Finite Difference Solution of Conjugate Heat Transfer in Double Pipe with Trapezoidal Fins

A conjugate heat transfer problem on the shell side of a finned double pipe heat exchanger is numerically studied by suing finite difference technique. Laminar flow with isothermal boundary conditions is considered in the finned annulus with fully developed flow region to investigate the influence of variations in the fin height, the number of fins and the fluid and wall thermal conductivities on the hydraulic and thermal design of the exchanger. The governing momentum and energy equations have been solved by a finite difference-based numerical algorithm. The improvement in heat transfer rates, the exchanger performance and the optimum configurations are discussed

Schwannoma of the Appendix Mimicking a Metastatic Breast Cancer: A case report

Metastatic breast cancer (MBC) represents 5-10% of newly diagnosed breast cancer cases, referred to as de novo stage IV MBC. Distinguishing a distant lesion in breast cancer patients can be challenging. Therefore, obtaining a histopathological confirmation of a metastasis is advisable, as a suspicious metastatic lesion may turn out to be benign or exhibit different immunohistochemistry compared to the primary site. In this case, we describe a woman undergoing staging scans for newly diagnosed breast cancer, where radiological findings suggested appendix metastasis. However, subsequent laparoscopic appendicectomy revealed an appendicular schwannoma, confirmed through immunohistochemistry. The patient then received curative-intent breast cancer treatment. With the increasing use of advanced staging scans in breast cancer, clinicians should thoroughly investigate and confirm metastatic disease, especially in uncommon metastatic sites, before initiating treatment. Keywords: Schwannoma, metastasis, breast cancer, appendix

Supra-subduction zone tectonic setting of the Muslim Bagh Ophiolite, northwestern Pakistan: Insights from geochemistry and petrology

The geology of the Muslim Bagh area comprises the Indian passive continental margin and suture zone, which is overlain by the Muslim Bagh Ophiolite, Bagh Complex and a Flysch Zone of marine–fluvial successions. The Muslim Bagh Ophiolite has a nearly-complete ophiolite stratigraphy. The mantle sequence of foliated peridotite is mainly harzburgite with minor dunite and contains podiform chromite deposits that grade upwards into transition zone dunite. The mantle rocks (harzburgite/dunite) resulted from large degrees of partial melting of lherzolite and have also been affected by melt–peridotite reaction. The Muslim Bagh crustal section has a cyclic succession of ultramafic–mafic cumulate with dunite at the base, that grades into wehrlite/pyroxenite with gabbros (olivine gabbro, norite and hornblende gabbro) at the top. The sheeted dykes are immature in nature and are rooted in crustal gabbros. The dykes are mainly metamorphosed dolerites, with minor intrusions of plagiogranites. The configuration of the crustal section indicates that the crustal rocks were formed over variable time periods, in pulses, by a low magma supply rate. The whole rock geochemistry of the gabbros, sheeted dykes and the mafic dyke swarm suggests that they formed in a supra-subduction zone tectonic setting in Neo-Tethys during the Late Cretaceous. The dykes of the mafic swarm crosscut both the ophiolite and the metamorphic sole rocks and have a less-marked subduction signature than the other mafic rocks. These dykes were possibly emplaced off-axis and can be interpreted to have been generated in the spinel peridotite stability zone i.e., < 50–60 km, and to have risen through a slab window. The Bagh Complex is an assemblage of Triassic–Cretaceous igneous and sedimentary rocks, containing tholeiitic, N-MORB-like basalts and alkali basalts with OIB-type signatures. Nb–Ta depletion in both basalt types suggests possible contamination from continental fragments incorporated into the opening Tethyan oceanic basin during break-up of Gondwana. The lithologies and ages of the Bagh Complex imply that these rocks formed in an area extending from the continental margin over the Neo-Tethyan ocean floor. The Bagh Complex was then juxtaposed with the Muslim Bagh Ophiolite in the final stage of tectonic emplacement

SYNTHESIS AND CHARACTERIZATION OF Mg-Al ALLOYS FOR HYDROGEN STORAGE APPLICATIONS

Mg-Al system and 2mol% Ni additive nano catalyst in the particle size range of 30-45 nm were synthesized at relatively low temperature by thermal decomposition of co- 4 and [Ni(Bipy

Human knockouts and phenotypic analysis in a cohort with a high rate of consanguinity

A major goal of biomedicine is to understand the function of every gene in the human genome. Loss-of-function mutations can disrupt both copies of a given gene in humans and phenotypic analysis of such 'human knockouts' can provide insight into gene function. Consanguineous unions are more likely to result in offspring carrying homozygous loss-of-function mutations. In Pakistan, consanguinity rates are notably high. Here we sequence the protein-coding regions of 10,503 adult participants in the Pakistan Risk of Myocardial Infarction Study (PROMIS), designed to understand the determinants of cardiometabolic diseases in individuals from South Asia. We identified individuals carrying homozygous predicted loss-of-function (pLoF) mutations, and performed phenotypic analysis involving more than 200 biochemical and disease traits. We enumerated 49,138 rare (<1% minor allele frequency) pLoF mutations. These pLoF mutations are estimated to knock out 1,317 genes, each in at least one participant. Homozygosity for pLoF mutations at PLA2G7 was associated with absent enzymatic activity of soluble lipoprotein-associated phospholipase A2; at CYP2F1, with higher plasma interleukin-8 concentrations; at TREH, with lower concentrations of apoB-containing lipoprotein subfractions; at either A3GALT2 or NRG4, with markedly reduced plasma insulin C-peptide concentrations; and at SLC9A3R1, with mediators of calcium and phosphate signalling. Heterozygous deficiency of APOC3 has been shown to protect against coronary heart disease; we identified APOC3 homozygous pLoF carriers in our cohort. We recruited these human knockouts and challenged them with an oral fat load. Compared with family members lacking the mutation, individuals with APOC3 knocked out displayed marked blunting of the usual post-prandial rise in plasma triglycerides. Overall, these observations provide a roadmap for a 'human knockout project', a systematic effort to understand the phenotypic consequences of complete disruption of genes in humans.D.S. is supported by grants from the National Institutes of Health, the Fogarty International, the Wellcome Trust, the British Heart Foundation, and Pfizer. P.N. is supported by the John S. LaDue Memorial Fellowship in Cardiology from Harvard Medical School. H.-H.W. is supported by a grant from the Samsung Medical Center, Korea (SMO116163). S.K. is supported by the Ofer and Shelly Nemirovsky MGH Research Scholar Award and by grants from the National Institutes of Health (R01HL107816), the Donovan Family Foundation, and Fondation Leducq. Exome sequencing was supported by a grant from the NHGRI (5U54HG003067-11) to S.G. and E.S.L. D.G.M. is supported by a grant from the National Institutes of Health (R01GM104371). J.D. holds a British Heart Foundation Chair, European Research Council Senior Investigator Award, and NIHR Senior Investigator Award. The Cardiovascular Epidemiology Unit at the University of Cambridge, which supported the field work and genotyping of PROMIS, is funded by the UK Medical Research Council, British Heart Foundation, and NIHR Cambridge Biomedical Research Centre ... Fieldwork in the PROMIS study has been supported through funds available to investigators at the Center for Non-Communicable Diseases, Pakistan and the University of Cambridge, UK

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown