Heteroatom Doping in Pollutant Diesel Soot-Derived Nanocarbon for Enhanced Zn-Ion Storage Performance

Herein, we have isolated onion-like nanocarbon (ONC) from the exhaust soot of diesel engines and further doped it with nitrogen (N) and sulfur (S) to fabricate N,S-co-doped ONC (N-S-ONC). To explore its application feasibility, we have assembled an aqueous Zn-ion hybrid supercapacitor (ZIHSC) with a N-S-ONC cathode, which attains high specific capacitance with good rate capability. In-depth analyses suggest that the mechanism of charge storage in the ONC is governed by both capacitive-controlled and diffusion-controlled processes, with the capacitive processes leading at all sweep rates. The ZIHSC demonstrated a good energy density of 50 Wh/kg, a maximum power density of 3.6 kW/kg, and an impressive cycle life with 73% capacitance retention after 50,000 charge-discharge cycles. The study suggests the potential possibly for the long-term application of BC derived nanocarbon in electrochemical energy storage systems (EESSs).

Molecular tools are crucial for malaria elimination

The eradication of Plasmodium parasites, responsible for malaria, is a daunting global public health task. It requires a comprehensive approach that addresses symptomatic, asymptomatic, and submicroscopic cases. Overcoming this challenge relies on harnessing the power of molecular diagnostic tools, as traditional methods like microscopy and rapid diagnostic tests fall short in detecting low parasitaemia, contributing to the persistence of malaria transmission. By precisely identifying patients of all types and effectively characterizing malaria parasites, molecular tools may emerge as indispensable allies in the pursuit of malaria elimination. Furthermore, molecular tools can also provide valuable insights into parasite diversity, drug resistance patterns, and transmission dynamics, aiding in the implementation of targeted interventions and surveillance strategies. In this review, we explore the significance of molecular tools in the pursuit of malaria elimination, shedding light on their key contributions and potential impact on public health.

Realization of Organocerium-Based Fullerene Molecular Materials Showing Mott Insulator-Type Behavior

Electron-rich organocerium complexes (C5Me4H)3Ce and [(C5Me5)2Ce(ortho-oxa)], with redox potentials E1/2 = -0.82 V and E1/2 = -0.86 V versus Fc/Fc+, respectively, were reacted with fullerene (C60) in different stoichiometries to obtain molecular materials. Structurally characterized cocrystals: [(C5Me4H)3Ce]2·C60 (1) and [(C5Me5)2Ce(ortho-oxa)]3·C60 (2) of C60 with cerium-based, molecular rare earth precursors are reported for the first time. The extent of charge transfer in 1 and 2 was evaluated using a series of physical measurements: FT-IR, Raman, solid-state UV-vis-NIR spectroscopy, X-ray absorption near-edge structure (XANES) spectroscopy, and magnetic susceptibility measurements. The physical measurements indicate that 1 and 2 comprise the cerium(III) oxidation state, with formally neutral C60 as a cocrystal in both cases. Pressure-dependent periodic density functional theory calculations were performed to study the electronic structure of 1. Inclusion of a Hubbard-U parameter removes Ce f states from the Fermi level, opens up a band gap, and stabilizes FM/AFM magnetic solutions that are isoenergetic because of the large distances between the Ce(III) cations. The electronic structure of this strongly correlated Mott insulator-type system is reminiscent of the well-studied Ce2O3.

Coronary bypass surgery guided by computed tomography in a low-risk population

BACKGROUND AND AIMS

In patients with three-vessel disease and/or left main disease, selecting revascularization strategy based on coronary computed tomography angiography (CCTA) has a high level of virtual agreement with treatment decisions based on invasive coronary angiography (ICA).

METHODS

In this study, coronary artery bypass grafting (CABG) procedures were planned based on CCTA without knowledge of ICA. The CABG strategy was recommended by a central core laboratory assessing the anatomy and functionality of the coronary circulation. The primary feasibility endpoint was the percentage of operations performed without access to the ICA. The primary safety endpoint was graft patency on 30-day follow-up CCTA. Secondary endpoints included topographical adequacy of grafting, major adverse cardiac and cerebrovascular (MACCE), and major bleeding events at 30 days. The study was considered positive if the lower boundary of confidence intervals (CI) for feasibility was ≥75% (NCT04142021).

RESULTS

The study enrolled 114 patients with a mean (standard deviation) anatomical SYNTAX score and Society of Thoracic Surgery score of 43.6 (15.3) and 0.81 (0.63), respectively. Unblinding ICA was required in one case yielding a feasibility of 99.1% (95% CI 95.2%-100%). The concordance and agreement in revascularization planning between the ICA- and CCTA-Heart Teams was 82.9% with a moderate kappa of 0.58 (95% CI 0.50-0.66) and between the CCTA-Heart Team and actual treatment was 83.7% with a substantial kappa of 0.61 (95% CI 0.53-0.68). The 30-day follow-up CCTA in 102 patients (91.9%) showed an anastomosis patency rate of 92.6%, whilst MACCE was 7.2% and major bleeding 2.7%.

CONCLUSIONS

CABG guided by CCTA is feasible and has an acceptable safety profile in a selected population of complex coronary artery disease.

Coronary computed tomography angiography-based SYNTAX score for comprehensive assessment of advanced coronary artery disease

BACKGROUND

Since the initial attempt to adapt the anatomical SYNTAX score (aSS) to coronary computed tomography angiography (CCTA), CCTA imaging technology has evolved, and is currently used as a "decision-maker" for revascularization strategy in complex coronary artery disease (CAD) and has rendered necessary some updating of the aSS to the CCTA modality.

OBJECTIVES

The aim is to provide updated definitions of the aSS derived from CCTA in patients with complex CAD undergoing CABG.

METHODS

The modifications of CCTA-aSS are the following; (i) updated definition and detection criteria of total occlusion (TO) in CCTA based on length assessment, (ii) inclusion of scoring points for serial bifurcations located in one single coronary segment. (iii) inclusion of weighing score points for lesions located distal to a TO, not visualized on conventional coronary angiography, but visible in CCTA, (iv) removal of thrombus and bridging collateral items from the weighing score, considering the limited diagnostic capability of CCTA in detecting these specific lesion characteristics.

RESULTS

the updated CCTA-aSS was tested in a first-in-man study using the sole guidance of CCTA for the planning and performance of bypass surgery in complex CAD (n ​= ​114). An interobserver analysis showed excellent reproducibility (ICC ​= ​0.96, 95 ​% confidence interval 0.94-0.97).

CONCLUSION

The updated CCTA-aSS was implemented in a cohort of patients with complex CAD undergoing CABG with the sole guidance of CCTA and FFRCT and the Inter-reproducibility of the analysis of the updated score was found excellent. The prognostic value of the modified CCTA-aSS will be examined in future studies.

Retrospective Comparative Analysis of Clinical and Functional Outcome After Arthroscopic Bankart Repair using All-Suture Anchor and Metal Anchor

Introduction

Both knotted all suture anchors and metal anchors are used for arthroscopic Bankart repair. We retrospectively evaluated and compared clinical and functional outcomes after arthroscopic Bankart repair using the knotted all-suture anchors and knotted metal anchors.

Materials and methods

In a retrospective cohort analysis, patients who underwent arthroscopic Bankart repair without any concomitant additional lesion repair using either all-suture anchors or metal anchors, between January 2015 and May 2018 were identified. Their pre- and post-operative functional and clinical outcomes were compared using Rowe and WOSI scores. The recurrence rate in the two groups was also compared.

Results

A total of 41 patients in all suture anchors group and 47 in the metal anchors group were identified as per inclusion and exclusion criteria. The demographic profile of both groups was comparable. There was no significant difference in clinical and functional outcome between the two suture anchor groups as per Rowe (pre-operative 40.13+6.51 vs 38.09+6.24 and post-operative 2 years 93.28+7.09 vs 92.55+9.2) and WOSI (pre-operative 943.05+216.64 vs 977.55+165.46 and post-operative 2 years 278.21+227.56 vs 270.94+186.25) scores. There was a significant improvement in both the groups between preoperative and post-operative ROWE and WOSI scores at 6 months and 2 years follow-up as compared to pre-operative scores (p<0.001). Re-dislocation rates were also comparable (4.8% vs 6.3%).

