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ObjectiveChylopericardium (CPE) is a rare condition associated with accumulation of triglyceride-rich chylous fluid in the pericardial cavity. Due to minimal information on CPE within the literature, we conducted a systematic review of all published CPE cases to understand its clinical characteristics, management and outcomes.MethodsWe performed a literature search and identified cases of patients with CPE from 1946 until May 2021 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified relevant articles for pooled analyses of clinical, diagnostic and outcome data.ResultsA total of 95 articles with 98 patients were identified. Patient demographics demonstrated male predominance (55%), with a mean age of 37±15 years. Time from symptom onset to diagnosis was 5 (Q1 4.5, Q3 14) days, with 74% of patients symptomatic on presentation. Idiopathic CPE (60%) was the most common aetiology. Cardiac tamponade secondary to CPE was seen in 38% of cases. Pericardial fluid analysis was required in 94% of cases. Lymphangiography identified the leakage site in 59% of patients. Medical therapy (total parenteral nutrition, medium-chain triglycerides or octreotide) was undertaken in 63% of cases. In our cohort, 32% progressed towards surgical intervention. During a median follow-up of 180 (Q1 180, Q3 377) days, CPE recurred in 16% of cases. Of the patients with recurrence, 10% were rehospitalised.ConclusionCPE tends to develop in younger patients and may cause serious complications. Many patients fail medical therapy, thereby requiring surgical intervention. Although overall mortality is low, associated morbidities warrant close follow-up and possible reintervention and hospitalisations.

PurposeTo compare the success rate, clinical outcomes, and complications of retroperitoneal (RP) versus transperitoneal (TP) percutaneous catheter drainage (PCD) of the necrotic pancreatic fluid collections.Materials and methodsThis retrospective study comprised consecutive patients with acute pancreatitis who underwent PCD of lesser sac collections amenable to drainage via both TP and RP routes. The patients were divided into two groups based on the route of drainage (group I, RP, and group II, TP). The technical success, clinical success, complications, and clinical outcomes were compared between the groups. Subgroup analysis was performed based on the timing of drainage (acute necrotic collections, ANC vs. walled-off necrosis, WON) and organ failure (OF).ResultsSeventy-nine patients [mean age, 38.7 ± 12.3 years, 54 males] were included in the study. Group I and II comprised 22 (27.8%) and 57 (72.2%) patients, respectively. The procedures were technically successful in all the patients. There was no significant difference in the complication rate between the two groups. The clinical success was higher in group II (75.4%) as compared to group I (54.5%). However, the difference was not statistically significant (p = 0.070). There was no significant difference in the hospital stay (p = 0.298), intensive care unit stay (p = 0.401), need for surgical necrosectomy (p = 0.243), and mortality (p = 0.112) between the two groups. The outcomes in patients with OF and ANC were not affected by the route of PCD. Clinical success rate was significantly higher in WON undergoing TP drainage (p = 0.009).ConclusionBoth RP and TP routes of PCD are safe and effective. Clinical success rate was significantly higher in WON undergoing TP drainage.

Atypical fibroxanthoma (AFX) is a rare spindle cell proliferation arising from significant sun exposure. AFX often appears as a red papule, typically found in the head and neck region of elderly patients. Since there is no specificity in immunohistology, various stains differentiate AFX from other skin cancers. The stains include cluster of differentiation 68 (CD68), cluster of differentiation 163 (CD163), vimentin, cytokeratin epithelial (CKAE), and melanin. While local recurrence is common, AFX rarely metastasizes. Thus, the treatment options are complete surgical excision or micrographically oriented histographic surgery.

Micronutrients like iron (Fe), zinc (Zn), copper (Cu), manganese (Mn), boron (B), nickel (Ni), and molybdenum (Mo) perform significant roles in the regulation of plant metabolism, growth, and development. Micronutrients, namely Fe, Zn, Cu, Mn, and Ni, are involved in oxidative stress and antioxidant defense as they are cofactors or activators of various antioxidant enzymes, viz . , superoxide dismutase (Fe, Cu/Zn, Mn, and Ni), catalase (Fe), and ascorbate peroxidase (Fe). An effort has been made to incorporate recent advances along with classical work done on the micronutrient deficiency-induced oxidative stress and associated antioxidant responses of plants. Deficiency of a micronutrient produces ROS in the cellular compartments. Enzymatic and non-enzymatic antioxidant defense systems are often modulated by micronutrient deficiency to regulate redox balance and scavenge deleterious ROS for the safety of cellular constituents. ROS can strike cellular constituents such as lipids, proteins, and nucleic acids and can destruct cellular membranes and proteins. ROS might act as a signaling molecule and activate the antioxidant proteins by interacting with signaling partners such as respiratory burst oxidase homolog (RBOH), G-proteins, Ca 2+ , mitogen activated protein kinases (MAPKs), and various transcription factors (TFs). Opinions on probable ROS signaling under micronutrient deficiency have been described in this review. However, further research is required to decipher micronutrient deficiency-induced ROS generation, perception, and associated downstream signaling events, leading to the development of antioxidant responses in plants.

