This new human pathogenic coronavirus belongs to lineage B betacoronaviruses, taking into account its genome. The SARS-CoV-2 genes code for the structural and non-structural proteins used throughout their life cycle and pathogenesis. These proteins govern the functional characteristics of SARS-CoV-2 infection and its association with host proteins in pathogenesis. These open new horizons in the battle virus/host and provide a better understanding of COVID-19 infection. These understandings are revealed by transcriptome-wide and genome-wide analyses showing viral and host crosstalk from viral entry to disease development. It also discloses the acquaintance about antiviral immunity against SARS-CoV-2 and disease severity. The most crucial event is the combat between the virus and the host’s antiviral immunity. Based on insight into immunopathogenesis and pathology, potential susceptibility genes are involved in immune dysregulation, auto-inflammation, or autoimmunity mechanisms. This paper addresses host susceptibility, considerations of immune responses, and the use of these prospects for antiviral therapeutic leads. Significant interactions between SARS-CoV infection and host antiviral pathways address innate immune signaling, which can be a crucial genetic determinant in analyzing COVID-19 susceptibility and disease outcomes. The susceptibility of individuals is highly associated with genetics and genetic variants, and their frequencies cause the deviation in the patient vulnerability, which further decides the clinical condition of viral infection in patients. These associations provided relationships among host and viral genes that uncover hidden aspects of giving insights into the vaccine design and antiviral treatment strategies.

In the Central Himalayas, where environmental conditions vary greatly, understanding the biophysical limitations on forest carbon is crucial for accurately determining the region’s forest carbon stocks. This study investigates the role of climate and disturbance on the spatial variation of two key forest carbon pools: aboveground carbon (AGC) and soil organic carbon (SOC). Using field-observed plot-level carbon pool estimates from Nepal’s national forest inventory and structural equation modeling, we explore the relationship between forest carbon stocks and proxies of environmental constraints. The forest AGC and SOC models explained 25 % and 59 % of the observed spatial variation in forest AGC and SOC, respectively. The climatic availability of water and energy in broad-scale gradients combined with the fine-scale gradients of terrain and disturbance intensity were found to influence forest carbon stocks, but the sign and strength of the statistical relationships differ for forest AGC and SOC. While AGC showed a negative relationship to disturbance, SOC was impacted by the availability of climatic energy. Disturbances such as selective logging and firewood collection result in immediate forest carbon loss, while soil carbon changes take longer to respond. The lower decomposition rates in the high-elevation region, due to lower temperatures, preserve organic matter and contribute to the high SOC stocks observed there. These results have important implications for forest carbon management and conservation in the Central Himalayas.

The aim of this research work is to analyse the biomolecules of pollen present in seven different species of Solanum L. i.e., S. erianthum, S. indicum, S. macranthum, S. melongena, S. sisymbriifolium, S. torvum and S. xanthocarpum. The pollen grains were collected from plants growing in Santiniketan, Sriniketan, Prantik and Bolpur of Birbhum district. The flowering season, anthesis time, pollen morphology, pollen protein profile were studied and total carbohydrates, proteins, lipids, amino acids, DNA were estimated using standard methods. The flowering season and anthesis time vary among the studied species. The size of pollen grains varies between 17 x 16 µm to 68 x 72 µm. The total content of carbohydrates, lipids and proteins were highest in S. xanthocarpum whereas total free amino acid and DNA was highest in S. erianthum. The S. macranthum reported lowest amount of total lipids, proteins and free amino acids among all. The proline present in all species ranging 0.59-3.00 mg/g, an essential amino acid for pollen germination. The SDS- PAGE of pollen protein revealed 44 major polypeptide bands of different molecular weight ranging from 19 kDa to 135 kDa and variation in polypeptide bands observed from 7 to 13. A dendrogram was drawn based on morphology and biomolecules of pollen found that S. macranthum, showed less similarity with other species and it placed alone in a separate cluster.