Conclusion

All-suture anchors showed comparable clinical and functional results as the metal anchors for arthroscopic Bankart repair at two-year follow-up.

Spironolactone improves left atrial function and atrioventricular coupling in patients with resistant hypertension

To determine the blood pressure independent effects of spironolactone on left atrial (LA) size and function in patients with resistant hypertension (RHTN). Patients with RHTN (n = 36, mean age 55 ± 7) were prospectively recruited. Spironolactone was initiated at 25 mg/day and increased to 50 mg/day after 4 weeks. Other antihypertensives were withdrawn to maintain constant blood pressure. Cardiac magnetic resonance imaging was performed at baseline and after 6 months of spironolactone treatment and changes in LA functional metrics were assessed. LA size and function parameters were improved (p < 0.05) from baseline to month-6: LA volumes indexed to body surface area (LAVI) were reduced (LAVImaximum 41.4 ± 12 vs. 33.2±9.7 mL/m2; LAVIpre-A 32.6 ± 9.8 vs. 25.6 ± 8.1 mL/m2; median LAVIminimum 18.5 [13.9-24.8] vs. 14.1 [10.9-19.2] mL/m2); left atrioventricular coupling index was reduced (28.2 ± 11.5 vs. 22.7 ± 9.2%); LA emptying fractions (LAEF) were increased (median total LAEF 52.4 [48.7-60.3] vs. 55.9 [50.3-61.1] %; active LAEF 40.2 ± 8.6 vs. 43.1 ± 7.8%). LA global longitudinal strain in the active phase was increased (16.3 ± 4.1 vs. 17.8 ± 4.2%). The effect of spironolactone was similar in patients with high (N = 18) and normal (N = 18) aldosterone status (defined by plasma renin activity and 24-h urine aldosterone). Treatment of RHTN with spironolactone is associated with improvements in LA size and function, and atrioventricular coupling, regardless of whether aldosterone levels were normal or high at baseline. This study suggests the need for larger prospective studies examining effects of mineralocorticoid receptor antagonists on atrial function and atrioventricular coupling.

Caffey's disease in disguise: a child abuse mimic

A male infant was brought in a paediatric emergency with swelling in the right hand associated with restriction of wrist movements. Examination confirmed similar findings. The history of trauma was not forthcoming. Given the ambiguous history, the possibility of child abuse was kept. X-ray showed local soft tissue swelling with periosteal thickening and raised inflammatory markers in blood tests, which on review of the literature, was consistent with Caffey disease. Due to the self-limiting nature of the condition, the child was managed conservatively. Child abuse should be suspected in children with unexplained injuries, and before labelling abuse, its mimickers should be ruled out.

Facilitators of, barriers to, and preferences for e-mental health interventions for depression and anxiety in men: Metasynthesis and recommendations

BACKGROUND

Little is known about men's use of online mental health (eMH) interventions and factors that promote their engagement or attrition. We aimed to synthesise the qualitative literature on men's preferences for, attitudes towards, and experiences of using eMH interventions for depression and anxiety, and develop recommendations from the findings.

METHOD

Systematic searches were conducted (Jan 2000-Oct 2020) in six databases; study quality was assessed using Qualsyst with a minimum total of 0.55 required for inclusion. Extracted data were synthesised using meta-aggregation.

RESULTS

Eight studies met inclusion criteria and three synthesised findings were generated. (1) Facilitators of men's eMH use: finding apps and technology motivating and convenient, support and encouragement from important others, and interventions allowing men to take action, gain control over their mental health, and resulting in positive outcomes; (2) Barriers to men's eMH use: lack of free time, predicted or experienced lack of benefit from use, and technical difficulties; (3) What men want in eMH: personalised, tailored, relevant interventions that are bright and easy to use, with information presented in multiple formats, psychoeducation, exercises, self-monitoring, information on further resources, and the option of clinician involvement, without any repetitive questioning, boring tools, or negative feedback.

LIMITATIONS

All included studies were conducted in high income, 'Western' countries; most data related to experiences of using an existing eMH intervention within a trial, rather than in 'real world' settings where eMH acceptability is generally lower and experiences may differ.

CONCLUSIONS

Practice, research, and policy recommendations are presented.

A narrative review of pulsed radiofrequency for the treatment of carpal tunnel syndrome

OBJECTIVE

Carpal tunnel syndrome (CTS), which is the most common peripheral nerve entrapment syndrome, can commonly persist despite conservative treatment modalities such as wrist splinting or medications. Pulsed radiofrequency represents a minimally invasive pain intervention technique to alleviate pain. The literature was reviewed to establish the effectiveness of PRF therapy for CTS.

STUDY DESIGN

This is a narrative review of relevant articles on the effectiveness of PRF for CTS.

METHOD

Four databases, MEDLINE, Cochrane Central Register of Controlled Trials, Embase, OVID Emcare, and Web of Science, were systematically searched. 804 records were screened, and the reference lists of eligible articles were examined. For this review, eight extracted studies were narratively explored.

RESULTS

One case report, three retrospective cohorts, one observational prospective study, and three randomized-controlled trials were included. PRF likely provides both an analgesic and functional benefit in patients with mild to severe CTS, and it also shows benefit as an adjunct to carpal tunnel release surgery. Long-term data is limited. It also appears likely that steroid injection may represent a comparable treatment modality to PRF, and there have been positive results when these modalities are used together. Notably, all studies differed in their methodology, making direct comparisons between studies challenging.

CONCLUSIONS

The evidence for PRF in the treatment of CTS, across the range of spectrum of severity or peri-operative to CTS surgery, appears favorable and avoids known side effects of steroid injections. Potential mechanisms for PRF and future directions for research are explored.

Impact of Atherosclerosis Imaging-Quantitative Computed Tomography on Diagnostic Certainty, Downstream Testing, Coronary Revascularization and Medical Therapy: The CERTAIN Study

AIMS

The incremental impact of Atherosclerosis Imaging-Quantitative Computed Tomography (AI-QCT) on diagnostic certainty and downstream patient management is not yet known. The aim of the present study was to compare the clinical utility of routine implementation of AI-QCT versus conventional visual coronary CT angiography (CCTA) interpretation.

METHODS AND RESULTS

In this multicenter crossover study in 5 expert CCTA sites, 750 consecutive adult patients referred for CCTA were prospectively recruited. Blinded to the AI-QCT analysis, site physicians established patient diagnosis and plans for downstream non-invasive testing, coronary intervention and medication management based on the conventional site assessment. Next, physicians were asked to repeat their assessments based upon AI-QCT results. The included patients had an age of 63.8 ± 12.2 years, 433 (57.7%) were male. Compared to conventional site CCTA evaluation, AI-QCT analysis improved physician's confidence 2-5-fold at every step of the care pathway and was associated with change in diagnosis or management in the majority of patients (428; 57.1%; p < 0.001), including for such measures as Coronary Artery Disease-Reporting and Data System (CAD-RADS) (295; 39.3%; p < 0.001) and plaque burden (197; 26.3%; p < 0.001). After AI-QCT including ischemia assessment, the need for downstream non-invasive and invasive testing was reduced by 37.1% (p < 0.001), compared with the conventional site CCTA evaluation. Incremental to the site CCTA evaluation alone, AI-QCT resulted in statin initiation/increase an aspirin initiation in an additional 28.1% (p < 0.001) and 23.0% (p < 0.001) of patients, respectively.

CONCLUSIONS

Use of AI-QCT improves diagnostic certainty, and may result in reduced downstream need for non-invasive testing and increased rates of preventive medical therapy.

