Search

This study aims to carry out the extraction and isolation of bioactive compounds from the peel of Punica Granatum Linn and investigate the wound healing activity of isolated compounds. Soxhlet extraction of P. Granatum peel powder was done with ethanol as solvent. The isolation of phytochemical constituents, Punicalin and Punicalagin present in the obtained extract, was done with the help of column chromatography using n-butanol and ethyl acetate fractions. The column was packed with silica gel, and 100-200 mesh was used as a stationary phase separately at different stages of the isolation process. All fractions obtained from column chromatography were subjected to HPLC, LCMS, FTIR, 1HNMR studies to identify and confirm the obtained isolated bioactive. The study was further extended to assess the wound healing activity of isolated punicalin and punicalagin by using in vitro excision and incision models. The activity of prepared alcoholic extract and isolated bioactive was compared to standard 10 % w/w povidone-iodine ointment. The highest wound healing strength observed was 201.83 ± 4.98 for isolated 10% w/w punicalagin ointment in the incision wound model. Also, in the excision wound model, the highest % reduction in the wound was observed on the 15th day as 88 ± 0.78, which was optimum compared to the standard with a % reduction in the wound as 92 ± 0.91. As a result, bioactive punicalagin and punicalin obtained from methanol extract of Punica Granatum peel powder can be used as potent phytoconstituents and wound healing agents for pharmaceutical preparations

Whether coevolution determines distribution patterns of facultative symbionts among individuals of a host species is an open question. We used theDictyostelium discoideum-Paraburkholderiasystem to investigate the role of host fitness and symbiont transmission in co-occurrence patterns of naturally occurring (native) host-symbiont strain pairs.P. bonnieais able to persistently infectD. discoideumin the lab, yet few wildD. discoideumisolates natively host this symbiont. If native host-symbiont combinations lead to higher fitness for host and symbiont compared to nonnative combinations, we assumed a stronger chance that coevolution had led to their co-occurrence. We approached the factors that influence the fitness consequences of host-symbiont interactions in terms of host defense mechanisms and symbiont virulence mechanisms. Given a specific combination of host and symbiont, variable host resistance and symbiont proliferation lead to variation in symbiont density, while variable host tolerance and symbiont benevolence lead to variation in host fitness relative to symbiont density. We used both vegetative and social stages of the host life cycle to approximate interactions betweenD. discoideumandP. bonniea, when hosts form social groups and symbiont horizontal transmission is facilitated by these social groups. We found no difference in host defense mechanisms between native and nonnative hosts ofP. bonniea, butP. bonnieapossesses variable phenotypes in proliferation and benevolence. More importantly, variation in symbiont benevolence led to increased horizontal transmission of benevolent strains compared to malevolent strains during the social stage of the host life cycle.ImportanceHosts and symbionts in a facultative symbiosis do not depend on each other for survival. Perhaps due to this labile relationship, we lack a solid understanding of why only some individual hosts carry facultative symbionts rather than all. We used the social amoebaDictyostelium discoideumand its bacterial symbiontParaburkholderia bonnieato test whether naturally occurring (native) host-symbiont strain pairs are the result of coevolution. We find that native combinations of hosts and symbionts do not enjoy improved fitness compared to nonnative combinations. Instead, both host and symbiont fitness depend on symbiont identity, asP. bonnieastrains varied in their ability to proliferate within groups of hosts and in the degree of fitness loss they caused given a similar infection prevalence. More importantly, variation in the latter property, known as benevolence, led to increased horizontal transmission of benevolent strains compared to malevolent strains during the social stage of the host life cycle.

Introduction. Nowadays, health-conscious consumers attend to nutritional, health, and easy-to-use products. Demand for healthy snacks is significantly increasing. Our study aimed to develop high protein nutrition bars by incorporating pumpkin seed flour and banana flour and assess their quality. Study objects and methods. We analyzed three bar samples for nutritional, textural, and sensory quality. The bars contained banana flour, pumpkin seed flour, and the mixed flour. Proximate analysis was performed following the AOAC method. The mineral content and antioxidant properties of the bars were determined by using emission spectrophotometry and the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging modified method, respectively. Results and discussion. The mixed flour nutrition bar had significantly higher total phenolic content and antioxidant activity than the bar with banana flour and the bar with pumpkin seed flour. Textural analysis demonstrated that the mixed flour sample had significantly (P < 0.05) higher hardness and color parameters compared to the other bar samples. Nutritional analysis indicated that mixed flour bar contained significantly higher amounts of protein, fat, and calcium; while pumpkin seed flour bar had higher ash, iron, and magnesium contents. The mixed flour sample also had better sensory parameters. Conclusion. The mixed flour demonstrated good quality. Hence, both banana and pumpkin seed flour have a potential to be used in bar formulations.

Energy storage is a vital aspect for the successful implementation of renewable energy resources on a global scale. Herein, we investigated the redox cycle of nickel(II) bis(diethyldithiocarbamate), Ni

Climate has a considerable influence on tree growth. Forest managers benefit from the empirical study of the historic relationship between climatic variables and tree growth to support forest management frameworks that are to be applied under scenarios of climate change. Through this research, we have utilized long-term permanent sample plot records, historic climate data sets, and linear mixed modelling techniques to evaluate the historic influence of climatic variables on the growth rates of major boreal tree species in Newfoundland and Labrador, Canada. For the commercially significant spruce and fir forests of the province, we found growing degree-days (GDD) to negatively correlate with tree productivity in warmer regions, such as much of Newfoundland (±1350 GDD), but positively correlate with growth in cooler regions, such as those in Labrador (±750 GDD). With respect to precipitation, environmental moisture was not on average a limiting factor to species productivity in the province. These dynamics have implications for the productivity of the spruce–fir forests of the study area when considered alongside contemporary climate projections for the region, which generally entail both a warmer and wetter growing environment.

