Search

We develop new rate-type constitutive relations on a set of orthonormal tensor basis and the corresponding set of Lode invariants, which require only 9 material parameters to predict the mechanical response of the human brain tissue. The mode-dependent response of the tissue is captured by invoking the Hill-stable elastic potential of Prasad and Kannan (2020) and constructing a new form for the rate of dissipation, thus introducing the mode-of-deformation dependent modulus terms and the mode-of-deformation-rate dependent viscosities into the rate-type thermodynamic framework of Rajagopal and Srinivasa (2000). Through the analysis-driven construction of the rate of dissipation, we incorporate maximum change in the viscosities with respect to the mode-of-deformation rates and limit the number of material parameters. Our model satisfactorily predicts the complicated load-unload cycles (pre-conditioned and conditioned) and the stress relaxation data under multiple modes of deformation and multiple rates for the Corona Radiata (CR) region of the brain tissue. It also captures the tension–compression asymmetry in the response and the higher relaxation time in compression loading than in shear loading.

This study addresses the gap in the comprehensive literature on the intersection of readiness technology and changes in the manufacturing sector. This study employs a hybrid review (bibliometric analysis and conceptual framework) to offer a panoramic overview of the field. We scrutinised 77 publications from peer-reviewed journals, from 2005 to 2023, using methodological lenses such as keyword co-occurrence networks and thematic maps. The review reveals the major contributors (publication trends, themes, and topics) to integrating 3D printing, additive manufacturing, Tech Competition and Lifecycle Assessment in Manufacturing, and Smart Manufacturing Strategies. Based on these insights, we advocate a focused research agenda to expand scholarly contributions to this field. We introduce a framework that offers a theoretically robust tool for scholars and practitioners studying the impact of technology readiness in the manufacturing sector. Consequently, this study not only distils the existing literature, but also sets the stage for future research. This study places significant emphasis on the implementation of technological solutions as a means to improve production operations. Additionally, this research emphasises the significance of ensuring that investment strategies follow the organisation’s technological preparedness. An additional crucial implication concerns the cybersecurity protocols. This is consistent with the research’s emphasis on investigating cybersecurity concerns in the manufacturing industry.

Abstract A bulk of graphene oxide nanosheets was prepared using the modified Hummers’ method. Rare earth materials, such as europium nitrate pentahydrate compounds, are added to graphene oxide in varying percentages to study the dielectric behavior of graphene oxide. The morphological analysis revealed a nanosheet-like pattern in pure graphene oxide, while for europium-doped graphene oxide, a cluster of europium atoms seemed trapped between layers of graphene. The electron diffraction rings are indexed using multiphase analysis, and the hexagonal carbon structure remains unaltered in the doped samples. Electrochemical impedance spectroscopy (EIS) studies were conducted on pure and Europium-doped graphene oxide. The frequency variations with respect to the real and imaginary parts of the dielectric constants are studied for both the composite material and pure graphene oxide. Additionally, photoluminescence (PL) studies were performed. The emission spectrum of Eu3+-doped graphene oxide was used to study the Judd–Ofelt parameters, and the allowed transition probability was determined. Graphical Abstract

The clinicopathologic conditions of the long head of the biceps tendon vary, encompassing tendinitis, peritendinous inflammation, hypertrophy, and partial or complete tears. These symptoms are typically linked with SLAP tears and instability of the long head of the biceps tendon, often resulting in partial displacement or complete dislocation. The choice between tenotomy and tenodesis depends on varied factors. The choice of suprapectoral or subpectoral tenodesis is a difficult decision and should be weighed on a tailored basis. Our approach to suprapectoral tenodesis presents a blend of factors, maintaining uniform tension in the bicipital groove, limiting the number of portals for arthroscopy, re-tensioning the tendon after initial anchor placement, and preserving the inherent length of the functional biceps tendon without compromising its quality.

Allergic rhinitis (AR) is a common disorder caused by immune system dysregulation. The present contribution describes a randomized, double-blind, placebo-controlled comparative evaluation of the influence of a unique food-grade co-delivery form of curcumin and ashwagandha extracts (CQAB) in comparison to a bioavailable curcumin formulation (CGM) and placebo employing healthy participants, (n = 96), characterized with mild AR. The subjective measurements (TNSS, BIS and POMS-SF questionnaires) clearly demonstrated the efficacy of CQAB over CGM in the alleviation of AR symptoms and hence the quality of life. Further, CQAB administration also showed significant modulation of biochemical parameters (significant decrease in Th2 cytokines, pro-inflammatory cytokines, CD4+/CD8+ ratio and IgE, and a significant increase in Th1 cytokines, anti-inflammatory cytokine IL-10 as well as for the immunoglobulins IgG, IgM, and IgA) in support of its improved immune-balancing effect, compared to CGM. Both CQAB and CGM were well tolerated without any adverse events.

Introduction Thailand was one of the first low- and middle-income countries to publicly fund seasonal influenza vaccines, but the lack of predictability in the timing of epidemics and difficulty in predicting the dominant influenza subtypes present a challenge for existing vaccines. Next-generation influenza vaccines (NGIVs) are being developed with the dual aims of broadening the strain coverage and conferring longer-lasting immunity. However, there are no economic evaluations of NGIVs in Thailand.Methods We estimated the health impact and cost-effectiveness of NGIVs in Thailand between 2005 and 2009 using a combined epidemiological and economic model. We fitted the model to data on laboratory-confirmed influenza cases and then simulated the number of influenza infections, symptomatic cases, hospitalisations and deaths under different vaccination scenarios based on WHO-preferred product characteristics for NGIVs. We used previous estimates of costs and disability adjusted life years (DALYs) for influenza health outcomes to estimate incremental net monetary benefit, vaccine threshold prices and budget impact.Results With the current vaccine programme, there were an estimated 61 million influenza infections. Increasing coverage to 50% using improved vaccines reduced infections to between 23 and 57 million, and with universal vaccines to between 21 and 49 million, depending on the age groups targeted. Depending on the comparator, threshold prices for NGIVs ranged from US$2.80 to US$12.90 per dose for minimally improved vaccines and US$24.60 to US$69.90 for universal vaccines.Conclusion Influenza immunisation programmes using NGIVs are anticipated to provide considerable health benefits and be cost-effective in Thailand. However, although NGIVs might even be cost-saving in the long run, there could be significant budget implications for the Thai government even if the vaccines can be procured at a substantial discount to the maximum threshold price.

Poaching is morally wrong and has ecological consequences. Recent times have witnessed a large number of horrific poaching cases happening in India. Asiatic Lion, Bengal Tiger, Kashmir Red Stag, Blackbuck, etc., are a few species in India that have already been driven to endangerment. This paper proposes a UAS-based solution to help forest authorities prevent poaching activity. A wireless sensor network in which each node consists of a Peripheral Interface Controller (PIC) microcontroller, acoustic sensor, and Pyroelectric InfraRed (PIR) sensor is set up in wildlife hotspots for detecting intruders. The drone is deployed to the location of the triggered node. Using a robust two-fold collision avoidance system, the drone travels autonomously while avoiding obstacles in the dense forest cover. The UAS is programmed to detect poachers and animals using a custom-trained You Look Only Once (YOLO) model, and if poachers are detected, an alert is raised to the authorities. Simulations are done to validate navigation, collision avoidance, and poacher detection in the forest landscape. Proof of Concept of the proposed method was done on a hexacopter, which uses a Raspberry Pi 4B as the onboard companion PC for autonomous flight. The YOLO-based detection model’s ability to accurately identify items across various categories is reflected in its mean Average Precision (mAP) score of 0.914. In contrast, its F1 score of 0.88 highlights its ability to balance precision and recall. The prototype designed to illustrate the proposed algorithms was powered by a 2200 mAh battery, allowing a flight duration of around 7 minutes.

