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Abstract The quality and uniformity of green coffee beans significantly influence the overall flavor and value of the product. In the coffee industry, automated flaws and bean-type identification offer numerous advantages. This study examines the effectiveness of multiple YOLO (You Only Look Once) models for identifying and classifying green coffee beans. Various YOLO variants, including YOLOv3, YOLOv4, YOLOv5, YOLOv7, YOLOv8, and custom models, are compared with a focus on computational efficiency, accuracy, and speed. Utilizing a dataset of 4,032 training and 506 testing images encompassing diverse bean types, defects, and lighting conditions, we assessed the performance. The bounding boxes generated by our models accurately encompass coffee beans, with the background typically uniform and set to black. Our analysis reveals the superior performance of the custom-YOLOv8n model, which we meticulously customized for green coffee bean detection. This model achieved high precision, recall, f1-score, and mAP, demonstrating its potential for real-world implementation in coffee bean quality control systems. The customization process involved fine-tuning the model to focus on significant features relevant to green coffee bean detection and employing specific labeling strategies. Customization allows you to fine-tune the model to focus on important features relevant to green coffee bean detection. This sensitivity ensures that the model can effectively distinguish between different bean types and detect even subtle defects. This paper clarifies our primary objective of evaluating YOLO models’ performance in identifying and categorizing green coffee beans, with potential implications for enhancing efficiency and consistency in the coffee industry. A succinct key sentence underscores the benefits of our research for readers seeking efficient YOLO model selection and implementation in agricultural systems.

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary kidney diseases. In addition to renal involvement, vascular complications including intracranial arterial, aortic aneurysms and dissections are common in these patients. We report the case of a 35-year-old male patient with ADPKD who presented with hematuria and was diagnosed with two intrarenal arterial pseudoaneurysms. Endovascular embolization using coils was performed to resolve these symptoms. Vascular complications are often encountered in patients with ADPKD; hence, sufficient clinical suspicion and timely diagnosis can help manage the disease. The most common causes of hematuria in ADPKD patients are cyst hemorrhage or infection; however, vascular aneurysms should also be considered a possibility.

Context: Melanin pigmentation of the gingiva exists in all ethnicities and genders. Demand for repigmentation is mainly for esthetic reasons. Gingival depigmentation is a mucogingival surgical procedure where depigmentation is done by various techniques. However, the selection of a method depends on the clinical experiences and individual preferences. Aim: The aim of the study is to compare the pain score using the Visual Analog Scale (VAS) and the recurrence rate of gingival pigmentation, using the three different techniques, i.e., scalpel, laser, and electrosurgery. Settings and Design: This randomized control trial was conducted on 30 systemically healthy patients divided into two groups. Materials and Methods: A split-mouth design was adopted and pigmentation was removed using scalpel and laser in Group I and scalpel and electrocautery in Group II. Dummett Oral Pigmentation Index scale and VAS were used to appraise the potency of hyperpigmentation and pain of the patient, respectively. Statistical Analysis Used: Independent t-test was used for the comparisons. P < 0.05 was considered statistically significant. Results: The pain intensity was up high in patients treated with scalpel compared to laser and electrocautery, which was statistically highly significant. Conclusion: The findings suggest that laser depigmentation still serves to be the best modality considering the bloodless field and reduced postoperative pain.

Root-knot nematodes (Meloidogyne spp.) are sedentary endo-parasite that causes severe yield loss in carrot. Chemical nematicides currently used to manage Meloidogyne incognita are being phased out because of rising health and environmental issues. This study aimed to evaluate nematicidal effect of various concentrations, viz., 250, 500, 750, 1000ppm of leaf extract of Ipomoea carnea against M. incognita infecting carrot under in vitro and in pots assays. In our result, all tested concentrations displayed J2s mortality and egg hatching inhibition along with improving growth of carrot and reduced J2s population and root-knot index. Molecular docking performed predicts binding interactions of two major compounds, viz., neophytadiene and 2-amino-2-methyl-1-propanol as shown by GC-MS analysis with targeted protein, odorant response gene-1 of M. incognita, to confirm nematicidal action of I. carnea leaf extract. The obtained results also suggested that neophytadiene interacted more and strongly bound with odorant response gene-3 than 2-amino-2-methyl-1-propanol. The biochemical ligand-target protein interaction described in the present work will be helpful in the logical selection of biomolecules and essential proteins. Therefore, plant extract may be used the best alternative to chemical nematicides to control root-knot nematodes and caused longitudinal growth of the plant as well as reduce environmental risks.

Abstract Due to waning immunity following primary immunization with COVID-19 vaccines, booster doses may be required. The present study assessed a heterologous booster of SII-NVX-CoV2373 (spike protein vaccine) in adults primed with viral vector and inactivated vaccines. In this Phase 3, observer-blind, randomized, active controlled study, a total of 372 adults primed with two doses of ChAdOx1 nCoV-19 (n = 186) or BBV152 (n = 186) at least six months ago, were randomized to receive a booster of SII-NVX-CoV2373 or control vaccine (homologous booster of ChAdOx1 nCoV-19 or BBV152). Anti-S IgG and neutralizing antibodies (nAbs) were assessed at days 1, 29, and 181. Non-inferiority (NI) of SII-NVX-CoV2373 to the control vaccine was assessed based on the ratio of geometric mean ELISA units (GMEU) of anti-S IgG and geometric mean titers (GMT) of nAbs (NI margin > 0.67) as well as seroresponse (≥ 2 fold-rise in titers) (NI margin −10%) at day 29. Safety was assessed throughout the study period. In both the ChAdOx1 nCoV-19 prime and BBV152 prime cohorts, 186 participants each received the study vaccines. In the ChAdOx1 nCoV-19 prime cohort, the GMEU ratio was 2.05 (95% CI 1.73, 2.43) and the GMT ratio was 1.89 (95% CI 1.55, 2.32) whereas the difference in the proportion of seroresponse was 49.32% (95% CI 36.49, 60.45) for anti-S IgG and 15% (95% CI 5.65, 25.05) for nAbs on day 29. In the BBV152 prime cohort, the GMEU ratio was 5.12 (95% CI 4.20, 6.24) and the GMT ratio was 4.80 (95% CI 3.76, 6.12) whereas the difference in the proportion of seroresponse was 74.08% (95% CI 63.24, 82.17) for anti-S IgG and 24.71% (95% CI 16.26, 34.62) for nAbs on day 29. The non-inferiority of SII-NVX-CoV2373 booster to the control vaccine for each prime cohort was met. SII-NVX-CoV2373 booster showed significantly higher immune responses than BBV152 homologous booster. On day 181, seroresponse rates were ≥ 70% in all the groups for both nAbs and anti-S IgG. Solicited adverse events reported were transient and mostly mild in severity in all the groups. No causally related SAE was reported. SII-NVX-CoV2373 as a heterologous booster induced non-inferior immune responses as compared to homologous boosters in adults primed with ChAdOx1 nCoV-19 and BBV152. SII-NVX-CoV2373 showed a numerically higher boosting effect than homologous boosters. The vaccine was also safe and well tolerated.

Abstract Vaccination with live attenuated Leishmania parasites such as centrin deleted Leishmania donovani (LdCen −/− ) against visceral leishmaniasis has been reported extensively. The protection induced by LdCen −/− parasites was mediated by both CD4+ and CD8+ T cells. While the host immune mediators of protection are known, parasite determinants that affect the CD4+ and CD8+ T cell populations remain unknown. Parasite encoded inflammatory cytokine MIF has been shown to modulate the T cell differentiation characteristics by altering the inflammation induced apoptosis during contraction phase in experimental infections with Leishmania or Plasmodium. Neutralization of parasite encoded MIF either by antibodies or gene deletion conferred protection in Plasmodium and Leishmania studies. We investigated if the immunogenicity and protection induced by LdCen −/− parasites is affected by deleting MIF genes from this vaccine strain. Our results showed that LdCen −/− MIF −/− immunized group presented higher percentage of CD4+ and CD8+ central memory T cells, increased CD8+ T cell proliferation after challenge compared to LdCen −/− immunization. LdCen −/− MIF −/− immunized group presented elevated production of IFN-γ+ and TNF-α+ CD4+ T cells concomitant with a reduced parasite load in spleen and liver compared to LdCen −/− group following challenge with L. infantum. Our results demonstrate the role of parasite induced factors involved in protection and long-term immunity of vaccines against VL.

With the proliferation of data, relational database management systems face the challenge of managing big volumes of data because of the absence of dynamic data models, high functioning, high scalability, high availability, and low cost. The NoSQL technology has the features which RDBMS lacks. Therefore, many organizations are migrating from RDBMS to NoSQL databases. The migration from RDBMS to NoSQL is not always effective if the data is lost, if the data is replicated while transmission, and if the performance is degraded. For this reason, enhancement of transformation algorithm proposed by Shabana Ramzan et al. has been performed to implement the methodology which is used to successfully migrate data from structured and normalized SQL database MySQL to NoSQL graph database Neo4j. SchemaCrawler engine has been used to metamodeling from source to destination database and execute the transformation rules. This study has also evaluated and validated the performance of the enhanced algorithm after successful migration of data. The NoSQL graph database Neo4j handles the most common form of data that are unstructured, semi-structured, and structured as well as they support the ACID property of relational databases. This feature is not supported by other NoSQL databases such as Oracle NoSQL, MongoDB, and HBase databases.

Summary: Understanding the cell biological mechanisms that enable tumor cells to persist after therapy is necessary to improve the treatment of recurrent disease. Here, we demonstrate that transient receptor potential channel 6 (TRPC6), a channel that mediates calcium entry, contributes to the properties of breast cancer stem cells, including resistance to chemotherapy, and that tumor cells that persist after therapy are dependent on TRPC6. The mechanism involves the ability of TRPC6 to regulate integrin α6 mRNA splicing. Specifically, TRPC6-mediated calcium entry represses the epithelial splicing factor ESRP1 (epithelial splicing regulatory protein 1), which enables expression of the integrin α6B splice variant. TRPC6 and α6B function in tandem to facilitate stemness and persistence by activating TAZ and, consequently, repressing Myc. Therapeutic inhibition of TRPC6 sensitizes triple-negative breast cancer (TNBC) cells and tumors to chemotherapy by targeting the splicing of α6 integrin mRNA and inducing Myc. These data reveal a Ca2+-dependent mechanism of chemotherapy-induced persistence, which is amenable to therapy, that involves integrin mRNA splicing.

Abstract In the present investigation, the direct reduction of magnetite and hematite powder with and without 5% bitumen at various temperatures has been studied in a hydrogen atmosphere. The prepared samples were fired in the temperature range of 673–1373 K to observe the weight loss and to find the effect of the bitumen in the samples. The microstructural results show that bitumen mixed with iron ore powder exhibited a more porous structure with cracks after reduction at 773 K and 973 K respectively. At temperatures above 1073 K, the carbon present in bitumen contributed to an enhanced rate of reduction of iron oxide samples. It was observed that, the reactivity of samples was affected by the level of impurities, crystal structure, binder, and composition of the reducing agent. Graphical Abstract

Percutaneous drains are commonly used to drain collections in surgical patients. The choice of drain can determine the potential complications. Herein, the authors presented a case of a 32- year-old female with a drain complication and its management in a posttransplant patient. The patient developed a post-transplant perigraft lymphocele and underwent drainage using Malecot’s catheter. However, during the removal of drain, the Malecot catheter accidentally broke, leaving the tip inside the perigraft region. To locate the tip, a non-contrast Computed Tomography (CT) scan was performed. Subsequently, the patient underwent a transperitoneal reexploration, successfully removing the tip. It was discovered that the catheter tip had ingrown tissue between the prongs, impeding its removal. It is crucial to exercise caution in such situations as Malecot catheters may sometimes have ingrown tissue between the prongs, hindering their removal.

