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Objectives: Woman consistently experiences more stress, anxiety, lifestyle changes, various health problems, and work -- related musculoskeletal disorders. Hence a need was felt to understand the problems related physical, psychosocial and satisfaction from life in Indian housewives and Employed Women. Methodology 156 (Employed women-78, housewives-78) were assessed using the following questionnaires. 1) Perceived Stress Scale 2) Satisfaction with Life Scale (SWLS) 3) Visual Analogue Scale 4) Musculoskeletal Discomfort Form 5) Researcher's Assisted Questionnaire Results: The findings of present study shows that in total 156 (employed women -78 and housewives-78) mental stress (PSS) is higher in housewives that is 61% as compared to employed women that is 39%. Life satisfaction (LSS) higher in employed women that are 56% as compared to employed women that is 44%. Maximum Housewives reported discomfort in knee and back area while employed women in neck region and back. Conclusion: PSS had higher stress level in housewives than employed women. LSS had higher life satisfaction in employed women than housewives knee and back are highly affected areas of discomfort and pain among housewives and neck region and back area in employed women. [ABSTRACT FROM AUTHOR]

Background: Transgender people experience their gender identification as extraordinary from the intercourse which turned into assigned to them at starting. Aim: The purpose of the study was to compare transgender and non -transgender population on the variables relationship satisfaction and body image. Method: A population of 25 transgender and 25 non-transgender individuals participated in the study for this and were recruited from Delhi NCR. The participants completed a measure of Relationship scale questionnaire and Dresden Body Image questionnaire. Result: The result reveal that there is no significant difference in any variable among transgender population when compared to non- transgender population based on the analysis of data done by using Independent Sample t-test. Conclusion: Efforts to boom body image satisfaction in transgender people are therefore warranted, as it can make contributions to greater high quality of relationship satisfaction. [ABSTRACT FROM AUTHOR]

Mastalgia is defined as pain in the breast for more than 1 week of menstrual cycle. A number of drugs have been recommended for its treatment. However, there is some debate among the experts about the most beneficial agent. In this study, we compared the effectiveness and cost-effectiveness of centchroman and tamoxifen in the treatment of mastalgia. We recruited 106 ladies with mastalgia in a two-arm parallel design open-labelled randomised controlled trial with a non-inferiority hypothesis comparing 3-month therapy with either centchroman or tamoxifen. The response of therapy was assessed by visual analogue scale (VAS) of 0–10, on 1-, 2-, 3-, and 6-month follow-up. Direct and indirect costs were computed for each patient. Baseline mean VAS score was 6.25 in tamoxifen and 6.49 in centchroman group. Women in both groups enjoyed significant pain relief (pain score became < 3). The number of patients who achieved VAS less than 3 were 51 (96.2%) in centchroman and 49 (92.5%) in tamoxifen group at the end of 3 months of treatment. Centchroman was found to be more effective than tamoxifen (p < 0.001). Cost per unit successful relief of mastalgia in the centchroman group was 393 Nepalese Rupees and that in the tamoxifen group was 311.5 Nepalese Rupees. Centchroman is not inferior to Tamoxifen in relieving mastalgia. Tamoxifen proved more cost-effective than centchroman because of lower cost of tamoxifen in Nepal. [ABSTRACT FROM AUTHOR]

BACKGROUND: Complete lesion after spinal cord injury (SCI) remains irreversible with little hope of neurological recovery. Newer interventions such as re-stimulation of damaged neurons using artificial agents and the use of stem cells for neuronal regeneration have shown promising results. AIM: This study was undertaken for evaluating the neurological status of acute SCI participants after stem cell augmentation and comparing them with other treatment methods. SETTING AND DESIGN: Randomized controlled trial in the northern Indian population. MATERIALS AND METHODS: A total 193 SCI participants of complete paraplegia with unstable T4–L2 injury having thoracolumbar injury severity score ≥4 were enrolled in this study. Participants were randomly allocated for three different treatment modalities, namely, conventional with stem cell augmentation (Group-1), conventional (Group-2), and conservative (Group-3). Neurological recovery after 1 year was evaluated through the ASIA Impairment Scale (AIS)-grading, sensory, and motor scores. STATISTICAL ANALYSIS: T-test for sensory-motor score analysis of each group and analysis of variance for comparison of same variables between the groups. RESULTS: After 1-year significant difference was observed in the AIS-grade, sensory and motor scores in-Group 1 (P < 0.001). In Group-1 versus 2, the mean difference at 1 year for AIS grade, sensory and motor scores were 0.40 (P = 0.010, 95% confidence interval [CI] 0.075–0.727), 8.52 (P = 0.030, 95% CI 0.619–16.419), and 4.55(P = 0.003, 95% CI 1.282–7.815), respectively. In Group-1 versus 3, 1.03, 19.02 and 7.22 (P < 0.001 for each of the parameters) and in Group-2 versus 3, 0.63 (P < 0.001), 10.49 (P = 0.009), and 2.68 (P = 0.019), respectively. CONCLUSIONS: Significant motor neurological recovery and AIS-grade promotion was observed in Group-1 as compared to Group-2 and 3. [ABSTRACT FROM AUTHOR]

Nursing is considered as a noble profession which deals with devotion. Nurses dedicate time to provide health care to individuals who need to take care systematically. The purpose of the study is to compare job satisfaction and wellbeing of staff nurse from government and private hospitals. The 200 nurses divided as 100 nurses from government and 100 from private hospital were selected as sample. The Generic Job Satisfaction Scale (GJSS) which was developed by Macdonald & Maclntyre (1997) and the PGI General wellbeing scale, developed by Verma and Verma (1989), was used as research tools. The t-test was calculated to assess the diff erence. It is found that government hospital nurses have more satisfaction than the private hospital and nurses of government hospital found to have bett er wellbeing than nurses of private hospitals. [ABSTRACT FROM AUTHOR]

Background: In 2013, outpatient use of chloral hydrate (CH) was limited and other alternatives such as oral pentobarbital (PB) were explored to achieve conscious sedation in young children for transthoracic echocardiography (TTE). We aimed to assess efficacy and safety of the two medications. Methods: Clinical information, from a computerized database, about children who received sedation with either CH or PB for TTE at our center (2008–2015) was reviewed, and the two groups were compared for sedation effectiveness and complications. Results: Three thousand eight hundred fifty one pediatric patients (median age 8 months) underwent conscious sedation during TTE (mean doses CH 50 mg/kg, PB 4 mg/kg). Demographic characteristics of the two groups were similar. Sedation failure rate (CH 2.4%, PB 2.9%, P = NS), need for supplemental doses (CH 17.9%, PB 16.2%, P = NS), and overall adverse event rate (PB 1.4%, CH 1.9%; P = NS) were similar in the two groups. There were fewer episodes of respiratory depression with PB (0.3% vs 1.6%, P < 0.05). The rate of paradoxical reactions was higher with PB (1% vs 0.03%, P < 0.05). Increasing age predicted the need for supplemental doses and for sedation failure in both groups. Neonates (7.5% vs 0%) and infants (2% vs 0.6%) given CH were more likely to develop adverse reactions. Conclusion: Chloral hydrate and PB are equally effective. However, CH is associated with an increased incidence of transient desaturation, while PB is associated with an increased incidence of a paradoxical reaction. Increasing age is predictive of the need for supplemental doses and for failure of sedation in both groups. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis is a major public health problem in India. According to RNTCP guidelines, all efforts are to be made to diagnose tuberculosis on the basis of detection of Acid-Fast Bacilli (AFB)/ Macrobacterium Tubercle Bacilli (MTB) in the clinical specimen; hence all those cases where AFB/ MTB have not been detected are presumptive cases of tuberculosis. Aim and Objectives: To detect AFB/ MTB in the sputum of clinico-radiologically presumptive cases of pulmonary tuberculosis using direct ZN microscopy, Modified Petroff's method followed by ZN microscopy & MGIT liquid culture method. Materials and Methods: A total of 94 sputum samples which were negative for AFB by direct ZN microscopy at the Designated Microscopy Centers (DMC) of the institute, were subjected to Modified Petroff's method followed by microscopy & MGIT liquid culture test to find out any additional yield of bacteriologically confirmed disease. Result: Among all the specimens, Modified Petroff's method added 10 AFB positive & MGIT method could add 30 cases (including those found positive by Modified Petroff's method). Conclusion: Modified Petroff's method followed by ZN microscopy & MGIT test for mycobacterial culture can improve case detection. [ABSTRACT FROM AUTHOR]

