Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic ...Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.展开更多
The application of heterosis is a promising approach for greatly increasing yield in soybean(Glycine max L.). Nuclear male sterility is essential for hybrid seed production and the utilization of heterosis. Here we re...The application of heterosis is a promising approach for greatly increasing yield in soybean(Glycine max L.). Nuclear male sterility is essential for hybrid seed production and the utilization of heterosis. Here we report the cloning of the gene underlying the soybean male-sterile mutant ms-1,which has been widely used for recurrent selection in soybean breeding programs. We initially delimited the ms1 locus to a 16.15 kb region on chromosome13, based on SLAF_BSA sequencing followed by genotyping of an F_(2) population segregating for the locus. Compared with the same region in fertile plants, the mutant region lacks a sequence of approximately 38.7 kb containing five protein-coding genes, including an ortholog of the kinesin-like protein gene NACK2, named Gm Ms1. The Gm Ms1 knockout plants generated via CRISPR/Casmediated gene editing displayed a complete malesterile phenotype. Metabolic profiling showed that fertile anthers accumulated starch and sucrose normally, whereas sterile anthers had higher anthocyanin levels and lower flavonoid levels and lower antioxidant enzyme activities. These results provide insights into the molecular mechanisms governing male sterility and demonstrate that Gm Ms1 could be used to create male-sterile lines through targeted mutagenesis. These findings pave the way for designing seed production technology and an intelligent male-sterile line system to utilize heterosis in soybean.展开更多
AIM: To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas, the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenom...AIM: To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas, the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenomatous polyps. METHODS: In the current double-blind, placebo-controlled trial at this VA Medical Center, patients with colorectal adenomas were randomly assigned to receive either a daily 5 mg dose of folic acid or a matched identical placebo for 3 years. All polyps were removed at baseline colonoscopy and each patient had a follow up colonoscopy at 3 years. The primary endpoint was a reduction in the number of recurrent adenomas at 3 years. RESULTS: Of 137 subjects, who were eligible after confirmation of polyp histology and run-in period to conform compliance, 94 completed the study; 49 in folic acid group and 45 in placebo group. Recurrence of adenomas at 3-year was compared between the two groups. The mean number of recurrent polyps at 3-year was 0.36 (SD, 0.69) for folic acid treated patients compared to 0.82 (SD, 1.17) for placebo treated subjects, resulting in a 3-fold increase in polyp recurrence in the placebo group. Patients below 70 years of age and those with left-sided colonicadenomas or advanced adenomas responded better to folic acid supplementation. CONCLUSION: High dose folic acid supplementation is associated with a signif icant reduction in the recurrence of colonic adenomas suggesting that folic acid may be an effective chemopreventive agent for colorectal neoplasia.展开更多
With high performance liquid chromatography, the concentrations of α-endosulfan, DDE, parathion methyl, isoproturon, atrazine, carbaryl and carbofuran were determined in farmed raised fish Labeo rohita of two weight ...With high performance liquid chromatography, the concentrations of α-endosulfan, DDE, parathion methyl, isoproturon, atrazine, carbaryl and carbofuran were determined in farmed raised fish Labeo rohita of two weight groups. All these pesticide residues were detected in fish meat samples. All these pesticide residues except isoproturon were identified in soil sediments, whereas all these pesticide residues except isoproturon, carbaryl and DDE were also present in water samples. DDT, heptachlor, β-endosulfan, chlorpyrifos, dimethoate, captan, cypermethrin, chlorobromuron and chlorotoluron were absent in all samples of water, sediments and fish flesh. The pesticide residues levels were in order of parathion methyl 〉 DDE 〉 carbofuran 〉 atrazine 〉 α-endosulfan 〉 isoproturan 〉 carbaryl. The concentrations of pesticides were higher in fish weighing 800 -1 300 g than in those weighing 250 -750 g. The DDE was remained highest in sediments, while that was not detected in water samples. The pesticides （endosulfan, parathion methyl, atrazine and carbofuran） had crossed their MRL values （0.001 μg/g） in water samples.展开更多
The liver is the commonest site of metastatic disease for patients with colorectal cancer,with at least 25%developing colorectal liver metastases(CRLM)during the course of their illness.The management of CRLM has evol...The liver is the commonest site of metastatic disease for patients with colorectal cancer,with at least 25%developing colorectal liver metastases(CRLM)during the course of their illness.The management of CRLM has evolved into a complex field requiring input from experienced members of a multi-disciplinary team involving radiology(cross sectional,nuclear medicine and interventional),Oncology,Liver surgery,Colorectal surgery,and Histopathology.Patient management is based on assessment of sophisticated clinical,radiological and biomarker information.Despite incomplete evidence in this very heterogeneous patient group,maximising resection of CRLM using all available techniques remains a key objective and provides the best chance of long-term survival and cure.To this end,liver resection is maximised by the use of downsizing chemotherapy,optimisation of liver remnant by portal vein embolization,associating liver partition and portal vein ligation for staged hepatectomy,and combining resection with ablation,in the context of improvements in the functional assessment of the future remnant liver.Liver resection may safely be carried out laparoscopically or open,and synchronously with,or before,colorectal surgery in selected patients.For unresectable patients,treatment options including systemic chemotherapy,targeted biological agents,intraarterial infusion or bead delivered chemotherapy,tumour ablation,stereotactic radiotherapy,and selective internal radiotherapy contribute to improve survival and may convert initially unresectable patients to operability.Currently evolving areas include biomarker characterisation of tumours,the development of novel systemic agents targeting specific oncogenic pathways,and the potential reemergence of radical surgical options such as liver transplantation.展开更多
Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms an...Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms and respiratory decline were finally explained by the diagnosis of West Nile-encephalitis. During her admission, the isolated peaked T-waves indicated the underlying stress-induced cardiomyopathy. The absence of all other causes of hyperacute T-waves, their subsequent resolution with the resolution of infection and improvement in wall motion abnormalities, further supported the association. This case highlights the importance of considering hyperacute T-waves in an approach towards the diagnosis of WNV-encephalitis related atypical variant of stress-induced cardiomyopathy.展开更多
The effect of cold rolling and post-rolling heat treatment on the microstructural and electrochemical properties of the 316L stainless steel was investigated.Two-pass and four-pass cold-rolled stainless steel specimen...The effect of cold rolling and post-rolling heat treatment on the microstructural and electrochemical properties of the 316L stainless steel was investigated.Two-pass and four-pass cold-rolled stainless steel specimens were heat-treated by annealing at 900℃followed by quenching in water.During the cold rolling,the microstructure of the as-received specimen transformed from austenite to strain-inducedα′-martensite due to significant plastic deformation that also resulted in significant grain elongation(i.e.,~33%and 223%increases in the grain elongation after two and four rolling passes,respectively).The hardness of the heat-treated as-received specimen decreased from HV 190 to 146 due to the recovery and recrystallization of the austenite grain structure.The cyclic polarization scans of the as-rolled and heat-treated specimens were obtained in 0.9wt%NaCl solution.The pitting potential of the four-pass rolled specimen was significantly increased from 322.3 to 930.5 mV after post-rolling heat treatment.The beneficial effect of the heat treatment process was evident from~10-times-lower corrosion current density and two-orders-of-magnitude-lower passive current density of the heat-treated specimens compared with those of the as-rolled specimens.Similarly,appreciably lower corrosion rate(3.302×10^(−4)mm/a)and higher pitting resistance(1115.5 mV)were exhibited by the postrolled heat-treated specimens compared with the as-rolled 316L stainless steel specimens.展开更多
This paper presents a large gathering dataset of images extracted from publicly filmed videos by 24 cameras installed on the premises of Masjid Al-Nabvi,Madinah,Saudi Arabia.This dataset consists of raw and processed ...This paper presents a large gathering dataset of images extracted from publicly filmed videos by 24 cameras installed on the premises of Masjid Al-Nabvi,Madinah,Saudi Arabia.This dataset consists of raw and processed images reflecting a highly challenging and unconstraint environment.The methodology for building the dataset consists of four core phases;that include acquisition of videos,extraction of frames,localization of face regions,and cropping and resizing of detected face regions.The raw images in the dataset consist of a total of 4613 frames obtained fromvideo sequences.The processed images in the dataset consist of the face regions of 250 persons extracted from raw data images to ensure the authenticity of the presented data.The dataset further consists of 8 images corresponding to each of the 250 subjects(persons)for a total of 2000 images.It portrays a highly unconstrained and challenging environment with human faces of varying sizes and pixel quality(resolution).Since the face regions in video sequences are severely degraded due to various unavoidable factors,it can be used as a benchmark to test and evaluate face detection and recognition algorithms for research purposes.We have also gathered and displayed records of the presence of subjects who appear in presented frames;in a temporal context.This can also be used as a temporal benchmark for tracking,finding persons,activity monitoring,and crowd counting in large crowd scenarios.展开更多
Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is th...Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is the leading cause of morbidity and mortality from an infectious disease in developing countries. Pakistan is ranked fifth in the world in terms of tuberculosis high-burden countries. Various pleural fluid parameters have been used to identify the cause of pleural effusion. It has been discovered that tuberculous pleural effusions had a greater alkaline phosphatase (ALP) concentration than transudative effusions. This study used pleural fluid alkaline phosphatase levels to distinguish between tuberculous pleural effusion and malignant pleural effusion because there is little information from tuberculosis-high burden nations like Pakistan. Study Design: A descriptive cross-sectional study conducted at the Jinnah Postgraduate Medical Center in Karachi between October 2016 and October 2017. Material and Methods: The study comprised all patients who were admitted to the department of chest medicine at Jinnah post graduate medical centre (JPMC) of either gender between the ages of 18 and 70 who had exudative lymphocytic pleural effusions lasting two weeks or more included in the study. Non probability consecutive sampling was used to collect data. Patients who have tonsillitis, pharyngitis, pneumonia, asthma, Chronic obstructive pulmonary disease (COPD), or a history of hemoptysis, Bleeding disorders like, platelet function disorder, thrombocytopenia, Liver cirrhosis and Pregnant women were excluded. Parents’ informed consent was obtained after being informed of the study’s protocol, hazards, and advantages. Each patient had their level of pleural fluid alkaline phosphate (PALP) assessed. In order to evaluate the patient’s pleural effusion, a pre-made questionnaire was used. All the collected data were entered into the SPSS 20. An independent sample t-test was used to recognize alkaline phosphate level展开更多
Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery exa...Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery examination pass rate. Methods: This was a cross-sequential study involving 148 surgical candidates (72 UK trainees, 75 non-UK trainees) who had attended our revision course (Phoenix FRCS Course) from June 2017 until 2023. Each course comprised a two-day weekend preparation with dedicated sections for clinical, viva, and academic reading, incorporating SBL as its key learning style. We maintained a prospective database of candidate and course details, examination results, and feedback since the course inception. Results: We found that 97% of candidates passed the FRCS examination after their first attempt. The course was attended once by 89% of candidates, and only 3 of the 148 candidates exhausted all four attempts at the examination. Candidate feedback for the course and its style of learning was positive, with simulation-based table viva sessions and virtual clinical sessions proving the most popular learning sessions (95% and 80% of candidates attending courses run in December 2017, April 2018, and May 2021 rated them “Excellent” respectively). Conclusions: The course is centered around shared adult learning and mindfulness tools to encourage candidates to learn from each other and develop confidence and mastery in all domains of surgical practice. These methods have been shown to be effective in achieving high success rates in the Intercollegiate and International FRCS examinations for UK and overseas surgeons.展开更多
