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Electrochemical impedance spectroscopy (EIS) is gaining immense popularity in the current times due to the ease of integration with microelectronics. Keeping this aspect in mind, various detection schemes have been developed to make impedance detection of nucleic acids more specific. In this context, the current work makes a strong case for specific DNA detection through EIS using nanoparticle labeling approach and also an added selectivity step through the use of dielectrophoresis (DEP), which enhances the detection sensitivity and specificity to match the detection capability of quantitative polymerase chain reaction (qPCR) in real-time context as compared to the individually amplified DNA (Liu et al., 2008). The detection limit of the proposed biochip is observed to be 3-4 PCR cycles for 582 bp bacterial DNA, where the complete procedure of detection starts in less than 10 min. The process of integrated DEP capture of labeled products coming out of PCR and their impedance-assisted detection is carried out in an in-house micro-fabricated biochip. The gold nanoparticles, which possess excellent optical, chemical, electronic, and biocompatibility properties and are capable of generating lump-like DNA structure without modifying its basic impedance signature are introduced to the amplified DNA through the nanoparticle labeled primers.

Tuberculosis (TB) is a chronic infectious granulomatous disease caused by the air-borne bacillus Mycobacterium tuberculosis and less frequently by other bacteria in the M. tuberculosis complex (Mycobacterium Bovis and Mycobacterium africanum). Tuberculous osteomyelitis of the condyle may present atypical clinical findings akin to temporomandibular joint arthritis or middle ear infections. A detailed clinical and radiographic examination aided by a histopathological and a microbiological diagnostic workup is the key to timely detection and administration of appropriate therapeutic regimens. A high degree of clinical suspicion is thus advocated in patients with such atypical presentations. We, hereby, are presenting a rare case of tuberculous osteomyelitis in a 15-year-old female child.

To determine and compare the accuracy and efficiency of a dynamic navigation system (DNS) with a freehand (FH) technique when conducting root-end resection in a human cadaver model.Forty roots in cadaver heads were included and divided into two groups: DNS (n = 20) and FH (n = 20). Cone beam computed tomography (CBCT) scans of all teeth were taken. The drilling path and depth were planned virtually to using the X-guide software (X-Nav Technologies, Lansdale, PA, USA). Osteotomy and root-end resection were done under navigation in the DNS group, and freehand under the dental operating microscope in the FH group. Post-operative CBCTs were taken. Linear deviations, angular deflection, time of operation and number of mishaps were compared with determine the accuracy and efficiency. Shapiro-Wilk, one-way ANOVA and Fisher exact tests were used (P 0.05).Linear deviations, angular deflection and operation time were significantly less in the DNS group (P 0.05). The number of mishaps was not different between the two groups (P 0.05). Subgroup analyses revealed that the distance of5 mm from buccal cortical plate was significantly associated with lower accuracy, increased operation time and greater incidence of mishaps in the FH group (P 0.05), but not in the DNS group.The dynamic navigation system was more accurate and more efficient in root-end resection in a cadaver model than the freehand technique. The distance of the roots from the buccal cortical plate had a significant negative impact on the accuracy and efficacy of the root-end resection procedure when using the freehand technique. The dynamic navigation system has the potential to be a safe and reliable technological addition to endodontic microsurgery.

The 14th edition of the Workshop on Recent Issues in Bioanalysis (14th WRIB) was held virtually on June 15-29, 2020 with an attendance of over 1000 representatives from pharmaceutical/biopharmaceutical companies, biotechnology companies, contract research organizations, and regulatory agencies worldwide. The 14th WRIB included three Main Workshops, seven Specialized Workshops that together spanned 11 days in order to allow exhaustive and thorough coverage of all major issues in bioanalysis, biomarkers, immunogenicity, gene therapy and vaccine. Moreover, a comprehensive vaccine assays track; an enhanced cytometry track and updated Industry/Regulators consensus on BMV of biotherapeutics by LCMS were special features in 2020. As in previous years, this year's WRIB continued to gather a wide diversity of international industry opinion leaders and regulatory authority experts working on both small and large molecules to facilitate sharing and discussions focused on improving quality, increasing regulatory compliance and achieving scientific excellence on bioanalytical issues. This 2020 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop and is aimed to provide the Global Bioanalytical Community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. Due to its length, the 2020 edition of this comprehensive White Paper has been divided into three parts for editorial reasons. This publication (Part 3) covers the recommendations on Vaccine, Gene/Cell Therapy, NAb Harmonization and Immunogenicity). Part 1 (Innovation in Small Molecules, Hybrid LBA/LCMS & Regulated Bioanalysis), Part 2A (BAV, PK LBA, Flow Cytometry Validation and Cytometry Innovation) and Part 2B (Regulatory Input) are published in volume 13 of Bioanalysis, issues 4 and 5 (2020), respectively.

Blepharitis is an eyelid disorder characterized by inflammation and pain. It affects all the ages and ethnic groups. Primary cause of blepharitis is poor hygienic condition. Topical antibiotics are the preferred first line therapeutic agents along with eyelid cleansing and warm compresses are recommended. Topical steroids, oral antibiotics and calcineurin inhibitors are also recommended in severe conditions. However, recurrence of disease, dose related side effects and safety regimen are still uncertain with these agents. Blepharitis needs a long term treatment, thus novel formulations and products with natural components may be considered more reliable to overcome such issues. In this review article we have discussed human clinical trials (HCTs) conducted with conventional synthetic drugs, novel drug delivery systems developed with synthetic drugs and drugs of natural origin and other supportive measures. As compared to synthetic drugs, formulations with natural origin were found to be safe with minimum side effects.

