A DFT approach towards understanding the thermal stability of TKX-50 and their key precursors through band gaps and MESP.

TKX-50 (dihydroxylammonium 5,5'-bistetrazolate-1,1'-dioxide) is a recent time invention by Klapotke et. al. in the field of high energy materials, and it outperforms all the existing materials by means of performance parameters. It is rising as potential energetic material due to favorable thermal insensitivity, low toxicity and safe handling. The decomposition temperature (Tmax) values of precursors such as glyoxime (I), 1,2-dichloroglyoxime (II), 1,2-diazidoglyoxime (III), and bistetrazoledihydroxide (IV) and ending products TKX-50 (V) and ABTOX (VI) have been attempted to correlate with the results obtained from molecular electrostatic potentials and band gaps calculated from the difference of ionization potential and electron affinity. The molecular electrostatic potential values of azido attached -NO group of III are much less than that of hydro/chloro attached -NO group of I/II and that of tetrazole groups IV, V, and VI. The band gaps calculated from stability trend in the increasing order of III < II < I < IV < V < VI are well corroborated with stability trend drawn from experimentally determined decomposition temperatures. Further, employing conceptual density functional theory (DFT) molecular descriptors, band gap values were calculated via the difference of ionization potential and electron affinity to understand the thermal stability of TKX-50, ABTOX, and its precursors.

Comparison of INSAT-3D retrieved total column ozone with ground-based and AIRS observations over India.

Ozone plays an important role in the thermal structure and chemical composition of the atmosphere. The present study compares the temporal and spatial distributions of Total Column Ozone (TCO) over the Indian sub-continent retrieved from a geostationary Indian National Satellite (INSAT-3D) and Atmospheric Infrared Sounder (AIRS). The INSAT-3D TCO values are also evaluated against the Dobson spectrophotometer observations at two locations. The inter-comparison results reveal a good correlation of 0.8, the bias of -5 DU, and Root Mean Square Error (RMSE) of 15 DU approximately between the TCO retrieved from INSAT-3D and AIRS. The lowest RMSE and highest correlation coefficient were found in the pre-monsoon season. The INSAT-3D and AIRS show reasonable agreement with the RMSE varying between 10 and 30 DU. On the other hand, evaluation of the INSAT-3D TCO with the ground-based observations from Dobson spectrophotometers located at New Delhi and Varanasi showed fair agreement with a maximum monthly mean correlation coefficient of 0.68 and 0.76, respectively, and RMSE varying from 11 to 16 DU for both the stations. The seasonal distribution of TCO and its variation over the Indian region has also been studied using INSAT-3D and AIRS data. The analysis exhibits strong seasonal variations, with higher values in pre-monsoon season and minimum values in winter season. The noticeable seasonal variability of TCO can be attributed to complex combination of photochemical and dynamical processes in the troposphere and stratosphere. The main objectives of the study are to compare the INSAT-3D TCO with two independent ground-based Dobson spectrophotometer observations and Atmospheric Infrared Sounder (AIRS) aboard NASA's Aqua satellite.

Complete remission with immunotherapy: Case report of a patient with metastatic bladder cancer to the humerus.

Bladder cancer is the sixth most common malignancy in the United States. Cisplatin combination regimens are first line therapy for patients with metastatic urothelial bladder cancer who are eligible candidates and no treatments have shown to improve outcome compared to chemotherapy for the past 20 years. Significant advances were made in past 2-3 years and the most significant was the introduction of checkpoints inhibitors in bladder cancer treatment. We present a patient diagnosed with metastatic urothelial carcinoma who progressed while on cisplatin/gemcitabine chemotherapy in the form of oligometastasis to the bone. He has achieved a durable complete response with atezolizumab.

Understanding the relationship between soil properties and litter chemistry in three forest communities in tropical forest ecosystem.

