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Abstract Background Robotic cystectomy is the mainstay surgical intervention for treatment‐refractory nonmuscle‐invasive and muscle‐invasive bladder cancer. However, paralytic ileus may complicate the postoperative recovery and may be a consequence of an inflammatory response associated with transient gut ischaemia. We have therefore investigated clinical, operative and inflammatory biomarker associations between paralytic ileus in the context of robotic cystectomy and intracorporeal ileal conduit urinary diversion. Methods Prospective consective patients referred for robotic cystectomy were consented and included in the study, while patients >75 years old and converted to open procedure were excluded. The pneumoperitoneum pressure (PP) for carbon dioxide insufflation required to perform the procedure efficiently and safely was recorded (12 or 15 mmHg). We also recorded the postoperative days patients passed flatus and stools, whether they developed ileus, as well as other standard clinical and demographic data. The expression of select proinflammatory and anti‐inflammatory cytokines was determined by multiplex analysis using a cytometric bead array with changes in profiles correlated with the pressures applied and with the existence of an ileus. Results Twenty‐seven patients were recruited, but only 20 were used in the study with 10 patients in each PP group. Seven patients were excluded all of whom had an extracorporeal ileal conduit formation. There were differences in the 40‐min shorter operative time and 1 day shorter length of stay, as well as passing flatus 1 day and stools 1.5 days earlier in the 12 mmHg compared with the 15 mmHg group. More patients had ileus in the 15 mmHg group vs 12 mmHg group (30% vs. 10.0%). These were not statistically significant. Similarly, there were no statistical differences in the expression of proinflammatory cytokines at the two different pressures or between patient groups, but there were outliers, with the median indicating nonsymmetrical distribution. By comparison, anti‐inflammatory cytokines showed some significant differences between groups, with IL‐6 and IL‐10 showing elevated levels postsurgery. No statistical difference was observed between pressures or the existence of an ileus, but the maximum levels of IL‐6 and IL‐10 detected in some patients reflect a pressure difference. Conclusions The initial findings of this novel scientific study indicated a higher risk of paralytic ileus postrobotic cystectomy and robotic intracorporeal urinary diversion when a higher pressure of 15 mmHg is used compared with 12 mmHg. Although further studies are required to establish the linkage between cytokine profile expression, pressure and ileus, our initial data reinforces the advantages of lower pressure robotic cystectomy and intracorporeal urinary diversion in patient outcomes.

Heat stress caused due to increasing warming climate has become a severe threat to global food production including rice. Silicon plays a major role in improving growth and productivity of rice by aiding in alleviating heat stress in rice. Soil silicon is only sparingly available to the crops can be made available by silicate solubilizing and plant-growth-promoting bacteria that possess the capacity to solubilize insoluble silicates can increase the availability of soluble silicates in the soil. In addition, plant growth promoting bacteria are known to enhance the tolerance to abiotic stresses of plants, by affecting the biochemical and physiological characteristics of plants. The present study is intended to understand the role of beneficial bacteria viz. Rhizobium sp. IIRR N1 a silicate solublizer and Gluconacetobacter diazotrophicus, a plant growth promoting bacteria and their interaction with insoluble silicate sources on morpho-physiological and molecular attributes of rice (Oryza sativa L.) seedlings after exposure to heat stress in a controlled hydroponic system. Joint inoculation of silicates and both the bacteria increased silicon content in rice tissue, root and shoot biomass, significantly increased the antioxidant enzyme activities (viz. superoxidase dismutase, catalase and ascorbate peroxidase) compared to other treatments with sole application of either silicon or bacteria. The physiological traits (viz. chlorophyll content, relative water content) were also found to be significantly enhanced in presence of silicates and both the bacteria after exposure to heat stress conditions. Expression profiling of shoot and root tissues of rice seedlings revealed that seedlings grown in the presence of silicates and both the bacteria exhibited higher expression of heat shock proteins (HSPs viz., OsHsp90, OsHsp100 and 60 kDa chaperonin), hormone-related genes (OsIAA6) and silicon transporters (OsLsi1 and OsLsi2) as compared to seedlings treated with either silicates or with the bacteria alone. The results thus reveal the interactive effect of combined application of silicates along with bacteria Rhizobium sp. IIRR N1, G. diazotrophicus inoculation not only led to augmented silicon uptake by rice seedlings but also influenced the plant biomass and elicited higher expression of HSPs, hormone-related and silicon transporter genes leading to improved tolerance of seedling to heat stress.