Introduction: Microcytosis is a condition in which red blood cells are unusually small as measured by their mean corpuscular volume.1 The most common cause of microcytosis is iron deficiency anemia.2 In severe microcytosis, both thrombocytosis and thrombocytopenia may be seen although thrombocytosis is more frequently seen. Aim and Objectives: To study the values of platelet count and mean platelet volume in cases of severe microcytosis. Materials and Methods: A 1 year prospective study (1st January 2017 to 31st December 2017) of 200 patients was carried out in the Post Graduate Department of Pathology, Acharya Shri Chander College of Medical Sciences (ASCOMS) and Hospital, Sidhra after obtaining due clearance from Institutional Ethical Committee. Platelet count and mean platelet volume (MPV) of 200 patients with low mean corpuscular volume (MCV) was done. Results: A total of 200 patients with severe microcytosis (MCV

PurposeThe primary objective of this study is to prioritize the main intentions behind investment in cryptocurrency, in spite of its volatile nature and no regulatory framework.Design/methodology/approachThis research paper has worked on collective constructs of the unified theory of acceptance and use of technology (UTAUT), the technology acceptance model (TAM) and social support theory with an added construct of financial literacy. A fuzzy analytical framework has been applied to prioritize the intentions of investors.FindingsThe result indicates that “Social Influence (SI)” is the most influencing factor, while “Effort Expectancy (EE)” is the least influencing factor considered by investors. The subdimensions ranked in the top priority by investors are as follows: “I want to invest in cryptocurrencies because I have a good level of financial knowledge (FL1)”; “The people who are important to me will think that I should use cryptocurrencies (SI2)”; “I have the necessary resources to use cryptocurrencies (FC2).” The least importance is given to “It will be easy for me to become an expert in the use of cryptocurrencies (EE3).”Research limitations/implicationsFew of the constructs of the UTAUT, the TAM and social support theory have been considered while prioritizing intentions. Different other intentions also prevail under different theories that need to be researched further.Practical implicationsUnlike previous studies, this research adds the archetype of social commerce, social support and utility theories to analyze and prioritize the behavioral perspective of using cryptocurrencies in digital transactions.Originality/valueThis paper fills the gap in the research study, along with assisting the regulators and cryptocurrency practitioners to widen their knowledge base and to recognize the prioritized intentions.

Background: At the time of pandemics like COVID-19, dental professionals being one of the frontline workers must face a lot of challenges in workplace bringing about a lot of anxiety and stress. The purpose of this survey was to assess the physiological well-being of the dental professionals, the majority of challenges faced by them, , how they are dealing with it and what changes in their opinion could be implemented to be prepared in the wake of any future adversity. Methodology: We conducted a cross sectional survey via an online questionnaire that was sent to dentists in 4 different countries- India, US, UK, and Iran. The questionnaire comprised of closed ended questions grouped in broad categories of demographics, physiological well-being of dentists, Changes in dental practice during COVID-19 and Changes to be implemented post Covid-19. Descriptive analysis was performed to summarize the data with SPSS-19 software. Results: A total of 312 dentists (181 Males and 131 Females) from four countries responded to the study. Most of them (56.4 %) were in the age group of 30 to 40 years, 27.9 % in 25- 30 years, and 7.1% above 50 years. 47.5% dentists reported suffering from stress and anxiety due to the shutting down of their private dental practices. 72.5% dentists reported that they are worried about the operational and financial challenges to run their practice during Covid-19. 60% of the dentists had concerns due to the shortage of personal protective equipment. Most of the dental professionals (73.9%) are of the opinion that management of medical emergencies should be included in the dental curriculum, so that dentists can volunteer their services at the time of crisis and also can be well-prepared to take care of their patients. Conclusion: During the COVID-19 pandemic, dentists like medical professionals must face a lot of ethical and moral dilemma along with dealing with the operational challenges. The present study draws our attention to the fact that despite having faced pandemics like SARS, health professions like dentistry still need a lot of preparedness and requires modifications to face any such challenges in future.

Purpose: Only a minority of patients with advanced non–small cell lung cancer (NSCLC) truly benefits from single-agent PD-1 checkpoint blockade, and more robust predictive biomarkers are needed. Experimental Design: We assessed tumor samples from 67 immunotherapy-treated NSCLC cases represented in a tissue microarray, 53 of whom had pretreatment samples and received monotherapy. Using GeoMx Digital Spatial Profiling System (NanoString Technologies), we quantified 39 immune parameters simultaneously in four tissue compartments defined by fluorescence colocalization [tumor (panCK+), leucocytes (CD45+), macrophages (CD68+), and nonimmune stroma]. Results: A total of 156 protein variables were generated per case. In the univariate unadjusted analysis, we found 18 markers associated with outcome in spatial context, five of which remained significant after multiplicity adjustment. In the multivariate analysis, high levels of CD56 and CD4 measured in the CD45 compartment were the only markers that were predictive for all clinical outcomes, including progression-free survival (PFS, HR: 0.24, P = 0.006; and HR: 0.31, P = 0.011, respectively), and overall survival (OS, HR: 0.26, P = 0.014; and HR: 0.23, P = 0.007, respectively). Then, using an orthogonal method based on multiplex immunofluorescence and cell counting (inForm), we validated that high CD56+ immune cell counts in the stroma were associated with PFS and OS in the same cohort. Conclusions: This pilot scale discovery study shows the potential of the digital spatial profiling technology in the identification of spatially informed biomarkers of response to PD-1 checkpoint blockade in NSCLC. We identified a number of relevant candidate immune predictors in spatial context that deserve validation in larger independent cohorts.

