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Background: The purpose of this study was to assess the impact of metabolic and bariatric surgery (MBS) on Quality of Life (QoL) in Indian patients with obesity over 10 years., Methods: A retrospective chart review was conducted at 11 centres for individuals with MBS between February 2013 and May 2022. Patient medical records provided the source of de-identified data., Results: Data from 2132 individuals with a mean age of 43.28 ± 11.96 years was analysed. There were 37.43% men and 62.57% females in the study population. The study population had a mean preoperative body mass index (BMI) of 45.71 ± 10.38 kg/m 2 . The Bariatric Analysis and Reporting Outcome System (BAROS) scoring method showed a higher overall QoL score throughout all follow-up periods, with 'very good' outcomes at one, three and 7 years and 'good' outcomes at 5 and 10 years. Improvements in QoL were associated with a substantial improvement (p < .01) in BMI at every follow-up time point., Conclusions: Following MBS, individuals with obesity exhibited a substantial and long-term improvement in their overall QoL for up to 10 years. This study presents Indian data on QoL, which is considered one of the most important decision-making factors for or against an intervention., (© 2024 The Author(s). Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Pigeon pea, a protein-rich legume with low protein digestibility (PD) due to its high polyphenol content and other antinutritional factors (ANFs). Consequently, processing methods are crucial to improve PD. We investigated the effects of thermal treatments (cooking, hydrothermal, autoclaving, infrared rays) treatments and germination on modulation of PD, its properties and association with ANFs in two distinct genotypes based on polyphenol content: high (Pusa Arhar 2018-4) and low (ICP-1452). Treatments improved in vitro PD and essential amino acid content, with autoclaving showing significantly higher PD (ICP-1452: 90.4%, Pusa-Arhar 2018-4: 84.32%) ascribed to disruption of tight protein matrices. Significant increase in β-turn, reduction in protein: starch, protein: polyphenol interactions as well as breakdown of storage proteins revealed by the analysis of protein structural properties. This study suggests thermal treatments, particularly autoclaving, can enhance pigeon pea protein's nutritional quality for its utilization as a new ingredient in development of healthy foods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The therapeutic potential of two important flavonoids, i.e. hesperidin and naringenin, remains unutilized due to pharmacokinetics issues, especially poor aqueous solubility. Hydrotropic solid dispersions with different agents like sodium salicylate, niacinamide, benzoic acid, and urea etc. can change the solubility profile of poorly soluble drugs. The current study investigated the potential of different hydrotropic agents in improving the solubility of both natural bioactives. The hydrotropic solid dispersion in 1:3 w/w drug: sodium salicylate ratio showed maximum solubility and dissolution amongst all the tested hydrotropes. This novel and economical approach could be explored for other poorly soluble pharmaceuticals.

Objective The present study aimed to assess and compare the surgical outcomes of hemorrhoidectomies performed using two different techniques: conventional Milligan-Morgan and another popular vessel sealing approach of LigaSure hemorrhoidectomy. Methods This retrospective study was conducted at our tertiary care hospital and involved patients who underwent either of the surgical procedures from June 2016 to March 2022. The patient demographics and data on the duration of operation, hospital stay, and postoperative recovery were collected and evaluated. Results Of the 91 cases reviewed, a total of 44 patients underwent Milligan-Morgan open hemorrhoidectomy and 47 had LigaSure hemorrhoidectomy. The mean operative time was significantly shorter for LigaSure hemorrhoidectomy (33.84 ±9.18 vs. 23.15 ±3.36 minutes for Milligan-Morgan and LigaSure, respectively, p<0.0001). Additionally, in comparison to Milligan-Morgan open hemorrhoidectomy, the LigaSure hemorrhoidectomy group exhibited a significant reduction in hospital stay (2.20 ±0.79 vs. 1.47 ±0.50 days), lower pain score [6.55 ±1.19 vs. 5.30 ±1.10 on the visual analog scale (VAS) on day one and 2.25 ±1.26 vs. 1.47 ±0.78 VAS on day seven], and faster return to normal activities (18.18 ±4.30 vs. 14.85 ±3.15 days). Conclusions When pitted against the traditional Milligan-Morgan method, the LigaSure approach to performing a hemorrhoidectomy is superior, owing to the shorter duration of operation, shorter hospital stays, lesser pain, and earlier return to normal activities. In light of these findings, surgeons may consider choosing this procedure to improve surgical outcomes and efficiency., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee at Dayanand Medical College and Hospital (DMCH), Ludhiana issued approval IEC No: 2022-737. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Virk et al.)

Climate influences near-surface biogeochemical processes and thereby determines the partitioning of carbon dioxide (CO 2 ) in shale, and yet the controls on carbon (C) weathering fluxes remain poorly constrained. Using a dataset that characterizes biogeochemical responses to climate forcing in shale regolith, we implement a numerical model that describes the effects of water infiltration events, gas exchange, and temperature fluctuations on soil respiration and mineral weathering at a seasonal timescale. Our modeling approach allows us to quantitatively disentangle the controls of transient climate forcing and biogeochemical mechanisms on C partitioning. We find that ~3% of soil CO 2 (1.02 mol C/m 2 /y) is exported to the subsurface during large infiltration events. Here, net atmospheric CO 2 drawdown primarily occurs during spring snowmelt, governs the aqueous C exports (61%), and exceeds the CO 2 flux generated by pyrite and petrogenic organic matter oxidation (~0.2 mol C/m 2 /y). We show that shale CO 2 consumption results from the temporal coupling between soil microbial respiration and carbonate weathering. This coupling is driven by the impacts of hydrologic fluctuations on fresh organic matter availability and CO 2 transport to the weathering front. Diffusion-limited transport of gases under transient hydrological conditions exerts an important control on CO 2(g) egress patterns and thus must be considered when inferring soil CO 2 drawdown from the gas phase composition. Our findings emphasize the importance of seasonal climate forcing in shaping the net contribution of shale weathering to terrestrial C fluxes and suggest that warmer conditions could reduce the potential for shale weathering to act as a CO 2 sink., Competing Interests: Competing interests statement:The authors declare no competing interest.

