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Sickle cell disease (SCD) decreases the oxygen-carrying capacity of red blood cells. Children with SCD have reduced/restricted cerebral blood flow, resulting in neurocognitive deficits. Hydroxyurea is the standard treatment for SCD; however, whether hydroxyurea influences such effects is unclear. A key area of SCD-associated neurocognitive impairment is working memory, which is implicated in other cognitive and academic skills. The neural correlates of working memory can be tested using n-back tasks. We analyzed functional magnetic resonance imaging (fMRI) data of patients with SCD (20 hydroxyurea-treated patients and 11 controls, aged 7–18 years) while they performed n-back tasks. Blood-oxygenation level–dependent (BOLD) signals were assessed during working memory processing at 2 time points: before hydroxyurea treatment and ~1 year after treatment was initiated. Neurocognitive measures were also assessed at both time points. Our results suggested that working memory was stable in the treated group. We observed a treatment-by-time interaction in the right cuneus and angular gyrus for the 2- >0-back contrast. Searchlight-pattern classification of the 2 time points of the 2-back tasks identified greater changes in the pattern and magnitude of BOLD signals, especially in the posterior regions of the brain, in the control group than in the treated group. In the control group at 1-year follow-up, 2-back BOLD signals increased across time points in several clusters (e.g., right inferior temporal lobe, right angular gyrus). We hypothesize that these changes resulted from increased cognitive effort during working memory processing in the absence of hydroxyurea. In the treated group, 0- to 2-back BOLD signals in the right angular gyrus and left cuneus increased continuously with increasing working memory load, potentially related to a broader dynamic range in response to task difficulty and cognitive effort. These findings suggest that hydroxyurea treatment helps maintain working memory function in SCD. [ABSTRACT FROM AUTHOR]

Background: Relapse remains a challenge after transplantation in pediatric patients with hematological malignancies. Myeloablative regimens used for disease control are associated with acute and long-term adverse effects. We used a CD45RA-depleted haploidentical graft for adoptive transfer of memory T cells combined with NK-cell addback and hypothesized that maximizing the graft-versus-leukemia (GVL) effect might allow for reduction in intensity of conditioning regimen. Methods: In this phase II clinical trial (NCT01807611), 72 patients with hematological malignancies (complete remission (CR)1: 25, ≥ CR2: 28, refractory disease: 19) received haploidentical CD34 + enriched and CD45RA-depleted hematopoietic progenitor cell grafts followed by NK-cell infusion. Conditioning included fludarabine, thiotepa, melphalan, cyclophosphamide, total lymphoid irradiation, and graft-versus-host disease (GVHD) prophylaxis consisted of a short-course sirolimus or mycophenolate mofetil without serotherapy. Results: The 3-year overall survival (OS) and event-free-survival (EFS) for patients in CR1 were 92% (95% CI:72–98) and 88% (95% CI: 67–96); ≥ CR2 were 81% (95% CI: 61–92) and 68% (95% CI: 47–82) and refractory disease were 32% (95% CI: 11–54) and 20% (95% CI: 6–40). The 3-year EFS for all patients in morphological CR was 77% (95% CI: 64–87) with no difference amongst recipients with or without minimal residual disease (P = 0.2992). Immune reconstitution was rapid, with mean CD3 and CD4 T-cell counts of 410/μL and 140/μL at day + 30. Cumulative incidence of acute GVHD and chronic GVHD was 36% and 26% but most patients with acute GVHD recovered rapidly with therapy. Lower rates of grade III-IV acute GVHD were observed with NK-cell alloreactive donors (P = 0.004), and higher rates of moderate/severe chronic GVHD occurred with maternal donors (P = 0.035). Conclusion: The combination of a CD45RA-depleted graft and NK-cell addback led to robust immune reconstitution maximizing the GVL effect and allowed for use of a submyeloablative, TBI-free conditioning regimen that was associated with excellent EFS resulting in promising long-term outcomes in this high-risk population. The trial is registered at ClinicalTrials.gov (NCT01807611). [ABSTRACT FROM AUTHOR]

The present study was conducted to record the transitional period reproductive disorders in crossbred cows reared in organized farms as well as nearby villages around Palampur, Himachal Pradesh. A total of two hundred seventy eight (N=278) crossbred cows with different parities were studied to record the incidence of reproductive disorders viz., dystocia, metritis, genital prolapse and retained fetal membranes. Overall incidence of transitional period reproductive disorder recorded in current study was 34.9% with highest incidence in dystocia (16.7%) followed by metritis (11.7%), genital prolapse (3.7%) and retained fetal membrane (2.7%), respectively. Adult animals (<7 yrs, 65.9%) were more susceptible for reproductive disorders than older cows (>7yrs, 34.1%; P<0.05). Majority (93.8%) of the affected animals had prolonged postpartum anoestrus and lower conception rates. In conclusion, one-third of the crossbred cows are affected with transitional period reproductive disorders. Therefore, there is a dire need to prevent transitional period reproductive disorders through appropriate management of cows. [ABSTRACT FROM AUTHOR]

