Continuous emission monitoring systems (CEMS) in India: Performance evaluation, policy gaps and financial implications for effective air pollution control.

Continuous Emission Monitoring Systems (CEMS) are devices used to measure and report real-time emission of air pollutants. Although CEMS have been extensively deployed in developed countries to ensure compliance with emission standards and enhance their environmental performance, their adoption in India is still in its early stages. The present study aims to evaluate the effectiveness of CEMS in India, identify obstacles in terms of policy, regulation, technology and finance that impede their adoption and suggest mechanisms and incentives to facilitate their expansion. The findings indicate that CEMS offer benefits for air pollution control in India by improving monitoring accuracy, transparency, accountability and enforcement. The study also highlights institutional challenges faced by CEMS, including the absence of a certification system, lack of quality assurance measures, issues with data validation and challenges in its calibration as well as integration concerns with existing regulatory framework. To address these challenges effectively it is recommended that India must develop a policy framework for CEMS along with regulations. Essential steps such as establishing a certification and accreditation system should be taken while enhancing stakeholders' capacity and awareness.

Cross-Modal Imaging Reveals Nanoparticle Uptake Dynamics in Hematopoietic Bone Marrow during Inflammation.

Nanoparticles have been employed to elucidate the innate immune cell biology and trace cells accumulating at inflammation sites. Inflammation prompts innate immune cells, the initial responders, to undergo rapid turnover and replenishment within the hematopoietic bone marrow. Yet, we currently lack a precise understanding of how inflammation affects cellular nanoparticle uptake at the level of progenitors of innate immune cells in the hematopoietic marrow. To bridge this gap, we aimed to develop imaging tools to explore the uptake dynamics of fluorescently labeled cross-linked iron oxide nanoparticles in the bone marrow niche under varying degrees of inflammation. The inflammatory models included mice that received intramuscular lipopolysaccharide injections to induce moderate inflammation and streptozotocin-induced diabetic mice with additional intramuscular lipopolysaccharide injections to intensify inflammation. In vivo magnetic resonance imaging (MRI) and fluorescence imaging revealed an elevated level of nanoparticle uptake at the bone marrow as the levels of inflammation increased. The heightened uptake of nanoparticles within the inflamed marrow was attributed to enhanced permeability and retention with increased nanoparticle intake by hematopoietic progenitor cells. Moreover, intravital microscopy showed increased colocalization of nanoparticles within slowly patrolling monocytes in these inflamed hematopoietic marrow niches. Our discoveries unveil a previously unknown role of the inflamed hematopoietic marrow in enhanced storage and rapid deployment of nanoparticles, which can specifically target innate immune cells at their production site during inflammation. These insights underscore the critical function of the hematopoietic bone marrow in distributing iron nanoparticles to innate immune cells during inflammation. Our findings offer diagnostic and prognostic value, identifying the hematopoietic bone marrow as an imaging biomarker for early detection in inflammation imaging, advancing personalized clinical care.

Obturator hernia: An uncommon cause of intestinal obstruction: A case report.

INTRODUCTION AND IMPORTANCE: An obturator hernia is a rare cause of bowel obstruction. Due to its narrow passage in the obturator canal, these are more susceptible to becoming incarcerated and subsequently strangulated. Due to its challenging detection, obturator hernia is often diagnosed late. CASE PRESENTATION: A 75-year-old thin-built female with COPD presented to the emergency room with symptoms of abdominal obstruction. Abdominal examination revealed distension, firmness, rigidity, and tenderness with no bowel sounds. An erect abdominal X-ray showed multiple air-fluid levels, indicating an acute abdomen due to intestinal obstruction. Emergency exploratory laparotomy revealed an obturator hernia with strangulated ileum and perforation, necessitating resection and double barrel ileostomy. Unfortunately, despite all medical interventions, the patient succumbed to hospital-acquired pneumonia following the surgery. DISCUSSION: Obturator hernia, known as 'the skinny old woman hernia,' is rarely externally visible or palpable, leading to frequent undiagnosed cases. It presents with bowel obstruction or perforation and carries the highest morbidity among abdominal hernias. Timely intervention is crucial to prevent complications like bowel strangulation. CONCLUSION: This case report highlights the challenges of diagnosing and managing obturator hernia, a rare condition with significant morbidity. Early detection through imaging or operative findings is crucial to prevent complications like bowel strangulation, especially in older women at higher risk.

