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Background: Intraligamentary anesthesia (ILA) injection using a single-tooth anesthesia (STA) system has been used as a supplementary technique for pulpal anesthesia in cases of irreversible pulpitis. Aims and Objective: The current clinical trial was undertaken to assess and compare the effectiveness of the conventional inferior alveolar nerve block (IANB) and the ILA technique utilizing the STA system for endodontic management of mandibular molars presenting symptomatic irreversible pulpitis. Materials and Methods: Patients diagnosed with symptomatic irreversible pulpitis inmandibular molar were allocated into two groups: Group I IANB (n=30) and Group II- STA system (n=30). The onset of anesthesia was evaluated using the electric pulp test, whereas for pain perception the Heft-Parker Visual Analog Scale score was recorded before, during, and after anesthesia. Post-anesthetic pain was recorded at 3 h, 24 h, and 1 week. The collected data was evaluated for effectiveness pain perception, and acceptability of the anesthetic technique, using appropriate statistical tests. Results: The mean time of onset for the Group II STA system (2.93±1.80) was significantly higher (P=0.0001) than Group I IANB (1.40±0.86). Pain at the site of injection was insignificant (P>0.05) between both groups. The severity of pain during the root canal procedure was significantly different (P

We introduce a novel framework for studying small-scale primordial perturbations and their cosmological implications. The framework uses a deep reinforcement learning to generate scalar power spectrum profiles that are consistent with current observational constraints. The framework is shown to predict the abundance of primordial black holes and the production of secondary induced gravitational waves. We demonstrate that the set up under consideration is capable of generating predictions that are beyond the traditional model-based approaches.

The ultraviolet (UV) radiation triggers a pigmentation response in human skin, wherein, melanocytes rapidly activate divergent maturation and proliferation programs. Using single-cell sequencing, we demonstrate that these 2 programs are segregated in distinct subpopulations in melanocytes of human and zebrafish skin. The coexistence of these 2 cell states in cultured melanocytes suggests possible cell autonomy. Luria-Delbrück fluctuation test reveals that the initial establishment of these states is stochastic. Tracking of pigmenting cells ascertains that the stochastically acquired state is faithfully propagated in the progeny. A systemic approach combining single-cell multi-omics (RNA+ATAC) coupled to enhancer mapping with H3K27 acetylation successfully identified state-specific transcriptional networks. This comprehensive analysis led to the construction of a gene regulatory network (GRN) that under the influence of noise, establishes a bistable system of pigmentation and proliferation at the population level. This GRN recapitulates melanocyte behaviour in response to external cues that reinforce either of the states. Our work highlights that inherent stochasticity within melanocytes establishes dedicated states, and the mature state is sustained by selective enhancers mark through histone acetylation. While the initial cue triggers a proliferation response, the continued signal activates and maintains the pigmenting subpopulation via epigenetic imprinting. Thereby our study provides the basis of coexistence of distinct populations which ensures effective pigmentation response while preserving the self-renewal capacity.

Medical and educational techniques and approaches have evolved globally over the past few decades. The modern approach is more learner-centred, with a focus on the acquisition of skills. The recently implemented competency-based medical education (CBME) for the National Medical Commission (NMC) undergraduate course curriculum is also competency-based rather than an outcome-based traditional curriculum. It is vital to embrace innovative teaching–learning and educational strategies to achieve the aspiration of CBME. This article provides a list of some of the newer tools and their perceived advantages and challenges and serves as a guide for using these methods effectively to meet the objectives of CBME as proposed by the NMC. Virtual teaching, learning from digital resources, objective-structured practical and clinical examination, flipped classroom, case-based learning, serious gaming, simulation-based learning and learning from role-plays and portfolios emerged as novel instructional strategies.

Patients with head and neck cancer (HNC) have ongoing pain but Stellate ganglion block which is a sympatholytic block may be a viable therapy for treating it. The data were retrospectively collected from five histopathologically confirmed HNC patients who had completed chemotherapy and radiation doses. Stellate ganglion block was given to these patients and was subsequently monitored for 3 months to assess pain alleviation and overall satisfaction. Over a 3-month period, there was a decrease in the pain levels with a better quality of life so the stellate ganglion block can be a promising modality for reducing the pain of HNC.

