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In heart failure, sympathetic overdrive is evidenced by norepinephrine spillover, receptor level changes, etc. Beta-blockers continue to be the cornerstone of treatment in patients with chronic heart failure due to their ability to counteract sympathetic overdrive. Extensive clinical research has demonstrated that long-term beta-blocker treatment with metoprolol succinate, carvedilol, or bisoprolol enhances left ventricular function and reverses left ventricular remodeling, decreases hospitalization risk, and increases survival. The aim of this consensus paper is to identify patient profiles, initiation or up-titration of beta-blockers and benefits of chirally pure beta-blocker in patients with heart failure. This expert consensus will ensure precise implementation of beta-blockers in heart failure as a part of guideline-directed medical therapy., (© Journal of the Association of Physicians of India 2024.)

The infusion of nanotechnology into cosmetic formulations marks a transformative shift in beauty science. Although Raymond Reed originally used the word "cosmeceutical," Dr. Albert Kligman popularised the idea in the late 1970s. Cosmetic Nano Wonders are redefining skincare by leveraging nanomaterials to enhance the stability, delivery, and efficacy of active ingredients. The paradigm shift holds promise for overcoming longstanding challenges in traditional cosmetic formulations. This article aims to explore and showcase the revolutionary impact of nanotechnology on the cosmetic industry. Focusing on key nanocarriers, such as liposomes and nanoparticles, our objective is to illuminate how nanotechnology elevates the performance of beauty products, providing advanced solutions for skincare concerns. This revolution promotes sustainability through green synthesis techniques and enables more accurate and effective therapies for a variety of skin issues, including acne and ageing that raises the bar for safety and innovation in the cosmetics business by enhancing product performance and environmental impact. Conducting a thorough literature review, we analyze recent scientific studies and industry reports to unveil the mechanisms and applications of nanotechnology in cosmetics. Special attention is given to the role of nanocarriers in stability enhancement, targeted delivery, and controlled release, unraveling the methods that drive the transformative potential of Cosmetic Nano Wonders. The database sources are Scopus, PubMed, Google Scholar, and Google Patents. The examination of recent research underscores the tangible benefits of nanotechnology in cosmetics. Cosmetic Nano Wonders demonstrate superior stability, enhanced penetration into skin layers, and controlled release mechanisms, showcasing their potential to revolutionize beauty science and address longstanding challenges in skincare. Cosmetic Nano Wonders represent a groundbreaking shift in beauty science, offering unprecedented possibilities for formulators and consumers. As nanotechnology continues to reshape cosmetic formulations, the future holds the promise of safer, more effective, and personalized skincare solutions, ushering in a new era in beauty science., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

TCF1 high progenitor CD8 + T cells mediate the efficacy of immunotherapy; however, the mechanisms that govern their generation and maintenance are poorly understood. Here, we show that targeting glycolysis through deletion of pyruvate kinase muscle 2 (PKM2) results in elevated pentose phosphate pathway (PPP) activity, leading to enrichment of a TCF1 high progenitor-exhausted-like phenotype and increased responsiveness to PD-1 blockade in vivo. PKM2 KO CD8 + T cells showed reduced glycolytic flux, accumulation of glycolytic intermediates and PPP metabolites and increased PPP cycling as determined by 1,2- 13 C glucose carbon tracing. Small molecule agonism of the PPP without acute glycolytic impairment skewed CD8 + T cells toward a TCF1 high population, generated a unique transcriptional landscape and adoptive transfer of agonist-treated CD8 + T cells enhanced tumor control in mice in combination with PD-1 blockade and promoted tumor killing in patient-derived tumor organoids. Our study demonstrates a new metabolic reprogramming that contributes to a progenitor-like T cell state promoting immunotherapy efficacy., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Background: Synoptic operative reports (SORs) are checklists or templates that contain standardized elements of an operation. These elements are associated with standardized inclusion of critical elements of the operative report that translate into numerous potential benefits. Whereas SORs for melanoma, breast, and colorectal cancer surgery have already been widely implemented, similar templates for hepato-pancreato-biliary (HPB) cancer surgery are currently lacking., Methods: An anonymous voluntary online survey was distributed to HPB attendings and fellows at HPB and complex general surgical oncology (CGSO) fellowship programs., Results: The 54 participants in this study comprised 31 (57%) HPB surgery attendings, 15 (28%) HPB surgery fellows, and 8 (15%) CGSO fellows. Notably, only six (11%) participants reported consistent use of an HPB SOR. The most commonly reported barriers to SOR uptake were the "lack of a readily available template" (55%) and the "lack of consensus/guidelines" (49%). Despite these limiting factors, a majority of respondents indicated a strong willingness to use a standardized and readily available HPB SOR (mean, 4.13/5 ± 1.23). This interest did not differ between attendings and fellows (p = 0.52) or between the participants stratified by surgical experience (p = 0.58). Finally, the participants were provided a comprehensive list of possible elements to incorporate into a standardized pancreatic and hepatobiliary SOR. After the exclusion of elements with less than 75% agreement, the pancreatic SORs included 17 (57%) of 30 possible elements, and the hepatobiliary SORs included 19 (76%) of 25 possible elements., Conclusion: Broad consensus on several elements of the HPB SOR suggests that uptake should be accelerated in HPB surgery., (© 2024. Society of Surgical Oncology.)