Rationale and design of the CONFIRM2 (Quantitative COroNary CT Angiography Evaluation For Evaluation of Clinical Outcomes: An InteRnational, Multicenter Registry) study

BACKGROUND

In the last 15 years, large registries and several randomized clinical trials have demonstrated the diagnostic and prognostic value of coronary computed tomography angiography (CCTA). Advances in CT scanner technology and developments of analytic tools now enable accurate quantification of coronary artery disease (CAD), including total coronary plaque volume and low attenuation plaque volume. The primary aim of CONFIRM2, (Quantitative COroNary CT Angiography Evaluation For Evaluation of Clinical Outcomes: An InteRnational, Multicenter Registry) is to perform comprehensive quantification of CCTA findings, including coronary, non-coronary cardiac, non-cardiac vascular, non-cardiac findings, and relate them to clinical variables and cardiovascular clinical outcomes.

DESIGN

CONFIRM2 is a multicenter, international observational cohort study designed to evaluate multidimensional associations between quantitative phenotype of cardiovascular disease and future adverse clinical outcomes in subjects undergoing clinically indicated CCTA. The targeted population is heterogenous and includes patients undergoing CCTA for atherosclerotic evaluation, valvular heart disease, congenital heart disease or pre-procedural evaluation. Automated software will be utilized for quantification of coronary plaque, stenosis, vascular morphology and cardiac structures for rapid and reproducible tissue characterization. Up to 30,000 patients will be included from up to 50 international multi-continental clinical CCTA sites and followed for 3-4 years.

SUMMARY

CONFIRM2 is one of the largest CCTA studies to establish the clinical value of a multiparametric approach to quantify the phenotype of cardiovascular disease by CCTA using automated imaging solutions.

Application of Transcranial Sonography for the Assessment of Brain Midline Shift in Patients Presenting With Suspected Intracranial Pathology to the Emergency Department of a Tertiary Care Hospital in Central Gujarat, India

BACKGROUND

A shift in midline brain structure indicates raised intracranial pressure (ICP), thereby a sign of compromised perfusion to brain tissues or a mass effect. Early diagnosis can help in planning timely neurosurgical interventions that could prevent further neuron loss. Also, this may aid in neuroprognostication.

OBJECTIVES

The objectives of the study were to find the accuracy of bedside assessment of brain midline shift (MLS) using transcranial sonography (TCS) in comparison to a computed tomography (CT) scan of the brain for patients presenting with suspected intracranial pathology to the emergency department (ED).

METHODS

This prospective observational study was carried out for one year in an ED. A total of 124 patients with suspected intracranial pathology were included in the study. Transtemporal scanning along the orbitomeatal line was performed to image the third ventricle. The distance between the third ventricle and the internal side of the temporal bone was measured on both sides as A and B. The MLS was then calculated using the following formula: midline shift = (A-B)/2. The data were entered and analyzed using a Microsoft Excel worksheet (Microsoft Corp., Redmond, WA).

RESULTS

Out of the total 124 patients enrolled in this study, adequate views for 12 patients were not obtained and, hence, they were excluded from the study. The time to perform a TCS assessment of brain MLS was around 22 minutes (range: 15-30 minutes). In our study, out of 112 analyzed patients, 33 (29.5% of our study) had a significant MLS in the brain (defined by an MLS of more than 5 mm) diagnosed by TCS. Analyzing CT brain results revealed that out of the total 112 patients under study, 27 had a significant brain MLS (24.1% of the total population under study) as defined above.

CONCLUSION

A TCS is a promising alternative to a brain CT in an emergency for brain MLS detection.

Feasibility and accuracy of real-time 3D-holographic graft length measurements

Aims

Mixed reality (MR) holograms can display high-definition images while preserving the user's situational awareness. New MR software can measure 3D objects with gestures and voice commands; however, these measurements have not been validated. We aimed to assess the feasibility and accuracy of using 3D holograms for measuring the length of coronary artery bypass grafts.

Methods and results

An independent core lab analyzed follow-up computer tomography coronary angiograms performed 30 days after coronary artery bypass grafting in 30 consecutive cases enrolled in the FASTTRACK CABG trial. Two analysts, blinded to clinical information, performed holographic reconstruction and measurements using the CarnaLife Holo software (Medapp, Krakow, Poland). Inter-observer agreement was assessed in the first 20 cases. Another analyst performed the validation measurements using the CardIQ W8 CT system (GE Healthcare, Milwaukee, Wisconsin). Seventy grafts (30 left internal mammary artery grafts, 31 saphenous vein grafts, and 9 right internal mammary artery grafts) were measured. Holographic measurements were feasible in 97.1% of grafts and took 3 minutes 36 s ± 50.74 s per case. There was an excellent inter-observer agreement [interclass correlation coefficient (ICC) 0.99 (0.97-0.99)]. There was no significant difference between the total graft length on hologram and CT [187.5 mm (157.7-211.4) vs. 183.1 mm (156.8-206.1), P = 0.50], respectively. Hologram and CT measurements are highly correlated (r = 0.97, P < 0.001) with an excellent agreement [ICC 0.98 (0.97-0.99)].

Conclusion

Real-time holographic measurements are feasible, quick, and accurate even for tortuous bypass grafts. This new methodology can empower clinicians to visualize and measure 3D images by themselves and may provide insights for procedural strategy.

Invasive Management of Hypertrophic Cardiomyopathy With Clinically Important Obstruction: Surgical Myectomy Is Superior, but Only When Accessible

For patients with hypertrophic cardiomyopathy (HCM), a thickened intraventricular septum and systolic anterior motion of the mitral valve (SAM) can contribute to significant left ventricular outflow tract obstruction (LVOTO), mitral regurgitation, and debilitating symptoms. Current guidelines recommend septal reduction therapy through alcohol septal ablation or surgical septal myectomy for patients whose symptoms persist despite medical therapy. Although alcohol septal ablation is a less invasive treatment option, it is not suitable for patients with septal perforator branch anatomy that is not compatible with the procedure, those with midcavitary obstruction, and patients in whom the mechanism of LVOTO is primarily related to SAM. Septal ablation also has a notably higher rate of atrioventricular block requiring permanent pacemaker insertion, and the need for reintervention has been reported to be 15% or more. In contrast, septal myectomy offers direct visualisation and can address thickened septum and mitral valve (MV) anomalies. It can be used to treat a wider variety of anatomies, with lower rates of reoperation. Aside from the more invasive nature of the procedure, a major limitation of septal myectomy, however, is access, because relatively few surgeons specialise in the procedure. This is important because there is a significant correlation between procedural volumes and outcomes. Patients should be evaluated by a multidisciplinary heart team to ensure that they are aware of all treatment options. In this review, we explore the 2 methods of septal reduction therapy and highlight the need for further training of septal myectomy surgeons to ensure access to optimal septal reduction therapies for Canadian patients with HCM.

CCTA-based CABG SYNTAX Score: a tool to evaluate completeness of coronary segment revascularization after bypass surgery

To describe the updated coronary computed tomographic angiography (CCTA)-based coronary artery bypass graft (CABG) anatomic SYNTAX Score (aSS) and assess its utility and reproducibility for assessing the completeness of revascularization after CABG. The CCTA-CABG aSS is a visual assessment using CCTA post-CABG which quantifies the failure in effectively grafting stenotic coronary segments, and therefore assesses the completeness of surgical revascularization. It is calculated by subtracting the aSS of successfully anastomosed coronary segments from the aSS of the native coronary tree. The inter-observer reproducibility of the CCTA-CABG aSS was evaluated in 45 consecutive patients with three-vessel disease with or without left main disease who underwent a CCTA 30 days (± 7 days) after CABG. The CCTA-CABG aSS was evaluated in 45 consecutive patients with 117 bypass grafts and 152 anastomoses. The median native coronary aSS was 35.0 [interquartile range (IQR) 27.0-41.0], whilst the median CCTA-CABG aSS was 13.0 (IQR 9.0-20.5). The inter-observer level of agreement for the native coronary aSS and the CCTA-CABG aSS were both substantial with respective Kappas of 0.67 and 0.61. The CCTA-CABG aSS was feasible in all patients who underwent CABG for complex coronary artery disease with substantial inter-observer reproducibility, and therefore can be used to quantify the completeness of revascularization after CABG.