Objective: Borderline ovarian tumors (BOT) are characterized by atypical epithelial proliferation without stromal invasion and majority are diagnosed in women of reproductive age group desirous of fertility preservation., Methods: A retrospective review of medical records of patients diagnosed with BOT and on regular follow up at the All India Institute of Medical Sciences New Delhi, during a nine-year study period from March 2014 to March 2023 was performed. Surgical treatment was classified as radical or fertility sparing surgery (FSS). Surgical staging was defined as complete, partial or un-staged., Results: Median age of 91 women was 34 years. Follow up period ranged from 4 to 222 months (median 77 months). Among 68 premenopausal women, 31 (46 %) underwent radical surgery and FSS in 37 (54 %) cases. Median time to conception in 29 women with future fertility wishes was 13 months (range, 4 to38 m). Seven of 29 cases (29 %) required ovulation induction. The pregnancy rate was 82.7 % and live birth rate was 80 %. Eight cases (8.7 %) had a recurrence (7- un-staged, 1- partially staged) and median time to recur was 36 months. There was no significant difference in recurrence between cystectomy/oophorectomy. Ovary was the site of recurrence in all surgically salvaged cases except peritoneal cavity in 1 case with mortality. Relapse free survival at 5 and 10 years in FSS and radical surgery group were similar., Conclusion: FSS is a safe procedure and should be considered in young patients desirous of future fertility along with a comprehensive peritoneal staging. Reproductive outcomes are excellent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The molecular pathogenesis of colorectal cancer is known to differ between the right and left side of the colon. Several previous studies have focussed on the differences in clinicopathological features, proteomic and genetic biomarkers, the composition of gut microbiota, response to therapy, and the characteristics of the tumour microenvironment. However, the morphology and density of collagen in the extracellular matrix (ECM) have not been studied intensively. In this study, we employed 2-photon laser scanning microscopy (2PLSM) to visualise the intrinsic second-harmonic generation (SHG) signal emitted by collagen fibres in the heterogeneous ECM of human colon tumour tissues. Through texture analysis of the SHG signal, we quantitatively distinguished the imaging features generated by structural differences of collagen fibres in healthy colon and cancers and found marked differences. The fibres inside of tumours exhibited a loss of organisation, particularly pronounced in right-sided colon cancer (RSCC), where the chaotic regions were significantly increased. In addition, a higher collagen content was found in left-sided colon cancer (LSCC). In future, this might aid in subclassification and therapeutic decisions or even in designing new therapy regimens by taking into account the differences between collagen fibres features between colon tumours located at different sides., (© 2024. The Author(s).)

A series of natural alcohols motif containing novel substituted cinnamates were developed and screened against five bacterial strains namely, Enterococcus faecal ( E. faecalis ) , Escherichia coli ( E. coli ) , Bacillus subtilis ( B. subtilis ) , Pseudomonas aeruginosa (P. aeruginosa ) and Klebsiella pneumonieae ( K. pneumonieae ). Among all cinnamates, YS17 was identified with 100% bacterial growth inhibition across the panel, except in E. faecalis with MIC values of 0.25 mg/mL against B. subtilis and P. aeruginosa whereas 0.125, 0.5 and 1 mg/mL against E. coli, K. pneumonieae and E. faecalis , respectively. The growth inhibitory property of YS17 was further validated by disk diffusion, synergistic study and in vitro toxicity assays. Interestingly, YS17 exhibits synergistic effect in combination with the standard drug Ampicillin (AMP). The single crystal structure analysis of YS4 and YS6 was also performed which reconfirmed their proposed structures. Molecular docking visualized significant non-covalent interactions between E. coli MetAP and YS17 and the structural and conformational changes were further analysed using MD simulation studies. Overall, the study provided a suitable core for further synthetic alterations for their optimization as an antibacterial agent. Communicated by Ramaswamy H. Sarma.

Background Pilonidal sinus disease (PSD) is a chronic skin condition caused by hair retention that affects the sacrococcygeal cleft. The purpose of this study is to compare the efficacy of negative pressure wound therapy (NPWT) to routine daily dressings (DDs) in wound healing after complex or infected pilonidal sinus tract excision. Materials and methods The study included 81 individuals who had extensive local excisions for pilonidal sinuses that were complex or infected. Randomly selected participants were given either NPWT or the usual dressing. Between the two groups, the length of hospitalization, the amount of time needed to resume daily activities, and the amount of time needed for full wound closure were compared. Results Forty-two patients received NPWT, while 39 patients received DDs as usual. There was no discernible difference between the two groups in terms of operating time or hospital stay. However, patients who underwent NPWT experienced a quicker final wound closure (59.24 ± 10.21 days compared to routine DD with a mean time of 75.31 ± 14.68 days, P = 0.001) and returned to normal activities earlier (17.36 versus 21.75 days in NPWT and routine DD, respectively). Conclusion Compared to patients who received standard DDs, those who were postoperatively managed with NPWT showed faster wound healing and return to normal activities. Whenever feasible, this strategy may be employed to improve patient recovery., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kansal et al.)

The reproductive uniqueness of pangolins has been documented through diverse biological reports with discernible data discrepancies in gestation, copulation, and pregnancy. These mechanistic reproductive differences have yet to be endocrinologically quantified, which could assist in optimizing natural breeding in zoos to recover endangered species. The present research characterizes the Chinese pangolin's annual seasonal reproductive pattern by measuring immunoreactive estrogens and progestagens in 34 captive females and testosterone in 29 captive males. Our results showed that Chinese pangolins are seasonal breeders, with most births witnessed during Sept-Dec, overlapping with the field records. Females exhibited spontaneous ovulation and post-partum ovulation. Pregnant females exhibited a higher P4 level for ~ 9 months (Jan-Sept) and decreased before parturition (Oct-Dec). The circulating E2 is maintained at the baseline in pregnant females year-round. Contrastingly, in non-pregnant females, P4 is maintained at the baseline, apart from a slight elevation in January, and E2 demonstrates a sudden hike from November and remains elevated until February, suggesting the onset of ovulation. The serum testosterone concentration in males peaked during October, which is in sync with the female ovulation period. As a result that their major reproductive events, ovulation, mating, and parturition, all transpire in November-March. Evidence also supports that Chinese pangolins exhibit signs of postimplantation (pregnancy) ranging only from 5 to 6 months (May-Oct), preceded by possible facultative delay implantation triggered by lactation. The provided data not only fill in the knowledge gap for this critically endangered species but can also assist in making informed decisions, which can directly affect the successful breeding of this species in captivity., (© 2023. Springer Nature Limited.)

Background: Gender disparity in surgery remains an issue worldwide. We analysed the trends in gender distribution in surgical subspecialties across Australia and New Zealand over the last 8 years., Methods: Workforce reports from the Royal Australasian College of Surgeons were reviewed from 2014 to 2021. Data relating to 4802 applicants, 1554 trainees and 6839 active surgeons across nine surgical subspecialties was analysed. Statistical analysis was performed using a difference of proportions hypothesis test. Predictions regarding time to parity were performed using a linear regression model., Results: All nine surgical subspecialties' surgeon numbers saw a steady increase in the representation of women between 2014 and 2021. The most significant rise seen in general surgery from 14% to 21% (P ≤ 0.001). Proportions of women trainees were variable, the only significant rise was seen in orthopaedics from 9% to 19% (P ≤ 0.001). Proportions of women applicants and successful applicants have also been variable. General surgery saw the only consistent increase in women applicants over the last 6 years, from 35% in 2016 to 43% in 2021. Linear regression predictions estimate that paediatric surgery will be the first to reach gender parity in 23 years, and orthopaedics the last, in 186 years., Conclusion: A steady increase in women has been observed across all surgical subspecialities over the last 8 years. However, estimates based on current trends suggest that gender parity may be out of reach for the next eight generations in subspecialties such as cardiothoracic and orthopaedic surgery., (© 2023 Royal Australasian College of Surgeons.)

Two-dimensional (2D) graphene oxide nanosheets serve as an excellent support material for immobilizing metal complexes to deal with the drawbacks of homogeneous catalysis. In this work, we report a magnetically retrievable graphene oxide (MGO) based copper nanocatalytic system that has been efficiently exploited for obtaining a series of pharmaceutically and biologically active benzoxazole scaffolds. The nanocatalyst was designed by covalent immobilization of dehydroacetic acid (DHA) onto a magnetic amino-silanized graphene oxide nanosupport which was accompanied by its metallation with copper acetate. The structure of the synthesized MGO hybrid material (Cu@DHA@APTES@MGO) was characterized by numerous physico-chemical techniques such as transmission electron microscopy (TEM), field emission scanning electron microscopy (FE-SEM), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), vibrating sample magnetometry (VSM), elemental mapping, atomic absorption spectroscopy (AAS), thermogravimetric analysis (TGA), Brunauer-Emmett-Teller (BET) surface area analysis and energy-dispersive X-ray fluorescence spectroscopy (ED-XRF). The fabricated architectures exhibited high efficiency for cyclization of 2-aminophenols and β-diketones with wide substrate scope, excellent functional group tolerance, a higher conversion percentage (>98%) and a high turnover number (TON). The exceptional catalytic activity could be attributed to the 2D architecture of graphene oxide which provides space for trapping of reactants between 2D graphitic overlayers and metal surfaces and the reaction proceeds to afford benzoxazole products with moderate to excellent conversion percentages. Notably, this nanocomposite could be recovered easily through an external magnetic force and reused for multiple runs without any appreciable loss in its catalytic efficacy.

Enhanced rock weathering (ERW) in soils is a promising carbon removal technology, but the realistically achievable efficiency, controlled primarily by in situ weathering rates of the applied rocks, is highly uncertain. Here we explored the impacts of coupled biogeochemical and transport processes and a set of primary environmental and operational controls, using forsterite as a proxy mineral in soils and a multiphase multi-component reactive transport model considering microbe-mediated reactions. For a onetime forsterite application of ~ 16 kg/m 2 , complete weathering within five years can be achieved, giving an equivalent carbon removal rate of ~ 2.3 kgCO 2 /m 2 /yr. However, the rate is highly variable based on site-specific conditions. We showed that the in situ weathering rate can be enhanced by conditions and operations that maintain high CO 2 availability via effective transport of atmospheric CO 2 (e.g. in well-drained soils) and/or sufficient biogenic CO 2 supply (e.g. stimulated plant-microbe processes). Our results further highlight that the effect of increasing surface area on weathering rate can be significant-so that the energy penalty of reducing the grain size may be justified-only when CO 2 supply is nonlimiting. Therefore, for ERW practices to be effective, siting and engineering design (e.g. optimal grain size) need to be co-optimized., (© 2023. The Author(s).)

Mitochondrial dysfunction is one of the fundamental causes of ischemia reperfusion (I/R) damage. I/R refers to the paradoxical progression of cellular dysfunction and death that occurs when blood flow is restored to previously ischemic tissues. I/R causes a significant rise in mitochondrial permeability resulting in the opening of mitochondrial permeability transition pores (MPTP). The MPTP are broad, nonspecific channels present in the inner mitochondrial membrane (IMM), and are known to mediate the deadly permeability alterations that trigger mitochondrial driven cell death. Protection from reperfusion injury occurs when long-term ischemia is accompanied by short-term ischemic episodes or inhibition of MPTP from opening via mitochondrial ATP dependent potassium (mitoK ATP ) channels. These channels located in the IMM, play an essential role in ischemia preconditioning (PC) and protect against cell death by blocking MPTP opening. This review primarily focuses on the interaction between the MPTP and mitoK ATP along with their role in the I/R injury. This article also describes the molecular composition of the MPTP and mitoK ATP in order to promote future knowledge and treatment of diverse I/R injuries in various organs., Competing Interests: Conflict of interest statement There are no conflicts of interest., (Copyright © 2023. Published by Elsevier Masson SAS.)

Fractures are integral to the hydrology and geochemistry of watersheds, but our understanding of fracture dynamics is very limited because of the challenge of monitoring the subsurface. Here we provide evidence that long-term, high-frequency measurements of the river concentration of the ultra-trace element thorium (Th) can provide a signature of bedrock fracture processes spanning neighboring watersheds in Colorado. River Th concentrations show abrupt (subdaily) excursions and biexponential decay with approximately 1-day and 1-week time constants, concentration patterns that are distinct from all other solutes except beryllium and arsenic. The patterns are uncorrelated with daily precipitation records or seasonal trends in atmospheric deposition. Groundwater Th analyses are consistent with bedrock release and dilution upon mixing with river water. Most Th excursions have no seismic signatures that are detectable 50 km from the site, suggesting the Th concentrations can reveal aseismic fracture or fault events. We find, however, a weak statistical correlation between Th and seismic motion caused by distant earthquakes, possibly the first chemical signature of dynamic earthquake triggering, a phenomenon previously identified only through geophysical methods., (© 2023. The Author(s).)

Objective: Benign prostate hyperplasia (BPH) is a common cause for bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS) in men. The pathophysiology of BPH is multifactorial and inflammation has been linked with progression of BPH and LUTS. The association between histological prostatitis found at transurethral resection of the prostate (TURP) and adverse post-operative urinary outcomes is not clearly defined. Our aim was to evaluate the association between histological prostatitis and adverse post-operative urinary outcomes following TURP procedure., Methods: Patients who had undergone TURP for BPH at a single institution between 2014 and 2018 were included. The study population was divided into three cohorts: those with no histological inflammation, those with any form of inflammation and those specifically with prostatic stromal inflammation. Functional outcomes were assessed by defining a series of measurable post-operative "LUTS events" and comparing these to time-to-event profile using a Kaplan-Meier estimator., Results: A total 198 patients were included (no inflammation n = 101; any inflammation n = 97, prostatic stromal inflammation n = 81). All three groups were comparable in terms of baseline characteristics. The any inflammation group had significantly more adverse post-operative outcomes after TURP compared to the no inflammation group, P = 0.0065. The stromal inflammation group had more LUTS events after surgery compared to the no inflammation groups in the first year of follow-up n = 0.011; over a 5-year follow-up period the results were not statistically significant, P = 0.244., Conclusion: Histological prostatitis is associated with worse urinary outcomes after TURP compared to no inflammation. These results are useful in improving prognostic discussions with patients after TURP., (© 2023 John Wiley & Sons Australia, Ltd.)

The intriguing features of surface-engineered hexagonal two-dimensional boron nitride ( h -BN) nanostructures have captivated the immense interest of researchers working in the arena of materials science. Inspired by striking attributes exhibited by h -BN nanosheets as the support material, we devoted our efforts towards synthesizing a novel magnetically retrievable h -BN/Fe 3 O 4 /APTES-AMF/Cu II catalytic system, which was then comprehensively characterized using various techniques including SEM, TEM, EDX, SEM-based elemental mapping, ED-XRF, AAS, XRD, FT-IR, VSM, XPS, TGA, and BET. Further, the catalytic potential of h -BN/Fe 3 O 4 /APTES-AMF/Cu II nanocomposites was investigated in the one-pot multicomponent coupling reaction to gain access to a library of biologically active 2-amino-4-aryl(or heteroaryl)-7,7-dimethyl-5-oxo-5,6,7,8-tetrahydro-4 H -chromene-3-carbonitriles under ambient conditions. In addition, the use of green solvent, facile magnetic recoverability, and reusability of up to six successive runs made this protocol environmentally benign and economical. This work throws light on the development of covalently functionalized 2D-BN nanostructure-based copper catalysts and establishes its significance in furnishing industrially demanding products that would pave the way towards sustainable chemistry.

