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Microbial electrochemical cells (MxCs) offer a sustainable approach for wastewater treatment and energy recovery by harnessing the electroactive properties of microorganisms. This study explores the enrichment of Geobacter species on anode biofilms in single-(S-MxCs) and double-chambered (D-MxCs) MxCs, using domestic wastewater without an external anode potential. Stable current densities were achieved within 10 days for S-MxCs (9.52 ± 0.8 A/m2) and 14 days for D-MxCs (4.28 ± 0.9 A/m2), with S-MxCs showing a superior electrochemical performance. Hydrogen production rates were higher in D-MxCs (14.93 ± 0.66 mmol H2/L/day) compared to S-MxCs (9.46 ± 0.8 mmol H2/L/day), with cumulative production rates of 12.9 ± 1.3 mmol H2/g COD and 6.48 ± 1.4 mmol H2/g COD, respectively. Cyclic voltammetry confirmed enhanced bioelectrocatalytic activity in S-MxCs, while SEM imaging showed denser biofilms on S-MxC anodes. The novelty of this study lies in its demonstration of efficient biofilm development and microbial community resilience under non-potentialized conditions, providing insights that advance the practical application of MxCs in environmental biotechnology.

INTRODUCTION: In the hypothalamic-pituitary-gonadotrophin axis, estrogen plays a key role in the regulation of bone maturation and growth plate closure. This study was designed to explore the link between single nucleotide polymorphisms (SNPs) in the estrogen receptor 1 (ESR1) gene with idiopathic short stature (ISS) susceptibility in a North Indian population. METHODS: Four SNPs of ESR1 (rs543650, rs6557177, rs2234693 and rs9340799) were genotyped by Sanger sequencing in ISS patients and controls. Linkage disequilibrium (LD) and haplotyping were done by SNPStat and SHEsisPlus software. The extent of LD was determined by calculating D’ and R2 values in SNP paired combinations. RESULTS: Fifty-two ISS patients were compared with 68 controls. A significant positive association was found between rs6557177 and rs543650 genotype and ISS susceptibility. The frequencies of the rs6557177 CC genotype [p=0.030; odds ratio (OR)=0.13; 95% confidence interval (CI): 0.01-1.10] and rs543650 genotype TT (p=0.043; OR=0.29; 95% CI: 0.09-0.92) were increased in the ISS group compared with controls. However, no significant correlation was observed between clinical parameters of patients and these SNPs. rs543650 showed strong LD with rs2234693 and rs9340799, similarly rs2234693 and rs9340799. DISCUSSION AND CONCLUSION: Our study showed that the CC genotype at rs6557177 and TT genotype at rs543650 of ESR1 constituted a risk factor for developing ISS in North Indian children. These findings may lead to a better understanding of the SNPs associated with ISS susceptibility.

Abstract Introduction Decompressive craniectomy [DC] is one of the leading armaments to lower refractory intracranial pressure. Post-DC hydrocephalus [PDCH] occurs in 11.9–36% of patients undergoing DCs for TBIs. Various theories have been given regarding pathophysiological mechanism of PDCH but remain dubious. Risk factors predicting PDCH still under research. Exact timeline regarding developmental process of PDCH remains undefined. Method This retrospective study was conducted on 422 patients who underwent DCs in our tertiary care trauma center over the period of one year. 60 patients out of 422 who developed PDCH were analyzed with respect to demographic variables and preoperative and postoperative risk factors. A total of 20 randomly selected patients, who underwent DCs but did not develop hydrocephalus, were selected and compared with patients who developed PDCH. Outcome analysis was done by dichotomizing the groups into independent and dependent groups. Results Among 422 patients undergoing DC, 14.21%[n = 60] developed PDCH. Younger [34.2 y vs 43.3 y, p = 0.0004] male age group was predominant in our study. Age [p = 0.021, multivariate analysis] and midline shift [p = 0.008, multivariate analysis] were significant preoperative predicting risk factors for PDCH. Interhemispheric hygroma [p = 0.031], brain bulge [ p = 0.008], and blood in postoperative scan [p = 0.029] were significant postoperative risk factors. Lower GCS score at admission [p = 0.0003], postoperative day 10 and at the time of establishment of PDCH were significantly predicted surgery to hydrocephalus time. Midline shift [p = 0.007] and thickness of interhemispheric hygroma [p = 0.021] were associated with poor outcome in patients with PDCH. Conclusion Younger age group and presence of midline shift are significant preoperative predictors of PDCH. Blood in postoperative scan, interhemispheric hygroma and brain bulge in postoperative period are significant predictors for PDCH. Deterioration in GCS score in postoperative period following DC should be taken as high index of suspicion for developing PDCH.

Catechins are the predominant form of flavonoids present in plants and have high antioxidant capacity, but their usage is limited in clinical practice due to low bioavailability. Nano formulation of catechin was prepared by using sodium alginate polymer to address the bioavailability problem. Nanoparticles were synthesized by the co-precipitation method. In vivo antioxidant property of alginate-coated catechin nanoparticles was assessed against carbon tetrachloride-induced hepatopathy in a rat model. Rats were randomly divided into ten groups, with six rats (n = 6) in each group. Carbon tetrachloride @ 4 ml/Kg body weight was used to cause subacute hepatotoxicity in rats; Group I (healthy control), Group II (disease control), Group III (blank catechin), Group IV (blank alginate), Group V (Silymarin), Group VI and Group VII (Alginate coated catechin nanoparticles, two different dose intervals), Group VIII, Group IX, Group X (Alginate coated catechin nanoparticles, Three different doses). Oxidative stress assay, histopathological examination, and May-Grünwald staining were done on the 28th day of the trial. Haemato-biochemical parameters and oxidative stress markers on the 28th day in the rats of Group VI showed significant improvement as compared to other groups. Significant improvement in the healing pattern of gross tissues of the liver was observed in Group VI. May-Grünwald Giemsa staining depicted prominent regenerative changes in liver cells in Group VI. The study concluded that the alginate coating of catechin improves the bioavailability and depicted better regeneration of hepatocytes.

Abstract Background Decompressive craniectomy (DC) is a neurosurgical procedure, frequently used in lowering the refractory intracranial pressure (ICP) following traumatic brain injuries. Post-traumatic hydrocephalus (PTH), a debilitating complication in the patients with traumatic brain injuries, occurs in 11.9–36% patients undergoing DCs. Sunken flap syndrome (SFS) is a rare entity, following DCs or cerebrospinal fluid (CSF) diversion procedures for PTH after DCs and leads to neurological deterioration of the patients. Literature regarding risk factors associated with SFS in the patients undergoing ventriculoperitoneal shunt procedures for hydrocephalus following DCs is scarce. The aim of this study is to determine the incidence of SFS and to establish a relationship between several clinico-radiological features and SFS in patients undergoing shunt procedures for PTH. Results This retrospective study was conducted in a tertiary care trauma centre upon 60 patients who underwent shunt procedures for PTH. Intraventricular haemorrhage (P 43 was a significant risk factor in development of SFS. Conclusions SFS is the common complication following shunt procedures for PTH after DCs. MFHI is significant risk predictor for SFS. MFHI > 43 is associated with higher chances of developing SFS following shunt insertion in PTH. Early cranioplasty following DCs might prevent development of SFS.

