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The widely advertised category of unhealthy food and beverages (F&B) is calorie-dense, nutrient-poor, and associated with long-term harm, particularly for children. Business literature has been largely silent regarding the ethicality of its advertising targeting children and lacks clarity on questions future research needs to address. Based on a bibliometric analysis of 1,851 articles published between 1973 and 2021 containing 70,379 citations, we uncovered five intellectual clusters underlying research on the ethics of unhealthy F&B advertising to children (ATC). Importantly, we propose a concrete roadmap featuring actionable and pertinent unanswered questions to stimulate research in this crucial domain.

Background: Achieving accuracy and precision during total knee arthroplasty (TKA) is challenging due to complex knee anatomy, patient demographic and expectations of younger patients opting for the surgery. Real-time input and personalization help surgeons achieve their aim with robotic surgery. Method: This single-center, non-randomized, retrospective study included male and female patients over 18 years with primary OA knee with Varus and Valgus deformity, and able to provide written informed consent. Patients with infected TKR requiring revisional surgery and those reluctant to engage in the trial were excluded. The accuracy and efficiency of the fully automated Joint Robot was measured by the difference between planned and measured resection thickness and angle. Results: The study enrolled 100 patients of whom 53 % underwent RA-TKA of right knee and 47 % had left knee RA-TKA. Women patients dominated the study (69 %), and overall average age of the patients enrolled was 65.55 ± 9.15 years. The difference in mean resection thickness was well within the desired limit, with root mean square of 0.78 mm and 0.96 mm in medial distal and lateral distal planes; 0.94 mm and 1.13 mm in posterior femoral planes. Medial tibial as well as lateral tibial planes were 0.83 and 0.95 mm. The differences in mean resection angle were 0.77° (varus/valgus [V/V]), 0.98° (flexion/extension [F/E]) at distal femoral plane and 0.59° (V/V) and 1.5° (F/E) at posterior femoral plane. At tibial plane V/V was 0.76° and 0.85 °F/E. Conclusion: The study's results support the efficacy and precision of RA-TKA, showcasing its ability to maintain resection thickness and angles in line with anticipated values. These findings solidify the reliability and safety of robotic assisted total knee arthroplasty, characterized by minimal variations in resection parameters.

Magnesium alloys have many advantages as lightweight materials for engineering applications, especially in the fields of automotive and aerospace. They undergo extensive cutting or machining while making products out of them. Dry cutting, a sustainable machining method, causes more friction and adhesion at the tool-chip interface. One of the promising solutions to this problem is cutting tool surface texturing, which can reduce tool wear and friction in dry cutting and improve machining performance. This paper aims to investigate the impact of dimple textures (made on the flank face of cutting inserts) on tool wear and chip morphology in the dry machining of AZ31B magnesium alloy. The results show that the cutting speed was the most significant factor affecting tool flank wear, followed by feed rate and cutting depth. The tool wear mechanism was examined using scanning electron microscope (SEM) images and energy dispersive X-ray spectroscopy (EDS) analysis reports, which showed that at low cutting speed, the main wear mechanism was abrasion, while at high speed, it was adhesion. The chips are discontinuous at low cutting speeds, while continuous at high cutting speeds. The dimple textured flank face cutting tools facilitate the dry machining of AZ31B magnesium alloy and contribute to ecological benefits.

Abstract The study of the water cycle at planetary scale is crucial for our understanding of large-scale climatic processes. However, very little is known about how terrestrial precipitation is distributed across different environments. In this study, we address this gap by employing a 17-dataset ensemble to provide, for the first time, precipitation estimates over a suite of land cover types, biomes, elevation zones, and precipitation intensity classes. We estimate annual terrestrial precipitation at approximately 114,000 ± 9400 km3, with about 70% falling over tropical, subtropical and temperate regions. Our results highlight substantial inconsistencies, mainly, over the arid and the mountainous areas. To quantify the overall discrepancies, we utilize the concept of dataset agreement and then explore the pairwise relationships among the datasets in terms of “genealogy”, concurrency, and distance. The resulting uncertainty-based partitioning demonstrates how precipitation is distributed over a wide range of environments and improves our understanding on how their conditions influence observational fidelity.

Abstract Background Lung diseases, both infectious and non-infectious, are the most prevalent cause of mortality overall in the world. Medical research has identified pneumonia, lung cancer, and Corona Virus Disease 2019 (COVID-19) as prominent lung diseases prioritized over others. Imaging modalities, including X-rays, computer tomography (CT) scans, magnetic resonance imaging (MRIs), positron emission tomography (PET) scans, and others, are primarily employed in medical assessments because they provide computed data that can be utilized as input datasets for computer-assisted diagnostic systems. Imaging datasets are used to develop and evaluate machine learning (ML) methods to analyze and predict prominent lung diseases. Objective This review analyzes ML paradigms, imaging modalities' utilization, and recent developments for prominent lung diseases. Furthermore, the research also explores various datasets available publically that are being used for prominent lung diseases. Methods The well-known databases of academic studies that have been subjected to peer review, namely ScienceDirect, arXiv, IEEE Xplore, MDPI, and many more, were used for the search of relevant articles. Applied keywords and combinations used to search procedures with primary considerations for review, such as pneumonia, lung cancer, COVID-19, various imaging modalities, ML, convolutional neural networks (CNNs), transfer learning, and ensemble learning. Results This research finding indicates that X-ray datasets are preferred for detecting pneumonia, while CT scan datasets are predominantly favored for detecting lung cancer. Furthermore, in COVID-19 detection, X-ray datasets are prioritized over CT scan datasets. The analysis reveals that X-rays and CT scans have surpassed all other imaging techniques. It has been observed that using CNNs yields a high degree of accuracy and practicability in identifying prominent lung diseases. Transfer learning and ensemble learning are complementary techniques to CNNs to facilitate analysis. Furthermore, accuracy is the most favored metric for assessment.

