Unraveling the Narrow Alley: A Case Report of Groove Pancreatitis.

Groove pancreatitis, a rare subtype of chronic pancreatitis, predominantly affects middle-aged men with a history of alcohol abuse. We present a unique case of a 31-year-old female with minimal alcohol consumption. Imaging revealed characteristic findings consistent with groove pancreatitis. Despite its rarity in young females, clinical suspicion led to the appropriate diagnosis and conservative management, resulting in symptomatic resolution. This case underscores the importance of recognizing atypical presentations of groove pancreatitis, emphasizing the necessity of tailored diagnostic approaches, and highlighting the efficacy of conservative management in achieving favorable outcomes, particularly in non-typical demographics.

Correction: Facile fabrication of a graphene-based chemical sensor with ultrasensitivity for nitrobenzene.

[This corrects the article DOI: 10.1039/D3RA08794H.].

Fabrication of Multifunctional Tents Using Canvas Fabric.

Herein, this study was compiled to investigate a suitable solution for the fabrication and development of the multifunctional defense tent from previously reported research. The military always needs to protect their soldiers and equipment from detection. The advancement of infrared detection technology emphasizes the significance of infrared camouflage materials, reducing thermal emissions for various applications. Objects emit infrared radiation detectable by devices, making military targets easily identifiable. Infrared camouflage mitigates detection by lowering an object's infrared radiation, achieved by methods such as reducing surface temperature, which is crucial in designing military tents with infrared (IR) camouflage, considering water repellency and antibacterial features. Water repellency, as well as antimicrobial properties, in army tents is also important as they have to survive in different situations. All these problems should be addressed with the required properties; therefore, the authors try to introduce a new method from which multifunctional tents can be produced through economical, multifunctional, and sustainable materials that have IR protection, water repellency, ultraviolet (UV) protection, air filtration and permeability, and antimicrobial properties. There is still no tent that performs multiple functions at a time, even those functions that do not correlate with each other such as water repellency, IR protection, antimicrobial, and air permeability. So, a multifunctional tent could be the solution to all these problems having all the properties discussed above. In this study based on the literature review, authors concluded a method for the required tent for canvas fabric coated with zinc sulfide (ZnS), graphene oxide (GO), and zinc oxide (ZnO), or these materials should be incorporated in fiber formation because fiber composition has more impact. These multifunctional tents will be very beneficial due to their multifunctions like weather resistance, durability, and long life. These would help the army in their missions by concealing their soldiers and equipment from detection by cameras and providing filtered air inside the tent in case of gases or explosions. The proposed method will help to fulfill the stated and implied needs of customers.

Mapping the Meltdown Behavior of Frozen Dairy Desserts.

The meltdown test is an efficient tool widely and commonly used to characterize structural changes in frozen desserts resulting from different ingredients and processing conditions. The meltdown is commonly determined by a gravimetric test, and it is used to obtain the onset (Mon), rate (Mrate), and maximum (MMax) meltdown. However, these parameters are calculated ambiguously due to the inconsistency in the methodology. This work aims at modeling the meltdown curves (weight vs time) of different commercial samples (36 commercial samples). Samples of commercial frozen desserts (40-60 g) was placed on a 304 stainless wire cloth (1.50 mm opening size and 52% open area) suspended about 15 cm above of an analytical balance, and the dripped portion of the melted ice cream was continuously recorded throughout the duration of the test. The meltdown test was conducted at room temperature. Each meltdown test generated more between 3000 to 4000 data points and was modeled using 4 equations: The logistic model, the Gompertz model, the Richard model, and the Hill model. All the meltdown curves were sigmoidal in shape, regardless of the type of frozen dessert. The experimental meltdown curves were adequately represented by the Logistic model, judging by several criteria (R2 = 0.999, adjusted RAdj2 = 0.999, Akaike probability = 6582, and F-value = 1.88 × 106). Thus, the Logistic model was shown to be an effective tool for predicting the meltdown curves of frozen desserts, and it can be used to define unambiguously the onset, rate, and maximum meltdown. Moreover, a dimensionless response (meltdown behavior, MBe) that combines Mon, Mrate, and MMax was developed and used for mapping the meltdown of different commercial frozen desserts.

Chest Pain Redefined: Atypical Presentation of Superior Mesenteric Artery Syndrome.

