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To integrate network load and line uncertainties in the radial distribution network (RDN), the probabilistic and possibilistic method has been applied. The load uncertainty is considered to vary as Gaussian distribution function whereas line uncertainty is varied at a fixed proportion. A voltage stability index is proposed to assign solar PV-DG optimally followed by application of PSO technique to determine the optimal power rating of DG. Standard IEEE 33- and 69-bus RDN are considered for the analysis. The impact of various uncertainties in the presence of optimally integrated solar PV-DG has been carried out on 69-bus network. The results obtained are superior to fuzzy-arithmetic algorithm. Faster convergence characteristic is obtained and analyzed at different degree of belongingness and realistic load models. The narrower interval width indicates that the observed results are numerically stable. To improve network performance, the technique takes into account long-term changes in the load profile during the planning stage. The significant drop in network power losses, upgraded bus voltage profile and noteworthy energy loss savings are observed due to the introduction of renewable DG. The results are also statistically verified.

A non-convex Environmental Economic Loss Dispatch (NCEELD) is a constrained multi-objective optimization problem that has been solved for assigning generation cost to all the generators of the power network with equality and inequality constraints. The objectives considered for simultaneous optimization are emission, economic load and network loss dispatch. The valve-point loading, prohibiting operating zones and ramp rate limit issues have also been taken into consideration in the generator fuel cost. The tri-objective problem is transformed into a single objective function via the price penalty factor. The NCEELD problem is simultaneously optimized using a fuzzy based real-coded genetic algorithm (GA). The proposed technique determines the best solution from a Pareto optimal solution set based on the highest rank. The efficacy of the projected method has been demonstrated on the IEEE 30-bus network with three and six generating units. The attained results are compared to existing results and found superior in terms of finding the best-compromise solution over other existing methods such as GA, particle swarm optimization, flower pollination algorithm, biogeography-based optimization and differential evolution. The statistical analysis has also been carried out for convex multi-objective problem.

The variations in load and generation result in higher degree of uncertainty in power flow calculation and create new challenge for the system operator to develop new tools to assess the current and future state of the system. Therefore, the incorporation of the system uncertainties plays a vital role for sustainable planning of the power system. This paper demonstrates the combined application of the probabilistic and possibilistic approach to address line, load and distributed generation (DG) uncertainties in a radial distribution system. The uncertainty in load demand is represented as a Gaussian distribution function, whereas line and DG uncertainty are varied at a fixed proportion. The load is modelled as composite. Type I (penetrates real power), Type II (penetrates reactive power) and Type IV (penetrates both real and reactive power) DG are considered depending upon the type of power injected. The efficacy of improved power flow techniques with the inclusion of various types of DG and its effect on power losses is verified by four test cases on three IEEE test systems: 33-bus, 34-bus and 69-bus. The obtained results are compared to the possibilistic-only approach and found out to be superior. The convergence characteristic is also analysed at various degree of belongingness. The technique converges in smaller number of iterations as compared to other methods. The lower interval width signifies the numerical stability. The statistical analysis of power losses reduction with DG penetration is also carried out.

OBJECTIVE: To examine associations of cumulative exposure to proton pump inhibitors (PPIs) with total cardiovascular disease (CVD; comprised of stroke, coronary heart disease, and heart failure [HF]) and HF alone in a cohort study of white and African American participants: the Atherosclerosis Risk in Communities Study. PATIENTS AND METHODS: PPI use was assessed via pill bottle inspection at Visit 1 (January 1, 1987– 1989) and up to 10 additional times before baseline (Visit 5; 2011–13). We calculated cumulative exposure to PPIs as days of use from Visit 1 to baseline. Participants (n=4346 free of total CVD at Visit 5; mean age=75) were followed for incident total CVD and HF events through December 31, 2016. We used Cox regression to measure associations of PPIs with total CVD and HF. RESULTS: After adjustment for potential confounding variables, participants with a cumulative exposure to PPIs of >5.1 years had a 2.02-fold higher risk of total CVD (95% confidence interval [CI], 1.50–2.72) and a 2.21-fold higher risk of HF (95% CI, 1.51–3.23) than nonusers. CONCLUSIONS: Long-term PPI use was associated with twice the risk of total CVD and HF compared to nonusers. Our findings are in concordance with other research and suggest another reason to be cautious of PPI overuse.

