Management of Hyperparasitaemia in Severe Malaria: A Sea Change With the Availability of Artesunate.

OBJECTIVE: This study aims to study the efficacy of exchange transfusion in complicated malaria with hyperparasitaemia. METHOD: This is a retrospective case-control study conducted in a tertiary care referral hospital in northeastern India. A retrospective chart review was done, and 34 children with hyperparasitaemia were identified. Of these, 16 children received only antimalarial chemotherapy, and 18 received adjunct exchange blood transfusion (EBT). The data was analyzed for survival benefit as the main outcome measure. RESULTS: The subjects in each of the groups were comparable in terms of age, sex distribution, and mean haemoglobin at presentation. The patients treated with EBT were more ill than those who did not receive EBT; they met a greater number of WHO criteria for severe malaria (2.94 ± 1.16 vs. 1.81 ± 0.83; p=0.002) and had higher levels of parasitaemia (23.96 ± 17.55 vs. 16.14 ± 6.89; p=0.0007). The mean volume exchanged was 44.88 ± 20.49 ml/kg, against a target of 70 ml/kg due to the unavailability of fresh, compatible whole blood. There was no difference in mortality in the exchange transfusion group compared to the chemotherapy alone group (22.22% vs. 31.25%; p=0.83). CONCLUSIONS: In resource-limited areas, lower volumes of fresh whole blood for exchange transfusion can reduce hyperparasitaemia to a significant degree, and this may give some mortality benefit in very sick cases. Artesunate, by virtue of its rapid action, is capable of reducing hyperparasitaemia and may question the very place of blood transfusion in complicated malaria. It may also be worthwhile to accumulate more data comparing EBT against artesunate instead of quinine.

Structural and electronic transport properties of Zn- and Ga-doped Bi2-xSbxTe3-ySeytopological insulator single crystals.

A comprehensive study of structural and magnetotransport properties of pristine Bi2-xSbxTe3-ySey(BSTS) single crystals and doped with Zn (BSTS:Zn) and Ga (BSTS:Ga) are presented here. Magnetic field dependent Hall resistivities of the single crystals indicate that the holes are the majority carriers. The field dependent resistivity curves at different temperatures of the crystals display cusp-like characteristics at low magnetic fields, attributed to two-dimensional (2D) weak antilocalization (WAL) effect. We fit the observed low-field WAL effects at low temperatures using 2D and three-dimensional (3D) Hikami-Larkin-Nagaoka (HLN) equations. The 2D HLN equation fits the data more closely than the 3D HLN equation, indicating a 2D nature. The 2D HLN equation fit to the low field WAL effects at various temperatures reveal a phase coherence length (lφ) that decreases as temperature increases. The variation oflφwith temperature followsT-0.41power law for BSTS:Zn, suggesting that the dominant dephasing mechanism is a 2D electron-electron (e-e) interactions. For pristine BSTS and BSTS:Ga,lφ(T) is described by considering a coexistence of 2De-eand electron-phonon (e-p) interactions in the single crystals. The temperature variation of the longitudinal resistance in BSTS:Ga is described by 3D Mott variable range hoping model. In contrast, the transport mechanisms of both pristine BSTS and BSTS:Zn are described by a combination of 2D WAL/EEI models and 3D WAL.

The Outcome of Scaphoid Fracture Nonunion Managed by 1,2 Intercompartmental Supraretinacular Artery (1,2 ICSRA) Vascularized Bone Graft.

BACKGROUND: Scaphoid fracture is most often missed and mismanaged leading to scaphoid nonunion with or without avascular necrosis. When avascular necrosis of the proximal pole is confirmed with intraoperative evaluation, conventional bone graft is not enough. The treatment modalities are evolving day by day. The current trend is vascular bone grafting, which has shown good outcomes in terms of union and wrist function. METHODS: Fifty patients with nonunion fracture of the scaphoid were treated with vascularized pedicle bone graft from the dorsum of the distal radius using the 1st and 2nd intercompartmental supraretinacular artery, from 2014 to 2022. Preoperative and postoperative clinical evaluation included pain, range of motion, grip strength, and satisfaction. The average follow-up period was 12 months. RESULTS: Among 18 patients, 14 were clinically improved after a mean follow-up period of eight weeks. Thirteen patients reported the absence of any discomfort, three patients reported slight discomfort after hard work, and two patients reported pain with light work. The wrist range of motion improved significantly, and the hand grip strength also improved. According to the modified Mayo wrist scoring chart, clinical results were rated as excellent in 24 cases, good in 19 cases, and poor in four cases. CONCLUSION: 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) is superficial to the extensor retinaculum and is a proper pedicle of vascularized bone graft due to the ease of visibility and dissection. The functional results and union rates were satisfactory in our study.

