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This study aims to explore the potential of the engraving milling process to manufacture 3D structures and layouts like rotor wheels. An experimental study was carried out to manufacture a stepped rotor wheel from EN8 steel blank using a computer numeric control (CNC) engraving milling machine tool. The impact of variable parameters, namely rotational speed (SR), feed (f), and plunge feed (Pf), on maximum roughness depth (Rt) and material removal rate (MRR) was determined through a total of fourteen tests, each with two replications based on Box-Behnken design (BBD) of the response surface methodology (RSM). The best variable combination was found using desirability functional analysis (DFA) with goals of minimizing Rt and maximizing the MRR. The best values achieved at the optimal combination of variable parameters were 2.95 µm as Rt and 43.45 mm³/min as MRR. Micrographs of the rotor wheel blades and cutting tool supported the findings.

The aim of the paper is to explore the factors impacting export intensity of SMEs in India. It examines the influence of various firm level variables on export intensity. The sample considered for the study includes 50 SME firms from different industries ranging from equipment and manufacturing to textile. Data for ten years (2011–2020) has been analyzed for drawing relevant results. For regression, Least Square Dummy Variable corrected (LSDVC) estimates have been used to address the issue of heteroskedasticity and autocorrelation issue present in the data. The results arrived at indicate that the expenditure incurred on research and development, selling and distribution acts as an investment which provides returns in terms of better export performance. Also, top managers having international experience can be an important asset for a firm looking for expanding in international market. These results have substantial implications for the management of SME firms.

Background: The Hospital-based Cancer Registry (HBCR) part of the National Cancer Registry Programme provides the number of cancer cases attending the hospital in various disciplines and the exact type of cases classified, diagnosed and treated. This study was done to assess the socio-demographic, clinical profile, and trend of malignancy cases in the tertiary care centres of Mangalore. Methodology: This Record-based retrospective study was conducted in tertiary care hospitals affiliated with Kasturba Medical College, Mangalore and all the cases of malignancies admitted during the study period were included. The data were collected using a proforma and analyzed using SPSS version 25.0. The results were expressed as proportions using appropriate tables and graphs. Results: A total of 600 cancer cases were identified, with females comprising nearly half 48.8%(n=293) and among them the highest number of cases, 28% (n=82) were found in the age group 60 and above. Overall, cancer cases appear to be more prevalent in older age groups for both genders. Among males, the most common cancers were Oral cavity cancers 34.2%(n=105), followed by Gastrointestinal (GI) tract cancers,16.3%(n=50). In females the most common cancers were found to be of the breast followed by uterine cancer then by oral cavity Conclusion: The prevalence of cancer in both genders were found to be almost the same. The highest number of cases were reported from Karnataka followed by Kerala. The highest prevalence was found in higher extremes of age above 60 years.

Aluminum is a light and soft material that is difficult to machine. It is the most produced non-ferrous metal and undergoes extensive machining for the development of a wide range of products. Advances in industry inspire the need to find sustainable ways of machining aluminum and its alloys using conventional machining processes. In the study reported in this paper, two sets of experiments were conducted to investigate the machinability of aluminum 7075 using a plain carbide tool under a dry environment, i.e., no lubrication. In the first set, four rough experiments were conducted where three important machining parameters, i.e., cutting speed CS (115-495 RPM), depth of cut DOC (0.8-1.5 mm), and Feed rate FR (0.08-0.2 mm/rev) have been varied at two levels each to check the behavior of responses or machinability indicators, i.e., surface roughness and tool wear, at machining parameters' highest and lowest values. Based on the results of the first set of experiments, the ranges and levels of parameters have been fixed in the second set for a detailed study of the machinability of aluminum. A total of nine experiments based upon Taguchi's robust design of experiment technique with orthogonal array L9 have been conducted where an additional machining parameter, i.e., machining time MT, has been introduced. The effect of machining parameters on tool wear and surface roughness has been studied in detail, and it is found that the dry machining of aluminum is possible without the early failure of the tool. Dry machining with low values of CS, DOC, FR, and medium MT is desirable for better machinability, i.e., minimum roughness and tool wear, an optimum combination of machining parameter cutting speed-115 RPM, depth of cut-0.8 mm, feed rate-0.12 mm/rev, and machining time-90 seconds. The findings of the present work will assist engineers and researchers in attaining quality, productivity, and sustainability while manufacturing parts and components from aluminum to be used in the automotive, defense, and aerospace sectors.

Isometric handgrip (IHG) exercise causes changes in heart rate variability (HRV) and hemodynamic responses with individual differences. We test the hypothesis that baseline measurements affect post-exercise outcomes.

Background: Breast cancer is one of the leading cancers among women especially in developing countries and is amenable to complete cure if detected early. BSE is one of the screening techniques for early detection of breast lumps and early detection of breast cancer. This study was done to study the awareness, attitudes, and practices towards BSE among the study participants. Methodology: This cross-sectional study was conducted on 656 female students in pre-university and non-health degree colleges of Mangalore, belonging to the Science and Commerce streams selected using cluster random sampling. Data collection was done using a semi-structured questionnaire and analysed using Statistical Package for Social Sciences (SPSS) version 25. Results were expressed using tables and figures. The chi-square test was used for comparison across the groups, and p-value < 0.05 was considered statistically significant. Results: Among the 656 subjects,90%(n=570) belonged to age group of 18-20 years and 44.8%(n=287) were from science stream. Overall,41%(n=268) students were aware about the practice of BSE and a statistically significant association was seen with their stream. Also, 12%(n=78) performed BSE and out of them 69% (n=54) performed it at an ideal frequency. Among the students with a positive family history of breast cancer (4.5%), 92.3% felt the need for BSE education as compared to others. Conclusion: High number of young females (59.14%) did not have knowledge and those who performed BSE, followed incorrect techniques (94.7%). Most of them had a favourable attitude towards learning more about BSE.

