Silica-Based Superhydrophobic and Superoleophilic Cotton Fabric with Enhanced Self-Cleaning Properties for Oil-Water Separation and Methylene Blue Degradation.

Superhydrophobic textiles with multifunctional characteristics are highly desired and have attracted tremendous research attention. This research employs a simple dip-coating method to obtain a fluorine-free silica-based superhydrophobic and superoleophilic cotton fabric. Pristine cotton fabric is coated with SiO2 nanoparticles and octadecylamine. SiO2 nanoparticles are anchored on the cotton fabric to increase surface roughness, and octadecyl amine lowers the surface energy, turning the hydrophilic cotton fabric into superhydrophobic. The designed cotton fabric exhibits a water contact angle of 159° and a sliding angle of 7°. The prepared cotton fabric is characterized by attenuated total reflectance-fourier transform infrared spectroscopy, X-ray diffraction, atomic force microscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. In addition, the coated fabric reveals excellent features, including mechanical and chemical stability, superhydrophobicity, superoleophilicity, and the self-cleaning ability. SiO2 nanoparticles and octadecylamine-coated cotton fabric demonstrate exceptional oil-water separation and wastewater remediation performance by degrading the methylene blue solution up to 89% under visible light. The oil-water separation ability is tested against five different oils with more than 90% separation efficiency. This strategy has the advantages of low-cost precursors, a simple and scalable coating method, enhanced superhydrophobicity and superoleophilicity, self-cleaning ability, efficient oil-water separation, and exceptional wastewater remediation performance.

2D MXenes and their composites; design, synthesis, and environmental sensing applications.

Novel 2D layered MXene materials were first reported in 2011 at Drexel University. MXenes are widely used in multidisciplinary applications due to their anomalous electrical conductivity, high surface area, and chemical, mechanical, and physical properties. This review summarises MXene synthesis and applications in environmental sensing. The first section describes different methods for MXene synthesis, including fluorinated and non-fluorinated methods. MXene's layered structure, surface terminal groups, and the space between layers significantly impact its properties. Different methods to separate different MXene layers are also discussed using various intercalation reagents and commercially synthesized MXene without compromising the environment. This review also explains the effect of MXene's surface functionalization on its characteristics. The second section of the review describes gas and pesticide sensing applications of Mxenes and its composites. Its good conductivity, surface functionalization with negatively charged groups, intrinsic chemical nature, and good mechanical stability make it a prominent material for room temperature sensing of environmental samples, such as polar and nonpolar gases, volatile organic compounds, and pesticides. This review will enhance the young scientists' knowledge of MXene-based materials and stimulate their diversity and hybrid conformation in environmental sensing applications.

Retrospective Diagnosis of Ca Thyroid on Thyroid Pertechnetate Scan -A part of Routine Post Thyroidectomy Work up For Nontoxic Multi Nodular Goiter.

Unsuspected thyroid cancer can be detected in multinodular goiter (MNG) where the risk of malignancy is 7-9%. Fine needle aspiration (FNAc) is performed in case of suspicious findings on ultrasound. With benign FNAC results there is no need for surgery unless the patient has pressure symptoms or cosmetic concerns, but the risk of overlooked malignancy is always present. We present the case of a patient with unexpected detection of papillary thyroid cancer on thyroid scan.

Artificial intelligence for automated detection of diabetic foot ulcers: A real-world proof-of-concept clinical evaluation.

OBJECTIVE: Conduct a multicenter proof-of-concept clinical evaluation to assess the accuracy of an artificial intelligence system on a smartphone for automated detection of diabetic foot ulcers. METHODS: The evaluation was undertaken with patients with diabetes (n = 81) from September 2020 to January 2021. A total of 203 foot photographs were collected using a smartphone, analysed using the artificial intelligence system, and compared against expert clinician judgement, with 162 images showing at least one ulcer, and 41 showing no ulcer. Sensitivity and specificity of the system against clinician decisions was determined and inter- and intra-rater reliability analysed. RESULTS: Predictions/decisions made by the system showed excellent sensitivity (0.9157) and high specificity (0.8857). Merging of intersecting predictions improved specificity to 0.9243. High levels of inter- and intra-rater reliability for clinician agreement on the ability of the artificial intelligence system to detect diabetic foot ulcers was also demonstrated (Kα > 0.8000 for all studies, between and within raters). CONCLUSIONS: We demonstrate highly accurate automated diabetic foot ulcer detection using an artificial intelligence system with a low-end smartphone. This is the first key stage in the creation of a fully automated diabetic foot ulcer detection and monitoring system, with these findings underpinning medical device development.