Lipid dyshomeostasis has been implicated in a variety of diseases ranging from obesity to neurodegenerative disorders such as Neurodegeneration with Brain Iron Accumulation (NBIA). Here, we uncover the physiological role of Nazo, the Drosophila melanogaster homolog of the NBIA-mutated protein-c19orf12, whose function has been elusive. Ablation of Drosophila c19orf12 homologs leads to dysregulation of multiple lipid metabolism genes. nazo mutants exhibit markedly reduced gut lipid droplet and whole-body triglyceride contents. Consequently, they are sensitive to starvation and oxidative stress. Nazo is required for maintaining normal levels of Perilipin-2, an inhibitor of the lipase-Brummer. Concurrent knockdown of Brummer or overexpression of Perilipin-2 rescues the nazo phenotype, suggesting that this defect, at least in part, may arise from diminished Perilipin-2 on lipid droplets leading to aberrant Brummer-mediated lipolysis. Our findings potentially provide novel insights into the role of c19orf12 as a possible link between lipid dyshomeostasis and neurodegeneration, particularly in the context of NBIA.

This study examines the use of layer by layer (LbL) coated coir (CC) systems to eliminate bacterial pathogens and emerging contaminants from water. Bacterial and chemical contaminants found in river water pose risks to human health and aquatic ecosystems. The study initially compared the effectiveness of CC to uncoated coir (UC) treatment in removing bacterial pathogens. CC treatment demonstrated superior removal efficacy compared to UC treatment. For samples with a bacterial concentration of 3.6×103 CFU/mL, CC treatment achieved a removal rate exceeding 90% and viability losses of over 60% for E. coli and over 90% for S. aureus. As the number of bilayers increased, the regrowth potential of bacteria decreased, leading to mortality rates of ∼ 97% for S. aureus and 65% for E. coli respectively. Furthermore, the superiority of CC over UC in removing emerging contaminants were demonstrated. CC attained removal efficiencies of over 99% for isoniazid, 95.08% for lidocaine, 95.21% for mefenamic acid, and 87.73% for caffeine. The reproducibility of the CC system was tested and showed stable removal efficiency over multiple cycles. These findings highlight the potential of CC systems as effective eco-friendly alternatives for water purification to remove bacterial pathogens and emerging contaminants.

Abstract Two lanthanide metal–organic frameworks [Ln-MOFs, Ln = Eu(III), Tb(III)] composed of oxalic acid and Ln building units were hydrothermally synthesized and fully characterized by powder X-ray diffraction, Fourier-transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscope, and energy-dispersive X-ray spectroscopy. Furthermore, their magnetic susceptibility measurements were obtained using SQUID based vibrating sample magnetometer (MPMS 3, Quantum Design). Both Ln-MOFs exhibited highly efficient luminescent property. Solid-state photoluminescence (PL) measurements revealed phosphorescence emission bands of Eu-MOF and Tb-MOF centered at 618 nm (red emission) and 550 nm (green emission) upon excitation at 396 nm and 285 nm, respectively. Eu-MOF and Tb-MOF displayed a phosphorescence quantum yield of 53% and 40%, respectively. Time-resolved PL analyses showed very long lifetime values, at 600 and 1065 ± 1 µs for Eu-MOF and Tb-MOF, respectively. Calculations performed by density functional theory indicated a charge transfer form metal centres to the ligand which was in good agreement with the experimental studies. Therefore, this new mode of highly photoluminescent MOF materials is studied for the first time which paves the way for better understanding of these systems for potential applications.

Objectives The idiopathic group is a significant cause of chronic kidney disease (CKD) in developing countries. Literature available on ocular surface changes has predominantly been reported in patients undergoing hemodialysis. Little is known about the changes in patients undergoing peritoneal dialysis. The present study aimed to identify ocular surface changes in an idiopathic group of CKD undergoing dialysis. Aim To compare tear film disorders and the severity of ocular surface changes (goblet cell density, squamous metaplasia, and corneoconjunctival calcification) in patients of idiopathic etiology with CKD undergoing hemodialysis and peritoneal dialysis. This is an analytical study. Materials and Methods Asymptomatic adult patients of idiopathic CKD, on treatment with dialysis underwent comprehensive ophthalmic examination, including best-corrected visual acuity, slit-lamp examination, and a dilated fundus examination. Dry eye assessment was done by ocular surface staining score, Schirmer test, and tear breakup time (TBUT). Conjunctival impression cytology was studied to assess changes on ocular surface. Chest X-rays for aortic calcification were reviewed and data analyzed. Results Both eyes of 76 patients of hemodialysis and 32 patients of peritoneal dialysis were studied. Ocular surface staining (OSS) scores were low. Impression cytology showed a drop in goblet cell density, presence of squamous metaplasia, and conjunctival keratinization significantly more in the hemodialysis group. No correlation was seen between the presence of conjunctival calcification and aortic calcification. Conclusion The hemodialysis group had mild subclinical dry eye but keratinization of conjunctiva was seen. Similarly, advanced squamous metaplasia was seen in the peritoneal dialysis group. These changes were positively correlated to decrease in goblet cell density.

Abstract Background Introducing radiological anatomy in the preclinical curriculum can increase the understanding of Anatomy. Regardless of the integration when teaching anatomy, it is essential to maintain oversight as to what and how much is being taught. In addition, the knowledge requirements for preclinical students should be considered. The purpose of this kind of integration is that the student should be able to apply the knowledge which can help them better understand anatomy and not to make the course more challenging. This study aimed to understand whether adding radiological images would increase the difficulty level of the questions. Methods We introduced radiological images, including X Rays, CT scans and MRIs, when teaching anatomy in the preclinical curriculum. A class of 99 students were tested using A-type MCQs (n = 84). All 84 questions were categorized on whether they were case-based with or without a radiological image. The item analysis of both groups of test questions was then compared based on their difficulty and discrimination index. A qualitative student perception regarding the inclusion of radiological images in anatomy was also measured using a questionnaire with a 5-point Likert scale. Results The results showed that the performance level of the students was similar when comparing the test questions in both groups. The item analysis of the MCQs in the two groups revealed that by integrating radiological images when teaching anatomy, the various parameters in both groups of test questions were in the same range. More than 80% of the students felt that radiological images facilitate the achievement of learning outcomes and help to apply their knowledge in clinical contexts. The study's findings reported that the rate of satisfaction by including radiological images when teaching anatomy is high. Conclusion Recognition and interpretation of images are essential in an undergraduate medical program. Students found it helpful when radiological images were introduced to them when teaching anatomy. Since the students' performance in summative exams in both groups of questions was in the same range, the findings also point out that adding radiological images when teaching anatomy does not increase the difficulty of the subject.