OBJECTIVE To identify relationships between clinical assessments of chronic pain to enable the generation of a multivariate model to predict patient satisfaction with spinal cord stimulation (SCS) treatment. MATERIALS AND METHODS Data from an exploratory clinical trial of sub-perception SCS (SPSCS) were reviewed. Forty-seven subjects tested multiple SPSCS programs for three to four days each. At the end of each program period, subjects recorded pain intensity, patient satisfaction with treatment (PSWT), modified patient global impression of change, and physical activity tolerance times. Twelve outcome variables were evaluated. Pearson's correlation coefficient was used to assess pair-wise correlations. Multigenerational mixed effects modeling was performed to create a model to best explain relationships between those variables. RESULTS A final model was generated that predicted PSWT using evening pain intensity (EPI) and the interaction between EPI and walking tolerance time. The mixed effects model allows for visualization of the interactions between EPI, walking tolerance time, and patient satisfaction with SCS. CONCLUSIONS Patient-centered outcomes are desirable when evaluating complex multidimensional health impairments but accurately predicting patient satisfaction with treatment remains a challenge. Understanding the variables that predict (either by causation or association) satisfaction would be useful for clinicians. The results of this study suggest that a composite measure of activity tolerance (i.e., walking tolerance) and pain intensity can predict patient satisfaction with SCS therapy. This study highlights the utility of composite outcomes metrics in evaluating the benefits of SCS for chronic low back and leg pain.

Covid-19 was declared as global pandemic by WHO. World is not unknown to the family of coronaviruses due to previous epidemic caused by SARS and MERS. Healthcare professions have from time to time change their ways of practicing because of the direct threat posed by such infections, capable of causing human to human transmission. This article, based on our experience and guidelines issued by CDC as well as IDA, intends to provide a review of recommended protocols for dental professionals.

The assessment of programmed death 1 ligand 1 (PD-L1) expression by Immunohistochemistry (IHC) is the US Food and Drug Administration (FDA)-approved predictive marker to select responders to checkpoint blockade anti-PD-1/PD-L1 axis immunotherapies. Different PD-L1 immunohistochemistry (IHC) assays use different antibodies and different scoring methods in tumor cells and immune cells. Multiple studies have compared the performance of these assays with variable results. Here, we investigate an alternative method for assessment of PD-L1 using a new technology known as digital spatial profiling. We use a previously described standardization tissue microarray (TMA) to assess the accuracy of the method and compare digital spatial profiler (DSP) to each FDA approved PD-L1 assay and one LDT assay and 3 quantitative fluorescence assays. The standardized cell line Index tissue microarray contains 10 isogenic cells lines in triplicates expressing various range of PD-L1. The dynamic range of PD-L1 digital counts was measured in the ten cell lines on the Index TMA using GeoMx DSP assay and readout on the nCounter platform. The digital method shows very high correlation with immunohistochemistry scored with quantitative software and with quantitative fluorescence. High correlation of PD-L1 digital DSP counts were seen between rows on the same Index TMA. Finally, experiments from two Index TMAs showed reproducibility of DSP counts were independent of variable slide storage time over a three-week period after antibody labeling but before collection of cleaved tags. In summary, DSP appears to have quantitative potential comparable to quantitative immunohistochemistry. It is possible that this technology could be used as a PD-L1 protein measurement system for companion diagnostic testing for immune therapy., Summary: Digital spatial profiling is a new high-plex technology with potential to multiplex hundreds of proteins on a single slide. Here the authors validate the digital aspect of the technology on a control tissue microarray with known amounts of PD-L1 expression to show it has quantitative capacity comparable to quantitative immunofluorescence.

Introduction: Most studies on opioid agonist treatment (OAT) from South Asia have assessed retention over short term. The aim of this study was to assess retention rates on buprenorphine-based OAT ...

Background and Objectives The emergence of resistant strains of Cutibacterium acnes can limit the efficacy of currently approved antibiotics for acne. VB-1953 is a next-generation antibiotic that exerts a bactericidal effect on resistant C. acnes. In this study, we investigated the safety, tolerability, and efficacy of VB-1953 topical gel in patients with moderate to severe acne having clindamycin-resistant C. acnes. Methods An investigator-initiated, open label, single-arm clinical study was conducted in patients with moderate to severe facial acne vulgaris showing poor or no response to previous clindamycin treatment. Nineteen subjects were enrolled in the study based on laboratory screening for the presence of clindamycin-resistant C. acnes in acne swab samples collected from patients. VB-1953 2% gel was applied on the entire face twice daily over 12 weeks. The primary efficacy endpoints were absolute changes in inflammatory and noninflammatory lesion counts from baseline at week 12, while the secondary efficacy endpoint was the proportion of subjects achieving Investigator Global Assessment success (score of 0 or 1) or a grade 2 or higher improvement from baseline at week 12. The presence and severity of local skin reactions (erythema, edema, scaling/dryness, burning/stinging, pruritus) were evaluated for safety. Additionally, the detection and quantification of drug-resistant C. acnes strains were performed in the laboratory using acne swab samples collected from patients. Results The occurrence of treatment-emergent adverse events or changes in vital signs, physical examinations, and urinalysis for any of the patients during the course of the entire study were clinically insignificant. Topical application of 2% VB-1953 topical gel resulted in a significant reduction of mean absolute inflammatory and noninflammatory lesion counts by 53.1% and 52.2%, respectively (p

SRAM is a very fast memory with low power consumption. The main objective of this work is to perform a 64-digit SRAM with 90 nm innovation. Execution depended on a granular perspective. SRAM's base module is similar to an N-MOS inverter, flip-flop, and semiconductor. We design this module according to the configuration rule of the ? format. Using Harvard technology, SRAM can easily retrieve information from memory. To create advanced rational circuits, it is important to see how an SRAM is assembled and how it works. The bottom line is that with 0.12 micron 90nm technology, we are developing a 5T SRAM and we can read and write. It is a fundamental part of a computer's central processing unit. RAM is a building block made up of several circuits. The 64-bit SRAM reader was developed with MICROWIND and DSCH2. With the MICROWIND program, the developer can design and simulate an integrated circuit at the physical description level. DSCH2 allows switching of digital logic design.

