Search

Computational fluid dynamics is a compelling apparatus for getting stream flow and anticipating how this flow will react to various limiting boundary conditions. With this learning, the focal point of this research is applying computational fluid elements such as CFD to issues dealing with stream flow measurement/estimation in closed conduits such as pipes utilizing differential stream meters like the Venturi meter. After thorough research from the existing literature, it was determined that the convergent angle (CA) of a standard Venturi meter has not been optimized yet. The range given for a standard ASME Venturi CA is 20–22°. More than 50 models were created and run in ANSYS FLUENT, which was used as a CFD tool. Three β-ratios are taken into consideration here, which are 0.4, 0.5 and 0.6. An optimum value of CA, corresponding to each β, is obtained by finding out the best coefficient of discharge (closest to 0.99) for each test value of CA. Another aspect explored in this research is the relationship between Reynolds number and coefficient of discharge. This is done with the integration of ANSYS FLUENT and laboratory results. The results of this study yield a definite value of CA for each β.

Kerala's Idukki district, which is situated on the Western Ghats of India, is susceptible to flooding and landslides. As a result of the 2018 Kerala floods, this disaster-prone region experienced drought conditions. In order to lessen the effects of future disasters, it is also necessary to identify and evaluate the district's groundwater potential (GWP). This work used three machine-learning (ML) algorithms – Random Forest (RF), Adaptive Boosting (AdaBoost), and Gradient Boosting (GB) – to model and produce GWP zonation maps for the Idukki district. Fourteen conditioning factors include elevation, slope, curvature, Topographic Roughness Index, lineament density, soil, geology, geomorphology, Topographic Wetness Index, Sediment Transport Index, drainage density, rainfall, land-use/land-cover (LULC), and Normalised Difference Vegetation Index that were adopted as input parameters in the modelling. All showed prominence when they were examined for feature importance using the recursive feature elimination (RFE) method. The RF model outperformed the other two ML models in terms of fit, with an area under curve (AUC) value of 0.92, while the GB and AdaBoost models displayed less fit, with AUC values of 0.90 and 0.88, respectively. GWP maps produced by each model were reclassified into five zones – very high to very low – it was discovered that the zones were evenly spread throughout the Idukki region.

Medicinal plants have been used with practical implementation of certain herbal great source of plant based flavonoids, antioxidants compounds. Medicinal plants were traditionally used for health care and serve as the bases for the emergence of modern medicine. They have possess the high quality of the extracts to evaluate their therapeutic efficacy for their pharmacological action. Large variety of medicinal plants have been used as aromatic purposes and hence valuate for aroma and pharmacological sectors. Medicinal plants snowed stronger binding to the proteins secreted by the parasitic worms thus inhibiting them to proliferate in the cellular tissues thus acting as main source of immunity booster to the living tissues against the dyspepsia, gastritis, hyperacidity, menorrhagia, diabetes. Saraca asoca also used as source of medicinal pant due to its to antibacterial activity because of its potential against the of multiple bacterial strains. Some of the medicinal plants acting as dual nature such as targeting the microbial proteins and peptides playing important role in the development of natural therapies. Nanoparticles based therapies can be utilized for treatment of infectious diseases.

Objective: To determine the frequency of dyslipidemia and its types in adult diabetics of Karachi. Study Design: Cross Sectional, Observational study. Setting: Diabetic Outpatient Clinic in JPMC, Karachi. Period: January 2019 to June 2019. Material & Methods: 248 adult diabetics presenting in diabetic outpatient clinic in JPMC, Karachi selected by non-purposive convenient sample technique. Diagnosed diabetics who were not on any lipid lowering therapy were included in the study. Non diabetics and those diabetics who are already on lipid lowering drugs were excluded. After relevant information is taken the lipid profile of the participants was done with a 12 hours fasting and the data was secured on a pre-designed performa. The results were analyzed on SPSS. Results: Among the 248 diabetics that presented 88(35.4%) were males and 160(64.5%) were females. The prevalence of dyslipidemia is 85.9% (213 diabetics had dyslipidemia). High triglycerides were present in 52.4% (130), high LDL in 28.2% (70) and low HDL in 175(70.6%). [P=0.000]. At least one dyslipidemic factor was deranged in 81(32.7%), two in 102(41.1%) and 3 in 30(12.1%) persons. In males, 53 out of 88(60.2%) were dyslipidemic, and in females all had dyslipidemia (100%). [P = 0.000]. Hypertriglyceridemia was present in 38(43.1%) males and 92(57.5%) females [P=.021], High LDL in 21(23.8%) males and 49(44%) females [P=.163], while low HDL was present in 16(22%) males and 159(99%) females [P=.000]. Conclusion: Dyslipidemia is highly prevalent in our population. Female diabetic patients had relatively higher triglycerides than men.

Objective: The main objective is to elaborate and discuss different techniques used in data mining, to analyze different strategies of data mining to make improvements, and to find more powerful mining techniques for the betterment of the business. Methods: Multiple techniques and strategies of data mining are used to improve the business. We employed the data warehouse methods for the improvements of the business using Business Intelligence (BI) and Business Analytics (BA) along with their types and instruments. We are also discussing some tools used for data mining or ordering organizational data. Findings: We employed Business Intelligence-(BI) and Business Analytics-(BA) techniques for the improvement of the business. Earlier, there were only four (Regression, Classification, Association, and Clustering) techniques that were used for business improvements. It is found that Crawler is the best tool for BI or BA data mining. Novelty : This study analyzed that, BI and BA are the best ways used for data mining, data ordering, or format of data in business. Earlier, these ways were not in use for data mining. Data mining may be the best approach to improve the business. Keywords: Business Intelligence (BI); Business Analytics Data Mining (BADM); Data Warehouse (DW); Knowledge Discovery (KDD) Customer Relationship Management (CRM); Enterprise Resource Planning (ERP)

Background: Polycystic ovary syndrome (PCOS) is the most frequent pathology among women of reproductive age characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries on ultrasound. Evidence suggests that high androgen levels are the fundamental factor in the pathogenesis of PCOS. The objectives of the present study was to determine serum free testosterone levels in polycystic ovarian syndrome patients, and observe its correlation with clinical hyperandrogenism. Patients and methods: This cross-sectional study was conducted at Jinnah Allama Iqbal Institute of Diabetes and Endocrinology Lahore, Pakistan from 15th May 2019 to 15th November 2019. The study included 140 patients of PCOS diagnosed as per Rotterdam criteria. Serum testosterone levels were determined in these patients by ELISA method. Ferriman-Gallwey (FG) score was used to assess severity of clinical hyperandrogenism in the form of hirsutism. Patients were categorized into three groups, mild (FG score 8-15), moderate (FG score 15-25) and severe (FG score >25). Correlation between clinical (hirsutism) and biochemical hyperandrogenism (serum free testosterone levels) was assessed using Fisher exact test. Data was analyzed using SPSS version 25. Results: Biochemical hyperandrogenism in the form of raised free testosterone levels was present in 46 (32.9%) PCOS patients. Out of 12 patients having Ferriman Gallwey score >25, 10 (83.3%) had biochemical hyperandrogenism. Out of 70 patients having Ferriman Gallwey score 15-25, 22 (31.4%) had biochemical hyperandrogenism whereas out of 58 patients having Ferriman Gallwey score 8-15, only 14 (24.1%) patients had biochemical hyperandrogenism. Conclusion: Prevalence of biochemical hyperandrogenism in PCOS patients in our studied population was significantly low when compared to the population studied worldwide making it less reliable as diagnostic tool in this part of the world. Also there was significant positive correlation between free testosterone levels and degree of hirsutism which means that diagnostic accuracy of free testosterone in PCOS patients is considerably high in those having clinical hyperandrogenism.

