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Abstract Suspensions containing microencapsulated phase change materials (MPCMs) play a crucial role in thermal energy storage (TES) systems and have applications in building materials, textiles, and cooling systems. This study focuses on accurately predicting the dynamic viscosity, a critical thermophysical property, of suspensions containing MPCMs and MXene particles using Gaussian process regression (GPR). Twelve hyperparameters (HPs) of GPR are analyzed separately and classified into three groups based on their importance. Three metaheuristic algorithms, namely genetic algorithm (GA), particle swarm optimization (PSO), and marine predators algorithm (MPA), are employed to optimize HPs. Optimizing the four most significant hyperparameters (covariance function, basis function, standardization, and sigma) within the first group using any of the three metaheuristic algorithms resulted in excellent outcomes. All algorithms achieved a reasonable R-value (0.9983), demonstrating their effectiveness in this context. The second group explored the impact of including additional, moderate-significant HPs, such as the fit method, predict method and optimizer. While the resulting models showed some improvement over the first group, the PSO-based model within this group exhibited the most noteworthy enhancement, achieving a higher R-value (0.99834). Finally, the third group was analyzed to examine the potential interactions between all twelve HPs. This comprehensive approach, employing the GA, yielded an optimized GPR model with the highest level of target compliance, reflected by an impressive R-value of 0.999224. The developed models are a cost-effective and efficient solution to reduce laboratory costs for various systems, from TES to thermal management.

The major objective of the presented work is to explore the effect of post injection (PI) strategy using neat diesel fuel (D100) blended with cetane number enhancer (CNE). The motive behind adding CNE in diesel fuel was to lower its self-ignition temperature and hence delay period subsequently. This can lead to more efficient combustion of post injected fuel which leads to lower incomplete combustion losses. The CNE used was Di-Tert-Butyl Peroxide (DTBP) which was blended with D100 in proportion of 1 % by volume. Initially experiments were conducted with D100 under various PI modes where variation of post injection timing (PIT) as well as post quantity (PQ) was considered. The experimental results showed that implementing PI resulted in lower smoke, unburned hydrocarbon (UHC), carbon monoxide (CO) and nitrogen oxides (NOx) emissions compared to single injection while affecting fuel consumption negatively. Then after similar experiments under various PI modes were repeated using blends of D100 and DTBP (D/DTBP) and results were compared with D100 case. It was found that addition of CNE in D100 resulted in more complete combustion of post fuel which further reduced CO and UHC emissions. The shorter delay period in case of D/DTBP blend compared to D100 case led to lower NOx emissions as well as higher smoke emissions. The obtained results revealed that PI mode with 3 mg PQ and 20° after top dead center (ATDC) PIT with D/DTBP blend offered 41.18 %, 17.55 %, 64 % and 62.5 % reduction in smoke, NOx, UHC and CO emissions respectively compared to single injection mode using D100 fuel.

This experimental study introduces a novel approach to enhancing solar still performance through the integration of wax-filled rods, marking a significant advancement in solar desalination technology. These rods, innovatively designed to absorb and store both sensible and latent heat during peak solar radiation hours, release this stored energy gradually, particularly during the evening and night. This unique mechanism results in a notable and consistent increase in water temperature within the modified solar still after 17:00, setting it apart from conventional models. The study's findings reveal that the modified solar still achieves a 12.8 % higher cumulative distillate yield and a 16.3 % increase in efficiency compared to traditional solar stills. Furthermore, this enhancement translates into a 6.3 % reduction in distillate production costs, underscoring the economic viability and superior performance of the modified design.

Abstract Heart failure poses a global health challenge affecting millions of individuals, and access to guideline-directed medical therapy is often limited. This limitation is frequently attributed to factors such as drug availability, slow adoption, clinical inertia, and delayed diagnosis. Despite international recommendations promoting the use of guideline-directed medical therapy for heart failure management, personalized approaches are essential in settings with resource constraints. In India, crucial treatments like angiotensin II receptor blocker neprilysin inhibitors and sodium-glucose co-transporter 2 inhibitors are not fully utilized despite their established safety and efficacy. To address this issue, an expert consensus involving 150 specialists, including cardiologists, nephrologists, and endocrinologists, was convened. They deliberated on patient profiles, monitoring, and adverse side effects and provided tailored recommendations for guideline-directed medical therapy in heart failure management. Stressing the significance of early initiation of guideline-directed medical therapy in patients with heart failure, especially with sodium-glucose co-transporter 2 inhibitors, the consensus also explored innovative therapies like vericiguat. To improve heart failure outcomes in resource-limited settings, the experts proposed several measures, including enhanced patient education, cardiac rehabilitation, improved drug access, and reforms in healthcare policies.

The present study explores the prospects of operational stability of dual fuel operation comprehensively, considering that; methanol and diesel are of two different kinds which exhibit different combustion processes. To this effect, investigating the stability of engine operation under such condition becomes important. In this investigation, the harshness of the operation and the non-repeatability of the combustion cycles are examined, which have been identified as the major stability indicator in many studies. Such stability indices are characterized in this study through a comprehensive set of parameters, including of maximum pressure rise rate (ROPRmax) and coefficient of variation of indicated mean effective pressure (COVIMEP); and of peak pressure (COVPP) and crank angle of 50% mass fraction burn (COVCA50). The experimental investigation is carried out under a split injection strategy by varying injection timings as well as injection mass percentages at predefined methanol injection durations. It is shown that the partially premixed mode under the split injection strategy exhibits significant potential in reducing the harshness of operation indicated by lower peak pressure rise and increasing the repeatability of the combustion cycles implied by the substantially lower scores of the considered parameters for mapping stability.

Understanding how to manage the hydrophilicity and hydrophobicity of a surface has been the focus of a lot of research in recent years. The surface's energy often controls its hydrophobic state. There are numerous techniques to realize a change in the surface energy. Smart nano-based materials are being used to create super hydrophobic coatings that will serve as layers of defence against mechanical abrasion, corrosion, and fouling agents on the surface of metallic components. These coatings, which have recently gained popularity, have shown to be excellent choices for protecting steel pipelines. The recently created super hydrophobic coatings for glass surfaces, papers, cotton, steel pipes, etc., are examined in-depth and critically in this review study, emphasizing their use in different industries. It explains how to create super hydrophobic coatings on glass substrates using various techniques and the most recent research results on various coating production techniques. An in-depth discussion is also given to the recent applications of these created super hydrophobic coatings for treatments, including anti-bio fouling, dicing, and corrosion prevention over the past five years. According to the literature, spraying is the most adaptable and popular technique for creating super hydrophobic coatings for any substrate.

