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Spur gear, helical gear, worm gear, and bevel gear are all important components in industrial applications such as vehicles, pushes, conveyors, elevators, bowl mill, rolling mills, ribbon blender, machine tools, aeroplanes, and windmills. When various types of defects, such as wear, tooth breakage, corrosion, and scratches on bearings, appear in gearboxes, normal machine function may be abruptly terminated. As a result, output and dependability suffer. As a result, several quality tracking and evaluation approaches have been adopted by companies. Finite element analysis (FEA) is one of the approaches. This research paper presents the FEA of a ribbon blender worm gear pair by using Ansys 18.0 to identify the weak gear of the worm gear pair, natural frequency, and deformation. Proe-5 utilized for creation of three-dimensional geometry of threaded worm and toothed worm wheels, as well as other related elements such as shafts and bearings. Steel is used for the worm, shaft, and bearing, whereas bronze is used for the worm wheel. Ansys 18.0 is implemented to carry out worm gear pair model analysis. The results demonstrate that the worm wheel had the most deformation when compared to the worm, and that the natural frequency is greater than the operational frequency of the worm gear pair. The findings of the research study, worm wheel deteriorate early than worm, model analysis plays a significant role in vibration monitoring of worm gear pair, and this work is valuable for further fault analysis of ribbon blender worm gearbox utilising vibration response.

IntroductionAI technologies have the potential to transform patient care. AI has been used to aid in differential diagnosis and treatment planning for psychiatric disorders, administer therapeutic protocols, assist with interpretation of cognitive testing, and patient treatment planning. Despite advancements, AI has notable limitations and remains understudied and further research on its strengths and limitations in patient care is required. This study explored the responses of AI (Chat-GPT 3.5) and trained clinicians to commonly asked patient questions.MethodsThree clinicians and AI provided responses to five dementia/geriatric healthcare-related questions. Responses were analyzed by a fourth, blinded clinician for clarity, accuracy, relevance, depth, and ease of understanding and to determine which response was AI generated.ResultsAI responses were rated highest in ease of understanding and depth across all responses and tied for first for clarity, accuracy, and relevance. The rating for AI generated responses was 4.6/5 (SD = 0.26); the clinician s' responses were 4.3 (SD = 0.67), 4.2 (SD = 0.52), and 3.9 (SD = 0.59), respectively. The AI generated answers were identified in 4/5 instances.ConclusionsAI responses were rated more highly and consistently on each question individually and overall than clinician answers demonstrating that AI could produce good responses to potential patient questions. However, AI responses were easily distinguishable from those of clinicians. Although AI has the potential to positively impact healthcare, concerns are raised regarding difficulties discerning AI from human generated material, the increased potential for proliferation of misinformation, data security concerns, and more.

Background: Labor induction is a common and essential procedure in obstetrics. Various new formulations of prostaglandins are currently being used for labor induction. Trials are being conducted regularly using new formulations to see the efficacy and outcome of labor induction. Materials and Methods: Prospective observational study was conducted to compare the clinical outcome of dinoprostone pessary (DP) and intracervical dinoprostone gel (DG) on induction of labor. The objectives were to study the efficacy on induction-to-delivery duration, to compare the time taken from application to initiation of labor, and the number of applications required. The study also compared the need for oxytocin augmentation, cesarean rate, and neonatal outcomes after delivery. Results: In the DP group, 86.7% of patients required single application and 68.4% of patients in the DG group required double application. In 91.6% of patients in the DG group and 68.3% of patients in the DP group labor were initiated in

Background and Aims: Most studies have found that lumbar epidural catheterisation is technically easier with a paramedian than median approach. There is scant literature comparing the two approaches to the epidural space in the mid-thoracic spine. This study aims to compare the median versus paramedian approaches in the location of epidural space in the T7–9 region in patients undergoing laparotomy under combined general and epidural anaesthesia. Methods: A prospective observational study was conducted after ethical approval and written informed consent on 70 patients undergoing major abdominal surgery. The patients received epidural analgesia either through a median or paramedian approach (Group M, n = 35 and Group P, n = 35). The primary objective was the incidence of successful epidural catheter placement in the first attempt. The secondary objectives were the overall success rate, the requirement of change of intervertebral space, approach or operator and complications associated with the procedure. Results: Sixty-seven patients were analysed. Epidural catheter was placed successfully in the first attempt in 40% of patients in Group M and 78.1% in Group P (P = 0.003). The overall success rate was 74.3% in Group M and 87.5% in Group P (P = 0.223). The number of attempts in Group M was more (one attempt 14, two 6, three 5 and four 1) as compared to Group P (one 25, two 2, three 1 and four 0) (P = 0.014). The incidence of complications was comparable between the groups. Conclusion: Epidural catheter insertion was technically easier in paramedian as compared to the median approach in T7–9 thoracic region with no difference in complications.

