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The Descemet membrane (DM) is the basement membrane of corneal endothelial cells, which are responsible for maintaining corneal transparency. DM detachment (DMD) can occur due to various reasons, with the most common etiology being post-surgical. Older age, blunt instruments, and faulty surgical technique predispose to the intraoperative or postoperative occurrence of DMD, and one should have a high index of suspicion for DMD in cases with unexplained or an atypical pattern of corneal edema after surgery. Prompt intervention for DMD management is imperative to effect early visual rehabilitation, decrease corneal morbidity, and avoid permanent damage leading to scarring of the cornea. Various classifications of DMD and management protocols have been described. Anterior-segment optical coherence tomography (AS-OCT) imaging is the most effective imaging to detect DMD and quantify its extent. Desmetopexy with air/gas is the initial treatment of choice and could be aided by suture fixation. Non-responsive cases might need endothelial keratoplasty.

Background and Objectives: Sensory neuronopathies (SNNs) are a rare group of pure sensory disorders causing asymmetrical, multifocal pattern of sensory loss with distinct clinical and electrophysiological features. We aimed to study the clinical features and etiology and share the experience of treating SNN from our center. Methods: A prospective observational study was conducted over 3 years. Patients with predominant sensory complaints and electrophysiological evidence of neuropathy were evaluated. Possible/probable SNN was diagnosed using Camdessanch´e criteria. Detailed workup was done to determine the etiology and treatment given accordingly. Follow-up was done and response to treatment was assessed using modified Rankin Scale grading at 12 months. Results: Fourteen patients with SNN were studied. Two (14.3%) patients were diagnosed with Sjogren’s syndrome (SS-SNN), two (14.3%) with paraneoplastic syndrome, one (7.1%) with leprous ganglionitis, and nine (64.3%) were idiopathic sensory neuronopathy (I-SNN) cases. Improvement occurred in nine (64.3%), stability in three (21.4%), and worsening in two (14.3%) patients. Out of 11 SS-SNN and I-SNN patients, eight showed improvement on follow-up, seven with injection rituximab (RTX) and one with azathioprine. We found positive correlation between RTX treatment and improvement on follow-up (P = 0.0256). Six (66.66%) out of nine I-SNN patients had early initiation of immunotherapy, of which all improved. There was positive correlation between early treatment initiation time in I-SNN patients and improvement (P = 0.0119). Conclusions: Promising results were noted in SS-SNN and I-SNN patients with intensive treatment approach using RTX. Hit hard and early treatment approach is crucial for achieving improvement in sensory neuronopathies.

The high ductile brittle transition temperature of tungsten (W) poses challenges like cracking and porosity during its laser-powder bed additive manufacturing (L-PBFAM). Computational alloy design evaluated niobium (Nb) and carbon (C) to activate eutectic solidification, addressing the cracking issues during the terminal stage of solidification. Furthermore, these elements prevent O segregation at grain boundaries, thereby enhancing grain boundary cohesion in W. In combination with effective process parameters, the novel W-Nb-C alloy developed for L-PBFAM produces near crack-free specimens with heterogeneous microstructures. The intrinsic mechanical responses associated with the heterogenous microstructure were delineated by nanoindentation analysis.

Abstract Objective Robotic surgical approaches are increasingly utilized; however, standard medical school curricula omit this topic. This study examines the need for robotic-specific surgical education from the medical students' perspective. Design A 10-question web-based survey was designed to assess factors including class year, intended specialty, exposure to robotic surgery, and perceived necessity for robotic surgery education. The survey was validated by small group of surgical residents. Setting This study was conducted at a busy tertiary academic center. Participants Survey was distributed to 425 post-core clerkship medical students. Results Out of 79 respondents (18.5% response rate), 71% had some exposure to robotic surgery. The majority (72%) of respondents, regardless of their intended specialty, agreed on the necessity to learn about robotic surgery. Respondents identified terminology, proper patient counseling, and bedside assisting skills as potential topics to incorporate in robotic surgery medical school curricula. Conclusions Medical students irrespective of their intended specialty favor robotic surgery specific education. These findings underscore the need to incorporate robotics education into core medical school curricula.

Abstract Background Axial spondyloarthritis (axSpA) is a chronic inflammatory disease which mainly affects the spine and sacroiliac joints, causing longstanding back pain, stiffness, and limited mobility. AxSpA is an underrecognized disease in non-rheumatology practices because of its heterogeneous clinical features that may be difficult to identify. Main body Sports medicine practitioners are well positioned to suspect and recognize axSpA among their patients with chronic back pain and refer them to a rheumatologist. Early referral to a rheumatologist is important for timely diagnosis, prompt treatment, and improved long-term outcomes for patients with axSpA. Physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs) remain the first-line treatment for and the cornerstone of axSpA management. For patients with inadequate response to or intolerance of NSAIDs, biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic (ts) DMARDs are indicated. These drugs can reduce pain, inflammation, fatigue, and disability and can improve health-related quality of life. The goal of this review is to improve awareness of axSpA among sports medicine practitioners and other non-rheumatologists so that these providers ensure timely referral of patients with suspected axSpA to rheumatologists for appropriate treatment and better outcomes. We also provide an update on current treatment possibilities for axSpA and describe how rheumatologists use treatment guidelines and disease activity measures to identify and optimally treat patients with active axSpA. Conclusion Sports medicine practitioners have an excellent opportunity to identify patients with suspected axSpA and refer them to rheumatologists in a timely manner, as well as monitor symptoms among patients diagnosed with axSpA to identify inadequately controlled disease.

Background: Medicines are an integral part of health. It becomes essential to promote rational drug use. The relationship between doctors and the pharmaceutical industry has gained increasing attention recently. So there are chances that detailing activities by pharmaceutical representatives may lead to an undesirable effect on the prescribing pattern of doctors, like polypharmacy and use of fixed drug combinations; hence this study was planned to evaluate the effect of evaluation of the effect of drug promotional literature on prescribing using WHO prescribing indicators (DPL) on the prescribing pattern of doctors. Setting and Design: This prospective observational cross-sectional study was performed in a medical college and tertiary care center in Maharashtra. MATERIALS AND METHODS: 30 DPL and 10 prescriptions from each doctor were collected. Such total of 3000 DPL and 1000 prescriptions were collected from 100 doctors. Statistical Analysis: The prescriptions and DPL were analyzed together, and information was entered in Microsoft Excel; the parameters were calculated in percentage. Results: This study highlighted that drugs prescribed by generic name were 3.36%, the percentage of antibiotics prescribed was 27.37%, and the percentage of prescriptions containing medicines from the essential medicine list (EML) or formulary was 44.07%. In this study, 27.9% of drugs in the prescriptions were those drugs that are advertised in the DPL. Conclusion: Polypharmacy, prescribing drugs by brand names, drugs out of national list of essential medicine, use of more fixed drug combinations (FDC), antibiotics, and nutritional supplements could be attributed to the effect of DPL on the prescribing pattern. Hence it could be said that there is an association between a greater reliance on the promotion of medicines by the pharmaceutical companies and inappropriate prescribing patterns.