Present study was undertaken in buffaloes (n=176) of different districts of Himachal Pradesh to study the effect of different minerals attributes on buffalo infertility. These profiles of different types of infertile (endometritis and anestrus) buffaloes were evaluated and compared with normal cyclic. In present study the levels of P, Cu, Zn and Na in buffaloes suffering with anestrus were significantly low in comparison to normal cyclic and endometritic buffaloes. The level of Ca was significantly low in anestrus buffaloes than normal cyclic ones. Similarly the levels of K and Mg were also low in anestrus buffaloes in comparison to normal cyclic and endometritis showing buffaloes but the level of significance was non-significant. So the deficiency of different minerals had shown their impact in causing infertility in buffaloes. [ABSTRACT FROM AUTHOR]

When firm implantation has occurred, pregnancy losses during the late embryonic or early fetal period are less common and typically occur before 60 days of gestation. A rare case of early fetal death due to Geotrichum candidum infection in a pluriparous Jersey crossbred cow was sporadically recorded during routine screening at the university cattle farm. The early fetal death was diagnosed using sequential sonographic examinations, and the aetiology was confirmed through microbiological examination and histopathological evaluation of an endometrial biopsy sample. It is concluded that, although mycotic abortions and fetal deaths are uncommon and sporadic, routine screening of cows for late embryonic and early fetal death remains essential. [ABSTRACT FROM AUTHOR]

Objective: The risk of hydrocephalus following hemispherectomy for drug resistant epilepsy (DRE) remains high. Patients with pre-existing hydrocephalus pose a postoperative challenge, as maintaining existing shunt patency is necessary but lacks a clearly defined strategy. This study examines the incidence and predictors of shunt failure in pediatric hemispherectomy patients with pre-existing ventricular shunts. Methods: We performed a retrospective chart review at our center to identify pediatric patients diagnosed with DRE who were treated with ventricular shunt prior to their first hemispherectomy surgery. Demographic and perioperative data were obtained including shunt history, hydrocephalus etiology, epilepsy duration, surgical technique, and postoperative outcomes. Univariate analysis was performed using Fisher's exact test and Pearson correlation, with Bonferroni correction to a = 0.00625 and a = 0.01, respectively. Results: Five of nineteen (26.3%) patients identified with ventriculoperitoneal shunting prior to hemispherectomy experienced postoperative shunt malfunction. All 5 of these patients underwent at least 1 shunt revision prior to hemispherectomy, with a significant association between pre- and post-hemispherectomy shunt revisions. There was no significant association between post-hemispherectomy shunt failure and valve type, intraoperative shunt alteration, postoperative external ventricular drain placement, hemispherectomy revision, lateralization of shunt relative to resection, postoperative complications, or postoperative aseptic meningitis. There was no significant correlation between number of post-hemispherectomy shunt revisions and age at shunt placement, age at hemispherectomy, epilepsy duration, or shunt duration prior to hemispherectomy. Conclusions: Earlier shunt revision surgery may portend a subsequent need for shunt revision following hemispherectomy. These findings may guide neurosurgeons in counseling patients with pre-existing ventricular shunts prior to hemispherectomy surgery. [ABSTRACT FROM AUTHOR]

Genital tumours are rare among cattle, largely due to their relatively short lifespans. Leio-myoma, a smooth muscle tumour being more prevalent in dogs, appears only at a rate of 1.00 - 2.00% in cattle, affecting reproductive efficiency in cases of complete uterine obstruction. This case report involves an 8-year-old cow with repeated insemination attempts unveiled 5.00 cm intra-luminal uterine mass, obstructing the right uterine horn. Transrectal sonography (TRUS) revealed a highly vascularized mass with normal ovarian function. Confirmation of clinical condition, i.e., uterine leiomyoma, via uterine biopsy concluded the presence of neoplastic smooth muscle cells arranged in interlacing bundles showing mild pleomorphism, and special staining using Masson's trichrome revealed an unappreciable amount of connective tissue; subsequently right flank celiotomy was performed to remove the benign tumour. Forty-five days after celiotomy, TRUS examination confirmed an unobstructed uterine horn, and bilateral oviduct patency was adjudged with 2.50% methylene blue. Following treatment for chronic endometritis, artificial insemination led to conception nearly 90 days post-procedure. The TRUS aids preliminary diagnosis, while definitive identification demands necropsy and surgical methods. This case underscores the diagnostic significance of TRUS, histopathology and celiotomy for identifying and managing uterine leiomyoma in cattle. [ABSTRACT FROM AUTHOR]

This article discusses a case report of a patient with sickle cell disease (SCD) who underwent a donor-specific antibody desensitization treatment using daratumumab prior to a hematopoietic cell transplant. The patient had a history of red cell antibodies and high levels of HLA antibodies, which increased the risk of graft failure. Traditional pretransplant immune suppression methods were ineffective, so the patient received daratumumab along with other treatments, resulting in a reduction in antibody levels. The patient successfully underwent the transplant and achieved full donor chimerism with no evidence of graft-versus-host disease. This is the first reported use of daratumumab for this indication in SCD. The document also includes a table summarizing three different studies on patients who underwent allogeneic hematopoietic cell transplantation (AlloHCT), providing information on various factors such as desensitization regimens and donor chimerism. The authors acknowledge funding support and declare any conflicts of interest. [Extracted from the article]

We introduce DiffOpt.jl, a Julia library to differentiate through the solution of optimization problems with respect to arbitrary parameters present in the objective and/or constraints. The library builds upon MathOptInterface, thus leveraging the rich ecosystem of solvers and composing well with modeling languages like JuMP. DiffOpt offers both forward and reverse differentiation modes, enabling multiple use cases from hyperparameter optimization to backpropagation and sensitivity analysis, bridging constrained optimization with end-to-end differentiable programming. DiffOpt is built on two known rules for differentiating quadratic programming and conic programming standard forms. However, thanks to its ability to differentiate through model transformations, the user is not limited to these forms and can differentiate with respect to the parameters of any model that can be reformulated into these standard forms. This notably includes programs mixing affine conic constraints and convex quadratic constraints or objective function. History: Accepted by Ted Ralphs, Area Editor for Software Tools. Funding: The work of A. Sharma on DiffOpt.jl was funded by the Google Summer of Code program through NumFocus. M. Besançon was partially supported through the Research Campus Modal funded by the German Federal Ministry of Education and Research [Grant 05M14ZAM, 05M20ZBM]. J. Dias Garcia was supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001. B. Legat was supported by a BAEF Postdoctoral Fellowship, the NSF [Grant OAC-1835443], and the ERC Adv. [Grant 885682]. Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information (https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2022.0283), as well as from the IJOC GitHub software repository (https://github.com/INFORMSJoC/2022.0283). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/. [ABSTRACT FROM AUTHOR]

We sought to perform a systematic review and individual participant data meta‐analysis to identify predictors of treatment response following thalamic neuromodulation in pediatric patients with medically refractory epilepsy. Electronic databases (MEDLINE, Ovid, Embase, and Cochrane) were searched, with no language or data restriction, to identify studies reporting seizure outcomes in pediatric populations following deep brain stimulation (DBS) or responsive neurostimulation (RNS) implantation in thalamic nuclei. Studies featuring individual participant data of patients with primary or secondary generalized drug‐resistant epilepsy were included. Response to therapy was defined as >50% reduction in seizure frequency from baseline. Of 417 citations, 21 articles reporting on 88 participants were eligible. Mean age at implantation was 13.07 ± 3.49 years. Fifty (57%) patients underwent DBS, and 38 (43%) RNS. Sixty (68%) patients were implanted in centromedian nucleus and 23 (26%) in anterior thalamic nucleus, and five (6%) had both targets implanted. Seventy‐four (84%) patients were implanted bilaterally. The median time to last follow‐up was 12 months (interquartile range = 6.75–26.25). Sixty‐nine percent of patients achieved response to treatment. Age, target, modality, and laterality had no significant association with response in univariate logistic regression. Until thalamic neuromodulation gains widespread approval for use in pediatric patients, data on efficacy will continue to be limited to small retrospective cohorts and case series. The inherent bias of these studies can be overcome by using individual participant data. Thalamic neuromodulation appears to be a safe and effective treatment for epilepsy. Larger, prolonged prospective, multicenter studies are warranted to further evaluate the efficacy of DBS over RNS in this patient population where resection for curative intent is not a safe option. [ABSTRACT FROM AUTHOR]

The present research was carried out to assess the serum progesterone (P4) concentration and uterine hemodynamics at estrus till ovulation in cyclic cows (N = 130) with healthy or diseased uterus. At estrus, 85 cows were diagnosed with clinical endometritis (CE; n = 44) and sub-clinical endometritis (SCE; n = 41); whereas, 45 cows being served as control namely no endometritis (NE; n = 45) were included in the study. Serum progesterone estimation at 12 - 14 and 40 hr after the onset of estrus and Doppler sonography of both middle uterine arteries were done to envisage the uterine hemodynamics and ovulation. The serum progesterone concentration was significantly higher at 12 - 14 hr after onset of estrus in CE and SCE cows. At 12 - 14 hr after onset of estrus, a cut-off value of ≥ 0.48 ng mL-1 P4 was obtained, above which 22.72% CE, 26.82% SCE and only 8.88% NE cows failed to ovulate within 36 - 40 hr of estrus onset. Among the Doppler indices, pulsatility and resistance indices were significantly higher; whereas, volume and velocity indices were significantly lower in NE cows. In cows diagnosed with CE and SCE, a higher supra-basal P4 concentration, and velocity and volume of blood flow to uterus at estrus negatively affected the duration to ovulation. [ABSTRACT FROM AUTHOR]

Periprosthetic joint infections (PJI) of the knee are mostly due to a single organism, very rarely, it is due to dual organisms, and even rarer are dual Gram-negative bacilli and fungal infections. Most fungal infections are caused by Candida albicans; however, very few case reports are available for nonalbicans Candida in immunocompetent patients. We report an unusual case of nonalbicans Candida infection with Gram-negative bacilli in the knee joint with no predisposing risk factors. A 59-year-old man reported following mild pain, swelling, and restricted knee movements in a case of a primary total knee arthroplasty. The patient had minimal symptoms but had gross lysis around implants on imaging. His inflammatory markers were significantly high and knee aspiration was turbid, with raised polymorphs without any conclusive staining result. The culture reports revealed a fungal and Gram-negative organism infection. The patient was managed by debridement, prosthesis removal and antibiotic-loaded cement spacer insertion, and culture-specific antibiotics, followed by revision TKA and oral fluconazole therapy. The patient had a good clinical performance at 3 months and 1-year follow-up visits, with a painless range of motion of 10°–90° and there was no evidence of recurrence of infection. Dual Gram-negative and fungal prosthetic joint infection is a rare but serious complication. In the presence of mild clinical symptoms, but extensive lysis around the implant, fungal pathology should be considered irrespective of the immune status of the patient. [ABSTRACT FROM AUTHOR]