Abstract INTRODUCTION Methylphenidate has been shown to improve apathy in patients with Alzheimer's disease (AD). The authors evaluated the impact of methylphenidate on neuropsychiatric symptoms (NPS) of AD, excluding apathy, using data from the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) study. METHODS A secondary analysis was conducted on data from the ADMET 2 study to determine the effect of methylphenidate on Neuropsychiatric Inventory (NPI) scores outside of apathy. Caregiver scores were compared from baseline to month 6 in 199 participants receiving methylphenidate (20 mg/day) or placebo regarding the presence or absence of individual neuropsychiatric symptoms, emergence of new symptoms, and individual domain scores. RESULTS No clinically meaningful improvement was observed in any NPI domain, excluding apathy, in participants treated with methylphenidate compared to placebo after 6 months. A statistical difference between groups was appreciated in the domains of elation/euphoria (P = 0.044) and appetite/eating disorders (P = 0.014); however, these findings were not considered significant. DISCUSSION Methylphenidate is a selective agent for symptoms of apathy in patients with AD with no meaningful impact on other NPS. Findings from this secondary analysis are considered exploratory and multiple limitations should be considered when interpreting these results, including small sample size and use of a single questionnaire. HIGHLIGHTS Methylphenidate was not associated with significant improvement on the Neuropsychiatric Inventory in domains outside of apathy. Methylphenidate did not show a statistically significant emergence of new neuropsychiatric symptoms (NPS) throughout the 6‐month treatment period compared to placebo. Methylphenidate appears to be a highly selective agent for apathy in Alzheimer's disease, potentially supporting catecholaminergic dysfunction as the driving force behind this presentation of symptoms.

The research delves into the topic of power quality event extraction and compares two parameters—voltage sag/swell and harmonics—using data supplied by SVG and waveforms created by Matlab. When it comes to power quality analysis, the SVG method shines through in the qualitative comparison of findings.

Analogue electronics devices are losing ground to digital electronics components in today’s technologically evolved society. Another aspect of our increasingly digital society is the home device control system. A lot of people are chatting it up over the cellular phone network. These phone networks rely on WIFI modules as their foundation. A shorthand way to say “global system of mobile communication” is WIFI. In addition to being widely employed in industry, it is also used in several electronics projects undertaken by engineering students. It is possible to operate equipment from afar using WIFI-based projects. For instance, what if you wanted to be able to operate any equipment from afar using only your cell phone? Would it be possible? Sure, I can help you with that. Wi-Fi modules and cell phones make it easy to power on and off various gadgets. The home devices control system was developed to enable the control of home equipment from a mobile phone by using the aforementioned ideas. This document makes use of a regulated 5V, 1A power source. When controlling voltage, a 7805 three-terminal regulator is ideal. When a 230/12V step-down transformer’s secondary AC output needs rectifying, a bridge-type full wave rectifier is the way to go.

This observer study investigates the effect of computerized artificial intelligence (AI)-based decision support system (CDSS-T) on physicians’ diagnostic accuracy in assessing bladder cancer treatment response. The performance of 17 observers was evaluated when assessing bladder cancer treatment response without and with CDSS-T using pre- and post-chemotherapy CTU scans in 123 patients having 157 pre- and post-treatment cancer pairs. The impact of cancer case difficulty, observers’ clinical experience, institution affiliation, specialty, and the assessment times on the observers’ diagnostic performance with and without using CDSS-T were analyzed. It was found that the average performance of the 17 observers was significantly improved (p = 0.002) when aided by the CDSS-T. The cancer case difficulty, institution affiliation, specialty, and the assessment times influenced the observers’ performance without CDSS-T. The AI-based decision support system has the potential to improve the diagnostic accuracy in assessing bladder cancer treatment response and result in more consistent performance among all physicians.

