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Statement of the Problem: Root canal preparation with rotary files causes dentinal cracks in root canals of primary teeth affecting their longevity.Purpose: Nickel-titanium rotary files have been widely used for root canal preparation in primary teeth. The present study compared occurrence of dentinal microcracks in root canals of extracted primary molar teeth prepared using Hedstrom (H) files, ProTaper Universal rotary files, and ProTaper Next rotary file systems.Materials and Method: In this in vitro experimental study, 80 primary molar mesial root canals were randomly divided into four groups of 20 canals each (n=20). Group I was prepared with H files. Group II was prepared with ProTaper Universal rotary files using shaping files SX and S2. Group III was instrumented with ProTaper Next rotary files X1 and X2 while Group IV was left unprepared and served as control. Roots were stained with 1% methylene blue solution and sectioned perpendicular to the long axis at 2mm, 4mm, and 6mm from the apical foramen. Slices obtained were examined under the stereomicroscope. Data obtained were subjected to statistical analysis using chi square tests.Results: Dentinal microcracks were observed in groups prepared using H files, ProTaper Universal, and ProTaper Next rotary files. Highest percentage of cracked root canals (20%) was seen in Group I, prepared by H files. These cracks were complete in nature, found in apical sections and statistically significant (p= 0.016). Group III prepared with ProTaper Next showed 10% dentinal cracks, followed by ProTaper Universal group with 5% cracked root canals.Conclusion: H files may be considered more aggressive at apical third due to complete cracks produced.

The quantum of solid waste generated by the world is growing with increasing development and changing lifestyles, making waste management a daunting challenge. The Solid Waste Management Rules, 2016, of India, along with initiatives by the Smart City Mission and Swachh Bharat Abhiyan, are pivotal in encouraging sustainable waste management. This paper establishes progress, gaps, and ground realities in solid waste management (SWM) in three of the best-performing cities in India. The paper first documents trends and practices in SWM in the three cities and then cross-checks the ground scenario through a primary survey of 322 citizens. The results show that all three cities have experienced improvements in SWM following government initiatives. Segregation of waste is the dominant protocol, and all three cities show a positive trend. The decentralization of wet waste treatment and sorting processes has facilitated material recovery. Centralized facilities, such as the waste-to-energy plant in Vishakhapatnam, the compressed biogas plant in Pune, and the biomethanation plant in Tirupati, are adding economic value to the system. Effective segregation and recovery have enabled scientific disposal, and advances have been made in the redemption of former dumpsites, with complete success in Tirupati.

This study aimed to evaluate the safety and efficacy of oral administration of Ashwagandha root extract (ARE) in cats subjected to different types of stress. A randomized, double-blind, placebo-controlled veterinary clinical trial was conducted with sixteen healthy pet cats. Each cat was randomly assigned to receive ARE (15 mg/kg body weight) or a placebo and were subjected to four types of stress over a period of one month. No detrimental changes were observed in ALP, ALT, AST, glucose, creatinine, and BUN levels on day 30 with ARE with all values within the physiological range. Additionally, in the ARE-treated group, the protein (p

Background: Pit-and-fissure sealants, particularly the resin-based type, are widely used as the most efficient technique for preventing caries on the occlusal surfaces of permanent molars. School-based dental sealant (SBDS) program is a system where sealants are applied to the children in their schools with the primary aim to certify and safeguard the permanent molars that are sealed at the earliest after eruption. Aim: The aim of this study was to evaluate the retention and effectiveness of SBDS Programs in Lucknow, UP. Materials and Methods: A split-mouth randomized controlled trial was conducted among 6-year-old school-going children of Lucknow, UP. The study was carried out by a single trained and calibrated investigator who recorded the dentition status. The investigator interviewed the participants using a pro forma and examined the subjects included in the study. The sealant was applied to one tooth in the pair of fully erupted permanent first molars, and no treatment was done on the other side. Results: The proportion of total retention after 1½ years was significantly higher in mandibular as compared with maxillary molars (Z = 2.04; P = 0.04). The risk of having caries was 3.52 times more among children with no treatment as compared to children with treatment (odds ratio [OR] – 3.52 [1.01, 13.11]; P = 0.04; statistically significant). The association between survival rate of sealant and International Caries Detection and Assessment System codes (0 and 1–2) as well as that between retention of sealant and caries status was statistically significant (P < 0.01 and 0.00001, respectively). The risk of having caries was 1.28 times more among males as compared to females (OR – 1.28 [0.38, 4.24]; P = 0.06), 1.61 times for sugar exposure (OR – 1.61 [0.53, 6.19]; P = 0.53; nonsignificant). Conclusion: Sealant application proved to be an efficient method in preventing dental caries development; hence, SBDS programs, wherein the sealants were placed at school, were highly efficacious and acceptable in the vulnerable populace.

Introduction: Intramuscular hemangiomas (IMH) are rare benign vascular tumors. They can occur anywhere in the body but are more common in the head and neck. Their location in the muscles of the abdominal wall is uncommon. Case presentation: A 14-year-old girl presented with 5 months of progressive swelling on the right side of her abdomen followed by intermittent pain. On examination, a solitary mass with ill-defined borders was noted fixed to the subcutaneous tissue in the right lumbar quadrant. After elevating the right leg, the swelling became more prominent. Doppler ultrasonography revealed a mixed echogenic mass in the subcutaneous plane of the anterior abdominal wall of the right lumbar region. Magnetic resonance imaging of abdomen was suggestive of hemangioma, and the patient underwent surgical excision. Histopathological examination confirmed the diagnosis of capillary hemangioma. During follow-up at 3 and 6 months, the patient did not present with recurrence and was healthy. Conclusion: Although IMH is a rare soft-tissue tumor, it should be considered when diagnosing symptomatic intramuscular swelling.

Tactile information acquired through palpation plays a crucial role in relation to surface characterisation and tissue differentiation - an essential clinical requirement during surgery. In the case of Minimally Invasive Surgery, access is restricted, and tactile feedback available to surgeons is therefore reduced. This paper presents a novel stiffness controllable, dynamic force range sensor that can provide remote haptic feedback. The sensor has an abraded optical fibre integrated into a silicone dome. Forces applied to the dome change the curvature of the optical fibres, resulting in light attenuation. By changing the pressure within the dome and thereby adjusting the sensor’s stiffness, we are able to modify the force measurement range. Results from our experimental study demonstrate that increasing the pressure inside the dome increases the force range whilst decreasing force sensitivity. We show that the maximum force measured by our sensor prototype at 20 mm/min was 5.02 N, 6.70 N and 8.83 N for the applied pressures of 0 psi (0 kPa), 0.5 psi (3.45 kPa) and 1 psi (6.9 kPa), respectively. The sensor has also been tested to estimate the stiffness of 13 phantoms of different elastic moduli. Results show the elastic modulus sensing range of the proposed sensor to be from 8.58 to 165.32 kPa.

IntroductionThis investigation delves into the mechanical behaviour of titanium dental implants, a preferred choice for tooth replacement due to their superior reliability over alternative materials. The phenomenon of implant loosening, frequently induced by masticatory activities, underscores the significance of surface modification or texturing to bolster the interaction between the implant and bone tissue. This research comprehensively examines the effects of four distinct surface texturing techniques and five varied bone quality conditions on the biomechanical performance of these implants.MethodsThe scope of this study is delineated by its focus on implants of diameters 4 mm and 6 mm, with lengths measuring 9 mm and 12 mm respectively. Furthermore, the analysis incorporates the evaluation of four different coatings—hydroxyapatite, HA3TO, HA3Sr, and HA1.5TO1.5Sr—to investigate their efficacy in enhancing the osseointegration process on textured surfaces of dental implants.ResultsThe experimental design entails the assessment of stress distribution within the implant and its coatings, alongside the strain exerted on the surrounding cancellous bone, under the conditions of an average vertical biting force. A comparative analysis between solid implants and those subjected to surface texturing techniques has been conducted. This comparison elucidates the advantageous microstrain profiles presented by certain textured surfaces, which are deemed more conducive to optimal osseointegration.DiscussionNotably, across all examined textures, the application of hydroxyapatite (HA) and a modified HA composition (HA1.5TO1.5Sr) demonstrates significant improvements in mechanical stability, particularly in scenarios involving weak and very weak bone conditions. This study's findings contribute to the ongoing advancement in dental implant technology, emphasizing the critical role of surface texturing and coating strategies in promoting implant longevity and integration within the biomechanical environment of the human oral cavity.

