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Sinus tympani is one of the hidden space in the retrotympanic area of middle ear which is commonly invaded by cholesteatoma and known for recidivism. Conventional surgical approaches sometimes fail to access deep sinuses and eradicate the disease. The aim of our study was to measure endoscopic depth of Sinus tympani in Indian Population. Total of 30 patients underwent mastoid exploration and intraoperatively depth of Sinus Tympani was measured using a 0.5 mm calibrated probe with 30 degree rigid Hopkins endoscope. Endoscopic depth in the present study ranges between 2.5 and 5.5 mm. It was higher in right ear in case of females however no significant difference were seen in males and females on left side. It is difficult to clear disease from Sinus Tympani because of its inaccessible location. Sinus Tympani can also show variations in terms of its depth further making difficult to clear disease. [ABSTRACT FROM AUTHOR]

Background: Oral anticoagulation (OAC) is the mainstay of treatment for the prevention of strokes in patients with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) account for increasing OAC in patients with AF. However, prescribing DOACs for patients with established AF poses various challenges and general practice pharmacists may have an important role in supporting their management. Aim: To investigate the effectiveness of pharmacist-led interventions in general practice in optimising the use of OAC therapies in AF. Design & setting: A retrospective observational study in general practices in Bradford. Method: The data were collected retrospectively from 1 November 2018–31 December 2019 using electronic health record data. The data were analysed: 1) to identify patients with AF not on OAC; 2) to describe inappropriate DOAC prescriptions; and 3) to calculate HAS-BLED scores. Results: Overall, 76.3% (n = 470) of patients with AF received OAC therapy, and of these, 63.4% received DOACs. Pharmacist-led interventions increased DOAC prescribing by 6.0% (P = 0.03). Inappropriate DOAC use was identified in 24.5% of patients with AF, with underdosed and overdosed identified in 9.7% and 14.8%, respectively. Post-intervention, inappropriate prescribing was reduced to 1.7%. The mean HAS-BLED score decreased from 3.00 to 2.22 (P<0.01). Successful transition from vitamin K antagonist (VKA) therapy to DOACs was achieved in 25.7% of patients. Conclusion: Pharmacist-led interventions have successfully improved the use of OAC therapies in patients with AF, and effectively managed the bleeding risks and transition from VKA to DOAC therapy, in line with guidelines. [ABSTRACT FROM AUTHOR]

Background: Peripheral artery disease (PAD) can present as chronic limb threatening ischemia (CLTI) with ischemic pain and tissue loss. Progression of distal disease can lead to a "no option" or end-stage disease without traditional open or endovascular revascularization due to lack of pedal targets. Innovations in endovascular technology allow for the use of percutaneous deep vein arterialization (pDVA) to treat patients with CLTI. Purpose: We describe our experience and technique for treating four patients with end-stage PAD with pDVA. Research Design: Four patients with end-stage PAD were followed during and after pDVA creation. Technical success, complications, wound healing, and freedom from major amputation were analyzed. Data Collection and Analysis: Patient data and outcomes were collected via chart review and at time of follow up appointments in vascular surgery clinic. Results: Technical success was 100%, without post-procedural complications, and patients were continued on antiplatelet and anticoagulation. Three patients (75%) had successful wound healing, with 2 patients healing after transmetatarsal amputation (TMA), and 1 healing a distal foot ulceration that did not require surgery. One patient had worsening ischemic breakdown of a TMA, despite re-intervention on the pDVA, which required a below knee amputation (BKA). Freedom from major amputation was 75% overall, with an average follow-up time of 410 days post-procedure (Range: 113-563 days). Conclusions: Percutaneous deep vein arterialization attempts to provide blood flow to the preserved venous bed in patients with end-stage PAD. Exploration and utilization of this technique continues to expand in the modern vascular era. This case series highlights 4 patients with end-stage PVD who underwent pDVA, with 100% procedural success, and 75% limb salvage rate. [ABSTRACT FROM AUTHOR]

A single 300 mg dose of tafenoquine (an 8-aminoquinoline), in combination with a standard 3-day course of chloroquine, is approved in several countries for the radical cure (prevention of relapse) of Plasmodium vivax malaria in patients aged ≥ 16 years. Despite this, questions have arisen on the optimal dose of tafenoquine. Before the availability of tafenoquine, a 3-day course of chloroquine in combination with the 8-aminoquinoline primaquine was the only effective radical cure for vivax malaria. The World Health Organization (WHO)-recommended standard regimen is 14 days of primaquine 0.25 mg/kg/day or 7 days of primaquine 0.5 mg/kg/day in most regions, or 14 days of primaquine 0.5 mg/kg/day in East Asia and Oceania, however the long treatment courses of 7 or 14 days may result in poor adherence and, therefore, low treatment efficacy. A single dose of tafenoquine 300 mg in combination with a 3-day course of chloroquine is an important advancement for the radical cure of vivax malaria in patients without glucose-6-phosphate dehydrogenase (G6PD) deficiency, as the use of a single-dose treatment will improve adherence. Selection of a single 300 mg dose of tafenoquine for the radical cure of P. vivax malaria was based on collective efficacy and safety data from 33 studies involving more than 4000 trial participants who received tafenoquine, including over 800 subjects who received the 300 mg single dose. The safety profile of single-dose tafenoquine 300 mg is similar to that of standard-dosage primaquine 0.25 mg/kg/day for 14 days. Both primaquine and tafenoquine can cause acute haemolytic anaemia in individuals with G6PD deficiency; severe haemolysis can lead to anaemia, kidney damage, and, in some cases, death. Therefore, relapse prevention using an 8-aminoquinoline must be balanced with the need to avoid clinical haemolysis associated with G6PD deficiency. To minimize this risk, the WHO recommends G6PD testing for all individuals before the administration of curative doses of 8-aminoquinolines. In this article, the authors review key efficacy and safety data from the pivotal trials of tafenoquine and argue that the currently approved dose represents a favourable benefit–risk profile. [ABSTRACT FROM AUTHOR]

Adsorption of small Te clusters on tellurene and M o S 2 monolayers have been studied within density functional framework. With adsorption on 2D monolayers, Te clusters show distortion in cluster geometry along with local distortions in the monolayer. Adsorption energy is found to be higher in T e n $ t e l l u r e n e as compared to T e n $ M o S 2 , suggesting that there exists a strong interaction between Te clusters and tellurene substrate. Adsorption of clusters on monolayers results in the modification of the effective band gap of these monolayers. Analysis of the charge density difference profile shows that a certain amount of charge is transferred from the clusters to the substrates. This results in the redistribution of the charge. Our optical calculations for the interband transitions show that Te cluster creates quantum states inside of monolayers, which leads to increasing optical absorption of the system. Additional low-intensity absorption peak, in addition to the main peak, has been noticed in cluster-adsorbed M o S 2 monolayer for E ‖ C. The real part of the dielectric function reveals the existence of plasmon frequencies. We conclude that the cluster adsorption on different monolayers alters the electronic and dielectric properties of monolayers. [ABSTRACT FROM AUTHOR]