Potato fries, a relatively an untapped food matrix for fortification, was fortified with iron using vacuum impregnation technique and impact of this fortification on quality attributes (structure, color, texture, flavor, acrylamide, sensory characteristics) of the product was assessed. Further, to reduce the dietary restraints of consumers for fried fries, fat reduction was achieved using vacuum frying. Ferrous ammonium sulphate hexahydrate was used as a fortificant to yield 3.15 mg iron from 30 g fries (RACC for snacks- Recommended Amount Customarily Consumed). Effect of iron fortificant level, blanching, vacuum and restoration time (independent variable) were evaluated on responses (iron impregnation level and firmness) of fries using box-behnken design of response surface methodology. Results showed that blanching time was the most significant variable affecting iron impregnation followed by iron concentration and vacuum time. Ferrous ammonium sulphate hexahydrate was found to be the most appropriate fortificant since reflecting the least colour and sensory changes in fries. A fortified raw potato fries when fried under vacuum, provided better retention of colour and reduced fat absorption (by 17.72%) with comparable crispiness (0.37 kg/sec vs 0.35 kg/sec), firmness (0.39 kg/sec vs 0.38 kg/sec), color (ΔE = 1.39) and sensory score (7.9 vs 8.1 on 9-point scale) with control fries., Competing Interests: Conflicts of interestThe authors have not disclosed any competing interests., (© Association of Food Scientists & Technologists (India) 2022.)

Death due to abuse and accidental ingestion of methanol is widely known around the globe. The paper presents the postmortem changes in concentrations of methanol in the vitreous humor, aqueous humor, and ocular tissues in a rabbit model in methanol intoxication. Rabbits were intoxicated with methanol at a dose of 6.3 ml/kg through oral gavage. After 3.5 h of methanol administration, the rabbits were sacrificed. Vitreous humor, aqueous humor, and ocular tissues were collected both, perimortem (immediately) and postmortem (17 h post-death). Whole blood and plasma samples were also collected to explore the correlation between levels of methanol in whole blood/plasma and ocular fluids/ocular tissues if any. All the samples were analyzed by Headspace Gas Chromatography. The analysis revealed a decrease in methanol levels at postmortem for all the matrices, except for retina-choroid than its perimortem value. For retina-choroid, no significant change in methanol levels at postmortem was found., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background Systemic vascular resistance (SVR) is an integral component of the hemodynamic profile. Previous studies have demonstrated a close correlation between an estimated SVR analog (eSVR) based on echocardiographic methods and SVR by direct hemodynamic measurement. However, the prognostic impact of eSVR remains unestablished. Methods and Results Study participants with established coronary artery disease from the Heart and Soul Study formed this study cohort. We defined Doppler-derived eSVR as the ratio of systolic blood pressure to left ventricular outflow tract velocity time integral. Study participants were separated based on baseline eSVR tertile: <5.6, 5.6 to <6.9, and ≧6.9. An elevated eSVR was defined as an eSVR in the third tertile (≧6.9). Follow-up eSVR was calculated at the fifth year of checkup. Cardiovascular outcomes included heart failure, major cardiovascular events, and all-cause death. Among the 984 participants (67±11 years old, 82% men), subjects with the highest baseline eSVR tertile were the oldest, with the highest systolic blood pressure and lowest left ventricular outflow tract velocity time integral. A higher eSVR was associated with increased risk of heart failure, major cardiovascular events, and death. The hazard ratio for major cardiovascular events was 1.38 (95% CI, 1.02-1.86, P =0.03) for subjects with the highest eSVR tertile compared with the lowest. In addition, those with a persistently elevated eSVR during follow-up had the most adverse outcomes. Conclusions An elevated eSVR, derived by the ratio of systolic blood pressure and left ventricular outflow tract velocity time integral, was more closely correlated with cardiovascular events than systolic blood pressure alone. Repeatedly elevated eSVR was associated with more adverse outcomes.

The severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) is β-coronavirus that is responsible for the pandemic coronavirus disease 2019 (COVID-19) all over the world. The rapid spread of the novel SARS CoV-2 worldwide is raising a significant global public health issue with nearly 61.86 million people infected and 1.4 million deaths. To date, no specific drugs are available for the treatment of COVID-19. The inhibition of proteases essential for the proteolytic treatment of viral polyproteins is a conventional therapeutic strategy for conquering viral infections. In the study, molecular docking approach was used to screen potential drug compounds among the phytochemicals of Vitex negundo L. against COVID-19 infection. Molecular docking analysis showed that oleanolic acid forms a stable complex and other phyto-compounds ursolic acid, 3β-acetoxyolean-12-en-27-oic acid and isovitexin of V. negundo natural compounds form a less-stable complex. When compared with the control the synergistic interaction of these compounds shows inhibitory activity against papain-like protease (PL pro ) of SARS CoV-2 (COVID-19). The molecular dynamics (MD) simulation (50 ns) were performed on the complexes of PL pro and the phyto-compounds viz . oleanolic acid, ursolic acid, 3β-acetoxyolean-12-en-27-oic acid and isovitexin followed by the binding free energy calculations using MM-GBSA and these molecules have stable interactions with PL pro protein binding site. The MD simulation study provides more insight into the functional properties of the protein-ligand complex and suggests that these molecules can be considered as a potential drug molecule against COVID-19. In this pandemic situation, these herbal compounds provide a rich resource to produce new antivirals against COVID-19.Communicated by Ramaswamy H. Sarma.

Objective: Medical schools are charged with assisting medical students to acquire the confidence, knowledge and skills for behavior change conversations in primary healthcare. The present study evaluated teaching brief motivational interviewing (MI) to pre-clinical medical students., Methods: Forty-six students participated in an educational intervention premised on the Learn, See, Practice, Prove, Do, Maintain pedagogical framework, comprising 2 × 2-h lectures, a 2-h role-play triad session, and 3 × 2-h small group simulated patient encounters supported by scaffolding strategies. Measures of brief MI knowledge (MI Knowledge and Attitudes Test & Multiple-Choice Knowledge Test) and confidence (MI Confidence Scale) were taken at baseline, post-training, and 3-month follow-up, and skills (Behavior Change Counseling Index) were assessed at three intervals during simulated patient encounters., Results: Students who received brief MI training improved in knowledge and confidence from baseline to post-training and gains remained at 3-months. Brief MI skills improved across the simulation sessions., Conclusion: Pre-clinical medical students can attain knowledge, confidence and skills in brief MI after participation in a short intervention and improvements are sustainable., Practice Implications: Our results support the use of an evidence-based pedagogical framework for teaching brief MI in pre-clinical years of medical curricula and our scaffolding strategy affords promise., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Learner autonomy is an invaluable asset in graduate medical education, preparing the trainee to independently face challenges in the future professional settings. Educational institutions face the difficult task of providing a balance between learner autonomy and supervision. In graduate medical education, trainees often prefer less supervision than what is imparted by their attending physician. This increased supervision comes at the cost of learner autonomy and has not exhibited improvement in patient outcomes or safety. When attendings exhibit control over details, the trainees may label them as "micromanagers". Cardinal features of a micromanager include excessively requesting updates, insisting that the task be done their way, and scrutinizing every detail. This micromanaging behavior is non-conducive to the learning environment and may even contribute to supervisor burnout. The business literature reveals a debate about this very topic. Unfortunately, there is still a lack of literature on micromanagement in graduate medical education. Although a conglomerate of internal factors may lead to excessive supervision in an academic medical institution, we surmise that micromanagement exists because of a complex dynamic between three drivers: accountability, trust, and autonomy. When trainees are held accountable, they learn to take ownership for their actions which leads to establishment of trust which further enables motivation and gaining of autonomy. Supervising attendings should ideally be able to comfortably adjust their level of supervision based on their trust and the trainee's competence, accountability, and autonomy. The micromanaging physician is unable to do so, and this can have a detrimental effect on the learner. Micromanagement can be perceived by some as a beneficial component during the early immersion of the trainee with the rationalization for better patient outcomes and safety. However, in the long term, it threatens the learning environment and erodes the complex relationship between accountability, trust, and autonomy. We recommend an action plan to mitigate micromanagement at three levels-the micromanager, the micromanaged, and the organizational structure-and hope that these solutions enhance the learning environment for both the trainee and supervisor., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mookerjee et al.)