Sustained ventricular tachycardia and ventricular fibrillation (VF) are life-threatening arrhythmias which remain highly prevalent in patients with advanced heart failure. These ventricular arrhythmias may impair the support provided by continuous-flow left ventricular assist devices (CF-LVADs) and lead to frequent hospitalizations, antiarrhythmic medication use, external defibrillations, and need for heart transplantation. We report a case in which a patient with a CF-LVAD and an implantable cardioverter defibrillator at end of life presented with asymptomatic low-flow alarms and was found to have VF of unknown duration. Unique in our case was the presence of apparent organized contractility and rhythmic opening of the mitral valve on echocardiogram despite VF on electrocardiogram.

This article presents the distributed generator (DG) integration in a radial distribution system (RDS). The DG penetration changes the single power source to multiple power sources and bidirectional load flow which enhances the system reliability and reduces system power losses. The particle swarm optimization and gravitational search algorithm are implemented for the optimal siting and sizing of one and three DG units in the RDS to examine its impact on system reliability and loss reduction. The types of DGs considered are Type I (injects real power) and Type IV (injects reactive and real power). The constant power is the chosen load model. The reliability indices taken for the analysis of system reliability are Average Energy Not Supplied, Total Energy Not Supplied and Average System Interruption Duration Index. The efficacy of the proposed method is validated on 33-bus in the presence of single and multiple DGs. The significant decrease in system power losses with the upgraded bus voltage profile, system reliability and remarkable annual loss saving is analyzed for Type IV DG over Type I DG. The results determined are compared to other meta-heuristic approaches as well as analytical techniques to demonstrate the superiority of the proposed methodology. The results are also statistically verified.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare, heritable myocardial disease associated with the development of ventricular arrhythmias, heart failure, and sudden cardiac death in early adulthood. Multimodality imaging is a central component in the diagnosis and evaluation of ARVC. Diagnostic criteria established by an international task force in 2010 include noninvasive parameters from echocardiography and cardiac magnetic resonance imaging. These criteria identify right ventricular structural abnormalities, chamber and outflow tract dilation, and reduced right ventricular function as features of ARVC. Echocardiography is a widely available and cost-effective technique, and it is often selected for initial evaluation. Beyond fulfillment of diagnostic criteria, features such as abnormal tricuspid annular plane excursion, increased right ventricular basal diameter, and abnormal strain patterns have been described. 3-dimensional echocardiography may also expand opportunities for structural and functional assessment of ARVC. Cardiac magnetic resonance has the ability to assess morphological and functional cardiac features of ARVC and is also a core modality in evaluation, however, tissue characterization of the right ventricle is limited by spatial resolution and low specificity for detection of pathological changes. Nonetheless, the ability of cardiac magnetic resonance to identify left ventricular involvement, offer high negative predictive value, and provide a reproducible structural evaluation of the right ventricle enhance the ability and scope of the modality. In this review, the prognostic significance of multimodality imaging is outlined, including the supplemental value of multidetector computed tomography and nuclear imaging. Strengths and weaknesses of imaging techniques, as well as future direction of multimodality assessment, are also described.

In the present study, we have synthesized polythiophene–Al2O3 based nanosorbent and removed Pb2+, Cd2+ and Zn2+ ions from waste water. The polythiophene–Al2O3 (PTh–Al2O3) based nanosorbent has been characterized by different analytical methods such as FTIR, FESEM, powder XRD and EDX. The adsorption study was included contact time, temperature, dosage, concentrations and pH. The maximum adsorption was achieved at optimized conditions such as contact time 60 min, dosage 1 g and pH 6. The adsorption efficiencies for Pb2+, Cd2+ and Zn2+ ions have been recorded 69.9, 49.9 and 30.2% at contact time 60 min, 84.9, 73.9 and 69.5% at pH 6 and 65.8, 43.7 and 23.2% at the dosage of sorbent 1 g, respectively. The equilibrium data of adsorption were tested with different kinetic and isothermal models and the equilibrium data of adsorption best fitted to Langmuir, Freundlich, Temkin, pseudo first order and intra particles diffusion models.

Distributed generators in a distribution network directly affect the network’s performance due to which distribution utilities have to pay a lot of attention toward its optimal integration. This work presents a weighted-sum multi-objective index-based technique for optimal placement and an analytical approach is utilized to size different types of DG optimally. The constant power type load model is considered for the present formulation. The DG taken for the analysis purpose is: Type I and Type IV. The power flow results of the network are calculated by formulating BR matrix. The efficiency of the projected method is verified and authenticated using the 12-node network. The noteworthy reduction in the network power losses with upgraded voltage profile and remarkable annual energy loss saving is observed with Type IV DG over Type I DG.

