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Introduction: Mitral Valve Replacement (MVR), an important treatment for rheumatic mitral valve disease, is being widely promoted worldwide. MVR using the total leaflet preservation technique can produce good results; however, patient-specific factors and anatomical considerations must be taken into account when selecting the appropriate surgical approach. Aim: To investigate the benefits of Posterior Leaflet Preservation (PLP) in MVR in individuals with severe mitral stenosis. Materials and Methods: The current prospective interventional study included patients with Rheumatic Heart Disease (RHD) who had severe mitral valve stenosis and/or regurgitation and underwent MVR between December 2019 and December 2021 in the Department of Cardiothoracic and Vascular Surgery at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. The study included 50 patients with MVR (PLP) to preserve the posterior leaflets and 50 patients with classic MVR (no PLP). Left Ventricular Ejection Fraction (LVEF), Left Ventricular End-Systolic Diameter (LVESD), and Left Ventricular End-Diastolic Diameter (LVEDD) were measured before surgery, one, three, and six months after surgery. Results: The majority of patients in the present study were between 23 and 46 years old. The PLP group consisted of 17 men and 33 women, while the non-PLP group had 16 men and 34 women. The difference in cross-clamp time between Group-A and B was significant (p=0.0001). Cardiopulmonary Bypass (CPB) time was significantly different between Group-A and B (p=0.001). Only 4 (8%) patients in Group-A had low cardiac output syndrome, compared with 8 (16%) of patients in Group-B. Comparison of LVEF between groups over time revealed no significant difference (p=0.05). The mean change in LVEF from pre-operative to six months in Group-A was significant (p=0.004), but there was no significant change in Group-B (p=0.25). Conclusion: PLP had no improved beneficial outcome on left ventricular performance in cases with rheumatic stenosis during the six-month follow-up. Even after long-term follow-up, haemodynamic valve properties do not alter with adequate PLP. [ABSTRACT FROM AUTHOR]

Background and aims: The present study aims to investigate the disparities in healthcare utilization and healthcare burden among individuals with and without diabetes. The prevalence of diabetes is more pronounced among older adults, which can detrimentally influence their health and quality of life while also restricting their capacity to self-manage and giving rise to competing healthcare demands. Thus, it is crucial to understand the implications of diabetes on healthcare demands and expenditures to mitigate its detrimental consequences. Methods: Data was used from the initial round of the Longitudinal Aging Study in India (LASI), conducted in 2017–18. The analytical sample included 65,562 individuals aged 45 or above, and 8429 individuals were identified as having diabetes. The primary outcome variable was the out-of-pocket expenditure (OOPE) in the most recent hospitalization. Descriptive statistics and logistic regression are used to find the trend in the prevalence of morbidities both in diabetic and nondiabetic groups. Additionally, quantile regression was used to study the association between the presence of diabetes and the risk of excess healthcare expenditure calculated through out-of-pocket expenditure for hospitalization and expenditure on medicines. Results: 16% of people with diabetes were hospitalized in the past year, compared to 9% without diabetes. The mean hospitalization length for diabetics was 13.6 days, compared to 6.5 for nondiabetics. Diabetes is significantly associated with higher OOPE for hospitalization across all quintiles, and its effect on hospitalization is weakest in the highest quintile. Having diabetes is also found to be significantly associated with the expenditure on medicines across all quintiles. Conclusion: The study highlights the need for diabetes awareness programs and interventions integrated into national health policies. The quantile regression model provides crucial insights into the association between diabetes and OOPE for hospitalization and medicine The increase of OOPE for hospitalisation and medicine due to the presence of diabetes emphasizes the need to address the financial burden faced by people with diabetes, highlighting the urgency of prioritizing measures to improve access to affordable care. [ABSTRACT FROM AUTHOR]

Background: Pregnancy registration is one of the most critical components of women's reproductive health because it is the gateway to entering the continuum of care services such as antenatal care, institutional delivery, and postnatal care. There is a lack of studies exploring the relationship between pregnancy intention and pregnancy registration, especially in the Indian context. Method: This study used the National Family Health Survey-5 (2019-21) data to explore the relationship between birth intention and failure of pregnancy registration. The bivariate and multivariate (binary logistic regression) analysis was carried out. Results: Adjusting the effects of socio-demographic and economic characteristics, compared with women with an intended pregnancy, the odds of failure of pregnancy registration were significantly high among women with a mistimed pregnancy (OR = 1.60, 95% CI = 1.47–1.73) and unwanted pregnancy (OR = 1.38, 95% CI = 1.26–1.52). The study found pregnancy intention as a significant predictor of pregnancy registration. Conclusions: Results suggest strengthening the interaction of grassroots-level health workers with women, especially those with possibly lower healthcare autonomy and unintended pregnancy. Higher and earlier pregnancy registration will enhance maternal healthcare utilization and reduce adverse health consequences to mothers and children, thus ensuring better maternal and child health. [ABSTRACT FROM AUTHOR]

Background: In India, more than half of the newborns experience delayed breastfeeding, and non-exclusive breastfeeding is practiced in 63% of babies below the age of six months. The goal of this study is to investigate the extent to which external environment, demographic and socioeconomic, pregnancy and birthing characteristics, as well as utilization of maternal care services, are associated with delayed initiation and non-exclusive breastfeeding among children in India. Methods: Data was gathered from the fifth round of the National Family Health Survey (NFHS), which was conducted in 2019-21. This study used information on 85,037 singleton infants aged 0–23 months and 22,750 singleton infants aged 0–5 months. Delayed initiation of breastfeeding and non-exclusive breastfeeding was used as outcome variables in this study. Unadjusted and adjusted multivariable binary logistic regression was performed to analyse the association of delayed breastfeeding and non-exclusive breastfeeding with selected background characteristics. Results: Factors significantly associated with increased risks of delayed initiation of breastfeeding included infants from in the central region (OR 2.19; 95% CI 2.09, 2.29), mothers in the 20 to 29 years age group at the time of childbirth (OR 1.02; 95% CI 0.98, 1.05), caesarean deliveries (OR 1.97; 95% CI 1.90, 2.05). The likelihoods for non-exclusive breastfeeding significantly increased among children belonging to the richest household status (OR 1.30; 95% CI 1.17, 1.45), mothers who had less than nine months of pregnancy period (OR 1.15; 95% CI 1.06, 1.25), and mothers who gave birth in non-health facility (OR 1.17; 95% CI 1.05, 1.31). Conclusions: The connections between several different categories of factors and non-exclusive breastfeeding and delayed breastfeeding initiation show the need for comprehensive public health programmes using a multi-sectoral approach to promote breastfeeding behaviours in India. [ABSTRACT FROM AUTHOR]

An editorial is presented on the evolving use of endovascular treatment (EVT) for patients with acute ischemic stroke and large vessel occlusion. Topics include the efficacy of EVT in extending the treatment window, the inclusion of patients with large ischemic cores in recent studies, and the challenges in defining a "large core" and identifying patients most likely to benefit from EVT.