Background Early diagnosis and treatment of diabetic eye disease (DED) improve prognosis and lessen the possibility of permanent vision loss. Screening of retinal fundus images is a significant process widely employed for diagnosing patients with DED or other eye problems. However, considerable time and effort are required to detect these images manually. Methods Deep learning approaches in machine learning have attained superior performance for the binary classification of healthy and pathological retinal fundus images. In contrast, multi-class retinal eye disease classification is still a difficult task. Therefore, a two-phase transfer learning approach is developed in this research for automated classification and segmentation of multi-class DED pathologies. Results In the first step, a Modified ResNet-50 model pre-trained on the ImageNet dataset was transferred and learned to classify normal diabetic macular edema (DME), diabetic retinopathy, glaucoma, and cataracts. In the second step, the defective region of multiple eye diseases is segmented using the transfer learning-based DenseUNet model. From the publicly accessible dataset, the suggested model is assessed using several retinal fundus images. Our proposed model for multi-class classification achieves a maximum specificity of 99.73%, a sensitivity of 99.54%, and an accuracy of 99.67%.

Genetic diversity is the foundation of evolutionary resilience, adaptive potential, and the flourishing vitality of living organisms, serving as the cornerstone for robust ecosystems and the continuous evolution of life on Earth. The landscape of directed evolution, a powerful biotechnological tool inspired by natural evolutionary processes, has undergone a transformative shift propelled by innovative strategies for generating genetic diversity. This shift is fuelled by several factors, encompassing the utilization of advanced toolkits like CRISPR-Cas and base editors, the enhanced comprehension of biological mechanisms, cost-effective custom oligo pool synthesis, and the seamless integration of artificial intelligence and automation. This comprehensive review looks into the myriad of methodologies employed for constructing gene libraries, both in vitro and in vivo, categorized into three major classes: random mutagenesis, focused mutagenesis, and DNA recombination. The objectives of this review are threefold: firstly, to present a panoramic overview of recent advances in genetic diversity creation; secondly, to inspire novel ideas for further innovation in genetic diversity generation; and thirdly, to provide a valuable resource for individuals entering the field of directed evolution.

Background Advanced atrioventricular block (AVB), that is, higher than second‐degree Mobitz‐1, is an abnormal finding in athletes. Despite intensive investigation, in several cases the pathogenesis remains unknown, but frequently pacemaker implantation is still indicated. Increasing evidence points to circulating anti‐Ro/Sjögren syndrome–related antigen A (SSA) antibodies cross‐reacting with L‐type calcium channel and inhibiting the related current as an epidemiologically relevant and potentially reversible cause of isolated AVB in adults. The aim of the study was to determine the prevalence of anti‐Ro/SSA‐associated advanced AVBs in a large sample of young athletes. Methods and Results A total of 2536 consecutive athletes aged

This study assessed the impacts of climate change on the water balance of the Krishna River Basin (KRB) in India. A frequency-based metric, known as symmetric uncertainty, was used to select the top 50% of global climate models (GCMs) from a pool of 18 Coupled Model Intercomparison Project Phase 6 (CMIP6) GCMs for hydrological modelling. The impact of climate change was projected for three future time frames, namely, near future (NF: 2026–2050), mid-future (MF: 2051–2075) and far future (FF: 2076–2100), using four scenarios from shared socio-economic pathways (SSPs): SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5. The Soil and Water Assessment Tool model was used to simulate climate change impact during historical and future periods in the basin. The results showed a significant increase in the annual average precipitation, surface runoff, water yield and streamflow in the future under all SSP scenarios. The increase in the projected annual average precipitation ranges from 12 to 54% for four SSP scenarios compared to the historical ensemble average. Future periods showed a shift in the monthly peak flows compared to the baseline period. More availability of water in the future in the KRB can be effectively used for various water management works. HIGHLIGHTS The impact of climate change on the water balance of the Krishna River Basin was assessed using CMIP6-based climate models.; The symmetric uncertainty concept was used to screen the 50% suitable GCMs from a pool of CMIP6 climate models.; High values of NSE and R2 at different gauging locations across the KRB suggested that the SWAT model is spatially performing well.; The uncertainty bounds of simulated water balance components were estimated to understand the behaviour of selected GCMs.;

Abstract Public imaging datasets are critical for the development and evaluation of automated tools in cancer imaging. Unfortunately, many do not include annotations or image-derived features, complicating downstream analysis. Artificial intelligence-based annotation tools have been shown to achieve acceptable performance and can be used to automatically annotate large datasets. As part of the effort to enrich public data available within NCI Imaging Data Commons (IDC), here we introduce AI-generated annotations for two collections containing computed tomography images of the chest, NSCLC-Radiomics, and a subset of the National Lung Screening Trial. Using publicly available AI algorithms, we derived volumetric annotations of thoracic organs-at-risk, their corresponding radiomics features, and slice-level annotations of anatomical landmarks and regions. The resulting annotations are publicly available within IDC, where the DICOM format is used to harmonize the data and achieve FAIR (Findable, Accessible, Interoperable, Reusable) data principles. The annotations are accompanied by cloud-enabled notebooks demonstrating their use. This study reinforces the need for large, publicly accessible curated datasets and demonstrates how AI can aid in cancer imaging.

Objective: Hirayama disease is a rare cause of cervical myelopathy predominantly affecting young individuals. The disease is classically characterized by muscle atrophy in the distal upper limbs. While various etiopathogenesis such as dural sac dysplasia, nerve root dysplasia, structural abnormalities of the spinal ligament, and venous dysplasia have been proposed, this study explores the potential role of venous pathology and surgical management on the basis of it. Methodology: This is a prospective descriptive case series of nine cases. The diagnosis was made based on the Huashan diagnostic criteria which includes clinical manifestation, imaging, and electrophysiology. In cases where magnetic resonance imaging (MRI) failed to demonstrate engorged veins, a computed tomography (CT) venogram of the cervical spine was used as an imaging tool. All patients underwent cervical laminectomy and coagulation of the posterior epidural venous plexus with or without laminoplasty. All the patients were followed up regularly; clinical improvement and neck disability index were assessed. Results: All nine patients were male and exhibited classical clinical features, electrophysiological abnormalities, and MRI findings except, in one patient where a CT venogram helped in establishing the diagnosis as the MRI was inconclusive. Postoperatively, all patients had neurological improvement and stabilization of the disease. All patients who underwent CT venogram and cervical spine X-ray in neutral and dynamic position demonstrated no recurrence of engorged venous plexus or significant instability except one patient developing kyphosis. One patient experiencing symptoms in the other limb underwent a second surgery. Conclusion: This comprehensive case series strongly supports venous pathology as a potential etiology of Hirayama disease. Surgical management with laminectomy and venous coagulation with or without expansile laminoplasty has delivered consistent improvement in neurological outcomes and long-term disease stabilization without the restriction of movements and lesser complications. However, further research is warranted to elucidate the mechanism underlying cervical venous dilatation.

