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Introduction: Postpartum Haemorrhage (PPH) is one of the main causes of maternal morbidity and mortality globally, accounting for about 25% of maternal deaths. Uterine Artery Embolisation (UAE) has gained recognition as a valuable non surgical treatment option for managing PPH, providing effective haemorrhage control while maintaining fertility. Aim: To assess the effectiveness and safety of UAE in the treatment of PPH. Materials and Methods: A thorough investigation was performed using PubMed, Scopus, Science Direct and the Cochrane Library to locate studies released between 2000 and 2024. The included studies comprised Randomised Controlled Trials (RCTs), case-control studies, and cohort studies that assessed the efficacy of UAE for PPH. The primary outcomes assessed were clinical success rates, technical success rates, and complication rates. Secondary outcomes included fertility preservation, postpartum recovery time, and the impact on future pregnancies. Data analysis was undertaken using Review Manager 5.3, with Mean Differences (MD) and Risk Ratios (RR) calculated for continuous and dichotomous outcomes, respectively. Results: Out of 437 identified studies, 13 met the inclusion criteria for evaluating the effectiveness of UAE as a treatment for PPH. These comprised five RCTs with 1,200 participants, four case-control studies with 800 participants, and four cohort studies with 1,000 participants. The RCTs were conducted in North America, Europe, and Asia, involving women who had experienced PPH. Case-control studies compared UAE recipients to those receiving alternative treatments, considering factors like age, severity of PPH, and obstetric history. Cohort studies followed UAE recipients over time to assess long-term outcomes. The pooled technical success rate was 96% (95% CI, 94.0-98.0; I2=20.0%; p-value=0.143), and the clinical success rate was 92% (95% CI, 88.0-96.0; I2=35.6%; p-value=0.012). The complication rate was 8% (95% CI, 5.0-11.0; I2=40.1%; p-value=0.021). These findings indicate a high effectiveness and reliability of UAE for PPH treatment. The diverse study types and participant populations enhance the generalisability of these results, underscoring UAE’s potential to improve outcomes for women experiencing PPH globally. Conclusion: UAE demonstrates high clinical and technical success rates with a relatively low complication rate, establishing it as a safe and effective intervention for PPH. Future studies need to look into lasting outcomes, including fertility preservation and impacts on subsequent pregnancies, to further substantiate UAE’s role in PPH management.

Abstract Aquatic foods are highly traded, with nearly 60 million tonnes exported in 2020, representing 11% of global agriculture trade by value. Despite the vast scale, basic characteristics of aquatic food trade, including species, origin, and farmed vs wild sourcing, are largely unknown due to the reporting of trade data. Consequently, we have a coarse picture of aquatic food trade and consumption patterns. Here, we present results from a database on species trade that aligns production, conversion factors, and trade to compute apparent consumption for all farmed and wild aquatic foods from 1996 to 2020. Over this period, aquatic foods became increasingly globalized, with the share of production exported increasing by 40%. Importantly, trends differ across aquatic food sectors. Global consumption also increased by 19.4% despite declining marine capture consumption, and some regions became increasingly reliant on foreign-sourced aquatic foods. To identify sustainable diet opportunities among aquatic foods, our findings, and underlying database enable a greater understanding of the role of trade in rapidly evolving aquatic food systems.

Abstract Background This study aims to tackle the lack of freshwater ecotoxicological effect factors (EFs) crucial for determining freshwater ecotoxicity characterization factors (CFs) using the widely accepted scientific consensus USEtox model for ecotoxicity impact characterization. The objectives are: (1) to offer a collection of experimental EFs to support USEtox ecotoxicity characterization factor computations and (2) to contrast ecotoxicity data produced by various quantitative structure–activity relationship (QSAR) models against experimental data. Results Experimental ecotoxicity data were gathered from the REACH database and CompTox Version 2.1.1, which includes toxicity information from ToxValDB v9.4. QSAR-driven ecotoxicity data were extracted from ECOSAR v1.11 and T.E.S.T. v5.1.2. The experimental and estimated data underwent a harmonization process to ensure consistency. Subsequently, aquatic ecotoxicological EFs were determined. The merged REACH and CompTox databases list EFs for 11,295 substances, each identified by a unique CAS number. Among these, the USEtox database already catalogs 2426 substances with freshwater ecotoxicological EFs. This study expanded on that by calculating EFs for an additional 8869 substances. Using estimated data, EFs were determined for 6029 chemicals based on ECOSAR data and 6762 chemicals using TEST data. Conclusions This study calculated EFs for an additional 8869 substances, thereby broadening their inclusion in LCA evaluations. When integrated with the USEtox EFs database, this research encompasses 11,368 chemicals. The high correlation observed between experimental EFs and those in the USEtox database lends significant confidence to the calculations for chemicals not listed in USEtox. Conversely, the low correlation between estimated EFs and those in USEtox suggests limited confidence in calculations based on estimated data. Furthermore, the disparity in correlations between EFs calculated using ECOSAR and TEST indicates that different QSARs can yield varied results. This discrepancy underscores the need for caution when relying on estimated data. Given that EFs are contingent on data availability, it is imperative to periodically update EFs as new data emerges.

Introduction: The application of direct current can have a significant impact on the rate of tooth movement and surrounding periodontal ligament collagen turnover. This study aims to provide insight into the optimal characteristics of applied current to achieve enhanced tissue response. Method: Eighteen male Wistar rats were divided into three groups (I, II, and III). Split mouth design was used, and each side was allocated into an experimental group or control group. Experimental sides of groups I, II, and III received 20, 10, and 15 μA of current (15 min, twice daily for 3 days). Both the experimental and control groups receive an orthodontic force via the NiTi closed coil spring. The amount of tooth movement was determined daily. Immunohistochemistry slides were scored using the immunoreactive scoring (IRS) system for collagen types I and III. One-way Analysis of Variance (ANOVA) and Tukey post hoc test were used to analyse the rate of tooth movement, while Mann–Whitney test was used to analyse IRS distribution between control and experimental groups. Results: Compared with the control group, there was a statistically significant difference in tooth movement in all the experimental groups, with group 3 showing the maximum rate on days 2 and 3. This was supported by immunoreactive scores for both collagen types I and III. Conclusions: After 72 hours, the expression of collagen types 1 and 3 increased significantly for group III. This finding was in harmony with the rate of tooth movement, which was maximum for group 3 (15 μA) as compared to other groups.

Student restaurants at Chalmers University have adopted take-away lunch boxes as a convenient dining option for students with disposable single-use containers being the norm. However, there is a growing interest in more sustainable, reusable alternatives. This study conducted a comparative Life Cycle Assessment (LCA) to assess the potential environmental and economic impacts of using reusable lunch boxes in comparison to disposable ones, considering 18 environmental impact categories. The functional unit chosen for evaluation was the provision of takeaway lunches to Chalmers students over the course of a year. The findings revealed that reusable boxes with 20 uses outperformed their disposable counterparts in many environmental impacts, reducing the climate change impact by 59%. However, water and energy consumption were higher for the reusable option by 99% and 62% respectively, primarily due to the cleaning process. From an economic perspective, reusable boxes proved to be 3.3% more costly than disposable ones. In conclusion, this study highlights the benefits of reusable solutions, showing reductions in various environmental footprints but presenting slightly higher economic footprints over 20 uses. However, as the number of uses increases, the advantages also increase, leading to recommendations for better management of the lunch boxes to maximize their reusable potential.