Being one of the major energy consumers, cooking is a necessary part of daily life. Non renewable cooking fuel sources, such as wood or cow dung cause hazardous pollution and a poor ecosystem worldwide. Over the past few decades, solar-powered cooking has undergone numerous improvements. Solar cooking has been predominantly used as a substitute for reducing oil and gas dependence, increasing environmental sustainability, and reducing global warming threats. This paper talks about the recent development of the box-type solar cooker. The paper discusses the principles and classifications of various parameters that affect the performance, energy, and exergy related to the solar cooking system. In line with the sustainable development goals of the UN agenda 2030 and especially the heed to the accomplishment of SDG 7 and SDG 13, various economic factors, such as the payback period (PP), net present value (NPV), benefit–cost (B–C) ratios, internal rate of return (IRR), levelized cost of heat (LCOH), and levelized cost of cooking a meal (LCCM) have been discussed. The environmental analysis has also been presented to show the overall benefit of solar cooking. The review also focuses on the current development of a box-type solar cooker, its components, and its heat transfer characteristic. Various geometrical modifications, the use of reflectors, and transparent insulating materials that improve cooking have been discussed. The concept of energy storage in the form of Phase change material (Latent heat storage) with the latest studied designs improvements of solar cookers has been obtained to be efficient, which also help in late-evening cooking. It can be said that with better policy implications, the social and economic acceptability of the solar cooker can be achieved. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose was to study the anatomical and functional outcome following single low-dose suprachoroidal triamcinolone acetonide (LD-SCTA) (2 mg) injection in noninfectious posterior uveitis. METHODS: Eleven patients with macular edema (ME) more than 280 μ secondary to noninfectious uveitis were included in the study. A single LD-SCTA (0.5 ml) injection was performed in the study eye with the help of a novel suprachoroidal microneedle (Pricon, Iscon Surgicals, Jodhpur, Rajasthan, India). The study parameters were noted at 4 and 12 weeks post LD-SCTA injection. RESULTS: Ten of 11 patients had a significant decrease in central macular thickness (CMT). The mean CMT measurement at baseline was 513.6 ± 191.73 μm for the 10 patients who responded to the treatment, which reduced significantly to 265.1 ± 34.72 μm (P < 0.003) and 260.6 ± 34.72 μm (P < 0.002) at 4 and 12 weeks, respectively. The mean best-corrected visual acuity (BCVA) at baseline was 0.84 ± 0.41 logMAR unit which improved to 0.52 ± 0.33 (P < 0.001) and 0.25 ± 0.22 (P < 0.000) at weeks 4 and 12, respectively. The mean intraocular pressure at baseline recorded was 16.36 ± 2.97 mmHg, 19.45 ± 4.80 mmHg (P = 0.06) at 4 weeks, and 17.27 ± 2.53 mmHg (P = 0.35) at 12 weeks. One eye which did not respond to LD-SCTA was a case of recurrent Vogt–Koyanagi–Harada disease. CONCLUSION: Single LD-SCTA injection is efficacious in reducing CMT in ME, improving BCVA, and controlling the inflammation in noninfectious posterior uveitis. LD-SCTA can be used as a first-line therapy in noninfectious uveitis over other routes of steroid administration with a favorable outcome and safety profile. [ABSTRACT FROM AUTHOR]

The Jagpura Au-Cu deposit is situated within the Aravalli craton in the northwestern part of India. In the present work, petrography, mineral chemistry, fluid inclusion and sulfur isotopic compositions were used to study the Jagpura Au-Cu deposit. The ore mineral association of the deposit is arsenopyrite, loellingite, chalcopyrite, pyrrhotite and pyrite, along with native gold, magnetite and apatite. The gold fineness ranges from 914–937‰ (avg. 927‰). The presence of Au-Bi-Te phases, pyrite (>1 Co/Ni ratio), magnetite (≥1 Ni/Cr ratio, <1 Co/Ni ratio) and apatite (>1 F/Cl ratio) suggest the hydrothermal origin Au-Cu mineralization. A fluid inclusion study indicates the different episodes of fluid immiscibility with the homogenization temperatures varying between 120–258 °C and salinities range within the 8.86–28.15 wt% NaCl eq. The sulfur isotopic composition of sulfides varies from 8.98 to 14.58‰ (avg. 11.16‰). It is inferred that the variation in the sulfur isotopic compositions of sulfides is due to the cooling and dilution of the metalliferous fluid of mixed origin, derived from the basement meta-sedimentary rocks and the high saline basinal fluid. The iron oxide-copper-gold-apatite associations, structural control of mineralization, pervasive hydrothermal alteration, fluid salinity and sulfur isotope compositions indicate that the Jagpura Au-Cu deposit is similar to the iron oxide-copper-gold (IOCG)-iron oxide-apatite (IOA)types of deposits. Based on the ore geochemistry and the trace elements systematic of magnetite, the deposit is further classified as an IOCG-IOA type: IOCG-Co (reduced) subtype. [ABSTRACT FROM AUTHOR]

The current paper summarizes the development of nano‐enhanced phase change materials (NPCMs) using capric acid (CA) and manganese dioxide (α‐MnO2) nanoparticles. The nanoparticles were obtained by the green synthesis technique using the leaves of Ficus retusa plant. The obtained nanoparticles were used in 1%, 2%, and 3% weight fractions in the nano‐formulations. The field‐emission scanning electron microscopy (FESEM) was employed to confirm the morphological structure and energy‐dispersive X‐ray (EDX) spectroscopy was used for the elemental analysis of the synthesized nanoparticles. The crystallographic studies were done using X‐ray diffraction (XRD) spectroscopy. The Fourier‐transform infrared (FT‐IR) spectroscopy results showed that the insertion of nanoparticles did not disturb the chemical configuration of CA. The differential scanning calorimetry (DSC) analysis revealed that the developed nanocomposites had excellent thermal energy storage capability that lay within the range of 145–164 kJ/kg. Five hundred extended thermal cycles were carried out which showed that the developed PCM had excellent thermal reliability and can be useful for a year‐long application. The variations reported with 1% nano‐formulation was −1.43% to +0.53%, −0.03% to +1.52%, and −6.67% to 9.94% with respect to onset, peak melting temperature, and latent heat of fusion. The thermal gravimetric analysis (TGA) results showed that developed PCMs were stable within the working temperature range. The melting/solidification curve showed faster heat storage and release rates owing to the increased thermal conductivity. These developed PCMs are useful for photovoltaic/thermal and building applications. [ABSTRACT FROM AUTHOR]

Background: In India, the usage of modern contraception methods among women is relatively lower in comparison to other developed economies. Even within India, there is a state-wise variation in family planning use that leads to unintended pregnancies. Significantly less evidence is available regarding the determinants of modern contraception use and the level of inequalities associated with this. Therefore, the present study has examined the level of inequalities in modern contraception use among currently married women in India.Methods: This study used the fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16. Our analysis has divided the uses of contraception into three modern methods of family planning such as Short-Acting Reversible Contraception (SARC), Long-Acting Reversible Contraception (LARC) and permanent contraception methods. SARC includes pills, injectable, and condoms, while LARC includes intrauterine devices, implants, and permanent contraception methods (i.e., male and female sterilization). We have employed a concentration index to examine the level of socioeconomic inequalities in utilizing modern contraception methods.Results: Our results show that utilization of permanent methods of contraception is more among the currently married women in the higher age group (40-49) as compared to the lower age group (25-29). Women aged 25-29 years are 3.41 times (OR: 3.41; 95% CI: 3.30-3.54) more likely to use SARC methods in India. Similarly, women with 15 + years of education and rich are more likely to use the LARC methods. At the regional level, we have found that southern region states are three times more likely to use permanent methods of contraception. Our decomposition results show that women age group (40-49), women having 2-3 children and richer wealth quintiles are more contributed for the inequality in modern contraceptive use among women.Conclusions: The use of SARC and LARC methods by women who are marginalized and of lower socioeconomic status is remarkably low. Universal free access to family planning methods among marginalized women and awareness campaigns in the rural areas could be a potential policy prescription to reduce the inequalities of contraceptive use among currently married women in India. [ABSTRACT FROM AUTHOR]

Researchers have long been concerned about the association between depression and the prevalence of multiple chronic diseases or multimorbidity in older persons. However, the underlying pathway or mechanism in the multimorbidity-depression relationship is still unknown. Data were extracted from a baseline survey of the Longitudinal Ageing Survey of India (LASI) conducted during 2017–18 (N = 31,464; aged ≥ 60 years). Depression was assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10). Multivariable logistic regression was used to examine the association. The Karlson–Holm–Breen (KHB) method was adopted for mediation analysis. The prevalence of depression among older adults was nearly 29% (men: 26% and women 31%). Unadjusted and adjusted estimates in binary logistic regression models suggested an association between multimorbidity and depression (UOR = 1.28; 95% CIs 1.27–1.44 and AOR = 1.12; 95% CIs 1.12–1.45). The association was particularly slightly strong in the older men. In addition, the association was mediated by functional health such as Self Rated Health (SRH) (proportion mediated: 40%), poor sleep (35.15%), IADL disability (22.65%), ADL disability (21.49%), pain (7.92%) and by behavioral health such as physical inactivity (2.28%). However, the mediating proportion was higher among older women as compared to older men. Physical inactivity was not found to be significant mediator for older women. The findings of this population-based study revealed that older people with multimorbidity are more likely to suffer depressive symptoms in older ages, suggesting the need for more chronic disease management and research. Multimorbidity and depression may be mediated by certain functional health factors, especially in older women. Further longitudinal research is needed to better understand the underlying mechanisms of this association so that future preventive initiatives may be properly guided. [ABSTRACT FROM AUTHOR]

Manual small-incision cataract surgery (MSICS) preserves its utility as a cost-effective and efficient strategy for mitigating cataract-associated blindness. Numerous techniques of nucleus delivery in MSICS have been described in the literature. The fish hook technique of nucleus extraction was advocated in 1997 and has been popular for high-volume surgery in limited pockets of the world. This article describes in detail the steps involved in the construction of a fish hook, tips of nucleus extraction with the help of a fish hook, and the pros and cons of fish hook-based MSICS through text, diagram, and video supplement. [ABSTRACT FROM AUTHOR]

Frequency deviations are triggered by load changes and the inclusion of renewable energy sources. Hence, a novel type-2 fuzzy proportional derivative-integral control tactic is suggested for controlling load frequency in a deregulated power system with distributed generating (DG) units and plug-in electric vehicles (PEVs). The suggested controller is tuned with arithmetic optimizer (AO) to minimize the integrated time-squared error. Practical constraints such as boiler characteristics, governor dead bands, and generation rate constraints are incorporated into the thermal system. Simulations show the superiority of the suggested scheme compared to integral, proportional-derivative, proportional-integral, proportional-integral-derivative, and type-1 fuzzy logic proportional-derivative branched with integral controllers in rejecting step load disturbances occurring in frequency deviations and tie-line power. Furthermore, the dominance of the suggested AO over other well-known evolutionary methods is established by performing comparative studies. The robustness of the suggested strategy is also studied by considering ±30% perturbation in various system parameters. Moreover, the efficiency of the suggested scheme in rejecting random load disturbance, and the effect of integrating DG units and PEVs on the system are also studied. Finally, the suggested control scheme's dominance is also demonstrated by comparing the results with previously reported control strategies. The maximum frequency deviation in area-1 is improved by 1.35% while that of area-2 is improved by over 6.70% as compared to reported works. [ABSTRACT FROM AUTHOR]

Flexible and lightweight films of Polyvinylidene fluoride (PVDF) loaded with nanosheets of reduced graphene oxide (RGO) have been prepared via solution casting method. The structure of RGO nanosheets have been examined through X-ray diffraction (XRD), Transmission electron microscopy (TEM) and Raman spectroscopy technique. FTIR studies revealed that the enhancement of β-phase from 53 to 70% has been observed by adding RGO nanosheets in PVDF matrix. The frequency dependent dielectric constant and dielectric loss have been studied. Ultraviolet–visible spectra show a decrease in optical band gap with increases RGO concentration in nanocomposite films. The ferroelectric behavior of RGO loaded PVDF nanocomposite films showed remarkable improvement in remnant polarization values as compared to bare PVDF. The piezo-response of RGO loaded nanocomposite films showed significant enhancement in output voltage from 0.886 to 1.915 V. On exposure to ultraviolet–visible light, RGO loaded nanocomposite PVDF films showed about 13.8% enhancement in piezo- voltage with action of same pressure. [ABSTRACT FROM AUTHOR]

Summary: In the existent paper, the performance of thermal storage hybrid buildings exploiting the latent heat of phase change materials (PCMs) for thermal refrigeration and heating of the contemporary period has been investigated. The conventional buildings consume a large amount of electricity, primarily for the heating and cooling applications. Electricity generation primarily relies on coal‐based thermal power plants. The emissions from these establishments pose a serious threat to the environment. Moreover, conventional heating/cooling units rely on exorbitant energy cost. The usage of any kind of thermal storage system is an efficacious way of stockpiling thermal energy and utilizing it when needed. This paper gives a comprehensive overview of the available thermal storage units incorporating PCMs. The various segments of the buildings, viz, ceiling, window, wall, and floor have been analyzed in details. The results are quite promising in terms of load reduction and overall energy saving. Indoor surface temperature reduction of up to 7oC has been achieved. The energy saving of up to 40% can be realized by employing PCM. A comprehensive list of the PCMs is also tried to build up for end users according to their temperature requirement. [ABSTRACT FROM AUTHOR]

Introduction: Pathological myopia is commonly associated with myopic traction maculopathy, which includes foveoschisis, foveal retinal detachment, macular hole (MH) and/or macular detachment (MD). Macular buckling is a rarely practiced extraocular surgical modality these days. The purpose of this study was to investigate the efficacy of primary buckling with Morin-Devin T implant for MD with MH and posterior staphyloma. Case description: A 52-year-old female presented with light perception vision in her right eye with posterior staphyloma, localized neurosensory detachment, and MH. She underwent primary macular buckling with Morin-Devin T implant. During the immediate postoperative day the wedge indentation was found misaligned to the fovea. A revision surgery was done after 2 weeks for repositioning of the macular wedge. Spectral domain optical coherence tomography confirmed indentation at the MH with resolution of subretinal fluid and hole closure. Her BCVA was 2/60 at 3 months postoperative and it remained the same even at 6 months of follow-up. Conclusions: Primary macular buckling can be an effective procedure in eyes with MH with detachment and posterior staphyloma with or without associated foveoschisis. Morin-Devin T implant placement is a relatively simple procedure with short surgical time and excellent outcome. [ABSTRACT FROM AUTHOR]

In this study, a sensitivity analysis on a VECTRI dynamical model of malaria transmission is investigated to determine the relative importance of model parameters to disease transmission and prevalence. Apart from being most climatic prone, Odisha is a highly endemic state for malaria in India. The lack in sufficient modeling studies severely impacts the malarial process studies which further hinder the possibility of malaria early warning systems and preventive measures to be undertaken beforehand. Therefore, modeling studies and investigating the relationship between malaria transmission process studies and associated climatic factors are the need of the hour. Environmental conditions have pronounced effects on the malaria transmission dynamics and abundance of the poikilothermic vectors, but the exact relationship of sensitivity for these parameters is not well established. Sensitivity analysis is a useful tool for ascertaining model responses to different input variables. Therefore, in order to perform the requisite study, a dynamical model, VECTRI, is utilized. The study period ranges from 2000 to 2013, where several sensitivity tests are performed using different model parameters such as infiltration and evaporation rate loss of ponds, degree-days for parasite development, threshold temperature for parasite development, threshold temperature for egg development in the vector, and maximum and minimum temperature for larvae survival. The experiments suggest that the lower value of minimum temperature for larvae survival (rlarv_tmin), i.e., 16 °C, provides higher vector density and entomological inoculation rate (EIR) values. EIR reaches its maximum, when the threshold temperature for parasite development (rtsporo) is 22 °C and degree-days for parasite development (dsporo) is 8 degree-days. No change is observed in the vector density; even when rtsporo is 30 °C, values of EIR are close to 0. A successive increment of infiltration and evaporation rate loss of ponds (rwaterfrac evap126) values from 130 to 200 mm/day result in approximately 5% consistent decline in vector density and EIR. The study concludes that the most sensitive parameters are dsporo, rlarv_tmin, and rwaterfrac evap126. The VECTRI model is rather insensitive to maximum temperature for larvae survival (rlarv_tmin) for vector density and EIR variables. Further certain modifications and improvements are required in VECTRI to predict out variables like vector density and EIR more accurately in highly endemic region. [ABSTRACT FROM AUTHOR]

