The impacts of shape factor and heat transfer on two-phase flow of nano and hybrid nanofluid in a saturated porous medium.

The focus of this article is to obtain the effect of shape factor of the hybrid nanoparticles on the convective heat and mass transference of two immiscible fluids in an inclined duct by employing the perturbation technique. The hybrid nanoparticle of Carbon Nanotube & Sodium alginate is being used with Silicon oil as the base fluid to study the heat and mass phenomena due to the soret effect, viscous dissipation, Darcy and Thermal diffusion. The physical flow problem is then modelled into a set of differential equations. The system of equations is solved analytically to obtain various graphical and numerical results for analyzing the impact of various material parameters on velocity and thermal field. The heat transfer rate and skin friction analysis for the flow dynamics are also investigated. It is observed that the shape factor enhances the fluid flow and temperature distribution. In specific lamina shape particles have better performance comparatively, significance of the soret number can also be observed.

Tyrosine kinase domain mutations in chronic myelogenous leukemia patients: A single center experience.

INTRODUCTION: Despite the impressive responses achieved with tyrosine kinase inhibitor (TKI) therapy, treatment resistance develops in 16-33% of patients of chronic myelogenous leukemia (CML). Of the BCR-ABL1 dependent mechanisms, mutations in the tyrosine kinase domain (TKD) are the commonest cause of resistance. MATERIAL AND METHODS: Allele specific oligonucleotide - polymerase chain reaction (ASO-PCR) was done for testing the six common TKD mutations, T315I, G250E, E255K, M244V, M351T, and Y253F. RESULTS AND CONCLUSION: TKD mutation study was done on 83 patients. Of these 44 (53%) were positive for one or more mutations. On analyzing specific mutations, E255K was the commonest mutation seen in 24 (29%) cases, followed by T315I in 23(28%) cases. Y253F mutation was not seen in the present study sample. In the present cohort of 83 patients, 29 (35%) cases were positive for single mutation, 12 (14%) had two mutations and 3 (4%) had three mutations.

Acceptability of Neuroscientific Interventions in Education.

Researchers are increasingly applying neuroscience technologies that probe or manipulate the brain to improve educational outcomes. However, their use remains fraught with ethical controversies. Here, we investigate the acceptability of neuroscience applications to educational practice in two groups of young adults: those studying bioscience who will be driving future basic neuroscience research and technology transfer, and those studying education who will be choosing among neuroscience-derived applications for their students. Respondents rated the acceptability of six scenarios describing neuroscience applications to education spanning multiple methodologies, from neuroimaging to neuroactive drugs to brain stimulation. They did so from two perspectives (student, teacher) and for three recipient populations (low-achieving, high-achieving students, students with learning disabilities). Overall, the biosciences students were more favorable to all neuroscience applications than the education students. Scenarios that measured brain activity (i.e., EEG or fMRI) to assess or predict intellectual abilities were deemed more acceptable than manipulations of mental activity by drug use or stimulation techniques, which may violate body integrity. Enhancement up to the norm for low-achieving students and especially students with learning disabilities was more favorably viewed than enhancement beyond the norm for high-achieving students. Finally, respondents rated neuroscientific applications to be less acceptable when adopting the perspective of a teacher than that of a student. Future studies should go beyond the acceptability ratings collected here to delineate the role that concepts of access, equity, authenticity, agency and personal choice play in guiding respondents' reasoning.

Preoperative cisplatin, fluorouracil, and docetaxel with or without radiotherapy after poor early response to cisplatin and fluorouracil for resectable oesophageal adenocarcinoma (AGITG DOCTOR): results from a multicentre, randomised controlled phase II trial.

BACKGROUND: Patients with oesophageal/gastro-oesophageal junction adenocarcinoma (EAC) not showing early metabolic response (EMR) to chemotherapy have poorer survival and histological response rates <5%. We investigated whether tailoring neoadjuvant therapy can improve outcomes in these patients. PATIENTS AND METHODS: Patients with resectable EAC were enrolled and randomised into two single-arm, multicentre phase II trials. After induction cisplatin and 5-fluorouracil (CF), all were assessed by day 15 positron emission tomography (PET). Patients with an EMR [maximum standardised uptake values (SUVmax) ≥35% reduction from baseline to day 15 PET] received a second CF cycle then oesophagectomy. Non-responders were randomised 1 : 1 to two cycles of CF and docetaxel (DCF, n = 31) or DCF + 45 Gy radiotherapy (DCFRT, n = 35) then oesophagectomy. The primary end point was major histological response (<10% residual tumour) in the oesophagectomy specimen; secondary end points were overall survival (OS), progression-free survival (PFS), and locoregional recurrence (LR). RESULTS: Of 124 patients recruited, major histological response was achieved in 3/45 (7%) with EMR, 6/30 (20%) DCF, and 22/35 (63%) DCFRT patients. Grade 3/4 toxicities occurred in 12/45 (27%) EMR (CF), 13/31 (42%) DCF, and 25/35 (71%) DCFRT patients. No treatment-related deaths occurred. LR by 3 years was seen in 5/45 (11%) EMR, 10/31 (32%) DCF, and 4/35 (11%) DCFRT patients. PFS [95% confidence interval (CI)] at 36 months was 47% (31% to 61%) for EMR, 29% (15% to 45%) for DCF, and 46% (29% to 61%) for DCFRT patients. OS (95% CI) at 60 months was 53% (37% to 67%) for EMR, 31% (16% to 48%) for DCF, and 46% (29% to 61%) for DCFRT patients. CONCLUSIONS: EMR is associated with favourable OS, PFS, and low LR. For non-responders, the addition of docetaxel augmented histological response rates, but OS, PFS, and LR remained inferior compared with responders. DCFRT improved histological response and PFS/LR outcomes, matching the EMR group. Early PET/CT has the potential to tailor therapy for patients not showing an early response to chemotherapy. TRIAL REGISTRATION: ACTRN12609000665235.

