Abstract
Background
Percutaneous radiologic gastrostomy is an established mode of enteral feeding for nutritional support for patients with dysphagia from upper digestive tract malignancy. Its role ...as a rescue measure in patients with advanced malignancy, presenting with absolute dysphagia and failure of nasogastric tube insertion has not been well established.
Purpose
This study was performed to assess technical success and long-term outcomes of percutaneous radiologic gastrostomy (push type) for nutritional support for patients with absolute dysphagia as a last ditch nonsurgical rescue effort for enteral access.
Materials and Methods
This was a prospective observational study of 31 patients who underwent push-type percutaneous radiologic gastrostomy over a period of 2 years (March 2017–March 2019). The study was a part of a larger trial approved by the institutional ethics committee. Patients were followed till the removal of tube, death, or 1 year, whichever was earlier. Gastrostomy tube-related problems and complications were documented. Descriptive summary statistics were employed to analyze the success rate and complications.
Results
Thirty-one patients with mean age 56 years (26–78 years) including 18 males and 13 females with head and neck squamous cell cancer and esophageal cancer presenting with absolute dysphagia or significant dysphagia with failed nasogastric or endoscopic enteral access were included. Overall technical success was 93.5% (29/31), achieved in 26/31 patients with just fluoroscopy guidance and 3/5 patients with computed tomography guidance. One major (3.3%) and two minor (6.5%) complications were encountered. Five out of 29 gastrostomy tubes had to be exchanged, after a mean of 44 days (1–128 days) after insertion.
Conclusion
Percutaneous radiologic gastrostomy is a safe and effective intervention even as a rescue measure in patients with absolute dysphagia from advanced upper digestive tract malignancies.
•Response surface methodologies (RSM), Non-sorted genetic algorithm II (NSGA II) for ITPTR geometric parameters are applied.•Cold head temperature and compressor input power is chosen as objective ...functions.•The proposed generated model is significant as the values of the F test, Prob>F, from the ANOVA analysis.•A set of optimal solutions are found using NSGA II.
The modeling and optimization of a Pulse Tube Refrigerator is a complicated task, due to its complexity of geometry and nature. The aim of the present work is to optimize the dimensions of pulse tube and regenerator for an Inertance-Type Pulse Tube Refrigerator (ITPTR) by using Response Surface Methodology (RSM) and Non-Sorted Genetic Algorithm II (NSGA II). The Box–Behnken design of the response surface methodology is used in an experimental matrix, with four factors and two levels. The diameter and length of the pulse tube and regenerator are chosen as the design variables where the rest of the dimensions and operating conditions of the ITPTR are constant. The required output responses are the cold head temperature (Tcold) and compressor input power (Wcomp). Computational fluid dynamics (CFD) have been used to model and solve the ITPTR. The CFD results agreed well with those of the previously published paper. Also using the results from the 1-D simulation, RSM is conducted to analyse the effect of the independent variables on the responses. To check the accuracy of the model, the analysis of variance (ANOVA) method has been used. Based on the proposed mathematical RSM models a multi-objective optimization study, using the Non-sorted genetic algorithm II (NSGA-II) has been performed to optimize the responses.
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•Time-calibrated phylogeny representing ca. 90% of Hypolimnas species.•Hypolimnas originated in Africa and dispersed to Asia supporting ‘Out-of-Africa’ hypothesis.•Broader host plant ...range of non-African lineage in comparison to that of African lineage.•A common mitotype in H. bolina and H. alimena, and its strong association with Wolbachia.