Drug-resistant tuberculosis represents a global emergency, requiring new drugs. We found that minocycline was highly potent in laboratory strains of Mycobacterium tuberculosis and that 30 drug-susceptible and multidrug/extensively drug-resistant clinical strains were susceptible to clinically achievable concentrations. In the hollow fiber system model, lung concentration-time profiles of 7 mg/kg/day human-equivalent minocycline dose achieved bacterial kill rates equivalent to those of first-line antituberculosis agents. Minocycline killed extracellular bacilli directly. Minocycline also killed intracellular bacilli indirectly, via concentration-dependent granzyme A-driven apoptosis. Moreover, minocycline demonstrated dose-dependent antiinflammatory activity and downregulation of extracellular matrix-based remodeling pathways and, thus, could protect patients from tuberculosis immunopathology. In RNA sequencing of repetitive samples from the hollow fiber system and in independent protein abundance experiments, minocycline demonstrated dose-dependent inhibition of sonic hedgehog-patched-gli signaling. These findings have implications for improved lung remodeling and for dual immunomodulation and direct microbial kill-based treatment shortening regimens for drug-susceptible and drug-resistant latent and active M. tuberculosis infection. [ABSTRACT FROM AUTHOR]

African American (AA) women are often diagnosed with more aggressive breast cancers and have worse survival outcomes than their Caucasian American (CA) counterparts. However, a comprehensive understanding of this disparity remains unclear. In this study, we attempted to identify the race-specific non-invasive protein biomarkers that may particularly benefit interventions aimed at reducing the risk of recurrence and metastasis in breast cancers (BrCa). Our technical strategy has been to discover candidate protein biomarkers in patient sera using a high throughput antibody microarray platform. A total of 240 subjects were selected, composed of controls and all immunohistochemistry-based subtypes of breast cancer cases, subdivided by pre- and post-menopausal status and by race. A global Wilcoxon analysis comparing no-cancer controls and cancer patients identified Pyk2, SAPK/JNK, and phosphatase and tensin homolog as present in higher concentrations in cancer patient serum. A paired t-test revealed that c-kit and Rb are significantly over-represented in AA cancer serum when compared to CA cancer serum. Interestingly, VEGFR2, a protein linked to BrCa metastasis and poor prognosis, was significantly over-represented in AA cancer serum compared to AA controls; however, this was not found in CA cancer serum compared to CA controls, suggesting a possible explanation for the higher incidence of aggressive BrCa in AA versus CA patients. Through examining race-specific differences in the protein landscape of BrCa patient serum, the identified proteins could lay the groundwork for the development of an all-inclusive "liquid mammogram test." [ABSTRACT FROM AUTHOR]

Aim: To find the aetiological spectrum, clinical features to differentiate organic from functional constipation (FC) and the efficacy of polyethylene glycol (PEG) over lactulose in the treatment of childhood constipation.Methods: From January 2007 to December 2014, 316 consecutive children (up to 18 years) with constipation were included in this study. FC was defined as per Rome III criteria. Standard treatment protocol (disimpaction with PEG followed by laxatives) was followed in FC. Lactulose was used in the first 4 years of study and PEG in the last 4 years. Success of therapy was assessed at 3 months.Results: The median age was 44 (25.00-78.00) months, and 227 (72%) were boys. The majority, 245 (77.5%), had FC, while Hirschsprung disease was the most common organic cause (39.4%). On multivariate analysis, delayed passage of meconium, growth failure, absence of retentive posturing and absent faecal impaction significantly (P < 0.05) determined an organic aetiology. In FC, successful outcome at 3 months was achieved equally with PEG and lactulose (81 vs. 76%, respectively). However, more children in lactulose group had to be switched over to PEG due to lack of efficacy (P = 0.0002).Conclusions: FC is the most common cause of constipation in children. Presence of delayed passage of meconium, growth failure and absence of retentive posturing and absent faecal impaction raise the suspicion of an organic cause. Both lactulose and PEG are equally effective. PEG has an edge over lactulose as the need for switch over was uncommon. [ABSTRACT FROM AUTHOR]

Background: While previous studies have shown higher union rates and a quicker return to work with operative treatment of substantially displaced clavicle fractures, there is disagreement whether operative treatment results in improved clinical outcomes. Patients who undergo operative treatment sometimes require additional surgery for implant removal. Nonoperative treatment may fail so that delayed surgical intervention is ultimately required. The duration for which the clinical benefits of operative treatment remain superior to those of nonoperative treatment has not been well established in the literature. Considering these uncertainties, surgeons are faced with a difficult decision regarding whether operative treatment of a midshaft clavicle fracture will be cost-effective. The purpose of this study was to identify the most cost-effective strategy by considering these uncertain parameters with use of decision-analysis techniques.Methods: An expected-value decision tree was built to estimate the quality-adjusted life years (QALYs) and costs for operative and nonoperative treatment of substantially displaced midshaft clavicle fractures. Values for parameters in the decision model were derived from the literature. Medical costs were obtained from the Medicare database. A Markov model was used to calculate the QALYs for the duration of life expectancy. The decision model was used to analyze the duration for which the clinical results of operative treatment were superior to those of nonoperative treatment during the first 5 years after the operation and during a lifetime. Sensitivity analysis was performed to determine which parameters have the most influence on cost-effectiveness.Results: Operative treatment was more cost-effective than nonoperative treatment in 54% and 68% of the Monte Carlo trials in the 5-year and lifetime analyses, respectively. The cost per QALY with operative management was <$38,000 and <$8,000 in the 5-year and lifetime analyses, respectively. This is below the willingness-to-pay threshold of $50,000 per QALY. For operative treatment to remain cost-effective, its clinical benefits must persist for at least 3 years.Conclusions: Operative treatment is more cost-effective than nonoperative treatment for substantially displaced midshaft clavicle fractures. The clinical benefits derived with operative treatment must persist for at least 3 years for operative treatment to remain cost-effective. This research should not be used to conclude that all clavicle fractures should be treated surgically. It is best that such a decision is made through a patient-surgeon shared decision-making process.Level Of Evidence: Economic and Decision Analysis Level II. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of intramyometrial vasopressin plus rectal misoprostol with intramyometrial vasopressin alone to reduce blood loss during laparoscopic myomectomy.Study Design: A randomized, single-blind, controlled trial was conducted at All India Institute of Medical Sciences, New Delhi, India. Sixty women with symptomatic leiomyoma scheduled for laparoscopic myomectomy were recruited for the study. Thirty women received intramyometrial vasopressin plus rectal misoprostol (30 min before procedure) (Group I) and 30 women received intramyometrial vasopressin alone (Group II) during laparoscopic myomectomy. The primary outcome measure was intra-operative blood loss during surgery. Secondary outcome measures included decrease in postoperative haemoglobin, ease of enucleation of myomas, duration of surgery, need for additional haemostatic measures or blood transfusion, intra- and postoperative morbidity, and duration of hospital stay.Results: The baseline demographic features and characteristics of leiomyomas were comparable in both groups. The mean (±standard deviation) blood loss in Group I was 139 ± 96.7 ml, which was significantly less than that for Group II (206 ± 101.2 ml) (p = 0.008). The mean postoperative haemoglobin was 11.6 ± 1.3 g/dl in Group I and 10.0 ± 1.2 g/dl in Group II (p = 0.001). Although blood loss was not clinically significant in either group, the decrease in haemoglobin was significantly higher in Group II. The mean score for ease of enucleation (surgeon-rated measure) was significantly lower in Group I (2.6 ± 1.1) compared with Group II (3.4 ± 1.1) (p = 0.029). Intra- and postoperative vital signs, duration of surgery, need for blood transfusion and postoperative morbidity were comparable in both groups.Conclusions: The addition of rectal misoprostol to intramyometrial vasopressin led to a significant reduction in blood loss and decreased the postoperative drop in haemoglobin. The combination also improved the ease of enucleation of myomas. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to determine attitudes and practices of physicians in training with respect to the evaluation and treatment of obesity.Methods: Resident-generated admission and discharge notes of all 1,765 general medicine hospital admissions during 4 nonconsecutive months were analyzed, and any references to weight, obesity, BMI, adiposity, and body fat were identified. The full general resident cohort was then surveyed for perceptions and behaviors related to obesity.Results: Obesity was considered a highly important medical issue by 98.5% of residents; 90% correctly identified a class II obesity Stunkard phenotype, and 80% accurately calculated a BMI given height and weight in metric units. Residents overestimated inpatient obesity prevalence (estimate = 75%; actual = 35%) and the rate of obesity recording in the hospital admission note (estimate = 94%; actual = 49.5%). A BMI or current weight in the admission note or discharge summary was reported in none of the 1,765 patient records, and only 6% of the patients with obesity had obesity noted in either the inpatient admission or discharge assessment or plan.Conclusions: Though residents recognize obesity and its clinical implications, it is underreported in the assessment of inpatients. This low level of documenting obesity and its impact on clinical care planning underscores a missed opportunity to establish appropriate referrals and initiate treatment at a clinically opportune time. [ABSTRACT FROM AUTHOR]