Peaberries are a special type of coffee bean with an oval shape. Peaberries are not considered defective, but separating peaberries is important to make the shapes of the remaining beans uniform for roasting evenly. The separation of peaberries and normal coffee beans increases the value of both peaberries and normal coffee beans in the market. However, it is difficult to sort peaberries from normal beans using existing commercial sorting machines because of their similarities. In previous studies, we have shown the availability of image processing and machine learning techniques, such as convolutional neural networks (CNNs), support vector machines (SVMs), and k-nearest-neighbors (KNNs), for the classification of peaberries and normal beans using a powerful desktop PC. As the next step, assuming the use of our system in the least developed countries, this study was performed to examine their implementation in and the limitations of Raspberry Pi 3. To improve the performance, we modified the CNN architecture from our previous studies. As a result, we found that the CNN model outperformed both linear SVM and KNN on the use of Raspberry Pi 3. For instance, the trained CNN could classify approximately 13.77 coffee bean images per second with 98.19% accuracy of the classification with 64×64 pixel color images on Raspberry Pi 3. There were limitations of Raspberry Pi 3 for linear SVM and KNN on the use of large image sizes because of the system's small RAM size. Generally, the linear SVM and KNN were faster than the CNN with small image sizes, but we could not obtain better results with both the linear SVM and KNN than the CNN in terms of the classification accuracy. Our results suggest that the combination of the CNN and Raspberry Pi 3 holds the promise of inexpensive peaberries and a normal bean sorting system for the least developed countries.

Summary: Background: NVX-CoV2373, a Covid-19 vaccine was developed in the USA with ∼90% efficacy. The same vaccine is manufactured in India after technology transfer (called as SII-NVX-CoV2373), was evaluated in this phase 2/3 immuno-bridging study. Methods: This was an observer-blind, randomised, phase 2/3 study in 1600 adults. In phase 2, 200 participants were randomized 3:1 to SII-NVX-CoV2373 or placebo. In phase 3, 1400 participants were randomized 3:1 to SII-NVX-CoV2373 or NVX-CoV2373 (940 safety cohort and 460 immunogenicity cohort). Two doses of study products (SII-NVX-CoV2373, NVX-CoV2373 or placebo) were given 3 weeks apart. Primary objectives were to demonstrate non-inferiority of SII-NVX-CoV2373 to NVX-CoV2373 in terms of geometric mean ELISA units (GMEU) ratio of anti-S IgG antibodies 14 days after the second dose (day 36) and to determine the incidence of causally related serious adverse events (SAEs) through 180 days after the first dose. Anti-S IgG response was assessed using an Enzyme-Linked Immunosorbent Assay (ELISA) and neutralizing antibodies (nAb) were assessed by a microneutralization assay using wild type SARS CoV-2 in participants from the immunogenicity cohort at baseline, day 22, day 36 and day 180. Cell mediated immune (CMI) response was assessed in a subset of 28 participants from immunogenicity cohort by ELISpot assay at baseline, day 36 and day 180. The total follow-up was for 6 months. Trial registration: CTRI/2021/02/031554. Findings: Total 1596 participants (200 in Phase 2 and 1396 in Phase 3) received the first dose. SII-NVX-CoV2373 was found non-inferior to NVX-CoV2373 (anti-S IgG antibodies GMEU ratio 0.91; 95% CI: 0.79, 1.06). At day 36, there was more than 58-fold rise in anti-S IgG and nAb titers compared to baseline in both the groups. On day 180 visit, these antibody titers declined to levels slightly lower than those after the first dose (13–22 fold-rise above baseline). Incidence of unsolicited and solicited AEs was similar between the SII-NVX-CoV2373 and NVX-CoV2373 groups. No adverse event of special interest (AESI) was reported. No causally related SAE was reported. Interpretation: SII-NVX-CoV2373 induced a non-inferior immune response compared to NVX-CoV2373 and has acceptable safety profile. Funding: SIIPL, Indian Council of Medical Research, Novavax.

Case: This is a case report of a 23-year-old male who sustained right femur fracture. He presented to us with nonunion shaft of femur with intramedullary locking nail broken at second last locking hole. The patient has been operated wherein the broken nail has been removed with the help of a stainless-steel (SS) wire. Conclusion: Removal of broken intramedullary nail is often a challenging task. Many techniques have been described. We herein described a step-by-step approach of how to remove the retained fragment without opening the fracture site with the help of a SS wire, indigenously available.

Background: Lopinavir-ritonavir is a repurposed drug for coronavirus disease-2019 (COVID-19). In this study, a pooled effect of lopinavir-ritonavir on mortality, virological cure, radiological improvement and safety profile in COVID-19 patients has been evaluated. Methods: The databases were searched for comparative randomized controlled studies evaluating the efficacy and/or safety of lopinavir-ritonavir in COVID-19 patients. The mortality outcome was pooled as a risk difference (RD) with 95% CI. The virological cure, radiological improvement and adverse events were pooled as risk ratio (RR) with 95% CI. All outcomes were pooled using the Mantle-Hanzle method random effect model. The heterogeneity was assessed using the I2 test. Results: Out of 82 full text assessed, seven studies were included in the analysis. The included studies had five different control interventions: supportive care (n = 4), umifenovir (arbidol) (n = 2), navaferon (recombinant anti-tumour and anti-virus protein) (n = 1), lopinavir-ritonavir + novaferon (n = 1) and lopinavir-ritonavir + interferon beta 1b + ribavirin (n = 1). Lopinavir-ritonavir group did not show significant difference in mortality [RD: 0.00 (95% CI: −0.01, 0.02), I2 = 0], virological cure [RR: 1.06 (95% CI: 0.85, 1.31), I2 = 0%], radiological improvement [RR: 0.81 (95% CI: 0.62, 1.05)] and adverse events [RR: 2.59 (95% CI: 0.17, 38.90), I2 = 75%] than supportive care. Similarly, no difference was observed for any efficacy outcomes between lopinavir-ritonavir and other control interventions. We observed significantly high risk of adverse events with lopinavir-ritonavir as compared to umifenovir [RR: 2.96 (95% CI: 1.42–6.18); I2 = 0%]. Conclusion: There is no benefit of the addition of lopinavir-ritonavir to the standard care in COVID-19 patients.