The direct expansion solar heat pump (DX-SHP) is a competent and sustainable option for domestic heating and drying applications. The solar collector-evaporator is a vital component of DX-SHP, which operates on solar energy and low-temperature ambient energy. The heat collection capacity, coefficient of performance, and evaporation temperature are used to quantify its performance. In this context, a systematic literature review on recent advancements in the collector-evaporator of DX-SHP is presented. This paper highlights and discusses the various configurations of solar collector-evaporators, theoretical and experimental investigations, and the selection method of eco-friendly refrigerants. The impact of different performance factors, such as ambient conditions, structural parameters, and types of refrigerants, on solar collector-evaporators is also reviewed. The optimal range for solar radiation, wind speed, and temperature is found to be 350 W/m2-700 W/m2, 0.5 m/s -2.5m/s, and 5°C to 35°C. The DX-SHP system produces hot water from 15°C to 60°C, with an average COP of 1.5 to 4.5. The finned solar collector-evaporator with R290 refrigerant performs optimally in various climatic conditions. Integrating solar collector-evaporators with innovative technologies such as microchannel, heat pipe, thermoelectric generators, photovoltaic thermal collectors with compound parabolic and Fresnel lenses can improve the system's performance. In this review, researchers can find scope for performance enhancement of the collector-evaporator used in DX-SHP.

Abstract Nanoparticulate systems have the prospect of accounting for a new making of drug delivery systems. Nanotechnology is manifested to traverse the hurdle of both physical and biological sciences by implementing nanostructures indistinct fields of science, particularly in nano-based drug delivery. The low delivery efficiency of nanoparticles is a critical obstacle in the field of tumor diagnosis. Several nano-based drug delivery studies are focused on for tumor diagnosis. But, the nano-based drug delivery efficiency was not increased for tumor diagnosis. This work proposes a method called point biserial correlation symbiotic organism search nanoengineering-based drug delivery (PBC-SOSN). The objective and aim of the PBC-SOSN method is to achieve higher drug delivery efficiency and lesser drug delivery time for tumor diagnosis. The contribution of the PBC-SOSN is to optimized nanonengineering-based drug delivery with higher r drug delivery detection rate and smaller drug delivery error detection rate. Initially, raw data acquired from the nano-tumor dataset, and nano-drugs for glioblastoma dataset, overhead improved preprocessed samples are evolved using nano variational model decomposition-based preprocessing. After that, the preprocessed samples as input are subjected to variance analysis and point biserial correlation-based feature selection model. Finally, the preprocessed samples and features selected are subjected to symbiotic organism search nanoengineering (SOSN) to corroborate the objective. Based on these findings, point biserial correlation-based feature selection and a symbiotic organism search nanoengineering were tested for their modeling performance with a nano-tumor dataset and nano-drugs for glioblastoma dataset, finding the latter the better algorithm. Incorporated into the method is the potential to adjust the drug delivery detection rate and drug delivery error detection rate of the learned method based on selected features determined by nano variational model decomposition for efficient drug delivery.

Acute Subdural Haemorrhage (SDH) frequently arises as a complication after head trauma, often resulting in sudden loss of consciousness and neurological impairments in an individual who was previously healthy [1]. Uncommonly, a ruptured aneurysm may present with SDH. Among these cases, a ruptured aneurysm at the junction of the Internal Carotid Artery (ICA) and the Posterior Communicating Artery (Pcom) stands out as the most common site associated with this uncommon spontaneous acute SDH [2]. This manuscript documents imaging and endovascular management of a rare case of a ruptured Pcom aneurysm presenting as acute SDH. The purpose of presenting this case was to underscore awareness of this condition, helping to prevent diagnostic and therapeutic errors

Background: Although multiparametric (mp) 1H magnetic resonance imaging (MRI) is increasingly used to detect and localize prostate cancer (PC), its correlation with tumor grade is limited. Hyperpolarized (HP) carbon-13 (13C) MR is an emerging imaging technique, which can be used to interrogate key biologic processes through in vivo detection of various HP probes. A distinct attribute of HP 13C MRI is the ability to detect multiple HP probes within a single acquisition. Here we report on the first simultaneous dual HP [1-13C]pyruvate and [13C]urea MRI with correlations to histopathologic findings in a patient with localized PC scheduled for radical prostatectomy. Material and methods: Paired HP 13C and standard mp 1H MRI were performed in a patient with biopsy-proven Gleason score 4 + 3 = 7 adenocarcinoma of the prostate scheduled for radical prostatectomy through a first-in-human pilot study of dual-agent HP MRI (NCT02526368). HP 13C MRI was performed using a clinical 3T scanner with 13C transmit-and-receive capabilities. Dynamic series of HP 13C pyruvate, lactate and urea imaging were acquired following intravenous (IV) injection of co-hyperpolarized [13C]urea (25 mM) and [1–13C]pyruvate (125 mM). The [1-13C]pyruvate-to-[1-13C]lactate conversion rate (kPL) was calculated using an inputless two-site exchange model; AUCurea was the [13C]urea signal summed over time. Following radical prostatectomy, whole-mount prostate histopathological slides were prepared and reviewed by an experienced genitourinary pathologist. Results: Following informed consent, the patient underwent paired mp 1H MRI and dual-agent HP MRI. mp 1H MRI revealed a 1.2 cm lesion in the left apical posterior zone. Dual-agent HP MRI identified a focus of increased [1-13C]pyruvate-to-[1-13C]lactate conversion rate (kPL) extending from the left apical posterior peripheral zone to the right gland. A corresponding area of abnormal tissue perfusion (AUCurea) was seen in the left gland. Metabolism-perfusion mismatch (with several foci of increased kPL/AUCurea) was observed throughout the tumor. Tumor extension to the right midgland was confirmed at the time of radical prostatectomy and staining for lactate dehydrogenase-A was increased throughout the tumor relative to surrounding benign prostatic tissue. Conclusion: This first-in-human radiopathologic study demonstrates the feasibility of dual-agent HP MRI in PC patients. Simultaneous assessment of tumor metabolism and perfusion was able to detect occult disease as well as to show a significant mismatch between intra-tumoral metabolism and tissue perfusion in high-grade PC. Prospective validation of these findings is warranted.

The present study focuses on research findings related to the development and assessment of thiadiazole-linked thiazole derivatives as promising anti-tubercular agents. We present the synthesis data of eleven new compounds (4a-4k) and confirm their structures using spectroscopic techniques. Subsequently, the compounds were screened for their anti-tuberculosis activities against M. tuberculosis H37Ra. The results demonstrated that compounds 3 and 4b exhibited minimum inhibitory concentration (MIC) of 3.90 μg/mL and 7.81 μg/mL, respectively. In-vitro, studies for few compounds exhibited high antioxidant activity against DPPH and OH radical scavengers along with minimal to no cytotoxicity against RBCs which is a promising result. Investigation of molecular docked conformations revealed different molecular interactions such as hydrogen bonds, halogen bonds, and interactions involving Pi electron cloud. The study sheds light on conserved interactions with residues like Met131, Val163, His90 and Gln161 from the tubercular MCAT enzyme. Interestingly, the synthetic chemistry reveals that the employment of tetra-n-butylammonium bromide (TBAB) plays a crucial role for N-butylation and it also expedites the reaction in tetrahydrofuran solvent.