In this study, we investigated the relationship between soil properties and litter chemistry in three forest communities, i.e., Sal mixed forest (SMF), dry mixed forest (DMF), and teak plantation forest (TPF), in tropical deciduous forest ecosystem in North India. Fresh leaf litter and soil samples were collected at two soil depths (0-15 and 15-30 cm) from all these three forest communities. Litter bag experiment was also conducted to know differences in litter nutrients after its decomposition. The concentrations (mg kg-1) of different nutrients such as sodium (Na) 2.6, potassium (K) 38.5, calcium (Ca) 425, and carbon (C) 45.54% were highest in fresh litter collected from DMF. Total organic carbon (g kg-1) was significantly higher in SMF (19.23) in comparison to DMF (18.41) and TPF (13.61) at 0-15-cm soil depth. Na, K, Ca, available P, total P, available N, and total N were highest in DMF soil. We observed significantly positive correlation between all nutrients of litter and soil. Although soil bulk density (BD) and particle density (PD) showed their significant negative correlation with litter C, total porosity was positively correlated. Similarly, litter Na has its significant negative correlation with BD and positive correlation with PD. The litter chemistry played a significant role in changing soil pH and TOC. All litter nutrients, except total P, have their significant positive correlation with soil pH. Total P, C, and N of litter have their significant positive correlation with total soil organic carbon. This indicates that litter chemistry and soil properties have specific relation among them despite unique species composition in each forest community.

Interaction of abiotic factor on soil CO2 efflux in three forest communities in tropical deciduous forest from India.

Environmental factors along with soil physico-chemical properties play a significant role on the diurnal trend of soil CO2 efflux. Soil CO2 efflux in Indian tropical forests is poorly studied. We studied the soil CO2 efflux in a representative tropical deciduous forest at Katerniaghat Wildlife Sanctuary (KWLS), Uttar Pradesh. The three forest communities namely dry mixed (DMF), Sal mixed (SMF), and Teak plantation (TPF) were selected for measuring soil CO2 efflux in the summer season during April to May 2017 using automated LI-COR 8100 soil CO2 flux system. Soil physico-chemical parameters were also studied in the three abovementioned forest communities. We also measured the different microclimatic variables at forest understorey in all three communities during the summer season. Total day time soil CO2 efflux of 826.70, 1089.24, and 828.94 (µmolCO2 m-2d-1) was observed in TPF, SMF, and DMF respectively. Soil CO2 efflux observed significant differences (P < 0.01) among the three forest communities studied for the summer season in tropical deciduous forest of Terai Himalaya. Average soil CO2 efflux rate (µmol CO2 m-2 s-1) of 4.06 ± 0.36, 5.03 ± 0.45, and 4.37 ± 0.79 was observed in TPF, SMF, and DMF, respectively, which is positively correlated with total organic carbon (TOC) and water holding capacity (WHC) among soil physico-chemical variables. Among microclimatic variables, soil temperature (ST, °C) and air temperature (AT, °C) observed strong positive correlation with day time soil CO2 efflux in all three communities. Significant increase in soil CO2 flux was observed with increasing air and soil temperature (AT and ST) in DMF and SMF. Maximum TOC of 19.23 g Kg-1 was observed in SMF among all communities in the summer season. The result showed that soil CO2 efflux is closely associated with TOC, WHC, AT, and ST for Indian deciduous forest ecosystems.

Assessment of arterial elasticity among HIV-positive participants with high CD4 cell counts: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.

OBJECTIVES: Both HIV infection and antiretroviral therapy (ART) may increase cardiovascular disease (CVD) risk. Assessments of vascular function and structure can be used to study the pathogenesis and progression of CVD, including the effects of ART and other interventions. The objective of this report is to understand methods to assess vascular (dys)function and report our experience in the Arterial Elasticity Substudy in the Strategic Timing of AntiRetroviral Treatment (START) trial. METHODS: We review literature and analyze baseline data from the Arterial Elasticity Substudy, which estimated vascular (dys)function through analysis of the diastolic blood pressure (BP) waveform. Linear regression was used to study cross-sectional associations between baseline clinical factors and small or large arterial elasticity. RESULTS: Arterial elasticity measurement was chosen for its improved measurement reproducibility over other methodologies and the potential of small arterial elasticity to predict clinical risk. Analysis of baseline data demonstrates that small artery elasticity is impaired (lower) with older age and differs by race and between geographical regions. No HIV-specific factors studied remained significantly associated with arterial elasticity in multivariate models. CONCLUSIONS: Longitudinal analyses in this substudy will provide essential randomized data with which to study the effects of early ART initiation on the progression of vascular disease among a diverse global population. When combined with future biomarker analyses and clinical outcomes in START, these findings will expand our understanding of the pathogenesis of HIV-related CVD.

Acute and chronic immune biomarker changes during interferon/ribavirin treatment in HIV/HCV co-infected patients.

