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Abstract This study presents nanostructured composite Bi2MoO6/MXene heterostructure by using hydrothermal method for photodegradation of the congo-red dye and also for energy storage devices. X-ray diffractometer (XRD), High Resolution Transmission Electron Microscopy (HRTEM), Field emission scanning electron microscope (FESEM) and X-ray photoelectron spectroscopy (XPS), Brunauer-Emmett-Teller (BET) were performed to examine the structural properties along with surface area and porosity of the material. Due to addition of MXene the larger surface area and improved pore size help to quickly break down additional organic pollutants by adsorbing them. The band gap of Bi2MoO6/MXene nanostructured composite reduced to 2.4 eV suggesting transfer of electrons from VB to CB. Bi2MoO6/MXene exhibits a high (92.3%) photocatalytic degradation rate for a duration of 16 min which was verified using UV-visible spectroscopy, also scavenger test was conducted to ascertain the reactive agent along with the degradation pathway was confirmed by LCMS. Elemental content was also established by using inductively coupled plasma mass spectrometry (ICP-MS). For estimating energy storage capacity cyclic voltammetry (CV) was performed. It was observed Bi2MoO6/MXene nanostructured composite electrodes had specific capacitance of 642.91Fg− 1, power density of 1.24 kWkg− 1, and energy density of 22.32 Whkg− 1 at a current density of 5Ag− 1 also it exhibited 64.42% capacity retention having current density 20 Ag− 1 throughout 10,000 Galvanostatic charge discharge (GCD) cycles. High electrical conductivity of Bi2MoO6/MXene electrode was again examined by Electrochemical impedance spectroscopy (EIS). These findings demonstrate the potential of Bi2MoO6/MXene nanostructured composites in both photodegradation and energy storage applications.

Abstract In this work our aim was to identify early biomarkers in plasma samples associated with mortality in children with perinatal HIV treated early in life, to potentially inform early intervention targeting this vulnerable group. 20/215 children (9.3%) with perinatal HIV, enrolled within 3 months of age died prematurely within the first year of the study, despite early ART initiation. Using a propensity score, we selected 40 alive study participants having similar clinical and virological records compared to the deceased group. 13 HIV unexposed (HU) healthy children were additionally used as controls. Baseline plasma samples were analyzed using a targeted proteomic approach, and to assess pathogen-associated and damage-associated molecular patterns (PAMPs, DAMPs) levels. Data from deceased participants were compared to both control groups, with multivariate logistic regression models used to evaluate the association between mortality and plasma proteins. We developed a machine learning model to predict mortality risk, finding that IL-6 and CXCL11 not only were higher in deceased children than Matched-children with HIV (p

Introduction: The first rib is the shortest, most curved and atypical of all ribs. An angle is visible between the head and the tubercle at the inferior portion of the neck, which can indicate the sex of the individual when viewed in a non anatomical position. Aim: To determine the morphometric and morphological variations of the first rib in the population of Rajasthan. Materials and Methods: This cross-sectional study was conducted in the Anatomy Department of SMS Medical College, Jaipur, Rajasthan, India, from January 2023 to April 2024. A total of 90 adult human dry first ribs (45 right and 45 left) of unknown age and sex were studied. Intact right and left ribs were included, while damaged first ribs were excluded. Data were collected using a Vernier calliper and thread to measure length, height, angle, external length, internal length, shortest external length and shortest internal length. Morphological variations, such as the scalene tubercle and vascular groove, were observed. Independent samples t-tests were used to compare means between the right and left-sides and correlation analysis assessed relationships between angular orientation and anatomical dimensions. The statistical analysis was performed using Microsoft Excel 2020 and IBM Statistical Package of Social Sciences (SPSS) version 23.0. Results: The descriptive statistics for the measured variables are as follows: the mean height and length on the right-side were 6.99±3.45 cm and 26.69±2.41 cm, respectively, while on the left-side they were 7.35±2.55 cm and 26.10±2.80 cm, respectively. The angle was greater on the left-side (16.59±6.18º). Statistical analysis indicated non significant differences between all the variables of the right and left-sides (p-value >0.05), except for strong positive correlations between angle and height (Right: r-value=0.986, p-value=0.001; Left: r-value= 0.952, p-value=0.001). Conclusion: The morphometric parameters of the first rib indicate non significant differences between the right and left-sides. The strong positive correlations between angle and height have clinical significance, as they can assist in forensic and anatomical studies related to intervertical dimensions and anatomical alignment based on the angular orientation of the first rib.

Abstract Air is an essential human necessity, and inhaling filthy air poses a significant health risk. One of the most severe hazards to people’s health is air pollution, and appropriate precautions should be taken to monitor and anticipate its quality in advance. Among all the countries, the air quality in India is decreasing daily, which is a matter of concern to the health department. Many studies use machine learning and Deep learning methods to predict atmospheric pollutant levels, prioritizing accuracy over interpretability. Many research studies confuse researchers and readers about how to proceed with further research. This paper aims to give every detail of the considered air pollutants and brief about the techniques used, their advantages, and challenges faced during pollutant prediction, which leads to a better understanding of the techniques before starting any research related to air pollutant prediction. This paper has given numerous prospective questions on air pollution that piqued the study’s interest. This study discussed various machine and deep learning methods and optimization techniques. Despite all the discussed machine learning and deep learning techniques, the paper concluded that more datasets, better learning techniques, and a variety of suggestions would enhance interpretability while maintaining high accuracy for air pollution prediction. The purpose of this review is also to reveal how a family of neural network algorithms has helped researchers across the globe to predict air pollutant(s).

Abstract With the new discoveries enabled thanks to the recent space missions, stellar physics is going through a revolution. However, these discoveries opened the door to many new questions that require more observations. The European Space Agency’s Human and Robotic Exploration program provides an excellent opportunity to push forward the limits of our knowledge and better understand stellar structure and dynamics evolution. Long-term observations, Ultra-Violet observations, and a stellar imager are a few highlights of proposed missions for late-type stars that will enhance the already planned space missions.

The study is on the cost dynamics which is concerned with finite queues in particular to susceptibility to server outages, threshold-driven recovery and Catastrophic events, but main focus is on balking behaviour of the customers. A thorough investigation of the financial implications of interruptions and efficacy to recovery strategies is done and to alleviate the impact of breakdowns, disasters and customer refusals the queue system designs through empirical research is conducted. Various recovery policies have been compared with the existing thresholds, and the study further endeavors to categorize the cost-effective approach to mitigate the economic concerns of server failures and catastrophic incidents. The study brings discernments on the expected development in the management of the queuing system along with the assistance in complete decision-making in cost efficiency and enhancement of the complete system performance.

Introduction: Constipation in elderly individuals is typically complex, with co-morbid conditions. In Ayurveda, numerous plants and mixtures have been recommended for the treatment of Vibandha. In order to evaluate complementary and alternative medicine interventions that are too complicated to be studied using conventional research designs, notably the randomized controlled trial design, whole system research (WSR) has emerged as a new method. WSR is primarily focused on clinical medicine and places an emphasis on treating patients as individuals rather than in groups. Methods: A total of 60 patients with old age constipation, fulfilling inclusion criteria were recruited. Group A (Kalyanaka kshara [KK]) (control) and Group B (Trial) (WSR) based on kostha assessment were given for 10 days. ROME III criteria were used to assess the efficacy of KK and whole system approach (WSA) of Ayurveda interventions. The Wilcoxon match paired test and the Mann–Whitney U-test were used for the statistical analysis to compare the data between and within groups. Results and Conclusion: Within group results of both the group showed significant changes at all-time points (P < 0.005). Whole system approach of Ayurveda interventions has showed significant changes in between group results than the KK at all-time points (P < 0.005). The present study showed that whole system approach has showed promising results as the assessment of constipation and medicine prescription based on the kostha assessment plays a very important role.

Aim: This paper highlights the difficulties and lacunae in the Mental Health Care Act 2017 that hinder its implementation and use for the care and treatment of persons with mental illness in India. Methods: An online nationwide survey, involving structured questions as well as open-ended questions, to elicit the level of implementation, experience in complying with the provisions of the Act, and level of satisfaction, of practicing psychiatrists was carried out. Responses were analyzed using appropriate statistics. Results: 600 respondents answered the online questionnaire. A majority of psychiatrists were senior practitioners with over 10 years of experience. 92.5% respondents were dissatisfied with the MHCA, wherein 73.3% wanted it amended, and 19.2% asked for repeal. Procedural issues were deterrent for 66.5% from taking medically necessary or helpful decisions for patients. Non-implementation of the Act was a major finding. Major dissatisfaction was expressed regarding judicial over reach in admission and discharge procedures, inclusion of general hospital psychiatry units in the definition of mental health establishment, non-applicability of provisions like advance directive and nominated representative in Indian setting, and that all treatment should be covered under insurance. Conclusion: The Act in its present form defies the spirit of its own objectives and is unimplementable. It needs major revisions.

