Vascular calcification is closely associated with cardiovascular-related mortality,particularly high-risk of occurring this disease is in patients suffering from hypertension.Vascular calcification involves the active...Vascular calcification is closely associated with cardiovascular-related mortality,particularly high-risk of occurring this disease is in patients suffering from hypertension.Vascular calcification involves the active deposition of calcium and other mineral substances in the vascular wall.In blood vessels,intimal calcification is related to atherosclerosis,whereas medial calcification is a non-occlusive process that increases vascular stiffness and reduces vascular compliance.In the valves,calcification of the leaflets can change the mechanical properties of the tissue and result in stenosis.Cardiovascular diseases are being lead significant health risk worldwide and its estimated 30%of deaths.Synthetic drugs can help in the treatment of cardiovascular disease but they have limited efficacy and carry substantial risks.High risk and narrow margin of safety of synthetic drugs growing our interest to explore the different plants with specific medicinal properties in treatment of different cardiovascular disorders including hypertension,atherosclerosis,cardiac arrest and heart failure.Plants like Daucus carota,Nerium oleander,Amaranthus,Terminalia arjuna,and Picrorhiza kurroa contain phytochemicals like tea flavonoids,polyphenols,plant sterols,and terpenoids that can prevent low density lipoprotein cholesterol oxidation,inhibit cholesterol synthesis and promote vasodilation.Researchers has identified many medicinal herbs and their chemical components that show potential in alleviating vascular calcification via antioxidant mechanisms.In this study,we briefly discuss the role of vascular calcification in the pathophysiology of cardiac diseases.Utilizing the efficacy of these natural molecules will lead to the development of new treatment methods for chronic heart disease associated with vascular calcification.展开更多
BACKGROUND Bilateral hip disorder is a common finding that can occur in approximately 42%of the population with osteoarthritis.It is estimated that 25%individuals with osteoarthritis requiring total hip replacement(TH...BACKGROUND Bilateral hip disorder is a common finding that can occur in approximately 42%of the population with osteoarthritis.It is estimated that 25%individuals with osteoarthritis requiring total hip replacement(THR)may require a bilateral replacement.This has resulted in the test of the greatest strategy to run single staged bilateral hip replacement while addressing the outcomes to achieve swift and cost-effective patient recovery.AIM To assess the outcomes and cost effectiveness of bilateral THR(B/L THR)at our tertiary care hospital.METHODS Retrospective observational cross-sectional study was undertaken from Jan 2018 to July 2023 to assess the clinical outcomes of patients who underwent single stage B/L THR.RESULTS Data of 75 patients were analysed.The mean age was 36 years.Our complication rate was 4.0%including acute coronary syndrome,intra-operative acetabular fracture and paralytic ileus.The re-admission rate was 4%.CONCLUSION The choice of sequential or bilateral hip replacement is controversial.While,our study showed that bilateral hip replacement is safe and cost effective.As surgeons,we were careful in patient selection(low American Society of Anesthesiologist score).Though more than 50%of our B/L THR patients were obese[body mass index(BMI)>25],our outcomes were equivalent to normal BMI patients with lower risk of complication as well as early ambulation.Systemic complication deep vein thrombosis and pulmonary embolism were handled prophylactively by close monitoring,use of mechanical and pharmacological agents along with anticoagulants.Patients who require THR,often require them bilaterally and single stage replacement thus offers early restoration of an individual into their activities of daily living with minimal complications.Our findings support the use of single-stage B/L THR as a viable option for bilateral hip disorders,having favourable outcomes.展开更多
Extracorporeal therapies have a definite role in patients with acute liver failure,acute on-chronic liver failure,and progressive chronic liver disease.They act as a bridge-to-transplant in these patients.With the inc...Extracorporeal therapies have a definite role in patients with acute liver failure,acute on-chronic liver failure,and progressive chronic liver disease.They act as a bridge-to-transplant in these patients.With the increasing success of liver transplantation,the immediate postoperative complication spectrum continues to expand.Extracorporeal therapies can play an important role in managing these complications.However,the literature on extracorporeal therapies in the postliver transplant period is limited.This review article discussed various extracorporeal therapies that are still evolving or marred by limited evidence but can improve patient outcomes.These extracorporeal therapies can be divided into two subgroups:(1)Therapies for infective complications.Endotoxin and cytokine adsorption columns;and(2)Therapies for noninfective complications like small for size syndrome,primary allograft nonfunction,early allograft dysfunction,hyperacute rejection,hepatopulmonary syndrome,etc.(plasma exchange,double plasma molecular adsorption,molecular adsorbent recirculation system,and extracorporeal membrane oxygenation,among others).展开更多
The growing importance of maintaining and extending the functional lifespan of reinforced concrete structures has resulted in an increased emphasis on non-destructive testing techniques as essential tools for evaluati...The growing importance of maintaining and extending the functional lifespan of reinforced concrete structures has resulted in an increased emphasis on non-destructive testing techniques as essential tools for evaluating structural conditions.Non-destructive testing procedures offer a notable benefit in assessing the uniformity,homogeneity,ability to withstand compression,durability,and degree of corrosion in reinforcing bars within reinforced concrete structures.This study aimed to evaluate the existing condition of partially constructed residential buildings in Rewari district,located in the state of Haryana.The reinforced concrete structure of the building had been completed eight years ago,however,the project was abruptly stopped.Prior to recommencing the construction,it is important to assess the present state of the structure in order to evaluate the deterioration in Reinforced Cement Concrete(RCC).The building’s state was evaluated by visually inspecting the building,conducting on-site examinations,and analyzing samples in a laboratory.The findings emphasize the assessment of the robustness and durability of concrete to ascertain the degree of deterioration and degradation in the structure.The study incorporates visual inspection,and non-destructive evaluation utilizing different instruments to evaluate the corrosion condition of reinforcing bars.In addition,selected RCC columns,beams,and slabs undergo chemical testing.It has been observed that the strength results and chemical results were within permissible limits.展开更多
Objective:This study aims to assess nursing faculty’s perceptions and challenges in teaching Generation Z students,providing insights into the barriers and opportunities in bridging the generational learning gap.Mate...Objective:This study aims to assess nursing faculty’s perceptions and challenges in teaching Generation Z students,providing insights into the barriers and opportunities in bridging the generational learning gap.Material and Methods:A descriptive cross-sectional study was conducted among 335 nursing faculty members in the Delhi NCR region.Participants were recruited using a snowball sampling technique,and data were collected via a self-administered structured questionnaire.The questionnaire measured faculty perceptions and challenges using a Likert scale,with reliability assessed using Cronbach’s alpha.Data were analyzed through Descriptive and inferential statistics.Results:Findings revealed that while faculty recognize the need for technology integration and student-centered learning,they face challenges such as academic integrity concerns,psychological stress,and adapting to Gen Z’s expectations for personalized learning.The correlation between faculty perceptions and challenges was negligible(r=0.020,P=0.717),indicating that faculty perceptions remain stable despite these difficulties.Conclusion:Nursing faculty need to adapt pedagogical approaches to meet the evolving needs of Gen Z students.Bridging the gap between traditional teaching methods and the evolving needs of Generation Z requires faculty training,institutional support,and curriculum innovations.展开更多
