Heat transfer innovation of engine oil conveying SWCNTs-MWCNTs-TiO2 nanoparticles embedded in a porous stretching cylinder.

The influence of boundary layer flow of heat transfer analysis on hybrid nanofluid across an extended cylinder is the main focus of the current research. In addition, the impressions of magnetohydrodynamic, porous medium and thermal radiation are part of this investigation. Arrogate similarity variables are employed to transform the governing modelled partial differential equations into a couple of highly nonlinear ordinary differential equations. A numerical approach based on the BVP Midrich scheme in MAPLE solver is employed for solution of the set of resulting ordinary differential equations and obtained results are compared with existing literature. The effect of active important physical parameters like Magnetic Field, Porosity parameter, Eckert number, Prandtl number and thermal radiation parameters on dimensionless velocity and energy fields are employed via graphs and tables. The velocity profile decreased by about 65% when the magnetic field parameter values increases from 0.5 to 1.5. On the other hand increased by 70% on energy profile. The energy profile enhanced by about 62% when the Radiation parameter values increases from 1.0 < Rd < 3.0. The current model may be applicable in real life practical implications of employing Engine oil-SWCNTs-MWCNTs-TiO2 nanofluids on cylinders encompass enhanced heat transfer efficiency, and extended component lifespan, energy savings, and environmental benefits. This kind of theoretical analysis may be used in daily life applications, such as engineering and automobile industries.

Disseminated Medicopsis romeroi infection in a kidney transplant recipient: A case report.

Medicopsis romeroi is a rare, dematiaceous fungus that is difficult to identify using conventional fungal tests. Although uncommon, immunocompromised patients are particularly susceptible to this opportunistic fungus. Here, we report the case of a renal transplant recipient who presented with painful disseminated subcutaneous and soft tissue lesions. Sequencing of the Internal transcribed spacer (ITS) region of the ribosomal DNA identified the fungus as Medicopsis romeroi. Additionally, tissue samples from a non-healing wound on the left forearm grew Rhizopus spp. on Sabouraud dextrose agar, indicating a Mucormycosis superinfection. The patient's condition improved with surgical intervention and antifungal therapy with Posaconazole and Terbinafine. This case demonstrates the need for a high index of suspicion in order to facilitate early diagnosis and treatment and thus reduce the risk of dissemination.

Heterogeneous precipitation mediated heterogeneous nanostructure enhances strength-ductility synergy in severely cryo-rolled and annealed CoCrFeNi2.1Nb0.2 high entropy alloy.

Possibilities of enhancing mechanical properties of brittle intermetallic containing high entropy alloys (HEAs) using novel processing and microstructural design strategies were investigated in the present work. For this purpose, homogenized CoCrFeNi2.1Nb0.2 HEA consisting of FCC matrix and complex Laves phase particles was successfully processed by severe cold- or cryo-rolling to 90% reduction in thickness followed by annealing (800 °C/1 hour(h)). As compared to cold-rolling, cryo-rolling resulted in a finer lamellar nanostructure and decidedly greater fragmentation of the Laves phase. Upon annealing, the cold-rolled HEA showed a recrystallized FCC matrix dispersed with D019 structured ε nano-precipitates. In contrast, the finer nanostructure and greater driving force for accelerated precipitation of profuse nano-precipitates at the early stages of annealing inhibited recrystallization in the cryo-rolled HEA and resulted in the formation of heterogeneous microstructure consisting of retained deformed and recrystallized regions. The novel heterogeneous microstructure of the cryo-rolled and annealed HEA resulted in a remarkable enhancement in strength-ductility synergy. The present results indicated that cryo-rolling could be used as an innovative processing strategy for tailoring heterogeneous microstructure and achieving novel mechanical properties.

Nanostructuring with Structural-Compositional Dual Heterogeneities Enhances Strength-Ductility Synergy in Eutectic High Entropy Alloy.

A lamellar (L12 + B2) AlCoCrFeNi2.1 eutectic high entropy alloy (EHEA) was severely deformed by a novel hybrid-rolling process. During hybrid-rolling, the deformation was carried out in two stages, namely cryo-rolling followed by warm-rolling at 600 °C. The strain (ε) imparted in each of these steps was identical ~1.2, resulting in a total strain of ε~2.4 (corresponding to 90% reduction in thickness). The novel processing strategy resulted in an extremely heterogeneous microstructure consisting of retained lamellar and transformed nanocrystalline regions. Each of these regions consisted of different phases having different crystal structures and chemical compositions. The novel structure-composition dual heterogeneous microstructure originated from the stored energy of the cryo-rolling which accelerated transformations during subsequent low temperature warm-rolling. The dual heterogeneous microstructure yielded an unprecedented combination of strength (~2000 MPa) and ductility (~8%). The present study for the first time demonstrated that dual structure-composition heterogeneities can be a novel microstructural design strategy for achieving outstanding strength-ductility combination in multiphase high entropy alloys.

