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Key Clinical Message Dulaglutide is a relatively unpopular GLP‐1 receptor agonist used for weight loss. This case demonstrates that dulaglutide may be beneficial for weight loss in morbidly obese patients with multiple comorbidities after thoroughly evaluating its efficacy, benefits, and long‐term adverse effects through clinical trials. Abstract We present a case of a 27‐year‐old ex‐sumo wrestler with bipolar II disorder, morbid obesity, hypertension, Type 2 Diabetes Mellitus (DM), and a Body Mass Index (BMI) of 49.66 kg/m2. He was non‐compliant with lifestyle modifications and resistant to conventional treatments, including metformin, and was also using multiple antipsychotic drugs. After introducing dulaglutide, he achieved a 40 kg (−21%) weight loss and a BMI reduction of 10.3 kg/m2 over 6 months, with no side effects and improved glycemic control, demonstrating dulaglutide's efficacy for weight loss in such challenging presentations.

Abstract A 3-year field experiment was setup to address the threat of underground water depletion and sustainability of agrifood systems. Subsurface drip irrigation (SDI) system combined with nitrogen management under conservation agriculture-based (CA) maize-wheat system (MWS) effects on crop yields, irrigation water productivity (WPi), nitrogen use efficiency (NUE) and profitability. Grain yields of maize, wheat, and MWS in the SDI with 100% recommended N were significantly higher by 15.8%, 5.2% and 11.2%, respectively, than conventional furrow/flood irrigation (CT-FI) system. System irrigation water savings (~ 55%) and the mean WPi were higher in maize, wheat, and MWS under the SDI than CT-FI system. There was saving of 25% of fertilizer N in maize and MWS whereas no saving of N was observed in wheat. Net returns from MWS were significantly higher (USD 265) under SDI with 100% N (with no subsidy) than CT-FI system despite with higher cost of production. The net returns were increased by 47% when considering a subsidy of 80% on laying SDI system. Our results showed a great potential of complementing CA with SDI and N management to maximize productivity, NUE, and WPi, which may be economically beneficial and environmentally sound in MWS in Trans-IGP of South Asia.

Owing to enormous increase in the automobile population, traditional petroleum fuels for internal combustion engines will be usable only for a few years. Moreover, by releasing toxic emissions into the atmosphere at higher levels these fuels create severe environmental problems. In general, Carbon-monoxide (CO), Unburnt hydrocarbons (UHC), and smoke are emissions emitted by engines. The pollution of the environment can be controlled by replacing petroleum fuel with the use of alternative fuels like acetylene gas, hydrogen, CNG, LPG etc. In this current research, an experimental investigation was carried out in Compression Ignition engine using acetylene fuel, further enhancing the performance and emission properties by using diethyl ether (DEE) and ethanol as oxygenated fuel. In view of the performance and outflow (emission) parameters optimizing valve of acetylene gas as 12 lpm with oxygenated fuels, the performance and outflow characteristics were improved. The findings show an enhancement in brake thermal-efficiency of up to 3 to 4%, a decrease in exhaust temperature and emissions like CO, UHC and smoke of up to 40%, 20%–30% and 10%–35% respectively, there is decrease in fuel consumption of 10%–30%. It was found that ethanol is better than diethyl ether and diesel fuels when used as an oxygenated fuel with acetylene gas. In view of the performance and emission parameters, the best oxygenated fuel is ethanol and the optimize blend for diesel engine is E15+A12.

Coconut-coir, a natural fiber, strong and lightweight, abundantly in India and Vietnam, can be an excellent choice to produce polymer composites. Due to the higher specific modulus and durability, these composites have a myriad of applications. This article provides a novel experimental research study on the fabrication and investigation of mechanical as well as thermal behavior of coir fiber/woven-carbon fiber/epoxy resin hybrid composite. The composite samples were formulated with distinct fiber weight percentages viz. 30%, 20%, and 10% using the vacuum bagging technique. Mechanical behavior (tensile, compressive, flexural, and impact strength) and thermal behavior (Thermogravimetric analysis) of coir fiber/carbon fiber/epoxy resin hybrid composites were studied according to the ASTM standards. Moreover, Scanning Electron Microscopy (SEM) was performed to examine the morphological characterization of tensile fractography specimens and analyze the properties of the fiber/matrix bonding of the surface before and after alkaline treatment. The treated fiber shows good matrix binding and less fiber pull-out as compared with untreated fibers. The result also revealed that the hybrid composite has more robust properties under mechanical loading than single fiber-reinforced composite.

