Clinical Metabolomics Investigation of Rheumatoid Arthritis Patients Receiving Ayurvedic Whole System Intervention

BACKGROUND: Arthritis is a common clinical condition seen in Ayurveda clinics. Clinical trials have reported Ayurvedic interventions to be of benefits in many arthritic conditions including Rheumatoid Arthritis (RA). No mechanistic details however are available about how such interventions on their own or as a combination of whole system Ayurveda might be working. OBJECTIVE: The study aims to evaluate simultaneously the clinical outcome of Ayurveda whole system (AWS) intervention in RA patients and identifying the serum metabolic signatures which could be useful for diagnosing the disease and monitoring treatment response. MATERIAL AND METHODS: RA patients (n = 37) simultaneously diagnosed as Amavata fulfilling the specific inclusion and exclusion criteria were recruited in the study and were given Ayurveda whole system (AWS) intervention comprised of oral medicines, local therapy and dietary recommendation for 3 months. The clinical and serum metabolic changes were investigated for pre-treatment RA patients (baseline RA group, n = 37) and post-treatment RA patients (following treatment of 6-weeks (RA_F, n = 26) and three months (RA_T, n = 36). For comparative serum metabolomics analysis, 57 normal healthy control (HC) subjects were also involved and the serum metabolic profiles were measured at high-field 800 MHz NMR spectrometer. The serum metabolic profiles were compared using multivariate statistical analysis and discriminatory metabolic features were evaluated for diagnostic potential using receiver operating characteristic (ROC) curve analysis. RESULTS: A significant reduction in DAS-28 ESR, AAM Score, total swollen joints, total tender joints were observed following AWS intervention. The clinical outcomes were concordant with changes in metabolic profiles of RA patients as these were also shifting towards the normal levels following the intervention. Compared to healthy control (HC) subjects, the sera of baseline RA patients were characterised by increased circulatory level of succinate, lysine, mannose, creatine, and 3-Hydroxybutyrate (3-HB) and decreased levels of alanine. The present study also evaluated the serum metabolic ratios for their discriminatory and diagnostic potential and notably, six metabolic ratios (KHR, KThR, KVR, GHR, PTR and SHR) were found significantly altered (elevated) in baseline RA patients. However, in RA patients receiving AWS treatment, these metabolic changes showed marked convergence towards the metabolic signatures of healthy controls. CONCLUSION: This first of its kind study clearly shows the clinical efficacy of Ayurvedic Whole System (AWS) intervention in the management of Rheumatoid Arthritis (RA), as demonstrated by significant improvements in key clinical parameters. The intervention not only alleviated symptoms but also induced a profound metabolic shifting towards normalization; thus, underscoring the potential of AWS intervention to modulate cellular metabolism in a manner that facilitates a return to homeostasis in RA patients. However, future studies are imperative to confirm these preliminary observations and delineate the underlying mechanisms of action of intervention in cases of RA

Numerical investigation on effect of spark plug configuration on performance in an engine cylinder

A numerical investigation of combustion inside single and twin-spark engines was performed to study the effect of a spark plug, positions and spark timings on engine performance. Improvement in engine performance is one of the automotive industry's primary research areas. Consequently, the study's results can be utilised to optimise engine configurations to achieve maximum performance. The investigation was conducted using a finite volume-based open-source software, OpenFOAM, for computational simulations. Simulations were conducted using the XiEngineFOAM solver with a transport equation for modelling flame fronts. The Standard k-e turbulence model was used to predict turbulence parameters. The simulation was conducted for compression and power stroke (crank angle between - 180° and 180°), assuming an even distribution of the air-fuel mixture within the pentroof 4-valve engine cylinder. Simulations were conducted for four cases, including variations in the position and timing of spark plugs in single-spark and twin-spark engines. According to the results of the simulations, the single-spark engine provides the best performance when the spark plug is ignited early and positioned at the cylinder's centre. When placed at an optimal position determined by flame travel and collision, the twin-spark engine gives the best performance at the highest difference between the spark timings of the two spark plugs