In this work, we have reported a noble metal free heterogeneous photocatalyst to carry out direct (het)arene C-H arylation and solvent-free CO 2 capture via single-electron transfer processes at room temperature and under pressure. The catalytic system comprises a cobalt(III) complex grafted over the silica coated magnetic support for the efficient recovery of the photocatalytic moiety without hampering its light-harvesting capability. The novel Earth-abundant cobalt(III) based photocatalyst possesses various fascinating properties such as high surface area to volume ratios, large pore volume, crystalline behaviour, high metal loading, excellent stability and reusability. The general efficacy of the highly abundant and low-cost cobalt based heterogeneous nanocatalyst was checked for the selective conversion of aryldiazonium salts into synthetically and pharmaceutically significant biaryl motifs under ambient conditions upon irradiation with visible light. The highly efficient photocatalytic conversion of carbon dioxide (CO 2 ) to a value-added chemical was accomplished under mild reaction conditions with high selectivity, showing the added benefit of operational simplicity.

Background: In the west, survival following treatment of childhood acute lymphoblastic leukaemia (ALL) approaches 90%. Outcomes in India do not exceed 70%. To address this disparity, the Indian Collaborative Childhood Leukaemia group (ICiCLe) developed in 2013 a contemporary treatment protocol for uniform risk-stratified management of first presentation ALL based on cytogenetics and minimal residual disease levels (MRD). A multicentre randomised clinical trial opened in 2016 (ICiCLe-ALL-14) and examines the benefit of randomised interventions to decrease toxicity and improve outcomes., Methods: Patients 1-18 years with newly diagnosed ALL are categorised into four risk groups based on presentation features, tumour genetics and treatment response. Standard risk includes young (< 10 years) B cell precursor ALL (BCP-ALL) patients with low presentation leucocyte count (< 50 × 10 9 /L) and no high-risk features. Intermediate risk includes BCP-ALL patients with no high-risk features but are older and have high presentation leucocyte counts and/or bulky disease. High risk includes BCP-ALL patients with any high-risk feature, including high-risk genetics, central nervous system leukaemia, poor prednisolone response at treatment day 8 and high MRD (≥ 0·01%) at the end of induction. Patients with T-lineage ALL constitute the fourth risk group. All patients receive four intensive treatment blocks (induction, consolidation, interim maintenance, delayed intensification) followed by 96 weeks of maintenance. Treatment intensity varies by risk group. Clinical data management is based on a web-based remote data capture system. The first randomisation examines the toxicity impact of a shorter induction schedule of prednisolone (3 vs 5 weeks) in young non-high-risk BCP-ALL. The second randomisation examines the survival benefit of substituting doxorubicin with mitoxantrone in delayed intensification for all patients. Primary outcome measures include event-free survival (overall, by risk groups), sepsis rates in induction (first randomisation) and event-free survival rates following second randomisation., Discussion: ICiCLe-ALL-14 is the first multicentre randomised childhood cancer clinical trial in India. The pre-trial phase allowed standardisation of risk-stratification diagnostics and established the feasibility of collaborative practice, uniform treatment, patient enrolment and data capture. Pre-trial observations confirm the impact of risk-stratified therapy in reducing treatment-related deaths and costs. Uniform practice across centres allows patients to access care locally, potentially decreasing financial hardship and dislocation., Trial Registration: Clinical Trials Registry-India (CTRI) CTRI/2015/12/006434 . Registered on 11 December 2015., (© 2022. The Author(s).)

Real-time monitoring of harmful gases is of great significance to identify the environmental hazards to people's lives. However, this application scenario requiring low-power consumption, superior sensitivity, portability, and self-driven operation of gas sensors remains a challenge. Herein, an electrospun triboelectric nanogenerator (TENG) is synthesized using highly electronegative and conducting MXene nanofibers (NFs) paired with biodegradable cellulose acetate NFs (CA-NFs) as triboelectric layers, which supports a sufficient power density (∼1361 mW/m 2 @2 MΩ) and shows a self-powered ability to operate the chemiresistive gas sensor fabricated in this work. Further, by using cellulose nanofibers (C-NFs) as a substrate, a new kind of MXene/TiO 2 /C-NFs heterojunction-based sensory component is developed for detection of NH 3 . This sensor exhibits excellent reproducibility, high selectivity, and sensitivity toward NH 3 (1-100 ppm) along with a fast response/recovery time (76 s/62 s) at room temperature. Finally, a monitoring system comprising a TENG-powered sensor, an equivalent circuit, and an LED visualizer has been assembled and successfully demonstrated as a fully self-powered device for NH 3 leakage detection. Thus, this work pushes forward the intelligent gas sensing network self-driven by human motion energy, dispensing the external battery dependence for environment monitoring to reduce the possible health effects.