Objective The conventional criteria for defining the basilar invagination (BI) focus on the relationship of odontoid tip to basion and opisthion, landmarks that are intrinsically variable especially in presence of occipitalised atlas. A universal single reference line is proposed that helps in unequivocally establishing the diagnosis of BI, may be relevant in establishing both Goel types A and B BI, as well as in differentiating a ‘very high’ from ‘regular’ BI. Methods Study design – case-control study. In 268 patients (group I with BI [n = 89] including Goel type A BI [n = 66], Goel type B BI [n = 23], and group II controls [n = 179]), the perpendicular distance between odontoid tip and line subtended between posterior tip of hard palate-internal occipital protuberance (P-IOP line) was measured. Logistic regression analysis determined factors influencing the proposed parameter (p < 0.05). Results In patients with a ‘very high’ BI (n = 5), the odontoid tip intersected/or was above the P-IOP line. In patients with a ‘regular’ BI (n = 84), the odontoid tip was 6.56 ± 3.9mm below the P-IOP line; while in controls, this distance was 12.53 ± 4.28 mm (p < 0.01). In Goel type A BI, the distance was 7.01 ± 3.78 mm and in type B BI, it was 5.07 ± 4.19 mm (p = 0.004). Receiver-operating characteristic curve analysis identified 9.0 mm (8.92–9.15 mm) as the cut-point for diagnosing BI using the odontoid tip-P-IOP line distance as reference. Conclusion The odontoid tip either intersecting the P-IOP line (very high BI) or being < 9 mm below the P-IOP line (Goel types A and B BI) is recommended as highly applicable criteria to establish the diagnosis of BI. This parameter may be useful in establishing the diagnosis in all varieties of BI.

Computed tomography (CT) is routinely used for preoperative anatomical evaluation of renal donors, but recent studies show that it may be useful as a predictor of renal function too. This study aimed to compare CT volumetry-attenuation-based glomerular filtration rate (GFR) with Tc99m–diethylene-triamine-pentaacetic acid (DTPA) renal scintigraphy GFR and predict post-donor nephrectomy renal function. This is a prospective study involving 39 renal donors at a tertiary care hospital in northern India from 2014 to 2017. Renal volume and attenuation were determined by CT using a semiautomatic tool, and split renal function (SRF) was calculated for each side. CT-GFR was obtained using CT-SRF and global GFR from modification of diet in renal disease equation. At 12 months after nephrectomy, GFR was estimated from serum creatinine (eGFR). Predonation CT-GFR of preserved kidney was used to predict post-nephrectomy renal function which was compared with post-donation renal function calculated using serum creatinine as well as with DTPA-GFR. Pearson correlation coefficient and scatter diagram were used to assess and test the linear relationship between two continuous variables. The Statistical Package for the Social Sciences, version 23, was used for data analysis. There was a highly significant change in mean DTPA-GFR and mean CT-GFR compared to eGFR values (50.79–64.25, 26.50%, and 50.77–64.25, 26.55%, respectively). Similarly, there was a very good correlation between DTPA-GFR and eGFR (r = 0.968, P

ABSTRACT Purpose Preoperative computed tomography or magnetic resonance (MR) imaging are commonly used for radiological evaluation of renal cell carcinoma (RCC) before radical nephrectomy or nephron sparing surgery(NSS). This study aimed to assess the role of MRI for predicting postoperative renal function by preoperative estimation of renal parenchymal volume and correlation with glomerular filtration rate (GFR). Materials and Methods A prospective observational study was conducted from February 2015 to October 2016 at a tertiary care hospital in northern India. MR imaging was done on 3 Tesla MR scanner (Signa Hdxt General Electrics, Milwaukee, USA). MR volumetry was used to estimate the renal parenchymal volume. GFR was measured in all patients using Tc99m Diethyl-triamine-penta-acetic acid using Russell’s algorithm. Such measurement was done preoperatively, and postoperatively 3 months after surgery. Results 30 patients with suspected RCC underwent NSS (n=10) and radical nephrectomy (n=20). Median tumour volume was 175.7cc (range: 4.8 to 631.8cc). The median volume of the residual parenchyma on the affected side was 84.25±41.97cc while that on the unaffected side was 112.25±26.35cc. There was good correlation among the unaffected kidney volume and postoperative GFR for the radical nephrectomy group (r=0.83) as well as unaffected kidney volume, total residual kidney volume and residual volume of affected kidney with postoperative GFR for the NSS group (r=0.71, r=0.73, r=0.79 respectively; P

Background: The present pilot study evaluated the potential of newer renal biomarkers (neutrophil gelatinase-associated lipocalin [NGAL], cystatin-C [Cys-c], and kidney injury molecule-1 [KIM-1]) in estimating subclinical renal injury due to renal artery stenosis (RAS). Materials and Methods: A total of 13 patients of magnetic resonance angiography confirmed RAS and 14 normotensive healthy controls were enrolled in the study after obtaining ethics approval and informed consent. Serum was collected from participants to check for serum levels of NGAL, KIM-1, and Cys-c by quantitative enzyme immunoassay. The data of RAS patients were compared and analyzed against the data of healthy controls. Results: sNGAL, sKIM-1, and sCys-c values in RAS patients showed rising trend as compared to normal healthy control; however, the difference in their values was not statistically significant. This could be due to small and heterogeneous sample size. However, statistically significant difference was noted in the values of sNGAL and sCys-c between healthy controls and RAS patients with abnormal serum creatinine. This difference in the values of these biomarkers was also statistically significant between RAS patients with normal and elevated serum creatinine. Conclusion: In RAS patients, sNGAL, sCys-c, and sKIM-1 seem to have potential as an early biomarker of kidney injury.