Humans use collaborative robots as tools for accomplishing various tasks. The interaction between humans and robots happens in tight shared workspaces. However, these machines must be safe to operate alongside humans to minimize the risk of accidental collisions. Ensuring safety imposes many constraints, such as reduced torque and velocity limits during operation, thus increasing the time to accomplish many tasks. However, for applications such as using collaborative robots as haptic interfaces with intermittent contacts for virtual reality applications, speed limitations result in poor user experiences. This research aims to improve the efficiency of a collaborative robot while improving the safety of the human user. We used Gaussian process models to predict human hand motion and developed strategies for human intention detection based on hand motion and gaze to improve the time for the robot and human security in a virtual environment. We then studied the effect of prediction. Results from comparisons show that the prediction models improved the robot time by 3% and safety by 17%. When used alongside gaze, prediction with Gaussian process models resulted in an improvement of the robot time by 2% and the safety by 13%.

Background: Elderly patients, particularly those over 75 years old, have been disproportionately affected by COVID-19, exhibiting higher rates of severe outcomes, such as ICU admissions and mortality. This study aimed to evaluate and compare the effectiveness of various clinical scoring systems—qSOFA, PRIEST, PAINT, and ISARIC4C—in predicting ICU admission, the need for mechanical ventilation, and mortality among elderly COVID-19 patients. Methods: In this retrospective cohort study conducted at two tertiary care hospitals, 131 elderly patients (aged ≥ 75) and 226 younger controls (aged < 65) with confirmed COVID-19 were included. Clinical scores were computed at admission and five days after symptom onset. Kaplan–Meier survival analysis and Receiver Operating Characteristic (ROC) curve analysis were performed to assess the predictive performance of the scores regarding severe outcomes. Results: Kaplan–Meier analysis indicated significantly lower survival probabilities for elderly patients with high scores at admission. Those with an ISARIC4C score above 11.8 had a survival probability of 25% compared to 74% for those below this threshold (p < 0.001). Similarly, elderly patients with a qSOFA score above 2.1 had a survival probability of 36% compared to 72% for those with lower scores (p < 0.001). The PRIEST and PAINT scores also demonstrated predictive validity; patients with a PRIEST score above 6.3 and a PAINT score above 6.5 at admission showed comparable decreases in survival probabilities. ROC analysis at five days post-symptom onset revealed that the ISARIC4C score had the highest area under the curve (AUC) of 0.772, suggesting excellent predictive validity for severe outcomes, including mortality. The optimal cutoffs identified were 11.2 for ISARIC4C, 6.3 for PRIEST, and 6.5 for PAINT, each displaying high sensitivity and specificity. Conclusions: The ISARIC4C, qSOFA, PRIEST, and PAINT scores are robust predictors of severe outcomes in elderly COVID-19 patients over 75 years old, as confirmed by Kaplan–Meier and ROC analyses. These tools can be crucial for early identification of patients at high risk of adverse outcomes, guiding clinical decision making, and optimizing resource allocation. The use of these scoring systems should be encouraged in clinical settings to enhance the management of elderly COVID-19 patients. Further research is necessary to validate these findings across different populations and settings.

Pulmonary fibrosis detected during the acute phase of SARS-CoV-2 infection may significantly influence patient prognosis. This study aimed to evaluate the prognostic value of initial high-resolution computed tomography (HRCT) findings of pulmonary fibrosis in hospitalized COVID-19 patients and to examine how these findings relate to disease severity and clinical outcomes, with a particular focus on the development and validation of predictive scoring systems. In this multicentric prospective cohort study from January 2023 to January 2024, 120 adult patients with confirmed SARS-CoV-2 infection requiring hospitalization were enrolled from two Romanian university hospitals. Patients were categorized based on the presence (n = 60) or absence (n = 60) of pulmonary fibrosis signs on admission HRCT scans, identified by reticular opacities, traction bronchiectasis, honeycombing, and architectural distortion. Biochemical analyses, severity scores (SOFA, APACHE II, NEWS 2), and novel compound scores combining clinical and radiological data were assessed. Patients with HRCT evidence of pulmonary fibrosis had significantly higher severity scores and worse clinical outcomes. The HRCT score alone was a strong predictor of severe COVID-19 (area under the ROC curve [AUC] = 0.885), with a best cutoff value of 9.72, yielding 85.7% sensitivity and 79.8% specificity. Compound Score 1, integrating SOFA, APACHE II, and HRCT scores, demonstrated excellent predictive performance with an AUC of 0.947, sensitivity of 92.5%, and specificity of 88.9%. Compound Score 2, combining systemic inflammation markers (SIRI, SII) and NEWS 2, also showed a strong predictive capability (AUC = 0.913), with 89.2% sensitivity and 85.7% specificity at the optimal cutoff. Regression analysis revealed that Compound Score 1 had the highest hazard ratio for severe COVID-19 outcomes (HR = 4.89; 95% CI: 3.40–7.05), indicating its superior prognostic value over individual markers and traditional severity scores. Initial HRCT findings of pulmonary fibrosis are significantly associated with increased disease severity in hospitalized COVID-19 patients. The HRCT score is a valuable prognostic tool, and, when combined with clinical severity scores into Compound Score 1, it enhances the prediction of severe COVID-19 outcomes with high sensitivity and specificity. These compound scores facilitate the early identification of high-risk patients, guiding clinical decision-making and optimizing patient management to improve outcomes.

Tens of millions of images from biological collections have become available online over the last two decades. In parallel, there has been a dramatic increase in the capabilities of image analysis technologies, especially those involving machine learning and computer vision. While image analysis has become mainstream in consumer applications, it is still used only on an artisanal basis in the biological collections community, largely because the image corpora are dispersed. Yet, there is massive untapped potential for novel applications and research if images of collection objects could be made accessible in a single corpus. In this paper, we make the case for infrastructure that could support image analysis of collection objects. We show that such infrastructure is entirely feasible and well worth investing in.

Abstract Heat shock protein 90 (Hsp90) and its co-chaperones promote cancer, and targeting Hsp90 holds promise for cancer treatment. Most of the efforts to harness this potential have focused on targeting the Hsp90 N-terminus ATP binding site. Although newer-generation inhibitors have shown improved efficacy in aggressive cancers, induction of the cellular heat shock response (HSR) by these inhibitors is thought to limit their clinical efficacy. Therefore, Hsp90 inhibitors with novel mechanisms of action and that do not trigger the HSR would be advantageous. Here, we investigated the mechanism by which capsaicin inhibits Hsp90. Through mutagenesis, chemical modifications, and proteomic studies, we show that capsaicin binds to the N-terminus of Hsp90 and inhibits its ATPase activity. Consequently, capsaicin and its analogs inhibit Hsp90 ATPase-dependent progesterone receptor reconstitution in vitro. Capsaicin did not induce the HSR, instead, it promoted the degradation of Hsp70 through the lysosome-autophagy pathway. Remarkably, capsaicin did not induce degradation of the constitutively expressed cognate Hsc70, indicating selectivity for Hsp70. Combined treatments of capsaicin and the Hsp90 inhibitor 17-AAG improved the anti-tumor efficacy of 17-AAG in cell culture and tridimensional tumor spheroid growth assays using breast and prostate cancer models. Consistent with this, in silico docking studies revealed that capsaicin binding to the ATP binding site of Hsp90 was distinct from classical N-terminus Hsp90 inhibitors, indicating a novel mechanism of action. Collectively, these findings support the use of capsaicin as a chemical scaffold to develop novel Hsp90 N-terminus inhibitors as well as its ability to be a potential cancer co-therapeutic.