Introduction Advances in transjugular intrahepatic portosystemic shunt (TIPS) technology have led to expanded use. We sought to characterize contemporary outcomes of TIPS by common indications. Methods This was a multicenter, retrospective cohort study using data from the Advancing Liver Therapeutic Approaches study group among adults with cirrhosis who underwent TIPS for ascites/hepatic hydrothorax (ascites/HH) or variceal bleeding (2010-2015). Adjusted competing risk analysis was used to assess post-TIPS mortality or liver transplantation (LT). Results Among 1,129 TIPS recipients, 58% received TIPS for ascites/HH and 42% for variceal bleeding. In patients who underwent TIPS for ascites/HH, the subdistribution hazard ratio (sHR) for death was similar across all Model for End-Stage Liver Disease Sodium (MELD-Na) categories with an increasing sHR with rising MELD-Na. In patients with TIPS for variceal bleeding, MELD-Na ≥20 was associated with increased hazard for death, whereas MELD-Na ≥22 was associated with LT. In a multivariate analysis, serum creatinine was most significantly associated with death (sHR 1.2 per mg/dL, 95% confidence interval [CI] 1.04-1.4 and 1.37, 95% CI 1.08-1.73 in ascites/HH and variceal bleeding, respectively). Bilirubin and international normalized ratio were most associated with LT in ascites/HH (sHR 1.23, 95% CI 1.15-1.3; sHR 2.99, 95% CI 1.76-5.1, respectively) compared with only bilirubin in variceal bleeding (sHR 1.06, 95% CI 1.00-1.13). Discussion MELD-Na has differing relationships with patient outcomes dependent on TIPS indication. These data provide new insights into contemporary predictors of outcomes after TIPS.

In the present study, first 0.9KNbO3–0.1BaNi0.5Nb0.5O3(KBNNO) nanosized powder was synthesized by solution combustion method and then a series of KBNNO:Ag2O and KBNNO:Bi2O3 composites with varying weight ratios (75:25, 50:50, and 25:75) were prepared by a simple precipitation technique/solid-state method. Preparation method and processing temperature have significant effect on phase stability and interface formation. The structural, morphological and photoabsorption behaviour of the synthesized powders were studied systematically by XRD, TEM, XPS and UV–visible spectroscopy. The photocatalytic performance of the photocatalysts was evaluated for the degradation of rhodamine B (RhB) solution under visible light exposure. In particular, KBNNO:Ag2O composites exhibited better photodegradation of RhB. KBNNO:Ag2O (50:50) nanocomposite can completely mineralize the RhB in 25 min, whereas KBNNO:Bi2O3 (25:75) can mineralize 96% of RhB in 45 min. The rate constant (k) for dye degradation of KBNNO:Ag2O (50:50) (0.113 min−1) sample showed the highest value which was 4.71 and 5.94 times better than that of KBNNO and Ag2O under visible light irradiation. The rate constant for KBNNO:Bi2O3 (25:75) (0.048 min−1) exhibited the highest k value which is 1.94 and 3.13 times greater than that of KBNNO and Bi2O3 under similar irradiation condition. The significant absorption in visible region and reduced recombination time of charge carriers in the composite than the parent materials were responsible for excellent photocatalytic properties. The mechanism for degradation was also studied in detail. Moreover, a reasonable degradation of 95% (on an average) was observed after five cycles, suggesting a good photocatalytic stability of the composites.

Background and study aims Storage of full-length endoscopic procedures is becoming increasingly popular. To facilitate large-scale machine learning (ML) focused on clinical outcomes, these videos must be merged with the patient-level data in the electronic health record (EHR). Our aim was to present a method of accurately linking patient-level EHR data with cloud stored colonoscopy videos. Methods This study was conducted at a single academic medical center. Most procedure videos are automatically uploaded to the cloud server but are identified only by procedure time and procedure room. We developed and then tested an algorithm to match recorded videos with corresponding exams in the EHR based upon procedure time and room and subsequently extract frames of interest. Results Among 28,611 total colonoscopies performed over the study period, 21,170 colonoscopy videos in 20,420 unique patients (54.2 % male, median age 58) were matched to EHR data. Of 100 randomly sampled videos, appropriate matching was manually confirmed in all. In total, these videos represented 489,721 minutes of colonoscopy performed by 50 endoscopists (median 214 colonoscopies per endoscopist). The most common procedure indications were polyp screening (47.3 %), surveillance (28.9 %) and inflammatory bowel disease (9.4 %). From these videos, we extracted procedure highlights (identified by image capture; mean 8.5 per colonoscopy) and surrounding frames. Conclusions We report the successful merging of a large database of endoscopy videos stored with limited identifiers to rich patient-level data in a highly accurate manner. This technique facilitates the development of ML algorithms based upon relevant patient outcomes.