Hypolimnas butterflies (Nymphalidae), commonly known as eggflies, are a popular model system for studying a wide range of ecological questions including mimicry, polymorphism, wing pattern evolution, and Wolbachia-host interactions. The lack of a time-calibrated phylogeny for this group has precluded understanding its evolutionary history. We reconstruct a species-level phylogeny using a nine gene dataset and estimate species divergence times. Based on the resulting tree, we investigate the taxon’s historical biogeography, examine the evolution of host plant preferences, and test the hypothesis that the endosymbiotic bacterium Wolbachia mediates gene transfer between species. Our analyses indicate that the species are grouped within three strongly supported, deeply divergent clades. However, relationships among these three clades are uncertain. In addition, many Hypolimnas species are not monophyletic or monophyletic with weak support, suggesting widespread incomplete lineage sorting and/or introgression. Biogeographic analysis strongly indicates that the genus diverged from its ancestor in Africa and subsequently dispersed to Asia; the strength of this result is not affected by topological uncertainties. While the larvae of African species feed almost exclusively on Urticaceae, larvae of species found further east often feed on several additional families. Interestingly, we found an identical mitochondrial haplotype in two Hypolimnas species, H. bolina and H. alimena, and a strong association between this mitotype and the Wolbachia strain wBol1a. Future investigations should explore the plausibility of Wolbachia-mediated introgression between species.
Abstract Cervical cancer is still the leading cause of cancer mortality worldwide even after introduction of vaccine against Human papillomavirus (HPV), due to low vaccine coverage, especially in the ...developing world. Cervical cancer is primarily treated by Chemo/Radiotherapy, depending on the disease stage, with Carboplatin/Cisplatin-based drug regime. These drugs being non-specific, target rapidly dividing cells, including normal cells, so safer options are needed for lower off-target toxicity. Natural products offer an attractive option compared to synthetic drugs due to their well-established safety profile and capacity to target multiple oncogenic hallmarks of cancer like inflammation, angiogenesis, etc. In the current study, we investigated the effect of Bergenin (C-glycoside of 4- O -methylgallic acid), a natural polyphenol compound that is isolated from medicinal plants such as Bergenia crassifolia , Caesalpinia digyna, and Flueggea leucopyrus . Bergenin has been shown to have anti-inflammatory, anti-ulcerogenic, and wound healing properties but its anticancer potential has been realized only recently. We performed a proteomic analysis of cervical carcinoma cells treated with bergenin and found it to influence multiple hallmarks of cancers, including apoptosis, angiogenesis, and tumor suppressor proteins. It was also involved in many different cellular processes unrelated to cancer, as shown by our proteomic analysis. Further analysis showed bergenin to be a potent-angiogenic agent by reducing key angiogenic proteins like Galectin 3 and MMP-9 (Matrix Metalloprotease 9) in cervical carcinoma cells. Further understanding of this interaction was carried out using molecular docking analysis, which indicated MMP-9 has more affinity for bergenin as compared to Galectin-3. Cumulatively, our data provide novel insight into the anti-angiogenic mechanism of bergenin in cervical carcinoma cells by modulation of multiple angiogenic proteins like Galectin-3 and MMP-9 which warrant its further development as an anticancer agent in cervical cancer.
Carcinoma penis is a rare neoplasm, and the literature is scarce on long-term survival and its predictors. The aim of the study was to determine the clinical profile and management patterns, identify ...predictors of survival, and the impact of education and rural/urban dwelling on survival.
Patients with a histological diagnosis of carcinoma penis from January 2015 to December 2019 were included in the study. Demographics, clinical profile, education status, primary residence address, and outcomes were obtained from the case records. Distance from the treatment centre was obtained from the postal code. The primary objectives were to assess relapse-free survival (RFS) and overall survival (OS). The secondary objectives were to identify the predictors of RFS and OS and to determine the clinical profile and treatment patterns in patients with carcinoma penis in India. Time-to-event was calculated by Kaplan-Meir analysis and survival was compared by the log-rank test. Univariate and multivariable Cox regression analyses were used to find independent predictors of relapse and mortality. Logistic regression analyses to examine the associations of rural residence, education status, and distance from the treatment centre with the relapse adjusting for measured confounding variables.
