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Zifang Shang,1,* Vipasha Sharma,2,* Tarun Kumar,3 Kamal Dev,4,5 Sandip Patil6 1Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou Academy of Medical Sciences, Meizhou People’s Hospital (Huangtang Hospital), Meizhou, 514031, People’s Republic of China; 2Department of Biotechnology, University Institute of Biotechnology, Chandigarh University, Mohali, Punjab, India; 3Mkelly Biotech Pvt Ltd., Mohali, Punjab, India; 4Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh, India; 5Department of Pharmacology and Toxicology, Wright State University, Dayton, OH, USA; 6Department of Haematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Sandip Patil; Vipasha Sharma, Email sandippatil1309@yahoo.com; sharma.vipasha@gmail.comBackground: The global threat of multi-drug-resistant bacteria has severely limited the options available for effective antibiotics. This study focuses on the antimicrobial activity and phytochemical characterization of C. oppositifolia extracts, aiming to identify novel plant-based therapeutic agents.Methods: C. oppositifolia specimens-leaves and inflorescence. Specimens were cleaned, sterilized, dried, and ground into a fine powder. Extracts were obtained using methanol and petroleum ether via a Soxhlet apparatus, followed by fractionation with chloroform, n-butanol, and ethyl acetate. Volatile oil was extracted through hydro distillation using a Clevenger apparatus. Phytochemical analysis was conducted to identify bioactive compounds. Biophysical techniques, including UV-visible spectrophotometry, TLC, HPLC, GC-MS, FTIR, and NMR, were employed for characterization. Antimicrobial activity was tested against S. aureus ATCC25922 and E. coli ATCC25922 using agar well and disc diffusion methods, and synergistic effects were assessed with erythromycin and amoxicillin.Results: Methanol extract exhibited bacteriostatic activity with inhibition zones of 13.0 ± 0.2 mm for both S. aureus and E. coli. Petroleum ether, chloroform, n-butanol, and ethyl acetate fractions showed varying inhibition zones. Erythromycin demonstrated bactericidal activity, which was enhanced synergistically when combined with methanol extract and volatile oil, increasing inhibition zones against S. aureus. Phytochemical analysis identified phenols, flavonoids, tannins, coumarins, alkaloids, terpenoids, saponins, and glycosides. FTIR analysis revealed functional groups such as amines, aldehydes, nitriles, alkenes, and sulfones. GC-MS identified 24 compounds, with α-pinene, caryophyllene, and carene as major components. NMR spectra indicated no complex formation between oils and antibiotics, suggesting the compounds act as synergists.Conclusion: The C. oppositifolia extracts possess significant antimicrobial activity and synergistic potential, particularly against S. aureus. The presence of various bioactive compounds suggests a promising role in developing new plant-based therapeutics.Keywords: C. oppositifolia, antimicrobial activity, phytochemical characterization, multidrug-resistant pathogens, synergistic effects

Objective: Public spitting attributable to Smokeless Tobacco (SLT) use not only causes a threat to public cleanliness but also to the people exposed around them. An electronic search on various anti-spitting laws and ban in India was done using Google search engine for duration of three months (November 2018 to January 2019). Material and Methods: The original state gazettes were reviewed to extract the data on spit ban and penalty. Renewals of Acts were also thoroughly checked for recent updates of penalty or severity of the act. The law implementing bodies were broadly classified as National, State, Municipal, Village councils (Gram Panchayat), Airports, Metro Railway, and Company Law Tribunal. Results: A total of 42 Anti-spitting laws were identified in this search and 16 states had anti spitting law under different sectors. Discussion: Under these laws, sign boards and warnings are placed commonly at Airports, Railway stations, and metro stations. States with high rates of SLT users like Tripura, Arunachal Pradesh and Mizoram did not have any policy on spitting. Conclusion: Strong enforcement of anti-spitting laws in India will not only reduce spread of communicable diseases but also indirectly will reduce the act of using SLT also.

Aim: The aim of this study was to evaluate the penetration depth of three different irrigant solutions incorporated with nanoparticles (NPs) using a confocal laser scanning microscope. Methods: Forty-two single-rooted teeth were used. Access cavities were prepared, and working length was determined. The samples were split into three groups at random (n = 14). Group 1 – chitosan NPs, Group 2 – zinc oxide NPs, and Group 3 – silica-doped titanium NPs. Each group was further divided into subgroup A with activation and subgroup B without activation. Each tooth received final irrigants for 1 min. Each sample is sectioned at 3 mm from the apex. A confocal laser scanning microscope was used to observe the irrigant penetration. Results: The results showed that there was a significant difference in the penetration depth in Group 2A and Group 3A. Conclusion: Activation with PATS Vario increases the penetration when compared to conventional syringe, and zinc oxide NP solution showed increased penetration when compared with other groups.

Abstract The current study aimed at population genetic characterization of B. vogeli based on the cytochrome b (cyt b) gene sequences (≥ 685 bp) available in the GenBank. Phylogenetic trees placed all the sequences of B. vogeli in a single large monophyletic clade; however, it was further divided into two subclades (Bv1 and Bv2). Out of seven nucleotide variations observed between Bv1 and Bv2 subclades, four were synonymous (G92A, C170T, T488C and A659G), and three were non-synonymous (G324A, C438A and G465A) resulting in amino acid substitutions at three places (V108I, L146I and V155I). Within different B. vogeli populations, the nucleotide and haplotype diversities were low. The median-joining haplotype network revealed only two haplotypes (Hap_1 and Hap_2). A geographical sub-structuring was noticed in the B. vogeli populations, with moderate genetic differentiation (FST = 0.05000; P

Abstract We derive novel black hole solutions in a modified gravity theory, namely the Hu–Sawicki model of f(R) gravity. After obtaining the black hole solution, we study the horizon radius of the black hole from the metric and then analyse the dependence of the model parameters on the horizon. We then use the 6th order WKB method to study the quasinormal modes of oscillations (QNMs) of the black hole perturbed by a scalar field. The dependence of the amplitude and damping part of the QNMs are analysed with respect to variations in model parameters and the error associated with the QNMs are also computed. After that we study some thermodynamic properties associated with the black hole such as its thermodynamic temperature as well as greybody factors. It is found that the black hole has the possibility of showcasing negative temperatures and is thermodynamically unstable for feasible values of model parameters. Then we analyse the geodesics and derive the photon sphere radius as well as the shadow radius of the black hole. The photon radius is independent of the model parameters while shadow radius showed fair amount of dependence on the model parameters. We tried to constrain the parameters with the help of Keck and VLTI observational data and obtained some bounds on m and $$c_{2}$$ c 2 parameters.

With the advent of technology, it has become possible to perform direct numerical simulations and the demand for high accuracy computing is increasing. Numerical simulations play an important part in understanding physics of the flow and instability mechanism in flows. For high accuracy, numerical schemes must be chosen that satisfy the physical dispersion relation, should not amplify or attenuate the solution and resolve all possible length and time scales. In the present paper, spectral stability analysis of linear convection equation is performed using first order forward difference (FD1) method and fourth order Runge Kutta (RK4) method, consisting of four stages, for time discretization and a second order central difference (CD2) method for evaluating spatial derivative. The results show that the presence of numerical instability for FD1 method is independent of the CFL number, consistent with the stability analysis which showed FD1 method to be unconditionally unstable. However, for RK4 method, the solution is found to be neutrally stable only for a particular range of CFL number, even stable solution introduced error by attenuating the computed or analytical solution.

