Advancements in multiferroic, dielectric, and impedance properties of copper-yttrium co-doped cobalt ferrite for hydroelectric cell applications

This paper explores yttrium and copper co-doped cobalt ferrite [Co1-xCuxFe1.85Y0.15O4] synthesized via the sol-gel auto-combustion route (0.0 ⩽x⩽ 0.08). Investigating the impact of co-dopants on CoFe2O4, the study reveals altered cation distribution affecting the structure, multiferroic, and electrical properties. X-ray diffraction studies show nanocrystalline co-doped cobalt ferrites with lattice expansion and smaller grains due to Cu-Y co-doping. Fourier transform infrared spectroscopy confirms inverse spinel family classification with tetrahedral lattice shrinkage. Field emission scanning electron microscopy indicates a grain size of approximately 0.12μm. Ferroelectric analysis reveals a peak saturation polarization of 23.42μC cm-2for 8% copper doping, attributed to increased Fe3+ions at tetrahedral sites. Saturation magnetization peaks at 54.4706 emu g-1for 2% Cu2+ion substitution [Co0.98Cu0.02Fe1.85Y0.15O4] and decreases to 37.09 emu g-1for 4% Cu substitution due to irregular iron atom distribution at tetrahedral sites. Dielectric studies uncover Maxwell-Wagner polarization and high resistance in grain and grain boundaries using impedance spectroscopy. Fabricated hydroelectric cells exhibit improved ionic diffusion, suggesting their use in potential hydroelectric cell applications.

Analytical validation of HER2DX genomic test for early-stage HER2-positive breast cancer

BACKGROUND

HER2DX, a multianalyte genomic test, has been clinically validated to predict breast cancer recurrence risk (relapse risk score), the probability of achieving pathological complete response post-neoadjuvant therapy (pCR likelihood score), and individual ERBB2 messenger RNA (mRNA) expression levels in patients with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer. This study delves into the comprehensive analysis of HER2DX's analytical performance.

MATERIALS AND METHODS

Precision and reproducibility of HER2DX risk, pCR, and ERBB2 mRNA scores were assessed within and between laboratories using formalin-fixed paraffin-embedded (FFPE) tumor tissues and purified RNA. Robustness was appraised by analyzing the impact of tumor cell content and protocol variations including different instruments, reagent lots, and different RNA extraction kits. Variability was evaluated across intratumor biopsies and genomic platforms [RNA sequencing (RNAseq) versus nCounter], and according to protocol variations.

RESULTS

Precision analysis of 10 FFPE tumor samples yielded a maximal standard error of 0.94 across HER2DX scores (1-99 scale). High reproducibility of HER2DX scores across 29 FFPE tumors and 20 RNAs between laboratories was evident (correlation coefficients >0.98). The probability of identifying score differences >5 units was ≤5.2%. No significant variability emerged based on platform instruments, reagent lots, RNA extraction kits, or TagSet thaw/freeze cycles. Moreover, HER2DX displayed robustness at low tumor cell content (10%). Intratumor variability across 212 biopsies (106 tumors) was <4.0%. Concordance between HER2DX scores from 30 RNAs on RNAseq and nCounter platforms exceeded 90.0% (Cohen's κ coefficients >0.80).

CONCLUSIONS

The HER2DX assay is highly reproducible and robust for the quantification of recurrence risk, pCR likelihood, and ERBB2 mRNA expression in early-stage HER2-positive breast cancer.

Serum vitamin D level alterations in retinal vascular occlusions

AIM

To evaluate serum vitamin D levels in sub-types of retinal vascular occlusions and compare the levels in ischemic and non-ischemic presentations.

METHODS

This study included 50 patients of retinal vascular occlusions comprising central retinal vein occlusion, branch retinal vein occlusion, central retinal artery occlusion, branch retinal artery occlusion (study group) diagnosed on basis of clinical characteristics as well as investigations and an age and gender-matched healthy control group (control group). The study group was further classified into ischemic and non-ischemic subtypes and serum vitamin D levels were analysed and compared.

RESULTS

There were 50 patients of various sub-types of retinal vascular occlusions comprising 13 cases of CRVO, 30 cases of BRVO, 05 cases of CRAO, 02 cases of BRAO and 50 age and sex-matched controls. Mean BCVA and CMT in RVO patients was +1.12 log MAR, 346.72 ± 27.93 µm while in control group was +0.37 log MAR, 236.22 ± 3.71 µm which were statistically significant (p = 0.004; p = 0.002). The mean serum vitamin D value in study group was 18.39 ng/dl as compared to 32.31 ng/dl in control group which was statistically significant (p = 0.001). The difference in the baseline vitamin D value between the ischemic and non -ischemic sub groups among total vascular occlusion was found to be statistically significant (p = 0.010). However, baseline vitamin D levels difference among ischemic and non-ischemic cases in individual sub-types of vascular occlusion was statistically insignificant.

CONCLUSION

High prevalence of low serum vitamin D levels is seen in patients of retinal vascular occlusion spectrum diseases. Moreover, ischemic types of retinal vascular occlusion have significantly lower serum vitamin D levels as compared to non - ischemic despite having fewer no of patients in arterial occlusion sub-types. Therefore, vitamin D supplements may be considered as possible future targeted therapy in optimizing the severity of disease.

Assessment of the prevalence of types of head and neck cancer in a tertiary cancer center at Madurai, Tamil Nadu: A cross-sectional study

AIM

The aim of the study was to assess the prevalence of types of head and neck cancer in Madurai, Tamil Nadu.

OBJECTIVES

The objectives of the study were to assess the prevalence of types of head and neck cancer in Madurai, Tamil Nadu using a questionnaire.

MATERIALS AND METHODS

A descriptive cross-sectional study was carried out for two months among 300 head and neck cancer patients at a tertiary cancer center in Madurai. A convenience sampling technique was used. The data were collected using a pretested, self-structured questionnaire. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software.

RESULTS

Of 300 head and neck cancer patients, the mean age of the patients was about 51.04 ± 16.49 years. The majority of the patients were male (80%), employed (85%), and literate (65%). Among the head and neck cancer patients, 65% were tobacco users and 42.4% were alcohol consumers. Squamous cell carcinoma was the most common type of head and neck cancer, and 79.7% were diagnosed at an advanced stage of said cancer, such as stages III and IV.

CONCLUSION

Lack of knowledge and awareness is a major cause of increasing prevalence of head and neck cancer in our country. It is most important to increase the knowledge and awareness of early symptom recognition and its seriousness among the general population.

Unveiling the impact of Ni2+/Y3+ co-substitution on the structural, dielectric, and impedance properties of multiferroic spinel ferrite for hydroelectric cell application

Substitution with rare earth (RE3+) and transition (X = Cu, Ni, Mn, Zn, etc.) metals can distort the spinel ferrite structure and create defects, which can be exploited in multifarious applications. In this study, yttrium and nickel co-substituted cobalt ferrites [Co1-xNixFe1.85Y0.15O4], (0.0 ≤ x ≤ 0.15) were synthesized by a modified sol-gel reaction route. The X-ray diffraction (XRD) patterns confirmed the single phase and highly crystalline nature of the prepared samples. Field emission scanning electron microscopy with energy dispersive X-ray (FESEM-EDX) spectroscopy confirmed the morphology of the prepared samples sintered at 800 °C and showed the grain sizes of the particles decreased with the addition of nickel ions. The simultaneous co-existence of saturation magnetization and ferroelectricity at room temperature confirmed the multiferroic nature of the co-substituted cobalt ferrites. The dielectric and impedance studies confirmed the Maxwell-Wagner polarization phenomenon and the enhanced values with Y-Ni co-substitution. The maximum saturation ferroelectric polarization was attained around 6.142 μC cm-2 for yttrium-substituted cobalt ferrite and then decreased with the increase in the substitution % of nickel. The maximum value of saturation magnetization (Ms = 99.50 emu g-1) was obtained with the highest substitution % of nickel of x = 0.15 in yttrium-substituted cobalt ferrite (YCFO) nanoferrites, which was also confirmed from the vibrating sample magnitude (VSM) studies at room temperature. The improvements in the structural, morphological, electrical, and multiferroic properties in the co-substituted cobalt ferrites were found to correlated to the substitution of the bigger cationic Y3+ ions compared to the Fe3+ ions, while the small substitution of Ni2+ ions lead to changes in the lattice parameters, porosity, and conduction behavior. These significant enhancements in co-substituted cobalt ferrites can be exploited for hydroelectric cell applications.

Toxoplasma Retinochoroiditis Following Intravitreal Dexamethasone Implant Injection for Diabetic Macular Edema: A Rare Complication

PURPOSE

To report a case of ocular toxoplasmosis as a rare complication of intravitreal dexamethasone implant in a case of diabetic macular edema.

METHODS

A 56 years old male, a known case of Proliferative Diabetic Retinopathy, received intravitreal dexamethasone implant for diabetic macular edema in left eye. He developed toxoplasma retinochoroiditis involving the macula with further diminution of vision in his left eye 3 weeks after the injection. His serum titres were positive for Toxoplasma IgG (161 IU/ml). He was treated with oral Sulfamethoxazole 800 mg + Trimethoprim 160 mg 12 hourly for 4 weeks.

RESULTS

The visual acuity in left eye improved with resolution of retinochoroiditis after the course of antibiotic therapy.

CONCLUSION

It is imperative to follow-up closely after intravitreal steroid implantation, to look for the possible rare complication of infectious retinitis/retinochoroiditis, as timely antimicrobial treatment can lead to a good visual outcome.

Association of serum vitamin D levels with clinical spectrum of central serous chorioretinopathy patients of Indian origin

BACKGROUND

Vitamin D, a fat-soluble prohormone has been implicated in various ophthalmological diseases such as ocular inflammation, glaucoma, diabetic retinopathy and ocular angiogenesis. Many studies have shown effect of vitamin D on oxidative stress, angiogenesis and retinal circulation. However, there is definitive lack in published literature on effect of vitamin D on central serous chorioretinopathy especially in view of various epidemiological studies reporting risk of vitamin deficiency in up to 40% adult population.

OBJECTIVE

To determine serum vitamin D levels in various clinical profiles of central serous chorioretinopathy and their effect on its pathophysiology in Indian population.

DESIGN

Case control observational study METHODS: Study included 42 patients (group P) of central serous chorioretinopathy (CSCR) diagnosed with optic coherence tomography (OCT), fundus fluorescein angiography (FFA) which were further sub-grouped into acute(P1), chronic (P2) and recurrent (P3). A total of 44 age & sex-matched healthy control subjects (group C) were also included. The vitamin D levels of both groups were examined and analyzed.

