A Comparative Evaluation of Arginine Complex Combined With Flouride and Two Standard Non-Fluoridated Remineralizing Agents: An In Vitro Study.

Background Dental caries represents a dynamic process, often reversible in its early stages. Fluoride has conventionally served as the cornerstone for remineralization and early caries arrest. However, excessive fluoride intake can lead to both local and systemic toxicity. Hence, there's a pressing need to develop adjunct therapies that enhance fluoride's efficacy while minimizing its dosage. This study aims to assess and compare the remineralization potential of a novel combination comprising arginine bicarbonate and fluoride against established technologies such as Bioactive glass (NovaMin Technology; Sensodyne Repair and Protect, GlaxoSmithKline, UK) and CPP-ACP technology (GC Tooth Mousse; Tokyo Japan). Materials and methods The experiment utilized extracted premolars designated for orthodontic extraction. The initial evaluation employed the DIAGNOdentTM fluorescence method. Subsequently, teeth underwent demineralization and were measured for values. Following this, the teeth were subjected to seven cycles of remineralization, after which moment values were reassessed. Statistical analysis was performed on the recorded values. Results Participants were divided into six groups (BR-A, AR-A, BR-B, AR-B, BR-C, AR-C). T-tests demonstrated significant reductions in moment values within each group, indicating the effectiveness of all remineralizing agents. Group C exhibited the most substantial difference (-6.900 ± 0.4), followed by Group A and Group B. ANOVA analysis revealed statistically significant differences among all three groups (p=0.016). Tables showed significant distinctions between the remineralizing values of Groups A and C and Groups B and C (p=0.02 and 0.002, respectively), with no discernible distinction between Groups A and B. Conclusion The study elucidates the superior efficacy of the arginine complex with fluoride combination compared to CPP-ACP and Bioactive Glass individually. This finding underscores the potential of the novel combination therapy in enhancing remineralization while minimizing fluoride dosage, thus presenting a promising strategy for addressing early-stage dental caries.

Generative interpolation and restoration of images using deep learning for improved 3D tissue mapping.

The development of novel imaging platforms has improved our ability to collect and analyze large three-dimensional (3D) biological imaging datasets. Advances in computing have led to an ability to extract complex spatial information from these data, such as the composition, morphology, and interactions of multi-cellular structures, rare events, and integration of multi-modal features combining anatomical, molecular, and transcriptomic (among other) information. Yet, the accuracy of these quantitative results is intrinsically limited by the quality of the input images, which can contain missing or damaged regions, or can be of poor resolution due to mechanical, temporal, or financial constraints. In applications ranging from intact imaging (e.g. light-sheet microscopy and magnetic resonance imaging) to sectioning based platforms (e.g. serial histology and serial section transmission electron microscopy), the quality and resolution of imaging data has become paramount. Here, we address these challenges by leveraging frame interpolation for large image motion (FILM), a generative AI model originally developed for temporal interpolation, for spatial interpolation of a range of 3D image types. Comparative analysis demonstrates the superiority of FILM over traditional linear interpolation to produce functional synthetic images, due to its ability to better preserve biological information including microanatomical features and cell counts, as well as image quality, such as contrast, variance, and luminance. FILM repairs tissue damages in images and reduces stitching artifacts. We show that FILM can decrease imaging time by synthesizing skipped images. We demonstrate the versatility of our method with a wide range of imaging modalities (histology, tissue-clearing/light-sheet microscopy, magnetic resonance imaging, serial section transmission electron microscopy), species (human, mouse), healthy and diseased tissues (pancreas, lung, brain), staining techniques (IHC, H&E), and pixel resolutions (8 nm, 2 µm, 1mm). Overall, we demonstrate the potential of generative AI in improving the resolution, throughput, and quality of biological image datasets, enabling improved 3D imaging.

Three-dimensional assessments are necessary to determine the true, spatially-resolved composition of tissues.

