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Osteogenesis imperfecta (OI) is a rare genetic disorder commonly caused by variants of the type I collagen genes COL1A1 and COL1A2. OI is associated with increased bone fragility, bone deformities, bone pain, and reduced growth. Setrusumab, a neutralizing antibody to sclerostin, increased areal bone mineral density (aBMD) in a 21-week phase 2a dose escalation study. The phase 2b Asteroid (NCT03118570) study evaluated the efficacy and safety of setrusumab in adults. Adults with a clinical diagnosis of OI type I, III, or IV, a pathogenic variant in COL1A1/A2, and a recent fragility fracture were randomized 1:1:1:1 to receive 2, 8, or 20 mg/kg setrusumab doses or placebo by monthly intravenous infusion during a 12-mo treatment period. Participants initially randomized to the placebo group were subsequently reassigned to receive setrusumab 20 mg/kg open label. Therefore, only results from the 2, 8, and 20 mg/kg double-blind groups are presented herein. The primary endpoint of Asteroid was change in distal radial trabecular volumetric bone mineral density (vBMD) from baseline at month 12, supported by changes in high-resolution peripheral quantitative computed tomography micro-finite element (microFE)-derived bone strength. A total of 110 adults were enrolled with similar baseline characteristics across treatment groups. At 12 mo, there was a significant increase in mean (SE) failure load in the 20 mg/kg group (3.17% [1.26%]) and stiffness in the 8 (3.06% [1.70%]) and 20 mg/kg (3.19% [1.29%]) groups from baseline. There were no changes in radial trabecula vBMD (p>05). Gains in failure load and stiffness were similar across OI types. There were no significant differences in annualized fracture rates between doses. Two adults in the 20 mg/kg group experienced related serious adverse reactions. Asteroid demonstrated a beneficial effect of setrusumab on estimates of bone strength across the different types of OI and provides the basis for additional phase 3 evaluation., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society for Bone and Mineral Research.)

This novel research addresses the critical need for sustainable and efficient materials, aiming to enhance the optical and thermoelectric properties of Aluminum doped Zinc Oxide (Al-doped ZnO) on cellulose fabric for diverse applications. At first stage, Cellulosic fabric of Al-doped ZnO were experimentally studied in detail with respect to varying levels of annealing temperature. Structural analysis unveiled structural evolution in hexagonal crystal formations with a reduction in particle size up to 27.5 % on average, with increased temperature. Further, Raman spectroscopy revealed the doping effects on the vibrational modes of ZnO, potentially due to alterations in lattice structure. The ZnO optical modes are found as E 2 (low) = 110 cm -1 with observed phonon frequency in the Raman spectra of ZnO at A 1 (TO) = 364 cm -1 . Fourier transform infrared spectroscopy (FTIR) revealed the presence of characteristic stretching of developed material. Furthermore, the optical characters revealed a decrement of 43.22 % in bandgap values with increasing annealing temperature. The analysis of thermoelectric attributes documented that the prominent sample annealed at 300°C exhibited the maximum Seebeck coefficient and power factor of 2.1 × 10 -3  μV/ o C and 5.8 × 10 -21 Wm -1  K -2 , respectively. At second stage the optical characteristics of experimentally optimized sample were rigorously studied through the application of Material Studio software, while varying the doping ratio., Competing Interests: Declaration of competing interest On behalf of all my co-authors I hereby declare that we have no conflict of interest for the manuscript being submitted for publication to the journal “International Journal of Biological Macromolecules”., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Patients who sustain a hip fracture are known to be at imminent refracture risk. Their complex multidisciplinary rehabilitation needs to include falls prevention and anti-osteoporosis medication (AOM) to prevent such fractures. This study aimed to determine which hospital-level organizational factors predict prescription of post-hip fracture AOM and refracture risk. A cohort of 178 757 patients aged ≥60 yr who sustained a hip fracture in England and Wales (2016-2019) was examined and followed for 1 yr. Patient-level hospital admission datasets from 172 hospitals, the National Hip Fracture Database, and mortality data were linked to 71 metrics extracted from 18 hospital-level organizational reports. Multilevel models determined organizational factors, independent of patient case-mix, associated with (1) AOM prescription and (2) refracture (by ICD10 coding). Patients were mean (SD) 82.7 (8.6) yr old, 71% female, with 18% admitted from care homes. Overall, 101 735 (57%) were prescribed AOM during admission, while 50 354 (28%) died during 1-yr follow-up, 12 240 (7%) refractured. Twelve organizational factors were associated with AOM prescription, for example, orthogeriatrician-led care compared to traditional care models (odds ratio [OR] 4.65 [95% CI, 2.25-9.59]); AOM was 9% (95% CI, 6%-13%) more likely to be prescribed in hospitals providing routine bone health assessment to all patients. Refracture occurred at median 126 d (IQR 59-234). Eight organizational factors were associated with refracture risk; hospitals providing orthogeriatrician assessment to all patients within 72 h of admission had an 18% (95% CI, 2%-31%) lower refracture risk, weekend physiotherapy provision had an 8% (95% CI, 3%-14%) lower risk, and where occupational therapists attended clinical governance meetings, a 7% (95% CI, 2%-12%) lower risk. Delays initiating post-discharge community rehabilitation were associated with a 15% (95% CI, 3%-29%) greater refracture risk. These novel, national findings highlight the importance of orthogeriatrician, physiotherapist, and occupational therapist involvement in secondary fracture prevention post hip fracture; notably, fracture risk reductions were seen within 12 mo of hip fracture., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society for Bone and Mineral Research.)

We assessed multiple components of muscle function in ten adults with X-linked hypophosphatemia (XLH) receiving burosumab treatment. Lower limb power (+ 9%), short physical performance battery (SPPB) score (+ 1.2 points), and physical activity (+ 65%) increased following 6 months of treatment, and hand grip increased (+ 10%) between 6 and 12 months of treatment., Purpose: X-linked hypophosphatemia (XLH) is a rare genetic disorder of phosphate metabolism. Burosumab is a monoclonal antibody treatment shown to improve phosphate homeostasis and improve symptoms as well as fracture healing when used as a therapy for XLH in adults. However, little is known about its effects on the large deficits in multiple components of physical function previously reported in XLH., Methods: Ten adults (6 females, age 41.1 ± 15.7 y) were recruited from specialist centres in London and Bristol. During clinical visits for initial burosumab treatment and at 6-month and 12-month follow-up, physical function, and physical activity (PA) assessments were performed. In detail, lower limb power was assessed by mechanography via a countermovement jump, mobility by short physical performance battery (SPPB), functional capacity by 6-min walk test (6MWT), upper limb strength by hand grip dynamometry, and PA via an International Physical Activity Questionnaire (IPAQ). Differences between baseline and 6-month follow-up, and in a subset of 5 patients between 6- and 12-month follow-up, were assessed., Results: Lower limb power increased by 9% (P = 0.049) from baseline to 6 months, as did SPPB score (+ 1.2 points, P = 0.033) and total PA (+ 65%, P = 0.046) although hand grip and 6MWT did not differ. Only for hand grip was a significant improvement (+ 10%, P = 0.023) seen between 6 and 12 months., Conclusions: Burosumab treatment is associated with improved lower limb function and mobility at 6 months, with improvement in hand grip strength at 12 months. Future studies should explore the underlying mechanisms and describe on function and other patient outcomes., (© 2024. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)

Soil salinity poses a substantial threat to agricultural productivity, resulting in far-reaching consequences. Green-synthesized lignin nanoparticles (LNPs) have emerged as significant biopolymers which effectively promote sustainable crop production and enhance abiotic stress tolerance. However, the defensive role and underlying mechanisms of LNPs against salt stress in Zea mays remain unexplored. The present study aims to elucidate two aspects: firstly, the synthesis of lignin nanoparticles from alkali lignin, which were characterized using Field Emission Scanning Electron Microscopy (FE-SEM), Transmission Electron Microscopy (TEM), Fourier Infrared Spectroscopy (FT-IR) and Energy Dispersive X-Ray Spectroscopy (EDX). The results confirmed the purity and morphology of LNPs. Secondly, the utilization of LNPs (200 mg/L) in nano priming to alleviate the adverse effects of NaCl (150 mM) on Zea mays seedlings. LNPs significantly reduced the accumulation of Na + (17/21%) and MDA levels (21/28%) in shoots/roots while increased lignin absorption (30/31%), resulting in improved photosynthetic performance and plant growth. Moreover, LNPs substantially improved plant biomass, antioxidant enzymatic activities and upregulated the expression of salt-tolerant genes (ZmNHX3 (1.52 & 2.81 FC), CBL (2.83 & 3.28 FC), ZmHKT1 (2.09 & 4.87 FC) and MAPK1 (3.50 & 2.39 FC) in both shoot and root tissues. Additionally, SEM and TEM observations of plant tissues confirmed the pivotal role of LNPs in mitigating NaCl-induced stress by reducing damages to guard cells, stomata and ultra-cellular structures. Overall, our findings highlight the efficacy of LNPs as a practical and cost-effective approach to alleviate NaCl-induced stress in Zea mays plants. These results offer a sustainable agri-environmental strategy for mitigating salt toxicity and enhancing crop production in saline environments., 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.)

Normal-anion-gap metabolic acidosis (NAGMA) is a common but often under-recognised and poorly understood condition, especially by less-experienced clinicians. In adults, NAGMA might be an initial clue to a more significant underlying pathology, such as autoimmune diseases, hypergammaglobulinemia or drug toxicities. However, identifying the aetiology can be challenging due to the diverse processes involved in the development of acidosis. A better understanding of the pathophysiology of NAGMA can help treating physicians suspect and evaluate the condition early and reach the correct diagnosis. This article provides an overview of renal acid-base regulation, discusses the pathophysiological processes involved in developing NAGMA and provides a framework for evaluation to reach an accurate diagnosis., (© 2024 The Author(s). Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians.)

The overuse of pesticides has shown their malpractices. Novel and sustainable formulations have consequently attracted abundant attention but still appear to have drawbacks. Here, we use a maleic anhydride-functionalized cellulose nanocrystals-stabilized Pickering emulsions template to prepare thermo-responsive microcapsules for a pesticide delivery system via radical polymerization with N-isopropyl acrylamide. The microcapsules (MACNCs-g-NIPAM) are characterized by the microscope, SEM, FTIR, XRD, TG-DTG, and DSC techniques. Imidacloprid (IMI) is loaded on MACNCs-g-NIPAM to form smart release systems (IMI@MACNCs-g-NIPAM) with high encapsulation efficiency (~88.49%) and loading capability (~55.02%). The IMI@MACNCs-g-NIPAM present a significant thermo-responsiveness by comparing the release ratios at 35°C and 25°C (76.22% vs 50.78%). It also exhibits advantages in spreadability, retention and flush resistance on the leaf surface compared with the commercial IMI water-dispersible granules (CG). IMI@MACNCs-g-NIPAM also manifest a significant advantage over CG (11.12 mg/L vs 38.90 mg/L for LC 50 ) regarding activity tests of targeted organisms. In addition, IMI@MACNCs-g-NIPAM has shown excellent biocompatibility and low toxicity. All the benefits mentioned above prove the excellent potential of IMI@MACNCs-g-NIPAM as a smart pesticide formulation., Competing Interests: Declaration of competing interest The authors declare no competing financial interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

N-doped TiO 2 /carbon composites (N-TiPC) have shown excellent photodegradation performances to the organic contaminants but are limited by the multistage preparation (i.e., preparation of porous carbon, preparation of N-doped TiO 2 , and loading of N-doped TiO 2 on porous carbon). Here, we develop a handy way by combining the Pickering emulsion-gel template route and chelation reaction of polysaccharides. The N-TiPC is obtained by calcinating pectin/Dl-serine hydrazide hydrochloride (SHH)-Ti 4+ chelate and is further described by modern characterization techniques. The results show that the N atom is successfully doped into the TiO 2 lattice, and the bandgap value of N-TiPC is reduced to 2.3 eV. Moreover, the particle size of N-TiPC remains about 10 nm. The configurations of the composites are simulated using DFT calculation. The photocatalytic experiments show that N-TiPC has a high removal efficiency for methylene blue (MB) and oxytetracycline hydrochloride (OTC-HCL). The removal ratios of MB (20 mg/L, 50 mL) and OTC-HCL (30 mg/L, 50 mL) are 99.41 % and 78.29 %, respectively. The cyclic experiments show that the photocatalyst has good stability. Overall, this study provides a handy way to form N-TiPC with enhanced photodegradation performances. It can also be promoted to other macromolecules such as cellulose and its derivatives, sodium alginate, chitosan, lignin, etc., Competing Interests: Declaration of competing interest The authors declare no competing financial interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This research addresses the need for enhanced biomaterials by investigating the influence of the NCO/OH ratio on sodium alginate-based polyurethane elastomers(Al-PUEs), offering novel insights into their structural, thermal, mechanical and swelling behavior. Al-PUEs were prepared by blending the chain extenders with key ingredients in a specific molar ratio using aliphatic HMDI and HTPB monomers. The chemical linkages, crystalline behavior, homogeneity, and surface morphology of PUEs were evaluated by FT-IR, XRD, SEM, and EDX analysis. Thermo-mechanical studies were performed using TGA, DSC and tensile testing. Swelling behavior and absorption analysis were analyzed in DMSO and water. The analysis indicated that the hydrophilicity and swelling behavior of the prepared PUEs were affected by the addition of sodium alginate content. The results exhibit the tailor-made network structure of Al-PUEs, resulting in better thermal stability, elasticity of materials via stress-strain behavior and marvelous characteristic features than traditional high-tech yields. Furthermore, the resulting Al-PUEs are potential candidates for biomedical implants., Competing Interests: Declaration of competing interest On behalf of all my co-authors I hereby declare that we have no conflict of interest for the manuscript being submitted for publication to the journal “International Journal of Biological Macromolecules”., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Roemheld syndrome (RS) is a condition that triggers cardiac symptoms due to gastrointestinal compression of the heart. It is often misdiagnosed as other types of cardiac or digestive disorders, leading to unnecessary treatments and reduced quality of life. Here, we provide a thorough review of RS, covering its pathogenesis, etiology, diagnosis, treatment, and outcome. We found that a number of conditions, including gallstones, hiatal hernia, excessive gas, and gastroesophageal reflux syndrome, can cause RS. The symptoms of RS can include chest pain, palpitations, shortness of breath, nausea, vomiting, bloating, and abdominal pain. Clinical history, physical examination, electrocardiograms, and improvement in symptoms following gastrointestinal therapy can all be used to identify RS. We also propose a set of criteria, the IKMAIR criteria, to improve the diagnostic approach for this condition. Dietary changes, lifestyle adjustments, pharmaceutical therapies, and surgical procedures can all be used to control RS. Depending on the underlying etiology and the outcome of treatment, RS has a varying prognosis. We conclude that RS is a complicated and understudied disorder that needs more attention from researchers and patients as well as from medical professionals. We recommend the inclusion of RS in the differential diagnosis for individuals with gastrointestinal problems and unexplained cardiac symptoms. Additionally, we advise treating RS holistically by attending to its cardiac and gastrointestinal components., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

The thermal stability of polyurethanes, known for its limitations, was addressed in this research by seeking improvement through the introduction of carbohydrate-based chain extenders. In this research paper, we systematically sought to improve the thermal resistance of polyurethanes by incorporating carboxymethyl cellulose and chitosan, representing a pioneering application of the mixture design approach in their preparation. In this synthesis, hydroxyl-terminated polybutadiene and isophorone diisocyanate (IPDI) were reacted to prepare -NCO terminated prepolymer, which was subsequently reacted with varying mole ratios of CMC and CSN to develop a series of five PU samples. The prepared PU samples were characterized using the Fourier-transformed infrared spectroscopic technique. Thermal pyrolysis of PU samples was examined using thermal gravimetric analysis (TGA). It was observed that, among all the samples, PUS-3 showed remarkable thermal stability over a wide temperature range. A comprehensive statistical analysis was conducted to substantiate the experimental findings. It was estimated that CMC and CSN significantly enhance the thermal stability of the samples when involved in an interaction fashion. The ANOVA Table for the mixture design demonstrates that over 90 % of the total variation in thermal stability is explained by the mixture model across a wide temperature range. Moreover, PSU-3 exhibited 4 % more thermal stability over a wide range of temperatures on average, as compared to contemporary samples., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: To describe determinants of persisting humoral and cellular immune response to the second COVID-19 vaccination among patients with myeloma., Methods: This is a prospective, observational study utilising the RUDYstudy.org platform. Participants reported their second and third COVID-19 vaccination dates. Myeloma patients had an Anti-S antibody level sample taken at least 21 days after their second vaccination and a repeat sample before their third vaccination., Results: 60 patients provided samples at least 3 weeks (median 57.5 days) after their second vaccination and before their third vaccination (median 176.0 days after second vaccine dose). Low Anti-S antibody levels (<50 IU/mL) doubled during this interval (p = .023) and, in the 47 participants with T-spot data, there was a 25% increase negative T-spot tests (p = .008). Low anti-S antibody levels prior to the third vaccination were predicted by lower Anti-S antibody level and negative T-spot status after the second vaccine. Independent determinants of a negative T-spot included increasing age, previous COVID infection, high CD4 count and lower percentage change in Anti-S antibody levels., Conclusions: Negative T-spot results predict low Anti-S antibody levels (<50 IU/mL) following a second COVID-19 vaccination and a number of biomarkers predict T cell responses in myeloma patients., (© 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.)

