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Public Key Cryptosystem (PKC) completely relies under the assumption that user’s private key is absolutely secure. Exposure of private key may lead to disastrous situations in the communication network. To diminish the damage of private key exposure in PKC, key-insulation mechanism was introduced. In key-insulated cryptosystems, a user can update his private key with the help of a physically secure device from time to time. Identity-based cryptosystem alleviates the heavy certificate management problems in traditional PKC. Recently, many Identity-based key insulated signature schemes have been proposed in literature; however, most of the Identity-based schemes are designed based on the expensive bilinear pairing operation over elliptic curves. Due to the heavy computational cost of a pairing, the pairing based schemes are less efficient in practice. In order to improve the computational and communicational efficiency and to resist the problem of private key exposure in Identity-based signature schemes, we present a pairing-free key insulated signature scheme in identity based setting. We show that this scheme is unforgeable and achieves strong key insulation property with secure key updates, under the hardness of the Elliptic Curve Discrete Logarithm Problem (ECDLP). The performance analysis shows that our scheme is more efficient than the existing schemes.

Private key exposure can be the most devastating attack on cryptographic schemes; as such exposure leads to the breakage of security of the scheme as a whole. In the real world scenario, this problem is perhaps the biggest threat to cryptography. The threat is increasing with users operating on low computational devices (e.g. mobile devices) which hold the corresponding private key for generating signatures. To reduce the damage caused by the key exposure problem in aggregate signatures and preserve the benefits of identity-based (ID-based) cryptography, we hereby propose the first key-insulated aggregate signature scheme in ID-based setting. In this scheme the leakage of temporary private keys will not compromise the security of all the remaining time periods. The security of our scheme is proven secure in the random oracle paradigm with the assumption that the Computational Diffie–Hellman (CDH) problem is intractable. The proposed scheme allows an efficient verification with constant signature size, independent of the number of signers.

Background: Cutaneous invasive fungal infections are a highly feared complication of cancer chemotherapy in children. The increased risk for these infections is often attributed to the profound immunosuppression and neutropenia resulting from intensive chemotherapy. Common pathogens include Zygomycetes, Aspergillus, and Candida species, each showing a wide array of clinical manifestations. Case report: We describe an outbreak of four cases of cutaneous invasive fungal infections in children undergoing induction chemotherapy for hematological malignancies from a pediatric hematology and oncology unit in India. Aspergillus and Zygomycetes infections and their varying clinical manifestations, along with diagnostic and treatment challenges, are highlighted. Iatrogenic skin breach and neutropenia were common risk factors observed in all four cases. Conclusion: Prompt microbiological diagnosis, early initiation of antifungals, and effective local control measures are essential to obtain improved outcomes. Mortality and morbidity rates continue to remain high despite numerous antifungal agents.

In this study, we have demonstrated the conformational changes to DNA induced by abnormal interactions of copper using circular dichroism, in combination with UV-absorbance and fluorescence spectroscopy. Results confirm that binding of copper to bases of DNA in chromatin is concentration dependent. Binding efficiency of Cu2+ ions to DNA is increased in proportion to the degree of unwinding of the double helix induced by denaturation. Altered B-DNA conformation will alter the integrity of DNA which may affect the normal process of DNA replication and transcription. Copper induced DNA damage in the brain may cause neurotoxicity and the neuronal cell death and is implicated in Alzheimer's disease and other neurological disorders. Keywords: Human brain, Chromatin, DNA, Copper, Neurodegenerative disorders

The rising global demand for clean and renewable energy has intensified interest in hydrokinetic energy harvesting, with Savonius turbines gaining attention due to their simplicity and low cost. While numerous studies have focused on refining blade designs for wind turbines, limited research has been conducted on water turbines to identify the best design. This study investigates the effect of blade geometry on the efficiency of Savonius hydrokinetic turbines to identify the optimal configuration. Three new blade designs were tested, incorporating inner blades and varying blade numbers. These designs were experimentally evaluated to identify the optimal turbine configuration for maximum efficiency, and the findings were then validated through numerical studies. Rotational analysis was conducted to investigate torque variations across a full turbine rotation from 0° to 360°, and flow characteristic analysis was performed by utilizing pressure and contour plots at critical positions, including 0°, minimum torque coefficient (CT Min), and maximum torque coefficient (CT Max). Results indicate that the 2-blade Savonius turbine achieved the highest efficiency, with a maximum torque coefficient of 0.29 and a power coefficient of 0.22. It demonstrated 63.5 % greater power efficiency compared to the 3-Blade Savonius Turbine, 2.65 times greater than the Segmented Quarter Savonius Turbine, and 2.26 times greater than the Concentric Arc Savonius Turbine. These findings highlight the importance of blade geometry optimization in improving the performance of Savonius turbines for efficient hydrokinetic energy generation.

Quantum-dot cellular automata (QCA) is a promising nanotechnology that appears to meet the requirements of high speed radar applications. Due to its advantages, including its extremely low power dissipation and less occupied area, it is highly regarded. The multiplier module is an essential component in Phased Array Radar (PAR). In the real-time PAR based systems, many applications like digital beam forming, local oscillators, and communication receivers etc. requires multiplication operation. However, the most important factors in these systems are the area and power consumption. This paper presents an ultra-low power vedic multiplier using QCA technology, and it provides the effective clocking, reduce the number of cells, and low energy dissipation. The 4×4 vedic multiplier utilizes only 2940 cells and occupies 7.33μm2 area with 7.64×10−1eV of energy dissipation. The total consumed power of this module is 1.61nW. This architecture outperforms complementary metal-oxide-semiconductor (CMOS) based circuits in terms of power by 90%. The proposed contribution will initiate a new direction of research into real-time PAR based systems.

