Asymptomatic cardiac manifestations in CKD

Background: Chronic kidney disease is recognised as health concern globally with more than 40 percent of morbididty and mortality. CKD is one of the independent risk factor for cardiovascular diseases and its unfavourable health outcomes. The risk factors like smoking, hypertension, dyslipidemia and diabetes which are highly prevalent in CKD. The therapeutic interventions in CKD patients to reduce CVD events does not hold a desired effect and has bad prognosis in end stage renal disease. The initial evidence indicating a relationship between CKD and CVD is more apparent in patient with dialysis. The aim of the study was to evaluate the asymptomatic cardiac manifestations in 2-4 stages of CKD through non-invasive methods like ECG and Echocardiography.Methods: It is a cross sectional study investigated on 250 CKD patients receiving care in JSS hospital, Mysore. For the primary objective, correlational analysis were performed to evaluate the association of renalfunctional parameters like serum creatinine, urine albumin, eGFR with cardiac parameters through ECG and Echocardiographic changes.Results: ECG revealed LVH with pressure overload pattern in 36%. 25% patients had ST-T changes. Echocardiography revealed LVH and diastolic dysfunction as abnormalities. LVH has significant p value.Conclusions: CVD is a leading cause of morbidity and mortality in patients of CKD who succumb to Cardio vascular deaths before reaching the end stage renal disease. Thus, focus of patient care in early CKD stages should be directed to prevention of cardiovascular complications through early ECG and Echocardiography

Bone marrow transplantation alters the tremor phenotype in the murine model of globoid-cell leukodystrophy

Tremor is a prominent phenotype of the twitcher mouse, an authentic genetic model of Globoid-Cell Leukodystrophy (GLD, Krabbe’s disease). In the current study, the tremor was quantified using a force-plate actometer designed to accommodate low-weight mice. The actometer records the force oscillations caused by a mouse’s movements, and the rhythmic structure of the force variations can be revealed. Results showed that twitcher mice had significantly increased power across a broad band of higher frequencies compared to wildtype mice. Bone marrow transplantation (BMT), the only available therapy for GLD, worsened the tremor in the twitcher mice and induced a measureable alteration of movement phenotype in the wildtype mice. These data highlight the damaging effects of conditioning radiation and BMT in the neonatal period. The behavioral methodology used herein provides a quantitative approach for assessing the efficacy of potential therapeutic interventions for Krabbe’s disease

Health Care Chatbot Assistant System

Rasa stack consists of many open source AI apparatuses solely utilized in plan to make a logical chatbot. It consists of incredible APIs embedded along the Rasa stack that incorporates  Natural language understanding. It incorporates the sack of words calculation helping in streamlining portrayl utilized in measurable displaying and AI stages and furthermore trend setting innovation. The proposed framework is to make an option in contrast to this ordinary strategy for visiting a clinic and making a meeting with a specialist to get analysis. From the user queries chatbot will, predicts the infection and prescribes treatment along with necessary medicine. It like wise support the utilization of this RASA stage for the client specific format according to their prerequisites and furthermore elevates in building up the system for better efficiency

Bone Marrow Transplantation Alters the Tremor Phenotype in the Murine Model of Globoid-Cell Leukodystrophy

This is the publisher's version, also available electronically from "http://www.mdpi.com".Tremor is a prominent phenotype of the twitcher mouse, an authentic genetic model of Globoid-Cell Leukodystrophy (GLD, Krabbe’s disease). In the current study, the tremor was quantified using a force-plate actometer designed to accommodate low-weight mice. The actometer records the force oscillations caused by a mouse’s movements, and the rhythmic structure of the force variations can be revealed. Results showed that twitcher mice had significantly increased power across a broad band of higher frequencies compared to wildtype mice. Bone marrow transplantation (BMT), the only available therapy for GLD, worsened the tremor in the twitcher mice and induced a measureable alteration of movement phenotype in the wildtype mice. These data highlight the damaging effects of conditioning radiation and BMT in the neonatal period. The behavioral methodology used herein provides a quantitative approach for assessing the efficacy of potential therapeutic interventions for Krabbe’s disease

SIGNAL PROCESSING TECHNIQUES FOR EV CHARGING

With the conventional energy resources diminishing at a rapid rate, it has become extremely important that alternate sources of energy be found to drive vehicles. Electricity is one such option. But it has been observed that by making use of electricity a slight change in the vehicular hardware is required. As a result the plug-in hybrid electric vehicles (PHEV) and the plug-in electric vehicles (PEV) have been developed. These vehicles have to be charged for their usage. It is observed that the electric power distribution grid is not currently prepared to effectively accommodate the increase in load caused by charging of the Electric Vehicle (EVs) batteries. Solving this issue involves infrastructure development such as establishment of smart grids and also application of a number of signal processing techniques. This paper introduces the main issues related with the operation of EVs in a smart grid infrastructure and the different signal processing techniques can be applied in this context

Bone Marrow Transplantation Augments the Effect of Brain- and Spinal Cord-Directed Adeno-Associated Virus 2/5 Gene Therapy by Altering Inflammation in the Murine Model of Globoid-Cell Leukodystrophy

