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Aerodynamic sound generation and self-noise mechanisms from lifting surfaces such as airfoil involve the fields of classical acoustics and fluid mechanics. In this paper, trailing edge noise production is evaluated using empirical model for NACA 0012 and NACA 6320 airfoils. The sound pressure levels from trailing edge surface are calculated for different flow configurations. The growth of boundary layer thickness and displacement thickness, for different chord lengths and Mach numbers with varying angles of attack, is illustrated for NACA 0012. The sound pressure levels were computed numerically between 00 to 60 angles of attack and at constant chord length of 1.2m using Brookes Pope Marcolini method. The results showed a change of ~2-5dB in peak amplitude for mid frequencies region of spectrum. The effects of varying chord length and Mach number on sound pressure levels are illustrated for both airfoils. The relative velocity field for airfoils was computed using the boundary element method. The combined effect of thickness and camber on sound power level is demonstrated at a 40 angle of attack and for a Mach number of 0.191. Validation of sound pressure levels is done based on the results obtained for NACA0012 for similar flow conditions.

Background: Non-cardiac chest pain is common with two-thirds due to gastroesophageal reflux disease (GERD).Objective: To evaluate the effectiveness and safety of guided vs. empirical therapy in non-cardiac chest pain.Methods: Adults with normal angiogram or stress test were randomized into either a guided or empirical group. In the guided group, after the ambulatory pH-impedance test, if GERD then dexlansoprazole 30 mg/day for 8 weeks, but if functional or hypersensitive chest pain, then theophylline SR 250 mg/day for 4 weeks. In the empirical group, dexlansoprazole 60 mg/day was given for 2 weeks. The primary outcome was global chest pain visual analog score (VAS) and secondary outcomes were Quality of Life in Reflux and Dyspepsia (QOLRAD), GERD questionnaire (GERDQ), and pH parameters, all determined at baseline, 2nd and 8th weeks.Results: Of 200 screened patients, 132 were excluded, and of 68 randomized per-protocol, 33 were in the guided group and 35 in the empirical group. For between-group analysis, mean global pain scores were better with guided vs. empirical group at 8th week (P = 0.005) but not GERDQ or QOLRAD or any of pH measures (all P > 0.05). For within-group analysis, mean QOLRAD improved earliest at 8th week vs. baseline (P = 0.006) in the guided group and 2nd week vs. baseline (P = 0.011) in the empirical group but no differences were seen in other secondary outcomes (P > 0.05). No serious adverse events were reported.Conclusions: Guided approach may be preferred over short-term empirical therapy in symptom response, however QOLRAD, acid-related symptoms, or pH measures are not significantly different (trial registration ID no. NCT03319121).

Bush frogs from Garo and Khasi Hills were collected, and a thorough examination based on morphology and geographic distribution revealed that two of the populations sampled from Garo Hills during this study agree with the holotypes and descriptions of the taxa Ixalus garo and I. kempiae, described more than a century ago. The original description lacked information on several morphological characters, genetic material, and photographs of the species in life. The absence of such information posed challenges in field identification of these species. Our phylogeny shows them to be nested within the Raorchestes clade, and therefore, we allocate these two species to this genus and formally announce their rediscovery. We also redescribe these two species here based on additional adult vouchers and report geographic range extensions from new localities. Based on molecular and morphological analysis, we reassess the status of the recently described Raorchestes cangyuanensis, resulting in its placement under the subjective junior synonymy of R. kempiae. We also describe a morphologically distinct new species from this region. This paper bridges an important gap in the knowledge of the genus Raorchestes in this part of India and highlights the importance of systematic surveys in documenting and understanding amphibian diversity in the region.

Abstract Study of correlation functions in AdS/CFT and in-in correlators in de Sitter space often requires the computation of Witten diagrams. Due to the complexity of evaluating radial integrals for these correlators, several indirect approaches have been developed to simplify computations. However, in momentum space, these methods have been limited to fields with integer spin. In this paper, we formulate tools for evaluating Witten diagrams with spin − 1 2 $$ \textrm{spin}-\frac{1}{2} $$ fields in momentum space and discuss where they differ from the corresponding integer-spin analysis. We formulate our tools explicitly for massless fermions and present how appropriate Weight shifting operators with respect to the external kinematics can be used to obtain the generalization to fermions with integer mass (in units of 1/l AdS). We apply these tools to loop Witten diagrams and also discuss their use for evaluating in-in correlators in dS. In cases where we can evaluate the loop integrals, we find their transcendentality is lower than the corresponding scalar field results. Further, we classify the nature of IR divergences encountered for interacting massive scalars and fermions. We also prove a novel Weinberg-like soft theorem for gauge fields coupled to matter in AdS and show that the universal terms in the leading soft factor are sensitive to the spin of the matter field. These generalize the recently discovered soft theorems for pure Yang-Mills to Yang-Mills with matter.

Abstract Background The ability to relearn a lost skill is critical to motor recovery after a stroke. Previous studies indicate that stroke typically affects the processes underlying motor control and execution but not the learning of those skills. However, these studies could be confounded by the presence of significant motor impairments. Furthermore, prior research involving the upper extremity indicates that stroke survivors have an advantage in offline motor learning when compared with controls. However, this has not been examined using motor acuity tasks (i.e., tasks focusing on the quality of executed actions) that have direct functional relevance to rehabilitation. Objective Investigate how stroke affects leg motor skill learning during walking in stroke survivors. Methods Twenty-five participants (10 stroke; 15 controls) were recruited for this prospective, case-control study. Participants learned a novel foot-trajectory tracking task on two consecutive days while walking on a treadmill. The task necessitated greater hip and knee flexion during the swing phase of the gait. Online learning was measured by comparing tracking error at the beginning and end of each practice session, offline (rest-driven) learning was measured by comparing the end of the first practice session to the beginning of the second, and retention was measured by comparing the beginning of the first practice session to the beginning of the second. Online learning, offline learning, and retention were compared between the stroke survivors and uninjured controls. Results Stroke survivors improved their tracking performance on the first day (p = 0.033); however, the amount of learning in stroke survivors was lower in comparison with the control group on both days (p ≤ 0.05). Interestingly, stroke survivors showed higher offline learning gains when compared with uninjured controls (p = 0.011). Conclusions Even stroke survivors with no perceivable motor impairments have difficulty acquiring new motor skills related to walking, which may be related to the underlying neural damage caused at the time of stroke. Furthermore, stroke survivors may require longer training with adequate rest to acquire new motor skills.

