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Farmer Producer Companies (FPCs) have emerged as a potential solution to address the limitations of cooperatives. This study was conducted in Kerala, India, and 25 percent of the FPCs established on or before 31/03/2020 were selected as the sample. A simple percentage analysis was employed to evaluate the general profile of the FPCs. The findings indicated that FPCs are dominated by small and marginal farmers (98.92 percent) and, on average, the share capital of NABARD-promoted and CDB-promoted FPCs were Rs.19.62 lakhs and Rs. 218.88 lakhs respectively. FPCs perform multiple functions starting from marketing, processing, value addition, storage, drying, input shop, consultancy services, credit and insurance support, agency for government procurement, agro-service centers, and labor banks and exports. Consequently, FPCs address nearly all the requirements of farmers in the value chain from providing timely inputs at reasonable rates to facilitating the product's journey to the final consumers. Despite certain limitations, such as poor resource base, lack of linkages, and inadequate management, with appropriate guidance and sufficient support in terms of finance, technical, and managerial resources, FPCs have the potential to thrive and become a promising avenue for small and marginal farmers in the country. [ABSTRACT FROM AUTHOR]

To assess the learning efficacy of self-directed virtual reality ultrasound simulators as an alternative to traditional physician-led teaching for cardiac point-of-care ultrasound (POCUS) training. Single blinded (observer), noninferiority, parallel group, randomized controlled study. Tertiary university hospital in Singapore. Forty-three medical students with no prior formal ultrasound training. Participants first completed an e-learning module on basic ultrasonography. Participants' baseline knowledge was subsequently assessed using a multiple-choice question (MCQ) test. Participants were then randomized to either physician-led (PL) teaching or independent learning with a virtual-reality (VR) simulator to learn the 4 cardiac POCUS views. A post-training MCQ test and a practical skills test scored by 2 blinded assessors were conducted. Students repeated the MCQ test and skills test 1 month later. The VR group had higher baseline MCQ scores compared to the PL group (mean, 13.4 v 10.7). Immediately post-training, the PL group had a greater improvement in mean MCQ scores (from baseline) and higher total practical scores compared to the VR group (p = 0.03 and p < 0.01, respectively). At 1 month post-training, the PL group similarly had a greater mean change from baseline MCQ scores, but this difference was not statistically significant (p = 0.12). For practical scores, the VR group scored higher than the PL group, although this difference was not statistically significant (p = 0.06). Our study demonstrates that at 1 month post-training, self-directed VR training was noninferior to PL training. Although differences observed were not significant, there were trends to suggest enhanced retention of knowledge and skills with VR learning. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors (ICIs) are now considered revolutionary agents in the treatment of various cancers. Prospective data are limited on the patterns of usage and toxicity profile of these drugs. We planned this study for addressing the same in Indian patients. This prospective study was conducted over a period of 2 years. All patients who were treated with Nivolumab, pembrolizumab, atezolizumab, and durvalumab were included. Immune-related adverse events were recorded. Toxicities were graded and number of patients experiencing dose limiting toxicities was recorded. A total of 53 patients received one of the above four agents. Majority of patients were less than 60 years of age. Carcinoma lung was the most frequent malignancy followed by renal cell carcinoma, Hodgkin's Lymphoma, Urinary Bladder cancers, Malignant Melanoma, and Recurrent/Metastatic Head and neck cancer. Nivolumab was used in most of the study population followed by pembrolizumab. Majority of agents were used in second line. The frequency of all grade adverse events for fatigue, anemia, pneumonitis, skin rash, dyspnea, diarrhea, and hypothyroidism were (in %) 73.58, 62.26, 16.9, 11.32, 9.43, 9.43, and 7.55, respectively. No grade 5 toxicity was observed. None of the grade 3 or 4 toxicities led to treatment discontinuation. Statistically, no difference was found for all grade toxicities among ICI drugs and among the various lines of use. Nivolumab was the commonest drug used in our cohort. Most of ICIs were used in second-line setting. Toxicities are in line with the published literature. [ABSTRACT FROM AUTHOR]

Although guidelines recommend low-density lipoprotein cholesterol (LDL-C) to be < 70 mg/dL in patients with atherosclerotic cardiovascular disease (ASCVD), the rate of achieving this goal remains suboptimal. We sought to understand real world contemporary practice patterns of LDL-C management in patients with ASCVD, and whether LDL-C testing influenced management across US health systems. A retrospective cohort study utilizing electronic medical record data from five health systems participating in the CardioHealth Alliance was performed on patients with an LDL-C measurement in 2021 and prior ASCVD. Multivariable regression modeling was used to determine the relationship of clinical factors with achievement of guideline directed LDL-C target. Changes in lipid lowering therapy (LLT) after LDL-C testing were also described. Among 216,074 patients with ASCVD, 129,886 (60.1%) had uncontrolled LDL-C (i.e. ≥ 70 mg/dL). Compared with participants with controlled LDL-C (< 70 mg/dL), those with uncontrolled LDL-C were more frequently female (50.9% vs. 35.1%), or Black (13.7% vs. 10.3%), and less commonly had coronary artery disease as the form of vascular disease (73.0% vs. 83.5% %), heart failure (21.3% vs. 29.1% %), diabetes (34.1% vs. 48.2%), atrial fibrillation (19.3% vs. 26.1%), or chronic kidney disease (25.1% vs. 32.2%). In multivariable analyses, the factors most strongly associated with failure to achieve LDL-C control were female sex (RR 1.13 [95% CI 1.12-1.14] P <.001) and Black race (1.15 [1.14-1.17] P <.001). Among the 53,957 (41.5%) of those with uncontrolled LDL-C ≥70 mg/dL not on lipid lowering therapy (LLT) at baseline, only 21% were initiated on any LLT within 6 months of the uncontrolled LDL-C value. Within 5 diverse large health systems in the CardioHealth Alliance, more than half of the patients with ASCVD had uncontrolled LDL-C with significant disparities based on sex and race at baseline. The vast majority were not initiated on any lipid lowering therapy within 6 months of an elevated test result indicating persistent gaps in care that will likely worsen health inequities in outcomes. This highlights the urgent need for implementation efforts to improve equitable care. [ABSTRACT FROM AUTHOR]

Formation pressure is an important indicator of field production potential. Currently, the common practice to estimate reservoir pressure is the hydrodynamic exploration test. This method requires shutting down the well, often for a long time. Such long shutdowns lead to less production from the reservoir and worsen the economics of the field. Here, we present the method for determining the pressure without shutting down the well by using statistical methods for such tasks. In this article, we describe the method of finding the formation pressure by using multidimensional multivariate analysis of the actual reservoir data from the Sukharev field. To build the model, several operational, geological, and reservoir properties at various stages of the field pressure were combined into a model to predict reservoir pressure. Results showed that with this simple statistical method, formation pressure varies in two distinctive stages. In the first stage, the formation pressure is influenced by the reservoir petrophysical parameters, whereas in the second stage, operational parameters were more prominent. Finally, three separate formations in the Sukharev field were examined to predict reservoir pressure, and the results were in very good agreement with the actual measured data. This confirmed that the method was practical and capable of predicting reservoir pressure at any time of the well's lifetime. [ABSTRACT FROM AUTHOR]

• Research towards enhancing productivity of a passive stepped solar still is summarized and concluded. • Influence of parameters like absorber material, condensing cover inclination, glass thickness, cavity volume space between glass and basin is discussed. • Effect of various controllable factors affecting productivity like absorber area, depth of water and free surface area of saline water is reviewed. Augmenting the productivity of fresh water with minimum environmental impact is a challenging task for researchers across the globe. Solar desalination is an environment-friendly approach with minimum CO 2 emissions. Researchers have investigated the influence of different design and operating variables to enhance the distillate productivity using passive-type stepped solar stills. The stepped solar stills were similar in shape and size compared to the conventional solar still and had increased distillate output. The influence of cavity volume space, the depth of water, and the surface area of the absorber in contact with the saline water on the distillate output is discussed in this paper. Most researchers proved the fact that stepped stills had higher productivity compared to conventional stills. In this review, an attempt is made to discuss the different design and operating parameters influencing the productivity of stepped still. [ABSTRACT FROM AUTHOR]