Cadmium (Cd) is classified as a heavy metal (HM) and is found into the environment through both natural processes and intensified anthropogenic activities such as industrial operations, mining, disposal of metal-laden waste like batteries, as well as sludge disposal, excessive fertilizer application, and Cd-related product usage. This rising Cd disposal into the environment carries substantial risks to the food chain and human well-being. Inadequate regulatory measures have led to Cd bio-accumulation in plants, which is increasing in an alarming rate and further jeopardizing higher trophic organisms, including humans. In response, an effective Cd decontamination strategy such as phytoremediation emerges as a potent solution, with innovations in nanotechnology like biochar (BC) and nanoparticles (NPs) further augmenting its effectiveness for Cd phytoremediation. BC, derived from biomass pyrolysis, and a variety of NPs, both natural and less toxic, actively engage in Cd removal during phytoremediation, mitigating plant toxicity and associated hazards. This review scrutinizes the application of BC and NPs in Cd phytoremediation, assessing their synergistic mechanism in influencing plant growth, genetic regulations, structural transformations, and phytohormone dynamics. Additionally, the review also underscores the adoption of this sustainable and environmentally friendly strategies for future research in employing BC-NP microaggregates to ameliorate Cd phytoremediation from soil, thereby curbing ecological damage due to Cd toxicity., 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.)

In the present study, a range of sustainable, biocompatible and biodegradable polyurethanes (PU-1 to PU-4) were synthesized using different combinations of biobased polyol (obtained through the epoxidation of soybean oil, followed by ring opening with ethanol) and polyethylene glycol (PEG) and isophorone diisocyanate. The sustainable chain extender used in this study was synthesized by the esterification of lactic acid with ethylene glycol (EG). The synthesized PU samples were characterized through scanning electron microscopy (SEM), Fourier transformed infrared (FTIR) and nuclear magnetic resonance ( 1 H NMR and 13 C NMR) spectroscopy. Wetting ability and thermal degradation analysis (TGA) of the samples were also studied. Subsequently, these PUs were examined as potential drug delivery systems using Gabapentin as a model drug, which was loaded in the polymer matrix using the solvent evaporation method. The drug release studies were carried out in 0.06 N HCl as a release medium according to the method outlined in the United States Pharmacopeia. The maximum drug release was observed for sample PU-P1, which was found to be 53.0 % after 6 h. Moreover, a comparison of different PU samples revealed a trend wherein the values of drug release were decreased with an increase in the PEG content., Competing Interests: Declaration of competing interest We have no conflict of interest for the manuscript being submitted for publication to the journal “International Journal of Biological Macromolecules”., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Hypophosphatasia (HPP) is an inborn error of metabolism caused by reduced or absent activity of the tissue non-specific alkaline phosphatase (TNSALP) enzyme, resulting from pathogenic variants in the ALPL gene. Clinical presentation of HPP is highly variable, including lethal and severe forms in neonates and infants, a benign perinatal form, mild forms manifesting in adulthood, and odonto-HPP. Diagnosis of HPP remains a challenge in adults, as signs and symptoms may be mild and non-specific. Disease presentation varies widely; there are no universal signs or symptoms, and the disease often remains underdiagnosed or misdiagnosed, particularly by clinicians who are not familiar with this rare disorder. The absence of diagnosis or a delayed diagnosis may prevent optimal management for patients with this condition. Formal guidelines for the diagnosis of adults with HPP do not exist, complicating efforts for consistent diagnosis. To address this issue, the HPP International Working Group selected 119 papers that explicitly address the diagnosis of HPP in adults through a Medline, Medline In-Process, and Embase search for the terms "hypophosphatasia" and "HPP," and evaluated the pooled prevalence of 17 diagnostic characteristics, initially selected by a group of HPP clinical experts, in eligible studies and in patients included in these studies. Six diagnostic findings showed a pooled prevalence value over 50% and were considered for inclusion as major diagnostic criteria. Based on these results and according to discussion and consideration among members of the Working Group, we finally defined four major diagnostic criteria and five minor diagnostic criteria for HPP in adults. Authors suggested the integrated use of the identified major and minor diagnostic criteria, which either includes two major criteria, or one major criterion and two minor criteria, for the diagnosis of HPP in adults., (© 2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)

Background: This manuscript provides a summary of the current evidence to support the criteria for diagnosing a child or adult with hypophosphatasia (HPP). The diagnosis of HPP is made on the basis of integrating clinical features, laboratory profile, radiographic features of the condition, and DNA analysis identifying the presence of a pathogenic variant of the tissue nonspecific alkaline phosphatase gene (ALPL). Often, the diagnosis of HPP is significantly delayed in both adults and children, and updated diagnostic criteria are required to keep pace with our evolving understanding regarding the relationship between ALPL genotype and associated HPP clinical features., Methods: An International Working Group (IWG) on HPP was formed, comprised of a multidisciplinary team of experts from Europe and North America with expertise in the diagnosis and management of patients with HPP. Methodologists (Romina Brignardello-Petersen and Gordon Guyatt) and their team supported the IWG and conducted systematic reviews following the GRADE methodology, and this provided the basis for the recommendations., Results: The IWG completed systematic reviews of the literature, including case reports and expert opinion papers describing the phenotype of patients with HPP. The published data are largely retrospective and include a relatively small number of patients with this rare condition. It is anticipated that further knowledge will lead to improvement in the quality of genotype-phenotype reporting in this condition., Conclusion: Following consensus meetings, agreement was reached regarding the major and minor criteria that can assist in establishing a clinical diagnosis of HPP in adults and children., (© 2023. Crown.)

Micronutrient application has a crucial role in mitigating salinity stress in crop plants. This study was carried out to investigate the effect of zinc (Zn) and boron (B) as foliar applications on fenugreek growth and physiology under salt stress (0 and 120 mM). After 35 days of salt treatments, three levels of zinc (0, 50, and 100 ppm) and two levels of boron (0 and 2 ppm) were applied as a foliar application. Salinity significantly reduced root length (72.7%) and shoot length (33.9%), plant height (36%), leaf area (37%), root fresh weight (48%) and shoot fresh weight (75%), root dry weight (80%) and shoot dry weight (67%), photosynthetic pigments (78%), number of branches (50%), and seeds per pod (56%). Fenugreek's growth and physiology were improved by foliar spray of zinc and boron, which increased the length of the shoot (6%) and root length (2%), fresh root weight (18%), and dry root weight (8%), and chlorophyll a (1%), chlorophyll b (25%), total soluble protein content (3%), shoot calcium (9%) and potassium (5%) contents by significantly decreasing sodium ion (11%) content. Moreover, 100 ppm of Zn and 2 ppm of B enhanced the growth and physiology of fenugreek by reducing the effect of salt stress. Overall, boron and zinc foliar spray is suggested for improvement in fenugreek growth under salinity stress., (© 2024. The Author(s).)

Background: Reducing delayed diagnosis is a significant healthcare priority for individuals with rare diseases. Fibrous Dysplasia/ McCune Albright Syndrome (FD/MAS) is a rare bone disease caused by somatic activation mutations of NASA. FD/MAS has a broad clinical phenotype reflecting variable involvement of bone, endocrine and other tissues, distribution and severity. The variable phenotype is likely to prolong the diagnostic journey for patients further., Aim: To describe the time from symptom onset to final diagnosis in individuals living with FDMAS., Methods: We used the UK-based RUDY research database ( www.rudystudy.org ), where patients self-report their diagnosis of FD/MAS. Participants are invited to complete the diagnostic journey based on the EPIRARE criteria., Results: 51 individuals diagnosed with FD/MAS were included in this analysis. Among them, 70% were female, and the median age was 51.0 years (IQR 34.5-57.5]. 12 (35%) individuals reported McCune Albright Syndrome, 11 (21.6%) craniofacial and 11(21.6%) for each of poly- and mono-ostotic FD and 6 (11.8%) did not know their type of FD/MAS. Pain was the commonest first symptom (58.8%), and 47.1% received another diagnosis before the diagnosis of FD/MAS. The median time to final diagnosis from the first symptom was two years with a wide IQR (1,18) and range (0-59 years). Only 12 (23.5%) of individuals were diagnosed within 12 months of their first symptoms. The type of FD/MAS was not associated with the reported time to diagnosis. Significant independent predictors of longer time to final diagnosis included older current age, younger age at first symptom and diagnosis after 2010., Conclusion: Individuals with FDMAS have a variable time to diagnosis that can span decades. This study highlights the need for further research on how to improve diagnostic pathways within Orthopaedic and Ear, Nose and Throat (ENT)/Maxillofacial services. Our data provides a baseline to assess the impact of novel NHS diagnostic networks on reducing the diagnostic odyssey., (© 2024. The Author(s).)

In the studies of the connected networks, metric dimension being a distance-based parameter got much more attention of the researches due to its wide range of applications in different areas of chemistry and computer science. At present its various types such as local metric dimension, mixed metric dimension, solid metric dimension, and dominant metric dimension have been used to solve the problems related to drug discoveries, embedding of biological sequence data, classification of chemical compounds, linear optimization, robot navigation, differentiating the interconnected networks, detecting network motifs, image processing, source localization and sensor networking. Dominant resolving sets are better than resolving sets because they carry the property of domination. In this paper, we obtain the dominant metric dimension of wheel, gear and anti-web wheel network in the form of integral numbers. We observe that the aforesaid networks have bounded dominant metric dimension as the order of the network increases. In particular, we also discuss the importance of the obtained results for the robot navigation networking., Competing Interests: 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., (© 2024 The Authors.)

After the UN Climate Action Summit in 2019, many countries started progressing towards race to zero targets. The intricate framework of digitalization and green technologies has the potential to persuade governments to implement policies that promote a zero-carbon economy, i.e., green economy. Hence, this study determines the effect of digital trade (DGT) and green technological innovation (GTI) on environmental sustainability (ENS) by considering the role of renewable energy consumption (REC), globalization (GLOB), and economic growth (EG). The study measured ENS by taking into account three proxy variables, i.e., ecological footprint (EF), carbon dioxide emission (CO 2 e), and methane emissions (CH 4 e). POLS and PMG-ARDL techniques are applied to the panel data of BRICS (Brazil, Russia, India, China, and South Africa) from 2000 to 2019. Panel Quantile Regression (PQR) along with AMG and CCEMG estimators is applied hereafter for checking the robustness of the empirical results. The long-run empirical outcomes show the positive association of DGT, GTI, REC, and GLOB with ENS. Lastly, this study inscribed the Environmental Kuznets Curve (EKC) and highlights policy implications and governmental measures to ensure environmental sustainability in BRICS economies., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Melatonin is a naturally occurring biologically active amine produced by plants, animals and microbes. This review explores the biosynthesis of melatonin in plants, with a particular focus on its diverse roles in Arabidopsis thaliana , a model species. Melatonin affects abiotic and biotic stress resistance in A. thaliana . Exogenous and endogenous melatonin is addressed in association with various conditions, including cold stress, high light stress, intense heat and infection with Botrytis cinerea or Pseudomonas , as well as in seed germination and lateral root formation. Furthermore, melatonin confers stress resistance in Arabidopsis by initiating the antioxidant system, remedying photosynthesis suppression, regulating transcription factors involved with stress resistance (CBF, DREB, ZAT, CAMTA, WRKY33, MYC2, TGA) and other stress-related hormones (abscisic acid, auxin, ethylene, jasmonic acid and salicylic acid). This article additionally addresses other precursors, metabolic components, expression of genes (COR , CBF , SNAT , ASMT , PIN , PR1 , PDF1.2 and HSFA ) and proteins (JAZ, NPR1) associated with melatonin and reducing both biological and environmental stressors. Furthermore, the future perspective of melatonin rich agri-crops is explored to enhance plant tolerance to abiotic and biotic stresses, maximise crop productivity and enhance nutritional worth, which may help improve food security.

The complement system is critical to the body's innate defense against exogenous pathogens and clearance of endogenous waste, comprising the classical, alternative, and lectin pathways. Although tightly regulated, various congenital and acquired diseases can perturb the complement system, resulting in specific complement deficiencies. Systemic rheumatic, neurological, ophthalmological, renal, and hematological disorders are some prototypical complement-mediated diseases. An adequate understanding of the mechanisms of the normal complement system and the pathophysiology of complement dysregulation is critical for providing diagnostic clues and appropriately managing these conditions. This review guides clinicians in understanding the role of complement factors in systemic diseases and what diagnostic and therapeutic options are available for complement-mediated disorders., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Wang et al.)

Thromboembolic events resulting from disturbances in the body's balance of thrombotic and antithrombotic abilities are among the most life-threatening complications of nephrotic syndrome. Certain causes of nephrotic syndrome leave the patient particularly susceptible to thromboembolism. The severity of proteinuria and degree of hypoalbuminaemia are other common predictors of risk. Timely initiation of prophylactic therapy can help prevent morbidity and mortality associated with this complication in patients with nephrotic syndrome. The duration of treatment and choice of therapeutic agent depends on several factors, including the degree of hypoalbuminaemia, risk factors for thrombosis and risk of bleeding. This article reviews current understanding of the pathophysiology and risk factors for thromboembolism associated with nephrotic syndrome, and summarises recommendations and strategies for preventing and treating thromboembolic events in patients with nephrotic syndrome.

Hypophosphatasia (HPP) is a rare inborn error of metabolism that presents variably in both age of onset and severity. HPP is caused by pathogenic variants in the ALPL gene, resulting in low activity of tissue nonspecific alkaline phosphatase (TNSALP). Patients with HPP tend have a similar pattern of elevation of natural substrates that can be used to aid in diagnosis. No formal diagnostic guidelines currently exist for the diagnosis of this condition in children, adolescents, or adults. The International HPP Working Group is a comprised of a multidisciplinary team of experts from Europe and North America who have expertise in the diagnosis and management of patients with HPP. This group reviewed 93 papers through a Medline, Medline In-Process, and Embase search for the terms "HPP" and "hypophosphatasia" between 2005 and 2020 and that explicitly address either the diagnosis of HPP in children, clinical manifestations of HPP in children, or both. Two reviewers independently evaluated each full-text publication for eligibility and studies were included if they were narrative reviews or case series/reports that concerned diagnosis of pediatric HPP or included clinical aspects of patients diagnosed with HPP. This review focused on 15 initial clinical manifestations that were selected by a group of clinical experts.The highest agreement in included literature was for pathogenic or likely pathogenic ALPL variant, elevation of natural substrates, and early loss of primary teeth. The highest prevalence was similar, including these same three parameters and including decreased bone mineral density. Additional parameters had less agreement and were less prevalent. These were organized into three major and six minor criteria, with diagnosis of HPP being made when two major or one major and two minor criteria are present., (© 2023. The Author(s).)

Despite comparable outcomes with the extracorporeal dialysis modalities, peritoneal dialysis (PD) is seldom considered a viable option for managing acute kidney injury (AKI) in developed and resource-rich countries, where continuous renal replacement therapies (CRRTs) are the mainstay of treating AKI. PD has fewer infrastructure requirements and has been shown to save lives during conflicts, natural disasters, and pandemics. During the ongoing COVID-19 pandemic, the developed world was confronted with a sudden surge in critically ill AKI patients requiring renal replacement therapy. There were acute shortages of CRRT machines and the trained staff to deliver those treatments. Some centres developed acute PD programmes to circumvent these issues with good results. This experience re-emphasised the suitability of PD for managing AKI. It also highlighted the need to review the current management strategies for AKI in developed countries and consider incorporating PD as a viable tool for suitable patients. This article reviews the current evidence of using PD in AKI, attempts to clarify some misconceptions about PD in AKI, and argues in favour of developing acute PD programmes., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Background: Fear of losing psychological resources can lead to stress, impacting psychological health and behavioral outcomes like burnout, absenteeism, service sabotage, and turnover., Objective: The study examined the impact of job stressors (time pressure, role ambiguity, role conflict) on employee well-being and turnover intentions. The study also investigated the mediating role of employee well-being between job stressors and turnover intention based on the conservation of resources (COR) theory., Methods: Data from 396 IT executives in Malaysian IT firms were analyzed using the Partial Least Squares - Structural Equation Modeling (PLS-SEM) technique., Results: Results confirmed a significant negative correlation between time pressure (-0.296), role ambiguity (-0.423), role conflict (-0.104), and employee well-being. Similarly, employee well-being showed a significant negative relationship with turnover intentions (-0.410). The mediation analysis revealed that employee well-being mediates the relationship between time pressure (0.121), role ambiguity (0.173), role conflict (0.043), and turnover intentions., Conclusion: This paper aims to manifest the importance of designing employee well-being policies by firms to retain employees. Findings reflect the role of the managerial approach towards ensuring employee well-being for employee retention, thereby reducing recruitment and re-training costs.

Vegetable cultivation under sewage irrigation is a common practice mostly in developing countries due to a lack of freshwater. Long-term usage provokes heavy metals accumulation in soil and ultimately hinders the growth and physiology of crop plants and deteriorates the quality of food. A study was performed to investigate the role of brassinosteroid (BRs) and silicon (Si) on lettuce, spinach, and cabbage under lead (Pb) and cadmium (Cd) contaminated sewage water. The experiment comprises three treatments (control, BRs, and Si) applied under a completely randomized design (CRD) in a growth chamber. BRs and Si application resulted in the highest increase of growth, physiology, and antioxidant enzyme activities when applied under canal water followed by distilled water and sewage water. However, BRs and Si increased the above-determined attributes under the sewage water by reducing the Pb and Cd uptake as compared to the control. It's concluded that sewerage water adversely affected the growth and development of vegetables by increasing Pb and Cd, and foliar spray of Si and BRs could have great potential to mitigate the adverse effects of heavy metals and improve the growth. The long-term alleviating effect of BRs and Si will be evaluated in the field conditions at different ecological zones.

Background: Contemporary literature raises serious questions about the inclusion of negatively worded items in the safety climate scale. Despite these reservations, limited efforts have been made to address this shortcoming., Objective: The present study aims to adapt and empirically validate the ten-items group-level safety climate scale with the purpose of replacing negatively worded items with positively worded ones after a thorough validation process. The present study is one of the first to propose an empirically validated group-level safety climate scale that uses positive items to measure the safety climate construct., Methods: Study 1 was conducted using a sample of 135 participants. Study 2 used a time-lagged approach to validate the scale, with a sample of 173 production workers from six oil and gas organizations in Malaysia. The Partial Least Squares Structural Equation Modeling (PLS-SEM) method was used to test the hypothesized relationships., Results: In Study 1, the results of the exploratory factor analysis showed good reliability for the revised scale. In Study 2, the results of the PLS-SEM analysis demonstrated a positive relationship between safety climate and safety behaviors, thereby validating the revised and translated scale of safety climate., Conclusion: The revised safety climate scale will not only improve data quality, but it will also increase response rates. Additionally, the revised scale will assist managers in understanding the true perceptions of safety climate in their organization, regardless of the cultural context in which the scale is used.

Okra (Abelmoschus esculentus L.) is the most consumed vegetable worldwide with the potential for diverse ecological adaptation. However, increasing salinization and changing climatic conditions are posing serious threats to the growth, yield, and quality of okra. Therefore, to mitigate increasing soil salinization and ensure sustainable okra production under rapidly changing climatic conditions, evaluation of new okra germplasm to develop salt tolerant cultivars is direly needed. The present study was designed to evaluate the genetic resources of okra genotypes for salt tolerance at growth and reproductive phases. Based on mophological and physio-biochemical responses of plants under stress condition, genotypes were divided into salt tolerant and succeptible groups. The experiment was comprised of 100 okra genotypes and each genotype was grown under control conditions and 6.5 dS m -1 NaCl concentration in a pot having 10 kg capacity. The experiment was conducted in a completely randomized design and each treatment was replicated three times. The results showed vast genetic variability among the evaluated okra germplasm traits like days to emergence, pod length, pod diameter, plant height, stem girth, and other yield-related parameters. Correlation analysis showed a highly significant positive association among the number of leaves at first flower and plant height at first flower.Likewise, pod weight also revealed a highly significant positive relationship for pod weight plant -1 , pod length, and K + : Na + . Principal Component Analysis (PCA) revealed that out of 16 principal components (PCs), five components showed more than one eigenvalue and the first six PCs contributed 67.2% of the variation. Bi-plot analysis illustrated that genotypes 95, 111, 133, 99, and 128, under salt stress conditions, exhibited both high yield per plant and salt-tolerant behavior in other yield-related traits. On the basis of all studied traits, a salt susceptible group and a salt-tolerant group were formed. The salt tolerant group comprised of 97, 68, 95, 114, 64, 99, 111, 133, 128, and 109 genotypes, whereas, the salt susceptible group contained 137, 139, 130, 94, and 125 genotypes. Salt-tolerant okra genotypes were suggested to be used in further breeding programs aimed to develop salt tolerance in okra. These insights will empower precision breeding, underscore the importance of genetic diversity, and bear the potential to address the challenges of salt-affected soils while promoting broader agricultural resilience, economic prosperity, and food security., (© 2023. The Author(s).)

Background: knowledge on the natural history of rare diseases is necessary to improve outcomes. Disease registries may play a key role in covering these unmet needs in the rare bone and mineral community., Objective: to map existing bone and mineral conditions registries in Europe and their characteristics., Methods: online survey about the use of registries/databases and their characteristics. This survey was disseminated among members of the European Reference Network on Rare Bone Diseases (ERN BOND) and non-ERN experts in the field of bone and mineral conditions as well as patient organisations., Results: sixty-three responses from health care providers (HCPs) and 10 responses from patient groups (PGs) were collected. The response rate for ERN BOND members was 55%. Of 63 HCPs, 37 declared using a registry. Osteogenesis imperfecta (OI) was the most registered condition. We mapped 3 international registries, all were disease-specific., Conclusions: There is a need for developing a common high-quality platform for registering rare bone and mineral conditions., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Introduction: Late presentation of multiple myeloma (MM) heightens the risk of complication risks, including end-organ damage. This study aimed to: 1) detail the diagnostic journey of MM patients, encompassing symptoms, initial diagnoses, and healthcare professionals met; 2) establish the median duration from symptom onset to MM diagnosis; and 3) examine factors linked to timely MM diagnosis within 12 weeks., Methods: A total of 300 adults self-reporting MM were analysed from the Rare and Undiagnosed Diseases cohort Study (RUDY). The RUDY study is a web-based platform, where participants provide dynamic consent and self-report their MM diagnosis and information about their diagnostic journey. This includes the estimated date of initial potential first symptoms, descriptions of these symptoms, the healthcare professionals they consulted, and other diagnoses received before the MM diagnosis. Descriptive statistics, combinatorial analyses and logistic regression analyses were used to describe and examine the diagnostic journey of individuals with MM., Results: Overall, 52% of the participants reported other diagnoses before MM diagnosis, with musculoskeletal disorders (47.8%), such as osteoporosis, costochondritis, or muscle strains, being the most common. The most prevalent initial reported symptom was back pain/vertebral fractures (47%), followed by chest/shoulder pain, including rib pain and fractures (20%), and fatigue/tiredness (19.7%). 40% of participants were diagnosed by direct referral from primary care to haematology without seeing other healthcare professionals whilst 60% consulted additional specialists before diagnosis. The median time from symptom onset to MM diagnosis was 4 months (IQR 2-10 months, range 0-172). Seeing an Allied Healthcare Professional such as a physiotherapist, chiropractor or an osteopath (OR = 0.25, 95% CI [0.12, 0.47], p <0.001), experiencing infection symptoms (OR = 0.32, 95% CI [0.13, 0.76], p = 0.013), and having chest or shoulder pain (OR = 0.45, 95% CI [0.23, 0.86], p = 0.020) were associated with a lower likelihood of being diagnosed with MM within 12 weeks. Older age (OR = 1.04, 95% CI [1.02, 1.07], p = 0.001) was associated with a higher likelihood of diagnosis within 12 weeks., Discussion: Developing resources for allied health professionals may improve early recognition of MM., Competing Interests: The 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. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Vijjhalwar, Song, Shrestha, Bowcock, Sanchez-Santos, Ramasamy and Javaid.)

Introduction: Osteogenesis imperfecta (OI) is a rare genetic disease associated with multiple fractures throughout life. It is often treated with osteoporosis medications but their effectiveness at preventing fractures is unknown. The Treatment of Osteogenesis Imperfecta with Parathyroid Hormone and Zoledronic Acid trial will determine if therapy with teriparatide (TPTD) followed by zoledronic acid (ZA) can reduce the risk of clinical fractures in OI., Methods and Analysis: Individuals aged ≥18 years with a clinical diagnosis of OI are eligible to take part. At baseline, participants will undergo a spine X-ray, and have bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) at the spine and hip. Information on previous fractures and previous bone targeted treatments will be collected. Questionnaires will be completed to assess pain and other aspects of health-related quality of life (HRQoL). Participants will be randomised to receive a 2-year course of TPTD injections 20 µg daily followed by a single intravenous infusion of 5 mg ZA, or to receive standard care, which will exclude the use of bone anabolic drugs. Participants will be followed up annually, have a repeat DXA at 2 years and at the end of study. Spine X-rays will be repeated at the end of study. The duration of follow-up will range between 2 and 8 years. The primary endpoint will be new clinical fractures confirmed by X-ray or other imaging. Secondary endpoints will include participant reported fractures, BMD and changes in pain and HRQoL., Ethics and Dissemination: The study received ethical approval in December 2016. Following completion of the trial, a manuscript will be submitted to a peer-reviewed journal. The results will inform clinical practice by determining if TPTD/ZA can reduce the risk of fractures in OI compared with standard care., Trial Registration Number: ISRCTN15313991., Competing Interests: Competing interests: All authors report funding from the Efficacy and Mechanism Evaluation programme of the NIHR and non-financial support from Eli Lilly to support this work. BLL reports research grants from Mereo Pharmaceuticals outside this work and consultancy funding from Amgen, UCB, and Gedeon Richter. PO reports that she is an employee of the Brittle Bone Society. SR reports research grants from Kyowa Kirin and Astra-Zeneca outside the submitted work and funding to his institution from Pfizer, Abbvie, Kyowa Kirin, Alexion, Amgen, Cellgene, Janssen-Cilag, Novartis, Eli Lilly, Thornton & Ross, and Sanofi Genzyme and UCB outside the submitted work. SR also reports that he is a member of the Scientific Advisory Board of the Brittle Bone Society. KJ reports consultancy funding from Amgen outside the submitted work and reports that he is chair of the Medical Advisory Board of the Brittle Bone Society. JW reports that she is a member of the Medical Advisory Board of the Brittle Bone Society. CK and CW have no other conflicts of interest to declare., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: One-third of people with epilepsy continue to experience seizures despite treatment with existing anti-seizure medications (ASMs). The failure of modern ASMs to substantially improve epilepsy prognosis has been partly attributed to overreliance on acute rodent models in preclinical drug development as they do not adequately recapitulate the mechanisms of human epilepsy, are labor-intensive and unsuitable for high-throughput screening (HTS). There is an urgent need to find human-relevant HTS models in preclinical drug development to identify novel anti-seizure compounds., Objectives: This paper developed high-throughput preclinical screening models to identify new ASMs., Methods: 14 natural compounds (α-asarone, curcumin, vinpocetine, magnolol, ligustrazine, osthole, tanshinone IIA, piperine, gastrodin, quercetin, berberine, chrysin, schizandrin A and resveratrol) were assessed for their ability to suppress epileptiform activity as measured by multi-electrode arrays (MEA) in neural cultures derived from human induced pluripotent stem cells (iPSCs). In parallel, they were tested for anti-seizure effects in zebrafish and mouse models, which have been widely used in development of modern ASMs. The effects of the compounds in these models were compared. Two approved ASMs were used as positive controls., Results: Epileptiform activity could be induced in iPSCs-derived neurons following treatment with 4-aminopyridine (4-AP) and inhibited by standard ASMs, carbamazepine, and phenytoin. Eight of the 14 natural compounds significantly inhibited the epileptiform activity in iPSCs-derived neurons. Among them, piperine, magnolol, α-asarone, and osthole showed significant anti-seizure effects both in zebrafish and mice. Comparative analysis showed that compounds ineffective in the iPSCs-derived neural model also showed no anti-seizure effects in the zebrafish or mouse models., Conclusion: Our findings support the use of iPSCs-derived human neurons for first-line high-throughput screening to identify compounds with anti-seizure properties and exclude ineffective compounds. Effective compounds may then be selected for animal evaluation before clinical testing. This integrated approach may improve the efficiency of developing novel ASMs., Competing Interests: Declaration of Competing Interest PK’s institution has received research grants from Eisai, GW Pharmaceuticals, LivaNova, Novartis, UCB Pharma, and Zynerba outside the submitted work; he has received speaker fees from Angelini, Eisai, LivaNova, SK Life and UCB Pharma outside the submitted work. The other 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 © 2023. Production and hosting by Elsevier B.V.)

Introduction Chronic kidney disease-related mineral and bone disorder (CKD-MBD), characterized by abnormalities in calcium, phosphate, and parathyroid hormone metabolism, with impaired bone turnover and extravascular calcification is a known complication of advanced chronic kidney disease (CKD). Secondary hyperparathyroidism (SHPT) develops early in the disease and its prevalence gradually increases with the disease progression, becoming almost universal in patients with end-stage renal disease (ESRD). The treatment for SHPT includes synthetic vitamin D analogs, calcitriol or calcimimetics. Recently, intravenous etelcalcetide was introduced as a second-generation calcimimetic. This article provides the real-world experience of using etelcalcetide in multiethnic Asian patients receiving hemodialysis at community-based hemodialysis centers in Singapore. Methods This study was real-world evidence, generated by a retrospective clinical audit of routine clinical care of hemodialysis patients in community-based centers in Singapore who received etelcalcetide for treating SHPT. The information on the starting and maximum dose of etelcalcetide, duration of treatment on hemodialysis, parathyroid hormone (PTH) levels, dialysate calcium, concomitant medications, and reasons for discontinuation were collected from the medical records. PTH levels were collected at four-, eight-, and twelve-month intervals. Results A total of 148 patients received etelcalcetide during the study period. Ten patients died and twenty discontinued their treatment, with 118 patients remaining on treatment. Demographically, the patients included Chinese, Malay, Indians, and those belonging to other racial groups. The starting dose of etelcalcetide ranged from 2.5 mg once per week to 7.5 mg three times a week. There was a 16.8% reduction (p=<0.001) in intact-PTH after four months of therapy. Target intact-PTH level of less than 60 pmol/L, was reported as 1.4% at baseline, with 22.3% at four months (p<0.001) and 25.9% at eight months (p=0.028). Calcium and phosphate levels were also tracked as part of the safety and efficacy measures of using etelcalcetide. No symptomatic hypocalcemia was noted and phosphate levels were noted to decline significantly. Overall, the calcium-phosphate product reduced at four months (13.2%, p=<0.001) and eight months (12.7%, p<0.05). An analysis of concomitant medication usage, dialysate calcium utilized, and the side effects of etelcalcetide were also recorded. Finally, a brief descriptive analysis of the patient's subjective feedback regarding etelcalcetide was also reported, especially regarding the reduction in pill burden and overall compliance to medications. Conclusion Etelcalcetide is safe and effective for treating SHPT in multi-ethnic Asian hemodialysis patients and can be considered an alternative to oral cinacalcet. Our study showed no side effects, which was one of the key reasons for non-compliance to traditional calcimimetics. A favorable compliance profile with reduced pill burden was noted by using this intravenous calcimimetic., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Khan et al.)

