Continuous solutions of cosmic-rays and waves in astrophysical environments.

The propagation of energetic charged particles and cosmic rays in magnetized thermal plasma is focused. We consider a four-fluid system that consists of thermal plasma, cosmic rays, and two opposite propagating Alfvén waves to investigate the dynamics and energy exchange mechanisms of the system. Additionally, cosmic rays diffusion within the plasma is considered along the magnetic field lines whereas neglected the cross field line diffusion effects. This study is important for understanding of pressure gradients and their impact on the feedback in astrophysical environment. Over the last few decades, this problem becomes important when we discuss the interaction of cosmic rays with plasma in space, such as interstellar clouds or interstellar medium.

Structural Stability and Phase Transitions in Zeolite A: An In Situ High Pressure-High Temperature Investigation.

The high pressure-high temperature structural stability of Zeolite A (ZA) has been studied using the X-ray diffraction (XRD) method. Structural studies at high temperatures show a reduction in the oxygen occupancy, belonging to the water molecule, indicating thermal dehydration and subsequent expulsion of water molecules from the pores of the structure. ZA does not undergo structural phase transition with temperature. However, structural transitions are observed in in situ XRD studies at high pressure and high temperature. At 1.3 GPa and 300 °C, the cubic ZA concomitantly transformed to cubic sodalite (SOD) and tetragonal zeolite NaP (ZNP). This transition was completely forbidden at 2.7 GPa, where a temperature-induced amorphization was favored at 250 °C. The thermal studies at higher pressure reveal the marginal influence of pressure on the thermal expansion coefficients of hydrated ZA. Pressure evolution of the high pressure-high temperature phases indicates no further phase transitions up to 5.9 GPa. The equation of state fit to the pressure-volume data of these phases show that ZNP is less compressible, followed by SOD and ZA. In contrast to the behavior at 0.1 MPa, SOD shows a pressure-induced negative thermal expansion (NTE) at 5.9 GPa. On the other hand, the positive thermal expansion (PTE) observed along the direction of c axis is compensated by the NTE along the a axis leading to a negligible volume thermal expansion for the ZNP structure. The bulk moduli and thermal expansion coefficients of all of the observed phases are reported. The outcomes of this study have been consolidated as a pressure-temperature phase diagram, which provides an insight into the technological and industrial applications of ZA at extreme conditions.

The impact of casirivimab-imdevimab antibody cocktail in patients amidst and post COVID 19 treatment: A retro-prospective comparative study in India.

BACKGROUND: Monoclonal antibodies have gained attention in developing countries owing to its benefits portrayed by few clinical trials. However, no studies until now have been undergone in India. METHODS: A retro-prospective comparative observational study was conducted in symptomatic COVID19 patients to evaluate the impact of Casirivimab and Imdevimab antibody cocktail in the high-risk population. Through an extensive data retrieval for 6 months, 152 samples were documented and sorted into test (Casirivimab and Imdevimab treated patients, n = 79) and control (Non- Casirivimab and Imdevimab treated individuals, n = 73) subsets. The research had two phases; first, estimation of mechanical ventilation and high flow oxygen requirement and mortality in samples amidst the treatment, and second was the post COVID19 patients' feedback through validated (Cronbach's alpha coefficient = 0.7) questionnaire that evaluated their health and vaccination status, and treatment satisfaction. RESULTS: We noticed lesser requisite for mechanical ventilation (6.3%; p < 0.001), high flow oxygen (5.1%; p < 0.001) and no death during Casirivimab and Imdevimab therapy. Meanwhile, non-vaccinated test groups were not on mechanical ventilation and those fully immunized seldom entailed high flow oxygen (test, 6.3%; control, 41.9%, p < 0.01). On evaluating the post COVID19 status of each patient in the study, 90.1% of the test samples were healthy and 97.2% were satisfied with the treatment than those in control group. CONCLUSIONS: Casirivimab and Imdevimab regimen was clinically beneficial for high risk COVID19 patients than those treated without the antibody cocktail.