Simple Summary: This study addresses the challenge of respiratory motion in pediatric patients undergoing proton therapy for total lymphoid irradiation (TLI), an essential component of reduced-intensity conditioning regimens for hematopoietic cell transplant (HCT) patients. The primary concern is the interplay effect, which can cause deviations from the planned dose during respiratory motion. The research utilized static and 4D CT images from ten patients to simulate the interplay effect and assess its impact on treatment planning. The study concludes that 4D plan evaluation and robust optimization techniques can help address respiratory motion challenges in proton TLI treatments, especially in cases where other motion management strategies like breath-holding are not feasible due to the patient's young age, the need for anesthesia, or medical conditions. Patient-specific respiratory motion evaluations are crucial to ensure adequate dosimetric coverage in proton therapy for pediatric patients. (1) Background: The most significant cause of an unacceptable deviation from the planned dose during respiratory motion is the interplay effect. We examined the correlation between the magnitude of splenic motion and its impact on plan quality for total lymphoid irradiation (TLI); (2) Methods: Static and 4D CT images from ten patients were used for interplay effect simulations. Patients' original plans were optimized based on the average CT extracted from the 4D CT and planned with two posterior beams using scenario-based optimization (±3 mm of setup and ±3% of range uncertainty) and gradient matching at the level of mid-spleen. Dynamically accumulated 4D doses (interplay effect dose) were calculated based on the time-dependent delivery sequence of radiation fluence across all phases of the 4D CT. Dose volume parameters for each simulated treatment delivery were evaluated for plan quality; (3) Results: Peak-to-peak splenic motion (≤12 mm) was measured from the 4D CT of ten patients. Interplay effect simulations revealed that the ITV coverage of the spleen remained within the protocol tolerance for splenic motion, ≤8 mm. The D100% coverage for ITV spleen decreased from 95.0% (nominal plan) to 89.3% with 10 mm and 87.2% with 12 mm of splenic motion; (4) Conclusions: 4D plan evaluation and robust optimization may overcome problems associated with respiratory motion in proton TLI treatments. Patient-specific respiratory motion evaluations are essential to confirming adequate dosimetric coverage when proton therapy is utilized. [ABSTRACT FROM AUTHOR]

Diamond-Blackfan anemia (DBA) is one of the most common inherited causes of bone marrow failure in children. DBA typically presents with isolated erythroid hypoplasia and anemia in infants. Congenital anomalies are seen in 50% of the patients. Over time, many patients experience panhematopoietic defects resulting in immunodeficiency and multilineage hematopoietic cytopenias. Additionally, DBA is associated with increased risk of myelodysplastic syndrome, acute myeloid leukemia and solid organ cancers. As a prototypical ribosomopathy, DBA is caused by heterozygous loss-of-function mutations or deletions in over 20 ribosomal protein genes, with RPS19 being involved in 25% of patients. Corticosteroids are the only effective initial pharmacotherapy offered to transfusion-dependent patients aged 1 year or older. However, despite good initial response, only ~20-30% remain steroid-responsive while the majority of the remaining patients will require life-long red blood cell transfusions. Despite continuous chelation, iron overload and related toxicities pose a significant morbidity problem. Allogeneic hematopoietic cell transplantation (HCT) performed to completely replace the dysfunctional hematopoietic stem and progenitor cells is a curative option associated with potentially uncontrollable risks. Advances in HLA-typing, conditioning regimens, infection management, and graft-versus-host-disease prophylaxis have led to improved transplant outcomes in DBA patients, though survival is suboptimal for adolescents and adults with long transfusion-history and patients lacking well-matched donors. Additionally, many patients lack a suitable donor. To address this gap and to mitigate the risk of graft-versus-host disease, several groups are working towards developing autologous genetic therapies to provide another curative option for DBA patients across the whole age spectrum. In this review, we summarize the results of HCT studies and review advances and potential future directions in hematopoietic stem cell-based therapies for DBA. [ABSTRACT FROM AUTHOR]

South Asian gay, bisexual, and other men who have sex with men (GBMSM) in the United States are subsumed under the broad, heterogeneous category of Asian GBMSM in national surveillance systems. Disaggregated data on their rates of HIV and sexually transmitted infection (STI) testing are not publicly reported. This is problematic as the diversity of ancestries, cultures, and customs across subgroups of Asian GBMSM may contribute to differential HIV and STI testing experiences. To address this deficit in knowledge, 115 South Asian GBMSM recruited through social media advertising and peer referral were surveyed about their patterns of HIV and STI testing. In the past 6 months, almost two-thirds (n = 72, 62.61%) had two or more male sex partners, and more than a quarter (n = 33, 28.70%) had condomless anal sex with two or more male partners. In the past year, more than one in four (n = 32, 27.83%) had not been tested for HIV, and more than two in five (n = 47, 40.87%) had not been tested for STIs. The prevalence of past-year HIV and STI testing was lower among participants aged ≥35 years and those who had never used pre-exposure prophylaxis. Participants who were partnered were less likely to have been tested for HIV, and those who were born outside the United States were less likely to have been tested for STIs in the past year. Findings highlight gaps in domestic HIV- and STI-prevention efforts with respect to adequately engaging South Asian GBMSM and suggest that some segments of this subgroup may benefit from targeted outreach. [ABSTRACT FROM AUTHOR]

