Search

Abstract The utilization of switched inductors, involving parallel charging and series discharging of inductors, is extensively embraced in diverse DC–DC converters for attaining high voltage gain; nevertheless, the stress on switch voltage and diode current escalates considerably with an increased count of inductors integrated into the switched inductors network. In the classical multistage switched inductor converter, the switch voltage aligns with the output voltage, and the diode experiences a high current as the number of stages increases. This research recommends a DC–DC multistage converter for energy conversion and high voltage gain with low stress. In this paper, a novel multistage switched inductor converter is introduced and designed to attain higher voltage gain while mitigating the stresses on switch voltage and diode current. The proposed circuit is created by replacing the standard multistage switched inductor converter's possible diodes with power switches. All of the switching devices are connected in such a way that the output voltage and input current are shared by all of the switches and diodes, respectively. As a consequence, the voltage stress on switches and the current stress on diodes are comparatively low, resulting in a high efficiency compared to a typical multistage switched inductor converter. It's interesting to note that the proposed converter and a typical multistage switched inductor converter both require the same amount of components. Different operation modes, analysis, a non‐ideal model, and a comparison of the suggested and recently constructed converters are discussed. The effectiveness and performance of the circuit are validated experimentally.

Esophageal cancer is a highly aggressive and deadly disease, ranking as the sixth leading cause of cancer-related deaths worldwide. Despite advances in treatment, the prognosis remains poor. A multidisciplinary approach is crucial for achieving complete remission, with treatment options varying based on disease stage. Surgical intervention and endoscopic treatment are used for localized cancer, while systemic treatments like chemoradiotherapy and targeted drug therapy play a crucial role. Molecular markers such as HER2 and EGFR can be targeted with drugs like trastuzumab and cetuximab, and immunotherapy drugs like pembrolizumab and nivolumab show promise by targeting immune checkpoint proteins. Epigenetic modifications offer new avenues for targeted therapy. Treatment selection depends on factors like stage, tumor location, and patient health, with post-operative and rehabilitation care being essential. Early diagnosis, appropriate treatment, and supportive care are key to improving outcomes. Continued research is needed to develop effective targeted drugs with minimal side effects. This review serves as a valuable resource for clinicians and researchers dedicated to enhancing esophageal cancer treatment outcomes.

Abstract A photovoltaic (PV) cell is the smallest unit in an array that exhibits nonlinear characteristic curves. To gather the maximum amount of energy from a PV array under partial shading conditions (PSCs), it is necessary to follow the largest peak in the power–voltage (P–V) curve. PV cells are partially or totally shaded due to atmospheric conditions, which show multiple peaks in the PV curve. To overcome the losses occurring due to PSCs, PV array reconfiguration action is advisable. The authors of this work proposed a novel 5×5 quad‐tied PV array configuration and compared its performance to that of other current configurations such as series‐parallel, total‐cross tied, and others in terms of global maximum power point tracking, mismatch loss, fill factor, and efficiency. The MATLAB/Simulink 2020a platform was used to generate PV array curves under various shading conditions.

Sickle cell disease (SCD) is a complex genetic disorder associated with multiple clinical manifestations, including increased susceptibility to bacterial and viral infections. This review article presents a comprehensive analysis of the current literature obtained from various online databases focusing on the relationship between SCD and infections caused by specific pathogens, such as pneumonia- and influenza-causing pathogens, Escherichia coli, Staphylococcus aureus, parvovirus, and hepatitis viruses. We discuss the underlying mechanisms that contribute to the increased susceptibility of individuals with SCD to these infections, primarily related to the pathophysiology of variant hemoglobin (HbSS) and its impact on vascular occlusion, hemolysis, functional asplenia, and immune deficiency. Moreover, we highlight the significant burden of infections on SCD patients, particularly children under five years of age, where they are the leading cause of morbidity and mortality. Additionally, we address the challenges faced in attempts for reducing the global mortality rate associated with SCD, particularly in low-income countries, where factors such as increased pathogen exposure, co-morbidities like malnutrition, lower vaccination rates, and limited healthcare facilities contribute to the high disease burden. This review emphasizes the need for targeted interventions, improved healthcare access, vaccination programs, and infection prevention strategies to alleviate the impact of infections on individuals with SCD and reduce the global mortality rates associated with the disease.