BackgroundVirtual reality (VR), a simulated experience that can be similar to or completely different from the real world, has become increasingly useful within the psychiatric and medical fields. This VR technology has been applied in medical school trainings, exposure therapy for individuals with posttraumatic stress disorder (PTSD), and reminiscence therapy associated with mood disorders for older adults. Perceptions of VR through the lens of the health care provider require further exploration. VR has grown in popularity; however, this modality continues to be underused in most Veterans Affairs (VA) hospitals. ObjectiveA web-based survey was used to explore health care provider perceptions of immersive VR availability and use for older adults and identify potential barriers for immersive VR use in older adults with cognitive impairment. MethodsAn 8-item web-based survey was developed to obtain health care provider feedback. This survey was disseminated throughout a single Veterans Integrated Services Network (VISN). The VR survey was developed via the Survey Monkey platform and distributed through the secure VA email network. Providers were asked to voluntarily participate in the brief, anonymous survey and offer their perceptions of immersive VR use within their patient population. Survey data were reviewed and interpreted using descriptive statistics. ResultsA total of 49 respondents completed the survey over a 15-day period. Of them, 36 respondents (73%) had heard of a VR device, though the majority (n=44, 90%) had never used or prescribed a VR device. Respondents identified several potential barriers to immersive VR use in older adults with cognitive impairment (eg, hearing difficulties, perceptions of technology, cognitive concerns, access to resources, and visual impairment). Despite the barriers identified, providers (n=48, 98%) still reported that they would feel comfortable prescribing immersive VR as an intervention for their patient population. ConclusionsSurvey findings revealed that health care providers within this VISN for VAs have heard of VR, although they may not have actively engaged in its use. Most of the providers reported that they would prescribe the use of an immersive VR intervention for their older adult patients. This key point highlights the desire to implement VR strategies for patient use by their providers. If underlying barriers can be addressed and relatively resolved, this technological intervention has the potential to create substantial breakthroughs in clinical care.

In tomato (Lycopersicon esculentum L.), the effects of combined drought (D) and high temperature (HT) stress during the flowering stage had not been studied in detail. Therefore, this study was conducted with an objective of quantifying the effects of foliar spray of melatonin under individual and combined drought and HT stress. At flowering stage, D stress was imposed through withholding irrigation, while HT stress was imposed through exposing the plants to ambient temperature (AT) along with an increase of +5 °C. Under D + HT, plants were first subjected to drought followed by a + 5 °C increase in AT. The duration of individual or combined stress was ten days. At 80% available soil moisture, 100 µM melatonin was sprayed on D, HT, or D + HT treated plants. Among the stresses, D + HT stress increased the thylakoid membrane damage and decreased the photosynthetic rate and fruit yield more than D or HT stress. Foliar spray of 100 µM melatonin produced decreased thylakoid membrane damage [D: 31%, HT: 26%, and D + HT: 18%] and increased antioxidant enzyme, viz., superoxide dismutase, catalase, peroxidase, ascorbate peroxidase, and glutathione reductase, activity over stress-control plants. The photosynthetic rate [D: 24%, HT: 22%, and D + HT: 19%] and fruit yield [D: 32%, HT: 23%, and D + HT: 16%] were increased over stress-control plants. Hence, it is evident that the increased photosynthetic rate and fruit yield in D + HT and 100 µM melatonin-sprayed plants may be associated with an increased antioxidant defense system. Melatonin as a novel biostimulator has a great potential in scavenging free radicals through increased antioxidant activity, which shields the photosynthetic membrane from damage and therefore helps in stress mitigation.

Gene expression in endosperm-a seed tissue that mediates transfer of maternal resources to offspring-is under complex epigenetic control. We show here that plant-specific RNA polymerase IV (Pol IV) mediates parental control of endosperm gene expression. Pol IV is required for the production of small interfering RNAs that typically direct DNA methylation. We compared small RNAs (sRNAs), DNA methylation, and mRNAs in Arabidopsis thaliana endosperm from heterozygotes produced by reciprocally crossing wild-type (WT) plants to Pol IV mutants. We find that maternally and paternally acting Pol IV induce distinct effects on endosperm. Loss of maternal or paternal Pol IV impacts sRNAs and DNA methylation at different genomic sites. Strikingly, maternally and paternally acting Pol IV have antagonistic impacts on gene expression at some loci, divergently promoting or repressing endosperm gene expression. Antagonistic parent-of-origin effects have only rarely been described and are consistent with a gene regulatory system evolving under parental conflict.

