Resectable Distal Duodenal Gastrointestinal Stromal Tumour Presenting with Features of Anaemia.

Although gastrointestinal stromal tumours (GISTs) are encountered all along the gastrointestinal tract, duodenal GISTs are uncommon and account for <5% of the cases. A 45-year-old woman presented chiefly with anaemia and associated symptoms, whom on further evaluation was found to have a non-metastatic GIST in the distal duodenum sparing the pancreas and major vasculature. Patient was undertaken for segmental duodenectomy with the help of advanced bipolar energy device (tumour occupying D3-D4 with 1 cm proximal margin and 15 cm jejunum) preserving the pancreas and ampulla with end-to-end duodenojejunostomy with an uneventful postoperative course and clear margins on histopathology. Thus, the patient underwent a less morbid procedure with satisfactory oncological outcome and early resumption of activity. This highlights the need to conduct more trials to gather high level evidence in favour of conservative resection and its oncological adequacy and impact on overall survival and recurrence.

Nanocomposite Marvels: Unveiling Breakthroughs in Photocatalytic Water Splitting for Enhanced Hydrogen Evolution.

An overview of the significant innovations in photocatalysts for H2 development, photocatalyst selection criteria, and photocatalytic modifications to improve the photocatalytic activity was examined in this Review, as well as mechanisms and thermodynamics. A variety of semiconductors have been examined in a structured fashion, such as TiO2-, g-C3N4-, graphene-, sulfide-, oxide-, nitride-, oxysulfide-, oxynitrides, and cocatalyst-based photocatalysts. The techniques for enhancing the compatibility of metals and nonmetals is discussed in order to boost photoactivity within visible light irradiation. In particular, further deliberation has been carried out on the development of heterojunctions, such as type I, type II, and type III, along with Z-systems, and S-scheme systems. It is important to thoroughly investigate these issues in the sense of visible light irradiations to enhance the efficacy of photocatalytic action. In fact, another advancement in this area may include hiring mediators including grapheme oxide and metals to establish indirect Z-scheme montages with a correct band adjustment. The potential consideration of reaction chemology, mass transfer, kinetics of reactions, restriction of light diffusion, and the process and selection of suitable light and photoreactor also will optimize sustainable hydrogen output efficiency and selectivity.

A randomized controlled trial of brief intervention for patients with cannabis use disorder.

Objectives: Effective interventions for cannabis use disorders are fairly limited. The present randomized controlled trial (RCT) aimed to compare the reduction in cannabis use (number of days cannabis used) with brief intervention and simple advice in patients with cannabis use disorder. Materials and Methods: This non-blinded and parallel two-group RCT included 100 male patients with cannabis use disorder. A semi-structured pro forma and severity of dependence scale (SDS) were used. Participants were then randomized to either of the two arms (brief intervention and simple advice) in a 1:1 ratio. Cannabis use patterns and SDS scores were assessed over the phone at week 4, week 8, and week 12. Results: The two groups were comparable in sociodemographics and cannabis use characteristics. Participants in both groups were using cannabis for 30 days in the past month before enrolment. The brief intervention group had a lesser number of days of cannabis use vis-a-vis the simple advice group at 4, 8, and 12 weeks. There was a significant time effect for change in SDS scores (F = 30.629, P < 0.001), but the group effect was not significant (F = 0.379, P = 0.541). Conclusion: In this population of regular cannabis users, brief intervention may be useful in reducing cannabis usage. It can be integrated into routine assessments and management of those with regular use of cannabis.

A graphene-based material for green sustainable energy technology for hydrogen storage.

The usage of graphene-based materials (GMs) as energy storage is incredibly popular. Significant obstacles now exist in the way of the generation, storage and consumption of sustainable energy. A primary focus in the work being done to advance environmentally friendly energy technology is the development of effective energy storage materials. Due to their distinct two-dimensional structure and intrinsic physical qualities like good electrical conductivity and wide area, graphene-based materials have a significant potential to be used in energy storage devices. Graphene and GMs have been employed extensively for this due to their special mechanical, thermal, catalytic and other functional qualities. In this review, we covered the topic of employing GMs to store hydrogen for green energy.