Aim of the study: High-resolution ultrasound is less often used to evaluate the radial nerves. The radial nerve is often involved in entrapment syndromes. The aim of the study is to establish the reference values for the cross-sectional area of the normal radial nerve on high-resolution ultrasonography, and to identify relationships between the cross-sectional area and the subject’s age, gender, height, weight, body mass index, and hand dominance. Material and methods: The study was conducted on 200 subjects of both sexes, between 18 and 75 years of age, who did not have history of peripheral neuropathy or trauma to the upper limb. High-resolution real-time sonographic examination of the radial nerves was performed in both arms at two different levels. Level 1 was taken just proximal to the nerve bifurcation, and level 2 just after the nerve exits the spiral grove. Results: The mean cross-sectional area measured at level 2 (4.3 ± 0.4 mm2) was greater than that measured at level 1 (2.3 ± 0.3 mm2). No significant relationship was seen with age and hand dominance (p >0.05), but the cross-sectional area values at above mentioned levels were larger in males than in females (p

Aim: High-resolution ultrasonography is a new and promising technique to evaluate peripheral and spinal nerves. Its validity as a diagnostic tool in neurological diseases has been demonstrated in adults. The aims of study were to establish the reference values for the cross-sectional area of the normal sciatic nerve on high-resolution ultrasonography, and to determine the relationship between the cross-sectional area of the normal sciatic nerve and the subjects’ age, gender, height (in cm), weight (in kg), and body mass index. Material and methods: Two hundred subjects of both genders and above 18 years of age were studied with high-resolution ultrasonography. The subjects had no history of peripheral neuropathy or trauma to the lower limb. The cross-sectional areas of the normal sciatic nerves were obtained at two different levels in both lower limbs. The mean cross-sectional areas of the sciatic nerves were measured at two different levels, one located at 1 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves, and the other 4 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves. Results: A positive correlation of the mean cross-sectional area was established with height, weight, and body mass index. Women had smaller cross-sectional areas of the normal sciatic nerves than men at both measuring sites. No significant relationship was established with the age of the subjects. Conclusions: The established reference values of the cross-sectional area of the sciatic nerve can facilitate the analysis of pathological nerve conditions.

Background: The current coronavirus disease-19 (COVID-19) pandemic call attention to the key role informatics play in healthcare. The present study discovers an independent role of computerised tomography chest (CT) scans in prognosis of COVID-19 using classification learning algorithms. Methods: In this retrospective study, 57 RT PCR positive COVID-19 patients were enrolled from SMS Medical College, Jaipur (Rajasthan, India) after approval from the Institutional Ethics Committee. A set of 21 features including clinical findings and laboratory parameters and chest CT severity score were recorded. The CT score with mild, moderate and severe categories was chosen as response variable. The dimensionality reduction of feature space was performed and classifiers including, decision trees, K-nearest neighbours, support vector machine and ensemble learning were trained with principal components. The model with highest accuracy and area under the ROC curve (AUC) was selected. Results: The median age of patients was 55 years (range: 20-99 years) with 37 males. The feature space was reduced from 21 to 7 predictors, that included fever, cough, fibrin degradation products, haemoglobin, neutrophil-lymphocyte ratio, ferritin and procalcitonin. The linear support vector machine was chosen as the best classifier with 73.7 % and 0.69 accuracy and AUC for severe CT chest score, respectively. The variance contributed by first three principal components were 97.5 %, 2.4 % and 0.0 %, respectively. Conclusion: In view of low degree of relationships between predictors and chest CT scan severity score category as interpreted from accuracy and AUC it can be concluded that chest CT scan has an independent role in the prognosis of COVID-19 patients.

This work presents the wire-EDM of WC-Co composite and optimization of process parameters using an integrated technique of response surface methodology (RSM), Vise Kriterijumska Optimizacija Kompromisno Resenje (VIKOR) and artificial bee colony (ABC) algorithm to obtain the best set of machinability indicators. Wire feed (WF), servo voltage (SV), pulse off-time (Pon) and pulse on-time (Poff) are the variable process parameters, whereas root mean square roughness (Rq), average surface roughness (Ra) and material removal rate (MRR) are the machinability indicators considered in the present work. A total of twenty nine experiments have been conducted based on Box Behnken design (BBD) technique of response surface methodology. VIKOR has been used for normalization of responses and followed by solving empirical models using ABC algorithm to obtain optimized process parameters setting. WF-12 m/min, SV-65V, Pon-116 µs, Poff-20 µs are the optimum wire-EDM parameters obtained by intelligent RSM-VIKOR-ABC technique that produced best values of Ra-4.51 µm, Rq-5.64 µm, MRR-0.061 mm3 /min simultaneously. The validation test confirmed an improvement up to 15% in the response characteristics which proved the effectiveness of this novel hybrid technique for optimization. The optimum parameter setting is for ready industrial reference to attain best surface quality and process productivity for WC-Co composite machining by wire-EDM.