In order to obtain important knowledge for raising the performance and efficiency of propulsion systems, in this paper we investigate the dynamics process of pressure gain combustion in the Pulse Detonation Engine. Through comprehensive experimentation, we analyse the intricate mechanisms governing the pressure gain combustion in PDEs. Our findings present innovative methods for increasing combustion efficiency, boosting thrust generation, and addressing operational difficulties in PDE designs. Additionally, we discuss creative strategies for utilizing pressure gain effects to enhance engine performance metrics.

Abstract The ability to image tissues in three dimensions (3D) with label-free molecular contrast at the mesoscale would be a valuable capability in biology and biomedicine. Here, we introduce Raman spectral projection tomography (RSPT) for volumetric molecular imaging with optical sub-millimeter spatial resolution. We have developed a RSPT imaging instrument capable of providing 3D molecular contrast in transparent and semi-transparent samples. We also created a computational pipeline for multivariate reconstruction to extract label-free spatial molecular information from Raman projection data. Using these tools, we demonstrate imaging and visualization of phantoms of various complex shapes with label-free molecular contrast. Finally, we apply RSPT as a tool for imaging of molecular gradients and extracellular matrix heterogeneities in fixed and living tissue-engineered constructs and explanted native cartilage tissues. We show that there exists a favorable balance wherein employing Raman spectroscopy, with its advantages in live cell imaging and label-free molecular contrast, outweighs the reduction in imaging resolution and blurring caused by diffuse photon propagation. Thus, RSPT imaging opens new possibilities for label-free molecular monitoring of tissues.

Abstract Background The healthcare system in India is tiered and has primary, secondary and tertiary levels of facilities depending on the complexity and severity of health challenges at these facilities. Evidence suggests that emergency services in the country is fragmented. This study aims to identify the barriers and facilitators of emergency care delivery for patients with time-sensitive conditions, and develop and implement a contextually relevant model, and measure its impact using implementation research outcomes. Methods We will study 85 healthcare facilities across five zones of the country and focus on emergency care delivery for 11 time-sensitive conditions. This implementation research will include seven phases: the preparatory phase, formative assessment, co-design of Model “Zero”, co-implementation, model optimization, end-line evaluation and consolidation phase. The “preparatory phase” will involve stakeholder meetings, approval from health authorities and the establishment of a research ecosystem. The “formative assessment” will include quantitative and qualitative evaluations of the existing healthcare facilities and personnel to identify gaps, barriers and facilitators of emergency care services for time-sensitive conditions. On the basis of the results of the formative assessment, context-specific implementation strategies will be developed through meetings with stakeholders, providers and experts. The “co-design of Model ‘Zero’” phase will help develop the initial Model “Zero”, which will be pilot tested on a small scale (co-implementation). In the “model optimization” phase, iterative feedback loops of meetings and testing various strategies will help develop and implement the final context-specific model. End-line evaluation will assess implementation research outcomes such as acceptability, adoption, fidelity and penetration. The consolidation phase will include planning for the sustenance of the interventions. Discussion In a country such as India, where resources are scarce, this study will identify the barriers and facilitators to delivering emergency care services for time-sensitive conditions across five varied zones of the country. Stakeholder and provider participation in developing consensus-based implementation strategies, along with iterative cycles of meetings and testing, will help adapt these strategies to local needs. This approach will ensure that the developed models are practical, feasible and tailored to the specific challenges and requirements of each region.

Abstract Cisplatin-induced nephrotoxicity restricts its clinical use against solid tumors. The present study elucidated the pharmacological effects of Renogrit, a plant-derived prescription medicine, using cisplatin-induced human renal proximal tubular (HK-2) cells and Caenorhabditis elegans. Quantification of phytochemicals in Renogrit was performed on HPTLC and UHPLC platforms. Renogrit was assessed in vitro in HK-2 cells post-exposure to clinically relevant concentration of cisplatin. It was observed that renoprotective properties of Renogrit against cisplatin-induced injury stem from its ability to regulate renal injury markers (KIM-1, NAG levels; NGAL mRNA expression), redox imbalance (ROS generation; GST levels), and mitochondrial dysfunction (mitochondrial membrane potential; SKN-1, HSP-60 expression). Renogrit was also found to modulate apoptosis (EGL-1 mRNA expression; protein levels of p-ERK, p-JNK, p-p38, c-PARP1), necroptosis (intracellular calcium accumulation; RIPK1, RIPK3, MLKL mRNA expression), mitophagy (lysosome population; mRNA expression of PINK1, PDR1; protein levels of p-PINK1, LC3B), and inflammation (IL-1β activity; protein levels of LXR-α). More importantly, Renogrit treatment did not hamper normal anti-proliferative effects of cisplatin as observed from cytotoxicity analysis on MCF-7, A549, SiHa, and T24 human cancer cells. Taken together, Renogrit could be a potential clinical candidate to mitigate cisplatin-induced nephrotoxicity without compromising the anti-neoplastic properties of cisplatin.

Abstract The present investigation reported that FYM application in different seasons influenced root, shoot, and seedling length, straw K, vigour index-I, nutrient uptake, grain, and stover yield of pearl millet significantly (P kharif > rabi. Applying FYM in both seasons resulted in higher N, P, and K content in pearl millet grain (1.99%, 0.17%, and 0.37%, respectively) followed by kharif season application (1.93, 0.16, and 0.35%, respectively). Applying 15 t FYM ha−1 significantly increased the grain N (13.19%), P (63.16%), K (22.29%), protein (13.56%), stover N (32.76%), P (46.66%) and root length (29.83%) over FYM0. After 50 cropping cycles, continuous application of FYM15, FYM10, and FYM5 significantly improved vigour index-I by 52.85, 39.26, and 23.63% over no FYM, respectively. Applying 120 kg N ha−1 significantly increased N (6.38%), P (15.89%), and protein (6.03%) content, germination (5.91%), and vigour indexes (24.52 to 30.91%) of pearl millet grain over no fertilizer N. The treatment FYM15 × N120 increased the seedling length of pearl millet by 30.54 over N120 and 11.08% over FYM15 alone, respectively. Adding FYM either during both seasons or in the kharif season along with fertilizer N proved superior in improving the quality and yield of pearl millet.

Abstract More than half of the world’s rivers dry up periodically, but our understanding of the biological communities in dry riverbeds remains limited. Specifically, the roles of dispersal, environmental filtering and biotic interactions in driving biodiversity in dry rivers are poorly understood. Here, we conduct a large-scale coordinated survey of patterns and drivers of biodiversity in dry riverbeds. We focus on eight major taxa, including microorganisms, invertebrates and plants: Algae, Archaea, Bacteria, Fungi, Protozoa, Arthropods, Nematodes and Streptophyta. We use environmental DNA metabarcoding to assess biodiversity in dry sediments collected over a 1-year period from 84 non-perennial rivers across 19 countries on four continents. Both direct factors, such as nutrient and carbon availability, and indirect factors such as climate influence the local biodiversity of most taxa. Limited resource availability and prolonged dry phases favor oligotrophic microbial taxa. Co-variation among taxa, particularly Bacteria, Fungi, Algae and Protozoa, explain more spatial variation in community composition than dispersal or environmental gradients. This finding suggests that biotic interactions or unmeasured ecological and evolutionary factors may strongly influence communities during dry phases, altering biodiversity responses to global changes.

