Search Results (13)

This study aimed to compare the clinical and biochemical profiles as well as the complications in males and females with type 2 diabetes (T2DM) presenting to a private tertiary diabetes care centre in India. This is a retrospective study, conducted between 1 January 2017 and 31 December 2019, and included 72,980 individuals with T2DM, aged ≥ 18 years (age and sex-matched—males—36,490; females—36,490). Anthropometric measurements, blood pressure, fasting plasma glucose (FPG), post-prandial plasma glucose (PPPG), glycated haemoglobin (HbA1c), lipids, urea, and creatinine were measured. Retinopathy was screened using retinal photography, neuropathy using biothesiometry, nephropathy measuring urinary albumin excretion, peripheral vascular disease (PVD) using Doppler, and coronary artery disease (CAD) based on the history of myocardial infarction and/or drug treatment for CAD and/or electrocardiographic changes. Obesity (73.6% vs. 59.0%) rates were significantly higher in females compared to males. FPG, PPPG, and HbA1c were higher among younger age groups among both sexes, with males having higher values compared to females. However, after the age of 44 years, control of diabetes was worse among females. In addition, only 18.8% of the females achieved glycemic control (HbA1c < 7%) compared to 19.9% in males (p < 0.001). Males had higher prevalence of neuropathy (42.9% vs. 36.9%), retinopathy (36.0% vs. 26.3%), and nephropathy (25.0% vs. 23.3%) compared to females. Males had 1.8- and 1.6-times higher risk of developing CAD and retinopathy compared to females. Hypothyroidism (12.5% vs. 3.5%) and cancers (1.3% vs. 0.6%) were significantly higher in females compared to males. In this large sample of T2DM seen at a chain of private tertiary diabetes centres, females had higher prevalence of metabolic risk factors and poorer diabetes control compared to males, emphasizing the need for better control of diabetes in females. However, males had higher prevalence of neuropathy, retinopathy, nephropathy, and CAD compared to females. Full article

Several advances in computing facilities were made due to the advancement of science and technology, including the implementation of automation in multi-specialty hospitals. This research aims to develop an efficient deep-learning-based brain-tumor (BT) detection scheme to detect the tumor in FLAIR- and T2-modality magnetic-resonance-imaging (MRI) slices. MRI slices of the axial-plane brain are used to test and verify the scheme. The reliability of the developed scheme is also verified through clinically collected MRI slices. In the proposed scheme, the following stages are involved: (i) pre-processing the raw MRI image, (ii) deep-feature extraction using pretrained schemes, (iii) watershed-algorithm-based BT segmentation and mining the shape features, (iv) feature optimization using the elephant-herding algorithm (EHA), and (v) binary classification and verification using three-fold cross-validation. Using (a) individual features, (b) dual deep features, and (c) integrated features, the BT-classification task is accomplished in this study. Each experiment is conducted separately on the chosen BRATS and TCIA benchmark MRI slices. This research indicates that the integrated feature-based scheme helps to achieve a classification accuracy of 99.6667% when a support-vector-machine (SVM) classifier is considered. Further, the performance of this scheme is verified using noise-attacked MRI slices, and better classification results are achieved. Full article

