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A 44-year-old female with no prior comorbidities presented with a history of easy fatiguability and yellowish discolouration of eyes of 3 months duration. On examination, she had pallor and icterus. Jugular venous pressure was elevated. Earlier, the patient was diagnosed to have autoimmune haemolytic anaemia and was started on steroids 2 weeks ago elsewhere. Laboratory investigations showed severe anaemia, elevated mean corpuscular volume and lactate dehydrogenase levels. Corrected reticulocyte count was 2.5%. Unconjugated hyperbilirubinaemia was evident. Coomb's test was positive. In view of suspicion for cold agglutinin syndrome (CAS), monospecific agglutinin test with cold agglutinin titres was done, which tested positive. Serological testing was positive for human immunodeficiency virus (HIV) 1. The patient was diagnosed to have CAS secondary to HIV infection.

Here the authors propose a crystal thermodynamics framework describing the tensor stress induced phase transformations in solids based on nonlinear elasticity and first principles calculations. The proposed approach enables balanced design of high-strength, high-ductility materials.

With the emphasis on the properties of titanium dioxide nanoparticles and numerous applications of chemical reactive distilled water due to bioconvection in the industries, nothing is known about the significance of adding titanium dioxide nanoparticles to an existing distilled water conveying aluminum oxide and zinc oxide nanoparticles when viscous dissipation, heat source, and higher buoyancy forces and thermal radiation are substantial. The governing partial differential equations that model the motion of both transport phenomena mentioned earlier were transformed into ordinary differential equations using appropriate similarity transmutations and solved with bvp4c (MATLAB built-in function). Multiple linear regression (i.e., a statistical tool used to explain outcomes related to engineering parameters of interest) was adopted for a deep scrutinization and exploration. The outcome of the analysis suggests that the thermal radiation parameter can be used to control the heat transferred via convection in the fluid flow. It is detected that the magnetic field parameter and volume fraction of nanoparticle parameters are useful to reduce the shear stress near the surface. The heat source ameliorates the fluid temperature, and the concentration of the fluid decreases with the rise in the chemical reaction parameter. Worthy to conclude that the Peclet and Schmidt number escalates the density number of motile microorganisms.

Submesoscale oceanic structures (

Abstract Earth Observation Satellite (EOS)‐04 launched on 14 February 2022, carries a C‐band Synthetic Aperture Radar (SAR) for Agriculture, Forestry, Hydrology, and Flood mapping applications. In this paper, we have used C‐band SAR images and near‐simultaneous observations from the global precipitation measurements (GPM) to study the signatures of multiple convective rain cells. The bright patches are found on C‐band SAR imagery, which depicts the information of hydrometeors such as graupels or hails in the melting layer. For the first time, unambiguously estimated the diameter of the convective core rain cells from the C‐band SAR backscattered signal and compared with near‐simultaneous observations from GPM‐GMI and Ku‐band radar to confirm our findings. Thus, the present study demonstrates the potential of C‐band SAR for identifying the signatures of convective rain cells.

A magnitude MW7.8 earthquake occurred on 25 April 2015 (referred as Gorkha earthquake). We have analyzed the spatial variation of b-value and two-dimensional strain within Nepal Himalaya before and after the Gorkha earthquake. We have used continuous Global Navigation Satellite System (GNSS) data from 30 stations in the Nepal region for geodetic strain estimation and earthquake data for b-value estimation. The GNSS data were processed using double differencing technique for the accurate position of each station. The precise velocity vectors show a general azimuth of north east for all the stations and have been used to derive two-dimensional strain. Between epicenters of Gorkha (25 April 2015) and Dolakha earthquakes (12 May 2015), we observed high co-seismic horizontal displacements (0.2 m to 2 m). In the Pre-seismic deformation study, maximum strain accumulation (56.40 × 10−9) and low b-value (0.79–0.89) was observed in and around the Western Nepal region, which may be responsible for the 2015 Gorkha earthquake. The potential seismic zones were identified by GIS based integration of geodetic strain and b-value map and superimposition using weighted overlay method. The Maximum strain and low b-value are now observed in the eastern part of Nepal. Hence, the spatial disposition of elastic energy has changed after the two major earthquakes and continuous seismic hazard assessment is required in the eastern Nepal.

