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Children with congenital heart disease (CHD) have a higher prevalence of motor impairment secondary to brain injury, resulting in cerebral palsy (CP). The purpose of this study is to determine the prevalence of CP in CHD in a single-center cohort, stratify risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories and identify risk factors. Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF. A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P < 0.001). Developmental disabilities and rehabilitation needs were significantly greater for children with CHD and CP when compared with those with CHD alone (P < 0.001). In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD. [ABSTRACT FROM AUTHOR]

Definitive pelvic intensity modulated radiation therapy (IMRT) in cervical cancer is susceptible to geographic miss due to daily positional and volumetric variations in target and organs at risk. Hence, despite evidence of reduced acute and late treatment-related toxicities, implementation of image-guided IMRT (IG-IMRT) with a reasonable safety margin to encompass organ motion is challenging. In this prospective, nonrandomized phase 2 study, patients with cervical cancer International Federation of Gynecology and Obstetrics (2009) stage IB2-IIIB between the ages of 18 and 65 years were treated with definitive pelvic chemoradiotherapy with a prespecified organ (bladder and rectum) filling protocol. Reproducibility of organ filling was assessed along with the implementation of daily comprehensive adaptive image-guided radiotherapy (IGRT), with a library of 3 IMRT (volumetric modulated arc therapy) plans with incremental expansions of clinical target volume (CTV) to planning target volume (PTV) (primary) margins (small, 0.7 cm; adequate, 1 cm; and large, 1.5 cm) and a backup motion robust 3-dimensional conformal radiotherapy plan; the appropriate plan is chosen based on pretreatment cone beam computed tomography (CBCT) ("plan of the day" approach). Fifty patients with a median age of 49 years (IQR, 45-56 years) received definitive radiation therapy (45-46 Gy in 23-25 fractions to pelvis, with simultaneous integrated boost to gross nodes in 15 patients) with the aforementioned IGRT protocol. In the analysis of 1171 CBCT images (in 1184 treatment sessions), the mean planning computed tomography (CT) and CBCT bladder volumes were 417 and 373 cc, respectively. Significant interfractional variation in bladder volume was noted with a mean absolute dispersion of 29.5% with respect to planning CT; significant influential random factors were postchemotherapy sessions (P ≤.001), pre-CBCT protocol duration (P =.001), and grades of chemotherapy induced nausea vomiting (P =.001). Significantly higher variation in bladder filling was noted in patients with older age (P =.014) and larger planning CT bladder volume (P ≤.001). Time trend analysis of fraction-wise bladder volume revealed an absolute systemic reduction of 16.3% in bladder volume means from the first to the fifth week. Variation in rectal diameter was much less pronounced, with 19.2% mean dispersion and without any significant factors affecting it. Although in 19% and 2% of sessions large IMRT PTV and 3-dimensional conformal radiotherapy were necessary to cover the primary target, respectively, reduction in treated volume was possible in 43% of sessions with small PTV selection instead of standard adequate PTV (36% sessions). Plan of the day selection had a moderate to strong correlation with nonabsolute dispersion of bladder filling (Spearman ρ =0.4; P =.001) and a weak (but significant) correlation with grades of acute toxicities. The planned protocol was well tolerated with no radiation-induced local grade 3 toxicity. Interfractional variation in organ filling (especially bladder) is inevitable despite fixed pretreatment protocol in definitive settings (intact cervix). Despite the logistical challenges, adaptive IGRT in the form of plan of the day based on incremental CTV-to-PTV margins is a relatively simple and feasible strategy to minimize geometric uncertainties in radical IG-IMRT of cervical cancer. [ABSTRACT FROM AUTHOR]

