Optimization of Manning's roughness coefficient using 1-dimensional hydrodynamic modelling in the perennial river system: A case of lower Narmada Basin, India.

This research bears significant implications for river management, flood forecasting, and ecosystem preservation in the Lower Narmada Basin. A more precise estimation of Manning's Roughness Coefficeint (n) will enhance the accuracy of hydraulic models and facilitate informed decision-making regarding flood risk management, water resource allocation, and environmental conservation efforts. Ultimately, this study aspires to contribute to the sustainable management of perennial river systems in India and beyond by offering a robust methodology for optimizing Manning's n tailored to the complex hydrological dynamics of the Lower Narmada Basin. Through a synthesis of empirical evidence and computational modelling, it seeks to empower stakeholders with actionable insights toward preserving and enhancing these invaluable natural resources. Using the new HEC-RAS v 6.0, a one-dimensional hydrodynamic model was developed to predict overbank discharge at different points along the basin. The study analyzes water levels, stream discharges, and river stage, optimizing Manning's n and required flood risk management. The model predicted a strong output agreement with R2, NSE, and RMSE for the 2020 event as 0.83, 0.81, and 0.36, respectively, with an optimum Manning's n of 0.03. The lower Narmada Basin part near the coastal zone (validation point) appears inundated frequently. The paper aims to provide insights into optimizing Manning's coefficient, which can ultimately lead to better water flow predictions and more efficient water management in the region.

Application of Hybrid ANN Techniques for Drought Forecasting in the Semi-Arid Region of India.

The intensity and frequency of diverse hydro-meteorological disasters viz., extreme droughts, severe floods, and cyclones have increasing trends due to unsustainable management of land and water resources, coupled with increasing industrialization, urbanization and climate change. This study focuses on the forecasting of drought using selected Artificial Neural Network (ANN)-based models to enable decision-makers to improve regional water management plans and disaster mitigation/reduction plans. Four ANN models were developed in this study, viz., one conventional ANN model and three hybrid ANN models: (a) Wavelet based-ANN (WANN), (b) Bootstrap based-ANN (BANN), and (c) Wavelet-Bootstrap based-ANN (WBANN). The Standardized Precipitation Evapotranspiration Index (SPEI), the best drought index identified for the study area, was used as a variable for drought forecasting. Three drought indices, such as SPEI-3, SPEI-6 and SPEI-12 respectively representing "short-term", "intermediate-term", and "long-term" drought conditions, were forecasted for 1-month to 3-month lead times for six weather stations over the study area. Both statistical and graphical indicators were considered to assess the performance of the developed models. For the hybrid wavelet model, the performance was evaluated for different vanishing moments of Daubechies wavelets and decomposition levels. The best-performing bootstrap-based model was further used for analysing the uncertainty associated with different drought forecasts. Among the models developed for drought forecasting for 1 to 3 months, the performances of the WANN and WBANN models are superior to the simple ANN and BANN models for the SPEI-3, SPEI-6, and SPEI-12 up to the 3-month lead time. The performance of the WANN and WBANN models is the best for SPEI-12 (MAE = 0.091-0.347, NSE = 0.873-0.982) followed by SPEI-6 (MAE = 0.258-0.593; NSE = 0.487-0.848) and SPEI-3 (MAE = 0.332-0.787, NSE = 0.196-0.825) for all the stations up to 3-month lead time. This finding is supported by the WBANN analyze uncertainties as narrower band width for SPEI-12 (0.240-0.898) as compared to SPEI-6 (0.402-1.62) and SPEI-3 (0.474-2.304). Therefore, the WBANN model is recommended for the early warning of drought events as it facilitates the uncertainty analysis of drought forecasting results.

Histological and in vivo Study on Novel Polyelectrolyte Complex Vildagliptin Loaded Microbeads in Streptozotocin-induced Rat Model.

BACKGROUND: This study aimed to investigate the effect of vildagliptin-containing polyelectrolyte complex microbeads formulation in a streptozotocin-induced diabetic rat model. OBJECTIVE: Vildagliptin-containing polyelectrolyte complex microbeads were given to diabetic rats at a dose of 2.5 mg/kg body weight in order to study their antidiabetic, hypolipidemic histopathological conditions. METHODS: A portable glucometer was used to measure the blood glucose level using a reagent strip. After vildagliptin formulation was administered orally to healthy streptozotocin-induced rats, other parameters, such as liver profile and total lipid levels, were assessed. RESULT: Vildagliptin-containing polyelectrolyte complex microbeads were found to significantly decrease high glucose levels and improve kidney, liver, and hyperlipidaemia caused due to diabetes. Vildagliptin-containing polyelectrolyte complex microbeads also had a favourable impact on alterations in the liver and pancreatic histopathology in diabetes caused by streptozotocin. CONCLUSION: Vildagliptin-containing polyelectrolyte complex microbeads have the ability to enhance a variety of lipid profiles, including those related to body weight, liver, kidney, and total lipid profiles. Vildagliptin-containing polyelectrolyte complex microbeads have also been found to be effective in preventing the histological alterations in the liver and pancreas occurred in streptozotocin-induced diabetes.

Water Stress Identification of Winter Wheat Crop with State-of-the-Art AI Techniques and High-Resolution Thermal-RGB Imagery.

Timely crop water stress detection can help precision irrigation management and minimize yield loss. A two-year study was conducted on non-invasive winter wheat water stress monitoring using state-of-the-art computer vision and thermal-RGB imagery inputs. Field treatment plots were irrigated using two irrigation systems (flood and sprinkler) at four rates (100, 75, 50, and 25% of crop evapotranspiration [ETc]). A total of 3200 images under different treatments were captured at critical growth stages, that is, 20, 35, 70, 95, and 108 days after sowing using a custom-developed thermal-RGB imaging system. Crop and soil response measurements of canopy temperature (Tc), relative water content (RWC), soil moisture content (SMC), and relative humidity (RH) were significantly affected by the irrigation treatments showing the lowest Tc (22.5 ± 2 °C), and highest RWC (90%) and SMC (25.7 ± 2.2%) for 100% ETc, and highest Tc (28 ± 3 °C), and lowest RWC (74%) and SMC (20.5 ± 3.1%) for 25% ETc. The RGB and thermal imagery were then used as inputs to feature-extraction-based deep learning models (AlexNet, GoogLeNet, Inception V3, MobileNet V2, ResNet50) while, RWC, SMC, Tc, and RH were the inputs to function-approximation models (Artificial Neural Network (ANN), Kernel Nearest Neighbor (KNN), Logistic Regression (LR), Support Vector Machine (SVM) and Long Short-Term Memory (DL-LSTM)) to classify stressed/non-stressed crops. Among the feature extraction-based models, ResNet50 outperformed other models showing a discriminant accuracy of 96.9% with RGB and 98.4% with thermal imagery inputs. Overall, classification accuracy was higher for thermal imagery compared to RGB imagery inputs. The DL-LSTM had the highest discriminant accuracy of 96.7% and less error among the function approximation-based models for classifying stress/non-stress. The study suggests that computer vision coupled with thermal-RGB imagery can be instrumental in high-throughput mitigation and management of crop water stress.

Significance of Tip Apex Distance in Intertrochanteric Fracture femur managed with Proximal femoral nailing.

