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An accurate and efficient approach is required to identify the unknown parameters of solid oxide fuel cell (SOFC) mathematical model for a robust design of any energy system considering SOFC. This research study proposes a modified fire hawk algorithm (MFHA) to determine the values of SOFC model parameters. The performance evaluation of MFHA is tested on two case studies. Firstly, the performance of MFHA is tested on commercially available cylindrical cell developed by Siemens at four temperatures. Results reveal that the least value of sum of squared error (SSE) is 1.04E−05, 2.30E−05, 1.03E−05, and 1.60E−05 at 1073 K, 1173 K, 1213 K, and 1273 K respectively. Results obtained using MFHA have been compared with original fire hawk algorithm (FHA) and other well established and recent algorithms. Secondly, MFHA is implemented for estimating unknown parameters of a 5 kW dynamic tabular stack of 96 cells at various pressures and temperatures. The obtained value of SSE at different temperatures of 873 K, 923 K, 973 K, 1023 K and 1073 K is 1.18E−03, 6.12E−03, 2.21E−02, 5.18E−02, and 6.00E−02, respectively whereas, SSE at different pressures of 1 atm, 2 atm, 3 atm, 4 atm, and 5 atm is 6.05E−02, 6.11E−02, 5.53E−02, 5.11E−02, and 6.64E−02 respectively.

INTRODUCTION:Carvedilol is effective in the prevention of bleeding in patients with cirrhosis and high-risk varices. Although it reduces drivers of clinical decompensation (portal pressure, systemic inflammation, and bacterial translocation), the data on its use for prevention of ascites-related complications are limited.METHODS:In this open-label randomized control tria, patients having uncomplicated new-onset ascites with no or low-risk esophageal varices were randomized (n = 104) to receive carvedilol (group A, n = 52) or no carvedilol (group B, n = 52) in addition to standard treatment. The composite primary outcome was incidence of any ascites-related complications, namely, spontaneous bacterial peritonitis, hepatorenal syndrome acute kidney injury, refractory ascites, or severe hyponatremia at 1 year. The secondary outcomes included need for paracentesis, change in hepatic venous pressure gradient, Child-Turcotte-Pugh, and Model for End-Stage Liver Disease score and mortality at 1 year.RESULTS:The baseline characteristics were comparable between the groups, with metabolic dysfunction-associated steatotic liver disease as the commonest etiology (overall 41.3%) followed by alcohol-associated liver disease (21.2%). Patients in group A compared with group B had lower incidence of complicated ascites (38.5% vs 67.3%; P = 0.03), mainly related to reduced incidence of acute kidney injury (AKI) (34.6% vs 63.4%, P = 0.003), refractory ascites, and spontaneous bacterial peritonitis along with a significant reduction in HVPG (14.89 ± 2.8 to 11.86 ± 1.9 mm Hg [P < 0.05]) and lesser progression in variceal grade (21.8% vs 53.1%, P = 0.009). Patients in group A than B demonstrated better ascites resolution (61.5% vs 31.8%, P = 0.01) and fewer large volume paracentesis sessions (26.9% vs 57.6%; P = 0.01). At 1 year, patients in group B had higher Child-Turcotte-Pugh scores (9.31 ± 1.43 vs 8.17 ± 1.7, P = 0.001). Use of carvedilol was associated with lower 1 year mortality (9.1% vs 24.2%, P = 0.05). No patient had treatment-related severe adverse events.DISCUSSION:Administration of carvedilol in patients with cirrhosis with new-onset uncomplicated ascites without high-risk varices is safe and prevents further ascites-related complications, with reduced need for large volume paracentesis and improved survival.

An accurate model of a fuel cell (FC) is essential because it significantly impacts the transient and dynamic analysis of the FC in simulation studies. However, the mathematical model of FC consists of some unknown parameters and its identification is a challenging task. This article proposes a new implementation of the Ali Baba and forty thieves (ABFT) algorithm in extracting the values of unknown parameters to develop an accurate proton exchange membrane FC (PEMFC) model. The extraction process is expressed as an optimization challenge as well as solved based on the sum of squared error (between the experimental as well as estimated voltages) using the ABFT algorithm and aims to minimize the objective function with a set of inequality constraints. The accuracy of the proposed ABFT algorithm-based PEMFC model is evaluated by contrasting the achieved outcomes to the empirical outcomes of commonly available PEMFCs, including the NedStack PS6, Ballard Mark V, BCS 500 W, 250 W Stack, and obtained values of the objective functions are 2.303554E + 00, 8.53608E−01, 1.1698E−02, and 3.31348E−01, respectively. Moreover, to prove the superiority of the proposed ABFT, its outcomes are compared to those obtained using well-established meta-heuristic (MH) techniques as well as that are reported in the literature. It is found that the ABFT algorithm is superior over these algorithms in terms of statistical analysis. It is elucidated that simulated I–V, I–P, as well as efficiency curves closely match the experimental curves in each of the examined cases. The analyses are conducted by taking into consider various operational conditions (temperature and pressure). In addition, a statistical analysis as well as box plot study are carried out to validate the accuracy as well as reliability of the ABFT algorithm. Furthermore, the Friedman as well as Wilcoxon tests have been performed and it is elucidated that the proposed ABFT algorithm achieved Ist rank and proved its robustness and effectiveness in all the case studies in identifying unknown parameters.