Superior mesenteric artery (SMA) syndrome is a rare cause of small bowel obstruction characterized by duodenal compression due to the narrowing of the SMA-aorta angle. We present a case of a 43-year-old male with postprandial chest pain, severe weight loss, and a narrowed aortomesenteric angle evident on computed tomography. Conservative management, including hydration, positioning, and weight gain, was initiated, leading to symptom resolution. SMA syndrome diagnosis requires clinical suspicion and radiological confirmation. Understanding this syndrome's varied presentations, diagnostic challenges, and therapeutic approaches is crucial for prompt management, especially when atypical symptoms like chest pain manifest, as seen in our case.

Facile fabrication of a graphene-based chemical sensor with ultrasensitivity for nitrobenzene.

Chemical sensors have a wide range of applications in a variety of industries, particularly for sensing volatile organic compounds. This work demonstrates the fabrication of a chemical sensor based on graphene deposited on Cu foils using low-pressure chemical vapor deposition, following its transfer on oxidized silicon through a wet etching method. Scanning electron microscopy, Raman spectroscopy and UV-vis spectroscopy of the transferred graphene were performed. A device was fabricated by simply connecting the strips of a Cu tape along the two opposite edges of graphene, which acted as a chemical sensor. The sensor was exposed to different analytes, namely acetone, propanol, benzyl chloride, nitrobenzene, carbon tetrachloride and acetic acid. A relative change in the resistance of the device was observed, which was attributed to the interaction of analytes with graphene as it changes charge concentrations in the graphene lattice. The fabricated sensor showed a notable sensitivity and response time for all analytes, particularly a sensitivity as high as 231.1 for nitrobenzene and a response time as short as 6.9 s for benzyl chloride. The sensor was also tested for analyte leakage from containers for domestic, laboratory and industrial applications.

A Rare Association of Epstein-Barr Virus and Budd-Chiari Syndrome.

Budd-Chiari syndrome (BCS) is a rare hepatic venous outflow obstruction typically associated with hypercoagulable states. We present a unique case of a 29-year-old male with BCS triggered by a recent Epstein-Barr virus (EBV) infection. Workup unveiled antiphospholipid antibody syndrome as an underlying prothrombotic condition. Diagnostic challenges included inconclusive ultrasound findings, necessitating magnetic resonance imaging for confirmation. This case underscores the importance of considering infectious triggers for venous thromboembolism in BCS. Understanding the potential link between EBV and thrombosis warrants further investigation.

Response Surface Methodology (RSM) approach to formulate and optimize the bilayer combination tablet of Tamsulosin and Finasteride.

An orally administered bilayer tablet with Tamsulosin (TAM) as the sustained release (SR) and Finasteride (FIN) as immediate release (IR) was manufactured. A response surface methodology was employed to formulate bilayer tablets with individual release layers, i.e., sustained and immediate release (SR and IR). Independent variables selected in both cases comprise hydroxypropyl methylcellulose (HPMC) as SR polymer, and avicel PH102 in the inner layer while Triacetin and talc in the outer layer, respectively. Tablets were prepared by direct compression, a total of 11 formulations were prepared for inner layer TAM, and 9 formulations for outer layer FIN were designed; these formulations were evaluated for hardness, friability, thickness, %drug content, and %drug release. A central composite design was employed in response surface methodology to design and optimize the formulation. The percentage of drug released was evaluated by in-vitro USP dissolution method of optimized formulation for 0.5, 2, and 6 hrs, and results were 24.63, 52.96, and 97.68 %, respectively. Drug release data was plotted in various kinetic models using a D.D solver, where drug release was first order that is concentration dependent and was best explained by Korsmeyer-Peppa kinetics, as the highest linearity was observed (R2 = 0.9693). However, a very close relationship was also noted with Higuchi kinetics (R2 = 0.9358). The mechanism of drug release was determined through the Korsmeyer model, and exponent "n" was found to be 0.4, indicative of an anomalous diffusion mechanism or diffusion coupled with erosion.

Comparison of Pakistani CKD-EPI, new Asian-modified CKD-EPI and revised Lund-Malmö study equations in a South Asian CKD population: a study from a Pakistani CKD cohort.