Bilateral hydrocele of the canal of Nuck: A case report.

INTRODUCTION: The hydrocele of the canal of Nuck is a rare cause of bilateral inguino-labial swelling. Due to its rarity, lack of clinician knowledge regarding this entity, and paucity of relevant literature, it can be misdiagnosed and often mistreated. CASE PRESENTATION: We present a case of a two-year-old female with bilateral inguino-labial swelling who was diagnosed with a hydrocele of the canal of Nuck based on history and clinical examination. The patient underwent bilateral hydrocele excision with high pouch ligation, and she experienced an uneventful recovery. DISCUSSION: Bilateral hydrocele of the canal of Nuck is rare in females. Diagnosis can be made based on history and clinical findings. In cases of diagnostic uncertainty, preoperative ultrasonography may aid in diagnosis. Management of hydrocele of the canal of Nuck involves surgical intervention, which is necessary for both definitive diagnosis and treatment. CONCLUSIONS: Although rare, hydrocele of the canal of Nuck must be suspected in cases with inguino-labial swelling, properly diagnosed, and surgically excised. It can be misdiagnosed; therefore, clinicians need to have a high index of suspicion to reach a provisional diagnosis and prevent morbidity and further complications.

Screening for Multifarious Plant Growth Promoting and Biocontrol Attributes in Bacillus Strains Isolated from Indo Gangetic Soil for Enhancing Growth of Rice Crops.

Multifarious plant growth-promoting Bacillus strains recovered from rhizospheric soils of the Indo Gangetic plains (IGPs) were identified as Bacillus licheniformis MNNITSR2 and Bacillus velezensis MNNITSR18 based on their biochemical characteristics and 16S rDNA gene analysis. Both strains exhibited the ability to produce IAA, siderophores, ammonia, lytic enzymes, HCN production, and phosphate solubilization capability and strongly inhibited the growth of phytopathogens such as Rhizoctonia solani and Fusariun oxysporum in vitro. In addition, these strains are also able to grow at a high temperature of 50 °C and tolerate up to 10-15% NaCl and 25% PEG 6000. The results of the pot experiment showed that individual seed inoculation and the coinoculation of multifarious plant growth promoting (PGP) Bacillus strains (SR2 and SR18) in rice fields significantly enhanced plant height, root length volume, tiller numbers, dry weight, and yield compared to the untreated control. This indicates that these strains are potential candidates for use as PGP inoculants/biofertilizers to increase rice productivity under field conditions for IGPs in Uttar Pradesh, India.

Role of cord blood IGF-1 and maternal HbA1c levels to predict interventricular septal hypertrophy among infants of diabetic mothers: A case-control study.

