Benefits of Turbinectomy vs Turbinoplasty – A Prospective Study

Introduction Inferior turbinate hypertrophy (ITH) is one of the major causes of nasal airway obstruction. Nasal obstruction due to inferior turbinate hypertrophy is noted in around 20% of the population. Surgical reduction of the hypertrophied inferior turbinate is required when medical treatment fails. This study aimed to compare the Nasal obstruction symptom evaluation (NOSE) scores and complications of inferior turbinate reduction by turbinectomy and turbinoplasty. Materials and Methods In this prospective observational randomized controlled study, 30 patients underwent turbinectomy and 30 underwent turbinoplasty. Pre and postoperative NOSE scores and incidence of postoperative bleeding and crusting were compared at first week and six months. Results The mean preoperative NOSE score of turbinectomy group was 75.83 and that of turbinoplasty group was 76.83. Both the groups showed statistically significant improvement (p< 0.05) in NOSE score post-operatively. Functional outcome is achieved with turbinoplasty by sparing the nasal mucosa and submucosa along with retention of function bearing structures (inferior turbinate). Though not statistically significant, the incidence of post-operative bleeding and crusting were lower after turbinoplasty, in comparison to turbinectomy. Conclusion Inferior turbinoplasty provides excellent outcome in a wide variety of patients with minimal morbidity. Turbinoplasty is associated with lesser mucosal injury, post-operative bleeding and crusting, and excellent outcome in terms of symptomatic relief and functionality. Hence, we recommend that it can be done for the treatment of ITH

Sequential herbicide application coupled with mulch enhances the productivity and quality of winter onion (Allium cepa L.) while effectively controlling the mixed weed flora

Weed control poses substantial difficulties for winter season onion (Allium cepa L.) cultivation in the north-western Indo-Gangetic Plains, primarily due to the constrained efficacy of the existing herbicides. To address this issue, a 2-year field study was conducted to assess the efficacy of pre- and post-emergence herbicides (pendimethalin, ethoxysulfuron, imazethapyr, and quizalofop-p-ethyl) individually and in combination with crop residue mulch for weed control in winter onion. The results revealed that using herbicides or mulches in isolation did not provide satisfactory weed control. However, the integration of natural mulch with pendimethalin followed by quizalofop-p-ethyl application proved to be the most effective weed control strategy, resulting in the least reduction in bulb yield (10.3%) compared to other treatments. On the contrary, combinations of pendimethalin with ethoxysulfuron or imazethapyr showed adverse effects on the onion crop and inflicted the highest yield losses among all treatments (78.6 and 83.4%, respectively). However, the combination of pendimethalin with quizalofop-p-ethyl coupled with crop mulch resulted in season-long weed control and over 80% bulb yield (36.58 t/ha) gains compared to the weed-free condition. These findings emphasize the efficacy of combining herbicides and mulches as an integrated weed management strategy for onions. By adopting such integrated approaches, farmers could improve weed control while maintaining bulb yield and quality, reducing the risks associated with herbicide resistance, and promoting sustainable onion production in the north-western Indo-Gangetic Plains

Genome Diversity and the Origin of the Arabian Horse

The Arabian horse, one of the world\u27s oldest breeds of any domesticated animal, is characterized by natural beauty, graceful movement, athletic endurance, and, as a result of its development in the arid Middle East, the ability to thrive in a hot, dry environment. Here we studied 378 Arabian horses from 12 countries using equine single nucleotide polymorphism (SNP) arrays and whole-genome re-sequencing to examine hypotheses about genomic diversity, population structure, and the relationship of the Arabian to other horse breeds. We identified a high degree of genetic variation and complex ancestry in Arabian horses from the Middle East region. Also, contrary to popular belief, we could detect no significant genomic contribution of the Arabian breed to the Thoroughbred racehorse, including Y chromosome ancestry. However, we found strong evidence for recent interbreeding of Thoroughbreds with Arabians used for flat-racing competitions. Genetic signatures suggestive of selective sweeps across the Arabian breed contain candidate genes for combating oxidative damage during exercise, and within the Straight Egyptian subgroup, for facial morphology. Overall, our data support an origin of the Arabian horse in the Middle East, no evidence for reduced global genetic diversity across the breed, and unique genetic adaptations for both physiology and conformation

Thermal Spray Coatings for Electromagnetic Wave Absorption and Interference Shielding: A Review and Future Challenges

This review paper aims to consolidate scattered literature on thermally sprayed coatings with non-ionising electromagnetic (EM) wave absorption and shielding over specific wavelengths potentially useful in diverse applications (e.g., microwave to millimeter wave, solar selective, photocatalytic, interference shielding, thermal barrier-heat/emissivity). Materials EM properties such as electric permittivity, magnetic permeability, electrical conductivity, and dielectric loss are critical due to which a material can respond to absorbed, reflected, transmitted, or may excite surface electromagnetic waves at frequencies typical of electromagnetic radiations. Thermal spraying is a standard industrial practice used for depositing coatings where the sprayed layer is formed by successive impact of fully or partially molten droplets/particles of a material (used in the form of powder or wire) exposed to high or moderate temperatures and velocities. However, as an emerging novel application of an existing thermal spray techniques, some special considerations are warranted for targeted development involving relevant characterisation. Key potential research areas of development relating to material selection and coating fabrication strategies and their impact on existing practices in the field are identified. The study shows a research gap in the feedstock materials design and doping (including hollow and yolk-shelled structure types) and their complex selection covered by thermally sprayed coatings that can be critical to advancing applications exploiting their electromagnetic properties

Thermal Spray Coatings for Electromagnetic Wave Absorption and Interference Shielding: A Review and Future Challenges

This review paper aims to consolidate scattered literature on thermally sprayed coatings with non-ionising electromagnetic (EM) wave absorption and shielding over specific wavelengths potentially useful in diverse applications (e.g., microwave to millimeter wave, solar selective, photocatalytic, interference shielding, thermal barrier-heat/emissivity). Materials EM properties such as electric permittivity, magnetic permeability, electrical conductivity, and dielectric loss are critical due to which a material can respond to absorbed, reflected, transmitted, or may excite surface electromagnetic waves at frequencies typical of electromagnetic radiations. Thermal spraying is a standard industrial practice used for depositing coatings where the sprayed layer is formed by successive impact of fully or partially molten droplets/particles of a material (used in the form of powder or wire) exposed to high or moderate temperatures and velocities. However, as an emerging novel application of an existing thermal spray techniques, some special considerations are warranted for targeted development involving relevant characterisation. Key potential research areas of development relating to material selection and coating fabrication strategies and their impact on existing practices in the field are identified. The study shows a research gap in the feedstock materials design and doping (including hollow and yolk-shelled structure types) and their complex selection covered by thermally sprayed coatings that can be critical to advancing applications exploiting their electromagnetic properties

Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2)

OBJECTIVES: We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence and topic areas that were not previously addressed. DESIGN: International consensus conference series involving 52 multidisciplinary international content experts in PARDS and four methodology experts from 15 countries, using consensus conference methodology, and implementation science. SETTING: Not applicable. PATIENTS: Patients with or at risk for PARDS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eleven subgroups conducted systematic or scoping reviews addressing 11 topic areas: 1) definition, incidence, and epidemiology; 2) pathobiology, severity, and risk stratification; 3) ventilatory support; 4) pulmonary-specific ancillary treatment; 5) nonpulmonary treatment; 6) monitoring; 7) noninvasive respiratory support; 8) extracorporeal support; 9) morbidity and long-term outcomes; 10) clinical informatics and data science; and 11) resource-limited settings. The search included MEDLINE, EMBASE, and CINAHL Complete (EBSCOhost) and was updated in March 2022. Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to summarize evidence and develop the recommendations, which were discussed and voted on by all PALICC-2 experts. There were 146 recommendations and statements, including: 34 recommendations for clinical practice; 112 consensus-based statements with 18 on PARDS definition, 55 on good practice, seven on policy, and 32 on research. All recommendations and statements had agreement greater than 80%. CONCLUSIONS: PALICC-2 recommendations and consensus-based statements should facilitate the implementation and adherence to the best clinical practice in patients with PARDS. These results will also inform the development of future programs of research that are crucially needed to provide stronger evidence to guide the pediatric critical care teams managing these patients.</p

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population.

In clinical practice and for scientific purposes, cardiologists and primary care physicians perform risk assessment in patients with cardiac diseases or conditions with high risk of developing such. The European Heart Rhythm Association (EHRA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS) set down this expert consensus statement task force to summarize the consensus regarding risk assessment in cardiac arrhythmias. Objectives were to raise awareness of using the right risk assessment tool for a given outcome in a given population, and to provide physicians with practical proposals that may lead to rational and evidence-based risk assessment and improvement of patient care in this regard. A large variety of methods are used for risk assessment and choosing the best methods and tools hereof in a given situation is not simple. Even though parameters and test results found associated with increased risk of one outcome (e.g. death) may also be associated with higher risk of other adverse outcomes, specific risk assessment strategies should be used only for the purposes for which they are validated. The work of this task force is summarized in a row of consensus statement tables

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec