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In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient–healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care.

Solar PV has become increasingly popular in the past decade, both for standalone and grid-connected systems. Solar PV systems exhibit non-linear output characteristics due to weather fluctuations, which can substantially impact the overall PV system’s output. Consequently, selecting the optimal MPPT technique for a given PV system is a complex task, as each method has different strengths and weaknesses. Therefore, conducting a comprehensive examination of these techniques is crucial. A survey of academic publications on ‘Google Scholar’ spanning the past seven years (2015-2022) revealed a total of seventy-one review articles addressing various MPPT techniques. Among the studies, seven have directed their attention toward non-uniform solar irradiance, while four have dedicated their focus to uniform conditions. Surprisingly, none have ventured into the realm of hybrid optimization MPPT techniques. Moreover, several of these reviews have covered a restricted range of MPPT methods, and none have delivered an all-encompassing assessment that encompasses both online and offline strategies for uniform conditions, alongside an evaluation of hybrid MPPT techniques in the context of non-uniform solar irradiance conditions. Unfortunately, there have been minimal efforts in this direction. Consequently, the need of the hour is a comprehensive review paper that encompasses nearly all known MPPT techniques within a single publication. This paper places its primary emphasis on categorizing MPPT algorithms into offline, hybrid, and online optimization techniques, addressing both non-uniform and uniform irradiance scenarios. It serves as a comprehensive resource by consolidating diverse MPPT techniques, presenting their mathematical formulations, operational principles, and visual representations through block diagrams and flowcharts. The objective of this research endeavor is to provide a valuable reference for strategists, researchers, and energy engineers, offering them a roadmap to steer future research endeavors and practical implementations in the realm of optimization of MPPT.

Agriculture faces significant challenges due to climate change and unpredictable environmental factors, which impact crop yields and threaten food security. This study proposes a novel approach to crop yield prediction and risk assessment using neutrosophic logic and least squares regression. By integrating these methods, we aim to improve accuracy in predicting crop losses under uncertain conditions. The model classifies crops based on profitability and environmental risks, utilizing the independence test to evaluate the relationships between crop attributes. Our approach leverages deep learning techniques, such as restricted Boltzmann machines (RBM), to enhance the analysis of crop data and provide farmers with actionable insights for decisionmaking. The results demonstrate that the proposed method effectively estimates crop yield damage with the ability to assess risk under varying conditions, such as extreme weather. This approach can help farmers optimize crop management strategies, minimize losses, and improve overall productivity. Future work will explore the application of this method to other crops and farming systems to expand its utility. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain is one of the most common complaints in clinical practice with life time prevalence ranging from 65-80%. Lumbar disc herniation is the cause for less than 5 % of back pain problems but is the most common cause of sciatica. Absolute indication for surgery includes cauda equine syndrome and progressive neurological weakness. More often, surgery is done to provide more rapid pain relief and disability in those patients whose recovery is unacceptably low with non-operative treatment. Materials and methods: A prospective study was conducted in the Department of Orthopedics, Maharaja Institute of Medical Sciences, Nellimarla, Vizianagaram from January 2023 till December 2023. A patient case report form was designed to collect patient related informaton. Informed written consent was taken from the entire patient prior to interviewing the patient. All patients aged more than 18 years, who presented to the outpatient clinic of the Department of Orthopedics, Maharaja Institute of Medical Sciences, Nellimarla, Vizianagaram with complaints of leg or back pain, or other neurological symtoms, supported by Magnetic Resonance Imaging (MRI) suggestive of disc herniation, were included in the study. Results: We included 106 patients during the study period, average age was 40.17 ± 8.5 years. 64 patients were males. Most of the patients have had symptoms for less than 6 months. L4-L5 was the most commonly level involved. None of the patients had any post-operative infections. 40% of the patients had 5 to 6 days of hospital stay, followed by 32% having 7 to 10 days of hospital stay. We assessed the patients using the Macnab's criteria postoperatively at the time of surgery, 1 month, 3 months and 6 months after surgery. 57% of the patients reported excellent level of well being at the end of 6 months as compared to only 4% at the time of surgery. 35% reported good level of well being and no patient reported poor level of well being at the end of 6 months postoperatively. Conclusion: Microdiscectomy, as demonstrated by our outcome scores, has a high success rate for patients with lumbar disc herniations who have failed a period of conservative management. Findings of our study demonstrate that minimally invasive lumbar microdiscectomy cause very few postoperative complications, shorter stays in hospital, improve objective functionality scores postoperatively and patients rate well being assesment scores as good to excellent. [ABSTRACT FROM AUTHOR]