Improved outcomes for inborn babies with uncomplicated gastroschisis.

INTRODUCTION: Gastroschisis (GS) is a common abdominal wall defect necessitating neonatal surgery and intensive care. We hypothesized that inborn patients had improved outcomes compared to patients born at an outside hospital (outborn) and transferred for definitive treatment. METHODS: A single center, retrospective chart review at a pediatric tertiary care center was performed from 2010 to 2015. All patients whose primary surgical treatment of GS was performed at this center were included. We compared patients delivered within our center (inborn) to patients delivered outside of our center and transferred for surgical care (outborn). Babies with complicated gastroschisis were excluded. RESULTS: During the study period 79 patients with GS were identified. Of these, 53 were inborn and 26 were outborn. Sixteen patients were excluded for complicated GS. The rate of complicated GS was higher in the outborn group (32%) compared to the inborn population (11%) (p=0.03). Duration of stay, readmission rate and time on TPN were all significantly decreased for inborn patients, while time to definitive closure was similar. Mortality was 0% for both inborn and outborn patients. CONCLUSION: Patients with uncomplicated GS seem to benefit from delivery with immediate pediatric surgical care available eliminating the need for transfer. LEVEL OF EVIDENCE: III.

An evaluation of nasolabial angle and the relative inclinations of the nose and upper lip.

UNLABELLED: Esthetics is one of the major motivating factors for patients seeking orthodontic treatment. Hard tissue and soft tissue drape both determine the facial esthetics. The structures in this region are so variable that the nasolabial angle (NLA) has been drawn differently by various investigators. Variations can lead to erroneous conclusions in orthodontic diagnosis. AIMS AND OBJECTIVES: The study was done to evaluate a reliable method of constructing the nasolabial angle (NLA) and to correlate the soft tissue profile parameters with one another. MATERIALS AND METHODS: Lateral cephalogram of 50 randomly selected adult patients were taken. The tracings were made and 10 copies of each tracing were randomly distributed to 10 different orthodontists to draw the NLA. RESULTS: Pearson's correlation coefficient (r) showed both N/ FH and L/FH angles to have significant p values when compared with NLA. The regression analysis showed that the nasolabial angle can be calculated for any given value of N/FH or L/FH by the formula: NLA = 80.33° + 1.02° (N/FH) and NLA = 14.2° + 1.04° (L/FH). The mean value of N/FH was 17.42° ± 8.40° and L/FH was 80.68° + 6.45° for this sample. Inter examiner reliability calculated by repeated measures of ANOVA and Dahlerg's formula showed high degree of reliability and reproducibility of the method. CLINICAL SIGNIFICANCE: NLA can be predicted for any given value of N/FH and L/FH. NLA = 80.33° + 1.02° (N/FH) and NLA = 14.2° + 1.04° (L/FH). If an individual has either N/FH or L/FH in the normal range but not the NLA then one could calculate the correct NLA using this formula. Thereby the NLA can be brought within the normal range by altering the other nasolabial parameters by correct treatment planning. Since the nasolabial angle plays a vital role in profile esthetics of a person, the clinician should place greater emphasis in evaluating this area and plan treatment mechanics to place this angle within the accepted normal variation.

Anemia, inflammation and health-related quality of life in chronic kidney disease patients.

BACKGROUND: There is controversy regarding whether an incremental increase in hemoglobin levels is associated with improvements in health-related quality of life (HRQOL) in chronic kidney disease (CKD) patients treated with erythropoiesis-stimulating agents (ESAs). We hypothesized that HRQOL in anemic CKD patients has a multifactorial etiology, including the effects of anemia and inflammation. METHODS: 69 non-dialysis CKD patients over 18 years of age with a mean estimated glomerular filtration rate (eGFR) of 43.7 ± 28.8 ml/min/1.73 m2 were divided into anemic and non-anemic cohorts. Kidney disease quality of life (KDQOL) was prospectively recorded using Short Form (SF)-36 components of KDQOL-SF-™ version 1.3 questionnaire. Inflammation was assessed by using a composite of interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF)-α levels in the upper two quartiles. RESULTS: Anemic patients had significantly worse SF-36 components of KDQOL-SF-™ version 1.3, including SF-12 mental component (p = 0.02), role emotional (p = 0.002) and physical function (p = 0.01) compared to patients without anemia. However, in multiple linear regression models, adjusted for GFR, age, gender and inflammatory markers including C-reactive protein (CRP), albumin, ferritin, IL-6, IL-8 and TNF-α, anemia predicted mental components of SF-36 (SF-12 mental component (p = 0.02) and role emotional (p = 0.04)) but not physical components (SF-12 physical component (p > 0.05) and physical function (p > 0.05), supporting the multifactorial nature of reduced HRQOL in anemic patients. CONCLUSIONS: Reduced HRQOL in anemic patients is likely related to both anemic and inflammatory status. Prospective studies will be needed to evaluate whether modulating the inflammatory state independent of changes in the hemoglobin concentration improves physical components of HRQOL.