Abstract The present work examines the physical, thermal tensile, and chemical properties of wood skin fibers obtained from second generation Bitter Albizia (BA) tree skin. Chemical characterization of BA fibers showed the presence of various chemical contents such as cellulose of 74.89 wt. %, hemicellulose of 14.50 wt. %, wax of 0.31 wt. %, lignin of 12.8 wt. %, moisture of 11.71 wt. %, and ash of 19.29 wt. %. The density of BA fibers (BAFs) was showed 1285 kg/m3. XRD analysis of BAFs showed a crystallinity index (CI) of 57.20% and size of crystallite of 1.68 nm. Tensile strength and strain to failure of BAFs examined through tensile test were 513–1226 MPa and 0.8–1.37% respectively. TGA portrayed the thermal steadiness of BAFs as 339 °C with 55.295 kJ/mol kinetic activation energy, its residual mass was 23.35% at 548 °C. BAFs with high CI, less wax content, and better tensile strength make more suitable for making polymer matrix composites. SEM images of the BAFs surface depicted that the fiber outer surface has more rough which shows that they can contribute to hige fiber-matrix adhesion during composites preparation.

In the present experimental effort is made to increase the performance of a solar still (SS) by including a novel design of a zig-zag-shaped air-cooled condenser (ZZACC) and cuprous oxide (CuO) as a nanomaterial. Research work is conducted in the climatic conditions of Gandhinagar, Gujarat, India, from September to November 2020. A comparison was made to assess the performance of a conventional solar still (CSS) and a solar still equipped with a zig-zag shape air-cooled condenser (SSWZZACC) with CuO. The experiments’ findings showed that adding CuO to SSWZZACC increases the distillate production by 46.83% and the daily energy efficiency by 45.98%, respectively, compared to CSS. Also, SSWZZACC demonstrates a better efficiency of exergy and latent heat of vaporization than CSS because CuO causes an increase in the evaporative heat transfer coefficient of water. In life cycle cost analysis study discovered that SSWZZACC has a 27.77% lower cost per litre of water (CPL) than CSS. The obtained maximum energy and exergy efficiency values for CSS and SSWZZACC were 2.36% & 25.75% and 3.9% & 37.59%, respectively. In economic and environmental aspects, it was found that SSWZZACC with CuO showed a cost-effective desalination unit and was highly effective from a carbon credit point of view (CCP) by CO2 mitigation.

Reversed flow in the basilar artery can be acquired or congenital. Acquired reversed flow in the basilar artery can result from acute thrombosis of the basilar artery or retrograde vertebral artery flow. Congenital continuous retrograde basilar artery flow has not been described. We report a 2-day-old male presenting with hypocalcemic seizures which led us to obtain a Duplex echoencephalogram. An echocardiogram was subsequently ordered. In the coronal plane through the anterior fontanelle, retrograde flow was seen in the basilar artery and the right vertebral artery. In the axial plane through the temporal window, the flow was anteroposterior in both posterior communicating arteries. In the posterior cerebral arteries, the flow was retrograde in the P1 segment and anterograde in the P2 and P3 segments. An interrupted aortic arch was suspected. The echocardiogram showed a large perimembranous ventricular septal defect with bidirectional shunting, a hypoplastic and bicuspid aortic valve, an aortic arch interrupted between the left common carotid artery and the left subclavian artery (type B interrupted aortic arch), and a 5 mm patent ductus arteriosus with predominant right to left flow. Because of the patency of the large patent ductus arteriosus, our patient showed no sign of posterior circulation insufficiency. Prostaglandin E1 therapy was initiated immediately. Diagnosis of DiGeorge syndrome was proven. The infant underwent interrupted aortic arch repair and anterograde flow was established in the basilar artery. We conclude that congenital asymptomatic continuous retrograde flow in the basilar artery and left vertebral artery is a medical emergency as it implies the presence of type B interrupted aortic arch with large patent ductus arteriosus in a neonate.

This study tests binary and ternary n-pentanol, ethanol, and petrol blends to increase spark-ignition (SI) engine performance and minimize CO and HC emissions. To improve brake thermal efficiency (BTE) and reduce emissions, adding ethanol into gasoline is one of the practices used in Automobiles. But the literature reported some performance limitations and problems with adding a high ethanol concentration to gasoline as phase separation problem occurs in fuel tank due to the hygroscopic nature of ethanol, a higher ethanol concentration may corrode some parts of the fuel supply system. Ethanol has a lower calorific value than gasoline, so a higher ethanol concentration in blends beyond a specific limit reduces BTE. N-pentanol as a fuel additive in gasoline can better solve these problems due to its high caloric value compared to ethanol. Also, when n-pentanol is mixed with gasoline and exposed to moisture, it does not separate in stages as in the ethanol case. Accordingly, this research aims to evaluate n-pentanol's viability as a fuel additive in petrol and ethanol-gasoline blends at different compression ratios. The experiments were carried out on a single-cylinder, four-stroke spark-ignition engine running at a constant speed. Different blends of n-pentanol with gasoline and ethanol were tested, and results were compared against gasoline and E10 (the optimal blend of ethanol-gasoline, 10/90 v/v %). Various parameters were examined, including BTE, brake-specific fuel consumption (BSFC), and different exhaust pollutants. The effects of compression ratio values on these parameters were also recorded. The 1.5 vol% pentanol with E10 (E10P1.5) mix has the best overall characteristics, including low BSFC, high BTE, and low CO and HC emissions compared to petrol and E10 fuels. E10P1.5 shows a maximum enhancement in BTE, low BSFC, CO reduction, and HC reduction by 23.79%, 19.80%, 37.79%, and 19.46%, respectively, over gasoline. Compared to E10, the improvement is 3.64% for BTE, 4.59% for BSFC, 8.88% for CO emission reduction, and 4.13% for HC emission reduction.

Abstract Cryptococcus-associated immune reconstitution inflammatory syndrome (C-IRIS) is a condition frequently occurring in immunocompromised patients receiving antiretroviral therapy. C-IRIS patients exhibit many critical symptoms, including pulmonary distress, potentially complicating the progression and recovery from this condition. Here, utilizing our previously established mouse model of unmasking C-IRIS (CnH99 preinfection and adoptive transfer of CD4+ T cells), we demonstrated that pulmonary dysfunction associated with the C-IRIS condition in mice could be attributed to the infiltration of CD4+ T cells into the brain via the CCL8-CCR5 axis, which triggers the nucleus tractus solitarius (NTS) neuronal damage and neuronal disconnection via upregulated ephrin B3 and semaphorin 6B in CD4+ T cells. Our findings provide unique insight into the mechanism behind pulmonary dysfunction in C-IRIS and nominate potential therapeutic targets for treatment.

Objectives: The study evaluated the effects of climatic conditions and its variables on incidence of ACS in Gujarati Asian Indians. Methods: In this multicentric, retrospective, observational case control study of a total of 3256 patients, the Electronic Medical Records (EMS) of all 740 patients who were hospitalised for ACS at the 2 tertiary care centres of Ahmedabad over 3 years between January 2017 to December 2019 were compared with demographically matched 2516 non- ACS, CAD controls were compared for the impact of climatic parameters viz. temperature, barometric pressure, humidity as reported by monthly averages by the state meteorological department for monthly incidence of ACS. Results: The highest number of ACS cases were observed during the month of September (N = 127; 27%) followed by August (N = 123; 26%). Higher humidity and decreasing atmospheric pressure were associated with highest occurrence of ACS in the state of Gujarat. ST elevation Myocardial Infarction (STEMI) was the most common type of ACS (N = 598; 80.8%). In ACS, the Coefficient of correlation for humidity was 0.712 (P = 0.009), while that for temperature was 0.506 (P = 0.093). Effect of atmospheric pressure was found to be significant with a negative Coefficient of correlation of −0.571 (P = 0.052). However amongst the controls, the coefficient of correlation for humidity was 0.062 (P = 0.722) and atmospheric pressure Correlation coefficient was 0.107 (P = 0.539) non-significant. Conclusions: The higher humidity/temperature and lower atmospheric pressure had a positive correlation with the incidence of ACS with highest incidence noted in August and September in the state of Gujarat.

