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Introduction: Platelet-rich fibrin (PRF) is the newer treatment option for treatment of chronic non-healing ulcers of leg and it contains various growth factors which boosts the wound healing. Objectives: To detect the efficacy of autologous PRF dressing in chronic non-healing leg ulcers and to assess the reduction in ulcer area at the end of each week. Materials and Methods: 30 patients (17 females, 13 males) were taken in this prospective study with informed consent. PRF was prepared by drawing 10cc venous blood and directly centrifuging it at 3000rpm (approximately 400g) for 10 minutes without adding anticoagulant. Three fractions were formed consisting of red coloured lower fraction containing RBCs, middle fraction containing PRF and upper fraction consisting of upper straw coloured platelet poor plasma (PPP). PPP fraction was discarded; middle PRF fraction was collected by separating it from the lower RBC fraction with forceps and scissors. PRF was then applied over the healthy bed of chronic non-healing ulcers every week till the wound heals. Reduction in ulcer at the end of each week is assessed by calculating area (Length×Width×0.7854). Results: The mean size of the ulcers was 10.4 cm2 initially; mean duration of ulcer was 4.7months. Complete healing required minimum 3 and the maximum 8 sittings (mean 4) no adverse events seen. Conclusion: We conclude that PRF dressing can be used as it is effective, safe, outpatient procedure in chronic non-healing leg ulcers.

The COVID-19 pandemic has taken the entire world by storm. Almost all dermatology laser procedures are considered non-essential and there is a consensus that they should be deferred till the threat of the COVID-19 is well and truly over. The article presents recommendations for the use of lasers and energy based devices in a safe manner during and in the immediate aftermath of COVID-19 pandemic. Plume generating procedures need full personal protective equipment to be used. Special precautions are required for specific laser and energy based procedures. A robust disinfection strategy based on preventing fomite borne COVID-19 transmission in the laser operating room is essential.

To broadly synthesize the literature regarding rural health disparities in otolaryngology, categorize findings, and identify research gaps to stimulate future work.Scoping review.A comprehensive literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and CINAHL.The methods were developed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Peer-reviewed, English-language, US-based studies examining a rural disparity in otolaryngology-related disease incidence, prevalence, diagnosis, treatment, or outcome were included. Descriptive studies, commentaries, reviews, and letters to the editor were excluded. Studies published prior to 1980 were excluded.The literature search resulted in 1536 unique abstracts and yielded 79 studies that met final criteria for inclusion. Seventy-five percent were published after 2010. The distribution of literature was as follows: otology (34.2%), head and neck cancer (20.3%), endocrine surgery (13.9%), rhinology and allergy (8.9%), trauma (5.1%), laryngology (3.8%), other pediatrics (2.5%), and adult sleep (1.3%). Studies on otolaryngology health care systems also accounted for 10.1%. The most common topics studied were practice patterns (41%) and epidemiology (27%), while the Southeast (47%) was the most common US region represented, and database study (42%) was the most common study design.Overall, there was low-quality evidence with large gaps in the literature in all subspecialties, most notably facial plastic surgery, laryngology, adult sleep, and pediatrics. Importantly, there were few studies on intervention and zero studies on resident exposure to rural populations, which will be critical to making rural otolaryngology care more equitable in the future.

With the emergence of smart devices, the antennas that can fulfil the requirements of such devices are very much in demand. As the devices should be connected to the internet, antennas that are aesthetically good and easy to interface anywhere on the routers or repeaters are needed. One of the solutions to this problem is by using transparent antennas that are visibly neutral and can be placed anywhere in the system. Transparent antennas integrated with dielectric resonator (DR) elements lead to fewer conduction losses due to the high dielectric constant of DR, and so an antenna resonating in the frequency band of 2.4 GHz (IEEE 802.11) WLAN applications is proposed that was simulated using Ansys High-Frequency Structure Simulator (HFSS) software. The optical transparency along with wide impedance bandwidth (31.26%), directional radiation pattern, gain and efficiency values greater than 1.5 dBi, and 75%, respectively makes the antenna suitable for smart wireless applications. The DRA fabricated using transparent material AgHT-8, Plexiglas, and Borosilicate glass show good agreement with the simulated results.