BACKGROUND: Infants of diabetic mothers (IDMs) develop interventricular septal hypertrophy (ISH) (> 6 mm) [1]. The proportion of IDMs developing ISH varies from country to country. Maternal HbA1c and cord blood Insulin-like growth factor-1 (IGF-1) levels have been found useful to predict ISH. METHODS: This was a case-control study of term neonates of diabetic mothers (cases) and of non-diabetic mothers (controls) to evaluate echocardiographic (ECHO) differences among cases and controls and to find the correlation of interventricular septal thickness (IVS) thickness with maternal HbA1C and cord blood IGF-1 levels. RESULTS: Of 32 cases and 34 controls (mean gestational age 37.7 ± 0.9 weeks), 15 (46.8 %) cases, no control developed ISH. Septal thickness was more (6 ± 0.15 cm vs 3 ± 0.06 cm; p = 0.027) in cases than controls. Functional ECHO parameters including left ventricle ejection fraction were comparable (p = 0.9) among the two groups. Maternal HbA1C levels were higher (6.5 % ± 1.3 vs 3.6 % ± 0.7; p = 0.001) with a positive correlation with IVS (Pearson's coefficient 0.784, p < 0.001). Cord blood IGF1 levels were too higher in cases (99.1 ± 6.09 ng/ml vs 37.1 ± 2.99 ng/ml; p < 0.001) with moderate correlation with IVS thickness (Pearson's coefficient 0.402; p = 0.00). Receiver operator curve analysis showed, that at a cut-off of 72 ng/ml, cord blood IGF1 predicted ISH with 72 % sensitivity; 88 % specificity and at a cut-off of 7.35 %, maternal HbA1c predicted ISH with sensitivity; specificity of 93.8 % and 72.1 % respectively. CONCLUSION: ISH was present in 46.8 % in cases as compared to none in controls. IVS thickness correlated well with maternal HbA1C and moderately with cord blood IGF-1 levels. Functional parameters on ECHO were unaffected by maternal diabetic control. At the cut-off of maternal HbA1c of 7.35 % and cord blood IGF-1 of 72 ng /ml, babies need to be monitored clinically with ECHO to look for ISH.

Xanthogranulomatous Cholecystitis Mimicking Carcinoma Gallbladder.

Xanthogranulomatous cholecystitis (XGC) is a rare benign chronic inflammatory disease of the gallbladder that often presents as cholecystitis and can mimic gallbladder carcinoma. Distinguishing XGC from gallbladder cancer preoperatively is challenging. We present a case of a 62-year-old male who presented with features of carcinoma gallbladder in the CECT abdomen and MRCP. Intraoperatively, there was a mass in the gallbladder and extension into the adjacent structures with involvement of the hepatic artery, 1st part of the duodenum, portal vein, and hepatic flexure of the colon, and thus a palliative cholecystectomy was done. The histopathological report came out as XCG. The case aims to outline the clinical presentation of XGC and differentiate it from carcinoma gallbladder.

Role of Ensemble Deep Learning for Brain Tumor Classification in Multiple Magnetic Resonance Imaging Sequence Data.

The biopsy is a gold standard method for tumor grading. However, due to its invasive nature, it has sometimes proved fatal for brain tumor patients. As a result, a non-invasive computer-aided diagnosis (CAD) tool is required. Recently, many magnetic resonance imaging (MRI)-based CAD tools have been proposed for brain tumor grading. The MRI has several sequences, which can express tumor structure in different ways. However, a suitable MRI sequence for brain tumor classification is not yet known. The most common brain tumor is 'glioma', which is the most fatal form. Therefore, in the proposed study, to maximize the classification ability between low-grade versus high-grade glioma, three datasets were designed comprising three MRI sequences: T1-Weighted (T1W), T2-weighted (T2W), and fluid-attenuated inversion recovery (FLAIR). Further, five well-established convolutional neural networks, AlexNet, VGG16, ResNet18, GoogleNet, and ResNet50 were adopted for tumor classification. An ensemble algorithm was proposed using the majority vote of above five deep learning (DL) models to produce more consistent and improved results than any individual model. Five-fold cross validation (K5-CV) protocol was adopted for training and testing. For the proposed ensembled classifier with K5-CV, the highest test accuracies of 98.88 ± 0.63%, 97.98 ± 0.86%, and 94.75 ± 0.61% were achieved for FLAIR, T2W, and T1W-MRI data, respectively. FLAIR-MRI data was found to be most significant for brain tumor classification, where it showed a 4.17% and 0.91% improvement in accuracy against the T1W-MRI and T2W-MRI sequence data, respectively. The proposed ensembled algorithm (MajVot) showed significant improvements in the average accuracy of three datasets of 3.60%, 2.84%, 1.64%, 4.27%, and 1.14%, respectively, against AlexNet, VGG16, ResNet18, GoogleNet, and ResNet50.