Recent advances in sustainable nature-based functional materials for biomedical sensor technologies.

The lightweight, low-density, and low-cost natural polymers like cellulose, chitosan, and silk have good chemical and biodegradable properties due to their individually unique structural and functional elements. However, the mechanical properties of these polymers differ from each other. In this scenario, chitosan lacks good mechanical properties than cellulose and silk. The synthesis of nano natural polymer and reinforcement with suitable chemical compounds as the development of nanocomposite gives them promising multidisciplinary applications. Many kinds of research are already published with innovative bio-derived polymeric functional materials (Bd-PFM) applications. Most research interest is carried out on health concerns. Lots of attention has been paid to biomedical applications of Bd-PFM as biosensors. This review aims to provide a glimpse of the nanostructures Bd-PFM biosensors.

Clinical outcomes of ankle fractures in sub-Saharan Africa: a systematic review.

PURPOSE: Ankle fractures may cause disability and socioeconomic challenges, even when managed in a high-resource setting. The outcomes of ankle fractures in sub-Saharan Africa are not widely reported. We present a systematic review of the patient-reported outcomes and complications of patients treated for ankle fractures in sub-Saharan Africa. METHODS: Medline, Embase, Google Scholar and the Cochrane Central Register of Controlled Trials were searched, utilising MeSH headings and Boolean search strategies. Ten papers were included. Data included patient demographics, surgical and non-surgical management, patient-reported outcome measures and evidence of complications. RESULTS: A total of 555 patients with ankle fractures were included, 471 of whom were followed up (range 6 weeks-73 months). A heterogenous mix of low-quality observational studies and two methodologically poor-quality randomised trials demonstrated mixed outcomes. A preference for surgical management was found within the published studies with 87% of closed fractures being treated operatively. A total of five different outcome scoring systems were used. Most studies included in this review were published by well-resourced organisations and as such are not representative of the actual clinical practice taking place. CONCLUSION: The literature surrounding the clinical outcomes of ankle fractures in sub-Saharan Africa is sparse. There appears to be a preference for surgical fixation in the published literature and considering the limitations in surgical resources across sub-Saharan Africa this may not be representative of real-life care in the region.

A Numerical Investigation on Hydrothermal Performance of Micro Channel Heat Sink with Periodic Spatial Modification on Sidewalls.

Electronic gadgets have been designed to incorporating very small components such as microcontrollers, electronic chips, transistors, microprocessors, etc. These components are exceptionally heat sensitive and can be wrecked if heat is not released. As a result, the thermal control of such components is critical to their optimum performance and extended life. The use of a microchannel heat sink (MCHS) has shown promising solutions to remove the excess heat. In this paper, we have proposed a novel design of MCHS and investigated it numerically. Four different surface modifications on the sidewall of the passage, namely, extended triangular surface (ETS), extended circular surface (ECS), triangular groove surface (TGS), and the circular groove surface (CGS) in the passage of the microchannel have been exploited in the Reynolds number of 100-900. In the presence of geometrical modification, the cooling capacities have been enhanced. The results show that the Nusselt numbers of ETS-MCHS, ECS-MCHS, TGS-MCHS, and CGS-MCHS are increased by 4.30, 3.61, 1.62, and 1.41 times in comparison to the Nusselt number of MCHS with smooth passage, while the friction factor values are increased by 7.33, 6.03, 2.74, and 1.68 times, respectively. In addition, the thermohydraulic performance parameter (THPP) has been evaluated and discussed. The fact that MCHS have THPP values greater than unity demonstrates that the passage's geometries are a practical means of achieving effective thermal management.

MyrliMax® and Low Back Pain: A Multicentric, Observational, Post-Marketing Surveillance Study in Indian Patients Suffering from Chronic Low Back Pain of Various Pain Intensity.