Potable water is limited on the earth today, and its use is increasing day by day due to the industrial revolution and population. Solar still is a simple device used to convert saline/brackish water into potable water by application of solar energy. The distillate output of solar still remains lower. Also, it is the main problem of the solar still, so the researchers are trying to discover new innovations to improve distillate output. The main objective of this research paper is to use toner waste powder (TWP) mixed with black paint and its effect on distillate output and energy-exergy efficiency analysis. Toner waste powder characterized by FESEM and XRD tests. In the present work, two similar-sized solar stills have been used under climate conditions of Palanpur (24.1724° N, 72.4346° E), India, from April 2022 to May 2022. Observations of solar stills like water, inner glass cover temperature, distillate output, wind speed and solar intensity are measured every hour during experimental days. It has been found that the coating of the absorber plate with toner waste powder improved distillate output by 55.71 % and 51.90 % at water depths 2 cm and 3 cm as compared with the conventional solar still & 9.54 % higher at 2 cm water depth compared to 3 cm water depth. Energy and exergy efficiency also increased with the toner waste powder in solar still. From this research work, it has been concluded that the toner waste powder is a good low-cost material to increase the distillate output, energy and exergy efficiency.

In this experimental study, a novel approach combining a helical coiled wire (HCW) turbulator and bubble injection (BI) method has been employed to synergistically improve the heat transfer efficiency of double tube heat exchanger. The thermal-frictional characteristics were evaluated by investigating different parameters, including the bubble injection flow rate ranging from 2 to 5 l/min and HCW pitch ranging from 2.5 to 10 mm. For all cases, the thermal enhancement factor (TEF) is employed to determine the optimal configurations. The experimental findings indicate that the introduction of bubble injection, the implementation of the HCW turbulator, and the simultaneous utilization of both methods result in an enhancement of heat transfer by 66 %, 78 %, and 156 % respectively. However, it should be noted that the usage of these methods also leads to an increase in pressure drop. Also, the findings indicate that the integration of two methods yields favorable outcomes in terms of thermal performance when compared to their individual functions. In the optimal scenario, the TEF has the potential to reach a maximum value of 1.28. Furthermore, in order to obtain a more precise comprehension of the relationship between TEF and the parameters under investigation, an empirical equation have been derived and presented.

BackgroundIdentification of cancer metastasis-relevant molecular networks is desired to provide the basis for understanding and developing intervention strategies. Here we address the role of GIPC1 in the process of MACC1-driven metastasis. MACC1 is a prognostic indicator for patient metastasis formation and metastasis-free survival. MACC1 controls gene transcription, promotes motility, invasion and proliferation of colon cancer cells in vitro, and causes tumor growth and metastasis in mice.MethodsBy using yeast-two-hybrid assay, mass spectrometry, co-immunoprecipitation and peptide array we analyzed GIPC1 protein binding partners, by using the MACC1 gene promoter and chromatin immunoprecipitation and electrophoretic mobility shift assay we probed for GIPC1 as transcription factor. We employed GIPC1/MACC1-manipulated cell lines for in vitro and in vivo analyses, and we probed the GIPC1/MACC1 impact using human primary colorectal cancer (CRC) tissue.ResultsWe identified MACC1 and its paralogue SH3BP4 as protein binding partners of the protein GIPC1, and we also demonstrated the binding of GIPC1 as transcription factor to the MACC1 promoter (TSS to -60 bp). GIPC1 knockdown reduced endogenous, but not CMV promoter-driven MACC1 expression, and diminished MACC1-induced cell migration and invasion. GIPC1 suppression reduced tumor growth and metastasis in mice intrasplenically transplanted with MACC1-overexpressing CRC cells. In human primary CRC specimens, GIPC1 correlates with MACC1 expression and is of prognostic value for metastasis formation and metastasis-free survival. Combination of MACC1 and GIPC1 expression improved patient survival prognosis, whereas SH3BP4 expression did not show any prognostic value.ConclusionsWe identified an important, dual function of GIPC1 - as protein interaction partner and as transcription factor of MACC1 – for tumor progression and cancer metastasis.

Ziziphus mauritiana Lam. (Rhamnaceae) is a large spiny shrub or small tree, native to the Indian subcontinent that can reach a maximum height of 9–15 m. This plant stands as a renowned tropical fruit variety, commonly recognized as the Indian plum, Desert apple, or Indian Jujube. The objective of this study was to examine the standard physicochemical parameters of Z. mauritiana seed kernel oil and to formulate the ketoconazole soap (2 % w/w), using the obtained oil, as a base. The oil was obtained through hexane extraction from the seed kernels. To formulate pharmaceutical ketoconazole soap, Z. mauritiana seed kernel oil was subjected to a basic saponification reaction using potassium hydroxide. All the examined physicochemical parameters, namely acid value (4.71 mg KOH/g), saponification value (229.18 mg KOH/g), peroxide value (4.15 milliequivalents KOH/g), ester value (224.47 mg KOH/g), iodine value (11.19 mg KOH/g), refractive index (1.448), pH (5.93), viscosity (89 cP), and specific gravity (0.912 g/mL) were within the acceptable range for industrial purposes. The examination of quality control parameters, namely drug content (99.49 %), total fatty matter (71.13 %), foam retention time (17.21 min), foam height (18.56 cm), moisture content (9.14 %), and pH (7.16) indicated that the newly formulated ketoconazole soap complied with the acceptable limits. In summary, our research demonstrated the excellent physicochemical stability of Z. mauritiana seed kernel oil and its suitability as a soap base, supporting its promising prospects for cost-effective production of cosmetics, soaps, and shampoos in the pharmaceutical and cosmeceutical industries, reducing reliance on synthetic bases.

Objective: The advent of 3D transesophageal echocardiography (TEE) was supposed to facilitate more accurate etiological diagnosis of prosthetic valve dysfunction as compared to 2D TEE; however, data to support the same is sparse especially in Asian Indians. Methods: This was a prospective, open- label study of 50 consecutive patients with prosthetic valve dysfunction who were eligible for the study. All patients underwent both 2D and 3D TEE for assessment of prosthetic valve dysfunction apart from their demographics, clinical evaluation, laboratory assessment and fluoroscopy. Results: Of 50 patients, 12 had aortic valve prosthetic dysfunction and 38 patients had mitral valve prosthesis dysfunction. Of these, 10 were male and remaining 40 were female patients. Overall, 41 (82%) patients had subtherapeutic prothrombin time at the time of presentation. Thrombus in situ was visualized in 34% of patients with 3D TEE as compared to 2D TEE (4%) (p=0.004). Pannus formation was observed in 20% of patients with 3D TEE as compared to 2D TEE, which could not identify pannus formation in any patient (p=0.03). In 34% of patients, normal motion of leaflets could be seen using 3D TEE as compared to 30% of patients by 2D TEE. Conclusion: Compared to 2D TEE, 3D TEE imaging offers superior capabilities in assessing prosthetic valve dysfunction, particularly when evaluating thrombus and pannus formation. Additionally, both modalities show nearly similar effectiveness in assessing leaflet motion.

