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Introduction: In remote communities, maternal and child health is often compromised due to limited access to healthcare. Simultaneously, these communities historically rely greatly on traditional birth attendants (TBAs). However, optimal integration of these traditional methods with modern healthcare practices remains a topic of debate. We assessed the effect of maternal and child health training of traditional birth attendants on adverse pregnancy outcomes. Methods: We conducted a systematic review and meta-analysis to answer the above research question. We independently screened studies using databases like PubMed, Scopus, and CENTRAL, extracted data, and assessed the study quality. Due to fewer original studies in this field, we considered both pre-post and between-group differences to assess the effect of differences. These were synthesised separately, assessed against a p-value function, and subjected to sensitivity analyses. Results: We included six interventional studies. Training TBAs reduced the risk of perinatal mortality [0.69, 0.61–0.78] and 7-day neonatal mortality [0.65, 0.53–0.80] but not stillbirth [0.70, 0.39–1.26]. In randomized controlled trials, there is a lower risk of perinatal mortality [0.73, 0.67–0.79] and neonatal mortality [0.70, 0.62–0.80] but not stillbirth [0.81, 0.56–1.18] with trained traditional birth attendants. There are methodological concerns with most existing studies, including domains like allocation concealment. Discussion: There is some evidence of the benefit of training TBAs, though of a low to very low certainty. Due to fewer studies, inconsistent estimates for different critical outcomes, and concerns with the existing studies, further well-designed studies can give more insights. They can also help optimize the contents of TBA training interventions. Protocol: CRD42023412935 (PROSPERO).

Background: A variety of materials and techniques are used for skin closure after caesarean section (CS), common ones being sutures and staples. The technique chosen should be simple, quick, painless, and provide good cosmesis with least wound complications, and there is a need to identify which provides the best outcome. Objectives: The aim was to compare metallic surgical staples versus subcuticular sutures for skin closure after caesarean delivery in terms of wound complications, skin closure time, pain score on day 3, and patient satisfaction after 6 weeks. Materials and methods: A total of 300 women undergoing CS with Pfannenstiel incision were randomized into two groups using sealed envelopes. Skin closure was done, and time was noted simultaneously. Wound condition and pain score were assessed on day 3 and 6 weeks post-operatively. Results: On day 3 post-operatively, 22% patients in each group had abnormal healing. After 6 weeks, 1.37% patients with sutures and 3.44% patients with staples had abnormal healing (p value 0.39). Total 10 patients (3.33%), 5 in each group, underwent resuturing within 6 weeks post-operatively. Staples reduced skin closure time as compared to sutures (p value <0.001). Mean pain score was comparable between two groups on day 3 post-operatively (p value 0.08) and at 6 weeks (p value 0.45). Patient satisfaction score considering the appearance and comfort of scar was comparable between both groups (p value 0.25). Conclusion: Staples and subcuticular sutures are equivalent to each other, and the choice of skin closure material is at the discretion of the surgeon.

Background and Objectives: To assess mismatch repair (MMR) status and programmed death-ligand 1 (PD-L1) expression in squamous cell carcinomas of the cervix and their association with clinicopathologic parameters. Material and Methods: Expression of PD-L1 and MMR status (MSH2, MSH6, MLH1, and PMS2) was assessed on 50 cases of SCCs of the cervix by immunohistochemistry. Results: 80% of tumor cells and 84% of tumor-infiltrating lymphocytes showed PD-L1 expression. 80% of cases had a combined positive score (CPS) of > 1, whereas 20% had a CPS of < 1. 94% of cases showed pMMR proteins, while 6% showed dMMR. 94% of the SCCs were HPV associated, and 6% were HPV-independent. All HPV-independent SCCs of the cervix showed PD-L1 expression, and all HPV-associated SCCs showed MMR deficiency. Between PD-L1 expression in the tumor and the grade of the tumor, a statistically significant association was noted (p= 0.022). All MMR-deficient SCCs were HPV-independent. Conclusion: This research highlighted the HPV association in cervical SCCs in the Indian population. Most of the cervical SCCs were HPV-associated. Furthermore, most of the HPV-associated SCCs were MMR stable. This study found no significant association between MMR status and PD-L1 expression in cervical SCCs.

