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• The incidence of eclampsia can be reduced with early warning systems like Maternal Early Warning Trigger (MEWT) tool. • The presence of pathways with suggested management protocols for the treatment of severe hypertension helps in the improvement of outcomes. • The concept of two non-severe triggers or one severe trigger to stimulate a pathway helped in the appropriate management of severe hypertension. • MEWT tool reduced maternal deaths and morbidity in hypertensive women. To observe the incidence of eclampsia before and after implementing Maternal Early Warning Trigger (MEWT) tool. A retrospective observational study to evaluate the effect of introduction of MEWT tool in a tertiary referral center with 10,000 annual births. Two epochs of five years duration were compared before and after implementing MEWT tool. MEWT tool has triggers for early identification of clinical deterioration and pathways for four most important maternal morbidity causes including hypertension. Hypertension pathway has emphasis on rapid control of severe acute hypertension, lab tests and magnesium sulfate prophylaxis. All pregnant women who registered and delivered at the study institute were included. Primary outcome was effect of MEWT tool on the incidence of eclampsia. A subset analysis was done to study the effect of MEWT tool on maternal and perinatal outcomes in women with hypertensive disease. Maternal ICU admissions, HELLP, pulmonary oedema, intracranial bleed and maternal deaths, and perinatal mean birthweight and gestational age, NICU admissions, prematurity, stillbirths, and neonatal deaths were compared. The study period had 37,043 and 45,637 women in pre- and post-MEWT periods. The incidence of eclampsia reduced by 45.4 % from 1.1 to 0.6 per 1000 women (p 0.001). The most significant reduction was seen with antepartum eclampsia (0.8 to 0.3 per 1000, p = 0.02). There was significant reduction in all maternal and perinatal outcomes in women with hypertensive disorders (3,506 and 6,016 in pre- and post- MEWT periods) after introduction of MEWT tool. Integrating the MEWT tool into the obstetric practice helps in reducing the incidence of eclampsia and improving maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Background: The prevalence of cardiovascular disease (CVD) has been continuously increasing, and this trend is projected to continue. CVD is rapidly becoming a significant public health issue. Every year there is a spike in hospital cases of CVD, a critical health concern in lower- and middle-income countries. Based on identification of novel biomarkers, it would be necessary to study and evaluate the diagnostic requirements or CVD to expedite early detection. Main body: The literature review was written using a wide range of sources, such as well-known medical journals, electronic databases, manuscripts, texts, and other writings from the university library. After that, we analysed the specific markers of CVD and compiled a systematic review. A growing body of clinical research aims to identify people who are at risk for cardiovascular disease by looking for biomolecules. A small number of biomarkers have been shown to be useful and reliable in medicine. Biomarkers can be used for a variety of clinical applications, such as predicting heart disease risk, diagnosing disease, or predicting outcomes. As a result of the ability for a single molecule to act as a biomarker, its usefulness in medicine is expected to increase significantly. Conclusions: Based on assessing the current trends in the application of CVD markers, we discussed and described the requirements for the application of CVD biomarkers in coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other cardiovascular illnesses. Furthermore, the current review focuses on biomarkers for CVD and the procedures that should be considered to establish the comprehensive nature of the expression of biomarkers for cardiovascular illness. [ABSTRACT FROM AUTHOR]

Festivals are an integral part of the rich and varied cultures of indigenous communities in India. Festivals are closely linked to an indigenous group's occupations, such as cultivation, and mark a ritual calendar that directs the dietary behaviour of the community. This paper examines the festivals and food cultures of indigenous groups living in six villages in Telangana, India, using participatory qualitative methods such as focus group discussions and the mapping of seasonal calendars. There are seventy-nine unique festivals, out of which 40% (32) celebrate farm activities such as sowing and harvesting of crops, or the worship of nature and animals. Differences in dietary behaviours during festivals follow gender, age, and economic status. An examination of the traditional food culture of indigenous communities guided by festivals and traditions can provide insights relevant to the promotion of goals leading to sustainable food security in India. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder with manifestations in cognitive, functional and neuropsychiatric symptoms (NPS). Agitation is one of the most prevalent and challenging NPS to manage. Antipsychotics are widely used for the pharmacological management of agitation. However, they offer modest efficacy, and the side effects are substantial. Serotonin‐6 receptor (5‐HT6) blockade may have therapeutic utility in the management of disorders associated with mood and behavior. Masupirdine is a potent and selective 5‐HT6 receptor antagonist. Method: Masupirdine has been evaluated in a phase‐2, 26‐week proof‐of‐concept clinical study (NCT02580305). Subgroup analyses of study results based on the neuropsychiatric inventory scale was carried out. Masupirdine was also evaluated in animal models to assess its effect on behavior and brain neurotransmitters modulations. A double‐blind, randomized, placebo‐controlled, parallel group, adequately powered global phase‐3 study is in progress to evaluate the efficacy, safety, tolerability, and pharmacokinetics of masupirdine for the treatment of agitation in participants with dementia of the Alzheimer's type (NCT05397639). A total of 375 patients are planned to be enrolled in the study who will be randomly assigned to receive either 50 mg masupirdine or 100 mg masupirdine or placebo. Patients will be treated for 12 weeks. The primary efficacy endpoint of this study is the Cohen‐Mansfield Agitation Inventory items score aligning to the international psychogeriatric association agitation criteria domains (physical aggression, excessive motor activity, and verbal aggression) and the key secondary endpoint is improvement in modified Alzheimer's Disease Cooperative Study‐Clinical Global Impression of Change score as related to agitation. Result: The observations from the post hoc analysis of phase‐2 clinical study in AD patients and animal models support the potential beneficial effects of masupirdine on agitation. The phase‐3 study has been initiated in USA and Europe, and the subject enrolment is expected to be completed by Q3 2024. Conclusion: The need for new treatments for the management of agitation is significant and unmet. The Phase‐3 study results will inform the utility of masupirdine for the potential treatment of agitation in patients with dementia of Alzheimer's type. Phase‐3 study data readout is anticipated in Q1/Q2 2025. [ABSTRACT FROM AUTHOR]

The objective of this paper is to understand individual nutritional outcomes through an examination of gendered time use patterns. The analysis of the data from eight villages in the Semi-Arid Tropics (SAT), India confirm previous conclusions about the gendered influence of agricultural interventions, especially time demands on the rural poor. Agricultural interventions in the harsh, drought-prone environment of the SAT tend to increase the time burden on women. Sociological perspectives indicate that changes in time use patterns are also due to changing agricultural practices such as cropping patterns, type of productive work (farm to non-farm) among other factors, leading to variations in outcomes like nutrition for different members of the household. These changes demand innovative gender-responsive approaches and policies to leverage agriculture for nutrition and health. The paper concludes that empowering women through more information and control over income, assets and resources enhances their agency to make decisions for efficient time use, food consumption, sanitation and healthy practices. The authors opine that the context is important and policies must be based on sound data and rigorous analysis, including social and gender considerations. • A gendered analysis of time-use patterns in agriculture suggests time use a transformative indicator of gender equality. • Age, education and social groups have varied effects on time-use patterns of men and women in SAT households. • Rural diets to become more diverse and healthy through enhanced quality and quantity of the food baskets along with better sanitation practices. [ABSTRACT FROM AUTHOR]

Arsenic is a significant water pollutant that causes a severe threat to human health due to its high toxicity. Therefore, the development of sensitive digital point-of-care test (POCT) Kits is highly relevant in monitoring the quality of potable water and beverage. The present work has developed an indigenous green sensor kit for detecting arsenic in liquid samples like potable water, soft drinks, and fruit juices. In this test Kit, in-situ hydrogen generated by electrolysis, which converts arsenic into arsine gas and reacts with Au3+ on a paper strip. Due to the specific nature of the reaction, the paper strip acted as a paper sensor for arsenic by changing its color from light yellow to a wide range of gray-red. An App was developed for quantifying arsenic using the RGB values of the paper sensor response. The prototype successfully detected arsenic in spiked water and beverages and was in good agreement with the Atomic Absorption Spectrophotometer (AAS). It can detect arsenic concentrations ranging from 4 to 100 µg/L with a response time of 5 min for 4–30 µg/L and 3 min for 30–100 µg/L. The kit has advantages such as lower sensitivity, faster response time, reusability, user-friendliness, eco-friendliness, and green technology. [Display omitted] • Electrochemically empowered prototype for a low concentration of arsenic. • An indigenous App compatible with a smartphone for assessing arsenic concentration. • A prototype of indigenous hybrid digital arsenic sensors. • Highly sensitive paper-based optical green sensor. • Detected arsenic concentration in soft drinks, fruit juices, and portable water. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop a Transdermal patch containing Cinnarizine using different ratios of hydrophilic and hydrophobic polymeric systems by solvent evaporation technique employing Polyethylene glycol (PEG 400) as plasticizer. The physicochemical compatibility of the drug and the polymers were studied by performing FT-IR spectroscopic analysis. Formulated patches were evaluated for physicochemical properties, skin irritation, in vitro drug release, ex-vivo permeation studies across rat abdominal skin and stability studies. The results of FT-IR studies revealed that there were no interactions between drug and polymers used. All the formulations exhibited uniformity in physicochemical properties. In vitro permeation studies of the formulations were performed by using Franz diffusion cells. Formulation F3 showed better permeation through rat skin (i.e., 8527.5±1.25μg/cm² /hr) compared to rest of formulations and followed Fick's diffusion mechanism. On the basis of in-vitro drug release and ex-vivo skin permeation performance, Formulation F3 containing the polymeric blend 19:1 Hydroxypropylmethyl Cellulose (HPMC E 50cps: Eudragit RL 100) has shown optimum release in comparison to other formulations and indicated good physical stability. So it has been demonstrated that Cinnarizine can be designed as matrix type transdermal drug delivery system (TDDS) and further in-vivo evaluations were required. [ABSTRACT FROM AUTHOR]

There is controversy surrounding the association between caudal block and complication rates after hypospadias repair. Conflicting results have been reported mostly from single-center, low volume studies and those that did not include relevant variables. We hypothesized that caudal block is not associated with increased rates of reoperation after primary repair and is associated with more complex hypospadias surgery. The Clinical Practice Solutions Center database was queried to identify patients who received a primary hypospadias repair between 2009 and 2010. Primary hypospadias repair was further categorized as meatal advancement and glanduloplasty, distal, one-stage proximal, or one-stage perineal repair. Anesthesia coding was evaluated to identify those who received a caudal block. Any revision surgery was captured between 2009 and 2019 and the types of revision surgeries were identified. Variables such as caudal block, age, insurance type, surgeon volume, and surgeon years in practice were analyzed with mixed effects multiple logistic regression models. The dataset query identified 3343 pediatric males who had primary hypospadias repair. The procedures were performed by 50 surgeons at 27 hospitals. Primary surgeries included meatal advancement and glanduloplasty (23%), distal (69%), proximal (6.9%), and perineal repairs (1%). Caudal block was administered to 42% of patients. Utilization of caudal block was not associated with type of primary surgery (p = 0.21). Adjusting for all other variables, increased patient age was associated with decreased usage of caudal block (p < 0.001). Analysis did not demonstrate a statistically significant association between utilization of caudal block with rates of revision surgery. This large, multi-institution study demonstrates that the use of caudal block was not associated with more complex hypospadias surgery nor statistically significantly associated with increased rates of revision surgery after primary hypospadias repair. Summary Table Mixed Effects Logistic Regression Analysis of Rate of Revision Surgery After Primary Surgery with Caudal Block Variable. Table Primary Surgery Odds Ratio (95% CI) P-Value MAGPI 1.45 (0.61–2.14) 0.67 Distal 1.04 (0.77–1.39) 0.81 One Stage Proximal HS Repair 1.47 (0.74–2.92) 0.28 One Stage Perineal HS Repair 0.82 (0.12–5.87) 0.84 -Data from the AAMC-Vizient Clinical Practice Solutions Center®. All rights reserved. Abbreviations: MAGPI, meatal advancement and glanduloplasty; CI, confidence interval; HS, hypospadias repair. [ABSTRACT FROM AUTHOR]