In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient-healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care. [ABSTRACT FROM AUTHOR]

Solar photovoltaic (PV) plants experience performance degradation due to environmental, operational, and material factors. Therefore, conducting a degradation analysis is essential to ensure the optimal performance and longevity of a solar PV plant. The main objective of this study is to investigate the impact of degradation on solar panels in various abnormal scenarios by evaluating performance indicators and electrical parameters of the PV plant. The core novelty of this research lies in the development of an integrated real-time degradation analysis framework for grid-interfaced solar PV plants, using both an I-V curve tracer and a thermal image camera in abnormal scenarios. This approach provides a comprehensive and precise assessment of the PV system's health by capturing detailed electrical characteristics and identifying thermal anomalies indicative of degradation. The key findings include the evaluation of electrical parameters and performance indicators such as peak power (Pmax), short-circuit current (Isc), open circuit voltage (Voc), Performance Ratio (PR), Fill Factor (FF), and the annual power degradation rate in various abnormal scenarios. An error analysis for all electrical parameters of the PV plant was conducted, comparing the percentage errors for each parameter with the panel parameters measured under standard test conditions. Finally, the performance metrics of the current study were compared with previous literature. [ABSTRACT FROM AUTHOR]

One of the key components of computer vision applications like satellite and remote sensing and medical diagnosis is multi-modal image fusion. There are various multi-modal image fusion techniques, and each has advantages and disadvantages of its own. This paper proposes a new method based on multi-scale guided filtering. Initially, each source image is divided into coarse and fine layers at various scales using a guided filter. In order to fuse coarse and fine layers, two different saliency maps are used: an energy saliency map to coarse layers and a modified spatial frequency energy saliency map to fine levels. According to the simulation results, the suggested technique performs better in terms of quantitative evaluations of quality than other state-of-the-art techniques. All the simulation results are carried on a standard brain atlas database. [ABSTRACT FROM AUTHOR]

An attempt is made in this paper to diagnose brain-related diseases like sarcoma, fatal stroke disease, cerebral disease, and Alzheimer's disease by using saliency information from magnetic resonance and computed tomography source images. The saliency information for each source image is computed using guided and median filters. The obtained saliency maps are used for computing the weight maps of each source image by using image statistics. The obtained weights are used to fuse the approximate and detailed layers of the source images by using the weighted average fusion technique. The proposed algorithm is simulated in MATLAB for various benchmark data sets of brains taken from the brain atlas provided by Harvard Medical School, available at https://www.med.harvard.edu/aanlib. In order to test the efficacy of the novel method, comparative analysis is performed in terms of image quality assessment metrics like mean, mutual information, average gradient, standard deviation, spatial frequency, etc. From the analysis, this paper concludes that the proposed algorithm improved gradient information in the fused image by 35.7%, entropy by 5.7%, spatial frequency by 32.7%, edge strength by 14.5%, and minimized the information loss by 43.6%. Therefore, the novel method of weight map computation produces a detailed and noise-free image, which is helpful for better diagnosis in clinical applications. [ABSTRACT FROM AUTHOR]

Purpose: To determine the changes in hepatic profile during the evaluation of herbal mixtures of Moringa oleifera and Raphanus sativus in streptozotocin-nicotinamide (STZ- NA)-induced diabetic rat model. Methods: Forty-eight (48) albino rats were randomly divided into six groups of eight rats each. Diabetes was induced in all the groups except Group I (normal control) using nicotinamide (110 mg/kg) and streptozotocin (55 mg/kg). Groups I and II (untreated control) received only distilled water (2 mL/kg) while Group III received 100 mg/kg of metformin. Groups IV to VIII were treated with a dose of 200 mg/kg of the herbal mixtures (HEMA-C) at different ratios of M. oleifera and R. sativus. Blood samples were analyzed for biochemical markers while liver histopathology was assayed after 29 days of treatment. Results: Acute toxicity study showed that the herbal mixtures did not exhibit mortality or adverse effect in rats up to a dose of 2000 mg/kg (LD50 > 2000 mg/kg) with a safe dose of 200 mg/kg (1/10th LD50). Induction of diabetes significantly increased serum aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), alkaline phosphatases (ALP) and bilirubin levels in untreated control compared to normal control (p < 0.001). Administration of the herbal mixtures, especially HEMB, significantly (p < 0.001) restored these liver marker levels to levels comparable to metformin. Furthermore, histological examination showed that HEMB significantly restored the STZ-NA-induced liver damage in rats. Conclusion: The herbal mixture possesses hepatoprotective effect and ameliorates the adverse diabetic conditions caused by STZ-NA-induced diabetes in rats. The herbal mixture also demonstrated better and extended therapeutic potential than the single herbs. Further pharmacological and biochemical investigations will elucidate the mechanisms of action and clarify the potentials of the herbal mixture as a therapeutic tool as an anti-diabetic therapy. [ABSTRACT FROM AUTHOR]

Defective clearance of apoptotic cells due to impaired efferocytosis sustains error in self-tolerance that exacerbates rheumatoid arthritis (RA). However, the molecular determinant that directly or specifically impairs efferocytosis in RA is not yet studied. We identified a new perspective that IL-17A significantly impedes efferocytosis via preferential activation of the JAK/STAT-3/ADAM17 signaling axis. In contrast, disruption of the IL-17A/IL-17RA interaction using cyanidin or silencing of IL-17RA obstructed JAK/STAT-3 activation that further abolished ADAM17 expression. Subsequent depletion of ADAM17 inhibited the shedding of Mer tyrosine kinase receptor (MERTK), which significantly increased apoptotic cell intake and restored efferocytosis in adjuvant-induced arthritic (AA) model. Concomitantly, the amplification of the efferocytosis process due to IL-17A/IL-17RA interaction disruption was sensitive to mitochondrial fission mediated via Drp-1 phosphorylation downstream of STAT-3 inhibition. As expected, cyanidin treated AA synovial macrophages that exhibited increased efferocytosis demonstrated a phenotypic shift towards CD163 anti-inflammatory phenotype in a STAT-5 dependent manner. Similar results were obtained in IL-17A-sensitized AA synovial macrophages treated with S3I-201 (a STAT-3 inhibitor) indicating that IL-17A influences efferocytosis via the STAT-3 pathway. In view of our previous work where cyanidin restored Th17/Treg balance, our present investigation fulfils a critical gap by providing scientific validation that cyanidin escalated PD-L1 expression during the efferocytosis process that could have impacted the restoration of Th17/Treg balance in an AA model. Together, these data corroborate the hypothesis that IL-17A signaling can impair efferocytosis via regulating STAT-3/ADAM17/FL-MERTK axis and that its inhibition can amplify a pro-resolution signal against RA progression., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Psoriasis is a paradigmatic condition characterised by a heightened autoimmune response and chronic inflammation. However, the exact nature and the pathological causes behind it are still unknown. Growing evidence suggest dysregulated cytokine network as a result of over-activated T cells and plasmacytoid dendritic cells (pDCs) as the critical drivers in the development of psoriasis. In the present study, we aimed to investigate the therapeutic efficacy of 3,3'-diindolylmethane (DIM) on pDC activation and Th17 cell development in imiquimod (IMQ)-induced psoriasis mice. Our in vitro research investigated the IRF-7 signalling in pDCs that explained the reduced expression of the transcription factor IRF-7 responsible for pDC activation as a result of DIM treatment. Concurrently, DIM treatment decreased the release of Th17 cell polarising cytokines (IFN-α, IL-23, and IL-6) by pDCs which validated a reduction in differentiated pathogenic Th17 cell population and associated cytokine IL-17A in IMQ-induced psoriatic mice. Thus, our recent findings provide therapeutic evidence in targeting the early potential contributors for psoriasis treatment by preventing IRF-7-mediated pDC activation and Th17 cell development in IMQ-induced psoriasis mice., (© 2024. The Society for In Vitro Biology.)

Background: Accumulation of tau in synapses in the early stages of Alzheimer's disease (AD) has been shown to cause synaptic damage, synaptic loss, and the spread of tau pathology through trans-synaptically connected neurons. Moreover, synaptic loss correlates with a decline in cognitive function, providing an opportunity to investigate therapeutic strategies to target synapses and synaptic tau to rescue or prevent cognitive decline in AD. One of the promising synaptic targets is the 5-HT4 serotonergic receptor present postsynaptically in the brain structures involved in the memory processes. 5-HT4R stimulation exerts synaptogenic and pro-cognitive effects involving synapse-to-nucleus signaling essential for synaptic plasticity. However, it is not known whether 5-HT4R activation has a therapeutic effect on tau pathology., Methods: The goal of this study was to investigate the impact of chronic stimulation of 5-HT4R by two agonists, prucalopride and RS-67333, in PS19 mice, a model of tauopathy. We utilized gradient assays to isolate pre- and post-synaptic compartments, followed by biochemical analyses for tau species and ubiquitinated proteins in the synaptic compartments and total brain tissue. Next, we performed kinetic assays to test the proteasome's hydrolysis capacity in treatment conditions. Moreover, behavioral tests such as the open field and non-maternal nest-building tests were used to evaluate anxiety-like behaviors and hippocampal-related cognitive functioning in the treatment paradigm., Results: Our results show that 5-HT4R agonism reduced tauopathy, reduced synaptic tau, increased proteasome activity, and improved cognitive functioning in PS19 mice. Our data suggest that enhanced proteasome activity by synaptic mediated signaling leads to the enhanced turnover of tau initially within synapses where the receptors are localized, and over time, the treatment attenuated the accumulation of tau aggregation and improved cognitive functioning of the PS19 mice., Conclusion: Therefore, stimulation of 5-HT4R offers a promising therapy to rescue synapses from the accumulation of toxic synaptic tau, evident in the early stages of AD., Competing Interests: ES is currently employed at Mount Sinai Neuropathology Brain Bank. AR is currently employed at Recursion Pharmaceuticals. RS is currently employed at Garuda Therapeutics. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jiang, Sydney, Runyan, Serpe, Srikanth, Figueroa, Yang and Myeku.)

Resistin, a cytokine hormone predominantly secreted by adipose tissue, is elevated in various metabolic disorders such as obesity, type 2 diabetes, and cardiovascular disease. In addition to its involvement in metabolic regulation, resistin has been implicated in the pathogenesis of psoriasis, a chronic inflammatory skin disorder. Numerous studies have reported increased resistin levels in psoriatic skin lesions, suggesting a possible association between resistin and psoriasis. Recent studies have suggested the potential involvement of resistin in the development and progression of certain cancers. Resistin is overexpressed in breast, colorectal, and gastric cancers. This suggests that it may play a role in the development of these cancers, possibly by inducing inflammation and cell growth. The link between resistin and cancer raises the possibility of shared underlying mechanisms driving the pathogenesis of psoriasis. Chronic inflammation, one such mechanism, is a hallmark of psoriasis and cancer. Further research is needed to fully understand the relationship between resistin and psoriasis. Identifying potential therapeutic targets is crucial for effective management of psoriasis. By doing so, we may be able to develop more effective treatment options for individuals living with psoriasis and ultimately improve their quality of life. Ultimately, a more comprehensive understanding of the mechanisms underlying the impact of resistin on psoriasis is essential for advancing our knowledge and finding new ways to treat and manage this challenging condition.