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Background: This study was designed to study the frequency distribution of etiology of various grades of severity of hemoptysis and to determine the influence of underlying etiology on the type of treatment modalities selected. Materials and Methods: Adult patients presenting with hemoptysis at a tertiary care hospital over 18 months were included in the study. Detailed analysis of their clinical profile, underlying etiologies as well as management, modalities, and a 6-month follow-up was done. Results: One hundred and five patients were included in the final analysis. Pulmonary tuberculosis (PTB) sequelae were the most common etiology of hemoptysis across all grades of severity. Active PTB was the second leading cause. Chronic cavitary pulmonary aspergillosis (CCPA) was diagnosed in 6.6% of patients who mostly presented with massive hemoptysis. Bronchial artery embolization (BAE) was done in 15 patients. Most of the patients undergoing BAE had old PTB (53%) and CCPA (33%) with moderate-to-massive hemoptysis. Conclusions: Tuberculosis and its sequelae continue to be the most common etiology of hemoptysis in India. CCPA is a significant predictor of “moderate and massive” hemoptysis (5 out of 7 patients of CCPA) and these patients had recurrence of hemoptysis even after BAE. BAE is successful in decreasing the severity of hemoptysis and has a high utility in developing countries like India.

Introduction: Activation of the focal adhesion kinase (FAK) in podocytes is involved in the pathogenesis of minimal change disease (MCD), but the pathway leading to its activation in this disease is unknown. Here, we tested whether podocyte β1 integrin is the upstream modulator of FAK activation and podocyte injury in experimental models of MCD-like injury. Methods: We used lipopolysaccharide (LPS) and MCD sera to induce MCD-like changes in vivo and in cultured human podocytes, respectively. We performed functional studies using specific β1 integrin inhibitors in vivo and in vitro, and integrated histological analysis, western blotting, and immunofluorescence to assess for morphological and molecular changes in podocytes. By ELISA, we measured serum LPS levels in 35 children with MCD or presumed MCD (idiopathic nephrotic syndrome [INS]) and in 18 healthy controls. Results: LPS-injected mice showed morphological (foot process effacement, and normal appearing glomeruli on light microscopy) and molecular features (synaptopodin loss, nephrin mislocalization, FAK phosphorylation) characteristic of human MCD. Administration of a β1 integrin inhibitor to mice abrogated FAK phosphorylation, and ameliorated proteinuria and podocyte injury following LPS. Children with MCD/INS in relapse had higher serum LPS levels than controls. In cultured human podocytes, β1 integrin blockade prevented cytoskeletal rearrangements following exposure to MCD sera in relapse. Conclusions: Podocyte β1 integrin activation is an upstream mediator of FAK phosphorylation and podocyte injury in models of MCD-like injury. Resumen: Antecedentes: La activación de la quinasa de adhesión focal (FAK) en podocitos juega un papel en la patogénesis de la enfermedad de cambios mínimos (ECM), pero su mecanismo de activación en dicha enfermedad es desconocido. En este estudio investigamos si la integrina β1 de los podocitos modula la activación de FAK y del daño podocitario en modelos experimentales de la ECM. Métodos: Utilizamos lipopolisacárido (LPS) y suero de pacientes con ECM para inducir daño podocitario in vivo e in vitro, respectivamente. Realizamos estudios funcionales usando inhibidores específicos de la integrina β1 in vivo e in vitro, así como estudios histológicos, western blots y técnicas de inmunofluorescencia para evaluar cambios morfológicos y moleculares en podocitos. Usando ELISA medimos los niveles séricos de LPS en 35 niños con ECM o sospecha de ECM (síndrome nefrótico idiopático [SNI]) y en 18 individuos sanos. Resultados: Los ratones inyectados con LPS desarrollaron cambios morfológicos (fusión de pedicelos, con apariencia normal de los glomérulos) y moleculares (pérdida de la expresión de sinaptopodina, cambio en la localización de la nefrina fosforilada y fosforilzación de FAK), que son característicos de la ECM en humanos. La administración de un inhibidor de la integrina β1 en ratones disminuyó la fosforilación de FAK, proteinuria y daño podocitario que ocurre tras la inyección de LPS. En niños con ECM/SNI, los niveles séricos de LPS fueron más elevados que en controles. En cultivos de podocitos humanos, la adicción de un inhibidor de la integrina β1 al suero de niños con ECM en recaída evitó cambios en el citoesqueleto. Conclusiones: La integrina β1 de los podocitos actúa como mediador de la activación de la FAK y del daño podocitario en modelos experimentales de la ECM.

Objectives This article evaluates the immediate success, recurrence rate, complications, and the culprit vessel of bronchial artery embolization (BAE) in patients presenting with hemoptysis. Materials and Methods All patients who underwent BAE from July 1, 2018 to August 31, 2021 were included. BAE was done for moderate to severe hemoptysis or for mild hemoptysis which was recurrent and not controlled by medical management. Patients referred for surgical intervention and hemoptysis controlled on medical management were excluded. Results One hundred and thirty patients underwent BAE in the study period. Mean age was 41.5 years and majority (73.1%) was male. Forty-three (33.1%) patients had mild, 46 (35.4%) had moderate, and 41 (31.5%) with the duration of symptoms ranging from 3 days to 25 years. Most common culprit vessel was posterior intercostal artery closely followed by the intercostobronchial artery. Hypervascularity was the most common angiographic abnormality encountered. On an average, 2.75 vessels were embolized per BAE with a wide range of 1 to 8 vessels. Hemoptysis control was seen in 96.1% patients immediately, 90.7 % at 1 month, 82.3 % at 3 months, and 66.9 % at 6 months. Overall recurrence was seen in 43 patients (33.1%). Chest pain was the most common minor side effect occurring in 77.1% cases. Conclusion BAE is a safe and effective procedure that can be performed routinely in patients presenting with moderate to massive hemoptysis or with mild hemoptysis refractory to medical management.

Abstract In the Agriculture sector, the farmers need a reliable estimation for pre-harvest crop yield prediction to decide their import-export policies. The present work aims to assess the impact of remote sensing-based derived products with Climate data on the accuracy of a prediction model for the sugarcane yield. The regression method was used to develop an empirical model based on VCI, Historical Sugarcane Yield, and Climatic Parameters of 75 districts of six major sugar-producing states of India. The MOD13Q1 product of MODIS on Board Terra Satellite at 16-day intervals was accessed during the growing season of sugarcane crop with 36 meteorological parameters for experimentation. The accuracy of the model was evaluated using R2, Root Mean square Metric (RMSE), Mean Absolute Error (MAE), and mean square error (MSE). The preliminary results concluded that the proposed methodology achieved the highest accuracy with (R2 =0.95, MAE=5.18, MSE=34.5, RMSE=5.87). The conclusion of the study highlighted that the coefficient of determination can be improved significantly by incorporating maximum and minimum temperature parameters with Remote sensing derived vegetation indices for the sugarcane yield.

Massive hemoptysis can lead to respiratory failure and life-threatening hypoxia in patients with underlying post-tubercular fibrocavitary disease. In the absence of urgent surgical interventions in a resource-poor country, interventional bronchoscopy and bronchial artery embolization (BAE) can be lifesaving in critical care management of such patients. We present a young male who required mechanical ventilation, emergency bronchoscopic intervention, and BAE, and showed recovery.

