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Pleural effusions of diverse aetiologies are encountered in patients with chronic kidney disease (CKD). The objectives of the present study were to examine the frequency of occurrence, causes, clinical features and management strategies of pleural effusion in patients with CKD including renal transplant recipients.A prospective cross-sectional observational analysis of pleural effusion in adult patients with CKD (stages 3 to 5) attending the Departments of Nephrology and Respiratory Medicine of a tertiary care institution in Eastern India was performed over a period of one year (February 2010 to January 2011).Pleural effusion was found in 29 out of 430 patients with CKD (6.7%) and in two out of 34 post-renal transplant recipients (5.9%) evaluated during the study period. The mean age was 37.35 +/- 1.8 (mean +/- SEM [standard error of mean]) with a male to female ratio of 2:1. Exudates and transudates were found in equal frequencies. Heart failure was the single most common cause (41.9%, 13 of 31). Tuberculosis (TB) (n = 8, 25.8%) and uraemic effusions (n = 6, 19.4%) were responsible for the majority of exudates. Unilateral effusion with a normal heart size had a positive predictive value of 83.3% for non-heart failure aetiology.Symptomatic pleural effusion was present in a small proportion of 6.7%; (n = 29) patients with CKD including post-renal transplant recipients. Heart failure, TB and uraemic effusions accounted for most of the cases. Differentiating TB from uraemic effusion requires a combined clinico-pathological approach and this differentiation is absolutely necessary for proper management.

Developing green or red light-activated drug delivery systems (DDSs) for cancer treatment is highly desirable. Herein, we have reported a green light-responsive single component-based organic fluorescence nano-DDS by simply anchoring 2-hydroxy-6-naphthacyl (phototrigger) on both sides of the 1,5-diaminonaphthalene (DAN) chromophore. This green light (λ ≥ 500 nm)-activated DDS released two equivalents of the anticancer drug (valproic acid) in a spatio-temporally controlled manner. Our photoresponsive DDS [DAN-bis(HO-Naph-VPA)] exhibited interesting properties such as excited-state intramolecular proton transfer (ESIPT) accompanied with aggregation-induced emission (AIE) phenomena. AIE initiated the photorelease, and ESIPT enhanced the rate of the photorelease. Further

A phenothiazine-based photoremovable protecting group (PRPG) for single and dual release of carboxylic acids was developed. The change in the oxidation state of the sulfur atom of the phenothiazine PRPG resulted in singlet oxygen generation, rather than photorelease. The difference in the photochemistry between oxygen-free and oxygen-functionalized phenothiazine was investigated and supported by DFT calculations.

Divergence measures have a long association with statistical inference, machine learning and information theory. The density power divergence and related measures have produced many useful (and popular) statistical procedures, which provide a good balance between model efficiency on one hand and outlier stability or robustness on the other. The logarithmic density power divergence, a particular logarithmic transform of the density power divergence, has also been very successful in producing efficient and stable inference procedures; in addition it has also led to significant demonstrated applications in information theory. The success of the minimum divergence procedures based on the density power divergence and the logarithmic density power divergence (which also go by the names $\beta$-divergence and $\gamma$-divergence, respectively) make it imperative and meaningful to look for other, similar divergences which may be obtained as transforms of the density power divergence in the same spirit. With this motivation we search for such transforms of the density power divergence, referred to herein as the functional density power divergence class. The present article characterizes this functional density power divergence class, and thus identifies the available divergence measures within this construct that may be explored further for possible applications in statistical inference, machine learning and information theory., Comment: This new version greatly improves the scope of the characterization presented in the previous version while dropping smoothness assumptions on the concerned function

We have utilized an m-amino benzyl based photoremovable protecting group (PRPG) to develop a new water soluble H2S donor. It efficiently releases H2S on demand in a spatio-temporally controlled fashion by an excited state "meta effect" with good chemical and photochemical quantum yield in an aqueous environment. The efficient photorelease of H2S under physiological conditions was also demonstrated by in vitro studies.

In this paper, we present a method for conducting global sensitivity analysis of randomized trials in which binary outcomes are scheduled to be collected on participants at pre-specified points in time after randomization and these outcomes may be missing in a non-monotone fashion. We introduce a class of missing data assumptions, indexed by sensitivity parameters, that are anchored around the missing not at random assumption introduced by Robins (Statistics in Medicine, 1997). For each assumption in the class, we establish that the joint distribution of the outcomes are identifiable from the distribution of the observed data. Our estimation procedure uses the plug-in principle, where the distribution of the observed data is estimated using random forests. We establish √n asymptotic properties for our estimation procedure. We illustrate our methodology in the context of a randomized trial designed to evaluate a new approach to reducing substance use, assessed by testing urine samples twice weekly, among patients entering outpatient addiction treatment. We evaluate the finite sample properties of our method in a realistic simulation study. Our methods have been implemented in an R package entitled slabm. This article is protected by copyright. All rights reserved.

