Lime activated flyash-phosphogypsum blend as a low-cost alternative binder.

This study investigates the potential of a blended binder formulated from two industrial solid wastes viz. phosphogypsum and fly ash in combination with lime. Three mix proportions of phosphogypsum and fly ash were investigated, and the minimum lime contents required for activation were determined using the Eades and Grim pH test. The lime-fly ash-phosphogypsum blends were then cast into cubes, both in their paste form as well as mortar form, mixed with sand in the ratio of 1:3. They were cured for a period of seven days, and afterwards, their compressive strength was determined. Ordinary Portland cement and lime mortar blocks were also cast as control specimens for comparative evaluation of the strength. The optimal lime-fly ash-phosphogypsum blend was identified and used to construct a masonry prism, and the strengths of the masonry prisms were also evaluated. The optimal lime-fly ash-phosphogypsum blend mortar was also subjected to an X-ray diffraction analysis to determine the reaction products formed during hydration. The study revealed that 5% lime mixed with fly ash:phosphogypsum in the ratio of 3:1 was the optimal proportion which gave the maximum strength to the cubes. The optimal lime-fly ash-phosphogypsum blend mortar developed strength that was higher than conventional Portland cement and lime mortar. The optimal lime-fly ash-phosphogypsum blend mortar masonry prisms developed strength that was comparable to that of Portland cement mortar masonry. The X-ray diffraction analysis revealed the formation of calcium silicate hydrate minerals as well as ettringite and portlandite which were responsible for strength gain.

Endovascular Trapping of a Giant Splenic Artery Aneurysm by Liquid Embolic in a Case of EHPVO with Hypersplenism with a Complicated Post Procedure Course.

Case of extrahepatic portovenous obstruction (EHPVO) with giant splenic artery aneurysm and concomitant hypersplenism. The presence of bicytopenia and venous collaterals around the giant splenic aneurysm made splenectomy risky, and endovascular trapping of the giant aneurysm with partial splenic embolization was planned. Due to high flow, intraprocedural crossing of the giant aneurysm was not possible, and large coils were unstable. The aneurysm was successfully embolized with liquid embolic glue: lipiodol 50% mixture. Although the patient did not have septic complications despite large splenic infarct, the patient had secondary thrombocytosis leading to significant thrombotic complications akin to postsplenectomy syndrome. These were all successfully managed medically, and splenectomy was avoided.

Modified Lateral Position for Achilles Tendon Surgeries: A Technical Tip.

Most Achilles tendon surgeries are performed with the patient in the prone position. Some advocate supine position but the access to the tendon is compromised. We describe an innovative technique wherein the patient is positioned lateral but the surgeon has full access to the Achilles tendon as if the patient were positioned prone. We consider that this technique could be easily reproduced and hence widely adopted.

Congenital Extraskeletal Osteochondroma of the Web Space Displacing the Lesser Toes: A Unique Presentation.

Extraskeletal osteochondroma is a rare benign tumor that occurs predominantly in the soft tissues of the hands and feet. The congenital occurrence of this lesion in children is very rare. We report the case of a 9-year-old male who presented with slowly progressive swelling in his left third web space since birth that was painful with prolonged walking and had displaced his fourth toe further laterally, causing both functional and cosmetic problems. Radiographs and computed tomography revealed a well-circumscribed densely ossified lesion. Excision biopsy of the lesion showed a lobulated extraskeletal osteochondroma. At the end of 1 year of follow-up, the child had had no recurrence. To the best of our knowledge, this is the first report of congenital extraskeletal osteochondroma of the foot in English-language published studies.

Ameliorating activity of ginger (Zingiber officinale) extract against lead induced renal toxicity in male rats.

Lead poisoning has been known to be associated with structural and functional abnormalities of multiple organ systems of human body. The aim of this investigation was to study the renal protective effects of ginger (Zingiber officinale) extract in lead induced toxicity rats. In this study renal glutathione (GSH) level, glutathione peroxidase (GPX), glutathione-s-transferase (GST), and catalase enzymes were measured in lead nitrate (300 mg/kg BW), and lead nitrate plus ginger extract (150 mg/kg BW) treated rat groups for 1 week and 3 weeks respectively. The glutathione level and GSH dependent antioxidant enzymes such as glutathione peroxidase, glutathione-s-transferase, and catalase significantly (P < 0.05) increased in ginger extract treated rat groups. In addition, histological studies showed lesser renal changes in lead plus ginger extract treated rat groups than that of lead alone treated rat groups. These results indicate that ginger extract alleviated lead toxic effects by enhancing the levels of glutathione, glutathione peroxidase, glutathione-s-transferase and catalase.

