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Diffuse large B-cell lymphoma is treated with anti-CD 20 and multi-drug chemotherapy for cure. Positron emission tomography (PET) scans are performed at end of treatment (EOT) to assess response. EOT Deauville scores (DS) are equivocal for treatment response in some situations, requiring physicians to determine the need for further investigations or treatment. Studies have suggested the delta maximum standardised uptake value (ΔSUVmax) to be superior to DS for assessment of metabolic response at interim PET, although its use at EOT PET, especially in cases of equivocal response, has yet to be established. We investigated whether ΔSUVmax could better discriminate prognosis than DS 3 or 4 at EOT. ΔSUVmax did not outperform DS. Combination of DS 3 and International Prognostic Index (IPI)

A memristor‐transistor hybrid ternary content addressable memory (MTCAM) with a memristor‐based ternary memory cell is proposed. New emerging devices like memristors have recently been explored to overcome the limitations of CMOS‐based memory circuits. The memristor is used as a binary memory cell in these MTCAM designs to replace a CMOS‐based memory cell. This proposed design used a memristor as a ternary memory cell by exploiting its variable resistance characteristics. The associated wiring is reduced almost by a factor of 2 as a ternary cell is used instead of two binary cells. Area efficiency is further enhanced as the MTCAM cell is comprised of two transistors and two memristors (2T2M). A segmentation technique of match line along with a robust write/search operation method is presented to enhance the search speed of the proposed MTCAM. Simulation based on a mathematical model of memristor is presented and analysed using 65 nm TSMC MOS model parameters. Corner simulations and Monte Carlo simulations are carried out to substantiate the robustness of the design against process variation. Simulation results show the worst search delay of 0.75 ns and the energy/bit/search of 0.866 fJ for the 128 × 128 bit MTCAM.

Introduction: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worldwide and has contributed to over 650,000 deaths. This review synthesizes the literature on COVID-19 pharmacotherapy to inform practice and policymaking. Areas covered: The authors systematically review the published literature on COVID-19 therapeutics, grouping candidate treatments into repurposed, adjunct, and experimental agents. They conducted meta-analysis where appropriate and provide recommendations based on compilation from real-time/interim therapeutic guidelines. They then advise on how to navigate and advance the evidence in the current context of uncertainty and urgency and provide expert opinion on suggested framework. Expert opinion: Current evidence does not support a clear role for pharmacotherapy in COVID-19. While promising signals have been found through limited number of RCTs, these must be interpreted with caution. Without proper protection from bias and confounding we risk exposing patients to treatments where the potential for benefit is at best unclear, yet the potential for harm from adverse effects is high leading to a trade-off dilemma in decision making. Advancing the evidence requires a coordinated effort to design and conduct robust trials and to systematically synthesize and critically evaluate findings. Therapies should be reserved for use in clinical trials, emergency or compassionate access until we gain more confidence in the balance of benefit and harm.

Background: Peptic ulcer perforation management is still an enigma. Though the overall incidence has been reduced worldwide due to wide use of anti-ulcerants, still it is not uncommon. But there is a debate regarding its conservative management over surgical management. Objective: To determine whether surgery could be avoided in selected patients with perforated peptic ulcer disease Methods: This study was conducted in the department of Surgery of Sir Salimullah Medical College and Mitford Hospital during the period from 1st March 2016 to 31st August 2016. After approval from the institutional ethics committee, 30 patients of suspected perforated peptic ulcer disease were successively assigned in this study on clinical and radiological basis. All were given non-operative regimen up to 24 hours. Then they were closely monitored to see improvement of clinical condition or development of any complication. Non-operative treatment was abandoned if the patient failed to improve or deteriorated within 24 hours of non-operative treatment. The data were collected by active participation of patients’ interview in preformed data collection sheet. Results: The data analysis of 30 patients yielded that most of them (86.67%) recovered well after receiving non-operative management, whereas only 4 patients (13.33%) showed no progression and were treated by laparotomy. 73.08% patients with uneventful outcome left the hospital within 10 days of admission and the others were a little late to leave. Conclusion: Patients with perforated peptic ulcer disease can be effectively treated by conservative approach in properly selected cases by proper monitoring under strict supervision of an experienced consultant. Journal of Surgical Sciences (2018) Vol. 22 (2) : 95-98

BackgroundUrinary tract infection (UTI) is frequently implicated as a precipitant of delirium, which refers to an acute confusional state that is associated with high mortality, increased length of stay, and long-term cognitive decline. The pathogenesis of delirium is thought to involve cytokine-mediated neuronal dysfunction of the frontal cortex and hippocampus. We hypothesized that systemic IL-6 inhibition would mitigate delirium-like phenotypes in a mouse model of UTI.MethodsC57/BL6 mice were randomized to either: (1) non-UTI control, (2) UTI, and (3) UTI + anti-IL-6 antibody. UTI was induced by transurethral inoculation of 1 × 108Escherichia coli. Frontal cortex and hippocampus-mediated behaviors were evaluated using functional testing and corresponding structural changes were evaluated via quantification of neuronal cleaved caspase-3 (CC3) by immunohistochemistry and western blot. IL-6 in the brain and plasma were evaluated using immunohistochemistry, ELISA, and RT-PCR.ResultsCompared to non-UTI control mice, mice with UTI demonstrated significantly greater impairments in frontal and hippocampus-mediated behaviors, specifically increased thigmotaxis in Open Field (p p p p p r2 = 0.5087/p = 0.0028) and frontal IL-6 and CC3 (r2 = 0.2653,p ConclusionsThese data provide evidence for a role for IL-6 in mediating delirium-like phenotypes in a mouse model of UTI. These findings provide pre-clinical justification for clinical investigations of IL-6 inhibitors to treat UTI-induced delirium.