Abstract We derive formulae for the soft limit of tree-level gluon and graviton correlators in Anti-de Sitter space, which arise from Feynman diagrams encoding the Weinberg soft theorems in flat space. Other types of diagrams can also contribute to the soft limit at leading order in the soft momentum, but have a different pole structure. We derive these results at four points using explicit formulae recently obtained from the cosmological bootstrap and double copy, and extend them to any multiplicity using bootstrap techniques in Mellin-momentum space.

Abstract Integrating flexible electronics and photonics can create revolutionary technologies, but combining these components on a single polymer device has been difficult, particularly for high-volume manufacturing. Here, we present a robust chiplet-level heterogeneous integration of polymer-based circuits (CHIP), where ultrathin polymer electronic and optoelectronic chiplets are vertically bonded at room temperature and shaped into application-specific forms with monolithic Input/Output (I/O). This process was used to develop a flexible 3D integrated optrode with high-density microelectrodes for electrical recording, micro light-emitting diodes (μLEDs) for optogenetic stimulation, temperature sensors for bio-safe operations, and shielding designs to prevent optoelectronic artifacts. CHIP enables simple, high-yield, and scalable 3D integration, double-sided area utilization, and miniaturization of connection I/O. Systematic characterization demonstrated the scheme’s success and also identified frequency-dependent origins of optoelectronic artifacts. We envision CHIP being applied to numerous polymer-based devices for a wide range of applications.

Katherine E Hanlon,1,2 Alysia N Lozano-Ondoua,1 Puja J Umaretiya,1 Ashley M Symons-Liguori,1 Anupama Chandramouli,1 Jamie K Moy,1 William K Kwass,1 Patrick W Mantyh,1 Mark A Nelson,3 Todd W Vanderah,11Department of Pharmacology, University of Arizona College of Medicine, Tucson, AZ, USA; 2Department of Biomedical Sciences, University of New England College of Osteopathic Medicine, Biddeford, ME, USA; 3Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, USA Introduction: Cannabinoid compounds, both nonspecific as well as agonists selective for either cannabinoid receptor 1 (CB1) or cannabinoid receptor 2 (CB2), have been shown to modulate the tumor microenvironment by inducing apoptosis in tumor cells in several model systems. The mechanism of this modulation remains only partially delineated, and activity induced via the CB1 and CB2 receptors may be distinct despite significant sequence homology and structural similarity of ligands. Methods: The CB2-selective agonist JWH-015 was used to investigate mechanisms downstream of CB2 activation in mouse and human breast cancer cell lines in vitro and in a murine mammary tumor model. Results: JWH-015 treatment significantly reduced primary tumor burden and metastasis of luciferase-tagged murine mammary carcinoma 4T1 cells in immunocompetent mice in vivo. Furthermore, JWH-015 reduced the viability of murine 4T1 and human MCF7 mammary carcinoma cells in vitro by inducing apoptosis. JWH-015-mediated reduction of breast cancer cell viability was not dependent on Gαi signaling in vitro or modified by classical pharmacological blockade of CB1, GPR55, TRPV1, or TRPA1 receptors. JWH-015 effects were calcium dependent and induced changes in MAPK/ERK signaling. Conclusion: The results of this work characterize the actions of a CB2-selective agonist on breast cancer cells in a syngeneic murine model representing how a clinical presentation of cancer progression and metastasis may be significantly modulated by a G-protein-coupled receptor.Keywords: cannabinoid receptor-2, CB2, breast cancer, JWH-015, MAPK/ERK, apoptosis, calcium

Abstract Background Restoration of limb function for individuals with unilateral weakness typically requires volitional muscle control, which is often not present for individuals with severe impairment. Mirror therapy—interventions using a mirror box to reflect the less-impaired limb onto the more-impaired limb—can facilitate corticospinal excitability, leading to enhanced recovery in severely impaired clinical populations. However, the mirror box applies limitations on mirror therapy, namely that all movements appear bilateral and are confined to a small area, impeding integration of complex activities and multisensory feedback (e.g., visuo-tactile stimulation). These limitations can be addressed with virtual reality, but the resulting effect on corticospinal excitability is unclear. Objective Examine how virtual reality-based unilateral mirroring, complex activities during mirroring, and visuo-tactile stimulation prior to mirroring affect corticospinal excitability. Materials and methods Participants with no known neurological conditions (n = 17) donned a virtual reality system (NeuRRoVR) that displayed a first-person perspective of a virtual avatar that matched their motions. Transcranial magnetic stimulation-induced motor evoked potentials in the nondominant hand muscles were used to evaluate corticospinal excitability in four conditions: resting, mirroring, mirroring with prior visuo-tactile stimulation (mirroring + TACT), and control. During mirroring, the movements of each participant’s dominant limb were reflected onto the nondominant limb of the virtual avatar, and the avatar’s dominant limb was kept immobile (i.e., unilateral mirroring). The mirroring + TACT condition was the same as the mirroring condition, except that mirroring was preceded by visuo-tactile stimulation of the nondominant limb. During the control condition, unilateral mirroring was disabled. During all conditions, participants performed simple (flex/extend fingers) and complex (stack virtual blocks) activities. Results We found that unilateral mirroring increased corticospinal excitability compared to no mirroring (p

Background: Suicide is a primary health concern worldwide, and has a negative impact on the individual, family, and society. The literature suggests that females are more prone to attempt suicide and have more suicidal inclinations; however, males are more serious suicide attempters compared to females. Objective: The objective of this study was to assess the sociodemographic and clinical profile of patients admitted to acute care with the current suicide attempt. Materials and Methods: One hundred consecutive patients, aged between 18 and 60 years, who were medically stable and presented to the emergency or medical wards at the hospital with suicidal attempt, were included in this study. Beck’s Suicide Intent Scale (SIS), Beck Scale for Suicidal Ideation, Beck Hopelessness Scale, and Beck Depression Inventory–II were administered to assess the current suicidal intent and ideation, depression, and hopelessness. Results: The diagnostic breakup was – 69% mood (affective) disorders, 21% adjustment disorders, 4% schizophrenia, and 6% other disorders. Most suicide attempters were female (66% vs. 34%) and belonged to a younger age group (28.30 ± 10.08 years vs. 34.73 ± 13.97 years) compared to males (P < 0.05). Although both genders displayed high suicide intent, a significant difference in the SIS score was noted between females and males (36.53 ± 7.68 vs. 41.47 ± 8.82; P < 0.05). Conclusion: There is a difference in the clinical and demographic profile among male and female suicide attempters. Hence, appropriate interventions can be devised to prevent the future suicide attempts as per the demographic and clinical characteristics specific to the study population.