Over the past decade, the use of Unmanned Aerial Vehicles (UAVs) has grown significantly due to their agility, maneuverability, and rapid deployability. An important application is the use of UAV-mounted 360-degree cameras for real-time streaming of Omnidirectional Videos (ODVs), enabling immersive experiences with up to six Degrees-of-freedom (6DoF) for applications like remote surveillance and gaming. However, streaming high-resolution ODVs with low latency (below 1 second) over an air-to-ground (A2G) wireless channel faces challenges due to its inherent non-stationarity, impacting the Quality-of-experience (QoE). Limited onboard energy availability and energy consumption variability based on flight parameters add to the complexity. This paper conducts a thorough survey of challenges and research efforts in UAV-based immersive video streaming. First, we outline the end-to-end 360-degree video transmission pipeline, covering coding, packaging, and streaming with a focus on standardization for device and service interoperability. Next, we review the research on optimizing video streaming over UAV-to-ground wireless channels, and present a real testbed demonstrating 360-degree video streaming from a UAV with remote control over a 5G network. To assess performance, a high-resolution 360-degree video dataset captured from UAVs under different conditions is introduced. Encoding schemes like AVC/H.264, HEVC/H.265, VVC/H.266, VP9, and AV1 are evaluated for encoding latency and QoE. Results show that HEVC‘s hardware implementation achieves a good QoE-latency trade-off, while AV1’s software implementation provides superior QoE. The paper concludes with discussions on open challenges and future directions for efficient and low-latency immersive video streaming via UAVs.

Abstract Intra-tumor heterogeneity contributes to treatment failure and poor survival in urothelial bladder carcinoma (UBC). Analyzing transcriptome from a UBC cohort, we report that intra-tumor transcriptomic heterogeneity indicates co-existence of tumor cells in epithelial and mesenchymal-like transcriptional states and bi-directional transition between them occurs within and between tumor subclones. We model spontaneous and reversible transition between these partially heritable states in cell lines and characterize their population dynamics. SMAD3, KLF4 and PPARG emerge as key regulatory markers of the transcriptional dynamics. Nutrient limitation, as in the core of large tumors, and radiation treatment perturb the dynamics, initially selecting for a transiently resistant phenotype and then reconstituting heterogeneity and growth potential, driving adaptive evolution. Dominance of transcriptional states with low PPARG expression indicates an aggressive phenotype in UBC patients. We propose that phenotypic plasticity and dynamic, non-genetic intra-tumor heterogeneity modulate both the trajectory of disease progression and adaptive treatment response in UBC.

Background: The purpose of this study is to explore the effect of vitamin B complex supplementation following periodontal flap surgery on clinical and microbiological parameters. Materials and Methods: A randomized controlled trial on 10 patients with periodontitis in split-mouth design was undertaken to find the effect of vitamin B complex supplementation with open flap debridement on periodontal wound healing. Multiplex polymerase chain reaction (PCR) for Tannerella forsythus and Porphyromonas gingivalis was done using subgingival plaque samples at 0 and 90th day. Results: The results showed a significant reduction (P < 0.01) of clinical (plaque index, gingival index, gingival bleeding index, probing pocket depth, and relative attachment level) and microbial profile in both treatment groups, whereas on intergroup analysis, more reduction in all clinical parameters were observed in the test group, but statistically, the results were insignificant.

Spinal dysraphism (SD) is a collective term for congenital malformations of the spine and spinal cord. It includes a wide range of congenital anomalies resulting from aberrations in the stages of gastrulation, primary neurulation and secondary neurulation. Spinal dysraphism may lead to neurological impairment of varying severity including weakness of the extremities, incontinence of bowel and bladder, sexual dysfunction, among others. Diagnosis of SDs is quite challenging because of its wide spectrum and complex cascade of embryologic events. Knowledge of normal embryology and proper understanding of imaging features of SD are important for early accurate diagnosis. Contribution: This series of five cases describes the imaging spectrum of spinal dysraphism and highlights the embryological basis for their development, which could facilitate early correct diagnosis, surgical planning and reduced morbidity related to these malformations. It also includes an extremely rare case of complex spinal dysraphism (Type II diastematomyelia with right hemimyelomeningocoele and left hemilipomyelomeningocoele) with Chiari II malformation.

