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Introduction: Smokeless tobacco (SLT) use is an intermediate risk factor for various noncommunicable diseases. Identifying the risk factors associated with ever use of SLT is important when we focus on the prevention of its initiation. Objectives: To estimate the prevalence and identify the factors associated with ever use of SLT among participants attending life skills training and counseling services program across Karnataka from 2017 to 2022. Methodology: Pretraining data of 3104 participants from 108 training programs between 2017 and 2022 were utilized. Univariate and multivariable logistic regression analysis was performed with various hypothesized exposure variables based on a conceptual framework and ever use of SLT as the outcome. Results: The overall prevalence of ever use of SLT among participants was 4.2%. Being men (adjusted odds ratio [AOR] = 7.05, 95% confidence interval [CI]: 1.68–29.57), having a diagnosed health problem (AOR = 1.88, 95% CI: 1.23–2.87), use of smoked tobacco products (AOR = 21.76, 95% CI: 13.79–34.33), use of SLT products among peers (AOR = 3.88, 95% CI: 2.43–6.21) significantly increased the odds of ever use of SLT while every unit increase in the environmental quality of life score (AOR = 0.98, 95% CI: 0.96–0.99) was significantly associated with reduced odds of ever use of SLT. Conclusion: This study contributes to a growing understanding of factors associated with ever use of SLT products. Gender, use of smoked tobacco, peer influences, and environmental quality of life needs to be stressed on while targeting SLT initiation, especially among teachers. Our study provides important insights while planning cost-effective health promotion interventions, specifically in countries like India.

In view of the complexity and importance of nuclear research reactor (NRR) installations, it is imperative to uphold high standards of reliability and quality in the electricity being supplied to them. In this paper, the performance of low-voltage (LV) distribution feeders integrated with NRRs is improved in terms of reduced distribution loss, improved voltage profile, and reduced greenhouse gas (GHG) emissions by determining the optimal location and size of photovoltaic (PV) systems. In the second stage, the power quality of the feeder is optimized by reducing the total harmonic distortion (THD) by optimally allocating D-STATCOM units. In the third and fourth stages, the reliability and resilience aspects of the feeder are optimized using optimal network reconfiguration (ONR) and by integrating an energy storage system (ESS). To solve the non-linear complex optimization problems at all these stages, an efficient meta-heuristic Chernobyl disaster optimizer (CDO) is proposed. Simulations are performed on a modified IEEE 33-bus feeder considering the non-linear characteristics of NRRs, variability of the feeder loading profile, and PV variability. The study reveals that the proposed methodology can significantly improve the service requirements of NRRs for attaining sustainable research activities.

Introduction: Postpartum hemorrhage (PPH) is defined as a blood loss of more than 0.5 liters within 24 hours of birth, and a blood loss of more than 1 liter is considered a significant PPH. In low- and middle-income countries, PPH is a major factor causing maternal morbidity and mortality, whereas in high-income countries, the mortality is comparatively lower, but still PPH poses a major risk for postpregnancy complications. Uterine atony is the most frequent cause of the PPH, and it accounts for up to 80% of PPH cases. Aim: The aim of this study is to examine the prophylactic effects of oxytocin and carbetocin in preventing atonic PPH in individuals receiving recurrent elective CS under spinal anesthesia. Materials and Methods: A computerized, randomized, cross-sectional prospective comparative study was conducted on 100 pregnant women at Konaseema Institute of Medical Sciences and Research Foundation for the time period of an year, from October 2020 to October 2021. Inclusion Criteria: This study includes patients with singleton pregnancy, gestational age >38 weeks, spinal anesthesia and repeated C.S with cephalic, breech, or any malpresentations. Exclusion Criteria: Patients with placenta previa and placental abruption, uterine myomata, congenital uterine anomalies, gestational age before 38 weeks, women having emergency cesarean section for fetal or maternal distress, and patients with hepatic or pre-existing bleeding disorder were excluded from the study. The patients included based on the above criteria were split into two equal groups. Group I received carbetocin as a single dose of 100 microgram slow intravenous, and Group II received oxytocin as 5 IU intravenous drip followed by 20 IU of oxytocin infusion on 500 ml saline or lactated ringer with a rate of 150 ml per hour. Results: When compared to the oxytocin group, the blood loss was considerably reduced in the carbetocin group. The levels of Hb and hematocrit [HCT] were evaluated pre- and postoperative in both the groups. The levels of preoperative Hb and HCT showed nonsignificant difference between the two groups, while the levels of postoperative Hb and HCT were significantly higher in carbetocin group than oxytocin group concluding that carbetocin showed the better results in controlling the blood loss and maintaining the levels of Hb and HCT volume and the carbetocin group showed less need for administration of uterotonic agents (20%) in comparison with (32%) in oxytocin group but with no statistically significant difference. Only 8 (16%) patients showed PPH in carbetocin treatment, whereas 14 (28%) showed PPH in patients on oxytocin treatment.

Abstract Speech-in-noise (SIN) perception is a primary complaint of individuals with audiometric hearing loss. SIN performance varies drastically, even among individuals with normal hearing. The present genome-wide association study (GWAS) investigated the genetic basis of SIN deficits in individuals with self-reported normal hearing in quiet situations. GWAS was performed on 279,911 individuals from the UB Biobank cohort, with 58,847 reporting SIN deficits despite reporting normal hearing in quiet. GWAS identified 996 single nucleotide polymorphisms (SNPs), achieving significance (p

ObjectiveKyasanur Forest Disease (KFD) is a viral zoonosis reported from Karnataka, India. We investigated cases in the Shivamogga district, Karnataka, to describe the epidemiology and identify risk factors in the affected block in 2022.MethodsA case was defined as a laboratory-confirmed KFD-positive resident of Shivamogga from 1 January-31 May 2022. We extracted the records of KFD cases from district surveillance. We conducted a 1:3 case-control study in the Thirthahalli block. We enrolled laboratory-confirmed KFD-positive Thirthahalli residents from January to May 2022 as cases, and residents without “fever with myalgia” as controls. We reported adjusted odds ratios (aOR) with 95% confidence intervals (CI).ResultsShivamogga reported 35 cases, with a median age of 46 (4–75) years, of which 51% were men, and one death. Among 25 cases and 90 controls, knowledge of avoiding recent monkey death sites was low (cases = 0%, controls = 11%). Monkey death sites within 500 m [aOR = 8.6 (1.8–41.9)] and household tick exposure [aOR = 3.7 (1.3–10.7)] were independent risk factors.ConclusionThis was a laboratory-confirmed cluster of KFD cases in Thirthahalli, with residence near a monkey death site and household tick exposure considered significant risk factors. We recommend evaluating monkey carcass disposal procedures and increasing awareness of tick protective measures.

Ubiquitination is one of the most conserved post-translational modifications and together with mRNA translation contributes to cellular protein homeostasis (proteostasis). Temporal and spatial regulation of proteostasis is particularly important during synaptic plasticity, when translation of specific mRNAs requires tight regulation. Mutations in genes encoding regulators of mRNA translation and in ubiquitin ligases have been associated with several neurodevelopmental disorders. RNA metabolism and translation are regulated by RNA-binding proteins, critical for the spatial and temporal control of translation in neurons. Several ubiquitin ligases also regulate RNA-dependent mechanisms in neurons, with numerous ubiquitination events described in splicing factors and ribosomal proteins. Here we will explore how ubiquitination regulates translation in neurons, from RNA biogenesis to alternative splicing and how dysregulation of ubiquitin signaling can be the underlying cause of pathology in neurodevelopmental disorders, such as Fragile X syndrome. Finally we propose that targeting ubiquitin signaling is an attractive novel therapeutic strategy for neurodevelopmental disorders where mRNA translation and ubiquitin signaling are disrupted.