Genomic profile of diabetic retinopathy in a north indian cohort

BACKGROUND

Diabetic Retinopathy (DR) is one of the major microvascular complications of diabetes. Being a complex disease, it is important to delineate the genetic and environmental factors that influence the susceptibility to DR in a population. Therefore, the present study was designed to investigate the role of genetic and lifestyle risk factors associated with DR susceptibility in a North-Indian population.

METHODS

A total of 848 subjects were enrolled, comprising of DR cases (n = 414) and healthy controls (n = 434). The Sequenom MassARRAY technology was used to perform target genome analysis of 111 SNPs across 57 candidate genes and 14 intergenic region SNPs that are involved in the metabolic pathways associated with type 2 diabetes (T2D) and DR. Allele, genotype and haplotype frequencies were determined and compared among cases and controls. Logistic regression models were used to determine genotype-phenotype and phenotype-phenotype correlations.

RESULTS

The strongest association was observed with TCF7L2 rs12255372 T allele [p < 0.0001; odds ratio (OR) = 1.81 (1.44-2.27)] and rs11196205 C allele [p < 0.0008; OR = 1.62 (1.32-1.99)]. Genotype-phenotype and phenotype-phenotype correlations were found in the present study.

CONCLUSION

Our study provides strong evidence of association between the TCF7L2 variants and DR susceptibility.

Observing Similarities and Differences in the Properties of Isostructural Niobium(V)/Tantalum(V) Coordination Compounds with Strong Pi-Donor Ligands

While niobium and tantalum are found together in their mineral ores, their respective applications in technology require chemical separation. Nb/Ta separations are challenging due to the similar reactivities displayed by these metals in the solution phase. Coordination complexes of these metals have been studied in the contexts of catalysis, small-molecule activation, and functional group insertion reactivity; relatively few studies exist directly comparing the properties of isostructural Nb/Ta complexes. Such comparisons advance the development of Nb/Ta separation chemistry through the potential for differential reactivity. Here, we explore fundamental physicochemical properties in extensively characterized Nb/Ta coordination complexes [Na(DME)3][MClamp], (Clamp6- = tris-(2-(3',5'-di-tert-butyl-2'-oxyphenyl)amidophenyl)amine; M = Nb, Ta) to advance the understanding of the different electronic, optical, and excited-state properties that these metals exhibit in pi-loaded coordination complexes.

miRNA Expression Patterns in Early- and Late-Stage Prostate Cancer Patients: High-Throughput Analysis

Prostate cancer (PCa) is one of the most common types of cancer among men. To date, there have been no specific markers identified for the diagnosis and prognosis or response to treatment of this disease. Thus, there is an urgent need for promising markers, which may be fulfilled by small non-coding RNAs known as microRNAs (miRNAs). Therefore, the present study aimed to investigate the miRNA profile in tissue samples obtained from patients with PCa using microarrays, followed by reverse transcriptase quantitative PCRs (RT-qPCRs). In the discovery phase, 754 miRNAs were screened in tissues obtained from patients (n = 46) with PCa in early and late stages. Expression levels of miRNA-324-3p, miRNA-429, miRNA-570, and miRNA-616 were found to be downregulated, and miRNA-423-5p expression was upregulated in patients with early-stage cancer compared to the late-stage ones. These five miRNAs were further validated in an independent cohort of samples (n = 39) collected from patients with PCa using RT-qPCR-based assays. MiRNA-324-3p, miRNA-429, miRNA-570, and miRNA-616 expression levels remained significantly downregulated in early-stage cancer tissues compared to late-stage tissues. Remarkably, for a combination of three miRNAs, PSA levels and Gleason scores were able to discriminate between patients with early-stage PCa and late-stage PCa, with an AUC of 95%, a sensitivity of 86%, and a specificity close to 94%. Thus, the data obtained in this study suggest a possible involvement of the identified miRNAs in the pathogenesis of PCa, and they may also have the potential to be developed into diagnostic and prognostic tools for PCa. However, further studies with a larger cohort are needed.

Scale-up of the Australian Fans in Training (Aussie-FIT) men's health behaviour change program: a protocol for a randomised controlled hybrid effectiveness-implementation trial

INTRODUCTION

Improving physical activity (PA) and healthy eating is critical for primary and secondary prevention of cardiovascular disease (CVD). Behaviour change programmes delivered in sporting clubs can engage men in health behaviour change, but are rarely sustained or scaled-up post trial. Following the success of pilot studies of the Australian Fans in Training (Aussie-FIT) programme, a hybrid effectiveness-implementation trial protocol was developed. This protocol outlines methods to: (1) establish if Aussie-FIT is effective at supporting men with or at risk of CVD to sustain improvements in moderate-to-vigorous PA (primary outcome), diet and physical and psychological health and (2) examine the feasibility and utility of implementation strategies to support programme adoption, implementation and sustainment.

METHODS AND ANALYSIS

A pragmatic multistate/territory hybrid type 2 effectiveness-implementation parallel group randomised controlled trial with a 6-month wait list control arm in Australia. 320 men aged 35-75 years with or at risk of CVD will be recruited. Aussie-FIT involves 12 weekly face-to-face sessions including coach-led interactive education workshops and PA delivered in Australian Football League (Western Australia, Northern Territory) and rugby (Queensland) sports club settings. Follow-up measures will be at 3 and 6 months (both groups) and at 12 months to assess maintenance (intervention group only). Implementation outcomes will be reported using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework.

ETHICS AND DISSEMINATION

This multisite study has been approved by the lead ethics committees in the lead site's jurisdiction, the South Metropolitan Health Service Human Research Ethics Committee (Reference RGS4254) and the West Australian Aboriginal Health Ethics Committee (HREC1221). Findings will be disseminated at academic conferences, peer-reviewed journals and via presentations and reports to stakeholders, including consumers. Findings will inform a blueprint to support the sustainment and scale-up of Aussie-FIT across diverse Australian settings and populations to benefit men's health.

TRIAL REGISTRATION NUMBER

This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623000437662).

Use of angled-tip aspiration catheters is associated with a lower cost of thrombectomy in patients with acute ischemic stroke secondary to large and medium vessel occlusions

BACKGROUND

Recently, the angled-tip Zoom™ aspiration catheters were introduced. The tip is designed to improve suction force for clot retrieval. We evaluated the possibility of reducing procedure costs when using angled-tip catheters and compared the safety and angiographic effectiveness of angled-tip versus straight-tip catheters.

METHODS

We conducted a retrospective single-center cohort study involving patients with acute ischemic stroke due to large and medium vessel occlusions. The patients were divided into two groups: the post-Zoom group, in which angled-tip aspiration catheters were used and the pre-Zoom group, in which traditional straight-tip catheters were employed.

RESULTS

A total of 163 patients were included; 95 (58.3%) in the pre-Zoom group and 68 (41.7%) in the post-Zoom group. The groups were well-matched at entry. The post-Zoom group demonstrated a significant decrease in mean procedure cost ($9728 vs. $12,127; p = 0.002), shorter time to achieve modified thrombolysis in cerebral infarction ≥2b reperfusion (38.30 min vs. 53.26 min; p = 0.018), and shorter puncture to procedure completion time (46.42 min vs. 62.38 min; p = 0.022). Additionally, the mean procedural cost when using the ADAPT technique supported by the Zoom catheters was significantly lower than the Solumbra technique ($5754 ± $2806 vs. $13,498 ± $3244, p < 0.001). There were no differences in the rate of hemorrhage between the pre-Zoom group (17.9%) and the post-Zoom group (20.6%), p = 0.690.

CONCLUSION

The study demonstrated significant benefits, including cost reduction and shorter time to achieve reperfusion in patients treated with Zoom aspiration catheters. These findings support the use of angled-tip catheters in acute ischemic stroke management.

[Efficacité du tirofiban intracoronaire avant pose d'un stent suivi d'une perfusion dans une charge de thrombus importante prouvée par angiographie : une étude randomisée]

BACKGROUND

The presence of angiographic thrombus is associated with poor outcomes in contemporary cardiology practice. Percutaneous coronary intervention (PCI) in such lesions is associated with slow flow and no-reflow phenomenon which translate into poor clinical outcomes.

METHODS

This was a single-centre, prospective, open-label, randomized controlled study with 50 patients each in intervention group and control group. Patients with angiographically proven large thrombus burden were recruited. In the intervention group, patients were given loading dose of intracoronary tirofiban (25 mcg/kg infused over 5 minutes) followed by prolonged infusion of tirofiban (0.15 mcg/kg/min for 12-18 hours) followed by PCI after 48-72 hours interval. In control group patients were taken up directly for PCI during the index procedure. Outcomes were assessed angiographically and in terms of clinical endpoints.

RESULTS

The primary composite-endpoint of recurrent angina, myocardial infarction, cardiovascular death, target lesion revascularization and unscheduled CABG was significantly lower in the intervention arm compared to control arm (4% vs 16%, p = 0.04). Amongst the secondary endpoints, a statistically significant 30-day increase in ejection fraction from baseline was observed in the intervention group compared to the control group (1.6 ± 1.3 vs 0.2 ± 0.4, p = 0.0001). Overall mortality was similar in the two groups (4% vs 8%, p = 0.39). The primary safety endpoint of major bleeding was also similar in the 2 groups (2% vs 0%, p = 0.31).

CONCLUSIONS

Tirofiban use prior to PCI in high thrombus burden was associated with improved clinical and angiographic endpoints with similar adverse events compared to controls.

Indium extraction from nitrate medium using Cyphos ionic liquid 104 and its mathematical modeling

The treatment and recovery of pollutants in aquatic system is one of the greatest challenges for environmentalists throughout the world. In this study, solvent extraction of indium using phosphonium ionic liquid (Cyphos IL 104) as an extractant and its mathematical model was proposed for prediction of In(III) ion transport across a FSSLM (flat-sheet-supported liquid membrane). Solvent extraction experiments on indium have been carried out under various experimental conditions in order to assert some fundamental parameters using mathematical analysis for mass transfer process. Diffusion is the process which facilitates metal ion transport across liquid membrane, indicating the applicability of Fick's law of diffusion in model formulation. The influence of different parameters like composition of diluent, feed acidity, and ligand concentration on In(III) ion transport rate has been reported. At different extractant concentrations, the modeling outputs and experimental indium extraction were observed to be in reasonably good agreement.

Coronary artery disease is associated with impaired atrial function regardless of left ventricular filling pressure

BACKGROUND

Left atrial (LA) strain is impaired in left ventricular (LV) diastolic dysfunction, associated with increased LV end diastolic pressure (LVEDP). In patients with preserved LV ejection fraction (LVEF), coronary artery disease (CAD) is known to impair LV diastolic function. The relationship of LVEDP with CAD and impact on LA strain is not well studied.

METHODS AND RESULTS

Patients with LVEF >50% (n = 37, age 61 ± 7 years) underwent coronary angiography, high-fidelity LV pressure measurements and cardiac magnetic resonance imaging. LA volumes, LA emptying fraction (LAEF), LA reservoir strain (LARS) and LA long-axis shortening (LALAS) were measured. By coronary angiography, patients were assigned into 3 groups: severe-CAD (n = 19, with obstruction of major coronary arteries >70% and/or history of coronary revascularization), mild-to-moderate-CAD (n = 10, obstruction of major coronary arteries 30-60%), and no-CAD (n = 8, obstruction of major coronary arteries and branches <30%). Overall, LVEF was 65 ± 8% and LVEDP was 14.4 ± 5.6 mmHg. Clinical characteristics, LVEDP and LV function measurements were similar in 3 groups. Severe-CAD group had lower LAEF, LALAS and LARS than those in no-CAD group (P < 0.05 all). In regression analysis, LARS and LALAS were associated with CAD severity and treatment with Nitrates, whereas LAEF and LAEFactive were associated with CAD severity, treatment with Nitrates and LA minimum volume (P < 0.05 all). LAEFpassive was associated with LVED volume (P < 0.05).

CONCLUSIONS

LA functional impairment may be affected by coexistent CAD severity, medications, in particular, Nitrates, and loading conditions, which should be considered when assessing LA function and LA-LV interaction. Our findings inspire exploration in a larger cohort.

Energy-Dense Zinc Ion Hybrid Supercapacitors with S, N Dual-Doped Porous Carbon Nanocube Based Cathodes

Zinc ion hybrid supercapacitors (ZIHSCs) are truly promising as next-generation high-performance energy storage systems because they could offer high energy density like batteries while exhibiting high power output and long cycle life traits of supercapacitors. The key point of constructing a high-performance ZIHSC is to couple the Zn anode with an appropriate cathode material, which has high theoretical capacity, cost-effectiveness, and intrinsic safety features. In this work, we have demonstrated the potentiality of S, N co-doped porous carbon nanocubes (S, N-CNCs) as a cathode material for devising a ZIHSC with excellent energy density and cycle life. The S, N-CNCs are prepared from a zeolitic imidazolate framework (ZIF)-8 precursor via a simultaneous pyrolyzing-doping strategy in an inert atmosphere. Resultant CNCs are monodisperse with an average size of around 65 nm and porous in nature, with uniform N and S doping throughout the structure. Benefitted from such hierarchical porous architecture and the presence of abundant heteroatoms, the assembled ZIHSC with S, N-CNC as the cathode and Zn-foil as the anode in a ZnSO4 aqueous electrolyte could reach a specific capacity as high as 165.5 mA h g-1 (331 F g-1) at 1 A g-1, which corresponds to a satisfactory energy density of 148.9 W h kg-1 at the power density of 900 W kg-1. The ZIHSC has displayed a good cycle stability with more than 70% capacity retention after 10,000 charge-discharge cycles. Furthermore, to verify the practical feasibility of such a cathode material, an aqueous 3D Zn@Cu//S, N-CNC full-cell device is fabricated, which has demonstrated a satisfactory specific capacity (49.6 mAh g-1 at 0.25 A g-1) and an impressive energy density (42.2 Wh kg-1 with 212.2 W kg-1). Full ZIHSC devices are also found to be efficient in powering light-emitting diodes, further substantiating their feasibility in next-generation energy storage applications.

Real-world approach to comprehensive artificial intelligence-aided CT evaluation of coronary artery disease in 530 patients: A retrospective study

Purpose

Recent guidelines provide broader support for the use of less invasive imaging modalities for the evaluation of patients with stable chest pain. Coronary CT angiography (CCTA) uses increasingly sophisticated techniques to improve evaluation of coronary lesions. The purpose of this study is to describe one center's experience implementing AI-assisted advanced imaging techniques to diagnose coronary artery disease.

Materials & methods

Retrospective study of patients who had AI-assisted CCTA interpretation, including a subgroup who underwent fractional flow reserve CT (FFR-CT) and invasive coronary angiography. Descriptive statistics summarized baseline characteristics and univariate statistics compared findings between groups of patients with and without anatomically and hemodynamically significant lesions based on FFR-CT. For patients who underwent invasive coronary angiography, concordance between CCTA and angiography was evaluated.

Results

Of 532 included patients, AI-assisted CCTA identified statistically significant difference in calcification scores, plaque types and total plaque volume between lesions <50% and ≥50% stenosis. CCTA results were mostly concordant with invasive coronary angiography. Importantly, we identified a subset of patients with less than 50% anatomical stenosis that demonstrated physiologically significant stenosis on FFR-CT and invasive coronary angiography.

