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In a randomized trial, 294 patients with advanced heart failure were assigned to receive either a new centrifugal-flow pump or an axial-flow pump. At 6 months, the centrifugal-flow pump was associated with better outcomes. A scarcity of effective therapeutic options for advanced heart failure has led to the development of durable mechanical circulatory support devices. Left ventricular assist devices, more accurately known as left ventricular assist systems, increase the rate of survival and improve quality of life among patients with advanced heart failure. However, these clinical benefits are balanced by an increased risk of infection, bleeding, neurologic events, and pump malfunction that is due principally to pump thrombosis. 1 , 2 As adoption of circulatory pumps has expanded, concerns about pump thrombosis have heightened. In 2013, two reports suggested that there has been an increase in . . .

Rapid industrialization and mass urbanization have generated a challenging situation for the city ' s planners and managers to maintain a balance between economic development and a sustainable environment for its inhabitants. Circular economy concepts can offer a unique opportunity to decouple growth from resource requirements. At the core of the circular economy, is the proposition of complete elimination of waste - i.e. waste not in its traditional sense, but any form of underutilization of assets and resources. A case study of the textile manufacturing industry in Surat, India is taken to compare the performances of traditional supply chain processes and the advantages of adopting circular economy concepts. Temporal sprawl of the textile industry is used to find the changes in trip lengths of urban freight trips over the last two decades. For estimating freight trips volume and patterns, roadside interviews of freight vehicles and establishment surveys of manufacturing and trading units were conducted. Overall urban freight transport contribution from the textile industry is estimated by modelling field data. Organized trip planning and optimized utilization of payload capacities can reduce vehicular emission generated from commercial goods movement in the textile industry to 2/3rd of its current levels. The paper asserts reinforces that the integration of circular economy principles with supply chain processes is beneficial from sustainability as well as a business point of view. The congestion mitigation due to the reduced number of trips offers a further reduction in the overall traffic emissions due to better traffic flows on the city's road network.

Most of the cities in developing countries are found to have non-uniform distribution of urban space, complex land use patterns, mixed traffic conditions, extensive use of non-motorized vehicles and lack of traffic discipline. In comparision to the developed countries, it is more complicated to manage urban freight transport in developing countries due to the lack of sufficient infrastructure, wide socio-economic gaps between urban and non-urban areas and haphazard peripheral developments. Therefore the methods and strategies used to manage urban freight transport in developed countries cannot be directly used for cities in developing countries. It is necessary to devise distinctive solutions to improve the efficieny of urban freight transport in these cities, which may otherwise, inhibit the economic growth of these cities as well as hamper the overall momentum of country’s GDP growth gathered over decades. In recent years some studies focussing on urban freight transport are carried out in India, China and Brazil. This paper reviews urban freight studies carried out for Indian cities. India, world’s second most populous country to China, has 39 cities with a million plus population. Most of its cities are facing problems like congestion and air quality degradation due to inefficient freight movement practices. Review of urban freight studies is carried out based on different parameters influencing efficiency of freight movement. Various challenges and limitations faced by the researchers and administrators are discussed. Based on the review results, suggestions and future scope for research in different aspects of urban freight are presented in the paper.

Classification of acute decompensated heart failure (ADHF) is based on subjective criteria that crudely capture disease heterogeneity. Improved phenotyping of the syndrome may help improve therapeutic strategies. To derive cluster analysis-based groupings for patients hospitalized with ADHF, and compare their prognostic performance to hemodynamic classifications derived at the bedside. We performed a cluster analysis on baseline clinical variables and PAC measurements of 172 ADHF patients from the ESCAPE trial. Employing regression techniques, we examined associations between clusters and clinically determined hemodynamic profiles (warm/cold/wet/dry). We assessed association with clinical outcomes using Cox proportional hazards models. Likelihood ratio tests were used to compare the prognostic value of cluster data to that of hemodynamic data. We identified four advanced HF clusters: 1) male Caucasians with ischemic cardiomyopathy, multiple comorbidities, lowest B-type natriuretic peptide (BNP) levels; 2) females with non-ischemic cardiomyopathy, few comorbidities, most favorable hemodynamics; 3) young African American males with non-ischemic cardiomyopathy, most adverse hemodynamics, advanced disease; and 4) older Caucasians with ischemic cardiomyopathy, concomitant renal insufficiency, highest BNP levels. There was no association between clusters and bedside-derived hemodynamic profiles (p = 0.70). For all adverse clinical outcomes, Cluster 4 had the highest risk, and Cluster 2, the lowest. Compared to Cluster 4, Clusters 1-3 had 45-70% lower risk of all-cause mortality. Clusters were significantly associated with clinical outcomes, whereas hemodynamic profiles were not. By clustering patients with similar objective variables, we identified four clinically relevant phenotypes of ADHF patients, with no discernable relationship to hemodynamic profiles, but distinct associations with adverse outcomes. Our analysis suggests that ADHF classification using simultaneous considerations of etiology, comorbid conditions, and biomarker levels, may be superior to bedside classifications.

