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Healthcare monitoring systems have improved with the Internet of Things and machine learning prediction models. Traditional batch machine-learning approaches cannot generate an effective model since most data will be continuous and real-time. Real-time medical data processing is challenging since the entire data is unavailable during prediction. Here, a continuous model adaptation based on incremental learning is demanded. The development of such a system can significantly improve patient outcomes and reduce healthcare costs. This paper proposes an Incremental Naive Bayes Learner that can handle concept drifts in data. The algorithm keeps a sliding window of data constantly updated as new data is added. The adaptive window size determines how much data is used to train the model at any given time. After processing each chunk of data, the algorithm calculates the model's accuracy. The system detects a concept drift and dynamically updates the training set if the accuracy drops below a predefined threshold. We conducted a comparative evaluation of state-of-the-art batch and incremental learning algorithms on different medical datasets, demonstrating the impact of incremental learning. The results demonstrate the effectiveness of our approach: the Agrawal dataset achieved the highest accuracy at 66.6%, followed by Dialysis at 61.6%, while Liver and HCC achieved 50% and 58.3% accuracy, respectively. This approach ensures a sustained high level of accuracy in healthcare monitoring systems over time, even amidst concept drift. [ABSTRACT FROM AUTHOR]

An exponential growth of interest in the healthcare IoT over the past few years has increased the adoption of AI. However, healthcare analytics demands highly accurate and reliable systems that can not afford even a small amount of vulnerability. The black-box nature of AI models raises significant concerns about the computations involved in these predictions, leading to a lack of trust in these models. Explainable Artificial Intelligence (XAI) seeks to resolve this problem by providing a human-understandable explanation for AI decisions, bringing transparency, trust, and fairness to these AI models. This paper evaluates the existing XAI models on numeric and graph-structured healthcare data. The LIME and SHAP models are first used to explain the predictions in the numerical dataset of fetal health prediction. Second, graph-structured data is analyzed using GNN Explainer and PG Explainer. This evaluation suggests that XAI model interpretations benefit healthcare professionals and patients to trust AI predictions. [ABSTRACT FROM AUTHOR]

Fetal ultrasound images are widely used for visualizing fetal development during pregnancy. These ultrasound image planes provide information about the anatomy of the fetus, thus helping healthcare professionals identify any abnormalities. Several AI tools are now being applied to classify fetal planes automatically. Accurate classification of fetal ultrasound image planes is crucial for the correct prenatal diagnosis and healthcare. However, while deep learning models have shown promise in image classifications, their "black box" nature makes their decisions challenging to interpret, which is a significant concern in healthcare analytics. This paper addresses the problem of interpretability of the decisions made by a Convolutional Neural Network(CNN) for fetal ultrasound image classification using an XAI technique. Despite their accuracy, the established solutions lack the transparency essential for medical professionals to trust the model's predictions. The LIME(Local Interpretable Model-agnostic Explanations) is applied to interpret the CNN classification that provides a high classification accuracy. The results of LIME interpretability model on the top of CNN highlight the critical regions that positively and negatively contribute to the classification decision. This approach offers a transparent and trusted solution for leveraging AI in prenatal diagnostics. [ABSTRACT FROM AUTHOR]

Fetal ventriculomegaly is one of the major risks in prenatal diagnosis, which is an enlargement of the ventricles of the developing fetus's brain. Timely prediction of these brain disorders helps patients and healthcare providers make informed decisions and treatment plans. This paper investigates the classification of ventriculomegaly from MRI images using a deep learning approach. Segmentation of ventricles is performed using DeeplabV3+ and U-Net architectures and the accuracy, dice coefficient, and loss of these two approaches are compared. Additionally, a novel approach for size estimation was developed, utilizing contour detection to delineate ventricle boundaries and compute their areas by enclosing them within rectangles. A threshold-based classification method was then applied to differentiate between abnormal ventriculomegaly and normal cases. This research contributes to the assessment and comparison of the segmentation algorithms for aiding in the identification and classification of ventriculomegaly cases, offering potential implications for clinical diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