Introduction: Preterm birth is linked to various complications in both infancy and adulthood. We assessed the association between preterm birth and hypertension in adulthood., Materials and Methods: PubMed, EMBASE, and Cochrane CENTRAL Register were searched for randomized controlled trials (RCT) comparing systolic and diastolic blood pressures in individuals born preterm and those born full-term, from inception till April 11 th , 2022. Data were extracted, pooled, and analyzed. Forest plots were created for a visual demonstration., Results: Twenty-eight studies were included in our meta-analysis. SBP and DBP across all categories (Mean, Ambulatory, Daytime, and Nighttime) were higher in the preterm group compared to the term group. Mean SBP, mean ambulatory SBP, mean daytime SBP and mean nighttime SBP were 4.26 mmHg [95% CI: 3.09-5.43; P < 0.00001], 4.53 mmHg [95% CI: 1.82-7.24; P = 0.001], 4.51 mmHg [95% CI: 2.56-6.74; P < 0.00001], and 3.06 mmHg [95% CI: 1.32-4.80; P = 0.0006] higher in the preterm group, respectively. Mean DBP, mean ambulatory DBP, mean daytime DBP, and mean nighttime DBP were 2.32 mmHg [95% CI: 1.35-3.29; P < 0.00001], 1.54 mmHg [95% CI 0.68-2.39; P = 0.0004], 1.74 mmHg [95% CI: 0.92-2.56; P < 0.0001], and 1.58 mmHg [95% CI: 0.34-2.81; P = 0.01] higher in the preterm group, respectively., Conclusion: Our observations suggest that individuals who were born preterm may have higher blood pressures as compared to those who were born full-term., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

The present research work aims to synthesize a blend of chitosan (CSN) and curcumin (CRN) based aqueous polyurethane dispersions (CSN-CRN APUDs) for the modification of textile surfaces. A series of anionic CSN-CRN APUDs were prepared by the reaction of isophorone diisocyanate (IPDI) with polyethylene glycol (PEG) and extended with chain extenders (CSN and CRN). Structural characterizations of prepared materials were examined through a fourier transformed infrared (FTIR) spectrophotometer. The performances of coated CSN-CRN APUDs on the colorfastness properties (washing, rubbing and perspiration) and the mechanical properties like tensile strength and tearing strength of plain weaved poly/cellulosic textiles (dyed, printed and white) were examined before and after the application of CSN-CRN APUDs. The findings showed that the mechanical and colorfastness properties of all the CSN-CRN APUDs treated poly/cellulosic textile samples were improved significantly as compared with untreated poly/cellulosic textile samples. The newly synthesized CSN-CRN APUD coating materials are sustainable and greener products, particularly derivatized from bio-resources. These coating materials can be utilized as outstanding eco-friendly substitutes for poly/cellulosic textile coatings for surface modifications., Competing Interests: Declaration of competing interest On behalf of all my co-authors I hereby declare that we have no conflict of interest for the manuscript being submitted for publication to the journal “International Journal of Biological Macromolecules”., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Arid soils are often weak, low in fertility, and lack essential plant nutrients. Organic amendments might be a feasible solution to counter the detrimental impact and rehabilitate weak arid soil for the growth of legumes. The study aimed to investigate how organic amendments of compost and humic acid may affect winter field pea productivity in arid soil. Over 2 years of field experiments, a range of treatments were applied, including different amounts of compost and humic acid. The results showed higher microbial carbon (C), and nitrogen (N) biomass, root length, shoot length, grains pod -1 , and grain yield of pea, gained from the collective application of 8 Mg ha -1 compost and 15 kg ha -1 humic acid compared to all other treatments. Organic amendments increased soil microbial C density by 67.0 to 83.0% and N biomass by 46.0 to 88.0% compared with the control. The combined application of compost and humic acid increased soil microbial N biomass by 57.0 to 60.0% compared to the sole applications of compost-only and humic acid-only. It was concluded that organic amendments of 8 Mg ha -1 compost and 15 kg ha -1 humic acid in arid soil modulated microbial density, resulting in improved winter field pea productivity. This study suggests organic amendments of compost and humic acid might be a practicable solution to rehabilitate weak arid soil to grow legumes., (© 2023. Springer Nature Limited.)

Monoclonal gammopathy of undetermined significance (MGUS) is usually an asymptomatic pre-malignant condition caused by the proliferation of clonal plasma cells. Often considered a benign condition, it has the potential to progress to malignant plasma cell or lymphoproliferative disorders. Moreover, MGUS can rarely cause glomerular disease by activating the alternative complement pathway resulting in immunoglobulin-negative C3-positive glomerulonephritis called C3 glomerulopathy. Because of its rarity, the diagnosis might not be considered by the treating physicians, leading to delayed diagnosis or misdiagnosis. Untreated C3 glomerulopathy can lead to irreversible glomerular damage and end-stage renal failure, and a high index of suspicion is essential for timely diagnosis and management. Here, we present the case of a patient with a prior diagnosis of MGUS who presented with proteinuria and microscopic haematuria and was diagnosed with C3 glomerulopathy. The patient had complete resolution of the disease after receiving treatment with a combination of dexamethasone, lenalidomide and bortezomib for the underlying MGUS., (© 2023 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians.)

The research objective of this research paper is to examine the relationships between organizational commitment to emission trading schemes, artificial intelligence, and climate entrepreneurship, as well as their impact on sustainable performance, i.e., environmental and organizational performance in organizations. This study aims to identify the key drivers and barriers to the adoption of these factors and to understand how they influence environmental and organizational performance. The study utilizes a cause-and-effect design on the sampled size of 387 subjects and employs the Smart PLS version 4.0 statistical tool to estimate the interactions between all constructs in the structural equation modeling. The research questions aim to explore the key drivers and barriers to the adoption of these factors in organization and their impact on sustainable performance, i.e., environmental and organizational performance. The study hypothesizes that organizational commitment to emission trading schemes, AI, and climate entrepreneurship has a positive impact on sustainable performances such as environmental and organizational performance. The findings suggest that attitudes toward AI and emission trading schemes have a direct impact on climate entrepreneurship, environmental performance, and organizational performance. By considering these factors together, the study seeks to uncover the synergistic effects and potential interactions between them and sheds light on their combined influence on environmental and organizational performance. Organizations can enhance environmental and organizational performance by prioritizing their attitudes toward emission trading schemes, AI, and climate entrepreneurship through resource allocation, technology investment, and fostering a climate entrepreneurship mindset. The research concludes that businesses that demonstrate high organizational commitment, positive attitude toward the ETS, and a focus on climate entrepreneurship experiences improved environmental and organizational performance., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Originality/purpose: The current study aims to investigate the novel approach of utilizing work organization and job content (WOJC) as a higher-order construct that is one of the domains of the Copenhagen Psychosocial Questionnaire (COPSOQ), examining its relationship with sleeping troubles and somatic stress, while also exploring the moderating effect of leadership quality., Sample/methods: Snowball sampling technique was used to collect the data in this study, with a population consisting of 360 workers employed in hazardous work environments at poultry feed mills. The structural equation modelling technique was applied to achieve the range of outcomes., Results: The results reveal that WOJC has a significant negative impact on both psychological (sleeping troubles) and physiological (somatic stress) health factors among poultry workers. Although leadership quality did not moderate the relationship between WOJC and physiological health factors, it did moderate the relationship between WOJC and psychological health factors., Conclusion/implications: This study has significant implications for researchers, poultry feed mill owners, policymakers, and regulatory bodies. Additionally, the methodological contribution of utilizing WOJC as a higher-order construct provides unique insights for researchers., Limitations: Due to COVID-19 restrictions, the data was collected online from one province only; future studies should spread the sampling framework to all provinces with different domains of COPSOQ., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Javaid et al.)

Background: Observational studies relating maternal 25-hydroxyvitamin D status to timing and mode of delivery have reported inconsistent results. We assessed the effect of antenatal cholecalciferol supplementation on the incidence of preterm birth, delivery mode and post-partum haemorrhage (PPH)., Methods: MAVIDOS was a randomized, double-blind, placebo-controlled trial of 1000 IU/day cholecalciferol from 14 weeks' gestation until delivery. Gestational age, mode of delivery [categorized as spontaneous vaginal delivery (SVD), instrumental (including forceps and vacuum extraction) or Caesarean section] and PPH (>500 ml estimated blood loss) were determined from medical records., Results: A total of 965 women participated in the study until delivery. Gestation at birth and incidence of preterm birth (cholecalciferol 5.7%, placebo 4.5%, P = 0.43) were similar between the two treatment groups. SVD (versus instrumental or Caesarean delivery) was more likely in women randomized to cholecalciferol [Relative Risk (RR) 1.13, 95% confidence interval (CI) 1.02,1.25] due to lower instrumental (RR 0.68, 95%CI 0.51,0.91) but similar risk of Caesarean delivery (RR 0.94, 95%CI 0.74,1.19). PPH was less common in women randomized to cholecalciferol [32.1% compared with placebo (38.1%, P = 0.054) overall], but similar when stratified by delivery mode., Conclusions: Antenatal cholecalciferol supplementation did not alter timing of birth or prevalence of preterm birth but demonstrated a possible effect on the likelihood of SVD., (© The Author(s) 2022. Published by Oxford University Press on behalf of Faculty of Public Health.)

