AZ63/Ti/Zr Nanocomposite for Bone-Related Biomedical Applications.

Considering the unique properties of magnesium and its alloy, it has a vast demand in biomedical applications, particularly the implant material in tissue engineering due to its biodegradability. But the fixing spares must hold such implants till the end of the biodegradation of implant material. The composite technology will offer the added benefits of altering the material properties to match the requirements of the desired applications. Hence, this experimental investigation is aimed at developing a composite material for manufacturing fixing spares like a screw for implants in biomedical applications. The matrix of AZ63 magnesium alloy is reinforced with nanoparticles of zirconium (Zr) and titanium (Ti) through the stir casting-type synthesis method. The samples were prepared with equal contributions of zirconium (Zr) and titanium (Ti) nanoparticles in the total reinforcement percentage (3%, 6%, 9%, and 12%). The corrosive and tribological studies were done. In the corrosive study, the process parameters like NaCl concentration, pH value, and exposure time were varied at three levels. In the wear study, the applied Load, speed of sliding, and the distance of the slide were considered at four levels. Taguchi analysis was employed in this investigation to optimize the reinforcement and independent factors to minimize the wear and corrosive losses. The minimum wear rate was achieved in the 12% reinforced sample with the input factor levels of 60 N of load on the pin, 1 m/s of disc speed at a sliding distance was 1500 m, and the 12% reinforce samples also recorded a minimum corrosive rate of 0.0076 mm/year at the operating environment of 5% NaCl-concentrated solution with the pH value of 9 for 24 hrs of exposure. The prediction model was developed based on the experimental results.

Modelling and optimization of thermophilic anaerobic digestion using biowaste.

Biowaste generation is considerably increasing multiple times recently due to various social and environmental changes like population growth, economic prosperity, globalisation etc. they contain different composition and generated at different stages of their life cycle. Though studies reported for recycle, reproduce and reuse of them, this investigation is unique by focussing to investigate the ideal circumstances for the production of biogas and methane from anaerobic digestion of vegetable waste using response surface methods and artificial neural networks with thermophilic temperature range. Thermophilic temperature of 20.78, organic loading rate of 0.2, pH of 8.81, agitation time of 5.8 and hydro retention time of 3 are the ideal input parameter values for the generation of biogas 3.03 m3 and methane% 186.08 with a desirability of 1. The Response surface model was surpassed by the Artificial Neural Network model.

Indian Guidelines on Nebulization Therapy.

Inhalational therapy, today, happens to be the mainstay of treatment in obstructive airway diseases (OADs), such as asthma, chronic obstructive pulmonary disease (COPD), and is also in the present, used in a variety of other pulmonary and even non-pulmonary disorders. Hand-held inhalation devices may often be difficult to use, particularly for children, elderly, debilitated or distressed patients. Nebulization therapy emerges as a good option in these cases besides being useful in the home care, emergency room and critical care settings. With so many advancements taking place in nebulizer technology; availability of a plethora of drug formulations for its use, and the widening scope of this therapy; medical practitioners, respiratory therapists, and other health care personnel face the challenge of choosing appropriate inhalation devices and drug formulations, besides their rational application and use in different clinical situations. Adequate maintenance of nebulizer equipment including their disinfection and storage are the other relevant issues requiring guidance. Injudicious and improper use of nebulizers and their poor maintenance can sometimes lead to serious health hazards, nosocomial infections, transmission of infection, and other adverse outcomes. Thus, it is imperative to have a proper national guideline on nebulization practices to bridge the knowledge gaps amongst various health care personnel involved in this practice. It will also serve as an educational and scientific resource for healthcare professionals, as well as promote future research by identifying neglected and ignored areas in this field. Such comprehensive guidelines on this subject have not been available in the country and the only available proper international guidelines were released in 1997 which have not been updated for a noticeably long period of over two decades, though many changes and advancements have taken place in this technology in the recent past. Much of nebulization practices in the present may not be evidence-based and even some of these, the way they are currently used, may be ineffective or even harmful. Recognizing the knowledge deficit and paucity of guidelines on the usage of nebulizers in various settings such as inpatient, out-patient, emergency room, critical care, and domiciliary use in India in a wide variety of indications to standardize nebulization practices and to address many other related issues; National College of Chest Physicians (India), commissioned a National task force consisting of eminent experts in the field of Pulmonary Medicine from different backgrounds and different parts of the country to review the available evidence from the medical literature on the scientific principles and clinical practices of nebulization therapy and to formulate evidence-based guidelines on it. The guideline is based on all possible literature that could be explored with the best available evidence and incorporating expert opinions. To support the guideline with high-quality evidence, a systematic search of the electronic databases was performed to identify the relevant studies, position papers, consensus reports, and recommendations published. Rating of the level of the quality of evidence and the strength of recommendation was done using the GRADE system. Six topics were identified, each given to one group of experts comprising of advisors, chairpersons, convenor and members, and such six groups (A-F) were formed and the consensus recommendations of each group was included as a section in the guidelines (Sections I to VI). The topics included were: A. Introduction, basic principles and technical aspects of nebulization, types of equipment, their choice, use, and maintenance B. Nebulization therapy in obstructive airway diseases C. Nebulization therapy in the intensive care unit D. Use of various drugs (other than bronchodilators and inhaled corticosteroids) by nebulized route and miscellaneous uses of nebulization therapy E. Domiciliary/Home/Maintenance nebulization therapy; public & health care workers education, and F. Nebulization therapy in COVID-19 pandemic and in patients of other contagious viral respiratory infections (included later considering the crisis created due to COVID-19 pandemic). Various issues in different sections have been discussed in the form of questions, followed by point-wise evidence statements based on the existing knowledge, and recommendations have been formulated.