Bimetallic nanostructures can exhibit significant broadening of Mie resonances compared to monometallic nanoparticles. Here, we study these materials using Electron Energy Loss Spectroscopy at a single particle level. This technique is immensely effective to probe direct structure-property correlation of nanoparticles. We are thus able to confirm the broadening of Mie resonances at a single particle level. This effect is analyzed in the context of emergence of a new dielectric constant that originates from metallic interfaces. We employ Coronado-Schatz corrections to the usual dielectric constants of the constituent metals to quantitatively simulate these materials. The resultant materials thus exhibit optical cross-sections that are 38.5 % and 4.2 % of the gold and silver nanoparticle optical cross-section at 2.5 eV and 3.45 eV, respectively. A strong agreement between theory and experiment is observed. We also confirmed the effectiveness of our approach for nanoparticles with different morphologies as well as different compositional ratios. Our study suggests an effective strategy to regulate the dielectric properties of bimetallic nanostructures through interface engineering.

The global coronavirus disease 2019 (COVID-19) pandemic originating from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exerted profound damage to millions of lives. Baicalein is a flavonoid that has gotten a lot of attention as a possible SARS-CoV-2 main protease (Mpro) inhibitor because it can fight off many different viruses. We prepared and screened three sets of databases, each containing 2563 baicalein analogues, against Mpro using molecular docking simulation. The data showed that several baicalein analogues exhibited stable binding energies relative to standard baicalein, indicating that they have some selectivity against Mpro. The binding properties of the top three stable analogues from each database were further analyzed with respect to their binding properties, such as binding mode, binding energy, and binding interaction of putative stable ligand confirmations at the target binding site region.

An experimental study evaluated heat transfer with perpendicular and wall-impinging air jets on stainless steel foil, for Reynolds numbers Re = 3000, 5000, 8000, and 10000, where the perpendicular jet targets the bottom and the wall jet the top, creating a unique, non-interacting effect. Distances to nozzle diameter ratios for wall jets (S/d = 4, 6, 8, 10) and perpendicular jets (Z/d = 2, 4, 6, 8) were varied. Significant heat transfer increases were noted, with the Nusselt number rising by up to 49.20 % for a Z/d = 6 and S/d = 8 combination at Re = 5000. Improvements ranged from 10.03 % to 49.20 %, peaking when the jets' high heat transfer regions overlapped. Optimal performance for Re = 3000 was at S/d = 10, aligning the wall jet's maximum with the perpendicular jet's stagnation area. For Re = 5000 to 10000, optimal S/d values were 8 and 4 for Z/d = 6, 8 and Z/d = 2, 4, respectively. The Nusselt number increase ranged from 29.21 % to 46.57 % at S/d = 10 for Re = 3000, the highest among all tested values. Wall jet heat transfer downstream increased by 90–105 % over perpendicular jets in corresponding regions. Increasing the wall to perpendicular jet distance improved heat transfer near the stagnation point, suggesting this cooling method for high-density electronics like CPUs and GPUs.

This study explored the impact of pulsation on the hydro-thermal behavior of an interrupted microchannel heat sink. A homogeneous blend of Al2O3-water was employed as the coolant. The investigation considers the influence of varying amplitude, pulsation frequency and Reynolds number. Findings indicate that using pulsating flow instead of steady flow substantially improved the thermal efficiency of the microchannel. The pulsating flow was observed to improve the Nusselt number by 17.43 %, 33.38 %, 50.66 %, 68.39 %, and 86.12 % at 5, 10, 15, 20, and 25 Hz, respectively compared to a steady flow. However, with heat transfer enhancement, there is an accompanying pressure drop caused by pulsating flow. Pressure drops increased with the pulsation frequency and reached a maximum value of 0.2695 MPa at f = 25 Hz and A = 0.8. Nevertheless, the performance evaluation criteria showed that although pulsating flow increases pressure drop, it offers significantly better overall thermal and hydraulic performance than steady flow. The PEC improved by 90.47 % at Re = 100, f = 25 Hz, and A = 0.2. The results demonstrate a conceivable technique to use pulsating flow to improve heat transfer performance in systems with high power density in confined spaces.

Post-stroke fatigue (PSF) is a commonly overlooked symptom that impacts daily functioning and quality of life. It is caused by altered functional connectivity within the brain networks, which can potentially be influenced by neuromodulation. Multiple cortical regions have been targeted to reduce PSF, but the most efficient ones remain uncertain. Therefore, we aim to identify the most appropriate cortical stimulation site to reduce PSF. Twenty participants with PSF will be included in this cross-over trial. Each participant will receive one session of active anodal high definition- transcranial direct current stimulation (HD-tDCS) over three different cortical areas and one session of sham tDCS in a cross-over manner, with a two-week of washout period in between. Pre- and post- fatigue will be assessed using Fatigue Severity Scale and fatigability using electromyography by determining the time to task failure. Resting-state electroencephalography will be performed before and after each stimulation session to determine the functional connectivity of the cortical areas stimulated.

Mangroves are crucial ecosystems that play a role in carbon sequestration, shoreline fortification, and provide habitats for diverse species. In developing nations like India, there is a need for more knowledge on the occurrence and distribution of MPs in mangrove forests under changing seasons. Our investigation aimed to fulfil this research gap by studying the seasonal patterns of microplastic distribution within the sediments of the Kota mangroves in south-western India. The mean (± standard deviation) microplastic abundance was 1418.52 (±1404.34) MPs/kg during the wet season and 1414.32 (±1368.65) MPs/kg during the dry season. A consistent pattern in microplastic categories was observed, with fibres being the predominant shape followed by film, fragment, and foam. Microplastics of size 0.1–0.3mm were dominant in all seasons. Fourier Transformed Infrared Spectroscopy (FTIR-ATR) and Raman Spectroscopy analyses revealed the presence of polypropylene, polyethylene, polyethylene terephthalate, and polystyrene. Energy Dispersive Spectroscopy between control and extracted samples revealed adsorption of Cd, Zn, Pb, Fe, and Ni onto the extracted microplastics. The primary contributors to the MP pollution were attributed to fishing related activities, fish meal processing industry, tourism, and local households. This study established a baseline information on the seasonal dynamics governing the distribution of microplastics in sediment of Kota mangroves.

Background: A rare category of hereditary illnesses known as osteopetrosis (OP) causes increased bone radiodensity on radiographs. Due to brittle bone and frequent fractures, symptomatic management is the mainstay of treatment. The underlying pathology of osteopetrosis in a patient presenting with long bone fractures may be missed due to the rarity of the condition and lack of awareness on the part of the treating surgeon. There is no consensus on fracture management in osteopetrosis. When opting for surgical fixation of fractures, there is often a conflict about what implants to use to ensure stable fixation and early functional redemption. Iatrogenic fractures during implant placement, overheating, and drill/saw breakage are some of the difficulties that may arise during surgery. Methods: Our study is a retrospective observational analysis of eight patients with osteopetrosis who underwent surgery for a femur fracture with various types of implants at our facility between January 2010 and March 2022. Following surgery, clinico-radiological follow-ups were done at one, two, six months, 12 months, and then yearly thereafter. Clinically, the patients were assessed based on the Lower Extremity Functional Score (LEFS). Results: The patients who underwent combined extra and intramedullary fixation showed a faster return of LEFS and union time of the fracture. Conclusion: When addressing the fractures in osteopetrosis, it is crucial to consider the risks of fixation in these individuals. Although plate fixation is considered easier, the risk of peri-implant fractures is high. In our experience, intramedullary nailing with plate augmentation and bone grafting provides a much more stable construct which can reduce the risk of further fractures.

Objective:: To survey members of the International Continence Society (ICS) for exploring global differences in practices with regard to intermittent catheterization (IC) and reuse of catheters in the neuro-urological patient. A project of the Neuro-Urology Promotion Committee (NUPC) of the ICS. Methods:: Cross-sectional survey of ICS members using the SurveyMonkey platform. Initial survey preparation, revisions, pilot, and finalization were performed within the NUPC. Opt-in survey emailed to all members by the ICS office. Foundation questions ascertained type of clinical practice, health care system, and country of residence which was stratified by World Bank criteria as ‘high-income group, HIG’ or ‘not high-income group, non-HIG’ for analysis. Several questions addressed the reuse of catheters and related practices. Survey results were analyzed using R (version 3.1.3) statistical analysis (p-value 90 times, and till visible deterioration in 25.0%, 25.8%, 15.8%, 7.5%, 5.0%, 5.0%, and 15.8%, respectively. Conclusion:: Reuse of catheters by patients on IC was not restricted to less affluent countries. There were wide variations in every aspect of the IC protocol. These issues are critical to patients, communities, and the environment and urgently require research.

Introduction:: We report the findings of a survey conducted to ascertain practice patterns of members of the Urological Society of India (USI) with regard to diagnosis and management of female voiding dysfunction (FVD). Methods:: A19-question survey was conducted on the SurveyMonkey® platform from December 17, 2019 to January 9, 2020. Questions included demographic details of respondents and policies regarding evaluation and treatment of FVD. Results:: 1278 of the 2649 qualified urologists of USI responded (48.2%). 1090 valid responses were included in the final analysis. While the majority of the respondents opted to check post void residual urine and 2/3rd ordered uroflowmetry in patients presenting with history of poor flow and/or incomplete emptying of urine, 38.6% and 45.7% of the respondents did not consider invasive urodynamics and cystoscopy, respectively, to be appropriate investigations in these patients. 29.6% were comfortable in dilating the urethra of female patients based on obstructive symptoms alone. 60% of respondents had performed at least one of the specialized surgical procedures for FVD. Conclusion:: Most Indian urologists treat FVD with 60% having at least some experience with surgical interventions. However, this survey revealed considerable heterogeneity and identified critical lacunae in the practice of FVD by Indian urologists. Inappropriate evaluation and management practices are surprisingly common. Findings of this survey could be useful in designing appropriate training programs for practitioners.

Background: Pediatric isolated PCL avulsion from the tibial attachment is a rare occurrence.Although an isolated PCL lesion can be treated conservatively, it has shown poor results due to alteration in biomechanics.Surgical treatment restores the anatomy, reducing the incidence of osteoarthritis. Case report: We report a case of PCLavulsion fracture in an adolescent with open physis. We surgically fixed the ligament by passing a fiberwire through the substance of PCL and tied it over a suture disc anteriorly over the medial cortex of proximal tibia. At one year follow up, the fracture had united, and the patient regained full range of motion. Conclusion: Tibial sided avulsion fracture of PCL in children is an infrequent injury, with only a handful of cases reported. Fixation with a fiberwire and suture disc is a viable option for treating these injuries.

BACKGROUND: Doppler studies of uteroplacental–fetal circulation have been proven useful in diagnosing fetal growth restriction, appropriately timing delivery, and improving perinatal morbidity and mortality. There has been an extensive search for the ideal means to identify fetuses between the compensatory and acidemic phase (ie, the “preacidemic phase”), and the aortic isthmus Doppler seems to show promise. OBJECTIVE: This study aimed to investigate: (1) the prevalence of abnormal aortic isthmus Dopplers in a cohort of small-for-gestational-age fetuses and their correlation with other conventional Doppler abnormalities, and (2) the predictive ability of abnormal aortic isthmus Dopplers with regard to short-term adverse neonatal outcomes. STUDY DESIGN: Fetuses diagnosed as small-for-gestational-age at ≥24 weeks’ gestation were included. Management was as per the standard protocol. Aortic isthmus Doppler was performed within a week of delivery with other conventional Dopplers. The adverse perinatal outcomes studied were: requirement of neonatal resuscitation at birth, Apgar score at 5 minutes

Currently, there is a growing interest in various alternative energy sources due to the global energy scenario and rising crude oil prices. Renewable sources of energy like biomass can be exploited to produce energy-rich syngas. The biomass gasification process converts energy-rich solid fuel into syngas by partial combustion. In the present study, rice husk gasification using steam and, a mixture of steam and CO2 at temperatures ranging from 650°C to 750 °C and steam to biomass ratio of 0.5–2 is studied. Steam gasification enhances hydrogen production, and mixing with CO2 helps optimizing the H2/CO ratio. The study uses the Euler-Euler method in combination with kinetic theory granular of flow which is modeled using the computational fluid dynamics approach implementing user-defined functions for heterogeneous char reactions. The increased particle diameter harms the gasification performance due to the lower heating value of the syngas. As the steam to biomass ratio is increased, there is a positive effect on syngas quality, while temperature has a negative effect. The addition of CO2 increases the CO conversion in the syngas. The heterogeneous reaction rate vanishes close to zero after a height of 0.4 m, where all solid carbon is consumed.

Diabetes is a chronic medical condition due to the lack of insulin or ineffective use of insulin. In recent years, diabetes has become one of the rapidly growing chronic diseases, and it has caused a burden on the individual and the economy. Rhodanine has been identified as an important scaffold in drug discovery because of its wide range of biological properties including antidiabetic. A number of studies have been reported regarding the activity of rhodanine-based compounds in the treatment of diabetes mellitus and its complications. This review aimed to explore the antidiabetic activity of rhodanine-based compounds and their structure–activity relationship (SAR) based on studies that have been reported. Our study discovered several studies about the compounds’ biological screening against a variety of targets, including aldose reductase, α-glucosidase, α-amylase, PPAR-γ and PTPT1B. Some compounds mentioned are also tested in vivo in living organisms. This review offers a resource for future antidiabetic drug development, as many of the hit compounds listed exhibited good antidiabetic properties.

Development of novel multimodality radiotherapy treatments in metastatic breast cancer, especially in the most aggressive triple negative (TNBC) subtype, is of significant clinical interest. Here we show that a novel inhibitor of Polo-Like Kinase 4 (PLK4), CFI-400945, in combination with radiation, exhibits a synergistic anti-cancer effect in TNBC cell lines and patient-derived organoids in vitro and leads to a significant increase in survival to tumor endpoint in xenograft models in vivo, compared to control or single-agent treatment. Further preclinical and proof-of-concept clinical studies are warranted to characterize molecular mechanisms of action of this combination and its potential applications in clinical practice.

Background: The current cross-sectional study analyses patients' plasma iron measurements and spirometry to determine the relationship between serum iron, percent transferrin saturation, serum ferritin, total iron-binding capacity (TIBC), and forced expiratory flow (FEF 25–75%), forced expiratory volume 1(FEV1)/Forced vital capacity (FVC), FVC, and FEV1. Methods: Spirometry measurements were assessed by comparing reference values based on age, height, sex, and race. Descriptive analysis of data included percentages, means, and standard deviations. Multivariate analyses were done using the Pearson correlation test and the multiple linear regression method. Results: According to the findings, the average age of those who participated in the study was 59.63 ± 10.32 years old. Serum iron concentrations were shown to be extremely significant and positively correlated with the percent anticipated values of FVC, FEV1/FVC FEV1, and FEF (25–75%). The total iron-binding capacity was extremely significant and linked strongly with the percent expected values of FVC, FEV1, FEF (25–75%), and FEV1/FVC. The percent transferrin saturation was extremely significant and linked positively with the percent anticipated values of FVC, FEV1, FEF (25–75%), and FEV1/FVC. Conclusion: Plasma iron levels were independently linked with both FEV1 and FEF (25–75%) percent predicted in the current investigation. Consequently, the blood iron concentration in COPD patients can be utilized as a biomarker for assessing disease severity because it is relatively simple and inexpensive.