Evaluation of the Effectiveness of Telemedicine in Postoperative Follow-Up Care After Dental Implant Surgery. A Pilot Study

AIM: Telemedicine has emerged as a potential solution to enhance postoperative follow-up care after dental implant surgery, offering the convenience of remote monitoring and reduced need for in-person visits. MATERIALS AND METHODS: Participants were randomly assigned to either the telemedicine group (n = 15) or the in-person group (n = 15). In the telemedicine group, patients received remote follow-up care through virtual consultations, during which they could communicate their concerns and share images of the surgical site. The in-person group received standard in-person follow-up visits. Patient satisfaction was measured using a standardized survey, with responses collected on a Likert scale. RESULTS: Telemedicine group exhibited comparable levels of patient satisfaction (mean satisfaction score ± standard deviation: 4.6 ± 0.3) to the in-person group (4.7 ± 0.2). Moreover, clinical outcomes, including wound healing assessment, were similar between the two groups. No significant differences were observed in the incidence of postoperative complications or the need for additional interventions. CONCLUSION: In conclusion, this pilot study demonstrates that telemedicine is an effective alternative to traditional in-person follow-up care for postoperative dental implant surgery patients. It offers comparable patient satisfaction and clinical outcomes while proving to be more cost-effective

Computational analysis of convective heat transfer properties of turbulent slot jet impingement

PurposeConvective heat transfer features of a turbulent slot jet impingement are comprehensively studied using two different computational approaches, namely, URANS (unsteady Reynolds-averaged Navier–Stokes equations) and SAS (scale-adaptive simulation). Turbulent slot jet impingement heat transfer is used where a considerable heat transfer enhancement is required, and computationally, it is a quite challenging flow configuration.Design/methodology/approachCustomized OpenFOAM 4.1, an open-access computational fluid dynamics (CFD) code, is used for SAS (SST-SAS k-ω) and URANS (standard k-ε and SST k-ω) computations. A low-Re version of the standard k-ε model is used, and other models are formulated for good wall-refined calculations. Three turbulence models are formulated in OpenFOAM 4.1 with second-order accurate discretization schemes.FindingsIt is observed that the profiles of the streamwise turbulence are under-predicted at all the streamwise locations by SST k-ω and SST SAS k-ω models, but follow similar trends as in the reported results. The standard k-ε model shows improvements in the predictions of the streamwise turbulence and mean streamwise velocity profiles in the zone of outer wall jet. Computed profiles of Nusselt number by SST k-ω and SST-SAS k-ω models are nearly identical and match well with the reported experimental results. However, the standard k-ε model does not provide a reasonable profile or quantification of the local Nusselt number.Originality/valueHybrid turbulence model is suitable for efficient CFD computations for the complex flow problems. This paper deals with a detailed comparison of the SAS model with URANS and LES for the first time in the literature. A thorough assessment of the computations is performed against the results reported using experimental and large eddy simulations techniques followed by a detailed discussion on flow physics. The present results are beneficial for scientists working with hybrid turbulence models and in industries working with high-efficiency cooling/heating system computations.</jats:sec

Formulation of Energy Consumption in Wireless Sensor Network

ABSTRACT Wireless sensor networks (WSNs) depends on their reliable operation for extended times without human intervention. Wireless and ad-hoc deployment, which is essential in some scenarios and cost-effective in others, prevents the use of a wired energy infrastructure. Wireless Sensor Networks usually battery powered, thus energy-constrained, present energy efficiency as the main challenge. Usually in WSNs the communication consumes most of the energy. But recently wireless sensor nodes are introduced that comprise also energy-consuming sensors, apart from the &apos;traditional&apos; ones like temperature, air pressure and humidity sensors. This paper presents the feasible formulation to express the energy consumption of a wireless sensor network application in terms of its energy constituents, effective realization of the intended application in terms of cost, lifetime, and functionality