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Rosa davurica Pall. is widely used in traditional oriental herbal therapy, but its components and molecular mechanisms of action remain unclear. This study investigates the antidiabetic potential of Rosa davurica Pall. root extract (RDR) and elucidates its underlying molecular mechanisms with in vitro and in vivo models. Data from the current study show that RDR exhibits strong antioxidant activity and glucose homeostasis regulatory effects. It significantly impacts glucose homeostasis in C2C12 skeletal muscle cells by inhibiting α-glucosidase activity. Further molecular mechanistic studies revealed that RDR promoted glucose uptake by phosphorylation of AMP-activated protein kinase (AMPK)/acetyl-CoA carboxylase (ACC), but not Phosphatidylinositol 3-kinase (PI 3-kinase)/Akt in C2C12 skeletal muscle cells. These actions increased the expression and translocation of glucose transporter type 4 (GLUT4) to the plasma membrane. In addition, RDR treatment in the STZ-induced diabetic rats remarkably improved the low body weight, polydipsia, polyphagia, hyperglycemia, and islet architecture and increased the insulin/glucose ratio. The liver (ALT and AST) and kidney marker enzyme (BUN and creatinine) levels were restored by RDR treatment as well. Phytochemical analysis identified eight major constituents in RDR, crucial for its antioxidant and antidiabetic activity. Through the molecular docking of representative glucose transporter GLUT4 with these compounds, it was confirmed that the components of RDR had a significantly high binding score in terms of structural binding. These findings from the current study highlight the antidiabetic effects of RDR. Collectively, our data suggest that RDR might be a potential pharmaceutical natural product for diabetic patients. [ABSTRACT FROM AUTHOR]

This paper introduces a novel approach for rapidly balancing lithium-ion batteries using a single DC–DC converter, enabling direct energy transfer between high- and low-voltage cells. Utilizing relays for cell pair selection ensures cost-effectiveness in the switch network. The control system integrates a battery-monitoring IC and an MCU to oversee cell voltage and ensure battery protection. A prototype circuit with twelve lithium-ion batteries demonstrates the method's efficacy, achieving a remarkable balancing time of 48 min during charging with a maximum efficiency of 89.85%. Comparative analysis with other methods underscores the superior performance of the proposed balancing circuit in terms of balancing time and implementation cost. Furthermore, this paper delves into hardware aspects of battery management systems (BMSs) for electric vehicles and stationary applications. It offers an overview of prevailing concepts in state-of-the-art systems, aiding readers in assessing considerations essential for BMS design in various applications. The discussion includes examples of battery packs sourced from commercially available electric vehicles. Subsequently, the manuscript addresses implementation aspects concerning the measurement of critical physical variables such as voltage, current, and temperature, alongside balancing strategies. [ABSTRACT FROM AUTHOR]

A wave active filter (WAF) based on a differential difference current conveyor (DDCC) is presented in this paper. An active filter formation depends entirely on wave quantity processing. The wave method is demonstrated for the basic wave active elements (WAEs) of active filters such as a series inductor and a shunt capacitor. The novelty of the proposed work is that the mathematical operations required to implement the wave active components, such as lossy integration-subtraction; subtraction; summation and inverter, are performed using the DDCC as an analog building block (ABB). Designing WAFs of lower to higher-order is extremely challenging, i.e., great motivation to propose a WFA using a CMOS-based DDCC for lower and higher-order low-pass Butterworth filter topologies. Additionally, the filter performances are verified through noise analysis, percentage total harmonic distortion (%THD) and Monte Carlo analysis. The proposed WFA is theoretically verified for n th order low-pass Butterworth filter designs (n = 2 , 3 , 4 , 5 , 6) using DDCC-based WAEs and validated using SPICE simulations with 0. 1 8 μ m TSMC CMOS technology parameters for DDCC, operating on ± 0. 9 0 V. [ABSTRACT FROM AUTHOR]

In this paper, a review of advances in total maximum daily load (TMDL) implementation planning by modeling best management practices (BMPs) and green infrastructure (GI) practices along with enhanced (hybrid/streamlining) approaches is presented. The review emanates from Chapter 12 of the recent ASCE Manual of Practice on TMDLs. The latest models and modeling tools, specifically the United States Environmental Protection Agency's (USEPA's) GI Modeling Toolkit and the Landscape and Green Infrastructure Design (L-GrlD) model for formulating GI strategies with flexibility to support stakeholder engagement, are reviewed. In addition, other decision support tools that can help advance the state-of-the-practice of TMDL implementation are included in the synthesis. Advances in incorporating model uncertainties related to BMPs and GI practices in TMDL analysis are briefly discussed. Furthermore, enhanced approaches to cost-effective TMDL implementation measures are discussed, which can be combined with other watershed management strategies for greater synergy between TMDL modelers and other watershed stakeholders. Some emerging technologies such as remote sensing can be useful for monitoring the effectiveness of the TMDL implementation measures over time. Several emerging technologies are discussed through an example illustrating the long-term efficacy of implementation practices. Finally, an enhanced approach to the full TMDL life cycle that explicitly incorporates BMPs and GI practices in the TMDL is proposed, and expected benefits of this approach are demonstrated with conceptual diagrams. [ABSTRACT FROM AUTHOR]

Hyaluronan (HA) plays well-recognized mechanical and biological roles in articular cartilage and synovial fluid, where it contributes to tissue structure and lubrication. An understanding of how HA contributes to the structure of other musculoskeletal tissues, including muscle, bone, tendon, and intervertebral discs, is growing. In addition, the use of HA-based therapies to restore damaged tissue is becoming more prevalent. Nevertheless, the relationship between biomechanical stimuli and HA synthesis, degradation, and signaling in musculoskeletal tissues remains understudied, limiting the utility of HA in regenerative medicine. In this review, we discuss the various roles and significance of endogenous HA in musculoskeletal tissues. We use what is known and unknown to motivate new lines of inquiry into HA biology within musculoskeletal tissues and in the mechanobiology governing HA metabolism by suggesting questions that remain regarding the relationship and interaction between biological and mechanical roles of HA in musculoskeletal health and disease. [ABSTRACT FROM AUTHOR]