Summary: The Epithelial-to-Mesenchymal Transition (EMT) is a hallmark of cancer metastasis and morbidity. EMT is a non-binary process, and cells can be stably arrested en route to EMT in an intermediate hybrid state associated with enhanced tumor aggressiveness and worse patient outcomes. Understanding EMT progression in detail will provide fundamental insights into the mechanisms underlying metastasis. Despite increasingly available single-cell RNA sequencing (scRNA-seq) data that enable in-depth analyses of EMT at the single-cell resolution, current inferential approaches are limited to bulk microarray data. There is thus a great need for computational frameworks to systematically infer and predict the timing and distribution of EMT-related states at single-cell resolution. Here, we develop a computational framework for reliable inference and prediction of EMT-related trajectories from scRNA-seq data. Our model can be utilized across a variety of applications to predict the timing and distribution of EMT from single-cell sequencing data.

In this work, evidence of isothermal magnetic entropy change (∆SM) over a broad temperature region is presented in a series of La1.4Sr1.6Mn2−xNbxO7 Ruddlesden–Popper compounds with niobium modification (Nb) (0.0 ≤ x ≤ 0.15) at the manganese (Mn) site. The ceramic samples were obtained through a solid-state sintering method in optimized conditions. All compounds predominantly possessed Ruddlesden–Popper phase while a few additional reflections were resolved in Nb-doped compounds which indicates the separation of structural phases. These peaks are assigned to a separate layered perovskite and single perovskite with tetragonal symmetry and hexagonal symmetry, respectively. The microstructure of the pure sample reveals uniform grain morphology but in Nb-doped specimens chiefly three types of grains were found. It was assumed that the inter-connected large particles were of R-P phase which is dominant in both parent and x = 0.05 compounds, while the hexagonal and polygonal morphology of grains in higher concentrations of dopants directly corroborates with the symmetry of single perovskite and additional layered perovskite phases, respectively. The parent compound exhibits a single ∆SM curve, whereas all Nb-substituted samples display bifurcated ∆SM curves. This indicated two transition regions with multiple magnetic components, attributed to distinct structural phases. The highest ∆SM values obtained for components corresponding to the R-P phase are 2.32 Jkg−1k−1, 0.75 Jkg−1k−1, 0.58 Jkg−1k−1 and 0.43 Jkg−1k−1 and for the second component located around room temperature are 0.0 Jkg−1k−1, 0.2 Jkg−1k−1, 0.28 Jkg−1k−1 and 0.35 Jkg−1k−1 for x = 0.0, 0.05, 0.10 and 0.15 compositions, respectively, at 2.5 T. Due to the collective participation of both components the ∆SM was expanded through a broad temperature range upon Nb doping.

Introduction: Despite various advancements over last two decades in pain medicine, post-operative pain remains inadequately addressed, even in a tertiary medical center. There are very limited studies addressing post-operative pain management in India. Few published studies have assessed post-operative pain, but only at 24 hours intervals, and utilising tools focusing on any one parameter of pain. Hence, a holistic assessment using four different pain assessment tools should be done to get a wider overview of the condition. Aim: To assess the intensity and severity of post-operative pain at 6, 12, 24 & 48 hours postoperatively for patients undergoing surgery for orthopaedics, gastrointestinal, general surgery, obstetrics & gynaecological ailments and patient satisfaction at 24 hours postoperatively. Materials and Methods: A prospective observational survey was conducted at a tertiary care centre of New Delhi from October 2020 to October 2021. Three scales were used to determine the status of post-operative pain at 6,12,24 and 48 hours follow-up. The three different pain scales were Numerical Pain Rating Scale (NRS-pain) static and dynamic, Global Perceived Effect (GPE) and Neuropathic Pain System Inventory (NPSI). Results: Total of 400 patients, with mean age of the study population was 43.26±4.98 years. Majority were males, 250 (60%) and of ASA Grade I, 208 (52%). Significant improvement was observed in the NRS pain score at each follow-up among those undergoing orthopaedic surgery, general surgery, and gynaecological procedures. Improvement in the mean GPE scale was only seen for orthopaedic surgeries. There was a significant neuropathic pain component observed in all the surgeries except gynaecological surgeries. Majority 321 (80.25%) had received information about their pain treatment but only 174 (43.5%) were satisfied with their pain treatment. Conclusion: A majority of the patients undergoing orthopaedic or general surgery, and gynaecological procedures had improvement in pain. This survey highlights the need for investigating future post-operative pain management protocols so that the intensity of post-operative pain, incidence of chronic persistent pain & resulting suffering, as well as disability, can be minimised to a large extent.

Background: Warfarin is traditionally the drug of choice for stroke prophylaxis or treatment of venous thromboembolism in patients with end-stage renal disease (ESRD) on hemodialysis as data on apixaban use is scarce. We aimed to assess the safety and efficacy of Apixaban in patients with ESRD on hemodialysis when compared with warfarin. Methods: A comprehensive literature search in PubMed, Google Scholar, and Cochrane databases from inception until Nov 25, 2019, was performed. Studies reporting clinical outcomes comparing Apixaban (2.5 mg BID or 5 mg BID) versus Warfarin in ESRD patients on hemodialysis were included. Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data. Results: Four studies (three retrospective and one randomized) with a total of 9862 patients (apixaban = 2,547, warfarin = 7315) met inclusion criteria. The overall mean age was 66.6 ± 3.9 years and mean CHA2DS2-VASc score 4.56 ± 0.58. Apixaban was associated with lower rates of major bleeding (RR 0.53, 95% CI 0.45–0.64, p

Surgical internal drainage of pancreatic pseudocyst can be done into the stomach, duodenum or jejunum depending on the anatomic relation of pseudocyst with hollow viscera. For cystojejunostomy, a Roux-en-Y loop is preferred over loop cystojejunostomy as former is thought to avoid the reflux of jejunal contents into the cyst cavity. This study presents our experience with laparoscopic loop cystojejunostomy showing loop cystojejunostomy for the pseudocyst of the pancreas can be safely performed laparoscopically with simpler technique with no complications including reflux.

Context: Class V cavity presents a clinical challenge in the field of restorative dentistry as the margin placement is partially in enamel and partly in cementum, and the trouble associated with this design is the microleakage at the tooth restoration interface. Aims: To evaluate and compare marginal microleakage in Class V cavities when restored with flowable composite and Cention-N restorative material. Methods and Material: This in-vitro study was performed on 30 human maxillary premolars, which were extracted for orthodontic reasons. Class V cavities were prepared on the buccal surfaces of each tooth. After application of seventh-generation bonding agent (3M ESPE, Single Bond Universal Adhesive), the teeth were divided into two groups of 15 each and restored with flowable composite (3M ESPE Filtek Z350 XT) and Cention-N (Ivoclar Vivadent) and were subjected to thermocycling. The teeth were then immersed in 0.1% Rhodamine B dye for 48 h. They were sectioned longitudinally into mesial and distal parts with the help of an isomet diamond saw. The sections were observed under a confocal laser scanning microscope (CLSM). Statistical Analysis Used: The results were subjected to statistical analysis using the Mann–Whitney U test and Pearson's Chi-square test. Results: The analysis showed statistically significant results among the groups. Cention-N showed lesser microleakage, which was statistically significant when compared to flowable composite (P = 0.005). Conclusions: Cention-N showed significantly lesser leakage and better adaptation than flowable composite.

