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Abstract Soil reinforcement is one of the techniques used to enhance the engineer characteristics of the soil. Various techniques can be employed to stabilise problematic soils, such as soft clay. These include the utilisation of portland cement, lime, fly ash, ground freezing, jet grouting, prefabricated vertical drains, and thermal approaches. Similarly, stone columns are one of the most popular methods for enhancing soil and have been adopted across the world to enhance bearing capacity and minimise total and differential settlements of structures built on soft clay. Additionally stone columns serving as vertical drains, thus accelerate consolidation process. But with higher demand of construction material and depletion of natural resources, there is a need of using waste products as a substitute to existing construction materials. In this paper, manufacturing waste like steel slag is used as a sustainable material for column infill and can be affordable and also address the current environmental concern which by removing solid waste… A series of numerical investigation was carried out to study the various behavioural characteristics of virgin soft clay bed, clay bed installed with ordinary steel slag column and also with encased steel slag column. A comparison was made among all for studying the various parameters such as settlement, excess pore water pressure, stress concentration ratio & lateral deformation of columns. more...

Purpose: The study was aimed to elucidate the incidence and associated risk factors for Retinopathy of Prematurity (ROP) in new-born babies in a tertiary care teaching hospital in North India. Methods: The present study was a prospective follow-up study involved in the screening of new-born babies who are at risk of developing ROP conducted in the Ophthalmology department of a teaching hospital in Jammu district, India. Results: During the course of the present study, 199 infants were screened and 13 were found to be having ROP. Incidence of ROP thus was 6.53%. Univariate analysis revealed that neonatal factors like birth weight, O2 supplementation >5 days, patent ductus arterious, sepsis and apnoea of prematurity were significantly associated with ROP (P < 0.05). C-PAP and mechanical ventilation (>5 days) were the only significant predictors for ROP on multivariate logistic regression. Conclusion: A relatively low incidence of ROP was observed with neonatal risk factors more significantly associated with ROP. The prevention of pre-term births and sustaining the gains in neonatal care should go a long way to reduce the incidence of ROP in infants. more...

Abstract Background With a growing number of elderly patients requiring elective and non-elective procedures, frailty-based preoperative risk stratification is an emerging tool in orthopedic surgery to minimize adverse postoperative outcomes. This paper sought to understand the current literature regarding preoperative Orthopedic Frailty Risk Stratification (OFRS) and describe the disparate frailty indices and their capabilities for discrimination in predicting adverse postoperative outcomes. Methods A literature search was conducted in Pubmed, Cochrane, and Scopus for articles published during or prior to February 2024 assessing frailty following surgery for orthopedic pathologies. Qualitative variables including study characteristics and application of frailty were collected and synthesized. Quantitative meta-analysis was performed for pooled odds ratio (OR) and area under the curve (AUC) of frailty for mortality and complications. All methods were performed in accordance with PRISMA guidelines. Results Of the 81 included articles, over half (52%) addressed traumatic orthopedic pathologies with traumatic hip fractures being the most studied in the OFRS (25 studies). Less common categories included oncology, sports, and foot/ankle. Functional status and independence were the most common frailty domain (25, 96.2%) and component across scales (20, 76.9%), respectively. The 5-Item Modified Frailty Index (mFI-5) was the most common frailty index (28 publications). Meta-analysis demonstrated increasing frailty was an independent predictor of mortality (30-day OR: 2.89, 95% CI: 2.00–4.18; 1 year OR: 1.81, 95% CI: 1.48–2.22, p more...

Background: Respectful maternity care (RMC) is increasingly being accepted as an essential element for health systems. Every childbearing woman has a right to get dignified and respectful healthcare. Initial research has highlighted that disrespect and abuse are widespread, however, there is a paucity of quantitative evidence. Materials and Methods: In this community-based cross-sectional study, among 485 participants, conducted in 28 villages of Northern India, we ascertained the experience of RMC during childbirth by using the person-centered maternity care (PCMC) scale. Results: The majority (88.7%) of women experienced RMC. The domain with the lowest score was communication and autonomy (62.9%), followed by supportive care (76.1%). Self-introduction by health providers, the position of choice during delivery, relief from pain, and availability of preferred companions during delivery were the deficient areas. Women who gave birth in private health facilities were more likely to receive RMC than those who gave birth in government facilities, while those belonging to marginalized social groups had lesser odds of receiving RMC as compared to other women. Conclusion: Communication skills should be promoted to maternity care providers. Self-introduction by healthcare providers and choice of position during delivery are the deficient areas, which should be focused upon. more...

