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According to research, procrastination is a frequent and damaging type of self-regulation failure. With so many deadlines and pressure to complete their work, students struggle with academic procrastination. As a result, even feeling unwell can delay coursework and affect academic progress. Not even Students do procrastinate as if they have to do something, employees and other people do the same. This delay affects many things. It affects our mental health and leads to stressful lives. To reduce this procrastination, a software model is developed called “Procrastination Preventer using YOLO” that helps to avoid procrastination, reduce stress and help complete a specific task on time. This model also has a pomodoro timer which will also help in managing time efficiently. The intriguing thing about it is that, it has integrated text-to-speech technology. It means that in addition to notifying the user by displaying the text, the timer will also verbally announce it at the same time. This model is built using Python, Jupyter Notebook, OpenCV, Pomodoro timer, Text to Speech converter.

Migration and embolization of the Amplatzer septal occluder (ASO) have been reported. However, there is only limited information on the methods of systematic retrieval of these devices. In this report, we describe the a case of a 4 year old girl who underwent closure of her atrial septal defect (ASD) using a 17 mm ASO. The device migrated in to the right atrium an anteroposterior plane 24 hours later with a resultant residual shunt. The device was successfully retrieved percutaneously and the ASD was closed using a 20 mm ASO.

Although coronary artery aneurysms occur in Kawasaki disease, giant aneurysms are rare. We report a very large coronary artery aneurysm, measuring 25 mm and involving left anterior descending artery, in a 2-year-old child with Kawasaki disease. The challenges in management of such a patient have been highlighted.

Purpose: To compare post-operative pain perception using bandage contact lens (BCL) stored at 2-8°C (Cold BCL, CL-BCL) or room temperature (23 - 25°C, RT-BCL) after photorefractive keratectomy (PRK) or corneal collagen-crosslinking (CXL) and determine status of nociception associated factors., Methods: In this prospective interventional study, 56 patients undergoing PRK for refractive correction and 100 keratoconus (KC) undergoing CXL were recruited following approval from the institutional ethics committee with informed consent. Patients undergoing bilateral PRK received RT-BCL on one eye and CL-BCL on the other. Pain was graded by Wong-Baker scoring on the first post-operative day (PoD1). Expression of transient receptor potential channels (TRPV1, TRPA1, TRPM8), calcitonin gene-related peptide (CGRP) and IL-6 was measured in cellular content from used BCLs collected on PoD1. Equal number of KC patients received RT-BCL or CL-BCL post-CXL. Pain was graded by Wong-Baker scoring on PoD1., Results: Pain scores on PoD1 were significantly (P < 0.0001) reduced in subjects receiving CL-BCL (Mean ± SD: 2.6 ± 2.1) compared to RT-BCL (6.0 ± 2.4) post-PRK. 80.4% of subjects reported reduced pain scores with CL-BCL. 19.6% reported no change or increased pain scores with CL-BCL. TRPM8 expression was significantly (P < 0.05) increased in BCL of subjects reporting reduced pain with CL-BCL compared to those who did not. Pain scores on PoD1 were significantly (P < 0.0001) reduced in subjects receiving CL-BCL (3.2 ± 2.1) compared to RT-BCL (7.2 ± 1.8) post-CXL., Conclusion: The simple approach of using a cold BCL post-operatively substantially reduced pain perception and could overcome post-operative pain-related limited acceptance of PRK/CXL., Competing Interests: None