Recent advancements in the fabrication and photocatalytic applications of graphitic carbon nitride-tungsten oxide nanocomposites.

The present review focuses on the widely used graphitic carbon nitride (g-C3N4)-tungsten oxide (WO3) nanocomposite in photocatalytic applications. These catalysts are widely employed due to their easy preparation, high physicochemical stability, nontoxicity, electron-rich properties, electronic band structure, chemical stability, low cost, earth-abundance, high surface area, and strong absorption capacity in the visible range. These sustainable properties make them predominantly attractive and unique from other photocatalysts. In addition, graphitic carbon nitride (g-C3N4) is synthesized from nitrogen-rich precursors; therefore, it is stable in strong acid solutions and has good thermal stability up to 600 °C. This review covers the historical background, crystalline phases, density-functional theory (DFT) study, synthesis method, 0-D, 1-D, 2-D, and 3-D materials, oxides/transition/nontransition metal-doped, characterization, and photocatalytic applications of WO3/g-C3N4. Enhancing the catalytic performance strategies such as composite formation, element-doping, heterojunction construction, and nanostructure design are also summarized. Finally, the future perspectives and challenges for WO3/g-C3N4 composite materials are discussed to motivate young researchers and scientists interested in developing environment-friendly and efficient catalysts.

Stearic Acid and CeO2 Nanoparticles Co-functionalized Cotton Fabric with Enhanced UV-Block, Self-Cleaning, Water-Repellent, and Antibacterial Properties.

Superhydrophobic cotton fabrics with multifunctional features are highly desired in domestic and outdoor applications. However, the short coating longevity and hazardous reagents significantly reduce their commercial-scale applications. Herein, we introduce CeO2 nanoparticles and stearic acid (SA) to develop a fluorine-free, durable superhydrophobic cotton fabric that mimics the lotus effect. The pristine cotton fabric is treated with APTES-functionalized CeO2 nanoparticles by immersion followed by a dip and drying treatment with a 2% myristic acid solution. This sequential process creates a stable superhydrophobic cotton fabric (SA/CeO2-cotton fabric) with a water contact angle of 158° and a water sliding angle of 5°. The results are attributed to the combined effect of CeO2 nanoparticles and stearic acid that enhances surface roughness and reduces surface sorption energy. APTES facilitates the durable attachment of CeO2 nanoparticles and stearic acid to the cotton fabric. The modified cotton fabric is characterized by advanced analytical tools, demonstrating enhanced superhydrophobicity, self-cleaning, and antiwater absorption properties. Additionally, it exhibits remarkable UV-blocking (UPF 542) and antibacterial properties. The designed superhydrophobic cotton fabric unveils good mechanical, thermal, and chemical durability. The proposed strategy is simple, green, and economical and can be used commercially for functional fabric preparation.

Smartphone-integrated colorimetric and microfluidic paper-based analytical devices for the trace-level detection of permethrin.

Permethrin is a pyrethroid pesticide and insect repellent that prevents mosquito-borne infections like dengue and malaria in tropical areas. This work describes a new colorimetric sensor based on metronidazole-stabilized silver nanoparticles (MTZ-AgNPs) for the first rapid, sensitive, and selective permethrin detection. The MTZ-AgNPs-based colorimetric sensor has a limit of detection (LOD) of 0.0104 µM and a limit of quantification (LOQ) of 0.0348 µM, respectively. The sensor is further integrated with smartphone and microfluidic fabrication of paper-based analytical devices (µPADs) for real-time and on-site detection of permethrin. Under optimal settings, no potential environmental contaminants interfere with permethrin detection, confirming its high selectivity. Finally, the practical applicability of sensors is confirmed in real tomato and apple extract samples. The US environmental protection agency's recommended UPLC method validated the detection efficiency of the proposed colorimetric sensor. The % recoveries from UPLC and MTZ-AgNPs suggest that the present sensor can quantitatively analyze permethrin in real samples.

Idiopathic unilateral third nerve palsy with pupillary sparring in 10-year-old child -a case report.

