Layer-dependent electronic structures and magnetic ground states of polar-polar LaVO3/KTaO3\rm{LaVO_3/KTaO_3} (001) interfaces

Using first-principles and model Hamiltonian approach, we explore the electronic properties of polar-polar LaVO$_3$/KTaO$_3$ (LVO/KTO, 001) hetero-interfaces of up to six and five layers of KTO and LVO, respectively. Our calculations suggest the presence of multiple Lifshitz transitions (LT) in the $t_{2g}$ bands which may show up in high thermal conductivity and Seebeck coefficient. The LT can be tuned by the number of LaVO$_3$ layers or gate voltage. The spin-orbit coupling is found to be negligible, coming only from the Ta $5d_{xy}$-derived band, 5$d_{xz}$ and 5$d_{yz}$ bands being far away from the Fermi level. The magnetic properties of the interfaces, due to Vanadium ions, turn out to be intriguing. The magnetic states are highly sensitive to the number of layers of LaVO$_3$ and KTaO$_3$: the interfaces with equal number of LVO and KTO layers always favor an antiferromagnetic (AFM) ordering. Moreover, the combination of even-even and odd-odd layers shows an AFM order for more than two LaVO$_3$ layers. The spin-polarized density of states reveals that all the interfaces with ferromagnetic (FM) ground states are \textit{half-metallic}. The small energy differences between AFM and FM configurations indicate a possible coexistence of competing AFM and FM ground states in these interfaces. In addition, the interface requires different number of LVO layers for it to be metallic: half-metallic FM for three and above, and metallic AFM for four and above.Comment: 11 pages, 10 figure

An acquired Bartter syndrome with secondary Sjögren syndrome

Renal tubular involvement in Sjögren's syndrome (SS) often described with renal tubular acidosis, nephrogenic diabetes insipidus, or rarely with Fanconi syndrome. SS presenting with clinical features of Bartter's syndrome or Gitelman's syndrome is rare. We report a case of a female patient who presented an acquired Bartter syndrome with a secondary SS. Our case highlights the fact that hypokalemia with metabolic alkalosis in an adult patient should prompt clinicians to look for common and uncommon conditions. While assessing for abnormal conditions, acquired Bartter syndrome should be considered if a patient has an underlying autoimmune, endocrine, or connective tissue disease

Modified dual osteotomy for Madelung’s deformity

Madelung’s deformity is one of the rare congenital deformities of the forearm and wrist, typically seen as positive ulnar variance and increased volar tilt due to the “Vickers” ligament. Different corrective surgical methods for this have been done in the literature. In this case of a 9-year-old Madelung’s like deformity, we have performed a modified dual osteotomy with periosteal preservation allowing natural articulation and bone to be modified, especially in a younger child. This article gives the surgical option to orthopedics for the future, especially in a younger child with severe deformity. This is a level V evidence-based therapeutic study

Optimization of Activated Tungsten Inert Gas welding process parameters using heat transfer search algorithm: with experimental validation using case studies

The Activated Tungsten Inert Gas welding (A-TIG) technique is characterized by its capability to impart enhanced penetration in single pass welding. Weld bead shape achieved by A-TIG welding has a major part in deciding the final quality of the weld. Various machining variables influence the weld bead shape and hence an optimum combination of machining variables is of utmost importance. The current study has reported the optimization of machining variables of A-TIG welding technique by integrating Response Surface Methodology (RSM) with an innovative Heat Transfer Search (HTS) optimization algorithm, particularly for attaining full penetration in 6 mm thick carbon steels. Welding current, length of the arc and torch travel speed were selected as input process parameters, whereas penetration depth, depth-to-width ratio, heat input and width of the heat-affected zone were considered as output variables for the investigations. Using the experimental data, statistical models were generated for the response characteristics. Four different case studies, simulating the real-time fabrication problem, were considered and the optimization was carried out using HTS. Validation tests were also carried out for these case studies and 3D surface plots were generated to confirm the effectiveness of the HTS algorithm. It was found that the HTS algorithm effectively optimized the process parameters and negligible errors were observed when predicted and experimental values compared. HTS algorithm is a parameter-less optimization technique and hence it is easy to implement with higher effectiveness

Choroidal Metastasis as the Initial Presentation of Rectal Adenocarcinoma

Choroidal metastasis from rectal cancer is a rare occurrence with limited literature on appropriate evidence-based treatment options. We describe the case of 44-year-old man who presented with left-sided painful vision loss who was found to have left choroidal and multiple lung metastasis from an unknown primary which was later found to be rectal adenocarcinoma

Role of fiberoptic bronchoscopy in sputum smear negative suspected cases of pulmonary tuberculosis: a study conducted in Southern part of Rajasthan