INTRODUCTION Prospective Observational Study in 34 Patients from December 2018 till November 2022 in Tertiary Care Hospital to objectively assess diagnostic utility of anterior rhinomanometry in symptomatic patients undergoing Adenoidectomy preoperatively and postoperatively and subjectively compare changes in quality of life. MATERIALS AND METHODS Patients with clinical history of adenoid hypertrophy managed clinically for 2 months, posted for adenotonsillectomy were performed Anterior Rhinomanometry using M/s GENESIS MEDICAL SYSTEMS NASOBALANCE – P 5 to calculate both baseline and post decongestion resistance values. Postoperatively anterior rhinomanometry is performed after 12 weeks and compared with preoperative nasal resistance values. Quality of Life measured by Visual Analogue Scale. RESULTS Comparison of Preop post decongestion and postop pre decongestion of nasal resistance following adenoidectomy revealed nasal resistance significantly reduced (p

The increasing demand for soft robotic systems in agricultural, biomedical and other applications has driven the development of actuators that can mimic the flexibility and adaptability of human muscles. Several studies have explored the design and implementation of soft actuators for robotic applications, however, there is a need for soft actuators demonstrating delicate gripping capabilities but also excel in specific biomedical applications, such as therapeutic massaging. The objective of this work is to develop a multi-finger soft pneumatic actuator mimicking human fingers for Ayurvedic therapeutic massaging and gripping applications. The actuator is geometrically modeled to mimic the dexterity and flexibility of a human finger and its mechanical behavior such as bending angle and gripping force under air pressure is studied through finite element analysis (FEA). The simulation results are experimentally validated. The finger-based actuator is fabricated using liquid silicone rubber, and its performance namely, bending deformation and gripping force generated at various pressure is determined and these results are compared with the simulated test cases. The study also provides a detailed analysis of the performance of the actuator, thus providing detailed insights into its applicability in therapeutic purposes. • Human finger inspired actuators are expected to demonstrate the dexterity and flexibility of human hands, which poses challenges in its modeling and analysis. • The load carrying capacity and bending movements of the actuator is assessed using numerical method of Finite Element Analysis. • Simulation results are validated through an experimental method using force sensors and image analysis of the bending movement of the soft actuator.

Summary: Low response rates and immune-related adverse events limit the remarkable impact of cancer immunotherapy. To improve clinical outcomes, preclinical studies have shown that combining immunotherapies with N-terminal Hsp90 inhibitors resulted in improved efficacy, even though induction of an extensive heat shock response (HSR) and less than optimal dosing of these inhibitors limited their clinical efficacy as monotherapies. We discovered that the natural product Enniatin A (EnnA) targets Hsp90 and destabilizes its client oncoproteins without inducing an HSR. EnnA triggers immunogenic cell death in triple-negative breast cancer (TNBC) syngeneic mouse models and exhibits superior antitumor activity compared to Hsp90 N-terminal inhibitors. EnnA reprograms the tumor microenvironment (TME) to promote CD8+ T cell-dependent antitumor immunity by reducing PD-L1 levels and activating the chemokine receptor CX3CR1 pathway. These findings provide strong evidence for transforming the immunosuppressive TME into a more tumor-hostile milieu by engaging Hsp90 with therapeutic agents involving novel mechanisms of action.

Objective: Low back pain (LBP) is a major cause of pain and disability. Identification of the pathology accurately or the pain generators is sometimes difficult with the conventional modalities such as magnetic resonance imaging (MRI), computed tomography (CT), or X-ray. Nuclear medicine investigations such as single-photon emission CT (SPECT/CT) or 18-fluorodeoxyglucose positron emission tomography-CT (18-FDG PET-CT) have emerged as an adjuvant tool in these cases. In this study, we evaluated and analyzed the role of 18-FDG PET-CT in identifying active pain generators and the outcomes of interventions based on that compared to MRI. Methodology: This study included all patients who fell under inclusion criteria presented with chronic LBP with or without radiculopathy. History and clinical examination were done as well as Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were calculated. All the patients underwent MRI lumbosacral spine with sacroiliac (SI) joint and 18-FDG PET-CT whole spine. Patients in whom PET-CT was positive and active pain generator was identified were managed for the specific level or pain generator responsible by appropriate modalities, i.e. surgery, interfacetal injections, transforaminal epidural injections, and SI joint injections. Patients in whom PET-CT was negative were managed according to the pain generator identified on the basis of MRI and clinical correlation. Patients were told to follow-up after 1 week and 1 month, and subsequent improvement was evaluated on the basis of VAS after 1 week and 1 month and ODI score after 1 month. Results: A total of 20 patients were included in the study, with a mean age of 41.9 ± 13.53 years. Twelve patients had multiple level pathology without the indication of significant pain generator and eight patients' symptoms did not correlate with the MRI findings. 18-FDG PET-CT was done in all patients. 10% (2/20) patients were identified with active pain generators on PET-CT which were not identified on MRI. Eleven out of twenty patients underwent intervention in the form of surgery or pain injections. The mean VAS and ODI score in the patients intervened on the basis of 18-FDG PET-CT improved by 70.59% and 50%, respectively, whereas in patients who underwent intervention on the basis of MRI had improvement in mean VAS and ODI score by 58.57% and 30.81%, respectively after 1 month. Conclusion: Inflammation and associated degenerative process in the spine is a continuous process and affects multiple levels and might not be easily picked up on MRI or other conventional modalities. Thus, 18-FDG PET-CT is useful in identifying these active inflammatory processes and thereby helping in the localization of active pain generators. Treating these active pain generators has a better outcome in patients after intervention in terms of better pain relief and quality of life and also reduces the levels being treated.

Rainfall is a vital input to model watershed hydrology, and the availability of numerous gridded and point-observed rainfall datasets poses a major challenge to the modellers to choose the appropriate data. This study compares three gridded rainfall datasets (i.e., 1° × 1°, 0.5° × 0.5°, and 0.25° × 0.25°) and point rainfall observations of the India Meteorological Department (IMD) on the simulation of streamflow of a river basin in the southern Western Ghats (India) using the Soil and Water Assessment Tool (SWAT). The results show that the different datasets lead to different optimal model parameter values and consequent water balance components, significantly in groundwater hydrology. The 0.5° × 0.5° and 0.25° × 0.25° datasets result in comparable SWAT model performances (NSE = 0.75 and 0.70, respectively), probably due to the similarity in the rain gauge network density employed for deriving the datasets and also due to the spatial discretization threshold used for sub-watershed delineation. However, the coarser resolution data (1° × 1°) results in poor performance (NSE = 0.21). The study suggests that the choice of rainfall data depends on the spatial resolution of the data and the spatial discretization threshold while compromising the computational requirement vis-à-vis simulation accuracy. HIGHLIGHTS The effects of various IMD gridded rainfall datasets and point rainfall observations on the simulation of streamflow of a river basin of the southern Western Ghats (India) was assessed.; The optimal parameter values for 1° × 1° rainfall data are far deviated from the point observation data.; The 0.25° × 0.25° and 0.5° × 0.5° have better model performances compared to 1° × 1° and point observations.;

In budding yeast the Rif1 protein is important for protecting nascent DNA at blocked replication forks, but the mechanism has been unclear. Here we show that budding yeast Rif1 must interact with Protein Phosphatase 1 to protect nascent DNA. In the absence of Rif1, removal of either Dna2 or Sgs1 prevents nascent DNA degradation, implying that Rif1 protects nascent DNA by targeting Protein Phosphatase 1 to oppose degradation by the Sgs1-Dna2 nuclease-helicase complex. This functional role for Rif1 is conserved from yeast to human cells. Yeast Rif1 was previously identified as a target of phosphorylation by the Tel1/Mec1 checkpoint kinases, but the importance of this phosphorylation has been unclear. We find that nascent DNA protection depends on a cluster of Tel1/Mec1 consensus phosphorylation sites in the Rif1 protein sequence, indicating that the intra-S phase checkpoint acts to protect nascent DNA through Rif1 phosphorylation. Our observations uncover the pathway by which budding yeast Rif1 stabilises newly synthesised DNA, highlighting the crucial role Rif1 plays in maintaining genome stability from lower eukaryotes to humans.