Fossil fuels are depended upon often in the transport sector. The use of diesel engines in all areas produce pollutants, such as NOx and CO, which cause serious environmental pollution and hazards, such as global climate change and breathing difficulties. Conventional fuel usage should be reduced, and there should be a shift toward alternative fuels. For compression ignition (CI) engines, microalgae biodiesel has been promoted as a clean, sustainable fuel. This is because it possesses desired traits, such as a quick rate of development, high productivity, and the capacity to turn CO₂ into fuel. When algal biodiesel is used, pollutants, such as CO, UBHC, and smoke, are typically reduced, whereas NOx emissions are typically increased. The adoption of an exhaust gas recirculation technology and the advancement or delay of injection timing can effectively reduce NOx formation. Incorporating antioxidant chemicals such as butylated hydroxyl anisole (BHA) into fuel also minimizes NOx formation. In this study, the use of microalgae biodiesel as a substitute fuel for CI engines was investigated by altering the injection timing and adding each antioxidant in two doses. According to ASTM standard test procedures for biodiesel, the fuel qualities of various blends of algal biodiesel with antioxidants were tested and compared with the diesel fuel. The experiments were conducted using CI engines, and parameters were examined, such UBHC, CO, NOx, and smoke opacity. In comparison to diesel fuel, B20 + 30% BHA (21 bTDC) blends produced 49% lower oxides of nitrogen. The smoke, HC, and CO emissions of fuel blend B20 + 30% BHA (25 bTDC) were reduced by 33.33%, 32.37%, and 11.21%, respectively, compared with those of diesel fuel. The fuel blend B20 + 30% BHA (25 bTDC) showed the highest brake thermal efficiency of 14.52% at peak load condition. A multi-output regression deep long short-term memory (MDLSTM) model was designed to predict the performance and emissions of CI engines operating with varied fuel mixtures. The average RMSE and R² values for the proposed MDLSTM were 0.38 and 0.9579, respectively. Full article

Abnormalities in lipid metabolism have been linked to the development of obesity. We used a nutrigenetic approach to establish a link between lipids and obesity in Asian Indians, who are known to have a high prevalence of central obesity and dyslipidaemia. A sample of 497 Asian Indian individuals (260 with type 2 diabetes and 237 with normal glucose tolerance) (mean age: 44 ± 10 years) were randomly chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a previously validated questionnaire. A genetic risk score (GRS) was constructed based on cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genetic variants. There was a significant interaction between GRS and saturated fatty acid (SFA) intake on waist circumference (WC) (P_interaction = 0.006). Individuals with a low SFA intake (≤23.2 g/day), despite carrying ≥2 risk alleles, had a smaller WC compared to individuals carrying <2 risk alleles (Beta = −0.01 cm; p = 0.03). For those individuals carrying ≥2 risk alleles, a high SFA intake (>23.2 g/day) was significantly associated with a larger WC than a low SFA intake (≤23.2 g/day) (Beta = 0.02 cm, p = 0.02). There were no significant interactions between GRS and other dietary factors on any of the measured outcomes. We conclude that a diet low in SFA might help reduce the genetic risk of central obesity confirmed by CETP and LPL genetic variants. Conversely, a high SFA diet increases the genetic risk of central obesity in Asian Indians. Full article

Wireless sensor networks (WSNs) and the Internet of Things (IoT) are increasingly making an impact in a wide range of domain-specific applications. In IoT-integrated WSNs, nodes generally function with limited battery units and, hence, energy efficiency is considered as the main design challenge. For homogeneous WSNs, several routing techniques based on clusters are available, but only a few of them are focused on energy-efficient heterogeneous WSNs (HWSNs). However, security provisioning in end-to-end communication is the main design challenge in HWSNs. This research work presents an energy optimizing secure routing scheme for IoT application in heterogeneous WSNs. In our proposed scheme, secure routing is established for confidential data of the IoT through sensor nodes with heterogeneous energy using the multipath link routing protocol (MLRP). After establishing the secure routing, the energy and network lifetime is improved using the hybrid-based TEEN (H-TEEN) protocol, which also has load balancing capacity. Furthermore, the data storage capacity is improved using the ubiquitous data storage protocol (U-DSP). This routing protocol has been implemented and compared with two other existing routing protocols, and it shows an improvement in performance parameters such as throughput, energy efficiency, end-to-end delay, network lifetime and data storage capacity. Full article