Background: Eye care organizations and professionals worldwide are increasingly focusing on bridging the gap between population health and medical practice. Recent advances in genomics and anthropology have revealed that most Indian groups trace their ancestry to a blend of 2 genetically distinct populations: Ancestral North Indians, who share genetic affinities with Central Asians, Middle Easterners, Caucasians, and Europeans; and Ancestral South Indians, genetically distinct from groups outside the Indian subcontinent. Studies conducted among North Indian populations can therefore offer insights that are potentially applicable to these diverse global populations, underscoring significant implications for global health., Objective: The Bodhya Eye Consortium is a collaboration among 8 high-volume nonprofit eyecare organizations from across North India. The consortium aims to harness real-world data consistently and with assured quality for collaborative research. This paper outlines the formation of the consortium as a proposed model for controlled collaborative research among the leading eyecare organizations of North India., Methods: We detail the creation and effective implementation of a consortium following a structured road map that included planning and assessment, establishing an exploratory task force, defining specialty areas, setting objectives and priorities, and conducting a SWOT (strengths, weaknesses, opportunities, and threats) analysis. Central to this process was a comprehensive data audit aimed at standardizing data collection across all participating organizations., Results: The consortium currently comprises 9 organizations, each represented in the governance structure by the Governing Council. Scientific standards for published research are established and overseen by the Scientific Committee, while the Conflict Resolution Committee manages any unresolved disputes. The consortium's working groups, organized by various eyecare specialties, collaborate on research projects through virtual interactions. A foundational step in this process was the organizationwide data audit, which revealed that most organizations complied with accurate and standardized data collection practices. Organizations with deficiencies in data completeness developed action plans to address them. Subsequently, the consortium adopted data collection proformas, contributing to the publication of high-quality manuscripts characterized by low dropout rates., Conclusions: The collaborative research conducted by the Bodhya Eye Consortium-a group of high-volume eyecare organizations primarily from North India-offers a unique opportunity to contribute to scientific knowledge across various domains of eyecare. By leveraging the established heterogeneity of anthropological and genomic origins within the population, the findings can be generalizable, to some extent, to European, Middle Eastern, and European American populations. This access to potentially invaluable, generalizable data has significant global health implications and opens possibilities for broader collaboration. The model outlined in this descriptive paper can serve as a blueprint for other health care organizations looking to develop similar collaborations for research and knowledge sharing., (©Ishaana Sood, Shalinder Sabherwal, Umang Mathur, Elesh Jain, Madhu Bhadauria, Deepshikha Agrawal, Ashi Khurana, Vikas Mittal, Avinash Mahindrakar, Vishal Govindahari, Sucheta Kulkarni, Ken K Nischal. Originally published in the Online Journal of Public Health Informatics (https://ojphi.jmir.org/), 30.09.2024.)

Multiple sclerosis (MS) is an unceasing, demyelinating, idiopathic inflammatory, and neurodegenerative disease of the Central Nervous System (CNS.) The disease is characterized by the occurrence of neurological symptoms over a period of days to weeks, abide by partial or absolute diminutions of various durations. In this review, a concise outline on disease activity and progression of MS, pathogenesis with the special prominence on the biomarkers for the MS as therapeutic targets has been discussed by carrying out a comprehensive literature survey employing chief websites and search engines for investigation. Cortical inflammation, neurodegeneration, demyelination, axonal injury, axonal loss, oligodendrocytes, mitochondrial dysfunction, microglia activation, oxidative and nitrosative stress are the pathological hallmarks of the MS. CNS neurofilaments, chitinase and chitinase 3-like proteins, soluble circulating form (sCD163), Chemokine ligand 13 (CXCL13), immunoglobulin M, MicroRNA (miRNA) and messenger Ribonucleic Acid (mRNA), Glial fibrillary acidic protein (GFAP), serum osteopontin, 8-iso-prostaglandin F2α (8-iso-PGF2 α), apo-Lipoprotein E and myelinreactive T cells are some of the therapeutically valuable biomarkers for such multifarious disorder. MS is one of the chronic neurodegenerative diseases with undefined etiology. The study of the pathophysiology of the disease and the involvement of certain biomarkers can help identify new targets for therapeutic intercession, identify individuals at risk of developing the disease later in life, and allow more effective treatment of progressive diseases such as MS., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The incidence of heart failure (HF) in India is estimated to be 0.5-1.7 cases per 1,000 people per year, and approximately 4,92,000-1.8 million new cases are detected every year. Despite the high rate of mortality associated with HF, most patients do not receive maximal guideline-directed medical therapy (GDMT). Current guidelines advocate early multidrug combination therapy with four classes of drugs, namely, beta-blockers (BBs), mineralocorticoid receptor antagonists (MRAs), angiotensin receptor-neprilysin inhibitors (ARNIs), and sodium-glucose transport protein 2 inhibitors (SGLT-2is), particularly in patients with heart failure with reduced ejection fraction (HFrEF). ARNIs reduce cardiac morbidity and mortality in patients with HFrEF. However, recent data indicated that only 4.8% of patients with HFrEF receive ARNI in India. Hence, at a national consensus on HF meeting, cardiology experts from India formulated a national consensus on the use of ARNI in HF based on current evidence and guidelines. The consensus states that ARNI should be used early in HF, particularly in de novo patients with HFrEF, and those with acute decompensated heart failure (ADHF), irrespective of the presence of low systolic blood pressure (SBP) or diabetes. Moreover, those with HFrEF on renin-angiotensin-aldosterone system (RAAS) inhibitors should be switched to ARNI to reduce the risk of repeated hospitalization for HF, worsening HF, and cardiac death, and to improve the quality of life (QoL). Starting ARNI during the first hospitalization is preferable, and it is safe and effective across all doses. ARNIs can also be used for secondary benefits in patients with preserved ejection fraction [heart failure with preserved ejection fraction (HFpEF)] and HF with mildly reduced EF [heart failure with mildly reduced ejection fraction (HFmrEF)]., (© Journal of the Association of Physicians of India 2024.)

Genetic testing is the gold standard for diagnosing different epidermolysis bullosa (EB) subtypes; however, testing rates are low. We conducted a pilot study to test feasibility of a novel, home-based registry that involved patients with EB submitting self-reported clinical symptoms using secure, online surveys (REDCap) and submitting buccal swabs for exome sequencing of EB-related genes (GeneDx). In total, 50 EB participants were enrolled, with an average age of 17 years and an average distance of 198 miles from EB specialty centers. All buccal swabs (N = 24) provided sufficient DNA for sequencing without causing mucosal trauma and 80% of participants were found to have pathogenic variants in COL7A1, the gene mutated in DEB. Participants with recessive dystrophic EB (RDEB) reported a higher prevalence of esophageal dilations (65.7% vs. 0%, p = .009) and mitten deformities of the feet (57.1% vs. 0%, p = .047) compared to non-RDEB participants., (© 2024 Wiley Periodicals LLC.)

