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The authors proposed an evolutionary-optimization technique known as the Genetic Algorithm (GA) for the optimization and order reduction of high order systems (HOSs) in the time domain. As we know a lot of optimization techniques are available in the frequency domain but limited in the time domain. The proposed technique is applicable for time-domain systems. The reduced model (RM) obtained by the proposed technique can be replaced with the original HOS as it retains all the important time and frequency response specifications of the original HOS. The efficacy of the proposed method has been tested on few numerical examples from the literature. The important time and frequency response specifications of the proposed RM are compared with RM obtained by recent techniques using MATLAB/Simulink. The proposed algorithm is applicable for Single-input single-output (SISO) and multi-input multi-output (MIMO) linear, nonlinear, time-invariant, and time-variant systems.

Although software-defined networking (SDN) promotes a centralized control plane for better resource management, it suffers from reliability and scalability issues. Consequently, the distributed software-defined networking (SDN) architecture proposes logically centralized but physically distributed SDN controllers. However, in the distributed architecture, the load among the controllers may not be balanced, which makes the system less scalable. In this paper, our goal is to balance the load of the controllers. We perform a detailed analysis to establish the ideal load of a controller. Our aim is to minimize the difference between a controller's ideal and instantaneous load. We use short-term traffic forecasts to predict the load of a controller in the next epoch. Thereupon the load balance is affected by migrating the switches. The prediction-based load balancing approach not only balances the load but also minimizes the switch reassignment by preventing switch oscillations. Extensive experiments and comparative performance analyses are performed to validate the framework.

In this study, the influence of gravity-driven convection and Marangoni convection due to the temperature-dependent surface tension gradient on the rise of an axisymmetric bubble moving in another fluid in a self-rewetting system inside a rectangular tube is studied in the presence and absence of a magnetic field. The axisymmetric bubble (fluid 1) moving in another fluid (fluid 2) is considered immiscible. A two-dimensional cylindrical polar coordinate system has been chosen to present the sketch of the problem. Partial differential equations governing the mentioned flow situations are written and converted into non-dimensional forms and their analytical solutions have been obtained. The deformation in the bubble in the form of its radius and length is simulated. The motion of the droplet is also analysed in the microgravity region by graphing the position of the bubble. The graphical results show that there is a decrease in the contribution of the Marangoni effect and gravitational effect when the magnetic field is increased. In the absence of a magnetic field, the contribution of both the Marangoni effect and gravitational effect decrease on increasing the relative viscosity.

Some evidence has demonstrated that both inflammation and immune cell dysregulation are coincident at late phase (post 24 h) of sepsis. The present study was designed to determine the pathological role of hyperinflammation and renal immune cells mobilization during late phase of sepsis induced acute kidney injury (S-AKI) and tests the pharmacological effects of PDE-4 inhibitor on these events. Sepsis was induced by cecal ligation puncture and renal function, oxidative-inflammatory stress biomarkers were assessed after 24 h. PDE-4 inhibitor was administered for 7 days prior to induction of S-AKI. Renal immune cells infiltration during sepsis was analyzed by H&E staining and papanicolaou staining method was used for detecting leukocytes and cast in urinary sediments, periodic acid schiff (PAS) staining was used for detection of brush border loss. AKI developed 24 h post sepsis insult as depicted by increase in serum creatinine, blood urea nitrogen (BUN), renal oxidative stress, and elevated inflammatory biomarkers levels. Moreover, septic rats displayed increased bacterial load, renal expression of phosphodiesterase-4B, 4D isoforms, enhanced vascular permeability, caspase-3 and myeloperoxidase activity, electrolyte imbalance, reduced Na+ K+ ATPase activity, declined cAMP levels, increased interstitial leukocyte infiltration, and leakage in urinary sediments along with histological alterations. Pre-treatment with roflumilast at high dose completely prevented the various AKI associated manifestations in septic rats. Renal hyper-inflammation and leukocyte infiltration was detected in late phase of S-AKI. Roflumilast pre-treatment resolved sepsis induced renal dysfunction and histological damage by suppressing late phase renal immune cells invasion and anti-inflammatory effects mediated by up-regulation of renal cAMP levels.

The authors proposed a new mixed order reduction technique for large-scale linear dynamic systems (LSLDSs). The denominator of the original LSLDS is reduced by the proposed renovated pole clusterin...

