Orthotopic Liver Transplantation in a Case of Novel YAP1-TFE3 Hepatic Epithelioid Hemangioendothelioma [HEHE]; Case Report and Review of Literature

Epithelioid hemangioendothelioma is an extremely rare vascular neoplasm arising in soft-tissues and different visceral organs, with liver being the most commonly involved viscera. Hepatic epithelioid hemangioendothelioma (HEHE) is a malignant tumour with an indolent behaviour and unpredictable clinical course. It has a better prognosis among the malignant tumours of the liver, in spite of being a diffuse multifocal liver disease or metastatic at the time of presentation. HEHE is usually found to be noted in the fifth decade with slight female preponderance. No single treatment strategy has yet been established owing to its variable clinical course, ranging from an indolent tumour with prolonged survival to an aggressive, metastatic disease with a fatal outcome. Here, we present a case of a novel HEHE in a 25-year-old female who was treated successfully with orthotopic living donor liver transplantation and discuss the presentation, histopathology and management of this rare, fatal yet treatable malignant tumour

An integrated Hardware/Software Verification and Validation methodology for Signal Processing Systems

The testing and validation services team assesses project deliverables at various stages of development using innovative and effective verification and validation, to ensure that the deliverables are compliance with the customer specifications and requirements. Whenever new products and devices are released, completely integrated verification and validation services are delivered to accurate and complete records usability, performance, and quality assurance services. Throughout the product development and testing process, the testing and validation services team employs verification and validation techniques. Code reviews, walk through, inspections, desk-checking, and code execution are all examples of verification and validation techniques. Services for verification and validation are used to assess whether or not the software or application provided complies with the requirements and serves the intended purpose. A procedure used to ensure that the software created is of good quality and consistently operates as expected is independent testing and validation services. Unit testing (also known as “White Box Testing”), hardware-software integration testing (HSIT), and system testing are the three primary independent verification and validation approaches (Black Box Testing). The teams responsible for the verification and validation services actively participate in each stage of the project and design the services according to the project’s needs (e.g., prototype, spiral, iterative, V Model, and Agile). Our expertise in the embedded domain, tried-and-true verification and validation techniques, and a thorough methodology provide a quick turnaround and excellent results for the targeted solution. Independent Verification and validation services covering Source code, design, and requirements White box testing, or unit testing Testing for hardware-software integration Black box testing, or system testing To reduce test cycle-time significantly on test Automation solutions. Verification and validation techniques can be used to effectively and efficiently carry out stress and performance tests, and to detect defects early in the life cycle. Documentation of test process. Liaison and Certificatio

Patient Attitudes and Participation in Hand Co-Washing in an Outpatient Clinic Before and After a Prompt

Despite recent national emphasis, outpatient hand washing can be less than optimal. We tested a new approach involving both patient and physician hand washing. The study consisted of 384 questionnaires, 184 from phase 1 and 200 from phase 2. Patients stated doctors washed their hands 96.6% before examining them pre-intervention and 99.5% of the time post-intervention. Patients endorsed the importance of hand washing 98.7% of the time. “Co-washing” may offer a process to increase the practice of hand washing and decrease infection risk

Structural basis for bacterial energy extraction from atmospheric hydrogen

Diverse aerobic bacteria use atmospheric H2 as an energy source for growth and survival1. This globally significant process regulates the composition of the atmosphere, enhances soil biodiversity and drives primary production in extreme environments2,3. Atmospheric H2 oxidation is attributed to uncharacterized members of the [NiFe] hydrogenase superfamily4,5. However, it remains unresolved how these enzymes overcome the extraordinary catalytic challenge of oxidizing picomolar levels of H2 amid ambient levels of the catalytic poison O2 and how the derived electrons are transferred to the respiratory chain1. Here we determined the cryo-electron microscopy structure of the Mycobacterium smegmatis hydrogenase Huc and investigated its mechanism. Huc is a highly efficient oxygen-insensitive enzyme that couples oxidation of atmospheric H2 to the hydrogenation of the respiratory electron carrier menaquinone. Huc uses narrow hydrophobic gas channels to selectively bind atmospheric H2 at the expense of O2, and 3 [3Fe–4S] clusters modulate the properties of the enzyme so that atmospheric H2 oxidation is energetically feasible. The Huc catalytic subunits form an octameric 833 kDa complex around a membrane-associated stalk, which transports and reduces menaquinone 94 Å from the membrane. These findings provide a mechanistic basis for the biogeochemically and ecologically important process of atmospheric H2 oxidation, uncover a mode of energy coupling dependent on long-range quinone transport, and pave the way for the development of catalysts that oxidize H2 in ambient air

Assessment of Diabetic Foot

Diabetic Foot Complications are the main reason for hospitalization and amputation in people with diabetes. Globally ~435 million people have diabetes, with ~83–148 million of those estimated to develop foot ulcers in their lifetime. It is estimated that 16.8 million YLDs resulted from diabetic foot complications. Once an ulcer has developed, there is an increased risk of wound progression that may lead to amputation (~85% cases). In every 30 seconds, one lower limb amputation in diabetes patients occurs world-wide. The average cost for each amputation is over $70,000. American Podiatric Medical Association says that diabetic foot complications can be prevented by periodical Assessment of foot, which include visual inspection of bare foot; deformities, neurovascular abnormalities of foot and assessment of footwear. Relevant assessment and proactive foot care can reduce the burden of diabetic foot disease which will increase quality of life and reduce health care costs

Interaction of a viral insulin-like peptide with the IGF-1 receptor produces a natural antagonist

Lymphocystis disease virus-1 (LCDV-1) and several other Iridoviridae encode viral insulin/IGF-1 like peptides (VILPs) with high homology to human insulin and IGFs. Here we show that while single-chain (sc) and double-chain (dc) LCDV1-VILPs have very low affinity for the insulin receptor, scLCDV1-VILP has high affinity for IGF1R where it can antagonize human IGF-1 signaling, without altering insulin signaling. Consequently, scLCDV1-VILP inhibits IGF-1 induced cell proliferation and growth hormone/IGF-1 induced growth of mice in vivo. Cryo-electron microscopy reveals that scLCDV1-VILP engages IGF1R in a unique manner, inducing changes in IGF1R conformation that led to separation, rather than juxtaposition, of the transmembrane segments and hence inactivation of the receptor. Thus, scLCDV1-VILP is a natural peptide with specific antagonist properties on IGF1R signaling and may provide a new tool to guide development of hormonal analogues to treat cancers or metabolic disorders sensitive to IGF-1 without affecting glucose metabolism. The authors previously identified a family of viral insulin-like peptides (VILPs) with high homology to human insulin/IGF−1. Here, they report that one of these VILPs exhibits antagonist properties associated with a unique conformation of the IGF1R

Dynamics of GLP-1R peptide agonist engagement are correlated with kinetics of G protein activation

The glucagon-like peptide-1 receptor (GLP-1R) has broad physiological roles and is a validated target for treatment of metabolic disorders. Despite recent advances in GLP-1R structure elucidation, detailed mechanistic understanding of how different peptides generate profound differences in G protein-mediated signalling is still lacking. Here we combine cryo-electron microscopy, molecular dynamics simulations, receptor mutagenesis and pharmacological assays, to interrogate the mechanism and consequences of GLP-1R binding to four peptide agonists; glucagon-like peptide-1, oxyntomodulin, exendin-4 and exendin-P5. These data reveal that distinctions in peptide N-terminal interactions and dynamics with the GLP-1R transmembrane domain are reciprocally associated with differences in the allosteric coupling to G proteins. In particular, transient interactions with residues at the base of the binding cavity correlate with enhanced kinetics for G protein activation, providing a rationale for differences in G protein-mediated signalling efficacy from distinct agonists

Diabetic Peripheral Neuropathy

Diabetes mellitus is one of the most common medical disorders often associated with neurological complications. Peripheral neuropathy is the most common neurological complication from diabetes with a prevalence of 10–26% of newly diagnosed adult diabetics. Diabetic neuropathy is a heterogeneous group of conditions that present with sensory and/or motor and/or autonomic dysfunction and affect different parts of the peripheral nervous system. Diabetic neuropathy might present as a polyneuropathy, mononeuropathy, mononeuropathy multiplex, radiculopathy, and/or plexopathy. Diabetic neuropathies may also be associated with foot ulcers and infections in 5–24% of patients, which translate into five out of 1000 of diabetics ending with an amputation. Therefore, it is essential to screen diabetic patients for early recognition and management of diabetic neuropathies

Knowledge and attitude of endodontic postgraduate students toward sterilization of endodontic files: A cross-sectional study

Aim: With the whole world looking at the eradication of existing infectious diseases and preventing any new infections, sterilization of instruments is significant to ensure optimal patient care. Infection preventions and controls are the most important components for providing a safe environment for patients and staff within a dental practice. Hence, the objective was to assess the level of knowledge, attitudes, and practices regarding the sterilization of endodontic files by the postgraduate (PG) students from the Department of Conservative Dentistry and Endodontics at dental colleges in Bangalore. Materials and Methods: A cross-sectional study was conducted among PG students of Conservative and Endodontics in Bangalore using a pretested questionnaire. Results: A total of 88% accepted endodontic files need to be sterilized and 60% reported that endodontic instruments can be used four or more times, but 44% practiced it. Interestingly, 74% reported that dental assistants are not trained for sterilization protocols. Conclusion : The study shows that although there is high knowledge and positive attitude regarding sterilization of endodontic files, but it is seldom practiced creating lacunae in motivation. To bridge this gap, frequent reinforcement is needed in the critical area of sterilization

<span style="font-size:11.0pt;font-family: "Times New Roman";mso-fareast-font-family:"Times New Roman";mso-bidi-font-family: Mangal;mso-ansi-language:EN-GB;mso-fareast-language:EN-US;mso-bidi-language: HI" lang="EN-GB">Synthesis and characterization of Pt supported on Fe₅(PO₄)₃(OH)₅catalysts</span>

566-571Pt supported on iron hydroxyphosphate catalysts has been synthesized and characterized by various adsorption and spectroscopic methods. X-ray diffraction patterns of the supported and unsupported catalysts indicate a very weak diffraction line due to the Fe5(PO4)3(OH)5 phase. The X-ray photoelectron spectroscopic studies reveal a surface composition attributed to Fe5(PO4)3(OH)5 species. The temperature programmed sequential reduction-oxidation-reduction of 1wt.% Pt/Fe5(PO4)3(OH)5 indicates the absence of H2 spillover due to Pt on the Fe5(PO4)3(OH)5 support. The temperature programmed reduction studies also show the non-reducible behavior of Fe5(PO4)3(OH)5 phase