Objectives: To study the epidemiology of non-coronavirus disease-2019 (non-COVID-19) respiratory viral infections with respect to their clinical profile, intensive care needs and predictors of outcome once the non-pharmacological interventions (NPI) during the coronavirus disease-2019 (COVID-19) pandemic were relaxed. Methods: Retrospective analysis of children with Severe Acute Respiratory Illness (SARI) who were SARS-CoV-2 negative, admitted to the Pediatric Emergency/Intensive Care Unit (PICU) from July 2021 through October 2021 was conducted. Results: One hundred and thirty nine children with median age of 11 (4-28.5) mo were included. Besides respiratory symptoms in all, diarrhea was reported in 90 (64.7%) children. Nearly half (n = 66; 47%) presented in hypoxemic respiratory failure (SpO2 <88%). Fifty-two (37.4%) children had co-morbidities, commonest being congenital heart disease in 12 (23.1%). Baseline parameters revealed leukopenia (specifically lymphopenia) 39 (28%), elevated aspartate transaminase [Serum glutamic-oxaloacetic transaminase (SGOT)] in 108 (77.6%), elevated N-acetyl-cysteine-activated creatinine kinase (CK-NAC) 23 (79%) and lactate dehydrogenase (LDH) 15 (88%). Intensive care needs included mechanical ventilation 51 (36.6%), vasoactive support 34 (24.5%), and renal replacement therapy 10 (7.1%). Forty-two (30.2%) children developed multi-organ dysfunction syndrome (MODS). One hundred and three (74.1%) children were discharged, 31 (22.3%) died, and 5 (3.6%) left against medical advice. On multivariate regression analysis, elevated liver enzymes (>5 times normal), hypoxemic respiratory failure at admission, hypotensive shock and MODS predicted mortality. Conclusions: A surge in non-COVID SARI was observed once lockdown measures were relaxed. Nearly 1/3rd progressed to multi-organ failure and died. Elevated liver enzymes, hypoxemic respiratory failure at admission, hypotensive shock and MODS predicted death. [ABSTRACT FROM AUTHOR]

Diabetic ketoacidosis in children is associated with a wide gamut of complications, which can be either disease- or therapy-related. Common complications in children with DKA include cerebral edema, acute kidney injury, hypokalemia, hypoglycemia, etc. As opposed to asymptomatic hypophosphatemia, which is common during the management of DKA, severe symptomatic hypophosphatemia leading to life-threatening complications like rhabdomyolysis, hemolysis, respiratory failure secondary to muscle weakness, and cardiac complications are rare. The authors present a case of a newly diagnosed T1DM patient who, during the course of management, developed severe hypophosphatemia leading to arrhythmias and cardiac dysfunction, which improved with prompt recognition and correction. [ABSTRACT FROM AUTHOR]

Renewed interest in psychedelic substances in the 21st century has seen the exploration of psychedelic treatments for various psychiatric disorders including substance use disorder (SUD). This review aimed to assess the effectiveness of psychedelic treatments for people with SUD and those falling below diagnostic thresholds (i.e. substance misuse). We systematically searched 11 databases, trial registries, and psychedelic organization websites for empirical studies examining adults undergoing psychedelic treatment for SUD or substance misuse, published in the English language, between 2000 and 2021. Seven studies investigating treatment using psilocybin, ibogaine, and ayahuasca, alone or adjunct with psychotherapy reported across 10 papers were included. Measures of abstinence, substance use, psychological and psychosocial outcomes, craving, and withdrawal reported positive results, however, this data was scarce among studies examining a wide range of addictions including opioid, nicotine, alcohol, cocaine and unspecified substance. The qualitative synthesis from three studies described subjective experience of psychedelic-assisted treatments enhanced self-awareness, insight, and confidence. At present, there is no sufficient research evidence to suggest effectiveness of any of the psychedelics on any specific substance use disorder or substance misuse. Further research using rigorous effectiveness evaluation methods with larger sample sizes and longer-term follow-up is required. [ABSTRACT FROM AUTHOR]

Aims: Brepocitinib is a tyrosine kinase 2/Janus kinase 1 inhibitor being investigated for the treatment of several autoimmune diseases. This study assessed the absorption, distribution, metabolism and excretion of oral brepocitinib, and the absolute oral bioavailability (F) and fraction absorbed (Fa) using a 14C microtracer approach. Methods: This was a phase 1 open‐label, nonrandomized, fixed sequence, two‐period, single‐dose study of brepocitinib in healthy male participants. Participants received a single oral 60 mg dose of 14C brepocitinib (~300 nCi) in Period A, then an unlabelled oral 60 mg dose followed by an intravenous (IV) 30 μg dose of 14C labelled brepocitinib (~300 nCi) in Period B. Mass balance, pharmacokinetic parameters and safety were assessed. Results: Six participants were enrolled. Brepocitinib was absorbed rapidly following oral administration. In Period A, total recovery of the oral dose was 96.7% ± 6.3% (88.0% ± 8.0% in urine, 8.7% ± 2.1% in faeces). In Period B, a small fraction (6.0% of the oral dose) was recovered unchanged in urine. F and Fa were 74.6% (90% confidence interval 67.3%, 82.8%) and 106.9%, respectively. Brepocitinib demonstrated an acceptable safety profile and was well tolerated following oral or oral then IV administrations. No deaths, serious adverse events or discontinuations were reported. Conclusion: Intestinal absorption of brepocitinib was essentially complete after oral administration, with F ~75%. Drug‐related material recovery was high, with the majority excreted in urine. The major route of elimination of brepocitinib was renal excretion as metabolites, whereas urinary elimination of unchanged brepocitinib was minor. NCT: NCT03770039. [ABSTRACT FROM AUTHOR]

Introduction The role of endoscopes in the ear, nose, and throat (ENT) field has been described since the 1980s; It started with endoscopic nasal surgeries, followed by otological and laryngological procedures, and, since then, it has experienced a rapid evolution. Endoscopes help otologists understand how to approach difficult areas of middle ear, as well as the physiology of middle ear cleft. Objectives Despite the introduction of endoscopes in the field of otology, microscopes are still widely used in clinics and in operation theaters either alone or with endoscopes. The present study, which was conducted amongst otologists in India, is on their experience with and knowledge of the use of the endoscope compared to microscopes. Methods A Google form-based questionnaire comprising 18 questions was developed and sent online to otologist all over the country. The final dataset included responses from 354 active otologists. Results Out of 354 participants, only 3% had more than 5 years of experience in endoscopic ear surgery (EES), and 16.1% had never worked with an endoscope. Endoscopes were used in clinics and in operation theaters by 74.9% of the participants. Conclusion There has been a rise in the acceptance and use of endoscopes among Indian otologists and otology surgeons in last few decades. [ABSTRACT FROM AUTHOR]

Sensorineural hearing loss is relatively well established in the squamosal chronic otitis media. However, its association with mucosal COM is still debated. The present study aimed at evaluating the prevalence of sensorineural hearing loss in unilateral mucosal COM. The study was conducted at a tertiary care hospital in New Delhi, and 60 patients with unilateral mucosal chronic otitis media were recruited. Pure tone thresholds were ascertained for air and bone conduction in an acoustically treated room and matched against certain patient and disease characteristics. In this study, the combined prevalence of SNHL/Mixed Hearing loss in mucosal COM was found to be 8.3%. A statistically significant association between SNHL/Mixed HL was seen in the 40–50-year age group (p-0.004). Prevalence with a disease duration of more than 10 years was 33% (p-0.019). All the patients who presented with SNHL/Mixed HL had an actively discharging ear. 80% of the patients who presented with SNHL/Mixed HL had large perforations. SNHL/Mixed HL prevalence of 28.6% was found in smokers, compared to 5.7% in non-smokers (p-0.039). The risk of developing SNHL/Mixed HL increased with increasing patients' age, disease duration, and size of the perforation and smokers. [ABSTRACT FROM AUTHOR]

In the present paper, the digital transformation in metrology is discussed, which is revolutionizing the world and is one of the most interesting developments in science & technology today. The study also discusses, how current technologies like Artificial Intelligence, the Internet of Things, Cloud computing, and more significantly digital twins would become synonymous with digital metrology, thus bolstering the future of manufacturing industries. The basic objective of any digital transformation initiative is to enhance the current processes, while each one will have its own unique set of objectives. As metrology is considered as the main pillar of Quality Infrastructure (QI), the digital transformation of metrology requires a holistic approach for all stakeholders working within the advanced QI of a country or economy. [ABSTRACT FROM AUTHOR]

Background: Prediabetes is a condition of intermediate hyperglycaemia in which blood glucose levels are high, but not more than the required diagnostic criteria to be labelled as Diabetes Mellitus. Now, there is a growing evidence regarding occurrence of peripheral neuropathy as well as cardiovascular autonomic neuropathy even in prediabetics. Aim: To determine nerve conduction abnormalities and cardiovascular autonomic dysfunction in pre-diabetics. Material and Methods: Total 100 subjects were divided into two groups of 50 each i.e. cases and controls, according to the ADA Criteria. Nerve conduction studies and Ewing's cardiovascular autonomic reflex tests (CARTs) were performed on all the subjects. Results: On comparing the changes in the nerve conduction studies of the pre-diabetic subjects with the controls, statistically significant difference was found in the conduction velocity of the B/L peroneal nerve. Similarly, difference in the amplitude of the B/L tibial nerve was also found to be statistically significant. Cardiovascular autonomic neuropathy was found in 18 % of the pre-diabetic subjects. Conclusion: Neuropathy is often associated with long standing diabetes mellitus but neuropathy can occur even in pre-diabetics. Although full blown neuropathy is not present but the nerve damage has already started at the prediabetic stage, which is reflected upon by the nerve conduction abnormalities and cardiovascular autonomic dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary complications develop in patients suffering from liver disease either with or without Decompensation. Hypoxemia can develop in patients with liver cirrhosis due to massive ascites, active aggressive U.G.I. bleed, primary pulmonary or cardiovascular cause, or due to pulmonary complications of liver cirrhosis. Hypoxemia in liver cirrhosis patient should be evaluated for pulmonary complications of liver cirrhosis along-with other primary pulmonary or cardiac causes. Development of these complications worsen the prognosis of disease and modifies the line of management. This study was undertaken to find out the prevalence of arterial hypoxemia and hepatopulmonary syndrome in patients of liver cirrhosis. Objectives: To determine the arterial hypoxemia using arterial blood gas analysis in liver cirrhosis. To further determine the intrapulmonary vascular dilatation and hepatopulmonary syndrome using 2d-Contrast enhanced echocardiography. Material and Methods: The cross-sectional study was conducted on 80 patients, aged 18 years and above, fulfilling the inclusion and exclusion criteria, diagnosed with chronic liver disease. The detailed history was taken followed by clinical examination which was done after due consent. All these patients underwent routine blood investigations, chest x-ray, ultrasonography, UGI endoscopy, 2samples of arterial blood gas analysis(one supine and other upright), and agitated saline enhanced 2D-Echocardiography to detect intra-pulmonary vasodilation. The patients who had arterial hypoxemia, orthodeoxia, and had intrapulmonary vasodilation were diagnosed to have Hepatopulmonary syndrome. Results: Six(6)out of those 80 patients had hypoxemia in the population which were included in the study. Among those 6 patients who had hypoxemia, 4 patients had Intra-pulmonary vessel dilation on saline agitated 2dechocardiography and were labelled as Hepatopulmonary syndrome. Conclusion: The patients of liver cirrhosis presenting with hypoxia and other pulmonary manifestations, with or without Decompensation, should be evaluated for hepatopulmonary syndrome. The early detection of intra-pulmonary vessel dilatation leads to early modification of line of management and poor prognosis of liver disease can be explained at early stages. [ABSTRACT FROM AUTHOR]

Background: Electronic repeat dispensing (eRD) has been part of the community pharmacy contact since 2005 and a requirement in the General Medical Services contract since 2019. NHS England highlights benefits of eRD as increased efficiency in general practice of 2.7 million hours annually if 80% of all repeat prescriptions are issued as eRD. Despite clear benefits to patients, community pharmacies and general practices, the uptake of eRD remains low and variable across general practices in West Yorkshire, UK. Objectives: To investigate the impact of COVID-19 on eRD in general practice and understand the key enablers to its uptake. Methods: A 19-item questionnaire was developed and piloted during cognitive interviews. A cross-sectional survey was conducted via emails to general practices in West Yorkshire, UK, between July 2020 and November 2020. Results: Sixty-seven complete responses were received (23 pharmacists, 21 practice managers, 11 general practitioners, seven pharmacy technicians, four advanced practitioners, one prescription clerk). 59% of respondents were aware of eRD uptake in their surgery (mean value 4.56% ± 0.229%). Higher uptake of eRD was demonstrated where the general practice integrated eRD into routine workflows during the repeat prescription reauthorisation process (P < 0.001) and where an eRD service lead is nominated (P = 0.04). Conclusion: Utilising eRD in the respective practices should be considered due to potential efficiency gains and the increase in average eRD utilisation observed in the study participating general practices was from 7.2% average uptake in March 2020 to 10.4% November 2020, as the response to COVID-19. The stated benefits of eRD by NHS England of 2.7 million hours per annum predates the roll out of electronic transmission of prescriptions suggesting further research is needed to quantify the efficiency gains in present NHS general practice environments. [ABSTRACT FROM AUTHOR]

Aim: To study epidemiological and clinical profile of Scrub typhus in hospitalised patients of SMS hospital, Jaipur. Materials and Methods: All the cases of febrile illness diagnosed as scrub typhus were analysed. Diagnosis was made by ELISA based IgM serology. Results: Of the 159 cases, 29.56% belonged to age group 18 - 25 years and female populations were more commonly affected 55%. Common symptoms were high grade fever, headache, myalgia, cough and breathlessness followed by nausea and vomiting. Eschar was seen in 28 cases (17.6%) and the common sites were axilla, chest and groin. Thrombocytopenia was present in (68.5%) 109 patients. Liver enzymes were elevated in (80.5%) 128 patients. MODS (in 39 patients, 24.5%), Hypotension (40 patients, 25.16%), ARDS (8 patients, 5%), A.K.I. (6 patients, 3.7%), were some of the important complications. 2 patient sucumbed to death. All were treated with doxycyclin or azithromycin. Conclusion: There is a definite need to increase awareness among people as well as primary physicians and have high index of suspicion, especially in the light of increasing number of patients presenting with atypical manifestations. [ABSTRACT FROM AUTHOR]

Purpose: To assess the perception of college-going girls toward corneal donation in Northern India. Methods: An online survey with a pre-structured, pre-validated questionnaire was conducted on 1721 college-going girls in Northern India. The knowledge and attitude scores were regressed, and latent class analysis was carried out. Results: The average of scores for all participants was computed individually for the knowledge questions and the attitude questions, and based on this score, total participants were divided into two groups: Better corneal donation behaviors (BCDB) and poor corneal donation behaviors. The binomial logistic regression model of knowledge domain for predicting BCDB, age of the participant, their awareness about corneal donation, and willingness to discuss eye donation among family members were found significant. Similarly, for the attitude domain, awareness about corneal donation, knowledge about hours within which ideal eye donation needs to be undertaken, and knowledge about eye donation during coronavirus disease 2019 (COVID-19) pandemic were found to be significant. Latent class analysis identified one subset of participants having poorer knowledge and attitude scores and that they were more from a rural background, were having more than first order as birth order, were belonging to SC/ST classes, had illiterate or secondary education of father and mother, and were living in rented houses. Conclusion: The findings of the study significantly contribute to devising a mechanism to improve knowledge and influencing the attitude about eye donation among the youth, especially young women, who can act as counselors and motivators for the masses as well as their own families, in the generations to come. [ABSTRACT FROM AUTHOR]

Objectives: To compare the epidemiological, clinical profile, intensive care needs and outcome of children hospitalized with SARS-CoV-2 infection during the first and second waves of the pandemic. Methods: This was a retrospective study of all children between 1 mo and 14 y, admitted to a dedicated COVID-19 hospital (DCH) during the first (1st June to 31st December 2020) and second waves (1st March to 30th June 2021). Results: Of 217 children, 104 (48%) and 113 (52%) were admitted during the first and second waves respectively. One hundred fifty-two (70%) had incidentally detected SARS-CoV-2 infection, while 65 (30%) had symptomatic COVID-19. Comorbidities were noted in 137 (63%) children. Fifty-nine (27%) and 66 (30%) children required high-dependency unit (HDU) and ICU care respectively. Severity of infection and ICU needs were similar during both waves. High-flow oxygen (n = 5, 2%), noninvasive ventilation [CPAP (n = 34, 16%) and BiPAP (n = 8, 5%)] and invasive ventilation (n = 45, 21%) were respiratory support therapies needed. NIV use was more during the second wave (26% vs. 13%; p = 0.02). The median (IQR) length (days) of DCH stay among survivors was longer during the first wave [8 (6–10) vs. 5.5 (3–8); p = 0.0001]. Conclusions: Disease severity, associated comorbidities, PICU and organ support need and mortality were similar in the first and second waves of the pandemic. Children admitted during the second wave were younger, had higher proportion of NIV use and shorter length of COVID-19 hospital stay. [ABSTRACT FROM AUTHOR]

Background: In drug development, few molecules from a large pool of early candidates become successful medicines after demonstrating a favourable benefit-risk ratio. Many decisions are made along the way to continue or stop the development of a molecule. The probability of pharmacological success, or PoPS, is a tool for informing early-stage decisions based on benefit and risk data available at the time. Results: The PoPS is the probability that most patients can achieve adequate pharmacology for the intended indication while minimising the number of subjects exposed to safety risk. This probability is usually a function of dose; hence its computation typically requires exposure–response models for pharmacology and safety. The levels of adequate pharmacology and acceptable risk must be specified. The uncertainties in these levels, in the exposure–response relationships, and in relevant translation all need to be identified. Several examples of different indications are used to illustrate how this approach can facilitate molecule progression decisions for preclinical and early clinical development. The examples show that PoPS assessment is an effective mechanism for integrating multi-source data, identifying knowledge gaps, and forcing transparency of assumptions. With its application, translational modelling becomes more meaningful and dose prediction more rigorous. Its successful implementation calls for early planning, sound understanding of the disease-drug system, and cross-discipline collaboration. Furthermore, the PoPS evolves as relevant knowledge grows. Conclusion: The PoPS is a powerful evidence-based framework to formally capture multiple uncertainties into a single probability term for assessing benefit-risk ratio. In GSK, it is now expected for governance review at all early-phase decision gates. [ABSTRACT FROM AUTHOR]

Eisenmenger Syndrome is a rare constellation of symptoms due to untreated congenital heart disease with right to left shunt and increased pulmonary arterial hypertension. A female of 58 years old came to ER with respiratory failure and upon evaluation found to have Eisenmenger syndrome. Intensive work up concluded in medical management with patient. Eisenmenger syndrome patients' need to be closely monitored once diagnosed owing to decreased life expectancy. [ABSTRACT FROM AUTHOR]

Sub-Optimal deployment of Self expanding interwoven stents (Supera) has been shown to increase the rate of Clinically Driven Target Lesion Revascularization (CD-TLR). Meanwhile, drug coated balloons (DCB) have been shown to reduce CD-TLR in the femoral-popliteal segment in de- novo and restenotic lesions. However, the clinical effects of vessel preparation with DCB in nominal, compressed, and elongated Supera has not been widely studied. The purpose of this study is to assess the outcomes of clinically driven re-intervention, major amputations, and mortality in relation to the use of DCB as vessel preparation in different deployment conditions (nominal, compressed, elongated) of the Supera stent. Patient chart data was collected at a single center hospital between March 2015 and May 2020. All patients were adults (≥ 18 years old) and were treated with at least one (≥ 1) Supera stent. Deployment status was extrapolated from anonymized angiograms. The primary endpoint of this study was CD-TLR. Secondary endpoints included amputation and mortality rates associated with each deployment condition. A total of 670 limbs were treated and patients were followed for 36 months. Nominal stent deployment was observed in 337 limbs, followed by elongated condition (n = 176), then by compressed conditions (n = 159). CD-TLR was observed most frequently with elongated deployment. Drug coated balloons were used as vessel prep prior to stenting and showed a protective effect regardless of deployment status; O.R = 0.44 (CI 0.30–0.66, p <.05). [ABSTRACT FROM AUTHOR]