Sustained ventricular tachycardia and ventricular fibrillation (VF) are life-threatening arrhythmias which remain highly prevalent in patients with advanced heart failure. These ventricular arrhythmias may impair the support provided by CF-LVADs and lead to frequent hospitalizations, antiarrhythmic medication use, external defibrillations, and need for heart transplantation. We report a case in which a patient with a CF-LVAD and an ICD at end-of-life (EOL) presented with asymptomatic low-flow alarms and was found to have VF of unknown duration. Unique in our case was the presence of organized contractility and rhythmic opening of the mitral valve on echocardiogram despite VF on ECG.

The optimal installation of a renewable distributed generation (DG) in a radial distribution network (RDN) provides a sustainable and clean solution for the future smart network. A weighted-sum multi-objective approach is applied to determine the optimal location of solar PV-DG followed by a PSO algorithm to find optimal DG size. The impact of optimal DG allocation in distorted and non-distorted distribution network is efficaciously demonstrated and validated on IEEE 33-bus RDN. The harmonic analysis in the presence of the six-pulse converter non-linear load and non-linear DG is carried out for IEEE 34-bus network. The non-linear loads are modelled as harmonic current source. As composite load model provides lowest voltage drop with decreased capital investment cost, hence, its effect and the effect of constant power load model on energy loss saving, network loss and total harmonic distortion at various load levels is being analysed. The harmonic load flow results obtained considering non-linear and linear loads are compared to other analytical methods and nature-inspired techniques to illustrate the robustness of the proposed strategy for enhancing the performance of the network. The statistical significance of the results is verified by the Wilcoxon test.

This paper proposes a hybrid technique for improving the voltage stability of a given system with optimal power flow solution using FACTS device installation. The hybrid technique is the combination of Improved Gravitational Search Algorithm (IGSA) and Firefly Algorithm (FA). The Thyristor Controlled Series Compensator (TCSC) device is utilized to evaluate the performance of the proposed algorithm by its optimal location and determining its capacity with optimized parameters. Therefore, the voltage stability is improved while satisfying a given set of operating and physical constraints and proposed technique is used to optimize the loading factor and apparent power flow index respectively. The algorithm is implemented in MATLAB working platform and the power flow security and voltage stability is evaluated with IEEE 30 bus transmission systems. Then, the total generated power, voltage stability, generation cost and TCSC cost are examined by changing the system load. The performance of the proposed method is perceived to be superior when compared with traditional Gravitational Search Algorithm and other techniques existing in literature.

The work presented in this article provides a hybrid approach of Cuckoo Search algorithm (CS) and Ant Lion Optimization (ALO) for solving a multi-objective optimization problem of secured optimal power flow and optimal placement and rating of thyristor-controlled series compensator (TCSC) in IEEE standard 30-node power transmission network to minimize network power losses and simultaneous improvement in node voltage profile. The power flow solution is computed using Newton–Raphson (NR) algorithm under both normal and overloading operating condition. The quadratic fuel cost is chosen as the objective functions. A new power flow index is proposed for finding the optimal location for TCSC. The optimal size of TCSC is determined using ALO. The efficacy of the proposed approach is examined and verified by comparing it with the other algorithms such as gravitational search, firefly algorithm, and other techniques such as fuzzy and neural networks. The statistical analysis is also performed to evaluate the competency of the methodology.

Aim To compare and evaluate the effect of different liners separately and in combination with lasers that is resin modified glass-ionomer cement (RMGIC), Laser+RMGIC, Biodentine, Laser+Biodentinein the treatment of deep carious lesions. Materials and methods Forty patients with deep caries indicated for pulp capping were selected. Curative procedure including the cavity preparation with maximal removal of softened dentine using spoon excavator, slow speed handpiece with round burs was performed. Patients were divided into four groups with 10 patients in each group In group A RMGIC liner, group B laser biostimulation followed by RMGIC liner, group C biodentine liner, group D laser biostimulation followed by Biodentine liner were placed in the cavity after caries removal. Cavities were temporarily restored with IRM for 8 weeks. After 8 weeks, liners in each group were removed, and cavities were permanently restored lower half of the cavity with a layer of flowable Z350 XT composite, and then the remaining half of the cavity with P60 filled composites (3 M ESPE, USA) in all the groups. The observation period was 12 months. Results All the patients showed a positive response to cold test and electric pulp test at 3 months, 6 months, 12 months follow-up. In group A (RMGIC) two patients and in group B (Laser+Biodentine) three patients did not return back for the follow-up. To standardize the samples, seven patients were selected from each group with a total of 28 samples included in the study (n = 7) and statistical analysis was done using analysis of variance (ANOVA) test. The mean for the total amount of dentine deposited after 12 months was highest in: Group D-(Laser+Biodenitne) 0.32 mm > Group C-(Biodentine) 0.25 mm > Group B-(Laser+RMGIC) 0.10 > Group A-(RMGIC) 0.07 mm Conclusion: Within the limitation of the present study the following conclusion was drawn: • Lasers and biodentine are good indirect pulp capping agents • Laser has an additional effect on the tertiary dentine formation. Clinical significance Lasers with antibacterial effect penetrate into dentinal tubules and accelerate the rate of dentin bridge formation in deep carious lesions.