Background: Gutta-percha cones used directly from the manufacturer's sealed packs harbour micro-organisms. During clinical use, the chances of contamination of gutta-percha increases. Hence, disinfection of gutta-percha cones before use is essential to prevent canal recontamination. Aim: To evaluate the antimicrobial efficacy of babul against chemical disinfectants, and its effectiveness in disinfecting gutta-percha cones. Materials and Methods: The extract of babul was used to assess its antimicrobial activity against E-faecalis, S. aureus and C. albicans using the agar diffusion method. A total of 120 cones acquired from freshly opened manufacturers' pack were cut into three equal parts and divided into group I which was directly placed into a nutrient broth, group II was clinically contaminated with gloves for 30 s and placed into a nutrient broth, and the third part was clinically contaminated with gloves and decontaminated for 5 min using the experimental disinfectants to check for the presence of turbidity. Statistical Analysis: The data were analysed by an Unpaired t-test and Chi-square test at a significance level of P < 0.05 using software SPSS 20. Results: Two percent chlorhexidine showed maximum antibacterial action against E. faecalis and S. aureus followed by babul extract. It was also found more efficacious in decontaminating gutta-percha cones followed by babul and 3% sodium hypochlorite in 5 min. Conclusion: Babul herbal extract is indeed effective in decontaminating gutta-percha cones and is a better alternative to chemical disinfectants.

We consider a scenario of large-scale modification of gravity that does not invoke extra degrees of freedom, but includes coupling between baryonic matter and dark matter in the Einstein frame. The total matter energy density follows the standard conservation, and evolution has the character of deceleration in this frame. The model exhibits interesting features in the Jordan frame realised by virtue of a disformal transformation where individual matter components adhere to standard conservation but gravity is modified. A generic parametrization of disformal transformation leaves thermal history intact and gives rise to late time acceleration in the Jordan frame, which necessarily includes phantom crossing, which, in the standard framework, can be realised using at least two scalar fields. This scenario is embodied by two distinguished features, namely, acceleration in the Jordan frame and deceleration in the Einstein frame, and the possibility of resolution of the Hubble tension thanks to the emergence of the phantom phase at late times.

In this study, our aim is to investigate the structural, magnetic, and magnetocaloric properties of the FeNi binary alloy. The FeNi alloy with Fe65Ni35 composition was prepared by ball milling followed by the annealing and quenching processes. A Rietveld refinement analysis of structural results reveals that this system has coexisting cubic structural phases with a dominant face-centered cubic phase (Fm-3m;γ-FeNi). Magnetization results of this compound indicate the presence of ferromagnetic ordering and the magnetic transition observed around 100 K. Moreover, an Arrott plot study provides information about the order of phase transition, which is found in the second-order near the ordering temperature, whereas first-order nature is also noted in the low-temperature region. The significant magnetocaloric parameters, i.e., magnetic entropy change (ΔSM~0.495 J/kg-K) and relative cooling power (88 J/kg), are noted over a wide temperature range. The power law dependency of magnetic entropy change with the applied field is also investigated. Due to their significant magnetocaloric performance over a wide temperature range, these multiphase alloys may be a good candidate for room-temperature to low-temperature magnetic refrigeration.

Iron-transition metal-based binary and ternary alloys have attracted great attention due to their relevant mechanical, electrical, and magnetic properties. In this paper, we systematically investigate the structural, magnetic, and magnetocaloric behavior of as-milled Fe65T35 (T = Ni and Mn) alloy. The polycrystalline alloys were produced by the planetary ball milling, using a powder-to-ball ratio of 1:3. A structural study reveals that both Fe65Ni35 and Fe65Mn35 compounds have stabilized in α and γ mixed phase within the cubic crystal structure. The alloyed compounds are further characterized by high-resolution field emission scanning electron microscopy (HR-FESEM), which confirms the mixing of both metals in the alloying process. Temperature-dependent magnetic studies do not show any blocking in zero-field-cooled and field-cooled results; however, the field-dependent magnetization study demonstrates the ferromagnetic nature with small hysteresis in both compounds. Both compounds show a significant magnetocaloric effect over a wide temperature range around room temperature. Fe65Ni35 exhibit a slightly higher value in comparison to Fe65Mn35. In both the alloys, magnetic entropy change follows the power law behavior against the external magnetic field, and the value of exponent ‘m’ explains the presence of magnetic correlation. Our investigation in this study communicates that the phase control or coexistence of both phases may be efficacious in obtaining the desirable characteristic of magnetic and magnetocaloric demeanors in such a binary Fe-T alloy.

