Information Fusion in Autonomous Vehicle Using Artificial Neural Group Key Synchronization.

Information fusion in automated vehicle for various datatypes emanating from many resources is the foundation for making choices in intelligent transportation autonomous cars. To facilitate data sharing, a variety of communication methods have been integrated to build a diverse V2X infrastructure. However, information fusion security frameworks are currently intended for specific application instances, that are insufficient to fulfill the overall requirements of Mutual Intelligent Transportation Systems (MITS). In this work, a data fusion security infrastructure has been developed with varying degrees of trust. Furthermore, in the V2X heterogeneous networks, this paper offers an efficient and effective information fusion security mechanism for multiple sources and multiple type data sharing. An area-based PKI architecture with speed provided by a Graphic Processing Unit (GPU) is given in especially for artificial neural synchronization-based quick group key exchange. A parametric test is performed to ensure that the proposed data fusion trust solution meets the stringent delay requirements of V2X systems. The efficiency of the suggested method is tested, and the results show that it surpasses similar strategies already in use.

Boron-Containing Lipids and Liposomes: New Conjugates of Cholesterol with Polyhedral Boron Hydrides.

A series of boron-containing lipids were prepared by reactions of cyclic oxonium derivatives of polyhedron boranes and metallacarboranes (closo-dodecaborate anion, cobalt and iron bis(dicarbollides)) with amine and carboxylic acids which are derived from cholesterol. Stable liposomal formulations, on the basis of synthesized boron-containing lipids, hydrogenated soybean l-α-phosphatidylcholine and (HSPC) 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethylene glycol)-2000] (DSPE-PEG) as excipients, were prepared and then characterized by dynamic light scattering (DLS) that revealed the formation of particles to be smaller than 200 nm in diameter. The resulting liposomal formulations showed moderate to excellent loading and entrapment efficiency, thus justifying the design of the compounds to fit in the lipid bilayer and ensuring ease of in vivo use for future application. The liposomal formulations based on cobalt and iron bis(dicarbollide)-based lipids were found to be nontoxic against both human breast normal epithelial cells MCF-10A and human breast cancer cells MCF-7.

Fluorescence resonance energy-transfer-based fluoride ion sensor.

The present work describes an energy-transfer-based fluoride sensor using the highly photo-stable Coumarin 540a (C540a)-Rhodamine 6g (Rh6g) dye pair. Rh6g exhibits a decrease in fluorescence emission, whereas C540a shows no change in response to fluoride. The increase in fluoride concentration decreases the energy transfer efficiency between the C540a donor and Rh6g acceptor in acetonitrile, leading to a subsequent recovery of fluorescence emission from C540a molecules. The sensing mechanism using fluorescence resonance energy transfer is found to be highly specific towards fluoride detection when compared to the response towards other anions. The fluorescence emission of both dyes is monitored to enable fluoride detection within a broad range.

Defining giant mandibular ameloblastomas - Is a separate clinical sub-entity warranted?

CONTEXT: The term giant mandibular ameloblastoma (GMAs) while being in popular usage in the medical literature remains largely equivocal. Although a few authors have in the past attempted to ascribe definite criteria to this entity, these are by and large arbitrary and without any benefit in decision-making or contributing to its management. AIMS: The aim of this study is to propose a set of objective criteria for GMAs that can be clinically correlated and thereby aid in the management of this entity. PATIENTS AND METHODS: Of a total of 16 patients with ameloblastoma of the mandible presenting at our institute from August 2012 to September 2016, 11 patients were identified as having GMAs as per the criteria proposed. RESULTS: The defects in the mandible following segmental resection ranged from 7 to 11.5 cm in length (mean: 9.3 cm). No clinical or radiological evidence of tumour recurrence was found during a mean follow-up period of 10.7 months (range: 2-28 months). CONCLUSIONS: Defining GMA based on objective inclusion and exclusion criteria allows segregation of these lesions, thereby helping to remove ambiguity, simplify decision-making and facilitate communication among treating reconstructive surgeons. Inclusion criteria include: (i) The segmental bone defect following resection with a minimum 1 cm margin of healthy bone should exceed 6 cm (ii) The segmental bone defect should involve the central mandibular segment.

The circadian clock modulates anti-cancer properties of curcumin.

BACKGROUND: Curcuminoids of the spice turmeric and their enhanced derivatives have much potential as cancer treatments. They act on a wide variety of biological pathways, including those regulating cell division and circadian rhythms. It is known that circadian clocks can modify cancer therapy effectiveness, according to studies aimed at optimizing treatments based on the circadian cycle. It is therefore important to determine whether treatments with curcumin or similar chemotherapeutic agents are regulated by circadian timing. Similarly, it is important to characterize any effects of curcumin on timing abilities of the circadian clocks within cancer cells. METHODS: We examined the circadian clock's impact on the timing of cell death and cell division in curcumin-treated C6 rat glioma cells through continuous video microscopy for several days. To evaluate its persistence and distribution in cancer cells, curcumin was localized within cell compartments by imaging its autofluorescence. Finally, HPLC and spectroscopy were used to determine the relative stabilities of the curcumin congeners demethoxycurcumin and bisdemethoxycurcumin that are present in turmeric. RESULTS: Circadian rhythms in cell death were observed in response to low (5 µM) curcumin, reaching a peak several hours before the peak in rhythmic expression of mPER2 protein, a major circadian clock component. These results revealed a sensitive phase of the circadian cycle that could be effectively targeted in patient therapies based on curcumin or its analogs. Curcumin fluorescence was observed in cell compartments at least 24 h after treatment, and the two congeners displayed greater stability than curcumin in cell culture medium. CONCLUSIONS: We propose a mechanism whereby curcuminoids act in a sustained manner, over several days, despite their tendency to degrade rapidly in blood and other aqueous media. During cancer therapy, curcumin or its analogs should be delivered to tumor cells at the optimal phase for highest efficacy after identifying the circadian phase of the cancer cells. We confirmed the greater stability of the curcumin congeners, suggesting that they may produce sustained toxicity in cancer cells and should be considered for use in patient care.

Japanese encephalitis associated acute encephalitis syndrome cases in West Bengal, India: A sero-molecular evaluation in relation to clinico-pathological spectrum.

Japanese encephalitis (JE) is a major public health problem in Asia and worldwide and it is responsible mainly for viral acute encephalitis syndrome (AES). The sole etiologic agent of JE is Japanese encephalitis virus (JEV). Although JE/AES cases have been regarded traditionally as a disease of children, a growing number of patients with JE/AES cases are also seen in the adult age group every year in the state of West Bengal, India in spite of vaccination. Therefore, a systematic study was performed to differentiate and characterize the clinico-pathological parameters and viral diversity among the patients of different age groups. Viral diversity was also evaluated from the JE/AES cases, depending on their disease severity. A total of 441 JE/AES cases were included in this study. By MAC-ELISA, 111 samples were found JEV IgM positive and among the IgM negative cases, 26 samples were found RT-PCR positive against JEV infection. Neck rigidity, abnormal behavior, convulsion, protein in CSF, WBC in CSF, and aspartate transaminase in blood differed significantly among the patients of pediatric-adolescent and adult group in both IgM positive and RT-PCR positive cases. Viral diversity was increased significantly in the pediatric-adolescent group compared to adult patients. Interestingly, with the rise in disease severity the viral diversity was found to be increased among the patients, irrespective of their age distribution. Based on clinico-pathological parameters and analysis of viral diversity, it can be concluded that viral diversity which occurs naturally is likely to affect disease severity, especially in the patients of pediatric-adolescent group.

A hemoglobin variant associated with neonatal cyanosis and anemia.

Globin-gene mutations are a rare but important cause of cyanosis. We identified a missense mutation in the fetal Gγ-globin gene (HBG2) in a father and daughter with transient neonatal cyanosis and anemia. This new mutation modifies the ligand-binding pocket of fetal hemoglobin by means of two mechanisms. First, the relatively large side chain of methionine decreases both the affinity of oxygen for binding to the mutant hemoglobin subunit and the rate at which it does so. Second, the mutant methionine is converted to aspartic acid post-translationally, probably through oxidative mechanisms. The presence of this polar amino acid in the heme pocket is predicted to enhance hemoglobin denaturation, causing anemia.

Effect of intense pulsed light on immature burn scars: A clinical study.

INTRODUCTION: As intense pulsed light (IPL) is widely used to treat cutaneous vascular malformations and also used as non-ablative skin rejunuvation to remodel the skin collagen. A study has been undertaken to gauze the effect of IPL on immature burn scars with regard to vascularity, pliability and height. MATERIALS AND METHODS: This study was conducted between June 2013 and May 2014, among patients with immature burn scars that healed conservatively within 2 months. Photographic evidence of appearance of scars and grading and rating was done with Vancouver Scar Scale parameters. Ratings were done for both case and control scar after the completion of four IPL treatment sessions and were compared. RESULTS: Out of the 19 cases, vascularity, pliability and height improved significantly (P < 0.05) in 13, 14 and 11 scars respectively following IPL treatment. CONCLUSIONS: Intense pulsed light was well-tolerated by patients, caused good improvement in terms of vascularity, pliability, and height of immature burn scar.