Introduction: According to the World Health Organisation (WHO), the American College of Cardiology (ACC), and the American Heart Association (AHA), the issued prediction charts can be used to make an absolute prediction of a study variable’s Cardiovascular Disease (CVD) risk. This study aimed to examine the combined effects of gender, Family History (FH) of CVD, tobacco use, alcohol consumption, smoking, physical activity levels, and other health conditions on the presence of CVD confirmed by angiography. Predicting CVD risk is crucial; particularly because young individuals aged 25 to 40 are affected by these diseases and from the foundation of any nation. Moreover, CVDs significantly contribute to human mortality compared to other ailments. This approach sought to identify the risk factors for CVD. Aim: To investigate the impact and the association between hereditary characteristics, behaviour, and self-control factors on coronary angiography findings among the study participants from a statistical viewpoint. Materials and Methods: An observational cross-sectional study related to angiography report of 274 study participants visiting the Department of cardiology at Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra with complaints of CVD was conducted from January 2023 to May 2023. Statistical Analysis was performed with the help of Statistical Package for Social Sciences (SPSS) version 28.0, InStat and Microsoft Excel. Chi-square test was applied to study association of demographic study parameters with CVD. Logistic regression was carried out to develop the regression model. Results: Angiography significant CVD was associated with father’s history of CVD (40, 71.42%), alcohol consumption (68, 70.8%), tobacco chewing (115, 69.7%), no exercise (89,79.46%), diabetes (83,75.45%), and diabetic with medication (14,93.33%) showed significant associations with CVD. Logistic regression analysis identified these variables as the best predictors of CVD. Genetics, lifestyle choices, and co-morbidities all contribute to the risk of Coronary Artery Disease (CAD). Conclusion: The study effectively identifies and quantifies the relationships between hereditary characteristics, behavioural factors, and self-control measures with coronary angiography findings. Exercise and diabetic status are significant predictors of the outcome, while tobacco-chewing leans towards significance and other studied variables are at their reference levels. This predictive model will help clinicians, patients, and their families in mentally preparing for confirmation of the disease’s presence or absence.

Under DAPHNE4NFDI, the X-ray absorption spectroscopy (XAS) reference database, RefXAS, has been set up. For this purpose, we developed a method to enable users to submit a raw dataset, with its associated metadata, via a dedicated website for inclusion in the database. Implementation of the database includes an upload of metadata to the scientific catalogue and an upload of files via object storage, with automated query capabilities through a web server and visualization of the data and files. Based on the mode of measurements, quality criteria have been formulated for the automated check of any uploaded data. In the present work, the significant metadata fields for reusability, as well as reproducibility of results (FAIR data principles), are discussed. Quality criteria for the data uploaded to the database have been formulated and assessed. Moreover, the usability and interoperability of available XAS data/file formats have been explored. The first version of the RefXAS database prototype is presented, which features a human verification procedure, currently being tested with a new user interface designed specifically for curators; a user-friendly landing page; a full list of datasets; advanced search capabilities; a streamlined upload process; and, finally, a server-side automatic authentication and (meta-) data storage via MongoDB, PostgreSQL and (data-) files via relevant APIs.

Background: School-going adolescents are found to be on the leading edge when it comes to social media usage. Aim and Objectives: The study was designed to see the behavioral issues related to excessive usage of social media among school-going adolescents from the Sonitpur district of Assam, India. Materials and Methods: Cross-sectional descriptive research design and simple random sampling were used to collect data. At the onset, 1045 respondents were recruited, but finally, n = 943 respondents were kept for the final study. Tools administered were sociodemographic data sheet, a semi-structured questionnaire, strength and difficulty questionnaire, and social media addiction scale. Statistical analysis was done using SPSS version 23.0. Results: The level of social media addiction was very high in 30.5% of the respondents. In Pearson’s coefficient correlation, social media addiction score was found to be significantly positively correlated with the emotional problem (r = 0.509, P = 0.01), conduct problem (r = 0.398, P = 0.01), hyperactivity problem (r = 0.489, P = 0.01), and peer problem (r = 0.359, P = 0.01). Conclusion: The present study highlighted the high prevalence of social media addiction among school-going adolescents. Hence, based on the findings, precautionary measures are the need of the hour. Intervention can be planned at the school level in collaboration with mental health-care personnel such as psychologists, school counselors, and social workers, etc.

Waste water reuse is an effective method for reducing the quantity of wastewater that enters the environment. As a result, the appropriateness was assessed in accordance with its composition and the global criteria for drinking water quality. This study aims to evaluate the quality of surface water of Brahmani River, Odisha, by adapting multivariate statistical approaches, namely Cluster Analysis (CA) and multi-criteria decision-making (MCDM) methods such as Simple Additive Weighting (SAW). Again, Geographical Information System (GIS) is employed to assess the drinking water's quality in relation to its application. Around 15 physicochemical parameters, gathered from seven distinct sites, following a period of 2022 till 2024. The results showed high values of EC, SO42−, NO3−, PO43−, F− and Ca2+, in three stations, while other studied parameters are within the permissible limits defined by WHO standards. The CA three distinct classifications of sites namely, low, medium, and high, based on how comparable the various physicochemical traits and pollutant levels were throughout the sampling locations. Sites H-(4–6) were included in cluster 1, site H-(3) and (7) classified under Cluster 2 and finally, H-(1–2) indicated as Cluster 3. Thus, as stated by CA, 42.86 % of tested water samples were fall into the group of good quality and about 57.14 % of examined locations resides in the poor category of water. The findings indicate which characteristics, as determined by the CA technique, were accountable for the alteration in the water quality and raise the potential of runoff from cities, farms, and industries. Subsequently, MCDM techniques has been implemented to facilitate rapid comprehension of surface water behavior and address problems with water resource management. The obtained SAW index ranges from 0.5 to 0.94. Here, H-(1), (2), and (7) grouped as highly polluted zone, and they seemed to be connected to runoff from farms and untreated industrial and municipal trash as well as local pollution sources. From this innovative study, it is found that even though the water is fit for drinking at 3 places, it is medium to highly suitable for human consumption. Therefore, there needs to be treated in some way before being used in addition to being protected against contamination. Most often, the findings indicate that appropriate management actions are important to restore the water quality of this catchment in order to support a robust and promising aquatic ecosystem. Additionally, the significance of this restoration for objective ecological policy and decision-making processes is underscored.