With China's agricultural sector being a major contributor to both the national economy and energy consumption, the rebound effect—the phenomenon where energy efficiency improvements lead to increased energy use—poses significant challenges to sustainable energy use. The motivation for this study stems from the need to understand the extent of this rebound impact and its underlying drivers, particularly in the context of China's agricultural modernization efforts. This study examines the rebound effect of energy consumption in China's agricultural productivity and the factors influencing it over the period from 1990 to 2023. Using a Generalized Method of Moments (GMM) model, this research analyzes the relationship between energy consumption, agricultural productivity, and several influencing factors, including technological innovation, rural-urban migration, and financial development. The results reveal that (1) energy efficiency improvements have led to a significant rebound effect in China's agricultural sector, limiting potential energy savings, (2) technological advancements have mitigated the rebound effect to some extent, but the effect remains substantial, (3) rural-urban migration has contributed to labor shortages, increasing mechanization and energy demand, and (4) financial development has positively influenced both agricultural productivity and energy use, exacerbating the rebound effect. The study suggests that policymakers should focus on developing stricter energy efficiency standards and promoting technological innovations that reduce energy intensity in agriculture, while also addressing labor migration challenges to curb the rebound impact and achieve more sustainable agricultural growth.

There is a greater awareness of safety issues, emerging risks, and challenges in dairy products. Lean philosophy is one of the strategies that significant corporations worldwide have tried to adopt to stay competitive in an increasingly global market. This paper presents the relationship between different critical success factors for the Information and Communication Technology (ICT) enabled lean dairy supply chain. This study will help to bring leanness in the perishable supply chain by showing the interrelationship of digitalization and emerging Information and Communication Technologies like automation, cloud computing, big data, digital twins, metaverse, etc., with other critical success factors of the supply chain. This paper proposes a twelve-level hierarchical model to illustrate the inter-relationships among the critical success factors of the ICT-enabled lean dairy supply chain.

Transcription factors (TFs) are regulatory proteins which bind to a specific DNA region known as the transcription factor binding regions (TFBRs) to regulate the rate of transcription process. The identification of TFBRs has been made possible by a number of experimental and computational techniques established during the past few years. The process of TFBR identification involves peak identification in the binding data, followed by the identification of motif characteristics. Using the same binding data attempts have been made to raise computational models to identify such binding regions which could save time and resources spent for binding experiments. These computational approaches depend a lot on what way they learn and how. These existing computational approaches are skewed heavily around human TFBRs discovery, while plants have drastically different genomic setup for regulation which these approaches have grossly ignored. Here, we provide a comprehensive study of the current state of the matters in plant specific TF discovery algorithms. While doing so, we encountered several software tools’ issues rendering the tools not useable to researches. We fixed them and have also provided the corrected scripts for such tools. We expect this study to serve as a guide for better understanding of software tools’ approaches for plant specific TFBRs discovery and the care to be taken while applying them, especially during cross-species applications. The corrected scripts of these software tools are made available at https://github.com/SCBB-LAB/Comparative-analysis-of-plant-TFBS-software.

Introduction Caregivers of patients with end-stage kidney disease (ESKD) face significant challenges that contribute to caregiver burden, negatively impacting their psychosocial well-being. Virtual-reality (VR)-guided mindfulness interventions have shown promise in reducing stress, anxiety and depression in various populations.Methods and analysis This pilot study aims to evaluate the efficacy and feasibility of a VR-guided mindfulness intervention for ESKD caregivers. A single-centre, single-blind, parallel-group pilot randomised controlled trial will be conducted. Thirty ESKD caregivers will be randomly allocated to either the VR-guided mindfulness intervention group or the sham VR control group. The intervention group will receive a 6 week home-based VR-guided mindfulness programme, while the control group will view relaxing nature videos without mindfulness content. Participants will be assessed at baseline, post-intervention (6 weeks) and follow-up (12 weeks) using validated questionnaires for caregiver burden (Zarit Burden Interview (ZBI)), stress, anxiety, depression (Depression Anxiety Stress Scale-21 (DASS-21)), quality of life (36-Item Short Form Health Survey (SF-36)) and mindfulness (Five Facet Mindfulness Questionnaire (FFMQ)). Feasibility outcomes include accrual rates, retention, adherence, questionnaire completion and side effect rates. Semi-structured interviews will explore participants’ experiences with the intervention.Ethics and dissemination The study has been approved by the NHG Domain Specific Review Board (Reference: 2024–3940-APP1). The results of this pilot study will be reported in peer-reviewed open-access journals and shared with participants and stakeholders.Trial registration NCT06479200.

Introduction Peritoneal dialysis (PD) is an effective home-based treatment for end-stage kidney disease (ESKD) that offers several advantages over in-centre haemodialysis, including better quality of life, increased autonomy and lower costs. Despite these benefits, PD remains underused globally, with wide variations in adoption rates across countries. Qualitative studies have explored the experiences, perceptions and decision-making processes of patients, caregivers and healthcare providers regarding PD, but their findings have not been systematically synthesised. This protocol outlines a systematic review of qualitative studies to identify and synthesise the multilevel factors that influence PD adoption.Methods and analysis We will conduct a comprehensive search of electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO, Scopus) and grey literature sources for qualitative studies published in English from each database inception to June 2024 that explore barriers and facilitators to PD adoption. Two reviewers will independently screen titles, abstracts and full texts for eligibility based on predefined criteria. Eligible studies will include those that use qualitative methods (eg, interviews, focus groups, observations) to explore the perspectives of adult ESKD patients, their caregivers and/or healthcare providers on factors influencing PD adoption, initiation or maintenance. Data will be extracted using a standardised form and synthesised using thematic analysis. The methodological quality of included studies will be appraised using the Critical Appraisal Skills Programme Qualitative Checklist. Confidence in the review findings will be assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research approach.Ethics and dissemination Ethics approval is not required as this study will merely synthesise data from published studies. The results will be disseminated through peer-reviewed publications as well as conference presentations.Study registration PROSPERO, CRD42024570521.

Background: The burgeoning prevalence of Type 2 Diabetes Mellitus (T2DM) has been linked to a spectrum of health complications, including those affecting the musculoskeletal system. Knee proprioception, muscle strength, and stability are essential for maintaining functional mobility and preventing falls, yet their relationship with T2DM is not fully elucidated. Objectives: This study aimed to compare knee proprioception, muscle strength, and limits of stability (LOS) between individuals with T2DM and asymptomatic controls and to examine the moderating role of physical activity on these relationships. Methods: In a cross-sectional design, 192 participants (96 with T2DM and 96 asymptomatic) underwent assessments for knee proprioception using a digital inclinometer, muscle strength via a handheld dynamometer, and LOS through dynamic posturography, graded as a percentage of maximum lean without losing balance. Results: Our analysis revealed that individuals with T2DM demonstrated reduced knee muscle strength, with mean differences of 12.90 Nm (right) and 18.80 Nm (left) in 25° of flexion, and 25.78 Nm (right) and 26.36 Nm (left) in 40° of flexion, compared to asymptomatic controls. Proprioception errors were greater in the T2DM group (p

ObjectiveThis study evaluates the impact of physiotherapy interventions on health outcomes and explores the correlation between physiotherapy session characteristics and improvements in health among older individuals.MethodsIn a cross-sectional design, 384 older adults with chronic conditions such as arthritis, osteoporosis, Chronic Obstructive Pulmonary Disease (COPD), diabetes, and hypertension were recruited.ResultsThe proportion of arthritis (39.1%) and hypertension (45.8%) was notably high. Participants receiving physiotherapy showed significant improvements in pain levels (mean reduction from 5.09 to 2.95), mobility scores (improvement from 3.0 to 3.96), and functional independence. A positive correlation was identified between the frequency of physiotherapy sessions and pain reduction (r = 0.26, p = 0.035), and a stronger correlation between session duration and both pain reduction (r = 0.38, p = 0.002) and mobility improvement (r = 0.43, p = 0.001). High satisfaction rates with physiotherapy were reported, and age was found to be a significant negative predictor of health outcomes (Coef. = −0.3402, p = 0.0009).ConclusionPhysiotherapy interventions significantly improve health outcomes in older adults with chronic diseases.

Introduction: A positive childbirth experience and satisfaction are the key indicators defining the quality of care pregnant mothers receive in a healthcare institution. Therefore, researchers have sought multiple strategies to improve childbirth experience and maternal satisfaction. In light of this background, the current research aims to evaluate the effectiveness of peanut ball intervention in improving maternal satisfaction and promoting positive childbirth experiences and behavioural responses. Methods: The current research employed a randomised control trial in which 768 low-risk primigravid women were recruited into two groups: treatment (n = 384) and control (n = 384). A comparative evaluation of the outcomes was carried out between the peanut ball intervention provided to the treatment group and the standard care provided to the control group. Data was collected using an observation checklist for behavioural response and a questionnaire for childbirth experience and maternal satisfaction. Results: The study revealed a significant mean score difference in behavioural response, childbirth experience and maternal satisfaction, indicating the effectiveness of the peanut ball intervention in improving these outcomes. Conclusion: The peanut ball intervention can effectively improve positive behavioural response, childbirth experience and maternal satisfaction among low-risk primigravid women. The current study provides insight into healthcare providers' consideration of the peanut ball intervention among pregnant mothers as a safe and comfortable method of childbirth.

Abstract Ritonavir is a potent inhibitor of the cytochrome P450 3A4 enzyme and is commonly used as a pharmacokinetic (PK) enhancer in antiviral therapies because it increases bioavailability of concomitantly administered antivirals. Decades of experience with ritonavir-enhanced HIV therapies and, more recently, COVID-19 therapies demonstrate that boosting doses of ritonavir are well tolerated, with an established safety profile. The mechanisms of PK enhancement by ritonavir result in the potential for drug–drug interactions (DDIs) with several classes of drugs, thus making co-medication management an important consideration with enhanced antiviral therapies. However, rates of DDIs with contraindicated medications are low, suggesting these risks are manageable by infectious disease specialists who have experience with the use of PK enhancers. In this review, we provide an overview of ritonavir’s mechanisms of action and describe approaches and resources available to mitigate adverse events and manage concomitant medication in both chronic and short-term settings.

Abstract The Bmp/Smad1 pathway plays a crucial role in developmental processes and tissue homeostasis. Mitogen-activated protein kinase (Mapk)/Erk mediated phosphorylation of Smad1 in the linker region leads to Smad1 degradation, cytoplasmic retention and inhibition of Bmp/Smad1 signaling. While Fgf/Erk pathway has been documented to inhibit Bmp/Smad1 signaling, several studies also suggests the cooperative interaction between these two pathways in different context. However, the precise role and molecular pathway of this collaborative interaction remain obscure. Here, we identified Xbra induced by Fgf/Erk signaling as a factor in a protective mechanism for Smad1. Xbra physically interacted with the linker region phosphorylated Smad1 to make Xbra/Smad1/Smad4 trimeric complex, leading to Smad1 nuclear localization and protecting it from ubiquitin-mediated proteasomal degradation. This interaction of Xbra/Smad1/Smad4 led to sustained nuclear localization of Smad1 and the upregulation of lateral mesoderm genes, while concurrently suppression of neural and blood forming genes. Taken together, the results suggests Xbra-dependent cooperative interplays between Fgf/Erk and Bmp/Smad1 signaling during lateral mesoderm specification in Xenopus embryos.

Abstract Background The infodemic accompanying the COVID-19 pandemic has led to an overwhelming amount of information, including questions, concerns and misinformation. Pandemic fatigue has been identified as a concern from early in the pandemic. With new and ongoing health emergencies in 2022, it is important to understand how pandemic fatigue is being discussed and expressed by users on digital channels. This study aims to explore and report on key narrative themes associated with expressions of pandemic fatigue by users on digital platforms. Methods This paper describes the collection of publicly available data over a 3-month period from multiple online sources using the Meltwater and CrowdTangle platforms to source data from Twitter, Facebook, Instagram, YouTube, TikTok, Pinterest, Product Reviews, Twitch, blogs & forums. A comprehensive search strategy was developed and tested. A total of 1,484,042 social media posts were identified during the time-period that included the defined search terms for pandemic fatigue. These data were initially sorted by highest levels of engagement and from this dataset, analysts reviewed the identified posts to isolate and remove irrelevant content and identify dominant narratives. A thematic analysis was carried out on these narratives to identify themes related to expression of pandemic fatigue. Two researchers reviewed the data and themes. Results The thematic analysis of narratives identified six main themes relating to expression of pandemic fatigue, and one theme of counter narratives against pandemic fatigue. Data volume increased concurrent with the time of the mpox emergency announcement. Emergent themes showed the different ways users expressed pandemic fatigue and how it was interlaced with issues of trust, preventative measure acceptance and uptake, misinformation, and being overwhelmed with multiple or sustained emergencies. Conclusions This paper has identified the different ways users express pandemic fatigue on digital channels over a 3-month period. Better understanding the implications of the information environment on user’s perceptions, questions, and concerns regarding pandemic and more broadly emergency fatigue is vital in identifying relevant interventions and, in the longer term, strengthening the global architecture for health emergency preparedness, prevention, readiness and resilience, as evidenced in this paper. There are clear pathways for further research, including incorporating additional languages and reviewing these themes over longer time periods.

Background Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with systemic implications, potentially affecting musculoskeletal health. This study aimed to assess shoulder muscle strength and joint repositioning accuracy in individuals with T2DM, exploring potential correlations and shedding light on the musculoskeletal consequences of the condition. The objectives were two-fold: (1) to assess and compare shoulder strength and joint repositioning accuracy between individuals with T2DM and asymptomatic counterparts, and (2) to examine the correlation between shoulder strength and joint repositioning accuracy in individuals with T2DM. Methods A cross-sectional study enrolled 172 participants using the convenience sampling method, including 86 individuals with T2DM and an age-matched asymptomatic group (n = 86). Shoulder strength was assessed using a handheld dynamometer, while joint repositioning accuracy was evaluated with an electronic digital inclinometer. Results Individuals with T2DM exhibited reduced shoulder muscle strength compared to asymptomatic individuals (p

Background: Stellate ganglion block (SGB) is effectively utilized in various sympathetically mediated pain conditions of head and neck, upper limb such as complex regional pain syndrome, postherpetic neuralgias, but there has been a paucity of evidence of SGB for the management of phantom limb pain (PLP). Methods: Ten upper extremity PLP patients underwent ultrasound-guided SGB block. Under real-time needle tip visualization and after ensuring negative aspiration, 5 mL of 1% lignocaine and 4 mg of dexamethasone were injected. Postprocedure pain score (numerical rating scale [NRS]) and patient satisfaction score (Likert scale) were noted, and patients were followed-up for the next 60 days. Results: The baseline NRS score (Mean [standard deviation]) of 7.8 (0.748) showed significant reduction (P < 0.001) to 2.8 (0.748) at immediate postinjection, to 2.6 (0.663) at day 7, at day 30 (2.9 [0.7]), and at day 60 (30.775). Most of the patients (80%–90%) were somewhat to very much satisfied with the treatment response (score 4–5 on Likert scale) at all the follow-up intervals. Only mild and transient adverse events were demonstrated in two patients who developed hoarseness of voice. Conclusion: Ultrasound-guided SGB effectively reduces pain and improves patient satisfaction in postamputee patients who developed PLP, over 2 months of the follow-up period. Further prospective randomized controlled trials over a larger duration with more sample size are needed to provide more concrete evidence.

Abstract Background The posterior cranial fossa (PCF) and the foramen magnum (FM) are the critical anatomical components of the craniovertebral junction region, which comprise and transmit numerous vital neurovascular structures. So, a fundamental knowledge of the basic radiological anatomy of PCF and FM is of paramount importance in the evaluation of associated pathologies and approaching these areas surgically. The aim of this study is to describe different linear and angular craniometric parameters of PCF, FM and surrounding territory based on reconstructed computed tomography (CT) images. Material and methods This study was conducted in our tertiary care hospital in northern India from the period of January 2023 to June 2023 on 120 patients, and CT screening was done for the head and spine region following a history of head injury. Results In this study, 120 patients were included, of whom 50.83% (n = 61) were females and 49.17% (n = 59) were males. Age ranged from 18 to 70 years with mean age of 43.5 ± 14.08 years. The mean values for linear craniometric parameters of PCF were statistically nonsignificant for different age groups. Statistically significant differences were found for twinning line (TL) (p

Abstract Chhurpe is a naturally fermented traditional dairy food of high altitude Western Himalayan region. They are generally prepared from cow or yak milk and are consumed during harsh winters. The present study was conducted to characterize the different Chhurpe samples traditionally prepared by the ethnic groups utilizing milk from different animal breeds such as cow, yak, Zomo (cow × yak), and Germo (Zomo × yak). Nutritional characterization revealed that 100 g of Chhurpe could completely meet the dietary protein requirements of children and adults with high concentrations of methionine and lysine. Tryptophan and valine were the limiting amino acids among all the Chhurpe samples. Palmitic, stearic, and oleic acids were the predominant fatty acids. The Chhurpe samples were a rich source of micronutrients such as calcium, iron, and zinc meeting above 70% of recommended dietary allowances (RDA) among children (3–10 years) and up to 20% RDA for adults. Culture-independent metagenomic analysis revealed that lactic acid bacteria were the predominant group, consisting of genera such as Lactobacillus, Leuconostoc, Lactococcus, and Streptococcus followed by acetic acid bacteria, mainly Acetobacter. At the species level, Lactobacillus delbrueckii was the abundant strain among all the Chhurpe samples. Species diversity was significantly higher in Chhurpe prepared from Zomo milk. Probiotic bacterial strains such as Lactobacillus helveticus, L. delbrueckii, L. brevis, and Leuconostoc mesenteroides were identified in the Zomo Chhurpe indicating their superior quality. The present study was an attempt to popularize Chhurpe and promote its wider consumption by highlighting its nutritional properties.

The manuscript portrays the investigation of a quantum plasmonic gold torus nanodipole antenna on a zinc oxide dielectric substrate for optical near-field communication. Initially, the dispersive behavior of gold and zinc oxide materials at terahertz is demonstrated through Drude and Lorentz models to confirm the suitability of the material for the design of nano-antenna. The proposed torus nanodipole antenna is analyzed in detail using substrate, torus and feeding gap design parameters of the antenna to obtain the desired plasmon resonance characteristics for optical near-field communication. The minimal reflection of -50.50 dB is observed at 71.3 THz with a directivity of 1.91 dBi using a single nanodipole element. The torus nanodipole antenna array is proposed to enhance the directivity and gain of the torus nanodipole antenna. The directivities of 9.425 dBi, 12.63 dBi and 14.63 dBi and the gain of 7.69 dBi, 10.77 dBi and 13.3 dBi are observed for the $2\times 2$ , $3\times 3$ and $4\times 4$ element nanodipole arrays, respectively. The circuit modeling for the torus nanostructure is proposed and validated using the finite integration technique.

Introduction: Monogenic urinary stone disease (MUSD) tends to be more severe with early onset of symptoms and a higher risk of chronic kidney disease than sporadic USD. The literature on the outcome after renal transplant in patients with certain MUSD is scarce. Materials and Methods: This is a retrospective single-center observational study conducted in a tertiary care renal transplant unit in North India between 2018 and 2021. The renal transplant recipients who developed an end-stage renal disease (ESRD) due to renal calculus disease/nephrocalcinosis were included in the study. All the patients presented to us in an anuric state, and hence, a 24-h urine metabolic profile could not be performed. Ear, nose, and throat and ophthalmological evaluations were done to rule out extrarenal manifestations. These patients were subjected to genetic analysis, i.e., clinical exome sequencing using next-generation sequencing. Results: Out of 283 live renal transplants, 11 patients developed ESRD due to nephrocalcinosis/renal calculus disease. Out of 11, only 4 had genetic mutations and the rest did not have any identifiable genetic mutations. The gene mutations were identified in ADCY10, CLDN16, CaSR, and SLC3A4. The patient with ADCY10 mutation had a strong family history. The clinical phenotype and in silico parameters analysis predicted the variant to be damaging except the one with CaSR mutation which causes Hypocalciuric hypercalcemia syndrome, type 1. Three of four underwent surgical intervention at younger age. All underwent successful live-related renal transplantation, with good graft function on follow-up, without any recurrence of calculus in the allograft. Conclusion: Renal transplantation can be safely proceeded in patients with the above monogenic mutations. Genetic analysis should be a part of pretransplant evaluation in young onset nephrolithiasis and end-stage kidney disease patients to look for a monogenic cause, to assess the risk of recurrence postrenal transplant.

Mandro in Sahibganj District of Jharkhand State, India is known for its abundance of petrified wood and floral impressions from the Rajmahal Traps of Albian–Aptian age. This locality is among the 34 Geological Heritage Sites identified by the Geological Survey of India. The scientific importance of the site is vested in the intricate preservation of petrified wood and floral impressions in a single locality. The plants were transported by pyroclastic volcanic activity, and the tuff and crystal-laden pumice helped preserve the fossils, including upright tree stumps with intact root systems. Such an association of floral fossils with ignimbrite is of high scientific relevance and is one of its kind in India. At present, the Geoheritage Site, Mandro is compromised by the lack of legislative provisions guiding conservation of the site. Our study highlights bottlenecks in the development of the Geoheritage Site and suggests the formulation of an integrated–sustainable tourism circuit combining natural, anthropological, cultural and historical touristic components. We advocate operating the circuit through community participation, ensuring trust and capacity building among the local People. The circuit is an exclusively local tourism engine that could address socioeconomic disparities while developing as a hub for research and innovation across different disciplines. Paramount to these efforts is attaining Sustainable Development Goals and global recognition for the Geoheritage Site and the Circuit.

Abstract Protease inhibitor nirmatrelvir coadministered with ritonavir as a pharmacokinetic enhancer (PAXLOVID™; Pfizer Inc) became the first orally bioavailable antiviral agent granted Emergency Use Authorization in the United States in patients ≥12 years old with mild to moderate coronavirus disease 2019 (COVID‐19). This population pharmacokinetic analysis used pooled plasma nirmatrelvir concentrations from eight completed phase I and II/III studies to characterize nirmatrelvir pharmacokinetics when coadministered with ritonavir in adults with/without COVID‐19. Influence of covariates (e.g., formulation, dose, COVID‐19) was examined using a stepwise forward selection (α = 0.05) and backward elimination (α = 0.001) approach. Simulations with 5000 subjects for each age and weight group and renal function category were performed to support dosing recommendations of nirmatrelvir/ritonavir for adults with COVID‐19 and guide dose adjustments for specific patient populations (e.g., renal insufficiency, pediatrics). The final model was a two‐compartment model with first‐order absorption, including allometric scaling of body weight and dose‐dependent absorption (power function on relative bioavailability). Nirmatrelvir clearance (CL) increased proportionally to body surface area–normalized creatinine CL (nCLCR) up to 70 ml/min/1.73 m2 and was independent of nCLCR above the breakpoint. Significant covariates included carbamazepine or itraconazole coadministration as markers for drug interactions, COVID‐19 on CL, formulation on relative bioavailability, and age on central volume of distribution. Simulation results support current dosing recommendations of nirmatrelvir/ritonavir 300/100 mg twice daily (b.i.d.) in adults with normal renal function or mild impairment and pediatrics (12 to

Background: Chronic Ankle Instability (CAI) is a common musculoskeletal condition characterized by recurring ankle sprains and impaired postural control (PC). Understanding the relationship between ankle muscle strength, PC, and the role of pain is essential for effective management. Objectives: This prospective cross sectional study aimed to 1. Compare ankle isometric muscle strength (IMS) and PC between CAI and asymptomatic sides. 2. Assess the correlations between ankle IMS and PC and explore the potential mediating effect of pain in individuals with CAI. Methods: A total of 44 individuals with CAI, were enrolled in the study. Ankle IMS (dorsiflexors, plantar flexors, invertors, and evertors) was measured using a dynamometer, while PC was evaluated using sway parameters (anterior-posterior and medial-lateral sway, ellipse area). Pain levels were reported using a Visual Analog Scale. Results: The CAI ankles exhibited significantly lower ankle IMS in all muscle groups compared to the asymptomatic ankles (p

