The limited space in urban areas often presents a challenge for harnessing renewable energy, particularly solar energy. However, this obstacle can be overcome by using building facades to generate energy. The global energy consumption significantly affected by building, contributing significantly demand and greenhouse gases. These buildings require energy (electrical & thermal) for various processes. Photovoltaic/thermal (PV/T) systems can offer a solution by producing both electrical and thermal energies, simultaneously. The circulating working fluid within the system will reduce the surface temperatures of PV panels and subsequently improving the electrical efficiency. Integrating PV/T systems into building facades, known as building-integrated PV/T (BIPV/T) systems, enables efficient production of energy, enhancing the overall energy consumption of buildings. The aim of the current review is to provide an outline of BIPV/T systems; explaining how they work, their classification, the benefits of their utilization in buildings, and techniques for energy enhancement in buildings. The primary objective of this review is to offer researchers up-to-date information on BIPV/T systems available in the literature. It includes recent published technological advancements in BIPV/T systems, focuses on the cited works and their key areas of interest, and provide readers with a comprehensive and systematic overview of the topic rather than an exhaustive analysis of BIPV/T systems.

Successful Endoscopic Endonasal Trans-Sphenoidal Resection for Pituitary Macro Adenoma with Apoplexy in a Twin Pregnancy: A Case Report.Ujjwal kumar jha1, Pragyan Basnet1 , Sunil kumar Das21Patan Academy of health sciences, Laganakhel lalitpur2General practice and emergency medicine, Rampur hospital, Rampur PalpaAuthors :Dr. sunil kumar das, GPEM Rampur hospital , Rampur, Palpa

Background Estimating malnutrition risk among hospitalized patients is challenging, yet critical due to its association with adverse outcomes such as prolonged hospital stays, increased mortality, impaired wound healing, depression, and increased hospital costs. This research study aims to evaluate the risk of malnutrition among type 2 diabetic hospitalized patients and its impact on the patient’s length of stay in two tertiary hospitals based in Kigali. Method In this retrospective cross-sectional study, 300 adult hospitalized type 2 diabetic patients from Kigali’s tertiary hospital and King Faisal Hospital were enrolled between January 2021 and October 2022. Data collected includes demographics, anthropometrics, serum albumin, and length of hospital stay. The Nutrition Risk Index was used to determine malnutrition risk. Results 55.3% of hospitalized type 2 diabetes patients were found to be at risk of malnutrition based on the Nutrition Risk Index. Gender distribution showed no significant difference (p = 0.724), with 56.6% females and 54.5% males at risk. Significant associations were found with age (r=0.018, p= 0.017), hypertension as comorbidity (r=-0.169, p = 0.004), hospital stay duration (r=0.139, p= 0.016), and blood glucose levels (r=-0.087, p = 0.001). Conclusion A study finds high malnutrition risk in hospitalized type 2 diabetes patients, linked to longer stays and poor outcomes. Early malnutrition screening, proper nutrition support, and a multidisciplinary care team are crucial for improved clinical care and cost-effectiveness.

Background and Purpose: Hyoscine butylbromide (HBB) has a low oral (PO) bioavailability. Further, limited data on its activity on non-gastrointestinal (GI) smooth muscle spasms after oral dosing are available, meaning its effect outside the GI tract has been questioned. This pharmacokinetic/pharmacodynamic (PK/PD) study, conducted using female rats, aims to cover this gap. Experimental Approach: PK study: HBB and atropine (comparator) were administered PO and IV to rats, and concentrations in plasma, and colon, uterus and urinary bladder (CUB) were measured. PD study-1: Concentration–response (C-R) curves of HBB and atropine (10-9–10-4M) were obtained for carbachol (CCH)-induced (10-5 M) pre-contracted CUB; PD study-2: CUB were pre-incubated with HBB and atropine at maximum concentrations (Cmax) from PK study, and CCH C-R curves (10-9–10-4 M) were obtained; PD study-3: HBB and atropine were administered PO and IV to rats as for PK study, CUB were collected at 0.5 h (IV) and 4 h (PO), and CCH C-R curves (10-9–10-4 M) were obtained. Key Results: PO HBB showed higher Cmax in CUB (192.5, 3.70 and 1.85 ng∙g-1, respectively) than plasma (0.008 ng∙mL-1). HBB and atropine reduced (concentration dependently) CCH-induced contractions in CUB. PO HBB showed highest spasmolytic activity in colon (40%), followed by uterus (30%) and urinary bladder (10%). Conclusion and Implications: This is the first comparative study investigating PO and IV HBB and atropine in GI and non-GI tissues. Despite low bioavailability, PO HBB accumulates and exerts spasmolytic effects outside the GI tract.