Background: Sputum smear negative pulmonary tuberculosis is a common problem faced by clinicians. Fiberoptic bronchoscopy may be very useful in diagnosing these cases which have no sputum or whose sputum smear is negative for acid fast bacilli. Objective of the current study was to assess the role of fiberoptic bronchoscopy in sputum smear negative under NTEP and radiologically suspected cases of pulmonary tuberculosis.Methods: Clinico-radiological suspected cases of pulmonary tuberculosis patients in whom two sputum smear for acid fast bacilli by Ziehl Neelsen stain under NTEP was negative were included in the study. Fiberoptic bronchoscopy was performed in all these patients and samples taken were sent for investigations.Results: Fiberoptic bronchoscopy was performed in 250 patients of suspected pulmonary tuberculosis whose sputum for AFB smear was negative. Cough was the most predominant symptom. Radiologically, right side disease was more common and upper zone was most commonly involved and infiltrates were common radiological finding. During bronchoscopy, congestion and hyperaemia (36%) and mucopurulent/mucoid secretions (32%) was seen in maximum number of cases. BAL was positive in 200 patients (80%), post bronchoscopy sputum was positive in 70 cases (28%) and biopsy was positive in 12 patients out of 16 performed biopsies (75%). The total TB positive cases after combining all the methods were 215 making the overall diagnostic yield of 86%.Conclusions: Fiberoptic bronchoscopy and post bronchoscopy sputum can be very useful for diagnosing sputum for AFB smear negative but clinico-radiological suspected cases of pulmonary tuberculosis patients

A study of bronchial asthma in school going children in Southern part of Rajasthan

Background: Asthma is a chronic and common inflammatory disease involving mainly large airways of lungs. Childhood asthma is common chronic illness among school going children and is usually underdiagnosed and undertreated. The aim of the present study was to find out of the prevalence of Bronchial asthma in school going children of age group 6-12 years in southern part of Rajasthan (India), and its relation with gender, socio-economic status and heredity.Methods: A questionnaire-based study has been carried out in 1500 children of 6 to 12 years age group in four schools of Udaipur city (Rajasthan, India) with a response rate of 60.23% (904/1500).Results: The overall prevalence of asthma observed is 4.75% (43/904). The prevalence is higher among boys (5.55%) as compared to girls (3.75%). Further the prevalence is higher in upper (7.18%) and upper middle class (7.14%) children as compared to lower middle (4.84%) and upper lower class (2.01%) socioeconomic status. The children with positive family history of asthma also have higher prevalence (26.31%) of asthma.Conclusions: The prevalence of childhood asthma in Udaipur city is relatively lower and supports the already reported relation with gender, socioeconomic status and heredity.

Phase 1 study of mTORC1/2 inhibitor sapanisertib (TAK-228) in advanced solid tumours, with an expansion phase in renal, endometrial or bladder cancer

Background: This Phase 1 dose-escalation/expansion study assessed safety/tolerability of sapanisertib, an oral, highly selective inhibitor of mTORC1/mTORC2, in advanced solid tumours. Methods: Eligible patients received increasing sapanisertib doses once daily (QD; 31 patients), once weekly (QW; 30 patients), QD for 3 days on/4 days off QW (QD × 3dQW; 33 patients) or QD for 5 days on/2 days off QW (QD × 5dQW; 22 patients). In expansion cohorts, 82 patients with renal cell carcinoma (RCC), endometrial or bladder cancer received sapanisertib 5 mg QD (39 patients), 40 mg QW (26 patients) or 30 mg QW (17 patients). Results: Maximum tolerated doses of sapanisertib were 6 mg QD, 40 mg QW, 9 mg QD × 3dQW and 7 mg QD × 5dQW. Frequent dose-limiting toxicities (DLTs) included hyperglycaemia, maculo-papular rash (QD), asthenia and stomatitis (QD × 3dQW/QD × 5dQW); expansion phase doses of 5 mg QD and 30 mg QW were selected based on tolerability beyond the DLT evaluation period. One patient with RCC achieved complete response; nine experienced partial responses (RCC: seven patients; carcinoid tumour/endometrial cancer: one patient each). Sapanisertib pharmacokinetics were time-linear and supported multiple dosing. Pharmacodynamic findings demonstrated treatment-related reductions in TORC1/2 biomarkers. Conclusions: Sapanisertib demonstrated a manageable safety profile, with preliminary antitumour activity observed in RCC and endometrial cancer

LEARN: A multi-centre, cross-sectional evaluation of Urology teaching in UK medical schools

OBJECTIVE: To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. MATERIALS AND METHODS: LEARN was a national multicentre cross-sectional study. Year 2 to Year 5 medical students and FY1 doctors were invited to complete a survey between 3rd October and 20th December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). RESULTS: 7,063/8,346 (84.6%) responses from all 39 UK medical schools were included; 1,127/7,063 (16.0%) were from Foundation Year (FY) 1 doctors, who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. CONCLUSION: LEARN is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated by the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures