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Introduction: Congenital hypoplasia or aplasia of the internal carotid artery (ICA) is believed to affect less than 0.01% of the population, with fewer than 200 unilateral and 30 bilateral cases reported in the literature. While often asymptomatic, they have been associated with stroke, transient ischemic attack (TIA), and other neurovascular pathologies. Case Report: We describe a 33-year-old 28 weeks pregnant female with a history of patent foramen ovale (PFO) and ischemic stroke in the right middle cerebral artery (MCA) distribution three years prior who experienced new onset transient right upper extremity weakness and numbness. Duplex sonography revealed bilateral hypoplasia of the internal carotid arteries (HICA), confirmed by CT and MR angiography of the head and neck. Discussion: To our knowledge, this is the first reported case of bilateral HICA with concurrent PFO and pregnancy presenting with TIA. All three conditions are associated with stroke and TIA. HICA should be included in the differential diagnosis of neurologic deficit despite its rarity.

The microfluidic devices can effectively be used for the renewable energy conversion, such as solar to chemical (e.g., H2) energy, to meet the global energy demand. The microchannel design plays a vital role in improving the mass transfer in photocatalytic processes. In this study, a simple, rapid, and inexpensive adhesive tape-based method was used to fabricate the serpentine, planar and micropillared optofluidic microreactors with sharp edges without any wall irregularities. The sol-gel method was used for the CdS catalyst coating in the microreactors. The effect of liquid flow rate (0.05–1 mL min−1) and sacrificial reagent (Na2SO3/Na2S) concentration (0.05–0.5 M) on the hydrogen generation under visible light was studied. A higher H2 production rate was observed in the serpentine microreactor as compared to that in planar and micropillared microreactors. The serpentine microreactor, having higher surface-to-volume ratio, induced the micromixing that enhanced the mass transfer of the sacrificial reagent and formed H2 gas. A maximum H2 production rate of 2.65 μmol h−1 cm−2 was observed at a flow rate of 1.0 mL min−1 and a sacrificial reagent concentration (Na2SO3/Na2S) of 0.5 M. The new approach developed in this study is a step forward in fabricating highly efficient and inexpensive optofluidic microdevices for the hydrogen production from solar energy.

This research paper explores the concept of edge computing and the advancements in this technology. Edge computing is a distributed computing paradigm that brings computation and data storage closer to the devices that generate and collect data in order to reduce latency and improve performance. It has been identified as a powerful tool for providing low-latency access to data and applications and is becoming increasingly popular in the IoT and 5G era. This paper focuses on the various advancements in edge computing technology, such as the emergence of edge cloud platforms and the development of edge analytics and machine learning solutions. It also discusses various applications of edge com- puting, such as autonomous driving, augmented/virtual reality, and the Internet of Things, and how they are being used to improve efficiency and reduce latency. Finally, the paper analyses the various challenges and opportunities associated with edge computing, including security, scalability and privacy concerns.

We aimed to identify prevalence and association of comorbid chronic kidney disease (CKD), acute kidney injury (AKI) and utilization prevalence of continuous renal replacement therapy (CRRT) in COVID-19-hospitalized patients as a function of severity status. With the ongoing struggle across the globe to combat COVID-19 disease, published literature has described the role of kidney disease in COVID-19 patients based on single/multicenter experiences across the globe. We extracted data from observational studies describing comorbid CKD, AKI and CRRT and outcomes and severity of COVID-19-hospitalized patients from December 1, 2019–August 20, 2020 following PRISMA guidelines. Severity of COVID-19 includes intensive care unit admission, oxygen saturation