As a technology, a Heat Melt Refuse Compactor (HMRC) has been developed to process municipal solid waste by converting into tiles and on-site valuable products. The HMRC compacts, heats the solid waste to 200°C and recovers the water from the MSW. The heating causes volatile contaminants to be released into the air. The model has evaluated the design and testing parametrs for MSW processing and analysis. HMRC testing has demonstrated water recovery upto 99%, waste volume reduction upto 80%, tile stabilization for long-term, passive separation of liquid/gas phase, and operations with low maintenance cost.Heat melt refuse compactor has designed to compress by compaction process, encapsulate the waste bi-product, residual gas/water at atmoshpheric pressure, waste volume reduction and microbial stabilization. The model design shows the benefit of a heat melt refuse compactor on-site use by converting the solid waste into valuable products with thermal and compression technique. HMRC model has processed ∼1300 kg of solid waste; which produced ∼700 kg of tile, recovered ∼400 kg of water, and ∼200 kg of gaseous and residual waste. The compression ratio (Cc) of solid waste has been estimated with a compression cell with a diameter between 65 to 100 mm, mesoscale data for a diameter of 195 mm to 265 mm and high-scale data for a diameter of 300 to 400 mm. Cc is a more sensitive variable in formation of bi-products from MSW. Ground base HMRC has designed for Cc stress ranges from 20 to 300 kPa to function within the physical and environmental constraints.E-control contaminant removal mechanism keeps the environment clean and safe.

Background: Heart rate varies during breathing and the heart rate variability (HRV) facilitates the autonomic homeostatic capacity. The maximum HRV was observed at around 10 s of prolonged respiration as per HRV biofeedback literature. However, there is a gap in understanding the variations in HRV by different respiration lengths during simple Bhramari practice. Objective: To assess the effect of various respiration lengths (8, 10, 12, and 14 s) on HRV during the simple Bhramari (humming) practice. Methodology: A total of 118 individuals (67 males, 51 females) signed up for the study based on convenience sampling at a wellness center. A randomized (simple permutation) within-subject crossover design with repeated measures was used to measure their HRV during the simple Bhramari practice. The results were analyzed with one-way ANOVA and paired samples t-test. Results: The results indicate that, unlike the 10 s of respiration during HRV biofeedback breathing, maximum HRV during humming happens between 12 and 14 s of long breathing. Conclusions: The unique findings of the study demonstrate the maximization of HRV between the respiration lengths of 12 and 14 s. Future work should explore expanding the research to a broader group of participants, including individuals with chronic conditions and other demographic variables and mantra chanting.

Globally During the winter of the year, having a warm place to stay is a necessity, especially true in mountainous regions. Electric heating and biomass burning are the most common methods for this purpose. However, solar PV-based electric heating is a sustainable way to eliminate the cost of heating, which requires more panels and a large floor area. Alternatively, a solar thermal system is used for building heating during the winter season. But the effectiveness and duration of heating support depend on the system's features and the researchers' efforts to maximize them. This research aims to develop a zero-emission/energy-building heating system with a PCM. The influence of PCM choice is validated experimentally to maximize winter heating. Solar parabolic dish collectors (14 sq. m) with two distinct PCM embedded absorbers, such as KNO3–NaNO3 and KNO3–NaNO3–NaNO2, were considered for the investigation to optimize the PCM for the best performance with respect to building heating. The experimental results reveal that the KNO3–NaNO3 PCM outperformed by exhibiting a higher heat transfer rate than the PCM of KNO3–NaNO3–NaNO2. Hence the maximum output water temperature was recorded as 94 °C, and the quantity of heat transfer was 6273 W. The system's energy efficiency was 50.6%, and the exergy was 5.99% with the absorber, which embedded KNO3–NaNO3 PCM. It was found that the black coating decreased heat loss from the absorber's surface, and net heat transfer to the absorber was improved significantly.

A microplate heat exchanger is one of the most compact types of heat exchanger used for cooling systems, and not much research was carried out to study the performance of this type of heat exchanger with hybrid nanofluids. In this regard, the performance analysis of the microplate heat exchanger is carried out by estimating the convective heat transfer coefficient in terms of Nusselt number using a hybrid nanofluid. In current research work, Microplate heat exchangers tested using TiO2/ethylene glycol, ZnO/ethylene glycol nanofluids, and a hybrid nanofluid with varied nanoparticle volume fractions. Based on the results, it was found that the thermal conductivity of hybrid nanofluids and the overall heat transfer coefficient by applying hybrid nanofluids show better enhancement than nanofluids. The maximum thermal conductivity ratio between the hybrid nanofluid and the base fluid is 2.10. The maximum Nusselt number of 35.8 was observed for hybrid (TiO2–ZnO/ethylene glycol) at 50 °C and a volume fraction of 4%.

Cardiac amyloidosis (CA), a significant condition resulting in infiltrative cardiomyopathy and heart failure with preserved ejection fraction (HFpEF), is caused by extracellular deposition of amyloid fibrils in the heart. Even though this has been known for an extended period, its prevalence in elderly patients with heart failure is increasingly being recognized. Recent advances in diagnosis with non-invasive methods like technetium pyrophosphate-labeled cardiac scintigraphy (i.e., Tc-PYP scan) and treatment options with tafamidis have played a pivotal role in awareness of the burden of this disease. Management of cardiac complications like heart failure, atrial arrhythmias, conduction block, ventricular arrhythmias, coronary artery disease, and aortic stenosis is now more critical than ever. We aim to review and outline the recent advances in diagnoses of CA. We also review management strategies for cardiac complications of CA with a brief summary of disease-modifying therapies.