Background and Aims: Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to discern their relative efficacy and safety. Methods: This meta-analysis included randomised controlled trials (RCTs) comparing ESP and TLIP blocks in lumbar spine surgeries. The primary outcome was 24-h opioid consumption, and secondary outcomes were visual analogue scale (VAS) scores at 1 h and 24 h and various complications. PubMed, Central Register of Controlled Trials, SCOPUS, EMBASE databases and cross-references were electronically searched. Two authors extracted data independently, cross-checked, and analysed them using RevMan 5.4. Binary outcomes were reported as odds ratios (OR), while continuous outcomes were presented as standardised mean differences (SMDs) accompanied by 95% confidence intervals (95% CIs). Results: Among 1107 articles, six RCTs (492 patients) were finally included. The ESP block demonstrated lower 24-h opioid consumption compared to TLIP [SMD -0.32 (95% CI: -0.50, -0.14); P < 0.001, I2 = 83%]. At 1 and 24 h, ESPB yielded significantly lower VAS scores compared to TLIP [1 h: SMD -0.38 (95% CI: -0.57, -0.18); P < 0.001, I2 = 83%; 24 h: SMD -0.57 (95% CI: -0.76, -0.37); P < 0.001, I2 = 73%]. No significant difference was noted in adverse events. Conclusion: In comparison to the TLIP block, the ESP block has significantly lower 24-h opioid consumption and VAS scores at 1 and 24 h in patients undergoing lumbar spine surgery.

Abstract Background Despite recent advances, optimal therapeutic approaches applicable to subpopulations with primary central nervous system (CNS) lymphoma outside of clinical trials remain to be determined. Methods We performed a retrospective study of immunocompetent, adult patients with histologically confirmed diffuse large B‐cell lymphoma of the CNS (PCNSL). 190/204 (93%) patients (median age: 65) received one of five high‐dose methotrexate (HD‐MTX) containing chemotherapy regimens: MPV/Ara‐C (HD‐MTX, procarbazine, and vincristine, followed by cytarabine [Ara‐C]) (n = 94, 50%), MATRix (HD‐MTX, Ara‐C, thiotepa, and rituximab) (n = 19, 10%), HD‐MTX/Ara‐C (n = 31, 16%), HD‐MTX monotherapy (n = 35, 18%) and MBVP (HD‐MTX, carmustine, teniposide, prednisolone) (n = 11, 6%). Results Cumulative median HD‐MTX and Ara‐C doses were 17 g/m2 (range: 1–64 g/m2) and 12 g/m2 (0–32 g/m2) respectively. Using 14 g/m2 as the reference dose, the median HD‐MTX relative dose intensity (HD‐MTX‐RDI) was 1.25 (0.27‐4.57) with 84% receiving > 0.75. The overall response rate (ORR) was 72% (complete response: 50%) after completing HD‐MTX. At a median follow‐up of 3.41 years (0.06–9.42), progression‐free survival (PFS) and overall survival (OS) were different between chemotherapy cohorts, with the best outcomes achieved in the MPV/Ara‐C cohort (2‐year PFS 74%, 2‐year OS 82%; p = 0.0001 and p = 0.0024 respectively). On multivariate analysis, MPV/Ara‐C administration and HD‐MTX‐RDI > 0.75 were associated with longer PFS and OS. Conclusion Sequential, response‐adapted approaches can improve outcomes, even in older patients who are ineligible for a high‐intensity concurrent chemotherapy approach and do not undergo traditional consolidative strategies.

Background Hydrocephalus secondary to tuberculous meningitis (TBM) is a challenging condition to treat. Though ventriculo-peritoneal (VP) shunt is an accepted modality of treatment for hydrocephalus in TBM, there is a high rate of complications associated with the same. Objective The study was planned to evaluate various factors associated with shunt malfunction in patients undergoing VP shunt surgery for hydrocephalus due to TBM. Materials and Methods A retrospective review of all the patients undergoing VP shunt and shunt revision for TBM between 2004 and 2008 was performed. 449 VP shunt surgeries were performed in 432 patients for hydrocephalus due to TBM. Among these 70 shunt revisions were performed in 53 patients. Results Shunt malfunction rate in our series was 16.2%. High cerebrospinal fluid (CSF) protein concentration (>200 mg/dL) was associated with 5 times increased incidence of shunt malfunction. Patients with hyponatremia (Na+

In the present-day nanotechnology is popular in all the fields of technology. The extended application of nanotechnology was utilized in drug delivery, dye absorption, wastewater removal, and in environmental pollutant eradication. However, it is important to follow green synthesis of nanomaterials for safety purposes. In the present study, the zinc nanomaterial was synthesized using a hydrothermal method from Crotalaria pallida leaf extract, which shows that the average size distribution of zinc nanomaterials that have been synthesized was 45 nm and cuboidal in shape. This is identified from the characterization studies that includes X-ray diffraction (XRD), UV–visible spectroscopy (UV–Vis), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, Field emission scanning electron microscopy (FESEM), and Dynamic Light Scattering (DLS). Thus, the study has identified that the hydrothermal synthesis of nanomaterials is easy to synthesize, feasible and efficient. Some biological assays such as alpha-amylase and alpha-glucosidase inhibition for anti-diabetic activity, cytotoxicity assays for anticancer activities and various other biological assays were carried out for different purposes. All these assays have proved that the nanomaterial extracted from Crotalaria pallida leaf extract has applicability in various fields. Interestingly most of the assays provide increased activity in increased concentration of nanomaterial and proved their therapeutic effect on medicine.

Multiple myeloma (MM) accounts for almost 15 % of all neoplastic malignancies around the globe. This systematic review intends to analyse data on the treatment and management of MM in selected regions in Asia to identify and prioritize areas that need attention. A comprehensive review of original articles, published in English from 2005 to 2022, derived from the PubMed/MEDLINE database was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. There were 98 studies from select regions of Asia (China, India, Taiwan, Hong Kong, and Singapore) on newly diagnosed MM and relapsed/refractory MM. This review evaluated the trends in disease outcomes with the gradual shift in treatment regimens from doublet to triplet. Additionally, this review also explored autologous stem cell transplant outcome and anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy in MM patients. This is the first systematic review attempting to collect data on the utility and comparison of innovative agents and modifications in treatment regimens in the context of the Asian population. This review established that the body of evidence for the management of MM was generally of poor quality and there is a need for more versatile studies in the region. Novel and innovative drug regimens may help in combating the illness but consorted efforts by researchers, industry partners, policymakers, and the government are key factors in the long-term survival of MM patients. In the current systematic review, the authors have tried to give a comprehensive account of the available treatments, trends in MM management and prognosis for MM in Asia.