Experiments have examined the phenomenon of direct contact condensation when steam is injected vertically into the subcooled water pool. The investigation is carried out by varying the steam mass flow rate and submergence depth of the steam injection pipe in the range of 10–50 kg/h and 1–13 cm, respectively. The behavior of the bubble that appeared at the pipe outlet, transient heat transfer coefficient, pressure variation in the steam injection pipe, and its associated frequency have been analyzed. The images captured by high-speed camera showed different bubble shapes. The overall cycle time of bubble evolution has decreased with an increase in the mass flow rate and increased with an increase in the pipe submergence depth. The time-averaged heat transfer coefficient increased with an increase in the mass flow rate and decreased with the rise of the pipe submergence depth. The pressure drop within the steam injection pipe shows the parabolic variation with an increase in the mass flow rate and is slightly influenced by the submergence depth due to changes in interfacial structures within the pipe. The peak frequency associated with the pressure has increased with an increase in the mass flow rate and decreased with an increase in the pipe submergence depth at higher mass flow rates. The fast Fourier transform of interfacial area of the larger bubble at the pipe outlet shows that the first peak frequency lies between 0.5 and 5 Hz, and the second peak frequency lies in the range of 25–30 Hz.

Purpose: Aortic arch anatomical variations are of surgical importance. Many variations of the aortic arch and associated vessels may be found incidentally or post-mortem. Methods: A 61-year-old presented with symptoms suspicious of a cerebrovascular accident. Results: The patient was found to have the right internal and external carotid arteries emanating from the right subclavian artery in absence of a common carotid artery on computed tomography angiography of the neck. Conclusion: A recent comprehensive review noted 41 published cases of common carotid artery aplasia with the right internal carotid originating from the subclavian artery in only 4 of these cases. The current case represents a rare absence of the right CCA with the right ICA and ECA originating separately from the right subclavian artery.

Summary The therapy algorithm for severe aplastic anaemia (sAA) is established but moderate AA (mAA), which likely reflects a more diverse pathogenic mechanism, often represents a treatment/management conundrum. A cohort of AA patients (n = 325) was queried for those with non-severe disease using stringent criteria including bone marrow hypocellularity and chronic persistence of moderately depressed blood counts. As a result, we have identified and analyzed pathological and clinical features in 85 mAA patients. Progression to sAA and direct clonal evolution (paroxysmal nocturnal haemoglobinuria/acute myeloid leukaemia; PNH/AML) occurred in 16%, 11% and 1% of mAA cases respectively. Of the mAA patients who received immunosuppressive therapy, 67% responded irrespective of time of initiation of therapy while conservatively managed patients showed no spontaneous remissions. Genomic analysis of mAA identified evidence of clonal haematopoiesis with both persisting and remitting patterns at low allelic frequencies; with more pronounced mutational burden in sAA. Most of the mAA patients have autoimmune pathogenesis similar to those with sAA, but mAA contains a mix of patients with diverse aetiologies. Although progression rates differed between mAA and sAA (P = 0·003), cumulative incidences of mortalities were only marginally different (P = 0·095). Our results provide guidance for diagnosis/management of mAA, a condition for which no current standard of care is established.

The ostentatiously steep increase in the number of malwares a year has given rise to a growing demand for a decision support system which would help against the same. The reason for such a steep increase in malware is because of slight mutation added to them to avoid detection. Thus, the malware from the same family with slight mutation is proliferated across the internet causing harm. We have come up with a Convolutional Neural Network (CNN) (Ciresan DC, Meier U, Masci J, Maria Gambardella L, Schmidhuber J, IJCAI Proceedings-international joint conference on artificial intelligence, vol 22, p 1237 (2011)) approach to battle a quarter of a million malwares a day, which heavily relies on the classification of the malwares based on the visual resemblance of malware samples of the same family. Binaries of malwares are represented visually as it has the ability to retain changes while keeping the global structure intact to help in detecting variations. The feasibility and performance of the proposed approach have been tested on the Malimg dataset which has shown avant-garde performance results. 98.97% precision was obtained by the proposed process.

