Priyanka Priyanka

Medical imaging applications in hospitals and laboratories have shown benefits in visualizing patient’s body for diagnosis and treatment of disease. Ultrasound (US) is considered as safest medical imaging technique and is therefore used extensively in medical and healthcare using computer aided system. However presence of some artifacts due to patient mobility and equipment limitations makes diagnosis of these US images difficult. There is need for some pre-processing methods to improve quality of images for the purpose of classification and segmentation while preserving pixels of interest. These pixels contain information about images known as image features which forms the data model for classification. So, feature extraction and selection is important phase in classification step of diagnostic system. Keeping this in mind, this study focuses on preprocessing and feature extraction and selection phase of ultrasound images of kidney for making a classification model. Four operations cropping, interpolation, rotation and background removal are applied as preprocessing methods to enhance the quality of images and for making diagnosis easy and effective. Afterwards, a number of second order statistical texture features including energy, entropy, homogeneity, correlation, contrast, dissimilarity are generated using GLCM. Finally obtained features are reduced to optimal subset using principal component analysis (PCA). The results show that GLCM in combination with PCA for feature reduction gives high classification accuracy when classifying images using Artificial Neural Network (ANN).

Typical bioprocess comprises of different unit operations wherein a near optimal environment is required for cells to grow, divide, and synthesize the desired product. However, bioprocess control caters to unique challenges that arise due to non-linearity, variability, and complexity of biotech processes. This article presents a review of modern control strategies employed in bioprocessing. Conventional control strategies (open loop, closed loop) along with modern control schemes such as fuzzy logic, model predictive control, adaptive control and neural network-based control are illustrated, and their effectiveness is highlighted. Furthermore, it is elucidated that bioprocess control is more than just automation, and includes aspects such as system architecture, software applications, hardware, and interfaces, all of which are optimized and compiled as per demand. This needs to be accomplished while keeping process requirement, production cost, market value of product, regulatory constraints, and data acquisition requirements in our purview. This article aims to offer an overview of the current best practices in bioprocess control, monitoring, and automation.

This review examines on our current understanding of microbial lipase solvent tolerance, with a specific focus on the molecular strategies employed to improve lipase stability in a non-aqueous environment. It provides an overview of known solvent tolerant lipases and of approaches to improving solvent stability such as; enhancing stabilising interactions, modification of residue flexibility and surface charge alteration. It shows that judicious selection of lipase source supplemented by appropriate enzyme stabilisation, can lead to a wide application spectrum for lipases. Organic solvent stable lipases are, and will continue to be, versatile and adaptable biocatalytic workhorses commonly employed for industrial applications in the food, pharmaceutical and green manufacturing industries.

Skin, being the largest organ of the body, is an important site for drug administration. However, most of the drugs have poor permeability and thus drug delivery through the skin is very challenging. In this study, we examined the transdermal delivery capability of IMT-P8, a novel cell-penetrating peptide. We generated IMT-P8-GFP and IMT-P8-KLA fusion constructs and evaluated their internalization into mouse skin after topical application. Our results demonstrate that IMT-P8 is capable of transporting green fluorescent protein (GFP) and proapoptotic peptide, KLA into the skin and also in different cell lines. Interestingly, uptake of IMT-P8-GFP was considerably higher than TAT-GFP in HeLa cells. After internalization, IMT-P8-KLA got localized to the mitochondria and caused significant cell death in HeLa cells signifying an intact biological activity. Further in vivo skin penetration experiments revealed that after topical application, IMT-P8 penetrated the stratum corneum, entered into the viable epidermis and accumulated inside the hair follicles. In addition, both IMT-P8-KLA and IMT-P8-GFP internalized into the hair follicles and dermal tissue of the skin following topical application. These results suggested that IMT-P8 could be a potential candidate to be used as a topical delivery vehicle for various cosmetic and skin disease applications.

About one-third of critically ill patients with acute kidney injury (AKI) develop persistently decreased kidney function, known as acute kidney disease (AKD), which may progress to chronic kidney disease (CKD). Although sepsis is the most common cause of AKI, little is known about sepsis-associated AKD.Using data from a large randomized trial including 1341 patients with septic shock, we studied patients with stage 2 or 3 AKI on day 1 of hospitalization. We defined AKD as a persistently reduced glomerular filtration rate for >7 days. In addition to clinical data, we measured several urinary biomarkers (tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7 [TIMP-2∗IGFBP7], neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule-1 [KIM-1], liver-type fatty acid binding protein, and type 4 collagen) at 0, 6, and 24 hours, to predict AKD.Of 598 patients, 119 (19.9%) died within 7 days, 318 (53.2%) had early reversal of AKI within the first 7 days, whereas 161 (26.9%) developed AKD. In patients with early reversal, 45 (14.2%) had relapsed AKI after early reversal, and only about one-third of these recovered. Among patients developing AKD, only 15 (9.3%) recovered renal function prior to discharge. Male sex, African American race, and underlying CKD were more predominant in patients developing AKD. None of the biomarkers tested performed well for prediction of AKD, although NGAL modestly increased the performance of a clinical model.AKD is common in patients with septic shock, especially among African American males and those with underlying CKD. Existing AKI biomarkers have limited utility for predicting AKD but might be useful together with clinical variables. Novel predictive biomarkers for renal recovery are needed.

The Pseudomonas sp. have been long recognized for their exogenous lipolytic activities yet the genus still contains a lot of unexplored strains. Due to the versatile metabolic machinery and their potential for adaptation to fluctuating environmental conditions Pseudomonas sp. are of great interest for biotechnological applications. In this study, a new extracellularly produced lipolytic enzyme from Pseudomonas sp. (P. reinekei) was purified and characterized. The production of lipase from P. reinekei (H1) was enhanced 10-fold by optimizing the nitrogen source. The 50 kDa H1 lipase was purified using negative and positive mode anion exchange chromatography. The purified lipase was active over a broad pH range (5.0–9.0) and was stable for 24 h at 40 °C. The lipase showed significant stability, and indeed activation, in the presence of organic solvents with log P ≥ 2.0. These features render this lipase of interest as a biocatalyst for applications such as biodiesel production, detergent formulations and biodegradation of oil in the environment.

To examine the effect of kidney recovery on mortality, dialysis and kidney transplantation up to 15 years after AKI. We studied 29,726 survivors of critical illness and compared these outcomes stratified by AKI and recovery status at hospital discharge. Kidney recovery was defined as a return of serum creatinine to ≤150% of baseline without dialysis prior to hospital discharge. Overall AKI occurred in 59.2% in which two thirds developed stage 2–3 AKI. Recovery rate of AKI at hospital discharge was 80.8%. Patients who did not recover experienced the worst 15-year mortality compared to those who recovered and those without AKI (57.8% vs 45.2% vs 30.3%, p < 0.001). This pattern was also found in subgroups of patients with suspected sepsis-associated (57.1% vs 47.9% vs 36.5%, p < 0.001) and cardiac surgery-associated AKI (60.1% vs 41.8% vs 25.9%, p < 0.001). The rates of dialysis and transplantation at 15 years were low and not associated with recovery status. Recovery of AKI in critically ill patients at hospital discharge had an effect on long-term mortality for up to 15 years. These results have implications for acute care, follow-up and choice of endpoints for clinical trials.

Fossil fuels have solved our energy problems since the beginning of the industrial revolution that started in the eighteenth century. However, from past few decades, the world has seen an unprecedented and uncontrolled use of fossil fuels. In the current era, we heavily rely on fossil fuels for energy demands. It is undeniably true that fossil fuels hold the credit of shaping our world, but on the cost of environmental and related hazards. The negative environmental impacts of fossil usage are now being realized, and the search for alternative energy sources has begun. Bioenergy crops are one such energy source that could positively impact the environment to reduce the level of carbon dioxide, emission of greenhouse gases and soil erosion. The biofuel generation using fast growing and photosynthetically efficient bioenergy crops is emerging as a reliable alternative to fossil fuels. Bioenergy plants increase soil carbon and fix atmospheric carbon. In addition, bioenergy crops (miscanthus, sorghum and poplar) could also be used for the phytoremediation of heavy metal-contaminated soils. The bioenergy crops include specific plants that are grown and maintained at lower costs for biofuel production. The bioenergy crops are classified into five types namely, first-, second- and third-generation bioenergy crops, dedicated energy crops and halophytes. The first-generation bioenergy crops include corn, sorghum, rapeseed and sugarcane, whereas the second-generation bioenergy crops are comprised of switchgrass, miscanthus, alfalfa, reed canary grass, Napier grass and other plants. The third-generation bioenergy crops contain boreal plants, crassulacean acid metabolism (CAM) plants, eucalyptus and microalgae. Bioenergy halophytes are comprised of the genera Acacia, Eucalyptus, Casuarina, Melaleuca, Prosopis, Rhizophora and Tamarix. The dedicated energy crops include perennial herbaceous and woody plant species as giant miscanthus, switchgrass, jatropha and algae.

Purpose: This study was designed to ascertain the quality of patient information available on the World Wide Web on the topic of knee arthroscopy. Methods: For the purpose of quality analysis, we used a pool of 232 search results obtained from 7 different search engines. We used a modified assessment questionnaire to assess the quality of these Web sites. This questionnaire was developed based on similar studies evaluating Web site quality and includes items on illustrations, accessibility, availability, accountability, and content of the Web site. We also compared results obtained with different search engines and tried to establish the best possible search strategy to attain the most relevant, authentic, and adequate information with minimum time consumption. For this purpose, we first compared 100 search results from the single most commonly used search engine (AltaVista) with the pooled sample containing 20 search results from each of the 7 different search engines. The search engines used were metasearch (Copernic and Mamma), general search (Google, AltaVista, and Yahoo), and health topic–related search engines (MedHunt and Healthfinder). The phrase “knee arthroscopy” was used as the search terminology. Results: Excluding the repetitions, there were 117 Web sites available for quality analysis. These sites were analyzed for accessibility, relevance, authenticity, adequacy, and accountability by use of a specially designed questionnaire. Our analysis showed that most of the sites providing patient information on knee arthroscopy contained outdated information, were inadequate, and were not accountable. Only 16 sites were found to be providing reasonably good patient information and hence can be recommended to patients. Understandably, most of these sites were from nonprofit organizations and educational institutions. Furthermore, our study revealed that using multiple search engines increases patients’ chances of obtaining more relevant information rather than using a single search engine. Conclusions: Our study shows the difficulties encountered by patients in obtaining information regarding knee arthroscopy and highlights the duty of knee surgeons in helping patients to identify the relevant and authentic information in the most efficient manner from the World Wide Web. Clinical Relevance: This study highlights the importance of the role of orthopaedic surgeons in helping their patients to identify the best possible information on the World Wide Web. Purpose: This study was designed to ascertain the quality of patient information available on the World Wide Web on the topic of knee arthroscopy. Methods: For the purpose of quality analysis, we used a pool of 232 search results obtained from 7 different search engines. We used a modified assessment questionnaire to assess the quality of these Web sites. This questionnaire was developed based on similar studies evaluating Web site quality and includes items on illustrations, accessibility, availability, accountability, and content of the Web site. We also compared results obtained with different search engines and tried to establish the best possible search strategy to attain the most relevant, authentic, and adequate information with minimum time consumption. For this purpose, we first compared 100 search results from the single most commonly used search engine (AltaVista) with the pooled sample containing 20 search results from each of the 7 different search engines. The search engines used were metasearch (Copernic and Mamma), general search (Google, AltaVista, and Yahoo), and health topic–related search engines (MedHunt and Healthfinder). The phrase “knee arthroscopy” was used as the search terminology. Results: Excluding the repetitions, there were 117 Web sites available for quality analysis. These sites were analyzed for accessibility, relevance, authenticity, adequacy, and accountability by use of a specially designed questionnaire. Our analysis showed that most of the sites providing patient information on knee arthroscopy contained outdated information, were inadequate, and were not accountable. Only 16 sites were found to be providing reasonably good patient information and hence can be recommended to patients. Understandably, most of these sites were from nonprofit organizations and educational institutions. Furthermore, our study revealed that using multiple search engines increases patients’ chances of obtaining more relevant information rather than using a single search engine. Conclusions: Our study shows the difficulties encountered by patients in obtaining information regarding knee arthroscopy and highlights the duty of knee surgeons in helping patients to identify the relevant and authentic information in the most efficient manner from the World Wide Web. Clinical Relevance: This study highlights the importance of the role of orthopaedic surgeons in helping their patients to identify the best possible information on the World Wide Web. Note: To access the supplementary tables accompanying this report, visit the May issue of Arthroscopy at www.arthroscopyjournal.org.