Aspirin induced urticaria in a recently diagnosed ischemic stroke patient: A case report and literature review. Abhinav Dahal : Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal Email: abhinav.dahal333@gmail.comSushant gautam: Nepalgunj medical college, banke,Nepalemail: gautamsushant1941@outlook.comAliza Shakya : Manipal college of medical sciences, Pokhara, Nepalemail: shakyaaliza@gmail.comAshmita pant: Manipal college of medical sciences, Pokhara, Nepalemail: ashmita.pant@gmail.comKriti Bhandari , Nepal Medical College, Jorpati, Kathmandu, Nepal itirkbhandari977@gmail.comAbhigan Babu Shrestha, M Abdur Rahim Medical College, Dinajpur, Bangladesh. Abigan17@gmail.comCorresponding author:ABS; M Abdur Rahim Medical College, Dinajpur, Bangladesh. Abigan17@gmail.comAbstract: Aspirin and urticaria correlation has not been fully understood. The pharmacological inference is suspected to be the diversion of arachidonic acid metabolism. Aspirin sensitivity can aggravate pre-existing chronic urticaria and in some instances causes acute urticaria. We report a case of a 53-year old male, recently diagnosed with stroke, who presented with complaints of multiple rash over trunk and upper extremity with aspirin. NSAIDs induced urticarial are usually neglected by physicians during diagnosis. Keywords: Aspirin, urticarial, stroke, hemiplegiaIntroduction: Aspirin is a drug which is widely used to reduce the risk of stroke, transient ischemic attack, and cardiovascular events. This is due to its antithrombotic properties by irreversibly inhibiting the cyclooxygenase enzyme, reducing the synthesis of Thromboxane A2 and thus subsequently reducing platelet aggregation [1– 3]. Aspirin and NSAIDs’ pharmacological properties also result in adverse reactions like GI upset, renal toxicity, and hemorrhagic complications, as well as potentiate hypersensitivity reactions [4]. Aspirin Hypersensitivity is reported by 0.9 to 1.5% of the general population [5]. Hypersensitivity reactions to NSAIDs are classified on the basis of their involvement of the skin, like urticaria or angioedema, the airways or other organs, their acute or delayed onset, the presence of underlying diseases, and their cross reactivity[6]. In this report, we document a case of aspirin induced urticaria in a patient with a recent history of Ischaemic stroke and Hypertension.Case Description: A 53 years old male presented to the emergency department with a chief complaint of multiple rashes with burning and itching sensation over trunk and extremities. Figure 1 and 2. The patient was a known case of hypertension with recent diagnosis of left sided ischemic stroke with right sided hemiparesis 7 days back for which he was admitted for 3 days. There were no significant reactions to the treatment noticed during the hospital stay. He was discharged with a daily dose of aspirin 75 mg o.d., enalapril 10 mg o.d., atorvastatin 20 mg o.d., omeprazole 20 mg b.d. He was advised for proper bed rest with two hourly posture changes & physiotherapy. He was solely on prescribed medications for the past 4 days. On the next day, he was admitted following the appearance of cutaneous manifestations with no other associated symptoms such as angioedema or shortness of breath. He had no prior history of allergic reactions. On further enquiry, he denied any changes to diet or environmental stimuli including no exposure to any pets or animals. He also gave a negative history of family members having such allergic manifestations. On examination, multiple, pruritic, erythematous, blanching macules were present on bilateral upper extremities and trunk(Figure 1). His vital signs were within normal limits. Leukocytosis (wbc:12,000 cells/mm3) with higher eosinophil count ( 550 per ml of blood) was noted while other complete blood count and comprehensive metabolic panels were unremarkable. Medical history revealed he was taking enalapril 10 mg o.d. for the past 3 years for hypertension. As ACE inhibitors are commonly responsible for causing the side effects such as allergies, drug rash & even angioedema, it was replaced with amlodipine 5 mg o.d. He was started on histacin 4 mg b.d for symptomatic management. However, there was no significant improvement in his condition. Therefore, we decided to stop the current medication one at a time to identify the culprit drug. Aspirin was replaced with clopidogrel 75 mg o.d. & given daily. He was kept under observation & followed up the next day with improvement. Patient told that his itching and the degree of rash spread throught his body were diminished. Three days later, the rashes almost fully subsided & he was advised to continue histacin for 1 more week without stopping clopidogrel intake. Aspirin was identified as the sole cause for the rashes. He was discharged following complete recovery of cutaneous symptoms after 3 days with proper counselling regarding his condition and precaution to be taken for future aspirin use.Discussion: Aspirin and other NSAID are known to cause hypersensitivity reactions. One of the manifestation of such reactions is urticaria. The prevalence of aspirin induced urticaria is estimated to be around 0.3% excluding individuals with recurrent urticaria, hay fever and chronic chest disease [7]. Aspirin induced Urticaria(AIU) can be classified into two types as aspirin intolerant acute urticaria(AIAU) and aspirin intolerant chronic urticaria(AICU). The symptoms develop within minutes to 24 hour in AIAU and lasts for less than 6 weeks whereas, in AICU symptoms typically last for more than 6 weeks.[8] Elevated IgE levels and atopy are suggested as a common predisposingfactors for AIU according to a genetic study done in Korean population[8]. In addition, HLA-DRB1 * 1302 - DQB1*0609 also has been identified as a genetic marker[9]. Besides this, various genetic studies have reported that high affinity IgE receptor[10] , histamine N‐methyltransferase[11] and adenosine A3 receptor[12] are other genetic determinants for AIU. These findings allude that, causes leading to the release of inflammatory mediators either by increased histamine release, faulty histamine degradation or augmented mast cell signalling, contributes to the manifestation of AIU. NSAIDs and Aspirin are known to be one of the common drugs causing hypersensitivity drug reactions.(13) Drug Hypersensitivity Reactions constitute about one third of all adverse drug reactions and affects 10-20% of hospitalized patients and 7% of outpatients.[14] Depending on the type of hypersensitivity reaction, patient can develop an array of cutaneous manifestations ranging from urticaria/ angioedema, fixed drug eruption, maculopapular exanthem to more severe manifestations such as DRESS or SJS/TEN.[15] We have previously encountered a case of Stevens Johnson Syndrome, Type III Hypersensitivity Reaction due to an antibiotic namely Cefixime.[16] In this case, we have encountered a case of Single NSAID Induced Urticaria/ Angioedema or Anaphylaxis, a Type I Hypersensitivity Reaction. Figure 3.To date, there are only few case reports published in pubmed highlighting the association of aspirin with urticaria. This may be due to the fact that aspirin sensitivity is often neglected because of the cross reaction with NSAIDs. One case report has documented urticaria in three patients caused by aspirin where pharmaceutical excipients present in the formulation of drug was found to be the sole cause for the hypersensitivity reaction in two of those patients.[17]However, acute urticaria is not uncommon and when patients present with an urticarial reaction clinicians do not consider NSAIDs as the cause, as the reaction occurs in context of different triggers and is thus difficult to establish.Beyond drug induced urticaria, differential diagnosis of acute urticaria includes urticaria attributed to infections, foodstuffs, contact dermatitis, solar urticaria, cholinergic urticaria, arthropod bite reactions, autoimmune disorders, small vessel vasculitis. Diagnostic workup for many of these etiologies rely on laboratory parameters and histological evidence in addition to history. Initial laboratory investigations revealed lekocytosis with a predominance of eosinophils. However, access to further testing was limited due to patient’s refusal and unfortunately no blood investigations or skin biopsy was taken at presentation. Management of NSAID induced urticaria includes strict culprit NSAID avoidance along with symptomatic management of acute urticaria.[18] Antihistamines are the first line treatment for management of acute urticaria. In severe cases, corticosteroids can be added to control symptoms.[19,20] Some types of NSAID hypersensitivity are known to exhibit cross reactivity thus strict NSAID avoidance should be done until potential of cross-intolerance is ruled out. If patient has history suggesting selective NSAID induced urticaria, challenge to chemically unrelated strong COX-1 inhibitor may be done to rule out crossreactivity type hypersensitivity.[21] Once diagnosis of SNIUAA is established, use of drug allergy passport and patient education help both the medical provider and the patient know about the NSAID hypersensitivity status, avoidance of the culprit NSAID as well as use of chemically unrelated NSAIDs as safe alternatives. In this entity, alternative drug to aspirin must be sought.[18,21] Therefore our clinical reasoning is composed from detailed patient’s history, physical examination and clinical course. Our patient did not have any history of multisystem involvement, recent infection, past medical history of atopy, inducible urticaria due to heat, cold or stress, recent contact with common irritants or insect bite. The patient had been taking Aspirin, Enalapril and Atorvastatin following the diagnosis of Ischemic Stroke with Right Sided Hemiparesis. The urticaria and pruritus should not be caused by Enalapril, since the patient was tolerating the medication well for the past 3 years and the patient’s symptoms worsened even after withdrawing of the drug. The temporal correlation between the appearance of urticarial rash and aspirin intake, and the resolution of urticarial rash and pruritus following aspirin discontinuation suggests the possibility of Aspirin Induced Urticaria. The causality assessment of the adverse drug reaction (ADR) was carried out using the Naranjo Scale, a method for estimating the probability of adverse drug reactions. The assessment revealed the ADR to be ‘Probable’(+6) to be associated with Aspirin.[22]The patient’s history notably lacked presence of chronic urticaria. While the drug provocation test for cross intolerance was not done, the patient’s history reveals previous tolerance to other NSAIDs like ibuprofen and paracetamol.

