How does deep learning/machine learning perform in comparison to radiologists in distinguishing glioblastomas (or grade IV astrocytomas) from primary CNS lymphomas?: a meta-analysis and systematic review.

BACKGROUND: Several studies have been published comparing deep learning (DL)/machine learning (ML) to radiologists in differentiating PCNSLs from GBMs with equivocal results. We aimed to perform this meta-analysis to evaluate the diagnostic accuracy of ML/DL versus radiologists in classifying PCNSL versus GBM using MRI. METHODOLOGY: The study was performed in accordance with PRISMA guidelines. Data was extracted and interpreted by two researchers with 12 and 23 years' experience, respectively, and QUADAS-2 tool was used for quality and risk-bias assessment. We constructed contingency tables to derive sensitivity, specificity accuracy, summary receiver operating characteristic (SROC) curve, and the area under the curve (AUC). RESULTS: Our search identified 11 studies, of which 8 satisfied our inclusion criteria and restricted the analysis in each study to reporting the model showing highest accuracy, with a total sample size of 1159 patients. The random effects model showed a pooled sensitivity of 0.89 [95% CI:0.84-0.92] for ML and 0.82 [95% CI:0.76-0.87] for radiologists. Pooled specificity was 0.88 [95% CI: 0.84-0.91] for ML and 0.90 [95% CI: 0.81-0.95] for radiologists. Pooled accuracy was 0.88 [95% CI: 0.86-0.90] for ML and 0.86 [95% CI: 0.78-0.91] for radiologists. Pooled AUC of ML was 0.94 [95% CI:0.92-0.96]and for radiologists, it was 0.90 [95% CI: 0.84-0.93]. CONCLUSIONS: MRI-based ML/DL techniques can complement radiologists to improve the accuracy of classifying GBMs from PCNSL, possibly reduce the need for a biopsy, and avoid any unwanted neurosurgical resection of a PCNSL.

Serological and molecular detection of neurocysticercosis among epileptic patients in Nagpur, Maharashtra state (India).

Neurocysticercosis (NCC), one of the most important neuroparasitic diseases in humans, is caused by Cysticercus cellulosae, the metacestode stage of digenetic zoonotic cestode Taenia solium. The present study aims at the detection of anti-cysticercus antibodies in the sera of epileptic patients (n=26) visiting a tertiary care hospital in Nagpur, Maharashtra state, India, by an in-house developed indirect IgG-ELISA and enzyme-linked immunoelectro transfer blot (EITB) assay using different antigens (namely, Whole Cyst Antigen (WCA), Cystic Fluid Antigen (CFA), Scolex Antigen (SA), Excretory-Secretory Antigen (ESA) and Membrane-Body Antigen (MBA)) prepared from T. solium metacestodes to find out the status of NCC. An attempt has also been made for molecular detection of NCC from blood samples of those patients by Polymerase Chain Reaction (PCR) assay targeted at large subunit rRNA gene of T. solium. The IgG ELISA level of anti-cysticercus antibodies against WCA, CFA, SA, ESA and MBA antigens were as follows: 19.23 %, 23.07 %, 38.46 %, 30.76 % and 15.38 %. The seroreactivity to CFA, SA and ESA was found in equal proportions in patients with ring-enhancing lesions. In the EITB assay, the lower and medium molecular weight protein bands of SA and ESA were immunodominant compared to the higher WCA and CFA peptides. PCR positivity could be observed in 34.6 % (9/26) of the patients under study. It is the first report of detecting NCC among epileptic patients of the Nagpur region of Maharashtra state in India using serological and molecular tools.

Evaluation of Effects of Various Alpha and Beta Angulations for T-loop Made of Stainless Steel and Titanium Molybdenum Archwires during Space Closure: Finite Element Method (FEM) Study.

Space closure follows the initial stage of levelling and alignment in Pre-adjusted Edgewise treatment. There are majorly two methods of space closure, Loop mechanics and Sliding mechanics. Loop mechanics or frictionless mechanics is a preferred method because of its potential to produce pre-determined moment-to-force ratios which accurately achieve controlled movement of teeth. The aim of this finite element study was to evaluate the effects of three types of retraction loops with different moment bends (alpha and beta) made of 0.016"×0.022" stainless steel and TMA archwires with Finite Element Analysis. A Finite element model of CAD geometric model of standard MBT prescription (0.018" slot), Stainless Steel and Titanium Molybdenum Alloy (TMA) wire (0.016" × 0.022") and 3 loops (T-loop, Open Vertical and Closed helical loop) were constructed. A solid model of upper jaw with all permanent maxillary teeth except 1st premolar (extraction) with surrounding periodontal ligament and alveolar bone was prepared. Force, moment to force ratio, mesio-distal crown tipping, mesio-distal root tipping and vertical root movement (extrusion) were measured for different alpha and beta bends in anterior and posterior segments respectively. Force values without moment bends was found to be highest in open vertical loop in both anterior (SS- 414gms; TMA- 255gms) and posterior region (SS-540; TMA-370gms) with both SS and TMA wires. Moment to Force ratio (M/F) at both anterior and posterior segment was found to be highest in T-loop followed by closed helical loop and least in open vertical loop. Extrusion was found to be minimal in T-loop followed by closed helical loop, was maximum in open vertical loop. T-loop showed maximal control in terms of minimal extrusion and maximum M/F ratio amongst the three loops.