Background: Obstetric Anal Sphincter Injuries (OASI) are associated with significant morbidity. Data regarding induction of labor (IOL) and risk of OASI is conflicting. The objective of this study is to evaluate if IOL increases the odds of OASI when compared to spontaneous labor. Methods: This is a retrospective case–control study in women with term, singleton pregnancies, who had a vaginal delivery at a single, academic center in an urban setting from October 2015 to December 2021. Individuals with the primary outcome, OASI, were identified and matched with controls (no OASI) by delivery date. Results: 303 OASI individuals were identified and matched with 1106 controls. Women with OASI were more likely to be White or Asian, have commercial insurance, and have a previous cesarean delivery (CD). IOL increased the likelihood of OASI by 49% compared to spontaneous labor (OR 1.49, 95% CI [1.138, 1.949]). IOL was no longer significant when adjusting for confounding variables and known risk factors. Conclusion: IOL was not associated with OASI when accounting for known antepartum and intrapartum risk factors. Further investigation of modifiable and non-modifiable risks during labor is imperative to decrease the risk of OASI and associated pelvic floor disorders.

Abstract Nitroaromatic compounds represent a class of highly toxic pollutants discharged into aquatic environments by various industrial activities, posing significant threats to ecological integrity and human health due to their persistent and hazardous nature. In this study, Pd-doped ZnO nanoparticles were investigated as a potential solution for the degradation of nitro organics, offering heightened photocatalytic efficacy and prolonged stability. The synthesis of Pd-doped ZnO NPs was achieved via the hydrothermal method, with subsequent analysis through XRD spectra and XPS confirming successful Pd doping within the ZnO matrix. Characterization through FESEM and HRTEM unveiled the heterogeneous morphologies of both undoped and Pd-doped ZnO nanoparticles. Additionally, UV–vis and PL spectroscopy provided insights into the optical properties, chemical bonding, and defect structures of the synthesized Pd-doped ZnO NPs. Pd doping induces a redshift in ZnO’s absorption spectra, reducing the bandgap from 3.12 to 2.94 eV as Pd concentration rises from 0 to 0.2 wt.%. The photocatalytic degradation, following pseudo-first-order kinetics, achieved 90% nitrobenzene abatement (200 µg/L, pH 7) under visible light within 320 min with a catalyst loading of 16 µg/mL. The photocatalytic efficacy of 0.08 wt% Pd-doped ZnO (k = 0.058 min⁻1) exhibited a 25-fold enhancement compared to bare ZnO (k = 3.1 × 10–4 min-1). Subsequent quenching and ESR experiments identified hydroxyl radicals (OH•) as the predominant active species in the degradation mechanism. Mass spectrometry analysis unveiled potential breakdown intermediates, illuminating a plausible degradation pathway. The investigated Pd-doped ZnO nanoparticles demonstrated reusability for up to five successive treatment cycles, offering a sustainable solution to nitro organics contamination challenges.

This article summarises efforts towards understanding the calculation of sample size determination in Randomised controlled Clinical Trials (RCTs). Readers would gain insight into the procedures behind sample size calculation in RCTs and its significance. Additionally, researchers, including residents, will learn to calculate sample sizes independently, aiding in their postgraduate thesis or dissertation work, especially for straightforward projects. The determination of sample size depends on various factors, several of which are discussed in this article. The concepts of biostatistics, which underpin sample size calculations and other statistical computations, are also elucidated. Examples are provided to illustrate how formula variations correspond to changes in influencing factors. Furthermore, a list of relevant software tools is included.

Abstract Background Mechanical ventilation (MV) in intensive care units (ICUs) is a stressful experience for patients. However, these experiences have not been systematically explored in low- and lower-middle-income countries (LLMICs). This systematic review (SR) aims to explore the patients’ experiences of MV in ICUs in LLMICs and the factors influencing their experiences. Methods The PICO framework will be used to operationalize the review question into key concepts: population (mechanically ventilated adult patients in ICUs), phenomenon of interest (experiences) and context (LLMICs). PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, Scopus and Web of Science will be systematically searched since database inception. Citation, reference list and PubMed-related article searching of included studies will be done to ensure literature saturation. Empirical peer-reviewed literature exploring adult patients’ (aged ≥ 18 years) experiences of MV in ICUs in LLMIC will be included. All study designs (quantitative, qualitative and mixed methods) will be included. Two independent reviewers will perform screening, data extraction and critical appraisal. The mixed-methods appraisal tool (MMAT) and Popay’s narrative synthesis will be used for critical appraisal and data synthesis, respectively. Discussion This SR aims to bridge a gap in knowledge as previous evidence synthesis has described this phenomenon in developed countries. The review design, with the inclusion of quantitative, qualitative and mixed-methods studies, intends to provide a rich and in-depth exploration of the issue. The findings will be presented as themes, subthemes and their explanatory narratives. The gaps in available literature will be identified, and implications of SR findings on policy, practice and future research will be presented. The strength of this SR lies in its systematic, comprehensive, transparent, robust and explicit methodology of identifying, collating, assessing and synthesizing available evidence. By prior registration and reporting of this SR protocol, we aim to ensure transparency and accountability and minimize bias. Systematic review registration PROSPERO CRD42024507187

Introduction: Dr. Hirata of Japan first described insulin autoimmune syndrome (IAS) in 1970. Seven hundred ninety-five cases of this rare syndrome have been reported from Japan and China and 29 from India. IAS has the following characteristic features 1) severe spontaneous attacks of hyperinsulinemic hypoglycaemia, 2) high total immunoreactive insulin levels, 3) elevated insulin autoantibody (IAA) titres, 4) no prior exposure to exogenous insulin, and 5) no pathological abnormalities of the pancreatic islet cells. Methods: We treated six cases of IAS with high doses of prednisolone for 4-6 weeks and then gradually reduced the doses. Diagnosis of IAS was established by documenting Whipple’s triad of symptoms and signs of hypoglycaemia, blood sugar 3 uU/ml, C-peptide levels >0.6 ng/ml, and increased titres of anti-insulin autoantibodies. Insulinoma and non-pancreatic tumours were ruled out by CECT (contrast-enhanced computerised tomography) or MRI (magnetic resonance imaging) of the abdomen and if necessary endoscopic ultrasonography and gallium 68 Dotanoc PET (positron enhanced tomography). Autoimmune screening and serum electrophoresis were done to rule out multiple myeloma. Monitoring of the patient’s blood sugars was done by the laboratory, glucometer readings, and a freestyle libre glucose monitoring system. Results: Remission of hypoglycaemic episodes, hyperglycaemic episodes, and marked reduction of serum insulin and insulin autoantibodies in four out of six patients with diet therapy and steroids. Two patients resistant to steroids were treated with rituximab successfully. Patient 6 developed serious complications of cytomegalovirus and Pneumocystis carnii after rituximab, which were treated successfully. Conclusion: A careful history including recent infections, medications, and vaccinations provides vital clues in the evaluation. An increased awareness of IAS will prevent unnecessary and costly investigations and surgery. Although it is often self-remitting, steroids are contributory in severe cases. Immunosuppressives are used successfully in cases refractory to steroids. Continuous glucose monitoring system (CGMS), by freestyle libre glucose monitoring system, provided real-time blood sugar values, total time in hypoglycaemia, and total time in the range (TIR), which proved very valuable in managing IAS patients. Low CGMS values should be corroborated clinically and with laboratory or glucometer values.

Maternal isoimmunization occurs when a pregnant woman develops an immune reaction due to the inheritance of a red-cell antigen, which is paternally derived and can result in fetal anemia, hemolysis, fetal death, and hydrops fetalis as the antibodies might travel through the placenta and get adhered to the antigens present in the erythrocytes of the fetus. This report highlights a rare case of Rh isoimmunization leading to fetal anemia in a 26-year-old female and evaluates the impact of intrauterine transfusion (IUT) in terms of the gestational age at delivery along with the mode of delivery, procedural complications, and overall survival rate of the fetus. In conclusion, the most frequent cause of fetal anemia is Rh alloimmunization, which should be taken into consideration while making a differential diagnosis throughout the assessment. Improvements in IUT procedures and earlier detection of the MCA-PSV by Doppler ultrasonographic examination have also contributed to better results.