In this article, a retail management system (RMS) called Shopwell is developed which keeps track of the expiry date of products along with the total expenditure analysis through Python, MySQL, and Android Studio where customers can keep track of the budget utilized for buying the products like groceries, cosmetics, and medication and it alerts when the product expiry is near while shopping online or offline. The customers hardly keep track of expiry dates on products and sometimes it is hard to keep track of total spending over a while. The proposed system can be linked with any retail business and comes in handy in the form of an app that can be installed on mobiles, tablets, and laptops. Once the retail business ties up with Shopwell, the bill which is created after shopping generates a link which directly links to the app once clicked by the customer when shopping online otherwise the link is established once the cashier scans the QR code available in the customer's app after scanning the products over offline mode. Once the app has the required data of the purchased items, it assists the customers to keep a record of the purchase details chiefly on the expiration date and the total expenditure thus avoiding consumers to stop using out of date products while keeping the daily budgets within stipulated limits.

Anthracycline chemotherapeutics are highly effective, but their clinical usefulness if hampered by adverse side effects such as cardiotoxicity. Cytochrome P450 2J2 (CYP2J2) is a cytochrome P450 epoxygenase in human cardiomyocytes that converts arachidonic acid (AA) to cardioprotective epoxyeicosatrienoic acid (EET) regioisomers. Herein, we performed biochemical studies to understand the interaction of anthracycline derivatives (daunorubicin, doxorubicin, epirubicin, idarubicin, 5-iminodaunorubicin, zorubicin, valrubicin, and aclarubicin) with CYP2J2. We utilized fluorescence polarization (FP) to assess whether anthracyclines bind to CYP2J2. We found that aclarubicin bound the strongest to CYP2J2 despite it having large bulky groups. We determined that ebastine competitively inhibits anthracycline binding, suggesting that ebastine and anthracyclines may share the same binding site. Molecular dynamics and ensemble docking revealed electrostatic interactions between the anthracyclines and CYP2J2, contributing to binding stability. In particular, the glycosamine groups in anthracyclines are stabilized by binding to glutamate and aspartate residues in CYP2J2 forming salt bridge interactions. Furthermore, we used iterative ensemble docking schemes to gauge anthracycline influence on EET regioisomer production and anthracycline inhibition on AA metabolism. This was followed by experimental validation of CYP2J2-mediated metabolism of anthracycline derivatives using liquid chromatography tandem mass spectrometry fragmentation analysis and inhibition of CYP2J2-mediated AA metabolism by these derivatives. Taken together, we use both experimental and theoretical methodologies to unveil the interactions of anthracycline derivatives with CYP2J2. These studies will help identify alternative mechanisms of how anthracycline cardiotoxicity may be mediated through the inhibition of cardiac P450, which will aid in the design of new anthracycline derivatives with lower toxicity.

Background: Vitiligo is an acquired disorder characterized by depigmented macules or patches on the skin due to the loss of functional melanocytes. Segmental vitiligo (SV) is a subtype of vitiligo refractory to treatment. Objective: We studied safety and efficacy of 308-nm monochromatic excimer light (MEL) in combination with 0.1% tacrolimus ointment for the treatment of SV. Methods: Fifty patients with SV were enrolled. MEL was given on alternate dates in combination with topical tacrolimus. Clinical photographs were taken once a month. Two independent dermatologists analyzed and graded the results. Results: Five patients were lost to follow-up. Concerning overall treatment success, 77.8 percent of patients demonstrated at least 75-percent repigmentation. More specifically, 35.6 percent of patients showed complete (100%) repigmentation (Grade 5), whereas 42.2 percent of patients showed more than 75-percent repigmentation (Grade 4). Conclusion: Combination therapy with topical 0.1% tacrolimus and a 308-nm excimer lamp appears to be efficacious with a good safety profile. The duration of disease was a statistically significant factor inversely correlated with treatment success rate. The site of vitiligo also plays a significant part in the outcome, as facial lesions responded best to the treatment.

A smart parking system using Raspberry Pi and android app access is proposed in this article. An automated smart parking system which provides the user to pre-book along with on the spot booking facility of parking spaces available around the area is implemented. The system also helps to store the user’s information in database which enables for fast parking access thus reducing the traffic congestion. The hardware is realized using Raspberry Pi and IR sensor. In addition, the system is controlled through an app which is made using Kodular App Development tool, that helps the user to keep track of the updates about available parking spaces. The scalable and precise database can be created on firebase and host it on an application in real-time which is useful to store data in a json format (bucket format). The system is a perfect partner for people to book the parking spaces at their ease from remote locations without wasting time and avoiding traffic congestion.