Abstract In this manuscript, a hexagonal-shaped graphene quantum plasmonic nanopatch antenna sensor is designed and investigated on silicon dioxide, zinc oxide and silicon substrates for quantum plasmonic biosensing applications. The optical properties of graphene are demonstrated using Kubo modeling to analyze the plasmon resonance characteristics of the nanopatch antenna. Nano-circuit modeling of the hexagonal-shaped graphene nano-antenna is proposed and validated using CST simulations. The parametric analysis of the hexagonal-shaped nanopatch antenna is performed using design parameters such as R (radius of the hexagon), T p (thickness of the hexagon) and µ c (chemical potential of graphene) to obtain optimum characteristics suitable for quantum plasmonic sensing applications. The study demonstrates that the proposed hexagonal-shaped nano-antenna exhibits gain of 4.9 dBi, 2.46 dBi, 14.99 dBi, 8.25 dBi, 5.15 dBi, 10.87 dBi and 2.4 dBi at 29.87 THz, 30 THz, 35 THz, 113.5 THz, 132.5 THz, 85 THz and 24 THz, respectively. The field enhancement factors observed at these frequencies are 794, 779, 584, 255, 234, 654 and 217, respectively.

Abstract Background Conventional quantitative or qualitative methodologies may not encompass the wide array of experiences of individuals living with Chronic Obstructive Pulmonary Disease (COPD). We used a novel approach – photovoice—to understand the impact of COPD on activities of daily living (ADLs) in a multicultural Asian country. Methods We recruited a purposive sample of eight patients from the outpatient clinics of the National University Health System, Singapore, between December 2020 and August 2021. We adopted a photovoice approach for data collection; participants were invited to take photos of how ADLs were impacted by COPD and attend a follow-up interview. An Interpretative Phenomenological Analysis method was used to analyze the data. Data saturation was reached by the seventh patient. Results COPD and the resulting breathlessness had a profound and diverse impact on our participants’ lives. Living with COPD required substantial changes to how everyday tasks are performed, and participants learnt new strategies to deal with such tasks. A mixture of active and passive coping styles was evident. Feelings of frustration, anxiety and a sense of isolation were also reported. Contextual factors impacting ADLs included challenging climatic conditions and the local popularity of traditional or alternative medicine. Conclusion The photovoice technique improved our understanding of the lived experiences of COPD patients and can benefit those who struggle to articulate their views by offering a different way to communicate beyond conventional interviewing.

This study attempts to overcome the challenges associated with the degradation of complex organic substances like corn straw hydrolysate in hydrogen recovery by strategically enriching functional microbial communities in single-chamber cubic microbial electrolysis cells (MECs). We applied negative pressure, using acetate or xylose as electron donors, to mitigate the hydrogen sink issues caused by methanogens. This innovative method significantly enhanced MEC performance. MECs enriched with xylose demonstrated superior performance, achieving a hydrogen production rate 3.5 times higher than that achieved by those enriched with acetate. Under negative pressure, hydrogen production in N-XyHy10 reached 0.912 ± 0.08 LH2/L MEC/D, which was 6.7 times higher than in the passive-pressure MECs (XyHy10). This advancement also resulted in substantial increases in current density (73%), energy efficiency (800%), and overall energy efficiency (540%) compared with MECs operated under passive pressure with 10% hydrolysate feed. The enrichment of polysaccharide-degrading bacteria such as Citrobacter and Pseudomonas under negative pressure underscores the potential for their industrial application in harnessing complex organic substrates for bioenergy production in single-chamber MECs. This is a promising approach to scaling up bioenergy recovery processes. The findings of this research study contribute significantly to the field by demonstrating the efficacy of negative pressure in enhancing microbial activity and energy recovery, thereby offering a promising strategy for improving bioenergy production efficiency in industries.

We study certain Volterra integral equations that extend and recover first order ordinary differential equations (ODEs). We formulate the former equations from the latter by replacing classical derivatives with nonlocal integral operators with anti-symmetric kernels. Replacements of spatial derivatives have seen success in fracture mechanics, diffusion, and image processing. In this paper, we consider nonlocal replacements of time derivatives which contain future data. To account for the nonlocal nature of the operators, we formulate initial “volume” problems (IVPs) for these integral equations; the initial data is prescribed on a time interval rather than at a single point. As a nonlocality parameter vanishes, we show that the solutions to these equations recover those of classical ODEs. We demonstrate this convergence with exact solutions of some simple IVPs. However, we find that the solutions of these nonlocal models exhibit several properties distinct from their classical counterparts. For example, the solutions exhibit discontinuities at periodic intervals. In addition, for some IVPs, a continuous initial profile develops a measure-valued singularity in finite time. At subsequent periodic intervals, these solutions develop increasingly higher order distributional singularities.

A stable aerobic consortium was enriched to degrade crystalline cellulose (Whatman filter paper 1). The degradation efficiency of the consortium after 7 days of incubation was 91% compared to the control. One bacterial isolate, C7, capable of degrading various cellulosic substrates, was obtained from the consortium under aerobic conditions. The sequencing of 16s rDNA revealed that it was related to Paenibacillus sp. It degraded 83% of cotton after 3 days of incubation. The degradation efficiency of Paenibacillus sp. C7 for filter paper, cotton, and avicel was 90%, 90%, and 92% after 5 days of incubation compared to the control. It also degraded non-pretreated agricultural residues efficiently by 70% for rice straw and 46% for wheat bran in 10 days. Scanning electron micrographs (SEMs) of degraded filter paper after 2 days of incubation indicated smoother and thinner fabrics in its structure. It is a potential cheaper candidate for the degradation of lignocellulosic biomass without any pretreatment.

Objective: Chronic orofacial pain (CP) is a persistent and debilitating condition that affects the face, mouth, and jaw and can have a significant impact on an individual’s quality of life by posing problems to eat, speak, and perform everyday activities. By the means of this narrative review, we aim to assess different types of management modalities that exist to combat chronic orofacial pain. Design: Various databases were explored with MeSH keywords of chronic orofacial pain, orofacial pain, and interventions and treatment protocols for eligible articles. After an extensive literature search, it was ascertained that this review identified four major categories of treatment modalities for the management of chronic orofacial pain, namely pharmacological management, psychological management, lifestyle interventions-based management, and current stimulation-based management. Results: Of the four categories discussed, although pharmacological intervention offered the most immediate relief—especially from orofacial pain that was of a sudden, stab-like in nature—psychological management demonstrated a remarkable ability to reduce/alleviate the more serious aspect of chronic orofacial pain and was deemed better in comparison to the rest. Lifestyle-based techniques and current stimulation-based management were of limited use since they tended to focus more on the causal and not the symptomatic aspect of orofacial pain. Conclusions: Many patients with persistent orofacial discomfort can experience notable improvements in their symptoms and general well-being by all the treatment modalities evaluated.

Audio classification incurs unique difficulties in speaker recognition and human emotion detection, which have applicable relevance to the real world. This paper introduces a novel multimodal solution to the two challenges of speaker verification and sentiment detection in a customer service call centre setting. For speaker recognition, utilizing a small subset of the LibriSpeech Library, features are extracted via Mel-frequency cepstral coefficients (MFCCs). A three-layer Long Short-Term Memory (LSTM) architecture using triplet loss for training produces an Equal Error Rate (EER) of 6.89%, demonstrating efficacy and precision. Simultaneously, we also conduct emotion detection on the RAVDESS dataset via CNN to classify eight feelings the emotions proposed by Ekman, plus neutral and relaxed resulting in an F1 score of 0.85. This contribution demonstrates that such deep learning approaches can be applied in the real world for telephone speaker authentication and help centers, as speaker verification and emotion detection provide additional meaning to what is being conveyed.

Introduction Caregiver burden is a significant issue in the care of patients with advanced kidney disease. Its assessment is crucial for evaluating the needs of caregivers and for the development of interventions to support them. Several instruments have been developed to measure caregiver burden in these patients. However, the measurement properties of these instruments have not been systematically reviewed.Methods and analysis This systematic review will include a comprehensive search of databases including PubMed, CINAHL, Embase, Cochrane Library, SCOPUS and Web of Science by using keywords and MeSH terms to identify relevant studies starting from each database inception to 1 January 2024 and covering papers in English. The search strategy will combine relevant keywords and database-specific subject headings related to the following concepts: (1) caregivers, (2) burden, stress, distress, (3) chronic kidney disease, end-stage kidney disease, dialysis. Reference lists of eligible articles will also be hand searched. We will include quantitative and qualitative studies evaluating measurement properties of instruments assessing caregiver burden in caregivers of adult patients (aged ≥18 years). Data will be extracted from the selected studies and analysed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist as the study quality assessment tool. Subsequently, the van der Vleuten utility index will be used to critique and categorise the instruments. A narrative that synthesises the utility of all instruments will be presented along with recommendations for the selection of instruments depending on specific clinical contexts. This systematic review will provide an overview of the measurement properties of available instruments, including discussion on reliability, validity and responsiveness. Results from the review may give rise to the subsequent development of most appropriate instrument that could be applied to the assessment of caregiver burden in advanced kidney disease.Ethics and dissemination Ethics approval is not required as this study will merely synthesise data from published studies. The results will be disseminated through peer-reviewed publications as well as conference presentations.PROSPERO registration number CRD42023433906.

BackgroundThe significance of studying Kinesiophobia, Limits of Stability (LOS), and functional balance in geriatric patients with CLBP and osteoporosis lies in their profound impact on rehabilitation outcomes and fall risk, ultimately affecting patients’ quality of life. This study aimed to examine LOS and functional balance in the geriatric population concurrently experiencing Chronic Low Back Pain (CLBP) and osteoporosis, in comparison to age-matched healthy controls; to assess the correlations between Kinesiophobia, LOS, and functional balance assessments; and to evaluate the mediating influence of Kinesiophobia on the association between LOS and functional balance tests.MethodsThis cross-sectional study included a total of 86 participants in each group. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK). LOS variables were evaluated with a computerized Iso-free platform in eight different directions. Functional balance was measured using the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS).ResultsPatients with CLBP and osteoporosis showed significantly lower LOS percentages (45.78 ± 6.92) and impaired Functional Balance, reflected in a TUG Score (10.45 ± 2.23), compared to asymptomatic controls (LOS: 76.95 ± 8.21; TUG: 8.73 ± 1.90). Kinesiophobia showed a significant moderate negative correlation with LOS, indicated by r = −0.362 (p

Introduction: This study presents a comprehensive design and analysis of a 300L steel fuel tank intended for heavy off-road vehicles. The design process integrates numerical simulations and experimental investigations to optimize the tank's performance and durability under various operating conditions.Methods: The design methodology involves CAD model optimization, numerical analysis setup, and experimental validation. CAD model optimization simplifies the tank geometry while retaining structural integrity. Numerical analysis setup includes defining boundary conditions, meshing strategies, and simulation parameters. Experimental validation entails testing the tank under dynamic loading conditions to assess its structural response.Results: Numerical simulations reveal insights into stress distribution, deformation behavior, and fluid dynamics within the tank. Experimental tests confirm the numerical predictions and provide valuable data for model validation. Key results include stress concentrations in critical areas, deformation patterns under different loading conditions, and fluid flow characteristics.Discussion: The integrated approach combining numerical simulations and experimental tests offers a comprehensive understanding of the fuel tank's behavior. Findings highlight areas for design improvement, such as reinforcement of stress-prone regions and optimization of fluid flow dynamics. The study contributes to enhancing the performance, reliability, and safety of fuel tanks for heavy off-road vehicles.

The objectives of this study are to compare hip muscle strength, hip joint proprioception, and functional balance between individuals with unilateral hip OA and asymptomatic individuals and to examine the relationships among these variables in the hip OA population. In a prospective cross-sectional study, 122 participants (unilateral Hip OA: n = 56, asymptomatic: n = 56) were assessed at the CAMS/KKU musculoskeletal Physical Therapy laboratory. Ethical standards were upheld throughout the research, with informed consent obtained. Hip muscle strength was measured using a hand-held dynamometer, hip joint proprioception with a digital inclinometer, and functional balance using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Hip OA individuals exhibited significantly lower muscle strength and proprioceptive accuracy, and poorer functional balance than controls (p < 0.003). Correlation analyses revealed a positive correlation between muscle strength and BBS scores (r = 0.38 to 0.42) and a negative correlation with TUG test times (r = -0.36 to -0.41). Hip joint reposition sense (JRS) in flexion showed a negative correlation with balance (r = -0.46), while JRS in abduction was positively correlated (r = 0.46). The study highlights the clinical importance of muscle strength and proprioception in functional balance among individuals with unilateral hip OA. The results support the incorporation of muscle strengthening and proprioceptive training in interventions to improve balance and mobility in this population.

Background: Limits of stability is required to perform functional activities and other advanced tasks of life without losing balance, and assessment of limits of stability is essential in clinical practice. Forward, Lateral, and Oblique direction reach tests are clinical balance tests that assess limits of stability, and these reach distances in various directions may be symmetrical or asymmetrical. The aim was to establish the symmetry between various reach distances on three reach tests and to establish the concurrent validity of oblique, forward, and lateral direction reach test distances with limits of stability measured by the Iso Free machine of TecnoBody company. Methods: The measurements of oblique, forward, and lateral reach tests and limits of stability excursions of center of pressure were taken in eight directions on Iso Free machine of Techno Body in fifty typical college-going young adults who were recruited through convenience sampling. Pearson correlation test was used to find the relationship between forward, lateral, and oblique direction reaches and limits of stability in forward, lateral, and oblique directions. Regression analysis was used to find the factors influencing the forward, lateral, and oblique reach tests. Results: The reach distances were symmetrical, and out of the three tests, the lateral and oblique direction reach tests have a moderate positive correlation with limits of stability test in lateral and oblique directions with an r-value of 0.569 (p

Background Post-stroke individuals are observed to have reduced limits of stability (LOS) in all directions. Functional activities are rarely performed in pure cardinal planes; instead, they are most likely to be performed in an oblique direction. Existing tools are either expensive or sophisticated to assess the LOS in an oblique direction. Therefore, this study’s primary objective is to evaluate the intra-rater, inter-rater reliability, and validity of the oblique direction reach test (ODRT) among stroke subjects. Materials & Methods A total of 96 first-time stroke patients with age, gender, height, and weight-matched healthy controls aged 18–80 years were recruited for the study. Oblique, forward, and lateral reach distances were assessed using the standard procedure of ODRT, Functional Reach Test (FRT), and Lateral Reach Test (LRT), respectively. Validity was tested by correlating the ODRT distance with the Berg Balance Scale (BBS) Score using Spearman’s rank correlation coefficient. Intraclass correlation coefficients (ICCs) and Bland Altman analysis were used to establish inter-rater reliability. ICCs were used to find intra-rater reliability. The Mann-Whitney U test was used to establish the mean difference of the FRT, LRT, and ODRT. Spearman’s rank correlation coefficient and linear regression were used to correlate the distance of FRT and LRT with ODRT. Results A high concurrent validity was found between BBS and ODRT with an r-value of 0.905 (p < 0.001). Inter-rater reliability was high with an ICC of 0.997 (95% CI [0.996–0.998]), and intra-rater reliability was highly significant with an ICC of 0.996 (95% CI [0.994–0.998]). The stroke subjects reached a significantly shorter distance than healthy individuals in FRT, ODRT, and LRT. ODRT was highly correlated with FRT (r = 0.985) and LRT (r = 0.978) (p < 0.001) and had an R2 = 0.987. Conclusion ODRT is a highly valid and reliable tool that can be used to evaluate balance in stroke patients. Individuals who reached less in the forward and lateral directions showed reduced reach distance in the oblique direction.

