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As it appears that we are currently at the cusp of an era in which drugs that are new, re-purposed, or "supplements" will be introduced to the management of celiac disease, we need to reflect on whether the framework is set for celiac disease to be treated increasingly with pharmaceuticals as well as diet. This refers to reflecting on the rigor of current diagnostic practices; the limitations of the current standard of care, which is a gluten-free diet; and that we lack objective markers of disease severity. Investigating these issues will help us to identify gaps in technology and practices that could be critical for selecting patients with a well-defined need for an improved or alternative treatment. Both aspects, circumscribed limitations of the gluten-free diet and diagnostics helping to define celiac disease target groups, together with the guiding requirements by the responsible regulatory authorities, will contribute to defining the subgroups of patients with confirmed celiac disease eligible for distinct pharmacologic strategies. Because many patients with celiac disease are diagnosed in childhood, these aspects need to be differentially discussed for the pediatric setting. In this perspective, we aimed to describe these contextual issues and then looked ahead to the future. What might be the major challenges in celiac disease clinics in the coming years once drugs are an option alongside diet? And what will be the future objectives for researchers who further decipher the mucosal immunology of celiac disease? Speculating on the answers to these questions is as stimulating as it is fascinating to be part of this turning point. [ABSTRACT FROM AUTHOR]

The investigation for hydrogen storage in armchair single walled carbon nanotubes (SWCNTs) with decoration of osmium atom on the surface of tube has been done using ab-initio method utilizing Density Functional Theory (DFT). In the present work, single/dual osmium atoms decoration on the surface of SWCNTs (5,5) has been investigated regarding the effects on structural, electronic and thermodynamic properties. Frontier molecular orbital (FMO) i.e. HOMO and LUMO structures and electrostatic potential surfaces (ESP) of all geometrically optimized and stable species are studied. Investigations regarding metal-metal clustering are carried out by calculating diffusion barrier energy for osmium atoms and atomistic molecular dynamic simulations performed at 300°K temperature for 1ps. It is found that osmium decoration on SWCNTs enhances the hydrogen storage capacity via spillover mechanism. It is observed that the adsorption energy per hydrogen molecule in case of Pristine SWCNT is -0.001eV, which is increased with decoration of osmium atoms and finally found to be -0.575eV/H 2 in case of single osmium decorated SWCNT (Os-CNT) and -0.681eV/H 2 due to double osmium decoration on SWCNT (2Os-CNT). This study reveals gravimetric hydrogen storage capacity of 1.32 wt% and 2.53 wt% for Os-CNT and 2Os-CNT respectively at 298.15 K temperature and 10 atm pressure. Average Van't Hoff desorption temperature for osmium decorated SWCNTs are also calculated. • Hydrogen storage via spillover mechanism. • Electronically, structurally and thermodynamically stable hydrogen storage process. • Enhancement in hydrogen storage capacity due to decoration of double osmium on the surface of armchair SWCNT. • 2.53 wt% of gravimetric hydrogen storage capacity is observed for dual osmium decorated SWCNTs. • Molecular dynamic simulations (ADMP) ensure the solidity of material. [ABSTRACT FROM AUTHOR]

There is a need to develop safe and effective pharmacologic options for the treatment of celiac disease (CeD); however, consensus on the appropriate design and configuration of randomized controlled trials (RCTs) in this population is lacking. A 2-round modified Research and Development/University of California Los Angeles Appropriateness Method study was conducted. Eighteen gastroenterologists (adult and pediatric) and gastrointestinal pathologists voted on statements pertaining to the configuration of CeD RCTs, inclusion and exclusion criteria, gluten challenge, and trial outcomes. Two RCT designs were considered, representing the following distinct clinical scenarios for which pharmacotherapy may be used: trials incorporating a gluten challenge to simulate exposure; and trials evaluating reversal of histologic changes, despite attempted adherence to a gluten-free diet. Each statement was rated as appropriate, uncertain, or inappropriate, using a 9-point Likert scale. For trials evaluating prevention of relapse after gluten challenge, participants adherent to a gluten-free diet for 12 months or more with normal or near-normal–sized villi should be enrolled. Gluten challenge should be FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) free, and efficacy evaluated using histology with a secondary patient-reported outcome measure. For trials evaluating reversal of villus atrophy, the panel voted it appropriate to enroll participants with a baseline villus height to crypt depth ratio ≤2 and measure efficacy using a primary histologic end point. Guidance for measuring histologic, endoscopic, and patient-reported outcomes in adult and pediatric patients with CeD are provided, along with recommendations regarding the merits and limitations of different end points. We developed standardized recommendations for clinical trial design, eligibility criteria, outcome measures, gluten challenge, and disease evaluations for RCTs in patients with CeD. An expert panel of gastroenterologists and pathologists established recommendations for the design of clinical trials evaluating new drugs for the treatment of celiac disease in adults, adolescents, and children. [ABSTRACT FROM AUTHOR]