Recalcitrant dermatophytic infections of the glabrous skin (tinea corporis/cruris/faciei) pose a huge challenge to health care systems. Combinations of oral and topical drugs may potentially improve cure rates, but the same has never been objectively assessed for this condition in laboratory or clinical studies. The present study was undertaken with the aim of identifying synergistic combinations of oral and topical antifungals by testing clinical isolates obtained from patients with recalcitrant tinea corporis/cruris. Forty-two patients with tinea corporis/cruris who had failed oral antifungals or had relapsed within 4 weeks of apparent clinical cure were recruited. Twenty-one isolates were identified by sequencing (all belonging to the Trichophyton mentagrophytes/T. interdigitale species complex) and subjected to antifungal susceptibility testing (AFST) and squalene epoxidase (SQLE) gene mutation analysis. Finally, five isolates, four with underlying SQLE gene mutations and one wild-type strain, were chosen for checkerboard studies using various combinations of antifungal agents. Most isolates (n = 16) showed high MICs of terbinafine (TRB) (0.5 to >16 μg/ml), with SQLE gene mutations being present in all isolates with MICs of ≥0.5 μg/ml. Synergistic interactions were noted with combinations of itraconazole with luliconazole, TRB, and ketoconazole and propylene glycol monocaprylate (PGMC) with luliconazole and with the triple combination of PGMC with luliconazole and ketoconazole. In vitro synergistic interactions provide a sound scientific basis for the possible clinical use of antifungal combinations. Hence, these synergistic combinations may be tested for clinical utility in the wake of rising resistance among dermatophytic infections of the glabrous skin.

During March to June 2021 India has experienced a deadly second wave of COVID-19 with an increased number of post-vaccination breakthrough infections reported across the country. To understand the possible reason of these breakthroughs we collected 677 clinical samples (throat swab/ nasal swabs) of individuals who had received two doses (n=592) and one dose (n=85) of vaccines (Covishield and Covaxin,) and tested positive for COVID-19, from 17 states/Union Territories of country. These cases were telephonically interviewed and clinical data was analyzed. A total of 511 SARS-CoV-2 genomes were recovered with genome coverage of higher than 98% from both the cases. Analysis of both the cases determined that 86.69% (n=443) of them belonged to the Delta variant along with Alpha, Kappa, Delta AY.1 and Delta AY.2. The Delta variant clustered into 4 distinct sub-lineages. Sub-lineage–I had mutations: ORF1ab-A1306S, P2046L, P2287S, V2930L, T3255I, T3446A, G5063S, P5401L, A6319V and N-G215C; Sub-lineage –II : ORF1ab- P309L, A3209V, V3718A, G5063S, P5401L and ORF7a-L116F; Sub-lineage –III : ORF1ab- A3209V, V3718A, T3750I, G5063S, P5401L and Spike-A222V; Sub-lineage –IV ORF1ab- P309L, D2980N, F3138S and spike - K77T. This study indicated that majority of the clinical cases in the breakthrough were infected with the Delta variant and only 9.8% cases required hospitalization while fatality was observed in only 0.4% cases. This clearly suggests that the vaccination does provide reduction in hospital admission and mortality.

This research work intensively studied the impact of thermal effects on the logic performance of dynamic comparators implemented using 16 nm strained silicon/metal gate/high-K CMOS technology and with a power supply (V DD ) of 0.7 V. The double tail latch type and pre-amplifier and latch type dynamic CMOS comparators exhibited a delay of 45.03 pS and 63.09 pS respectively. Moreover, the double tail latch type and pre-amplifier and latch type comparators consumed a power of 69.16 µW and 58.76 µW respectively. In order to investigate the thermal effects in dynamic CMOS comparators the operating temperature is varied from 30°C to 110°C and the pre-amplifier and regenerative latch type dynamic comparator is found to be exhibiting minimal noise compared with traditional double tail comparators. These two dynamic comparators implemented using 16 nm CMOS technology with a V DD of 0.7 V are considered to be promising circuits for future ultra low power and high speed ADCs.

Breath alcohol analyser is used to detect alcohol content in end-expiratory breaths in order to enforce driving regulations under the influence of alcohol legislation. The accuracy and reliability of the routine measurements of alcohol content performed with breath alcohol analyser can be achieved by the calibration of the breath alcohol analyser using standards traceable to SI reference material. Proper calibration is essential for transparency in legal verification for which reference material is needed. At international level, a number of NMIs are active to address this important measurement issue of providing accurate measurements. Several international key comparison programs have been organized so far for the determination of ethanol content in aqueous and in nitrogen/air matrix. NIST, USA; BAM, Germany; IRMM, Belgium, Portugal, INMETRO, Brazil, LGC, UK etc. have developed certain reference materials of ethanol in water solution/air with different concentration ranges. However, no such reference material is introduced in India as an indigenous standard, rather, being procured from abroad or using high purity alcohol for calibration purposes. CSIR-NPL, India, being the NMI is now focusing on establishing the calibration facility and development of SI traceable aqueous alcohol standard to provide test reliability for the testing in breath alcohol analyser. This program has a societal impact which contributes to human health and regulatory needs for the nation.

Gorham–Stout disease (GSD) is a rare form of osteolysis, the aetiology and pathogenesis of which remains controversial to this date. Although more than 200 cases of GSD have been reported so far, this disease continues to go undiagnosed in the initial stages owing to its varied clinical presentations and rarity. Through this case report of GSD in a 3-year-old boy, we discuss the slow progression of the disease over a period of 13 years. The literature review is also done with an emphasis on the role of an oral and maxillofacial radiologist in understanding the disease at its incipient stage.