Lung cancer, characterized by its heterogeneity, presents a significant challenge in therapeutic management, primarily due to the development of resistance to conventional drugs. This resistance is often compounded by the tumor’s ability to reprogram its metabolic pathways, a survival strategy that enables cancer cells to thrive in adverse conditions. This review article explores the complex link between drug resistance and metabolic reprogramming in lung cancer, offering a detailed analysis of the molecular mechanisms and treatment strategies. It emphasizes the interplay between drug resistance and changes in metabolic pathways, crucial for developing effective lung cancer therapies. This review examines the impact of current treatments on metabolic pathways and the significance of considering metabolic factors to combat drug resistance. It highlights the different challenges and metabolic alterations in non-small-cell lung cancer and small-cell lung cancer, underlining the need for subtype-specific treatments. Key signaling pathways, including PI3K/AKT/mTOR, MAPK, and AMPK, have been discussed for their roles in promoting drug resistance and metabolic changes, alongside the complex regulatory networks involved. This review article evaluates emerging treatments targeting metabolism, such as metabolic inhibitors, dietary management, and combination therapies, assessing their potential and challenges. It concludes with insights into the role of precision medicine and metabolic biomarkers in crafting personalized lung cancer treatments, advocating for metabolic targeting as a promising approach to enhance treatment efficacy and overcome drug resistance. This review underscores ongoing advancements and hurdles in integrating metabolic considerations into lung cancer therapy strategies.

Esophageal cancer is a formidable challenge in the realm of cancer treatment. Conventional methods such as surgery, chemotherapy, and immunotherapy have demonstrated limited success rates in managing this disease. In response, targeted drug therapies have emerged as a promising strategy to improve outcomes for patients. These therapies aim to disrupt specific pathways involved in the growth and development of esophageal cancer cells. This review explores various drugs used to target specific pathways, including cetuximab and monoclonal antibodies (gefitinib) that target the epidermal growth factor receptor (EGFR), trastuzumab that targets human epidermal growth factor receptor 2 (HER-2), drugs targeting the vascular endothelial growth factor receptor (VEGFR), mTOR inhibitors, and cMET inhibitors. Additionally, the article discusses the impact of drug resistance on the effectiveness of these therapies, highlighting factors such as cancer stem cells, cancer-associated fibroblasts, immune-inflammatory cells, cytokines, hypoxia, and growth factors. While drug targeting approaches do not provide a complete cure for esophageal cancer due to drug resistance and associated side effects, they offer potential for improving patient survival rates.

Abstract Gram pod borer, Helicoverpa armigera (Hub.) is the major insect pest of pigeonpea and prediction of number of generations (no. of gen.) and generation time (gen. time) using growing degree days (GDD) approach during three future climate change periods viz., Near (NP), Distant (DP) and Far Distant (FDP) periods at eleven major pigeonpea growing locations of India was attempted. Multi-model ensemble of Maximum (Tmax) and Minimum (Tmin) temperature data of four Representative Concentration Pathways viz., RCP 2.6, 4.5, 6.0 and 8.5 of Coupled Model Inter comparison Project 5 (CMIP5) models was adopted here. The increase in projected Tmax and Tmin are significant during 3 climate change periods (CCPs) viz., the NP, DP and FDP over base line (BL) period under four RCP scenarios at all locations and would be higher (4.7–5.1 °C) in RCP 8.5 and in FDP. More number of annual (10–17) and seasonal (5–8) gens. are expected to occur with greater percent increase in FDP (8 to 38%) over base line followed by DP (7 to 22%) and NP (5to 10%) periods with shortened annual gen. time (4 to 27%) across 4 RCPs. The reduction of crop duration was substantial in short, medium and long duration pigeonpeas at all locations across 4 RCPs and 3 CCPs. The seasonal no.of gen. is expected to increase (5 to 35%) with shortened gen. time (4 to 26%) even with reduced crop duration across DP and FDP climate periods of 6.0 and 8.5 RCPs in LD pigeonpea. More no. of gen. of H. armigera with reduced gen. time are expected to occur at Ludhiana, Coimbatore, Mohanpur, Warangal and Akola locations over BL period in 4 RCPs when normal duration of pigeonpeas is considered. Geographical location (66 to 72%), climate period (11 to 19%), RCPs (5–7%) and their interaction (0.04–1%) is vital and together explained more than 90% of the total variation in future pest scenario. The findings indicate that the incidence of H. armigera would be higher on pigeonpea during ensuing CCPs in India under global warming context.

