Rapid exchange of a percutaneous gastrostomy tube during an early episode of COVID-19

We retrospectively report a case of rapid exchange of a percutaneous radiologic gastrostomy tube (balloon-occluded type catheter) via off-label use of a pigtail catheter for nutrition supply during a very early episode of coronavirus disease 2019 (COVID-19) in an outpatient clinic. This case demonstrates that minimally invasive percutaneous procedures might be provided safely and effectively under appropriate precautions for preventing COVID-19 transmission during the pandemic.Copyright © 2023, Society of Gastrointestinal Intervention.

Home Made Soft Tissue Retractor During COVID-19 Supply Chain Disruption

Objective: Soft tissue retractor is used in minimally invasive cardiac surgery to facilitate visualization of intrathoracic structures and provide entry for the instruments into the thoracic cavity during specific cardiac surgical procedures. During COVID-19 period our institute have shortages in some supplies including soft tissue retractor. Method(s): Home made soft tissue retractor was designed from supplements can be found in the Cardiac operating room. By using Adhesive tapes, fabric plastic that cover guide wire and ruler contributed to create the retractor. Result(s): The designed retractor aids the exposure of surgical field during valve procedure by minimally invasive approach. Conclusion(s): Disruption of soft tissue retractor supplies was not impediment to continue performing minimally invasive valve surgery by designed retractor during covid 19 period.

Why do freelance tour guides still stay after the attack of COVID-19：A path-dependent perspective

The tourism industry has been devastated by COVID-19 (Corona Virus Disease 2019), with tour guides taking the brunt. Through in-depth interviews with 24 freelance tour guides in China and thematic analysis, this study addressed why they continue to work in this field and provided some insights for the freelance tour guides to stay in the tourism industry. The findings revealed that some individuals stay active because of their optimistic and open personality, professional recognition, etc. In contrast, others are passively locked into their current career path due to their cautious personality, fear of losing human capital, inertia, low self-efficacy, and limited job opportunities. These findings promote the application of path dependence theory in the career decision-making of freelancers by enhancing our understanding of the diverse reasons underlying individuals' retention behaviors in an unorganized setting in the context of COVID-19.

Good Architecture Matters: The Architect's Perspective on Design for Ageing and Energy Efficiency

Custom-built solutions for ageing, urban regeneration, energy efficiency, thermal performance, and well-being are contemporary challenges that have prompted considerable research over the past decades. In the construction field, subjects such as energy efficiency and thermal performance are often addressed within the scope of mandatory regulations, the suitability of construction solutions and the incorporation of technical equipment. Considering four residential structures for older adults under construction in Portugal, this paper aims to highlight the importance of a comprehensive approach to these issues, including architectural quality as the main target. In pursuit of this, a cohesive set of intervention principles guided the analysis: the adaptive reuse of raw materials;taking advantage of the site's conditions;vegetation (type and location);construction options and durability;solar exposure and shading;the pedagogy of building use;and the comfort and thermal perception. Several reflections emerge from the analysis: good architectural design must consider dynamic models incorporating each context and the site's conditions;the culture of use and maintenance and the notion of "adaptive comfort" are primary factors to enhance thermal performance and energy efficiency;and each building is a unique result of a complex negotiation process. Bridging research through practice, and multidisciplinary scientific integration enable engagement with reality and raise awareness of the constraints and challenges to innovation in LTC design.