ABSTRACTMiddle East respiratory syndrome coronavirus (MERS-CoV) is a lethal beta-coronavirus that emerged in 2012. The virus is part of the WHO blueprint priority list with a concerning fatality rate of 35%. Scientific efforts are ongoing for the development of vaccines, anti-viral and biotherapeutics, which are majorly directed toward the structural spike protein. However, the ongoing effort is challenging due to conformational instability of the spike protein and the evasion strategy posed by the MERS-CoV. In this study, we have expressed and purified the MERS-CoV pre-fusion spike protein in the Expi293F mammalian expression system. The purified protein was extensively characterized for its biochemical and biophysical properties. Thermal stability analysis showed a melting temperature of 58°C and the protein resisted major structural changes at elevated temperature as revealed by fluorescence spectroscopy and circular dichroism. Immunological assessment of the MERS-CoV spike immunogen in BALB/c mice with AddaVaxTM and Imject alum adjuvants showed elicitation of high titer antibody responses but a more balanced Th1/Th2 response with AddaVaxTM squalene like adjuvant. Together, our results suggest the formation of higher-order trimeric pre-fusion MERS-CoV spike proteins, which were able to induce robust immune responses. The comprehensive characterization of MERS-CoV spike protein warrants a better understanding of MERS spike protein and future vaccine development efforts.

The primary objective of this study was to enhance the operational efficiency of the current healthcare system by proposing a quicker and more effective approach for healthcare providers to deliver services to individuals facing acute heart failure (HF) and concurrent medical conditions. The aim was to support healthcare staff in providing urgent services more efficiently by developing an automated decision-support Patient Prioritization (PP) Tool that utilizes a tailored machine learning (ML) model to prioritize HF patients with chronic heart conditions and concurrent comorbidities during Urgent Care Unit admission. The study applies key ML models to the PhysioNet dataset, encompassing hospital admissions and mortality records of heart failure patients at Zigong Fourth People's Hospital in Sichuan, China, between 2016 and 2019. In addition, the model outcomes for the PhysioNet dataset are compared with the Healthcare Cost and Utilization Project (HCUP) Maryland (MD) State Inpatient Data (SID) for 2014, a secondary dataset containing heart failure patients, to assess the generalizability of results across diverse healthcare settings and patient demographics. The ML models in this project demonstrate efficiencies surpassing 97.8% and specificities exceeding 95% in identifying HF patients at a higher risk and ranking them based on their mortality risk level. Utilizing this machine learning for the PP approach underscores risk assessment, supporting healthcare professionals in managing HF patients more effectively and allocating resources to those in immediate need, whether in hospital or telehealth settings.

Climate change and increasing anthropogenic activities, such as over-exploitation of groundwater, are exerting unavoidable stress on groundwater resources. This study investigated the spatio-temporal variation of depth to groundwater level (DGWL) and the impacts of climatic (precipitation, maximum temperature, and minimum temperature) and anthropogenic (gross district product (GDP), population, and net irrigated area (NIA)) variables on DGWL during 1994–2020. The study considered DGWL in 113 observation wells and piezometers located in arid western plains (Barmer and Jodhpur districts) and semi-arid eastern plains (Jaipur, Ajmer, Dausa, and Tonk districts) of Rajasthan State, India. Statistical methods were employed to examine the annual and seasonal patterns of DGWL, and the generalized additive model (GAM) was used to determine the impacts of climatic and anthropogenic variables on DGWL. During 1994–2020, except for Barmer District, where the mean annual DGWL was almost constant (around 26.50 m), all other districts exhibited increase in DGWL, with Ajmer District experiencing the most increase. The results also revealed that 36 observation wells and piezometers showed a statistically significant annual increasing trend in DGWL and 34 observation wells and piezometers exhibited a statistically significant decreasing trend in DGWL. Similarly, 32 observation wells and piezometers showed an statistically significant increasing trend and 37 observation wells and piezometers showed a statistically significant decreasing trend in winter; 33 observation wells and piezometers indicated a statistically significant increasing trend and 34 had a statistically significant decreasing trend in post-monsoon; 35 observation wells and piezometers exhibited a statistically significant increasing trend and 32 observation wells and piezometers showed a statistically significant decreasing trend in pre-monsoon; and 36 observation wells and piezometers reflected a statistically significant increasing trend and 30 observation wells and piezometers reflected a statistically significant decreasing trend in monsoon. Interestingly, most of the observation wells and piezometers with increasing trends of DGWL were located in Dausa and Jaipur districts. Furthermore, the GAM analysis revealed that climatic variables, such as precipitation, significantly affected DGWL in Barmer District, and DGWL in all other districts was influenced by anthropogenic variables, including GDP, NIA, and population. As a result, stringent regulations should be implemented to curb excessive groundwater extraction, manage agricultural water demand, initiate proactive aquifer recharge programs, and strengthen sustainable management in these water-scarce regions.

IntroductionDespite being a primary impairment in individuals with cerebral palsy (CP), selective motor control (SMC) is not routinely measured. Personalized treatment approaches in CP will be unattainable without the ability to precisely characterize the types and degrees of impairments in motor control. The objective of this study is to report the development and feasibility of a new methodological approach measuring muscle activation patterns during single-joint tasks to characterize obligatory muscle co-activation patterns that may underly impaired SMC.MethodsMuscle activation patterns were recorded during sub-maximal voluntary isometric contraction (sub-MVIC) tasks at the hip, knee, and ankle with an interactive feedback game to standardize effort across participants. We calculated indices of co-activation, synergistic movement, mirror movement, and overflow (indices range 0–2, greater scores equal to greater impairment in SMC) for each isolated joint task in 15 children – 8 with typical development (TD) (mean age 4.7 ± 1.0 SD years) and 7 with CP (mean age 5.8 ± 0.7 SD years). Indices were compared with Mann–Whitney tests. The relationships between the indices and gross motor function (GMFM-66) were examined with Pearson’s r.ResultsMean indices were higher in the CP vs. the TD group for each of the six tasks, with mean differences ranging from 0.05 (abduction and plantarflexion) to 0.44 (dorsiflexion). There was great inter-subject variability in the CP group such that significant group differences were detected for knee flexion mirroring (p = 0.029), dorsiflexion coactivation (p = 0.021), and dorsiflexion overflow (p = 0.014). Significant negative linear relations to gross motor function were found in all four indices for knee extension (r = −0.56 to −0.75), three of the indices for ankle dorsiflexion (r = −0.68 to −0.78) and in two of the indices for knee flexion (r = −0.66 to −0.67), and ankle plantarflexion (r = −0.53 to −0.60).DiscussionIndices of coactivation, mirror movement, synergy, and overflow during single-joint lower limb tasks may quantify the type and degree of impairment in SMC. Preliminary concurrent validity between several of the indices of SMC and gross motor function was observed. Our findings established the feasibility of a new methodological approach that quantifies muscle activation patterns using electromyography paired with biofeedback during single-joint movement.

Abstract Cyclic high-dose testosterone administration, known as bipolar androgen therapy (BAT), is a treatment strategy for patients with metastatic castration-resistant prostate cancer (mCRPC). Here, we report the results of a multicenter, single arm Phase 2 study (NCT03554317) enrolling 45 patients with heavily pretreated mCRPC who received BAT (testosterone cypionate, 400 mg intramuscularly every 28 days) with the addition of nivolumab (480 mg intravenously every 28 days) following three cycles of BAT monotherapy. The primary endpoint of a confirmed PSA50 response rate was met and estimated at 40% (N = 18/45, 95% CI: 25.7–55.7%, P = 0.02 one-sided against the 25% null hypothesis). Sixteen of the PSA50 responses were achieved before the addition of nivolumab. Secondary endpoints included objective response rate (ORR), median PSA progression-free survival, radiographic progression-free survival (rPFS), overall survival (OS), and safety/tolerability. The ORR was 24% (N = 10/42). Three of the objective responses occurred following the addition of nivolumab. After a median follow-up of 17.9 months, the median rPFS was 5.6 (95% CI: 5.4–6.8) months, and median OS was 24.4 (95% CI: 17.6–31.1) months. BAT/nivolumab was well tolerated, resulting in only five (11%) drug related, grade-3 adverse events. In a predefined exploratory analysis, clinical response rates correlated with increased baseline levels of intratumoral PD-1 + T cells. In paired metastatic tumor biopsies, BAT induced pro-inflammatory gene expression changes that were restricted to patients achieving a clinical response. These data suggest that BAT may augment antitumor immune responses that are further potentiated by immune checkpoint blockade.