Craniopharyngioma (CP) is a benign neuroepithelial tumor generally treated with maximal safe resection and radiation therapy (RT) in incompletely resected CP or in recurrent tumors to achieve long-term control. We analyzed the clinical outcomes of patients with CPs treated with a multimodality approach. A retrospective clinical audit of histologically proven CPs registered between 2008 and 2019 at a specialized neuro-oncology center in India was performed. Time-to-event outcomes (overall survival [OS] and progression-free survival [PFS]) were analyzed. One hundred and twenty-two patients with CP were analyzed. The median age of the population was 14 years (interquartile range [IQR], 8–26) with a significant male preponderance. Gross total resection was achieved in only 25% of patients. At a median follow-up of 57.1 months (IQR, 27.8–87.8), 5-year estimates of PFS and OS were 52% (95% confidence interval, 46%–63.4%) and 85.8% (95% confidence interval, 78.6%–93%), respectively. Recurrence or progression was observed in 48 of 122 patients (39.3%) at a median time of 84.4 months (IQR, 24.7–174.8). On multivariate analysis, the absence of residual disease (P = 0.004), near-total resection (P = 0.035), and use of up-front adjuvant RT (P < 0.001) significantly improved the 5-year PFS, whereas the absence of extracavernous extension (P = 0.058) and any use of postoperative RT (P = 0.026) significantly improved the 5-year OS. This study represents one of the largest single-institutional series of CPs, showing improved PFS with up-front adjuvant RT in most cases of CP. Deferring adjuvant RT should be considered only in patients with no evidence of residual disease (as shown on dedicated sellar imaging) after primary surgery. [ABSTRACT FROM AUTHOR]

Packaging materials based on lightweight and flexible thermoplastic/graphene composite films are gaining popularity in both the academic and industrial sectors. In this research work, graphene nanoplatelet (GNP) of 1–5 wt% was integrated into linear low density polyethylene (LLDPE) by employing melt compounding technique at 160 °C to produce flexible composite films. The LLDPE/GNP nanocomposite films were irradiated with doses up to 50 kGy using a 2.5 MeV electron beam accelerator in air at ambient temperature. The uniform distribution of GNP in the thermoplastic matrix obtained from FESEM analysis improved the samples' mechanical characteristics. As the GNP concentration in the LLDPE matrix increases, both the thermal stability and impermeability qualities (oxygen and water vapor) get significantly improved. Electron beam irradiation of film samples further enhances the physico-mechanical, thermal and gas barrier properties compared to non-irradiated composite films and neat LLDPE film. The tighter connections between graphene and LLDPE chains as well as the development of cross-linked networks by E-beam irradiation are responsible for the improved performance properties. Therefore, GNP incorporation as well as electron beam irradiation of thermoplastic nanocomposite films could be a viable alternative for producing high-performance and high-barrier flexible LLDPE/GNP composite films for packaging applications. • Combine effects of GNP addition and electron beam irradiation on properties of LLDPE composite films. • The fabricated flexible composite films irradiated up to the dose of 50 kGy. • The E-beam irradiated samples improved mechanical, thermal and barrier properties. • These irradiated, and high-barrier composite films for flexible packaging materials. [ABSTRACT FROM AUTHOR]

In capturing visco-elastic behavior, experimental tests play a fundamental role, since they allow in building up theoretical constitutive laws very useful for simulating their own behavior. In the present contribution, estimation is made to investigate the transient phenomena in a homogeneous isotropic three-dimensional medium whose surface is subjected to a time-dependent thermal loading and is free of traction, in the context of two-temperature three-phase-lag thermoelastic model with non-local fractional operators. The governing equations are formulated for Kelvin-Voigt two-temperature theory and are solved employing the normal mode analysis. Numerical estimates of the thermophysical quantities are depicted graphically for a copper-like material. This mathematical formulation is assessed by experimental tests and the effect of two-temperature theory and the non-local fractional operator is analyzed. Also, the effect of viscosity on the thermophysical quantities is reported in the literature. [ABSTRACT FROM AUTHOR]

Heat shock protein 90 (HSP90) is a molecular chaperone that is up-regulated in cancer and is required for the folding of numerous signaling proteins. Consequently, HSP90 represents an ideal target for the development of new anti-cancer agents. The human HSP90 isoform, glucose-regulated protein 94 (GRP94), resides in the endoplasmic reticulum and regulates secretory pathways, integrins, and Toll-like receptors, which contribute to regulating immunity and metastasis. However, the cellular function of GRP94 remains underinvestigated. We report thatGRP94knockdown cells are defective in intracellular transport and, consequently, negatively impact the trafficking of F-actin toward the cellular cortex, integrin α2 and integrin αL toward the cell membrane and filopodia, and secretory vesicles containing the HSP90α-AHA1-survivin complex toward the leading edge. As a result, GRP94 knockdown cells form a multipolar spindle instead of bipolar morphology and consequently manifest a defect in cell migration and adhesion. [ABSTRACT FROM AUTHOR]