The present article describes a novel surgical technique of a primary mini-capsulorhexis in midperiphery to minimize surgical complications in white intumescent cataracts. Patients with white mature cataracts with a convex anterior capsule or swollen lens fibers were selected. An initial puncture was made 3-4 mm away from the center, in the midperipheral anterior capsule, with a conventional cystitome. A mini-capsulorhexis (2-2.5 mm) was created. Loose cortical matter and fluidic contents were aspirated to reduce the intralenticular pressure. Two cuts were made at the margin of the mini-capsulorhexis, and an adequately sized secondary rhexis was completed, after which phacoemulsification was done. A circular curvilinear capsulorhexis was successfully achieved in all cases, including those with a small pupil. Rhexis could be completed in a patient where an initial extension occurred due to head movement. This refined technique aims to enhance the safety and precision of capsulorhexis in intumescent cataracts, thereby reducing the risk of complications such as the Argentinian flag sign. Further exploration and validation of this approach through clinical trials are warranted to establish its efficacy and safety profile., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

RA is characterized by chronic inflammation, joint damage, and systemic complications. Despite available treatments, many patients experience inadequate responses or adverse effects. Novel therapeutic strategies are needed to address these challenges. Nanoparticulate technologies offer promising opportunities to enhance drug delivery and targeting in RA treatment. The main objective is to explore recent advancements in nanoparticulate technologies for RA treatment, focusing on their potential to improve drug delivery and efficacy while minimizing adverse effects. This review examines recent studies on nanoparticulate technologies for treating rheumatoid arthritis (RA), focusing on the use of nanocarriers for targeted drug delivery. Studies investigating the effectiveness of nanocarriers in delivering drugs specifically for RA treatment were included in the analysis. Nanoparticulate technologies have shown promise in improving the delivery and efficacy of RA treatments. Various nanocarriers, such as liposomes, polymeric nanoparticles, and micelles, have been developed to enhance drug delivery to inflamed joints. These nanocarriers loaded with curcumin, Aceclofenac, Boswellic acid, methotrexate, resveratrol, etc. can improve drug stability, prolong circulation time, and enhance targetability to inflamed tissues. By overcoming the limitations of traditional therapies, these technologies have the potential to improve patient outcomes and quality of life. Future research should focus on optimizing nanocarrier design, evaluating long-term safety, and conducting clinical trials to validate their efficacy in RA management., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The process of brain tumour segmentation entails locating the tumour precisely in images. Magnetic Resonance Imaging (MRI) is typically used by doctors to find any brain tumours or tissue abnormalities. With the use of region-based Convolutional Neural Network (R-CNN) masks, Grad-CAM and transfer learning, this work offers an effective method for the detection of brain tumours. Helping doctors make extremely accurate diagnoses is the goal. A transfer learning-based model has been suggested that offers high sensitivity and accuracy scores for brain tumour detection when segmentation is done using R-CNN masks. To train the model, the Inception V3, VGG-16, and ResNet-50 architectures were utilised. The Brain MRI Images for Brain Tumour Detection dataset was utilised to develop this method. This work's performance is evaluated and reported in terms of recall, specificity, sensitivity, accuracy, precision, and F1 score. A thorough analysis has been done comparing the proposed model operating with three distinct architectures: VGG-16, Inception V3, and Resnet-50. Comparing the proposed model, which was influenced by the VGG-16, to related works also revealed its performance. Achieving high sensitivity and accuracy percentages was the main goal. Using this approach, an accuracy and sensitivity of around 99% were obtained, which was much greater than current efforts., (© 2024. The Author(s).)

Motion sickness also known as kinetosis is a condition in which there exists a disagreement between visually perceived movement and the vestibular system's sense of movement. Nausea, vomiting, dizziness, fatigue, and headache are the most common symptoms of motion sickness. This study mainly focuses on the taste masking of Promethazine Hydrochloride (PMZ) by inclusion complexation method, its formulation development in the chewing gum form by using directly compressible gum base HIG® and its quality and performance testing. Different molar ratios (1:1, 1:2, 1:3 and 1:4) of PMZ-cyclodextrin complexes were prepared by using β-Cyclodextrin (β-CD) as a taste masking agent. These complexes were evaluated for FTIR, DSC, % Entrapment Efficiency, % drug yield, and taste evaluation by E-Tongue. The optimized ratio was further evaluated by sophisticated analytical techniques such as Scanning Electron Microscopy (SEM) and X-Ray Diffraction (XRD). A central composite design (CCD) (3 ^2) was utilized to examine the effects of independent variables (amount of gum-X 1 and amount of plasticizer-X 2 ) on dependent variables (%CDRY 1 and hardness Y 2 ). The prepared gums were evaluated for drug content, organoleptic properties, in-vitro dissolution testing by fabricated disintegration apparatus, texture analysis, etc. The optimization statistics showed that on decreasing the amount of gum, in- vitro drug release increases and hardness decreases. The optimized batch MCG-2 of Promethazine MCG showed 92.34 ± 0.92% of drug release, whereas for marketed formulation (Phenergan®-25 mg) drug release value was 86.19 ± 1.88%. Results provided evidence that PMZ MCGs could be a better alternative to conventional tablet formulations with improved drug release, palatability and texture., (© 2024. The Author(s), under exclusive licence to American Association of Pharmaceutical Scientists.)

