The Materials Genome Initiative(MGI)advanced a new paradigm for materials discovery and design,namely that the pace of new materials deployment could be accelerated through complementary efforts in theory,computation,...The Materials Genome Initiative(MGI)advanced a new paradigm for materials discovery and design,namely that the pace of new materials deployment could be accelerated through complementary efforts in theory,computation,and experiment.Along with numerous successes,new challenges are inviting researchers to refocus the efforts and approaches that were originally inspired by the MGI.In May 2017,the National Science Foundation sponsored the workshop“Advancing and Accelerating Materials Innovation Through the Synergistic Interaction among Computation,Experiment,and Theory:Opening New Frontiers”to review accomplishments that emerged from investments in science and infrastructure under the MGI,identify scientific opportunities in this new environment,examine how to effectively utilize new materials innovation infrastructure,and discuss challenges in achieving accelerated materials research through the seamless integration of experiment,computation,and theory.This article summarizes key findings from the workshop and provides perspectives that aim to guide the direction of future materials research and its translation into societal impacts.展开更多
AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent management.METHODS:Retrospective analysis of data from 108 patients with re...AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent management.METHODS:Retrospective analysis of data from 108 patients with rectal carcinoma who underwent AR or low anterior resection(LAR)to identify the various preoperative,operative,and post operative factors that might have influence on anastomotic leaks and strictures.RESULTS:There were 68 males and 40 females with an average of 47 years(range 21-75 years).The median distance of the tumor from the anal verge was 8 cm(range 3-15 cm).Sixty(55.6%)patients underwent handsewn anastomosis and 48(44.4%)were stapled.The median operating time was 3.5 h(range2.0-7.5 h).Sixteen(14.6%)patients had an anastomotic leak.Among these,11 patients required reexploration and five were managed expectantly.The anastomotic leak rate was similar in patients with and without diverting stoma(8/60,13.4%with stoma and 8/48;16.7%without stoma).In 15(13.9%)patients,resection margins were positive for malignancy.Ninteen(17.6%)patients developed anastomotic strictures at a median duration of 8 mo(range 3-20 mo).Among these,15 patients were successfully managed with per-anal dilatation.On multivariate analysis,advance age(>60 years)was the only risk factor for anastomotic leak(P=0.004).On the other hand,anastomotic leak(P=0.00),mucin positive tumor(P =0.021),and lower rectal growth(P=0.011)were found as risk factors for the development of an anastomotic stricture.CONCLUSION:Advance age is a risk factor for an anastomotic leak.An anastomotic leak,a mucin-secreting tumor,and lower rectal growth predispose patients to develop anastomotic strictures.展开更多
Soil organic carbon （SOC） sequestration is one of the major agricultural strategies to mitigate greenhouse gas （GHG） emissions, enhance food security, and improve agricultural sustainability. This paper synthesize...Soil organic carbon （SOC） sequestration is one of the major agricultural strategies to mitigate greenhouse gas （GHG） emissions, enhance food security, and improve agricultural sustainability. This paper synthesizes the much-needed state- of-knowledge on the effects of tillage, crop residue, and nutrient management practices on SOC sequestration and identifies potential research gap, opportunities, and challenges in studying SOC dynamics in rice （Oryza sativa L.）-based cropping systems in South Asia, mainly in Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. Improved management prac- tices such as reduced- and no-tillage management, nitrogen （N） fertilizer and farmyard manure （FYM） application, and crop residue addition can improve SOC accumulation. Positive effects of no-tillage, crop residue addition, N addition through manure or compost application, and integration of organic and chemical fertilizers on SOC accumulation in rice-based cropping systems have been documented from South Asia. However, limited data and enormous discrepancies in SOC measurements across the region exist as the greatest challenge in increasing SOC sequestration and improving agricultural sustainability. More research on SOC as influenced by alternative tillage, crop residue, and nutrient management systems, and development of SOC monitoring system for existing long-term experiments will advance our understanding of the SOC dynamics in rice-based cropping systems and improve agricultural system sustainability in South Asia.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common comorbidity with type 2 diabetes.The existing therapeutic options for NAFLD are not adequate.Hypocaloric diet and exercise is the cornerstone of therapy i...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common comorbidity with type 2 diabetes.The existing therapeutic options for NAFLD are not adequate.Hypocaloric diet and exercise is the cornerstone of therapy in NAFLD.Pioglitazone is the only drug recommended in diabetes patients with biopsy proven non-alcoholic steatohepatitis.The frequent coexistence of NAFLD and type 2 diabetes with their combined adverse health consequences and inadequate therapeutic options makes it necessary to search for newer alternatives.AIM To assess the effect of sodium glucose cotransporter-2(SGLT-2)inhibitors on liver enzymes in type 2 diabetes patients with NAFLD.METHODS We searched PubMed/MEDLINE,Cochrane library,Google scholar,and Clinicaltrials.gov for the relevant articles to be included in this systematic review.Human studies done in type 2 diabetes patients with NAFLD treated with SGLT-2 inhibitors for at least 12 wk were included.Data from eight studies(four randomised controlled trials and four observational studies)were extracted and a narrative synthesis was done.A total of 214 patients were treated with SGLT-2 inhibitors in these studies(94 in randomised controlled trials and 120 in observational studies).RESULTS The primary outcome measure was change in serum alanine aminotransferase level.Out of eight studies,seven studies showed a significant decrease in serum alanine aminotransferase level.Most of the studies revealed reduction in serum level of other liver enzymes like aspartate aminotransferase and gamma glutamyl transferase.Five studies that reported a change in hepatic fat exhibited a significant reduction in hepatic fat content in those treated with SGLT-2 inhibitors.Likewise,among the three studies that evaluated a change in indices of hepatic fibrosis,two studies revealed a significant improvement in liver fibrosis.Moreover,there was an improvement in obesity,insulin resistance,glycaemia,and lipid parameters in those subjects taking SGLT-2 inhibitors.The studies disclosed that about 17%(30/176)of the sub展开更多