Background: The world has been hit by an unknown obstacle in the form of the COVID-19 pandemic. India also faced a never seen before situation in trying to contain the spread of COVID-19 by enforcing one of the most stringent lockdowns in the world. The billion-plus population of the country throws a severe challenge at the operational level in enforcing the measures. The frontline workers in these trying times such as the Police, Central Industrial Security Force, health-care workers, volunteers, and essential service workers have done a praiseworthy job under exceptionally hard conditions. Aim: The study aimed to investigate the awareness of COVID-19 among the frontline police workers who were posted during lockdown in our state. Materials and Methods: A questionnaire comprising 25 questions was randomly distributed among the police personnel who were on COVID-19 duty. The knowledge they had was assembled, assessed, and scrutinized. Results: A total of 150 police officers took part in the study. Mean age of 39.91 ± 9.96 years was seen. The majority of them had enough knowledge about the ongoing pandemic and they were seen to be taking good precautions to fight the virus. Conclusion: The joint effort of public and the frontline workers was the mainstream reason to bring our country back on track. Police had put their best efforts into controlling the spread of this contagion by maintaining a strict lockdown. They did immensely well and we as citizens should be grateful to them for protecting us from this pandemic.

Abstract Introduction Head and neck malignancy treatment often involves invasive surgeries, necessitating effective postoperative pain control. However, chronic reliance on opioid medications remains a challenge for many patients after surgery. Multimodal analgesia (MMA) within enhanced recovery after surgery protocols has shown success in limiting narcotic pain medications for other cancer types. In a prior study, MMA comprising acetaminophen, ketorolac, gabapentin, and a neurogenic block reduced opioid use in the 7‐day postoperative period for major head and neck reconstructive surgery. This study investigates the impact of multimodal analgesia on opioid prescription and pain during the 6‐week postoperative period for patients undergoing major head and neck oncologic surgeries, aiming to understand the longer‐term effects of narcotic use. Methods The study retrospectively examined participants in a [hybrid type 1 effectiveness‐implementation pragmatic trial to assess multimodal analgesia's long‐term effectiveness in head and neck free flap surgery. Arm A received scheduled acetaminophen and as‐needed opioids, while Arm B received scheduled gabapentin, ketorolac, a regional nerve block at the donor site, scheduled acetaminophen, and as‐needed opioids. Retrospective data collection included opioid prescription use and pain scores up to 6 weeks after surgery, gathered from the Kansas prescription drug monitoring program, K‐TRACS. Results Thirty patients participated, 14 in Arm A and 16 in Arm B. The average morphine milligram equivalents per day of filled prescriptions were not significantly different between Arm A and Arm B (7.23 vs. 7.88, p = .845). Additionally, average pain scores at 6 weeks showed no significant difference between the two groups (1.4 vs. 1.9, p = .612). Conclusion Patients with head and neck cancer treated with multimodal analgesia during the perioperative period did not exhibit significant differences in opioid use and pain within 6 weeks after discharge. To confirm these findings, a re‐examination with strict measures of opioid use and scheduled pain assessments in a prospective manner is warranted. Level of Evidence 4.

Abstract Objectives To provide a comprehensive summary of the different modalities available to measure soft tissue fibrosis after radiotherapy in head and neck cancer patients. Data Sources PubMed, Scopus, and Web of Sciences. Review Methods A search was conducted using a list of medical subject headings and terms related to head and neck oncology, radiation fibrosis, and quantitative measurements, including bioimpedance, MRI, and ultrasound. Original research related to quantitative measurement of neck fibrosis post‐radiotherapy was included without time constraints, while reviews, case reports, non‐English texts, and inaccessible studies were excluded. Discrepancies during the review were resolved by discussing with the senior author until consensus was reached. Results A total of 284 articles were identified and underwent title and abstract screening. Seventeen articles had met our criteria for full‐text review based on relevance, of which nine had met our inclusion criteria. Young's modulus (YM) and viscoelasticity measures have demonstrated efficacy in quantifying neck fibrosis, with fibrotic tissues displaying significantly higher YM values and altered viscoelastic properties such as increased stiffness rate‐sensitivity and prolonged stress‐relaxation post‐radiation. Intravoxel incoherent motion offers detailed insights into tissue changes by assessing the diffusion of water molecules and blood perfusion, thereby differentiating fibrosed from healthy tissues. Shear wave elastography has proven to be an effective technique for quantifying radiation‐induced fibrosis in the head and neck region by measuring shear wave velocity. Conclusion There are various modalities to measure radiation‐induced fibrosis, each with its unique strengths and limitations. Providers should be aware of these implications and decide on methodologies based on their specific clinical workflow. Level of Evidence Step 5.

Background Intratumorally delivered immunotherapies have the potential to favorably alter the local tumor microenvironment and may stimulate systemic host immunity, offering an alternative or adjunct to other local and systemic treatments. Despite their potential, these therapies have had limited success in late-phase trials for advanced cancer resulting in few formal approvals. The Society for Immunotherapy of Cancer (SITC) convened a panel of experts to determine how to design clinical trials with the greatest chance of demonstrating the benefits of intratumoral immunotherapy for patients with cancers across all stages of pathogenesis.Methods An Intratumoral Immunotherapy Clinical Trials Expert Panel composed of international key stakeholders from academia and industry was assembled. A multiple choice/free response survey was distributed to the panel, and the results of this survey were discussed during a half-day consensus meeting. Key discussion points are summarized in the following manuscript.Results The panel determined unique clinical trial designs tailored to different stages of cancer development—from premalignant to unresectable/metastatic—that can maximize the chance of capturing the effect of intratumoral immunotherapies. Design elements discussed included study type, patient stratification and exclusion criteria, indications of randomization, study arm determination, endpoints, biological sample collection, and response assessment with biomarkers and imaging. Populations to prioritize for the study of intratumoral immunotherapy, including stage, type of cancer and line of treatment, were also discussed along with common barriers to the development of these local treatments.Conclusions The SITC Intratumoral Immunotherapy Clinical Trials Expert Panel has identified key considerations for the design and implementation of studies that have the greatest potential to capture the effect of intratumorally delivered immunotherapies. With more effective and standardized trial designs, the potential of intratumoral immunotherapy can be realized and lead to regulatory approvals that will extend the benefit of these local treatments to the patients who need them the most.

This research paper presents a comprehensive analysis of a newly designed Gravitational Water Vortex Power Plant (GWVHP), utilizing both Computational Fluid Dynamics (CFD) simulations and experimental studies to assess its performance characteristics. The GWVHP was developed using Finite Element Analysis (FEA) simulations, incorporating components such as a water pump, primary water tank, secondary collection tank, channel, and rotor blades. Focusing on the crucial interplay between flow rate, torque, and efficiency, key factors in evaluating renewable energy systems, the study reveals notable findings. Simulation results showcase the plant achieving a peak torque of 6 at a flow rate of 2 m3/min, with experimental results closely trailing at 5.7 under identical conditions. Similarly, the simulation and experimental data both indicate maximum efficiencies of 58 % and 56 %, respectively, at the same flow rate. The novelty lies in the comparative analysis of simulation and experimental outcomes, exposing slight deviations attributed to factors such as modeling uncertainties and experimental setup variations. Addressing a critical gap in vortex basin and turbine optimization research, this paper introduces a novel approach by utilizing CFD analysis to experimentally validate the GWVHP's performance. Additionally, the study addresses the limitation of lab-scale models by simulating an actual-scale model, offering insights into scalability and reliability. The practical design of the GWVHP, tailored for real-site applications in small water bodies, enhances the applicability of the findings and contributes to advancing GWVHP technology for renewable energy. This multi-faceted approach underscores the potential of GWVHPs for practical and scalable renewable energy solutions.