The world is grappled with an unprecedented challenges due to Corona virus. We are all battling this epidemic together, but we have not been able to defeat this epidemic yet. A new variant of this virus, named ‘Omicron’ is spreading these days. The fractional differential equations are providing us with better tools to study the mathematical model with memory effects. In this paper, we will consider an extended SER mathematical model with quarantined and vaccinated compartment to speculate the Omicron variant. This extended Susceptible Exposed Infected Recovered SER model involves equations that associate with the group of individuals those are susceptible (S), exposed (E): this class includes the individuals who are infected but not yet infectious, infectious (W): this class includes the individuals who are infected but not yet Quarantined, quarantined (Q): this class includes those group of people who are infectious, confirmed and quarantined, recovered (R) this class includes the group of individuals who have recovered, and vaccinated (V): this class includes the group of individuals who have been vaccinated. The non-negativity and of the extended SER model is analysed, the equilibrium points and the basic reproduction number are also calculated. The proposed model is then extended to the mathematical model using AB derivative operator. Proof for the existence and the uniqueness for the solution of fractional mathematical model in sense of AB fractional derivative is detailed and a numerical method is detailed to obtain the numerical solutions. Further we have discussed the efficiency of the vaccine against the Omicron variant via graphical representation.

This work is devoted to get a new family of analytical solutions of the (2+1)-coupled dispersive long wave equations propagating in an infinitely long channel with constant depth, and can be observed in an open sea or in wide channels. The solutions are obtained by using the invariance property of the similarity transformations method via one-parameter Lie group theory. The repeated use of the similarity transformations method can transform the system of PDEs into system of ODEs. Under adequate restrictions, the reduced system of ODEs is solved. Numerical simulation is performed to describe the solutions in a physically meaningful way. The profiles of the solutions are simulated by taking an appropriate choice of functions and constants involved therein. In each animation, a frame for dominated behavior is captured. They exhibit elastic multisolitons, single soliton, doubly solitons, stationary, kink and parabolic nature. The results are significant since these have confirmed some of the established results of S. Kumar et al. (2020) and K. Sharma et al. (2020). Some of their solutions can be deduced from the results derived in this work. Other results in the existing literature are different from those in this work.

Arterial cannulation is an essential procedure for invasive blood pressure measurement as well as repeated arterial blood gas sampling in intensive care unit setting. Common sites for placing an arterial cannula are the radial artery, femoral artery, brachial artery, and dorsalispedis artery. In certain situations such as in the case of prone ventilation, arterial cannula from common peripheral sites may get accidentally disconnected and it becomes very difficult for even a senior anesthesiologist to place an arterial cannula in the prone position. In those circumstances, an alternate site such as the popliteal artery may serve as a site for arterial cannulation. Therefore, here we present three cases of severe acute respiratory distress syndrome, whose arterial cannula was accidentally dislodged during prone ventilation maneuver and were successfully managed by ultrasound-guided popliteal artery cannulation.

Purpose: To map the interventions that have been implemented to promote voluntary human milk donation in India. Methods: A search was conducted on four electronic databases to locate studies published in English, from 2011 to 2022. We followed Arskey and O'Malley's ScR guidelines. Results: Four studies were included in this review. Interventions included PDSA cycles based on “quality improvement”, one to one lactation counseling, group counseling and focused counseling. Improvement in voluntary milk donation was observed in all four studies. Conclusion: The limited evidence demonstrated the need for curating more awareness interventions related to human milk donation and its usability.

BackgroundOsteoporosis, characterized by reduced bone mass and micro-architectural deterioration, poses a significant public health concern due to increased fracture susceptibility. Beyond bone health, this cross-sectional study aimed to assess and compare lower extremity proprioception and postural stability in individuals with and without osteoporosis and to explore their correlation within the osteoporosis group.MethodIn this prospective cross-sectional study, 80 participants were divided into two groups: osteoporosis (n = 40) and control (n = 40). The demographic characteristics and clinical parameters of the participants were as follows: Age (years) – Osteoporosis group: 65.04 ± 4.33, Control group: 65.24 ± 4.63; Sex (%) – Osteoporosis group: Male 30%, Female 70%; Control group: Male 30%, Female 70%; Body mass index (kg/m2) – Osteoporosis group: 23.7 ± 3.2, Control group: 24.5 ± 4.6; T-score (Lumbar) – Osteoporosis group: −2.86 ± 1.23, Control group: 0.27 ± 0.58; T-score (hip) – Osteoporosis group: −2.28 ± 0.79, Control group: 0.68 ± 0.86. Joint Position Sense (JPS) at the hip, knee, and ankle was assessed using a digital inclinometer, and postural stability was measured using computerized force platforms.ResultOsteoporosis participants exhibited higher errors in hip (5.63° vs. 2.36°), knee (4.86° vs. 1.98°), and ankle (4.46° vs. 2.02°) JPS compared to controls. Postural stability measures showed increased anterior–posterior sway (10.86 mm vs. 3.98 mm), medial-lateral sway (8.67 mm vs. 2.89 mm), and ellipse area (966.88 mm2 vs. 446.19 mm2) in osteoporosis participants. Furthermore, correlation analyses within the osteoporosis group unveiled significant positive associations between lower extremity proprioception and postural stability. Specifically, hip JPS exhibited a strong positive correlation with anterior–posterior sway (r = 0.493, p = 0.003), medial-lateral sway (r = 0.485, p = 0.003), and ellipse area (r = 0.496, p

High-Performance computing provides a new infrastructure for scientific calculation and its simulation. However, unbalanced load distribution among the processors causes a decreased performance in such computations, and creates a massive requirement of computing resource allocation, that requires an increased simulation. Therefore long-range resource utilization prediction becomes essential to achieve optimal performance in an HPC environment. This paper introduces a novel ensemble technique, which includes two algorithms, the Feature-based capability prediction algorithm(FBCA), and the Accuracy and Relative Runtime Error Prediction Algorithm (ARRE). A three-level architectural framework (the simulation environment, resource prediction, and resource queue) has also been proposed and tested on Phold and SoS. The proposed framework can deal with the requirements of computing and simulations. The FBCA algorithm reduces the redundancy between available features, and the ARRE algorithm ensures our ensemble technique’s effectiveness. We have compared the performance of the proposed schemes with other existing methods such as the Regressive Approach, Linear Regression and Random Forest, and found that our proposed algorithm achieves better accuracy from 8% to 18%.