• Mortality among Indian children with infantile epileptic spasms syndrome seems to be comparable with developed countries. • The commonest cause of mortality observed among children with infantile epileptic spasms syndrome is sepsis. • Presence of seizures other than epileptic spasms is associated with lower survival time. • Presence of inborn error of metabolism as etiology is associated with lower survival time. • Children with idiopathic IESS have good survival prospects. The existing literature indicates a higher risk of mortality among children with Infantile epileptic spasms syndrome (IESS). Our aim was to find the mortality pattern and factors that affect survival among children with IESS. Children with IESS who had age of onset between one month and 24 months were included. The primary outcome was survival. We used Kaplan-Meier estimates for survival analysis and Cox regression analyses to evaluate possible factors associated with mortality. During the follow-up period (120 months), 19/160 children (11.9%) expired. Three children expired in the first week after initiation of ACTH. There were six deaths (3.8%; 31.6% of deaths), within two years. Clinical findings and laboratory investigations revealed the cause of death to be severe pneumonia in ten children. Three died of severe sepsis. Four died due to metabolic crisis and two children died due to probable Sudden unexpected death in epilepsy (SUDEP). On multivariable analysis, mortality was predicted by 'presence of seizures other than spasms' and an inborn error of metabolism (IEM) as the underlying cause. None of the children in the idiopathic group died. Survival in our single center cohort with IESS was good in comparison to previous studies. Considering that pneumonia and sepsis were the most common cause of mortality that we detected, steps for prevention of sepsis might be worth considering in these children. Presence of seizures other than epileptic spasms, and an IEM should prompt the physician to let the family know that risk of mortality is high. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• After mild traumatic brain injury, patients reported higher symptom severity. • After mild traumatic brain injury, patients had and had worse cognitive performance. • Plasma micro-RNA miR423-3p levels were significantly higher among mTBI patients. • Plasma micro-RNA miR423-3p levels provided moderate discriminative ability. • None of the assessed miRNA biomarkers predicted persistent symptoms at 7 days. The diagnosis of mild traumatic brain injury (mTBI) and early identification of patients who have persistent symptoms remains challenging. Symptoms are variably reported, and tests for cognitive impairment require specific expertise. The aim of this study was to assess the ability of plasma micro-ribonucleic acid (miRNA) biomarkers to distinguish between patients with mTBI and healthy controls. A secondary aim was to assess whether miRNA biomarker levels on the day of injury could predict persistent symptoms on day 7. Injured patients presented to an adult, tertiary referral hospital emergency department and were diagnosed with isolated mTBI (n = 75). Venous blood samples were collected within 6 h of injury. Symptom severity was assessed using the Rivermead Post-Concussion Symptom Questionnaire (RPQ) on the day of injury and at 7 days post-injury. The comparator group (n = 44) were healthy controls without any injury, who had bloods sampled and symptom severity assessed at the same time-point. Patients after mTBI reported higher symptom severity and had worse cognitive performance than the control group. Plasma miR423-3p levels were significantly higher among mTBI patients acutely post-injury compared to healthy controls and provided moderate discriminative ability (AUROC 0.67; 95 %CI: 0.57–0.77). None of the assessed miRNA biomarkers predicted persistent symptoms at 7 days. Plasma miR423-3p levels measured within 6 h of injury can discriminate for mTBI compared to healthy controls, with potential utility for screening after head injury or as an adjunct to the diagnosis of mTBI. Acute plasma miRNA levels did not predict patients who reported persistent symptoms at 7 days. [ABSTRACT FROM AUTHOR]

This in vitro study aimed to comparatively evaluate the fracture resistance of contracted endodontic cavities (CECs) versus traditional endodontic cavities (TECs) in mandibular molars after subjecting the samples to a chewing simulator. A total of 24 freshly extracted human mandibular molars were included in the study. Teeth with intact crowns and mature root apices that were devoid of caries, attrition, restorations, and cracks were selected and randomly assigned to 3 groups (n = 8) as follows: Group 1: TECs, Group 2: CECs, and Group 3: intact teeth (control group). After endodontic treatment, the teeth were restored with EverX bulk-fill composite and layered occlusally with nanohybrid composite SolareX and subjected to a chewing simulator where 240,000 masticatory cycles were simulated, which translates to 1 year of clinical function. The teeth were then subjected to static loading in a universal testing machine and the maximum load to fracture and the pattern of failure (restorable/unrestorable) were recorded. Data were evaluated with analysis of variance and the Tukey post hoc test for multiple comparisons. The CEC group had higher fracture resistance when compared with the TEC group; however, the difference was not statistically significant. The fracture resistance of the samples in the control group was statistically higher than those in the experimental groups (P <.005). There was no difference observed in the fracture resistance of mandibular molars with TECs and CECs subjected to masticatory loading. [ABSTRACT FROM AUTHOR]