1,2,4-trioxane is a pharmacophore, which possesses a wide spectrum of biological activities, including anticancer effects. In this study, the cytotoxic effect and anticancer mechanism of action of a set of 10 selected peroxides were investigated on five phenotypically different cancer cell lines (A549, A2780, HCT8, MCF7, and SGC7901) and their corresponding drug-resistant cancer cell lines. Among all peroxides, only 7 and 8 showed a better P-glycoprotein (P-gp) inhibitory effect at a concentration of 100 nM. These in vitro results were further validated by in silico docking and molecular dynamic (MD) studies, where compounds 7 and 8 exhibited docking scores of −7.089 and −8.196 kcal/mol, respectively, and remained generally stable in 100 ns during MD simulation. Further experiments revealed that peroxides 7 and 8 showed no significant effect on ROS accumulations and caspase-3 activity in A549 cells. Peroxides 7 and 8 were also found to decrease cell membrane potential. In addition, peroxides 7 and 8 were demonstrated to oxidize a flavin cofactor, possibly elucidating its mechanism of action. In conclusion, apoptosis induced by 1,2,4-trioxane was shown to undergo via a ROS- and caspase-3-independent pathway with hyperpolarization of cell membrane potential.

Background: Perioperative anticoagulation management with uninterrupted or minimally interrupted anticoagulation during atrial fibrillation (AF) ablation is thought to be critical to minimize thromboembolic complications. Protamine is often administered to neutralize the effects of heparin and expedite vascular hemostasis post-procedure. Objective: We performed a systematic review and meta-analysis to determine the effectiveness of protamine to expedite vascular hemostasis and ambulation in patients undergoing AF ablation. Methods: Electronic searches on PubMed, The Cochrane Library, EMBASE, EBSCO, Web of Science, and CINAHL databases from the inception through August 7, 2021, were performed. The primary outcomes included—time to hemostasis (minutes) and time to ambulation (minutes). The secondary outcomes included - any vascular complications (excluding minor hematoma), minor hematoma, or cerebrovascular accidents (CVA). Results: A total of 5 eligible studies (3 retrospective cohort studies and two randomized trials) consisting of 1012 patients (515 patients received protamine group and 497 patients did not receive protamine group) were included in the meta-analysis. There was a significant reduction in time to ambulation [weighted mean difference (WMD) –176.6 minutes, 95% Confidence interval (CI) –266.9 to –86.3; p < 0.01] and time to hemostasis (WMD –13.72 minutes, 95% CI –22 to –5.4, p < 0.01) in the protamine group compared to the contrary. At a follow-up up to 3 months, there was no statistical difference between the two groups with regards to vascular complications (2.9% vs. 7.4%; Risk ratio (RR) 0.46 95% CI 0.17 to 1.24; p = 0.12), minor hematoma (2.1% vs. 5.8%; RR 0.43, 95% CI 0.16 to 1.2; p = 0.11) or CVA (0 vs. 0.3%; RR 0.62, 95% CI 0.08 to 4.98; p = 0.65). Conclusion: Protamine administration was associated with reduced time to ambulation (176 minutes reduction) and time to hemostasis (13 minutes reduction) without an increase in any adverse events.

Abstract Background Cell-free circulating DNA (cfDNA) is becoming a useful biopsy for noninvasive diagnosis of diseases. Microbial sequences in plasma cfDNA may provide important information to improve prognosis and treatment. We have developed a stringent method to identify microbial species via microbial cfDNA in the blood plasma of early-onset breast cancer (EOBC) patients and healthy females. Empirically, microbe-originated sequence reads were identified by mapping non-human PE reads in cfDNA libraries to microbial databases. Those mapped concordantly to unique microbial species were assembled into contigs, which were subsequently aligned to the same databases. Microbial species uniquely aligned were identified and compared across all individuals on MCRPM (Microbial CfDNA Reads Per Million quality PE reads) basis. Results The predominant microbial cfDNAs in all plasma samples examined are originated from bacteria and these bacteria were limited to only a few genera. Among those, Acinetobacter johnsonii XBB1 and low levels of Mycobacterium spp. were commonly found in all healthy females, but also present in an EOBC patient. Compared to those in healthy counterparts, bacterial species in EOBC patients are more diverse and more likely to present at high levels. Among these three EOBC patients tested, a patient who has record high titer (2,724 MCRPM) of Pseudomonas mendocina together with 8.82 MCRPM of Pannonibacter phragmitetus has passed away; another patient infected by multiple Sphingomonas species remains alive; while the third patient who has similar microbial species (Acinetobacter johnsonii XBB1) commonly seen in normal controls is having a normal life. Conclusions Our preliminary data on the profiles of microbial cfDNA sequences suggested that it may have some prognostic value in cancer patients. Validation in larger number of patients is warranted.

Background: Dysregulation in cytokines like interleukin-6 (IL-6), interleukin-17A (IL-17A) and transforming growth factor-beta (TGF β1) has been pathogenically implicated in systemic sclerosis (SSc). The present study aimed to assess their serum levels in patients with SSc and correlate with clinical manifestations. Methods: This cross-sectional, observational study included 93 patients fulfilling the 2013 revised ACR/EULAR SSc classification criteria and 33 age-and sex-matched healthy controls. Antinuclear antibody (ANA), extractable nuclear antigen (ENA) profile, chest radiograph, pulmonary function tests and electrocardiography were done. HRCT of thorax and echocardiography were done wherever indicated. Modified Rodnan skin score (MRSS) was calculated. Serum IL-6, IL-17A and TGF β1 levels were assayed using ELISA kit and compared among disease subtypes and clinical parameters. Spearman coefficient was used to test correlation between continuous variables. P value of

Vinyl cyanide is a molecule having planar geometry with electric dipole moment components, μa=3.821D and μb=0.687D. Thus, a-type transitions are very strong as compared to b-type transitions, and are considered in this investigation. The rotational levels for a-type transitions, may be divided into two distinct groups: one group having odd values of ka and the other having even values of ka. Using the known values of rotational and centrifugal distortion constant along with the electric dipole moment μa, we have calculated energies of lower 120 rotational levels, having energy up to 92cm−1, for each group, and the probabilities for radiative transitions between the levels. These radiative transition probabilities in conjunction with the scaled values of collisional rate coefficients are used in the Sobolev Large Velocity Gradient analysis. Out of a large number of lines, we have selected the strongest ones. In the low lying levels, besides the 4 observed lines of CH2CHCN, we have discussed about 8 additional transitions, of which 2 showing the phenomenon of anomalous absorption and 6 showing emission feature are found. These lines may play important role for the search of vinyl cyanide in a cosmic object.

The preoperative diagnosis of metastatic intestinal gastrointestinal stromal tumors (GIST) on cytology can be quite difficult at times. The present case characterizes the cytomorphological and immunocytochemical features of GIST, emphasizing the utility of fine-needle aspiration cytology (FNAC) in the evaluation of spindle cell tumors of gastrointestinal tract. An accurate and early diagnosis of GIST affects the treatment, primarily allowing the use of tyrosine kinase inhibitors in unresectable or metastatic cases. Presence of highly cellular fragments of spindle-to-oval cells with variable degree of pleomorphism, atypia, and necrosis supplemented by immunocytochemistry can render a cytological diagnosis of GIST in dilemmatic clinical situations. Our case highlights the diagnostic role of FNAC in the evaluation of a pelvic mass, which was clinicoradiologically misdiagnosed as ovarian carcinoma.

Single cell transcriptome (SCT) analysis provides superior resolution to illustrate tumor cell heterogeneity for clinical implications. We characterized four SCTs of MCF-7 using 143 housekeeping genes (HKGs) as control, of which lactate dehydrogenase B (LDHB) expression is silenced. These SCT libraries mapped to 11,423, 11,486, 10,380, and 11,306 RefSeq genes (UCSC), respectively. High consistency in HKG expression levels across all four SCTs, along with transcriptional silencing of LDHB, was observed, suggesting a high sensitivity and reproducibility of the SCT analysis. Cross-library comparison on expression levels by scatter plotting revealed a linear correlation and an 83-94% overlap in transcript isoforms and expressed genes were also observed. To gain insight of transcriptional diversity among the SCTs, expressed genes were split into consistently expressed (CE) (expressed in all SCTs) and inconsistently expressed (IE) (expressed in some but not all SCTs) genes for further characterization, along with the 142 expressed HKGs as a reference. Distinct transcriptional strengths were found among these groups, with averages of 1,612.0, 88.0 and 1.2 FPKM for HKGs, CE and IE, respectively. Comparison between CE and IE groups further indicated that expressions of CE genes vary more significantly than that of IE genes. Gene Ontology analysis indicated that proteins encoded by CE genes are mainly involved in fundamental intracellular activities, while proteins encoded by IE genes are mainly for extracellular activities, especially acting as receptors or ion channels. The diversified gene expressions, especially for those encoded by IE genes, may contribute to cancer drug resistance.

IntroductionWe used sex and apolipoprotein E ε4 (APOE ε4) carrier status as predictors of pathologic burden in early-onset Alzheimer's disease (EOAD).MethodsWe included baseline data from 77 cognitively normal (CN), 230 EOAD, and 70 EO non-Alzheimer's disease (EOnonAD) participants from the Longitudinal Early-Onset Alzheimer's Disease Study (LEADS). We stratified each diagnostic group by males and females, then further subdivided each sex by APOE ε4 carrier status and compared imaging biomarkers in each stratification. Voxel-wise multiple linear regressions yielded statistical brain maps of gray matter density, amyloid, and tau PET burden.ResultsEOAD females had greater amyloid and tau PET burdens than males. EOAD female APOE ε4 non-carriers had greater amyloid PET burdens and greater gray matter atrophy than female ε4 carriers. EOnonAD female ε4 non-carriers also had greater gray matter atrophy than female ε4 carriers.DiscussionThe effects of sex and APOE ε4 must be considered when studying these populations.HighlightsNovel analysis examining the effects of biological sex and apolipoprotein E ε4 (APOE ε4) carrier status on neuroimaging biomarkers among early-onset Alzheimer's disease (EOAD), early-onset non-AD (EOnonAD), and cognitively normal (CN) participants. Female sex is associated with greater pathology burden in the EOAD cohort compared to male sex. The effect of APOE ε4 carrier status on pathology burden was the most impactful in females across all cohorts.

In this paper we proposed a automated Artificial Neural Network (ANN) based classification system for cardiac arrhythmia using multi-channel ECG recordings. In this study, we are mainly interested in producing high confident arrhythmia classification results to be applicable in diagnostic decision support systems. Neural network model with back propagation algorithm is used to classify arrhythmia cases into normal and abnormal classes. Networks models are trained and tested for MIT-BIH arrhythmia. The different structures of ANN have been trained by mixture of arrhythmic and non arrhythmic data patient. The classification performance is evaluated using measures; sensitivity, specificity, classification accuracy, mean squared error (MSE), receiver operating characteristics (ROC) and area under curve (AUC).Our experimental results gives 96.77% accuracy on MIT-BIH database and 96.21% on database prepared by including NSR database also.

The main reason for unfavourable outcome in endodontic treatment of mandibular incisor is the inability to detect the presence of second canal. Pain even after extirpation of complete pulp tissue from root canal of vital teeth is the main indication of hidden canals. The present case report is also on pain because of another neglected canal in all mandibular incisors in the same patient.