Growth performance, intestinal histomorphology, gut microflora and ghrelin gene expression analysis of broiler by supplementing natural growth promoters: A nutrigenomics approach

In an epoch of escalating number of antibiotic-resistance bacteria, there is a dire need to develop efficient and novel feeding strategies for animal nutrition as alternatives to antibiotics. Here, implicating nutrigenomic approach, phytobiotics and organic acids were used to evaluate ghrelin gene expression levels, gut microflora composition, performance parameters and intestinal histomorphological changes in broiler chickens. One-day-old chicks (n = 315) were reared for 42 days and distributed randomly into five experimental groups; each with three replicates (21 birds per replicate). Experimental groups were control: basal diet only, antimicrobial growth promoter: 40 g/metric ton of basal diet (virginiamycin), organic acids: 4 kg/metric ton of basal diet, phytobiotics: 3 kg/metric ton of basal diet, combination: 7 kg/metric ton of basal diet (organic acids 4 kg and phytobiotics 3 kg metric ton of feed). Growth performance, histological and ghrelin gene expression analysis were executed on 21 and 42 days while, quantitative bacterial analysis of cecum and ileum was performed on day 42. Increased feed intake and body weight (p < 0.05) were noticed in phytobiotics group. Addition of phytobiotics significantly improved (p < 0.05) villus height and ratio of villus height/crypt depth in ileum, jejunum, and duodenum and down-regulated ghrelin gene expression levels. Total coliform and Escherichia coli in cecal and ileal digesta were decreased significantly (p < 0.05) in organic acids group. Correlation analysis revealed Lactobacillus spp. were positively correlated to villus height/crypt depth ration in duodenum. The findings indicated the importance of gene-nutrient-microbiota interactions based on nutrigenomics approach. Hence, phytobiotics and organic acids might be suitable alternatives to antibiotics for improved performance and immunity, along with healthier meat production in poultry.

Outcomes with venetoclax in myelodysplastic syndromes: A systematic review

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Background: Myelodysplastic syndromes (MDS) are clonal hemopoietic disorders causing cytopenia(s) and increased risk of transformation to acute myeloid leukemia (AML). Venetoclax is a B-cell lymphoma-2 (BCL-2) inhibitor that induces apoptosis in malignant cells. The FDA has approved venetoclax for the treatment of newly diagnosed adult AML patients unfit for intensive chemotherapy and its utility in MDS is being explored. We present a systematic review aimed to evaluate outcomes with venetoclax in MDS patients. Methods: We performed a literature search on 3 databases (Pubmed, Cochrane, and Clinicaltrials.gov) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We screened 62 studies using the Mesh terms ‘myelodysplastic syndrome’ and ‘venetoclax’. After excluding review, duplicate and non-relevant articles, 8 studies were included in the analysis. Quality evaluation was done using the NIH quality assessment tool. Pooled analysis was done using the ‘meta’ package (Schwarzer et al, R programming language) and proportions with 95% confidence intervals (CI) were computed. The Inter-study heterogeneity among the studies was assessed using the Q statistic proposed by Cochrane and the I2 index introduced by Higgins and Thompson. Results: We identified 313 patients from 8 studies (1 prospective, 3 retrospective, 2 ex-vivo, 2 clinical trials). Venetoclax was used in combination with hypomethylating agents (HMA) in 6 studies and with other agents in 2 studies. Most patients were pre-treated. Complete response (CR) with or without hematological recovery (CRi) was reported in 45% of patients (95% CI 0.26-0.66, I2= 90%, n = 292). Stable disease (SD) was seen in 18% patients (95% CI 0.08-0.37, I2= 85%, n = 223). Overall response rate (ORR) was 51% (95% CI 0.31-0.70, I2= 89%, n = 122). Hematopoietic stem cell transplant (HCT) was performed in 22% patients (95% CI 0.09-0.44, I2= 75%, n = 122). Twenty percent patients (95% CI 0.15-0.28, I2= 0%, n = 149) died. Common adverse events seen with venetoclax were cytopenias, gastrointestinal side effects and infections, often requiring drug interruption or dose. Conclusions: Despite heterogeneity of available literature, venetoclax seems to be a promising agent in treatment of MDS patients. Prospective clinical trial data is needed to ascertain safety and efficacy of venetoclax in MDS and impact on overall survival, in particular, in patients proceeding to HCT.[Table: see text]