• The Dyspnea Challenge is reliable in heart failure. • The Dyspnea Challenge is reliable in COPD. • The Dyspnea Challenge can differentiate between pathophysiology. In heart failure (HF), exertional dyspnea is a common symptom, but validated field-based tests for its measurement are limited. The Dyspnea Challenge is a two-minute uphill treadmill walk designed to measure exertional dyspnea in cardiopulmonary disease. The purpose of this study was to establish the test-retest reliability of the Dyspnea Challenge in HF and to compare the exercise responses to a group with chronic obstructive pulmonary disease (COPD). The study was an experimental, single-blind, randomized, multi-site project that recruited individuals with HF (New York Heart Association I-III) and COPD (Global Initiative for Chronic Obstructive Lung Disease II-IV). Participants completed two visits. On the first visit, participants performed two six-minute walk tests (6MWT), followed by two to three Dyspnea Challenges to calculate treadmill speed and gradient. At Visit Two, participants performed two separate Dyspnea Challenges, with one including measures of pulmonary gas exchange and central hemodynamics. Twenty-one individuals with HF (10 female; 66±11years; ejection fraction:45.3 ± 6.1%; six-minute distance(6MWD) 520 ± 97 m), and 25 COPD (11 female; 68 ± 10 yr; forced expiratory volume in 1 s:47.6 ± 11.5%; 6MWD: 430 ± 101 m). Intraclass correlation coefficients demonstrated excellent test-retest reliability for HF (0.94, P <.01) and COPD (0.95, P <.01). While achieving similar end-exercise exertional dyspnea intensities (P =.60), the HF group walked at a higher average speed (4.2 ± 0.8 vs. 3.5 ± 0.8km·h−1) and gradient (10.3 ± 2.8 vs. 9.6 ± 2.8%) and a greater oxygen uptake (P <.01) and ventilation (P <.01) than those with COPD. While achieving similar cardiac outputs (P =.98), stroke volumes (P =.97), and heart rates (P =.83), those with HF displayed a larger arteriovenous oxygen difference (P <.01), while those with COPD exhibited greater decreases in inspiratory capacity (P=.03), arterial oxygen saturation (P=.02), and breathing reserve (P<.01). The Dyspnea Challenge is a reliable test-retest measure of exertional dyspnea in HF. Typical to their pathologies, HF seemed limited by an inadequate modulation of cardiac output, while ventilatory constraints hampered those with COPD. [ABSTRACT FROM AUTHOR]

Inspiratory muscle training (IMT) is used across various pathology domains to improve respiratory function. Limited literature exists which demonstrates IMT benefit among patients with Diaphragmatic dysfunction. 7 individuals with a mean age of 59.6yrs had unilateral diaphragmatic dysfunction (UDD) post cardiac surgery and were referred to a cardiac rehab program where an IMT strength based protocol was prescribed. IMT implementation over an average of 13 weeks yielded an average improvement in maximum inspiratory pressure (MIP) of 48 % (p value 0.018), peak inspiratory flow rate (PIFR) of 45 % (p value 0.018), forced expired volume in 1 sec (FEV1) of 15 % (p value 0.028) and forced vital capacity (FVC) of 15 % (p value 0.018). This case series of data adds to the limited evidence that exists currently and outlines the benefits of IMT application within unilateral diaphragmatic dysfunction. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The fascial system not only enables the body to operate in an integrated manner but modifies its tension in response to the stress on it. Recent animal, cadaveric and in-vitro trials have shown that "myofascial force transmission" (MFT) can play a major role in homeostasis, musculoskeletal function and pain. Human evidence for the in-vivo existence of MFT is scarce. This scoping review attempts to gather and interpret the available evidence of the in-vivo existence of MFT in humans, its role in homeostasis, and musculoskeletal function. A search of major databases using the keywords 'myofascial force transmission' and 'epimuscular force transmission' yielded 247 articles as of November 2021. For the final analysis, only original in-vivo human studies were considered. In-vitro human studies, cadaveric or animal studies, reviews, and similar studies were excluded. A qualitative analysis of the studies was conducted after rating it with the Oxford's Center for Evidence –based Medicine (CEBM) scale. Twenty studies ranging from randomized controlled trials (RCTs) to case studies covering 405 patients have been included in this review. The analysed trials were highly heterogeneous and of lower methodological quality meddling with the quantitative analysis. The majority of the appraised studies demonstrated a higher probability of MFT existence, while two studies revealed a lower probability. Our search for proof of the in vivo existence of MFT in humans has led us to support such an existence, albeit prudently. Previous research on animals and human cadavers reinforces our finding. We are optimistic that the forthcoming studies on the topic will pave the way for the unraveling of several musculoskeletal riddles that are currently unknown or less well-known. [ABSTRACT FROM AUTHOR]

[Display omitted] • Papilionaceous and keel-blossom types functioned as floral advertisements and nectar and pollen grains served as floral rewards. • Six floral visitors including 5 bees recorded as floral visitors. • Large-bodied bees are appropriate to break the wing-keel complex which facilitates cross-pollination. • Floral visitors abundance was high in samples recorded with more individuals or more flowers. • Melittophily is the effective mode of reproduction in C.paniculata especially by Xylocopa. The present study investigates the morphology of floral parts adapted towards the mode of pollination by bees in a lesser-known shrub, Crotalaria paniculata Willd of the family Fabaceae. The morphology and orientation of flowers, colour, shape, size and number of each floral part were recorded. The floral odour was assessed qualitatively at various stages of flowers manually and the quantity of nectar produced per flower was also measured. The flowering individuals were regularly monitored to observe the floral visitors and their foraging activity on a series of aged flowers. The performance of each floral visitors like visitation frequency, handling time, relative abundance, activity rate, visitation rate index and visitor activity index was calculated. The flowers of C. paniculata are typical papilionaceous and keel-blossom types that function as floral advertisement and nectar and pollen grains are served as floral rewards. The standard petal serves an advertisement whereas the wing-keel complex acts as a landing platform for floral visitors. The large-bodied bees tend to break the wing-keel complex which facilitates cross-pollination. Xylocopa latipes (Apidae) was observed as the most effective pollinator due to their higher frequency of visits, activity rate, visitation rate index and visitor activity index. Due to the pressure applied by large-bodied bees like Xylocopa latipes by landing on the wing-keel complex, the reproductive parts become exposed and the stigma brushes the pollen load in the body of the visitors and effect cross-pollination. The study concludes that large-bodied bees are effective floral visitors of C. paniculata which effect cross-pollination. [ABSTRACT FROM AUTHOR]