Bilateral--otitis media, dacroadenitis, parotitis and left sided infranuclear facial palsy: unusual manifestations of Wegener's granulomatosis.

Wegener's granulomatosis is a systemic vasculitis of unknown aetiology. Although it classically involves the upper respiratory tract, lungs and kidneys, virtually any organ may be affected. We report a rare case of a 45 year old female who presented with bilateral-dacroadenitis, otitis media, parotid enlargement and left sided lower motor neuron type of facial palsy as the initial manifestations of Wegener's granulomatosis.

Techniques in recurrent giant cell tumour of the first metatarsal in adolescents - A rare report of 2 cases.

Giant cell tumour of the foot is very rare. Very few cases of first metatarsal giant cell tumour were reported. We report two cases of recurrent giant cell tumour in adolescent patients. One was treated with wide excision and fibula grafting. The second patient underwent Boyd's amputation because of superceded infection. Both had no pain, recurrence at the end of final follow up. Recurrent giant cell tumour of the first metatarsal in adolescents and its management is not described in English literature to the best of our knowledge.

Accuracy of Femoral Tunnel Placement between Anteromedial and Anterolateral Visualisation Portals in Anterior Cruciate Ligament Reconstruction - Outcomes of a CT based Cross-Sectional Study.

Introduction: Anatomical femoral tunnel placement is critical for anterior cruciate ligament reconstruction (ACLR). Tunnel placement may vary with different surgical techniques. The aim of this study was to compare the accuracy of femoral tunnel placement between the Anteromedial (AM) and Anterolateral (AL) visualisation portals on post-operative CT scans among a cohort of ACLR patients. Materials and methods: This cross-sectional study was conducted from January 2018 to March 2020 after obtaining ethics clearance. Patients who went for arthroscopic ACLR in our institute were divided into an AM (group 1) and an AL (group 2) based on the visualisation portal for creating the femoral tunnel and a 3D CT scan was done. The femoral tunnel position was calculated in deep to shallow and high to low direction using the Bernard Hertel grid. Femoral tunnel angle was measured in the 2D coronal image. Statistical analysis was done with the data collected. Results: Fifty patients with an average age of 26.36 (18-55) years ±7.216 SD were enrolled in the study. In this study, the AM technique was significantly more accurate (p<0.01) than the AL technique in terms of femoral tunnel angle. Furthermore, the deep to the shallow position was significantly (p= 0.018) closer to normative values, as determined by the chi-square test. The chances of error in tunnel angle in femoral condyle are 2.6 times greater in the AL technique (minimal clinical difference). Conclusion: To conclude, in ACLR the anteromedial visualisation portal can facilitate accurate femoral tunnel placement compared to the anterolateral visualisation portal.

A rare case of closed pantalar dislocation combined with Lisfranc's injury--The unusual complex.

Closed pantalar dislocation with associated Lisfranc's injury is a very rare injury. We report a rare case of such injury. Our patient had fall from height and presented with closed pantalar dislocation with Lisfranc's injury of the left foot and other multiple injuries. He was immediately operated and dislocation was reduced and was stabilised with multiple Kirschner wires. At the end of 1 year follow up, he had an AOFAS score of 78 and had painless ankle movements. To the best of our knowledge, this is the first case reported with such a rare combination of injury.

Transcriptomic profiling of sporadic Alzheimer's disease patients.