Background: Prevalence of emotional, behavioral, and psychiatric outcomes in child and adolescent survivors of childhood acute lymphoblastic leukemia treated on a chemotherapy-only protocol were not well defined.Methods: Self- and parent-reported emotional and behavioral symptoms were assessed for 161 survivors of childhood acute lymphoblastic leukemia (51.0% female; mean [SD] age 12.1[2.6] years; 7.5[1.6] years post-diagnosis). Age- and sex-adjusted scores were calculated for standardized measures and compared with 90th percentile of norms. Frequencies of survivor psychiatric disorders from structured diagnostic interviews with parents were compared with the general population. Parent emotional distress and post-traumatic stress symptoms were assessed. Associations between child symptoms/disorders and parent distress were examined with log-binomial models, adjusting for highest parent education.Results: Compared with population expectations (10%), more survivors self-reported symptoms of inattention (27.9; 95% CI, 21.0%-35.7%), hyperactivity/impulsivity (26.0%; CI, 19.2%-33.6%), and oppositional-defiant behavior (20.1%; CI, 14.1%-27.3%). Parents reported survivors with more symptoms of inattention (23.6%; CI, 17.2%-31.0%), higher frequencies of obsessive-compulsive disorder (10.3% vs 2%) and oppositional defiant disorder (16.0% vs 9.5%), but not attention-deficit/hyperactivity disorder (7.1% vs 7.8%) or generalized anxiety disorder (3.2% vs 4.1%), compared with national norms. Parent-report of child anxiety disorders was associated with parent self-reported emotional distress but not survivor self-report of anxiety.Conclusion: A significant minority of survivors have long-term psychiatric morbidity, multi-informant assessment is important to understand these symptom profiles and to inform selection of appropriate interventions. Interventions targeting inattention and oppositional behavior in children and emotional distress in parents are warranted in families with survivors who display behavioral problems. [ABSTRACT FROM AUTHOR]

Objective: To correlate qualitative and quantitative diffusion weighted imaging (DWI) characteristics of intrahepatic cholangiocarcinoma (ICC) with histopathologic tumour grade and fibrosis content.Methods: Fifty-one patients (21M/30F; mean age 61y) with ICC and MRI including DWI were included in this IRB-approved multicentre retrospective study. Qualitative tumour features were assessed. Tumour apparent diffusion coefficient (ADC) mean, minimum, and normalized (nADCliver) values were computed. Tumour grade [well(G1), moderately(G2), or poorly differentiated(G3)] and tumour fibrosis content [minimal(1), moderate(2), or abundant(3)] were categorized pathologically. Imaging findings and ADC values were compared with pathologic measures. Utility of ADC values for predicting tumour grade was assessed using ROC analysis.Results: 51 ICCs (mean size 6.5±1.1 cm) were assessed. 33/51(64%) of ICCs demonstrated diffuse hyperintensity and 15/51(29%) demonstrated target appearance on DWI. Infiltrative morphology (p=0.02) and tumour size (p=0.04) were associated with G3. ADCmean and nADCmean of G3 (1.32±0.47x10-3 mm2/sec and 0.97±0.95) were lower than G1+G2 (1.57±0.39x10-3 mm2/sec and 1.24±0.49; p=0.03 and p=0.04). ADCmean and nADCmean were inversely correlated with tumour grade (p<0.025). No correlation was found between ADC and tumour fibrosis content. AUROC, sensitivity and specificity of nADCmean for G3 versus G1+G2 were 0.71, 89.5% and 55.5%.Conclusion: ADC quantification has reasonable accuracy for predicting ICC grade.Key Points: • ADC quantification was useful for predicting ICC tumour grade. • Infiltrative tumour morphology and size were associated with poorly differentiated ICCs. • ADC values depended more on ICC tumour grade than fibrosis content. • Ability to predict ICC tumour grade non-invasively could impact patient management. [ABSTRACT FROM AUTHOR]

The purpose of this study is to present comparative performance analysis of different machine learning algorithms for large area crop classification. Ten Indian districts with significant rabi crops viz. wheat, mustard, gram, red lentils (masoor) have been selected for the study. Most popular classical ensemble models – bagging/ARCing, random forest (RF), gradient boosting and Importance Sampled Learning Ensemble (ISLE) with traditional single model (decision tree) have been selected for comparative analysis. To incorporate dependency of large area crop in different variables viz. parent material and soil, phenology, texture, topography, soil moisture, vegetation, climate etc., 35 digital layers are prepared using different satellite data (ALOS DEM, Landsat-8, MODIS NDVI, RISAT-1, Sentinental-1A) and climatic data (precipitation, temperature). In rabi season, field survey about crop type is carried out to prepare training data. Performance is evaluated on the basis of marginal rates, F-measure and Jaccard’s coefficient of community, Classification Success Index and Agreement Coefficients. Score is calculated to rank the algorithm. RF is best performer followed by gradient boosting for crop classification. Other ensemble methods ARCing, bagging and ISLE are in decreasing order of performance. Traditional non-ensemble method decision tree scored higher than ISLE. [ABSTRACT FROM AUTHOR]

When modelling "social bads," such as illegal drug consumption, researchers are often faced with a dependent variable characterised by a large number of zero observations. Building on the recent literature on hurdle and double-hurdle models, we propose a double-inflated modelling framework, where the zero observations are allowed to come from the following: nonparticipants; participant misreporters (who have larger loss functions associated with a truthful response); and infrequent consumers. Due to our empirical application, the model is derived for the case of an ordered discrete-dependent variable. However, it is similarly possible to augment other such zero-inflated models (e.g., zero-inflated count models, and double-hurdle models for continuous variables). The model is then applied to a consumer choice problem of cannabis consumption. We estimate that 17% of the reported zeros in the cannabis survey are from individuals who misreport their participation, 11% from infrequent users, and only 72% from true nonparticipants. [ABSTRACT FROM AUTHOR]