Introduction and importance: Aneurysm, diabetes mellitus, central nervous system (CNS) infections, pituitary tumors, and ischemia alterations are all potential causes of unilateral oculomotor nerve palsy, a common clinical disease. Case presentation: A 10-year-old child presented with right eyelid ptosis and restricted eye movements associated with diplopia and pain in the right eye. Brain imaging and laboratory tests revealed no obstruction, infection, or hypercoagulable state. The condition was labeled as idiopathic. A patient was diagnosed with ptosis through a sling procedure and after 2 and 4 weeks of follow-up was told he had mild anemia. The patient was prescribed ferrous sulfate 8mg once daily for 4 months and his condition improved. Clinical discussion: Surgery can correct the appearance of crossed eyes, but it seldom restores or significantly improves binocular function. Amblyopia and the loss of binocular vision can occur in children with third nerve palsy due to the excessive angle of incitant strabismus and the resulting ptosis. Conclusion: Patients with idiopathic third nerve palsy must be informed of their prognosis so that they can make an informed decision about whether or not to undergo surgery. Clinical examination is the only way to identify a child's condition and proper investigations and a full history of prenatal and antenatal courses are required.

Exploration of Effects of Graduated Compression Stocking Structures on Performance Properties Using Principal Component Analysis: A Promising Method for Simultaneous Optimization of Properties.

This paper focuses on the comfort properties of graduated and preventive compression stockings for people who work long hours in standing postures and for athletes for proper blood circulation. The present study was conducted in order to investigate the effects of the yarn insertion density and inlaid stitches on the performance of the compression stockings. The effects of these parameters on the thermo-physiological comfort properties were tested with standard and developed methods of testing. All compression stockings were maintained with class 1 pressure as per German standards. The structural parameters of the knitted fabric structures were investigated. The stretching and recovery properties were also investigated to determine the performance properties. The theoretical pressure was predicated using the Laplace's law by testing the stockings' tensile properties. The compression interface pressures of all stockings were also investigated using a medical stocking tester (MST) from Salzmann AG, St. Gallen, Switzerland. Correlation between the theoretical pressures and pressures measured using the MST system were also assessed. The current research used a multi-response optimization technique, i.e., principal component analysis (PCA), to identify the best structure based on the optimalization of the above-mentioned properties. The results also revealed that samples with higher insertion density levels exhibit better comfort properties. The results showed that sample R1 was the best sample, followed by R2 and P. In addition, all developed stocking samples exhibited better comfort properties than the control sample from the market.

MAF1, a repressor of RNA polymerase III-dependent transcription, regulates bone mass.

MAF1, a key repressor of RNA polymerase (pol) III-mediated transcription, has been shown to promote mesoderm formation in vitro. Here, we show that MAF1 plays a critical role in regulating osteoblast differentiation and bone mass. Global deletion of MAF1 (Maf1-/- mice) produced a high bone mass phenotype. However, osteoblasts isolated from Maf1-/- mice showed reduced osteoblastogenesis ex vivo. Therefore, we determined the phenotype of mice overexpressing MAF1 in cells from the mesenchymal lineage (Prx1-Cre;LSL-MAF1 mice). These mice showed increased bone mass. Ex vivo, cells from these mice showed enhanced osteoblastogenesis concordant with their high bone mass phenotype. Thus, the high bone mass phenotype in Maf1-/- mice is likely due to confounding effects from the global absence of MAF1. MAF1 overexpression promoted osteoblast differentiation of ST2 cells while MAF1 downregulation inhibited differentiation, indicating MAF1 enhances osteoblast formation. However, other perturbations used to repress RNA pol III transcription, inhibited osteoblast differentiation. However, decreasing RNA pol III transcription through these perturbations enhanced adipogenesis in ST2 cells. RNA-seq analyzed the basis for these opposing actions on osteoblast differentiation. The different modalities used to perturb RNA pol III transcription resulted in distinct gene expression changes, indicating that this transcription process is highly sensitive and triggers diverse gene expression programs and phenotypic outcomes. Specifically, MAF1 induced genes known to promote osteoblast differentiation. Furthermore, genes that are induced during osteoblast differentiation displayed codon bias. Together, these results reveal a novel role for MAF1 and RNA pol III-mediated transcription in osteoblast fate determination, differentiation, and bone mass regulation.

Ashwagandha as a Unique Cause of Thyrotoxicosis Presenting With Supraventricular Tachycardia.

Ashwagandha root extract (ARE) is a reputed herbal supplement in Ayurvedic medicine for a variety of health conditions. To date, scant attention has been paid to thyrotoxicosis associated with Ashwagandha and it is rarely reported in the literature. We report a 73-year-old female who presented with supraventricular tachycardia, symptoms of hyperthyroidism and significantly low TSH levels, after two years of using ARE as a self-administered treatment for hypothyroidism. Full symptomatic resolution and biochemical improvement ensued upon cessation of the supplement. Though the pathophysiology remains obscure, we hope to promote awareness concerning this rare yet possible side effect of Ashwagandha.

Genetic Spectrum of Syndromic and Non-Syndromic Hearing Loss in Pakistani Families.