Objective: Patients with rheumatic mitral stenosis, despite having normal left ventricular ejection fraction (LV EF), have ventricular dysfunction in the form of impaired longitudinal excursion. Tissue Doppler velocity is a useful indicator for assessment of long-axis ventricular shortening and lengthening. The aim of our study was to evaluate the effect of percutaneous balloon mitral valvuloplasty (PBMV) on LV function in rheumatic MS and to study echocardiographic parameters with M-Mode and Tissue Doppler Imaging pre PBMV, post PBMV and on follow-up to determine predictors of LV function. Methods: We analysed 52 patients with severe mitral stenosis with normal LV EF, who underwent PBMV at our institute. Baseline parameters of LV function were compared with immediate post PBMV and at three months follow up. Results: The mean age of the patients was 33.73 (10.87) years with female preponderance. The mean mitral valve area before PBMV was 0.92 (0.13) cm2 which increased to 1.65 (0.21) cm2 after PBMV and at 3 month it was 1.61 (0.23) cm2 (p0.05). Mitral valve E’ was 8.71 (1.54) cm/s which increased to 10.13 (1.68) cm/s post PBMV and at 3 month it was 10.83 (1.34) cm/s (p

The energy and exergy analysis of a single slope solar stills using ceramic type rectangular and circular magnets in the basin was carried out in this study and compared to conventional solar still. The results showed that the rectangular magnet solar still (RMSS) had higher hourly productivity of about 5.8% and 13.7% than circular magnet solar still (CMSS) and conventional solar still (CSS), respectively. For 12 h of reading, the cumulative productivity in RMSS, CMSS, and CSS was observed at 3.15 kg/m2, 2.82 kg/m2, and 2.15 kg/m2, respectively. Compared to CMSS and CSS, the RMSS has enhanced its energy efficiency by 4.9% and 6.9%, respectively. The observed exergy efficiency in RMSS has increased to 3.4% and 17.2%, respectively, than CMSS and CSS. Due to sensible heat absorbed by magnets, the amount of exergy lost in the RMSS and CMSS basin is much less than in CSS. In economic analysis, the estimated produced water cost (PWC) of RMSS is 4.5% and 22.2% lower than the PWC estimated in CMSS and CSS, respectively. Overall, the results showed that the magnetization of saline water made the solar still work much better.

Coronary artery anomalies are estimated to be present in 1.8% of the population. Though majority of them are benign, some may lead to angina pectoris, myocardial infarction, cardiac arrhythmias, congestive heart failure and sudden cardiac death, especially in the young. Hence the need arises to identify and treat possible malignant anomalies.

Background: Various inotropic agents/vasopressors combinations are used in patients of cardiogenic shock. We performed this study to observe hemodynamic effects of various inotrope/vasopressor combinations in patients with NSTEMI cardiogenic shock (CS) at tertiary cardiac centre Methods and materials: Of 3832 NSTEMI, we studied 59 consecutive such patients with CS who hadn't undergone revascularization in the first 24 h in a prospective, open label, observational study. Group 1 comprised of background Dopamine with Noradrenaline titration(N = 38), Group 2 had background Dobutamine and Noradrenaline titration(N = 15) and Group 3 comprised of triple combination of Dopamine, Noradrenaline & Adrenaline(N = 6). Results: The mean change in hemodynamic parameters between these groups from baseline to 24 h showed no statistical difference. Cardiac output(CO), mean arterial pressure(MAP), central venous pressure(CVP) and cardiac power output(CPO) in group 2 were favorable at 6 and 24 h compared to baseline but mean change was insignificant as compared to others. In group 3, the increase in MAP was significant. IABP use did not change CO, CPO or SVR in any group except lower dosages of Dobutamine (49%) in IABP group. Lower in-hospital mortality in group 2 compared to others (P = 0.004) may be reflective of sicker patients in group 1 and 3. Conclusion: The mean changes in hemodynamic parameters were not significant between all groups. All regimes of inotropes when selected as per clinical indication in CS with ACS resulted in similar hemodynamic effects. The mortality difference may not truly be reflective of regimes rather reflect sicker patients in the higher mortality group.

Thermal energy storage is crucial for the sustainability of an energy supply system. One of the best thermal energy storage systems is latent heat thermal energy storage tanks. In the present study, a shell and tube heat storage tank is simulated based on computational fluid dynamics. The tank consists of 18 hot and cold tubes and the space between them is filled with paraffin as a phase change material (PCM). The effects of adding SWCNT and GNP nanoparticles are evaluated on the PCM in different heat fluxes. The simulation is implemented by developing the C++ code in OpenFOAM software, and the solution is performed with the PIMPLE algorithm and finite volume method. Results reveal that the melting volume ratio of the PCMs is independent of the inlet heat flux, and increasing the inlet heat flux only accelerates the melting process. Adding SWCNT to the paraffin reduced the melting time by 43% and stored 147% more latent heat energy in comparison to pure paraffin.

Introduction: To evaluate the efficacy/safety profile of the Abluminus DES+ over 2-years follow-up in the "real-world" scenario in diabetics as compared to non-diabetics. Methods: In prospective, all-comers, open-label registry conducted at 31 sites, patients were analyzed for 1 & 2-year outcomes with the primary endpoint defined as 3P-MACE of CV death, target vessel related myocardial infarction (TV-MI), ischemia-driven target lesion revascularization (TLR)/target vessel revascularization (TVR) apart from Stent thrombosis (ST). Results: Of 2500 patients of PCI with 3286 Abluminus-DES+, 1641 (65.64%) were non-diabetics while859 (34.36%) were diabetics. The 3-P MACE for the cohort at 1 & 2 years were 2.9%, and 3.16%; TLR/TVR - 1.4% at both the intervals for 2493 patients at 2 yrs. follow-up. TV-MI & ST were 0.36% and0.56% at 1st and 2nd year respectively. The 3P-MACE was lower in non-diabetics at 1 & 2 years (2.3%vs 4.2%; 2.4% vs 4.7% respectively). For components of MACE, CV mortality (0.9 vs 1.9% at 1 yr ; 1.0vs 2.1% at 2 years) was significant (P < 0.05) while TLR (1.1 vs 1.9% at 1 yr. & 1.1 vs 2.1% at 2 yrs.) and TV-MI (0.9 vs 1.9% at 1 yr. & 1 vs 2.1% at 2 years) were similar for diabetics and non-diabetics so was ST (P > 0.05). Conclusion: Abluminus-DES+ showed excellent 2-year safety and efficacy with low 3-P MACE which was higher in diabetics driven by higher CV death but similar TLR, TV-MI and ST.

ECG is a non-invasive tool for arrhythmia detection. In recent years, wearable ECG-based ambulatory arrhythmia monitoring has gained increasing attention. However, arrhythmia detection algorithms trained on existing public arrhythmia databases show higher FPR when applied to such ambulatory ECG recordings. It is primarily because the existing public databases are relatively clean as they are recorded using clinical-grade ECG devices in controlled clinical environments. They may not represent the signal quality and artifacts present in ambulatory patient-operated ECG. To help build and evaluate arrhythmia detection algorithms that can work on wearable ECG from free-living conditions, we present the design and development of the CACHET-CADB, a multi-site contextualized ECG database from free-living conditions. The CACHET-CADB is subpart of the REAFEL study, which aims at reaching the frail elderly patient to optimize the diagnosis of atrial fibrillation. In contrast to the existing databases, along with the ECG, CACHET-CADB also provides the continuous recording of patients' contextual data such as activities, body positions, movement accelerations, symptoms, stress level, and sleep quality. These contextual data can aid in improving the machine/deep learning-based automated arrhythmia detection algorithms on patient-operated wearable ECG. Currently, CACHET-CADB has 259 days of contextualized ECG recordings from 24 patients and 1,602 manually annotated 10 s heart-rhythm samples. The length of the ECG records in the CACHET-CADB varies from 24 h to 3 weeks. The patient's ambulatory context information (activities, movement acceleration, body position, etc.) is extracted for every 10 s interval cumulatively. From the analysis, nearly 11% of the ECG data in the database is found to be noisy. A software toolkit for the use of the CACHET-CADB is also provided.