The Simons Foundation Autism Research Initiative (SFARI) has launched SPARKForAutism.org, a dynamic platform that is engaging thousands of individuals with autism spectrum disorder (ASD) and connecting them to researchers. By making all data accessible, SPARK seeks to increase our understanding of ASD and accelerate new supports and treatments for ASD.

Background Fear of autism has led to a decline in childhood-immunization uptake and to a resurgence of preventable infectious diseases. Identifying characteristics of parents who believe in a causal role of vaccines for autism spectrum disorder (ASD) in their child may help targeting educational activities and improve adherence to the immunization schedule. Objectives To compare caregivers of children with ASD who agree or disagree that vaccines play an etiological role in autism for 1) socio-demographics characteristics and 2) developmental and clinical profiles of their children. Methods Data from 16,525 participants with ASD under age 18 were obtained from SPARK, a national research cohort started in 2016. Caregivers completed questionnaires at registration that included questions on beliefs about the etiologic role of childhood immunizations and other factors in ASD. Data were available about family socio-demographic characteristics, first symptoms of autism, developmental regression, co-occurring psychiatric disorders, seizures, and current levels of functioning. Results Participants with ASD were 80.4% male with a mean age of 8.1 years (SD = 4.1). Overall, 16.5% of caregivers endorsed immunizations as perceived causes of autism. Compared to caregivers who disagreed with vaccines as a cause for ASD, those who believed in vaccine causation came disproportionately from ethnic minority, less educated, and less wealthy backgrounds. More often their children had experienced developmental regression involving language and other skills, were diagnosed earlier, had lost skills during the second year of life, and had worse language, adaptive, and cognitive outcomes. Conclusion One in six caregivers who participate in a national research cohort believe that child immunizations could be a cause of autism in their child. Parent social background (non-White, less educated) and child developmental features (regression in second year, poorer language skills, and worse adaptive outcomes) index caregivers who are more likely to harbor these beliefs and could benefit from targeted educational activities.

White rosettes are shiny white structures seen as four oval-shaped points that come together in the center. They resemble four-leaf clover [1]. Earlier it was thought they were specific for actinic keratosis and squamous cell carcinoma, but they are noted in many other conditions [2]. With polarized light dermoscopy, it is evident that rosettes are seen only and they are due to the optical effect between polarized light and follicular structures [3]. Here, authors describe cases of discoid lupus erythematosus (DLE) demonstrating rosettes under polarized dermoscopy.

Background Understanding the pathogenesis of vitiligo has lead to innovation of new drugs and new uses of the existing drugs to enhance treatment outcome. Objective The aim of this observational pilot study was to assess the role of cyclosporine (CsA) to tackle the commonest aesthetic problem "perilesional halo" after autologous noncultured melanocyte-keratinocyte cell transplant (NCMKT) for localized, stable vitiligo. Materials and methods Of the total 50 enrolled patients who underwent NCMKT for stable/resistant vitiligo, aged 12 to 68 years (mean 29.92 years), 18 were male and 32 were female. Group I (n = 25) patients did not receive any postoperative treatment. Group II (n = 25) patients received CsA postoperatively at 3 mg·kg·d for 3 weeks followed by 1.5 mg·kg·d for 6 weeks. Results In Group I, results were as follows: 28% (n = 7) achieved >75% repigmentation, 16% (n = 4) achieved 50% to 75% repigmentation, 52% (n = 13) achieved 25% to 50% repigmentation, and 4% (n = 1) achieved 75% (median 90.7%) repigmentation post-NCMKT at the end of 6 months. Conclusion This new drug regimen using CsA resulted in rapid and uniform repigmentation without leaving any perilesional halo in Group II patients after NCMKT.

Trichostasis spinulosa (TS) is a common yet underdignosed condition affecting hair follicles. Diagnosis is based on the clinical features, hair mount, and dermoscopy. Here, the authors describe a case of TS in a nevoid distribution wherein dermoscopy aided the diagnosis.How to cite this articleAnkad BS, Shah S, Mallapur AA. Nevoid Trichostasis Spinulosa: Dermoscopic Point of View. Int J Dermoscop 2017;1(2):65-66.