Dermatofibrosarcoma protuberans(DFSP)is a rare cutaneous intermediate-grade soft tissue tumor characterized by COL1A1::PDGFB fusion in most cases.This fusion drives tumorigenesis and forms the basis for imatinib treat...Dermatofibrosarcoma protuberans(DFSP)is a rare cutaneous intermediate-grade soft tissue tumor characterized by COL1A1::PDGFB fusion in most cases.This fusion drives tumorigenesis and forms the basis for imatinib treatment,which acts by blocking platelet-derived growth factor receptor-beta kinase activity.Apart from this canonical fusion,there is an expanding spectrum of rare fusions,including COL6A3::PDGFD,EMILIN::PDGFD,TNC::PDGFD,etc.,through mole-cular profiling.These atypical rearrangements may be encountered in morpho-logically classic DFSP,unusual anatomic sites,or diagnostically challenging variants such as fibrosarcomatous DFSP.Their recognition is clinically relevant,as they may influence tumor biology,response to targeted therapy,and eligibility for clinical trials.This newly documented DFSP involving the lacrimal sac was initially misdiagnosed as a solitary fibrous tumor,emphasizing the diagnostic pitfalls in anatomically constrained regions and the importance of integrated diagnosis combining histology,immunohistochemistry,and molecular testing.In this editorial commentary,we briefly highlight the ever-growing genomic land-scape of DFSP,report rare fusions and their biological implications,and examine the role of expanded molecular diagnostics in refining diagnosis,guiding therapy,and informing prognosis.Incorporating comprehensive fusion analysis into routine workup may be critical for accurate classification,especially in unusual presentations where reliance on morphology alone risks misdiagnosis.展开更多
With cloud computing,large chunks of data can be handled at a small cost.However,there are some reservations regarding the security and privacy of cloud data stored.For solving these issues and enhancing cloud computi...With cloud computing,large chunks of data can be handled at a small cost.However,there are some reservations regarding the security and privacy of cloud data stored.For solving these issues and enhancing cloud computing security,this research provides a Three-Layered Security Access model(TLSA)aligned to an intrusion detection mechanism,access control mechanism,and data encryption system.The TLSA underlines the need for the protection of sensitive data.This proposed approach starts with Layer 1 data encryption using the Advanced Encryption Standard(AES).For data transfer and storage,this encryption guarantees the data’s authenticity and secrecy.Surprisingly,the solution employs the AES encryption algorithm to secure essential data before storing them in the Cloud to minimize unauthorized access.Role-based access control(RBAC)implements the second strategic level,which ensures specific personnel access certain data and resources.In RBAC,each user is allowed a specific role and Permission.This implies that permitted users can access some data stored in the Cloud.This layer assists in filtering granular access to data,reducing the risk that undesired data will be discovered during the process.Layer 3 deals with intrusion detection systems(IDS),which detect and quickly deal with malicious actions and intrusion attempts.The proposed TLSA security model of e-commerce includes conventional levels of security,such as encryption and access control,and encloses an insight intrusion detection system.This method offers integrated solutions for most typical security issues of cloud computing,including data secrecy,method of access,and threats.An extensive performance test was carried out to confirm the efficiency of the proposed three-tier security method.Comparisons have been made with state-of-art techniques,including DES,RSA,and DUAL-RSA,keeping into account Accuracy,QILV,F-Measure,Sensitivity,MSE,PSNR,SSIM,and computation time,encryption time,and decryption time.The proposed TLSA method provides an accuracy of 89.23%,F-Measure of 0.876,and SSIM of 0.8564 at a computation time of 5.7 s.A comparison with existing methods shows the better performance of the proposed method,thus confirming the enhanced ability to address security issues in cloud computing.展开更多
During its growth stage,the plant is exposed to various diseases.Detection and early detection of crop diseases is amajor challenge in the horticulture industry.Crop infections can harmtotal crop yield and reduce farm...During its growth stage,the plant is exposed to various diseases.Detection and early detection of crop diseases is amajor challenge in the horticulture industry.Crop infections can harmtotal crop yield and reduce farmers’income if not identified early.Today’s approved method involves a professional plant pathologist to diagnose the disease by visual inspection of the afflicted plant leaves.This is an excellent use case for Community Assessment and Treatment Services(CATS)due to the lengthy manual disease diagnosis process and the accuracy of identification is directly proportional to the skills of pathologists.An alternative to conventional Machine Learning(ML)methods,which require manual identification of parameters for exact results,is to develop a prototype that can be classified without pre-processing.To automatically diagnose tomato leaf disease,this research proposes a hybrid model using the Convolutional Auto-Encoders(CAE)network and the CNN-based deep learning architecture of DenseNet.To date,none of the modern systems described in this paper have a combined model based on DenseNet,CAE,and ConvolutionalNeuralNetwork(CNN)todiagnose the ailments of tomato leaves automatically.Themodelswere trained on a dataset obtained from the Plant Village repository.The dataset consisted of 9920 tomato leaves,and the model-tomodel accuracy ratio was 98.35%.Unlike other approaches discussed in this paper,this hybrid strategy requires fewer training components.Therefore,the training time to classify plant diseases with the trained algorithm,as well as the training time to automatically detect the ailments of tomato leaves,is significantly reduced.展开更多
We introduce a dual distribution of relaxation(DRT)based approach for analyzing electrochemical impedance spectroscopy(EIS)data in perovskite solar cells(PSCs),combining regression and classification with Bayesian mod...We introduce a dual distribution of relaxation(DRT)based approach for analyzing electrochemical impedance spectroscopy(EIS)data in perovskite solar cells(PSCs),combining regression and classification with Bayesian model selection and Havriliak-Negami(HN)modeling to resolve spectra into discrete,Lorentzian-like peaks.This time-domain decomposition offers a powerful alternative for identifying underlying physical processes,such as charge transfer,trap-assisted recombination,and ionic migration by directly extracting characteristic relaxation times(τ).In contrast to traditional equivalent circuit fitting or conventional DRT methods,which often yield broad and overlapping Gaussian-like peaks,our method enables sharper resolution of individual electrochemical signatures.Furthermore,we validated the framework using simulated EIS spectra for two distinct system types,determining the optimal number of peaks(Q)through statistical model selection.Applied to experimental PSC data under varying bias conditions,the approach helps to identify the voltage-dependent relaxation processes,including fast charge transfer(τ~10^(-6)s),intermediate trap-mediated recombination(τ~10^(-2)s),and slow ionic motion(τ~1 s).Lower-Q models fail to capture low-frequency features such as polarization and charge accumulation,while optimal Q yields accurate,physically meaningful representations of device behavior.This data-driven methodology highlights time-domain DRT as a rigorous and insightful tool for dissecting the complex kinetics that govern PSC performance.展开更多