Abstract. Background:. To evaluate intraoperative and postoperative cytokines in patients who underwent robotic prostatectomy (RP) at a pressure of 12 or 15 mm Hg, and the risk of postoperative ileus. Materials and methods:. We presented the first series evaluating intraoperative and postoperative cytokines in patients undergoing RP at a pressure of 12 or 15 mm Hg by a single surgeon. Changes in cytokine concentrations were shown to correlate with surgical outcomes and pathological states. The study investigated the changes in cytokine concentrations (interferon-γ, tumor necrosis factor-α, interleukin-1β [IL-1β], IL-2, IL-4, IL-6, IL-12, and IL-17) at different pneumoperitoneum pressures and their potential role in the development of postoperative ileus. Results:. The data on 10 consecutive patients confirmed that a lower pneumoperitoneum pressure was associated with lower cytokine levels and a lower risk of ileus. There were increased levels of postoperative interferon-γ, tumor necrosis factor-α, IL-12p70, IL-1β, IL-2, IL-4, and IL-17a at 15 mm Hg when compared to 12 mm Hg. Conclusions:. The data indicated that lower pressure RP reduced intra-/postoperative cytokine levels confirming our hypothesis. Larger patient numbers are required to further validate this but the implications of this data will benefit not only urological patients but also other speciality patients undergoing minimally invasive surgery.

The use of robotic-assisted laparoscopic techniques has transformed the face of urological surgery in the last decade, with demonstrable benefits over both unassisted laparoscopic and traditional open approaches. For example, robotic-assisted partial nephrectomy is associated with lower morbidity, improved convalescence, reduced postoperative pain, shorter length of hospital stay, and a superior cosmetic result when compared to an open procedure. This review discusses the various perioperative influences on the renal physiology of patients undergoing robotic-assisted urological procedures.

The anatomical form of a tooth can undergo changes leading to loss of tooth form. The loss of tooth surface can be due to varying etiology. Dental caries, attrition, abrasion, erosion, involving any surface of the tooth can lead to loss of tooth structure. The rate of tooth destruction may proceed to such an extent that the esthetics, function and comfort may be lost. The role of a practioner lies in identification and screening of such case and motivate for oral rehabilitation that includes habit cessation. Computerized dentistry has raised the bar as far as esthetic restorations are concerned. Demanding esthetics has made zirconia crowns as the material of choice in full mouth rehabilitations. However, appropriate treatment planning with scientific evidence and a recommended treatment protocol with careful implementation results in successful restorations and satisfied patients.

Heat stress caused due to increasing warming climate has become a severe threat to global food production including rice. Silicon plays a major role in improving growth and productivity of rice by aiding in alleviating heat stress in rice. Soil silicon is only sparingly available to the crops can be made available by silicate solubilizing and plant-growth-promoting bacteria that possess the capacity to solubilize insoluble silicates can increase the availability of soluble silicates in the soil. In addition, plant growth promoting bacteria are known to enhance the tolerance to abiotic stresses of plants, by affecting the biochemical and physiological characteristics of plants. The present study is intended to understand the role of beneficial bacteria viz. Rhizobium sp. IIRR N1 a silicate solublizer and Gluconacetobacter diazotrophicus, a plant growth promoting bacteria and their interaction with insoluble silicate sources on morpho-physiological and molecular attributes of rice (Oryza sativa L.) seedlings after exposure to heat stress in a controlled hydroponic system. Joint inoculation of silicates and both the bacteria increased silicon content in rice tissue, root and shoot biomass, significantly increased the antioxidant enzyme activities (viz. superoxidase dismutase, catalase and ascorbate peroxidase) compared to other treatments with sole application of either silicon or bacteria. The physiological traits (viz. chlorophyll content, relative water content) were also found to be significantly enhanced in presence of silicates and both the bacteria after exposure to heat stress conditions. Expression profiling of shoot and root tissues of rice seedlings revealed that seedlings grown in the presence of silicates and both the bacteria exhibited higher expression of heat shock proteins (HSPs viz., OsHsp90, OsHsp100 and 60  kDa chaperonin), hormone-related genes (OsIAA6) and silicon transporters (OsLsi1 and OsLsi2) as compared to seedlings treated with either silicates or with the bacteria alone. The results thus reveal the interactive effect of combined application of silicates along with bacteria Rhizobium sp. IIRR N1, G. diazotrophicus inoculation not only led to augmented silicon uptake by rice seedlings but also influenced the plant biomass and elicited higher expression of HSPs, hormone-related and silicon transporter genes leading to improved tolerance of seedling to heat stress. [ABSTRACT FROM AUTHOR]