The advancement of Internet of Everything (IoE) propels the fast growth of next-generation, such as 6G networks, leading to a new era of coverage, connectivity, and technological innovation, which calls for novel approaches to address rising energy consumption and maximize resource use. The proposed article presents a robust hybrid algorithm that combines leader-based optimization and Adaptive Differential Evolution (DE) in the framework of the Energy Efficient Hybrid Evolutionary Algorithm (EEHEA), which is specifically designed for the complex environment of IoE-enabled 6G networks. The scheme EEHEA combines the efficacy of leader-based optimization (LBO) for an effective decision-making process and adaptive differential evolutionary optimization (ADE)’s dynamic network-parameters adaptation, enhanced convergence, and global searching ability, persistently fine-tuning optimization strategies based on the dynamics of the network. Combining these components into the scheme EEHEA allows it to balance local exploitation and global exploration effectively. This implies better resource allocation and improved energy efficiency in ecosystems with IoE-driven 6G (IoE-6G). The outcomes report that the scheme EEHEA can address the rising energy consumption issues and enhance the efficiency of IoE-6G. Based on simulation experiments, the proposed scheme EEHEA can demonstrate faster convergence times, higher accuracy, and superior flexibility concerning changing network conditions. Its capability to handle energy-related challenges and navigate complex network environments with resilience shows the ability to enhance the performance of IoE-6G. The EEHEA scheme reports its efficacy over state-of-the-art schemes regarding localization, latency, coverage, and energy expenditure performance metrics.

This work systematically investigates the microstructure-property relationship in Mg alloys. Emphasis is placed on understanding, through high resolution crystal plasticity modeling, how grain size and texture collectively impact material strengthening and hardening, net plastic anisotropy, and tension-compression asymmetry. To achieve this, 528 fully three-dimensional finite element calculations are performed, which comprise eleven textures, four grain sizes, six loading orientations, and two uniaxial loading states (tension and compression). The grain size effect follows Hall-Petch relation that depends on both, loading orientation and initial texture. The reduction in extension twinning with grain size refinement is influenced by texture as well. Below a threshold textural strength, grain size refinement leads to an appreciable reduction in the net plastic anisotropy at yield, quantified using Hill anisotropy, and reduced tension-compression asymmetry. Using a micromechanical basis, the effect of grain size and texture on material ductility is predicted to be non-monotonic. The computational predictions serve as synthetic data sets for experimental validation and reduced-order modeling.

The pursuit of energy efficiency in machining processes is a critical aspect of sustainable manufacturing. A significant portion of global energy consumption is by the industrial sector; thus, improving the energy efficiency of machining processes can lead to substantial environmental and economic benefits. The present study reviews the recent advancement made for improving the energy efficiency of machining processes. First the energy consumption of the machining processes was explored and then the key areas and developments in their energy consumption modeling were identified. Following this, the review explores various strategies for achieving energy savings in machining. These strategies include energy-efficient machine tools, the accurate modeling of the energy consumption of machining processes, the implementation of optimization techniques and the application of artificial intelligence (AI). Additionally, the review highlights the potential of AI in further reducing energy consumption within machining operations and achieving energy efficiency. A review of these energy-saving strategies in machining processes reveals impressive potential for significant reductions in energy consumption: energy-efficient design can achieve up to a 45% reduction, optimizing cutting parameters may minimize consumption by around 40%, optimizing tool paths can reduce consumption by approximately 50%, optimizing non-cutting energy consumption and sequencing can lead to savings of about 30% and employing AI shows promising energy efficiency improvements of around 20%. Overall, the present review offers valuable insights into recent advancements in making machining processes more energy-efficient. It identifies key areas where significant energy savings can be achieved.

Introduction: Helicobacter pylori (H. pylori) is predominantly responsible for acute and chronic progressive gastroduodenal inflammation. Symptoms of gastric diseases vary from dyspepsia to altered bowel movements, leading to ulcers and potential gastrointestinal bleeding. Consequently, H. pylori can have a variable effect on the gastrointestinal tract and other organs. Ongoing research has shown associations between H. pylori and haematological manifestations. Recent studies have reported a 90% incidence of duodenal ulcers and an 80% incidence of gastric ulcers in patients with H. pylori infection. Aim: To investigate haematological manifestations in H. pyloriinfected patients with and without ulcers, and to compare the haematological variables. Materials and Methods: This cross-sectional study was conducted in the Department of Gastroenterology at King George’s Medical University in Lucknow, India, from October 2021 to October 2022. One hundred patients diagnosed with H. pylori-positive biopsy through endoscopy were enrolled in the study. Among these patients, 51% had ulcers with H. pylori infection (enrolled as cases), while 49% were H. pylori infected but without ulcers (enrolled as controls). Samples were analysed for Haemoglobin (Hb) levels, Red Blood Cell (RBC) count, Reticulocyte Count (RetC), serum iron, serum ferritin, Total Iron Binding Capacity (TIBC), serum vitamin B12, and Homocysteine (HCy) levels. Statistical analysis involved independent sample t-tests to compare continuous data and chi-square tests to compare categorical data. Results: The majority of patients included in the study, both with ulcers (70.6%) and without ulcers (59.2%), were males with mean±Standard Deviation (SD) ages of 32.39±7.25 years and 29.86±7.66 years, respectively. In the present study, low reticulocyte count, anaemia, deranged RBC count, low serum iron, high TIBC, and low ferritin were observed in 9%, 22%, 61%, 11%, 12%, and 8% of the patients, respectively. Vitamin B12 deficiency and hyperhomocysteinemia were observed in 6% and 1% of the cases, respectively. Among patients with ulcers, the strongest correlation was found between serum iron and serum ferritin (r-value=0.901), while the weakest correlation was found between vitamin B12 and RetC (r-value=0.206). Among patients without ulcers, the strongest correlation was found between serum iron and Hb (r-value=0.884), while the weakest correlation was found between TIBC and HCy (r-value=0.270). Conclusion: The present study demonstrates a significant association between H. pylori infection-induced ulcers and decreased mean reticulocyte count, serum iron, and serum ferritin levels. Recognising these haematological derangements and including them as indications for H. pylori eradication may lead to a remarkable improvement in the management regime.