Rice straw,which is produced after the harvest of rice,is a major agricultural waste in the world.Rice straw has a high carbon/nitrogen ratio and is more resistant to microbial degradation than other straws because it...Rice straw,which is produced after the harvest of rice,is a major agricultural waste in the world.Rice straw has a high carbon/nitrogen ratio and is more resistant to microbial degradation than other straws because its main constituents are cellulose and hemicelluloses encrusted by lignin.When rice straw is burned,hazardous substances such as carbon dioxide,methane,carbon monoxide,and nitrogen monoxide are released into the air as smoke(less than 10μm-sized particles).The rise in the burning of rice straw has contributed to too many accidents and health issues in the general population residing in Haryana,Punjab,and Uttar Pradesh of India.These states are being urged by the National Green Tribunal to generate money instead of burning rice straw.Even though these lignocellulosic materials might be beneficial,not much has been carried out with them.This overview covers the properties of rice straw and husks,the numerous procedures used to create valuable products,and various applications that may be made for them.These include energy sources,environmental adsorbents,building supplies,and specialist commodities.展开更多
BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effec...BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effectiveness of GLP-1RAs in these situations.AIM To evaluate the safety and efficacy of GLP-1RA in patients with T2DM fasting during Ramadan.METHODS Electronic databases were systematically searched for relevant studies that featured GLP-1RA in the intervention arm and other glucose-lowering medications in the control arm.The primary outcome was adverse events(AEs)during Ramadan for both groups;other outcomes included changes in glycemic and anthropometric measures during the peri-Ramadan period.RESULTS Four studies[three randomized-controlled trials with low risk of bias(RoB)and one prospective observational study with serious RoB]involving 754 subjects were analyzed.GLP-1RA group achieved greater glycated hemoglobin reduction than the non-GLP-1RA group[mean difference(MD):-0.31%,95%CI:-0.61 to-0.01,P=0.04,I2=77%]with a lower risk of documented symptomatic hypoglycemia(risk ratio=0.38,95%CI:0.16 to 0.88,P=0.02).Any AEs,serious AEs,or AEs that led to treatment discontinuation were comparable between the two groups.The GLP-1RA group experienced greater weight loss compared to the non-GLP-1RA group(MD:-2.0 kg,95%CI:-3.37 to-0.63,P=0.004,I2=95%).There were comparable changes in blood pressure and lipid profile between the two groups.GLP-1RA users experienced higher risks of gastrointestinal AEs,nausea,and vomiting;however,the risks of heartburn,abdominal pain,and diarrhea were similar in both groups.CONCLUSION Limited evidence suggests that GLP-1RAs are safe for T2DM management during Ramadan,offering modest benefits in blood sugar control and weight loss.Large multicenter trials are needed to confirm their safety and efficacy in at-risk populations,improving clinical practice decision-making.展开更多
BACKGROUND Despite therapeutic benefits,discontinuation of tirzepatide is common in randomized controlled trials(RCTs)due to adverse events(AEs)and other causes.No previous systematic reviews have explored the reasons...BACKGROUND Despite therapeutic benefits,discontinuation of tirzepatide is common in randomized controlled trials(RCTs)due to adverse events(AEs)and other causes.No previous systematic reviews have explored the reasons for discontinuing tirzepatide in the RCTs.AIM To explore the reasons for permanent discontinuation of tirzepatide vs controls[placebo,insulin,and glucagon-like peptide-1 receptor agonists(GLP-1Ras)]in RCTs.METHODS Relevant RCTs were systematically searched using related terms through multiple databases such as MEDLINE(via PubMed),Scopus,Cochrane Central Register,and ClinicalTrials.gov from their inception until June 20,2024.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as risk ratios(RR)with 95%confidence intervals(CI).RESULTS Seventeen RCTs(n=14645),mostly having low risks of bias,were analyzed.Compared to placebo,the risk of permanent discontinuation of the study drug was substantially lower with tirzepatide 10 mg(RR:0.69,95%CI:0.51-0.93,P=0.02)and similar with tirzepatide 5 mg(RR:0.74,95%CI:0.47-1.17,P=0.20)and 15 mg(RR:0.94,95%CI:0.68-1.31,P=0.71).Tirzepatide had identical discontinuation risks when compared to insulin at 5 mg(RR:0.96,95%CI:0.75-1.24,P=0.77)and 10 mg(RR:1.19,95%CI:0.77-1.82,P=0.44)doses,whereas such risk was higher with tirzepatide 15 mg than insulin(RR:1.31,95%CI:1.03-1.67,P=0.03).Compared to GLP-1RA,the permanent discontinuation risk was similar with tirzepatide 5 mg(RR:0.98,95%CI:0.70-1.37,P=0.90)but was higher with tirzepatide 10 mg(RR:1.40,95%CI:1.03-1.90,P=0.03)and 15 mg(RR:1.70,95%CI:1.27-2.27,P=0.0004).Tirzepatide,at all doses,had higher risks of AE-related discontinuation than insulin;such risks were only greater with higher doses of tirzepatide than with placebo or GLP-1RA.Discontinuation risk due to withdrawal by the study subjects was lower with tirzepatide than with placebo or insulin.Compared to the placebo,tirzepatide(all doses)conferred a lower risk of study drug discontinuation due to other causes not specifically mentioned.CONCLUSION The discontinuation risk is not higher in tirzepatide group than in the placebo arm.Many factors other than AEs led to drug discontinuation in the included RCTs.展开更多
Sudden sensorineural hearing loss(SSNHL)is an enigmatic entity,with obscure pathophysiology and debatable efficacy of the treatment agents used.An underlying cause is identified in only 10-15%of cases.The management o...Sudden sensorineural hearing loss(SSNHL)is an enigmatic entity,with obscure pathophysiology and debatable efficacy of the treatment agents used.An underlying cause is identified in only 10-15%of cases.The management of the remaining patients,classified as‘idiopathic’,is empirical,and is conventionally with systemic steroids,vasodilator therapy,rheological agents,and antioxidants,to list a few amongst the host of the agents employed for the treatment.The availability of conflicting outcomes and lack of conclusive evidence has resulted in the propagation of consensus-based treatment protocols.In the present review,we discuss the various controversial issues and newer developments in the management of idiopathic SSNHL.The current review aims to present a narrative outlook of the updated evidence base available from PUBMED,augmented with relevant designated publications.展开更多
Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory involvement.It can be triggered by infections,vaccinations,surgery,trauma,transplantation and drugs.Anti...Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory involvement.It can be triggered by infections,vaccinations,surgery,trauma,transplantation and drugs.Anti-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine,can be very rarely associated with GBS.Patient concerns:A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for rabies.Diagnosis:Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell vaccine.Interventions:Intravenous high dose steroids.Outcomes:Patient recovered completely within 1 month.Lessons:Although anti-rabies cell culture vaccines are highly immunogenic and safe,they are rarely associated with GBS.Clinicians should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.展开更多