Interstitial pregnancy accounts for only 2%–4% of all ectopic pregnancies, however, it is associated with higher mortality rates as compared to other ectopic pregnancies, due to the associated risk of uterine rupture, and hemorrhage. A 35-year-old gravida 4 abortion 3 woman reported at the 8th week of gestation for antenatal care with comorbidity of protein C and protein S deficiency and recurrent pregnancy loss with for routine care. She was diagnosed as a case of interstitial pregnancy by transvaginal sonography and magnetic resonance imaging. She was subsequently managed by laparoscopic cornuostomy. Prompt recognition and definitive management are crucial in averting life-threatening hemorrhage due to this rare condition.

Osmotic demyelination syndrome (ODS) is well known to be associated with the rapid correction of hyponatremia. However, there is limited literature on its link to persistent or corrected hyperglycemic states in diabetic patients. We report two young patients with ODS and hyperglycemia. Neuroimaging and blood tests indicated central pontine and extrapontine myelinolysis with a hyperglycemic hyperosmolar state (HHS). These unusual cases provide insight into the neurologic complications of hyperglycemia.

Abstract Background Noncommunicable diseases (NCDs) are public health threats globally and recognized impediments to socioeconomic development. This study aimed to identify the prevalence and clustering of NCDs risk factors among Bangladeshi men and women aged 20–59 years using nationally representative data. Methods This study was conducted in 82 rural, nonslum urban, and slum clusters across all eight administrative divisions of Bangladesh using multistage cluster sampling. A total of 4917 men and 4905 women aged 20–59 years were included in the study. Descriptive analyses were performed to report the prevalence and distribution of behavioral and clinical risk factors. Multivariable binary logistic regression was performed to identify factors associated with the coexistence of three or more NCD risk factors. Results The prevalence of tobacco use (any form), insufficient physical activity, inadequate fruit and vegetable consumption, overweight and obesity, and central obesity were 38.3%, 13.6%, 87.1%, 42.3%, and 36.0%, respectively. Furthermore, 21.9% and 4.9% participants had hypertension and self‐reported diabetes, respectively. Regarding the clustering of risk factors, 37.1% men and 50.8% women had at least three NCD risk factors. Only 3.0% men and 1.8% women reported no NCD risk factors. Age, place of residence, education, and wealth status were associated with the presence of at least three risk factors for both sexes. Conclusion Since a large proportion of Bangladeshi 20–59 years old population had multiple risk factors, population‐based programs with multisectoral approaches are essential to reduce NCDs among Bangladeshi women and men.

The safety of railways is ensured by the regular maintenance of tracks, signals and rolling stocks. This mainly involves manual inspection by skilled maintainers and automated inspection systems are not commonly used. The development of an automated inspection system is crucial for maintaining good rail conditions. In this study on automatic surface defect detection systems, we focused on wheels as the target because they are critical components of rolling stocks, and any wheel defects can cause severe safety problems. Wheel-tread-profile dimensions have been measured using laser instruments in previous studies. In this research, to validate the accuracy of the measurement equipment, special test pieces with surface defects are prepared. We propose a combined inspection system using laser sensors, and a machine vision technique to confirm the effectiveness of the proposed system. An artificial intelligence (AI)-based surface defect detection system is employed to improve the proposed system. Combining edge detection through image transformation with an AI-based surface defect detection system offers remarkable benefits. The effectiveness of the system is experimentally confirmed using test pieces that simulate different materials and passing speeds of wheels.

The study focuses on the physico-chemical characteristics of the wild fruit Meyna laxiflora Robyns (Alu) and fruit powder, which was gathered from the Konkan region of Maharashtra. Alu fruit powder is made by using a drying aid called maltodextrin (MD). Powder samples (MP1, MP2, MP3, MP4 and MP5) were made using different amounts of MD (0.5, 1.0, 1.5, 2.0 and 2.5 g). Preliminary phytochemical screening of fruit pulp and powder showed the presence of some phytoconstituents such as reducing sugar, saponin, flavonoids, and terpenoids, whereas alkaloids, tannins, steroids and protein were absent in both. The parameters of the powder are directly influenced by the amount of MD, as evidenced by the variations in bulk density, total soluble solids, pH, specific gravity and the proximate among the powder samples. High solubility was found in the sample with a medium of MD. The highest of particle distribution was found in MD-added samples (MP2 (1 g), MP3 (1.5 g), MP4 (2 g)) whereas the raw (MP0) showed the least. Sensory analysis was done using 9-point hedonic scale, which revealed that MP2, MP3, and MP4 were highly acceptable. This study assumed that fresh Alu fruit, pulp and in the form of powder can be useful for the development of new products.

Abstract Introduction Real-world data on ixekizumab utilization in axial spondyloarthritis (axSpA) are limited. We evaluated ixekizumab treatment patterns and health care resource utilization (HCRU) in patients with axSpA using United States Merative L.P. MarketScan® Claims Databases. Methods This retrospective cohort study included adults with axSpA who initiated ixekizumab during the index period (September 2019–December 2021). Index date was the date of the first ixekizumab claim. All patients had continuous medical and pharmacy enrollment during the 12-month pre-index and follow-up periods. Descriptive statistics were used to assess patient demographics (index date); clinical characteristics (pre-index period); treatment patterns (12-month follow-up period); and HCRU (pre-index and 12-month follow-up periods). Results The study included 177 patients (mean age 45.8 years; females 54.8%) with axSpA who initiated ixekizumab. Overall, 79.1% of patients reported prior biologic use; of these, 70.7% received tumor necrosis factor-alpha inhibitors (TNFi) and 49% received secukinumab. The mean (standard deviation [SD]) Charlson Comorbidity Index score was 1.1 (1.3) and ~ 27% of patients reported ≥2 comorbidities. The median (inter-quartile range [IQR]) number of ixekizumab prescription refills was 7 (4–11). The mean (SD) Proportion of Days Covered (PDC) for ixekizumab was 0.6 (0.3) and adherence (PDC ≥80%) was 34.5% (N = 61). Overall, 26.6% (N = 47) of patients switched to a non-index medication and 54.2% (N = 96) of patients discontinued ixekizumab. Among the patients who discontinued ixekizumab (N = 96), 19.8% (N = 19) restarted ixekizumab and 49.0% (N = 47) switched to a non-index medication. The median (IQR) ixekizumab persistence was 268 (120–366) days. Mean axSpA-related outpatient, inpatient, and emergency room visits were similar between the pre-index and follow-up periods. Treatment patterns were largely similar between biologic-experienced patients (N = 140; 79.1%) and the overall population. Conclusions Despite high comorbidity burden and majority of the patients being biologic-experienced, patients initiating ixekizumab for axSpA showed favorable persistence profiles during the 12-month follow-up period.