Conclusions

AI-assisted CCTA and other advanced techniques are a tool to support high quality diagnostic assessment of coronary lesions in a clinical environment. Combined CCTA with FFRCT in mild to moderate coronary stenosis identifies patients with hemodynamically significant stenosis even when quantitative stenosis is <50%. Implementation of AI-assisted coronary CT angiography is feasible in a community hospital setting, but these technologies do not replace the need for expert review and clinical correlation.

MiRNA-146a-A Key Player in Immunity and Diseases

miRNA-146a, a single-stranded, non-coding RNA molecule, has emerged as a valuable diagnostic and prognostic biomarker for numerous pathological conditions. Its primary function lies in regulating inflammatory processes, haemopoiesis, allergic responses, and other key aspects of the innate immune system. Several studies have indicated that polymorphisms in miRNA-146a can influence the pathogenesis of various human diseases, including autoimmune disorders and cancer. One of the key mechanisms by which miRNA-146a exerts its effects is by controlling the expression of certain proteins involved in critical pathways. It can modulate the activity of interleukin-1 receptor-associated kinase, IRAK1, IRAK2 adaptor proteins, and tumour necrosis factor (TNF) targeting protein receptor 6, which is a regulator of the TNF signalling pathway. In addition, miRNA-146a affects gene expression through multiple signalling pathways, such as TNF, NF-κB and MEK-1/2, and JNK-1/2. Studies have been carried out to determine the effect of miRNA-146a on cancer pathogenesis, revealing its involvement in the synthesis of stem cells, which contributes to tumourigenesis. In this review, we focus on recent discoveries that highlight the significant role played by miRNA-146a in regulating various defence mechanisms and oncogenesis. The aim of this review article is to systematically examine miRNA-146a's impact on the control of signalling pathways involved in oncopathology, immune system development, and the corresponding response to therapy.

Effect of COVID-19 on the Burden and Profile of Orthopaedic Patients Admitted Post-Resumption of Routine Services in a Tertiary Care Hospital in Delhi

Purpose On resumption of routine services post-lockdown during coronavirus disease 2019 (COVID-19), we expected a backlog of orthopaedic patients who could not get appropriate and timely care and would now present with complications due to missed or delayed treatment. This study aimed to quantify the effect of COVID-19 on the burden and profile of orthopaedic patients admitted post-resumption of routine services. Materials and methods Data on all the patients admitted to the orthopaedic department were collected using an interviewer-administered schedule for a complete one-year period after the resumption of routine orthopaedic services in a tertiary care hospital in Delhi. For comparison of the burden of trauma patients with that during the pre-COVID-19 period, data were obtained from a similar study done on trauma patients in 2017 at the same institution. For patients with non-traumatic conditions, previous hospital records were used. Results A total of 1585 patients were admitted during the one-year period post-resumption of routine services following COVID-19 restrictions, which was 41% less than that compared to the corresponding pre-COVID-19 data. The proportion of patients from other neighbouring states showed a decline from 52% in the pre-COVID-19 period to 41.55% when healthcare services resumed during the COVID-19 period. Out of all admitted trauma patients in 2021, 12.7% presented with a missed or complication of treatment as compared to 3.1% in the pre-COVID period. Around half of them (52.5%) attributed their complications to a COVID-19-related lockdown. Conclusion There was a significant decline in the number of patients post-resumption of routine orthopaedic care services. Converting whole tertiary care teaching hospitals to COVID-19-dedicated hospitals must not be done as it leads to an increase in missed or complication of orthopaedic treatment.

Effects of Ultrasound-Guided Lower Extremity Nerve Blocks for Below-Knee Procedures in the Emergency Department of a Tertiary Care Hospital, Central Gujarat

Background and objectives Ultrasound-guided femoral and popliteal sciatic nerve blocks are useful adjuncts for many below-knee procedures like debridement, amputation, etc. The objectives of the study were to find the efficacy and feasibility of the ultrasound-guided combined femoral and popliteal sciatic nerve block for below-knee procedures in the Emergency Medicine Department (ED). Methodology This prospective clinical study was carried out over three months in ED. A total of 30 patients undergoing below-knee procedures were included in the study. Femoral and popliteal sciatic nerve blocks were administered to each patient using the high-frequency linear ultrasound probe by emergency physicians trained in ultrasound. The effect of blocks, amount of local anesthetic (LA) used, duration of the procedure, and post-block analgesia were recorded. Patients were monitored for possible complications, if any. Data were entered and analyzed using a Microsoft Excel worksheet. Results The average volume of LAs required was around 34.5 cc for both blocks combined. No complications like vascular puncture or nerve injury were reported during the study. The time taken to complete the procedure was around 33 minutes, and the average time to achieve sensory block was around 9 minutes after completing the procedure. Conclusions An ultrasound-guided combined femoral and popliteal sciatic nerve block is an effective and feasible procedure and thus should be considered in ED for below-knee procedures.

Electrocardiogram to Determine Mitral and Aortic Valve Opening and Closure

PURPOSE

Knowledge of the timing of cardiac valve opening and closing is important in cardiac physiology. The relationship between valve motion and electrocardiogram (ECG) is often assumed, however is not clearly defined. Here we investigate the accuracy of cardiac valve timing estimated using only the ECG, compared to Doppler echocardiography (DE) flow imaging as the gold standard.

METHODS

DE was obtained in 37 patients with simultaneous ECG recording. ECG was digitally processed and identifiable features (QRS, T, P waves) were examined as potential reference points to determine opening and closure of aortic and mitral valves, as compared to DE outflow and inflow measurement. Timing offset of the cardiac valves opening and closure between ECG features and DE was measured from derivation set (n = 19). The obtained mean offset in combination with the ECG features model was then evaluated on a validation set (n = 18). Using the same approach, additional measurement was also done for the right sided valves.

RESULTS

From the derivation set, we found a fixed offset of 22 ± 9 ms, 2 ± 13 ms, 90 ± 26 ms, and - 2 ± - 27 ms when comparing S to aortic valve opening, Tend to aortic valve closure, Tend to mitral valve opening, and R to mitral valve closure respectively. Application of this model to the validation set showed good estimation of aortic and mitral valve opening and closure timing value, with low model absolute error (median of the mean absolute error of the four events = 19 ms compared to the gold standard DE measurement). For the right-sided (tricuspid and pulmonic) valves in our patient set, there was considerably higher median of the mean absolute error of 42 ms for the model.

CONCLUSION

ECG features can be used to estimate aortic and mitral valve timings with good accuracy as compared to DE, allowing useful hemodynamic information to be derived from this easily available test.

Artemisinin-based combination therapy successfully treated two hyperparasitaemic Plasmodium falciparum cases

Hyperparasitaemia is an important event in the cascade of Plasmodium falciparum severe malaria (SM), and may also lead to SM associated complications and death, if left untreated. Here, we report two hyperparasitaemic patients with no life-threatening complications. Malaria diagnosis was performed using thick and thin blood smears and immunochromatographic-based rapid diagnostic tests (RDTs) purchased from three different manufacturers. Parasitaemia was calculated following the World Health Organization (WHO) guidelines. Haematological and biochemical investigations were also performed. Weekly follow-up of blood smear examination, blood pressure and temperature were recorded up to day 63. The first patient had 42% parasitaemia (100% asexual parasites). The second patient had 9.5% parasitaemia, comprising 46% asexual and 54% sexual stages, with a 1:1 male to female ratio. On the day of admission, both had presented abnormal haematological and biochemical parameters compared to the reference values. Remarkably, both the patients recovered successfully with oral artemisinin-based combination therapy (ACT) and a single dose of primaquine on day 1. Weekly follow-up did not show any parasite suggesting successful treatment with ACT without any side effects. The presence of hypergametocytaemia may hinder malaria elimination efforts, if not treated immediately.