Background: Central airway obstruction (CAO) is a significant cause of morbidity and mortality in patients with thoracic malignancies. In this prospective study, we describe the role of rigid bronchoscopy (RB) in the multimodality management of CAO. Methods: Prospective description of different rigid bronchoscopic techniques used for CAO between July 2016 and July 2019. Results: A total of 152 procedures (124 therapeutic/palliative and 28 diagnostics) in 111 adults and 10 pediatric patients were performed. The mean age in 111 adults (66 males) and 10 pediatric (5 males) patients were 45.4 ± 15.8 (range 16–80) and 5.4 ± 3.6 (range 1–10) years, respectively. Palliation of the airway obstruction (48.8%) and establishment of diagnosis (23.2%) were the main indications of RB in our study. Mechanical debulking in 53 (57%) and airway dilatation in 40 (43%) patients were the most utilized interventions during the palliative or therapeutic RB. There was a significant decrease in mean (modified Medical Research Council) dyspnea scale from 3.9 ± 1.0 to 1.42 ± 0.63 and increase in mean Visual Analogue Scale from 2.06 ± 0.74 to 8.7 ± 0.54 after the procedure (P < 0.0001). Additional therapy was undertaken in 38 (31.4%) of 121 patients, and surgical excision was the primary form of definitive treatment in 17 patients Moderate bleeding was encountered in 13.3% of the procedures mainly in the diagnostic RB. The mean procedure duration was 28.4 (range, 11–49) min and 13.2 (7–22) min in the adults and pediatric patients, respectively. A total of 31 patients succumbed to the illness due to the progressive nature of their disease. Conclusions: An individualized approach to interventional procedures is safe and effective way to achieve and maintain palliation of CAO. RB with multimodality treatment achieves the goal in majority of the patients.

The root-knot nematode Meloidogyne incognita is one of the most damaging plant-parasitic nematodes and is responsible for significant crop losses worldwide. Rising human health and environmental concerns have led to the withdrawal of commonly used chemical nematicides. There has been a tremendous demand for eco-friendly bio-nematicides with beneficial properties to the nematode hosting plants, which encourages the need for alternative nematode management practices. The current study was undertaken to determine the nematicidal potential of cotton seed cake (CSC) against second-stage juvenile (J2) hatching, J2 mortality, and J2 penetration of M. incognita in tomato plants in vitro. J2s and egg masses of M. incognita were exposed to four concentrations (250, 500, 750, and 1000 mg/L) of CSC extracts. The higher J2 mortality and inhibition of J2 hatching were found at 1000 mg/L, while the least effective result was observed at 250 mg/L of the CSC extract. The CSC extract applied with the concentrations mentioned above also showed inhibition of J2 penetration in tomato roots; 1000 mg/L showed the highest inhibition of penetration, while 250 mg/L displayed the least inhibition. Using gas chromatography-mass spectroscopy, we identified 11 compounds, out of which 9,12-Octadecadienoic acid, Hexadecanoic acid, and Tetradecanoic acid were found as major compounds. Subsequently, in silico molecular docking was conducted to confirm the nematicidal behavior of CSC based on binding interactions of the above three major compounds with the targeted protein acetylcholine esterase (AChE) of M. incognita. The values of binding free energy are −5.3, −4.5, and −4.9 kcal/mol, observed for 9,12-Octadecadienoic acid, n-Hexadecanoic acid, and Tetradecanoic acid, respectively, suggesting that 9,12-Octadecadienoic acid binds with the receptor AChE more efficiently than the other two ligands. This study indicates that CSC has nematicidal potential that can be used to control M. incognita for sustainable agriculture.

Background and Aims: Radiological evaluation of renal cell carcinoma (RCC) is used for non-invasive staging for better surgical planning. However, the correlation of radiological staging using magnetic resonance imaging (MRI) with histopathological findings has not been done so far. The aim of this study is to assess the role of MRI in pre-operative staging of RCC in patients undergoing radical nephrectomy and nephron sparing surgery (NSS) and correlate it with histopathological findings. Settings and Design: This prospective observational study was conducted from February 2015 to October 2016 at a tertiary care hospital in northern India. Methods: MR imaging was done on 3 Tesla MR scanner (Signa Hdxt General Electrics, Milwaukee, USA). Preoperative staging was based on 2010 TNM staging system. The preoperative parameters in MRI were tumor size, detection/breach of pseudocapsule, tumor extension into perirenal fat and detection of tumor venous thrombus. The staging on MRI was compared with surgical and pathological staging. Statistical Analysis Used: The agreement between these three staging methods was determined using the kappa statistics (0.0-0.2, poor; 0.2-0.4, fair; 0.4-0.6, moderate; 0.6-0.8, good; 0.8-1.0, excellent). Results: 30 patients with suspected RCC underwent NSS (n - 10) and radical nephrectomy (n - 20). Mean tumor size was 9.66 ± 2.99 cm in the radical nephrectomy group and 4.06 ± 1.16 cm in the NSS group. There was perfect agreement between MRI, surgical and pathological staging for breach of pseudocapsule (κ -1.0, Percentage of Agreement - 100%,P < 0.05). In none of the patients, MRI missed extension beyond the Gerota’s fascia or presence of venous thrombus. Conclusion: MRI staging of RCC is an accurate predictor of the surgical and pathological stage and has the potential to become a useful tool for preoperative identification of patients with RCC who can undergo NSS.

Bronchioloalveolar carcinoma (BAC) is a rare subtype of adenocarcinoma of lung with distinct features and distinctive characteristics. We present a case series of four patients of BAC who underwent evaluation for nonresolving pneumonia. All the patients were nonsmokers and ranged in age from 25 to 78 years. BAC was suspected because of characteristic clinicoradiological features, and the analysis of fine-needle aspiration biopsy specimen confirmed the diagnosis. Clinicians should be aware of this presentation of BAC, which would lead to early detection and improved outcome.