This review delves into the effect of cardio, aerobic, Zumba, and yoga on physical, mental, and emotional health. Cardiovascular exercises enhance heart strength, aid weight management, boost lung capacity, increase endurance, and positively impact metabolism. Aerobic exercise contributes to heart health, lowers blood pressure, and promotes mental wellness. Zumba a dynamic dance-fitness program offers cardiovascular benefits, calorie burning, muscle toning, enhanced coordination, and stress reduction, fostering both physical and social well-being. Yoga, a holistic practice, improves flexibility, strengthens muscles, enhances balance, supports joint health, and cultivates good posture. Additionally, yoga positively influences mental and emotional health by promoting relaxation, reducing anxiety, enhancing focus, and fostering self-awareness. The combination of scientific insights across these diverse exercise modalities offers a holistic understanding of how physical activity profoundly shapes our overall well-being, making this review paper a valuable resource for individuals and health-care professionals alike.

Abstract Intervalley excitons with electron and hole wavefunctions residing in different valleys determine the long-range transport and dynamics observed in many semiconductors. However, these excitons with vanishing oscillator strength do not directly couple to light and, hence, remain largely unstudied. Here, we develop a simple nanomechanical technique to control the energy hierarchy of valleys via their contrasting response to mechanical strain. We use our technique to discover previously inaccessible intervalley excitons associated with K, Γ, or Q valleys in prototypical 2D semiconductors WSe2 and WS2. We also demonstrate a new brightening mechanism, rendering an otherwise “dark” intervalley exciton visible via strain-controlled hybridization with an intravalley exciton. Moreover, we classify various localized excitons from their distinct strain response and achieve large tuning of their energy. Overall, our valley engineering approach establishes a new way to identify intervalley excitons and control their interactions in a diverse class of 2D systems.

Abstract This research paper investigates the oceanic fishery resources of the Andaman archipelago. The primary objective of this study is to gain a comprehensive understanding of the fishery and its dynamics including the environmental linkage surrounding these oceanic resources and to develop an effective strategy for sustainable exploration. Data were collected during an exploratory tuna long-line survey conducted between July 2022 and February 2023. The study documented a total of 13 species of fishes belonging to 11 genera, with tuna being the most abundant. Additionally, the study observed a significant increase in the population of pelagic stingrays, which nearly matched the number of hooked sharks (32). However, the hooking rates of sharks and bill fishes were observed to be gradually declining, resulting in a lower contribution to the overall species composition. One notable finding of the study was that site 11oN; 93oE (S4) exhibited the highest species diversity and potential. Furthermore, the aggregate hooking rates of fishes were particularly high between latitudes 11oN and 12oN. The study also analysed the seasonal distribution of each fish species and explored the correlation between environmental factors such as depth and temperature with species abundance and distribution. Statistical analysis indicates that there is no significant variation (p value = 0.20) between the environmental factors and the frequency of the species occurrence. Specifically, depth shows the highest correlation (r = 0.57) with the species distribution. In light of the diminishing hooking rate of oceanic fishery resources, the study puts forth several possible reasons and emphasizes the urgent need to implement conservation measures.

Abstract Newcastle disease (ND), an economically important disease in poultry, is caused by virulent strains of the genetically diverse Orthoavulavirus javaense (OAVJ). Laboratories rely on quantitative real-time reverse transcription PCR (qRT-PCR) to detect OAVJ and differentiate between OAVJ pathotypes. This study demonstrates that a fusion cleavage site based molecular beacon with reverse transcription loop mediated isothermal amplification (MB-RT-LAMP) assay can detect and differentiate OAVJ pathotypes in a single assay. Data show that the assay can rapidly identify diverse OAVJ genotypes with sensitivity only one log-fold lower than the current fusion qRT-PCR assay (104 copies), exhibits a high degree of specificity for OAVJ, and the molecular beacon can differentiate mesogenic/velogenic sequences from lentogenic sequences. Further, data show that a two-minute rapid lysis protocol preceding MB-RT-LAMP can detect and differentiate OAVJ RNA from both spiked samples and oropharyngeal swabs without the need for RNA isolation. As the MB-RT-LAMP assay can rapidly detect and discriminate between lentogenic and mesogenic/velogenic sequences of OAVJ within one assay, without the need for RNA isolation, and is adaptable to existing veterinary diagnostic laboratory workflow without additional equipment, this assay could be a rapid primary screening tool before qRT-PCR based validation in resource limited settings.

District Mental Health Program (DMHP) is part of the broader National Mental Health Program (NMHP) launched in 1982. In India, DMHP has evolved over the years, moving from a pilot project to an integrated component of the NMHP. Efforts have been made to expand services, protect the rights of individuals with mental illness, and integrate mental healthcare into the primary healthcare system. Recent updates and efforts taken by the Government of India and state governments (60% and 40% budget share respectively) have improved the quality of services provided under DMHP. With the increasing use of the internet and mobile technology, DMHP has spread its arena of services more deeply and widely in the last few years reaching up to 738 districts in the country. However, there is still work to be done to address many challenges associated with mental health in India though the recent developments seem promising as a substantial number of patients are now having access to the programme. This narrative review is the summary of information available to date on the evolution of implementation and expansion of DMHP over the years and provides a gist of the positive aspects as well as limitations of the DMHP witnessed in recent years.

Performance of short hydrodynamic journal bearing lubricated with Copper oxide (CuO) nanoparticle suspensions in base oil (nanolubricants) is investigated numerically. Dimensionless pressure, load carrying capacity and friction parameter are calculated by numerical solution of the modified Reynolds equation by means of finite difference method. The particular values of couple stress parameter for nanolubricants are evaluated and used for finding pressure distribution. Modified Krieger Dougherty equation is used to predict the viscosity of nanolubricant. Two short bearing configurations with aspect ratio 0.25 and 0.5 are analyzed by evaluating the pressure profile, load carrying capacity and friction parameter. The comparative results between plain lubricants and nanolubricants are presented. The results reveal improved pressure and load carrying capacity accompanied by decrease in friction parameter of short bearing. The shorter bearing configuration with aspect ratio of 0.25 shows better results than the others.