Background: Children with non-Hodgkin lymphoma (NHL) undergo treatment with central nervous system-directed therapy, the potentially neurotoxic effects of which have not been reported in NHL survivors.Methods: NHL survivors (n = 187) participating in the St. Jude Lifetime Cohort who were 10 or more years from their diagnosis and were 18 years old or older underwent neurocognitive, emotional distress (Brief Symptom Inventory 18), and health-related quality of life (HRQOL) assessments (36-Item Short Form Health Survey). Age-adjusted z scores were compared with community controls (n = 181) and normative data. Treatment exposures were abstracted from medical records. Models adjusted for the age, sex, and time from diagnosis were used to calculate the risk of impairment.Results: The mean ages at evaluation were similar for the survivors and the controls (35.7 ± 8.9 vs 35.5 ± 11.0 years; P = .86). Survivors were 25.2 ± 8.8 years from their diagnosis: 43 (23%) received cranial radiation, 70 (37%) received high-dose methotrexate, 40 (21%) received high-dose cytarabine, and 151 (81%) received intrathecal chemotherapy. Survivors' intelligence and attention were within normal limits; however, their memory, executive function, processing speed, and academics were impaired in comparison with both population norms and community controls (P values < .05). Treatment-related exposures were not associated with neurocognitive function; however, neurocognitive impairment was associated with lower educational attainment, unemployment, and occupational status (P values < .03). Slower processing speed and worse self-reported executive function were associated with symptoms of depression (P values ≤ .003) and poorer HRQOL (P values < .05).Conclusions: Adult survivors of childhood NHL experience impaired neurocognitive function, which is associated with lower social attainment and poor HRQOL. Early-detection and intervention strategies are recommended. Cancer 2017. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]

Objective: To examine the potential mediating role of body image dissatisfaction on the association between treatment-related scarring/disfigurement and psychological distress in adult survivors of childhood cancer.Methods: Participants included 1714 adult survivors of childhood cancer (mean [SD] age at evaluation = 32.4 [8.0] years, time since diagnosis = 24.1 [8.1] years) enrolled in the St. Jude Lifetime Cohort Study. Survivors completed measures of body image, emotional distress, and posttraumatic stress symptoms (PTSS). Body image dissatisfaction (BID) was categorized into 2 groups (cancer-related and general) based on factor analysis. Using causal mediation analysis, we estimated the proportion of psychological distress associated with treatment-related scarring/disfigurement that could be eliminated by resolving BID through a hypothetical intervention.Results: Among survivors with scarring/disfigurement of the head, a sizable proportion of the relative excess of psychological distress could be eliminated if BID was successfully treated (males: [cancer-related BID: depression: 63%; anxiety: 100%; PTSS: 52%]; [general BID: depression: 70%; anxiety: 100%; PTSS: 42%]; females: [cancer-related BID: depression: 20%; anxiety; 36%; PTSS: 23%]; [general BID: depression: 32%; anxiety: 87%; PTSS: 38%]). The mediating effect of BID was less pronounced for the association between scarring/disfigurement of the body and psychological distress for both males and females.Conclusions: Body image dissatisfaction mediates the association treatment-related scarring/disfigurement and psychological distress among adult survivors of childhood cancer, particularly among survivors with scarring/disfigurement of the head and male survivors. Successful treatment of body image dissatisfaction has the potential to eliminate a substantial proportion of psychological distress related to scarring/disfigurement among adult survivors of childhood cancer. [ABSTRACT FROM AUTHOR]

Background: Childhood cancer survivors treated with chest-directed radiotherapy have substantially elevated risk for developing breast cancer. Although genetic susceptibility to breast cancer in the general population is well studied, large-scale evaluation of breast cancer susceptibility after chest-directed radiotherapy for childhood cancer is lacking.Methods: We conducted a genome-wide association study of breast cancer in female survivors of childhood cancer, pooling two cohorts with detailed treatment data and systematic, long-term follow-up: the Childhood Cancer Survivor Study and St. Jude Lifetime Cohort. The study population comprised 207 survivors who developed breast cancer and 2774 who had not developed any subsequent neoplasm as of last follow-up. Genotyping and subsequent imputation yielded 16 958 466 high-quality variants for analysis. We tested associations in the overall population and in subgroups stratified by receipt of lower than 10 and 10 or higher gray breast radiation exposure. We report P values and pooled per-allele risk estimates from Cox proportional hazards regression models. All statistical tests were two-sided.Results: Among survivors who received 10 or higher gray breast radiation exposure, a locus on 1q41 was associated with subsequent breast cancer risk (rs4342822, nearest gene PROX1 , risk allele frequency in control subjects [RAF controls ] = 0.46, hazard ratio = 1.92, 95% confidence interval = 1.49 to 2.44, P = 7.09 × 10 -9 ). Two rare variants also showed potentially promising associations (breast radiation ≥10 gray: rs74949440, 11q23, TAGLN , RAF controls = 0.02, P = 5.84 × 10 -8 ; <10 gray: rs17020562, 1q32.3, RPS6KC1 , RAF controls = 0.0005, P = 6.68 × 10 -8 ). Associations were restricted to these dose subgroups, with consistent findings in the two survivor cohorts.Conclusions: Our study provides strong evidence that germline genetics outside high-risk syndromes could modify the effect of radiation exposure on breast cancer risk after childhood cancer. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of mobilization with movement and end range mobilization along with conventional therapy for the treatment of frozen shoulder. Study Design: Experimental study design. Subjects: 30 patients between the age group 40 yrs to 60 yrs were selected as per the inclusion and exclusion criterion. Procedure: By random sampling method the 30 subjects were divided into 2 equal groups with 15 patients each.Experimental group A received Hot Pack,Exercises,MWM .Experimental group B received Hot Pack,Exercises,ERM. The study was performed for 4 months.The treatment was given 6 days per week.once in a day for 12 weeks .Evaluation was done before starting the treatment and then after 4 months. Outcomes scores were evaluated using SPADI & ROM . Result: Experimental group A showed improvement in SPADI score 62.9 % and ROM improved by 81.87 degree. The ERM group showed improvement in SPADI scores by 47.9 % and 76.8 degree Conclusion: The study found that both the treatment that is MWM and ERM are effective in the management of frozen shoulder but MWM is found to be slightly more effective. [ABSTRACT FROM AUTHOR]

Objectives : A number of factory workers experience various health problems in the form of work- related stress, disturbance in sleep quality, nicotine and alcohol dependence and work-related musculoskeletal discomfort and pain. Hence a need was felt to understand the problems related to life style, mental and physical health of the footwear factory workers and analyse the impact of day and night work shifts on these factors. Methodology: 214 (day shift-107, night shift-107) male subjects, were assessed using the following questionnaires. * Occupational Stress Index * Visual Analogue Scale * AUDIT questionnaire * Nordic questionnaire * Pittsburgh sleep quality index * Fagerstrom test for nicotine dependence. Results: Among night shift workers (NSW), 5.60% had low, 42.1 % had moderate and 52.3 % had high nicotine dependence (HND). Among dayshift workers (DSW), 83.3% had low, 13.1 % had moderate and 3.7 % had HND. Among NSW, 78.50% had low risk and 21.50 % had high risk for alcohol dependence. Among DSW, 15.90% had low risk and 84.10 % had high risk for alcohol dependence. Among NSW, 72.90% had poor and 27.10 % good sleep quality. Among DSW 28% had poor and 72% had good sleep quality. High stress level was found in NSW as compared to DSW (day-55.23±10.20, night-61.1±12.27). Maximum workers reported discomfort and pain in the wrists/hands, shoulders in both shifts. Conclusion: NSW had higher stress level than DSW. Wrist/hands and shoulders were highly affected areas of discomfort and pain among the sample. There was higher nicotine dependence in NSW than in DSW. DSW had high risk of alcohol dependence as compared to NSW and we have identified DSW had good sleep quality than NSW. [ABSTRACT FROM AUTHOR]