Abstract Effects of increase in horizontal resolution (from 2°, to 1° and 0.5°) in simulating Indian summer monsoon (ISM) in Community Atmosphere Model version 5 (CAM5) are reported herein. Various parameters — temperature, rainfall, winds, surface evaporation, precipitable water, specific humidity, and clouds — of the model simulations are examined with respect to observations {India Meteorological Department (IMD) and Tropical Rainfall Measuring Mission (TRMM) data for precipitation and Modern-Era Retrospective analysis for Research and Applications (MERRA) products for rest of the variables}. With increase in horizontal resolution overall improvement in majority of surface driven parameters like surface air temperature, surface specific humidity, and low-level winds is observed that highlights the importance of better representation of orography. Over the Indian subcontinent and surrounding oceans, rainfall is overestimated due to the overestimation of the large-scale precipitation in the model, which significantly gets alleviated with increase in resolution. Overall, seasonal mean features of ISM show significant improvements, which are likely to further improve by representing finer spatial features with increase in resolution. However, some aspects of its temporal variations — seasonal, intraseasonal, and diurnal variations — of monsoon rainfall do not show much improvement with increase in resolution, suggesting that traditional physics parameterizations do not work well at high resolution and hence there is a need for improvement in model physics. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a heterogeneous disease which is divided broadly into luminal, HER2 and basal type based on molecular profiling. Increased body mass index (BMI) has been associated with the risk of developing breast cancer but the association based on molecular subtype remains conflicting. Methods: This was an observational study carried out over a period of 2 years. Nonmetastatic breast cancer patients were evaluated for the tumour subtype based on surrogate markers (ER, PR and HER2). The BMI of these patients was correlated with the tumour subtype and size. Results: We studied 476 patients with breast cancer with the median age of 46 years (range, 25-86) and 58% were premenopausal. The mean BMI of the cohort was 24.1, which was significantly higher in postmenopausal women (24.9 versus 23.6, p < 0.05). Overall, only 10% of patients were obese. The mean BMI in the luminal, HER2 and TNBC subtypes was 24.7, 22.4 and 23.9, respectively (p < 0.01). Also, the mean tumour size in luminal, HER2 and TNBC subtype was 4.02, 3.80 and 4.27 cm, respectively (p = 0.158). Conclusion: The average BMI was higher in patients with luminal subtype followed by TNBC and lowest for HER2 at the time of diagnosis. The mean tumour size was numerically higher for TNBC and lowest for HER2 subtype although the difference was not statistically significant. Larger studies may provide clarity of association between the BMI and tumour subtype. [ABSTRACT FROM AUTHOR]

The influence of surface topography resolution in Indian summer monsoon simulation is investigated. Three sets of six-member ensemble simulations with climatological sea surface temperature are conducted with the Community Atmospheric Model, version 5.1 (CAM5.1):COARSEsimulation at 1.9832.58 latitude- longitude resolution, FINE simulation at 0.478 3 0.638 resolution, and HYBRID simulation, that is, using COARSE surface topography imposed on the FINE configuration. With regard to the representation of the surface topography, substantial differences occur at the regional scales between the simulations, especially over the foothills and steep flanks of the mountains. In the COARSE and HYBRID simulations, the orographic height of the foothills is overestimated whereas that of the steep flanks adjacent to the foothills is underestimated. The biases are severe (up to 1 km) over the Himalayas and Tibet and have detrimental effects on regional climate through barrier effects on the low-level flow, and the lapse rate and elevated heat source effects. Overall, the simulations show remarkable improvement with an increase in resolution, mainly because of the improved representation of atmospheric and surface processes. However, local climate - surface air temperature, sea level pressure, precipitable water, and wind - of the orographic regions, particularly where large orographic biases exist in COARSE, is found to benefit substantially from increased resolution of surface topography. Local precipitation and evaporation are exceptions, although, as they are negligibly sensitive to topographic resolution, showing strong dependence on the resolution of surface and atmospheric processes. Moreover, resolution of surface topography generally does not have notable remote impacts. [ABSTRACT FROM AUTHOR]

Background: T-cell prolymphocytic leukemia (T-PLL) is a rare lymphoid malignancy with dismal prognosis. Most patients have increased lymphocyte count (>1,00,000/dL) and widespread disease at presentation. Despite high response rate seen with alemtuzumab, the disease relapse is inevitable. Materials and Methods: This was a retrospective observational study done at a tertiary cancer center in South India. All patients diagnosed with T-PLL from August 2010 to July 2015 were studied for the clinical characteristics, pathological findings and treatment outcomes. Results: Seven patients were diagnosed as T-PLL over a period of 5 years. The median age at diagnosis was 51 years. In the present series, 6 patients (86%) had splenomegaly and 3 had hepatomegaly (43%). Generalized lymphadenopathy was seen in 4 (57%) patients at presentation. Skin lesions were seen in 5 (71%) patients, whereas pleural effusion was seen in only one patient (14%). All had elevated total leukocyte count, with more than 1, 00,000/dL in 4 patients. The median survival was 5 months with different chemotherapy (CT) regimens (5 patients treated with CT and 2 received best supportive care). Conclusion: T-PLL is a rare disease with no definite treatment guidelines. At present, the best outcomes are achieved if treatment with alemtuzumab is followed by stem cell transplant, but the disease invariably relapses. Countries where affordability remains a big challenge, the best approach needs to be defined beyond the monoclonal antibodies and transplant. [ABSTRACT FROM AUTHOR]

Background: Bilateral breast cancer (BBC) is a rare clinical entity with limited data regarding clinicopathological aspects and treatment guidelines. Materials and Methods: This was an observational study of patients diagnosed with BBC from August 2012 to July 2014. Synchronous breast cancers (SBCs) was defined as two tumors diagnosed within an interval of 6 months and metachronous breast cancer (MBC) as second cancer diagnosed after 6 months. Results: Out of 750 breast cancer patients seen during a 2-year period, 35 had BBC. Ten patients were diagnosed as SBC whereas 25 patients as MBC. Among patients with MBC, the average time for development of contralateral breast cancer was 5 years. In 8 patients, the contralateral breast cancer was detected mammography whereas rest 27 patients were detected by clinical breast examination. At a median follow-up of 24 months, 23 (66%) patients were disease free, 9 (26%) patients had disease relapse, and 3 (8%) patients succumbed to the progressive disease. Conclusions: Every patient with breast cancer should be regularly followed up with clinical breast examination at a more frequent interval. The role of frequent clinical breast examination appears more than mammography especially beyond 5 years for early detection of contralateral breast cancer. [ABSTRACT FROM AUTHOR]

Introduction: Primary angiosarcoma of the breast is a rare entity with incidence of less than 0.05% of all malignant breast neoplasms. It occurs in young females without any associated risk factors. The tumor behaves aggressively and has a poor prognosis compared to invasive ductal carcinoma. Method: It was a retrospective observational study done at a tertiary cancer center from January 2012 to December 2016. The medical records of patients diagnosed with primary breast angiosarcoma were reviewed for the study. Clinicopathological profile, treatment, and the outcomes were analyzed. Results: Four patients were diagnosed with primary breast angiosarcoma out of 2560 breast cancer patients seen over a period of 5 years. Two had metastatic disease at presentation. Among four patients, two underwent surgery of the primary tumor, whereas, all received chemotherapy either as adjuvant or palliative setting. One patient received adjuvant radiation therapy. Three patients received 2nd line and one received 3rd line chemotherapy on disease progression. After a median follow-up of 18 months one patient was surviving on 3rd line chemotherapy with trabectedin. Other three succumbed to disease after progression. Conclusion: Due to a small number of this malignancy randomized studies are difficult to perform and optimum treatment strategy still need to be defined. [ABSTRACT FROM AUTHOR]

