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The coronavirus disease 2019 (COVID -19) pandemic caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) has affected almost every country in the world, resulting in severe morbidity, mortality and economic hardship, and altering the landscape of healthcare forever. Although primarily a pulmonary illness, it can affect multiple organ systems throughout the body, sometimes with devastating complications and long-term sequelae. As we move into the second year of this pandemic, a better understanding of the pathophysiology of the virus and the varied imaging findings of COVID-19 in the involved organs is crucial to better manage this complex multi-organ disease and to help improve overall survival. This manuscript provides a comprehensive overview of the pathophysiology of the virus along with a detailed and systematic imaging review of the extra-thoracic manifestation of COVID-19 with the exception of unique cardiothoracic features associated with multisystem inflammatory syndrome in children (MIS-C). In Part I, extra-thoracic manifestations of COVID-19 in the abdomen in adults and features of MIS-C will be reviewed. In Part II, manifestations of COVID-19 in the musculoskeletal, central nervous and vascular systems will be reviewed.

Background Metformin, by reducing intracellular Mycobacterium tuberculosis growth, can be considered an adjunctive therapy to anti-tuberculosis treatment (ATT). We determined whether metformin with standard ATT reduces time to sputum culture conversion and tissue inflammation in adults with pulmonary tuberculosis (PTB). Methods In a randomized, 8-week, clinical trial, newly diagnosed, culture-positive PTB patients were randomized to standard ATT (HREZ = control arm) or standard ATT plus daily 1000 mg metformin (MET-HREZ = Metformin with Rifampicin [METRIF] arm) for 8 weeks during 2018–2020 at 5 sites in India. The primary end point was time to sputum culture conversion by liquid culture during 8 weeks of ATT. Plasma inflammatory markers were estimated in a subset. A Cox proportional hazard model was used to estimate time and predictors of culture conversion. Results Of the 322 patients randomized, 239 (74%) were male, and 212 (66%) had bilateral disease on chest radiograph with 54 (18%) showing cavitation. The median time to sputum culture conversion by liquid culture was 42 days in the METRIF arm and 41 days in the control arm (hazard ratio, 0.8; 95% confidence interval [CI], .624–1.019). After 8 weeks of ATT, cavitary lesions on X-ray (7, 5.3% vs 18, 12.9%; relative risk, 0.42; 95% CI, .18–.96; P = .041) and inflammatory markers were significantly lower in the METRIF arm. Higher body mass index and lower sputum smear grading were associated with faster sputum culture conversion. Conclusions The addition of metformin to standard ATT did not hasten sputum culture conversion but diminished excess inflammation, thus reducing lung tissue damage as seen by faster clearance on X-ray and reduced inflammatory markers. Clinical Trials Registration Clinical Trial Registry of India (CTRI/2018/01/011176)

Ectoparasites in livestock and pets are associated with the transmission of diseases of veterinary and public health importance. The paucity of data on the ectoparasite diversity of pet and domesti...

This study measures the distress and Quality of Life (QoL) among people with type II diabetics in relation to physical exercise. The study was conducted using diabetic participants chosen from various hospitals, aerobic centres, playgrounds and gyms in the city of Hyderabad in India. The participants were divided into two groups – group 1 comprising people who did not adopt physical activity as part of their diabetes management strategy and group 2 comprising people who engaged in physical activity. A quasi-experimental study was performed on both groups employing purposive and snowball sampling methods. Pearson r showed that distress is negatively correlated with QoL among type II diabetics in both groups. Independent t-test indicated that participants in group 2 showed better QoL and lower levels of distress compared to their counterparts in group 1.

Background: Diagnosis of atypical glandular cells (AGCs) is challenging to the cytopathologist due to the overlapping features of various neoplastic and nonneoplastic lesions. The aim of this study was to assess the utility of conventional Papanicolaou (Pap) smears in detecting uterine glandular lesions. Materials and Methods: Archived records of all histopathologically diagnosed endometrial adenocarcinoma and endocervical adenocarcinoma during the study period were identified. Corresponding Pap smears, if available, were retrieved. In addition, all cytologically reported AGCs and adenocarcinoma during the same period were retrieved. Pap smears of histopathology discordance cases were reviewed. The prevalence of AGC and sensitivity and specificity of Pap smears in detecting glandular lesions were calculated. Results: The prevalence of AGC was 0.65%. There were 11 false negatives and 10 false positives initially, which were reduced to 6 and 5, respectively, after the review. The sensitivity and specificity of Pap smear in detecting AGC was 72.9% and 99.81% initially, which improved marginally to 81.8% and 99.9%, respectively. Conclusions: The prevalence of AGC in Pap smears is low with a moderate sensitivity and good specificity. As the association of clinically significant lesion is high, all cases with AGC diagnosis must be followed up with colposcopic and histopathologic examination of uterus and cervix.