This paper addresses the scheduling of machines, an Automated Guided Vehicle (AGV) and two robots in a Flexible Manufacturing System (FMS) formed in three loop layouts, with objectives to minimize the makespan, mean flow time and mean tardiness. The scheduling optimization is carried out using Sheep Flock Heredity Algorithm (SFHA) and Artificial Immune System (AIS) algorithm. AGV is used for carrying jobs between the Load/Unload station and the machines. The robots are used for loading and unloading the jobs in the machines, and also used for transferring jobs between the machines. The algorithms are applied for test problems taken from the literature and the results obtained using the two algorithms are compared. The results indicate that SFHA performs better than AIS for this problem.

A new evolutionary computation algorithm, Superbug algorithm, which simulates evolution of bacteria in a culture, is proposed. The algorithm is developed for solving large scale optimization problems such as scheduling, transportation and assignment problems. In this work, the algorithm optimizes machine schedules in a Flexible Manufacturing System (FMS) by minimizing makespan. The FMS comprises of four machines and two identical Automated Guided Vehicles (AGVs). AGVs are used for carrying jobs between the Load/Unload (L/U) station and the machines. Experimental results indicate the efficiency of the proposed algorithm in its optimization performance in scheduling is noticeably superior to other evolutionary algorithms when compared to the best results reported in the literature for FMS Scheduling.

Job Shop Scheduling Problem (JSSP) and Flow Shop Scheduling Problem (FSSP) are strong NP-complete combinatorial optimization problems among class of typical production scheduling problems. An improved Sheep Flock Heredity Algorithm (ISFHA) is proposed in this paper to find a schedule of operations that can minimize makespan. In ISFHA, the pairwise mutation operation is replaced by a single point mutation process with a probabilistic property which guarantees the feasibility of the solutions in the local search domain. A Robust-Replace (R-R) heuristic is introduced in place of chromosomal crossover to enhance the global search and to improve the convergence. The R-R heuristic is found to enhance the exploring potential of the algorithm and enrich the diversity of neighborhoods. Experimental results reveal the effectiveness of the proposed algorithm, whose optimization performance is markedly superior to that of genetic algorithms and is comparable to the best results reported in the literature.

Abstract The increasing prevalence of heart failure (HF) in ageing populations drives demand for echocardiography (echo). There is a worldwide shortage of trained sonographers and long waiting times for expert echo. We hypothesised that artificial intelligence (AI)-enhanced point-of-care echo can enable HF screening by novices. The primary endpoint was the accuracy of AI-enhanced novice pathway in detecting reduced LV ejection fraction (LVEF)

Abstract We compute logarithmic correction to the entropy of BPS black holes in asymptotically flat five dimensional space-time using finite temperature black hole geometry and find perfect agreement with the microscopic results and macroscopic computations based on zero temperature near horizon geometry. We also reproduce the Bekenstein-Hawking term for zero temperature black hole entropy from the corresponding term for finite temperature black hole.

Abstract Circadian rhythms are oscillations in physiology and behavior caused by the circadian regulator. Cryptochromes, Periods, and Bmal1 are circadian clock genes that have been linked to aging and cancer. Human pathologies alter circadian clock gene expression, and transgenic rats with clock gene defects progress to cancer and age prematurely. In the growth of age‐linked pathologies and carcinogenesis, cell proliferation and genome integrity play critical roles. The relationship concerning the cell cycle regulation and circadian clock is discussed in this article. The circadian clock controls the behavior and countenance of many main cell cycle and cell cycle check‐point proteins, and cell cycle‐associated proteins, in turn, control the activity and expression of circadian clock proteins. The circadian clock can be reset by DNA disruption, providing a molecular mechanism for mutual control amid the cell cycle and the clock. This circadian clock‐dependent regulation of cell proliferation, composed with other circadian clock‐dependent physiological functions including metabolism control, genotoxic and oxidative stress response, and DNA repair, unlocks new avenues for studying the processes of aging and carcinogenesis.

Abstract Supersymmetric elementary string states in the compactified heterotic string theory are described by small black holes that have zero area event horizon. In this paper we compute the supersymmetric index of such elementary string states using gravitational path integral. The dominant contribution to the path integral comes from an Euclidean rotating black hole solution of the supergravity theory with a finite area event horizon, but the logarithm of the index, computed from the saddle point, vanishes. Nevertheless we show that the solution is singular on certain subspaces of the horizon where higher derivative corrections can be important, and once the higher derivative corrections are taken into account the solution could yield a finite result for the logarithm of the index whose form agrees with the microscopic results up to an overall numerical constant. While the numerical constant is not determined in our analysis, we show that it is independent of the details of the compactification and even the number of non-compact dimensions, in agreement with the microscopic results.

Abstract Background Stroke remains a major cause of long-term adult disability in the United States, necessitating the need for effective rehabilitation strategies for post-stroke gait impairments. Despite advancements in post-stroke care, existing rehabilitation often falls short, prompting the development of devices like robots and exoskeletons. However, these technologies often lack crucial input from end-users, such as clinicians, patients, and caregivers, hindering their clinical utility. Employing a human-centered design approach can enhance the design process and address user-specific needs. Objective To establish a proof-of-concept of the human-centered design approach by refining the NewGait® exosuit device for post-stroke gait rehabilitation. Methods Using iterative design sprints, the research focused on understanding the perspectives of clinicians, stroke survivors, and caregivers. Two design sprints were conducted, including empathy interviews at the beginning of the design sprint to integrate end-users’ insights. After each design sprint, the NewGait device underwent refinements based on emerging issues and recommendations. The final prototype underwent mechanical testing for durability, biomechanical simulation testing for clinical feasibility, and a system usability evaluation, where the new stroke-specific NewGait device was compared with the original NewGait device and a commercial product, Theratogs®. Results Affinity mapping from the design sprints identified crucial categories for stakeholder adoption, including fit for females, ease of donning and doffing, and usability during barefoot walking. To address these issues, a system redesign was implemented within weeks, incorporating features like a loop-backed neoprene, a novel closure mechanism for the shoulder harness, and a hook-and-loop design for the waist belt. Additional improvements included reconstructing anchors with rigid hook materials and replacing latex elastic bands with non-latex silicone-based bands for enhanced durability. Further, changes to the dorsiflexion anchor were made to allow for barefoot walking. Mechanical testing revealed a remarkable 10-fold increase in durability, enduring 500,000 cycles without notable degradation. Biomechanical simulation established the modularity of the NewGait device and indicated that it could be configured to assist or resist different muscles during walking. Usability testing indicated superior performance of the stroke-specific NewGait device, scoring 84.3 on the system usability scale compared to 62.7 for the original NewGait device and 46.9 for Theratogs. Conclusion This study successfully establishes the proof-of-concept for a human-centered design approach using design sprints to rapidly develop a stroke-specific gait rehabilitation system. Future research should focus on evaluating the clinical efficacy and effectiveness of the NewGait device for post-stroke rehabilitation.