• Novel liquid-liquid CCTPF-structures in an 11 mm ID tube are explored & characterized at seven flow-orientations. • Complex & time-varying interfacial distribution & attributes of the flow-structures are explored. • Objective signatures of flow-structures are extracted in terms of time-series signals. • Signals are parameterized, & the flow-structures are characterized in terms of signals' NPPD plots & statistical parameters. • CI-based categorizer is developed, & the flow-structures are automatically categorized at each orientation. Attempts are made to identify, characterize, and automatically categorize the liquid-liquid counter-current two-phase flow-structures in a circular-conduit of 11 mm diameter by varying the flow-orientation. Rigorous experimentations are performed for a wide range of superficial kerosene and water velocities at seven conduit-orientations. Some unique liquid-liquid counter-current two-phase flow-structures, not reported in the literature to date, are found in the present investigation. Interfacial distributions and the highly time-varying nonlinear attributes of the flow-structures corresponding to different combinations of the superficial water and kerosene velocities at each conduit-orientation are detected and recognized through high-resolution photography and high-speed videography. Objective descriptions of the flow-structures are accumulated in the form of time-series current and voltage signals using a differential-pressure-transmitter and in-house fabricated conductivity-probes, respectively. Statistical analyses are performed to parameterize the time-series repetitive objective signatures. The non-parametric probability distribution plot and statistical parameters extracted from the signals are found to be very effective in detecting and distinguishing the individual flow-structures. Flow-structures are parameterized using those statistical parameters. A computational intelligence-based categorization methodology is developed to automatically categorize the obtained flow-structures considering these statistical parameters as the inputs. A good agreement is found for each orientation between the flow-regime groups based on visual observation and those obtained through the categorization methodology. It simply establishes that the flow-structures are perfectly characterized by the statistical parameters extracted from their objective-signatures. [ABSTRACT FROM AUTHOR]

Abstract: We consider a unimodal continuous function of N variables over an N-dimensional rectangular parallelopiped and explain a search method to find the domain of uncertainty which contains the point that maximizes the function. Our search method does not require differentiability assumption. The function is projected along each dimension. An algorithm is developed to eliminate the subset of the domain at each step, which does not contain the solution. Lucas numbers are used in the elimination process. [Copyright &y& Elsevier]

The first total synthesis of penipanoid C and 2-(4-hydroxybenzyl)quinazolin-4(3 H )-one is reported using a greener mild deep eutectic solvent mediated cyclization strategy with good overall yields. NU1025 drug is also synthesized using the similar protocol. [ABSTRACT FROM AUTHOR]

Total synthesis of actinophenanthroline A, a marine actinomycete within the family of Streptomycetaceae (strain CNQ-149) is reported. Both the racemic and enantiopure actinophenanthroline A have been synthesized with good overall yields. Highlight of the synthesis contains the classical and economical double Doebner–Miller reaction to access the 1,7-phenanthroline core followed by a modified EDCI coupling. [ABSTRACT FROM AUTHOR]

Experimentations are conducted, and kerosene-water counter-current two-phase flow-structure in a duct of 15 mm diameter are identified, categorized, and characterized in five duct-orientations for different combinations of kerosene and water superficial velocities. Some unique counter-current liquid-liquid flow-structures, which have not yet been reported till date, are found through the present experimental investigation. Flow-structures' interfacial distributions and highly time-varying attributes are captured using a high-resolution DSLR camera and a high-speed video camera, respectively, to distinguish and identify them. The subjective descriptions may confuse the observer. Thus, the objective interpretations of the flow-structures are collected as time-series current and voltage signals using a DPT and in-house fabricated conductivity probes, respectively. Statistical analyses of the time-series data are performed, and statistical parameters are extracted using MATLAB coding. The flow-structures are successfully parameterized and characterized in terms of the 'non-parametric probability distribution (NPPD)' plots and those statistical parameters of the objective signatures. These extracted NPPD plots and statistical parameters are found to be very useful for recognizing and distinguishing the individual flow-structures. [Display omitted] • Novel liquid-liquid CCTPF-structures in a 15 mm ID tube for 5 flow-orientations are experimentally identified. • High-resolution images of the developed complex flow-structures are recorded using a DSLR camera. • Flow-structures' rapidly time-varying attributes are captured by high-speed videography using a high-speed camera. • Flow-structures' objective interpretations are collected using DPT and in-house fabricated CP. • Flow-regimes are expressed using the NPPD plots and statistical parameters of the objective interpretations. [ABSTRACT FROM AUTHOR]