Unconventional methods of material removal have been developed for fulfilling the difficulties of traditional machining and appealed to be a suitable alternate approach for traditional material removal. Wire Electrical Discharge Machining (WEDM) is one among the available advanced machining process that has been mainly adopted to machine hard materials. Proper use of intelligent decision making tools helps the manufacturer to attain benefits in manufacturing fields. Haste Alloy C276 is a nickel alloy, known as difficult to machine materials and exclusively used to various engineering files such as nuclear, gas and aerospace applications. Since it has higher strength and lower thermal conductivity, it has the tendency of reduced life of tool and poor machining performance by the use of traditional machining processes. This present investigation describes the analysis on process variables and development of neural network models for WEDM process. The experimental runs are planned and analyzed by Taguchi’s approach. Grey Relational Analysis (GRA) is adopted for attaining the Grey Relational Grade (GRG) for representing a multi-performance index. An Artificial Neural Network (ANN) model has been proposed to predict the Grey Relational Grade (GRG). Grey Relational Coefficient (GRC) values which are generated by the GRA method, given as input data for developing the Neural Network (NN) model to predict the desired multi-performance index (GRG). The closeness among the actual and predicted values are derived with the help of a comparative analysis.

Highlights • Coeliac artery aneurysm is a very rare visceral artery aneurysm. • Intervention is indicated in symptomatic aneurysms and those larger than 2.5 cm. • Excision/ligation of aneurysm with revascularization is the treatment of choice. • Revascularization can be avoided in the presence of natural collateral circulation of coeliac artery., Introduction Celiac artery aneurysm is very rare visceral artery aneurysm. Symptomatic and ≥ 2.5 cm sized aneurysm requires treatment. Excision and revascularization is the most commonly employed procedure. Case presentation We report a case of ligation and excision of celiac artery aneurysm extending onto the splenic and hepatic arteries without vascular reconstruction. The patient was a 52 year old lady who was evaluated for abdominal pain and was found to have a celiac artery aneurysm involving the hepatic and splenic arteries. She was evaluated with computerized tomography and digital subtraction angiography of the abdominal vessels. These confirmed good natural collaterals from the branches of superior mesenteric artery supplying the liver, stomach and spleen. We performed ligation and excision of the aneurysm and ligation and division of hepatic, splenic and left gastric arteries as the aneurysm was extending on to these vessels, without any vascular reconstruction, utilizing the natural collaterals from the superior mesenteric artery. Discussion Ligation of celiac artery aneurysm without revascularization is often done in emergency situations. Excision and revascularization is the treatment of choice to ensure adequate blood supply to liver, spleen and stomach. We could utilize the natural collateral circulation of celiac artery from superior mesenteric artery avoiding a complex procedure of revascularization. Conclusion We present this because of the rarity of the disease as well as rarity of the technique of not performing vascular reconstruction. We emphasize on the pre-operative and operative evaluation of collateral circulation with conventional angiography and intraoperative Doppler respectively.

Pelvic floor dysfunction is a relatively common but often complex condition, presenting with a variety of clinical symptoms, especially when it involves multiple compartments. Clinical exam alone is often inadequate and requires a complementary imaging study. Magnetic resonance defecography (MRD) is an excellent noninvasive diagnostic study with its multiplanar capability, lack of ionizing radiation and excellent soft tissue resolution. It can identify both anatomic and functional abnormalities in the pelvic floor and specifically excels in its ability to simultaneously detect multicompartmental pathology and help with vital pre-operative assessment. This manuscript reviews the relevant anatomical landmarks, describes the optimal technique, highlights an approach to the interpretation of MRD, and provides an overview of the various pelvic floor disorders in the different anatomical compartments.

This article proposes an optimal control for renewable energy-based microgrid. The proposed microgrid is composed of the solar photovoltaic systems (SPV), battery energy storage system (BESS) at bu...

The coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) has affected almost every country in the world resulting in severe morbidity, mortality and economic hardship, altering the landscape of healthcare forever. Its devastating and most frequent thoracic and cardiac manifestations have been well reported since the start of the pandemic. Its extra-thoracic manifestations are myriad and understanding them is critical in diagnosis and disease management. The role of radiology is growing in the second wave and second year of the pandemic as the multiorgan manifestations of COVID-19 continue to unfold. Musculoskeletal, neurologic and vascular disease processes account for a significant number of COVID-19 complications and understanding their frequency, clinical sequelae and imaging manifestations is vital in guiding management and improving overall survival. The authors aim to provide a comprehensive overview of the pathophysiology of the virus along with a detailed and systematic imaging review of the extra-thoracic manifestation of COVID-19. In Part I, abdominal manifestations of COVID-19 in adults and multisystem inflammatory syndrome in children will be reviewed. In Part II, manifestations of COVID-19 in the musculoskeletal, central nervous and vascular systems will be reviewed.

Epilepsy affects around 50 million people across the globe and is the third most common chronic brain disorder. It is a non-communicable disease of the brain that affects people of all ages. It is accompanied by depression, anxiety, and substantially increased morbidity and mortality. A large number of third-generation anti-epileptic drugs are available, but they have multiple side-effects causing a decline in the quality of life. The inheritance and etiology of epilepsy are complex with multiple underlying genetic and epigenetic mechanisms. Different neurotransmitters play intricate functions to maintain the normal physiology of various neurons. If there is any dysregulation of neurotransmission due to aberrant transmitter levels or their receptor biology, it can result in seizures. In this review, we have discussed the roles played by various neurotransmitters and their receptors in the pathophysiology of epilepsy. Drug-resistant epilepsy (DRE) has remained one of the forefront areas of epilepsy research for a long time. Understanding the mechanisms underlying DRE is of utmost importance because of its high incidence rate among epilepsy patients and increased risks of psychosocial problems and premature death. Here we have enumerated various hypotheses of DRE. Further, we have discussed different non-conventional therapeutic strategies, including combination therapy and non-drug treatment. The recent studies supporting the modern approaches for the treatment of epilepsy have been deliberated with particular reference to the mTOR pathway, breakdown of the blood-brain barrier, and inflammatory pathways.

