Differentiable Preisach Modeling for Characterization and Optimization of Particle Accelerator Systems with Hysteresis.

Future improvements in particle accelerator performance are predicated on increasingly accurate online modeling of accelerators. Hysteresis effects in magnetic, mechanical, and material components of accelerators are often neglected in online accelerator models used to inform control algorithms, even though reproducibility errors from systems exhibiting hysteresis are not negligible in high precision accelerators. In this Letter, we combine the classical Preisach model of hysteresis with machine learning techniques to efficiently create nonparametric, high-fidelity models of arbitrary systems exhibiting hysteresis. We experimentally demonstrate how these methods can be used in situ, where a hysteresis model of an accelerator magnet is combined with a Bayesian statistical model of the beam response, allowing characterization of magnetic hysteresis solely from beam-based measurements. Finally, we explore how using these joint hysteresis-Bayesian statistical models allows us to overcome optimization performance limitations that arise when hysteresis effects are ignored.

Association of Serum Ferritin Levels with Microalbuminuria, Glycemic Control and Dyslipidemia.

As diabetes is on the rise worldwide, early screening and detection of its complications is crucial. The first clinical sign of renal dysfunction in diabetes is microalbuminuria. Ferritin may have a possible role in the development and prediction of microalbuminuria and other complications of diabetes by 3 possible mechanisms- 1) it is a marker of elevated body iron stores. 2) acts as acute-phase reactant and elevation reflects inflammation 3) Delayed clearance of glycosylated ferritin in patients with diabetes causes raised ferritin levels. In this premise, we studied the association between serum ferritin levels and microalbuminuria, glycemic control and dyslipidemia in type 2 diabetic patients. MATERIAL: A cross-sectional study was carried out at a tertiary hospital in northern India involving 152 patients of type 2 diabetes mellitus. Anthropometric measurements (weight, height), sample collection for basic laboratory parameters including complete blood count, kidney function tests, liver function tests, HbA1c, lipid profile, serum iron and ferritin levels, urinary albumin- creatinine ratio was done. A fundus examination was performed. Results were analyzed using descriptive statistics and making comparisons among various groups. Categorical data were summarized as proportions or percentages while discrete as mean. Chi-square test was used for testing associations. OBSERVATION: Mean serum ferritin levels were significantly higher in patients having microalbuminuria as against patients having normal urinary albumin- creatinine ratio (539 vs 292, p-value- 0.04). Patients having poor glycemic control (HbA1c > 7) had higher ferritin levels (p-value- 0.024). There was a near-significant association (p-value-0.06) between serum ferritin and triglyceride levels. More cases with raised serum ferritin had higher triglyceride levels. Patients having microalbuminuria had a higher prevalence of diabetic retinopathy (p-value- 0.003) and higher triglyceride levels (p-value- 0.041). CONCLUSION: Ferritin can act as a marker of diabetic nephropathy, poor glycemic control and dyslipidemia in type 2 diabetic patients. Our study, therefore, indicates that programs to prevent complications of diabetes would be more effective by placing greater emphasis on patients having higher ferritin levels.

Biomechanical analysis and comparison between 'Zeta' miniplate design and conventional miniplate system for fixation of fracture segments in transition zone of parasymphysis body region of mandible - an in vitro study.

The parasymphysis area of the mandible is highly dynamic because it is subjected to both occlusal and muscular forces. As a result, the fractures in this transition zone have a special pattern, posing a challenge for surgeons whether to use one miniplate versus two miniplates, as per Champy's recommendations. The commonest complication resulting to treat this area is mental nerve paraesthesia due to the dissection and stretching of the nerve. Hence, an in vitro research study of a newly designed 'Zeta' miniplate is performed, to evaluate the biomechanical behaviour using finite element (FE) analysis and biomechanical analysis along with a comparison study with the conventional miniplate configurations. The results showed that the Zeta miniplate produces the lowest stresses 17.511 MPa and the least total structural deformation of 0.0011 mm after applying the maximum occlusal bite force. On application of torsional load, total structural deformation was 0.0004 mm and von Mises (VM) stress value was 0.24 MPa which was lowest when compared with the two miniplate system. Hence, the newly developed Zeta miniplate is superior in terms of stability. Another benefit of its design is that it helps in preventing mental nerve paraesthesia and tooth root damage while fixing and stabilising the fractured bony segments.

