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Maize (Zea mays Linnaeus), a prominent cereal crop of Nepal, which suffers significantly from storage pest, particularly maize weevil (Sitophilus zeamais (Motschulsky)), during storage by creating holes and consuming the internal part. Effective management of the pest and reduction grain loss is crucial. To address this problem, a study was conducted at the Nepal Agricultural Research Council in Khumaltar, Lalitpur, from April to August, 2023, evaluating the efficacy of essential oils of Acorus calamus Linnaeus, Cuminum cyminum Linnaeus, and Piper nigrum Linnaeus against S. zeamais. Essential oils were extracted using the Clevenger type steam hydrodistillation method. Concentrations of essential oils (5%, 2.5%, 1.25%, 0.63%, 0.31%, 0.15%) were tested in a two factor completely randomized design (CRD) using oils and doses as the two factor, with four replications and control group. The study assessed lethal concentration, weight loss, and repellence tests in petridishes. Progeny of maize weevils (1-7 days old) were introduced into petridishes having 7mm diameter of Whatman filter paper to evaluate the mortality and repellency effect. The number of insects on both side of the petridish (treated and untreated paper) was counted as part of the repellence test. Mortality in treated grains was observed over a 20 days, and with weight loss measured after 60 days. Results showed significant insecticidal activity, with the median lethal concentration (LC50) of A. calamus oil at 24 and 72 hours calculated as 1.24% and 0.43%, respectively in laboratory bioassay. The LC50 for A. calamus treated maize was 4.70% and 0.70% for 1 and 20 days, respectively, followed by C. cyminum and P. nigrum. Acorus calamus Linnaeus oil demonstrated the highest repellent activity (90.00%) at 5% concentration after 4 hours of treatment. Moreover, maize treated with A. calamus oil showed significantly lower weight loss (0.62%) compared to the control. This study indicated the potential of A. calamus oil for pest control, concerns remain regarding its suitability for feed and food purposes due to associated health risks. These findings underscore the need for further research to explore safer alternatives for pest management in maize storage.

Abstract Deposition of wildfire smoke on snow contributes to its darkening and accelerated snowmelt. Recent field studies have identified dark brown carbon (d-BrC) to contribute 50–75% of shortwave absorption in wildfire smoke. d-BrC is a distinct class of water-insoluble, light-absorbing organic carbon that co-exists in abundance with black carbon (BC) in snow across the world. However, the importance of d-BrC as a snow warming agent relative to BC remains unexplored. We address this gap using aerosol-snow radiative transfer calculations on datasets from laboratory and field measurement. We show d-BrC increases the annual mean snow radiative forcing between 0.6 and 17.9 W m− 2, corresponding to different wildfire smoke deposition scenarios. This is a 1.6 to 2.1-fold enhancement when compared with BC-only deposition on snow. This study suggests d-BrC is an important contributor to snowmelt in midlatitude glaciers, where ~40% of the world’s glacier surface area resides.

Abstract Pyrocumulonimbus (pyroCb) firestorm systems have been shown to inject significant amounts of black carbon (BC) to the stratosphere with a residence time of several months. Injected BC warms the local stratospheric air, consequently perturbing transport and hence spatial distributions of ozone and water vapor. A distinguishing feature of BC-containing particles residing within pyroCb smoke is their thick surface coatings made of condensed organic matter. When coated with non-refractory materials, BC’s absorption is enhanced, yet the absorption enhancement factor (E abs ) for pyroCb BC is not well constrained. Here, we perform particle-scale measurements of BC mass, morphology, and coating thickness from inside a pyroCb cloud and quantify E abs using an established particle-resolved BC optics model. We find that the population-averaged E abs for BC asymptotes to 2.0 with increasing coating thickness. This value denotes the upper limit of E abs for thickly coated BC in the atmosphere. Our results provide observationally constrained parameterizations of BC absorption for improved radiative transfer calculations of pyroCb events.

Background Predictive scales have been used to prognosticate long-term outcomes of traumatic brain injury (TBI), but gaps remain in predicting mortality using initial trauma resuscitation data. We sought to evaluate the association of clinical variables collected during the initial resuscitation of intubated pediatric severe patients with TBI with in-hospital mortality.Methods Intubated pediatric trauma patients

Neurodevelopmental disorders (NDDs) are a class of pathologies arising from perturbations in brain circuit formation and maturation with complex etiological triggers often classified as environmental and genetic. Neuropsychiatric conditions such as autism spectrum disorders (ASD), intellectual disability (ID), and attention deficit hyperactivity disorders (ADHD) are common NDDs characterized by their hereditary underpinnings and inherent heterogeneity. Genetic risk factors for NDDs are increasingly being identified in non-coding regions and proteins bound to them, including transcriptional regulators and chromatin remodelers. Importantly, de novo mutations are emerging as important contributors to NDDs and neuropsychiatric disorders. Recently, de novo mutations in transcriptional co-factor Zmiz1 or its regulatory regions have been identified in unrelated patients with syndromic ID and ASD. However, the role of Zmiz1 in brain development is unknown. Here, using publicly available databases and a Zmiz1 mutant mouse model, we reveal that Zmiz1 is highly expressed during embryonic brain development in mice and humans, and though broadly expressed across the brain, Zmiz1 is enriched in areas prominently impacted in ID and ASD such as cortex, hippocampus, and cerebellum. We investigated the relationship between Zmiz1 structure and pathogenicity of protein variants, the epigenetic marks associated with Zmiz1 regulation, and protein interactions and signaling pathways regulated by Zmiz1. Our analysis reveals that Zmiz1 regulates multiple developmental processes, including neurogenesis, neuron connectivity, and synaptic signaling. This work paves the way for future studies on the functions of Zmiz1 and highlights the importance of combining analysis of mouse models and human data.