In this work, we have reported the electrical transport properties of two-dimensional molybdenum disulfide (MoS 2 ) nanosheets prepared by supercritical fluid method. Drop-casting technique has been used to make MoS 2 thinfilm. The surface morphology and crystallinity of as-prepared MoS 2 are studied using TEM, AFM, Raman and X-ray diffraction analyses. The observation of non-linear current-voltage ( I-V ) characteristics has been analyzed with different current conduction mechanisms such as Schottky barrier (SB), space-charge limited conduction, Fowler-Nordheim tunneling, and Poole-Frenkel conduction. Clear symmetricity in I-V curves confirms that charge-transport is not influenced by SB. However, all other transport mechanisms are to be found responsible for the non-linearity. The charge carrier mobility of the device is determined as ~1530 cm 2 /V s which is the highest value among supercritical fluid processed MoS 2 to-date. The presence of bulk counterpart in MoS 2 is accountable for such anomalous transport behavior and it is supported by Raman mapping analysis, evidently. Overall, our results demonstrate the understanding of the fundamental charge transport mechanisms in MoS 2 thinfilm that can be the essential factors in development of various MoS 2 based electronic devices and their applications.

Funders and policy makers have strongly recommended the uptake of the FAIR principles in scientific data management. Several initiatives are working on the implementation of the principles and standardized applications to systematically evaluate data FAIRness. This paper presents practical solutions, namely metrics and tools, developed by the FAIRsFAIR project to pilot the FAIR assessment of research data objects in trustworthy data repositories. The metrics are mainly built on the indicators developed by the RDA FAIR Data Maturity Model Working Group. The tools’ design and evaluation followed an iterative process. We present two applications of the metrics: an awareness-raising self-assessment tool and an automated FAIR data assessment tool. Initial results of testing the tools with researchers and data repositories are discussed, and future improvements suggested including the next steps to enable FAIR data assessment in the broader research data ecosystem.

Relay coordination is one of the most significant and difficult task in Radial Distribution System. The Radial Distribution System interconnected with the Distributed Generation like solar PV system and wind generator. It carries new challenges in standard protection systems and their coordination losses in between primary and backup relays. In this system relay pickup currents and time multiplier settings are changed for proper relay coordination. In this paper a method has been proposed for appropriate relay coordination and has been analysed for the test system. The IEEE-13 bus system has been considered for the proposed method. Mi-Power software is used for the simulation purpose.

Intrusion detection system (IDSs) are important to industries and organizations to solve the problems of networks, and various classifiers are used to classify the activity as malicious or normal. Today, the security has become a decisive part of any industrial and organizational information system. This chapter demonstrates an association rule-mining algorithm for detecting various network intrusions. The KDD dataset is used for experimentation. There are three input features classified as basic features, content features, and traffic features. There are several attacks are present in the dataset which are classified into Denial of Service (DoS), Probe, Remote to Local (R2L), and User to Root (U2R). The proposed method gives significant improvement in the detection rates compared with other methods. Association rule mining algorithm is proposed to evaluate the KDD dataset and dynamic data to improve the efficiency, reduce the false positive rate (FPR) and provides less time for processing.

Background: Percutaneous nephrolithotomy (PCNL) is an effective minimally invasive surgical modality for the management of renal calculi. It is generally considered safe with commonly encountered complications being urinary extravasation, fever, and bleeding. Injury to the biliary tract or puncture of the gallbladder is an extremely rare but a grave complication of PCNL. Case Presentation: We present a case of a 70-year-old man who underwent PCNL for an obstructing right renal pelvic calculus. Upon middle caliceal puncture to access the pelvicaliceal system, an unexpected green aspirate suggestive of bile was noted egressing through the puncture needle when stiletto was detached. The needle was swiftly withdrawn and percutaneous renal access was effective on the second puncture to complete the procedure. In the postoperative period, biliary ascites was confirmed on imaging, which was managed in a minimally invasive manner with an ultrasonography-guided abdominal drain insertion. The patient recovered well and was discharged home. Conclusion: Biliary ascites with or without peritonitis is a rare but potentially fatal consequence of biliary tract injury that can occur during PCNL. If there is recognition of biliary aspirate during a percutaneous renal procedure, aggressive management, including diverting the biliary fluid in appropriately selected cases, can obviate the need for emergent open or laparoscopic surgical intervention as highlighted in our case.

Intrusion detection systems must detect the vulnerability consistently in a network and also perform efficiently with the huge amount of traffic. Intrusion detection systems must be capable of detecting emerging and proactive threats in the networks. Various classifiers are used to classify the threats as normal or intrusive by supervising the system activity. In this chapter, layered fuzzy rule-based classifier is proposed to detect the various intrusions, and fuzzy entropy-based feature selection is proposed to identify the relevant features. Layered fuzzy rule-based classifier is proposed to improve the performance of the intrusion detection system. KDD dataset contains various attacks; these attacks are grouped into four classes, namely Denial-of-Service (DoS), Probe, Remote-to-Local (R2L), and User-to-Root (U2R). Real-time dataset is also considered in this research. Experimental result shows that the proposed method provides good detection rate, minimizes the false positive rate, and less computational time.