The hydrogen adsorption capability of functionalized armchair single walled carbon nanotubes (SWCNTs) has been studied to analyze their candidature for hydrogen sensing and storage. Our proposed approach serves as a frame for assessing and prophesying the scope of Au/Ag/Cu/boron/nitrogen atoms doped/co-doped CNTs in the field of hydrogen energy. To corroborate the efficacy of our approach, we perform an ample investigation using armchair SWCNTs having chirality (5,5). Applying our criteria, we thoroughly screen Au/Ag/Cu/boron/nitrogen doped/co-doped in SWCNTs and analyze structural stability, electrical stability and thermo-dynamical stability of the substrates. Our results are based on the calculations of binding energy, bond distances, Bader's Topological Analysis, band gaps, electrophilicity, Density of states (DOS), Mulliken and Natural bond orbital (NBO) charge distribution, adsorption energies, adsorption enthalpy and Gibbs free energy of all the species by utilizing density functional theory (DFT). We found that Au-BCNT, Au-Ag-CNT and Au-Cu-CNT structures have good hydrogen sensing properties, whereas, Ag-NCNT shows better hydrogen storage among all studied species with an average adsorption energy of −0.815eV/H 2 and it can adsorb four hydrogen molecules at 298.15K temperature and 1atm pressure. The storage of H 2 in Ag-NCNT is reversible at desorption temperature of 605K–172K. [Display omitted] • Profound study of electronic, structural and thermodynamic properties of functionalized SWCNTs for hydrogen adsorption. • Enhancement in hydrogen adsorption ability due to transition metals (Au/Ag/Cu) with heteroatom (B/N) co-doping in SWCNT. • Improved hydrogen adsorption ability proffer the use of Au-Ag-CNT, Au-Cu-CNT and Ag-NCNT structures for sensing and storage applications. [ABSTRACT FROM AUTHOR]

Celiac disease can reduce bone mineral density. We sought to determine the prevalence and risk factors for low areal bone mineral density (aBMD) in children with celiac disease. We performed a retrospective cohort study of 673 children with celiac disease (63% female; median age at diagnosis, 10.6 y; interquartile range, 7.8–13.9) who underwent dual x-ray absorptiometry (DXA) from 2009 through 2016 at the Children's Hospital of Philadelphia. We collected demographic, clinical, and laboratory data from medical records. We performed logistic regression analysis to identify factors associated with low (Z less than -2) lumbar spine aBMD Z (aBMD-Z) scores at initial and subsequent tests. The time between diagnosis of celiac disease and first DXA was 0 days (interquartile range, -11 to 31 d). The mean aBMD-Z score at the children's initial scan was -0.4 ± 1.2; 46 children had aBMD-Z scores less than -2 (6.8%; 95% CI, 5.2%–9.0%). Those who had a second DXA analysis (n = 108; 16.0%) had a significant increase in aBMD-Z score (mean change, 0.29; P =.0005). Higher body mass index (BMI) was associated with lower odds of a low aBMD-Z score at the initial DXA analysis (odds ratio, 0.46, 95% CI, 0.35–0.50). BMI-Z scores greater than -0.4 identified children with a low aBMD-Z at their initial DXA analysis with a 95% negative predictive value. Approximately 7% of subjects with celiac disease had a low aBMD-Z score, determined by DXA, at the time of diagnosis; this value was nearly 3-fold higher than expected from a population of children of this age and sex distribution. BMI-Z scores could be used to identify children with celiac disease at risk for low BMD who should receive DXA screening. [ABSTRACT FROM AUTHOR]