High thoracic epidural anesthesia in cardiac surgery as the sole anesthetic technique is used in a select groups of patients having severe pulmonary co morbidities. We describe a case series of three patients at high risk for post operative pulmonary complications where this technique was used along with dexmedetomidine infusion for conscious sedation in off pump coronary artery bypass grafting. Proper selection of patients, proper placement of the epidural catheter at the appropriate level and timing of catheter insertion and removal are of paramount importance.

Abstract Background COVID-19 infection has been linked with erectile dysfunction, which has also raised apprehensions about the impact of COVID-19 vaccination on male sexual functions. The purpose of this study was to investigate the impact of COVID-19 vaccination on male sexual functions, such as erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Methods We used International Index of Erectile Function (IIEF) questionnaire for data collection. Mixed methods were adopted for this study, which consisted of Google online form distribution and the distribution of hard copies of the form to those who were not internet friendly. All data were entered in a spreadsheet and scores were assigned to each response according to the standard scores given in the IIEF questionnaire. Fifteen questions, one corresponding to each question in the IIEF questionnaire, were included to assess the impact of COVID-19 vaccination on each sexual function. Results In the first part of analysis, we calculated sexual function scores and men reporting low sexual function scores (~ 15%) were excluded, providing us with 465 individuals for further analysis. Regarding the impact of COVID-19 vaccination on male sexual functions, 71% individuals reported no impact, 3% reported a decline, 2.7% reported an improvement, and 23.3% could not assess the impact. We also performed analysis on the basis of age-groups of the participants and the duration after vaccination, finding that there was no impact irrespective of the age of subjects or the length of period after vaccination. Conclusions COVID-19 vaccination does not affect male sexual functions, including erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction.

Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19), and its severity is linked to the adverse outcomes of multiorgan involvement. We attempted to assess the clinical outcomes and determinants of mortality in patients admitted to our COVID-19 care center from May to November 2020 who developed AKI through a retrospective examination of their case records. The data of those who developed AKI were analyzed for their clinical parameters, clinical presentation, history, laboratory parameters, urine output measurements, requirements for dialysis, treatment, and treatment outcomes (discharge or death). These outcomes were correlated to the comorbidities, laboratory parameters, the Kidney Disease Improving Global Outcomes (KDIGO) AKI stage, sequential organ failure assessment score, and need for dialysis or renal replacement therapy. Of 1890 patients admitted, 132 (6.98%) patients developed AKI. Of 450 deaths from all causes, 67 (14%) were in AKI patients. There were 100 (75.8%) males and 32 (24.8%) females. The mean age was 62.05 ± 11.48 years. The median duration of stay was 7 days (interquartile range: 4––11.75 days). The number of patients in AKI Stages 1, 2, and 3 was 1 (0.75%), 64 (48.48%), and 67 (50.75%), respectively. The most common symptoms were breathlessness (85.6%), fever (84.5%), myalgia (81.19%), and weakness (76.5%). Multivariate analysis showed that the determinants of mortality were a partial pressure of oxygen saturation (pO2) of 85%, not receiving remdesivir, and KDIGO Stage >2.