Post-operative adhesions can occur following abdominal or pelvic surgery and are a significant cause of morbidity and mortality. Adhesions are an important cause of abdominal complaints, especially chronic abdominal pain, infertility, and bowel obstruction; responsible for an estimated $2.3 billion annual burden in the United States alone. There is a paucity of literature describing CT findings indicative of the presence of adhesions, however, findings suggestive of this entity may be discovered by a discerning eye. Early recognition and diagnosis may be beneficial for reducing consumption of health-care resources related to abdominal complaints. In addition, these findings may impact surgical planning and facilitate recognition of adhesion-related complications, said to be responsible for a significant number of malpractice claims. The following review discusses various CT findings which may indicate the presence of adhesions. These findings may initially be overlooked, but remain valuable as the clinical presentation evolves to become consistent with adhesive disease. Detection of bowel and peritoneal adhesions can be recognized on imaging modalities based on distortion of bowel loops. This pictorial review illustrates the spectrum of findings related to bowel adhesions encountered on computed tomography imaging.

According to Moore's Law, number of transistors on chip doubles in every next two years, So the complexity of the circuit increases. So it needs to be careful in designing and verification. Register Transfer Level (RTL) designing and its verification is also most important part of circuit design. The intent behind verification is to check that design meets all system specification and requirements or not. It is important to verify RTL before simulation and synthesis the design because It save clock cycle and time of simulation. This paper is focused on the RTL verification tool, Such as HAL linting and Spyglass RTL signoff tool. This type of RTL verification is used to find bugs and error in design before synthesis. It is easy to debug RTL design and pinpoint the problem and their solution. It is important to identify design issues as early as possible before synthesis RTL design.

Instruments play an essential role in creating research data. Given the importance of instruments and associated metadata to the assessment of data quality and data reuse, globally unique, persistent and resolvable identification of instruments is crucial. The Research Data Alliance Working Group Persistent Identification of Instruments (PIDINST) developed a community-driven solution for persistent identification of instruments which we present and discuss in this paper. Based on an analysis of 10 use cases, PIDINST developed a metadata schema and prototyped schema implementation with DataCite and ePIC as representative persistent identifier infrastructures and with HZB (Helmholtz-Zentrum Berlin f\"ur Materialien und Energie) and BODC (British Oceanographic Data Centre) as representative institutional instrument providers. These implementations demonstrate the viability of the proposed solution in practice. Moving forward, PIDINST will further catalyse adoption and consolidate the schema by addressing new stakeholder requirements.

Pressing environmental and societal challenges demand the reuse of data on a much larger scale. Central to improvements on this front are approaches that support structured and detailed data descriptions of published data. In general, the reusability of scientific datasets such as measurements generated by instruments, observations collected in the field, and model simulation outputs, require information about the contexts through which they were produced. These contexts include the instrumentation, methods, and analysis software used. In current data curation practice, data providers often put a significant effort in capturing descriptive metadata about datasets. Nonetheless, metadata about instruments and methods provided by data authors are limited, and in most cases are unstructured.The ‘Interoperability’ principle of FAIR emphasizes the importance of using formal vocabularies to enable machine-understandability of data and metadata, and establishing links between data and related research entities to provide their contextual information (e.g., devices and methods). To support FAIR data, PANGAEA is currently elaborating workflows to enrich instrument information of scientific datasets utilizing internal as well as third party services and ontologies and their identifiers. This abstract presents our ongoing development within the projects FREYA and FAIRsFAIR as follows:Integrating the AWI O2A (Observations to Archives) framework and associated suite of tools within PANGAEA’s curatorial workflow as well as semi-automatized ingestion of observatory data. Linking data with their observation sources (devices) by recording the persistent identifiers (PID) from the O2A sensor registry system (sensor.awi.de) as part of the PANGAEA instrumentation database. Enriching device and method descriptions of scientific data by annotating them with appropriate vocabularies such as the NERC device type and device vocabularies or scientific methodology classifications. In our contribution we will also outline the challenges to be addressed in enabling FAIR vocabularies of instruments and methods. This includes questions regarding reliability and trustworthiness of third party ontologies and services. Further, challenges in content synchronisation across linked resources and implications on FAIRness levels of data sets such as dependencies on interlinked data sources and vocabularies.We will show in how far adapting, harmonizing and controlling the used vocabularies, as well as identifier systems between data provider and data publisher, improves the findability and re-usability of datasets , while keeping the curational overhead a slow as possible. This use case is a valuable example of how improving interoperability through harmonization efforts, though initially problematic and labor intensive, can benefits to a multitude of stakeholders in the long run: data users, publishers, research institutes, and funders.

In the present work, an attempt has been made to develop polybenzoxazine- silica hybrid through in-situ sol–gel method using renewable bio-resource raw materials such as cardanol and furfurylamine for high thermal and flame retardant applications. In this context, a new approach has been adopted to incorporate an inorganic component (MPTMS) in to cardanol benzoxazine (BZ–C–F) via chemical interaction between the unsaturated group of cardanol and mercapto group (–SH) of MPTMS by thermally initiated thiol-ene click reaction. The developed PBZ–C–F–silica hybrids were characterized for their molecular structure, thermal and flame resistant properties using modern analytical techniques. Data obtained from thermal and flame retardant studies, it is suggested that the developed PBZ–C–F–silica hybrid can be used in the form of coatings, sealants, encapsulants and matrices for thermally stable and flame retardant applications.