INTRODUCTION: Tip Apex distance (TAD) is well established method of prediction of outcome in intertrochanteric fractures managed by Dynamic Hip Screw. This retrospective study was done to assess the significance of Tip Apex Distance in the management of the intertrochanteric fractures by Proximal femoral nail. MATERIAL AND METHODS: The study was done in a tertiary care centre where 174 follow-up patients operated for intertrochanteric fractures with proximal femoral nail were included in the study. The radiological outcome of patients was assessed using the neck shaft angle, neck length and the offset whereas the functional status was assessed using the Harris hip score and the Lower extremity functional scoring system. These functional and radiological outcomes were compared with the TAD for any significant findings. RESULTS: The tip apex distance on the postoperative X-ray was found to be 22.93+3.88mm. The Lower Extremity Functional Score was found to be 70.71+8.153. The Harris Hip Score was found to be 85.408+9.586. Change in the neck length as compared to the uninjured hip was found to be 1.46+1.705. Change in the offset and neck shaft angle was 1.38+1.567 and -2.61+1.27 respectively. There were 8 cases of screw cut out and 8 cases of superficial infection. DISCUSSION: The Harris hip score and the LEFS increased with decreasing values of the Tip Apex distance. The Neck shaft angle, Neck length and the offset all decreased with the increase in the Tip Apex Distance. The Harris hip score and the LEFS decreased with the decrease in the Neck shaft angle, Neck length and the offset. On examining the 2 groups one with TAD <25mm and the other with TAD >25mm it was seen that both functionally and radiologically, the outcome was better in the group having TAD<25mm. CONCLUSION: This study indicates that the Tip Apex Distance can be used as a useful predictor of the outcome of the proximal femoral nail in intertrochanteric fractures. LEVEL OF EVIDENCE: IV.

Glycated Hemoglobin, Plasma Glucose, and Erythrocyte Aging.

BACKGROUND: The relationship between HbA1c and blood glucose averages has been characterized many times, yet, a unifying, mechanistic description is still lacking. METHODS: We calculated the level of HbA1c from plasma glucose averages based solely on the in vivo rate of hemoglobin glycation, and the different turnover rates for erythrocytes of different ages. These calculations were then compared to the measured change of HbA1c due to changes in mean blood glucose (MBG), to complex models in the literature, and our own experiments. RESULTS: Analysis of data on erythrocyte ageing patterns revealed that 2 separate RBC turnover mechanisms seem to be present. We calculated the mean red blood cell (RBC) life span within individuals to lie between 60 and 95 days. Comparison of expected HbA1c levels to data taken from continuous glucose monitors and finger-stick MBG yielded good agreement (r = .87, P < .0001). Experiments on the change with time of HbA1c induced by a change of MBG were in excellent agreement with our calculations (r = .98, P < .0001). CONCLUSIONS: RBC turnover seems to be dominated by a constant rate of cell loss, and a mechanism that targets cells of a specific age. Average RBC life span is 80 ± 10.9 days. Of HbA1c change toward treatment goal value, 50% is reached in about 30 days. Many factors contribute to the ratio of glycated hemoglobin, yet we can make accurate estimations considering only the in vivo glycation constant, MBG, and the age distribution of erythrocytes.

Chondroblastoma of the Medial Malleolus: A Case Report of A Rare Tumor at an Extremely Uncommon Site.

INTRODUCTION: Tumors of the medial malleolus are rare. Chondrogenic tumors of the medial malleolus are extremely rare. Chondroblastoma of the medial malleolus has not been reported previously in the English literature. The purpose is to present a rare tumor occurring at an unusual site and its successful management. CASE PRESENTATION: We report a case of a 30 years old female with chondroblastoma of the medial malleolus with its clinical features, radiographic features, differential diagnosis, and management at an unusual site. Treatment comprised of an open biopsy followed by aggressive curettage, phenolization and bone cement. Symptoms resolved after treatment with resumption of normal activities and no signs of recurrence at 1 year follow-up. CONCLUSION: This case appears to be the first reported case of chondroblastoma occurring at medial malleolus. The present case report will increase the awareness of this rare tumor occurring at this unusual site thereby avoiding any chance of misdiagnosis.

Steroid maintenance is associated with an increased risk of infections but has no effect on patient and graft survival in pancreas transplantation: A retrospective review of the UNOS database.

INTRODUCTION: The appropriateness of steroid maintenance in pancreas transplantation is unproven. The current literature is insufficient due to small numbers, short follow-up and sparse data. METHODS: Data from the UNOS database on adults ≥18 years old, who received pancreas and kidney-pancreas transplants between January 1996 and March 2014 were analyzed (n = 27,077). Two groups were evaluated: (a) Steroids Induction only (n = 4391) and (b) Steroid maintenance (n = 22,686). One-, 3-, 5-, 10-, and 15-year unadjusted patient and graft survival rates were compared. A Cox proportional hazards model was used to determine what patient factors were associated with these outcomes. RESULTS: There were differences in patient survival at 1 and 3 years and in graft survival at 3 and 5 years. There was a higher rate of infectious complications in the maintenance group, but after controlling for several recipient factors, whether a patient received steroid maintenance or not, was not significantly associated with the risk of death or graft failure. CONCLUSION: The use of maintenance steroids is significantly associated with an increased risk of infectious complications, but no difference in patient death or graft failure after controlling for multiple recipient factors. There is also no benefit with the use of steroid maintenance after pancreas transplantation.

Interaction of aqueous leaf extract of Aegle marmelos (L.) Corr. with cholinergic, serotonergic and adrenergic receptors: an ex vivo study.

OBJECTIVES: The aim was to study interaction of aqueous leaf extract of Aegle marmelos (AM) with cholinergic, serotonergic, and adrenergic receptor systems using appropriate rat tissues-ileum, fundus and tracheal chain, respectively. MATERIALS AND METHODS: Cumulative concentration-response curves (CRC) were constructed at various doses on each tissue for AM and respective standard agonist. The CRC was again plotted in presence and absence of respective standard antagonist to confirm the interaction of receptor system and AM. RESULTS: AM induced concentration-dependent contractions in isolated rat ileum (0.2-6.4 mg/ml) and fundus (0.2-3.2 mg/ml) that were inhibited significantly (P < 0.05) in the presence of atropine (10(-7) M) and ketanserin (10(-6) M), respectively. The relaxant effect, produced by AM (0.2 mg/ml) on carbachol (10(-5) M) precontracted rat tracheal chain, was also inhibited significantly (P < 0.05) by propranolol (1 ng/ml). CONCLUSION: It may be concluded that AM possesses agonistic activity on cholinergic, serotonergic and adrenergic receptors.

Peroneus Brevis Attrition & Longitudinal Split Tear without Subluxation and Associated Hypertrophy of Peronal Tubercle" - Treatment of an Uncommon Lesion.

INTRODUCTION: Peroneus brevis tendinitis with its attritional longitudinal split rupture without any subluxation from peroneal groove and associated enlarged peroneal tubercle is un common presentation. CASE REPORT: A 40 year old female presented with moderate swelling and tenderness over the lateral and dorso-lateral aspect of left ankle with history of old trauma to ankle with swelling, persistant pain and difficulty in walking. On physical examination during passive eversion and inversion the excursion of the peroneal tendons was painful. Most tender point was just posterior to the tip of the fibula. During surgery we found the intact superior peroneal ligament with both peroneal tendons placed at normal site without subluxation, tendon sheath was inflamed and swollen, on further dissection we could see the attrition of inner surface of the peroneus brevis and a 2 cm longitudinal split tear of the same. CONCLUSION: Although rare but peroneus brevis tendon attrition and tear can occur without subluxation from peronal groove. Refractory ankle pain on lateral aspect presenting with on and off swelling should arise suspicion of peroneal tendon tear. Correct diagnosis and proper surgical repair can produce excellent results.

Management of Intrarticular Fractures of Distal End of Humerus using Modification of the Triceps Aponeurosis Tongue Approach.

OBJECTIVE: To evaluate the functional outcome and extensor apparatus of operative management of intra-articular fractures of distal humerus using modification of the Triceps Tongue Flap approach. METHODS: This prospective study was conducted between June, 2012 to April,2014 in NIMS Medical College and Hospital, Jaipur, Rajasthan(India). We included 23 patients with intraarticular fractures of distal humerus that were managed surgically. Modification of Triceps Tongue Flap approach with Triceps flap in inverted 'V' shape was used. Follow-up was done using standard radiograph anteroposterior/lateral (AP/Lat) at immediate postoperative day, 1,3, 6 and 12 month intervals. Functional outcome was assessed using range of motion at elbow joint, Disability of Arm, Shoulder and Hand (DASH)Score and Objective Muscle Strength Testing (MRC Grade) of triceps muscle at 1,2, 3,6 and 12 month follow-up. RESULTS: Overall we included 23 patients of whom 16 (69.5%) were men and 7 (30.5%) were women with mean age of 34.6+4.8years. Mean duration of the follow-up was 12.9+1.1 months. Mean DASH Score at final follow up was 7.7+1.1(indicating mild residal impairment). Mean muscle strength at final follow-up was 4.7 ± 0.4 (Range 3 to 5). Mean flexion deformity at elbow was 9.2 ±0.9 (Range 5 to 45) degrees and mean arc of flexion extension as 119 ± 3.4(Range 65to 140) degrees. CONCLUSION: This approach provides an excellent exposure as well as a good functional outcome as measured by DASH score and full range of motion at the elbow joint with return of almost complete power of the extensor apparatus in patients with intra-articular fractures of distal humerus.

