Most Viewed Articles

In the research of steam turbine rotor, start-up optimization is a very key research problem. A series of start-up optimization research can greatly improve the start-up efficiency of steam turbine and the safety performance of the unit. The start-up optimization of steam turbine is inseparable from the analysis of the start-up process of steam turbine and the mathematical model of the startup process of steam turbine unit, because the optimization of steam turbine unit can be regarded as a function to find the optimal solution. This paper analyzes the start-up process of 300 MW steam turbine, analyzes the start-up process of steam turbine unit through the data used in the actual power plant, and gives the mathematical model of cold start-up of steam turbine according to the start-up process of steam turbine, so as to further study the start-up optimization of steam turbine. Finally, the optimization model is determined by several key parameters, which are three weight coefficients α1,α2,α3, the actual damage value Di and damage limit value Dlim, and the start-up time ti and total start-up time t0 of each stage.

A survey was conducted in the agricultural farms in Dhulikhel Municipality, mid-hill, Kavre, Nepal aiming at assessing the status of agrobiodiversity with the purpose of understanding its role in food security taking altogether 133 farming households scattered in several settlements with lowland, upland, and home garden being the general agricultural land use systems. Biodiversity index: Shannon-Wiener Index was used to assess diversity of plant. The main purpose was to assess the farm agrobiodiversity and to find out whether biodiversity level has a direct link to household food self-sufficiency. For descriptive analysis frequency, percentage, mean and standard errors were used. In the case of inferential statistics independent sample t - test and binary logistic was used to find the odd ratio of practicing home garden. The result showed that the average landholding size was 0.66 ha/household with 0.37 ha, 0.3 ha, and 0.06 ha being upland, low land, and home garden, respectively. A total of 136 plant species were documented out of which 74 were the effective number of species in the study area. Among the used plants, fodder shared 27% of the total plant diversity followed by fruit (21%), vegetable (19%), medicinal plants (8%), pulses (8%), spices (7%), oilseeds (5%) and cereals (5%). Similarly, the mean livestock unit (LSU) was 2.65. The overall Shannon-Wiener Index was 4.30 indicating high diversity of species and 87.7% of the species were evenly distributed. The Index was higher for vegetable (3.11) followed by fruits (2.9) and fodder (2.85). Higher diversity was found in fodder trees in lowlands whereas vegetable species were more diverse in upland and home garden. Similarly, the Index was 4.29 in the upland whereas it was 4.078 in the home garden followed by 3.13 in the lowland. The evenness was 0.899, 0.87, and 0.74 in upland, home garden and lowland, respectively. Higher species diversity revealed that the site was rich in agrobiodiversity. A significant positive correlation (0.22) was observed between Shannon-Wiener Index and farming years. Similarly, positive correlation (0.33) was found between an increase in the level of agrobiodiversity and food self-sufficiency. The result demonstrated that increasing crop diversity increases the household’s ability towards food sufficiency implying the need for the formulation and implementation of efficient policy to conserve the agrobiodiversity at municipality as well as national levels.

The rob(15;22) is one of the rarest translocations which accounts for only 0.6% of the entire Robertsonian translocations reported in humans. A case of rob(15;22) in association with trisomy 21 still has not been reported. In the present study, a case of a 3-year 6-month-old male child with rob(15;22) with trisomy 21 is focused. The phenotype comprises generalized hypotonia, delayed developmental milestones, simian crease, dysmorphic facies, etc. Chromosome analysis with peripheral blood was executed and the karyotype was interpreted as 46,XY,der(15;22)(q10;q10)+21. To analyse whether the chromosomal translocation was de-novo or inherited, the chromosome analysis with the peripheral blood of his parents was performed. The karyotype of the father was interpreted as 46,XY, and of the mother was 45,XX,der(15;22). It was concluded that the rob(15;22) was inherited from his mother, although trisomy 21 was a de novo incidence. Hence, this case study can be proven useful in the understanding of rob(15;22) in solo and rob(15;22) in association with trisomy 21.