Background: The hamstring is the two-joint muscle, located on the posterior aspect of the thigh. The tightness of the hamstring muscle is more common than the other skeletal muscle. Lack of hamstring flexibility leads to postural changes and reduces muscle strength and length. To improve hamstring flexibility, muscle energy technique and self-myofascial release are effective. Objectives: To determine the effectiveness of muscle energy technique versus self-myofascial release by using a foam roller to improve hamstring flexibility in young individuals. Methods: 30 subjects were selected according to inclusive and exclusive criteria and they were divided into two groups, Group A treated with a self-myofascial release technique, and Group Was treated with a muscle energy technique. Results: To compare both groups, an unpaired t-test was used. The post-intervention value of flexibility in Group A is 8.4 and in Group B is 12.8. There is a significant difference between Group A and Group B for flexibility. According to the results, both techniques are effective but as a comparison, Group B i.e. muscle energy technique is more effective than Group A self-myofascial release. Conclusion: The muscle energy technique is more helpful in improving hamstring flexibility as per comparison to SMFR by using a foam roller. [ABSTRACT FROM AUTHOR]

The present study was carried out to synthesize silver nanoparticles (AgNPs) from an aqueous leaf extract of Cynoglossum furcatum, which functioned as a capping agent and reducing agent. The synthesized AgNPs have been revealed using a variety of microscopy techniques. The spherical dimension is exploited by electron microscopies, which have an average nanoparticle size of 33 nm. A topographical photograph of Cynoglossum furcatum AgNPs was obtained using atomic force microscopy, demonstrating the reduction of surface irregularity. The MTT assay was employed to evaluate the effect of the plant extract and the AgNPs on the Vero, 3T3 L1, and A431 cell lines. The agar disk diffusion was employed to evaluate the antibacterial efficacy with E.coli, S.typhi, S.aureus, and E.faecalis, as well as the antifungal efficacy against A.niger, C.albicans, A.flavus, and A.fumigates, which exhibited substantial antimicrobial activity. [ABSTRACT FROM AUTHOR]

Background: Optic neuritis (ON) is a complex clinical syndrome that has diverse etiologies and treatments based on its subtypes. Notably, ON associated with multiple sclerosis (MS ON) has a good prognosis for recovery irrespective of treatment, whereas ON associated with other conditions including neuromyelitis optica spectrum disorders or myelin oligodendrocyte glycoprotein antibody–associated disease is often associated with less favorable outcomes. Delay in treatment of these non-MS ON subtypes can lead to irreversible vision loss. It is important to distinguish MS ON from other ON subtypes early, to guide appropriate management. Yet, identifying ON and differentiating subtypes can be challenging as MRI and serological antibody test results are not always readily available in the acute setting. The purpose of this study is to develop a deep learning artificial intelligence (AI) algorithm to predict subtype based on fundus photographs, to aid the diagnostic evaluation of patients with suspected ON. Methods: This was a retrospective study of patients with ON seen at our institution between 2007 and 2022. Fundus photographs (1,599) were retrospectively collected from a total of 321 patients classified into 2 groups: MS ON (262 patients; 1,114 photographs) and non-MS ON (59 patients; 485 photographs). The dataset was divided into training and holdout test sets with an 80%/20% ratio, using stratified sampling to ensure equal representation of MS ON and non-MS ON patients in both sets. Model hyperparameters were tuned using 5-fold cross-validation on the training dataset. The overall performance and generalizability of the model was subsequently evaluated on the holdout test set. Results: The receiver operating characteristic (ROC) curve for the developed model, evaluated on the holdout test dataset, yielded an area under the ROC curve of 0.83 (95% confidence interval [CI], 0.72–0.92). The model attained an accuracy of 76.2% (95% CI, 68.4–83.1), a sensitivity of 74.2% (95% CI, 55.9–87.4) and a specificity of 76.9% (95% CI, 67.6–85.0) in classifying images as non-MS–related ON. Conclusions: This study provides preliminary evidence supporting a role for AI in differentiating non-MS ON subtypes from MS ON. Future work will aim to increase the size of the dataset and explore the role of combining clinical and paraclinical measures to refine deep learning models over time. [ABSTRACT FROM AUTHOR]