Food practices and bowl habit of teachers from a municipality in the interior of Rio Grande do Sul during the covid-19 pandemic: a cross-cross study

Introduction and objective: Functional Intestinal Constipation is a disease of high prevalence and origin not fully clarified. However, its primary treatment involves lifestyle changes, like improving eating habits, exercising and increase of water intake. Materials and Methods: According to this, the present study aimed to evaluate intestinal habits and associated factors of teachers from a municipal school in the city of Passo Fundo, Rio Grande do Sul. Thus, a cross-sectional study was made with teachers aged 20 years or over. Data collection was done through an electronic form involving the Bristol Scale Tool, Rome III Criteria and a form about dietary habits based on the Food Guide for the Brazilian Population, sent to the institutional e-mail of the teachers. Socioeconomic issues and water intake were also evaluated. After the collection, data were analyzed by statistical software. Results: The prevalence of functional constipation was 44,7% (The Rome III Criteria) and 24,3% (Bristol Scale Tool). Furthermore, its prevalence was 1,727 times (95%CI = 1,135;2,629) higher in the. With moderate / regular eating habits compared to habits with excellent practices. Discussion: Results similar to the study are observed in the literature. Conclusion: This way, the present study observed that the prevalence of constipation was related to the eating habits of the studied population.

In-demand, interactive and an appetite for more: Analysis of learner enrolments and feedback in an open-access introductory telehealth course during COVID-19

Introduction: The use of telehealth has accelerated with health service delivery restrictions experienced during the COVID-19 pandemic. This research assessed learner enrolments and feedback in an introductory, online, open-access, rural-focused telehealth training course to inform future telehealth education design.Methods: Differences in enrolled learner demographics "before" (n = 331) and "after" (n = 3,776) COVID-19-related changes in Australia were assessed. Content analysis of learner feedback was conducted to understand the beneficial aspects of the course and to inform future telehealth education and training development.Results: Concurrent with telehealth changes announced in Australia in March 2020, enrolments in the course sharply increased. While students comprised most enrolments, initial growth was strongest amongst health educators and health professionals. More learners enrolled from major city areas and other countries. User feedback indicated the flexible delivery mode, policy, links to resources and multimedia content were the most beneficial aspects of the course. Learners would like more client perspectives as well as discipline-and context-specific information. There is also an appetite for more practice -based telehealth education.Conclusions: Growth in demand for the course and positive learner feedback showed it was filling an important introductory training gap. Learner feedback also highlighted several perceived barriers among learners in being able to implement best-practice telehealth in their current or future practice. This feedback could be used to inform the design of further telehealth training for health professionals and students to, ultimately, enhance the use of telehealth technologies.

WMSA 2: a multiple DNA/RNA sequence alignment tool implemented with accurate progressive mode and a fast win-win mode combining the center star and progressive strategies.

Multiple sequence alignment is widely used for sequence analysis, such as identifying important sites and phylogenetic analysis. Traditional methods, such as progressive alignment, are time-consuming. To address this issue, we introduce StarTree, a novel method to fast construct a guide tree by combining sequence clustering and hierarchical clustering. Furthermore, we develop a new heuristic similar region detection algorithm using the FM-index and apply the k-banded dynamic program to the profile alignment. We also introduce a win-win alignment algorithm that applies the central star strategy within the clusters to fast the alignment process, then uses the progressive strategy to align the central-aligned profiles, guaranteeing the final alignment's accuracy. We present WMSA 2 based on these improvements and compare the speed and accuracy with other popular methods. The results show that the guide tree made by the StarTree clustering method can lead to better accuracy than that of PartTree while consuming less time and memory than that of UPGMA and mBed methods on datasets with thousands of sequences. During the alignment of simulated data sets, WMSA 2 can consume less time and memory while ranking at the top of Q and TC scores. The WMSA 2 is still better at the time, and memory efficiency on the real datasets and ranks at the top on the average sum of pairs score. For the alignment of 1 million SARS-CoV-2 genomes, the win-win mode of WMSA 2 significantly decreased the consumption time than the former version. The source code and data are available at https://github.com/malabz/WMSA2.

Magseed wide local excisions - The first 50

Introduction: Prior to 2021, impalpable tumours in our unit were localised with Somatex wires. During the COVID pandemic we introduced Magseed due to its logistical advantages in allowing surgery on a site distant from our breast unit. We wanted to ensure our clinical outcomes with this new system were equivalent to those using wire localisation. Method(s): Electronic records for the first 50 consecutive Magseed localised wide local excisions and the preceding 50 consecutive wire localised wide local excisions were compared. Excision biopsies, palpable lesions, bracketed lesions and post neoadjuvant treatment patients were excluded. Patient demographics, tumour size, inadequate radial margin involvement rate, reoperation rate for margins, specimen weight, number of cavity shaves and operative time were recorded. [Formula presented] Results: Results are shown in table 1. There were no preoperative differences in the two groups. There were no significant differences in outcomes between the two groups, with a trend towards lower margin involvement rates but more shaves in the Magseed group. The mean operative time was slightly shorter in the Magseed group despite more axillary procedures being performed in this group. Conclusion(s): The change to the Magseed system led to logistical advantages with patient outcomes at least equivalent to wire guided excision.Copyright © 2023

Optimized nanoparticle-mediated base editing of cystic fibrosis-causing variants

Background: Next-generation SARS-CoV-2 vaccines demonstrated that nanoparticle messenger ribonucleic acid (mRNA) delivery is effective and safe for in vivo delivery in humans. Current treatments for cystic fibrosis (CF) primarily focus on modulator drug therapies designed to correct malfunctioning CF transmembrane conductance regulator (CFTR) protein, but these modulators are ineffective for the 10% of people with CF with variants that do not allow protein production. Among these is the splice variant 3120 + 1G >A, the most common CF-causing mutation in native Africans. Gene editing would allow production of CFTR protein and enhancement of function using available CFTR modulators. We have demonstrated that electroporation of a modified CRISPR-Cas9 base editor to primary human bronchial epithelial cells carrying 3120 + 1G >A and F508del mutant alleles achieved 75% genome editing of the splice variant, resulting in approximately 40% wild-type (WT) CFTR function [1]. Here,we evaluate the effectiveness of several new nanoparticle formulations at delivering green fluorescent protein (GFP) mRNA to CF bronchial epithelial (CFBE41o-) cells. Using the optimal formulation,we then tested the efficacy correction of the 3120 + 1G >Avariant in a CFTR expression minigene (EMG) integrated into the genome of isogenic CFBE cells using mRNA and plasmid deoxyribonucleic acid (DNA) encoding adenine base editor (ABE) and guide (g)RNA. Method(s): GFP served as a reporter to evaluate transfection efficiency, cell viability, and mean fluorescence intensity (MFI) for three dosages (150, 75, 32.5 ng of mRNA), four polymer-to-mRNA to weight (w/w) ratios (60, 40, 30, 20), and four polymers (R, Y, G, B). 7-AAD served as a live/dead stain to quantify viability, with flow cytometry results analyzed using FlowJo software. CFBE cells stably expressing the 3120 + 1G >A EMG were transfected with the optimized nanoparticle formulation to deliver ABE and gRNA at two dosages (150, 75 ng) of mRNA and DNA. CFTR function in CFBE cellswas measured by short circuit current, forskolin stimulation, and inh-172 inhibition as a measure of editing efficiency. Result(s): Flow cytometry showed that polymer R achieved more than 85% GFP transfection, compared with a maximum of approximately 35% for the other three polymers at the maximum 150-ng dose, with approximately 80% viability normalized to untreated cells. In addition, polymer R achieved GFP MFI more than one order of magnitude as high as other formulations (~30 000 vs 2700 MFI) for the other three polymers at 150-ng dose and 40 w/w ratio. CFBE cells transfected with polymer R nanoparticles containing ABE and guide RNA at 75 ng and 150 ng showed mean CFTR function increase to 10 muA 6 (standard error of the mean [SEM] 1.1 muA) (~10% of WT) and 6.3 muA (SEM 0.9 muA) (~6% of WT), respectively. Greater toxicity at the higher dose could explain the larger increase in CFTR current at the lower dose. DNA-encoded ABE plasmid and gRNA showed a less robust increase in CFTR function (2.9 muA [SEM 0.4 muA] for 75-ng dose;3.0 muA [SEM 0.4 muA] for 150-ng dose), which was probably a result of the nanoparticle formulation being optimized for RNA instead of DNA cargo or the additional intracellular barriers that must be overcome for successful DNA delivery. Conclusion(s): We demonstrated that an optimized nanoparticle formulation containing ABE and gRNA can correct splicing of isogenic cells bearing the 3120 + 1G >A CFTR variant, resulting in recovery of CFTR function. In ongoing work, we are adapting these nanoparticles for RNA- and DNAencoded ABE and gRNA delivery to primary human bronchial epithelial cells.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

A field guide for implementing a flipped classroom.

The way flipped classrooms are perceived and even practiced by teachers is sometimes approximate. For instance, while the Covid-19 pandemic has pushed many universities to adopt distance learning, flipped classrooms have often been mentioned as a solution in that context. This inducement maintains a confusion between flipped classrooms and distance learning that might be detrimental for students and teachers. Moreover, embarking on a new pedagogical practice such as flipped classroom could be intimidating and time-consuming for the newcomer teacher. For these reasons, this article aims to share some tips for implementing a flipped classroom, with examples from biology and biochemistry. Based on our experiences but also on the current scientific literature, we structured these advise around three phases: preparation, implementation, and follow-up. In the preparation phase, we advise planning early to invert time in class and outside the classroom, but also to say it explicitly, as well as to identify (or optionally create) resources for students to learn in autonomy. In the implementation phase, we suggest to (i) be explicit in the acquisition of knowledge and foster students' autonomy; (ii) explore active learning in class; (iii) develop cooperation and sharing skills; and (iv) differentiate teaching practices to adapt to student needs. Lastly, in the follow-up phase, we propose to (i) evaluate both student learning and the pedagogical setting; (ii) take care of the logistics and the teacher's posture; (iii) document the flipped classroom, and (iv) share the teaching experience.

Recent progress of molecular diagnosis via CRISPR Cas-based biosensors and bioassays

The immune systems of bacteria and archaea served as the inspiration for CRISPR/Cas technology, which won the 2020 Nobel Prize in Chemistry for its achievements in genetic manipulation. Because of its enormous value globally, molecular diagnostics emerged as a fresh wave of diagnostic technologies. A growing number of studies have demonstrated the compatibility of CRISPR/Cas technology with biosensors and bioassays for molecular diagnostics. As highly precise, sensitive, easily programmable, and device-independent sensors, CRISPR-based detection has received a lot of interest. One of the most precise and sensitive diagnostic techniques is nucleic acid-based detection. It has the potential for detecting other biomarkers, such as proteins and tiny compounds, with more study. This study provides insight into CRISPR-based biosensors and recent advancements from nucleic acids to other non-nucleic small molecules or analytes such as proteins and presents the challenges and perspectives of CRISPR biosensors and bioassays.

Percutaneous tracheostomy in head and neck oncology surgery: How Covid-19 changed our practice

Enhanced experience in performing percutaneous tracheostomies during the COVID-19 pandemic resulted in changes to airway management protocol for patients undergoing major head and neck reconstructive surgery within our department. Most patients now receive a percutaneous tracheostomy over the previously favoured surgical tracheostomy. The aim of this study was to review our experience in performing percutaneous tracheostomies, whilst comparing complication rates with surgical tracheostomies performed in similar settings. All consecutive patients undergoing free flap reconstructive surgery for head and neck cancer between June 2020 and November 2021 were included, with 56 patients receiving a percutaneous tracheostomy. Data across a range of variables including age, BMI, comorbidities and complications was compared with 56 surgical tracheostomies performed for the same group of patients before the COVID-19 pandemic and resultant protocol changes. In the percutaneous group, a marginally lower complication rate was observed over the surgical tracheostomy group;28.57% and 30.35% respectively. Analysis of the 16 patients who experienced complications in the percutaneous group led to development of selection criteria to identify appropriate patients to receive a percutaneous tracheostomy in future, based on factors such as BMI, bleeding risk and positioning deformities. The COVID-19 pandemic has offered a multitude of learning experiences for healthcare professionals to change our practice. In our unit, this has involved modifying the routine tracheostomy procedure used for airway management intra- and post-operatively in major head and neck reconstruction surgery.Copyright © 2023 The Authors