Background: Blood-based biomarkers for early detection of pancreatic ductal adenocarcinoma (PDAC) are urgently needed. Current biomarkers lack high sensitivity and specificity for population screening. The gold-standard biomarker, CA 19-9, also fails to demonstrate the predictive value necessary for early detection.Methods: To validate a functional genomics-based plasma migration signature biomarker panel, plasma tissue factor pathway inhibitor (TFPI), tenascin C (TNC-FN III-C), and CA 19-9 levels were measured by enzyme-linked immunosorbent assays in three early-stage PDAC plasma cohorts, including two independent blinded validation cohorts containing a total of 43 stage I, 163 stage II, 86 chronic pancreatitis, 31 acute biliary obstruction, and 108 controls. Logistic regression models developed classification rules combining TFPI and/or TNC-FN III-C with CA 19-9 for patient cases and control subjects, with or without adjustment for age and diabetes status. Model classification performance was evaluated and analyses repeated among subpopulations without diabetes and pancreatitis history. Two-sided P values were calculated using bootstrap method.Results: The TFPI/TNC-FN III-C/CA 19-9 panel improved CA 19-9 performance in all early-stage cohorts, including discriminating stage IA/IB/IIA, stage IIB, and all early-stage cancer from healthy controls. Statistical significance was reached for a number of subcohorts, including for all early-stage cancer vs healthy controls (cohort 1 AUC = 0.92, 95% CI = 0.86 to 0.96, P  = .04; cohort 3 AUC = 0.83, 95% CI = 0.76 to 0.89, P  = .045). Among subcohorts without diabetes and pancreatitis history, the panel approaches potential clinical utility for early detection to discriminate early-stage PDAC from healthy controls including an area under the curve (AUC) of 0.87 (95% CI = 0.77 to 0.95) for stage I/IIA, an AUC of 0.93 (95% CI = 0.87 to 0.98) for stage IIB, and a statistically significant AUC of 0.89 (95% CI = 0.82 to 0.95) for all early-stage cancer ( P  = .03).Conclusions: TFPI/TNC-FN III-C migration signature adds statistically significantly to CA 19-9's predictive power to detect early-stage PDAC and may have clinical utility for early detection of surgically resectable PDAC, as well as for enhanced survival from this routinely lethal cancer. [ABSTRACT FROM AUTHOR]

Highlights: [•] A detail comparative study of the growth of ZnO nanorods by annealing method was done. [•] Comparison between air, oxygen and water loaded oxygen annealing ambient was carried out. [•] Temperature and ambient were found to critically affect the density and aspect ratio. [•] It was found that water vapor enhances the density of nanorods greatly by 1–2 order (∼109/cm2). [•] A stress–diffusion based growth mechanism and a simple and efficient synthesis method was proposed. [ABSTRACT FROM AUTHOR]

The present study provides a comparative morphological analysis of spikes in different Indian species of Selaginella. The salient features of spikes including their types and also the shape and margin of sporophylls of the closely related taxa are characteristically useful in taxonomic delineation. We have used the term Leaf-flap, for the first time, and the Sporophyll-pteryx to denote the occurrence of vertical/oblique projection on the dorsal surface of leaf and sporophyll, respectively. The shape and colour of both mega- and micro-sporangia are also helpful in taxonomy; however, their size is not much significant as these are variable within the same spike of the species. A new pattern of sporangial distribution is being reported for the first time in the spike of S. plana (Desv. ex Poir.) Hieron. [ABSTRACT FROM AUTHOR]

Pyrazolines derivatives are nitrogen-containing heterocyclic compound, which exhibit the broad spectrum of biological activities such as antibacterial, antifungal, antiprotozoal, and anti-inflammatory. The optimized geometry, frequency, and intensity of vibrational bands of these compounds are obtained by the density function theory (DFT) using 6–31+G(d,p) basis set. The scaled harmonic vibrational frequencies have been compared with experimental Fourier transform infrared spectroscopy (FTIR) values and found to be in good agreement. The electronic properties of these molecules are discussed with the help of highest occupied molecular orbital (HOMO), lowest unoccupied molecular orbital (LUMO), and molecular electrostatic potential (MESP) surfaces, and a number of electronic and thermodynamic parameters are calculated, which are closely related to their chemical reactivity and reaction path. We also notice that pyrazoline derivatives show biological activity for preventing dyskinesia. This study may provide a further investigation on pyrazolines derivatives for pharmacological importance. [ABSTRACT FROM AUTHOR]

Transgenic Panicum virgatum L. silencing ( KD) or overexpressing ( OE) specific genes or a small RNA ( GAUT4- KD, mi RNA156- OE, MYB4- OE, COMT- KD and FPGS- KD) was grown in the field and aerial tissue analysed for biofuel production traits. Clones representing independent transgenic lines were established and senesced tissue was sampled after year 1 and 2 growth cycles. Biomass was analysed for wall sugars, recalcitrance to enzymatic digestibility and biofuel production using separate hydrolysis and fermentation. No correlation was found between plant carbohydrate content and biofuel production pointing to overriding structural and compositional elements that influence recalcitrance. Biomass yields were greater for all lines in the second year as plants establish in the field and standard amounts of biomass analysed from each line had more glucan, xylan and less ethanol (g/g basis) in the second- versus the first-year samples, pointing to a broad increase in tissue recalcitrance after regrowth from the perennial root. However, biomass from second-year growth of transgenics targeted for wall modification, GAUT4- KD, MYB4- OE, COMT- KD and FPGS- KD, had increased carbohydrate and ethanol yields (up to 12% and 21%, respectively) compared with control samples. The parental plant lines were found to have a significant impact on recalcitrance which can be exploited in future strategies. This summarizes progress towards generating next-generation bio-feedstocks with improved properties for microbial and enzymatic deconstruction, while providing a comprehensive quantitative analysis for the bioconversion of multiple plant lines in five transgenic strategies. [ABSTRACT FROM AUTHOR]

Background: Urinary neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-D-glucosaminidase (NAG), and interleukin 18 (IL-18) were found to be useful for early detection of acute kidney injury (AKI). The objective of this study was to determine the predictive ability of biomarkers for mortality and variation in levels in relation to different stages of AKI, need for dialysis, etiologies, and with duration of hospital stay. Methods: Urinary NGAL, NAG, and IL-18 levels were measured in 50 children with AKI and 30 age- and gender-matched healthy controls. AKI was classified as per pediatric Risk, Injury, Failure, Loss, and End-stage (RIFLE) criteria. Results: Median NGAL, NAG, and IL-18 values were significantly increased in AKI patients compared with controls ( p < 0.001), with significant increase among risk, injury, and failure stages. Nonsurvivors had significantly higher median levels of NGAL ( p = 0.008) and NAG ( p = 0.018) than survivors. NGAL had highest area under the curve (AUC) at 0.750 [confidence interval (CI) 0.580-0.920], followed by NAG at 0.724 (CI 0.541-0.907), with sensitivity and specificity of 75 % each; and IL-18 (AUC 0.688, CI 0.511-0.864), with sensitivity 62.5 % and specificity 70.8 %, for predicting mortality. Values were significantly higher in patients who required peritoneal dialysis (PD) than in those in whom it was not indicated. Levels were comparable among different etiologies. Only NGAL level was found to be a significant risk factor associated with longer duration of hospital stay. Conclusions: Urinary NGAL and NAG had modest predictive ability for mortality. Children requiring dialysis had significantly raised levels, and the NGAL level had significant association with duration of hospital stay. [ABSTRACT FROM AUTHOR]