Background: We reviewed the long-term results of surgery for discrete subaortic membrane (SubAM) from a single institute.Methods: A retrospective review of medical records of all patients (n = 146) who underwent resection of a SubAM for discrete subaortic stenosis between 1990 and 2015 at the All India Institute of Medical Sciences, New Delhi, India was undertaken.Results: Median age at surgery was 9.0 years (9 months-47 years). There was one early death. Preoperative peak left ventricular outflow tract (LVOT) Doppler gradient was 83.4 ± 26.2 mmHg (range: 34-169 mmHg). On preoperative echocardiography, aortic regurgitation (AR) was absent in 69 (47.3%), mild in 35 (24%), moderate in 30 (20.5%), and severe in 12 (8.2%). After surgery, the LVOT gradient was reduced to 15.1 ± 6.2 mmHg (P < 0.001). Fourteen patients (9.6%) who had residual/recurrent significant gradients are currently being followed-up or awaiting surgery. There was improvement in AR for operated patients with freedom from AR of 92.6 ± 0.03% at 15 years. Kaplan-Meier survival at 25 years was 93.0 ± 3.9% (95% confidence interval: 79.6, 97.7). Freedom from re-operation at 25 years was 96.9 ± 1.8%.Conclusions: Long-term results of surgery for discrete SubAM are good. Resection of the membrane along with septal myectomy decreases the risk of recurrence. [ABSTRACT FROM AUTHOR]

The article reports on occurrence of gem variety green sphalerite and dyscrasite in rocks of the Aravalli Supergroup in India. It states that the typical properties of sphalerite, viz. translucent light green colour and very high dispersion make it a worthy gem stone. It is opined that further search for this variety of sphalerite may be given priority in the Zawar Belt of Aravalli.

Microbiome-based rhizospheric engineering has emerged as a promising approach towards attaining agricultural sustainability. While the top-down approach of acclimatizing the rhizospheric microbiome to stressors is relatively easy to perform, the mechanisms involved in plant growth promotion by directed evolution are yet to be understood. The present study aimed to understand the mechanism of stress management by a salt stress-acclimatized microbiome, generated through indirect plant-mediated selection over multiple plant (Vigna radiata) growth cycles, with a focus on the emission of volatile compounds. A culture bank was generated by isolation of bacterial strains from the stress-acclimatised microbiome, using group-specific media. Characterization of the strains was performed by examining their potential plant growth-promoting (PGP) traits followed by phylogenetic affiliation using 16S rRNA sequencing. The strains exhibited strong tolerance to salinity stress when grown on artificial root exudate medium and V8 medium, at different salt concentrations. Based on PGP scoring, the eleven best performing bacterial strains were assessed for their ability to impact plant morphology and growth attributes in a split plate assay allowing only volatile compounds to be exchanged, using Arabidopsis as a model plant. An alteration in the seedling morphology of Arabidopsis was observed due to the production of volatile bioactive compounds by some of the strains. To delineate the specific volatiles produced by the bacterial strains responsible for such an impact on Arabidopsis seedlings, the volatiles emitted by selected strains were collected and analyzed by GC-MS. A correlation could be drawn between the specific volatiles produced by key bacterial members of the acclimatized microbiome e.g. Bacillus haynesii, Pseudomonas monteilii and Ochrobactrum soli , and their contribution towards alleviation of salinity stress in A. thaliana. A detailed analysis of the volatilomes emitted by stress-acclimatized bacterial strains revealed the identity of crucial metabolites, for instance hydrocarbons like 7 methyl-hexadecane, 2-(2-butoxyethoxy) ethanol or sulfur containing volatiles, which could at least partially contribute to plant growth promotion and stress tolerance. This work opens up new avenues for rhizospheric engineering as a way towards more resilient and sustainable crop production. • Mode of action of engineered microbiome in stress mitigation revealed. • Strains with multi-PGP traits were identified from stress-acclimatized microbiome. • Bacteria exhibited salinity stress tolerance and growth promotion in Arabidopsis. • Volatiles' importance in stress mitigation by acclimatised microbiome highlighted. • Key volatiles mediating growth promotion and stress tolerance were identified. [ABSTRACT FROM AUTHOR]

RGB-D cameras, which give an RGB image together with depths, are becoming increasingly popular for robotic perception. In this paper, we address the task of detecting commonly found objects in the three-dimensional (3D) point cloud of indoor scenes obtained from such cameras. Our method uses a graphical model that captures various features and contextual relations, including the local visual appearance and shape cues, object co-occurrence relationships and geometric relationships. With a large number of object classes and relations, the model's parsimony becomes important and we address that by using multiple types of edge potentials. We train the model using a maximum-margin learning approach. In our experiments concerning a total of 52 3D scenes of homes and offices (composed from about 550 views), we get a performance of 84.06% and 73.38% in labeling office and home scenes respectively for 17 object classes each. We also present a method for a robot to search for an object using the learned model and the contextual information available from the current labelings of the scene. We applied this algorithm successfully on a mobile robot for the task of finding 12 object classes in 10 different offices and achieved a precision of 97.56% with 78.43% recall.1 [ABSTRACT FROM PUBLISHER]

The main aim of this simulation work is to assess the financial possibility analysis of 10 MWP grid-associated solar photovoltaic (PV) power plants in seven cities i.e. Lucknow, Agra, Meerut, Gorakhpur, Kanpur, Allahabad, and Varanasi of Uttar Pradesh (UP) state of India with the RETScreen Software. The presented research work demonstrates the method of selection of profitable locations for solar PV power plants according to financial viability indicators. It is found that Allahabad city is the most profitable site with values of 16,686 MWh of electricity exported to the grid (EEG), US$20,896.30/year of electricity export revenue (EER), 9.4 years of simple payback period (SPP), 7.7 years of equity payback period (EPP), 19545.9 tCO2/year of GHG emission reduction, US$3492.82/year of the annual life cycle savings (ALCS), 1.5 benefit-cost (B-C) ratio, US$27394.59 of net present value (NPV), 16.5% internal rate of return on equity (IRR-equity), 12.3% modified internal rate of return on equity (MIRR-equity), 5.4% internal rate of return on assets (IRR-assets), and 7% modified internal rate of return on assets (MIRR-assets). The second most profitable site is found in Gorakhpur city and Varanasi city is found the least profitable site. The other two cities, Agra and Kanpur are not found suitable because of the negative values of NPV and ALCS. [ABSTRACT FROM AUTHOR]

The study was conducted on 48 surgically created wounds in twelve apparently healthy goats of either sex of one and half to two years of age weighing between 10 to 15 kg b. wt. The wounds of group I were treated with Sunflower oil topically while wounds of group II and III were treated with Oive oil and normal saline solution (control), respectively. Histochemical parameters viz. collagen, elastin and reticulin fibers were more marked on 25 days of observation in group I followed group II and III. Therefore, it is concluded that sunflower oil and olive oil enhanced the healing process of surgical wounds with topical application in goats. [ABSTRACT FROM AUTHOR]

Phase change materials have been overwhelmingly used for thermal energy storage applications. Among organics, fatty acids are an important constituent of latent heat storage. Most of the saturated fatty acid PCMs so far studied are either unary or binary constituents of pure fatty acids. In the present study, ternary blends of saturated fatty acids i.e., capric, lauric, myristic, stearic, and palmitic acids have been developed with different weight proportions. A series of 28 ternary blends viz. CA-LA-MA, CA-LA-PA, CA-LA-SA, CA-MA-PA, CA-MA-SA, and CA-PA-SA were prepared and analyzed with differential scanning calorimetry, thermal gravimetric analysis, and Fourier transform infrared spectroscopy. DSC analysis revealed that the prepared materials lie in the 15–30 °C temperature range. Also, 300 thermal melt/freeze cycles were conducted which showed ±10% variation in terms of the melting peak for most of the PCMs, with the average latent heat of fusion between 130 and 170 kJ/kg. The TGA analysis showed that most of the PCMs are thermally stable up to 100 °C and useful for medium-low storage applications, and FTIR analysis showed that the materials are chemically stable after repeated thermal cycles. Based on cycle test performances, the developed materials were found to be reliable for long-term use in building and photovoltaic applications. [ABSTRACT FROM AUTHOR]