Diabetes mellitus is the most common cause of Charcot neuropathy affecting foot and ankle. Acute Charcot foot(CF) presents with a red and swollen foot in co-ntrast to the painless deformed one of chronic CF. En-hanced...Diabetes mellitus is the most common cause of Charcot neuropathy affecting foot and ankle. Acute Charcot foot(CF) presents with a red and swollen foot in co-ntrast to the painless deformed one of chronic CF. En-hanced osteoclastogenesis plays a central role in the pathogenesis of acute CF. Many studies have shown elevated levels of bone turnover markers in patients with acute CF confirming it. These findings have led cl-inicians to use anti-resorptive agents [bisphosphonates(BP), calcitonin, and denosumab] along with immobi-lization and offloading in acute CF patients. The ma-ximum evidence among all anti-resorptive agents is available for BPs, although its quality is low. Pamidronate has been shown to reduce the markers of activity of CF like raised skin temperature, pain, edema, and bone turnover markers in the majority of studies. Intravenous BPs are known to cause acute phase reactions leading to flu-like illness following their first infusion, which can be ameliorated by oral acetaminophen. Alendronate is the only oral BP used in these patients. It needs to be taken on an empty stomach with a full glass of water to avoid esophagitis. The side-effects and contraindications to BPs should be kept in mind while treating acute CF patients with them.展开更多
There is an urgent need to match food production with increasing world population through identification of sustainable land management strategies.However,the struggle to achieve food security should be carried out ke...There is an urgent need to match food production with increasing world population through identification of sustainable land management strategies.However,the struggle to achieve food security should be carried out keeping in mind the soil where the crops are grown and the environment in which the living things survive.Conservation agriculture(CA),practising agriculture in such a way so as to cause minimum damage to the environment,is being advocated at a large scale world-wide.Conservation tillage,the most important aspect of CA,is thought to take care of the soil health,plant growth and the environment.This paper aims to review the work done on conservation tillage in different agro-ecological regions so as to understand its impact from the perspectives of the soil,the crop and the environment.Research reports have identified several benefits of conservation tillage over conventional tillage(CT)with respect to soil physical,chemical and biological properties as well as crop yields.Not less than 25%of the greenhouse gas effluxes to the atmosphere are attributed to agriculture.Processes of climate change mitigation and adaptation found zero tillage(ZT)to be the most environmental friendly among different tillage techniques.Therefore,conservation tillage involving ZT and minimum tillage which has potential to break the surface compact zone in soil with reduced soil disturbance offers to lead to a better soil environment and crop yield with minimal impact on the environment.&2015 International Research and Training Center on Erosion and Sedimentation and China Water and Power Press.Production and Hosting by Elsevier B.V.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Objective:To evaluate the in vitro antifungal activity of Aegle marmelos leaf extracts and fractions on the clinical isolates of dermatophytic fungi like Trichophyton mentagrophytes,Trichophyton rubrum,Microsporum can...Objective:To evaluate the in vitro antifungal activity of Aegle marmelos leaf extracts and fractions on the clinical isolates of dermatophytic fungi like Trichophyton mentagrophytes,Trichophyton rubrum,Microsporum canis,Microsporum gypseum and Epidermophyton floccosum.Methods:The minimum inhibitory concentration(MIC) and minimum fungicidal concentration(MFC) of various extracts and fractions of the leaves of Aegle marmelos were measured using method of National Committee for Clinical Laboratory Standards(NCCLS).Results:Aegle marmelos leaf extracts and fractions were found to have fungicidal activity against various clinical isolates of dermatophytic fungi.The MIC and MFC was found to be high in water and ethyl alcohol extracts and methanol fractions(200μg/mL) against dermatophytic fungi studied.Conclusions:Aegle marmelos leaf extracts significantly inhibites the growth of all dermatophytic fungi studied.If this activity is confirmed by in vivo studies and if the compound is isolated and identified,it could be a remedy for dermatophytosis.展开更多
AIM： To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease （NAFLD） and to assess their histological severity at presentation.METHODS： Consecutive patients presenting t...AIM： To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease （NAFLD） and to assess their histological severity at presentation.METHODS： Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences （AIIMS） with raised transaminases to at least 1.5 times upper limit of normal, and histologically confirmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profile of this group was studied. RESULTS： Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34（17-58） years and 26.7（21.3-32.5） kg/m^2 respectively and 46 （90.1%） were males. The majority of the patients had mild inflammation, either grade 1 [32 （63%）] or grade 2 [16 （31%）] and only 3 （6%） patients had severe （grade 3） inflammation. Twenty-three （45%）, 19 （37%）, 8（16%） and 1（2%） patient had stage 0, 1, 2 and 3 fibrosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % （OR = 7.1; 95% CI： 1.6-31.5, P = 0.002） and AST ALT ratio 〉 1 （OR = 14.3; 95% CI： 1.4-678.5, P = 0.008） were associated with high grades of inflammation and none was associated with advanced fibrosis. On multivariate logistic regression analysis, hypertriglyceridemia 〉150 mg% was the only factor independently associated with presence of high grade of inflammation （OR = 1.6; 95% CI： 1.3-22.7, P =0.02）, while none was associated with advanced fibrosis. Triglyceride levels correlated positively with inflammatory grade （r = 0.412; P = 0.003）. CONCLUSION： NAFLD in North Indian patients is a disease of young over-weight males, most of whom are insulin resistant and they tend to have a mild histological disease at presentation.展开更多
Due to the inconsistency of rice variety,agricultural industry faces an important challenge of rice grading and classification by the traditional grading system.The existing grading system is manual,which introduces s...Due to the inconsistency of rice variety,agricultural industry faces an important challenge of rice grading and classification by the traditional grading system.The existing grading system is manual,which introduces stress and strain to humans due to visual inspection.Automated rice grading system development has been proposed as a promising research area in computer vision.In this study,an accurate deep learning-based non-contact and cost-effective rice grading system was developed by rice appearance and characteristics.The proposed system provided real-time processing by using a NI-myRIO with a high-resolution camera and user interface.We firstly trained the network by a rice public dataset to extract rice discriminative features.Secondly,by using transfer learning,the pre-trained network was used to locate the region by extracting a feature map.The proposed deep learning model was tested using two public standard datasets and a prototype real-time scanning system.Using AlexNet architecture,we obtained an average accuracy of 98.2%with 97.6%sensitivity and 96.4%specificity.To validate the real-time performance of proposed rice grading classification system,various performance indices were calculated and compared with the existing classifier.Both simulation and real-time experiment evaluations confirmed the robustness and reliability of the proposed rice grading system.展开更多
The risk of fracture is increased in both type 1 diabetes mellitus(T1DM)and type 2 diabetes mellitus(T2DM).However,in contrast to the former,patients with T2DM usually possess higher bone mineral density.Thus,there is...The risk of fracture is increased in both type 1 diabetes mellitus(T1DM)and type 2 diabetes mellitus(T2DM).However,in contrast to the former,patients with T2DM usually possess higher bone mineral density.Thus,there is a considerable difference in the pathophysiological basis of poor bone health between the two types of diabetes.Impaired bone strength due to poor bone microarchitecture and low bone turnover along with increased risk of fall are among the major factors behind elevated fracture risk.Moreover,some antidiabetic medications further enhance the fragility of the bone.On the other hand,antiosteoporosis medications can affect the glucose homeostasis in these patients.It is also difficult to predict the fracture risk in these patients because conventional tools such as bone mineral density and Fracture Risk Assessment Tool score assessment can underestimate the risk.Evidence-based recommendations for risk evaluation and management of poor bone health in diabetes are sparse in the literature.With the advancement in imaging technology,newer modalities are available to evaluate the bone quality and risk assessment in patients with diabetes.The purpose of this review is to explore the patho-physiology behind poor bone health in diabetic patients.Approach to the fracture risk evaluation in both T1DM and T2DM as well as the pragmatic use and efficacy of the available treatment options have been discussed in depth.展开更多
Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi...Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.展开更多
Perovskite-based solar cells with high power conversion efficiencies(PCEs)are currently being demonstrated in solid-state device designs.Their elevated performances can possibly be attained with different non-standard...Perovskite-based solar cells with high power conversion efficiencies(PCEs)are currently being demonstrated in solid-state device designs.Their elevated performances can possibly be attained with different non-standard geometries,for example,the fiber-shaped perovskite solar cells,in the light of careful design and engineering.Fiber-shaped solar cells are promising in smart textiles energy harvesting towards next-generation electronic applications and devices.They can be made with facile process and at low cost.Recently,fiber-shaped perovskite solar devices have been reported,particularly with the focus on the proof-of-concept in such non-traditional architectures.In this line,there are so many technical aspects which need to be addressed,if these photovoltaic(PV)cells are to be industrialized and produced massively.Herein,a well-organized and comprehensive discussion about the reported devices in this arena is presented.The challenges that need to be addressed,the possible solutions and the probable applications of these PV cells are also discussed.More still,the perovskite fiber-shaped PV cells with other fiber PV devices reported in literature in terms of their scope,characteristic designs,performances,and other technical considerations have been summarised.展开更多
Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance characteristics.We aimed to identify noninvasive independent predictors of endoscopic retrograde cholangi...Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance characteristics.We aimed to identify noninvasive independent predictors of endoscopic retrograde cholangiopancreatography(ERCP)-confirmed choledocholithiasis and accordingly developed predictive machine learning models(MLMs).Methods:Clinical data of consecutive patients undergoing first-ever ERCP for suspected chol-edocholithiasis from 2015 to 2019 were abstracted from a prospectively-maintained database.Multiple logistic regression was used to identify predictors of ERCP-confirmed choledocholithiasis.MLMs were then trained to predict ERCP-confirmed choledocholithiasis using pre-ERCP ultrasound(US)imaging only as well as using all available noninvasive imaging(US,computed tomography,and/or magnetic reso-nance cholangiopancreatography).The diagnostic performance of American Society for Gastrointestinal Endoscopy(ASGE)“high-likelihood”criteria was compared to MLMs.Results:We identified 270 patients(mean age 46 years,62.2%female,73.7%Hispanic/Latino,59%with noninvasive imaging positive for choledocholithiasis)with native papilla who underwent ERCP for suspected choledocholithiasis,of whom 230(85.2%)were found to have ERCP-confirmed chol-edocholithiasis.Logistic regression identified choledocholithiasis on noninvasive imaging(odds ratio(OR)¼3.045,P¼0.004)and common bile duct(CBD)diameter on noninvasive imaging(OR¼1.157,P¼0.011)as predictors of ERCP-confirmed choledocholithiasis.Among the various MLMs trained,the random forest-based MLM performed best;sensitivity was 61.4%and 77.3%and specificity was 100%and 75.0%,using US-only and using all available imaging,respectively.ASGE high-likelihood criteria demonstrated sensitivity of 90.9%and specificity of 25.0%;using cut-points achieving this specificity,MLMs achieved sensitivity up to 97.7%.Conclusions:MLMs using age,sex,race/ethnicity,presence of diabetes,fever,body mass index(BMI),total bilirubin,maximum CBD diameter,and choledocholithiasis on pre-ER展开更多