Chronic kidney disease (CKD) is a major contributor to morbidity and mortality in India. CKD often coexists with heart failure (HF), diabetes, and hypertension. All these comorbidities are risk factors for renal impairment. HF and CKD are pathophysiologically intertwined, and the deterioration of one can worsen the prognosis of the other. There is a need for safe renal pharmacological therapies that target both CKD and HF and are also useful in hypertension and diabetes. Neurohormonal activation achieved through the activation of the sympathetic nervous system (SNS), the renin-angiotensin-aldosterone system (RAAS), and the natriuretic peptide system (NPS) is fundamental in the pathogenesis and progression of CKD and HF. Angiotensin receptor neprilysin inhibitor (ARNi), sodium-glucose cotransporter 2 inhibitors (SGLT-2i), and selective β1-blocker (B1B) bisoprolol suppress this neurohormonal activation. They also have many other cardiorenal benefits across a wide range of CKD patients with or without concomitant HF, diabetes, or hypertension. This consensus statement from India explores the place of ARNi, SGLT-2i, and bisoprolol in the management of CKD patients with or without HF and other comorbidities., (© Journal of the Association of Physicians of India 2024.)

Objective: In 2016, the Lipid Association of India (LAI) developed a cardiovascular risk assessment algorithm and defined low-density lipoprotein cholesterol (LDL-C) goals for prevention of atherosclerotic cardiovascular disease (ASCVD) in Indians. The recent refinements in the role of various risk factors and subclinical atherosclerosis in prediction of ASCVD risk necessitated updating the risk algorithm and treatment goals., Methods: The LAI core committee held twenty-one meetings and webinars from June 2022 to July 2023 with experts across India and critically reviewed the latest evidence regarding the strategies for ASCVD risk prediction and the benefits and modalities for intensive lipid lowering. Based on the expert consensus and extensive review of published data, consensus statement IV was commissioned., Results: The young age of onset and a more aggressive nature of ASCVD in Indians necessitates emphasis on lifetime ASCVD risk instead of the conventional 10-year risk. It also demands early institution of aggressive preventive measures to protect the young population prior to development of ASCVD events. Wide availability and low cost of statins in India enable implementation of effective LDL-C-lowering therapy in individuals at high risk of ASCVD. Subjects with any evidence of subclinical atherosclerosis are likely to benefit the most from early aggressive interventions., Conclusions: This document presents the updated risk stratification and treatment algorithm and describes the rationale for each modification. The intent of these updated recommendations is to modernize management of dyslipidemia in Indian patients with the goal of reducing the epidemic of ASCVD among Indians in Asia and worldwide., Competing Interests: Declaration of competing interest Raman Puri: Boehringer Ingelheim, Novartis Manish Bansal: Sun Pharmaceuticals, USV, Dr Reddy's Labs, Cipla, Eris Lifesciences, Intas Pharmaceuticals, AstraZeneca Pharma India, Novartis Vimal Mehta: Institutional research grants from Amgen, Boehringer Ingelheim, Novo Nordisk, Eli Lilly, LIB Therapeutics, AstraZeneca, Torrent P Barton Duell: Advisory activities: Akcea/Ionis, Esperion, Regeneron, Kaneka, Novo Nordisk. Institutional grants: Regeneron, Regenxbio, Retrophin/Travere Nathan Wong: Research support through UC Irvine: Regeneron, Novo Nordisk, Novartis, Eli Lilly, Consultant: Novartis, Ionis, Agepha SS Iyengar: Reddy's Lab, Amgen, Emcure, Glenmark, Boehringer Ingelheim, Pfizer, Novartis Devaki Nair: Novartis, Daichi Sankyo Krishnaswami Vijayaraghavan: Amgen, AstraZeneca, Boehringer Ingelheim, Esperion, Novo Nordisk, Pfizer V Mohan: Servier, MSD, Novo Nordisk, Novartis, Eli Lilly, USV, Lifescan J & J, Sanofi Aventis, Merck, Boehringer Ingelheim, Abbott, Several Indian Pharmaceutical companies Shashank Joshi: Biocon, Cadilla, Twin Health, Glenmark, Torrent, Marico, MSD, Novo Nordisk, Sanofi, Boehringer Ingelheim, Abbott, AstraZeneca, USV, Alkem, Serdia Saumitra Ray: Merck, Novartis, Boehringer Ingelheim, Astra Zeneca, Novartis Sandeep Bansal: Novo Nordisk, Vascular Innovations Co. Ltd, Bayer, Portico India, ICMR SN Narasingan: IPCA, Novartis, USV, Torrent, SUN Pharma J C Mohan: Novartis, Lupin, Sun pharmaceuticals, Astra Zeneca, Intas, Le Servier, Sanofi Other authors report no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

Rheumatoid Arthritis (RA) is an inflammatory disease that causes severe joint destruction and persistent inflammation. This review aims to evaluate the efficacy, safety, and mechanisms of action of various herbal interventions in managing RA, providing valuable insights for patients and healthcare practitioners. To investigate the anti-inflammatory and antioxidant properties of selected herbal interventions, including turmeric, ginger, Boswellia serrata (frankincense), green tea, and Ashwagandha, to assess their potential as complementary treatments for RA, a comprehensive analysis is performed on the anti-inflammatory mechanisms and antioxidant effects of selected herbs. Emphasis is placed on the modulation of key inflammatory pathways and their ability to counteract oxidative stress, which are crucial factors in RA progression. Safety profiles and potential adverse effects of herbal remedies are also scrutinized. The review reveals promising evidence supporting the efficacy of turmeric and ginger in alleviating RA symptoms by modulating inflammatory pathways. Additionally, Boswellia serrata shows potential as an adjunct therapy for joint health and inflammation. The antioxidant-rich properties of green tea and Ashwagandha are highlighted, suggesting their role in counteracting oxidative stress associated with RA. In conclusion, while herbal remedies like turmeric, ginger, Boswellia serrata, green tea, and Ashwagandha offer potential complementary treatments for RA, their safety profiles and adverse effects warrant careful consideration. Rigorous clinical trials are needed to confirm their efficacy and safety, highlighting the necessity for further research in this area. These findings are crucial for patients and healthcare providers in making informed decisions about incorporating herbal interventions into RA treatment strategies., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Described herein is a straightforward approach to synthesizing three biindenofluorene (BIF) derivatives, composed of antiaromatic indenofluorene units, which are the first non-alternant congeners of known bipentacene. Dimerization of indeno[1,2- b ]fluorene and indeno[2,1- c ]fluorene units by connecting carbons 3 and 3' and carbons 2 and 2', respectively, is shown to influence the highest occupied and lowest unoccupied molecular orbital energy levels of the resulting BIFs, affording band gaps (1.5-1.6 eV) that are smaller than that of a known indenofluorene polymer (2.3 eV). The hole mobilities of BIFs were determined to be ∼10 -2 cm 2 V -1 s -1 .