Cloud computing has evolved with various techniques for satisfying the needs of users to reduce costs and offer better results. The users' needs may include sharing of resources like memories, processors, apps, information, data, applications, etc., whereas, performance should be in terms of improved DC processing period & response time. Apart from the above-said, there is also a requirement to manage the stability of the system and be flexible to make amendments to the system. Static data is used to optimize the project schedule. However, the traditional does not take into account the personnel allocation matrix when scheduling projects. The ACO model is not a suitable solution to the scheduling problem. The classic ACO methodology operates in two phases: the first phase uses an event-based scheduler to address the complex planning issue. Planning and allocating resources for a project are both constrained by these two approaches. The event-based ACO model was developed to match the resource restrictions and activity schedule to handle dynamic data allocation. When it comes to multi-objective scheduling, EBS with ACO is not an adequate approach. An updated ACO technique to optimum global search employing a neural network approach was presented to schedule many activities to tackle the difficulty of multiple objectives. Using the suggested multi-objective technique, an activity with a defined number of tasks and necessary resources may be optimally organized. The algorithm LBACO is the most effective one to apply for optimizing the objective function, according to the test results, as well as the fastest. An advantage of ACO over other techniques is its ability to provide better plans with higher statistics and mean access times, as well as more consistent job assignments.

Abstract The spread of viral and bacterial pathogens mediated by contact with surfaces is a leading cause of infection worldwide. COVID‐19 and the continuous rise of deaths associated with antibiotic‐resistant bacteria highlight the need to impede surface‐mediated transmission. A sprayable coating with an intrinsic ability to resist the uptake of bacteria and viruses from surfaces and droplets, such as those generated by sneezing or coughing, is reported. The coating also provides an effective microbicidal functionality against bacteria, providing a dual barrier against pathogen uptake and transmission. This antimicrobial functionality is fully preserved following scratching and other induced damage to its surface or 9 days of submersion in a highly concentrated suspension of bacteria. The coatings also register an 11‐fold decrease in viral contamination compared to the noncoated surfaces.

Introduction: Aorto-iliac Occlusive Disease (AIOD) involves the infra-renal aorta and the iliac arteries. Recent studies advocate endovascular management in TASC C and D lesions also. It involves balloon angioplasty with or without stent deployment.5 The aim of this retrospective study is to evaluate the results of endovascular balloon angioplasty and primary stenting in patients of AIOD. Methods: Twenty-five patients with Aorto-iliac occlusion disease who met the inclusion criteria during 1-year study period were included. Patients with acute thrombosis, abdominal aorta or iliac artery aneurysm and additional common femoral artery occlusion were excluded. The TASC II classification was used to define the characteristics of the lesions. The baseline data, procedural details and follow-up results were analysed. Results: Amongst 25 patients studied, age ranged from 40-75 years. Self-expanding metallic stent was employed in all patients. Technical success following primary stenting was achieved in all patients. Procedural times for TASC-II A, B, C and D lesions were 90+ 30, 110+ 40, 135+35 and 155+ 45 minutes, respectively. During follow-up, the cumulative primary patency rates at 1 month and 6 months were 100%. Cumulative primary patency rates at 1 year were 91.67%. Conclusion: Short- term outcomes of balloon angioplasty and stenting for Aorto-iliac artery occlusions in terms of primary patency rates were excellent.

Introduction: Endovascular and percutaneous interventions are promising alternatives to surgical management of traumatic renal injuries and often avert the need for nephrectomies. In this study, we aimed to evaluate the role of interventional radiology and angiographic interventions in the management of renal vascular injury. Materials and Methods: Our prospective study was performed over a period of 6 months. Twenty-five patients who presented with either persistent hematuria or hemodynamic instability after traumatic or iatrogenic renal injuries were selected. Angiographic embolization using varying combinations of coils, glue, and Gelfoam® was performed to address the vascular injuries, either directly in hemodynamically unstable patients or after preprocedural imaging in hemodynamically stable patients. Patients were then followed up till discharge from hospital 48 h later and at 2 weeks and 4 weeks postprocedure for any recurrence of hematuria or hemodynamic instability. Technical and clinical success rates were calculated using descriptive statistics. Results: Pseudoaneurysms were the most common form of arterial injury (22 cases), followed by arteriovenous fistula (8) and active extravasation (5). Segmental arteries are the most commonly involved (12 cases), followed by interlobar (9) and arcuate (3) arteries. Gelfoam® was used in five patients with active contrast extravasation and was 100% effective in arresting active bleeding. Coiling alone had a 79.16% technical success rate in management, while additional use of glue in four failed cases led to a 95.83% technical success rate in the first attempt. The ultimate technical and clinical success rate of interventional radiology in renal trauma management (after the second attempt in one failed case) was 100%. Conclusion: Endovascular management is an effective and safe alternative to surgical management of both iatrogenic and accidental renal vascular injuries.

Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous syndrome that is characterised by hamartomas in multiple organs, the characteristic imaging features of which are illustrated in this case report. Angiomyolipoma (AML) is the most common renal manifestation of TSC, which may present with life-threatening haemorrhage at the time of diagnosis. Interventional management with selective renal embolisation is currently the treatment of choice for the safe and effective management of ruptured renal AML.

There are no large scale studies exclusive for pulmonary artery aneurysms as a cause of massive hemoptysis, only small studies are there. No randomised control trial is there to suggest efficacy of surgical excision or endovascular treatment over each other. It's well known that definite treatment by surgical excision carries high mortality when done in emergency sitting. Endovascular approach in such a patient is a less utilised treatment modality and that too with coil embolisation is not much practiced. This article emphasises the role of CTA in diagnosing and embolisation as emergency management of these aneurysms.

Schwannomas are truly encapsulated benign tumours associated with the nerves arising from the schwann cells. Schwannomas arising from the sciatic nerve is of rare occurrence and is estimated to be less than one in hundred cases of schwannomas detected. Generally sciatic nerve schwannomas symptomatically mimic sciatica due to herniated disc or sometimes it may be asymptomatic and incidentally detected. In this case report, we are describing a case of asymptomatic middle aged female patient, who is a follow up case of hysterectomy and bilateral salpingo-oophorectomy for a gyanecological malignancy around 5 years back. During routine follow up sonography (TVS), a mass was detected deep within the pelvis, which was further investigated with MRI and found to be a possible nerve sheath tumour of sciatic nerve at the left sciatic foramen. Further TVS guided biopsy and histopathological correlation, confirmed it to be an ancient schwannoma (neurilemmoma).

Nephrin (Nphs1) is an adhesion protein that is expressed at the podocyte intercellular junction in the glomerulus. Nphs1 mutations in humans or deletion in animal genetic models results in a developmental failure of foot process formation. A number of studies have shown decrease in expression of nephrin in various proteinuric kidney diseases as well as in animal models of glomerular disease. Decrease in nephrin expression has been suggested to precede podocyte loss and linked to the progression of kidney disease. Whether the decrease in expression of nephrin is related to loss of podocytes or lead to podocyte detachment is unclear. To answer this central question we generated an inducible model of nephrin deletion (Nphs1Tam-Cre) in order to lower nephrin expression in healthy adult mice. Following tamoxifen-induction there was a 75% decrease in nephrin expression by 14 days. The Nphs1Tam-Cre mice had normal foot process ultrastructure and intact filtration barriers up to 4-6 weeks post-induction. Despite the loss of nephrin expression, the podocyte number and density remained unchanged during the initial period. Unexpectedly, nephrin expression, albeit at low levels persisted at the slit diaphragm up to 16-20 weeks post-tamoxifen induction. The mice became progressively proteinuric with glomerular hypertrophy and scarring reminiscent of focal and segmental glomerulosclerosis at 20 weeks. Four week-old Nphs1 knockout mice subjected to protamine sulfate model of podocyte injury demonstrated failure to recover from foot process effacement following heparin sulfate. Similarly, Nphs1 knockout mice failed to recover following nephrotoxic serum (NTS) with persistence of proteinuria and foot process effacement. Our results suggest that as in development, nephrin is necessary for maintenance of a healthy glomerular filter. In contrast to the developmental phenotype, lowering nephrin expression in a mature glomerulus resulted in a slowly progressive disease that histologically resembles FSGS a disease linked closely with podocyte depletion. Podocytes with low levels of nephrin expression are both susceptible and unable to recover following perturbation. Our results suggest that decreased nephrin expression independent of podocyte loss occurring as an early event in proteinuric kidney diseases might play a role in disease progression.