Whether metformin exposure is associated with improved outcomes in patients with type 2 diabetes mellitus and sepsis.Retrospective cohort study.Patients admitted to ICUs in 16 hospitals in Pennsylvania from October 2008 to December 2014.Adult critical ill patients with type 2 diabetes mellitus and sepsis.None.We conducted a retrospective cohort study to compare 90-day mortality in diabetic patients with sepsis with and without exposure to metformin during hospitalization. Data were obtained from the electronic health record of a large healthcare system in Pennsylvania from October 2008 to December 2014, on patients admitted to the ICU at any of the 16 hospitals within the system. The primary outcome was mortality at 90 days. The absolute and adjusted odds ratio (OR) with 95% CI were calculated in a propensity score-matched cohort. Among 14,847 patients with type 2 diabetes mellitus and sepsis, 682 patients (4.6%) were exposed to metformin during hospitalization and 14,165 (95.4%) were not. Within a total of 2,691 patients subjected to propensity score-matching at a 1:4 ratio, exposure to metformin (n = 599) was associated with decreased 90-day mortality (71/599, 11.9% vs 475/2,092, 22.7%; OR, 0.46; 95% CI, 0.35-0.60), reduced severe acute kidney injury (50% vs 57%; OR, 0.75; 95% CI, 0.62-0.90), less Major Adverse Kidney Events at 1 year (OR, 0.27; 95% CI, 0.22-0.68), and increased renal recovery (95% vs 86%; OR, 6.43; 95% CI, 3.42-12.1).Metformin exposure during hospitalization is associated with a decrease in 90-day mortality in patients with type 2 diabetes mellitus and sepsis.

Real-time estimation of physiological properties of the cell during recombinant protein production would ensure enhanced process monitoring. In this study, we explored the application of dielectric spectroscopy to track the fed-batch phase of recombinant Escherichia coli cultivation for estimating the physiological properties, namely, cell diameter and viable cell concentration (VCC). The scanning capacitance data from the dielectric spectroscopy were pre-processed using moving average. Later, it was modeled through a nonlinear theoretical Cole-Cole model and further solved using a global evolutionary genetic algorithm (GA). The parameters obtained from the GA were further applied for the estimation of the aforementioned physiological properties. The offline cell diameter and cell viability data were obtained from particle size analyzer and flow cytometry measurements to validate the Cole-Cole model. The offline VCC was calculated from the cell viability % from flow cytometry data and dry cell weight concentration. The Cole-Cole model predicted the cell diameter and VCC with an error of 1.03% and 7.72%, respectively. The proposed approach can enable the operator to take real-time process decisions to achieve desired productivity and product quality.

Infectious keratoconjunctivitis (IKC) is a highly contagious ocular inflammatory condition, which is often reported in domestic small and large ruminants. Multiple infectious aetiologies are reported to be involved, but information about the role of certain fastidious bacterial pathogens such as chlamydiae and mycoplasmas is limited in India. Hence, this study was performed to determine the role of these pathogens and their identification by molecular approach. A total of 53 samples from 31 ovine, 14 caprine and eight bovine having clinical symptoms were collected and tested using species-specific PCR tests for chlamydiae and mycoplasmas followed by nucleotide sequence analysis. The results showed 77·41, 14·29 and 25% samples were chlamydiae positive in ovine, caprine and bovine, respectively, whereas 41·93, 14·29 and 37·5% prevalence of mycoplasma infection was detected in ovine, caprine and bovines, respectively. Chlamydophila abortus, Chlamydophila psittaci, Mycoplasma arginini and Mycoplasma hyorhinis were detected from tested samples. To the best of our knowledge, this is the first time these species are identified in IKC cases from India. Coinfection of both chlamydial and mycoplasmal species was detected in eight IKC cases of ovine which suggest synergistic roles played by both chlamydiae and mycoplasma in IKC samples. Significance and Impact of the Study Infectious keratoconjunctivitis (IKC) in ruminants has multiple aetiologies, but the role of fastidious chlamydial and mycoplasmal species in clinical cases remains largely unknown. We screened a total of 53 cases of IKC from 31 ovine, 14 caprine and eight bovine, and Chlamydophila abortus, C. psittaci, Mycoplasma arginini and Mycoplasma hyorhinis were detected. These are rarely reported bacteria in clinical IKC. The detection of mixed infection in few cases is also indicative of interspecies synergism. This study highlights the role of lesser reported ocular pathogens in the precipitation of clinical IKC among ruminants that may contribute to a better understanding of pathogenesis and the treatment of IKC.

Extraction of medication information embedded in clinical text is important for research using electronic health records (EHRs). However, most of current medication information extraction systems identify drug and signature entities without mapping them to standard representation. In this study, we introduced the open source Java implementation of MedEx, an existing high-performance medication information extraction system, based on the Unstructured Information Management Architecture (UIMA) framework. In addition, we developed new encoding modules in the MedEx-UIMA system, which mapped an extracted drug name/dose/form to both generalized and specific RxNorm concepts and translated drug frequency information to ISO standard. We processed 826 documents by both systems and verified that MedEx-UIMA and MedEx (the Python version) performed similarly by comparing both results. Using two manually annotated test sets that contained 300 drug entries from medication list and 300 drug entries from narrative reports, the MedEx-UIMA system achieved F-measures of 98.5% and 97.5% respectively for encoding drug names to corresponding RxNorm generic drug ingredients, and F-measures of 85.4% and 88.1% respectively for mapping drug names/dose/form to the most specific RxNorm concepts. It also achieved an F-measure of 90.4% for normalizing frequency information to ISO standard. The open source MedEx-UIMA system is freely available online at http://code.google.com/p/medex-uima/.

Groundwater is the major source for fulfilling the water needs of domestic and agricultural sectors in Mewat district, Haryana, India and its continuous use has put an enormous pressure on the groundwater resource, which along with low rainfall and variable geographical conditions lead to the declining water levels. The other problem of this area is high salinity which is reported intruding to the freshwater zone1. Taking into account the twin problem of declining water level and high salinity the study was taken up jointly by National Institute of Hydrology, Roorkee; Sehgal Foundation, Gurgaon and Indian Institute of Technology, Roorkee. Groundwater level and TDS (Total dissolved solids) data for pre-monsoon and post-monsoon seasons for the time period of 2011–2015 of 40 monitoring wells developed by Sehgal Foundation, Gurgaon was collected and analysed. It has been found that the groundwater level is decreasing in the area while TDS values show inconsistent trends during 2011-15. Further monitoring of the wells is continued to get the more information on water level and TDS which will help in facilitating the researchers in finding out the applicable solutions for the above problems in the Mewat, Haryana.

Pseudomonads are one of the most studied species of bacteria as they display remarkable metabolic and physiological versatility. This enables them to colonize a wide variety of terrestrial and aquatic habitats, generating biotechnologically interesting enzymes. Here, the partial purification and characterization of a novel, extracellularly-produced, lipase from Pseudomonas brenneri is described. The partially purified lipase was active over a broad pH range (5.0–9.0) and was stable at 70 °C for 45 min. The lipase displayed significant stability, and in some cases activation, in the presence of organic solvents with log P ≥ 2.0. Such stability characteristics indicated that this lipase could potentially be useful as a biocatalyst for biodiesel production. This was subsequently demonstrated through the facile production of Fatty Acid Methyl Esters in the presence of olive oil and methanol. Possible applications for this novel, stable lipase include the bioremediation of oil in the environment.

Background: Ondansetron is a preferred anti-emetic in critical care to treat nausea and vomiting, and has historically been considered a largely safe option. A recent pharmacoepidemiology study reported that ondansetron may be associated with an increased risk for acute kidney injury (AKI). Methods: We interrogated the High-Density Intensive Care (HiDenIC-15) database containing intensive care data for 13 hospitals across Western Pennsylvania between Oct 2008-Dec 2014. AKI was defined using the Kidney Disease, Improving Global Outcomes 2012 guidelines. Ondansetron use was considered as receiving any form of ondansetron within 24 h of admission. The subsequent 48 h (hours 25-72 after admission) were analyzed for outcomes. Primary outcome was development of AKI; secondary outcomes included 90-day mortality and time to AKI. Propensity-matched, multivariate logistic regression was applied for both outcomes. Comparator groups were metoclopramide and prochlorperazine using the same exposure criteria. Results:AKI occurred in 965 (5.6%), 12 (3.0%), and 61 (6.5%) patients receiving ondansetron, prochlorperazine, and metoclopramide, respectively. In the adjusted analysis, no anti-emetic was associated with a significant change in the odds of developing AKI. Ondansetron was associated with a 5.48% decrease (CI -6.17--4.79) in death within 90 days of ICU-admission, which was independent of AKI status; an effect not seen with other anti-emetics. Anti-emetic usage was not associated with a change in the time to first AKI. Conclusion:Anti-emetic usage did not alter AKI risk. Ondansetron was associated with a significant decrease in 90-day mortality that was not seen by other anti-emetics, which requires further exploration.

Abstract: Primary immunodeficiency disorder also known as Inborn errors of immunityare potentially life threatning disorders, frequently remain undiagnosed in both developing and underdeveloped nations. A systematic and thorugh evaluation is required to attain a definitive diagnosis. This review outline the standardised approach essential for unravelling the diagnosis of such clinical condition during childhood.

The institution of marriage prescribes different norms for men and women. Patriarchal and heterosexual marriage expects husband and wife to follow their set gender roles which is an inseparable part of this institution. It works in a hierarchy. The Palestinian novelist Sahar Khalifeh, who hails from the West Bank, condemns the hypocrisy of the institution of traditional marriage that oppresses women in Arab society. In her literary narratives, Khalifeh portrays the traditions and customs of Arab society which act as weapons of oppression against women. In her works, she demonstrates that it is the customs and traditional practices imposed on women that are oppressive rather than religion. The objective of the paper is to dissect the way in which the institution of marriage largely supports and upholds the patriarchal and neopatriarchal values even in an ostensibly revolutionary population such as the Palestinian society by focusing on one of the Arabic novels of Khalifeh - Of Noble Origins translated into English. This paper examines the patriarchal norms of male dominance in public spheres and also highlights how the Palestinian women resist these sexist ideologies prevailing in their society. Thus, the study of Khalifeh's narratives in this paper is two-pronged: first, to analyse how male domination works, and second, to scrutinize how the women in her novels find ways to respond to the multi-level patriarchal domination. The paper includes a theoretical framework comprising patriarchy, neopatriarchy and male gaze.

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Ayurveda is a holistic science that emphasizes the maintenance and promotion of health through the prevention and curing aspects. According to Sushruta Samhita, term swasthya is the equilibrium state of Dosha, Agni, Dhatu, and Mala. Three doshas (vata, pitta, kapha), Agni (dhatvagni, bhutagni and jatharagni), Sapta Dhatu (Ras, rakta, mansa, meda, asthi, majja, shukra) and Trimala are responsible for maintaining good health. Rasayan is one of the eight clinical specialties of Ayurveda. The Rasayan therapy improves the qualities of Rasa and enriches it with nutrients so one can attain longevity, memory, intelligence, freedom from disorder, youthfulness, excellence of luster, complexion, and voice. The word “Rasayana” means the way to attain excellent Rasadi Dhatus. In Ayurveda, one of the major methods of presentation of positive health has been described i.e. Rasayana. This resistance power of the body, which prevents the development of diseases, is called Immunity or Vyadhikshamatva. The ultimate aim of Rasayana therapy is to correct Dosha imbalance and improve Agni and Dhatu function which overall improves strength and immunity. The application of Rasayan therapy comes in perspective of premature ageing and death. Rasayanas are used for preventive, curative, and health-promotive purposes.

UDC 517.5 For <mml:math> <mml:mrow> <mml:mn>0</mml:mn> <mml:mo>&lt;</mml:mo> <mml:mi>α</mml:mi> <mml:mo>≤</mml:mo> <mml:mn>1</mml:mn> </mml:mrow> </mml:math> and <mml:math> <mml:mrow> <mml:mi>λ</mml:mi> <mml:mo>&gt;</mml:mo> <mml:mn>0</mml:mn> <mml:mo>,</mml:mo> </mml:mrow> </mml:math> let The general form of the Silverman class introduced by Tuneski and Irmak [Int. J. Math. and Math. Sci., {\bf 2006}, Article~ID 38089 (2006)]. Our differential inequality formulation lays out several sufficient conditions for this class. Further, we consider a class <mml:math> <mml:mrow> <mml:mi>Ω</mml:mi> </mml:mrow> </mml:math> given by For these two classes, we establish inclusion relations involving some well-known subclasses of <mml:math> <mml:mrow> <mml:msup> <mml:mi>𝒮</mml:mi> <mml:mo>*</mml:mo> </mml:msup> </mml:mrow> </mml:math> and compute radius estimates featuring various pairings of these classes.

The many uses of saline solution include as providing temporary fluids when there is under or no hydration among the trauma cases. In addition, they participate in the control of salt and the levels of electrolytes in the body. To maintain the level of a saline bottle, hospital nurses or aides prime responsibility is to check it on a regular basis. The failure to replace them in time may result in a reversal of blood flow, compromising the patient’s life. An Internet of Things (IoT)-based Smart Saline Level was developed to solve this issue and to provide an automated and efficient solution for remote monitoring. The Proposed system employs Internet of Things (IoT) technology, integrating NodeMCU, a load cell amplifier (HX711), Arduino UNO, Pulse oximeter (MAX 30100) sensor, DHT11 Sensor and a voltage regulator(L7805). The load cell, in combination with the HX711 amplifier, accurately measures the weight of the saline bottle. MAX30100 sensor measures Heart Rate &amp; Oxygen saturation (SPo2) levels in blood. DHT11 Sensor detects the Humidity and Temperature levels. All the data is transmitted to the Arduino UNO, which serves as a master, the NodeMCU facilitates wireless communication, relaying the collected data from the Arduino UNO to the designated IoT cloud platform for remote monitoring.

Abstract Fourth order extended Fisher Kolmogorov reaction diffusion equation has been solved numerically using a hybrid technique. The temporal direction has been discretized using Crank Nicolson technique. The space direction has been split into second order equation using twice continuously differentiable function. The space splitting results into a system of equations with linear heat equation and non linear reaction diffusion equation. Quintic Hermite interpolating polynomials have been implemented to discretize the space direction which gives a system of collocation equations to be solved numerically. The hybrid technique ensures the fourth order convergence in space and second order in time direction. Unconditional stability has been obtained by plotting the eigen values of the matrix of iterations. Travelling wave behaviour of dependent variable has been obtained and the computed numerical values are shown by surfaces and curves for analyzing the behaviour of the numerical solution in both space and time directions.

A novel synthetic protocol for environmentally benign 5′-CMP-β-FeOOH soft hydrogels exhibiting a rapid pH-responsive reversible sol–gel transition, efficient adsorption and slow release capabilities is reported.

To compare 5% albumin with 0.9% saline for large-volume resuscitation (> 60 mL/Kg within 24 hr), on mortality and development of acute kidney injury.Retrospective cohort study.Patients admitted to ICUs in 13 hospitals across Western Pennsylvania. We analyzed two independent cohorts, the High-Density Intensive Care databases: High-Density Intensive Care-08 (July 2000 to October 2008, H08) and High-Density Intensive Care-15 (October 2008 to December 2014, H15).Total of 18,629 critically ill patients requiring large-volume resuscitation.Five percent of albumin in addition to saline versus 0.9% saline.After excluding patients with acute kidney injury prior to large-volume resuscitation, 673 of 2,428 patients (27.7%) and 1,814 of 16,201 patients (11.2%) received 5% albumin in H08 and H15, respectively. Use of 5% albumin was associated with decreased 30-day mortality by multivariate regression in H08 (odds ratio 0.65; 95% CI 0.49-0.85; p = 0.002) and in H15 (0.52; 95% CI 0.44-0.62; p < 0.0001) but was associated with increased acute kidney injury in H08 (odds ratio 1.98; 95% CI 1.56-2.51; p < 0.001) and in H15 (odds ratio 1.75; 95% CI 1.58-1.95; p < 0.001). However, 5% albumin was not associated with persistent acute kidney injury and resulted in decreased major adverse kidney event at 30, 90, and 365 days. Propensity matched analysis confirmed similar associations with mortality and acute kidney injury.During large-volume resuscitation, 5% albumin was associated with reduced mortality and major adverse kidney event at 30, 90, and 365 days. However, a higher rate of acute kidney injury of any stage was observed that did not translate into persistent renal dysfunction.

Prostate cancer (CaP) is a common reproductive cancer among men. This study was conducted to correlate the cancer incidence with Gangetic zone and to correlate the tumor marker prostate specific antigen (PSA) level in serum with different age groups and stage of malignancy. Patients suffering from CaP in the pathology unit of Mahavir Cancer Sansthan (Hospital and Research Centre), Patna, Bihar, India were studied from June 2009 to May 2010. PSA level in the serum of CaP patients was estimated by ELISA method. CaP incidence was highly recorded in Gangetic zone than the non-Gangetic zone. Maximum patients were in the 56 - 75 years age group with a marked predominance. Results of PSA examination showed that serum PSA level was not correlating with the age of patient and stage of malignancy. Significantly, elevated level of more than 10 ng/ml of PSA was recorded among the studied cancer patients. In this study, it is concluded that Gangetic zone habitat have high risk of CaP and elevated level of PSA was marked in Bihar, India.

Lumen-apposing metal stents (LAMS) use in gastrointestinal endoscopy has been on the rise for various indications for the last few years. Currently, LAMS is a well-established treatment for post-pancreatitis peri-pancreatic fluid collections and walled-off necrosis (WON), but it is still not a standard of care in the treatment of post-surgical fluid collections (PSFC). Most of the earlier studies for treatment of PSFC utilized double pigtail plastic stents (DPS). We present a series of 3 cases where LAMS was successfully used for PSFC drainage. The cases include a patient with perigastric abscess after Whipple's procedure, a case of peri-pancreatic collection after distal pancreatectomy, and a patient with peri-pancreatic fluid collection after right partial hepatectomy and splenectomy due to lacerations from a motor vehicle accident.

Alternative, more sustainable and environmentally positive, sources of energy are one of the current global challenges. One approach to achieving more sustainable sources of energy is to use waste from one system as a raw material for energy production, following the circular biosystem philosophy. This study successfully adopted this approach whereby microalgae strains Chlorella emersonii and Pseudokirchneriella subcapitata were bioprospected and metabolically engineered in simulated wastewater supplemented with glucose to produce neutral lipids. Using a two-step cultivation approach neutral lipid content was enhanced in Chlorella emersonii and Pseudokirchneriella subcapitata biomass. Via in-situ transesterification, these neutral lipids were subsequently bioconverted to biodiesel feedstock fatty acid methyl esters using novel solvent stable lipase(s) from Pseudomonas reinekei and Pseudomonas brenneri. The culturing of appropriate microalgae on wastewater, and bioconversion via organo-stable lipases may provide a commercially viable and sustainable biodiesel feedstock to help address the current global energy challenge.

Abstract Background Acute kidney disease (AKD) is defined as impaired kidney function present for &lt;90 days with or without an acute kidney injury (AKI) event. Adults with AKD have an increased risk for progression to chronic kidney disease (CKD) and mortality. There are no data on the epidemiology of AKD in children after transplant. The aim of this study was to evaluate the incidence and risk factors for AKI, AKD, and CKD in children after transplantation. Methods This is a retrospective cohort study of all children undergoing non‐kidney solid organ transplant between 2011 and 2019 at UPMC Children's Hospital of Pittsburgh. AKI and AKD were defined using the Kidney Disease Improving Global Outcomes criteria. Patients with a new estimated glomerular filtration rate &lt;60 ml/min/1.73m 2 persisting for &gt;3 months met criteria for new CKD. Variables associated with AKI, AKD, and CKD were analyzed. Results Among 338 patients, 37.9% met criteria for severe AKI, 13% for AKD, and 8% for a new diagnosis of CKD. Stage 3 AKI was independently associated with AKD (OR: 5.35; 95% CI: 2.23–12.86). Severe AKI was not associated with new‐onset CKD, whereas AKD was associated with new‐onset CKD (OR: 29.74; CI: 11.22–78.82). Conclusion AKD may be superior to AKI in predicting risk of CKD in children after non‐kidney solid organ transplantation.

Automatic License Plate Recognition (ALPR) system is very useful in many applications. There are a lot of challenges in designing and implementing an ALPR system concerning different conditions. In the literature, most of the techniques available are restricted to few conditions of the ALPR system. Before working on any technique of ALPR system researchers should have an idea about different challenges in this field. In this paper, various challenges in the ALPR system in the Indian scenario are discussed.

Timing for renal replacement therapy (RRT) initiation for cardiac-surgery associated acute kidney surgery (CSA-AKI) is subject to debate. Evidence suggests earlier initiation leads to shorter length of stay (LoS). We investigated differences in healthcare costs associated with timing of RRT initiation in CSA-AKI.A cost-consequences model compared costs of Early (<24 h) vs. Delayed (>24 h) RRT initiation. Data were from the ELAIN trial in Germany, and the HiDenIC database, a US multi-hospital database. Resource utilization was determined by RRT duration, ICU, and hospital LoS. All resources were costed from a US healthcare perspective. Extensive sensitivity analyses (SA) were conducted, notably regarding the proportion of patients not initiated on RRT with the Delayed strategy.Early RRT initiation exhibited cost savings compared to Delayed RRT initiation. With ELAIN data, savings reached -$122,188 (ranging from -$157,707 to -$74,763 in the SA). Findings were confirmed with HiDenIC data; Early RRT initiation showed savings of -$77,303 (ranging from -$108,971 to -$47,012 in the SA).Our costing model indicates that Early RRT initiation for CSA-AKI may result in appreciable cost savings. Delaying RRT, in the setting of CSA-AKI, may lead to longer LoS and increased healthcare costs.

Purpose The purpose of this paper is to examine the effect of gamification on students’ e-learning adoption. In addition, this paper examines the effect of two mediations, that is, flow and engagement between gamification and e-learning adoption by using sequential mediation analysis. Design/methodology/approach The authors used the online survey method to collect the 570 responses through convenience sampling procedure. Sequential mediation analysis technique was used to test the mediation hypothesis. Findings The findings of this paper revealed that gamification elements are an important feature of flow, engagement in e-learning adoption process. Also, the paper found that engagement in the learning process is a key element for students to adopt e-learning. Research limitations/implications This paper makes its contribution to the literature related to gamification and e-learning adoption. The paper signifies the importance of gamification as an educational application in e-learning environment and its contribution in designing an interactive learning environment. Originality/value Empirically, to the best of the authors’ knowledge, it is the first paper to examine the sequential mediation model of gamification in the education sector in a developing nation like India. Furthermore, this paper also extends engagement and flow theory related to e-learning process by showing how students’ engagement and flow impact the e-learning adoption in the gamified environment.

The dissemination of Extraintestinal pathogenic Escherichia coli (ExPEC) in food is a critical concern for human health and food safety. The present study is the first to systematically examine the diverse plant-origin foods such as cucumber, carrot, tomato, radish, chilli, fenugreek, coriander, peppermint, spring onion, cabbage, and spinach for the presence of ExPEC or specific putative ExPEC pathotypes with an in-depth assessment of their phylogenetics, virulence, and drug resistance. A total of 77 (15.9 %) ExPEC isolates were recovered from 1780 samples of the diverse plant-origin foods of distinct environments. Specific putative ExPEC pathotypes such as Uropathogenic E. coli (UPEC, 23.3 %) and Septicemia-associated E. coli (SEPEC, 24.6 %) were identified among ExPEC isolates. The Clermont revisited new phylotyping method revealed the varied distribution (1-27 %) of specific putative ExPEC pathotypes in the different phylogenetic lineages such as A, D/E, B1, and Clade 1, etc. All putative ExPEC pathotypes possess multiple genes (4.3-92.8 %) or phenotypes (3.3-100 %) associated with their virulence. In-vitro antimicrobial susceptibility testing of all putative ExPEC pathotypes demonstrated the presence of 100 % multidrug resistance with moderate to high (52-100 %) resistance to drugs used as last-resorts (chloramphenicol, colistin) or frontline (nitrofurantoin, sulfamethoxazole, ampicillin, gentamicin) in ExPEC-associated infections in humans. Overall, the present findings significantly contribute to our better understanding of the presence of ExPEC in the non-clinical niche, such as plant-origin foods with a possible consequence on human health and food safety.

LC-TOF-MS is powerful analytical technique. It is a combination of two techniques one of which is belongs to chromatography and other is from spectroscopy. Chromatography is separation technique and perform both techniques separately it is very time consuming but combined both techniques to save time and provide better results. This represents the potential of liquid chromatography with (quadrupole) time-of-flight mass spectrometry [LC-(Q)TOF-MS] in examining the presence of pesticide metabolites in food and water samples. This method portrays a quick enhanced screen for blood and urine specimens in post-mortem, driving under the influence and drug facilitated sexual assault forensic toxicology casework. (LC–MS) is an analytical technique that amalgamate the physical separation capability of liquid chromatography with the mass analysis capability of mass-spectrometry (MS).This technique can be used in analysis of pharmacokinetics, proteomics/metabolomics, development drug, analysis of pesticides in vegetables, analysis of medicinal panaxherbs for metabolomic research, identification of diphenhydramine in segment sample, investigation of pesticides metabolites in food and water etc.

The present study investigates the influence of layer thickness and stacking engineering on the electronic, structural, and optical properties of monolayer PtS 2 using the density functional theory calculations. The monolayer PtS 2 (m‐PtS 2 ) is found to possess an indirect bandgap, 1.73 eV, which reduces to 0.67 eV for bilayer PtS 2 (b‐PtS 2 ). Impact of stacking engineering on the electronic and optical properties is explored through six different stacking patterns and the AA 1 configuration is found to be most stable displaying the highest reflectance and refractive index values. Moreover, this PtS 2 bilayer structure demonstrates promising light absorption capability over a wide range (2–12 eV) with the position of absorption edge showing a redshift as the layers number increases. These computed electronic and optical properties of monolayer PtS 2 validate it as a prospective material for future optoelectronic devices.

A variety of practical problems can be addressed in the framework of rotation (successive) sampling.The present work presents a sample rotation pattern where sampling units are drawn on two successive occasions.The problem of estimation of population variance on current (second) occasion in two -occasion successive (rotation) sampling has been considered.A class of estimators has been proposed for population variance that includes many estimators as a particular case.Asymptotic properties of the proposed class of estimators are discussed.The proposed class of estimators is compared with the sample variance estimator when there is no matching from the previous occasion.Optimum replacement policy is discussed.Results are supported with the empirical means of comparison.

An efficient and simple approach for the synthesis of functionalized 4H-chromenes has been developed via acid catalyzed Michael addition of phenols to benzylidene oxobutanoates. Preliminary mechanistic studies were conducted, suggesting that intermediate chroman derivative is initially formed which on dehydration produces final 4H-chromene. The conversion of 4H-chromenes into linear and angular pyranocoumarins is also described. The structural arrangements between the pyran and coumarin rings have been established by X-ray crystallographic analysis and 2D NMR spectroscopy.

Recommender systems have become extremely common in recent years.It helps the customer to discover information and settle on choices where they do not have the required learning to judge a specific item.It can be utilized as a part of different diverse approaches to encourage its customer with effective information sorting.It is a software tool and techniques that provide suggestion based on the customer's taste to discover new appropriate thing for them by filtering personalized information based on the user's preferences from a large volume of information.Users taste and preferences should be constructed accurately in order to provide most relevant suggestions.This survey paper compares and details the various type of recommender system and popular recommendation algorithms and its uses.

Deep Neural Networks have become an increasingly favourite choice for a variety of machine learning tasks. Two important components are largely responsible for this success, improved neural network functionalities, and availability of suitable hardware for training large complex networks. Using these types of novel networks and functions, Deep Neural Networks have been shown to be very highly efficient for various classification tasks. As the next level of optimization, dedicated ASIC and FPGA ICs are being developed, to realize Deep Neural Networks. This provides an additional level of performance optimization beyond traditional software-based implementations. Towards this direction, in this work, we have developed CMOS circuits for realizing the highly popular Rectified Linear (ReLu) activation function. The ReLu activation function has largely replaced the traditional sigmoid activation function due to better learning rates and reduced computational requirements. With dedicated CMOS implementations of such functions, we get better operating speed with lower power consumption, leading to improved real-time implementations of classification tasks.

Abstract Background: Young adults with congenital heart disease (CHD) are increasing in number with an increased risk for acute kidney injury. Little is known concerning the impact of non-recovery of kidney function for these patients. Therefore, we sought to explore the rates of acute kidney disease, persistent renal dysfunction, and their associations with adverse outcomes in young adults with CHD. Methods: This is a single-centre retrospective study including all patients at the ages of 18–40 with CHD who were admitted to an intensive care unit between 2010 and 2014. Patients with a creatinine ≥ 1.5 times the baseline at the time of hospital discharge were deemed to have persistent renal dysfunction, while acute kidney disease was defined as a creatinine ≥ 1.5 times the baseline 7–28 days after a diagnosis of acute kidney injury. Outcomes of death at 5 years and length of hospital stay were examined using multivariable logistic regression and negative binomial regression, respectively. Results: Of the (89/195) 45.6% of patients with acute kidney injury, 33.7% had persistent renal dysfunction and 23.6% met the criteria for acute kidney disease. Persistent renal dysfunction [odds ratio (OR), 3.27; 95% confidence interval (CI): 1.15–9.29] and acute kidney disease (OR: 11.79; 95% CI: 3.75–39.09) were independently associated with mortality at 5 years. Persistent renal dysfunction was associated with a longer duration of hospital stay (Incidence Rate Ratio: 1.96; 95% CI: 1.53–2.51). Conclusions: In young adults with CHD, acute kidney injury was common and persistent renal dysfunction, as well as acute kidney disease, were associated with increased mortality and length of hospitalisation.

Abstract Review: 49 refs.

Nanobiotechnology involves the use of nanotechnology integrated with biology. It is an emergent field of research that holds vivid applications in agriculture sector and food industry. In agriculture, nanofertilizers are helping to enhance plant growth by providing smart nourishment. Nanopesticides (control pests), nanoinsecticides (against insects), nanofungicides, and nanoherbicides (control weeds in the field) are the output of advanced nanobiotechnological research. Nanoparticles are also used in seed science to enhance seed germination. The technological breakthough in nanotechnology was achieved after the development of nanosensors. Nanobiosensors are available for detecting phytopathogens and pesticide residues. In food sectors, nanoparticles are utilized in food processing and packaging. Besides this, nanoadditives, nutraceutical delivery agents, and nanoencapsulation devices find multiple applications in several fields. Nanoparticles have been effectively used in the food packaging to enhance storage period and decrease pathogenic growth on stored food. Nanobiosensors are utilized to detect the contamination of foodborne pathogens, toxic substance, and pesticide detection in food. Despite a lot of advantages of nanobiotechnology, the environmental toxicity of nanoparticles is a matter of concern that requires risk assessment of nanoparticles on human health and environmental effects.

Abstract BACKGROUND Complex biotherapeutics such as non‐glycosylated antibody fragments can be easily manufactured in Escherichia coli due to advancements in recombinant DNA technology. Ranibizumab is one such example of a complex, non‐glycosylated protein used to treat age‐related macular degeneration and macular oedema. Ranibizumab, a humanized monoclonal antibody fragment, is often expressed as inclusion bodies using the E. coli expression system. In this study, we propose a novel strategy for achieving efficient expression of antibody fragments in E. coli BL21 (DE3). Here, the whole antibody fragment (heavy chain + light chain of ranibizumab) has been engineered and cloned in a pET series vector under single promoter belonging to a prokaryotic host along with an extra ribosome binding site to allow equal expression of the light and heavy chains. RESULTS We demonstrate heterologous expression of ranibizumab with a protein concentration of 0.4 ± 0.019 mg mL –1 , confirmed using reversed‐phase high‐performance liquid chromatography with the double copy clone. The reduced and refolded antibody fragment have been analytically characterized using liquid chromatography–mass spectrometry, where masses of the in‐house clone were in correspondence with marketed product. Native polyacrylamide gel electrophoresis and surface plasmon resonance (SPR) analyses were performed to confirm the formation of purified and active recombinant product. Binding kinetics to the target analyte vascular endothelial growth factor of refolded in‐house product was found to be similar to the marketed product as per SPR (12.7 nmol L −1 vs . 10.4 nmol L −1 ). CONCLUSION Cloning and process optimization have been performed to enhance expression yield. The proposed strategy offers an efficient approach for enhanced production of antibody fragments in microbial hosts. © 2021 Society of Chemical Industry (SCI).

Ranibizumab is an antibody fragment used for treatment of blurred vision due to age-related macular degeneration. Most manufacturers currently express it in Escherichia coli BL21 (DE3), where low-level expression of this complex protein has been acknowledged to result in higher production cost. This paper aims to present a strategy involving the use of additives with previously developed clone of Ranibizumab to enhance its expression in E. coli. The effect of ethanol (as additive) on cell size (control 1.82 μm and optimized 2 μm), cellular physiology (no cell swelling, or shrinkage observed) and cellular viability (better in optimized sample) were examined. A 2-fold improvement in Ranibizumab expression has been demonstrated (from 0.23 mg/mL to 0.48 mg/mL in single copy clone and 0.4 mg/mL to 0.72 mg/mL in double copy clone) using the optimized conditions vis-a-vis the control, thereby demonstrating the efficacy of the proposed approach. LC–MS confirmed correct disulfide bond formation and surface plasmon resonance confirmed the formation of active recombinant protein via binding to its target VEGF (KD = 12.7 nM). Transcriptomic analysis and RT-qPCR validation indicated that changes in membrane properties and DNA synthesis results in growth, gene amplification and enhances synthesis of inducible proteins in case of the optimized medium.

Appendix S1: Supporting Information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Opium poppy is one of the most important medicinal plant species cultivated in several regions of the world for pharmaceutical and food purposes. Although it has been bred and used in many countries for centuries, taxonomical studies on the intraspecific variability are still not numerous. In the course of this study, the genetic diversity of 58 opium poppy accessions were assessed with SSR markers. Out of the 25 tested SSR markers, only 19 showed successful amplification and seven were found to reveal polymorphism. These seven markers produced 2–11 alleles within the size range of 144–280 bp. PIC value varied between 0.284 and 0.767, expected heterozygosity was between 0.136 and 1, and observed heterozygosity was between 0.344 and 0.794. Altogether, a low genetic diversity was found, and several accessions have been characterized with the same SSR allele profile. The clustering in the PCoA co-ordinate system indicates four groups, which is confirmed by the STRUCTURE analysis as well and reflects the known relationships of hybrid cultivars in several cases. The landrace taxa clearly deviate from the majority of cultivars selected for industrial purposes. The applied SSR markers were not able to distinguish the genotypes according to their geographic origin or seed color. However, in several cases, the grouping in the PCoA system reflected a diversification connected to alkaloid content and petal color of the accessions. Our results demonstrate the importance of further molecular marker studies focusing on genotypes with different alkaloid content and useful agronomical traits in order to establish more effective breeding.