This article presents the texture development of magnesium AZ31 alloy in the accumulative roll bonded (ARB) AZ31/AZ31 multilayer and AZ31/AA5086 laminate composite. The comparative study demonstrates that the texture evolution in AZ31 in a multilayer system is strongly influenced by the interfaces. A typical basal texture of AZ31 has been observed in AZ31/AZ31 multilayer with texture intensity increased with the rolling deformation. Presence of AZ31/AA5086 interface in the laminate composite leads to a tilted basal texture along the rolling direction (RD) in AZ31 alloy. The texture intensity of composite increased initially with rolling reduction and weakened at the higher rolling strain. Weakening of texture in AZ31 during the laminate processing at higher strain has been attributed to the development of wavy interfaces in AZ31/AA5086 laminate.

Context: The ongoing COVID-19 pandemic poses important challenges to mental health. Pregnant women are a vulnerable group to experience adverse psychological impact of the pandemic, with consequences on maternal and foetal outcomes; currently there are scant data for the same in India. To the best of our knowledge, this report is the first from India on psychological status of pregnant women during COVID-19 pandemic. Aim: The aim is to study the impact of ongoing COVID-19 pandemic on psychological status of pregnant women. Setting and Design: Cross-sectional observational study in a tertiary care hospital setting in Mumbai. Materials and Methods: Out of total 98 pregnant women reporting to antenatal clinic of the hospital during the study period from June to July 2020, 66 gave informed consent to participate in the study. Perceived Stress Scale (PSS-10), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) were administered using an online form. Statistical Analysis: Group comparisons were analyzed using appropriate nonparametric tests. Results: About 66.7% of women were primigravida, 39% in second trimester and 75.8% in age group 21–30 years. 28.8% missed scheduled antenatal visit, higher when compared to hospital data prior to pandemic. 39.4% worried about their unborn baby getting infected from Corona virus and 25.8% worried about themselves getting infected. About 72.2% reported moderate levels of perceived stress as measured by PSS-10, 51.6% reported mild-to-moderate level of depressive symptoms by PHQ-9 and 39.4% reported mild-to-moderate anxiety symptoms by GAD-7. PHQ-9 and GAD-7 scores of women aged 21–30 years were higher than those aged 31–40 years (P = 0.017 and 0.005 respectively). Conclusion: High rates of perceived stress, depressive, and anxiety symptoms in pregnant women found in this study suggest a need to incorporate psychological screening and interventions in routine antenatal care during ongoing pandemic.

Abhijeet Singh, 1 Rajendra Prasad, 1, 2 Viswesvaran Balasubramanian, 1 Nikhil Gupta 3 1Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi 110007, India; 2Department of Pulmonary Medicine, King George Medical University, Lucknow, Uttar Pradesh 226003, India; 3Department of Internal Medicine, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh 226010, IndiaCorrespondence: Rajendra PrasadDepartment of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi 110007, IndiaTel +91 9415 021 590Email rprasaddirvpci@gmail.comAbstract: Drug-resistant tuberculosis (DR-TB), including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), is considered a potential obstacle for elimination of TB globally. HIV coinfection with M/XDR-TB further complicates the scenario, and is a potential threat with challenging management. Reports have shown poor outcomes and alarmingly high mortality rates among people living with HIV (PLHIV) coinfected with M/XDR-TB. This coinfection is also responsible for all forms of M/XDR-TB epidemics or outbreaks. Better outcomes with reductions in mortality have been reported with concomitant treatment containing antiretroviral drugs for the HIV component and antitubercular drugs for the DR-TB component. Early and rapid diagnosis with genotypic tests, prompt treatment with appropriate regimens based on drug-susceptibility testing, preference for shorter regimens fortified with newer drugs, a patient-centric approach, and strong infection-control measures are all essential components in the management of M/XDR-TB in people living with HIV.Keywords: drug-resistant, HIV, multidrug-resistant, extensively drug-resistant, tuberculosis

Phytoplasmas are associated with many plant diseases. In palms, lethal bronzing disease, Texas Phoenix palm decline, and coconut lethal yellowing decline are some of them. In Sri Lanka, coconut leaf wilt decline has been reported in the Weligama area of the Southern province, and the disease is called Weligama coconut leaf wilt disease (WCLWD). Unlike other phytoplasma diseases of palms, WCLWD shows slow disease progress. Pathogen detection entirely relies on nested polymerase chain reaction (PCR). However, inconsistencies in pathogen detection have been experienced, i.e., symptomatic plants often produce negative results. The objectives of this study were to reconsider the choice of primers and to determine the best sampling tissue types for consistent detection of the pathogen. Among the six universal primer combinations tested, P1/Tint nested with fU5/rU3 produced consistent results. BLASTn searches of the sequences showed 99–100% similarity to sugarcane white leaf disease (SWL) or grassy shoot (SGS) disease-causing phytoplasma. The optimized nested PCR protocol was successful, with the minimum success rating of 88% and 100% specificity. Midribs of milky white bud leaf samples were the best tissue type for rapid detection. Systemic movement of the pathogen and a tentative latent period were also reported. The findings are helpful in the early detection of the disease.