Abstract Background Helicobacter pylori is a prominent causative agent of gastric ulceration, gastric adenocarcinoma and gastric lymphoma and have been categorised as a group 1 carcinogen by WHO. The treatment of H. pylori with proton pump inhibitors and antibiotics is effective but also leads to increased antibiotic resistance, patient dissatisfaction, and chances of reinfection. Therefore, an effective vaccine remains the most suitable prophylactic option for mass administration against this infection. Results We modelled a multi-chimera subunit vaccine candidate against H. pylori by screening its secretory/outer membrane proteins. We identified B-cell, MHC-II and IFN-γ-inducing epitopes within these proteins. The population coverage, antigenicity, physiochemical properties and secondary structure were evaluated using different in-silico tools, which showed it can be a good and effective vaccine candidate. The 3-D construct was predicted, refined, validated and docked with TLRs. Finally, we performed the molecular docking/simulation and immune simulation studies to validate the stability of interaction and in-silico cloned the epitope sequences into a pET28b(+) plasmid vector. Conclusion The multiepitope-constructed vaccine contains T- cells, B-cells along with IFN-γ inducing epitopes that have the property to generate good cell-mediated immunity and humoral response. This vaccine can protect most of the world’s population. The docking study and immune simulation revealed a good binding with TLRs and cell-mediated and humoral immune responses, respectively. Overall, we attempted to design a multiepitope vaccine and expect this vaccine will show an encouraging result against H. pylori infection in in-vivo use.

Abstract Real-time surveillance of airborne SARS-CoV-2 virus is a technological gap that has eluded the scientific community since the beginning of the COVID-19 pandemic. Offline air sampling techniques for SARS-CoV-2 detection suffer from longer turnaround times and require skilled labor. Here, we present a proof-of-concept pathogen Air Quality (pAQ) monitor for real-time (5 min time resolution) direct detection of SARS-CoV-2 aerosols. The system synergistically integrates a high flow (~1000 lpm) wet cyclone air sampler and a nanobody-based ultrasensitive micro-immunoelectrode biosensor. The wet cyclone showed comparable or better virus sampling performance than commercially available samplers. Laboratory experiments demonstrate a device sensitivity of 77–83% and a limit of detection of 7-35 viral RNA copies/m3 of air. Our pAQ monitor is suited for point-of-need surveillance of SARS-CoV-2 variants in indoor environments and can be adapted for multiplexed detection of other respiratory pathogens of interest. Widespread adoption of such technology could assist public health officials with implementing rapid disease control measures.

Zinc Finger MIZ-Type Containing 1 (Zmiz1), also known as ZIMP10 or RAI17, is a transcription cofactor and member of the Protein Inhibitor of Activated STAT (PIAS) family of proteins. Zmiz1 is critical for a variety of biological processes including vascular development. However, its role in the lymphatic vasculature is unknown. In this study, we utilized human dermal lymphatic endothelial cells (HDLECs) and an inducible, lymphatic endothelial cell (LEC)-specific Zmiz1 knockout mouse model to investigate the role of Zmiz1 in LECs. Transcriptional profiling of ZMIZ1-deficient HDLECs revealed downregulation of genes crucial for lymphatic vessel development. Additionally, our findings demonstrated that loss of Zmiz1 results in reduced expression of proliferation and migration genes in HDLECs and reduced proliferation and migration in vitro. We also presented evidence that Zmiz1 regulates Prox1 expression in vitro and in vivo by modulating chromatin accessibility at Prox1 regulatory regions. Furthermore, we observed that loss of Zmiz1 in mesenteric lymphatic vessels significantly reduced valve density. Collectively, our results highlight a novel role of Zmiz1 in LECs and as a transcriptional regulator of Prox1, shedding light on a previously unknown regulatory factor in lymphatic vascular biology.

Key features of virtual reality (VR) that impact the effectiveness of pain reduction remain unknown. We hypothesized that specific features of the VR experience significantly impact VR's effectiveness in reducing pain during pediatric burn dressing care. Our randomized controlled trial included children 6 to 17 years (inclusive) who were treated in the outpatient clinic of an American Burn Association-verified pediatric burn center. Participants were randomly assigned (1:1:1) to active VR (playing the VR), passive VR (immersed in the same VR environment without interactions), or standard-of-care. On a scale from 0 to 100, participants rated overall pain (primary outcome) and features of the VR experience (game realism, fun, and engagement). Path analysis assessed the interrelationships among these VR key features and their impact on self-reported pain scores. From December 2016 to January 2019, a total of 412 patients were screened for eligibility, and 90 were randomly assigned (31 in the active VR group, 30 in the passive VR group, and 29 in the standard-of-care group). The current study only included those in the VR groups. The difference in median scores of VR features was not statistically significant between the active (realism, 77.5 [IQR: 50-100]; fun, 100 [IQR: 81-100]; engagement, 90 [IQR: 70-100]) and passive (realism, 72 [IQR: 29-99]; fun, 93.5 [IQR: 68-100]; engagement, 95 [IQR: 50-100]) VR distraction types. VR engagement had a significant direct (-0.39) and total (-0.44) effect on self-reported pain score (p