Background: Psychosocial interventions, crucial for recovery in patients with schizophrenia, have often been developed and tested in high income countries. We aimed at developing and validating home-based a booklet based psycho-social intervention with inputs from stakeholders: patients, families, and mental health professionals (MHP) for patients with schizophrenia and related disorders in low resource settings. Methods: We developed a preliminary version of psychosocial intervention booklets based on six themes derived from focus group discussions conducted with patients, families, and MHP. Initially, quantitative assessment of content validity was done by MHP on overall and Content Validity Index of individual items of the specific booklets, followed by in-depth interviews about their views. The booklets were modified based on their inputs. Further, pilot testing of manuals was done on the users - nine pairs of patients and caregivers followed by development of a final version of psycho-social intervention. Results: The percentage content validity of individual modules and overall booklets was ≥78.5% indicating good validity. Most MHP reported that the manuals were relevant and easy to use but were text-heavy, and lengthy. On pilot testing of modified manuals with patients and their family caregivers, majority (77.8%) of them found booklets useful and suggested that there should be separate booklets for both patients and caregivers for providing information and entering separate response for the activities, integrating helpful tips. Language should be simple. Finally, two sets of booklets (“info book” and “workbook”) named ‘Saksham’ (meaning empowered) were created with specific modules (viz., ‘Medicine adherence’, ‘Daily routine’, ‘Eating right’, ‘Physical activity’, ‘Physical health monitoring’, ‘Self-reliance’, and ‘Psychoeducation’) for patients and caregivers each, in two languages (Hindi and English). Conclusion: Booklets with modules for psychosocial interventions for patients with schizophrenia and their caregivers were developed after establishing content validity and pilot testing.

Abstract Background Prior research has showed the importance of providing integrated support services to prevent and reduce youth not in education, employment, or training (NEET) related challenges. There is limited evidence on NEET youth’s perspectives and preferences for employment, education, and training services. The objective of this study was to identify employment, education and training service preferences of NEET youth. We acknowledge the deficit-based lens associated with the term NEET and use ‘upcoming youth’ to refer to this population group. Methods Canadian youth (14–29 years) who reported Upcoming status or at-risk of Upcoming status were recruited to the study. We used a discrete choice experiment (DCE) survey, which included ten attributes with three levels each indicating service characteristics. Sawtooth software was used to design and administer the DCE. Participants also provided demographic information and completed the Global Appraisal of Individual Needs–Short Screener. We analyzed the data using hierarchical Bayesian methods to determine service attribute importance and latent class analyses to identify groups of participants with similar service preferences. Results A total of n=503 youth participated in the study. 51% of participants were 24–29 years of age; 18.7% identified as having Upcoming status; 41.1% were from rural areas; and 36.0% of youth stated that they met basic needs with a little left. Participants strongly preferred services that promoted life skills, mentorship, basic income, and securing a work or educational placement. Three latent classes were identified and included: (i) job and educational services (38.9%), or services that include career counseling and securing a work or educational placement; (ii) mental health and wellness services (34.9%), or services that offer support for mental health and wellness in the workplace and free mental health and substance use services; and (iii) holistic skills building services (26.1%), or services that endorsed skills for school and job success, and life skills. Conclusions This study identified employment, education, and training service preferences among Upcoming youth. The findings indicate a need to create a service model that supports holistic skills building, mental health and wellness, and long-term school and job opportunities.

Introduction: Crown lengthening is a reliable procedure that enables the restoration of teeth with a short clinical crown, extensive subgingival caries, and correction of excessive gingival display for aesthetic purposes. Blue laser, a recent technology in dentistry, has shown significant effectiveness at low power settings, promoting favourable wound healing effects. Aim: To compare the Visual Analogue Scale (VAS) scores and wound healing outcomes between blue laser and denlase in performing crown lengthening procedures. Materials and Methods: A randomised clinical trial was conducted in the Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, involving 14 patients who were divided into two groups. Participants were recruited from September 2021 to April 2022.Ethical clearance was obtained from the Institutional Ethics and Review Board. Group-A underwent crown lengthening using blue laser (445 nm), while Group-B received treatment with denlase (980 nm). VAS scores and the wound healing index were recorded and compared between the two groups at baseline, 10 days, and one month after the surgery. Statistical tests such as the Mann-Whitney U test, unpaired t-test, and repeated measures ANOVA were used for analysis. Results: The study revealed a statistically significant difference (p-value=0.006) in VAS scores between the blue laser group (mean value of 0.5) and the denlase group (mean value of 1.3). However, statistically significant differences in Wachtel’s early wound healing index were not observed in either of the groups. Conclusion: Blue laser treatment was found to be more comfortable for patients, as indicated by the lower VAS scores. Both groups demonstrated good wound healing properties based on Wachtel’s early wound healing index, with no significant difference between them. It is important to note that literature on blue laser technology is still in its early stages and requires further comprehensive investigation.