Graphical Abstract“CALM”ing strategies during COVID-19 pandemic. Created with BioRender.com.

Renal luminal sodium transport is essential for physiological blood pressure control, and abnormalities in this process are strongly implicated in the pathogenesis of essential hypertension. Renal G protein-coupled receptors (GPCRs) are critical for the regulation of the reabsorption of essential nutrients, ions, and water from the glomerular filtrate. Recently, we showed that GPCR 37L1 (GPR37L1) is expressed on the apical membrane of renal proximal tubules (RPT) and regulates luminal sodium transport and blood pressure by modulating the function of the sodium proton exchanger 3 (NHE3). However, little is known about GPR37L1 intracellular signaling. Here, we show that GPR37L1 is localized to the nuclear membrane, in addition to the plasma membrane in human RPT cells. Furthermore, GPR37L1 signals via the PI3K/AKT/mTOR pathway to decrease the expression of DNA (cytosine-5)-methyltransferase 1 (DNMT1) and enhance NHE3 transcription. Overall, we demonstrate the direct role of a nuclear membrane GPCR in the regulation of renal sodium through epigenetic gene regulation.

Closed-loop neurostimulation is a promising therapy being tested and clinically implemented in a growing number of neurological and psychiatric indications. This therapy is enabled by chronically implanted, bidirectional devices including the Medtronic Summit RC+S system. In order to successfully optimize therapy for patients implanted with these devices, analyses must be conducted offline on the recorded neural data, in order to inform optimal sense and stimulation parameters. The file format, volume, and complexity of raw data from these devices necessitate conversion, parsing, and time reconstruction ahead of time-frequency analyses and modeling common to standard neuroscientific analyses. Here, we provide an open-source toolbox written in Matlab which takes raw files from the Summit RC+S and transforms these data into a standardized format amenable to conventional analyses. Furthermore, we provide a plotting tool which can aid in the visualization of multiple data streams and sense, stimulation, and therapy settings. Finally, we describe an analysis module which replicates RC+S on-board power computations, a functionality which can accelerate biomarker discovery. This toolbox aims to accelerate the research and clinical advances made possible by longitudinal neural recordings and adaptive neurostimulation in people with neurological and psychiatric illnesses.

Introduction: Most patients (70%) with limited-stage SCLC (LS-SCLC) who are treated with curative-intent therapy suffer disease relapse and cancer-related death. We evaluated circulating tumor DNA (ctDNA) as a predictor of disease relapse and death after definitive therapy in patients with LS-SCLC. Methods: In our previous work, we developed a plasma-based ctDNA assay to sequence 14 genes (TP53, RB1, BRAF, KIT, NOTCH1-4, PIK3CA, PTEN, FGFR1, MYC, MYCL1, and MYCN) that are frequently mutated in SCLC. In this work, we evaluated 177 plasma samples from 23 patients with LS-SCLC who completed definitive chemoradiation (n = 21) or surgical resection (n = 2) and had an end-of-treatment blood collection (median 4 d, range 0–40 d from treatment completion) plus monthly surveillance blood sampling. Median overall survival (OS) and progression-free survival (PFS) were compared using a Wilcoxon test. Results: The median OS among patients in whom we ever detected ctDNA after definitive treatment (n = 15) was 18.2 months compared with a median OS of greater than 48 months among patients in whom we never detected ctDNA after definitive treatment (n = 8; p = 0.081). The median PFS among patients in whom we ever detected ctDNA after definitive treatment was 9.1 months compared with a median PFS of greater than 48 months among patients in whom we never detected ctDNA after definitive treatment (p < 0.001). Conclusions: Detection of ctDNA in patients with LS-SCLC after curative-intent therapy predicts disease relapse and death. Prospective trials using ctDNA as an integral biomarker for therapeutic selection should be considered in SCLC.