(1) Background: To critically evaluate dorsal onlay buccal mucosal graft urethroplasty (DOBMGU) for posterior urethral stenosis repair following transurethral resection and other endoscopic prostate procedures. (2) Methods: A retrospective multi-institutional review of patients with membranous or bulbomembranous urethral stenosis for whom treatment with DOBMGU was conducted after receipt of prostate endoscopic procedures. Baseline data, peri-operative care, post-operative care and patient-reported outcomes were analyzed. The primary outcomes were procedural failure and development of de novo stress urinary incontinence (SUI). The secondary outcomes were changes in voiding, sexual function and patient satisfaction. (3) Results: A total of 107 men with a mean age of 69 ± 9.5 years and stenosis length of 3.5 ± 1.8 cm were included. Prior endoscopic procedures among participants were 47 patients (44%) with monopolar TURP, 33 (30.8%) with bipolar TURP, 16 (15%) with Greenlight laser, 9 (8.4%) with Holmium laser enucleation and 2 (1.9%) with bladder neck incision. At a mean follow-up time of 59.3 ± 45.1 months, stenosis recurred in 10 patients (9.35%). Multivariate analysis confirmed that postoperative complications (OR 12.5; p = 0.009), history of radiation (OR 8.3; p = 0.016) and ≥2 dilatations before urethroplasty (OR 8.3; p = 0.032) were independent predictors of recurrence. Only one patient (0.9%) developed de novo SUI. Patients experienced significant improvement in PVR (128 to 60 cc; p = 0.001), Uroflow (6.2 to 16.8 cc/s; p = 0.001), SHIM (11.5 to 11.7; p = 0.028), IPSS (20 to 7.7; p < 0.001) and QoL (4.4 to 1.7; p < 0.001), and 87 cases (81.3%) reported a GRA of + 2 or better. (4) Conclusions: DOBMGU is an effective and safe option for patients with posterior urethral stenosis following TURP and other prostate endoscopic procedures. This non-transecting approach minimizes external urinary sphincter manipulation, thus limiting postoperative risk of SUI or erectile dysfunction. Full article

Magnetic-field-accelerated photocatalytic degradation of the phenol red (PR) as a model organic pollutant was studied using rare-earth elements modified BiFeO₃ (Bi_1−xR_xFeO₃ (R = Ce, Tb; x = 0.0, 0.05, 0.10 and 0.15); BFO: RE) nanostructures. The nanostructures were prepared via the hydrothermal process and their morphological, structural, functional, optical and magnetic features were investigated in detail. The effect of magnetic fields (MFs) on photocatalysis were examined by applying the different MFs under visible light irradiation. The enhanced photodegradation efficiencies were achieved by increasing the MF up to 0.5T and reduced at 0.7T for the compositions x = 0.10 in both Ce and Tb substituted BFO. Further, mineralization efficiencies of PR, reproducibility of MF-assisted photocatalysis, stability and recyclability of BFO: RE nanostructures were also tested. Full article

This paper presents a compact, bouquet-inspired, four-element MIMO array for super wideband (SWB) applications. The proposed unit element monopole antenna has compact geometry, and it is deployed by the fusion of an elliptical and circular-shaped radiator. The convoluted geometry and semi-elliptical ground plane, along with the narrow rectangular slit defected ground structure, provides a wide impedance bandwidth. The designed unit cell has the dimensions of 32 mm × 20 mm × 0.8 mm, operates from 2.9 to 30 GHz (S₁₁ ≤ −10 dB) and provides a bandwidth dimension ratio (BDR) of 2894. The proposed low-profile diversity array without any decoupling structures consists of four orthogonally placed, uncorrelated antennas with an inter element spacing of 0.05 λ₀, occupies an area of 57 mm × 57 mm and provides dual polarization. The performance metrics of the diversity array were validated for frequencies over ultra-wideband, using mutual coupling characteristics, envelope correlation coefficient (ECC) by far-field radiation, diversity gain (DG), total active reflection coefficient (TARC), channel capacity loss (CCL) and cumulative distribution function (CDF) analysis. The measured mutual coupling over the operating band was less than −18 dB, the ECC was less than 0.004 and the TARC was less than −15 dB, and a better CCL of ˂0.28 bits/s/Hz was achieved by the fabricated antenna. Full article