Abstract The analysis of neural circuits has been revolutionized by optogenetic methods. Light-gated chloride-conducting anion channelrhodopsins (ACRs)—recently emerged as powerful neuron inhibitors. For cells or sub-neuronal compartments with high intracellular chloride concentrations, however, a chloride conductance can have instead an activating effect. The recently discovered light-gated, potassium-conducting, kalium channelrhodopsins (KCRs) might serve as an alternative in these situations, with potentially broad application. As yet, KCRs have not been shown to confer potent inhibitory effects in small genetically tractable animals. Here, we evaluated the utility of KCRs to suppress behavior and inhibit neural activity in Drosophila, Caenorhabditis elegans, and zebrafish. In direct comparisons with ACR1, a KCR1 variant with enhanced plasma-membrane trafficking displayed comparable potency, but with improved properties that include reduced toxicity and superior efficacy in putative high-chloride cells. This comparative analysis of behavioral inhibition between chloride- and potassium-selective silencing tools establishes KCRs as next-generation optogenetic inhibitors for in vivo circuit analysis in behaving animals.

Abstract Background Increasing patient loads, healthcare inflation and ageing population have put pressure on the healthcare system. Artificial intelligence and machine learning innovations can aid in task shifting to help healthcare systems remain efficient and cost effective. To gain an understanding of patients’ acceptance toward such task shifting with the aid of AI, this study adapted the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), looking at performance and effort expectancy, facilitating conditions, social influence, hedonic motivation and behavioural intention. Methods This was a cross-sectional study which took place between September 2021 to June 2022 at the National Heart Centre, Singapore. One hundred patients, aged ≥ 21 years with at least one heart failure symptom (pedal oedema, New York Heart Association II-III effort limitation, orthopnoea, breathlessness), who presented to the cardiac imaging laboratory for physician-ordered clinical echocardiogram, underwent both echocardiogram by skilled sonographers and the experience of echocardiogram by a novice guided by AI technologies. They were then given a survey which looked at the above-mentioned constructs using the UTAUT2 framework. Results Significant, direct, and positive effects of all constructs on the behavioral intention of accepting the AI-novice combination were found. Facilitating conditions, hedonic motivation and performance expectancy were the top 3 constructs. The analysis of the moderating variables, age, gender and education levels, found no impact on behavioral intention. Conclusions These results are important for stakeholders and changemakers such as policymakers, governments, physicians, and insurance companies, as they design adoption strategies to ensure successful patient engagement by focusing on factors affecting the facilitating conditions, hedonic motivation and performance expectancy for AI technologies used in healthcare task shifting.

Since we rely entirely on plastics or their products in our daily lives, plastics are the invention of the hour. Polyester plastics, such as Polyethylene Terephthalate (PET), are among the most often used types of plastics. PET plastics have a high ratio of aromatic components, which makes them very resistant to microbial attack and highly persistent. As a result, massive amounts of plastic trash accumulate in the environment, where they eventually transform into microplastic (

Introduction: "Periarthritis" and "adhesive capsulitis" have been used synonymously with frozen shoulder. The condition known as "frozen shoulder," which has an unknown cause, is characterized by a delayed, spontaneous restoration of all shoulder joint movements to some extent or entirely over several months to a year. Various treatment methods have been employed to manage periarthritis shoulder, with varying outcomes. The Aim: To evaluate the functional outcomes and pain relief of periarthritis shoulder treated with intra-articular steroid injection and manipulation under anesthesia. Material and Methods: A prospective study was conducted on adults with periarthritis shoulder admitted, evaluated, and followed up on 30 periarthritis shoulder cases using intra-articular steroid injection and manipulation over three months. Results: In our study, most of the patients were females and elderly, with diabetics being more prone to periarthritis of the shoulder. The range of movements improved, and pain was relieved in all 30 patients. Excellent results were found in 26 cases (86.6%) by DASH Score criteria. Conclusion: Intra-articular steroid injection and manipulation of the shoulder in periarthritis shoulder with follow-up for 12 weeks resulted in the study finding a significant improvement in the range of shoulder movement, pain, and function in patients with shoulder periarthritis. Keywords: Periarthritis shoulder; intra-articular steroid injection; Range of movement.

Boosting the charge‐transport pathways in gel–polymer electrolytes (GPEs) is important to extract their full potential for non‐Faradaic, supercapacitive energy‐storage devices. Herein, a series of polyoxometalates (POMs) ([P6W18O79]20−, [PW9O34]9− and [PW12O40]3−) as electrochemical polarization promoters is demonstrated to achieve 15‐fold enhancement in ionic conductivity of 1‐butyl‐3‐methylimidazolium bis(trifluoromethylsulfonyl)imide‐based GPEs. Fundamentally, the three POMs offer systematically differing charge densities (200, 45, and 6.5 e− nm−3) that are linearly correlated to the observed enhancements in ionic conductivities. The charge density on the POMs contributes to the formation of additional charge‐migrative pathways across the GPE, as evidenced from facile polarization characteristics. Importantly, the presence of POM beyond a critical concentration acts as charge‐trapping centers to impede the ionic conductivity of the GPEs. The insights obtained through such detailed spectroscopic and electrochemical techniques are integrated into full‐scale supercapacitive devices with a rationally designed porous hard carbon as the electrode material. The resulting electrode–electrolyte interface synergies achieve a best‐in‐class supercapacitor exhibiting energy density of 58 Wh kg−1, power density of 14 kW kg−1, and a relaxation time constant of 0.66 s, without compromising on cycling stability for direct integration with intermittent energy‐harvesting devices. Thus, the fundamental insights presented here outline the design principles for extracting high‐performance from GPE‐based energy‐storage devices.

Abstract It has been argued by Iliesiu, Kologlu and Turiaci in arXiv:2107.09062 that one can compute the supersymmetric index of black holes using black hole geometry carrying finite temperature but a specific complex angular velocity. We follow their prescription to compute the logarithmic correction to the entropy of BPS states in four dimensions, defined as the log of the index of supersymmetric black holes, and find perfect agreement with the previous results for the same quantity computed using the near horizon AdS2 × S 2 geometry of zero temperature black holes. Besides giving an independent computation of supersymmetric black hole entropy, this analysis also provides a test of the procedure used previously for computing logarithmic corrections to Schwarzschild and other non-extremal black hole entropy.