Ovarian cancer is the second most common gynaecological malignancy. It usually occurs in women older than 50 years, and because 75% of cases are diagnosed at stage III or IV it is associated with poor diagnosis. Despite the chemosensitivity of intraperitoneal chemotherapy, the majority of patients is relapsed and eventually dies. In addition to the challenge of early detection, its treatment presents several challenges like the route of administration, resistance to therapy with recurrence and specific targeting of cancer to reduce cytotoxicity and side effects. In ovarian cancer therapy, nanocarriers help overcome problems of poor aqueous solubility of chemotherapeutic drugs and enhance their delivery to the tumour sites either by passive or active targeting, and thus reducing adverse side effects to the healthy tissues. Moreover, the bioavailability to the tumour site is increased by the enhanced permeability and retention (EPR) mechanism. The present review aims to describe the current conventional treatment with special reference to passively and actively targeted drug delivery systems (DDSs) towards specific receptors designed against ovarian cancer to overcome the drawbacks of conventional delivery. Conclusively, targeted nanocarriers would optimise the intra-tumour distribution, followed by drug delivery into the intracellular compartment. These features may contribute to greater therapeutic effect.

Background The pathobiology of atopic asthma is complex and the symptoms similar to other respiratory diseases. As such, identification of biomarkers of atopic asthma is of prime importance for better diagnosis and control of the disease. Objectives We sought to study the changes in plasma proteome and cytokine-expression profile across healthy and atopic asthmatics for identifying biomarkers and exploring aberrant pathways for atopic asthma. Methods A pilot-scale study in humans was performed to identify differentially expressed proteins in blood plasma of healthy controls (n=5) and treatment-naive atopic asthma patients (n=5) using quantitative label-free liquid chromatography-tandem mass spectrometry proteomics and ELISA. Results Mass spectrometry-based proteomic analysis revealed ApoE to be significantly downregulated in atopic asthmatics compared to healthy volunteers. Decreased expression of ApoE in atopic asthmatics was validated by immunoblotting (50.74% decrease). Comparison with atopic asthmatics and COPD patients showed that ApoE was decreased (36.33%) in atopic asthma compared to COPD. IL33 was significantly upregulated in atopic asthmatics compared to healthy subjects (3.84-fold). Conclusion ApoE was downregulated and IL33 upregulated in atopic asthma patients compared to healthy volunteers. These two proteins' profiles were distinct in atopic asthma from healthy and COPD plasma samples. Differential expression of these proteins could serve as a probable candidate for a two-protein classifier-based prognostic biomarker of atopic asthma.

Topically applied antibacterial agents are widely used. Opinions regarding the clinical efficacy of topical antibiotics are conflicting, and for most indications, alternative oral therapies are available. Topical application has many potential advantages over systemic therapy that includes high and sustained concentrations of drug directly at the infected site, low quantity of antibiotic needed, better compliance, fewer systemic side effects and potentially less chance of antimicrobial resistance. Despite these advantages, an important concern has been the difficulty in monitoring antibiotic dosage and duration of therapy. Most topical preparations are applied on sites with pre-existing normal bacterial flora, and the detrimental effect of antibiotic on the 'good' bacteria is difficult to control. Unnecessary exposure of the resident microflora to high drug levels may select drug-resistant phenotypes. The number of antibiotics available and the quality and composition of the formulations recommended for topical drug delivery are improving. Their role in the prevention and treatment of locally invasive infections is established for many clinical conditions. However, there is still a lacuna in the availability of pharmacokinetic (PK) knowledge of these topical preparations and translation of the same to clinical practice. In addition, reporting the clinical outcome following the use of these agents and its analysis considering the recently proposed epidemiological cut-off value-based cut-offs are also areas which merit further research. In this review, we highlight the clinical utility and the PK aspects of topical antimicrobials in various infections. We also discuss the limitations of the current antimicrobial susceptibility testing (AST) protocols and new methods for AMST for topical agents.

Background The cancer-associated fibroblast (CAF) population is implicated in immune dysregulation. Here, we test the hypothesis that CAF profiles in pretreatment tumor specimens are associated with response to immune checkpoint blockade of programmed cell death 1 (PD-1). Methods Pretreatment whole tissue sections from 117 melanoma patients treated with anti-PD-1 therapy were assessed by multiplex immunofluorescence to detect CAFs defined by Thy1, smooth muscle actin (SMA), and fibroblast activation protein (FAP). Two independent image analysis technologies were used: inForm software (PerkinElmer) to quantify cell counts, and AQUA™ to measure protein by quantitative immunofluorescence (QIF). CAF parameters by both methodologies were assessed for association with previously measured immune markers (CD3, CD4, CD8, CD20, CD68, PD-L1), best overall response, progression-free survival (PFS), and overall survival (OS). Results CAF parameters, by cell counts or QIF, did not correlate with immune markers nor with best overall response. However, both Thy1 and FAP cell counts had significant positive associations with PFS (all P

This paper analyses the performance of India's Public Sector Undertakings (PSUs) us-ing measures of labour and overall efficiency and productivity indicators as opposed to finan-cial returns. Using methods that correct for selection bias, the results show that performance contracts do not improve firm efficiency but disinvestment has a very strong positive effect on firm efficiency. Disinvestment improves labour productivity and efficiency, which is not surprising, but it also improves overall efficiency. India should pursue much bolder privati-zation even of PSUs which claim to be making operational profits - such as Air India, because privatization improves overall firm efficiency and unlocks capital for use elsewhere, espe-cially in public infrastructure, and reduces the possibility of political interference in their functioning in future.