Retinal optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) are promising tools for the early-stage diagnosis of Alzheimer’s disease (AD). These non-invasive imaging techniques are cost-effective and more accessible than alternative neuroimaging tools. However, the current literature lacks an extensive review of AD or cognitive impairment diagnosis using OCT or OCTA. This motivated us to examine recent deep learning studies using the PRISMA approach to systematic review. We used Publish or Perish software to locate relevant research from databases such as Scopus, PubMed, and Web of Science, obtaining an initial pool of 2725 references. We then followed the PRISMA review process to identify twelve relevant studies and two patent applications for detailed analysis. Half of the papers we reviewed described longitudinal mouse studies targeting early AD detection. Whereas earlier research used patient demographics and pre-computed features as inputs to the classical machine learning classifiers, more recent studies tend to employ end-to-end deep learning models with OCT and OCTA image inputs. However, this approach presents issues such as small datasets and an absence of scan- ning standards, which the reviewed literature addresses in various ways. We discuss the lack of open OCT/OCTA datasets (about Alzheimer’s disease) as the main issue impeding progress in the field.

The study on radiation characteristics of a uniformly circular, planar, and linear arrays antenna with linearly and centrally-fed microstrip patch uses 9-elements arrays are analysed here. Array antenna design plays a vital role in digital radio communications, fifth generation mobile communications, and satellite communications. High power transmission, reduced power consumption, enhanced spectral efficiency, and improved communications performance are easily achieved by using antenna arrays. Thus, the uniform circular, planar, and linear arrays with 9-element microstrip patch arrays antenna are proposed for fifth generation mobile communication applications. In this paper, the proposed design of uniformly circular, planar, and linear array antenna systems operates at 12 GHz. In parallel, wireless base stations need azimuthally-omnidirectional antennas with sufficient power and beamwidth in the elevation plane to cover as wide an area as possible. The design objectives considered here are: radius of the array is quarter wavelength and spacing between centres of arrays is the half wavelength of centre frequency respectively. Based on the analysis of characteristics, the performance results are demonstrated and suggested that a uniformly circular array performs well for 5G New Radio systems.

Biologging involves the use of animal-borne data loggers to investigate behavioral ecology and physiology, and is widely used in various taxonomic groups, including freshwater turtles. Two methods of attachment of the logger were used in previous studies on freshwater turtles. Technological advances have led to a variety of devices and experimental periods and their characteristics vary depending on each species of turtle. Thus, the ideal attachment method for each species and experimental purpose should be considered. This study proposes a new method that utilizes quick-setting epoxy to bond the carapace to a basement. We conducted field experiments on a wild Reeves’ pond turtle and a wild red-eared slider. The new method was used for the pond turtle and the traditional approach of drilling holes in the carapace for attaching the logger with cable ties was used for the slider. The data logger was deployed on the pond turtle for > 3 h and on the slider for 26 days. Results revealed that the movement speed of the pond turtle and the dynamic acceleration of the slider tended to be small in the periods from sunset to sunrise. Although the duration of attachment in the new method was short compared to previous studies, results show that the method is useful for repeatedly attaching and removing the device from turtles, as it is simple and noninvasive.

Ablation is a more effective treatment than drug therapy for ventricular tachycardia, and its safety is increasingly emphasized. This case reports the treatment of acute cerebral infarction following ventricular tachycardia ablation, with prompt restoration of cerebral blood flow and a positive prognosis. These results provide valuable insights for cardiology colleagues.

Low-head dams can be built in ephemeral streambeds to trap sediments which can store water or serve as sand reserves for other uses. For sand dams to provide sustainable and dependable water supplies, or to provide valuable sand for other purposes, these reservoirs should primarily fill with coarse sand rather than fine sediments. The problem of sand dams being negatively impacted by an excess of fine sediments is a widespread issue. In Kenya, 40-60 percent of sand dams are reported to be affected by this problem, which can limit their ability to recharge and provide recoverable water. We describe a novel approach to preventing collection of fine sediments by geomorphic management of reservoir sedimentation. Specifically, we suggest building dams with “Eiffel Tower” shaped outlets (broad at the base and narrowing with height) to remain open until the reservoir is sediment filled. The opening is designed to provide constant Rouse number of 2.5 for 0.125 mm grains so that regardless of flow, only sand of size greater than 0.125 mm will accumulate. Considering the limitations of 1-dimensional simulations in capturing edge effects, a stage discharge relationship acquired through HEC-RAS simulation is utilized to correct the opening. Numerical modeling confirmed that these outlets maintain constant bed shear stress, and thus promote the deposition of uniform coarse sediments within the reservoir regardless of riverine flow rate. The findings of the HEC-RAS simulation demonstrate that bottom-notch openings, especially those of the “Eiffel Tower” shape, exhibit superior performance with an MSE value of less than 1% when determining the deviation between the desired Rouse number (2.5) and the calculated Rouse number.

This work develops a method for solving nonlinear evolution equations. The method, termed a bivariate spectral linear partition method, BSLPM, combines the Chebyshev spectral collocation method, bivariate Lagrange interpolation, and a linear partition technique as an underlying linearization method. It is developed for an n th order nonlinear differential equation and then used to solve three known evolution problems. The results are compared with known exact solutions from literature. The method’s applicability, reliability, and accuracy are confirmed by the congruence between the numerical and exact solutions. Tables, error graphs, and convergence graphs were generated using MATLAB (R2015a), to confirm the order of accuracy of the method and verify its convergence. The performance of the method is also observed against other methods performing well in these types of differential equations and is found to be comparable in terms of accuracy. The proposed method is also efficient as it uses minimal computation time.

