Episodes of prolonged “trance-like state” in an infant with hypothalamic hamartoma

Hypothalamic hamartoma (HH) is one of the most common causes of central precocious puberty (CPP) in first few years of life. It can present with either seizures or CPP, although both manifestations coexist in the majority of the children. Gelastic seizures (GS), or laughing spells, are usually the first type of seizures seen in patients with HH. Although a wide variety of seizure types are known to occur in children with HH, GS are most common and consistent seizure type. The clinical presentation of HH may vary with the size and position of the mass, although large tumours typically present with both CPP and seizures. Although CPP can be managed with medical therapy, seizures can be very difficult to treat, even with multiple antiepileptic drugs. Noninvasive gamma knife surgery has been used with some success for the treatment of refractory epilepsy. We present a case of HH with very early onset seizures and CPP. The patient had an atypical form of seizures described by the parents as a "trance-like state" in which the patient had prolonged episodes of unresponsiveness lasting for hours with normal feedings during the episodes. GS occurred late in the course and were refractory to various combinations of antiepileptic drugs. A brain magnetic resonance imaging showed a large sessile HH (>20 mm). Later in the course of the disease, the patient experienced cognitive and behavioural problems. The patient underwent gamma knife surgery at nearly 5 years of age and experienced a modest response in seizure frequency. This case highlights the presentation of HH as a previously unreported seizure morphology described as a prolonged "trance-like state.

IMPACT OF CHANNEL ENGINEERING (SI1-0.25GE0.25) TECHNIQUE ON GM (TRANSCONDUCTANCE) AND ITS HIGHER ORDER DERIVATIVES OF 3D CONVENTIONAL AND WAVY JUNCTIONLESS FINFETS (JLT)

The paper explores the analog analysis and higher order derivatives of drain current (ID) at gate source voltage (VGS), by introducing channel engineering technique of 3D conventional and Wavy Junctionless FinFETs (JLT) as silicon germanium  (Si1-0.25Ge0.25) device layer. In view of this, the performances are carried out for different gate length (LG) values (15-30 nm) and current characteristics determined by maintaining constant ON current (ION 10-5) (A/μm) for both devices. With respect to this, a comparison has been made between these MOS structures at molefraction x = 0.25 and it was found that the electric field is perpendicular to the current flow which induces volume inversion approach. Accordingly, for the simulation study better channel controllability over the gate is observed for Wavy structures and high ID induces as the LG scales down. With respect to this the constant ION determine ID, transconductance (gm), transconductance generation factor (TGF) and its higher order terms (g\m, and g\\m) of the devices are studied with relaxed SiGe approximation. The extensive simulation study on short channel (SC) parameters are also performed and it is observed that the Wavy JL FinFET shows less sensitivity towards short channel effects (SCEs) over conventional one, therefore the dependency of N-type doping concentration (ND = 1.7x1019 cm-3) and metal workfunction (ϕM = 4.6 eV) are responsible to achieving reduced SCEs. 

An Appraisal on auto-ignition/fire problems in coal mines: It's impact and few curative measures

Indeed, 'Agni' or the Fire is foremost important and essential for creature on the mother earth, but it is not well-thought of acceptable for coal mining fraternity. Despite of so much helpful to the mankind, auto-ignition/ fire in coal mines create several distresses. The problem of spontaneous combustion or fire in coal mines are became a global catastrophe. Due to fire in coal mines not only loss of huge amount of non-renewal energy resources, but it also produces several agonies on economy, society and environment of the nation. Despite of other reasons, coal mine fire also leads an immense impact on global warming. It leads to several complications on safety of the miners as well as productivity of mines. In this paper, problem associated with coal mine fire, its method of early detection, along with prevention and control methodologies used worldwide are discussed

Mobilization of Stem Cells Using G-CSF for Acute Ischemic Stroke: A Randomized Controlled, Pilot Study

