The prevalence of smartphones is deeply embedded in modern society,impacting various aspects of our lives.Their versatility and functionalities have fundamentally changed how we communicate,work,seek entertainment,and...The prevalence of smartphones is deeply embedded in modern society,impacting various aspects of our lives.Their versatility and functionalities have fundamentally changed how we communicate,work,seek entertainment,and access information.Among the many smartphones available,those operating on the Android platform dominate,being the most widely used type.This widespread adoption of the Android OS has significantly contributed to increased malware attacks targeting the Android ecosystem in recent years.Therefore,there is an urgent need to develop new methods for detecting Android malware.The literature contains numerous works related to Android malware detection.As far as our understanding extends,we are the first ones to identify dangerous combinations of permissions and system calls to uncover malicious behavior in Android applications.We introduce a novel methodology that pairs permissions and system calls to distinguish between benign and malicious samples.This approach combines the advantages of static and dynamic analysis,offering a more comprehensive understanding of an application’s behavior.We establish covalent bonds between permissions and system calls to assess their combined impact.We introduce a novel technique to determine these pairs’Covalent Bond Strength Score.Each pair is assigned two scores,one for malicious behavior and another for benign behavior.These scores serve as the basis for classifying applications as benign or malicious.By correlating permissions with system calls,the study enables a detailed examination of how an app utilizes its requested permissions,aiding in differentiating legitimate and potentially harmful actions.This comprehensive analysis provides a robust framework for Android malware detection,marking a significant contribution to the field.The results of our experiments demonstrate a remarkable overall accuracy of 97.5%,surpassing various state-of-the-art detection techniques proposed in the current literature.展开更多
BACKGROUND Intravascular lithotripsy(IVL)is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery disease.However,mu...BACKGROUND Intravascular lithotripsy(IVL)is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery disease.However,much of the available literature on IVL is focused on its use in coronary arteries,with relatively limited data on non-coronary artery use.AIM To analyze the safety and efficacy of current IVL use in non-coronary artery lesions,as reported in case reports and case series.METHODS We searched EMBASE,PubMed,and Reference Citation Analysis databases for case reports and case series on IVL use in peripheral artery disease.We then extracted variables of interest and calculated the mean and proportions of these variables.RESULTS We included 60 patients from 33 case reports/case series.Ninety-eight percent of the cases had IVL usage in only one blood vessel,while four had the IVL used in two vessels(2.0%),resulting in 64 Lesions treated with IVL.The mean age of the patients was 73.7(SD 10.9).IVL was successfully used in severe iliofemoral artery stenosis(51.6%),severe innominate,subclavian,and carotid artery stenosis(26.7%combined),and severe mesenteric vessel stenosis(9.4%).Additionally,IVL was successfully used in severe renal(7.8%)and aortic artery(4.7%)stenosis.There were complications in 12%of the cases,with dissection being the commonest.CONCLUSION IVL has successfully used in plaque modification and endovascular revascularization in severely calcified and challenging lesions in the iliofemoral,carotid,subclavian,aorta,renal,and mesenteric vessels.The most severe but transient complications were with IVL use in the aortic arch and neck arteries.展开更多
Bilirubin has traditionally been considered a cytotoxic waste product.However,recent studies have shown bilirubin to have anti-oxidant,anti-inflammatory,vasodilatory,anti-apoptotic and anti-proliferative functions.The...Bilirubin has traditionally been considered a cytotoxic waste product.However,recent studies have shown bilirubin to have anti-oxidant,anti-inflammatory,vasodilatory,anti-apoptotic and anti-proliferative functions.These properties potentially confer bilirubin a new role of protection especially in coronary artery disease(CAD),which is a low grade inflammatory process exacerbated by oxidative stress.In fact,recent literature reports an inverse relationship between serum concentration of bilirubin and the presence of CAD.In this article,we review the current literature exploring the association between levels of bilirubin and risk of CAD.We conclude that current evidence is inconclusive regarding the protective effect of bilirubin on CAD.A causal relationship between low serum bilirubin level and increased risk of CAD is not currently established.展开更多
AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBS...AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBSCO,CINAHL,Web of Science and Cochrane databases,of all studies published from the inception through October 10,2016.Inclusion criteria included:(1) Adult humans with OHCA and successful sustained return of spontaneous circulation;and(2) studies including mortality/brain death,acute thrombotic events as their end points.Primary efficacyoutcome was "brain death or Cerebral Performance Category(CPC) score of 5".Secondary outcomes were "CPC score 1,and 2-4","overall thrombotic events" and "acute coronary stent thrombosis".RESULTS We analyzed a total of 606 participants(n = 276 received Epo and n = 330 with standard of care alone) who experienced OHCA enrolled in 3 clinical trials.No significant difference was observed between the Epo and no Epo group in brain death or CPC score 5(OR = 0.77;95%CI:0.42-1.39),CPC score 1(OR = 1.16,95%CI:0.82-1.64),and CPC score 2-4(OR = 0.77,95%CI:0.44-1.36).Epo group was associated with increased thrombotic complications(OR = 2.41,95%CI:1.26-4.62) and acute coronary stent thrombosis(OR = 8.16,95%CI:1.39-47.99).No publication bias was observed.CONCLUSION Our study demonstrates no improvement in neurological outcomes and increased incidence of thrombotic events and acute coronary stent thrombosis in OHCA patients who were treated with Epo in addition to standard therapy.展开更多
Nanocrystalline cellulose(NCC) was produced from rice husk biomass(Oryza sativa) by a chemical extraction process to explore the potential aspect of agro-waste biomass in Australia. In this work, the delignified rice ...Nanocrystalline cellulose(NCC) was produced from rice husk biomass(Oryza sativa) by a chemical extraction process to explore the potential aspect of agro-waste biomass in Australia. In this work, the delignified rice husk pulp(D-RHP) was produced by alkaline delignification of raw rice husk biomass(R-RHB) using 4 mol·L^(-1) alkali solutions(Na OH) in a jacketed glass reactor under specific experimental conditions. D-RHP was bleached using 15% sodium hypochlorite, and the bleached rice husk pulp was coded as B-RHP. Finally,raw suspension of NCC was produced by the acid hydrolysis of B-RHP using 4 mol·L^(-1) sulphuric acid. The raw suspension of NCC was neutralized by a buffer solution and analyzed by TAPPI, FT-IR, XRD, SEM, AFM, and TEM. FT-IR spectra of NCC are different to R-RHB but similar with B-RHP and D-RHP. From XRD results, the crystallinity of NCC was found to be approximately 65%. In AFM analysis particle thicknesses have been confirmed to be in the range of(25 ± 15.14) nm or(27 ± 15.14) nm which is almost the same. From TEM analysis particle dimensions have been confirmed to be in the range of(50 ± 29.38) nm width and(550 ± 302.75) nm length with the aspect ratio ~ 11:1(length/diameter) at a 500 nm scale bar. On the other hand, at a 200 nm scale bar the particle dimensions have been confirmed to be in the range of(35 ± 17) nm width and(275 ± 151.38)nm length with the aspect ratio ~ 8:1. The aspect ratio of individual crystalline domain was determined in TEM analysis which is 10:1(100/10). Therefore the aspect ratios and dimensions of nanoparticles in NCC suspension are almost the same and in nano-meter scale, as confirmed from both AFM and TEM results. The yield of NCC from B-RHP was found to be approximately 95%, and the recovery of cellulose from R-RHB is about 90%.展开更多
Gallbladder perforation(GBP) is a rare but serious complication of cholecystitis and needs to be managed promptly. Acalculus cholecystitis leading to GBP is frequently associated with enteric fever and found in critic...Gallbladder perforation(GBP) is a rare but serious complication of cholecystitis and needs to be managed promptly. Acalculus cholecystitis leading to GBP is frequently associated with enteric fever and found in critically ill patients, and a surgical approach is not always feasible in such patients. Use of percutaneous tube cholecystostomy(PTC) in such patients is a known entity but it is usually followed by interval cholecystectomy. Here we report a case of perforated gallbladder in a child managed conservatively and successfully with PTC as the definitive treatment wherein cholecystectomy was avoided. The functionality of the gallbladder was confirmed by a Tc99m-HIDA scan.展开更多