Objectives: The quality of life (QOL) of patients with coronary artery disease (CAD) is known to be impaired. Non-cardiac chest pain referrals are often under-diagnosed and untreated, and there are hardly any studies comparing the QOL of CAD and panic disorder related (non-cardiac) chest pain referrals (PDRC). Methods: We assessed the psychiatric morbidity and QOL of patients newly diagnosed with CAD (n = 40) at baseline and six weeks post-treatment and compared their QOL with patients with PDRC (n = 40) and age- and gender-matched healthy controls (n = 57). Psychiatric morbidity in the CAD group was assessed using the General Health Questionnaire (GHQ12) item, Hamilton Anxiety Scores (HAM-A), and Hamilton Depression Scores (HAMD). QOL measures were determined by the World Health Organization QOL questionnaire (brief ) and Seattle Angina Questionnaire. The CAD group was treated with anti-ischemic drugs (nitrates, betablockers), antiplatelet drugs (acetylsalicylsalicylic acid), anticoagulants (low molecular weight heparin, clopidogrel), and managed for risk factors. The PDRC group was treated with selective serotonin reuptake inhibitors and anxiolytics. Results: Patients with panic disorder had a worse QOL than those with CAD and healthy controls in the physical domain and psychological domain (PDRC vs. CAD vs. healthy controls, p < 0.001). In the CAD group, smoking was associated with change in angina stability (p = 0.049) whereas other tobacco products were associated with change in angina frequency (p = 0.044). Psychiatric morbidity was present in 40.0% of patients with CAD. In the PDRC group, a significant correlation of HAM-A scores was noted in the physical (p = 0.000), psychological (p = 0.001), social (p = 0.006), and environment (p = 0.001) domains of QOL. Patients with panic disorder had a significant improvement in anxiety scores after treatment compared to baseline (HAM-A scores difference 21.0 [16.5-25.6]; p < 0.001). Conclusions: Patients in the PDRC group had a worse QOL than those in the CAD and healthy control groups. This highlights the need for careful diagnosis and prompt treatment of panic disorder in these patients to improve their QOL. Additionally, smoking, the use of other tobacco products, and hypercholesterolemia were associated with angina symptoms in patients with CAD. [ABSTRACT FROM AUTHOR]

Background: Invasive placental disorders are potentially life-threatening. Its diagnosis and evaluation of degree of invasiveness is vital in surgical and treatment planning. Purpose: To compare the role of various imaging modalities used in current practice for evaluation of invasive placental disorders, and evaluate the validity of certain imaging signs for prediction of invasive placenta. Material and Methods: Twenty-two patients, which were clinically stratified as a risk group for underlying invasive placental abnormality, underwent Doppler sonography and magnetic resonance imaging (MRI). Abnormal placental invasiveness was assessed using various Doppler sonography and MRI signs described in the existing literature. We systematically evaluated the utility of each of these modalities and signs, and compared the roles played by them separately and in combination. All the cases were correlated with surgical and pathological findings. Results: Nine patients had surgical and pathological confirmation of placental adhesive disorders, of which eight were predicted correctly by MRI (true positive) while one was misdiagnosed as normal placenta (false negative). All the nine cases were correctly identified by Doppler sonography. MRI was more accurate in predicting bladder invasion, identifying 5/6 cases. Conclusion: Both MRI and Doppler sonography are useful for detection of invasive placental disorders. However, MRI is a better predictor of bladder invasion. [ABSTRACT FROM AUTHOR]

Sunscreen formulations containing UVB filters, such as Zinc-oxide (ZnO) and titanium-dioxide (TiO2) nanoparticles (NPs) have been developed to limit the exposure of human skin to UV-radiations. Unfortunately, these UVB protective agents have failed in controlling the skin cancer incidence. We recently demonstrated that silver nanoparticles (Ag-NPs) could serve as novel protective agents against UVB-radiations. Here our goal was to perform comparative analysis of direct and indirect UVB-protection efficacy of ZnO-, TiO2- and Ag-NPs. Sun-protection-factor calculated based on their UVB-reflective/absorption abilities was the highest for TiO2-NPs followed by Ag- and ZnO-NPs. This was further confirmed by studying indirect protection of UVB radiation-induced death of HaCaT cells. However, only Ag-NPs were active in protecting HaCaT cells against direct UVB-induced DNA-damage by repairing bulky-DNA lesions through nucleotide-excision-repair mechanism. Moreover, Ag-NPs were also effective in protecting HaCaT cells from UVB-induced oxidative DNA damage by enhancing SOD/CAT/GPx activity. In contrast, ZnO- and TiO2-NPs not only failed in providing any direct protection from DNA-damage, but rather enhanced oxidative DNA-damage by increasing ROS production. Together, these findings raise concerns about safety of ZnO- and TiO2-NPs and establish superior protective efficacy of Ag-NPs. [ABSTRACT FROM AUTHOR]

Objectives Lack of insight and neurocognitive deficits are often seen in schizophrenia patients. While there are several studies investigating the relationship between suicidal ideation, executive function and insight, there are relatively fewer investigating the triangular relationship between suicide intent, insight and cognitive competence in schizophrenia. The aim of our study was to address this issue. Methods One hundred seventy five subjects with DSM-IV TR diagnoses of schizophrenia or schizoaffective disorder were enrolled and the diagnosis was established using the Hindi version of the Diagnostic Interview for Genetic Studies and other available information in consultation with a Board certified senior Psychiatrist. All the subjects were interviewed on Beck's cognitive insight scale and tested on the Trail Making Test. All the subjects who had lifetime history of suicide attempt were interviewed on Pierce's suicide intent scale. Results Ever attempters scored significantly higher on Beck's cognitive insight scale (p = 0.012) and outperformed non-attempters on Trail Making Test A and B (p = 0.026 and p = 0.012 respectively), indicating better executive functions in the former. However among ever attempters, significant relationship was not found between executive functions, insight and severity of suicide intent. Conclusion Our study suggests that good insight and better executive functioning may be significantly correlated with suicide attempts at some time during the course of illness. Patients with schizophrenia should be evaluated for potential suicidality once denial, neurocognitive deficits and other factors associated with poor insight abate. [ABSTRACT FROM AUTHOR]

In recent past, many moving object segmentation methods under varying lighting changes have been proposed in literature and each of them has their own benefits and limitations. The various methods available in literature for moving object segmentation may be broadly classified into four categories i.e., moving object segmentation methods based on (i) motion information (ii) motion and spatial information (iii) learning (iv) and change detection. The objective of this paper is two-fold i.e., firstly, this paper presents a comprehensive comparative study of various classical as well as state-of-the art methods for moving object segmentation under varying illumination conditions under each of the above mentioned four categories and secondly this paper presents an improved approximation filter based method in complex wavelet domain and its comparison with other methods under four categories mentioned as above. The proposed approach consist of seven steps applied on given video frames which include: wavelet decomposition of frames using Daubechies complex wavelet transform; use of improved approximate median filter on detail co-efficient (LH, HL, HH); use of background modeling on approximate co-efficient (LL sub-band); soft thresholding for noise removal; strong edge detection; inverse wavelet transformation for reconstruction; and finally using closing morphology operator. The qualitative and quantitative comparative study of the various methods under four categories as well as the proposed method is presented for six different datasets. The merits, demerits, and efficacy of each of the methods under consideration have been examined. The extensive experimental comparative analysis on six different challenging benchmark data sets demonstrate that proposed method is performing better to other state-of-the-art moving object segmentation methods and is well capable of dealing with various limitations of existing methods. [ABSTRACT FROM AUTHOR]

The multilevel inverter utilization has been increased since the last decade. These new type of inverters are suitable in various high voltage and high power applications due to their ability to synthesize waveforms with better harmonic spectrum and faithful output. This paper analyzes the Total Harmonic Distortion (THD) performance of a three phase 5- level inverter. The five level inverter is configured with RL load for the analysis. Three different Pulse Width Modulation (PWM) schemes are proposed for the analysis of five level inverter. The simulation results are presented to prove that THD is reduced with different Pulse Width Modulation scheme. [ABSTRACT FROM AUTHOR]

Moving object segmentation in maritime domain is a challenging task due to the various real time practical problems, such as waves on the water surface, boat wakes and weather issues (such as bright sun, fog and heavy rain). These problems contribute to generate a highly dynamic background, gradual and sudden illumination changes, camera jitter, shadows and reflections that can provoke false detections. To deal with above issues, in this paper a fast and robust moving object segmentation method on a water surface for maritime surveillance using dynamic background modeling and shadow suppression (OSDBMSS) in the complex wavelet domain is proposed. For dynamic background modeling, we have used frame difference, background registration, background difference and background difference mask in the complex wavelet domain. For shadow detection and removal, we exploit the high frequency subband in the complex wavelet domain. A comparative analysis of the proposed method is presented both qualitatively and quantitatively with other standard methods available in the literature for publicly available datasets of videos in different maritime scenarios, with varying light and weather conditions. Experimental results indicate that the proposed method is performing better in comparison to other standard methods for all the test cases. [ABSTRACT FROM AUTHOR]

