A New Proposed PDF for the Sub-Optimum Receiver Architecture

The detection performance of communication systems in general is limited by the presence of undesirable energy in the received signal. And this undesirable energy at communication receiver is modeled as the sum of gaussian noise and impulsive interference for which closed form probability density function generally does not exist. Due to this implementation of optimum receivers becomes very difficult. In this paper an alternate PDF is proposed written in closed form which provides a much simple architecture

Evaluation of the Efficacy of a Conventional Bristle Brush and Cross-action Brush in Routine Oral Hygiene Practice: A Comparative Study

Background: Toothbrush filament configuration can vary to a large extent with a considerable emphasis on the design and texture of bristle of a toothbrush in order to enhance effective removal of plaque. Aims: The aim of the study was to compare the plaque removing efficiency of two branded toothbrushes with different brush head design and bristle arrangement in routine oral hygiene practice. Materials and methods: The study was randomized single blind, involving 100 healthy individuals, 50 samples in each group. At the time of initial examination the subjects randomly picked toothbrushes (Oral B fresh-clean and Oral B crossaction) and common toothpaste by lottery method along with the printed instructions to use the assigned brush for next 28 days. Plaque and gingival indices were recorded at appointed time every 0, 7th, 14th, 21st and 28th day. Finally, the resultswere subjected to student’s unpaired ‘t test’. Results: Plaque and gingival scores showed a significant decrease in all parameters at all time intervals. Plaque and gingival scores were found to be significantly reduced in 3rd and 4th week time interval with respect to both the brushes though the cross-action brush showed better result with mean reduction of gingival index score from 1.812 at baseline to 1.5733 at 4th week as compared to fresh-clean brush which showed mean reduction of gingival index score from 1.4161 at baseline to 1.4016 at 4th week. Conclusion: Among the two toothbrushes it was Oral-B crossaction toothbrush which showed the maximum reduction in plaque and gingival index scores followed by Oral-B fresh-clean toothbrush. It can be concluded that the arrangement of bristles plays a convincing role in reduction of plaque besides the manual dexterity of an individual

Students, perception of computer assisted teaching and learning of anat- omy-in a scenario where cadavers are lacking

Abstract Computer software program for three dimensional (3D) modeling of anatomical structures in the human body that presents detailed and step by step cadaver dissections can be used for computer assisted teaching and learning of anatomy. Anatomical drawing, models, skeletons, and live demonstrations supplement the classroom learning environment. It can provide detailed human anatomical training for students, where there is a lack of cadaver facility. The multimedia equipped interactive Anatomical laboratory software's enhance both memorization and visual learning skill and has been shown to be an effective teaching aid (Guy & Frisby, 1992), they will improve imaging data analysis and so represent a major advance in determining prognosis and therapeutic strategy. THE AIM of the study is to survey student's opinion/perception on the use of computer assisted classes for teaching anatomy and to determine the place of computer in the teaching-learning process of anatomy to bachelor of medicine and bachelor of surgery (MBBS) students, as whether they can replace or substitute cadavers. A questionnaire model was given to MBBS students. While studying anatomy, the students accessed a room equipped with computers containing previously loaded anatomy programs. The analysis of the questionnaire showed that for students the computer room considerably facilitate the study of anatomy in easy manner and also potentially increases the understanding of the lesson, at the same time considered that the computer room cannot replace cadaver dissection

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Cellular therapies for the treatment of immune-mediated GI and liver disease.

INTRODUCTION Immune-mediated liver and gastrointestinal diseases are chronic conditions that lack curative treatments. Despite advances in the understanding and treatment of these conditions, they frequently remain refractory to treatment and represent a significant unmet need. Cellular therapies are an emerging option and hold the potential to have a major impact. DATA SOURCES A literature review was carried out using Pubmed. Keywords used for search were 'ATMP', 'immune mediated', 'autoimmune liver disease' and 'immune mediated gastrointestinal conditions', 'cell therapy', 'MSC', 'HSCT', 'Regulatory T cells', 'GVHD', 'Coeliac disease' 'IBD', 'PSC', 'AIH', 'PBC'. No new data were generated or analysed in support of this review. AREAS OF AGREEMENT There is substantial evidence from clinical trials to support the use of cell therapies as a treatment for immune-mediated liver and gastrointestinal conditions. Cellular therapy products have the ability to 'reset' the dysregulated immune system and this in turn can offer a longer term remission. There are ongoing clinical trials with mesenchymal stromal cells (MSCs) and other cells to evidence their efficacy profile and fill the gaps in current knowledge. Insights gained will inform future trial designs and subsequent therapeutic applications. AREAS OF CONTROVERSY There remains some uncertainty around the extrapolation of results from animal studies to clinical trials. Longevity of the therapeutic effects seen after the use of cell therapy needs to be scrutinized further. Heterogeneity in the selection of cells, source, methods of productions and cell administration pose challenges to the interpretation of the data. GROWING POINTS MSCs are emerging as a key therapeutic cells in immune-mediated liver and gastrointestinal conditions. Ongoing trials with these cells will provide new insights and a better understanding thus informing future larger scale studies. AREAS TIMELY FOR DEVELOPING RESEARCH Larger scale clinical trials to build on the evidence from small studies regarding safety and efficacy of cellular therapy are still needed before cellular therapies can become off the shelf treatments. Alignment of academia and industry to standardize the processes involved in cell selection, manipulation and expansion and subsequent use in clinical trials is an important avenue to explore further

Cell Therapy for Liver Disease: From Promise to Reality.

Over the last decade, there has been a considerable progress in the development of cell therapy products for the treatment of liver diseases. The quest to generate well-defined homogenous cell populations with defined mechanism(s) of action has enabled the progression from use of autologous bone marrow stem cells comprising of heterogeneous cell populations to allogeneic cell types such as monocyte-derived macrophages, regulatory T cells, mesenchymal stromal cells, macrophages, etc. There is growing evidence regarding the multiple molecular mechanisms pivotal to various therapeutic effects and hence, careful selection of cell therapy product for the desired putative effects is crucial. In this review, we have presented an overview of the cell therapies that have been developed thus far, with preclinical and clinical evidence for their use in liver disease. Limitations associated with these therapies have also been discussed. Despite the advances made, there remain multiple challenges to overcome before cell therapies can be considered as viable treatment options, and these include larger scale clinical trials, scalable production of cells according to good manufacturing practice standards, pathways for delivery of cell therapy within hospital environments, and costs associated with the production