Methods for spatially resolved cellular profiling using thinly cut sections have enabled in-depth quantitative tissue mapping to study inter-sample and intra-sample differences in normal human anatomy and disease onset and progression. These methods often profile extremely limited regions, which may impact the evaluation of heterogeneity due to tissue sub-sampling. Here, we applied CODA, a deep learning-based tissue mapping platform, to reconstruct the three-dimensional (3D) microanatomy of grossly normal and cancer-containing human pancreas biospecimens obtained from individuals who underwent pancreatic resection. To compare inter- and intra-sample heterogeneity, we assessed bulk and spatially resolved tissue composition in a cohort of two-dimensional (2D) whole slide images (WSIs) and a cohort of thick slabs of pancreas tissue that were digitally reconstructed in 3D from serial sections. To demonstrate the marked under sampling of 2D assessments, we simulated the number of WSIs and tissue microarrays (TMAs) necessary to represent the compositional heterogeneity of 3D data within 10% error to reveal that tens of WSIs and hundreds of TMA cores are sometimes needed. We show that spatial correlation of different pancreatic structures decay significantly within a span of microns, demonstrating that 2D histological sections may not be representative of their neighboring tissues. In sum, we demonstrate that 3D assessments are necessary to accurately assess tissue composition in normal and abnormal specimens and in order to accurately determine neoplastic content. These results emphasize the importance of intra-sample heterogeneity in tissue mapping efforts.

A Comparative Evaluation of the Fracture Resistance of Mineral Trioxide Aggregate (MTA) Plus and MTA Angelus: An In Vitro Study.

Background Mineral trioxide aggregate (MTA) is a biocompatible dental material used for root-end filling in endodontics. A wide variety of literature has been published on the assessment of fracture resistance of MTA. However, the results were conflicting in the reported studies, and the sample size used was insufficient to conclude the efficacy of materials such as MTA Plus and MTA Angelus. Therefore, this study was designed to compare and evaluate the effectiveness of two commercially available MTAs, namely, MTA Plus (Avalon Biomed Inc. by Prevest Denpro Ltd, Jammu, India) and MTA Angelus (Angelus Dental Solutions, Brazil) in terms of fracture resistance. Methodology To determine fracture resistance, 300 freshly extracted healthy human teeth with single roots and canals were collected by simple random sampling. Teeth were decoronated, the apical third was enlarged, and root canals were prepared to receive MTA as a 5 mm apical filling. The root segments were randomly categorized into two experimental groups of 100 samples each, namely, group A (MTA Plus) and group B (MTA Angelus), and the remaining 100 root segments were used as control (unfilled). Fracture resistance was determined using the Instron Universal testing machine. Results The results of our study showed statistically significant increased fracture resistance for MTA Plus (532.14 ± 5.19 N) than MTA Angelus (540.81 ± 3.56 N) and the control group (460.63 ± 7.91 N). Conclusions The control group showed the least fracture resistance. The composition and structure of MTA Angelus (group B) containing Portland cement, with a 4:1 addition of bismuth oxide, make it more fracture resistant than MTA Plus (group A).

ECS1 and ECS2 suppress polyspermy and the formation of haploid plants by promoting double fertilization.

The current pace of crop plant optimization is insufficient to meet future demands and there is an urgent need for novel breeding strategies. It was previously shown that plants tolerate the generation of triparental polyspermy-derived plants and that polyspermy can bypass hybridization barriers. Polyspermy thus has the potential to harness previously incompatible climate-adapted wild varieties for plant breeding. However, factors that influence polyspermy frequencies were not previously known. The endopeptidases ECS1 and ECS2 have been reported to prevent the attraction of supernumerary pollen tubes by cleaving the pollen tube attractant LURE1. Here, we show that these genes have an earlier function that is manifested by incomplete double fertilization in plants defective for both genes. In addition to supernumerary pollen tube attraction, ecs1 ecs2 mutants exhibit a delay in synergid disintegration, are susceptible to heterofertilization, and segregate haploid plants that lack a paternal genome contribution. Our results thus uncover ECS1 and ECS2 as the first female factors triggering the induction of maternal haploids. Capitalizing on a high-throughput polyspermy assay, we in addition show that the double mutant exhibits an increase in polyspermy frequencies. As both haploid induction and polyspermy are valuable breeding aims, our results open new avenues for accelerated generation of climate-adapted cultivars.

Targeting multidrug resistant Staphylococcus aureus with cationic chlorpromazine-peptide conjugates.

Antimicrobial resistance is a serious public health risk. Its severity is fueled on an unprecedented scale, necessitating the demand for novel antimicrobial scaffolds aimed at novel targets. Herein, we present cationic chlorpromazine peptide conjugates that are rationally intended to targetmultidrug-resistant (MDR) bacteria. The most potent compound, CPWL, of all the conjugates evaluated, showed promising antibacterial activity against clinical, MDR S. aureus, with no cytotoxicity. The molecular docking experiments confirmed that CPWL possessed a very high affinity for S. aureus enoyl reductase (saFabI). Furthermore, CPWL antibacterial action against saFabI was further corroborated by MD simulation studies. Thus, our findings highlight cationic chlorpromazine as a promising scaffold for the development of saFabI inhibitors to target severe staphylococcal infections.

An ultrastructural and genomic study on the SARS-CoV-2 variant B.1.210 circulating during the first wave of COVID-19 pandemic in India.

PURPOSE: The study aims to isolate and understand cytopathogenesis, ultrastructure, genomic characteristics and phylogenetic analysis of SARS-CoV-2 virus of B.1.210 lineage, that circulated in India during first wave of the pandemic. METHODS: Clinical specimen from an interstate traveller from Maharashtra to Karnataka, in May 2020, who was positive by RT PCR for SARS-CoV-2 infection was subjected to virus isolation and Whole Genome Sequencing. Vero cells were used to study cytopathogenesis and ultrastructural features by Transmission Electron Microscopy (TEM). Phylogenetic analysis of the whole genome sequences of several SARS-CoV-2 variants downloaded from GISAID was performed in comparison with the B.1.210 variant identified in this study. RESULTS: The virus was isolated in Vero cells and identified by immunofluorescence assay and RT PCR. The growth kinetics in infected Vero cells revealed a peak viral titre at 24 â€‹h post-infection. Ultrastructural studies revealed distinct morphological changes with accumulation of membrane-bound vesicles containing pleomorphic virions in the cytoplasm, with single or multiple intranuclear filamentous inclusions and dilated rough endoplasmic reticulum with viral particles. Whole genome sequence of the clinical specimen as well as the isolated virus revealed the virus to be of lineage B.1.210 with the D614G mutation in the spike protein. Phylogenetic analysis of the whole genome sequence in comparison with other variants reported globally revealed that the isolated SARS-CoV-2 virus of lineage B.1.210 is closely related to the original Wuhan virus reference sequence. CONCLUSIONS: The SARS-CoV-2 variant B.1.210 virus isolated here showed ultrastructural features and cytopathogenesis similar to that of the virus reported during early phase of pandemic. Phylogenetic analysis showed that the isolated virus is closely related to the original Wuhan virus, thereby suggesting that the SARS-CoV-2 lineage B.1.210 that was circulating in India during the early phase of pandemic is likely to have evolved from the original Wuhan strain.

Recovery From the Impact of COVID-19 on Treatment Times and Clinical Outcomes of Patients With ST-Segment Elevation Myocardial Infarction: An Interim Analysis.