Background: Endometrial morular metaplasia, a clinical conundrum from a diagnostic and management angle given its rarity and low oncogenic potential, has been linked to endometrial hyperplasia and carcinoma. Case report: A 77-year-old woman with no significant past medical history, was found to have an asymptomatic thickened endometrium on pelvic imaging, after presenting with lower abdominal pain, 3yrs ago. Diagnostic hysteroscopy identified an endometrial polyp within a pyometra. Histopathology showed focal complex endometrial hyperplasia without atypia with superimposed morular metaplasia(EMM) with a negative microbiology assay.Following conservative management with multidisciplinary team(MDT) overview, as-per patient choice with 6-monthly follow-up hysteroscopy, endometrial biopsies and a short use of the Mirena® Intrauterine system (discontinued following poor tolerance), histopathology shows resolved hyperplasia with persistent EMM. Due to persistent disease, a hysterectomy is under consideration.Discussion: Current evidence suggests that a sub-type of EMM, a likely histological manifestation of beta-catenin (CTNNB1) gene mutation: could be a precursor of endometrial hyperplasia and low-grade endometrioid-endometrial carcinoma sub-type. Though low-grade in nature, the increased recurrence risk raises significant concerns.Prognostication following gene mutation identification can help with management options which include conservative, hormonal therapy with adjunct repeat endometrial sampling: or hysterectomy. The optimal frequency of endometrial sampling when uterine-sparing, is unclear, leading to a management conundrum, whilst persistent disease may require a hysterectomy.Conclusion: Management of endometrial morular metaplasia can be difficult but must reflect the woman’s choice with a MDT-overview. Immuno-histochemical tools utilizing new molecular biological advances, can simplify the diagnostic and prognostication processes, aiding clinical management.

A thought-provoking debate in the popular literature concerning vaccination has blossomed in recent years [1-6]. While “traditionalists” support universal immunization against a variety of infectious diseases, many influential individuals hold that vaccinations do far more harm than good. The web sites vactruth.com and anhinternational.org are typical web sites to visit to understand their concerns.  More details on the debate, offering commentary on both sides of the issue, can be explored at wikipedia.org/wiki/Vaccine_controversies. In essence, however, those arguing for the universal use of vaccines point to the many millions of lives saved since mass immunization programs were introduced and further argue that resistance to routine vaccination is almost always based on false information. Those arguing against the routine use of vaccines usually either contend that the vaccines are unsafe (often maintaining that vaccine components such as formaldehyde or thimerosal are highly toxic) or alternately argue that governments simply do not have the moral authority to encroach on an individual’s freedom to make medical decisions for themselves or for their children.

When grouping children with psoriasis depending on TaqI (T/C) genotypes of the VDR gene, the youngest age of disease onset and the longest duration of dermatitis (5.60 ± 0.77 years and 4.90 ± 0.68 years, respectively) showed up in case of the CC genotype. In case of the TT genotype, disease onset coincided with an older age, and the history of present illness was the shortest (10.26 ± 0.64 years and 2.59 ± 0.58 years, respectively). PASI (20.32 ± 3.43) and BSA (40.00 ± 6.11) severity indices were the highest and of statistically significant difference to those in other groups in the presence of the CC genotype. In case of the TC genotype, the index PGA (2.80 ± 0.15) was the lowest and made a statistically significant difference to the values of other groups. A negative correlation between vitamin D levels and the PASI, PGA, BSA was identified in children holding CC and TC genotypes. Conclusion: The clinical presentation of dermatitis and its epidemiological features in children with psoriasis, namely the age of disease onset, duration of exacerbation, body surface area and the intensity of psoriasis symptoms depend on vitamin D serum levels and genotypes of the TaqI polymorphic variant of the VDR gene.

This review explores the evolving landscape of psoriasis treatment with a focus on the transformative impact of biologic drugs. Psoriasis, a prevalent and persistent skin condition characterized by red and scaly patches, historically relied on topical, phototherapeutic, and systemic treatments, each with limitations. The advent of biologics represents a significant advancement, offering targeted interventions by addressing specific immunologic mechanisms underlying the disease. Biologics are now considered the preferred systemic therapy for chronic moderate-to-severe plaque psoriasis, particularly when conventional treatments prove ineffective or present disadvantages.The review delineates the mechanisms of action for biologics targeting tumour necrosis factor-alpha (TNF-α), interleukin-17 (IL-17) and interleukin-23 (IL-23). Specific drugs under each category, including etanercept, infliximab, adalimumab, secukinumab, ustekinumab, and others, are detailed with recommended dosages. Biologics have demonstrated substantial effectiveness, with clinical trials and real-world studies showcasing significant improvements in disease severity and patient’s quality of life. Notably, these drugs exhibit rapid action, often yielding noticeable changes within weeks.While biologics have revolutionized psoriasis treatment, the review emphasizes the importance of judicious use due to potential side effects such as injection-site reactions and respiratory infections. Serious adverse events, including infections and autoimmune reactions, necessitate careful patient selection and monitoring for safety. In conclusion, biologics offer a precise and effective approach to psoriasis treatment, promising marked symptom improvement and enhanced quality of life. The review underscores the need for responsible utilization, considering patient-specific factors, and anticipates ongoing advancements in biologics for improved control over this chronic dermatitis.