Alcoholic beverages have been a significant industry. However, they present food safety risks, necessitating heightened regulation and monitoring. The safety risk assessment of alcoholic beverages encompasses a variety of factors, including microorganisms, excessive methanol content, chemical adulteration, and food additives. The data used in this paper is sourced from the National Food Safety Sampling Inspection Results Query System in China. The primary conclusions are as follows: (1) A deviation reconstruction-based multi-weight decision model is proposed, which incorporates three distinct weight acquisition methods to perform optimization calculations. (2) The comparative investigations serve as evidence of the risk assessment model’s effectiveness. (3) The multi-weight decision model based on deviation reconstruction and the NSGA-II (non-dominated sorting genetic algorithm-II) exhibit excellent adaptability. The results of the risk assessment are analyzed, and recommendations are offered based on the categories of alcoholic beverages and the detection indicators. This paper investigates the regulation of food safety and the identification of risks in intoxicating beverages. It also transitions the response to food safety risks from a passive to an active protection strategy. This method has the potential to improve the public’s perception of safety and satisfaction with food-related concerns, as well as to provide the industry with practical solutions for sustainable growth. Simultaneously, this document establishes new risk assessment regulations for alcoholic beverages, offering recommendations for enhancing regulatory efficiency.

This pharmacokinetic study was carried out in rabbits following single oral administration of ciprofloxacin to study kinetic behaviour of ciprofloxacin in the presence of vitamin B1 and selected essential amino acid phenylalanine. Rabbits weighing 2-4 kg were randomly assigned to 5 groups of 6 each. Group 1 served as blank without any treatment. Group 2 served as ciprofloxacin control whereas Group 3, 4 and 5 rabbits were co-administered with thiamine (80 mg/kg), phenylalanine (48 mg/kg), combination of thiamine and phenylalanine along with ciprofloxacin (40 mg/kg) orally. Blood samples were collected at predetermined time intervals up to 24 h, and plasma was used for estimation of ciprofloxacin through bioassay. Results obtained from the experiment revealed that rabbits of Group 3, 4 and 5 showed improved levels of Cmax 4.74±0.17, 3.00±0.22, 2.18±0.12 µg/mLand AUC 20.30±5.19, 10.09±1.48, 12.85±1.34 µg.h/mL, respectively when compared to Cmax (2.10±0.14 µg/mL) and AUC (5.90±0.81 µg.h/mL) in Group II rabbits. PK-PD integration of the present study revealed that Cmax: MIC>8, AUC: MIC>125 in Group 3, 4 and 5 implying that the co-administration of vitamin B1 and phenylalanine and their combination improves the antibacterial activity and reduces the development of resistance at the selected dose of ciprofloxacin.

It is often assumed that media literacy serves to protect and uphold democratic practice and that media literate citizens are the best safeguards for democracy. However, little attention is paid to defining this practice and its relationship to ongoing inequities within democratic societies. In this essay, we argue media literacy operates from three core assumptions; media literacy creates knowledgeable individuals, empowers communities, and encourages democratic participation. The first assumption draws out an individual's skills and critical thinking in media literacy practices. The second assumption focuses on the community aspect of media literacy, specifically which communities are best served by media literacy and why. Finally, the connection between media literacy and democratic practices is evaluated to understand how the democratic ideals of equity and justice are situated within the existing literature. Through an exploration of these assumptions, this essay provokes a discussion into the assumptions that media literacy scholarship and practice addresses to highlight some of the gaps in constructing impactful practice that centers on equity and social justice.

