Antepartum transabdominal amnioinfusion in oligohydramnios - a comparative study

Background: The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion in oligohydramnios with the view to improving pregnancy outcome in oligohydramnios, a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies.Methods: The study comprised of a prospective analysis of 130 pregnant women with oligohydramnios, divided into two groups, the study and control group of 65 patients each and were similar with regard to age, gravidity, parity, gestational age. TAA was performed on all patients in the study group and the results were compared and analyzed.Results: Mean gestational age at first treatment was 29.98 weeks in study group. Mean pre-procedure amniotic fluid index was 4.01 and post-procedure was 12.49. A total of 106 infusions were done on 65 patients (mean1.63). Mean latency period in study group was 49.53 and in controls 26.49. There was significant decrease in fetal distress in patients in study group. 30 % of patients needed caesarean section in study group compared to 60% in controls. Number of preterm deliveries was 18 and 45 respectively in study and control groups. 61% of newborns in the study group weighed more than 2.5 kg compared to only 24% in control group. Neonatal ICU admissions and newborn deaths were lesser in study group.Conclusions: Transabdominal amnioinfusion is an extremely useful procedure to reduce complications arising from oligohyramnios. It significantly increases the latency period, decreases the occurrence of fetal distress preterm deliveries, need for caesarean or instrumental deliveries, improves birth weight of the newborns and significantly reduces the neonatal morbidity and mortality

Magnetite Molybdenum Disulphide Nanofluid of Grade Two: A Generalized Model with Caputo-Fabrizio Derivative

Heat and mass transfer analysis in magnetite molybdenum disulphide nanofluid of grade two is studied. MoS2 powder with each particle of nanosize is dissolved in engine oil chosen as base fluid. A generalized form of grade-two model is considered with fractional order derivatives of Caputo and Fabrizio. The fluid over vertically oscillating plate is subjected to isothermal temperate and species concentration. The problem is modeled in terms of partial differential equations with sufficient initial conditions and boundary conditions. Fractional form of Laplace transform is used and exact solutions in closed form are determined for velocity field, temperature and concentration distributions. These solutions are then plotted for embedded parameters and discussed. Results for the physical quantities of interest (skin friction coefficient, Nusselt number and Sherwood number) are computed in tables. Results obtained in this work are compared with some published results from the open literature

Regulation of TNF-α and NF-κB activation through the JAK/STAT signaling pathway downstream of histamine 4 receptor in a rat model of LPS-induced joint inflammation.

Histamine 4 receptor (H4R) is a novel target for the pharmacological modulation of histamine-mediated immune signals during inflammatory diseases. The purpose of this study was to assess the effects of the H4R agonist 4-methylhistamine dihydrochloride (4-MeH) and antagonist JNJ7777120 (JNJ) in the inflamed rat knee. Animals were fasted for 18h before a single dose of 4-MeH or JNJ (30mg/kg) was administered intraperitoneally (i.p.), both followed by intra-articular (i.a.) injection of LPS 2h later. Blood and synovial fluid were collected after a short incubation period and TNF-α, NF-κB, and IkB-α levels were measured via flow cytometry. Additionally, we assessed the effects of H4R engagement on the expression of IL-1β, TNF-α, and NF-κB mRNAs and the protein levels of TNF-α, NF-κB, JAK-1, and STAT-3 in the inflamed knee tissue. These results revealed increased TNF-α and NF-κB expression and decreased IkB-α levels in both the LPS alone and 4-MeH treated groups in whole blood and synovial fluid. Further, IL-1β, TNF-α, and NF-κB mRNA levels were significantly increased and western blot analysis confirmed increased expression of TNF-α, NF-κB, JAK-1, and STAT-3 in both LPS and 4-MeH treatment groups. Furthermore, these increases were completely inhibited in the inflamed knee tissue of the JNJ-treated group. Thus, the inhibition of inflammatory mediators and signaling pathways by the H4R antagonist JNJ suggests the anti-arthritic importance of this molecule

Methyl 4-hy­droxy-2-meth­oxy­carbonyl­methyl-1,1-dioxo-1,2-dihydro-1λ6,2-benzothia­zine-3-carboxyl­ate1

There are two independent mol­ecules in the asymmetric unit of the title compound, C13H13NO7S, which have almost identical geometries. The thia­zine ring adopts a sofa conformation in both mol­ecules and the mol­ecular conformations are stabilized by intramolecular O—H⋯O hydrogen bonds. Inter­molecular C—H⋯O hydrogen bonds stabilize the crystal packing

Thermodynamic and technoeconomic comparative justification of a waste heat recovery process with integration of multifluid and indirect evaporative cooler

For a well-developed, efficient and feasible system, it is necessary to produce power generation enormously with a reduction in harmful emissions like Carbon dioxide (CO2), Carbon monoxide (CO), Nitrogen (N), Nitrogen oxide (NOx), and Sulphur dioxide (SO2). Waste heat gases emit directly into an environment, it has many adverse effects on the environment including global warming, environmental pollution, and effect on human health as well. Researchers believe that a thermally efficient system could be achieved by converting waste heat gases into net power output. From this system, the efficiency obtained is 5% to 8% unable to meet the space and cost demands of this waste heat recovery (WHR) system. For waste heat recovery, the most typical cycles used for this are the Rankine cycle and Brayton cycle. Even though these are the best cycles but their efficiency is not as such maximum. By observing all these aspects, there is a different way of recovering waste heat and that is an indirect evaporative cooler (IDE). An indirect evaporative cooler is beneficial in terms of enormous power generation, getting maximum efficiency, low operating cost, and acquiring a sustainable system. The focus of current research was to recover industrial waste heat gases exhausted from SP boilers in the cement industry. ASPEN HYSYS software is used for generating a waste heat recovery model that further operates on the Maisotsenko cycle (M cycle). The topping cycle and bottoming cycle are used in this model. Both the working fluid air and binary mixture CO2-C7H8 operated in a model. By manipulating the model with working fluid air, this system generated a net power output of 68.53 MW with 35.44% thermal efficiency. Integrating the model with a binary mixture of CO2-C7H8 permits 48.59 MW output power with a 38.57% efficiency value. Comparison analysis is performed for extracting the best optimal parameters with extreme power generation and the greatest efficiency value. The industrial operating parameters of the Bestway cement industry operated in this developed model present 38.04 MW and 30.63 MW of power generation with 27.78% and 27.77% efficiency by executing both fluids air and CO2-C7H8 mixture. A techno-economic analysis (TEA) is performed for this entire waste heat recovery system which exhibits a cost of $30/MWh along 3 years payback period

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe