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Sarah Cook,1 David Osborn,2,3 Arti Maini,1 Ravi Parekh,1 Shamini Gnani,1 Thomas Beaney,1 Ana Luisa Neves,1 Sonia Saxena,1 Jennifer K Quint1 1School of Public Health, Imperial College London, London, UK; 2Division of Psychiatry, University College London, London, UK; 3Camden and Islington NHS Foundation Trust, London, UKCorrespondence: Sarah Cook, White City Campus, Imperial College London, 9th Floor Michael Uren Building, London, W12 0BZ, UK, Email sarah.cook@imperial.ac.ukPurpose: Electronic health records (EHR) are valuable resources for health research; however, their use is challenging. A validated alcohol use disorder (AUD) codelist for UK primary care is needed to improve population-based research in this patient group. We aimed to develop an AUD codelist for use in the Clinical Practice Research Datalink (CPRD) Aurum database, a UK EHR primary-care database.Methods: The CPRD code browser was searched using keywords related to alcohol use using a previously developed search strategy. The resulting codes were categorised as AUD if they were: a) diagnostic of AUD, b) indicated alcohol withdrawal, or c) indicated chronic alcohol-related harm (physical or mental). Codes related to alcohol use but not used to define AUD were also classified into relevant categories (alcohol status, acute harm, and alcohol screening). All codes were categorised independently by at least two reviewers (one person reviewed all codes and five reviewers (all practising GPs) each reviewed a subset of codes (100– 200 codes each). Disagreements in categorisation were discussed by at least three coders and a consensus was reached. The reliability of categorisation was assessed using kappa statistics.Results: In total, 556 potential codes related to alcohol use were identified. The Kappa for reliability between coders was moderate for both AUD (0.72) and across all categories (0.62), with substantial variability between coders (AUD: 0.33– 0.97; all categories 0.36– 0.74). In the final codelist, 138 codes were included as indicating AUD: 38 codes identified which indicated diagnosis of AUD, 14 indicating withdrawal plus 85 codes indicating chronic alcohol-related harm (41 physical health and 44 mental health).Conclusion: Many codes are used in primary care to record alcohol use and associated harms, and there is substantial variability in how clinicians categorise them. While future work formally validating the codelist against gold standard clinical reviews and qualitative work with General Practitioners is needed for a deeper understanding of coding processes, we have documented here the process used for the development of an AUD codelist within primary care which can be used as a reference for future research.Keywords: alcohol use disorder, electronic health records, primary care, clinical practice research datalink

Ritu Arora,1 Ruchi Goel,1 Samreen Khanam,1 Sumit Kumar,1 Shalin Shah,1 Sonam Singh,1 Mohit Chhabra,1 Ravi Meher,2 Nita Khurana,3 Tanu Sagar,4 Suresh Kumar,5 Sandeep Garg,5 Jyoti Kumar,6 Sonal Saxena,4 Rashmi Pant7 1Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India; 2Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India; 3Department of Pathology, Maulana Azad Medical College, New Delhi, India; 4Department of Microbiology, Maulana Azad Medical College, New Delhi, India; 5Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India; 6Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India; 7Society for Health Education and Allied Research, New Delhi, IndiaCorrespondence: Ruchi GoelDepartment of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, 110002, IndiaTel +91 9811305645; +91-11-41440108Email gruchi1@rediffmail.comPurpose: To list the clinico-epidemiological profile and possible risk factors of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) patients presenting to a COVID dedicated hospital during the second wave of COVID-19 in India.Patients and Methods: A cross-sectional, single-center study was done on 60 cases of probable CA-ROCM based on clinical features and supportive diagnostic nasal endoscopic findings and/or radiologic findings. Patients with recent or active COVID-19 were included. The demographic profile, clinical features, possible risk factors and diagnostic workup (microbiological, pathological and radiological) were analysed to identify the triggering factors for CA-ROCM.Results: The age of patients ranged from 29 to 75 years and male–female ratio was 3:1. The duration between the first positive COVID report and onset of CA-ROCM was 0 to 47 days. Forty-nine (81.66%) patients had a recent COVID infection and 11 (18.33%) had active COVID infection at presentation. Thirty-five patients (58%) had ocular/orbital involvement at presentation. In the affected eye, 10 had no perception of light and in the rest visual acuity ranged from log MAR 0 to +1.5. Ocular manifestations were ptosis (29), ophthalmoplegia (23), periocular tenderness and edema (33), proptosis (14), black discoloration of eyelids (3), facial palsy (3), endophthalmitis (4), retinal artery occlusion (8), disc edema (4) and disc pallor (5). Twenty-two (25%) patients had neither received steroids nor oxygen. Thirty patients (50%) were managed with oxygen while 38 patients (63.3%) with systemic steroids. The most common risk factor was diabetes in 59 patients. The average glycosylated hemoglobin (HbA1c) was 10.31 ± 2.59%. Systemic Amphotericin B was started in all the patients. Radical surgical debridement was performed in 12 patients and the remaining were planned.Conclusion: SARS-CoV-2 variant with accompanying glycaemic dysregulation was found to be the triggering factor for the epidemic of CA-ROCM.Keywords: COVID-19 treatment, CA-ROCM, orbital apex syndrome, ophthalmoplegia, retinal arterial occlusion, COVID-19 associated rhino-orbital-cerebral mucormycosis

Deepanshu Mallan,1 Sandeep Sharan,2 Sumi Saxena,3 Tapas Kumar Singh,2 Faisal21Department of Anaesthesiology and Critical Care, Saraswati Medical College, Lucknow, India; 2Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; 3Department of Anaesthesiology and Critical Care, TSM Medical College, Lucknow, Uttar Pradesh, IndiaCorrespondence: Tapas Kumar SinghDepartment of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, IndiaEmail singh.tapas1@gmail.comAbstract: Transverse abdominis plane (TAP) blocks, over the past decade, have emerged as a reliable tool in multimodal analgesia. Although they block only the somatic component of pain, studies have still revealed a consistent benefit in the first 24–48 hours after surgery in terms of pain scores and overall opioid consumption. The safety and dependability has increased with ultrasound usage. The aim of this review is to help the reader appreciate the applied anatomy required for a TAP block and its congeners, to standardize its nomenclature, and to help choose between variants of a TAP block and its complications and safety profile.Keywords: tap block, ultrasound, regional anesthesia, truncal block

Renu Narain,1 Sanjai Saxena,1 Achal Kumar Goyal2 1Department of Biotechnology, Thapar University, Punjab, India; 2University Computer Center, Gurukul Kangri University, Haridwar, Uttarakhand, India Purpose: Currently cardiovascular diseases (CVDs) are the main cause of death worldwide. Disease risk estimates can be used as prognostic information and support for treating CVDs. The commonly used Framingham risk score (FRS) for CVD prediction is outdated for the modern population, so FRS may not be accurate enough. In this paper, a novel CVD prediction system based on machine learning is proposed.Methods: This study has been conducted with the data of 689 patients showing symptoms of CVD. Furthermore, the dataset of 5,209 CVD patients of the famous Framingham study has been used for validation purposes. Each patient’s parameters have been analyzed by physicians in order to make a diagnosis. The proposed system uses the quantum neural network for machine learning. This system learns and recognizes the pattern of CVD. The proposed system has been experimentally evaluated and compared with FRS.Results: During testing, patients’ data in combination with the doctors’ diagnosis (predictions) are used for evaluation and validation. The proposed system achieved 98.57% accuracy in predicting the CVD risk. The CVD risk predictions by the proposed system, using the dataset of the Framingham study, confirmed the potential risk of death, deaths which actually occurred and had been recorded as due to myocardial infarction and coronary heart disease in the dataset of the Framingham study. The accuracy of the proposed system is significantly higher than FRS and other existing approaches.Conclusion: The proposed system will serve as an excellent tool for a medical practitioner in predicting the risk of CVD. This system will be serving as an aid to medical practitioners for planning better medication and treatment strategies. An early diagnosis may be effectively made by using this system. An overall accuracy of 98.57% has been achieved in predicting the risk level. The accuracy is considerably higher compared to the other existing approaches. Thus, this system must be used instead of the well-known FRS. Keywords: myocardial infarction, atherosclerosis, Framingham risk score, cardiovascular disease