International audience; Experimental Self-Mixing (SM) or optical feedback interferometric signals are usually affected by additive white Gaussian noise (AWGN) and impulsive noise. Depending on SM sensing setup , these noises can significantly reduce the signal to noise ratio (SNR) of SM signals which in turn affects the measurement performance of signal processing algorithms employed for metric information retrieval. In this paper, adaptive line enhancement (ALE) technique is proposed to remove AWGN and impulsive noise from SM signals. Specifically, a recursive least squares (RLS) based ALE algorithm has been designed and the results have been compared with established methods such as high-order digital low-pass filtering and discrete wavelet transform. The comparison indicates better precision in case of use of RLS-ALE even when significant variations occur in the operating optical feedback regime and remote target velocity as well as in presence of speckle. The proposed algorithm can also estimate the SNR of SM signals belonging to weak-, moderate-, and strong-optical feedback regime with SNR ranging from 0 dB to 40 dB, with a mean absolute error of 1.35 dB and a 1.09 dB precision. Statistical analysis of noise recovered from different experimental SM signals attests the Gaussian-and impulsive-nature of noise. Thus, the proposed method also enables a simple and reliable quantitative analysis and comparison of different laser diode based SM laser sensors operating under variable optical conditions.

Patients with inflammatory bowel disease (IBD) have numerous risk factors for low bone mineral density (BMD). We aimed to study the prevalence of low BMD in IBD and the factors associated with it. BMD was measured by radial quantitative ultrasound, and clinical and biochemical characteristics were compared in prospectively enrolled patients and healthy age and gender-matched controls. Chi-square test, t test for independent samples, analysis of variance (ANOVA), Mann–Whitney U test and Kruskal–Wallis H tests were used as appropriate for univariate analysis to compare the characteristics between patients with and without abnormal BMD. Binary logistic regression analysis was done to determine the factors associated with low BMD in IBD patients. One hundred and six patients (Crohn’s disease [CD] = 35, ulcerative colitis [UC] = 71) and 55 controls were included. Low BMD was equally prevalent in CD, UC and controls (42.9%, 36.6%, 36.4% respectively, p = 0.791). Serum calcium and vitamin D were significantly lower in IBD patients compared to controls (p

Objectives: To determine the association of low serum vitamin D levels with poor glycemic control and obesity in type 2 diabetic patients. Study Design: Descriptive Cross Sectional study. Setting: Sakina Institute of Diabetes and Endocrine Research Centre (SIDER), Shalamar Hospital Lahore. Period: 1st June to 31th august 2017. Material & Methods: After applying strict exclusion criteria, about 450 patients with known type II diabetes were enrolled in the present study and their HBA1C and fasting vitamin D levels were measured. Patients were divided into two groups, group 1 with poor glycemic control (HBA1C>8%) and group 2 with good glycemic control (HBA1C 23 were having suboptimal Vitamin D levels (p value

Introduction: Coronavirus has spread rapidly in Pakistan. These patients were kept at quarantine facilities on suspicion, even before RT-PCR was done. We were able to collect clinical, laboratory, and management features from them. Objective: To assess the features of Corona confirmed and unconfirmed patients, and compare them. It could help in deciding if confirmed and unconfirmed patients were correctly identified and managed appropriately. Material and Methods: Retrospective, Descriptive, Crossectional study between 8th April to 30th April 2020. Patient data was collected from different sites retrospectively, on a Performa. Clinical, Laboratory, and Management data as collected. It was analyzed on SPSS 23. All patients in quarantines and ICU were included, irrespective of their corona PCR status, if the treating physicians had a strong suspicion. Home quarantine and less than 15-year old patients were excluded. Results: Clinical features showed more preponderance for males and smokers. Chronic disease patients were also significantly involved. Fatigue, nasal congestion, runny nose, sickness, and vomiting were more common in confirmed patients. CURB 65 scores 3 and 4 were more in unconfirmed patients. CT involvement was more common in unconfirmed patients as was high white cells and neutrophils. More patients had mechanical ventilation in the unconfirmed group, and they also had more secondary infections and shock. Antibiotic use was more common in the confirmed group. Conclusion: Corona was more common in males and smokers. Though fever and cough were common, the presence of fatigue, runny nose, nasal congestion sickness, and vomiting discriminated confirmed patients. Antibiotics should be used irrespective of RT-PCR results, especially if CT showed an abnormality.

Video quality assessment is a challenging problem having a critical significance in the context of medical imaging. For instance, in laparoscopic surgery, the acquired video data suffers from different kinds of distortion that not only hinder surgery performance but also affect the execution of subsequent tasks in surgical navigation and robotic surgeries. For this reason, we propose in this paper neural network-based approaches for distortion classification as well as quality prediction. More precisely, a Residual Network (ResNet) based approach is firstly developed for simultaneous ranking and classification task. Then, this architecture is extended to make it appropriate for the quality prediction task by using an additional Fully Connected Neural Network (FCNN). To train the overall architecture (ResNet and FCNN models), transfer learning and end-to-end learning approaches are investigated. Experimental results, carried out on a new laparoscopic video quality database, have shown the efficiency of the proposed methods compared to recent conventional and deep learning based approaches.

Cell communication via exosomes is capable of influencing cell fate in stress situations such as exposure to ionizing radiation. In vitro and in vivo studies have shown that exosomes might play a role in out-of-target radiation effects by carrying molecular signaling mediators of radiation damage, as well as opposite protective functions resulting in resistance to radiotherapy. However, a global understanding of exosomes and their radiation-induced regulation, especially within the context of an intact mammalian organism, has been lacking. In this in vivo study, we demonstrate that, compared to sham-irradiated (SI) mice, a distinct pattern of proteins and miRNAs is found packaged into circulating plasma exosomes after whole-body and partial-body irradiation (WBI and PBI) with 2 Gy X-rays. A high number of deregulated proteins (59% of WBI and 67% of PBI) was found in the exosomes of irradiated mice. In total, 57 and 13 miRNAs were deregulated in WBI and PBI groups, respectively, suggesting that the miRNA cargo is influenced by the tissue volume exposed to radiation. In addition, five miRNAs (miR-99b-3p, miR-200a-3p, miR-200a, miR-182-5p, miR-182) were commonly overexpressed in the exosomes from the WBI and PBI groups. In this study, particular emphasis was also given to the determination of the in vivo effect of exosome transfer by intracranial injection in the highly radiosensitive neonatal cerebellum at postnatal day 3. In accordance with a major overall anti-apoptotic function of the commonly deregulated miRNAs, here, we report that exosomes from the plasma of irradiated mice, especially in the case of WBI, prevent radiation-induced apoptosis, thus holding promise for exosome-based future therapeutic applications against radiation injury.