The main goal of informal computing is to overcome the limitations of hypersensitivity to defects and uncertainty while maintaining a balance between high accuracy,accessibility,and cost-effectiveness.This paper inves...The main goal of informal computing is to overcome the limitations of hypersensitivity to defects and uncertainty while maintaining a balance between high accuracy,accessibility,and cost-effectiveness.This paper investigates the potential applications of intuitionistic fuzzy sets(IFS)with rough sets in the context of sparse data.When it comes to capture uncertain information emanating fromboth upper and lower approximations,these intuitionistic fuzzy rough numbers(IFRNs)are superior to intuitionistic fuzzy sets and pythagorean fuzzy sets,respectively.We use rough sets in conjunction with IFSs to develop several fairly aggregation operators and analyze their underlying properties.We present numerous impartial laws that incorporate the idea of proportionate dispersion in order to ensure that the membership and non-membership activities of IFRNs are treated equally within these principles.These operations lead to the development of the intuitionistic fuzzy rough weighted fairly aggregation operator(IFRWFA)and intuitionistic fuzzy rough ordered weighted fairly aggregation operator(IFRFOWA).These operators successfully adjust to membership and non-membership categories with fairness and subtlety.We highlight the unique qualities of these suggested aggregation operators and investigate their use in the multiattribute decision-making field.We use the intuitionistic fuzzy rough environment’s architecture to create a novel strategy in situation involving several decision-makers and non-weighted data.Additionally,we developed a novel technique by combining the IFSs with quaternion numbers.We establish a unique connection between alternatives and qualities by using intuitionistic fuzzy quaternion numbers(IFQNs).With the help of this framework,we can simulate uncertainty in real-world situations and address a number of decision-making problems.Using the examples we have released,we offer a sophisticated and systematically constructed illustrative scenario that is intricately woven with the complexity ofmedical evaluation i展开更多
Wireless technology is transforming the future of transportation through the development of the Internet of Vehicles(IoV).However,intricate security challenges are intertwinedwith technological progress:Vehicular ad h...Wireless technology is transforming the future of transportation through the development of the Internet of Vehicles(IoV).However,intricate security challenges are intertwinedwith technological progress:Vehicular ad hoc Networks(VANETs),a core component of IoV,face security issues,particularly the Black Hole Attack(BHA).This malicious attack disrupts the seamless flow of data and threatens the network’s overall reliability;also,BHA strategically disrupts communication pathways by dropping data packets from legitimate nodes altogether.Recognizing the importance of this challenge,we have introduced a new solution called ad hoc On-Demand Distance Vector-Reputation-based mechanism Local Outlier Factor(AODV-RL).The significance of AODVRL lies in its unique approach:it verifies and confirms the trustworthiness of network components,providing robust protection against BHA.An additional safety layer is established by implementing the Local Outlier Factor(LOF),which detects and addresses abnormal network behaviors.Rigorous testing of our solution has revealed its remarkable ability to enhance communication in VANETs.Specifically,Our experimental results achieve message delivery ratios of up to 94.25%andminimal packet loss ratios of just 0.297%.Based on our experimental results,the proposedmechanismsignificantly improves VANET communication reliability and security.These results promise a more secure and dependable future for IoV,capable of transforming transportation safety and efficiency.展开更多
Today’s forensic science introduces a new research area for digital image analysis formultimedia security.So,Image authentication issues have been raised due to the wide use of image manipulation software to obtain a...Today’s forensic science introduces a new research area for digital image analysis formultimedia security.So,Image authentication issues have been raised due to the wide use of image manipulation software to obtain an illegitimate benefit or createmisleading publicity by using tempered images.Exiting forgery detectionmethods can classify only one of the most widely used Copy-Move and splicing forgeries.However,an image can contain one or more types of forgeries.This study has proposed a hybridmethod for classifying Copy-Move and splicing images using texture information of images in the spatial domain.Firstly,images are divided into equal blocks to get scale-invariant features.Weber law has been used for getting texture features,and finally,XGBOOST is used to classify both Copy-Move and splicing forgery.The proposed method classified three types of forgeries,i.e.,splicing,Copy-Move,and healthy.Benchmarked(CASIA 2.0,MICCF200)and RCMFD datasets are used for training and testing.On average,the proposed method achieved 97.3% accuracy on benchmarked datasets and 98.3% on RCMFD datasets by applying 10-fold cross-validation,which is far better than existing methods.展开更多
The application of extracellular vesicles,particularly exosomes(EXs),is rapidly expanding in the field of medicine,owing to their remarkable properties as natural carriers of biological cargo.This study investigates u...The application of extracellular vesicles,particularly exosomes(EXs),is rapidly expanding in the field of medicine,owing to their remarkable properties as natural carriers of biological cargo.This study investigates utilization of exosomes derived from stromal cells of tumor adjacent normal tissues(NAF-EXs)for personalized medicine,which can be derived at the time of diagnosis by endoscopic ultrasound.Herein,we show that exosomes(EXs)derived from NAFs demonstrate differential bio-physical characteristics,efficient cellular internalization,drug loading efficiency,pancreatic tumor targeting and delivery of payloads.NAF-derived EXs(NAF-EXs)were used for loading ormeloxifene(ORM),a potent anti-cancer and desmoplasia inhibitor as a model drug.We found that ORM maintains normal fibroblast cell phenotype and renders them incompatible to be triggered for a CAF-like phenotype,which may be due to regulation of Ca^(2+) influx in fibroblast cells.NAF-EXs-ORM effectively blocked oncogenic signaling pathways involved in desmoplasia and epithelial mesenchymal transition(EMT)and repressed tumor growth in xenograft mouse model.In conclusion,our data suggests preferential tropism of NAF-EXs for PDAC tumors,thus imply feasibility of developing a novel personalized medicine for PDAC patients using autologous NAF-EXs for improved therapeutic outcome of anti-cancer drugs.Additionally,it provides the opportunity of utilizing this biological scaffold for effective therapeutics in combination with standard therapeutic regimen.展开更多