Objective: To examine the risk factors, resource utilization, and 1-year mortality associated with vasopressor-resistant hypotension (VRH) compared with vasopressor-sensitive hypotension (VSH) among critically ill adults with vasodilatory shock. We also examined whether combination vasopressor therapy and patient phenotype were associated with mortality. Design: Retrospective cohort study. Setting: Eight medical-surgical intensive care units at the University of Pittsburgh Medical Center, Pittsburgh, PA. Patients : Critically ill patients with vasodilatory shock admitted between July 2000 and October 2008. Interventions : None. Measurements and Main Results: Vasopressor-resistant hypotension was defined as those requiring greater than 0.2 μg/kg per minute of norepinephrine equivalent dose of vasopressor consecutively for more than 6 h, and VSH was defined as patients requiring ≤0.2 μg/kg per minute to maintain MAP between 55 and 70 mm Hg after adequate fluid resuscitation. Of 5,313 patients with vasodilatory shock, 1,291 patients (24.3%) developed VRH. Compared with VSH, VRH was associated with increased risk of acute kidney injury (72.7% vs. 65.0%; P &lt; 0.001), use of kidney replacement therapy (26.0% vs. 11.0%; P &lt; 0.001), longer median (interquartile range [IQR]) intensive care unit length of stay (10 [IQR, 4.0-20.0] vs. 6 [IQR, 3.0-13.0] days; P &lt; 0.001), and increased 1-year mortality (64.7% vs. 34.8%; P &lt; 0.001). Vasopressor-resistant hypotension was associated with increased odds of risk-adjusted mortality (adjusted odds ratio [aOR], 2.93; 95% confidence interval [CI], 2.52-3.40; P &lt; 0.001). When compared with monotherapy, combination vasopressor therapy with two (aOR, 0.91; 95% CI, 0.78-1.06) and three or more vasopressors was not associated with lower mortality (aOR, 0.93; 95% CI, 0.68-1.27). Using a finite mixture model, we identified four unique phenotypes of patient clusters that differed with respect to demographics, severity of illness, processes of care, vasopressor use, and outcomes. Conclusions: Among critically ill patients with vasodilatory shock, VRH compared with VSH is associated with increased resource utilization and long-term risk of death. However, combination vasopressor therapy was not associated with lower risk of death. We identified four unique phenotypes of patient clusters that require further validation.

Mini-tablets represent a new trend in solid dosage form design, with the main goal of overcoming some therapeutic obstacles. Mini tablets are multiple unit dosage forms and are advantageous than pellets or any other oral dosage forms as they are easy to manufacture and stability problems are less. Offering some therapeutic benefits such as dose flexibility and combined release patterns. They do not require any solvent for their production and also local irritation can be avoided by the use of mini tablet Mini tablet offer several advantages like they can be manufactured relatively easily, They are not require less coating materials and also there is a great flexibility during their formulation development. Mini tablet are more acceptable in children and elderly people as they are easy to swallow. The objective of controlled drug delivery systems is to reduce the frequency of the dosing and to increase the effectiveness of the drug by localization.&#x0D; Keywords: Mini-tablets, solid dosage form, oral dosage forms.

This study focuses on optimization of the substrate feeding profile for enhanced production of ranibizumab, a recombinant therapeutic protein, in Escherichia coli. An established process analyzer, dielectric spectroscopy, was deployed to monitor the production process and to estimate real-time biomass. A validated mechanistic model was employed to formulate a multiobjective optimization (MOO) problem. The substrate flow rate during the fed-batch phase (F) was taken as the decision variable for MOO. The Pareto front resulting from MOO revealed that for a minimum broth volume (V) of 1.96 L, a maximum of 58.8 g of total biomass (XV) could be generated. The total biomass obtained from the optimal substrate feeding profile was 20.6% higher than the experimentally achieved total biomass. Enhanced productivity was achieved by the proposed MOO formulation, which facilitates the choice of any operating point from the Pareto front based on downstream expenses of the therapeutic product.

The present article intends to develop some imputation methods to reduce the impact of non response at both the occasions in two-occasion successive (rotation) sampling. Utilizing the auxiliary information, which is only available at the current occasion, estimators have been proposed for estimating the population mean at the current occasion. Estimators for the current occasion are also derived as a particular case when there is non response either on the first occasion or second occasion. Behaviors of the proposed estimators are studied and their respective optimum replacement policies are also discussed. To study the effectiveness of the suggested imputation methods, performances of the proposed estimators are compared in two different situations, with and without non response. The results obtained are demonstrated with the help of empirical studies.

Mobile ad hoc networks( MANETs) catch the great attention of researchers because of its unique characteristics like independent of infrastructure, dynamic topology behavior, limited energy source, multihop routing, mobility of nodes etc. All these characteristics chase lots of challenges about security, reliability and performance issues. In this paper we present a comparative analysis a set of IEEE WLANs standards family used for MANETs (i.e IEEE 802.11, 802.15, 802.15.4, 802.16 and 802.20). We also present a close look to the performance of various IEEE standards and check their co-existence nature with zero interference occurrence. In this paper we give more emphasis how to choose one reliable technology for any wireless network on the bases of your required network attributes out of all wireless technologies.

IoT, the Internet of Things is today's most prevalent type of application area of internet. It is the network having various small networks connecting to the internet for remote sharing of services. The Internet of Things is not backing off, and the list of connected individuals, systems and things continues developing. In current research the IoT is being used for Health services data sharing. So that two remote hospitals can share the data with each other. For this they require the shortest path identification for efficient delivery of data. This shortest path can be determined best using ACO. It is based on numerous parameters like path length, path identification duration, and local efficient threshold. Previously reasearchers have used global efficiency factor F g’ for Link (L) at time T q for ant colony algorithm. Using ACO with enhanced parameters, the performance of the algorithm will be enhanced with respect to various parameters like Energy, Time, and Latency.

The high cost of soluble enzymes can limit their use for commercial and industrial purposes. Immobilization can enhance enzyme reusability, thereby reducing product isolation costs and overcoming this economic barrier. In the current study, two novel, purified lipases from Pseudomonas sp. (Pseudomonas reinekei and Pseudomonas brenneri) were entrapped in a calcium alginate matrix, with the aim of simultaneously enhancing enzyme reusability and stability. Following entrapment, the retained activity of the enzyme-alginate composite was verified by an enzymatic hydrolysis reaction of a p-nitrophenol palmitate substrate. The effect of the enzyme-alginate entrapment against various physiochemical parameters such as pH, temperature, metal ions, and solvents were subsequently examined. The entrapment was found to have minimal beneficial stability gains. However, enhanced enzyme reusability (up to 3 cycles) and stability (up to 18 days at 4°C) of the calcium alginate entrapped lipase, as indicated by residual hydrolysis of p-nitrophenol palmitate, was observed, suggesting potential roles for calcium alginate entrapped lipases in cost efficient enzyme catalysis.HIGHLIGHTS•Two novel lipases have been entrapped in calcium alginate for the first time.•A statistically enhanced stability in 1M EDTA was observed following entrapment.•The novel entrapped lipases display excellent storage stability and reusability.

Objectives: We evaluated the association between breast cancer and breast density (BD) measured using fully automated software. We also evaluated the performance of cancer risk models such as only clinical risk factors, density related measures, and both clinical risk factors and density-related measures for determining cancer risk. Materials and Methods: This is a retrospective case–control study. The data were collected from August 2015 to December 2018. Two hundred fifty women with breast cancer and 400 control subjects were included in this study. We evaluated the BD qualitatively using breast imaging-reporting and data system density and quantitatively using 3D slicer. We also collected clinical factors such as age, familial history of breast cancer, menopausal status, number of births, body mass index, and hormonal replacement therapy use. We calculated the odds ratio (OR) for BD to determine the risk of breast cancer. We performed receiver operating characteristic (ROC) curve to assess the performance of cancer risk models. Results: The OR for the percentage BD for second, third, and fourth quartiles was 1.632 (95% confidence intervals [CI]: 1.102–2.416), 2.756 (95% CI: 1.704–4.458), and 3.163 (95% CI: 1.356–5.61). The area under ROC curve for clinical risk factors only, mammographic density measures, combined mammographic, and clinical risk factors was 0.578 (95% CI: 0.45, 0.64), 0.684 (95% CI: 0.58, 0.75), and 0.724 (95% CI: 0.64, 0.80), respectively. Conclusion: Mammographic BD was found to be positively associated with breast cancer. The density related measures combined clinical risk factors, and density model had good discriminatory power in identifying the cancer risk.

Diabetes is a chronic and progressive metabolic disorder characterized by a high level of blood sugar, i.e., glucose in the body.Glucose is the main source of energy in the human body.The level of glucose in the blood is controlled by the hormone called insulin, released by the pancreas.Gestational diabetes mellitus (GDM) is characterized as glucose intolerance that begins and first recognition during pregnancy.Diabetes is very common in Asian countries, especially Indians.Obesity and advanced gestational age are the other risk factors for gestational diabetes.The acute, long-term, and transgenerational health complications of diabetes disease affect approximately 9-25 per cent of pregnancies worldwide.The present article discusses the concept, risk factors, pathogenesis, screening, and treatment of diabetes in pregnancy, as well as the complications, it can cause the mother and the fetus, as well as the long-term consequences.

The pest and plant diseases are conventionally controlled by leaf spraying or coating seeds with pesticides. However, excessive use of chemical pesticides has led to an alarming increase in problems of pest resistance, environment pollution, soil health damage, and harmful effects on benign insects, animals, and human health. Reversal of this damage requires technological intervention and chemical pesticide alternatives. Use of nanopesticide nanoformulations in agriculture could provide better plant disease protection compared to chemical pesticides. Microemulsion, nanoemulsion, nanodispersion, and nanoencapsulation are the types of nanoformulation of pesticide with varied properties. Nanoformulation of pesticides enhances the solubility of poorly water-soluble pesticide, protects the premature degradation of pesticide, and impacts target pest. Nanopesticide has various applications in agriculture and food industry. In agriculture, nanopesticides are used for treating pest-related diseases and to control weeds. In the food industry, the important application of nanopesticide includes food processing, packaging, and preservation. Nanoparticles are also used in the material of food packaging utilized for storage purpose and reduced the growth of pathogens in stored food.

Image filtering processes are applied on images to remove the different types of noise that are either present in the image during capturing or introduced into the image during transmission. The salt &amp; pepper (impulse) noise is the one type of noise which is occurred during transmission of the images or due to bit errors or dead pixels in the image contents. The images are blurred due to object movement or camera displacement when we capture the image. This pepper deals with removing the impulse noise and blurredness simultaneously from the images. The hybrid filter is a combination of wiener filter and median filter.

Occupational health hazards have deleterious effect on the individual health and safety as well as the organizational effectiveness.Emerging occupational health problems are to be tackled along with existing public health problems like communicable disease, malnutrition and inadequate medical care.Globalization and rapid industrial growth in the past few years have added further to complexities of occupational health related issues.Quantitative approach was used and research design was descriptive survey research design.Sample were factory employees of sugarcane factory, sample size was 100 and sample technique was convenient sampling, setting for the study was sugarcane factory of Doiwala, Dehradun, and tool used were checklist related to occupational health hazards.Majority (36%) of the subjects were between 47 to 56 years, majority (39%) subjects had educational status up to primary, majority (57%) of the subjects having monthly income more than 15000, majority (55%) of the subjects were from nuclear family, majority (55%) of the subjects were non vegetarian, majority (77%) of subjects were living in rural areas, majority (33%) of subjects were consuming tobacco, majority (81%) of subjects were having working experience more than 10 years, majority (95%) of the subjects were having working hours more than 8. Through this checklist we found that (42%) of subjects were having back ache, joint or muscles problems, (52%) of subjects were suffering from vision problems and (81%) of a subject says that PPE is not available for all workers.

Recombinant monoclonal antibodies are primarily expressed in Chinese Hamster Ovary (CHO) cell lines. Post-translational modifications (PTMs) in biotherapeutics contribute significantly to population heterogeneity with respect to charge and glycosylation. Cell culture medium components are known to significantly contribute to PTMs. This study aims to target the charge variant profile of an innovator molecule Herceptin® by using metal ions as charge variant modulators. Inhouse produced trastuzumab was found to have significantly lower acidic variants (17.64 ± 1.07% acidic and 12.86 ± 0.43% basic) compared to the innovator product (24.97 ± 0.54% acidic and 11.41 ± 1.44% basic). Following a thorough investigation, zinc was chosen to regulate the basic charge variations, whereas iron was used to alter the acidic charge variants. With supplementation of the metal ion at optimal concentration, the charge variant profile for the in-house mAb (24.7 ± 0.83% acidic and 14.4 ± 0.64% basic) was near identical to that of the innovator product. While minor reduction in viable cell density and product titer were observed (~7%), there was no significant impact on other quality attributes including glycans and specific productivity of cells. This study would be of high interest to biosimilar manufacturers who strives to demonstrate the analytical and functional biosimilarity of their products to the innovator.