Urban growth drivers are critical components of urbanization. Potential drivers only drive the city development, which leads to the formation of new growth drivers, and this viscos loop leads to urban sprawl. It is necessary to investigate the influence of growth drivers on the city’s growth pattern. The objectives of this study are to assess the spatiotemporal change in the city’s growth pattern and to determine which growth factors are significantly driving the growth. This research looks into the various reasons of urban sprawl in Surat, India, which is located in the western region of the country. According to a 5-year spatial analysis of urban expansion, the city developed from 34.71 sq. km in 1991 to 158.32 sq. km in 2021, increasing roughly 4.12 sq. km of built-up area per year. The Landscape Expansion Index is employed in the study to understand growth. The urban land density curve demonstrated that the city could be easily separated into the central business district, the inner city, and the suburbs. The steepness of the curve indicated that the core region witnessed compact development, inner urban areas experienced uniform development, and suburban areas experienced scattered growth. Further, Distance and direction analysis confirmed that the urban growth drivers such as proximate to significant facilities, government interventions and planning efforts, environmental parameters, socioeconomic parameters, and topographic features are having an effect on the urban growth pattern of Surat city. To classify the type of urban development, the Landscape Expansion Index was calculated, and the resulting value indicates that almost infill and edge expansion development occurred within 9 km of the city center. Beyond the 9 km distance, the majority of the city’s growth since 2016 has occurred in leapfrog fashion in all directions. The current study will aid in determining the type of city expansion, whether compact or sprawl. These spatial analyses will help municipal planners and policymakers establish staged strategies for systematic land use and reducing the negative consequences of haphazard growth.

Introduction IL-13 is the primary upregulated cytokine in atopic dermatitis (AD) skin and is the pathogenic mediator driving AD pathophysiology. Lebrikizumab, tralokinumab and cendakimab are therapeutic monoclonal antibodies (mAb) that target IL-13. Methods We undertook studies to compare in vitro binding affinities and cell-based functional activities of lebrikizumab, tralokinumab and cendakimab. Results Lebrikizumab bound IL-13 with higher affinity (as determined using surface plasma resonance) and slower off-rate. It was more potent in neutralizing IL-13-induced effects in STAT6 reporter and primary dermal fibroblast periostin secretion assays than either tralokinumab or cendakimab. Live imaging confocal microscopy was employed to determine the mAb effects on IL-13 internalization into cells via the decoy receptor IL-13Rα2, using A375 and HaCaT cells. The results showed that only the IL-13/lebrikizumab complex was internalized and co-localized with lysosomes, whereas IL-13/tralokinumab or IL-13/cendakimab complexes did not internalize. Conclusion Lebrikizumab is a potent, neutralizing high-affinity antibody with a slow disassociation rate from IL-13. Additionally, lebrikizumab does not interfere with IL-13 clearance. Lebrikizumab has a different mode of action to both tralokinumab and cendakimab, possibly contributing to the clinical efficacy observed by lebrikizumab in Ph2b/3 AD studies.

The transportation industry is responsible for 14.2% of total Greenhouse gas (GHG) emissions, with road transport accounting for 12.5%; henceforth, a rapid transition to Electric vehicle (EV) is required. It is anticipated that a complete transition from conventional to electric vehicles will reduce GHG emissions from road transport by over half. However, EV penetration rates are low, so many parameters that hinder adoption are still unknown. Developing countries lack peer-reviewed journals for extensive research, and researchers have limited access to technology. With the objective of portraying worldwide research to help researchers in developing countries. As a result, a literature review of 105 papers published in the last decade focussed on EV adoption, charging infrastructure, incentives and policies, consumer acceptability, user preferences, user perception, barriers, and GHG emissions. Matrix analysis is used to investigate the main factors affecting the adoption of electric vehicles for green and clean energy. The study’s conclusions indicate that developed countries have adopted technology at a far faster rate than developing ones, particularly in the areas of well laid charging infrastructure and government incentives. The findings will not only help researchers and policymakers understand the key enablers and drivers that influence the global adoption of electric vehicles, but they will also help achieve Sustainable Development Goals (SDGs), such as SDG 7 for affordable and clean energy and SDGs 11 and 13 to achieve sustainable cities, improve air quality; and thus, combat climate change’s effects.

The rise of electric vehicle (EV) usage in India is hindered by insufficient public charging infrastructure, which is considered a key hindrance to widespread EV adoption. To overcome this, it is essential to deploy public charging infrastructure in a demand-driven approach to meet the needs of EV users. This study provides a framework for developing a public charging infrastructure plan using geographic information systems, where demand for public charging is calculated based on ten indirect parameters such as population density, petrol stations, public spaces, and others. The proposed methodology was demonstrated through a case study in the city of Surat, where geospatial data was used to determine local charging demand. The analysis results produced a public charging demand map for 2025, which showed high EV charging demand in the core city region and along key transport corridors. The study highlights the need for policy interventions to effectively utilize installed charging infrastructure. The geospatial analysis is a useful tool for determining optimal locations for public charging infrastructure deployment, which can help decision-makers use the city's resources optimally.

Somatostatin receptor (SSTR) imaging is a useful method in the diagnosis of acute myocarditis. We present a case of a 54-year-old male with a clinical diagnosis of acute myocarditis in whom, 68Ga-DOTANOC positron emission tomography/computed tomography PET/CT showed diffuse left ventricular myocardial uptake. SSTR imaging can act as a surrogate marker of active inflammation. SSTR imaging is useful in deciding site of biopsy, assessing response to therapy and for prognostication.

X-linked retinoschisis (XLRS) is the most common juvenile macular degeneration in males. Unlike most other X-linked retinal dystrophies, carrier heterozygous females are very rarely reported to show clinical features of the disease. Herein, we describe unusual retinal features in a 2-year-old female infant with family history and genetic testing consistent with XLRS.