Introduction Elective care in the UK came to a standstill with the advent of the COVID-19 pandemic. A restart could only be enabled with ‘green site’ separation and a ‘covid protected’ zone. A ‘hospital within the hospital’ concept was developed including 9 elective theatres, 28 ring fenced elective beds, a surgical enhanced care unit, a canteen, and a separated entrance. This model was underpinned with PPE, enhanced infection control and guidance for staff. The study documented the ability to recover elective activity and therefore provide a training environment for surgical trainees. Method Data was collected weekly (7/20 to 1/21) through the business informatics system with regard to theatres cases completed compared to the activity achieved in the 11-theatre elective estate pre COVID-19. Results Pre COVID-19, an average of 263 cases were completed per week. In the first week of operation, 31% of theatre capacity was achieved. By week 7, 106% of pre COVID was recorded and 130% by week 11. This was maintained until the impact of the second wave where activity has reduced to 50% but is not anticipated to reduce further as local anaesthetic and blocks maybe utilised. Conclusions This ‘hospital within the hospital’ has enabled elective care to return to above normal levels, with increased efficiencies. This has enabled a rapid return to a training environment for trainees disheartened with deployment to critical care in the first wave.

not available Bangladesh Journal of Urology, Vol. 14, No. 2, July 2011 p.58-61

Mechanical ventilation is a known risk factor for delirium, a cognitive impairment characterized by dysfunction of the frontal cortex and hippocampus. Although IL-6 is upregulated in mechanical ventilation–induced lung injury (VILI) and may contribute to delirium, it is not known whether the inhibition of systemic IL-6 mitigates delirium-relevant neuropathology. To histologically define neuropathological effects of IL-6 inhibition in an experimental VILI model, VILI was simulated in anesthetized adult mice using a 35 cc/kg tidal volume mechanical ventilation model. There were two control groups, as follow: 1) spontaneously breathing or 2) anesthetized and mechanically ventilated with 10 cc/kg tidal volume to distinguish effects of anesthesia from VILI. Two hours before inducing VILI, mice were treated with either anti–IL-6 antibody, anti–IL-6 receptor antibody, or saline. Neuronal injury, stress, and inflammation were assessed using immunohistochemistry. CC3 (cleaved caspase-3), a neuronal apoptosis marker, was significantly increased in the frontal (P < 0.001) and hippocampal (P < 0.0001) brain regions and accompanied by significant increases in c-Fos and heat shock protein-90 in the frontal cortices of VILI mice compared with control mice (P < 0.001). These findings were not related to cerebral hypoxia, and there was no evidence of irreversible neuronal death. Frontal and hippocampal neuronal CC3 were significantly reduced with anti–IL-6 antibody (P < 0.01 and P < 0.0001, respectively) and anti–IL-6 receptor antibody (P < 0.05 and P < 0.0001, respectively) compared with saline VILI mice. In summary, VILI induces potentially reversible neuronal injury and inflammation in the frontal cortex and hippocampus, which is mitigated with systemic IL-6 inhibition. These data suggest a potentially novel neuroprotective role of systemic IL-6 inhibition that justifies further investigation.

Exosomes, a component of extracellular vesicles, are shown to carry important small RNAs, mRNAs, protein, and bioactive lipid from parent cells and are found in most biological fluids. Investigators have demonstrated the importance of mesenchymal stem cells derived exosomes in repairing stroke lesions. However, exosomes from endothelial progenitor cells have not been tested in any stroke model, nor has there been an evaluation of whether these exosomes target/home to areas of pathology. Targeted delivery of intravenous administered exosomes has been a great challenge, and a targeted delivery system is lacking to deliver naïve (unmodified) exosomes from endothelial progenitor cells to the site of interest. Pulsed focused ultrasound is being used for therapeutic and experimental purposes. There has not been any report showing the use of low-intensity pulsed focused ultrasound to deliver exosomes to the site of interest in stroke models. In this proof of principle study, we have shown different parameters of pulsed focused ultrasound to deliver exosomes in the intact and stroke brain with or without intravenous administration of nanobubbles. The study results showed that administration of nanobubbles is detrimental to the brain structures (micro bleeding and white matter destruction) at peak negative pressure of >0.25 megapascal, despite enhanced delivery of intravenous administered exosomes. However, without nanobubbles, pulsed focused ultrasound enhances the delivery of exosomes in the stroke area without altering the brain structures.

Erosive lichen planus affecting the vulva and vagina (ELPV) is a rare inflammatory skin disease, presenting with painful erosions and severe scarring.1 The disease course is persistent and often refractory to treatment: up to 45% patients do not experience remission with topical treatments, while evidence for systemic treatments remains scarce.2 Hydroxychloroquine (HCQ) is frequently used in daily practice as a first choice systemic therapy.3 However, little evidence is available on HCQ for ELPV.2 The aim of this study was to analyse the effectiveness and safety of HCQ in ELPV.

Therapy resistance in glioblastoma (GBM), a hypervascular, hyperproliferative, and hypoxic neoplasia of the central nervous system with an extremely high mortality rate has always been an attractive topic of investigation. The transient benefits of adjuvant antiangiogenic therapies (AAT) in normalizing blood vessels, controlling abnormal vasculatures, and preventing recurrence coupled with higher rates of relapse are attributed to the AAT-induced therapy resistance due to activation of alternative neovascularization mechanisms such as vascular mimicry (VM). An overactive IL-8-CXCR2 axis-driven VM contributed to AAT therapy resistance in preclinical models of GBM. Intervening the IL-8-CXCR2 axis with SB225002 (a CXCR2 antagonist) reduced (i) the GBM tumor burden, (ii) CXCR2 + and endothelial-like GBM subpopulations, and (iii) VM structures in the tumors. This chapter throws light on these novel findings and corroborates the therapeutic potential of a CXCR2 antagonist in combination with other antitumor agents in preclinical and clinical trials to reverse GBM therapy-induced resistance.

Background The health burden in developing world informal settlements often coincides with a lack of spatial data that could be used to guide intervention strategies. Spatial video (SV) has proven to be a useful tool to collect environmental and social data at a granular scale, though the effort required to turn these spatially encoded video frames into maps limits sustainability and scalability. In this paper we explore the use of convolution neural networks (CNN) to solve this problem by automatically identifying disease related environmental risks in a series of SV collected from Haiti. Our objective is to determine the potential of machine learning in health risk mapping for these environments by assessing the challenges faced in adequately training the required classification models. Results We show that SV can be a suitable source for automatically identifying and extracting health risk features using machine learning. While well-defined objects such as drains, buckets, tires and animals can be efficiently classified, more amorphous masses such as trash or standing water are difficult to classify. Our results further show that variations in the number of image frames selected, the image resolution, and combinations of these can be used to improve the overall model performance. Conclusion Machine learning in combination with spatial video can be used to automatically identify environmental risks associated with common health problems in informal settlements, though there are likely to be variations in the type of data needed for training based on location. Success based on the risk type being identified are also likely to vary geographically. However, we are confident in identifying a series of best practices for data collection, model training and performance in these settings. We also discuss the next step of testing these findings in other environments, and how adding in the simultaneously collected geographic data could be used to create an automatic health risk mapping tool.

With the significant changes that the energy sector has been facing in the past decades, microgrids have become a reality. D.C. microgrids are considered to be more reliable and stable, which makes it preferred over A.C. systems. However, it still faces challenges in its operation, which makes it necessary for finding an alternative protection system. New technologies are being studied and developed for protections of low and high voltage D.C. systems, and circuit breakers made with semiconductors can be applied as they are found to be faster and more efficient than the traditional mechanical breakers. This paper presents the reviews of the current technology and some applications that have been studied in the field recently.

Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study was carried out to find out various risk factors of burst abdomen following emergency laparotomy, to find out the high risk group of patients for burst abdomen, to determine the predictors of burst abdomen, to prevent the rate of burst abdomen & find out morbidity and mortality of burst abdomen. This cross sectional study was done among 100 cases of burst abdomen occurring in Sir Salimullah Medical College & Mitford Hospital, Dhaka and Dhaka Medical college,Dhaka during the period of July,2011 to December,2011. The patients were admitted for various surgical problems and underwent emergency laparotomy. Burst abdomen was taken into account. Another group of 100 patients who undergone emergency laparotomy but did not develop burst abdomen were also taken into account to make a comparison with the burst group. Patients who undergone elective laparotomy,paediatric age group,patients undergone exploration through mini laparotomy or transverse incision,patients with pregnancy were excluded from the study populations.Patients were assessed by history taking, examination and appropriate investigation before surgery and observed post operatively for any complication. The results were prepared on 100 patients underwent emergency laparotomy in SSMCMH & DMCH. Burst abdomen following emergency laparotomy results from multifactorial causes. The main outcome measure found significant as the risk factors of burst abdomen in this study were peritonitis (95%),anaemia (26%),malnutrition (18%), in the preoperative period; inadequate peritoneal toileting and faulty surgical techniques in the per operative period; and wound infection (62%), postoperative cough (28%), abdominal distension (22%). The result also shows that the rate of burst abdomen is still very high in SSMCMH & DMCH and most of them occur in operations done by trainee surgeons (86%) and in those patients who has 3 or more of the risk factors (44%). We hope this study will arouse awareness and concern about this problem, so that more active steps will be taken for its prevention by identifying the high risk groups. This will certainly reduce the incidence of burst abdomen. Bangladesh Med J. 2017 May; 46 (2): 38-42

Formation of neutrophil extracellular traps worsens cerebrovascular outcomes after traumatic brain injury., Traumatic brain injury (TBI) is a major cause of mortality and morbidity. Preventative measures reduce injury incidence and/or severity, yet one-third of hospitalized patients with TBI die from secondary pathological processes that develop during supervised care. Neutrophils, which orchestrate innate immune responses, worsen TBI outcomes via undefined mechanisms. We hypothesized that formation of neutrophil extracellular traps (NETs), a purported mechanism of microbial trapping, exacerbates acute neurological injury after TBI. NET formation coincided with cerebral hypoperfusion and tissue hypoxia after experimental TBI, while elevated circulating NETs correlated with reduced serum deoxyribonuclease-1 (DNase-I) activity in patients with TBI. Functionally, Toll-like receptor 4 (TLR4) and the downstream kinase peptidylarginine deiminase 4 (PAD4) mediated NET formation and cerebrovascular dysfunction after TBI. Last, recombinant human DNase-I degraded NETs and improved neurological function. Thus, therapeutically targeting NETs may provide a mechanistically innovative approach to improve TBI outcomes without the associated risks of global neutrophil depletion.

Given their pro-tumorigenic function and prevalence in most malignant tumors with lower survival, early detection and intervention of CD206-positive M2-macrophages may boost the clinical outcome. To determinein vivodistribution of M2-macrophages, we adopted111In-oxine-based radiolabeling of the targeted exosomes. When injected these radiolabeled targeted exosomes into breast tumor-bearing mice, exosomes accumulated at the periphery of the primary tumor, metastatic foci in the lungs, spleen, and liver.Ex vivoquantification of radioactivity also showed similar distribution. Injected DiI dye-labeled exosomes into the same mice showed adherence of exosomes to the CD206-positive M2-macrophages onex vivofluorescent microscopy imaging. In addition, we utilized these engineered exosomes to carry the Fc portion of IgG2b with the intention of augmenting antibody-dependent cell-mediated cytotoxicity. We have auspiciously demonstrated that M2-macrophage targeting therapeutic exosomes deplete M2-macrophages bothin vitroandin vivo, and reduce tumor burden increasing survival in a metastatic breast cancer model.

BACKGROUND: Glioblastoma (GBM) was shown to relapse faster and displayed therapeutic resistance to antiangiogenic therapies (AATs) through an alternative tumor cell-driven mechanism of neovascularization called vascular mimicry (VM). We identified highly upregulated interleukin 8 (IL-8)-CXCR2 axis in tumor cells in high-grade human glioma and AAT-treated orthotopic GBM tumors. METHODS: Human GBM tissue sections and tissue array were used to ascertain the clinical relevance of CXCR2-positive tumor cells in the formation of VM. We utilized U251 and U87 human tumor cells to understand VM in an orthotopic GBM model and AAT-mediated enhancement in VM was modeled using vatalanib (anti-VEGFR2) and avastin (anti-VEGF). Later, VM was inhibited by SB225002 (CXCR2 inhibitor) in a preclinical study. RESULTS: Overexpression of IL8 and CXCR2 in human datasets and histological analysis was identified as a bonafide candidate to validate VM through in vitro and animal model studies. AAT-treated tumors displayed a higher number of CXCR2-positive GBM-stem cells with endothelial-like phenotypes. Stable knockdown of CXCR2 expression in tumor cells led to decreased tumor growth as well as incomplete VM structures in the animal models. Similar data were obtained following SB225002 treatment. CONCLUSIONS: The present study suggests that tumor cell autonomous IL-8-CXCR2 pathway is instrumental in AAT-mediated resistance and VM formation in GBM. Therefore, CXCR2 can be targeted through SB225002 and can be combined with standard therapies to improve the therapeutic outcomes in clinical trials.