Typically human absorption, distribution, metabolism, and excretion (ADME) studies are executed using radiolabeled (e.g., carbon‐14) material, the synthesis of which is a time‐consuming activity. In this study, we were able to assess the metabolism and excretion of unlabeled nirmatrelvir (PF‐07321332) within the first‐in‐human study via a novel application of quantitative fluorine (19F) nuclear magnetic resonance (NMR) spectroscopy in place of a standard radiolabel ADME study. Six healthy participants received a single 300‐mg oral dose of nirmatrelvir (in combination with ritonavir), and excreta were collected up to 10 days. Virtually all drug‐related material was recovered within 5 days, and mass balance was achieved with 84.9 ± 8.9% (range = 70.7–95.5%) of the administered dose recovered in urine and feces. The excretion of fluorine‐containing material in urine and feces was 47.0% and 33.7%, respectively. Unchanged nirmatrelvir represented 82.5% of the normalized drug‐related material with a carboxylic acid metabolite M5, derived from hydrolysis of the P2 amide bond, present at 12.1% of dose. Nirmatrelvir was the only drug‐related entity observed in plasma. Approximately 4.2% of the dose was excreted as metabolite M8 (measured by liquid chromatography–mass spectrometry), which was 19F NMR silent due to hydrolysis of the trifluoroacetamide moiety. Hydrolysis of nirmatrelvir to M5 and M8 was shown to occur in cultures of human gut microflora. This successful demonstration of quantitative 19F NMR spectroscopy to establish the mass‐balance, excretion, and metabolic profile of nirmatrelvir offers an advantageous means to execute human ADME studies for fluorine‐containing compounds early in drug development. [ABSTRACT FROM AUTHOR]

We study the intrinsic 3D shapes of quiescent galaxies over the last half of cosmic history based on their axial ratio distribution. To this end, we construct a sample of unprecedented size, exploiting multiwavelength u -to- Ks photometry from the deep wide-area surveys KiDS+VIKING paired with high-quality i -band imaging from HSC-SSP. The dependences of the shapes on mass, redshift, photometric bulge prominence and environment are considered. For comparison, the intrinsic shapes of quenched galaxies in the IllustrisTNG simulations are analysed and contrasted with their formation history. We find that over the full 0 < z < 0.9 range, and in both simulations and observations, spheroidal 3D shapes become more abundant at |$M_* \gt 10^{11}\, \mathrm{M}_{\odot }$|⁠ , with the effect being most pronounced at lower redshifts. In TNG, the most massive galaxies feature the highest ex situ stellar mass fractions, pointing to violent relaxation via mergers as the mechanism responsible for their 3D shape transformation. Larger differences between observed and simulated shapes are found at low to intermediate masses. At any mass, the most spheroidal quiescent galaxies in TNG feature the highest bulge mass fractions, and, conversely, observed quiescent galaxies with the highest bulge-to-total ratios are found to be intrinsically the roundest. Finally, we detect an environmental influence on galaxy shape, at least at the highest masses, such that at fixed mass and redshift, quiescent galaxies tend to be rounder in denser environments. [ABSTRACT FROM AUTHOR]

Zimlovisertib (PF‐06650833) is a selective, reversible inhibitor of interleukin‐1 receptor‐associated kinase 4 (IRAK4) with anti‐inflammatory effects. This phase 1, open‐label, fixed‐sequence, two‐period, single‐dose study aimed to evaluate the mass balance and excretion rate of zimlovisertib in healthy male participants using a 14C‐microtracer approach. All six participants received 300 mg 14C‐zimlovisertib with lower radioactivity per mass unit orally in Period A, then unlabeled zimlovisertib 300 mg orally and 14C‐zimlovisertib 135 μg intravenously (IV) in Period B. Study objectives included extent and rate of excretion of 14C‐zimlovisertib, pharmacokinetics, and safety and tolerability of oral and IV zimlovisertib. Total radioactivity recovered in urine and feces was 82.4% ± 6.8% (urine 23.1% ± 12.3%, feces 59.3% ± 9.7%) in Period A. Zimlovisertib was absorbed rapidly following oral administration, with the fraction absorbed estimated to be 44%. Absolute oral bioavailability of the 300‐mg dose was 17.4% (90% confidence interval 14.1%, 21.5%) using the dose‐normalized area under the concentration–time curve from time 0 to infinity. There were no deaths, serious adverse events (AEs), severe AEs, discontinuations or dose reductions due to AEs, and no clinically significant laboratory abnormalities. These results demonstrate that zimlovisertib had low absolute oral bioavailability and low absorption (<50%). [ABSTRACT FROM AUTHOR]

Calibration and performance evaluation of a differential pressure transducer is vital for its application in industries, especially those involved with foreign trade. For these industries, a proper universally accepted method is a need for differential pressure metrology. So, a novel method of calibration and characterization for digital differential pressure transducer is studied and carried out for a sample device of differential transducer (Model No. 3K650000137526, Make. ABB), with the use of differential pressure standard in hydraulic mode. The differential pressure transducer is calibrated in a differential pressure range from 0.2 to 2 MPa with maximum static pressure up to 50 MPa, against a twin-pressure balance (Model 55614, Desgranges & Huot, France) available at CSIR-National Physical Laboratory (CSIR-NPL), India. The uncertainty in pressure measurement using twin pressure balance has been estimated, which shows a maximum uncertainty of 3.681E-3 MPa in percentage of readings (coverage factor k = 2). The mentioned calibration method not just only gives the metrological uncertainty but also other performance parameters too. The device under calibration shows a maximum error of 0.42% of reading, average error due to repeatability of 0.12% of reading, maximum error due to reproducibility of 0.21% of reading. It is also found out that the behavior of the digital differential transducer is the same in its positive and negative range span. Finally, a regression equation is developed to predict differential pressure at desired pressure for the system and thus the differential pressure transducer is fully characterized. [ABSTRACT FROM AUTHOR]