Abstract Background Heart failure (HF) and diabetes are associated with increased incidence and worse prognosis of each other. The prognostic value of global longitudinal strain (GLS) measured by cardiovascular magnetic resonance (CMR) has not been established in HF patients with diabetes. Methods In this prospective, observational study, consecutive patients (n = 315) with HF underwent CMR at 3T, including GLS, late gadolinium enhancement (LGE), native T1, and extracellular volume fraction (ECV) mapping. Plasma biomarker concentrations were measured including: N-terminal pro B-type natriuretic peptide(NT-proBNP), high-sensitivity troponin T(hs-TnT), growth differentiation factor 15(GDF-15), soluble ST2(sST2), and galectin 3(Gal-3). The primary outcome was a composite of all-cause mortality or HF hospitalisation. Results Compared to those without diabetes (n = 156), the diabetes group (n = 159) had a higher LGE prevalence (76 vs. 60%, p

Technology innovation for the sixth generation (6G) era should focus on improving quality of life by addressing societal needs, advancing human experience with the fusion of digital and physical worlds, and achieving a sustainable well-being. The 6G networks are expected to bring higher capacity and coverage combined with dependable real-time properties but must additionally be able to control the balance between quality of service (QoS) and quality of experience (QoE). QoS is the ability to offer reliable performance to connect people and things. QoE is a way to measure the quality of a service as perceived by the end-user, enabling a more customer-centric network design approach for end-user services. To provide excellent QoS, accurate estimation of QoE and corrective measures to adapt QoS to maintain acceptable QoE from the end-user perspective will be needed. In this paper, we propose a linear weighted QoE model in terms of mean opinion score (MOS) and the ability to adapt QoS. We further validate our model with a QoE impairment model and analyze the results with respect to the latency and bit rate metrics, which are critical for our target use case of Virtual Reality (VR) gaming. We also propose to use the QoE model to enable adaptive QoS in the 6G radio access network (RAN), including dynamic learning of QoS metrics.

Introduction: The prevalence of Type 2 Diabetes Mellitus (T2DM) is increasing worldwide. Microangiopathic and macroangiopathic complications are the main causes of morbidity and mortality in diabetes. Endothelial dysfunction is important in the early pathophysiology of vascular complications. Screening is very important in order to prevent these complications. Aim: To investigate endothelial dysfunction, as measured by Flow Mediated Vasodilation (FMD) of the brachial artery, in diabetic individuals. It also aims to explore the correlation between FMD and Glycated Haemoglobin (HbA1c), as well as the association between FMD and microvascular complications such as diabetic neuropathy, diabetic retinopathy, and albuminuria. Materials and Methods: This cross-sectional study was conducted at Mahatma Gandhi Medical College and Research Institute, Puducherry, India, between 2020 and 2021 on 160 patients. All patients diagnosed with T2DM, attending the Outpatient Department (OPD) or admitted to the ward, were enrolled in the study using consecutive sampling. FMD was measured for each patient, and Urine Albumin Creatinine Ratio (UACR) was also assessed. Diabetic retinopathy was evaluated through fundus examination, and diabetic neuropathy was screened using the monofilament test. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 27.0 to determine the correlation between FMD and these variables. Results: A total of 160 patients were enrolled in this study, including 104 (65%) males and 56 (35%) females. The median age was 52 years, and the participants had a median Body Mass Index (BMI) of 29.5 kg/m2 . The median HbA1c was 8.7%. The median Fasting Blood Sugar (FBS) and Postprandial Blood Sugar (PPBS) levels were 145 mg/dL and 242 mg/dL, respectively. The median FMD among all patients was 5.6%, with an Interquartile Range (IQR) of 4.9% to 6.6%. There was an inverse correlation between HbA1C and FMD values, with a correlation coefficient of -0.718 (p-value

This study explores the characteristics and potential engineering applications of Cu-Al-Mn and Cu-Al-Be-Mn shape memory alloys (SMAs). The research investigates the chemical composition, transformation temperatures, and mechanical properties of these SMAs when incorporated into Al metal matrix composites. It was found that the addition of Mn and Be has a significant impact on the performance of Cu-Al alloys. Among Cu-Al-Mn SMAs, SMA 1, with a composition of Cu-80.94%, Al-10.54%, and Mn-8.52%, exhibited superior strain recovery, super elasticity (SE), and improved mechanical properties compared to other compositions. The study also demonstrates that the inclusion of SMA fibers in Al composites enhances residual strength, energy absorption capacity, and the ability to close fissures, contributing to a more robust and resilient material. In the case of Cu-Al-Be-Mn SMA (SMA 6) with Cu-87.42%, Al-11.8%, Be-0.48%, and Mn-0.3%, displayed improved properties, outperforming other compositions in terms of strain recovery, residual strength, energy absorption capacity, and crack-closing ability. These findings suggest that Cu-Al-Be-Mn SMAs hold promise for various engineering applications. The study provides valuable insights into the potential of these SMAs to enhance the performance of structural materials, offering increased strength, ductility, and resilience. This research contributes to a deeper understanding of the applications and advantages of SMAs in the field of engineering.

Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital anomalies, so the condition can be considered as an ID–overweight syndrome. Case Description: We evaluated a child presenting with DD/ID and a craniofacial phenotype reminiscent of a Pitt–Hopkins syndrome (PTHS)-like condition. We performed a clinical exome analysis on his biological sample, as well as an in silico prediction of the obtained data. At the same time, we interrogated the DeepGestalt technology powered by Face2Gene (F2G), using a frontal image of the proband, and clinically reviewed the earlier CHUJANS patients. In this child, we found a novel PHIP pathogenetic variant, which we corroborated through a protein modeling approach. The F2G platform supported the initial clinical hypothesis of a PTHS-like condition, while the clinical review highlighted the lack of the main frequent CHUJANS clinical features in this child. Conclusions: The unusual clinical presentation of this novel patient resembles a PTHS-like condition. However, a novel variant in PHIP has been unexpectedly detected, expanding the phenotypic spectrum of CHUJANS. Notably, PTHS (MIM#610954), which is a different ID syndrome caused by heterozygous variants in TCF4 (MIM*610954), is not classically considered in the differential diagnosis of CHUJANS nor has been cited in the previous studies. This could support other complex diagnoses and invite further patients’ descriptions.