Purpose: To study ocular surface signs, symptoms, and tear film composition following prophylactic thermal pulsation therapy (TPT) prior to refractive surgery, and to compare these outcomes with those who underwent TPT after refractive surgery., Methods: Patients with mild-to-moderate evaporative dry eye disease (DED) and/or meibomian gland dysfunction (MGD) undergoing refractive surgery were included. Group 1 patients received TPT (LipiFlow) prior to laser-assisted in situ keratomileusis (LASIK; n = 32, 64 eyes), and Group 2 patients received TPT three months after LASIK (n = 27, 52 eyes). Ocular Surface Disease Index (OSDI) score, Schirmer's test (ST1, ST2), Tear Breakup Time (TBUT), meibography, and tear fluid were obtained preoperatively and at three months postoperatively in Groups 1 and 2. Additional postoperative evaluation was performed three months after TPT in Group 2. Tear soluble factor profile was measured by multiplex enzyme-linked immunosorbent assay (ELISA) using flow cytometry., Results: Postoperative OSDI score was significantly lower and TBUT was significantly higher when compared with matched preoperative values of Group 1 participants. On the other hand, the postoperative OSDI score was significantly higher and TBUT significantly lower when compared with matched preoperative values of Group 2 participants. TPT significantly reduced the postoperative elevation in OSDI and significantly reduced the postoperative reduction in TBUT in Group 2 participants. Tear Matrix metalloproteinase-9/ Tissue inhibitor matrix metalloproteinase 1 (MMP-9/TIMP1) ratio was significantly higher, postoperatively, when compared with matched preoperative levels in Group 2. However, MMP9/TIMP1 ratio remained unaltered in Group 1 participants., Conclusion: TPT prior to refractive surgery improved postsurgical ocular surface signs and symptoms and reduced tear inflammatory factors, thereby suggesting the plausibility of reduced post-refractive surgery DED in patients., Competing Interests: None

With changes in lifestyle, such as the increasing use of digital screens and rising demand for refractive surgery, dry eye disease has become increasingly prevalent in recent times. While we are equipped with a number of diagnostic modalities and a myriad of treatment forms, ranging from topical medication to procedural therapies, the condition remains an enigma in terms of varied patient satisfaction. An understanding of the molecular basis of a disease may open up new avenues in the customization of its treatment. We attempt to simplify this in the form of a stepwise protocol to incorporate biomarker assays in dry eye management., Competing Interests: None

Objective: This study is an investigation of anaerobic nitrite and fumarate reduction/respiration abilities of two characterised Prevotella species namely Prevotella nigrescens (SS6B) and Prevotella buccae (GS6B) isolated from the periodontal pockets of chronic periodontitis (ChP) patients., Methods: Isolation and identification of the periodontal bacteria from 20 patients showing clinical symptoms of ChP. Characterisation of anaerobic nitrite and fumarate reduction was done in P. nigrescens (SS6B) and P. buccae (GS6B) using reduction assays, inhibition assays with use of specific inhibitors, growth assays and enzyme activity assays. Degenerate PCR was used to detect and amplify nitrite reductase (nrfA) and fumarate reductase (frdA) gene sequences in these Prevotella isolates. In addition, molecular and in silico analysis of the amplified anaerobic reductase gene sequences was performed using NCBI conserved domain analysis, Interpro database and MegaX., Results: We provided experimental evidence for presence of active nitrite and fumarate reductase activities through enzyme activity, reduction, inhibitor and growth assays. Moreover, we were able to detect presence of 505 bps nrfA gene fragment and 400 bps frdA gene fragment in these Prevotella spp. These fragments show similarity to multiheme ammonia forming cytochrome c nitrite reductases and fumarate reductases flavoprotein subunit, respectively., Conclusion: Anaerobic nitrite and fumarate respiration abilities in P. nigrescens and P. buccae isolates appear to be important for detoxification process and growth, respectively., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Early detection of cancer will improve survival rates. The blood biomarker 5-hydroxymethylcytosine has been shown to discriminate cancer. In a large covariate-controlled study of over two thousand individual blood samples, we created, tested and explored the properties of a 5-hydroxymethylcytosine-based classifier to detect colorectal cancer (CRC). In an independent validation sample set, the classifier discriminated CRC samples from controls with an area under the receiver operating characteristic curve (AUC) of 90% (95% CI [87, 93]). Sensitivity was 55% at 95% specificity. Performance was similar for early stage 1 (AUC 89%; 95% CI [83, 94]) and late stage 4 CRC (AUC 94%; 95% CI [89, 98]). The classifier could detect CRC even when the proportion of tumor DNA in blood was undetectable by other methods. Expanding the classifier to include information about cell-free DNA fragment size and abundance across the genome led to gains in sensitivity (63% at 95% specificity), with similar overall performance (AUC 91%; 95% CI [89, 94]). We confirm that 5-hydroxymethylcytosine can be used to detect CRC, even in early-stage disease. Therefore, the inclusion of 5-hydroxymethylcytosine in multianalyte testing could improve sensitivity for the detection of early-stage cancer., (© 2022. The Author(s).)

Prevotella species, a gram-negative obligate anaerobe, is commonly associated with human infections such as dental caries and periodontitis, as well as other conditions such as chronic osteomyelitis, bite-related infections, rheumatoid arthritis and intestinal diseases like ulcerative colitis. This generally harmless commensal possesses virulence factors such as adhesins, hemolysins, secretion systems exopolysaccharide, LPS, proteases, quorum sensing molecules and antibiotic resistance to evolve into a well-adapted pathogen capable of causing successful infection and proliferation in the host tissue. This review describes several of these virulence factors and their advantage to Prevotella spp. in causing inflammatory diseases like periodontitis. In addition, using genome analysis of Prevotella reference strains, we examined other putative virulence determinants which can provide insights as biomarkers and be the targets for effective interventions in Prevotella related diseases like periodontitis., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Globally, the prevalence of chronic coronary syndrome (CCS) increases with age. In India, there is a rapidly growing burden of coronary artery disease (CAD), which has become the leading cause of morbidity and mortality. Despite recommended medical therapy, patients with CCS are still at risk of ischemic events. Currently, dual antiplatelet therapy (DAPT) is recommended in the form of aspirin and a P2Y12 inhibitor or low dose rivaroxaban in patients with stable CAD and/or peripheral artery disease (PAD). A low dose of rivaroxaban in combination with aspirin is a promising approach; however, for patients who might benefit the most, it still remains a challenge. Clinical trial data on this new drug was certainly very encouraging, with evidence from the COMPASS trial and prespecified subgroups of COMPASS trials suggesting that the addition of rivaroxaban to aspirin was associated with a significantly lower risk of ischemic events, mortality, and tolerable bleeding profile in patients with CCS and high-risk factors. This combination is cost-effective and generally well tolerated in patients with CAD and/or PAD, as well as patients with CCS and multimorbidity or high-risk populations., (© Journal of the Association of Physicians of India 2011.)

Biocompatible nanogels are highly in demand and have the potential to be used in various applications, e.g., for the encapsulation of sensitive biomacromolecules. In the present study, we have developed water-in-oil microemulsions of sodium alginate sol/hexane/Span 20 as a template for controlled synthesis of alginate nanogels, cross-linked with 3d transition metal cations (Mn 2+ , Fe 3+ , and Co 2+ ). The results suggest that the stable template of 110 nm dimensions can be obtained by microemulsion technique using Span 20 at concentrations of 10mM and above, showing a zeta potential of -57.3 mV. A comparison of the effects of the cross-links on the morphology, surface charge, protein (urease enzyme) encapsulation properties, and stability of the resulting nanogels were studied. Alginate nanogels, cross-linked with Mn 2+ , Fe 3+ , or Co 2+ did not show any gradation in the hydrodynamic diameter. The shape of alginate nanogels, cross-linked with Mn 2+ or Co 2+ , were spherical; whereas, nanogels cross-linked with Fe 3+ (Fe-alginate) were non-spherical and rice-shaped. The zeta potential, enzyme loading efficiency, and enzyme activity of Fe-alginate was the highest among all the nanogels studied. It was found that the morphology of particles influenced the percent immobilization, loading capacity, and loading efficiency of encapsulated enzymes. These particles are promising candidates for biosensing and efficient drug delivery due to their relatively high loading capacity, biocompatibility, easy fabrication, and easy handling.

