosage-sensitive proteins such as the small heat shock protein Hsp20, which exists in a dodecameric conformation. Further, we observed that Hsp20 is poorly expressed in WT Mtb and that its expression is greatly induced upon depletion of clpC1 or clpP2. Remarkably, high Hsp20 protein levels were detected in the clpC1(2) or clpP2(2) knockdown strains but not in the parental bacteria, despite significant induction of hsp20 transcripts. In summary, the cellular levels of oligomeric proteins such as Hsp20 are maintained post-translationally through their recognition, disassembly, and degradation by ClpC1, which requires disordered ends in its protein substrates [ABSTRACT FROM AUTHOR]

[Display omitted] Limited stowage volume of launch vehicles demands compact packaging of large deployable membrane structures. Employment of different folding approaches led to the unavoidable fold-lines(creases). Moreover, wrinkle reduction is essential in such thin-film solar sail and inflatable antenna structures. This article analyzes the combined effect of multiple creases and wrinkles on deployed thin Kapton's surface accuracy. Authors have introduced a novel approach for employing membrane length shortening because of multiple creases and fold characteristics. Real-world logarithmic behaviour of crease relaxation and fold-region properties help in computing the crease curvature. A rhombus-shaped shell model with Z-folding is introduced and explored for the effect of the number of creases and their orientation. Stress concentration and wrinkle contours for applied edge tensile loading state that the fold lines affect the stress transfer path. Non-linear post-buckling analyses for the Kapton® membrane express higher wrinkle evolution in the central region over the loading edge. Besides, a discrepancy in wrinkle amplitude and wavelength reveals the effect of fold-line orientation on wrinkling. Sighting actual conditions for antenna structure, creasing profile normal to the loading direction was found preferable for maintaining reflector surface-effectiveness. Additionally, double creased membranes achieve maximum surface correctness for any angular position, as the mirror effect fold shapes reduce wrinkles the most. Results are validated by comparing with experimental outcomes. [ABSTRACT FROM AUTHOR]

Summary Tremendous amount of physiological and functional complexities acquired through decades of evolutionary pressure makes Mycobacterium tuberculosis (Mtb) one of the most dreadful microorganisms infecting humans from centuries. Astonishing advances in genomics and genome editing tools substantially grew our knowledge about Mtb as an organism but dramatically failed to completely understand it as a pathogen. Though conventional tools based on homologous recombination, antisense, controlled proteolysis, etc. have made important contributions in advancing our understanding of the pathophysiology of Mtb, yet these approaches have not accentuated our exploration of mycobacterium on account of certain technical limitations. In this review article we have compiled various approaches implemented in genome editing of mycobacteria along with the latest adaptation of clustered regularly interspaced short palindromic repeat (CRISPR)-interference (CRISPRi), emphasizing the achievements and challenges associated with these techniques. [ABSTRACT FROM AUTHOR]

Objective: To investigate the frequency of various nonorthostatic complaints in children with postural orthostatic tachycardia syndrome (POTS). Study design: We used our autonomic laboratory database to identify all pediatric patients with traditionally defined POTS who had completed the Ohio Dysautonomia Survey (ODYSA). The responses of the patients to questions targeting various autonomic complaints, including syncope, gastrointestinal symptoms, sleep disturbances, headaches, urinary symptoms, chronic pain, and Raynaud-like symptoms, were collected and analyzed. Results: A total of 53 pediatric patients completed the ODYSA questionnaire. The participants reported high frequencies of sleep abnormalities, chronic pain, Raynaud-like symptoms, and gastrointestinal abnormalities, with lower rates of headaches, syncope, and urinary complaints. Conclusions: Our findings demonstrate the occurrence of various nonorthostatic symptoms in pediatric patients with POTS. These findings suggest the need for an interdisciplinary approach to the treatment and management of POTS, as well as for further investigation into the mechanisms that lead to the concurrent presentation of both orthostatic and nonorthostatic symptoms in these patients. [ABSTRACT FROM AUTHOR]