Case records of 102 patients treated during the above period were retrieved. The median age was 55.5 (interquartile range IQR 42-65 years). Ulcero-proliferative growth (65%), pain (57%), and dysuria (36%) were the most common presenting features. Clinical examination or imaging revealed inguinal lymphadenopathy in 70.6% of patients, however, only 42% of these lesions were pathologically involved. A total of 58.8% of patients were from rural areas, 46.9% had no formal education, and 50.9% had a primary residence ≥100 km from the hospital. Patients with lower education and rural households had higher TNM stages and nodal involvement. Median RFS and OS were 57.6 months (15.8 months to not reached) and 83.9 months (32.5 months to not reached), respectively. On univariate analysis tumor stage, involvement of lymph nodes, T stage, performance status, and albumin was predictive for relapse and survival. However, on multivariate analysis, the stage remained the only predictor of RFS and nodal involvement, and metastatic disease was a predictor of OS. Education status, rural habitation, and distance from the treatment centre were not predictors for relapse or survival.
Patients with carcinoma have locally advanced disease at presentation. Rural dwellings and lower education were associated with the advanced stage but did not have a significant bearing on the survival outcomes. The stage at diagnosis and nodal involvement is the most important predictor of RFS and OS.
An indigenous programme on design and development of a small high speed cryogenic turboexpander has been taken up at NIT, Rourkela. This paper aims at the development of a small high speed cryogenic ...turboexpander in Indian condition by using aerodynamic thrust bearings. Attention has been paid to the study of the performance of turboexpander and the effect of stability on the vibration of bearings. Series of tests were conducted to confirm the findings. The maximum rotational speed obtained was 200,000 rpm and a temperature drop of 30 °C. The outcome may help the designers, researchers and manufacturer of these components.
L'objectif de cette étude est de fournir des données expérimentales qui pourraient être utilisées pour prédire l'efficacité et la performance d'un échange de chaleur à ailettes de plaque dans des ...conditions de basse température. Dans cette étude, les échangeurs de chaleur à ailettes de plaque sont testés avec une variation du débit massique. De tels échangeurs de chaleur ont une densité d'ailettes élevée et offrent des passages étroits pour le flux de fluide, ce qui entraîne souvent une chute de pression importante. Une configuration expérimentale est réalisée en laboratoire pour tester l’échangeur de chaleur à ailettes de plaque à température cryogénique. Dans cette configuration, l'azote gazeux comprimé passera à travers l'échangeur de chaleur à ailettes de plaque sous forme de flux chaud. Le flux de gaz chaud passera à travers un échangeur thermique à serpentin d'azote liquide pour refroidir le gaz à haute pression. Le gaz froid est ensuite transmis en tant que flux inverse de l’échangeur de chaleur à ailettes de plaque. Le dispositif expérimental est monté sur l’instrument de mesure, comme les sondes RTD, le manomètre, le manomètre différentiel, le débitmètre à plaque à orifice, etc. L'efficacité de l'échange thermique sera calculée à partir des températures mesurées en provenance de l'expérience directement. En outre, la chute de température sera obtenue à partir des analyses. Les données d'efficacité et de chute de température sont également obtenues par analyse numérique et validées à l'aide de résultats expérimentaux. The objective of this study is to provide experimental data that could be used to predict the effectiveness and performance of a plate fin heat exchange for low-temperature conditions. In this study, plate-fin heat exchangers are tested with a variation of the mass flow rate. Such heat exchangers have high fin density and offer narrow passages for the fluid flow, which often leads to a significant pressure drop. An experimental setup is made in the laboratory to test the plate fin heat exchanger at cryogenic temperature. In this setup, compressed nitrogen gas will be passed through the plate-fin heat exchanger as a hot stream. The hot stream gas will be passed through a liquid nitrogen coil heat exchanger to cool the high-pressure gas. The cold gas is then passed as a reverse stream of the plate fin heat exchanger. The experimental setup is mounted to the measurement instrument like RTDs, Pressure gauge, Differential pressure gauge, Orifice plate flow meter, etc. The effectiveness of heat exchange will be calculated from the measured temperatures directly from the experiment. Also, the temperature drop will be obtained from the analyses. The effectiveness and temperature drop data are also obtained through numerical analysis and validate it with experimental results.
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