In the past two decades, targeted cancer therapy has emerged as a novel class of anticancer therapeutics, besides traditional chemotherapy, surgery, and radiotherapy. Inhibition of HDACs represents a promising avenue for cancer therapeutics and initial success in treating select T-cell lymphomas has led to the FDA approval of four HDAC-targeted agents. The majority of currently available HDAC inhibitors have weak anticancer activity, with significant side effects. To address these drawbacks, in the present work we have designed and synthesized a novel series of histone deacetylase inhibitors combining 2-(4-substituted phenyl) quinazoline bioactive fragment as cap group and N-hydroxycinnamamide/ N-hydroxybenzamide as linker group, and evaluated for their cytotoxic activity against the three cancer cell lines (HeLa, MCF-7 and HCT-116) and HDAC inhibitory activity. All three cancer cell lines were most sensitive to the N-hydroxyacrylamide derivatives (5a-f) as compared to N-hydroxybenzamides (7a-f) derivatives. In particular, compound 5a (0.39, 0.26, 0.41 µM respectively) and 5b (0.27, 0.57, 0.32 µM respectively) were found to be the most potent derivatives among all tested cell lines. For HDAC inhibitory activity, it was found that compounds 5a, 5b, and 5d possessed comparable, even better HDAC inhibitory activity as compared to SAHA. These compounds also tested in vitro heamolytic activity, most of the compounds found biocompatible with human erythrocytes thereby evidencing the lack of haemolytic toxicity of anticancer drugs. In silico ADMET and molecular docking studies further corroborated with the experimental results. Overall, the new synthesized compounds exhibited significant HDAC and cytotoxic activity. Also, the different substituents and unsaturated bond influenced both HDAC inhibitory and cytotoxic activity. The outcome of the current work is that several potential HDAC inhibitors have emerged for further design of more potent HDAC inhibitors with better cytotoxicity.

Objective Neuroblastoma typically affects children within the first 5 years of life and accounts for 10% of all pediatric malignancies. Neuroblastoma at onset may manifest as a localized or metastatic illness. The aim of this study was to identify hematomorphological features in neuroblastoma infiltrating marrow as well as to ascertain the prevalence of bone marrow infiltration in neuroblastoma. Materials and Methods This retrospective study included newly diagnosed 79 cases of neuroblastoma, which were referred for bone marrow examination for the staging of the disease. Medical records were retrieved to acquire hematomorphological findings of peripheral blood and bone marrow smears. Statistical Package for Social Sciences, IBM Inc., USA, version 21.0 was used to analyze the data. Results The interquartile age range of neuroblastoma cases was 24.0 to 72.0 months (median = 48 months) with a male to female ratio of 2.7:1. Also, 55.6% (44/79) of cases in the study population showed evidence of marrow infiltration. The bone marrow infiltration was significantly linked to thrombocytopenia (p = 0.043) and nucleated red blood cells (p = 0.003) in peripheral blood. The bone marrow smears of cases with infiltration showed a significant shift to the left in the myeloid series (p = 0.001) and an increased number of erythroid cells (p = 0.001). Conclusion For neuroblastoma patients, a diligent, exhaustive search for infiltrating cells in bone marrow is advised if thrombocytopenia or nucleated red blood cells are identified on a peripheral blood smear and bone marrow smears showed myeloid left shift with an increased number of erythroid cells.

Objective Sepsis is a major global health issue due to its high death and morbidity rates. To avoid the negative effects of sepsis and decrease mortality, it is vital to diagnose and treat it as soon as possible. Blood cultures can take up to 2 days to give result, and they are not always reliable. According to recent studies, neutrophil CD64 expression might be a sensitive and specific option for assessing sepsis. This study aimed to evaluate the diagnostic performance of a flow cytometry analysis for the expression of neutrophil CD64 in sepsis and its comparison with other standard tests in a tertiary care center. Materials and Methods Prospective analysis on 40 blood samples from suspected sepsis patients admitted to intensive care units with criteria for the systemic inflammatory response syndrome on presentation was performed for expression of neutrophil CD64, C-reactive protein, procalcitonin, and complete blood count. Ten healthy volunteers were also enrolled in this prospective study. The laboratory results were compared in different groups. Results The neutrophil CD64 had the highest diagnostic value to differentiate between patients of sepsis and nonsepsis groups with a sensitivity of 100% (95% confidence interval [CI]: 77.19–100%) and 100% (95% CI: 55.32–86.83%); specificity of 90.00% (95% CI: 59.58–99.49%) and 87.24% (95% CI: 66.69–99.61%); and likelihood ratio of 10.00 and 7.84, respectively. Conclusion The neutrophil CD64 expression provides a more sensitive, specific, and novel marker for the early detection of sepsis in critically ill patients.