Green hydrogen production is a vital requirement of the upcoming hydrogen fuel-based locomotion and economy. Water electrolysis facilitated by electricity derived from renewable sources and direct solar-to-hydrogen conversion centred on photochemical and photoelectrochemical water splitting is a promising pathway for sustainable hydrogen production. All these methods require a highly active noble metal catalyst to make the water-splitting process more energy-efficient and in order to make it economical, metal-free hydrogen evolution catalysts such as graphene nanoplatelets (GNPs) are essential. Herein, we report the effect of a range of functionalizations on the catalytic properties of graphene nanoplatelets (GNPs) for the hydrogen evolution reaction (HER). We also account for the effect of functionalization on the strength of the electrical double layer formation on the surface of functionalized GNPs. It is observed that the catalytic activity and the electrical double layer strength are inversely related to each other. Our first-principles-based density functional theoretical (DFT) modelling unravels the origin of the observed electrocatalytic activity and its trend and the strength of the electrical double layers in terms of free energy changes during the ion absorption/desorption events on the electrode surface. Based on our observations, minimizing the electrical double layer strength is identified as an approach to improve the catalytic performance of the catalysts.

Shewanella oneidensis, a metal reducer and facultative anaerobe, expresses a large number of c-type cytochromes, many of which function as anaerobic reductases. All of these proteins contain the typical heme-binding motif CXXCH and require the Ccm proteins for maturation. Two c-type cytochrome reductases also possess atypical heme-binding sites, the NrfA nitrite reductase (CXXCK) and the SirA sulfite reductase (CX 12 NKGCH). S. oneidensis MR-1 encodes two cytochrome c synthetases (CcmF and SirE) and two apocytochrome c chaperones (CcmI and SirG). SirE located in the sir gene cluster is required for the maturation of SirA, but not NrfA. Here we show that maturation of SirA requires the combined function of the two apocytochrome c chaperones CcmI and SirG. Loss of either protein resulted in decreased sulfite reductase. Furthermore, SirA was not detected in a mutant that lacked both chaperones, perhaps due to misfolding or instability. These results suggest that CcmI interacts with SirEFG during SirA maturation, and with CcmF during maturation of NrfA. Additionally, we show that CRP regulates expression of sirA via the newly identified transcriptional regulatory protein, SirR.

Optical characterization of aerosol was performed by assessing the columnar aerosol optical depth (AOD) and angstrom wavelength exponent (α) using data from the Microtops II Sunphotometer. The data were collected on cloud free days over Goa, a coastal site along the west coast of India, from January to December 2008. Along with the composite aerosol, the black carbon (BC) mass concentration from the Aethalometer was also analyzed. The AOD0.500 μm and angstrom wavelength exponent (α) were in the range of 0.26 to 0.7 and 0.52 to 1.33, respectively, indicative of a significant seasonal shift in aerosol characteristics during the study period. The monthly mean AOD0.500 μm exhibited a bi-modal distribution, with a primary peak in April (0.7) and a secondary peak in October (0.54), whereas the minimum of 0.26 was observed in May. The monthly mean BC mass concentration varied between 0.31 μg/m(3) and 4.5 μg/m(3), and the single scattering albedo (SSA), estimated using the OPAC model, ranged from 0.87 to 0.97. Modeled aerosol optical properties were used to estimate the direct aerosol shortwave radiative forcing (DASRF) in the wavelength range 0.25 μm4.0 μm. The monthly mean forcing at the surface, at the top of the atmosphere (TOA) and in the atmosphere varied between -14.1 Wm(-2) and -35.6 Wm(-2), -6.7 Wm(-2) and -13.4 Wm(-2) and 5.5 Wm(-2) to 22.5 Wm(-2), respectively. These results indicate that the annual SSA cycle in the atmosphere is regulated by BC (absorbing aerosol), resulting in a positive forcing; however, the surface forcing was governed by the natural aerosol scattering, which yielded a negative forcing. These two conditions neutralized, resulting in a negative forcing at the TOA that remains nearly constant throughout the year., (© 2013.)