Ti and Zr metals are the most common bio-metallic materials that are frequently employed in a variety of orthopedic applications due to their excellent biocompatibility and mechanical stability. However, these metals still suffer from poor wear and corrosion resistance in the physiological environments. To mitigate these limitations, Ti–50Zr alloy was fabricated using the Laser Engineering Net Shape (LENS™) additive manufacturing technique. At 600 °C for 2 and 6 h, the samples underwent thermal nitridation (TN) and thermal oxidation (TO), respectively. The assessment of the surface treatments on the in-situ grown nitride and oxide coating thickness, phase identifications, and in-vitro tribological properties of Ti–50Zr alloy were carried out in simulated conditions. The results showed that thermal treatments could significantly change the film thickness, hardness, wear resistance, and corrosion resistance properties of Zr–50Ti alloy. The sample that underwent nitriding at 600 °C for 6 h showed the highest in-vitro wear resistance. Compared to thermally oxidized samples, nitridation of Ti–50Zr alloy can be used for bio implant applications, with adequate mechanical stability, excellent wear, and corrosion resistance.

Introduction: Myotonic dystrophy type 1 (DM1) is a multisystemic genetic disorder caused by the increased number of CTG repeats in 3′ UTR of Dystrophia Myotonia Protein Kinase (DMPK) gene. DM1 patients experience conduction abnormalities as well as atrial and ventricular arrhythmias with increased susceptibility to sudden cardiac death. The ionic basis of these electrical abnormalities is poorly understood.Methods: We evaluated the surface electrocardiogram (ECG) and key ion currents underlying the action potential (AP) in a mouse model of DM1, DMSXL, which express over 1000 CTG repeats. Sodium current (INa), L-type calcium current (ICaL), transient outward potassium current (Ito), and APs were recorded using the patch-clamp technique.Results: Arrhythmic events on the ECG including sinus bradycardia, conduction defects, and premature ventricular and atrial arrhythmias were observed in DMSXL homozygous mice but not in WT mice. PR interval shortening was observed in homozygous mice while ECG parameters such as QRS duration, and QTc did not change. Further, flecainide prolonged PR, QRS, and QTc visually in DMSXL homozygous mice. At the single ventricular myocyte level, we observed a reduced current density for Ito and ICaL with a positive shift in steady state activation of L-type calcium channels carrying ICaL in DMSXL homozygous mice compared with WT mice. INa densities and action potential duration did not change between DMSXL and WT mice.Conclusion: The reduced current densities of Ito, and ICaL and alterations in gating properties in L-type calcium channels may contribute to the ECG abnormalities in the DMSXL mouse model of DM1. These findings open new avenues for novel targeted therapeutics.

Objective To study the indications, technical nuances, learning curve, and outcomes associated with minimally invasive tubular discectomy of spine (MITDS) and minimally invasive tubular decompression (MITD) using the tubular retractor system and compare the outcomes with open microdiscectomy and open decompression. Materials and Methods All patients who underwent MITDS and MITD received a trial of conservative management for 6 weeks prior to surgery. Patients who had undergone open microdiscectomy and open decompression during the same period were used as controls. Operating time, intraoperative blood loss, preop and postop visual analogue scale (VAS) scores, preop and postop Oswestry disability index (ODI) scores, duration of hospital stay, complications, and need for redo surgery were analyzed. Results Thirty-two patients who underwent MITDS and 8 patients who underwent MITD were compared with an equal number of patients who underwent open microdiscectomy and open decompression, respectively. MITDS and MITD were associated with shorter hospital stay. Short-term pain outcome was better in MITDS and MITD group, although it was not statistically significant in MITD group. Functional outcome measured in terms of ODI at 6 months was not statistically significant between minimally invasive and open procedures. Conclusion Both MITDS and MITD have a significant learning curve and have a distinct advantage of shorter hospital stay. MITDS has the distinct advantage of better short-term pain relief compared with open procedures. For MITD, comparison of short-term pain relief requires a larger sample size. To establish long-term advantages of MITDS and MITD, larger sample size and long-term follow-up are needed.

In recent times, there has been an increased demand for electric vehicles. In this context, the energy management of the electric motor, which are an important constituent of electric vehicles, plays a pivotal role. A lot of research has been conducted on the optimization of heat flow through electric motors, thus reducing the wastage of energy via heat. Futuristic power sources may increasingly rely on cutting-edge innovations like energy harvesting and self-powered induction motors. In this context, effective thermal management techniques are discussed in this paper. Importance was given to the potential energy losses, hotspots, the influence of overheating on the motor efficiency, different cooling strategies, certain experimental approaches, and power control techniques. Two types of thermal analysis computation methods, namely the lumped-parameter circuit method (LPCM) and the finite element method (FEM), are discussed. Also, this paper reviews different cooling strategies. The experimental research showed that the efficiency was greater by 11% with the copper rotor compared to the aluminum rotor. Each rotor type was reviewed based on the temperature rise and efficiency at higher temperatures. The water-cooling method reduced the working temperatures by 39.49% at the end windings, 41.67% at the side windings, and by a huge margin of 56.95% at the yoke of the induction motor compared to the air-cooling method; hence, the water-cooling method is better. Lastly, modern cooling strategies are proposed to provide an effective thermal management solution for squirrel-cage induction motors.

The Anti-Theft Flooring System (ATFS) is Internet of Things (IoT) solution developed for enhancing residential safety and security. The system employs pressure sensors that are integrated into the flooring or into the floor mat, this system easily identifies intruder presence upon stepping, initiating a secure One-Time Password (OTP) generation process. The OTP is dispatched to pre-registered mobile numbers, serving as a safe and secure verification mechanism. The OTP when entered correctly within time triggers the system to unlock the door automatically. In case, OTP is entered wrongly or remains unentered for a 60-second timeframe, a Global System for Mobile (GSM) communication module triggers an alarm to promptly inform the user of potential security threats. This is how the system seamlessly combines IoT technology for real-time communication, offering an effective and proactive approach to residential safety at lower costs.

Abstract Inflammatory diseases including COVID-19 are associated with a cytokine storm characterized by high interleukin-6 (IL-6) titers. In particular, while recent studies examined COVID-19 associated arrhythmic risks from cardiac injury and/or from pharmacotherapy such as the combination of azithromycin (AZM) and hydroxychloroquine (HCQ), the role of IL-6 per se in increasing the arrhythmic risk remains poorly understood. The objective is to elucidate the electrophysiological basis of inflammation-associated arrhythmic risk in the presence of AZM and HCQ. IL-6, AZM and HCQ were concomitantly administered to guinea pigs in-vivo and in-vitro. Electrocardiograms, action potentials and ion-currents were analyzed. IL-6 alone or the combination AZM + HCQ induced mild to moderate reduction in heart rate, PR-interval and corrected QT (QTc) in-vivo and in-vitro. Notably, IL-6 alone was more potent than the combination of the two drugs in reducing heart rate, increasing PR-interval and QTc. In addition, the in-vivo or in-vitro combination of IL-6 + AZM + HCQ caused severe bradycardia, conduction abnormalities, QTc prolongation and asystole. These electrocardiographic abnormalities were attenuated in-vivo by tocilizumab (TCZ), a monoclonal antibody against IL-6 receptor, and are due in part to the prolongation of action potential duration and selective inhibition of Na+, Ca2+ and K+ currents. Inflammation confers greater risk for arrhythmia than the drug combination therapy. As such, in the setting of elevated IL-6 during inflammation caution must be taken when co-administering drugs known to predispose to fatal arrhythmias and TCZ could be an important player as a novel anti-arrhythmic agent. Thus, identifying inflammation as a critical culprit is essential for proper management.