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Steven Chaffee stated that 'the most likely "effect" of communication...is further communication' (p. 72). The present study asks to what extent this offering, referred to as 'The Chaffee Principle,' is realized in extant communication research. A manual content analysis of two top-tier communication journals (N = 2,040) offers an assessment of empirical attention to a variety of communicative acts in mass, interpersonal, and mediated-interpersonal communication research, as well as across subfields, contexts, methods, and time. The analysis finds that communication-to-communication effect sizes (r =.28) largely surpass those found in more dominant areas, and yet receive relatively scant attention in the communication literature. A call is made for a more systematic study of The Chaffee Principle to advance communication research. [ABSTRACT FROM AUTHOR]

The popularity of nonoperative management for acute appendicitis is based on the untested assumption that it offers a lower risk alternative to surgery in patients who are at high risk for morbidity and mortality with appendectomy. We hypothesized that patients who were at a high risk with appendectomy would also be at a high risk for complications following nonoperative management. This is a retrospective cohort study of patients with acute, uncomplicated appendicitis in the 2004–2017 National Inpatient Sample. We used a logistic regression model to predict the risk of morbidity or mortality following appendectomy and applied this model to predict the risk of patients managed nonoperatively. High risk was defined as ≥2 standard deviations above the mean predicted risk of morbidity or mortality. We used inverse probability weighting of the propensity score to compare outcomes of nonoperative versus operative management for high-risk patients. The sample included 21,242 high-risk patients with a median age of 68 years (interquartile range 57–78), and 31% were managed nonoperatively. Compared to surgery, nonoperative management was associated with a 9% decrease in complications (95% confidence interval [CI] 7%–10%), 2% increase in mortality (95% CI 2%–3%), $10,202 increase in hospital costs (95% CI $9,065–$11,339), 3-day increase in length of stay (95% CI 2–3), and 9% greater likelihood of discharge to skilled nursing facilities (95% CI 8%–10%). Nonoperative management of acute appendicitis in high-risk patients may reduce morbidity but increase mortality, duration of hospitalization, discharge to skilled facility, and costs. Surgeons should exercise caution when considering nonoperative management in these vulnerable patients. [ABSTRACT FROM AUTHOR]

The proliferation of digital media has led to an increased need for secure and efficient systems for image and video retrieval and authentication. Traditional approaches often struggle with scalability and vulnerability to tampering, compromising the integrity of media management systems. The rise of artificial intelligence and deep neural networks (DNNs) offers transformative potential to address these challenges. By leveraging DNNs, this study proposes an advanced framework for secure media management, integrating robust retrieval and authentication mechanisms. The method employs a convolutional neural network (CNN)-based encoder-decoder architecture to extract and match high-dimensional features for image and video retrieval. For authentication, a blockchain-backed hash validation ensures the originality and integrity of media assets. The system is trained and evaluated on benchmark datasets, such as MS-COCO and UCF101, with augmentation techniques enhancing its adaptability across diverse media formats and resolutions. Key performance metrics include retrieval accuracy, processing time, and authentication robustness. Experimental results show a retrieval accuracy of 96.8%, with a mean processing time of 0.85 seconds per query. Authentication robustness achieves a 99.2% success rate in detecting altered media, significantly outperforming existing systems. The proposed framework ensures both scalability and security, offering an innovative solution for media management in domains such as journalism, legal evidence management, and social media platforms. [ABSTRACT FROM AUTHOR]

We aimed to develop a registry ('Keto-Reg') for individuals with epilepsy referred for ketogenic dietary therapy (KDT) and to test feasibility of its implementation. The purpose of the registry is to provide a platform for collaborative research to answer specific research questions regarding long-term clinical and safety outcomes and to identify the most suitable candidates for KDT. Registry data items were determined via an international Delphi survey of KDT healthcare professionals, and then entered into an electronic platform. Three UK and two other European KDT centres entered data for 10 'patients' and reported on its acceptability and feasibility of use via questionnaire. 25 % of data was validated against medical records. A national survey was distributed and 19 parents and four young people were interviewed about a potential future patient/family section to the registry. Healthcare professionals from six continents responded to the Delphi (n = 153 round 1, n = 79 round 2); 70 items reached the agreement threshold. Registry data entry was accurate (0.3 % errors identified) and reported to be feasible and acceptable in the short-term. Lack of time was identified as the main barrier to longer-term implementation, with funded hours required. 87 % of the 53 survey responders and all interviewees viewed a patient/family section to be positive and feasible. We have shown healthcare professional involvement in Keto-Reg to be feasible in the short-term, and have identified what is necessary for the next stage: prospective longitudinal data entry from a larger number of international centres. • Ketogenic dietary therapy for epilepsy registry developed - Keto-Reg, data items determined by international Delphi survey. • Keto-Reg tested in 3 UK and 2 other European centres. • Healthcare professional involvement in Keto-Reg feasible with accurate data entry. • Extra time needed for long term international implementation. • Parent and young people interest in a future family/patient section of Keto-Reg. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the cardioprotective effect of bioassay-guided isolated fractions of Cleome viscosa methanolic extract in streptozotocin-induced diabetic rats. Methods: Total phenolics, flavonoids, and in vitro antioxidant activities of the methanolic extract of Cleome viscosa were evaluated. The FD-40 fraction from this extract was further evaluated for antihyperglycemic efficacy (insulin and HbA1c), antioxidant activity, and cardioprotective effects (creatine kinase-MB, lactate dehydrogenase, and histopathology) in streptozotocin-induced diabetic rats. In silico studies were also conducted to assess the bioactivity of FD-40. Results: Cleome viscosa methanolic extract exhibited the highest antioxidant activity in DPPH, ABTS, H2O2, and FRAP assays compared to other extracts. Treatment with FD-40 (40 mg/kg b.w.) isolated from this extract normalized blood glucose, insulin, HbA1c, creatine kinase-MB, and lactate dehydrogenase levels in diabetic rats. It also significantly reduced oxidative stress by increasing antioxidant enzymes, decreasing lipid peroxidation as well as restoring the levels of ascorbic acid and glutathione. Histological study demonstrated that FD-40 treatment improved cardiac structure in diabetic rats. Molecular docking analysis revealed that phytocompounds from FD-40 had strong binding affinities with cardiac markers and oxidative enzymes. Hexose (5TMS) demonstrated greater binding affinity with xanthine oxidase and lactate dehydrogenase. Conclusions: FD-40 of Cleome viscosa methanolic extract exhibits significant cardioprotective effects in diabetic rats by regulating cardiac markers and reducing oxidative stress. The underlying mechanisms need to be elucidated in the future. [ABSTRACT FROM AUTHOR]