Ultrasound-assisted varicose vein surgery and endovenous laser ablation using 1470-nm laser for treatment of great saphenous vein incompetence has similar outcomes at 1 year in a single-center prospective randomized study.

BACKGROUND: Technical errors are the most common preventable cause of recurrence after high ligation and stripping procedures for the treatment of great saphenous vein incompetence. Ultrasound-assisted varicose vein surgery (UAVS) uses intraoperative ultrasound during high ligation and stripping to minimize such failures, although no data have been reported regarding its use during open surgery. The present study compared the short-term outcomes of UAVS and endovenous laser ablation (EVLA) with a 1470-nm laser. METHODS: The present prospective randomized study was conducted from January 2019 to December 2019. We compared 40 patients who had undergone UAVS under regional anesthesia with an equal number of patients who had undergone EVLA under tumescent anesthesia. Both groups received 1 week of standardized postoperative analgesia. The improvements in the pain score, venous clinical severity score, and recurrence at 6 months and 1 year were studied. RESULTS: No significant differences were found in either clinical or radiologic great saphenous vein recurrence after UAVS compared with EVLA at 1 year. The mean pain score at 8 hours after the procedure was higher in the UAVS group (3.7 ± 1.2 vs 2.9 ± 1.0; P = .03). At 1 week, the score was higher in the EVLA group (1.8 ± 0.7 vs 1.4 ± 0.5; P = .01). At 6 months, the venous clinical severity score had improved from 9.2 ± 3.7 to 2.4 ± 1.4 in the UAVS group and from 9.3 ± 3.2 to 2.1 ± 0.8 in the EVLA group (P = .64). At 1 year, the corresponding scores were 1.3 ± 0.7 and 1.4 ± 0.6 (P = .21). CONCLUSIONS: UAVS has high technical success, making it a suitable alternative to EVLA using a 1470-nm laser.

Structural phase transition, equation of state and phase diagram of functional rare earth sesquioxide ceramics (Eu1-xLax)2O3.

The intriguing functional nature of ceramics containing rare earth sesquioxide (RES) is associated with the type of polymorphic structure they crystallize into. They prefer to be in the cubic, monoclinic or hexagonal structure in the increasing order of cation size, RRE. Since the functional properties of these ceramics varies with RRE, temperature and pressure, a systematic investigation delineating the cation size effect is indispensable. In the present work we report the structural stability and compressibility behaviour of the RES ceramics, (Eu1-xLax)2O3, of RESs with dissimilar structure and significant difference in cationic radii. The selected compositions of (Eu1-xLax)2O3 have been studied using the in-situ high pressure synchrotron X-ray diffraction and the structural parameters obtained through Rietveld refinement. The cubic structure, which is stable for 0.95 Å [Formula: see text] RRE [Formula: see text] Å at ambient temperature and pressure (ATP), prefers a cubic to hexagonal transition at high pressures. The biphasic region of cubic and monoclinic structure, which is stable for 0.98 Å [Formula: see text] RRE [Formula: see text] Å at ATP, prefers a cubic/monoclinic to hexagonal transition at high pressures. Further, in the biphasic region of monoclinic and hexagonal structure, observed for 1.025 Å [Formula: see text]RRE [Formula: see text] Å, the monoclinic phase is found to be progressing towards the hexagonal phase with increasing pressure. The pure hexagonal phase obtained for 1.055 Å [Formula: see text] RRE [Formula: see text] 1.10 Å is found to be structurally stable at high pressures. The bulk moduli are obtained from the Birch-Murnaghan equation of state fit to the compressibility data and its dependance on the cation size is discussed. The microstrain induced by the difference in cation size causes an internal pressure in the crystal structure leading to a reduction in the bulk modulus of [Formula: see text] and 0.6. A pressure-concentration (P-x) phase diagram upto a pressure of 25 GPa is constructed for (Eu1-xLax)2O3. This would provide an insight to the fundamental and technological aspects of these materials and the RESs in general.

FAT1 acts as an upstream regulator of oncogenic and inflammatory pathways, via PDCD4, in glioma cells.

Glioblastoma multiforme (GBM) is the most aggressive and the commonest primary brain tumor with a tendency for local invasiveness. The pathways of neoplasia, invasion and inflammation are inextricably linked in cancer and aberrations in several regulatory pathways for these processes have been identified. Here we have studied the FAT1 (Homo sapiens FAT tumor-suppressor homolog 1 (Drosophila)) gene to identify its role in the tumorigenecity of the gliomas. The expression of FAT1 was found to be high in grade IV glioma cell lines (U87MG, A172, U373MG and T98G) but low in grade III glioma cell lines (GOS3 and SW1088). Two cell lines (U87MG and A172) with high FAT1 expression were chosen for in vitro FAT1-knockdown studies. FAT1 knockdown by small interfering RNA resulted in decreased migration and invasion of both the cell lines along with increased expression of the tumor-suppressor gene programmed cell death 4 (PDCD4). Increased PDCD4 expression led to the attenuation of activator protein-1 (AP- 1) transcription by inhibiting c-Jun phosphorylation and resulted in concomitant decrease in the expression of AP-1-target genes like MMP3, VEGF-C and PLAU, the pro-inflammatory regulator COX-2 and cytokines IL1b and IL-6. Conversely, simultaneous silencing of PDCD4 and FAT1 in these cells significantly enhanced AP-1 activity and expression of its target genes, resulting in increase in mediators of inflammation and in enhanced migratory and invasive properties of the cells. We also observed a negative correlation between the expression of FAT1 and PDCD4 (P = 0.0145), a positive correlation between the expression of FAT1 and COX-2 (P = 0.048) and a similar positive trend between FAT1 and IL-6 expression in 35 primary human GBM samples studied. Taken together, this study identifies a novel signaling mechanism mediated by FAT1 in regulating the activity of PDCD4 and thereby the key transcription factor AP-1, which then affects known mediators of neoplasia and inflammation.

Early clinical experience with the Anaconda re-deployable endograft in 106 patients with abdominal aortic aneurism: the west of Scotland Anaconda registry.

Endovascular repair of abdominal aortic aneurysm is a common procedure and not without complications. The aim of this study was to evaluate the early results of the Anaconda endograft (Vascutek Ltd., Inchinnan, Scotland, UK) in 106 patients in three hospitals in the west of Scotland. A prospective registry of 106 consecutive patients undergoing endoluminal repair of their abdominal aortic aneurysms using the Anaconda device was set up to record the clinical outcomes, with a mean follow-up of two years. There was no 30-day perioperative mortality in the 106 patients. Only type II endoleaks were detected on serial computed tomography scanning at follow-up. Technical success was achieved in 99% (105/106) in this study; one patient was converted to open surgical repair. Two cases of proximal device migration (>1 cm) were detected at one month and 19 months, respectively, with no associated endoleak or sac enlargement. Five cases of endograft limb thrombosis were noted in this study. Our early clinical experience with the Anaconda endograft compares favourably with other commercially available endografts in the treatment of abdominal aortic aneurysms. The main advantages of this device are that it is re-deployable and that it has a magnetic wire system which makes it easy to implant.

The role of white cell count and C-reactive protein in the diagnosis of acute appendicitis.