Alzheimer's disease (AD) manifested before age 65 is commonly referred to as early-onset AD (EOAD) (Reitz et al. Neurol Genet. 2020;6:e512). While the majority (> 90%) of EOAD cases are not caused by autosomal-dominant mutations in PSEN1, PSEN2, and APP, they do have a higher heritability (92-100%) than sporadic late-onset AD (LOAD, 70%) (Wingo et al. Arch Neurol. 2012;69:59-64, Fulton-Howard et al. Neurobiol Aging. 2021;99:101.e1-101.e9). Although the endpoint clinicopathological changes, i.e., Aß plaques, tau tangles, and cognitive decline, are common across EOAD and LOAD, the disease progression is highly heterogeneous (Neff et al. Sci Adv Am Assoc Adv Sci. 2021;7:eabb5398). This heterogeneity, leading to temporally distinct age at onset (AAO) and stages of cognitive decline, may be caused by myriad combinations of distinct disease-associated molecular mechanisms. We and others have used transcriptome profiling in AD patient-derived neuron models of autosomal-dominant EOAD and sporadic LOAD to identify disease endotypes (Caldwell et al. Sci Adv Am Assoc Adv Sci. 2020;6:eaba5933, Mertens et al. Cell Stem Cell. 2021;28:1533-1548.e6, Caldwell et al. Alzheimers Demen. 2022). Further, analyses of large postmortem brain cohorts demonstrate that only one-third of AD patients show hallmark disease endotypes like increased inflammation and decreased synaptic signaling (Neff et al. Sci Adv Am Assoc Adv Sci. 2021;7:eabb5398). Areas of the brain less affected by AD pathology at early disease stages-such as the primary visual cortex-exhibit similar transcriptomic dysregulation as those regions traditionally affected and, therefore, may offer a view into the molecular mechanisms of AD without the associated inflammatory changes and gliosis induced by pathology (Haroutunian et al. Neurobiol Aging. 2009;30:561-73). To this end, we analyzed AD patient samples from the primary visual cortex (19 EOAD, 20 LOAD) using transcriptomic signatures to identify patient clusters and disease endotypes. Interestingly, although the clusters showed distinct combinations and severity of endotypes, each patient cluster contained both EOAD and LOAD cases, suggesting that AAO may not directly correlate with the identity and severity of AD endotypes.

Frequenin/NCS-1 and the Ca2+-channel alpha1-subunit co-regulate synaptic transmission and nerve-terminal growth.

Drosophila Frequenin (Frq) and its mammalian and worm homologue, NCS-1, are Ca(2+)-binding proteins involved in neurotransmission. Using site-specific recombination in Drosophila, we created two deletions that removed the entire frq1 gene and part of the frq2 gene, resulting in no detectable Frq protein. Frq-null mutants were viable, but had defects in larval locomotion, deficient synaptic transmission, impaired Ca(2+) entry and enhanced nerve-terminal growth. The impaired Ca(2+) entry was sufficient to account for reduced neurotransmitter release. We hypothesized that Frq either modulates Ca(2+) channels, or that it regulates the PI4Kbeta pathway as described in other organisms. To determine whether Frq interacts with PI4Kbeta with consequent effects on Ca(2+) channels, we first characterized a PI4Kbeta-null mutant and found that PI4Kbeta was dispensable for synaptic transmission and nerve-terminal growth. Frq gain-of-function phenotypes remained present in a PI4Kbeta-null background. We conclude that the effects of Frq are not due to an interaction with PI4Kbeta. Using flies that were trans-heterozygous for a null frq allele and a null cacophony (encoding the alpha(1)-subunit of voltage-gated Ca(2+) channels) allele, we show a synergistic effect between these proteins in neurotransmitter release. Gain-of-function Frq phenotypes were rescued by a hypomorphic cacophony mutation. Overall, Frq modulates Ca(2+) entry through a functional interaction with the alpha(1) voltage-gated Ca(2+)-channel subunit; this interaction regulates neurotransmission and nerve-terminal growth.

A rare case of cryptococcal infection of talus with pathological fracture that healed with medical management.

Skeletal involvement occurs in 5% to 10% of reported cases of disseminated cryptococcal infection. We are reporting a very rare presentation of cryptococcal infection of the talus with pathological fracture, which healed with medical management. Our patient had pain and swelling around the ankle associated with fever. Radiologically, he had a lytic lesion of the talus with fracture of the talar neck. Biopsy and cultures revealed cryptococcal infection. He was treated with surgical debridement combined with antifungal therapy, and the fracture healed well by 5 months. At the end of the 1-year follow-up, he had painless ankle movement and there was no evidence of recurrence. He was able to walk without support or limp, and he could wear normal footwear.

Adsorption of Rare Earth Ce3+ and Pr3+ Ions by Hydrophobic Ionic Liquid.