Background: While personality predominantly influences human cognition, emotion, and behavior, there is still an unresolved research gap concerning the association between personality and substance use within the Sri Lankan context. Methods: This descriptive cross-sectional study aimed to investigate the association between personality traits and substance use among advanced-level students aged over 18 in Western province, Sri Lanka, in 2023. Data collection was carried out using selfadministered paper-pencil questionnaires. The study variables were measured using the brief version of the Big Five Personality Inventory and the Alcohol, Smoking, and Substance Involvement Questionnaire. Data analysis involved the use of the chi-square test and Spearman correlation. Findings: Of the 441 enrolled participants, 422 provided correct responses to the questionnaire. Among them, 154 (36.5%) reported substance use. The majority of students initiated substance use at the age of 17. The results reveal a significant association between the openness personality trait and substance use among advanced-level students in Western province. Additionally, there was a statistically significant positive correlation between the extroversion personality trait and amphetamine use among advanced-level students. Conclusion: The findings highlight a significant association between specific personality traits, particularly openness and extroversion, and substance use among advanced-level students in Western province, Sri Lanka. These results emphasize the significance of considering personality factors in understanding and addressing substance use behaviors among youth populations. Further research and targeted interventions are necessary to delve deeper into these associations and develop effective prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Every nation treasures its handloom heritage, and in India, the handloom industry safeguards cultural traditions, sustains millions of artisans, and preserves ancient weaving techniques. To protect this legacy, a critical need arises to distinguish genuine handloom products, exemplified by the renowned "gamucha" from India's northeast, from counterfeit powerloom imitations. Our study's objective is to create an AI tool for effortless detection of authentic handloom items amidst a sea of fakes. Six deep learning architectures—VGG16, VGG19, ResNet50, InceptionV3, InceptionResNetV2, and DenseNet201—were trained on annotated image repositories of handloom and powerloom towels (17,484 images in total, with 14,020 for training and 3464 for validation). A novel deep learning model was also proposed. Despite respectable training accuracies, the pre-trained models exhibited lower performance on the validation dataset compared to our novel model. The proposed model outperformed pre-trained models, demonstrating superior validation accuracy, lower validation loss, computational efficiency, and adaptability to the specific classification problem. Notably, the existing models showed challenges in generalizing to unseen data and raised concerns about practical deployment due to computational expenses. This study pioneers a computer-assisted approach for automated differentiation between authentic handwoven "gamucha"s and counterfeit powerloom imitations—a groundbreaking recognition method. The methodology presented not only holds scalability potential and opportunities for accuracy improvement but also suggests broader applications across diverse fabric products. [ABSTRACT FROM AUTHOR]

Background: Surgical procedures in the anterior mandibular region require a profound understanding of the complex anatomical structures to ensure patient safety. The lingual foramen (LF) and its intra-osseous canal are pivotal structures, supplying vascular and neural support to the mental region. The prevalence of LF is widely recognized, with variations among populations. Methods: The study involved 650 adult participants. Data were collected using high-resolution cone-beam computed tomography (CBCT), and statistical analysis was conducted, establishing inter-rater agreement. Results: The population had a varied age distribution, with males comprising 53.23% and females comprising 46.77%. The median lingual canal was found in the Supra and Infra spinosum (65.38%). Most participants had lateral lingual canals (60.92%). The most prevalent lingual foramina was 4 (30.62%). The study found no significant associations between gender and LF diameter, distribution in different travel directions, or LF locations. However, males had a slightly larger diameter. Conclusion: The findings provide valuable insights into LF variations based on anatomical locations, and there were no statistically significant differences in measurements across different age groups. This knowledge contributes to the evolving field of oral and maxillofacial surgery, ensuring better patient outcomes. [ABSTRACT FROM AUTHOR]

Summary: The thrombotic risk with haemoglobin C trait (HbAC) or haemoglobin C disease (HbCC) is unclear. However, individuals with HbCC have demonstrated chronic haemolysis, higher blood viscosity and altered rheology when compared to individuals with wild‐type haemoglobin (HbAA). These physiological alterations may theoretically translate to increased risk of thrombosis; therefore, a systematic literature review was performed to investigate the possible association between HbAC and/or HbCC and thrombosis. Twenty‐two studies met inclusion criteria representing 782 individuals with HbAC (n = 694) or HbCC (n = 88). Fifteen studies described the presence/absence of venous thromboembolism (VTE) in patients with HbAC (n = 685) or HbCC (n = 79), while seven studies described patients with HbAC (n = 9) or HbCC (n = 9) and arterial thrombosis. Most (n = 20) studies were case reports or case series; however, two studies suggested a potential increased VTE risk with HbAC compared to HbAA in (i) all patients (OR 2.2, 95% CI: 0.9–5.5) and in (ii) pregnant individuals (RR 3.7, 95% CI 0.9–16). This review is the largest assessment of patients with HbC trait or disease and thrombosis to date; despite its limitations, the findings suggest HbC may be a predisposing risk factor to thrombosis. Prospective cohort studies are warranted to definitively elucidate the risk of thrombosis in this population. [ABSTRACT FROM AUTHOR]