A document by Gail Budhu. Click on the document to view its contents.

Background: Surgical site infection (SSI) is a frequent complication following emergency equine laparotomy. It negatively impacts equine welfare, increases treatment costs and is a hospital biosecurity risk justifying investigations of ways to reduce SSI incidence. Objectives: To determine if a sutured-on stent dressing for anaesthetic recovery reduces SSI in horses following emergency laparotomy. Study design: Randomised controlled trial. Methods: Eligible horses undergoing emergency exploratory laparotomy were enrolled. Horses were randomised to have a sutured-on stent dressing (intervention) or standard adhesive textile dressing (control) placed for incisional protection during anaesthetic recovery. Horses were followed up to 90 days postoperatively. Data were analysed according to intention-to-treat principles. Time to SSI (primary outcome) for each group was analysed using a Cox proportional hazard model. Secondary outcomes (SSI during hospitalisation, pyrexia during hospitalisation, days hospitalisation and incisional hernia formation at 90 days) were analysed using Chi-squared tests and a univariable logistic regression model (categorical data) or by comparing means between groups (continuous data). Results: The study included 352 horses (167 intervention group, 185 control group). SSI developed in 101 horses (28.7%) at a mean of 9.7 days (SD 4.6 days). Rate of SSI was not significantly different between intervention and control groups unadjusted (Hazard Ratio [HR] 0.83, 95% CI 0.56 - 1.23, P=0.36) or adjusted for variables significantly associated with rate of SSI (HR 0.88, 95% CI 0.59 – 1.30, P=0.51). There were no significant differences in secondary outcomes between intervention and control groups. Main limitations: This study was performed at a single centre and only evaluated incisional protection for anaesthetic recovery. Conclusions: Use of a sutured-on stent dressing for anaesthetic recovery did not reduce the rate of SSI compared to a textile adhesive dressing. Further RCT are required to investigate efficacy of other interventions on reduction of SSI following emergency laparotomy

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Objective: To evaluate the impact of twin dating by ultrasound-measured crown-rump length (CRL) of the larger (CRL-L), smaller (CRL-S) or mean twin measurement (CRL-M) on the rates of preterm birth (PTB) and detection of fetal growth restriction. Design: A cohort study. Setting: A tertiary fetal medicine centre (London, UK). Population or sample: All twin pregnancies between 1998 and 2023 who underwent ultrasound assessment of first trimester CRL and fetal growth. Methods: Data collection included CRL measurement, estimated fetal weight (EFW), pregnancy outcome and birthweight (BW) for each twin. Pregnancies were retrospectively re-dated by CRL-S, CRL-L and CRL-M. Main outcome measures: Small for gestational age (SGA) <10 th centile and PTB rates. Results: Of the 1129 twin pairs median CRL was 61mm (IQR:56.0-66.0) and 63mm (IQR:58.4-68.9) for the smaller and larger twin respectively with a mean discordance of 4.0%. Prenatal SGA diagnosis occurred in 19.8% and 23.1% of smaller twins when dated by CRL-S and CRL-L respectively. When pregnancies were dated by CRL-M versus CRL-S or CRL-L there was no difference in prenatal SGA diagnosis (p=0.275 and p=0.419); SGA at birth (p=0.132 and p=0.325); or PTB (p=1.00 and p=0.765 respectively). Conclusions: Dating by the smaller, larger or mean-twin CRL doesn’t significantly alter rates of extreme preterm birth, SGA detection or SGA birth. Dating by the mean twin CRL reduces stigmatisation of the smaller twin, alleviating parental anxiety, whilst retaining the utility of accurate gestational age assessment without impacting on clinical outcomes.

Classical liquid activity coefficient models (LM), such as the NRTL model, fail near the critical point of the liquid-liquid equilibrium (LLE), unless a highly nonlinear temperature dependency is introduced for the molecular interaction parameters. In this work, we propose an approach to predict the LLE data near the critical point using data away from the critical region based on the global renormalization group theory (GRGT). In particular, we propose a non-empirical approach to determine the GRGT parameters, thus does not rely on experimental data. The performance of our method is examined with the NRTL model using 21 binary mixtures. Our results show that the predictive approach proposed in this work reduces the error in the critical solution temperatures by about 50% when compared to the classical NRTL model using linear temperature dependent interaction parameters.