Background: Prosopis juliflora is a clinically relevant allergic sensitizer worldwide and shares cross-reactivity with allergens from several tree pollen and food. The present study aims to purify and immunobiochemically characterize a major allergen from Prosopis pollen. The allergen was further investigated for its cross-reactivity with legume allergens., Methods: Prosopis extract was fractionated by Q Sepharose and Superdex 75 gel filtration column to purify the allergen. Specific IgE against purified protein was estimated via ELISA and immunoblot. The protein was subjected to mass spectrometric analysis. Glycan characterization was performed by Schiff staining and lectin binding assay followed by deglycosylation studies. The functional activity of the purified protein was evaluated by the basophil activation test. Cross-reactivity was assessed by inhibition studies with legume extracts., Results: A 35 kDa protein was purified and showed 75% IgE reactivity with the patients' sera by ELISA and immunoblot. Glycan characterization of protein demonstrated the presence of terminal glucose and mannose residues. A reduction of 40% and 27% in IgE binding was observed upon chemical and enzymatic deglycosylation of the protein, respectively. The glycoprotein allergen upregulates the expression of CD203c on basophils which was significantly reduced upon deglycosylation, signifying its biological ability to activate the effector cells. The identified protein shared significant homology with Lup an 1 from the lupine bean. Immunoblot inhibition studies of the purified allergen with legume extracts underlined high cross-reactive potential. Complete inhibition was observed with peanut and common bean, while up to 70% inhibition was demonstrated with soy, black gram, chickpea, and lima bean., Conclusion: A 35 kDa vicilin-like major allergen was isolated from P. juliflora. The protein possesses glycan moieties crucial for IgE binding and basophil activation. Furthermore, the purified protein shows homology with Lup an 1 and exhibits cross-reactivity with common edible legume proteins., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: GSTs are multifunctional enzymes involved in cellular detoxification and present as potent allergens in several sources. Present study investigates allergenic relevance of GST from P. americana and determine its cross reactive potential with other indoor allergen sources., Methods: Computational analysis with FASTA and ConSurf webserver was performed to determine potentially cross reactive allergens. Further, Per a 5 gene was cloned in pET 22b+ vector and expressed in E.coli BL21 cells and the rPer a 5 protein was purified using Ni-NTA affinity chromatography. Enzymatic activity of rPer a 5 was assessed using CDNB and cumene hydroperoxide. ELISA and immunoblot were performed using cockroach hypersensitive patient's sera. Functional activity of rPer a 5 was evaluated by basophil activation test. Inhibition studies were carried out with D. pteronyssinus, A. alternata and C. lunata extracts., Results: Per a 5 demonstrates highest sequence similarity with delta class GST of Blattella germanica (94.9%). It also exhibits significant sequence similarity (50-58%) with mite, fungal and helminth allergenic GSTs. ConSurf analysis reveals high degree of evolutionary similarity in N terminal region of Per a 5, especially at GST dimerization interface. The purified rPer a 5 protein resolved at 27 kDa on SDS-PAGE. The rPer a 5 protein exhibits GST activity and possess upto 65% immunoreactivity with cockroach hypersensitive patient's sera in ELISA and immunoblot. It upregulates expression of CD203c on basophils signifying its biological ability to activate effector cells. rPer a 5 significantly inhibits corresponding GSTs in P. americana, D. pteronyssinus, A. alternata and C. lunata with EC 50 values of 15.5 ng. 38.38 ng, 41.4 ng and 61.66 ng, respectively., Conclusion: Recombinant delta class GST of P. americana is a clinically relevant allergen showing upto 65% immunoreactivity with hypersensitive patient's sera. Per a 5 GST allergen showed phylogenetic similarity with dust mite, fungal and birch allergens thereby demonstrating allergen cross reactivity., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of immune dysregulation characterized by hyperactivation of the immune system, excessive cytokine secretion and severe systemic inflammation. HLH is classified as familial (FHL) when associated with mutations in PRF1, UNC13D, STX11 , and STXBP2 genes. There is limited information available about the clinical and mutational spectrum of FHL patients in Indian population. This study is a retrospective analysis of 101 molecularly characterized FHL patients over the last 10 years from 20 different referral centers in India. FHL2 and FHL3 together accounted for 84% of cases of FHL in our cohort. Patients belonging to different FHL subtypes were indistinguishable based on clinical and biochemical parameters. However, flow cytometry-based assays viz. perforin expression and degranulation assay were found to be specific and sensitive in diagnosis and classification of FHL patients. Molecular characterization of respective genes revealed 76 different disease-causing mutations including 39 (51%) novel mutations in PRF1, UNC13D, STX11 , and STXBP2 genes. Overall, survival was poor (28%) irrespective of the age of onset or the type of mutation in our cohort. Altogether, this article sheds light on the current scenario of FHL in India. Our data reveal a wide genetic heterogeneity of FHL in the Indian population and confirms the poor prognosis of FHL. This study also emphasizes that though mutational analysis is important for diagnostic confirmation of FHL, flow cytometry based assays help significantly in rapid diagnosis and functional validation of novel variants identified., Competing Interests: RV was employed by the company Medgenome, Pvt. Labs, Bangalore, India. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Shabrish, Kelkar, Yadav, Bargir, Gupta, Dalvi, Aluri, Kulkarni, Shinde, Sawant-Desai, Kambli, Hule, Setia, Jodhawat, Gaikwad, Dhawale, Nambiar, Gowri, Pandrowala, Taur, Raj, Uppuluri, Sharma, Kini, Sivasankaran, Munirathnam, Vedam, Vignesh, Banday, Rawat, Aggarwal, Poddar, Girish, Chaudhary, Sampagar, Jayaraman, Chaudhary, Shah, Jijina, Chandrakla, Kanakia, Arora, Sen, Lokeshwar, Desai and Madkaikar.)

[Figure: see text].

Background: This retrospective review was done to gauge the preliminary experience of COVID-19 in pregnancy during first 50 days of lockdown in a tertiary care hospital of India., Methods: This was a single-centered study, wherein all the suspected women (as defined by ICMR guidelines) who were tested for SARS-CoV 2 infection by nasopharyngeal/oropharyngeal swabs, and rendered to RT-PCR, were included. Parallel evaluation was performed for women in both groups for sociodemographic and obstetric attributes, risk factors, clinical presentation and feto-maternal outcome. Categorical variables were presented in number and percentage. Qualitative variables were equated using Chi-Square test/Fisher's exact test. A P value of < 0.05 was counted as significant., Results: Amongst 112 suspected cases, seven (6.25%) were found to be positive for SARS COV2. Majority of COVID-19 positive women hailed from urban hotspot areas (57.7%) and were un-booked (57.1%). Most were mild cases, and symptomatic (85.7%), with fever (57.1%) being predominant feature in all suspects; no adverse effects seen on pregnancy and fetus, with uneventful postpartum period., Conclusion: No adverse outcome in mother and baby after acquiring SARS-COV2 infection was observed, with maximum cases being mild; fever was the predominant symptom in all suspects, with significantly higher percentage in COVID-19 positives., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Pangolins are 'keystone species' driven towards extinction due to a lack of profound awareness and illegal trade. The drivers urge for immediate development in the understanding of demographics and reproductive dynamics of this species. In this study, we developed and validated a quantitative method to measure pangolin fecal extracts using the electrospray (ESI-MS/MS) interface in positive ionization mode. The method aids in the measurement of hormones from the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axis, making it a possibly appropriate technique to understand the cross-talk between the axes. The study aims to measure the relative abundance of adrenal and gonadal hormones such as corticosterone, cortisol, estrone, estradiol-17β, progesterone, testosterone, and a number of its metabolites. From the dried fecal extract, the principal metabolite identified from the estrogen family was estradiol-17β, whereas the gestagen family revealed that the pregnane series is predominated in 5α-configuration. On the other hand, epiandrosterone was seen as the dominant form in the male fecal extracts. Additionally, the glucocorticoids are excreted majorly as corticosterone, but traces of cortisol are also present in both the male and female fecal samples. The physiological validation confirmed that the ESI-MS/MS technique is suitable to determine physiologically caused differences in the fecal steroid concentrations. Physiologically, the age structure in pangolin is not responsible for causing differences within gender. However, the results revealed that glucocorticoids might vary between the sexes, i.e., males have a higher relative abundance of glucocorticoids over females. Therefore, our studies show that some of the main adrenal and gonadal metabolites can be predicted by exploiting MS/MS, which can steer research to potentially assess the reproductive status of captive and free-ranging pangolin species., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The present study evaluates the postmortem redistribution of ketamine in ocular matrices, such as vitreous humor, aqueous humor, and ocular tissues in an animal model. To understand the redistribution of ketamine and its metabolite (norketamine) in the ocular matrices, an in vivo study was performed in rabbits. The rabbits were divided into two groups: perimortem and postmortem. The postmortem samples were collected at 17 h after the administration of ketamine (40 mg/kg) intravenously. For a better understanding of the metabolism of ketamine in eyes, an ex vivo study was conducted in goat eyes after administration of ketamine intravitreally. The samples were analyzed by LC-MS/MS and the levels of ketamine and norketamine in these matrices were compared with that of whole blood and plasma. The results of the in vivo study showed a decrease in ketamine levels in whole blood and plasma while an increase in ocular matrices at postmortem. Though, in most cases, this increase/decrease was statistically insignificant. Moreover, there was an increase of norketamine level in ocular matrices. Ex vivo study also shows the presence of norketamine in ocular matrices of goat eyes. The presence of norketamine in goat eyes may be indicative of the metabolism of ketamine in the eyes., (Copyright © 2020. Published by Elsevier B.V.)