Background: Pregnancy induced hypertension (PIH) contributes greatly to maternal morbidity and mortality. Altered lipid profile and increased lipid peroxidation activate endothelial dysfunction and atherothrombosis leading to PIH. Therefore, estimation of lipid profile with serum malondialdehyde (MDA) in pregnancy may be helpful in predicting the development of PIH and further progression. Material and methods: In this prospective case-control study, serum lipid profile and MDA were estimated in 70 PIH subjects with gestational hypertension, pre-eclampsia, eclampsia; and 70 normotensive pregnant women aged 18 - 40 years, with gestational age of over 20 weeks. Results: A statistically significant higher serum total cholesterol, very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), TC/HDL-C, LDL-C/HDL-C and MDA, and a significantly lower HDL-C was noted in PIH subjects as compared to control subjects. When compared with the severity of PIH, all the lipoproteins (except HDL-C) along with MDA were found to be higher in women with eclampsia when compared with gestational hypertension, pre-eclampsia and normotensive pregnant women. Conclusions: An abnormal lipid metabolism along with oxidative stress may add to the promotion of vascular dysfunction leading to PIH. Lipoproteins and MDA alter significantly in eclampsia. Therefore, during pregnancy, early diagnosis and management of dyslipidaemia may prevent lipid peroxidation and progression of PIH thereby preventing obstetric complications.

Flame retardancy was imparted in cellulosic cotton textile using banana pseudostem sap (BPS), an eco-friendly natural product. The extracted sap was made alkaline and applied in pre-mordanted bleached and mercerized cotton fabrics. Flame retardant properties of both the control and the treated fabrics were analysed in terms of limiting oxygen index (LOI), horizontal and vertical flammability. Fabrics treated with the non-diluted BPS were found to have good flame retardant property with LOI of 30 compared to the control fabric with LOI of 18, i.e., an increase of 1.6 times. In the vertical flammability test, the BPS treated fabric showed flame for a few seconds and then, got extinguished. In the horizontal flammability test, the treated fabric showed no flame, but was burning only with an afterglow with a propagation rate of 7.5 mm/min, which was almost 10 times lower than that noted with the control fabric. The thermal degradation and the pyrolysis of the fabric samples were studied using a thermogravimetric analysis (TGA), and the chemical composition by FTIR, SEM and EDX, besides the pure BPS being characterized by EDX and mass spectroscopy. The fabric after the treatment was found to produce stable natural khaki colour, and there was no significant degradation in mechanical strengths. Based on the results, the mechanism of imparting flame retardancy to cellulosic textile and the formation of natural colour on it using the proposed BPS treatment have been postulated.

Sandeep Saxena,1 Khushboo Srivastav,1 Chui M Cheung,2 Joanne YW Ng,3 Timothy YY Lai3 1Retina Service, Department of Ophthalmology, King George’s Medical University Lucknow, India; 2Singapore National Eye Centre, Singapore; 3Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong Abstract: Spectral domain optical coherence tomography cross-sectional imaging of the macula has conventionally been resolved into four bands. However, some doubts were raised regarding authentication of the existence of these bands. Recently, a number of studies have suggested that the second band appeared to originate from the inner segment ellipsoids of the foveal cone photoreceptors, and therefore the previously called inner segment-outer segment junction is now referred to as inner segment ellipsoidband. Photoreceptor dysfunction may be a significant predictor of visual acuity in a spectrum of surgical and medical retinal diseases. This review aims to provide an overview and summarizes the role of the photoreceptor inner segment ellipsoid band in the management and prognostication of various vitreoretinal diseases. Keywords: spectral domain optical coherence tomography, inner segment-outer segment junction, external limiting membrane, macular hole, diabetic macular edema, age relate macular degeneration