Globoid-cell leukodystrophy (GLD) is an inherited demyelinating disease caused by the deficiency of the lysosomal enzyme galactosylceramidase (GALC). A previous study in the murine model of GLD (twitcher) demonstrated a dramatic synergy between CNS-directed adeno-associated virus 2/5 (AAV2/5) gene therapy and myeloreductive bone marrow transplantation (BMT). However, the mechanism by which these two disparate therapeutic approaches synergize is not clear. In addition, the therapeutic efficacy may have been limited since the CNS-directed gene therapy was restricted to the forebrain and thalamus. In the current study, intrathecal and intracerebellar injections were added to the therapeutic regimen and the mechanism of synergy between BMT and gene therapy was determined. Although AAV2/5 alone provided supraphysiological levels of GALC activity and reduced psychosine levels in both the brain and spinal cord, it significantly increased CNS inflammation. Bone marrow transplantation alone provided essentially no GALC activity to the CNS and did not reduce psychosine levels. When AAV2/5 is combined with BMT, there are sustained improvements in motor function and the median life span is increased to 123 d (range, 92–282 d) compared with 41 d in the untreated twitcher mice. Interestingly, addition of BMT virtually eliminates both the disease and AAV2/5-associated inflammatory response. These data suggest that the efficacy of AAV2/5-mediated gene therapy is limited by the associated inflammatory response and BMT synergizes with AAV2/5 by modulating inflammation

FACTIFY3M: A Benchmark for Multimodal Fact Verification with Explainability through 5W Question-Answering

Combating disinformation is one of the burning societal crises -- about 67% of the American population believes that disinformation produces a lot of uncertainty, and 10% of them knowingly propagate disinformation. Evidence shows that disinformation can manipulate democratic processes and public opinion, causing disruption in the share market, panic and anxiety in society, and even death during crises. Therefore, disinformation should be identified promptly and, if possible, mitigated. With approximately 3.2 billion images and 720,000 hours of video shared online daily on social media platforms, scalable detection of multimodal disinformation requires efficient fact verification. Despite progress in automatic text-based fact verification (e.g., FEVER, LIAR), the research community lacks substantial effort in multimodal fact verification. To address this gap, we introduce FACTIFY 3M, a dataset of 3 million samples that pushes the boundaries of the domain of fact verification via a multimodal fake news dataset, in addition to offering explainability through the concept of 5W question-answering. Salient features of the dataset include: (i) textual claims, (ii) ChatGPT-generated paraphrased claims, (iii) associated images, (iv) stable diffusion-generated additional images (i.e., visual paraphrases), (v) pixel-level image heatmap to foster image-text explainability of the claim, (vi) 5W QA pairs, and (vii) adversarial fake news stories.Comment: arXiv admin note: text overlap with arXiv:2305.0432

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Reliability analysis of composite channels using first order approximation and Monte Carlo simulations

Artificial open channels being costlier infrastructure, their design should ensure reliability along with optimality in project cost. This paper presents reliability analysis of composite channels, considering uncertainty associated with various design parameters such as friction factors, longitudinal slope, channel width, side slope, and flow depth. This study also considers uncertainties of watershed characteristics, rainfall intensity and drainage area to quantify the uncertainty of runoff. For uncertainty modeling, the advanced first order second moment method and Monte Carlo simulation are used and it is found that the results by both approaches show good agreement. Then, a reliability index that can be used to design a composite channel to convey design discharge for a specified risk or probability of failure is presented, and its sensitivity with different channel design parameters are analyzed. To validate the effectiveness of the present approach, the reliability values and safety factors for variable system loading scenario are obtained under static and dynamic environment. The sensitivity analysis shows that flow depth and bed width are the most influencing parameters that affect the safety factor and reliability

Trend analysis of rainfall in four meteorological subdivisions of southern India using nonparametric methods and discrete wavelet transforms

In recent times, trend analysis and change point detection in hydroclimatic variables receiving significant attention due to climate change and its socioeconomic consequences. In this study, long-term trends of rainfall in four subdivisions of southern India namely Kerala, Tamil Nadu, North Interior (NI) Karnataka and Telangana regions are analysed using linear regression, nonparametric Mann-Kendall (MK) test and Sen's slope estimator methods. Trend analysis of annual rainfall time series shows an increasing trend in three subdivisions - Tamil Nadu, NI Karnataka and Telangana, and a decreasing trend in Kerala subdivision. Further the sequential change in trend of annual and seasonal rainfalls in the four subdivisions is conducted using sequential MK (SQMK) method. The SQMK analysis shows an early divergence of progressive and retrograde modes of post-monsoon rainfall of Kerala and winter rainfall of Telangana subdivisions. Further it is observed that among different seasonal rainfalls, the post-monsoon rainfall of Kerala subdivision shows a statistically significant increase in the recent past. Then the trend analysis based on discrete wavelet transform (DWT) in conjunction with SQMK method is performed on the post-monsoon rainfall time series of Kerala subdivision, and the results show that there is a dominancy of short-term periodicity of less than a decade in the subdivision