Introduction: Second-generation supraglottic airway devices that provide high seal pressures are found to be suitable for patients undergoing laparoscopic surgery, as they have a separate port for gastric tube insertion, effectively separating the airway and the oesophagus. The present study compares the usage of two such second-generation supraglottic devices-AuraGain™ and i-gel® in patients undergoing gynaecological laparoscopic surgeries. Aim: To compare the Oropharyngeal Leak Pressure (OLP) and airway pressures achieved by the i-gel® and Ambu AuraGain™ after insertion in the supine position and during laparoscopic carbon dioxide peritoneum in the Trendelenburg position. Materials and Methods: This randomised clinical, singleblinded study conducted at the Department of Anaesthesiology, Narayana Medical College, Nellore, Andhra pradesh, India involved 100 female patients undergoing elective gynaecological laparoscopic surgeries under general anaesthesia with controlled ventilation. The primary objective was to compare the clinical performance of Ambu AuraGain™ (Group-A) and i-gel® (Group-I) concerning their oropharyngeal seal pressures and airway pressures in gynaecological laparoscopic surgeries. The secondary outcomes measured included the time taken for insertion, ease of insertion of the device, effects on postinsertion haemodynamic parameters like heart rate, blood pressure, oxygen saturation, ease of gastric tube insertion, and fibreoptic bronchoscopic grading of the visualised glottic structures after device placement, as well as postoperative side effects like blood staining upon removal of the device and sore throat. Data were analysed using Student's t-test and chi-square test. Results: The mean age in Group-A was 39.62±4.085 years, and in Group-I, it was 39.48±2.468 years. The mean peak inspiratory pressures after device insertion were 14.34 mmHg in Group-A and 16.66 mmHg in Group-I. Haemodynamic parameters postinsertion were similar in both groups {Group-A: Mean Heart Rate (HR) 87.22 bpm, Mean Arterial Pressure (MAP) 89.72 mmHg, Oxygen Saturation (SpO2) 99.58%; Group-I: Mean HR 87.50 bpm, MAP 89.72 mmHg, SpO2 99.72%). Fibreoptic bronchoscopic grading in Group-A was 0/0/9/41, and in Group-I, it was 0/0/11/39. Blood staining upon removal was noted in four patients (8%) in Group-A and in 3 patients (6%) in Group-I. Sore throat in the postoperative period was noted in 14% of patients in Group-A and 8% in Group-I. Conclusion: Ambu AuraGain™ was found to provide a better seal and higher OLP compared to the i-gel® in gynaecological laparoscopic surgeries and therefore provide safer and more effective ventilation for patients undergoing such surgeries. I-gel® was found to be easier and quicker to insert than the AuraGain™. [ABSTRACT FROM AUTHOR]

This article discusses a study conducted in northeast Assam to assess radiation exposure during coronary angiography computed tomography (CT) scans. The study found that the mean effective dose was 21.57 mSv.cm and highlighted the importance of establishing region-specific diagnostic reference levels (DRLs) to optimize image quality and minimize radiation exposure. The study also found a positive correlation between body mass index (BMI) and radiation exposure. The article suggests that certain populations may not need to undergo CTCA and that elderly males with a high pre-test probability of coronary artery disease should undergo coronary angiography instead. The authors declare no conflicts of interest, and the data supporting the findings are available upon request. [Extracted from the article]

An exact and quick finding of Covid-19 patients plays a major part in the initial period of medicinal treatment and prevention. Automatic recognition of COVID-19 cases utilizing lung X-ray images may help lessen the effect of this infection on human civilization. In recent years, computer vision is the major solution for diagnosing the covid-19 disease by utilizing X-ray images. Besides, many researchers had presented efficient Artificial Intelligence (AI)methods for identifying Covid-19 disease. Nevertheless, the accuracy and time consumption of the model is further to be improved. Thus, in this work, we proposed a novel Xception network with an optimized convolution neural network (OCNN). The CNN architecture is enhanced by using the adaptive seagull optimization (ASO) algorithm. There are three stages of the approach: pre-processing, feature extraction, and classification. At first, a median filter is applied to each image to reduce the noise present in the input image. Then, the noise-free images are fed to the Xception network to extract the features of the images. A convolution network is used to classify an image as positive or negative after feature extraction. The performance of the proposed approach is analyzed based on various metrics and performance compared with other techniques. [ABSTRACT FROM AUTHOR]

Background: This study aims to detect outer hair cell (OHC) function in patients with tinnitus, by comparing the otoacoustic emissions (OAEs) in tinnitus patients with normal hearing and normal-hearing subjects without tinnitus, thereby revealing the role of OHC in the generation of tinnitus. Methods: After approval by the local research and ethics committee, this study was done in the department of otolaryngology and associated hospitals, from April 2022 to January 2023. Consent was obtained from all the participants in the present work after explaining the test procedure. The study group included 60 subjects with bilaterally normal hearing to participate. They were classified into two groups: Group 1, i.e., the control group, comprised 30 subjects who were unaffected by tinnitus, whereas Group 2, i.e., the study group, comprised 30 subjects who were suffering from tinnitus. Basic audiological tests and OAE test were done on the respondents of both the groups followed by a comparison of outcomes. Results: The authors of the present study found a statistically significant difference between the amplitude and signal-to-noise ratio (SNR) of distortion product OAE (DPOAE) in tinnitus patients and the control group without tinnitus, suggesting that OHCs have a role in the generation of tinnitus. Conclusion: It can be concluded that OHC activity was reduced in patients with tinnitus, as detected by reduced DPOAE amplitude and SNR, suggesting that the dysfunction of OHCs can be attributable to the generation of tinnitus. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: As the growing season changes, the development of climate resilient crop varieties has emerged as a crucial adaptation in agricultural systems. Breeding new varieties for a changing climate requires enhanced capacity to predict the complex interactions between genotype and environment that determine flowering time. Hundreds of experiments with observations of flowering, the environment and plant genetics were used to build a model that can predict when a variety of common bean is going to flower. This model will help breeders to explore the phenological characteristics of their germplasm, speeding up selection for climate adaptation. Summary: There is an urgent need to accelerate crop breeding for adaptation to a changing climate. As the growing season changes, crop improvement programmes must ensure that the phenological characteristics of the varieties they develop remain well suited to their target population of environments.Meeting this challenge will require a clear understanding of how existing germplasm behave across Genotype ∗ Environment (G ∗ E) to enhance the efficiency of selection. Recent work calls for the development of simple models that can accurately simulate genotypic variation in key traits across target population of environments.Accordingly, we develop a simple machine learning framework for modelling time to flowering across G ∗ E and apply this to common bean in an equatorial target population of environments. Within this framework, we test three machine learning models and find that the best performing models display high levels of accuracy across G ∗ E.We advance understanding of the environmental drivers of flowering time in equatorial conditions by showing that thermal time and accumulated evaporation are powerful predictors of flowering time across all three models. [ABSTRACT FROM AUTHOR]