A comparative analysis between intra articular injections of injectable platelet rich fibrin versus platelet rich plasma in the management of temporomandibular disorders: A randomized control trial.

Background: Platelet concentrate has become an increasingly popular alternative source of growth factors for several types of dental and surgical procedures. It improves healing and stimulates cell proliferation, matrix remodeling, and angiogenesis. The injectable platelet-rich fibrin (i-PRF) has various advantages over platelet-rich plasma (PRP). The aim of our study was to evaluate the efficacy of intra-articular injections of i-PRF versus PRP in the management of temporomandibular disorders (TDMs). Method: The prospective randomized study involved 14 patients (N = 28 joints) of internal derangement between the age groups of 20 to 50 years divided randomly into two groups with seven patients (N = 14 joints) in each group. For all the patients, arthrocentesis was carried out in the first sitting followed by intra-articular injections of PRP and i-PRF in group I and group II, respectively, at 1-month interval for 6 months. A single surgeon has performed the procedure. All patients were assessed clinically for pain, maximal mouth opening (MMO), lateral movement, protrusive movement, and joint sounds and radiographically for disc position and joint effusion (JE). Results: Pain reduction, MMO, lateral movement, protrusive movement, and joint sounds were significant in both groups with more significance in group II. Disc position had improved toward normal in both groups and showed significant changes in both groups at the 9-month follow-up with better results in group II. Conclusion: PRP and i-PRF injections are regarded as simple and safe methods with potential beneficial effects and are cost-effective. In this preliminary study, i-PRF has been found to be scoring better in terms of efficacy over PRP across all set parameters.

A comparative evaluation of bone regeneration using mesenchymal stem cells versus blood coagulum in sinus augmentation procedures.

OBJECTIVE: The present study evaluated the quality and quantity of new bone formation in the maxillary sinus lift procedures and stability of implants in posterior atrophic maxilla. MATERIALS AND METHODS: This prospective randomized controlled split-mouth study included 20 patients (16 males and 4 females having a mean age of 36.7 years) having atrophic maxilla. They were divided randomly into two groups: Group A using mesenchymal stem cells and Group B into blood coagulum. They were radiographically evaluated using cone-beam computed tomography (CBCT) for residual bone height preoperatively and availability of new bone formation around implants, density, and stability of implants 6 months postoperatively. RESULTS: The placement of dental implants in posterior maxilla is challenging due to rapid resorption of alveolar bone after extraction of teeth due to pneumatization of maxillary sinuses. In both the groups, more pain and swelling were observed in the 2nd postoperative day which gradually decreased over a period of 7 days. Membrane perforation occurs in only four cases (20%). A significant gain in alveolar bone height was observed in Group A (7.69 mm ± 2.5 mm) and Group B (9.32 mm ± 2 mm) after 6 months. On comparing both the groups, there is a similar significant increase in bone density in Hounsfield units postoperatively at various levels buccally and palatally. Total 40 sinuses were lifted and 42 implants were placed, respectively. All implants showed primary stability. CONCLUSIONS: Such findings provide a significant contribution in future perspective studies that the use of stem cells had the same success rate as blood coagulum.

Emergent airway management in blunt tracheal trauma: A novel use of the mini-tracheostomy kit.

AIM: To report and discuss a novel way of managing the airway in a difficult case of anterior tracheal wall disruption caused by blunt trauma to the neck. BACKGROUND: Tracheal injury resulting in laceration of the windpipe may present with either one or many of the multitude of problems such as respiratory distress, hoarseness of voice and subcutaneous emphysema. Most often it requires surgical intervention. CASE DESCRIPTION: We hereby present the novel use of a mini-tracheostomy kit as an aid in the cannot-intubate-cannot-ventilate situation of a 30-year-old patient presenting with severe features of blunt tracheal injury. The airway was established critically with the use of the mini-tracheostomy kit in a "cannot-intubate-cannot-ventilate" situation during surgical tracheostomy and a potentially disastrous cardiorespiratory arrest situation was averted. CONCLUSION: Timely presence of airway equipment, adequate preparation, a willingness to innovate and a team approach are of paramount importance in dealing with difficult airway situations that are presented in myriad and complex ways. CLINICAL SIGNIFICANCE: The stylet of mini-tracheostomy kit can be used in emergent airway management especially in clinical situations mimicking ours specifically as a guide for insertion of the standard tracheostomy tube.