Zinner syndrome is a rare cystic malformation of seminal vesicle which consists a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. The usual presentation is between the third and fourth decades of life, with infertility being the most common complaint. Ultrasound, cystoscopy, and magnetic resonance tomography (MRI) can easily detect this condition. Treatment option varies according to the presenting symptoms of the patient. We present a case of a 19-year-old male with recurrent episodes of urinary tract infection (UTI) and poor urinary stream. On ultrasound examination, the patient was found to have absent right kidney with a cystic swelling noted to be arising from prostate or seminal vesicle region which was further confirmed on MRI examination. Cystoscopy reveals a bulge on the right side of the verumontanum abutting the neck of the bladder. An ultrasound-guided aspiration of the cyst was performed which relieved the symptoms of the patient. Cystic abnormalities of the seminal vesicle are very uncommon. Symptomatic cases may present as recurrent UTI, infertility, bladder outlet obstruction, and painful ejaculation. Surveillance may be the option in the absence of clinical manifestations. Interventions such as image-guided aspiration or surgical procedures are appropriate when conservative measures prove ineffective.

Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. All of them underwent uncemented total hip arthroplasty. All the available publications in the English language based medical literature were critically reviewed and results were summarized. The median age of presentation was 32 years (range : 24 years to 61 years). They were followed up for a mean duration of 25 months (range : 12 months to 59 months). The most common risk factor was corticosteroid consumption (7 out of 10 patients). All except one (modified Ficat and Arlet stage II) belonged to advanced stage of ONFH {stage III 3 patients (3 hips), stage IV 6 patients (8 hips)}. The mean time lag of ONFH to presentation was 22.3 months (range : 5 months to 60 months), and SSF to presentation was 13.8 days (range : 1 day to 28 days). Mean pre- operative Harris Hip Score was 10.8 (range : 8 to 14), which improved to 93 (range : 91 to 96) after total hip arthroplasty when last followed up (p

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that has been recognized for over 200 years by its clinically dominant motor system impairment. There are prominent non-motor symptoms as well, and among these, psychiatric symptoms of depression and anxiety and cognitive impairment are common and can appear earlier than motor symptoms. Although the neurobiology underlying these particular PD-associated non-motor symptoms is not completely understood, the identification of PARK genes that contribute to hereditary and sporadic PD has enabled genetic models in animals that, in turn, have fostered ever deepening analyses of cells, synapses, circuits, and behaviors relevant to non-motor psychiatric and cognitive symptoms of human PD. Moreover, while it has long been recognized that inflammation is a prominent component of PD, recent studies demonstrate that brain-immune signaling crosstalk has significant modulatory effects on brain cell and synaptic function in the context of psychiatric symptoms. This review provides a focused update on such progress in understanding the neurobiology of PD-related non-motor psychiatric and cognitive symptoms.

Aim Andrographolide, the major bioactive compound of the plant Andrographis paniculata, exerts anti-inflammatory, cyto-, neuro- and hepato-protective effects. Traditional remedies for infectious diseases include A. paniculata for maladies like fever, pain, rashes which are associated with chikungunya and other arboviral diseases. Since andrographolide and A. paniculata have potent antiviral properties, the present review aims to provide a comprehensive report of symptoms and immunological molecules involved in chikungunya virus (CHIKV) infection and the therapeutic role of andrographolide in the mitigation of chikungunya and associated symptoms. Materials and methods Studies on the therapeutic role of A. paniculata and andrographolide in chikungunya and other viral infections published between 1991 and 2021 were searched on various databases. Results and discussion The havoc created by chikungunya is due to the associated debilitating symptoms including arthralgia and myalgia which sometimes remains for years. The authors reviewed and summarized the various symptoms and immunological molecules related to CHIKV replication and associated inflammation, oxidative and unfolded protein stress, apoptosis and arthritis. Additionally, the authors suggested andrographolide as a remedy for chikungunya and other arboviral infections by highlighting its role in the regulation of molecules involved in unfolded protein response pathway, immunomodulation, inflammation, virus multiplication, oxidative stress, apoptosis and arthritis. Conclusion The present review demonstrated the major complications associated with chikungunya and the role of andrographolide in alleviating the chikungunya associated symptoms to encourage further investigations using this promising compound towards early development of an anti-CHIKV drug. Chemical Compound studied: andrographolide (PubChem CID: 5318517)

Shigella is the second leading cause of diarrhoeal mortality especially in children5 years of age in African and Asian countries. Rapid changes are occurring in the epidemiology of shigellosis and Shigella are increasingly becoming highly drug resistant. To determine the serogroup distribution and antimicrobial resistance of Shigella isolated at our tertiary care centre in North India.A retrospective study was conducted where demographic details along with antimicrobial susceptibility data of Shigella isolated from stool specimens from 1Shigella species was isolated in 1.31% (n = 137) of a total of 10,456 stool samples. Males predominated (n = 82; 59.8%) and majority of cases were admitted (n = 94; 68.6%). Children ≤5 years of age (n = 47; 34.3%) were the most commonly affected. Adults in the 21-40 age group contributed 27% of cases (n = 37). Overall, Shigella flexneri (n = 87; 63.5%) was the most common serogroup followed by non-agglutinable Shigella (n = 28; 20.4%) while Shigella sonnei (n = 12, 8.8%) and Shigella boydii (n = 9, 6.6%) fluctuated over the years. Shigella dysenteriae reappeared in 2019 after a hiatus of ten years. Overall, 45.3% (n = 62) of isolates were multidrug resistant to CLSI recommended drugs and high resistance was noted for ampicillin/amoxicillin (68.1%), cotrimoxazole (75.8%) ciprofloxacin (61.5%) and ceftriaxone/cefotaxime (45.2%).Shigella have become highly drug resistant to fluoroquinolones and cephalosporins. Community based studies are required to truly assess the burden of AMR in India.