Two NNN pincer complexes of Cu(ii) and Ni(ii) with BPIMe- [BPIMe- = 1,3-bis((6-methylpyridin-2-yl)imino)isoindolin-2-ide] have been prepared and characterized structurally, spectroscopically, and electrochemically. The single crystal structures of the two complexes confirmed their distorted trigonal bipyramidal geometry attained by three equatorial N-atoms from the ligand and two axially positioned water molecules to give [Cu(BPIMe)(H2O)2]ClO4 and [Ni(BPIMe)(H2O)2]ClO4. Electrochemical studies of Cu(ii) and Ni(ii) complexes have been performed in acetonitrile to identify metal-based and ligand-based redox activity. When subjected to a saturated CO2 atmosphere, both complexes displayed catalytic activity for the reduction of CO2 with the Cu(ii) complex displaying higher activity than the Ni(ii) analogue. However, both complexes were shown to decompose into catalytically active heterogeneous materials on the electrode surface over extended reductive electrolysis periods. Surface analysis of these materials using energy dispersive spectroscopy as well as their physical appearance suggests the reductive deposition of copper and nickel metal on the electrode surface. Electrocatalysis and decomposition are proposed to be triggered by ligand reduction, where complex stability is believed to be tied to fluxional ligand coordination in the reduced state.

The objective of our study was to determine if the waveform from a simple pulse oximeter-like device could be used to accurately assess intravascular volume status in cirrhosis.Patients with cirrhosis underwent waveform recording as well as serum brain natriuretic peptide (BNP) on the day of their cardiac catheterization where invasive cardiac pressures were measured. Waveforms were processed to generate features for machine learning models in order to predict the filling pressures (regression) or to classify the patients as volume overloaded or not (defined as an LVEDP15).Nine of 26 patients (35%) had intravascular volume overload. Regression analysis using PPG features (RMachine learning-enhanced analysis of pulse ox waveforms can estimate intravascular volume overload with a higher accuracy than conventionally measured BNP.

Sex-based differences are known to significantly contribute to outcomes in patients with chronic liver diseases; however, the role of patient sex in cirrhosis is unclear. We aimed to study the relationship between patient sex and cirrhosis.We analyzed a cohort of 20,045 patients with cirrhosis using a Chicago-wide electronic health record database that was linked with the United Network for Organ Sharing and cause of death data from the state death registry. Adjusted Cox survival analyses and competing risk analyses were performed to obtain subdistribution hazard ratios (HRs) for liver-related cause of death.Female and male patients had similar age, racial distribution, insurance status, and comorbidity status by Elixhauser score. Females had higher rates of cholestatic liver disease (17.1% vs. 6.2%, p0.001) and non-alcoholic steatohepatitis (29.8% vs. 21.2%, p0.001) than males. They were less likely to have portal hypertensive complications and had lower peak MELD-Na scores during follow-up. Female sex was associated with a decreased hazard of all-cause mortality (adjusted HR 0.85; 95% CI 0.80-0.90). This effect was attenuated when liver-related mortality was examined (subdistribution HR 0.93; 95% CI 0.87-1.00). No significant difference was noted for women who were 'ever-listed' in competing risk analyses for either all-cause mortality (subdistribution HR 1.09; 95% CI 0.88-1.35) or liver-related death (subdistribution HR 1.12; 95% CI 0.87-1.43), despite lower rates of listing (7.5% vs. 9.8%; p0.001) and transplant (3.5% vs. 5.2%; p 0.001).In this longitudinal study of patients with cirrhosis, female sex was associated with a survival advantage likely driven by lower rates of non-liver-related death. Women were not at an increased risk of liver-related death despite lower rates of listing and transplantation.Patient sex is an important contributor in many chronic diseases, including cirrhosis. Prior studies have suggested that female sex is associated with worse outcomes. We analyzed a cohort of 20,045 patients with cirrhosis using a Chicago-wide electronic health record database. Using multivariate competing risk analyses, we found that female sex in cirrhosis is actually associated with a lower risk of all-cause mortality and has no association with liver-related mortality. Our findings are novel because we show that women with cirrhosis have a similar risk of liver-related death as their male counterparts, despite lower rates of listing and transplantation.

BACKGROUND: Peripheral nerve injuries can be devastating complications of surgery, potentially resulting in severe functional disability and decreased quality of life. Long surgeries with considerable tissue manipulation, for example, liver transplantation, may present increased risk; however, neuropraxia in transplantation has not been well investigated. MATERIALS AND METHODS: This is a retrospective study of all adult patients undergoing liver transplantation at a large academic center between January 2013 and December 2015. Descriptive analyses, logistic regressions, and forward selection procedures were used to determine the odds of developing neuropraxia and associated factors. RESULTS: Of the 283 liver recipients, the mean age was 55.8 y, 35.1% were female, 65.6% were Caucasian, 8.9% were African American, 16.7% were Hispanic, and mean model for end-stage liver disease sodium score at transplant was 24.2 ± 10.9. The underlying etiology was alcohol (26.2%), hepatitis C (34.8%), nonalcoholic steatohepatitis (13.1%), and other (14.2%). The incidence of neuropraxia after liver transplantation was 8.3% (n = 25), with 60% (n = 16) upper extremities, 82% left sided, and 84% male. There was no difference in age, race, body mass index, hypertension, diabetes, hyperlipidemia, or smoking in those with neuropraxia versus those without. In multivariate analysis, neuropraxia was significantly associated with male gender, lower model for end-stage liver disease score, and longer duration of surgery (P < 0.05). Symptoms lasted median 5 d, with a wide range up to 187 d. Neuropraxia-specific treatment (physical therapy or medications) was required in 32% (n = 9). CONCLUSIONS: Peripheral nerve injuries are an unexplored complication of liver transplantation. Although transient, a high number (8.2%) of patients developed neuropraxia, negatively affecting their ability for recovery. Exploration of mechanisms for minimizing risk and intraoperative detection and prevention should be considered to mitigate this complication.