Outcomes with CD34 stem cell boost for poor graft function after allogeneic hematopoietic stem cell transplantation for hematologic malignancies: A systemic review and meta-analysis

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Background: Poor graft function (PGF) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation (allo-HCT) characterized by severe multilineage cytopenia in the absence of mixed donor chimerism, relapse, or severe graft-vs-host disease (GVHD). We present a systemic review and meta-analysis aimed to assess the outcomes with stem cell boost (SCB) for PGF in adult allo-HCT patients. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, 752 articles were screened from 4 databases (PubMed, Embase, Cochrane, and Clinical trials.gov) using MeSH terms and keywords for “hematological malignancies”, “hematopoietic stem cell transplantation”, “CD34 antigen(s)” and “treatment outcome(s)” from the date of inception to Jan 2021. After excluding review, duplicate and non-relevant articles, we included 8 studies (1 prospective, 7 retrospective) reporting hematologic complete/overall response rate (CR/ORR), GVHD and overall survival (OS) after SCB for PGF after Allo-HSCT. Quality evaluation was done using the NIH quality assessment tool. Pooled analysis was done using the ‘meta’ package (Schwarzer et al, R programming language) and proportions with 95% confidence intervals (CI) were computed. Inter-study variance was calculated using Der Simonian-Laird Estimator. Results: We identified 217 patients who received SCB for PGF after allo-HCT. Median age, time since transplant and SCB dose were 48 (37-54) years, 133 (113-450) days and 3.43 (1.7-4.9) million CD34 cells/kg respectively. CR and ORR were 71% (95%CI 0.63-0.77, I216%) and 80% (95%CI 0.74-0.85, I20%) respectively. After median follow up of 41.5 (5-77) months, actuarial survival rate (ASR) was 54% (95%CI 0.48-0.61, I20%). OS was reported from 80% (1y) to 40% (9y) Acute and chronic GVHD incidence after SCB was 17% (95% CI 0.12-0.23, I2=0%) and 17% (95% CI 0.08-0.32, I2=72%, n=197) respectively, and 25% (95% CI 0.14-0.39, I2=63%, n=163) deaths were due to relapse (Table). Conclusions: CD34 SCB improves outcomes after PGF after allo-HSCT with acceptable toxicity profile. However, current literature lacks high-quality randomized evidence and there remains an unmet need for prospective studies to address optimal dosing and manipulation of SCB. Outcomes with SCB for PGF after allo-HCT (n=217).[Table: see text]

Clinical outcomes and efficacy of endoscopic ultrasound guided ablation of pancreatic cancer a systematic review and a meta-analysis

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Background: Endoscopic ultrasound-guided ablation therapy (EUS-A) is a minimally invasive technique increasingly used for the management of surgically unresectable pancreatic cancer. The data on the efficacy and clinical outcome of EUS-A for unresectable pancreatic cancer is lacking. We conducted this systematic review and meta-analysis to evaluate the safety, technical and clinical success of EUS-A therapies specifically for unresectable pancreatic cancer. Methods: Studies were identified with a comprehensive search for EUS-A and pancreatic cancer on PubMed, Google Scholar, Web of Science and Embase data search as of October 2020. The technical and clinical success rates of EUS-A were primary outcomes while adverse events (AEs) rate was secondary outcome. We defined technical success as successful placement of probe within tumor and able to perform ablation regardless of tumor outcome. Clinical success was defined as symptomatic improvement and/or any reduction in tumor size or evidence of necrosis on radiological imaging after EUS-A. A compute pooled analysis was performed using the ‘meta’ package by Schwarzer et al. in the R programming language (version 4.0.2) using random effect model. Results: Nineteen studies including 192 patients (54% females) were included. Common pancreatic tumors were nonfunctional neuroendocrine tumor (NNET) 43.5% (97), followed by locally advanced pancreatic ductal adenocarcinoma (LAPDAC) 27.3% (61), insulinoma 17.9% (40), cystic neoplastic lesions 8.5% (19). The pancreatic head was the most common site of tumor 49.8% (111), followed by body, neck and tail 44.8% (100). EUS-RFA was the most commonly used ablative therapy 63% (12/19 studies), followed by EUS-EA (ethanol ablation) 26% (5/19 studies) while EUS-A using laser and lauromacrogol injection was used in one study each. The mean number of ablation sessions per patient was 1.4 based on the total 243 sessions in 176 patients. The pooled technical success rate of EUS-A was 99.5% [95% CI = 0.90-0.97, I2 = 0%]. The pooled clinical success rate calculated out of total number of pancreatic lesions was 91.1% [95% CI = 0.79-0.92, I2 = 16%]. Clinical improvement in symptoms was reported in 11 studies and a complete resolution or decrease in tumor size was reported in 16 studies. The pooled AEs rate was 22.9% [95% CI = 0.17-0.37, I2 = 43%]. Common AEs were abdominal pain 7.8% (15), pancreatitis 5.2% (10) and pancreatic pseudocyst 2.1% (4). The median follow-up was 9.5 months. Conclusions: EUS-A is a safe and promising modality in the management of unresectable pancreatic cancer with a high technical and clinical success rate. Large prospective studies and clinical trials are required for comparison of clinical outcome of different EUS-A therapies and its widespread application for unresectable pancreatic cancer.