An Investigation of Electrospun Clerodendrum phlomidis Leaves Extract Infused Polycaprolactone Nanofiber for In Vitro Biological Application.

The in vitro antibacterial, anticancer, and antioxidant activities of a few plant extracts were widely known for decades, and they were used for application in the conventional way. Specifically, electrospun nanofibrous mats have recently exhibited great antibacterial, anticancer, and antioxidant activities. The herbal extracts infused into these formations are expected to have a more efficient and integrated effect on in vitro biological applications. The purpose of this study is to develop polycaprolactone- (PCL-) based nanofiber mats that are infused with a traditional plant extract using Clerodendrum phlomidis leaves to improve the synthesized nanofibers' antibacterial, anticancer, and antioxidant efficacy. This study examined the morphology, thermal properties, mechanical properties, structure, and in vitro drug release studies of electrospun nanofibers. Antibacterial, anticancer, and antioxidant activities of the electrospun nanofibrous mats were also studied. The HRTEM and FESEM pictures of PCL and PCL-CPM nanofibers provide that smooth, defect-free, and homogeneous nanofibers were found to be 602.08 ± 75 nm and 414.15 ± 82 nm for PCL and PCL-CPM nanofibers, respectively. The presence of Clerodendrum phlomidis extract in the electrospun nanofibers was approved by UV-visible and FTIR spectroscopy. The incorporation of Clerodendrum phlomidis extract to nanofiber mats resulted in substantial antibacterial activity against bacterial cells. PCL-CPM mats exposed to oral cancer (HSC-3) and renal cell carcinoma (ACHN) cell lines displayed promising anticancer activity with less than 50% survival rate after 24 h of incubation. 2,2-Diphenyl-1-picrylhydrazyl (DPPH) assay performed on PCL-CPM nanofibers revealed the antioxidant scavenging activity with maximum inhibition of 34% suggesting the role of the secondary metabolites release from scaffold. As a result, the findings of this study revealed that Clerodendrum phlomidis extract encapsulating PCL electrospun nanofibers has a high potential for usage as a biobased antibacterial, anticancer, and antioxidant agent.

Synthesis and Characterization of Banana and Pineapple Reinforced Hybrid Polymer Composite for Reducing Environmental Pollution.

Nonbiodegradable polymers constitute major pollution and their usage cannot be ignored due to their properties. Hybrid polymer composite research has increased in recent times due to improved characteristics and biodegradable nature. The effect of different stacking sequences containing pineapple/banana/basalt fiber has been studied in the present work to reduce the usage of synthetic fibers without compromising on properties. Hybrid composites were manufactured using the hand layup method and were assessed for mechanical and morphological characteristics. The results showed that several properties improved by keeping the pineapple layer in the skin layer. The adhesion between the matrix and the fiber played a vital role in determining the properties of the composites manufactured. Morphological studies have concluded that the proper bonding between the matrix and the fiber has enhanced several properties.

