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Blended Elemental powders are an emerging alternative to pre-alloyed powders in metal additive manufacturing due to the wider range of alloys producible with them and the cost savings from not developing novel feedstock. In this study, in situ alloying and concurrent microstructure evolution during SLM are investigated by performing SLM on a BE Ti-185 powder while tracking the surface temperatures via Infra-red imaging and phase transforma- tion via synchrotron X-ray Diffraction. We then performed post-mortem electron microscopy (Backscatter Electron imaging, Energy Dispersive X-ray Spectroscopy and Electron Backscatter Diffraction) to further gain insight into microstructure development. We show that although exothermic mixing aids the melting process, laser melting results only in a mixture of alloyed and unmixed regions. Full alloying and thus a consistent microstructure is only achieved through further thermal cycling in the heat-affected zone.

Objective: Second-hand tobacco smoke (SHS) is a proven risk factor for negativeadverse health outcomes, especiallyparticularly among pregnant women. This study aimsaimed to address the research gap onconcerning the prevalence and correlates of SHS exposure at home and outsidein public settings among non-smoking pregnant women in India., Methods: The dataset offrom the Global Adult Tobacco Survey (GATS) (2016-2017), India, was usedutilised to determineevaluate the prevalence of SHS exposuresexposure in pregnant women both at home and outside.in public spaces. Multivariable logistic regression analysis was usedemployed to identify the determinants of SHS exposure among pregnant women. this population., Results: The prevalence of SHS exposure in theat home was 37% and %, while exposure outside the home was 27%. 10% of allAmong non-smokersmoking pregnant women, 10% were exposed to SHS inon public transport. The risk of SHS exposure in theat home was significantly higher forin the North (AOR-=5.33:; 95% CI-, 2.45-11.60), Central (AOR-=4.46; 95% CI-, 1.98-10.02)), and North-East (AOR-=4.18; 95% CI-, 1.78-9.81) regions compared to the South. Pregnant women aged 25-34 (AOR-=0.61; 95% CI-, 0.39-0.93) and those aged 35 and above (AOR-=0.48; 95% CI-, 0.27-0.86), as well as those with secondary (AOR-=0.50; 95% CI-, 0.30-0.85) or higher education (AOR-=0.30; 95% CI-, 0.15-0.58)), had lower odds of SHS exposuresexposure at home. For SHS exposure outside homes,the home, the North region (AOR-=2.53; 95% CI-, 1.19-5.36), employment status (AOR-=1.99; 95% CI-, 1.13-3.47), and belonging to scheduled tribes (AOR-=3.20; 95% CI-, 1.25-8.21) had were associated with higher odds., Conclusions: The prevalence of SHS exposure among pregnant non-smoking women was high at home as well as outside. SHS exposure at home was significantly associated with age, education, and region. SHS exposure outside homes was significantly associated with employment status, scheduled tribe, and regionnotably high both at home and in external environments.

Aim: Obesity is a major risk factor for diabetic peripheral neuropathy (DPN) in type 2 diabetes (T2D). This study investigated the effect of glucose lowering medication associated with weight change on DPN., Methods: Participants with T2D were grouped based on whether their glucose lowering medications were associated with weight gain (WG) or weight loss (WL). They underwent clinical, metabolic testing and assessment of neuropathic symptoms, vibration perception threshold (VPT), sudomotor function and corneal confocal microscopy (CCM) at baseline and follow-up between 4 and 7 years., Results: Of 76 participants, 69.7% were on glucose lowering medication associated with WG, and 30.3% were on glucose lowering medication associated with WL. At baseline, participants in the WG group had a significantly longer duration of diabetes (p < .01), higher douleur neuropathique en 4 (DN4) score (p < .0001) and VPT (p = .01) compared with those in the WL group. Over a 56-month period, participants in the WG group showed no significant change in body weight (p = .11), HbA1c (p = .18), triglycerides (p = .42), DN4 (p = .11), VPT (p = .15) or Sudoscan (p = .43), but showed a decline in corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL) (p < .0001). Participants in the WL group showed a reduction in weight (p = .01) and triglycerides (p < .05), no change in DN4 (p = .30), VPT (p = .31) or Sudoscan (p = .17) and a decline in the corneal nerve branch density (p < .01)., Conclusions: Participants treated with glucose lowering medication associated with weight gain had worse neuropathy and greater loss of corneal nerves during follow-up, compared to patients treated with medication associated with weight loss., (© 2024 The Author(s). Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society.)

Competing Interests: There are no conflicts of interest.