This article presents a methodology to solve a three dimensional bounded transportation problem. Bounded transportation problem is expounded by defining a parallel bounded transportation problem. Equivalence between the two problems is established. The proposed model is applied to public distribution system of North Delhi. A computing software LINGO 17:0 is used to solve the application.

Background/Aim: The recent pandemic of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) is yet another scourge from the coronaviridae family that causes illnesses ranging from common cold to more severe diseases such as Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV). The numbers are still on the rise, despite a country wide lockdown and yet no definitive drugs and or/vaccines are available to manage the active COVID-19 cases. Methods: The present research design was a hospital based observational descriptive study conducted at S. M. S. Medical College and Attached hospitals, Jaipur, that analysed data of all the patients with COVID-19 related mortality, admitted between 1 April to 4 May 2020. Patients included in this study were RT-PCR confirmed cases of SARS-CoV-2 using nasopharyngeal and oropharyngeal swab samples. Results: The mean age of patients with COVID-19 related mortality was 53.41 ± 18.42 year with majority of patients belonging to age group of more than 60 years (41.18 %) followed closely by COVID-19 positive patients in age range of 45 to 60 years (33.33 %). The male to female ratio was 1.68: 1. Mean time lag between hospitalization and death reported was 6.18 days. Majority of the patients admitted (72.5 %) succumbed within 3 days of hospitalization. Eleven patients (21 %) were brought dead to the hospital who were tested COVID-19 positive after death. Most common comorbidity reported in patients with COVID-19 related mortality was hypertension (30 %) followed by diabetes mellitus (27.5 %). Conclusion: Hypertension and diabetes mellitus might be independent risk factors making an individual susceptible to COVID-19 related death. Elderly patients also have a greater risk of mortality. The non-availability of definitive management protocol and/or vaccine against COVID-19 makes public health preventive measures of social distancing, use of masks and frequent handwashing an important modality in the fight against COVID-19.

Aim of the study: To study the cross-sectional area, the maximum thickness of the nerve fascicle and the thickness/width ratio of the sural nerve in patients with diabetes mellitus and non-diabetic subjects using high-resolution ultrasonography and to correlate the results with nerve conduction studies. Material and methods: This prospective study was conducted among 60 patients divided into two groups: A and B. Group A consisted of 30 patients >18 years of age with a history of type 2 diabetes mellitus, and Group B consisted of 30 non-diabetic patients >18 years of age. High-resolution ultrasonography was performed using a linear transducer with the frequency of 5–18 MHz in all the patients in the prone position with the transducer placed in a transverse position at the junction of the middle and lower thirds of the calf. Nerve conduction studies were performed using Aleron 201 (RMS) in all the patients. Results: As compared to the control group, the sural nerve in the diabetic group showed increased cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio (p

In this paper, we present a mathematical model of delivery logistics of swine flu vaccine in a rural area. The objective is to make the medicine available at the Primary health centres of that area in such a way that the total cost (purchasing and cartage) of obtaining the flu vaccination is minimized and the demand of the demand centres is met. One more constraint is taken into consideration: once the bottle of the medicine is opened, it has to be given to a fixed number of patients requiring swine flu vaccine simultaneously, failing which, the proportion of unused medicine becomes obsolete and can not be administered to the patients. But if the bottle of medicine could not be used fully at a time then, the unused medicine can be sold back at a discounted price. Under such conditions, our next objective is to determine the size of order that must be placed so that the expected total profit per year is maximized. The methodology to achieve this objective is: first, formulate the problem as a fixed charge capacitated transportation model with bounds on rim conditions to determine the number of units that should be purchased from various distribution centres such that the total cost (purchasing cost + cartage) of obtaining the medicine is minimized. Further, model the problem as an inventory model to determine the size of order.

5S is one of the important industrial engineering techniques to obtain workplace organization and efficiency enhancement. This paper reports a case study on implementation of 5S in a factory facility of a valve manufacturing company. The aim behind implementing 5S is to improve the productivity and efficiency by reducing the factory chaos, reducing the tool and material search time, and arranging the workplace for a better visibility of the machines, equipment, and items. Audit checklists, workplace pictures, and time study have been used to analyse the effect of 5S implementation. A strategic 5S implementation in this work resulted in much better workplace organization; improved visibility, appearance, and orderliness of objects; and significant reduction in the time to search or access tools.

Manufacturing of miniature gears with good accuracy and quality, and at low cost is a challenging task for traditional manufacturing processes. Wire-cut electric discharge machining (WEDM) has the capacity to machine any conductive material to fabricate typical shaped products like gears with high level of accuracy and quality. In present research, stainless steel (SS) alloy 316 is used to fabricate miniature gears by WEDM. The experimental array is designed according to Response Surface Methodology (RSM) based central composite face centered (CCFC). Four input parameters namely servo feed (SF), duty factor (DF), servo voltage (SV) and wire feed (WF) with three levels each are used for experimental array to investigate the process performance in terms of cutting rate (CR), and product i.e. gear quality in terms of mean roughness depth (Rz) and dimensional deviation (DD). After WEDM parameter optimization, confirmation experiments are performed at the parametric setting by considering equal importance to all response variables. A very close agreement between the experimental and predicted values have been observed.