This paper investigates the neutral gas phase of galactic winds via the Na  i Dλλ5890, 5895Å feature within z ∼ 0.04 MaNGA galaxies and directly compares their incidence and strength to the ionized winds detected within the same parent sample. We find evidence for neutral outflows in 127 galaxies (∼5 per cent of the analysed line-emitting sample). |${\rm Na\, \small {\rm I}\ D}$| winds are preferentially seen in galaxies with dustier central regions and both wind phases are more often found in systems with elevated star formation rate (SFR) surface densities, especially when there has been a recent upturn in the star formation activity according to the |$\rm SFR_{5 \, Myr}/SFR_{800 \, Myr}$| parameter. We find the ionized outflow kinematics to be in line with what we measure in the neutral phase. This demonstrates that, despite their small contributions to the total outflow mass budget, there is value to collecting empirical measurements of the ionized wind phase to provide information on bulk motion in the outflow. Depending on dust corrections applied to the ionized gas diagnostics, the neutral phase has ∼1.2−1.8 dex higher mass outflow rates (⁠|$\dot{M}_{\rm out}$|⁠), on average, compared to the ionized phase. We quantify scaling relations between |$\dot{M}_{\rm out}$| and the strengths of the physical wind drivers (SFR, L AGN). Using a radial–azimuthal stacking method, and by considering inclination dependencies, we find results consistent with biconical outflows orthogonal to the disc plane. Our work complements other multiphase outflow studies in the literature that consider smaller samples, more extreme objects, or proceed via stacking of larger samples. [ABSTRACT FROM AUTHOR]

The size- and diameter-dependent structural, electronic and dielectric properties of tellurium 1-D nanowire (Te-NW) and tellurium nanotubes (Te-NTs) with trigonal and hexagonal cross sections have been calculated using density functional theory. The nanostructures having trigonal cross sections are progressively more stable than hexagonal Te-NTs with decreasing binding energy. We further find that bandgap of trigonal cross section is larger as compare to the hexagonal one. Dielectric properties of these materials are strongly dependent on the direction of polarization of the incident light. The peaks in absorption spectrum come from the transition between the conduction and valence band states. The real part of dielectric function reveals the existence of plasma frequency which indicates that the materials are behaving like dielectric ones in the parallel polarization direction. It is anticipated that these results may point towards new possibilities in the development of optoelectronic devices. [ABSTRACT FROM AUTHOR]

Rapid and increasing use of high-pressure technology in science and engineering over the last few decades has prompted researchers to look for better instruments and technologies with lower measurement uncertainties in diversified applications wherein pressure is used as one of the most crucial process parameters. The present paper discusses the succinct assessment of high-pressure metrology (HPM). A graphical summary of the various key & supplementary comparisons (K&SC) carried out in pressure metrology along with Calibration and Measurement Capabilities (CMCs) of the various National Metrology Institutes (NMIs) is also included. Also discussed are the overview of the various high-pressure measurement facilities established at CSIRNPL, India and a summary of the various Proficiency Testing (PT) Programs conducted as reference laboratory by CSIR-NPL for 140 testing and calibration laboratories, accredited by the National Accreditation Board for the Testing and Calibration of Laboratories (NABL), India. The paper also briefly describes the impact of redefined SI unit of mass on the realization of the pressure scale. It is always difficult to find a concise report on all the aspects of a specific measuring parameter, high pressure in the present case, in a single window, therefore, authors believe that the present paper would be highly useful for the students, engineers, researchers, metrologists, industries, accredited laboratories, and other users. [ABSTRACT FROM AUTHOR]

Background: Health care linen is a source of healthcare-associated infections. Hospital laundry services play a vital role in linen decontamination. Effective laundry is essential in preventing hospital-acquired infections, especially in multidrug-resistant organisms. Aims and Objectives: The study aimed to check the microbial load in linen after the laundry process and the during the supply chain in the hospital. We investigated the bacterial load in linen before and after the laundering process and the linen from stored linen banks. Materials and Methods: Linens (n=125) from the hospital were collected in different stages of the laundry process [31 linen before decontamination; 94 linen after decontamination (Post washing = 30; Linen Bank = 34; Ward 30)]. A square inch of linen from each linen was vortexed in normal saline, and colony forming units (CFU)/inch of linen were calculated using appropriate media. The identification and susceptibility of organisms were performed using MALDI-TOF MS and CLSI disk diffusion methods, respectively. The difference in the load of the organism was analysed between different stages of the laundry and storage process. Results: We found that100% of pre-decontamination linen harbour viable organisms (22.59% including multidrug-resistant pathogenic organisms: MDROs), which decreased to 40% (no MDROs) postdecontamination. The overall load was reduced by a factor of 103.77. Conclusion: The microbial contamination of linen is common, and there is an urgent need to develop consensus on the microbial examination frequency and acceptable range of organisms on hospital linen worldwide. [ABSTRACT FROM AUTHOR]

The article describes the case of a six-year-old male with fever for four days, vomiting, and altered sensorium for two days and was diagnosed with acute necrotizing encephalopathy (ANEC) associated with dengue infection. Topics discussed include clinical characteristics of ANEC, basis of the diagnosis, and proposed diagnostic criteria for ANEC.

Salinity–induced land degradation poses a threat to environment and food production globally. Farmers' participatory research (2014–18) was carried out to assess the potential of gypsum (Gyp) and pressmud (PM) in alleviating the sodicity stress, and improvement in soil organic carbon (SOC) pools and its stability in the Trans Indo–Gangetic Plains of India. Intensive rice–wheat cultivation using alkali water increased soil pH, exchangeable sodium percentage (ESP), and bulk density (BD) causing a net depletion in SOC. Gypsum (supplies soluble Ca2+) and pressmud (mobilizes native CaCO3) mediated amelioration (Gyp + PM) significantly decreased soil sodification and compaction, and improved total organic carbon (TOC; 32%–64%) over the unamended control. Higher left–over C for SOC stabilization, crop biomass, and rhizodeposition returned through Gyp + PM significantly improved SOC pools and C sequestration culminating in ~25% yield superiority over the unamended control. Within SOC pools, highest proportion was equally retained in very labile and non–labile C pools. On average, the passive pool contained ~45% of TOC; albeit to a greater contribution through PM followed by Gyp + PM and Gyp. Rice–wheat system yield (RWSY) was positively correlated with SOC pools and indices while negatively correlated with soil pH, ESP, BD, CaCO3, and recalcitrant index. Multiple regression analysis showed stratification ratio, CaCO3, sensitivity index, and BD as key variables for yield prediction under the existing levels of soil sodicity. The key insights suggest ecosystem‐based approach using Gyp + PM in restoring the degraded lands, enhancing crop resilience and system (SOC enrichment and storage) stability, and achieving UN–Sustainable Development Goals related to food security and land degradation neutrality. [ABSTRACT FROM AUTHOR]