Jhancy Malay,1 Salah Eldin Kassab,2,3 Tarig Hakim Merghani,4 Ramya Rathan,5 Anusha Sreejith6 1Department of Pediatrics, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 2Department of Medical Education, Gulf Medical University, Ajman, United Arab Emirates; 3Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 4Department of Physiology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 5Department of Anatomy, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates; 6Department of Demography, College of Medicine, Gulf Medical University, Ajman, United Arab EmiratesCorrespondence: Jhancy Malay, Department of Pediatrics, RAK College of Medical Sciences, RAK Medical and Health Sciences University, PO Box 11172, Ras Al Khaimah, United Arab Emirates, Tel +971 72043000, Fax +971 7 226 9997, Email jhancy@rakmhsu.ac.aeIntroduction: An unprecedented disruption in medical education worldwide was caused due to the Covid 19 pandemic. Online teaching has become one of the primary forms of education. In this paper, we aimed to understand the faculty and students’ perceptions about the teaching styles adopted by the faculty during online large group teaching from two universities in the United Arab Emirates.Patients and Methods: This is a cross-sectional opinion survey-based study. A pre-validated teaching style inventory in higher education (TSIHE) questionnaire was emailed to the students and faculty involved in large group online learning and teaching activities during the lock-down period of the COVID 19 pandemic from two different medical Universities in the United Arab Emirates. A total of 423 students and 57 faculty participated in the study. Descriptive and Inferential statistics were used to analyze the data.Results: There was a significant difference between the faculty and students on the perception of faculty online teaching styles. The difference was significant in teacher-student interaction and teacher structuring styles. In contrast, faculty and students’ perceptions were comparable for decision-making negotiation and behavioral control teaching styles.Conclusion: The study found that there was a significant perception differences between the faculty and students on the faculty teaching style during online large group teaching. Importantly, faculty perceived that they were more emotionally attached and more flexible in teacher-student interaction and teaching structuring during online teaching than the student perceived.Keywords: COVID 19, medical education, online large group teaching, medical students, faculty perception

The advent of technologies has made allogenic transplantation a potential curative therapy for end-stage renal diseases, but the episodes of rejection still remain as one of the challenges in the post-transplant scenario. In the recent years, several human and animal studies have elucidated that gut microbial dysbiosis is closely linked with allogenic transplantation and post-transplant complications. But most of the studies focused on the use of high through-put sequencing technologies to analyze gut microbiota despite of its high cost, analysis and time constraints. Hence, in this work we aimed to study the impact of the two dominant gut phyla Firmicutes and Bacteroidetes on 38 renal transplant recipients, before and after transplantation and to find its association with allograft rejection. Significant changes (p

Background Postpancreatectomy hemorrhage (PPH) and Hemosuccus Pancreaticus (HP) may present with slow but significant intraluminal bleed which may not be evident on imaging. We evaluated the efficacy of empirical segmental-angioembolization of splenic artery in intraluminal PPH and HP. Result This is a cross-sectional study done by analyzing all consecutive patients with PPH and HP who underwent empirical coil embolization of splenic artery. There were total of 137 pancreaticoduodenectomies (PD), 68 distal pancreatectomies (DP), 11 patients with median pancreatectomies (MP) and 134 admissions for acute pancreatitis and exacerbation of chronic pancreatitis during the study period. Eleven (5.1%) patients had PPH, of which two were managed surgically. Among nine patients, 4/9 (44.4%) with pseudoaneurysm on computed tomography angiography (CTA) were excluded. Among pancreatitis, 7 (5.2%) had HP, and 5/7 (71.4%) patients with pseudoaneurysm on CTA were excluded. Hence, seven patients, PPH—5 and HP—2, were included. Both HP patients were managed successfully with empirical segmental coil embolization of splenic artery. Among PPH, one patient required laparotomy for failed embolization. Overall, 6/7 (85.7%) had successful coil embolization. No reintervention, continued bleed, or blood transfusions were required postprocedure, and no splenic infarct or abscess was seen in any of the seven patients postembolization. The 72-hour rebleed rate was 1/7 (14.3%), which was managed surgically. Conclusion Empirical segmental coil embolization of splenic artery in intraluminal pancreatic bleed holds promise as a salvage life-saving procedure even when no blush or pseudoaneurysm is evident.

Abstract Soybeans play a key role in global food security. U.S. soybean yields, which comprise $$32\%$$ 32 % of the total soybeans planted in the world, continue to experience unprecedented grain loss due to the soybean cyst nematode (SCN) plant pathogen. SCN remains one of the primary disruptive pests despite the existence of advanced management techniques such as crop rotation and SCN-resistant varieties. SCN detection is a key step in managing this disease; however, early detection is challenging because soybeans do not show any above ground symptoms unless they are significantly damaged. Direct soil sampling remains the most common method for SCN detection, however, this method has several problems. For example, the threshold damage methods—adopted by most of the laboratories to make recommendations—is not reliable as it does not consider soil pH, N, P, and K values and relies solely on the egg count instead of assessment of the root infection. To overcome the challenges of manual soil sampling methods, deep learning and hyperspectral imaging are important current topics in precision agriculture for plant disease detection and have been proposed as cost-effective and efficient detection methods that can work at scale. We have reviewed more than 150 research papers focusing on soybean cyst nematodes with an emphasis on deep learning techniques for detection and management. First: we describe soybean vegetation and reproduction stages, SCN life cycles, and factors influencing this disease. Second: we highlight the impact of SCN on soybean yield loss and the challenges associated with its detection. Third: we describe direct sampling methods in which the soil samples are procured and analyzed to evaluate SCN egg counts. Fourth: we highlight the advantages and limitations of these direct methods, then review computer vision- and remote sensing-based detection methods: data collection using ground, aerial, and satellite approaches followed by a review of machine learning methods for image analysis-based soybean cyst nematode detection. We highlight the evaluation approaches and the advantages of overall detection workflow in high-performance and big data environments. Lastly, we discuss various management approaches, such as crop rotation, fertilization, SCN resistant varieties such as PI 88788, and SCN’s increasing resistance to these strategies. We review machine learning approaches for soybean crop yield forecasting as well as the influence of pesticides, herbicides, and fertilizers on SCN infestation reduction. We provide recommendations for soybean research using deep learning and hyperspectral imaging to accommodate the lack of the ground truth data and training and testing methodologies, such as data augmentation and transfer learning, to achieve a high level of detection accuracy while keeping costs as low as possible.

Gold is a traditional favorite investment avenue for investors all over the globe, particularly during the crisis period. Irrespective of the nature of the crisis, investors are allocating their funds to different gold-backed assets. This paper uses various globally traded gold-backed assets to identify its role and market linkages during the Covid 19 pandemic. Daily prices of assets from March 2020 to January 2022 were employed. DCC GARCH model is used to ascertain time-varying correlations and quantile regression was employed to examine the relationship between assets in different quantiles. Based on the analysis, safe haven property of all the assets is revealed and it is associated with the severity of the stock market crash as specified by the quantiles. Moreover, double exposure of gold mining stock results in different flights to quality. Co-movement of gold bullion, gold futures, and gold volatility index is visible during this crisis. Gold Exchange Traded Funds and gold-backed cryptocurrency offer diversification by decoupling with gold bullion in the portfolio. The paper highlights the importance of the choice of gold-backed assets along with gold bullion in the investment portfolio based on its role and market linkages.