Introduction Pneumococcal diseases pose a significant public health concern in India, with substantial morbidity and mortality, with the elderly and those with coexisting medical conditions being most at risk. Pneumococcus was also seen to be one of the main reasons for co-infection, pneumonia and complications in COVID. Current guidelines recommend vaccination for specific adult populations, but there is a lack of uniformity and guidance on risk stratification, prioritisation and optimal timing. Methods Nation Against Pneumococcal Infections – Expert Panel Opinion (NAP-EXPO) is a panel convened to review and update recommendations for adult pneumococcal vaccination in India. The panel of 23 experts from various medical specialties engaged in discussions and evidence-based reviews, discussed appropriate age for vaccination, risk stratification for COPD and asthma patients, vaccination strategies for post-COVID patients, smokers and diabetics, as well as methods to improve vaccine awareness and uptake. Outcome The NAP-EXPO recommends the following for adults: All healthy individuals 60 years of age and above should receive the pneumococcal vaccine; all COPD patients, regardless of severity, high-risk asthma patients, post-COVID cases with lung fibrosis or significant lung damage, should be vaccinated with the pneumococcal vaccine; all current smokers and passive smokers should be educated and offered the pneumococcal vaccine, regardless of their age or health condition; all diabetic individuals should receive the pneumococcal vaccine, irrespective of their diabetes control. Strategies to improve vaccine awareness and uptake should involve general practitioners (GPs), primary health physicians (PHPs) and physicians treating patients at high risk of pneumococcal disease. Advocacy campaigns should involve media, including social media platforms. Conclusion These recommendations aim to enhance pneumococcal vaccination coverage among high-risk populations in India in order to ensure a reduction in the burden of pneumococcal diseases, in the post-COVID era. There is a need to create more evidence and data to support the recommendations that the vaccine will be useful to a wider range of populations, as suggested in our consensus.

Background: Troponin-I is conventionally correlated with myocardial injury, but its relevance in assessing the severity of coronavirus disease 2019 (COVID-19) and its implications for patient management remains an area of ongoing investigation. This study was designed to assess the correlation between troponin-I levels and the disease severity among patients with COVID-19. Materials and Methods: This retrospective study was conducted at a tertiary care center in India between April 2020 and November 2021. The patients with reverse transcription-polymerase chain reaction who tested positive for COVID-19 infection, and who underwent troponin-I examination at presentation were included in the study. A comparison of baseline clinical characteristics among patients who survived and who did not survive post-COVID-19 was done, and risk factors associated with mortality among hospitalized patients were analyzed. Results: A total of 1673 patients were enrolled in this study. Of these, 1431 patients survived, and 242 patients did not survive post-COVID-19. The mean age of the patients with troponin-I levels ≤0.06 ng/ml was 49.66 ± 17.88 years and that of patients with troponin-I levels >0.06 ng/ml was 60.13 ± 20.04 years. The nonsurvival rate was high in patients aged >50 years compared to the patients aged ≤50 years (81.4% vs. 18.6%; P < 0.001). The mortality rate was high in patients with troponin-I levels >0.06 ng/ml compared to the patients with troponin-I levels ≤0.06 ng/ml (51.7% vs. 48.3%; P < 0.001). Breathlessness (odds ratio [OR]: 26.901; P < 0.001), cut-off troponin-I levels (OR: 8.246; P < 0.001), and other comorbidities (OR: 8.246; P < 0.001) were independently correlated with mortality among hospitalized patients with COVID-19. Conclusion: This study demonstrated that elevated troponin-I level at presentation was associated with disease severity and increased mortality in patients with COVID-19.

The increasing commercial, industrial, and medical applications of plastics cannot be halted during the coming years. Microplastics are a new class of plastic pollutants which have emerged as escalating environmental threats. The persistence, effects, and removal of MPs present in soil, water, and numerous organisms have become an important research field. However, atmospheric microplastics (AMPs), which are subcategorized into deposited and suspended, remain largely unexplored. This review presents the recent developments and challenges involved in fully understanding suspended and deposited AMPs. The evaluation of indoor suspended MP fibers needs to be critically investigated to understand their implications for human health. Furthermore, the transportation of AMPs to isolated locations, such as cryospheric regions, requires immediate attention. The major challenges associated with AMPs, which have hindered advancement in this field, are inconsistency in the available data, limited knowledge, and the lack of standardized methodologies for the sampling and characterization techniques of AMPs.

In this paper, the investigation explores an anisotropic cosmological model based on Marder’s space-time Tsallis holographic dark energy (THDE) within the framework of f(R, T) theory of gravity, where R represents the Ricci scalar and T signifies the trace of the stress energy-momentum tensor. field equation have solved for class of f(R, T) gravity i.e. f(R, T) = R + f(T). To obtain the precise solution, we employed the density of the THDE model along with the volumetric expansion laws, namely the power law and exponential law. Also explores the physical and geometrical aspects of the model.

Selenium nanoparticles (Se-NPs) have attracted researchers’ attention because of their unique attributes and potential for application in diverse areas, such as biological medicine, environmental remediation, and energy generation. This review summarizes recent progress in the green synthesis and characterization of Se-NPs. It elaborates on the fabrication of Se-NPs through chemical, biological, and physical techniques, including advantages and challenges. Moreover, techniques for evaluating the chemical and physical characteristics of NPs are described. The promising applications of Se-NPs are emphasized, including antioxidant, anticancer, and antimicrobial applications, and treatment of neurodegenerative diseases. Because of their exceptional properties and biocompatibility, Se-NPs are used in diverse industries. Recently, plant-extract synthesized Se-NPs have become increasingly used because of their benefits over chemically synthesized Se-NPs, including lower cost and greater environmental friendliness.

This study employs a data-driven approach to examine the government's use of data insights and nudges to promote social distancing during the pandemic. Drawing from well-established technology adoption theories, a nationwide online survey was conducted among professionals and postgraduate students adapting to remote work and learning. The study unveils that access to suitable information and communication technology (ICT) significantly influences people's willingness to adhere to social distancing and work from home (WFH). Moreover, respondents' expectations of WFH's impact on job performance emerged as a critical driver for sustained social distancing, with individuals' habits playing a pivotal role in enhancing WFH performance expectancy. Notably, the study pioneers in exploring the psychological effects of government nudges during a pandemic, shedding light on an uncharted aspect of pandemic control strategies.

Introduction: While detecting active TB is central to public health efforts, modelling indicates that reducing latent TB through preventive therapy is crucial. Current regimens mitigate risk but are lengthy and have side effects, necessitating support for uninterrupted treatment. This paper presents the development and evaluation of a digital health platform designed to enhance adherence among LTBI patients. Methods: A Quasi-experimental study was conducted among LTBI patients in Delhi. A total of 163 participants were allocated to intervention (n=82) and control (n=81) groups. Participants were followed up for 6 months post recruitment. Effectiveness of mobile application was evaluated through quantitative tools. Results: Intervention group participants showed slightly higher treatment completion rates (65.91%), in comparison to participants in control group (63%). The analysis demonstrated no co-relation of gender, age, education and employment with treatment completion rates in intervention group. While text and video-based interventions have shown success, there remains a need for more user-centric digital health interventions in this area, given the limited number of studies to date. Conclusion: The mobile health applications can be useful for LTBI care. However, there is a need of involving users during development so that continued interest of users can be ensured.