The current molecular genetic diagnostic rates for hereditary hearing loss (HL) vary considerably according to the population background. Pakistan and other countries with high rates of consanguineous marriages have served as a unique resource for studying rare and novel forms of recessive HL. A combined exome sequencing, bioinformatics analysis, and gene mapping approach for 21 consanguineous Pakistani families revealed 13 pathogenic or likely pathogenic variants in the genes GJB2, MYO7A, FGF3, CDC14A, SLITRK6, CDH23, and MYO15A, with an overall resolve rate of 61.9%. GJB2 and MYO7A were the most frequently involved genes in this cohort. All the identified variants were either homozygous or compound heterozygous, with two of them not previously described in the literature (15.4%). Overall, seven missense variants (53.8%), three nonsense variants (23.1%), two frameshift variants (15.4%), and one splice-site variant (7.7%) were observed. Syndromic HL was identified in five (23.8%) of the 21 families studied. This study reflects the extreme genetic heterogeneity observed in HL and expands the spectrum of variants in deafness-associated genes.

Beyond bone biology: Lessons from team science.

Today, research in biomedicine often requires the knowledge and technologies in diverse fields. Therefore, there is an increasing need for collaborative team science that crosses traditional disciplines. Here, we discuss our own lessons from both interdisciplinary and transdisciplinary teams, which ultimately ushered us to expand our research realm beyond bone biology.

Repurposing erectile dysfunction drugs tadalafil and vardenafil to increase bone mass.

We report that two widely-used drugs for erectile dysfunction, tadalafil and vardenafil, trigger bone gain in mice through a combination of anabolic and antiresorptive actions on the skeleton. Both drugs were found to enhance osteoblastic bone formation in vivo using a unique gene footprint and to inhibit osteoclast formation. The target enzyme, phosphodiesterase 5A (PDE5A), was found to be expressed in mouse and human bone as well as in specific brain regions, namely the locus coeruleus, raphe pallidus, and paraventricular nucleus of the hypothalamus. Localization of PDE5A in sympathetic neurons was confirmed by coimmunolabeling with dopamine ß-hydroxylase, as well as by retrograde bone-brain tracing using a sympathetic nerve-specific pseudorabies virus, PRV152. Both drugs elicited an antianabolic sympathetic imprint in osteoblasts, but with net bone gain. Unlike in humans, in whom vardenafil is more potent than tadalafil, the relative potencies were reversed with respect to their osteoprotective actions in mice. Structural modeling revealed a higher binding energy of tadalafil to mouse PDE5A compared with vardenafil, due to steric clashes of vardenafil with a single methionine residue at position 806 in mouse PDE5A. Collectively, our findings suggest that a balance between peripheral and central actions of PDE5A inhibitors on bone formation together with their antiresorptive actions specify the osteoprotective action of PDE5A blockade.

Recognition of ischaemia and infection in diabetic foot ulcers: Dataset and techniques.

Recognition and analysis of Diabetic Foot Ulcers (DFU) using computerized methods is an emerging research area with the evolution of image-based machine learning algorithms. Existing research using visual computerized methods mainly focuses on recognition, detection, and segmentation of the visual appearance of the DFU as well as tissue classification. According to DFU medical classification systems, the presence of infection (bacteria in the wound) and ischaemia (inadequate blood supply) has important clinical implications for DFU assessment, which are used to predict the risk of amputation. In this work, we propose a new dataset and computer vision techniques to identify the presence of infection and ischaemia in DFU. This is the first time a DFU dataset with ground truth labels of ischaemia and infection cases is introduced for research purposes. For the handcrafted machine learning approach, we propose a new feature descriptor, namely the Superpixel Colour Descriptor. Then we use the Ensemble Convolutional Neural Network (CNN) model for more effective recognition of ischaemia and infection. We propose to use a natural data-augmentation method, which identifies the region of interest on foot images and focuses on finding the salient features existing in this area. Finally, we evaluate the performance of our proposed techniques on binary classification, i.e. ischaemia versus non-ischaemia and infection versus non-infection. Overall, our method performed better in the classification of ischaemia than infection. We found that our proposed Ensemble CNN deep learning algorithms performed better for both classification tasks as compared to handcrafted machine learning algorithms, with 90% accuracy in ischaemia classification and 73% in infection classification.

Oxytocin regulates body composition.