Sharing economy providers (SEPs) host digital platforms through which individuals can sell services to other individuals. These platforms offer two types of savings to consumers: monetary savings from lower prices typically offered by SEPs relative to legacy providers (LPs) and hassle savings from the reduced effort and/or time that consumers expend to search, identify, and transact with providers. We hypothesize that consumers will weigh monetary savings less than hassle savings if the former is below a certain threshold, but that the opposite will be true for larger savings. We empirically tested our hypothesis using ride data from Uber (SEP) and Yellow Taxi (LP). Consistent with our assumption, the study found a threshold ride distance, 6.64 miles, below which Yellow Taxi was preferred for the hassle savings and above which Uber was preferred for the monetary savings. This paper discusses implications that are generalizable for other sharing economy services. [ABSTRACT FROM AUTHOR]

Background: Cancer is an outcome of uncontrolled cell division eventually associated with dysregulated epigenetic mechanisms, including DNA methylation. DNA methyltransferase 1 is ubiquitously expressed in the proliferating cells and is essential for the maintenance of DNA methylation. It causes the abnormal silencing of tumor suppressor genes in human cancer which is necessary for proliferation, cell cycle progression, and survival. DNMT1 is involved in tumorigenesis of several cancers, its upregulation potentially upscale the promoter level inactivation of transcription of a tumor inhibitory gene by introducing repressive methylation marks on the CpG islands. This epigenetic perturbation caused by DNMT is targeted for cancer therapeutics.Purpose: To demonstrate the proliferative inhibitory potential of brazilin in human breast cancer cell line (MCF-7) with concurrent mitigation of DNMT1 functional expression and to understand its effect on downstream targets like cell cycle inhibitor p21.Study Design/ Methods: The impact of brazilin on the growth and proliferation of the MCF-7 cells was determined using the XTT assay. The global DNA 5-methyl cytosine methylation pattern was analyzed upon brazilin treatment. The gene and protein expression of DNMTs were determined with quantitative RTPCR and western blots respectively. The potential binding sites of transcription factors in the human DNMT1 promoter were predicted using the MatInspector tool on the Genomatix software. The chromatin immunoprecipitation (ChIP) assay was performed to demonstrate the transcription factors occupancy at the promoter. Methylation of promoter CpG islands was determined by the methylation-specific PCR (MSP) upon brazilin treatment. The molecular docking of the human DNMT1 with brazilin (ligand) was performed using the Schrödinger suite.Results: The heterotetracyclic compound brazilin, present in the wood of Caesalpinia sappan, inhibited the proliferation of the human breast cancer cell line (MCF-7) and reduced the DNMT1 expression with a decrease in global DNA methylation. Brazilin, by activating p38 MAPK and elevating p53 levels within the exposed cells. The elevated level of p53 enriched the occupancy at binding sites within 200 bp upstream to the transcription start site in the DNMT1 promoter, resulting in reduced DNMT1 gene expression. Furthermore, the brazilin restored the p21 levels in the exposed cells as the CpGs in the p21 promoter (-128 bp/+17 bp) were significantly demethylated as observed in the methylation-specific PCR (MSP).Conclusion: Highly potential anti-proliferative molecule brazilin can modulate the DNMT1 functional expression and restore the cell cycle inhibitor p21expression. We propose that brazilin can be used in therapeutic interventions to restore the deregulated epigenetic mechanisms in cancer. [ABSTRACT FROM AUTHOR]