The present paper reports the unusual enhancement of endurance life of ball bearings subjected to carbonitriding treatment. The microstructure was characterized by scanning electron microscopy and correlated with hard...The present paper reports the unusual enhancement of endurance life of ball bearings subjected to carbonitriding treatment. The microstructure was characterized by scanning electron microscopy and correlated with hardness and X-ray diffraction analysis. Endurance tests at 90% reliability revealed that the carbonitrided bearings exhibit nearly ten times more life than the non-carbonitrided bearings. This is attributed to synergic combination of retained austenitic, fine martensitic microstructure and ultrafine carbide precipitates obtained by carbonitriding treatment.展开更多
In the current work,forsterite samples with different surface area were investigated for its antibacterial activity.Dissolution studies show that the lower degradation of forsterite compared to other silicate bioceram...In the current work,forsterite samples with different surface area were investigated for its antibacterial activity.Dissolution studies show that the lower degradation of forsterite compared to other silicate bioceramics,which is a desirable property for repairing bone defects.Forsterite scaffold shows superior compressive strength than the cortical bone after immersion in simulated body fluid.Bactericidal tests indicate that the forsterite had inhibition effect on the growth of clinical bacterial isolates.Forsterite may be a suitable candidate material for load bearing applications with enhanced mechanical properties and lower degradation rate.展开更多
Two-dimensional(2D)MXenes have emerged as an archetypical layered material combining the properties of an organic-inorganic hybrid offering materials sustainability for a range of applications.Their surface functional...Two-dimensional(2D)MXenes have emerged as an archetypical layered material combining the properties of an organic-inorganic hybrid offering materials sustainability for a range of applications.Their surface functional groups and the associated chemical properties'tailorability through functionalizing MXenes with other materials as well as hydrophilicity and high conductivity enable them to be the best successor for various applications in textile industries,especially in the advancement of smart textiles and remediation of textile wastewater.MXene-based textile composite performs superb smartness in high-performance wearables as well as in the reduction of textile dyes from wastewater.This article critically reviews the significance of MXenes in two sectors of the textile industry.Firstly,we review the improvement of textile raw materials such as fiber,yarn,and fabric by using MXene as electrodes in supercapacitors,pressure sensors.Secondly,we review advancements in the removal of dyes from textile wastewater utilizing MXene as an absorbent by the adsorption process.MXene-based textiles demonstrated superior strength through the strong bonding between MXene and textile structures as well as the treatment of adsorbate by adsorbent(MXene in the adsorption process).We identify critical gaps for further research to enable their real-life applications.展开更多
AIM: To prospectively determine the safety and tolerability of oral L-selenomethionine(SLM) with concurrent chemoradiation(CCRT) for Stage Ⅲ non-small cell lung cancer(NSCLC) and estimate if the incidence and/or seve...AIM: To prospectively determine the safety and tolerability of oral L-selenomethionine(SLM) with concurrent chemoradiation(CCRT) for Stage Ⅲ non-small cell lung cancer(NSCLC) and estimate if the incidence and/or severity of adverse events could be reduced by its use.METHODS: Sixteen patients with stage Ⅲ NSCLC were accrued to this single arm, phase Ⅱ study. CCRT consisted of radiation given at 2 Gy per fraction for 30-33 fractions, 5 d per week with concurrent weekly Ⅳ paclitaxel 50 mg/m2 followed by carboplatin dosed at an area under the time-concentration curve of 2. SLM was dosed in a loading phase at 4800 μg twice daily for one week prior to CCRT followed by once daily dosing during treatment. RESULTS: No selenium-related toxicity was observed. Analysis revealed grade 3 or higher esophagitis in 3 of 16 patients(19%), pneumonitis in 0, leukopenia in 2(12.5%), and anemia in 1(6%); the latter two were significantly reduced when compared to the protocolstated expected rate of 35%(P = 0.045 for leukopenia, and P < 0.01 for anemia). Median overall survival was 14.9 mo and median failure-free survival was 9 mo(95%CI: 3.3-21.5).CONCLUSION: There may be some protective benefit of selenium in the setting of CCRT for inoperable NSCLC. The data suggests decreased rates of myelosuppression when compared to similarly-treated historical and contemporary controls. Further evaluation of selenium in this setting may be warranted.展开更多
文摘The Materials Genome Initiative(MGI)advanced a new paradigm for materials discovery and design,namely that the pace of new materials deployment could be accelerated through complementary efforts in theory,computation,and experiment.Along with numerous successes,new challenges are inviting researchers to refocus the efforts and approaches that were originally inspired by the MGI.In May 2017,the National Science Foundation sponsored the workshop“Advancing and Accelerating Materials Innovation Through the Synergistic Interaction among Computation,Experiment,and Theory:Opening New Frontiers”to review accomplishments that emerged from investments in science and infrastructure under the MGI,identify scientific opportunities in this new environment,examine how to effectively utilize new materials innovation infrastructure,and discuss challenges in achieving accelerated materials research through the seamless integration of experiment,computation,and theory.This article summarizes key findings from the workshop and provides perspectives that aim to guide the direction of future materials research and its translation into societal impacts.