States of strongly interacting particles are of fundamental interest in physics and can produce exotic emergent phenomena and topological structures. We consider here two-dimensional electrons in a magnetic field, and, departing from the standard practice of restricting to the lowest LL, introduce a model short-range interaction that is infinitely strong compared to the cyclotron energy. We demonstrate that this model lends itself to an exact solution for the ground as well as excited states at arbitrary filling factors ν<1/2p and produces a fractional quantum Hall effect at fractions of the form ν=n/(2pn+1), where n and p are integers. The fractional quantum Hall states of our model share many topological properties with the corresponding Coulomb ground states in the lowest Landau level, such as the edge physics and the fractional charge of the excitations. [ABSTRACT FROM AUTHOR]

Flexible polymer-based piezoelectric nanogenerators have attracted the researchers the most due to their mechanical flexibility, low fabrication cost and pollution-free energy harvesting from sources such as vibration, mechanical load, human motion and waste heat. Here, we report a flexible piezoelectric nanogenerator with different kinds of nanofiller such as reduced graphene oxide and bismuth aluminate Bi 2 Al 4 O 9 ceramic in Polyvinylidene fluoride (PVDF) matrix. The structural and morphological properties of nanocomposite films are examined by X-ray diffraction (XRD) and Scanning electron microscopy (SEM). The Fourier transform infrared spectroscopy (FTIR) studies revealed the fraction of β-phase enhancement from 53 to 76% with incorporation of these nanofillers. The nanocomposite films of PVDF/Bi 2 Al 4 O 9 /RGO showed maximum value of remnant polarization (P r) is 0.0189 μC/cm2 at an electric field of 165 kV/cm and the value of electric output voltage and current generated from nanocomposite films is 5.92 V and 0.76 μA for PVDF/Bi 2 Al 4 O 9 /RGO based nanocomposite. The PVDF/Bi 2 Al 4 O 9 /RGO based nanocomposite generates a maximum output power density of 0.457 μW/cm2 at 12 MΩ resistance which is around 20 times more than that of bare PVDF film. • The nanocomposite of PVDF/RGO, PVDF/Bi 2 Al 4 O 9 and PVDF/Bi 2 Al 4 O 9 /RGO are prepared via sol-casting method. • The value polar β-phase enhancement from 53% in PVDF to 76% in PVDF/Bi 2 Al 4 O 9 /RGO. • The P-E loop studies reveal that value of P r is maximum for PVDF/Bi 2 Al 4 O 9 /RGO. • The value of voltages and current for PVDF/Bi 2 Al 4 O 9 /RGO is found 5.92 V and 0.76μΑ. [ABSTRACT FROM AUTHOR]

Pollutants from navigation sector are key contributors to emission inventories of most coastal cities with heavy port activities. The use of high fuel sulfur content (FSC) bunker oil by ocean going vessels (OGVs) has been identified as a major source of sulfur dioxide (SO 2). Government authorities all over the world, including Hong Kong government, have implemented air pollution control regulations to cap FSC of fuel used by OGVs to 0.5%, from the existing 3.5%, to reduce SO 2 emissions. However, the lack of efficient screening tools to identify non-compliant OGVs has prevented effective enforcement. This study developed and evaluated an unmanned aerial vehicle (UAV)-borne lightweight (750 g) microsensor system (MSS), which is capable of measuring ship plume SO 2 , NO 2 , NO, CO 2 , CO, and particulate matter in real-time. Extensive experiments were conducted on the sensor system to evaluate its performance during laboratory and field operations. The effects of cross-sensitivity and meteorological conditions were studied and incorporated to account for the measurement conditions in dispersed ship plumes. The SO 2 to CO 2 concentration ratio-based FSC expression was formulated as per the 2016 European Union Directive and Regulations. Furthermore, the impact of plume dilution on the accuracy of FSC measurement was investigated at different stages using the MSS, with and without the UAV in both simulated conditions and real-world scenarios, maintaining a safe distance from the OGV exhaust stacks. The study demonstrates the robustness of using UAV-borne sensor system for ship emission sniffing and FSC determination. The results will assist in development of a technological framework for effective enforcement of ship emission control regulations. Unlabelled Image • Studied impacts of cross-sensitivity and meteorological changes on MSS performance. • Plume dilutions showed nominal effects on FSC estimation while using UAV-borne MSS. • FSC estimation accuracy of MSS validated by measuring predefined FSC emissions. • Airborne MSS emerges as an efficient tool for remotely screening non-compliant OGVs. • Useful in pollutant concentration ratio based assessment of varied emission sources. [ABSTRACT FROM AUTHOR]

The existing study concerned with the development and characterization of ternary eutectics prepared from medium‐chain fatty acids and long‐chain fatty acids. The acids used to prepare these blendings were commercial‐grade capric acid (CA), myristic acid (MA), stearic acid (SA), lauric acid (LA), and palmitic acid (PA). The different ternary groups using these acids were prepared, that is, CA‐LA‐MA, CA‐LA‐PA, CA‐LA‐SA, CA‐MA‐PA, CA‐MA‐SA, and CA‐PA‐SA having variable weight's compositions (90/5/5, 80/10/10, 70/15/15, 60/20/20, 50/25/25, 40/30/30, 30/35/35, 20/40/40, and 10/45/45). The various thermophysical properties such as melting temperature (MT) and latent heat of fusion (LHF) were measured calorimetrically using the differential scanning calorimeter. The MT obtained were in the range of 15°C‐50°C along with adequate LHF values, that is, 80‐200 kJ/kg, which are within the application range of different thermal systems. The various proportions of CA used in the blending have a decisive influence on determining the MT of the concerned ternary concoction. The data from the result authenticate that these developed materials can be useful for thermal regulation of buildings, photovoltaic, space, and solar water heating systems because of their enormous latent heat values and appropriate phase transition temperature. [ABSTRACT FROM AUTHOR]

Using reanalysis data and observations, interannual variations and long-term trends in the Somali Jet (hereafter, the Jet) and Indian Summer Monsoon Rainfall (ISMR) are characterized for drought vs flood, El Niño vs La Niña, and positive vs negative Indian Ocean Dipole (IOD) summer monsoon seasons. In flood years, the Jet is stronger over the upstream sector (i.e., Arabian Sea) and weaker over the downstream (i.e., Bay of Bengal), resulting in additional convergence and enhanced moisture transport over India, whereas the reverse occurs during drought years. The Jet and ISMR characteristics for El Niño (La Niña) years are similar to drought (flood) years, despite only around half of dry (wet) years, being associated with El Niño (La Niña). In +IOD years, the Jet shifts northward and intensifies over central and northern India, bringing more moisture and rainfall to those regions, while the −IOD has an opposite but relatively weak impact on ISMR. Over the last century, the Jet has become weaker over peninsular India, with reductions in rainfall across east India. Future projections under the SSP585 scenario from the CMIP6 multi-model mean suggest that the Jet will progressively shift northward and strengthen over the Arabian Sea, with associated rainfall increases over entire Indian region. The long-term changes in the Jet over the twentieth century are of comparable magnitude to interannual variations; however, the absolute magnitude of projected future changes is smaller than interannual variations observed in the past. [ABSTRACT FROM AUTHOR]