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Few studies among gay, bisexual and other men who have sex with men (GBMSM) have examined facilitators and barriers to self-collecting specimens for extragenital STI screening, and none have evaluated attitudes towards self-collecting hair samples that can be utilized for PrEP drug level testing to assess adherence. To address this gap, we interviewed 25 sexually active GBMSM who were offered a choice to self-collect and return finger-stick blood samples (for actual HIV testing), pharyngeal swabs, rectal swabs and urine specimens (for actual gonorrhea and chlamydia testing), and hair samples (to visually determine their adequacy for PrEP drug level testing): 11 who returned all, 4 who returned some, and 10 who did not return any. Participants found self-collecting finger-stick blood samples and rectal swabs more challenging than other specimens. Frequently discussed facilitators of return included an opportunity to confirm one's HIV or STI status, limited access to a healthcare provider and a desire to advance research focusing on home-based testing. Commonly cited barriers to return included low self-efficacy pertaining to self-collection and apprehension around the possibility of delay or loss of specimens during transit. Offering additional support such as real-time video conferencing may prove helpful in future field-based research with GBMSM. [ABSTRACT FROM AUTHOR]

The article presents the discussion on advanced prosthodontics. Topics include guide for clinical prosthodontics containing chapters like master level occlusion, full mouth rehabilitation, porcelain veneers, table top prostheses, implant dentistry, digital dentistry; and guide consisting of primary and intermediate shade tabs to help improve the accuracy of shade selection.

Background: Gay, bisexual, and other men who have sex with men (MSM), particularly Black or African American MSM (BMSM) and Hispanic or Latino MSM (HLMSM), continue to be disproportionately affected by the HIV epidemic in the United States. Previous HIV self-testing programs have yielded high testing rates, although these studies predominantly enrolled White, non-Hispanic MSM. Mobile health tools can support HIV prevention, testing, and treatment. This protocol details an implementation study of mailing free HIV self-tests (HIVSTs) nested within a randomized controlled trial designed to assess the benefit of a mobile phone app for increasing the uptake of HIV prevention and other social services. Objective: This study was a comparative effectiveness trial of innovative recruitment and testing promotion strategies intended to effectively reach cisgender BMSM and HLMSM. We evaluated the use of a mobile app for increasing access to care. Methods: Study development began with individual and group consultations that elicited feedback from 3 core groups: HIV care practitioners and researchers, HIV service organization leaders from study states, and BMSM and HLMSM living in the study states. Upon completion of the formative qualitative work, participants from 11 states, based on the observed areas of highest rate of new HIV diagnoses among Black and Hispanic MSM, were recruited through social networking websites and smartphone apps. After eligibility was verified, participants consented and were randomized to the intervention arm (access to the Know@Home mobile app) or the control arm (referral to web resources). We provided all participants with HIVSTs. The evaluation of the efficacy of a mobile phone app to support linkage to posttest prevention services that included sexually transmitted infection testing, pre-exposure prophylaxis initiation, antiretroviral treatment, and acquisition of condoms and compatible lubricants has been planned. Data on these outcomes were obtained from several sources, including HIVST-reporting surveys, the 4-month follow-up survey, laboratory analyses of dried blood spot cards returned by the participant, and data obtained from the state health department surveillance systems. Where possible, relevant subgroup analyses were performed. Results: During the formative development phase, 9 consultations were conducted: 6 in-depth individual discussions and 3 group consultations. From February 2020 through February 2021, we enrolled 2093 MSM in the randomized controlled trial from 11 states, 1149 BMSM and 944 HLMSM. Conclusions: This study was designed and implemented to evaluate the effectiveness of recruitment strategies to reach BMSM and HMSM and of a mobile app with regard to linkage to HIV prevention or treatment services. Data were also obtained to allow for the analyses of cost and cost-effectiveness related to study enrollment, HIV testing uptake, identification of previously undiagnosed HIV, sexually transmitted infection testing and treatment, and linkage to HIV prevention or treatment services. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to better understand the long‐term palliative and disease‐modifying effects of surgical resection beyond seizure freedom, including frequency reduction and both late recurrence and remission, in patients with drug‐resistant epilepsy. Methods: This retrospective database‐driven cohort study included all patients with >9 years of follow‐up at a single high‐volume epilepsy center. We included patients who underwent lobectomy, multilobar resection, or lesionectomies for drug‐resistant epilepsy; we excluded patients who underwent hemispherectomies. Our main outcomes were (1) reduction in frequency of disabling seizures (at 6 months, each year up to 9 years postoperatively, and at last follow‐up), (2) achievement of seizure remission (>6 months, >1 year, and longest duration), and (3) seizure freedom at last follow‐up. Results: We included 251 patients; 234 (93.2%) achieved 6 months and 232 (92.4%) experienced 1 year of seizure freedom. Of these, the average period of seizure freedom was 10.3 years. A total of 182 (72.5%) patients were seizure‐free at last follow‐up (defined as >1 year without seizures), with a median 11.9 years since remission. For patients not completely seizure‐free, the mean seizure frequency reduction at each time point was 76.2%, and ranged from 66.6% to 85.0%. Patients decreased their number of antiseizure medications on average by.58, and 53 (21.2%) patients were on no antiseizure medication at last follow‐up. Nearly half (47.1%) of those seizure‐free at last follow‐up were not seizure‐free immediately postoperatively. Significance: Patients who continue to have seizures after resection often have considerable reductions in seizure frequency, and many are able to achieve seizure freedom in a delayed manner. [ABSTRACT FROM AUTHOR]