Background: Change is the only constant in life, and humans continuously strive to cope and adapt based on the changes in their health (physical and mental) status. Cardiovascular diseases (CVD's) are the leading cause of cardiac emergencies that cause enormous impact on patients, families, and health systems prompting processes and strategies for coping with their health status changes and their aftermath effect. Aim: A discussion of the conceptual framework of transition theory applicable to the study to assess the impact of the cardiopulmonary resuscitation (CPR) duration on the functional outcome among patients with in-hospital cardiac arrest (IHCA). Methodology: The transition theory, a middle-range and situation specific theory is applied to the prospective study conducted at a tertiary care hospital in South India. The outcomes were measured using the cerebral performance category (CPC). Results: The theory identifies that cardiac arrest is a situational transition affected by the chronicity of the disease as described with unfavorable outcome with CPC score of 3-5. The fear of death, dependency state of the patient in an unfavorable outcome based on CPC, and caregiver burden on family due to the prolonged duration of acuity of the disease or death of the patient are identified as properties in this theory. Based on the study, the personal meaning includes lifestyle modifications, the impact of spiritualism, financial stability, and the educational qualifications of the patient and family identified as personal meanings that play a major role as facilitators and inhibitors. The patterns and responses in this study identified with follow-up appointments, confidence in caring for themselves, and coping for themselves among the survived cardiac arrest patients. The nursing therapeutics identified from the study are risks identified from the comprehensive assessment, readiness to intervene and implement nursing actions, educating the patient and family based on the transition, and enhancing the creation of a healthy environment. Conclusions: The transition theory is holistically applicable for patients with cardiac arrest, identifying the process and changes adapted by the patient and family with the progression of the disease and the roles adapted by the family members in the event of the patient's death. [ABSTRACT FROM AUTHOR]

Background: Fruit rot disease is one of the most important factors limiting the production potential of Bhut Jolokia (Capsicum chinense Jacq.), which is known as one of the hottest chillies in the world. The management strategies are highly dependent on synthetic chemicals which are causing a detrimental impact on the environment. Considering the factors, this study focuses on exploring potential endophytic microflora from native chilli cultivars which can suppress the fruit rot pathogen. Results: Endophytic microflora occurs ubiquitously in plants that possess various plant-benefiting abilities. A total of 34 endophytic isolates were obtained from different chilli cultivars. These endophytic isolates were subjected to screening in vitro for their potential to suppress the incitant pathogen Colletotrichumgloeosporioides (the causal agent of chilli fruit rot), which was confirmed based on cultural, morphological, pathogenicity and molecular studies. The preliminary screening yielded four bacterial endophytic isolates capable of suppressing the pathogen which was found non-pathogenic to Bhut Jolokia plant. On the basis of morphological, biochemical and molecular identification, the four most promising isolates were identified as Bacillus velezensis, B. mycoides, B. altitudinis and B. cereus, respectively, and used for further in vitro tests. B. velezensis showed the highest inhibition (68.67%) on mycelial growth of C. gloeosporioides, followed by B. mycoides (65.33%), B. altitudinis (52.89%) and B. cereus (45.33%). Among the compatible combination, the highest efficacy (56.00%) was found in the combination of B. velezensis and B. altitudinis. Conclusion: From the present study, it can be concluded that B. velezensis and B. mycoides alone and in combination can be used as potential biocontrol agent in managing the fruit rot of Bhut Jolokia considering their performance in field conditions. [ABSTRACT FROM AUTHOR]

Impact of p-capture reactions on the abundances of neon and magnesium considering the nuclear reaction chain, Neon–Sodium–Magnesium–Aluminum (hereafter extended Ne–Al) for stellar conditions of temperature range of 0.02 × 10 9 – 0.10 × 10 9 K and typical density of 100 g cc - 1 has been studied. Then, we have estimated abundances of Ne and Mg, which are of a little special importance. The estimated abundances of these aforesaid elements are then compared with their counterparts, which have been observed in some B-type stars. For those B-type stars, we have discovered a significant agreement in the abundances between the estimated and observed values with a correlation coefficient >0.8. [ABSTRACT FROM AUTHOR]

Background: Medical student burnout and anxiety has received growing attention in the past decade. The culture of competition and assessment has resulted in increasing stress levels amongst medical students, causing a decline in their academic performance and overall mental health. The objective of this qualitative analysis was to characterize recommendations from educational experts to aid students' academic progress. Methods: At an international meeting in 2019, worksheets were completed by medical educators during a panel discussion. Participants responded to four scenarios representing common challenges medical students face in school (eg. Postponing Step 1, failing clerkships, etc.). For each case, participants addressed what students, faculty and medical schools could do to mitigate the challenge. Inductive thematic analysis was conducted by two authors followed by deductive categorization using an individual-organizational resilience model. Results: Across the four cases, common suggestions made for students, faculty and medical schools were aligned to a resilience model representing the complex interplay between individuals and organizations and the impact on student wellbeing. Discussion: Using suggestions from medical educators from across the US, we were able to identify recommendations for students, faculty, and medical schools to help students succeed in medical school. By applying a model of resilience, faculty serve as a critical bridge to connect students to the medical school administration. Our findings also support a pass/fail curriculum to ease the competition and burden students place on themselves. [ABSTRACT FROM AUTHOR]