Introduction. High fiber bakery products can be a healthy snack option for consumers. Our study focused on the effect of replacing wheat flour with okara flour on the physicochemical, nutritional, textural, and sensory attributes of biscuits. Study objects and methods. We used 2, 4, 6, and 8% w/w okara flour to prepare biscuits. Refined wheat flour (control), mixed flour (okara and wheat flour), dough, and biscuits were assessed for physicochemical, textural, and nutritional properties, as well as sensory characteristics. The volume of particles was higher in 8% okara flour (145 μm) compared to refined wheat flour (91 μm). Results and discussion. 2, 4, 6, and 8% w/w okara flour biscuits showed significantly (P ≤ 0.05) lower spread ratio and weight loss than biscuits from wheat flour. Hardness, stickiness, and cohesiveness of 2, 4, 6, and 8% okara flour dough were significantly (P ≤ 0.05) lower compared to the control, resulting in decreased cutting strength and increased hardness of okara flour biscuits. Moisture, protein, ash, fat, and crude fiber contents of 2, 4, 6, and 8% okara biscuits were significantly (P ≤ 0.05) higher compared to the control biscuits. The sensory evaluation suggested that 4% okara biscuits had higher consumer acceptability and were superior to the control and other okara biscuits. Conclusion. Mixed flour biscuits made from okara and wheat flours were superior in physicochemical, nutritional, textural, and sensory attributes, which allows considering them as an alternative healthy snack.

The present paper aims to study the effect of different pore forming agent on the density, porosity, pore morphology and electrical properties of porous BZT-0.5BCT ceramics. The electrical property evaluation is focused on dielectric constant, ferroelectric properties (P-E loop) and piezoelectric constant (d33 and g33) of the porous BZT-0.5BCT ceramics. BZT-0.5BCT powder was prepared by solid-state route. The porous ceramic was prepared by mixing BZT-0.5BCT with different percentage (10, 20, 30, 40 and 50 vol%) of polyvinyl alcohol (PVA) and sucrose as pore-forming agents (PFA). As a result, density, relative permittivity, remanent polarization and piezoelectric constant decreased linearly with increase in pore former addition. The pores derived from PVA and sucrose as pore former were spherical to irregular in shape. Isolated pores are observed up to 30 vol% of PFA addition and pore interconnectivity is observed at 40 vol% of PVA and sucrose addition. The decrease in electrical properties is much higher in sucrose when compared with PVA as a pore former.

Risk scoring for patients with cirrhosis has evolved greatly over the past several decades. However, patients with low Model for End-Stage Liver Disease-Sodium scores still suffer from liver-related morbidity and mortality. Unfortunately, it is not clear which of these low Model for End-Stage Liver Disease-Sodium score patients would benefit from earlier consideration of liver transplantation. This article reviews the literature of risk prediction in patients with cirrhosis, identifies which patients may benefit from earlier interventions, such as transplantation, and proposes directions for future research.

Background: The average readability level in the USA is a sixth grade level and for patients with chronic disease it is lower. Cirrhosis is a prevalent chronic disease that requires complex knowledge and instructions to manage. No research has been done about the understandability of online educational content for cirrhotic patients. Patients can find online materials curated by both general health platforms and high-volume liver transplant centers, and thus these materials were analyzed. Methods: After determining exclusion criteria, the websites of the top 20 general health platform results and the websites of the top 20 high-volume hepatology centers were analyzed. Readability was assessed using the Patient Education Materials Assessment Tool (Audiovisual Materials) (PEMAT-A/V), Flesch-Kincaid Grade Level tests, word counts, sentence counts, words per sentence, and time for an average sixth grader to read. Results: The mean grade level readabilities were 12.3 and 11.3 for the general resources and the transplant center resources, respectively. The online resources ranged from 9 to 389 sentences requiring an average of 9.8 min to read. The mean PEMAT-A/V scores were 70.05% for the general resources and 72.45% for the transplant center resources. There was a statistically significant difference in the Flesch-Kincaid grade level, sentence number, words per sentence, word count, and time for an average sixth grader to read the general resources and transplant center resources (P < 0.05). Conclusions: The online resources both from health platforms and hepatology centers available to patients with cirrhosis are too long and complex and underscore the need for simpler and shorter resources. J Curr Surg. 2020;10(1-2):1-6 doi: https://doi.org/10.14740/jcs401

Energy storage is a vital aspect for the successful implementation of renewable energy resources on a global scale. Herein, we investigated the redox cycle of nickel dithiocarbamates for potential use as catholytes in non-aqueous redox flow batteries. The unique redox cycle of nickel dithiocarbamates (Ni(dtc)2) offers the ability to better understand these reactions by displaying 2e- chemistry upon oxidation from Ni(II) → Ni(IV) but 1e- chemistry upon reduction from Ni(IV) → Ni(III) → Ni(II). The underlying reasons for this cycle lie in the structural changes that occur between four-coordinate Ni(dtc)2 and six-coordinate [Ni(dtc)3]+. Cyclic voltammetry and spectroscopic experiments show that these 1e- and 2e- pathways can be controlled by the addition of ancillary ligands such as pyridine derivatives and Lewis acids such as Zn(II). Specifically, the addition of different pyridine based ancillary N-donor ligands (L) to the electrolyte solution results in 1e- oxidation producing a mixture of five-coordinate [Ni(dtc)2L]+ and six-coordinate [Ni(dtc)2(L)2]+ intermediate species which decay to [Ni(dtc)3]+ by parallel pathways. The equilibrium constants for L coordination were determined and found to increase with larger pKa values of the pyridine base. On the reduction side, the addition of Zn(II) to the electrolyte is shown to consolidate the two 1e- reduction peaks into a single 2e- reduction where [Ni(dtc)3]+ is reduced directly to Ni(dtc)2. This enhancement is believed to be due to chemical assistance in removing a dtc- ligand from a Ni(dtc)3 intermediate, allowing for easier reduction to Ni(dtc)2. Around 80% columbic efficiency obtained when Ni(dtc)2 was used as catholyte in the chrono potentiometric (CP) H cell experiment in presence of 24 mM Zn2+ ion.