Additive manufacturing has gained popularity among material scientists, researchers, industries, and end users due to the flexible, low cost, and simple manufacturing process. Among number of techniques, fused deposition modeling (FDM) is the most recognized technology due to easy operation, lower environmental degradation, and portable apparatus. Despite numerous advantages, the limitations of this technique are poor surface finish, dimensional accuracy, and mechanical strength, which must be improved. The present study focuses on the implementation of the genetic algorithm and Taguchi techniques to achieve minimum dimensional variability of FDM parts especially for polymeric biocomposites. The output has been measured using standard testing techniques followed by Taguchi and genetic algorithm analyses. Four response variables were measured and were converted into single variable with combination of different weightages of each response. Maximum weightage was given to width of FDM polymeric biocomposite parts which may play critical role in biomedical and aerospace applications. The advanced optimization and production techniques have yielded promising results which have been validated by advanced algorithms. It was found that layer thickness and orientation angle were significant parameters which influenced the dimensional accuracy whereas best fitness value was 0.377.

A total of 31 species of weeds belonging to 11 families was collected from rice fields in Fatehgarh District of Punjab between June and November 2017. Of the 31 species, 15 were dicots and 16 were monocots. Of the 11 families, six (Portulacaceae, Lythraceae, Solanaceae, Scrophulariaceae, Polygonaceae, and Commelinaceae) were represented by only one species each. Poaceae was the largest family represented by 10 species, followed by Asteraceae and Cyperaceae with five species each. The largest genus was Cyperus with four species, followed by Euphorbia, Echinochloa, and Eragrostis with two species each. Of the 31 weed species, 29 were annual and only two, Cyperus rotundus and Parthenium hysterophorus, were perennials. More detailed survey work is required on a regular basis to identify possible problematic weeds and new or improved control measures.

Acute lymphoblastic leukemia (ALL) is a cancer of the white blood cells and is typically well treated with combination chemotherapy, with a remission state after 5 years of 94% in children and 30-40% in adults. To establish how aggressive the disease is, further chromosome testing is required to determine whether the cancer is myeloblastic and involves neutrophils, eosinophils or basophils, or lymphoblastic involving B or T lymphocytes. This case study is on a 14-year-old patient diagnosed with a very aggressive form of ALL (positive for the Philadelphia chromosome mutation). A standard bone marrow transplant, aggressive chemotherapy and radiation therapy were revoked, with treatment being deemed a failure after 34 months. Without any other solutions provided by conventional approaches aside from palliation, the family administered cannabinoid extracts orally to the patient. Cannabinoid resin extract is used as an effective treatment for ALL with a positive Philadelphia chromosome mutation and indications of dose-dependent disease control. The clinical observation in this study revealed a rapid dose-dependent correlation.

Adenoviruses (AdVs) are icosahedral viruses with double-stranded DNA (dsDNA) genomes. Genome packaging in AdV is thought to be similar to that seen in dsDNA containing icosahedral bacteriophages and herpesviruses. Specific recognition of the AdV genome is mediated by a packaging domain located close to the left end of the viral genome and is mediated by the viral packaging machinery. Our understanding of the role of various components of the viral packaging machinery in AdV genome packaging has greatly advanced in recent years. Characterization of empty capsids assembled in the absence of one or more components involved in packaging, identification of the unique vertex, and demonstration of the role of IVa2, the putative packaging ATPase, in genome packaging have provided compelling evidence that AdVs follow a sequential assembly pathway. This review provides a detailed discussion on the functions of the various viral and cellular factors involved in AdV genome packaging. We conclude by briefly discussing the roles of the empty capsids, assembly intermediates, scaffolding proteins, portal vertex and DNA encapsidating enzymes in AdV assembly and packaging.

We present a case of 50-year-old male having unstable angina. A rare type of single coronary artery was identified during the Coronary angiogram. The left anterior descending (LAD) and left circumflex artery (LCX) had originated from the proximal segment of right coronary artery along with significant lesion in LCX. Computed tomographic (CT) coronary angiogram confirmed the origin and course following which successful percutaneous coronary intervention (PCI) was done to LCX. The incidence of this type of coronary anomaly is 0.004%. We emphasize the importance of having a CT coronary angiogram to identify the course before the intervention. The procedural risk during PCI in patients with single coronary ostium is high. Moreover, the angulation and course of the culprit artery also pose a challenge. Good coaxial guide support by using an appropriate guiding catheter is the key to success.

This study deals with anilofos tolerance and its mineralization by the common rice field cyanobacterium Synechocystis sp. strain PUPCCC 64. The organism tolerated anilofos up to 25 mg L(-1). The herbicide caused inhibitory effects on photosynthetic pigments of the test organism in a dose-dependent manner. The organism exhibited 60, 89, 96, 85 and 79% decrease in chlorophyll a, carotenoids, phycocyanin, allophycocyanin and phycoerythrin, respectively, in 20 mg L(-1) anilofos on day six. Activities of superoxide dismutase, catalase and peroxidase increased by 1.04 to 1.80 times over control cultures in presence of 20 mg L(-1) anilofos. Glutathione content decreased by 26% while proline content was unaffected by 20 mg L(-1) anilofos. The test organism showed intracellular uptake and metabolized the herbicide. Uptake of herbicide by test organism was fast during initial six hours followed by slow uptake until 120 hours. The organism exhibited maximum anilofos removal at 100 mg protein L(-1), pH 8.0 and 30°C. Its growth in phosphate deficient basal medium in the presence of anilofos (2.5 mg L(-1)) indicated that herbicide was used by the strain PUPCCC 64 as a source of phosphate.