Introduction: A surge in the number of patients with acute limb ischemia (ALI) was seen during the first and second waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This has been ascribed to the hypercoagulable state seen in COVID infections. The aim of this study is to report our experience and outcomes of ALI associated with SARS-CoV-2 infection. Materials and Methods: It was a single-center observational retrospective study from a prospectively maintained database of patients with SARS-CoV-2 infection presenting with ALI between July 2020 and December 2020 with 1-year follow-up. Results: Thirty-nine acutely ischemic limbs were treated in 32 patients including three upper limbs. The mean age of patients was 55.75 (range: 27–80). There were 23 (71.87%) males and 9 (28.12%) females. Majority of the limbs were in Class IIB of ALI, whereas 20.51% had irreversible ischemia. Of the 39 affected limbs in 32 patients, 22 limbs were revascularized, 9 had primary amputation, and 8 were managed conservatively with anticoagulation. The overall limb salvage was 26 out of 39 limbs (66.7%), whereas it was 81.8% for the limbs that had an intervention. The overall mortality was 9.4%. There was no further limb loss or mortality during 1-year follow-up. Interestingly, 15 patients did not have any symptoms suggestive of SARS-CoV-2 infection other than ALI. The severity of COVID infection did not correlate with the severity of ALI. Conclusion: COVID-19 infection can be associated with arterial thrombosis and ALI, which, if treated early with appropriate intervention, can result in a satisfactory limb salvage rate. Prophylactic anticoagulation in COVID-19-infected patients may not prevent arterial thrombosis, and the clinical severity of the COVID-19 infection is not a predictor of arterial thrombosis.

Introduction: In this modern era, a significant group of people is living in isolated hilly areas far away from civilization with their custom and beliefs. They are known as “tribes.” “Kodhu” tribe is one of the major Indian tribes present in the remote areas of Visakhapatnam. The objective is to assess the oral health status and oral health-related quality of life and education level in Kodhu Tribe in residing in Araku and Paderu regions of Visakhapatnam. Material and Methods: A descriptive cross-sectional study was conducted among the Kodhu tribal population situated in the Araku and Paderu areas Visakhapatnam, Andhra Pradesh. The study comprised of 800 participants selected using a simple random sampling technique. Chi-square test was used to assess the oral health status of the tribal population, while, independent t-test was used for multiple comparison of OHIP-14 and oral health status. A p-value ≤ 0.05 was considered statistically significant. Results: Among 800 participants, 458 were illiterate, and 342 were literate. The prevalence of dental caries was 49% among the illiterates while literates had 50.4% prevalence and the difference was statistically significant (P < 0.03). The periodontal status prevalence was found to be higher in illiterates (56.4%). The domains that are present in OHIP were found to be significantly associated with dental caries, periodontal status, and oral mucosal lesions (P < 0.001). Conclusion: The oral health status of Kodhu tribe was found to have high prevalence of the periodontal disease and dental caries. Regular oral examination by dental professionals, dental health education, and motivation to maintain oral hygiene should be insisted to improve the oral health status of this tribal community.

Statement of the Problem: The success of dental restorations depends mainly on its ability to bond to dental structures and resist the multitude of forces acting on it within the oral cavity. Purpose: Therefore, the aim of this study was to evaluate the shear bond strength (SBS) of three different glass ionomer based restorative materials. Materials and Method: In this in vitro analytical study, 30 intact primary molars were sectioned buccolingually to obtain 60 sections. These sections were embedded in auto polymerizing acrylic resin and polished to obtain a flat dentin surface. Restoration cylinders were built on the dentin surface with the help of a Teflon template called bonding jig. Each group (n= 20) was restored as group A with conventional glass ionomer cement (GIC) (GC Fuji Gold Label Type 9), group B with Bioactive restorative material (ACTIVATM KIDS BioACTIVE Restorative material), and group C with Zirconia reinforced glass ionomer cement (Zirconomer). Following restoration, SBS testing was performed using Universal Testing Machine. The data obtained were statistically analyzed using One way ANOVA test and post hoc Tukey test (p= 0.05). Results: The SBS values were significantly greater in the ACTIVA KIDS group as compared to the other two groups (p< 0.05). There was no significant difference in the SBS values between group B and group C (p> 0.05). Conclusion: The SBS of the ACTIVA KIDS to primary teeth dentin was the highest as compared to Zirconomer and conventional GIC. Therefore ACTIVA KIDS may protect primary teeth against recurrent caries and failure of the restoration.

Carbon nanotube (CNT) hybrid composites were formed by combining a CNT and silicone elastomer solution with Kevlar yarn, Kevlar fabric, and Kevlar veil materials. The integration of a CNT-silicone matrix with Kevlar yarn and fabric materials produced a composite with moderate electrical and thermal conductivity due to CNT fabric combined with the strength of Kevlar fabric or yarn. In the material synthesis, a notable difficulty was that the CNT-silicone did not bond strongly to the Kevlar. The composites passed the Vertical Flame Test ASTM D6413 and the Forced Air Oven Test NFPA 1971. These hybrid composites can have multiple applications in areas requiring favorable conductivity, strength, and flame and heat resistance. The application areas include firefighter apparel, military equipment, conductive/smart structures, and flexible electronics. The synthesis process used to manufacture CNT-silicone/Kevlar composites yielded composite sheets with an area of 2250 cm2. The process is scalable and customizable for the synthesis of CNT composites with tailored properties. Improvements in the bonding of CNT-silicone to Kevlar are being investigated.

The present work focuses on investigating the effect of process variables (power, travel speed, powder flow rate) on microstructure and mechanical properties of Laser Metal Deposited (LMD) γ-TiAl thin walls. To this end, LMD technique was used to deposit γ-TiAl thin walls at different processing conditions. Microstructures of as-deposited samples were investigated using both optical and scanning electron microscopy. X-ray diffraction (XRD) technique was used to determine the phases present. Microhardness measurements were carried out along both longitudinal and build directions. Microstructural analysis of as-deposited samples revealed a fine lamellar structure comprising of γ and α2 phases. Colony size of 30–60 μm and lamellar spacing between 0.1 and 0.7 μm were observed. XRD analysis confirmed the presence of γ and α2 phases. Comparison of elemental analysis results on both powder and as-deposited samples revealed a negligible loss of Al and no oxygen pick up in the deposited thin walls. Hardness values were found to decrease with an increase in wall height, and hardness values increased marginally (5%) with an increase in travel speed. Further, 3D transient thermal analysis was also carried out to complement the LMD of thin walls in terms of melt pool dimensions and cooling rates. It was found that the melt pool depth (MPDc = 0.266 mm) is smaller at the centre than the edge (MPDe = 0.513 mm) of the wall. Cooling rates decrease with increase in the number of layers deposited.

abstract: Plant pathogens are the important yield-limiting factors, which significantly reduce crop productivity globally, posing serious problems for food security and continues to be the biggest agricultural concern in the world. Even though chemical treatment is still the primary strategy for reducing the incidence of plant disease, their repeated application can cause the pathogens to become less susceptible. Over spraying can also pollute the environment and significantly affect soil microbiota. Therefore, to ensure agricultural sustainability and food security, efficient diagnostic techniques for the rapid identification of plant pathogens in the early stages of infection become crucial. Many molecular approaches for rapid plant pathogen detection have been developed to achieve this goal. However, they are time-consuming, costly, require skilled operators, and are generally unsuitable for in-situ analysis. Plant protection is feasible when any of the nanotechnology tools like microneedle patches, nanopore sequencing, nano barcoding, nano biosensors, quantum dots, nano diagnostic kit equipment, metal nanoparticles, miRNA based nanodiagnosis, and array based nano sensors is used for plant pathogen diagnosis. As they emerge as a potential tool to improve the sensitivity, accuracy, and rapidness of plant pathogen identification, and facilitate high-throughput analysis. The current review focuses on the use of nanotechnology for more quick, inexpensive, and accurate plant pathogens diagnosis.