The purpose of this article is to introduce the triple sequences and its convergence over instuitionistic fuzzy metric space (\textbf{IFMS}). The article also discusses ideal convergence of triple sequences, the uniqueness of ideal limits, the relationship between Pringsheim's limit and ideal limits, the ideal Cauchy sequences, and various specific spaces of triple sequences with respect to IFMS.

Background: Urolithiasis during pregnancy is a complex health problem that can affect maternal and fetal health, needs adequate understanding of the management options available and their relative pros and cons. Patient management needs involvement of obstetrician, radiologist and urologist, as a multidisciplinary team, to avoid any obstetric complications, such as spontaneous abortion and preterm delivery. Aims and Objectives: The aim of the study was to evaluate urolithiasis and its management in pregnant women at our tertiary care center. Materials and Methods: We analyzed data of 45 patients diagnosed with urolithiasis during pregnancy between January 2017 and March 2022.We evaluated patients age, gestational age history of urolithiasis, physical examination findings, routine laboratory findings, location, and size of the stone. The effectiveness and complications of the applied treatment methods were also evaluated. Results: The mean age of 45 patients included in our study was 25 (25.2±4.8) years with mean gestational age of 18.2 weeks. The mean stone size was 10.2 mm and the most common symptom at the time of presentation to hospital was flank pain (73%). Kidney stones were detected in 26 patients and ureteral stones in 19 patients. Although conservative treatment was sufficient in 22 (48.9%) patients, 31 (51.1%) patients required surgical intervention. Major obstetric complications, such as preterm delivery and miscarriage, did not occur in any patients. Conclusion: Urolithiasis during pregnancy can pose a challenge to urologists, obstetricians, and radiologists, requiring a prompt diagnosis and urgent treatment. On failure of medical management, definitive endoscopic treatment of an acute stone event is a reasonable strategy. In determining the treatment options, fetal and maternal health should be of utmost importance.

Participating in Short-Term Experiences in Global Health (STEGHs) has become an increasingly popular way for dental students to learn about the global burden of disease and health inequalities by traveling to a low-income community. However, there is little information available in the dental education literature providing guidelines on best practices for STEGHs. Often little is known about the local dental practice laws and ethics guidelines. One useful resource is the Brocher Declaration. The Brocher Declaration, created by the Advocacy for Global Health Partnerships (AGHP), is a comprehensive document outlining best practices for developing ethical and sustainable global health partnerships. The six guiding principles are: (1) mutual partnership with bidirectional input and learning, (2) empowered host country and community-defined needs and activities, (3) sustainable programs and capacity building, (4) compliance with applicable laws, ethical standards, and code of conduct, (5) humility, cultural sensitivity, and respect for all involved, and (6) accountability for actions. The principles of the Brocher declaration can serve as a foundation for ethics and sustainability and can be easily applied to STEGHs in dental education. The authors present a set of recommendations specific to each principle to guide dental schools in offering STEGHs to their students. Participating in STEGHs represents a unique opportunity for students to learn about the global burden of oral disease, its risk factors, and the population and public health strategies to reduce oral disease in diverse populations. When done ethically, they may serve as a spark for students to become future leaders in global health.

Morte, uma inevitável parte da vida, incita uma exploração a respeito da maneira e do método de sua ocorrência. Este estudo tem por objetivo analisar os padrões de lesões em casos de homicídios verificados em exames post-mortem. Em 2019, registrou-se um total de 28.918 casos de assassinato na India, mostrando um leve decréscimo de 0,3% em comparação com 2018 (29.017 casos). Este estudo objetiva entender os diferentes padrões de lesão em homicídios. No Departamento de Medicina Forense da Gandhi Medical College, em Bhopal, India, um total de 62 homens, 12 mulheres e uma pessoa de gênero não identificado, foram submetidas à análise post mortem. A maioria dos casos pertencia a áreas urbanas, com principal causa de morte sendo choque e hemorragia seguida de dano crânio cerebral. Este estudo conclui que arestas afiadas e cortes profundos foram os principais padrões de lesões em casos de homicídio.

S. Karkaus, K. Demirci, and O. Duman in 2008 studied the statistical convergence of a single sequence over Intuitionistic fuzzy normed space(\textbf{IFNS}). M. Mursaleen in 2009, generalized the above work for double sequences over IFNS. The present article is the study of statistical convergence of triple sequence and triple Cauchy sequences on IFNS. In addition, the article includes examples in support of some definitions and theorems. Furthermore, we examined the proof of the completeness of special sequence space.

Background: Xanthogranulomatous pyelonephritis (XGP) is chronic pyelonephritis subtype where in renal parenchymal destruction occurs and therefore results in progressive loss of kidney functions. Although middle age group is the predominant age group affected but it can be seen at any age. There is accumulation of macrophages (lipid-laden) leading to renal parenchymal destruction and fibrosis. In this study, we present our data of 15 patients who had undergone nephrectomy and were biopsy proven XGP. Aims and Objectives: The aim of the study was to describe the clinical and radiological features of XGP in adults. Materials and Methods: XGP constituted 4.31% of the 348 nephrectomies done for infective causes over a period of 7 years. All our patients had undergone unilateral total nephrectomy. Demographic and clinical records were analyzed after consent from all the patients. Results: The age range in our study was 18–65 years with mean 42.93±15.66 years. Nine of our patients, that is, 60% were females. Diabetes was present in 53.3% of our patients. Three patients had imaging suggestive of pyonephrosis, three patients had perinephric collection and 9 patients (60%) had concomitant nephrolithiasis. All the kidneys were grossly enlarged and were non-functional on renal scintigraphy. Conclusion: XGP is a form of chronic pyelonephritis which although being less common but is devastating given the destruction of renal parenchyma it does and associated morbidity. Clinicoradiologic correlation cannot be overemphasized. The definitive diagnosis is established after histopathologic examination.

Background: Though the treatment of uncomplicated varicose vein (UVV) might prevent late complications such as skin change or ulceration, but, there are limited studies available to justify this concept. Yoga and Naturopathy being a proficient tool in managing non communicable diseases including many cardiovascular diseases; no attempt was made to study its potential effect in Varicose Vein diseases. Objective: The present study aims to study the combination of Yoga and Naturopathy in uncomplicated varicose vein patients. Materials and methods: 50 UVV participants were prospectively recruited and randomly divided into two groups, Experimental and Active control groups. Both the groups practiced their respective interventions, and follow up was done after 1 and 3 months of active intervention. Finally study was completed with 46 participants (2 dropouts in each groups). The sample size was calculated based on the previous study, considering power as 0.8 and ‘α’ as 0.05, using ‘G’ power software. The variables such as Body weight, BMI, Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Heart rate (HR), high-sensitivity C-reactive protein (hs-CRP), homocysteine (HCy) were recorded before and after the intervention, but Aberdeen Varicose Vein Questionnaire (AVVQ) and Visual analogue heaviness scale (VAHS) were recorded on 60 and 120 days of the follow up in addition to active intervention period. Results: There was a significant decrease in hs-CRP (p

Global partnerships offer opportunities for academic departments in the health sciences to achieve mutual benefits. However, they are often challenged by inequities in power, privilege and finances between partners that have plagued the discipline of global health since its founding. In this article, a group of global health practitioners in academic medicine offer a pragmatic framework and practical examples for designing more ethical, equitable and effective collaborative global relationships between academic health science departments, building on the principles laid out by the coalition Advocacy for Global Health Partnerships in the Brocher declaration.

Abstract The relationship between the hydrological cycle and the temperature is rather complex and of great importance to human socioeconomic activities. The prevailing theory suggests that as temperature increases the hydrological cycle is intensified. Practically, this means more and heavier precipitation. However, the exact magnitude of hydrological cycle response and its spatio-temporal characteristics is still under investigation. Looking back in Earth’s hydroclimatic history, it is easy to find some periods where global temperature was substantially different than present. Here, we examine some of these periods to present the current knowledge about past hydrological cycle variability (specifically precipitation), and its relationship to temperature. The periods under investigation are the Mid-Miocene Climate Optimum, the Eemian Interglacial Stage, the Last Glacial Maximum, the Heinrich and Dansgaard–Oeschger Events, the Bølling–Allerød, the Younger Dryas, the 8.2 ka event, the Medieval Climate Anomaly, and the Little Ice Age. We report that the hypothesis that a warmer climate is a wetter climate could be an oversimplification, because the response of water cycle appears to be spatio-temporally heterogeneous.

In the new era, the Internet of Everything (IoE) provides distributed services like data, processes, people, and things, etc. The services to the connected IoE significantly increase the time of service, workload, energy consumption, and delay. These objectives conflict with each other. To address the issue, a novel multi-objective based evolutionary algorithm is proposed. In the proposed method, a new rapid mutation operator is incorporated with multi-objective differential evolution (MODE) to overcome the stagnation of the local optimum. The proposed method to maintain the diversity and enhance the convergence speed of the existing MODE algorithm is described. The proposed method provides more diversity and convergence speed for choosing better candidate solutions. The addition of the proposed method is evaluated with the application of IoE services. We have designed the two objective and three objective-based IoE services scenarios. Furthermore, the proposed method optimizes services like service cost, service delay, and the lifetime of sensors. It is interesting to observe that the proposed approach better performs the most recent state-of-the-art multiobjective evolutionary algorithms.

Background: Metastasis of the lymph node is one of the most significant prognostic factors for breast cancer (BC). Aim: To predict positivity of the lymph node in BC patients with help of USG and USG-guided FNAC and thus to prevent unnecessary morbidity. Methods: 50 patients of incisional/true cut biopsy-proven BC patients were included. All were subjected to mammography, USG and FNAC of the lump breast. USG-guided FNAC of the axillary lymph node was done in 25 of these patients. These findings were assessed by histological examination following dissection of the axillary lymph node. Results: Axillary lymph node (ALN) metastasis was present in 42 patients on histopathology; 21 patients suspicious of malignancy on preoperative USG were confirmed by HPE. Out of 88 confirmed lymph nodes evaluated on ultrasonography, 4 were benign, 18 were indeterminate and 66 were suspicious. The most promising features were tumour length/depth ratio of

Background: India shares the largest number of anemia patients globally. Anemia in reproductive-age female, affects not only the maternal mortality and morbidity but inversely affect the pregnancy outcome also. Tribals in India are geographically isolated and most of them belong to very low socio-economic status. Regarding Tharu tribes, to date, there is no study to find the prevalence of anemia in this community. Aim: We aim to find the prevalence of anemia in the reproductive-age female of the Tharu community. Additionally, we also accessed the severity and possible causes of anemia. Materials and Methods: A total of 440 reproductive age females from the Tharu community were recruited in this study from Tharu predominant Tulsipur tehsil of Balrampur district on 8 December 2019. CBC of each sample was performed by a 3-part basic hematology analyzer. Results: The mean (SD) hemoglobin level of the study group observed was 11.11 (±1.96) gm/dl with a median value of 11.3 gm/dl. Prevalence of anemia was noted in 283 (64.32%) participants. Amongst the anemic subjects, mild, moderate, and severe anemia was noted in 33.57%, 57.24%, and 9.19%, respectively. Microcytic, normocytic, and macrocytic anemia was noted in 53.00%, 44.88%, and 2.12%, respectively. Conclusion: The high prevalence of mild and moderate anemia in reproductive-age women is a matter of concern and should be dealt with priority. Community-based screening for hemoglobinopathies is also needed to evaluate the actual cause of anemia.