Revisiting the Mucosa of the Gastric Cardia: A Scope to Modify an Upper Gastrointestinal Endoscopy.

Introduction The mucosa in the cardiac region of the stomach has been less understood. Cardiac mucosa (CM) with less parietal and oxyntic cells has been defined as a normal mucosa. Studies have shown that CM can be the result of occult reflux. Oxyntic mucosa (OM) is normal, and it changes to CM with age. In advancing age, it is more common to find CM instead of OM and oxyntocardiac mucosa (OCM). This study is an attempt to examine the distribution of the three different types of mucosa in various age groups. Materials and methods The study was conducted in the Department of Anatomy and Department of Forensic Medicine and Toxicology of Gauhati Medical College, Guwahati, Assam, India, from 2017 to 2019. Once the stomach was opened, histological specimens were prepared, and the type of mucosa was observed and recorded. Then, the distribution of the types of mucosa in various age groups was analyzed. Results The distribution of mucosa varies significantly across different age groups, and CM increases with age. Conclusion Our present study suggests that CM frequency increases with age. This is in accordance with studies that suggest that CM is a result of occult reflux with age. This observation creates a scope to revise the approaches for upper gastrointestinal (GI) endoscopy.

Ru(II)-catalyzed oxidative coupling of sulfoxonium ylides with amines: efficient synthesis of α-ketoamides and indolo[2,1-a]isoquinolines.

The first use of sulfoxonium ylides for the synthesis of α-ketoamides is described via a Ru(II)-catalyzed amidation reaction with amines. The same Ru(II)-catalyzed reaction of sulfoxonium ylides with 2-phenylindoles provided indolo[2,1-a]isoquinolines instead of α-ketoamides.

Deep learning based correction of low performing pixel in computed tomography.

Low Performing Pixel (LPP)/bad pixel in CT detectors cause ring and streaks artifacts, structured non-uniformities and deterioration of the image quality. These artifacts make the image unusable for diagnostic purposes. A missing/defective detector pixel translates to a channel missing across all views in sinogram domain and its effect gets spill over entire image in reconstruction domain as artifacts. Most of the existing ring and streak removal algorithms perform correction only in the reconstructed image domain. In this work, we propose a supervised deep learning algorithm that operates in sinogram domain to remove distortions cause by the LPP. This method leverages CT scan geometry, including conjugate ray information to learn the interpolation in sinogram domain. While the experiments are designed to cover the entire detector space, we emphasize on LPPs near detector iso-center as these have most adverse impact on image quality specially if the LPPs fall on the high frequency region (bone-tissue interface). We demonstrated efficacy of the proposed method using data acquired on GE RevACT multi-slice CT system with flat-panel detector. Experimental results on head scans show significant reduction in ring artifacts regardless of LPP location in the detector geometry. We have simulated isolated LPPs accounting for 5% and 10% of total channels. Detailed statistical analysis illustrates approximately 5dB improvement in SNR in both sinogram and reconstruction domain as compared to classical bicubic and Lagrange interpolation methods. Also, with reduction in ring and streak artifacts, the perceptual image quality is improved across all the test images.

Multi-modal trained artificial intelligence solution to triage chest X-ray for COVID-19 using pristine ground-truth, versus radiologists.

The front-line imaging modalities computed tomography (CT) and X-ray play important roles for triaging COVID patients. Thoracic CT has been accepted to have higher sensitivity than a chest X-ray for COVID diagnosis. Considering the limited access to resources (both hardware and trained personnel) and issues related to decontamination, CT may not be ideal for triaging suspected subjects. Artificial intelligence (AI) assisted X-ray based application for triaging and monitoring require experienced radiologists to identify COVID patients in a timely manner with the additional ability to delineate and quantify the disease region is seen as a promising solution for widespread clinical use. Our proposed solution differs from existing solutions presented by industry and academic communities. We demonstrate a functional AI model to triage by classifying and segmenting a single chest X-ray image, while the AI model is trained using both X-ray and CT data. We report on how such a multi-modal training process improves the solution compared to single modality (X-ray only) training. The multi-modal solution increases the AUC (area under the receiver operating characteristic curve) from 0.89 to 0.93 for a binary classification between COVID-19 and non-COVID-19 cases. It also positively impacts the Dice coefficient (0.59 to 0.62) for localizing the COVID-19 pathology. To compare the performance of experienced readers to the AI model, a reader study is also conducted. The AI model showed good consistency with respect to radiologists. The DICE score between two radiologists on the COVID group was 0.53 while the AI had a DICE value of 0.52 and 0.55 when compared to the segmentation done by the two radiologists separately. From a classification perspective, the AUCs of two readers was 0.87 and 0.81 while the AUC of the AI is 0.93 based on the reader study dataset. We also conducted a generalization study by comparing our method to the-state-art methods on independent datasets. The results show better performance from the proposed method. Leveraging multi-modal information for the development benefits the single-modal inferencing.