BACKGROUND Liver disease indicates any pathology that can harm or destroy the liver or prevent it from normal functioning.The global community has recently witnessed an increase in the mortality rate due to liver dise...BACKGROUND Liver disease indicates any pathology that can harm or destroy the liver or prevent it from normal functioning.The global community has recently witnessed an increase in the mortality rate due to liver disease.This could be attributed to many factors,among which are human habits,awareness issues,poor healthcare,and late detection.To curb the growing threats from liver disease,early detection is critical to help reduce the risks and improve treatment outcome.Emerging technologies such as machine learning,as shown in this study,could be deployed to assist in enhancing its prediction and treatment.AIM To present a more efficient system for timely prediction of liver disease using a hybrid eXtreme Gradient Boosting model with hyperparameter tuning with a view to assist in early detection,diagnosis,and reduction of risks and mortality associated with the disease.METHODS The dataset used in this study consisted of 416 people with liver problems and 167 with no such history.The data were collected from the state of Andhra Pradesh,India,through https://www.kaggle.com/datasets/uciml/indian-liver-patientrecords.The population was divided into two sets depending on the disease state of the patient.This binary information was recorded in the attribute"is_patient".RESULTS The results indicated that the chi-square automated interaction detection and classification and regression trees models achieved an accuracy level of 71.36%and 73.24%,respectively,which was much better than the conventional method.The proposed solution would assist patients and physicians in tackling the problem of liver disease and ensuring that cases are detected early to prevent it from developing into cirrhosis(scarring)and to enhance the survival of patients.The study showed the potential of machine learning in health care,especially as it concerns disease prediction and monitoring.CONCLUSION This study contributed to the knowledge of machine learning application to health and to the efforts toward combating the problem of liver disease.However,relevant authorities have to invest more into machine learning research and other health technologies to maximize their potential.展开更多
The present study evaluated submergence responses in 88 lowland indigenous rice(Oryza sativa L.) landraces from Koraput, India, to identify submergence-tolerant rice genotypes. In pot experiments, variations in surviv...The present study evaluated submergence responses in 88 lowland indigenous rice(Oryza sativa L.) landraces from Koraput, India, to identify submergence-tolerant rice genotypes. In pot experiments, variations in survival rate, shoot elongation, relative growth index, dry matter, chlorophyll, soluble sugar and starch contents were evaluated in two consecutive years under well-drained and completely submerged conditions. Principal component analysis showed that the first three axes contributed 96.820% of the total variation among the landraces, indicating wide variation between genotypes. Major traits such as survival rate, relative growth index, soluble sugar and starch contents appeared to be important determinants of phenotypic diversity among the landraces. Phenotypic coefficient of variance was higher than genotypic coefficient of variance for all the traits and all showed high heritability(90.38%–99.54%). Five rice landraces(Samudrabali, Basnamundi, Gadaba, Surudaka and Dokarakuji) were the most tolerant to submergence. When submerged for up to 14d, Samudrabali, Basnamundi and Godoba were notable for having greater survival rates than a standard submergence tolerant variety FR13 A, and also notable for elongating more vigorously and accumulating more biomass. These three landraces may therefore be especially useful in lowland rice growing areas that are affected by both moderate stagnant water and flash flooding. Molecular genotyping revealed that the submergence tolerance of Samudrabali, Basnamundi and Godoba is linked to the presence of one or more different Sub1 loci and it may well prove useful for breeding improved submergence tolerant rice varieties, thereby assising to improve yield stability in the rainfed lowland agro-ecosystem.展开更多
In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraao...In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.展开更多
A number of optical sensing tools are now available and can potentially be used for refining need-based fertilizer nitrogen(N)topdressing decisions.Algorithms for estimating field-specific fertilizer N needs are based...A number of optical sensing tools are now available and can potentially be used for refining need-based fertilizer nitrogen(N)topdressing decisions.Algorithms for estimating field-specific fertilizer N needs are based on predictions of yield made while the crops are still growing in the field.The present study was conducted to establish and validate yield prediction models using spectral indices measured with proximal sensing using GreenSeeker canopy reflectance sensor,soil and plant analyzer development(SPAD)chlorophyll meter,and two different types of leaf color charts(LCCs)for five basmati rice genotypes across different growth stages.Regression analysis was performed using normalized difference vegetation index(NDVI)recorded with GreenSeeker sensor and leaf greenness indices measured with SPAD meter and LCCs developed by Punjab Agricultural University,Ludhiana(India)(PAU-LCC)and the International Rice Research Institute,Philippines(IRRI-LCC).The exponential relationship between NDVI and grain yield exhibited the highest coefficient of determination(R^(2))and minimum normalized root mean square error(NRMSE)at panicle initiation stage and explained 38.3%–76.4%variation in yield using genotype-specific models.Spectral indices pooled for different genotypes were closely related to grain yield at all growth stages and explained53.4%–57.2%variation in grain yield.Normalizing different spectral indices with cumulative growing degree days(CGDD)decreased the accuracy of yield prediction.Normalization with days after transplanting(DAT),however,did not reduce or improve the predictability of yield.The ability of each model to predict grain yield was validated with an independent dataset collected from two experiments conducted at different sites with a range of fertilizer N doses.The NDVI-based genotype-specific models exhibited a robust linear correlation(R^(2)=0.77,NRMSE=7.37%,n=180)between observed and predicted grain yields only at 35 DAT(i.e.,panicle initiation stage),while the SPAD,PAU-LCC,and IRRI-LCC consistently provided reliable predictions(with respective R^(2)of 0.63,0.60,and 0.53 and NRMSE of 10%,10%,and 13.6%)even with genotype invariant models with 900 data points obtained at different growth stages.The study revealed that unnormalized values of spectral indices,namely NDVI,SPAD,PAU-LCC,and IRRI-LCC,can be satisfactorily used for in-season estimation of grain yield for basmati rice.As LCCs are very economical compared with chlorophyll meters and canopy reflectance sensors,they can be preferably used by small farmers in developing countries.展开更多
Heterogeneous Wireless Network is currently a major area of focus in communication engineering.But the important issue in recent communication is the approachability to the wireless networks while maintaining the qual...Heterogeneous Wireless Network is currently a major area of focus in communication engineering.But the important issue in recent communication is the approachability to the wireless networks while maintaining the quality of service.Today,all the wireless access networks are working in tandem to keep the users always connected to the internet cloud that matches the price affordability and performance goals.In order to achieve seamless connectivity,due consideration has to be given to handoff precision and a smaller number of handoffs.Several researchers have used heuristic approaches to solve this issue.In the present work,a hybrid intelligent algorithm has been suggested for vertical handoff decisions.This hybrid intelligent algorithm is based on dual optimization approach which uses“Particle Swarm Optimization(PSO)”and“Mobile Robustness Optimization(MRO)”techniques for improving the quality of services.This approach performs well even in the failure network conditions and gives the best results in terms of connectivity.The results at the last has been compared with the conventional techniques and it has been observed that the proposed methodology outperforms the existing one.展开更多