The removal of lower third molar teeth is one of the most common surgical procedures performed worldwide, but many concepts in this surgery have been unclear and have engendered different opinions. This paper aims to review current thinking in certain pertinent aspects of this surgery to update the reader on the most current research and synthesise it to make clinical recommendations. Topics covered include preoperative imaging, timing of removal, flap design, lingual retraction, coronectomy, lingual split, closure techniques, and use of antibiotics, steroids, and drains. [ABSTRACT FROM AUTHOR]

• Patients with mTBI had higher levels of micro-RNA than healthy controls. • At day 7, pattern of change in micro-RNA levels were similar to symptom severity. • At day 28, pattern of change in micro-RNA levels were different to symptom severity. • Micro-RNA levels among recovered patients were different to those reporting symptoms. • Micro-RNA levels may provide unique information on brain injury and healing. Micro riboneucleic acids (miRNAs) may be transcribed after brain injury and be detectable in plasma. This study aimed to assess the discriminative ability of seven miRNAs in plasma to differentiate between patients with mild traumatic brain injury (mTBI) and healthy controls. Changes in miRNA levels over 28 days were compared to changes in self-reported symptom profile. This was a prospective cohort study with longitudinal measurements of miRNA levels and symptom self-report. The Rivermead Post-Concussion Symptom Questionnaire (RPQ) was used to determine symptom severity. Mean normalised expression ratios (NER) of miRNAs at day 0 between mTBI and healthy controls were compared. An analysis of response profiles compared the response over time of miRNA species with RPQ symptom severity. miRNA levels of subjects who were defined to have "recovered" on Day 7 and 28 were compared to "non-recovered" subjects. There were 28 mTBI patients and 30 healthy controls included for analysis. Symptom severity was significantly higher on the day of injury among mTBI subjects (p < 0.001), and miRNA 32-5p levels were also higher (p = 0.009). Change of miRNA levels were similar to RPQ change at Day 7, but significantly different at Day 28. Differences were observed among miRNA levels of recovered subjects. This study demonstrated differences in miRNA levels among mTBI subjects compared to healthy controls and different miRNA levels among those who had recovered compared to those reporting symptoms. The change in profiles of miRNAs was different to symptom severity, suggesting that the two measures reflect different aspects of brain injury and recovery. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare how often fine-needle aspiration (FNA) would be recommended for nodules in unselected, low-risk adult patients referred for sonographic evaluation of thyroid nodules by ACR Thyroid Imaging Reporting and Data System (TI-RADS), the American Thyroid Association guidelines (ATA), Korean Thyroid Imaging Reporting and Data System (K-TIRADS), European Thyroid Imaging Reporting and Data System (EU-TIRADS), and Artificial Intelligence Thyroid Imaging Reporting and Data System (AI-TIRADS).Methods: Seven practices prospectively submitted thyroid ultrasound reports on adult patients to the ACR Thyroid Imaging Research Registry between October 2018 and March 2020. Data were collected about the sonographic features of each nodule using a structured reporting template with fields for the five ACR TI-RADS ultrasound categories plus maximum nodule size. The nodules were also retrospectively categorized according to criteria from ACR TI-RADS, the ATA, K-TIRADS, EU-TIRADS, and AI-TIRADS to compare FNA recommendation rates.Results: For 27,933 nodules in 12,208 patients, ACR TI-RADS recommended FNA for 8,128 nodules (29.1%, 95% confidence interval [CI] 0.286-0.296). The ATA guidelines, EU-TIRADS, K-TIRADS, and AI-TIRADS would have recommended FNA for 16,385 (58.7%, 95% CI 0.581-0.592), 10,854 (38.9%, 95% CI 0.383-0.394), 15,917 (57.0%, 95% CI 0.564-0.576), and 7,342 (26.3%, 95% CI 0.258-0.268) nodules, respectively. Recommendation for FNA on TR3 and TR4 nodules was lowest for ACR TI-RADS at 18% and 30%, respectively. ACR TI-RADS categorized more nodules as TR2, which does not require FNA. At the high suspicion level, the FNA rate was similar for all guidelines at 68.7% to 75.5%.Conclusion: ACR TI-RADS recommends 25% to 50% fewer biopsies compared with ATA, EU-TIRADS, and K-TIRADS because of differences in size thresholds and criteria for risk levels. [ABSTRACT FROM AUTHOR]

In this paper, we describe our experiences extending a distributed data caching service in the mobile cloud to support active-active geo-replication. We show how our enhancements guarantee data consistency between regions after a network partition recovery. An approach is presented for keeping geo-distributed replicas synchronized despite the cache data operations replication not ensuring causal delivery in the presence of long network partitions. We use Redis, one of the most popular in-memory databases for the distributed data caching service in the mobile cloud, as a proof of concept to apply our approach in a plug-in way (minimizing the impact on both the server and client side of the cache service). Redis exposes a powerful extension API that allows new abstract data types to be associated with keys but does not provide direct support for adding and managing global dictionary metadata, which we added in our solution. That extension API is used to add the CRDT (Conflict-free Replicated Data Type) to resolve the writing conflicts from multiple regions. [ABSTRACT FROM AUTHOR]

The rapid expansion of oil palm (OP) has led to its emergence as a commodity of strategic global importance. Palm oil is used extensively in food and as a precursor for biodiesel. The oil generates export earnings and bolsters the economy of many countries, particularly Indonesia and Malaysia. However, oil palms are prone to basal stem rot (BSR) caused by Ganoderma boninense which is the most threatening disease of OP. The current control measures for BSR management including cultural practices, mechanical and chemical treatment have not proved satisfactory. Alternative control measures to overcome the G. boninense problem are focused on the use of biological control agents and many potential bioagents were identified with little proven practical application. Planting OP varieties resistant to G. boninense could provide the ideal long-term solution to basal stem rot. The total resistance of palms to G. boninense has not yet been reported, and few examples of partial resistances have been observed. Importantly, basidiospores are now recognized as the method by which the disease is spread, and control methods require to be revaluated because of this phenomenon. Many methods developed to prevent the spread of the disease effectively are only tested at nursery levels and are only reported in national journals inhibiting the development of useful techniques globally. The initial procedures employed by the fungus to infect the OP require consideration in terms of the physiology of the growth of the fungus and its possible control. This review assesses critically the progress that has been made in BSR development and management in OP. [ABSTRACT FROM AUTHOR]

Oral squamous cell cancers involving the masticatory space are staged as unresectable cancers and their treatment is difficult. Curative treatment with extensive surgery followed by adjuvant therapy is one of the treatment options. In this retrospective study, the survival of 123 patients (93 with T4a cancers, 30 with T4b cancers), treated during the period August 2009 to August 2015, was evaluated. The majority had bucco-alveolar cancers (62.6%), were male (61.8%), and were tobacco users (76.4%). The select group of T4b oral cancer patients were treated with surgery, which included infratemporal fossa clearance in all 30 patients, followed by adjuvant therapy. The masseter was the most commonly involved masticatory muscle, and 24 patients had fewer than three involved structures. Free margins were obtained in 90.2% of cases; 41.5% of cases were node-positive. One hundred and four patients (84.6%) completed adjuvant treatment. The median follow-up was 42 months. For node-negative patients with T4a and T4b cancers, the 5-year overall survival was 59% and 50.2%, respectively (P = 0.62), and 5-year disease-free survival was 64.6% and 53.5%, respectively (P = 0.01). In conclusion, the select group of patients with T4b oral cancers and less than three masticatory space structures involved had comparable outcomes to those with T4a cancers after treatment with surgery and adjuvant radiotherapy. [ABSTRACT FROM AUTHOR]

Objectives: Chronic obstructive pulmonary disease (COPD) results in airflow obstruction and a marked reduction in exercise capacity and health-related quality of life (HRQoL). Affecting over 1 in four Australians aged over 75 years, COPD remains one of the major causes of disability and death in the world. To date there have been over 80 randomised controlled trials examining the role of exercise training in a range of settings for individuals with COPD. This review will synthesise existing literature and provide health practitioners with broad evidence-based guidelines for exercise-training in this growing population.Design: Position stand.Methods: Synthesis of randomised controlled trials of exercise training and of existing guidelines for exercise in COPD. Systematic reviews of alternative modes of exercise training will also be reviewed.Results: There is convincing evidence that in adults with COPD, exercise-training improves exercise capacity, decreases symptoms such as dyspnoea and fatigue, and improves HRQoL. There is emerging evidence in this population that alternative modes of exercise training such as high intensity interval training (HIIT), aquatic based therapy, tai chi and neuromuscular electrical stimulation improve exercise outcomes when compared to no exercise.Conclusions: For individuals with COPD, an exercise program of aerobic and strength exercises delivered over at least an 8-week period, that engages lower and upper body skeletal muscles, will deliver significant health improvements. Programs should be individualised, take into consideration relevant co-morbid conditions and be delivered appropriately qualified health practitioners experienced in clinical exercise prescription. [ABSTRACT FROM AUTHOR]