Precise and accurate pressure measurements play a prominent role in several scientific applications. The pressure balances (PBs) are used as a primary standard for pressure measurements which requires utmost accuracy. In the case of calibration and characterization of these PBs, the method of cross-floating is an internationally accepted practice used for the comparison of 2 PBs for determining their metrological parameters, i.e. effective areas, distortion coefficient and zero pressure area etc. The present paper describes the work which has been carried out to develop a cross-floating pressure balance calibration system for an organization engaged in R&D activities and providing calibration services to the process industries. The study also describes some of the newly designed, developed, upgraded and fabricated components and devices for a cross-floating system in hydrostatic pressure range up to 150 MPa. The whole system consists of an upgraded hydraulic screw pump, newly designed, developed and fabricated oil reservoir, cross-float valve, use of two commercially available needle valves in combination with a pressure balance supplied by the customer with associated pressure fittings and connector in the pressure transmitting circuit. The characterization of the pressure balance was also done using the newly developed components/parts and instruments at 12 calibration points in the high pressure range (7–140) MPa and 11 calibration points in the low pressure range (0.2–7) MPa. The development process was started in the year 2018 and completed in the month of November 2020. The combined relative measurement uncertainty (at coverage factor, k = 2) associated in high pressure range is found to be 59.3 × 10−6 and 42.3 × 10−6 with associated pressure and effective area, respectively. Similarly, in low pressure range the combined relative measurement uncertainty (k = 2) is found to be 62.2 × 10−6 and 47.3 × 10−6 with associated pressure and effective area, respectively. The results obtained are found in excellent agreement with the values of uncertainty and the effective area reported by the manufacturer. This newly developed system will help the customer in providing in-house traceability to their own instruments as well services to the industries. [ABSTRACT FROM AUTHOR]

We assessed the improvement potential of pressmud – a sugar industry waste – on soil properties, physiological adaptation and yield‐related traits in a rice–wheat rotation in sodicity‐affected Ghaghar basin of Haryana, India. Large‐scale (0.2–0.4 ha) participatory trials comprising two treatments, with (+PM) and without (–PM) pressmud, were conducted on 125 farmers' fields covering non‐sodic (NS), slightly sodic (SS) and moderately sodic (MS) soils. Pressmud application (10 Mg ha−1) led to appreciable reductions in soil pH (1.6–3.6%) and exchangeable sodium percentage (ESP; 10.4–20.1%) with concomitant improvements in plant physiological and yield‐related traits across different soil alkali classes, albeit to a greater extent in SS and MS soils than in NS soils. Compared to prevailing farmers' practices (–PM), transformative improvements in mean leaf relative water content (RWC) (4 and 7%), membrane injury (MII) (−12 and −14%), photosynthetic rate (Pn) (21 and 25%), stomatal conductance (gS) (26 and 21%), transpiration rate (E) (38 and 22%), proline (P) (−19 and −20%) and Na+/K+ accumulation in shoot (NaK_S) (−24 and −22%) and root (NaK_R) (−23 and −27%) were observed in both rice and wheat grown under PM ameliorated soils. On an average, rice and wheat yields were increased by 15.8 and 14.6% in SS and 18.9 and 16.7% in MS soils, respectively, with pressmud application. Principal Component Analysis (PCA) showed significant correlations among highly weighted variables including physiological and yield‐related traits to influence the rice–wheat productivity with PM addition in SS and MS soils. Sustained use of this organic waste in agricultural lands seems to be an affordable solution for overcoming sodicity‐induced land degradation, and achieving developmental goals of environmental and livelihood security. [ABSTRACT FROM AUTHOR]

The Hydrogen and Fluorine planar armchairs graphene nanoribbons (H & F AGNRs), subjected to twist deformation within fixed periodic boundary conditions. H-AGNRs is highly elastic in nature, though passivation with Fluorine does induce the plasticity when twisted beyond threshold torsional strain. This plasticity attributes to the wider bond length distribution suggests distortion of benzo-rings. The bandgap response to the effective strain of narrow GNRs N = 6 , 7 , and 8 get arranged as (i) monotonously increasing for q = 0 , 2 and (ii) decreasing for q = 1 ; here, q = m o d N , 3 in effective strain space (θ 2 Σ 2 ) . The effective strain space is found to be more appropriate for gauging the response of torsional strain. This trend has also been observed for Fluorine passivated AGNRs; however, because of higher sensitive response to torsional strain, the bandgap of N = 7 F-AGNRs drops from E g ≃ 0.95 eV to E g ≃ 0.05 eV at extreme torsional strain forming Dirac cone at ± K allows dissipationless transport to charge carriers of high kinetic energy at low bias. [ABSTRACT FROM AUTHOR]

We analyzed the data of 102 confirmed patients with novel Coronavirus 2 infection (COVID-19) during the early period of nationwide lockdown announced in India after the declaration of pandemic. We analyzed epidemiological, clinical characteristics and outcome of hospitalization in 102 patients with positive results for novel corona virus (SARS-CoV-2) RNA testing which were traced on the basis of history of travel, contact with a confirmed COVID-19 case, resident of hotspot areas or presence of symptoms, thus providing an accurate estimate of the proportion of asymptomatic cases in the initial population. Of 102 patients enrolled in the study, 83.3% (85/102) were asymptomatic and 16.67% (17/102) were symptomatic. Seventy-seven (75.49%) were males and 24.50% (25/102) were females. Eighteen (17.6%) patients had associated comorbidities, the most prevalent of which were diabetes mellitus 10.8% (11/102), hypertension 7.8% (8/102), chronic obstructive pulmonary disease (COPD) in 3.92% (4/102), chronic kidney Disease (CKD) 0.98% (1/102), coronary artery Disease (CAD) 0.98% (1/102) and cerebro-vascular disease (CVD) 0.98% (1/102). The clinical spectrum among symptomatic COVID-19 patients varied from dry cough and fever to respiratory failure and multi-organ failure. Twelve (11.76%) patients were kept in intensive care unit (ICU). Ninety-nine (97.05%) patients recovered while three (2.94%) died during hospital stay. With majority of COVID-19 cases in India being asymptomatic, changes in biochemical and inflammatory profile were small and insignificant in asymptomatic patients when compared to symptomatic patients. Elevated NLR, lymphopenia, age and presence of comorbidities were associated with increased severity and poor outcome. [ABSTRACT FROM AUTHOR]

Background: Varicella–Zoster virus (VZV) infection in healthcare organizations, especially in intensive care units (ICU), having admitted immunocompromised patients, is of serious concern as well as poses threat to healthcare workers working in such critical areas. The present report defines the transmission and infection control measures initiated to curtail VZV infection spread in the trauma ICU of a tertiary care hospital of North India. Outbreak Report: At the infection outset, there were 12 patients admitted in ICU and 54 healthcare workers were posted to manage these critical patients. After confirmation of VZV infection, all susceptible patients as well as healthcare workers were quarantined and fresh intake of patients was restricted. Out of the total healthcare workers, 14 (25.92%) were found susceptible (as per protective VZV IgG titers) and were vaccinated. Of the 12 patients admitted in the ICU, six patients were discharged and sent home directly, four patients expired due to their critical disease state, one patient left against medical advice, and one patient remained admitted in ICU till the incubation period was over. Epidemiologically, line listing for index case reporting was done. The efficacy of control measures was re-evaluated to strengthen existing infection control practices and general measures viz. strict hand washing, adherence to aseptic protocols and intensification of environmental cleaning. Conclusions: Established varicella surveillance measures ensure VZV outbreaks are identified in a timely manner and control measures implemented to prevent further transmission. Also, vaccination policy among HCWs is the utmost requirement despite having huge financial implications. [ABSTRACT FROM AUTHOR]