Abstract We introduce University of Texas - GLObal Building heights for Urban Studies (UT-GLOBUS), a dataset providing building heights and urban canopy parameters (UCPs) for more than 1200 city or locales worldwide. UT-GLOBUS combines open-source spaceborne altimetry (ICESat-2 and GEDI) and coarse-resolution urban canopy elevation data with a machine-learning model to estimate building-level information. Validation using LiDAR data from six U.S. cities showed UT-GLOBUS-derived building heights had a root mean squared error (RMSE) of 9.1 meters. Validation of mean building heights within 1-km2 grid cells, including data from Hamburg and Sydney, resulted in an RMSE of 7.8 meters. Testing the UCPs in the urban Weather Research and Forecasting (WRF-Urban) model resulted in a significant improvement (55% in RMSE) in intra-urban air temperature representation compared to the existing table-based local climate zone approach in Houston, TX. Additionally, we demonstrated the dataset’s utility for simulating heat mitigation strategies and building energy consumption using WRF-Urban, with test cases in Chicago, IL, and Austin, TX. Street-scale mean radiant temperature simulations using the SOlar and LongWave Environmental Irradiance Geometry (SOLWEIG) model, incorporating UT-GLOBUS and LiDAR-derived building heights, confirmed the dataset’s effectiveness in modeling human thermal comfort in Baltimore, MD (daytime RMSE = 2.85°C). Thus, UT-GLOBUS can be used for modeling urban hazards with significant socioeconomic and biometeorological risks, enabling finer scale urban climate simulations and overcoming previous limitations due to the lack of building information.

Abstract Background Diet and exercise are important components of treatment for complex chronic conditions, however access to allied health support is limited. When available, support is often siloed and fragmented. Digital health incorporating patient choice may help to align health care services with preferences and goals. This study evaluated the implementation of a ubiquitously accessible patient-centred digital health diet and exercise service. Methods U-DECIDE was a single-centre, 26-week randomised controlled trial set in kidney and liver disease clinics in a tertiary hospital in Brisbane, Australia. Participants were adults with a complex chronic condition referred for dietetic consultation with at least one feature of the metabolic syndrome. All participants received a dietary consultation, an activity monitor and usual care. Intervention participants were offered one text message per week and access to additional digital health options (increased text message frequency, nutrition app, exercise app, group-based diet and/or exercise video consultations). The primary outcome of feasibility was determined by safety (study-related serious adverse events: SRSAEs), recruitment (≥ 50% eligible patients), retention (≥ 70%), exposure uptake (≥ 75% of intervention group had greater access to health professional contact than comparator) and video consultation adherence (≥ 80% attendance). Secondary outcomes included process evaluation metrics and clinical outcomes. Results Of 67 participants (intervention n = 33, comparator n = 34), 37 (55%) were men, median (IQR) age was 51 (41–58) years. The most chosen digital health options were the nutrition app (n = 29, 88%) and exercise video consultations (n = 26, 79%). Only one participant chose no additional digital health options. The intervention group had no SRSAEs. The study exceeded targets for recruitment (52%), retention (81%) and exposure uptake (94%). Video consultation adherence was 42%. Engagement across digital health options was inconsistent. Conclusions Digital health options incorporating patient choice were feasible and can be offered to people with complex chronic disease as a service model option. Trial registration Australia and New Zealand Trials Register: Trial Registration Number: ACTRN12620001282976. Registered 27th November 2020.

The androgen receptor (AR) is the main driver in the development of castration‐resistant prostate cancer, where the emergence of AR splice variants leads to treatment‐resistant disease. Through detailed molecular studies of the marine alkaloid manzamine A (MA), we identified transcription factor E2F8 as a previously unknown regulator of AR transcription that prevents AR synthesis in prostate cancer cells. MA significantly inhibited the growth of various prostate cancer cell lines and was highly effective in inhibiting xenograft tumor growth in mice without any pathophysiological perturbations in major organs. MA suppressed the full‐length AR (AR‐FL), its spliced variant AR‐V7, and the AR‐regulated prostate‐specific antigen (PSA; also known as KLK3) and human kallikrein 2 (hK2; also known as KLK2) genes. RNA sequencing (RNA‐seq) analysis and protein modeling studies revealed E2F8 interactions with DNA as a potential novel target of MA, suppressing AR transcription and its synthesis. This novel mechanism of blocking AR biogenesis via E2F8 may provide an opportunity to control therapy‐resistant prostate cancer over the currently used AR antagonists designed to target different parts of the AR gene.

Background: Respiratory diseases pose a significant challenge in Nepali clinical settings due to elevated smoking rates and environmental risks. This study explores the structural changes in conditions such as asthma, chronic obstructive pulmonary disease, and bronchiectasis, utilizing noninvasive multi-detector computed tomography to assess airway remodeling. Despite conflicting western literature on bronchoarterial ratios, this research emphasizes the importance of evaluating these ratios in the Nepalese context for predicting airway disease severity. Materials and Methods: The cross-sectional study conducted at Nobel Medical College and Teaching Hospital involved 129 participants aged over 20 undergoing chest computed tomography. It aimed to measure the bronchoarterial ratio and investigate its associations with age, gender, smoking history, and altitude of residence. Bronchoarterial ratios was calculated using averaged short-axis diameters of the right apical and right posterior basal segmental bronchi, excluding the left lung due to motion artifacts. Results: Analysis indicated a Mean Bronchoarterial Ratio of 0.823 (SD 0.151), with the apical and basal segment BARs at 0.832 (SD 0.148) and 0.814 (SD 0.153), respectively. Notably, individuals aged over 65 who were smokers exhibited a significant increase in BAR. Additionally, a higher altitude of residence demonstrated a significant correlation with the Bronchoarterial ratio in the apical lung segment. Conclusion: This study provides valuable insights into the bronchoarterial ratio within the Nepalese population, considering age, gender, smoking history, and altitude of residence. The findings underscore the potential relevance of these ratios in conditions involving airway remodeling, contributing to the understanding of respiratory diseases in this specific demographic.

Background: Subarachnoid spread of local anesthetics is quite erratic and is determined by several factors. There is a high predictive for the spread of spinal anaesthesia in terms of abdominal girth and vertebral column length. Our study is designed to determine the effect of abdominal girth and vertebral column length with cephalad spread of spinal anaesthesia for a given dose of 0.5% hyperbaric bupivacaine in Nepalese patients. Materials and Methods: In this prospective observational study, a total 100 patients of ASA PS I-II, aged16-65 years and undergoing lower extremity surgery under spinal anesthesia were enrolled. 2.8 mL of 0.5% hyperbaric bupivacaine was injected intrathecally at L3-4 interspace in sitting position. Extent of sensory blockade was assessed for 60 min. Simple linear regression, multiple linear regression and Pearson’s correlation coefficient analysis were performed to determine the correlation between patient variables viz abdominal girth, vertebral column length, height, weight, body mass index and age and maximum sensory block height. Results: Abdominal girth and vertebral column length correlated significantly with the maximal sensory block height after intrathecal administration of a fixed dose of 0.5% hyperbaric bupivacaine by all the three statistical tools used. Conclusion: Abdominal girth and vertebral column lengthcorrelate significantly with the maximal sensory block height in Nepalese patients receiving a fixed dose subarachnoid block with 0.5% hyperbaric bupivacaine

Objective: To perform a systematic review of the effects of Pilates on common body postures. Data sources: Web of Science, PubMed, Scopus, Science Direct, Springer Link, and CNKI. The search year is set from January 1, 2019, to November 15, 2023. Study Selection: Quasi-experimental studies, randomized controlled trials, randomized clinical trials, and nonrandomized controlled trials investigating the effects of Pilates on body posture. Data Extraction: The Physiotherapy Evidence Database scale was used to evaluate the quality of studies that met the inclusion requirements. Studies were independently assessed by 2 reviewers who read through the full text and labeled as “low quality,” “moderate quality,” “good quality,” and “excellence quality.” Disagreements were resolved by the third reviewer. The Cochrane Risk of Bias (RoB 2.0) tool was used to assess the risk of bias for each study. Data Synthesis: Of the 492 studies screened, 13 met the inclusion criteria involving a total of 783 trial participants. Six studies (46%) were of high quality or above, with main limitation related to the internal validity of the study design. The research outcomes focused primarily on effects of Pilates on body posture; cervical, thoracic, and lumbar spine; and followed by quality of life and pain. Conclusions: The findings of this systematic review provided valuable evidence for the role of Pilates in improving body posture problems. Pilates is a boon to patients suffering from postural disorders, and it is suggested that Pilates can be widely used as a complementary therapy. Nonetheless, more detailed studies are necessary in the future.