Outcomes with preemptive donor lymphocyte infusions after allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia and myelodysplastic syndromes: A systematic review and meta-analysis

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Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative therapy for acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) but relapse and graft versus host disease (GVHD) remain the most common challenges. Donor lymphocyte infusion (DLI) is the infusion in which lymphocytes from the original stem cell donor are infused, after the transplant, to augment an anti-tumor response or to ensure that the donor stem cells remain engrafted. In this systematic review and meta-analysis, we focused at outcomes of preemptive DLI in AML and MDS. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA) PubMed, CINAHL, Cochrane, and Clinical trials.gov were searched. We included 8 out of 214 articles, excluding duplicates and non-relevant articles. The quality of the included studies was evaluated using NIH quality assessment tool. Proportions along with 95% Confidence Interval (CI) were extracted to compute pooled analysis using the ‘meta’ package by Schwarzer et al. in the R programming language (version 4.16-2) to report the efficacy of preemptive DLI. We pooled the experimental arms results of the included trials using the inverse variance method and logit transformation. Between studies, the variance was calculated using Der Simonian-Laird Estimator. Results: We identified 222 patients who received preemptive DLI. Median age, time since transplant and DLI dose were 48 (32-58) years, 82 (7-160) days and 1.4 million cells/kg respectively. CR and PR were 43% (95%CI 0.14-0.78, I293%, n= 127) and 61% (95%CI 0.40-0.78, I262%, n= 81) respectively. After median follow up of 46 months, non-relapsed mortality (NRM) was 52% (95%CI 0.38-0.65, I249%, n = 121). OS was reported 72% (95%CI 0.62-0.80, I20%, n= 100). Acute and chronic GVHD incidence after DLI was 20% (95% CI 0.13-0.29, I24%, n= 105) and 25% (95% CI 0.08-0.56, I2=79%, n=101) respectively (Table). Conclusions: Preemptive DLI significantly improves OS with a low incidence of acute and chronic GVHD. However, NRM was seen in more than half of all the patients and prospective studies are needed to evaluate safety of preemptive DLI. Outcomes with preemptive DLI (n= 222).[Table: see text]

Frequency domain analysis of resilient consensus in multi-agent systems subject to an integrity attack

Unmanned systems like autonomous surface vessels are being enhanced with the communication infrastructure to improve their reliability, efficiency and sustainability. Regardless of the significance advantages, their open communication network and connectivity renders these systems to a variety of cyber-attacks. This paper considers the resilient consensus problem of multi-agent systems (MASs) under an integrity attack. Unlike the existing works in the time domain, a resilient consensus controller is designed and analyzed for MASs in the frequency domain. To this end, analysis and modeling of MASs under the integrity attacks (MU-IA) are addressed in the frequency domain in which each agent is a linear continuous system with an input time delay. A resilient H_∞ controller is proposed to tackle the tampering of information due to an integrity attack. The proposed H_∞ controller is designed based on an internal stability method for performance tracking and robustness of the MU-IA. A significant strength of this scheme is that the current approach does not enforce any limit on the number of agents or neighboring agents under the integrity attacks. A quantitative tuning method is used to trade off the nominal performance and robustness of the MU-IA. Simulation results show the effectiveness of the proposed control strategy.