Background The relationship of serial NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) measurements with changes in cardiac features and outcomes in heart failure (HF) remains incompletely understood. We determined whether common clinical covariates impact these relationships. Methods and Results In 2 nationwide observational populations with HF, the relationship of serial NT‐proBNP measurements with serial echocardiographic parameters and outcomes was analyzed, further stratified by HF with reduced versus preserved left ventricular ejection fraction, inpatient versus outpatient enrollment, age, obesity, chronic kidney disease, atrial fibrillation, and attainment of ≥50% guideline‐recommended doses of renin‐angiotensin system inhibitors and β‐blockers. Among 1911 patients (mean±SD age, 65.1±13.4 years; 26.6% women; 62% inpatient and 38% outpatient), NT‐proBNP declined overall, with more rapid declines among inpatients, those with obesity, those with atrial fibrillation, and those attaining ≥50% guideline‐recommended doses. Each doubling of NT‐proBNP was associated with increases in left ventricular volume (by 6.1 mL), E/e′ (transmitral to mitral annular early diastolic velocity ratio) (by 1.4 points), left atrial volume (by 3.6 mL), and reduced left ventricular ejection fraction (by −2.1%). The effect sizes of these associations were lower among patients with HF with preserved ejection fraction, atrial fibrillation, or advanced age (Pinteraction

Background The effect of glycated hemoglobin (HbA1c) variability on adverse outcomes in patients with heart failure (HF) is unclear. We aim to investigate the predictive value of HbA1c variability on the risks of all‐cause death and HF rehospitalization in patients with HF irrespective of their diabetic status. Methods and Results Using a previously validated territory‐wide clinical data registry, HbA1c variability was assessed by average successive variability (ASV) or SD of all HbA1c measurements after HF diagnosis. Multivariable Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) and its corresponding 95% CI. A total of 65 950 patients with HF were included in the study. Over a median follow‐up of 6.7 (interquartile range, 4.0–10.6) years, 34 508 patients died and 52 446 required HF rehospitalization. Every unit increment of variability in HbA1c was significantly associated with higher HF rehospitalization (HR ASV, 1.20 [95% CI, 1.18–1.23]) and all‐cause death (HR ASV, 1.50 [95% CI, 1.47–1.53]). Diabetes significantly modified the association between HbA1c variability and outcomes (Pinteraction

ABSTRACTMycobacterium abscessus is increasingly recognized as an emerging opportunistic pathogen causing severe lung diseases and cutaneous infections. However, treatment of M. abscessus infections remains particularly challenging, largely due to intrinsic resistance to a wide panel of antimicrobial agents. New therapeutic alternatives are urgently needed. Herein, we show that, upon limited irradiation with a blue-light source, newly developed porphyrin-peptide cage-type photosensitizers exert a strong bactericidal activity against smooth and rough variants of M. abscessus in planktonic cultures and in biofilms, at low concentrations. Atomic force microscopy unraveled important morphological alterations that include a wrinkled and irregular bacterial surface. The potential of these compounds for a photo-therapeutic use to treat M. abscessus skin infections requires further evaluations.IMPORTANCEMycobacterium abscessus causes persistent infections and is extremely difficult to eradicate. Despite intensive chemotherapy, treatment success rates remain very low. Thus, given the unsatisfactory performances of the current regimens, more effective therapeutic alternatives are needed. In this study, we evaluated the activity of newly described porphyrin-peptide cage-type conjugates in the context of photodynamic therapy. We show that upon light irradiation, these compounds were highly bactericidal against M. abscessus in vitro, thus qualifying these compounds for future studies dedicated to photo-therapeutic applications against M. abscessus skin infections.

Rhacophorus tuberculatus and Rhacophorus verrucopus are two morphologically similar species described in 1871 and 1983 respectively. Their taxonomic distinctiveness has been questioned in the past. In the current study, we encountered frogs that we confer to R. tuberculatus based on morphological similarity to a syntype of this species. We redescribe the species based on a re-examination of a syntype, which is designated as a lectotype here, and additional specimens from Garo hills of Meghalaya. We also present molecular data, natural history notes, and report a range extension of this species. Molecular phylogenetic analysis based on the 16S rRNA fragment revealed minimal genetic divergences (0.20–1.74% uncorrected p-distance) between specimens identified as either R. tuberculatus or R. verrucopus from different locations. On the basis of molecular data and morphological characteristics, we conclude that R. verrucopus is a junior synonym of R. tuberculatus.

Abstract This paper presents an evaluation of the wave function coefficients for conformally coupled scalars at both one and two-loop levels at leading order in the coupling constant, in momentum space. We take cues from time-dependent interactions in flat spacetime and under suitable approximations, these can also be used to study the wave function coefficients for general cosmologies. We make use of recursion relations developed in [20] to regularize certain bulk-point integrals and express the wave function coefficients in a form that simplifies the loop integrals. We utilize hard-cutoff regularization to regularize the loop integrals and further provide a discussion on their renormalization. Our results can also be analytically continued to obtain answers for transition amplitudes in AdS.

Abstract Water heating and disinfection with reduced energy and CO2 footprint demands new and efficient materials for solar-thermal conversion technologies. Here, we demonstrate nanostructured porous hard-carbon florets (NCF) as effective solar absorber coating achieving excellent photon thermalization efficiency (87%). Functional NCF coating on three-dimensionally tapered helical solar receivers generate high surface temperatures (up to 95 °C). Such ‘green-heat’ is channeled to heat water up to 82 °C that simultaneously results in water disinfection through thermal shock. Untreated lake-water with high turbidity (5 NTU), high bacterial load (106 CFU mL−1) and pathogenic fungi is effectively disinfected in a continuous flow process. Translating this, a fully automated SWAP prototype (solar water antimicrobial purifier), delivers bacteria free hot water at an output capacity of 42 L m−2 day−1 with the lowest CO2 footprint (5 kg L−1) in comparison to all other existing approaches (>40 kg L−1).

Abstract We used a dynamical systems perspective to understand decision-related neural activity, a fundamentally unresolved problem. This perspective posits that time-varying neural activity is described by a state equation with an initial condition and evolves in time by combining at each time step, recurrent activity and inputs. We hypothesized various dynamical mechanisms of decisions, simulated them in models to derive predictions, and evaluated these predictions by examining firing rates of neurons in the dorsal premotor cortex (PMd) of monkeys performing a perceptual decision-making task. Prestimulus neural activity (i.e., the initial condition) predicted poststimulus neural trajectories, covaried with RT and the outcome of the previous trial, but not with choice. Poststimulus dynamics depended on both the sensory evidence and initial condition, with easier stimuli and fast initial conditions leading to the fastest choice-related dynamics. Together, these results suggest that initial conditions combine with sensory evidence to induce decision-related dynamics in PMd.