This experimental work reports how different pilot masses of biodiesel-blended fuel in Common Rail Direct Injection (CRDI) engines affect engine performance, combustion, and emissions. This experiment used 20MEWCO (20 % Methyl Esters of Waste Cooking Oil + 80 % Diesel) as the test fuel. Several parameters, such as timing and injection mass, affect how the CRDI system delivers fuel. In this work, the pilot injection mass was varied by 5 %, 7.5 %, and 10 %, keeping other factors such as injection pressure at 500 bar and the timing of the pilot and main injections at 36°Crank Angle before Top Dead Centre (bTDC) and 15°Crank Angle before Top Dead Centre (bTDC), respectively. This work reveals that when pilot mass is increased in steps of 2.5%, the combustion performance parameters like cylinder pressure, heat release rate and specific fuel consumption values decrease. Also, it gave off less smoke, carbon monoxide and hydrocarbons than regular diesel with more nitrous oxide. Also, it was found that at 10 % of the pilot mass, carbon monoxide, hydrocarbon, and smoke emissions were significantly reduced, with a slight rise in oxide of nitrogen emissions at the same time, without affecting the engine performance.

Abstract Background Malignant perivascular epithelioid cell tumors (PEComas) are exceedingly rare malignant mesenchymal neoplasms with characteristic morphological and immunohistochemical (IHC) patterns. However, some malignant PEComas are poorly differentiated with atypical histopathological features, making a definitive diagnosis difficult. PEComas are most commonly found in females and often show either TSC1 or TSC2 alterations, which result in the activation of the mTOR pathway, or TFE3 fusions. Given these molecular characteristics, mTOR inhibitors have recently been approved by the FDA in the treatment of malignant PEComas, particularly in those with TSC1/2 alterations. Therefore, molecular analyses may be helpful for both the diagnostic workup of and predicting response to mTOR inhibitors in cases of malignant PEComas. Case presentation Here, we report a case of an aggressive, 23 cm mesenteric malignant PEComa with multiple peritoneal metastases in a young male patient. Pathological examination of the initial biopsy showed a malignant epithelioid neoplasm with high-grade morphology and atypical immunoprofile, which precluded a definitive diagnosis. Because of the patient’s excessive transfusion requirements due to intra-tumoral hemorrhage, a palliative R2 resection was performed. Histopathological examination of the tumor revealed focal immunoreactivity for Melan-A, HMB-45, desmin, and CD117. Although a diagnosis of malignant PEComa was favored, other entities such as epithelioid gastrointestinal stromal tumor (GIST) or melanoma could not be definitively ruled out. Given the favored diagnosis, the patient was started on sirolimus, an mTOR inhibitor, rather than chemotherapy. Molecular analyses were performed and the tumor was found to harbor mutations in TP53 and TSC2, supporting a definitive diagnosis of malignant PEComa. The patient was then switched to nab-sirolimus, with initial stabilization of the disease. Conclusions This report details a multidisciplinary approach for the diagnosis and management of a highly aggressive, metastatic malignant PEComa in a young male patient. The basis for the treatment of malignant PEComas with the recently FDA-approved mTOR inhibitor, nab-sirolimus, is also reviewed. In summary, this case highlights the importance of molecular analysis, particularly TSC1/2 alterations, for both the definitive diagnosis of malignant PEComas and predicting their response to nab-sirolimus.

Abstract Background Virtual reality (VR) gaming is considered a safe and effective alternative to standard pain alleviation in the hospital. This study addressed the potential effectiveness and feasibility of a VR game that was developed by our research team for repeated at-home burn dressing changes. Methods A randomized clinical trial was conducted among patients recruited from the outpatient burn clinic of a large American Burn Association–verified pediatric burn center between September 2019 and June 2021. We included English-speaking burn patients aged 5–17 years old requiring daily dressing changes for at least 1 week after first outpatient dressing change. One group played an interactive VR game during dressing changes, while the other utilized standard distraction techniques available in the home for up to a week. Both child and caretaker were asked to assess perceived pain on a numerical rating scale (NRS) of 0–10. For the VR group, patients were also asked to rate various aspects of the VR game on a NRS of 0–10 and caregivers were asked questions assessing ease of use. Results A total of 35 children were recruited for this study with 24 fully completing study measures. The majority of participants were male (n=19, 54.3%), White (n=29, 82.9%), and with second degree burns (n=32, 91.4%). Children and caregivers in the VR group reported less pain than the control group at the 4th dressing change. Participants in the VR group showed a clinically meaningful (≥30%) reduction in child-reported overall pain (33.3%) and caregiver-reported worst pain (31.6%) in comparison with subjects in the control group. Children’s satisfaction with the VR remained at a high level across dressing changes over the 1-week period, with reported realism and engagement increasing over time. Over half of the children (54.5%) enjoyed playing the game and did not report any challenges nor any side effects. Conclusions Subjects found the VR to be a useful distraction during home dressing changes and reported no challenges/side effects. VR should be considered as a nonpharmacologic companion for pain management during at-home burn dressing changes. Trial registration ClinicalTrials.gov Identifier: NCT04548635. Registered September 14, 2020—retrospectively registered

Introduction: India is committed to to prevent pneumonia related deaths in children which is leading cause of vaccine preventable deaths among children under five globally and in India. Objective : To know awareness about pneumococcal (PC) vaccine among medical and nursing students of civil hospital, Ahmedabad. Method: This cross sectional study was conducted on medical and nursing students of civil hospital, Ahmedabad, Gujarat. Baseline knowledge of PC Vaccine, side effects of PC vaccine, was assessed by a self-administered structured questionnaire. Statistical analysis - Data analysis was done in Microsoft excel and chi square test was applied. Results: There were 444 respondents and among them 240 (54%) were medical students and 204 (46%) were nursing students, with male female ratio was 95:127. Awareness regarding PC vaccine integration to national immunization schedule found significantly more in nursing students as compare to medical students, (Chi-square = 63.4 at p < 0.05). Medical students had more knowledge about PC vaccine as compared to nursing students. Conclusion:There is still gap in awareness of PC vaccine integration to national immunization schedule among medical students. Field visits among nursing students have positive effects on awareness of nursing students. Medical students should visit to this type of field activities to improve their knowledge about ongoing activities like this.

