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Abstract Human papillomavirus (HPV) drives cervical cancer (CaCx) pathogenesis and viral oncoproteins jeopardize global gene expression in such cancers. In this study, our aim was to identify differentially expressed coding (DEcGs) and long noncoding RNA genes (DElncGs) specifically sense intronic and Natural Antisense Transcripts as they are located in the genic regions and may have a direct influence on the expression pattern of their neighbouring coding genes. We compared HPV16-positive CaCx patients (N = 44) with HPV-negative normal individuals (N = 34) by employing strand-specific RNA-seq and determined the relationships between DEcGs and DElncGs and their clinical implications. By performing Gene set enrichment and protein–protein interaction (PPI) analyses of DEcGs, we identified enrichment of processes crucial for abortive virus life cycle and cancer progression. The DEcGs formed 16 gene clusters which we identified through Molecular Complex Detection (MCODE) plugin of Cytoscape. All the gene clusters portrayed cancer-related functions. We recorded significantly correlated expression levels of 79 DElncGs with DEcGs at proximal genomic loci based on Pearson’s Correlation coefficients. Of these gene pairs, 24 pairs portrayed significantly altered correlation coefficients among patients, compared to normal individuals. Of these, 6 DEcGs of 6 such gene pairs, belonged to 5 of the identified gene clusters, one of which was survival-associated. Out of the 24 correlated DEcG: DElncG pairs, we identified 3 pairs, where expression of both members was significantly associated with patient overall survival. The findings justify the cooperative roles of these gene pairs, in patient prognostication, thereby bearing immense potential for translation. Thus, elucidation of correlative strengths between paired DElncGs and DEcGs in patient and normal samples, could serve as a foundation for identification of therapeutic and prognostic targets of HPV16-positive CaCx. Graphical abstract

Introduction: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China, the epidemic has rapidly spread all over the world in just a few months. Different steroids have been proven effective in treating COVID-19 pneumonia. However, comparative efficacy data between different steroids have been evaluated in a few studies from various parts of the world. To date, no study with a large number of patients has been conducted in the eastern part of India. Aim: To compare the efficacy of dexamethasone and methylprednisolone in terms of outcomes and disease progression in COVID-19 pneumonia patients. Materials and Methods: This retrospective cohort study included 377 patients with moderate and severe COVID-19 pneumonia admitted to Medical College and Hospital from May 2020 to December 2020, Kolkata, West Bengal, India. Patient records were divided into two groups based on the type of steroids administered (dexamethasone and methylprednisolone). Clinical, laboratory, treatment, and outcome data were tabulated for analysis. Demographic patterns in the two groups were compared, and efficacy was analysed in terms of hospital course (hospital stay length, type of respiratory support received) and final outcome (cured or death) in both groups. The data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 29.0. Qualitative variables were expressed as counts and percentages, while quantitative variables were presented as mean±Standard Deviation (SD). Results: There were no significant differences between the two treatment groups based on demographic features (age, sex), co-morbidities (diabetes, hypertension, etc.), disease severity (hypoxia, hypotension) on admission day, and smoking status. The study showed that methylprednisolone significantly reduced the requirement for high-flow oxygen (p-value=0.002), Non Invasive Ventilation (NIV) (p-value=0.001), and invasive ventilation (p-value=0.001) compared to dexamethasone. However, there was no significant difference (p-value=0.800) in the duration of hospital stay between the methylprednisolone and dexamethasone treatment groups. Kaplan-Meier survival analysis also showed a significant survival benefit among patients who received methylprednisolone compared to dexamethasone (log-rank p-value=0.039). Conclusion: The present study concludes that in COVID-19 pneumonia, the administration of methylprednisolone leads to a significant reduction in mortality and the need for high-flow oxygen, NIV, and invasive ventilation compared to dexamethasone.