In an ordinary signature scheme any one can verify the validity of a signature produced by the signer. But public verifiability of signatures is not desirable in some applications where the signed message is sensitive to the signature receiver, for example signatures on medical records, tax information. To meet this requirement, the concept of directed signature was introduced. A directed signature scheme is a kind of signature scheme in which the verification ability is controlled by the signer. Many directed signature schemes have been proposed in different cryptographic settings and most of the schemes are using bilinear pairings over elliptic curves. But the computation of a bilinear pairing is very expensive. Hence the schemes which use pairings are less efficient and are not much applicable in practice. In order to improve the computational and communicational efficiency, in this paper, we propose a pairing- free certificateless directed signature scheme. The proposed scheme is proven secure in the random oracle model under the assumption that the elliptic curve discrete logarithm problem is hard. We compare our scheme with well known existing schemes and efficiency analysis shows that the proposed scheme is more efficient.

Objective: Patients with congenital thenar hypoplasia (Cavanagh syndrome) may undergo surgical intervention with a mistaken diagnosis of severe carpal tunnel syndrome. Conversely, patients with Cavanagh syndrome can develop co-morbid median nerve entrapment at the carpal tunnel later in life and may go untreated. This study is aimed at evaluating the role of ultrasonography in confirming/ruling out median nerve entrapment at the carpal tunnel in patients with Cavanagh syndrome. Methods: 6 patients with Cavanagh syndrome were identified during a 10-year period from among patients referred for preoperative electrodiagnostic confirmation of carpal tunnel syndrome. All patients underwent ultrasound imaging as well as electrodiagnostic studies including motor conduction study of the median nerve with recording electrodes over the lumbrical muscles. Results: Age range of patients was 39–76. The right hand was affected in 5 and left hand in 1 patient. Electrodiagnostic studies (EDX) confirmed carpal tunnel syndrome in 4 of the 6 patients. In one patient the nerve conduction studies were non-diagnostic due to absence of compound muscle action potential (CMAP) over the thenar, and the 2nd lumbrical muscles and absent sensory nerve action potentials (SNAP). Ultrasound images confirmed entrapment of median nerve at the carpal tunnel in all 5 patients. The sixth patient was mistakenly diagnosed with severe carpal tunnel syndrome by the referring physician, based on the thenar atrophy; the median nerve was normal in both ultrasound and electrodiagnostic studies. Conclusion: Ultrasound was useful for confirming/ruling out comorbid carpal tunnel syndrome in all 6 patients with Cavanagh syndrome. Significance: Ultrasound complements electrodiagnostic study findings in patients with congenital thenar hypoplasia and comorbid carpal tunnel syndrome. It is even more valuable when EDX findings are non-diagnostic due to absent CMAP and SNAP.

Background: Phytotherapeutic modulation of the immune system to mitigate infectious ailments has been in vogue all over the world. Objective: The present work has been designed to scientifically explore the immunomodulatory potential of Nyctanthes arbortristis stem bark using mice models. Materials & method: Methanolic (MNA) and aqueous (ANA) extracts of N. arbortristis stem bark were evaluated for possible modulation in humoral immunity through serum immunoglobulin estimation. The variation in cellular immunity was assessed using neutrophil adhesion test, carbon clearance assay, and cyclophosphamide-induced neutropenia. Results and discussion: Administration of MNA and ANA (both at 200 mg/kg, p.o.) significantly augmented the levels of serum immunoglobulins (humoral antibody), neutrophil adhesion, and phagocytic index (a measure of carbon clearance). Extracts also guarded the animals against cyclophosphamide-induced leukopenia, especially neutropenia. Conclusion: Results indicate that cellular and humoral immune responses were aroused by pretreatment of the animal with methanol and aqueous extract of N. arbortristis. Thus, the methanol and aqueous extract of N. arbortristis stem bark possesses a significant immunostimulant activity and can be used to uplift the immune system in the infectious condition.

Background: Right atrial appendage rupture from blunt trauma is exceedingly rare, even more so when no other chest wall injuries are found. Very few cases have been documented with respect to survival from such an injury. Purpose: To highlight the optimal management of such cases, namely through timely and safe transport to a trauma centre, maintaining a high degree of clinical suspicion for tamponade, early diagnostic ultrasound use, pericardial decompression, haemorrhage control and situational control. Case presentation: A case report delineating the diagnostic and therapeutic approach to an individual with right atrial appendage rupture. Subsequent post-operative and convalescent course till hospital discharge.A young male patient involved in a high-speed motor vehicle accident was hypotensive at the scene with altered sensorium. Transport to a trauma centre was delayed due to entrapment and geographical location. An ultrasound done on arrival identified cardiac tamponade, which was successfully treated with an emergent left lateral thoracotomy, pericardial decompression, and haemorrhage control from a ruptured right atrial appendage, with definitive closure in the operating theatre. Conclusion: Whilst rare, haemodynamic compromise in the absence of obvious thoracic trauma following high-energy, rapid deceleration mechanisms should raise suspicion for right atrial appendage rupture with pericardial tamponade. Aggressive resuscitation, early diagnostic ultrasound use and urgent pericardial decompression are essential in maximising the likelihood of positive outcomes.