BACKGROUND: Previous studies have documented a negative impact of the COVID-19 pandemic on emergent percutaneous treatment of patients with ST-segment elevation myocardial infarction (STEMI), but few have examined recovery of healthcare systems in restoring prepandemic STEMI care. METHODS: Retrospective analysis was performed of data from 789 patients with STEMI from a large tertiary medical center treated with percutaneous coronary intervention between January 1, 2019, and December 31, 2021. RESULTS: For patients with STEMI presenting to the emergency department, median time from door to balloon was 37 minutes in 2019, 53 minutes in 2020, and 48 minutes in 2021 (P < .001), whereas median time from first medical contact to device changed from 70 to 82 to 75 minutes, respectively (P = .002). Treatment time changes in 2020 and 2021 correlated with median emergency department evaluation time (30 to 41 to 22 minutes, respectively; P = .001) but not median catheterization laboratory revascularization time. For transfer patients, median time from first medical contact to device changed from 110 to 133 to 118 minutes, respectively (P = .005). In 2020 and 2021, patients with STEMI had greater late presentation (P = .028) and late mechanical complications (P = .021), with nonsignificant increases in yearly in-hospital mortality (3.6% to 5.2% to 6.4%; P = .352). CONCLUSION: COVID-19 was associated with worsening STEMI treatment times and outcomes in 2020. Despite improving treatment times in 2021, in-hospital mortality had not decreased in the setting of a persistent increase in late patient presentation and associated STEMI complications.

An integrated mammalian library approach for optimization and enhanced microfluidics-assisted antibody hit discovery.

Recent years have seen the development of a variety of mammalian library approaches for display and secretion mode. Advantages include library approaches for engineering, preservation of precious immune repertoires and their repeated interrogation, as well as screening in final therapeutic format and host. Mammalian display approaches for antibody optimization exploit these advantages, necessitating the generation of large libraries but in turn enabling early screening for both manufacturability and target specificity. For suitable libraries, high antibody integration rates and resulting monoclonality need to be balanced - we present a solution for sufficient transmutability and acceptable monoclonality by applying an optimized ratio of coding to non-coding lentivirus. The recent advent of microfluidic-assisted hit discovery represents a perfect match to mammalian libraries in secretion mode, as the lower throughput fits well with the facile generation of libraries comprising a few million functional clones. In the presented work, Chinese Hamster Ovary cells were engineered to both express the target of interest and secrete antibodies in relevant formats, and specific clones were strongly enriched by high throughput screening for autocrine cellular binding. The powerful combination of mammalian secretion libraries and microfluidics-assisted hit discovery could reduce attrition rates and increase the probability to identify the best possible therapeutic antibody hits faster.

Inhibiting Erastin-Induced Ferroptotic Cell Death by Purine-Based Chelators.

Ferroptosis is a cell death event caused by increased lipid peroxidation leading to iron-dependent oxidative stress and is associated with a wide variety of diseases. In recent years, ferroptosis inhibition has emerged as a novel strategy to target different pathologies. Here, we report the synthesis of two purine derivatives, 1 and 2, for iron chelation strategy and evaluate their potency to inhibit erastin-induced ferroptosis. Both compounds showed efficient iron chelation in solution as well as in cellular environment. The crystal structure of the purine derivatives with iron demonstrated a 2 : 1 (ligand to metal center) stoichiometry for iron and purine derivative complexation. The synthesized compounds also decrease the reactive oxygen species concentration in cell cultures. Compound 2 showed better potency towards the prevention of ferroptotic cell death as compared to commercially available iron chelator in the erastin-induced ferroptosis cell culture model. Such purine analogues are potential functional scaffolds for the development of target molecules for ferroptosis inhibition.

Outcomes of Transcatheter Aortic Valve Replacement in Patients Treated With Systemic Steroids.