The World Health Organization (WHO) declared COVID-19 as a pandemic worldwide. Containment of this pandemic requires the diagnosis of the disease at an early stage. Extensive accessibility to accurate and rapid testing procedures is the need of the hour to control SARS-CoV-2 virus infection and to check the amount of immunity in the community. As such, scientists, doctors, and individual laboratories and companies around the world have been working tirelessly to develop the critically needed test kits in huge numbers. The ready to use test kits are based on different principles including detection of viral proteins in samples obtained from feces, sputum, nasopharyngeal or oropharyngeal samples, etc., or in blood or serum, by detection of antibodies produced in the human body to fight the infection. The first kind involves molecular assays like polymerase chain reaction-based techniques for the detection of severe acute respiratory syndrome coronavirus viral RNA. The second one involves serological and immunological assays which mostly rely upon antibody detection in an individual produced as a result of exposure to the virus. While the nucleic acid-based viral RNA can detect current infection in a sample, the serological tests can give an estimate of the already infected population. Medical imaging, specially chest computed tomography (CT), is another kind of technique that is becoming a supplement to the reverse transcriptase-polymerase chain reaction, especially when the results by the former technique are not certain or take time to arrive. Apart from being a diagnostic tool, the CT scan can also help in prediction, assessing the disease progression and checking whether the patient is responsive to administered therapy. This chapter will provide a comprehensive overview of the various rapid and accurate diagnosis methods for SARS COVID-19 suggested by WHO for current infection, for example, detection of viral proteins, medical imaging, and previous infection, and detection of antibodies generated during COVID-19 infections and others that are currently being researched.

The technology of automation is playing a very vital role in human’s life. It makes the work trouble-free and effortless. This paper deals with the conception and practice of an automated office system using node MCU along with a mobile application. This system is based on different but crucial functionalities such as raising alarms if noise levels pass the required thresholds, checking the quality of air, watching the heat and wetness of the atmosphere at work, and detection of really bright sources of light like fire which may hinder the progress. To observe the workplace remotely, an android mobile application is developed with the help of sensors that provide real-time information over wireless networks. This application helps in preventing the hazardous event to happen, thereby creating a safer environment for the workforce.

Gliomas are one of the most frequent brain tumors and are classified into high grade and low grade gliomas. The segmentation of various regions such as tumor core, enhancing tumor etc. plays an important role in determining severity and prognosis. Here, we have developed a multi-threshold model based on attention U-Net for identification of various regions of the tumor in magnetic resonance imaging (MRI). We propose a multi-path segmentation and built three separate models for the different regions of interest. The proposed model achieved mean Dice Coefficient of 0.59, 0.72, and 0.61 for enhancing tumor, whole tumor and tumor core respectively on the training dataset. The same model gave mean Dice Coefficient of 0.57, 0.73, and 0.61 on the validation dataset and 0.59, 0.72, and 0.57 on the test dataset .

Since the exfoliation of graphene in the year 2004, a new material class comprising of sheet-like structure have come into existence. They earned their name as two-dimension (2D) materials precisely due to this structure with thickness equal to that of a single atom. The unique properties exhibited by them have garnered the attention of researchers across the world. The tremendous scope for exploitation of these characteristics has enforced rapid advancements in the field of 2D materials. This chapter focuses on the initial developments leading to the discovery of 2D materials. A detailed description providing insights on the nature of 2D materials is broadly discussed. The classification of this new material class is listed. Moreover, the nature of growing interests in this field and the reasons behind this are reported. Therefore, it is essential to understand the challenges and limitations in this field. A section in this chapter focuses on various prospects and challenges faced which provides the researcher an idea before entering into the analytics of 2D materials. Overall the entire chapter gives an overview of 2D materials and it acquaints the readers to this new generation materials.

The society is not safe for women in many aspects. Crime with women are rising with huge pace. Due to increasing crimes, the employed women are feeling unsafe. This project gives a fast responding technique that helps women under any circumstances. If anyone is intending to intimidate, then she can squeeze the button present on the belt and the information regarding the location can be send as an SMS alert to a fixed number with the information of latitude and longitude. We use ATMEGA328P as a controller. It is attached with a GSM modem, a push button, a GPS module, and an LCD display (16 × 2). If switch is squeezed, then micro-controller takes present location co-ordinates by the GPS module and dispatch the information at fixed number with the help of a GSM modem. We are using ‘JAVA’ language for making a communication medium with controller and other components. Safety of women is the main purpose of our project.

Data and information or knowledge have been playing an essential role to understand the human day to day activities. Data mining is the process of discovering knowledge in data from various contexts and summarising useful patterns. Because of certain limitations with traditional ICT infrastructure, businesses are finding cloud computing is the powerful and cost-effective solution. Cloud computing allows the integration of data mining techniques and methods, which deals with the massive amounts of data. Cloud data mining extracts “structured” information from different Web-based data sources. Web data may be semi-structured data or unstructured data. Data mining applications in cloud computing such as classification techniques, clustering techniques, and association rule mining techniques discussed in this work. Security and privacy are one of the major challenging issues in cloud computing. Some data mining techniques such as classification algorithms discussed to classify the DoSs in cloud computing environment.

The treatment of calcified root canals is challenging in endodontic practice. A 63-year-old man was referred to the postgraduate endodontic clinic at the University of Maryland School of Dentistry, Baltimore, MD, for the treatment of tooth #3. Because of the patient's history of head and neck radiation and the high risk of developing osteoradionecrosis, a nonsurgical endodontic approach was found to be the most reasonable treatment option despite the questionable prognosis of the tooth. During the endodontic treatment, the distobuccal canal appeared to be partially calcified and was not possible to be located freehand even with use of the dental operating microscope and cone-beam computed tomographic approximated approach. Therefore, the dynamic navigation system using the X-Guide system (X-Nav technologies, LLC, Lansdale, PA) was used, which allowed for the successful location of the canal. Conventional endodontic treatment was completed following standardized instrumentation, irrigation, and obturation. Details on how to use the dynamic navigation system are described including its advantages, disadvantages, and limitations.