The management of patients with neurogenic lower urinary tract dysfunction has been well-described, however this is most frequently discussed for common conditions such as spinal cord injury or multiple sclerosis. Our objective was to review uncommon neurologic disorders and summarize both the underlying disease process, and the relevant disease-specific research on the impact of the neurologic condition on the lower urinary tract. Among the degenerative and traumatic brain disorders, we have included frontotemporal dementia, amyotrophic lateral sclerosis, Huntington’s Disease, progressive supranuclear palsy, corticobasal degeneration, multiple system atrophy, and traumatic brain injury. Among the autoimmune disorders, we reviewed transverse myelitis, neuromyelitis optica spectrum disorders, Myelin oligodendrocyte glycoprotein antibody-associated disease, glial fibrillary acidic protein astrocytopathy, and meningitis-retention syndrome (a form of aseptic meningitis that presents with urinary retention). Hereditary spastic paraplegia, VACTERL association, and several peripheral neuropathies (Guillain Barre syndrome, chronic inflammatory demyelinating polyneuropathy, autoimmune autonomic gangliopathy, Wolfram syndrome spectrum disorder (a progressive peripheral neuropathy disorder with early onset diabetes, optic atrophy and megacystis in the early stage), Charcot Marie Tooth disease, and amyloid neuropathy are included. Practice points specific to the disorders are included where appropriate.

There is sparse Indian data on whether fetal echocardiography among pregnant diabetics would be useful to predict adverse perinatal/neonatal outcome. Objectives: To study fetal cardiac changes in diabetic mothers and non-diabetic controls from 24 weeks gestation until the neonatal period; correlate them with maternal glycemic control; study their implications on adverse perinatal/neonatal outcome. Methodology: Prospective observational cohort study. Pregnant diabetics (17 overt, 66 gestational) recruited beyond 24 weeks, divided as well (39) and poorly (44) controlled, based on American Diabetes Association 2016 criteria. Controls were 102 healthy non-diabetic pregnancies. Fetal echocardiography performed at weeks 24–32, 32–36, >37, and between 4 and 7 days on neonates. The thickness of Interventricular septum (IVS), Right Ventricle (RV), and Left ventricle (LV) assessed with M mode. E/A ratio across Tricuspid/Mitral valves and Tei index determined. TDI(Tissue Doppler imaging) used to assess tissue annular velocities across IVS, RV, and LV. Maternal glycemic control and various perinatal/neonatal adverse outcomes were recorded. Results: Significant myocardial hypertrophy seen among fetuses of diabetic mothers versus controls, most severe at term among the poorly controlled diabetics. Structural changes persisted in the neonate. At term, fetal myocardial dysfunction was evident among diabetic pregnancies only as poor annular systolic velocity across IVS, RV using TDI. However, Tissue Doppler changes could not predict adverse perinatal/neonatal outcome. Myocardial dysfunction could not be demonstrated in the neonates. Myocardial hypertrophy at term was a surrogate marker for suboptimal glycemic control, and it could predict important neonatal morbidities like hypoglycaemia, hyperbilirubinemia, prolonged NICU stays, and persistent foetal cardiac shunts. Conclusion: Our study shows a significant association between fetal myocardial hypertrophy and maternal glycemic control among GDM pregnancies. There also seems to be an association between fetal myocardial hypertrophy and some of the adverse perinatal events including hypoglycemia. However these newborns were not found to have clinically relevant cardiac comorbidities even though there was significant septal hypertrophy in utero.

Objective: Out-of-Hospital Cardiac Arrest (OHCA) is a global public health problem. There is inadequate data on OHCA in India. The Warangal Area out-of-hospital Cardiac Arrest Registry (WACAR) was planned to understand OHCA in a regional setting in India. Methods: WACAR is a prospective one-year observational cohort study of OHCA in the Warangal area, Telangana, India. The study included 814 subjects of OHCA of presumed cardiac etiology brought to the Mahatma Gandhi Memorial Hospital during January 1, 2018, and December 31, 2018. The data collected included; standard Utstein variables with additional data on clinical characteristics (modified Utstein template). Results: The majority of OHCA subjects were male with a median age of 60 years, and mostly occurring in residential locations within 1 h of onset of symptoms. Individuals with knowledge of CVD risk factors were more likely to report symptoms before OHCA. Data on resuscitation characteristics were inadequate. Conclusions: The WACAR study provides baseline data regarding OHCA in a regional setting in India. The study demonstrated barriers involving data collection, patient knowledge of CVD risk factors and disease, and access to healthcare, which; impacted the data registry.

The design of a new series of β3-Adrenergic receptor (β3-AdrR) antagonists is described. The use of a spiro building block in the core of the molecule provided novel compounds with reduced aromaticity and antagonist activity at the human β3-AdrR. A shortening of this core and exploration of a series of sulfonamide derivatives produced compounds with good selectivity over β1-AdrR and β2-AdrR. Alternative substitutions on the terminal aromatic rings produced compounds with further improvements in selectivity, particularly with respect to β2-AdrR. Finally, the incorporation of heteroatoms into the fused aromatic ring provided significant improvements in solubility. One compound from the series was shown to antagonize the effect of an exogenously administered β3-AdrR agonist on left ventricular pressure in the rat, making this a series of high interest for further Lead Optimization.