Functional and Aesthetical Full Mouth Rehabilitation of a patient with severely worn Dentition and Deep bite: A 3-Year Follow-UpNegin Yaghoobi1, Azam Mostafavi2 , *Soolmaz Barati 31 Assistant Professor, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Science, Tehran,2 Associate Professor, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Science, Tehran,*3 Postgraduate Prosthodontics Resident, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Science, Tehran, Iran.CorrespondenceSoolmaz Barati , Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran.Email: barati27.s@gmail.comKey Clinical Message:Full mouth reconstruction in a patient with deep bite and bruxism and worn dentition is a challenging situation. Minimally invasive approach by using CAD-CAM restorations is recommended in these cases.AbstractFull mouth reconstruction of a deep bite patient with severely worn dentition is a challenging situation for the prosthodontists. This study represents minimally invasive procedures in mentioned condition without increasing vertical dimension. After 3 years of follow up no complication was observed.Keywords: Bruxism, Full mouth reconstruction, Tooth wear, Computer-Aided DesignINTRODUCTIONTooth surface loss (TSL) or tooth wear (TW) is an irreversible loss of hard teeth structure which is observed clinically as attrition, abrasion, abfraction and erosion (1). Different types of tooth wear frequently coexist, making it difficult to determine the type of wear present (2).Abrasion is defined as physical wear of the teeth caused by something other than tooth-to-tooth contact like inappropriate toothbrushing or repeated use of a toothpick (2). Furthermore, the loss of tooth structure may occur when the teeth are in contact with one another, as a result of attrition or dental erosion caused by acids in the mouth. An abfraction, a wedge-shaped lesion with sharp line angles, has been attributed to eccentric forces acting on the natural dentition (3), whereas Dawson believed it is the result of tooth brushing rather than occlusal overload (4, 5).Severe tooth wear could cause tooth hypersensitivity related to dentine exposure, morphological change of occlusal surfaces of teeth, occlusal disharmony, functional impairment, temporomandibular joint disorders (TMD) and also poor aesthetic (1, 6, 7). In addition, loss of occlusal vertical dimension (OVD) may lead to dentoalveolar compensation or increased interocclusal rest space (8).Due to progress in restorative methods and modified materials there are many treatment options for patients with worn dentition such as: conventional full coverage restorations, direct or indirect composite resin restorations, cast adhesive alloys (metal palatal veneers) and bonded ceramic restorations (9).Malocclusion, which can be defined as ”an abnormal occlusion in which teeth are out of alignment with adjacent teeth in the same jaw or the opposing teeth when the jaws are closed” (3), can result in oral health complications if left untreated. As a specific type of malocclusion, deep bite is defined as an increased vertical overlap between the upper and lower incisors which is treated by several methods range from removable appliances to fixed appliances with or without orthognathic surgery (10); It is however believed that deep overbite with stable holding contacts constitute one of the most stable dentitions, in which case no dental treatment is necessary (5).Although restoration of worn teeth by reorganizing the occlusion at an increased VDO has been well documented, some complaints, such as TMD, chipping of unsupported ceramics, and relapse to previous conditions are frequent (6, 7, 11). For worn teeth with insufficient restorative space, intentional endodontic treatment, crown lengthening, and full coverage restorations have been recommended (5, 12).While full coverage restorations have been recommended to restore worn teeth with insufficient restorative space, based on the available literature, conservative approaches such as minimally invasive restorations have been found to be more conservative than conventional procedures (13, 14).A few examples of minimally invasive approaches that might be indicated in such worn dentition include establishing occlusal harmony with an ideal occlusal plane through laminate veneer restorations, as well as occlusal veneers (15-17).Consequently, a full-mouth rehabilitation involving an interdisciplinary approach for a patient with severe deep bite and worn dentition is described in this clinical report.CASE PRESENTATIONA 54- year-old man was referred to the department of prosthodontics for oral rehabilitation. His chief complaint was being worry about worn dentition and poor esthetic especially in anterior teeth. There was no specific diet or mal habit mentioned by the patient other than clenching and bruxism during the night. Extra oral examination revealed almost symmetrical esthetic proportions and no limitations or deviation was observed during maximum mouth opening. palpation of muscles, lymph nodes, and temporomandibular joints confirmed normal conditions. Intraoral examination revealed uneven incisal plane, smile disharmony and uneven gingival plane in both arches. General tooth surface loss and dentin exposure especially in mandibular incisors were detected without pain. (Figure 1)Abfraction of teeth #4 and #5 and unilateral lingual torus mandibularis in right canine/premolar area was observed (figure 2). Caries in teeth #3 #17#32 were detected. There was an amalgam filling in tooth number #5 that was not appropriate from both an aesthetic perspective and in terms of durability (figure 3). In the first visit, tooth number 7 had a metal ceramic full crown which did not match the color of the other teeth, showed metal margin exposure and an incorrect contour, all of which were noted in the smile view. Missing teeth of number #19 #20 #30, mesiolpalatal tilt of tooth number 2, mesial drift of #18 and #31 that caused insufficient space for replacement of missing teeth and also disharmonic occlusal plane was evident. Oral hygiene was appropriate but there was insufficient attached mucosa in teeth number #18 #31. All teeth had good crown root ratio in radiographic periapical view except #16. Tooth number #5 had unacceptable RCT (figure 4). VDO was evaluated and the freeway space was measured to be 4 mm (normal value is 2–4 mm) (18). Dense bone island detected as localized area of radiopacity near mesial root of tooth #18. These localized, well-defined, radiopaque lesions are asymptomatic and found more often in the mandible, especially in the molar region. Since their cause is unknown and their presence has no clinical significance, extraction of a tooth inserted into a DBI may result in an infected socket and bone resorption, therefore no specific treatment has been recommended (19). After related consultation, it was suggested that excess occlusal stress could be a contributing factor to DBI associated with the roots of the tooth, and that no treatment was indicated.For the diagnostic stage, primary impressions one-stage putty-wash (speedex coltene/switzerlan,) were made and poured by plaster (Moldano Dental Stone, Bayer Co). Centric relation was recorded by bimanual manipulation technique using acrylic anterior deprogrammer (Pattern Resin LS, GC Dental Corp) and bite registration silicone (Futar D; Kettenbach GmbH & Co) as bite registration material. The record was used for mounting the primary casts in a semi-adjustable articulator (Hanau Wide-Vue Whip Mix) by an arbitrary facebow (Hanau Springbow-Whip Mix). Posterior occlusion revealed interferences on teeth number #12, #13 and #20, #21. The possible treatment plan would be established according to investigation the space in vertical dimension at rest and occlusion and the space available for teeth restorations. Based on speech, smile evaluation and amount of restorative space in CR position it was decided to rehabilitate the dentition in the existing VDO. As a result, VDO was considered in CR at the interference point, which was approximately a 0.5 mm opening in the posterior segment and a 1 mm increase in the anterior one. Wax-up for lower anterior teeth was carried out after determination of mandibular canine level at the corner of the resting lips, followed by upper anterior teeth waxing. The quality and correctness of wax-up were verified by chairside mock-up (temporary crown and bridge material, master-dent, USA) in the mouth during phonetics, smile, and rest position. Then occlusal plane was determined using a Broadrick occlusal plane analyzer and that was verified in mouth in centric occlusion and eccentric movements. It is important to mention that mutually protection occlusal scheme was considered. Based on occlusal plane, inserting implant to replace teeth #3 and #15, RCT for teeth #8 #24 #25 #26, re-RCT of #5, crown lengthening of maxillary and mandibular anterior segment (from canine to canine), full crown of #4 #6 #8 #11, post and core crown #5 #23 #24 #25, fixed partial denture #18 #19 #20 and #29 #30 #31, porcelain laminate veneers of #7 #9 #10 #23 and occlusal veneers #12 #32 were decided.Once the treatment plan was accepted, provisional restorations were made using temporary crown and bridge material (master-dent, USA) for treatment sessions until the teeth preparation were finalized and printed temporary restorations were prepared. After scaling and root planning, caries removal was done and teeth were filled with composite (3M™ Filtek™ Z350 XT Universal Restorative/ USA). Crown lengthening stent for both jaws were made and gingival leveling in anterior segments of maxillary and mandibular arch was done in one session. Implant insertion was carried out using a semi-guided surgical guide (radiographic stent converted to surgical stent) in location of teeth number #3 (Ø 4.8mm RN, SLA® 8mm Straumann® Dental Implant System), #15 (Ø 4.8mm RN, SLA® 12mm Straumann® Dental Implant System) (figure 5). Fabrication of post resin pattern according to affirmed occlusal plane by index was done. Nickel-chrome casting post was cemented by Glass ionomer luting cement (GC Fuji I®Enhanced America).Preparation was done in this way: circumferential radial shoulder finish line was prepared for FPDs and crowns, light chamfer for laminates and conventional design (planar straight bevel) was considered for occlusal veneers.Impressions for temporary restorations were taken (Betasil Vario Putty Soft Muller Germany/Betasil Vario Light Body Muller Germany); CR registration according to past method and facebow transfer & mounting was done. After abutment selection (straight and angled tissue level regular neck), temporary restorations design was done in Exocad DentalCAD software, then they were printed (DigiDent Lite 4K, IRAN) by PMMA material shade A2 (kucco-koul, China).In try-in session, smile view, occlusal plane and occlusal contacts were assessed during CR and eccentric movements, and canine guidance and mutually protected occlusion was established. After assessing occlusion, marginal fitness and phonetic, impression making from temporary restorations & making Casts were done. Protrusive record for determining condylar inclination (R:30, L:26) and bennet angle (R:16, L:15) was completed and final impression from temporary restorations was taken. One stage putty-wash (speedex coltene/switzerlan,) and customized occlusal table were prepared. Then, final Impression was made in the same way mentioned before. Casts were mounted by cross mount technique (every other mounting procedure), cores were designed using Exocad software, then frameworks were milled IPS e.max®ZirCAD (Ivoclar Vivadent,Germany) for PFZ crowns and IPS Empress CAD( Ivoclar Vivadent , Germany) for PLV and occlusal veneers.Next, occlusal veneers were checked in mouth and radiographies were taken to check the marginal integrity. The porcelain was then applied to the frames (according to the manufacturer’s instructions) and a porcelain try-in