We develop the Riemann-Hilbert (RH) method for the generalized inhomogeneous Hirota equation with zero boundary condition. The RH problem is related to two kinds of scattering data: N simple poles and one N-order pole. Here we consider that when the scattering data have one or more higher-order poles, the formulas of bound-state (BS) solitons and multiple BS solitons are obtained, and the interaction between solitons and BS solitons are shown.

Population genetics is a tool that conservationists have continued to rely on to quantify population-level genetic variation and identify priority conservation units. The range-wide deforestation starting in the 1600s and rapid urban development and associated habitat modification in recent decades have posed significant challenges to the Hong Kong newt (Paramesotriton hongkongensis), a tropical salamander restricted to streams and forests in southern China. Our research, which sampled 310 adult P. hongkongensis from 10 breeding streams throughout its current distribution in Hong Kong, China to quantify genetic diversity and characterize its population genetic structure using 9 pairs of SSR primers, has revealed crucial insights. Despite long-term, repeated disturbance to its habitat and fragmentation caused by urban development, genetic diversity has been maintained within and among P. hongkongensis populations. Only two out of ten sites exhibited evidence of population bottlenecks. Bayesian clustering revealed five well-supported clusters within the range of P. hongkongensis in Hong Kong, which should be managed as separate conservation units. This work adds to the existing evidence that the effects of urbanization and human disturbance on genetic diversity in amphibians are not easily generalizable and should be addressed on a case-by-case basis.

Pollinators are unquestionably declining, however, current knowledge on the rate of decline is biased in two aspects which are fragmented (West-dominated) geographic scope and narrow (bee-dominated) taxonomic focus of studies. This bias has resulted in an unfortunate imbalance, whereby the most biologically diverse regions are less furnished with diversified data, and diverse pollinator groups are out of scope. We suggest evaluation of four major drivers of this bias – (i) concept generalization, (ii) data accessibility, (iii) scattered environmental regulations, and (iv) shifted infrastructure and funding resources. We argue that the complex interplay between these drivers has created a bias in knowledge that needs addressing. Using search engines in different languages and closer cooperation between developed and developing countries may help to overcome geographic bias in pollinator studies. The direction of research toward pollinator diversity and involvement of scientists in environmental policies can help to reach knowledge balance on the topic.

Objective: We examined the cost-effectiveness of conservative management (CM) compared to planned cesarean hysterectomy (CH) for placenta accreta spectrum (PAS). Design: A cost-effectiveness analysis in a theoretical cohort of patients. Setting : A decision analytic model. Population : A theoretical cohort of 1000 pregnant patients with PAS greater than 20 weeks gestation. Methods : In base case analysis, we assumed that between 20-40% of individuals would be eligible for CM. Model inputs were derived from the literature. Analysis was conducted from a healthcare system perspective with a one year analytic horizon. Outcomes included hysterectomy, surgical site infection (SSI), length of hospitalization, intensive care unit (ICU) admission, and death. An incremental cost-effectiveness ratio (ICER) of $50,000 per quality-adjusted life year (QALY) defined cost-effectiveness. Sensitivity analyses were performed. Main outcome measures: The cost gained per life year and per QALY. Results: For base-case estimates, CM was the cost-saving strategy with an ICER of $9330.51 USD. Compared to CH, CM resulted in 905 fewer hysterectomies, 80 fewer instances of SSI, and 5 fewer deaths. CM resulted in 149 more admissions with length of stay >5 days and 25 more ICU admissions . In probabilistic sensitivity analysis, CM was the cost-effective strategy in 71% of runs and the dominant strategy in 42% of runs. Conclusion: CM was the cost-effective strategy for management of PAS in greater than 70% of iterations of our model. Modeling demonstrated significant uncertainty in the comparative effectiveness of the two strategies, highlighting the need for prospective research evaluating the effectiveness of CM.

Background Colorectal carcinoma with isolated metastasis to the scapula is a rare occurrence. The is a paucity of accounts detailing experience with this unique scenario. We present a case of oligometastatic colon adenocarcinoma to the scapula with subsequent scapulectomy, in which the patient had eventual visceral disease recurrence yet still gained a palliative benefit from the procedure. Methods We detail the account of a patient with metastatic colorectal carcinoma to the right scapula and subsequent treatment for the scapular metastasis. Results The patient underwent successful total scapulectomy for metastatic colon adenocarcinoma with negative margins achieved. He had an uneventful postoperative course and discharged home on day three. Upon follow up after total scapulectomy, the patient experienced significant symptom improvement and functional recovery. Conclusion We believe a significant benefit to the patient's overall quality of life was provided by undergoing this procedure. Therefore, this option should remain part of the oncologic surgeon's armamentarium to offer a palliative option to patients with the goal of controlling pain and retaining function.