Investigations on influences of MWCNT composite membranes in oil refineries waste water treatment with Taguchi route.

Most of the 'oil refineries' severally pollutes the water resources by depleting their untreated waste water like cooling water, storm water and unsanitary sewage water. These wastewaters are to be treated with high care to protect the human, pebbles, plants, fish and other water animals and from harmful effects. The present study focused to treat the oil refinery wastewater by means of Multi wall carbon nanotube (MWCNT) coated Polyvinylidene Fluoride (PVDF) membrane. The main objectives are: to increases the life of filter, reduce the percolation flux and reduce the formation of antifouling in the filter by using MWCNT composite membrane in it. Different process parameters of the proposed water treatment process, like diameter of MWCNT (15 nm, 20 nm, 25 nm and 30 nm), operating pressure (3 bar, 4 bar, 5 bar and 6 bar), pH value (3, 5, 7 and 9) and temperature (25 °C, 30 °C, 35 °C and 40 °C) temperature. Taguchi statistical technique is employed for designing experiments and for optimizing the process parameters of wastewater treatment process of an oil refinery. The proposed filter for wastewater treatment exhibited appreciable performance in removal rate of Percolation flux, percentage of chemical oxygen demand removal and percentage of total carbolic rejection as 27.2 kg/m2h, 78.51% and 95.33% respectively.

Synthesis and Optimization of Deesterified Acacia-Alginate Nanohydrogel for Amethopterin Delivery.

Naturally obtained materials are preferable for the production of biomedicine in biomedical applications. Acacia gum is has recently become a hopeful one in the biomedicine production due to its excellent properties, namely, emulsifier, stabilizing mediator, suspending agent, etc. In this novel work, we synthesised and characterized the deesterified Acacia gum-alginate nanohydrogel (DEA-AG NPs) as a carrier for amethopterin (ATN) delivery. This combination is used in the drug effectiveness and tissue engineering. In this work, the Taguchi route is implemented for estimating of particle size and zeta potential (mV) through optimization. Following three parameters are considered for this work: DEA solution concentration (0.008, 0.016, 0.024, and 0.032 w/v %), alginate molecular weight (3, 6, 9, and 12 MW), and ATN/DEA ratio (1 : 4, 1 : 8, 1 : 12, and 1 : 16 w/w %). In particle size analysis and zeta potential analysis, the DEA solution concentration is highly influenced. Minimum particle size is found as 148.50 nm. Similarly, maximum zeta potential is identified as 29.5 mV.

Mycotoxigenic fungi contaminating wheat; toxicity of different Alternaria compacta strains.

We studied mycotoxigenic fungi contaminating stored wheat grain, measured the toxins they secreted, and assessed their harmfulness. We focused on one common genus Alternaria, and chose 19 isolates representing A. compacta to study how different strains differed in their mycotoxin secretion and toxicity. Toxicity was assessed in a bioassay with a model bacteria Bacillus subtilis. All 19 A. compacta strains secreted toxins. Both the mycotoxin pattern and the fungal toxicity differed between the A. compacta stains. It seemed that some other toxins than alternariols or altenue acted as the main virulence factors of A. compacta against B. subtilis. We suggest that the most commonly studied mycotoxins do not necessarily indicate the toxicity of the fungi. The high variation in the amounts and toxins that different Alternaria species and strains secrete pose a challenge to the food supply chain.

Association of WNT Pathway Genes With Nonsyndromic Cleft Lip With or Without Cleft Palate.