Majority of the lung cancer occurs in developing countries. In case of Bangladesh it's a burden for health in both serest. A definitive diagnosis of lung cancer can help the surgeons and physicians for making decisions about the plan of treatment. The rapidity of diagnosis also alleviates the patient's anxiety whether the lesion is nonmalignant or malignant Several studies proposed the role of CYFRA 21-1 level in diagnosis of lung cancer and its better management. To find the sensitive, feasible and cost effective test for detection of lung cancer and to evaluate the CYFRA 21-1 with their histopathological findings. This case control study was carried out in the department of Medicine of National Institute of Diseases of the Chest and Hospital (NIDCH) Dhaka and Enam Medical College Hospital, Savar, Dhaka during the period from January 2017 to September 2017. We included a total of 80 subjects among them 40 diagnosed cases of lung cancer and 40 controls with diseases other than lung cancer. The mean normal (< 3.5) serum CYFRA 21-1 level was (Mean *SD) 1.10 t 1.5 with ranging from 0.87 ng /ml — 1.5 ng lint Normal level of CYFRA 21-1 was found in all 40 (100%) of controls. The mean of high (> 3.5) serum CYFRA 21-1 level was (Mean +-SD) 18.20 ± 13.63 with rangingfrom 6.9 ng hnl — 49.30 ng/ml. High level of CYFRA 21-1 level was found in maximum 35(87.5%) cases. High (> 3.5 rig/m1) serum CYFRA 21-1 level was found maximum in squamous cell carcinoma (20), next adenocarcinoma (15). Among 40 cases diagnosed as malignant by histopathology, serum CYFRA 21-1 level was compared with histopathological findings. The sensitivity of serum CYFRA 21-1 level in case of squamous cell carcinoma, adenocarcinoma and combined were 90.90%, 83.33% and 87.5% respectively. The sensitivity and accuracy of serum CYFRA 21-1 for squamous cell carcinoma was more than that of adenocarcinoma. So serum CYFRA 21-1 level was highly sensitive for squamous cell carcinoma.

// Liyong Zhang 1 , Yan Wang 1 , Mohammad H. Rashid 1 , Min Liu 2 , Kartik Angara 1 , Nahid F. Mivechi 1 , Nita J. Maihle 1, 3 , Ali S. Arbab 1 and Lan Ko 1, 4 1 Georgia Cancer Center, Medical College of Georgia, Augusta University, Augusta, GA, USA 2 Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA 3 Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA, USA 4 Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, USA Correspondence to: Lan Ko, email: LKO@augusta.edu Keywords: angiogenesis, pericytes, oral cancer, glioblastoma Received: October 21, 2016 Accepted: May 01, 2017 Published: May 25, 2017 ABSTRACT Angiogenesis promotes tumor development. Understanding the crucial factors regulating tumor angiogenesis may reveal new therapeutic targets. Human GT198 ( PSMC3IP or Hop2) is an oncoprotein encoded by a DNA repair gene that is overexpressed in tumor stromal vasculature to stimulate the expression of angiogenic factors. Here we show that pericytes expressing GT198 give rise to tumor cells through angiogenesis. GT198 + pericytes and perivascular cells are commonly present in the stromal compartment of various human solid tumors and rodent xenograft tumor models. In human oral cancer, GT198 + pericytes proliferate into GT198 + tumor cells, which migrate into lymph nodes. Increased GT198 expression is associated with increased lymph node metastasis and decreased progression-free survival in oral cancer patients. In rat brain U-251 glioblastoma xenografts, GT198 + pericytes of human tumor origin encase endothelial cells of rat origin to form mosaic angiogenic blood vessels, and differentiate into pericyte-derived tumor cells. The net effect is continued production of glioblastoma tumor cells from malignant pericytes via angiogenesis. In addition, activation of GT198 induces the expression of VEGF and promotes tube formation in cultured U251 cells. Furthermore, vaccination using GT198 protein as an antigen in mouse xenograft of GL261 glioma delayed tumor growth and prolonged mouse survival. Together, these findings suggest that GT198-expressing malignant pericytes can give rise to tumor cells through angiogenesis, and serve as a potential source of cells for distant metastasis. Hence, the oncoprotein GT198 has the potential to be a new target in anti-angiogenic therapies in human cancer.

Glioblastoma (GBM) is a hypervascular and aggressive primary malignant tumor of the central nervous system. Recent investigations showed that traditional therapies along with antiangiogenic therapies failed due to the development of post-therapy resistant and recurrent GBM. Our investigations show that there are changes in the cellular and metabolic compositions in the tumor microenvironment (TME). It can be said that tumor cell-directed therapies are ineffective and we need to rethink how to treat GBM.We hypothesize that the composition of TME-associated cells will be different based on the therapy and therapeutic agents, and TME-targeting therapy will be better to decrease recurrence and improve survival. Therefore, the purpose of this study is to determine the changes in the TME in respect of T-cell population, M1 and M2 macrophage polarization status, and MDSC population following different treatments in a syngeneic model of GBM. In addition to these parameters, tumor growth and survival were also studied following different treatments.The results showed that changes in the TME-associated cells were dependent on the therapeutic agents and the TME-targeting therapy improved the survival of the GBM bearing animals.The current GBM therapies should be revisited to add agents to prevent the accumulation of bone marrow-derived cells in the TME or to prevent the effect of immune-suppressive myeloid cells in causing alternative neovascularization, the revival of glioma stem cells, and recurrence. Instead of concurrent therapy, a sequential strategy would be best to target TME-associated cells.

Background and Purpose: Chronic remote ischemic conditioning (C-RIC) is effective at improving cerebral blood flow (CBF) inducing vascular remodeling, and improving cognition in a bilateral carotid artery stenosis (BCAS) mouse model, a model for Vascular Cognitive Impairment and Dementia (VCID). This effect is lost in NOS3-KO mice. We wanted to determine if the beneficial effect of C-RIC can be restored by bone marrow cell-derived NOS3. Methods: We prepared BM chimera from adult WT (B6.SJL-Ptprc a ; CD45.1) to adult NOS3-KO (B6.129; CD45.2) & vice versa in male mice (5-6 months) following confirmation for BM engrafting with flow cytometry at 2 weeks. Microcoil (0.18 mm) induced BCAS model was used to induce chronic hypoperfusion. Mice were randomly assigned to 3-groups: (1) Sham (2) BCAS and (3) BCAS+RIC. RIC was started 7d post-surgery daily for 3-4 weeks. Behavioral test and CBF was performed before termination. Functional outcomes were assessed using novel object recognition (NOR) test for non-spatial working memory, and hanging wire and beam walk test for motor/muscular impairment. We measured whole blood P-NOS3, P-AMPK and VEGFR2/CD31 by flow cytometry. Results: C-RIC-therapy for 3-4 weeks improves CBF in engrafted BM of WT into NOS3-KO in the BCAS+RIC groups at both 2 weeks and 4 weeks compared to BCAS (Sham RIC groups).No effect of C-RIC was shown in engrafted BM of NOS3 into WT. There was significant change between the BCAS and BCAS+RIC groups in the functional outcomes and histopathological evidences also reflects major changing in the groups in the BM of WT into NOS3-KO mice. Whole blood P-NOS3, P-AMPK and VEGFR2/CD31 was increased by C-RIC. However, no effect was shown in the NOS3-KO into WT chimera. Conclusions: The Beneficial effect of C-RIC is dependent upon bone marrow derived NOS3.Further studies are needed to determine if the red blood cell is the key cell carrying NOS3

Selected eight inbreed line were used in crossing as half diallel fashion to find out different genetic parameter as well as targeting superior combination for hybrid vigour. Sunflower first introduce in Bangladesh 1980 by Bangladesh Agricultural Research Institute and Mennonite Central Committee. BARI Sunflower-1(Kironi) and BARI Sunflower-2 is only two released variety. But major obstacles for sunflower cultivation are both varieties are more than 1.50m height and require > 100 days for maturity. As this country is facing climate change unfavorable weather, sunflower cannot withstand in stormy weather. Specially at the time of prematurity stormy weather causes lodging due to over height, it is essential to develop dwarf stature plant. Due to strong crop competition in winter it cannot fit in major cropping pattern T-Aman-Mustard-Boro due to it long duration. Bangladesh has accessible land of 0.85 million hectares in saline areas (Banik et al., 2011). These lands can be used for sunflower cultivation as it is moderately saline tolerant (Rahman et. al. 2018). On the other hand in different part of Bangladesh (e.g. Cumilla, Manikgonj, Sherpur, Jamalpur, Netrokina, Tangail, Dinajpur, etc.), a huge amount of lands are kept fellow after T. Aman harvest. These current fellow lands can be easily used by sunflower cultivation if short duration varieties are available. Both plant height and days to maturity were considered as favorable for negative heterosis to obtain dwarf plant stature and short duration plant to fit in existing cropping pattern in Bangladesh. Positive heterosis is considered desirable for other yield contributing traits. The hybrid HE15, HE17 and HE16 showed significant negative heterosis both for mid parent and better parent. Negative heterosis for plant height is desirable to adopt hybrid in unfavorable weather condition. The Hybrid HE15 showed both for significant negative mid parent and better parent heterosis. High heritability along with significant mid parent and better parent heterosis indicate scope of utilization of hybrid as commercial and further use in breeding programmes. Several outstanding cross combinations, HE17, HE16, HE14, HE15, and HE18 showed significant and desirable heterosis for seed yield per plant over mid parent and better parent. The hybrid combinations HE17, HE16 and HE14 could be utilized to exploit the heterosis as well as commercial multiplication of seed to get direct benefit by the farmers.

Glioblastoma (GBM) is a hypervascular and aggressive primary malignant tumor of the central nervous system. Recent investigations showed that traditional therapies along with antiangiogenic therapies failed due to the development of post-therapy resistance and recurrence. Previous investigations showed that there were changes in the cellular and metabolic compositions in the tumor microenvironment (TME). It can be said that tumor cell-directed therapies are ineffective and rethinking is needed how to treat GBM. It is hypothesized that the composition of TME-associated cells will be different based on the therapy and therapeutic agents, and TME-targeting therapy will be better to decrease recurrence and improve survival. Therefore, the purpose of this study is to determine the changes in the TME in respect of T-cell population, M1 and M2 macrophage polarization status, and MDSC population following different treatments in a syngeneic model of GBM. In addition to these parameters, tumor growth and survival were also studied following different treatments. The results showed that changes in the TME-associated cells were dependent on the therapeutic agents, and the TME-targeting therapy improved the survival of the GBM bearing animals. The current GBM therapies should be revisited to add agents to prevent the accumulation of bone marrow-derived cells in the TME or to prevent the effect of immune-suppressive myeloid cells in causing alternative neovascularization, the revival of glioma stem cells, and recurrence. Instead of concurrent therapy, a sequential strategy would be better to target TME-associated cells.

Objectives: The role of N-Acetyl cysteine (NAC) in Rodenticide poisoning hasn’t been well established due to mixed results from various studies and lack of proper treatment guidelines. We aimed to evaluate the efficacy of NAC in the treatment of rodenticide poisoning. Methods: PubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify the literature. Reference list of included studies and Clinicaltrials.gov were also searched for relevant studies. Only the Randomized controlled trials and observational studies assessing the efficacy of NAC in rodenticide poisoning published in English were included in our review. Cochrane Risk of Bias Assessment Tool and New Castle Ottawa scale was used for quality assessment. Two authors were independently involved in study selection, data extraction and quality assessment of the studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: A total of 5 out of 2142 non-duplicate studies with 258 patients were considered for the analysis. Treatment with NAC was observed to have a better recovery rate (Odds Ratio [OR]: 2.32, 95% Confidence Interval [CI]: 1.32-4.09; 5 studies), lesser mortality (OR: 0.28, 95% CI: 0.15-0.53, 5 studies) and lesser intubation or ventilation rate (OR: 0.25, 95% CI: 0.11-0.60, 2 studies) when compared to the control group. However, there was no significant difference with respect to the hospitalization days (Mean Difference: 0.61, Standard deviation: -0.84 to 2.05, 3 studies). The quality of the included studies appeared to be moderate to high. Conclusions: Our findings indicate that NAC can be a promising agent in the management of rodenticide poisoning as it is showing a better survival and lower mortality rate when compared to the control group. Further high-quality studies are warranted. KEY WORDS: N-Acetyl Cysteine, Rodenticide, Efficacy, Recovery, Meta-analysis

Soils are habitats for major forms of life such as microorganisms (e.g., bacteria, archaea, fungi) as well as insects, annelids, algae, and plants. Microorganisms have potential roles to play in sustainable agricultural production due to their ability to promote plant growth and enhance biotic and abiotic stress resistance, remediate contaminated soils, recycle nutrients, manage soil fertility, and weather and mineralize rocks and other abilities that result in the reduced use of fertilizers or pesticides in agriculture. Recently introduced biotechnological approaches help to modify microbes that can be used to enhance bioremediation and phytoremediation of contaminated soil that can be used for agricultural production. Sustainable agriculture is essential today to meet our long-term agricultural needs by using natural resources without degrading the environment. Here, we discuss the structure and diversity of soil microorganisms and their potential role in nutrient recycling, remediation of heavy metal from contaminated environments, plant growth promotion, stress tolerance, phytohormone production, etc. for sustainable agriculture to feed future generations.

