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Acute Pancreatitis (AP) is a prevalent and rapidly progressive inflammatory disorder of the pancreas, often presenting with abdominal pain and elevated serum pancreatic enzymes. The present case report emphasises the crucial need for accurately diagnosing the underlying cause of Hypertriglyceridemic Pancreatitis (HTGP) in patients who present without any pre-existing co-morbidities. A 16-year-old female presented with a three-day history of generalised abdominal pain, vomiting and low-grade fever, with no co-morbidities. Initial clinical assessment revealed signs of dehydration, tachypnoea, tachycardia and diffuse abdominal tenderness. Laboratory workups indicated a significant rise in amylase and lipase, hyperglycaemia, metabolic acidosis and pronounced Hypertriglyceridemia (HTG). Imaging studies corroborated the diagnosis of AP, revealing necrotic fluid collections. The patient was immediately started on plasmapheresis, aggressive intravenous fluid resuscitation, insulin infusion and supportive care, which included electrolyte correction, pain management and vigilant monitoring of vital signs. The autoantibody panel for type 1 diabetes, Antiglutamic Acid Decarboxylase antibodies (GAD) returned positive. Over the following days, the patient exhibited marked clinical improvement, with decreased abdominal tenderness, stabilisation of vital parameters and normalisation of biochemical abnormalities. Subsequent imaging confirmed the resolution of pancreatitis. Upon discharge, the patient was prescribed a regimen of insulin, statins, fenofibrate and saroglitazar for ongoing management of her lipid levels and diabetes. This case underscores that HTG may present as the first clinical manifestation of Type 1 Diabetes Mellitus. It also emphasises the critical importance of prompt and coordinated therapeutic interventions in managing HTGP, where early and effective treatment is crucial for optimising patient outcomes.

Article highlights The present investigation explores the harmful gases emission reduction analysis of biodiesel by varying the load, IMEP and proportion of CuO nanoparticles on CI engine testing. Modification of fuel with nanotechnology can be a cost-effective option instead of costlier engine modification. Lesser emission is obtained with WCO biodiesel blend B30 by adding nanoparticles CuO in it.

When we talk about severe malaria, we usually think of Plasmodium falciparum. However, in recent times, Plasmodium vivax has also been reported to cause severe multi-organ dysfunction and life-threatening disease similar to P. falciparum. We report here a case of P. vivax malaria in a young boy from an endemic zone, who developed acute renal failure, severe thrombocytopenia, and anemia and later developed spontaneous subarachnoid hemorrhage. Multisystem involvement in a patient with P. vivax is rare, and subarachnoid hemorrhage is an unusual presentation.

The His274→Tyr (H274Y) oseltamivir (Tamiflu) resistance mutation causes a substantial decrease in the total levels of surface-expressed neuraminidase protein and activity in early isolates of human seasonal H1N1 influenza, and in the swine-origin pandemic H1N1. In seasonal H1N1, H274Y only became widespread after the occurrence of secondary mutations that counteracted this decrease. H274Y is currently rare in pandemic H1N1, and it remains unclear whether secondary mutations exist that might similarly counteract the decreased neuraminidase surface expression associated with this resistance mutation in pandemic H1N1. Here we investigate the possibility of predicting such secondary mutations. We first test the ability of several computational approaches to retrospectively identify the secondary mutations that enhanced levels of surface-expressed neuraminidase protein and activity in seasonal H1N1 shortly before the emergence of oseltamivir resistance. We then use the most successful computational approach to predict a set of candidate secondary mutations to the pandemic H1N1 neuraminidase. We experimentally screen these mutations, and find that several of them do indeed partially counteract the decrease in neuraminidase surface expression caused by H274Y. Two of the secondary mutations together restore surface-expressed neuraminidase activity to wildtype levels, and also eliminate the very slight decrease in viral growth in tissue-culture caused by H274Y. Our work therefore demonstrates a combined computational-experimental approach for identifying mutations that enhance neuraminidase surface expression, and describes several specific mutations with the potential to be of relevance to the spread of oseltamivir resistance in pandemic H1N1.