Hollow spheres of Co0.85Se con structed by two-dime nsional(2D)mesoporous ultrathi nnanosheets were synthesized via simple and costeffective approach.Their bifunctional electrocatalytic-supercapacitive properties were...Hollow spheres of Co0.85Se con structed by two-dime nsional(2D)mesoporous ultrathi nnanosheets were synthesized via simple and costeffective approach.Their bifunctional electrocatalytic-supercapacitive properties were obtained simultaneously due to synergistic effects betweenmacroscopic morphological features and microscopic atomic/electronic structure of Co0.85Se.The as-synthesized hollow spheres of Co0.85Sethat are con structed by 2D mesoporous ultrathin nanosheets exhibit in spiring electrochemical performance for supercapacitor,presenting maximum energy density at high power density(54.66 Wh·kg^-1 at 1.6 kW·kg^-1)and long cycle stability(88%retention after 8,000 cycles).Atthe same time,the hollow spheres of Co0.85Se constructed by 2D mesoporous ultrathin nanosheets display excellent catalytic performaneefor oxygen evolution reaction(OER)due to special structure,high surface area and mesoporous nature of sheets,which achieve lowoverpotential(290 mV at 10 mA·g^-1)and low Tafel slope(81 mV·dec^-1)for Iong-term operation(only 7.8%decay in current density after 9 h).It could be envisioned that the proposed simple approach will pave a new way to synthesize other metal chalcoge nides for energy conversionand storage technology.展开更多
Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admit...Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.展开更多
Various organizations store data online rather than on physical servers.As the number of user’s data stored in cloud servers increases,the attack rate to access data from cloud servers also increases.Different resear...Various organizations store data online rather than on physical servers.As the number of user’s data stored in cloud servers increases,the attack rate to access data from cloud servers also increases.Different researchers worked on different algorithms to protect cloud data from replay attacks.None of the papers used a technique that simultaneously detects a full-message and partial-message replay attack.This study presents the development of a TKN(Text,Key and Name)cryptographic algorithm aimed at protecting data from replay attacks.The program employs distinct ways to encrypt plain text[P],a user-defined Key[K],and a Secret Code[N].The novelty of the TKN cryptographic algorithm is that the bit value of each text is linked to another value with the help of the proposed algorithm,and the length of the cipher text obtained is twice the length of the original text.In the scenario that an attacker executes a replay attack on the cloud server,engages in cryptanalysis,or manipulates any data,it will result in automated modification of all associated values inside the backend.This mechanism has the benefit of enhancing the detectability of replay attacks.Nevertheless,the attacker cannot access data not included in any of the papers,regardless of how effective the attack strategy is.At the end of paper,the proposed algorithm’s novelty will be compared with different algorithms,and it will be discussed how far the proposed algorithm is better than all other algorithms.展开更多
Objective:To investigate the detection and sequencing of plasmid encoded tetracycline resistance genes(tet A and tet B) from food-borne and standard strains of Bacillus cereus(B. cereus).Methods:PCR was carried out to...Objective:To investigate the detection and sequencing of plasmid encoded tetracycline resistance genes(tet A and tet B) from food-borne and standard strains of Bacillus cereus(B. cereus).Methods:PCR was carried out to detect the tetracycline resistance genes(tet A and tet B) in food-borne B.cereus strains and the amplified products were sequenced.Results:The phenotypic resistance against tetracycline was observed in 39 of the 118 food-borne isolates and two reference strains(MTCC 430 and MTCC 1307) of B.cereus.Among the phenotypically resistant isolates,tet A was detected in 36 food-borne isolates and two reference strains(MTCC 430 and MTCC 1307).whereas,tel B was detected in 12 food-bome isolates and MTCC 1307 strain. Conclusions:A close association was therefore found between phenotypic resistance against tetracycline and presence of tetracycline resistance genes.The tet A and tet B gene fragments were amplified,purified and sequenced.The gene sequences of the isolates studied herein were found similar to tetA and tetB gene sequences of other bacteria available in NCBI.The occurrence of tetA and tetB genes in B.cereus indicate the horizontal transfer of antibiotic resistance determinants from other bacteria into B.cereus.The transfer of these resistant determinants to other potentially pathogenic bacteria may be a matter of great concern.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related complications.AIM To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning Frailty.METHODS This is a cohort study using the 2018-2020 National Readmission Database.Patients aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical modification.Johns Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and non-frail.The primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to ERCP.We used univariate and multivariate regression models for analysis.RESULTS A total of 9448 patients were admitted for any indications of ERCP.Frail and non-frail patients were 3445(36.46%)and 6003(63.53%)respectively.Indications for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared to non-frail.Larger studies are warrant展开更多
This work is concerned with the analysis of blood flow through inclined catheterized arteries having a balloon(angioplasty) with time-variant overlapping stenosis. The nature of blood in small arteries is analyzed mat...This work is concerned with the analysis of blood flow through inclined catheterized arteries having a balloon(angioplasty) with time-variant overlapping stenosis. The nature of blood in small arteries is analyzed mathematically by considering it as a Carreau nanofluid. The highly nonlinear momentum equations of nanofluid model are simplified by considering the mild stenosis case. The formulated problem is solved by a homotopy perturbation expansion in terms of a variant of the Weissenberg number to obtain explicit forms for the axial velocity, the stream function, the pressure gradient, the resistance impedance and the wall shear stress distribution. These solutions depend on the Brownian motion number, thermophoresis number, local temperature Grashof number G_r and local nanoparticle Grash of number B_r. The results were also studied for various values of the physical parameters, such as the Weissenberg number W_i, the power law index n, the taper angle φ, the maximum height of stenosis δ~*, the angle of inclination α, the maximum height of balloon σ~*, the axial displacement of the balloon z_d~*,the flow rate F and the Froud number Fr. The obtained results show that the transmission of axial velocity curves through a Newtonian fluid(Wi=0, n=1, Gr=0, Br=0, Nt=0, Nb≠0) is substantially lower than that through a Carreau nanofluid near the wall of balloon while the inverse occurs in the region between the balloon and stenosis. The streamlines have a clearly distinguished shifting toward the stenotic region and this shifting appears near the wall of the balloon, while it has almost disappeared near the stenotic wall and the trapping bolus in the case of horizontal arteries and Newtonian fluid(Wi=0, n=1, Gr=0, Br=0, Nt=0, Nb≠0) does not appear but for the case of Carreau nanofluid bolus appears.展开更多
文摘Since the first report of use of endoscopy in children in the 1970 s, there has seen an exponential growthin published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.