In the present study Li+ co-doped ZnMoO4:Eu3+ phosphor is prepared through Polyol method. The XRD has resulted triclinic structure of the ZnMoO4 sample. TEM and HRTEM illustrate rod-like morphology of the present samples. The PL-spectra has been recorded at 266, 395 and 465 nm excitation wavelength and characteristic emission peaks of the Eu3+ ion are observed. It is observed that the alkali lithium ion fills the vacancy which might be created due to mismatching between the oxidation states of metal and lanthanide ion. In this work highest PL-intensity observed for 10 at% Li+ co-doped sample. Moreover, color purity and quantum efficiency for 10 at% Li+ co-doped sample is found to 97 % and 35 %, respectively. Judd-Ofelt parameters have been calculated for all the samples and are correlated with the observed emission. The deep red emission from Li+ co-doped ZnMoO4:Eu3+ indicates that present phosphor has potential for white light emitting diodes and bio-imaging applications.

Abstract Background Mapping of left ventricular (LV) native T1 is a promising non-invasive, non-contrast imaging biomarker. Native myocardial T1 times are prolonged in patients requiring dialysis, but there are concerns that the dialysis process and fluctuating fluid status may confound results in this population. We aimed to assess the changes in cardiac parameters on 3T cardiovascular magnetic resonance (CMR) before and after haemodialysis, with a specific focus on native T1 mapping. Methods This is a single centre, prospective observational study in which maintenance haemodialysis patients underwent CMR before and after dialysis (both scans within 24 h). Weight measurement, bio-impedance body composition monitoring, haemodialysis details and fluid intake were recorded. CMR protocol included cine imaging and mapping native T1 and T2. Results Twenty-six participants (16 male, 65 ± 9 years) were included in the analysis. The median net ultrafiltration volume on dialysis was 2.3 L (IQR 1.8, 2.5), resulting in a median weight reduction at post-dialysis scan of 1.35 kg (IQR 1.0, 1.9), with a median reduction in over-hydration (as measured by bioimpedance) of 0.75 L (IQR 0.5, 1.4). Significant reductions were observed in LV end-diastolic volume (− 25 ml, p = 0.002), LV stroke volume (− 13 ml, p = 0.007), global T1 (21 ms, p = 0.02), global T2 (− 1.2 ms, p = 0.02) following dialysis. There was no change in LV mass (p = 0.35), LV ejection fraction (p = 0.13) or global longitudinal strain (p = 0.22). On linear regression there was no association between baseline over-hydration (as defined by bioimpedance) and global native T1 or global T2, nor was there an association between the change in over-hydration and the change in these parameters. Conclusions Acute changes in cardiac volumes and myocardial native T1 are detectable on 3T CMR following haemodialysis with fluid removal. The reduction in global T1 suggests that the abnormal native T1 observed in patients on haemodialysis is not entirely due to myocardial fibrosis.

The (Pro)renin receptor ([P]RR), also known as ATP6AP2, is a single-transmembrane protein that is implicated in a multitude of biological processes. However, the exact role of ATP6AP2 during blood vessel development remains largely undefined. Here, we use an inducible endothelial cell–specific (EC-specific) Atp6ap2-KO mouse model to investigate the role of ATP6AP2 during both physiological and pathological angiogenesis in vivo. We observed that postnatal deletion of Atp6ap2 in ECs results in cell migration defects, loss of tip cell polarity, and subsequent impairment of retinal angiogenesis. In vitro, Atp6ap2-deficient ECs similarly displayed reduced cell migration, impaired sprouting, and defective cell polarity. Transcriptional profiling of ECs isolated from Atp6ap2 mutant mice further indicated regulatory roles in angiogenesis, cell migration, and extracellular matrix composition. Mechanistically, we provided evidence that expression of various extracellular matrix components is controlled by ATP6AP2 via the ERK pathway. Furthermore, Atp6ap2-deficient retinas exhibited reduced revascularization in an oxygen-induced retinopathy model. Collectively, our results demonstrate a critical role of ATP6AP2 as a regulator of developmental and pathological angiogenesis.