The excision of large retroperitoneal masses poses a challenge for every surgeon. Sometimes the urologist must face situations that do not fit to any conventional approach or technique previously described. Obtaining adequate exposure for safe and oncologically correct management of these masses is based, on many cases, in the mobilization of anatomical adjacent structures to generate a sufficient field in abdominal areas of difficult access. Complex visceral mobilization maneuvers derived from multivisceral transplantation organ procurement surgery provides ancillary techniques that used properly facilitate their successful resolution. The main purpose of this paper is the description of these surgical maneuvers essential to increase both exposure and vascular control in addressing the ever-dreaded high-volume retroperitoneal masses.

Renal artery aneurysm is an infrequently seen disease. The most feared symptom is rupture, which is often rapidly fatal. Indications for intervention include size, intractable symptoms and pregnancy. Many cases are managed by endovascular techniques; however, very complex cases often are referred to the urologist. We report our experience with the rarely used technique of renal artery aneurysms repair comprised of nephrectomy, extracorporeal vascular reconstruction with aneurysmectomy, and autotransplant.

Shewanella oneidensis MR-1 is a metal reducer that uses a large number of electron acceptors including thiosulfate, polysulfide and sulfite. The enzyme required for thiosulfate and polysulfide respiration has been recently identified, but the mechanisms of sulfite reduction remained unexplored. Analysis of MR-1 cultures grown anaerobically with sulfite suggested that the dissimilatory sulfite reductase catalyses six-electron reduction of sulfite to sulfide. Reduction of sulfite required menaquinones but was independent of the intermediate electron carrier CymA. Furthermore, the terminal sulfite reductase, SirA, was identified as an octahaem c cytochrome with an atypical haem binding site. The sulfite reductase of S. oneidensis MR-1 does not appear to be a sirohaem enzyme, but represents a new class of sulfite reductases. The gene that encodes SirA is located within a 10-gene locus that is predicted to encode a component of a specialized haem lyase, a menaquinone oxidase and copper transport proteins. This locus was identified in the genomes of several Shewanella species and appears to be linked to the ability of these organisms to reduce sulfite under anaerobic conditions., (© 2010 Society for Applied Microbiology and Blackwell Publishing Ltd.)

Objective: To review trends in open partial nephrectomy (OPN) at our center, concentrating on patient selection, technique and perioperative complications., Methods: A comprehensive database was developed by chart review of consecutive patients undergoing OPN for renal masses at our center. Patient selection, technical modifications, perioperative morbidity, and histopathology were compared in patients undergoing OPN between 1992-1999, 2000-2003, and 2004-2008. Complications were divided into procedure-specific (PSCs) and nonspecific medical complications (NMCs). They were graded using the Common Terminology Criteria for Adverse Events (CTCAE), version 3.0., Results: One hundred and sixty-three OPNs were performed. Temporal trends identified include: an increase in the mean patient BMI (p = 0.04), an increase in the percentage of patients with central tumors (p < 0.001), decrease in cold ischemia time (p = 0.045), increasing use of a sequential renal vein clamp (p = 0.03), increasing utilization of tissue sealants (p < 0.001), reduced EBL (p = 0.05), reduced length of stay (p = 0.005), and a decline in PSCs from 16 to 7% (p = 0.002). The incidence of histologically benign tumors declined from 34 to 10% (p = 0.001). Thirty-three (20.2%) patients experienced perioperative complications: 70% were CTCAE grade 1 or 2 adverse events. BMI was the only factor that was found to be associated with the risk of complications on multivariate analysis [odds ratio 1.067, CI 95% (1.002-1.136); p = 0.031]., Conclusions: Increasingly, OPN is being utilized for a cohort of challenging patients who are overweight and have centrally located tumors. Despite this, the risk of PSCs is low. Patients who are overweight are at increased risk for perioperative NMCs.