Background Physical therapists are known to be susceptible to work-related musculoskeletal disorders (WMSDs), but the prevalence of WMSDs in Saudi Arabia has not been documented. This study aimed to establish the prevalence, characteristics, and risk factors of WMSDs among physical therapists in Saudi Arabia. Material and Methods A cross-sectional study was conducted among 113 physical therapists in Saudi Arabia using a 6-component questionnaire. Descriptive statistics, incidence, percentages, and χ 2 test were used for data analysis. Results The response rate was 68.8%. The reported 12-month incidence of WMSDs was 83.8%. The low back (63.7%) was the most common site of these disorders, followed by the neck (59.2%), while the hip/thigh (4.4%) was the least involved body part. Incidence was related to gender: females were more affected than males (neck, shoulders, low back); age: younger therapists were more affected than older ones (shoulders, low back); working sector: government sector workers were more affected than those employed in other sectors (neck); and specialty: orthopedic specialists were the most frequently affected, followed by those specializing in neurology (thumbs, upper back, knees, ankle/foot). Most of the physical therapists had >5 periods of neck, shoulder, and low-back WMSDs. The most important risk factor for WMSDs was treating more patients in a day (47.7%). The most frequently adopted handling strategy identified to combat WMSDS was modifying the patient’s position (62.8%). Conclusions Overall, WMSDs among physical therapists in Saudi Arabia are common, with the low back and the neck constituting the most frequently affected body regions. Professional experience and the awareness of ergonomics principles can help prevent the early development of WMSDs among physical therapists. Med Pr. 2021;72(4):363–73

Morphological leaf traits are frequently used to quantify, understand and predict plant and vegetation functional diversity and ecology, including environmental and climate change responses. Although morphological leaf traits are easy to measure, their coverage for characterising variation within species and across temporal scales is limited. At the same time, there are about 3100 herbaria worldwide, containing approximately 390 million plant specimens dating from the 16th to 21st century, which can potentially be used to extract morphological leaf traits. Globally plant specimens are rapidly getting digitised, and images are made openly available via various biodiversity data platforms such as iDigBio and GBIF. Based on a pilot study to identify the availability and appropriateness of herbarium specimen images for comprehensive trait data extraction, we developed a spatio-temporal dataset on intraspecific trait variability containing 128,036 morphological leaf trait measurements for seven selected species. After scrutinizing the metadata of digitised herbarium specimen images available from iDigBio and GBIF (21.9 million and 31.6 million images for Tracheophyta; accessed date December 2020), we identified approximately 10 million images potentially appropriate for our study. From the 10 million images, we selected seven species (Salix bebbiana Sarg., Alnus incana (L.) Moench, Viola canina L., Salix glauca L., Chenopodium album L., Impatiens capensis Meerb., Solanum dulcamara L.), which have a simple leaf shape, are well represented in space and time, and have high availability of specimens per species. We downloaded 17,383 images. Out of these, we discarded 5779 images due to quality issues. The remaining 11,604 images were used to measure the area, length, width and perimeter on 32,009 individual leaf blades using the semi-automated tool TraitEx. The resulting dataset contains 128,036 trait records.We demonstrate its comparability to trait data measured in natural environments following standard protocols by comparing trait values from the TRY database. We conclude that the herbarium specimens provide valuable information on leaf sizes. The dataset created in our study, by extracting leaf traits from the digitised herbarium specimen images of seven selected species, is a promising opportunity to improve ecological knowledge about the adaptation of size-related leaf traits to environmental changes in space and time.

Magnesium (Mg) and its alloys are currently under consideration for use as temporary implants. However, early degradation and maintaining mechanical integrity is a significant concern. Surface modification techniques are used to improve mechanical and corrosion properties of Mg based alloys. In the present study, friction stir processing (FSP) was used to tailor the surface characteristics of Mg-1Zn-2Dy (wt.%) alloy for temporary implant applications. The FSPed alloy was characterized using EBSD to understand the influence of FSP on crystallographic texture, grain size and grain boundaries and thereby their effect on corrosion, wettability and hardness. Results showed that the grain size of stir zone (SZ) was refined to less than 3 μm, as a result of dynamic recrystallization (DRX) during FSP and the FSPed alloy exhibited better wettability than as-cast alloy. An increase in the hardness (11.7%) and elastic modulus (6.84%) of FSPed alloy were also observed. Electrochemical corrosion and weight loss methods were conducted in Dulbecco's Modified Eagle's Medium (DMEM) with, 10% Fetal Bovine Serum (FBS) physiological solution. The lower degradation rate (0.72 mm/yr) of FSPed alloy has been attributed to the fine grains and evenly distributed secondary phase particles. Further, the influence of grain boundary characteristics and crystallographic texture on the corrosion behavior have been investigated.

Os odontoideum is an independent ossicle of variable size and shape separated from the body of C2. There are various theories on the etiology. Different hypothesis on etiology include traumatic and congenital. Because of the laxity of the ligaments associated with the anomalous odontoid, there can be associated instability at the craniovertebral junction. The authors presented their experience of treating these anomalies, their clinical presentations, evolution of the treatment strategies over years, and a brief review of literature on etiopathogenesis.

Background Cranioplasty using synthetic materials for restoration of the exact shape of the skull has always remained a challenge until the development of 3D printing technology. However, the high-cost of available 3D printed implants limits their extensive use. Objectives To study the effectiveness of a low-cost, 3D-printed template for molding the polymethyl methacrylate (PMMA) (bone cement) in order to achieve exact contours of the skull specific to each patient. Materials and Methods 10 cranioplasties have been performed between July 2018 to December 2019 in a variety of craniotomy defects using bone cement flaps shaped using custom-made molds. The mold was 3D-printed and based on each patient’s CT images in digital imaging and communications in medicine (DICOM). Miniplates and screws were used to fix the flap. Postoperatively, clinical and radiological evaluation were done to assess patient satisfaction and accuracy of contour achieved. Results Patient satisfaction as well as accuracy of contouring, as seen on postoperative CT scans, were excellent. There were no notable complications on follow-up. Conclusion PMMA cranioplasty flap, contoured using a 3D-printed mold, is a very cost-effective alternative for restoration of skull contour for various craniotomy defects. Polymethyl methacrylate (PMMA) molded to form the exact shape of lost calvarium using 3D printed plastic templates is a smart and economical solution.

Sterilization of ultra-high molecular weight polyethylene (UHMWPE) based composites used for acetabular cup liner via UV or gamma-irradiation before surgery is inevitable. Thus, understanding the alteration of mechanical properties and wear resistance of cup liner via irradiation process requires investigation. This paper aims to understand the effect of UV (0.03 J/cm2) and gamma (25 kGy) irradiation on mechanical properties and scratch resistance of compression molded UHMWPE composites reinforced with alumina (Al2O3), hydroxyapatite (HAp) and carbon nanotubes (CNTs). After irradiation, nearly 100% increased crystallinity of polyethylene, due to recrystallization, helped in enhancing the hardness and elastic modulus by ~1.5 times compared to that of as-processed UHMWPE (Hardness: ~70 MPa and Elastic modulus: ~1.25 GPa). The recrystallization was not favored by the presence of nano-reinforcements in irradiated UHMWPE based nanocomposites, and caused deterioration in the mechanical properties. The micro-scratch results revealed the remarkable wear resistance (i.e., 1.5 to 2 times lower wear rate) of irradiated samples than that of as-processed samples. Mouse fibroblast L929 in vitro cell culture test confirmed the cytocompatibility of irradiated samples. This study indicated that the UV and gamma irradiated UHMWPE nanocomposites are the challenging candidates as acetabular cup liner.