Rhodanine has been recognized as a privileged scaffold in medicinal chemistry due to its well-known ability to demonstrate a broad range of biological activities. The possibility of structural diversification has contributed to the significance of rhodanine structure in effective drug discovery and design. Many studies have confirmed the potential of rhodanine-derived compounds in the treatment of different types of cancer through the apoptosis induction mechanism. Furthermore, most of the rhodanine derivatives exhibited remarkable anticancer activity in the micromolar range while causing negligible cytotoxicity to normal cells. This review critically describes the anticancer activity profile of reported rhodanine compounds and the structure-activity relationships (SAR) to highlight the value of rhodanine as the core structure for future cancer drug development as well as to assist the researchers in rational drug design.

Pesticides are recalcitrant contaminants, which are bioaccumulative in nature. A good number of pesticides, particularly organochlorines, have been listed among the Persistent Organic Pollutant list of Stockholm convention. Organochlorine pesticides were significantly used in the past, however, their footprints still exist in environmental matrices.In the present study, degradation of pesticides using a solar still, with immobilised TiO2, is performed. Existing solar remediation systems have a limitation of utilizing ultraviolet portion of solar energy and the thermal energy remains unutilized in most cases. Solar distillation with a TiO2 photocatalysis enhances the purification properties of the solar still in terms of treatment of recalcitrant pollutants.Organochlorine pesticides like isomers of Hexachlorocyclohexane (HCH), Endosulphan and Dichlorodiphenyltrichloroethane (DDT) can be significantly degraded using a thermo-photocatalytic solar still described in the study. Besides this, degradation of synthetic pyrethroids like fenpropathrin, cyhalothrin, cyfluthrin, cypermethrin and fenvalerate is also studied. Combination of solar distillation and photocatalysis was effective for the treatment of water contaminated with pesticides, achieving more than 21–82% degradation for the studied pesticides. For Organochlorine pesticides, pp DDE’ was the compound which showed least degradation (21.4%) and maximum degradation was achieved for Alpha HCH (82.9%). In the synthetic pyrethroid group, fenpropathrin showed least degradation among all the compounds (60.4%) and fenvalerate showed a maximum degradation (96.4%).Solar photocatalytic distillation can find application in recycling of wastewater generated from agriculture-intensive areas and pesticide manufacturing industries.

Background: Scarcity of data in relationship between hyperuricemia and nonalcoholic fatty liver disease (NAFLD) in Type 2 diabetics (T2DM), particularly in terms of gender differences. Hence, the study was aimed to investigate the gender difference in association between hyperuricemia, and NAFLD in the Indian population. Methodology: A cross-sectional study was conducted with 134 Indian adults, of which 93 males and 41were females. Among them hyperurecemics are 66 (71%) males and 26 (63%) are females. The sample was collected at the department of gastroenterology. The student t-test was applied to assess the risk of hyper and non-hyperuricemia among the NAFLD in Type-2 diabetics. Pearson correlation was used to assess link between serum uric acid and other biochemical parameters. Results: The BMI, SGOT, ALP and LDL levels are significantly elevated in hyperuricemia male subjects (P

Objective: Two-Thumb(TT) technique provides superior quality chest compressions compared with Two-Finger(TF) in an instrumented infant manikin. Whether this translates to differences in blood flow, such as carotid arterial blood flow(CABF), has not been evaluated. We hypothesized that TT-CPR generates higher CABF and Coronary Perfusion Pressure(CPP) compared with TF-CPR in a neonatal swine cardiac arrest model. Methods: Twelve anesthetized & ventilated piglets were randomized after 3 min of untreated VF to receive either TT-CPR or TF-CPR by PALS certified rescuers delivering a compression rate of 100/min. The primary outcome, CABF, was measured using an ultrasound transonic flow probe placed on the left carotid artery. CPP was calculated and end-tidal CO2(ETCO2) was measured during CPR. Data(mean ± SD) were analyzed and p-value ≤0.05 was considered statistically significant. Results: Carotid artery blood flow (% of baseline) was higher in TT-CPR (66.2 ± 35.4%) than in the TF-CPR (27.5 ± 10.6%) group, p = 0.013. Mean CPP (mm Hg) during three minutes of chest compression for TT-CPR was 12.5 ± 15.8 vs. 6.5 ± 6.7 in TF-CPR, p = 0.41 and ETCO2 (mm Hg) was 29.0 ± 7.4 in TT-CPR vs. 20.7 ± 5.8 in TF-CPR group, p = 0.055. Conclusion: TT-CPR achieved more than twice the CABF compared with TF-CPR in a piglet cardiac arrest model. Although CPP and ETCO2 were higher during TT-CPR, these parameters did not reach statistical significance. This study provides direct evidence of increased blood flow in infant swine using TT-CPR and further supports that TT chest compression is the preferred method for CPR in infants.