Introduction: During the Coronavirus Disease 2019 (COVID-19) pandemic in India, two vaccinees were predominantly administered to prevent the spread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The first vaccine introduced in India was ChAdOx1-nCOV (Covishield), followed by BBV-152 (Covaxin). In the first phase, Healthcare Workers (HCW) were prioritised for vaccination, given their crucial role in the healthcare system. Aim: To assess the antibody response post Covishield vaccination at specific time intervals in HCWs and to determine the correlation of antibody response with age, gender, co-morbidities and blood group. Materials and Methods: This prospective study was conducted at Dr. Balasaheb Vikhe Patil Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India, over a duration of six months from January 2021 to June 2021. A total of 110 vaccinated HCWs who volunteered were included in this study. SARS-CoV-2 antibodies at specific time intervals were assessed using Ortho Clinical Diagnostic’s VITROS 3600 based on the principle of Chemiluminescent Immunosorbent Assay (CLIA). Assessment of anti-SARS-CoV-2 total and IgG antibodies was performed at 15 days, one month, one and a half months, two months, three months, and four months postfirst dose of vaccination, or in other words, 15 days and one month after the 1st dose, and 15 days, one month, two months, and three months post second dose of vaccination. For analysis, Pearson’s correlation and a regression model were performed using GraphPad Prism 8.0.2 version. Results: Fifteen days post second dose, 110 HCWs (100%) and 109 (99.09%) HCWs turned seropositive for total antibodies and IgG antibodies, respectively. It was observed that the majority of participants (33, 30.27%) with peak IgG levels in the medium range were from the age group of 31-40 years. Overall, there was a negative correlation between age and IgG antibody levels for peak IgG values (r-value=-0.224, p-value=0.019). The peak values were achieved in the majority of participants 15 days post second dose (53.6%). The difference in antibody levels based on gender was not significant (Chi-square value=3.387, p-value=0.184). No significant difference in SARS-CoV-2 IgG levels was observed between participants with co-morbidities and those without co-morbidities. Participants who developed SARS-CoV-2 infection during the study period exhibited robust antibody responses after vaccination. Conclusion: These findings help elucidate Covishield vaccine-specific antibody responses in vaccinees of different age groups, genders, blood groups, and with co-morbid conditions. The vaccine has substantially reduced the burden of disease by preventing serious illness in vaccinated HCWs during the second wave of the COVID-19 pandemic.

Introduction: Managing a challenging airway in awake, sedated, or anaesthetised patients has made Fibreoptic Intubation (FOI) using a flexible Fibreoptic Bronchoscope (FOB) a mainstay in clinical practice. Aim: To evaluate and compare fibreoptic nasotracheal intubation with or without Split Nasopharyngeal Airway (SNPA) as a conduit, focusing on time taken, ease of insertion, and haemodynamic changes. Materials and Methods: This randomised controlled study was conducted at the Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma, PGIMS, Rohtak, Haryana, India, on 80 patients who were randomly allocated into two groups: Group CL (the control group without SNPA) and Group NP (with SNPA). Both groups were induced with general anaesthesia, and nostrils were prepared for FOB. In Group CL, a well-lubricated FOB was inserted into the selected nostril without using SNPA, and endotracheal intubation was performed. In Group NP, an appropriately sized SNPA was lubricated and inserted into the selected nostril. The fiberscope was passed through the SNPA, the vocal cords were visualised, and the SNPA was removed before railroading the preloaded tube through the vocal cords to confirm correct placement. The time taken for bronchoscopy and intubation, ease of insertion, haemodynamic parameters, and bleeding were recorded in both groups. The data was coded, entered, and analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. A significance level was set at a p-value ≤0.05. Results: Demographic data, including age and gender distribution, mean weight, height, Body Mass Index (BMI), and airway parameters such as Mallampati grading, neck circumference, inter-incisor distance, and ASA grading, were standardised. There was no significant difference between the CL and NP groups regarding these parameters. The time taken for FOB and intubation in Group CL was 2.59±0.96 minutes and 3.61±1.04 minutes, respectively, compared to 1.87±0.91 minutes and 2.51±0.86 minutes in Group NP (p-value=0.001). The time taken to visualise the glottis was also shorter in the NP group (6.70±13.97 minutes) compared to the CL group (24.02±13.06 minutes), which was significant. Fibreoptic bronchoscopy was considered easy in 16 patients (40%) in Group CL and 27 patients (67.5%) in Group NP (p-value=0.04). The increase in mean arterial blood pressure was significantly higher in Group CL than in Group NP just after the insertion of the FOB into the nasopharynx (p-value=0.05). Conclusion: Fibreoptic nasotracheal intubation through an SNPA is less time-consuming and results in easier intubation. It causes less trauma to the nasal passage and leads to fewer haemodynamic variations in terms of mean arterial pressure and heart rate. Hence, SNPA is a better method for facilitating FOI compared to intubation without it.

IntroductionIn today's era, conducting nursing research is crucial for the advancement of the nursing profession. Scientific publications in clinical research aim to improve patient care outcomes and foster a sense of importance for nurses within the healthcare team. However, clinical nurses often fall behind due to factors such as limited familiarity, attitudes toward research, and encountered barriers.ObjectivesThis study was conducted to assess the knowledge, attitude, and perceived barriers regarding scientific research publications among clinical nurses at tertiary care hospitals in western Rajasthan.MethodologyA cross-sectional descriptive study was conducted among the clinical nurses. The participants were assessed for their knowledge, attitude, and perceived barriers regarding scientific research publications through a self-administered questionnaire.ResultsThe study revealed that 92% of the participants lacked sufficient knowledge about scientific research publications and 78.3% experienced moderate perceived barriers. Pearson's correlation coefficient indicated a weak positive correlation (r = 0.143, p = 0.007) between knowledge and attitude and a significant negative correlation (r = −0.143, p = 0.012) between knowledge and perceived barriers. However, multiple linear regression analysis showed no significant relationship among the clinical nurses in terms of knowledge, attitude, and perceived barriers toward scientific research publications.ConclusionThis study on clinical nurses revealed that the majority had insufficient knowledge about scientific research, while over half had neutral attitudes toward research publications. In addition, a significant portion of the clinical nurses reported experiencing moderate perceived barriers.

ABSTRACT Guanine nucleotides are required for growth and viability of cells due to their structural role in DNA and RNA, and their regulatory roles in translation, signal transduction, and cell division. The natural antibiotic mycophenolic acid (MPA) targets the rate-limiting step in de novo guanine nucleotide biosynthesis executed by inosine-5´-monophosphate dehydrogenase (IMPDH). MPA is used clinically as an immunosuppressant, but whether in vivo inhibition of bacterial IMPDH (GuaB) is a valid antibacterial strategy is controversial. Here, we describe the discovery of extremely potent small molecule GuaB inhibitors (GuaBi) specific to pathogenic bacteria with a low frequency of on-target spontaneous resistance and bactericidal efficacy in vivo against Acinetobacter baumannii mouse models of infection. The spectrum of GuaBi activity includes multidrug-resistant pathogens that are a critical priority of new antibiotic development. Co-crystal structures of A. baumannii, Staphylococcus aureus, and Escherichia coli GuaB proteins bound to inhibitors show comparable binding modes of GuaBi across species and identifies key binding site residues that are predictive of whole-cell activity across both Gram-positive and Gram-negative clades of Bacteria. The clear in vivo efficacy of these small molecule GuaB inhibitors in a model of A. baumannii infection validates GuaB as an essential antibiotic target.IMPORTANCEThe emergence of multidrug-resistant bacteria worldwide has renewed interest in discovering antibiotics with novel mechanism of action. For the first time ever, we demonstrate that pharmacological inhibition of de novo guanine biosynthesis is bactericidal in a mouse model of Acinetobacter baumannii infection. Structural analyses of novel inhibitors explain differences in biochemical and whole-cell activity across bacterial clades and underscore why this discovery may have broad translational impact on treatment of the most recalcitrant bacterial infections.