The concept of minimizing human error in maintenance is progressively gaining attention in various industries. The incorporation of human factors when solving engineering problems, particularly in maintenance, can no longer be ignored where high standards of performance are expected. The journey of improving maintenance performance through the reduction of human error begins with the understanding of causes and impact of human error in maintenance. This paper evaluates previous scholarly writings on human errors, to specifically establish the causes and impact of human error in maintenance. This study relies predominantly on the existing literature on human error in maintenance derived from published and unpublished research. The primary findings emerging from the research exhibit a number of key factors that cause a human error in maintenance such as poor management and supervision, organizational culture, incompetence, poorly written procedures, poor communication, time pressure, plant and environmental conditions, poor work design and many more. The literature review also revealed that human errors have a negative impact on safety, reliability, productivity and efficiency of the equipment. It was further discovered that equipment failures leading to accidents, incidents, loss of life and economic losses are the major effects of human error. Human error in mechanical systems’ maintenance is a serious problem which needs adequate attention in order to develop corrective and preventive measures. This review paper serves as a basis for maintenance practitioners and interested parties to develop corrective and preventive measures for minimizing human error in the maintenance of mechanical systems.

The present paper discusses enhanced flow in a capacitated indefinite quadratic transportation problem. Sometimes, situations arise where either reserve stocks have to be kept at the supply points say, for emergencies, or there may be extra demand in the markets. In such situations, the total flow needs to be controlled or enhanced. In this paper, a special class of transportation problems is studied, where the total transportation flow is enhanced to a known specified level. A related indefinite quadratic transportation problem is formulated, and it is shown that to each basic feasible solution called corner feasible solution to related transportation problem, there is a corresponding feasible solution to this enhanced flow problem. The optimal solution to enhanced flow problem may be obtained from the optimal solution to the related transportation problem. An algorithm is presented to solve a capacitated indefinite quadratic transportation problem with enhanced flow. Numerical illustrations are also included in support of the theory. Computational software GAMS is also used.

Objective: The subunit vaccine strategies and development of various diagnostic reagents for Mycobacterium avium infection relies on the presence of secreted, species-specific mycobacterial antigens. The M. avium 35 kDa protein has been suggested as a candidate for vaccine/diagnostic reagent, specifically for M. avium infection. The present study was conducted to evaluate the diagnostic specificity of the M. avium 35 kDa protein in the Indian population. Materials and Methods: Culture filtrate proteins were isolated by growing the bacilli in modified Youman′s medium. The 35 kDa protein was purified by high-resolution preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis and a blast search was carried out. Western blotting was performed with either monoclonal antibody CS-38 or serum samples of tuberculosis (TB) patients. The 35 kDa-specific immunoglobulin G antibody titer was estimated in the sera of TB patients and healthy individuals by indirect enzyme-linked immunosorbent assay (ELISA). Results: Despite the absence of gene for the 35 kDa protein, the sera of TB patients and TB patient′s contacts nonspecifically recognize it. Of 109 TB patients tested, the sera of 84 patients in ELISA (percentage recognition = 87.5%) and 27 of 29 TB patients tested in western immunoblotting (percentage recognition = 93.10%) recognized the M. avium 35 kDa protein, while with sera of TB patient′s contacts, the recognition was 50%. Conclusion: Contrary to Western studies, the M. avium 35 kDa protein does not seem to be a good candidate for the specific diagnosis of M. avium infection in the Indian population.

This study aims to evaluate the performance of a new algorithm for optimization of beam weights in anatomy-based intensity modulated radiotherapy (IMRT). The algorithm uses a numerical technique called Gaussian-Elimination that derives the optimum beam weights in an exact or non-iterative way. The distinct feature of the algorithm is that it takes only fraction of a second to optimize the beam weights, irrespective of the complexity of the given case. The algorithm has been implemented using MATLAB with a Graphical User Interface (GUI) option for convenient specification of dose constraints and penalties to different structures. We have tested the numerical and clinical capabilities of the proposed algorithm in several patient cases in comparison with KonRad® inverse planning system. The comparative analysis shows that the algorithm can generate anatomy-based IMRT plans with about 50% reduction in number of MUs and 60% reduction in number of apertures, while producing dose distribution comparable to that of beamlet-based IMRT plans. Hence, it is clearly evident from the study that the proposed algorithm can be effectively used for clinical applications.

Smile is one of the most natural and important expressions of human emotion. Man uses his lips mainly to register his emotions. Thus, the slightest asymmetry or weakness around the lips and mouth may transform this pleasant expression into embarrassment and distortion. The circumoral musculature, the major part of which is supplied by the marginal mandibular branch of the facial nerve, is the main factor in this expression. Therefore, an injury to this nerve during a surgical procedure can distort the expression of the smile as well as other facial expressions. This nerve often gets injured by surgeons in operative procedures in the submandibular region, like excision of the submandibular gland due to lack of accurate knowledge of variations in the course, branches and relations. In the present study, 50 facial halves were dissected to study the origin, entire course, termination, branches, muscles supplied by it, its anastomoses with other branches of facial nerve on the same as well as on the opposite side and its relations with the surrounding structures. The marginal mandibular branch of the facial nerve was found superficial to the facial artery and (anterior) facial vein in all the cases (100%). Thus the facial artery can be used as an important landmark in locating the marginal mandibular nerve during surgical procedures. Such a study can help in planning precise and accurate incisions and in preventing the unrecognized severance of this nerve during surgical procedures.