Fluoride (F) is a potent anti-cariogenic element, but only an appropriate dose is effective to have therapeutic action, else systemic toxicity may be observed. Additionally, two factors, amount of F and time of exposure, drive its action. Surprisingly, the susceptibility to toxic effects of F is genetically determined. The present study identified the effects of F on the liver proteome of mice susceptible (A/J) or resistant (129P3/J) to the effects of F. Weanling male A/J (n=6) and 129P3/J mice (n=6) were housed in pairs and assigned to three groups given low-F diet and drinking water containing 0, 15 or 50 ppm F for 7 weeks. Liver proteome profiles were examined using nano-LC-ESI-MS/MS. Protein function was classified by GO biological process (Cluego v2.0.7 + Clupedia v1.0.8). Difference in expression among the groups was determined using the PLGS software. In the control group (0 ppm F), most proteins with fold change were increased in A/J mice. Precisely the proteins related to energy flux and oxidative stress were quite significant in this context, suggesting the high susceptibility of these mice to the effects of F, since the exposure also induces oxidative stress. Treatment with the lower F concentration provoked more pronounced alterations in fold change in liver proteins in comparison to the treatment with the higher F concentration. Strikingly, most of the proteins with fold change upon following 15 ppm F treatment, were increased in the A/J mice compared with their 129P3/J counterparts, thus suggesting attempt of the former to fight against the toxic effects of F. With respect to 50 ppm F, most proteins with fold change were decreased in the A/J mice compared with their 129P3/J counterparts, especially proteins related to oxidative stress and protein folding, which might be related to the higher susceptibility of the A/J animals to the deleterious effects of F. Our findings can provide new insights into the molecular mechanisms underlying genetic susceptibility to fluorosis by indicating key protein players which need to be better addressed in future experimental studies. O Fluoreto (F) é um potente elemento anti-cariogênico, mas é somente efetivo terapeuticamente em uma dose apropriada. Por outro lado, doses acima das recomendadas levam a toxicidade sistêmica. Em adição, dois fatores decidem sua efetividade de ação: quantidade de F e tempo de exposição. A suscetibilidade aos efeitos tóxicos do F é determinada geneticamente. O presente estudo avaliou os efeitos do F no proteoma do fígado de camundongos suscetíveis (A/J) ou resistentes (129P3/J) aos efeitos do F. Camundongos machos desmamados A/J (n=6) e 129P3/J (n=6) foram alojados em pares e divididos em três grupos tratados com ração com baixo teor de F e água contendo 0, 15, ou 50 ppm de F por 7 semanas. Perfis proteômicos do fígado foram examinados usando nano-LC-ESI-MS/MS. A função de proteínas foi classificada pelo processamento biológico GO (Cluego v2.0.7 + Clupedia v1.0.8). A diferença de expressão entre os grupos foi determinada usando o software PLGS. No grupo controle (0 ppm F), a expressão da maioria das proteínas foi aumentada nos camundongos A/J e precisamente as proteínas relacionadas ao fluxo de energia e estresse oxidativo foram significativas neste contexto, sugerindo portanto, a alta sucetibilidade destes camundongos aos efeitos do F, já que a exposição também induz o estresse oxidativo. O tratamento com baixa concentração de F provocou alterações mais pronunciadas em proteínas do fígado comparado ao tratamento com alta concentração de F. Notadamente, a maioria das proteínas encontradas no fígado dos animais tratados com 15 ppm de F foi aumentada em camundongos A/J comparados aos camundongos 129P3/J, demonstrando portanto, uma tentativa dos A/J de neutralizar os efeitos tóxicos do F. Já nos animais tratados com 50 ppm de F, a maioria das proteínas foi diminuída nos camundongos comparados aos seus pares 129P3/J, especialmente proteínas relacionadas ao estresse oxidativo e enovelamento de proteínas, o que pode estar relacionado à alta suscetibilidade dos animais A/J aos efeitos deletérios do F. Nossos achados podem fornecer novos insights que podem contribuir para a interpretação os mecanismos moleculares relacionados à suscetibilidade genética à fluorose, indicando proteínas chaves que precisam ser melhor estudadas em estudos futuros.

Background The standard treatment of displaced femoral neck fracture is arthroplasty. THA is reportedly superior to BHA in terms of hip pain, function and reoperation rate. On the other hand THA has a higher rate of dislocation. Total hip replacement with dual mobility cup increases the range of motion and reduces the chances of dislocation. The aim of this study is to compare the functional outcome, rate of dislocation, complications and mortality between BHA and THA with dual mobility cuff for the treatment of displaced neck of femur fracture. Patients and method This is a non-commercialized retrospective cohort study conducted at our tertiary care level 1 trauma centre. Patients of age group 60 years and above who underwent hip arthroplasty (BHA or THA with dual mobility implant) between 2015 and 2017 for displaced neck of femur fracture with a complete follow up for one year were included. Both groups were assessed for postoperative surgical complications including dislocation, fracture, surgical site infection, and medical complications, one-year mortality and functional outcome were analysed via Harris Hip Score (HHS) at the latest follow up. Results Overall 104 patients were included in the study out of which 77 patients underwent BHA while 27 underwent THA with dual mobility cup. Baseline characteristics were found to be similar in both groups. Mean pre-op HHS for bipolar group was found to be 71.01 while for THA with dual mobility cup group it was 73.52 with the difference being statistically insignificant (P = 0.12). Mean post-op HHS for bipolar group was noted to be 68.82 whereas for THA with dual mobility cup group it was 76.81. The difference was found to be statistically significant with a P-value of, Highlights • The standard treatment of displaced femoral neck fracture is arthroplasty. • Total Hip Arthroplasty is reportedly superior to Bipolar Hemiarthroplasty in terms of hip pain, function and reoperation rate. • Total Hip Arthroplasty has a higher rate of dislocation rate than Bipolar Hemiarthroplasty. • Total Hip Arthroplasty with Dual mobility cup increases the functional outcome and reduces the chances of dislocation.

Background Hip fractures usually occur in old aged patients with osteoporotic bone. Management of hip fractures in old aged patient is aimed to ambulate patient immediately and to restore the pre-operative ambulation. Proximal femur replacement is an effective treatment option in elderly patient with osteoporotic bones. It allow immediate weight bearing and early return to preoperative ambulatory status and minimizes the chances of systemic complication associated with prolong bed rest associated with internal fixation. This study is aimed to review the outcome of the patients whom underwent proximal femur replacement as primary treatment for the patient with comminuted intertrochanteric and sub trochanteric fracture. Patients and method This is a study conducted in our university hospital which is a tertiary-care level-1 trauma center. A retrospective analysis of 21 patients who underwent proximal femur replacement for comminuted intertrochanteric and sub trochanteric fracture, age more than 60 years during the period from April 2011 to March 2018 was conducted. Data collected included: age, gender, comorbidities, mechanism of injury, type of fracture, functional outcome (calculated via Harris Hip Score) and one year mortality. Results The mean age of the patients was 74.05(range 64–91) years, out of which 13 (61.8%) were female and 8 (38.0%) were male. The mean follow up was 32.6(8–91 months).Immediate post-operative ambulation status was full weight bearing (FWB) in 17 patients (80.9%) of the patients while three patients (19.0%) had non-weight bearing (NWB) due to associated co-morbidities. The mean preoperative Harris Hip score was 68.0, while the mean postoperative Harris Hip score was 66.5 at last follow up. Post operatively one patient (4.7%) developed pulmonary embolism, one patient developed dislocation. One patent (4.7%) died of sepsis from implant infection at 8 months after surgery Conclusion Primary Proximal femoral replacement in a viable option in old aged patients with poor bone quality who developed intertrochanteric and subtrochanteric fracture. According to our study, with mortality rate comparable to that of primary fixation, yet with the added advantage of immediate post op ambulation and reduced incidences of decubitus ulcers, atelectasis and DVT., Highlights • Management of hip fractures in old aged patient is aimed to ambulate patient immediately. • Proximal femur replacement is an effective treatment option in elderly patient with osteoporotic bones. • Proximal femur replacement allows immediate weight bearing and early return to preoperative ambulatory status.