The heterojunction composites (Ba0.85Ca0.15)(Zr0.1Ti0.9)TiO3(BCZT)/Bi2O3 with different weight ratios (75:25, 50:50 and 25:75) were successfully synthesized by solid-state route. As-synthesized composite powders were characterized by XRD, FESEM, EDX, UV–visible and photoluminescence spectroscopy. Photocatalytic activity evaluation was carried out by the degradation of rhodamine B (RhB) under UV and visible light exposure. The results show that the heterojunction composites BCZT/Bi2O3 display better photocatalytic activity than pure BCZT or Bi2O3. Among all the heterojunction composites, BCZT/Bi2O3 (50:50) composite exhibits a lower recombination rate of electron–hole pair and shows the highest photocatalytic activity. The rate constant of BCZT/Bi2O3 (50:50) composite for RhB degradation is 15.4 and 2.1 times higher than those of pure BCZT and Bi2O3 under visible light irradiation, respectively. Finally, a possible mechanism for enhanced charge separation and photodegradation is proposed.

The effect of different amount of Li2ZrO3(LZ) (0-15wt%) addition on the properties of composite Li4SiO4 (LS) ceramic pebbles was studied. The Li4SiO4-Li2ZrO3 composite powder was prepared using solid state route at a calcination temperature as low as 900 °C via in-situ method. The composite pebbles were fabricated using a cost-effective and simple technique called extrusion-spherodization. The sintered pebbles were characterized for density, grain size, pore size distribution, crush load and moisture stability. The composite pebbles showed good sintered density (∼87.1%) for LS-5wt% LZ in comparison to LS pebbles (∼80%) when fired at 1000 °C. Moreover, the LS grain size in the composite pebble was significantly reduced by ∼19.7% when compared to LS pebbles. We also found that the average crush load value of the LS-5wt% LZ composite pebbles was improved by nearly 77% (30 N) to that of the pure LS pebbles (17 N). The LS-5wt% LZ pebbles showed excellent stability to moisture in terms of phase and mechanical crush load retention after 30 days of exposure to humidity. The results achieved in this work were found to be fit to the desired properties for use as a ceramic solid breeder.

The present report demonstrates the effects of three different binders on fabrication of Li4SiO4 pebbles by extrusion-spherodization technique. It is found that the nature of binders, concentrations and moisture content have significant effect on the density, sphericity, grain size and crush load of the Li4SiO4 pebbles. Different viscosity grade binders namely PVA, PVP and guargum have been explored for the fabrication of pebbles. XRD, FESEM, BET, Inverse gas chromatography, pebble crush load tester are used to study different properties. It has been observed that the pebbles fabricated with 6 wt% PVP show the desired properties [appreciable density (85%), smaller grain size (

The effect of different amount of Li2TiO3(LT) (0–15 wt%) addition on the properties of composite Li4SiO4 (LS) ceramic pebbles were studied. The Li4SiO4-Li2TiO3 composite powder was prepared in-situ using solid state method at a calcination temperature as low as 800 °C. The composite pebbles were fabricated using a cost-effective and simple technique called extrusion-spherodization. The sintered pebbles were characterized for density, grain size, pore size distribution, crush load and moisture stability. The density of Li4SiO4 composite pebbles was improved for LS-5 wt% LT in comparison to LS pebbles when fired at 1000 °C. Moreover, the LS grain size in the composite pebbles was reduced (5.8 μm) in comparison to LS pebbles. We also found that the average crush load value of the LS-5 wt%LT composite pebbles had been improved by nearly 100% (33 N) to that of the pure LS pebbles (17 N). The LS-5 wt% LT pebbles showed improvement in stability to moisture.

Nanosized (1–x)KNbO3–x( $${\text{BaNi}}_{\frac{1}{2}} {\text{Nb}}_{\frac{1}{2}} {\text{O}}_{3 - \delta }$$ ) (KBNNO) (x = 0–0.2) powders with an interval of 0.05 were prepared by solution combustion method using citric acid as the fuel. The effect of fuel to oxidizer (F/O) ratio on phase evolution and combustion process was studied and we observed that complete phase formation occurs at 600°C for $$\varphi_{{\text{e}}} $$ = 0.55. XRD and Raman analysis confirm that with increase in dopant content, gradual changes occur in phase transition from orthorhombic to cubic. Ba, Ni co-doping made KNbO3, visible light active, which was confirmed by UV–Vis absorption spectra. Photocatalytic experiments show that KBNNO 0.1 exhibited better photocatalytic activity in degrading RhB under visible light irradiation compared to KNbO3 and P25 (commercial TiO2-based photocatalyst). The rate constant of KBNNO 0.1 for RhB degradation is 3.17 and 1.4 times higher than KNbO3 and P25, respectively, under similar visible light illumination. The mechanisms behind photocatalytic activity and photostability have also been studied for the best composition.