An Overview of Hereditary Angioedema for the Primary Care Physician.

Hereditary angioedema is a rare autosomal dominant condition characterized by episodes of swelling of the upper airway, intestines, and skin. The disorder is characterized by deficiency in C1 esterase inhibitor (C1-INH) or a decrease in functional C1-INH. Treatment options include on demand therapy (treatment of acute attacks), long-term prophylaxis, and short-term prophylaxis. Corticosteroids, epinephrine, and antihistamines are not effective for this form of angioedema. The high mortality in patients undiagnosed underscores a need for broader physician awareness to identify these patients and initiate therapy.

Empowering Low-Income Patients with Home Blood Pressure Monitors to Improve Hypertension Control.

INTRODUCTION: Effective management of hypertension (HTN) is a priority in primary care. With telehealth now considered a staple care delivery method, uninsured and low-income patients without home blood pressure (BP) monitors may need additional attention and resources to achieve successful HTN control. METHODS: This prospective study at an underserved community clinic assessed the impact of distributing free BP monitors on patients' HTN control and therapy adherence. Enrollees were randomized into 2 groups, both completing 4 primary care physician (PCP) visits over a 6-month study period. Intervention participants collected home BP readings to report to their PCP and comparison participants completed an equivalent number of visits without having home BP data available for their PCP to review. Both groups completed an initial and final Therapy Adherence Scale (TAS) questionnaire. RESULTS: 263 patients were invited and 200 participants (mean age 50, 60% female, 19% Black, 67% Hispanic) completed the study. Intervention and comparison subjects featured comparable initial BP levels and TAS scores. After adjusting for age, race, ethnicity, sex, presence of diabetes and therapy adherence, intervention participants experienced higher odds of controlled HTN (OR 4.0; 95% Confidence Interval 2.1 to 7.7). A greater proportion of participants achieved BP control in the intervention arm compared with the comparison arm (82% vs 54% of participants, P < .001). TAS scores were higher in the intervention group (Mean = 44.1 vs 41.1; P < .001). DISCUSSION: The provision of free home BP monitors to low-income patients may feasibly and effectively improve BP control and therapy adherence.

Imprecise Clinical Assessments and Inaccurate Grades: Family Medicine Clerkship Director Perspectives.

BACKGROUND AND OBJECTIVES: As application to residency programs becomes increasingly competitive, educational leaders face growing student concern about imprecise clinical assessments and clerkship grades. METHODS: As part of a large annual survey of family medicine clerkship directors (FMCDs), 10 questions were disseminated in May 2023 about perceived levels of imprecise assessments by faculty. We aimed to determine to what extent respondents felt their institution's evaluation system propagated inaccurate grading. RESULTS: A total of 52% of 169 FMCDs responded to the survey. Of these, 7% of respondents were completely confident that their preceptors would give two students of identical competence the same clinical evaluation rating. FMCDs estimated that an average of 38% of their preceptors inaccurately rate student performance. Most clerkships use an Honors/High Pass/Pass/Fail grading system. We found that 51% of FMCDs prefer to use a different grading paradigm than they currently use. We asked FMCDs to estimate the percentage of students that expressed concern over inaccurate preceptor ratings. Grading systems with more tiers were associated with a higher percentage of concerned students. CONCLUSIONS: Clerkship grades are widely used by residency program directors to classify and differentiate student applicants. We identified a significant concern from FMCDs that clinical evaluation ratings can vary greatly. Given the high stakes and perceived inaccuracy of clerkship grading, we recommend continued investigation into the appropriate weighing and usage of clinical evaluations. Continued exploration is recommended to develop grading paradigms centered on criterion-based assessment.

Assessing the effectiveness of indigenous phosphate-solubilizing bacteria in mitigating phosphorus fixation in acid soils.