The exploration of Behçet’s disease challenges the idea that “the oral cavity reflects systemic diseases.” This chronic systemic vasculitis, characterized by oral and genital ulcers, cutaneous lesions, and multi-organ involvement, poses diagnostic complexities. A 30-year-old male patient reported with Behçet’s syndrome, diagnosed via International Criteria for Behçet Disease 2014 and HLA B51 positivity, who achieved relief with Colchicine, highlighting the role of oral medicine.

Longitudinally extensive transverse myelitis (LETM) is a neurological entity with characteristic inflammatory lesions in ≥3 vertebral segments of the spinal cord. It is most commonly associated with neuromyelitis optica spectrum disorder. Other causes include infections, autoimmune disorders, and neoplasms. Tuberculosis has been reported as a cause of LETM in few case reports. However, tuberculous meningitis (TBM) as a cause of LETM is extremely rare, more so with involvement of the complete spine cord from the brainstem to the conus medullaris. A 65-year-old female was admitted to our hospital with sudden-onset tetraplegia and sensory, bowel, and bladder involvement. With no significant past history, mild meningeal signs, and normal metabolic profile, cerebrospinal fluid analysis was done revealing polymerase chain reaction test positive for Mycobacterium tuberculosis. Magnetic resonance imaging of the spine was suggestive of complete spinal cord edema extending from the brainstem to the level of conus medullaris without skip lesions. A final impression of holocord LETM caused by TBM was suggested after ruling out other causes. The case highlights TBM as a potential cause of LETM especially in endemic countries, especially Asian and African countries, more so with holocord involvement without skip lesions.

The investigation of machine learning models in Europe and India for predicting future sales of electric cars (EVs) worldwide has been the focus of present research. In this study, Long Short-Term Memory (LSTM), Support Vector Regression (SVR), Autoregressive Integrated Moving Average (ARIMA), Linear Regression, hybrid long- and short-term memory neural network model and gradient boosted regression trees model (LSTM-GBRT) models based machine learning techniques are compared for performance analysis to predict EV sales. Moreover, in this study, a hybrid LSTM-GBRT technique was developed, which forecasts EV sales, particularly for Battery Electric Vehicles (BEVs) and Plug-in Hybrid Electric Vehicles (PHEVs) over the next five years. During the prediction of EV sales, it has been validated that hybrid LSTM-GBRT technique has better predictive power. In addition, the present study attempts to provide estimated sales statistics for the designated locations. The results indicate that EV industry is evolving, with India showing a strong growth rate in BEV sales and establishing itself as a major participant in the global EV scenario by showing a notable increase in its share of worldwide EV sales volume by 2027. Conversely, the performance of EV sales in Europe has been analysed and validated through the proposed LSTM-GBRT model.

Digoxin, a cardiac glycoside, functions by inhibiting the sodium potassium ATPase pump. It’s crucial to note that digoxin has a very narrow therapeutic range. Its serum level vary due to changes in body weight, age, renal function, hepatic impairment and concomitant drug therapy. Chronic toxicity can lead to different types of arrrythmia,which span from heart blocks to ventricular tachycardia.This report present a case of an elderly male, where Digoxin toxicity resulted in syncope and mild traumatic brain injury. Initially upon patient’s presentation ECG indicated myocardial infarction, subsequently bradycardia and complete heart block. The patient had a known history of chronic kidney disease and was prescribed 0.25mg of digoxin regularly without dose adjustment, which might have resulted in reduced digoxin elimination, leading to toxicity. Thus this case demonstrates a classic presentation of digoxin toxicity. Multiple risk factor such as old age, impaired renal function with continued digoxin treatment without dose adjustment was likely the cause of toxicity.

Tea tree essential oil (TEO) Rosemary Essential Oil (REO) and Guggul essential oil (GEO) (EOs) are a priceless essential oil that has been linked to several biological activities, including antibacterial, antifungal, immunomodulatory, anticancer, and anti-inflammatory effects. α-amylase inhibition is a hopeful curative target against type-2 diabetes as it can downgrade fierce digestion and absorption of carbohydrates into absorbable monosaccharides. The purpose of the study is in silico molecular docking of principal component of TEO, REO and GEO followed by and in vitro validation of inhibition of α-amylase activity. For docking Cb-dock2 tool was utilized. Ligand-Protein 2-D interactions were also studied. From the perspective of human health, in-silico ADMET pharmacoinformatic features (Physicochemical, Lipophilicity, Medicinal Chemistry, Druglikeness, Absorption, Water Solubility, Distribution, Metabolism, Pharmacokinetics, Excretion) have prospected. Using α-amylase, wet lab validation was carried out. 2, 2-Diphenyl-1-picryl hydrazyl (DPPH) radical inhibition assay was conducted to ascertain antioxidant role of all EO’s. Docking investigation demonstrated the effective binding of all the ligands with the α-amylase. The interaction results imply that the enzyme-ligand complexes form hydrogen, hydrophobic, and other interactions. In-silico ADMET examination disclosed that all the ligand molecules have no toxic effect and acceptable absorption as well. Further, TEO, REO and GEO has dose-dependent inhibitory action against α-amylase. All EO’s depicted good antioxidant potential. Kinetic analysis revealed that TEO, REO and GEO competitively inhibited α-amylase. It was concluded that these substances can function as model molecules for the synthesis of novel anti-diabetic substances.

Pediatric bronchopneumonia is a prevalent life-threatening disease, particularly in developing countries. Affordable and accessible blood biomarkers are needed to predict disease severity which can be based on the Duration of Hospitalization (DOH).

Rationale: Dengue fever is capable of inciting the formation of transient polyclonal antibodies directed at red blood cell antigens, resulting in complement-mediated hemolysis, leading to intravascular hemolysis and hemoglobinuria. Patient’s concern: A 12-year-old male patient who recovered from dengue fever a week ago had red blood cell agglutination, spherocytes, and engulfment of red blood cells (erythrophagocytosis) by monocytes and neutrophils on routine hematological peripheral blood smear. The unexpected blood smear results prompted the lab physicians to investigate autoimmune hemolytic anemia, which revealed a monospecific positive direct antiglobulin test for complement (C3d, C3b) and the presence of Donath-Landsteiner antibody. Diagnosis: Paroxysmal cold hemoglobinuria (PCH), secondary to dengue fever. Interventions: Oxygen supplements, antibiotics, intravenous immunoglobulins, steroid therapy, and packed cell transfusions were administered. Outcomes: The patient’s condition was improved following the therapy. Lessons: Post-dengue PCH is a rare complication that requires a thorough peripheral smear examination for erythrophagocytosis, as advanced hematology analyzers fail to detect such findings.