session was conducted. After confirming restorations aesthetic and contours, final glaze and delivery was done.In the delivery session, laminates were cemented by Choice 2 Veneer Cement (BISCO Dental, USA). Dual-cure resin cement (Panavia V5, Kuraray Co) was used for occlusal veneers, full coverage restorations cemented by glass ionomer cement (Fuji II, GC Dental Corp), for implant restorations abutments were torqued to 35N according to manufacturer instruction and temp bond (NE kerr S.R.I. Scafatia, Italia) was used (figure 6,7,8,9).After delivery of restorations, oral hygiene instructions using water jet and super floss was explained for the patient, and follow-up sessions were set for 1, 6, and 12 months later, and annually afterward. After that an impression (Alginate, Chromogel) was taken for making occlusal dual splint. Delivery of occlusal splint was done in next session.DISCUSSIONThe case that was presented focused on the treatment procedure of a patient suffered from progressive wear and parafunctional habits.The challenges in this specific case were anterior deep bite, severe worn teeth, the need of esthetic and functional rehabilitation in the existing vertical dimension due to patient‘s intolerance of increasing VD and also the resultant interference of elongated maxillary incisors following with phonetics and lower smile line. It is also challenging to achieve good alignment and occlusal harmony within abutments that have different natures (tooth abutments and implant abutments) simultaneously in full mouth rehabilitation with dental implants. Moreover, material selection is a critical factor that needs special attention in worn dentitions since minimal preparation must be performed on the teeth, as well as materials that have sufficient strength in a low thickness must be chosen.Another challenge was the need to rehabilitate some areas by implant prostheses due to the reported potential failure risk of implant prostheses because of occlusal overload (20-22); however, few researchers have assessed the impact of bruxism on dental implant outcome, and the results obtained are contradictory (22-24). At present, there are some expert opinions and cautionary approaches that should be considered in order to minimize the risk of implant failure in cases of bruxism (22). In this case, zirconia crown was selected for rehabilitating due to its superior esthetics and wear resistance (25). Based on studies, an appropriate occlusal scheme (Canine-guided occlusal concept to reduce occlusal forces during jaw movement) was selected and stable contacts and an equal distribution of forces were established (22, 26).It is obvious that the loss and wear of the posterior teeth will cause a deeper overbite (27).There are several options for gaining space necessary for restorations in these patients who have attrition combined with a deep bite, including restorative dentistry, orthodontics, and oral surgery.Dawson recommended the following methods for correcting deep bites: 1. Reshaping of anterior teeth as needed in mild cases 2. Orthodontics 3. Restorative procedures 4. Surgery (5). There are some cases in which increasing VDO is considered to provide enough space for restorations and to reduce anterior overbite. An alteration in VDO may cause adaptable reactions in the temporomandibular joint (TMJ), periodontium, and occlusal morphology (28). In contrast, previous studies have reported that increasing VDO during restorative procedures could be harmful to patients, disrupting their dental physiology and adaptability (29, 30). Hyperactivity of the masticatory muscles, elevation in occlusal forces, bruxism, and temporomandibular disorders (TMDs) are reported as consequences of increasing the VDO from the literature reviews (26, 27, 31). The VDO should not be increased in cases such as full occlusal rehabilitation where restorative space can be created by crown lengthening or reshaping the teeth (31). In the present case, after apace analyzing, gaining space by crown lengthening and restorations was done.The most important goal of treatment is to form stable occlusal contact in centric relation. The concept of minimally invasive dentistry in appropriate cases preserves dentitions and supporting structures; it has also positive effects on patients’ attitude who are impressed by conservative approaches (28). Consequently, in this case, stable occlusal contacts were provided for some intact teeth (#2, #13, #14, #17) since they were in appropriate contour and position. It was decided to prepare lithium disilicate laminates as thin as possible (0.3-0.5 mm) for teeth (#7, #9, #10, #23). Occlusal veneers, which are considered minimally invasive procedures, were considered for teeth # 12 and # 28. Ceramic occlusal veneers are also known for their superior abrasion and wear resistance, biocompatibility, color stability, and low amount of preparation needed, which is confined to 1 mm (24). Planar straight bevel occlusal veneer preparation was considered for occlusal veneers in light of its desirable fracture resistance, decrease in the amount of enamel reduction, favorable fracture load, and lowest maximum principal stress (29, 30).Finally, the patient’s chief complaints were effectively resolved, and he was satisfied with the functional and aesthetic outcomes of his treatment. After 2 years, no evidence of bone loss or loss of VDO and no signs of TMD were noted. The restorations had no signs of chipping or wear, and all the surfaces were smooth.CONCLUSIONFull-mouth rehabilitation requires the proper interdisciplinary concepts to achieve acceptable functional and aesthetic results. It is important to note that the present case report emphasized the steps and phases of the treatment process as well as the use of existing VDO for meeting the biologic, restorative, and esthetic requirements.Data AvailabilityThe data used to support the findings of this study are available from the corresponding author upon request.Conflicts of InterestThe authors have no conflict of interest in this study.Author ContributionsNY: prosthodontic treatment of patient, wrote the manuscriptAM: prosthodontic treatment of patient, study conception and designSB: study conception and design, wrote the manuscriptReferences:1. Warreth A, Abuhijleh E, Almaghribi MA, Mahwal G, Ashawish A. Tooth surface loss: A review of literature. The Saudi dental journal. 2020;32(2):53-60.2. Litonjua LA, Andreana S, Bush PJ, Cohen RE. Tooth wear: attrition, erosion, and abrasion. Quintessence international. 2003;34(6).3. Davies S, Gray R, Qualtrough A. Management of tooth surface loss. British dental journal. 2002;192(1):11-23.4. Dzakovich JJ, Oslak RR. In vitro reproduction of noncarious cervical lesions. The Journal of prosthetic dentistry. 2008;100(1):1-10.5. Dawson PE. Functional occlusion: from TMJ to smile design: Elsevier Health Sciences; 2006.6. Rostiny R. The correction of occlusal vertical dimension on tooth wear. Dental Journal (Majalah Kedokteran Gigi). 2007;40(4):161-4.7. Hasanzade M, Ghodsi S, Yaghoobi N. Rehabilitation of a deep bite patient with worn dentition using minimally invasive approach: A 3‐year follow‐up. Clinical Case Reports. 2021;9(11):e05121.8. Davies S. Malocclusion–a term in need of dropping or redefinition? British Dental Journal. 2007;202(9):519-20.9. Azouzi I, Kalghoun I, Hadyaoui D, Harzallah B, Cherif M. Principles and quidelines for manaqing tooth wear: a review. Int Med Care [Internet]. 2018;2(1):1-9.10. Huang GJ, Bates SB, Ehlert AA, Whiting DP, Chen SS-H, Bollen A-M. Stability of deep-bite correction: A systematic review. Journal of the World federation of orthodontists. 2012;1(3):e89-e96.11. Gopi Chander N, Venkat R. An appraisal on increasing the occlusal vertical dimension in full occlusal rehabilitation and its outcome. The Journal of Indian Prosthodontic Society. 2011;11(2):77-81.12. Beddis H, Durey K, Alhilou A, Chan M. The restorative management of the deep overbite. British Dental Journal. 2014;217(9):509-15.13. Chabouis HF, Faugeron VS, Attal J-P. Clinical efficacy of composite versus ceramic inlays and onlays: a systematic review. Dental materials. 2013;29(12):1209-18.14. Moreira A, Freitas F, Marques D, Caramês J. Aesthetic rehabilitation of a patient with bruxism using ceramic veneers and overlays combined with four-point monolithic zirconia crowns for occlusal stabilization: a 4-year follow-up. Case reports in dentistry. 2019;2019.15. Fradeani M, Barducci G, Bacherini L, Brennan M. Esthetic rehabilitation of a severely worn dentition with minimally invasive prosthetic procedures (MIPP). International Journal of Periodontics & Restorative Dentistry. 2012;32(2).16. Mainjot AKJ. The One step‐No prep technique: A straightforward and minimally invasive approach for full‐mouth rehabilitation of worn dentition using polymer‐infiltrated ceramic network (PICN) CAD‐CAM prostheses. Journal of Esthetic and Restorative Dentistry. 2020;32(2):141-9.17. Oudkerk J, Eldafrawy M, Bekaert S, Grenade C, Vanheusden A, Mainjot A. The one-step no-prep approach for full-mouth rehabilitation of worn dentition using PICN CAD-CAM restorations: 2-yr results of a prospective clinical study. Journal of dentistry. 2020;92:103245.18. Al-Omiri MK, Lamey P-J, Clifford T. Impact of tooth wear on daily living. International Journal of Prosthodontics. 2006;19(6).19. Applebaum AJ, Lichtenthal WG, Pessin HA, Radomski JN, Simay Gökbayrak N, Katz AM, et al. Factors associated with attrition from a randomized controlled trial of meaning‐centered group psychotherapy for patients with advanced cancer. Psycho‐Oncology. 2012;21(11):1195-204.20. Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ. Abfraction lesions: etiology, diagnosis, and treatment options. Clinical, cosmetic and investigational dentistry. 2016;8:79.21. Li Q, Jepsen S, Albers H-K, Eberhard J. Flowable materials as an intermediate layer could improve the marginal and internal adaptation of composite restorations in Class-V-cavities. Dental Materials. 2006;22(3):250-7.22. Fruits TJ, VanBrunt CL, Khajotia SS, Duncanson MG. Effect of cyclical lateral forces on microleakage in cervical resin composite restorations. Quintessence international. 2002;33(3).23. Peumans M, De Munck J, Van Landuyt K, Kanumilli P, Yoshida Y, Inoue S, et al. Restoring cervical lesions with flexible composites. Dental materials. 2007;23(6):749-54.24. Marus R. Esthetic and predictable treatment of abfraction lesions. Inside Dentistry. 2011;7(6).25. Carlsson GE, Egermark I, Magnusson T. Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period. Journal of orofacial pain. 2003;17(1).26. Komiyama O, Lobbezoo F, De Laat A, Iida T, Kitagawa T, Murakami H, et al. Clinical management of implant prostheses in patients with bruxism. International journal of biomaterials. 2012;2012.27. Naert I, Duyck J, Vandamme K. Occlusal overload and bone/implant loss. Clinical oral implants research. 2012;23:95-107.28. Sadowsky SJ. Occlusal overload with dental implants: a review. International journal of implant dentistry. 2019;5(1):1-5.29. Brägger U, Aeschlimann S, Bürgin W, Hämmerle CH, Lang NP. Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function. Clinical oral implants research. 2001;12(1):26-34.30. Engel E, Gomez-Roman G, Axmann-Krcmar D. Effect of occlusal wear on bone loss and Periotest value of dental implants. International Journal of Prosthodontics. 2001;14(5).31. Egbert JS, Johnson AC, Tantbirojn D, Versluis A. Fracture strength of ultrathin occlusal veneer restorations made from CAD/CAM composite or hybrid ceramic materials. Oral Science International. 2015;12(2):53-8.FiguresFigure 1. Intraoral frontal view.Figure 2. Mandibular occlusal view.Figure 3. Maxillary occlusal view.Figure 4. Initial panoramic view.Figure 5. Panoramic view after implant surgeryFigure 6. Intraoral frontal view after cementation.Figure 7. Mandibular occlusal view after cementation.Figure 8. Maxillary occlusal view after cementation.Figure 9. Final panoramic viewFigure 1