In this work, we report an ultra-high sensitive (S = 1.4 × 10 8 %), prompt response and recovering Pt/Pt+SiO 2 cermet layer/GaN-based hydrogen (H 2 ) sensor. A sensor fabricated with a 15 nm cermet layer, comprising Pt and SiO 2 , deposited between 15 nm Pt and GaN layers, exhibits significantly enhanced sensitivity in the detection of 4 %H 2 by ≈ 300×, as compared to the reference Pt/GaN sensor at ambient temperature (300 K). Furthermore, the sensitivity of the our sensor shows very weak dependence on temperature (T) with maximum sensitivity ([Formula: see text]) reducing from 1.4 × 10 8 % to 2.3 × 10 7 % as temperature increases from 300 to 423 K. The shift in the threshold voltage of the test sensor (ΔV t,test = 767 mV) increases by 50 % as compared to the shift in threshold voltage of the control sensor (ΔV t,control = 511 mV) at 1 mA/cm 2 . In addition, the cermet sensor also demonstrates fast response/recovery time, which reduces from 4.58 (2.36) seconds to 94 (39) milliseconds as the temperature increases from 300 to 423 K. The maximum sensitivity ([Formula: see text]), response (τ a ) and recovery (τ b ) times of the test sensor when exposed to 10 000 ppm of H 2 are 3.9 × 10 7 %, 30 secs and 30.1 secs respectively. The shift in the threshold voltage of the test sensor at 1 mA/cm 2 when exposed to 100 ppm, 1000 ppm, 5000 ppm, and 10 000 ppm are 40 mV, 70 mV, 460 mV, and 600 mV, respectively. The 2-Dimensional (2D) trapping of H-atoms by the oxygen atoms present in the Pt+SiO 2 cermet layer and porous/compact layer models explains the underlying mechanism, which results in a significant improvement of the sensing characteristics of the test sensor. The Thermionic Emission (TE) model effectively models the current density (J) - voltage (V) characteristics of both control and test sensors, with and without hydrogen. The prompt detection of high percentages of hydrogen in life-saving and commercial fuel applications becomes possible with the Pt+SiO 2 cermet-based sensor, with its response and recovery times in the order of milliseconds for a temperature range of 363-423 K.

Background and Aims: During the current pandemic of COVID-19, India is under lockdown which could cause disruption in diet and lifestyle in patients with type 2 diabetes (T2DM). We aimed to study lifestyle changes and other common issues related to treatment in our previously seen and treated patients with T2DM., Methods: Patients (n, 150) who were regularly following up before lockdown were interviewed telephonically (after 45 days of start of lockdown) regarding lifestyle changes, stress and other diabetes-related questions., Result: Carbohydrate consumption and frequency of snacking increased in 21% and 23% patients, respectively. Interestingly, 27% patients reported an increase in consumption of fruits. Exercise duration was reduced in 42% and weight gain occurred in 19% patients. Frequency of doing self-monitoring of blood glucose (SMBG) was decreased in 23% patients. 'Mental stress' of any kind was reported in 87% patients. Availability of medicines and insulin was uninterrupted in 91% patients. Knowledge about telemedicine was present in 69% and majority (92%) of these patients preferred video consultation., Conclusion: During 45 days of lockdown increase in carbohydrate intake, decrease in exercise, decreased SMBG and widespread mental stress in patients with T2DM was recorded, factors which may destabilize or exacerbate hyperglycemia and hypertension. Some positive changes (e.g. increased intake of fruits) were also observed., Competing Interests: Declaration of competing interest The authors do not mention any conflict of interest regarding this article., (Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Lockdown due to the Coronavirus disease 2019 (COVID 19) pandemic may cause weight gain and enhance the risk of type 2 diabetes mellitus (T2DM). We aimed to determine this risk in apparently non-diabetic individuals., Material Methods: Baseline demographic and clinical data from 100 apparently non-diabetic household members (related or unrelated) of patients with type 2 diabetes mellitus were collected until 49 days of lockdown and analyzed using the XL-STAT statistical software. A two-pronged analytical strategy was employed. First, the metabolic risk profile related to age, sex, weight, family history, and exercise pattern was analyzed. This was followed by an assessment of the risk of developing type 2 diabetes using an established risk assessment engine., Results: There was a trend towards weight gain seen in 40% of the cohort, with 16% of the population experiencing a 2.1-5 kg weight increment. When all the risk parameters were analyzed together using the ADA risk engine, there was an increase in the ADA diabetes risk score in 7% of the population, with 6.66% in the high-risk group. There was a further increase in weight among 3% of the population who were already obese at baseline., Conclusion: We show an increased risk of T2MD consequent to weight gain during 49 days of lockdown in India., Competing Interests: Declaration of competing interest None to declare., (Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Background: Limited assessments with handheld ultrasound have found meaningful clinical use in the care of acutely ill patients. However, there are limited data on incorporating handheld-based limited echocardiography into the echocardiography laboratory. The purpose of this study was to assess the efficacy of limited handheld tablet echocardiography as an alternative to traditional echocardiography during the coronavirus disease 2019 (COVID-19) pandemic as a means to limit exposure while providing essential clinical information., Methods: Ninety consecutive inpatients with known or suspected COVID-19 were scanned according to laboratory COVID-19 guidelines using a limited 11- to 20-clip protocol on a tablet sonograph. The primary assessment was length of study time. Comparison data were drawn from comprehensive echocardiographic examinations ordered on intensive care patients not under COVID-19 precautions., Results: Over a 36-day time period, a total of 91 requests were deemed to be appropriate for echocardiography on patients with suspected or confirmed COVID-19 (average age, 67 years; 64% men; mean body mass index, 32 kg/m 2 ). Of these, 90 (99%) examinations were performed using a handheld device, and all were deemed diagnostic and provided sufficient information for the clinical care team. Sonographer scan time decreased from an average of 24 ± 6.8 min on a traditional platform to 5.4 ± 1.9 min on a tablet., Conclusions: Limited handheld echocardiography can be successfully implemented in the echocardiography laboratory for screening of COVID-19-related cardiac conditions. The protocol performed with handheld tablet ultrasound provides adequate diagnostic information of major cardiac complications of COVID-19 while decreasing sonographer contact and simplifying decontamination., (Copyright © 2020 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)