文摘AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent management.METHODS:Retrospective analysis of data from 108 patients with rectal carcinoma who underwent AR or low anterior resection(LAR)to identify the various preoperative,operative,and post operative factors that might have influence on anastomotic leaks and strictures.RESULTS:There were 68 males and 40 females with an average of 47 years(range 21-75 years).The median distance of the tumor from the anal verge was 8 cm(range 3-15 cm).Sixty(55.6%)patients underwent handsewn anastomosis and 48(44.4%)were stapled.The median operating time was 3.5 h(range2.0-7.5 h).Sixteen(14.6%)patients had an anastomotic leak.Among these,11 patients required reexploration and five were managed expectantly.The anastomotic leak rate was similar in patients with and without diverting stoma(8/60,13.4%with stoma and 8/48;16.7%without stoma).In 15(13.9%)patients,resection margins were positive for malignancy.Ninteen(17.6%)patients developed anastomotic strictures at a median duration of 8 mo(range 3-20 mo).Among these,15 patients were successfully managed with per-anal dilatation.On multivariate analysis,advance age(>60 years)was the only risk factor for anastomotic leak(P=0.004).On the other hand,anastomotic leak(P=0.00),mucin positive tumor(P =0.021),and lower rectal growth(P=0.011)were found as risk factors for the development of an anastomotic stricture.CONCLUSION:Advance age is a risk factor for an anastomotic leak.An anastomotic leak,a mucin-secreting tumor,and lower rectal growth predispose patients to develop anastomotic strictures.
文摘Soil organic carbon （SOC） sequestration is one of the major agricultural strategies to mitigate greenhouse gas （GHG） emissions, enhance food security, and improve agricultural sustainability. This paper synthesizes the much-needed state- of-knowledge on the effects of tillage, crop residue, and nutrient management practices on SOC sequestration and identifies potential research gap, opportunities, and challenges in studying SOC dynamics in rice （Oryza sativa L.）-based cropping systems in South Asia, mainly in Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. Improved management prac- tices such as reduced- and no-tillage management, nitrogen （N） fertilizer and farmyard manure （FYM） application, and crop residue addition can improve SOC accumulation. Positive effects of no-tillage, crop residue addition, N addition through manure or compost application, and integration of organic and chemical fertilizers on SOC accumulation in rice-based cropping systems have been documented from South Asia. However, limited data and enormous discrepancies in SOC measurements across the region exist as the greatest challenge in increasing SOC sequestration and improving agricultural sustainability. More research on SOC as influenced by alternative tillage, crop residue, and nutrient management systems, and development of SOC monitoring system for existing long-term experiments will advance our understanding of the SOC dynamics in rice-based cropping systems and improve agricultural system sustainability in South Asia.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is a common comorbidity with type 2 diabetes.The existing therapeutic options for NAFLD are not adequate.Hypocaloric diet and exercise is the cornerstone of therapy in NAFLD.Pioglitazone is the only drug recommended in diabetes patients with biopsy proven non-alcoholic steatohepatitis.The frequent coexistence of NAFLD and type 2 diabetes with their combined adverse health consequences and inadequate therapeutic options makes it necessary to search for newer alternatives.AIM To assess the effect of sodium glucose cotransporter-2(SGLT-2)inhibitors on liver enzymes in type 2 diabetes patients with NAFLD.METHODS We searched PubMed/MEDLINE,Cochrane library,Google scholar,and Clinicaltrials.gov for the relevant articles to be included in this systematic review.Human studies done in type 2 diabetes patients with NAFLD treated with SGLT-2 inhibitors for at least 12 wk were included.Data from eight studies(four randomised controlled trials and four observational studies)were extracted and a narrative synthesis was done.A total of 214 patients were treated with SGLT-2 inhibitors in these studies(94 in randomised controlled trials and 120 in observational studies).RESULTS The primary outcome measure was change in serum alanine aminotransferase level.Out of eight studies,seven studies showed a significant decrease in serum alanine aminotransferase level.Most of the studies revealed reduction in serum level of other liver enzymes like aspartate aminotransferase and gamma glutamyl transferase.Five studies that reported a change in hepatic fat exhibited a significant reduction in hepatic fat content in those treated with SGLT-2 inhibitors.Likewise,among the three studies that evaluated a change in indices of hepatic fibrosis,two studies revealed a significant improvement in liver fibrosis.Moreover,there was an improvement in obesity,insulin resistance,glycaemia,and lipid parameters in those subjects taking SGLT-2 inhibitors.The studies disclosed that about 17%(30/176)of the sub