Title: Acute valve malfunction with thrombosed bioprosthetic valve after surgical aortic valve replacementAuthor name: Hiroki Moriuchi, Masaaki Koide, Yoshifumi Kunii, Takuya Maeda, Risa ShimboriAffiliations: SeireiHamamatsu Hospotal, Department of cardiovascular surgeryKey words: thrombus, bioprosthetic aortic valveCorresponding author’s address: 2-12-12, Sumiyoshi, Nakaku, Hamamatsu, Shizuoka, JapanEmail: porimori22@gmail.comAUTHOR CONTRIBUTIONSMasaaki Koide and Takuya Maeda involved in review and editing.ACKNOWLEDGEMENTSI appreciate Mr. Andrew for reviewing manuscript and Yuki Moriuchi for total support.FUNDING INFORMATIONNoneCONFLICT OF INTEREST STATEMENTThe authors report no conflict of interest.DATA AVAILABILITY STATEMENTNoneCONSENT STATEMENTWritten informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.CASE PRESENTATIONA 74-year-old man with chest pain was diagnosed with Stanford A acute aortic dissection and severe aortic regurgitation. Aortic valve replacement with a 21mm INSPIRIS (Edwards Lifesciences, Irvine, CA, USA) and ascending aortic replacement with 26mm J Graft (Japan Lifeline, Tokyo) was performed. Anticoagulation therapy using heparin and warfarin was started immediately. Postoperative Computed tomography(CT) revealed thrombus formation to all leaflets of the implanted valve(Figure1) and echocardiography revealed restricted leaflet motion, so surgical thrombectomy was performed. Abundant fresh thrombi adhered to all leaflets of the bioprosthetic valve, and those thrombi were carefully removed (Figure2). No damage or macroscopic degeneration on the leaflets were seen, so the implanted valve was preserved. We initiated argatoroban for 1 week, followed by aspirin and warfarin and postoperative CT showed no sign of thrombus. (Figure 3).We previously reported leaflet and coronary stent thrombosis after TAVR2, but acute bioprosthetic valve thrombosis after SAVR is extremely rare.1 Reference1. Cahill TJ, Khalique OK, Geourge Im et al. Valve thrombosis after transcatheter and surgical aortic valve replacement: Incidence and outcomes. J Thorac Cardiovasc Surg. 2022 Apr;163(4):1309-1315.2. Satoshi O, Masaaki K, Yoshifumi K, et al. Leaflet and coronary stent thrombosis after transcatheter aortic valve implantation treated by aortic valve replacement. Eur Heart J Cardiovasc Imaging. 2020 Mar 1;21(3):347Figure legendsFigure1: Computed tomography(CT) shows thrombi in all leafletsFigure2: All thrombi were removed completelyFigure3: Postoperative CT shows no thrombus in bioprosthetic aortic valveKey Clinical MessageAcute valve thrombosis after bioprosthetic aortic valve replacement even under appropriate anticoagulation therapy is extremely rare. Cardiac CT is a powerful imaging tool to detect valve thrombosis after both TAVR and SAVR.