BackgroundPatients with autoimmune inflammatory rheumatic diseases are susceptible to infections. This could be attributed to theimmunosuppressive effect of the underlying condition or the use of immunomodulatory medications. According to the Department of Health guidelines inthe UK and the European League Against Rheumatism (EULAR), patients who are immunosuppressed should be vaccinated against influenza and pneumococcal infection, as well as COVID-19 infection.ObjectivesOur aim was to explore the Pneumococcal, Influenza and COVID-19 vaccination uptake of our patients with different autoimmune inflammatory rheumatological conditions. In addition, to assess the side effects profile and the status of their underlying rheumatological diseases following COVID-19 vaccination.MethodsWe undertook a prospective audit of consecutive patients with regards to their vaccination update for influenza, pneumococcus, and COVID-19, utilizing a standard questionnaire and compared the results to our 2017 data.ResultsSome 81% of patients received the influenza vaccination (compared to 47% in 2017) representing a 172% improvement, pMost side-effects were observed following the first dose (74 patients) vs. the second dose (13 patients) and were mainly mild (66%), but also moderate (19%) and severe (15%). The sore arm was the commonest side-effect, whilst the majority of side-effects resolved within two days. Crucially, 28% reported a flare of the rheumatological condition following the vaccination. No patients receiving at least one dose were diagnosed with COVID-19 infection subsequently.ConclusionVaccination rates for influenza and pneumococcus have improved substantially since 2017, although the population with rheumatic diseases still has low uptake in pneumococcal vaccination. The COVID-19 vaccination uptake has been extremely high in this cohort.Disclosure of InterestsNone declared

BACKGROUND AND AIMS Estimates of racial disparity in cirrhosis have been limited by lack of large-scale, longitudinal data, which track patients from diagnosis to death and/or transplant. APPROACH AND RESULTS We analyzed a large, metropolitan, population-based electronic health record data set from seven large health systems linked to the state death registry and the national transplant database. Multivariate competing risk analyses, adjusted for sex, age, insurance status, Elixhauser score, etiology of cirrhosis, HCC, portal hypertensive complication, and Model for End-Stage Liver Disease-Sodium (MELD-Na), examined the relationship between race, transplant, and cause of death as defined by blinded death certificate review. During the study period, 11,277 patients met inclusion criteria, of whom 2,498 (22.2%) identified as Black. Compared to White patients, Black patients had similar age, sex, MELD-Na, and proportion of alcohol-associated liver disease, but higher comorbidity burden, lower rates of private insurance, and lower rates of portal hypertensive complications. Compared to White patients, Black patients had the highest rate all-cause mortality and non-liver-related death and were less likely to be listed or transplanted (P

BACKGROUND The vast majority of patients with cirrhosis have low Model for End-Stage Liver Disease-Sodium (MELD-Na) scores; however, the ability for the MELD-Na score to predict patient outcomes at low scores is unclear. METHODS Adult patients in a multicenter, Chicago-wide database of medical records with International Classification of Disease, Ninth Edition codes of cirrhosis and without a history of hepatocellular carcinoma were included. Records were linked with the state death registry, and death certificates were manually reviewed. Deaths were classified as "liver-related," "non-liver-related," and "non-descript" as adjudicated by a panel comprised of a transplant surgeon, a hepatologist, and an internist. A sensitivity analysis was performed where patients with hepatocellular carcinoma were included. RESULTS Among 7922 identified patients, 3999 patients had MELD-Na scores that were never higher than 15. In total, 2137 (27%) patients died during the study period with higher mortality rates for the patients in the high MELD-Na group (19.4 (41.6%) versus 4.1 (12.6%) per 100 person-y, P < 0.001). The high MELD-Na group died of a liver-related cause in 1142 out of 1632 (70%) as compared to 240 out of 505 (47.5%) deaths in the low MELD-Na group. There was no difference in the distribution of subcategory of liver-related death between low and high MELD-Na groups. Among subclassification of liver-related deaths, the most common cause of death was "Infectious" in both groups. CONCLUSIONS Despite persistently low MELD-Na scores, patients with cirrhosis still experience high rates of liver-related mortality.

Objective Liver cirrhosis is a leading cause of death and effects millions of people in the United States. Early mortality prediction among patients with cirrhosis might give healthcare providers more opportunity to effectively treat the condition. We hypothesized that laboratory test results and other related diagnoses would be associated with mortality in this population. Our another assumption was that a deep learning model could outperform the current Model for End Stage Liver disease (MELD) score in predicting mortality. Materials and methods We utilized electronic health record data from 34,575 patients with a diagnosis of cirrhosis from a large medical center to study associations with mortality. Three time-windows of mortality (365 days, 180 days and 90 days) and two cases with different number of variables (all 41 available variables and 4 variables in MELD-NA) were studied. Missing values were imputed using multiple imputation for continuous variables and mode for categorical variables. Deep learning and machine learning algorithms, i.e., deep neural networks (DNN), random forest (RF) and logistic regression (LR) were employed to study the associations between baseline features such as laboratory measurements and diagnoses for each time window by 5-fold cross validation method. Metrics such as area under the receiver operating curve (AUC), overall accuracy, sensitivity, and specificity were used to evaluate models. Results Performance of models comprising all variables outperformed those with 4 MELD-NA variables for all prediction cases and the DNN model outperformed the LR and RF models. For example, the DNN model achieved an AUC of 0.88, 0.86, and 0.85 for 90, 180, and 365-day mortality respectively as compared to the MELD score, which resulted in corresponding AUCs of 0.81, 0.79, and 0.76 for the same instances. The DNN and LR models had a significantly better f1 score compared to MELD at all time points examined. Conclusion Other variables such as alkaline phosphatase, alanine aminotransferase, and hemoglobin were also top informative features besides the 4 MELD-Na variables. Machine learning and deep learning models outperformed the current standard of risk prediction among patients with cirrhosis. Advanced informatics techniques showed promise for risk prediction in patients with cirrhosis.

