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Guidelines suggest patients with rheumatoid arthritis (RA) inadequately controlled by tumor-necrosis-factor-inhibitors (TNFis) may benefit from switching to Janus-kinase-inhibitors (JAKis); however, care coordination and access can be complicated. Disruptions in transitioning to JAKi treatment could lead to disease flares requiring hospitalization; however, transitioning between products within the same patient support program (PSP) services aimed at ensuring continuity of care may minimize disruptions.A retrospective, longitudinal cohort study of adult patients with RA newly prescribed JAKi following TNFi treatment in the Symphony Health claims database. Patients with baseline TNFi use and ≥ 6 months of data before (baseline) and after (follow-up) the initial JAKi claim (approved or denied) were included. Cohorts were defined by transitions between products within the same PSP [adalimumab (ADA) and upadacitinib (UPA)] or not. Disruptions were defined as gap in care ≥ 15 days due to failure/delay in receiving coverage approval or picking up an approved prescription. Disruptions followed by JAKi dispense were considered temporary and those without permanent. Odds ratios (ORs) of disruption and hospitalization were estimated from logistic regressions controlling for patient characteristics and treatment history.A total of 2371 patients were included: 317 transitioning from ADA-UPA, 321 TNFi-UPA, 860 ADA-another JAKi, and 873 another TNFi-another JAKi. Temporary and permanent disruptions increased odds of hospitalization by 47% and 123% (both p 0.05). Temporary disruption rates were lowest for ADA-UPA patients (19%) compared to other TNFi-UPA (25%; OR = 1.46), ADA-other JAKi (29%; OR = 1.59), and other TNFi-other JAKi (31%; OR = 1.74), all p 0.05. For transitions to UPA, temporary disruptions were lower for patients using the PSP (17%) versus not (24%; OR = 1.45, p 0.05). No differences were found for permanent disruptions.Disruptions for patients with RA transitioning from TNFi to JAKi treatment are associated with increased hospitalization rates. Transitioning between drugs within the same PSP could lower the risk of disruption.

This project is associated results and ongoing analysis of pre-registration: https://doi.org/10.17605/OSF.IO/KTPAB

To compare marginal bone loss (MBL), implant survival rate and prosthetic complications of implant-supported splinted and non-splinted restorations (NSR).This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The PROSPERO registry, which keeps track of prospective systematic reviews, also received this paper (CRD42021229477).An electronic search was done in PubMed, the Cochrane Central Trials Register, Scopus, Science Direct, and Google Scholar searches were carried out. The search was limited to articles published in English and covered the period from January 2010 to August 2020.To conduct the meta analysis, researchers employed methodologies such as continuous measurement and odds ratios.For both qualitative and quantitative analysis, 19 scientific studies were chosen. 3682 implants were placed in 2099 patients with a mean age of 59 years (splinted, 2529; non-splinted, 1153); the mean age was not provided in 5 trials. For splinted restorations, there were statistically significant differences in MBL, indicating the former has less MBL than for NSR. Splinted restorations had much greater survival rates than NSR, according to a qualitative study. Rest prosthesis complications with or without splinting were essentially the same.Splinted implant restorations lost less bone than non-splinted implant restorations, according to this meta analysis. This was particularly true for posterior restorations. Lower implant failure was associated with splinted restorations. Restorations with and without splinting had the same level of prosthetic problems.

Rheumatoid arthritis (RA) is a chronic autoimmune disease requiring long-term treatment. Upadacitinib (UPA), a Janus kinase (JAK) inhibitor, is a new treatment for RA. The benefit–risk profile of a medication is best understood by evaluating the number needed to treat (NNT) and the number needed to harm (NNH). This analysis evaluated the comparative risk–benefit of UPA versus adalimumab (ADA). Post-hoc analyses were performed using data from the SELECT-COMPARE trial of UPA versus placebo (PBO) and UPA versus ADA among patients with active RA who remained on stable methotrexate (MTX) treatment and had an inadequate response; patients who failed to achieve response were rescued by predefined criteria—PBO or ADA switch to UPA, and UPA switch to ADA (all patients on PBO were switched to UPA at week 26). This analysis assessed efficacy and adverse events of special interest (AESIs) at week 26, 48, and 156 (3 years). NNT and NNH (95% confidence intervals) values were calculated between UPA versus ADA for all time points, and between UPA versus PBO for week 26. NNT and NNH values were applied to a hypothetical cohort of 100 patients to estimate the comparative efficacy and safety profiles. UPA consistently showed greater efficacy than ADA, as evidenced by NNT values