In the high pressure applications, safety and handling of the design parts are crucial and essentially required. If the design parameters are not properly optimized, sometimes it leads to fatal accidents or huge money loss. With the advent of modern computational tools, the simulation based design analysis is now a day's address above issues amicably to ultimately helping to improve development process and final product. The paper describes the step by step design process and simulation analysis of the pressure chamber. The theoretical FEA studies carried out on the designed pressure cell show that the chamber is working smoothly within the desired pressure range from atmospherics pressure to 200 MPa based on safety factor of the material used. Such devices are mostly imported and not available indigenously. Thus, the fabrication of simulated device is one step forward to develop an import substitute item and promote 'Make in India' product. Simulated results are found to quite encouraging. The actual experiments on the fabricated pressure cell would be performed in due course of time. [ABSTRACT FROM AUTHOR]

Neutralizing antibody function provides a foundation for the efficacy of vaccines and therapies1–3. Here, using a robust in vitro Ebola virus (EBOV) pseudo-particle infection assay and a well-defined set of solid-phase assays, we describe a wide spectrum of antibody responses in a cohort of healthy survivors of the Sierra Leone EBOV outbreak of 2013–2016. Pseudo-particle virus-neutralizing antibodies correlated with total anti-EBOV reactivity and neutralizing antibodies against live EBOV. Variant EBOV glycoproteins (1995 and 2014 strains) were similarly neutralized. During longitudinal follow-up, antibody responses fluctuated in a ‘decay–stimulation–decay’ pattern that suggests de novo restimulation by EBOV antigens after recovery. A pharmacodynamic model of antibody reactivity identified a decay half-life of 77–100 days and a doubling time of 46–86 days in a high proportion of survivors. The highest antibody reactivity was observed around 200 days after an individual had recovered. The model suggests that EBOV antibody reactivity declines over 0.5–2 years after recovery. In a high proportion of healthy survivors, antibody responses undergo rapid restimulation. Vigilant follow-up of survivors and possible elective de novo antigenic stimulation by vaccine immunization should be considered in order to prevent EBOV viral recrudescence in recovering individuals and thereby to mitigate the potential risk of reseeding an outbreak.In many survivors of Ebola virus infection, antibody responses show long-term patterns of decline followed by restimulation, possibly owing to recrudescence of persisting virus. [ABSTRACT FROM AUTHOR]

Background: The menace of COVID-19 has put a huge burden on health care system predisposing health care workers engaged in management to COVID-19 infections. The nonavailability of effective drug against COVID-19 warrants extra cover as prophylactic therapy for health care workers, especially against transmission from asymptomatic patients. Hydroxychloroquine (HCQ) for prophylaxis of COVID-19 had been advocated by some researchers. Hence, in this project, evaluation of HCQ as preventive strategy for healthcare workers against COVID-19 infection was studied. Materials and Methods: HCQ was prescribed as a prophylactic therapy as per the advisory of National Task Force of Indian Council of Medical Research, India. The data regarding consumption profile, COVID-19 infection and adverse drug reaction profile of HCQ in healthcare workers was collected. Results: Record of 4,239 health workers with hydroxychloroquine consumed was available till date. 139 subjects were dropped out of study as they did not consume the HCQ tablets. 93 heath workers (2.19%) were infected with COVID-19 infection but in early weeks of prophylactic therapy and were asymptomatic. A few of them (08 patients) had mild symptomatic manifestation with RT- PCR reported positive for SARS-CoV-2. No mortality was reported as among healthcare workers, engaged in management of COVID-19 patients at the tertiary care institute in Jaipur, India. HCQ prophylaxis in standard doses produced predominantly gastrointestinal side effects in 20 subject and headache in 10 health workers. Conclusion: The present study showed that HCQ prophylaxis is safe and effective in standard doses against COVID-19 infection. The frontline workers engaged in management of COVID-19 may be given HCQ prophylaxis as an extra cover. However, it's broadening usage as preventive strategy, in general for people especially in cardiovascular incidences; require enhanced research and further validation. [ABSTRACT FROM AUTHOR]

Disaster incidents leading to massive obliterations often bring to the forefront the inadequacies of the systems, infrastructure as well as personages. In healthcare settings, these imperfections are usually exhibited specifically during fire disasters. This case report details a true fire incident that erupted in a patient bed-head panel of an emergency complex room and describes the real-life challenges encountered by the emergency staff in preserving both life and property. Bed-head units encompass both electrical and medical gases: a structural component quite common in modern hospitals. Precautionary measures should be implemented to mitigate such incidents, as well as specific attention, should be made during the designing and installation of these bed-head panels. Better coordination, scheduled training, and fire drills can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby, making a safer healthcare environment for every worker and patient. [ABSTRACT FROM AUTHOR]

Recently, synthesized Chevron graphene nanoribbons (CGNRs) and its laterally extended counterpart known as extended CGNRs (ECGNR) are constructed by making alternated regular cuts in pristine graphene nanoribbons (GNRs). First-principles calculations demonstrate that these GNRs are super-ductile and possess width-dependent mechanical properties. The Young's modulus is calculated to be 389.4 GPa and 414.6 GPa for CGNR and ECGNR, respectively. The bandgap of these nanoribbons decreases on the application of tensile strain. The carrier effective masses are found to be highly sensitive towards mechanical strains. The holes (electrons) mobility of ECGNR is calculated to be 7.68 × 104 cm2 V−1 s−1 (1.69 × 104 cm2 V−1 s−1), which is higher than that of CGNR can be further enhanced by elongation. The prominent peaks of the imaginary part of dielectric function and electron energy loss spectra show redshift on increasing the tensile strain. The electron energy loss spectra show intense plasmonic structure in low energy spectrum indicating GNRs to be more sensitive to the visible region than ultra violet spectrum. Our results provide insight about the possible applications of GNRs in the fields of high-speed transistors, sensors, photonics, and optoelectronics. [ABSTRACT FROM AUTHOR]

Hunger strike is a protest where an informed person refuses essential nourishment with the intention of accomplishing a specific goal. Hunger strikes conflict with medical, ethical, humanitarian and legal values. A multidisciplinary approach is important when dealing with hunger strike patients. On one hand, there is the wish to preserve life, and on the other to respect the strikers' autonomy and their wishes, values and advanced directives (or living will). Most hunger strikes are short-lived, but in complex and prolonged circumstances, legal advice must be sought from health service solicitors and a doctor's medical indemnity organisation. There is an emergent need to have defined guidelines for the management of these hunger strikes to be followed. [ABSTRACT FROM AUTHOR]