High quantum yield carbon dots and nitrogen-doped carbon dots as fluorescent probes for spectroscopic dopamine detection in human serum.

Recent advances in fluorescent carbon dots have shown great potential for the sensing of biological molecules. In this study, one-step hydrothermally synthesised carbon dots (CD) and nitrogen doped carbon dots (NCD) with high quantum yields of 54.29% and 89.82%, respectively, were investigated and demonstrated to be a reliable, cost-effective, and naked-eye fluorescent probe for the detection of dopamine, a neurotransmitter, in human serum fluids. The current study is well supported by a comprehensive synthesis approach and has been described utilizing a variety of microscopic and spectroscopic techniques. The discovered approach is time and pH dependent, and it provides a robust platform for specifically detecting aberrant dopamine levels using a fluorescence quenching mechanism. Dopamine detection limits for CD were calculated to be 5.54 µM for CD and 5.12 µM for NCD, respectively. The fluorescence quenching shows a linear continuous trend with a range within 3.3-500 µM and 3.3-400 µM of dopamine concentration for CD and NCD respectively. To further verify the sensitivity of CD and NCD as fluorescent probes, interference studies in the presence of different biological components were also studied and validated. This work shows that carbon-based nanomaterials and their doped nanostructures, due to their high fluorescence, have significant potential as fluorescent probes in neurological disease diagnosis as they display high selectivity, sensitivity and fast responses in the real time spectroscopic detection of dopamine in human fluid samples.

Guide catheter extension systems: Hype or a need?

Guide catheter extension system (GCES) is a valuable tool for interventional cardiologists, especially in complex cases. GCES increases guide back-up support and is crucial in complex PCI procedures, particularly in cases of severe calcification and tortuosity. Apart from their primary use to increase back-up support of guide by providing coaxial alignment, deep intubation and facilitation of stent delivery, GCES are now being increasingly used in different clinical indications including complex and high-risk coronary intervention interventions.

Performance optimisation of deep learning models using majority voting algorithm for brain tumour classification.

BACKGROUND: Although biopsy is the gold standard for tumour grading, being invasive, this procedure also proves fatal to the brain. Thus, non-invasive methods for brain tumour grading are urgently needed. Here, a magnetic resonance imaging (MRI)-based non-invasive brain tumour grading method has been proposed using deep learning (DL) and machine learning (ML) techniques. METHOD: Four clinically applicable datasets were designed. The four datasets were trained and tested on five DL-based models (convolutional neural networks), AlexNet, VGG16, ResNet18, GoogleNet, and ResNet50, and five ML-based models, Support Vector Machine, K-Nearest Neighbours, Naïve Bayes, Decision Tree, and Linear Discrimination using five-fold cross-validation. A majority voting (MajVot)-based ensemble algorithm has been proposed to optimise the overall classification performance of five DL and five ML-based models. RESULTS: The average accuracy improvement of four datasets using the DL-based MajVot algorithm against AlexNet, VGG16, ResNet18, GoogleNet, and ResNet50 models was 2.02%, 1.11%, 1.04%, 2.67%, and 1.65%, respectively. Further, a 10.12% improvement was seen in the average accuracy of four datasets using the DL method against ML. Furthermore, the proposed DL-based MajVot algorithm was validated on synthetic face data and improved the male versus female face image classification accuracy by 2.88%, 0.71%, 1.90%, 2.24%, and 0.35% against AlexNet, VGG16, ResNet18, GoogleNet, and ResNet50, respectively. CONCLUSION: The proposed MajVot algorithm achieved promising results for brain tumour classification and is able to utilise the combined potential of multiple models.

Multi-Scale Imaging of Vascular Pathologies in Cardiovascular Disease.