Tissue adhesive is one of the alternative to conventional suturing and has some added advantages. Fibrin glue has been used in obtaining haemostasis following trauma to spleen and liver. It has also been used in repair of dural tear and bronchial fistula. Fibrin glue is a biological tissue adhesive based on the final stage of coagulation wherein. Thrombin acting on fibrinogen converts it into fibrin. Thus, it has two components, one is fibrinogen and another is thrombin. We have prepared both components of fibrin glue. Fibrinogen was obtained from patient's own blood and thrombin from fresh frozen plasma of screened healthy donor. The glue was used in 20 cases requiring skin graft or flap. The results were compared with conventional suturing method. Use of the fibrin glue is simple, safe, cost effective, and rapid technique to fix the skin grafts and flaps with avoidance of peroperative bleeding and postoperative collection. It also has better overall results.

Four decades since the concept of polyamorphism was introduced by [L. S. Palatnik (1909–1994), Fiz. Nizk. Temp. 25, 400 (1909)], numerous investigations proved its presence in a broad variety of nonmagnetic short-range ordered materials, like structural, metallic, a-metallic, inorganic molecule, orientational, electron glasses, water, ice, carbons, and others. It was manifested by phase transitions between amorphous states as a function of the quench condition and under compression, mediated by long-wave fluctuations of an order parameter. There has been much recent discussion given to the phenomenon of polyamorphism where distinct, different states of amorphous liquids and solids are observed as a function of density. The outstanding contribution of the recently late [A. Sella, et al. (1956–2022), Nat. Mater. 21, 490 (2022)],2 in the field should be recognized here. Underlying this phenomenon is the possibility of a first-order liquid-liquid phase transition driven by the density and entropy differences between the two amorphous phases. Magnetic boost of multilayer graphene under pressure was also recently discovered. Their famous spin counterparts, such as spin liquid, spin ice, and spin glass have been less studied at this end despite numerous similarities, registered so far. Taking that in mind, for further polyamorphism platform development, we demonstrate the signatures of phase transition in spin glass, driven by a magnetic field, and eventually, a novel type of polyamorphism, the spin-glass one. [ABSTRACT FROM AUTHOR]

This article, titled "Magnetic Resonance Imaging of Tuberculous Infection of Various Joints: A Pictorial Review," discusses the usefulness of magnetic resonance imaging (MRI) in diagnosing tuberculous infection in different joints. It highlights the MRI appearances of tuberculous infection and describes key features that help differentiate it from inflammatory joint disease. The article also explores the pathophysiology of tuberculous infection in joints, imaging features that aid in distinguishing between inflammatory arthritis and tuberculous infection, and provides sample cases for reference. The authors conclude that MRI is a crucial imaging tool for diagnosing tuberculous infection in various joints and emphasize the importance of understanding the disease process for accurate diagnosis. [Extracted from the article]

For a diverse range of semiconductor devices, the charge carrier lifetime is an essential characteristic. However, the carrier lifetime is difficult to control, as it is usually determined by a variety of recombination processes. For indirect bandgap materials, it is well known that effective carrier lifetimes can be improved by passivating the surface, effectively extinguishing surface-related recombination processes. However, for some applications, such as photomodulators for sub-infrared radiation, it is beneficial to tailor lifetimes to specific values, in this particular case trading off between photo-efficiency and switching speed. In this paper, we design a new type of silicon-based metamaterial with a tunable electron–hole lifetime. By periodically patterning a dielectric surface passivation layer, we create a metamaterial whereby the filling fraction of passivated relative to unpassivated areas dictates the effective charge carrier lifetime. We demonstrate tunable lifetimes between 200 μs and 8 ms in a 670 μm thick Si wafer, though in principle our approach allows one to generate any lifetime between the fully passivated and unpassivated limits of a bulk semiconductor. Finally, we investigate the application of these metamaterials as photomodulators, finding switching times that depend upon both the photoexcitation intensity, wafer thickness, and the carrier lifetime. [ABSTRACT FROM AUTHOR]