Background: Chronic low back pain (LBP) is the most common musculoskeletal condition affecting a person's quality of life. Over the past decades, a lot of work was done in an attempt to reduce the negative impact of LBP, and help patients recover and maintain a better quality of life. Nevertheless, there is still a lot to be done to fully understand the problem of underlying chronic LBP and a wide gap that exist between basic science and applied rehabilitation research on LBP. Objectives: This was an open label, multicentric, observational, post-marketing surveillance study in a real-world setup designed to evaluate the efficacy and safety of MyrliMax® capsules containing standardised Commiphora myrrha gum resin extract in Indian subjects with chronic LBP varying in intensity. Materials and methods:This study included 204 subjects diagnosed with chronic LBP at the outpatient department of 20 centres under the supervision of a medical doctor. All subjects took MyrliMax® capsules twice daily for 20 days. Visual Analogue Scale (VAS) pain score, rescue medicine requirement, therapy satisfaction scores and safety parameters were assessed as per the schedule. Outcomes:Treatment with MyrliMax® capsules significantly (p<0.01) and progressively reduced the VAS score throughout treatment. A significant pain reduction was observed from the second visit. The mean VAS score was 6.58, 4.66, 2.99 and 1.88 on Day 0, Day 7, Day 14 and Day 20, respectively. A similar trend was also observed in subgroups based on gender and severity score. The need of rescue analgesics/NSAIDs was significantly reduced from the second week, indicating a potential of MyrliMax® capsules to increase the pain threshold. All physicians and patients were satisfied with the efficacy of MyrliMax® capsules assessed by physician's satisfaction score and patient's satisfaction score. There were no significant serious adverse events due to treatment during the study, which indicated that the treatment with MyrliMax® was well tolerated by subjects. Conclusion:MyrliMax® capsule is a potentially effective and safe therapy for pain reduction in patients suffering from chronic LBP. MyrliMax® capsules can be used to reduce pain in NSAIDs intolerant subjects suffering from chronic LBP.

Colloidal assembly by directional ice templating.

We investigate directional ice templating of dilute aqueous colloidal particle dispersions and examine the nature of the assemblies that result. We coat micron-size polystyrene colloids with cross-linkable polymer (polyethyleneimine, PEI), add cross-linker, and subject this dispersion to unidirectional freezing. We work at sufficiently low colloid concentrations, such that the particles do not percolate on freezing. When the aqueous dispersion freezes, ice crystals force polymer-coated particles and cross-linker into close proximity. This results in the formation of cross-linked clusters of particles at ice crystal boundaries. We vary the particle volume fraction from φ ∼ 2.5 × 10-3 to φ ∼ 5.0 × 10-2 and observe that there is a transition from isolated single particles to increasingly large sized clusters. Most of the clusters formed under these conditions are either linear, two-particle wide chains, or sheet-like aggregates. The probability (Pn) of clusters containing n particles (n > 2) obeys a power law Pn ∼ n-η, where η strongly depends on the particle concentration in the dispersion, varying from 2.10 (for φ ∼ 5.0 × 10-2) to 3.03 (for φ ∼ 2.5 × 10-3). This change in η is qualitatively different from the case of isotropic freezing, where η is particle concentration-independent and depends only on the ice nucleation density. To understand the differences between isotropic and directional ice templating, we performed lattice simulations of a highly simplified model, where ice crystals grow at a constant rate to force clustering. We ignore hydrodynamic interactions and ice growth instabilities. Despite ignoring these experimental details, the simulations capture the experimental results, nearly quantitatively. As the ice crystals grow and the space available to the colloids "closes up" so that the particles cluster to form aggregates, crystallization protocol-induced differences in the geometry of these "closed up" spaces determine the scaling behaviour of Pn.

A reservoir computing approach for forecasting and regenerating both dynamical and time-delay controlled financial system behavior.

Significant research in reservoir computing over the past two decades has revived interest in recurrent neural networks. Owing to its ingrained capability of performing high-speed and low-cost computations this has become a panacea for multi-variate complex systems having non-linearity within their relationships. Modelling economic and financial trends has always been a challenging task owing to their volatile nature and no linear dependence on associated influencers. Prior studies aimed at effectively forecasting such financial systems, but, always left a visible room for optimization in terms of cost, speed and modelling complexities. Our work employs a reservoir computing approach complying to echo-state network principles, along with varying strengths of time-delayed feedback to model a complex financial system. The derived model is demonstrated to act robustly towards influence of trends and other fluctuating parameters by effectively forecasting long-term system behavior. Moreover, it also re-generates the financial system unknowns with a high degree of accuracy when only limited future data is available, thereby, becoming a reliable feeder for any long-term decision making or policy formulations.