BACKGROUND: Newly proposed estimating glomerular filtration rate equations need to be studied, evaluated and compared for chronic kidney disease staging, diagnosis and medication dosing in South Asians. The objectives of the study were (1) to assess the performance of the CKD-EPIPK, CKD-EPIAsian-Modified, and LMRevised equations in the Pakistani chronic kidney disease population, and (2) to investigate prospective implications on chronic kidney disease classification and end-stage kidney disease prevalence. METHODS: We conducted a cross-sectional analysis on a chronic kidney disease cohort of 385 participants 18 years of age or above. RESULTS: CKD-EPIPK showed the lowest bias (- 1.33 ml/min/1.73 m2), highest precision [IQR, 2.33 (- 2.36, - 0.03)] and enhanced P30 accuracy (89.35%) compared to the CKD-EPIAsian-Modified and LMRevised equations. The mean difference (ml/min/1.73 m2), 95% limit of agreement (ml/min/1.73 m2) of the equations were; CKD-EPIAsian-Modified: - 5.98, - 13.03, LMRevised: - 4.06, - 8.13 and CKD-EPIPK: - 1.18, - 6.14 (P < 0.001). CKD-EPIAsian-Modified and LMRevised showed upward re-classification of the GFR categories compared to the CKD-EPIPK equation except in the G5 category where the highest count (217, 56.36%) was noted for the CKD-EPIPK equation. End-stage kidney disease prevailed in all age groups according to all equations, and the prevalence was high in females in all equations. CONCLUSION: CKD-EPIPK showed the best performance, whereas both CKD-EPIAsian-Modified and LMRevised showed poor performance and did not offer a sufficient advantage in chronic kidney disease classification and end-stage kidney disease prevalence estimation over CKD-EPIPK. Hence, CKD-EPIPK seems ideal for South Asians, thus appropriate measures should be taken for its implementation, at least in Pakistani laboratories.

Solid lipid nanoparticles: a versatile approach for controlled release and targeted drug delivery.

Solid Lipid Nanoparticles (SLN), the first type of lipid-based solid carrier systems in the nanometer range, were introduced as a replacement for liposomes. SLN are aqueous colloidal dispersions with solid biodegradable lipids as their matrix. SLN is produced using processes like solvent diffusion method and high-pressure homogenization, among others. Major benefits include regulated release, increased bioavailability, preservation of peptides and chemically labile compounds like retinol against degradation, cost-effective excipients, better drug integration, and a broad range of applications. Solid lipid nanoparticles can be administered via different routes, such as oral, parenteral, pulmonary, etc. SLN can be prepared by using high shear mixing as well as low shear mixing. The next generation of solid lipids, nanostructured lipid carriers (NLC), can reduce some of the drawbacks of SLN, such as its restricted capacity for drug loading and drug expulsion during storage. NLC are controlled nanostructured lipid particles that enhance drug loading. This review covers a brief introduction of solid lipid nanoparticles, manufacturing techniques, benefits, limitations, and their characterization tests.

Clinical and Genetic Description of Hereditary Chronic Pancreatitis in Pakistani Children.

BACKGROUND/AIMS: The purpose of this study was to identify the spectrum and frequency of pathogenic variants as well as the clinical and genetic insight of hereditary chronic pancreatitis in Pakistani children. MATERIALS AND METHODS: The deoxyribonucleic acid of affected probands of 44 unrelated Pakistani families, having hereditary chronic pancreatitis-affected children, were subjected to massive parallel sequencing for candidate reported genes (SPINK1, PRSS1, CFTR, CPA1, CTRC, CBS, AGL, PHKB, and LPL). Data were analyzed using different bioinformatics tools for the variants and in-silico analysis. All the identified variants were validated by direct sequencing of the targeted exons in the probands and their parents. RESULTS: There were 50 patients included in this study with confirmed hereditary chronic pancreatitis. Nine known mutations in SPINK1, PRSS1, CFTR, CTRC, CBS, and AGL genes, and 10 novel variants in LPL, CFTR, CTR, and PHKB genes were identified. The identified variants were found in heterozygous, compound heterozygous, and trans-heterozygous forms, with rare allele frequency in the normal population. The novel variants were [c.378C>T(p.Lys126Asn) and c.719G>A(p.Arg240Gln) in CTRC, c.586-3C>A and c.763A>G(p.Arg255Gly) in CPA1, c.1160_1161insT(p.Lys387Asnfs*26), c.784C>T(p.Gln262*), c.1139+1G>A, c.175G>A(p.Gly59Arg) in LPL, c.388C>G(p.leu130val) in CFTR, and c.2327G>A(p.Arg776His in PHKB)]. The phenotypic characteristics were variable and correlated with the relevant variant. CONCLUSIONS: The genetic composition plays a significant role in the predisposition of hereditary chronic pancreatitis. The clinical presentation varies with the genetic determinant involved. This information would help in building up a diagnostic algorithm for our population that can be used for genetic screening services in affected cohorts.

An unprecedented route to achieve persistent 1H-azirine.

1H-azirine, a highly reactive, antiaromatic, and unstable tautomer of the aromatic, stable, and (sometimes) isolable 2H-azirine, is stabilized, both thermodynamically and kinetically, via an unprecedented route, where the latter serves as the precursor-exploiting electronic and steric elements. Our density functional theory results invite experimentalists to realize isolable 1H-azirine.