Aims and objectives Surgical site infections (SSIs) are one of the most important causes of health care-associated infections. Understanding SSI reduces the social and economic burden of a hospital and society. In this context, we evaluated the various aspects of SSI in our institution, Rohilkhand Medical College & Hospital (RMCH), which is a tertiary care teaching hospital in rural Uttar Pradesh in North India. Materials and methods This prospective study was conducted in the Department of General Surgery, RMCH, Bareilly, Uttar Pradesh, India. A total number of 1,498 patients admitted for surgical procedures with effect from November 1, 2016 to December 31, 2016, formed the subjects of the present study. All operated cases during the above period, including major and minor, emergency and elective, laparoscopic and open procedures were included in the present study. Data so obtained were analyzed statistically. The Centers for Disease Control and Prevention, USA criteria were used for defining the wound. Sample swabs were collected from the first dressing and up to 2 to 4 weeks postoperatively. Samples were processed for aerobic and anaerobic flora, and the antibiotic sensitivity of the isolates was also performed. Results and discussion The SSI rate in the present study was 8.67%. Significantly higher incidence of SSI was detected with increasing age. The SSI rate in case of emergency surgeries was more (27.7%) as compared with routine/elective surgeries (6.3%). The higher incidence (18.75%) of SSI was detected in patients having preoperative hospital stay of more than 7 days, and the maximum incidence (15.7%) was observed in patients having longer postoperative hospital stay of more than 10 days. Dirty wounds had the highest incidence of SSI (53.45%). The incidence of SSI increased with duration of surgery, order of surgery, and with the increasing duration of postoperative drains. Staphylococcus aureus was the commonest isolate (32.30%) followed by Escherichia coli (39%). Conclusion Though the incidence of SSI in the present study was slightly low as compared with similar reports from other institutions of the country, more rational antibiotic policy and more stringent infection control measures are needed. How to cite this article Abbey RK, Mohan M, Malik N, Tiwari R, Nahar S. Surgical Site Infections in a Rural Teaching Hospital of North India. Int J Adv Integ Med Sci 2017;2(1):11-16.

The paper presents the load flow analysis of a radial distribution system penetrated by distributed generator which can inject real power into the system. The load flow is formulated using DLF matrix. The load is modeled as composite load model which includes all four practical load models. Simulation is carried out for 12-bus and IEEE 69-bus system to demonstrate the effectiveness of the projected method at different system loading conditions for constant power and composite load model. The noteworthy reduction in system power losses, cost of annual energy loss with enhanced voltage profile is observed with DG with composite load model compared to constant power model.

The paper focuses on the use of Interval Arithmetic to incorporate line and load uncertainties in the balanced radial distribution system. These uncertainties in input parameter are assumed to vary at fixed proportion as well as the Gaussian distribution function. The application of the Interval Arithmetic gives strictly bounded solutions for the power flow problem. The Interval Arithmetic power flow analysis is performed by formulating Distribution load flow (DLF) matrix. The results acquired from Interval Arithmetic based power flow problem are replicated on 31-bus system and found appropriate for planning and expansion planning of radial distribution system.

In this paper, power flow solution of a balanced distribution system is obtained by formulation and multiplication of two matrices BIBC (branch current and bus current) and BCBV (branch current and bus voltage). The load is modeled as composite load considering all four practical voltage dependent load models. The projected method has been evaluated to demonstrate the convergence ability of the power flow program for different voltage dependent load models by varying loading conditions, power factor, R/X ratios and load growth scenarios. The method is validated by testing it on two systems: IEEE 30- and IEEE 33-bus system and the results are compared with seven existing methods in the literature.