Abstract The present study analyzes the impact of the Southern Ocean (SO) sea ice concentration on the north Indian Ocean (NIO) wave fields through swells using 6 years (2016–2021) of WAVEWATCH III (WWIII) simulations. We did two experimental runs of WWIII, one with sea ice concentration and winds as the forcing (W3 with_ice ) and the second run with only wind forcing (W3 no_ice ). Analysis shows the impact of the SO sea ice concentration on northward swell peaks in September–November, coinciding with the maximum sea ice extent in the Antarctic region of the Indian Ocean. W3 no_ice simulations are biased more by ~ 60% and ~ 37% in significant wave height and period, respectively, against W3 with_ice when compared with NIO mooring data. W3 no_ice simulates low-frequency swells and travels fast towards NIO, with implications for operational oceanography. We have shown that the forecasts of the timing of high swell events along NIO coasts can be erroneous by ~ 12 h if the SO sea ice concentration is not included in the model. Further, W3 no_ice could potentially produce false swell alerts along southeastern Australian coasts. In summary, our study highlights the importance of the SO sea ice concentration inclusion in the wave models to accurately simulate NIO waves.

Highlight A high resolution mean surface velocity field is developed. Contrasting circulation changes are found during positive and negative IOD events. Mesoscale eddy activity is considerably influencing the Chlorophyll distribution.

Abstract T.M. Anoop Background The role of serum free light chain (FLC) as a prognostic biomarker in lymphoproliferative diseases is being increasingly studied. In this study we present the 5-year survival outcome for patients with aggressive B-cell non-Hodgkin's lymphoma (NHL) and their relation to FLC and other known prognostic markers. Materials and Methods This is a prospective study conducted in patients diagnosed with aggressive B-cell NHL. Serum FLC level and ratio were estimated prior to initiation of treatment. Results A total of 100 patients were included in the study from December 2013 to December 2015 with a median age of 53 years. Thirty-eight patients (38%) had elevated FLC level of which 26% were polyclonal and 12% were monoclonal elevations. Abnormal FLC ratio was noted in 12% patients. Median follow-up duration of the study was 75 months. Five-year relapse-free survival (RFS) for the study population was 54.4%. Five-year RFS was 64.1% for early stage and 48.2% for advanced stage diseases (p = 0.05). The RFS was significantly better in age less than 60 years (59.5% vs 43.8%, p

Peripheral artery disease is a prevalent illness affecting more than 200 million people worldwide. A commonly used technique to manage the condition has been open endarterectomy. However, in recent times, a shift towards minimally invasive techniques has resulted in endovascular intervention as a popular alternative. This review aims to assess the safety and efficacy of endovascular intervention when compared with endarterectomy. A systematic review of the articles published in PubMed, Ovid, Embase, and Scopus within the last 10 years was conducted. The PRISMA guidelines were adhered to, and the Newcastle-Ottawa and NICE quality assessment scales were used. A meta-analysis of proportions was performed using the RStudio software (RStudio Team (2021). RStudio: Integrated Development Environment for R, PBC, Boston, MA, USA). Twenty-six studies were included, with a total of 7126 patients (endovascular, 2496; endarterectomy, 4630). Technical success was greater for endarterectomy than endovascular intervention with an odds ratio of 0.38; 95% CI [0.27–0.54]. In terms of safety as well endovascular intervention was better than endarterectomy with an odds ratio of 0.22; 95% CI [0.15 to 0.31] for wound infection. Endovascular intervention is a safe and effective procedure; however, it cannot be considered superior to endarterectomy.

During the period of extreme financial turmoil, investors will include hedge and safe- haven assets in their portfolios. The present study looked at the dynamic link between gold return and the world stock return during crises. The study examined the conditional correlation between world stock and gold return. It investigated the usefulness of gold as a safe haven for stocks in the bear markets from January 2001 to June 2021 using daily MSCI stock index and gold price data. The crisis period is defined as the bear stock market in the present study, and bear markets were identified using the algorithm of Pagan and Sossounov (2003). Seven bear markets were identified for the purpose of the study. A combination of the DCC-GARCH model and OLS regression were employed to determine the relationship between gold and the MSCI world stock index. The study found that the dynamic conditional correlations are primarily negative in the bear markets under investigation. Gold performs the role of a safe haven for all bear markets except for the bear market from 2004-02-27 to 2004-06-30. It was concluded that gold acts as a robust, safe haven during turmoil and safe haven property depends on the severity of stock price changes. The findings have implications for policymakers and investors.

The effect of leading-edge tubercles on the aerodynamic performance of E216 airfoil is studied by steady 3D numerical simulations using Transition γ−Reθ turbulance model. The investigation is carried out for the various angles of attack in the pre-stall region at Reynolds number of 100,000. Various tubercle configurations with different combinations of amplitude ranging from 2 mm to 8 mm and wavelength varying from 15.5mm to 62 mm are studied. The effect of tubercle parameters on the laminar separation bubble (LSB) is extensively studied. Improvement in the coefficient of lift (Cl) is observed for most of the tubercled models and is significant at high angles of attack. But the simultaneous increase in the drag coefficient resulted in a marginal improvement in the coefficient of lift to drag ratio (Cl/Cd) for most of the cases except for A2W62, which produced a peak value of 46.91 at AOA 6◦ which is higher than that for the baseline by 7.37%. Compared to the baseline, the magnitude of suction peak is higher along the trough and lower along the peak. The low amplitude and low wavelength tubercle model exhibited smooth surface pressure coefficient (Cp) distribution without any sign of strong LSB formation. The LSB moves upstream with the increase in amplitude and wavelength. The LSB along the trough is formed ahead of that at peak inducing three-dimensional wavy shaped LSB unlike the straight LSB as in baseline. Two pairs of counter rotating vortices are formed on the airfoil surface between the adjacent peaks at two different chord-wise locations which strongly alter the flow pattern over it.

Objective: There is insufficient evidence on the effectiveness of gastric lavage in organophosphorus poisoning. This study was done to quantitate the level of chlorpyrifos and quinalphos retrieved in gastric lavage fluid.Methods: Patients presenting within six hours of ingesting quinalphos or chlorpyrifos with International Program on Chemical Safety Poison Severity Score (IPCS PSS) grade 2 or more were included in the study. After the stabilisation of patients, gastric lavage was performed with alliquotes of 200 ml of normal saline till aspirate became clear. Quantification of the pesticide was done in the first 10 ml of lavage fluid aspirated out and in blood with gas chromatography with triple quadruple mass spectrometer (GC-MSMS).Results: There were six patients in each pesticide group. Mean time for reaching hospital after the ingestion of pesticide was 2.8 ± 1.1(range 1.25-6) hours. Median quantity of chlorpyrifos in the lavage fluid was 10.24 (IQR 14.36) µg/L and in quinalphos, it was 1360.62 (IQR 1691.2) µg/L. Other compounds detected in lavage fluid and confirmed in blood were endosulfan, diazinon, pirimiphos, pyridafenthion, pyrazophos, pirimiphos ethyl, and azinphos.Conclusion: Chlorpyrifos and quinalphos are detected in lavage fluid after one hour of ingestion and few milligrams are retrieved by gastric lavage. The presence of other pesticides including endosulfan were confirmed in lavage fluid.