Background: To study depression and heart rate variability in physically healthy subjects. Materials & methods: A total of 60 patients were enrolled. The subjects were divided into 2 groups as control group and depression group. The age of patients was between 20 - 50 years. HRV recording was done. Chi-square test was employed to compare categorical variables. The data was analysed using SPSS software. Results: A total of 60 patients were enrolled. In the comparison of HRV measures in between the two groups, values of LF (nu) (p<0.001), LF:HF Ratio (p<0.001) were significantly higher and HF (nu) (p<0.001) parameter was significantly lower in depression group compared to controls. Conclusion: HRV recordings showed significant changes in the patients suffering from depression. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the association between ovarian structures, uterine characteristics and physical attributes of cervico-vaginal mucus (CVM) with conception rate in normal cyclic dairy cows (N=20) at estrus. Different physical parameters of CVM at estrus such as quantity, consistency, color, pH, Spinnbarkeit value and fern pattern were evaluated. Transrectal ultrasonography was done at estrus to carry out the morphometry of follicles and uterine horns as well as following artificial insemination, the mid-cyclic corpus luteum size and functionality were assessed on the 10th day using B-mode and color Doppler ultrasonography. Among the physical parameters, significantly higher (p<0.05) Spinnbarkeit values were recorded for subsequently pregnant (n=12) as compared to non-pregnant cows (n=8). The mean diameter of the preovulatory follicle at estrus and corpus luteum vascularity (%) was significantly higher (p<0.05) in subsequently pregnant as compared to non-pregnant cows while, no significant difference (p>0.05) was recorded for intraluminal uterine fluid diameter and endometrium thickness. In conclusion, higher spinnbarkeit and preovulatory follicle diameter at estrus led to a better conception rate in dairy cows. [ABSTRACT FROM AUTHOR]

An excerpt from the book "Clinical Fixed Prosthodontics-Master Volume" by Dr. Moez Khakiani is presented.

The aim of this paper is to examine the role of multiagent technology in the aviation industry in order to ensure a high level of aviation safety. The most important criterion for modern aircraft design and service is flight safety. Various agents have been built in the paradigms of designing, manufacturing, air space management, and maintenance, etc. according to existing literature. However, no research on the overall impact of multiagent technology (MAT) on the aviation sector's efficiency has been conducted. This paper analyses the role of multiagent technology in aviation sector by applying AHP and DEMATEL approach in a hybrid way. A structural model was developed by this hybrid approach in which AHP helps in determining the relative importance of variables of MAT and DEMATEL helps in capturing the interactive relationship among variables. The proposed model can provide a useful framework for the aviation industry in deciding which factor category of MAT can be used to monitor the corresponding problem. The findings would aid aviation professionals in reducing the risks of an airplane crash by implementing MAT efficiently and provide passengers with a high level of protection. This paper draws on the research results for implementation of agent technology and suggests some empirical tactics to enhance the performance of aviation sector so that many lives can be saved due to airplane crash. Finally, at the conclusion of this article, the limitations and scope of future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction Chronic kidney disease (CKD) patients face multiple complications. One of them is involvement of the auditory system and it deserves more attention than is paid by the current approaches as hearing loss has major repercussions on the quality of life. Early detection can prevent further deterioration of hearing and improve the quality of life of patients suffering from CKD. Material and methods The high frequency (8–18 kHz) audiometry with pure tones was performed in 82 patients with CKD and compared with age and sexes matched healthy control group of 90 patients. Individual ear were used for statistical calculations. Results This study clearly observed that the hearing thresholds for frequencies 8–18 kHz increased in CKD patients when compared to sex and aged matched healthy control group, the thresholds significantly increased in CKD with diabetes mellitus as compared to nondiabetic with CKD. The high frequency thresholds significantly increased in patients on hemodialysis, and were significantly correlated with age, stage of CKD and duration of CKD. Conclusion This study highlights the presence of high frequency (8–18 kHz) hearing loss in patients of CKD. The severity is significantly correlated with age, stage and duration of CKD. [ABSTRACT FROM AUTHOR]

The article presents a guide for clinical prosthodontics suited for clinicians who wish to expand their horizons in advanced dental technology. Topics include Roots of aesthetic dentistry lie in our relentless efforts at replicating nature in form and color; and role of a shade guide is to help standardize the perception of tooth color and facilitate it's communication with the dental laboratory.