This study reports the use of hydrophobic ionic liquid (IL) based on D-galactose for the recovery of Ce (III) and Pr (III) ions from solutions. The equilibrium data were obtained by optimization of batch parameters, and various isotherms and kinetic models were utilised to predict the mechanistic process of sequestration of ions. The Arrhenius activation energies are found to be between 5-40 kJ, suggesting the physisorption process of ions onto IL. The present process is understood to be rapid and exothermic in nature according to thermodynamic experiments. The loading capacity was found to be 179.3 g L-1 and 141.5 g L-1, respectively, for Ce (III) and Pr (III) ions at pH 5 with a contact time of 30 min and dose being 0.1 g L-1. The higher uptake capacity is attributed to the presence of a highly electronegative fluorine atom in the IL. These results highlight the potential application of IL in the sequestration of Ce (III) and Pr (III) ions from any water sources.

Predictors of Functional Outcome in Unstable Ankle Fractures Treated Surgically - A Prospective Cohort Study.

INTRODUCTION: Unstable ankle injuries require anatomical reduction and stabilisation for optimal outcome. In spite of adequate care, a few patients have poor outcome. In this study, we assessed the risk factors that predict the clinical outcomes in surgically treated unstable ankle fractures. MATERIAL AND METHODS: This prospective cohort study was conducted on 68 patients who underwent surgical management for an unstable ankle injury. Demographic details, fracture type and associated medical comorbidities were recorded. Pre-operative radiographic assessment was done for all patients. At the end of one year follow-up, clinical (American Orthopaedic foot and ankle society-AOFAS and Olerud-Molander ankle - OMAS) scores and radiological parameters were assessed and analysed. RESULTS: Fracture dislocation (0.008), diabetes mellitus (0.017), level of alchohol consumption (0.008) and pre-operative talocrural angle (TCA) > 100° (0.03) were significant predictors of poor outcomes as per AOFAS. Fracture dislocation (0.029), diabetes mellitus (0.004), pre-operative TCA > 100° (0.009), female gender (0.001), age more than 60 years (0.002) and open injuries (0.034) had significantly poor outcome as per OMAS. Other parameters (smoking, hypertension, classification, syndesmotic injury, medial clear space and tibiofibular overlap) did not affect the outcome significantly. CONCLUSION: Our study showed that poor outcome predictors in unstable ankle fractures are age >60 years, female gender, diabetes mellitus, alcohol consumption, fracture dislocation, open fractures and pre-op TCA >100°.

Recasting Ni-foam into NiF2 nanorod arrays via a hydrothermal process for hydrogen evolution reaction application.

A promising electrode for hydrogen evolution reaction (HER) has been prepared via a reduction process to form NiF2 nanorod arrays directly grown on a 3D nickel foam. We reveal NiF2@Ni nanorod arrays for a stable hydrogen evolution reaction (HER) application. The computational analysis for H2O, OH and H and experimentally in aqueous KOH endow considerable shift in Fermi levels for Ni (111) unlike for NiF2 (110) on account of an effective coalition of p-orbitals of fluorine and d-orbitals of Ni in NiF2, NiF2 under pinning the reduced overpotential of 172 mV at 10 mA cm-2 compared to Ni (242 mV) in same electrolyte. The electrocatalytic mechanism has been proposed using density functional theory (DFT) and is found in well accordance with the experimental findings of the present study. The preparation of self-grown porous nanostructured electrodes on the 3D nickel foam via a displacement reaction is possibly valuable for other metal halides for energy storage and conversion applications as these materials have inherently smaller overpotentials.

Porous metal-graphene oxide nanocomposite sensors with high ammonia detectability.

Nickel oxide-graphene oxide (NiO-GO), zinc oxide-graphene oxide (ZnO-GO) and bismuth oxide-graphene oxide (Bi2O3-GO) metal oxide-graphene oxide nanocomposite (MO-GO NC) sensors, operable at room temperature, were synthesized via a simple and cost-effective microwave-assisted combustion method for chemiresistive gas sensor applications. From the measured structural, morphological, and elemental detection properties, the sensors are found capable of detecting various gases. The Bi2O3-GO NC sensor exhibited excellent response over NiO-GO (~20 at 50 ppm) and ZnO-GO NC (~60 at 50 ppm) sensors for detecting NH3. The response of the Bi2O3-GO NC sensor at 50 ppm NH3 in just 14 s operation duration was ~81.23, which is improved 25-fold and 13-fold compared to pristine GO sensors. Additionally, the as-developed Bi2O3-GO NC sensor demonstrates outstanding repeatability and recovery kinetics, attributed to porosity and the combined effects of MO and GO. The sensing mechanism of the Bi2O3-GO NC gas sensors is proposed herein. The superior sensing performance, including quick response and recovery of the Bi2O3-GO NC sensor is attributed to favorable charge transfer across the Bi2O3 and GO interface. The significance of relative humidity on sensing potential of the Bi2O3-GO NC sensor has also been studied and the sensor is confirmed to be unaffected by relative humidity.