Objective: Bcl-2-associated athanogene-3 (BAG-3) is a cytoplasmic multidomain protein member that belongs to the BAG family of co-chaperones that are known to be involved in several cellular processes, including control of apoptosis, autophagy, and cytoskeletal dynamics. Normal tissues show weak to negligible expression as it is downregulated. However, its expression is upregulated in various epithelial and hematological malignancies, including endometrial, cervical, and chronic lymphoid leukemia. It plays a vital role in tumor cell proliferation, metastasis, and therapy resistance; thus, its expression has been determined to be a valuable tool in developing targeted therapeutic strategies. Endometrial cancers are one of the most common female genital tract malignancies with high mortality. Therefore, in this study, we evaluated the BAG-3 protein immunoexpression in 33 cases of endometrial cancer and correlated its expression with prognostic determiners. Materials and Methods: We performed a retrospective study of BAG-3 immunoexpression in 33 cases of endometrial carcinoma. Cytoplasmic and membranous staining was considered positive and its correlations with prognostic factors such as myometrial invasion, LVSI, and ovarian involvement were analyzed. Results: BAG-3 immunopositivity was seen in 31 (93.9%) cases and two cases were found to be negative. Twenty-two (66.6%) showed strong (3 +) intensity, seven (21.2%) showed moderate, and two (6.1%) showed weak BAG-3 immunostaining. No significant correlation was seen between grade and intensity. Conclusion: Inhibiting BAG-3 expression can induce apoptosis, thus promoting a new therapeutic target for the treatment of endometrial carcinoma.

Background: This study endeavors to assess the efficacy of quantitative fluorescent polymerase chain reaction (QF-PCR) as an alternative adjunctive modality to conventional karyotyping for prenatal diagnostic purposes. Methods: In this cohort study, 464 pregnant women deemed at high risk for chromosomal aneuploidies within gestational age 12–24 weeks, spanning from January 2020 to May 2023 were enrolled. Analysis was done on 347 women who underwent both QF-PCR and karyotype. Results: Within this cohort, concordant QF-PCR and karyotype results were achieved in 332 (95.67%) samples with 21 women showing trisomy 21 and two trisomy 18 in the fetus with results being 100% concordant with karyotype and QF-PCR. Notably, there were no false-negative or false-positive QF-PCR results. However, eleven cases presented discordant results, revealing various genetic abnormalities, such as deletions, translocations, inversions, and mosaicism. The overall frequency of chromosomal abnormalities was 8.82% (41/464). The mean age of the pregnant women was 28.7 ± 5.54 years, with 10.7% (50/464) of women having aged > 35 years. The median gestation age for amniocentesis and CVS procedures was 16 weeks (IQR 15.6–20) and 13 weeks (IQR 12.7–13.5), respectively. Conclusion: The study concluded that although QF-PCR may serve as a stand-alone diagnostic tool in some cases with appropriate pretest counseling, simultaneous karyotyping, or chromosomal microarray should be considered in pregnancies with normal QF-PCR results and abnormal USG findings such as increased nuchal translucency or structural malformations or a family history of a chromosomal disorder. Despite being a rapid and highly sensitive test, QF-PCR does not fully substitute conventional karyotype analysis.

Purpose of Study: Assessment of accuracy, intra-observer and inter-observer and agreement for CTG interpretation utilizing NICE guidelines 2017. Methods: This prospective observational study was completed at a tertiary-level hospital. 1650 CTG tracings were interpretations by 5 clinicians with various levels of clinical experience according to NICE 2017 CTG interpretation guidelines were analyzed. Inter-observer and intra-observer congruence was ascertained by employing Fleiss’ kappa and Cohen’s kappa using SPSS statistical software. Sensitivity, specificity, predictive values, likelihood ratios and overall accuracy of various CTG parameters for acidemia were computed. Results: Different CTG parameters had varied inter and intra-observer congruence which improved among clinicians with more than 5 years of experience. The best agreement was seen for baseline fetal heart (kf= 0.678), and others like identification of variability pattern, type of decelerations and concerning features of variable decelerations had fair to only slight agreement. Again, various CTG parameters had very diverse predictive values for metabolic acidosis. Overall CTG category had a sensitivity, specificity and overall accuracy of 85.00%, 82.64% and 82.67%, respectively. As a single parameter variable deceleration with concerning characters surpassed all other CTG variables for the prediction of acidosis. Conclusions: NICE 2017 guidelines for CTG interpretation were found to have fairly good predictive accuracy for acidemia. CTG had a high negative predictive value. A high level of non-correspondence in few CTG parameters as determining variability, identification of the deceleration type and concerning features probably point to the requirement for further objectivity while defining these parameters.

ABSTRACTThe hereditary spastic paraplegias (HSPs) represent a family of genetic disorders comprising at least 72 different genes with the common pathology of progressive locomotor deficits and spasticity. ATL1/SPG3A(atlastin GTPase 1) encodes an ER fusion protein that controls ER morphology, which implicates ER structure as a causal factor in HSP. Here we use Drosophila to study effects of decreased atl(atlastin) on properties of the larval body wall muscle. We found that muscle atlloss causes accumulation of aggregates containing polyubiquitin (polyUB), mostly bound to the autophagy receptor ref(2)P/SQSTM1/p62. Muscle atlloss also decreased volume and complexity of the endolysosomal network and decreased lysosome number. To determine effects of these lysosomal deficits on progression through the basal autophagy pathway, we expressed Atg8atagged with both GFPand mCherryin a wild-type and atlmutant background. We found numerous structures containing mCherry but not GFP fluorescence in wild type, indicating that Atg8a was found mostly in mature autolysosomes. In contrast, muscles lacking atlexhibited significant amounts of GFP signal, indicating failure of autophagosome maturation with acidic lysosomes. Many of these GFP-positive puncta contained the late-endosome marker Rab7 but not Lamp1, indicating that some autophagy cargo was accumulating within amphisomes. We also found that this autophagy block was accompanied by an inability to activate the mTor kinase. Our results provide mechanistic insights into the role of atlin maintaining proper function of the autophagy pathway and suggests that certain pathologies in patients with mutations in ATL1/SPG3Amight result from altered MTOR signaling.Abbreviationsatl atlastin; ALR autophagic lysosome reformation; ER endoplasmic reticulum; GFP green fluorescent protein; HSP hereditary spastic paraplegia; Lamp1 lysosomal associated membrane protein 1 PolyUB polyubiquitin; RFP red fluorescent protein; spin spinster; mTor mechanistic Target of rapamycin; VCP valosin containing protein