Researchers have focused on natural medicines to treat infectious diseases due to antibiotic resistance. Due to the medicinal importance of Datura stramonium and Prosopis farcta, the present study has investigated their antimicrobial effects against some gram-positive and negative bacteria by disc diffusion, micro broth dilution, and agar well diffusion methods and also their possible toxicity using MTT assay against HT29 cells. Additionally, the inhibitory effect of the extracts on the formation of bacterial biofilms was investigated. The hydroalcoholic extract of D. stramonium and P. fracta had antibacterial effects on the bacteria in both micro broth dilution and agar well diffusion methods. D.stramonium and P.fracta had the greatest effects on S.aureus and P.aeruginosa. Their weakest effects were seen towards K. pneumonia and A. baumannii. Anti-biofilm property was observed only for D. stramonium extract (50 mg/ml concentration). MTT assay showed that exposure of HT29 cells to concentrations of 25, 12.5, 6.25, and 3.1 mg/ml of D.stramonium and P.fracta extracts did not cause obvious toxicity. P.farcta and D.stramonium inhibited the growth of bacteria as well as biofilm formation in these strains, and they were not toxic to human cells. Trials on patients using these extracts are recommended, however

Aims Venous thromboembolism (VTE) is a rare but serious adverse drug reaction could be caused by antipsychotic drugs. However, the specific correlation of VTE caused by antipsychotic drugs is still controversial. This study explored the potential association between antipsychotics and VTE. Method All VTE cases of antipsychotic drugs as primary suspected medicines were extracted from the US Food and Drug Administration adverse event reporting system (FAERS) from 2004 to 2021.Disproportionality analyses were conducted by estimating the reporting odds ratio (ROR) and the information component (IC). Results 4, 455 VTE cases with antipsychotics as primary suspected drugs were identified. The VTE signal was detected in haloperidol, olanzapine, quetiapine and paliperidone. The RORs and the 95% confidence intervals (95% CI) of t haloperidol, olanzapine, quetiapine and paliperidone were (ROR=2.17, 95% CI(2.17-1.91), IC=1.1, 95%CI(1.52-0.66)), (ROR 2.53 95% CI 2.69–2.38 IC 1.31 95%CI 1.52-1.1), (ROR 1.37, 95% CI 1.47–1.28 IC 0.45 95%CI 0.67-0.23) and (ROR 1.6 95% CI 1.83–1.4 IC 0.67 95%CI 1.11-0.22), respectively. Pulmonary embolism occurred in more than 50% of VTE events (2760 cases, 52.84%). The outcome indicated that venous thrombosis caused by antipsychotics is usually a serious consequence. Conclusion The current data mining of FAERS suggested an association between VTE and antipsychotic drugs including olanzapine, haloperidol, paliperidone and quetiapine, which reminds health professionals to pay attention to the serious adverse drug effects of antipsychotic drugs leading to venous thromboembolism.