基金supported by the National Key Research and Development Program of China(2016YFD0100201)the National Natural Science Foundation of China(31771819)+1 种基金the National Natural Science Foundation of Anhui Province,China(1908085QC105)the Research Fundsfor Academic and Technological Leaders and Reserve Candidates in Anhui Province(RC312005)。
文摘The application of heterosis is a promising approach for greatly increasing yield in soybean(Glycine max L.). Nuclear male sterility is essential for hybrid seed production and the utilization of heterosis. Here we report the cloning of the gene underlying the soybean male-sterile mutant ms-1,which has been widely used for recurrent selection in soybean breeding programs. We initially delimited the ms1 locus to a 16.15 kb region on chromosome13, based on SLAF_BSA sequencing followed by genotyping of an F_(2) population segregating for the locus. Compared with the same region in fertile plants, the mutant region lacks a sequence of approximately 38.7 kb containing five protein-coding genes, including an ortholog of the kinesin-like protein gene NACK2, named Gm Ms1. The Gm Ms1 knockout plants generated via CRISPR/Casmediated gene editing displayed a complete malesterile phenotype. Metabolic profiling showed that fertile anthers accumulated starch and sucrose normally, whereas sterile anthers had higher anthocyanin levels and lower flavonoid levels and lower antioxidant enzyme activities. These results provide insights into the molecular mechanisms governing male sterility and demonstrate that Gm Ms1 could be used to create male-sterile lines through targeted mutagenesis. These findings pave the way for designing seed production technology and an intelligent male-sterile line system to utilize heterosis in soybean.
文摘AIM: To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas, the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenomatous polyps. METHODS: In the current double-blind, placebo-controlled trial at this VA Medical Center, patients with colorectal adenomas were randomly assigned to receive either a daily 5 mg dose of folic acid or a matched identical placebo for 3 years. All polyps were removed at baseline colonoscopy and each patient had a follow up colonoscopy at 3 years. The primary endpoint was a reduction in the number of recurrent adenomas at 3 years. RESULTS: Of 137 subjects, who were eligible after confirmation of polyp histology and run-in period to conform compliance, 94 completed the study; 49 in folic acid group and 45 in placebo group. Recurrence of adenomas at 3-year was compared between the two groups. The mean number of recurrent polyps at 3-year was 0.36 (SD, 0.69) for folic acid treated patients compared to 0.82 (SD, 1.17) for placebo treated subjects, resulting in a 3-fold increase in polyp recurrence in the placebo group. Patients below 70 years of age and those with left-sided colonicadenomas or advanced adenomas responded better to folic acid supplementation. CONCLUSION: High dose folic acid supplementation is associated with a signif icant reduction in the recurrence of colonic adenomas suggesting that folic acid may be an effective chemopreventive agent for colorectal neoplasia.
文摘With high performance liquid chromatography, the concentrations of α-endosulfan, DDE, parathion methyl, isoproturon, atrazine, carbaryl and carbofuran were determined in farmed raised fish Labeo rohita of two weight groups. All these pesticide residues were detected in fish meat samples. All these pesticide residues except isoproturon were identified in soil sediments, whereas all these pesticide residues except isoproturon, carbaryl and DDE were also present in water samples. DDT, heptachlor, β-endosulfan, chlorpyrifos, dimethoate, captan, cypermethrin, chlorobromuron and chlorotoluron were absent in all samples of water, sediments and fish flesh. The pesticide residues levels were in order of parathion methyl 〉 DDE 〉 carbofuran 〉 atrazine 〉 α-endosulfan 〉 isoproturan 〉 carbaryl. The concentrations of pesticides were higher in fish weighing 800 -1 300 g than in those weighing 250 -750 g. The DDE was remained highest in sediments, while that was not detected in water samples. The pesticides （endosulfan, parathion methyl, atrazine and carbofuran） had crossed their MRL values （0.001 μg/g） in water samples.
文摘The liver is the commonest site of metastatic disease for patients with colorectal cancer,with at least 25%developing colorectal liver metastases(CRLM)during the course of their illness.The management of CRLM has evolved into a complex field requiring input from experienced members of a multi-disciplinary team involving radiology(cross sectional,nuclear medicine and interventional),Oncology,Liver surgery,Colorectal surgery,and Histopathology.Patient management is based on assessment of sophisticated clinical,radiological and biomarker information.Despite incomplete evidence in this very heterogeneous patient group,maximising resection of CRLM using all available techniques remains a key objective and provides the best chance of long-term survival and cure.To this end,liver resection is maximised by the use of downsizing chemotherapy,optimisation of liver remnant by portal vein embolization,associating liver partition and portal vein ligation for staged hepatectomy,and combining resection with ablation,in the context of improvements in the functional assessment of the future remnant liver.Liver resection may safely be carried out laparoscopically or open,and synchronously with,or before,colorectal surgery in selected patients.For unresectable patients,treatment options including systemic chemotherapy,targeted biological agents,intraarterial infusion or bead delivered chemotherapy,tumour ablation,stereotactic radiotherapy,and selective internal radiotherapy contribute to improve survival and may convert initially unresectable patients to operability.Currently evolving areas include biomarker characterisation of tumours,the development of novel systemic agents targeting specific oncogenic pathways,and the potential reemergence of radical surgical options such as liver transplantation.
文摘Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms and respiratory decline were finally explained by the diagnosis of West Nile-encephalitis. During her admission, the isolated peaked T-waves indicated the underlying stress-induced cardiomyopathy. The absence of all other causes of hyperacute T-waves, their subsequent resolution with the resolution of infection and improvement in wall motion abnormalities, further supported the association. This case highlights the importance of considering hyperacute T-waves in an approach towards the diagnosis of WNV-encephalitis related atypical variant of stress-induced cardiomyopathy.