Calcium dysregulation and mitochondrial dysfunction are key elements in the development of sepsis-induced cardiac dysfunction. Evidences have suggested that inhibition of Wnt/β-Catenin signalling prevents cardiac dysfunction and remodelling in surgical, hypertension and pressure overload models. The present study investigated the effects of Wnt/β-Catenin inhibitor on calcium overload and mitochondrial dysfunction in rat sepsis model of cardiomyopathy. Induction of sepsis by cecal ligation puncture (CLP) resulted in the up-regulation of cardiac β-catenin transcriptional levels and cardiac dysfunction depicted by increased serum lactate dehydrogenase, CK-MB levels reduced maximum (dp/dt max.) and minimum developed pressure (dp/dt min.), increased LVEsDP and relaxation constant tau values. Moreover, oxidative and inflammatory stress, immune cell infiltration, increased myeloperoxidase activity, enhanced caspase-3 activity and fibronectin protein levels were observed in septic rat's heart. Also, septic rat's heart displayed mitochondrial dysfunction due to mPTP opening, increased calcium up-regulation in left ventricular apex tissues and whole heart, increased collagen staining, necrosis and structural damage. Pre-treatment with Wnt/β-Catenin antagonist attenuated sepsis-induced serum and tissue biochemical changes, cardiac dysfunction and structural alterations by inhibiting mitochondrial mPTP opening and restricting calcium overloading in cardiac tissue.

Medicines play a crucial role in treating various diseases. Most individuals, in their haste to get through their day, have developed the bad habit of improperly discarding their unwanted or expired prescriptions, which poses a number of risks to human health and contributes to environmental degradation. Disposal procedures of unused and expired pharmaceuticals among health care personnel at tertiary care centers have been the subject of very little research to date. Therefore, the purpose of this study is to examine how medical staff at Rajendra Institute of Medical Sciences in Ranchi, Jharkhand, handle stale or unwanted prescription drugs.The design of the study was cross-sectional analytical conducted among 385 health care professionals. Pretested semi-structured questionnaires prepared in Google Forms (Google LLC, Mountain View, California, United States) have been used for evaluation.The completely filled questionnaires were analyzed, evaluated, and expressed in the percentage using Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States). The most common method of disposal of unused and expired medications was throwing them in the dustbin.In this study, although, all the participants were health care professionals, because of the hectic schedule majority of them used unsafe methods of drug disposal. So, in order to protect our ecosystem, appropriate policy should be made to implement the methods for the safe disposal of unused and expired medications.

Carotid body tumour (CBT) is a rare hypervascular tumor in the head and neck region. It develops from neural crest origin paraganglionic tissue which is an arterial chemoreceptor. It presents as a slow growing mass at the carotid bifurcation. Its optimal evaluation and treatment requires involvement of multiple specialities. Because of the high rate of neurovascular complications, resection of this tumor is challenging for surgeons. Early tumor detection, meticulous evaluation and multidisciplinary approach are vital for successful management of these tumors. A case of CBT in a 50 year-old lady managed at our centre is being reported here along with a review of literature.

Laryngeal fractures are though uncommon they can be potentially life threatening. Comminuted laryngeal cartilage fractures are difficult to manage and various fixation techniques have been described in literature. Outcome results of fixation with different materials can be varied. We report a case of 27 years old male who sustained laryngeal cartilage fracture following accidental fall. Patient underwent emergency tracheostomy and early surgical repair of fractured laryngeal thyroid cartilage with one of the newest techniques "titanium mesh fixation". After a month of surgery tracheostomy tube was removed and patient recovered with good laryngeal function. Titanium mesh fixation gave immediate effective fixation and stability to laryngeal fracture leading to good surgical outcome.

To assess the level of patient satisfaction with day-care surgery at a tertiary care centre and to find out the different determinants that influence the patient satisfaction. Observational study; Tertiary care hospital in Western India; Patients undergoing Day-care surgery at Dept of ENT from Feb 2018 to Aug 2018; All patients who underwent day-care surgery were given a questionnaire to determine level of satisfaction. On analysis of data according to questions the average score was in the range of 3.5 to 4.22 out of a maximum score of 5. On analysis of data according to domains of patient care the scores ranged from 3.61 to 4.19. Although patients were generally satisfied with the level of care being provided to them there is still scope of improvement.