Background: Obstructive Sleep Apnea (OSA) is a potentially life-threatening condition in which there is a periodic cessation of breathing (for 10 sec or longer) that occurs during sleep in the presence of inspiratory effort. The aim of the study was to assess volumetric and dimensional differences between OSA patients and normal individuals in the upright posture. Material and Method: The present study was conducted on CBCT scans of 32 patients who were divided into two groups --Group I (control group) and Group II (OSA subjects). Group I consisted of 16 patients with normal airway with ESS score from 2 to 10, STOP BANG Questionnaire score of <3 and who had undergone CBCT for various diagnostic reasons. Group II had patients with ESS score >10, STOP BANG Questionnaire score of > 3, AHI index >5. Linear and angular parameters, volume and minimum cross-section area (MCA) of oropharyngeal airway, anteroposterior length and lateral width at MCA was compared amongst the groups. Results: The oropharyngeal volume, MCA, and the anteroposterior and lateral width of the airway at MCA of the OSA subjects was significantly lesser than that of normal subjects. The length of both soft palate and tongue was significantly more in Group II. The angle between the nasopharyngeal airway and the oropharyngeal airway was significantly more obtuse in Group II. Conclusion: The reduction in oropharyngeal volume in OSA patients could be attributed to different anatomical and pathophysiological factors that were corroborated with the findings of the present study. [ABSTRACT FROM AUTHOR]

Background and Aims: Post-operative pain is a major concern for day care surgeries like laparoscopic cholecystectomy. This study aimed to compare the efficacy of ultrasound guided abdominal field blocks (USAFB) with port site infiltrations for post-operative analgesia in terms of quality of pain relief, opioid consumption and patient satisfaction for day care surgeries Methods: Eighty patients presenting for laparoscopic cholecystectomy were randomly allocated to two groups either to receive port-site infiltration of local anaesthetic (n = 40, Group A) or USAFB (n = 40, Group B group). Numeric rating scores (NRS) were measured postoperatively to primarily assess the pain severity and opioid requirements. Data were analysed using Chi-Square test/Fisher's exact test for categorical data and Mann-Whitney test/unpaired t-test for quantitative data. Results: The study group (Group B) had significantly reduced NRS and opioid consumption over 24 h. The overall fentanyl consumption in patients receiving port infiltrations was approximately twice (200 ± 100 μg) as compared to patients in USAFB group (120 ± 74 μg) (P < 0.0001). Maximum fentanyl consumption was 400 μg (Group A) and 262 μg (Group B) over 24 h and the minimum requirement was 50 μg and zero, respectively. Conclusion: Superior post-operative analgesia was observed with USAFB which may help in minimising opioid-related adverse effects and facilitating faster recovery. [ABSTRACT FROM AUTHOR]

Highlights: [•] Proposed three nonlinear PDE based filters adapted to Poisson noise statistics for image restoration. [•] Methods for the regularization parameter estimation have been examined and introduced. [•] The examined regularization parameter estimation methods are GCV, discrepancy principles and UPRE. [•] Performance analysis and comparison of the proposed methods are presented. [•] The modified anisotropic diffusion based method along with GCV parameter estimation works better. [Copyright &y& Elsevier]

The thermal degradation of graft copolymers of both polysaccharides (guar gum and xanthan gum) showed gradual decrease in mass loss. Pure guar gum degraded about 95% but pure xanthan gum degraded about 76% up to 1173.15 K, while graft copolymers of guar gum and xanthan gum degraded only 65-76% up to 1173.15 K. Acrylic acid grafted guar gum and xanthan gum showing two-step degradation with formation of anhydride and ketonic linkage during heating, same pattern of degradation was found for xanthan gum- g-methacrylic acid. Guar gum- g-acrylamide degraded in single step and xanthan gum- g-acrylamide started to degrade above 448.15 K and it is a two-stage process and imparts thermal stability due to the formation of imide linkage with evolution NH. Guar gum- g-methacrylamide degraded in three steps due to the loss of NH and CO successively. 4-vinyl pyridine grafted both polysaccharides show single step degradation due to loss of pyridine pendent. N-vinyl formamide grafted guar gum and xanthan gum started to degrade at about 427.15 K, showed two-stage degradation process with the evolution of CO and NH molecules while guar gum- g-( N-vinyl-2-pyrrolidone) degraded into two steps by the loss of pyrrolidone nucleus. Gum- g-2-acrylamido-2-methyl-1-propane sulfonic acid (AMPS) showed two-step degradation processes in two successive degradation steps, while xanthan gum- g-AMPS has started degradation at about 427.15 K and completed in five degradation steps. Overall, it was found that the grafted polysaccharides are thermally more stable than pure polysaccharides. [ABSTRACT FROM AUTHOR]

Activation of the polyol pathway has been linked to the development of secondary diabetic complications. However, the underlying molecular mechanisms remain unclear. To probe the contribution of this pathway, we examined whether inhibition of aldose reductase, which catalyzes the first step of the pathway, affects hyperglycemia-induced activation of the inflammatory transcription factor nuclear factor (NF)-kappaB. Treatment of vascular smooth muscle cells with the aldose reductase inhibitors tolrestat and sorbinil prevented high-glucose-induced protein kinase C (PKC) activation, nuclear translocation of NF-kappaB, phosphorylation of IKK, and the increase in the expression of intracellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and aldose reductase. High-glucose-induced NF-kappaB activation was also prevented by the PKC inhibitors chelerythrine and calphostin C. Ablation of aldose reductase by small interference RNA (siRNA) prevented high-glucose-induced NF-kappaB and AP-1 activation but did not affect the activity of SP-1 or OCT-1. Stimulation with iso-osmotic mannitol activated NF-kappaB and increased the expression of aldose reductase but not ICAM-1 and VCAM-1. Treatment with aldose reductase inhibitors or aldose reductase siRNA did not affect mannitol-induced NF-kappaB or AP-1 activation. Administration of tolrestat (15 mg . kg(-1) . day(-1)) decreased the abundance of activated NF-kappaB in balloon-injured carotid arteries of diabetic rats. Collectively, these results suggest that inhibition of aldose reductase, which prevents PKC-dependent nonosmotic NF-kappaB activation, may be a useful approach for treating vascular inflammation caused by diabetes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. Materials and Methods: A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. Results: The results showed significant differences between the four groups for the length of obturation (P < 0.05). The endodontic pressure syringe showed the best results (98.5% optimal fillings) and jiffy tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Conclusions: Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to clinically evaluate and compare the efficacy and retention of various types of intracanal posts in the restoration of grossly decayed deciduous anterior teeth. The various posts used were polyethylene post, glass post, and composite post.Materials and Methods: A total number of 16 patients with 45 grossly decayed primary anterior teeth were selected. After biomechanical preparation and obturation, patients were randomly divided on the basis of posts to be used into three groups (Group I: Polyethylene post; Group II: Glass post, and Group III: Composite post). Then, space was created in the obturated canal and posts were placed, followed by core build up.Results: After an interval of 12 months, 86.67% of the teeth exhibited complete retention of the post restored with polyethylene post (P > 0.005) and 93.3% of the teeth exhibited complete retention of the post that were restored with glass post (P > 0.005) whereas only 60% of the teeth exhibited complete retention of the post that were restored with composite post (P< 0.005). Only 20% of the teeth exhibited marginal discoloration in both Groups I and III and 13.33% in Group II and this was nonsignificant.Conclusion: Both glass post and polyethylene post proved to be effective. Glass post showed the maximum retention and marginal adaptation followed by polyethylene post. Thus, it appears to be of potential interest for use especially in clinical pediatric dentistry. [ABSTRACT FROM AUTHOR]