文摘The effect of cold rolling and post-rolling heat treatment on the microstructural and electrochemical properties of the 316L stainless steel was investigated.Two-pass and four-pass cold-rolled stainless steel specimens were heat-treated by annealing at 900℃followed by quenching in water.During the cold rolling,the microstructure of the as-received specimen transformed from austenite to strain-inducedα′-martensite due to significant plastic deformation that also resulted in significant grain elongation(i.e.,~33%and 223%increases in the grain elongation after two and four rolling passes,respectively).The hardness of the heat-treated as-received specimen decreased from HV 190 to 146 due to the recovery and recrystallization of the austenite grain structure.The cyclic polarization scans of the as-rolled and heat-treated specimens were obtained in 0.9wt%NaCl solution.The pitting potential of the four-pass rolled specimen was significantly increased from 322.3 to 930.5 mV after post-rolling heat treatment.The beneficial effect of the heat treatment process was evident from~10-times-lower corrosion current density and two-orders-of-magnitude-lower passive current density of the heat-treated specimens compared with those of the as-rolled specimens.Similarly,appreciably lower corrosion rate(3.302×10^(−4)mm/a)and higher pitting resistance(1115.5 mV)were exhibited by the postrolled heat-treated specimens compared with the as-rolled 316L stainless steel specimens.
基金This research was supported by the Deanship of Scientific Research,Islamic University of Madinah,Madinah(KSA),under Tammayuz program Grant Number 1442/505.
文摘This paper presents a large gathering dataset of images extracted from publicly filmed videos by 24 cameras installed on the premises of Masjid Al-Nabvi,Madinah,Saudi Arabia.This dataset consists of raw and processed images reflecting a highly challenging and unconstraint environment.The methodology for building the dataset consists of four core phases;that include acquisition of videos,extraction of frames,localization of face regions,and cropping and resizing of detected face regions.The raw images in the dataset consist of a total of 4613 frames obtained fromvideo sequences.The processed images in the dataset consist of the face regions of 250 persons extracted from raw data images to ensure the authenticity of the presented data.The dataset further consists of 8 images corresponding to each of the 250 subjects(persons)for a total of 2000 images.It portrays a highly unconstrained and challenging environment with human faces of varying sizes and pixel quality(resolution).Since the face regions in video sequences are severely degraded due to various unavoidable factors,it can be used as a benchmark to test and evaluate face detection and recognition algorithms for research purposes.We have also gathered and displayed records of the presence of subjects who appear in presented frames;in a temporal context.This can also be used as a temporal benchmark for tracking,finding persons,activity monitoring,and crowd counting in large crowd scenarios.
文摘Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is the leading cause of morbidity and mortality from an infectious disease in developing countries. Pakistan is ranked fifth in the world in terms of tuberculosis high-burden countries. Various pleural fluid parameters have been used to identify the cause of pleural effusion. It has been discovered that tuberculous pleural effusions had a greater alkaline phosphatase (ALP) concentration than transudative effusions. This study used pleural fluid alkaline phosphatase levels to distinguish between tuberculous pleural effusion and malignant pleural effusion because there is little information from tuberculosis-high burden nations like Pakistan. Study Design: A descriptive cross-sectional study conducted at the Jinnah Postgraduate Medical Center in Karachi between October 2016 and October 2017. Material and Methods: The study comprised all patients who were admitted to the department of chest medicine at Jinnah post graduate medical centre (JPMC) of either gender between the ages of 18 and 70 who had exudative lymphocytic pleural effusions lasting two weeks or more included in the study. Non probability consecutive sampling was used to collect data. Patients who have tonsillitis, pharyngitis, pneumonia, asthma, Chronic obstructive pulmonary disease (COPD), or a history of hemoptysis, Bleeding disorders like, platelet function disorder, thrombocytopenia, Liver cirrhosis and Pregnant women were excluded. Parents’ informed consent was obtained after being informed of the study’s protocol, hazards, and advantages. Each patient had their level of pleural fluid alkaline phosphate (PALP) assessed. In order to evaluate the patient’s pleural effusion, a pre-made questionnaire was used. All the collected data were entered into the SPSS 20. An independent sample t-test was used to recognize alkaline phosphate level
文摘Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery examination pass rate. Methods: This was a cross-sequential study involving 148 surgical candidates (72 UK trainees, 75 non-UK trainees) who had attended our revision course (Phoenix FRCS Course) from June 2017 until 2023. Each course comprised a two-day weekend preparation with dedicated sections for clinical, viva, and academic reading, incorporating SBL as its key learning style. We maintained a prospective database of candidate and course details, examination results, and feedback since the course inception. Results: We found that 97% of candidates passed the FRCS examination after their first attempt. The course was attended once by 89% of candidates, and only 3 of the 148 candidates exhausted all four attempts at the examination. Candidate feedback for the course and its style of learning was positive, with simulation-based table viva sessions and virtual clinical sessions proving the most popular learning sessions (95% and 80% of candidates attending courses run in December 2017, April 2018, and May 2021 rated them “Excellent” respectively). Conclusions: The course is centered around shared adult learning and mindfulness tools to encourage candidates to learn from each other and develop confidence and mastery in all domains of surgical practice. These methods have been shown to be effective in achieving high success rates in the Intercollegiate and International FRCS examinations for UK and overseas surgeons.
基金funded by King Khalid University through a large group research project under Grant Number R.G.P.2/449/44.
