Acute respiratory distress syndrome (ARDS) is a devastating disease with distinct pathological stages. Fundamental to ARDS is the acute onset of lung inflammation as a part of the body's immune ...response to a variety of local and systemic stimuli. In patients surviving the inflammatory and subsequent fibroproliferative stages, transition from injury to resolution and recovery is an active process dependent on a series of highly coordinated events regulated by the immune system. Experimental animal models of acute lung injury (ALI) reproduce key components of the injury and resolution phases of human ARDS and provide a methodology to explore mechanisms and potential new therapies. Macrophages are essential to innate immunity and host defense, playing a featured role in the lung and alveolar space. Key aspects of their biological response, including differentiation, phenotype, function, and cellular interactions, are determined in large part by the presence, severity, and chronicity of local inflammation. Studies support the importance of macrophages to initiate and maintain the inflammatory response, as well as a determinant of resolution of lung inflammation and repair. We will discuss distinct roles for lung macrophages during early inflammatory and late resolution phases of ARDS using experimental animal models. In addition, each section will highlight human studies that relate to the diverse role of macrophages in initiation and resolution of ALI and ARDS.
•Artificial neural network use for energy analysis of a building.•Use of artificial neural network to find energy requirement of a building during summer and winter.•Use of artificial neural network ...to predict the indoor air temperature.•Prediction of energy consumption by using artificial neural network.•Heating, ventilating and air conditioning systems analysis by artificial neural network.
Artificial neural networks (ANNs) can be used to predict energy consumption more reliably than traditional simulation models and regression techniques. Artificial neural networks are nowadays accepted as an alternative technology offering a way to tackle complex and ill-defined problems. They are not programmed in the traditional way but they are trained using past history data representing the behaviour of a system. They have been used in a number of diverse applications. Results presented in this paper are testimony to the potential of artificial neural networks as a design tool in many areas of building services engineering.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The energy costs have increased substantially in recent years due to widespread development in India. Vast agro and animal waste resources are available which can easily be harnessed for biogas ...production economically Recently, there has been a renewed interest to revive the National biogas programme to meet the ever-increasing energy demand. India has set a target of reducing oil imports by 10% through the increased use of natural gas contribution in the current energy mix of 6.5%–15% by 2022. In this study the new Indian biogas policy initiatives for biogas production, new plant designs are presented along with a comparative analysis of the policy with similar policies of selected countries. The flaws in the past implementation of Indian bio-gas programmes, biogas technology as per most recent data along with identifying gaps in the new Indian biogas policy, are presented. A strategy is outlined to utilize large quantities of available food, agro and animal waste resources for a sustainable bio-gas policy as per UN sustainable development goal numbers 1, 7 and 13. The need for a sustainable biogas policy is emphasized to provide a clean fuel for cooking, heating, and lighting with focus on rural poor worldwide.
Strategy for a novel sustainable bio-gas policyThe flaws in the past implementation of Indian bio-gas programmes, current status of biogas technology as per most recent data along with identifying gaps in the new Indian biogas policy, are presented. Based on the comparative analysis of new Indian policy with similar policies of selected countries, a strategy is outlined to utilize vast quantities of available agro, food and animal resources for a sustainable bio-gas policy as per UN sustainable development goal numbers 1, 7 and 13, to provide clean bio-gas fuel to the poor worldwide. Display omitted
•New Indian Biogas Policy Perspectives are presented.•Biogas policies of selected countries are critically analyzed. .•Policy concerns of propagating liquid petroleum gas in rural areas, are identified.•Strategy is outlined for effective implementation of new sustainable biogas policy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract
Background
The impact of consumption of sugar-sweetened beverages (SSB) on health outcomes such as obesity have been studied extensively, but oral health has been relatively neglected. This ...study aims to assess the association between SSB consumption and dental caries and erosion.
Methods
Systematic review of observational studies. Search strategy applied to Medline, Embase, Cochrane Library, SciELO, LILACS, OpenGrey and HMIC. The risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cross-Sectional Studies and evidence certainty using Grading of Recommendation Assessment Development and Evaluation. Relationships between SSB consumption and caries and erosion were estimated using random-effects model meta- and dose–response analyses.