文摘Vascular calcification is closely associated with cardiovascular-related mortality,particularly high-risk of occurring this disease is in patients suffering from hypertension.Vascular calcification involves the active deposition of calcium and other mineral substances in the vascular wall.In blood vessels,intimal calcification is related to atherosclerosis,whereas medial calcification is a non-occlusive process that increases vascular stiffness and reduces vascular compliance.In the valves,calcification of the leaflets can change the mechanical properties of the tissue and result in stenosis.Cardiovascular diseases are being lead significant health risk worldwide and its estimated 30%of deaths.Synthetic drugs can help in the treatment of cardiovascular disease but they have limited efficacy and carry substantial risks.High risk and narrow margin of safety of synthetic drugs growing our interest to explore the different plants with specific medicinal properties in treatment of different cardiovascular disorders including hypertension,atherosclerosis,cardiac arrest and heart failure.Plants like Daucus carota,Nerium oleander,Amaranthus,Terminalia arjuna,and Picrorhiza kurroa contain phytochemicals like tea flavonoids,polyphenols,plant sterols,and terpenoids that can prevent low density lipoprotein cholesterol oxidation,inhibit cholesterol synthesis and promote vasodilation.Researchers has identified many medicinal herbs and their chemical components that show potential in alleviating vascular calcification via antioxidant mechanisms.In this study,we briefly discuss the role of vascular calcification in the pathophysiology of cardiac diseases.Utilizing the efficacy of these natural molecules will lead to the development of new treatment methods for chronic heart disease associated with vascular calcification.
文摘BACKGROUND Bilateral hip disorder is a common finding that can occur in approximately 42%of the population with osteoarthritis.It is estimated that 25%individuals with osteoarthritis requiring total hip replacement(THR)may require a bilateral replacement.This has resulted in the test of the greatest strategy to run single staged bilateral hip replacement while addressing the outcomes to achieve swift and cost-effective patient recovery.AIM To assess the outcomes and cost effectiveness of bilateral THR(B/L THR)at our tertiary care hospital.METHODS Retrospective observational cross-sectional study was undertaken from Jan 2018 to July 2023 to assess the clinical outcomes of patients who underwent single stage B/L THR.RESULTS Data of 75 patients were analysed.The mean age was 36 years.Our complication rate was 4.0%including acute coronary syndrome,intra-operative acetabular fracture and paralytic ileus.The re-admission rate was 4%.CONCLUSION The choice of sequential or bilateral hip replacement is controversial.While,our study showed that bilateral hip replacement is safe and cost effective.As surgeons,we were careful in patient selection(low American Society of Anesthesiologist score).Though more than 50%of our B/L THR patients were obese[body mass index(BMI)>25],our outcomes were equivalent to normal BMI patients with lower risk of complication as well as early ambulation.Systemic complication deep vein thrombosis and pulmonary embolism were handled prophylactively by close monitoring,use of mechanical and pharmacological agents along with anticoagulants.Patients who require THR,often require them bilaterally and single stage replacement thus offers early restoration of an individual into their activities of daily living with minimal complications.Our findings support the use of single-stage B/L THR as a viable option for bilateral hip disorders,having favourable outcomes.
文摘Extracorporeal therapies have a definite role in patients with acute liver failure,acute on-chronic liver failure,and progressive chronic liver disease.They act as a bridge-to-transplant in these patients.With the increasing success of liver transplantation,the immediate postoperative complication spectrum continues to expand.Extracorporeal therapies can play an important role in managing these complications.However,the literature on extracorporeal therapies in the postliver transplant period is limited.This review article discussed various extracorporeal therapies that are still evolving or marred by limited evidence but can improve patient outcomes.These extracorporeal therapies can be divided into two subgroups:(1)Therapies for infective complications.Endotoxin and cytokine adsorption columns;and(2)Therapies for noninfective complications like small for size syndrome,primary allograft nonfunction,early allograft dysfunction,hyperacute rejection,hepatopulmonary syndrome,etc.(plasma exchange,double plasma molecular adsorption,molecular adsorbent recirculation system,and extracorporeal membrane oxygenation,among others).
文摘The growing importance of maintaining and extending the functional lifespan of reinforced concrete structures has resulted in an increased emphasis on non-destructive testing techniques as essential tools for evaluating structural conditions.Non-destructive testing procedures offer a notable benefit in assessing the uniformity,homogeneity,ability to withstand compression,durability,and degree of corrosion in reinforcing bars within reinforced concrete structures.This study aimed to evaluate the existing condition of partially constructed residential buildings in Rewari district,located in the state of Haryana.The reinforced concrete structure of the building had been completed eight years ago,however,the project was abruptly stopped.Prior to recommencing the construction,it is important to assess the present state of the structure in order to evaluate the deterioration in Reinforced Cement Concrete(RCC).The building’s state was evaluated by visually inspecting the building,conducting on-site examinations,and analyzing samples in a laboratory.The findings emphasize the assessment of the robustness and durability of concrete to ascertain the degree of deterioration and degradation in the structure.The study incorporates visual inspection,and non-destructive evaluation utilizing different instruments to evaluate the corrosion condition of reinforcing bars.In addition,selected RCC columns,beams,and slabs undergo chemical testing.It has been observed that the strength results and chemical results were within permissible limits.
文摘Objective:This study aims to assess nursing faculty’s perceptions and challenges in teaching Generation Z students,providing insights into the barriers and opportunities in bridging the generational learning gap.Material and Methods:A descriptive cross-sectional study was conducted among 335 nursing faculty members in the Delhi NCR region.Participants were recruited using a snowball sampling technique,and data were collected via a self-administered structured questionnaire.The questionnaire measured faculty perceptions and challenges using a Likert scale,with reliability assessed using Cronbach’s alpha.Data were analyzed through Descriptive and inferential statistics.Results:Findings revealed that while faculty recognize the need for technology integration and student-centered learning,they face challenges such as academic integrity concerns,psychological stress,and adapting to Gen Z’s expectations for personalized learning.The correlation between faculty perceptions and challenges was negligible(r=0.020,P=0.717),indicating that faculty perceptions remain stable despite these difficulties.Conclusion:Nursing faculty need to adapt pedagogical approaches to meet the evolving needs of Gen Z students.Bridging the gap between traditional teaching methods and the evolving needs of Generation Z requires faculty training,institutional support,and curriculum innovations.