Predicted concentrations of anticancer drugs in the aquatic environment: What should we monitor and where should we treat?

Anticancer drugs have been detected in the aquatic environment, they have a potent mechanism of action and their consumption is expected to drastically increase in the future. Consequently, it is crucial to routinely monitor the occurrence of anticancer drugs and to develop effective treatment options to avoid their release into the environment. Prior to implementing a monitoring program, it is important to define which anticancer drugs are more prone to be found in the surface waters. In this study the consumption of anticancer drugs in the Lisbon region (Portugal), Belgium and Haryana state (India) were used to estimate the concentrations that can be expected in surface waters. Moreover, one important aspect is to define the major entry route of anticancer drugs in the aquatic environment: is it hospital or household effluents? The results disclosed in this study showed that in Belgium and Lisbon, 94 % of the total amount of anticancer drugs were delivered to outpatients, indicating that household effluents are the primary input source of these drugs and thus, upgrading the treatment in the domestic wastewater facilities should be the focus.

Bleomycin Sclerotherapy in Lymphangiomas of Head and Neck: Prospective Study of 8 Cases.

The aim of this study is to evaluate the role of bleomycin as a primary mode of nonsurgical treatment in lymphangiomas of head and neck and study their complications. This is a prospective study of 8 patients diagnosed with lymphangioma of head and neck presenting to ENT department of Tata main Hospital from December 2014 to January 2017. They were clinically and radiologically evaluated and treated with intralesional injection of bleomycin diluted in normal saline. Complete resolution was seen in 62.5% (5/8) of patients, 25% (2/8) had good response while 12.5% (1/8) had a poor response. No major complications were noted apart from fever and inflammation. Intralesional bleomycin can be used as a primary modality of treatment.

Melt-compounded composites of ethylene vinyl acetate with magnesium sulfate as flexible EPR dosimeters: Mechanical properties, manufacturing process feasibility and dosimetric characteristics.

Novel polymeric composites for radiation dosimetry were developed. The composites were prepared by solvent-free melt compounding of ethylene vinyl acetate (EVA) (40% vinyl) and magnesium sulfate (MgSO4). Mechanical properties, melt flow characteristics and dosimetric properties were investigated. The composites with up to 50% (wt) of MgSO4 were flexible and capable of flow. The dose response of the EPR signal of the composites was studied in the dose range 3Gy-4kGy and found to be linear between 18Gy and 4kGy. The reproducibility of dose measurements was good. The signal fading rate and the energy dependence of the dose response were found to be acceptable.

Comparison of three types of intervention to enhance placental redistribution in term newborns: randomized control trial.

OBJECTIVE: To compare the effect of combined delayed cord clamping and umbilical cord milking to either of them had done alone, on hematological parameters at 6 weeks of age in term neonates. STUDY DESIGN: It was a randomized controlled trial, conducted during January to December 2014. Three hundred eligible neonates were randomly allocated to three parallel groups. Primary outcome was hemoglobin and serum ferritin at 6 weeks of age. Data were analyzed using analysis of variance and Kruskal-Wallis test. RESULTS: Baseline characteristics and hemodynamic parameters were comparable in all the three groups. The median serum ferritin level at 6 weeks was significantly higher in the group receiving both delayed cord clamping and milking the cut cord group (295.49 (233.5 to 346.54) ng ml(-1)) as compared with the group that received only milking of the cut cord (184.55 (131.22 to 256.5) ng ml(-1)) or only delayed cord clamping (268.8 (189.4 to 315.44) ng ml(-1)). CONCLUSION: Delayed cord clamping with milking the cut cord improved iron stores at 6 weeks of age in term infants, then either of the two interventions alone.

Synthesis of a flexible poly(chloroprene)/methyl red film dosimeter using an environment-benign shear compounding method.

The paper reports synthesis of a new film dosimeter based on a solvent-free route. Methyl red (MR) dye was introduced into poly(chloroprene) (PC) in various concentrations. The films were intensely red with λmax ~515nm. The absorbance decreased linearly with absorbed radiation dose up to 30kGy without a significant change in λmax. Color coordinates of the films were also analyzed. Optical micrographs of the films showed no signs of inhomogeneous distribution of MR in the PC matrix, which was attributed to the polarity of PC. Radiation sensitivity, dose response linearity, effects of irradiation temperature and humidity, as well as the rate of fading, were also investigated.