Cascade systems are used in the large-scale production of astaxanthin, facilitating a successful value-added process despite high accumulating costs. However, their application to other high-value products (HVPs), like lutein, β-carotene, chlorophylls, and fatty acids, remains unexplored. This study investigates Chlamydomonas asymmetica in chemostatic cultures, focusing on the impact of light and dilution rate. A two-stage cascade system is designed, combining high-light growth with low-light pigment accumulation. The results show potential for productivity improvement. Notably, the spacetime yield (STY) of Chlorophyll a increased by 20.96%, reaching 2.73 g·L−1·d−1 at the lowest dilution rate. Lutein maintains a consistent concentration of 22.34 mg·g−1, while β-carotene achieves a maximum STY of 3.60 mg·L·d−1. A cascade modification with a hollow fiber membrane significantly enhances HVP concentrations—Chlorophyll b, Lutein, Chlorophyll a, β-carotene, EPS, and GLA increase 27.23%, 38.95%, 31.88%, 86.19%, 128.7%, and 57.71%, respectively. STY improvements for these HVPs range from 1.78% to 82.96%. This study offers insights into C. asymmetica’s response and proposes a cascade modification for enhanced HVP production and downstream processing efficiency.

Spinal anaesthesia is the most commonly used method for cesarean section. Although many cases are present that show the rare side effect of intrathecal administration of Bupivacaine which is a generalised tonic clonic seizure. We present a case of a 35 year old patient posted for cesarean section who developed myoclonic seizures followed by generalised tonic clonic seizures and status epilepticus after intrathecal administration of Bupivacaine. We conclude that status epilepticus is a rare an d possible lethal side effect of intrathecal Bupivacaine and documentation of these uncommon side effects helps to understand its pathophysiology and able to recognize and treat the condition early.

Graphene, a 2D single-layered carbon sp 2 hybrid substance set in a honeycomb network, is widespread in many carbon-based materials. Due to its extraordinary optical, electrical, thermal, mechanical, and magnetic competences as well as its significant specific surface area, it has attracted a lot of interest recently. Synthesizing graphene refers to any process for creating or extracting the material, depending on the desired purity, size, and efflorescence of the finished good. Numerous methods have been employed for graphene synthesis categorized as top-down procedures and bottom-up procedures. Graphene finds its implementations in various industries such as electronics, energy, chemical, transport, defence, and biomedical areas such as accurate biosensing. It has been widely used in water treatment as a binder for organic contaminants and heavy metals. Many researches have fixated on creating various modified graphene, graphene oxide composites, graphene nanoparticle composites and semiconductor hybrids of graphene for contaminant removal from water. In this review, we have tried to address various production methods for graphene and its composites along with their advantages and disadvantages. Furthermore, we have presented a summary on graphene’s outstanding immobilization of a variety of contaminants like toxic heavy metals, organic dyes, inorganic pollutants and pharmaceutical wastes. Additionally, a development of graphene-based microbial fuel cell (MFC) has been evaluated in an effort to produce ecological wastewater treatment and bioelectricity.