Image processing of 3D tomographic images to extract structural information of porous materials has become extremely important in porous media research with the commoditization of x-ray tomography equipment to the lab scale. Extracted pore networks from images using image analysis techniques enable transport properties calculation for bigger domains at a low computational cost, allowing pore-scale investigation of porous media over meaningful macroscopic length scales. The present study reports a pore network extraction algorithm to simultaneously extract void and solid networks from tomographic images of porous materials using simple image analysis techniques. Crucially, it includes connectivity and geometrical information of both void and solid phases as well as the interlinking of these phases with each other. Validation was obtained on networks extracted from simple cubic and random sphere packings over a range of porosities. The effective diffusivity in the void phase and thermal conductivity in the solid phase was then calculated and found to agree well with direct numerical simulation results on the images, as well as a range of experimental data. One important outcome of this work was a novel and accurate means of calculating interfacial areas between grains and voids directly from digital images, which is critical to many phenomena where phase interactions occur. The efficient ‘dual network’ algorithm is written in PYTHON using open source tools and provides a new way to study critical processes that depend on transport in both void and solid phase such as catalytic reactors and electrochemical systems.

Colorectal cancer (CRC) is the third most common type of cancer with the liver being the most common site for cancer spread. A precise understanding of patient liver anatomy and pathology, as well as surgical planning based on that, plays a critical role in the treatment process. In some cases, surgeons request a 3D reconstruction, which requires a thorough analysis of the available images to be converted into 3D models of relevant objects through a segmentation process. Liver vessel segmentation is challenging due to the large variations in size and directions of the vessel structures as well as difficult contrasting conditions. In recent years, deep learning-based methods had been outperforming the conventional image analysis methods in the field of medical imaging. Though Convolutional Neural Networks (CNN) have been proved to be efficient for the task of medical image segmentation, the way of handling the image data and the preprocessing techniques play an important role in segmentation. Our work focuses on the combination of different vesselness enhancement filters and preprocessing methods to enhance the hepatic vessels prior to segmentation. In the first experiment, the effect of enhancement using individual vesselness filters was studied. In the second experiment, the effect of gamma correction on vesselness filters was studied. Lastly, the effect of fused vesselness filters over individual filters was studied. The methods were evaluated on clinical CT data. The quantitative analysis of the results in terms of different evaluation metrics from experiments can be summed up as (i) each of the filtered methods shows an improvement as compared to unenhanced with the best mean DICE score of 0.800 in comparison to 0.740 for unenhanced, (ii) applied gamma correction provides a statistically significant improvement in the performance of each filter with improvement in mean DICE of around 2%, (iii) both the fused filtered images and fused segmentation give the best results (mean DICE score of 0.818 and 0.830, respectively) with the statistically significant improvement compared to the individual filters with and without Gamma correction. The results have further been verified by qualitative analysis and hence show the importance of our proposed fused filter and segmentation approaches.

Background The first case of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, China, in 2019. By the first half of 2020, coronavirus disease 2019 (COVID-19) turned into a global pandemic. Objectives The aim of this study is to describe the clinical and demographic characteristics including comorbidities and their outcomes among patients hospitalized with COVID-19 in four tertiary care hospitals across Lahore. This retrospective study was conducted at Fatima Memorial Hospital, Sir Ganga Ram Hospital, Lahore General Hospital, and Jinnah Hospital, all in Lahore, Pakistan, from May 1, 2020, to June 30, 2020. The sample size was 445, which was derived using the convenient sampling method. Clinical outcomes during hospitalization included the requirement of invasive positive pressure ventilation, need for renal replacement therapy (RRT), and death. Data regarding demographics, baseline comorbidities, important vital signs on reporting, and initial workup with results were also collected. Results A total of 445 patients' data were studied, of whom 291 (65.4%) were male patients and 154 (34.6%) female patients. The median age was 54 years (interquartile range [IQR]: 24). The most common comorbidities were hypertension (HTN) (195; 43.8%) followed by diabetes mellitus (DM) (168; 37.8%) and cardiovascular disease (CVD) (61; 13.7%). The median length of hospital stay was eight days (IQR: 3). Of the total patients, 137 (30.7%) were treated in intensive care unit settings, 40 (9%) received invasive mechanical ventilation, 40 (9%) patients had acute kidney injury, 38 (8.5%) received RRT, and 37 (8.3%) died. It was seen that more patients who were either diabetic or hypertensive received invasive mechanical ventilation as compared to those who did not have these comorbidities. The most common radiological finding on chest X-ray was the classical ground-glass appearance of COVID-19, which was found in 318 (71.4%) patients. Conclusions Patients with one or more underlying comorbidities had poor clinical outcomes compared to those with no comorbidities, with the most vulnerable group being patients with chronic kidney disease, DM, HTN, and CVD in descending order.

In our daily life, tools of fire and gas are compulsory parts of our lives, thus prevention against fire and gas leakage hazards is one of the essential requirements of every individual. For this purpose, there are many smoke and gas detectors being developed and under use. But normally they detect only smoke and gas leakage and turn on the alert systems. But for complete safety, in addition to this, there is higher demand of advanced tools and gadgets which should take automatic preventive steps too, to curtail destructions and hazards scale.Now the proposed system consists of an efficient smoke and gas detector, which beside detection of smoke and gas leakage, also takes automatically preventive measures to cope up the blowing fire and leaked gas hazards.Mechanism we used for this constitutes of sending information to the control room wirelessly in order to take some precautionary measures. In addition to this, cutting off the main power and gas supply at the time of detection of any danger is also done in this proposed mechanism

Tumor segmentation in Computed Tomography (CT) images is a crucial step in image-guided surgery. However, low-contrast CT images impede the performance of subsequent segmentation tasks. Contrast enhancement is then used as a preprocessing step to highlight the relevant structures, thus facilitating not only medical diagnosis but also image segmentation with higher accuracy. In this paper, we propose a goal-oriented contrast enhancement method to improve tumor segmentation performance. The proposed method is based on two concepts, namely guided image enhancement and image quality control through an optimization scheme. The proposed OPTimized Guided Contrast Enhancement (OPTGCE) scheme exploits both contextual information from the guidance image and structural information from the input image in a two-step process. The first step consists of applying a two-dimensional histogram specification exploiting contextual information in the corresponding guidance image, i.e. Magnetic Resonance Image (MRI). In the second step, an optimization scheme using a structural similarity measure to preserve the structural information of the original image is performed. To the best of our knowledge, this kind of contrast enhancement optimization scheme using cross-modal guidance is proposed for the first time in the medical imaging context. The experimental results obtained on real data demonstrate the effectiveness of the method in terms of enhancement and segmentation quality in comparison to some state-of-the-art methods based on the histogram.

Made available in DSpace on 2022-04-29T08:39:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Qualea grandiflora (QG) (Vochysiaceae), also known as “pau-ferro”, “pau-terra” or “pau-de-tucano”, is a very common deciduous tree in the Brazilian Cerrado used in traditional medicine to treat inflammations, ulcers, diarrhea, and infections. There are reports in the scientific literature that demonstrate the medicinal effects of the bark and leaf of the QG. However, studies involving this plant are rather imited. Aim of the study: To perform the phytochemical analysis of the QG hydroalcoholic extract (HAE) of leaves, and to investigate it effects on fibroblast and preosteoblasts. Methods: Phytochemical analysis was done by HPLC-DAD. Murine NIH/3T3 fibroblasts and MC3T3-E1 preosteoblasts cell lines (ATCC) were used for the experiments. Cell viability was assessed by the MTT colorimetric assay and the expression of MMP-14 and HIF-1a by immunofluorescence. Results and conclusion: The following compounds were identified by HPLC-DAD, such as quinic acid, ethyl galate, ellagic acid derivatives as O-methylellagic acid O-galloyl, O-methylellagic acid O-deoxyhexoside, galloyl derivatives, flavonol glycoside as kaempferol-O-deoxyhexoside, quercetin-O-deoxyhexoside, myricetin-O-deoxyhexoside and the pentacyclic triterpene arjunglucoside. Cell viability results demonstrated no cytotoxic effects in the studied concentrations. We found in QG HAE some compounds with therapeutic properties that can increase the expression of MMP-14 and HIF-1α, in fibroblasts and preosteoblasts. These data suggest that QG HAE has an action on these two molecules widely involved in physiological conditions, such as collagen remodeling, bone development and growth and pathological processes as HIF signaling in cancer metastasis. University of São Paulo Bauru School of Dentistry Department of Biological Sciences São Paulo State University Faculty of Sciences Department of Biological Sciences. c[Bauru São Paulo State University Faculty of Sciences Department of Biological Sciences. c[Bauru

Wastewater-based epidemiology (WBE) is a tool now increasingly proposed to monitor the SARS-CoV-2 burden in populations without the need for individual mass testing. It is especially interesting in metropolitan areas where spread can be very fast, and proper sewage systems are available for sampling with short flow times and thus little decay of the virus. We started in March 2020 to set up a once-a-week qualified spot sampling protocol in six different locations in Munich carefully chosen to contain primarily wastewater of permanent residential areas, rather than industry or hospitals. We used RT-PCR and sequencing to track the spread of SARS-CoV-2 in the Munich population with temporo-spatial resolution. The study became fully operational in mid-April 2020 and has been tracking SARS-CoV-2 RNA load weekly for one year. Sequencing of the isolated viral RNA was performed to obtain information about the presence and abundance of variants of concern in the Munich area over time. We demonstrate that the evolution of SARS-CoV-2 RNA loads (between, Graphical abstract Unlabelled Image

The authors present the parallel-hybrid recursive least square (PH-RLS) algorithm for an accurate self-mixing interferometric laser vibration sensor coupled with an accelerometer under industrial conditions. Previously, this was achieved by using a conventional RLS algorithm to cancel the parasitic vibrations where the sensor itself is not in the stationary environment. This algorithm operates in sequential mode and due to its compute and data-intensive nature, the algorithm does not work for real-time applications, hence requires parallel computing. Therefore, the existing conventional RLS C program is parallelized by using hybrid OpenACe C/MPI (Open Accelerators/Message Passing Interface) parallel programming models and tested on Barcelona Supercomputing Center CTE-Power9 Supercomputer. The computational performance of the proposed PH-RLS algorithm is compared with the existing conventional RLS code by executing on multi distributed processors and uni-core processor architecture, respectively. While comparing the performance of conventional RLS with a PH-RLS algorithm on eight nodes of CTE-Power9 supercomputer, the results show that the PH-RLS algorithm gets 5857 times of performance improvement as compared to the conventional RLS implementation on a single node system. The results show that the proposed PH-RLS also gives a scalable performance for a different range of vibration signals, making it a suitable choice for real-time self-mixing interferometer sensing systems working under industrial conditions.

Laparoscopic images and videos are often affected by different types of distortion like noise, smoke, blur and nonuniform illumination. Automatic detection of these distortions, followed generally by application of appropriate image quality enhancement methods, is critical to avoid errors during surgery. In this context, a crucial step involves an objective assessment of the image quality, which is a two-fold problem requiring both the classification of the distortion type affecting the image and the estimation of the severity level of that distortion. Unlike existing image quality measures which focus mainly on estimating a quality score, we propose in this paper to formulate the image quality assessment task as a multi-label classification problem taking into account both the type as well as the severity level (or rank) of distortions. Here, this problem is then solved by resorting to a deep neural networks based approach. The obtained results on a laparoscopic image dataset show the efficiency of the proposed approach., Comment: 5 Pages, ICIP 2020

Laparoscopic videos can be affected by different distortions which may impact the performance of surgery and introduce surgical errors. In this work, we propose a framework for automatically detecting and identifying such distortions and their severity using video quality assessment. There are three major contributions presented in this work (i) a proposal for a novel video enhancement framework for laparoscopic surgery; (ii) a publicly available database for quality assessment of laparoscopic videos evaluated by expert as well as non-expert observers and (iii) objective video quality assessment of laparoscopic videos including their correlations with expert and non-expert scores., SPIE Medical Imaging 2020 (Draft version)

Objective: To determine frequency of peripheral arterial disease (PAD) using ankle brachial index and its various risk factors in Pakistani patients. Study Design: Cross-sectional study. Place and Duration of Study: Allama Iqbal Medical College, Jinnah Hospital, Lahore, from Jan 2017 to Apr 2017. Material and Methods: High risk type 2 diabetic patients were recruited for the study. After detailed history and clinical examination, fasting and 2-hours postprandial sugar levels and blood pressure were measured. Ankle brachial index (ABI) was used to measure PAD using portable smart dop instrument. Patients with ABI

To study the clinical and biochemical profiles across the different ranges of impaired fasting glucose (IFG) based on American Diabetes Association (ADA) and World Health Organization (WHO) criteria. A cross-sectional study was conducted on 149 subjects, of which 63 belonged to group 1 (IFG = 100–110 mg/dl) and 86 to group 2 (IFG = 111–125 mg/dl). Basic anthropometric and clinical examinations were done for all subjects. Data was collected from patient by a questionnaire, which included the history of hypertension and diabetes and other comorbidities and complications. Biochemical profiles including Fasting Plasma Glucose (FPG), Oral Glucose Tolerance Test (OGTT), HbA1c, Fasting insulin levels and Fasting Lipid Profile were measured. Assessment of insulin resistance and beta cell function was done by Homeostasis Model Assessment (HOMA). Data were analysed using SPSS software version 15 and p

Appropriate doses of fluoride (F) have therapeutic action against dental caries, but higher levels can cause disturbances in soft and mineralized tissues. Interestingly, the susceptibility to the toxic effects of F is genetically determined. This study evaluated the effects of F on the liver proteome of mice susceptible (A/J) or resistant (129P3/J) to the effects of F. Weanling male A/J (n = 12) and 129P3/J (n = 12) mice were housed in pairs and assigned to two groups given low-F food and drinking water containing 15 or 50 ppm F for 6 weeks. Liver proteome profiles were examined using nano-LC-ESI-MS/MS. Difference in expression among the groups was determined using the PLGS software. Treatment with the lower F concentration provoked more pronounced alterations in fold change in liver proteins in comparison to the treatment with the higher F concentration. Interestingly, most of the proteins with fold change upon treatment with 15 ppm F were increased in the A/J mice compared with their 129P3/J counterparts, suggesting an attempt of the former to fight the deleterious effects of F. However, upon treatment with 50 ppm F, most proteins with fold change were decreased in the A/J mice compared with their 129P3/J counterparts, especially proteins related to oxidative stress and protein folding, which might be related to the higher susceptibility of the A/J animals to the deleterious effects of F. Our findings add light into the mechanisms underlying genetic susceptibility to fluorosis.

Fluoride exposure is widespread, with drinking water commonly containing natural and artificially added sources of the ion. Ingested fluoride undergoes absorption across the gastric and intestinal epithelia. Previous studies have reported adverse gastrointestinal effects with high levels of fluoride exposure. Here, we examined the effects of fluoride on the transepithelial ion transport and resistance of three intestinal epithelia. We used the Caco-2 cell line as a model of human intestinal epithelium, and rat and mouse colonic epithelia for purposes of comparison. Fluoride caused a concentration-dependent decline in forskolin-induced Cl- secretion and transepithelial resistance of Caco-2 cell monolayers, with an IC50 for fluoride of about 3 mM for both parameters. In the presence of 5 mM fluoride, transepithelial resistance fell exponentially with time, with a t1/2 of about 7 hours. Subsequent imaging by immunofluorescence and scanning electron microscopy showed structural abnormalities in Caco-2 cell monolayers exposed to fluoride. The Young's modulus of the epithelium was not affected by fluoride, although proteomic analysis revealed changes in expression of a number of proteins, particularly those involved in cell-cell adhesion. In line with its effects on Caco-2 cell monolayers, fluoride, at 5 mM, also had profound effects on Cl- secretion and transepithelial resistance of both rat and mouse colonic epithelia. Our results show that treatment with fluoride has major effects on the structure, function, and proteome of intestinal epithelia, but only at concentrations considerably higher than those likely to be encountered in vivo, when much lower fluoride doses are normally ingested on a chronic basis.

Introduction Hypogonadism is characterized by clinical and biochemical evidence of testosterone deficiency. Low testosterone levels have been reported in patients with type 2 diabetes mellitus (T2DM), which can predispose to coronary artery disease (CAD). It has been proposed that diabetic men with proven CAD have lower androgen levels than patients with normal coronary arteriograms. We conducted this study with the objective to determine the frequency of hypogonadism in patients with diabetes mellitus and its relationship with CAD. Materials and Methods It was a comparative cross-sectional study conducted at a tertiary care hospital. We recruited a total of 108 patients, divided into two groups, 54 patients in each arm of the study. Group A comprised patients with CAD, whereas group B consisted of diabetic patients without CAD. Hypogonadism was defined on the basis of erectile dysfunction clinically and total testosterone levels biochemically. CAD was diagnosed on the basis of findings of coronary angiography. Fasting blood samples were drawn and evaluated for fasting plasma glucose, HbA1c, fasting lipid profile, thyroid-stimulating hormone (TSH), serum prolactin, blood urea, serum creatinine, liver function tests (LFT), total testosterone, luteinizing hormone (LH), and follicle‑stimulating hormone (FSH) levels. Hypogonadism among two study groups was compared using chi-square and serum testosterone level was compared using independent t-test with p < 0.05 considered as statistically significant. Results There were 108 subjects in the study with the mean age of 54.4 ± 4.29 (range: 22 to 68) years. The mean duration of T2DM was 12.6 ± 8.2 years. The mean BMI of patients with and without CAD was 25.7 ± 2.37 and 26.9 ± 4.21 kg/m2, respectively. There was no significant difference in waist circumference and obesity between both the groups (p-value > 0.05). Fasting plasma glucose and HbA1c in both groups were not significantly different. Testosterone levels and erectile dysfunction score were found lower in T2DM with CAD compared to T2DM patients without CAD, although this difference was not statistically significant (p-value: 0.051). The majority of the subjects with hypogonadism in both groups had a hypogonadotrophic hypogonadism (39/42, 92.9% versus 16/20, 80.0%). No statistically significant difference was seen in serum levels of LH and FSH between the study groups. The frequency of hypogonadism was found higher in the group with CAD (72.2%, 39/54) as compared with T2DM patients without CAD (37.03%, 20/54; p-value = 0.000). Conclusion Testosterone deficiency is a significant problem of males with T2DM. Patients with CAD have markedly low levels of testosterone as compared with patients without any CAD.

The performance of Lithium-Ion batteries (LIB’s) strongly depends on 3D microstructure and continued research is needed for the development and optimization of electrode designs to further reduce cost and improve performance and durability. In this work, a pore network modelling approach is presented to understand the structure-performance relationship of porous cathodes of LIB’s. It was demonstrated that pore network models can efficiently predict the rate-dependent capacity of an electrode using only a 3-phase tomogram as input. The developed modelling framework was used to perform structural analysis on two Li(Ni0.5Mn0.3Co0.2)O2 (NMC532) cathodes of different thickness and calendaring pressure and revealed important insights of microstructural heterogeneities inside porous structures, including spatial distribution of concentration, potential and state of lithiation in electrolyte, active material and carbon binder domain. The computational performance of the pore network model was analyzed, and excellent performance was demonstrated, taking hours instead of weeks for a similar direct numerical simulation. The novel modelling framework reported in this study will enable the study of local heterogeneities in other types of cathode material to help screen next-generation electrode designs, augmenting and informing time-consuming cell fabrication and laboratory testing.

The brain undergoes ionizing radiation exposure in many clinical situations, particularly during radiotherapy for brain tumors. The critical role of the hippocampus in the pathogenesis of radiation-induced neurocognitive dysfunction is well recognized. The goal of this study is to test the potential contribution of non-targeted effects in the detrimental response of the hippocampus to irradiation and to elucidate the mechanisms involved. C57Bl/6 mice were whole body (WBI) or partial body (PBI) irradiated with 0.1 or 2.0 Gy of X-rays or sham irradiated. PBI consisted of the exposure of the lower third of the mouse body, whilst the upper two thirds were shielded. Hippocampi were collected 15 days or 6 months post-irradiation and a multi-omics approach was adopted to assess the molecular changes in non-coding RNAs, proteins and metabolic levels, as well as histological changes in the rate of hippocampal neurogenesis. Notably, at 2.0 Gy the pattern of early molecular and histopathological changes induced in the hippocampus at 15 days following PBI were similar in quality and quantity to the effects induced by WBI, thus providing a proof of principle of the existence of out-of-target radiation response in the hippocampus of conventional mice. We detected major alterations in DAG/IP3 and TGF-β signaling pathways as well as in the expression of proteins involved in the regulation of long-term neuronal synaptic plasticity and synapse organization, coupled with defects in neural stem cells self-renewal in the hippocampal dentate gyrus. However, compared to the persistence of the WBI effects, most of the PBI effects were only transient and tended to decrease at 6 months post-irradiation, indicating important mechanistic difference. On the contrary, at low dose we identified a progressive accumulation of molecular defects that tended to manifest at later post-irradiation times. These data, indicating that both targeted and non-targeted radiation effects might contribute to the pathogenesis of hippocampal radiation-damage, have general implications for human health.

Background: Diabetes Mellitus (DM) is a serious worldwide health concern. Pakistan is among the top 10 countries with the highest prevalence of diabetes in the world with estimates reaching as high as 21.6% in adults aged 30–79 years. HbA1C is the most useful diagnostic tool to assess the control and progression of disease and related complications. However, the predictors of good and bad control are not well established in our population. Objective: 1). To assess the level of A1C control among type 2 diabetic patients. 2). To find out factors which can predict uncontrolled A1C. Study Design: Retrospective observational study. Setting: Among type 2 diabetes mellitus patients attending the outpatient of Diabetes Endocrine and Metabolic Centre (DEMC) of Lahore General Hospital, Lahore. Period: June 2012 to Feb 2014. Material and methods: Total of 809 patients were randomly selected to assess A1C in this population. At the same time, we assessed other factors associated with uncontrolled A1C. Chart review of the included patients was done using a data collection sheet, structured for this purpose. Patient demographic data was gathered. Specific information including complications and laboratory results (HbA1C, Triglycerides (TG), Dyslipidemias) was collected. Diabetes complication data was obtained clinically and through laboratory workup. The outcome was calculated. Patients with A1C of

Background: Stroke is a leading cause of disability and the second principal cause of death in the world. The aim of this study was to analyze different characteristics in stroke patients in Medical Unit 1 of Lahore General Hospital, which is biggest referral hospital for Neurology patients in Punjab, to identify the risk factors and help in targeting prevention in our patients. Study Design: Descriptive study. Setting: Lahore General Hospital, Lahore. Period: January 2016, including data from January to November 2015. Methods: The demographic data, clinical manifestations, risk factors, side of weakness, cranial nerves involved, neurological weakness and Glasgow Coma Scale, duration of stay in hospital and outcome were included in the data. For the comparison between categorical variables Chi-square test was used. For other variables, t-test was used. Results: A total of 235 patients with stroke, age 20 to 105 (mean ±SD= 58±14.6) were included. 127 (54%) had Ischemic stroke (IS) and 100 (42.6%) had hemorrhagic stroke (HS). 127 (54%) were men and 108 (46%) were women. 17.9% of the patients with IS and 21.7% of the patients with HS died (OR 0.65 95% CI 0.48-0.89). Hypertension, diabetes and dyslipidemia were the most common risk factors. Conclusion: Burden of stroke is high in Pakistan. Mean age of patients with stroke is less. Hypertension, diabetes, dyslipidemia and smoking are highly prevalent and hypertension is the most common. Ischemic strokes are more common, mortality of intra-cerebral hemorrhage is higher.

Image processing of 3D tomographic images to extract structural information of porous materials has become extremely important in porous media research with the commoditization of x-ray tomography equipment to the lab scale. Extracted pore networks from image analysis techniques enable transport properties calculation for bigger domains at a very low computational cost, allowing substantial investigation of porous media. Consequently, they are being increasingly used to model Multiphysics transport processes in various energy storage devices like fuel cells and batteries, where the geometrical structure plays a vital role in electrochemical performance, but true pore-scale modeling is computationally infeasible. Traditionally, pore network modelling has been used to find electrochemical performance of Li Ion batteries by investigating pore phase interconnectivity in carbon electrodes. The actual lithium ion electrode, however, consists of active material, carbon binder and electrolyte filled pore phase. The interconnectivity of these phases influences the effective transport properties and hence electrochemical performance of cathode material. The presence of carbon binder phase not only reduces the SEI layer between active material and electrolyte phase but also influences tortuosity and effective electronic conductivity in the pore and solid phase respectively. The present work uses a pore network modelling frame work to investigate the effect of carbon binder phase on Lithium Ion battery cathode. We used actual three phase, X-ray tomography image of NMC-811 cathode material and studied its electrochemical performance with and without binder phase. Unlike previous models which compensate the importance of carbon binder as electrical conductor by assuming high electronic conductivity of active material, this study considers actual values of conductivities in all phases. Moreover, the impact of nanoporosity in the carbon binder phase was also explored and found to enhance the reaction rate compared to solid binder. The reduction in computational time achieved using the pore-network approach was so significant that adding additional physics and transient conditions could conceivably be included to increase the accuracy of the model, thereby providing more realistic simulations and point to the true limiting processes. The developed pore network model opens a new avenue for modelling complex electrochemical systems with less computational cost, enabling simulation of bigger electrode domains while keeping structural heterogeneities of material.

Pore-scale simulations of Li-ion battery electrodes were conducted using both pore-network modeling and direct numerical simulation. Ternary tomographic images of NMC811 cathodes were obtained and used to create the pore-scale computational domains. A novel network extraction method was developed to manage the extraction of N-phase networks which was used to extract all three phases of NMC-811 electrode along with their interconnections Pore network results compared favorably with direct numerical simulations (DNS) in terms of effective transport properties of each phase but were obtained in significantly less time. Simulations were then conducted with combined diffusion-reaction to simulate the limiting current behavior. It was found that when considering only ion and electron transport, the electrode structure could support current densities about 300 times higher than experimentally observed values. Additional case studies were conducted to illustrate the necessity of ternary images which allow separate consideration of carbon binder domain and active material. The results showed a 24.4% decrease in current density when the carbon binder was treated as a separate phase compared to lumping the CBD and active material into a single phase. The impact of nanoporosity in the carbon binder phase was also explored and found to enhance the reaction rate by 16.8% compared to solid binder. In addition, the developed technique used 58 times larger domain volume than DNS which opens up the possibility of modelling much larger tomographic data sets, enabling representative areas of typically inhomogeneous battery electrodes to be modelled accurately, and proposes a solution to the conflicting needs of high-resolution imaging and large volumes for image-based modelling. For the first time, three-phase pore network modelling of battery electrodes has been demonstrated and evaluated, opening the path towards a new modelling framework for lithium ion batteries. The described here was financially supported by the University of Engineering and Technology Lahore, Pakistan as well as the Natural Science and Engineering Research Council (NSERC) of Canada and in the UK by the Faraday Institution (EP/R042012/1 and EP/R042063/1). Pablo A. García-Salaberri thanks the support from the STFC Early Career Award (ST/R006873/1) during his stay at the Electrochemical Innovation Lab

Objective Although many studies worldwide explained the risk factors for developing Diabetic Foot Ulceration (DFU), little has been done to assess medical factors in DFU formation and link them in patients of Pakistan. This study aimed to link the DFU with different risk factors. Methods This descriptive cross-sectional retrospective study was conducted in Diabetes Endocrine and Metabolic Centre / Post Graduate Medical Institute / Lahore General Hospital. Data of all patients presenting between July 2017 to June 2018 were analyzed for risk factors. Analysis was done on SPSS version 21. Results Total of 3301 patient were seen during this period, out of which 2052 patient data was picked up as it was complete in respect to the information needed. Middle age, Male gender, Type 2 diabetes, and Hypertension, were insignificantly co-related. High waist circumference, Comorbidity like Neuropathy, Dyslipidemia, Greater body mass index, Poor compliance with Medication and type of medication used (combination of oral and injectable) were found statistically significant predictor for DFU. However retinopathy was not found to be a risk factor of DFU. This result was statistically significant. Conclusion Factors like obesity, waist circumference, combination of oral along with injectable therapies, neuropathy, dyslipidemia, retinopathy and poor compliance with medication were statistically significant and can be strongly linked with diabetic foot ulcer. Middle age, Male gender, Type 2 diabetes, and Hypertension were insignificantly co-related. However, further studies are needed in larger population to support these findings.