Acute Pancreatitis (AP) is a prevalent and rapidly progressive inflammatory disorder of the pancreas, often presenting with abdominal pain and elevated serum pancreatic enzymes. The present case report emphasises the crucial need for accurately diagnosing the underlying cause of Hypertriglyceridemic Pancreatitis (HTGP) in patients who present without any pre-existing co-morbidities. A 16-year-old female presented with a three-day history of generalised abdominal pain, vomiting and low-grade fever, with no comorbidities. Initial clinical assessment revealed signs of dehydration, tachypnoea, tachycardia and diffuse abdominal tenderness. Laboratory workups indicated a significant rise in amylase and lipase, hyperglycaemia, metabolic acidosis and pronounced Hypertriglyceridemia (HTG). Imaging studies corroborated the diagnosis of AP, revealing necrotic fluid collections. The patient was immediately started on plasmapheresis, aggressive intravenous fluid resuscitation, insulin infusion and supportive care, which included electrolyte correction, pain management and vigilant monitoring of vital signs. The autoantibody panel for type 1 diabetes, Antiglutamic Acid Decarboxylase antibodies (GAD) returned positive. Over the following days, the patient exhibited marked clinical improvement, with decreased abdominal tenderness, stabilisation of vital parameters and normalisation of biochemical abnormalities. Subsequent imaging confirmed the resolution of pancreatitis. Upon discharge, the patient was prescribed a regimen of insulin, statins, fenofibrate and saroglitazar for ongoing management of her lipid levels and diabetes. This case underscores that HTG may present as the first clinical manifestation of Type 1 Diabetes Mellitus. It also emphasises the critical importance of prompt and coordinated therapeutic interventions in managing HTGP, where early and effective treatment is crucial for optimising patient outcomes. [ABSTRACT FROM AUTHOR]

To ensure the safety and dependability of rubber components, deflection analysis and prediction play a crucial role in process of design. Material property testing and finite element analysis (FEA) are combined to forecast the maximum deflection of a railway elastomeric pad. IRMRA (Indian Rubber Manufacturer's Research Association) developed the chloroprene rubber. Using the FEA method, maximum deflections of an anti-vibration mount under several compressive loads are calculated. Mooney-Rivlin nonlinear hyperelastic three parameter model with element type Plane 182 is used for and FEA. Curve fitting of the uniaxial tensile test results is used to extract three parameter Mooney-Rivlin model constants by using FEA. Then, these Mooney-Rivlin model constants are used to analyze anti-vibration mount and predict the deflections at different compressive loads. The outcomes are contrasted with the technical specifications provided by the Research Designs and Standards Organization of Indian Railway and predicted deflections are within the limits of maximum values allowed. The results are also contrasted with data from literature, and 10% variation is observed between results obtained and literature results. This methodology can be used to predict deflections of any newly developed rubber at initial stage of design. [ABSTRACT FROM AUTHOR]

In the present research work, ultrasound-assisted synthesis of a series of novel azomethine derivatives of 1-phenylimidazo[1,5-a]pyridine has been achieved. The synthetic route involves the conversion of ethyl-1-phenylimidazo-[1,5-a]pyridine-3-carboxylate to 1-phenylimidazo[1,5-a]pyridine-3-carbohydrazide followed by nucleophilic addition-elimination reaction with diverse aromatic aldehydes. The developed clean and simple protocol offers a set of advantages such as mild reaction conditions, environment friendliness, and high atom economy apart from excellent yields (70–92%). All compounds were found to be stable in atmospheric conditions for a long period of time and were soluble in polar solvents. [ABSTRACT FROM AUTHOR]

Background: Giant cell tumor is a locally aggressive tumor of the bone. In the predenosumab era, treatment comprised surgery or radiotherapy in potentially resectable lesions. After the advent of denosumab, utilizing neoadjuvant denosumab followed by surgery has emerged as an effective treatment option. Objectives: We aimed primarily to assess and compare the locoregional failure-free survival of patients with giant cell tumor of the bone (GCTB) treated with either external beam radiotherapy or neoadjuvant denosumab followed by surgery. The secondary objective was to assess and compare the quality of life (QoL) of patients between the two arms. Materials and Methods: In this single institutional retrospective study, conducted between August 2022 and August 2023 in the Department of Radiotherapy in the Institute of Post Graduate Medical Education and Research and SSKM Hospital Kolkata, West Bengal, India, we included patients with histopathologically proven GCTB. These patients were treated with either radiotherapy (54 Gray in 27 fractions) or neoadjuvant denosumab (for 8 doses) followed by surgery and were followed up at least for 6 months after completing the first-line therapy. Patients were monitored every 3 months for 2 years and then every 6 months thereafter. Locoregional control of the tumor was assessed by clinical examination and imaging. QoL was assessed and compared by the EQ-5D-5L questionnaire and health today scoring system. Results: We enrolled 22 patients in the radiotherapy alone group and 26 patients in the group receiving neoadjuvant denosumab followed by surgery. The 5-year locoregional failure-free survival was achieved in 18/22 patients (81.8%) in the radiotherapy arm and in 20/26 patients (76.9%) in the neoadjuvant denosumab group (P, 0.680). There was no significant difference in the QoL between the two groups of patients (P, 0.850). Conclusion: Radiotherapy and neoadjuvant denosumab followed by surgery result in similar locoregional control and quality of life in the patients with giant cell tumor of bones, and both can be considered appropriate treatment options in patients with initially unresectable tumors.