Background: Ductal response to indomethacin in extremely-low-birth-weight (ELBW) infants is not well studied. Objective: The purpose of this study was to identify predictors of ductal closure in ELBW infants treated with indomethacin. Methods: A single-center, retrospective cohort of ELBW infants treated with indomethacin for patent ductus arteriosus (PDA) were included. Predictors of PDA closure were identified using multivariable adjusted logistic regression. Results: One hundred and five infants with a PDA were treated with indomethacin. Primary PDA closure with one course of indomethacin occurred in 61.9%. The rate of primary PDA closure was lower in infants with gestational age (GA) < 28 weeks compared to infants ≥ 28 weeks (58.1% vs 91.7%, p =0.03). Multivariable logistic regression model identified PDA size (OR 0.29, 95% CI 0.11-0.74, p =0.009) and exposure to antenatal indomethacin (OR 0.28, 95% CI 0.08–0.99, p =0.048) and magnesium (OR 0.31, 95% CI 0.12–0.82, p =0.019) as significant predictors for failure of ductal closure in infants treated with indomethacin. Infants with failed PDA closure were more likely to have moderate/severe bronchopulmonary dysplasia, severe intraventricular hemorrhage, and longer duration of hospitalization (p Conclusions: Large PDA and antenatal indomethacin and magnesium were predictors for failure of ductal closure with indomethacin. The negative association between antenatal indomethacin and magnesium on ductal closure with postnatal indomethacin warrants further investigation regarding routine use in mothers at risk for preterm delivery. Future studies focusing on developing predictive models to identify ideal candidates for indomethacin within the ELBW population could reduce the burden of the disease and improve overall outcomes.

OBJECTIVE: To evaluate whether extremely low gestational age neonates (ELGANs) randomized to erythropoietin have better or worse kidney-related outcomes during hospitalization and at 22–26 months corrected gestational age (cGA) compared with those randomized to placebo. STUDY DESIGN: We performed an ancillary study to a multicenter double-blind, placebo-controlled randomized clinical trial of erythropoietin in ELGANs. RESULTS: The prevalence of severe (stage 2 or 3) acute kidney injury (AKI) was 18.2%. We did not find a statistically significant difference between those randomized to erythropoietin vs. placebo for in-hospital primary (severe AKI) or secondary outcomes (any AKI and serum creatinine [SCr]/ cystatin C values at days 0, 7, 9 and 14). At 22–26 months cGA, 16% of the cohort had an estimated glomerular filtration rate (eGFR) 30 mg/g, 23% had a systolic blood pressure (SBP) >95(th) percentile for age, and 40% had a diastolic blood pressure (DBP) >95(th) percentile for age. SBP >90(th) percentile occurred less often among recipients of erythropoietin (p95(th) percentile or DBP >90(th) or >95(th) percentiles. CONCLUSIONS: ELGANs have high rates of in-hospital AKI and kidney-related problems at 22–26 months cGA. Recombinant erythropoietin (rhEpo) may protect ELGANs against long-term elevated SBP, but does not appear to protect from AKI, low eGFR, albuminuria or elevated DBP at 22–26 months cGA.

A Lipoma is benign tumor made of fat tissue as per modern that resemble in Ayurveda as Granthi in general and medojagranthi as specific.In ayurvedic classic charaka and Sushruta mentioned the management of medojagranthi is the sakoshensastrendagdhvai.e total excision. In this case a 55 years old female patient visited OPD of Shalya tantra with complaints of hanging painless mass like swelling at right gluteal region. On the basis of clinical findings and USG report a lipoma was diagnosed and excision was done under local anaesthesia (2% lignocaine hydrochloride with adrenaline). After excision there was 60*54*24 mm size pedunculated lipoma noted. Hence this case highlighted that lipoma can occur at unusal place like gluteal region and need the excision.