Rheumatoid arthritis (RA) is the most commonly occurring, progressive, autoimmune disease, affecting 1% of the population and the ratio of affected women is three times as compared to men in most developing countries. Clinical manifestations of RA are the presence of anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF) in blood, tendered joints and soreness of the muscles. Some other factors which may lead to chronic inflammation are genetic and environmental factors as well as adaptive immune response. Several conventional drugs are available for the treatment of RA but have their own drawbacks which can be overcome by the use of novel drug delivery systems. The objective of the present review is to focus on the molecular pathogenesis of the disease and its current conventional treatment with special reference to the role of novel drug delivery systems encapsulating anti-rheumatic drugs and herbal drugs in passive and receptor-mediated active targeting against RA. On reviewing the conventional and current therapeutics against RA, we conclude that although the current therapy for the treatment of RA is capable enough, yet more advances in the field of targeted drug delivery will sanguinely result in effective and appropriate treatment of this autoimmune disease.

As the number of core processors continues to increase, the current main-memory database system architecture becomes more challenging. The performance of the system can be improved if transactions are scheduled effectively, such that it can help avoid conflicts. A supervised or unsupervised machine learning model can be used to schedule the transactions that can estimate the probability of conflict. In this paper, the design of several intelligent transaction scheduling algorithms that are effective in improving the performance of the system are reviewed. The need for machine learning (ML) in database management systems (DBMS) and Transaction Processing Systems implementing online transaction processing (OLTP) has been strongly motivated in this paper. To inspire the need for this, the major focus of this paper is on employing artificial intelligence (AI) in systems to enhance their performance and also incorporate adaptive learning methods like intelligent scheduling or smart concurrency control methods to reduce response-time, handle or remove aborts and increase the throughput.

Mobile ad hoc network is a wireless network group of mobile devices having no infrastructure. Load balancing is an important problem in such networks due to dynamic topology of the nodes. Many protocols are developed to improve the bandwidth, energy efficiency and throughput of these networks. With the increasing use of MANETs they are evolving wit use of applications and for non- uniform load distribution it’s difficult to manage the load. Load balancing provides a single internet service from multiple servers as a commonly used application. Multi-casting support at the link layer is essential for the efficient use of network resources. system propose a light weight dynamic channel allocation scheme for MANET. The system compares two algorithms DCA -TRACE and CMH-T RACE to provide support for non-uniform load distributions and propose CDCA-TRACE. It increases the number of source nodes and reduce the number of collisions, energy consumption and average absolute IPDV drastically.

Attendance is very important task for an organization like school, colleges, companies etc. Taking of attendance manually is very time consuming. It takes up to 5 to 20 minutes and it depends upon the number of students in a class. Now a day’s technology become more advance, so we have to use biometric system for attendance because it takes very less time as compared to taking attendance manually. In this project we are going to make an attendance system using face recognition. There are many algorithms by which we can make an attendance system using face recognition. In this project we use Viola-Jones Algorithm and Local Binary Pattern Histogram (LBPH) Algorithm. Viola-Jones algorithm is used for face detection and Local Binary Pattern Histogram is used for samples training and face recognition

BACKGROUND: World health organization (WHO) has defined osteoporosis clinically on the basis of bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) scan and the presence of fractures. This facility is expensive and not readily available in majority of the centers in India. The authors have attempted to study defined measurements on radiographs (radiogrammetric parameters) to diagnose osteoporosis in Indian population. PATIENTS AND METHODS: We prospectively studied 200 proximal humerus radiographs for measuring radiogrammetric parameters and divided into Group A and B (N = 100 in each group). Group A involved patients with age 50 years and sustained acute osteoporotic fractures of distal radius/ anterior wedge vertebral fracture/intertrochanteric fracture following trivial trauma. Three parameters (cortical thickness, cortical index and deltoid tuberosity index) were measured by 3 observers at 2 different occasions. RESULTS: The mean age of patients was 37.87 years and 58.38 years for group A and B, respectively. The ‘cortical thickness’ of the proximal humerus diaphysis had the mean value for Group A and B to be 0.4 ± 0.07 cm and 0.33 ± 0.06 cm respectively. The mean values for the ‘cortical index’ of proximal humerus came out to be 0.4 ± 0.07 for group A and 0.32 ± 0.06 for group B. The ‘deltoid tuberosity index’ measurements showed the mean values for group A and B were 1.81 ± 0.23 and 1.55 ± 0.16, respectively. Inter-observer reliability for single measures was excellent for deltoid tuberosity index (ICC 0.8077) and good for cortical thickness (ICC 0.7032) and cortical index (ICC 0.7357). Observer 1 had excellent intra-observer reliabilities for all the three parameters. Observer 2 and 3 had excellent reliability for deltoid tuberosity index and good intra-observer reliability for cortical thickness and cortical index. The cortical thickness had a cut off of ≤ 0.372 cm with a sensitivity of 86.02 and specificity of 82.12. The cortical index had a cut off of ≤ 0.378 with a sensitivity of 89.16 and specificity of 84.22. The deltoid tuberosity index had a cut off of ≤ 1.684 with a sensitivity of 96.61 and specificity of 84.08. CONCLUSION: The outcome of this study is likely to help in early diagnosis of osteoporosis at the community level in the absence of DXA scan as it identifies threshold values for radiogrammetric parameters which can be a predictor of the osteoporosis. The deltoid tuberosity index was found to be the most suitable of these parameters.