A/J and 129P3/J mice strains have been widely studied over the last few years because they respond quite differently to fluoride (F) exposure. 129P3/J mice are remarkably resistant to the development of dental fluorosis, despite excreting less F in urine and having higher circulating F levels. These two strains also present different characteristics regardless of F exposure. Objective In this study, we investigated the differential pattern of protein expression in the liver of these mice to provide insights on why they have different responses to F. Material and Methods Weanling male A/J and 129P3/J mice (n=10 from each strain) were pared and housed in metabolic cages with ad libitum access to low-F food and deionized water for 42 days. Liver proteome profiles were examined using nLC-MS/MS. Protein function was classified by GO biological process (Cluego v2.0.7 + Clupedia v1.0.8) and protein-protein interaction network was constructed (PSICQUIC, Cytoscape). Results Most proteins with fold change were increased in A/J mice. The functional category with the highest percentage of altered genes was oxidation-reduction process (20%). Subnetwork analysis revealed that proteins with fold change interacted with Disks large homolog 4 and Calcium-activated potassium channel subunit alpha-1. A/J mice had an increase in proteins related to energy flux and oxidative stress. Conclusion This could be a possible explanation for the high susceptibility of these mice to the effects of F, since the exposure also induces oxidative stress.

Cystatin B was recently identified as an acid-resistant protein in acquired enamel pellicle; it could therefore be included in oral products to protect against caries and erosion. However, human recombinant cystatin is very expensive, and alternatives to its use are necessary. Phytocystatins are reversible inhibitors of cysteine peptidases that are found naturally in plants. In plants, they have several biological and physiological functions, such as the regulation of endogenous processes, defense against pathogens, and response to abiotic stress. Previous studies performed by our research group have reported high inhibitory activity and potential agricultural and medical applications of several sugarcane cystatins, including CaneCPI-1, CaneCPI-2, CaneCPI-3, and CaneCPI-4. In the present study, we report the characterization of a novel sugarcane cystatin, named CaneCPI-5. This cystatin was efficiently expressed in Escherichia coli, and inhibitory assays demonstrated that it was a potent inhibitor of human cathepsins B, K, and L ( Ki = 6.87, 0.49, and 0.34 nM, respectively). The ability of CaneCPI-5 to bind to dental enamel was evaluated using atomic force microscopy. Its capacity to protect against initial enamel erosion was also tested in vitro via changes in surface hardness. CaneCPI-5 showed a very large force of interaction with enamel (e.g., compared with mucin and casein) and significantly reduced initial enamel erosion. These results suggest that the inclusion of CaneCPIs in dental products might confer protection against enamel erosion.

International audience; In this paper, an adaptive method of cancellation of parasitic vibrations is presented for a Self-Mixing (SM) interferometric laser vibration sensor which has been coupled with a solid state accelerometer (SSA). Previously, this was achieved by using a pre-calibration of phase and gain mismatches over the complete bandwidth of the instrument. Such a pre-calibration is not only tedious to execute but also hinders a mass production of the instrument as every SSA-SM sensor couple requires customized calibration. On the other hand, the proposed method does not require any pre-calibration as it uses an adaptive filter that self-tunes to match any unknown phase and gain differences between the SSA and the SM sensor. Two different adaptive algorithms, namely Recursive Least Squares (RLS) and Least Mean Squares (LMS) algorithms are tested and a comparison is established on the basis of parameter dependence, convergence time, computational cost and rms error. The proposed algorithms have provided improved results (mean error of 19.1nm and 20.2nm for LMS and RLS respectively) as compared to pre-calibration based results (mean error of 24.7 nm) for a laser wavelength of 785 nm. Simulated and experimental results thus demonstrate the utility of such an approach for embedded vibration sensing corrupted by extraneous parasitic motion. Index Terms-adaptive filter, self-mixing, vibration measurement, embedded sensing, optical feedback, laser instrument.

Displaced proximal humeral fractures warrant surgical fixation for early rehabilitation and better functional outcome. These fractures are traditionally fixed by delto pectoral surgical approach. Direct lateral approach has recently gained interest as it involves less soft tissue dissection and is particularly helpful in certain fracture patterns. However, there have been concerns of axillary nerve damage with this approach. We report a case series of proximal humerus fractures fixed by direct lateral approach from our institution. All displaced Type 2 and 3 fractures were included in our study. Pathological and comminuted Type 4 fractures and fractures with ipsilateral clavicle or elbow fractures were excluded. Oxford Shoulder Score was done at regular intervals for assessment of functional outcome. We did not observe any axillary nerve damage in our case series and the outcomes of 70.5% of our patients were excellent while in 29.5% it was good. We recommend direct lateral approach for specific pattern of proximal humerus fractures.

Virtual reality (VR) training simulators have started playing a vital role in enhancing surgical skills, such as hand-eye coordination in laparoscopy, and practicing surgical scenarios that cannot be easily created using physical models. We describe a new VR simulator for basic training in laparoscopy, i.e. SmartSIM, which has been developed using a generic open-source physics engine called the simulation open framework architecture (SOFA). This paper describes the systems perspective of SmartSIM including design details of both hardware and software components, while highlighting the critical design decisions. Some of the distinguishing features of SmartSIM include: (i) an easy-to-fabricate custom-built hardware interface; (ii) use of a generic physics engine to facilitate wider accessibility of our work and flexibility in terms of using various graphical modelling algorithms and their implementations; and (iii) an intelligent and smart evaluation mechanism that facilitates unsupervised and independent learning.

To determine factors affecting cardiac rehabilitation attendance after myocardial infarction and coronary revascularization.A cross-sectional study was conducted on 416 patients admitted in Tabba Heart Institute, Karachi from December 2010 to May 2011. Patients admitted with diagnosis of acute myocardial infarction (AMI) or who underwent elective coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI) procedures were offered cardiac rehabilitation (CR). Out of these, patients who enrolled in 6 weeks outpatient CR programme were followed for number of CR sessions and their socio-demographic and clinical data were collected. Data was analyzed by Statistical Package for Social Sciences (SPSS) software, version 15.0. Chi-square test was applied to test association between categorical variables and Student's t-test for continuous variables.Out of 416 patients identified, only 151 patients (36.2%) enrolled and attended the CR programme. Of the 151 attendees, 111 (73.4%) patients subsequently completed more than 6 weeks of outpatient CR programme. We found significant association between CR attendance and easy access to the programme, elective CABG procedure, employment status, presence of diabetes or hypertension and baseline level of exercise (all por = 0.01). No association was found between CR attendance and patient age, gender, body mass index or different economic groups.Attendance rates of patients attending outpatient CR programme after AMI or coronary revascularization procedures are suboptimal. Patients who underwent elective CABG surgery and had easy access to the CR programme had better attendance. Factors contributing to poor attendance rates at CR programmes in developing countries need to be explored and subsequently addressed.