Background: Ewing sarcoma (ES) with ectopic adrenocorticotropic hormone (ACTH) syndrome (ectopic ACTH) is extremely unusual. This report details the first case in English literature of pediatric ES involving the proximal aspect of the humerus with florid ectopic ACTH. Case Report: A 9-year-old girl presented with mooning of the face and abdominal distension for the past 5 months with an unremarkable history. Her serum cortisol level measured at 8 AM was 42 μg/dL (reference range, 4.3-22.4 μg/dL). Serum ACTH level of 225 pg/mL (reference range, 10-46 pg/mL) suggested ACTH-dependent Cushing syndrome. Her serum cortisol level after the overnight dexamethasone suppression test was 60 μg/dL (reference value,

A typhoon is a severe weather process in tropical oceans. Typhoon transit is often accompanied by strong convective weather, such as gales and rainstorms, which threatens fishery, property, and human safety. In this study, the effects of typhoon Chanthu on chlorophyll a (Chl a), temperature, and ocean surface salinity are analyzed using remote sensing data. The results illustrate that before the transit of Chanthu (6–12 September), the mean concentration of Chl a and sea surface salinity (SSS) are low (0.74 mg/m3, 30.59 psu, respectively), while the mean sea surface temperature (SST) is high (29.01 °C). After the typhoon transits (13–30 September), the mean Chl a concentration and salinity increase (1.29 mg/m3, 30.87 psu respectively), while the mean SST decrease (27.43 °C). The Ekman pumping transports nutrients from the deep ocean to the surface layer, promotes the photosynthesis of surface phytoplankton, and increases the concentration of sea surface Chl a. Typhoon Chanthu causes the mixing and entrainment of the upper ocean, which causes the deep cold water of the ocean to rise into the mixed layer and cause the SST to decrease. Severe vertical mixing transports deep high-salt water to the surface, causing SSS to rise. The results of this study have important scientific significance and application value for developing coastal economy, aquaculture, and fishery.

Abstract The harvested plant products, specifically, the grains of cereals are major drivers of soil phosphorus (P) depletion. However, the breeding or biotechnology efforts to develop low P seeds have not been attempted because of possible adverse effects on seedling vigour and crop establishment. Several studies have contradictory observations on influence of seed P on seedling vigour. Lack of appropriate genetic material has been the major bottleneck in reaching the consensus. In this study, we used 30 EMS induced mutants of rice cultivar Nagina22 to understand the role of seed P on seedling vigour and associated physiological processes. Seedling vigour, morpho-physiological characteristics, acid phosphatases, alpha-amylase, and expression of P transporter genes were analyzed in seedlings obtained from seeds of high and low grain P mutants. The study suggests that seed P has a significant role on seedling vigour, chlorophyll content and photosynthesis process of young seedlings, and P transport from roots. Notably, we identified few mutants such as NH4791, NH4785, NH4714, NH4663, NH4614, and NH4618 which showed least influence of low seed P on seedling vigour and other metabolic processes. Therefore, these mutants can be used in breeding programs aiming for development of low P grains. Also, these and other identified mutants can be used to decipher the genetic and molecular mechanisms regulating the differential response of seed P on germination, seedling vigour and several other physiological processes influencing the crop growth and establishment.

A 19-year-old male presented with chief complaints of generalised weakness and unintentional weight loss from 50 Kg to 45 Kg within a span of 1 month. He complained of fever for 15 days and had developed petechiae over bilateral upper limbs and bilateral subconjunctival haemorrhage. Laboratory investigations done elsewhere showed platelet count of 10,000/mm3. On further investigation, Widal test, dengue serology, and smear examination for malarial parasite, antinuclear antibodies, and viral markers were negative. Abdominal ultrasonography showed multiple conglomerative enlarged lymph nodes in peripancreatic, peripatetic and paracaval, with few of them showing necrosis and loss of hilum and minimal ascites. Bone marrow examination showed megakaryocytic hyperplasia features, suggestive of immune thrombocytopenic purpura (ITP). No improvement in the platelet count was noted with intravenous methylprednisolone. On examination, the patient had ecchymotic patches over bilateral upper limbs and bilateral subconjunctival haemorrhages. Bilateral supraclavicular lymph nodes were palpable, non-tender, mobile, measuring 3 cm × 3 cm in the right side and 2 cm × 2 cm in the left side and firm in consistency. Cervical lymph node biopsy showed caseous necrotising granulomatous inflammation. Contrast-enhanced computed tomography neck, chest and abdomen showed multiple enlarged conglomerated heterogeneous enhancing lymph nodes with central non-enhancing areas s/o necrosis noted in the neck, mediastinum and abdomen. Tuberculin skin test (Mantoux test) revealed induration of 20 mm. The patient was started on eltrombopag, and four doses of intravenous immunoglobulin were given without improvement. The patient was started on liver-friendly anti-tuberculosis treatment in view of deranged liver function tests with isoniazid, rifampicin, ethambutol and levofloxacin and later pyrazinamide was added. The platelet count increased after 1 month of ATT to 40,000, and after 2 months, the count was 100,000/mm3.