Abstract Background Achieving effective drug delivery to the central nervous system (CNS) remains a challenge for treating neurological disorders. Intrathecal (IT) delivery, which involves direct injection into the cerebrospinal fluid (CSF), presents a promising strategy. Large animal studies are important to assess the safety and efficacy of most drugs and treatments and translate the data to humans. An understanding of the influence of IT injection parameters on solute distribution within the CNS is essential to optimize preclinical research, which would potentially help design human clinical studies. Methods A three-dimensional (3D) in vitro model of a cynomolgus monkey, based on MRI data, was developed to evaluate the impact of lumbar injection parameters on intrathecal solute dispersion. The parameters evaluated were (a) injection location, (b) bolus volume, (c) flush volume, (d) bolus rate, and (e) flush rate. To simulate the CSF flow within the subarachnoid space (SAS), an idealized CSF flow waveform with both cardiac and respiratory-induced components was input into the model. A solution of fluorescein drug surrogate tracer was administered in the lumbar region of the 3D in vitro model filled with deionized water. After injection of the tracer, the CSF system wide-solute dispersion was imaged using high-resolution cameras every thirty seconds for a duration of three hours. To ensure repeatability each injection protocol was repeated three times. For each protocol, the average spatial–temporal distribution over three hours post-injection, the area under the curve (AUC), and the percent injected dose (%ID) to extra-axial CSF (eaCSF) at three hours were determined. Results The changes to the lumbar injection parameters led to variations in solute distribution along the neuro-axis. Specifically, injection location showed the most impact, enhancing the delivery to the eaCSF up to + 10.5%ID (p = 0.0282) at three hours post-injection. Adding a post-injection flush of 1.5 ml at 1 ml/min increased the solute delivery to the eaCSF by + 6.5%ID (p = 0.0218), while the larger bolus volume resulted in a + 2.3%ID (p = 0.1910) increase. The bolus and flush rates analyzed had minimal, statistically non-significant effects. Conclusion These results predict the effects of lumbar injection parameters on solute distribution in the intrathecal space in NHPs. Specifically, the choice of injection location, flush, and bolus volume significantly improved solute delivery to eaCSF. The in vitro NHP CSF model and results offer a system to help predict and optimize IT delivery protocols for pre-clinical NHP studies.

Introduction: Oesophageal cancer is the seventh most common cancer worldwide and the sixth highest cause of cancer-related mortality. Radiation plays an important role in the multimodality treatment of carcinoma of the oesophagus. Aim: To compare locoregional control and toxicity of two External Beam Radiation Therapy (EBRT) fractionation schedules of concurrent chemoradiotherapy and high-dose intraluminal brachytherapy in patients with oesophageal carcinoma at a single institute. Materials and Methods: The present study was a pilot study including a total of 33 participants with histologically confirmed oesophageal cancer. Patients were prospectively randomised into two groups. Arm I: EBRT with a total dose of 46 Gy delivered in 23 fractions at a rate of 2 Gy per fraction over 4.3 weeks, along with Concurrent Injection of Cisplatin (CDDP) 100 mg/m2 on days 1 and 22, followed by Intraluminal Radiation Therapy (ILRT) with 6 Gy per session weekly. Arm II: EBRT with a total dose of 30 Gy delivered in 10 fractions at a rate of 3 Gy per fraction over two weeks and CDDP 100 mg/m2 on day 1 only. The primary endpoint of this study was to compare the locoregional response and toxicities (both acute and late) in the two arms at the end of radiotherapy and six months. Results: At the end of the two-month follow-up, no statistically significant difference was found in the response between the two arms (p-value=0.2697). Dysphagia relief was comparable in both arms; however, this difference was not statistically significant (p-value=0.9235). Conclusion: The responses in both arms were comparable, and further randomised trials with larger sample sizes should be encouraged.

Abstract The goal of this research is to create an ensemble deep learning model for Internet of Things (IoT) applications that specifically target remote patient monitoring (RPM) by integrating long short-term memory (LSTM) networks and convolutional neural networks (CNN). The work tackles important RPM concerns such early health issue diagnosis and accurate real-time physiological data collection and analysis using wearable IoT devices. By assessing important health factors like heart rate, blood pressure, pulse, temperature, activity level, weight management, respiration rate, medication adherence, sleep patterns, and oxygen levels, the suggested Remote Patient Monitor Model (RPMM) attains a noteworthy accuracy of 97.23%. The model's capacity to identify spatial and temporal relationships in health data is improved by novel techniques such as the use of CNN for spatial analysis and feature extraction and LSTM for temporal sequence modeling. Early intervention is made easier by this synergistic approach, which enhances trend identification and anomaly detection in vital signs. A variety of datasets are used to validate the model's robustness, highlighting its efficacy in remote patient care. This study shows how using ensemble models' advantages might improve health monitoring's precision and promptness, which would eventually benefit patients and ease the burden on healthcare systems.

Abstract Background Therapeutic options for early-stage hepatocellular carcinoma (HCC) in individual patients can be limited by tumor and location, liver dysfunction and comorbidities. Many patients with early-stage HCC do not receive curative-intent therapies. Stereotactic ablative body radiotherapy (SABR) has emerged as an effective, non-invasive HCC treatment option, however, randomized evidence for SABR in the first line setting is lacking. Methods Trans-Tasman Radiation Oncology Group (TROG) 21.07 SOCRATES-HCC is a phase II, prospective, randomised trial comparing SABR to other current standard of care therapies for patients with a solitary HCC ≤ 8 cm, ineligible for surgical resection or transplantation. The study is divided into 2 cohorts. Cohort 1 will compromise 118 patients with tumors ≤ 3 cm eligible for thermal ablation randomly assigned (1:1 ratio) to thermal ablation or SABR. Cohort 2 will comprise 100 patients with tumors > 3 cm up to 8 cm in size, or tumors ≤ 3 cm ineligible for thermal ablation, randomly assigned (1:1 ratio) to SABR or best other standard of care therapy including transarterial therapies. The primary objective is to determine whether SABR results in superior freedom from local progression (FFLP) at 2 years compared to thermal ablation in cohort 1 and compared to best standard of care therapy in cohort 2. Secondary endpoints include progression free survival, overall survival, adverse events, patient reported outcomes and health economic analyses. Discussion The SOCRATES-HCC study will provide the first randomized, multicentre evaluation of the efficacy, safety and cost effectiveness of SABR versus other standard of care therapies in the first line treatment of unresectable, early-stage HCC. It is a broad, multicentre collaboration between hepatology, interventional radiology and radiation oncology groups around Australia, coordinated by TROG Cancer Research. Trial registration anzctr.org.au, ACTRN12621001444875, registered 21 October 2021.

Abstract Background The high prevalence of osteoporosis has increased the economic burden on the health system globally. The burden of osteoporosis and its associated factors have not been adequately assessed in community settings in the Nepalese context thus far. Therefore, this study aimed to assess the prevalence of osteoporosis and its associated factors, lifestyle behaviors, and dietary calcium intake. Methods A community-based cross-sectional study was conducted among 395 people aged 50 years and older in the Madhesh Province of Nepal between July 2022 and August 2023. The Osteoporosis Self-assessment Tools for Asians (OSTA) index was used to measure osteoporosis. A structured questionnaire was used to collect sociodemographic information, anthropometric data, lifestyle behavior, daily dietary calcium intake, and frequency of calcium-rich food consumption. A food frequency questionnaire and 24-hour recall methods were used to assess dietary intake. The chi-square test, binary logistic regression and Mann‒Whitney U test were applied to measure the association between predictors and the outcome of interest. Results The prevalence of no risk, moderate risk and high risk of osteoporosis were 38.7%, 39%, and 22.3% respectively. The risk of osteoporosis was higher in females (aOR = 5.18, CI: 2.10-12.75, p