Background: Topological indices (TIs) are mathematical formulas that are applied in mathematical chemistry to predict the physical and chemical properties of various chemical structures. In this study, three different types of polycyclic aromatic hydrocarbon structures (PAHs) (i.e., Hexa-peri-hexabenzocoronene, Dodeca-benzo-circumcoronene, and Hexa-cata- hexabenzocoronene) are studied with the help of the different connection number-based Zagreb indices., Method: ϑ = (V(ϑ),E(ϑ)) is used as a graph, where V(ϑ) is a collection of vertices and E(ϑ) is a collection of edges. For a vertex y, ∈V(ϑ), the degree d&#95;ϑ (y), is the number of those vertices that are at a distance of 1 from y and the connection number ρ&#95;ϑ (y) is the number of such vertices that are at a distance of 2 from vertex y., Results: Theoretical applications of topological indices were described in detail., Conclusion: Finally, we obtained the first and second Zagreb connections as well as the modified first, second, third, and fourth Zagreb connection indices, which were calculated for three different types (Hexa-peri-hexabenzocorone, Dodeca-benzo-circumcoronene, and Hexa-cata-hexabenzocoronene) of polycyclic aromatic hydrocarbon structures., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Hip fracture care delivery varies between hospitals, which might explain variations in patient outcomes and health costs. The aim of this study was to identify hospital-level organisational factors associated with long-term patient outcomes and costs after hip fracture., Methods: REDUCE was a record-linkage cohort study in which national databases for all patients aged 60 years and older who sustained a hip fracture in England and Wales were linked with hospital metrics from 18 organisational data sources. Multilevel models identified organisational factors associated with the case-mix adjusted primary outcomes: cumulative all-cause mortality, days spent in hospital, and inpatient costs over 365 days after hip fracture., Findings: Between April 1, 2016, and March 31, 2019, 178 757 patients with an index hip fracture were identified from 172 hospitals in England and Wales. 126 278 (70·6%) were female, 52 479 (29·4%) were male, and median age was 84 years (IQR 77-89) in England and 83 years (77-89) in Wales. 365 days after hip fracture, 50 354 (28·2%) patients had died. Patients spent a median 21 days (IQR 11-41) in hospital, incurring costs of £14 642 (95% CI 14 600-14 683) per patient, ranging from £10 867 (SD 5880) to £23 188 (17 223) between hospitals. 11 organisational factors were independently associated with mortality, 24 with number of days in hospital, and 25 with inpatient costs. Having all patients assessed by an orthogeriatrician within 72 h of admission was associated with a mean cost saving of £529 (95% CI 148-910) per patient and a lower 365-day mortality (odds ratio 0·85 [95% CI 0·76-0·94]). Consultant orthogeriatrician attendance at clinical governance meetings was associated with cost savings of £356 (95% CI 188-525) and 1·47 fewer days (95% CI 0·89-2·05) in the hospital in the 365 days after hip fracture per patient. The provision of physiotherapy to patients on weekends was associated with a cost saving of £676 (95% CI 67-1285) per patient and with 2·32 fewer days (0·35-4·29) in hospital in the 365 days after hip fracture., Interpretation: Multiple, potentially modifiable hospital-level organisational factors associated with important clinical outcomes and inpatient costs were identified that should inform initiatives to improve the effectiveness and efficiency of hip fracture services., Funding: Versus Arthritis., Competing Interests: Declaration of interests PB reports funding by the European Commission (grant reference H2020-MSCA- ITN-2017 grant agreement identifier 7651141) and from the Hungarian Ministry of Innovation and Technology (grant reference 1783-3/2018/FEKUTSTRAT and TKP2020-IKA-02). AJu reports grants from National Institute for Health and Care Research (NIHR), Health Data Research UK, Versus Arthritis, Healthcare Quality Improvement Partnership, Royal College of Physicians, and Tommy's Health Foundation; chairs a data monitoring committee (NIHR Health Technology Assessment of the DISC trial at the University of Leicester, Leicester, UK) and a trial steering committee (NIHR Health Technology Assessment of the Gentle Years Yoga Trial, Newcastle University, Newcastle, UK); is a member of a steering committee at Nuffield Foundation (Multilevel Integrated Data for musculoskeletal health intelligence and Actions, University of Keele, Keele, UK); is a data monitoring committee member at Robotic Arthroplasty (RACER trial, Clinical Trials Unit, University of Warwick, Warwick, UK); is a sub-panel member of the NIHR Programme Grants for Applied Research programme; is on the Versus Arthritis Health Subcommittee; is co-chair of the Versus Arthritis Research Expert group; and is a member of the Nuffield Foundation Oliver Bird Fund Expert Panel. AJo is the clinical lead for the National Hip Fracture Database at the Royal College of Physicians, London, UK. JG reports an educational contract with Stryker that does not entail any relationships or activities that could have influenced the submitted work. TC is a member of the National Hip Fracture Database Advisory Board; has design and educational contracts with Stryker, Acumed, and Swemac; was a representative of the British Orthopaedic Association; previously sat on the board of the Falls and Fragility Fracture Audit Project (which includes the National Hip Fracture Database); and helped set up and perform British Orthopaedic Association multidisciplinary peer reviews for hip fractures. XLG reports funding from the NIHR Health Technology Assessment Programme; multiple other grants from NIHR for specific projects unrelated to this work; and consultancy fees from Johnson & Johnson and Stryker. MKJ reports honoraria, unrestricted research grants, and travel or subsistence expenses from Amgen, Consilient Health, Kyowa Kirin Hakin, UCB, AbbVie, Sanofi, and Besin Healthcare; participation in the committees or boards of Regeneron, International Osteoporosis Foundation Capture the Fracture Steering Committee, Fracture Liaison Service Database of England and Wales, and medical advisory board of Brittle Bone Society and Fibrous Dysplasia Support Society UK. ECB reports funding from the UK Prevention Research Partnership (Violence, Health and Society; grant reference MR-VO49879/1), the British Heart Foundation, the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, NIHR, Natural Environment Research Council, Public Health Agency (Northern Ireland), the Health Foundation, and the Wellcome Trust. YB-S reports book royalties from Oxford University Press and Wiley; consulting fees from Human Centric Drug Discovery; and is a member of the trial steering committee of the SIMPLIFIED trial. EMRM reports research funding from CeramTec UK, NIHR, Medical Research Council, and the Healthcare Quality Improvement Partnership; is a steering group committee advisor for an NIHR Health Services and Delivery Research grant and an NIHR Health Technology Assessment grant; and a committee member for the NIHR Research for Patient Benefit funding scheme since 2017 and NIHR Programme Grant for Applied Research funding scheme since 2023. CLG reports research grants from Wellcome Trust, Royal Osteoporosis Society, Chan Zuckerberg Donor Advised Fund, and Versus Arthritis; and is a Chair of the National Osteoporosis Guideline Group and a member of the Royal College of Physicians Falls and Fragility Fracture Scientific committee. RP reports funding from CeramTec UK on an unrelated study and after completion of the analyses for the present Article., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Rapid economic expansion has caused resource depletion, globalization issues, and environmental deterioration. Globalization has highlighted East and South Asian mineral richness. This article investigates the effects of technological innovation (TI), natural resources, globalization, and renewable energy consumption (REC) on environmental deterioration in the East and South Asian region from 1990 to 2021. The cross-sectional autoregressive distributed lag (CS-ARDL) estimator is used to estimate short- and long-run slope parameters and dependencies across countries. The results demonstrate that many natural resources significantly enhance environmental degradation, while globalization, TI, and REC reduce emission levels in East and South Asian economies and that economic growth significantly degrades ecological quality. This research suggests that governments in the East and South Asian region develop suitable policies that promote the efficient use of natural resources via technological advancements. Furthermore, future policies regarding energy consumption, globalization, and economic development should be aligned with the aims of sustainable environmental development., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)