The Budd-Chiari Syndrome (BCS) is associated with hepatic venous outflow obstruction. A 22-year-old female patient presented withabdominal pain and backache for 12 days, along with generalised weakness. Physical examination revealed pitting pedal oedema and abdominal distension. An abdominal ultrasound with Doppler Ultrasonography (USG) was performed, revealing liver parenchymal disease with gross ascites and occlusion of all three Hepatic Veins (HV), suggestive of BCS. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of the liver, as well as a right hepatic venogram using Digital Subtraction Angiography (DSA), showed chronic total occlusion at the ostium. An Accessory Hepatic Vein (AHV) was identified, joining the Right Hepatic Vein (RHV) to the Inferior Vena Cava (IVC). The accessory RHV exhibited high-grade stenosis (approximately 90-95%) at its junction with the IVC. Recanalisation of the AHV (balloon dilatation/stent insertion) was performed. Post-procedure accessory hepatic venogram showed a patent stented segment with a significant reduction in adjacent venous collaterals. No procedure-related complications were observed. The present case highlights the importance of AHV stenting in BCS patients, as it helps maintain normal physiology, in contrast to Direct Intrahepatic Porto-systemic Shunt (DIPS), which alters normal physiology by allowing portal venous blood to mix directly into the systemic circulation, bypassing the liver parenchyma.

Abstract Troponin is the American College of Cardiology and American Heart Association preferred biomarker for diagnosing acute myocardial infarction (MI). We provide a modeling framework for high sensitivity cardiac Troponin I (hs-cTnI) detection in chromatographic immunoassays (flow displacement mode) with an analytical limit of detection, i.e., LOD

Abstract To examine the size of the ciliary body stroma (CBS) in dependence of the morphology of the anterior chamber angle in enucleated human eyes, we histomorphometrically examined human enucleated eyes. The study included 107 eyes (with a mean axial length of 25.1 ± 2.8 mm (range 21.0–36.0 mm). The anterior chamber angle was open in 68 eyes and it was closed and endothelialized in 39 eyes. The maximal CBS width (541 ± 210 µm versus 59 ± 179 µm; P

Abstract Background Opioid overdose death rates are increasing for adults aged 55 and older, with especially high rates in large urban areas. In parallel, admissions to treatment programs for older adults using illicit substances are increasing as well. Despite these trends, there is a lack of information about older adults who use non-medical opioids (NMO) and even less knowledge about their health and service encounters. Conducted in Chicago, Illinois, this qualitative study explores the perspectives of health care and harm reduction service providers who work with older adults using non-medical opioids. Methods The study used snowball sampling to locate participants with expertise in working with older adults who use non-medical opioids. In total, we conducted 26 semi-structured interviews from September 2021-August 2022. We explored questions regarding participants’ perceptions of older adult opioid use patterns, comorbidities, and involvement in harm reduction outreach and opioid use disorder treatment. Results Many of the providers we interviewed consider older adults who use NMO as a distinct population that employ unique use behaviors with the intent to protect them from opioid overdose. However, these same unique behaviors may potentiate their risk for overdose in today’s climate. Providers report initial encounters that are not care seeking for opioid use and primarily oriented around health conditions. Older adults who use non-medical opioids are seen as complex patients due to the need to diagnostically untangle symptoms of substance use from co-morbidities and conditions associated with aging. Treatment for this population is also viewed as complicated due to the interactions between aging, comorbidities, and substance use. Providers also noted that older adults who use NMO have use behaviors that make them less visible to outreach and treatment service providers, potentially putting them at increased risk for overdose and health conditions associated with opioid use. Conclusions Findings from this study are intended to inform future research on care provision for older adults who use non-medical opioids and may be especially applicable to large urban reas with histories of opioid use dating back to earlier drug epidemics of the 1970s, 1980s, and 1990s.

Abstract Background This study aims to investigate the association between bony morphological features and ACL injury and to identify potential risk factors for the identification and prevention of ACL injuries. The study used knee MRIs to examine the distal femoral and proximal tibia morphology of 500 patients aged 19–50, including 250 cases with an injured ACL and 250 controls with a non-injured ACL. Previous literature has shown that ACL injuries are a common occurrence in sports and can have serious long-term consequences. Several risk factors have been identified, including anatomical variations in the bony structures of the knee. However, the relationship between bony morphology and ACL injury is not well understood, and there is a need to investigate the potential role of these factors in the identification and prevention of ACL injuries. This study was necessary because of the high incidence of ACL injuries and the potential long-term consequences, such as osteoarthritis, associated with this injury. By identifying potential risk factors, such as bony morphological features, it may be possible to develop targeted prevention strategies to reduce the incidence of ACL injuries. The study also adds to the existing literature by providing new insights into the relationship between bony morphology and ACL injury, and by identifying specific parameters that can be used to predict ACL injury. Results There was a significant difference in bony morphology between ACL-injured and non-injured patients. The most convincing parameters of femur and tibia were notch width index (NWI), medial tibial plateau depth (MTPD), and lateral tibial plateau slope (LTPS). A significantly smaller intercondylar notch was seen in the injured patients (mean 17.25 mm) than in controls (mean 18.41 mm) (p

The autonomic nervous system plays an integral role in motion and sensation as well as the physiologic function of visceral organs. The nervous system additionally plays a key role in primary liver diseases. Until recently, however, the impact of nerves on cancer development, progression, and metastasis has been unappreciated. This review highlights recent advances in understanding neuroanatomical networks within solid organs and their mechanistic influence on organ function, specifically in the liver and liver cancer. We discuss the interaction between the autonomic nervous system, including sympathetic and parasympathetic nerves, and the liver. We also examine how sympathetic innervation affects metabolic functions and diseases like nonalcoholic fatty liver disease (NAFLD). We also delve into the neurobiology of the liver, the interplay between cancer and nerves, and the neural regulation of the immune response. We emphasize the influence of the neuroimmune axis in cancer progression and the potential of targeted interventions like neurolysis to improve cancer treatment outcomes, especially for hepatocellular carcinoma (HCC).

Systemically administered immunotherapies have revolutionized the care of patients with cancer; however, for many cancer types, most patients do not exhibit objective responses. Intratumoral immunotherapy is a burgeoning strategy that is designed to boost the effectiveness of cancer immunotherapies across the spectrum of malignancies. By locally administering immune-activating therapies into the tumor itself, immunosuppressive barriers in the tumor microenvironment can be broken. Moreover, therapies too potent for systemic delivery can be safely administered to target location to maximize efficacy and minimize toxicity. In order for these therapies to be effective, though, they must be effectively delivered into the target tumor lesion. In this review, we summarize the current landscape of intratumoral immunotherapies and highlight key concepts that influence intratumoral delivery, and by extension, efficacy. We also provide an overview of the breadth and depth of approved minimally invasive delivery devices that can be considered to improve delivery of intratumoral therapies.