A novel fluorescent tag for labelling of some antisense oligonucleotides.

A new versatile fluorescent tag, 4-acetylamino-1,8-naphthalimido-N-caproic acid (NCA) has been synthesized and characterized, and the optimal conditions for the maximum fluorescence using this tag allow a sensitivity level of 10(-9) mol/l. Useful fluorescence is observed upon covalent linking of this tag via its activated carboxy end to an alkylamino moiety, activated by the use of carbonyldiimidazole and hexamethylenediamine at the 5'-termini of an octamer, d(TCTTGCTC), a 33-mer, and a 41-mer complementary to the tat initiator of the HIV-1 genome. A new method for the generation of alkylamino function at the 5'-termini of oligonucleotides by the use of N-(4-bromobutyl) phthalimide is also described. The variation in fluorescence with respect to alteration of chain length of the oligonucleotides has also been studied. The fluorescence exhibited by these oligodeoxynucleotide (ODN)-NCA conjugates suggests that they may have a potential application as experimental tools in medicine and molecular biology.

Potential adverse interaction between aspirin and lisinopril in hypertensive rats.

The potential clinical effect of aspirin (ASA) in patients treated with angiotensin converting enzyme (ACE) inhibitors is debatable. Several studies have suggested that ASA attenuates the beneficial effects of ACE inhibitors in hypertension, congestive heart failure (CHF) or coronary artery disease (CAD) and have questioned the safety of using ASA concomitantly with these agents. The present study aims to investigate the possible interaction between ASA and ACE inhibitor in hypertensive rats. Hypertension was induced in adult male Wistar rats using Methylprednisolone (MP) 20 mg/kg per week s.c. for 2 weeks. The systolic blood pressure (SBP) was measured by noninvasive BP technique. The effect of Lisinopril (LS) 15 mg/kg per day and that of combination of LS and ASA; 100 and 25 mg/kg per day p.o. was studied on hypertension induced by glucocorticoid. Concurrent ASA treatment with LS did not hinder the hypotensive effect of LS at either dose. However ASA 100 mg/kg per day caused mortality in animals and produced massive cardiac necrosis and renal damage as evident from histopathology. Treatment with ASA 25 mg/kg per day caused lower mortality with variable effects on cardiac and renal tissues. These results indicate that ASA attenuates the beneficial effects of ACE inhibitor on survival in hypertensive rats and this effect was more pronounced at higher dose of ASA.

A novel approach for the solid phase synthesis of DNA-peptide conjugates.

The strategy of this study involves automated synthesis of oligonucleotides on a CPG support using standard cyanoethyl phosphoramidite chemistry followed by covalent linkage to peptide fragments bearing a free terminal alpha-amino group and residues with protected side chains. Conjugation was formed through an alkyldiisocyanate linker. Conjugates were isolated by cleavage from the solid support and deprotection in one step.

Possible psychopharmacological agents. Part 3: Synthesis and CNS activity of some new fluorine-containing pyrazolo[3,4-e][1,4]thiazepines.

A series of new fluorine-containing pyrazolo [3,4-e][1,4]thiazepines has been synthesized by the condensation of 5-amino-3/1, 3-substituted pyrazole with appropriate arylaldehydes or ketones and mercaptoacetic acid in dry toluene. All synthesized compounds have been characterized by their m.p.'s elemental analysis, IR, H-NMR and F-NMR. A representative number of compounds has also been screened for their CNS activity and found to act as mild stimulants.

Possible psychopharmacological agents. Part 9: Synthesis and CNS activity of some new fluorine-containing 1,2,4-triazolo[4,3-b]pyridazines.

A number of new fluorine-containing 1,2,4-triazolo[4,3-b]pyridazines have been synthesized by the condensation of 4-amino-(4H)-1,2,4-triazole with appropriate fluorinated beta-diketones in glacial acetic acid. All synthesized compounds were characterized by their m.p.'s, nitrogen analysis, IR, 1H NMR and 19F NMR. A representative number of compounds was screened for their CNS activity and found to be mild stimulants.