Thermal injury induces concurrent inflammatory and immune dysfunction, which is associated with adverse clinical outcomes. However, these effects in the pediatric population are less studied and there is no standard method to identify those at risk for developing infections. Our goal was to better understand immune dysfunction and identify soluble protein markers following pediatric thermal injury. Further we wanted to determine which early inflammatory, soluble, or immune function markers are most predictive of the development of nosocomial infections (NI) after burn injury. We performed a prospective observational study at a single American Burn Association-verified Pediatric Burn Center. A total of 94 pediatric burn subjects were enrolled and twenty-three of those subjects developed a NI with a median time to diagnosis of 8 days. Whole blood samples, collected within the first 72 hours after injury, were used to compare various markers of inflammation, immune function, and soluble proteins between those who recovered without developing an infection and those who developed a NI after burn injury. Within the first three days of burn injury, innate and adaptive immune function markers (ex vivo lipopolysaccharide-induced tumor necrosis factor alpha production capacity, and ex vivo phytohemagglutinin-induced interleukin-10 production capacity, respectively) were decreased for those subjects who developed a subsequent NI. Further analysis of soluble protein targets associated with these pathways displayed significant increases in soluble CD27, BTLA, and TIM-3 for those who developed a NI. Our findings indicate that suppression of both the innate and adaptive immune function occurs concurrently within the first 72 hours following pediatric thermal injury. At the same time, subjects who developed NI have increased soluble protein biomarkers. Soluble CD27, BTLA, and TIM-3 were highly predictive of the development of subsequent infectious complications. This study identifies early soluble protein makers that are predictive of infection in pediatric burn subjects. These findings should inform future immunomodulatory therapeutic studies.

Introduction : India is committed to goal of Measles elimination and Rubella control by 2020, for this purpose MR vaccination campaign has implemented. Objective: To assess awareness of MR Campaign in medical and nursing students of civil hospital, Ahmedabad. Methods: This cross sectional study was conducted on medical and nursing students of civil hospital, Ahmedabad, Gujarat. Baseline knowledge of MR campaign, side effects of MR vaccine, was assessed by a self-administered structured questionnaire. Data analysis was done in Microsoft excel and chi square test was applied. Results: There were 222 respondents and among them 120 (54%) were medical students and 102 (46%) were nursing students, with male female ratio of 95:127. Awareness regarding MR Vaccination Campaign found significantly more in nursing students as compare to medical students whereas Medical students had more knowledge about MR vaccine as compared to nursing students. Conclusion: There is still gap in awareness of MR vaccination campaign among medical students. Field visits among nursing students have positive effects on awareness of nursing students.

Abstract Background The ASTRAL trial showed no difference in clinical outcomes between medical therapy and revascularization for atherosclerotic renal vascular disease (ARVD). Here we report a sub-study using echocardiography to assess differences in cardiac structure and function at 12 months. Methods ASTRAL patients from 7 participating centres underwent echocardiography at baseline and 12 months after randomisation. Changes in left ventricular ejection fraction (LVEF), left ventricular mass (LVM), left atrial diameter (LAD), aortic root diameter (AoRD), E:A, and E deceleration time (EDT) were compared between study arms. Analyses were performed using t-tests and multivariate linear regression. Results Ninety two patients were included (50 medical versus 42 revascularization). There was no difference between arms in any baseline echocardiographic parameter. Comparisons of longitudinal changes in echocardiographic measurements were: δLVEF medical 0.8 ± 8.7% versus revascularization − 2.8 ± 6.8% (p = 0.05), δLVM − 2.9 ± 33 versus − 1.7 ± 39 g (p = 0.9), δLAD 0.1 ± 0.4 versus 0.01 ± 0.5 cm (p = 0.3), δAoRD 0.002 ± 0.3 versus 0.06 ± 0.3 cm (p = 0.4), δE:A − 0.0005 ± 0.6 versus 0.03 ± 0.7 (p = 0.8), δEDT − 1.1 ± 55.5 versus − 9.0 ± 70.2 ms (p = 0.6). In multivariate models, there were no differences between treatment groups for any parameter at 12 months. Likewise, change in blood pressure did not differ between arms (mean δsystolic blood pressure medical 0 mmHg [range − 56 to + 54], revascularization − 3 mmHg [− 61 to + 59], p = 0.60). Conclusions This sub-study did not show any significant differences in cardiac structure and function accompanying renal revascularization in ASTRAL. Limitations include the small sample size, the relative insensitivity of echocardiography, and the fact that a large proportion of ASTRAL patient population had only modest renal artery stenosis as described in the main study.

Chemical injuries from household products cause significant morbidity and mortality annually in pediatric patients. We present a rare case of a 21-month-old male with significant esophageal and cutaneous chemical burns secondary to non-accidental trauma. Given the unique challenges associated with multiple burn types we describe this case and provide a current review of the literature on the management of these potentially devastating injuries.

Abstract These guidelines cover the care of patients from the period following kidney transplantation until the transplant is no longer working or the patient dies. During the early phase prevention of acute rejection and infection are the priority. After around 3–6 months, the priorities change to preservation of transplant function and avoiding the long-term complications of immunosuppressive medication (the medication used to suppress the immune system to prevent rejection). The topics discussed include organization of outpatient follow up, immunosuppressive medication, treatment of acute and chronic rejection, and prevention of complications. The potential complications discussed include heart disease, infection, cancer, bone disease and blood disorders. There is also a section on contraception and reproductive issues. Immediately after the introduction there is a statement of all the recommendations. These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people. Consequently we have not reworded or restated them in this lay summary. They are graded 1 or 2 depending on the strength of the recommendation by the authors, and AD depending on the quality of the evidence that the recommendation is based on.

Roberts syndrome is a genetically determined rare birth defect causing, skeletal deformities, particularly symmetrical limb reduction and craniofacial anomalies. For any child with limb and craniofacial bony malformations, this syndrome should be considered in the differentials. Although this syndrome represents only a small proportion of the total number of individuals with limb defi ciency, it is important to be identified in order to give accurate genetic counseling including recurrence risk in siblings and possible prenatal diagnosis. This is the case report of a 9 year old female child who presented with defective development of all four extremities and craniofacial abnormalities. The overall clinical and radiological features were suggestive of Roberts syndrome.