BACKGROUND: Despite recent advances in diagnostic medicine, the diagnosis of appendicitis is still doubtful in a number of cases. Majority of the clinicians rely on their clinical examination strengthened by the laboratory tests. This study was carried out to find out the specificity and sensitivity of white cell count (WCC) and C-Reactive Protein (CRP) in diagnosing appendicitis in patients presenting with right iliac fossa pain. METHODS: A total of 259 patients were included in this study that presented in the hospital with acute right iliac fossa pain and later on operated and had appendicectomy. The histopathology data was collected to find out the frequency of negative appendicectomy. According to the histopathology reports these patients were grouped into three sub-groups as normal appendix, inflamed appendix or perforated/gangrenous appendix. A record was kept of the WCC and CRP levels of these patients on admission. RESULTS: A total of 259 patients were included in this study and out of them 37 had a normal appendix giving an over all negative appendicectomy rate of 14.3%. Out of these 11 were male and 26 were female, male to female ratio being 1:2.3. The age range was 12-73 with a median age of 24. Among the 222 patients who had appendicitis, 96 had a ruptured/perforated appendix and 126 had an inflamed appendix. Over all the WCC was elevated in 185 patients and CRP was elevated in 168 cases. The cut off value for white cell count was 11 x 10(6)/L. The C reactive protein levels were calculated by immunoturbidimetric test and the cut off value was taken as 1.7 mg/dl. The sensitivity and specificity of WCC in this study was 83% and 62.1% and that for CRP was 75.6% and 83.7 %. CONCLUSION: Both the inflammatory markers i.e. WCC and C-reactive protein can be helpful in the diagnosis, when measured together as this increases their positive predictive value.

Primary osteosarcoma of the breast.

Primary osteosarcoma of the breast is a rare malignant tumour. We report such a case in a 77-year-old lady who presented with a hard lump which was clinically and mammographically indistinguishable from a calcified fibroadenoma. Wide local excision of the lesion was carried out. Detailed histological and immunohistochemical features of the tumour are described. Because there was no evidence of metastasis and adequate local excision, no further treatment was considered necessary and she remains disease free at 39 months.

Operative management of "hockey groin syndrome": 12 years of experience in National Hockey League players.

BACKGROUND: At the elite level of hockey, groin injuries can threaten a player's career. The aim of this review is to describe the clinical presentation and evaluate our operative approach to "hockey groin syndrome" in National Hockey League (NHL) players. METHODS: Between November 1989 and June 2000, 22 NHL players with debilitating groin pain underwent operative exploration. A repair, including ablation of the ilioinguinal nerve and reinforcement of the external oblique aponeurosis with a Goretex (W.L. Gore & Associates, Inc, Flagstaff, Ariz) mesh, was performed. Medical records were reviewed, and the players or their trainers were contacted by telephone after a mean follow-up period of 31.2 months to assess function, symptoms, and overall satisfaction. RESULTS: All patients had tearing of the external oblique aponeurosis, with branches of the ilioinguinal nerve emerging from the torn areas. At follow-up, 18 players (82%) had no pain, whereas 4 (18%) reported mild, intermittent pain. All 22 patients returned to playing hockey, with 19 (85%) able to continue their careers in the NHL. CONCLUSIONS: The "hockey groin syndrome," marked by tearing of the external oblique aponeurosis and entrapment of the ilioinguinal nerve, is a cause of groin pain in professional hockey players. Ilioinguinal nerve ablation and reinforcement of the external oblique aponeurosis successfully treats this incapacitating entity.

Early clinical experience with color three-dimensional intravascular ultrasound in peripheral interventions.

PURPOSE: To report early clinical experiences with color 3-dimensional intravascular ultrasound (3-D IVUS) in assisting peripheral interventions. TECHNIQUE: A 3.5-F, 20-MHz IVUS catheter that utilizes ChromaFlo computer software to demonstrate blood flow in color was evaluated in over 100 peripheral interventions. ChromaFlo captures up to 30 conventional IVUS frames every second and generates "real-time" imaging. The software compares sequential axial IVUS images and interprets any differences in the position of echogenic blood particles, which are displayed as colorized flow in axial or 3-D renderings. CONCLUSIONS: ChromaFlo-enhanced IVUS demonstrates colorized blood flow inside the vessel lumen, which is helpful in distinguishing echolucent disease from luminal blood flow and can also be used to perform peripheral interventions in patients with renal failure or allergy, avoiding the use of contrast media.

Pulmonary metastases from colorectal cancer: 25 years of experience.