Background: Varicella zoster virus (VZV) is the causative agent for chickenpox and herpes zoster (HZ, shingles). HZ is a debilitating disease affecting elderly and immunocompromised populations. Glycoprotein E (gE) is indispensable for viral replication and cell-to-cell spread and is the primary target for anti-VZV antibodies. Importantly, gE is the sole antigen in Shingrix, a highly efficacious, AS01B-adjuvanted vaccine approved in multiple countries for the prevention of HZ, yet the three-dimensional (3D) structure of gE remains elusive. Objectives: We sought to determine the structure of VZV gE and to understand in detail its interactions with neutralizing antibodies. Methods: We used X-ray crystallography and cryo-electron microscopy to elucidate structures of gE bound by recombinant Fabs of antibodies previously elicited through vaccination with Zostavax, a live, attenuated vaccine. Results: The 3D structures resolve distinct central and C-terminal antigenic domains, presenting an array of diverse conformational epitopes. The central domain has two beta-sheets and two alpha helices, including an IgG-like fold. The C-terminal domain exhibits 3 beta-sheets and an Ig-like fold and high structural similarity to HSV1 gE. Conclusions: gE from VZV-infected cells elicits a human antibody response with a preference for the gI binding domain of gE. These results yield insights to VZV gE structure and immunogenicity, provide a framework for future studies, and may guide the design of additional herpesvirus vaccine antigens. Teaser: Structures of varicella zoster virus glycoprotein E reveal distinct antigenic domains and define epitopes for vaccine-elicited human antibodies.

Non-invasive crop analysis through image-based methods holds great promise for applications in plant research, yet accurate and robust trait inference from images remains a critical challenge. Our study investigates the potential of AI model ensembling and hybridization approaches to infer sorghum crop traits from RGB images generated via unmanned aerial vehicle (UAV). In our study, we cultivated 21 sorghum cultivars in two independent seasons (2021 and 2022) with a gradient of fertilizer and water inputs. We collected 470 ground-truth N measurements and captured corresponding RGB images with a drone-mounted camera. We computed five RGB vegetation indices, employed several ML models such as MLR, MLP, and various CNN architectures (season 2021), and compared their prediction accuracy for N-inference on the independent test set (season 2022). We assessed strategies that leveraged both deep and handcrafted features, namely hybridized and ensembled AI architectures. Our approach considered two different datasets collected during the two seasons (2021 and 2022), with the training set from the first season only. This allowed for testing of the models’ robustness, particularly their sensitivity to concept drifts, in the independent season (2022), which is fundamental for practical agriculture applications. Our findings underscore the superiority of hybrid and ensembled AI algorithms in these experiments. The MLP + CNN-VGG16 combination achieved the best accuracy (R2 = 0.733, MAE = 0.264 N% on an independent dataset). This study emphasized that carefully crafted AI-based models applied to RGB images can achieve robust trait prediction with accuracies comparable to the similar phenotyping tasks using more complex (multi- and hyper-spectral) sensors presented in the current literature.

Abstract Background Mechanisms driving cancer-induced bone pain are poorly understood. A central factor implicated to be a key player in the process of tumorigenesis, osteoclastogenesis and nociception is p38 MAPK. We determined the role of p38 MAPK in a mouse model of breast cancer induced bone pain in which mixed osteolytic and osteoblastic remodeling occurs. Results In cancer-treated mice, acute as well as chronic inhibition of p38 MAPK with SB203580 blocked flinching and guarding behaviors in a dose-dependent manner whereas no effect on thresholds to tactile stimuli was observed. Radiographic analyses of bones demonstrated that chronic inhibition of p38 MAPK reduced bone loss and incidence of spontaneous fracture in cancer-treated mice. Histological analysis of bones collected from mice treated with the p38 MAPK inhibitor showed complete absence of osteoblastic growth in the intramedullary space as well as significantly reduced tumor burden. Conclusions Blockade of non-evoked pain behaviors but not hypersensitivity suggests differences in the underlying mechanisms of specific components of the pain syndrome and a possibility to individualize aspects of pain management. While it is not known whether the role of p38 MAPK signaling can be expanded to other cancers, the data suggest a need for understanding molecular mechanisms and cellular events that initiate and maintain cancer-induced bone pain for effective management for both ongoing pain as well as breakthrough pain.

Background: Exudative pleural effusion of unknown etiology is a diagnostic perplexity. Medical thoracoscopy (MT) is a less invasive procedure and has a high diagnostic utility in these patients. Objectives: The study goal was to analyze the value of MT in patients with exudative pleural effusion of unknown cause. Materials and methods: The cross-sectional observational study included clinical data of patients with unexplained pleural effusion of exudative type who had undergone MT at a tertiary care center between July 2019 and June 2022. Results: The diagnostic MT was performed on 28 patients with exudative pleural effusion, which diagnostic thoracentesis could not explain. The diagnostic yield was 96.42%. The mean age was 52.9 ± 13.5 (range 25–75) years, and 17 (60.7%) were males. Malignancy was diagnosed in 60.70% (17/28) of patients, tuberculosis in 28.60% (8/28) of patients, and nonspecific pleuritis/fibrosis in 10.70% (3/28) of patients. Out of 17 patients with malignancy, metastatic adenocarcinoma was detected in 70.58% (12/17) of patients, malignant mesothelioma in 17.64% (3/17) of patients, and poorly differentiated in 11.76 % (2/17) of patients. No major complications were observed and only three patients had minor complications. Conclusion: Medical thoracoscopy (MT) is a minimally invasive, risk-free, and effective tool for the diagnosis of unexplained exudative pleural effusion with added therapeutic advantages with high diagnostic yield and minimal complication rate.

Enhancement of wear resistance of components used in fast reactors is necessary for long service life of the components. Plasma nitriding is a promising surface modification technology to impart high hardness and improved wear resistance of various steel components. This study discusses the characterization of chrome nitrided SS316L casing ring used in secondary sodium pump of fast breeder reactor and its stability under long term sodium exposure. Microstructural and hardness analysis showed that stress relieved component could be chrome nitrided successfully to a thickness of about 100 μm. Assessment of in-sodium performance of the chrome nitrided casing ring subjected to long term exposure up to 5000h at 550°C, showed retention of chrome nitrided layer with a case depth almost similar to that before sodium exposure. A slight decrease in the hardness was observed due to prolonged high temperature sodium exposure. Tribological studies indicate very low coefficient of friction indicating the retention of good wear resistance of the coating even after long term sodium exposure.