To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management.

Objectives: Menstruation is a normal physiological phenomenon, but sometimes the abnormalities and pain associated with it can severely affect the daily routine of women and may create a stressful environment for them. The objective of this study was to conduct a comparative evaluation of the pattern of menstruation, lifestyle and the outlook toward menstruation among undergraduate female medical and nursing students. Methods: It was a descriptive cross-sectional study conducted among the undergraduate medical and nursing students of a tertiary care Institute. A semi-structured questionnaire was used to collect the data. Of the 400 students approached, 188 completed the questionnaire. Results: The mean age of the participants was 21.23 ± 1.47 years. The mean age of menarche was 12.65 ± 1.24 years among the medical students and 13.69 ± 1.38 years among the nursing students (P< 0.05). Overall, the common menstrual abnormalities observed were dysmenorrhea (71.2%) and premenstrual syndrome (70.2%) followed by menstrual irregularity (14.8%). On correlating lifestyle with menstrual abnormalities, no significant association was found. However, the most common reason for college absenteeism in both groups was dysmenorrhea and fear of unexpected heavy bleeding. Conclusion: Despite having a medical background and knowledge about the physiology of menstruation, medical and nursing students do carry certain myths regarding menstruation which are being carried forward in society. Small roleplays in the OPD (Outpatient Department) area and public awareness lectures should be planned. They will not only develop confidence and better understanding among the students but also create social awareness.

Introduction: Non-stress test is an important non-invasive tool of antepartum surveillance. The hypoxia, acidemia in the fetus can easily be picked up by a non-stress test. It is important to get a non-stress test done on time to prevent the adverse neonatal outcome. Aim: This quality improvement project aims to evaluate the waiting period for a non-stress test (NST) from the point of decision in the antenatal outpatient department and to increase the percentage of pregnant women getting NST done in less than 4 h from the point of decision from a baseline of 41% to 80% in 4 weeks. Method: This observational study was conducted in the Department of Obstetrics & Gynecology at All India Institute of Medical Sciences Jodhpur for twelve weeks. This study has three phases—baseline assessment, implementation phase and continued implementation with the assessment phase. The tool used for the analysis of this problem was the Fishbone method. Results: The baseline assessment showed that only 41% of pregnant women got the non-stress test done in 4 h. We conducted a plan-do-study-act (PDSA) cycle 3 times, and the target was achieved in the second PDSA cycle. Conclusion: This quality improvement project has demonstrated that increasing awareness among all the team members who are dealing with pregnant women requiring NST can significantly increase the percentage of pregnant women getting NST done within 4 h from the point of decision. By detecting the fetal heart rate variation, we can prevent adverse fetal and neonatal outcomes.

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Purpose: Conventional agriculture practice without proper diversification of crop rotations has become more energy-intensive having deteriorating effects on the environment due to high carbon emissions. Diversification of existing crop rotations for obtaining higher productivity and profitability per unit energy and carbon consumption is necessary to sustain the livelihood of farmers and ensure environmental safety. Methods: A field study was conducted in a randomized complete block design with 9 crop rotations involving 14 different crops to assess the system productivity, profitability, and environmental sustainability in terms of energy and carbon footprint in the semi-arid plains of India. The cereal-based crop rotation pearl millet-wheat-pearl millet-wheat is the conventional crop rotation of the region. The experimentation period (2010–2016) consists of 3 cycles of crop rotations with a 2-year rotational period each. Results: The study revealed that groundnut-wheat-cluster bean-onion (Gnut-Wh-Cb-O) crop rotation resulted in significantly higher system productivity (44.5%) and profitability (60.8%) with lower energy consumption (5.2%) and carbon footprint (21.8%) as compared to that of the conventional pearl millet-wheat-pearl millet-wheat (Pm-Wh-Pm-Wh) rotation. Another crop rotation, pearl millet-wheat-cluster bean-barley (Pm-Wh-Cb-Bly), with 36.4% lower irrigation water energy requirement than that of Gnut-Wh-Cb-O rotation, gave significantly higher system productivity (14.6%) and profitability (23.2%) than that of Pm-Wh-Pm-Wh. Conclusions: The study concluded that the groundnut-wheat-cluster bean-onion rotation (when irrigation water is not limited) and pearl millet-wheat-cluster bean-barley (when irrigation water is limited) would be the most productive, profitable, and energy and carbon-efficient crop rotation in semi-arid plains of North-West India that could be sustainable in the long run without having adverse impacts on climate change. Graphical abstract:

Introduction: There has been an advent in the use of Mobile Apps in the academic space. The pandemic hastened their usage, and forced us to rapidly innovate in order to meet the educational needs of our students. Also, Mobile Apps have been known to facilitate self-learning, make it enjoyable, and personalize the pace of learning of the individual. Given the level of skill-learning in Physiotherapy education, the use of Mobile Apps can pose a challenge, as well as offer an opportunity to explore its scope to enhance learning, and create innovative pedagogic strategies. There are a very few learning mobile apps that have been assessed in Physiotherapy education. Aim: To develop, establish content validity and internal consistency of a curriculum based App on the kinesiology of normal Gait for bachelor of physiotherapy students, and to evaluate the App with regards to use, quality, engagement, and overall experience. Materials & methods: In the first phase, a mobile app based on a bachelor of physiotherapy Gait curriculum was developed and validated using Delphi procedure, with 80% agreement criteria, by a group of experts. Subsequently, the App was rated by 200 users on: engagement, aesthetics, information, subjective quality. Results: The content validity index following 2 rounds of Delphi was found to be 0.88. Also, therapists found the App easy to use, and 80% gave it a rating of > 3 stars. Conclusion: Creating, designing, implementing, and evaluating the efficacy of a Gait App as a means to teaching the GAIT component to physiotherapy students was found to be appealing and beneficial.

Purpose: The purpose of the study is to identify the key antecedents relating to the interaction design of the e-groceryretail mobile applications and offer innovative marketing interventions to facilitate consumer–brand interaction and generate continuous usage intention. Design/methodology/approach: Data were collected from the subjects using a personally administered questionnaire by adopting a non-probability method. The target respondents of this study were individuals who are users of smartphone and have purchased groceries through mobile applications at least once in two months. On the basis of responses received, a sequential predictive analytic method that includes structural equation modelling (SEM) and artificial neural network (ANN) techniques were employed. Findings: The findings of the study highlighted the critical role of collaboration design in harbouring satisfaction and maintaining a regular clientele for e-grocery applications by confirming the presence of complementary mediation. Such validated proposition and tested research model backed by significant methodological rigour advances the research based on post-acceptance behavioural affordances in interactive marketing literature. Originality/value: The study endeavours to understand users' post-acceptance behaviour by analysing the contemporary factors relating to the interaction design of the platform in terms of mobile application attributes that would drive user patronage intentions. Further, the study highlights the pioneering role of collaboration design for e-grocery retailers, as the recent alliances among strategic players to achieve synergistic business leadership have proven to be a game-changing evolution in the industry.

Adsorption is most commonly applied in water treatment, gas purification/separation, catalysis, etc. It is a very simple and inexpensive technique. However, the performance depends on the type of adsorbent and its dosage. Researchers across the world keep seeking low-cost and more effective adsorbents. As a result, millions of research publications on adsorption have been published yearly. Most of these publications report the synthesis of new adsorbents from various sources and their application in the remediation of several inorganic and organic pollutants from water bodies. Researchers attempt to fit their experimental results with various isotherm models to understand the adsorption mechanism. Some researchers fit data into linear isotherm models, while others add non-linear isotherm models for estimating the isotherm parameters. The fit of isotherm models differs for various adsorbents and contaminants. The present paper is comprehensive review compiling information on isotherm models that explain the intrinsic mechanisms of adsorptive removal of pollutants such as antibiotics, dyes, proteins, pesticides and heavy metal ions. Furthermore, a detailed characteristic property of numerous cationic dyes, anionic dyes, proteins, antibiotics, pesticides and heavy metal ions was also discussed. It is observed that based on the literature reviewed, it was found that the adsorption equilibrium data of cationic dyes and anionic dyes were well defined with the Langmuir model. Additionally, in the case of the adsorption of proteins, antibiotics and heavy metal ions, the Langmuir model is well matched among all applications.

Marketers have recognised the unprecedented popularity of social networking sites and are prompting to invest in their social media presence to disseminate information and marketing messages. In specific, hospitality brands are establishing Facebook pages with the relevant information that contain anecdotes, photos, videos or other multimedia content. Such innovative communication mediums promote interaction among members of the brand page and facilitate their direct feedback through online engagement metrics. The objective of this paper is to analyse the content of the posts published on the official Facebook brand pages of the top ten international and domestic hotels operating in India and investigate their impact on the online engagement of users. The authors have performed manual coding for 950 posts by following a systematic coding strategy and thereafter, have applied the multivariate analysis. The findings contribute to the theory of information dissemination through social media platform and serve as a guide to hotels brand marketers in identifying posts characteristics that would be able to generate positive online responses.

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma, often occurs in adolescents and young adults with a particular predilection for the deep soft tissue of extremities. Occurrence of ASPS in the female genital tract is very uncommon and poses a significant diagnostic challenge. A case of ASPS of the uterine corpus is described in a young unmarried female, who presented to the out-patient clinic of our Institute with complaints of abnormal uterine bleeding for the past 9 mo. She was being treated with oral contraceptive pills, progesterone and tranexamic acid. Following radiological imaging and hysteroscopy, a therapeutic curettage of the lesion was done. The histopathologic features raised a differential diagnosis of a myriad of morphologic mimickers. The diagnosis was clinched by exclusion of mimickers by relevant immunohistochemical markers and strong nuclear expression of TFE3 on immunohistochemistry. The patient is on regular follow-up with oral contraceptives and antifibrinolytic medication. Despite being infrequent at this location, ASPS should be kept in differential diagnosis in young females presenting with abnormal uterine bleeding.

AbstractCovid-19 is one of the biggest issues of the world. It is an untreatable and communicable disease. Therefore lots of countries are in a lockdown process. Our government has also announced lockdown since mid of March 2020. During this pandemic people are feeling psychological presser like anxiety, depression and stress because they are not able to come out their homes and are not in a position to fulfill their needs. In this situation central and state government has launched various types of counseling programs to reduce their psychological presser. Counseling is one of the best strategies in which counselors provide support to the people to keep them healthy. Now, this is a part of regular follow up by psychologists, during this pandemic of covid-19. The main intention of this study is to know the impact of counseling on the psychological health of adults. There were two groups in the study-one group was counseling taker (including quarantined people) and another group was without counseling taker. Every group had 50 adults and they were selected by purposive sampling method through online and from quarantine centre. All the samples were administered Anxiety, Depression and Stress Scale to measure their psychological health. The present study reveals that counseling taker adults had less anxiety, depression and stress in comparison to without counseling taker adults. Thus counseling significantly influences the level of psychological health of the respondents. The study also shows that male adults feel greater level of anxiety, depression and stress in comparison to females during lockdown.

Coronavirus disease-19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Covid-19 pandemic began in the end of 2019 and spread all over the world in a short duration of time. Measures have been taken such as social distancing, compulsory lockdown and restriction of activities so as to prevent spread of virus. It has posed problem to both the antenatal women and maternity care workers. The care and management of pregnant women is an essential service to identify high-risk mothers and also to have good pregnancy outcome for both mother and baby. Any delay in this may lead to catastrophe, hence this issue needs to be addressed properly. This review briefs about the literature available on antenatal care during covid-19 pandemic. Pregnancy is not very adversely affected by the virus itself but extra caution should be taken to prevent and complications should they arise. The norms of social distancing by patients and wearing personal protective equipment by hospital staff, testing of pregnant women should be followed as per regional and national guidelines. This will help ensure safety of all people along with care to the expecting mother. The presence of covid-19 infection should not deter women from receiving antenatal care nor should the obstetric treatment be delayed during labor. Decision for timing and mode of delivery should be individualised based on obstetric indications and maternal–fetal status.

The bone marrow (BM) microenvironment/niche plays a key role in regulating hematopoietic stem and progenitor cell (HSPC) activities; however, mechanisms regulating niche cell function are not well understood. In this study, we show that niche intrinsic expression of the CXCR4 chemokine receptor critically regulates HSPC maintenance during steady state, and promotes early hematopoietic regeneration after myeloablative irradiation. At steady state, chimeric mice with wild‐type (WT) HSPC and marrow stroma that lack CXCR4 show decreased HSPC quiescence, and their repopulation capacity was markedly reduced. Mesenchymal stromal cells (MSC) were significantly reduced in the BM of CXCR4 deficient mice, which was accompanied by decreased levels of the HSPC supporting factors stromal cell‐derived factor‐1 (SDF‐1) and stem cell factor (SCF). CXCR4 also plays a crucial role in survival and restoration of BM stromal cells after myeloablative irradiation, where the loss of BM stromal cells was more severe in CXCR4‐deficient mice compared to WT mice. In addition, transplantation of WT donor HSPC into CXCR4‐deficient recipient mice demonstrated reduced HSPC homing and early hematopoietic reconstitution. We found that CXCR4 signaling attenuates irradiation‐induced BM stromal cell loss by upregulating the expression of the antiapoptotic protein Survivin via the PI3K pathway. Our study suggests that SDF‐1‐CXCR4 signaling in the stromal microenvironment cells plays a crucial role in maintenance of HSPCs during homeostasis, and promotes niche regeneration and early hematopoietic reconstitution after transplantation. Modulation of CXCR4 signaling in the HSPC microenvironment could be a means to enhance hematopoietic recovery after clinical hematopoietic cell transplantation. Bone marrow (BM) niche expressed CXCR4 critically regulates the hematopoietic stem and progenitor cell (HSPC) function. CXCR4 gene deletion exclusively in BM niche impairs wild‐type HSPC quiescence, retention in BM, and their repopulation ability. These defects in HSPC function are associated with a reduction in HSPC supporting factors in BM due to loss of mesenchymal stem and progenitor cells.