In this paper, a circular polarization-agile and beam switching enabled reconfigurable cavity-backed antenna having the ability to steer its radiation beam in different directions is presented. The antenna consists of two E-shaped driven patches, a tunable phase shifter integrated with PIN diodes for pattern switching and four switchable feeding probes for implementing polarization agility. The proposed antenna can simultaneously change its polarization and pattern. Beam switching and polarization agility are independently controlled by altering the OFF-ON states of diodes loaded on the feed network and switchable feeding probes. For validity of the proposed concept, the antenna prototype is fabricated and tested. The proposed antenna has measured impedance bandwidth (S 11 < -10 dB) and 3 dB axial ratio bandwidths of 23% and 17.4% respectively for all states over the frequency range 4.7–5.6 GHz. The measured and simulation results show that the antenna can scan up to ± 30° with five reconfigurable beams and two polarizations states for each reconfigurable beam. [ABSTRACT FROM AUTHOR]

In this paper, we present a dual wide-band ingestible antenna design for wireless capsule endoscopy (WCE) biotelemetry applications. The design process employs Characteristic Mode Analysis (CMA) and driven modal analysis. The effectiveness of the prototype antenna is afterward assessed through measurements using a tissue-equivalent phantom liquid model. We investigate the effects of antenna implantation depth and capsule shell thickness on its performance, providing insights into practical considerations. The proposed dual-band antenna demonstrates good performance in both the 1.4 GHz Wireless Medical Telemetry Services (WMTS) and 2.45 GHz Industrial, Scientific, and Medical (ISM) bands, exhibiting measured impedance bandwidths of 36% and 22%, respectively. The measured peak realized gains are −22.9 dBi and −25.3 dBi for the WMTS and ISM bands, respectively, with a compact footprint of 78.5 mm2. To ensure health and safety and optimal performance, we evaluate the antenna's specific absorption rate (SAR) and link margin (LM). Additionally, we assess the performance of the proposed antenna in comparison with the state-of-the-art design for capsule antennas in WCE applications. [ABSTRACT FROM AUTHOR]

Pycnodysostosis is an autosomal recessive skeletal dysplasia with easily recognizable clinical features and marked molecular heterogeneity. In this study, we explored the clinical and molecular spectrum of 25 Indian patients with pycnodysostosis from 20 families. Clinical information was collected on a predesigned clinical proforma. Sanger method was employed to sequence all the exons and exon/intron boundaries of the CTSK gene. Novel variants were systematically assessed by prediction softwares and protein modelling. The pathogenicity of variant was established based on ACMG-AMP criteria. An attempt was also made to establish a genotype-phenotype correlation and devise a diagnostic scoring system based on clinical and radiological findings. Consanguinity and positive family history were present in 65% (13/20) and 45% (9/20) of the families respectively. Short stature and fractures were the predominant presenting complaints and was evident in 96% (24/25) and 32% (8/25) of affected individuals respectively. Gestalt facial phenotype and acro-osteolysis were present in 76% (19/25) and 82.6% (19/23) of the individuals respectively. Hepatosplenomegaly was present in 15% (3/20) of the individuals with one of them having severe anaemia. Causative sequence variations were identified in all of them. A total of 19 variants were identified from 20 families amongst which 10 were novel. Homozygous variants were identified in 90% (18/20) families. Amongst the novel variants, there was a considerable proportion (40%) of frameshift variants (4/10). No significant genotype-phenotype correlation was noted. Scoring based on clinical and radiological findings led to the proposal that a minimum of 2 scores in each category is required in addition to high bone density to diagnose pycnodysostosis with certainty. This study delineated the genotypic and phenotypic characterisation of Indian patients with pycnodysostosis with identification of 10 novel variants. We also attempted to develop a clinically useful diagnostic scoring system which requires further validation. [ABSTRACT FROM AUTHOR]