文摘Dermatofibrosarcoma protuberans(DFSP)is a rare cutaneous intermediate-grade soft tissue tumor characterized by COL1A1::PDGFB fusion in most cases.This fusion drives tumorigenesis and forms the basis for imatinib treatment,which acts by blocking platelet-derived growth factor receptor-beta kinase activity.Apart from this canonical fusion,there is an expanding spectrum of rare fusions,including COL6A3::PDGFD,EMILIN::PDGFD,TNC::PDGFD,etc.,through mole-cular profiling.These atypical rearrangements may be encountered in morpho-logically classic DFSP,unusual anatomic sites,or diagnostically challenging variants such as fibrosarcomatous DFSP.Their recognition is clinically relevant,as they may influence tumor biology,response to targeted therapy,and eligibility for clinical trials.This newly documented DFSP involving the lacrimal sac was initially misdiagnosed as a solitary fibrous tumor,emphasizing the diagnostic pitfalls in anatomically constrained regions and the importance of integrated diagnosis combining histology,immunohistochemistry,and molecular testing.In this editorial commentary,we briefly highlight the ever-growing genomic land-scape of DFSP,report rare fusions and their biological implications,and examine the role of expanded molecular diagnostics in refining diagnosis,guiding therapy,and informing prognosis.Incorporating comprehensive fusion analysis into routine workup may be critical for accurate classification,especially in unusual presentations where reliance on morphology alone risks misdiagnosis.
基金funded by UKRI EPSRC Grant EP/W020408/1 Project SPRITE+2:The Security,Privacy,Identity and Trust Engagement Network plus(phase 2)for this studyThe authors also have been funded by PhD project RS718 on Explainable AI through UKRI EPSRC Grant funded Doctoral Training Centre at Swansea University.
文摘With cloud computing,large chunks of data can be handled at a small cost.However,there are some reservations regarding the security and privacy of cloud data stored.For solving these issues and enhancing cloud computing security,this research provides a Three-Layered Security Access model(TLSA)aligned to an intrusion detection mechanism,access control mechanism,and data encryption system.The TLSA underlines the need for the protection of sensitive data.This proposed approach starts with Layer 1 data encryption using the Advanced Encryption Standard(AES).For data transfer and storage,this encryption guarantees the data’s authenticity and secrecy.Surprisingly,the solution employs the AES encryption algorithm to secure essential data before storing them in the Cloud to minimize unauthorized access.Role-based access control(RBAC)implements the second strategic level,which ensures specific personnel access certain data and resources.In RBAC,each user is allowed a specific role and Permission.This implies that permitted users can access some data stored in the Cloud.This layer assists in filtering granular access to data,reducing the risk that undesired data will be discovered during the process.Layer 3 deals with intrusion detection systems(IDS),which detect and quickly deal with malicious actions and intrusion attempts.The proposed TLSA security model of e-commerce includes conventional levels of security,such as encryption and access control,and encloses an insight intrusion detection system.This method offers integrated solutions for most typical security issues of cloud computing,including data secrecy,method of access,and threats.An extensive performance test was carried out to confirm the efficiency of the proposed three-tier security method.Comparisons have been made with state-of-art techniques,including DES,RSA,and DUAL-RSA,keeping into account Accuracy,QILV,F-Measure,Sensitivity,MSE,PSNR,SSIM,and computation time,encryption time,and decryption time.The proposed TLSA method provides an accuracy of 89.23%,F-Measure of 0.876,and SSIM of 0.8564 at a computation time of 5.7 s.A comparison with existing methods shows the better performance of the proposed method,thus confirming the enhanced ability to address security issues in cloud computing.
基金funded by UKRI EPSRC Grant EP/W020408/1 Project SPRITE+2:The Security,Privacy,Identity,and Trust Engagement Network plus(phase 2)for this studyfunded by PhD project RS718 on Explainable AI through the UKRI EPSRC Grant-funded Doctoral Training Centre at Swansea University.
文摘During its growth stage,the plant is exposed to various diseases.Detection and early detection of crop diseases is amajor challenge in the horticulture industry.Crop infections can harmtotal crop yield and reduce farmers’income if not identified early.Today’s approved method involves a professional plant pathologist to diagnose the disease by visual inspection of the afflicted plant leaves.This is an excellent use case for Community Assessment and Treatment Services(CATS)due to the lengthy manual disease diagnosis process and the accuracy of identification is directly proportional to the skills of pathologists.An alternative to conventional Machine Learning(ML)methods,which require manual identification of parameters for exact results,is to develop a prototype that can be classified without pre-processing.To automatically diagnose tomato leaf disease,this research proposes a hybrid model using the Convolutional Auto-Encoders(CAE)network and the CNN-based deep learning architecture of DenseNet.To date,none of the modern systems described in this paper have a combined model based on DenseNet,CAE,and ConvolutionalNeuralNetwork(CNN)todiagnose the ailments of tomato leaves automatically.Themodelswere trained on a dataset obtained from the Plant Village repository.The dataset consisted of 9920 tomato leaves,and the model-tomodel accuracy ratio was 98.35%.Unlike other approaches discussed in this paper,this hybrid strategy requires fewer training components.Therefore,the training time to classify plant diseases with the trained algorithm,as well as the training time to automatically detect the ailments of tomato leaves,is significantly reduced.
基金the ORSP of Pandit Deendayal Energy University and DST SERB(IPA/2021/96)for the financial supportthe Deanship of Research and Graduate Studies at King Khalid University for funding this work through the Large Research Project under grant number RGP 2/345/45。
文摘We introduce a dual distribution of relaxation(DRT)based approach for analyzing electrochemical impedance spectroscopy(EIS)data in perovskite solar cells(PSCs),combining regression and classification with Bayesian model selection and Havriliak-Negami(HN)modeling to resolve spectra into discrete,Lorentzian-like peaks.This time-domain decomposition offers a powerful alternative for identifying underlying physical processes,such as charge transfer,trap-assisted recombination,and ionic migration by directly extracting characteristic relaxation times(τ).In contrast to traditional equivalent circuit fitting or conventional DRT methods,which often yield broad and overlapping Gaussian-like peaks,our method enables sharper resolution of individual electrochemical signatures.Furthermore,we validated the framework using simulated EIS spectra for two distinct system types,determining the optimal number of peaks(Q)through statistical model selection.Applied to experimental PSC data under varying bias conditions,the approach helps to identify the voltage-dependent relaxation processes,including fast charge transfer(τ~10^(-6)s),intermediate trap-mediated recombination(τ~10^(-2)s),and slow ionic motion(τ~1 s).Lower-Q models fail to capture low-frequency features such as polarization and charge accumulation,while optimal Q yields accurate,physically meaningful representations of device behavior.This data-driven methodology highlights time-domain DRT as a rigorous and insightful tool for dissecting the complex kinetics that govern PSC performance.