Introduction: There is a significant degree of anatomical variation at the level of the sphenoid sinus and sella turcica and a wide range of these values have been reported in literature and ethnic variation has also been found to contribute to this. Thus preoperative imaging of the central skull base with a knowledge of the normal anatomy and measurements in a specific population is imperative to identify these variations and prevent avoidable intraoperative complications. Aim: To assess the normal intracranial measurements of the intercarotid distance, pituitary fossa width, optic chiasm height, optic chiasm width and the pituitary to optic chiasm distance in healthy subjects of the South Indian population aged between 10 to 80 years and to establish normal reference ranges across the various age groups. Materials and Methods: This retrospective study was conducted in the Radiology Department at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, from July 2021 to December 2021. The study included normal Magnetic Resonance Imaging (MRI) brains of 700 healthy subjects (378 males and 322 females) in the age range of 10 to 80 years. Subjects were divided into seven groups of 100 subjects for each decade. The variables that were measured included the intercarotid distance, pituitary fossa width, optic chiasm height, optic chiasm width and the pituitary to optic chiasm distance. RStudio version 1.2.1093 was used for statistical analysis and p-value

Background: Current trends in spine surgeries have shifted to minimally invasive procedures. Minimally invasive approaches are getting more popular for lumbar interbody fusion procedures. Objectives: The objective of the study was to report technical modifications, learning curve, and short-term clinical results in minimally invasive transforaminal interbody fusion (MITLIF). Materials and Methods: All MITLIF cases performed from 2018 July to March 2020 were included. First three authors were operating surgeons. Visual analog scores (VAS) scoring for pain, Macnab criteria, and Oswestry disability index (ODI) were used for outcome assessment. Operating time, radiation exposure, and complications were assessed separately in a group of 20 as per time sequence in series to assess the learning curve. Results: A total of 61 patients were included. Various indications included spondylolisthesis, failed back surgery, calcified lumbar disc, and spondylodiscitis. Mean age was 47.08 ± 12.06. Intraoperative blood loss was 97.04 ± 25.58. Mean operating time and number of C-arm shots were 190.75 ± 37.11 and 159.3 ± 74.54, respectively, in initial 20 cases which however reduced in later operated cases. Significant improvement in VAS and ODI scores was observed at follow-up of 6.34 ± 4.67 months. Three cases needed surgical revision in the initial 20 cases, and there were no revision surgeries in later operated cases. Conclusion: MITLIF could be done in failed back surgery cases, spondylodiscitis, and deformity corrections in addition to spondylolisthesis. It has advantages of less injury to soft tissues, maintaining the posterior tension band, decrease in blood loss and hospital stays, and early mobilization. However, it has longer learning curve and takes minimum 20 cases for the surgeon to acquire reasonable experience and confidence.

Context: Control of pain during dental treatment is an essential aspect of pediatric dentistry. Aims: This study was conducted to evaluate and compare the anesthetic efficacy of 4% articaine buccal infiltration with 2% lignocaine inferior alveolar nerve block (IANB) for primary mandibular molar extractions. Settings and Design: The study was a prospective, split-mouth, randomized controlled trial. Methods: Bilateral symmetrical carious primary mandibular molar (n = 92) extractions in 46 healthy children aged 5–10 years were included in this randomized controlled trial. Extraction was performed on one side using 4% of articaine buccal infiltration and on the contralateral side using 2% lignocaine IANB in two subsequent appointments. Pain and behavior were assessed at baseline, during injection and extraction using Wong–Baker Faces Pain Rating Scale, Modified Behavior Pain Scale (MBPS), and Frankl Behavior Rating Scale. Statistical Analysis Used: Values thus obtained were statistically analyzed by one-way analysis of variance test and compared using independent samples test. Results: According to MBPS, the mean value of pain experienced in the form of cry during injection was reported to be more for 2% lignocaine IANB (1.76) as compared to 4% articaine buccal infiltration (1.30), which was statistically significant (P = 0.024). Comparison of behavior depicted showed no statistically significant difference between the groups. Conclusion: Buccal infiltration with 4% articaine can be utilized as an effective alternative to 2% lignocaine IANB for primary mandibular molar extractions.

Context: Outcomes of salvage procedures for thrombosed native arteriovenous fistulas (AVFs) are studied. Aims: The aim of this study is to assess the short- to mid-term results of percutaneous and hybrid approaches used for salvage of thrombosed native AVF. Settings and Design: This study design was a single-center, descriptive, prospective study. Materials and Methods: All patients undergoing hybrid or percutaneous salvage procedure between July 2018 and September 2019 were included in the study. Patient demographics, clinical, and operative details and follow-up data at 1 year were collected from a prospectively maintained database and subjected to statistical analysis. Salvage procedure selection and techniques were studied. Statistical Analysis: Chi-square test and Fisher's exact test. P < 0.05 was considered statistically significant. Results: Out of 135 patients undergoing salvage procedure during the study period, 85 patients were included in the study based on inclusion and exclusion criteria. The age of the study population ranged from 18 to 75 years with a mean of 53.33. 75.3% (n = 64) were males. Seventy-seven (90.58%) patients were hypertensive, 45 (52.94%) were diabetic, and 22 (25.88%) had coronary artery disease. The mean time to procedure from the failure of AVF was 8.22 days. The most common type of AVF was brachiocephalic (45.88% [n = 39]), followed by radiocephalic (36.47% [n = 31]) and basilic vein transposition (BVT) (17.64% [n = 15]). Stenotic sites were juxta anastomotic in 42 (49.41%), cephalic arch or axillary swing segment (for BVT) in 28 (32.94%), and intervening segment in 54 (63.52%). Sixty patients underwent hybrid salvage and 25 underwent percutaneous salvage procedure. Technical success was 88.23% on table and 83.53% at 24 h. Primary, primary assisted, and secondary patency was 67.86%, 82.14%, and 89.29% at 6 months and 50%, 68.75%, and 83.33% at 12 months. Anastomotic thrombosis was associated with significantly high technical failure (35.7% vs. 12.67%, P = 0.049). Conclusions: A combination of open and endovascular procedures to salvage thrombosed native AVF's is feasible and is associated with good short- and mid-term patency. A thrombosed anastomosis in a failed AVF decreases the success rate of salvage procedures.

Background: Periodontal disease is one of the leading causes of tooth loss in the geriatric population. Assessment of periodontal disease in a population is an important step in planning effective prevention and control programs for periodontal disease. Therefore, a study was carried out in old-age homes of Delhi to assess the periodontal status of 65–74-year-old elderly and recommend interventions to improve their periodontal health. Materials and Methods: A cross-sectional study was conducted among 464 elderly from old-age homes of Delhi. Periodontal health status of the participants was determined using the WHO oral health assessment form. Community Periodontal Index (CPI) and loss of attachment (LOA) were recorded. Collected data were analyzed using SPSS version 23. Chi-square test was used to determine statistically significant difference among CPI scores and LOA according to age and gender. P ≤ 0.05 was considered statistically significant. Results: The result of the study showed that 25.4% of the elderly had healthy periodontium, 71.1% had a periodontal pocket of 6 mm or more, and 2.40% had a pocket depth of 4–5 mm. Around 36% had 6–8 mm LOA and 34.70% had 9–11 mm LOA. The difference between CPI scores among gender and age group was not significant (P = 0.20, P = 0.096). However, the difference among gender for LOA was found significant (P = 0.014). Conclusion: The results from this study show that periodontal health of elderly residing in old-age homes is very poor. The periodontal status of this population can be enhanced by special collaborative efforts from the government and various nongovernmental organizations toward preventive and curative periodontal health services.