In the present scenario, research on Thermal Barrier Coatings (TBCs) is attracting significant attention in high-temperature applications due to the rising demand in industrial applications, such as gas turbine blades and internal combustion engine components. To meet these demands, it is essential to enhance the mechanical and oxidation properties of thermal barrier coatings. The atmospheric plasma spray methodology for producing these coatings has become a central focus in recent times. In this work, TBCs were prepared by blending pure alumina and Yttria-Stabilized Zirconia (YSZ) in equal proportions. Extensive study of TBCs carried out under high-temperature conditions through thermal cycle tests at elevated temperatures, around 850 °C. A total of 350 thermal cycles were conducted, and microstructures of the coating surface were examined at 150, 250, and 350 cycles. High-temperature stress, generated due to the sintering of the coating, also influences the life of the coatings. Specimen with a topcoat thickness of 300 μm, exhibited good thermal shock resistance compared to the specimens with topcoats of thickness of 100 μm and 200 μm. The effects of process parameters, porosity, and thermal shock resistance are presented in detail. The topcoat with a thickness of 300 μm demonstrated excellent thermal shock resistance and reduced formation of thermally grown oxide (TGO). The porosity of the coating, found to be between 2% and 3%, contributed to its dense nature, effectively reducing oxidation rates and enhancing the coating's lifespan under cyclic high-temperature conditions.

The design methodology of a Ka-band frequency doubling two cavity gyroklystron has been discussed in this paper. In this study, the amplifier’s design and simulation are accomplished by employing nonlinear analysis and validated using particle-in-cell simulation techniques. The output cavity functions in the TE02 mode at two times the input signal frequency at the second harmonic of the cyclotron frequency, while the input cavity is powered by a 17.5 GHz source and functions in the TE01 mode at the first harmonic of the cyclotron resonance. The device’s performance has been examined both in the presence and in the absence of a beam. A number of factors were taken into account in order to optimize the interaction structure dimension to reach the device’s targeted performance. By adjusting the structural features and electron beam parameters, the device’s RF output power is assessed in an effort to increase efficiency. Simulation results estimate that the device displays a gain of 21.5 dB, an efficiency of 21.6%, a power of 227 kW, and a −3 dB bandwidth of ∼0.3%.

Background: Accidental needle stick injuries (NSIs) are an occupational hazard for healthcare workers (HCWs). Despite the implementation of preventive measures, NSIs still continue to occur in health care settings. The cost incurred by an institute for the management of occupational exposure to blood borne pathogen is a significant economic burden.This retrospective study was aimed to estimate the prevalence, factors associated with NSIs and cost burden on hospital due to NSIs. Material and methods: Retrospective data of all reported NSIs among HCWs between January 2019 and December 2021 in a tertiary care hospital was collected and analyzed. CDC definition was used to calculate direct & indirect cost. Results: & Discussion- A total 205 NSIs were reported between January 2019 and December 2021. Nurses were the most affected category of HCWs. The maximum number of NSI cases (18.54 %) occurred during handling of biomedical waste. Both the source and the affected HCWs were tested and it was found that the source was seropositive in 30(14.63 %), seronegative in 128 (62.44 %) cases and in 47(22.93 %) cases there was an unknown source resulting in NSI. A total of 13, 21,206 INR, which included both direct and indirect cost, spent by hospital in the management of NSI's, over a period of 3yrs. Conclusion: Surveillance and analysis of NSI is very crucial for the planning of both preventive measures and training modules. Managing NSI generates significant cost. Hepatitis B vaccination for all healthcare workers plays major role in reducing cost of managing NSIs.

Global environmental concerns are leading to paradigm shift in the automobile eco-system. This comprehensive study of the automobile ecosystem, incorporates technical, economic, and environmental-social-governance (ESG) dimensions. An “integrated multi-criteria decision-making” (MCDM) methodology using “interpretive structural modelling” (ISM) and “fuzzy analytical hierarchy process” (FAHP) is deployed, The ISM models highlights prominent drivers and critical barriers, establishes their hierarchy, and depicts interrelationships. The FAHP rankings for drivers favours electric vehicles and hydrogen fuel vehicles over others, while barriers promote hybrids and alternate fuels like Biofuel, CNG/LNG. Unlike previous works, this study considers all eco-system factors, both critical drivers and barriers, and demonstrates hierarchy using a unique V-model. This is an innovative extension of V-model from traditional systems engineering to strategic project management domain. This holistic approach, in sync with the natural state of things, will enable government, industry, and academia in formulating a strategic framework towards future automobile sustainability.

Background: Caregiving is schizophrenia is challenging and burdensome. Aim and Objectives: The study aimed to know the sociodemographic predictors of care burden and psychological distress in schizophrenia. Materials and Methods: The present study was a cross-sectional descriptive study. A total sample of 540 caregivers of persons with schizophrenia was selected, using purposive sampling from the outpatient Department of LGBRIMH, Tezpur, Assam. The study was approved by the IEC of LGBRIMH, Tezpur. Statistical analysis was done using SPSS version 23.0. Results: The mean age of patients and their caregivers was 35.6 ± 13.4 and 37.7 ± 12.4 years, respectively. Moderate to severe level of care burden was present in male caregivers (55.6%). Severe level of stress, anxiety, and depression was present in majority of the male respondents (42.5%, 43.2%, and 49.0%, respectively) who were the primary caregivers (41.2%, 40.8%, and 48.9%, respectively), married (41.2%, 37.7%, and 48.1%, respectively), belonging to rural background (43.8%, 43.2%, and 48.5%, respectively), educated till primary level (42.6%, 44.6%, and 58.3%, respectively), mostly unemployed (49.2%, 47.5%, and 50.8%, respectively) belonging to lower socioeconomic background (46.6%, 49.2%, and 48.0%, respectively), and with a history of mental illness in the family (41.6%, 40.7%, and 48.0%, respectively). Extremely severe level of stress (57.1%), with severe level of anxiety and depression (41.7%, 52.8%), was present in majority of the caregivers having nuclear family type condition. Marital status, occupation, family income, and type of caregiving contribute significantly to the prediction of care burden (F [14,525] =11.6, P = 0.001), whereas, caregiver’s gender, education, and, patient’s onset of illness contribute significantly to the prediction of psychological distress among caregivers (F [14,525] =5.31, P = 0.001). Conclusion: Psychosocial intervention is the need of the hour.

Blunt trauma abdomen with abdominal wall herniation with bowel perforation is an acute emergency condition. Road traffic accidents causing blunt trauma are common in a youngster like in our case. Once the patient is resuscitated, ultrasonography and Computed tomography must be done. Early surgical exploration with mesh or primary repair of the defect is the mainstay of management. We have a case of a 25-year-old male with blunt trauma abdomen and anterior wall hernia following a road traffic accident who was managed with emergency exploratory laparotomy as computed tomography suggested anterior abdominal wall herniation of bowel content.