Digestive tract cancer patients treated with oxaliplatin are often associated with the development of peripheral neuropathy. The aim of the present study is to identify the influence of single-nucleotide polymorphisms (SNPs) in genes involved in oxaliplatin metabolism, cell cycle control, detoxification or excretion pathways with the development of oxaliplatin-induced acute peripheral neuropathy (acute OXAIPN) and its severity among digestive tract cancer patients treated with oxaliplatin-based chemotherapy. A total of 228 digestive tract cancer patients undergoing with the oxaliplatin-based chemotherapy between November 2014 and December 2016 were included in the current study. Genomic DNA was extracted from peripheral blood by standard phenol–chloroform method. Genotyping of five SNPs in four genes [GSTP1 (rs1965), ABCG2 (rs3114018), CCNH (rs2230641, rs3093816), AGXT (rs4426527)] was carried out by Real-Time TaqMan SNP genotyping assay. We found that the two genetic variants rs2230641 and rs3093816 in cyclin H (CCNH) gene were significantly associated with both the incidence and severity of acute OXAIPN. For CCNH-rs2230641 (AA vs AG+GG; dominant model) Incidence: OR 2.62, 95% CI 1.44–4.75, p = 0.001, severity; OR 4.64, 95% CI 1.58–13.62, p = 0.002. For CCNH-rs3093816 (AA vs AG+GG; dominant model); incidence: OR 3.43, 95% CI 1.57–7.50, p = 0.001; severity: OR 2.36, 95% CI 1.05–5.30, p = 0.033. The results of the present study found significant association between CCNH polymorphisms and acute OXAIPN development. However, further studies are warranted from independent groups to validate our study results.

Based on IEEE 802.11p and IEEE 1609.4 protocols, vehicular ad hoc network (VANETs) transmit safety and non-safety packets through multichannel. Due to the increase in usage of various infotainment applications, the quality-of-service (QoS) is not met in VANETs resulting in high congestion over transmission. To ensure QoS in safety, transport efficiency and infotainment applications, we proposed a multichannel approach with optimal minimum contention window (CW) technique named as reinforcement learning and multichannel MAC protocol (RL- M -MAC). In this paper, an algorithm is proposed to select the channel for transmission. Proposed RL-M-MAC protocol uses conditional Markov chain technique to identify the optimal CW value. Theoretical performance analysis and extensive simulation results shows that RL-M-MAC protocol can support QoS services with lower collision probability, higher throughput, and high fairness.

The need for a new antibiotic pipeline to confront threat imposed by resistant pathogens has become a major global concern for human health. To confront the challenge there is a need for discovery and development of new class of antibiotics. Nature which is considered treasure trove, there is re-emerged interest in exploring untapped microbial to yield novel molecules, due to their wide array of negative effects associated with synthetic drugs. Natural product researchers have developed many new techniques over the past few years for developing diverse compounds of biopotential. Taking edge in the advancement of genomics, genetic engineering, in silico drug design, surface modification, scaffolds, pharmacophores and target-based approach is necessary. These techniques have been economically sustainable and also proven efficient in natural product discovery. This review will focus on recent advances in diverse discipline approach from integrated Bioinformatics predictions, genetic engineering and medicinal chemistry for the synthesis of natural products vital for the discovery of novel antibiotics having potential application. Keywords: Genome mining, Genome shuffling, Metabolomics, Combinatorial synthesis and antibiotics

Implant abutment connection has proven to have a significant impact on the success of the prosthetic rehabilitation for an implant-supported restoration. This connection not only provides the base on which the restoration is supported but also maintains the integrity of the hard and the soft tissues surrounding the implant. In this review, we describe the performances of different implant-abutment connections that are the external implant connections, internal implant connections, and the Morse taper connections in terms of their mechanical properties, biological properties, and its biomechanical effects.

Background & objectives: Genetic aberrations disrupting toll-like receptor and interferon homeostasis enhance the risk of systemic lupus erythematosus (SLE). Raised serum interferon-alpha (IFN-α) levels in SLE patients have been ascribed to polymorphism (rs2004640 G/T) in interferon regulatory factor 5 (IRF5) gene, resulting in enhanced transcript splicing. A positive association between IRF5 polymorphism and SLE risk has been reported in many populations. This study was aimed to find out frequency of IRF5 rs2004640 G/T polymorphism in patients with SLE and healthy controls and to assess its influence on susceptibility, clinical and serological characteristics of SLE. Methods: IRF5 rs2004640 (G/T) polymorphism was analyzed in 300 SLE patients and 460 age and sex matched controls by real-time PCR. Results: The IRF5 rs2004640 (G/T) polymorphism did not confer risk of SLE or influence clinical or serological phenotype. However, the mutant allele conferred a borderline risk to develop thrombocytopenia (odds ratio: 2.05, 95% confidence interval: 0.97–4.3, P=0.06) in patients with SLE. Interpretation & conclusions: Our study revealed that the IRF5 rs2004640 polymorphism was not a risk factor for SLE in population from south India. It may, however, be a useful genetic marker for thrombocytopenia in SLE patients. Although we could not demonstrate susceptibility toward lupus in the presence of IRF5 rs2004640 (G/T) polymorphism, further exploration of the genetic variability of IRF5 may help uncover its pathogenic role in Indian SLE patients.