文摘The main goal of informal computing is to overcome the limitations of hypersensitivity to defects and uncertainty while maintaining a balance between high accuracy,accessibility,and cost-effectiveness.This paper investigates the potential applications of intuitionistic fuzzy sets(IFS)with rough sets in the context of sparse data.When it comes to capture uncertain information emanating fromboth upper and lower approximations,these intuitionistic fuzzy rough numbers(IFRNs)are superior to intuitionistic fuzzy sets and pythagorean fuzzy sets,respectively.We use rough sets in conjunction with IFSs to develop several fairly aggregation operators and analyze their underlying properties.We present numerous impartial laws that incorporate the idea of proportionate dispersion in order to ensure that the membership and non-membership activities of IFRNs are treated equally within these principles.These operations lead to the development of the intuitionistic fuzzy rough weighted fairly aggregation operator(IFRWFA)and intuitionistic fuzzy rough ordered weighted fairly aggregation operator(IFRFOWA).These operators successfully adjust to membership and non-membership categories with fairness and subtlety.We highlight the unique qualities of these suggested aggregation operators and investigate their use in the multiattribute decision-making field.We use the intuitionistic fuzzy rough environment’s architecture to create a novel strategy in situation involving several decision-makers and non-weighted data.Additionally,we developed a novel technique by combining the IFSs with quaternion numbers.We establish a unique connection between alternatives and qualities by using intuitionistic fuzzy quaternion numbers(IFQNs).With the help of this framework,we can simulate uncertainty in real-world situations and address a number of decision-making problems.Using the examples we have released,we offer a sophisticated and systematically constructed illustrative scenario that is intricately woven with the complexity ofmedical evaluation i
文摘Wireless technology is transforming the future of transportation through the development of the Internet of Vehicles(IoV).However,intricate security challenges are intertwinedwith technological progress:Vehicular ad hoc Networks(VANETs),a core component of IoV,face security issues,particularly the Black Hole Attack(BHA).This malicious attack disrupts the seamless flow of data and threatens the network’s overall reliability;also,BHA strategically disrupts communication pathways by dropping data packets from legitimate nodes altogether.Recognizing the importance of this challenge,we have introduced a new solution called ad hoc On-Demand Distance Vector-Reputation-based mechanism Local Outlier Factor(AODV-RL).The significance of AODVRL lies in its unique approach:it verifies and confirms the trustworthiness of network components,providing robust protection against BHA.An additional safety layer is established by implementing the Local Outlier Factor(LOF),which detects and addresses abnormal network behaviors.Rigorous testing of our solution has revealed its remarkable ability to enhance communication in VANETs.Specifically,Our experimental results achieve message delivery ratios of up to 94.25%andminimal packet loss ratios of just 0.297%.Based on our experimental results,the proposedmechanismsignificantly improves VANET communication reliability and security.These results promise a more secure and dependable future for IoV,capable of transforming transportation safety and efficiency.
基金funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2024R236),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘Today’s forensic science introduces a new research area for digital image analysis formultimedia security.So,Image authentication issues have been raised due to the wide use of image manipulation software to obtain an illegitimate benefit or createmisleading publicity by using tempered images.Exiting forgery detectionmethods can classify only one of the most widely used Copy-Move and splicing forgeries.However,an image can contain one or more types of forgeries.This study has proposed a hybridmethod for classifying Copy-Move and splicing images using texture information of images in the spatial domain.Firstly,images are divided into equal blocks to get scale-invariant features.Weber law has been used for getting texture features,and finally,XGBOOST is used to classify both Copy-Move and splicing forgery.The proposed method classified three types of forgeries,i.e.,splicing,Copy-Move,and healthy.Benchmarked(CASIA 2.0,MICCF200)and RCMFD datasets are used for training and testing.On average,the proposed method achieved 97.3% accuracy on benchmarked datasets and 98.3% on RCMFD datasets by applying 10-fold cross-validation,which is far better than existing methods.
基金UTRGV School of medicine start up,CPRIT TREC Award RP230419 and Integrated Cancer Research Core(ICRC)-RP210180Herb Kosten foundation for pancreatic cancer researchNational Institutes of Health grants R01CA206069,SC1GM139727,SC2GM139715,R01CA210192 and R01CA204552.
文摘The application of extracellular vesicles,particularly exosomes(EXs),is rapidly expanding in the field of medicine,owing to their remarkable properties as natural carriers of biological cargo.This study investigates utilization of exosomes derived from stromal cells of tumor adjacent normal tissues(NAF-EXs)for personalized medicine,which can be derived at the time of diagnosis by endoscopic ultrasound.Herein,we show that exosomes(EXs)derived from NAFs demonstrate differential bio-physical characteristics,efficient cellular internalization,drug loading efficiency,pancreatic tumor targeting and delivery of payloads.NAF-derived EXs(NAF-EXs)were used for loading ormeloxifene(ORM),a potent anti-cancer and desmoplasia inhibitor as a model drug.We found that ORM maintains normal fibroblast cell phenotype and renders them incompatible to be triggered for a CAF-like phenotype,which may be due to regulation of Ca^(2+) influx in fibroblast cells.NAF-EXs-ORM effectively blocked oncogenic signaling pathways involved in desmoplasia and epithelial mesenchymal transition(EMT)and repressed tumor growth in xenograft mouse model.In conclusion,our data suggests preferential tropism of NAF-EXs for PDAC tumors,thus imply feasibility of developing a novel personalized medicine for PDAC patients using autologous NAF-EXs for improved therapeutic outcome of anti-cancer drugs.Additionally,it provides the opportunity of utilizing this biological scaffold for effective therapeutics in combination with standard therapeutic regimen.
基金This research is financially supported by the Academy of Sciences large apparatus United Fund(No.U1832187)the National Natural Science Foundation of China(No.21471091)+4 种基金the 111 project(No.B12015)Shenzhen Science and Technology Research and Development Funds(No.JCYJ20170818104441521)the Natural Science Foundation of Shandong Province(Nos.R2019MEM030 and 2017CXGC0503)the Fundamental Research Funds of Shandong University(No.2018JC022)the Taishan Scholar Project of Shandong Province(No.ts2015U004).