Background: Anorectal diseases and pelvic floor disorders are prevalent among the general population. Patients may present with overlapping symptoms, delaying diagnosis, and lowering quality of life. Treating physicians encounter numerous challenges attributed to the complex nature of pelvic anatomy, limitations of diagnostic techniques, and lack of available resources. This article is an overview of the current state of artificial intelligence (AI) in tackling the difficulties of managing benign anorectal disorders and pelvic floor disorders., Methods: A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed database to identify all potentially relevant studies published from January 2000 to August 2023. Search queries were built using the following terms: AI, machine learning, deep learning, benign anorectal disease, pelvic floor disorder, fecal incontinence, obstructive defecation, anal fistula, rectal prolapse, and anorectal manometry. Malignant anorectal articles and abstracts were excluded. Data from selected articles were analyzed., Results: 139 articles were found, 15 of which met our inclusion and exclusion criteria. The most common AI module was convolutional neural network. researchers were able to develop AI modules to optimize imaging studies for pelvis, fistula, and abscess anatomy, facilitated anorectal manometry interpretation, and improved high-definition anoscope use. None of the modules were validated in an external cohort., Conclusion: There is potential for AI to enhance the management of pelvic floor and benign anorectal diseases. Ongoing research necessitates the use of multidisciplinary approaches and collaboration between physicians and AI programmers to tackle pressing challenges., (© 2024 by SLS, Society of Laparoscopic & Robotic Surgeons.)

Candida spp. is a significant cause of topical and fungal infections in humans. In addition to Candida albicans, many non-albicans species such as C. krusei, C. glabrata, C. parapsilosis, C. tropicalis, C. guilliermondii cause severe infections. The main antifungal agents belong to three different classes, including azoles, polyenes, and echinocandins. However, resistance to all three categories of drugs has been reported. Therefore, there is an urgent need to search for other alternatives with antifungal activity. Many herbal extracts and compounds from natural sources show excellent antifungal activity. In this study, we used an oil extract from the fruits of Zanthoxylum armatum, which showed significant antifungal activity against various Candida spp. by two different methods-minimum inhibitory concentration (MIC) and agar diffusion. In addition, we attempted to explore the possible mechanism of action in C. albicans. It was found that the antifungal activity of Z. armatum oil is fungicidal and involves a decrease in the level of ergosterol in the cell membrane. The decrease in ergosterol level resulted in increased passive diffusion of a fluorescent molecule, rhodamine6G, across the plasma membrane, indicating increased membrane fluidity. The oil-treated cells showed decreased germ tube formation, an important indicator of C. albicans' virulence. The fungal cells also exhibited decreased attachment to the buccal epithelium, the first step toward invasion, biofilm formation, and damage to oral epithelial cells. Interestingly, unlike most antifungal agents, in which the generation of reactive oxygen species is responsible for killing, no significant effect was observed in the present study., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Tubercular meningitis (TBM) is a serious public health problem in developing countries as it leads to significant mortality and residual neurological sequelae. The estimated mortality due to TBM in India is 1.5 per 100,000 population. In resource-limited settings, only the Ziehl-Neelsen (ZN) stain, which has very little sensitivity, is available. The World Health Organization recommended the Loop Mediated Isothermal Amplification (TB LAMP) assay for pulmonary tuberculosis only. We evaluated this test for tubercular meningitis as well., Methodology: In a cross-sectional study of 2-year duration, we have taken 239 cerebrospinal fluid samples from suspected cases of tubercular meningitis patients. ZN staining along with Mycobacteria Growth Indicator Tube (MGIT) TB culture, Xpert MTB/RIF Ultra assay, and commercial TB LAMP assay were performed for each sample., Results: Out of 239 samples, 40 samples (16.73%) were found TB LAMP assay positive, 48 samples (20.08%) were found Xpert ultra-assay positive, 12 samples (5.02%) were MGIT TB culture positive and acid-fast bacillus smear positive in ten samples (4.18 %). Out of 12 MGIT-positive samples, all samples (100%) were TB LAMP and Xpert ultra positive and one sample (8.33%) was ZN smear positive. In 199 negative samples from the TB LAMP assay, eight samples were positive by Xpert, none by MGIT TB culture and AFB smear. Sensitivity and specificity were found as 100% and 87.66%, respectively, for the TB LAMP assay., Conclusion: TB LAMP assay is a rapid, cost-effective, sensitive, and specific test for tubercular meningitis infection in resource-limited settings., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Vineeta Mittal, Manoj Kumar, Ajay Kumar Singh.)

Electric vehicles (EVs) have become an attractive alternative to IC engine cars due to the increased interest in lowering the consumption of fossil fuels and pollution. This paper presents the design and simulation of a 4 kW solar power-based hybrid EV charging station. With the increasing demand for electric vehicles and the strain they pose on the electrical grid, particularly at fast and superfast charging stations, the development of sustainable and efficient charging infrastructure is crucial. The proposed hybrid charging station integrates solar power and battery energy storage to provide uninterrupted power for EVs, reducing reliance on fossil fuels and minimizing grid overload. The system operates using a three-stage charging strategy, with the PV array, battery bank, and grid electricity ensuring continuous power supply for EVs. Additionally, the system can export surplus solar energy to the grid, reducing the load demand. The paper also discusses the use of MPPT techniques, PV cell modeling, and charge controller algorithms to optimize the performance of the hybrid charging station., (© 2024. The Author(s).)