Continuous glucose monitoring analysis as predictor of islet yield and insulin requirements in autologous islet transplantation after complete pancreatectomy.

We analyzed the pretransplant continuous glucose monitoring (CGM) data of 45 patients that underwent total pancreatectomy followed by autologous islet transplantation (AIT) at the University of Arizona Medical Center. Traditional and novel metrics of CGM time series were correlated to the total islet count (TIC), islet equivalents (IEQs), and weight-normalized IEQs (IEQ/kg). In a subset cohort (n = 26) we analyzed the relationship among the infused number of islets, the CGM indicators, and the first recorded insulin requirement after the procedure. We conclude that receiving a high islet yield is sufficient yet not necessary to achieve low or null insulin requirements within the first 50 days after surgery. Furthermore, CGM inertia and CGM length of curve (2 novel CGM indicators) are shown to be correlated to islet yield, and the CGMs normalized area (Ao) and time ratio above hyperglycemic level (To) are strongly correlated to insulin requirement. A screening test based on To is shown to have 100% sensitivity and 88% specificity discriminating insulin independence upon discharge.

Drag-force regimes in granular impact.

We study the penetration dynamics of a projectile incident normally on a substrate comprising of smaller granular particles in three-dimensions using the discrete element method. Scaling of the penetration depth is consistent with experimental observations for small velocity impacts. Our studies are consistent with the observation that the normal or drag force experienced by the penetrating grain obeys the generalized Poncelet law, which has been extensively invoked in understanding the drag force in the recent experimental data. We find that the normal force experienced by the projectile consists of position and kinetic-energy-dependent pieces. Three different penetration regimes are identified in our studies for low-impact velocities. The first two regimes are observed immediately after the impact and in the early penetration stage, respectively, during which the drag force is seen to depend on the kinetic energy. The depth dependence of the drag force becomes significant in the third regime when the projectile is moving slowly and is partially immersed in the substrate. These regimes relate to the different configurations of the bed: the initial loose surface packed state, fluidized bed below the region of impact, and the state after the crater formation commences.

Factors affecting transplant outcomes in diabetic nude mice receiving human, porcine, and nonhuman primate islets: analysis of 335 transplantations.

BACKGROUND: In the absence of a reliable islet potency assay, nude mice (NM) transplantation is the criterion standard to assess islet quality for clinical transplantation. There are factors other than islet quality that affect the transplant outcome. METHODS: Here, we analyzed the transplant outcomes in 335 NM receiving islets from human (n=103), porcine (n=205), and nonhuman primate (NHP; n=27) donors. The islets (750, 1000, and 2000 islet equivalents [IEQ]) were transplanted under the kidney capsule of streptozotocin-induced diabetic NM. RESULTS: The proportion of mice that achieved normoglycemia was significantly higher in the group implanted with 2000 IEQ of human, porcine, or NHP islets (75% normoglycemic) versus groups that were implanted with 750 IEQ (7% normoglycemic) and 1000 IEQ (30% normoglycemic). In this study, we observed that the purity of porcine islet preparations (P≤0.001), islet pellet size in porcine preparations (P≤ 0.01), and mice recipient body weight for human islet preparations (P=0.013) were independently associated with successful transplant outcome. NHP islets of 1000 IEQ were sufficient to achieve normoglycemic condition (83%). An islet mass of 2000 IEQ, high islet purity, increased recipient body weight, and high islet pellet volume increased the likelihood of successful reversal of diabetes in transplanted mice. Also, higher insulin secretory status of islets at basal stimulus was associated with a reduced mouse cure rate. The cumulative incidence of graft failure was significantly greater in human islets (56.12%) compared with porcine islets (35.57%; P≤0.001). CONCLUSION: Factors affecting NM bioassay were identified (islet mass, islet purity, pellet size, in vitro insulin secretory capability, and mouse recipient body weight) and should be considered when evaluating islet function.