There is overwhelming evidence that minority populations across the United States (US) have been disproportionately affected by the coronavirus (COVID-19) pandemic. While the disparities are clear, the reasons underlying the rapidity of disease spread—characterized by the basic reproduction ratio R _0 —in these communities are less so. Here, we investigate the relative impact of disparities in socioeconomic, environmental, and lung health factors on R _0 across 12 major metropolitan statistical areas (MSAs) in the US at the county-level. We inferred county-level R _0 values using an established metapopulation epidemiological model corresponding to the period 1 March–30 April 2020 marked by a rapid surge in COVID-19 cases across the US and implementation of strict lockdown measures. We find that disparities in long-term, ambient PM _2.5 exposure (particulate matter with aerodynamic diameter 2.5 μ m or less) and population density have an outsized effect on R _0 in comparison to disparities in the other factors. We also find that the effect of increasing population density on R _0 is dependent on ambient PM _2.5 mass concentrations. PM _2.5 exposure has a well-established causal effect with increased risks and severe outcomes during previous infectious disease outbreaks. Overall, we find the largest disparities in PM _2.5 exposure, population density, and associated increase in R _0 among the Hispanic-American population, followed by Asian-American and African-American populations, respectively. Longstanding geographic segregation of minority communities has led to extremely large fluctuations in county-level racial and ethnic minority fractions. As such, we conclude by providing each MSA with a roadmap for identifying which communities should be targeted for PM _2.5 mitigation policy implementation. The methodology and results of this study may be extrapolatable to the rest of the world toward discerning the consequences of population density and PM _2.5 disparities in COVID-19 spread.

Krishna Rajan, Ignazio Roppolo, Annalisa Chiappone, Sergio Bocchini, Denis Perrone, Alessandro Chiolerio Center for Space Human Robotics, Italian Institute of Technology, Turin, Italy Abstract: Printed electronics will bring to the consumer level great breakthroughs and unique products in the near future, shifting the usual paradigm of electronic devices and circuit boards from hard boxes and rigid sheets into flexible thin layers and bringing disposable electronics, smart tags, and so on. The most promising tool to achieve the target depends upon the availability of nanotechnology-based functional inks. A certain delay in the innovation-transfer process to the market is now being observed. Nevertheless, the most widely diffused product, settled technology, and the highest sales volumes are related to the silver nanoparticle-based ink market, representing the best example of commercial nanotechnology today. This is a compact review on synthesis routes, main properties, and practical applications. Keywords: silver nanoparticles, surface plasmon resonance, nanocomposites, inks, printed electronics

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor presenting in adolescent and young adult females. A previously healthy 13 year-old female presented to our institution with abdominal pain and emesis. Imaging revealed a pancreatic cystic mass. Endoscopic ultrasound (EUS) with fine needle biopsy suggested SPN. Pathologic evaluation following resection revealed immunohistochemical (IHC) staining positive for β-catenin and α-1-antitrypsin despite extensive necrosis. We discuss this patient as well as our institutional series of SPN of the pancreas, describing the evaluation, management, and histopathology of this rare tumor.

Kathleen A Ross,1 Hyelee Loyd,2 Wuwei Wu,2 Lucas Huntimer,3 Shaheen Ahmed,4 Anthony Sambol,5 Scott Broderick,6 Zachary Flickinger,2 Krishna Rajan,6 Tatiana Bronich,4 Surya Mallapragada,1 Michael J Wannemuehler,3 Susan Carpenter,2 Balaji Narasimhan1 1Chemical and Biological Engineering, Iowa State University, Ames, IA, USA; 2Animal Science, Iowa State University, Ames, IA, USA; 3Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA; 4Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA; 5Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA; 6Materials Science and Engineering, Iowa State University, Ames, IA, USA Abstract: H5N1 avian influenza is a significant global concern with the potential to become the next pandemic threat. Recombinant subunit vaccines are an attractive alternative for pandemic vaccines compared to traditional vaccine technologies. In particular, polyanhydride nanoparticles encapsulating subunit proteins have been shown to enhance humoral and cell-mediated immunity and provide protection upon lethal challenge. In this work, a recombinant H5 hemagglutinin trimer (H53) was produced and encapsulated into polyanhydride nanoparticles. The studies performed indicated that the recombinant H53 antigen was a robust immunogen. Immunizing mice with H53 encapsulated into polyanhydride nanoparticles induced high neutralizing antibody titers and enhanced CD4+ T cell recall responses in mice. Finally, the H53-based polyanhydride nanovaccine induced protective immunity against a low-pathogenic H5N1 viral challenge. Informatics analyses indicated that mice receiving the nanovaccine formulations and subsequently challenged with virus were similar to naïve mice that were not challenged. The current studies provide a basis to further exploit the advantages of polyanhydride nanovaccines in pandemic scenarios. Keywords: polymer, nanoparticle, vaccine, subunit, neutralizing antibody

Each set of conjoined twins has specific anatomic features dictating unique challenges to separation. Overcoming these challenges requires creative solutions that necessitate interdisciplinary collaboration. We present a unique case of pygopagus conjoined twins with fused spinal cords, imperforate anus without fistula, and a single anal sphincter complex. Separation included the use of novel applications of 3D printing and neurophysiologic monitoring. The 3D print helped to clarify the complex anatomy and facilitate communication during planning sessions. The neurophysiologic monitoring helped to distinguish a plane of separation for the spinal cords as well as the shared anal sphincter. Implementing these technologies and thus successfully separating these twins safely required a multidisciplinary team that extended beyond clinical specialties.