In early-stage non-small cell lung cancer, the combination of neoadjuvant anti-PD-L1 and subablative stereotactic body radiation therapy (SBRT) is associated with higher rates of major pathologic response compared to anti-PD-L1 alone. Here, we identify a 140-gene set, enriched in genes characteristic of highly proliferating cells, associated with response to the dual therapy. Analysis of on-treatment transcriptome data indicate roles for T and B cells in response. The 140-gene set is associated with disease-free survival when applied to the combined trial arms. This 140-gene set identifies a subclass of tumors in all 7 of The Cancer Genome Atlas tumor types examined. Worse survival is associated with the 140-gene signature in 5 of these tumor types. Collectively, our data support that this 140-gene set, discovered in association with response to combined anti-PD-L1 and SBRT, identifies a clinically aggressive subclass of solid tumors that may be more likely to respond to immunotherapies., Competing Interests: Declaration of interests N.K.A. has equity in Angiocrine Bioscience, TMRW, and View Point Medical. O.E. is supported by Janssen, J&J, AstraZeneca, Volastra, and Eli Lilly research grants. He is a scientific advisor and equity holder in Freenome, Owkin, Volastra Therapeutics, and One Three Biotech, and a paid scientific advisor to Champions Oncology. T.E.M. receives research funding from Janssen. Cornell University has filed a patent application on the work described in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: This study describes the technique of simple limbal epithelial transplantation (SLET) without amniotic membrane grafting (AMG) in limbal stem cell deficiency (LSCD)., Methods: Retrospective, interventional case series of 6 patients who underwent SLET without AMG were included. The procedure followed the standard technique, involving limbal biopsy from the healthy eye, resection of symblephera, and pannus dissection in the affected eye. Following host bed preparation, limbal explants were placed on the bare cornea and secured with fibrin glue. A large-diameter bandage contact lens was applied post surgery. No amniotic membrane was used. Preoperative data, including age, gender, cause of LSCD, best-corrected visual acuity, and previous ocular surgeries, were recorded. Postoperative clinical information, such as the duration of follow-up and recurrence of LSCD, best-corrected visual acuity, and other ocular examination findings, was recorded in an excel sheet., Results: Preoperatively, 2 patients had total LSCD (secondary to a firecracker injury and excision biopsy for ocular surface squamous neoplasia). 4 patients had partial LSCD (3 chemical injuries, 1 firecracker injury). The mean age of participants was 30.67 ± 15.91 years, with a mean follow-up duration of 9.33 ± 8.04 months. Intraoperatively, all patients exhibited a smooth corneal surface after pannus removal. Postoperatively, all limbal explants remained securely attached, with complete corneal epithelialization achieved within 2 to 3 weeks. The ocular surface remained stable throughout, and no recurrence of LSCD was observed in any patient. No loss of explants was seen., Conclusions: The present series suggests that AMG may not be a necessary step for performing SLET., Competing Interests: The authors have no funding or conflicts of interest to disclose, (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Cancer biomarkers have revolutionized the field of oncology by providing valuable insights into tumor changes and aiding in screening, diagnosis, prognosis, treatment prediction, and risk assessment. The emergence of "omic" technologies has enabled biomarkers to become reliable and accurate predictors of outcomes during cancer treatment., Content: In this review, we highlight the clinical utility of biomarkers in cancer identification and motivate researchers to establish a personalized/precision approach in oncology. By extending a multidisciplinary technology-based approach, biomarkers offer an alternative to traditional techniques, fulfilling the goal of cancer therapeutics to find a needle in a haystack., Summary and Outlook: We target different forms of cancer to establish a dynamic role of biomarkers in understanding the spectrum of malignancies and their biochemical and molecular characterization, emphasizing their prospective contribution to cancer screening. Biomarkers offer a promising avenue for the early detection of human cancers and the exploration of novel technologies to predict disease severity, facilitating maximum survival and minimum mortality rates. This review provides a comprehensive overview of the potential of biomarkers in oncology and highlights their prospects in advancing cancer diagnosis and treatment., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Several deep-learning assisted disease assessment schemes (DAS) have been proposed to enhance accurate detection of COVID-19, a critical medical emergency, through the analysis of clinical data. Lung imaging, particularly from CT scans, plays a pivotal role in identifying and assessing the severity of COVID-19 infections. Existing automated methods leveraging deep learning contribute significantly to reducing the diagnostic burden associated with this process. This research aims in developing a simple DAS for COVID-19 detection using the pre-trained lightweight deep learning methods (LDMs) applied to lung CT slices. The use of LDMs contributes to a less complex yet highly accurate detection system. The key stages of the developed DAS include image collection and initial processing using Shannon's thresholding, deep-feature mining supported by LDMs, feature optimization utilizing the Brownian Butterfly Algorithm (BBA), and binary classification through three-fold cross-validation. The performance evaluation of the proposed scheme involves assessing individual, fused, and ensemble features. The investigation reveals that the developed DAS achieves a detection accuracy of 93.80% with individual features, 96% accuracy with fused features, and an impressive 99.10% accuracy with ensemble features. These outcomes affirm the effectiveness of the proposed scheme in significantly enhancing COVID-19 detection accuracy in the chosen lung CT database., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: Fermented formulations are extensively used in Ayurveda due to several benefits like improved palatability, bioavailability, pharmacological potential, and shelf life. These formulations can also quench the heavy metals from the plant material and thus reduce the toxicity. Seeds of Silybum marianum (L.) Gaertn. are widely used for the management of many liver diseases., Study Design and Methods: In the present study, we developed a novel fermented formulation of S. marianum seeds and evaluated parameters like safety (heavy metal analysis) and effectiveness (hepatoprotective). As the developed formulation's validation is crucial, the critical process variables (time, pH, and sugar concentration) are optimized for alcohol and silybin content using the Box-Behnken design (BBD)., Results: The response surface methodology coupled with BBD predicted the optimized conditions (fermentation time (28 days), pH 5.6, and sugar concentration (22.04%)) for the development of a fermented formulation of the selected herb. Moreover, the alcohol content (6.5 ± 0.9%) and silybin concentration (26.1 ± 2.1%) were confirmed in optimized formulation by GC-MS and HPTLC analysis. The optimized formulation was also analyzed for heavy metals (Pb, As, Hg, and Cd); their concentration is significantly less than the decoction of herbs. Further, the comparative evaluation of the developed formulation with the marketed formulation also confirmed that the fermented formulation's silybin concentration and percentage release were significantly enhanced. In addition, the developed fermented formulation's percentage recovery of HepG2 cell lines after treatment with CCl4 was significantly improved compared with the marketed formulation., Conclusion: It can be summarized that the developed fermented formulation improves safety and effectiveness compared to other market formulations. Finally, it can be concluded that the developed fermented formulation could be further explored as a better alternative for developing Silybum marianum preparation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier GmbH.. All rights reserved.)