Platelet rich plasma therapy: A comparative effective therapy with promising results in plantar fasciitis.

Chronic muscle & tendon injuries are one of the problems which are encountered by human being since last long time. These injuries are generally repetitive strain injuries, commonly found in athletes. There are various treatments which include conservative methods in initial stages to surgery in later stages. On minimal invasive aspect Ultrasound-guided fenestration and tenotomy surgery has been used with good results as an effective treatment of chronic tendinopathies.(1,2) There are various injectable agents which were also researched including simple solutions such as hyperosmolar dextrose(3) (prolotherapy) to complex orthobiologic agents such as bone morphogenic protein,(4) but none have achieved uniform success. Platelet rich plasma (PRP) injection has emerged as a treatment alternative for many musculoskeletal conditions. We have done this study on sixty patients to evaluate & compare the effects of platelet rich plasma & steroid injection on patients with planter fasciitis. The results at the 1, 3 & 6 months were evaluated, which showed the good results with platelet rich plasma in comparison to steroid injections.

Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot - A rare Packaging disorder.

INTRODUCTION: Reduced intrauterine space gives rise to 'packaging disorder' which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK), bilateral congenital hip dislocation (CDH) and congenital talipes equino varus (CTEV)deformities. CASE REPORT: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper) with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. CONCLUSION: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good.

A new enzyme mixture to increase the yield and transplant rate of autologous and allogeneic human islet products.

BACKGROUND: The optimal enzyme blend that maximizes human islet yield for transplantation remains to be determined. In this study, we evaluated eight different enzyme combinations (ECs) in an attempt to improve islet yield. The ECs consisted of purified, intact or truncated class 1 (C1) and class 2 (C2) collagenases from Clostridium histolyticum (Ch), and neutral protease (NP) from Bacillus thermoproteolyticus rokko (thermolysin) or Ch (ChNP). METHODS: We report the results of 249 human islet isolations, including 99 deceased donors (research n=57, clinical n=42) and 150 chronic pancreatitis pancreases. We prepared a new enzyme mixture (NEM) composed of intact C1 and C2 collagenases and ChNP in place of thermolysin. The NEM was first tested in split pancreas (n=5) experiments and then used for islet autologous (n=21) and allogeneic transplantation (n=10). Islet isolation outcomes from eight different ECs were statistically compared using multivariate analysis. RESULTS: The NEM consistently achieved higher islet yields from pancreatitis (P<0.003) and deceased donor pancreases (P<0.001) than other standard ECs. Using the NEM, islet products met release criteria for transplantation from 8 of 10 consecutive pancreases, averaging 6510 ± 2150 islet equivalent number/gram (IEQ/g) pancreas and 694,681 ± 147,356 total IEQ/transplantation. In autologous isolation, the NEM yielded more than 200,000 IEQ from 19 of 21 pancreases (averaging 422,893 ± 181,329 total IEQ and 5979 ± 1469 IEQ/kg recipient body weight) regardless of the severity of fibrosis. CONCLUSIONS: A NEM composed of ChNP with CIzyme high intact C1 collagenase recovers higher islet yield from deceased and pancreatitis pancreases while retaining islet quality and function.

Encephalocoele as a complication of intranasal surgery.

Intranasal encephalocoele can be congenital or acquired as a consequence of injury to the floor of anterior cranial fossa disrupting dura resulting in herniation of brain tissue in the nasal cavity. Authors came across a case of encephalocoele as a complication of intranasal polypectoury. We are reporting this case due to its rareness.