Choosing the right wearable device (e.g., smartwatch and fitness tracker) for one's wrist can put consumers in a dilemma, especially in the market of abundant options. Further, the proliferation of social media has profoundly changed the practice of advertising, making the communication of wearable messages more interactive than ever before. This paper examines the gender differences in their preferences toward wearable devices (e.g., smartwatches vs. fitness trackers). This study also investigates the joint effect of device value and advertising value on consumers' intention to adopt wearable devices, with gender serving as a moderator variable. Amidst the socio-technical ecosystem of wearable devices and social networking site (SNS), gender is the most prominent demographic variable used for targeted advertising to ensure effectiveness. Data collected from 217 generation Y Indian Facebook users suggests that males preferred smartwatches and females preferred fitness trackers. The results revealed that the devices' performance expectancy and the entertainment value derived from Facebook advertising are positively related to consumer's intention to adopt the wearable devices. In particular, the relationship between privacy concerns about the advertising on behavioural intention is moderated gender.

The pervasiveness of social networking sites (SNS) is one of the major highlights of development of Web 2.0 applications. Social media is manifested as a disruptive vehicle for augmenting marketing strategies by the firms. It has been observed that the extant literature lacks a systematic review that comprehensively accounts and analyse the main factors (antecedences and consequences) of SNS marketing phenomenon. This paper presents a systematic review analysis of the literature pertaining to advertising effectiveness on SNS. Seven research databases (Elsevier, Taylor and Francis, Sage, Springer, IGI Global, Emerald, and IEEE) were explored and 60 of the most relevant research papers were selected for the analysis. Overall, this study identifies numerous emergent themes in the existing literature, thereby, deepening our understanding of advances in social media research. Further, the study provides logical classification schemes that may serve as a source of stimulus for further research.

Background: Embryo transfer (ET) is a crucial step in IVF process. Therefore, difficult ET can significantly impact the odds of implantation. We propose that hysteroscopy guided ET might be a feasible alternative to conventional ultrasound guided ET in such cases.Case Report: This is the case of a 27-year-old woman with six years of primary infertility with severe dysmenorrhoea and menorrhagia. TVS showed a bulky adenomyotic uterus with multiple fibroids primarily in the posterior wall distorting the endometrial cavity and bilateral huge endometriomas. She underwent laparoscopic adenomyomectomy, myomectomy and bilateral Tubo-ovarian mass removal. Subsequently, she underwent IVF with donor eggs after 5 months therapy with long-acting GnRH agonist. Mock ET was attempted but was unsuccessful due to acute anterior flexion of the cervix. So, she was planned for ET under general anaesthesia, but the ET catheter could not be negotiated through the internal os. A 30∘3 mm hysteroscope was then inserted through the cervical canal using saline as distension media. Additionally, a small polyp was noted at the internal os blocking the entry of ET catheter. Once the endocervical canal was distended the catheter was negotiated from the side of hysteroscope into the cervical canal and it passed through the internal os easily under direct vision of hysteroscope. The hysteroscope was then withdrawn holding the catheter at its place. Complete evacuation of saline from endometrial cavity was confirmed by trans abdominal USG and a double ET was done under USG guidance. The routine post ET medication protocol was followed. Her Serum β-hCG result was positive and after an uneventful pregnancy, she delivered healthy twin babies at 35 weeks.Conclusion: The introduction of hysteroscopy guided ET may be a suitable alternative in cases of difficult ET.

Background and objectives: Data on the association of vitamin D levels and clinical phenotype and disease activity in systemic lupus erythematosus (SLE) is controversial. Further, the optimal dose of oral vitamin D supplementation in SLE is not clear. Thus, the present study was designed to determine the association of plasma vitamin D levels with clinical phenotype, disease variables and serology in a large, cohort of SLE from South Asia and to evaluate the short-term effect of two different dosage regimens of oral vitamin D supplementation on disease flares and plasma vitamin D levels. Methods: This is a two-phase study. Phase I was a cross-sectional analytical study of patients from north (26.85° N) and south India (11.94° N). Plasma 25-hydroxyvitamin-D(25(OH)D) was measured, and its association with demography, serology, disease activity, Galectin-9 and CXCL-10 was analysed. In phase II, patients with SLEDAI-2KG < 10 and on stable immunosuppression were randomised to receive either high dose (weekly 60,000 U*5, followed by 60,000 U monthly) or routine dose (30,000 U monthly) oral vitamin D. Outcomes were assessed at 6 months Results: Phase I included 702 patients with a mean age of 29.46 + 10.7 years. The median plasma vitamin D was 22.83 (13.8–31.8) ng/ml. Deficiency (< 20 ng/ml) was seen in 41.5% of patients. Patients from South India had higher vitamin D levels (27.06 ± 20.21 ng/dl) as compared to North India (17.15 ± 16.07 ng/ml) (p< 0.01). Univariate analyses demonstrated weak negative correlation of vitamin D with SLEDAI2K and positive correlation with age. Galactin-9 had modest correlation with SLEDAI2K but not with vitamin D levels. On multiple linear regression, centre of recruitment (β= 4.37) and age (β= 0.18) predicted (p< 0.05) plasma vitamin D levels. Conclusion: Vitamin D deficiency is common in SLE. Geographical location of residence is the major determinant rather than the disease activity. The IFN regulated proteins reflect disease activity independent of vitamin D levels. High-dose oral vitamin D supplementation seems safe and more effective in improving vitamin D levels in SLE. Trial registration: The second phase of this study was a registered randomised controlled trial CTRI/2019/06/019658 [registered on: 14/06/2019].

Aging-associated defects in hematopoiesis are linked to declining in hematopoietic stem cell (HSC) self-renewal and multilineage differentiation capacity. The bone marrow (BM) microenvironment/niche has been suggested to influence HSC aging. However, the factors/mechanisms whereby the BM niche mediates hematopoietic stem and progenitor (HSPC) aging are poorly understood. We recently discovered that neuropeptide Y (NPY) plays a crucial role in HSPC trafficking by regulating the BM vascular gateway function (PMCID: PMC5707149). NPY is one of the most abundant neurotransmitters released in the BM by sympathetic nerve fibers. In this study, we found that the aging-induced deficit of NPY levels in the BM plays a critical role in niche defects and HSPC aging by impairing the molecular pathways involved in regulating oxidative stress, senescence, and stemness. The measurement of NPY levels in the BM of young (3-4 months) and aged (18-23 months) mice showed lower NPY levels in aged mice than in young mice (2.2-fold), which was associated with a decrease in mesenchymal stem cells (MSC) (2-fold, p=0.008) and endothelial cells (EC) (1.5-fold, p<0.05) numbers in the BM. In addition, we found that circulating NPY levels decline in the older human population (65-83 years) than in young/ middle age (23-55 years) individuals (1.5-fold, p=0.01). We hypothesized if aging-induced NPY deficit contributes to BM niche defects and HSPC aging, then NPY supplementation may attenuate/revert these processes. To explore this possibility, we administered exogenous NPY in aged mice (100ng/mouse) for 15 consecutive days and evaluated HSPC and niche cells. NPY supplementation in aged mice (18-23 months) substantially reverted aged HSPC phenotype, including NPY decreased the accumulation of HSC-enriched SLAM LSK (Lin-Sca-1+c-Kit+CD48-CD150+) in the BM (1.8-fold, p<0.05) and increased the HPC clonal expansion (1.9-fold, p<0.05) measured by flow cytometry and CFU-C assay, respectively. Competitive BM transplantation studies using donor cells from young, aged, or NPY-treated aged mice into lethally irradiated syngeneic mice showed myeloid biased repopulation from aged mice donor cells than young mice donor cells, and that was attenuated in NPY-treated aged mice donor cells (33%, p=0.003). In addition, NPY substantially reverted aging-related reduction in BM MSC (CD45-Ter119-CD31-Nestin+PDGFR+CD51+) and EC (CD45-Ter119-CD31+VE-cadherin+) numbers, and BM MSC clonal expansion (2-fold, p<0.05) as measured by CFU-F assay. To further validate NPY's role in the aged BM niche and HSPC function, we used NPY gene overexpressing and knockout (KO) mouse models. Compared to wild-type (WT) aged mice, NPY overexpressing aged mice showed a substantial increase in BM niche MSC numbers (1.4-fold, P=0.03) and improved HSPC clonal expansion (2.5-fold, P=0.002). In contrast, 16-18 months old NPY KO mice showed enhanced aging than aged WT mice, reflected by fewer MSC counts and lower HSPC clonal expansion (MSC: 1.6-fold, and CFU-F: 1.5-fold, <0.05). Oxidative stress and senescence are the hallmarks of aging. To examine if NPY attenuates HSPC aging by controlling oxidative and senescence, we measured reactive oxygen species (ROS) and senescence in SLAM-LSK of young, aged, and NPY-treated aged mice using CellROX and anti-p16 antibodies, respectively. The SLAM-LSK from aged mice showed higher expression of ROS (9-fold, p=0.03) and p16 than young mice (1.7-fold). However, ROS and p16 expression were decreased in NPY-treated aged mice (ROS: 2-fold, and p16: 1.3-fold, p<0.05). To identify the molecular pathways involved in NPY-mediated attenuation of HSPC aging, we performed RNA sequencing analysis of SLAM-LSK cells. Aged mice SLAM LSK showed impaired expression of genes involved in pathways regulating antioxidant defense, DNA damage repair and stemness than in young mice SLAM LSK. However, NPY treatment in aged mice substantially restored these pathways in SLAM LSK. In conclusion, our studies suggest that an aging-induced deficit in NPY levels in the BM is a crucial lesion contributing to niche defects and HSPC aging. Thus, NPY supplementation or protection of NPY-producing nerve fibers in the BM can attenuate/restore aging-induced niche damage and rejuvenate aged HSPC.

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Background: Tetrahydroindazole, a member of the fused-pyrazole system, is a least studied class of heterocyclic compounds owing to its scarcity in nature. However, a large number of synthetically prepared tetrahydroindazoles are known to show a variety of biological activities such as interleukin- 2 inducible T-Cell kinase inhibitors, AMPA receptor positive allosteric modulators, antitumor, antituberculosis, anti-inflammatory and antimicrobial activities. Vilsmeier-Haack reaction is one of the most important chemical reactions used for formylation of electron rich arenes. Even though Vilsmeier- Haack reaction was studied on a wide variety of hydrazones derived from active methylene compounds, literature lacks the examples of the use of 4-substituted cyclohexanones as a substrate for the synthesis of 4,5,6,7-tetrahydroindazoles. The study of the reaction of Vilsmeier-Haack reagent with hydrazones derived from cyclic keto compounds having active methylene has been considered the interested topic of investigation. In the present study, ethyl cyclohexanone-4-carboxylate was treated with one equivalent of various hydrazines for two hours and the resulted hydrazones were further treated with an OPC-VH reagent (Vilsmeier-Haack reagent isolated from phthaloyl dichloride and N,Ndimethylformamide) afforded 4,5,6,7-tetrahydroindazoles in excellent yields. The synthesized compounds 4a-f and 5a-f were screened for their antioxidant activities using the DPPH radical scavenging assay. The target compounds were synthesized regioselectively using 4+1 approach in excellent yields. A number of experiments using both conventional heating as well as microwave irradiation methods were tried and on comparison, microwave irradiation method was found excellent in terms of easy work up, high chemical yields, shortened reaction times, clean and, no by-products formation. Some of the synthesized compounds showed significant antioxidant activity. The microwave assisted synthesis of 4,5,6,7-tetrahydroindazoles from ethyl cyclohexanone-4-carboxylate has been reported under mild conditions in excellent yield. Easy work up, high chemical yield, shortened reaction times, clean and no by-products formation are the major advantages of this protocol. These advantages may make this method useful for chemists who are interested in developing novel 4,5,6,7-tetrahydroindazole based drugs.

The present study aimed to investigate the changes of endometrial progesterone and estrogen receptors in luteal phase biopsy specimens of infertile women and find a correlation, if any, between these and CD8+ receptors in the same.

Although mesenchymal stromal cells (MSCs) have significant potential in cell‐based therapies, little is known about the factors that regulate their functions. While exploring regulatory molecules potentially involved in MSC activities, we found that the endogenous multifunctional factor Survivin is essential for MSC survival, expansion, lineage commitment, and migration. Pharmacological or genetic blockade of Survivin expression in mouse and human bone marrow MSC enhances caspase 3 and 7 expression and reduces proliferation resulting in fewer MSC and clonogenic colony‐forming unit‐fibroblasts (CFU‐F), whereas ectopic Survivin overexpression in MSC results in their expansion. Survivin is also required for the MSC proliferative responses to basic fibroblast growth factor and platelet derived growth factor. In a wound healing model, Survivin inhibition results in suppression of MSC migration to the wound site. In addition, loss of Survivin in MSCs compromises their hematopoiesis‐supporting capacity. These results demonstrate that Survivin is a key regulator of mouse and human MSC function, and suggest that targeted modulation of Survivin in MSCs may have clinical utility to enhance MSC recovery and activity following insult or stress. StemCells2018;36:123–129 Pharmacological or genetic blockade of Survivin expression in mouse and human bone marrow MSC enhances apoptosis and reduces proliferation, CFU‐F formation, migration and hematopoietic niche activity, whereas Survivin over expression via growth factors/genetic modulation in MSC results in their expansion and enhancement of hematopoietic regeneration after irradiation injury.

Sertoli–Leydig cell tumours are uncommon sex cord stromal tumours of the ovary that often present diagnostic confusion due to the various morphological and histopathological patterns that may be assumed by the tumour. A 28-year-old female presented with abnormal uterine bleeding and thyromegaly is found to have right adnexal mass with elevated serum testosterone. The mass was diagnosed as a Sertoli–Leydig cell tumour, intermediate differentiation with heterologous elements and focal anaplasia. She was treated with surgical resection followed by adjuvant chemotherapy. Definitive diagnosis is made by histopathological study with immunohistochemistry. Prognosis is related to the degree of cellular differentiation and to the presence of heterologous elements with stage of disease at the time of diagnosis.