Fresh water bodies in populated plains of tropical countries face various disturbances in the form of pollutant and nutrient inflow, heavy metal and elemental precipitation (wet or dry) and constant silt inflow (natural or anthropogenic). The physico-chemical characteristics are very much important for any water body. In lentic water bodies these characteristics shows very much variation because in summer they have less and in rains large amount of water. These adverse constrain effectively influence the algal assemblage and can be a good indicator of overall health of the water body. In the study different Physico-chemical characteristics and algal diversity were monthly observed for one year duration (Jun. 2008 to May 2009). Some of 31 species of Cyanobacteria recorded from the study site viz. Microcystis aerughinosa, M. flos-aquae, M. robusta, Chroococcus minor, C.minutes, Gloeocapsa magma, Aphanocapsa littoralis, Aphanothece microscopis, Coelosphaerium kuetzingianum, Merismopedia glauca, M. tenuissima, Arthrospira spriulinoides, Spirulina gigantean, S. major, Oscillatoria formosa, O. subuliformis, O. princeps, Phormidium ambiguum, P. fragile, P. lucidum, Lyngbya contorta, O. epiphytica, O.majuscule, Cylindrospermum minutissimum, Nostoc commune, N. punctiforme, Anabaena oscillarioides, A. oryzae, Calothrix gloeocola, Rivularia aquatic and Gloeotrichia pisum.

In this paper, we established an ecological type three-dimensional nonlinear mathematical model to study the effect of aerosol particles in increasing rainfall in the regions of less intensity rain. The phenomenon of nonlinearity is based on the concepts of ecology related to growth rate, death rate and interaction process (Smith, 1974). It is assumed that clouds are formed in the atmosphere but are not able to develop uninterrupted rainfall. The rainfall can be enhanced by introducing aerosol particles conducive to raindrops formation from cloud droplets. It is shown that the intensity of rainfall increases as the concentration of externally introduced aerosols and the density of cloud droplets increases. The numerical simulation has also been performed tosupport analytical results.

El conocimiento del número y posición de los forámenes nutricios en los huesos largos es importante en los procedimientos ortopédicos, tales como la terapia de reemplazo de articulaciones, reparación de fracturas, injertos de hueso y micro-cirugía de hueso vascularizado. El presente estudio se llevó a cabo en el departamento de Anatomía, Colegio Médico Gubernamental de Amritsar. El estudio comprendió 100 tibias de humanos adultos obtenidas de 50 cadáveres masculinos y 50 femeninos. Todos los huesos del presente estudio presentaban el foramen nutricio situado en el tercio superior del eje y se dirigían hacia abajo. En la mayoría de los huesos, se encuentró lateral a la línea vertical en la superficie posterior de la diáfisis tibial. Las distancias medias de foramen nutricio de los extremos superior e inferior de la tibia eran mayores en los hombres en ambos lados. Además, estas mediciones mostraron valores más altos en los huesos de la mitad derecha. El conocimiento preciso de la ubicación de la forámenes nutricios en los huesos largos es útil en la prevención de las lesiones intra-operatorias en cirugía ortopédica, así como en cirugía plástica y reconstructiva y también es relevante en la práctica médico-legal. An understanding of the number and position of nutrient foramina in long bones is important in orthopedic procedures such as joint replacement therapy, fracture repair, bone grafts and vascularized bone microsurgery. The present study was conducted in the department of Anatomy, Govt. Medical College Amritsar. The study group comprised of 100 adult human tibiae obtained from 50 male and 50 female cadavers. All the bones of the present study depicted single nutrient foramen situated in the upper one third of the shaft and were directed downwards. In majority of the bones, it was located lateral to the vertical line on the posterior surface of tibial shaft. The mean distances of nutrient foramen from the upper and lower ends of tibia were found to be greater in males on both the sides. Also, these measurements showed higher values in the right sided bones.Precise knowledge of the location of the nutrient foramina in long bones is helpful in preventing intra-operative injuries in orthopedic as well as in plastic and reconstructive surgery and is also relevant in medicolegal practice.

Human paraoxonase 1 (h-PON1) is a serum enzyme that can hydrolyze a variety of substrates. The enzyme exhibits anti-inflammatory, anti-oxidative, anti-atherogenic, anti-diabetic, anti-microbial and organophosphate-hydrolyzing activities. Thus, h-PON1 is a strong candidate for the development of therapeutic intervention against a variety conditions in human. However, the crystal structure of h-PON1 is not solved and the molecular details of how the enzyme hydrolyzes different substrates are not clear yet. Understanding the catalytic mechanism(s) of h-PON1 is important in developing the enzyme for therapeutic use. Literature suggests that R/Q polymorphism at position 192 in h-PON1 dramatically modulates the substrate specificity of the enzyme. In order to understand the role of the amino acid residue at position 192 of h-PON1 in its various hydrolytic activities, site-specific mutagenesis at position 192 was done in this study. The mutant enzymes were produced using Escherichia coli expression system and their hydrolytic activities were compared against a panel of substrates. Molecular dynamics simulation studies were employed on selected recombinant h-PON1 (rh-PON1) mutants to understand the effect of amino acid substitutions at position 192 on the structural features of the active site of the enzyme. Our results suggest that, depending on the type of substrate, presence of a particular amino acid residue at position 192 differentially alters the micro-environment of the active site of the enzyme resulting in the engagement of different subsets of amino acid residues in the binding and the processing of substrates. The result advances our understanding of the catalytic mechanism of h-PON1.