Cardiovascular disease entails systemic changes in the vasculature. The endothelial cells lining the blood vessels are crucial in the pathogenesis of cardiovascular disease. Healthy endothelial cells direct the blood flow to tissues as vasodilators and act as the systemic interface between the blood and tissues, supplying nutrients for vital organs, and regulating the smooth traffic of leukocytes into tissues. In cardiovascular diseases, when inflammation is sensed, endothelial cells adjust to the local or systemic inflammatory state. As the inflamed vasculature adjusts, changes in the endothelial cells lead to endothelial dysfunction, altered blood flow and permeability, expression of adhesion molecules, vessel wall inflammation, thrombosis, angiogenic processes, and extracellular matrix production at the endothelial cell level. Preclinical multi-scale imaging of these endothelial changes using optical, acoustic, nuclear, MRI, and multimodal techniques has progressed, due to technical advances and enhanced biological understanding on the interaction between immune and endothelial cells. While this review highlights biological processes that are related to changes in the cardiac vasculature during cardiovascular diseases, it also summarizes state-of-the-art vascular imaging techniques. The advantages and disadvantages of the different imaging techniques are highlighted, as well as their principles, methodologies, and preclinical and clinical applications with potential future directions. These multi-scale approaches of vascular imaging carry great potential to further expand our understanding of basic vascular biology, to enable early diagnosis of vascular changes and to provide sensitive diagnostic imaging techniques in the management of cardiovascular disease.

Systematic spectroscopic investigation of structural changes and corona formation of bovine serum albumin over magneto-fluorescent nanoparticles.

Magneto-fluorescent nanoparticles have attracted great attention because of their dual nature as multimodal imaging probes in various biomedical applications. Particulary, it is desirable to understand how these nanoparticles interact with human serum proteins before they are used in biological systems. In this work, the physiological interactions between magneto-fluorescent nanoparticles (MFNPs) and bovine serum albumin (BSA) were systematically investigated. The present observations identified that the collision of MFNPs and BSA caused fluorescence quenching of BSA. Steady state fluorescence, lifetime and anisotropy measurements in the presence of MFNPs supported dynamic quenching of the BSA emission. Furthermore, in the presence of MFNPs, the conformation changes in the BSA structure indicate merely the secondary structural changes. The findings demonstrated that random interactions and hydrophobic forces play a major role in the dynamic quenching. Further, subsequent coating of BSA over MFNPs result in protein corona formation, as is evident through spectroscopic measurements. In light of the present work, MFNPs could serve a purpose in magnetic separation and optical detection of serum proteins from blood plasma in real-time disease diagnosis.

Mystery still unresolved: Untouched "Blue heart" presenting at 40yrs of age.

The modern-day surgical techniques and strategies have changed the outlook of patients with dextro-transposition of great arteries (d-TGA). The survival of an unrepaired d-TGA into late adulthood is difficult to explain. Even when large intracardiac shunts are present, it still remains a lethal cyanotic congenital heart disease if it is not surgically corrected soon after birth. Here, we report an extremely rare case of d-TGA presenting at 40 years of age, with moderately elevated pulmonary artery pressures and relatively stable symptoms.

Fluorescent Mantle Carbon Coated Core-Shell SPIONs for Neuroengineering Applications.

Superparamagnetic iron oxide nanoparticles (SPIONs) have been used for a variety of biomedical applications, from multimodal imaging to the mechanical activity of cells and tissues. Herein, we present fluorescently mantled carbon coated core-shell superparamagnetic iron oxide nanoparticles (FC-SPIONs) as an excellent material to promote the neuronal differentiation and neuronal network outgrowth in neural tissue engineering applications. Morphological, structural, and functional group characterizations were systematically investigated. FC-SPIONs showed superior magnetic and inherent fluorescence characteristic properties. Furthermore, FC-SPIONs interactions against neuronal PC12 cells showed promising results and deliberate their potential for significant applications in neuroengineering. Interestingly, FC-SPIONs were assessed as biocompatible and promoted the neuronal PC12 cell differentiation process. Accompanied by these results, network outgrowth and branching patterns of neuronal processes can be regulated using FC-SPIONs. Importantly, FC-SPIONs are promising due to their biocompatibility and selective affinity toward neuronal cells, paving the way for neuronal differentiation and outgrowth and neuronal therapeutics in neuroengineering applications.