Industry 4.0 being the new face of manufacturing for future, metal additive manufacturing is a key element in this framework. For metal additive manufacturing, laser-based additive manufacturing techniques are dominating today. However, some of the inherent technical limitations associated with these techniques lead to a significant gap between the industrial requirements and the final deliverables. Additive friction stir deposition is a promising alternative that is still in its early stages of development. This review summarizes the vital findings in AFSD with particular emphasis on microstructure evolution and physical properties. The technical limitations of laser-based AM techniques are discussed to describe the role of AFSD in their domain. AFSD is discussed sequentially covering the basic physical process, features, capabilities, and limitations. AFSD, being a solid-state thermomechanical process, results in a refined equiaxed microstructure with enhanced mechanical properties and no signs of porosity and residual stresses. In addition to this, AFSD is capable of depositing large scale components at a high build rate that leads to cost and energy-efficient fabrication. The existing limitations of the process are discussed with the scope for future improvements. This critical review concludes with the suggested strategies for the widespread adoption of AFSD. [ABSTRACT FROM AUTHOR]

Facial asymmetry secondary to unilateral condylar hyperplasia can be a diagnostic challenge to oral and maxillofacial surgeons. Single positron emission computed tomography (SPECT) scans provide a useful adjunct. We report a brief summary of the evidence describing the effectiveness of different methods of analysing SPECT scans and compare it with the results of a 10-year study at Sunderland Royal Hospital. Overall, both the evidence base and our study strongly favour use of the condyle:condyle ratio over the condyle:reference bone ratio, suggesting that no further comparisons are needed. [ABSTRACT FROM AUTHOR]

The development of nanoparticles that can be used as stimuli-responsive drug carriers for the treatment of different diseases has been an emerging area of research. In this study, we designed a chitosan-bilirubin micelle (ChiBil) carrying losartan, which is responsive to intrinsic reactive oxygen species (ROS), for the treatment of hepatic fibrosis. Because bilirubin is hydrophobic in nature, its carboxyl group was conjugated to an amine group from chitosan using EDC-NHS chemistry to form an amphiphilic conjugate, ChiBil. Losartan is an angiotensin receptor blocker that reduces hepatic fibrosis, and it was used as the therapeutic payload in this study to form ChiBil-losartan micelles. The release characteristics of ChiBil-losartan were tested by ROS generation to confirm losartan release. Human hepatic stellate cell line LX2 was found to be the best in vitro model for the study. The reduction of hepatic stellate cell activation after treatment with ChiBil-losartan was analyzed based on the expression of alpha-smooth muscle actin (α-SMA) in both in vitro and in vivo studies. Advanced liver fibrosis was induced in C3H/HeN mice using a thioacetamide (TAA) via intraperitoneal injection and 10% ethanol (EtOH) in their drinking water. In addition, the hydroxyproline levels, histopathological evaluation, and mRNA quantification in the liver showed a decreased collagen content in the treated groups compared to that in the untreated control group. Macrophage infiltration studies and qPCR studies of inflammatory markers also proved the reduction of hepatic fibrosis in the treatment group. The intravenous administration of ChiBil-losartan resulted in decreased fibrosis in a TAA/EtOH-induced liver fibrosis mouse model. The in vitro and in vivo results suggest that the ROS stimuli-responsive ChiBil nanoparticles carrying losartan may be a potent therapeutic option for the treatment of hepatic fibrosis. The combined effect of losartan and bilirubin exhibited a decreased hepatic fibrosis both in vitro and in vivo. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Existing research works for Alzheimer's disease (AD) can predict the prevalence of disease only after the advancement of the disease. With these existing prediction models, it is possible only to reduce and delay the symptoms of the disease. The exact usefulness is when the presence of the disease is identified at an early stage and this early detection makes a great impact in subjects' recovery. Thus, early detection of controls at high risk of development of Alzheimer's disease is of a key objective of the proposed work. Existing machine learning and deep learning algorithms derive only limited predictive accuracy. Also, they derive results based on expensive machine learning algorithms that had hard-to-collect features and classifying becomes complex with numerous overfitting in choosing decision boundaries. The proposed study intends to develop a learning algorithm for the prediction of Alzheimer's disease at an early stage. It also classifies the features if the subjects with Mild Cognitive impairment (MCI) and Pre-Mild Cognitive Impairment (Pre-MCI)has the likelihood to develop Alzheimer's disease. A dataset of AD controls was used to train different machine learning algorithms. Onset information like social behavior, demographic characteristics, neurological test scores, clinical cardiovascular index, and brain atrophy ratio can also be used as the extract predictor. A validation procedure was applied to identify a relevant subset of predictors. The conversion to AD in MCI and Pre MCI subjects are based only on non-invasively and effectively collectible predictors. [ABSTRACT FROM AUTHOR]

With the ageing people community, Alzheimer's disease (AD) is the most common disease in prevalence. It affects the memory of the affected individual by causing neuron degeneration. Such cognitive disability leads people to roam around places since they are ignorant about location. They may go afar from the safe area to traffic prone areas which cause serious, life threatening issues to them. Proposed study introduces a technology that involves a wearable device for Alzheimer disease affected elderly patients and listening device given to care takers or doctors. This system detects and notifies caregivers about the departure of people to risk locations from their residence zone. This system uses Bluetooth Low energy (BLE) communication technology that utilizes transmitter and receiver fixed to elderly individual as wearable device and in residence respectively. Based on the signal strength between the transmitter and receiver, the distance estimation between the elderly and the receiver is calculated with the help of a Raspberry Pi(Rpi) and an alert notification is sent to doctors/caretakers when the distance exceeds safety limit. [ABSTRACT FROM AUTHOR]