Background: The use of computed tomography (CT) for estimation of split renal function (SRF) has been reported previously. However, most of these studies have small samples, and many do not account for the renal attenuation at CT. Objective: The aim of this study was to compare multidetector computed tomography (MDCT) volumetry-attenuation-based SRF with that obtained via Tc99m-diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy in voluntary renal donors. Methods: Between January 2017 and January 2020, 526 voluntary renal donors were enrolled prospectively. All donors underwent contrast CT and DTPA scan before surgery. The semiautomatic region of interest (ROI) tool was applied slice by slice on axial CT images acquired in the arterial phase. The renal contour was drawn semiautomatically with mouse clicks around the renal parenchyma, and the renal volume was ascertained. Using renal volume and attenuation, SRF was determined and compared with results obtained at DTPA imaging. Results: The mean age was 44.91 ± 10.97 years (mean ± s.d.). There was no significant difference in SRF based on DTPA and MDCT volumetry for the left kidney (49.18% ± 3.40% vs. 49.15% ± 3.38%, p = 0.540) and for the right kidney (50.82% ± 3.40% vs. 50.86% ± 3.39%, p = 0.358). A very good correlation was observed between the two methods for the left kidney (r = 0.953, p = 0.000) and the right kidney (r = 0.955, p = 0.000). On simple linear regression analysis, 90.8% of DTPA SRF values for the left kidney and 91.3% of DTPA SRF values for the right kidney could be predicted correctly using the corresponding MDCT SRF values. Conclusion: MDCT volumetry-attenuation-derived estimation of SRF for living renal donors could be an alternative to renal scintigraphy-based SRF estimation.

The presence of inorganic and organic substances may alter the physicochemical properties of iron (Fe) salt precipitates, thereby stabilizing the antimony (Sb) oxyanions in potable water during the chemical treatment process. Therefore, the present study aimed to examine the surface characteristics, size of Fe flocs and coagulation performance of Sb oxyanions under different aqueous matrices. The results showed that surface properties of Fe flocs significantly varies with pH in both Sb(III, V) suspensions, thereby increasing the mobility of Sb(V) ions in alkaline conditions. The negligible change in surface characteristics of Fe flocs was observed in pure water and Sb(III, V) suspension at pH 7. The key role of Van der Waals forces of attraction as well as hydration force in the aggregation of early formed flocs were found, with greater agglomeration capability at higher more ferric chloride dosage. The higher Sb(V) loading decreased the size of Fe flocs and reversed the surface charge of precipitates, resulting in a significant reduction in Sb(V) removal efficiency. The competitive inhibition effect on Sb(III, V) removal was noticed in the presence of phosphate anions, owing to lowering of ζ-potential values towards more negative trajectory. The presence of hydrophobic organic matter (humic acid) significantly altered the surface characteristics of Fe flocs, thereby affecting the coagulation behavior of Sb in water as compared to the hydrophilic (salicylic acid). Overall, the findings of this research may provide a new insight into the variation in physicochemical characteristics of Fe flocs and Sb removal behavior in the presence of inorganic and organic compounds during the drinking water treatment process.

In the modern era, real-time imaging-guided transbronchial needle aspiration (TBNA) has completely replaced the traditional surgical approaches to sample the mediastinal lesions for diagnosis and cancer staging. However, there is a limited role of these innovations in the presence of critical airway narrowing due to a further decrease in cross-sectional area of the airway proportionate to the outer diameters of the scope. Rigid TBNA with airway control by rigid bronchoscopy is one alternative which can be used for mediastinal sampling when modern technique is impracticable. Herein, we report the use of rigid TBNA, an underutilized old method to sample the mediastinal lesion in a patient with severe orthopnea secondary to tracheal compression by mediastinal mass.

The renal transplant recipients are prone to the variety of infectious pathogens. The HRCT features could provide valuable information for differentiation diagnosis and treatment response. Findings in renal transplant recipients with manifestations of immune-compromised-related pulmonary diseases could be either pathogen-specific or -non-specific. It is particularly fundamental to recognize these imaging characteristics at suspicion of opportunistic infections in such patients. In this article, we present a review to refresh and update our knowledge of HRCT features of pulmonary infectious diseases in immune-compromised patients.

Renal biopsy is often needed to diagnose posttransplant graft dysfunction. Although it is very safe due to availability of real-time imaging, complications do occur. We report a rare case of anterior abdominal wall vessel injury during allograft biopsy resulting in a large perigraft hematoma. It mimics a subcapsular hematoma due to intrarenal vessel injury leading to diagnostic confusion. We detected a partially thrombosed pseudoaneurysm 3 weeks after the biopsy which had feeders from superior and inferior epigastric artery confirmed by injecting contrast into the pseudoaneurysm. The pseudoaneurysm is due to injury to small branch of these arteries. We used a novel and a cost-effective therapeutic intervention to treat this pseudoaneurysm. We injected thrombin percutaneously into pseudoaneurysm which enables thrombosis of the feeder vessels preventing recurrence.

During the production of steel from Electric Arc Furnace (EAF), large amount of by-product called EAF flue dust is generated. The major proportion of flue dust is comprised of Zn (41.5 % wt.). Different phases identified by XRD analysis are zincite, franklinite and magnetite with zincite being dominant. In this study, we have performed flue dust treatment using sodium hydroxide as leaching medium. Different concentrations of alkali were used to optimize maximum recovery of Zn. XRF and Wet Chemical method were used to characterize the dust samples both before and after leaching. The optimum alkali concentration for selective leaching of zinc was found to be 4 M with a zinc recovery of 90 %.

Autocrine VEGF signaling is critical for sustaining prostate and other cancer stem cells (CSCs), and it is a potential therapeutic target, but we observed that CSCs isolated from prostate tumors are resistant to anti-VEGF (bevacizumab) and anti-VEGFR (sunitinib) therapy. Intriguingly, resistance is mediated by VEGF/neuropilin signaling, which is not inhibited by bevacizumab and sunitinib, and it involves the induction of P-Rex1, a Rac GEF, and consequent Rac1-mediated ERK activation. This induction of P-Rex1 is dependent on Myc. CSCs isolated from the PTENpc−/− transgenic model of prostate cancer exhibit Rac1-dependent resistance to bevacizumab. Rac1 inhibition or P-Rex1 downregulation increases the sensitivity of prostate tumors to bevacizumab. These data reveal that prostate tumors harbor cells with stem cell properties that are resistant to inhibitors of VEGF/VEGFR signaling. Combining the use of available VEGF/VEGFR-targeted therapies with P-Rex1 or Rac1 inhibition should improve the efficacy of these therapies significantly.