Arginase isoforms in frog and lizard tissues.

Isoforms of arginase in the liver and kidney tissues of the ureotelic frog (Rana tigerina) and uricotelic lizard (Calotes versicolor) were fractionated by DEAE-cellulose chromatography (pH 8.3). Four molecular forms, designated as A'1, A2, A3 and A4 based on the KCl concentration required for their elution from the ion-exchange column, were detected in lizard liver, while only two forms were found in lizard kidney (A3 and A4) and frog liver and kidney (A2 and A3). No major differences were found in the pH optimum, substrate affinity and molecular weight of the isoenzymes. The isoforms in lizard tissues were either totally unaffected or only partially immunoprecipitated by antibodies raised against rat liver and beef liver arginases, but those in frog tissues were significantly activated by the two antibodies. While the physiological importance of the presence of four isoforms in lizard liver remains enigmatic, different sets of isoenzymes were present in the liver of the two ureotelic vertebrates, rat and frog. Hence, it appeared that a given mode of nitrotelism was not associated with a specific set of isoenzymes. Also, the data were not consistent with the generally held view that a basic isoform of arginase served as a component of the urea cycle in liver and a neutral/slightly acidic form functions in the synthesis of proline, glutamate and polyamines in extra-hepatic tissues. The isoforms appeared to show considerable functional overlap.

Microheterogeneity of molecular forms of arginase in mammalian tissues.

Two isoforms of arginase, A1 and A2, were found in rat liver, submaxillary gland and kidney as well as beef kidney. In beef liver, however, A2 was the only detectable form. Two additional forms, A3 and A4, found only in rat kidney were probably artifactitious. A1 and A2 exhibited chromatographic and immunological microheterogeneity. While A1 in rat liver and submaxillary gland was excluded by DEAE-cellulose (pH 8.3) and retained on CM-cellulose (pH 7.5), that (A'1) in beef and rat kidneys was excluded by both ion-exchangers. A2 in all tissues was retained on DEAE-cellulose, but not on CM-cellulose. Both A1 and A2 in rat liver and beef kidney, A1 from rat submaxillary gland and A2 from beef liver were precipitated by antibodies to rat and beef liver arginases. None of the forms in rat kidney (A1, A2, A3 and A4) showed any cross-reactivity to either antibody. Rat submaxillary gland A2 was precipitated by anti-rat liver arginase, but activated by anti-beef liver arginase. While the major molecular forms were A1 in rat liver and submaxillary gland and A2 in beef liver and rat kidney, the two forms occurred in equal proportions in beef kidney. It appears that different isoforms might function as components of the urea cycle in the liver of different mammals and of the arginine catabolic pathway in different extrahepatic tissues.

Compensatory changes in enzymes of arginine metabolism during renal hypertrophy in mice.

The present study investigates enzyme activities of the urea cycle, transamidinase and ornithine-proline inter-conversion in the hypertrophied kidney after unilateral nephrectomy in mice. Surgical removal of the left kidney in mice led to compensatory enlargement of the right kidney after 1 and 14 days. This renal growth was associated with an increase in glomerular volume (but not number) and enlargement of the proximal convoluted tubules. The total renal protein content increased in proportion to the increase in kidney weight, but the protein per gram weight of kidney did not change. The specific activity of only ornithine aminotransferase (OAT), the rate-limiting enzyme in the conversion of ornithine to proline, increased in 2 weeks of hypertrophy. The specific activity of all other enzymes was unchanged. However, the total enzyme activity per kidney of all the enzymes, without exception, was elevated in the hypertrophied kidney. While the increase in total OAT activity was much more than the increase in kidney weight, all other enzymes increased more or less in proportion to the increase in renal mass. The results suggest that compensation in OAT activity to chronic reduction in renal mass was complete, but only partial in the case of other enzymes.

Medialisation laryngoplasty: a new surgical frontier in the management of vocal cord paralysis.