Highlights • Top viruses detected in Haitian children are Rhinovirus, Influenza A and Adenovirus. • Top bacteria detected in Haitian children are S. pneumoniae and S. aureus. • Younger children are more likely to have Influenza A and S. pneumoniae detected. • Younger children are more likely to present with fever and diagnosed with pneumonia. • These data support early use of Influenza A and S. pneumoniae vaccines in Haiti., Objectives Acute Respiratory Infection (ARI) is the most common cause of childhood morbidity and mortality in developing countries, including Haiti. Our objective was to detect pathogens found in children with ARI in rural Haiti to help develop evidence-based guidelines for treatment and prevention. Methods Retrospective study of students with ARI at four schools in rural Haiti. Viral and/or bacterial pathogens were identified by qPCR in 177 nasal swabs collected from April 2013 through November 2015. Results Most common viruses detected were Rhinovirus (36%), Influenza A (16%) and Adenovirus (7%), and bacteria were Streptococcus pneumoniae (58%) and Staphylococcus aureus (28%). Compared to older children, children aged 3–5 years had more Influenza A (28% vs. 9%, p = 0.002) and Adenovirus detected (14% vs. 3%, p = 0.01). Similarly, S. pneumoniae was greatest in children 3–5 years old (71% 3–5yrs; 58% 6–15 years; 25% 16–20 years; p = 0.008). Children 3–10 years old presented with fever more than children 11–20 years old (22% vs 7%; p = 0.02) and were more often diagnosed with pneumonia (28% vs 4%, p

Electrodeposited copper zinc tin sulfide (CZTS) thin films grown on conducting glass substrates are investigated in this report. The photoelectrochemical cell (PEC), optical, structural and morphological properties of the deposited films have been characterized. PEC measurements of the CZTS thin film showed p-type electrical conductivity. Optical measurement showed that the transmittance of CZTS films is observed to about 0.5–3.4% in the wavelength range 300–1100 nm. It is also observed that the absorbance of the CZTS thin films rapidly increases in the wavelength range 580–620 nm and then it decreases slowly. The band gap of the CZTS thin film is observed to be in the range 1.6–2.2 eV. The transmittance and band gap decreases upon annealing at different temperatures but the absorbance and the grain size increases due to the improvement of crystalline quality upon annealing. From the X-ray diffraction study, the CZTS films are found to be polycrystalline with (112), (200), (105), (204), (312), (220) orientations of the tetragonal structure. The average crystallite size is estimated to 23 nm for as-deposited film, 26 nm for annealed at 300 °C and 40 nm for annealed at 350 °C. It is found from SEM study that the precursor film shows non-uniform distribution of agglomerated particles with well-defined boundaries. As the annealing temperature increases, the crystallization of the films is observed to improve, and hence the morphology of as-deposited precursor film is observed to change into the larger flat grains upon annealing.

1-D quantum-well (QW) formation and energy state confinement in armchair graphene nanoribbon (A-GNR) heterostructures have been studied. A photodetector device structure based on A-GNR-QWs has been proposed to incorporate both interband and intersubband optical transition using a back-gate potential. Photocurrent, dark current, and quantum efficiency of different A-GNR-QW photodetector structures are studied using self-consistent simulation between nonequilibrium Green’s function formalism including electron–photon interaction and Poisson’s equation. Optical detection from short-wavelength infrared to ultraviolet range has been observed having a tunable feature, which makes our device a promising candidate for future optoelectronics.

Because of the scarcity of clean water, treated wastewater potentially provides an alternative source for irrigation. In the present experiment, the feasibility of using low-cost filtered municipal wastewater in the irrigation of red amaranth ( Amaranthus tricolor L cv. Surma) cultivation was assessed. The collected municipal wastewater from fish markets, hospitals, clinics, sewage, and kitchens of households in Sylhet City, Bangladesh were mixed and filtered with nylon mesh. Six filtration methods were applied using the following materials: sand (T 1 ); sand and wood charcoal consecutively (T 2 ); sand, wood charcoal and rice husks consecutively (T 3 ); sand, wood charcoal, rice husks and sawdust consecutively (T 4 ); sand, wood charcoal, rice husks, sawdust and brick chips consecutively (T 5 ); and sand, wood charcoal, rice husks, sawdust, brick chips and gravel consecutively (T 6 ). The water from ponds and rivers was considered as the control treatment (T o ). The chemical properties and heavy metals content of the water were determined before and after the low cost filtering, and the effects of the wastewater on seed germination, plant growth and the accumulation rate of heavy metals by plants were assessed. After filtration, the pH, EC and TDS ranged from 5.87 to 9.17, 292 to 691 µS cm −1 and 267 to 729 mg L −1 , respectively. The EC and TDS were in an acceptable level for use in irrigation, satisfying the recommendations of the FAO. However, select pH values were unsuitable for irrigation. The metal concentrations decreased after applying each treatment. The reduction of Fe, Mn, Pb, Cu, As and Zn were 73.23%, 92.69%, 45.51%, 69.57%, 75.47% and 95.06%, respectively. When we considered the individual filtering material, the maximum amount of As and Pb was absorbed by sawdust; Cu and Zn by wood charcoal; Mn and Cu by sand and Fe by gravel. Among the six filtration treatments, T 5 showed the highest seed germination (67.14%), similar to the control T 0 (77.14%). The healthy plants/pot ratio (93.62%) was significantly higher for T 5 , even higher than the control (85.19%). Additionally, the average plant height for T 5 (8.097 in.) was statistically identical to the control (8.633 in.). The average number of leaves for T 5 (10) was near to the control (12). Finally, the minimum amount of heavy metals accumulated in the plants of T 5 , whereas the maximum accumulation rate varied among treatments. The accumulated levels of Fe, Mn, Cu, and Zn were within the safe limit; however, the concentrations of Pb and As exceeded their safe limits. The results showed that the low-cost filtration method potentially allows municipal wastewater to be used in irrigation for agricultural production.

Currently, there are only limited data available on rates of major diagnostic categories of illnesses among Haitian children. We have established a cohort of 1,245 students attending schools run by the Christianville Foundation in the Gressier/Leogane region of Haiti, for whom our group provides primary medical care. Among 1,357 clinic visits during the 2012-2013 academic year, the main disease categories (with rates per 1,000 child years of observation) included acute respiratory infection (ARI) (385.6 cases/1,000 child years of observation), gastrointestinal complaints (277.8 cases/1,000 child years), febrile illness (235.0 cases/1,000 child years), and skin infections (151.7 cases/1,000 child years). The most common diarrheal pathogen was enteroaggregative Escherichia coli (present in 17% of children with diarrhea); Vibrio cholerae O1 and norovirus were the next most common. Our data highlight the importance of better defining etiologies for ARI and febrile illnesses and continuing problems of diarrheal illness in this region, including mild cases of cholera, which would not have been diagnosed without laboratory screening.

Modern electric power system consists of complex interconnected network of components. This chapter covers the components that make up the modern power system. These include generators, transformers, and transmission line. It also focuses on the transmission of electric power, how to optimize its power transfer capability, the phenomena of over-voltages and the insulation requirement of transmission lines.

Recently there has been a push to put a ban on genetically Modified foods because many people believe that they are harmful to the health of the public but on the other hand with the world's population continuing to grow and many countries lacking enough food to support their populations. The balancing of possible risk verses benefits is critical because of the great quantities of food that Genetically Engineered Food can provide compared to unmodified foods, but with possible risk factors.

Distant metastasis is the primary cause of death in the majority of the cancer types. Recently, much importance has been given to tumor microenvironment (TME) in the development of invasive malignant tumors, as well as the metastasis potential. The ability of tumor cells to modulate TME and to escape immune-mediated attack by releasing immunosuppressive cytokines has become a hallmark of breast cancer. Our study shows the effect of IV formulation of HET0016 (HPßCD-HET0016) a selective inhibitor of 20-HETE synthesis, administered intravenously in immune-competent in vivo mouse model of murine breast cancer. 4T1 luciferase positive cells were implanted to the mammary fat pad in Balb/c mice. Treatment started on day 15, and was administered for 5 days a week for 3 weeks. The development of metastasis was detected via optical imaging. Blood, spleen, lungs, bone marrow and tumor were collected for flow cytometry, to investigate changes in myeloid-derived suppressive cells (MDSCs) populations and endothelial phenotype. Tumor and lungs were collected for protein analysis. Our results show that HPßCD-HET0016: (1) decreased tumor volume and lung metastasis compared to the vehicle group; (2) reduced migration and invasion of tumor cells and levels of metalloproteinases in the lungs of animals treated with HPßCD-HET0016 via PI3K/AKT pathway; and (3) decreased expression of pro-inflammatory cytokines, growth factors and granulocytic MDSCs population in the lung microenvironment in treated animals. Thus, HPßCD-HET0016 showed potential in treating lung metastasis in a preclinical mouse model and needs further investigations on TME.

This keynote presentation covers the chronological development of power electronics, few applications of power electronics, the importance of power electronics, the trends in power electronics, the trends in power semiconductor devices and the challenges in power electronics

Glioblastoma (GBM) was shown to relapse faster and displayed therapeutic resistance to antiangiogenic therapies (AATs) through an alternative tumor cell-driven mechanism of neovascularization called vascular mimicry (VM). We identified highly upregulated interleukin 8 (IL-8)-CXCR2 axis in tumor cells in high-grade human glioma and AAT-treated orthotopic GBM tumors.Human GBM tissue sections and tissue array were used to ascertain the clinical relevance of CXCR2-positive tumor cells in the formation of VM. We utilized U251 and U87 human tumor cells to understand VM in an orthotopic GBM model and AAT-mediated enhancement in VM was modeled using vatalanib (anti-VEGFR2) and avastin (anti-VEGF). Later, VM was inhibited by SB225002 (CXCR2 inhibitor) in a preclinical study.Overexpression of IL8 and CXCR2 in human datasets and histological analysis was identified as a bonafide candidate to validate VM through in vitro and animal model studies. AAT-treated tumors displayed a higher number of CXCR2-positive GBM-stem cells with endothelial-like phenotypes. Stable knockdown of CXCR2 expression in tumor cells led to decreased tumor growth as well as incomplete VM structures in the animal models. Similar data were obtained following SB225002 treatment.The present study suggests that tumor cell autonomous IL-8-CXCR2 pathway is instrumental in AAT-mediated resistance and VM formation in GBM. Therefore, CXCR2 can be targeted through SB225002 and can be combined with standard therapies to improve the therapeutic outcomes in clinical trials.

A CMOS amplifier architecture is presented with a voltage lowering technique so that it can be driven from a single 0.7 V bias supply. The topology does not need scaled gate voltages (or additional bias circuits) and uses branching of its bias path to reduce power requirement. A three-stage cascaded structure is adopted for high gain with the output common-drain block realizing a gain control mechanism. The technique achieves 6 dB gain regulation (with a control voltage) at the expense of small additional power (1.27 mW). A K-band architecture is simulated with a 90-nm CMOS process to verify the proposed mechanisms. The low-power (7.37 mW) unregulated front-end achieves >27 dB gain with a noise figure range of 2.99–3.06 dB within the 20.5–22.2 GHz bandwidth. Port reflection loss figures (S11 and S22) are analysed to be

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km(2)) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water.

Oral human papillomavirus (HPV) is associated with a rising incidence of certain head and neck cancers, and oral sex has been associated with oral HPV. This study sought to identify more specific patterns of oral sexual activity, including self-inoculation, that are associated with oral HPV infections in young women.A total of 1010 women attending a large university completed a computer-based questionnaire and provided oral specimens that were tested for any oral HPV using a Linear Array assay that detects any HPV as well as 37 HPV genotypes. Twenty-seven women provided additional samples up to 12 months after enrollment. Bivariable and multivariable analyses were conducted to identify oral sexual patterns and other risk factors associated with prevalent oral HPV.Nineteen women had prevalent oral HPV (1.9%), with 10 women (1%) having a type-specific infection. Oral HPV was significantly associated with lifetime coital sex partnership numbers (P = 0.03), lifetime and yearly oral sex partnership numbers (P0.01), and hand and/or sex toy transfer from genitals to mouth (P0.001). Oral HPV was also associated with greater use of alcohol, cigarettes, marijuana, and sharing of smoking devices, lipstick, or toothbrushes (P0.05 for each), with an apparent dose-response for alcohol use and smoking behavior, stratified by number of sexual partners. Of 7 women with prevalent HPV who provided follow-up samples, none had evidence of a persistent type-specific infection.These data provide additional evidence of transmission of oral HPV from oral sexual activity and also suggest possible transmission from self-inoculation or sharing of oral products.