Abstract We continue our investigation of the response tensors in planar Hall (or planar thermal Hall) configurations where a three-dimensional Weyl/multi-Weyl semimetal is subjected to the combined influence of an electric field $${\textbf{E}}$$ E (and/or temperature gradient $$\nabla _{{\textbf{r}} } T$$ ∇ r T ) and an effective magnetic field $${\textbf{B}}_\chi$$ B χ , generalizing the considerations of Phys. Rev. B 108 (2023) 155132 and Physica E 159 (2024) 115914. The electromagnetic fields are oriented at a generic angle with respect to each other, thus leading to the possibility of having collinear components, which do not arise in a Hall set-up. The net effective magnetic field $${\textbf{B}}_\chi$$ B χ consists of two parts—(a) an actual/physical magnetic field $${\textbf{B}}$$ B applied externally; and (b) an emergent magnetic field $${\textbf{B}}_5$$ B 5 which quantifies the elastic deformations of the sample. $${\textbf{B}}_5$$ B 5 is an axial pseudomagnetic field because it couples to conjugate nodal points with opposite chiralities with opposite signs. Using a semiclassical Boltzmann formalism, we derive the generic expressions for the response tensors, including the effects of the Berry curvature (BC) and the orbital magnetic moment (OMM), which arise due to a nontrivial topology of the bandstructures. We elucidate the interplay of the BC-only and the OMM-dependent parts in the longitudinal and transverse (or Hall) components of the electric, thermal, and thermoelectric response tensors. Especially, for the co-planar transverse components of the response tensors, the OMM part acts exclusively in opposition (sync) with the BC-only part for the Weyl (multi-Weyl) semimetals.

Abstract A metal-insulator-metal waveguide-based square-ring resonator plasmonic refractive index sensor is designed and optimized for achieving high sensitivity. The sensitivity of the sensor critically depends on the physical dimension and the geometrical parameters of the resonator. Systematic studies on varying geometrical parameters of the resonator reveal that the sensitivity increases with the number of concentric square-rings. Moreover, the full-width-half-maxima of the resonance line is found to increase with the number of square rings. Importantly, variations in the coupling length affect the transmitted intensity as well as the full-width-half-maxima of the resonance spectra in a characteristic fashion. An initial exploration of the optimized sensor for nanoplastic detection for a range of volume fractions 0.15625–0.625% shows a systematic linear increase in the resonance wavelength with changing refractive index of the surrounding medium. This offers the possibility of ultrasensitive detection of extremely small change $$(\sim 0.00025)$$ ( ∼ 0.00025 ) in the local refractive index as the signature of a minute level of plastic contamination. This was achieved by using an optimized sensor design with a sensitivity of 2700 nm/RIU and a full-width-half-maxima of 333 nm. Results presented in the paper demonstrate the considerable promise of the proposed plasmonic refractive index sensor towards nanoplastic detection.

Abstract The possibility of coherent manipulation of optical and thermal energies in noble metal nanostructures has given birth to an enduring research arena coined by thermoplasmonics. Upon interaction with electromagnetic radiation, the energy of the produced hot electrons in metallic nanostructures is converted into heat and is transferred to the medium as a consequence of numerous relaxation processes. Gold nanorods have, often, been adopted as the classical anisotropic nanostructures owing to excellent shape-selective plasmonic tunability in the vis–NIR region. When a pair of metallic nanostructures are sufficiently close to each other to imbue electromagnetic interaction, there occurs evolution of collective plasmon modes, substantial enhancement of near field and strong squeezing of electromagnetic energy at the interparticle spatial region of the dimeric nanostructures. Recent advances in the ‘tips and tricks’ guide to assembling, even, anisotropic nanostructures in colloidal dispersions have offered the opportunity to interplay with the phenomenological plasmonic and thermal characteristics. The photothermal attributes emerging due to electromagnetic coupling of fringing fields have been explored considering parallel and perpendicular configurations of gold nanorod dimers as the prototypical systems from theoretical and experimental perspectives and their biomedical consequences have been realised in a mice model towards the photothermal apoptosis of cancerous cells.

Abstract Huntington’s disease (HD) is a rare neurodegenerative disease caused due to aggregation of Huntingtin (HTT) protein. This study involves the cloning of 40 DnaJ chaperones from Drosophila, and overexpressing them in yeasts and fly models of HD. Accordingly, DnaJ chaperones were catalogued as enhancers or suppressors based on their growth phenotypes and aggregation properties. 2 of the chaperones that came up as targets were CG5001 and P58IPK. Protein aggregation and slow growth phenotype was rescued in yeasts, S2 cells, and Drosophila transgenic lines of HTT103Q with these overexpressed chaperones. Since DnaJ chaperones have protein sequence similarity across species, they can be used as possible tools to combat the effects of neurodegenerative diseases.