Infection after fractures of the tibial plafond is a challenging problem that may even result in amputation. The current study evaluates a limb salvage protocol and the associated long term functional outcome in 6 patients (mean age 46 years) who were treated for infection after a fracture of the distal tibial metaphysis and plafond. Our limb salvage protocol included 3 stages: 1) radical debridement and stabilization of the ankle with a bridging external fixator, 2) soft tissue coverage with free muscle flaps, and 3) ankle fusion using iliac crest bone graft for filling the existing defects measuring 4.2 cm on average. At a mean followup of 5.5 years (range, 2-10.5 years), limb-salvage and eradication of infection was accomplished in all extremities. Fusion of the ankle joint was achieved in all patients, with one patient requiring a supplemental bone grafting procedure for delayed healing of the fusion site. All patients are able to walk without assistive devices and five of six patients are pain free. Limb salvage with free muscle flaps, bone grafting, and ankle fusion is a viable option for the treatment of infected tibial metaphysis and plafond fractures.

A successful effort has been made to deposit vanadium carbide on AISI H13 steel using Nd:YAG laser. In this study a continuous, adherent, crack-, and porosity-free coating has been obtained which can serve as a protective layer for various surfaces. The coating is composite in nature. To explore the properties of this coating in greater detail, it has been evaluated for chemical, structural, and mechanical properties. Another aspect of this work is to identify the suitability of this coating to protect die-casting die surfaces from the attack of molten aluminum. A number of different mechanisms, such as corrosive attack and erosion by molten aluminum and oxidation of the die surface, act to reduce the life of die-casting dies. In view of this, the coating has been tested for preliminary analysis such as high-temperature oxidation by conducting thermogravimetric analysis and for liquid metal corrosion resistance by immersion test in liquid aluminum. It shows excellent oxidation resistance below 600 °C and performs well in the immersion test in liquid aluminum by reducing the extent of attack of molten aluminum on the H13 steel.

A successful effort has been made to deposit vanadium carbide on AISI H13 steel using Nd:YAG laser. A search for an ideal coating and equally suitable coating method for various applications will always be an interesting and challenging area in surface engineering. In the present study, a continuous, adherent, crack-porosity-free coating—composite in nature—has been obtained, which can serve as a protective tool for various surfaces. To explore the properties of this coating in greater detail, it has been evaluated for chemical, structural, mechanical, and tribological properties. It shows very high hardness and excellent wear resistance as compared to substrate H13 steel.

Refractory materials such as ceramics and refractory metals/alloys are widely used for structural applications in severe environments where more efficient use of energy is a prime need. Owing to properties such as high strength and refractoriness, low thermal expansion and electric conductivity these materials may be used as turbocharger rotors, valves, valve seats and turbocharger turbine wheels in gas turbine engines, tubes in industrial heat exchangers, fuel elements in nuclear reactors, fusion reactor wall material, tool materials in machining and casting and as electronic packaging. In these applications, however, these materials often experience extreme mechanical, thermal and chemical loading conditions and are expected to perform effectively beyond existing limits. The existing limits of performance for these materials can be extended only via coating technology, which presently appears to be the most suitable technical and economic approach. Thus there remains a critical need to develop a suitable and reliable refractory coating system and coating technique. In view of the above requirements, the present paper embarks on a brief review of refractory coatings. The review begins with a set of criteria required for an effective refractory coating. The criteria include general thermophysical and mechanical properties for the refractory coating only and properties of the coating-substrate as a system. The review continues with a section on methods of coating. The classification of methods of coating is based on categories such as gaseous, solution, molten/semi-molten and solid state processes. Each category is explained with conventional and novel techniques and coatings that can be synthesized using these techniques. These categories are supplemented also with examples of applications. A major emphasis has been put on refractory materials in the following section on coating material systems. The most important materials systems have been grouped as oxides and nitrides, carbides, borides, silicides and aluminides. The general properties that make them useful as refractory coatings, along with specific materials and applications, have been reviewed. Wettability and adhesion between coating and substrate are very important for the coating-substrate system to perform effectively and reliably. The last section discusses the fundamentals of wettability and work of adhesion, based on which wetting in metal-metal, metal oxide, metal-carbon/carbide systems has been discussed. Finally, the review sets the motion of thoughts with a description on future developments.