Phase pure Lithium orthosilicate (Li 4 SiO 4 ) nanopowder was synthesized by solution combustion method using glycine as the fuel and silicic acid as a silica source. The effect of the fuel-to-oxidizer ratio (Φ e ) (0.6–1.0) in the combustion process and phase evolution was studied. We found that by controlling the fuel-to-oxidizer ratio of the starting solution phase purity can be achieved at 700 °C. Li 4 SiO 4 powder was also prepared by solid state method and phase purity was achieved at 800 °C. The surface area, powder morphology, sintering behavior and CO 2 capture properties of the Li 4 SiO 4 were investigated. The powder synthesized by solution combustion route showed higher surface area, sinterability and CO 2 absorption capacity compared to the solid state route powder. It could be attributed to the nanostructured morphology of the particles. The grain size in the sintered sample could be kept well below 5 μm. The current report provides a novel method to fabricate lithium orthosilicate, and shows promise for application as high temperature CO 2 absorption as well as solid breeder in fusion reactor.

Porous ceramic was prepared by mixing BZT-0.5BCT with different percentage (10, 20, 30 and 40 vol%) of polyvinyl alcohol (PVA) and polyvinyl pyrrolidone (PVP) as pore-forming agents (PFA). Density, relative permittivity, remanent polarization and piezoelectric constant decreased linearly with increase in pore former addition. Pores derived from the pore former were spherical to irregular in shape. Isolated pores are observed with addition of PVA up to 20 vol% and pore interconnectivity is observed at 40 vol%. Incidentally pore interconnectivity is observed even at 20 vol% addition in case of PVP. The decrease in electrical properties is much higher in PVP when compared with PVA as a pore former.

The present investigation reveals the effect of processing parameters on the properties of alumina–titania (Al $$_{2}$$ O $$_{3}$$ –TiO $$_{2}$$ ) nanocomposites. A polymer-assisted (Pluronic P123 triblock co-polymer) co-precipitation route has been employed to synthesize $$\hbox {Al}_{2}\hbox {O}_{3}$$ – $$\hbox {TiO}_{2}$$ nanoparticles. As a surfactant, pluronic P123 polymer exhibits hydrophobic as well as the hydrophilic nature simultaneously which detains the agglomeration and hence the nano size particle have been obtained. Effect of surfactant concentration on morphology and particle size of product has also been investigated. Thermal behaviour of the prepared powder samples have been studied using differential scanning calorimeter/thermal gravimetric analysis and dilatometer. Formation of aluminium-titanate $$(\hbox {Al}_{2}$$ $$\hbox {TiO}_{5})$$ phase has been confirmed using X-ray diffraction analysis. It has been observed by field emission scanning electron microscopy analysis that the particle size reduced effectively (below 100 nm) when polymer-assisted co-precipitation route is used instead of the simple co-precipitation technique. A highly dense microstructure of sintered samples has been obtained, driven by reduced particle size.

Co-Ti co-substituted SrM hexagonal ferrite (SrCo 1.5 Ti 1.5 Fe 9 O 19 ) was synthesized by sol-gel combustion and solid state route. The effects of sources of TiO 2 raw materials; titanium tetra-isopropoxide (TTIP) and titanyl nitrate (TN) on the phase formation behavior and properties of the ferrite were studied. The thermal decomposition behavior of the gel was studied using TG-DSC. The phase formation behavior of the ferrite was studied by using X-ray powder diffraction and FTIR analysis. Phase formation was comparatively easier in the TN-based sol-gel process. The morphology of powder and sintered ferrite was investigated using scanning electron microscope. Magnetic properties like magnetization, coercivity, permeability, tan δ µ and dielectric properties were investigated. The ferrite synthesized by sol-gel based chemical route showed higher saturation magnetization, permeability and permittivity compared to the ferrite synthesized by solid state route.

Background Despite lower socioeconomic status, Hispanics in the United States paradoxically maintain equal or higher average survival rates compared to non-Hispanic Whites (NHW). Methods We used multivariable Cox regression to assess whether this "Hispanic paradox" applies to patients with liver cirrhosis using a retrospective cohort of twenty 121 patients in a Chicago-wide electronic health record database. Results Our study population included 3279 (16%) Hispanics, 9150 (45%) NHW, 4432 (22%) African Americans, 529 (3%) Asians, and 2731 (14%) of other races/ethnic groups. Compared to Hispanics, NHW (hazard ratio [HR] 1.26; 95% confidence interval [CI], 1.16-1.37), African American (HR 1.26; 95% CI, 1.15-1.39), and other races/ethnic groups (HR 1.55; 95% CI, 1.40-1.71) had an increased risk of death despite adjustment for age, sex, insurance status, etiology of cirrhosis, and comorbidities. On stratified analyses, a mortality advantage for Hispanics compared to NHW was seen for alcohol cirrhosis (HR for NHW 1.35; 95% CI, 1.19-1.52), hepatitis B (HR for NHW 1.35; 95% CI, 0.98-1.87), hepatitis C (HR for NHW 1.21; 95% CI, 1.06-1.38), and nonalcoholic steatohepatitis (HR for NHW 1.14; 95% CI, 0.94-1.39). There was no advantage associated with Hispanic race over NHW in cases of hepatocellular carcinoma or cholestatic liver disease. Conclusions Hispanic patients with cirrhosis experience a survival advantage over many other racial groups despite adjustment for multiple covariates.