Individuals’ beliefs, as well as their spiritual orientations (SOs), can affect the quality of their work life cycle. Given that a large portion of people’s lives are spent in organisations, it is crucial to consider the factors affecting quality of work life (QWL) among employees. Against this background, the present study investigated the effects of the Islam-based SOs on the QWL in Muslim employees working for Iraqi municipalities in 2022. For this purpose, an applied research design was adopted, using field studies of the correlational type for data collection. In total, 1345 staff of Iraqi municipalities were selected by simple random sampling in 2022, and two standardised questionnaires were utilised to collect the data. The content validity method was further recruited to determine the validity of the questionnaires, and the Cronbach’s alpha coefficient was used to measure the reliability. To analyse the data, descriptive tests, including frequency, mean and standard deviation (SD), along with inferential statistics, namely one-sample t-test, one-way analysis of variance (ANOVA) and independent-samples t-test, were implemented using the Statistical Package for the Social Sciences (SPSS) software package. The correlation coefficients accordingly showed a rising trend in the QWL among these employees following the growth in their SOs. Moreover, there was a significant relationship between the components of SOs, namely spiritual beliefs, sense of spirituality, spiritual self-actualisation and spiritual practices, and the QWL of the Muslim employees. Contribution: This study revealed that the increase in the Islam-based SOs and its components led to an increase in the QWL of Iraqi Muslim employees.

Global health agencies are increasingly promoting the scale-up of next-generation whole genome sequencing (NG-WGS) of pathogens into infectious disease control programs, including for tuberculosis (TB). However, little is known about how stakeholders in low-to-middle income countries (LMICs) understand the ethics, benefits, and risks of these proposals. We conducted a qualitative study in Greater Gaborone, Botswana to learn how TB stakeholders there viewed a potential scale-up of NG-WGS into Botswana's TB program. We conducted 30 interviews and four deliberative dialogues with TB stakeholders based in Greater Gaborone, the country's largest city and capital. We created and showed participants an animated video series about a fictional family that experienced TB diagnosis, treatment, contact tracing, and data uses that were informed by NG-WGS. We analyzed transcripts using reflexive thematic analysis. We found broad support for the scale-up of TB NG-WGS in Botswana, owing to perceived benefits. Support was qualified with statements about ensuring adequate planning, resource-allocation, community and stakeholder engagement, capacity-building, and assessing ethical norms around publishing data. Our results suggest that scaling up NG-WGS for TB in Botswana would be supported by stakeholders there, contingent upon the government and other entities adequately investing in the initiative. These findings are relevant to other LMICs considering scale-ups of NG-WGS and related technologies for infectious diseases and suggest the need for sustained research into the acceptability of pathogen sequencing in other contexts.