The outrigger structural system is one of the horizontal load resisting systems. In this system the belt truss ties all the external columns on the periphery of the structure and the outriggers connect these belt trusses to the central core of the structure thus restraining the exterior columns from rotation. The shear wall was implemented to oppose lateral loads. To complete these characteristic the Outrigger & wall belt system used in the structure. In this project a G+10 Storey structure has analysed using seven different cases named as RA1 to RA7-OTB. 1 to 7 indicates single outrigger system, shear core outrigger system truss belt support system with optimized trusses, at various locations under seismic zone III. The built up area used for various case as 315 sq. m. After performing result analysis, the comparative analysis of all the cases shows that the most efficient case for the above study is Case RA4. Here for efficiency of the project, two types of optimized truss belt support which has performed well and observed as most optimized and correspondingly minimum in all the cases. Keywords: Truss wall belt support, core wall belt support, outrigger, wall belt, CSI-ETABS, multi-storey

Mucoadhesive buccal films of rivastigmine were prepared by the solvent casting technique using HPMC K15M, sodium alginate, glycerine, and Eudragit RL100. Arranged films assessed for weight variation, thickness, % drug substance, % moisture loss, % moisture take-up, folding endurance, in-vitro medicament release, and Fourier transform Infrared spectroscopy (FTIR). The films showed a controlled release (CR) over 8 h. The preparation observed to be a worthy candidate for the development of buccal patches for therapeutic purposes. Drug-polymer compatibility considers FTIR demonstrated no contradiction between the medicament and the polymers. The optimized formulation found F7 indicated drug release 85% at the end of 8 h. Thinking about the correlation coefficient (R2) values got from the kinetic equations, the drug release from the formulations F1-F8 has discovered zero-order release mechanism. It can be concluded that oral buccal patches of rivastigmine, for treatment of Alzheimer’s and Parkinson’s disease, can be formulated. The study suggests that rivastigmine can be conveniently administered orally in the form of buccal patches, with the lesser occurrence of its side effects and improved bioavailability.

Ticks and tick-borne diseases are significant health concerns in small ruminants. The present study was conducted to identify and characterize the genetic makeup of Theileria and Anapalsma species in sheep and goats located in different districts of North Gujarat. A total of 226 blood samples were collected from sheep (n=78) and goats (n=148) viz. Banaskantha (n=175), Patan (n=26), and Bhuj (n=25). PCR was carried out using a species-specific primer of Theileria targeting 18S rRNA, SSU rRNA, and Anapalsma targetting the msp5 gene. A total of 29/78 (37.18%) sheep and 16/148 (10.81%) goats were found positive for Theileria. At the same time, 12/78 (15.38%) sheep and 38/148 (25.68%) goats were found positive for Anaplasma infection. Moreover, mixed infection was found in 10/226 (4.42%) sheep and goats. Tick-borne diseases were more prevalent in females compared to male sheep and goats. Theileria infection was more common in sheep, whereas Anapalsma was more dominant in goats of north Gujarat. Sequencing of six positive samples revealed the T. ovis and A. ovis infections in sheep and goats. Phylogenetic analysis of T. ovis SSU rRNA and Anaplasma spp. msp5 revealed that the pathogens identified in this study are clustered together, indicating similar molecular characteristics. Hyaloma and Rhipicephalus were common ticks identified in sheep and goats. We concluded that Theileria and Anaplasma are highly prevalent in the study area, and continuous monitoring of sheep and goats in North Gujarat is highly required. This is the first scientific report on Theileria and Anaplasma co-infections in sheep and goats from North Gujarat.

There is no current authoritative accounting of the number of clinical imaging physicists practicing in the United States. Information about the workforce is needed to inform future efforts to secure training pathways and opportunities. In this study, the AAPM Diagnostic Demand and Supply Projection Working Group collected lists of medical physicists from several state registration and licensure programs and the Conference of Radiation Control Program Directors (CRCPD) registry. By cross-referencing individuals among these lists, we were able to estimate the current imaging physics workforce in the United States by extrapolating based on population. The imaging physics workforce in the United States in 2019 consisted of approximately 1794 physicists supporting diagnostic X-ray (1073 board-certified) and 934 physicists supporting nuclear medicine (460 board-certified), with a number of individuals practicing in both subfields. There were an estimated 235 physicists supporting nuclear medicine exclusively (150 board-certified). The estimated total workforce, accounting for overlap, was 2029 medical physicists. These estimates are in approximate agreement with other published studies of segments of the workforce.