BACKGROUND: Chronic steroid therapy is associated with higher vascular complication rates in patients undergoing transcatheter aortic valve replacement (TAVR). The effect of corticosteroids on aortic annular complications has not been directly assessed in this population. METHODS: A retrospective analysis of 1095 patients undergoing transfemoral TAVR was performed. Patients treated with chronic steroids at the time of the procedure (n = 99) were compared with those who received no steroids (n = 992). The primary outcome included a composite of aortic annular complications, defined as a combination of aortic annular rupture, aortic dissection/perforation, and left ventricular perforation. RESULTS: The primary outcome was significantly higher in the steroid group (4.0% vs 0.5%; P<.01). This finding was primarily driven by higher rates of acute annular rupture in the steroid group (2.0% vs 0.2%; P=.04). Steroid use was associated with higher rates of intraoperative cardiac arrest (5.1% vs 1.5%; P=.03), device capture/retrieval (4.0% vs 0.8%; P=.01), and emergent conversion to open heart surgery (4.0% vs 0.6%; P<.01). There were no differences with respect to in-hospital mortality, stroke, myocardial infarction, need for permanent pacemaker, bleeding complications, minor vascular complications, hospital length of stay, hospital 30-day readmission, or 30-day echocardiographic findings. Additionally, within the steroid group, there were no significant differences between balloon-expandable vs self-expanding TAVR prostheses with respect to composite aortic annular complications. CONCLUSION: Chronic steroid therapy increases the risk of aortic annular complications in patients undergoing TAVR, with detrimental consequences including intraoperative cardiac arrest and conversion to open heart surgery. Steroid use should be considered in patient selection and determination of procedural technique for TAVR.

Oral Cancer in Young vs Old Individuals: A Systematic Review.

AIM: To compare various parameters associated with oral cancer in young and old patients and systematically compile the data on prognosis or outcome of oral cancer in young and old patients that include case series, matched-pair analyses, institutional series, and database reviews. BACKGROUND: Though oral cancer is considered a disease of old age, a recent clinical scenario witnesses its increasing incidence among young persons. When compared to old patients, young patients with oral cancer are exposed to the carcinogens for a very petite period of time suggesting underlying pathogenesis to be distinct from that in older individuals. Literature reports several studies about the occurrence of oral cancer in young patients; however, no unanimous opinion exists about its prognosis and treatment outcomes when compared to older patients. Keeping this in mind, we have extensively studied all the possible aspects (location, local and regional recurrence, nodal and distant metastasis, overall survival, etc.) from the English literature and systematically compiled the available data on prognosis or outcomes of oral cancer. REVIEW RESULTS: The overall outcome of the case series shows poorer prognosis in young patients, matched-pair analyses, and institutional series suggesting no significant differences whereas the databases favored a better prognosis in young patients. The mean overall survival rate was found to be better for young patients in the database and institutional review whereas worse in the matched-pair analyses. The mean 5-year survival rate was found to be more in young individuals in matched-pair analyses, database reviews, and institutional series as compared to older oral cancer patients. CONCLUSION: Though data extracted from various study designs are heterogeneous, the present review gives a scoping view of the papers published on oral cancer in young vs old patients. More prospective studies are suggested with a larger sample size in the future. CLINICAL SIGNIFICANCE: The present review will help to better understand the nature, course, and biologic behavior of oral cancer in young patients leading to the development of specific treatment strategies to manage the patients based on their age-groups.

Exploring the Financial Toxicities of Patients with Locally Advanced Head and Neck Malignancies, Being Treated in a Private Sector Hospital in North India: A Thematic Analysis.

BACKGROUND: The high cost of cancer diagnosis and treatment is a global concern. Evidence derived, mostly from high-income countries, shows how it gradually impacts the personal and household financial condition causing the increased psychosocial burden of the patient and their families (termed "financial toxicity"). AIM: To qualitatively explore the financial toxicities in patients with advanced head and neck malignancies in India, and to consider how it impacts the patient and his family. METHODS: Interviewing a purposive sample of 8 patients using semi-structured interviews face to face. Interviews were transcribed verbatim, and a thematic content analysis was carried out. RESULTS: Four major themes were identified: burden and amplifying factors, impact, rescue and relieving factors, and learning and innovation. The burden of cost relates to diagnosis, treatment and non-medical costs which gets amplified while navigating the healthcare labyrinth. Emerging themes describe financial journey of cancer patients, the issues faced by them and the ways they tackle these issues during their treatment. Healthcare system factors like limited availability of adequate/comprehensive/meaningful insurance and reimbursements potentiate the toxicity. The financial toxicity leads to a significant adverse financial, psychological and social impact on the patient and the family. While moving through the process of care, there were a few learnings and innovations which patients proposed. CONCLUSION: This study provides qualitative evidence of the considerable and pervasive nature of financial toxicity in head and neck cancer patients in India. The findings have implications for all cancer patients and highlight the unmet need of psychosocial support for these patients.