Recent Advancements in Liquid Chromatographic Techniques to Estimate Pesticide Residues Found in Medicinal Plants around the Globe

In the present review article, different advanced liquid chromatographic techniques and the advanced techniques other than liquid chromatography that are used to estimate the pesticide residues from different plant-based samples are presented. In the beginning of the article, details of pesticides, their health effects and various cell lines used for the related study has been outlined. Afterward, detailed descriptions regarding pesticides classification are inscribed. In the end, recent advancements in the area of analysis of pesticides for herbal drugs are explained. Solid phase micro extraction (SPME) and solid-phase extraction (SPE) are considered as most common method of sample preparation for pesticides and its residual analysis. The most commonly used analytical separation technique for pesticide analysis is liquid chromatography (LC) integrated with mass spectrometry (MS) and MS/MS as Triple Quadrupole Mass Spectrometer (QqQ) for the samples analysis where high level of sensitivity and accuracy is required in quantification.

Robust Scan Registration for Navigation in Forest Environment Using Low-Resolution LiDAR Sensors

Automated forest machines are becoming important due to human operators' complex and dangerous working conditions, leading to a labor shortage. This study proposes a new method for robust SLAM and tree mapping using low-resolution LiDAR sensors in forestry conditions. Our method relies on tree detection to perform scan registration and pose correction using only low-resolution LiDAR sensors (16Ch, 32Ch) or narrow field of view Solid State LiDARs without additional sensory modalities like GPS or IMU. We evaluate our approach on three datasets, including two private and one public dataset, and demonstrate improved navigation accuracy, scan registration, tree localization, and tree diameter estimation compared to current approaches in forestry machine automation. Our results show that the proposed method yields robust scan registration using detected trees, outperforming generalized feature-based registration algorithms like Fast Point Feature Histogram, with an above 3 m reduction in RMSE for the 16Chanel LiDAR sensor. For Solid-State LiDAR the algorithm achieves a similar RMSE of 3.7 m. Additionally, our adaptive pre-processing and heuristic approach to tree detection increased the number of detected trees by 13% compared to the current approach of using fixed radius search parameters for pre-processing. Our automated tree trunk diameter estimation method yields a mean absolute error of 4.3 cm (RSME = 6.5 cm) for the local map and complete trajectory maps.

Comparative Effect of No Finish Line, Heavy Chamfer, and Shoulder Marginal Designs on the Fracture Resistance of Zirconia (Cercon) Ceramic Restoration: An In Vitro Study

Background Because all-ceramic crowns are more aesthetic and biocompatible than metal-ceramic crowns, they have grown in popularity among patients and dentists. Poor finish line layout can result in restoration margin fracturing, hence, finish line arrangement is critical to maintaining the restoration's marginal integrity. The goal of this in-vitro study is to evaluate zirconia's resistance to fracture (Cercon) ceramic restorations with three marginal designs (no finish line, heavy chamfer, and shoulder). This study is important in contributing to the ongoing debate about the optimal finish line design for zirconia restorations. Methodology Three different finish lines, namely, biologically oriented preparation technique (BOPT) with a marginal width of less than 0.3 mm, heavy chamfer with a marginal width of up to 0.3 mm, and shoulder with a marginal width greater than 0.3 mm, were made on 10 extracted maxillary first premolar tooth to make 30 epoxy resin dies on which zirconia (Cercon) coping was done using CAD/CAM technology, and marginal discrepancies were measured using a three-dimensional scanner. All the copings were affixed to their respective dies using GIC luting cement, and fracture resistance was measured using a digital universal testing machine. Results The Kruskal-Wallis test revealed that the mean fracture resistance was more in the heavy chamfer finish line, followed by the no finish line (BOPT) and the shoulder finish line. No statistically significant difference was seen between the no finish line and the heavy chamfer finish line. There was a significant difference between the heavy chamfer and shoulder finish lines (p = 0.004). Conclusions To increase the biomechanical performance of posterior single zirconia restorations, heavy chamfer margins are indicated.

Mandibular Flexure and Crestal Bone Stress Distribution on an Implant-Supported Fixed Full Arch Mandibular Prosthesis: Finite Element Analysis in Three Dimensions

Aim This study's objective was to assess and analyze, using 3D Finite Element Analysis, the impact of four mandibular complete arch superstructures on the distribution of stress in the crestal bone during mandibular flexure. Materials and methods Four Finite element models of the mandible with different implant-retained framework designs have been developed. Three of these models had six axial implants placed at intervals of 11.8 mm, 18.8 mm and 25.8 mm from the midline, respectively. One model had two tilted implants and four axial implants splinted with a single piece of framework at intervals of 8.4 mm, 13.4 mm and 18.4 mm from the midline. For analyzing the stress distribution, the finished product was transferred to ANSYS R 18.1 software (Sirsa, Haryana, India) for finite element simulation, the models were constructed, the ends were restrained, and bilateral vertical loads of 50N, 100N and 150N were applied to the distal part of the framework. Results Bilateral loads were applied to each of the four 3D FEM and after assessment of Von Mises Stress and Total Deformation, a finding was made that the model with six axial implants supported by a single piece of framework underwent the highest total deformation and the model with four axial implants and two implants with distal tilts displayed most significant Von Mises stress. Conclusion Within the constraints of this 3D FEA, it was determined that mandibular flexure and peri-implant bone stress were affected by the way the framework is divided and the nature of mandibular movement. The three types of frames with the least bone stress are demonstrated by the mandibular deformation that results from two-piece frameworks on axial implants. Regardless of the number of implants, the single framework splinted with six implants shows a flexure in mandible with the highest bone stress around the implant irrespective of the angulation of the implant. Clinical significance When it comes to edentulous jaws, reducing stress in implant-supported restorative systems at varying degrees of the bone and implant interfaces and superstructures of prosthetics is one of the fundamental goals of implant treatment. A framework with proper design and a low modulus of elasticity reduces mechanical risk. Additionally, a larger number of implants helps to prevent cantilevers and spacing between the implants.

"You Don't Get That from Professionals": A Consumer-Led Peer Recovery Program for Families and Friends of Individuals with Alcohol and Other Drugs Use Issues in Darwin

While there has been a reduction in alcohol consumption among Australians aged 18 years and above, about 25% of people still drink above the recommended limit. The use of alcohol and other drugs is a substantial issue in the Northern Territory; however, there have been significant investments in alcohol reforms over the past few years. This paper reports on a pilot study that involved co-designing, implementing, and evaluating the Circles of Support consumer-led recovery and empowerment program for families and friends of individuals with alcohol and other drugs use issues. The evaluation comprised a mixed-methods approach; however, this article only presents the qualitative component (n = 7). Interview data were thematically analysed, and four main themes were identified: (1) the value of a peer-to-peer approach; (2) facing challenges and distress; (3) adopting self-care strategies; and (4) the development of valuable skills. Participants enjoyed the program content and learning. This involved self-care and communication strategies, boundary setting, service navigation, the concept of post-traumatic growth, the circles of control, and the stages of change model for families. Our findings strongly support the scaling up of the program in Darwin and other locations across the Northern Territory and future program adaptation for different vulnerable target audiences.

Correlation of lipid profile with diastolic dysfunction in normotensive young patients under 40 years of age

Background: Diastolic dysfunction in young adults is associated with increased morbidity and mortality. The identification of risk markers associated with diastolic dysfunction could allow for targeted primary prevention efforts. Aims and Objectives: The aim of the study was to study whether dyslipidemia is associated with diastolic dysfunction independent of systemic hypertension in young patients under 40 years of age. Materials and Methods: This was a cross-sectional analytical study done from April 2021 to March 2022 in SSMC and SGMH Rewa (M.P.), 214 normotensive cases under 40 years of age were taken as cases by simple random sampling. Sample size calculated by standard formula with confidence level of 95% and margin of error was <5%. Lipid profiles (S. Triglyceride [TG], S. Cholesterol, and S. low-density lipoprotein [LDL]) of all the patients were checked. 2D echocardiogram of patients was done to check for diastolic dysfunction. All data were compiled and compared with the previous studies. Results: We found that the prevalence of diastolic abnormalities in adults under 40 years of age was 21.9%. It was found that there was significant correlation between dyslipidemia and presence of diastolic dysfunction in patients. Patients with higher than normal levels of S. TG, S. Cholesterols, and S. LDL were found to have more prevalence of diastolic dysfunction then patients with normal levels of S. TG, S. Cholesterols, and S. LDL. Higher grades of diastolic dysfunction were found in patients with dyslipidemia as compared to patients without dyslipidemia. High levels of TG and LDL and even Borderline high levels of LDL can be good predictors of diastolic dysfunction. Conclusion: Dyslipidemia is associated with diastolic dysfunction in young patients even without systemic hypertension.