• Various optimization techniques in AGC are critically reviewed. • Role of demand side management in AGC is also addressed. • Impact of electric vehicle integration to the grid is studied. Load and generation must be balanced for the system to be stable, which implies frequency deviation must be minimal. Whenever load perturbation takes place in the network, frequency diverges from its nominal value and unplanned exchange of power leads to unfortunate consequences. This will cause the mal-operation of electrical equipment such as change in speed, low efficiency, vibrations, harmonics, inaccuracy etc. Automatic Generation Control (AGC) provides a signal to alter the actual output power of multiple generators within a certain range based on changes in system frequency. For this purpose, several control techniques were employed in the system. This paper focuses on various approaches in the domain of automatic generation control for microgrid based hybrid power system. AI based techniques shows progressive results as compared to other classical and cascaded approaches. Machine learning and deep learning based controlling schemes has also been studied and study shows that these techniques provides loftier performance in comparison of other AI methods due to the availability of large number of trained data sets of controlled variable. Further massive data of controlled variables can be used to restore the system after cyber-attack. It is also addressed how to integrate electric vehicles with the power grid for Load Frequency Control. At the end of this article, some research gap such as role of demand response, protection and control issues, resilient controllers for cyber threats etc. are also addressed which will be useful for researcher working in this area. [ABSTRACT FROM AUTHOR]

Hybrid organic–inorganic hetero-structures, especially inorganic two-dimensional (2D) materials and organic semiconductors are attracting great attention for optoelectronic applications. The quantum confinement effects of 2D materials and their low-cost processing and high performance in devices enable a high degree of tunable optoelectronic properties for these heterostructure. Herein, we attempted to doped poly(3-hexylthiophene) (P3HT) with 2D nanosheets of Molybdenum sulfide (MoS 2 ) to improve its mobility. We synthesized 2D MoS 2 nanosheets using ultrasonication method for exfoliation of MoS 2 . The successful synthesis of 2D MoS 2 monolayers is evidenced through substantial characterization viz Atomic Force Microscopy and UV-visible Spectroscopy. The thickness of these nanosheets varies between 8 and 10 nm. The doping of MoS 2 significantly improved the mobility of the P3HT as evident from the enhanced drain current of organic field effect transistors (OFET) as compared to the undoped P3HT. [ABSTRACT FROM AUTHOR]

• The nucleation and growth of { 11 2 ¯ 2 } twin is connected to the stability of ω-phase. • { 11 2 ¯ 2 } twin is nucleated by double α-ω-α phase transformation. • The migration of the twin boundary is mediated by the glide of pairs of steps. • Gliding of 2 steps convert boundary's configuration into ω-phase and back to α-phase. • The pair of steps, with ω-phase in between, is a dissociated b 3/3 disconnection. A recently proposed mechanism of { 11 2 ¯ 2 } twin nucleation in Ti by reverse phase transformation is analysed. It is demonstrated that, not only nucleation, but also growth mechanism of an already formed twin is connected to the possibility of the phase transformation in the system, which leads to the existence of several competing structures of twin boundary. The twin growth is mediated by subsequent glide of step-like defects (disconnections) along the { 11 2 ¯ 2 } boundary. The twin shear is completed by gliding of pair of disconnections, which also converts twin boundary structure between two alternative variants. [Display omitted]. [ABSTRACT FROM AUTHOR]

• By viewing gender differences through GNH's multidimensional domains and indicators understandings of gender equality in Bhutan are advanced. • The GNH survey indicates that men are happier than women with wellbeing gaps widest in work, leisure time, literacy, and political participation. • The GNH survey indicates gender wellbeing is strongest in assets and land tenure, but gender-biased perceptions that disadvantage women exist. • GNH can benefit from gender analysis by expanding to include qualitative methods that explore gendered socio-cultural attitudes and stigmas. • Gender analysis of practical and strategic needs can benefit from GNH by adding a third dimension of wellbeing needs as an outcome of development. At a moment when market-oriented, techno-centric and consumption-led approaches prevail in response to otherwise complex socio-cultural and political-economic realities, innovative concepts from Bhutan present an alternative bearing on equitable, sustainable and holistic development. Elaborated in the 1970 s by the 4th King of Bhutan, Jigme Singye Wangchuck, GNH is encoded in Bhutan's constitution, the driving philosophy of its development process, and is gaining momentum as an alternative development approach globally. While GNH has been studied from various angles, the survey findings have not been analyzed from a gender perspective. Recognizing this as a critical gap, this study seeks to better understand gender differences in Bhutan. It does so through the disaggregation and analysis of the first GNH nationwide survey data, domains and indicators by gender, triangulation of the findings against secondary literature, and contextualization within contemporary debates about gender in the context of development. Such an exercise is critical, given the disconnects that exist between perceptions of gender 'neutrality' and 'equality' based on women's relatively strong position in certain areas, and the GNH data, which demonstrates gender differences in wellbeing in Bhutan. Our study finds that overall men are happier than women. Men fair better in GNH domains such as education, psychological wellbeing, time use, governance, community vitality, whereas women do better in the domains of living standards and ecological diversity and resilience. Several gender barriers exists, including social stigmas and attitudes that disadvantage women in terms of political participation, decision-making and status. Such an analysis is timely, given the Royal Government of Bhutan's efforts to pro-actively address gender issues that crosscut the GNH domains and shape gender relations, culture and society. The study reflects on Bhutan as a unique context for the study of gender and development, and highlights novel contributions that advance the field of development by studying GNH from a gender lens, and vice versa. [ABSTRACT FROM AUTHOR]