A Novel Synthesized 1D Nanobelt-like Cobalt Phosphate Electrode Material for Excellent Supercapacitor Applications.

In the present report, we synthesized highly porous 1D nanobelt-like cobalt phosphate (Co2P2O7) materials using a hydrothermal method for supercapacitor (SC) applications. The physicochemical and electrochemical properties of the synthesized 1D nanobelt-like Co2P2O7 were investigated using X-ray diffraction (XRD), X-ray photoelectron (XPS) spectroscopy, and scanning electron microscopy (SEM). The surface morphology results indicated that the deposition temperatures affected the growth of the 1D nanobelts. The SEM revealed a significant change in morphological results of Co2P2O7 material prepared at 150 °C deposition temperature. The 1D Co2P2O7 nanobelt-like nanostructures provided higher electrochemical properties, because the resulting empty space promotes faster ion transfer and improves cycling stability. Moreover, the electrochemical performance indicates that the 1D nanobelt-like Co2P2O7 electrode deposited at 150 °C deposition temperature shows the maximum specific capacitance (Cs). The Co2P2O7 electrode prepared at a deposition temperature 150 °C provided maximum Cs of 1766 F g-1 at a lower scan rate of 5 mV s-1 in a 1 M KOH electrolyte. In addition, an asymmetric hybrid Co2P2O7//AC supercapacitor device exhibited the highest Cs of 266 F g-1, with an excellent energy density of 83.16 Wh kg-1, and a power density of 9.35 kW kg-1. Additionally, cycling stability results indicate that the 1D nanobelt-like Co2P2O7 material is a better option for the electrochemical energy storage application.

Cardio-protective effect of Cocculus hirsutus in experimental hypertension in rats.

BACKGROUND: Ayurdvedic derived medicines are most promising and effective in the treatment of several cardiovascular diseases. Cocculus hirsutus (CH) has been reported for broad spectrum of activities like anticancer, antidiabetic, antioxidant, cardiotonic and hypotensive etc. OBJECTIVES: The present study aimed to find the cardio-protective effect of CH in experimental hypertension in rats. MATERIALS AND METHODS: For acute renal hypertension, CH animals were pre-treated with CH-1 (250 mg/kg) and CH-2 (500 mg/kg) p. o. for 14 days. On the 15th day, hypertension was induced by renal occlusion and the mean arterial blood pressure (MABP) was recorded. For CAL pretreatment of CH-1 and CH-2 was given for 7 days on the 8th day animals were operated on for ligation. The MABP and the time of onset of ventricular tachycardia (VT), premature ventricular systole (PVS) were recorded. For induction of hypercholesterolemia, animals were fed with a high cholesterol diet (CD) with CH-1 and CH-2 for 21 days. The antioxidant potential of CH was done using the assay of superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and glutathione peroxidase (GPx). RESULTS: CH treatment significantly decreases the MABP, the onset of VT and PVS. The histology show intact cardiac muscle with minimum necrosis and inflammation. CH treatment shows significant decrease in cholesterol, triglycerides, and glucose while HDL levels are significantly increased. The aortic section of CH-treated animals shows the intact layers of the artery, normal thickness and restoration of antioxidant enzymatic activity. CONCLUSION: The study shows significant cardio protective effect of CH in experimental animals.

Comparative Evaluation of Postoperative Pain in Primary Teeth Obturated With Zinc Oxide Eugenol versus Metapex: A Randomized Clinical Trial.