Flu-Net: two-stream deep heterogeneous network to detect flu like symptoms from videos using grey wolf optimization algorithm

The outbreak of COVID-19 (also known as Coronavirus) has put the entire world at risk. The disease first appears in Wuhan, China, and later spread to other countries, taking a form of a pandemic. In this paper, we try to build an artificial intelligence (AI) powered framework called Flu-Net to identify flu-like symptoms (which is also an important symptom of Covid-19) in people, and limit the spread of infection. Our approach is based on the application of human action recognition in surveillance systems, where videos captured by closed-circuit television (CCTV) cameras are processed through state-of-the-art deep learning techniques to recognize different activities like coughing, sneezing, etc. The proposed framework has three major steps. First, to suppress irrelevant background details in an input video, a frame difference operation is performed to extract foreground motion information. Second, a two-stream heterogeneous network based on 2D and 3D Convolutional Neural Networks (ConvNets) is trained using the RGB frame differences. And third, the features extracted from both the streams are combined using Grey Wolf Optimization (GWO) based feature selection technique. The experiments conducted on BII Sneeze-Cough (BIISC) video dataset show that our framework can 70% accuracy, outperforming the baseline results by more than 8%.

Diagnosis of cerebral malaria: Tools to reduce Plasmodium falciparum associated mortality

Cerebral malaria (CM) is a major cause of mortality in Plasmodium falciparum (Pf) infection and is associated with the sequestration of parasitised erythrocytes in the microvasculature of the host's vital organs. Prompt diagnosis and treatment are key to a positive outcome in CM. However, current diagnostic tools remain inadequate to assess the degree of brain dysfunction associated with CM before the window for effective treatment closes. Several host and parasite factor-based biomarkers have been suggested as rapid diagnostic tools with potential for early CM diagnosis, however, no specific biomarker signature has been validated. Here, we provide an updated review on promising CM biomarker candidates and evaluate their applicability as point-of-care tools in malaria-endemic areas.

Development and Evaluation of Cellulose/Graphene-Oxide Based Composite for Removing Phenol from Aqueous Solutions

In this study, a graphene oxide/cellulose composite (GO-cellulose) was prepared usingcellulose and graphene oxide (GO) through ultrasonication, followed by the freeze-dried method. The Brunauer-Emmett-Teller (BET) specific surface area of GO-cellulose (~6.042 m²/g) was higher compared to cellulose (1.023 m²/g).The UV-Visible spectraindicated that the prepared GO-cellulose composite removedphenol efficiently from aqueous solutions with high adsorption power. The effectiveness of the composite for phenol adsorption was examinedunder diverse conditions.The results reveal that the composite optimally improved the adsorption at pH 7 with a dose of 0.125 g/30 L in about 40 min. The adsorption process showed that in optimum conditions, 86 ± 2% of phenol was removed in 40 min with an adsorption capacity of 6.192 mg g^-1. The adsorption behavior was well fitted to the pseudo-second-order kinetic model and the Langmuir isotherms at all temperatures.The present study suggests that synthesized GO-cellulose is useful inthe removal of phenol pollutants from aqueous solutions.

Employee's performance and Kaizen events' success: does supervisor behaviour play a moderating role?

Purpose

The study's goal was to identify the factors contributing to the practical completion of Kaizen events (KEs). The effect of the work-study man's characteristics, the supervisor's conduct and the autonomy of the Kaizen team are analysed in this study.

Design/methodology/approach

Data were collected from 249 respondents working in the manufacturing sector in India, mainly those who had been involved in Kaizen projects. Three-step procedures, namely, exploratory factor analysis, confirmatory factor analysis and partial least squares, have been applied to test the research hypotheses through structural equational modelling.

Findings

The exploratory factor analysis extracted in-role performance, creative performance and human aspect as latent variables explaining work-study man's performance (eigenvalue = 1). The study's findings indicate that the performance of work-study man (in-role, creative and human) and supervisors' conduct is directly related to the success of KEs. It was shown that supervisors might influence the outcomes of KEs only by moderating the human aspects. Additionally, the degree of autonomy of the Kaizen team was found having a significant positive relationship with the success of KEs.

Practical implications

The current study suggests that in-role and creative performance are prime assets of a work-study man. At the same time, the human aspect is a delicate issue that can affect the supervisor's behaviour. Therefore, the study implies that work-study men have the tactics and abilities to work with other co-workers to make a Kaizen project successful.

Originality/value

Although the significance of Kaizen projects has been widely emphasised, past research has failed to establish what factors contribute to the success of Kaizen efforts. Similarly, the supervisor's critical role has been highlighted several times. However, it is unclear how their conduct influences the relationship between work-study man's performance and the effectiveness of Kaizen projects. This study contributes significantly to organisational culture and human resource management by answering these questions.

Rapidly expanding chondromyxoid fibroma of the mandible: A case report of rare entity

Chondromyxoid fibroma is an unusual, benign bone tumour that is usually sited in the metaphyseal region of the long bones. It accounts for less than 1% of all bone tumours. It manifests predominantly in males in their second and third decades of life. Rarely, it occurs in the bones of the craniofacial skeleton. For small, lesions enucleation and curettage and for larger lesions, resection followed by are the treatment modalities available. Here, we present a case of chondromyxoid fibroma with respect to the right side of the mandible which was managed by surgical resection followed by reconstruction under general anaesthesia. Resection followed by reconstruction provides satisfactory outcomes, especially in cases with large lesions. Chondromyxoid fibroma is an asymptomatic, benign, slow-growing lesion but can rapidly expand and involve the greater area of bone. Thus, its detection at an early stage and treatment at the proper time can lead to less morbidity associated with the lesion and improved quality of life of the patient.

Managing healthcare supply chain through artificial intelligence (AI): A study of critical success factors

Healthcare is one of the most critical sectors due to its importance in handling public health. With the outbreak of various diseases, more recently during Covid-19, this sector has gained further attention. The pandemic has exposed vulnerabilities in the healthcare supply chain (HSC). Recent advancements like the adoption of various advanced technologies viz. AI and Industry 4.0 in the healthcare supply chain are turning out to be game-changers. This study focuses on identifying critical success factors (CSFs) for AI adoption in HSC in the emerging economy context. Rough SWARA is used for ranking CSFs of AI adoption in HSC. Results indicate that technological (TEC) factors are the most influential factor that impacts the adoption of AI in HSC in the context of emerging economies, followed by institutional or environmental (INT), human (HUM), and organizational (ORG) dimensions.

How digitalization in banking improve service supply chain resilience of e-commerce sector? a technological adoption model approach

Supply chain resilience (SCR) is crucial for organizational sustainability and growth. This paper explores the factors of digitalization in the banking sector for achieving resilience in the e-commerce service supply chain. Most previous researchers have explored supply chain resilience in e-commerce using structural equation modeling. This study identifies and evaluates the crucial factors of digital banking that improve resilience in the e-commerce service supply chain using the Interpretive Structural Modeling (ISM) and Decision-Making Trial and Evaluation Laboratory (DEMATEL) technique. A conceptual framework is created based on the literature review and technology adoption theory. The framework comprises the critical digital technology adoption factors for the resilient service supply chain in Pakistan’s e-commerce sector. The results show that the most critical driving factors are “performance expectancy (F15),” “e-cost effectiveness (F5),” and “Trust (F8)” The research findings have several implications for decision-makers, and practitioners, providing insights into how digitalization in the banking sector can help in designing resilient supply chains in the e-commerce sector.