Abstract Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. HPVG when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention. We present a case of a 26‐year‐old young adult with superior mesenteric artery thrombosis who presented with severe abdominal pain. On imaging, HPVG and pneumatosis intestinalis were seen owing to the urgent intervention of the patient. The reliable interpretation of the imaging findings along with quick intervention led to a favorable outcome in our case. Herein, we present a thorough review of the imaging findings of HPVG to make a reliable diagnosis when presented with such a case.

The increased global prevalence of viral and noninfectious liver illnesses has coincided with a surge in scientific interest in gut microbiota (GM), a multispecies community of bacteria, fungi, archaea, and protozoans. Dietary nutrients that make up the host’s microbiome are responsible for maintaining intestinal homeostasis, whereas a disconnect between gut flora and nutrition might have serious consequences for digestive health. The risk of liver dysfunction was continuously elevated by changes in the commensal bacteria of the gut microbiome, which were carried to the liver via the portal vein. Insights into the role of gut microbiota in alcoholic liver disease, nonalcoholic liver disease, primary sclerosing cholangitis, and other liver disorders, as well as their link to liver cancer, continue to emerge. Systemic host defence against infections by the gut microbiota depends on the interplay between the microbiome, liver immunology, and liver disorders. Translocation of microbiota to the liver following injury and/or inflammation may mediate dysbiosis and the formation of gut microbial metabolite. This review discusses the role of the gut microbiota in connection to dysbiosis and how this knowledge might help us better understand the pathophysiology of various liver illnesses.

Introduction: The Black Carbon (BC) and Particulate Matters (PMs) was measured in the Diwali festival during 3-7 November, 2021. Diwali is being one of the main festivals of India accompanied by lighting and firecrackers bursting. Materials and methods: BC concentration was measured by aerosol black carbon low-cost sensor/detector and PM1, PM2.5 and PM10 mass concentration as well as number concentration was measured using Grimm Aerosol Spectrometer at Agra, India. Results: Average mass of PM1 (

The Karakoram Terrane (KT) represents the southern margin of the Eurasian Plate, mainly consisting of Late Jurassic-Early Cretaceous subduction-related granites and post-collisional Miocene leucogranites, which intrude the Late Neo-Proterozoic basement. We report for the first time the existence of the Cryogenian KT basement as recorded from the geochemistry and geochronology of tonalite gneiss (ca. 806 Ma) in the southeastern Karakoram terrane, NW India. Geochemically, the studied tonalite gneiss is slightly peraluminous (Molar Al2O3/CaO+Na2O+K2O=1.1), calc-alkaline volcanic-arc granitoid, strongly fractionated REE (LaN/YbN=33.99), and high Sr/Y =19.75, more akin to its affinity with Tonalite–trondhjemite–granodiorite (TTG)/adakite. The whole-rock elemental data suggest that tonalite gneiss is more likely sourced from ancient mafic lower crust where garnet remained in the residue. The petrogenetic modeling of REE suggests that the melt similar to the observed tonalite gneiss can be generated through ∼50% partial melting of a mafic lower crust with garnet, clinopyroxene, and amphibole assemblage. The synthesis and comparison of present and published Proterozoic magmatic records on the rocks from KT strongly dictate that the produced partial melt similar to observed tonalite gneiss most likely served as the parental melt for the development of TTGs in the Southern Pamir and more evolved granitoid in the Central Tibetan terrane. We propose that the studied tonalite gneiss from the southeast Karakoram is a product of Neoproterozoic Andean-type orogeny formed on the northwestern margin of the Rodinia supercontinent. Thus, our study favors the first time, the position of KT within the Cimmerian belt along with other East Asian continental blocks.

Abstract Neonatal gastric perforation (NGP) is a rare life‐threatening condition among preterm infants. NGP can occur secondary to necrotizing enterocolitis, distal obstruction, or as a result of gastric tube insertion. Sleeve gastrectomy can be a possible therapeutic option for multiple neonatal gastric perforations.

Thioredoxins (Trxs) and Glutaredoxins (Grxs) regulate several cellular processes by controlling the redox state of their target proteins. Trxs and Grxs belong to thioredoxin superfamily and possess characteristic Trx/Grx fold. Several phylogenetic, biochemical and structural studies have contributed to our overall understanding of Trxs and Grxs. However, comparative study of closely related Trxs and Grxs in organisms of all domains of life was missing. Here, we conducted in silico comparative structural analysis combined with amino acid sequence and phylogenetic analyses of 65 Trxs and 88 Grxs from 12 organisms of three domains of life to get insights into evolutionary and structural relationship of two proteins. Outcomes suggested that despite diversity in their amino acids composition in distantly related organisms, both Trxs and Grxs strictly conserved functionally and structurally important residues. Also, position of these residues was highly conserved in all studied Trxs and Grxs. Notably, if any substitution occurred during evolution, preference was given to amino acids having similar chemical properties. Trxs and Grxs were found more different in eukaryotes than prokaryotes due to altered helical conformation. The surface of Trxs was negatively charged, while Grxs surface was positively charged, however, the active site was constituted by uncharged amino acids in both proteins. Also, phylogenetic analysis of Trxs and Grxs in three domains of life supported endosymbiotic origins of chloroplast and mitochondria, and suggested their usefulness in molecular systematics. We also report previously unknown catalytic motifs of two proteins, and discuss in detail about effect of abovementioned parameters on overall structural and functional diversity of Trxs and Grxs.