OBJECTIVE: Nonsyndromic cleft lip with or without cleft palate (NSCL±P) is a common craniofacial anomaly with multifactorial etiology. Evidence suggests that variations in WNT pathway genes contribute to an increased susceptibility to NSCL±P. The aim of this study was to investigate the association of AXIN1, APC, CTNNB1, DVL2, and GSK3ß gene variants with NSCL±P in a case-control data set from Brazil. PATIENTS: 471 individuals with NSCL±P and 504 unrelated control individuals of Caucasian ethnicity. DESIGN: Twenty single-nucleotide polymorphisms (SNPs) in/nearby AXIN1, APC, CTNNB1, DVL2, and GSK3B genes were genotyped using Taqman chemistry in a Viia7 sequence detection instrument. Genotype, allele, and haplotype frequencies were compared among NSCL±P patients and controls using Fisher exact test, implemented in PLINK software. The level of significance was established at P ≤.002 under Bonferroni correction. In silico analysis of SNP function was assessed using MirSNP database. RESULTS: Significant association was found between GSK3B rs13314595 genotypes and NSCL±P ( P = .0006). Additionally, nominal associations were found between DVL2 (rs35594616) and APC (rs448475) with NSCL±P ( P = .02 and P = .03, respectively). SNP haplotypes for GSK3B and APC genes showed nominal associations with NSCL±P ( P < .05). In silico analysis predicted that APC rs448475 harbors a binding site for the microRNA miR-617 and that the switch from a G allele to C allele enhances binding, whereas DVL2 rs35594616 did not appear to harbor microRNA-binding sites. CONCLUSION: This study shows for the first time the association between GSK3B and NSCL±P and confirms the role of additional WNT pathway genes as candidates for NSCL±P.

Alignment of dynamic networks.

MOTIVATION: Network alignment (NA) aims to find a node mapping that conserves similar regions between compared networks. NA is applicable to many fields, including computational biology, where NA can guide the transfer of biological knowledge from well- to poorly-studied species across aligned network regions. Existing NA methods can only align static networks. However, most complex real-world systems evolve over time and should thus be modeled as dynamic networks. We hypothesize that aligning dynamic network representations of evolving systems will produce superior alignments compared to aligning the systems' static network representations, as is currently done. RESULTS: For this purpose, we introduce the first ever dynamic NA method, DynaMAGNA ++. This proof-of-concept dynamic NA method is an extension of a state-of-the-art static NA method, MAGNA++. Even though both MAGNA++ and DynaMAGNA++ optimize edge as well as node conservation across the aligned networks, MAGNA++ conserves static edges and similarity between static node neighborhoods, while DynaMAGNA++ conserves dynamic edges (events) and similarity between evolving node neighborhoods. For this purpose, we introduce the first ever measure of dynamic edge conservation and rely on our recent measure of dynamic node conservation. Importantly, the two dynamic conservation measures can be optimized with any state-of-the-art NA method and not just MAGNA++. We confirm our hypothesis that dynamic NA is superior to static NA, on synthetic and real-world networks, in computational biology and social domains. DynaMAGNA++ is parallelized and has a user-friendly graphical interface. AVAILABILITY AND IMPLEMENTATION: http://nd.edu/∼cone/DynaMAGNA++/ . CONTACT: tmilenko@nd.edu. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Relationship Between 'Immediate' Resistive Index Measurement After Renal Transplantation and Renal Allograft Outcomes.

BACKGROUND: The arterial resistive index, also referred to as the resistive index (RI) or Pourcelot Index, is a measure of pulsatile blood flow. Previous studies have demonstrated the usefulness of the RI as a predictor of allograft outcomes based on RI measurement in the later stages after transplantation. However, there is little evidence of the predictive value of "immediate" RI measurement within 24 hours after transplantation. METHODS: We performed a retrospective cohort study of 305 adult renal transplants carried out between 2003 and 2013. The associations between immediate RI measurement (within 24 hours after transplantation) and donor, recipient, and surgical factors were analyzed. In addition, the correlations between immediate RI measurement and renal allograft outcomes, including delayed graft function (DGF) and transplant failure (TF), also were evaluated. RESULTS: From a cohort of 305 patients, 52 were excluded on the basis of on confounding factors. Of the remaining 253 patients, the mean age was 48.4 years, 57.5% were male, and approximately one-third had diabetes. Two hundred twenty-six patients had an RI < 0.8, whereas only 27 had an RI ≥ 0.8. Significant associations were found between elevated RI (≥0.8) and both DGF (odds ratio = 3.22, P = .006) and TF (odds ratio = 3.54, P = .008). CONCLUSIONS: Immediate RI measurement after renal transplantation is a strong predictor of both DGF and TF.