Abstract Black carbon (BC) plays an important role in the climate system because of its strong warming effect, yet the magnitude of this effect is highly uncertain owing to the complex mixing state of aerosols. Here we build a unified theoretical framework to describe BC’s mixing states, linking dynamic processes to BC coating thickness distribution, and show its self-similarity for sites in diverse environments. The size distribution of BC-containing particles is found to follow a universal law and is independent of BC core size. A new mixing state module is established based on this finding and successfully applied in global and regional models, which increases the accuracy of aerosol climate effect estimations. Our theoretical framework links observations with model simulations in both mixing state description and light absorption quantification.

Introduction: Police personnel perform untiring duties to maintain law and order. The objectives of this study were to assess the physical and mental health status of police personnel in a selected rural subdivision of Bengaluru District. Methods: A cross-sectional study was conducted among 142 police personnel in 7 police stations of the selected rural subdivision using a universal sampling technique. A structured interview schedule was used, which included socio-demographic details, occupational details, anthropometry, blood pressure and blood sugar measurements, Patient Health Questionnaire-9 (PHQ-9) to screen for depression and Perceived Stress Scale (PSS) to identify stress. Results: The mean age of the police personnel was 40.28±10.97 years. Most of the workforce were males (83%). About 68.3% of the studied group were obese. High random blood sugar and high blood pressure values were observed in 5.6% and 48.6% of the personnel who had no previous history of diabetes mellitus and hypertension. The prevalence of mild to severe depression was found to be 36% and that of high stress was 83.1%. Conclusion: The high prevalence of increased blood pressure, obesity, depression and perceived stress warrants the need for routine screening and application of various levels of prevention. Health promotion and improved working conditions can improve their health status.

ObjectiveTo establish whether or not a natural language processing technique could identify two common inpatient neurosurgical comorbidities using only text reports of inpatient head imaging.Materials and methodsA training and testing dataset of reports of 979 CT or MRI scans of the brain for patients admitted to the neurosurgery service of a single hospital in June 2021 or to the Emergency Department between July 1-8, 2021, was identified. A variety of machine learning and deep learning algorithms utilizing natural language processing were trained on the training set (84% of the total cohort) and tested on the remaining images. A subset comparison cohort (n = 76) was then assessed to compare output of the best algorithm against real-life inpatient documentation.ResultsFor "brain compression", a random forest classifier outperformed other candidate algorithms with an accuracy of 0.81 and area under the curve of 0.90 in the testing dataset. For "brain edema", a random forest classifier again outperformed other candidate algorithms with an accuracy of 0.92 and AUC of 0.94 in the testing dataset. In the provider comparison dataset, for "brain compression," the random forest algorithm demonstrated better accuracy (0.76 vs 0.70) and sensitivity (0.73 vs 0.43) than provider documentation. For "brain edema," the algorithm again demonstrated better accuracy (0.92 vs 0.84) and AUC (0.45 vs 0.09) than provider documentation.DiscussionA natural language processing-based machine learning algorithm can reliably and reproducibly identify selected common neurosurgical comorbidities from radiology reports.ConclusionThis result may justify the use of machine learning-based decision support to augment provider documentation.

The emergence of numerous pandemics and microbial resistance has necessitated the development of novel heterocyclic compounds with potent biological effects. Five new (E)-2-((5-(1H-benzo[d]imidazol-1-yl)-3-methyl-1-phenyl-1H-pyrazol-4-yl)methylene)hydrazineyl)-4-(aryl)thiazole derivatives (9a-e) were synthesized through a one pot multicomponent reaction involving 5-(1H-benzo[d]imidazol-1-yl)-3-methyl-1-phenyl-1H-pyrazole-4-carbaldehyde, thiosemicabazide and various substituted phenacyl bromides. FT-IR, 1H NMR, and 13C NMR spectroscopic techniques were used to characterize the newly synthesized benzimidazole-pyrazole clubbed thiazole hybrids. The synthesized compounds were screened for antibacterial activity against E. coli, B. subtilis, B. megaterium, and S. aureus and antifungal activity against A. niger, A. oryzae, Rhizophus spp., and C. albicans. All newly synthesized compounds exhibited potent antibacterial action against all tested strains. Besides, % radical scavenging activity was also evaluated and results showed good antioxidant potential of the synthesized compounds. The cytotoxicity study revealed that synthesized compounds has no to less toxicity as compared to standard Triton X 100. Molecular docking simulations against DNA gyrase (PDB: 4URO) revealed binding interactions and MESP plots confirmed the binding locations.

La coccidiose aviaire est l'un des défis les plus importants et les plus persistants auxquels est confrontée l'industrie avicole mondiale, entraînant une baisse de productivité due aux dommages intestinaux causés par le protozoaire apicomplexe intracellulaire Eimeria. Le cycle de vie d'Eimeria est complexe, caractérisé par des stades intra- et extracellulaires. Le stade intracellulaire induit une réponse inflammatoire en partie responsable de la formation de lésions tissulaires, des hémorragies diarrhéiques, une mauvaise croissance, une sensibilité accrue à d'autres agents pathogènes et, dans certains cas sévères (E. tenella et E. necatrix), une forte mortalité. Une bonne gestion sanitaire est indispensable pour prévenir la coccidiose chez les poulets. L'administration d'anticoccidiens dans les aliments peut également réduire efficacement l’intensité de l’infection par Eimeria. Cependant, leur utilisation à grande échelle et sur une longue durée a entraîné le développement de résistances à ces additifs dans le monde entier. Des vaccins vivants non atténués et atténués ont été développés mais ils présentent certaines limites. En plus des méthodes conventionnelles de prévention et de contrôle, les produits phytogéniques émergent comme alternative pour contrôler la coccidiose aviaire. Les recherches en cours sur la sélection génétique et des vaccins recombinants et sous-unitaires sont prometteuses pour la prévention, mais leur efficacité et leur adoption dans l'industrie avicole restent à démontrer. De plus, comme alternatives aux coccidiostatiques, des stratégies utilisant des extraits naturels sont plus acceptées par les consommateurs et sont de plus en plus étudiées. Cet article présente donc une vue d'ensemble de l'impact économique de la coccidiose chez les poulets sur la production et aborde les stratégies intégrées de la santé pour contrôler la coccidiose chez les poulets.

AbstractPlatelets contribute to COVID-19 clinical manifestations, of which microclotting in the pulmonary vasculature has been a prominent symptom. To investigate the potential diagnostic contributions of overall platelet morphology and their α-granules and mitochondria to the understanding of platelet hyperactivation and micro-clotting, we undertook a 3D ultrastructural approach. Because differences might be small, we used the high-contrast, high-resolution technique of focused ion beam scanning EM (FIB-SEM) and employed deep learning computational methods to evaluate nearly 600 individual platelets and 30 000 included organelles within three healthy controls and three severely ill COVID-19 patients. Statistical analysis reveals that the α-granule/mitochondrion-to-plateletvolume ratio is significantly greater in COVID-19 patient platelets indicating a denser packing of organelles, and a more compact platelet. The COVID-19 patient platelets were significantly smaller –by 35% in volume – with most of the difference in organelle packing density being due to decreased platelet size. There was little to no 3D ultrastructural evidence for differential activation of the platelets from COVID-19 patients. Though limited by sample size, our studies suggest that factors outside of the platelets themselves are likely responsible for COVID-19 complications. Our studies show how deep learning 3D methodology can become the gold standard for 3D ultrastructural studies of platelets.