Fungal pre-treatment using Pleurotus ostreatus (PO) was carried out on individual and combinations of agro-waste wheat straw (WS), rice straw (RS), and pearl millet straw (PMS) with the addition of biochar (5%,7.5% and 10%) to reduce the pre-treatment duration. Further remaining substrate known as spent mushroom substrate (SMS) was used in anaerobic digestor (AD) for estimation enhanced biomethane yield. Equal ratios of RS + WS, WS + PMS, PMS + RS, and RS + PMS + WS and biochar addition were taken for enhancing pre-treatment, PO growth and AD process. The extent of pre-treatment was recorded with the maximum lignin removal of 40.4% for RS + PMS + WS as compared to untreated counterparts and 0.5%, 2.2%, and 3.3% times more lignin removal from individual PMS, RS, and WS respectively. Addition of biochar to the substrates reduced the total pre-treatment duration by days as compared to the non-biochar substrates. Biological efficiency (BE) used for the analysis of mushroom growth varied from 51–92%. Further, the average bio-methane yield was 187 ml/gVS for SMS of PMS + WS + RS with 10% biochar indicating an increment of 83.33% from untreated SMS of PMS + WS + RS. This, higher biomethane yield was 9.35%, 22.22% and 57.14% times higher than individual SMS of PMS, RS, and WS respectively. The current study shows that biochar not only enhances the bio-methane yield but also reduces the biological pre-treatment duration and removes the dependency on one lignocellulosic biomass for energy (bio-methane) and food (mushroom) production.

BackgroundMesenteric changes in acute pancreatitis (AP) are understudied and not accounted for in the current CT-based classification. This study aimed to evaluate and propose a new CT-based classification defining mesenteric changes and their predictive capability on the outcome.MethodsThe CT films of all consecutive moderately severe/severe AP patients were reviewed, and the mesenteric changes were classified as: Type 0 (no changes in mesentery); type 1a (only mesenteric root involved, no mass effect); type 1b (mesenteric root with mass effect); type 2 (diffuse haziness without mass effect) and type 3 (diffuse haziness with mass effect).Baseline characteristics, severity markers and outcome measures were compared between mesenteric changes and those without and among the different subgroups.ResultsThe CT and clinical course of 128 patients (male 76, 59.4%; mean age 41.5±13.7 years) included were evaluated. Mesenteric changes were seen in 84 (65.6%) of the patients. Patients with mesenteric changes had higher baseline APACHE II score (p<0.0001), higher incidence of intra-abdominal hypertension (p=0.004); organ failure (p<0.001); ICU admission (p<0.001), ventilator requirement (p<0.001) and mortality (p=0.003). Type 2 and 3 mesenteric changes had worse outcomes with a graded increase in adverse outcomes from type 0 to type 3, as shown in IDDF2022-ABS-0180 Table 1. Multivariable regression analysis showed that severe mesenteric changes (type 2&3) were significant mortality predictors (aOR- 4.55;CI 1.07–19.32).Abstract IDDF2022-ABS-0180 Table 1 Parameters No changes (n=44) Type 1a (n=38) Type 1b (n=7) Type 2 (n=31) Type 3 (n=8) P value Multiple Organ failure 4(20.0%) 11(42.3%) 1(16.7%) 17 (65.4%) 7 (87.5%) 0.011 Intraabdominal hypertension 13 (29.5%) 20 (52.6%) 2 (28.6%) 18 (58.1%) 7 (87.5%) 0.009 Hospital stay(days) 11.9±8.1 21.76±14.9 21.71±20.9 27.87±15.3 27.88±10.5 <0.0001 Mortality 3 (6.8%) 7 (18.4%) 2 (28.6%) 12 (38.7%) 4 (50.0%) 0.004 ConclusionsMesenteric changes are common and significantly affect outcomes in patients with AP. Higher grades of mesenteric changes corroborate with a graded increase in adverse outcomes, including mortality.

In intelligent web systems [2], web prefetching [27] plays a crucial role. In order to make accurate predictions for web prefetching, it is important but challenging to uncover valuable information from web use statistics [16]. Using statistics and domain expertise, this study presents a new approach dubbed SPUDK for efficient prefetching. In this paper, it is shown how web access logs can be used efficiently for browsing prediction. Our main focus is on the technique needed to manage the queries found in web access logs so that valuable information can be attained. We further process these access logs using a taxonomy and a thesaurus, WordNet, to find the semantics of queries. SPUDK, a system that organises use data into semantic clusters, is one example of this approach. Our contributions in this paper are as follows: (1) A technique to exploit query keywords from access logs. (2) An approach to enrich queries with semantic information. (3) A new similarity measure for finding similarity among URLs present in access logs. (4) A novel clustering technique to find semantic clusters of URLs. (5) Experimental evaluation of the proposed system. The proposed SPUDK system is evaluated using American Online (AOL) logs, which gives improvement of 39% in precision of prediction, 35% in hit ratio and reduction of 50.6% in latency on average as compared to other prediction techniques in the literature.