RESULTS

No significant difference between the groups P and C in respect of age, gender or baseline best corrected visual acuity (P = 0.153, P = 0.123 and P = 0.08, respectively) was noted. Vitamin D levels were determined as 16.473 ± 7.307 ng/mL in group P and 34.940 ± 8.348 ng/mL in group C and difference was statistically significant(P = 0.001). There were statistically significantly more no of patient in group P (78.57%) with deficient vitamin D levels as compared to normal serum levels (4.76%) (P = 0.04). Patients in group P1(acute CSCR) and P2(Chronic CSCR) also had significant more no of subjects with deficient vitamin D levels as compared to normal serum levels (P = 0.01 and P = 0.03).

CONCLUSIONS

The low serum vitamin D levels were determined in all clinical sub-types of central serous chorioretinopathy patients which point to its possible role in the pathophysiology of the disease. There is a need for further studies to determine the changes that could occur with vitamin replacement therapy in CSCR.

Purtscher-like retinopathy-unusual initial presentation of rheumatoid arthritis

Purtscher-like retinopathy is a rare phenomenon reported in disorders including acute pancreatitis, collagen vascular diseases, fat embolism, chronic renal failure, amniotic fluid embolism, battered baby syndrome and several autoimmune diseases. We report an atypical initial feature of rheumatoid arthritis in a middle-aged male. This case will raise awareness among generalists to recognize this disease early.

Comparison of changes in blood pressure in phacoemulsification cataract surgery performed via topical and peribulbar anaesthesia: A cohort study

Background

The purpose of study was to compare the changes in blood pressure in patients undergoing phacoemulsification cataract surgery under topical and peribulbar anaesthesia during preoperative, intraoperative and postoperative period.

Methods

In this prospective cohort study, 240 patients undergoing phacoemulsification were divided into topical (Group 1) and peribulbar (Group 2) equally. Proparacaine 0.5% drops were used for topical anaesthesia, and Inj lignocaine with Inj bupivacaine were used to give peribulbar anaesthesia. Preoperative blood pressure was taken 30 min before surgery with automated sphygmomanometer. Intraoperative blood pressure was taken during phacoemulsification, and postoperative blood pressure was taken 1 h after surgery. Outcomes assessed were systolic, diastolic and mean blood pressure.

Results

Systolic blood pressure in Group 1 was significantly increased in the intraoperative phase, whereas it was significantly decreased in Group 2 in the intraoperative phase. Diastolic and mean blood pressure in Group 1 showed no significant change, whereas in Group 2, both showed significant reduction in intraoperative and postoperative phases.

Conclusion

The increase in intraoperative systolic blood pressure in topical group could be due to discomfort from microscope light, iris manipulation, irrigation and aspiration during surgery. The decrease in intraoperative systolic and diastolic blood pressure in peribulbar group could be due to systemic absorption of local anaesthetic. The mean preoperative systolic blood pressure was also higher in the topical group, which could be due to anxiety or stress under topical anaesthesia. The changes in blood pressure need to be observed so that timely intervention can be made to achieve favourable postoperative outcome.

Immediately sequential bilateral cataract surgery in Down syndrome

The exponential increase in world population and average human lifespan is expected to result in geriatric population globally. The problem of preventable blindness due to cataract will increase manifold. Simultaneous Bilateral cataract surgery (SBCS) is a viable option in such subset of patients. Despite faster visual recovery, economic benefits to patients and health care providers, decreased risk of complications associated with General anaesthesia, there is significant resistance in accepting SBCS as a routine procedure. Bilateral endophthalmitis is the main deterrent in performing ISBCS. This case highlights successful ISBCS in 36 years old female patient with Down's syndrome.

Neuromyelitis optica spectrum disorder with negative aquaporin-4 antibodies and positive anti-myelin oligodendrocyte glycoprotein antibodies: A case report

Neuromyelitis optica spectrum disorders (NMOSDs) are rare autoimmune-mediated chronic inflammatory disorders involving the central nervous system. The concept of NMOSDs has widened up recently. Its diagnostic criteria have broadened the knowledge of this particular disease including the atypical cases where antiaquaporin-4 antibody is negative and anti-myelin oligodendrocyte glycoprotein (MOG) antibody is positive. Myelin oligodendrocyte glycoprotein is a protein expressed on the outer surface of myelin sheath and oligodendrocytes of the central nervous system. The detection of anti-MOG-Ab is emerging evidence, and thus, research on the role of this antibody in such seronegative cases is still underway. Early diagnosis and adequate therapy is essential in such cases. Here, we report an eight-year-old girl who was diagnosed with NMOSDs and found to have anti-MOG antibodies in place of AQP-4 antibodies.

An unusual case of eosinophilia, myalgia and skin contractures: Shulman's disease revisited

Shulman's disease (eosinophilic fasciitis) is a very rare autoimmune disorder with an unknown etiopathogenesis. During the initial period of disease, it usually causes limb and trunk edema followed by collagenous thickening of the subcutaneous fascia. Eosinophilia is a predominant laboratory finding during the initial phase of the disease and less prominent in the later phases. Patients may also present with arthritis, myositis, peripheral neuropathy, and rarely pleuropericarditis. Here, we are reporting a case of eosinophilic fasciitis presenting with vague constitutional symptoms, fever, and peripheral blood eosinophilia followed by rapidly evolving skin tightening with joint contractures and muscle stiffness, which misled the treating team toward Scleroderma and its overlap syndromes. The diagnosis was finally clinched by a full-thickness skin biopsy along with underlying fascia and muscle tissue from an effected area, with a gratifying treatment response to standard immune suppression.