Radiology has always been an important component in the evaluation of patients with head and neck cancers. Images that are appropriately acquired and systematically interpreted provide comprehensive information on local, regional, and distant disease extent. This impacts treatment decisions for primary or recurrent disease, and aids in prognostication and patient counselling. The recent significant advances in technology and instrumentation for treatment of head neck cancers have taken place in parallel with an increasing sophistication in radiodiagnostic systems. This is especially true for laryngeal neoplasms where there is now greater focus on functional outcomes and personalised treatment, thus expanding the scope and value of imaging. Purpose: To formulate evidence-based guidelines on imaging for cancers of the larynx, from diagnosis and staging to monitoring of disease control after completion of treatment. Methods and materials: A multidisciplinary analysis of current guidelines and published studies on the topic was performed. Results: On the basis of evidence gathered, guidelines were drawn up; optimal suggestions were included for low-resource situations. Conclusion: These guidelines are intended as an aid to all clinicians dealing with patients of laryngeal cancers. It is hoped that these will be instrumental in facilitating patient care, and in improving outcomes. [ABSTRACT FROM AUTHOR]

The leaf curl disease of Jatropha caused by geminiviruses results in heavy economic losses. In the present study, we report the identification of a new strain of a Jatropha leaf curl Gujarat virus (JLCuGV), which encodes six ORFs with each one having RNA silencing suppressor activity. Therefore, three artificial microRNAs (amiRNAs; C1/C4, C2/C3 and V1/V2) were designed employing overlapping regions, each targeting two ORFs of JLCuGV genomic DNA and transformed in tobacco. The C1/C4 and C2/C3 amiRNA transgenics were resistant while V1/V2 amiRNA transgenics were tolerant against JLCuGV. The relative level of amiRNA inversely related to viral load indicating a correlation with disease resistance. The assessment of photosynthetic parameters suggests that the transgenics perform significantly better in response to JLCuGV infiltration as compared to wild type (WT). The metabolite contents were not altered remarkably in amiRNA transgenics, but sugar metabolism and tricarboxylic acid (TCA) cycle showed noticeable changes in WT on virus infiltration. The overall higher methylation and demethylation observed in amiRNA transgenics correlated with decreased JLCuGV accumulation. This study demonstrates that amiRNA transgenics showed enhanced resistance to JLCuGV while efficiently maintaining normalcy in their photosynthesis and metabolic pathways as well as homeostasis in the methylation patterns. [ABSTRACT FROM AUTHOR]

Keywords: Isaac's syndrome; hemi body; Myokymia; Neuromyotonia; autoimmunity EN Isaac's syndrome hemi body Myokymia Neuromyotonia autoimmunity 1126 1128 3 10/05/21 20211001 NES 211001 Peripheral nerve hyperexcitability syndromes are a heterogenous group of disorders with involuntary, continuous muscle activity. Initially, the twitches involved the muscles of the left calf followed by arm, thigh and trunk muscles of the left side within a span of 2 years. To the best of our knowledge, this is the first case of hemi-Isaac's syndrome or acquired neuromyotonia with hemi-body phenotype. [Extracted from the article]

Open in new tab Download slide OBJECTIVES To assess the mid-term performance of CardioCel for the repair of congenital heart defects. METHODS Data were retrospectively collected from databases and hospital records in 3 congenital cardiac surgery centres in Australia. Kaplan–Meier curves and log-rank tests were used to test for associations between patient age, gender, patch type and site of implantation. Multivariable Cox regression was used to test whether any specific implantation site was associated with reintervention risk, after adjusting for age group, gender and patch type. RESULTS A total of 1184 CardioCel patches were implanted in 752 patients under the age of 18 years. Median age at implant was 12 months [interquartile range (IQR) 3.6–84]. Median follow-up was 2.1 years (IQR 0.6–4.6). Probability of freedom from CardioCel-related reintervention was 93% [95% confidence interval (CI) 91–95] at 1 year, 91% (95% CI 88–93) at 3 years and 88% (95% CI 85–91) at 5 years, respectively. On multivariable regression analysis, aortic valve repair had a higher incidence of reintervention [hazard ratio (HR) = 7.15, P  = 0.008] compared to other sites. The probability of reintervention was higher in neonates (HR = 6.71, P  = 0.0007), especially when used for augmentation of the pulmonary arteries (HR = 14.38, P  = 0.029), as compared to other age groups. CONCLUSIONS CardioCel can be used for the repair of a variety of congenital heart defects. In our study, in patients receiving a CardioCel implant, reinterventions were higher when CardioCel was used to augment the pulmonary arteries in neonates and for aortic valve repair as compared to other sites. [ABSTRACT FROM AUTHOR]

RNAi pathway is an antiviral defence mechanism employed by insects that result in degradation of viral RNA thereby curbing infection. Several viruses including flaviviruses encode viral suppressors of RNAi (VSRs) to counteract the antiviral RNAi pathway. Till date, no VSR has been reported in alphaviruses. The present study was undertaken to evaluate chikungunya virus (CHIKV) proteins for RNAi suppressor activity. We systematically analyzed all nine CHIKV proteins for RNAi suppressor activity using Sf21 RNAi sensor cell line based assay. Two non-structural proteins, namely, nsP2 and nsP3 were found to exhibit RNAi suppressor activity. We further validated the findings in natural hosts, namely in Aedes and in mammalian cell lines and further through EMSA and Agrobacterium infiltration in GFP silenced transgenic tobacco plants. Domains responsible for maximum RNAi suppressor activity were also identified within these proteins. RNA binding motifs in these domains were identified and their participation in RNAi suppression evaluated using site directed mutagenesis. Sequence alignment of these motifs across all species of known alphaviruses revealed conservation of these motifs emphasizing on a similar role of action in other species of alphaviruses as well. Further validation of RNAi suppressor activity of these proteins awaits establishment of specific virus infection models. [ABSTRACT FROM AUTHOR]

Introduction: Fine Needle Aspiration Cytology (FNAC) has become simple, safe, speedy, cost-effective, accurate and more diagnostic after advancement in imaging techniques. Sensitivity of image guided FNAC of intra-abdominal lymph nodes is relatively high. Ancillary techniques on FNAC material may increase the accuracy of diagnosis. Aim: To evaluate adequacy of material, cytologic assessment of samples obtained by image-guided aspiration and side effect/complication on account of the procedure. Materials and Methods: Image guided FNAC were performed on 60 patients which include retroperitoneal and abdominal nodes. A sterile 3.5/5-MHz micro convex sector probe was used for localisation of the node. FNAC was performed using a 0.7-0.9 mm needle with stylet removed and attached to a 20ml syringe and FNAC handle after the needle was visualised in the lesion. For each case a minimum of 4-5 smears were made and two observers without bias interpreted the smears. Results: A total of 60 patients were aspirated, of which adequate material for cytologic diagnosis was obtained in 58(96.6%) patients with a similar diagnostic accuracy. The 6th and 7th decade accounted for approximately half of the cases. Male to female ratio in our study was 2.16:1 (41:19). Most common cytologic diagnosis was metastasis 22(37%) followed by Non-Hodgkin lymphoma 17(28%) and followed by tubercular etiology seen in 16(27%) cases. All patients were followed by six monthly period for five years to further validate the study. Conclusion: Image-guided FNAC has a pivotal role, and is a cost-effective tool for establishing tissue diagnosis as a primary investigative modality. It is also helpful and accurate in followup of patients with a known malignant disease, thereby avoiding surgical intervention. [ABSTRACT FROM AUTHOR]