Introduction: liver diseases are associated with endocrine disturbances and secondary dysfunction of endocrine organ which apparent hormonal imbalance. This study aims to find out the correlation between the levels of FT3, FT4, TSH and severity of liver disease in Chronic Liver Disease patients. Materials and Method: A total of 100 subjects with Chronic Liver disease satisfying inclusion and exclusion criteria visiting medicine OPD and admitted in IPD of Muzaffarnagar Medical College during the period of 18 months was taken for study which was a Cross Sectional Observational Study.Thyroid function tests which includes FreeT3, FreeT4, TSH was done for all patients and tests such as Anti-TPO antibodies, USG neck, Doppler thyroid, FNAC thyroid was done wherever indicated The liver function tests including total and direct bilirubin, total protein and albumin, AST and ALT, APTT, PT, INR was done for all patients and USG abdomen and Oesophago-gastro-duodenoscopy was done wherever indicated. Results: The mean duration of liver disease in our study population was 5.92 ± 4.61 years (range 1-26 years). The mean FT3 levelwas 2.3059 ± 0.8883 p Mol/L. The mean FT4 level was1.1689 ± 1.0806 ng/dL . The mean TSH level was 3.3198 ± 1.0173 m IU/mL The mean total bilirubin was 8.445 ± 4.3438 mg/dL . Conclusion: Thyroid dysfunction forms important part of spectrum of Chronic liver disease. Patients with liver disease should be evaluated for thyroid dysfunction periodically. [ABSTRACT FROM AUTHOR]

As the number of childhood cancer survivors increases, a heightened awareness and recognition of therapy-related late effects is becoming more important. Pulmonary complications are the third leading cause of late mortality in cancer survivors. Diagnosis of these complications on chest imaging helps facilitate prompt treatment to mitigate adverse outcomes. In this review, we summarize the imaging of late pulmonary complications of cancer therapy in children and highlight characteristic findings that should be recognized by radiologists. [ABSTRACT FROM AUTHOR]

In this review, we summarize early pulmonary complications related to cancer therapy in children and highlight characteristic findings on imaging that should be familiar to a radiologist reviewing imaging from pediatric cancer patients. [ABSTRACT FROM AUTHOR]

Summary: We adjusted haematopoietic stem and progenitor cell (HSPC) apheresis collection from patients with sickle cell disease (SCD) by targeting deep buffy coat collection using medium or low collection preference (CP), and by increasing anticoagulant–citrate–dextrose–solution A dosage. In 43 HSPC collections from plerixafor‐mobilized adult patients with SCD, we increased the collection efficiency to 35.79% using medium CP and 82.23% using low CP. Deep buffy coat collection increased red blood cell contamination of the HSPC product, the product haematocrit was 4.7% with medium CP and 6.4% with low CP. These adjustments were well‐tolerated and allowed efficient HSPC collection from SCD patients. [ABSTRACT FROM AUTHOR]

Web-based HIV and sexually transmitted infection (STI) prevention studies are increasingly requesting gay, bisexual, and other men who have sex with men (GBMSM) to return self-collected specimens for laboratory processing. Some studies have solicited self-collected extragenital swabs for gonorrhea and chlamydia testing, but to date, none have solicited self-collected hair samples for pre-exposure prophylaxis (PrEP) adherence testing. Project Caboodle! offered 100 racially/ethnically diverse GBMSM aged 18 to 34 years residing across the United States a choice to self-collect at home and return by mail any of the following: a finger-stick blood sample (for HIV testing), a pharyngeal swab, a rectal swab and a urine specimen (for gonorrhea and chlamydia testing), and a hair sample (to visually assess its adequacy for PrEP drug level testing). Despite not incentivizing specimen return, 51% mailed back at least one type of specimen within 6 weeks (1% returned three specimens, 11% returned four specimens and 39% returned all five specimens). The majority of returned specimens were adequate for laboratory processing. Significantly more participants without a college education (p =.0003) and those who were working full-time or part-time (p =.0070) did not return any specimens. In addition, lower levels of HIV-related knowledge (p =.0390), STI-related knowledge (p =.0162), concern about contracting HIV (p =.0484), and concern about contracting STIs (p =.0108) were observed among participants who did not return any specimens. Self-collection of specimens holds promise as a remote monitoring strategy that could supplement testing in clinical settings, but a better understanding of why some GBMSM may choose to fully, partially, or not engage in this approach is warranted. [ABSTRACT FROM AUTHOR]

The present study was conducted on fifteen she-dogs presented to the Department of Veterinary Gynaecology and Obstetrics, CSK Himachal Pradesh Krishi Vishvavidyalaya (CSKHPKV), Palampur for determination of mating time. Serum progesterone was estimated from the blood sample collected in the clot activator by cephalic venepuncture from she-dogs during the proestrus and estrus stages. The objective of the study was to establish a correlation between epithelial cells proportion (%) in vaginal epithelium with serum progesterone concentration (ng/mL) during proestrus, early estrus, and mid to late estrus in she-dogs. A significant positive correlation (r= 0.74; p<0.01) between cornified cells and progesterone concentration was recorded during mid to late estrus whereas the correlation was non-significantly negative (p>0.05) for non-cornified cells (r= -0.7408 to -0.5807). Also, the cornified cell proportion was significantly higher (p<0.01) during mid to late estrus as compared to proestrus and early estrus. In conclusion, the present study validated the statistical association between cornified vaginal epithelial cells and serum progesterone concentration during mid to late estrus. [ABSTRACT FROM AUTHOR]