National survey of UK Dermatologists demonstrates significant variation in how to obtain consent for dermatological procedures.

Consent must be undertaken prior to any dermatological procedure; however, in doing this, the clinician needs to ensure consent is valid and satisfies the principles of determining material risk. We aimed to assess variations in obtaining consent in the UK and understanding of material risk through a nationally distributed survey to members of the British Society for Dermatological Surgery and British Association of Dermatologists. Of 165 responses, we found that written consent was being obtained for all procedures in 73.9% of cases and typically at the time of procedure in the operating room/theatre (78.8%). Fifty-seven per cent of respondents were not familiar with the term 'material risk' and almost one-third were not aware of the Montgomery vs. Lanarkshire ruling, which replaced the Bolam test in 2015. We would encourage readers to be aware of these changes to consent law in the UK and how it might affect their approach to obtaining consent.

Incidence of sleep problems and their mediating role on depression and anxious preoccupation in patients with resected, non-advanced cancer: data from NEOcoping study.

BACKGROUND: Our study analyzes the incidence of sleep problems and their mediating role on depression and anxious preoccupation in patients with resected, non-advanced cancer. METHODS: A multi-institutional, prospective, observational study was conducted with 750 participants of 14 hospitals in Spain. Participants' socio-demographic and clinical characteristics were collected using a standardized self-report form and using EORTC QoL-QLQ-C30, BSI, Mini-MAC questionnaires. RESULTS: In women, sleep problems, depression and anxious preoccupation were observed in 65, 41 and 21%, respectively. In men, sleep problems, depression and anxious preoccupation were reported in 51, 29 and 61%, respectively. More sleep problems, depression and anxious preoccupation were found among women than males. Depression was a significant predictor of anxious preoccupation. In males, sleep problems partially mediated this association. This was not confirmed in women. CONCLUSION: Our findings point toward the importance of developing interventions that decrease depression and sleep problems in cancer.

The management of tooth wear with crowns and indirect restorations.

This manuscript summarises the reasons behind choosing indirect restorations in the treatment of tooth wear. The purpose of this article is to discuss the use of crowns as a restorative treatment option for tooth wear. There are also challenges with the use of composites as they can repeatedly fail and in these situations the indications for crowns for treatment of tooth wear is worthy of consideration. This article is part of a themed issue discussing the management of tooth wear.

A retrospective audit of the outcome of composites used to restore worn teeth.

Objectives The aim of this audit was to monitor the outcome of composite restorations placed at an increased vertical dimension in patients with severe tooth wear.Methods This convenience sample of patients were treated by 11 specialist trainees in prosthodontics, and restored with direct composites. Exclusion criteria included bruxism, poor medical health and a preference for monitoring rather than intervention. The restorations were placed between 2012 and 2016 and were placed over more than one appointment and the outcome monitored for up to 14 months. Failure was assessed at a binary level, either success or failure (minor or major).Results A total of 35 patients with a mean age of 45 years (range 24-86), 27 of whom were male, received 251 restorations placed from November 2012 to November 2016. The patients had a mean of 11.51 (range 4 to 16) occluding pairs of teeth. There was a total of 40 restoration failures (17%) which was an 83% success rate based on the total number of restorations. For the patient-based data, 14 patients (39%) had no chips or bulk factures while 22 (61%) patients had failures, of which 60% were chips and 40% bulk fractures.Conclusion Restoration of worn teeth with composites is associated with a high incidence of fractures.Clinical significance The restoration of worn teeth with composite can involve regular maintenance following fractures and patients need to be aware of this when giving consent.

A Prospective Cohort Study to Assess and Correlate the Maternal Periodontal Status with Their Pregnancy Outcome.

BACKGROUND: There is an overwhelming body of evidence strongly suggesting that periodontal infection may have a significant negative impact on pregnancy outcome in some women. The aim of this study was to determine the association between periodontal disease and preterm low birth weight of babies. MATERIALS AND METHODS: A total of 300 pregnant women, between 20 and 24 weeks of gestation i.e., second trimester, were considered for the study. The periodontal status was recorded using the following parameters: probing pocket depth, clinical attachment level, oral hygiene index and plaque index. After initial examination in the second trimester, the pregnant women were followed till delivery of the baby. Postpartum data i.e., weight of baby, gestational age of pregnancy and type of delivery, were recorded. RESULTS: Out of 300 pregnant women, 248 women had full-term delivery (12 low birth weight and 236 normal birth weight) while 52 had preterm delivery (6 normal birth weight and 46 low birth weight). There was significant association between body mass index and level of periodontal disease severity of pregnant women with birth weight of babies, gestational age of pregnant women and mode of delivery, respectively. As the level of periodontal disease severity increased, the proportion of delivering preterm and low birth weight babies also increased. CONCLUSION: The conclusions obtained revealed that Periodontal disease is a potential risk factor for preterm low birth weight babies of pregnant women.