TB disease patterns by HIV and diabetes status

BACKGROUND: TB is commonly categorised as pulmonary (PTB) or extrapulmonary TB (EPTB). Knowledge of TB disease patterns (PTB and/or EPTB) and determining risk factors remains limited.METHODS: This was a prospective cohort study using point-of-care ultrasound (POCUS) in Indian patients with presumed TB. Clinical and imaging data were used to develop refined case definitions for PTB, concurrent PTB and EPTB (PTB + EPTB) and EPTB without PTB (EPTB). These groups were analysed by HIV (HIV+/-) and diabetes mellitus (DM+/-) status.RESULTS: Of 172 HIV-/DM- patients with TB, 48% had PTB, 23% PTB + EPTB and 29% had EPTB, totalling 52% with any EPTB (PTB + EPTB or EPTB). In HIV+/DM- patients with TB (n = 35), 6% had PTB, 40% had PTB + EPTB and 54% had EPTB, accounting for 94% with EPTB. In HIV-/DM+ patients with TB (n = 61), 61% had PTB, 28% had PTB + EPTB and 11% had EPTB, representing 39% with EPTB.CONCLUSION: Refined case definitions revealed high proportions of EPTB even without HIV or DM. HIV further altered the TB disease pattern towards EPTB and DM towards PTB. Therefore, the dichotomy between PTB or EPTB does not represent the actual spectrum of TB disease. EPTB should receive higher priority in research and clinical practice.

A Effect of Radial Clearance, Corner Radius and Micro Lateralization on Contact Stress of Metallic and Ceramic Hip Prosthesis

Edge loading leads to high contact stress at the rim of the contact. This is due to less radial clearance and excessive lateral head displacement which potentially causes implant failure. The ceramic implants have a high possibility of fracture compared with metallic implants because of above-said reasons. The present study focuses on the investigation of contact stress for the combined effect of radial clearance (0.05-0.75 mm) and micro-lateralisation conditions (1-2.5 mm) for Metal-on-Metal (M-o-M) and Ceramic-on-Ceramic (C-o-C) pairs. The contact stresses are analysed for round corners of the acetabulum cup geometry for the above-said combinations with four different arc radii (1- 4mm). Finite element modeling (FEM) of femur head with half of the acetabulum cup is considered for the current study. Contact stress values obtained for 2 mm and 4 mm round corner geometry are quite low when compared with 1 and 3 mm round corners even for larger radial clearances and high lateral head displacements. The study also showed von Mises stress value obtained for M-o-M pair is quite low for 4 mm round corner for larger radial clearance and high lateral head displacements. Similarly, in C-o-C pair the compressive stress values are minimum for 4 mm round corner. Since the stress values were minimum for 4 mm round corner geometry, it clearly indicates that even edge loading occurs and the round corner geometry would be very helpful in reducing the stress for both M-o-M and C-o-C pairs.

Tuberculosis and neuromyelitis optica spectrum disorder: A conundrum

Purpose: Infectious atypical optic neuritis (AON), like tubercular, is a vision threatening condition with phenotypic overlap with Neuromyelitis Optica Spectrum Disorder (NMOSD). The overlapping neurological manifestations and negative AQP4-Ab-assay make it difficult to discover the primary cause of neuritis. Case presentation: We report two paediatric cases with NMOSD that did not fulfil the diagnostic criteria. Moreover, associated undiagnosed tuberculosis at the time of presentation and negative AQP4-Ab clouded the diagnosis and delayed the treatment. The first case was initially diagnosed with infectious optic neuropathy. By the time steroids were started, optic atrophy had already set in. The second case had optic neuritis, LETM, and intracranial-tuberculomas with no signs of pulmonary-tuberculosis with negative CSF-analysis. So, systemic steroids were started promptly. The history of LETM in both cases raised the suspicion of NMOSD. Conclusion: The importance of accurate clinical diagnosis and early intervention in cases of AON was emphasized in a limited resource country, that could potentially result in salutary visual outcomes, especially in the paediatric age group Abbreviations: AON = atypical optic neuritis, TB = tuberculosis, NMOSD = neuromyelitis optica spectrum disorder, LETM = longitudinal extensive transverse myelitis, AQP4-Ab = anti-Aquaporin-4 Antibodies, RE = right eye, LE = left eye, MRI = magnetic resonance imaging, CSF = cerebrospinal fluid, ATT = anti-tubercular treatment, DOV = diminution of vision.

Acute myeloid leukemia presenting as unilateral central retinal vein occlusion

Ocular manifestations of leukemia are often bilateral and involve all ocular structures with non-specific features like retinal hemorrhages, cotton wool spots and choroidal infiltrates. We report a rare, atypical initial presentation of acute myeloid leukemia with unilateral central retinal vein occlusion in a middle-aged male. This case will raise awareness among ophthalmologists to recognize and diagnose underlying systemic disease early and decrease systemic morbidity in consultation with a hematologist.

Novel benchmark values for redo liver transplantation – does the outcome justify the effort?

Objective

In the era of organ shortage, redo liver transplantation (reLT) is frequently discussed in terms of expected poor outcome, high cost and therefore wasteful resources. However, there is a lack of benchmark data to reliably assess outcomes after reLT. The aim of this study was to define the ideal reLT case, and to establish clinically relevant benchmark values for best achievable outcome in reLT.