Giant flares(GFs)are unusual bursts from soft gamma-ray repeaters(SGRs)that release an enormous amount of energy in a fraction of a second.The afterglow emission of these SGR-GFs or GF candidates is a highly beneficia...Giant flares(GFs)are unusual bursts from soft gamma-ray repeaters(SGRs)that release an enormous amount of energy in a fraction of a second.The afterglow emission of these SGR-GFs or GF candidates is a highly beneficial means of discerning their composition,relativistic speed and emission mechanisms.GRB 200415A is a recent GF candidate observed in a direction coincident with the nearby Sculptor galaxy at 3.5 Mpc.In this work,we searched for transient gamma-ray emission in past observations by Fermi-LAT in the direction of GRB 200415A.These observations confirm that GRB 200415A is observed as a transient GeV source only once.A pure pair-plasma fireball cannot provide the required energy for the interpretation of GeV afterglow emission and a baryonic poor outflow is additionally needed to explain the afterglow emission.A baryonic rich outflow is also viable,as it can explain the variability and observed quasi-thermal spectrum of the prompt emission if dissipation is happening below the photosphere via internal shocks.Using the peak energy(Ep)of the time-resolved prompt emission spectra and their fluxes(Fp),we found a correlation between Ep and Fp or isotropic luminosity Liso for GRB 200415A.This supports the intrinsic nature of Ep-Liso correlation found in SGRs-GFs,hence favoring a baryonic poor outflow.Our results also indicate a different mechanism at work during the initial spike,and that the evolution of the prompt emission spectral properties in this outflow would be intrinsically due to the injection process.展开更多
Small bowel adenocarcinoma(SBA)is a rare malignancy of the gastrointestinal tract.However,these tumors are among those with worst prognosis.Vague clinical signs and symptoms and radiological diagnostic challenges ofte...Small bowel adenocarcinoma(SBA)is a rare malignancy of the gastrointestinal tract.However,these tumors are among those with worst prognosis.Vague clinical signs and symptoms and radiological diagnostic challenges often delay treatment,which negatively impacts the prognosis of the patients.However,recent advances in imaging technology,like multidetector computed tomography,magnetic resonance imaging,and capsule endoscopy,have made earlier and accurate diagnosis possible.Surgery is the treatment of choice followed by adjuvant therapy.However,there are no strict treatment guidelines available for the management of SBA.Most of the available evidence from colorectal and gastric carcinoma has been extrapolated to adequately manage SBA.Prognosis for SBA is better than gastric carcinoma but worse than colorectal carcinoma.Currently,there is not enough information on the molecular characteristics and tumor pathogenesis.Because the incidence of SBA is very low,there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.展开更多
BACKGROUND Home telemonitoring has been used as a modality to prevent readmission and improve outcomes for patients with heart failure.However,studies have produced conflicting outcomes over the years.AIM To determine...BACKGROUND Home telemonitoring has been used as a modality to prevent readmission and improve outcomes for patients with heart failure.However,studies have produced conflicting outcomes over the years.AIM To determine the aggregate effect of telemonitoring on all-cause mortality,heart failure-related mortality,all-cause hospitalization,and heart failure-related hospitalization in heart failure patients.METHODS We conducted a systematic review and meta-analysis of 38 home telemonitoring randomized controlled trials involving 14993 patients.We also conducted a sensitivity analysis to examine the effect of telemonitoring duration,recent heart failure hospitalization,and age on telemonitoring outcomes.RESULTS Our study demonstrated that home telemonitoring in heart failure patients was associated with reduced all-cause[relative risk(RR)=0.83,95% confidence interval(CI):0.75-0.92,P=0.001]and cardiovascular mortality(RR=0.66,95%CI:0.54-0.81,P<0.001).Additionally,telemonitoring decreased the all-cause hospitalization(RR=0.87,95%CI:0.80-0.94,P=0.002)but did not decrease heart failurerelated hospitalization(RR=0.88,95%CI:0.77-1.01,P=0.066).However,prolonged home telemonitoring(12 mo or more)was associated with both decreased all-cause and heart failure hospitalization,unlike shorter duration(6 mo or less)telemonitoring.CONCLUSION Home telemonitoring using digital/broadband/satellite/wireless or blue-tooth transmission of physiological data reduces all-cause and cardiovascular mortality in heart failure patients.In addition,prolonged telemonitoring(≥12 mo)reduces all-cause and heart failure-related hospitalization.The implication for practice is that hospitals considering telemonitoring to reduce heart failure readmission rates may need to plan for prolonged telemonitoring to see the effect they are looking for.展开更多
Surgery is the only curative treatment for cholangiocarcinoma. However, mostpatients present with advanced disease, and hence are unresectable. Thus, theintent of treatment shifts from curative to palliative in the ma...Surgery is the only curative treatment for cholangiocarcinoma. However, mostpatients present with advanced disease, and hence are unresectable. Thus, theintent of treatment shifts from curative to palliative in the majority of cases.Biliary drainage with intraluminal brachytherapy is an effective means ofrelieving the malignant biliary obstruction. In this review, we discuss the role ofbrachytherapy in the palliation of obstructive symptoms in extrahepatic cholangiocarcinoma.展开更多