This article reports on the first documented case of Tomato leaf curl Kerala virus (ToLCKeV) infecting papaya plants in India. The study was conducted in the Lucknow district of Uttar Pradesh, where diseased papaya plants with symptoms of leaf curl disease were collected. Genetic analysis confirmed the presence of ToLCKeV in the samples, which shared a high nucleotide sequence identity with other ToLCKeV isolates. The study highlights the need for host resistance strategies and further research on viral genome and evolution. [Extracted from the article]

Background: Seed quality of fenugreek is determined by its primary metabolites and an alkaloid diosgenin. Apart from these fenugreek seeds contains total oil, saponins, carbohydrates, protein and major nutrients. Seeds are bitter in taste due to presence of an alkaloid “trigonelline”. In India, major cultivated area of fenugreek is still dependent on conserved moisture and moisture stress conditions reduces its productivity. Methods: A field experiment was carried out in randomized block design (RBD) with three replications during Rabi 2016-2017. Performance of ten fenugreek genotypes was evaluated on the basis of seed quality parameters under normal and water stress condition. Seed samples from both normal and water stressed plant were used for quality analysis in laboratory. Analysis of different quality parameters was done by using standard methods and protocol. Result: Water stress was found to increase seed total oil, saponins and diosgenine content in all the genotypes. Genotypes RMt-1, RMt-305 and RMt-143 were able to accumulate significantly higher total oil and diosgenine content in normal as well as water stress conditions. Water stress condition induced more saponins synthesis in genotype RMt-361 and RMt-351 while crude protein and total carbohydrate declined in all the genotypes. The minimum decrease in crude protein and carbohydrate due to water stress was recorded in genotype RMt-351 and genotypes Hisar Sonali respectively. Moisture was found to decrease in all the genotypes under influence of water stress conditions, minimum (13.75%) being observed in genotype RMt-305. Maximum seed yield was recorded in genotype RMt-361 both under normal as well as water stress conditions. Genotype RMt-1 had least reduction in yield under water stress condition (3.54%). Results suggested that a significant genotypic variation in seed quality parameters of fenugreek genotypes induced through stress may be utilize to introduce novelty of different purpose for developing new cultivars. [ABSTRACT FROM AUTHOR]

In situ x-ray synchrotron diffraction experiments were carried out on nickel-based high-strength superalloys under pressure to understand their deformation mechanism using a diamond anvil cell (DAC). Radial x-ray diffraction determines the room-temperature equations of state and yield strengths of binary Ni3Al alloy and 500 ppm boron-doped Ni3Al to pressures of 20 and 46 GPa, respectively. Crystallographic preferred orientations observed in these superalloys due to anisotropic stress field in DAC indicate the onset of plastic deformation. Inverse pole figure analysis reveals that the underlying deformation mechanisms change from an octahedral slip to a simultaneous activation of octahedral and cube slips upon doping with boron. The yield-strength values were found to increase with pressure and are comparable to those determined from axial diffraction experiments. The results indicate that the yield strength of Ni3Al:B is about 0.5 GPa higher (at pressures below 20 GPa) due to grain boundary strengthening by boron. It is shown that due to high elastic anisotropy of Ni3Al alloy, the yield-strength estimations from diffraction experiments strongly depend on the micromechanical model used to convert the measured elastic strains into stresses. [ABSTRACT FROM AUTHOR]

This article, published in the journal Neuropediatrics, discusses the use of A20 (TNFAIP3) as a potential biomarker to distinguish relapse from remission in pediatric patients with monophasic MOGAD (MOG-IgG-associated disorders). MOGAD is a type of acquired demyelinating syndrome associated with antibodies against myelin oligodendrocyte glycoprotein. The study found that A20 levels were significantly lower during clinical events compared to remission in monophasic MOGAD patients. However, there was no significant difference in A20 levels between clinical events and remission in multiphasic MOGAD patients. The authors suggest that further research is needed to investigate the diagnostic, prognostic, and therapeutic implications of A20 in pediatric MOGAD patients. [Extracted from the article]