In this paper, a fuzzy mechanism based continuous genetic algorithm is employed to optimize the non-convex multi-objective problem for allocating power generation cost to all the generating units of the electrical system considering system constraints. Here, the total system cost for generation is optimized by considering Economic load dispatch and Environmental Dispatch simultaneously. The valve point loading effect is also considered in the proposed multi-objective problem to obtain Non-Convex Environmental Economic Dispatch problem. This biobjective problem is transformed as single objective problem considering price penalty factor. The proposed technique gives the best compromised solution with the highest rank out of the existing Pareto optimal solution set. The performance of the proposed method is confirmed and validated on two test systems having three and six generating units (IEEE-30 bus system). To show the dominance of the method the obtained results are further compared with the recently published result.

Cardiac arrest in pregnancy is rarely reported in the context of gestational hyperthyroidism and hyperemesis gravidarum, conditions that are often comorbid due to thyroid stimulation by hCG. A multidisciplinary approach is critical for prompt evaluation and management. A 31-year-old G2P1 female

Summary Background Well-tolerated and effective treatments are needed for chronic leg ulcers in sickle cell anaemia. Topical sodium nitrite, a known nitric oxide donor, enhances blood flow in ulcers and has known bacteriostatic effects. We aimed to assess the safety, tolerability, and pharmacokinetics of topical sodium nitrite in patients with sickle cell disease and chronic leg ulcers. Methods We enrolled adult patients from an ambulatory clinic at the National Institutes of Health (Bethesda, MD, USA) with sickle cell anaemia with leg ulcers (with a surface area of 2·5–100 cm 2 ) persisting for at least 4 weeks into a safety and tolerability phase 1 dose-escalation trial of topical sodium nitrite. Increasing concentrations of sodium nitrite cream were applied twice weekly for 4 weeks to one ulcer per patient at five dose levels (0·5%, 1%, 1·5%, 1·8%, and 2%). The primary endpoints were safety and tolerability, with secondary endpoints of pharmacokinetics, blood flow, and wound healing. Pain relief was analysed post hoc. Endpoints were analysed over time for the whole study population and according to dose level. This study is registered with ClinicalTrials.gov, number NCT01316796. Findings Between April 4, 2011, and March 19, 2013, we enrolled 18 adult patients with sickle cell anaemia and leg ulcers into our trial. We assigned three patients into each cohort, and each cohort was treated with a different concentration of sodium nitrite cream (cohort 1: 0·5%, cohort 2: 1·0%, cohort 3: 1·5%, and cohort 4: 2·0%). Patients were not enrolled into the next cohort dose until we were able to establish that no dose-limiting toxicities were observed. An additional six patients were enrolled to cohort 3a: 1·8%, after two patients in cohort 4 had asymptomatic drops in diastolic blood pressure. No grade 3–4 adverse events were observed, and there were no serious adverse events or dose-limiting side-effects. Pharmacokinetic analysis showed that systemic absorption of sodium nitrite was very low. Application of topical sodium nitrite was associated with a significant increase in peri-wound cutaneous blood flow measured by laser speckle contrast imaging (p=0·0002), corroborated by increased peri-wound skin temperature by infrared thermography (p=0·0119). We recorded a dose-dependent decrease in leg ulcer size (p=0·0012) and pain (p Interpretation Our results indicate that topical sodium nitrite 2% cream is suitable for additional clinical trials in adults with sickle cell anaemia to promote healing of leg ulcers. Funding National Heart, Lung and Blood Institute Division of Intramural Research (National Institutes of Health).

Chronic leg ulcers are frequent and debilitating complications of sickle cell anemia. Inadequate blood supply has been postulated to be an important factor in their occurrence and delayed healing. Little is known about their microcirculatory and histopathological changes. We evaluated the microcirculation of lower extremity ulcers with laser speckle contrast imaging and infrared thermography and obtained clinical and laboratory characteristics in 18 adults with sickle cell anemia and chronic leg ulcers. Skin biopsies were obtained in four subjects. Subjects had markers of severe disease, anemia, high degree of hemolysis, inflammation, and thrombophilia. The highest blood flow was present in the ulcer bed, progressively less in the immediate periwound area, and an unaffected control skin area in the same extremity. Microscopic examination showed evidence of venostasis, inflammation, and vasculopathy. Blood vessels were increased in number, had activated endothelium and evidence of thrombosis/recanalization. High blood flow may be due to chronic inflammation, cutaneous vasodilatation, venostasis, and in situ thrombosis. These changes in skin microcirculation are similar to chronic venous ulcers in the non-sickle cell disease (SCD) population, thus suggesting that leg ulcers may be another end-organ complication with endothelial dysfunction that appears in patients with SCD at a younger age and with higher frequency than in the general population.