Abstract Background Precancerous and malignant tumours arise within the oral cavity from a predisposed “field” of epithelial cells upon exposure to carcinogenic stimulus. This phenomenon is known as “Field Cancerization”. The molecular genomic and transcriptomic alterations that lead to field cancerization and tumour progression is unknown in Indian Oral squamous cell carcinoma (OSCC) patients. Methods We have performed whole exome sequencing, copy-number variation array and whole transcriptome sequencing from five tumours and dysplastic lesions (sampled from distinct anatomical subsites - one each from buccal anterior and posterior alveolus, dorsum of tongue–mucosal melanoma, lip and left buccal mucosa) and blood from a rare OSCC patient with field cancerization. Results A missense CASP8 gene mutation (p.S375F) was observed to be the initiating event in oral tumour field development. APOBEC mutation signatures, arm-level copy number alterations, depletion of CD8 + T cells and activated NK cells and enrichment of pro-inflammatory mast cells were features of early-originating tumours. Pharmacological inhibition of CASP8 protein in a CASP8-wild type OSCC cell line showed enhanced levels of cellular migration and viability. Conclusion CASP8 alterations are the earliest driving events in oral field carcinogenesis, whereas additional somatic mutational, copy number and transcriptomic alterations ultimately lead to OSCC tumour formation and progression.

Background: Osteosarcoma (Os) is the greatest histologic mimicker of all bone tumors. We conducted a retrospective study on its various histopathological patterns, vis-à-vis, clinical and diagnostic features, highlighting its variations. Aims and Objectives: The objective of this study was to study the demographic distribution of Os presenting to our centers and appreciate the histological variations of the disease prevalent in this part of the world as such a study had not been done before. Materials and Methods: Over a period of 25 years, we encountered 100 cases of Os at our institution. The clinical details, investigative findings, gross appearance of tumor tissue obtained, and their hematoxylin and eosin-stained microscopic appearance were studied. Results: The majority were in the 2nd and 3rd decades with a male-to-female ratio of 1.8:1. Long bones were most commonly involved. Microscopically, apart from the conventional type, the histological variants encountered were small cell, soft tissue, malignant fibrous histiocytoma-like, telangiectatic, and juxtacortical including parosteal, periosteal, and dedifferentiated parosteal. Patients were treated with radical amputations, chemo-radiotherapy, and limb salvage surgeries. Conclusion: Being obvious that Os presents with a variety of presentations eluding any prediction regards its biologic behavior, the pathologist should be keen on thorough sampling of tumor tissue and correlate the histologic type with the radiological appearance and clinical presentation.

Introduction: Various types of metaplastic changes, such as gastric metaplasia (foveolar type or antral type) and intestinal metaplasia, are observed in chronic cholecystitis but not in normal mucosa. Helicobacter species can be detected in the bile and gallbladder tissue of patients with benign gallbladder disease. Objective: The present study aimed to observe the correlation between chronic cholecystitis and the presence of Helicobacter pylori as well as the different types of metaplastic changes in gallbladder mucosa. Materials and Methods: This descriptive, observational study was conducted at the Departments of Pathology and Surgery at a tertiary care medical college and hospital from April 2021 to March 2022, using a cross-sectional design. All confirmed cases of chronic cholecystitis, with or without cholelithiasis, were included in the study. Results: Intestinal metaplasia was the most common type of metaplastic change in the gallbladder epithelium in chronic cholecystitis in this region. PAS and Alcian Blue positivity were significantly higher in cases with metaplasia compared to those without metaplasia. H. pylori was detected in 3 cases (1.55%) of chronic cholecystitis in this study population. Conclusion: Mucin histochemistry may help identify early metaplastic changes in gallbladder epithelium. The use of a combination of methods for the detection of H. pylori in gallbladder tissue may increase the detection of positive cases.

Introduction: Severe acute malnutrition (SAM) is a life-threatening condition affecting under-five children. Nutritional rehabilitation centers (NRC) were designed to provide comprehensive clinico-social management of SAM children at an institutional setting. Materials and Methods: The study was based on record analysis of 6 years between 2014 and 2019 after obtaining ethical and administrative approval. The objectives were to compare indices such as admission rate, bed occupancy, and sex-differentials over time as well as among different NRCs. Results: A total of 7316 children were admitted in the 9 NRCs. Quarterly admission ranged between 181 and 389. Gender parity index was higher for girls. Cure rate ranged between 39.8% and 70.9%; subtle modification in diet helped in improving cure rate. Bed-occupancy rate varied from 72.55% to 85.95%. Conclusion: Variability of performance of NRCs could be associated with factors such as available manpower, attitude of providers, and supply of logistics. Regular interaction with community and counseling is necessary to increase admission and hospital stay.