The aim of the strategy to formulate the pulsatile drug delivery system using terbutaline sulfate by direct compression technique and evaluate the effects of formulation and dissolution medium on the behavior of drug release, and to clarify the drug release mechanism based on acquiring results. Pulsatile release tablets include a drug and disintegrating agent-containing core and swellable external layers for slow down drug release, then rupturing the nearby surrounding outer layer for fast release. Core tablets prepared using disintegrating agent by direct compression method and coated with polymers like HPMC K100M, ethyl cellulose, karaya gum in different quantities. Several physical parameters of the tablets evaluated such as stiffness, thickness, friability, weight variation, disintegration, drug content and dissolution test. Terbutaline sulfate released from bi-layered tablets with pulsatile behaviors. In-vitro drug release rate readings showed that F3 and F6 are best based on the less quantity of drug release during the lag time (11% and 14% in 5 h). So, from the result, the F6 has nominated the best formulation. Thus, by the direct compression method prepared, coated tablets before drug release with an obvious lag time is possibly useful preparation for the medication of osteoarthritis, rheumatoid arthritis, dysmenorrhea, asthma which follows a circadian rhythm. It confirmed that eroding, diffusion, and swelling mechanisms were responsible for drug release. Ultimate pulsatile release activities may be done by modifying polymeric membrane quantities and proportions to meet the condition of pulsatile activities.

Introduction To compare all-cause and rheumatoid arthritis (RA)-related healthcare costs and resource use in patients with RA who do not achieve remission versus those who achieve remission, using clinical practice data. Methods Data were derived from Optum electronic health records linked to claims from commercial and Medicare Advantage health plans. Two cohorts were created: remission and non-remission. Remission was defined as Disease Activity Score 28-joint count with the C-reactive protein level or erythrocyte sedimentation rate (DAS28-CRP/ESR)

Microalgae have attracted significant interest worldwide as a prospective biofuel feedstock. Currently, biodiesel potential of microalgae has been confined at lab scale; however, economic feasibility is a limiting factor for commercialization. Thus, development of large-scale production system is an essential element to assess economic feasibility as well as policy support needed to implement large-scale production. To answer this, Dunaliella tertiolecta was selected for biodiesel feedstock production among other isolates, having 1.244 g/L dry biomass yield and 37%w/w lipid content. Operational cost of biodiesel production was 3.19 USD/L for lab scale which can be reduced to 0.77 USD/L at large-scale production by integrated and efficient resource utilization, namely, natural seawater (NSW), as growth media and unproductive coastland for production site. Capital investment of USD 82019.89 was calculated for biodiesel production facility with 16.7 KL annual production for one-hectare unproductive land. Economic evaluation of 10 years of production resulted into net present value (NPV) of USD 750.91 and 5.18% internal rate of return (IRR). Capital recovery can be achieved in 7.76 years as per normal payback analysis. Additionally, NPV can be increased to USD 30355 by upscaling production to five times with 50% more biomass productivity that would result into 14.23% IRR. Efficient resource integration, multiple products and co-products with market linkages, and appropriate policy facilitation are key factors for commercial viability of microalgae biodiesel production.

Background: Both cesarean-section (CS) delivery (CD) and vaginal delivery (VD) is associated with well-known measurable short- and long-term maternal and neonatal complications and benefits. Objective: The present retrospective observational study was conducted on a preliminary basis to evaluate the contributing factors that provoke CS delivery. Materials and Methods: The short-term (6 months) retrospective study was conducted at the Department of Obstetrics and Gynaecology, Pt. Deen Dayal Upadhyay and Northern Railway divisional hospital Moradabad, Uttar Pradesh, India. The sample size was calculated accordingly with a relative precision of 10.2% of prevalence and was found to be 140 and we have taken the sample size of 345. Results: The prevalence of CD for a particular course of duration was found to be 36.23%. The risk of CD increased (P < 0.001) with increased BMI. However, differential limits of normal BMI signify that lower limit of normal BMI possessed high % of CS. As the education profile was getting high the possibility of CS was found to be increased (P < 0.001). Women with negative Rh factor the probability of CS in terms of percentage was found to be 87.5%. There was a proportionate possibility of CS with an increased gap between parities. The % mortality of new-born by CD and VD was 14.28% and 85.71%, respectively, which signifies that CS prevents infant mortality. There was 99.2% possibility of undergoing CS if a woman possessing medical complications. Conclusion: The present study acknowledged that CD ensures feto-maternal safety. However, the study also highlighted some probable indications that might engender CD.