Objective: To evaluate the clinical spectrum of diffuse parenchymal lung diseases (DPLD) encountered in the Indian setting and to compare idiopathic pulmonary fibrosis (IPF) and connective tissue disease associated DPLD (CTD-DPLD), the two commonest aetiologies. Materials and Methods: A prospective study of clinical, imaging and laboratory parameters of patients diagnosed as DPLD and followed up in the Pulmonary Medicine Department of a tertiary-care teaching institution in eastern India was conducted over a period of one year. Results: 92 patients of DPLD were diagnosed in the study period with IPF (n = 35, 38.04%), CTD-DPLD (n = 29, 31.5%), hypersensitivity pneumonitis (n = 10, 10.9%), sarcoidosis (n = 5, 5.4%) and silicosis (n = 5, 5.4%) being the common causes. The CTD-DPLD group had a lower mean age (39.5 ± 1.86 vs 56.9 ± 1.12 years), a longer duration of symptoms (3.5 ± 0.27 vs 2.5 ± 0.26 years), more extra pulmonary manifestations, significantly more base line FVC and 6-minute-walk-distance than the IPF patients. 19 patients of IPF (54%) opted for treatment. All the IPF patients had a significant fall in FVC after six months (mean change -0.203 ± 0.01 litres) compared to the CTD-DPLD group (mean change - 0.05 ± 0.04 litres.) Conclusion: CTD-DPLD patients belong to a younger age group, with longer duration of symptoms, more extrapulmonary features, better physiological parameters and better response to therapy than IPF patients. Larger prospective epidemiological studies and enrolment in clinical trials are necessary for better understanding of the spectrum of diffuse parenchymal lung disorders and their therapeutic options.

Background: Pleural effusion among patients of chronic kidney diseases (CKD) is an ongoing dilemma to nephrologists and pulmonologists especially in developing countries where tuberculosis is a common cause of pleural effusion. While uremic effusion is a diagnosis of exclusion, the sensitivity and specificity of various modalities of diagnosis of tuberculous effusion vary. Methods: A prospective cross-sectional observational study of all adult patients of pleural effusion with either CKD (stages 3 to 5) or renal transplant attending a tertiary-care institute in eastern India was performed over a year. An analysis of the etiological profile, clinical characteristics and treatment modalities of pleural effusion in CKD was carried out. Results: 430 CKD (stages 3 to 5) patients and 34 post renal transplant patients were evaluated during the study period. Incidence of pleural effusion was 6.74% (29/430) in CKD patients and 5.88% (2/34) in post transplant patients. Exudative effusion was slightly more predominant (51.6%, 16 of 31) but heart failure remained the single most common etiology (41.9%, 13 of 31).Tuberculosis (n=8, 25.8%) and uremic effusion (n=6, 19.4%) were responsible for the majority of exudative effusions,followed by empyema (n=2). Conclusion: Symptomatic pleural effusion was present in 6.74% patients of CKD (stages 3 to5) and in 5.88% of post transplant patients. Heart failure, tuberculosis and uremic effusion accounted for 41.9%, 25.5% and 19.4% cases respectively. Differentiating tuberculosis from uremic effusion requires a combined clinico-pathological approach and this differentiation is absolutely necessary in view of its strong therapeutic implications.

Anonymous communication systems built on P2P infrastructures using anonymity forwarders are frequently affected by the churn problem, i.e. frequent joins and leaves of nodes. The problem unavoidably affects the quality of provided anonymity: The availability of anonymity forwarders will be decreased, which reduces the anonymity set; and the frequency of path reformation will increase, which increases the chance of successful intersection attacks. We propose an incentive-based P2P mechanism as an approach to providing reliable anonymity forwarding. It uses incentives to induce the peer nodes to provide anonymity forwarding as reliable service and to make stable and distributed forwarding decisions to minimize the frequency of path reformations. To support incentive, a payment system has been designed which meet the anonymity requirement and can handle typical scenarios of cheating and malicious attacks. To make sound forwarding decisions, we use game theory to carefully design the forwarding strategies used by the peer nodes. We have used event-driven simulations to evaluate the quality of anonymity provided by the mechanism under high churn and with the presence of malicious nodes. The results show that the quality of anonymity is maintained in those scenarios.

As grid computing scales up in size and diversity, anonymous communications will be desirable, and sometimes vital, for certain applications. However, existing anonymity protocols, when being applied to grid applications, either dramatically degrade system efficiency or cause severe performance bottlenecks. We found that a distributed and highly efficient anonymity protocol can be designed if one considers the existing trust in grids. We have designed such a protocol based on controlled anonymity, which maintains an entity's anonymity against untrustable entities. To our best knowledge, this protocol is the first one of its kind. Using the existing methods from anonymity studies, we quantitatively analyze the degree of anonymity that could be offered by this protocol, and use a simulator to confirm its efficiency advantage over the existing protocols.