Kv7.2 subunits encoded by the KCNQ2 gene provide a major contribution to the M-current (I_KM), a voltage-gated K⁺ current crucially involved in the regulation of neuronal excitability. Heterozygous missense variants in Kv7.2 are responsible for epileptic diseases characterized by highly heterogeneous genetic transmission and clinical severity, ranging from autosomal-dominant Benign Familial Neonatal Seizures (BFNS) to sporadic cases of severe epileptic and developmental encephalopathy (DEE). Here, we describe a patient with neonatal onset DEE, carrying a previously undescribed heterozygous KCNQ2 c.418G > C, p.Glu140Gln (E140Q) variant. Patch-clamp recordings in CHO cells expressing the E140Q mutation reveal dramatic loss of function (LoF) effects. Multistate structural modelling suggested that the E140Q substitution impeded an intrasubunit electrostatic interaction occurring between the E140 side chain in S₂ and the arginine at position 210 in S₄ (R210); this interaction is critically involved in stabilizing the activated configuration of the voltage-sensing domain (VSD) of Kv7.2. Functional results from coupled charge reversal or disulfide trapping experiments supported such a hypothesis. Finally, retigabine restored mutation-induced functional changes, reinforcing the rationale for the clinical use of Kv7 activators as personalized therapy for DEE-affected patients carrying Kv7.2 LoF mutations. Full article

Typhoid fever due to Salmonella Typhi and invasive nontyphoidal Salmonella (iNTS) infections caused by serovars Enteritidis (SE) and Typhimurium (STm) are major pediatric health problems in sub-Saharan Africa. Typhoid has high complication rates, and iNTS infections have high case fatality rates; moreover, emerging antimicrobial resistance is diminishing treatment options. Vi capsule-based typhoid conjugate vaccine (Typbar-TCV™), licensed in India and pre-qualified by the World Health Organization, elicits durable immunity when administered to infants, but no iNTS vaccines are licensed or imminent. We have developed monovalent SE and STm glycoconjugate vaccines based on coupling lipopolysaccharide-derived core-O polysaccharide (COPS) to phase 1 flagellin protein (FliC) from the homologous serovar. Herein, we report the immunogenicity of multivalent formulations of iNTS COPS:FliC conjugates with Typbar-TCV™. Rabbits immunized with the trivalent typhoid-iNTS glycoconjugate vaccine generated high titers of serum IgG antibody to all three polysaccharide antigens for which anti-COPS IgG antibodies were directed primarily against serogroup-specific OPS epitopes. Responses to SE and STm FliC were lower relative to anti-COPS titers. Post-vaccination rabbit sera mediated bactericidal activity in-vitro, and protected mice after passive transfer against challenge with virulent SE or STm Malian blood isolates. These results support accelerated progression to clinical trials. Full article

A non-isolated Multiport Single Ended Primary Inductor Converter (SEPIC) for coordinating photovoltaic sources is developed in this paper. The proposed multiport converter topologies comprise a Single Input Multi yield (SIMO) and Multi Input Multi Output (MIMO). It is having the merits of decreased number of parts and high power density. Steady state analysis verifies the improved situation of both the proposed topologies, which is further checked through simulation results. Full article

Background: Sexually transmitted infection with the human papillomavirus (HPV) is responsible for a significant burden of human cancers involving the cervix, anogenital tract, and oropharynx. Studies in the United States and Europe have demonstrated an alarming increase in the frequency of HPV-positive oropharyngeal cancer, but the same direct evidence does not exist in Canada. Methods: Using the London Health Sciences Centre pathology database, we identified tonsillar cancers diagnosed between 1993 and 2011. Real-time polymerase chain reaction was then used on pre-treatment primary-site biopsy samples to test for DNA from the high-risk HPV types 16 and 18. The study cohort was divided into three time periods: 1993–1999, 2000–2005, and 2006–2011. Results: Of 160 tumour samples identified, 91 (57%) were positive for HPV 16. The total number of tonsillar cancers significantly increased from 1993–1999 to 2006–2011 (32 vs. 68), and the proportion of cases that were HPV-positive substantially increased (25% vs. 62%, p < 0.002). Those changes were associated with a marked improvement in 5-year overall survival (39% in 1993–1999 vs. 84% in 2006–2011, p < 0.001). When all factors were included in a multivariable model, only HPV status predicted treatment outcome. Interpretation: The present study is the first to provide direct evidence that HPV-related oropharyngeal cancer is increasing in incidence in a Canadian population. Given the long lag time between HPV infection and clinically apparent malignancy, oropharyngeal cancer will be a significant clinical problem for the foreseeable future despite vaccination efforts. Full article