Determination of “Age” – the time elapsed since the last chemical purification – of a nuclear material is an important parameter in Nuclear Forensic analysis. Estimation of age may give crucial acumen of the possible production facility and the declared origin – if available – in case of a suspected nuclear material which is out of regulatory control. Mass spectrometry is the most common analytical technique used for chronological studies due to its superior precision (lower uncertainty). Though alpha spectrometry can be used for age determination, it better suits for irradiated fuel based radio-chronology because of higher specific activity of irradiated actinides (actinides formed by irradiation of actinides within a reactor) like plutonium. This paper describes the application of alpha spectrometry for the age determination in some natural U-metal samples with known history. The method utilises the radioactive non-equilibrium existing between 234U and 230Th isotopes in the sample for the elucidation of age of the material. Optimisation of a chemical procedure for the separation of ultra-trace amount of thorium isotopes from bulk uranium material using double column anion exchange chromatography is also presented. The chemical recoveries of uranium and thorium obtained with the present method were >95%. The uncertainty in age determination was

Background: The COVID 19 pandemic is associated with mental health concerns such as anxiety and depression at multiple levels and has recently been postulated to be linked to the long COVID syndrome. Objectives: To determine the prevalence and factors associated with depression and anxiety in individuals admitted with COVID-19 infection. Methods: 154 individuals admitted with COVID-19 infection were screened for depression and anxiety employing PHQ9 and GAD 7, respectively. Trained interns did the screening on consecutively admitted patients. Results: The proportion of depression and anxiety was 26.6%(n=41) and 20.1%(n=31), respectively. Moderate and above symptoms were present in 3.9% of the individuals(n=6) on both scales. Older age (t=2.124, p=.035), lower educational status (t=3.725, p=0.000), a family member losing their job during the pandemic (t=1.91, p=0.05), presence of fever (t=2.069, p=0.040), oxygen therapy (t=2.19, p=0.030) and treatment with hydroxychloroquine (t=2.122, p=0.035) were found to be significantly associated with high depression scores. Being less educated (t=3.594,p=0.000), admission under non-paying status (t=2.209, p=0.029), a family member losing their job during the COVID pandemic (t=1.946, p=0.05), presence of non-productive cough (t=1.940, p=0.05), fatigue (t=2.418, p=0.017)), myalgia (t=2.015, p=0.046), having Diabetes Mellitus (t=2.151, p=0.033) and requiring oxygen therapy (t=2.030, p=0.040) were significant risk factors for higher anxiety scores. Conclusions: The feasibility of screening for depression and anxiety by non-mental health professionals in poorly technology-enabled moderately ill inpatient populations within LAMIC settings have been demonstrated. Psychosocial disadvantage and indicators of relatively severe covid infection seem to be risk factors for depression and anxiety. A system for screening for these disorders employing feasible strategies should ideally be incorporated to mitigate both short term and long-term negative consequences of this pandemic, particularly in inpatient populations, who are already subject to various vulnerabilities.

Three-port converters (TPCs) enable the design of more efficient, power dense,and high-power dc–dc converters. This article investigates the operation of a resonant TPC in electric vehicle applications. Operating conditions of the resonant TPC are presented. The steady-state analysis of the converter with zero-voltage switching consideration is discussed. A controller concept to regulate the resonant TPC is proposed. State-space equations of the resonant TPC are derived, and a nested closed-loop control strategy is implemented. The converter operation is validated in the PLECS simulation environment under step-load and input voltage variation conditions. The resonant TPC can regulate its output voltage under the proposed control strategy and maintain its operation at various operating conditions.

The stagnation of Dennard scaling along with the move towards heterogeneous 2.5D and 3D ICs is increasing the thermal design power (TDP) envelopes of general-purpose CPUs. With conventional cooling approaches such as air-cooling and cold plates, it is challenging to meet these increased requirements. Moreover, these increasing cooling requirements necessitate larger thermal management overheads in datacenter settings. All these trends point towards the need for a more aggressive and efficient cooling solutions. Monolithic microfluidic cooling, where silicon micropin-fins or microchannels are etched directly into the backside of the functional silicon, has shown great potential in this regard. In this work, we use micropin-fins etched directly on the back of an Intel Core i7-8700K CPU and overclocked it to dissipate up to 215W of power while being cooled by room temperature de-ionized (DI) water. We demonstrate up to 44.4% reduction in junction-to-inlet thermal resistance while using only $0.3\times $ of volumetric coolant flow per Watt of power dissipated in the CPU compared to a conventional cold-plate. Furthermore, we demonstrate higher sustained core frequencies even when being cooled with elevated inlet temperatures, showing the potential for more efficient datacenter operations without the need for expensive and energy intensive refrigeration loops. The scalability towards heterogeneous 2.5D and 3D devices is also discussed. These results point towards a more scalable, efficient cooling solution, which can unlock higher power, more efficient compute systems, while minimizing the environmental impacts by reducing the thermal management overheads.

Aim: To emphasize the importance of a timely, systemic approach to hypercalcemia to reach an etiological diagnosis. Background: Hypercalcemia is commonly encountered in many individuals, in both inpatient and outpatient settings. Its evaluation entails careful history taking, a battery of investigations to arrive at an etiological diagnosis. Hypercalcemia is more common in adults but not uncommon in children and adolescents. Case description: Here, we present a case of an apparently healthy young male presenting with a nontraumatic vertebral fracture who was incidentally detected to have hypercalcemia. Further evaluation revealed parathyroid hormone (PTH)-independent hypercalcemia. He also had mild anemia and mildly impaired renal function at presentation. During his in-hospital stay, he developed bicytopenia. Bone marrow studies and flow cytometry showed a hypercellular marrow suggestive of acute lymphoblastic leukemia (ALL). Discussion: This case illustrates an uncommon presentation of aleukemic ALL, i.e., low-trauma fracture with PTH-independent hypercalcemia. Conclusion: Hypercalcemia, especially PTH-independent, should entail a high index of suspicion across all age groups for malignancies, including solid tumors and hematological malignancies. Clinical significance: Malignancies, even in younger individuals, can present with low-trauma fracture and hypercalcemia.

Objectives: There is limited literature on the prevalence and determinants of sarcopenia in the Indian predialysis chronic kidney disease (CKD) population. The current study attempts to characterize sarcopenia in CKD stages 3 & 4 using 3-compartment model dual-energy X-ray absorptiometry (DXA). Methods: This is secondary data from a randomized trial on bicarbonate supplementation for preserving muscle mass. A 3-compartment DXA was done to assess body composition in 188 subjects aged 18 to 65, with stable kidney function. Sarcopenia was defined by Asian Working Group criteria - appendicular skeletal mass index

IntroductionAngiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are the antihypertensive drug class of choice in patients with chronic kidney disease (CKD). Head-to-head comparisons of the renal or non-renal outcomes between ACEI/ARB users and nonusers have not been conducted in all population groups. We examined the renal and cardiovascular outcomes in users and nonusers enrolled in the Indian Chronic Kidney Disease (ICKD) Study.MethodsA total of 4,056 patients with mild-moderate CKD were studied. Patients were categorized as ACEI/ARB users or nonusers. Major adverse kidney events [ESKD (end stage kidney disease), ≥50% decline in eGFR and kidney death], all-cause mortality, and cardiovascular mortality were analyzed over a median follow-up period of 2.64 (1.40, 3.89) years between the two groups.ResultsOut of a total of 4,056 patients, 3,487 (87%) were hypertensive. The adjusted sub-hazard ratio (SHR) and 95 % CI for ACEI /ARB users was 0.85 (0.71, 1.02) for MAKE, 0.80 (0.64, 0.99) for a 50% decline in eGFR, and 0.72 (0.58, 0.90) for ESKD. For cardiovascular mortality, ACEI/ARB users were at lower risk (SHR = 0.55, 95% CI: 0.34, 0.88). Diuretic users were at increased risk of all-cause mortality (HR = 1.95, 95% CI: 1.50, 2.53) and cardiovascular mortality (adjusted SHR = 1.73, 95% CI: 1.09, 2.73). There was non-significant association between the use of other antihypertensives and any of the end points.DiscussionACEI/ARB use is associated with slower rate of decline in eGFR in those with CKD stage 1-3. ACEI/ARB users had a significantly lower risk of renal outcomes, and cardiovascular mortality.

Despite the significance of crisis leadership for organizations, especially in the wake of COVID-19, empirical research in this area is still nascent. Therefore, “What attributes make an effective leader during a crisis?” is unclear. Using lessons learned from the COVID-19 pandemic, this study seeks to address this gap in the literature by i) developing and validating a robust multi-dimensional crisis leadership model and ii) measure its effectiveness in handling the crisis. A higher-order measurement model of crisis leadership comprising of seven constructs (compassion and care, openness and communication, resilience and courage, decisiveness, consultation and collaboration, and empowerment) and two structural models to measure its predictive validity (effectiveness in handling the crisis) were proposed based on the review of crisis leadership literature. Next, using data collected through a global survey, the validity of the proposed models, including the relevance/appropriateness of each construct and the predictive power of the crisis leadership model in explaining the organizations’ effectiveness in handling the crisis, were assessed. The second-order confirmatory factor analysis established the existence of a higher-order measurement model for crisis leadership, with each of the seven constructs contributing uniquely and strongly. The structural equation modeling results confirmed the strong predictive power of the crisis leadership model in explaining the organizations’ effectiveness in handling the crisis across its different (beginning, current, and future) phases. The findings show that crisis leadership is multifaceted and requires an all-encompassing effort and provides a road map for organizations looking to develop crisis leadership capabilities for senior managers and leaders.

Summary: Background: Although colorectal cancer is increasing in India, the cost of comprehensive treatment and its consequences for patients and households are unknown. This study aimed to describe catastrophic expenditure and treatment attrition in patients with a treatment plan for colorectal cancer. Methods: A prospective, multicentre, cohort study was conducted in five tertiary hospitals in India from December 2020 to March 2022. Consecutive patients with a new treatment plan for colorectal cancer were followed-up for six months. The total cost of treatment was reported, including out-of-pocket payments (OOPP, paid by patients at the time-of-service use) and covered by third parties (insurance, public funds). The primary outcome was catastrophic expenditure, defined as OOPPs greater than 25% of patient's annual household income and the secondary outcome was treatment attrition, defined as unplanned interruption of the treatment course not recommended by the clinical team. Findings: Of 226 patients included, 20 died within six months of being offered a treatment plan and four were lost to follow-up. The median total cost of colorectal cancer treatment was 407,508 Indian Rupees (INR/5340 USD), to which the biggest contributor was the patient's OOPP (median 330,277 INR/4328 USD). Surgery and anaesthesia costs (median 85,944 INR/1126 USD) were higher than radiotherapy (median 55,525 INR/728 USD) and chemotherapy (median 14,780 INR/194 USD). The overall catastrophic expenditure rate was 90.1% (182/202) and the treatment attrition rate was 9.4% (19/202). Patients with treatment attrition made lower OOPPs than those who completed treatment (median 205,926 vs 349,398 INR, p

This study develops a clinical decision support system to assist physicians with monitoring Polycystic Ovarian Syndrome (PCOS). The proposed method uses a classification model with optimization techniques and machine learning algorithms. The existence of irrelevant features can deteriorate the performance of any classifiers. This work analyses the impact of such features on classification accuracy and automatically identifies and removes the irrelevant features from the dataset. A wrapper approach is employed for feature selection. It uses Red Deer Algorithm (RDA) to find the optimal features and a random forest (RF) classifier to evaluate them. RDA is an optimization algorithm inspired by red deer’s mating and roaring behaviour. Experiments were carried out on the PCOS dataset, which is available in the Kaggle dataset repository. The optimal dataset is trained and tested using an RF classifier with 50 estimators. RDA’s improved exploration and exploitation capabilities are the rationales behind using it as the search method. The novelty of the proposed method lies in the novel fitness function used, which considers both accuracy of the classification and the optimized number of features. The proposed CDSS displays accuracy of 89.81%. The results of the proposed work were compared with the performance of competing methods in the literature. Logistic Regression classifier, k-Nearest Neighbour (k-NN), Decision tree, Naïve Bayes, Support Vector Machine (SVM) classifier, RF-PSO, RF-Ant Colony Optimization, and RF-Genetic Algorithm and are found to be superior in terms of accuracy, sensitivity, and specificity. The statistical significance of the suggested feature selection approach is confirmed using McNamer’s test.

Affective computing plays an important role in simulating human affects through multimedia stimuli. To provide appropriate responses and quantify emotions, it is essential to identify and interpret emotions accurately. Often the audience is influenced by media content and it has an impact on the audience's emotions. The authors aim to develop a machine vision based smart affective system that investigates the correlation between the basic facial expressions and corresponding ratings given by the audience. For the same, a notion of emotion vector is introduced to measure the elicited emotion. The idea of measuring attention is also suggested to find if the con- tent could keep the audience engaged. Our results reveal that such systems are useful in capturing and analyzing individual and collective sentiment.

Abstract Background Hospitals in England have undergone considerable change to address the surge in demand imposed by the COVID-19 pandemic. The impact of this on emergency department (ED) attendances is unknown, especially for non-COVID-19 related emergencies. Methods This analysis is an observational study of ED attendances at the Imperial College Healthcare NHS Trust (ICHNT). We calibrated auto-regressive integrated moving average time-series models of ED attendances using historic (2015–2019) data. Forecasted trends were compared to present year ICHNT data for the period between March 12, 2020 (when England implemented the first COVID-19 public health measure) and May 31, 2020. We compared ICHTN trends with publicly available regional and national data. Lastly, we compared hospital admissions made via the ED and in-hospital mortality at ICHNT during the present year to the historic 5-year average. Results ED attendances at ICHNT decreased by 35% during the period after the first lockdown was imposed on March 12, 2020 and before May 31, 2020, reflecting broader trends seen for ED attendances across all England regions, which fell by approximately 50% for the same time frame. For ICHNT, the decrease in attendances was mainly amongst those aged

The research performance of a country is an indicator of its scientific progress and benchmarking it with regional countries is critical to assess a country’s regional competitiveness. This study aims to assess and benchmark the research productivity of the United Arab Emirates (UAE) against other member nations of the Gulf Cooperation Council (GCC), namely with Saudi Arabia, Oman, Kuwait, Qatar, and Bahrain, who have similar macroeconomic and socio-cultural characteristics. Scopus was used as the data source to extract the research output of each of the six countries studied for the period 1995–2019. Bibliometric indicators covering both quantity and impact of research such as publication output, citation, and collaboration indicators were used to assess the research performance of UAE and other GCC countries. The findings indicate good progress in the UAE’s overall research performance during the period of study. Also, UAE’s research performance in most of the bibliometric indicators is comparable or superior to the other GCC countries. This study is the first of its kind and addresses the dearth of bibliometric studies assessing UAE’s research productivity and GCC countries in general. The findings are useful for administrators and policymakers to benchmark the performance of the UAE with other GCC countries, including its impact, growth, and trajectories. For researchers, the study indicators and methods can be replicated to assess the overall research performance of other countries.

Stem cells are essential for the development and long-term maintenance of tissues and organisms. Preserving tissue homeostasis requires exquisite control of all aspects of stem cell function: cell potency, proliferation, fate decision and differentiation. RNA binding proteins (RBPs) are essential components of the regulatory network that control gene expression in stem cells to maintain self-renewal and long-term homeostasis in adult tissues. While the function of many RBPs may have been characterized in various stem cell populations, how these interact and are organized in genetic networks remains largely elusive. In this report, we show that the conserved RNA binding protein IGF2 mRNA binding protein (Imp) is expressed in intestinal stem cells (ISCs) and progenitors in the adult Drosophila midgut. We demonstrate that Imp is required cell autonomously to maintain stem cell proliferative activity under normal epithelial turnover and in response to tissue damage. Mechanistically, we show that Imp cooperates and directly interacts with Lin28, another highly conserved RBP, to regulate ISC proliferation. We found that both proteins bind to and control the InR mRNA, a critical regulator of ISC self-renewal. Altogether, our data suggests that Imp and Lin28 are part of a larger gene regulatory network controlling gene expression in ISCs and required to maintain epithelial homeostasis.

Perovskite SrIrO3 films and its heterostructures are very promising, yet less researched, avenues to explore interesting physics originating from the interplay between strong spin–orbit coupling and electron correlations. Elemental iridium is a commonly used source for molecular beam epitaxy (MBE) synthesis of SrIrO3 films. However, elemental iridium is extremely difficult to oxidize and evaporate while maintaining an ultra-high vacuum and a long mean free path. Here, we calculated a thermodynamic phase diagram to highlight these synthesis challenges for phase-pure SrIrO3 and other iridium-based oxides. We addressed these challenges using a novel solid-source metal-organic MBE approach that rests on the idea of modifying the metal-source chemistry. Phase-pure, single-crystalline, coherent, epitaxial (001)pc SrIrO3 films on (001) SrTiO3 substrate were grown. Films demonstrated semi-metallic behavior, Kondo scattering, and weak antilocalization. Our synthesis approach has the potential to facilitate research involving iridate heterostructures by enabling their atomically precise syntheses.

Interpreting the function and metabolism of enzymatic DNA modifications requires both position-specific and global quantities. Sequencing-based techniques that deliver the former have become broadly accessible, but analytical methods for the global quantification of DNA modifications have thus far been applied mostly to individual problems. We established a mass spectrometric method for the sensitive and accurate quantification of multiple enzymatic DNA modifications. Then, we isolated DNA from 124 archean, bacterial, fungal, plant, and mammalian species, and several tissues and created a resource of global DNA modification quantities. Our dataset provides insights into the general nature of enzymatic DNA modifications, reveals unique biological cases, and provides complementary quantitative information to normalize and assess the accuracy of sequencing-based detection of DNA modifications. We report that only three of the studied DNA modifications, methylcytosine (5mdC), methyladenine (N6mdA) and hydroxymethylcytosine (5hmdC), were detected above a picomolar detection limit across species, and dominated in higher eukaryotes (5mdC), in bacteria (N6mdA), or the vertebrate central nervous systems (5hmdC). All three modifications were detected simultaneously in only one of the tested species, Raphanus sativus. In contrast, these modifications were either absent or detected only at trace quantities, across all yeasts and insect genomes studied. Further, we reveal interesting biological cases. For instance, in Allium cepa, Helianthus annuus, or Andropogon gerardi, more than 35% of cytosines were methylated. Additionally, next to the mammlian CNS, 5hmdC was also detected in plants like Lepidium sativum and was found on 8% of cytosines in the Garra barreimiae brain samples. Thus, identifying unexpected levels of DNA modifications in several wild species, our resource underscores the need to address biological diversity for studying DNA modifications.

Sensor node location information is critical in many Wireless Sensor Network (WSN) applications with random sensor node deployment. In such applications, node localization using a faster area exploration mechanism is needed to initiate precise sensing and communication. In this paper, faster area exploration approach for mobility-assisted localization scheme is proposed for mission-critical WSN applications. Each Mobile Anchor (MA) node embedded with a localization module moves in the sensor field in a coordinated manner while localizing the deployed static nodes. The proposed area exploration scheme is implemented using a hybrid of max-gain approach and cost-utility based frontier (HMF) approach. The paper addresses the issue of sparse anchor node condition during the localization process. The simulation results obtained using Cooja simulator shows that the proposed mobility-assisted localization scheme results in accurate localization with minimum delay. The proof-of-concept of the proposed scheme is demonstrated using Berkeley static nodes and custom designed MA nodes.

We propose an innovative methodology to estimate the formative discharge of alluvial rivers from remote sensing images. This procedure involves automatic extraction of the width of a channel from Landsat Thematic Mapper, Landsat 8, and Sentinel-1 satellite images. We translate the channel width extracted from satellite images to discharge using a width–discharge regime curve established previously by us for the Himalayan rivers. This regime curve is based on the threshold theory, a simple physical force balance that explains the first-order geometry of alluvial channels. Using this procedure, we estimate the formative discharge of six major rivers of the Himalayan foreland: the Brahmaputra, Chenab, Ganga, Indus, Kosi, and Teesta rivers. Except highly regulated rivers (Indus and Chenab), our estimates of the discharge from satellite images can be compared with the mean annual discharge obtained from historical records of gauging stations. We have shown that this procedure applies both to braided and single-thread rivers over a large territory. Furthermore, our methodology to estimate discharge from remote sensing images does not rely on continuous ground calibration.

Introduction: Shortage of organs by donation is a national problem which needs a multipronged approach for its strengthening. Educating the people and increasing the awareness of the need for donation would be of the foremost priority. Identifying the target population who are more likely to respond would be very important to reap the maximum results. There is speculation that blood donors would be more amenable and likely to accept the idea and thought of organ donation. This study is being designed to study the same. Methodology: This was a cross-sectional comparative questionnaire-based study among two groups: blood donors and nonblood donors. Donors were defined as aged above 18 years and have made at least one whole blood/apheresis donation. Nondonors were the ones who were aged above 18 years and have not donated whole blood/apheresis blood products in the past. All the responses were entered in the Microsoft Excel sheets, and statistical analysis was carried out using Statistical Package for Social Sciences. Results: A total of 829 participated in the study. Among the 829 participants, 416 were donors, and 413 were nondonors. There was no difference in knowledge regarding organ donation among the groups except for perceived risks of organ donation among nondonors. Concerning attitudes, they were more favorable among blood donors, and it was statistically significant at a P < 0.05. Conclusion: There was no difference with respect to knowledge between donors and nondonors. However, donors had a more favorable attitude toward organ donation. Factors like concerns about misuse of donated organs, lack of clarity on their religion's policy toward organ donation, and potential for harm for the organ donor seem to account for the unfavorable attitude of nondonors toward organ donation.

Snake bite is an important cause for acute kidney injury (AKI) in the tropics and the victims are often otherwise healthy young adults without conventional risk factors for chronic kidney disease (CKD). Available literature on long-term outcomes of AKI –snake envenomation is limited, with only two small retrospective studies with follow-up periods of two years or less. In a hospital-based prospective and retrospective follow-up study, all consecutive adult patients who developed AKI and discharged alive were recruited in the prospective group and for retrospective analysis, we retrieved medical records of patients hospitalized with snake bite from the digitized medical records. Clinical and biochemical characteristics during hospitalization and on follow-up were collected. We recruited 193 patients with snake bite and AKI in a prospective (140) and a retrospective (53) group. Of the 193 AKI patients, 162 (84%) had estimated glomerular filtration rate (eGFR)

Background: India performed 7936 kidney transplantation operations in 2018 with living donor as the source in 85%. Identifying a living kidney donor (LKD) is difficult due to medical, social, and regulatory barriers. In addition, only a proportion of patients who volunteer may be able to donate eventually. Despite living donors being the predominant source, there are very few studies addressing the factors influencing living donor kidney donation in India. Methods: We analyzed data from our prospective LKD registry between July 1, 2011 and June 31, 2018. Demographic details, medical history, serum creatinine, and measured glomerular filtration rate (mGFR), blood pressure and the eventual outcome of LKD evaluation, including reason for noneligibility were collected. In a prospective cohort of 12 LKDs, renal functional reserve was studied using protein loading and dietary protein intake was measured from urine urea nitrogen excretion. Results: Over a period of 81 months, 316 LKDs were enrolled in our program. On 101 instances factors related to recipients prevented transplantation and on 92 occasions donor related factors precluded donation. Among 182 medically eligible LKDs with no evidence of CKD, only 33% had mGFR >90 ml/min/1.73 m2. Based on our institutional criteria, 22% of LKDs with mGFR 90 ml/min/1.73 m2. Eight LKDs with mGFR

Background: Multivariate meta-analysis is used when multiple correlated outcomes are reported in a systematic review. This study explored the application of multivariate meta-analysis in such a context. The objectives of the present study were to compare the summary findings and decisions between univariate and bivariate meta-analyses, as well as to assess how much sensitive the results are towards the strength of the correlation between the outcome variables. Methods: A systematic review that reported two correlated outcomes, Intact parathyroid hormone levels and serum phosphate was chosen for demonstrating the applications of bivariate meta-analysis. Both univariate and bivariate meta-analyses with fixed effect and random effect models were carried out and the results were compared. A sensitivity analysis was performed for a wide spectrum of correlations from −1 to +1 to assess the impact of correlation on pooled effect estimates and its precision. Results: Pooled effect estimates generated through bivariate meta-analysis were found to be varying when compared to those obtained through univariate meta-analysis. The confidence interval of the pooled effect estimates obtained through bivariate meta-analysis was wider than in univariate meta-analysis. Further, the value of the pooled effect estimates along with its confidence intervals also differed for varied levels of correlations. Conclusions: This study observed that when we have multiple correlated outcome variables to answer a single question bivariate meta-analysis could be a better approach. The magnitude of the correlation between the outcome variables also plays a vital role in meta-analysis.

Ce promoted Cu/γ-Al2O3 catalysts were prepared with varying amounts of Cu (x = 0–10 wt%) and Ce (y = 0–15 wt%). The prepared catalysts were characterized and tested for the conversion of aqueous glucose (5 wt%) to 1,2-propanediol in a batch reactor. 10%Ce-8%Cu/γ-Al2O3 showed the complete conversion of glucose with 62.7% selectivity of 1,2-propanediol and total glycols (1,2-propanediol, ethylene glycol & 1,2-butanediol) of 81% at milder reaction conditions. Cu facilitated the hydrogenation activity and Ce loading optimize the acid/base sites of Cu/γ-Al2O3 which obtain high selectivity of 1, 2-propanediol. Catalyst reusability is reported.

Vaidya Manorama is a folklore Kerala Ayurveda literature that encompasses time- tested low-budget formulations that can be prepared from easily available resources. Ayurveda Ophthalmology has been described in Chapter twenty-eight of the literature. Many unique formulations like eating firefly (khadyota), preparing ghee from fresh-water shellfish (tadaka-shuktika), Kadali phala (a special type of banana) bidalaka, dropping of juice of palasha (Butea monosperma) into eyes for various clinical conditions are described. We review the unique ophthalmology formulations in this chapter to bring them to limelight. Few herbo-mineral formulations are also described for which toxicity and safety studies are warranted. All these handy formulations may help clinicians in day-to-day practice or may be a lead for novel research.

OBJECTIVES:. To describe the prevalence, associated risk factors, and outcomes of serious neurologic manifestations (encephalopathy, stroke, seizure, and meningitis/encephalitis) among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:. Prospective observational study. SETTING:. One hundred seventy-nine hospitals in 24 countries within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. PATIENTS:. Hospitalized adults with laboratory-confirmed SARS-CoV-2 infection. INTERVENTIONS:. None. RESULTS:. Of 16,225 patients enrolled in the registry with hospital discharge status available, 2,092 (12.9%) developed serious neurologic manifestations including 1,656 (10.2%) with encephalopathy at admission, 331 (2.0%) with stroke, 243 (1.5%) with seizure, and 73 (0.5%) with meningitis/encephalitis at admission or during hospitalization. Patients with serious neurologic manifestations of COVID-19 were older with median (interquartile range) age 72 years (61.0–81.0 yr) versus 61 years (48.0–72.0 yr) and had higher prevalence of chronic medical conditions, including vascular risk factors. Adjusting for age, sex, and time since the onset of the pandemic, serious neurologic manifestations were associated with more severe disease (odds ratio [OR], 1.49; p < 0.001) as defined by the World Health Organization ordinal disease severity scale for COVID-19 infection. Patients with neurologic manifestations were more likely to be admitted to the ICU (OR, 1.45; p < 0.001) and require critical care interventions (extracorporeal membrane oxygenation: OR, 1.78; p = 0.009 and renal replacement therapy: OR, 1.99; p < 0.001). Hospital, ICU, and 28-day mortality for patients with neurologic manifestations was higher (OR, 1.51, 1.37, and 1.58; p < 0.001), and patients had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, –0.84, –1.34, and –0.84; p < 0.001). CONCLUSIONS:. Encephalopathy at admission is common in hospitalized patients with SARS-CoV-2 infection and is associated with worse outcomes. While serious neurologic manifestations including stroke, seizure, and meningitis/encephalitis were less common, all were associated with increased ICU support utilization, more severe disease, and worse outcomes.