Summary: It is not known whether obesity has a differential effect on allogeneic haematopoietic cell transplantation outcomes with alternative donor types. We report the results of a retrospective registry study examining the effect of obesity [body mass index (BMI) > 30] on outcomes with alternative donors (haploidentical related donor with two or more mismatches and receiving post‐transplant cyclophosphamide [haplo] and cord blood (CBU)] versus matched unrelated donor (MUD). Adult patients receiving haematopoietic cell transplantation for haematologic malignancy (2013–2017) (N = 16 182) using MUD (n = 11 801), haplo (n = 2894) and CBU (n = 1487) were included. The primary outcome was non‐relapse mortality (NRM). The analysis demonstrated a significant, non‐linear interaction between pretransplant BMI and the three donor groups for NRM: NRM risk was significantly higher with CBU compared to haplo at BMI 25–30 [hazard ratio (HR) 1.66–1.71, p < 0.05] and MUD transplants at a BMI of 25–45 (HR, 1.61–3.47, p < 0.05). The results demonstrated that NRM and survival outcomes are worse in overweight and obese transplant recipients (BMI ≥ 25) with one alternative donor type over MUD, although obesity does not appear to confer a uniform differential mortality risk with one donor type over the other. BMI may serve as a criterion for selecting a donor among the three (MUD, haplo and CBU) options, if matched sibling donor is not available. [ABSTRACT FROM AUTHOR]

Imparting epithelial to mesenchymal transition (EMT) during cellular transformation, a major driving force behind tumor progression, is one of the notorious oncogenic activities of transforming growth factor β (TGFβ); however, the secretary factors released during TGFβ‐induced EMT that may have role in potentiating EMT and tumor progression are poorly known. This study was undertaken to identify such secreted protein factors from TGFβ‐induced A549 cells cultured in serum‐free chemically defined medium (FreestyleTM) using Matrix Assisted Laser Desorption Ionization‐Time of flight/Time of flight (MALDI‐TOF/TOF) mass spectrometry. We identified some of the potential factors such as ESR, ANXA2, ALDH1A, TGFβ‐induced protein ig‐h3, and PAI‐1 that were not only secreted but some were also elevated in TGFβ‐induced A549 cells. Interestingly, these factors are widely reported to play crucial role in EMT induction and progression, which not only validates our findings but also opens avenues for further investigation, if upon secretion they act exogenously through certain receptors to potentiate cellular signaling involved in EMT induction and tumor progression. [ABSTRACT FROM AUTHOR]

The article focuses on shade selection and shade communication in prosthodontics, discussing different methods such as written communication, photographic communication, and direct shade selection by the technician. It emphasizes the importance of standardized and methodical approaches, including the use of shade guides, digital photography, and grey cards, to achieve predictable and satisfactory results in aesthetic and restorative dentistry.

Background: Embryonic mortality is one of the major factors leading to reproductive failure, decreased fertility and delayed pregnancy in cattle. Methods: The study was aimed for investigating the incidence of embryonic mortality(EM), differentiate embryonic development and mortality based on color Doppler ultrasonographic characteristics. Different characteristics correlated were corpus luteum(CL) vascularity, embryonic development and EM features, monitored on day 21 post-insemination. Result: The overall incidence of EM was recorded to be 25%, with 15% and 10% mortality occurred between days 21-28 and 28-35 of gestation. Color Doppler analysis stated that, the CL in pregnant cows had a higher percentage of luteal tissue with positive Doppler signals on initial examination (day 21) differing significantly (P<0.01) from non-pregnant and consistently increased till the end of the examination. However, cows with EM had a significantly lower CL vascularity than pregnant (P<0.05) but significantly higher (P<0.05) than non-pregnant cows on day 21. Embryos from pregnant cows (detected by 28 days) increased in size along the days of examination. However, cows diagnosed with EM showed signs (day 28), which included reduced intra-uterine allantoic fluid, absence of embryo proper with an embryonic heartbeat, hyperechoic free-floating embryonic debris in the uterus and distorted allanto-chorionic membrane. In conclusion, the present study firmly supports color Doppler ultrasonography in diagnosis of pregnant cows based on CL vascularity, visualizing the different characteristics signs of EM, and detecting non-pregnant animals undergoing EM as early as day 21. [ABSTRACT FROM AUTHOR]

Food safety and foodborne diseases are significant global public health concerns. Meat and poultry carcasses can be contaminated by pathogens like E. coli and salmonella, by contact with animal fecal matter and ingesta during slaughter and processing. Since fecal matter and ingesta can host these pathogens, detection, and excision of contaminated regions on meat surfaces is crucial. Fluorescence imaging has proven its potential for the detection of fecal residue but requires expertise to interpret. In order to be used by meat cutters without special training, automated detection is needed. This study used fluorescence imaging and deep learning algorithms to automatically detect and segment areas of fecal matter in carcass images using EfficientNet-B0 to determine which meat surface images showed fecal contamination and then U-Net to precisely segment the areas of contamination. The EfficientNet-B0 model achieved a 97.32% accuracy (precision 97.66%, recall 97.06%, specificity 97.59%, F-score 97.35%) for discriminating clean and contaminated areas on carcasses. U-Net segmented areas with fecal residue with an intersection over union (IoU) score of 89.34% (precision 92.95%, recall 95.84%, specificity 99.79%, F-score 94.37%, and AUC 99.54%). These results demonstrate that the combination of deep learning and fluorescence imaging techniques can improve food safety assurance by allowing the industry to use CSI-D fluorescence imaging to train employees in trimming carcasses as part of their Hazard Analysis Critical Control Point zero-tolerance plan. [ABSTRACT FROM AUTHOR]