The power generation with non-renewable energy sources has very harmful effects on the environment as well as these sources are depleting. On the other side the renewable energy sources are quite unpredictable source of power. The best trade-off is to use the combination of both kind of sources to make a hybrid system so that their individual power generation constraints can be overcome. The hybrid system taken for analysis in this work comprises of wind and diesel power generation systems. The complete modelling of the system has been done in MATLAB/SIMULINK environment. Doubly fed induction generator (DFIG) is used for power generation in wind power system. The modelling has been done considering the changing wind speed and varying load conditions. The mathematical models of DFIG and diesel power generator have been used to develop the simulink model which can be used for analysis of various performances of the system like frequency response and power sharing between different sources with load variation .The generating margin of DFIG is also simulated for the frequency support during varying load conditions .The generating margin is created by the control of active power output from DFIG. Also as the power demand rises the generating margin of DFIG keeps the balance between the power generation and load. Proportional Integral controller has been used for diesel generator plant for frequency control. The controller gains have been optimized with Particle Swarm Optimization technique. The proper selection of controller gains and wind power reserve help to achieve the enhanced frequency response of the hybrid system., SCOPUS indexed Singapore journal, e-ISSN: 0975-4024, p-ISSN: 2319-8613. 8 pages, 9 figures, 1 table

The system comprises of three interconnected power system networks based on thermal, wind and hydro power generation. The load variation in any one of the network results in frequency deviation in all the connected systems.The PI controllers have been connected separately with each system for the frequency control and the gains (Kp and Ki) of all the controllers have been optimized along with frequency bias (Bi) and speed regulation parameter (Ri). The computationally intelligent techniques like bacterial foraging optimization (BFO) and particle swarm optimization (PSO) have been applied for the tuning of controller gains along with variable parameters Bi and Ri. The gradient descent (GD) based conventional method has also been applied for optimizing the parameters Kp, Ki,Bi and Ri.The frequency responses are obtained with all the methods. The performance index chosen is the integral square error (ISE). The settling time, peak overshoot and peak undershoot of all the frequency responses on applying three optimization techniques have been compared. It has been observed that the peak overshoot and peak undershoot significantly reduce with BFO technique followed by the PSO and GD techniques. While obtaining such optimum response the settling time is increased marginally with bacterial foraging technique due to large number of mathematical equations used for the computation in BFO. The comparison of frequency response using three techniques show the superiority of BFO over the PSO and GD techniques. The designing of the system and tuning of the parameters with three techniques has been done in MATLAB/SIMULINK environment., SCOPUS indexed Singapore journal, ISSN (Print): 2319-8613, ISSN (Online): 0975-4024, 8 pages, 11 Figures, 5 tables

This paper proposes a hybrid technique for secured optimal power flow coupled with enhancing voltage stability with FACTS device installation. The hybrid approach of Improved Gravitational Search algorithm (IGSA) and Firefly algorithm (FA) performance is analyzed by optimally placing TCSC controller. The algorithm is implemented in MATLAB working platform and the power flow security and voltage stability is evaluated with IEEE 30 bus transmission systems. The optimal results generated are compared with those available in literature and the superior performance of algorithm is depicted as minimum generation cost, reduced real power losses along with sustaining voltage stability., Comment: Google Scholar Indexed Australian journal, ISSN: 2005-4238, 8 pages, 2 figures, 1 table

Background Leptomeningeal collaterals improve outcome after stroke, including reduction of hemorrhagic complications after thrombolytic or endovascular therapy, smaller infarct size, and reduction in symptoms at follow-up evaluation. The purpose of this study was to determine the demographic and clinical variables that are associated with a greater degree of cerebral collaterals. Methods Clinical data of patients presenting with M1 occlusions of the middle cerebral artery (MCA) and associated computed tomography angiography studies after admission from 3 separate institutions were retrospectively compiled (n = 82). Occluded hemispheres were evaluated against the intact hemisphere for degree of collateralization in the MCA territory. Regression analysis of variance was conducted between clinical variables and collateral score to determine which variables associate with greater collateral development. Results Smaller infarct size corresponded to greater collateral scores, whereas older age and statin use corresponded to lower collateral scores ( P Conclusions Cerebral collateralization is influenced by age and statin use and influences infarct size.