Background: Given the paucity of literature in the Jammu region on intergenerational relationships that contribute to a connected society promoting empathy and family support, this study was undertaken to evaluate its effect on depressive symptoms in older parents. The aim of this study was to examine patterns of intergenerational relationships between aging parents and their adult children. Setting and design: A cross-sectional study conducted in Darsopur village in R S Pura block, Jammu district. Methods and Material: This cross-sectional study was conducted on 350 male and female adults living in Darsopur village in RS Pura block of Jammu district. Study participants were selected using two-stage simple random sampling. Results were determined by ANOVA and binary logistic regression using IBM SPSS Statistics for Windows, version 20.0. Results: The mean score with standard deviation for the Geriatric Depression Score was 3.97 ± 3.78, indicating a lower level of depressive symptoms. Binary logistic regression analysis revealed that consensual normative solidarity was inversely associated with depression. Conclusions: The present research results showed a higher mean score of solidarity between parents and their children, which can be attributed to the fact that the study was conducted in rural India. more...

Transition metal phosphides are crucial for various environmental and energy applications. In this study, porous Ni12P5 and Ni12P5-rGO were synthesized using a one-step solvothermal method. Red phosphorus served as the phosphorus source, while ethylene glycol acted as a capping agent to promote the formation of nanomaterials within a nitrogen-rich atmosphere. The catalytic performance of these materials was evaluated through their hydrogen evolution reaction (HER), oxygen evolution reaction (OER), and capacitance properties. Notably, Ni12P5-rGO exhibited Tafel slopes of 66 mV/dec for OER and 33 mV/dec for HER, indicating enhanced charge transfer efficiency compared to Ni12P5, which showed slopes of 78 mV/dec and 102 mV/dec, respectively. This improvement suggests that Ni12P5-rGO facilitates faster electron transfer, resulting in superior catalytic performance. Additionally, the synergistic effect of reduced graphene oxide (rGO) contributes to improved charge storage capabilities. The Ni12P5-rGO demonstrated a specific capacitance of 192 F/g, significantly higher than the 110 F/g observed for Ni12P5 at a current density of 1 A/g. Remarkably, these materials maintained their capacity over 5000 cycles, achieving a commendable 98 % coulombic efficiency. These findings highlight the potential of Ni12P5-rGO as an effective material for energy conversion and storage applications, showcasing its promising role in advancing the efficiency of related technologies. more...

BackgroundAndrogenetic alopecia (AGA) is extremely prevalent with a multifactorial etiology.MaterialsWe conducted a cross-sectional study using the All of US (AoU) dataset Sept 2024 to better understand the epidemiology, social determinants and management of AGA.ResultsMost males were 20-39 years old and females 60-69 years old. Men typically have an earlier onset of AGA than females. Male AGA is generally managed with finasteride; oral minoxidil is prescribed in younger males. Females are prescribed spironolactone and oral minoxidil with finasteride in post-menopausal females. There was very little dutasteride prescribed. Topical minoxidil is available over the counter and was not evaluated. Early in 2011 there were reports of the Post-Finasteride Syndrome (PFS); subsequently, the finasteride prescription rate fell to about 10-20% of the pre-PFS prescription rate. There was increased reporting for AGA in those who drink, have an annual household income ≥$75,000, and those with a higher level of education. There was also higher reporting of female AGA in those with anxiety and depression. Patients with higher income and education may have less pressing medical concerns enabling them to bring their AGA to the physician's attention. Females in whom the AGA affects their anxiety and depression may seek help for the AGA as a way to address their underlying disorder.ConclusionsThis study provides a snapshot of the epidemiology and management of AGA in the USA. AGA is linked to the social determinants of health; addressing the AGA may help better manage the underlying mental and physical state. more...

BackgroundThe COVID-19 pandemic had a severe impact globally, yet African populations exhibited unexpectedly lower rates of severe disease and mortality. We investigated the potential role of pre-existing immunity in shaping the epidemiology of COVID-19 in Africa.MethodsPlasma collected from Senegalese female sex workers prior to the COVID-19 pandemic was screened for SARS-CoV-2 and human coronavirus (hCoV) antibodies by virion immunoblots. For antibody-reactive plasma, paired peripheral blood mononuclear cells were stimulated by fusion proteins and IFN-γ cellular responses were assessed via ELISPOT.ResultsWe observed substantial levels of pre-existing cross-reactive immunity to SARS-CoV-2, stemming from prior exposure to seasonal hCoVs. Our antibody analysis revealed a 23.5% (47/200) seroprevalence rate against SARS-CoV-2 nucleocapsid (N). These samples were then probed for antibodies against hCoV spike (S) and/or N antigens; 85.1% (40/47), 70.2% (33/47), and 95.7% (45/47) were antibody reactive against hCoV-229E, hCoV-OC43, or hCoV-HKU1, respectively. Our analysis of cellular responses also demonstrated cross-reactivity to SARS-CoV-2 with 80.0% (36/45) and 82.2% (37/45) showing IFN-γ responses against S and N, respectively. A unique pre-pandemic subject had cross-reactive SARS-CoV-2 S antibodies with detectable neutralization and cross-reactive cellular responses.ConclusionThese findings suggest that prior hCoV exposure may induce cross-reactive adaptive immunity, potentially contributing to protection against COVID-19. Our study provides unique data on the dynamics of hCoV and SARS-CoV-2 immunity in Senegal and underscores the importance of understanding the role of pre-existing immunity in shaping COVID-19 outcomes globally. more...

Onychomycosis is a common, difficult to treat nail disorder. Our objective was to explore disparities in current clinical management practices for onychomycosis in patients from underrepresented groups and with specific comorbidities. We conducted a cross-sectional study using the All of Us (AoU) research program. The AoU program gathers survey, and electronic health records from participants in the United States with the aim of increasing the representation of minorities groups in health research under the framework of precision medicine. We identified 18,763 onychomycosis patients (2017-2022) and compared the rates of diagnostic testing, prescription medications and surgical procedures. Younger patients were more likely to receive oral medications, while older patients were more likely to undergo surgical nail procedures. Patients with lower income and education, Black and Hispanic patients were less likely to receive testing to confirm diagnosis, and less likely to receive prescription medications (topical and/or oral) except in the case of fluconazole. Lower income and education were associated with a higher likelihood of debridement and trimming procedures, while Black and Hispanic patients were less likely to undergo these procedures. Patients with disabilities also received different treatments when compared to able-bodied individuals, being less likely to receive ciclopirox, efinaconazole and terbinafine, but more likely to undergo debridement and trimming procedures. There are clear differences in the management of onychomycosis in the different demographic and comorbid populations that we studied. Efforts to reduce these inequalities, such as expanded health coverage, reducing communication barriers and increasing patient and physician education are needed. more...

The scope of the emerging field of Ayurvedic-biology visualized thus far is confined to studies on dimensions pertaining to clinical and experimental pharmacology, basic trans-disciplinary science and drug design. However, given the multiple facets of classical Ayurveda knowledge system, its application in the field of organic agriculture perhaps also needs to be urgently explored. The urgency is due to the growing public acceptance of Ayurveda as a preferred clinical choice for well-being and disease management. The turnover of the sector across manufacturing and health services is estimated to be around Rs.1,00,000 crores per annum. Medicinal plants today and in the coming decade will therefore be required in large volumes and given that their applications are solely for enhancing health of humans, livestock (Pashu Ayurveda) and crops (Vriksh Ayurveda), it is imperative that they be cultivated in an organic manner employing the fusion of best available inter-cultural knowledge.The Ayurvedic subjects relevant for organic agriculture are Desh vichar, Dravya guna Shastra and Vriksh Ayurveda. From the perspective of modern biology subjects like soil micro biome, genetics, plant physiology and the natural geographical distribution of species are relevant.It must be stated at the very outset that this article is largely theoretical. While experiments in Vriksh Ayurveda have been attempted on a small scale, the fusion of Ayurveda and biology for improving organic agriculture of medicinal plants has thus far not been systematically explored. more...

Neurocognitive impairment is an important cause of HIV-associated morbidity. The advent of antiretroviral therapy (ART) has shifted the spectrum of HIV-associated cognitive impairment from HIV-associated dementia to milder forms of cognitive impairment. Independent replication of HIV within the central nervous system in those on effective ART with peripheral suppression is a recognised phenomenon known as cerebrospinal fluid (CSF) HIV RNA escape. CSF HIV RNA escape is independently associated with neurocognitive impairment but has also been detected in asymptomatic persons with HIV. The current consensus for management of CSF HIV RNA escape is based on expert opinion rather than empirical evidence. The current evidence suggests having a low threshold to investigate for CSF HIV RNA escape and optimising ART based on resistance profiles. The use of central nervous system (CNS) penetration effectiveness scores is no longer recommended. The evidence for statins, SSRIs, minocycline, lithium and valproate is limited to small-scale studies. There are potential new developments in the form of nanoparticles, Janus Kinase inhibitors and latency reversal agents. more...