Introduction: Lateral throat form plays an important role in the success of lower complete denture as it affects its retention and stability. The length and thickness of lower dentures should be properly established in this region. Aim of this study is to evaluate the difference in the extension of lateral throat form between the patient's mouth and lower dentures. Materials and Methods: The lateral throat form was classified according to Neil's classification into Class I, Class II and Class III. The length of the lateral throat form was measured in the patient's mouth and in lower dentures with the help of UNC periodontal probe, and a comparison was made between them. Results: Among all the patients in this study, Neil's Class I lateral throat form was 53%, Class II was 37% and Class III was 10%. The average variation between the extent of lateral throat form intraorally and in lower denture at the anterior edge of the retromolar pad was 1.7 ± 1.75 mm in the right side and 2.5 ± 2.00 mm in the left side, whereas at the posterior edge of retromolar pad, it was 2.23 ± 1.92 mm in the right side and 3.06 ± 2.25 mm in the left side. Conclusions: The proportion of Neil's Class I was the highest followed by Class II and Class III was the lowest. The difference between the length of lateral throat form in the patient's mouth and in lower denture was statistically significant (P < 0.05).

Background: The Kankrej cattle is the heaviest and most priced of the Indian breeds of cattle. It is adapted to the geo-climatic conditions of North Gujarat and Kutch, which is normally hot and dry. It is reared in the district of Banaskantha in the state of Gujarat and also distributed in other parts of India and abroad. The experiment was carried out to study the effect of the summer season on the milk composition and physiological responses in lactating Kankrej cow compared to the thermoneutral period. Methods: For the experiment, total number of 16 clinically healthy Kankrej cows were randomly selected from Livestock Research Station (LRS), Sardar Krushinagar Dantiwada Agricultural University, Banaskantha, Gujarat and categorized into two different groups according to seasons. Physiological responses i.e. respiration rate and rectal temperature were recorded and milk samples were collected from each animal during the summer and thermoneutral period at fortnight intervals. The milk samples were analyzed by using an automated milk analyzer. Result: The results demonstrate that fat, SNF and density were significantly higher in the summer season. The physiological responses include respiration rate and rectal temperature were found significantly higher during summer than thermoneutral period. Milk protein was significantly higher during the thermo-neutral period as compared to summer.

Introduction Our aim was to evaluate patient adherence and persistence with citrate-free adalimumab (ADA-CF), introduced in 2018 to reduce injection-site pain, compared with citrate-containing adalimumab (ADA-C). Methods This was a retrospective cohort study using a US claims database (IBM® MarketScan® Commercial and Medicare Supplemental Claims Database) from February 2018 to January 2020. Patients at least 18 years of age who were naïve to adalimumab 6 months before the index date (date of first adalimumab claim) and with at least 12 months of continuous medical and pharmacy coverage were eligible for the study. Adherence was assessed by determining the proportion of days covered (PDC) and the percentage of patients with PDC ≥ 80% during the 12-month follow-up period. Persistence was evaluated by measuring the rate of discontinuation and days to discontinuation (i.e., time on treatment) from the index date over the 12-month follow-up period. Continuous adherence outcomes (PDC) were evaluated using linear regression models. Binary adherence outcomes (PDC ≥ 80%) were assessed using logistic regression models. Kaplan–Meier analysis and Cox proportional hazards models were used to assess persistence outcomes. Results There were 2195 and 1005 patients in the ADA-CF and ADA-C cohorts, respectively, with most using adalimumab for rheumatoid arthritis (ADA-CF 29.7%, ADA-C 27.2%) and psoriasis (ADA-CF 24.5%, ADA-C 31.9%). Significantly greater adherence was achieved with ADA-CF compared with ADA-C (mean PDC [standard deviation] 0.68 [0.30] vs 0.61 [0.32], P

This study was carried out to explore biomass variety of sorghum, pearl millet and bamboo for second generation biofuel feedstock production at salinity and drought prone marginal land at three districts of Gujarat state, India. The biomass feedstock under study were compared with the native crop varieties for its economic sensitivity as well as native varieties of the same crops for energy and carbon dioxide equivalent (CO2eq) greenhouse gas (GHG) emission. Net income per matric tone of harvested biomass sorghum, pearl millet and bamboo were 52.02 USD, 20.37 USD and 124.66 USD respectively which is economically profitable as compared to native sorghum and pearl millet varieties. Bamboo showed highest net income of 8 USD/day based on the annual land occupancy which is double than biomass sorghum. Positive net energy balance of 454.29 GJ/Ha/crop cycle, 278.20 GJ/Ha/crop cycle and 602.49 GJ/Ha/Year were found for biomass sorghum, pearl millet and bamboo respectively. GHG emission was positive and lowest for bamboo 42.55 KgCO2eq/MT as compared to biomass sorghum 48.97 KgCO2eq/MT and pearl millet 74.53 CO2eq/MT. Cost benefit analysis revealed that bamboo has highest net income, lowest GHG emission, highest net energy balance and highest biomass production per USD spent among the other biomass crops.