Study of Spiritual Health Determinants in Indian Saints (Sadhus) at Ujjain Kumbh Mela (Simhast) 2016.

Spirituality is the oldest and most intrinsic health determinant. Unfortunately, it has surfed rough weather for a reasonable time. In spite of this chronic inattention, still in India we have established communes (saints) who thrive on spiritual living. Though they are an integral part to Indian society, their spiritual health and its determining factors are difficult to find. This study was to estimate the 'spiritual score and rank' of Indian saints and explore its psychological and social associates and predicates. Development of spirituality in Indian saints is practice oriented and multidimensional. This study was conducted in 2016-2017; data collection was done during Kumbh Mela (Simhasta) at Ujjain from 17th May to 16th June 2016. Spiritual health assessment was done by 'spiritual assessment inventory' (SAI), mental health by 'GAINN-SS' and pertinent social factors by self-designed pretested questionnaire. Descriptive, Chi-square, ANOVA and ordinal regression analysis were done by SPSS version 20. Data from 962 participants were analyzed. Their clan breakup stands at: 459 (47.7%) as Shiva followers/Shaviates, 251 (26.1%) Vishnu followers/Vaishnavites and 252 (26.2%) belonged to neutral/Sikhism clan. The mean age for participants was 54.6 years (SD ± 14.65), and mean spiritual score 165.18 (SD ± 10.78). 49.3% cases recorded a spiritual grade ≥ 'good.' Majority had formal education till 10th standard; 576 (60%) and 717 (74.5%) did not raise a family. Gurus (spiritual teachers) imparted spiritual training to 685 (71%), and Puranas (spiritual and moral scriptures) provided spiritual knowledge to 319 (33%). Worldly detachment was the objective in 249 (77%) for pursuance of spiritual life. Both Chi-square and ANOVA showed significant (p ≤ .05) associations of spirituality with participants hailing from spiritual (p ≤ .03) and religious (p ≤ .02) inclined families. Partisan from Vaishnavite clan (Akhada) demonstrated better grade (p ≤ .00). Self-motivated subjects under the guidance of Gurus recorded strong associations with spiritual scale. Role of family and friends was noticeable associates to spirituality. Attainment of nirvana and serving the society had notable spiritual associations. Ordinal regression analysis model also lends support (p < .05) to the clan factor, family background, role of religious and spiritual scriptures, motivation from self- and close quarters, objective of attainment of enlightenment and daily yogic and religious practices as notable factors with positive prediction potentials for spiritual growth. Like other health domain, spirituality has its own determinants which are intrinsic and interdependent. 49.3% of cases scoring spiritual grade ≥ 'good' need to be noted.

Tumor associated mast cells: biological roles and therapeutic applications / 대한해부학회지

Mast cells (MCs) are immune cells of the myeloid lineage and are present in connective tissues throughout the body. The activation and degranulation of MCs significantly modulates many aspects of physiological and pathological conditions in various settings. Recent data have expanded the concept that inflammation is a critical component for tumor progression. Interestingly, three of the most aggressive human cancers, malignant melanoma, breast carcinoma and colorectal adenocarcinoma, are commonly associated with a marked host response comprising of various inflammatory cells, but especially MCs around the tumor periphery. A systematic review of the literature was performed based on the English titles listed in the PubMed, EBSCO, Cochrane, Science Direct, ISI web Science, and SciELO databases using the keywords. Abstracts and full-text articles were assessed. This review summarizes the current understanding of the role of MCs in tumor progression.

Tumor associated mast cells: biological roles and therapeutic applications / 대한해부학회지

Mast cells (MCs) are immune cells of the myeloid lineage and are present in connective tissues throughout the body. The activation and degranulation of MCs significantly modulates many aspects of physiological and pathological conditions in various settings. Recent data have expanded the concept that inflammation is a critical component for tumor progression. Interestingly, three of the most aggressive human cancers, malignant melanoma, breast carcinoma and colorectal adenocarcinoma, are commonly associated with a marked host response comprising of various inflammatory cells, but especially MCs around the tumor periphery. A systematic review of the literature was performed based on the English titles listed in the PubMed, EBSCO, Cochrane, Science Direct, ISI web Science, and SciELO databases using the keywords. Abstracts and full-text articles were assessed. This review summarizes the current understanding of the role of MCs in tumor progression.