Background: Endometriosis is a chronic gynecologic disease that is dependent on estrogen and is associated with the existence of endometrial glands and stroma outside the uterus. It has been demonstrated that dienogest significantly and fairly effectively alleviates endometriosis-related symptoms such as dysmenorrhea and irregular menstruation. Material and Methods: This was a randomized, prospective, comparative, open-label study. For 12 weeks, Group A (n=30) received Dienogest 2 mg OD while Group B (n=30) received Medroxyprogesterone acetate (MPA) 10 mg BD. The patients were assessed at 4, 8, and 12 weeks to observe the VAS Score for dysmenorrhea, number of patients having dysmenorrhea, number of patients having irregular menstrual cycles. Adverse drug reactions (ADRs) were recorded for safety assessment. Results: After 12 weeks, VAS score & number of patients experiencing dysmenorrhea decreased in both groups significantly. Dienogest depicted better response than MPA in the reduction of VAS score (95.99% versus 84.91%; p-value=0.048) & reduction in the number of patients having dysmenorrhea after 12 weeks (6.67% versus 26.67%; p-value=0.038) and the difference was statistically significant. MPA group had a greater number of ADRs. Conclusion: Dienogest is significantly more effective than MPA, especially for dysmenorrhea. Dienogest shows better tolerability than MPA.

In recent years, overexplorations of ore and the growth of industries are the prime factors in the release of heavy metals in environments. As a result, the food crops and water bodies are contaminated with metals which may have several adverse effects on the health of humans and other living species. These metals and metalloids, such as Zn, Cu, Mn, Ni, Cr, Pb, Cd, and As, upset the biochemical pathways of metabolite synthesis in living organisms and contribute to the etiology of different diseases. Microorganisms include bacteria, archaea, viruses, and many unicellular eukaryotes, which can span three domains of life—Archaea, Bacteria, and Eukarya—and some microorganisms, such as cyanobacteria, have shown high efficiency in the biosorption rate of heavy metals. Cyanobacteria are suitable for bioremediation as they can grow in adverse environments, have a less negative impact on the surrounding environment, and are relatively cheaper to manage. The structure of cyanobacteria has shown no extensive internal-bound membranes, so it can directly employ the physiological mechanisms to uptake heavy metals from contamination sites. Such biochemical makeups are suitable for managing and bioremediating heavy metal concentrations in polluted environments. This review aims to explore the potential of cyanobacteria in the bioremediation of heavy metals and metalloids in water bodies. Additionally, we have identified the prospects for enhancing bioremediation effectiveness.

Antihyperglycemic effects of a novel polyherbal formula (HF344), comprising fifteen Thai herbal extracts, were elucidated for pharmacological mechanisms and potential for managing type 2 diabetes mellitus, by employing in vitro, ex vivo, and in vivo approaches. LC/MS analysis of HF344 extract revealed several phytoconstituents, with piperine identified as the major active compound. HF344 extract significantly enhanced insulin secretion in RINm5F cells in vitro and inhibited glucose uptake into the everted sacs of the mouse small intestine ex vivo in a concentration-dependent manner compared to the control (p

Purpose/objective(s)Bridging radiation therapy (bRT) is increasingly being utilized prior to chimeric antigen receptor (CAR) T-cell therapy for large B-cell lymphoma (LBCL). It is unknown how the extent of cytoreduction during bRT impacts outcomes.Materials/methodsWe retrospectively reviewed patients with LBCL treated with bRT followed by CAR T-cell therapy. Metabolic tumor volume (MTV), maximum standardized uptake value (SUVmax), SUVmean, and total lesion glycolysis (TLG) were extracted from F18-fluorodeoxyglucose positron emission tomography (PET) scans acquired prior to bRT and between completion of bRT and CAR T-cell infusion. Delta radiomics based on changes of these values were then calculated. The association between delta radiomics and oncologic outcomes [progression-free survival (PFS), freedom from distant progression (FFDP), and local control (LC)] were then examined.ResultsThirty-three sites across 23 patients with LBCL were irradiated. All metabolically active disease was treated in 10 patients. Following bRT, median overall decreases (including unirradiated sites) in MTV, SUVmax, SUVmean, and TLG were 22.2 cc (63.1%), 8.9 (36.8%), 3.4 (31.1%), and 297.9 cc (75.8%), respectively. Median decreases in MTV, SUVmax, SUVmean, and TLG in irradiated sites were 15.6 cc (91.1%), 17.0 (74.6%), 6.8 (55.3%), and 157.0 cc (94.6%), respectively. Median follow-up was 15.2 months. A decrease in SUVmax of at least 54% was associated with improved PFS (24-month PFS: 83.3% vs. 28.1%; p = 0.037) and FFDP (24-month FFDP: 100% vs. 62.4%; p < 0.001). A decrease in MTV of at least 90% was associated with improved FFDP (24-month FFDP: 100% vs. 62.4%; p < 0.001). LC was improved in sites with decreases in SUVmax of at least 71% (24-month LC: 100% vs. 72.7%; p < 0.001). Decreases of MTV by at least 90% (100% vs. 53.3%; p = 0.038) and TLG by at least 95% (100% vs. 56.3%; p = 0.067) were associated with an improved complete response rate.ConclusionbRT led to substantial reductions in MTV, SUVmax, SUVmean, and TLG. The relative extent of these decreases correlated with improved outcomes after CAR T-cell infusion. Prospective cohorts should validate the value of interim PET following bRT for quantifying changes in disease burden and associated prognosis.

Endometritis and sub-clinical endometritis are considered important factors for conception failure and repeat breeding conditions. Intra-uterine antibiotics infusion is generally recommended as the choice of treatment for endometritis. This work was performed to test the efficacy of ceftiofur sodium and marbofloxacin in the treatment of endometritis in cross-bred cows caused by Staphylococcus sp. One hundred cows found positive for Staphylococcus sp. from culture of uterine contents were grouped into two groups (CEF and MARB) of fifty cows each. Group CEF was treated with 1 g ceftiofur sodium (Xceft®, Alembic, India) intra-muscularly (IM) for five days and Group MARB was treated with 10% marbofloxacin (Marbomet®, Intas, India) at the dose rate of 2 mg/kg body weight IM once daily for 5 days. Animal from MARB and CEF groups were inseminated on next observed estrus after treatment and the conception rate was 52% and 32% compared to 60% in healthy control group, the difference being highly significant. The study reported antibiotic marbofloxacin as better alternative choice for the treatment of endometritis caused by Staphylococcus sp. in cross-bred cows.

Introduction CARISEL is an implementation–effectiveness “hybrid” study examining the perspectives of people living with HIV-1 (patient study participants [PSPs]) on cabotegravir (CAB) plus rilpivirine (RPV) long-acting (LA) dosed every 2 months (Q2M) across 5 European countries. Methods PSPs completed questionnaires on acceptability (Acceptability of Intervention Measure), appropriateness (Intervention Appropriateness Measure), and feasibility (Feasibility of Intervention Measure) at their first (Month [M] 1), third (M4), and seventh (M12) injection visits. Semistructured qualitative interviews were also conducted. Results Overall, 437 PSPs were enrolled, of whom 430 received treatment. Median (interquartile range) age was 44 (37-51) years, 25.3% (n = 109/430) were female (sex at birth), and 21.9% (n = 94/430) were persons of color. Across time points, PSPs found CAB + RPV LA highly acceptable, appropriate, and feasible (mean scores ≥4.47/5). Qualitative data supported these observations. Conclusions PSPs found CAB + RPV LA Q2M to be an acceptable, appropriate, and feasible treatment option.