Abstract Background The study aims to assess the accuracy of multi-parametric prostate MRI (mpMRI) and 18F-choline PET/CT in tumor segmentation for clinically significant prostate cancer. 18F-choline PET/CT and 3 T mpMRI were performed in 10 prospective subjects prior to prostatectomy. All subjects had a single biopsy-confirmed focus of Gleason ≥ 3+4 cancer. Two radiologists (readers 1 and 2) determined tumor boundaries based on in vivo mpMRI sequences, with clinical and pathologic data available. 18F-choline PET data were co-registered to T2-weighted 3D sequences and a semi-automatic segmentation routine was used to define tumor volumes. Registration of whole-mount surgical pathology to in vivo imaging was conducted utilizing two ex vivo prostate specimen MRIs, followed by gross sectioning of the specimens within a custom-made 3D-printed plastic mold. Overlap and similarity coefficients of manual segmentations (seg1, seg2) and 18F-choline-based segmented lesions (seg3) were compared to the pathologic reference standard. Results All segmentation methods greatly underestimated the true tumor volumes. Human readers (seg1, seg2) and the PET-based segmentation (seg3) underestimated an average of 79, 80, and 58% of the tumor volumes, respectively. Combining segmentation volumes (union of seg1, seg2, seg3 = seg4) decreased the mean underestimated tumor volume to 42% of the true tumor volume. When using the combined segmentation with 5 mm contour expansion, the mean underestimated tumor volume was significantly reduced to 0.03 ± 0.05 mL (2.04 ± 2.84%). Substantial safety margins up to 11–15 mm were needed to include all tumors when the initial segmentation boundaries were drawn by human readers or the semi-automated 18F-choline segmentation tool. Combining MR-based human segmentations with the metabolic information based on 18F-choline PET reduced the necessary safety margin to a maximum of 9 mm to cover all tumors entirely. Conclusions To improve the outcome of focal therapies for significant prostate cancer, it is imperative to recognize the full extent of the underestimation of tumor volumes by mpMRI. Combining metabolic information from 18F-choline with MRI-based segmentation can improve tumor coverage. However, this approach requires confirmation in further clinical studies.

Background: The use of herbal plant extracts in wound healing is known through decades, but it is necessary to provide scientific data through reverse pharmacology. Objective: The aim of the present study is to find the mechanism behind the healing of wounds using in vitro and in vivo assays. Material and methods: The study was designed to determine proliferation and mobilization of fibroblast and keratinocytes at the site of injury, angiogenesis at the site of healing and reduction in oxidative stress while healing. In our earlier studies it was observed that herbal extract of Vitex negundo L. (VN), Emblica officinalis Gaertn (EO), and Tridax procumbens L. (TP) showed rapid regeneration of skin, wound contraction and collagen synthesis at the site of injury in excision wound model. In the present study the cell mobilization was monitored in the scratch assay on L929 fibroblastic cell line and HaCaT keratinocytes cell line under the influence of aqueous plant extracts and its formulation. This formulation was also assessed for its angiogenic potential using CAM assay. Study was carried out to probe synergistic effect of polyherbal formulation using excision model in rat. Results: The formulation was found to contain high amount of flavonoids, tannins and phenols which facilitate wound healing. At 20 μg/ml concentration of formulation, significant increase in tertiary and quaternary vessels were observed due to angiogenic potential of formulation. Formulation at the concentration of 3 μg/ml and 5 μg/ml showed significant mobilization of keratinocytes and fibroblasts respectively at the site of injury. Polyherbal formulation showed rapid regeneration of skin and wound contraction. Biochemical parameters like hydroxyproline, hexosamine and collagen turnover was increased in test drug treated animals as compared to untreated, whereas antioxidants such as catalase and GSH were increased significantly and decreased amount of tissue MDA was observed. Conclusion: Polyherbal formulation prepared from the plant extracts accelerates wound healing process by proliferation and mobilization of fibroblast and keratinocytes, and angiogenesis at the site of injury. It also shows fast contraction of wound with its beneficial improvement in tissue biochemical and antioxidant parameters.