Serial population-based serosurveys for COVID-19 in two neighbourhoods of Karachi, Pakistan

OBJECTIVE

To determine population-based estimates of coronavirus disease 2019 (COVID-19) in a densely populated urban community of Karachi, Pakistan.

METHODS

Three cross-sectional surveys were conducted in April, June and August 2020 in low- and high-transmission neighbourhoods. Participants were selected at random to provide blood for Elecsys immunoassay for detection of anti-severe acute respiratory syndrome coronavirus-2 antibodies. A Bayesian regression model was used to estimate seroprevalence after adjusting for the demographic characteristics of each district.

RESULTS

In total, 3005 participants from 623 households were enrolled in this study. In Phase 2, adjusted seroprevalence was estimated as 8.7% [95% confidence interval (CI) 5.1-13.1] and 15.1% (95% CI 9.4-21.7) in low- and high-transmission areas, respectively, compared with 0.2% (95% CI 0-0.7) and 0.4% (95% CI 0-1.3) in Phase 1. In Phase 3, it was 12.8% (95% CI 8.3-17.7) and 21.5% (95% CI 15.6-28) in low- and high-transmission areas, respectively. The conditional risk of infection was 0.31 (95% CI 0.16-0.47) and 0.41 (95% CI 0.28-0.52) in low- and high-transmission neighbourhoods, respectively, in Phase 2. Similar trends were observed in Phase 3. Only 5.4% of participants who tested positive for COVID-19 were symptomatic. The infection fatality rate was 1.66%, 0.37% and 0.26% in Phases 1, 2 and 3, respectively.

CONCLUSION

Continuing rounds of seroprevalence studies will help to improve understanding of secular trends and the extent of infection during the course of the pandemic.

The Association of Acute Kidney Injury With Disease Severity and Mortality in COVID-19: A Systematic Review and Meta-Analysis

Background and objective

The coronavirus disease 2019 (COVID-19) pandemic has become a global healthcare emergency. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has a wide range of clinical manifestations ranging from subclinical infection to multi-organ failure. In addition to the respiratory system, COVID-19 also adversely affects the kidneys. In this study, we aimed to measure the prevalence of acute kidney injury (AKI) in COVID-19 and its association with the disease severity and mortality in COVID-19 patients.

Materials and methods

We conducted our study by following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. A comprehensive literature search using four databases (PubMed, EMBASE, Google Scholar, and clinicaltrial.gov) was performed. Our initial search returned 2,771 articles. After excluding review articles, duplicates, and non-relevant studies, we included 20 articles that reported an association between COVID-19 and AKI. We subsequently performed a random effect analysis to find the pooled prevalence, pooled odds ratio (OR) estimates, and 95% confidence intervals for severe COVID-19 and mortality outcomes in AKI using Cochrane RevMan (version 5.4) and R programming language (version 4.16-2).

Results

A total of 14,415 patients from various countries were included. Among the 20 cohorts, the median age was 55.8 ±8.39 years (range: 43-72 years), and 43.78% of the subjects were female. Out of a total of 14,415 patients, 3,820 developed AKI with a pooled prevalence of 11% (95% CI: 0.07-0.15; p<0.01; I²=98%). AKI was found to have a significant association with severe COVID-19 disease, with a pooled OR of 8.45 (95% CI: 5.56-12.56; p<0.00001; I²=0%). AKI was associated with significantly higher mortality in patients with COVID-19 with an OR of 13.52 (95% CI: 5.43-33.67; p<0.00001; I²=88%).

Conclusion

AKI manifests as a common COVID-19 complication, and COVID-19 patients with AKI generally have poor outcomes in terms of disease severity and mortality.