A Block Matrix based Multiple Regularization (BMMR) technique is proposed for improving conductivity image quality in Electrical Impedance Tomography (EIT). The response matrix (JTJ) has been partitioned into several sub-block matrices and the largest element of each sub-block matrix has been chosen as regularization parameter for the nodes contained by that sub-block. Simulated boundary data are generated for circular domains with circular inhomogeneities of different geometry and the conductivity images are reconstructed in a Model Based Iterative Image Reconstruction (MoBIIR) algorithm. Conductivity images are reconstructed with BMMR technique and the results are compared with the Single-step Tikhonov Regularization (STR) and modified Levenberg-Marquardt Regularization (LMR) methods. Results show that the BMMR technique improves the impedance image and its spatial resolution for single and multiple inhomogeneity phantoms of different geometries. It is observed that the BMMR technique reduces the projection error as well as the solution error and improves the conductivity reconstruction in EIT. Results also show that the BMMR method improves the image contrast and inhomogeneity conductivity profile by reducing background noise for all the phantom configurations.

A Projection Error Propagation-based Regularization (PEPR) method is proposed and the reconstructed image quality is improved in Electrical Impedance Tomography (EIT). A projection error is produced due to the misfit of the calculated and measured data in the reconstruction process. The variation of the projection error is integrated with response matrix in each iteration and the reconstruction is carried out in EIDORS. The PEPR method is studied with the simulated boundary data for different inhomogeneity geometries. Simulated results demonstrate that the PEPR technique improves image reconstruction precision in EIDORS and hence it can be successfully implemented to increase the reconstruction accuracy in EIT.

Human PON1 (h-PON1) is a multifaceted enzyme and can hydrolyze (and inactivate) a wide range of substrates. The enzyme shows anti-inflammatory, antioxidative, antiatherogenic, ant-diabetic, antimicrobial, and organophosphate (OP)-detoxifying properties. However, there are certain limitations regarding large-scale production and use of h-PON1 as a therapeutic candidate. These include difficulties in producing recombinant h-PON1 (rh-PON1) using microbial expression system, low hydrolytic activity of wild-type h-PON1 towards certain substrates, and low storage stability of the purified enzyme. This review summarizes the work done in our laboratory to address these limitations. Our results show that (a) optimized polynucleotide sequence encoding rh-PON1 can express the protein in an active form in E. coli and can be used to generate variant of the enzyme having enhanced hydrolytic activity, (b) in vitro refolding of rh-PON1 enzyme can dramatically increase the yield of an active enzyme, (c) common excipients can be used to stabilize purified rh-PON1 enzyme when stored under different storage conditions, and (d) variants of rh-PON1 enzyme impart significant protection against OP-poisoning in human blood (ex vivo) and mouse (in vivo) model of OP-poisoning. The rh-PON1 variants and their process of production discussed here will help to develop h-PON1 as a therapeutic candidate.

UNLABELLED: Recombinant human erythropoietin (rHuEpo) increases haemoglobin mass (Hb(mass)) and maximal oxygen uptake (v O(2 max)). PURPOSE: This study defined the time course of changes in Hb(mass), v O(2 max) as well as running time trial performance following 4 weeks of rHuEpo administration to determine whether the laboratory observations would translate into actual improvements in running performance in the field. METHODS: 19 trained men received rHuEpo injections of 50 IU•kg(-1) body mass every two days for 4 weeks. Hb(mass) was determined weekly using the optimized carbon monoxide rebreathing method until 4 weeks after administration. v O(2 max) and 3,000 m time trial performance were measured pre, post administration and at the end of the study. RESULTS: Relative to baseline, running performance significantly improved by ∼6% after administration (10:30±1:07 min:sec vs. 11:08±1:15 min:sec, p

The use of lauha bhasma, a traditional Indian herbometallic preparation, is in vogue for centuries for the treatment of various ailments related to iron deficiency. The preparation of lauha bhasma requires strict adherence to time-consuming, well-practiced, multistage, and multistep procedures. One of the steps is the treatment of purified metallic ingredients with Triphala decoction (the aqueous extract of Indian gooseberry, Chebulic myrobalans, and Beleric myrobalans) in the presence of sunlight (Bhanupaka). The formation of metal complexes due to the reaction of the metallic ingredients with the constituents of Triphala decoction has been ascertained by FTIR spectroscopy and carbon, hydrogen, and nitrogen analyses. Our results demonstrate that Bhanupaka is an essential step in the preparation of lauha bhasma.

Elevated FGF-23 is a predictor of mortality and is associated with LVH in CKD. It may be a biomarker or a direct toxin. We assessed the relationship between FGF-23 and LVH in CKD using CMRI. In vitro we studied the effect of phosphate, FGF-23, and Klotho on E-selectin and VCAM production in HUVECs. FGF-23 concentration correlates negatively with eGFR and positively with LVMI. FGF-23 was an independent predictor of LVH in CKD. E-selectin and VCAM production was elevated in HUVECs cultured in high phosphate with FGF-23 or Klotho. This effect was attenuated in cells exposed to both FGF-23 and Klotho. FGF-23 is an independent predictor of LVH as measured by CMRI. We show preliminary data which supports that FGF-23 is toxic resulting in activation of the vascular endothelium. We do not prove causality with elevated FGF-23 and LVH. Further research should ascertain if lowering levels of FGF-23 translates to improved clinical outcomes.