Context: Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate number of corneas collected. Well-informed nursing students could be expected to influence eye donation rates. Aims: To assess the awareness and perception of 188 first- and second-year nursing students towards eye donation in Bangalore. Settings and Design: Cross-sectional study design. Materials and Methods: A pretested, semi-structured questionnaire. Statistical Analysis Used: Data were analyzed using the Epi-Info software package, Version 6.04. Results: The majority (96.8%) of students knew that eyes can be donated after death but only 38.2% knew that the ideal time of donation was within 6 hours of death. Most participants (85.1%) were either willing or had already donated their eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.6% of students. Perceived reasons for not pledging eyes by the students were: the unacceptable idea of separating the eyes from the body (67.9%), lack of awareness (42.8%), objection by family members (28.5%), and unsuitability to donate because of health problem (10.7%). Conclusion: This study revealed that nursing students were well aware of eye donations and most of them were inclined to sign-up for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. The nursing students could be actively involved as volunteers in eye donation campaigns and they can act as counsellors for eye donors. They can also contribute by participating in creating awareness and motivating people to become eye donors.

Acute calcific discitis is a rare but well-known condition of unknown etiology. In symptomatic cases, the most common site is the cervical spine. We describe the CT scan and MRI findings in a symptomatic patient, with a lesion in the dorsolumbar spine.

102 cases of leprosy were studied clinically and histopathologically according to Ridleyâ€s scale of 1977; 8 odd cases of leprosy where criteria were not exactly fulfilled were excluded. Clinico-histopathological correlation (CHC) was studied in 94/102 cases. CHC was seen in 75/94 (79.7%). 63/102 cases had hypopigmented macules with variable degree of anaesthesia and CHC was seen in 49/63 (77.7%)

Abstract Histidine-rich peptides are commonly used in recombinant protein production as purification tags, allowing the one-step affinity separation of the His-tagged proteins from the extracellular media or cell extracts. Genetic engineering makes feasible the post-purification His-tag removal by inserting, between the tag and the main protein body, a target site for trans-acting proteases or a self-proteolytic peptide with regulatable activities. However, for technical ease, His tags are often not removed and the fusion proteins eventually used in this form. In this commentary, we revise the powerful biological properties of histidine-rich peptides as endosomolytic agents and as architectonic tags in nanoparticle formation, for which they are exploited in drug delivery and other nanomedical applications. These activities, generally unknown to biotechnologists, can unwillingly modulate the functionality and biotechnological performance of recombinant proteins in which they remain trivially attached.

Abstract Aggressive clinical and public health interventions have resulted in significant reduction in coronary artery disease (CAD) worldwide. However, South Asian immigrants (SAIs) exhibit the higher prevalence of CAD and its risk factors as compared with other ethnic populations. The objective of the current study is to assess the prevalence of metabolic syndrome (MS), its association with high density Lipoprotein (HDL) function, Apo lipoprotein A-I (APOA1) gene polymorphisms, and sub-clinical CAD using common carotid intima-media thickness (CCA-IMT) as a surrogate marker. A community-based cross-sectional study was conducted on SAIs aged 35-65 years. Dysfunctional/pro-inflammatory (Dys-HDL) was determined using novel cell free assay and HDL inflammatory index. Six intronic APOA1 gene polymorphisms were analyzed by DNA sequencing. According to the International Diabetes Federation definition, MS prevalence was 29.7% in SAIs without CAD and 26% had HDL inflammatory index ≥ 1 suggesting pro-inflammatory Dys-HDL. Six novel APOA1 single nucleotide polymorphisms (SNPs) were analyzed with logistic regression, three SNPs (G2, G3, and G5) were found to be significantly associated with MS (p = 0.039, p = 0.038, p = 0.054). On multi-variate analysis, MS was significantly associated with BMI > 23 (P = 0.005), Apo-A-I levels (p = 0.01), and Lp [a] (p < 0.0001). SAIs are known to be at a disproportionately high risk for CAD that may be attributed to a high burden for MS. There is need to explore and understand non-traditional risk factors with special focus on Dys-HDL, knowing that SAIs have low HDL levels. Large prospective studies are needed to further strengthen current study results.

Abstract Background Monocytes, their progeny such as dendritic cells and osteoclasts and products including tumor necrosis factor (TNF)-α, interleukin (IL)-1α and IL-1β play important roles in cancer, inflammation, immune response and atherosclerosis. We previously showed that mactinin, a degradative fragment of the cytoskeletal protein α-actinin, is present at sites of monocytic activation in vivo, has chemotactic activity for monocytes and promotes monocyte/macrophage maturation. We therefore sought to determine the mechanism by which mactinin stimulates monocytes. Results Radiolabeled mactinin bound to a heterocomplex on monocytes comprised of at least 3 proteins of molecular weight 88 kD, 79 kD and 68 kD. Affinity purification, mass spectroscopy and Western immunoblotting identified heat shock protein (Hsp)-90 as the 88 kD component of this complex. Hsp90 was responsible for mediating the functional effects of mactinin on monocytes, since Hsp90 inhibitors (geldanamycin and its analogues 17-allylamino-17-demethoxygeldanamycin [17-AAG] and 17-(dimethylaminoethylamino)-17-demethoxygeldanamycin [17-DMAG]) almost completely abrogated the stimulatory activity of mactinin on monocytes (production of the pro-inflammatory cytokines IL-1α, IL-1β and TNF-α, as well as monocyte chemotaxis). Conclusion Mactinin is a novel inducer of Hsp90 activity on monocytes and may serve to perpetuate and augment monocytic activation, thereby functioning as a "matrikine." Blockage of this function of mactinin may be useful in diseases where monocyte/macrophage activation and/or Hsp90 activity are detrimental.