Introduction: This study was undertaken to investigate whether sustained rather than a single measure of corneal nerve loss was associated with the onset of diabetic peripheral neuropathy (DPN) and the progression of neuropathic symptoms and deficits in individuals with type 2 diabetes (T2D)., Methods: Participants underwent clinical, metabolic testing and assessment of neuropathic symptoms, vibration perception threshold (VPT), sudomotor function, and corneal confocal microscopy (CCM) at baseline, 1, 2, and 4-7 years. Sustained corneal nerve loss was defined as abnormal corneal nerve fiber density (CNFD, <24 fibers/mm 2 ), corneal nerve branch density (CNBD, <21 branches/mm 2 ), and corneal nerve fiber length (CNFL, <16 mm/mm 2 ) persisting for ≥50% of the study duration., Results: A total of 107 participants with a mean duration of T2D of 13.3 ± 7.3 years, aged 54.8 ± 8.5 years, underwent baseline and follow-up assessments over a median duration of 4 years, ranging from 1 to 7 years. The DPN prevalence at baseline was 18/107 (16.8%), and of the 89 participants without DPN at baseline, 13 (14.6%) developed DPN during follow-up. Approximately half of the cohort had sustained corneal nerve damage, and corneal nerve measures were significantly lower in this group than those without sustained damage ( p  < 0.0001). Sustained corneal nerve damage was associated with the development of DPN ( p  < 0.0001), a progressive loss of vibration perception ( p  ≤ 0.05), an increased incidence of burning pain, numbness, or a combination of both ( p  = 0.01-0.001), and a borderline association with progressive sudomotor dysfunction ( p  = 0.07). Sustained abnormal CNFL effectively distinguished between participants who developed DPN and those who did not (AUC: 76.3, 95% CI: 65.9-86.8%, p  < 0.0001), while baseline and other sustained measures did not predict DPN onset., Conclusion: Sustained abnormal CCM is associated with more severe corneal nerve damage, DPN development, and the progression of neuropathic symptoms and deficits. Regular CCM monitoring may enable the identification of those at greater risk of developing and worsening DPN who may benefit from more aggressive risk factor reduction., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ponirakis, Al-Janahi, Elgassim, Homssi, Petropoulos, Gad, Khan, Zaghloul, Ali, Siddique, Mohamed, Ahmed, Dakroury, El Shewehy, Saeid, Mahjoub, Al-Thani, Ahmed, Hussein, Mahmoud, Hadid, Al Obaidan, Salivon, Mahfoud, Zirie, Al-Ansari, Atkin and Malik.)

Penetrating brain trauma is rare. We present a unique case involving a sugarcane injury that penetrated the brain via the orbit following a road traffic accident. A 32-year-old male arrived at our emergency department with a penetrating injury to his left eye. A non-contrast computerized tomography (NCCT) scan of the head showed a foreign body in the left orbit, extending to the frontal lobe. Left frontotemporal craniotomy, anterior cranial fossa exploration, retrieval of the foreign body (a sugarcane piece), and dural repair of the anterior cranial fossa were performed. The patient was discharged and showed positive progress on follow-up. Penetrating trauma to the eyes and brain can be fatal, leading to vision loss. Therefore, early surgical intervention and close coordination between ophthalmologists and neurosurgeons are imperative., Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest., (Copyright © 2024 Korean Neurotraumatology Society.)

Calcified subdural hematoma (CSDH) is a very rare presentation but a known and reported entity in literature. Most of the case reports have been described in children and the elderly. Surgical treatment for CSDH is still considered controversial. We report here a case of calcified subdural hematoma in a middle-aged male that was successfully operated on. A 45-year-old male presented with complaints of right-sided weakness and seizures with a history of head trauma three years ago. Non-contrast computerized tomography (NCCT) head showed calcified subdural hematoma associated with mass effect and midline shift. A frontotemporoparietal craniotomy was done to remove the CSDH. Intra-operatively the brain was pulsating well. He was discharged on the 12th postoperative day and doing well on a follow-up visit., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Anwer et al.)

Anomalous left coronary artery from pulmonary artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare cardiac disease. This condition may present with complications such as myocardial infarction, left ventricular dilatation, mitral regurgitation, and left heart failure in children. We report a case of a four-year-old boy who presented with shortness of breath, palpitations, and recurrent upper respiratory tract infections. He was diagnosed with mitral regurgitation. During the surgery, left coronary artery (LCA) was not present in its anatomical position and ALCAPA was identified. One should keep in mind the possibility of ALCAPA in presentation of mitral regurgitation in children despite not being reported in echocardiography.

Background and objective Lidocaine pretreatment is considered the gold standard for attenuating pain on injection of propofol. Valsalva maneuver (VM) causes baroreceptor reflex arc-induced antinociception by increasing the intrathoracic pressure. We aimed to evaluate the efficacy of VM in alleviating the pain on injection of propofol in this randomized comparative study. Methods A total of 90 patients were recruited for this randomized study. They were classified into two groups. Patients in group D received 5-mL 4% lidocaine in saline intravenously while the venous drainage was occluded. Then they were asked to press a rubber ball as hard as they could. Patients in group V received 5-ml saline pretreatment. They were then asked to perform VM by blowing into rubber tubing connected to a manometer and raising and holding the pressure up to 40 mmHg. The verbal response and behavioral signs were recorded with a score corresponding to no, mild, moderate, or severe pain. A t-test was performed to compare the mean of variables between the two groups. The Kolmogorov-Smirnov test was used for testing the equality of the distribution function of pain scores between the groups. Repeated measures analysis of variance (ANOVA) was performed to test the heart rate and mean arterial pressure (MAP) at different points of observation. Results The incidence of pain and pain scores were significantly higher among the patients in the VM group as compared to those in the lidocaine with distraction group. Conclusions VM performed immediately before the injection failed to attenuate the pain produced by propofol as compared to lidocaine pretreatment along with distraction., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Ahmed et al.)