Association of dietary calcium, magnesium, and vitamin D with type 2 diabetes among US adults: National health and nutrition examination survey 2007-2014-A cross-sectional study

Higher dietary intake of calcium (Ca), magnesium (Mg), and vitamin D has been associated with reduced risk of type 2 diabetes (T2DM), and a higher intracellular ratio of Ca to Mg leads to insulin resistance. Previous epidemiological studies did not examine the combined effects of dietary Ca, Mg, and vitamin D as well as ratio of Ca to Mg with T2DM. Therefore, we assessed the relationship between dietary intakes of Mg, Ca, and vitamin D (using 24-hr recalls) individually and in composite and T2DM in the National Health and Nutrition Examination Survey 2007-2014, which involved 20,480 adults (9,977 men and 10,503 women) with comprehensive information on related nutrients, and anthropometric, demographic, and biomarker variables using multivariable logistic regression. The results indicated that dietary calcium at Q3 (812 mg/day) was significantly linked with T2DM in women (OR: 1.30; 95% CI: 1.02, 1.65). Dietary vitamin D at Q3 (5.25 μg/day) significantly reduced the odds of T2DM by 21% in men (OR: 0.79; 95% CI: 0.64, 0.98). This is an interesting study that has important implications for dietary recommendations. It is concluded that US adults having dietary Ca below the RDA were associated with increased risk of T2DM in all population and women, while higher ratio of Ca to Mg was associated with increased risk of T2DM in all population and increased vitamin D intake is related to decreased risk of T2DM in men. Moreover, further research is needed to make more definitive nutritional recommendations.

Ruling out Color Transparency in Quasielastic ^{12}C(e,e^{'}p) up to Q^{2} of 14.2 (GeV/c)^{2}

Quasielastic ^{12}C(e,e^{'}p) scattering was measured at spacelike 4-momentum transfer squared Q^{2}=8, 9.4, 11.4, and 14.2  (GeV/c)^{2}, the highest ever achieved to date. Nuclear transparency for this reaction was extracted by comparing the measured yield to that expected from a plane-wave impulse approximation calculation without any final state interactions. The measured transparency was consistent with no Q^{2} dependence, up to proton momenta of 8.5  GeV/c, ruling out the quantum chromodynamics effect of color transparency at the measured Q^{2} scales in exclusive (e,e^{'}p) reactions. These results impose strict constraints on models of color transparency for protons.

Posterior Reversible Encephalopathy Syndrome (PRES) and Takotsubo: A Heart and Brain Affair!

Takotsubo cardiomyopathy (TC) is characterized by reversible left ventricle systolic dysfunction usually associated with stressors (physiological, psychological) being triggering factors. The increase in sympathetic activity, along with a subsequent surge of catecholamines, has been hypothesized as a possible etiology of TC. Posterior reversible encephalopathy syndrome (PRES), a relatively rare and recently recognized reversible clinico-radiological syndrome, is thought to share the same pathophysiology as TC. We present a case of an 83-year-old female who presented with seizures and was found to have PRES. Within three days of hospitalization, she developed takotsubo. She endorsed being under significant emotional stress that was thought to be the common culprit for both of her syndromes, i.e., PRES and TC.

Linking Information Communication Technology, trade globalization index, and CO2 emissions: evidence from advanced panel techniques

Previous studies consider ICT a two-edged sword that can harm or benefit the environment. In recent years, ICT penetration has considerably increased in the ASEAN-6 countries and the leaders of ASEAN are willing to bring a digital revolution by increasing ICT infrastructure and reducing trade barriers in the region under the Master Plan of ASEAN Connectivity-2025. Hence, this paper explores the effect of ICT and the recently developed trade globalization index on CO₂ emissions in ASEAN-6 countries. The study relies on advanced panel econometric approaches, including Westerlund (2007, 2008) and Pedroni cointegration tests, CUP-FM long-run method, and panel DH causality approach. The results suggest cointegration among variables. The results of CUP-FM indicate that ICT contributes to improving environmental quality by mitigating CO₂ emissions. Similarly, trade globalization is also sustainable in the region as it reduces emissions. The results are also confirmed by using the CUP-BC estimator. The findings from the DH causality test unfold causality from ICT and trade globalization index to CO₂ emissions. Besides, the long-run estimates reveal the detrimental effect of energy consumption on emissions and the U-shaped association between GDP and emissions. Moreover, unidirectional causality from ICT to trade globalization index and energy consumption indicates that ICT influences trade globalization and energy consumption. Finally, environmental policies in the context of ASEAN are extensively discussed.