Background/Objectives: In an 18- to 24-month Treatment Phase with once-daily efinaconazole 10% solution, subjects with onychomycosis showed an increased rate of cure at Month 24 versus the phase III trials. In order to further improve efficacy, we initiated an extended intermittent efinaconazole Maintenance Phase with use 2–3 times weekly for an additional 24 months from Month 24 to Month 48. These are the first data presented for a 48-month efinaconazole use period. Methods: For patients completing 18–24 months of once-daily efinaconazole, the target great toenail from the Treatment Phase was graded as ‘Clinical Cure’ (≤10% affected area) or ‘No Clinical Cure’ (>10% affected area) at Month 24. Mycological and clinical outcomes were assessed every 4 months from Month 24 to Month 48. There were 35 patients who enrolled in the extension and continued intermittent efinaconazole use to Month 48. Patients with ‘Clinical Cure’ at M24 were reviewed for sustained cure at M48; patients with ‘No Clinical Cure’ were reviewed for development of ‘Cure’ at M48. All patients were reviewed at all visits for adverse events that may be related to efinaconazole use. Results: ‘Clinical Cure’ was found in 6 of 35 enrolled patients at Month 24, and clinical cure status was sustained to Month 48 with intermittent efinaconazole maintenance use. For 29 patients with ‘No Clinical Cure’, 3/29 achieved ‘Clinical Cure’ status at Month 48 with intermittent efinaconazole. Effective Cure and Complete Cure rates improved over the maintenance period to Month 48 in subjects without clinical cure at Month 24. Younger patients showed higher cure rates over the maintenance period, but age group cure differences did not reach statistical significance in this dataset, and 49% of the ≥70-year population had at least a 20% reduction in nail area with maintenance therapy to Month 48. There was only 1 case of possible efinaconazole application site reaction in the Intermittent Maintenance Period to Month 48; prolonged efinaconazole use to Month 48 does not appear to increase the risk of reaction. Efinaconazole use periods are associated with very low positive culture rates in this dataset, including typical contaminant organisms, suggesting efinaconazole presence in the nail plate is providing prophylactic therapy. Conclusions: Intermittent efinaconazole may provide suitable prophylaxis of onychomycosis relapse. Prolonged efinaconazole therapy to Month 48 appears to be safe for all ages and can continue to provide prophylaxis of onychomycosis with Intermittent Maintenance use beyond Month 24 to Month 48. more...

We find the comment on the article titled “Diabetic Foot and Fungal Infections: Etiology and Management from a Dermatologic Perspective” informative and wish to thank the authors for their added insight on this complex topic [...] more...

Up to one-quarter of the United States population is affected by tinea pedis (athlete’s foot). Tinea pedis of the web space (interdigital tinea pedis) is a common clinical presentation causing skin macerations and fissures. A “dermatophytosis complex” (i.e., concomitant bacterial colonization) further complicates treatment. Here, we examined records of 14,429 skin specimens taken from the feet of dermatology and podiatry outpatients over a 4.6-year period; all specimens were subjected to multiplex qPCR diagnosis for the detection of dermatophytes, Candida, Corynebacterium minutissimum, Pseudomonas and Staphylococcus aureus. A literature search was conducted to review the reported prevalence of fungal and bacterial agents. In both interdigital and plantar foot specimens, dermatophytes (33.3–33.8%) and S. aureus (24.3–25%) were found to be the predominate pathogens. In the interdigital space, a higher prevalence of C. minutissimum (15.7% vs. 7.9%) and Pseudomonas (23.5% vs. 9.6%) was found. The detection of Pseudomonas was more likely to be observed in the presence of Candida, reflecting a higher risk of mixed infection. In dermatophyte-positive specimens, the “dermatophytosis complex” variant was observed at 45.5% (SD: 2.3). An analysis of patient characteristics showed male patients exhibiting higher likelihoods for dermatophyte, C. minutissimum, Pseudomonas and S. aureus detections. The elderly were disproportionately infected with Candida. In children, an S. aureus detection was more common, which could be attributed to impetigo. The recent literature lacks reporting on concomitant bacterial colonization in tinea pedis patients, likely due to the reliance on fungal culture supplemented with antibiotics. Geographical variation has been identified in the detection of the Trichophyton mentagrophytes complex. In conclusion, PCR diagnosis serves as a valuable tool for the management of tinea pedis. An accurate and timely detection of fungal pathogens and concomitant bacterial colonization can better inform healthcare providers of appropriate treatment selection. more...