Methods

We collected data on reLT between January 2010 and December 2018 from 22 high volume transplant centers on three continents. Benchmark cases were defined as recipients with model of end-stage liver disease score &lt;=25, absence of portal vein thrombosis, no mechanical ventilation before surgery, receiving a graft from a donor after brain death. In addition, early reLT including those for primary non-function (PNF) were excluded. Clinically relevant endpoints covering intra- and postoperative course were selected and complications were graded by severity using the Clavien-Dindo classification and the comprehensive complication index (CCI). The benchmark cutoff for each outcome was derived from the 75th percentile of the median values of all benchmark centers, indicating the “best achievable” result. To assess the utility of the newly established benchmark values, we analyzed patients who received reLT for PNF (non-benchmark patients).

Results

Out of 1110 reLT 413 (37.2%) qualified as benchmark cases. Benchmark values included: Length of intensive care unit and hospital stay: &lt;=6 and &lt;=24 days, respectively; Clavien-Dindo grade &gt;=3a complications and the CCI at 1 year: &lt;=76% and &lt;=72.2, respectively; in-hospital and 1-year mortality rates: &lt;=14.0% and &lt;=14.3%, respectively. The cutoffs for transplant-specific complications such as biliary complications at 1 year, outflow problems at 1 year and hepatic artery thrombosis at discharge were &lt;=27.3%, &lt;=2.5% and &lt;=4.8%, respectively. Patients receiving a reLT for PNF showed mean outcome values all outside the reLT benchmark values. In-hospital mortality rate was 34.4% and the mean CCI at discharge 68.8.

Conclusion

ReLT remains associated with high morbidity and mortality. The availability of benchmark values for outcome parameters of reLT may serve for comparison in any future analyses of individuals, patient groups, or centers, but also in the evaluation of new therapeutic strategies and principles.

Ray tracing biometry in post radial keratotomy eye

OBJECTIVE

To report a case of post radial keratotomy (RK) cataract in a 55-year-old lady wherein biometry was done by ray-tracing method incorporated in scheimpflug topographer (Sirius + Scheimpflug Analyzer, CSO, Italy).

METHOD

In our case, we performed intraocular lens (IOL) power calculation using a recent concept of ray tracing with scheimpflug topographer and compared with traditional methods available at American Society of Cataract and Refractive Surgery(ASCRS) website (www.ascrs.org) for eyes with prior RK. Phacoemulsification was performed and a monofocal + 24.5D IOL implanted in the capsular bag.

RESULT

Manifest refraction at six weeks postoperative period was + 1.0DS/-2.0DC × 75° with spherical equivalence of 0. On comparison of all the methods used to calculate IOL power, the absolute errors of ray tracing and Barrett true K were found to be the least, 0.14 and 0.18 respectively.

CONCLUSION

Ray tracing biometry with scheimpflug topographer seems to provide accurate IOL power in post RK eyes.

Impact of digital boards on hand and neck muscle activity during online teaching process

Academicians across the globe due to Covid 19 shifted to online teaching as a mainstream method by replacing the chalk and talk method. The main objective of this study is to find the impact of different sizes of digital boards used for online teaching on muscle activity and muscle fatigue, and then results are compared with conventional writing. Initially, a questionnaire survey is conducted among 100 college professors about the issue they faced while using online teaching methods. Experimental analysis are then conducted using electromyography sensor (sEMG) among ten college professors and their muscle activity on the dominant hand and neck while writing on two commercially available digital boards namely Type 1 (small writing area) and Type 2 (large writing area). Four muscles namely Flexor carpi radialis, Extensor carpi radialis, Biceps brachii, and Sternocleidomastoid (SCM) are chosen for the study. The results are then compared with muscle activity while writing on conventional A4 sheets. Normalized root mean square (RMS) is used to assess the muscle activity and the trend line of MPF value is utilized to assess the muscle fatigue. The results show that SCM muscle has more muscle activation compared to other selected muscles followed by flexor carpi radialis. Subjective analysis is carried out using the Borg scale, which has reported that Type 2 digital board having larger working area was preferred by the participants as it reduces muscle fatigue.

A comparison on efficiency and aerosol generation between “modified and conventional technique of bracket bonding”

Introduction:

The novel COVID-19 which spread's primarily through oral and nasal passage poses a major threat of spread during dental treatments. It is important for dental practitioners to use minimal aerosol techniques. The aim of this study is to compare the time taken, efficiency and aerosol generated between modified and conventional technique (CT) of bracket bonding.

Methods:

This study includes 40 patients who required complete orthodontic treatment. In all 40 patients, one of the arches was bonded with modified technique (MT) and the opposing with CT. The time taken to prepare tooth in both the techniques were accessed. The efficiency of bond was seen over a period of 6 months. The amount of aerosol particulate matter generated during CT and MT was observed using a laser air quality monitor

Conclusion:

There is no significant difference in the bond failure and time taken between both the techniques. The aerosol generated in MT was minimal or almost negligible when compared to the use of CT.

Deep Learning-Based Real-Time AI Virtual Mouse System Using Computer Vision to Avoid COVID-19 Spread

The mouse is one of the wonderful inventions of Human-Computer Interaction (HCI) technology. Currently, wireless mouse or a Bluetooth mouse still uses devices and is not free of devices completely since it uses a battery for power and a dongle to connect it to the PC. In the proposed AI virtual mouse system, this limitation can be overcome by employing webcam or a built-in camera for capturing of hand gestures and hand tip detection using computer vision. The algorithm used in the system makes use of the machine learning algorithm. Based on the hand gestures, the computer can be controlled virtually and can perform left click, right click, scrolling functions, and computer cursor function without the use of the physical mouse. The algorithm is based on deep learning for detecting the hands. Hence, the proposed system will avoid COVID-19 spread by eliminating the human intervention and dependency of devices to control the computer.