Caregiver's burden in pulmonary arterial hypertension: a clinical review.

Caregiver's burden is a multidimensional phenomenon affecting care-givers physically, emotionally and socially. It is critical to examine the burden of caregivers, because of the complex responsibility they have with their partners. There are relatively few studies that have examined factors linked with psychological burden amongst caregivers of pulmonary arterial hypertension (PAH) patients. Hence, it is pertinent to develop a good understanding of these factors and develop appropriate management strategies, modified to assist PAH caregivers.

Knockdown Resistance (kdr) Mutations in Indian Anopheles stephensi (Diptera: Culicidae) Populations.

Knockdown resistance (kdr) in insects resulting from mutation(s) in the voltage-gated sodium channel (VGSC) gene is one of the mechanisms of resistance against DDT and the pyrethroid group of insecticides. Earlier, we reported the presence of two classic kdr mutations, i.e., L1014F and L1014S in Anopheles stephensi Liston, a major Indian malaria vector affecting mainly urban areas. This report presents the distribution of these alleles in different An. stephensi populations. Seven populations of An. stephensi from six states of India were screened for the presence of two alternative kdr mutations L1014F and L1014S using allele-specific polymerase chain reaction assays. We recorded the presence of both kdr mutations in northern Indian populations (Alwar and Gurgaon), with the preponderance of L1014S, whereas only L1014F was present in Raipur (central India) and Chennai (southern India). None of the kdr mutations were found in Ranchi in eastern India and in Mangaluru and Mysuru in southern India. This study provides evidence for a focal pattern of distribution of kdr alleles in India.

Epidemiological Profile of Tobacco Users at Tobacco Cessation Centre: An Indian Experience.

Objective. Tobacco consumption continues to rise in India with about 34.6% of adult population being tobacco users. This study was done to evaluate the epidemiological profile of the tobacco users presenting to a Tobacco Cessation Centre (TCC) in Delhi. Methods. This is a retrospective observational study of subjects seen over a period of 10 years (2001-2010) at TCC of Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India. Information from a structured questionnaire filled by all tobacco users was pooled and analysed. Results. Of a total of 4493 subjects seen in the TCC, 4370 (97.3%) were males. 2704 (60.2%) subjects were smokers and remaining were users of smokeless tobacco. The highest number of subjects attending the clinic was between the age of 31 to 40 years. The mean age of starting tobacco use was 21 years. 2518 subjects started tobacco use due to "peer group pressure", while family history of tobacco use was observed in 2912 subjects. 3065 number of subjects attending the clinic were without any co-morbidity. Conclusions. Most of the subjects started tobacco use at a young age between 11 to 20 years. Peer pressure was the most common reason for initiation (56%). Most of the subjects (68.2%) had no co-morbidity. The present study observed that tobacco users probably want to quit smoking not only because of the consequences of co-morbidities but also because of the realisation of later harmful effects of continuing smoking.

Role of oxidative stress & transient receptor potential in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) affect millions of people worldwide and is known to be one of the leading causes of death. The highly sensitive airways protect themselves from irritants by cough and sneeze which propel endogenous and exogenous substances to minimize airway noxious effects. One noxious effect of these substances is activation of peripheral sensory nerve endings of nociceptor neurons innervating these airways lining thus transmitting dangerous signals from the environment to the central nervous system (CNS). Nociceptor neurons include transient receptor potential (TRP) ion channels, especially the vanilloid and ankyrin subfamilies, TRPV1/A1 which can be activated by noxious chemical challenges in models of airways disease. As oxidative stress may activate airways sensory neurons and contribute to COPD exacerbations we sought to review the role that TRP channel activation by oxidative signals may have on airway responses. i0 t would be prudent to target the TRP channels with antagonists and lower systemic oxidative stress with agents that can modulate TRP expression and boost the endogenous levels of antioxidants for treatment and management of COPD.

Consensus & Evidence-based INOSA Guidelines 2014 (First edition).

Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences amongst the general public as well as the majority of primary care physcians across India is poor. This necessiated the development of the INdian initiative on Obstructive Sleep Apnoea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health & Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep related symptoms or comorbidities or ≥ 15 such episodes without any sleep related symptoms or comorbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents and high risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography (PSG) is the "gold standard" for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioural measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

Consensus and evidence-based Indian initiative on obstructive sleep apnea guidelines 2014 (first edition).

Obstructive sleep apnea (OSA) and obstructive sleep apnea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences among the general public as well as the majority of primary care physicians across India is poor. This necessitated the development of the Indian initiative on obstructive sleep apnea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health and Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep-related symptoms or co-morbidities or ≥15 such episodes without any sleep-related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents, and high-risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers, and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography is the "gold standard" for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances (OA) are indicated for use in patients with mild to moderate OSA who prefer OA to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioral measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

Comparative study of the efficacy and safety of theophylline and doxofylline in patients with bronchial asthma and chronic obstructive pulmonary disease.

BACKGROUND: Bronchial asthma and chronic obstructive pulmonary disease (COPD) are the major obstructive disorders that may contribute to the severity in individual patients. The present study was designed to compare the efficacy and safety of theophylline and doxofylline in patients with bronchial asthma and COPD. METHODS: A total of 60 patients, 30 each with bronchial asthma and COPD, were enrolled for the study. Each group of 30 patients received standard treatment for asthma and COPD. Each group was again subdivided into two with 15 patients each, who received theophylline or doxofylline in addition to standard therapy, for a period of 2 months. Each patient was followed up fortnightly for the assessment of efficacy parameters using a pulmonary function test (PFT), clinical symptoms and emergency drug use, and safety was assessed by recording adverse drug reactions. RESULTS: Both theophylline and doxofylline produced enhancements in PFT at different time intervals in both asthma and COPD patients. The maximum beneficial effects were seen at 6 weeks for asthma patients and at 8 weeks for COPD patients for both theophylline and doxofylline. CONCLUSIONS: The comparative study showed that doxofylline was more effective as evidenced by improvement in PFT as well as clinical symptoms, and reduced incidence of adverse effects and emergency bronchodilator use.

MAGNA++: Maximizing Accuracy in Global Network Alignment via both node and edge conservation.

MOTIVATION: Network alignment aims to find conserved regions between different networks. Existing methods aim to maximize total similarity over all aligned nodes (i.e. node conservation). Then, they evaluate alignment quality by measuring the amount of conserved edges, but only after the alignment is constructed. Thus, we recently introduced MAGNA (Maximizing Accuracy in Global Network Alignment) to directly maximize edge conservation while producing alignments and showed its superiority over the existing methods. Here, we extend the original MAGNA with several important algorithmic advances into a new MAGNA++ framework. RESULTS: MAGNA++ introduces several novelties: (i) it simultaneously maximizes any one of three different measures of edge conservation (including our recent superior [Formula: see text] measure) and any desired node conservation measure, which further improves alignment quality compared with maximizing only node conservation or only edge conservation; (ii) it speeds up the original MAGNA algorithm by parallelizing it to automatically use all available resources, as well as by reimplementing the edge conservation measures more efficiently; (iii) it provides a friendly graphical user interface for easy use by domain (e.g. biological) scientists; and (iv) at the same time, MAGNA++ offers source code for easy extensibility by computational scientists. AVAILABILITY AND IMPLEMENTATION: http://www.nd.edu/∼cone/MAGNA++/

EXIT Llyod Davies

The EXIT (Ex utero intrapartum treatment) procedures have been, with a high degree of success, employed to treat a myriad types of fetal airway obstruction most commonly neck masses such as cystic hygroma and lymphangioma with ample plan including prenatal diagnosis by ultrasound scan or MRI. Before the advent of EXIT, formal documentations had been published with descriptions of intubation during intrapartum period and fetal airway protection either during normal or operative delivery. We report a 28-year-old gravida 2 para 1 who was referred to our Maternal Fetal Medicine (MFM) unit at 26 weeks and 3 days gestation with a foetal neck mass. We present a case of an successful EXIT procedure performed in the Lloyd Davies position with the hips abducted and flexed at 15 degrees as is employed during gynecologic laparoscopy surgery minus the Trendelenburg tilt. Both mother and baby are well. The benefits of this position are discussed.