Cylindrical solar collectors (CSCs) are getting attraction. Heat extraction part of these instruments consists of a helical tube which transfers thermal energy to working fluid. Enhancement of the heat transfer process within this part leads to enhancement of energy achievement. In this paper, influence of applying helical corrugation on helical absorber was evaluated. The number of corrugations and pitch and height of corrugations were considered as variant parameters. The system was evaluated from different viewpoints and performance of system was analyzed based on performance factor and economic viewpoints. The results revealed that the presence of helical Corrugation could increase heat transfer up to 19%. It was found that Dean number of 3000 could be considered as a critical Dean number from view point of performance factor. The application of the proposed system was more beneficial at Dean numbers below 3000. It was revealed that the application of helical corrugation could provide up to 24% enhancement in economic advantage of the system. Best economic performance was related to case with four starts which had corrugation height and corrugation pitch of 0.002 m and 0.103 m and occurred at Dean number of 2000.

BackgroundDuring the COVID-19 pandemic, telemedicine is a quickest expanding service solution to provide improved access to sophisticated healthcare that is efficient, cost-effective, and time-consuming.MethodsThis analysis is evaluated on the basis of several studies that look at the history, benefits, various techniques, challenges, uses, and impact of telemedicine in the treatment of heart failure and cardiac rehabilitation as during COVID-19 outbreak.ResultsPatients avoided or refused medical treatment during COVID-19 pandemic despite the risk of illness and the threat of infections spreading. Telemedicine has become a non-traditional form of care delivery due to better access and high-end technologies such as virtual consultations, face-to-face video, smartphone visits, two-way text communication, distant patient history, and distal characteristic assessment. Remote monitoring can help manage cardiovascular disease risk factors and increase patient participation in blood pressure, heart failure data, and workout or other activity progress.ConclusionBased on the findings of past studies, we can infer that telemedicine is still an emerging subject in the treatment and management of cardiovascular disease. Telemedicine and similar technologies will also revolutionize healthcare services by expanding their reach and providing a big pool of database for better research and analysis.

Introduction: Quantitative analysis of cardiac biomarkers, troponin I and CPK-MB, estimates the extent of myocardial injury while extent of benefit from coronary collateral circulation (CCC) to protect myocardium during acute myocardial infarction (AMI) needs validation. We analysed if the extent of collaterals had impact on baseline biomarkers at the time of coronary angiogram. Methods: We analysed 3616 consecutive patients who presented with AMI and underwent invasive coronary angiography (CAG) with intent to revascularisation with biomarkers assessment at the time of CAG. CCC to Infarct related artery (IRA) were graded as per Rentrop grading viz. poorly-developed CCC (Grade 0/1 as Group A) and well-developed CCC (Grade 2/3 as Group B). Results: Both groups (A and B) were matched for demographics, traditional risk factors, SYNTAX 1 Score, time to CAG from onset of angina and eGFR. 36.59% of patients had Non-ST segment elevation myocardial infarction (NSTEMI) as compared to 63.41% ST -segment elevation infarction (STEMI). Overall Troponin I (P=0.01, P=0.01) and CPK MB (P=0.00, P=0.002) values were lower in group B in both NSTEMI and STEMI groups respectively. Troponin I and CPK-MB were significantly lower in group B [with NSTEMI for SVD (Single vessel disease) (P=0.05) and DVD (Double vessel disease) (P=0.04),but not for TVD (Triple vessel disease) and with STEMI in SVD (P=0.01), DVD (P=0.01) and TVD (P=0.001)]. Conclusion: Patients with well-developed coronary collaterals had a lower rise in biomarkers in AMI as compared to those with poor collaterals amongst both NSTEMI and STEMI groups.

A sustainable approach to ensuring the thermal regulation of space is reliable with phase change materials (PCMs) operating at 15–25 °C. Henceforth, there is a need of a search of binary and ternary eutectic PCMs operating at desirable phase transition temperatures of 15–25 °C, high energy storage enthalpy (180–220 J/g), improved thermal conductivity and better absorptivity of solar energy. In this current research, we developed a ternary eutectic inorganic salt hydrate PCM intended for a low-temperature thermal regulation system. Based on the eutectic melting point theory, the phase transition temperature and proportion of sodium carbonate decahydrate (SCD), sodium phosphate dibasic dodecahydrate (SPDD) and sodium sulphate decahydrate (SSD) were determined. As per the calculated proportion, ternary eutectic PCM was experimentally prepared. Furthermore, to enhance the thermal property, graphene nanoplatelets (GNP) were dispersed at weight concentrations of 0.4%, 0.7% and 1.0%. The prepared nanoparticle-dispersed PCMs were characterized using an optical microscope, Fourier transform infrared (FT-IR) spectroscopy and a thermal conductivity meter, and a differential scanning calorimeter (DSC) was used to evaluate the morphology, chemical stability and thermal properties. The results showed increases in thermal conductivity and optical absorbance by 71.5% and 106.5%, respectively, with GNP at 1.0% weight concentration. Similarly, the degree of supercooling and transmissibility was reduced by 43.5% and 76.2% correspondingly. The prepared composite PCM is expected to contribute towards cooling, with an intention to contribute towards sustainable development.

Context: To study the demographics and clinical profile of patients with acute pulmonary embolism (PE) and impact of management as per risk stratification on outcome of patients with acute PE. Materials and Methods: Prospective observational study of demographics, clinical profile, risk stratification, management, and outcome of patients presenting with acute PE from August 2016 to July 2017. Results: One hundred and fifty patients who were detected to have acute pulmonary thromboembolism with a mean age of 45.08 years, with 70% being males, were included in the study. There were 6 (4%) patients in high-risk group, 69 (46%) patients in intermediate-high subgroup, 39 (26%) patients in intermediate-low subgroup and 36 (24%) patients in low-risk group as per the ESC 2019 guidelines using sPESI score, shock/hypotension, right ventricle (RV) dysfunction and cardiac marker elevation. 72 patients (52%) had antecedent deep vein thrombosis (DVT) of which 60 patients has proximal, whereas 12 patients had distal DVT. One hundred and forty-seven patients (98%) had moderate-to-severe TR, 117 patients (78%) had evidence of right atrium/RV dysfunction and 27 patients (18%) had evidence of thrombus in the heart. Computed tomography pulmonary angiogram showed middle pulmonary artery thrombus/dilatation in 63 patients (42%), saddle thrombus in 18 patients (12%), partial thrombus in the left pulmonary artery (LPA) and right pulmonary artery (RPA) in 84 (56%) and 75 (50%) patients, respectively. Majority (86%) of patients with tenecteplase; 9 (10.3%) patients with streptokinase and 3 (3.4%) was thrmobolysed with alteplase. Conclusion: PE can present with unexplained dyspnea and atypical chest pain, among other signs and symptoms. Early diagnosis, risk stratification, and guideline-directed prompt management can lead to favorable outcome.

Introduction: Intra-aortic balloon pump (IABP) is widely used as a mechanical support device. Current evidence after the IABP-SHOCK II trial is ambiguous. We evaluated the impact of IABP on hemodynamic parameters (Cardiac Output (CO), Cardiac Power Output (CPO) and Systemic Vascular Resistance (SVR)) measured at 6 and 24 hours in patients presenting with cardiogenic shock (CS) with Acute Coronary Syndrome (ACS) amongst Asian Indians. Methods: The efficacy of IABP was evaluated in patients presenting with CS in open-label, prospective, randomized (for randomization every alternate patient presented to an emergency was given IABP support), consecutive 60 patients in ACS with CS with group A (N=30) comprising of those with IABP and Group B without IABP (n=30). Results: Both the groups were matched for baseline characteristics. The revascularization rate was 85% and only the culprit vessel was addressed during the study. Total 9 (15%) patients were managed medically and did not undergo revascularization. The mean changes in Systemic vascular resistance (SVR), cardiac output (CO) and cardiac power output (CPO) after 24 hours in patients with and without IABP showed no statistical difference except for the lower mean dose use of dobutamine in Group A (with IABP) vs Group B (without IABP) (4.08 (1.41) vs. 7.92 (2.52) mcg/kg/min, p

IntroductionAlthough heart failure (HF) outcomes have improved dramatically with the use of guideline directed medical therapy and implantable devices, the overall prognosis of patients with HF and reduced ejection fraction (HFrEF) remains poor. Autonomic Regulation Therapy (ART) using chronic vagus nerve stimulation (VNS) has been evaluated in the ANTHEM-HF study, using changes in heart rate (HR) dynamics as a biomarker of autonomic nervous system engagement and cardiac control to guide VNS titration. ART was associated with sustained improvement in cardiac function and HF symptoms in patients with HFrEF and persistent HF symptoms despite guideline-directed medical therapy (GDMT). We sought to determine whether the responsiveness of the autonomic nervous system to ART, as reflected in HR response to vagus stimulation during the VNS duty cycle, is maintained after long-term chronic VNS administration.MethodsFifteen patients with HFrEF and implanted with a VNS systems in the ANTHEM-HF study were evaluated after 4.7 ± 0.3 years (range: 4.0–5.0 years) of chronic ART. ECG electrodes were placed on each patient’s wrists, and ECG rhythm strips were recorded. Instantaneous HR time series was computed at each patient’s chronically programmed VNS intensity and during progressively increasing VNS intensity. HR during active stimulation (on-time) was compared to HR just prior to initiation of each stimulation cycle (off-time).ResultsPersistent autonomic engagement was observed in a majority of patients (11 of 15, 73%) after chronic ART for four or more years. The average magnitude of HR reduction during ART on-time in all patients was 2.4 ± 3.2 bpm at the chronically programmed VNS pulse parameter settings.ConclusionAutonomic responsiveness to VNS persists in patients with HFrEF who received chronic ART for up to 5 years as a supplement to GDMT. This suggests that the effects of ART on autonomic engagement and cardiac control remain durable over time.Clinical Trial Registration[ClinicalTrials.gov], identifier [#NCT01823887, CTRI registration #CTRI/2012/05/002681].

Background: Hypertension is leading cause of deaths in the world. It is a modifiable and major risk factor for cardiovascular, renal and brain diseases. This study was done to see the current trend of prescription patterns of antihypertensive drugs in a tertiary care hospital in Nepal. Materials and Methods: Observational cross sectional study was done in the patients with hypertension from September 2018 to September 2019 in the department of Medicine of Civil Service Hospital, a tertiary care hospital in Kathmandu, Nepal. A total of 242 Patients who were undergoing antihypertensive treatment were included. All calculations and statistical analyses are processed by the SPSS 25.0. Results: Out of 242 prescriptions, 135(55.8%) were males, and 107(44.2%) were females. Among them, 49 (20.2%) patients had controlled Blood Pressure, 63(26%) patients had hypertension stage I and the remaining 130 patients (53.7%) patients had stage II hypertension. In the present study, 133 (54.96%) were treated with monotherapy while, 71 (29.33%) patients were prescribed with dual therapy. The most frequently prescribed drug as monotherapy was Calcium Channel Blocker in 71(53.3%) patients followed by Angiotensin Receptor Blockers in 38 (28.6%) and thiazide diuretics in 21 (15.7%) patients. Calcium Channel Blockers with Angiotensin Receptor Blockers was the most prescribed combination in 44 (62.1%) patients followed by Angiotensin Receptor Blockers and Thiazide Diuretics in 19 (26.8%) patients. Conclusion: Calcium channel blockers are the highest among the drugs that are used as monotherapy. In combination therapy, Calcium channel blockers with angiotensin receptor blocker and angiotensin receptor blockers with thiazide diuretics are the frequently prescribed drugs.

Context: No-flow phenomenon during percutaneous coronary intervention (PCI) is a complex and multifactorial phenomenon with often devastating complications during PCI, especially in acute coronary syndrome (ACS) settings. There is paucity of data on serological predictors of the same. Materials and Methods: This was an open-label, all-comers, observational, prospective study done on 175 patients covering the whole spectrum of coronary artery disease, undergoing PCI at the center. On admission detailed clinical history , general and systemic examination and laboratory investigations in form of hemoglobin, blood urea, serum creatinine, serum sodium, serum potassium, random blood sugar, electrocardiogram(ECG) and tropinin T were also done. Post procedure creatinine protein kinase MB (CPK MB) was done after 24 hrs, and thrombolysis in myocardial infarction (TIMI) flow was assessed during PCI in all patients by the operating interventional cardiologist. Results: The mean value of NT-proBNP among patients with TIMI flow

Background: The risk of myocardial infarction (MI) is high in patients with diabetes mellitus. The study aimed to evaluate the risk factors focusing on presenting glycated hemoglobin (HBA1C) and the angiographic profile of diabetic patients with ST elevation myocardial infarction (STEMI) and in-hospital 3-point major adverse cardiac event (MACE). Materials and Methods: Two hundred consecutive diabetic patients presenting with STEMI were enrolled for prospective observational study. Each patient underwent investigations including HbA1C, electrocardiogram, echocardiography, and coronary angiography with SYNTAX 1 SCORE (SS1) with intent to early revascularization. Continuous variables were compared using the unpaired Student's t-test. A receiver operator characteristic analysis was performed to determine a cutoff point for HbA1c value for predicting disease severity and prognosticate in-hospital 3-point MACE using multivariate analysis after normalizing the confounders. Results: Of the total 200 patients, 70 (35%) had single-vessel disease, 58 (29%) had the double-vessel disease, while 72 (36%) had triple-vessel disease. Among these patients, left main coronary artery was involved in 22 (11%) of patients. Hypertension (73.8% vs. 60%), obesity (35.4% vs. 18.4%), and left ventricular (LV) dysfunction (13.7% vs. 2.9%) were risk factors associated with disease severity with an odds ratio of 1.88 (95% confidence interval [CI]: 1.01–3.49; P = 0.04), 2.4 (95% CI: 1.19–4.84; P = 0.01), and 5.46 (95% CI: 1.23–24.29; P = 0.03), respectively. Receiver operating characteristic analysis of HbA1c with respect to 3P-MACE of in-hospital death, recurrent MI, and CV stroke revealed HBA1C 8.9 g% (95% CI: 0.66–0.79; P = 0.0004) with 65% sensitivity and 76.7% specificity. HbA1c >7.9 g% were more likely to have multivessel disease and SS1 >33. Patients with surgical site infection >33 were more likely to be hypertensive and had severe LV dysfunction and higher 3P MACE. Conclusion: Diabetic Asian Indian patients with STEMI with HbA1c >7.9 g% were more likely to have a multivessel disease and SYNTAX 1 Score >33. There was a significant association between presenting HbA1c >7.9 g% and disease severity and higher 3-P MACE among presenting with HbA1c >8.9 g%.