Cu-tetracatechol metallopolymer catalyst for three component click reactions and ß-borylation of α,ß-unsaturated carbonyl compounds.

Phenol-metal coordination polymers are used in applications such as catalysis, sensing and separation science. In addition, combining eco-friendly conditions with economical and handling advantages of the polymeric catalyst is of interest to the community. Here, we report a simple one pot synthesis of a tetracatechol based ligand and its coordination polymer with copper ions. The Cu polymer showed electrochemical potential with a band gap of 1.01 eV. The BET surface area of the metallopolymer was 91.19 m2 g-1 with 0.14 cm3 g-1 pore volume. The polymer catalyst was used in a one pot three component click reaction and in the borylation of unsaturated carbonyl compounds with a maximum 99% conversion in water and good turnover efficiency even after 4 repetitive catalysis cycles. The polymer catalyst offers several advantages such as high activity, easy handling, scalability, recyclability and cost effectiveness.

Unusual Combination of a Fracture Monteggia Equivalent With Post-traumatic Radial Artery Pseudoaneurysm in a Child: A Case Report and Review of Literature.

CASE: We report a unique case of a combination of forearm fracture and traumatic radial artery pseudoaneurysm in an 8-year-old child. The fracture pattern was a Monteggia equivalent with a mid-diaphyseal ulnar fracture and a radial neck fracture with displacement of the distal radial diaphyseal fracture fragment. The pseudoaneurysm, which probably developed after vigorous manipulation by a bonesetter, thrombosed spontaneously, and the fracture was managed nonoperatively with a good outcome. CONCLUSION: Pseudoaneurysm of the radial artery is a rare phenomenon associated with fracture in a child. A history of vigorous manipulation of displaced fracture fragments in the vicinity of a major vessel should raise suspicion of this possible complication.

Bioinspired adenine-dopamine immobilized polymer hydrogel adhesives for tissue engineering.

Nontoxic adhesive hydrogels are of great importance in tissue engineering. Herein, we report a simple synthesis of a few biocompatible hydrogels from adenine and dopamine immobilized polyacrylic acid (PAA) and alginic acid (Alg) polymers. The adenine-dopamine adduct incorporated hydrogels showed enhanced adhesiveness, transparency and biocompatibility, and induced cell proliferation in 2D and 3D-cell culture models within 24 h. Moreover, blending the modified PAA and Alg polymers (P2P4) further increased the stability and bioactivity of the hydrogel. Such biogels can be developed as smart materials for biomedical applications.

Post-MI Ventricular Septal Defect During the COVID-19 Pandemic.

With the COVID-19 pandemic, the fear among patients of contracting it has made them reluctant to seek medical attention on a timely basis even for emergent conditions. We present a case of post infarction ventricular septal rupture due to delayed presentation as a consequence of the fear of COVID-19. (Level of Difficulty: Intermediate.).

Functional Catechol-Metal Polymers via Interfacial Polymerization for Applications in Water Purification.