Assessment of the perceived stress and burden of family caregivers of the head-and-neck cancer patients at a tertiary care cancer center: A cross-sectional study

Introduction

Cancer is a major life-threatening disease and has an impact on both patients and their family members. Caring for cancer patients may lead to several levels of stress which may affect their own health as well as their quality of life.

Aim

To assess the perceived stress and burden of family caregivers of head and neck cancer patients (HNC) attending cancer care centre at a tertiary care centre, Tamil Nadu.

Objectives

To assess the perceived stress and the burden among caregivers of patients with head and neck cancer using the Perceived Stress Scale (PSS) and Caregiver Strain Index (CSI) respectively.

Materials and Method

A Cross-sectional study was carried out for a period of three months among the caregivers of head and neck cancer patients at a cancer care centre, Madurai. A total of 200 caregivers were selected by Convenience sampling method. Data was collected using a pretested, self-structured, closed-ended questionnaire by face to face interview method.

Results

The study population consisted of Caregivers aged 21-60 years, mostly females (80%), spouses (54%), employed (57%) and uneducated (66%). Most of the caregivers were from lower socioeconomic status (66%) and those who are providing care for 1 to 6 months were more in number. In this study, 82% of caregivers reported high caregiver burden (CSI ≥7) and 67% of caregivers reported high stress (PSS ≥ 26 - 40).

Conclusion

Caregivers are experiencing significant burden, particularly with respect to their physical and psychological well-being, economic circumstances, social and personal relationships.

Evaluation of LDPE Degradation Under Controlled Composting

The compost burial test was performed to determine the degradation of commercially available low-density polyethylene in natural compost for a period of six months. Biodegradability of polyethylene films in compost was monitored using scanning electron microscopy (SEM), Energy dispersive X-Ray, Fourier transform infrared spectroscopy (FTIR), X-Ray diffraction (XRD), thermal gravimetric analysis (TGA), differential scanning calorimetry (DSC), and weight reduction analysis. After six months of compost exposure, a major change over the surface of LDPE was observed. SEM images clearly showed the exfoliation and cracks on the film leading to degradation. The other analysis also showed a change in the thermal properties and crystallinity of the LDPE films. The composting method could prove to be the reliable and ecological method of degrading plastic waste without hindering the natural ecosystem.

A Convolutional Neural Network-Based Triplet-Mining Metric Learning Schema for Measuring Patient Similarity Addressing Personalized Healthcare

Prediction of the development risk of some diseases is an important area of Health Care Research. When exploring the personalized care of the patients, precise identification and classification of similarity in patients from their past report is an important process. Electronically stored health information EHRs that has been sampled unevenly as well as which has variable appointment durations, is considered to be unsuitable for measuring the similarity among patients directly, as there is no proper representation that are fitting. In addition, a technique is required that is efficient to evaluate similarities in patient. We propose two new similarities learning environments using deep learning that learn simultaneously the representations of the patients as well as measurement of similarity in pairs. A Convolutional Neural Network (CNN) is used to understand EHRs that contains crucial information which are local thereby providing scholastic illumination in the triplet loss otherwise entropy loss. When the training is completed, distances are calculated as well as similarities scores. Using this similarity information, disease predictions along with patient grouping is performed. Experimentally the results gives an idea that CNN can represent the EHR sequences in a better way and the schema offered are more efficient than the modern metric distance learning.

Quantum Microwave Radiometry with a Superconducting Qubit

The interaction of photons and coherent quantum systems can be employed to detect electromagnetic radiation with remarkable sensitivity. We introduce a quantum radiometer based on the photon-induced dephasing process of a superconducting qubit for sensing microwave radiation at the subunit photon level. Using this radiometer, we demonstrate the radiative cooling of a 1 K microwave resonator and measure its mode temperature with an uncertainty ∼0.01  K. We thus develop a precise tool for studying the thermodynamics of quantum microwave circuits, which provides new solutions for calibrating hybrid quantum systems and detecting candidate particles for dark matter.

Does application of complexity theory simplify concepts of psychiatry: Analogies and insights

Scientific curiosity has not been able to explain the cause of psychiatric illness based on primarily biological or social paradigm. Available literatures were explored to understand causality of psychiatric illness from perspective of physics. Theory of complexity and other relevant theories were extrapolated to address these questions. Mental illness appeared to be a complex interplay of reductionism and emergentism, genetic and epigenetics, stress and the vulnerability or the core and the periphery. Mental illness displayed complex interaction between biological trait and environmental state.

Acute Coronary Syndrome From Green Snake Envenomation

BACKGROUND

Snake bite is a grossly underreported public health issue in subtropical, tropical suburban, and rural areas of Africa and South Asia. In literature, ophitoxemia (snake bite envenomation) as a cause of acute coronary syndrome (ACS) is limited to very few case reports. Viper envenomation is the most common cause of ACS among snake bites. We report the first case of unstable angina caused by Colubridae snake bite (Ahaetullanasuta, commonly called green snakes) in a young man without comorbidities.