Abstract Water pollution is a major concern for a decaying river. Polluted water reduces ecosystem services and human use of rivers. Therefore, the present study aims to assess the irrigation suitability of the Jalangi River water. A total of 34 pre-selected water samples were gathered from the source to the sink of the Jalangi River with an interval of 10 km and one secondary station’s data from February 2012 to January 2022 were used for this purpose. The Piper diagram exhibits that the Jalangi River water is Na+–HCO3 − types, and the alkaline earth (Ca2+ + Mg2+) outperforms alkalises (Na+ + K+) and weak acids (HCO3 − + CO3 2−) outperform strong acids (Cl− + SO4 2−). SAR values ranging from 0.35 to 0.64 show that water is suitable for irrigation and poses no sodicity risks. The %Na results show that 91.18% of water samples are good and acceptable for irrigation. RSC levels indicate a significant alkalinity hazard, with 94.12% of samples considered inappropriate for irrigation. PI findings show that 91.18% of water samples are suitable for irrigation. Apart from the spatial water samples, seasonal water samples exhibit a wide variations as per the nature of irrigation hazards. Gibbs plot demonstrates that the weathering of rocks determined the hydro-chemical evolution of Jalangi River water. This study identifies very little evaporation dominance for pre- and post-monsoon water. The analysis of variance (ANOVA) test illustrates that there are no spatial variations in water quality while seasonal variations are widely noted (p

Abstract Synthetic textile dye malachite green (MG) and heavy metals present in industrial wastewater are hazardous to the ecosystem. Bioremediation of dyes and heavy metals using dry-biomasses has advantages over chemical methods. This study screened an acclimatized, heavy metal-resistant, and dye-degrading Gram positive Bacillus licheniformis AG3 strain from the textile wastewater near Kolkata, West Bengal. The EDXRF analysis of this colored wastewater effluent showed 36.33 mg/L lead, significantly higher than the WHO recommendation. Previously, Bag et al. showed bioremediation of synthetic dyes using dry-biomass of Bacillus cereus M1 16 from an aqueous solution (Bag et al. Arch Microbiol 203(7):3811–3823, 2021). Here, a consortium of dry-biomasses of B. licheniformis AG3 and B. cereus M1 16 strains (1:1 w/w ratio) was prepared for the simultaneous removal of lead and MG from wastewater. Statistical optimization determines that the pH, initial concentration of contaminants, and dry-biomass concentrations are critical for bioremediation under batch procedures. Further, optimization using the response surface methodology showed that 0.01% consortium dry-biomasses eliminated a maximum of 99.35% MG and 96.01% lead (II) within 6 h. SEM–EDS and FTIR confirmed a strong surface biosorption. Furthermore, a fixed-bed biofilter column of the consortium dry-biomasses was prepared, which was able to remove 98.1% MG and 98.5% lead at the 0.5–1 mL/min flow rate. Together, this study developed a biofilter with a consortium dry biomasses of B. licheniformis AG3 and B. cereus M1 16 for the simultaneous removal of MG and lead from wastewater.

Background: Critically ill patients on Non- invasive Ventilation (NIV) or Continuous Positive Airway Pressure (CPAP) tend to desaturate off ventilatory support. Hence, they are unable to meet their nutritional needs, leading to increase in hospital stay. It was evident during the COVID 19 pandemic. The failure rates of NIV were unusually high, from 30-45%. Despite the overall success of the treatment modality, NIV failure rates still range between 18% and 40% in the acute setting. It was seen that the patients on NIV get only 650 Kcal/ day which is far lower than the required energy requirement. There is a need to have an affordable and sustainable solution to deliver adequate nutrition to critically ill patients on NIV and CPAP, which is able to maintain a NG/ OG tube without frequent disconnections from the ventilator. With this fact in mind a NIV mask with inbuilt feeding port (NIV-IFP) was designed. Aims and Objectives: The aim of this case series was to compare the modified NIV-IFP mask with the conventional mask in terms of both effectiveness of ventilation as well as caloric replacement in critically ill patients. For the purpose of this study, we enlisted three patients who were critically ill and required NIV. Results: With the use of NIV-IFP mask we were able to substitute adequate amount of nutrition (2000Kcal to 2500 Kcal) without any discontinuation of NIV application and with minimal leak in the mask. Conclusion: When compared to other available technologies in this field, the NIV mask with the inbuilt feeding port is very economical and can be a boon in third world countries. The placement of this unique mechanism in the mask was instrumental in weaning off patients from NIV and avoided Invasive ventilation. It was proved beyond doubt that addition of this gland nut assembly was extremely effective in delivering adequate nutrition to our patients without compromising on the ventilation.