Multiple risk factors have been predicted in post operative hypoparathyroidism in total thyroidectomy patients but none have been clearly defined. Present study aims at evaluating the clinic pathological and surgical impact factors in predicting the risk of post operative hypoparathyroidism in thyroidectomy patients. The study was done in Karpaga Vinayaga Institute of Medical Science and Research Centre where Retrospective prospective cohort study who underwent and undergoing total thyroidectomy with or without central neck dissection for both benign and malignant thyroid disorders during 2014 to 2022 was analyzed. The study has analyzed the various risk factors from clinic pathological and surgical skills of identifying the Inferior thyroid artery at its origin and tracing the branches to the parathyroid gland and evaluating the incidence of hypocalcemia in both study and control groups. Two groups were analyzed during the period 2014 to 2022. The study group was included patients with thyroidectomy where ITA were identified and traced up to the parathyroid gland. They were further classified into category A where both sides ITA were identified and saved, category B where only one side was preserved. In control group, the surgery was done only on basis of capsular dissection and peripheral ligation of vessels close to the gland. Total study participants in our study was 416. The overall prevalence of hypocalcemia in our study was 11.4%. The age, gender and pathological variants were comparable between the two groups. Female preponderance (76%) was seen among both the groups. Among total study subjects who underwent total thyroidectomy 44.8% were having multi nodular goitre, 7.3% toxic goitre, 9.8% follicular adenoma, 30.2% papillary carcinoma and 7.9% follicular carcinoma. In our study benign and malignant thyroid disorders had no significant difference. Prevalence of hypocalcemia among control group 14.5% vs study group 3.8%. We found incidence of hypocalcaemia was comparitively lesser among patients with thyroidectomy alone, than those with unilateral or bilateral CND. Prevalence of hypocalcemia among control group was 33% (45/133) and study group 7% (12/153), when thyroidectomy alone was done. However, with neck dissection in bilateral CND, incidence was 41% (23/56) in study group and 61% (11/18) in control group. In unilateral CND, study and control group had 31% (10/32) and 54% (13/24) which was found to be statistically significant. Parathyroid auto transplantation among the control group (29%) compared to the study group (16%). Bilateral neck dissection and gross extrathyroidal extension and cases with PTG inadvertent removal posed significant risk factors for hypoparathyroidism. The prevalence of immediate hypocalcemia among Cat A, Cat B and control group were 14%, 20.3% and 37.5% respectively and was statistically significant (P <.0001). Symptomatic and Biochemical hypocalcemia at the end of 1 week among Cat A, Cat B, and control group was 8%, 12%, and 33.6, & 12.9%, 21% and 30% respectively. Whereas transient hypocalcemia reported among these groups was 1.6%, 5% and 14.6%. Permanent hypocalcemia was < 1% in study group and 4% among control group. We observed that permanent hypocalcemia was high among patients with bilateral neck dissection and auto transplanted PTG. There was no significant statistical difference in hypocalcemia (transient or permanent) among study and control group, but the incidence of hypocalcemia had significantly reduced in both study groups when unilateral or bilateral identification of ITA was done compared to control group. Our hypothesis in this study aims at preserving the branches of ITA supplying PTG distally has greater functional preservation of the parathyroid than conventional technique. This technique also helps us maintaining the plane and capsular dissection if done properly. By trying to preserve the ITA surgeons may acquire better meticulous dissection skills and understanding the anatomical variation of vessels around PTG more precisely which improve the surgical outcome in preventing both transient and permanent hypocalcaemia. [ABSTRACT FROM AUTHOR]

Object detection has become a very prominent subject for research in recent times. This study's main goal is to suggest a technique for video saliency object detection. It seems to sense that using the depth information in photos to detect salient things. Since depth offers abundant information about scene structure, object forms, and other 3D cues. This information is very compatible to distinguish between objects in the foreground and background. As a result of the high object density, small object size, and cluttered background, aerial photos and movies provide results with low precision. In this paper, the proposed SPTM (Super Pixel Transmission Map)-YOLO model, the input RGB image has applied Dark Channel Prior (DCP) method for estimating the transmission map. From the transmission map only, the background probability is estimated with the help of SLIC (simple linear iterative clustering algorithm) superpixel segmentation. That foreground extracted image is further learned with YOLO architecture to detect the objects effectively. For object detection in aerial images, this proposed SPTM-YOLO approach outperforms classic YOLO by up to 6% accuracy. Accurate detection of things that are small in size, partially occluded, and out of view is possible. [ABSTRACT FROM AUTHOR]

Magnesium (Mg) is an essential macronutrient that can be obtained through mineralization of mine spoils. The leftover mine spoils of magnesite mines still contain a reliable amount of Mg in it. The Mg present in raw magnesite spoils is in its carbonate form and hence it has to be mineralized to convert it into plant available soluble forms of Mg. The effect of B. cereus and B. stercoris in the mineralization of Mg has been studied in synthetic mineral salts medium (MSM). To obtain maximum mineralization results it is important to know the optimal conditions of the organisms under which they can grow and produce more Mg. The mineralizing capability of the individual organisms and their combined effect as a consortium under various concentrations of carbon source, pH, temperature and soil organic matter has been studied. It has been seen that the organisms grow and mineralize better when 1% of glucose has been supplemented as carbon source. The optimal pH and temperature were found to be pH 7 and 35°C, respectively. The addition of anthraquinone-2-sulphonic acid (ADQS) as soil organic matter enhances the mineralization Mg in synthetic medium. Rendering to SEM and EDX analysis, the mineralization of Mg in the synthetic medium was established. [ABSTRACT FROM AUTHOR]