Summary: Breast cancer-induced activated fibroblasts support tumor progression. However, the role of normal fibroblasts in tumor progression remains controversial. In this study, we used modified patient-derived organoid cultures and demonstrate that constitutively secreted cytokines from normal breast fibroblasts initiate a paracrine signaling mechanism with estrogen receptor-positive (ER+) breast cancer cells, which results in the creation of an interleukin (IL)-1β-enriched microenvironment. We found that this paracrine signaling mechanism is shared between normal and activated fibroblasts. Interestingly, we observed that in reconstructed tumor microenvironment containing autologous ER+ breast cancer cells, activated fibroblasts, and immune cells, tamoxifen is more effective in reducing tumor cell proliferation when this paracrine signaling is blocked. Our findings then suggest that ER+ tumor cells could create a growth-promoting environment without activating stromal fibroblasts and that in breast-conserving surgeries, normal fibroblasts could be a significant modulator of tumor recurrence by enhancing the proliferation of residual breast cancer cells in the tumor-adjacent breast tissue. : Molecular Mechanism of Behavior; Functional Aspects of Cell Biology; Cancer Subject Areas: Molecular Mechanism of Behavior, Functional Aspects of Cell Biology, Cancer

Introduction: Renal infiltration by leukemia causing massive bilateral nephromegaly is an extremely rare presentation of T-cell acute lymphoblastic leukemia(T-ALL). Case report: 18-month-old female toddler presented with fever and progressive abdominal distension of 4–6 weeks duration. Imaging revealed bilateral massively enlarged kidneys with normal excretion. Peripheral blood counts and smear examination was unremarkable and immunophenotypic evaluation of marrow was consistent with T-ALL. Chest imaging was unremarkable. She was started on modified Indian Childhood Collaborative Leukemia Group (ICiCLe) ALL protocol. Even with the best anti-tumor lysis syndrome (TLS) prophylaxis the child required two sessions of hemodialysis. An end-induction morphological remission & end-consolidation negative minimal residual disease (MRD) could be achieved. Conclusion: Bilateral massive nephromegaly is an extremely rare presentation of T-ALL. This case emphasizes the unusual presentation, need for prompt remediation of TLS, and most importantly the use of early intensification with four drug anthracycline & dexamethasone-based therapy for the treatment of T-ALL in children.

The intelligent transportation system (ITS) offers a wide range of applications related to traffic management, which often require high data rate and low latency. The ubiquitous coverage and advancements of the Long Term Evolution (LTE) technology have made it possible to achieve these requirements and to enable broadband applications for vehicular users. In this paper, we perform field trial measurements in various different commercial LTE networks using software defined radios (SDRs) and report our findings. First, we provide a detailed tutorial overview on how to post-process SDR measurements for decoding broadcast channels and reference signal measurements from LTE networks. We subsequently describe the details of our measurement campaigns in urban, sub-urban, and rural environments. Based on these measurements, we report joint distributions of base station density, cellular coverage, link strength, disconnected vehicle duration, and vehicle velocity in these environments, and compare the LTE coverage in different settings. Our experimental results quantify the stronger coverage, shorter link distances, and shorter duration of disconnectivity in urban environments when compared to sub-urban and rural settings.

Testicular veins are known to show many variations in their origin, course and termination. Some of their variations can lead to male sterility. We report a unique variation of right testicular vein here. Pampiniform plexus reduced to three testicular veins (medial, middle and lateral) at the deep inguinal ring on the right side. The medial vein terminated into the right renal vein, the middle vein terminated into the inferior vena cava above the level of right renal vein (close to the suprarenal gland) and the lateral vein terminated partly into the veins in the capsules of the kidney and partly into the veins under the diaphragm. The medial and middle testicular veins were connected through an oblique communicating vein. The middle and lateral testicular veins were also connected to each other through another oblique communicating vein. Knowledge of this case could be useful to radiologists, nephrologists and surgeons in general.

A series of novel (isopropylidene) uridine-[1,2,3]triazole hybrids (3a–3n) were efficiently synthesized via the copper-catalyzed azide–alkyne cycloaddition (CuAAC) from N-propargyl 2′,3′-O-(isopropylidene) uridine with different aryl azides. All the synthesized compounds were screened for their in vitro anticancer and antibacterial activities. The anticancer activity results revealed that compounds 3d and 3f have registered equipotent activity against MCF-7 and 3n has shown excellent activity against HeLa in comparison with the standard drug Cisplatin. Remaining compounds have shown moderate to good anticancer activity against MCF-7 and HeLa cell lines. The antibacterial activity screening results revealed that, compounds 3b and 3n have shown excellent inhibition against Escherichia coli and Bacillus subtilis, 3d against Proteus vulgaris, 3k against Staphylococcus aureus and 3l against S. aureus and B. subtilis have shown equipotent activity in comparison with the standard drug Streptomycin.

Melanomas accumulate a high burden of mutations that could potentially generate neoantigens, yet somehow suppress the immune response to facilitate continued growth. In this study, we identify a subset of human melanomas that have loss-of-function mutations in ATR, a kinase that recognizes and repairs UV-induced DNA damage and is required for cellular proliferation. ATR mutant tumors exhibit both the accumulation of multiple mutations and the altered expression of inflammatory genes, resulting in decreased T cell recruitment and increased recruitment of macrophages known to spur tumor invasion. Taken together, these studies identify a mechanism by which melanoma cells modulate the immune microenvironment to promote continued growth.