A Practical and Empirical Comparison of Three Topic Modeling Methods using a COVID-19 Corpus: LSA, LDA, and Top2Vec

This study was prepared as a practical guide for researchers interested in using topic modeling methodologies. This study is specially designed for those with difficulty determining which methodology to use. Many topic modeling methods have been developed since the 1980s namely, latent semantic indexing or analysis (LSI/LSA), probabilistic LSI/LSA (pLSI/pLSA), naïve Bayes, the Author-Recipient-Topic (ART), Latent Dirichlet Allocation (LDA), Topic Over Time (TOT), Dynamic Topic Models (DTM), Word2Vec, Top2Vec and \variation and combination of these techniques. For researchers from disciplines other than computer science may find it challenging to select a topic modeling methodology. We compared a recently developed topic modeling algorithm-Top2Vec- with two of the most conventional and frequently-used methodologies-LSA and LDA. As a study sample, we used a corpus of 65,292 COVID-19-focused s. Among the 11 topics we identified in each methodology, we found high levels of correlation between LDA and Top2Vec results, followed by LSA and LDA and Top2Vec and LSA. We also provided information on computational resources we used to perform the analyses and provided practical guidelines and recommendations for researchers. © 2023 IEEE Computer Society. All rights reserved.

Radiologic and Endoscopic Treatment for a Disconnected Pancreatic Duct Syndrome Associated to Percutaneous Pancreatic Fistula: Achieving the "Internalization of the Fistula"

Background and aim: A 40-year-old male was referred to our institute for the management of a percutaneous pancreatic fistula after acute pancreatitis due to SARS-COV2 infection. He developed a peripancreatic collection(PPC) which was percutaneously drained due to infection. After the resolution of PPC, a percutaneous leakage of the main pancreatic duct (MPD) was observed, so he underwent Endoscopic Retrograde ColangioPancreatography(ERCP) with biliary plus pancreatic sphincterotomy and placement of both pancreatic and biliary stent without resolution of the leak. Material(s) and Method(s): Then he was referred to our institution, where initial management included ERCP with placement of two trans-papillary pancreatic stents and the removal of percutaneous catheter, but the fistula kept to drain. Result(s): A multidisciplinary-board decided to perform a rendezvous with interventional radiology to facilitate an endoscopic ultrasound(EUS) trans-gastric drainage of the pancreatic area draining in the percutaneous fistula. Conclusion(s): The procedure included an initial ERCP with replacement of the two pancreatic stents while the radiologist places percutaneously a guidewire through the fistula to the pancreatic point of leakage into MPD. After that, EUS identified the point in which the percutaneous guidewire was getting into the MPD and a trans-gastric EUS-guided insertion of a guidewire achieved the MPD through a 19-Gauge needle. The latter guidewire crossed the percutaneous fistula and came out. At that point, a dilation up to 10 mm was performed to create a trans-gastric pancreatic fistula. The next step was to insert percutaneously a double pigtail(10 Fr) releasing the distal side into the stomach and the proximal side into the main pancreatic duct in order to stabilize the neo-fistula. Another trans-gastric plastic stent was endoscopically placed through the pancreato-gastric neo-fistula. At the end, injection of contrast dye through the percutaneous fistula showed a complete drainage into stomach. In conclusion, the procedure achieved the complete exclusion and resolution of the pancreatic-cutaneous fistula.Copyright © 2023. Editrice Gastroenterologica Italiana S.r.l.

An Eventful Rotational Atherectomy Over the Left Main Stem and Left Anterior Descending Artery in an Elderly Male

Clinical Information Patient Initials or Identifier Number: SHS Relevant Clinical History and Physical Exam: Mr. SHS was admitted in August 2022 for acute decompensated heart failure secondary to NSTEMI, complicated with ventricular tachycardia (VT). CPR was performed for6 minutes on the day of admission and was subsequently transferred to the Cardiac Care Unit. His hospital stay was complicated with Covid-19 infection(category 2b) which he recovered well from. During admission, he developed recurrent episodes of angina. Physical examination was otherwise unremarkable. His ejection fraction was 45%. Relevant Catheterization Findings: Cardiac catheterization was performed, which revealed significant calcification of left and right coronary arteries. There was a left main stem bifurcation lesion (Medina 0,1,1) with subtotal occlusion over ostial the LAD, receiving collaterals from RCA and 90% stenosis over ostial LCx. RCA was dominant, heavily calcified with no significant stenosis. He was counselled for CABG (Syntex score26) but refused. As he was symptomatic, he was planned for PCI to the left coronary system. [Formula presented] [Formula presented] [Formula presented] Interventional Management Procedural Step: The left main was engaged with a 7F EBU 3.5guiding catheter via transradial approach. Sion Blue wired into LAD and LCx. IVUS catheter couldn't cross the LAD and LCx lesions, hence we decided for up front rotational atherectomy. Sion blue was exchanged to Rotawire with the assistance of Finecross microcatheter. A 1.5mm burr was used at 180000 rpm. After the first run of rotablation, patient developed chest pain and severe hypotension (BP ranging 50/30). 4 inotropes/vasopressors were commenced. The shock was refractory hence an intraarterial balloon pump was inserted. Symptoms and blood pressure improved. Another 2 runs of atherectomy done (patient developed hypotension after each run). IVUS examination then showed calcification of proximal to mid LAD with an IVUS Calcium score of 3. LAD was further predilated with Scoreflex balloon 3.0/20mm at 8-22ATM. LCx was predilated with Scoreflex balloon 2.0/15mm at 12-14ATM. DCB Sequent Please NEO2.0/30mm was deployed at 7ATM at ostial to proximal LCx. Proximal to mid LAD was stented with Promus ELITE 2.5/32mm at 11ATM, which was then post dilated with stent balloon at 11ATM. Ostial LM to proximal LAD (overlap) was stented with Promus ELITE 4.0/28mm at 11ATM. LMS POT was then done with NC Balloon 4.0/15mm at 24ATM. LCx was rewired and kissing balloon technique with NC balloon 4.0/15mm at 14ATM (LAD) and NC balloon 2.0/10mm at 12ATM (LCx) was done, followed by a final POT with NC balloon 4.0/15mm at 14ATM. Final IVUS showed good MSA. [Formula presented] [Formula presented] [Formula presented] Conclusion(s): This patient developed hemodynamic instability with each rotational atherectomy run, hence we decided not to perform rotablation to the circumflex artery. His hemodynamic condition improved with the use of intra aortic balloon pump. IABP use can reduce procedural event rate and potentially reduce long term mortality in appropriately selected patients who are at high risk of adverse events. He was followed up a month following the procedure and remained asymptomatic. For complex, calcified coronary lesions involving the left main stem, coronary artery bypass graft surgery is an alternative option.Copyright © 2023

Optical Coherence Tomography Guided Percutaneous Coronary Intervention of Spontaneous Recanalized Coronary Thrombus

Clinical Information Patient Initials or Identifier Number: 56 years old woman Relevant Clinical History and Physical Exam: A 56-years-old woman with underlying history of hyperlipidemia without medical treatment. She experienced effort precordial tightness and shortness of breath for 8 months after COVID-19 vaccination. She received exercise TI 201 myocardial perfusion scan showed myocardial ischemia. EKG found old anterior wall myocardial infarction. Echocardiogram showed left ventricle anterior wall hypokinesia, LVEF 38%. [Formula presented] Relevant Test Results Prior to Catheterization: Coronary angiogram found left anterior descending artery from proximal to middle 70~80% long diffuse stenosis with spontaneous recanalized coronary thrombus. Also left anterior descending artery diagonal 2 branch bifurcation was 70% stenosis with spontaneous recanalized coronary thrombus (Medina 1.1.1) [Formula presented] [Formula presented] Relevant Catheterization Findings: Coronary angiogram found left coronary artery middle and diagonal branch braided apperance. OCT found recanalized thrombi, high backscattered septa that divided the lumen into multiple small cavities, created "lotus root" appearance. [Formula presented] [Formula presented] Interventional Management Procedural Step: Left main coronary artery was engaged with EBU3.5/7F guiding catheter. We advanced Runthrough to LAD-D and second wire Sion to LAD-DB2 but can't advance. Then we used with Sasuke double lumen catheter and successful advance Pilot 50 to LAD-DB2 distal. OCT found multiple channels with LAD-D and DB2 branch wires are at different channels, so we used cutting balloon 2.5 x 10mm as unconventional method. OCT was rechecked again and successfully destroyed to multiple channel of SRCT between LAD and Diagonal 2 branch. Long diffuse dissection found after POBA so we deployed to LAD-DB2 branch with DES Synergy 2.5 x 16mm and advanced LAD-M bifurcation to Pantera LEO 3.0 x 20mm and done Mini-Crush technique. Deployed for main vessel LAD-P to M long diffuse lesion with DES Xience 2.75 x 48mm at 14atm. Then we rewire Fielder XTR to DB2 branch with the support of Sasuke but difficult to deliver to Diagonal 2 branch. POT with Pantera LEO 3.0 x 20mm to LAD stent proximal site. Then successfully advance Fielder XTR to DB2 branch. Final kissing balloon technique with Pantera 2.75 x 12mm to LAD main vessel and MINI TREK 1.5 x15mm to LAD-DB2. [Formula presented] [Formula presented] [Formula presented] Conclusion(s): This is a case of SRCT (Spontaneous Recannalized Coronary Thrombus) that was confirmed with OCT. For secure side branch patency, main trunk & side branch wire must be in same channel. Due to relatively unstable hemodynamic, we chose to use unconventional method with 2.5 x 10mm Wolverine cutting balloon. Relatively large side-branch diagonal branch, possible dissection at ostial diagonal branch, we chose upfront 2 stents, bifurcation stenting technique we used Mini-crush stenting. Some difficult when rewire to side branch and initial POT to main branch stent proximal and then successfully delivered. If without guidewire recross, unrescuable side-branch occlusion can be occurred.Copyright © 2023

STUDY BUDDY-Making Learning Easy

Study buddy is an all-in-one package for your studies. We provide an automatically generated timetable as well as pdfs and video links all for Free for our students of class 10th, 12th and, those appearing for JEE. The aim is to increase job opportunities for college students with expertise in a particular subject as well as retired teachers to help school students divide their time and stay motivated. Kids nowadays are always stressed during exam days because they can't make a schedule to study. So we wanted to bring an end to those days of anxiety and fear. We decided to make a website, "Study Buddy"where a student will have the following 4 options: a) Generate Time table b) Reference Material c) Discussion Forum d) Mentor Help.In our research, we would walk through the above-mentioned points and also compare how our proposed method and software package stands out from the already existing software. This will be followed by our system design, result and future scope. This software is a buddy for the students during their hard times. It will not only help the students but will also provide an employment opportunity to retired teachers and college students. We also plan to implement machine learning in order to understand the basic trend of student psychology during exams. © 2022 IEEE.