The primitive neurohypophyseal nonapeptide oxytocin (OXT) has established functions in parturition, lactation, appetite, and social behavior. We have shown that OXT has direct actions on the mammalian skeleton, stimulating bone formation by osteoblasts and modulating the genesis and function of bone-resorbing osteoclasts. We deleted OXT receptors (OXTRs) selectively in osteoblasts and osteoclasts using Col2.3Cre and Acp5Cre mice, respectively. Both male and female Col2.3Cre+:Oxtrfl/fl mice recapitulate the low-bone mass phenotype of Oxtr+/- mice, suggesting that OXT has a prominent osteoblastic action in vivo. Furthermore, abolishment of the anabolic effect of estrogen in Col2.3Cre+:Oxtrfl/fl mice suggests that osteoblastic OXTRs are necessary for estrogen action. In addition, the high bone mass in Acp5Cre+:Oxtrfl/fl mice indicates a prominent action of OXT in stimulating osteoclastogenesis. In contrast, we found that in pregnant and lactating Col2.3Cre+:Oxtrfl/fl mice, elevated OXT inhibits bone resorption and rescues the bone loss otherwise noted during pregnancy and lactation. However, OXT does not contribute to ovariectomy-induced bone loss. Finally, we show that OXT acts directly on OXTRs on adipocytes to suppress the white-to-beige transition gene program. Despite this direct antibeiging action, injected OXT reduces total body fat, likely through an action on OXT-ergic neurons. Consistent with an antiobesity action of OXT, Oxt-/- and Oxtr-/- mice display increased total body fat. Overall, the actions of OXT on bone mass and body composition provide the framework for future therapies for osteoporosis and obesity.

Circulating levels of CD34+ cells predict long-term cardiovascular outcomes in patients on maintenance hemodialysis.

CD34+ cells maintain vascular homeostasis and predict cardiovascular outcomes. We previously evaluated the association of CD34+ cells with cardiovascular disease (CVD) events over 23 months, but long-term CVD outcomes in relation to levels of CD34+ cells in patients on maintenance hemodialysis are unclear. Herein, we analyzed the long-term predictive potential levels of CD34+ cells for CVD outcomes and all-cause mortality. Between March 2005 and May 2005, we enrolled 215 patients on maintenance hemodialysis at Nagoya Kyoritsu Hospital and followed them up to 12.8 years. According to the CD34+ cell counts, patients were classified into the lowest, medium, and highest tertiles. Levels of CD34+ cells were analyzed in association with four-point major adverse CV events (MACEs), CVD death, and all-cause mortality. In univariate analysis age, smoking habit, lower geriatric nutrition risk index, lower calcium × phosphate product, and lower intact parathyroid hormone were significantly associated with the lowest tertile. Whereas, in multivariate analysis, age and smoking habit were significantly associated with the lowest tertile. Among 139 (64.7%) patients who died during a mean follow-up period of 8.0 years, 39 (28.1%) patients died from CVD. Patients in the lowest tertile had a significantly lower survival rate than those in the medium and highest tertiles (p ≤ 0.001). Using multivariable analyses, the lowest tertile was significantly associated with four-point MACEs (hazard ratio 1.80, p = 0.023) and CVD death (hazard ratio 2.50, p = 0.011). In conclusion, our long-term observational study revealed that a low level of CD34+ cells in the circulation predicts CVD outcomes among patients on maintenance hemodialysis.

Elevated FGF23 in a patient with hypophosphatemic osteomalacia associated with neurofibromatosis type 1.

CONTEXT: The mechanism behind hypophosphatemia in the setting of neurofibromatosis type 1 (NF1) is not known. We describe a possible role of fibroblast growth factor-23 (FGF23) in the pathophysiology of hypophosphatemia in a patient with NF1. CASE DESCRIPTION: A 34-year woman with NF1 presented with severe hypophosphatemia, osteomalacia, and elevated plasma FGF23. The patient had considerable improvement on replacement of oral phosphate. Two Ga68 DOTANOC PET-CT scans over a period of 2 years failed to detect any localized uptake. Immuno-staining for FGF23 was absent in the neural-derived tumour cells of the neurofibromas in the proband. CONCLUSION: The patient with NF1 had elevated circulating FGF23. Tumour cells in the neurofibroma tissues did not stain for FGF23 on IHC. It is unlikely for neurofibromas to contribute to high circulating FGF23 levels in the proband.

Higher degrees in nursing: traditional research PhD or professional doctorate?

Doctoral-level study is increasingly popular for clinicians who wish to advance their clinical, research and academic career pathways. A range of alternatives to the traditional PhD are now well-established. This article aims to outline the different approaches and discuss some advantages and drawbacks of doctoral-level postgraduate study. By comparing the various doctoral programmes, the authors seek to clarify the issues for clinicians who may wish to embark on a future doctorate. Primary clinical or medical degrees are not discussed.