Generally in summer, air conditioning systems are essential for improving the human comfort and productivity. The mechanical vapor compression system (VCS) is probably the most used system. However, the refrigerant used in VCS is harmful to the environment and the initial cost is high. So, the aim of this study is to introduce a sustainable, energy-efficient and climate-friendly air conditioning system in which there is no refrigerant. The proposed system is the integration of two modules i.e., Direct evaporative cooling (DEC) module and vacuum-assisted isothermal membrane-based air dehumidification (VIMAD) module, where the DEC module will cool and humidify the entering air stream and then this cool and humidified air will enter into the VIMAD module and the air will get dehumidified. Finally, the output will be cool and dehumidified air at the exit of the system. In this paper, the proposed system is explained. Moreover, the basic principle of the DEC, the background of DEC and the basic principle of the VIMAD system, background on the types of membrane materials that can be used in VIMAD are explained. Also, the effects of various parameters on the performance of the DEC and VIMAD are presented.

Immediate dental implant placement refers to insertion of an implant directly after a tooth is extracted, whereas de layed positioning occurs at some later time. Implant-supported fixed prostheses are usually attempted before other options such as conventional bridges or removable dentures to avoid damage to adjacent teeth. Stable and predictable esthetic and functional results can be achieved with different surgical and prosthetic management techniques of the hard and soft tissue around implant restorations. It has been suggested that immediate implant placement after tooth extraction preserves the dimensions of the alveolar ridge regardless of the mode of tooth failure. After tooth extraction, the residual alveolar ridge generally provides limited bone volume because of ongoing resorbtion. In this case we extracted mandibular anterior teeth immediately placed the implants.

Necrotizing enterocolitis (NEC ≥ Stage II) is associated with high mortality and morbidity in preterm infants. To assess if introduction of standardized feeding regimen (SFR) and routine probiotic supplementation (RPS) was associated with reduced incidence of NEC in preterm infants in our nursery in a resource limited set up. This was a retrospective cohort study assessing the incidence of NEC ≥ Stage II before (Epoch 1: N = 144) vs. after (Epoch 2, N = 144) implementation of SFR and RPS in preterm infants

The manufacturing industries continuously demanded the new class of engineering materials for various applications. It results in improvement of metal matrix composites. Development of newer materials like MMCs are one of the keen area of research now a day’s. In this regard various literatures are available in open literature on development, characterization and application of MMCs. In this work an attempt is made to discuss the available literatures in terms of their output findings. The work also focuses on the area where the more attention is required to carry out the research work.

Energy conservation is an increasingly important issue for the dairy and food industry. Therefore, attention towards thermal insulation systems for plant equipment has grown in recent years. Thermal insulation is the reduction of heat transfer (the transfer of thermal energy between objects of differing temperature) between objects in thermal contact or in range of radiative influence. In this study, a literature review on different thermal insulation material with their properties, types and applications. The selection of optimal thermal insulation has great potential towards the energy saving.

Currently, Mobile operators are busy with deployment of 4G technology namely, LTE-advanced or WIMAX 802.16m. This 4G technology will be concluded within two years. 5G technology is not standardizing yet, probably 5G standard will define in two to three years, and its deployment will start around 2020. In future, people will expect same quality of internet connectivity as the device is capable. This technology will include all types of advanced features, which make 5G technology more powerful. The main features we want to add in 5G mobile network is that user can simultaneously connect to the multiple wireless technologies and can switch between them. Forthcoming mobile technology has to support IPv6 and flat IP. This paper explains different technology which we want to include making future mobile technology more powerful and more in demand.

Submit Manuscript | http://medcraveonline.com MOJ Toxicol 2015, 1(4): 00018 condition progresses medication may be required. The condition is due to a combination of lifestyle and genetic factors. Obesity has been found to contribute to majority of cases of type II diabetes. The classic symptoms of diabetes are polyuria, polydipsia, polyphagia, fatigue and weight loss. Type II diabetes is a result of combination of lifestyle and genetic factors. The natural progression of type II diabetes necessitates most diabetes patients eventually to start insulin therapy. Insulin is a plays role in the control of lipid and carbohydrate metabolism. When glucose is released from dietary carbohydrates and absorbed, elevated concentrations of glucose in the blood stimulates the release of insulin. Insulin facilitates entry of glucose into adipose tissues, muscle and several other tissues. Insulin also stimulates the liver for storage of glucose in the form of glycogen. As blood glucose concentrations fall, insulin secretion stops. In the absence of insulin, the cells in the body will switch to using alternative fuels like fatty acids for energy, and subsequently, enzymes will break down the glycogen in the liver. Glucagon is the hormone which plays a major role for conversion of glycogen to glucose in liver which is then released into the blood stream.