Tumor initiation and evolution is driven by the reciprocal actions between stromal and immune cells within the tumor microenvironment (TME). Tumor-associated macrophages (TAMs) specifically M2-macrophages, a critical component of TME; participate in immune suppression, epithelial to mesenchymal transition, invasion, angiogenesis, tumor progression and subsequent metastasis foci formation. Given their prevalence in most of the human tumor tissue and correlation of their higher infiltration with lower survival, M2-macrophages represent promising targets for diagnosis, prognosis and anticancer therapy. Hence, early in vivo detection and intervention of M2-macrophages in the TME may boost the clinical outcome. Exosomes are biological nanoparticles sizing 30-150 nm, recently drawing huge attention for their potential application as therapeutic and diagnostic tool because they are more biocompatible and biodegradable with lesser toxicity than other synthetic nanoparticles and can easily percolate through the body’s barrier systems or through abnormally formed blood vessels in tumor tissue. We have generated engineered exosomes from HEK293 cells by lentiviral transfection system that carry specific peptide sequence on their external surface for targeting CD206 positive M2-macrophages. To determine the in vivo distribution of M2-macrophages, we adopted 111In-oxine based radio-labeling of the targeted exosomes and single-photon emission computed tomography (SPECT). Up to the time, among the used techniques, nuclear imaging is the foremost method to trace exosomes in vivo for better tissue penetration, sensitivity and quantitative analysis. After the labeling with 111In-oxine, we analyzed the binding efficacy and serum stability of the targeted exosome by thin layer paper chromatography (TLPC) using 100% methanol and 2M Sodium acetate solution (1:1) as eluent. More than 98% of 111In-oxine was bound to exosomes and only 5% of free 111In-oxine was dissociated from the exosomes even 24 hours after the incubation with 20% serum. When we injected these radio-labeled targeted exosomes in to 4T1 breast tumor-bearing mice, they went mostly to the periphery of the primary tumor, metastatic area in the lungs, spleen and to the liver. We performed ex vivo quantification of radioactivity from individual organ by gamma counter after final SPECT scan and observed similar distribution of the radio-labeled targeted exosomes. We also labeled the exosomes with DiI dye and injected into the same mice followed by euthanasia after 3 hours and organ collection. Fluorescent imaging from the tumor and spleen showed the adherence of exosomes to the CD206 positive macrophages confirming the targeting efficacy of the exosomes. Henceforth, we intend to utilize these exosomes as a therapeutic probe for carrying chemotherapeutic or antibody to intervene the actions of M2-macrophages in primary and distal TME. Citation Format: Mohammad H. Rashid, Thaiz F. Borin, Roxan Ara, Kartik Angara, Achyut Bhagelu, Jingwen Cai, Yutao Liu, Ali S. Arbab. CD206 positive M2-macrophage targeting engineered exosomes as a potential diagnostic and therapeutic tool [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1139.

Despite the fact that security monitoring system is high in communications using optical fibre, communications are still easy to be penetrated and information could be stolen. Companies have developed tools and equipment bugging and stealing data sent over optical fibre network, especially in those areas experiencing high loss of optical signal. Thus, it has become necessary to design and construct monitoring and warning system to avoid penetration or access to optical cable network. It is more convenient to install field application and control security system for optical cable communications that are parallel with the oil transportation pipeline. The project aims to sending a signal light with low-power ability and sensitivity by using Wavelengths Division Multiplexer (WDM), Dense Wavelengths Division Multiplexer (DWDM), and Optical Time Domain Reflect Meter (OTDR) as measurement and Optical Spectrum Analyser as a detector (OSA). The system is then used in monitoring oil and gas pipeline leakage or muggers and monitoring damage in the body of dams by adding fibre optics sensors. The sensors are to be distributed on the surface and connected with each other in the form of retinal rings to reach the receiving devices. It could also monitor ranges reaching to up about a hundred kilometres.

The significant impact of infrastructure projects on the environment has created needs to assess its sustainability and responsiveness which indirectly respond to carbon emission reduction. A rating system is widely utilized as a tool to analyze the sustainability of buildings or infrastructures. Malaysia is one of the advanced nations which applies in road green rating system, whereby two rating systems for roads are established; MyGHI for highways and pHJKR (Roads) for non-tolled roads. Preliminary study on pHJKR (Roads) identified that this rating tool assesses road sustainability performance only at planning, design & construction stages. Since the establishment of pHJKR (Roads), no re-assessment has been carried out after the roads begin to operate. Whilst in sustainability resiliency, it is important to sustain its engineering and enhance its performance and services including carbon assessment, under operation and maintenance (OM MyGHI for highways and pHJKR (Roads) for non-tolled roads. Preliminary study on pHJKR (Roads) identified that this rating tool assesses road sustainability performance only at planning, design & construction stages. Since the establishment of pHJKR (Roads), no re-assessment has been carried out after the roads begin to operate. Whilst in sustainability resiliency, it is important to sustain its engineering and enhance its performance and services including carbon assessment, under operation and maintenance (O&M) of roads. This paper highlights the methodology of development for assessment criteria and elements during the operation and maintenance phase. The methodology leads to proposed score development which later will be used in association to index indicator for O&M pHJKR (Roads). The data for this study is gathered and analyzed from a comprehensive review of current pHJKR (Roads) with a comparison made to national and cross-nation green road rating index. An expert panel discussion will also be utilized as a method of verification in order to identify suitable sustainability factors during O&M. The outcome of the study will be proposed for the enhancement of pHJKR (Roads) with assessment criteria for operation and maintenance phase and eventually leads to the establishment of multiple life cycle phases for pHJKR (Roads).

Objectives To investigate final-year dental students' perceived motivation for choosing dentistry as a professional career at one dental school in the United Arab Emirates (UAE). Method Final-year dental students of Ajman University (n = 87) completed a questionnaire. Univariate and multivariate analysis of the data were undertaken using statistical software. Results A response rate of 82% (n = 71) was achieved, 65% of whom were female. Students ranged from 21 to 29 years of age. Motivation to study dentistry was led by a ‘desire to work in health care’ (93%), ‘wish to provide a public service’ (88.7%) and because ‘degree leads to a recognised job’ (84.5%). Males were significantly more likely to report ‘high income’ (84% vs. 67%; P = 0.01) and females ‘influence of family’ (80% vs. 60%; P = 0.02) as motivating influences. The reliability and internal consistency of the instrument as calculated by Cronbach's alpha was 0.82. Eight factors explaining the 71% of the variation were: ‘professional job factors’ (11.7%), ‘experience and advice’ (9.8%), ‘business and financial with independence’ (9.7%), ‘careers, advice and possibilities’ (8.9%), ‘knowledge and job security’ (8.8%), ‘health care, people and public service’ (8%), ‘family and friends’ (7.2%) and ‘career in dentistry’ (6.9%). Gender was a significant predictor of ‘business and financial’ factor (b = −0.76; P = 0.003) and age for ‘careers in dentistry’ (b = −0.18; P = 0.03). Conclusion Students are motivated by a wide range of factors similar to those found in other studies; however, business features and family influences were significantly associated with gender.

Objective: To compare the outcome of endovascular profunda femoral artery revascularization (ePFR) with ePFR and concurrent endovascular femoropopliteal revascularization (eFPR). Methods: A retrospective review of the consecutive patients with PFA and femoropopliteal vaso-occulsive disease who underwent ePFR or ePFR + eFPR for severe limb ischemia was performed. Results: A total of 18 ePFRs and 26 ePFR + eFPRs were performed; 17 (94%) ePFRs and 22 (85%) ePFR + eFPRs were technically successful. The 12-month survival free from amputation and reintervention rates following isolated ePFR were 78% and 72%, respectively, and following ePFR + eFPR were 96% and 81%, respectively. There was no significant difference in the survival free from amputation ( P = .4) or reintervention ( P = .91) rates between the 2 groups. Conclusion: These contemporary data suggest isolated ePFRs and ePFR + eFPRs are associated with good and comparable early limb salvage rates.