文摘Diabetes mellitus is the most common cause of Charcot neuropathy affecting foot and ankle. Acute Charcot foot(CF) presents with a red and swollen foot in co-ntrast to the painless deformed one of chronic CF. En-hanced osteoclastogenesis plays a central role in the pathogenesis of acute CF. Many studies have shown elevated levels of bone turnover markers in patients with acute CF confirming it. These findings have led cl-inicians to use anti-resorptive agents [bisphosphonates(BP), calcitonin, and denosumab] along with immobi-lization and offloading in acute CF patients. The ma-ximum evidence among all anti-resorptive agents is available for BPs, although its quality is low. Pamidronate has been shown to reduce the markers of activity of CF like raised skin temperature, pain, edema, and bone turnover markers in the majority of studies. Intravenous BPs are known to cause acute phase reactions leading to flu-like illness following their first infusion, which can be ameliorated by oral acetaminophen. Alendronate is the only oral BP used in these patients. It needs to be taken on an empty stomach with a full glass of water to avoid esophagitis. The side-effects and contraindications to BPs should be kept in mind while treating acute CF patients with them.
文摘There is an urgent need to match food production with increasing world population through identification of sustainable land management strategies.However,the struggle to achieve food security should be carried out keeping in mind the soil where the crops are grown and the environment in which the living things survive.Conservation agriculture(CA),practising agriculture in such a way so as to cause minimum damage to the environment,is being advocated at a large scale world-wide.Conservation tillage,the most important aspect of CA,is thought to take care of the soil health,plant growth and the environment.This paper aims to review the work done on conservation tillage in different agro-ecological regions so as to understand its impact from the perspectives of the soil,the crop and the environment.Research reports have identified several benefits of conservation tillage over conventional tillage(CT)with respect to soil physical,chemical and biological properties as well as crop yields.Not less than 25%of the greenhouse gas effluxes to the atmosphere are attributed to agriculture.Processes of climate change mitigation and adaptation found zero tillage(ZT)to be the most environmental friendly among different tillage techniques.Therefore,conservation tillage involving ZT and minimum tillage which has potential to break the surface compact zone in soil with reduced soil disturbance offers to lead to a better soil environment and crop yield with minimal impact on the environment.&2015 International Research and Training Center on Erosion and Sedimentation and China Water and Power Press.Production and Hosting by Elsevier B.V.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).
文摘Objective:To evaluate the in vitro antifungal activity of Aegle marmelos leaf extracts and fractions on the clinical isolates of dermatophytic fungi like Trichophyton mentagrophytes,Trichophyton rubrum,Microsporum canis,Microsporum gypseum and Epidermophyton floccosum.Methods:The minimum inhibitory concentration(MIC) and minimum fungicidal concentration(MFC) of various extracts and fractions of the leaves of Aegle marmelos were measured using method of National Committee for Clinical Laboratory Standards(NCCLS).Results:Aegle marmelos leaf extracts and fractions were found to have fungicidal activity against various clinical isolates of dermatophytic fungi.The MIC and MFC was found to be high in water and ethyl alcohol extracts and methanol fractions(200μg/mL) against dermatophytic fungi studied.Conclusions:Aegle marmelos leaf extracts significantly inhibites the growth of all dermatophytic fungi studied.If this activity is confirmed by in vivo studies and if the compound is isolated and identified,it could be a remedy for dermatophytosis.
文摘AIM： To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease （NAFLD） and to assess their histological severity at presentation.METHODS： Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences （AIIMS） with raised transaminases to at least 1.5 times upper limit of normal, and histologically confirmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profile of this group was studied. RESULTS： Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34（17-58） years and 26.7（21.3-32.5） kg/m^2 respectively and 46 （90.1%） were males. The majority of the patients had mild inflammation, either grade 1 [32 （63%）] or grade 2 [16 （31%）] and only 3 （6%） patients had severe （grade 3） inflammation. Twenty-three （45%）, 19 （37%）, 8（16%） and 1（2%） patient had stage 0, 1, 2 and 3 fibrosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % （OR = 7.1; 95% CI： 1.6-31.5, P = 0.002） and AST ALT ratio 〉 1 （OR = 14.3; 95% CI： 1.4-678.5, P = 0.008） were associated with high grades of inflammation and none was associated with advanced fibrosis. On multivariate logistic regression analysis, hypertriglyceridemia 〉150 mg% was the only factor independently associated with presence of high grade of inflammation （OR = 1.6; 95% CI： 1.3-22.7, P =0.02）, while none was associated with advanced fibrosis. Triglyceride levels correlated positively with inflammatory grade （r = 0.412; P = 0.003）. CONCLUSION： NAFLD in North Indian patients is a disease of young over-weight males, most of whom are insulin resistant and they tend to have a mild histological disease at presentation.