Vaccination for coronavirus disease 2019(COVID-19)is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).After widespread COVID-19 vaccine implementat...Vaccination for coronavirus disease 2019(COVID-19)is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).After widespread COVID-19 vaccine implementation,isolated case reports about myocarditis as a potential adverse reaction started coming.As of November 12,2021,Centers for Disease Control and Prevention(CDC)has reported 1793 cases of myocarditis or pericarditis among young people with age 12-29 years,most cases have been reported in the male adolescent age group after the second dose of mRNA COVID-19 vaccines.It is very important to monitor the safety standards and adverse reactions of vaccines to effectively implement the vaccination policies.The CDC and the United States Food and Drug Administration actively monitor vaccine-associated adverse reactions a well-known platform such as Vaccine Adverse Event Reporting System.CDC continues to recommend COVID-19 vaccines and booster doses for eligible individuals(age limit according to the type of vaccine)after careful consideration from risk-benefit assessment and favorable outcomes from vaccination.Mechanisms behind COVID-19 vaccine-induced myocarditis are not clear yet but several possibilities such as molecular mimicry between the spike protein of SARS-CoV-2 and self-antigens,immune response to mRNA,and activation of host immunological system,trigger of the pre-existing dysregulated immunological system have been documented in the literature.Overall,data suggests a good prognosis,especially in young patients.In this review article,we cover currently available data on COVID-19 vaccine-related myocarditis incidence,concerns,possible mechanisms of myocarditis,current treatment,and outcome trends,risk vs benefit assessment of COVID-19 vaccination in this current pandemic.展开更多
Various directions of obtaining novel structured matrices are discussed. A new class of matrices, called “the L-family” matrices are introduced and their properties are studied.
Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinos...Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinoscrotal swelling.They were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,respectively.Later,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two patients.All these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the pelvis.These collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’approach.Two of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal collections.All the patients were discharged in satisfactory condition.Inguinoscrotal swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate diagnosis.Local drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.展开更多
文摘The prevalence of smartphones is deeply embedded in modern society,impacting various aspects of our lives.Their versatility and functionalities have fundamentally changed how we communicate,work,seek entertainment,and access information.Among the many smartphones available,those operating on the Android platform dominate,being the most widely used type.This widespread adoption of the Android OS has significantly contributed to increased malware attacks targeting the Android ecosystem in recent years.Therefore,there is an urgent need to develop new methods for detecting Android malware.The literature contains numerous works related to Android malware detection.As far as our understanding extends,we are the first ones to identify dangerous combinations of permissions and system calls to uncover malicious behavior in Android applications.We introduce a novel methodology that pairs permissions and system calls to distinguish between benign and malicious samples.This approach combines the advantages of static and dynamic analysis,offering a more comprehensive understanding of an application’s behavior.We establish covalent bonds between permissions and system calls to assess their combined impact.We introduce a novel technique to determine these pairs’Covalent Bond Strength Score.Each pair is assigned two scores,one for malicious behavior and another for benign behavior.These scores serve as the basis for classifying applications as benign or malicious.By correlating permissions with system calls,the study enables a detailed examination of how an app utilizes its requested permissions,aiding in differentiating legitimate and potentially harmful actions.This comprehensive analysis provides a robust framework for Android malware detection,marking a significant contribution to the field.The results of our experiments demonstrate a remarkable overall accuracy of 97.5%,surpassing various state-of-the-art detection techniques proposed in the current literature.