Studies in potential organo-fluorine antibacterial agents. Part 6: Synthesis and antibacterial activity of some new fluorine containing 1,3,4,5,7-pentasubstituted dipyrazolo[3,4-b,; 4,3-3]pyridines.

Ten new fluorine containing dipyrazolo [3,4-b;4,3-3]pyridines have been synthesized as possible antibacterial agents. The synthesis involves the condensation of 5-amino-1,3-disubstituted pyrazoles with an appropriate arylaldehyde at 220-240 degrees C. The synthesized compounds have been characterized by their m. p.'s elemental analysis, TLC, IR, 1H-NMR and 19F-NMR. A representative number of compounds have also been screened for their antibacterial activity and most of them were found to inhibit the growth of different bacteria.

Breast feeding patterns in an urban resettlement colony of Delhi.

Studies on duration and patterns of breast feeding based on recall may lead to a bias about the exact feeding status. The present study was designed to overcome this bias using the 'current status analysis method'. Mothers of 650 infants from 0 to 12 months of age attending a Health Centre were interviewed about the current feeding patterns of the infants and other socioeconomic variables. Month-wise prevalence of feeding patterns was determined. It was observed that breast feeding was maintained at a high level (more than 90%) throughout infancy while exclusive breast feeding showed a rapid decline. At 1 month, 74% and at 4 months, 46% of infants were exclusively breast-fed. The median duration of exclusive breast feeding was 3.83 months. Mothers with lesser education and lower family income were more likely to exclusively breast feed (p < 0.05). The time interval between birth and first breast feed was 24-48 hours in most (48.9%) of the infants. Majority (76.9%) of the infants received pre-lacteal feeds. Hospital-born infants received their first feed earlier and were less likely to receive pre-lacteal feeds as compared to those born at home (p < 0.001). Thus, the practice of exclusive breast feeding has to be promoted amongst pregnant and lactating mothers by health personnel. Also knowledge regarding infant feeding has to be imparted in schools and colleges.

Knowledge and attitudes of Anganwadi workers about infant feeding in Delhi.

PIP: In North Delhi, India, 83 community workers (anganwadi workers) in the ICDS project Alipur participated in a survey designed to assess their knowledge and attitude about breast feeding and to identify gaps in their knowledge of breast feeding. 98.7% knew that breast feeding should be begun immediately after birth. 92.7% knew that the newborn should receive the colostrum. Only 56.6% knew that top milk should not be diluted. 93.9% correctly knew that unhygienic bottle feeds are a leading source of diarrhea and that breast feeding should be continued during a diarrheal episode. Yet 48.2% did not know that mothers with tuberculosis should continue breast feeding and that infants with a fever should continue to receive breast milk. 25.4-48% of the anganwadi workers had incorrect perceptions on breast feeding and social considerations (e.g., 31.4% considered breast feeding to be embarrassing outside the house). Only 57.8% considered breast feeding to benefit maternal health. Only 50.5% knew that mothers should totally avoid bottle feeding. 75.9% incorrectly thought that almonds and dry fruits increase breast milk secretion. These overall encouraging findings about breast feeding may be due to the increased focus on the importance of teaching breast feeding during preplacement training and possibly due to repeated health education messages on breast feeding through the mass media. The findings indicate a need for educating anganwadi workers about continuation of breast feeding during diseases, however.^ieng

Knowledge of Anganwadi workers about growth monitoring in Delhi.

PIP: In an Integrated Child Development Services (ICDS) block, Alipur, in Delhi, India, interviews were conducted with 100 anganwadi workers (one of whose major functions is growth monitoring) to determine their knowledge on growth monitoring and to identify gaps in that knowledge. Each anganwadi worker serves a population of 1000. 99% had adequate knowledge about the significance of the lines on the growth charts that indicate different grades of nutritional status. Yet only 43% knew that they can begin growth monitoring for any child under age 6. 37% did not know that assessment of correct age is not essential for growth monitoring. 90-91% had correct knowledge about weight of a child at 1 and 3 years. Yet only 17-30% knew the correct mid-upper arm circumference (MUAC) for an optimally nourished child aged 2 and 4. These findings suggest that training programs and various meetings have emphasized inputs of growth monitoring but not on age at which growth monitoring can be started, on correct age for successfully conducting growth monitoring, and on the cut-off measurements for MUAC. Continued education on various aspects of growth monitoring are needed for anganwadi workers.^ieng