Typically, the synthesis problem starts from a set of preestablished connections between steams and unit operations resulting in distillation sequences, which can be included into superstructure representations and reformulated as mathematical programming problems. Nevertheless, in the last decades novel approaches to process synthesis that depart from the concept of unit operation and are based on phenomenological approaches have been proposed. This work decomposes distillation structures into distillation modules where a module is equivalent to a vapor-liquid equilibrium stage in which input and output material and heat flows connect modules. Also, a process synthesis an intensification (PS+I) framework is proposed for the synthesis of distillation structures separating ternary mixtures. The proposed framework has the following steps: database generation of distillation modules, optimization, solution interpretation, validation, and post-optimization. The separation of the BTX ternary mixture was taken as case study and several interpretation guidelines have been proposed.

In a power system, the conventional method for computing participation factors of generators associated with an oscillatory mode involves using linearized system models and element-by-element products of corresponding right and left eigenvectors. Unlike traditional modal analysis methods, this paper proposes a new approach for estimating participation factors from measurements on generator responses under a range of disturbances. This method computes extended participation factors that coincide with accurate model-based participation factors, provided that the measured responses satisfy an ideally symmetric condition. This paper further relaxes the symmetric condition by identifying a coordinate transformation from the original measurement space to an optimal new space for the best symmetry. Consequently, the optimal estimation of participation factors solely from measurements is achieved, and the factors influencing accuracy are discussed. The proposed approach is comprehensively demonstrated using a two-area system and then tested on an NPCC 48-machine power system.

When an airfoil is placed in a flow, it is subjected to forces whose result consists mainly of a lift and drag force. On each section of the profile, the local densities strongly depend on the wing having an aerodynamic surface with the velocity of the flow. At first sight, an aerodynamic profile can be considered a rigid body with which we associate an initial takeoff angle. But, to optimize its performance (maximize its lift and minimize its drag), it is vital to consider deformations under the flow force. The profile deforms mainly in bending and torsion. When this deformation takes place, it is called a flexible profile. Our study on elasticity has shown, for a loading in bending-torsion simulating an aerodynamic force, significant flexibility of a material allows the optimization of a wing beat. Indeed, the results indicate an increase in lift concentrated mainly in the wing contour. Therefore, to maximize the drag the rigid profile of the material is set. The rigid wing interacts with the air concentrated in its center and ensures a planar flight. Second, the study made it possible to affirm flight control. The wings’ position at ±20° from the center of interaction showed that it was possible to ensure a better displacement. The last simulation made it possible to study the particles of collisions by using an approximate elasticity compromise at 572MPa and an angle of incidence of ±20° affirming an optimal contact between the modeled wing and the laminar flow.

The transparency of machine learning models is central to good practice when they are applied in high stakes applications. Recent developments make this feasible for tabular data, which is prevalent in risk modelling and computer-based decision support across multiple domains including healthcare. Important motivating factors for interpretability are outlined and practical approaches are summarised, signposting the main methods available, with pointers to the supporting literature. A key finding is that any black box classifier making probabilistic predictions of class membership from data in tabular form can be represented with a globally interpretable model without loss of performance.

Model-based real-time monitoring of biopharmaceutical production is a major step towards Quality-by-Design in this field and the fundament for model predictive control. Data-driven models have been proven a viable option to model bioprocesses. In the high stakes setting of biopharmaceutical manufacturing it is essential to ensure high model accuracy, robustness and explainability. That is only possible when (i) the data used for modeling is of high quality, (ii) state-of-the-art modeling algorithms are employed and (iii) the input-output mapping of the model has been characterized. In this study we evaluate the accuracy of multiple data-driven models in predicting the monoclonal antibody concentration, dsDNA concentration, host cell protein concentration, and high molecular weight impurity content during elution from a protein A chromatography capture step. We demonstrate how permutation/occlusion-based methods can be used to gain understanding on dependencies learned by of one of the most complex data-driven models; convolutional neural network ensembles. Finally, we present a workflow to test the model behavior in case of simulated sensor fouling and failure. This study represents a major step towards improved viability of data-driven models in biopharmaceutical manufacturing.

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Key clinical messageGallbladder (GB) neuroendocrine carcinoma (NEC) is rare and has poor prognosis. Furthermore, there is no consensus on treatment of GB-NEC.Here, we report a case of GB-NEC for which nivolumab was effective.Key word: Gallbladder NEC, immune checkpoint inhibitors, EUS-FNA

A document by Shyam Duvuru. Click on the document to view its contents.

While a variety of solar concentrators have been studied for decades, the study of the spherical glass concentrator has never been reported, to the best of our knowledge. For that, this paper examines the optical characteristics of the novel solar spherical glass concentrator and identifies its performance and features. In addition, the thermal and exergetic performance of the concentrator are studied with three cavity receiver designs under various operating temperatures and different mass flow rates. More specifically, the examined receiver shapes: spiral, conical, and cylindrical. All the cavities are analyzed in order to determine the best design which maximizes the thermal efficiency of the solar collector. According to the results, the spherical collector can concentrate the heat flux up to 25 times the incident flux value. Also, the study is defined the best receiver dimensions that achieve optimum optical performance. Then, the optical analysis is conducted with an optical simulation in COMSOL Ray Optics to validate this work’s findings. Moreover, the best design is found to be the one with a spiral shape, while the conical is the next choice. The cylindrical is the third design in the performance sequence.

Rare pyoderma gangrenosum correlated with systemic lupus erythematosus: A case reportOmid pourbagherian1, Kamran Javidi1, Mohammad Taghizadieh3, Mehdi Jafarpour2*1 Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran2Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran3Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran.Drafting of the manuscript: Mehdi Jafarpour, Omid pourbagherianData Collection: Kamran Javidi, Mohammad Taghizadieh, Mehdi JafarpourCritical revision of the manuscript for important intellectual content: Mehdi Jafarpour, Omid pourbagherianCase supervision: Mehdi JafarpourCorresponding author: Mehdi JafarpourAddress: Connective Tissue Diseases Research Center, Flat 1, Imam Reza Hospital, Tabriz, IranPhone number: 0098 41 33332704Fax: 0098 41 35413520Mobile: 09148651269Reference count: 10Figure/table count: 2/1Funding: none.Conflict of interest: noneWritten informed permission from the patient to publish the facts and photographs was granted.Manuscript word count:999