Nephrin is expressed at the basolateral aspect of podocytes and is an important signaling protein at the glomerular slit diaphragm. In vitro studies have demonstrated that Nephrin phosphorylation-dependent signaling is able to assemble a protein complex that is able to polymerize actin. However, proximal signaling events that result in nephrin tyrosine phosphorylation are not well understood. Nephrin deletion in mice and human nephrin mutations result in developmental failure of the podocyte intercellular junction resutling in proteinuria. This has been presumed to be due to a failure to respond to an external polarized cue in the absence of nephrin or a failure to transduce an outside-in signal in patients with nephrin mutations. The nephrin extracellular domain binds to itself or neph1 across the foot process intercellular junction. Nephrin is tyrosine phosphorylation-silent in healthy glomeruli when presumably the nephrin extracellular domain is in an engaged state. These observations raise the possibility of an alternate proximal signaling mechanism that might be responsible for nephrin tyrosine phosphorylation. Here we present data showing that integrin engagement at the basal aspect of cultured podocytes results in nephrin tyrosine phosphorylation. This is abrogated by incubating podocytes with an antibody that prevents integrin β1 ligation and activation in response to binding to extracellular matrix. Furthermore, nephrin tyrosine phosphorylation was observed in podocytes expressing a membrane-targeted nephrin construct that lacks the extracellular domain. We propose, integrin-activation based signaling might be responsible for nephrin phosphorylation rather than engagment of the nephrin extracellular domain by a ligand.

With the advent of nanotechnology, by looking further deep down into the molecular level, today, we are able to understand basic and applied sciences even better than ever before. Not only has nanoscience and nanotechnology allowed us to study the composing structures of materials in detail, it has also allowed us to fabricate and synthesize such nanostructures using top-down and bottom-up approaches. One such field, which has been significantly influenced by the dawn of nanotechnology is biomimetics. With powerful spectroscopic and microscopic tools presenting us with images like double nanostructured pillars on the lotus surface for superhydrophobicity, the conical protuberances of moth eye demonstrating anti-reflection properties and nanostructured spatulae of gecko feet for high adhesivity, we are now able to fabricate these structures in the lab with properties showing close resemblance to their natural counterparts. Here, we present a review of various nanostructures that exist in nature, their fabrication techniques and some of their promising future applications. We hope this review will provide the reader with a basic understanding of what biomimetics is and how nanotechnology has significantly influenced this field.

Actin dynamics has emerged at the forefront of podocyte biology. Slit diaphragm junctional adhesion protein Nephrin is necessary for development of the podocyte morphology and transduces phosphorylation-dependent signals that regulate cytoskeletal dynamics. The present study extends our understanding of Nephrin function by showing in cultured podocytes that Nephrin activation induced actin dynamics is necessary for lamellipodia formation. Upon activation Nephrin recruits and regulates a protein complex that includes Ship2 (SH2 domain containing 5' inositol phosphatase), Filamin and Lamellipodin, proteins important in regulation of actin and focal adhesion dynamics, as well as lamellipodia formation. Using the previously described CD16-Nephrin clustering system, Nephrin ligation or activation resulted in phosphorylation of the actin crosslinking protein Filamin in a p21 activated kinase dependent manner. Nephrin activation in cell culture results in formation of lamellipodia, a process that requires specialized actin dynamics at the leading edge of the cell along with focal adhesion turnover. In the CD16-Nephrin clustering model, Nephrin ligation resulted in abnormal morphology of actin tails in human podocytes when Ship2, Filamin or Lamellipodin were individually knocked down. We also observed decreased lamellipodia formation and cell migration in these knock down cells. These data provide evidence that Nephrin not only initiates actin polymerization but also assembles a protein complex that is necessary to regulate the architecture of the generated actin filament network and focal adhesion dynamics.