Abstract Alloys of platinum with alkaline earth metals promise to be active and highly stable for fuel cell applications, yet their synthesis in nanoparticles remains a challenge due to their high negative reduction potentials. Herein, we report a strategy that overcomes this challenge by preparing platinum-magnesium (PtMg) alloy nanoparticles in the solution phase. The PtMg nanoparticles exhibit a distinctive structure with a structurally ordered intermetallic core and a Pt-rich shell. The PtMg/C as a cathode catalyst in a hydrogen-oxygen fuel cell exhibits a mass activity of 0.50 A mgPt −1 at 0.9 V with a marginal decrease to 0.48 A mgPt −1 after 30,000 cycles, exceeding the US Department of Energy 2025 beginning-of-life and end-of-life mass activity targets, respectively. Theoretical studies show that the activity stems from a combination of ligand and strain effects between the intermetallic core and the Pt-rich shell, while the stability originates from the high vacancy formation energy of Mg in the alloy.

The electron-electron and electron-phonon coupling in complex materials can be more complicated than simple density-density interactions, involving intertwined dynamics of spin, charge, and spatial symmetries. This motivates studying universal models with complex interactions and whether BCS-type singlet pairing is still the “natural” fate of the system. To this end, we construct a Yukawa-SYK model with nonlocal couplings in both spin and charge channels. Furthermore, we provide for time-reversal-symmetry breaking dynamics by averaging over the Gaussian unitary ensemble rather than the orthogonal ensemble. We find that the ground state of the system can be an orbitally nonlocal superconducting state arising from incoherent fermions with no BCS-like analog. The superconductivity has an equal tendency to triplet and singlet pairing states separated by a non-Fermi liquid phase. We further study the fate of the system within the superconducting phase and find that the expected ground state, away from the critical point, is a mixed singlet/triplet state. Finally, we find that, while at T_{c} the triplet and singlet transitions are dual to one another, below T_{c} the duality is broken, with the triplet state more susceptible to orbital fluctuations just by its symmetry. Our results indicate that such fluctuation-induced mixed states may be an inherent feature of strongly correlated materials.

Background The paucity of state-supported rehabilitation for chronically ill patients with long-term tracheostomies has ramifications of prolonged hospital-stay, increased burden on acute-care resources, and nosocomial infections. Few interventions describe home rehabilitation of adult tracheostomized patients. Almost none involve stakeholders. This paper describes the All-India Institute of Medical Sciences (AIIMS) ICU rehabilitation (AIR) healthcare intervention developed to facilitate home rehabilitation of chronically ill tracheostomized patients. Methods The AIR intervention development was based on the experience-based codesign theory (EBCD). A core research-committee studied prevalent knowledge and gaps in the area. Patients-carer and health-care stakeholders’ experiences of barriers and facilitators to home care resulted in an intervention with interlinked components: family-carer training, equipment bank, m-health application, and follow-up, guided by the Medical Research Council (MRC) framework. Healthcare stakeholders (doctors, nurses, medical equipment vendors) and patient-carer dyads were engaged to gather experiences at various stages to form smaller codesign teams for each component. Multiple codesign meetings iteratively allowed refinement of the intervention over one year. The Template for Intervention Description and Replication (TIDieR) checklist was used to report the AIR intervention. Results The first component comprised a minimum of three bedside hands-on training sessions for carers relating to tracheostomy suction, catheter care, monitoring oxygenation, enteral feeding, skincare, and physiotherapy, buttressed by pictorial-books and videos embedded in a mobile-application. The second was an equipment-bank involving a rental-retrieval model. The third component was a novel m-health tool for two-way communication with the core group and community of other patient-carers in the project for follow-up and troubleshooting. Home visits on days 7 and 21 post-discharge assessed patient hygiene, nutrition, physiotherapy, and established contact with the nearest primary healthcare facility for the future. Conclusions Findings support the EBCD-based development using active feedback from stakeholders. Assessment of feasibility, process and effectiveness evaluation will follow.

This paper proposed the design and development of reversible cost-efficient innovative quantum dual-full adder and subtractor or QD-FAS circuit using quantum gate. The proposed circuit can be used as full adder and full subtractor simultaneously, which is designed using double Peres gate or DPG and Feynman gate or FG. The quantum cost, garbage output and constant input of the QD-FAS is 8, 1 and 1. Which is better w.r.t previously reported work. The QD-FAS circuit, as proposed, includes shared sum and difference terminals, as well as a carry-out and a borrow output terminal. Notably, this innovation showcases a remarkable 27.27% reduction in quantum cost. The improvement in garbage output is even more striking, showing a 50% enhancement. When assessing the overall advancement in quantum cost, it falls within the range of 27.27% to 66.66%. To confirm the viability of this design, extensive testing is carried out using the IBM Qiskit simulator. This design holds significant importance in a variety of applications, including quantum computing, cryptography, and the realm of reversible Arithmetic Logic Units (ALU).