Chronic viral infections lead to persistent immune activation, which is alleviated by eradicating or suppressing the infection. To understand the effects of interferon treatment on immune system activation by chronic infections, we evaluated kinetic patterns of a broad spectrum of serum biomarkers during HCV treatment in HIV/HCV co-infected patients. HCV viral load and 50 biomarkers were analysed at baseline and 27 time points during pegylated interferon-alpha and ribavirin (IFN/RBV) treatment of 12 HIV/HCV co-infected patients. We evaluated biomarker changes from baseline for each time point and biomarker correlations with clinical parameters, treatment response and liver histopathology. IL-1α, IL-12p40, IL-1RA, IP-10, MIG, MIP-1α/1ß, HGF, sCD40L, TRAIL and leptin increased in the first day. IL-12p70, IL-17A, IL-10, GROα, IL-8, MCP-3, IL-4 and M-CSF peaked later during week 1. IL-1α, HGF, IP-10, MIP-1α, TRAIL, sCD40L, IL-10, IL-12p70, MCP-3, FGFb, ENA-78, TGF-ß, IL-2, IFN-γ, IL-6, IL-15, IL-7 and PDGF-BB decreased below baseline over the course of treatment. Higher BMI, baseline HCV viral load and leptin levels were associated with lack of sustained virologic response. ENA-78 was associated with sustained viral response. Positive correlations were found between liver inflammation and baseline CD4 count, sVCAM and HGF; fibrosis stage and HGF; liver steatosis, BMI and leptin. Our findings suggest IFN/RBV treatment initially increases levels of several biomarkers, but eventually leads to a decline in many immune markers. These findings shed light on the relationship between IFN treatment and immune activation by chronic viral infections, such as HCV.

Knowledge and attitudes about hepatitis C virus (HCV) infection and its treatment in HCV mono-infected and HCV/HIV co-infected adults.

Hepatitis C virus (HCV) treatment is rapidly changing but little is known about patients' attitudes and knowledge about HCV. This study used a cross-sectional survey to examine the relationship between HCV knowledge and attitudes towards HCV in patients with HCV mono-infection and HIV/HCV co-infection. Subsequently, an education intervention was developed with an abridged version of the cross-sectional survey administered before and after the education session to assess changes in knowledge and attitudes. 292 people participated in the cross-sectional survey, and 87 people participated in the education intervention. In the cross-sectional survey, the mean knowledge score regarding HCV was low (<50% of the total possible score). Mono-infected and co-infected individuals shared similar knowledge deficits and attitudes towards HCV despite having distinct demographic differences. Attitudes endorsed by patients included the following: 57% feared the consequences of HCV on their life, 37% felt HCV was not fatal, 27% did not believe they needed HCV medication, 21% felt ashamed of having HCV and 16% felt HCV treatment was not important. Attitudes that reflected indifference and shame towards HCV were associated with lower knowledge scores (HCV knowledge score of 15.1 vs. 17.5, P < 0.01 for indifference and 15.3 vs. 17.2 for shame, P = 0.02). The education intervention improved knowledge scores but did not modify the assessed attitudes. Intervention studies are needed to effectively change attitudes towards HCV infection and treatment.

Pedicled buccal fat pad in the management of oroantral fistula: a clinical study of 15 cases.

This study evaluated the long term effectiveness of pedicled buccal fat pad (BFP) with or without buccal advancement flap in the closure of oroantral fistula (OAF). A prospective clinical study involving 15 patients with chronic OAF was carried out. All cases were managed with pedicled BFP as the primary or secondary procedure. Cases with doubtful outcome were closed in two layers using BFP along with buccal advancement flap. Cases were followed for 3 months (1, 4, 8 and 12 weeks) to evaluate any postoperative complications such as wound dehiscence, necrosis or infection. Females (66.7%) in their third to fourth decade were commonly affected in the right posterior region (75%). Dental extraction (73.3%) followed by maxillofacial pathology was the most common causes for developing OAF. Only 2 of 15 cases were closed in two layers. Complete epithelialisation of all the cases was observed with no postoperative complications. Pedicled BFP is an effective and reliable flap for the repair of OAF. Cases of larger oral defects with doubtful outcome can be closed in two layers using BFP along with buccal advancement flap.

Kruppel-like factor 2 (KLF2) regulates monocyte differentiation and functions in mBSA and IL-1ß-induced arthritis.