Infection after fractures of the tibial plafond is a challenging problem that may even result in amputation. The current study evaluates a limb salvage protocol and the associated long term functional outcome in 6 patients (mean age 46 years) who were treated for infection after a fracture of the distal tibial metaphysis and plafond. Our limb salvage protocol included 3 stages: 1) radical debridement and stabilization of the ankle with a bridging external fixator, 2) soft tissue coverage with free muscle flaps, and 3) ankle fusion using iliac crest bone graft for filling the existing defects measuring 4.2 cm on average. At a mean followup of 5.5 years (range, 2-10.5 years), limb-salvage and eradication of infection was accomplished in all extremities. Fusion of the ankle joint was achieved in all patients, with one patient requiring a supplemental bone grafting procedure for delayed healing of the fusion site. All patients are able to walk without assistive devices and five of six patients are pain free. Limb salvage with free muscle flaps, bone grafting, and ankle fusion is a viable option for the treatment of infected tibial metaphysis and plafond fractures.

Bone disease is a side effect of concern regarding chronic glucocorticoid (GC) administration. Most GC-treated patients exhibit a process of bone loss, frequently leading to osteoporosis, with increased fracture risk, especially in spinal vertebrae. Some GC-treated patients will develop osteonecrosis, a disease with distinct clinical and histopathological features, most often occurring underneath the articular surface of the femoral head. Remarkably, both of these GC-induced bone diseases are associated with osteoblast and osteocyte apoptosis, which is emerging as a potential primary pathogenic mechanism. Here, we review the evidence for osteoblast and osteocyte apoptosis in GC-induced bone disease and highlight current debates: (1) With recent reports describing the antiapoptotic effect of GCs in some in vitro osteoblast models, and with the known adverse effects of GCs on osteoblast cell cycle and differentiation, could the in vivo osteoblast apoptosis be an indirect rather than a direct effect of GCs? (2) What is the pathogenic relationship between GC-induced osteoporosis and osteonecrosis? Could the latter be a mere manifestation of the former? and (3) How does apoptosis fit into the traditional concept of ischemia as a key etiology in osteonecrosis? Regardless of the answers, recent studies with cells, animals, and humans point out bone cell apoptosis as a potential target in the design of treatment for GC-induced bone disease.

Bone disease is a side effect of concern regarding chronic glucocorticoid (GC) administration. Most GC-treated patients exhibit a process of bone loss, frequently leading to osteoporosis, with increased fracture risk, especially in spinal vertebrae. Some GC-treated patients will develop osteonecrosis, a disease with distinct clinical and histopathological features, most often occurring underneath the articular surface of the femoral head. Remarkably, both of these GC-induced bone diseases are associated with osteoblast and osteocyte apoptosis, which is emerging as a potential primary pathogenic mechanism. Here, we review the evidence for osteoblast and osteocyte apoptosis in GC-induced bone disease and highlight current debates: (1) With recent reports describing the antiapoptotic effect of GCs in some in vitro osteoblast models, and with the known adverse effects of GCs on osteoblast cell cycle and differentiation, could the in vivo osteoblast apoptosis be an indirect rather than a direct effect of GCs? (2) What is the pathogenic relationship between GC-induced osteoporosis and osteonecrosis? Could the latter be a mere manifestation of the former? and (3) How does apoptosis fit into the traditional concept of ischemia as a key etiology in osteonecrosis? Regardless of the answers, recent studies with cells, animals, and humans point out bone cell apoptosis as a potential target in the design of treatment for GC-induced bone disease.

A laser-based coating technique was employed to deposit VC on H13 steel for enhanced performance of H13 steel in die-casting die application. The coating was composite (VC/H13 steel) in nature. As oxidation is one of the performance controlling factors for dies, high temperature (200-1000 °C) oxidation of the coating was studied using a thermogravimetric analysis technique (TGA). The oxidation behavior of the individual components (VC and H13) of the composite coating was also evaluated using TGA. The oxidation behavior of the composite coating is dictated by the behavior of VC, which is parabolic for lower temperature range (200-600 °C) and linear for higher temperature range (200-600 °C). These observations indicated that the composite coating on H13 steel could be synthesized with tailored amounts of VC content for enhanced performance in die-casting die application.