文摘Rice straw,which is produced after the harvest of rice,is a major agricultural waste in the world.Rice straw has a high carbon/nitrogen ratio and is more resistant to microbial degradation than other straws because its main constituents are cellulose and hemicelluloses encrusted by lignin.When rice straw is burned,hazardous substances such as carbon dioxide,methane,carbon monoxide,and nitrogen monoxide are released into the air as smoke(less than 10μm-sized particles).The rise in the burning of rice straw has contributed to too many accidents and health issues in the general population residing in Haryana,Punjab,and Uttar Pradesh of India.These states are being urged by the National Green Tribunal to generate money instead of burning rice straw.Even though these lignocellulosic materials might be beneficial,not much has been carried out with them.This overview covers the properties of rice straw and husks,the numerous procedures used to create valuable products,and various applications that may be made for them.These include energy sources,environmental adsorbents,building supplies,and specialist commodities.
基金thankful to Dr.Marina George Kudiyirickal MSc,MJDF-RCS,PhD for providing us the audio core tip of this article.
文摘BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effectiveness of GLP-1RAs in these situations.AIM To evaluate the safety and efficacy of GLP-1RA in patients with T2DM fasting during Ramadan.METHODS Electronic databases were systematically searched for relevant studies that featured GLP-1RA in the intervention arm and other glucose-lowering medications in the control arm.The primary outcome was adverse events(AEs)during Ramadan for both groups;other outcomes included changes in glycemic and anthropometric measures during the peri-Ramadan period.RESULTS Four studies[three randomized-controlled trials with low risk of bias(RoB)and one prospective observational study with serious RoB]involving 754 subjects were analyzed.GLP-1RA group achieved greater glycated hemoglobin reduction than the non-GLP-1RA group[mean difference(MD):-0.31%,95%CI:-0.61 to-0.01,P=0.04,I2=77%]with a lower risk of documented symptomatic hypoglycemia(risk ratio=0.38,95%CI:0.16 to 0.88,P=0.02).Any AEs,serious AEs,or AEs that led to treatment discontinuation were comparable between the two groups.The GLP-1RA group experienced greater weight loss compared to the non-GLP-1RA group(MD:-2.0 kg,95%CI:-3.37 to-0.63,P=0.004,I2=95%).There were comparable changes in blood pressure and lipid profile between the two groups.GLP-1RA users experienced higher risks of gastrointestinal AEs,nausea,and vomiting;however,the risks of heartburn,abdominal pain,and diarrhea were similar in both groups.CONCLUSION Limited evidence suggests that GLP-1RAs are safe for T2DM management during Ramadan,offering modest benefits in blood sugar control and weight loss.Large multicenter trials are needed to confirm their safety and efficacy in at-risk populations,improving clinical practice decision-making.
文摘BACKGROUND Despite therapeutic benefits,discontinuation of tirzepatide is common in randomized controlled trials(RCTs)due to adverse events(AEs)and other causes.No previous systematic reviews have explored the reasons for discontinuing tirzepatide in the RCTs.AIM To explore the reasons for permanent discontinuation of tirzepatide vs controls[placebo,insulin,and glucagon-like peptide-1 receptor agonists(GLP-1Ras)]in RCTs.METHODS Relevant RCTs were systematically searched using related terms through multiple databases such as MEDLINE(via PubMed),Scopus,Cochrane Central Register,and ClinicalTrials.gov from their inception until June 20,2024.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as risk ratios(RR)with 95%confidence intervals(CI).RESULTS Seventeen RCTs(n=14645),mostly having low risks of bias,were analyzed.Compared to placebo,the risk of permanent discontinuation of the study drug was substantially lower with tirzepatide 10 mg(RR:0.69,95%CI:0.51-0.93,P=0.02)and similar with tirzepatide 5 mg(RR:0.74,95%CI:0.47-1.17,P=0.20)and 15 mg(RR:0.94,95%CI:0.68-1.31,P=0.71).Tirzepatide had identical discontinuation risks when compared to insulin at 5 mg(RR:0.96,95%CI:0.75-1.24,P=0.77)and 10 mg(RR:1.19,95%CI:0.77-1.82,P=0.44)doses,whereas such risk was higher with tirzepatide 15 mg than insulin(RR:1.31,95%CI:1.03-1.67,P=0.03).Compared to GLP-1RA,the permanent discontinuation risk was similar with tirzepatide 5 mg(RR:0.98,95%CI:0.70-1.37,P=0.90)but was higher with tirzepatide 10 mg(RR:1.40,95%CI:1.03-1.90,P=0.03)and 15 mg(RR:1.70,95%CI:1.27-2.27,P=0.0004).Tirzepatide,at all doses,had higher risks of AE-related discontinuation than insulin;such risks were only greater with higher doses of tirzepatide than with placebo or GLP-1RA.Discontinuation risk due to withdrawal by the study subjects was lower with tirzepatide than with placebo or insulin.Compared to the placebo,tirzepatide(all doses)conferred a lower risk of study drug discontinuation due to other causes not specifically mentioned.CONCLUSION The discontinuation risk is not higher in tirzepatide group than in the placebo arm.Many factors other than AEs led to drug discontinuation in the included RCTs.
文摘Sudden sensorineural hearing loss(SSNHL)is an enigmatic entity,with obscure pathophysiology and debatable efficacy of the treatment agents used.An underlying cause is identified in only 10-15%of cases.The management of the remaining patients,classified as‘idiopathic’,is empirical,and is conventionally with systemic steroids,vasodilator therapy,rheological agents,and antioxidants,to list a few amongst the host of the agents employed for the treatment.The availability of conflicting outcomes and lack of conclusive evidence has resulted in the propagation of consensus-based treatment protocols.In the present review,we discuss the various controversial issues and newer developments in the management of idiopathic SSNHL.The current review aims to present a narrative outlook of the updated evidence base available from PUBMED,augmented with relevant designated publications.
文摘Rationale:Guillain Barre syndrome(GBS)is an acute neurological illness leading to quadriparesis with respiratory involvement.It can be triggered by infections,vaccinations,surgery,trauma,transplantation and drugs.Anti-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine,can be very rarely associated with GBS.Patient concerns:A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for rabies.Diagnosis:Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell vaccine.Interventions:Intravenous high dose steroids.Outcomes:Patient recovered completely within 1 month.Lessons:Although anti-rabies cell culture vaccines are highly immunogenic and safe,they are rarely associated with GBS.Clinicians should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.