This paper proposes a new generalized switched-inductor-capacitor module for a non-isolated dc-dc converter with low voltage dc source applications. Further, the proposed module can be extended to an $n$ number of modules to achieve high voltage gain. The derived structure has low voltage stress on power components. This structure benefits the designer by allowing him/her to choose a low $r_{DS}$ (ON) switch due to the low voltage stress across the semiconductor devices, resulting in high efficiency and low cost. In most dc/dc converters, the voltage stress on the output diode will equal the output (high) voltage ( $V_{o}$ ). But in the case of the proposed topology, the diode voltage will be the difference between $V_{o}$ and the input voltage ( $V_{g}$ ), which eases the reverse recovery problem. The key metrics of the derived topology, such as component count, voltage stresses, and gain factor, are analyzed to compare with similar existing topologies. The scaled down prototype setup is developed for 200 W with an efficiency of 93%. Finally, various experimental results are discussed for the different duty cycles.

Introduction: In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India. Methods and Analysis: This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases. Discussion: Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.

Global climatic changes and increased carbon footprints provided the main impetus for the decrease in the use of fossil fuels for electricity generation and transportation. Matured manufacturing technologies of solar PV panels and on-shore and off-shore windmills have brought down the cost of generation of electricity using solar energy on par with conventional fossil fuel. Initially, solar and wind power generation was envisioned for microgrids, serving small local communities. However, advancements in power electronics have now facilitated large solar and wind farms to be integrated with main power grids. In this context, hosting capacity, which is the amount of distributed energy resources a grid can accommodate, without significant infrastructure up-gradation, has gained importance. In determining the hosting capacity at a particular location, the uncertainties of wind and solar power generation play a role. Effective forecasting models using time-series weather data can be built to predict wind and solar power generation. This forecast is essential to ensure proper grid operation and control when renewable energy sources are already installed. The forecast is also useful in the planning stages for investment decisions and distribution system planning. While long-term forecasts are rarely needed for the operation of integrated grids, accurate short-term predictive models are necessary for scheduling. This paper presents an extensive review of various forecast models available in the literature. The study mainly focuses on the short-term forecast, providing a critical review of the duration of data used in each model and a synoptic comparison of their performance indices.

The main aim of this paper is to introduce a framework for the design and modelling of a photovoltaic (PV)-wind hybrid system and its control strategies. The purpose of these control techniques is to regulate continuous changes in the operational requirements of the hybrid system;currently, in power system networks, the distribution of energy plays a major role in maintaining power reliability in distribution systems. In this study, the proposed hybrid system was incorporated with a combined PV and wind energy system. Maximum power point tracking (MPPT) methods have been proposed to achieve maximum efficiency from the designed system. In addition, this study focused on improving the stability of the hybrid system. To improve the power quality and transient stability of the proposed system, we introduce a novel control strategy called the distributed power flow controller (DPFC) implementation with an optimization technique called the lion optimization algorithm(LOA)technique. This LOA control technique was developed for the first time in the application of a DPFC controller in a grid-connected system. The control technique was developed using signals from the system parameters, that is, voltage and current. To tune these parameters, this study used fuzzy logic and lion optimization techniques. The proposed system with controllers was tested in MATLAB/Simulink and the results were compared.