Wireless Sensor Networks (WSN) play a major role in various applications, yet maintaining energy efficiency remains a critical challenge due to their limited energy availability. Network lifetime is one of the primary parameters for analyzing the performance of a WSN. This proposed work aims to improve the network lifetime of a WSN by enhancing its energy utilization through the Enhanced Monkey Search Algorithm (E-MSA). The E-MSA provides an optimum solution for this issue by finding a better routing decision by analyzing the available energy on the nodes and the distance between the source and destination. Additionally, a Class Topper Optimization (CTO) algorithm is also included in the work for determining an efficient node to be the cluster head and lead cluster head. In this technique, the data packets are collected by the lead cluster head from the other cluster heads for sending the information in a sequential manner to the base station for reducing data loss. A simulation model is implemented in the NS2 platform with 700 nodes in a 300 × 300 square meter area with 0.5 J of energy to each node for finding the efficiency of the proposed E-MSA with CTO algorithm over the traditional On-Demand Distance Vector (ODV) and Destination-Sequenced Distance Vector (DSDV) approaches. The experimental outcome indicates that the proposed work can reach a maximum lifetime of 1579 s which is comparatively better than the ODV and DSDV approaches by 212 and 358 s, respectively. Similarly, a packet delivery ratio of 79% is achieved with a throughput of 0.85 Mbps along with a delay of 0.48 s for the operation of all 700 nodes. [ABSTRACT FROM AUTHOR]

2 Danielle Allen, I Our Declaration: A Reading of the Declaration of Independence in Defense of Equality i (New York: Liveright Publishing, 2014), 31. 3 Danielle Allen, I Difference Without Domination i : I Pursuing Justice in Diverse Democracies i (Chicago, IL: University of Chicago Press, 2020), 42. 4 Allen, I Our Declaration i , 23. 5 Danielle Allen. In this century we must commit ourselves to the democratic wholeness that Allen has described throughout her oeuvre - even when we do not see it from the same political-ideological vantage - or we will lose democracy itself to history, and I think that's the very stark and grave choice that is before us. Keywords: democracy; inequality; organizing; pragmatism; structural change; political change EN democracy inequality organizing pragmatism structural change political change 851 856 6 10/03/23 20231001 NES 231001 I have known Danielle Allen since I was a graduate student at the University of Chicago. [Extracted from the article]

The telomeric quadruplex structures formed by the guanine-rich sequences of DNA have emerged as targets for small molecules designed and synthesized to stabilize the G-quadruplexes. This report presents a newly synthesized tyrosine-tethered cyclodextrin derivative and its platinum complex. Their structures are characterized using IR, NMR, and mass spectral techniques. The binding interactions of the platinum complex with CT-DNA and the kit22, myc22, and telo24 G-quadruplexes are investigated employing absorption and fluorescence spectral titrations. The binding constant or KSV values of the interaction with the G-quadruplexes are more significant than those with the duplex DNA by order of 10. It presents the compound as a G-quadruplex-selective binder. Further, the well-known G-quadruplex binding molecule Berberine is encapsulated in the Tyr- β-CD through a host: guest association. The structure of the host: guest complex is investigated employing 2D ROESY spectroscopy. In addition, the study on the binding interaction of the complex to the DNA targets is also carried out. The mode and strength of interaction of the free and the Berberine-loaded Tyr-β-CD to the duplex and the quadruplexes are reported. [ABSTRACT FROM AUTHOR]

Introduction: As the most common cancer in Australia, skin cancer generates a considerable health burden. This study outlines the establishment of a new model of integrated care for the diagnosis and management of skin cancer. Methods: A new model of integrated care was established to provide access to all aspects of skin cancer management. General practitioners (GPs) were upskilled through hands-on training and a 6-month skin cancer education program and partnered with specialist Dermatologists and Plastic Surgeons co-located in the same clinic. Data including median wait times between the initial consultation and treatment were prospectively collected and compared patients seen through the integrated pathway to patients referred from their primary GP to specialist Dermatologists and Plastic Surgeons directly (non-integrated pathway). The percentage of patients needing coconsultation with a specialist in the integrated pathway was also measured over time. Results: A total of 25341 patients were seen from the commencement of the clinic in August 2015 to June 2021. In 2017 and 2018 the median wait time to be treated was 7 days for the integrated model compared to 54 days (2017) and 46 days (2018) for non-integrated care (p < 0.0001). The percentage of GPs requesting specialist coconsultations for assessment of skin cancer fell from 98% in 2015, to 5.6% in 2021. Histopathology shows that 66% of lesions excised by GPs in this model were malignant or pre-malignant. Conclusions: This study firstly shows a significant reduction in time to treatment in an integrated skin cancer model over traditional models of health. Secondly it demonstrates GP upskilling over time in the integrated program. Integrating GP and specialist medical practitioners in the treatment of skin cancer offers potential for more efficient, accessible, and affordable care. This cooperative, co-located model may provide a template for the integrating the management of other conditions. [ABSTRACT FROM AUTHOR]

This article, titled "Gangrene and Perforation of the Gallbladder as a Complication of Typhoid Fever ¿ A Case Report," discusses a rare complication of typhoid fever known as gall bladder gangrene with perforation. The article presents a case report of a male adolescent patient who developed this complication and underwent cholecystectomy and intervention, which had a positive outcome. The article emphasizes the importance of early detection and treatment to prevent the high morbidity and fatality rates associated with this complication. [Extracted from the article]

Lead-free K1/2Na1/2NbO3 (KNN) powder was synthesized using the molten-salt process in the eutectic mixture of KCl–NaCl at a low temperature of 700 ℃ for 2 h, which is less than that of the widely used conventional technique solid-state synthesis. X-ray diffraction (XRD) was used to investigate the purity and phase formation. To characterize the surface morphology of sintered ceramics, scanning electron microscopy (SEM) is used. The studies of dielectric permittivity and impedance spectroscopy were performed ranging from 1 Hz to 1 MHz on KNN at temperatures ranging from room temperature (RT) to 580 ℃. The piezoelectric coefficient constant d33 of KNN was obtained, and it is 90 × 10−12 pC/N. Nyquist plots of complex impedance were used to deduce the mechanism of relaxation. These plots depict non-Debye relaxation behavior. The conductivity contributions of grain and grain boundary were estimated using Cole–Cole plots. In addition, antibacterial activity for the KNN was tested using a four-plate approach. [ABSTRACT FROM AUTHOR]