Introduction: Venous hypertension (VH) is a distressing complication following the creation of arteriovenous fistula (AVF). The aim of management is to relieve edema with preservation of AVF. Extensive edema increases surgical morbidity with the loss of hemodialysis access. We present our experience in management of VH. Methods: A retrospective study was conducted on 37 patients with VH managed between July 2005 to May 2014. Patient demographics, evaluation, and procedures performed were noted. A successful outcome of management with surgical ligation (SL), angioembolization (AE), balloon dilatation (BD) or endovascular stent (EVS) was defined by immediate disappearance of thrill and murmur with resolution of edema in the next 48-72 h, no demonstrable flow during check angiogram and resolution of edema with preservation of AVF respectively. Results: All 8 distal AVF had peripheral venous stenosis and were managed with SL in 7 and BD in one patient. In 29 proximal AVF, central and peripheral venous stenosis was present in 16 and 13 patients respectively. SL, AE, BD, and BD with EVS were done in 18, 5, 4, and 3 patients, respectively. All patients had a successful outcome. SL was associated with wound related complications in 11 (29.73 %) patients. A total of 7 AVF were salvaged. One had restenosis after BD and was managed with AE. BD, EVS, and AE had no associated morbidity. Conclusions: Management of central and peripheral venous stenosis with VH should be individualized and in selected cases it seems preferable to secure a new access in another limb and close the native AVF in edematous limb for better overall outcome.

Context: Percutaneous computed tomography (CT)-guided needle aspiration and biopsy technique have developed over time as a method for obtaining tissue specimen. Although this is a minimally invasive procedure, complications do occasionally occur. Aims: The aim of the study was to evaluate the diagnostic yield and complications of 265 percutaneous CT-guided aspiration and biopsy procedures performed on various intrathoracic lesions. Settings and Design: Data of percutaneous CT-guided aspiration and biopsy procedures of intrathoracic lesions performed over a 4 year period were retrospectively analyzed. Subjects and Methods: Procedure details, radiological images, and pathological and microbiological reports were retrieved from radiology records and hospital information system. Technical success, diagnostic yield, and complication rates were calculated. Results: Total 265 procedures were performed for lung (n = 179), mediastinum (n = 73), and pleural lesions (n = 13). Diagnostic yield for lung, mediastinal, and pleural lesions was 80.7%, 74.2, and 75%, respectively, for core biopsy specimens. Major complication was noted in only one procedure (0.4%). Minor complications were noted in 13.6% procedures which could be managed conservatively. Conclusions: Percutaneous CT-guided aspiration and biopsy procedures for intrathoracic lesions are reasonably safe with good diagnostic yield. Complications are infrequent and conservatively managed in most of the cases.

Lymphatic leak and lymphocele are well-known complications after renal transplantation, occurring among one-fourth of the recipients. We present a case of 42 year old male who underwent renal transplantation and developed recurrent perigraft collection causing hydronephrosis and rise in serum creatinine. Biochemical analysis of the fluid confirmed lymphocele. Successful treatment was done by ultrasound guided percutaneous catheter placement and instillation of 0.5% povidone iodine for 15 days. Percutaneous drainage catheter placement and sclerotherapy with 0.5% povidone-iodine is safe and effective for treatment lymphoceles and lymphatic leaks in renal allograft recipient.

Introduction: Arteriovenous fistula (AVF) is the gold standard vascular access for hemodialysis (HD). A thrill or murmur immediately after creation of AVF is considered a predictive sign of success. However, this does not ensure final maturation for successful HD. Our objective was to determine different clinical and duplex parameters within AVF to predict maturation and subsequent successful HD. Materials and Methods: A prospective observational study was conducted on 187 patients who had AVF formation from July 2012 to May 2013. Following surgery, all patients had Doppler ultrasound (DU) on Days 0 and 7. Doppler parameters noted in the outflow vein were: Thrill, broadening of spectral waveform with increased peak systolic velocity (PSV) and spiral laminar flow (SLF). Patients with at least one positive parameter at Day 0 were followed-up serially and underwent repeat Doppler imaging on Day 7. Patients with the absence of all three parameters on Day 0 were excluded from the study. Endpoint was maturation of AVF, i.e. successful HD. Statistical analysis was performed with binary logistic regression, to find out the strongest and earliest predictor for maturation of AVF using SPSS version 20. Results: SLF and broadening of spectral waveform with increased PSV were found to have a significant association with maturation (P = 0.0001). Presence of SLF on Day 0 most strongly predicted maturation. Presence of thrill or murmur could not predict the maturation. Conclusions: SLF pattern in AVF is the most important and the earliest predictor of maturation.

Urolithiasis is one of the most common conditions seen in urology practice. Renal transplantation is associated with a lower incidence of urolithiasis compared to general population. In these patients, the incidence of isolated ureteric calculi is 5–10 times lower than renal calculi. If renal and/or ureteric calculi are present in transplanted kidney, they must be attended urgently as the presentation in such patients is atypical due to lack of sympathetic innervation of the graft kidney and the condition may rapidly progress to graft dysfunction. The diagnosis of renal and upper ureteric calculi is usually made on graft ultrasonography. For mid and distal ureteric calculi, CT and MR urography are more sensitive. For nonobstructive calculi, treatment is with extracorporeal shock wave lithotripsy (ESWL) or flexible ureteroscopic removal for smaller stone burden (

Empyema necessitans is a rare sequel of untreated pleural space infection and is most commonly secondary to tuberculosis. Isolated tuberculous empyema necessitans in a renal transplant recipient is extremely rare. It is an important differential diagnosis of a chest mass in renal transplant recipient. Early identification and treatment prevents progression and morbidity. We hereby report a 62-year-old male renal transplant recipient who presented with classical features of tubercular empyema necessitans and was managed with antitubercular therapy and tube thoracostomy drainage.

Malignancies in renal transplant recipients (RTRs) usually have an aggressive biological behavior. They are detected at an advanced stage and have a poor survival rate. Post-transplant urinary bladder malignancy is an uncommon occurrence and most of these patients are in their 5th or 6th decade. We report a rare occurrence of bladder cancer in RTR in the 4th decade more than 10 years after renal transplantation with rapid progression and death within 12 weeks of diagnosis.