基金the Indian National Academy of Science, New Delhi for providing research fellowship in the Department of Electrical Engineering, Indian Institute of Technology, New Delhi and Department of Electrical and Electronics Engineering, Mepco Schlenk Engineering College, Sivakasi, India for providing the necessary research facilities
文摘Due to the inconsistency of rice variety,agricultural industry faces an important challenge of rice grading and classification by the traditional grading system.The existing grading system is manual,which introduces stress and strain to humans due to visual inspection.Automated rice grading system development has been proposed as a promising research area in computer vision.In this study,an accurate deep learning-based non-contact and cost-effective rice grading system was developed by rice appearance and characteristics.The proposed system provided real-time processing by using a NI-myRIO with a high-resolution camera and user interface.We firstly trained the network by a rice public dataset to extract rice discriminative features.Secondly,by using transfer learning,the pre-trained network was used to locate the region by extracting a feature map.The proposed deep learning model was tested using two public standard datasets and a prototype real-time scanning system.Using AlexNet architecture,we obtained an average accuracy of 98.2%with 97.6%sensitivity and 96.4%specificity.To validate the real-time performance of proposed rice grading classification system,various performance indices were calculated and compared with the existing classifier.Both simulation and real-time experiment evaluations confirmed the robustness and reliability of the proposed rice grading system.
文摘The risk of fracture is increased in both type 1 diabetes mellitus(T1DM)and type 2 diabetes mellitus(T2DM).However,in contrast to the former,patients with T2DM usually possess higher bone mineral density.Thus,there is a considerable difference in the pathophysiological basis of poor bone health between the two types of diabetes.Impaired bone strength due to poor bone microarchitecture and low bone turnover along with increased risk of fall are among the major factors behind elevated fracture risk.Moreover,some antidiabetic medications further enhance the fragility of the bone.On the other hand,antiosteoporosis medications can affect the glucose homeostasis in these patients.It is also difficult to predict the fracture risk in these patients because conventional tools such as bone mineral density and Fracture Risk Assessment Tool score assessment can underestimate the risk.Evidence-based recommendations for risk evaluation and management of poor bone health in diabetes are sparse in the literature.With the advancement in imaging technology,newer modalities are available to evaluate the bone quality and risk assessment in patients with diabetes.The purpose of this review is to explore the patho-physiology behind poor bone health in diabetic patients.Approach to the fracture risk evaluation in both T1DM and T2DM as well as the pragmatic use and efficacy of the available treatment options have been discussed in depth.
文摘Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.
基金the National Key Research and Development Program of China(2016YFA0201702/2016YFA0201700)the Shanghai Natural Science Foundation(19ZR1400900)+3 种基金the Science and Technology Commission of Shang-hai Municipality(16JC1400700)the Fundamental Research Funds for the Central Universities(Grant No.2232018A3-01)the Program for Innovative Research Team at the University of Ministry of Education of China(IRT_16R13)the International Joint Laboratory for Advanced Fiber and Low-dimension Materials(18520750400),the(No.111-2-04).
文摘Perovskite-based solar cells with high power conversion efficiencies(PCEs)are currently being demonstrated in solid-state device designs.Their elevated performances can possibly be attained with different non-standard geometries,for example,the fiber-shaped perovskite solar cells,in the light of careful design and engineering.Fiber-shaped solar cells are promising in smart textiles energy harvesting towards next-generation electronic applications and devices.They can be made with facile process and at low cost.Recently,fiber-shaped perovskite solar devices have been reported,particularly with the focus on the proof-of-concept in such non-traditional architectures.In this line,there are so many technical aspects which need to be addressed,if these photovoltaic(PV)cells are to be industrialized and produced massively.Herein,a well-organized and comprehensive discussion about the reported devices in this arena is presented.The challenges that need to be addressed,the possible solutions and the probable applications of these PV cells are also discussed.More still,the perovskite fiber-shaped PV cells with other fiber PV devices reported in literature in terms of their scope,characteristic designs,performances,and other technical considerations have been summarised.
基金J.H.Tabibian was supported in part by the United States National Center for Advancing Translational Sciences grant UL1 TR000135.