Among meta-heuristic algorithms, differential evolution (DE) is one of the most powerful nature-inspired algorithm used to solve the complex problems in various application areas. In DE algorithm at higher generations, there is an increase in the computational cost because existing mutation operator may not provide more diversity. In this paper, a new variant of DE has been proposed by incorporating the homeostasis adaption based mutation operator (HABMO), which maintains the diversity when it stuck to the local optimum problem. This operator with DE is applied for the cost estimation in software development, where proposed optimization technique is used with constructive cost model (COCOMO) for optimizing the tuning parameters. The main objective of this work is accurate prediction and minimization of the error like MMRE, MMER, MSE and RMSE in less number of iteration, for COCOMO model. Further, the proposed variant of DE has been compared with different versions of DE and it has been concluded that the proposed HABDE is able to improve the performance of DE algorithm.

Background: The Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs. Aim: This study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians. Methods: An anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs. Results: Twenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration. Lessons learnt: This study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.

Introduction: The Axillary Arch Muscle (AAM), is a rare anomalous finding in the axilla also known as langer’s muscle. In the literature, it is explained as a narrow muscular slip that extends from the latissimus dorsi to the pectoralis major. Variations of this muscular anomaly have been observed. The abduction and external rotation like simulation of the arm in the cadaver suggest the possibility of neurovascular compression by the AAM. The AAM causing compression is considered an etiology of thoracic outlet syndrome by some authors. The symptoms generated by neural or vascular compression can be differentiated clinically. The purpose of this article was to compare the potential role of AAM in causing neural or vascular compression and discussion with the clinical studies which showed varied results. Aim: To find out the possible anatomy of axillary arch muscle and its relation with neurovascular structures. Materials and Methods: The descriptive cadaveric study was conducted in the Department of Anatomy at Seth G.S.M.C. and KEM hospital, Mumbai, India from November 2012 to November 2014. Study included 120 axillae of 60 embalmed cadavers (60 right and 60 left axilla). Axillary arch muscles were identified and their relations with neurovascular structure in an abducted position of the arm were noted and photographed. The simple statistical method of calculating percentages (%) of the collected data was applied to the study. Results: The dissection of the axillary region was carried out in 120 axillae which included 53 male and 7 female cadavers. The axillary arch muscles were identified in the three male axillae unilaterally. Its extent and relations with the neurovascular structure were different in all three cases. Its medial attachment was on the lateral border of latissimus dorsi, fascia over the latissimus dorsi, or the subscapularis muscle, while the lateral attachment was on fascia over coracobrachialis or biceps brachii. All the cases showed close relations with neural as well as vascular structures with the potential of causing compression in varied numbers. Conclusion: Though the existence of this muscle is rare, the findings of the present study will help clinicians, surgeons, and physiotherapists to be vigilant in diagnosing the cases with AAM amongst the individuals frequently adopting hyperabduction maneuvers in their occupations or sports thereby causing neurovascular compression.

Contributions: An adoption framework to include generative artificial intelligence (GenAI) in the university curriculum. It identifies and highlights the role of different stakeholders (university management, students, staff, etc.) during the adoption process. It also proposes an objective approach based upon an evaluation matrix to assess the success and outcome of the GenAI adoption. Background: Universities worldwide are debating and struggling with the adoption of GenAI in their curriculum. GenAI has impacted our perspective on traditional methods of academic integrity and the scholarship of teaching, learning, and research. Both the faculty and students are unsure about the approach in the absence of clear guidelines through the administration and regulators. This requires an established framework to define a process and articulate the roles and responsibilities of each stakeholder involved. Research Questions: Whether the academic ecosystem requires a methodology to adopt GenAI into its curriculum? A systematic approach for the academic staff to ensure the students' learning outcomes are met with the adoption of GenAI. How to measure and communicate the adoption of GenAI in the university setup? Methodology: The methodology employed in this study focuses on examining the university education system and assessing the opportunities and challenges related to incorporating GenAI in teaching and learning. Additionally, it identifies a gap and the absence of a comprehensive framework that obstructs the effective integration of GenAI within the academic environment. Findings: The literature survey results indicate the limited or no adoption of GenAI by the university, which further reflects the dilemma in the minds of different stakeholders. For the successful adoption of GenAI, a standard framework is proposed 1) for effective redesign of the course curriculum; 2) for enabling staff and students; and 3) to define an evaluation matrix to measure the effectiveness and success of the adoption process.