Background: Masupirdine is a potent and selective 5‐HT6 receptor antagonist and has completed Phase‐2 clinical proof of concept studies in patients with Alzheimer's type dementia. 5‐HT6 receptors are G‐protein coupled receptors mainly localized in the brain regions primarily involved in cognition and behavior i.e., cortex, dorsal hippocampus and striatum. Evidence from the studies in animal models suggests that 5‐HT6 receptor antagonists may have a potential role in controlling neuropsychiatric behavior such as agitation. Method: Masupirdine has been evaluated in a phase‐2a proof‐of‐concept, 26‐week, randomized, double‐blind, placebo‐controlled, multicenter, parallel groups in United States under active US IND. Sub group analyses has been carried out to evaluate the effects of masupirdine on domains related to agitation/ aggression using Neuropsychiatric Inventory (NPI‐12) scale. Masupirdine was also tested in resident intruder task to evaluate its effects on animal model relevant to aggression. Additionally, masupirdine has been evaluated using microdialysis technique to assess its effect on the modulation of monoaminergic neurotransmitters. Result: In Phase‐2 clinical study subgroup analyses, masupirdine showed robust efficacy in agitation/aggression scores in subjects who had baseline symptoms of agitation/aggression. The effect observed was greater than the minimum difference observed to be clinically important. Similar beneficial effects were observed on extended composite NPI‐12 score related to agitation/ aggression (agitation/ aggression + aberrant motor behavior + sleep and nighttime behavior disorder). Masupirdine was found to be safe and well tolerated in this study. In preclinical animal models, masupirdine reduced the aggressive behaviour in resident intruder task and increased neurotransmitters with role in modulation of agitation and aggression. Conclusion: Masupirdine showed clinically meaningful improvement in the neuropsychiatric symptoms associated with agitation/aggression in patients with AD and reduced aggression in animal models. Masupirdine could be a differentiated novel therapeutic option for the management of agitation/ aggression in Alzheimer's patients. [ABSTRACT FROM AUTHOR]

A significant share of undernourished people are smallholder farmers in low and middle-income countries. Recent studies advocate improving market access as an important pathway towards improving the dietary diversity of farm households over increasing farm production diversity. A systematic review of five databases using Priori criteria identified 28 original studies from 14 low and middle income countries by screening 786 articles using different indicators of market access, diets, and nutrition. Most of the studies reported a consistent positive association between access to markets and dietary diversity, and few studies reported positive or negative association. However, findings are context-specific from several countries in Africa and Asia. Further research is needed to conclude that improving market access is an effective pathway to improve a farm household's dietary quality. Eight research priorities are identified based on the gaps in the existing research literature. • Employed five databases with priori criteria to screen 786 original articles following PRISMA guidelines and identified 28 original studies from 14 developing countries for analysis. • Most of the studies reported a consistent positive association between access to markets and dietary diversity, but they are context-specific. • Evidences are from the few countries in Africa; further research is needed to conclude that improving market access is an effective pathway to improve a farm household's dietary quality. • Eight research priorities are identified for future research based on the gaps in existing research. [ABSTRACT FROM AUTHOR]

Carbon dots (CDs) are one of the most valuable nanomaterials in the recent world because of their diversity in applications. This work reports the applications of N-doped CDs in photoluminescence (PL) based picric acid (PA) sensing and the synthesis of CD- multi-walled carbon nanotubes (MWCNT) nano-composite for UV-photodetection. The CDs were synthesized from cigarette-tobacco by a single-step microwave-assisted heating technique. The detailed characterizations of the synthesized CDs have been performed as well. These synthesized CDs showed an average particle size of 2.8 ± 1.04 nm with a quantum yield (QY) up to ~9.98%. The calculated detection limit (LOD) for PA-sensing was 32.1 ppb, which is relatively low compared to the reported literature considering a wider linear range of concentration (0.1–50 μM). The sensing mechanism is also discussed in detail. This sensing ability was then successfully tested to detect PA acid in real water samples, which showed a good recovery percentage with a minimal deviation of ± 10%. For the second application, the CDs were attached with (MWCNTs) to synthesize a novel UV- photoresponsive CD-MWCNT nano-composite. The photocurrent-generation and the mechanism of electron transfer through the nano-composite have been discussed with detailed explanations. The transient photo-response of the nano-composite has also been presented. This transient response was used to calculate the rise and decay time of the system, and the