Background: Superficial mycoses are fungal infections limited to the outermost layers of the skin and its appendages. The chief causative agents of these mycoses are dermatophytes and yeasts. The diagnosis of dermatophytosis can be made by direct mycological examination with potassium hydroxide (10%-30%) of biological material obtained from patients with suspected mycosis, providing results more rapid than fungal cultures, which may take days or weeks. This information, together with clinical history and laboratory diagnosis, ensures that the appropriate treatment is initiated promptly. However, false negative results are obtained in 5%-15%, by conventional methods of diagnosis of dermatophytosis., Objectives: To study the metabolic profiles of the commonly occurring dermatophytes by NMR spectroscopy., Patients/materials: We have used 1D and 2D Nuclear Magnetic Resonance (NMR) experiments along with Human Metabolome Database (HMDB) and Chenomx database search for identification of primary metabolites in the methanol extract of two fungal species: Trichophyton mentagrophyte (T. mentagrophyte) and Trichophyton rubrum (T. rubrum). Both standard strains and representative number of clinical isolates of these two species were investigated. Further, metabolic profiles obtained were analysed using multivariate analysis., Results: We have identified 23 metabolites in the T. mentagrophyte and another 23 metabolites in T. rubrum. Many important metabolites like trehalose, proline, mannitol, acetate, GABA and several other amino acids were detected, which provide the necessary components for fungal growth and metabolism. Altered metabolites were defined between Trichophyton mentagrophyte and T. rubrum strains., Conclusion: We have detected many metabolites in the two fungal species T. mentagrophyte and T. rubrum by using NMR spectroscopy. NMR spectroscopy provides a holistic snapshot of the metabolome of an organism. Key metabolic differences were identified between the two fungal strains. We need to perform more studies on metabolite profiling of the samples from these species for their rapid diagnosis and prompt treatment., (© 2024 Wiley-VCH GmbH. Published by John Wiley & Sons Ltd.)

A complicated biological reaction of vascular tissues to damaging stimuli like infections, harmed cells, or irritants is called inflammation. Symptoms include redness, inflamed joints, stiffness, discomfort in the joints, and loss of joint function. NSAIDs are frequently used to treat inflammation. Sadly, these drugs raise the possibility of blood clots, which can result in heart attacks and strokes. Consequently, there is ongoing research focusing on developing potent anti-inflammatory drugs using natural ingredients. Natural products, due to their diverse chemical composition, offer a rich source for the development of novel medications. The treatment of various inflammation- related disorders heavily relies on a natural substance derived from medicinal plants. The objective of the present study is to assemble information on potential parts of the plants or phytochemicals derived from medicinal plants used on inflammatory models, employing state-ofthe- art scientific methodologies. In this study, state-of-the-art scientific methodologies are utilized to investigate the effects of phytochemicals derived from medicinal plants. Relevant data is collected, focusing on the examination of these phytochemicals in experimental models of inflammation. The study aims to collect thorough data on potential plant parts or promising phytochemicals derived from medicinal plants that have been evaluated using advanced scientific techniques in the realm of inflammation models. This compilation will offer valuable insights into their potential as anti-inflammatory agents. The findings have the potential to contribute to the development of new and improved anti-inflammatory medications with fewer or no adverse effects compared to current treatments. While many of these studies hold academic interest only a few are accepted into clinical trials. Numerous phytoconstituents have been identified for exhibiting diverse pharmacological actions., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Therapeutic gene delivery may be facilitated by the use of polymeric carriers. When combined with nucleic acids to form nanoparticles or polyplexes, a variety of polymers may shield the cargo from in vivo breakdown and clearance while also making it easier for it to enter intracellular compartments., Aim and Objectives: Polymer synthesis design choices result in a wide variety of compounds and vehicle compositions. Depending on the application, these characteristics may be changed to provide enhanced endosomal escape, longer-lasting distribution, or stronger connection with nucleic acid cargo and cells. Here, we outline current methods for delivering genes in preclinical and clinical settings using polymers., Methodology: Significant therapeutic outcomes have previously been attained using genetic material- delivering polymer vehicles in both in-vitro and animal models. When combined with nucleic acids to form nanoparticles or polyplexes, a variety of polymers may shield the cargo from in vivo breakdown and clearance while also making it easier for it to enter intracellular compartments. Many innovative diagnoses for nucleic acids have been investigated and put through clinical assessment in the past 20 years., Results: Polymer-based carriers have additional delivery issues due to their changes in method and place of biological action, as well as variances in biophysical characteristics. We cover recent custom polymeric carrier architectures that were tuned for nucleic acid payloads such genomemodifying nucleic acids, siRNA, microRNA, and plasmid DNA., Conclusion: In conclusion, the development of polymeric carriers for gene delivery holds promise for therapeutic applications. Through careful design and optimization, these carriers can overcome various challenges associated with nucleic acid delivery, offering new avenues for treating a wide range of diseases., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objectives: Primary mental health admissions are increasing across US children's hospitals. These patients may experience agitation requiring pharmacologic restraint. This study characterized pharmacologic restraint use in medical inpatient units by primary mental health diagnosis., Methods: This retrospective, cross-sectional study used the Pediatric Health Information System database. The study included children aged 5 to 17 years admitted with a primary mental health diagnosis between 2016 and 2021. Rates of pharmacologic restraint use per 1000 patient days were determined for 13 mental health diagnoses and trended over time with Poisson regression., Results: Of 91 898 hospitalizations across 43 hospitals, 3% of admissions and 1.3% of patient days involved pharmacologic restraint. Trends in the rate of pharmacologic restraint use remained stable (95% confidence interval [CI], 0.7-2.1), whereas the incidence increased by 141%. Diagnoses with the highest rates of pharmacologic restraint days per 1000 patient days included autism (79.4; 95% CI, 56.2-112.3), substance-related disorders (45.0; 95% CI, 35.9-56.4), and disruptive disorders (44.8; 95% CI, 25.1-79.8). The restraint rate significantly increased in disruptive disorders (rate ratio [RR], 1.4; 95% CI, 1.1-1.6), bipolar disorders (RR, 2.0; 95% CI, 1.4-3.0), eating disorders (RR, 2.4; 95% CI, 1.5-3.9), and somatic disorders (RR, 4.2; 95% CI, 1.9-9.1). The rate significantly decreased for autism (RR, 0.8; 95% CI, 0.6-1.0) and anxiety disorders (RR, 0.3; 95% CI, 0.2-0.6)., Conclusions: Pharmacologic restraint use among children hospitalized with a primary mental health diagnosis increased in incidence and varied by diagnosis. Characterizing restraint rates and trends by diagnosis may help identify at-risk patients and guide targeted interventions to improve pharmacologic restraint utilization., (Copyright © 2024 by the American Academy of Pediatrics.)