The emerging biobased economy will require robust, adaptable, organisms for the production and processing of biomaterials as well as for bioremediation. Recently, the search for solvent tolerant organisms and solvent tolerant enzymes has intensified. Resilient organisms secreting solvent stable lipases are of particular interest for biotechnological applications.Screening of soil samples for lipase-producing organisms was carried out on Rhodamine B plates. The most productive lipase-producing organisms were further screened for their resistance to solvents commonly used in biotechnological applications.In the course of screening, one of the isolated organisms that exhibited extracellular lipase activity, was identified as the human pathogen Listeria monocytogenes through 16S rRNA sequencing. Further exploration revealed that this organism was resistant to solvents ranging from log P - 0.81 to 4.0. Moreover, in the presence of these solvents, L. monocytogenes secreted an extracellular, solvent tolerant, lipase activity. This lipase retained approximately 80% activity when incubated in 30% (v/v) methanol for 24 h.These findings identify L. monocytogenes as a potentially useful organism for biotechnological applications. However, the fact that Listeria is a pathogen is problematic and it will require the use of non-pathogenic or attenuated Listeria strains for practical applications. Nonetheless, the ability to adapt to rapidly changing environmental conditions, to grow at low temperatures, to resist solvents and to secrete an extracellular solvent tolerant lipase are unique and highly useful characteristics. The potential application of L. monocytogenes in wastewater bioremediation and plastics degradation is discussed.

Context: Free radicals contribute to more than one hundred disorders in humans including atherosclerosis, hypertension, arthritis, ischemia, gastritis, central nervous system injury, reperfusion injury of many tissues, cancer, Alzheimer’s disease, Parkinsonism, diabetes mellitus and AIDS. There is considerable evidence that antioxidants could help to prevent these diseases because they have the capacity to quench free radicals. Aim: Free radical scavenging activity of methanolic extract of the leaves of Luffa cylindrica (MELC) was evaluated in various in vitro systems. Materials and Methods: The methods were extensively reviewed and free radical scavenging activity was performed by employing various in‑vitro assay methods like DPPH, hydroxyl radical, superoxide and nitric oxide scavenging activities. Statistical Analysis: Results were analyzed statistically using one way analysis of variance (ANOVA) followed by Dunnett’s multiple comparison test and were expressed as mean ± SE of three observations. Values of P < 0.05 were considered significant. Results: In all the studies, a significant correlation existed between concentrations of the extract and percentage inhibition of free radicals. The preliminary phytochemical screening of MELC indicated the presence of terpenoids, steroids, flavonoids and glycosides. The extract was found to contain 53.78 ± 1.01 μg/mg total polyphenolics expressed as GAE (micrograms per milligram of GAE). Conclusion: The results of the study suggested that the methanolic extract of the leaves of Luffa cylindrica possessed a significant scavenging effect with increasing concentrations probably due to its antioxidant potential and could serve as a potential source of natural antioxidants effective in treatments against free radical mediated diseases. Key words: Antioxidant, Luffa cylindrica, methanolic extract, phenolic compounds

Fingerprints are the most widely used biometric identifier because of their ease of acquisition, storage and further processing for identification/ verification. Fingerprint recognition (FPR) has been used for security purposes and criminal identifications since a long time. This paper presents overview of a basic FPR system, various FPR techniques and challenges. After that a brief discussion on how to compare/verify FPR systems is presented. FPR applications in different areas are listed with some industries and government sectors using this technology. Finally, use of advanced image processing techniques for better results of FPR is discussed, which actually provides a platform for research and development in this area for researchers.

The resolution of racemic coumarinyl amino alcohols 5–10 was achieved by using the inexpensive and readily accessible chiral resolving agent N-carbethoxy-l-proline (S)-11. Direct esterification of rac-5–10 with (S)-11 furnished diastereomeric esters, which were easily separated by column chromatography. The obtained diastereomers yielded the desired enantiopure coumarinyl amino alcohols (S)-(+)-5–10 and (R)-(−)-5–10 in good yields with high enantiomeric excess on saponification. The absolute configurations were determined by X-ray crystal analysis and/or by comparison of the specific rotations. Furthermore, in in vitro antifilarial motility inhibition assays, enantiopure coumarins (S)-(+)-9, (R)-(−)-9 and (S)-(+)-10, (R)-(−)-10 were found to be less efficient in affecting the viability of macrofilariae of Brugia malayi than their racemic forms 9 and 10, respectively, indicating the synergistic effect of the enantiomers in evoking antifilarial action.

BACKGROUND 70% of ureteral stones are located in the lower third of the ureter.Medical expulsive therapy (MET) using adrenergic antagonists has recently emerged as an alternative strategy for the initial management of small distal ureteral stones.We planned a study to compare the efficacy of silodosin 8 mg/ day with tamsulosin 0.4 mg/ day with respect to stone expulsion time and stone expulsion rate. MATERIALS AND METHODSA randomised controlled study was carried out on 70 cases having distal ureteric stones (DUS) of size ≤ 10 mm.All cases were above 20 years of age.35 patients received single dose of tamsulosin 0.4 mg/ day and 35 patients received single dose of silodosin 8 mg/ day.Patients were followed by ultrasonography till stones were passed or upto 4 weeks after initiation of medical expulsive therapy. RESULTS15 out of 27 cases in group tamsulosin and 23 out of 28 cases in group silodosin expelled the stones by the end of study.The mean time of expulsion in tamsulosin group was 19.1 ± 8.6 days, while silodosin group was 16.7 ± 6.8 days.The difference between tamsulosin and silodosin group did not reach statistical significance.The expulsion rate in tamsulosin group was 55.5% and silodosin group was 82.1%, which had statistical significance.The outcome of silodosin and tamsulosin was found to be not affected by the gender of patients.Silodosin is more effective in patients with distal ureteric calculi > 7 mm. CONCLUSIONSilodosin was found to be more effectual than tamsulosin in terms of stone expulsion rate and stone expulsion time for the management of distal ureteric stones of size ≤ 10 mm.

A woman, aged 52 years, experienced severe headache, confusion, nausea, dizziness, and diplopia for three days. Magnetic resonance imaging of the brain showed multiple acute and subacute infarcts suggestive of embolic events. Dermatological examination was notable for splinter hemorrhages and macular patches on the fingernails and feet, respectively. Further diagnostic imaging of the chest and abdomen revealed pulmonary emboli and an ovarian mass with omental deposits and splenic infarcts. Fine-needle aspiration cytology and surgery confirmed a diagnosis of high-grade serous adenocarcinoma of the ovary with clear cell features. Extensive evaluation for malignancy should be considered on a case-by-case basis for patients with thromboembolic disease and an initial negative diagnostic evaluation for stroke. Consideration of patent foramen ovale closure is reasonable in patients with malignancy who are at risk for recurrent strokes.

Leafy vegetables contributes to the inflation rate in Ambon City due to low productivity in rainy season. Some vegetables are imported from other islands while importantvegetables such as local petsai (Brassica chinensis L.) and chili (Capsicum annum L.) are cultivated in low nitrogen soil, Entisols. Lack of nitrogen could be overcome by using inorganic fertilizeras well as biofertilzer. The soil can be inoculated with rhizobacteria, such as Azotobacter, to increase the nitrogen uptake and improve the quality of vegetables. This research was conducted to isolate and select Azotobacter from rhizosphere of vegetables and to examine the effect of Azotobacter inoculation on chili-seedling growth and nitrogen uptake by using bioassay method. Azotobacter sp. was isolated in nitrogen-free Ashby’s Media. The bioassay was held in the green house with randomized block design experiment, which examined the combination of isolates and population of Azotobacter sp. on chili. Two best isolates which was selected based on pH, nitrogen content and cell viability were s2a10 (from petsai's rhizosphere) and c2a9 (from chili’s rhizosphere). Bioassay showed that Azotobacter inoculation followed by reduced NPK fertilizer doses had no effect on transplant dry weight and nitrogen uptake. All Azotobacter 8 -1inoculation except 10 CFU mL s2a10 maintain soil nitrogen although Azotobacter population in soil was slightly reduced. This showed that Azotobacter sp. potentially reduce the use of inorganic biofertilizer.

Introduction - In December 2019, a group of patients of unknown aetiology with atypical pneumonia emerged in Wuhan, China [1]. Severe Acute Respiratory Syndrome Corona Virus 2 (SARS CoV-2), a novel beta-coronavirus was identied as the cause of these cases [2]. RTPCR testing leads to delay in diagnosis in cases where early and rapid diagnosis of COVID-19 is warranted which leads to tension and anxiety both among patient and treating health care workers. Material And Methods- This retrospective observational study was designed and conducted at the Department of Microbiology; Moti Lal Nehru Medical College (MLNMC), Prayagraj Uttar Pradesh. This study was approved by the Institutional Ethics Committee (IEC). All study data was retrieved from Hospital Information System of medical college. Result - Among 200 patients, sample for Truenat, RT-PCR and Cobas 6800 testing were collected during study period. Out of 200 samples 57(28.5%) samples were positive by Cobas 6800 with 15(7.5%) invalid results and 128(64%) negative results. In RT-PCR 71(35.5%) samples were positive and 129(64.5%) samples were negative with no invalid results. 200 positive samples were then selected from the RTPCR and COBAS 6800 positive samples for Truenat testing. Out of these 200 positive samples results of 60(30%) samples were presumptive positive and 128(64%) were negative invalid results 12(6%). Conclusion- we have concluded that RT-PCR is the best diagnostic method for the detection of COVID-19 in a country like India, where there is shortage of trained man power, well equipped labs and poor infrastructure. It also reduces the nancial burden in the era of pandemics, where whole population needs to be catered.

Chickpea is one of the major legumes predominately cultivated in North Interior Karnataka (NIK). This simulation study using CROPWAT model aimed at quantifying yield reduction under rainfed conditions and proper irrigation scheduling in chickpea variety BGD-103. This would help NIK farmers in tapping the potential yields of this crop through proper irrigation management. Crop management input in the model was based on the recommended practices of UAS, Dharwad, across four dates of sowing from 1st October to 15th October at quarterly intervals on black clay soil. The simulated outputs were analyzed at decadal interval for both past (1991-2020) and projected climate (2021-2050). Under past climate, two irrigation was simulated i.e., one irrigation at 40-45 days after sowing (DAS) and another at pod filling stage (70 DAS). The number of irrigations decreased by one under projected climate i.e., only one irrigation at 45 DAS. Yield reduction in rainfed conditions on black clay soil under past climate was 31.6 %, which in contrast, decreased by 16.4 % under projected climate and is presented against spatial distribution across NIK. Sowing early i.e., on 01st October under projected climate (2021-2050) simulated the lowest yield reduction (rainfed) and require fewest irrigations across 12 districts of NIK.

Gadilam River is located in Cuddalore district, Tamilnadu nearer to Bay of Bengal. This river is used for agricultural purposes and by a 12-watt Micro hydro power plant. Using the Pollution Index and NSFWQI, this study sought to assess the water quality s tate of the Gadilam River at the Nellikuppam portion of Cuddalore that is impacted by a sugar plant, agriculture, and community activity (National Sanitation Foundation- Water Quality Index). The NSFWQI ranged from 84 to 87, while the pollution index varied from 0.54 to 0.76. As a re sult, the river’s water quality depends on these indexes. In summary, the Gadilam River’s water quality was not negat ively impacted by residents living along the riverbank or the micro-hydro plant.

Over the last few years, Convolution Neural Networks (CNN) have shown dominant performance over real world applications due to their ability to find good solutions and deal with image data. However their performance is highly dependent on the network architecture and methods for optimizing their hyper parameters especially number and size of filters. Designing a good CNN architecture requires human expertise and domain knowledge. So, it is difficult in CNN to find sufficient number and size of filters for classification problems. The standard GWO algorithm used for any optimization purpose suffers from some issues such as slow convergence speed, trapping in local minima and unable to maintain balance between exploration and exploitation. In order to have proper balance between these phases, two modifications in GWO are introduced in this paper. A technique for finding optimum CNN architecture using methods based on Enhanced Grey Wolf Optimization (E-GWO) is proposed. The paper presents optimization of hyper parameters (numbers and size of filters in convolution layer) of CNN using E-GWO to improve the performance of the model. Kidney ultrasound images dataset collected from ultrasound centre is used to evaluate the performance of the proposed algorithm. Experimental results showed that optimization of CNN with E-GWO outperformed CNN optimized with traditional GA, PSO and GWO and conventional CNN yielding 97.01% accuracy. At last, the obtained results are statistically validated using t-test.