Background: Amidst the COVID-19 pandemic, telemedicine was rapidly implemented to maintain patient care during quarantine. However, there is little data on how this transition may have impacted weight loss outcomes and interventions among patients with overweight or obesity., Methods: This was a retrospective observational study of adults who established care for medically managed obesity at the Weill Cornell Comprehensive Weight Control Center during September-November 2019 and May-July 2020 and who completed 6 months of follow-up. Weight loss outcomes and weight management interventions were explored and stratified by patient-provider interaction: in-person visits only, in-person and video visits, and video visits only., Results: Of 499 charts eligible for review, 245 (49%) returned for their 6-month follow-up visit and were included for analysis. Of 245 patients, 69 had in-person visits only ("in-person"), 85 started in-person and later switched to video visits ("hybrid"), and 91 had video visits only ("video"). All cohorts were predominantly white and female. Median ages were 56, 49, and 49 years; baseline median weights were 98.9, 96.8, and 93.0 kg; and baseline median BMIs were 35.3, 34.4, and 34.0 kg/m 2 for in-person, hybrid, and video cohorts, respectively. The median percent weight changes over 6 months were not significantly different among cohorts: -4.3% [-8.5, -1.5] in the in-person cohort, -5.6% [-8.7, -2.2] in the hybrid group, and -5.8% [-9.7, -2.4] in the video cohort. The percent of patients who achieved ≥5% weight loss were also similar: 46.4%, 55.3%, and 59.3%, respectively. The median number of visits in the video cohort was more than in the in-person or hybrid groups (5 vs. 4). Median number of anti-obesity medications (AOMs) prescribed was similar among groups. The most common AOMs were metformin (all cohorts) followed by semaglutide 1.0 mg (in-person and video) or topiramate (hybrid)., Conclusion: Patients on anti-obesity medications who were followed for 6 months via video or video plus in-person visits (hybrid) experienced clinically significant weight loss. Median number of AOMs were similar among groups, and the most common AOMs were metformin, semaglutide 1.0 mg, and topiramate. More investigation is required to compare telemedicine models with in-person care., Competing Interests: LJA reports receiving consulting fees from and serving on advisory boards for Jamieson Laboratories, Pfizer, Novo Nordisk, Eisai, Erx Pharmaceuticals, Real Appeal, Janssen Pharmaceuticals, and Gelesis; receiving research funding from Aspire Bariatrics, Allurion, Eisai, AstraZeneca, Gelesis, Janssen Pharmaceuticals and Novo Nordisk; having equity interests in Intellihealth Corp, Allurion, Erx Pharmaceuticals, Zafgen, Gelesis, Myos Corp., and Jamieson Laboratories; and serving on a board of directors for Intellihealth Corp., Myos Corp., and Jamieson Laboratories. BGT reports consulting and/or commission fees from Novo Nordisk, 2nd.MD, Intellihealth, and Elsevier. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tchang, Morrison, Kim, Ahmed, Chan, Alonso, Aronne and Shukla.)

Introduction: Pseudoaneurysm of the uterine artery is a condition in which extra luminal collection of blood with a turbulent flow that communicates with flowing blood of uterine artery through a defect in its arterial wall. As per literature uterine artery pseudoaneurysm is a very rare condition and its incidence is 2-3/1000 deliveries. Clinical diagnosis is very challenging and in the index case haematuria was the presenting complaint which in fact is the extremely rare presenting complaint. Angioembolization is the ideal treatment modality for such a rare condition., Case Presentation: A 25-year old female presented in a shock state with history of massive haematuria two months after delivering a baby. She was resuscitated with fluid, blood and blood products. A computed tomography angiogram was done which showed a large pseudoaneurysm of the left uterine artery so consequently angioembolization was done with n-butyl cyanoacrylate (NBCA) and lipoid mixture. Serial assessment of biochemical and clinical parameters depicted improvement in the clinical status of the patient. She was doing well at 6 months of follow up., Discussion: A post-partum massive haematuria could be due to pseudo aneurysm of uterine artery. The presentation of haematuria may occur due to communication of aneurysm with urinary bladder and which further get ruptured. Aggressive resuscitation and angioembolization of the pseudoaneurysm is employed to treat such patients., Conclusion: Pseudoaneurysm of uterine artery is rare condition which may present as haematuria. Once clinical diagnosis is suspected it's better to first resuscitate and plan for angioembolization for better outcome., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)