Small extracellular vesicles, often termed as “exosomes” carry informative cargo containing proteins and lipids, reflective of their cellular origin. Thus, they are promising biomarkers for early diagnosis of cancer. However, conventional profiling methods like quantitative polymerase chain reaction (qPCR) require complex procedures, thereby limiting the analytical sensitivity of exosomes for liquid biopsies. Here, we demonstrate a sensitive microfluidic device (CDEXO) that isolates and profiles cancer-associated exosomes directly from blood plasma using assembled chiral gold nanoparticles (AuNPs). The unique changes in chiral signals are associated with specific biomolecules on the exosomes’ membranes. Thus, we can distinguish exosomes of lung cancer patients from those of healthy individuals and detect mutated EGFR proteins on the membrane. Hence, this low-cost microfluidic device is an attractive technique for rapid, sensitive, and versatile profiling of various extracellular vesicles. Methods: The top layer of CDEXO devices were fabricated by soft lithography using polydimethylsiloxane (PDMS). The bottom glass slide was functionalized with a layer-by-layer assembly of cationic poly(dimethyl diallyl ammonium chloride) and anionic polystyrene sulfonate. AuNPs were prepared by adding gold nanoplates to a growth solution. Next, AuNPs were conjugated with biotinylated Annexin-V, using Neutravidin-biotin chemistry. Exosomes were harvested from lung cancer cell lines (A549, H1650, H3255) and lung fibroblasts (MRC5) and spiked into the CDEXO chip. EDTA was used to release the captured exosomes and quantified using nanoparticle tracking analysis (NTA). CD spectra were measured by spectrometry. Imaging of AuNPs and exosomes were done using scanning electron microscope (SEM). Results: CDEXO captures cancer-associated exosomes with an efficiency of 81.1±1.5%. H3255 derived exosomes that exhibited EGFR point mutation showed the greatest change in spectral signals from the baseline, followed by A549 (wild type), H1650, (EGFR exon19 deletion) and MRC5 (healthy). The CD responses were measurable at exosome numbers as low as 100. Further validation with 19 lung cancer patients showed an average 40% change in chiral signals from isolated exosomes that were 5.6 times higher in patients than healthy donors. Conclusions: A microfluidic device with chiral AuNPs allows sensitive and accurate detection of lung cancer-associated exosomes by conjugation with Annexin V. The resulting strong CD peaks that arise from specific interactions between exosomal surface proteins and chiral AuNPs facilitate in-depth profiling of target exosomes, including EGFR mutation expression. Citation Format: Yoon-Tae Kang, Ji-Young Kim, Emine Sumeyra Turali-Emre, Hee-Jeong Jang, Minjeong Cha, Abha Kumari, Colin Palacios-Rolston, Chitra Subramanian, Emma Purcell, Sarah Owen, Chung-Man Lim, Rishindra Reddy, Shruthi Jolly, Nithya Ramnath, Nicholas A. Kotov, Sunitha Nagrath. Chiroptical detection and mutation analysis of cancer-associated extracellular vesicles in microfluidic devices with oriented chiral nanoparticles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 994.

This study reports a deep-reactive-ion-etched microneedle device (ExoNeedle chip) coated with a hybrid hydrogel that can directly capture cancer-associated extracellular vesicles (EVs) in interstitial fluid (ISF) in a minimally invasive manner, as opposed to conventional liquid biopsy methods involving sample extraction and EV isolation in-vitro or tissue biopsies for melanoma. Tumor derived EVs give insight into a tumor’s mutational burden and provide both prognostic and diagnostic value as a liquid biopsy tool. Melanoma is an aggressive cancer with a lack of promising markers for early detection, onset of metastasis, and monitoring of recurrence. The ExoNeedle chip is intended to pierce through the epidermis and parts of the dermis to isolate melanoma secreted EVs from the ISF to alleviate these unmet needs. The microneedle arrays were created through the Deep Reactive Ion Etching (DRIE) process and a subsequent wet etching step to sharpen the needles. A 4 inch silicon wafer spin coated with 3 microns of positive photoresist was lithographically patterned and etched by DRIE using the standard Bosch processes to expose arrays of cylindrical pillars. Next, the cylindrical features were sharpened using an isotropic wet etch consisting of a mixture of hydrofluoric and nitric acid. The microneedle arrays were made and cleaved into individual patches. Meanwhile, hybrid hydrogel solution was made from Polyvinyl alcohol (PVA) and alginate by dissolving each of them separately in water under heat, followed by mixing the solutions. After centrifuging and filtering the hydrogel, it was conjugated with Annexin V (Av) protein to give it affinity for cancerous exosomes. Lastly, this hydrogel complex was added onto the microneedle patches and gelated with the help of a humidifier that deposited Ca2+ ion vapor over the hydrogel. The microneedles were first optimized and validated using melanoma cell line secreted EVs. Melanoma EVs were successfully isolated and quantified to evaluate the efficacy of the microneedle patches yielding above an 80% capture efficiency from purified serum samples. The microneedle patches were DiO stained, fluorescently imaged, visualized in a scanning electron microscope, and protein concentration was determined respectfully. Additionally, the functional hydrogel coatings on the microneedles are dissolved in ethylenediaminetetraacetic acid (EDTA), subsequently unbinding EVs from Av due to EDTA-based Ca2+ chelation. The dissolved solution is then used for enumeration and quantification of EVs by nanoparticle tracking analysis. We are further validating these patches in skin mimicking models and patient derived xenograft models of melanoma. The technology developed in this study for the isolation of melanoma EVs can broadly pave the way for minimally invasive point of care cancer diagnostics and tracking for melanoma patients. Citation Format: Scott M. Smith, Abha Kumari, Thiago Reis, Yoon-Tae Kang, Sunitha Nagrath. Deep reactive ion etched microneedle array for in-vivo melanoma cancer monitoring via cancer exosome isolation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3297.