Abstract We introduce an enhanced light-harvesting MoS2-based nanocomposite exhibiting improved solar light induced photocurrent generation, both in solution and solid phases. The MoS2-CdS composite was synthesized via easy to achieve, cost effective, two-step solution process for the photocatalytic potassium dichromate [Cr(VI)] reduction and photocurrent generation in thin-film optoelectronic devices. Incorporating 10 wt% MoS2 into the composite increased the degradation efficiency of CdS from 43.9 to 91.9%. Furthermore, the MoS2-CdS composite demonstrated a 2.88-fold increase in the degradation rate constant and a 2.15% enhancement in the apparent quantum yield compared to controlled CdS. Additionally, the electrical power consumption per order decrease in Cr(VI) reduced from 25.74 kWh m−3 for controlled CdS to 9 kWh m−3 aimed at 10 wt% MoS2-CdS composite, indicating optimal synergy between the counterparts of MoS2-CdS in its composite. The resulting thin-film device with 10 wt% MoS2-CdS exhibited robust photocurrent generation and nonlinear I–V characteristics under solar illumination, attributed to the unique electronic properties of the MoS2-CdS heterojunction, influencing carrier transport via band alignment and interface carrier trapping effects. Moreover, photocurrent generation increased linearly with illumination intensity, and dynamic photo response studies revealed rapid photocurrent generation under illumination. Furthermore, the optoelectronic key parameters of CdS, including photosensitivity, photoresponsivity, and detectivity, were enhanced by factors of 5.09, 3.33, and 12.3, respectively, upon composite formation with MoS2. This study offers novel insights into developing high-performance and cost-effective bimetallic sulfide photocatalysts for efficient solar light-induced photocurrent generation in both solution and solid phases.

Abstract The earth is thought to have gone through complex physicochemical changes during the accretion and magma ocean stages. To better understand this evolution process at the fundamental level, we investigate the behavior of a bulk earth melt system by simulating the composition Fe35.7Mg19.0Si15.2O30.2 (in wt%) at high pressure. A deep neural network potential trained by first-principles data can enable accurate molecular dynamics simulation of large supercells that greatly enhances sampling for reliable evaluation of elemental partitioning. Our simulated system undergoes a phase separation in which the four elements clump together to different extents into two major domains. Based on the coordination and space-decomposition analyses, the inferred composition at 3000 K and 29.1 GPa contains 96.2, 0.1, 1.9 and 1.7 wt% of Fe, Mg, Si, and O, respectively, for the one domain and the corresponding elemental proportions are 3.0, 29.7, 22.0, and 45.3 wt% for the other domain. The predicted segregation thus leads to the formation of an iron-rich phase which corresponds to the metallic core and a magma ocean phase which corresponds to the silicate mantle. The metallic domain incorporates more silicon and more oxygen whereas the magma ocean domain gains more iron oxides at higher temperatures. Our predicted compositions compare favorably with those derived from experimental work for the equilibrium state metal and silicate reacting under high-pressure conditions.