Patients who are victims of vocal cord paralysis usually suffer from husky or hoarse voice which is very much jeopardising their future particularly in professional voice users like singers, priests, teachers, etc. Phonosurgical techniques like medialisation laryngoplasty has opened a new horizon in the management of dysphonia with unilateral vocal cord paralysis. Medialisation laryngoplasty is sometimes described under the heading of laryngoplastic phonosurgery or thyroplasty. A report of 10 cases of unilateral vocal cord paralysis with dysphonia subjected to medialisation laryngoplasty from March 1996 to March 1998 with 90% success is presented. Only one patient developed inspiratory stridor as a complication.

Arytenoid adduction technique for correction of Paralytic Dysphonia.

Development of phonosurgical techniquec like Medialization Laryngoplasty (M. L.) or Thyroplasty has opened new horizon in the management of paralytic dysphonia. The Arytenoid Adduction (A. A.) technique as originally described by professor Isshiki of Japan added a new dimension for improvement of voice in cases of paralytic dysphonia particularly in large posterior commissure defects. 9 cases of primary and secondary arytenoid adduction technique done as complementary to medialization laryngoplasty over a period of 2 years are described.

Arytenoid adduction technique for correction of paralytic dysphonia.

Development of phonosurgical techniques like Medialization Laryngoplasty (M.L) or Thyroplasty has opened new horizons in the management of paralytic dysphonia. The Arytenoid Adduction (A.A) technique as originally described by Professor Isshiki of Japan, added a new dimension for improvement of voice in cases of paralytic dysphonia particularly in large posterior complimentary to medialization laryngoplasty over a period of 2 years are described.

Medialization laryngoplasty with silastic implant in unilateral vocal cord paralysis.

The state of art of Laryngoplastic surgery gaining day to day importance where Rhinoplasty stood almost a century ago. Medialization Laryngoplasty using Silastic Implant for the correction of symptomatic unilateral vocal cord paralysis is discussed.

Attenuation of experimental hypertension by dietary linoleic acid is model dependent.

OBJECTIVE: The purpose of this study was to evaluate the interaction of a linoleic acid enriched diet with NaCl on the development of hypertension in Dahl salt sensitive (Dahl-S) rats and in two-kidney, one-clip Sprague Dawley rats. METHODS: In both experimental models, separate groups of animals were fed either linoleic acid enriched (provided as safflower oil) or control (containing coconut oil) diets for 5 weeks. Diets were further subdivided on the basis of either a low NaCl (0.3%) or a high NaCl (3.0%) content. Tail systolic blood pressure, direct mean intra-arterial pressure, and cardiac output were measured in chronically instrumented, conscious rats. RESULTS: In Dahl-S, on both NaCl intakes, and in two-kidney, one-clip rats on a high NaCl diet, safflower oil had no effect on arterial pressure. In contrast, in two-kidney, one-clip rats fed the low NaCl diet, both indirect tail systolic blood pressures and direct mean arterial pressure were lower (p<0.01) in animals on the linoleic acid enriched diet; total peripheral resistance was also decreased (p<0.01). CONCLUSION: Safflower oil has a hypotensive effect only in the two-kidney, one-clip rat on a low NaCl, but not on a high NaCl intake, and not in Dahl-S rats. Additional studies are required to identify the mechanism(s) for the hypotensive effect of safflower oil and to define the relationship of this animal study to human hypertension.

Antihypertensive effect of pioglitazone is not invariably associated with increased insulin sensitivity.

Hypertension is often associated with insulin resistance, and several chemically diverse agents that increase insulin sensitivity attenuate the development of experimental hypertension. We undertook the present study to determine whether attenuation of hypertension by pioglitazone, a thiazolidinedione derivative that increases insulin sensitivity without increasing insulin secretion, is specifically related to its effect on insulin-mediated glucose uptake. Pioglitazone administered daily by oral gavage (20 mg/kg per day) for 3 weeks attenuated the development of hypertension in both the Dahl salt-sensitive (DS) rat (an insulin-resistant model of hypertension) and the one-kidney, one clip rat (a model of hypertension not associated with insulin resistance). Based on euglycemic insulin clamp studies in conscious animals, the glucose clearance rate was increased (P < .05) in pioglitazone-treated DS rats (36 +/- 3 mg/kg per minute) compared with control DS rats (27 +/- 1 mg/kg per minute). However, pioglitazone did not affect the glucose clearance rate in one-kidney, one clip hypertensive rats. Metformin, an unrelated agent that also improves glucose tolerance, had no significant effect on blood pressure or glucose clearance rate in either DS or one-kidney, one clip rats. Thus, the hypotensive effect of pioglitazone is not invariably associated with its capacity to improve insulin-induced glucose utilization.