Multicystic Dysplastic Kidney (MCDK) is one of the most common renal conditions seen in paediatric population. The natural history typically involves involution and many of the patients with unilateral disease may actually never become symptomatic. The initial evaluation is usually done on Ultrasonography (USG) while cross-sectional imaging and nuclear scan are reserved for diagnostic dilemmas. Management is conservative and surgery is done for selected patients with symptomatic cysts or suspicion of neoplasm. We present an interesting case of MCDK in a nine-month-old female hypertensive child presenting with a large abdominal mass increasing in size with imaging features similar to cystic neoplasm and managed with nephrectomy.

Although the α6β1 integrin has been implicated in the function of breast and other cancer stem cells (CSCs), little is known about its regulation and relationship to mechanisms involved in the genesis of CSCs. We report that a CD44high/CD24low population, enriched for CSCs, is comprised of distinct epithelial and mesenchymal populations that differ in expression of the two α6 cytoplasmic domain splice variants: α6A and α6B. α6Bβ1 expression defines the mesenchymal population and is necessary for CSC function, a function that cannot be executed by α6A integrins. The generation of α6Bβ1 is tightly controlled and occurs as a consequence of an autocrine vascular endothelial growth factor (VEGF) signaling that culminates in the transcriptional repression of a key RNA-splicing factor. These data alter our understanding of how α6β1 contributes to breast cancer, and they resolve ambiguities regarding the use of total α6 (CD49f) expression as a biomarker for CSCs.

Developing a non-invasive method such as diffusion-weighted magnetic resonance imaging (DWMRI) could be used as a feasible and reproducible modality in the differential diagnosis of allograft dysfunction. We assessed the functional status of the renal allograft by DWMRI and its applicability in assessment of graft dysfunction on all end-stage renal transplant patients who attained normal renal function on the 7 th day post-transplantation. Follow-up imaging of the recipient allograft was performed at the end of 90 and 180 days and in case of graft dysfunction. Kidney biopsies were performed to correlate with the corresponding MRI. The apparent diffusion coefficient (ADC) maps of the cortex and medulla were obtained by studying the DWMRI. The ADC values were significantly lower in the medulla compared with the cortex in normal donor kidneys and normally functioning transplanted kidneys, while they decreased significantly when rejection occurred. The reduction in ADC values occurred both in the cortex and in the medulla, and correlated with the degree of rejection on the kidney biopsies. The ADC values increased significantly during the recovery from rejection. We conclude that DWMRI can be beneficial in the diagnosis and follow-up of transplant patients during acute rejection.

The high rate of recurrence after radiation therapy in triple-negative breast cancer (TNBC) indicates that novel approaches and targets are needed to enhance radiosensitivity. Here, we report that neuropilin-2 (NRP2), a receptor for vascular endothelial growth factor (VEGF) that is enriched on subpopulations of TNBC cells with stem cell properties, is an effective therapeutic target for sensitizing TNBC to radiotherapy. Specifically, VEGF/NRP2 signaling induces nitric oxide synthase 2 (NOS2) transcription by a mechanism dependent on Gli1. NRP2-expressing tumor cells serve as a hub to produce nitric oxide (NO), an autocrine and paracrine signaling metabolite, which promotes cysteine-nitrosylation of Kelch-like ECH- associated protein 1 (KEAP1) and, consequently, nuclear factor erythroid 2-related factor 2-mediated (NFE2L2-mediated) transcription of antioxidant response genes. Inhibiting VEGF binding to NRP2, using a humanized mAb, results in NFE2L2 degradation via KEAP1, rendering cell lines and organoids vulnerable to irradiation. Importantly, treatment of patient-derived xenografts with the NRP2 mAb and radiation resulted in significant tumor necrosis and regression compared with radiation alone. Together, these findings reveal a targetable mechanism of radioresistance, and they support the use of NRP2 mAb as an effective radiosensitizer in TNBC., Introduction Triple-negative breast cancer (TNBC) is highly aggressive and is associated with a poor prognosis compared with other breast cancer subtypes (1, 2). Fortunately, several reports have shown that TNBC [...]

Abstract The characterization of cells with tumour initiating potential is significant for advancing our understanding of cancer and improving therapy. Aggressive, triple‐negative breast cancers (TNBCs) are enriched for tumour‐initiating cells (TICs). We investigated that hypothesis that VEGF receptors expressed on TNBC cells mediate autocrine signalling that contributes to tumour initiation. We discovered the VEGF receptor neuropilin‐2 (NRP2) is expressed preferentially on TICs, involved in the genesis of TNBCs and necessary for tumour initiation. The mechanism by which NRP2 signalling promotes tumour initiation involves stimulation of the α6β1 integrin, focal adhesion kinase‐mediated activation of Ras/MEK signalling and consequent expression of the Hedgehog effector GLI1. GLI1 also induces BMI‐1, a key stem cell factor, and it enhances NRP2 expression and the function of α6β1, establishing an autocrine loop. NRP2 can be targeted in vivo to retard tumour initiation. These findings reveal a novel autocrine pathway involving VEGF/NRP2, α6β1 and GLI1 that contributes to the initiation of TNBC. They also support the feasibility of NRP2‐based therapy for the treatment of TNBC that targets and impedes the function of TICs. → See accompanying article http://dx.doi.org/10.1002/emmm.201302505

Genetic diversity and phylogenetic relationships among 48 cowpea [Vigna unguiculata (L.) Walp.] genotypes collected from different places in India were evaluated using simple sequence repeat molecular markers. A set of 40 primer combinations developed from cowpea genomic/expressed sequence tags and evaluated for their ability to detect polymorphisms among the various cowpea genotypes. Eleven primer combinations detected polymorphisms; sixteen primer combinations were monomorphic, with the remaining 13 primer sets failing to yield PCR amplification products. From one to 5 alleles were found among the informative primer combinations. The genetic diversity of the sample varied from 0.02 to 0.39 (mean = 0.205). The polymorphic information content ranged from 0.12 to 0.86 (mean = 0.49). The inter-cluster representatives of distant clusters (based on morphological and molecular markers) would be more useful for choosing the parents in cowpea breeding programmes.