Abstract Spatio-temporal variation of lightning activity over the Jammu and Kashmir province has been studied in the present research using LIS data for the period of 12 years (2001–2013). In addition, the association of lightning activity with the elevation range, vegetation cover, and absorbing aerosol index (AAI) has been studied using the LULC data of MODIS, elevation data of SRTM DEM and multi-sensor AAI data (GOME-1, SCIAMACHY, GOME-2 and OMI). It was observed through the analysis of data sets that the J&K region which lies in the Himalayan range experiences very high frequency of lightning occurrences in entire India. The lightning frequency is much higher towards the south-western side of J&K region at an altitude range of 300–1600 m. It was observed that the mixed forests and croplands contribute more towards the higher occurrence of the lightning activity. Furthermore, it has been discerned that there is a positive correlation between the Mean Monthly flash density (FD) and Mean Monthly Absorbing aerosol index (AAI) with a correlation coefficient of 0.61 and an increase in FD and AAI was observed in summer months and decreases towards the onset of spring to winter. The comparison between the AAI and FD indicates that the spatial distribution of the two components has alike features over southwestern portion, with maximum values in the summer months and decrease upto the winter season. The findings of the present study suggest that the elevation range, Absorbing Aerosol Index along with the type of LULC plays an important role in a linkage with the occurrence of higher lightning activities in J&K region. Highlights • High lightning frequency in south-western portion. • Positive correlation between FD and AAI with upward trend in summer months. • Strong linkage between the lightning events with the elevation, vegetation cover, and (AAI). [ABSTRACT FROM AUTHOR]

The municipal wastewater of coastal cities contains not only chemical oxygen demand (COD), nitrogen (N), and phosphorus (P) pollutants but also a significant concentration of sulfate (about 30–100 mg S-SO 4 /L). This emerging sulfate-laden wastewater, possibly resulting from the disposal of industrial waste or the seawater intrusion in the municipal wastewater, poses noteworthy operational problems like odor emissions, localized pipe corrosion, and inhibition of conventional biological treatment. To resolve these problems, we have recently developed a new sulfur-cycle enhanced biological phosphorus removal (SC-EBPR) process capable of removing COD, N, and P and controlling sulfide production. This study investigates the possibility of cultivating SC-EBPR biomass under various influent COD and sulfate concentrations (with initial organic carbon (C) to sulfur (S) ratios of 1, 2, and 3 g C/g S), which dominanted by sulfate-reducing bacteria, sulfur-oxidizing bacteria and unknown bacteria. Moreover, anaerobic batch experiments were conducted for (i) elucidating the fundamental mechanisms of carbon uptake/poly-hydroxyalkanoates formation (1.8–3.8 mg C/(gVSS h)), sulfate reduction/sulfur storage (0.9–1.9 mg S/(gVSS h)), and poly-phosphate degradation/P release (0.6–3.0 mg P/(gVSS h)), and (ii) understanding a new anaerobic pathway of simultaneous intracellular uptake of carbon and sulfur (as verified by carbon balance with only 5–10% error). Finally, a possible way of implementing the new SC-EBPR biomass in high-sulfate wastewater treatment was discussed. [ABSTRACT FROM AUTHOR]

The act of modeling and forecasting stock market volatility has become essential to risk management practice; it has emerged as one of the most popular themes in financial econometrics and has been mainly and constantly used in the valuation of financial assets and the Value at Risk, as well as the pricing of options and derivatives, are all part of the process. The purpose of this paper is to contrast the GARCH (Generalized Auto Regressive Conditional Heteroscedasticity) family models -- GARCH, PGARCH, EGARCH, GJR-GARCH, MGARCH, and IGARCH -- with the EWMA (Exponentially Weighted Moving Average) models in the prospect of establishing the best algorithm to forecast TSEC volatility weighted index from Taiwan stock market. We employ daily returns for the range between July 1997 and July 2023. The sample data spans a long time period i.e. 26 years of data with 6375 observations, which includes dramatic events such as the financial crisis of 2008, the COVID-19 epidemic, and the war between Russia and Ukraine. We observe that the asymmetric model PGARCH with a Student's t distribution develops the best model for assessing the volatility of the chosen index, but PGARCH with a normal error distribution produces the best estimating performance outcomes and hence outperforms the EWMA model. The present empirical investigation also seeks to illustrate the potential for investment returns as well as the associated risk. Our findings may have implications for risk management in Taiwan, together with a deeper exploration of the TSEC weighted index from Taiwan stock market volatility dynamics, given the scarcity of prior such studies. [ABSTRACT FROM AUTHOR]

Cataract causes bilateral blindness in 20 million people globally, the vast majority of whom live in developing countries. Manual small-incision cataract surgery (MSICS) has emerged as an efficient and economical alternative to phacoemulsification, giving comparable results in terms of final visual gain. One of the important determinants of postoperative visual gain is the status of the corneal endothelium. Multiple factors such as corneal distortion, irrigation solution turbulence, mechanical trauma by instruments, nuclear fragments, intraocular lens contact, and free oxygen radicals, all have been implicated in causing corneal damage during cataract surgery. MSICS with posterior chamber intraocular lens implantation has been reported to cause an endothelial cell loss of 15.83%, which is comparable with other modes of cataract surgery like extracapsular cataract extraction and phacoemulsification. Thorough preoperative assessment of endothelial status and taking necessary steps for endothelial protection during surgery can decrease the endothelial cell loss and overall burden of pseudophakic bullous keratopathy. In addition to surgical techniques, the type of irrigating solutions, ocular viscoelastic devices, intracameral dyes, and drugs all affect the endothelial cell status. This review presents a summary of available literature on the protection of endothelial cells during different steps of MSICS. This is especially relevant for developing countries where large-scale MSICS cataract surgeries are performed to decrease the cataract blindness burden. [ABSTRACT FROM AUTHOR]

Cooking is known to be one of the most energy-intensive sectors, with an estimated energy consumption of about 30–40% of global energy consumption, with a significant share in developing and underdeveloped countries. Traditional cooking, mainly based on biomass and fossil fuels, is one of the main sources of particulate matter (PM) emissions in household buildings, which is an important risk factor for lung cancer. Due to the negative impact on the environment and the waste of energy by traditional cooking systems, innovative and environmentally friendly cooking technologies are becoming more and more popular. Solar energy, as a renewable resource, is best suited for integration into cookers. Several researchers have studied solar cooking technologies to improve their performance and support their use worldwide. Among various solar cooking technologies, concentrating solar cookers (CSCs) have recently attracted much attention, especially in large-scale cooking, due to their special characteristics of generating high temperatures and significantly reducing cooking time. This study has focused on CSCs including parabolic through solar cookers (PTSCs), parabolic dish solar cookers (PDSCs), and Fresnel lens solar cookers (FLSCs), and describes their various aspects, including their operating principles, design considerations, thermal operation, and test procedures, while recent progress in the research and evolvement of these cookers are comprehensively discussed, taking into account their economic aspects. The major drawback of CSCs remains their high initial cost, especially when thermal energy storage (TES) is integrated. However, overcoming the limitations and realizing the great advantages of CSCs to replace them with other cooking methods can make their use more successful and improve their possibility to become commercial worldwide. [ABSTRACT FROM AUTHOR]

The Korsakoff syndrome is defined as “an abnormal mental state in which memory and learning are affected out of all proportion to other cognitive functions in an otherwise alert and responsive patient.” Confabulation refers to false or erroneous memories arising, not deliberately, in the context of a neurological amnesia and is often thought of as pathognomonic of the Korsakoff syndrome. Although the exact pathophysiology is unknown, various studies have identified brain lesions in the thalami, mammillary bodies, and frontal cortex. We report a case of a 68-year-old male presenting with acute altered mental status on July 16, 2015. The neuropsychological dysfunctions included prominent Korsakoff’s syndrome, which became apparent when the altered mental status resolved. Amnesia was accompanied by prominent confabulation, disorientation, and lack of insight into his own disability. Neuroradiological data indicated that the intralaminar and dorsomedial nuclei in bilateral thalami were infarcted by occlusion of the artery of Percheron. We believe that ours is one of few reported cases of Korsakoff syndrome in a patient with infarction involving the territory of the artery of Percheron. We conclude that bilateral thalamic lesions could cause Korsakoff’s syndrome and the intralaminar and dorsomedial nuclei might be important structures in the pathogenesis of confabulation. [ABSTRACT FROM AUTHOR]