Background: Acute kidney injury (AKI) is one of the common manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. An early identification of AKI is of paramount importance to modulate the management of AKI, limiting the severity, avoiding nephrotoxic medicines, and modifying the drug dose depending on renal function. Aim: To determine the utility of urinary mitochondrial deoxyribonucleic acid (umt-DNA) and neutrophil gelatinase-associated lipocalin (NGAL) in predicting coronavirus disease 2019 (COVID-19)-associated AKI and mitochondrial stress. Materials and Methods: Live-related renal transplant recipients (RTRs) (n = 66), who acquired SARS-CoV-2 infection and were admitted to a COVID hospital were included and subclassified into AKI (n = 19) with > 1.5-fold rise in serum creatinine level from the pre-COVID-19 serum creatinine level, and non-AKI (n = 47) whose serum creatinine value remained stable, or a rise of

Abstract Background Coronary artery bypass graft surgery (CABG) is one of the principle therapies for coronary artery disease, as it improves survival rate and quality of life (QoL). Polypropylene suture is commonly used in vascular and cardiac surgeries for anastomosis due to its long-term tensile strength and minimal tissue trauma. This study compared the clinical equivalence of Trulene® (Healthium Medtech Limited) and Prolene® (Ethicon-Johnson & Johnson) polypropylene sutures regarding incidence of myocardial infarction, stroke, renal failure and cardiac death (MACCE) occurring up to 26 weeks’ period post-CABG surgery. Methods This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (n = 89) was conducted between August 2020 and September 2021. The primary endpoint, post-surgery cumulative incidence of MACCE was evaluated. In addition, anastomotic revision, surgical site infection (SSI), operative time, length of post-operative hospital stay, repeat revascularization, intraoperative suture handling characteristics, time taken to return to work and resume normal day to day activities, subject satisfaction score and QoL, and other adverse events were also recorded. Results A total of 80 (89.89%) males and 9 (10.11%) females participated in the study. No incidence of MACCE was recorded in any of the study participants. Non-significant difference was observed in anastomotic revision, SSI, operative time, post-operative hospital stay, revascularization, return to work and normal day-to-day activities, subject satisfaction score and QoL, and intraoperative handling parameters (except ease of passage) between the treatment groups, Trulene® and Prolene®. Compared to screening visit, proportion of subjects with ‘no problems’ for each QoL dimension and the mean visual analogue scale increased with each subsequent follow-up visit. Conclusion Trulene® polypropylene suture is clinically equivalent to Prolene® polypropylene suture and is safe and effective for anastomosis construction in CABG surgery during a routine clinical procedure. Trial registration CTRI Registration No.: CTRI/2020/05/025157 (Registered on: 13/05/2020).

Objective To evaluate traumatic spondyloptosis cases for neurological, surgical, and outcome perspectives. Materials and Methods This retrospective study includes 17 patients of spondyloptosis admitted in our department between August 2016 and January 2020. Each patient was evaluated in terms of demographic profile, clinical presentation, duration of injury, mode of injury, associated injuries, level and type of spondyloptosis, spinal cord status, nociceptive and neuropathic pain severity, severity of injury based on International Standards for Neurological Classification of Spinal Cord Injury (ISNCSI) assessment, surgical approaches, complications, and outcome. Unpaired t- test and Chi-square test were used for statistical analysis. Values with p < 0.05 were considered statistically significant. Results Fall from height (58.8%) was the most common mode of injury. Most common level of spondyloptosis was T12–L1 (41.1%). Sagittal–plane spondyloptosis (76.5%) were more common than coronal–plane spondyloptosis (23.5%). Most common associated injury was musculoskeletal (64.7%). Neurological status of the patient at presentation (p = 0.0007) was significantly associated with outcome after 3 months of surgery/conservative management. Residual listhesis was present in 53.3% of patients postoperatively. Postoperative nociceptive pain (p = 0.0171) and neuropathic pain (0.0329) were significantly associated with residual listhesis. Duration of injury (p = 0.0228) was also significantly associated with postoperative residual listhesis. Conclusion Complete reduction of spondyloptosis should be the goal of surgery. Overall prognosis of spinal cord injury (SCI) due to traumatic spondyloptosis is poor.

Abstract The high-altitude alpine regions are characterized by highly variable and harsh environmental conditions. However, relatively little is known about the diverse mechanisms adopted by alpine plants to adapt to these stressful conditions. Here, we studied variation in transcriptome and physiological adjustments occurring across the year at high elevation environments in the leaf tissue of Rhododendron anthopogon, an evergreen shrub of Himalaya. The samples were collected at 12 different time-points, from August until snowfall in November 2017, and then from June to September 2018. It was observed that with a drop in both ambient air temperature and photoperiod towards onset of winter, the freezing resistance of plants increased, resulting in ‘cold acclimation’. Further, ‘de-acclimation’ was associated with a decrease in freezing resistance and increase in photosynthetic efficiency of leaves during spring. A considerable amount of variation was observed in the transcriptome in a time-dependent sequential manner, with a total of 9,881 differentially expressed genes. Based on gene expression profiles, the time-points could be segregated into four clusters directly correlating with the distinct phases of acclimation: non-acclimation (22-August-2017, 14-August-2018, 31-August-2018), early cold acclimation (12-September-2017, 29-September-2017), late cold acclimation (11-October-2017, 23-October-2017, 04-November-2017, 18-September-2018) and de-acclimation (15-June-2018, 28-June-2018, 14-July-2018). Cold acclimation was a gradual process, as indicated by presence of an intermediate stage (early acclimation). However, the plants can by-pass this stage when sudden decrease in temperature is encountered. The maximum variation in expression levels of genes occurred during the transition to de-acclimation, hence was ‘transcriptionally’ the most active phase. The similar or higher expression levels of genes during de-acclimation in comparison to non-acclimation suggested that molecular functionality is re-initiated after passing through the harsh winter conditions.

Recently, most of the conventional (industrial) materials such as steel, aluminum, and copper are being replaced by composite materials. Among the various composite materials, CFRP material is one of the most popular materials in many industries due to its excellent mechanical properties like-high strength, high modulus, compressive strength, etc. However, the micro hole in micro EDM drilling in the CFRP composite material is challenging due to fiber orientation, uneven distribution of conducting fiber, and delamination affecting the material removal rate (MRR) and micro hole quality performance. The objective of the article is to optimize the process parameters for optimum hole quality in the micro EDM drilling of CFRP composites. For this purpose, response surface methodology is applied to investigate the effect of the input process parameters which are voltage, capacitance, and tool rotation speed on material removal rate, roundness error, and tapper of the micro-hole. The experiments have been conducted according to the box behnken design of experiments. Regression equations, and response surfaces are developed. Optimum responses are determined by the desirability function approach. The experimental investigation shows that capacitance is the highly significant factor among the input process parameters affecting hole quality output responses such as material removal rate, roundness error, and tapper. The MRR increases with increasing the capacitance and tool rotation speed initially but its value decreases on further increasing the capacitance at a particular voltage. Roundness error and the tapper initially decrease on increasing capacitance and tool rotation speed then increases. The optimum material removal rate and hole quality are obtained in a range of 150–250 nF capacitance, and 1400–1600 rpm tool rotation speed, at 100 voltage.

Cervical proprioception and postural stability play crucial roles in maintaining optimal head and neck positioning, yet their relationship and implications in cervical spondylosis (CS) remain underexplored. This study aims to investigate cervical proprioceptive reposition errors, limits of stability, and their association in individuals with CS while considering the mediating effects of pain and kinesiophobia. The primary objectives are to compare cervical proprioceptive reposition errors and limits of stability variables between individuals with CS and age-matched healthy controls, explore their associations within the CS group, and determine the mediating roles of pain and kinesiophobia. A cross-sectional study recruited 60 individuals with CS and 60 healthy controls. Cervical joint reposition errors (JREs) were assessed using a cervical range-of-motion device, while limits of stability were evaluated using a computerized dynamic posturography system. Pain, kinesiophobia, and demographic data were collected. Parametric tests, correlation analyses, and multiple regression were employed for data analysis. Individuals with CS exhibited significantly higher cervical JREs in flexion, extension, and rotation compared with healthy controls (p < 0.001). Within the CS group, correlations revealed associations between JREs and limits-of-stability variables (p < 0.05). Mediation analysis demonstrated significant direct and indirect effects of pain and kinesiophobia on the relationship between JREs and limits-of-stability variables in the CS group (p < 0.005). CS is associated with impaired cervical proprioception, increased reposition errors, and compromised postural stability. This study highlights the interplay between proprioception, stability, pain, and psychological factors, emphasizing the need for comprehensive interventions in individuals with CS to enhance functional outcomes and quality of life.