Kruppel-like factor 2 (KLF2) plays an important role in the regulation of a variety of immune cells, including monocytes. We have previously shown that KLF2 inhibits proinflammatory activation of monocytes. However, the role of KLF2 in arthritis is yet to be investigated. In the current study, we show that recruitment of significantly greater numbers of inflammatory subset of CD11b(+)F4/80(+)Ly6C+ monocytes to the inflammatory sites in KLF2 hemizygous mice compared to the wild type littermate controls. In parallel, inflammatory mediators, MCP-1, Cox-2 and PAI-1 were significantly up-regulated in bone marrow-derived monocytes isolated from KLF2 hemizygous mice, in comparison to wild-type controls. Methylated-BSA and IL-1ß-induced arthritis was more severe in KLF2 hemizygous mice as compared to the littermate wild type controls. Consistent with this observation, monocytes isolated from KLF2 hemizygous mice showed an increased number of cells matured and differentiated towards osteoclastic lineage, potentially contributing to the severity of cartilage and bone damage in induced arthritic mice. The severity of arthritis was associated with the higher expression of proteins such as HSP60, HSP90 and MMP13 and attenuated levels of pPTEN, p21, p38 and HSP25/27 molecules in bone marrow cells of arthritic KLF2 hemizygous mice compared to littermate wild type controls. The data provide new insights and evidences of KLF2-mediated transcriptional regulation of arthritis via modulation of monocyte differentiation and function.

VATER association with multiple ribs anomalies.

VATER association is an exceptionally rare condition; however it is associated with multiple rib anomalies, which is one of its unique presentation. We are reporting a case of VATER associated with rib anomalies in various forms like bifid rib, ribbon rib and rudimentary rib.

Hepatitis C is associated with type 2 diabetes mellitus in HIV-infected persons without traditional risk factors.

OBJECTIVES: Hepatitis C virus (HCV) monoinfection has been linked to type 2 diabetes mellitus (DM). We evaluated the effect of HCV on risk of DM in relation to traditional risk factors such as age, body mass index (BMI) and family history of DM in an HIV-infected population. METHODS: This was a retrospective, cross-sectional study of 1529 HIV-infected out-patients. An adjusted multivariate logistic regression was performed to assess the effect of HCV seropositivity on DM stratified by low and high propensity for DM based on age, BMI and family history. RESULTS: Race, age, BMI, family history and HCV were associated with DM. Use of protease inhibitors (PIs) was not associated with DM, but HIV/HCV-coinfected patients were less likely to be on PIs than those with HIV infection alone. In a multivariate analysis controlled for race, the association between HCV and DM was stronger in lean, young patients without a family history of DM; the low-risk group. No association between HCV and type 2 DM was seen in patients who were older or overweight or had a family history of DM; the high-risk group. PI use did not affect the association between HCV and DM. CONCLUSIONS: Hepatitis C is an independent risk factor for type 2 diabetes in young, lean, HIV-infected patients. HIV-infected patients with HCV infection, regardless of whether they are on PIs, should be carefully screened for DM even if traditional risk factors for DM are not present.

Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV-coinfected patients: factors associated with response.

As therapy for human immunodeficiency virus (HIV) infection evolves, optimizing hepatitis B virus (HBV) treatment and identifying factors that impact its response in the HIV/HBV-coinfected population is critical. We identified retrospectively 45 HBV/HIV-coinfected patients with detectable HBV DNA by the Bayer VERSANT HBV 3.0 bDNA assay (limit of quantification 2000 copies/mL) at baseline and/or year 1 of therapy. Patients were divided into three groups based on the active HBV agent in their antiretroviral regimen: group 1 (n = 15) received lamivudine; group 2 (n = 10), lamivudine plus tenofovir and group 3 (n = 20), lamivudine followed by lamivudine plus tenofovir. HBV genotypes and resistance profiles were determined by the Bayer Trugene HBV 1.0 assay. More patients in group 2 achieved HBV DNA suppression below 2000 copies/mL (80%), loss of HBe antigen (HBeAg) (40%) and loss of HBeAg and gain of anti-HBe (20%) than did patients in group 1 or 3. More patients with HBV genotype A, achieved HBV DNA suppression <2000 copies/mL than did patients with non-A genotypes [74% (26/35) vs 20% (2/10)], respectively (P = 0.003). Risk for virological nonresponse was significant in those with non-A genotypes [odds ratio (OR) 11.1; 95% CI: 2.0-50], previous HIV therapy (OR 6.5; 95% CI: 1.2-35) and <90% compliance (OR 3.7; 95% CI: 0.99-14.3). Simultaneous therapy with lamivudine/tenofovir suppresses HBV DNA more effectively than lamivudine or tenofovir added to lamivudine. More patients infected with HBV genotype A responded than the non-A patients, regardless of therapeutic regimen, compliance or prior HIV therapy.