Evidence on the causal link between plasma triglyceride (TG) levels and risk for cardiovascular disease (CVD) has recently emerged. Individuals with the metabolic syndrome have an increased risk for acquiring elevated TG levels later in life. Moreover, common DNA sequence variations in genes affecting TG levels identify individuals at risk for elevated plasma TG levels. We evaluated whether a 3-single nucleotide polymorphism (SNP) TG gene risk score (GRS) and a metabolic risk score (MetRS) both improved CVD risk prediction. A 3-SNP GRS and MetRS were generated in the EPIC-Norfolk cohort (n = 20,074) based on 3 SNPs in LPL and APOA5 or the number of Metabolic Syndrome criteria present (maximum 5), respectively. The associations between the 3-SNP GRS, MetRS, TG levels, and CVD risk were evaluated. The 3-SNP GRS and MetRS were both linearly associated with plasma TG levels, that is, +0.25 mmol/L [95% CI 0.22–0.27] per allele change (P <.001) and +0.72 mmol/L [95% CI 0.70–0.73] per increase of number of metabolic syndrome risk score points (P <.001), respectively. We observed a positive association between the 3-SNP GRS and the risk of CVD with an adjusted hazard ratio (HR) of 1.35 [95% CI 1.04–1.74] for the highest versus the lowest GRS, which was independent of the MetRS. For the MetRS, the adjusted HR was 2.03 [95% CI 1.73–2.40] for the highest versus the lowest MetRS. Both the 3-SNP GRS and the MetRS are associated with increased plasma TG levels and increased risk for CVD. • Metabolic risk score is associated with plasma triglycerides. • Gene risk score is associated with plasma triglycerides. • Metabolic risk score and TG-gene risk score are both associated with increased CVD risk. [ABSTRACT FROM AUTHOR]

Highlights • Patients with mental disorders were evaluated for non-communicable disease risk factors. • There was high prevalence of hypertension, obesity and physical inactivity. • Hypertension was more common in older males. • Obesity and physical inactivity was more common in females. Abstract Objective Screening for non-communicable disease (NCD) risk factors can help in prevention or reduction in the ill-effects of NCDs. Data on NCD risk factors in community-dwelling patients with common mental disorders (CMD) is lacking. This study was designed to screen for selected NCD risk factors in patients attending a community psychiatry service (CPS) in the states of Punjab and Haryana in North India. Methods Following ethical clearance, the study was conducted in 4 satellite clinics of the CPS of a tertiary hospital from North India. Consecutive adult patients were approached and 719 patients were assessed. A one-time cross-sectional assessment was carried out which included socio-demographic data, clinical details, history of tobacco and alcohol use, personal history of hypertension and diabetes, family history of diabetes, prevalence of hypertension, obesity (central and generalised) and levels of physical activity. Results 302 males and 417 females were assessed. Most patients were diagnosed with CMD. The prevalence of hypertension was 42.7% in males and 34.1% in females. The prevalence of central and generalised obesity in males and females was 41.4%, 71.2% and 34.8%, 45.6% respectively. 32.5% of males and 40.2% females were assessed to be inadequately physically active. Conclusions The results of the study suggest that there is high prevalence of NCD risk factors in patients with CMD. Hypertension is more common in males while obesity and inadequate physical activity is more common in females. NCD risk factor screening and management, health education should be integrated in CPS. [ABSTRACT FROM AUTHOR]

Introduction Nodular Fasciitis, also known as infiltrative or pseudosarcomatous fasciitis, is a benign soft tissue tumour of fibroblastic/myofibroblastic differentiation, that was first described in 1955 by Konwaler et al. Presentation of case This is a case report of a 27-year old male with complaints of a swelling in the right axilla for 2 and ½ years measuring 12 cm × 10 cm. Chest X-Ray was normal. Magnetic Resonance Imaging of the right arm and chest showed an irregular mass in the axilla in the muscular-subcutaneous plane measuring 10.8 cm × 8.8 cm × 12 cm, with no neural involvement. Magnetic Resonance Angiogram showed feeders from the branches of the Right Subclavian and Right Axillary Artery and venous drainage into the Right Subclavian Vein. USG guided biopsy was done which showed benign spindle cell neoplasm. Patient underwent wide local excision under general anesthesia. The specimen was sent for histopathological examination which showed histological and immunohistochemical features in favour of Nodular Fasciitis. Discussion Most nodular fasciitis lesions are solitary and occur in adults 20–40 years of age. Nodular fasciitis affects both men and women with equal frequency. Differential diagnosis of nodular fasciitis includes, fibrosarcoma, fibroma, fibrous histiocytoma, and desmoids and histopathology and immunohistochemistry play a key role in identifying the condition. Conclusion Owing to the size, location and findings of the Magnetic Resonance Angiogram we initially suspected a Soft Tissue Sarcoma, but to our surprise, on further investigation the mass was revealed to be Nodular Fasciitis. [ABSTRACT FROM AUTHOR]