A term male baby, after delivery, was found to have a 3-centimeter beefy-red mass protruding from the left chest wall, adjacent to the left nipple. Radiological imaging suggested it’s origin from the left lateral liver segment. A diagnostic laparoscopy confirmed the isolated connection to the liver, elevated left hemidiaphragm, and protrusion between the ribs. The mass was excised using electrocautery, and pathologic examination showed normal liver tissue.

Biofilm formation in wounds is a serious problem which inhibits proper wound healing. One possible contributor to biofilm formation in a wound is the bacteria growing within the overlying bandage. To test this mechanism, we used bandages that contained a coating of organo-selenium that was covalently attached to the bandage. We tested the ability of this coating to kill bacteria on the bandage and in the underlying tissue. The bandage material was tested with both lab strains and clinical isolates of Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus epidermidis. It was found that the organo-selenium coated bandage showed inhibition, of biofilm formation on the bandage in vitro (7–8 logs), with all the different bacteria tested, at selenium concentrations in the coating of less than 1.0%. These coatings were found to remain stable for over one month in aqueous solution, 15 min in boiling water, and over 6 years at room temperature. The bandages were also tested on a mouse wound model where the bacteria were injected between the bandage and the wound. Not only did the selenium bandage inhibit biofilm formation in the bandage, but it also inhibited biofilm formation in the wound tissue. Since selenium does not leave the bandage, this would appear to support the idea that a major player in wound biofilm formation is bacteria which grows in the overlying bandage.

The right ventricular function(RV) is usually assessed subjectively by the Echo. Speckle tracking analyzes 2D Echo images to assess the wall motion. This modality has not been used routinely to assess the RV function. Objective: We compared RV segmental function with normal age matched controls

Vitex Negundo and Murraya Koenigii are popular Indian herbs which are used for various clinical disorders. The basic literature survey exposed that Vitex Negundo hasantioxidant, antiulcer and anti-nociceptive activity and Murraya Koenigii possessing anthelmintic, analgesic, cooling activity, but not many scientific studies have been carried out to reveal and collaborate the anti-inflammatory activity of Vitex Negundo and Murraya Koenigii leaves. All animals were divided into five groups, six rats in each group. Group I was treated as toxicant control to observe swelling, group II was treated with Aspirin (10 mg/kg, p.o), group III and IV were treated with hydroalcoholic extract of leaves of Vitex Negundo and Murraya Koenigii at two doses (100 mg/kg, p.o.) respectively. The anti-inflammatory activity was studied by using carrageenan induced paw edema in rats. Present study showed that hydroalcoholic leaves extract of Vitex Negundo and Murraya Koenigii significantly reduce paw edema when compared with group I (Toxicant control) rats and the result were dose dependent. The toxicity study also revealed its safeness, thus the plant can be hypothesized it is nontoxic. All data were expressed as mean+SEM and were statistically analysed one way ANOVA. It is concluded that hydroalcoholic leaves extract of Vitex Negundo and Murraya Koenigii can offer protection against carrageenan induced paw edema in rats.

In this paper we describe the design, simulation, fabrication, and test of a 32-bit 2's complement integer multiplier constructed from a combination of CMOS standard cells and threshold logic elements in a 65 nm low power process. As compared to a multiplier designed solely using CMOS standard cells, the threshold logic based multiplier is 1.23x smaller and consumes 1.41x less dynamic power and 2.5x less leakage power at the same process corner.