Tunable lanthanide/transition metal ion-doped novel phosphors for possible application in w-LEDs: a review.

Lanthanide-based phosphors have been extensively investigated for their possible applications in solid-state lighting technologies especially for white-light-emitting diodes. In this review article emphasis has been laid on discussing the recent developments of phosphors for warm white-light production based on various optical characteristics such as quantum efficiency, thermal stability, short emission decay time, long-term stability, facile synthesis, and low cost of production. We have tried to cover the essential and latest discoveries of the lanthanide/rare earth-doped phosphors after 2010. New generations of narrow-band phosphors have also been included. The optical and material properties of several novel phosphors and their luminescence characteristics have been thoroughly discussed.

Azilsartan: Current Evidence and Perspectives in Management of Hypertension.

Hypertension continues to be global pandemic with huge mortality, morbidity, and financial burden on the health system. Unfortunately, most patients with hypertension would eventually require two or more drugs in combination to achieve their target blood pressure (BP). To this end, emergence of more potent antihypertensive drugs is a welcome sign. Angiotensin receptor blockers (ARBs) are cornerstones of hypertension management in daily practice. Among all ARBs, azilsartan is proven to be more potent in most of the head-to-head trials till date. Azilsartan is the latest ARB approved for hypertension with greater potency and minimal side effects. This review highlights the role of azilsartan in management of hypertension in the current era.

Penetration of CD8+ Cytotoxic T Cells into Large Target, Tissue Cysts of Toxoplasma gondii, Leads to Its Elimination.

CD8+ cytotoxic T cells kill target cells through direct cell-cell contact. However, it remains unclear how these T cells eliminate a target of large mass. We investigated how CD8+ T cells remove tissue cysts of Toxoplasma gondii, which can grow to the size of >50 µm in diameter within infected cells. Notably, immunohistologic analyses in the brains of infected mice visualized the presence of numbers of CD8+ immune T cells that had migrated halfway through the cyst wall as well as T cells located fully within the cysts. Perforin was required for their invasion and cyst elimination. Cysts invaded by the T cells displayed morphologic deterioration and destruction. Within these deteriorated cysts, granular structures intensely positive for granzyme B were detected in association with T. gondii bradyzoites. Furthermore, the bradyzoites within the destroyed cysts were located within accumulated ionized calcium binding adaptor molecule 1 (Iba1)-positive microglia and Ly6C+ macrophages, suggesting that these phagocytes had phagocytosed those organisms for their eradication. The present study uncovered a previously unappreciated capability of CD8+ cytotoxic T cells to penetrate into a large target, T. gondii cysts, for their elimination. This invasive capability of CD8+ cytotoxic T cells in collaboration with phagocytes appears to be a powerful effector mechanism that functions against not only T. gondii cysts but also other large targets, including solid cancers.

Multiple tuberous and tendinous xanthomas diagnosed on fine-needle aspiration cytology-report of a rare case.

Xanthomas are papulonodular skin lesions present in lipoprotein metabolism disorders, which result in cholesterol deposits in subcutaneous tissue, tendons, ligaments, periosteum, etc. A 11-year-old male presented with multiple soft tissue swellings, prominently over joints. Fine-needle aspiration (FNA) from multiple sites had similar appearance with foamy histocytes and giant cells. Oil Red O and polarized microscopy were also positive for fat. We describe an unusual case of tendinous and tuberous xanthoma diagnosed by cytology. Acquaintance with fine-needle aspiration cytology findings in xanthomas can help to avoid the need of surgical biopsy, as xanthomas can regress on medical therapy alone.