Background & Aims: Eosinophilic esophagitis (EoE) is a disorder characterized by a severe, isolated eosinophilic infiltration of the esophagus unresponsive to aggressive acid blockade but responsive to the removal of dietary antigens. We present information relating to our 10-year experience in children diagnosed with EoE. Methods: We conducted a retrospective study between January 1, 1994, and January 1, 2004, to evaluate all patients diagnosed with EoE. Clinical symptoms, demographic data, endoscopic findings, and the results of various treatment regimens were collected and evaluated. Results: A total of 381 patients (66% male, age 9.1 ± 3.1 years) were diagnosed with EoE: 312 presented with symptoms of gastroesophageal reflux; 69 presented with dysphagia. Endoscopically, 68% of patients had a visually abnormal esophagus; 32% had a normal-appearing esophagus despite a severe histologic esophageal eosinophilia. The average number of esophageal eosinophils (per 400× high power field) proximally and distally were 23.3 ± 10.5 and 38.7 ± 13.3, respectively. Corticosteroids significantly improved clinical symptoms and esophageal histology; however, upon their withdrawal, the symptoms and esophageal eosinophilia recurred. Dietary restriction or complete dietary elimination using an amino acid–based formula significantly improved both the clinical symptoms and esophageal histology in 75 and 172 patients, respectively. Conclusions: Medications such as corticosteroids are effective; however, upon withdrawal, EoE recurs. The removal of dietary antigens significantly improved clinical symptoms and esophageal histology in 98% of patients. [Copyright &y& Elsevier]

Several photoautotrophic microalgae can bear machinery for enhanced utilization of externally added sugars under mixotrophic and heterotrophic conditions. Literatures on microalgae have reported numerous standard media which might be adequate for lab scale studies but not for the concentrated production at industrial scale due to poor biomass and lipid productivities. An optimized medium fortified with all essential nutrients is vital to produce concentrated microalgae biomass along with high lipid content. The present study is presenting the development of optimized media by using the Box-Behnken statistical design method for the enhanced biomass of Arthrospira platensis, Nannochloropsis sp. and Spirulina sp. cultivated under photoautotrophic, mixotrophic and heterotrophic conditions. All the nine optimization models were significant and exhibited quite high coefficient of multiple determination, R2 greater than 0.987 showing the applicability of the generated models. Mixotrophic optimized media of each microalgae resulted in maxima of biomass and lipid in comparison to that of other two cultivation conditions media. Maximum biomass productivity of A. platensis, Nannochloropsis sp. and Spirulina sp. was 7.23 g/L/d, 6.01 g/L/d, and 7.69 g/L/d, respectively in respective mixotrophic optimized media. Proper balance of carbon, nitrogen and vitamins in the media induced lipid up to 77 % of cell biomass. The productivities of both biomass and lipid achieved using mixotrophic optimized media in batch are many folds higher than that obtained in standard cultivation media. Results obtained from batch operation ensures that mixotrophic optimized media would trigger the microalgae production if employed with appropriate feeding strategy in fed batch or continuous operation. [ABSTRACT FROM AUTHOR]

Pulmonary Embolism and Massive hemoptysis are two very potentially fatal emergencies in Respiratory medicine practice. These two conditions are kind of antagonizing conditions requiring completely different and pharmacologically opposite nature of treatment. We hereby present the case of a 37-year old young male presented to our Hospital with massive hemoptysis, who on evaluation also had a concurrent large pulmonary embolism. The bleed was managed with bronchial artery embolization followed by anticoagulation therapy from a day later for embolism. This case report gives an insight on to how to manage a practical therapeutic challenge which is the concurrence of a massive hemoptysis and life threatening pulmonary embolism. [ABSTRACT FROM AUTHOR]