Introduction: Pain is the most unpleasant subjective feeling comprising of innumerable emotional and psychological components that require medical advice for relief, regardless of the cause. Transversus Abdominis Plane (TAP) block and Erector Spinae Plane (ESP) block are effectively studied blocks that provide adequate pain control. Aim: To compare postoperative analgesic efficacy in pregnant women undergoing caesarean section under spinal anaesthesia with Ultrasound (USG)-guided TAP block and USG-guided ESP block. Materials and Methods: In this institution-based interventional randomised clinical study, two categories comprising 30 subjects in group I with USG-guided bilateral TAP block and group II with USG-guided bilateral ESP block using Ropivacaine were involved. Visual Analogue Scale (VAS) was used to compare analgesic efficacy. Other parameters for analysis included time of first rescue analgesia, total number of administrations of rescue analgesia within 24 hours, together with Adverse Drug Reactions (ADRs). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21.0. Student’s t-test and Chi-square test were used for data analysis. Results: Subjects in group I had a mean age of 24.9±4.66 years while those in group II were 25.5±3.99 years. The VAS score at 24 hours in group I was 7.22±0.89 and in group II was 6.8±0.83, which was statistically significant with a p-value of 0.0241. USG-guided ESP block was superior to USG-guided TAP block, providing analgesia for 24 hours. Following the first dose, there was a significant delay in rescue analgesia and a reduction in the total administration of rescue analgesia within 24 hours. The first rescue analgesia in group I was at 10.66±2.32 hours and in group II was at 16.66±2.53 hours, with a p-value of 0.0001 indicating a statistically significant difference. No ADRs were reported in either group of participants. Conclusion: ESP block provided a prolonged duration of analgesia, as shown by a decrease in the total VAS score. There was also a significant reduction in the total number of administrations of rescue analgesia within 24 hours when compared to TAP block, suggesting that ESP block provides superior analgesia. Hence, for pain relief in postcaesarean section individuals, ESP block can be regarded as a novel potent option.

Background: Tuberculosis (TB) and malnutrition are epidemiologically interrelated two major public health problems in India. Food security also influences nutritional status. This aspect needs evaluation in diverse geographical areas. This study aimed to assess the level of food security, nutritional status and correlates among adult TB patients in a block of Murshidabad, West Bengal. Methods: This cross-sectional study was undertaken in the Nabagram block of Murshidabad district during April–July 2023. All adult (≥18 years) patients registered under the Tuberculosis Unit of the block during a reference period of 6 months (October 2022–March 2023) were considered study subjects. Eighty such eligible participants recruited randomly were interviewed with a pre-designed schedule for socio-demographic and programmatic characteristics. Household food security was measured using a validated U.S. Household Food Security Survey Module. Anthropometric measurements were taken, and nutritional status was determined based on body mass index. Statistical Package for the Social Sciences (SPSS) version 26 was used for analysis. Results: Among 80 TB patients, 51% were underweight and 20% were severely underweight. The majority (90%) of them had high or marginal food security, and 10% had low or very low food security. On multivariable logistic regression, Hindu religion (adjusted odds ratio (AOR): 6.74, 95% confidence interval (CI): 2.12–29.39), presence of any chronic morbidity (AOR: 11.61, 95%CI: 2.71–49.78) and receipt of dietary counselling by a health worker (AOR: 7.25, 95%CI: 1.22–43.13) appeared as predictors of underweight. Conclusions: Underweight among TB patients is quite prevalent in the area, and few programmatic interventions are influencing factors. This underscores the importance of nutritional counselling services and the universal provision of Poshan benefits.

Background and Aims: Anemia impairs glucose homeostasis, affects glycemic control, and predisposes to complications in diabetics. It correlates with oxidative stress and increases the risk of developing microvascular and macrovascular complications. However, it is an underrecognized comorbidity in diabetics. This study was conducted to assess the prevalence of anemia in diabetic patients and compare the metabolic profiles of anemic and non-anemic diabetics. Methods: This is a cross-sectional study, conducted among type 2 diabetes (T2DM) patients, at the outpatient clinic. Patients with chronic kidney disease (CKD), known hematological disorders, and chronic inflammatory disorders were excluded. Results: Of the 97 patients, 37 (38.14%) were found to be anemic (hemoglobin (Hb): male