Background. There is emerging evidence to support the use of granulocyte colony-stimulating factor (G-CSF) therapy in patients with acute ischemic stroke. Aims. To explore feasibility, safety, and preliminary efficacy of G-CSF therapy in patients with acute ischemic stroke. Patients and Method. In randomized study, 10 patients with acute ischemic stroke were recruited in 1 : 1 ratio to receive 10 μg/kg G-CSF treatment subcutaneously daily for five days with conventional care or conventional treatment alone. Efficacy outcome measures were assessed at baseline, one month, and after six months of treatment included Barthel Index (BI), National Institute of Health Stroke Scale, and modified Rankin Scale. Results. One patient in G-CSF therapy arm died due to raised intracranial pressure. No severe adverse effects were seen in rest of patients receiving G-CSF therapy arm or control arm. No statistically significant difference between intervention and control was observed in any of the scores though a trend of higher improvement of BI score is seen in the intervention group. Conclusion. Although this study did not have power to examine efficacy, it provides preliminary evidence of potential safety, feasibility, and tolerability of G-CSF therapy. Further studies need to be done on a large sample to confirm the results

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio

Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% 10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% 5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million 6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million 2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million 1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million 67.7-90.8] DALYs or 55.5% 48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million 22.3-48.6] DALYs or 24.3% 15.7-33.2]), high fasting plasma glucose (28.9 million 19.8-41.5] DALYs or 20.2% 13.8-29.1]), ambient particulate matter pollution (28.7 million 23.4-33.4] DALYs or 20.1% 16.6-23.0]), and smoking (25.3 million 22.6-28.2] DALYs or 17.6% 16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries

Slope Stability Analysis of Open Cast Mines Using FLAC 3D

Slope stability analysis has the most prominent influence in the productivity and longevity of a mine. Instability of slope of open cast mines can lead to enormous damages to man and machinery. A deterioration of slope in the area being worked of a mine can lead to a severe economic safety as well as great economic catastrophe. The slope failure is largely controlled by maintaining the geometry and geological status within safety limit, which are practically unique to a specific location of rock mass to prevent slope failure. A comprehensive study is necessitated to ensure stable slopes which are aided by numerical, analytical, physical, kinematic and empirical analyses. Using the FLAC 3D software stability of slope is analysed. The basic objective of the project work was aimed at to study the stability of slopes using numerical modelling; at the same time examine the influence of various parameters such as bench slope angle, cohesion, friction angle, bench height, bench width and change in number of benches on the stability of the slope. The analysis also covers the analysis of effect of defects on the stability of the slope. Numerical modelling was carried out by using FLAC 3D software for finding the factor of safety. It was observed that factor of safety increases with increase in the value of cohesion and friction angle and decreases with increase in cohesion. As the bench width of the open cast mine increases, factor of safety also increases whereas when bench height increases factor of safety decreases. Since bench width and bench height also play an important role in the stability of the slope so, bench width should be maintained between 15-25m and bench height should be maintained between 15-20m for an open cast coal mine. It was also observed that factor of safety of model without defect was 2.69 and with defect of size 5m×5m was 1.74.Thus, it is concluded that even small defect makes the slope unstable and stability of the slope depends on volume of defects

CF_4-<i>n</i>(SO₃)<i>_n</i> (<i>n</i> = 1–4): a new series of organic superhalogens

Superhalogens are species having higher electron affinity (EA) or vertical detachment energy (VDE) than those of halogen atoms. CF4 is a molecule having no positive EA or VDE. In the quest for new organic superhalogens, we substitute SO3 in the place of F in CF4 successively and study the resulting CF4-n(SO3)n (n = 1–4) neutral molecules and their anions using density functional theory and quantum theory of atoms in molecule at the ωB97xD/6-311 + G(d) and B3LYP/6-311 + G(d) levels, respectively. The EA of CF4-n(SO3)n and VDE of their anions, being greater than 5 eV, suggest that all these molecules behave as superhalogens. There is significant structural relaxation in C(SO3)4 molecule, leading to the remarkably high VDE of corresponding anions. The superhalogen properties have been explained on the basis of the electronic charge delocalisation over SO3 moieties. We believe that these findings will add a new chapter in the exploration of organic superhalogens.</p