Intensive tillage, removal or burning of crop residues, limited organic manure use, declining irrigation water resources and scarcity of labour are the major causes of soil degradation and unsustainability of rice (Oryza sativa L.) wheat (Triticum aestivum L.) system (RWS) in South Asia.Resource conservation technologies (RCTs) such as zero tillage (ZT), dry direct seeded rice (DSR) and crop residues retained as mulch have shown promise to increase the productivity and profitability of RWS in South Asia. Effects of RCTs on soil biological parameters are unclear and contradictory. We evaluated the effects of conservation agriculture practices on changes in soil biochemical properties at different growth stages of wheat grown as the fifth crop in RWS. Twelve treatment combinations of tillage, crop establishment and crop residue management included four main plot treatments in rice: (1) conventional tillage (CT)-DSR, (2) ZT-DSR, (3) DTR, ZT machine transplanted rice and (4) PTR, conventional puddled transplanted rice. The three subplot treatments were: (i) CTW-R, CT wheat with both rice and wheat residues removed, (ii) ZTW-R, ZT wheat with residues of both the crops removed and (iii) ZTW+R, ZT wheat with rice residue retained as surface mulch in subsequent wheat. Irrespective of rice establishment methods, mean wheat grain yield under ZTW+R was 6% and 10% greater than CTW-R and ZTW-R respectively. Soil enzyme activities increased (5-18%) under ZTW+R compared with ZTW-R and CTW-R at different growth stages of wheat. The residual effect of rice establishment methods was significant on soil enzyme activities during wheat cropping, which were highest under ZT-DSR followed by CT-DSR, DTR and PTR. Soil organic carbon content in the 0-7.5 cm layer was significantly higher (7-9%) under the ZTW+R treatment compared with all the other treatments. Principal component analysis (PCA) identified three enzyme activities (dehydrogenase, fluorescein diacetate and phosphatase), and soil organic carbon content as the most sensitive indicators for assessing soil quality for RWS based on conservation agriculture. The PCA discriminated rice establishment systems with rice residue as surface mulch from rice establishment systems without rice residue and the maximum tillering stage from the other stages of wheat. The present study provided reliable biochemical indicators to monitor soil biological quality changes in response to conservation agriculture practices in RWS. Additional keywords: Conventional tillage, rice establishment methods, rice straw retention, soil enzymes, wheat growth stages., Introduction Rice-wheat system (RWS) is an important cropping sequence for food security, employment, income and livelihood for millions of people in Asia (Singh et al. 2014). This system occupies ~13.5 [...]

Conventional tillage and crop establishment methods for the rice–wheat (RW) system are input intensive (water, labour and energy). About 24.5 million tonnes of rice residues are burnt every year on farms in north-western India before sowing of wheat, causing air pollution and soil health degradation. Therefore, alternative tillage, crop establishment and residue management practices are needed for long-term sustainability of the RW system. A 4-year field study evaluated four tillage and crop establishment methods in rice (in main plots) and three tillage and rice residue management methods in wheat (in subplots) for their effects on yield, soil fertility, and profitability of the RW system. Average rice yields were similar under conventional puddled transplanted rice (PTR) and conventional till dry seeder rice (CTDSR). Both of these treatments produced significantly greater yields (10–16%) compared with zero till DSR (ZTDSR) and ZT machine transplanted rice in non-puddled soil, respectively, regardless of tillage and straw management methods in the previous wheat crop. Wheat yields in ZT wheat (ZTW) with 100% surface retention of rice residue (+R) were significantly greater than conventional till without residue retention after 2 years of experimentation, and accompanied by significant increases in macro-nutrient (potassium) availability in soil. The ZTW−R (no residue) treatment produced 15% lower wheat yield than ZTW+R. System yield was highest in CTDSR-ZTW+R, which was 5% higher than the conventional practice PTR-CTW−R, resulting in Rs 17 000 ha−1 greater net returns. The sustainability of conventional rice–wheat production systems in northwestern India has become a major concern for addressing the issues of energy, labour, water scarcity and quality. Resource conservation technologies such as zero tillage with residue retention showed higher productivity, profitability and potential in improving the soil health. The adoption of sowing of wheat into rice residues can achieve high crop productivity and income, while avoiding ill effects of straw burning on the environment. [ABSTRACT FROM AUTHOR]