Present study was performed so as to compare adsorptive removal efficiencies of low-cost adsorbent rice husk ash (RHA) and commercial granular activated carbon (GAC) for the removal of bisphenol-A (BPA), an endocrine disrupting chemical, from aqueous solution. Effect of variables such as initial concentration (C0), adsorbent dose (m), temperature (T), pH, and time (t) were studied. Optimized values atC0 = 100 mg/L were found to be:m = 30 g/L,t = 3 h for RHA whereas for GAC, optimum values were:m = 20 g/L andt = 2 h. Pseudo-second-order model best represented the adsorption kinetic data; and Freundlich and Temkin models best fitted the isotherm data. The adsorption of BPA onto GAC and RHA was found to be endothermic in nature. Value of change in entropy and enthalpy for BPA adsorption onto RHA was found to be: 21.38 J/mol K and 0.335 kJ/mol, respectively. Respective values for BPA adsorption onto GAC were found to be: 29.6 J/mol K and 4.03 kJ/mol, respectively. [ABSTRACT FROM AUTHOR]

Aim: To describe the hospital costs, hospital types and differences across states and territories for children with medical complexity cared for in Australian public hospitals.Methods: Retrospective national administrative database study of 212 Australian public hospitals from six states (excluding Queensland) and two territories that submitted cost data to the National Hospital Costing Data Collection for 2010-2011. Participants included all hospitalised patients with comparisons between adults and children (17 years of age and younger), and adults with chronic diseases and children with medical complexity. Total hospital costs were the main outcome measure.Results: The National Hospital Costing Data Collection contained data from 212 public hospitals; total admissions (adults and children) were 3 519 140 at a total hospital cost of $16 187 400 000. Children accounted for 350 499 (9.9%) of the admissions at a total hospital cost of $1 931 585 123 (11.9%). Of all children, those with medical complexity accounted for 48 758 (13.9%), and their total hospital costs were $620 948 769 (32.1%). Six children's hospitals had 145 213 (41%) of the total children admissions at a total hospital cost of $936 041 843 (48%). Across the states and territories, the number of childhood admissions ranged from 9164 to 146 618 with 4.7-14.8% for children with medical complexity. Total hospital costs ranged from $44 to $592 million with 15.4-39.4% for children with medical complexity.Conclusions: The national burden of hospitalised children is substantial. Children with medical complexity only account for a small percentage of hospitalisations but almost one third of total hospital costs for children, with children's hospitals bearing the major costs. [ABSTRACT FROM AUTHOR]

Background: To study the effect of Lanconone® (1000 mg) on acute pain on exertion as compared to the standard of care, Ibuprofen (400 mg).Method: The study recruited 72 subjects diagnosed with mild to moderate knee joint pain on exertion. Subjects with Pain Visual Analogue Scale of more than 40 mm were included. Uphill walking was provided as the stressor using Naughton's protocol on a treadmill. The subjects walked for 10 minutes continuously followed by a rest period and baseline pain score for index knee joint was recorded. Subjects were administered a single dose of Lanconone® (1000 mg)/Ibuprofen (400 mg). Thereafter the same stressor was provided at 0.5, 1, 2, 3, 4, and 6 hours, subsequently, pain scores were recorded on a visual analogue scale. Double stopwatch method was used to evaluate the onset of pain relief and time taken to meaningful pain relief.Result: Both Lanconone® and Ibuprofen showed the first perceived pain relief at 65.31 ± 35.57 mins as compared to 60.82 ± 32.56 mins respectively. The mean time taken to experience meaningful pain relief in Lanconone® group was 196.59 ± 70.85 mins compared to 167.13 ± 71.41 mins amongst Ibuprofen group. The meaningful pain relief continued for 6 hours.Conclusion: The current study successfully demonstrated rapid pain-relieving potential of Lanconone® which was comparable to Ibuprofen. No adverse event related to the interventions was reported in the study.Trial Registration: Clinical trials.gov NCT02417506 . 21 January 2015. [ABSTRACT FROM AUTHOR]

Background: The integrity of connections between the hippocampus and the anterior cingulate cortex (ACC) is critical for adaptive cognitive and emotional processing; these connections may be compromised in posttraumatic stress disorder (PTSD). However, there is a lack of PTSD research that combines structural and functional connectivity data, and no studies have examined whether abnormal ACC-hippocampal connectivity is associated with genetic variability, particularly for polymorphisms of a gene that has been previously associated with PTSD, FKBP5. This was the goal of the present study.Methods: Fifty-four women with and without PTSD underwent diffusion tensor imaging and resting-state MRI. Probabilistic tractography was used to examine ACC-hippocampal structural connectivity; mean fractional anisotropy (FA) values were extracted from connectivity streamlines, which represent the cingulum bundle. Genotype data were collected for a single nucleotide polymorphism (SNP) of FKBP5, rs1360780.Results: Participants with PTSD demonstrated poorer structural connectivity (lower cingulum FA) compared to traumatized controls (F1, 50 = 6.77, P < .05). An interaction of FKBP5 genotype and diagnostic group was also observed (F1, 37 = 4.52, P = .04), indicating lower cingulum FA in carriers of two risk alleles for this SNP, compared to other diagnostic and genotype groups. Carriers of two FKBP5 risk alleles also demonstrated poorer hippocampus-ACC connectivity at rest (P < .05). When cingulum FA was used a regressor in a brain-wide, seed-based regression analysis, significant associations were found between the hippocampus and dorsal regions of the ACC (P < .05).Conclusions: Individuals with PTSD demonstrated compromised structural connectivity of the hippocampus-ACC pathway. Altered hippocampus-ACC connectivity may represent a highly salient intermediate neural phenotype for PTSD. [ABSTRACT FROM AUTHOR]

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Background: Control of the global burden of tuberculosis is obstructed due to lack of simple, rapid and cost effective diagnostic techniques that can be used in resource poor-settings. To facilitate the early diagnosis of TB directly from clinical specimens, we have standardized and validated the use of nested multiplex PCR, targeting gene fragments IS6110, MTP40 and 32kD α-antigen encoding genes specific for Mycobacterium tuberculosis complex and non-tubercular mycobacteria (NTM), in comparison to smear microscopy, solid culture and single step multiplex PCR. The results were evaluated in comparison to a composite reference standard (CRS) comprising of microbiological results (smear and culture), clinical, radiological and cytopathological findings, clinical treatment and response to anti-tubercular therapy.Methods: The nested multiplex PCR (nMPCR) assay was evaluated to test its utility in 600 (535 pulmonary and 65 extra-pulmonary specimens) clinically suspected TB cases. All specimens were processed for smear, culture, single step multiplex PCR and nested multiplex PCR testing.Results: Out of 535 screened pulmonary and 65 extra-pulmonary specimens, 329 (61.5%) and 19 (29.2%) cases were culture positive for M. tuberculosis. Based on CRS, 450 patients had "clinical TB" (definitive-TB, probable-TB and possible-TB). Remaining 150 were confirmed "non-TB" cases. For culture, the sensitivity was low, 79.3% for pulmonary and 54.3% for extra-pulmonary cases. The sensitivity and specificity results for nMPCR test were evaluated taken composite reference standard as a gold standard. The sensitivity of the nMPCR assay was 97.1% for pulmonary and 91.4% for extra-pulmonary TB cases with specificity of 100% and 93.3% respectively.Conclusion: Nested multiplex PCR using three gene primers is a rapid, reliable and highly sensitive and specific diagnostic technique for the detection and differentiation of M. tuberculosis complex from NTM genome and will be useful in diagnosing paucibacillary samples. Nested multiplex PCR assay was found to be better than single step multiplex PCR for assessing the diagnosis of TB. [ABSTRACT FROM AUTHOR]