Chronic myeloid leukemia (CML) is potentially fatal blood cancer, but there is an unmet need to discover novel molecular biomarkers. The hypothesis of this study aimed to elucidate the relationship of HIF1α with the redox system, Krebs cycles, notch1, and other regulatory proteins to better understand the pathophysiology and clinical relevance in chronic myeloid leukemia (CML) patients, as the molecular mechanism of this axis is still not clear. This study included CML patient samples (n = 60; 60: blood; 10: bone marrow tissues) and compared them with healthy controls (n = 20; blood). Clinical diagnosis confirmed on bone marrow aspiration, marrow trephine biopsy, and BCR/ABL1 translocation. Cases were subclassified into chronic, accelerated, and blast crises as per WHO guidelines. Molecular experiments included redox parameters, DNA fragmentation, Krebs cycle metabolites, and gene expression by RT-PCR/Western blot/LC-MS, PPI (STRING), Pearson correlation, and ROC curve analysis. Here, our findings show that p210/p190BCR/ABL1 translocation is common in all blast crisis phases of CML. Redox factor/Krebs oncometabolite concentrations were high, leading to upregulation and stabilization of HIF1α. HIF1α leads to the pathogenesis in CML cells by upregulating their downstream genes (Notch 2/4/Ikaros/SIRT1/Foxo-3a/p53, etc.). Whereas, downregulated ubiquitin proteasomal and apoptotic factors in CML pateints, can trigger degradation of HIF1α through proline hydroxylation. However, HIF1α showed a negative corelation with the notch1 pathway. Notch1 plays a tumor-suppressive role in CML and might have the potential to be used as a diagnostic marker along with other factors in CML patients. The outcome also revealed that oxidant treatment could not be effective in augmentation with conventional therapy because CML cells can enhance the levels of antioxidants for their survival. HIF1α might be a novel therapeutic target other than BCR/ABL1 translocation.

Short- term experiences in global health (STEGH), also known as short-term medical missions continue to be a popular mode of engagement in global health activities for students, healthcare providers, and religious groups, driven primarily by organizations from high-income countries. While STEGH have the potential to be beneficial, a large proportion of these do not sustainably benefit the communities they intend to serve, may undermine local health systems, operate without appropriate licenses, go beyond their intended purposes, and may cause harm to patients. With heightened calls to “decolonize” global health, and to achieve ethical, sustainable, and practical engagements, there is a need to establish strong guiding principles for global health engagements. The Advocacy for Global Health Partnerships (AGHP), a multi-sectoral coalition, was established to reflect on and address the concerns relating to STEGH. Towards this end, AGHP created theBrocher Declarationto lay out six main principles that should guide ethical and appropriate STEGH practices. A variety of organizations have accepted the Declaration and are using it to provide guidance for effective implementation of appropriate global health efforts. The Declaration joins broader efforts to promote equity in global health and a critical reevaluation of volunteer-centric, charity-based missions. The current state of the world’s health demands a new model of collaboration – one that sparks deep discussions of shared innovation and builds ethical partnerships to address pressing issues in global health.

Introduction: Cyclin D1 is a protein encoded by the CCND1 (BCL-1) gene on chromosome 11q13 and it is an important regulator of G1 to S phase progression. Over expression of cyclin D1 protein releases cells from their normal controls when they need to exit from the cell cycle. This obstructs their maturation, and promotes transformation into a malignant phenotype. Aim: To study the role of cyclin D1 expression in trephine biopsies of multiple myeloma patients and its association with C-Reactive Protein (CRP), β2-microglobulin level and treatment response rate. Materials and Methods: This prospective observational study was conducted at Department of Pathology in collaboration with Department of Clinical Haematology, King George’s Medical University, Lucknow, India, from September 2018 to August 2019. Total 40 cases of multiple myeloma fulfilling inclusion and exclusion criteria were enrolled. Bone marrow aspiration and biopsy was done in all the cases. Immunohistochemical (IHC) expression of cyclin D1 on trephine biopsy was associated with CRP levels and β2-microglobulin expression. All investigations were repeated at six months follow-up and response was compared with expression of cyclin D1. The statistical tests applied were Chi-square test, Student t-test and paired t-test. Results: The age of cases ranged between 44 to 78 years and the mean age of the study subjects was 64.40±7.13 years. Total 67.5% of patients were males. On IHC, cyclin D1 expression was not observed in majority of cases (n=23), weak cyclin D1 expression was observed in 8 cases, while strong cyclin D1 expression was observed in 9 cases. Out of eight cases with weak cyclin D1 expression, five cases achieved partial response and two cases achieved complete response. One case was lost to follow-up. Among nine patients with strong cyclin D1 expression, six patients expired on six months follow-up and three patients achieved partial response. On comparison of two groups cyclin D1 positive and cyclin D1 negative cases it was found that cyclin D1 positive cases had an early age of onset, more than 50% plasma cells on marrow aspirate and were associated with plasmablastic morphology. Cyclin D1 positive cases also had increased CRP level as compared to cyclin D1 negative cases. Similarly, serum calcium, serum creatinine and β2-microglobulin levels were more in cyclin D1 positive group. Conclusion: Cases who have strong cyclin D1 expression at time of diagnosis showed poor response to treatment. This was also associated with increased serum CRP and β2-microglobulin levels. Hence, cyclin D1 can be used as a prognostic marker in multiple myeloma.

The COVID-19 pandemic has demanded governments and diverse organizations to work on strategies to prepare and help communities. Increasing recognition of the importance of identifying vulnerable populations has raised a demand for better tools. One of these tools is the Social Vulnerability Index (SVI). The SVI was created in 2011 to identify and plan assistance for socially vulnerable populations during hazardous events, by providing disaster management personnel information to target specific areas. We aimed to evaluate and determine the social vulnerability in different provinces and districts of Peru in the context of the COVID-19 pandemic using an adapted version of the SVI index. Ecological, observational, and cross-sectional study was conducted. We adapted the SVI and collected indicators related to COVID-19. We organized and analyzed the population data of the 196 provinces of Peru, using data from government institutions. We found a distribution of high and very high SVI in the mountainous areas of Peru. High and very high social vulnerability indexes, due to the presence of some or all the variables were predominantly distributed in the provinces located in the southern and highlands of the country. The association between mortality rate and social SVI-COVID19 was inverse, the higher the vulnerability, the lower the mortality. Our results identify that the provinces with high and very high vulnerability indexes are mostly located in rural areas nearby the Andes Mountains, not having a direct correlation with COVID-19 mortality.