This paper describes the Trauma-informed Equity-minded Asset-based Model (TEAM) framework for social justice-oriented educators. We draw on traumainformed approaches to illustrate how systemic racism as systemic trauma and normative whiteness as dominant ideology are embedded in the U.S education and media institutions. From an equity-minded perspective, we critique notions such as egalitarianism, colorblind racism, neoliberal multiculturalism, and abstract liberalism. Using an asset-based model, we urge educators to avoid deficit ideologies to frame marginalized communities. The TEAM approach offers the following "Six R's" as strategies: (1) "Realizing" that dominant ideologies are embedded in educational systems, (2) "Recognizing" the long-term effects of systemic trauma on learners from aggrieved communities, (3) "Responding" to trauma by emphasizing safety, trust, collaboration, peer network, agency, and voice within learning environments, (4) "Resisting" retraumatization within learning environments, (5) Replacing egalitarianism with equity-mindedness and (6) "Reframing" deficit ideology with an asset-based lens to learners.

Introduction: The important components that contribute to successful dental care are maximum accessibility, visibility, comfort, and control over clinical processes. Dental practitioners are more prone to developing musculoskeletal disorders due to awkward working postures. To minimise all these risk factors, a new concept called Proprioceptive Derivative (PD) has come into existence. Aim: The main aim of this study was to evaluate the comfort levels of the patient and ergonomics of the dental professional in the PD approach and conventional approach. Materials and Methods: A cross-sectional study was conducted in which manual scaling was performed by 20 dentists on 120 patients using the PD concept and conventional concept. A 13-item questionnaire was distributed among the patients and clinicians to record their perceptions of comfort levels, clinicians’ treatment satisfaction levels, and the time needed to complete the procedure after mastering the PD concept. In indepedent sample t-test was use to compare the responses among the two groups. p≤0.05 was considered statistically significant. Results: The comfort levels of the clinician (q1) during treatment in the conventional approach, with a mean value of 2.96±0.69, were significantly lower than in the PD approach, with a mean value of 3.46±0.85 (p0.05). Conclusion: The clinicians had more ergonomic benefits and improved time factors under the PD concept. By following the work postures according to the PD concept, clinicians can avoid musculoskeletal discomfort, which is beneficial to all clinicians and can increase the longevity of their clinical practice.

Introduction: Coronavirus Disease 2019 (COVID-19) is associated with an increased risk of Venous Thromboembolism (VTE) and coagulopathy. The available studies have shown the anticoagulant and mucolytic effects of nebulised heparin in non COVID-19 patients. Hence it was decided to conducted to study the efficacy of nebulised heparin in patients suffering from COVID-19 pneumonia requiring mechanical ventilation. Aim: To evaluate the safety and efficacy of nebulised heparin administered to patients with COVID-19. Materials and Methods: A double-blinded randomised controlled trial was conducted at Basaveshwara Medical College and Hospital in Chitradurga, Karnataka, India among 100 patients with COVID-19 who required mechanical ventilation from February 2021 to May 2021. They were randomly assigned to two equal groups of 50 patients each. One group received nebulised heparin, and the other group received a placebo. The patients were compared for baseline characteristics, coagulation characteristics, and Oxygen Saturation (SpO2 ). Data were analysed using Statistical Package for Social Sciences (SPSS) version 22.0, expressed as frequency and percentages, and displayed in tables and figures. The association between two variables was determined using the Chi-square test and paired t-test. Results: The two groups did not differ significantly in terms of age, sex, respiratory failure, vasopressin use, and severity score. Respiratory failure was present in 54% of the heparin group and 38% of the placebo group. Vasopressin was used in 64% of the heparin group and 56% of the placebo group. The severity score was 4.44 in the heparin group and 4.42 in the placebo group. Activated Partial Thromboplastin Time (APTT) levels did not differ significantly between the groups. None of these parameters showed significant differences between the heparin and placebo groups. However, both groups showed a significant difference in Thrombin Antithrombin (TAT) complex levels from baseline to follow-up (p