Coconut-Water-Mediated Carbonaceous Electrode: A Promising Eco-Friendly Material for Bifunctional Water Splitting Application.

The organic and eco-friendly materials are extended to prevail over the worldwide energy crisis where bio-inspired carbonaceous electrode materials are being prepared from biogenic items and wastes. Here, coconut water is sprayed over three-dimensional (3D) nickel foam for obtaining a carbonaceous electrode material, i.e., C@Ni-F. The as-prepared C@Ni-F electrode has been used for structural elucidation and morphology evolution studies. Field emission scanning electron microscopy analysis confirms the vertically grown nanosheets of the C@Ni-F electrode, which is further employed in the oxygen evolution reaction (OER) and hydrogen evolution reaction (HER), where excellent OER and HER performances with small overpotentials of 219 and 122 mV and with stumpy Tafel slopes, i.e., 27 and 53 mV dec-1, are respectively obtained, suggesting a bifunctional potential of the sprayed electrode material. Moreover, sustainable bifunctional performance of C@Ni-F proves considerable chemical stability and moderate mechanical robustness against long-term operation, suggesting that, in addition to being a healthy drink to mankind, coconut water can also be used for water splitting applications.

Sirolimus-based calcineurin inhibitor withdrawal immunosuppressive regimen in kidney transplantation: a single center experience.

BACKGROUND/AIM: This observational study was conducted to evaluate the safety and efficacy of the conversion from calcineurin inhibitors (CNIs) to sirolimus (SRL)-based immunosuppressive therapy in kidney transplantation. MATERIALS AND METHODS: Sixty-four kidney recipients of mean age 38.3 +/- 14.6 years were converted to SRL. The main reasons for conversion were elective in 45 (70.3%) and biopsy-proven chronic allograft nephropathy in 11 (17.2%). The primary CNI used was cyclosporine A in 51 patients. Mean time to conversion was 50.5 months. After conversion, 61 patients received mycophenolate mofetil. We evaluated the impact of conversion on renal function for 5 years post-conversion. The overall mean follow-up time was 72.8 months. RESULTS: The analysis showed significant improvement in renal function at month 3 post-conversion (P < 0.05) with stabilization thereafter. Lipid parameters and blood sugar levels were similar pre- and post-conversion. Abnormal liver function test was transient in 12.8%. Reasons for SRL discontinuation were nephrotic range proteinuria in two patients and mouth ulceration in one. We compared patients with serum creatinine <140 micromol/l and those with serum creatinine > or = 140 micromol/l, and found that serum creatinine was an independent risk factor for chronic allograft dysfunction (P = 0.02). Graft loss occurred in three patients because of cardiovascular death in two and an acute rejection episode in one. CONCLUSIONS: We concluded that conversion from CNIs to SRL is an option and of benefit without significant acute rejection episodes or chronic allograft dysfunction especially in well-selected kidney transplant recipients with good graft function.

(2E,6E)-2,6-Bis(2,4,5-trimethoxy-benzyl-idene)cyclo-hexa-none.

In the title compound, C(26)H(30)O(7), one atom in the cyclo-hexa-none ring is disordered over two positions with a site-occupancy ratio of 0.871 (6):0.129 (6). The dihedral angles formed between the mean plane through the six C atoms of the major component of the cyclo-hexa-none ring and two benzene rings are 35.09 (10) and 34.21 (10)°; the corresponding angles for the minor component are 20.1 (2) and 19.5 (2)°. Both the major and minor disordered components of the cyclo-hexa-none ring adopt half-boat conformations. In the crystal packing, inter-molecular C-H⋯O hydrogen bonds connect the mol-ecules into a three-dimensional network.