OBJECTIVE: To examine the experience of pulmonary resections for colorectal metastases at the McGill University Health Centre. DESIGN: A chart review. PATIENTS: Forty-nine patients treated surgically between 1975 and 1998 for pulmonary metastases from colorectal cancer. INTERVENTION: Thoracotomy with pulmonary resection. OUTCOME MEASURES: Survival of patients with various preoperative and post operative clinical variables. RESULTS: The perioperative death rate was 4%. Overall 5- and 10-year survival rates were 55% and 40% respectively. The mean interval between the initial colonic resection and resection of pulmonary metastases (discase-free interval) was 36 months. The 7 patients who also under went resection of extrapulmonary metastases had a 5-year survival rate of 52%. Significant preoperative variables that carried a poor prognosis included the following: more than one pulmonary lesion, a disease-free interval of less than 2 years, and moderately or poorly differentiated colorectal cancer. The 16 patients who received chemotherapy after their thoracotomy had a 5-year survival rate of 51% compared with 54% for the 33 patients who did not receive chemotherapy. Recurrent resections of pulmonary lesions did not reduce survival. CONCLUSIONS: Pulmonary resection for metastatic colorectal cancer is both effective and safe. Resectable extrapulmonary metastases and pulmonary recurrence should not preclude lung resection. Postoperative chemotherapy has no survival benefit. Preoperative variables should guide the clinician when considering surgical intervention.

Unsuspected penetrating maxillo-orbitocranial injury: a case report.

A healthy 37-year-old man presented to the emergency room, complaining of blunt trauma to his mandible from a tree branch. Plain radiographs and computed tomography demonstrated a penetrating orbitocranial foreign body with the maxillary sinus as the entry site. The foreign body was a chain-saw file. It was extracted successfully through the oral cavity. The patient's recovery was uncomplicated and he suffered no neurologic or opthalmic sequelae.

Decreased neurofilament gene expression is an index of selective axonal hypotrophy in ageing.

Axonal atrophy may reflect earlier and more reversible events in neurodegeneration and ageing than somatic atrophy. Innervation density by sympathetic fibres from the rat superior cervical ganglion (SCG) to the middle cerebral artery (MCA) decreases dramatically in old age, while that to the iris is largely unchanged. In situ hybridization was used in conjunction with retrograde tracers to examine the role of the neuronal cytoskeleton in this selective axonal vulnerability. Using a riboprobe complementary to neurofilament light chain (NF-L) mRNA, there was a 22-25% decrease in the mean grain density in aged neurones when all neurones were examined. A small subset of these neurones was shown to project to the MCA and another to the iris. In young SCG, both subpopulations expressed intermediate grain densities for NF-L mRNA. In MCA-projecting neurones, there was a 40% decline in grain density with ageing (p < 0.05), with no change in iris-projecting neurones. Our results demonstrate that major decreases in NF-L expression may represent cellular markers of selective axonal hypotrophy by aged neurones.

Decreased neurofilament gene expression is an index of selective axonal hypotrophy in ageing.

Axonal atrophy may reflect earlier and more reversible events in neurodegeneration and ageing than somatic atrophy. Innervation density by sympathetic fibres from the rat superior cervical ganglion (SCG) to the middle cerebral artery (MCA) decreases dramatically in old age, while that to the iris is largely unchanged. In situ hybridization was used in conjunction with retrograde tracers to examine the role of the neuronal cytoskeleton in this selective axonal vulnerability. Using a riboprobe complementary to neurofilament light chain (NF-L) mRNA, there was a 22-25% decrease in the mean grain density in aged neurones when all neurones were examined. A small subset of these neurones was shown to project to the MCA and another to the iris. In young SCG, both subpopulations expressed intermediate grain densities for NF-L mRNA. In MCA-projecting neurones, there was a 40% decline in grain density with ageing (p < 0.05), with no change in iris-projecting neurones. Our results demonstrate that major decreases in NF-L expression may represent cellular markers of selective axonal hypotrophy by aged neurones.