Aim: To commission and validate commercial deformable image registration (DIR) systems (SmartAdapt® and Velocity™) using task group 132 (TG-132) digital phantom datasets. Additionally, the study compares and verifies the DIR algorithms of the two systems. Materials and Methods: TG-132 digital phantoms were obtained from the American Association of Physicists in Medicine website and imported into SmartAdapt® and Velocity™ systems for commissioning and validation. The registration results were compared with known shifts using rigid registrations and deformable registrations. Virtual head and neck phantoms obtained online (DIR Evaluation Project) and some selected clinical data sets from the department were imported into the two DIR systems. For both of these datasets, DIR was carried out between the source and target images, and the contours were then propagated from the source to the target image data set. The dice similarity coefficient (DSC), mean distance to agreement (MDA), and Jacobian determinant measures were utilised to evaluate the registration results. Results: The recommended criteria for commissioning and validation of DIR system from TG-132 was error

Thermoplastics used to construct a variety of patient medical devices can become contaminated by harmful bacteria. We investigated whether two different Bacillus species recovered from patient radiation therapy thermoplastic masks could similarly contaminate thermoplastic material used to construct patient orthoses (splints). Bacillus bacteria form dormant spores, which have been shown to enhance its attachment to thermoplastics. Bacterial attachment and recovery were examined using an orthotic thermoplastic with an anti-stick coating being compared to uncoated material used in radiation therapy applications. Triplicate sample squares were seeded with a saline suspension of either B. cereus (MAB03F) or B. megaterium (DAB01F) containing a similar number of spores. Squares were subsequently sampled at 1 h, 1 week, 2 weeks, 4 weeks, and 8 weeks. The number of recovered bacteria was counted. Differences in material hydrophobicity were determined by water contact angle analysis. Both Bacillus species attached to each material within 1 h, and their spores were recovered at 8 weeks. However, a decreasing trend in adhesion, over time, was noted to the coated material with an opposite increasing trend in the uncoated material. Decreased Bacillus species spore adhesion to coated material with a lower hydrophobicity suggests a greater potential for spore transfer to patients wearing contaminated orthoses.

Background: Pneumonia is a ubiquitous health condition with severe outcomes. The advancement of ultrasonography techniques allows its application in evaluating pulmonary diseases, providing safer and accessible bedside therapeutic decisions compared to chest X-ray and chest computed tomography (CT) scan. Because of its aforementioned benefits, we aimed to confirm the diagnostic accuracy of lung ultrasound (LUS) for pneumonia in adults. Methods: A systematic literature search was performed of Medline, Cochrane and Crossref, independently by two authors. The selection of studies proceeded based on specific inclusion and exclusion criteria without restrictions to particular study designs, language or publication dates and was followed by data extraction. The gold standard reference in the included studies was chest X-ray/CT scan or both. Results: Twenty-nine (29) studies containing 6702 participants were included in our meta-analysis. Pooled sensitivity, specificity and PPV were 92% (95% CI: 91–93%), 94% (95% CI: 94 to 95%) and 93% (95% CI: 89 to 96%), respectively. Pooled positive and negative likelihood ratios were 16 (95% CI: 14 to 19) and 0.08 (95% CI: 0.07 to 0.09). The area under the ROC curve of LUS was 0. 9712. Conclusions: LUS has high diagnostic accuracy in adult pneumonia. Its contribution could form an optimistic clue in future updates considering this condition.

Abstract Background Alzheimer’s disease (AD) is a neurodegenerative disease characterized by Aβ plaques and neurofibrillary tangles. Chronic inflammation and synaptic dysfunction lead to disease progression and cognitive decline. Small extracellular vesicles (sEVs) are implicated in AD progression by facilitating the spread of pathological proteins and inflammatory cytokines. This study investigates synaptic dysfunction and neuroinflammation protein markers in plasma-derived sEVs (PsEVs), their association with Amyloid-β and tau pathologies, and their correlation with AD progression. Methods A total of 90 [AD = 35, mild cognitive impairment (MCI) = 25, and healthy age-matched controls (AMC) = 30] participants were recruited. PsEVs were isolated using a chemical precipitation method, and their morphology was characterized by transmission electron microscopy. Using nanoparticle tracking analysis, the size and concentration of PsEVs were determined. Antibody-based validation of PsEVs was done using CD63, CD81, TSG101, and L1CAM antibodies. Synaptic dysfunction and neuroinflammation were evaluated with synaptophysin, TNF-α, IL-1β, and GFAP antibodies. AD-specific markers, amyloid-β (1–42), and p-Tau were examined within PsEVs using Western blot and ELISA. Results Our findings reveal higher concentrations of PsEVs in AD and MCI compared to AMC (p

Abstract Background In the US, over 50% of suicide deaths are by firearm injury. Studies have found that limiting access to firearms, including storing them temporarily outside of the home or locking and unloading them securely at home, helps prevent suicide. Family members and other loved ones are in a unique position to encourage secure firearm storage. This paper describes the development of a workshop to empower loved ones of individuals at risk for suicide to discuss secure firearm storage in New York State. Methods Using a multistakeholder engagement framework, we partnered with New York State county-level suicide prevention coalitions, local firearms experts, and other stakeholders to develop a 90-min workshop addressing secure firearm storage for suicide prevention. Pilot workshops were co-facilitated by a suicide prevention coalition member and a local firearms expert. Feedback gathered via surveys from workshop attendees and interviews with workshop co-facilitators were used to revise workshop content and inform dissemination. Following pilot workshops, a 1-day training event was held for potential future facilitators, and survey data were collected to assess trainee experiences and interest in facilitating future workshops. Data analysis included rapid qualitative analysis of interviews and statistical analysis of survey responses about acceptability of workshop. Results Four pilot workshops included a total of 23 attendees. Pilot workshop attendees endorsed willingness and confidence to discuss secure firearm storage with a family member or loved one. The training event included 42 attendees, of which 26 indicated interest in facilitating a workshop within the next year. Co-facilitators agreed on several key themes, including the importance of having a “trusted messenger” deliver the firearms portion of the workshop, keeping the conversation focused on firearm safety for suicide prevention, and developing interventions that reflect firearm owning community’s culture. Conclusions Consistent with a public health approach to suicide prevention, this study leveraged a multistakeholder engagement framework to develop a community-based workshop empowering loved ones of individuals at risk for suicide to discuss secure firearm storage. The workshop will be disseminated across New York State. We noted positive and collaborative relationships across stakeholder groups, and willingness to facilitate the workshop among both suicide prevention and firearm stakeholders.

Abstract Parkinson’s Disease (PD) is a prevalent neurological condition characterized by motor and cognitive impairments, typically manifesting around the age of 50 and presenting symptoms such as gait difficulties and speech impairments. Although a cure remains elusive, symptom management through medication is possible. Timely detection is pivotal for effective disease management. In this study, we leverage Machine Learning (ML) and Deep Learning (DL) techniques, specifically K-Nearest Neighbor (KNN) and Feed-forward Neural Network (FNN) models, to differentiate between individuals with PD and healthy individuals based on voice signal characteristics. Our dataset, sourced from the University of California at Irvine (UCI), comprises 195 voice recordings collected from 31 patients. To optimize model performance, we employ various strategies including Synthetic Minority Over-sampling Technique (SMOTE) for addressing class imbalance, Feature Selection to identify the most relevant features, and hyperparameter tuning using RandomizedSearchCV. Our experimentation reveals that the FNN and KSVM models, trained on an 80–20 split of the dataset for training and testing respectively, yield the most promising results. The FNN model achieves an impressive overall accuracy of 99.11%, with 98.78% recall, 99.96% precision, and a 99.23% f1-score. Similarly, the KSVM model demonstrates strong performance with an overall accuracy of 95.89%, recall of 96.88%, precision of 98.71%, and an f1-score of 97.62%. Overall, our study showcases the efficacy of ML and DL techniques in accurately identifying PD from voice signals, underscoring the potential for these approaches to contribute significantly to early diagnosis and intervention strategies for Parkinson’s Disease.