Advanced lightweight materials like laminated composite cylindrical shells and laminated plates are used in modern aerospace structures, military and automotive industries for enhancing their structural efficiency and performance. Such thin walled structures are defenseless against to buckling when subjected to static and dynamic compressive stresses.In this work, the Experimental and the numerical (finite element analysis) analysis on buckling loading conditions of carbon fiber reinforced plastics (CFRP) layered composite plates was analyzed. Here different geometric sections are considered for analysis of buckling load namely composite plate with and without hole.These analyses were carried out by using ANSYS 15.0 software with further experimental observations on buckling testing on composite plates. Finally the Experimental observation is compared with Numerical analysis.

Background: Chronic otitis media is one of the commonest conditions managed in otolaryngology practice. In developing countries such as India, advanced disease presentation is often seen mostly owing to lack of awareness of the disease and its potential complications, long distance between the patient’s home and the treatment centre, causing delay in treatment. Surgical management is the mainstay of treatment of chronic otitis media.Methods: The aim of this study was to retrospectively analyze the patients with complex chronic middle ear disease, who underwent tympanomastoid surgery. Forty-seven patients (4.9%) out of a total of 968 patients with chronic otitis media presented with complex advanced disease and challenging intra-operative situations at our tertiary referral centre between January 2016 to December 2020. The extent of disease, associated complications, challenges in surgical management, and the eventual outcomes were studied in detail.Results: Among these forty-seven patients, there were 24 males and 23 females. Of the 47 patients, 8 were children (17%). Extensive cholesteatoma causing facial palsy, labyrinthine fistula, dural involvement, internal auditory meatus involvement, extensive granulations extending into the inner ear through the oval or round window, extensive tympanosclerosis was noted in these patients. All patients underwent surgical management, and achieved satisfactory outcomes.Conclusions: Advanced chronic otitis media has the potential to pose various challenges during tympanomastoid surgery. Appropriate planning for surgery aiming at complete disease clearance, meticulous after-care and long-term surveillance result in favorable outcomes.

Background Heart disease is the leading cause of death in the world, and coronary angiography (CAG) is the standard test for detection of critical diseases. Nearly 25% patients undergoing angiography are found to have normal coronary arteries (NCAs). Recent publications say that the follow-up of the NCA patients is not benign. Aim The main objective of this study is to know outcomes of patients diagnosed with normal coronaries on conventional angiograms. Methods This is a single-center observational study. The authors collected the data of patients who came for CAG to their institute from January 1 to December 31, 2014. They included the patients who have normal coronaries in this study. The indication to do the CAG is chest pain (angina) for evaluation. The authors contacted every patient telephonically to know the outcomes after 2 years of CAG. The telephonic data were collected either from patients or from attendants by asking the questionnaire about the present status of patients. Results The authors collected the data of 1,526 patients who underwent the CAG during study period. Out of 1,526 patients, 201 patients with mean age of 52.45 ± 10.7 years met the inclusion criteria; 108 (53.73%) were hypertensives and 57 (28.36%) were diabetic. Acute coronary syndrome (ACS) was the presenting symptom in 28 (13.9%) of patients; the remaining patients presented with chronic stable angina (CSA). Left ventricular (LV) dysfunction was present in 15 (7.5%) of patients. At the 2-year follow-up, 12 (5.9%) patients were symptomatic, and out of them, 7 died (mortality 3.5%).The binary logistic regression showed that only blood urea (BU) was determinant factor for mortality (p = 0.022). Even LV dysfunction (p = 0.39) was not a contributor for mortality. A subanalysis of gender also showed similar findings (male, p = 0.02; female, p = 0.05). Conclusion In angina patients with NCA on CAG, the BU showed statistical significance for morality. This is true even on further sex-based analysis (male, p = 0.02; female, p = 0.05). This study helps understand that even the people with normal coronaries, they may have the symptomatic outcomes, not only because of coronaries and also with other associated diseases.

This paper investigates the thermal performance of a newly prepared Nano-enhanced phase change material (NEPCM), constituting SiO2 Nanoparticles (NPs) in myristic acid. SiO2 NPs with mass fractions of 0.2 wt%, 0.5 wt%, 0.8 wt% and 1.0 wt% were suspended in myristic acid, which serves as the base Phase change material (PCM) separately, to determine the maximum enhancement of thermal conductivity. The size and morphology of the as synthesized SiO2 NPs were studied by Field emission scanning electron microscopy (FESEM). The phase change properties of NEPCMs were assessed with the help of Differential scanning calorimetry (DSC). The thermal conductivity enhancement of NEPCMs was measured using a Laser flash analyzer (LFA). Results clearly indicate that the duration of the melting and solidification processes of NEPCMs decreased compared to that of the base PCM. Thus, the newly prepared NEPCM is a potential candidate for harvesting solar energy for low-temperature heating systems.

Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system that provides standardization in the interpretation and reporting of observations in patients at risk of developing hepatocellular carcinoma (HCC). Computed tomography/magnetic resonance imaging (CT/MRI) LI-RADS v2018 includes 8 diagnostic categories, which reflect the probability of benignity, malignancy in general, or HCC specifically. This article reviews the diagnostic categories of CT/MRI LI-RADS v2018, highlighting the key imaging features, diagnostic criteria, and management implications.

The paper provides a comparative overview of machine learning techniques in medical diagnosis. We present a performance evaluation analysis of some of the state-of-the-art machine learning approaches applied for medical diagnosis. The research considered six machine learning classification algorithms: Naive Bayes (NB), Logistic Regression (LR), Support Vector Machine (SVM), Linear Discriminant Analysis (LDA), and two decision trees classifying algorithms: C5.0 and Random Forest. UCI three medical data sets: Cleveland Heart Disease dataset, Wisconsin Diagnostic Breast Cancer dataset, and Pima Indians Diabetes Datasets. Our experimental results show the SVM classification algorithm has achieved the most promising result over all the three medical datasets.

Renal biopsy is an essential tool that is underutilized in the management of T1a small renal masses. Image-guided biopsy has the potential to establish a diagnosis, assess severity, and determine prognosis for patients with a renal mass that would otherwise be subjected to surgical intervention. Ultrasound technology is familiar to urologists, as it is widely applied to prostate biopsy. In a select group of patients, office-based ultrasound-guided renal mass biopsy has shown to be a safe and cost-effective alternative to hospital-based procedures. In this chapter, we will discuss patient selection, biopsy technique, complications, and outcomes of percutaneous office-based renal biopsy.

The aim of this research work is to study the density and dielectric properties of the functionally graded ceramic material with fused silica. The low density and low dielectric properties of this material made it use in the aerospace applications significantly such as, radomes which are used in protecting the radar antenna from high temperature and typical environmental conditions. The fused silica samples are produced by slip casting process with uniform density and sintered up to high temperatures to achieve desired strength, density and the dielectric properties. It has been observed that the properties have shown significant change with the change in time and temperature of the sintering process.

The pelvic floor is composed of a network of muscles, ligaments, and fasciae, which provide active and passive support for the pelvic organs. Impairment of these pelvic floor elements can result in a variety of functional abnormalities and single or multicompartment organ prolapse. Knowledge of normal pelvic floor anatomy can aid the radiologist in understanding the complex nature of pelvic floor dysfunction and is important for comprehensive image interpretation. This article provides an overview of normal anatomy of the pelvic floor as seen on magnetic resonance imaging, ultrasound, and fluoroscopic studies performed in the evaluation of pelvic floor function.

Terrestrial and oceanic carbon sinks together sequester >50% of the anthropogenic emissions, and the major uncertainty in the global carbon budget is related to the terrestrial carbon cycle. Hence, it is important to understand the major drivers of the land carbon uptake to make informed decisions on climate change mitigation policies. In this paper, we assess the major drivers of the land carbon uptake—CO2 fertilization, nitrogen deposition, climate change, and land use/land cover changes (LULCC)—from existing literature for the historical period and future scenarios, focusing on the results from fifth Coupled Models Intercomparison Project (CMIP5). The existing literature shows that the LULCC fluxes have led to a decline in the terrestrial carbon stocks during the historical period, despite positive contributions from CO2 fertilization and nitrogen deposition. However, several studies find increases in the land carbon sink in recent decades and suggest that CO2 fertilization is the primary driver (up to 85%) of this increase followed by nitrogen deposition (∼10%–20%). For the 21st century, terrestrial carbon stocks are projected to increase in the majority of CMIP5 simulations under the representative concentration pathway 2.6 (RCP2.6), RCP4.5, and RCP8.5 scenarios, mainly due to CO2 fertilization. These projections indicate that the effects of nitrogen deposition in future scenarios are small (∼2%–10%), and climate warming would lead to a loss of land carbon. The vast majority of the studies consider the effects of only one or two of the drivers, impairing comprehensive assessments of the relative contributions of the drivers. Further, the broad range in magnitudes and scenario/model dependence of the sensitivity factors pose challenges in unambiguous projections of land carbon uptake. Improved representation of processes such as LULCC, fires, nutrient limitation and permafrost thawing in the models are necessary to constrain the present-day carbon cycle and for more accurate future projections.

Objective Extended-field radiotherapy (EFRT) with concurrent chemotherapy represents standard treatment in cervical cancer patients with para-aortic lymph nodal (PALN) metastasis. While EFRT with Intensity Modulated RT (IMRT) has been demonstrated to reduce toxicities, the dose thresholds for minimizing acute toxicity is not clear. The present study was undertaken to report the early toxicity with extended-field intensity-modulated radiotherapy (EF-IMRT) for carcinoma of the cervix in our cohort of patients and determine dose-volume parameters that predict ≥grade II haematological toxicity and diarrhoea. Methodology This was a retrospective study of consecutive cervical cancer patients with PALN metastasis treated with EF-IMRT. Patients received rotational IMRT +/- neoadjuvant chemotherapy (NACT) and/or concurrent chemotherapy (45-50 Gy/25#/5 weeks) followed by high-dose rate brachytherapy. Acute haematological and gastrointestinal toxicity (diarrhoea and vomiting) was correlated with doses received by bowel and marrow. Receiver operator characteristics curves were used for deriving thresholds that predict for increased toxicity and tested on univariate and multivariate analysis. Finally, disease free and overall survival (DFS and OS) was calculated. Results A total of 43 patients were included. One-fourth of the patients (11/43) received NACT and 88% received concurrent chemotherapy. Within the upfront EF-IMRT cohort, 22.6% and 9.7% patients developed grade ≥III haematological (HT) and gastrointestinal (GI) toxicity respectively, with an increase in HT (≥ grade III HT =67%) in patients receiving NACT (p = 0.007). In the entire cohort bone marrow Volume receiving 10 Gy (V10>) 90% correlated with an increase in ≥ grade III HT (p = 0.05). No dose volume thresholds could be validated for GI toxicity. The OS and DFS at 2 years was 56% and 54%, respectively. Conclusion EF-IMRT is a feasible option for cervical cancer patients with PALN involvement and is associated with acceptable grade III toxicity. Future studies need to focus on minimizing HT toxicity.