The developed load flow algorithm is computationally efficient, provides a good convergence property, is independent of load model, nos. of laterals and sub-laterals, nos. of buses and R/X ratio of conductors, can be used for online as well as offline applications, and in contingency. Loads, in the present formulation, have been represented as constant power. Finally, IEEE 69-bus system is used as a test system to demonstrate the effectiveness of the proposed work. The load flow results and results for critical loading condition for constant complex power load obtained for 69-bus system have been verified with the results published with other existing method and found to be in exact agreement. The convergence characteristics is analysed for various system parameters and loading conditions. The proposed distributed load flow method is superior in terms of time taken for execution when compared with six other existing methods for 33-node as well as 69-node network.

Background: Glioblastoma multiforme (GBM) is a highly malignant central nervous system tumor that is extremely refractory to therapy due to its rapid growth and local invasive potential. The ability of glioma cells to invade the surrounding tissue has been attributed to the expression of matrix metalloproteinase-2 (MMP-2) in human gliomas. The -1306C/T polymorphism in the MMP-2 gene has been found to be associated with gastric adenocarcinoma, lung cancer and various other cancers including GBM. Racial and ethnic variations are known in such genetic polymorphisms. Aims: This prospective, case control study was aimed to find out an association of MMP-2 gene polymorphism with susceptibility to develop glioblastoma in Indian population. Material and Methods: MMP-2 gene polymorphism was studied using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 110 GBM patients and 150 healthy controls. The SPSS 17.0 statistical software (Chicago, IL, USA) was used for data management and analysis Results and Conclusions: A significant association of MMP-2 (−1306C/T) polymorphism with GBM (P = 0.475) was not found, suggesting that MMP-2 (−1306C/T) polymorphism is not associated with increased GBM susceptibility.

Matrix metalloproteinase-1 (MMP-1) is known to be involved in the pathogenesis of glioma. It damages the extra-cellular matrix to produce invasiveness in cancer tissue, and hence has a direct effect in cancer invasion. The study aims to explore the association of single nucleotide polymorphism of -1607 MMP-1 gene with susceptibility to glioblastoma multiforme (GBM) in northern Indian subjects. One hundred and ten GBM patients and 150 healthy controls were included in this study. 1607 MMP-1 gene was studied by PCR-RFLP; different genotypes being combinations of 1G and 2G allele (1G/1G, 1G/2G and 2G/2G). 2G/2G genotype was significantly associated with GBM patients (OR, 2.24; P = 0.016; 95% CI, 1.16-4.30) as compared to controls. Prevalence of the 2G allele of -1607 MMP-1 polymorphism was significantly greater in GBM patients as compared to controls (62.3 vs 48.3%, OR, 1.76; P = 0.002; 95% CI, 1.23-2.52). This study suggests that the 2G/2G genotype and 2G allele of -1607 MMP-1 polymorphism are associated with an increased susceptibility for developing GBM.