Phenols and polyphenols have been used as a scaffold for generating multidimensional molecular architectures via complexation with metal ions. Here, we report the synthesis and characterization of metallopolymer films from three catechol derivatives having different alkyl/aryl substituents via complexation with iron and copper ions at the organic-water interface. Such interfacial polymerization is instantaneous, one step to generate functional materials, and gives good control over the organization of repeating units along the film. The films were transferred to different substrates such as filter paper, cotton, or polyester fabrics. The films are superhydrophobic with a contact angle >160° which can be tuned by regulating the orientation of nonpolar groups at the interface during polymerization. In addition, the fabricated cloth membrane showed excellent oil/water separation efficiency of more than 99% even after 50 cycles. The polymers also showed good dye extraction capacity from aqueous solutions with fast kinetics data. Such metallopolymer networks can serve as a versatile material for applications in catalysis, protective coatings, drug delivery, water filtration membranes, and liquid separations.

Comparison of Benefit of Transcatheter Aortic Valve Implantation in Patients With Low Gradient Versus High Gradient Aortic Stenosis and Left Ventricular Dysfunction.

Patients with low gradient severe aortic stenosis (LG-AS) often exhibit significant limitations in functional status and quality of life. We aimed to evaluate the clinical effect of transcatheter aortic valve implantation (TAVI) on LG-AS patients compared to those with high transvalvular gradients and similar left ventricular dysfunction. Retrospective analysis of records for all patients with a left ventricular ejection fraction <50% who underwent TAVI at our institution was performed. Patients were grouped according to their transvalvular gradient. Data were collected from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Clinical benefit endpoints included improvements in left ventricular ejection fraction and changes in the Kansas City Cardiomyopathy Questionnaire. Additional outcomes analyzed included 1-year all-cause mortality, stroke rates, rates of rehospitalization, need for a permanent pacemaker, and hospital length of stay. Two hundred three patients met our inclusion criteria. one hundred one LG-AS patients (mean transvalvular gradient <40 mm Hg) were compared to 102 patients with high transvalvular gradients (mean transvalvular gradient >40 mm Hg). LG-AS patients yielded similar improvements in left ventricular ejection fraction (43.5% ± 63.7 vs 37.7% ± 58.7; p = 0.525) and Kansas City Cardiomyopathy Questionnaire scores (423.51% ± 1257.02 vs 266.56% ± 822.81; p = 0.352). There were no differences between the groups with respect to 1-year mortality (16.8% vs 12.7%; p = 0.412), stroke rates, hospital length of stay, need for permanent pacemaker implantation or hospital readmissions. In conclusion, we found that TAVI is associated with comparable improvement in clinical and echocardiographic outcomes in LG-AS patients as compared to those with high gradient severe aortic stenosis.

Application of ANN and RSM on fluoride removal using chemically activated D. sissoo sawdust.

Response surface methodology (RSM) and artificial neural network (ANN) were used to generate a model for the optimization of fluoride removal using chemically activated Dalbergia sissoo sawdust (CADS). The single and collective effects of process parameters, i.e., solution pH, CADS dose, initial fluoride concentration, and contact time, were studied. The point of zero charge was found to be 4.2 with zeta potential analysis. In the first phase, a single-parameter study was performed to reveal dependency of fluoride removal on a particular process parameter. Positive effects of increment in CADS dose and contact time and negative effects of solution pH and initial fluoride concentration were observed. The second phase included RSM in which analysis of variance (ANOVA) was applied to test the feasibility of the mathematical model. The F value 1.91, R2 value 0.87, and P value 0.11 show significance of the proposed model. Results obtained from the experiment set for central composite design (CCD) were used to predict the ANN response. Reasonable acceptable values of regression for training, test, and validation (0.76, 0.93, and 0.37) represent the suitability of the model. The ANN predicted 22.1% fluoride removal, which was close to the actual value (20.1%) and was comparable with CCD prediction (25.0%). BET surface area of CADS was found to be 76.33 m2/g. FTIR was performed to recognize the functional groups available for fluoride binding while SEM and EDX were conducted to ensure the changes in adsorbent surface morphology. Regeneration of CADS was feasible using an alkali medium. This study shows that CADS can be used for fluoride removal from aqueous stream in an efficient way.