CASE REPORT

A young healthy man had a green snake bite that was camouflaged in the green fodder. He was managed elsewhere with anti-snake serum. He developed acute chest pain and breathlessness on day 3 of his treatment. Electrocardiogram (ECG) showed biphasic T wave inversions suggestive of type A Wellens pattern in the anterior chest leads (V1-V4). He was treated for ACS medically outside and was referred to our institute for further management on the following day. ECG and cardiac enzymes were normal. The echocardiogram showed no regional wall motion abnormality. Computed tomography coronary angiography showed normal epicardial coronaries. He was discharged in stable condition and asymptomatic at 2 months follow-up. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ACS after a snake bite is not limited to venomous snakes. The diagnosis should be considered promptly even with a nonvenomous snake bite, especially in those with typical symptoms and ECG changes. The time interval between snake bite and development of ACS can be long and warrants prolonged medical supervision.

A Series of Ferulic Acid Amides Reveals Unexpected Peroxiredoxin 1 Inhibitory Activity with in vivo Antidiabetic and Hypolipidemic Effects

Insulin resistance is a major pathophysiological feature in the development of type 2 diabetes (T2DM). Ferulic acid is known for attenuating the insulin resistance and reducing the blood glucose in T2DM rats. In this work, we designed and synthesized a library of new ferulic acid amides (FAA), which could be considered as ring opening derivatives of the antidiabetic PPARγ agonists Thiazolidinediones (TZDs). However, since these compounds displayed weak PPAR transactivation capacity, we employed a proteomics approach to unravel their molecular target(s) and identified the peroxiredoxin 1 (PRDX1) as a direct binding target of FAAs. Interestingly, PRDX1, a protein with antioxidant and chaperone activity, has been implied in the development of T2DM by inducing hepatic insulin resistance. SPR, mass spectrometry-based studies, docking experiments and in vitro inhibition assay confirmed that compounds VIe and VIf bound PRDX1 and induced a dose-dependent inhibition. Furthermore, VIe and VIf significantly improved hyperglycemia and hyperlipidemia in streptozotocin-nicotinamide (STZ-NA)-induced diabetic rats as confirmed by histopathological examinations. These results provide guidance for developing the current FAAs as new potential antidiabetic agents.

Combined cardiac anomalies in Noonan syndrome: A case report

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Noonan syndrome is the second most common syndromic cause of CHD.

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We present a rare case of Noonan syndrome having a combination of ASD, PS and HCM.

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Patient underwent balloon valvotomy for pulmonary stenosis.

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The patient is under regular follow-up and awaiting heart transplant.

Introduction

Noonan syndrome is the second most common syndromic cause of congenital heart disease. Most patients have an autosomal dominant inheritance, but some cases may be sporadic. Pulmonary stenosis is the most common cardiac manifestation in Noonan syndrome, associated with the atrial septal defect and hypertrophic cardiomyopathy. A combination of these three is present only in 5% of patients.

Presentation of case

We report a case of a 21-year-old female who presented to our hospital concomitant cardiac lesions associated with pulmonary stenosis, atrial septal defect, and hypertrophic cardiomyopathy. This combination of cardiac defects is an infrequent manifestation of Noonan syndrome. The patient presented with complaints of exertion syncope over the past two years. 2D-Echocardiography showed biventricular hypertrophy, dysplastic pulmonary valve, severe pulmonary stenosis, asymmetric septal hypertrophy and large atrial septal defect. The genetic analysis report showed autosomal dominant inheritance with Ras/MAPK (mitogen-activated protein kinase) Positive.

Discussion

Due to the wide spectrum of symptoms and presentations in Noonan cases, accurate clinical and genetic diagnosis, and comprehensive management of the disorder are strongly recommended.

Conclusion

We have described a case of rare combination of cardiovascular defects in Noonan Syndrome with a view to achieve better insight into the disease course and advantages of timely treatment and follow up. Our patient is currently in follow-up after treatment with percutaneous balloon pulmonary valvuloplasty, has improved symptoms, and is awaiting heart transplant.

Abstract C066: Epigenetics and inflammatory environment may contribute to racial disparities in colorectal cancer

Colorectal cancer (CRC) mortality rates dropped by half in the past three decades, but CRC continues to demonstrate racial disparities in incidence and survival. It is believed that unfavorable socioeconomic conditions may lead to an inflammatory phenotype. Furthermore, epigenetic events play a major role in regulating inflammatory genes that have been linked to CRC health disparities. The objective of the study was to identify gene(s) that are dysregulated in CRC using The Cancer Genome Atlas (TCGA) database, and, furthermore, to characterize those genetic event(s) that are associated with CRC health disparities. The Engrailed-2 (En2) gene encodes for a homeobox-containing transcription factor regulating embryonic brain development. The data indicate that Nanog, IL-8, and EN2 were upregulated in colorectal cancer. EN2 was highly expressed in CRC stem cells and cell lines but its expression was very low or absent in normal cells. EN2 gene was highly expressed in CRC tissues derived from African American patients compared to those from Caucasian Americans. The expression of EN2 significantly increased with patients' age. There was no difference in EN2 expression between males and females of CRC patients. Higher expression of EN2 was correlated with poor survival of CRC patients with greater IL-8 expression. EN2 may act as a novel prognostic biomarker for CRC. Our data indicate that CRC disparities may be associated with epigenetic factors regulating the inflammatory environment.