Background: Eosinophilic esophagitis (EoE) is a chronic inflammatory disease with isolated eosinophils in the esophagus predominantly triggered by foods. The optimal testing to identify inciting foods remains unclear. Objectives: We sought to determine the effectiveness of allergy testing–directed diets in patients with EoE. Methods: A retrospective analysis of all children with EoE seen at the Children''s Hospital of Philadelphia between 2000 and 2011 identified 941 patients with EoE. Skin prick tests (SPTs) and atopy patch tests (APTs) were conducted, and predictive values were calculated. IgE-mediated food reactions were also identified. A food was considered to cause EoE if its elimination led to resolution of esophageal eosinophilia or reintroduction led to reoccurrence of EoE. The effectiveness of the various elimination diets was compared with targeted food antigen elimination. Results: Definitive foods causing EoE were identified, with milk, egg, wheat, and soy as the most common foods in 319 patients. IgE-mediated reactions (urticaria and anaphylaxis) were seen in 15%. The negative predictive value for the combination of SPTs and APTs averaged 92%, with the exception of milk at 44%, and the positive predictive value averaged 44%. An empiric 6-food elimination diet or removal of positive foods on allergy testing (SPTs/APTs) both had a histologic success rate of 53%. Removal of foods identified on SPTs/APTs plus empiric elimination of milk leads to resolution in 77% of patients. Conclusion: An elimination diet based on SPT/APT results leads to resolution of esophageal eosinophilia in a similar proportion of patients as empiric removal of foods but required that fewer foods be removed. These observations suggest that both methods are acceptable options. [Copyright &y& Elsevier]

Ethnopharmacological relevance The poly-herbal formulation DB14201 is a new combination of ayurvedic ingredients for treatment of diabetes. The aim of present study was to investigate safety and in vivo efficacy of DB14201 extract. Further this work was aimed to develop, characterize and standardize DB14201 extract and develop it as a botanical drug. Materials and methods The polyherbal extract was standardized using four chemical markers. The LC-MS/MS method was developed for identification and quantification of mangiferin, berberine, kaempferol and curcumin. The extract was standardized for heavy metal content, aflotoxins, and microbial tests. The mechanism of action of DB14201 extract was explored through glucose uptake by adipocytes, TNF-α production and free fatty acid release, in vitro , was studied using murine adipocytes (3T3-L1). The effect of extract on insulin release was evaluated using murine pancreatic beta cell (β TC-6). The safety and in vivo efficacy of extract was studied using suitable animal model. Hematology and blood biochemistry parameters were also assessed. Results In vitro studies of DB14201 in murine adipocytes and murine pancreatic beta cells demonstrated the plausible mechanism of action of DB14201 could be through increase in glucose uptake and by stimulation of insulin release by RIN-5f cells. The microbial load, heavy metals were found to be within the AYUSH permissible limits and aflotoxins were absent. Preclinical efficacy studies in animal models proved the anti-diabetic potential of the extract. The preclinical acute dose toxicity study and 90-days repeated dose toxicity study of DB14201 extract in wistar rats by oral route indicated that the extract is safe up to 1000 mg/kg dose. Hematology and blood biochemistry parameters were within the normal range. Conclusions The data presented herein demonstrated anti-diabetic potential of developed DB14201 extract and this study will serve as the benchmark for the further research on this polyherbal formulation. [ABSTRACT FROM AUTHOR]

Abstract: Terminalia arjuna has been marked as a potential cardioprotective agent since vedic period. The present study was aimed to investigate the effects of butanolic fraction of Terminalia arjuna bark (TA-05) on Doxorubicin (Dox)-induced cardiotoxicity. Male wistar rats were used as in vivo model for the study. TA-05 was administered orally to Wistar rats at different doses (0.42mg/kg, 0.85mg/kg, 1.7mg/kg, 3.4mg/kg and 6.8mg/kg) for 6days/week for 4 weeks. Thereafter, all the animals except saline and TA-05-treated controls were administered 20mg/kg Dox intraperitonially. There was a significant decrease in myocardial superoxide dismutase (38.94%) and reduced glutathione (23.84%) in animals treated with Dox. Concurrently marked increase in serum creatine kinase-MB (CKMB) activity (48.11%) as well as increase in extent of lipid peroxidation (2.55-fold) was reported. Co-treatment of TA-05 and Dox resulted in an increase in the cardiac antioxidant enzymes, decrease in serum CKMB levels and reduction in lipid peroxidation as compared to Dox-treated animals. Electron microscopic studies in Dox-treated animals revealed mitochondrial swelling, Z-band disarray, focal dilatation of smooth endoplasmic reticulum (SER) and lipid inclusions, whereas the concurrent administration of TA-05 led to a lesser degree of Dox-induced histological alterations. These findings suggest that butanolic fraction of Terminalia arjuna bark has protective effects against Dox-induced cardiotoxicity and may have potential as a cardioprotective agent. [Copyright &y& Elsevier]