India is one of the most drought prone countries in the world and droughts are impacting agricultural production and livelihoods. Building resilience of agriculture has become important in view of the large-scale impacts of climate change and quantification of resilience is essential for objective assessment of technologies and systems for their performance. The focus of the study is to assess the impact of technologies in alleviating the impact of drought and to operationalize the concept of resilience to climatic stress. Two indices, resilience score, which indicates the performance of the technology during stress vis-à-vis the farmers’ practice during normal rainfall year and resilience gain, which indicates the performance of technology over that of the farmers’ practice during the stress year were used for assessing resilience. Location specific climate resilient technologies are adopted as a part of the ongoing project (National Innovations in Climate Resilient Agriculture (NICRA-since 2011)) and the extent of resilience achieved due to adoption of technologies is assessed with reference to drought occurred in 2016–2017 by collecting data from 113 households from two villages representing prevalent production systems of the villages vis-a-vis during the normal rainfall year (2015–16). Statistical significance of the impact of technologies adopted was ascertained using independent sample t-test and dummy variable regression technique. Drought has significant negative impact (p

The concerns over the increase in carbon footprints and global climatic changes have given momentum to find ways that reduce the use of fossil fuels to generate electricity. Offshore and onshore windmills for electricity generation are viable options for bulk power generation. A wind generation system has a variable frequency variable voltage supply at the induction generator terminals in response to the changes in the wind velocity and in turn, the speed of the wind turbine. There is a need for an additional power electronic interface to maintain the frequency and voltage at the terminals of the wind generator constant. This paper introduces a novel three-phase Bifurcated Winding Induction Generator (BWIG) comprising a bifurcated set of stator windings. A prototype model has been developed by bifurcating the stator windings of a three-phase induction machine. One part of the winding acts as the excitation winding, and the other half is used as output winding capable of producing three-phase voltages at a constant frequency at all speeds of the prime over. The machine is tested for sub and super synchronous speeds and the characteristics plotted. The flux analysis of the machine is simulated using Ansys Maxwell software. The voltage is controlled by a simple off-on control implemented using a digital controller, TMS320F28335.

For renewable sources application like smart grids, microgrids, etc. high voltage gain converter becomes a fundamental unit. In this article, a new hybrid circuit of zeta and boost converter based on active-quad-switched-inductor (AQSL) is proposed. The discontinuous input current in classical zeta circuit determines the less consumption of input source. However, the proposed hybrid zeta-boost converter provides a higher voltage gain with continuous input and output currents. It achieves higher voltage gain devoid of the high-frequency transformer, and multiple stages of diode and capacitor circuit. The mode of operation, boundary region, and non-ideal model of the proposed converter are presented. Design consideration and a comparison study with recent circuits are provided. The design circuitry of the proposed converter investigated and the functionality of the suggested circuit is validated.

Solar insolation is sun radiation converted to electrical energy and injected into the utility network using grid-connected solar power plants. Recently, in many nations’ electricity grids, the share of power generated using solar photovoltaic (PV) power plants is rapidly increasing. In this case study, solar insolation levels on different latitudes with fix & two seasonal tilt angles have been measured using Meteonorm® software. For these latitudes, fourteen airport locations have been chosen across the globe. From the case study, it has been evident that a double seasonal tilt angle provides more global insolation as compared to fix tilt angle with a suitable azimuth angle. There is also a reduction in insolation level at fixed and two seasonal tilt angles if going away from the equator. Further, up to three seasonal tilt angles, there is sufficient enhancement has been observed in solar insolation. It is also analyzed that for multiple seasonal tilt angle based solar PV Plant, month-wise tilt angle selection is more important. Further Average, Rectangular, and Trapezoidal methods have been used for estimation of cumulative inclined insolation for a specific period and compared. From the comparison, the trapezoidal method has been found optimal for accurate estimation of cumulative inclined insolation.

We present the results of an experimental investigation of quasi-periodical kinetic instabilities exhibited by magnetically confined electron cyclotron resonance heated plasmas. The instabilities were detected by measuring plasma microwave emission, electron losses, and wall bremsstrahlung. The instabilities were found to be grouped into fast sequences of periodic plasma losses, separated by ∼100 µs between the bursts, followed by 1–10 ms quiescent periods before the next event. Increasing the plasma energy content by adjusting the plasma heating parameters, in particular the magnetic field strength, makes the instabilities more chaotic in the time domain. Statistical analysis reveals that the energy released in a single instability event depends on the magnetic field strength and microwave power but not on the neutral gas pressure. The effects of these ion source parameters on the instability characteristics are explained qualitatively by considering their influence on the electron energy distribution. A correlation is found between the energy dissipated in an instability event and the recovery time of the periodic bursts, i.e., a large amplitude instability leads to a long recovery time of the electron energy distribution.