Abstract Given the relationship between poor engagement and worse treatment outcomes, improving engagement has been the focus of attention in recent years. Engagement is a particular challenge among minoritized and otherwise challenged youth, such as those from socioeconomically disadvantaged groups, including youth in low- and middle-income countries (LMICs), where they face lower levels of access to resources, including mental health treatment. The present study describes engagement challenges that arose in an uncontrolled pre-post evaluation of a school-based, modular, multi-problem, stepped-care intervention delivered in urban Indian communities. Specifically, the study aimed to (1) characterize barriers and facilitators of youth treatment engagement; and (2) evaluate treatment acceptability and fit of treatment from the youth perspective. Youth participants completed semi-structured interviews, which were transcribed and coded using thematic analysis. Participants described numerous facilitators to engagement (e.g., positive therapeutic relationship) and reported high overall satisfaction with the intervention, while also identifying barriers to engagement (e.g., concerns about confidentiality) and offering suggestions to increase fit and acceptability (e.g., more visually appealing treatment materials). Findings highlight ways in which engagement can be enhanced and implementation supports improved to maximize treatment effectiveness among minoritized and disadvantaged youth in LMICs.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors involving the gastrointestinal tract, arising from the interstitial cells of Cajal. GIST comprises about 1% of all GI tumors. Rectal GISTs are rare and comprise of approximately 5% of all GISTs and only 0.1% of rectal tumors are found to be GISTs. Rectal GISTs may be diagnosed incidentally or present with symptoms, including defecation problems, bleeding, and/or pain. We report a case of a 46-year-old male with rectal GIST metastasized to the liver and bilateral lung parenchyma managed by Imatinib Mesylate (IM) regimen. Rectal GIST although being rare, must be considered as a differential diagnosis in a patient presenting with defecatory problems with bleeding.

The stated goal of the research is to investigate the surface water quality of the Baitarani River in Odisha to ascertain its compatibility for various uses. Large, complex datasets generated during the one-year (2021-2022) monitoring program were collected from 13 locations and encompassed 22 parameters. To examine temporal and spatial fluctuations in and to interpret these datasets, MCDMs like TOPSIS and the Entropy-based Water Quality Index (EWQI) were utilized. The physical and chemical outcomes of the current experiment were compared to WHO standards. According to the analysis’s results, turbidity and total coliform (TC) are indicators that have a greater impact on water quality in all locations during both seasons and are directly linked to home and agricultural non-point source pollution. As per EWQI interpretation, 30.77 % of the observations in PRM and POM fall under the poor category. The findings showed how anthropogenic activities have harmed St. 8, 11, 12, and 13 and require effective management. A quantifiable approach was also carried out to decide the efficacy of TOPSIS. Farming attributes, including SAR, % Na, RSC, MR, KI, and PI, were estimated to delineate the agriculturally practicable zones. This work can offer a reference database for the betterment of water quality.

Women suffer from various conditions related to menstrual cycle due to changing lifestyle, bad food habits, physical and mental stress. Pre Menstrual Syndrome (PMS) is a combination of physical and emotional symptoms that many women get one or two weeks before the start of their menstrual period. In the present study, 14 years old female patient having symptoms-lower abdominal pain, backache, breast tenderness, constipation, pimples, tiredness and unexplained anger typically in luteal phase from last 4 months, was diagnosed with mild to moderate symptoms of PMS. After proper analysis, she was suggested to consume light to digest dietary articles advised in classical texts for minimizing specific symptoms during menstruation.Thus Green gram Soup and Barley porridge was prescribed to her as lunch and dinner respectively for first three days of menstruation cycle for continuous 6 cycles. It is observed that consumption of these dietary products during the menstruation time period assisted to minimize the symptoms of PMS. This illustrates that there is a wide scope to explore the ayurvedic dietary regimen recommended during menstruation which can be used more rationally to suit menstrual disorders.

Photocatalysis is an advanced oxidation process where light exposure triggers a semiconducting nanomaterial (nano-photocatalyst) to generate electron-hole (e−/h+) pairs and free radicals. This phenomenon is widely used for the photocatalysis-assisted removal of organic and other contaminants using wide range of nano-photocatalysts, offering an efficient approach to environmental remediation. However, the introduction of powdered nano-photocatalysts into water systems often leads to unintended secondary pollution in the form of residual nano-photocatalysts, ion leaching, free radicals, toxic by-products etc. Such practices potentially introduce emerging secondary contaminants into aquatic environments, posing risks to both aquatic life and human health. The resulting chemical by-products and intermediates can effectively induce chronic toxicity, neurological and developmental disorders, cardiovascular defects, and intestinal ailments in humans and aquatic species. Despite having a range of health and environmental consequences, this dark side of nano-photocatalysts has been comparatively less explored and discussed in the literature. In this review, the pros and cons of powder nano-photocatalysts are discussed in view of their advantages as well as disadvantages in wastewater treatment. The discussion encompasses their classification based on composition, dimensions, structure, and activity, as well as recent advancements in improving their photocatalytic efficiency. The article also explores the recent advances on their applications in photocatalytic removal of various water pollutants/contaminants of emerging concern (i.e., organic pollutants, micro/nano plastics, heavy ions, disinfections, etc.) Furthermore, an emphasis on the role of such nano-photocatalysts as emerging (secondary) contaminants in water system, along with a thorough discussion of latest studies related to the health and environmental issues, has been discussed. Additionally, it addresses critical issues in applying powder nano-photocatalysts for wastewater detoxification and explores potential solutions to these challenges followed by future prospects.

In this present research report, the series of Ba3LaNa(PO4)3Fphosphor doped with Sm3+ was successfully synthesized by using a high-temperature solid-state reaction method. The phase purity was examined using X-ray diffraction (XRD), which confirmed a pure phase of prepared material after sintering the sample at 700 °C. Fourier transform infrared (FT-IR) spectra showed absorption bands corresponding to the stretching and vibrational modes of PO4 in phosphate. Scanning electron microscopy (SEM) images displayed the morphology of sample and agglomerated structure of micron-sized particles. Photoluminescence excitation (PLE) and emission spectra of the Ba3LaNa(PO4)3F: Sm3+ phosphors were studied. When excited with near-UV light, the phosphor showed three prominent peaks at 567, 604, and 643 nm. The emission spectra for different concentrations of Sm3+ ions were also measured to find the optimal dopant concentration. The highest intensity was observed at a 2.0 mol% concentration of Sm3+ ions at 604 nmwith concentration quenching occurring beyond this point. The CIE chromaticity coordinates for the different concentration phosphor were located in the orange-red region, indicating its characteristic light emission. So therefore, these results suggested that the synthesized reddish-orange light-emitting Ba3LaNa(PO4)3F: Sm3+prepared phosphor is promising for applications in white light-emitting diodes (WLEDs).