文摘Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance characteristics.We aimed to identify noninvasive independent predictors of endoscopic retrograde cholangiopancreatography(ERCP)-confirmed choledocholithiasis and accordingly developed predictive machine learning models(MLMs).Methods:Clinical data of consecutive patients undergoing first-ever ERCP for suspected chol-edocholithiasis from 2015 to 2019 were abstracted from a prospectively-maintained database.Multiple logistic regression was used to identify predictors of ERCP-confirmed choledocholithiasis.MLMs were then trained to predict ERCP-confirmed choledocholithiasis using pre-ERCP ultrasound(US)imaging only as well as using all available noninvasive imaging(US,computed tomography,and/or magnetic reso-nance cholangiopancreatography).The diagnostic performance of American Society for Gastrointestinal Endoscopy(ASGE)“high-likelihood”criteria was compared to MLMs.Results:We identified 270 patients(mean age 46 years,62.2%female,73.7%Hispanic/Latino,59%with noninvasive imaging positive for choledocholithiasis)with native papilla who underwent ERCP for suspected choledocholithiasis,of whom 230(85.2%)were found to have ERCP-confirmed chol-edocholithiasis.Logistic regression identified choledocholithiasis on noninvasive imaging(odds ratio(OR)¼3.045,P¼0.004)and common bile duct(CBD)diameter on noninvasive imaging(OR¼1.157,P¼0.011)as predictors of ERCP-confirmed choledocholithiasis.Among the various MLMs trained,the random forest-based MLM performed best;sensitivity was 61.4%and 77.3%and specificity was 100%and 75.0%,using US-only and using all available imaging,respectively.ASGE high-likelihood criteria demonstrated sensitivity of 90.9%and specificity of 25.0%;using cut-points achieving this specificity,MLMs achieved sensitivity up to 97.7%.Conclusions:MLMs using age,sex,race/ethnicity,presence of diabetes,fever,body mass index(BMI),total bilirubin,maximum CBD diameter,and choledocholithiasis on pre-ER
文摘The present paper reports the unusual enhancement of endurance life of ball bearings subjected to carbonitriding treatment. The microstructure was characterized by scanning electron microscopy and correlated with hardness and X-ray diffraction analysis. Endurance tests at 90% reliability revealed that the carbonitrided bearings exhibit nearly ten times more life than the non-carbonitrided bearings. This is attributed to synergic combination of retained austenitic, fine martensitic microstructure and ultrafine carbide precipitates obtained by carbonitriding treatment.
基金This research was financially supported by Vellore Institute of Technology Research Grants for Engineering,Management,and Science(VITRGEMS)The authors thank DST-FIST for the XRD and SEM/EDX characterization.Also thankful to CAMPT-VIT for Mechanical testing.
文摘In the current work,forsterite samples with different surface area were investigated for its antibacterial activity.Dissolution studies show that the lower degradation of forsterite compared to other silicate bioceramics,which is a desirable property for repairing bone defects.Forsterite scaffold shows superior compressive strength than the cortical bone after immersion in simulated body fluid.Bactericidal tests indicate that the forsterite had inhibition effect on the growth of clinical bacterial isolates.Forsterite may be a suitable candidate material for load bearing applications with enhanced mechanical properties and lower degradation rate.
基金the University Malaysia Pahang for the financial aid providing the grants(Nos.RDU 213308 and RDU 192207).
文摘Two-dimensional(2D)MXenes have emerged as an archetypical layered material combining the properties of an organic-inorganic hybrid offering materials sustainability for a range of applications.Their surface functional groups and the associated chemical properties'tailorability through functionalizing MXenes with other materials as well as hydrophilicity and high conductivity enable them to be the best successor for various applications in textile industries,especially in the advancement of smart textiles and remediation of textile wastewater.MXene-based textile composite performs superb smartness in high-performance wearables as well as in the reduction of textile dyes from wastewater.This article critically reviews the significance of MXenes in two sectors of the textile industry.Firstly,we review the improvement of textile raw materials such as fiber,yarn,and fabric by using MXene as electrodes in supercapacitors,pressure sensors.Secondly,we review advancements in the removal of dyes from textile wastewater utilizing MXene as an absorbent by the adsorption process.MXene-based textiles demonstrated superior strength through the strong bonding between MXene and textile structures as well as the treatment of adsorbate by adsorbent(MXene in the adsorption process).We identify critical gaps for further research to enable their real-life applications.
基金Supported by The Health Research Council of New Zealand
文摘AIM: To prospectively determine the safety and tolerability of oral L-selenomethionine(SLM) with concurrent chemoradiation(CCRT) for Stage Ⅲ non-small cell lung cancer(NSCLC) and estimate if the incidence and/or severity of adverse events could be reduced by its use.METHODS: Sixteen patients with stage Ⅲ NSCLC were accrued to this single arm, phase Ⅱ study. CCRT consisted of radiation given at 2 Gy per fraction for 30-33 fractions, 5 d per week with concurrent weekly Ⅳ paclitaxel 50 mg/m2 followed by carboplatin dosed at an area under the time-concentration curve of 2. SLM was dosed in a loading phase at 4800 μg twice daily for one week prior to CCRT followed by once daily dosing during treatment. RESULTS: No selenium-related toxicity was observed. Analysis revealed grade 3 or higher esophagitis in 3 of 16 patients(19%), pneumonitis in 0, leukopenia in 2(12.5%), and anemia in 1(6%); the latter two were significantly reduced when compared to the protocolstated expected rate of 35%(P = 0.045 for leukopenia, and P < 0.01 for anemia). Median overall survival was 14.9 mo and median failure-free survival was 9 mo(95%CI: 3.3-21.5).CONCLUSION: There may be some protective benefit of selenium in the setting of CCRT for inoperable NSCLC. The data suggests decreased rates of myelosuppression when compared to similarly-treated historical and contemporary controls. Further evaluation of selenium in this setting may be warranted.