Cold Metal Transfer (CMT) is a proven type of welding method using Metal Inert Gas (MIG). It is a welding technique which can be employed for marine fabrications too. Plates of AA5086-H111 and AA6061-T6 with AA4043 filler is welded by CMT. Parameters like current, voltage, arc length, shield gas pressure etc. are varied to obtain a continuous weld without any crack. Welded thin plates are subjected to a tensile test as per American Welding Society (AWS B4.0:2007) and thereafter impact loads are applied. The plates subjected to impact loads in the range of sub-ordinance level velocities, the feasibility of ordinance and ultra-ordinance can be scaled and compared. Responses and terminal ballistics limit are determined for plate thickness of 1.2 mm and 3 mm. Present work consists of simulation using Abaqus Software and experiments using Laboratory prepared gun. It was observed that, there was petaling in very thin plates and in some plates it was perforated by plugging for lower ballistic loads and thinner plates. The work gives new insights into the application of CMT in joining plates of different materials with varied thickness values. The material property of plates joined by this welding method was found to be new resource information to the permanent literature of material technology. [ABSTRACT FROM AUTHOR]

A moonpool is meant to access the underwater part of hull from onboard ship. Moonpools are openings right through the hull from deck to bottom, allowing equipments, ROVs, etc. to be put into the water at a location on the vessel under permissible ship motion condition. Open moonpools in a drillship are causing additional resistance when the ship is in forward speed. It was shown that the water inside the moonpool started to oscillate at forward speed. The drillship is mainly subjected to two types of motions of water mass inside the column namely, piston mode and sloshing mode. The later mode will be dominant in longer moonpools and piston mode in shorter. The amplitude of water particles inside the moonpool is correlated with the forward speed such that increased forward speed leads to increased amplitudes. The main objective of this study is to find the total resistance and the free surface flow caused by the moonpool when the drillship is at low forward speed condition. Drillship with and without moonpool are considered for the study. Proven packages are used to calculate the calm water resistance of the drillship with moonpool. The incremental change in resistance caused by the moonpool in forward motion is a measure of water motion inside the moonpool for that particular field. [ABSTRACT FROM AUTHOR]

Upon heat exposure, the thermoregulatory system evokes reflex increases in sweating and skin blood flow responses to facilitate heat dissipation and maintain heat balance to prevent the continuing rise in core temperature. These heat dissipating responses are mediated primarily by autonomic and cardiovascular adjustments; which, if attenuated, may compromise thermoregulatory control. In patients with heart failure (HF), the neurohumoral and cardiovascular dysfunction that underpins this condition may potentially impair thermoregulatory responses and, consequently, place these patients at a greater risk of heat-related illness. The aim of this review is to describe thermoregulatory mechanisms and the factors that may increase the risk of heat-related illness in patients with HF. An understanding of the mechanisms responsible for impaired thermoregulatory control in HF patients is of particular importance, given the current and projected increase in frequency and intensity of heat waves, as well as the promotion of regular exercise as a therapeutic modality. Furthermore, novel therapeutic strategies that may improve thermoregulatory control in HF, and the clinical relevance of this work in this population will be discussed. [ABSTRACT FROM AUTHOR]

Prediction of post-concussive syndrome after apparent mild traumatic brain injury (TBI) and subsequent cognitive recovery remains challenging, with substantial limitations of current methods of cognitive testing. This pilot study aimed to determine if levels of micro ribonucleic acids (RNAs) circulating in plasma are altered following TBI, and if changes to levels of such biomarkers over time could assist in determination of prognosis after TBI. Patients were enrolled after TBI on presentation to the Emergency Department and allocated to three groups: A – TBI (physical trauma to the head), witnessed loss of consciousness, amnesia, GCS = 15, a normal CT Brain and a recorded first pass after post-traumatic amnesia (PTA) scale; B TBI, witnessed LOC, amnesia, GCS = 15, a normal CT brain and a PTA scale test fail and: C – TBI and initial GCS <13 on arrival to the ED. Venous blood was collected at three time points (arrival, day 5 and day 30). Isolation of cell-free total RNA was then assayed using a custom miRNA PCR array. Two micro-RNAs, mir142-3p and mir423-3p demonstrated potential clinical utility differentiating patients after mild head injury into those at greater risk of developing amnesia and therefore, post-concussive syndromes. In addition, these miRNA demonstrated a decrease in expression over time, possibly indicative of brain healing after the injury. Further evaluation of these identified miRNA markers with larger patient cohorts, correlation with clinical symptoms and analysis over longer time periods are essential next steps in developing objective markers of severity of TBI. [ABSTRACT FROM AUTHOR]