PurposeWe propose a novel compensator-based IMRT system designed to provide a simple, reliable, and cost-effective adjunct technology, with the goal of expanding global access to advanced radiotherapy techniques. The system would employ easily reusable tungsten bead compensators that operate independent of a gantry (e.g., mounted in a ring around the patient). Thereby the system can be retrofitted to existing linac and cobalt teletherapy units. This study explores the quality of treatment plans from the proposed system and the dependence on associated design parameters.MethodsWe considered 60 Co-based plans as the most challenging scenario for dosimetry and benchmarked them against clinical MLC-based plans delivered on a linac. Treatment planning was performed in the Pinnacle treatment planning system with commissioning based on Monte Carlo simulations of compensated beams. 60 Co-compensator IMRT plans were generated for five patients with head-and-neck cancer and five with gynecological cancer and compared to respective IMRT plans using a 6 MV linac beam with an MLC. The dependence of dosimetric endpoints on compensator resolution, thickness, position, and number of beams was assessed. Dosimetric accuracy was validated by Monte Carlo simulations of dose distribution in a water phantom from beams with the IMRT plan compensators.ResultsThe 60 Co-compensator plans had on average equivalent PTV coverage and somewhat inferior OAR sparing compared to the 6 MV-MLC plans, but the differences in dosimetric endpoints were clinically acceptable. Calculated treatment times for head-and-neck plans were 7.6 ± 2.0 min vs 3.9 ± 0.8 min (6 MV-MLC vs 60 Co-compensator) and for gynecological plans were 8.7 ± 3.1 min vs 4.3 ± 0.4 min. Plan quality was insensitive to most design parameters over much of the ranges studied, with no degradation found when the compensator resolution was finer than 6 mm, maximum thickness at least 2 tenth-value-layers, and more than five beams were used. Source-to-compensator distances of 53 and 63 cm resulted in very similar plan quality. Monte Carlo simulations suggest no increase in surface dose for the geometries considered here. Simulated dosimetric validation tests had median gamma pass rates of 97.6% for criteria of 3% (global)/3 mm with a 10% threshold.ConclusionsThe novel ring-compensator IMRT system can produce plans of comparable quality to standard 6 MV-MLC systems. Even when 60 Co beams are used the plan quality is acceptable and treatment times are substantially reduced. 60 Co-compensator IMRT plans are adequately modeled in an existing commercial treatment planning system. These results motivate further development of this low-cost adaptable technology with translation through clinical trials and deployment to expand the reach of IMRT in low- and middle-income countries.

The essay reflects on the context of the publication and reception of The Portuguese Empire in Asia, 1500-1700, a book that first appeared in 1993, and was translated into Portuguese, French and Chinese. It suggests that while some of the principal arguments of the book have gained acceptance, others have been resisted in many quarters. Notably, the book’s plea to insert Portuguese activities in their full Asian and East African historical and historiographical contexts has only been espoused by a minority of historians.

Abstract Background A receptive and easily comprehended technique was evolved for simultaneous assessment of Bempedoic acid and Ezetimibe and its impurities characterized by UPLC–MS/MS. Results This technique involves chromatographic separation with a C18 column of water symmetry (150 mm × 4.6 mm, 3.5 µm). A mobile phase of 0.1% OPA (orthophosphoric acid) and acetonitrile in 50:50 v/v with 1 mL/min flow rate and ambient temperature was used. UV observation was taken at 230 nm. The recoveries, linearity, and quantification limits were found to be within the acceptable limit. Conclusions This technique was successfully tested with UPLC–MS to confirm the chemical structures of newly formed degradation products of Bempedoic acid and Ezetimibe and stress studies as per ICH Q2 (R1) guidelines.

Background: Castor (Ricinus communis L.) is cultivated for seed oil and to feed (leaves) Eri silkworm, Samia ricini (Donovan) Hutt. Alternaria blight affects castor cultivation resulting substantial yield loss (∼30%). Uses of synthetic fertilizers and agrochemicals for disease management have serious concerns as the castor leaves are fed to eri silkworms for rearing. Application of plant growth promoting rhizobacteria for disease suppression and to enhance plant growth will be a healthier choice in castor cultivation. The aim of this study was to assess the efficacy of Alternaria blight disease suppression by native rhizobacteria isolated from wasteland castor and their ability on plant growth promotion. Methodology: We isolated 50 bacterial antagonists from castor rhizosphere using the dilution plate method and evaluated their antagonistic activity against the castor blight pathogen, Alternaria ricini. Based on antimicrobial bioassay and plant growth promotion (PGP) traits (phosphate solubilization, ACC deaminase activities, production of IAA, GA3, HCN, NH3 and siderophore), salt and acid tolerance; we have chosen ten potential isolates and identified them through 16SrRNA gene sequencing and analysis. Disease suppression and plant growth studies were evaluated in pot experiments. Results and conclusion: Three isolates namely, Enterobacter hormaechei (LRP-2), Bacillus mycoides (HF-1) and B. aryabhattai (UR-6) showed potential antagonistic activities and PGP traits which were selected for disease suppression and PGP studies. Application of PGPR consortia (LRP-2+HF-1) could suppress the plants from A. ricini infection in challenged inoculation. Mix inoculation of LRP-2 and UR-6 showed synergistic effect and enhanced plant growth in pot experiments. Combinations of E. hormaechei (LRP-2), B. mycoides (HF-1) and B. aryabhattai (UR-6) can be applied as bio-control and bio-fertilizer formulation to protect castor from Alternaria blight and also to enhance plant growth.

Despite being the most favorable ammonia (NH3) gas sensors, metal oxide semiconductors fail to deliver high selectivity and room temperature (RT) sensing. Tuning the metal oxide with doping is an attractive way of overcoming these disadvantages. Herein, we report Mn-doped ZnO microspheres as promising sensors for highly sensitive and selective RT sensing of NH3. ZnO and 2 wt% Mn-doped ZnO microspheres were synthesized by a low-cost and fast solution combustion synthesis, and their structure, morphology, and gas sensing properties were investigated. Mn-doping resulted in a change in the lattice parameters, an increase in the oxygen vacancies, and surface acidity of ZnO as confirmed by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and Temperature programmed desorption (TPD), respectively. Mn-doped ZnO showed a response (Ra/Rg) of 20.2 in 100 ppm NH3, which is significantly higher than ZnO. The sensor showed high selectivity, three times higher than that of ZnO, and good stability. Improvement in the sensing performance of Mn-doped ZnO is attributed to the increase in the defects and surface acidity with Mn-doping.

In this modern era, brain tumour is one of the dreadful diseases that occur due to the growth of abnormal cells or by the accumulation of dead cells in the brain. If these abnormalities are not detected in the early stages, they lead to severe conditions and may cause death to the patients. With the advancement of medical imaging, Magnetic Resonance Images (MRI) are developed to analyze the patients manually. However, this manual screening is prone to errors. To overcome this, a novel depth search-based network termed light weight channel attention and residual network (LWCAR-Net) is proposed by integrating with a novel depth search block (DSB) and a CAR module. The depth search block extracts the pertinent features by performing a series of convolution operations enabling the network to restore low-level information at every stage. On other hand, CAR module in decoding path refines the feature maps to increase the representation and generalization abilities of the network. This allows the network to locate the brain tumor pixels from MRI images more precisely. The performance of the depth search based LWCAR-Net is estimated by testing on different globally available datasets like BraTs 2020 and Kaggle LGG dataset. This method achieved a sensitivity of 95%, specificity of 99%, the accuracy of 99.97%, and dice coefficient of 95% respectively. Furthermore, the proposed model outperformed the existing state-of-the-art models like U-Net++, SegNet, etc by achieving an AUC of 98% in segmenting the brain tumour cells.

Abstract Background Using a Symmetry C18 (4.6 × 150 mm, 3.5) column, a high-performance liquid chromatographic method for quantification of Rilpivirine and Cabotegravir in active pharmaceutical ingredients was developed and validated. The mobile phase is made up of buffer, acetonitrile, and 0.1 percent formic acid in a 20:80v/v ratio. The flow rate was kept constant at 1.0 ml/min, and detection was accomplished through absorption at 231 nm with a photodiode array detector. Results The calibration curve was linear, with a regression coefficient (R2) value of 0.999 and concentrations ranging from 30 to 450 g/ml of Rilpivirine and 20–300 g/ml of Cabotegravir. The method's LOD and LOQ were 0.375 g/ml, 1.238 g/ml, and 0.25 g/ml, 0.825 g/ml for Rilpivirine and Cabotegravir, respectively. Conclusions In the forced degradation studies, the degradants were characterized by using LCMS and FTIR. The current application was found to be simple, economical, and suitable, and validated according to ICH guidelines.

Pemphigus is an uncommon condition of mucosal and dermatological manifestations. Isolated laryngeal pemphigus without skin lesions is extremely rare. Supraglottic lesions are common in laryngeal pemphigus. Laryngeal manifestations may vary from simple hoarseness, throat pain, dysphagia to severe edema causing airway obstruction. This may necessitate tracheostomy. Laryngeal pemphigus with stridor is an extremely rare presentation. A 57-year-old gentleman, presented to emergency room with stridor. To secure the air way an emergency tracheostomy was done, followed by direct laryngoscopy and biopsy under anesthesia. A suspicion of laryngeal malignancy was made clinically. But to our surprise histopathology revealed pemphigus. Dermatologist opinion was taken and the patient was treated accordingly. He had very good response and was decannulated. Patient was followed regularly.