Sanitation is becoming more crucial as urban populations rise, making waste management a crucial issue in smart cities. Accurate waste material identification and classification are necessary because the waste items vary as they deteriorate. Furthermore, traditional methods do not overcome the risk of contamination when non-recyclable or hazardous products are improperly disposed of with ordinary waste, and there is an issue of identifying the waste that deteriorates over time. Hence a novel method ''Simplified White Shark with Multivariate Deep Belief Network'' is proposed, it improves system effectiveness and efficiency by identifying waste things that deteriorate with time using an object detection algorithm called Simplified White Shark Object. In addition, a Nearest Centroid Deep Belief Network classification technique for precise waste classification in smart cities is also proposed. The suggested algorithm considerably boosts waste management performance by increasing classification accuracy, efficiency and sensitivity which reaches a maximum of 99.78 %, 99.34 %, 97.69 %, and the minimum error rate of 0.182.

In this study, the influence of phosphorus doping on the electrocatalytic activity of glycerol-based carbon-supported nickel towards glycerol electrooxidation is investigated. The P-doped and un-doped glycerol-based carbon are synthesized through dehydration using phosphoric acid and thermal treatment, respectively. The P-doped catalysts with different Ni loadings (names as P-carbon_Ni (200), P-carbon_Ni (400), and P-carbon_Ni (600)) and the un-doped catalyst; carbon_Ni (600) are analysed for their physicochemical properties, indicating that P-doping can enhance the electrocatalytic activities of the fabricated electrodes. The scanning electron microscopy, energy dispersive X-ray spectroscopy, and X-ray photoelectron spectroscopy analyses reveal the higher porosity of P-carbon_Ni (600) relative to the un-doped carbon_Ni (600) and a uniform distribution of the doped elements. The cyclic voltammetric studies show that the un-doped carbon_Ni (600) possesses a smaller electrochemical surface area (98.49 cm2) and poorer surface coverage with –OH (6.35 × 10−5 mol/cm2) compared to P-carbon_Ni (600) whose electrochemical surface area and surface coverage with –OH are 115.49 cm2 and 7.62 × 10−5 mol/cm2, respectively. Undoubtedly, the electrocatalytic performance of P-carbon_Ni (600) for glycerol oxidation is significantly better than the un-doped carbon_Ni (600), as also revealed by chronoamperometry and electrochemical impedance studies. P-carbon_Ni (600) is able to stabilize at higher current density as the electrooxidation of glycerol progresses and possesses a lower charge transfer resistance indicating that the incorporation of phosphorus into glycerol-based carbon enhances the conductivity of glycerol-based carbon-supported nickel. Furthermore, the HPLC analysis of the bulk electrolysis of glycerol after 15,000 seconds shows 100 % glycerol conversion.

ABSTRACTA cell’s ability to store energy, and produce power is limited by its capacity fading with age. This paper presents the findings on the performance characteristics of prismatic Lithium-iron phosphate (LiFePO4) cells under different ambient temperature conditions, discharge rates, and depth of discharge. The accelerated life cycle testing results depicted a linear degradation pattern of up to 300 cycles. Linear extrapolation reveals that at 25°C temperature, an increase in the discharge rate from 0.5 C to 0.8 C reduces the cycle life significantly by 52.9%. On the other hand, at a constant discharge rate, an increase in temperature reduced predicted cycle life in the range of 23.2–41.36%. Lithium-ion cells’ reliability modeling and analysis was carried out using an exponential distribution showing the increasing failure rate with age, with the temperature significantly reducing the expected life of the cells.

ABSTRACTAZD1222 (ChAdOx1 nCoV-19) is a replication-deficient adenoviral vectored coronavirus disease-19 (COVID-19) vaccine that is manufactured as SII-ChAdOx1 nCoV-19 by the Serum Institute of India Pvt Ltd following technology transfer from Oxford University/AstraZeneca. The non-inferiority of SII-ChAdOx1 nCoV-19 with AZD1222 was previously demonstrated in an observer-blind, phase 2/3 immuno-bridging study (trial registration: CTRI/2020/08/027170). In this analysis of immunogenicity and safety data 6 months post first vaccination (Day 180), 1,601 participants were randomized 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (immunogenicity/reactogenicity cohort n = 401) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort n = 1,200). Immunogenicity was measured by anti-severe acute respiratory syndrome coronavirus 2 spike (anti-S) binding immunoglobulin G and neutralizing antibody (nAb) titers. A decline in anti-S titers was observed in both vaccine groups, albeit with a greater decline in SII-ChAdOx1 nCoV-19 vaccinees (geometric mean titer [GMT] ratio [95% confidence interval (CI) of SII-ChAdOx1 nCoV-19 to AZD1222]: 0.60 [0.41–0.87]). Consistent similar decreases in nAb titers were observed between vaccine groups (GMT ratio [95% CI]: 0.88 [0.44–1.73]). No cases of severe COVID-19 were reported following vaccination, while one case was observed in the placebo group. No causally related serious adverse events were reported through 180 days. No thromboembolic or autoimmune adverse events of special interest were reported. Collectively, these data illustrate that SII-ChAdOx1 nCoV-19 maintained a high level of immunogenicity 6 months post-vaccination. SII-ChAdOx1 nCoV-19 was safe and well tolerated.

ABSTRACTCOVID-19 remains a major public health concern. Monoclonal antibodies have received emergency use authorization (EUA) for pre-exposure prophylaxis against COVID-19 among high-risk groups for treatment of mild to moderate COVID-19. In addition to recombinant biologics, engineered synthetic DNA-encoded antibodies (DMAb) are an important strategy for direct in vivo delivery of protective mAb. A DMAb cocktail was synthetically engineered to encode the immunoglobulin heavy and light chains of two different two different Fc-engineered anti-SARS-CoV-2 antibodies. The DMAbs were designed to enhance in vivo expression and delivered intramuscularly to cynomolgus and rhesus macaques with a modified in vivo delivery regimen. Serum levels were detected in macaques, along with specific binding to SARS-CoV-2 spike receptor binding domain protein and neutralization of multiple SARS-CoV-2 variants of concern in pseudovirus and authentic live virus assays. Prophylactic administration was protective in rhesus macaques against signs of SARS-CoV-2 (USA-WA1/2020) associated disease in the lungs. Overall, the data support further study of DNA-encoded antibodies as an additional delivery mode for prevention of COVID-19 severe disease. These data have implications for human translation of gene-encoded mAbs for emerging infectious diseases and low dose mAb delivery against COVID-19.