IMPACT OF TIMING OF RENAL REPLACEMENT THERAPY INITIATION ON OUTCOME OF ACUTE KIDNEY INJURY IN SEPTIC PATIENTS

Objective: To identify whether the timing of initiation of continuous renal replacement therapy affects outcome in septic patients with acute kidney injury in term of 28 days mortality. Study Design: Cross sectional analytical study. Place and Duration of Study: This research was conducted at department of Anaesthesiology and critical careunit of the Aga Khan University Hospital, Karachi, from Oct 2018 to Jun 2019. Methodology: The study reviewed all adult patients aged >18 years who developed acute kidney injury afterseptic shock and required continuous renal replacement therapy in surgical intensive care unit. Considering thevalue of blood urea nitrogen, patients were classified into two groups. One was in early group that‟s was defined as blood urea nitrogen value of <100 mg/dl just before continuous renal replacement therapy initiation while the patients who have blood urea nitrogen value of ≥100 mg/dl just prior to continuous renal replacement therapy initiation were classified as late group. Kaplan-Meier survival analysis was performed and median survival was computed. Results: Forty patients were included for analysis. There were thirty patients (75%) in early group in whomcontinuous renal replacement therapy was started with mean blood urea nitrogen of 66 ± 20.2 mg/dL and 10(25%) patients were in late group with mean blood urea nitrogen of 137 ± 28.4 mg/dL. The overall survival ratesin both groups were 49.6%, and 10.4% at 10 and 25 days, respectively. Median survival time was not statisticallysignificant between early and late continuous renal replacement...........

Effect of capsaicin supplementation on lactational and reproductive performance of Holstein cows during summer

Context Summer ambient temperature and humidity are major factors negatively influencing the physiology and the productive and reproductive efficiency of dairy cows. Various management and breeding approaches may be useful for maintaining productivity in dairy cows during summer to minimise these effects. Aims The experiment was designed to test a natural phytochemical supplementation of capsaicin (CPS), followed by a specific oestrus synchronisation protocol as a means to maintain productivity and reproductive performance of Chinese Holstein cows during summer in Hubei province, China. Methods Lactating Chinese Holstein cows (n = 109) were randomly divided into four groups and supplemented with 0 (control, n = 27), 20 (CPS-20, n = 26), 40 (CPS-40, n = 28) and 60 (CPS-60, n = 28) mg of capsaicin (CPS) per kg of total mixed ration respectively for continuous 30 days initiated on 10 July 2018. Milk production and composition were measured over 45 days from the start of CPS supplementation. After CPS supplementation, all cows were synchronised through a modified Ovsynch oestrus synchronisation protocol, and reproductive variables were recorded. Metabolic parameters were measured on the days before CPS supplementation, artificial insemination (AI) and 50 days post-AI. Key results Highest (P &lt; 0.05) milk production were found in the CPS-40 group, and highest total solids and milk fat in the CPS-20 and CPS-40 groups. Milk urea nitrogen and milk fat were generally increased in CPS supplemented cows compared with the control group. Significant increases (P &lt; 0.05) in oestrus response, ovulatory follicle size, ovulation rate and pregnancy rates were observed in the CPS-40 group compared with other groups. Glucose, lipoprotein esterase and aspartate aminotransferase were increased (P &lt; 0.05) in CPS-40 and CPS-60 supplemented groups at the time of AI and 50 days post-AI. Conclusions CPS supplementation has the capacity to maintain milk yield, milk composition and serum metabolites in Chinese Holstein dairy cows during summer. The synergistic effect of CPS and the modified oestrus synchronisation protocol also improved reproductive variables of the cows. Implications Adoption of CPS as a supplement along with oestrus synchronisation could be a useful and economical strategy for dairy herd keepers to improve herd performance during summer.