Vascular endothelium and atherosclerosis.

Atherosclerosis depends critically on altered behavior of the intrinsic cells of the artery wall, the endothelial cells and smooth muscle cells, and inflammatory leukocytes that join them in the arterial intima during the atherogenic process. The homeostatic properties of the normal endothelium contribute importantly to maintenance of aspects of arterial health including the appropriate regulation of blood flow, a basal anti-inflammatory state, promotion of fibrinolysis while opposing blood coagulation, and control of the balance of cellular proliferation and death. Alterations in these endothelial homeostatic mechanisms contribute critically to atherogenesis, the progression of this disease, and ist complications. Recent advances have highlighted novel molecular mechanisms that regulate the atheroprotective functions of normal endothelial cells that go awry during atherogenesis. Therapeutic strategies that alter the course of atherosclerosis may act by combating endothelial dysfunction.

Myocarditis and multiple cerebral and cerebellar infarction following scorpion sting.

An unusual case of scorpion sting followed by multiple cerebral and cerebellar watershed infarctions is being reported. Myocarditis, hypotension and hypoperfusion infarction is being considered as the possible explanation for this pathology. Hypoperfusion leading to parieto-occipital infarction has been reported earlier, however cerebellar infarction in this context is extremely rare.

Progressive multifocal leucoencephalopathy in AIDS camouflaged with catatonia: A wolf in sheep's clothing.

Progressive multifocal leucoencephalopathy (PML) may pose a clinical and diagnostic dilemma. The patient may remain in a protracted psychotic state with negative symptoms, without overt features of dementia. The condition blends with catatonia, and eventually with akinetic mutism in a patient of AIDS in the absence of clinical evidence of an immunocompromised state. The present case report highlights the need for an in-depth clinical, biochemical and MRI assessment of patients with catatonia and akinetic mutism. Stupor of an 'akinetic mutism' pattern seems an important indication for HIV screening, particularly in high-risk patients.

Role of transforming growth factor-beta1/Smads in regulating vascular inflammation and atherogenesis.

Accumulating evidence supports the role of inflammation in the development of a variety of chronic vascular diseases such as atherosclerosis, transplantation arteriosclerosis, and restenosis after vascular mechanical injury. Thus, identification of mechanisms to control inflammation may provide novel therapeutic targets to limit such disease states. Transforming growth factor-beta1 (TGF-beta1) is a pleiotropic growth factor with potent immunomodulating effects on cells important to atherosclerotic lesion formation including endothelial cells, vascular smooth muscle cells, macrophages, and T cells. The mechanisms responsible for the protective, anti-inflammatory effects of TGF-beta1 have recently become elucidated. This review focuses on the emerging role of the downstream TGF-beta1 signaling mediators, termed Smads, as regulators of vascular inflammation. These findings are beginning to establish a mechanistic scaffold with which to understand the cell-type specific function of Smads in the development of chronic inflammatory vascular disease states.

Gabapentin in the management of pentazocine dependence: a potent analgesic--anticraving agent.

OBJECTIVES: To evaluate the role of Gabapentin in the management of Pentazocine dependence for suppressing muscle aching and craving during its withdrawal. MATERIAL AND METHODS: Patients of Pentazocine dependence were divided in two groups GpA and GpB (n = 10 in each) and were administered Clonidine (P.O.) in first seven days (acute detoxification phase) and later Naltrexone (P.O.) from seventh day onwards (stabilisation-maintenance phase). Gabapentin (1200 mg/day) was additionally added in group B. Muscle pain and craving were rated on 100 mm visual-analogue scale. Psychological dependence was assessed on four step categorical scale. RESULTS: Group B (Gabapentin group) scored significantly lower (p < 0.001) than group A on both the parameters. Psychological dependence was significantly low (p < 0.01) in Gabapentin group. CONCLUSION: Gabapentin is an important adjuvant to the management of opiate dependence both in acute detoxification as well as stabilisation phase.