High-sensitivity of initial SrO growth on the residual resistivity in epitaxial thin films of SrRuO[Formula: see text] on SrTiO[Formula: see text] (001).

The growth of SrRuO[Formula: see text] (SRO) thin film with high-crystallinity and low residual resistivity (RR) is essential to explore its intrinsic properties. Here, utilizing the adsorption-controlled growth technique, the growth condition of initial SrO layer on TiO[Formula: see text]-terminated SrTiO[Formula: see text] (STO) (001) substrate was found to be crucial for achieving a low RR in the resulting SRO film grown afterward. The optimized initial SrO layer shows a c(2 [Formula: see text] 2) superstructure that was characterized by electron diffraction, and a series of SRO films with different thicknesses (ts) were then grown. The resulting SRO films exhibit excellent crystallinity with orthorhombic-phase down to [Formula: see text] 4.3 nm, which was confirmed by high resolution X-ray measurements. From X-ray azimuthal scan across SRO orthorhombic (02 ± 1) reflections, we uncover four structural domains with a dominant domain of orthorhombic SRO [001] along cubic STO [010] direction. The dominant domain population depends on t, STO miscut angle ([Formula: see text]), and miscut direction ([Formula: see text]), giving a volume fraction of about 92 [Formula: see text] for [Formula: see text] 26.6 nm and [Formula: see text] (0.14[Formula: see text], 5[Formula: see text]). On the other hand, metallic and ferromagnetic properties were well preserved down to t [Formula: see text] 1.2 nm. Residual resistivity ratio (RRR = [Formula: see text]/[Formula: see text]) reduces from 77.1 for t [Formula: see text] 28.5 nm to 2.5 for t [Formula: see text] 1.2 nm, while [Formula: see text] increases from 2.5 [Formula: see text]cm for t [Formula: see text] 28.5 nm to 131.0 [Formula: see text]cm for t [Formula: see text] 1.2 nm. The ferromagnetic onset temperature ([Formula: see text]) of around 151 K remains nearly unchanged down to t [Formula: see text] 9.0 nm and decreases to 90 K for t [Formula: see text] 1.2 nm. Our finding thus provides a practical guideline to achieve high crystallinity and low RR in ultra-thin SRO films by simply adjusting the growth of initial SrO layer.

Vibrational spectra of Pb2Bi2Te3, PbBi2Te4, and PbBi4Te7 topological insulators: temperature-dependent Raman and theoretical insights from DFT simulations.

Herein, using Raman spectroscopy, we have presented the investigation of a temperature-dependent frequency shift and the line broadening of phonon modes by inserting the atomic layers of Pb and PbTe in the prototype 3D topological insulator Bi2Te3. Good quality single crystals of Pb2Bi2Te3, PbBi2Te4, and PbBi4Te7 were grown using the modified Bridgman technique. The Raman modes show progressive blue-shift with the decrease in temperature from 298 K to 93 K in Pb2Bi2Te3, PbBi2Te4, and PbBi4Te7 due to the anharmonic vibrations of the lattice as well as the increase in the strength of Bi-Te covalent interactions. The experimental results were complemented by extensive first principles calculations, where a reasonable matching between the experimental and computational data was found. Chemical pressure, induced by the insertion of Pb and PbTe layers in Bi2Te3, modified the interactions at the boundaries of the quintuple-layers, which was evident from the evolution of the A21u mode. The enhancement in the out-of-plane Bi-Te vibrations with respect to the in-plane Bi-Te vibrations was observed at low temperatures. The temperature coefficients of the Raman modes were useful in determining the thermal conductivity, which is a key design parameter for the fabrication of spintronic devices using topological insulators. The estimated first order temperature coefficient (χ') for Pb2Bi2Te3 signified the decrease in the thermal conductivity relative to Bi2Te3, which was caused by the insertion of the Pb layers in the van der Waals gaps of Bi2Te3.

Unusual Conductance Fluctuations and Quantum Oscillation in Mesoscopic Topological Insulator PbBi4Te7.