Results
A total of 38 cross-sectional studies were included, of which 26 were rated as high quality. Comparing moderate-to-low consumption, there was significantly increased risk of both caries OR = 1.57, 95% CI: 1.28–1.92; decayed, missing and filled teeth weighted mean differences (DMFT WMD) = 0.82, 95% CI: 0.38–1.26 and erosion (OR = 1.43, 95% CI: 1.01–2.03). Comparing high-to-moderate consumption, there was further increased risk of caries (OR = 1.53, 95% CI: 1.17–1.99; DMFT WMD = 1.16, 95% CI: −0.59–2.91) and erosion (OR = 3.09, 95% CI: 1.37–6.97). A dose–response gradient and high certainty of evidence was observed for caries.
Conclusions
Increasing SSB consumption is associated with increased risk of dental caries and erosion. Studies were cross-sectional, hence temporality could not be established, but the positive dose–response suggests this relationship is likely to be causal. These findings illustrate the potential benefits to oral health of policies that reduce SSB consumption, including sugar taxation.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
Background
Internet and software‐based platforms (e‐learning) have gained popularity as teaching tools in medical education. Despite widespread use, there is limited evidence to support their ...effectiveness for surgical training. This study sought to evaluate the effectiveness of e‐learning as a teaching tool compared with no intervention and other methods of surgical training.
Methods
A systematic literature search of bibliographical databases was performed up to August 2015. Studies were included if they were RCTs assessing the effectiveness of an e‐learning platform for teaching any surgical skill, compared with no intervention or another method of training.
Results
From 4704 studies screened, 87 were included with 7871 participants enrolled, comprising medical students (52 studies), trainees (51 studies), qualified surgeons (2 studies) and nurses (6 studies). E‐learning tools were used for teaching cognitive (71 studies), psychomotor (36 studies) and non‐technical (8 studies) skills. Tool features included multimedia (84 studies), interactive learning (60 studies), feedback (27 studies), assessment (26 studies), virtual patients (22 studies), virtual reality environment (11 studies), spaced education (7 studies), community discussions (2 studies) and gaming (2 studies). Overall, e‐learning showed either greater or similar effectiveness compared with both no intervention (29 and 4 studies respectively) and non‐e‐learning interventions (29 and 22 studies respectively).
Conclusion
Despite significant heterogeneity amongst platforms, e‐learning is at least as effective as other methods of training.
As good as other methods
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
In recent times, waste management has emerged as a significant environmental challenge, and sewage is among the major contributors due to the rapidly increasing population. Despite sewage treatment ...plants (STPs) being the solution for the treatment of sewage, they have been identified as sources of greenhouse gas (GHG) emissions. This study aimed to estimate the contribution of STPs to GHG emissions in the state. This was achieved by visiting the sites, filling scientifically designed questionnaires, sample collection as well as computational methods by Intergovernmental Panel on Climate Change. The assessment of direct and indirect emissions from the STPs revealed that emissions were caused by the activated sludge process, electricity consumption, transportation, and sludge storage. Electricity consumption by STPs was responsible for the highest emissions, accounting for 43% of the total emissions, equivalent to 20,823 tCO
eq. The activated sludge process contributed 31% (14,934 tCO
eq) of the emissions, while storage of sludge in landfills accounted for 24% (11,359 tCO
eq). Additionally, transportation contributed 2% (1121 tCO
eq) of the emissions. In total, the STPs in Himachal Pradesh had the potential to contribute 48,237 tCO
eq GHG emissions annually. Thus, the study suggests process-level modifications in STPs of Himachal Pradesh to mitigate GHG emissions. This research provides insight into the GHG emissions from STPs and highlights the need for their management to reduce environmental impacts.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Charged particle multiplicities in proton-proton collisions measured in the LHCb detector at a center-of-mass energy of √s = 7 TeV in different windows of pseudorapidity, η, in the forward region of ...the vertex detector are studied by using different statistical distributions. Three distributions are compared with the data, and the moments of the distributions are calculated. The data constituting two sets, one of minimum bias events and another of hard QCD events, are analyzed. The distributions considered derive from different functional forms based on underlying interaction dynamics. The analysis complements the multiplicity analysis done by LHCb in terms of Monte Carlo event generators. The present analysis is from a different perspective, using statistical distributions.
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CMK, CTK, FMFMET, IJS, NUK, PNG, UM
Background
Major surgery is associated with high rates of postoperative complications, many of which are deemed preventable. It has been suggested that these complications not only present a risk to ...patients in the short term, but may also reduce long‐term survival. The aim of this review was to examine the effects of postoperative complications on long‐term survival.