Quantum-Based Photonic Sensors for Pressure, Vacuum, and Temperature Measurements: A Vison of the Future with NIST on a Chip

The NIST on a Chip (NOAC) program's central idea is the idea that measurement technology can be developed to enable metrology to be performed "outside the National Metrology Institute" by the creation of deployed and often miniaturized standards. These standards, when based on fundamental properties of nature, are directly tracible to the international system of units known as the SI. NIST is also developing quantum-based standards for SI traceability known as QSI, or Quantum based International System of units. Specifically, this paper will cover NIST efforts in the area of thermodynamic metrology to develop NOAC standards for pressure, vacuum and temperature measurements.

Probing the Deuteron at Very Large Internal Momenta

We measure ^{2}H(e,e^{'}p)n cross sections at 4-momentum transfers of Q^{2}=4.5±0.5  (GeV/c)^{2} over a range of neutron recoil momenta p_{r}, reaching up to ∼1.0  GeV/c. We obtain data at fixed neutron recoil angles θ_{nq}=35°, 45°, and 75° with respect to the 3-momentum transfer q[over →]. The new data agree well with previous data, which reached p_{r}∼500  MeV/c. At θ_{nq}=35° and 45°, final state interactions, meson exchange currents, and isobar currents are suppressed and the plane wave impulse approximation provides the dominant cross section contribution. We compare the new data to recent theoretical calculations, where we observe a significant discrepancy for recoil momenta p_{r}>700  MeV/c.

Epiploic appendagitis of the vermiform appendix--An unusual mimic of acute appendicitis

Epiploic appendagitis is a condition resulting from ischemia or necrosis involving the appendage epiploica either due to torsion or spontaneous thrombosis of the venous outflow. It is one of the myriad causes of acute abdominal pain and can masquerade clinically as appendicitis, omental infarction, sclerosing mesenteritis and even diverticulitis. Epiploic appendagitis of the vermiform appendix is a rare entity, clinically indistinguishable from appendicitis. We present a 45-year-old male patient with 4-day duration of right iliac fossa pain and tenderness, with strong clinical suspicion of acute appendicitis. CT scan of the abdomen and pelvis demonstrated Epiploic appendagitis of the vermiform appendix, whilst the appendix remained uninflamed. The patient was thus discharged with conservative management without having to go undergo needless surgery, thereby avoiding the potential complications thereof.

Endocrine dysfunction in psychology during social distancing measures

OBJECTIVES

To determine the psychological impact of the social distancing measures in place due to the coronavirus pandemic.

METHODS

We conducted a cross-sectional study on the Pakistani population. Informed consent was taken from all the participants. The data was collected through an online questionnaire. Cronbach's alpha was used to assess the internal consistency of the questionnaire, and it was found to be 0.80. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 26.

RESULTS

Out of 706 participants, 489 (69.26 %) were males and 217 (30.74 %) were females. The mean age of the participants was 35.24 ± 12.08 years. The majority of the participants were from Punjab (66.00 %).The mean time since quarantine measures had been established was 10.35 ± 5.09 days. The mean total score was 9.08 ± 2.38 points. A majority of the participants (25.64 %) were daily wage workers. t-test was significant when the time of quarantine was compared to the psychological impact. Significant results were also found when gender was compared to the impact.

CONCLUSIONS

Social distancing measures have an impact on psychology and endocrinology of people in general. The impact can take the shape of long-lasting consequences (Tab. 3, Ref. 19).

A High-Grade Glioma of Temporal Lobe in a Child: A Case Report and Literature Review

High-grade glioma is also called a malignant glioma because it is fast-growing and spread rapidly through brain tissue. Due to the rarity of high-grade glioma, its diagnosis and management are multi-faceted. We present a case of a 10-year-old girl presented with headache, seizure, and right-sided weakness of upper and lower limbs. Neurological exam revealed reduced power in both upper and lower right limbs with reduced sensation and reflexes. Magnetic resonance imaging revealed an ill-defined altered signal intensity mass involving the left temporal lobe with parenchymal involvement and surrounding perilesional vasogenic edema. Biopsy of the lesion confirmed high-grade glioma. The patient underwent external beam radiation therapy with concomitant daily temozolomide treatment, followed by adjuvant standard temozolomide. However, progressive neurological worsening and an increased lesion size led to partial tumor resection through a craniotomy to remove intracranial hypertension, which was unsuccessful, and the patient could not survive after the procedure.