We present a detail study of Shubinikov-de-Haas (SdH) oscillations accompanied by conductance fluctuations in a mesoscopic topological insulator PbBi4Te7 device. From SdH oscillations, the evidence of Dirac fermions with π Berry phase is found and the experimentally determined two main Fermi wave vectors are correlated to two surface Dirac cones (buried one inside the other) of layered topological insulator PbBi4Te7. We have also found evidence of conductance fluctuations, the root mean square amplitude of which is much higher than the usual universal conductance fluctuations observed in nanometer size sample. Calculated autocorrelation functions indicate periodic unique fluctuations may be associated with the topological surface states in the compound.

Pottels Equation for Estimation of Glomerular Filtration Rate.

The retrospective study was carried out to examine performance of Pottels height- independent equation compared to Schwartzs height-dependent equation to estimate glomerular filtration rate in 115 children in Indian setting. The Pottels equation performed well compared to updated Schwartz equation (R2=0.94, mean bias 0.25, 95% LOA=20.4, -19.9). The precision was better at lower range of estimated GFR.

Hierarchical Pictorial Structures for Simultaneously Localizing Multiple Organs in Volumetric Pre-Scan CT.

Parsing volumetric computed tomography (CT) into 10 or more salient organs simultaneously is a challenging task with many applications such as personalized scan planning and dose reporting. In the clinic, pre-scan data can come in the form of very low dose volumes acquired just prior to the primary scan or from an existing primary scan. To localize organs in such diverse data, we propose a new learning based framework that we call hierarchical pictorial structures (HPS) which builds multiple levels of models in a tree-like hierarchy that mirrors the natural decomposition of human anatomy from gross structures to finer structures. Each node of our hierarchical model learns (1) the local appearance and shape of structures, and (2) a generative global model that learns probabilistic, structural arrangement. Our main contribution is two fold. First we embed the pictorial structures approach in a hierarchical framework which reduces test time image interpretation and allows for the incorporation of additional geometric constraints that robustly guide model fitting in the presence of noise. Second we guide our HPS framework with the probabilistic cost maps extracted using random decision forests using volumetric 3D HOG features which makes our model fast to train and fast to apply to novel test data and posses a high degree of invariance to shape distortion and imaging artifacts. All steps require approximate 3 mins to compute and all organs are located with suitably high accuracy for our clinical applications such as personalized scan planning for radiation dose reduction. We assess our method using a database of volumetric CT scans from 81 subjects with widely varying age and pathology and with simulated ultra low dose cadaver pre-scan data.

DNA engineered tri-functional Ni-Au nano-chain: understanding of its formation and novel magnetic properties.

A plausible mechanism have been proposed here on the formation of chain like structure of Ni-Au-DNA (deoxyribo nucleic acid) composite which has been synthesized by simple wet-chemical process. The composite has been designed in such a fashion that it can be easily probed by optically, electrically and magnetically. In this paper, we are reporting its structural and physical properties in detail. Optical properties have been probed by Circular Dichroism (CD) which indicates no denaturization or melting of DNA even after formation of the composite structure. X-ray diffraction (XRD) study and Fourier transform infrared spectroscopy (FTIR) analysis show the nickel and gold are fcc in phase and bound to DNA through chemical bond, respectively. The composite shows room temperature semiconductor behavior. Temperature dependent magnetization and magnetic hysteresis loops are investigated in detail. The detail study of the composite indicates a possibility of its capability to be used in bio-devices. Furthermore, the tri-functionality of the composite will open-up its versatile applications.

The Arabidopsis stress responsive gene database.

Plants in nature may face a wide range of favorable or unfavorable biotic and abiotic factors during their life cycle. Any of these factors may cause stress in plants; therefore, they have to be more adaptable to stressful environments and must acquire greater response to different stresses. The objective of this study is to retrieve and arrange data from the literature in a standardized electronic format for the development of information resources on potential stress responsive genes in Arabidopsis thaliana. This provides a powerful mean for manipulation, comparison, search, and retrieval of records describing the nature of various stress responsive genes in Arabidopsis thaliana. The database is based exclusively on published stress tolerance genes associated with plants.

Synthesis of Co(x)Pt(1-x) alloy nanoparticles of different phase by micellar technique and their properties study.

Among many ferromagnetic materials, CoPt alloy nanoparticles with high coercivity and small grain size are one of the potential candidates having its application in high-density storage media manufacturing. CoPt alloy nanoparticles of different compositions have been prepared in TX-100 micellar medium and capped with sodium oleate to prevent the agglomeration during annealing at high temperature. Their structural and magnetic properties were investigated before and after heat treatment. The particles with approximately 50:50 compositions of Co and Pt gives L1(0) phase after annealing at 900 degrees C for 1 h and show a high coercivity (approximately 4.4 kOe at room temperature) and remanence due to its highly anisotropic L1(0) structure.