With the technology of Network Function Virtualization (NFV), a multicast service (e.g., real-time multimedia streaming or event monitoring) may be accommodated with a Service Function Chain (SFC). The SFC consists of an ordered set of network functions running on generic physical hardware to provide services from source node to each destination node of the multicast service. In this paper, we define the problem of Multicast-aware Service Function Tree Embedding (M-SFTE), which allows the multicast flows to traverse through network service functions before reaching destination nodes. The M-SFTE maps user's SFC-based multicast requests onto a shared substrate network while considering the constraints of network functionality, computing demand of each virtual network function node, and the bandwidth demand of the request. We propose a novel algorithm, called Minimum Cost Multicast Service Function Tree (MC-MSFT) to jointly optimize the process of constructing SFC-based multicast tree and allocating requested resource to embed the tree onto the physical network. The experimental results show that the MC-MSFT algorithm outperforms the traditional greedy-based algorithms as much as by 35% in terms of the total bandwidth consumption.

Collagenofibrotic glomerulopathy is a rare condition characterized by deposition of Type III collagen fibers in the subendothelial space and mesangium of the glomerulus. Only 17 cases have been reported from India. A definite diagnosis can only be established when typical histological findings are supported by electron microscopy. It is characterized by indolent progression and has no definitive therapy.

Background: Systemic lupus erythematosus (SLE), a systemic autoimmune disease, occurs due to disruption of immune homeostasis against self-antigens. The etiology of SLE is complex and multiple genetic factors contribute to disease susceptibility and clinical phenotypes. Protein tyrosine phosphatase, nonreceptor type 22 (PTPN22) is a lymphoid-specific phosphatase that negatively regulates T-cell receptor signaling and is responsible for the maintenance of T-cell homeostasis. Genetic aberrations affecting the function of PTPN22 result in the proliferation of autoreactive T-cells and development of autoimmune diseases. Methods: We carried out a case–control genetic study to analyze the association of PTPN22 R620W polymorphism (rs2476601) with disease susceptibility and clinical and autoantibody profile in Indian Tamils with SLE. Three hundred SLE patients satisfying the 1997 revised American College of Rheumatology classification criteria for SLE were enrolled in the study. Disease activity was measured using the SLE Disease Activity Index. We recruited 460 age-, sex-, and ethnicity-matched individuals without a family history of autoimmune diseases as control population. Genomic DNA was extracted from the blood sample by salting-out method. The PTPN22-1858C->T (rs2476601) polymorphism was screened by polymerase chain reaction-restriction fragment length polymorphism. Results: The frequency of the ancestral allele “C” was similar in both cases and controls (99.3% and 99.8%, respectively) and the mutant allele “T” was less frequent in South Indian Tamil population; it did not influence clinical or serological phenotypes. Conclusion: Our findings suggest that the PTPN22 (rs2476601) polymorphism is less frequent and did not confer a risk for lupus or its associated clinical or serological phenotypes in South Indian Tamils.

This paper presents a metadata model for physical samples, developed by CSIRO for its role as an allocating agent. The model is essential for connecting various samples to the Web in a systematic manner. It serves as a basis for registering and publishing samples from researchers and laboratories in CSIRO with the International Geo Sample Number (IGSN). The model is simple, extensible and publicly available. We specify how existing controlled vocabularies are incorporated into the model development, and discuss their relevance and limitations. We also describe the mappings between the developed model and existing standards. This is necessary to extend the model's adoption across various science domains. The model has been implemented and tested in the context of two large sample repositories in CSIRO. The results demonstrate the effectiveness of the metadata model while maintaining its flexibility to adapt to various sample types.

In the network several problems are caused due to the presence of malicious nodes. It is very important to find the malicious nodes in the network in order to eliminate the problems caused by those nodes. This paper proposes a model where Reed-Muller codes are used to find the locations of the malicious nodes and calculate the probability that a node is malicious. Based on the probability of each malicious node, the system localizes or discards the nodes which have higher error probability. Sometimes removal of a malicious node causes breakage of network into parts i.e. if it is an articulation point. It leads to the reconstruction of the network. This reconstruction process is very complex and expensive. In this case, such nodes cannot be discarded. To avoid the reconstruction of the network an algorithm is proposed to handle the malicious activity caused by an articulation point. Message tampering is the frequently occurred malicious activity in most of the networks when the communication takes place between source and destination. To handle message tampering at articulation points, this system performs error correction using Reed-Muller decoding algorithm.