DFT investigation of role of N - H⋯O and N - H⋯π interactions in the stabilization of the hydrogen bonded complexes of anisole with aromatic amines.

Theoretical investigations have been performed on hydrogen (H-) bonded complexes of two aromatic amines with anisole to investigate the effect of the methyl substituent on N - H⋯O and N - -H⋯π interactions. Natural bond orbital (NBO) and quantum theory of atoms in molecules (QTAIM) analyses were done to elucidate the nature of H- bonding. In 1:1 complexes, the total interaction energy of N-methylaniline complex is higher than that of aniline complex. The existence of bond critical point between N-H of amine and oxygen of anisole confirms weak hydrogen bonding. The energy decomposition analysis showed the role of CT in stabilizing complexes.

Efficacy of Simvastatin in Bone Regeneration After Surgical Removal of Mandibular Third Molars: A Clinical Pilot Study.

INTRODUCTION: Simvastatin, a common cholesterol-lowering drug that inhibits hepatic hydroxymethylglutaryl coenzyme A reductase, the rate-limiting enzyme in the mevalonate pathway, increases expression of the BMP-2 gene and thus promotes bone regeneration. MATERIALS AND METHODS: A study was conducted in mandibular third molar sockets to study the efficacy of the drug by implanting it into sockets (experimental group) and observations were made over 3 months to compare the healing with the (control group). CONCLUSION: The results showed faster regeneration of the bone in the simvastatin site using the gray level histogram values.

Modeling and simulation of turbulent flows through a solar air heater having square-sectioned transverse rib roughness on the absorber plate.

Solar air heater is a type of heat exchanger which transforms solar radiation into heat energy. The thermal performance of conventional solar air heater has been found to be poor because of the low convective heat transfer coefficient from the absorber plate to the air. Use of artificial roughness on a surface is an effective technique to enhance the rate of heat transfer. A CFD-based investigation of turbulent flow through a solar air heater roughened with square-sectioned transverse rib roughness has been performed. Three different values of rib-pitch (P) and rib-height (e) have been taken such that the relative roughness pitch (P/e = 14.29) remains constant. The relative roughness height, e/D, varies from 0.021 to 0.06, and the Reynolds number, Re, varies from 3800 to 18,000. The results predicted by CFD show that the average heat transfer, average flow friction, and thermohydraulic performance parameter are strongly dependent on the relative roughness height. A maximum value of thermohydraulic performance parameter has been found to be 1.8 for the range of parameters investigated. Comparisons with previously published work have been performed and found to be in excellent agreement.

Establishment of glutamine synthetase of Mycobacterium smegmatis as a protein acetyltransferase utilizing polyphenolic acetates as the acetyl group donors.

Acetoxy Drug: Protein Transacetylase (TAase) mediating the transfer of acetyl group(s) from polyphenolic acetates (PA) to certain functional proteins in mammalian cells was identified by our earlier investigations. TAase activity was characterized in the cell lysates of Mycobacterium smegmatis and the purified protein was found to have M(r) 58,000. TAase catalysed protein acetylation by a model acetoxy drug 7,8-diacetoxy-4-methylcoumarin (DAMC) was established by the demonstration of immunoreactivity of the acetylated target protein with an anti-acetyllysine antibody. The specificity of the TAase of M. smegmatis (MTAase) to various acetoxycoumarins was found to be in the order DAMC > 7-AMC > 6-AMC > 4-AC > 3-AC > ABP. Also, the N-terminal sequence of purified MTAase was found to perfectly match with glutamine synthetase (GS) of M. smegmatis. The identity of MTAase with GS was confirmed by the observation that the purified MTAase as well as the purified recombinant GS exhibited all the properties of GS. The finding that purified Escherichia coli GS was found to have substantial TAase activity highlighted the TAase function of GS in other bacteria. These results conclusively established for the first time the protein acetyltransferase function of GS of M. smegmatis.