Background: The left upper quadrant of the abdomen may be occupied by a wide range of urologic pathology. When these lesions are large, safely resecting them often presents a significant technical challenge, with the possibility of resultant morbidity and mortality., Objective: We describe a technique derived from our experience with multivisceral transplant and organ procurement, which provides excellent exposure of this anatomic region., Design, Setting, and Participants: From May 1999 to April 2006, 70 patients underwent en bloc mobilization of the spleen and the pancreas and, as necessary, the stomach for masses in the left upper retroperitoneum. Pathology included malignant and benign lesions, including renal cell carcinoma (RCC) with or without inferior vena cava (IVC) involvement, adrenal tumors, retrocrural lymphadenopathy from testicular cancer, and transitional cell carcinoma of the renal pelvis., Surgical Procedure: An extended subcostal transabdominal approach was used to resect large tumors in the left upper abdomen. This approach offers significant advantages over conventional approaches, including a flank, thoracoabdominal, or midline transabdominal incision with reflection of the descending colon., Measurements: Intraoperative variables, including operative time, blood loss, transfusion rate, and extent of mobilization were recorded. Postoperative complications, including prolonged intubation, ileus, and deep venous thrombosis were also noted., Results and Limitations: Mean estimated blood loss during surgery was 973 ml. There were no perioperative deaths. No patients had pancreatitis or acute renal failure. Deep venous thrombosis was not seen. Cardiopulmonary bypass was used in one patient with an atrial thrombus. At a median follow-up of 42 mo, two patients died due to metastasis., Conclusions: Techniques acquired from organ harvesting as well as our experience at multivisceral transplant, such as en bloc mobilization of the spleen, pancreas, and stomach, can be utilized safely and effectively to gain excellent exposure to the left upper retroperitoneum via an extended subcostal incision with no additional morbidity for the patient.

Background: Corrosive esophageal strictures require dilatation at frequent intervals., Objective: To determine the efficacy of self-dilatation in treatment of corrosive esophageal strictures., Methods: Retrospective analysis of data from 51 patients with corrosive esophageal strictures seen in a surgical unit. Eighteen patients underwent per-oral antegrade dilatation of stricture using gum elastic bougies (Group I); 15 patients underwent retrograde dilatation with endless string using an India rubber dilator devised at the authors' institution, followed by per-oral antegrade dilatation (Group II); 15 patients underwent retrograde dilatation followed by antegrade dilatation with endless string through esophagostomy (Group III). In three patients with stricture of the entire esophagus, endless string could not be passed; they were subjected to esophagocoloplasty. All patients were taught self-dilatation with gum elastic bougies as the final step, and were put on a progressive, domiciliary, self-dilatation program. Quarterly follow up was done for one year, to ascertain whether self-bougienage was being performed properly., Results: All patients responded well to treatment, with significant relief of dysphagia and improvement in health and barium study findings. Six patients developed mediastinitis (3, 2 and 1 in Groups I, II and III, respectively) during initial dilatation; all improved with conservative management. Only one patient who failed to carry out self-bougienage had to be readmitted and retrained in the procedure, after which he remained asymptomatic., Conclusions: Patients with corrosive esophageal strictures can be treated with a long-term self-bougienage program, which avoids the need for frequent hospital admissions for esophageal dilatation.

Cyclin A-kinase, an enzyme required for coordinating S phase progression, forms stable in vivo complexes with E2F-1, a growth-promoting transcription factor, which binds to the retinoblastoma gene product and is involved in the timely activation of genes whose products contribute to G1 exit and S phase traversal. Complex formation results in a negative biochemical effect of cyclin A-kinase: the shut-off of E2F-1-dependent DNA binding function in S/G2. Thus, specific and timely cell cycle-dependent interactions of E2F-1 with proteins that inhibit its function (i.e., RB during G1 and cyclin A-kinase during S/G2) may contribute to the periodicity of expression of certain E2F-1-responsive genes at the G1/S transition.

The E2F family of transcription factors functions in the control of the mammalian cell cycle. Here it is shown that two family members, E2F-1 and DP-1, form specific heterodimers in vivo, a process that enhances DNA binding, transactivation, and the binding of the retinoblastoma gene product. These results suggest that heterodimerization regulates E2F function and contributes to cell cycle control.