Since the 1987 Clean Water Act Section 319 amendment, the US Government has required and funded the development of nonpoint source pollution programs with about $5 billion dollars. Despite these expenditures, nonpoint source pollution from urban watersheds is still a significant cause of impaired waters in the United States. Urban stormwater management has rapidly evolved over recent decades with decision-making made at a local or city scale. To address the need for a better understanding of how stormwater management has been implemented in different cities, we used stormwater control measure (SCM) network data from 23 US cities and assessed what physical, climatic, socioeconomic, and/or regulatory explanatory variables, if any, are related to SCM assemblages at the municipal scale. Spearman’s correlation and Wilcoxon rank-sum tests were used to investigate relationships between explanatory variables and SCM types and assemblages of SCMs in each city. The results from these analyses showed that for the cities assessed, physical explanatory variables (e.g. impervious percentage and depth to water table) explained the greatest portion of variability in SCM assemblages. Additionally, it was found that cities with combined sewers favored filters, swales and strips, and infiltrators over basins, and cities that are under consent decrees with the Environmental Protection Agency tended to include filters more frequently in their SCM inventories. Future work can build on the SCM assemblages used in this study and their explanatory variables to better understand the differences and drivers of differences in SCM effectiveness across cities, improve watershed modeling, and investigate city- and watershed-scale impacts of SCM assemblages.

Climate change is now unequivocal and influences crops and the incidence of insect pests. Understanding the spatially variable, species-specific, and complex effects of climate change is essential in developing an appropriate pest management strategy. The two dimensions of climate change i.e., elevated temperature ( e Temp.) and elevated CO _2 ( e CO _2 ) influence insect herbivores. In the present study, the growth and development of an invasive insect pest, fall armyworm, Spodoptera frugiperda (J E Smith) (Lepidoptera: Noctuidae) on maize at e CO _2 and e Temp conditions using CO _2 and temperature Gradient Chambers (CTGC) was estimated. Dilution of bio-chemical constituents was noted with lower leaf nitrogen (9%–14%), higher carbon (3%–11%), higher C : N (18%–26%), and higher tannins (13%) in maize foliage at e CO _2 + e Temp levels. A significant influence on primary parameters of insect viz., higher total consumption by larvae (38%), extended larval duration (13%) with increased larval weights (17%), and differential pupal weights (14%) in successive generations was recorded at e CO _2 + e Temp compared to ambient. Their effect was continued on various insect performance indices also, with higher relative consumption rate, RCR (40%), lower relative growth rate, RGR (11%), and varied approximate digestibility (AD), the efficiency of conversion of ingested food (ECI) and digested food (ECD) of S frugiperda larvae. The interactive effect of e CO _2 and e Temp led to a higher Potential Population Increase Index (PPII) (19%) due to higher fecund adults. The effect of e CO _2 offsets the impact of e Temp when interacting together on some of the insect parameters. The present results indicate that e CO _2 and e Temp play a key role in influencing the growth and development of S frugiperda indicating higher pest incidence in future climate change periods.

Abstract Background Gangliogliomas are rare tumors of the central nervous system. They can occur anywhere in the central nervous system but are most commonly located in the temporal lobe and are mainly found in children. Anaplastic ganglioglioma can result from either de novo or transformation of a pre-existing lesion. Case presentation We report a case of de novo anaplastic ganglioglioma in the parieto occipital region, which is a rare location. A 34-year-old lady presented with features of raised intracranial pressure (ICP) with right side hemiparesis. Contrast-enhanced magnetic resonance imaging (CEMRI) of the brain showed well-defined intense heterogenously enhancing solid cystic mass lesion 5.3 × 5.2 cm in the left parieto occipital region with mass effect and midline shift. Intraoperatively, a cystic mass lesion with reddish brown nodule was seen in the left occipital lobe. Complete tumor excision was done. Microscopic and IHC examination was suggestive of anaplastic ganglioglioma. The post-operative period was uneventful. The patient received 60-Gy radiotherapy with temozolamide as adjuvant therapy, and repeat imaging showed no tumor recurrence. Conclusion Anaplastic gangliogliomas are rare tumors with parieto occipital as rare location.