Renal angiomyolipoma is classified as a benign tumour comprising fat, smooth muscle cells, and vascular tissue. Renal giant angiomyolipoma with rupture is a relatively rare clinical emergency condition. Here, the authors present a case of a 37-year-old female patient who presented with complaints of right flank pain for six hours. The patient was anaemic and did not have haematuria. On non contrast Computed Tomography (CT) imaging, there was a right perirenal haematoma with a mixed-density, fat-containing tumour in the upper interpolar region of the right kidney. On Contrast-Enhanced Computed Tomography (CECT) imaging, the right renal tumour showed multiple abnormal tortuous vessels with moderate to intense enhancement, consistent with a large angiomyolipoma. She was managed with primary therapeutic endovascular embolisation for a ruptured right renal angiomyolipoma under local anaesthesia via a right transfemoral artery approach. The procedure was uneventful, and postembolisation syndrome was managed with medications. The patient was discharged in a stable condition. During the one-month follow-up, the patient’s symptoms improved, and the need for major surgery like nephrectomy was avoided. Super selective embolisation to devascularise the tumour and preserve renal parenchyma was done under local anaesthesia via a right transfemoral approach without any complications. Postembolisation syndrome was managed medically.

Abstract A series of epidemiological studies have shown the limited life expectancy of patients suffering from idiopathic normal pressure hydrocephalus (iNPH). In most cases, comorbid medical conditions are the cause of death, rather than iNPH. Though it has also been shown that shunting improves both life quality and lifetime. We sought to investigate the utility of the Charlson comorbidity index (CCI) for improved preoperative risk–benefit assessment of shunt surgery in individual iNPH cases. 208 shunted iNPH cases were prospectively investigated. Two in-person follow up visits at 3 and 12 months assessed postoperative clinical status. The correlation of the age adjusted CCI with survival was investigated over the median observation time of 2.37 years (IQR 1.16–4.15). Kaplan Meier statistics revealed that patients with a CCI score of 0–5 have a 5-year survival rate of 87%, compared to only 55% in patients with CCI > 5. Cox multivariate statistics revealed that the CCI was an independent predictor of survival, while common preoperative iNPH scores (modified Rankin Scale (mRS), gait score, and continence score) are not. As expected, mRS, gait, and continence scores improved during the postoperative follow up period, though relative improvement on any of these was not predicted by baseline CCI. The CCI is an easily applicable preoperative predictor of survival time in shunted iNPH patients. The lack of a correlation between the CCI and functional outcome means that even patients with multiple comorbidities and limited remaining lifetime may appreciate benefit from shunt surgery.

Mobile networks of the fifth generation have stringent requirements for data throughput, latency and reliability. Dual or multi-connectivity is implemented to meet the mobility requirements for certain essential 5G use cases, and this ensures the user’s connection to one or more radio links. Packet duplication (PD) over multi-connectivity is a method of compensating for lost packets by reducing re-transmissions on the same erroneous wireless channel. Utilizing two or more uncorrelated links, a high degree of availability can be attained with this strategy. However, complete packet duplication is inefficient and frequently unnecessary. The wireless channel conditions can change frequently and not allow for a PD. We provide a novel adaptive fractional packet duplication (A-FPD) mechanism for enabling and disabling packet duplication based on a variety of parameters. The signal-to-interference-plus-noise ratio (SINR) and fade duration outage probability (FDOP) are important performance indicators for wireless networks and are used to evaluate and contrast several packet duplication scenarios. Using ns-3 and MATLAB, we present our simulation results for the multi-connectivity and proposed A-FPD schemes. Our technique merely duplicates enough packets across multiple connections to meet the outage criteria.

Abstract Geogenic fluoride contaminates the water of tens of millions of people. However, many are unaware of the fluoride content due in part to shortcomings of detection methods. Biosensor tests are a relatively new approach to water quality testing that address many of these shortcomings but have never been tested by non-experts in a “real-world” setting. We therefore sought to assess the accuracy and usability of a point-of-use fluoride biosensor using surveys and field tests in Nakuru County, Kenya. Biosensor tests accurately classified elevated fluoride (≥1.5 ppm) in 89.5% of the 57 samples tested. Usability was also high; all participants were able to use the test and correctly interpreted all but one sample. These data suggest that biosensor tests can provide accurate, meaningful water quality data that help non-experts make decisions about the water they consume. Further scaling of these technologies could provide new approaches to track global progress towards Sustainable Development Goal 6.

Aims: Headache is a common presenting complaint of ophthalmic patients, but it is also a symptom of a wide range of systemic problems some of which are life threatening while others benign. This study aimed to detect the common ocular causes of headache in patients visiting the eye outpatient department (OPD). Settings and Design: This was a cross-sectional, observational study of one year duration conducted in a tertiary care center. Materials and Methods: Demographic data and a detailed history was collected from 395 patients complaining of headache and attending the eye OPD, followed by a detailed ocular examination including visual acuity, refraction, intraocular pressure, slit-lamp examination, and fundus. Statistical Analysis: The data was analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21. Frequencies and percentages were calculated. A P value of

The Case Study describes the clinical radiographic Surgical Procedure with reconstruction and histopathology Infantile fibromatosis of infratemporal fossa extending to oral cavity and Oropharynx in a two-year-old male child. This condition is rarer in two-year-old child mainly in infratemporal fossa extending to Oropharynx and protruding into oral cavity leading to tremendous suffering of the child for breast feeding, eating with occasional profuse bleeding. The differential diagnosis, management and long term follow up for two years are also mentioned. The need for aggressive surgical management, rare site and operability in this region is very rarer of rarest. The absence of recurrence after 2 years follow up is significant and we can declare the patient is cured from the primary disease. This paper gives guide to how to approach the disease process.

Abstract A long‐term goal of breeders and researchers is to develop crop varieties that can resist environmental stressors and produce high yields. However, prioritising yield often compromises improvement of other key traits, including grain quality, which is tedious and time‐consuming to measure because of the frequent involvement of destructive phenotyping methods. Recently, non‐destructive methods such as hyperspectral imaging (HSI) have gained attention in the food industry for studying wheat grain quality. HSI can quantify variations in individual grains, helping to differentiate high‐quality grains from those of low quality. In this review, we discuss the reduction of wheat genetic diversity underlying grain quality traits due to modern breeding, key traits for grain quality, traditional methods for studying grain quality and the application of HSI to study grain quality traits in wheat and its scope in breeding. Our critical review of literature on wheat domestication, grain quality traits and innovative technology introduces approaches that could help improve grain quality in wheat.

Natural killer (NK) cells are one of the most important effector T -lymphocytes having antitumor effect. Only a few studies are present in the literature, correlating the expression of cluster of differentiation 57 (CD-57) in NK cells in oral squamous cell carcinoma (OSCC). To analyze the effect of the presence of NK cells in the stroma of OSCC and their effect on the tumor progression and prognosis. A retrospective study was performed over 122 OSCC patients who had undergone surgical treatment between 2014 and 16. Wax blocks were obtained and subjected to immunohistochemical (IHC) analysis for CD-57 expression. Patients were followed up for 3 years and 100 cases were finally included in the study and divided into three groups. The association between variable were studied through the Chi-square test, Kruskal–Wallis test, and Mann–Whitney U test. A total of 91% of cases showed positive staining for CD-57. Maximum positive expression (96.6%) was observed in the patients who were alive and without recurrence (Group-II) as compared to dead patients (Group-I) and in well-differentiated squamous cell carcinoma (WDSCC) cases (96.8%) than in poorly differentiated cases. Also, the mean CD-57 positive cells count was found to be highest in Group-II and WDSCC cases. A significant correlation was observed between CD-57 expression and patients' health status. As the expression of CD-57 increased in the tumor stroma of OSCC, the chances for the patient to be alive were increased; therefore, it may serve as a good prognostic marker.