HYPORT adjuvant trial is a randomised phase III open-label noninferiority trial comparing standard moderately hypofractionated 3 week adjuvant radiation therapy in breast cancer with a novel 1-week schedule. The trial was initiated in March 2019 and is open to recruitment with a total sample size of 2100. We report the results of dosimetric quality assurance, acute toxicity and pre planned first interim safety analysis in the first 271 patients.Stage I-III breast cancer planned for adjuvant radiation therapy to the breast/chest-wall (along with regional nodes as indicated) were randomised to receive 40 Gy/15 fractions/3 weeks or 26 Gy/5 fractions/1 week. For simultaneous integrated boost, the patients in the control arm received 8 Gy/15 fractions/3 weeks, while those in the experimental arm received 6 Gy/5 fractions/1 week (to the tumour bed). For sequential boost, the prescribed dose was 12 Gy/4 fractions/4 days in both arms. Compliance to pre specified dosimetric parameters and acute toxicities were evaluated.Data of the first 271 patients was analysed of whom 104 patients received tumour bed boost using SIB. All mandatory dosimetric criteria were met apart from one patient with a higher contralateral breast dose due to optimal internal mammary nodal coverage. Overall three patients (1.1%) experienced grade 3 radiation dermatitis (none received SIB), no other Grade 3 or higher toxicities reported.This acute toxicity interim analysis demonstrates that hypofractionated adjuvant radiotherapy with SIB for patients with breast cancer is feasible, and associated with minimal severe acute toxicities.

Transcriptional factors act as mediators in regulating stress response in plants from signal perception to processing the directed gene expression. WRKY, MYB, AP2/ERF, etc. are some of the major families of transcription factors known to mediate stress mechanisms in plants by regulating the production of secondary metabolites. NAC domain-containing proteins are among these large transcription factors families in plants. These proteins play impulsive roles in plant growth, development, and various abiotic as well as biotic stresses. They are involved in regulating the different signaling pathways of plant hormones that direct a plant's immunity against pathogens, thereby affecting their immune responses. However, their role in stress regulation or defence mechanism in plants through the secondary metabolite biosynthesis pathway is studied for very few cases. Emerging concern over the requirement of medicinal plants for the production of biocompatible drugs and antibiotics, the study of these vast, affecting proteins should be focused to improve their qualitative and quantitative production further. In medicinal plants, phytochemicals and secondary metabolites are the major biochemicals that impose antimicrobial and other medicinal properties in these plants. This review compiles the NAC transcription factors reported in selected medicinal plants and their possible roles in different mechanisms. Further, the comprehensive understanding of the molecular mechanism, genetic engineering, and regulation responses of NAC TFs in medicinal plants, can lead to improvement in stress response, immunity, and production of usable secondary metabolites.

An investigation was undertaken to study the variability in litchi hybrids developed at BAU, Sabour and their parents with respect to flowering and fruiting behavior. The experiment was carried out in Horticulture garden Bihar Agricultural University, Sabour. A critical analysis of the data for various characters of flowering and fruiting parameters like date of panicle initiation, duration of panicle emergence, flowering duration, flower colour, inflorescence shape and size, maturity period and fruit morphology were taken. Initiation of panicle emergence varied from 21/01/2013 (H-587, H-590) to 17/02/2013 (H-141, Kasba). Duration of anthesis varied from 25/02/2013 (H-517, H-574, H-598 & Early Bedana) to 12/03/2013 (H-70, H-104) and maturity period ranged from 55 to 68 days. Among different genoty [pes. H-73, H-98, H-104, H-510 had fruit shape oval to round similar to their male parent Bedana. Dark red fruit colour of H-70, H-73, H-104, H-566 also resembled Bedana i.e. their male parent. Significant genetic variability was found among the genotypes with respect to flowering characters, thus there is an ample scope for selection of promising genotypes. Thus from above finding it may be concluded that extended period of flowering, fruit set and harvesting span could be achieved through hybridization.