Methods
MEDLINE, Web of Science and reference lists of relevant articles were searched up to July 2013. Studies assessing only procedure‐specific, or technical failure‐related, complications were excluded, as were studies of poor methodological quality. Meta‐analysis was performed using a random‐effects model. Risk of bias was assessed using funnel plots.
Results
Eighteen eligible studies were included, comprising results for 134 785 patients with an overall complication rate of 22·6 (range 10·6–69) per cent. The studies included operations for both benign and malignant disease. Median follow‐up was 43 (range 28–96) months. Meta‐analysis demonstrated reduced overall survival after any postoperative complication for ten studies with eligible data (20 755 patients), with a hazard ratio (HR) of 1·28 (95 per cent confidence interval 1·21 to 1·34). Similar results were found for overall survival following infectious complications: HR 1·92 (1·50 to 2·35). In analyses of disease‐free survival the HR was 1·26 (1·10 to 1·42) for all postoperative complications and 1·55 (1·12 to 1·99) for infectious complications. Inclusion of poor‐quality studies in a sensitivity analysis had no effect on the results.
Conclusion
Postoperative complications have a negative effect on long‐term survival. This relationship appears to be stronger for infectious complications.
Postoperative complications reduced long‐term survival
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The aim of this review is to examine and quantify the long-term risk of immune-mediated systemic conditions in people with periodontitis compared to people without periodontitis.
Medline, EMBASE and ...Cochrane databases were searched up to June 2022 using keywords and MeSH headings. The 'Risk of Bias in Non-Randomised Studies of Interventions' tool was used to assess bias. Cohort studies comparing incident metabolic/autoimmune/inflammatory diseases in periodontitis to healthy controls were included. Meta-analysis and meta-regression quantified risks and showed impact of periodontitis diagnosis type and severity.
The search retrieved 3354 studies; 166 studies were eligible for full-text screening, and 30 studies were included for review. Twenty-seven studies were eligible for meta-analysis. The risks of diabetes, rheumatoid arthritis (RA) and osteoporosis were increased in people with periodontitis compared to without periodontitis (diabetes-relative risk RR: 1.22, 95% CI: 1.13-1.33; RA-RR: 1.27, 95% CI: 1.07-1.52; osteoporosis-RR: 1.40, 95% CI: 1.12-1.75). Risk of diabetes showed gradient increase by periodontitis severity (moderate-RR = 1.20, 95% CI = 1.11-1.31; severe-RR = 1.34, 95% CI = 1.10-1.63).
People with moderate-to-severe cases of periodontitis have the highest risk of developing diabetes, while the effect of periodontal severity on risk of other immune-mediated systemic conditions requires further investigation. More homologous evidence is required to form robust conclusions regarding periodontitis-multimorbidity associations.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Treatment options for advanced thyroid cancer refractory to standard therapies are limited. The safety and efficacy of pembrolizumab were evaluated in patients with advanced differentiated thyroid ...cancer expressing programmed death ligand 1 (PD-L1).
Patients with advanced thyroid cancer were enrolled in the nonrandomized, phase Ib KEYNOTE-028 trial conducted to evaluate safety and antitumor activity of the anti-programmed death 1 (PD-1) antibody pembrolizumab in advanced solid tumors. Key eligibility criteria were advanced papillary or follicular thyroid cancer, failure of standard therapy, and PD-L1 expression in tumor or stroma cells (assessed by immunohistochemistry). Pembrolizumab 10 mg/kg was administered every 2 weeks up to 24 months or until confirmed progression or intolerable toxicity. The primary endpoint was objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors, version 1.1.
Twenty-two patients were enrolled: median age was 61 years; 59% were women; and 68% had papillary carcinoma. Median follow-up was 31 months (range, 7-34 months). Treatment-related adverse events were observed in 18 (82%) patients; those occurring in ≥15% of patients were diarrhea (n = 7) and fatigue (n = 4). One grade ≥ 3 treatment-related adverse event occurred (colitis, grade 3); no treatment-related discontinuations or deaths occurred. Two patients had confirmed partial response, for an ORR of 9% (95% confidence interval CI, 1-29%); response duration was 8 and 20 months. Median progression-free survival was 7 months (95% CI, 2-14 months); median overall survival was not reached (95% CI, 22 months to not reached).
Results of this phase Ib proof-of-concept study suggest that pembrolizumab has a manageable safety profile and demonstrate evidence of antitumor activity in advanced differentiated thyroid cancer in a minority of patients treated. Further analyses are necessary to confirm these findings.
Clinicaltrials.gov identifier: NCT02054806 . Registered 4 February 2014.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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