文摘Hollow spheres of Co0.85Se con structed by two-dime nsional(2D)mesoporous ultrathi nnanosheets were synthesized via simple and costeffective approach.Their bifunctional electrocatalytic-supercapacitive properties were obtained simultaneously due to synergistic effects betweenmacroscopic morphological features and microscopic atomic/electronic structure of Co0.85Se.The as-synthesized hollow spheres of Co0.85Sethat are con structed by 2D mesoporous ultrathin nanosheets exhibit in spiring electrochemical performance for supercapacitor,presenting maximum energy density at high power density(54.66 Wh·kg^-1 at 1.6 kW·kg^-1)and long cycle stability(88%retention after 8,000 cycles).Atthe same time,the hollow spheres of Co0.85Se constructed by 2D mesoporous ultrathin nanosheets display excellent catalytic performaneefor oxygen evolution reaction(OER)due to special structure,high surface area and mesoporous nature of sheets,which achieve lowoverpotential(290 mV at 10 mA·g^-1)and low Tafel slope(81 mV·dec^-1)for Iong-term operation(only 7.8%decay in current density after 9 h).It could be envisioned that the proposed simple approach will pave a new way to synthesize other metal chalcoge nides for energy conversionand storage technology.
文摘Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.
基金Deanship of Scientific Research at Majmaah University for supporting this work under Project Number R-2023-811.
文摘Various organizations store data online rather than on physical servers.As the number of user’s data stored in cloud servers increases,the attack rate to access data from cloud servers also increases.Different researchers worked on different algorithms to protect cloud data from replay attacks.None of the papers used a technique that simultaneously detects a full-message and partial-message replay attack.This study presents the development of a TKN(Text,Key and Name)cryptographic algorithm aimed at protecting data from replay attacks.The program employs distinct ways to encrypt plain text[P],a user-defined Key[K],and a Secret Code[N].The novelty of the TKN cryptographic algorithm is that the bit value of each text is linked to another value with the help of the proposed algorithm,and the length of the cipher text obtained is twice the length of the original text.In the scenario that an attacker executes a replay attack on the cloud server,engages in cryptanalysis,or manipulates any data,it will result in automated modification of all associated values inside the backend.This mechanism has the benefit of enhancing the detectability of replay attacks.Nevertheless,the attacker cannot access data not included in any of the papers,regardless of how effective the attack strategy is.At the end of paper,the proposed algorithm’s novelty will be compared with different algorithms,and it will be discussed how far the proposed algorithm is better than all other algorithms.
基金Head of Departments of Veterinary Public Health and Animal Biotechology of Guru Angad Dev Veterinary and Animal Sciences University,Ludhiana(India) for providing all the necessary facilities and funds to make this research successfulHead of Departments of Veterinary Public Health (SKUSAT-K) for providing the reference strain of B.cereus(NCTC11143)
文摘Objective:To investigate the detection and sequencing of plasmid encoded tetracycline resistance genes(tet A and tet B) from food-borne and standard strains of Bacillus cereus(B. cereus).Methods:PCR was carried out to detect the tetracycline resistance genes(tet A and tet B) in food-borne B.cereus strains and the amplified products were sequenced.Results:The phenotypic resistance against tetracycline was observed in 39 of the 118 food-borne isolates and two reference strains(MTCC 430 and MTCC 1307) of B.cereus.Among the phenotypically resistant isolates,tet A was detected in 36 food-borne isolates and two reference strains(MTCC 430 and MTCC 1307).whereas,tel B was detected in 12 food-bome isolates and MTCC 1307 strain. Conclusions:A close association was therefore found between phenotypic resistance against tetracycline and presence of tetracycline resistance genes.The tet A and tet B gene fragments were amplified,purified and sequenced.The gene sequences of the isolates studied herein were found similar to tetA and tetB gene sequences of other bacteria available in NCBI.The occurrence of tetA and tetB genes in B.cereus indicate the horizontal transfer of antibiotic resistance determinants from other bacteria into B.cereus.The transfer of these resistant determinants to other potentially pathogenic bacteria may be a matter of great concern.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related complications.AIM To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning Frailty.METHODS This is a cohort study using the 2018-2020 National Readmission Database.Patients aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical modification.Johns Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and non-frail.The primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to ERCP.We used univariate and multivariate regression models for analysis.RESULTS A total of 9448 patients were admitted for any indications of ERCP.Frail and non-frail patients were 3445(36.46%)and 6003(63.53%)respectively.Indications for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared to non-frail.Larger studies are warrant
文摘This work is concerned with the analysis of blood flow through inclined catheterized arteries having a balloon(angioplasty) with time-variant overlapping stenosis. The nature of blood in small arteries is analyzed mathematically by considering it as a Carreau nanofluid. The highly nonlinear momentum equations of nanofluid model are simplified by considering the mild stenosis case. The formulated problem is solved by a homotopy perturbation expansion in terms of a variant of the Weissenberg number to obtain explicit forms for the axial velocity, the stream function, the pressure gradient, the resistance impedance and the wall shear stress distribution. These solutions depend on the Brownian motion number, thermophoresis number, local temperature Grashof number G_r and local nanoparticle Grash of number B_r. The results were also studied for various values of the physical parameters, such as the Weissenberg number W_i, the power law index n, the taper angle φ, the maximum height of stenosis δ~*, the angle of inclination α, the maximum height of balloon σ~*, the axial displacement of the balloon z_d~*,the flow rate F and the Froud number Fr. The obtained results show that the transmission of axial velocity curves through a Newtonian fluid(Wi=0, n=1, Gr=0, Br=0, Nt=0, Nb≠0) is substantially lower than that through a Carreau nanofluid near the wall of balloon while the inverse occurs in the region between the balloon and stenosis. The streamlines have a clearly distinguished shifting toward the stenotic region and this shifting appears near the wall of the balloon, while it has almost disappeared near the stenotic wall and the trapping bolus in the case of horizontal arteries and Newtonian fluid(Wi=0, n=1, Gr=0, Br=0, Nt=0, Nb≠0) does not appear but for the case of Carreau nanofluid bolus appears.