Reinforced polymer blend is a well-practiced area of interest adopted by materials scientist throughout the world due to its tunable end properties. The present study has been fueled by developing an immiscible thermoplastic elastomeric blend (polystyrene/ethylene-co- methyl acrylate copolymer) with loading of conducting carbon black (Vulcan XC 72); an overworked conductive clustered carbon filler. The work emphasized selective dispersion of carbon particulates in one phase (ethylene-co-methyl acrylate copolymer) resulting lowering of electrical percolation and excellent EMI shielding effectiveness in low loading. The conductive blend was also cross-checked to establish their superiority in physico-mechanical, rheological behaviors and thermal stability. The microscopic analysis has implied dispersed islands of clustered carbon particles inside blend ensuing path for electronic hopping. The segregated microstructure also has been correlated to their frequency dependent conductivity, skin depth analysis and EMI shielding measurement. [Display omitted] [ABSTRACT FROM AUTHOR]

• Dexmedetomidine is an α2-adrenoreceptor agonist used for sedation. • This case report outlines a novel use for this drug in cessation of status epilepticus. • The mechanism is not fully understood, but operation outside of GABAergic agonism is potentially a crucial factor in the management of refractory and super refractory status epilepticus. This case report details a novel approach to the management of super-refractory status epilepticus (SRSE) in a boy with new-onset seizures progressing to SRSE. After exhausting multiple medications, dexmedetomidine, an α2-adrenoreceptor agonist used for sedation, stopped his SRSE. Dexmedetomidine provides a unique mechanism of action to treat this condition. Further studies are needed to determine its role in SRSE. [ABSTRACT FROM AUTHOR]

The present numerical calculation considers a converging-diverging funnel-type real-scale IRS (infrared suppression) device made up of two conical funnels, one above the other. The device's mass suction and outlet temperature are calculated by changing geometrical and operational parameters, such as the Reynolds number, inlet temperature, funnel, and exhaust pipe overlapping. For the current computation, the effect of the above parameter on the non-dimensional mass entrained and the outlet temperature was studied. Various governing equations like mass, momentum, and energy conservation are applied to the computational domain for a real-scale IRS device. The numerical computation results indicate that the inlet temperature significantly impacts the mass entrainment ratio more than the Reynolds number. This impact is quite visible for the Reynolds number at higher inlet temperatures. A better mass entrainment ratio is achieved at a negative overlap, but the changes are negligible after a negative funnel overlap of 0.4 m. Similarly, mass entrainment improves when the exhaust pipe is kept far from the bottom funnel. This study proposes new correlations for mass entrainment and outlet temperature ratios. [ABSTRACT FROM AUTHOR]

Electromagnetic interference (EMI) is unwanted noise or interference that often affects electronic equipment and human health. An effective EMI shielding material is needed to protect electronic equipment and human health to block EMI signals. In this work, we have developed electrically conductive polymer composites via the preferential localization of MWCNTs in a co-continuous ethylene-co-methyl acrylate (EMA)/thermoplastic polyolefin (TPO) (80/20 w/w) binary blend system using a solution mixing technique. The electrical percolation threshold was achieved by incorporating 3 to 5 wt% of MWCNT in the blend matrix. FESEM and TEM images indicated a co-continuous morphology in which MWCNT was thermodynamically and kinetically driven into the EMA phase of the polymer blend. The DC and AC conductivity of the fabricated composite was significantly increased upon loading the MWCNT in the polymer composite. A total EMI shielding effectiveness of −35 dB was achieved by adding 15 wt% MWCNT into the matrix in the frequency range of 14.5–20.0 GHz, along with good thermal conductivity, dielectric properties, and mechanical properties. • EMA/TPO/MWCNT nanocomposite is fabricated through solution mixing technique. • Preferential filler distribution reduces the percolation threshold of DC conductivity. • Thermal conductivity with low MWCNT loading reveals the double percolation phenomena. • Polymer nanocomposite shows excellent EMI shielding properties at lower filler loading. • Nanocomposite shows −35 dB EMI shielding at 15 wt% MWCNT filler incorporation. [ABSTRACT FROM AUTHOR]