Abstract Background Multispectral fluorescence imaging coupled with linear unmixing is a form of image data collection and analysis that allows for measuring multiple molecular signals in a single biological sample. Multiple fluorescent dyes, each measuring a unique molecule, are simultaneously measured and subsequently “unmixed” to provide a read-out for each molecular signal. This strategy allows for measuring highly multiplexed signals in a single data capture session, such as multiple proteins or RNAs in tissue slices or cultured cells, but can often result in mixed signals and bleed-through problems across dyes. Existing spectral unmixing algorithms are not optimized for challenging biological specimens such as post-mortem human brain tissue, and often require manual intervention to extract spectral signatures. We therefore developed an intuitive, automated, and flexible package called SUFI: spectral unmixing of fluorescent images. Results This package unmixes multispectral fluorescence images by automating the extraction of spectral signatures using vertex component analysis, and then performs one of three unmixing algorithms derived from remote sensing. We evaluate these remote sensing algorithms’ performances on four unique biological datasets and compare the results to unmixing results obtained using ZEN Black software (Zeiss). We lastly integrate our unmixing pipeline into the computational tool dotdotdot, which is used to quantify individual RNA transcripts at single cell resolution in intact tissues and perform differential expression analysis, and thereby provide an end-to-end solution for multispectral fluorescence image analysis and quantification. Conclusions In summary, we provide a robust, automated pipeline to assist biologists with improved spectral unmixing of multispectral fluorescence images.

Abstract The purpose of the study was to examine peculiarities of the inner limiting membrane (ILM) in axially elongated eyes. The histomorphometric study included human globes enucleated due to reasons such as painful secondary angle-closure glaucoma or malignant uveal melanomas. Using light microscopy, we searched for regions with ILM-specific features in association with a marked axial elongation. Out of 279 eyes (279 patients) (mean age: 61.8 ± 13.9 years; axial length: 25.5 ± 3.1 mm (range: 20.0–37.0 mm)), two eyes (axial length: 30 mm and 34 mm, respectively) showed one region and two regions, respectively, characterized by ILM presence and absence of all other retinal layers, retinal pigment epithelium, Bruch´s membrane (BM) and choroid. The length of these regions, called ILM-bridges, was 1.06 mm, 0.73 mm, and 0.62 mm, respectively. All ILM-bridges were spatially associated with a larger, underlying BM defect and with localized scleral thinning without a staphylomatous scleral configuration. The distance between the ILM-bridges and the optic disc ranged between 1.92 mm and 4.21 mm. In univariable analysis, ILM-bridge number increased with longer axial length (beta: 0.19; P = 0.002) and higher BM defect prevalence (beta: 0.21; P = 0.001), while in multivariable analysis, the ILM-bridges number remained to be significantly correlated only with a higher prevalence of BM defect (beta: 0.15; P = 0.048). ILM-bridges occur in eyes with pathologic myopia in spatial association with underlying, larger BM defects. They may be due to an axial elongation-associated local stretching and rupture of all other retinal layers, caused by the BM defect-related enlargement of the retinal undersurface. Future studies may explore whether these histologic observations support the notion of the ILM having a relatively high biomechanical strength against myopic stretching-associated forces.

Abstract The purpose of the study was to examine the density of retinal photoreceptors and retinal pigment epithelium (RPE) cells in relation to myopic axial elongation in human eyes. Using light microscopy, we assessed the density of photoreceptors and RPE cells at the ora serrata, equator, and midperiphery (equator/posterior pole midpoint), and the RPE cell density additionally at the posterior pole, in enucleated human globes. The study included 78 eyes (mean age: 59.2 ± 15.6 years; range: 32–85 years) with a mean axial length of 27.3 ± 3.6 mm (range: 21.5–37.0 mm). Close to the ora serrata, at the equator and midperiphery, photoreceptor and RPE cell density was 246 ± 183, 605 ± 299 and 1089 ± 441 photoreceptors/mm and 56.1 ± 13.7, 45.2 ± 15.1, and 48.8 ± 15.6 RPE cells/mm, respectively. Densities of both cell types in all three regions were positively correlated with each other (all P

Electrochemical oxidation/reduction of radicals is a green and environmentally friendly approach to generating fuels. These reactions, however, suffer from sluggish kinetics due to a low local concentration of radicals around the electrocatalyst. A large applied electrode potential can enhance the fuel generation efficiency via enhancing the radical concentration around the electrocatalyst sites, but this comes at the cost of electricity. Here, we report about a ~45% saving in energy to achieve an electrochemical hydrogen generation rate of 3×1016 molecules cm–2s–1 (current density: 10 mA/cm2) through localized electric field-induced enhancement in the reagent concentration (LEFIRC) at laser-induced periodic surface structured (LIPSS) electrodes. The finite element model is used to simulate the spatial distribution of the electric field to understand the effects of LIPSS geometric parameters in field localization. When the LIPSS patterned electrodes are used as substrates to support Pt/C and RuO2 electrocatalysts, the η10 overpotentials for HER and OER are decreased by 40.4 and 25%, respectively. Moreover, the capability of the LIPSS-patterned electrodes to operate at significantly reduced energy is also demonstrated in a range of electrolytes, including alkaline, acidic, neutral, and seawater. Importantly, when two LIPSS patterned electrodes were assembled as the anode and cathode into a cell, it requires 330 mVs of lower electric potential with enhanced stability over a similar cell made of pristine electrodes to drive a current density of 10 mA/cm2. This work demonstrates a physical and versatile approach of electrode surface patterning to boost electrocatalytic fuel generation performance and can be applied to any metal and semiconductor catalysts for a range of electrochemical reactions.

Abstract Classification of different cancer types is an essential step in designing a decision support model for early cancer predictions. Using various machine learning (ML) techniques with ensemble learning is one such method used for classifications. In the present study, various ML algorithms were explored on twenty exome datasets, belonging to 5 cancer types. Initially, a data clean-up was carried out on 4181 variants of cancer with 88 features, and a derivative dataset was obtained using natural language processing and probabilistic distribution. An exploratory dataset analysis using principal component analysis was then performed in 1 and 2D axes to reduce the high-dimensionality of the data. To significantly reduce the imbalance in the derivative dataset, oversampling was carried out using SMOTE. Further, classification algorithms such as K-nearest neighbour and support vector machine were used initially on the oversampled dataset. A 4-layer artificial neural network model with 1D batch normalization was also designed to improve the model accuracy. Ensemble ML techniques such as bagging along with using KNN, SVM and MLPs as base classifiers to improve the weighted average performance metrics of the model. However, due to small sample size, model improvement was challenging. Therefore, a novel method to augment the sample size using generative adversarial network (GAN) and triplet based variational auto encoder (TVAE) was employed that reconstructed the features and labels generating the data. The results showed that from initial scrutiny, KNN showed a weighted average of 0.74 and SVM 0.76. Oversampling ensured that the accuracy of the derivative dataset improved significantly and the ensemble classifier augmented the accuracy to 82.91%, when the data was divided into 70:15:15 ratio (training, test and holdout datasets). The overall evaluation metric value when GAN and TVAE increased the sample size was found to be 0.92 with an overall comparison model of 0.66. Therefore, the present study designed an effective model for classifying cancers which when implemented to real world samples, will play a major role in early cancer diagnosis.

Lineage plasticity is increasingly recognized as an emergent resistance mechanism after treatment with androgen receptor signalling inhibitors. To understand determinants of resistance, the authors analyzed the transcriptomes of patient tumor biopsies before enzalutamide treatment and at progression and identified a gene expression program associated with lineage plasticity risk and poor outcomes.