Physical activity (PA) and nutrition are the essential components of a healthy lifestyle, as they can influence energy balance, promote functional ability of various systems and improve immunity. Infections and their associated symptoms are the common and frequent challenges to human health that are causing severe economic and social consequences around the world. During aging, human immune system undergoes dramatic aging-related changes/dysfunctions known as immunosenescence. Clinically, immunosenescence refers to the gradual deterioration of immune system that increases exposure to infections, and reduces vaccine efficacy. Such phenomenon is linked to impaired immune responses that lead to dysfunction of multiple organs, while lack of physical activity, progressive loss of muscle mass, and concomitant decline in muscle strength facilitate immunosenescence and inflammation. In the present review, we have discussed the role of nutrition and PA, which can boost the immune system alone and synergistically. Evidence suggests that long-term PA is beneficial in improving immune system and preventing various infections. We have further discussed several nutritional strategies for improving the immune system. Unfortunately, the available evidence shows conflicting results. In terms of interaction with food intake, PA does not tend to increase energy intake during a short time course. However, overcoming nutritional deficiencies appears to be the most practical recommendation. Through the balanced nutritious diet intake one can fulfill the bodily requirement of optimal nutrition that significantly impacts the immune system. Supplementation of a single nutrient as food is generally not advisable. Rather incorporating various fruits and vegetables, whole grains, proteins and probiotics may ensure adequate nutrient intake. Therefore, multi-nutrient supplements may benefit people having deficiency in spite of sufficient diet. Along with PA, supplementation of probiotics, bovine colostrum, plant-derived products and functional foods may provide additional benefits in improving the immune system.

Introduction: The neuropeptide-Y (NPY) is involved in the development of alcoholism through NPY receptors. A T>C mutation causes substitution of leucine to proline at codon 7 (L7P; rs16139) in the signal peptide of neuropeptide Y is known to cause a 42% increase in plasma NPY levels. Studies that analyzed the association between NPY rs16139 and alcoholism risk did not demonstrate conclusive evidence for this relationship. The present study aims to evaluate the association between NPY gene rs16139 variant and alcohol dependence.Method: An electronic search of databases including PubMed and Google Scholar was performed to retrieve studies investigating the association between NPY rs16139 and alcoholism. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated in allelic and dominant genetic models. Sensitivity analyses and publication bias were assessed in our meta-analysis. The meta-analysis was conducted using the MetaGenyo web tool.Result: Significant heterogeneity was observed across studies (p < 0.001). Our results have shown that there is no significant association between NPY rs16139 variant and the risk of alcoholism in allelic (OR = 0.98, 95% CI 0.70–1.38, p = 0.921) and dominant models (OR = 0.98, 95% CI 0.69–1.40, p = 0.919). Begg's funnel plot and Egger's test have not shown publication bias (p = 0.332).Conclusion: To the best of our knowledge, this is the first meta-analysis that evaluates the relationship between the NPY rs16139 polymorphism and the risk of alcoholism. Our large-scale meta-analysis suggests that NPY rs16139 polymorphism is not associated with alcoholism. However, further studies are needed to increase our understanding of the relationship between NPY variants in alcoholism.