Objective Cochlear re-implantation (CRI) is becoming increasingly common throughout the world. However, studies regarding CRI incidence and etiology are lacking from developing countries like ours. The aim of this study was to present the Indian experience with CRI based on our experience. Objectives were to determine the incidence and the indications of CRI and the cumulative survival rate (CSR) of cochlear implantation (CI). Methods Our study was a retrospective one, conducted at a tertiary care centre in southern India. 1,500 consecutive cochlear implanted ears from 1997 to 2016 were studied. All patients who underwent CRI during this period were included in the study. Results There were a total of 53 ears (31 male and 22 female ears) who underwent CRI. This gives an incidence of 3.53%. The most common indication of CRI was device failure in 39 ears contributing to 73.6% of the total CRI. The overall CSR of CI in pediatric population was 96.5% over a 20-year period. Conclusion The CRI incidence and etiology at our centre appears to reflect the findings of the literature. Cochlear implant centres across the world should report the CSR of devices used at their respective centres so that it can be made an important criterion in choice of implant.

Nanotechnology, a term coined by Norio Taniguchi first time in 1974, pertains to controlling, building, designing, restructuring materials and devices on the scale of atoms and molecules. Till today nanotechnology is used in the entire spectrum of the agriculture sector, such as agriculture production, single-molecule detection for the determination of enzyme-substrate interactions, nanocapsules for efficient and timely delivery of agrochemicals and growth hormones in a controlled fashion, nanosensors for monitoring soil conditions, crop growth and quality and for detection of animals and plant pathogens, nanochips for the preservation of identity and tracking, nanocapsules for vaccine delivery and nanoparticles to deliver DNA (Deoxyribonucleic Acid) to plants, a process known as “targeted genetic engineering.” Especially in the agriculture sector, research and technical innovation are important, addressing the crucial global challenges like population growth, drastic climate change and the limited availability of prime plant elemental nutrients such as phosphorus and potassium. Despite these tremendous advantages, uses of nanotechnology are still comparably marginal in the agricultural sector and research has not been commercialized and reached to market to any larger extent in comparision to the other sectors of nanotechnology application. Major safety concerns and stringent laws related to human health and the environment were raised towords industrial-scale manufacturing and use of nanomaterials hinders its use in the agriculture sector as well.

The knowledge of endoscopic anatomy is the utmost important thing to deal with sinus pathologies, execution of surgery and prevention of complications. The complexity of natural anatomy and enormous person to person variations raised the need to know it in great detail. The pre-surgical detailed assessment of radiology helps in the identification of the individual variations, planning of surgery, and selection of instruments. The nasal cavity is lined by three turbinates on each side. The space lateral to that is known as the meatus. Frontal, ethmoids, maxillary and sphenoid are the four paranasal sinuses on each side. They communicate with nasal cavity in the meatal region. The level of pneumatization is affecting the choice of surgical approach, instrumentation, and risk of complications. The pathologies of sino-nasal region can be deal by local and general anesthesia. The limited nasal polyposis, biopsies, and few other selected procedures such as sphenopalatine artery ligation, reduction of turbinates, etc. can be managed under local anesthesia. The proper case selection, detailed knowledge of local anesthetic drugs application, doses and injection technique are the pre-requisite for smooth surgery. The awareness of doses, the technique is required to prevent drug-induced complications. The good surgical field is the key to surgical success. Extensive nasal polyposis, benign and malignant lesions are generally managed under general anesthesia. The major limiting factor for endoscopic sinus and skull base surgeries is the vascularity of mass lesion. The intraoperative hemodynamic control by experience anesthetist is the key factor for the completion of the endoscopic procedures. The types of drugs, anesthesia technique, hypotensive anesthesia, and anesthesia in an emergency situation are discussed in Part C (Sect. 1.3). Part D (Sect. 1.4) is providing detail on surgical techniques. The knowledge of types of uncinectomy and its indications are must to prevent orbital complication. The safest way to perform ethmoidectomies, maxillotomies, and sphenoidotomy are discussed in detail in Section D. Bleeding is one of the commonest presentations in the accident and emergency room. The control of surgical bleeding is the major management focus during and after surgical procedures. The various types of packing materials are available in the market. They can be broadly classified into non-absorbable and absorbable type. The number of non-absorbable type of packing material can be prepared in Operation Theater. Non-absorbable materials are associated with the risk of mucosal injury whereas absorbable materials are more associated with the risk of adhesion formation.

The file is a metabolic model of Halolamina pelagica CDK2 in sbml format.