Phosphorus (P) is the key to several structural molecules and catalyzes numerous biochemical reactions in plant body besides its involvement in energy transfer. Any deficit in P availability is likely to result in reduced RNA and protein content, inhibiting crop growth and development. Thus, availability of soil P is extremely crucial for plant growth especially in acid soils of India, where most of the fraction is bound to solid phase rendering their availability. The present communication deals with the isolation of elite phosphate-solubilizing bacterial (PSB) strains from the acid soils to work out their ability to improve the fertilizer P use efficiency in the acidic environment. Initially twenty-six bacteria were isolated from the acid soils of Northeastern India. Among them, ten bacteria were selected based on formation of halo zone in the Pikovskaya agar plate. In addition, these bacteria were able to solubilize insoluble zinc (Zn) and potassium (K). The isolates were subject to in vitro optimization for P solubilization under different insoluble P source utilization and at different pH and salinity conditions. Strains AN3, AN11, and AN21 exhibited significant solubilization of insoluble P, Zn, and K, and were identified as Streptomyces sp., Enterobacter sp., and Paraburkholderia caribensis. These three bacteria solubilized 206.53 to 254.08 µg mL-1 P, 79.7 to 177.55 µg mL-1 Zn, and 0.96 to 1.56 µg mL-1 K from insoluble minerals. Their performance was further evaluated in pot culture experiment using green gram as test crop. These three bacteria were found to improve P uptake and dry matter accumulation in green gram plant substantially. Seed bio-priming with the PSB strains enhanced the efficiency of added P fertilizer, resulting in a 1.40 to 1.52 times higher effectiveness compared to the control. On the whole, AN11 may be ranked as best inoculant for the acidic soils of Northeastern India. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-024-04042-2.

Synthesis of tetrachalcogenide-substituted phenalenyl derivatives: preparation and solid-state characterization of bis(3,4,6,7-tetrathioalkyl-phenalenyl)boron radicals.

We report the synthesis and properties of a series of spiro-bis(3,4,6,7-tetrachalcogenide-substituted-phenalenyl)boron salts and two of the corresponding tetrathioalkyl-substituted spiro-bis(phenalenyl)boron radicals [tetrathiomethyl (10) and tetrathioethyl (11)] in which all of the active positions of the phenalenyl (PLY) nucleus are functionalized. In the solid state, radicals 10 and 11 exist as a weak π-dimers due to the steric congestion of the thioalkyl groups in the superimposed PLY units. As a result, the spins are localized in the isolated (nonsuperimposed) PLY rings, and the structure, magnetic susceptibility measurements, and band structure calculations confirm that these PLY units are unable to undergo strong intermolecular interaction as a result of the orientation of the thioalkyl groups.

Envelope protein gene based molecular characterization of Japanese encephalitis virus clinical isolates from West Bengal, India: a comparative approach with respect to SA14-14-2 live attenuated vaccine strain.

BACKGROUND: Increasing virulence of Japanese encephalitis virus (JEV), a mosquito-borne zoonotic pathogen is of grave concern because it causes a neurotrophic killer disease Japanese Encephalitis (JE) which, in turn, is responsible globally for viral acute encephalitis syndrome (AES). Despite the availability of vaccine, JE/AES cases and deaths have become regular features in the different rural districts of West Bengal (WB) state, India, indicating either the partial coverage of vaccine or the emergence of new strain of JEV. Therefore, a study was undertaken to characterize and compare the complete envelope (E) protein gene based molecular changes/patterns of JEVs circulating in WB. METHODS: Total of 98 AES case-patients' samples were tested to detect the presence of JEV specific immunoglobulin M (IgM) antibody by Mac-ELISA method. Only JEV IgM negative samples with a history of ≤3 days' illness were screened for virus isolation and RT-PCR. E gene sequences of JEV isolates were subjected to molecular phylogeny and immunoinformatics analysis. RESULTS: Present study confirmed JEV etiology in 39.7% and 29.1% of patients presenting ≤15 days' febrile illness, as determined by Mac-ELISA and RT-PCR respectively. Phylogenetic analysis based on complete E gene sequences of JEV isolates showed the co-circulation of JEV genotype I (GI) with genotype III (GIII). This study also demonstrated that isolate-specific crucial amino acid substitutions were closely related to neurovirulence/neuroinvasiveness of JE. On the basis of immunoinformatics analysis, some substitutions were predicted to disrupt T-cell epitope immunogenicity/antigenicity that might largely influence the outcome of vaccine derived from JEV GIII SA14-14-2 strain and this has been observed in a previously vaccinated boy with mild JE/AES due to JEV GI infection. CONCLUSIONS: Based on molecular evolutionary and bioinformatic approaches, we report evolution of JEV at a local level. Such naturally occurring evolution is likely to affect the disease profile and the vaccine efficacy to protect against JEV GI may demand careful evaluation.

Hereditary Angioedema: A Disease Often Misdiagnosed and Mistreated.