In recent decades, there has been a growing interest in the design and development of power loss reduction in electric drive systems. To realize the full potential of the Brushless DC motor (BLDCM), the design methodology of an effective intelligent controller is vital. On the other hand, the Landsman converter is used in a bridgeless configuration to enhance the power factor and minimize the power loss of the BLDCM. In addition, BLDCM utilizes the different intelligent controllers that are used to decrease power loss. The performance of the Landsman converter and CSC converter is analyzed concerning various configurations/stages, and the numerical MATLAB 2016a simulation results are discussed to arrive at the suitable intelligent controller for the BLDC motor, and comparison results are presented. The proposed converter is designed and validated using hardware implementation by minimizing power loss. Effectiveness can be tested and valued for the proposed controller for the various intelligent controllers of BLDCM.

Green stormwater infrastructure (GSI) is increasingly used to reduce stormwater input to the subsurface stormwater network. This work investigated how GSI interacts with surface runoff and stormwater structures to affect the spatial extent and distribution of roadway flooding and subsequent effects on the performance of the traffic system using a dual-drainage model. The model simulated roadway flooding using PCSWMM (Personal Computer Stormwater Management Model) in Harvard Gulch, Denver, Colorado, and was then used in a microscopic traffic simulation using the Simulation of Urban Mobility Model (SUMO). We examined the effect of converting between 1% and 5% of directly connected impervious area (DCIA) to bioretention GSI on roadway flooding. The results showed that even for 1% of DCIA converted to GSI, the extent and mean depth of roadway flooding was reduced. Increasing GSI conversion further reduced roadway flooding depth and extent, although with diminishing returns per additional percentage of DCIA converted to GSI. Reduced roadway flooding led to increased average vehicle speeds and decreased percentage of roads impacted by flooding and total travel time. We found diminishing returns in the roadway flooding reduction per additional percentage of DCIA converted to GSI. Future work will be conducted to reduce the main limitations of insufficient data for model validation. Detailed dual-drainage modeling has the potential to better predict what GSI strategies will mitigate roadway flooding.

Purpose: Sickle cell disease (SCD) is the most common and serious form of an inherited blood disorder that lead to higher risk of early mortality. SCD patients are at high risk for developing multiorgan acute and chronic complications linked with significant morbidity and mortality. Some of the ophthalmological complications of SCD include retinal changes, refractive errors, vitreous hemorrhage, and abnormalities of the cornea. Materials and Methods: The present study includes 96 SCD patients. A dilated comprehensive eye examination was performed to know the status of retinopathy. Refractive errors were measured in all patients. In patients with >10 years of age, cycloplegia was not performed before autorefractometry. A subset of fifty patients' genotyping was done for NOS3 27-base pair (bp) variable number of tandem repeat (VNTR) and IL4 intron-3 VNTR polymorphisms using polymerase chain reaction-electrophoresis. Chi-square test was performed to test the association between the polymorphisms and refractive errors. Results: The results of the present study revealed that 63.5% of patients have myopia followed by 19.8% hyperopia. NOS3 27-bp VNTR genotypes significantly deviated from Hardy–Weinberg equilibrium (P < 0.0001). Although IL4 70-bp VNTR increased the risk of developing refractive errors, it is not statistically significant. However, NOS3 27-bp VNTR significantly reduced the risk of development of myopia. Conclusion: In summary, our study documents the prevalence of refractive errors along with some retinal changes in Indian SCD patients. Further, this study demonstrates that the NOS3 VNTR contributes to the susceptibility to development of myopia in SCD cases.

Road traffic accidents are a major cause of head injury. Direct head-on collision, hit by vehicle, and overturning of vehicle are some of the modes of road traffic accidents leading to head injury. A dupatta is an accessory worn by many females in the Indian subcontinent. It is wrapped around the neck like a scarf. It can get entangled in the vehicle leading to skidding of vehicle and consequent traumatic injury. There are many reported cases of cervical spine injury by this mechanism. However, this can also result in head injury due to direct impact. In this article we report two cases of head injury caused by entanglement of dupatta in the tire of a two-wheeler vehicle. In both cases the dupatta got entangled in the tire of vehicle leading to skidding of bike and then leading to head injury.