文摘BACKGROUND Intravascular lithotripsy(IVL)is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery disease.However,much of the available literature on IVL is focused on its use in coronary arteries,with relatively limited data on non-coronary artery use.AIM To analyze the safety and efficacy of current IVL use in non-coronary artery lesions,as reported in case reports and case series.METHODS We searched EMBASE,PubMed,and Reference Citation Analysis databases for case reports and case series on IVL use in peripheral artery disease.We then extracted variables of interest and calculated the mean and proportions of these variables.RESULTS We included 60 patients from 33 case reports/case series.Ninety-eight percent of the cases had IVL usage in only one blood vessel,while four had the IVL used in two vessels(2.0%),resulting in 64 Lesions treated with IVL.The mean age of the patients was 73.7(SD 10.9).IVL was successfully used in severe iliofemoral artery stenosis(51.6%),severe innominate,subclavian,and carotid artery stenosis(26.7%combined),and severe mesenteric vessel stenosis(9.4%).Additionally,IVL was successfully used in severe renal(7.8%)and aortic artery(4.7%)stenosis.There were complications in 12%of the cases,with dissection being the commonest.CONCLUSION IVL has successfully used in plaque modification and endovascular revascularization in severely calcified and challenging lesions in the iliofemoral,carotid,subclavian,aorta,renal,and mesenteric vessels.The most severe but transient complications were with IVL use in the aortic arch and neck arteries.
文摘Bilirubin has traditionally been considered a cytotoxic waste product.However,recent studies have shown bilirubin to have anti-oxidant,anti-inflammatory,vasodilatory,anti-apoptotic and anti-proliferative functions.These properties potentially confer bilirubin a new role of protection especially in coronary artery disease(CAD),which is a low grade inflammatory process exacerbated by oxidative stress.In fact,recent literature reports an inverse relationship between serum concentration of bilirubin and the presence of CAD.In this article,we review the current literature exploring the association between levels of bilirubin and risk of CAD.We conclude that current evidence is inconclusive regarding the protective effect of bilirubin on CAD.A causal relationship between low serum bilirubin level and increased risk of CAD is not currently established.
文摘AIM To assess safety and efficacy of early erythropoietin(Epo) administration in patients with out-of-hospital cardiac arrest(OHCA).METHODS A systematic literature search was performed using PubM ed,MEDLINE,EMBASE,EBSCO,CINAHL,Web of Science and Cochrane databases,of all studies published from the inception through October 10,2016.Inclusion criteria included:(1) Adult humans with OHCA and successful sustained return of spontaneous circulation;and(2) studies including mortality/brain death,acute thrombotic events as their end points.Primary efficacyoutcome was "brain death or Cerebral Performance Category(CPC) score of 5".Secondary outcomes were "CPC score 1,and 2-4","overall thrombotic events" and "acute coronary stent thrombosis".RESULTS We analyzed a total of 606 participants(n = 276 received Epo and n = 330 with standard of care alone) who experienced OHCA enrolled in 3 clinical trials.No significant difference was observed between the Epo and no Epo group in brain death or CPC score 5(OR = 0.77;95%CI:0.42-1.39),CPC score 1(OR = 1.16,95%CI:0.82-1.64),and CPC score 2-4(OR = 0.77,95%CI:0.44-1.36).Epo group was associated with increased thrombotic complications(OR = 2.41,95%CI:1.26-4.62) and acute coronary stent thrombosis(OR = 8.16,95%CI:1.39-47.99).No publication bias was observed.CONCLUSION Our study demonstrates no improvement in neurological outcomes and increased incidence of thrombotic events and acute coronary stent thrombosis in OHCA patients who were treated with Epo in addition to standard therapy.
基金funded by RMIT University, Melbourne, VIC 3001, Australia
文摘Nanocrystalline cellulose(NCC) was produced from rice husk biomass(Oryza sativa) by a chemical extraction process to explore the potential aspect of agro-waste biomass in Australia. In this work, the delignified rice husk pulp(D-RHP) was produced by alkaline delignification of raw rice husk biomass(R-RHB) using 4 mol·L^(-1) alkali solutions(Na OH) in a jacketed glass reactor under specific experimental conditions. D-RHP was bleached using 15% sodium hypochlorite, and the bleached rice husk pulp was coded as B-RHP. Finally,raw suspension of NCC was produced by the acid hydrolysis of B-RHP using 4 mol·L^(-1) sulphuric acid. The raw suspension of NCC was neutralized by a buffer solution and analyzed by TAPPI, FT-IR, XRD, SEM, AFM, and TEM. FT-IR spectra of NCC are different to R-RHB but similar with B-RHP and D-RHP. From XRD results, the crystallinity of NCC was found to be approximately 65%. In AFM analysis particle thicknesses have been confirmed to be in the range of(25 ± 15.14) nm or(27 ± 15.14) nm which is almost the same. From TEM analysis particle dimensions have been confirmed to be in the range of(50 ± 29.38) nm width and(550 ± 302.75) nm length with the aspect ratio ~ 11:1(length/diameter) at a 500 nm scale bar. On the other hand, at a 200 nm scale bar the particle dimensions have been confirmed to be in the range of(35 ± 17) nm width and(275 ± 151.38)nm length with the aspect ratio ~ 8:1. The aspect ratio of individual crystalline domain was determined in TEM analysis which is 10:1(100/10). Therefore the aspect ratios and dimensions of nanoparticles in NCC suspension are almost the same and in nano-meter scale, as confirmed from both AFM and TEM results. The yield of NCC from B-RHP was found to be approximately 95%, and the recovery of cellulose from R-RHB is about 90%.
文摘Gallbladder perforation(GBP) is a rare but serious complication of cholecystitis and needs to be managed promptly. Acalculus cholecystitis leading to GBP is frequently associated with enteric fever and found in critically ill patients, and a surgical approach is not always feasible in such patients. Use of percutaneous tube cholecystostomy(PTC) in such patients is a known entity but it is usually followed by interval cholecystectomy. Here we report a case of perforated gallbladder in a child managed conservatively and successfully with PTC as the definitive treatment wherein cholecystectomy was avoided. The functionality of the gallbladder was confirmed by a Tc99m-HIDA scan.
基金support by the Fundamental Research Funds for the Central Universities(14380035)supported by National Key Research and Development Programs of China(2018YFA0404204)+3 种基金the National Natural Science Foundation of China(Grant Nos.11833003,U1838105 and U1831135)the Program for Innovative Talents,Entrepreneur in Jiangsuthe Strategic Priority Research Program on Space Science,the Chinese Academy of Sciences(Grant No.XDB23040400)BRICS grant DST/IMRCD/BRICS/PilotCall1/ProFCheap/2017(G)for the financial support。
文摘Giant flares(GFs)are unusual bursts from soft gamma-ray repeaters(SGRs)that release an enormous amount of energy in a fraction of a second.The afterglow emission of these SGR-GFs or GF candidates is a highly beneficial means of discerning their composition,relativistic speed and emission mechanisms.GRB 200415A is a recent GF candidate observed in a direction coincident with the nearby Sculptor galaxy at 3.5 Mpc.In this work,we searched for transient gamma-ray emission in past observations by Fermi-LAT in the direction of GRB 200415A.These observations confirm that GRB 200415A is observed as a transient GeV source only once.A pure pair-plasma fireball cannot provide the required energy for the interpretation of GeV afterglow emission and a baryonic poor outflow is additionally needed to explain the afterglow emission.A baryonic rich outflow is also viable,as it can explain the variability and observed quasi-thermal spectrum of the prompt emission if dissipation is happening below the photosphere via internal shocks.Using the peak energy(Ep)of the time-resolved prompt emission spectra and their fluxes(Fp),we found a correlation between Ep and Fp or isotropic luminosity Liso for GRB 200415A.This supports the intrinsic nature of Ep-Liso correlation found in SGRs-GFs,hence favoring a baryonic poor outflow.Our results also indicate a different mechanism at work during the initial spike,and that the evolution of the prompt emission spectral properties in this outflow would be intrinsically due to the injection process.
文摘Small bowel adenocarcinoma(SBA)is a rare malignancy of the gastrointestinal tract.However,these tumors are among those with worst prognosis.Vague clinical signs and symptoms and radiological diagnostic challenges often delay treatment,which negatively impacts the prognosis of the patients.However,recent advances in imaging technology,like multidetector computed tomography,magnetic resonance imaging,and capsule endoscopy,have made earlier and accurate diagnosis possible.Surgery is the treatment of choice followed by adjuvant therapy.However,there are no strict treatment guidelines available for the management of SBA.Most of the available evidence from colorectal and gastric carcinoma has been extrapolated to adequately manage SBA.Prognosis for SBA is better than gastric carcinoma but worse than colorectal carcinoma.Currently,there is not enough information on the molecular characteristics and tumor pathogenesis.Because the incidence of SBA is very low,there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.