Citation Format: Y.M. Ma, S.K. Roy, R.K. Srivastava, S. Shankar. Epigenetics and inflammatory environment may contribute to racial disparities in colorectal cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C066.

Finite element submodeling technique to analyze the contact pressure and wear of hard bearing couples in hip prosthesis

Finite element (FE) simulation plays a major role in computing stress and predicting the failure of biomedical components. Normally in past, researchers focused on developing a global computational model from the scanned data of patients to analyze the stresses and deformations. To compute the wear of the hip prosthesis, mostly the global model (GM) is used to predict the expected life for million cycles using nodal updating technique which leads to high computational effort and time. The proposed work utilizes a submodeling finite element technique to analyze the contact pressure and wear of biomaterials for three different combinations in hip prosthesis including metal, ceramic and polycrystalline diamond materials. Initially the global model boundary and loading conditions are transferred to the submodel. The mesh is refined further using finer mesh and then the results are computed which consumes lesser time. The contact stress as well as the linear wear of biomaterials is found to be quite high for the local model (LM) when compared with the global model. However, no changes in volumetric wear of these biomaterials are observed when compared with previous experimental results. The computational time as well as accuracy in estimating the contact stress and the wear of bearings is improved effectively. Among local model with different element sizes, 0.75 mm element size of local model showed improved results in estimating the contact stress and linear wear of bearing.

Prevalence of work related musculoskeletal disorders among occupational bus drivers of Karnataka, South India

BACKGROUND

Work-related health problems result in an economic loss of 4-6% in GDP (Gross domestic Product) of the most countries. In the industrialized countries, 1/3rd of the health-related absence to duty are due to musculoskeletal disorders. Professional driving is one such occupation which looks like sedentary occupation, but involves many risk factors that contribute to work-related musculoskeletal disorders (WMSD) due to its nature of working and work environment. This research describes the various risk factors associated with WMSDs and their effects on drivers health.

OBJECTIVE

To assess the prevalence of WMSD and its associated risk factors among the bus drivers of Karnataka State Road Transport Corporation (KSRTC), Karnataka.

METHODS

Subjects considered in this study are 301 full-time bus drivers from the central division KSRTC which consists of 6 depots in Bengaluru. Information regarding reported WMSD symptoms during immediate past 7 days to 12 months, the intervention of WMSD in their day-to-day life and the overall comfort of the body are determined through Standardized Nordic Questionnaire and also by direct observation. The survey questionnaire is conducted by face to face interview.

FINDINGS

From the statistical analysis, it is found that around 55.8% of the study population has experienced WMSD. The prevalence of WMSD is most common in the age group of 29-39 years (53.5%) followed by the age group of >40 years.

CONCLUSION

In this study, some of the work-related and lifestyle/health-related factors show significant association with WMSD in bus drivers of Karnataka. Musculoskeletal disorders can be prevented by designing the driver's workspace ergonomically so that the design suits to all sorts of drivers and the drivers should also be trained on basics of vehicle ergonomics (posture, seat adjustments, in-vehicle controls adjustments).

INTERPRETATION

KSRTC should educate drivers on the basics of vehicle ergonomics, harmful use of tobacco/alcohol, unhealthy food habits and also to involve in physical exercise at least 75-150 mins weekly. If not, the trend of drivers suffering from WMSD belonging to mid-age will increase exponentially.

SCOPE FOR FUTURE WORK

Statistical result and direct observation insist on undertaking further studies on ergonomic interventions at driver's cabin, lifestyle/occupational health factors which mitigate WMSD in different parts of the body during driving.

Strategies to Reduce Radiation Exposure in Electrophysiology and Interventional Cardiology

Clinical diagnosis sometimes involves the use of medical instruments that employ ionizing radiation. However, ionizing radiation exposure is a workplace hazard that goes undetected and is detrimental to patients and staff in the catheterization laboratory. Every possible effort should be made to reduce the amount of radiation, including scattered radiation. Implementing radiation dose feedback may have a role in reducing exposure. In medicine, it is important to estimate the potential biologic effects on, and the risk to, an individual. In general, implantation of cardiac resynchronization devices is associated with one of the highest operator exposure doses due to the proximity of the operator to the radiation source. All physicians should work on the principle of as low as reasonably achievable. Methods for reducing radiation exposure must be implemented in the catheterization laboratory. In this article, we review the available tools to lower the radiation exposure dose to the operator during diagnostic, interventional, and electrophysiological cardiac procedures.

Percutaneous Coronary Intervention in an Octogenarian With Anomalous Origin Arising From Right Sinus: A Rare Case Report

Anomalous coronary artery origins are not common in routine clinical practice. The incidence of coronary anomalies in patients undergoing coronary angiography is less than 1%. The greatest challenges faced in the management are delays in identification and difficulty engaging the anomalous coronary artery. Operator experience in promptly identifying the anomaly and selection of the appropriate catheter is critical for successful intervention. We are presenting a case of acute inferior and posterior wall myocardial infarction (MI) with an anomalous origin of the left circumflex artery from the right coronary sinus. Learning objective is that percutaneous coronary intervention (PCI) in an anomalous left circumflex can be technically difficult because selective cannulation of the vessel may not be easy. An anomalous left circumflex artery has a rare presentation of ST-elevation myocardial infarction (STEMI). Complicated STEMI with cardiogenic shock is not commonly seen in anomalous coronary artery origin from the right sinus. Percutaneous intervention in patients with STEMI with an anomalous left circumflex artery has a high risk and is technically challenging.