IntroductionMusculoskeletal (MSK) conditions account for up to one-third of general practice consultations and over one-fifth of emergency department attendances in the UK. Postpandemic, the elective orthopaedic surgery backlog remains one of the most substantial across surgical specialties. Despite this burden, undergraduate exposure to trauma and orthopaedics (T&O) remains limited and inconsistent. Most UK medical students receive only 2–3 weeks of T&O teaching, with up to 40% of foundation doctors feeling underprepared to manage MSK conditions. The Evaluation of Trauma and Orthopaedic Teaching in Medical Schools Nationally (TENDON Study) aims to evaluate the current state of undergraduate T&O education in UK medical schools from both student and educator perspectives.Methods and analysisThis national, prospective, cross-sectional survey will be conducted between 25 July and 27 October 2025. A dual-instrument electronic survey was developed through Qualtrics, informed by the British Orthopaedic Association (BOA) Undergraduate Curriculum and UK Medical Licensing Assessment content map. Participants will include medical students (Years 1–6), foundation doctors and orthopaedic educators recruited through British Orthopaedic Medical Students Association and BOA networks, and designated school representatives. Survey domains include curriculum coverage, teaching methods, clinical exposure and self-reported competence. Quantitative data will be analysed using descriptive and inferential statistics; qualitative data will undergo thematic analysis. Reporting will follow the Checklist for Reporting Of Survey Studies framework, with relevant elements drawn from the Checklist for Reporting Results of Internet E-Surveys checklist.Ethics and disseminationEthical approval was obtained from the Human Biology Research Ethics Committee, University of Cambridge. Findings will be disseminated via peer-reviewed publication, conference presentations and summary reports to curriculum leads and relevant educational bodies.

The nanoparticles with different size, shape and structure for drug delivery against Leishmania donovani . Visceral leishmaniasis (VL) is the most lethal of all leishmaniasis diseasesand the second most common parasiticdisease after malaria and,still, categorized as a neglected tropical disease (NTD). According to the latest WHO study, >20 Leishmania species spread 0.7–1.0 million new cases of leishmaniasis each year. VL is caused by the genus, Leishmania donovani (LD), which affects between 50,000 and 90,000 people worldwide each year. Lack of new drug development, increasing drug resistance, toxicity and high cost even with the first line of treatmentof Amphotericin B (AmB), demands new formulation for treatment of VLFurther the lack of a vaccine, allowedthe researchers to develop nanofomulation-based AmB for improved delivery. The limitation of AmB is its kidney and liver toxicity which forced the development of costly liposomal AmB (AmBisome) nanoformulation. Success of AmBisome have inspired and attracted a wide range of AmB nanoformulations ranging from polymeric, solid lipid, liposomal/micellar, metallic, macrophage receptor-targetednanoparticles (NP) and even with sophisticated carbon/quantum dot-based AmBnano delivery systems. Notably, NP-based AmB delivery has shown increased efficacy due to increased uptake, on-target delivery and synergistic impact of NP and AmB. In this review, we have discussed the different forms of leishmaniasis disease and their current treatment options with limitations. The discovery, mechanism of action of AmB, clinical status of AmB and improvement with AmBisome over fungizone (AmB-deoxycholate)for VL treatment was further discussed. At last, the development of various AmB nanoformulation was discussed along with its adavantages over traditional chemotherapy-based delivery.

Bleomycin toxicity predominantly affects the skin and lungs. Cutaneous toxicity classically known to present with bleomycin are flagellate erythema and drug rash. We hereby report an isolated case of (bleomyicn)-induced acquired partial (lipodytrophy) having potential cosmetic implications in a young women prescribed postoperatively following a case of germ cell carcinoma of ovary (endodermal sinus tumor).

With the increase in the cases of multidrug resistance tuberculosis, second line anti-tubercular drugs like the cycloserine are being prescribed frequently. Isoniazid and ethambutol are reported to cause psychosis like state; however, few reports of cycloserine induced psychosis are available. To the best of our knowledge, this is the first case of cycloserine induced psychosis with hepatic dysfunction.

Background: Breast cancer is common in females and its treatment with chemotherapeutic agents is not free from hematological toxicity. There are many agents to ameliorate this toxicity. Aim and Objective: The present prospective, randomized, open label, comparative study was conducted in a tertiary care hospital to evaluate the effect of wheatgrass on hematological toxicity in breast cancer patients. Material and Methods: The standard anticancer therapy 5-Flourouracil (500mg/m2), Adriamycin (50mg/m2)/Epirubicin (100 mg/m2), Cyclophosphamide (500mg/m2) or Doxorubicin (60mg/m2) and Cyclophosphamide (600mg/m2) plus GCSF(300μgm). Group A served as control arm and Group B as test arm which received wheat grass two tablets (wheat grass ingredient 500 mg) three times a day beside the anticancer treatment. Results: The deterioration of hematological parameters (Haemoglobin, Platelet Count) produced in Ca breast patients by anti cancer therapy has been effectively prevented by the adding WG. Moreover, in the WG group there were less number of blood transfusions requirement compared to the control arm. Conclusion: The study concluded that wheat grass is effective in preventing the deterioration of hemoglobin and platelet count and curtailed the number of transfusions needed by patients of breast cancer on anticancer treatment.