Background: Dipeptidyl peptidase 4 (DPP4) inhibitors have increasingly been linked to bullous pemphigoid, but there is paucity of data from India where about 1.85 million patients have been estimated to use these drugs., Methods: In 30,000 patients with T2DM seen by us in two tertiary care centres since 2015, we detected 13 cases of bullous pemphigoid linked to DPP4 inhibitors. We used WHO-UMC (World Health Organisation-Uppsala Monitoring Centre) causality assessment system for assessment., Results: Lesions of bullous pemphigoid appeared at varied intervals (within 1 weeks-2 years) after start of DPP4 inhibitors. Implicated drugs were Linagliptin (n, 8), Vildagliptin (n, 4) and Sitagliptin (n, 1). Mostly, lesions were seen after 60 years age, and over trunk and extremities. Skin biopsy was compatible with bullous pemphigoid in two patients. Lesions regressed within a month of stopping DPP4 inhibitors in 9 patients while delayed regression up to 6 months in 4 patients. Overall, skin lesions remitted in all patients and did not recur., Conclusion: Any new bullous lesion appearing while patient is on DPP4 inhibitors should be considered as bullous pemphigoid and should necessitate prompt withdrawal of the drug., Competing Interests: Declaration of competing interest No potential conflicts of interest., (Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

In this work, pharmaceutically and biologically important compounds containing imidazo[1,5- a ]pyridine nuclei have been synthesized via transannulation of N-heteroaryl aldehydes or ketones with alkylamines using a graphene oxide-supported copper catalyst. The nanocatalyst was fabricated by the covalent immobilization of 4-aminoantipyrine onto an amine-functionalized graphene oxide nanosupport followed by its metallation with copper acetate. Structural analysis by transmission electron microscopy, scanning electron microscopy, X-ray photoelectron spectroscopy (XPS), and X-ray diffraction demonstrates that the two-dimensional sheet-like structure of graphene oxide is maintained even after the chemical modifications, whereas XPS revealed crucial information related to elemental composition and surface electronic states of the metal present in the catalyst. Apart from this, Fourier transform infrared spectroscopy helped in identifying the degree of oxidation and the presence of oxygenated groups in graphene oxide nanocomposites. As a heterogeneous catalyst, this graphene oxide-supported copper complex showed moderate to good catalytic activity in the C(sp 3 )-H bond activation/amination of a variety of substrates. This superior catalytic performance originated from the unique 2-dimensional structure of graphene oxide-based material which provided space between graphitic overlayers due to appropriate positioning of metal on their basal planes, decreasing the diffusion resistances of reactant surfaces, thus making it function as a nanoreactor. More importantly, this nanomaterial could be recovered easily and reused repeatedly by simple washing without chemical treatment with no appreciable loss in its catalytic activity, showing good potential for increasing the overall turnover number of this synthetically useful catalyst., Competing Interests: The authors declare no competing financial interest.

Globally, pangolins are threatened by poaching and illegal trade. Taiwan presents a contrary situation, where the wild pangolin population has stabilized and even begun to increase in the last two decades. This paper illustrates the factors responsible for causing mortality and morbidity in the wild Taiwanese pangolin (Manis pentadactyla pentadactyla) based on radio-tracking data of wild pangolins and records of sick or injured pangolins admitted to a Taiwanese wildlife rehabilitation center. Despite being proficient burrowers, results from radio-tracking show that Taiwanese pangolins are highly susceptible to getting trapped in tree hollows or ground burrows. Data from Pingtung Rescue Center for Endangered Wild Animals showed that trauma (73.0%) was the major reason for morbidity in the Taiwanese pangolin with trauma from gin traps being the leading cause (77.8%), especially during the dry season, followed by tail injuries caused by dog attacks (20.4%). Despite these threats, Taiwan has had substantial success in rehabilitating and releasing injured pangolins, primarily due to the close collaboration of Taiwanese wildlife rehabilitation centers over the last twenty years., Competing Interests: The authors have declared that no competing interests exist.

There is significant spatial and temporal variability associated with greenhouse gas (GHG) fluxes in high-latitude Arctic tundra environments. The objectives of this study are to investigate temporal variability in CO 2 and CH 4 fluxes at Barrow, AK and to determine the factors causing this variability using a novel entropy-based classification scheme. In particular, we analyzed which geomorphic, soil, vegetation and climatic properties most explained the variability in GHG fluxes (opaque chamber measurements) during the growing season over three successive years. Results indicate that multi-year variability in CO 2 fluxes was primarily associated with soil temperature variability as well as vegetation dynamics during the early and late growing season. Temporal variability in CH 4 fluxes was primarily associated with changes in vegetation during the growing season and its interactions with primary controls like seasonal thaw. Polygonal ground features, which are common to Arctic regions, also demonstrated significant multi-year variability in GHG fluxes. Our results can be used to prioritize field sampling strategies, with an emphasis on measurements collected at locations and times that explain the most variability in GHG fluxes. For example, we found that sampling primary environmental controls at the centers of high centered polygons in the month of September (when freeze-back period begins) can provide significant constraints on GHG flux variability - a requirement for accurately predicting future changes to GHG fluxes. Overall, entropy results document the impact of changing environmental conditions (e.g., warming, growing season length) on GHG fluxes, thus providing clues concerning the manner in which ecosystem properties may be shifted regionally in a future climate., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is an uncommon subtype of Hodgkin lymphoma (HL) with few published studies in children, entirely from North America and Europe. We analyzed clinical features and treatment outcome of pediatric NLPHL., Procedure: Children less than 18 years of age diagnosed after histopathology review to have NLPHL between June 1998 and August 2016 were retrospectively analyzed. Descriptive details of clinical presentation and treatment were collected, and outcomes analyzed using Kaplan-Meier survival analysis., Results: Of the 42 patients with a confirmed diagnosis of NLPHL during this period, there was complete information on 35. Median age was 11 years (range 6-16 years), male:female ratio was 4.8:1, there were 15, 11, 6, and 3 patients with Stage I, Stage II, Stage III, and Stage IV disease, respectively. Six patients had B symptoms, 10 had bulky disease, and 3 had bone marrow as well as extranodal involvement. Histology was typical NLPHL in 23 and variant in 12. Twenty-nine received chemotherapy, 10 with additional radiation, 3 patients with early stage disease received only radiotherapy and three others underwent complete node resection alone. Median follow-up was 55 months (range 7-165 months), 5 year event-free survival (EFS) was 83.3%, and overall survival 97.1%. Variant NLPHL histology was associated with higher incidence of unfavorable presentation and lower EFS., Conclusions: NLPHL in India has an excellent outcome, despite a higher incidence of unfavorable presentations such as advanced stage disease, B symptoms, and bulky disease. Variant histology is an adverse prognostic factor., (© 2018 Wiley Periodicals, Inc.)