observed values are of 0.38 and 0.42 s, respectively. Therefore, the ability of the CDs to be used in different areas of applications has opened up a vast range of scopes for the researchers. Cigarette has been utilized as a precursor material to produce N-doped CD which acts as a Picric acid sensor and it is attached with MWCNT to synthesize a composite containing photo-responsive characteristics. ga1 • N-doped carbon dots were synthesized from cigarette-tobacco. • The avg. particle size and the QY of the CDs were 2.8 ± 1.04 nm and 9.98% respectively. • The CDs were used as a sensing probe to detect picric acid (PA) in water bodies. • The inner filter effect and charge transfer complex dominated the sensing mechanism. • The CDs were attached with MWCNTs to synthesize UV-responsive nano-composite. [ABSTRACT FROM AUTHOR]

Studies on the effects of unintentional intake of pyrethroid pesticides that are akin to actual human exposure settings are very rare. Such an exposure is primarily by consuming the food products as routine diet that contain residual levels of pyrethroids. In this study, rats were orally administered for 15 months with a mixture of pyrethroids at a dose that is one-fifth (high dose; HD) or one-twenty fifth (low dose; LD) of the residual levels commonly present in the average amount of rice and vegetables consumed by Indian population. Lipid profile, kidney and liver function were assessed. Lipid peroxidation, nitric oxide, antioxidant enzyme activities and histopathological changes were analyzed in the liver, lung, kidney, pancreas, testes, caput, cauda and prostate. The effect on the male reproductive system as a function of sperm count, enzyme activity of 3β-HSD and 17β-HSD and the expression profile of genes involved in spermatogenesis, steroidogenesis, genetic reprogramming and apoptosis of male gametes were evaluated. Significant increase in the relative organ weight, perturbations in the activities of antioxidant enzymes, lipid profile and liver function were observed in both LD and HD groups. Damage to the anatomical architecture was evident in all the tissues due to pyrethroid toxicity. Exposure to LD and HD of pyrethroid mixture resulted in decreased sperm count, activities of 3β-HSD and 17β-HSD, impaired capacitation and acrosome reaction and perturbations in the expression of genes that govern male gamete production. Results of our study indicate that exposure to pyrethroids for longer durations even at doses that are far below the residual levels present in the food consumed will result in severe damage to general physiological processes as well as reproductive function. • Daily exposure to pyrethroids occurs through food consumption. • Male rats exposed to mixture of pyrethroids present in food for 15 months. • Alterations in lipid profile, liver function and reproductive indices observed. • Perturbations in genes that govern spermatogenesis and steroidogenesis evident. • Expression of factors that dictate germ cell apoptosis and epigenetics altered. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The aim of the study was to assess and compare the efficacy of various scoring systems in predicting the severity and outcome of patients with acute pancreatitis (AP) admitted in intensive care unit (ICU). Methods: Prospective, single institution review of 55 consecutive AP patients admitted in ICU during a 2-year period. Disease severity scores and mortality predictions were calculated using the collected data in the first 48 hours of ICU admission for Ranson and Glasgow scores and in the first 24 hours for other scores. Results: Forty-two patients (76.4%) developed severe pancreatitis. Intensive care unit and 30-day mortality was 18.2% and 27.3%, respectively. Use of mechanical ventilation (MV) was an independent predictor of outcome on multivariate analysis with lack of MV being protective (adjusted odds ratio, 0.003; 95% confidence interval [CI], 0.00001-0.67; P = .04). All scoring systems had comparable accuracy in predicting severity and 30-day mortality, but sequential organ failure assessment (SOFA) score had greater efficacy with its area under curve for predicting severity and 30-day mortality being 0.81 (95% CI, 0.69-0.92) and 0.93 (95% CI, 0.85-0.99), respectively. Sensitivity and specificity (SOFA score, >4) was 76.2% and 69.2%, respectively, for predicting severity, and sensitivity and specificity (SOFA score, >8) was 86.7% and 90%, respectively, for predicting 30-day mortality. Conclusions: Use of MV is an independent predictor of outcome in AP patients admitted to ICU. Although all scoring systems had reliable accuracy in predicting severity and outcome, SOFA score performed better with additional advantages of easy applicability and timely assessment. [Copyright &y& Elsevier]