Background: The amount of interocclusal distance in any individual is mainly an expression of muscle function, its equilibrium, and gravity. In some medically compromised patients, it is difficult to determine the interocclusal distance. Aim: This study aims to evaluate the correlation of interocclusal distance and corresponding gonial angle on the lateral profile of dentulous individuals in lateral cephalograms in Gujarati population and correlation of these values for edentulous individuals. Material and methods: A total of 100 individuals were involved in this study within age group of 20-35 years. Interocclusal distance was determined by the difference between the readings of vertical dimension of rest and vertical dimension of occlusion in dentulous individuals.Gonial angle was calculated with the help of cephalometric radiographs and the two were correlated. Results: Range of gonial angle and interocclusal distance were obtained and the mean of the values was derived. A strong correlation was found to exist.Conclusion: By applying the processes of linear regression to the paired results, a formula was obtained which may be used to predict the best value of one variable for any given value of the other. Thus, in an edentulous case, where the value of the interocclusal distance measurement is unknown and difficult to determine, a method is provided for predicting its best value by the determination of the patient's gonial angle through cephalometric analysis.

Background The pathogenesis of Clostridioides difficile infection (CDI) involves a significant host immune response. Generally, corticosteroids act by suppressing the host inflammatory response, and their anti-inflammatory effects are used to treat gastrointestinal disorders. Although previous investigations have demonstrated mixed results regarding the effect of corticosteroids on CDI, we hypothesized that the anti-inflammatory effect of corticosteroids would decrease the risk of CDI in hospitalized patients. Methods This was a case–control study of hospitalized adults. The case population included patients diagnosed with primary CDI who received at least 1 dose of a high-risk antibiotic (cefepime, meropenem, or piperacillin-tazobactam) in the 90 days before CDI diagnosis. The control population included patients who received at least 1 dose of the same high-risk antibiotic but did not develop CDI in the 90 days following their first dose of antibiotic. The primary study outcome was the development of CDI based on receipt of corticosteroids. Results The final study cohort consisted of 104 cases and 153 controls. Those who received corticosteroids had a lower odds of CDI after adjusting for age, proton pump inhibitor use, and antibiotic days of therapy (odds ratio, 0.54; 95% CI, 0.30–0.97; P = .04). We did not observe an association between corticosteroid dose or duration and CDI. Conclusions We demonstrated a 46% relative reduction in the odds of developing CDI in patients who received corticosteroids in the past 90 days. We believe that our results provide the best clinical evidence to further support mechanistic studies underlying this phenomenon.

Introduction The impact of the COVID-19 pandemic on routine medical care may result in altered healthcare resource use in patients with immune-mediated conditions. The aim of this study was to determine the impact of treatment interruptions in patients with and without COVID-19 infections who were treated with targeted immunomodulators (TIMs) in the USA. Methods Data from the IBM® MarketScan® Research Databases were analyzed in patients with immune-mediated conditions from January 1, 2018, through December 31, 2020. Healthcare resource use (HCRU) including hospitalizations, emergency department (ED) visits, in-person outpatient visits, and respiratory outcomes was assessed in a cohort of patients without COVID-19 who had uninterrupted versus interrupted TIM use. The impact of treatment interruption on HCRU and respiratory outcomes was also evaluated in a cohort of patients with COVID-19. Results from adjusted logistic regression were reported as adjusted odds ratios (aORs) with 95% confidence intervals. Results Approximately 25% of patients in both the COVID-19 (N = 787) and non-COVID-19 cohorts (N = 77,178) experienced interruptions in TIM therapy. In the non-COVID-19 cohort, the likelihood of being hospitalized was 20% less in patients with uninterrupted versus interrupted TIM use (aOR = 0.80, 95% CI 0.71–0.90). Patients with uninterrupted TIM use had a similar likelihood of an ED visit (aOR = 0.99, 95% CI 0.91–1.08) and respiratory outcome (aOR = 0.97, 95% CI 0.71–1.31) versus patients with interrupted TIM use. The likelihood of having an in-person outpatient visit was 87% greater in patients with uninterrupted versus interrupted TIM use (aOR = 1.87, 95% CI 1.81–1.94). Similar findings were observed in the COVID-19 cohort. Conclusion This analysis of real-world claims data showed that uninterrupted TIM use was not associated with an increased likelihood of hospitalizations, ED visits, or negative respiratory outcomes compared to interrupted TIM use among patients with immune-mediated conditions, regardless of COVID-19 diagnosis. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01906-4.