Hereditary angioedema is a rare autosomal dominant condition characterized by episodes of swelling of the upper airway, intestines, and skin. The disorder is characterized by deficiency in C1 esterase inhibitor (C1-INH) or a decrease in functional C1-INH. Treatment options include on demand therapy (treatment of acute attacks), long-term prophylaxis, and short-term prophylaxis. Corticosteroids, epinephrine, and antihistamines are not effective for this form of angioedema. The high mortality in patients undiagnosed underscores a need for broader physician awareness to identify these patients and initiate therapy.

Metaheuristic secured transmission in Telecare Medical Information System (TMIS) in the face of post-COVID-19.

The outbreak of novel corona virus had led the entire world to make severe changes. A secured healthcare data transmission has been proposed through Telecare Medical Information System (TMIS) based on metaheuristic salp swarm. Patients need proper medical remote treatments in this Post-COVID-19 time from their quarantines. Secured transmission of medical data is a significant challenge of digitally overwhelmed environment. The objective is to impart the patients' data by encryption with confidentiality and integrity. Eavesdroppers can carry sniffing and spoofing in order to deluge the data. In this paper, a novel scheme on metaheuristic salp swarm based intelligence has been sculptured to encrypt electrocardiograms (ECG) for data privacy. Metaheuristic approach has been blended in cryptographic engineering to address the TMIS security issues. Session key has been derived from the weight vector of the fittest salp from the salp population. The exploration and exploitation control the movements of the salps. The proposed technique baffles the eavesdroppers by the key strength and other robustness factors. The results, thus obtained, were compared with some existing classical techniques with benchmark results. The proposed MSE and RMSE were 28,967.85, and 81.17 respectively. The time needed to decode 128 bits proposed session key was 8.66 × 1052 years. The proposed cryptographic time was 8.8 s.

Climate Change as a Social Determinant of Health: An Interactive Case-Based Learning Activity.

Introduction: Despite consensus on climate change's impact on humans, medical schools have not widely adopted inclusion of environmental topics into their mandatory curriculum. This educational activity explicitly addresses climate change as one of the environmental determinants of health (EDH). Methods: We developed a required, 1-hour module for all first-year medical students. This interactive, case-based, small-group activity was incorporated into a curriculum within an advising program but could be run independently. Before and after the session, participants completed evaluations assessing knowledge gains and attitude shifts. Results: Of 183 first-year students, 155 completed both pre- and postmodule surveys. Participants' rating increased on the postmodule survey item "priority should be given to the discussion of EDH in medical education." The Wilcoxon signed rank test determined this difference in priority was statistically significant (p < .001). Reported strengths of this activity included the cases, informative content on EDH, the video, the discussion, and highlighted EDH resources. Suggested areas for improvement included more information on how to apply concepts to clinical contexts, guidance on how to engage in EDH concepts, and more discussion time. As a result of the module, students planned to engage in recycling, reduced consumption, advocacy, and changes to mode of transportation. Discussion: Climate change remains the greatest global threat to human health, and future physicians must be equipped to educate patients and policymakers on the harms of environmental hazards. This brief yet effective module offers one approach to incorporating this topic into medical school curricula.

Molecular evidence for the occurrence of Japanese encephalitis virus genotype I and III infection associated with acute encephalitis in patients of West Bengal, India, 2010.

BACKGROUND: Japanese encephalitis virus (JEV), a mosquito-borne zoonotic pathogen, is the sole etiologic agent of Japanese Encephalitis (JE); a neurotropic killer disease which is one of the major causes of viral encephalitis worldwide with prime public health concern. JE was first reported in the state of West Bengal, India in 1973. Since then it is being reported every year from different districts of the state, though the vaccination has already been done. Therefore, it indicates that there might be either partial coverage of the vaccine or the emergence of mutated/new strain of JEV. Considering this fact, to understand the JEV genotype distribution, we conducted a molecular epidemiological study on a total of 135 serum/cerebrospinal fluid (CSF) samples referred and/or collected from the clinically suspected patients with Acute encephalitis syndrome (AES), admitted in different district hospitals of West Bengal, India, 2010. FINDINGS: JEV etiology was confirmed in 36/135 (26.6%) and 13/61 (21.3%) 2-15 days' febrile illness samples from AES cases by analyzing Mac-ELISA followed by RT-PCR test respectively. Phylogenetic analysis based on complete envelope gene sequences of 13 isolates showed the emergence of JEV genotype I (GI), co-circulating with genotype III (GIII). CONCLUSION: This study represents the first report of JEV GI with GIII, co-circulating in West Bengal. The efficacy of the vaccine (derived from JEV GIII strain SA-14-14-2) to protect against emerging JEV GI needs careful evaluation. In future, JE outbreak is quite likely in the state, if this vaccine fails to protect sufficiently against GI of JEV.