To assess the Effectiveness of Planned Teaching Programme on Knowledge and Awareness regarding Covid-19 among B.Sc. Nursing Students in selected Nursing College, Bareilly.” Objectives: - 1. To assess the pre-test and post-test knowledge regarding Covid -19 among B.sc Nursing students. 2. To assess the effectiveness of planned teaching programme on knowledge regarding Covid-19 among B.sc nursing students. Method: Pre-experimental design one group pre-test post- test design without control group was selected as the research design for the present study. Sample size were 130 B.SC Nursing Students in Rohilkhand College of Nursing, Bareilly (UP), fulfilled the criteria was selected. Purposive sampling technique was used in this study. The study will be conducted at Rohilkhand College of Nursing, Bareilly (UP). The population is B.SC Nursing first, second, third and fourth year Students participate in this study in Rohilkhand College of Nursing, Bareilly. Data was collected to assess the level of knowledge structure questionnaire regarding Covid -19 among B.Sc. Nursing students. Result The pretest score is mean and standard deviation 28±7.47 and post test score is mean and standard deviation 36±5.7. Mean difference 8.2 and calculated value (t) is 2.49.

Children’s health reflects the National health and wealth. Respiratory diseases are very often found in children’s especially in school children’s. It is one of the leading causes of mortality and mortality in young Children. India has 440 million children and about 27 million children are born each year in India. But nearly 2 million of them do not live to the age of 5. Acute respiratory infections are leading cause of child mortality (30%) in India. Hence the study “A Quasi experimental study to assess the effectiveness of steam inhalation with tulsi leaves and turmeric powder to relieve the symptoms of common cold among children in selected community areas at, District, Mandi (H.P.).The study was conducted at community area of Nerchowk Distt. Mandi. TheNerchowk was nearby 180 children in the community area. Among them total number of children selected were 40. The children were selected for study by simple random sampling technique. The checklist was use to assess the effectiveness of tulsi leaves inhalation with turmeric powder for relieving common cold. The data collected was analyzed was done with Descriptive Statistics and Inferential Statistics. The result of study depicts that among 40 children, 20 children were in Experimental group and 20 children were in Control group. The result of study depicts that in pre-test symptoms of common cold among Experimental group children, out of 20 children majority of 14(70%) have moderate cold, 6(30%) of them have severe cold and none of them have mild cold. In comparison to control group, out of 20 children majority of 13(65%) have moderate cold, 7(35%) of them have severe cold and none of them have mild cold and in post-test symptoms of common cold among Experimental group children, out of 20 children majority of 16(80%) have mild cold (1-6), 4(20%) of them have moderate cold and none of them have severe cold. In comparison to control group, out of 20 children majority of 17(85%) have moderate cold, 3(15%) of them have severe cold and none of them have mild cold. The findings of the study showed that the mean score of pre-test and post-test assessment on symptoms of common cold among the children in experimental and control group. The mean score of experimental group pre- test 12.05 (SD= 1.468) and post-test 2.95(SD= 3.762) respectively. In control group the mean score of pre-test 11.950(SD=1.276) and post test 11.90(SD=1.165 respectively.It means after assessment of effectiveness of steam inhalation with tulsi leaves and turmeric powder the symptoms of common cold among the children are improved.

Background:Acute appendicitis is the most common condition that needs urgent intervention, has to be diagnosed and evaluated at the earliest. It is found that a correlation exists between appendicular perforation and high serum bilirubin level. In the absence of radiological investigations, patients with clinical signs with hyperbilirubinemia might have a higher probability of appendicular perforation. Aim: To study the role of elevated serum bilirubin level as a diagnostic marker of acute appendicitis and to evaluate the predictive potential of hyperbilirubinemia in appendicular perforation. Methods: This is an observational prospective study of 100 cases of acute appendicitis with or without appendicular perforation admitted in General Surgery department of Rajendra Institute of Medical Sciences, Ranchi, who underwent appendicectomy for acute appendicitis from August 2019 to October 2021. Results: Most of the patients belonged to the age group of 15-24 years with male to female ratio 1.4:1. Total serum bilirubin levels were raised in 72% patients, comparatively higher in appendicular perforation 77.78% than in acute appendicitis 70.73%. Sensitivity n specicity of hyperbilirubinemia was 70.73% and 22.22% respectively. Conclusion: Serum bilirubin level appears to be a promising new diagnostic laboratory marker which when combined with thorough history taking and clinical examination can aid signicantly to arrive to the diagnosis of acute appendicitis. Higher level of serum bilirubin (≥ 2mg/dl) hints towards the increased chances of appendicular perforation.

Marma is one of the unique part and concept of Ayurveda that has been discussed in all the classical texts and deeply elaborated by Acharya Sushruta in 6th chapter of Sharir Sthana. It can be explained as sandhisthanam or jeevasthanam. Marma are meeting place of ve elements of the body - Mamsa, Sira, Snayu, Asthi and Sandhi. Marma are the vital areas avoided during surgical procedures due to its fatality. In vedas Instructions in the battle eld to protect marmas and techniques of attacking marma places to inactivate the apponent. Acharya susruta described 107 marma and classied them in different ways. Katikataruna marma is one of the prushthagata marma located on either side of the vertebral column where each component of the shroni khandam joins to form the katikataruna marma. This marma is located on sciatic notch with dimension of half anguli and they are 2 in number. It is very well said that injury to spinal cord or its supporting structure can cause permanent change in its strength, sensation and other body functions. The knowledge of marma is one such concept used all over the world for prevention and cure of diseases since centuries. It holds its own prime importance in shalyatantra. This paper gives knowledge about anatomical location, structural entity and clinical importance of Katikataruna Marma.

Numerous dosage forms, including churna, vati, avaleha, modaka, asava-arishta, and others, were described in Ayurveda. The acharyas have granted freedom to create various formulas. The colour and taste of Ayurvedic medicines are now drawing increasing attention from society. By making simple changes, we can alter the colour and avour of Ayurvedic medications. The best technique to present Ayurvedic medicines in a fresh way is through pharmaceutical modication. One Ayurvedic medicine in the powder form with signicant therapeutic value is Hingwashtaka churna. Due to its palatability, distinctive fragrance, and colour, form, it is considered to be challenging to deliver to children. Here's an attempt to make Arka (Distillate) from Hingwashtaka churna, changing the medication's solid (powder) form to liquid. Prepared Arka (Distillate) was administered to different age grouped healthy volunteers; feedback was good in terms of palatability.

Background And Purpose Abnormal uterine bleeding is a common gynaecological problem in women which signicantly affects the quality of life. The prevalence increases with age peaking just prior to menopause. In perimenopausal age, variation in normal cyclical pattern may be due to physiological hormonal changes or pathological. Most ovulatory dysfunction can be traced to endocrinopathies mainly thyroid disorders. It can present as spectrum of menstrual abnormalities ranging from amenorrhoea, infrequent bleeding to episodes of extreme heavy menstrual bleeding. Thyroid disorders are one of the preventable causes and if properly diagnosed, unnecessary surgical interventions can be avoided. Methods: This is a cross sectional study, conducted in the SAThospital, Thiruvananthapuram, where women in age group of 45-55 with abnormal uterine bleeding attending gynaecology OP or as IP, for a period of one year after excluding cervical or genital infections, pregnancy and related causes of bleeding per vagina (PV) and postmenopausal bleeding were selected. Thorough history taking clinical examination and investigations including imaging, TSH, FT3, FT4 were done using questionnaire. Endometrial samples among those with thyroid abnormality were obtained. Data was analysed and statistical test of signicance calculated by chi square test. ResultsIn our study, 31.7% women with AUB was hypothyroid and 9.5% women were hyperthyroid. The most common pattern of perimenopausal AUB was frequent cycles, which was prolonged, irregular and associated with heavyow. Irregular cycles were noted in both hyperthyroidism and hypothyroidism which was signicant. 73 percent of women with a thyroid dysfunction had a palpable thyroid. 47.4% women had normal ndings in USG which signify non-structural causes in perimenopausal women which was signicant (p value &lt;0.001). Out of those already diagnosed with thyroid disorder and on regular treatment, 76.7% had symptomatic relief while on treatment. Conclusion Thyroid disorders are prevalent among premenopausal women with AUB. Thyroid disorders should be considered as an important associated factor for menstrual abnormalities even in perimenopausal women. It is important to screen look for thyroid disorders in women coming with abnormal uterine bleeding. These are preventable causes of AUB. Prompt treatment of thyroid disorders enhances the quality of life of women and prevents unnecessary hormonal treatment and surgery

Journal Article Corrected proof Recurrent flare-associated urticaria in adenosine deaminase type 2 deficiency Get access Priyanka Priyanka, Priyanka Priyanka Department of Pediatrics, All India Institute of Medical Sciences, Patna, India Search for other works by this author on: Oxford Academic PubMed Google Scholar Pratap Kumar Patra, Pratap Kumar Patra Department of Pediatrics, All India Institute of Medical Sciences, Patna, India Correspondence to: Pratap Kumar Patra, Pediatric Rheumatology Unit, Department of Pediatrics, All India Institute of Medical Sciences, Patna 801507, India. E-mail: pratap_patra3@yahoo.co.in https://orcid.org/0000-0002-0338-7517 Search for other works by this author on: Oxford Academic PubMed Google Scholar Aaqib Zaffar Banday, Aaqib Zaffar Banday Department of Pediatrics, Government Medical College, Srinagar, India https://orcid.org/0000-0001-5486-4267 Search for other works by this author on: Oxford Academic PubMed Google Scholar Pakkiresh Reddy, Pakkiresh Reddy Department of Pediatrics, All India Institute of Medical Sciences, Patna, India Search for other works by this author on: Oxford Academic PubMed Google Scholar Nutan Sharma, Nutan Sharma Department of Pediatrics, All India Institute of Medical Sciences, Patna, India Search for other works by this author on: Oxford Academic PubMed Google Scholar Jannarthanan Jannarthanan, Jannarthanan Jannarthanan Department of Pediatrics, All India Institute of Medical Sciences, Patna, India Search for other works by this author on: Oxford Academic PubMed Google Scholar Dharmagat Bhattarai Dharmagat Bhattarai Advanced Center for Immunology and Rheumatology, Katmandu, Nepal Search for other works by this author on: Oxford Academic PubMed Google Scholar Rheumatology, kead443, https://doi.org/10.1093/rheumatology/kead443 Published: 25 August 2023

<br>Primary sarcoma of the ovary is extremely rare. There are inadequate data in the literature regarding ovarian sarcoma in the pediatric age group. We report a case of an 8-year-old girl presenting with large abdominal mass and cachexia. Raised alpha-fetoprotein levels suggested germ cell tumor. Tru-cut biopsy histopathological report suggested a spindle cell tumor. The IHC staining suggested non rhabdomyosarcoma. As tumour was large and ovarian pediatric non rhabdomyosarcoma was not reported in the literature, we started on rhabdomyosarcoma neoadjuant regimen. Good response was noted for neoadjuvant chemotherapy, which was followed by complete surgical excision of the tumor and radiotherapy. At present, the overall outcome of the disease is dismal. Increased available data and gaining more evidence may help in improvising the treatment option.<br>

&lt;p&gt;The Internet of Things (IoT) connects and improves crucial global technologies like sensor nodes. The Internet is evolving from a human-centric network to one that enables inanimate things to wirelessly communicate with one another. The lifespan of an IoT network may be affected by the energy requirements of its routing protocol. Data is transmitted through the internet, and it may compromise the security of the data. An attacker can access the data and modify the data in order to break the security of the network. Although various solutions are available, such as cryptography and steganography-based approaches, none provide secure data transmission in large-scale networks with low energy consumption. Blockchain technology plays a vital role in the prevention of network malware. In this paper, an attempt has been made to propose a credit-based mechanism for secure data transmission in an efficient manner with low energy consumption. In order to achieve optimal results, the proposed framework uses blockchain for data security and credit distribution to avoid delays. The proposed framework has been simulated using the Contiki Cooja (CC) simulator. The efficiency of the proposed framework is measured by comparing its performance with state-of-the-art techniques.&lt;/p&gt;

In present day technology human-machine interaction is growing in demand and machine needs to understand human gestures and emotions. Emotions can understand by text, vocal, verbal and facial expressions. Facial expressions are a rich source of communicative information about human behaviour and emotion. Facial Expression Recognition is challenging problem up till now because of many reasons, moreover, it consists of three sub challenging tasks face detection, facial feature extraction and expression classification. Automatic facial expression analysis is an interesting and challenging problem which impacts important applications in many areas such as human-computer interaction and data driven animation.Deriving effective facial representative features from face images is a vital step towards successful expression recognition.Most of the systems are able to recognize basic prototype emotions like Happy, Sad, Surprise, Anger, Fear and Disgust.These general expressions are detected using certain variations of the facial features like broadening of mouth, closing of eyes, twitching of nose, etc.The proposed method achieves a fast and robust facial feature extraction based on consecutively applying filters to the image.The proposed method implements the real time emotion recognition from facial image using three steps face detection, features extraction and classifier for classification of emotions.The proposed method uses raspberry pi for implementing emotions recognition.