Abstract Several recent studies have documented that supplementation with pomegranate fruit extract inhibits inflammatory symptoms in vivo. However, the molecular basis of the observed effects has not been fully revealed. Although previous studies have documented the inhibition of nitric oxide and cyclooxygenase (COX) activity in vitro by plant and fruit extracts added directly into the culture medium but whether concentrations of bioactive compounds sufficient enough to exert such inhibitory effects in vivo can be achieved through oral consumption has not been reported. In the present study we determined the effect of rabbit plasma obtained after ingestion of a polyphenol rich extract of pomegranate fruit (PFE) on COX enzyme activity ex vivo and the IL-1β-induced production of NO and PGE2 in chondrocytes in vitro. Plasma samples collected before and 2 hr after supplementation with PFE were tested. Plasma samples collected after oral ingestion of PFE were found to inhibit the IL-1β-induced PGE2 and NO production in chondrocytes. These same plasma samples also inhibited both COX-1 and COX-2 enzyme activity ex vivo but the effect was more pronounced on the enzyme activity of COX-2 enzyme. Taken together these results provide additional evidence of the bioavailability and bioactivity of compounds present in pomegranate fruit after oral ingestion. Furthermore, these studies suggest that PFE-derived bioavailable compounds may exert an anti-inflammatory effect by inhibiting the inflammatory cytokine-induced production of PGE2 and NO in vivo.

Abstract Background The Amazonian medicinal plant Sangre de grado (Croton palanostigma) has traditional applications for the treatment of wound healing and inflammation. We sought to characterize two extracts (progrado and zangrado) in terms of safety and oligomeric proanthocyanidin chain length. Additionally progrado was evaluated for antioxidant activity and possible chondroprotective actions. Methods Acute oral safety and toxicity was tested in rats according under OECD protocol number 420. The profile of proanthocyanidin oligomers was determined by HPLC and progrado's antioxidant activity quantified by the ORAC, NORAC and HORAC assays. Human cartilage explants, obtained from surgical specimens, were used to assess chondroproteciton with activity related to direct inhibitory effects on human matrix metalloproteinase (MMP, gelatinolytic) activity using synovial fluid and chondrocytes activated with IL-1β (10 ng/ml). Additionally, progrado (2–10 μg/ml) was tested for its ability to maintain optimal IGF-1 transcription and translation in cartilage explants and cultured chondrocytes. Results Both progrado and zangrado at doses up to 2000 mg/kg (po) displayed no evidence of toxicity. Oligomeric proanthocyanidin content was high for both progrado (158 mg/kg) and zangrado (124 mg/kg), with zangrado almost entirely composed of short oligomers ( Conclusion Progrado has a promising safety profile, significant chondroprotective and antioxidant actions, directly inhibits MMP activity and promotes the production of the cartilage repair factor, IGF-1. This suggests that progrado may offer therapeutic benefits in joint health, wound healing and inflammation.

Abstract Open Access online publishing is the trend of the future for unrestricted rapid and international dissemination of knowledge. Several journals are published on acquired immune deficiency syndrome (AIDS) research, but none of them appear to be Open Access. To eliminate or to abate the scourge of AIDS, it is important that the knowledge acquired through research be disseminated as soon as possible. The Open Access journal, AIDS Research and Therapy, is intended to fill this knowledge gap by online publication of basic, preclinical, and clinical research articles.

Mosquito-borne diseases continue to pose a great threat to global public health systems due to increased insecticide resistance and climate change. Accurate vector identification is crucial for effective control, yet it presents significant challenges. IDX - an automated computer vision-based device capable of capturing mosquito images and outputting mosquito species ID has been deployed globally resulting in algorithms currently capable of identifying 53 mosquito species. In this study, we evaluate deployed performance of the IDX mosquito species identification algorithms using data from partners in the Southeastern United States (SE US) and Papua New Guinea (PNG) in 2023 and 2024. This preliminary assessment indicates continued improvement of the IDX mosquito species identification algorithms over the study period for individual species as well as average regional accuracy with macro average recall improving from 55.3 % [Confidence Interval (CI) 48.9, 61.7] to 80.2 % [CI 77.3, 84.9] for SE US, and 84.1 % [CI 75.1, 93.1] to 93.6 % [CI 91.6, 95.6] for PNG using a CI of 90 %. This study underscores the importance of algorithm refinement and dataset expansion covering more species and regions to enhance identification systems thereby reducing the workload for human experts, addressing taxonomic expertise gaps, and improving vector control efforts., Competing Interests: Declaration of competing interest All authors are employed by and partial owners of Vectech, the company developing and distributing the IDX hardware and software, (Copyright © 2024. Published by Elsevier B.V.)