A Case Series Demonstrating the Difficulties in Diagnosing COVID-19 Associated Pulmonary Aspergillus.

Many bacterial, viral, and fungal co-infections have been reported with COVID-19-associated acute respiratory distress syndrome (ARDS). Invasive Aspergillosis has been described with COVID-19 ARDS. However, it continues to evade diagnosis in critically ill patients admitted to the intensive care unit (ICU). The difficulty is discerning an actual infection from colonization. Unfortunately, a timely diagnosis is crucial since COVID-19-associated pulmonary Aspergillus (CAPA) has high morbidity and mortality. We present three ICU cases of CAPA to illustrate the difficulty in diagnosing and treating the disease. We hope to bring awareness and improve patient outcomes of CAPA.

Cause or Coincidence: A Case of Necrotizing Pancreatitis in the Setting of Herpes Simplex Virus Infection.

This study explores a rare occurrence of acute pancreatitis induced by herpes simplex virus (HSV) in an immunocompetent adult. The patient, initially diagnosed with pancreatitis presumed to be gallstone-related, exhibited persistent symptoms and elevated lipase levels. Endoscopic ultrasound revealed necrotizing pancreatitis without stones, prompting suspicion of an atypical cause. Subsequent serology confirmed acute HSV infection. This case underscores the importance of considering viral etiologies in atypical pancreatitis cases, especially when hepatitis coexists. The study contributes to the limited literature on HSV-induced pancreatitis in immunocompetent individuals, emphasizing the significance of early recognition and appropriate management in the absence of typical risk factors.

Geographic accessibility to childhood tuberculosis care in Pakistan.

BACKGROUND: Tuberculosis (TB) in children is difficult to detect and often needs specialists to diagnose; the health system is supposed to refer to higher level of health care when diagnosis is not settled in a sick child. In Pakistan, the primary health care level can usually not diagnose childhood TB and will refer to a paediatricians working at a secondary or tertiary care hospital. We aimed to determine the health services access to child TB services in Pakistan. OBJECTIVE: We aimed to determine the geographical access to child TB services in Pakistan. METHOD: We used geospatial analysis to calculate the distance from the nearest public health facility to settlements, using qGIS, as well as population living within the World Health Organization's (WHO) recommended 5-km distance. RESULT: At primary health care level, 14.1% of facilities report child TB cases to national tuberculosis program and 74% of the population had geographical access to general primary health care within 5-km radius. To secondary- and tertiary-level health care, 33.5% of the population had geographical access within 5-km radius. The average distance from a facility for diagnosis of childhood TB was 26.3 km from all settlement to the nearest child TB sites. The population of one province (Balochistan) had longer distances to health care services. CONCLUSION: With fairly good coverage of primary health care but lower coverage of specialist care for childhood TB, the health system depends heavily on a good referral system from the communities.

An Unusual Case of Hemorrhagic Pleuropericarditis After COVID-19 Vaccination.

As coronavirus disease 2019 (COVID-19) vaccines are being increasingly administered worldwide, subsequent side effects, such as myocarditis, pericarditis, and myopericarditis, are becoming increasingly more common. Our case describes a 64-year-old male who developed chest pain and shortness of breath one week after receiving the Moderna (Cambridge, Massachusetts) COVID-19 mRNA vaccine. He was found to have a large, left-sided pleural effusion and a small pericardial effusion. The patient underwent thoracentesis and video-assisted thoracoscopic procedure with chest tube placement, which drained bloody pleural and pericardial fluid. He was treated with a course of colchicine. Subsequent imaging revealed the resolution of pericardial and pleural effusions, along with the resolution of symptoms.

Synthesis of Chemically Cross-Linked pH-Sensitive Hydrogels for the Sustained Delivery of Ezetimibe.

In recent years, pH-sensitive hydrogels have been developed for the delivery of therapeutic agents to specific target sites that have a defined pH range. The use of pH-responsive polymers in hydrogels allows drug delivery to the desired pH range of the target organ. The primary aim is to increase the retention time of the drug in the small intestine by utilizing the swelling mechanism of the hydrogel at intestinal pH. In this study, polyethylene glycol (PEG) was used as a polymer to formulate a pH-sensitive hydrogel of Ezetimibe to deliver the drug to the small intestine where it inhibits the absorption of cholesterol. Design Expert software was applied to design and optimize the trial formulations in order to obtain an optimized formulation that has all the desired characteristics of the hydrogels. The PEG/Acrylic Acid hydrogels showed the maximum swelling at pH 6.8, which is consistent with the pH of the small intestine (pH 6-7.4). The maximum entrapment efficiency of the hydrogels was 99%. The hydrogel released 80-90% of the drug within 24 h and followed first-order release kinetics, which showed that the release from the drug was sustained. Hence, the results showed that the choice of a suitable polymer can lead to the development of an efficient drug-loaded hydrogel that can deliver the drug at the specific pH of the target organ.