Objectives: To compare the intraoperative and postoperative parameters of two techniques of facial nerve dissection: Centripetal vs Centrifugal. Study Design: Prospective study. Setting: Academic tertiary referral centre. Methods: In our study, cases of superficial parotidectomy were randomly selected from the outpatient departments of ORL & HNS. Of these patients, 30 underwent standard anterograde dissection group (Group A) and 30 underwent retrograde facial nerve dissection (Group B). All the patients were assessed pre-operatively, intra-operatively and post-operatively to compare the various parameters. Results: The most common complaint in both groups was parotid swelling. The operative time for A was shorter at 2.1 h as compared to 1.9 h min in group B. The resolution of symptoms was nearly comparable in both groups. Facial nerve palsy was slightly more in group B but the difference was not statistically significant. Conclusion: The operative time and post-operative complications were both comparable between AFND and RFND, implying both techniques can be used by surgeons depending on the individual cases. [ABSTRACT FROM AUTHOR]

Summary: A routing protocol for cognitive radio ad hoc networks (CRAHNs), namely, primary user supported routing (PSR) is demonstrated in this research. Unlike existing routing protocols for CRAHN, where routing of cognitive users (CUs) is accomplished within CUs, in this proposed protocol, some of the primary users (PUs) support CUs to communicate, by forwarding CU packets. This service provided by PU is of voluntary nature. However, such assistance shall be provided by the PUs, only when they are idle, thereby, preserving the principles of cognitive radio networks (CRNs), which indicates that the operation of PU should not be disturbed by the CU activities. The proposed work is compared with cognitive ad hoc on‐demand distance vector (CAODV) protocol. The performance parameters considered are routing overhead, rate of loss of packets, and e2e packet delay. PSR outperforms CAODV in all these performance parameters. There has been on average 26.25% improvement in routing overhead, 34.12% decrease in loss, and 27.01% improvement in e2e delivery in the proposed PSR. [ABSTRACT FROM AUTHOR]

Picture fuzzy aggregation operators are the standard mathematical tools for the combination of several inputs with respect to attributes into one unique output. The Choquet integral operator has been proven more ideal than traditional aggregation operators in the modelling of interaction phenomena among the attributes in decision-making problems. Firstly, we propose the Choquet integral picture fuzzy Einstein geometric aggregation operator and Choquet integral picture fuzzy Einstein ordered geometric aggregation operator with certain properties of these operators being established. We validate the functioning of the operators with illustrative examples. The proposed operators clearly capture the comprehensive correlative relationships of attributes in a simpler manner. Furthermore, the algorithm for a multi attribute decision-making problem based on proposed operators is given. The application of the proposed operators was explored to deal with the selection of the best mobile apps for online education. Finally, comparisons are conducted to illustrate the discussion and advantages of the proposed operators. [ABSTRACT FROM AUTHOR]

Wireless methodologies are the focal point of electronic devices, including telephones, computers, sensors, mobile phones, laptops, and wearables. However, wireless technology is not yet utilized extensively in underwater and deep-space communications applications, and it is also not applied in certain critical medical, military, and industrial applications due to its limited battery life. Self-energy-harvesting techniques overcome this issue by converting ambient energy from the surroundings into usable power for electronic devices; devices that use such techniques are next-generation wireless devices that can operate without relying on external power sources. This methodology improves the sustainability of the wireless device and ensures its prolonged operation. This article gives an in-depth analysis of the recent techniques that are implemented to design an efficient energy-harvesting wireless device. It also summarizes the most preferred energy sources and generator systems in the present trends. This review and its summary explore the common scope of researchers in narrowing their focus in designing new self-energy-harvesting wireless devices. [ABSTRACT FROM AUTHOR]

Accurate assessment and monitoring of level of consciousness is fundamental for prompt management and recognising warning signs of deterioration in the patient. The Glasgow coma scale (GCS), a widely used tool was compared with full outline of unresponsiveness (FOUR) score as an alternate tool for assessment and prognostication of the outcome. The purpose of this study aimed to compare and evaluate the accuracy between GCS and FOUR score (FS) tool in the neurological assessment and predicting the functional outcome. Materials and Methods: For this observational study, 131 patients were recruited from two major teaching hospitals in Middle Eastern countries. Data was collected on admission from emergency department and reassessed on day two & four. Patient was followed on discharge and outcome evaluated using the Glasgow outcome scale (GOS). Results: The mean age was 56.39±17.29 (18- 87years) with 83(63.4%) male patients. 93 (71%) patients admitted with neurological problems. In terms of predicting the outcome using the GOS, the area under the ROC curve was 92% (CI- 95%, 0.870-0.975) for FS and 74.73 % (CI-95%, 0.825-0.951) for GCS. The sensitivity and specificity for FS on admission (0.976 & 0.543), day two (0.971 & 0.495) & day four (0.971 & 0.340) and for GCS is (0.918 & 0.370) (0.941 & 0.433) (0.971 & 0.330). Conclusions: The FS tool is precise in predicting power of mortality and is an ideal complementary or substitute tool for GCS. [ABSTRACT FROM AUTHOR]

The article explores the intersection of menstruation and sickle cell disease (SCD), highlighting the understudied sexual and reproductive health consequences, particularly focusing on menstruation-associated SCD pain. Topics include the prevalence of such pain, potential mitigating factors like disease-modifying therapies and hormonal contraception, and the need for further research to address the unmet healthcare needs of menstruating individuals with SCD.