文摘BACKGROUND Liver disease indicates any pathology that can harm or destroy the liver or prevent it from normal functioning.The global community has recently witnessed an increase in the mortality rate due to liver disease.This could be attributed to many factors,among which are human habits,awareness issues,poor healthcare,and late detection.To curb the growing threats from liver disease,early detection is critical to help reduce the risks and improve treatment outcome.Emerging technologies such as machine learning,as shown in this study,could be deployed to assist in enhancing its prediction and treatment.AIM To present a more efficient system for timely prediction of liver disease using a hybrid eXtreme Gradient Boosting model with hyperparameter tuning with a view to assist in early detection,diagnosis,and reduction of risks and mortality associated with the disease.METHODS The dataset used in this study consisted of 416 people with liver problems and 167 with no such history.The data were collected from the state of Andhra Pradesh,India,through https://www.kaggle.com/datasets/uciml/indian-liver-patientrecords.The population was divided into two sets depending on the disease state of the patient.This binary information was recorded in the attribute"is_patient".RESULTS The results indicated that the chi-square automated interaction detection and classification and regression trees models achieved an accuracy level of 71.36%and 73.24%,respectively,which was much better than the conventional method.The proposed solution would assist patients and physicians in tackling the problem of liver disease and ensuring that cases are detected early to prevent it from developing into cirrhosis(scarring)and to enhance the survival of patients.The study showed the potential of machine learning in health care,especially as it concerns disease prediction and monitoring.CONCLUSION This study contributed to the knowledge of machine learning application to health and to the efforts toward combating the problem of liver disease.However,relevant authorities have to invest more into machine learning research and other health technologies to maximize their potential.
文摘The present study evaluated submergence responses in 88 lowland indigenous rice(Oryza sativa L.) landraces from Koraput, India, to identify submergence-tolerant rice genotypes. In pot experiments, variations in survival rate, shoot elongation, relative growth index, dry matter, chlorophyll, soluble sugar and starch contents were evaluated in two consecutive years under well-drained and completely submerged conditions. Principal component analysis showed that the first three axes contributed 96.820% of the total variation among the landraces, indicating wide variation between genotypes. Major traits such as survival rate, relative growth index, soluble sugar and starch contents appeared to be important determinants of phenotypic diversity among the landraces. Phenotypic coefficient of variance was higher than genotypic coefficient of variance for all the traits and all showed high heritability(90.38%–99.54%). Five rice landraces(Samudrabali, Basnamundi, Gadaba, Surudaka and Dokarakuji) were the most tolerant to submergence. When submerged for up to 14d, Samudrabali, Basnamundi and Godoba were notable for having greater survival rates than a standard submergence tolerant variety FR13 A, and also notable for elongating more vigorously and accumulating more biomass. These three landraces may therefore be especially useful in lowland rice growing areas that are affected by both moderate stagnant water and flash flooding. Molecular genotyping revealed that the submergence tolerance of Samudrabali, Basnamundi and Godoba is linked to the presence of one or more different Sub1 loci and it may well prove useful for breeding improved submergence tolerant rice varieties, thereby assising to improve yield stability in the rainfed lowland agro-ecosystem.
文摘In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.
基金funded by the Department of Biotechnology(DBT)Government of India(No.BT/IN/UKVNC/42/RG/2014-15)the Biotechnology and Biological Sciences Research Council(BBSRC)under the international multi-institutional collaborative research project entitled Cambridge-India Network for Translational Research in Nitrogen(CINTRIN)(No.BB/N013441/1)。
文摘A number of optical sensing tools are now available and can potentially be used for refining need-based fertilizer nitrogen(N)topdressing decisions.Algorithms for estimating field-specific fertilizer N needs are based on predictions of yield made while the crops are still growing in the field.The present study was conducted to establish and validate yield prediction models using spectral indices measured with proximal sensing using GreenSeeker canopy reflectance sensor,soil and plant analyzer development(SPAD)chlorophyll meter,and two different types of leaf color charts(LCCs)for five basmati rice genotypes across different growth stages.Regression analysis was performed using normalized difference vegetation index(NDVI)recorded with GreenSeeker sensor and leaf greenness indices measured with SPAD meter and LCCs developed by Punjab Agricultural University,Ludhiana(India)(PAU-LCC)and the International Rice Research Institute,Philippines(IRRI-LCC).The exponential relationship between NDVI and grain yield exhibited the highest coefficient of determination(R^(2))and minimum normalized root mean square error(NRMSE)at panicle initiation stage and explained 38.3%–76.4%variation in yield using genotype-specific models.Spectral indices pooled for different genotypes were closely related to grain yield at all growth stages and explained53.4%–57.2%variation in grain yield.Normalizing different spectral indices with cumulative growing degree days(CGDD)decreased the accuracy of yield prediction.Normalization with days after transplanting(DAT),however,did not reduce or improve the predictability of yield.The ability of each model to predict grain yield was validated with an independent dataset collected from two experiments conducted at different sites with a range of fertilizer N doses.The NDVI-based genotype-specific models exhibited a robust linear correlation(R^(2)=0.77,NRMSE=7.37%,n=180)between observed and predicted grain yields only at 35 DAT(i.e.,panicle initiation stage),while the SPAD,PAU-LCC,and IRRI-LCC consistently provided reliable predictions(with respective R^(2)of 0.63,0.60,and 0.53 and NRMSE of 10%,10%,and 13.6%)even with genotype invariant models with 900 data points obtained at different growth stages.The study revealed that unnormalized values of spectral indices,namely NDVI,SPAD,PAU-LCC,and IRRI-LCC,can be satisfactorily used for in-season estimation of grain yield for basmati rice.As LCCs are very economical compared with chlorophyll meters and canopy reflectance sensors,they can be preferably used by small farmers in developing countries.
基金Deepak Dahiya would like to thank Deanship of Scientific Research at Majmaah University for supporting this work under Project No.R-2022-74.
文摘Heterogeneous Wireless Network is currently a major area of focus in communication engineering.But the important issue in recent communication is the approachability to the wireless networks while maintaining the quality of service.Today,all the wireless access networks are working in tandem to keep the users always connected to the internet cloud that matches the price affordability and performance goals.In order to achieve seamless connectivity,due consideration has to be given to handoff precision and a smaller number of handoffs.Several researchers have used heuristic approaches to solve this issue.In the present work,a hybrid intelligent algorithm has been suggested for vertical handoff decisions.This hybrid intelligent algorithm is based on dual optimization approach which uses“Particle Swarm Optimization(PSO)”and“Mobile Robustness Optimization(MRO)”techniques for improving the quality of services.This approach performs well even in the failure network conditions and gives the best results in terms of connectivity.The results at the last has been compared with the conventional techniques and it has been observed that the proposed methodology outperforms the existing one.