Studies assessing EUS-guided biliary drainage (EUS-BD) or gallbladder drainage (EUS-GB) using lumen-apposing metal stents (LAMSs) have shown variable results based on the type of LAMS. We performed a meta-analysis of the available data. Multiple online databases were searched for studies using LAMSs (Axios [Boston Scientific, Marlborough, Mass, USA] or Spaxus [Taewoong Medical Co, Gimpo, Korea]) for EUS-BD and EUS-GB. The outcomes of interest were technical success, clinical success, and adverse events. Pooled proportions along with 95% confidence intervals were calculated. A total of 18 observational studies were included: 11 for the Axios stent (433 patients; mean age, 72 years; 54% male) and 7 for the Spaxus stent (242 patients; mean age, 74 years; 50% male). The respective pooled outcomes for the Axios stent (EUS-BD and EUS-GB, respectively) were technical success, 96.2% and 96.2%; clinical success, 92.8% and 92.7%; total adverse events, 10.1% and 23.6%; and bleeding, 3.7% and 4.8%. The respective pooled outcomes for the Spaxus stent (EUS-BD and EUS-GB, respectively) were technical success, 93.8% and 95.9%; clinical success, 90.1% and 94.2%; total adverse events, 12.6% and 9.5%; and bleeding, 3.1% and 1.8%. Axios and Spaxus stents demonstrate similar pooled technical and clinical success rates. Adverse events occurred in 23.6% of patients (Axios stent) and 9.5% of patients (Spaxus stent) during EUS-GB. [ABSTRACT FROM AUTHOR]

• Rasmussen syndrome (RS) currently lacks detailed diagnostic/treatment algorithms. • The survey highlights trends and significant variations in RS management. • Variations in practice are targets for research and consensus guidelines in RS. Rasmussen syndrome (RS) is marked by progressive unihemispheric atrophy, resulting in hemiparesis, refractory epilepsy, and cognitive/language decline. Detailed diagnostic and treatment algorithms are currently lacking. We aimed to survey medical providers on their current practices in the diagnosis and treatment of RS. A steering committee was formed to create the survey, which was disseminated to the international medical community. One hundred twelve surveys were completed. Descriptive statistics, as well as comparisons by level of experience, patient age group cared for, and geographic region using Fisher's exact test, were conducted. Analysis of cerebrospinal fluid (82 %) and serum (78 %) for autoimmune encephalitis (AE) are completed by most, while approximately one-third obtain genetic and metabolic studies in all patients (36 % and 38 %, respectively). Providers in US and Europe more readily pursue serum AE antibody panels (85 % and 85 %, respectively, versus 67 %, p = 0.019) and genetic testing (56 % and 47 %, respectively, versus 14 %, p < 0.001) than the rest of the world. Thirty-six percent proceed to biopsy in patients otherwise meeting diagnostic criteria, and US providers are more likely to suggest this than others (73 % versus 14–41 %, p < 0.001). Opinions differed on the prioritization of hemispherectomy/hemispherotomy versus immunotherapy in 14 clinical scenarios with various neurologic deficit severity provided. Preferred immunotherapy regimens also varied, with US providers more often choosing IVIG as first-line (67 %) compared to others (28 %-32 %, p = 0.030). Surgical standard of care was identified as functional hemispherectomy or hemispherotomy by 90 %. The survey highlights trends but also significant variations in clinical practice that can serve as targets for future research and expert consensus guidelines. [ABSTRACT FROM AUTHOR]

Cr3+ doped Li2Ba3(P2O7)2 pyrophosphate nanopowder was successfully synthesised by solid-state reaction technique. The nanopowder was characterised by several techniques. X-ray diffraction analysis reveals orthorhombic crystal structureand average crystallite size values 34.21 and 28.41 nm are determined by Debye Scherrer's formula and Williamson-Hall (W-H) method. The morphology displayed both SEM and HR-TEM images are irregular stone-like shapes. EDS analysis confirms the constituted elements. The SAED patterns of HR-TEM with well matched with XRD data. FT-IR and Raman spectra analysis confirmed incorporation of Cr3+ in the Li2Ba3(P2O7)2 pyrophosphate nanopowder. The EPR spectrum exhibited signal at g = 1.968 which is attributed to interaction between Cr3+ and Cr3+ exchange pair. The site symmetry of Cr3+ ions occupy a distorted octahedral. Photoluminescence spectrum exhibited bands correspond to ultraviolet, blue and green regions. The evaluated CCT of 6517 K indicates yellowish-green emission near cold light which reveals that the present prepared sample is useful for LEDs applications. [ABSTRACT FROM AUTHOR]