To eliminate this time-consuming part of the process, students in the lab course are now provided with a support structure during the design phase, designed by upper-level students, as shown in Fig. After the lab equipment is printed, a lab session is devoted to using the printed object to do a physics experiment; all students do the same activity, sharing the printed equipment. The lab courses for introductory calculus-based mechanics at Bridgewater College have been redesigned to incorporate projects involving 3D printing. [Extracted from the article]

Diabetic retinopathy (DR) is a complication of diabetes attributed to macular degeneration among patients with type II diabetes. The early symptoms of this disease can be predicted through annual eye checkups. This prediction can help such patients prevent vision loss before the disease progress to retinal detachment. Thus, creating awareness among diabetic patients about this disease is necessary to prevent vision loss. Thus, there is a need to develop a computer-assisted method that can effectively predict the disease. The proposed system uses adaptive histogram equalization (AHE), hop field neural networks, and Adaptive Resonance Theory (ART) for image enhancement, blood vessel segmentation, and blood vessel classification. The proposed system analyzes the disease and classifies the disease level effectively with high accuracy. The system can notify users about the stages of the disease. The proposed system can be evaluated with clinical and open fundus image datasets such as DRIVE, STARE, MESSIDOR, HRF, DRIONS, and REVIEW for DR prediction. Physicians evaluated the system and concluded that the result of the proposed system does not deviate from the quality of disease analysis and grading; the proposed technique achieves 99.99% accuracy. Evaluations conducted by ophthalmologists and witnesses confirmed the quality of the proposed system. [ABSTRACT FROM AUTHOR]

To assess the diagnostic accuracy of NBI endoscopy for the diagnosis of early recurrent laryngeal and hypopharyngeal cancers after radiotherapy. The study was conducted over a period of two and a half years from June 2019 to February 2022 and included 123 post-RT patients with laryngeal and hypopharyngeal cancers. The patients were planned for endoscopy with white light and narrow-band imaging. The biopsy was carried out in NBI suspected lesions and sent for histopathological examination. The pathologist was blinded to the outcome of NBI and WLE results to eliminate observer bias. The age group most commonly affected in our study was 40–50 years. Out of the 123 patients, 106 were males and 17 were females. The overall Sensitivity, Specificity, Positive predictive value and Negative predictive value of NBI for malignant lesions were 90.6%, 99%, 95.2% and 98% respectively. NBI Technology is a first-rate diagnostic tool that can help in diagnosing early recurrent cancer lesions, especially after RT, in which the recurrence is otherwise difficult to differentiate from post-radiotherapy oedema. This technology can significantly reduce the rates of failure to detect cancers in early stages. [ABSTRACT FROM AUTHOR]

To compare postoperative complications, functional rehabilitation, surgical outcomes of the radial artery forearm free flap (RAFFF) and split thickness skin graft (STSG) reconstruction of postsurgical defect in T2 lesions of cancer oral cavity. Observational Prospective comparative study. Academic tertiary referral centre. In our study of forty four patients, after tumour resection, half underwent reconstruction using RAFFF (Group I) and another half by STSG (Group II). All of the patients were followed postoperatively to determine and compare their functional outcomes related to donor site and recipient site complications, speech, deglutition and mouth opening. The speech intelligibility and deglutition were each assessed using Articulation Handicap Index and Vedio-fluoroscopy using the Functional oral intake scale. Operative time for STSG reconstruction was shorter at 2.2 ± 0.97 SD hours compared to 5.9 ± 1.24 SD hours for RAFFF reconstruction. Hospital stay was 8.3 ± 1.19 SD days for STSG patients and 12.6 ± 1.7 SD days for RAFFF patients. The functional outcomes of speech quality and swallowing were near comparable in both groups but the donor site complications were significant in the RAFFF group. Operative time, hospital stay and donor site complications are both significantly reduced with the STSG as opposed to RAFF. Functional and oncologic results of both methods are near comparable. To conclude, STSG can be used for reconstruction of the post-surgical defects in T2 lesions of the tongue. [ABSTRACT FROM AUTHOR]

Purpose: This case-control study aims to examine possible associations of VSX1 exon3 gene variants with the development of keratoconus (KC) in Malaysian patients. Methods: A case-control study was done on 42 keratoconus cases, 127 family member controls, and 96 normal controls. Results: Three gene variants, p.A182A, p.P237P, and p.R217H showed significant associations with keratoconus (P < 0.05). While p.A182A and p.P227P were more prevalent than in the family and normal controls (OR 3.14--4.05), the reverse was observed with p.R217H (OR 0.086--1.59). With Haploview analysis, p.A182A and p.P237P were shown to be in linkage disequilibrium (LD) (LOD (logarithm of the odds score) score of 2.0, r2 of 0.957, and 95% confidence interval (CI) of 0.96--1.00). Conclusion: The study results suggest that the p.A182A and p.P237P variants could have contributed to the development of keratoconus in some Malaysians and that these two variants are likely to be co-inherited. In contrast, the p.R217H variant appeared to confer some protection against the development of keratoconus. [ABSTRACT FROM AUTHOR]

Spatial planning is an important policy in negotiating between increasing space requirements and existing space constraints. In the context of spatial planning at the village level, The Village Spatial Planning (VSP) can be one of solutions in solving spatial planning challenges in the scope of the village area. The existence of VSP has its pros and cons, due to the lack of empirical evidence on how village spatial planning should be done. This research aims to explain the background and process of preparing the VSP, as well as the factors that influence it based on inductive-qualitative approach. The research location was conducted in Jepitu Village, Gunung Kidul Regency, Yogyakarta Special Region Province. The consideration for choosing this location was due to various village management challenges that have the potential to impact space utilization, namely (1) Increasing the development of coastal tourism; (2) Southern Cross Road Program (SCRP); and (3) Village boundary issues related to the management of water resources. The data used are field observation data and in-depth interviews, and are supported by secondary data. The result of this research, there are internal factors and external factors that trigger the background for the preparation of the VSP. The internal factors consist of (1) Concerns of the Village Pamong; (2) Beach Tourism Area Management; (3) Economics; (4) Development Planning; and (5) Regional Mapping. The triggers from external factors, namely the presence of Supporting Agent. Meanwhile, the factors in the process of preparing the VSP, namely (1) Actors; (2) Community Participation; (3) Regional Mapping; and (5) Resistance. Based on the results of this study, VSP can be one of solution in solving various village area management challenges related to the provision spatial data on village boundaries and potentials to be used as a guide for village development planning. [ABSTRACT FROM AUTHOR]