Saliva is a unique diagnostic fluid that helps in diagnosis of wide range of both systemic and oral diseases. Recent advancement in the field of diagnostics is really helping our health professionals to reach their goal. One of the major advancements in the field of diagnosis is detection of various diseases with the help of saliva. The various biomarkers present in saliva not only help in diagnosis of oral diseases but also various systemic conditions. This review article mainly discusses about the type of biomarkers and the role of saliva in diagnosis of certain diseases and conditions. Therefore, saliva is the promising fluid of the future.

Background: Indian women have high Prevalence of diabetes and their relative risk of developing gestational diabetes mellitus (GDM) is 11.3 times compared to white women. The metabolic adaptations during pregnancy are designed to maintain a continuous availability of substrate to accommodate the fetal growth. Aims of present study were the antenatal screening of Gestational diabetes mellitus and its pregnancy outcome.Methods: The present study is a type of prospective study in this study 6000 pregnant women were randomly selected for screening irrespective of gestational age and any of the risk factor. All consenting pregnant, who came for first absolute neutrophil count in outpatient department, pregnant women of any parity, and singleton pregnancies were included.Results: Out of 6000 women screened 200 were found positive for GDM. The study indicated that GDM was 3.33%. The incidence of GDM was found to be more in women &gt; 25 years age. Fetal outcome was satisfactory in well controlled GDM, only 7 babies were macrosomic, 13 intrauterine death and 5 still birth, 10 babies required NICU admission for hypoglycemia, respiratory distress syndrome, septicemia.Conclusions: Fetal outcome was satisfactory in well controlled GDM. There was no neonatal mortality. Hence, GDM and its complications are preventable.

Introduction: The patients are increasingly using the internet to inform themselves of health-related topics and procedures, including EGD. We analyzed the quality of information and readability of the websites on the topic of upper GI endoscopy after searching on 3 different search engines. Methods: An assessment tool was developed in addition to using validated instruments for website quality like Global quality score (GQS) and Health on Net (HON) certification for the web site quality analysis (Table1). The readability was assessed using Flesch-Kincaid Reading Ease (FRE) and Flesch-Kincaid grade level (FKG). First 30 results of each search term ‘EGD’ and ‘upper endoscopy’ from Google and first 15 each from Bing and Yahoo were included. A total of 45 websites were selected from 100 URLs after removing duplicates, video-links and journal articles. Results: Content quality: Only 3 URLs were found to be adequate for the content (Table 2). Some mention of pre-procedure, procedure-related and post-procedure details was noted in 36(91%), 41(95%) and 38(84%) of the URLs. The complications were discussed only on 18(40%), and the post-procedure warning signs on 22(48.9%) websites. Only 5(11 %) websites had references. 3(7%) websites had HON certification. Additionally, 13 more sites had a GQS > or equal to 4 (Table 2). Readability: The overall readability level was high, with mean Flesch-Kincaid Reading Ease (FRE) score of 46.92 (Range 81.6-6.5) and Flesch-Kincaid grade level (FKG) was 11th grade (range 6->12). Only 2 websites had a AMA recommended reading level of Grade 6 and below (medlineplus.gov, scripps.org) and 6 websites were written at 8th grade and below level(Table 3). Conclusion: Mostly moderate quality information is available on internet on EGD. Only 3 websites were found to be recommendable(Table 2). A tendency to not mention complications or their warning signs was noted for both for-profit and non-profit websites. Since the the median reading level was 11th grade, this emphasizes the challenges faced by the low education patients seeking quality information presented appropriately for their reading skills. We were able to recognize at least 3 websites with readability level of 8th grade or below and GQS of 4 in an attempt to help this cohort of patients (Table 4). We believe gastroenterologists should be more aware of the quality of the resources available on the internet for EGD and help direct the patients to high-quality websites.504_A Figure 1 No Caption available.504_B Figure 2 No Caption available.504_C Figure 3 No Caption available.

Soil salinization is one of the major causes of declining agricultural productivity in many parts of the world, which is continuously increasing due to water evaporation and the use of saline water for irrigation. According to the United Nations Environment Program (UNEP), it is estimated that approximately 20% of agricultural land and 50% of cropland in the world is facing salt stress. The continuous increase in soil salinity and increased demand for feeding rapidly increasing world population has created some serious agricultural issues that need a solution. Such solutions demand remediation of arable lands. For soil salinity, remediation of the development of salt-tolerating plant varieties was tried out, but its land-specific implementation and variety development is not suitable for developing countries. The mycoremediation could be used as a low-cost alternative for such countries in which a group of fungi called arbuscular mycorrhizal fungus (AMF) is used. The AMF creates a symbiotic association with plant and assists to cope with soil salinity. It was observed that stress-adaptive mechanisms developed by plants are improved by AMF application. This chapter emphasizes the significance of mycoremediation on salt stress and their beneficial effects on plant growth and productivity. Many positive effects of AMF application show improved host plant nutrition; higher K+/Na+ ratio in plant tissues; and better osmotic adjustment by the accumulation of compatible solutes such as proline, glycine betaine, and soluble sugars. The arbuscular mycorrhizal (AM) plants show improved photosynthesis and water use efficiency under salt stress. The AM plants also enhance the activity of antioxidant enzymes to reduce the reactive oxygen species (ROS) generated by the salinity. The AM symbiosis regulates the expression of the proline biosynthesis genes, late embryogenesis abundant protein genes, and aquaporins genes. Thus, it can be said that AMF symbiosis assists in host plants in the amelioration of salt stress at different levels.

Abstract Fluorescent dyes offer a useful method for the measurement of intracellular lipids. They are inexpensive and require simple optical measurement instrumentation, whilst simultaneously providing high throughput application. Nile Red is a hydrophobic, metachromatic dye which has been widely used for detection of intracellular lipids. However, Nile Red fluorescence depends on its concentration, microenvironment polarity, incubation time and, therefore, requires strain specific optimization. Hence, neutral lipids in Chlorella emersonii and Pseudokirchneriella subcapitata cannot be quantified using existing Nile Red methods developed for other microalgae strains and, therefore an optimised procedure for these strains is required. In this method development, the optimal excitation and emission wavelengths were selected based on the solvent used for Nile Red dissolution. The effect of Nile Red concentration, microalgae cell concentration, incubation time on fluorescence intensity was explored and optimised. Quintuplet assay repeats were executed for increased assay robustness for two microalgae strains, Chlorella emersonii and Pseudokirchneriella subcapitata , with protocol reliability confirmed by fluorescence microscopy. In brief, 20% (v/v) DMSO containing 10μg/ml and 5μg/ml Nile red was found to be ideal concentration for neutral lipid estimation in Chlorella emersonii and Pseudokirchneriella subcapitata respectively when an incubation time of 60mins and 40mins at 40°C was used. This optimised Nile Red protocol is a robust, simple and cost-effective method for neutral lipid quantification in Chlorella emersonii and Pseudokirchneriella subcapitata .

Convolutional Neural Networks (CNN) have played very significant role in image related tasks due to their high accuracy and real time processing. Some applications of these networks are image classification, image segmentation, object detection in images. Images are usually applied in healthcare field for both diagnosis as well as surgical operations. CNN has showed superior performance in solving complex image processing problems. These CNN are further optimized with meta-heuristic techniques to obtain better accuracy to accomplish the need of the hour. This paper provides a brief survey on the usage of CNN in medical image classification as well as the applicability of meta-heuristic in improving the performance of CNN for classification purpose.

Deep common bile duct (CBD) cannulation using standard technique is possible in majority of cases. Remaining cases may require advanced cannulation techniques such as transpancreatic sphincterotomy (Goff septotomy), needle knife sphincterotomy or EUS guided CBD cannulation. We study success rate and complication rates of Goff septotomy.

e18525 Background: AML has numerous mutations that predict response to treatment and overall survival. We aimed to assess various mutations in newly diagnosed therapy related AML cases by NGS and their association with clinicopathologic parameters. Methods: We performed molecular studies on DNA extracted from bone marrow aspirate specimens in 35 newly diagnosed treatment naïve therapy related AML (WHO 2008 criteria) patients (8/2013 to 8/2015). Entire coding sequences of 28 genes (ABL1, ASXL1, BRAF, DNMT3A, EGFR, EZH2, FLT3, GATA1, GATA2, HRAS, IDH1, IDH2, IKZF2, JAK2, KIT, KRAS, MDM2, MLL, MPL, MYD88, NOTCH1, NPM1, NRAS, PTPN11, RUNX1, TET2, TP53, WT1) were sequenced using TruSeq chemistry on Illumina MiSeq platform. FLT3 and CEBPA mutation analysis were detected by PCR. Results: Median age was 71 years with 49% males and 51% females. Twelve (34.3%) and 3 (8.6%) patients had prior MDS and MDS/MPN respectively. CBC: [median (range)]: Hb 9 g/dL (4.9-12.9), platelets 48 K/μL (3-378), WBC 4.6 K/μL (0.4-156.6), ANC 1.3 K/μL (0-27.21), AMC 0.2 K/μL (0-14.2). BM blast % [median (range)]: 35% (5-92). Karyotype (n = 35): 7 (20%) diploid, 9 (25.7%) 1, 3 (8.6%) had 2, 1 (2.9%) had 3, 15 (42.9%) > three abnormalities, 17 (48.6%) monosomies, 10 (28.6%) trisomies. Three cases (8.6%) had t(8;21) , 3 (8.6%) t(9;11)(p22;q23), 1 (3%) t(15;17), 1 (3%) t(1;22). MRC risk categories were: favorable 4 (11.4%), intermediate 14 (40%), adverse 17 (48.6%). Mutations are detailed in Table 1. 13 (37.1%) had mutations in 1, 9 (25.7%) in 2, 4 (11.4%) in 3 and 2 (5.7%) in > 3 genes. Positive associations identified were: WBC and ASXL1, platelet count and JAK2, ASXL1, PTPN11, and peripheral blood (PB) blast % and FLT3. Conclusions: Therapy related AML is heterogeneous at the genetic level and multiple mutations likely indicate clonal evolution. With longer follow-up, we could use this data to refine prognostic models for AML. Genes No. of cases % of cases TP53 12 34.29% DNMT3A 6 17.14% TET2 6 17.14% FLT3 5 14.29% NRAS 5 14.29% IDH1 3 8.57% RUNX1 3 8.57% ASXL1 2 5.71% KRAS 2 5.71% NPM1 2 5.71% PTPN11 2 5.71% GATA1 1 2.86% JAK2 1 2.86% IDH2 1 2.86% KIT 1 2.86% WT1 1 2.86%

WiMAX is an effective metropolitan area broadband access technology, supplying wireless coverage over an area of several kilometers with high data rates.WiMAX technology has introduced WiMAX broadband to provide an alternative to the high cost of broadband connection through cable or DSL.In this paper, simulative investigations have been done for the WiMAX network using different path loss models.Investigations have been done in terms of performance metrics such as path loss, throughput and delay.Considering VoIP as major application, extensive results of different path loss models have been indicated which will help the network engineers in planning and design.

Correlates of body mass index (BMI) with their socio