Abstract Background Lysimachia ramosa (Wall. ex Duby) is a traditionally used medicinal plant in Meghalaya, a northeastern state of India. The people use the leaves of the plant to cure gastrointestinal worm infection. Kaempferol derivative, isolated from the leaves of the plant L. ramosa, was found to be the active anthelmintic compound in previous studies. The phytochemical present in the leaves causes alterations in the ultrastructure of the tegument of cestode, its glycogen content and tegumental enzymes. However, it has been found in the review of the literature that phytoproduct should be consumed in a limited dose during longtime treatment period to avoid any potential ill effects on the health of the consumers as many plant-based products are found to be toxic beyond a safe dose limit. Thereby, it becomes necessary to check the potential toxic effects of the active compound taking an animal model. Hence, the present study had been carried out to evaluate the toxicity of the active component on Wistar rats to find out the safe dose of the test compound for oral consumption through observations, if any, on chromosomal abnormalities, ultrastructural changes in bone marrow cells and apoptosis in liver and kidney. Results The result shows kaempferol derivative causes a significant rise in chromosomal abnormalities (2.83 ± 0.19%, 3.83 ± 0.11%) and a significant decline in mitotic indices (3.17 ± 0.02%, 3.10 ± 0.01%) upon treatment with 500 mg and 1000 mg/kg b.w. dosages. At this level, the number of micronucleated erythrocytes increases significantly in the animals (2.33 ± 0.33%, 3.15 ± 0.24%). Intercellular integrity and eosinophil in the bone marrow are observed to be deformed and damaged on treatment with 1000 mg compound/kg b.w. of animals. Apoptotic indices are seen to be increased significantly (3.12 ± 0.18%, 6.17 ± 0.17%) and (2.43 ± 0.13%, 4.17 ± 0.17%) for the liver and kidney, respectively, in the animals of higher-dose treatment groups. Conclusions The compound, kaempferol derivative in the present study, has been found to have cytotoxic and pro-apoptotic effects on the test animals beyond a certain dose, if consumed for longer period of time. Therefore, it can be concluded that kaempferol derivative extracted from Lysimachia ramosa should be tested for future trials on animals/humans at dose below 250 mg/kg body weight.

Pulse Detonation Engine has been a point of interest in the propulsion industry for some time and the interest has been rising due to its better output and results. But any system can perform its task efficiently based on the efficiency of its control system. In this paper we have presented a comparative study between multiple control systems- one based on Bluetooth technology, the other based on infrared sensor technology and one based on wired electrical system. For the wireless system, the signal received from either of the media is passed to the various sensors and systems connected through an Arduino board that further controls the solenoid valves and ignition system. Primarily, a control system circuit is developed using Arduino board and different sensors to connect the fuel supply and ignition system. In the next stage, Bluetooth sensors are connected using an android app and then an infrared sensor based system is integrated with the Arduino to control the engine and the performance of the two systems are compared. Whereas for wired system, every sub system is controlled through optical wires including the solenoid valves, the injection system and the sensors.

Abstract Background The risk of recurrent adverse birth outcomes has been reported worldwide, but there are limited estimates of these risks by social subgroups such as race and ethnicity in the United States. We assessed racial and ethnic disparities in the risk of recurrent adverse birth outcomes, including preterm birth, low birthweight, fetal growth restriction, small for gestational age, stillbirth, and neonatal mortality in the U.S. Methods We searched MEDLINE, CINAHL Complete, Web of Science, and Scopus from the date of inception to April 5, 2022. We identified 3,540 articles for a title and abstract review, of which 80 were selected for full-text review. Studies were included if they focused on the recurrence of any of the six outcomes listed in the objectives. Study quality was assessed using the NIH Study Quality Assessment Tool. Heterogeneity across studies was too large for meta-analysis, but race and ethnicity-stratified estimates and tests for homogeneity results were reported. Results Six studies on recurrent preterm birth and small for gestational age were included. Pooled comparisons showed a higher risk of recurrent preterm birth and small for gestational age for all women. Stratified race comparisons showed a higher but heterogeneous risk of recurrence of preterm birth across Black and White women. Relative risks of recurrent preterm birth ranged from 2.02 [1.94, 2.11] to 2.86 [2.40, 3.39] for Black women and from 3.23 [3.07, 3.39] to 3.92 [3.35, 4.59] for White women. The evidence was weak for race and ethnicity stratification for Hispanic and Asian women for both outcomes. Conclusions Disparities exist in the recurrence of preterm birth, and race/ethnicity-concordant comparisons suggest race is an effect modifier for recurrent preterm birth for Black and White women. Due to the small number of studies, no conclusions could be made for small for gestational age or Hispanic and Asian groups. The results pose new research areas to better understand race-based differences in recurrent adverse birth outcomes.

The confinement of electrons in gold nanoparticles results in Surface Plasmon Resonance (SPR), which is characterized by electric field enhancement in the vicinity of these nanoparticles. This property has been extensively studied and applied in various fields. In our research, we conduct a detailed investigation of plasmonic coupling in spherical gold nanoparticles. Specifically, we use the Discrete Dipole Approximation (DDA) method implemented in DDSCAT to simulate the coupling of electric fields in a doublet of nanoparticles as a function of the distance between them. Our simulations show that the coupling of SPR between two nanoparticles occurs up to a separation of 12 nm. Moreover, we extend our simulations to study the coupling of nanoparticles in linear chains consisting of up to five nanoparticles and in clustered forms. Our results indicate that the SPR coupling in a linear chain occurs, and as the number of nanoparticles increases, the field enhancement also increases. However, we observe that this effect saturates after four nanoparticles in a line. Our study provides insights into the plasmonic coupling in gold nanoparticles, which can aid in the design and optimization of plasmonic devices for various applications.

Scour around bridges present a severe threat to the stability of railroad and highway bridges. Scour needs to be monitored to prevent the bridges from becoming damaged. This research studies the feasibility of using green laser for monitoring the scour around candidate railroad and highway bridges. The laboratory experiments that provided the basis for using green laser for underwater mapping are also discussed. The results of the laboratory and field experiments demonstrate the feasibility of using green laser for underwater infrastructure monitoring with limitations on the turbidity of water that affects the penetrability of the laser. This method can be used for scour monitoring around offshore structures in shallow water as well as corrosion monitoring of bridges.

Esotropia, which is the medial deviation of one or both eyes, is a rare withdrawal symptom that has been associated with opiate addiction. We report a case of a 36-year-old female patient who developed acute-onset esotropia and diplopia after self-admission to a psychiatric facility for fentanyl addiction treatment and a systematic review of this rare presentation. A search of four databases (PubMed, Scopus, Embase, and Google Scholar) was conducted as of January 2024. We found 15 documented cases of opiate withdrawal-associated esotropia, with an average age of 27.2 years and an average time between last use and symptom onset of 5.61 days. The most common symptom was diplopia, especially binocular diplopia, and the majority of cases resolved without pharmacologic intervention. Considering the current opioid crisis, our systematic review and case report add valuable insight into the less-explored neurological and ophthalmological consequences of opiate withdrawal, a condition that should always be considered in cases of acute or chronic onset esotropia.

Introduction: Arterial thromboembolism is a major cause of morbidity and mortality in Coronavirus Disease 2019 (COVID-19) patients in both General Inpatient ward and Intensive Care Unit (ICU) settings. As COVID-19 is associated with coagulopathy or vasculopathy, it is necessary to investigate whether the peripheral vessels were also affected due to COVID-19-related thrombosis. Computed Tomography Angiography (CTA) is a quick, accurate, non invasive, and reliable method for assessing the location, extent and severity of arterial thrombosis. Aim: To evaluate the association of acute peripheral arterial thrombosis in patients with COVID-19 infection and assess the differences in peripheral extremity clot burden using peripheral limb CTA. Materials and Methods: A retrospective observational study was conducted in the Department of Radiology, Topiwala National Medical College and B.Y.L. Nair Charitable. Hospital, Mumbai, Maharashtra, India, from April 2020 to April 2021. A total of 70 patients with medical records of acute limb ischaemia, consisting of 35 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection-positive patients and 35 SARS-CoV-2 negative patients, who underwent peripheral CTA were included in the present study. For calculating arterial clot severity and extent in the peripheral extremities, three different systems were used. Age, sex, symptoms, co-morbidities, and CT thrombus burden score were analysed in both groups. The association between variables was analysed using the Chi-square test. Results: The age range of patients presenting with acute limb ischaemia was 24-74 years (mean age=50 years). Claudication, pain and redness had a significant association with COVID-19 positive patients (p-value

Job satisfaction significantly impacts teachers’ overall well-being and mental health. Research reveals a strong connection between employment status and mental health, with teaching being a particularly stressful profession. The COVID-19 pandemic exacerbated these challenges, with the shift to online education and limited support causing heightened stress, anxiety, and depression. This study analyses scientific literature exploring the link between job satisfaction and mental health (depression, stress, and anxiety) in teachers. By examining relevant articles in major databases like Web of Science, PSYNDEX, PsycINFO, MEDLINE, EMBASE, and Google Scholar, the research identifies numerous sociodemographic and institutional factors contributing to teachers’ mental health struggles, including workload, teaching experience, job satisfaction, gender, and the nature of online education. The findings highlight the urgent need for educational policymakers to develop policies prioritizing teacher well-being, especially during times of crisis. This involves addressing factors affecting job satisfaction and implementing strategies to promote mental health support for educators.

Abstract Background Takotsubo cardiomyopathy is a novel form of rapidly reversible heart failure occurring secondary to a stressor that mimics an acute coronary event. The underlying etiology of the stressor is highly variable and can include medical procedures. Pacemaker insertion is an infrequent cause of Takotsubo cardiomyopathy. Case presentation An 86-year-old Caucasian woman underwent an uncomplicated pacemaker insertion for symptomatic complete heart block in the background of slow atrial fibrillation. A transient episode of polymorphic ventricular tachycardia was noted on day 1 following the procedure; however, her pacemaker was checked and, as she remained stable, she was discharged home. She presented again 5 days later with symptomatic heart failure. Chest X-ray confirmed pulmonary edema. Echocardiography confirmed new onset severe left ventricle dysfunction. Pacemaker checks were normal and lead placement was confirmed. Though her troponin I was elevated, her coronary angiogram was normal. Contrast enhanced echocardiography suggested apical ballooning favoring Takotsubo cardiomyopathy. She was treated for heart failure and made a good recovery. Her follow-up echocardiography a month later showed significant improvement in left ventricle function. Conclusions Takotsubo cardiomyopathy is mediated by a neuro-cardiogenic mechanism due to hypothalamic–pituitary–adrenal axis activation. It generally has a good prognosis. Complications though uncommon, can occur and include arrhythmias. Pacemaker insertion as a precipitant stressor is an infrequent cause of Takotsubo cardiomyopathy. As pacemaker insertions are more frequent in the elderly age group, this phenomenon should be recognized as a potential complication.

Abstract Growing urban population and the distinct strategies to accommodate them lead to diverse urban development patterns worldwide. While local evidence suggests the presence of urban signatures in rainfall anomalies, there is limited understanding of how rainfall responds to divergent urban development patterns worldwide. Here we unveil a divergence in the exposure to extreme rainfall for 1790 inland cities globally, attributable to their respective urban development patterns. Cities that experience compact development tend to witness larger increases in extreme rainfall frequency over downtown than their rural surroundings, while the anomalies in extreme rainfall frequency diminish for cities with dispersed development. Convection-permitting simulations further suggest compact urban footprints lead to more pronounced urban-rural thermal contrasts and aerodynamic disturbances. This is directly responsible for the divergent rainfall responses to urban development patterns. Our analyses offer significant insights pertaining to the priorities and potential of city-level efforts to mitigate the emerging climate-related hazards, particularly for countries experiencing rapid urbanization.

Abstract Background Food insecurity (FI) is associated with negative health outcomes and increased healthcare utilization. Rural populations face increased rates of FI and encounter additional barriers to achieving food security. We sought to identify barriers and facilitators to screening and interventions for FI in rural primary care practices. Methods We conducted a mixed-methods study using surveys and semi-structured interviews of providers and staff members from rural primary care practices in northern New England. Survey data were analyzed descriptively, and thematic analysis was used to identify salient interview themes. Results Participants from 24 rural practices completed the survey, and 13 subsequently completed an interview. Most survey respondents (54%) reported their practices systematically screen for FI and 71% reported food needs were “very important” for their patients and communities. Time and resource constraints were the most frequently cited barriers to screening for and addressing FI in practices based on survey results. Interview themes were categorized by screening and intervention procedures, community factors, patient factors, external factors, practice factors, process and implementation factors, and impact of FI screening and interventions. Time and resource constraints were a major theme in interviews, and factors attributed to rural practice settings included geographically large service areas, stigma from loss of privacy in small communities, and availability of food resources through farming. Conclusions Rural primary care practices placed a high value on addressing food needs but faced a variety of barriers to implementing and sustaining FI screening and interventions. Strategies that utilize practice strengths and address time and resource constraints, stigma, and large service areas could promote the adoption of novel interventions to address FI.

Background: Lip and oral cavity cancers are the second most common cancers in India and Sri Lanka. Hence, there is a need to enhance partnership among countries and institutions to develop the capacity to ameliorate the huge burden of oral cancer in the SEAR region. Methods: An observership model was field tested with the inter-country collaboration from India and Sri Lanka in December 2018 on seven Sri Lankan dentists from National Cancer Control Program participated in the observership model conducted in India. Results: This model covered all the components of oral cancer prevention including awareness on oral cancer and oral potentially malignant disorder management training. Conclusions: This model emphasized the significance of inter-country handholding and strengthening of the existing cancer prevention activities.

Background: Diabetic neuropathies, affecting over 50% of diabetes patients, present varied forms of polyneuropathy impacting somatic and autonomic nerves. Clinical assessments, laboratory findings, and nerve conduction studies (NCSs) aid in precise diagnosis, while recent technological advances highlight ultrasonography (US) as a promising, cost-effective diagnostic tool. Aims and Objectives: This study aims to assess the efficacy of US in early polyneuropathy diagnosis in type II diabetes, exploring its potential as an alternative to NCS. Materials and Methods: In this prospective observational study, we enrolled 30 adult patients with type II non-controlled diabetes and 30 age-matched controls, comprising 15 controlled diabetic patients and 15 normal individuals. The comprehensive assessments encompassed history-taking for diabetes duration, hypertension, and diabetic complications, along with clinical examinations and investigations involving nerve electrophysiology and US on one upper limb based on patient complaints. Results: Significant increases in the cross-sectional area (CSA) of the median nerve were observed in diabetic peripheral neuropathy groups compared to controls, with a P