The main purpose of the present study was to find out the differences on suicidal ideation, hostility, hopelessness and negative self-evaluation among heroin addicts with comorbid depression. After reviewing the literature, it was hypothesized that heroin addicts with high depression may have high scores on variable of suicidal ideation, hostility, hopelessness, and negative self-evaluation as compared to those with low depression. The sample was consisted of 60 males from Low-socioeconomic status (SES) (34 of them were screened as having high scores on the variable of depression and 26 were screened as low scorers). Siddiqui Shah Depression Scale (Siddiqui & Shah, 1997) and Urdu version of Suicide Probability Scale (Cull & Gill, 1982) was administered. To compare heroin addicts with high and low depression on various variables, t - test was applied. The research findings showed that heroin addicts with mean age of 30 years (range 20 to 40) having the mean duration of heroin dependence of 10 years with high depression were significantly high on the variable of suicidal ideation, hostility and hopelessness ((p < .05) as compared to those with low depression. And there was no significant difference on the variable of negative self-evaluation for both groups (p > .05). So it was concluded that services for patients with Heroin addiction should include periodic screening for suicidal behavior along with psychiatric treatment and psychosocial support.

Background: Aautologous hematopoietic stem cell transplants (HSCT) is the standard of care for newly diagnosed patients with multiple myeloma (MM) who are eligible for autologous transplantation. Although cryopreservation is routinely employed, autologous HSCT can be performed using non-cryopreserved stem cells.Methods and materials: A retrospective study of patients with MM who received autologous HSCT between the 10th of October 2010 and the 31st of January 2022 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia was performed.Results: Over 11 years and 113 days, a total of 135 autologous HSCTs were performed for 119 patients with MM at our institution. Single autologous HSCTs were performed for 119 patients, while 16 of these patients received either planned tandem autologous transplants or second autografts due to either progression or relapse of their myeloma. The median age of patients with MM at autologous HSCT was 51.5 years. At presentation of their MM, the following high-risk (HR) features were encountered: stage III disease according to the revised international scoring system (RISS) in 12.3%; adverse cytogenetics in 31.93% of patients; advanced bone disease in 60.50%; and renal dysfunction or failure in 11.76% of patients. A total of 104 autologous HSCTs (77.04%) were performed without cryopreservation while 31 autografts (22.96%) were performed using cryopreserved apheresis stem cell products. Additionally, 54 autologous HSCTs (40.00%) were done at outpatient while 81 autografts (60.00%) were performed in an inpatient setting. Survival for 100 days post-HSCT for all patients with MM who received autologous transplants including those done at outpatient was 100%. The 4 years overall survival (OS) an progression-free survival (PFS) for patients with MM who received non- cryopreserved or fresh autologous HSCTs were 82% and 68% respectively.Conclusion: Autologous HSCT without cryopreservation is safe, and feasible and can lead to short-term as well as long-term outcomes that are comparable to autologous transplantation with cryopreservation. Non- cryopreserved autologous grafts allow the performance of autologous transplants in an outpatient setting to save beds and reduce costs.

Sepsis refers to a generalized inflammatory response of the organism to an infection or to bacterial products in circulation, rather than the development of an infection per se. Despite recent advances in clinical practice and overall medical care, sepsis remains a great health care problem and is still the most common cause of death in critically ill patients with infection. We suppose that during the course of sepsis the expression of TRAIL in different organs correlates with acute mortality and further development of multiple organ dysfunction syndrome (MODS). It is expected that dendritic cells (DCs) might become targets for apoptotic processes in a result of elevated TRAIL expression. This hypothesis is a bias for detailed investigations for in vivo studies in animal models and for in vitro studies of septic patients.