A 50-year-old male with a history of a dull headache and neck pain for a few weeks presented to the ER with complaints of progressive weakness and difficulty walking. Physical examination revealed a lethargic, confused patient with abnormal tremors at rest. Initial lab work was significant for elevated hemoglobin, hematocrit, and hyponatremia. Additionally, CT imaging was significant for prominent ventricles. Several serologies and polymerase chain reaction (PCR) tests were ordered to determine the etiology of the patient's meningitis. On day 10 of admission, serology results returned positive for  Coccidioides  antibodies. The patient was started on an IV fluconazole treatment and underwent a ventriculoperitoneal shunt and Ommaya reservoir placement procedure. Cases of coccidioidal meningitis are rarely noted in recent literature. We present this clinical case of coccidioidomycosis dissemination into the central nervous system (CNS) to highlight the rare localization of the fungal infection in a baseline immunocompetent patient., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Fatima et al.)

Abstract: We used the Food and Drug Administration-cleared Aptima Mycoplasma genitalium assay to evaluate for M. genitalium infection among young women without urogenital symptoms presenting to a community-based emergency department in Birmingham, Alabama, between August 2016 to August 2019 for evaluation of nongynecological concerns. M. genitalium was detected in 23 (14.8%) of 155 women., Competing Interests: Conflict of Interest and Sources of Funding: K.B.W. reports receiving research support paid to his institution from Roche Molecular Systems, Inc. B.V.D.P. reports receiving honorarium, consulting fees, or research support paid to her institution from Abbott Molecular, Atlas Genetics, BD Diagnostics, Click Diagnostics, Cepheid, Luminex, Rheonix, and Roche Molecular Systems, Inc. W.M.G. reports receiving honoraria or consulting fees from Hologic, Inc.; Roche Molecular Systems, Inc.; and Quest Diagnostics, and research support paid to his institution by Hologic, Inc., (Copyright © 2020 American Sexually Transmitted Diseases Association. All rights reserved.)

Saliva is known to be protective for esophageal mucosa. Increased chewing strokes result in a quantitative and qualitative enhancement of saliva. Reduction in the amount of saliva produced results in an increased incidence of gastroesophageal reflux disease (GERD), which can be objectively measured by the DeMeester score. The impact of increased chewing strokes on the DeMeester score remains largely unknown, thus this study aimed to find out their impact on the value of the DeMeester score and its individual components.The effect of increased chewing strokes on the DeMeester score was investigated in 12 subjects (5 male and 7 female) who were diagnosed with GERD. All subjects underwent a 48-hour pH monitoring using the Bravo® pH capsule. All the patients chewed their food 20 times more on Day 2 as compared to Day 1. The data were analyzed for change in the DeMeester score and its individual components in 2 days.In patients with GERD (DeMeester score > 14.72 on Day 1), the number of long refluxes (>5 minutes) on Day 2 (mean = 3.2, SD = 2.3) was significantly lower than on Day 1 (mean = 6.4, SD = 2.7); Z = -2.032, p = 0.04. Though, the DeMeester score and its other individual parameters decreased on Day 2, they were not statistically significant.In patients with GERD, increased chewing strokes lead to a decrease in the number of long reflux episodes. Though there is a decrease in the DeMeester score and its other individual components, larger randomized controlled studies are required to reach statistical significance., (© The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Most colonoscopies are completed in the left lateral (LL) position but in cases of suboptimal caecal preparation, changing the patient's position to supine (S) and, if needed, to right lateral (RL) improves caecal intubation rate, mucosal visibility, and adenoma detection., Aim: To determine if position change during colonoscopy facilitates optimal visualisation of the caecum., Material and Methods: A total of 359 patients were grouped into three categories based on the initial caecal intubation position. After caecal intubation, caecal visibility was scored on a four-point scale depending on the number of imaginary quadrants of the caecum completely visualized - Arya Caecal Prep Score. A score of 1 or 2 was unsatisfactory, while 3 or 4 was considered satisfactory. In patients with unsatisfactory score, position was changed from LL to S and then RL and visibility was scored again., Results: The initial caecal intubation in the LL position was achieved in 66.8% of patients, S in 28.5%, and RL in 4.8% of patients. 84.5% (300/355) of patients had an acceptable visualisation score at the initial caecal intubation position. Of the 55 patients with unsatisfactory caecum visualisation scores in the initial intubation position, 30 (8.5%) had satisfactory scores after the first position change (95% CI: 5.77-11.84). Twenty-five (7.04%) subjects required two position changes (95% CI: 4.61-10.22%). An additional 9.3% (11/118) of adenomas were detected in caecum and ascending colon following position change., Conclusions: Changing patient position improves caecal intubation rate, mucosal visibility, and adenoma detection.

Objective: In this randomized clinical trial, we have compared the Shudh™ colon cleanse (SCC) with HalfLytely(®) colon prep (HCP) to evaluate the efficacy, bowel preparation time (BPT), adverse events, electrolyte abnormalities and patient acceptability., Methods: Patients were randomized to receive either SCC (n = 65) or HCP (n = 68). All colonoscopies were performed by a single, blinded endoscopist. Colon prep was evaluated on a 5 point grading scale. Statistical non-inferiority was pre-defined as a difference of <15 % in the lower limit of the 95.5 % confidence interval for the treatment difference. Data that were collected include bowel prep score, BPT, adverse events, electrolyte abnormalities and patient acceptability., Results: Bowel preparation efficacy was rated as "successful" for 59/65 (90.7 %) in SCC versus 66/68 (97.1 %) in HCP. This gave a success difference of -6.4 % with a 1-sided 95 % lower confidence limit (LCI) for the difference = -13.3 % (non-inferiority p = 0.25). This difference fell within the predefined limit for non-inferiority. The average BPT for SCC was 1.9 h versus 10.9 in HCP (p < 0.001). No serious adverse events were reported in either group. None of the patients in either group had any clinically significant electrolyte imbalance. Patient ratings for palatability and willingness to repeat were significantly better for SCC (p < 0.05)., Conclusion: SCC was found to not be inferior to PEG with regards to the quality of bowel preparation. It is worth highlighting that a major advantage of SCC is shorter BPT.