文摘BACKGROUND Home telemonitoring has been used as a modality to prevent readmission and improve outcomes for patients with heart failure.However,studies have produced conflicting outcomes over the years.AIM To determine the aggregate effect of telemonitoring on all-cause mortality,heart failure-related mortality,all-cause hospitalization,and heart failure-related hospitalization in heart failure patients.METHODS We conducted a systematic review and meta-analysis of 38 home telemonitoring randomized controlled trials involving 14993 patients.We also conducted a sensitivity analysis to examine the effect of telemonitoring duration,recent heart failure hospitalization,and age on telemonitoring outcomes.RESULTS Our study demonstrated that home telemonitoring in heart failure patients was associated with reduced all-cause[relative risk(RR)=0.83,95% confidence interval(CI):0.75-0.92,P=0.001]and cardiovascular mortality(RR=0.66,95%CI:0.54-0.81,P<0.001).Additionally,telemonitoring decreased the all-cause hospitalization(RR=0.87,95%CI:0.80-0.94,P=0.002)but did not decrease heart failurerelated hospitalization(RR=0.88,95%CI:0.77-1.01,P=0.066).However,prolonged home telemonitoring(12 mo or more)was associated with both decreased all-cause and heart failure hospitalization,unlike shorter duration(6 mo or less)telemonitoring.CONCLUSION Home telemonitoring using digital/broadband/satellite/wireless or blue-tooth transmission of physiological data reduces all-cause and cardiovascular mortality in heart failure patients.In addition,prolonged telemonitoring(≥12 mo)reduces all-cause and heart failure-related hospitalization.The implication for practice is that hospitals considering telemonitoring to reduce heart failure readmission rates may need to plan for prolonged telemonitoring to see the effect they are looking for.
文摘Surgery is the only curative treatment for cholangiocarcinoma. However, mostpatients present with advanced disease, and hence are unresectable. Thus, theintent of treatment shifts from curative to palliative in the majority of cases.Biliary drainage with intraluminal brachytherapy is an effective means ofrelieving the malignant biliary obstruction. In this review, we discuss the role ofbrachytherapy in the palliation of obstructive symptoms in extrahepatic cholangiocarcinoma.
文摘Vaccination for coronavirus disease 2019(COVID-19)is a critical strategy in controlling the current pandemic of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).After widespread COVID-19 vaccine implementation,isolated case reports about myocarditis as a potential adverse reaction started coming.As of November 12,2021,Centers for Disease Control and Prevention(CDC)has reported 1793 cases of myocarditis or pericarditis among young people with age 12-29 years,most cases have been reported in the male adolescent age group after the second dose of mRNA COVID-19 vaccines.It is very important to monitor the safety standards and adverse reactions of vaccines to effectively implement the vaccination policies.The CDC and the United States Food and Drug Administration actively monitor vaccine-associated adverse reactions a well-known platform such as Vaccine Adverse Event Reporting System.CDC continues to recommend COVID-19 vaccines and booster doses for eligible individuals(age limit according to the type of vaccine)after careful consideration from risk-benefit assessment and favorable outcomes from vaccination.Mechanisms behind COVID-19 vaccine-induced myocarditis are not clear yet but several possibilities such as molecular mimicry between the spike protein of SARS-CoV-2 and self-antigens,immune response to mRNA,and activation of host immunological system,trigger of the pre-existing dysregulated immunological system have been documented in the literature.Overall,data suggests a good prognosis,especially in young patients.In this review article,we cover currently available data on COVID-19 vaccine-related myocarditis incidence,concerns,possible mechanisms of myocarditis,current treatment,and outcome trends,risk vs benefit assessment of COVID-19 vaccination in this current pandemic.
文摘Various directions of obtaining novel structured matrices are discussed. A new class of matrices, called “the L-family” matrices are introduced and their properties are studied.
文摘Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinoscrotal swelling.They were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,respectively.Later,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two patients.All these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the pelvis.These collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’approach.Two of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal collections.All the patients were discharged in satisfactory condition.Inguinoscrotal swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate diagnosis.Local drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.