The fundamental objective of pulp treatment is to preserve the integrity and health of oral tissues. Pulp necrosis or irreversible pulpitis is the key indication for performing pulpectomy in primary teeth. It can be performed as a single-visit or multi-visit procedure using suitable obturating material. Various obturating materials can be used like zinc-oxide eugenol or metapex. A controversy reflects in literature and among experts in regard to single-visit or multi-visit endodontics. Hence, the purpose of this randomized clinical trial is to assess the incidence of postoperative pain with zinc oxide eugenol and metapex as an obturating material in single-visit and multiple-visit pulpectomy. The study was conducted at M S Ramaiah Dental College and Hospital, Bangalore in one year duration from 2020 to 2021. Two groups of children, forty in each group, aged between four to eight years, were included in the study. Groups were divided to perform single-visit and multi-visit endodontics with zinc-oxide eugenol and metapex as obturating material. The sample size of 40 were considered and allocated to respective group by concealment allocation. The conventional pulpectomy procedure was carried out. The post operative pain was assessed by using the pain scale through the telephonic conversation with the patient within 24 hours of treatment. Proportions were compared using Chi-square test of significance and the "p" value of less than 0.05 indicates statistical significance. The results showed, no statistically significant difference in teeth obturated with zinc oxide eugenol and metapex in both single-visit and multi-visit pulpectomy. The comparison of zinc oxide eugenol and metapex in single-visit group and multi-visit group had a 'p' value of 0.9233 and 0.4233 respectively. There were no differences between single and multi-visit treatment protocols with respect to the incidence of post operative pain. Single visit pulpectomy can be performed with added advantages with either zinc oxide eugenol or metapex.

Graphene overcoats for ultra-high storage density magnetic media.

Hard disk drives (HDDs) are used as secondary storage in digital electronic devices owing to low cost and large data storage capacity. Due to the exponentially increasing amount of data, there is a need to increase areal storage densities beyond ~1 Tb/in2. This requires the thickness of carbon overcoats (COCs) to be <2 nm. However, friction, wear, corrosion, and thermal stability are critical concerns below 2 nm, limiting current technology, and restricting COC integration with heat assisted magnetic recording technology (HAMR). Here we show that graphene-based overcoats can overcome all these limitations, and achieve two-fold reduction in friction and provide better corrosion and wear resistance than state-of-the-art COCs, while withstanding HAMR conditions. Thus, we expect that graphene overcoats may enable the development of 4-10 Tb/in2 areal density HDDs when employing suitable recording technologies, such as HAMR and HAMR+bit patterned media.

Bioactive role of plant stress hormone methyl jasmonate against lipopolysaccharide induced arthritis.

The current investigation was carried out to screen antiarthritic potential of Methyl Jasmonate (MJ) against lipopolysaccharide (LPS) induced arthritis. Cartilage damage was induced in experimental animals by intraplantar administration of LPS (1 mg/kg) and antiarthritic effect of MJ was screened in two doses of MJ-1 (20 mg/kg), MJ-2 (40 mg/kg) by intraperitoneally administration. Indomethacin (30 mg/kg p.o.) was used as standard drug. The severity of arthritis was evaluated by assessing arthritis score, secondary lesions, motility test, stair climbing ability, and dorsal flexion pain score method. The estimation of blood cytokine tumor necrosis factor- aplha (TNF-α),interleukine (IL-2 and IL-6) and thymus/spleen index was carried out to access the severity of inflammation. Estimation of hepaticenzymatic antioxidant activity superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), glutathione peroxidase (GPx)and radiological examination was carried out on 28th day. Results indicated that MJ showed significant reduction in severity of arthritis by decreasing arthritis score, secondary lesions where as significant increase in motility, climbing ability and flexion pain score was observed. Significant decreased in blood cytokine viz. TNF-α, IL-2, IL-6 andthymus/spleen index was observed in MJ treated animals in dose dependent manner. MJ treated animals showed significant increased and restoration of hepatic antioxidant enzymatic activityof SOD, CAT, GSH, GPx where asradiological examination indicates protective effect on joint structure as compared to LPS treated rats. These current studies conclude that MJ has protective role in arthritis.

Methicillin-resistant Staphylococcus aureus: epidemiology and antimicrobial susceptibility experiences from the University Hospital 'Luigi Vanvitelli' of Naples.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the important pathogens worldwide showing resistance to several widely used antibiotics. This has made the treatment of MRSA infections harder, especially due to their prevalence in the hospital setting. We evaluated the antibiotic susceptibility patterns of healthcare-associated MRSA infections with a focus on Vancomycin Intermediate S. Aureus (VISA) and macrolide-licosamide-streptogramin B (MLSB) phenotypes. A total of 417 Staphylococcus aureus (S. aureus) cases were isolated between January 2017 and December 2018, through several clinical specimens collected from the University Hospital 'Luigi Vanvitelli' of Naples. We identified bacterial strains using Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) and antimicrobial susceptibility using Phoenix BD (Becton Dickinson, NJ, USA). Out of the total 417 S. aureus cases, 140 were MRSA (33.6%) and of these, 50% were soft tissue infections. All MRSA and Methicillin sensible S.aureus MSSA isolates were susceptible to linezolid and daptomycin. Two MRSA cases exhibited intermediate resistance to vancomycin and were of constitutive MLSB phenotype. Among the MRSA strains, 11.4% were constitutive and 43.6% were inducible MLSB phenotypes and 8.6% were macrolide-streptogramin B phenotype. This study characterized the epidemiological status, antibiotic resistance patterns, and current prevalent phenotypes of healthcare-associated MRSA. This knowledge can aid clinicians in improving the antimicrobial stewardship program by adapting appropriate guidelines for the proper use of MRSA antibacterial agents.