Efficient designing of half-moon-shaped chalcogen heterocycles as non-fullerene acceptors for organic solar cells.

One key strategy to further improve the power conversion efficiency (PCE) of organic solar cells (OSCs) is to incorporate various complementary functional groups in a molecule. Such strategies proved attractive for tuning the photovoltaic performances of the materials and can show a much higher absorption phenomenon with narrower band gaps. Despite the outstanding benefits, materials selection and their efficient modeling is also an extremely challenging job for the development of OSCs materials. In this manuscript, we proficiently developed an efficient series of small molecule-based non-fullerene acceptors (SM-NFAs) SN1-SN9 for OSCs and characterized by density functional theory (DFT) and time-dependent DFT (TD-DFT). The characteristics required to estimate electron and hole mobility, and open-circuit voltage (Voc) were investigated by optimizing the geometrical parameters, absorption spectra, exciton binding energy, frontier molecular orbitals (FMOs), electronic structures, and charge transfer rates. The outcomes of these materials showed that all newly constructed small-molecule-based non-fullerene acceptors exhibit broader and better absorption efficiency (λmax = 761 to 778 nm) and exciton dissociation, while much lower LUMO energy levels which may help to enhance the reorganizational energies. Further, a narrow bandgap also offers better photovoltaic properties. Hence, the designed molecules exhibited narrow bandgap values (Eg = 2.82 to 2.98 eV) which are lower than that of the reference molecule (3.05 eV). High Voc and photocurrent density values with lower excitation and binding energies eventually increase the PCEs of the OSC devices. The obtained results have shown that designed molecules could be effective aspirants for high-performance OSCs.

Ab Initio Study of Two-Dimensional Cross-Shaped Non-Fullerene Acceptors for Efficient Organic Solar Cells.

In the present work, five novel non-fullerene acceptor molecules are represented to explore the significance of organic solar cells (OSCs). The electro-optical properties of the designed A-D-A-type molecules rely on the central core donor moiety associated with different halogen families such as fluorine, chlorine, and bromine atoms and acyl, nitrile, and nitro groups as acceptor moieties. Among these, M1 exhibits the maximum absorption (λmax) at 728 nm in a chloroform solvent as M1 has nitro and nitrile groups in the terminal acceptor, which is responsible for the red shift in the absorption coefficient as compared to R (716 nm). M1 also shows the lowest value of the energy band gap (2.07 eV) with uniform binding energy in the range of 0.50 eV for all the molecules. The transition density matrix results reveal that easy dissociation of the exciton is possible in M1. The highest value of the dipole moment (4.6 D) indicates the significance of M4 and M2 in OSCs as it reduces the chance of charge recombination. The low value of λe is given by our designed molecules concerning reference molecules, indicating their enhanced electron mobility. Thus, these molecules can serve as the most economically efficient material. Hence, all newly designed non-fullerene acceptors provide an overview for further development in the performance of OSCs.

Theoretical Study on Reaction Mechanisms of Dinitrogen Activation and Coupling by Carbene-Stabilized Borylenes in Comparison with Intramolecular C-H Bond Activation.

Dinitrogen (N2 ) activation is particularly challenging due to the significantly strong N≡N bond, let alone the catenation of two N2 molecules. Recent experimental study shows that cyclic (alkyl)(amino)carbene (CAAC)-stabilized borylenes are able to tackle N2 activation and coupling below room temperature. Here we carry out density functional theory calculations to explore the corresponding reaction mechanisms. The results indicate that the reaction barrier for the dinitrogen activation by the first borylene is slightly higher than that by the second borylene. In addition, replacing the CAAC moiety of the borylenes with cyclic diaminocarbenes (CDACs) could make such dinitrogen activation and coupling more favorable thermodynamically. The reaction mechanisms of the intramolecular C-H bond activation of borylene have also been discussed, which is found to be favorable both thermodynamically and kinetically in comparison with N2 activation. Thus, adequate attention should be paid to the design of borylenes aiming at N2 activation. In addition, our calculations suggest that the CDAC moiety of the borylene could lead to a different product in terms of intramolecular C-H bond activation. All these findings could be useful for the development of dinitrogen activation as well as C-H bond activation by main group species.