Background The pathogenesis of Clostridioides difficile infection (CDI) involves a significant host immune response. Generally, corticosteroids act by suppressing the host inflammatory response, and their anti-inflammatory effects are used to treat gastrointestinal disorders. Although previous investigations have demonstrated mixed results regarding the effect of corticosteroids on CDI, we hypothesized that the anti-inflammatory effect of corticosteroids would decrease the risk of CDI in hospitalized patients. Methods This was a case–control study of hospitalized adults. The case population included patients diagnosed with primary CDI who received at least 1 dose of a high-risk antibiotic (cefepime, meropenem, or piperacillin-tazobactam) in the 90 days before CDI diagnosis. The control population included patients who received at least 1 dose of the same high-risk antibiotic but did not develop CDI in the 90 days following their first dose of antibiotic. The primary study outcome was the development of CDI based on receipt of corticosteroids. Results The final study cohort consisted of 104 cases and 153 controls. Those who received corticosteroids had a lower odds of CDI after adjusting for age, proton pump inhibitor use, and antibiotic days of therapy (odds ratio, 0.54; 95% CI, 0.30–0.97; P = .04). We did not observe an association between corticosteroid dose or duration and CDI. Conclusions We demonstrated a 46% relative reduction in the odds of developing CDI in patients who received corticosteroids in the past 90 days. We believe that our results provide the best clinical evidence to further support mechanistic studies underlying this phenomenon.

Pay-for-performance (P4P) has been used expansively to improve quality of care delivered by physicians. However, to what extent P4P works through the provision of information versus financial incentives is poorly understood. To determine whether an increase in information feedback without changes to financial incentives resulted in improved physician performance within an existing P4P program. Implementation of a new registry enabling real-time feedback to physicians on quality measure performance. Observational, predictive piecewise model at the physician-measure level to examine whether registry introduction associated with performance changes. We used detailed physician quality measure data 3 years prior to registry implementation (2010–2012) and 2 years after implementation (2014–2015). We also linked physician-level data including age, gender, and board certification; group-level data including registry click rates; and patient panel data including chronic conditions. Four hundred thirty-four physicians continuously affiliated with Advocate from 2010 to 2015. Physician performance on ten quality metrics. We found no consistent pattern of improvement associated with the availability of real-time information across ten measures. Relative to predicted performance without the registry, average performance increased for two measures (childhood immunization status—rotavirus (p

With over 500,000 bone grafting procedures performed annually in the United States, the advancement of bone regeneration technology is at the forefront of medical research. Many tissue-engineered approaches have been explored to develop a viable synthetic bone graft substitute, but a major challenge is achieving a load-bearing graft that appropriately mimics the mechanical properties of native bone. In this study, sintered hydroxyapatite (HAp) was used to structurally reinforce a scaffold and yield mechanical properties comparable to native bone. HAp was packed into a cylindrical framework and processed under varying conditions to maximize its mechanical properties. The resulting HAp columns were further tested in a 6-week degradation study to determine their physical and mechanical response. The cellular response of sintered HAp was determined using a murine preosteoblast cell line, MC3T3-E1. Cell viability and morphology were studied over a one-week period and MC3T3-E1 differentiation was determined by measuring the alkaline phosphatase levels. Finite element analysis was used to determine the columns' geometric configuration and arrangement within our previously developed composite bone scaffold. It was determined that incorporating four cylindrical HAp columns, fabricated under 44 MPa of pressure and sintered at 1200°C for 5 hr, led to load-bearing properties that match the yield strength of native whole bone. These preliminary results indicate that the incorporation of a mechanically enhanced HAp structural support system is a promising step toward developing one of the first load-bearing bone scaffolds that can also support cell proliferation and osteogenic differentiation. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 732-741, 2019.

High-throughput screening is one of the most crucial aspects that helps a society to respond effectively in an emergency, such as a pandemic. The current medical technologies have advanced the diagnostic ability in terms of its speed, quality, effectiveness and sensitivity. However, these technologies are not developed beyond the conventional diagnoses of certain diseases, such as immunodeficiency, cancers, and neurological disorders. In this regard, the manufacturing of diagnosis kits has seen revolutionary changes when nanotechnology has been incorporated. This technology has enabled the design of innovative tools and techniques to improve the whole healthcare system in general, and diagnosis in particular. The most significant changes brought by nanotechnology in medical diagnosis include rapid testing and early diagnosis. The characteristic physicochemical properties, advantageous functionalization chemistry and biological compatibility of nanoparticles (e.g., gold nanoparticles, silver nanoparticles, quantum dots, carbon nanotubes, and graphene oxide) have gained tremendous attention for revolutionizing the overall field. In addition to the use of novel nanoparticles, the medical diagnostics field has benefitted from the application of nanotechnology in chips, sensors, single-cells, and micro-electromechanical structures. Therefore, this chapter aims to introduce and review nanotechnology-based tools and devices for the diagnosis of critical diseases.