Gastrin, secreted by G-cells, and glucagon-like peptide-1 (GLP-1), secreted by L-cells, may participate in the regulation of sodium balance. We studied the effect of sodium in mice in vivo and mouse ileum and human L-cells, on GLP-1 secretion, and the role of NFAT5 and gastrin-releasing peptide receptor (GRPR) in this process. A high-sodium diet increases serum GLP-1 levels in mice. Increasing sodium concentration stimulates GLP-1 secretion from mouse ileum and L-cells. GRP enhances the high sodium-induced increase in GLP-1 secretion. High sodium increases cellular GLP-1 expression, while low and high sodium concentrations increase NFAT5 and GRPR expression. Silencing NFAT5 in L-cells abrogates the stimulatory effect of GRP on the high sodium-induced GLP-1 secretion and protein expression, and the sodium-induced increase in GRPR expression. GLP-1 and gastrin decrease the expression of Na+-K+/ATPase and increase the phosphorylation of sodium/hydrogen exchanger type 3 (NHE3) in human renal proximal tubule cells (hRPTCs). This study gives a new perspective on the mechanisms of GLP-1 secretion, especially that engendered by ingested sodium, and the ability of GLP-1, with gastrin, to decrease Na+-K+/ATPase expression and NHE3 function in hRPTCs. These results may contribute to the better utilization of current and future GLP-1-based drugs in the treatment of hypertension.

Cancer cells that survive initial drug treatment can persist in the presence of drugs. Here, the authors generate persister cells that are resistant to the EGFR tyrosine kinase inhibitor erlotinib and show by single cell analysis that multiple mechanism give rise to the drug-resistant persister state.

OBJECTIVE:Area of muscle, fat, and bone is often measured in thigh CT scans when tissue composition is a key outcome. SliceOmatic software is commonly referenced for such analysis but published methods may be insufficient for new users. Thus, a quick start guide to calculating thigh composition using SliceOmatic has been developed. METHODS:CT images of the thigh were collected from older (69 ± 4 yrs, N = 24) adults before and after 12-weeks of resistance training. SliceOmatic was used to segment images into seven density regions encompassing fat, muscle, and bone from -190 to +2000 Hounsfield Units [HU]. The relative contributions to thigh area and the effects of tissue density overlap for skin and marrow with muscle and fat were determined. RESULTS:The largest contributors to the thigh were normal fat (-190 to -30 HU, 29.1 ± 7.4%) and muscle (35 to 100 HU, 48.9 ± 8.2%) while the smallest were high density (101 to 150 HU, 0.79 ± 0.50%) and very high density muscle (151 to 200 HU, 0.07 ± 0.02%). Training significantly (P0.05). Contributions to area were altered by ~1% or less and the results of training were not affected by accounting for skin and marrow. CONCLUSIONS:When using SliceOmatic to calculate thigh composition, accounting for skin and marrow may not be necessary. We recommend defining muscle as -29 to +200 HU but that smaller ranges (e.g. low density muscle, 0 to 34 HU) can easily be examined for relationships with the health condition and intervention of interest. TRIAL REGISTRATION:Clinicaltrials.gov NCT02261961.

Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7) years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS)) and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life) were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9) compared to the control group (0.5; 95% CI, −0.3–1.3) at 8 weeks (average intergroup difference (95% CI), 5.5 (4.3–6.7), p < 0.001) after adjusting for baseline. Conclusion. This study establishes that the Wii-Fit exercise program is efficacious in improving balance in community dwelling older Veterans. This trial is registered with ClinicalTrials.gov Identifier NCT02190045.

Congenital posterior urethral diverticulum is an uncommon anomaly, sometimes complicated by infection or calculi formation. A conventional voiding cystourethrogram (VCUG) is the most commonly used diagnostic modality. Dynamic magnetic resonance imaging (MRI) has not been frequently described in this entity. We describe a case of posterior urethral diverticulum complicated with secondary calculi, where the patient was evaluated using dynamic MRI and conventional VCUG.

Objective : To evaluate the risks imposed by tobacco smoking, in particular, bidi smoking, in the development of lung cancer. Methods : Two hundred eighty-four histologically confirmed patients of bronchogenic carcinoma and 852 controls matched for age, sex, and socioeconomic status were interviewed according to a predesigned questionnaire. Effects of individual variables defining the various aspects of tobacco smoking, in particular, bidi smoking, were assessed using logistic regression models. Results : 81.3% cases of bronchogenic carcinoma were ever smokers as compared with 42.2% among controls. The odd ratios for ever smoking, bidi smoking, and cigarette smoking were 5.9 (confidence interval [CI] 4.3, 8.4), 6.1 (CI 4.3, 8.7), and 5.3 (CI 2.7, 10.4), respectively. Conclusion : Bidi smoking poses a very high risk for lung cancer even more than that of cigarette smoking.