Dimensions of body size are an important measurement in animal ecology, though they can be difficult to obtain due to the effort and cost associated with the invasive nature of these measurements. We avoid these limitations by using camera-trap images to derive dimensions of animal size. To obtain measurements of object dimensions using this method, the size of the object in pixels, the focal length of the camera, and the distance to that object must be known. We describe a novel approach of obtaining the distance to the object through the creation of a portable distance marker, which, when photographed, creates a “reference image” to determine the position of the animal within an image. This method allows for the retrospective analysis of existing datasets and eliminates the need for permanent in-field distance markers. We tested the accuracy of this methodology under controlled conditions with objects of known size resembling Felis catus, our study species, validating the legitimacy of our method of size estimation. We then apply our method to measure feral cat body size using images collected in Tasmania, Australia. The precision of our methodology was evaluated by comparing size estimates across individual cats, revealing consistent and reliable results. The average height (front paw to shoulder) of the feral cats sampled was 25.25 cm (CI = 24.4, 26.1) and the average length (base of tail to nose) was 47.48 cm (CI = 46.0, 48.9), suggesting wild feral cats in our study area are no larger than their domestic counterparts. Given the success of its application within our study, we call for further trails with this method across a variety of species.

Introduction Implantable loop recorders (ILR) are recommended to detect atrial fibrillation (AF) in cases of cryptogenic stroke (CS). However, the utility of loop recorder for detection of other actionable arrhythmias in these patients is limited. Objective: To evaluate the utility of ILR to detect arrythmias other than AF in patients with cryptogenic stroke. Methods: We enrolled consecutive CS patients referred for an ILR. A retrospective chart review was conducted from 2018 to 2021. All patients were monitored for a minimum of one year. Results: The cohort included 260 consecutive patients with cryptogenic stroke with a mean age of 68. 2 +/- 13.27 years patients of this cohort had at least one actionable arrhythmic event. AF was found in 47 (18%) patients and 44 (17%) patients were found to have other arrhythmias. Out of these 44 patients, 23 patients (9%) were found to have supraventricular tachycardias (SVT), 4 patients (2%) had ventricular tachycardias, 9 patients (3%) had pauses, 8 patients (3%) had significant bradycardia events. Anticoagulation was initiated in all 47 patients with AF. A total of 15 patients (6%) underwent procedures which included 7 pacemakers, 1 implantable cardioverter-defibrillator, 1 SVT ablation, 6 electrophysiology studies because of ILR findings. Conclusion: ILRs can successfully identify AF in patients with cryptogenic stroke. However, there is a high incidence of other arrythmias that can be detected by implanting ILRs that would otherwise would not be identified or have delayed detection. The study demonstrates the advantage of long-term remote monitoring of patients with CS beyond AF detection.

Backgroubd: Septic cardiomyopathy is a potentially fatal complication of sepsis. In this study, transcriptomic and proteomic analyses of the sera of sepsis patients were performed to identify the underlying pathological mechanism as well as potential targets for the treatment of septic cardiomyopathy. Methods: This study presents a prospective single-center investigation into the progression of sepsis patients to septic cardiomyopathy during their ICU admission. A total of 50 patients were enrolled, categorized into two groups: sepsis with cardiomyopathy (25 cases) and sepsis alone (25 cases). To elucidate the biological significance of identified proteins, we employed co-expression network analysis. Furthermore, leveraging proteomic and transcriptomic data, we constructed molecular networks to elucidate the interactions among pivotal molecules. This approach aims to enhance the clarity and logical coherence of our data interpretation, thereby strengthening the overall argumentation of the study. Results: A total of 216 differentially expressed proteins (| Fold change > 1.5 and P-value < 0.05) were identified in the proteomic analysis. Transcriptome association analysis showed that two proteins were co-downregulated in patients with septic cardiomyopathy, with IL-27B associated with the immune response. KEGG pathway enrichment showed that IL-27B was involved in the cytokine-cytokine receptor-interaction signaling pathway. Conclusion: Comprehensive transcriptomic and proteomic analyses identified specific changes in protein expression in septic cardiomyopathy, most of which were associated with inflammation-related pathways and amino acid metabolism. These findings thus describe the pathological features and pathways associated with septic cardiomyopathy and identify potential therapeutic targets.

A document by Shriya Sharma. Click on the document to view its contents.