The design, development and performance analysis of a mixed mode tent- type solar dryer for drying of fishes is reported. The collector and dryer area were calculated based on the moisture load and local ambient conditions. During the experimental period, maximum collector outlet temperature of 86 °C was attained under no load condition, in natural convection mode. A mathematical model was developed to predict the collector outlet temperature and the energy balance equations were solved using SageMath programming language. No-load performance index (NLPI) was calculated to be 2.11 at average solar radiation of 600 W/m2. The moisture content of the fishes kept in the solar dryer reduced from about 89% to 10% in 18 sunshine hours, whereas, it took 38 h to dry the same in open, as it is done practically in field. A drying model was developed and it fitted well with the Lewis model of drying. The computed value of the diffusivity based on the moisture ratio was found to be 1.53 × 10−7 m2/s. Such a kind of solar dryer would be of significance in coastal communities involved in fish drying, as it would improve throughput and offer a hygienic practice.

Second generation biofuel needs lignocellulosic biomass cultivated on marginal wasteland that does not conflict with food crops for land and should be long-term economically viable. Therefore, high biomass yielding varieties of sorghum (Sorghum bicolor (L.) Moench), pearl millet (Pennisetum glaucum) and bamboo (Bambusa balcooa) were cultivated for 3 consecutive years in the farmers' fields of three districts of Gujarat state of India. Capital and operational costing, total revenue generation and operational profit were calculated for cultivation process. Net present value (NPV) and internal rate of return (IRR) were calculated to compare profitability. Biomass varieties of sorghum, pearl millet and bamboo showed annually 40.18 MT, 26.56 MT and 24.2 MT per hectare biomass yields with gross profit of 1804.42 USD, 293.11 USD and 3016.8 USD respectively. Gujarat state possesses 2488600 ha marginal wasteland classified as culturable waste land, current fallow land and other fallow land. If these marginal wastelands cultivate biomass sorghum and bamboo, considering 70% yield compared to farmer's field trials, then 28.13 MT dry biomass from sorghum and 16.94 MT dry biomass from bamboo can be produced annually per hectare with gross profit of 898.00 USD per ha and 1924.4 USD per ha respectively. Economic sensitivity analysis suggested that biomass yield less than 50% for sorghum and less than 30% for bamboo, as compared to the farmers' field data showed lower IRR and payback time beyond 10 years with negative NPV. A thoughtful resource and policy integration have been recommended to promote bio-energy feedstock cultivation on marginal lands in India.

Uncontrolled anthropogenic activities and technological revolution increase fossil fuel consumption at higher rate that prompted researchers looking for alternative energy source to cover the current need and future demand of energy. Biomass of terrestrial crops has been studied as a promising source of renewable energy in last few decades however large scale production is still questionable because of lower productivity, indirect use of fossil fuel, lack of land availability and food vs. fuel conflict. These limitations of land based system fetch opportunity to look into untapped potential use of microalgae with high biomass productivity from saline and waste water stream. This unconventional way of feedstock generation can additionally produce value added products apart from clean energy. This review presents current scenario of microalgae applications in biofuel production and micro algae based high value bio-product industries leveraging environmental protection and waste utilization benefits. Microalgae cultivation, harvesting and biomass conversion technologies for biodiesel production have been reviewed based on adapting ancient learning to understand critical factors affecting overall productivity and economic viability. Dedicated efforts from technical experts are still required for economic viability of large scale biodiesel production in spite of positive finding at small scale. Several high value bio-products from microalgae amplified magnetism of trades for investment in this field. Microalgae cultivation intersects two key concern areas of global warming and water pollution control/water recycling by CO2 sequestration and waste water utilization respectively. Integration of suitable upstream and downstream processing technologies with multiple product portfolio would make the microalgae bio-refinery economical viable.