Acinetobacter baumannii is a prominent hospital-associated bacterium whose eradication is increasingly challenging due to its remarkable ability to resist antibiotics. The most common illnesses caused by antibiotic-resistant A. baumannii are biofilm-associated. Therefore, novel methods to combat A. baumannii are urgently needed. Application of antimicrobial peptides (AMPs) is one of the avenues to be explored. Epsilon poly-l-lysine (ε-PL) is an antimicrobial peptide with low mammalian toxicity. It is commonly used as a food preservative and has advantages such as biodegradability, good water solubility, and thermal stability.Therefore, the antimicrobial activity of ε-PL against clinical isolates of A. baumannii was investigated. The effect of ε-PL on antimicrobial sensitivity was determined by broth dilution assay. The effect of ε-PL on biofilm formation and dispersion was studied using a crystal violet assay. The changes in the expression of quorum sensing related and virulence genes (abaI, csuE, pilT, bap, and luxI) were analyzed using qPCR by the Δ Δ CT method.All the A. baumannii clinical isolates (n = 28) tested, were resistant to multiple drugs. The treatment with ε-PL resulted in a significant (p

Neuroparalytic snake bite presents commonly as early morning neuroparalytic syndrome with ptosis, ophthalmoplegia and respiratory muscle paralysis. However, there are multiple lesser-known constituents of the snake venom that can cause other life-threatening complications, including persistent mydriasis, alterations in blood pressure, hyponatremia, and rhabdomyolysis. Venom-derived natriuretic peptides can produce significant hyponatremia due to urinary wasting. We report a 14-year-old girl who presented with EMNPS and subsequently developed persistent profound hyponatremia, found to be due to excess urinary sodium losses, that responded well to fluid management including administration of hypertonic saline.

Abstract Soybean is a rainfed crop grown across a wide range of environments in India. Its grain yield is a complex trait governed by many minor genes and influenced by environmental effects and genotype × environment interactions. In the current investigation, grain yield data of different sets of 41, 30 and 48 soybean genotypes evaluated during 2019, 2020 and 2021, respectively across 19 locations and twenty years’ data on 19 different climatic parameters at these locations was used to study the environmental effects on grain yield, to understand the genotype × environment interactions and to identify the mega-environments. Through analysis of variance (ANOVA), it was found that predominant portion of the variation was explained by environmental effects (E) (53.89, 54.86 and 60.56% during 2019, 2020 and 2021, respectively), followed by genotype × environment interactions (GEI) (31.29, 33.72 and 28.82% during 2019, 2020 and 2021, respectively). Principal Component Analysis (PCA) revealed that grain yield was positively associated with RH (Relative humidity at 2 m height), FRUE (Effect of temperature on radiation use efficiency), WSM (Wind speed at 2 m height) and RTA (Global solar radiation based on latitude and Julian day) and negatively associated with VPD (Deficit of vapour pressure), Trange (Daily temperature range), ETP (Evapotranspiration), SW (Insolation incident on a horizontal surface), n (Actual duration of sunshine) and N (Daylight hours). Identification of mega-environments is critical in enhancing the selection gain, productivity and varietal recommendation. Through envirotyping and genotype main effect plus genotype by environment interaction (GGE) biplot methods, nineteen locations across India were grouped into four mega-environments (MEs). ME1 included five locations viz., Bengaluru, Pune, Dharwad, Kasbe Digraj and Umiam. Eight locations—Anand, Amreli, Lokbharti, Bidar, Parbhani, Ranchi, Bhawanipatna and Raipur were included in ME2. Kota and Morena constitutes ME3, while Palampur, Imphal, Mojhera and Almora were included in ME4. Locations Imphal, Bidar and Raipur were found to be both discriminative and representative; these test locations can be utilized in developing wider adaptable soybean cultivars. Pune and Amreli were found to be high-yielding locations and can be used in large scale breeder seed production.

Background: Health professionals despite having a fair knowledge of staying fit and healthy lose their productive hours and lives to lifestyle diseases. An early identification of Metabolic Syndrome (MetS) and understanding of its lifestyle correlates can play a pivotal role in its prevention. Aim and Objectives: The objective of this study was to estimate the prevalence and associated lifestyle-related risk factors of MetS in medical students. Material and Methods: The study was an institution-based, cross-sectional, and non-interventional study. A total of 300 MBBS students of all three professional years constituted the study population. Sociodemographic variables and lifestyle-related risk factors were recorded, followed by anthropometric assessment, blood pressure measurement, and required laboratory investigations. International Diabetes Federation (IDF) criteria were used for MetS. Results: The prevalence of MetS in the current study was found to be 9.0%. Lower level of HDL-C emerged to be the most common parameter (57.37%) followed by abdominal obesity (25.6%) and raised triglycerides (18%). MetS increased as one progressed through the various academic years of medical training. Prevalence of MetS among male students (12.4%) was significantly higher than their female counterparts (4.1%). Frequency of eating > 7 times/week of fast food/ junk food [OR 1.75 (1.196- 1.306)], habit of watching screen while eating food [OR 1.78 (0.872-0.892)], >3 drinks (30 ml alcohol per drink) per month [OR 1.73 (1.068-1.170)] were found to be significant risk factors. Conclusion: Considering the high prevalence of MetS among medical students and its association with various lifestyle risk factors, it is imperative that health education, screening, early detection, lifestyle interventions and framing of new health policies are given careful consideration to manage the rising trend of MetS among them.

Abstract In recent years biochar (BC) has gained importance for its huge carbon (C) sequestration potential and positive effects on various soil functions. However, there is a paucity of information on the long-term impact of BC on the priming effect and nutrient availability in soil with different properties. This study investigates the effects of BC prepared from rice husk (RBC4, RBC6), sugarcane bagasse (SBC4, SBC6) and mustard stalk (MBC4, MBC6) at 400 and 600 °C on soil C priming and nitrogen (N), phosphorus (P), and potassium (K) availability in an Alfisol, Inceptisol, and Mollisol. BC properties were analyzed, and its decomposition in three soil orders was studied for 290 days in an incubation experiment. Post-incubation, available N, P, and K in soil were estimated. CO2 evolution from BC and soil alone was also studied to determine the direction of priming effect on native soil C. Increasing pyrolysis temperature enhanced pH and EC of most of the BC. The pyrolysis temperature did not show clear trend with respect to priming effect and nutrient availability across feedstock and soil type. MBC6 increased C mineralization in all the soil orders while RBC6 in Alfisol and SBC6 in both Inceptisol and Mollisol demonstrated high negative priming, making them potential amendments for preserving native soil C. Most of the BC showed negative priming of native SOC in long run (290 days) but all these BC enhanced the available N, P, and K in soil. SBC4 enhanced N availability in Alfisol and Inceptisol, RBC4 improved N and P availability in Mollisol and P in Alfisol and MBC6 increased K availability in all the soils. Thus, based on management goals, tailored BC or blending different BC can efficiently improve C sequestration and boost soil fertility.

Introduction: This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method: A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results: Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion: Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

The rising advancements in Industry 4.0 technologies have made more usual to acquire significant volumes of machine operating data in real time. In response to inconsistent data distribution and label scarcity in target domains, this work suggests a machine learning (ML) approach for rolling element bearing failure identification under a variety of circumstances. This study presents, a new method called Composite coyote optimized resilient linear regression (CCO-RLR) for defect recognition and classification in rolling element bearings. Early rolling bearing failure diagnosis is a crucial and time-sensitive operation that guarantees the dependability and security of mechanical fault systems. Initially, the rolling element bearings dataset is collected and preprocessed using Min-max normalization. For extracting the feature, Fourier transform (FT) is employed. The result shows that the CCO-RLR accuracy is 97.8% when compared with those existing methods. Our suggested method offers an effective means of quantifying flaws and significantly improving classification effectiveness.

Abstract Background Researchers, prompted by the toxicity and side effects associated with cisplatin, are exploring alternative approaches for developing transition metal-based anticancer agents. Employing a green biochemical approach, we transformed Nickel pyridine dicarboxylic acid compounds into the nanoscale using the aqueous extract of Macrotyloma uniflorum (horse gram). Results Characterization of the biosynthesized nanoparticles involved electronic and IR spectroscopy. A scanning electron microscope revealed a predominant spherical shape for most Nickel nanoparticles (Ni-NPs), with XRD patterns indicating particle sizes ranging from approximately 30–150 nm. The nanoparticles were evaluated for their free radical scavenging efficiency and in vitro anti-malignant properties against HeLa and A549 cancer cell lines. Numerical optimization of the DPPH and MTT assays was conducted using response surface methodology (RSM), focusing on the effects of 3,4-pyridine dicarboxylic acid (ML1), 2,4-pyridine dicarboxylic acid (ML2), nickel nanoparticles concentration, and temperature. In this investigation, the incorporation of Horse Gram seed extract (Macrotyloma uniflorum) has unveiled its abundance in phenolic and flavonoid compounds, widely acknowledged for their robust antioxidant activity in the existing literature. Conclusion The present study highlights the potential for refining the bio-toxicity and biochemical attributes of Ni-NPs to pave the way for a new generation of versatile anticancer agents with clinically established efficacy. Notably, the anticipated data closely corresponds with experimental outcomes, reinforcing the trustworthiness and validity of the RSM model for examining anticancer and antioxidant properties in this context. ML2 exhibited heightened antioxidant and anticancer activities in comparison to ML1 nanoparticles. Graphical abstract

Background: The lung is a respiratory organ in which steady development begins during the embryonic period at 0–7 weeks’ gestation and continues into early childhood. Cardiothoracic surgeries and procedures such as lobectomy, segmental resection of bronchoscopy, require a thorough knowledge of the anatomy of the lung. Study of length, fissures and lobes of the lung can guide the surgeons for the above procedures and help them to prevent undue complications during surgery. Many variations are noted by researchers till date in both the lungs in regards to length, breadth, fissures, and lobes. In the current study, we have also observed variations in fissures of lung. Aims and Objectives: To study the normal length, breadth, and thickness of both sides of lungs, variations in the length, breadth, and thickness of both sides of the lungs. To study the normal fissures, lobes and their variations, of both right and left lungs, and also to study the number of bronchi, pulmonary artery, and pulmonary vein. Materials and Methods: 50 Right and 50 left lungs were obtained from embalmed cadavers, used for dissection in the Department of Anatomy, King George’s Medical University, Lucknow, UP, by using measuring tape and measuring scale. Photography was done by a DSLR camera. Results: The left lung shows maximum variations in the hilum. Out of 50 left lungs, 6 showed the absence of oblique fissures, 2 lungs had 2 arteries, 2 lungs had 2 Veins, and 1 had 2 bronchi. Out of 50 right lungs, 2 lungs showed 2 arteries, 2 lungs had 2 veins, and 2 had 3 bronchi. Conclusion: Knowledge of normal measurements of both sides of the lungs and their variations may help cardiothoracic surgeons avoid complications during surgery and it may help radiologists resolve uncertain radiographic findings.

Dear Editor, World-famous Nobel laureate Boris Pasternak rightly quotes, “Surprise is the greatest gift which life can grant us.” Likewise, AstraZeneca, a UK-based pharmaceutical giant, surprised and shocked the world by admitting in a UK court that the Coronavirus Disease-2019 (COVID-19) vaccine (marketed as COVISHIELD in India) “can, in very rare cases, cause Thrombosis with Thrombocytopenia Syndrome (TTS),” or simply, blood clots with low platelets. Later, the company decided to withdraw the vaccine from the global market due to commercial reasons. This pharma behemoth could not escape the scrutinising eyes of the scientific community and was held responsible for the development of TTS in several vaccinated patients [1]. Although this confessed in the UK, the news was fired on social media platforms, caused a furore throughout the world, including India, where millions of people had received this vaccine for their survival [2]. Therefore, an impactful concern that has been bothering us since the recent and ongoing controversy is: will we also lose faith in vaccines for other diseases?

The chemokine co-receptors CXCR4 and CCR5 mediate HIV entry and signal transduction necessary for viral infection. However, to date only the CCR5 antagonist maraviroc is approved for treating HIV-1 infection. Given that approximately 50% of late-stage HIV patients also develop CXCR4-tropic virus, clinical anti-HIV CXCR4 antagonists are needed. Here, we describe a novel allosteric CXCR4 antagonist TIQ-15 which inhibits CXCR4-tropic HIV-1 infection of primary and transformed CD4 T cells. TIQ-15 blocks HIV entry with an IC50 of 13 nM. TIQ-15 also inhibits SDF-1α/CXCR4-mediated cAMP production, cofilin activation, and chemotactic signaling. In addition, TIQ-15 induces CXCR4 receptor internalization without affecting the levels of the CD4 receptor, suggesting that TIQ-15 may act through a novel allosteric site on CXCR4 for blocking HIV entry. Furthermore, TIQ-15 did not inhibit VSV-G pseudotyped HIV-1 infection, demonstrating its specificity in blocking CXCR4-tropic virus entry, but not CXCR4-independent endocytosis or post-entry steps. When tested against a panel of clinical isolates, TIQ-15 showed potent inhibition against CXCR4-tropic and dual-tropic viruses, and moderate inhibition against CCR5-tropic isolates. This observation was followed by a co-dosing study with maraviroc, and TIQ-15 demonstrated synergistic activity. In summary, here we describe a novel HIV-1 entry inhibitor, TIQ-15, which potently inhibits CXCR4-tropic viruses while possessing low-level synergistic activities against CCR5-tropic viruses. TIQ-15 could potentially be co-dosed with the CCR5 inhibitor maraviroc to block viruses of mixed tropisms.

In the present day, recycling and reducing environmental pollution are the primary objectives of sustainable development. A lot of experts are considering the possibility of creating a new composite technology with waste materials. This work aims to investigate the effects of waste material on mechanical and hydrophobic properties, with a particular focus on bagasse fiber with stubble. The tensile, flexural, impact, and hardness properties of bagasse with stubble polyester composite were investigated to see if it may be used as a novel material in various engineering applications for a longer life. To improve the impact resistance of the composite, bagasse fibers is mixed in different ratios with polyester and stubble as infill. Additionally, a very tiny amount of TiO2 was added to every sample. Tensile, flexural, and impact mechanical properties were assessed using the Universal Testing Machine, the Rockwell Hardness Testing Machine, and the Izod Impact Test. Samples were hand-set out using varying weight ratios of binder, filler, and fiber. The study's findings demonstrated that the sample with a higher percentage of bagasse fiber demonstrated better mechanical and hydrophobic qualities as compared to the neat and other samples. It is an economical, long-lasting, and environmentally responsible option for a variety of applications.

Abstract Introduction Cabotegravir plus rilpivirine (CAB + RPV) is the first complete long‐acting (LA) regimen recommended for maintaining HIV‐1 virological suppression. Cabotegravir And Rilpivirine Implementation Study in European Locations (CARISEL) is an implementation–effectiveness study examining the implementation of CAB+RPV LA administered every 2 months (Q2M) in European HIV centres. We present staff study participant (SSP) perspectives on the administration of CAB+RPV LA over 12 months. Methods Eighteen clinics were randomized to one of two implementation support packages: standard arm (Arm‐S) or enhanced arm (Arm‐E). Arm‐S included video injection training and provider/patient toolkits. Additionally, Arm‐E included skilled wrap‐around team meetings, face‐to‐face injection training and continuous quality improvement (CQI) calls. SSPs completed surveys on the acceptability, appropriateness and feasibility of CAB+RPV LA as an intervention and its implementation into their clinics, as well as barriers and facilitators to implementation. All surveys were completed at Month (M)1 (baseline), M5 and M12; data collection was completed by February 2022. Qualitative data were obtained from semi‐structured interviews at M1, M5 and M12. The primary objective was assessed via formal statistical comparisons between study arms of the Acceptability of Implementation Measure, Implementation Appropriateness Measure and Feasibility of Implementation Measure surveys (1–5 Likert scale ranging from 1 = “completely disagree” to 5 = “completely agree”). Equivalent measures anchored to CAB+RPV LA as a therapy were also assessed. Results Seventy SSPs completed surveys and interviews at M1, 68 at M5 and 62 at M12. Mean acceptability/appropriateness/feasibility scores were ≥3.8 (out of 5) at M12 for implementation‐ and intervention‐based measures. An analysis of covariance showed no significant differences between study arms for these outcomes. Although barriers were noted, most SSPs were not overly concerned that these would impact implementation; concern about these anticipated barriers also decreased over time. At M12, 90.3% (n = 56/62) of SSPs held a positive opinion about CAB+RPV LA implementation. Qualitative interviews and CQI calls highlighted three top practices that supported implementation: implementation planning; education about CAB+RPV LA clinical efficacy; and education around administering injections and managing pain/discomfort after injections. Conclusions CARISEL demonstrated that CAB+RPV LA dosed Q2M was successfully implemented across a range of European locations, with SSPs finding implementation highly acceptable, appropriate and feasible. ClinicalTrials.gov number NCT04399551

IntroductionThe formidable survival mechanisms employed by Mycobacterium tuberculosis (Mtb), combined with the low bioavailability of anti-tubercular drugs and their associated hepatotoxicity, worsen tuberculosis management. Traditional medicinal plants offer potential solutions to these challenges. This study focuses on exploring the anti-tubercular potential of Solanum virginianum against Mycobacterium smegmatis, mc2155.Methods and resultsHPTLC and UHPLC phytochemically characterized the hydro-methanolic extract of Solanum virginianum (SVE). SVE curtails the growth and viability of mc2155 under normal and in vitro stress conditions. The compromised cell wall integrity of mc2155 with SVE is depicted through scanning electron microscopy (SEM) while EtBr permeability assays and TLC-based comparative changes in lipids extraction addressed the integrity of the cell wall. Furthermore, SVE augmented the susceptibility of mc2155 towards Isoniazid (INH) through enhanced bioavailability. Adjunct treatment of SVE with INH demonstrated a markedly reduced survival of the intracellular bacilli. The study also uncovered the hepatoprotective potential of SVE in HepG2 cells.ConclusionThis research paves the way for deeper exploration into the potential of Solanum virginianum against virulent Mtb strains, emphasizing over the significance of traditional medicinal plants in tuberculosis treatment. Collectively, the findings suggest SVE as a potent candidate for independent or adjunct anti-tubercular therapy.

IntroductionLatent tuberculosis infection (LTBI) is a common coinfection in people living with HIV (PWH). How LTBI and HIV exposure in utero influence the development of infant humoral immunity is not well characterized. To address this question, we assessed the relationship between maternal humoral responses in pregnant women with HIV or with HIV/LTBI on humoral responses in infants to BCG vaccination and TB acquisition.MethodsPlasma samples were obtained from mother infant pairs during pregnancy (14-34 wks gestation) and in infants at 12 and 44 wks of age from the IMPAACT P1078 clinical trial. LTBI was established by Interferon gamma release assay (IGRA). Progression to active TB (ATB) disease was observed in 5 women at various times after giving birth. All infants were BCG vaccinated at birth and tested for IGRA at 44 weeks. Mtb (PPD, ESAT6/CFP10, Ag85A, LAM), HIV (GP120), and Influenza (HA) specific IgG, IgM, and IgA were measured in plasma samples using a bead based Luminex assay with Flexmap 3D.ResultsIn maternal plasma there were no differences in Mtb-specific antibodies or viral antibodies in relation to maternal IGRA status. ATB progressors showed increases in Mtb-specific antibodies at diagnosis compared to study entry. However, when compared to the non-progressors at entry, progressors had higher levels of Ag85A IgG and reduced ESAT6/CFP10 IgG and LAM IgG, IgM, and IgA1. All infants showed a decrease in IgG to viral antigens (HIV GP120 and HA) from 12 to 44 weeks attributed to waning of maternally transferred antibody titers. However, Mtb-specific (PPD, ESAT6/CFP10, Ag85A, and LAM) IgG and IgM increased from 12 to 44 weeks. HIV and HA IgG levels in maternal and 12-week infant plasma were highly correlated, and ESAT6/CFP10 IgG and LAM IgG showed a relationship between maternal and infant Abs. Finally, in the subset of infants that tested IGRA positive at 44 weeks, we observed a trend for lower LAM IgM compared to IGRA- infants at 44 weeks.DiscussionThe results from our study raise the possibility that antibodies to LAM are associated with protection from progression to ATB and support further research into the development of humoral immunity against TB through infection or vaccination.

This paper investigates the impact of fractional derivatives on the activation functions of an artificial neural network (ANN). Based on the results and analysis, a three-layer backpropagation neural network model with fractional and integer derivatives employed in the activation function and fractional gradient descent method backpropagation learning algorithm has been proposed. Specifically, three perceptrons have been proposed based on fractional and integer derivatives applied to activation functions and learning algorithms. They are fractional derivative activation function (FDAF) perceptron, integer derivative activation function (IDAF)-fractional derivative learning algorithm (FDLA) perceptron, and fractional derivative learning algorithm (FDLA) perceptron. The Riemann-Liouville (RL) fractional derivative, Grunwald-Letnikov (GL) derivative, Caputo-Fabrizio (CF) fractional derivative, Caputo (C) fractional derivative, and Atangana-Baleanu (AB) fractional derivative have been employed. The impact of these derivatives’ fractional-order (FO) is investigated in a wide range from 0.1−0.9 on testing mean square error (MSE) and time required to train the perceptron. FO-based and IO-based perceptrons are compared with the help of performance metrics such as testing MSE and the time required to train the models. The training and testing simulation results illustrate that Caputo-Fabrizio derivative-based perceptrons outperform other fractional derivatives. Also, the performance of the FO-based perceptron is better in terms of the least MSE.

Plants adjust their developmental processes for their survival against changing environments. Plant development is adversely affected by arsenic (As) contamination. In order to mitigate As toxicity, the effect of silicon (Si) (as silicic acid) and nitric oxide (NO) (as sodium nitroprusside; SNP) was observed on 7 days old radish (Raphanus sativus L.) seedlings under 0.3, 0.5 and 0.7 mM As concentrations. Plant growth traits, oxidative stress, carbohydrates, protein, antioxidants and osmolytes were measured. Arsenic stress inhibited the growth parameters and caused oxidative damage by elevating the level of oxidative stress markers and by causing membrane and nuclear damage, as shown by histochemical studies. Activities of antioxidative enzymes, content of non-enzymatic antioxidants, and levels of osmolytes were also decreased by As stress. However, Si and NO supplementation enhanced the As tolerance by improving the plant growth parameters. Moreover, Si and NO application improved carbohydrates and protein contents and stimulated plant antioxidant defense systems by decreasing the level of malondialdehyde and hydrogen peroxide and by diminishing the membrane and nuclear damage caused by As. An increase in the osmolytes levels were observed by the application of Si and NO. Fourier transform infrared analysis showed that Si and NO exerted various peaks in different lipids, proteins, carbohydrates and cell wall component regions. This study suggests that Si and NO can help mitigating As-induced toxicity in R. sativus seedlings and augment growth.

Abstract Macrophages assume diverse phenotypes and functions in response to cues from the microenvironment. Earlier we reported an anti-inflammatory effect of Collagenase Santyl® Ointment (CSO) and the active constituent of CSO (CS-API) on wound macrophages in resolving wound inflammation indicating roles beyond debridement in wound healing. Building upon our prior finding, this study aimed to understand the phenotypes and subsets of macrophages following treatment with CS-API. scRNA-sequencing was performed on human blood monocyte-derived macrophages (MDM) following treatment with CS-API for 24 h. Unbiased data analysis resulted in the identification of discrete macrophage subsets based on their gene expression profiles. Following CS-API treatment, clusters 3 and 4 displayed enrichment of macrophages with high expression of genes supporting extracellular matrix (ECM) function. IPA analysis identified the TGFβ-1 pathway as a key hub for the CS-API-mediated ECM-supportive phenotype of macrophages. Earlier we reported the physiological conversion of wound-site macrophages to fibroblasts in granulation tissue and impairment of such response in diabetic wounds, leading to compromised ECM and tensile strength. The findings that CSO can augment the physiological conversion of macrophages to fibroblast-like cells carry significant clinical implications. This existing clinical intervention, already employed for wound care, can be readily repurposed to improve the ECM response in chronic wounds.

Trehalose (Tre) is a non-reducing disaccharide found in many species, including bacteria, fungi, invertebrates, yeast, and even plants, where it acts as an osmoprotectant, energy source, or protein/membrane protector. Despite relatively small amounts in plants, Tre concentrations increase following exposure to abiotic stressors. Trehalose-6-phosphate, a precursor of Tre, has regulatory functions in sugar metabolism, crop production, and stress tolerance. Among the various abiotic stresses, temperature extremes (heat or cold stress) are anticipated to impact crop production worldwide due to ongoing climate changes. Applying small amounts of Tre can mitigate negative physiological, metabolic, and molecular responses triggered by temperature stress. Trehalose also interacts with other sugars, osmoprotectants, amino acids, and phytohormones to regulate metabolic reprogramming that underpins temperature stress adaptation. Transformed plants expressing Tre-synthesis genes accumulate Tre and show improved stress tolerance. Genome-wide studies of Tre-encoding genes suggest roles in plant growth, development, and stress tolerance. This review discusses the functions of Tre in mitigating temperature stress—highlighting genetic engineering approaches to modify Tre metabolism, crosstalk, and interactions with other molecules—and in-silico approaches for identifying novel Tre-encoding genes in diverse plant species. We consider how this knowledge can be used to develop temperature-resilient crops essential for sustainable agriculture.

Background: Ropivacaine is an ammino-amide local anesthetic agent with properties similar to bupivacaine, but its decreased lipophilicity is associated with reduced incidence of central nervous system toxicity and cardiotoxicity. This study evaluated the safety, efficacy, effects on hemodynamics and complications of spinal anesthesia using 0.5% hyperbaric bupivacaine and 0.75% hyperbaric ropivacaine in patients undergoing transurethral resection of the prostate (TURP). Aims and Objectives: The aim was to evaluate the safety, efficacy, hemodynamic stability, and side effects of spinal anesthesia using 0.5% hyperbaric bupivacaine and 0.75% hyperbaric ropivacaine in patients undergoing TURP. Materials and Methods: Sixty adult patients with physical status classes I and II, as determined by the American Society of Anesthesiologists, scheduled to undergo elective transurethral resection of prostate, were randomly allocated to receive either hyperbaric ropivacaine 0.75% 2.8 mL plus fentanyl 15 mcg or hyperbaric bupivacaine 0.5% 2.8 mL plus fentanyl 15 mcg. The parameters, such as demographic characteristics, duration of surgery, onset of sensory and motor blockade, hemodynamic stability, and complications, were compared in both groups. Results: Hyperbaric ropivacaine exhibited significantly slower onset times for sensory and motor blockade compared to hyperbaric bupivacaine. Patients in the ropivacaine group demonstrated better hemodynamic stability and experienced less hypotension compared to those who received bupivacaine. Moreover, the sensory and motor block lasted significantly longer in the bupivacaine group. Conclusion: About 0.75% hyperbaric ropivacaine is a better choice for spinal anesthesia in elderly patients undergoing TURP as compared to 0.5% hyperbaric bupivacaine.

Abstract Measuring SARS-CoV-2-specific T cell responses is crucial to understanding an individual’s immunity to COVID-19. However, high inter- and intra-assay variability make it difficult to define T cells as a correlate of protection against COVID-19. To address this, we performed systematic review and meta-analysis of 495 datasets from 94 original articles evaluating SARS-CoV-2-specific T cell responses using three assays – Activation Induced Marker (AIM), Intracellular Cytokine Staining (ICS), and Enzyme-Linked Immunospot (ELISPOT), and defined each assay’s quantitative range. We validated these ranges using samples from 193 SARS-CoV-2-exposed individuals. Although IFNγ ELISPOT was the preferred assay, our experimental validation suggested that it under-represented the SARS-CoV-2-specific T cell repertoire. Our data indicate that a combination of AIM and ICS or FluoroSpot assay would better represent the frequency, polyfunctionality, and compartmentalization of the antigen-specific T cell responses. Taken together, our results contribute to defining the ranges of antigen-specific T cell assays and propose a choice of assay that can be employed to better understand the cellular immune response against viral diseases.

Introduction: Endometrial hyperplasia affects both premenopausal and postmenopausal women and is a pathological condition that ranges from mild, reversible glandular proliferations to direct precursors of cancer. B-cell Lymphoma 2 (Bcl-2), an antiapoptotic gene involved in the regulation of apoptosis, and Ki-67, a proliferation marker, serve as indicators for cell proliferation from endometrial hyperplasia to endometrial carcinoma. Aim: To examine the expression of Bcl-2 and Ki-67 in endometrial hyperplasia and disordered endometrium. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at MVJ Medical College and Research Hospital, located in Hoskote, Karnataka, India, over a period of two years, from September 2020 to September 2022. All endometrial samples and hysterectomy specimens were included. Immunohistochemical staining was performed using Bcl-2 and Ki-67 in disordered proliferative endometrium and endometrial hyperplasia, and the staining and intensity were graded. Statistical analysis was performed, with qualitative variables presented as percentages and quantitative variables presented as Mean±Standard Deviation (SD). A p-value

Context: Personality traits influence one's behavior and are an important determinant of psychological well-being. Though personality traits influencing criminal behavior have been well researched, the influence of these personality traits on the mental health of prisoners still needs to be studied. Aims: The current study was undertaken with the aim to compare the personality traits of convicted prisoners with and without psychiatric morbidity. Settings and Design: Two hundred convicted prisoners were administered a semi-structured questionnaire assessing sociodemographic and criminological variables and their personality characteristics were assessed using the Hindi PEN inventory. Subjects and Methods: They were categorized into two groups, i.e., with and without psychiatric morbidity based on whether or not they had any psychiatric disorder when assessed using mini-international neuropsychiatric interview and their personality characteristics were compared. Statistical Analysis Used: Frequencies with percentages, mean, and standard deviations were calculated for descriptive statistics using SPSS Version 20 (IBM Corp., Armonk, NY, USA). Mann–Whitney test was used for comparing two samples and Kruskal–Wallis one-way analysis of variance by ranks was used for comparing more than two samples. Spearman rank correlation was used for assessing the correlation between two variables. The level of significance was set at P < 0.05. Results: Convicts with psychiatric disorders scored significantly higher on neuroticism (10.78 ± 3.51) and psychoticism (8.64 ± 2.93) dimensions of personality as compared to their counterparts without psychiatric morbidity who had significantly higher scores on Extraversion (12.35 ± 2.92) (P < 0.01). Male convicts had significantly higher scores on the extraversion dimension of personality (10.79 ± 3.77) compared to their female counterparts (9.27 ± 3.49; P < 0.01) There was a significant negative correlation between extraversion and neuroticism (=−0.509), extraversion and psychoticism (=−0.355) and a high positive relationship between neuroticism and psychoticism (=0.634). Conclusions: A baseline personality assessment of prisoners at the time of intake into jail is strongly recommended to identify those with high vulnerability to develop psychiatric problems so that effective and timely interventions can be planned.

Ameloblastoma, a benign epithelial odontogenic tumor, has an intriguing feature by virtue of its diverse histopathologic variants. One such variant that is not yet acclimatized in the literature due to the paucity of cases is “hemangiomatous ameloblastoma” (HA). HA exhibits the histology of conventional ameloblastoma with marked vascularity, which resembles the enamel organ and dental sac. Herein, we present the case of a 33-year-old male patient with swelling of the lower left back region of the jaw for 6 months, which on imaging presented multilocular radiolucency. Incisional biopsy was suggestive of ameloblastoma, and an excisional procedure showed odontogenic epithelial islands with marked vascular proliferation, based on which the diagnosis of HA was rendered. The rarity of this histologic variant and lack of long-term follow-up records in the literature challenges the clinician to predict its biological behavior. Hence, further research is required to understand the same.

Abstract The most common denture material used for dentistry is poly-methyl-methacrylate (PMMA). Usually, the polymeric PMMA material has numerous biological, mechanical and cost-effective shortcomings. Hence, to resolve such types of drawbacks, attempts have been made to investigate fillers of the PMMA like alumina (Al2O3), silica (SiO2), zirconia (ZrO2) etc. For the enhancement of the PMMA properties a suitable additive is required for its orthopedic applications. Herein, the main motive of this study was to synthesize a magnesium oxide (MgO) reinforced polymer-based hybrid nano-composites by using heat cure method with superior optical, biological and mechanical characteristics. For the structural and vibrational studies of the composites, XRD and FT-IR were carried out. Herein, the percentage of crystallinity for all the fabricated composites were also calculated and found to be 14.79–30.31. Various physical and optical parameters such as density, band gap, Urbach energy, cutoff energy, cutoff wavelength, steepness parameter, electron–phonon interaction, refractive index, and optical dielectric constant were also studied and their values are found to be in the range of 1.21–1.394 g/cm3, 5.44–5.48 eV, 0.167–0.027 eV, 5.68 eV, 218 nm, 0.156–0.962, 4.273–0.693, 1.937–1.932, and 3.752–3.731 respectively. To evaluate the mechanical properties like compressive strength, flexural strength, and fracture toughness of the composites a Universal Testing Machine (UTM) was used and their values were 60.3 and 101 MPa, 78 and 40.3 MPa, 5.85 and 9.8 MPa-m1/2 respectively. Tribological tests of the composites were also carried out. In order to check the toxicity, MTT assay was also carried out for the PM0 and PM15 [(x)MgO + (100 − x) (C5O2H8)n] (x = 0 and 15) composites. This study provides a comprehensive insight into the structural, physical, optical, and biological features of the fabricated PMMA-MgO composites, highlighting the potential of the PM15 composite with its enhanced density, mechanical strength, and excellent biocompatibility for denture applications.