Heart failure (HF) is a global health concern that is prevalent in India as well. HF is reported at a younger age in Indian patients with comorbidity of type 2 diabetes (T2DM) in approximately 50% of patients. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), originally approved for T2DM, are new guideline-recommended and approved treatment strategies for HF. Extensive evidence highlights that SGLT2i exhibits profound cardiovascular (CV) benefits beyond glycemic control. SGLT2i, in conjunction with other guideline-directed medical therapies (GMDT), has additive effects in improving heart function and reducing adverse HF outcomes. The benefits of SGLT2i are across a spectrum of patients, with and without diabetes, suggesting their potential place in broader HF populations irrespective of ejection fraction (EF). This consensus builds on the updated evidence of the efficacy and safety of SGLT2i in HF and recommends its place in therapy with a focus on Indian patients with HF., (© Journal of the Association of Physicians of India 2024.)

Cancer is a complex, one of the fatal non-communicable diseases, and its treatment has enormous challenges, with variable efficacy of traditional anti-cancer agents. By 2025, it is expected that 420 million additional cases of cancer will be diagnosed yearly. However, among various types of cancer, brain cancer treatment is most difficult due to the presence of blood-brain barriers. Nowadays, phytoconstituents are gaining popularity because of their biosafety and low toxicity to healthy cells. This article reviews various aspects related to curcumin for brain cancer therapeutics, including epidemiology, the role of nanotechnology, and various challenges for development and clinical trials. Furthermore, it elaborates on the prospects of curcumin for brain cancer therapeutics. In this article, our objective is to illuminate the anti-cancer potential of curcumin for brain cancer therapy. Moreover, it also explores how to defeat its constraints of clinical application because of poor bioavailability, stability, and rapid metabolism. This review also emphasizes the possibility of curcumin for the cure of brain cancer using cuttingedge biotechnological methods based on nanomedicine. This review further highlights the recent patents on curcumin-loaded nanoformulations for brain cancer. Overall, this article provides an overview of curcumin's potential in brain cancer therapy by considering challenges to be overwhelmed and future prospective. Moreover, this review summarizes the reported literature on the latest research related to the utility of curcumin in brain cancer therapy and aims to provide a reference for advanced investigation on brain cancer treatment., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Lung cancer is a foremost global health issue due to its poor diagnosis. The advancement of novel drug delivery systems and medical devices will aid its therapy., Objective: In this review, the authors thoroughly introduce the ideas and methods for improving nanomedicine- based approaches for lung cancer therapy. This article provides mechanistic insight into various novel drug delivery systems (DDSs) including nanoparticles, solid lipid nanoparticles, liposomes, dendrimers, niosomes, and nanoemulsions for lung cancer therapy with recent research work. This review provides insights into various patents published for lung cancer therapy based on nanomedicine. This review also highlights the current status of approved and clinically tested nanoformulations for their treatment., Methodology: For finding scholarly related data for the literature search, many search engines were employed including PubMed, Science Direct, Google, Scihub, Google Scholar, Research Gate, Web of Sciences, and several others. Various keywords and phrases were used for the search such as "nanoparticles", "solid lipid nanoparticles", "liposomes", "dendrimers", "niosomes", "nanoemulsions", "lung cancer", "nanomedicine", "nanomaterial", "nanotechnology", " in vivo " and " in vitro ". The most innovative and cutting-edge nanotechnology-based approaches that are employed in pre-clinical and clinical studies to address problems associated with lung cancer therapies are also mentioned in future prospects. A variety of problems encountered with current lung cancer therapy techniques that frequently led to inadequate therapeutic success are also discussed in the end., Conclusion: The development of nanoformulations at the pilot scale still faces some difficulties, but their prospects for treating lung cancer appear to be promising in the future. Future developments and trends are anticipated as the evaluation comes to a close., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)