Nickel-Graphene Nanoplatelet Deposited on Carbon Fiber as Binder-Free Electrode for Electrochemical Supercapacitor Application.

A binder-free process for the electrode preparation for supercapacitor application was suggested by drop casting graphene nanoplatelets on a carbon fiber (GnP@CF) followed by electrodeposition of Ni nanoparticles (NPs). The microstructure of the electrode showed that Ni was homogeneously distributed over the surface of the GnP@CF. XRD analysis confirmed the cubic structure of metallic Ni NPs. The Ni-GnP@CF electrode showed excellent pseudocapacitive behavior in alkaline solution by exhibiting a specific capacitance of 480 F/g at 1.0 A/g, while it was 375 F/g for Ni@CF. The low value of series resistance of Ni-GnP@CF (1 Ω) was attributed to the high capacitance. The enhanced capacitance of the electrode could be correlated to the highly nanoporous structure of the composite material, synergetic effect of the electrical double layer charge-storage properties of graphene, and the pseudocapacitive nature of Ni NPs.

Audio/visual recording of doctors in hospitals: Guideline from the Association of Anaesthetists.

Guidelines are presented that summarise the legal position regarding the audio/visual recording of doctors and others in hospitals. In general, there are few, if any, legal grounds for refusing a request by patients to record procedures and/or discussions with clinicians, although some staff may feel uncomfortable being recorded. Trusts and others are advised to draw up local policies and ensure staff and patients are adequately informed.

Guidelines for safe transfer of the brain-injured patient: trauma and stroke, 2019: Guidelines from the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society.

The location of care for many brain-injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of evidence-based and consensus-based statements. We have received assistance from many organisations representing clinicians who care for these patients, and we believe our views represent the best of current thinking and opinion. We encourage departments to review their own practice using our suggestions for audit and quality improvement.

Guidelines on suicide amongst anaesthetists 2019.

Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.

Nanorods to hexagonal nanosheets of CuO-doped manganese oxide nanostructures for higher electrochemical supercapacitor performance.

In this work, the extraordinary properties of CuO addition on the morphology and supercapacitive performance of Mn2O3 electrodes were demonstrated. Concisely, CuO/Mn2O3 thin films were prepared by an easy and inexpensive successive ionic layer adsorption and reaction (SILAR) method. The prepared thin films were characterized by various sophisticated physiochemical systems. The results demonstrated formation of Mn2O3 thin films with noteworthy morphological alteration upon introduction of CuO. Furthermore, a significant effect of CuO introduction was observed on the electrocatalytic properties of the nanostructured Mn2O3 electrodes. At 3% CuO doping, the Mn2O3 electrodes displayed the maximum specific capacitance owing to formation of nanoplate-like structures. The enhanced specific capacitance attained for 3% CuO doping in the Mn2O3 electrode was 500 F/g at 5 mV/s in a 3 M KOH electrolyte. All results confirmed the plausible potential of the CuO/Mn2O3 electrode for supercapacitor applications.

Effect of weight loss on neutrophil resolvins in the metabolic syndrome.

BACKGROUND: Non-resolving inflammation associates with obesity and insulin resistance, and may be dependent on the balance of inflammatory substances and specialised pro-resolving mediators of inflammation (SPM) that act to halt the inflammatory response. This controlled trial examined the effect of weight loss on neutrophil synthesis of SPM in volunteers with the metabolic syndrome (MetS). METHODS: Volunteers with MetS (n = 42) were matched for age and gender and randomly assigned to a 12-wk weight loss program followed by 4-wk weight stabilization or a 16-wk weight maintenance program. At baseline and 16 weeks, isolated neutrophils were stimulated with calcium ionophore and the released SPM were measured by LC-MS/MS. RESULTS: At baseline the SPM resolvin (Rv) E1, 18R-RvE3, RvD2 and Maresin-1 (MaR-1) were detected from stimulated neutrophils. The concentration of released RvE1 was at least 6-fold that of other detected SPM. Weight loss of 4.7 ±â€¯0.8 kg, led to a 2-fold increase in RvE1, P = 0.013, relative to the weight maintenance group. The increase in RvE1 after weight loss was related to, but independent of leukotriene B4. CONCLUSION: Following weight loss, human neutrophils from individuals with the metabolic syndrome are capable of releasing larger amounts of RvE1 upon stimulation.