Background:Physical function and health-related quality of life(HRQoL) are negatively impacted in patients(pts) with PsA. Treatment with conventional and biological (b) DMARDs improved patient-reported outcomes(PROs).Objectives:To assess impact of adalimumab(ADA) vs placebo(PBO) on PROs following 12-week (wk) treatment.Methods:Pts(n=315) with moderately to severely active PsA and bDMARD naive were randomized to ADA 40mg or PBO every other wk. We assessed PROs at baseline(BL) and wk 12 using the 36-item Short-Form(SF-36) Health Survey physical(PCS) and mental component summary(MCS) scores, 8 domain scores ranging from 0(worst) to 100(best), and SF-6D utility measure derived from all 8 SF-36 domains with scores ranging from 0.296(worst) to 1.00(full health) and minimally important difference(MID) of 0.041. Patient Global Assessment of disease activity(PtGA) and pain(both utilizing 100 mm visual analog scale[VAS]) and HAQ disability index(DI) were assessed. Mean changes from BL, percentages of pts with improvements ≥minimum clinically important differences(MCID), and scores ≥US age-and gender-matched normative values(A/G norms) were analyzed, based on as observed data.Pvalues were assessed by analysis of variance model for continuous variables andCochran–Mantel–Haenszeltest for binary outcomes, adjusting by baseline MTX use and extent of psoriasis. Numbers needed to treat(NNTs) are reported using proportions of pts reporting improvements ≥MCID in SF-36, PtGA, pain, and HAQ-DI.Results:BL PRO scores were similar between ADA(n=151) and PBO(n=162;Table 1). Improvements from BL at wk 12 with ADA vs PBO were significant in PtGA, pain, HAQ-DI, and SF-36 PCS(change: 9.3 vs 1.4;PTable 1). Six of 8 SF-36 domains significantly improved from BL to wk 12 with ADA vs PBO(allP≤0.05;Table 1andFigure 1). SF-6D improvements exceeded MID with ADA(change: 0.071) vs PBO(0.018). Proportions of pts reporting improvements ≥MCID at wk 12 were significantly greater with ADA vs PBO in all PROs, except SF-36 role emotional and mental health domains, with corresponding NNTs ≤6.4(Figure 2). Proportions of pts who reported scores ≥A/G norms in HAQ-DI, SF-36 PCS, and 6 of 8 SF-36 domains were significantly greater with ADA vs PBO(Figure 2).Table 1.Mean Disease Characteristics and SF-36 Domain Scores by Treatment Group at Baseline and Wk 12 Compared With Age-and Gender-Matched Normative ValuesADA 40 mg eowPBOA/G normsBaselineWeek 12[change from baseline to week 12]BaselineWeek 12[change from baseline to week 12]SF-36 PCS33.242.5[9.3**]33.334.7[1.4]≥50SF-36 MCS48.149.8[1.6]46.648.4[1.2]≥50SF-6D0.6530.724[0.071]0.6410.659[0.018]—PtGA47.125.9[–21.7**]48.147.5[0.2]—Pt pain51.126.8[–24.1**]48.849.1[1.3]—HAQ-DI1.00.6[–0.4**]1.00.9[–0.1]≤0.25Baseline(vs A/G norms)Week 12(vs A/G norms)Baseline(vs A/G norms)Week 12(vs A/G norms)Physical Functioning50.8(−31.5)65.9***(−16.4)48.2(−34.1)52.0(−30.3)82.3Role Physical37.1(−45.9)65.9***(−17.1)32.6(−50.4)40.6(−42.4)83.0Bodily Pain41.3(−31.6)61.0***(−11.9)40.2(−32.7)43.7(−29.2)72.9General Health49.5(−20.8)62.1***(−8.2)52.1(−18.2)53.0(−17.3)70.3Vitality41.4(−17.8)55.1***(−4.1)41.6(−17.6)45.0(−14.2)59.2Social Functioning66.3(−19.0)77.8†(−7.5)61.7(−23.6)66.7(−18.6)85.3Role Emotional65.1(−23.4)70.4(−18.1)59.1(−29.4)66.0(−22.5)88.5Mental Health67.6(−8.5)72.9(−3.2)64.9(−11.2)67.3(−8.8)76.1ADA, adalimumab; A/G norm, age-and gender-matched normative value; eow, every other week; DI, disability index; MCS, mental component summary; MID, minimally important difference; PBO, placebo; PCS, physical component summary; PtGA, Patient Global Assessment of disease activity; SF-36, 36-item Short-Form Health Survey; SF-6D, Short-Form 6D.SF-6D MID=0.041.Statistical analysis ADA vs PBO:†PPPPConclusion:Statistically significant and clinically meaningful improvements and scores ≥A/G norms(higher definition of response) at week 12 were reported with ADA vs PBO in pts with moderately to severely active PsA.Disclosure of Interests:Vibeke Strand Consultant of: AbbVie, Amgen, Biogen, Celltrion, Consortium of Rheumatology Researchers of North America, Crescendo Bioscience, Eli Lilly, Genentech/Roche, GlaxoSmithKline, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron Pharmaceuticals, Inc., Sanofi, UCB, Pankaj Patel Shareholder of: AbbVie, Employee of: AbbVie, Naijun Chen Shareholder of: AbbVie Inc, Employee of: AbbVie Inc, Elizabeth Lesser Shareholder of: AbbVie Inc, Employee of: AbbVie Inc