Abstract 1080 Background: The pathophysiology of sickle cell disease (SCD) involves vascular complications such as stroke and pulmonary hypertension. Elevated pulmonary artery pressure estimated by cardiac ultrasound or measured by invasive right heart catheterization is associated with early mortality among patients with SCD. Peripheral vascular dysfunction has also been observed in SCD and may be easier to assess than pulmonary vascular resistance and therefore more suitable for epidemiologic or interventional studies of SCD. Three previous studies found no difference in the maximal blood flow (or percentage increase) stimulated by occlusion and reperfusion of the brachial artery, a conduit vessel, when measured by Doppler ultrasound at periodic intervals. However, a study using continuous laser Doppler measurements of cutaneous microvascular blood flow found that patients with SCD had prolonged time to maximal blood flow and prolonged time to return to baseline compared to healthy controls. In our study, we used two-dimensional laser speckle contrast imaging (LSCI) to assess the cutaneous microvascular blood flow response in adults with SCD after five minutes of brachial artery occlusion. Methods: Nine subjects with sickle cell disease were enrolled and compared against nine healthy African-American control subjects matched for age, sex, ethnicity, and body mass index. Cutaneous blood flow was directly measured using LCSI at baseline, during and after a standard brachial artery occlusion-reperfusion maneuver (inflation of an occlusive pneumatic cuff for five minutes). This stimulates a transient increase in blood flow to levels above baseline during the reperfusion phase. Blood flow data were averaged over a defined region of interest on the medial aspect of the forearm. Microvascular blood flow responsiveness was calculated as the time to maximum (time elapsed from 50% of maximum to maximum blood flow) and the time to return to baseline (time elapsed from maximum to 50% of maximum blood flow). We performed measurements on each individual on two separate days, and compared the microvascular blood flow responses between the groups using two-way ANOVA with repeated measures. Results: We enrolled nine patients with sickle cell disease (age 35 ± 8.8, BMI 23 ± 3.9, 3 men/6 women) and nine healthy controls (age 35 ± 10.7 years, BMI 25 ± 3.2, 3 men/6 women). Baseline microvascular blood flow measured in arbitrary units (AU) was greater in patients with sickle cell disease compared to healthy controls (53.1 ± 9.2 AU vs 37.2 ± 4.4 AU, p < 0.0001) but maximal microvascular blood flow was similar (121.3 ± 29.3 AU vs 124.7 ± 26.6 AU, p = 0.58). Analysis of the time from half-maximum to maximum blood flow revealed that patients with sickle cell disease take longer to reach maximum blood flow (19.1 ± 11.6 s vs 11.8 ± 1.0 s, p = 0.03) and longer to decrease from maximum to half-maximum blood flow during the recovery period (43.5 ± 13.0 s vs 28.6 ± 10.4 s, p = 0.002). Conclusion: Compared to healthy individuals, patients with SCD have greater baseline microvascular blood flow but similar maximal blood flow during reperfusion. However, patients with SCD differ significantly from healthy control subjects in the time required to reach maximal blood flow and the time required to return to baseline, both of which are prolonged in patients with SCD. This may reflect delayed or impaired endothelial responses to shear stress and/or greater viscosity of blood. Time to maximal blood flow might represent a useful physiological biomarker as a proxy for clinical severity of sickle cell anemia, and a potential surrogate marker in early phase clinical trials. This technique merits additional characterization and validation. Disclosures: No relevant conflicts of interest to declare.

Abstract 1009 Background: Leg ulcerations are a serious and debilitating complication of sickle cell disease (SCD) and other hemolytic anemias, whose etiology is not completely understood. Wound healing involves an ordered progression of vasoconstriction (hemostatic phase), followed by vasodilatation (inflammatory and proliferative phase) and epithelialization. Little is known about the changes in the microcirculation of chronic wounds in patients with sickle cell disease. Endothelial function affects microcirculation and regulates blood flow. Endothelial dysfunction is a recognized pathway to end organ dysfunction in SCD. Laser speckle contrast imaging (LSCI) and Infrared Thermography (IR) are non-invasive technique used to assess dynamic changes in blood flow in response to vaso-reactive and other insults in both health and disease, while peripheral arterial tonometry is utilized for early detection of cardiovascular disease. The aim of this study was to evaluate skin's microvasculature response and endothelial function in adults with HbSS and chronic leg ulceration. Methods: Twelve adults with HbSS and chronic leg ulcers (> 1 month duration) were evaluated at steady state with a detailed medical and ulcer history, physical examination, and clinical labs. Clinical and laboratory data were compared to 269 adults with Hb SS, without active leg ulcers, enrolled in a Pulmonary Hypertension screening protocol (Clin trial no. NCT00011648). Blood flow (LCSI) and IR measurements of the ulcer bed, the peri-ulcer area and of a distant, unaffected area (baseline) were obtained and compared. Peripheral arterial tonometry (PAT) was obtained to calculate the ratio of post-occlusion dilatation to baseline reactive hyperemia index: RHI. An RHI>1.67 is indication of normal endothelial function. Results: Mean age for the 12 subjects with chronic active leg ulcer: 31 years ± 11yrs, 5 male, 5 had a history of trauma. When compared to SS patients without active leg ulcers: mean MAP 82 vs 103 mmHg (p Conclusions: With this study we confirm that patients with HbSS and leg ulcers represent a subgroup with severe disease, as demonstrated by the high use of HU and/or transfusion, and number of complications at a relatively young age. We report high blood flow in the ulcer bed and immediate surrounding regions, compared to unaffected areas, never prior demonstrated. It is probable that the increase in blood flow observed in the wound and peri-wound regions reflect s a high vasodilated state, resulting from severe anemia, relative hypotension, and chronic inflammation. Laboratory and clinical data supports the presence of a persistent inflammatory and hemolytic state, as well as low arginine bioavailabitlity. Laser Speckle Contrast Imaging, Infrared Thermography and Peripheral Arterial Tonometry are effective, non invasive novel techniques useful for studying microvascular and endothelial function in patients with SCD and leg ulcers. Disclosures: No relevant conflicts of interest to declare.