Objective: To study skin sensitivity to various allergens in patients of nasobronchial allergy. Materials and Methods: 2880 skin prick tests with 60 allergens were performed in 48 patients of nasobronchial allergy. Results: Most common offending allergens were insects (21.2%), followed by dusts (12.0%), pollens (7.8%), animal dander (3.1%), and fungi (1.3%). The common insect antigen were locust female (33.3%) followed by locust male (25%), grasshopper (20.8%), cricket (16.7%), cockroach female (16.7%) and cockroach male (14.6%). Common dust allergens were house dust, wheat dust, cotton mill and paper dust. Among pollens, Amaranthus spinosus, Argemone mexicana, Adhatoda vasica, Ailanthus and Cannabis were found to be common allergens. In animal danders common offending allergens were cow dander and dog dander. Among fungi Aspergillus fumigatus, Aspergillus flavus, Alternaria teneis and Fusarium sodani were common allergens. Patients of bronchial asthma had associated allergic rhinitis in 80% cases. Conclusion: Common allergens in patients of nasobronchial allergy were identified. The data may prove useful in of allergen avoidance and immunotherapy in these patients.

Objective : To compare the standard medical therapy (SMT) and noninvasive posi-tive pressure ventilation (NPPV) in acute on chronic hypercapnic respiratory fail-ure due to exacerbation of chronic obstructive pulmonary disease (COPD). Method : Between June 2002 and May 2003, 19 patients with acute on chronic hypercapnic respiratory failure were prospectively and randomly recruited to re-ceive either SMT (n=10) or NPPV plus SMT (n=9) in a general respiratory ward and followed up after 4 to 6 weeks after discharge. NPPV was given with a silicone cushioned nasal mask via a bilevel ventilator with initial pressure support of 5 cm of H 2 O. Results : At the time of randomization there was no significant difference in respiratory rate, PaO 2 , PaCO 2 , pH and HCO3 - , between the two groups. At 2 hours with SMT, there was significant improvement only in respiratory rate (p = 0.0000) and PaO 2 (p=0.0014). However with NPPV, respiratory rate (p=0.0000), PaO2 (p=0.0011), pH (0.0002), pulse rate (p=0.0329) and mean arterial pressure (p=0.0096) improved significantly at 2 hours while PaCO2 (p=0.0008 significantly improved at24 hours. Hospital stay was significantly shorter for NPPV group as compared to SMT group (9.63 + 1.4 days vs. 13.33 + 4.69 days, p < 0.05). There was 1 failure (12.5%) in NPPV group as compared to 2 failures (20%) in SMT group of which one was salvaged by NPPV. Conclusion : The study suggests that early application of NPPV in acute on chronic hypercapnic respiratory failure due to COPD facilitates improvement, favors early mobiliation and discharge from hospital.

Integrated PET/CT has emerged as an integral component of oncology management because of its unique potential of providing both functional and morphological images in a single imaging session. In this work, performance of the ′bismuth germinate (BGO) crystal′-based PET of a newly installed Discovery ST PET/CT was evaluated in 2D and 3D mode for whole-body scanning using National Electrical Manufacturers Association (NEMA) NU 2-2001 protocol and the recommended phantoms. During the entire measurements, the system operates with an energy window of 375-650 keV and 11.7 ns coincidence time window. The set of tests performed were spatial resolution, sensitivity, scatter fraction (SF) and counting rate performance. The average transaxial and axial spatial resolution measured as full width at half maximum (FWHM) of the point spread function at 1 cm (and 10 cm) off-axis was 0.632 (0.691) and 0.491 (0.653) cm in 2D and 0.646 (0.682) and 0.54 (0.601) cm in 3D respectively. The average sensitivity for the two radial positions ( R = 0 cm and R = 10 cm) was 2.56 (2.63) cps/kBq in 2D and 11.85 (12.14) cps/kBq in 3D. The average scatter fraction was 19.79% in 2D and 46.19% in 3D. The peak noise equivalent counting rate (NECR) evaluated with single random subtraction was 89.41 kcps at 49 kBq/cc in 2D and 60 kcps at 12 kBq/cc in 3D acquisition mode. The NECR with delayed random subtraction was 61.47 kcps at 40.67 kBq/cc in 2D and 45.57 kcps at 16.45 kBq/cc in 3D. The performance of the PET scanner was satisfactory within the manufacturer-specified limits. The test result of PET shows excellent system sensitivity with relatively uniform resolution throughout the FOV, making this scanner highly suitable for whole-body studies.