Sarcopenia is associated with both increased wait-list mortality and mortality following liver transplantation.To determine the course of sarcopenia from transplant evaluation until 1 year post-transplant, and its implications on hospitalisation and mortality following liver transplantation.Two hundred and ninety-three transplant recipients from 2002 to 2006 had pre-transplant CT scans analysed at the third lumbar region for sarcopenia, myosteatosis and abdominal visceral fat content. Half the recipients had post-transplant CT scan for interpretation (161/293).Sarcopenia was present in 146/293 (50%) of the patients pre-transplant. There was a significant decrease in muscle mass (loss 2.0 ± 4.9 cmSarcopenia progresses up to 1 year following liver transplantation and is associated with an increase in post-transplant length of stay.

Introduction: Ipilimumab is an immune checkpoint inhibitor targeting cytotoxic T-lymphocyte associated antigen 4 (CTLA4), approved to treat metastatic melanoma. It was the first therapy shown to prolong survival in a large, randomized clinical trial. However, immune-related adverse events are common and can be severe. Enterocolitis is a common adverse event with ipilimumab, but enteritis without colitis has not been previously described. Case Report: An 83-year-old man presented to our hospital with grade 3 diarrhea for 5 days. One month prior, he had started treatment with ipilimumab for metastatic melanoma. On presentation, he was found to have severe electrolyte disturbances, including hyponatremia, hypokalemia, and acute kidney injury. Causes of infectious diarrhea were excluded, and he was treated with corticosteroids for presumed ipilimumab-associated enterocolitis. However, colonoscopy revealed normal mucosa, both grossly and on pathology of random biopsies. Steroids were weaned but his symptoms recurred. He then underwent upper endoscopy with enteroscopy. Biopsy of the duodenum was notable for acute inflammation, villous blunting, and other changes consistent with ipilimumab-associated injury. He was restarted on high-dose steroids and his symptoms resolved. Discussion: Ipilimumab-induced enteritis is a serious and potentially life-threatening immune related adverse event that warrants prompt recognition and aggressive management. As in cases of ipilimumab-associated enterocolitis, steroids are an effective therapy. Enteritis without colitis should be suspected in patients on ipilimumab who present with severe diarrhea but have a normal colonoscopy.

We report on the co-existence of longitudinal and transverse oscillations in an active filament. On March 15$^{th}$ 2013, a M1.1 class flare was observed in the active region AR 11692. A CME was found to be associated with the flare. {The CME generated a shock wave that triggered the oscillations in a nearby filament}, situated at the south-west of the active region as observed from National Solar Observatory (NSO)\textit{Global Oscillation Network Group}(GONG) H$\alpha$ images. In this work we report the longitudinal oscillations in the two ends of the filament, co-existing with the transverse oscillations. We propose a scenario in which {an} incoming shock wave hits the filament obliquely and triggers both longitudinal and transverse oscillations. Using the observed parameters, we estimate the lower limit of the magnetic field strength. We use simple pendulum model with gravity as the restoring force to estimate the radius of curvature. We also calculate the mass accretion rate which causes the filament motions to damp quite fast., Comment: Accepted for publication in Solar Physics

Recently, piezoelectric wafers/substrates have opened new opportunities for nondestructive evaluation (NDE) of structures in defense, aerospace, and industrial sectors. Such substrates can be easily made by tape casting of slurries where dispersants and binders play a critical role. In the present work, tape casting slurry of BZT-0.5BCT powder has been prepared using MEK-EtOH (solvent), phosphate ester (dispersant), polyvinyl butyral (binder), poly ethylene glycol and benzyl butyl pthalate (plasticizer). It was found that 1 wt.% phosphate ester is sufficient for effective dispersion of BZT-0.5BCT to obtain a stable slurry. Variation of PVB content shows that at least 3 wt.% PVB is required to obtain the workable green tape. The highest density (94% of true density), relative permittivity (1700 at 1 kHz) and the high values of strain (0.23%) have been obtained for tape with 3 wt.% PVB content and 65% solid loading after firing at 1500 °C/4 h.

MgO (0–2.0 vol%) added Ba(Zr0.2Ti0.8)O3–0.5(Ba0.7Ca0.3)TiO3 (BZT-0.5BCT) ceramics have been prepared by the conventional solid-state reaction method. The effects of MgO powder on the phase formation, densification, dielectric, piezoelectric and mechanical properties (flexural strength, hardness) of the BZT-0.5BCT ceramics have been studied systematically. The synthesized powder could be densified to 97 % of true density at a temperature of 1350 °C. The MgO addition also provided materials with better mechanical properties. The most interesting aspect of MgO added samples is their relative permittivity vs. temperature response. MgO additions effectively suppress the relative permittivity around phase transition temperature. The aging rate of d33 observed for BZT-0.5BCT is 14 %/decade. MgO addition reduces the ageing rate and for 1 vol% MgO added, BZT-0.5BCT shows aging rate of 3 %/decade. BZT-0.5BCT/MgO ceramics possesses good mechanical properties viz., flexural strength 93 MPa, which is almost 25 % higher than that of monolithic BZT-0.5BCT (73 MPa).