In the present contribution, an iterative process is used in solving prey and predator interactions through a nonsingular fractional model. The structure used in this model is the general Holling type interactions. The theoretical properties of the system, including the local stability conditions of equilibrium points along with the proof of existence and uniqueness of solutions for the model is also investigated. To highlight the effect of the parameters in the model, various simulations have been performed to better clarify the role of some parameters in the problem. The fractional operator used in the model of this paper can be considered a powerful tool in better describing the phenomenon. Our results confirm that the considered ecosystem can approximately simulate the expected conditions in the real problem. These results encourage us to use fractional structures with non-single kernels in modeling similar computational problems in the transmission of epidemic diseases.

Solving partial differential equations has always been one of the significant tools in mathematics for modeling applied phenomena. In this paper, using an efficient analytical technique, exact solutions for the unstable Schrödinger equation are constructed. This type of the Schrödinger equation describes the disturbance of time period in slightly stable and unstable media and manages the instabilities of lossless symmetric two stream plasma and two layer baroclinic. The basis of this method is the generalization of some commonly used methods in the literature. To better demonstrate the results, we perform many numerical simulations corresponding to the solutions. All these solutions are new achievements for this form of the equation that have not been acquired in previous research. As one of the strengths of the article, it can be pointed out that not only is the method very straightforward, but also can be used without the common computational complexities observed in known analytical methods. In addition, during the use of the method, an analytical solution is obtained in terms of familiar elementary functions, which will make their use in practical applications very convenient. On the other hand, the utilized methodology empowers us to handle other types of well-known models. All numerical results and simulations in this article have been obtained using computational packages in Wolfram Mathematica.

Background: The effect of beta-blockade (BB) on response to vagus nerve stimulation (VNS) has not been reported in patients with heart failure and reduced ejection fraction (HFrEF). In the ANTHEM-HF Study, 60 patients received chronic cervical VNS. Background pharmacological therapy remained unchanged during the study, and VNS intensity was stable once up-titrated. Significant improvement from baseline occurred in resting 24-hour heart rate (HR), 24-hour HR variability (SDNN), left ventricular EF (LVEF), 6-minute walk distance (6MWD), and quality of life (MLWHFS) at 6 months post-titration. We evaluated whether response to VNS was related to percentage of target BB dose (PTBBD) at baseline. Methods: Patients were categorized by baseline PTBBD, then analyzed for changes from baseline in symptoms and function at 6 months after VNS titration. Results: All patients received BB, either PTBBD ≥ 50 % (16 patients, 27 %; group 1) or PTBBD

Vertical PCM enclosures are widely used in different applications. The weak heat conduction in these systems is their main deficiency. In present work, the “L” shaped fin was utilized instead of ordinary double rectangular fins. 10 different cases were considered which included two typical arrangements. First arrangement, included the fins placed at the lower side of the enclosure and the second arrangement was for the fins placed at the upper side of the enclosure. Furthermore, dimensions of vertical part (LV) and horizontal (LH) were considered as the varying parameters. The left vertical wall was heated and has constant temperature of 343 K. Luaric acid was used as PCM material. The results indicated that the orientation and dimensions of the “L” shaped fins have significant effect on the melting performance, energy storage and exergy of the enclosure. It was found that the application of upward L shaped fin is better than the upward form in the melting process of a vertical enclosure. The best case was related to fin mounted at the lower side of the enclosure which had LH and LV of 40 and 20 mm, presenting about 45% enhancement in the melting time.

Performance enhancement of energy storing unite is a very important issue in renewable energy systems. In the present investigation, L shaped fins with two different orientations and various geometrical properties were considered to enhance the solidification performance inside a vertical enclosure. Furthermore, effect of two types of Nano-particles with different concentrations were evaluated. It was found that the application of downward L shaped fin is better than upward form in solidification process. Also, results revealed that case with same length in vertical and horizontal part of L shaped fin has best performance. Furthermore, results presented that there is no need to use high cost Nano-particles of Cu because low cost Nano-particles of Al2O3 have better performance in considered issue. Best performance was related to case 3 which had 12.3% enhancement in the solidification time. Also, between the downward fins, the best case was related to case 8 which provided about 21.5% reduction in the solidification time. Furthermore, it was found that the application of AL2O3 with concertation of 2% and case 8, provided about 27% improvement in the total melting time when compared to the Base case.

Through the present investigation, the thermal and power output of novel-shaped solar panels are evaluated. For the cooling of the mentioned forms, forced air flow was utilized. Three novel shapes, of Pyramid, Hexagonal, and Conical which had the equal lateral surface were considered. For the simulation, an open source CFD software was utilized. The lateral surfaces were put under identical amount of heat flux. Air as the coolant fluid was injected with constant inlet temperature from the trapdoors at the bottom of different shaped structures. Three different values of heat flux and air injection rate were evaluated for each shape. The outcomes presented that the conical shaped solar panel exhibits better thermal performance than other geometries. Furthermore, conical form finds the least temperature that was about 10.5 °C less than that of the pyramid-shaped panel. Furthermore, it was revealed that the corners of pyramid and hexagonal-shaped solar panels have higher temperature. Also, it was found that the efficiency of conical shaped panel was up to 8.4% more than that of pyramid-shaped panel.

The Indian healthcare practice is pluralistic and unique since it is poised with many challenges. High out of pocket (OOPE) expenditure, scanty institutional facilities, and expensive private healthcare, etc. have strong bearing on adoption of traditional health care practices besides socio-cultural and other gradients. The paper addresses the dynamics and determinants of the access to traditional medicines in India using the representative dataset of the national sample survey (71st and 75th round) conducted in 2014 and 2017–2018. The analysis includes descriptive statistics, conditional Logit regression with marginal effects and Tobit regressions models. Results confirm increased access to traditional medicines even in case of major ailments which has reduced the OOPE on healthcare. The Covid19 pandemic has synergised the use of AYUSH owing to its immunity-boosting measures. The paper also incorporates some of the recent policy initiatives taken over recently in India to facilitate the Ayurveda, Yoga and Naturopathy, Unani, Sowa Rigpa, Siddha and Homoeopathy (AYUSH).