Data offloading at the network with less time and reduced energy consumption are highly important for every technology. Smart applications process the data very quickly with less power consumption. As technology grows towards 5G communication architecture, identifying a solution for QoS in 5G through energy-efficient computing is important. In this proposed model, we perform data offloading at 5G using the fuzzification concept. Mobile IoT devices create tasks in the network and are offloaded in the cloud or mobile edge nodes based on energy consumption. Two base stations, small (SB) and macro (MB) stations, are initialized and the first tasks randomly computed. Then, the tasks are processed using a fuzzification algorithm to select SB or MB in the central server. The optimization is performed using a grasshopper algorithm for improving the QoS of the 5G network. The result is compared with existing algorithms and indicates that the proposed system improves the performance of the system with a cost of 44.64 J for computing 250 benchmark tasks. [ABSTRACT FROM AUTHOR]

The presence of recalcitrant organic molecules with high amounts of chemical oxygen demand, low biodegradability, and lack of effective treatment for pharmaceutical wastewater result in environmental pollution. Batch wet peroxide oxidation (WPO) experiments have been performed to study the effect of temperature (150°C‐250°C), oxidant coefficient (OC 0‐3), and reaction time (20 minutes‐60 minutes) on degradation efficiency of industrial pharmaceutical wastewater. Box‐Behnken design (BBD) with response surface methodology was used to study the effect of independent parameters on total organic carbon (TOC) removal response. The optimum temperature, oxidant coefficient, and reaction time of the process were found to be 250°C, OC 3, and 60 minutes, which resulted in TOC conversion of 57.96%. The obtained quadratic model has been able to predict the response with minimum deviation. The experimental modelling results conveyed that influence of process parameters followed the order: temperature > time > oxidant coefficient. To improve the mineralization efficiency, process parameters were changed to attain the near complete conversion (~99%) of the pharmaceutical wastewater. The qualitative analysis also showed that only a few components of pharmaceuticals were present in the treated effluent. [ABSTRACT FROM AUTHOR]

An efficient and accurate 3D full wave numerical solution model for computing the radar cross section (RCS) of wake-vortex is presented, by solving Euler equation to compute the pressure in the aircraft wake region by computational fluid dynamics model and parallel integral equation (IE), based on method of moments (MoM) is used to compute the volume polarization currents, under the plane wave incidence. Then the currents are used to compute far-field from the vortex region. [ABSTRACT FROM AUTHOR]

Introduction. High impact injuries to the neck, shoulder and upper arm can lead to both cervical cord or brachial plexus injuries, which at times prove to be a diagnostic dilemma should imaging be inconclusive. We present a case of a trauma patient, with indeterminate scans. A 20 year-old motorcyclist, with no significant past medical history, presented after colliding with a cyclist and shoulder pain was complained on scene. Trauma series imaging (CT head, spine, thorax, abdomen and pelvis) noted intact clavicles, scapulae, sternum and proximal humerus with no fracture identified. He had a small pneumothorax and lung contusion. Clinically, the patient had significant pain across the whole right upper limb, power 0/5 on muscle power assessment (MRC) scale on shoulder abduction, elbow flexion and extension, and wrist flexion and extension. The presentation was in keeping with a brachial plexus injury. Results. Cervical spine and brachial plexus MRI noted not only cervical cord oedema and haemorrhage, but also noted possible preganglionic type of root avulsion injury. There was also no gross discontinuity of the brachial plexus and was inconclusive. The right hemidiaphragm was also elevated in chest x-ray which was suggestive of phrenic nerve injury. Nerve conduction studies performed confirmed severe right pan-plexopathy, with all sensory and motor response on the right upper limb attenuated or absent. The neuropathic pain was managed with gabapentin, amitriptyline and opiates which controlled the pain. He was referred to the plastic surgeons for considerations of nerve reconstruction surgery. Conclusion. Although brachial plexus MRI is deemed to be the gold standard for assessing brachial plexus injuries, its role maybe limited in cases where images are inconclusive and proves a diagnostic dilemma to distinguish between spinal cord and brachial plexus injury. Clinical examination together with nerve conduction studies plays a salient role in diagnosing for appropriate management. [ABSTRACT FROM AUTHOR]

It is the responsibility of the dentist to fabricate a denture that is fully functional and perfectly esthetic. One prime oral function that has always been overlooked in this regard is speech. It has been thought that speech will follow mere replacement of teeth and that it is the patient′s duty to fine tune this function with practice. Phonetics, esthetics, function and comfort form the foundation of a successful prosthodontic treatment. Accurate approximation of palatal contours of a maxillary complete denture to a patient′s tongue can improve speech intelligibility, if other factors such as tooth position, occlusal plane and occlusal vertical dimension are satisfactory. Customizing palatal contours of a maxillary complete denture can be accomplished by using tissue-conditioning material, which provides sufficient working time for a patient to pronounce a series of sibilant sounds while recording dynamic impression of the tongue. This article describes a technique of obtaining palatogram and customizing palatal contours of a maxillary complete denture with autopolymerizing acrylic resin to improve the intelligibility of speech.