Background: Colonoscopy is now the gold standard for colon cancer screening and a vital diagnostic and therapeutic tool in 21st century medical practice. Although advances have been swift since colonoscopy came into wide use a generation ago, its effectiveness can be compromised by patients' ability to adequately prepare for the procedure. Many patients dread this task more than the procedure itself. While no prep regimen can be ideal for all patients, the authors present a novel approach that represents a potential time-saving improvement for younger, healthier patients. It is a modern version of an Indian practice called shankh prakshalana, in which lukewarm saline is used in combination with five yoga postures to cleanse the bowel., Objective: The objective of this study was to examine the safety, efficacy, and tolerability of lukewarm saline and yoga (LWS/yoga) as a colonoscopy preparation in comparison with NuLytely(®) (PEG-3350, sodium chloride, sodium bicarbonate, and potassium chloride solution) used according to the manufacturer's instructions., Research Design: This was a pilot study comprising 54 healthy adults, ages 18-65, equally divided into two groups: Group A preparing with lukewarm saline and yoga postures (LWS/yoga); and Group B preparing with NuLytely(®) as directed on the label., Measurements: Data were collected on the quality of bowel preparation, patient safety, patient tolerability, and side-effects. The setting was a Joint Commission accredited outpatient endoscopy clinic., Interventions: Patients performed the series of five yoga postures known as shankh prakshalana, interrupting the exercises at regular intervals to consume 480 mL of lukewarm saline. The solution was prepared by adding 9 g of sodium chloride per liter of lukewarm water (99°F-102°F/37.2°C-38.9°C)., Results: The mean total score was significantly better in Group A versus Group B (20.63 ± 5.09 versus 16.48 ± 5.18, p < 0.0007). In Group A, 24/27 (88.9%) of patients had excellent or optimum total scores, compared with 21/27 (77.8%) in Group B (not significant). In our pilot study, LWS/yoga, used under supervision, produced better colon preparation than Nulytely, used as directed., Limitations: A randomized, endoscopist-blinded study is needed to confirm these results., Conclusions: Shankh prakshalana is effective as a colonoscopy preparation.

We demonstrate the use of Tc-99m ciprofloxacin imaging in a follow-up case of squamous cell carcinoma of the tongue post hemi-mandibulectomy with clinical suspicion of local recurrence of osteomyelitis. On Tc-99m ciprofloxacin scan, we observed a focus of sharply increasing radiotracer concentration in the left side of the mandible after 24 hours, indicating active bacterial infection. Histopathologic analysis revealed no evidence of local recurrence, whereas the culture examination showed bacterial growth sensitive to ciprofloxacin. A follow-up Tc-99m ciprofloxacin scan after debridement and 8 weeks of antibiotic treatment showed no focus of tracer concentration in the region of the mandible.

In three experiments we studied the baseline and changes in VER during different natural estrous cycle stages (n=146) in ovarian structures and in plasma progesterone during estrus induced by prostaglandin injection (n=16) and the VER at insemination (n=90) in an attempt to predict estrus, ovulation and the best VER range for inseminating buffaloes for optimum conception. The baseline VER was classified on the basis of ovarian findings and estrous cycle stages. The mean VER during estrus, metestrus, diestrus, proestrus and anestrus was 32.68 +/- 0.46, 41.26 +/- 1.17, 50.23 +/- 0.55, 43.20 +/- 0.64 and 55.86 +/- 0.57 ohms, respectively. There was a significant difference (P<0.01) between the VER except those between metestrus and proestrus. The ANOVA for VER over estrous cycle stages showed a highly significant (P<0.01) effect of stage of estrous cycle on VER in buffaloes. The percent decrease in VER was more pronounced from diestrus to estrus. In the second part of the study plasma progesterone profiles and the appearance of estrus in buffaloes induced to estrus using two dose schedules and routes of PGF2alpha administration showed that luteolysis and estrus induction was slower in the 10 mg i.v.s.m. route (Intra Vulvo Submucosal) (only 60% animals evinced estrus in 48 to 72 hours) as compared to the 25 mg i.m. route (83.33% evidenced estrus in 48 to 72 hrs). Fall in plasma progesterone was synchronous to a fall in VER, the correlation (0.65) between them being positive and significant (P<0.01). After ovulation the VER started rising, showing a distinct relationship between VER and ovulation. By using VER, an additional 36.6% of the buffaloes could be detected in estrus. In the third part of the study, insemination of buffaloes induced to estrus (n=11) and normal-estrus buffaloes (n=79) showed that the overall conception rates to single insemination when the buffaloes were inseminated at the VER range of 26 to 30, 31 to 35 and 36 to 40 ohms were 81.48, 58.97 and 16.66%, respectively. Buffaloes showing VER from 31 to 35 ohms and 36 to 40 ohms also evidenced atypical and Null fern pattern in the cervicovaginal mucus. The study proved that VER can be used successfully to predict the stage of estrous cycle, ovarian status and ovulation; and insemination at a low VER distinctly improves the conception rates in buffaloes.