Introduction: Population pyramids are significantly impacted by the global phenomena of ageing. It has been reported that depression and cognitive function have an impact on the nutritional status of older adults. Depression is the most common psychiatric problem in old age, and cognitive deterioration is frequently observed in this age group. Objective: This descriptive and comparative study set out to compare the cognitive abilities, nutritional health and depression status of older adults who lived in community settings and in assisted living facilities. Materials and Methods: A total of 250 older women (125 from institutionalised old age home and 125 from community) participated in a cross-sectional study (residing at Rajarhat, Newtown area). The lengthy version of the Mini Nutritional Assessment tool (MNA®) was used to evaluate the participants’ nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination (MMSE), cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal–Wallis test, and Spearman’s rho correlation coefficient were computed. Results: In the present study, it was observed that only 30.4% of the respondents who are community-dwelling elderly had normal MNA score, whereas 69.6% were at risk of malnutrition or already malnourished. Considering institutionalised elderly it was observed that only 7.2% were normal and 92.8% were malnourished/at risk of malnutrition. Statistically significant association was observed between nutritional status and mental health status (P = 0.00) as well as cognitive function (P = 0.00) among old age home residing elderly. Among the community-dwelling elderly mental health status has significant association with their nutritional status (P = 0.00) and cognitive function (P = 0.00) as well. Conclusions: Community-dwelling elderly were relatively healthy compared to old age home residents. Maintaining the nutritional, cognitive, and mental health of institutionalised and community-dwelling elderly women requires the implementation of physical and cognitive stimulation activities as well as interventions targeted at improving a healthy diet.

Abstract A magnetic perovskite-spinel oxide nanocomposite synthesized through a sol–gel self-combustion process is used for the first time as an adsorbent to remove toxic heavy metals (i.e., Pb2+). The synthesized LaFeO3:CoFe2O4 ((LFO)1:(CFO)x) (x = 0.11–0.87) nanocomposites possess good stability, abundant oxygenated active binding sites, and unique structural features, making them suitable for removing divalent Pb2+ ions. Scanning electron microscopy, X-ray diffraction, BET surface area, magnetization measurements, zeta-potential analyses, and X-ray photoelectron spectroscopy were used to analyze the nanocomposites, and their structural changes after Pb2+ ions adsorption. Batch tests confirmed that (LFO)1:(CFO)x efficiently removes Pb2+ from water with a maximum adsorption capacity of 105.96 mg/g. The detailed quantitative study indicates that the interaction of hydroxyl groups with Pb2+ ions occurs through electrostatic interactions and complex formation. We also demonstrate a new ring-magnetic separator system that allows magnetic separation of the toxic ions at a higher speed compared to traditional block magnets. The unique structure, high porosity, large specific surface area, and oxygenated functional groups of (LFO)1:(CFO)x nanocomposites make them promising materials for removal of heavy metal ions and possibly other environmental pollutants. This study provides a new approach to preparing nanocomposites of magnetic spinel ferrites with perovskite oxides for environmental applications.

Abstract Vitamin D modulates innate and adaptive immunity, the molecular mechanisms of which we aim to understand under human in vivo conditions. Therefore, we designed the study VitDHiD (NCT03537027) as a human investigation, in which 25 healthy individuals were supplemented with a single vitamin D3 bolus (80,000 IU). Transcriptome-wide differential gene expression analysis of peripheral blood mononuclear cells (PBMCs), which were isolated directly before and 24 h after supplementation, identified 452 genes significantly (FDR

Abstract The present study was aimed at showing the importance of HPV DNA status and the clinical history of the patients required by the cytologist for accurate reporting. A total of 1250 symptomatic women who attended the gynaecology outpatient department of the Mahavir Cancer Sansthan and Nalanda Medical College, Patna, for pap smear examinations were screened and recruited for the study. Due to highly clinical symptoms out of the negative with inflammatory smears reported, one hundred and ten patients were randomly advised for biopsy and HPV 16/18 DNA analysis by a gynaecologist to correlate negative smears included in the study. Pap smear reports revealed that 1178 (94.24%) were negative for intraepithelial lesions (NILM) with inflammatory smears, 23 (1.84%) smears showed low-grade squamous intraepithelial lesions (LSIL), 12 (0.96%) smears showed high-grade squamous intraepithelial lesions, and 37 (2.96%) smears showed an atypical squamous cell of undetermined significance (ASC-US). A biopsy of 110 out of 1178 (NILM) patients revealed that 15 (13.63%) women had cervical cancer, 29 women had CIN I, 17 women had CIN II + CIN III, 35 women had benign cervical changes, and 14 women had haemorrhages. On the other hand, HPV 16/18 DNA was detected as positive in 87 out of 110. The high positivity of HPV in biopsied cases where frank cervical cancer and at-risk cancer were also observed in the negative smear-screened patients reveals that the HPV status and clinical history of the patients will be quite helpful to the cytologist for accurate reporting, and suggests that a negative HPV DNA result may be a stronger predictor of cervical cancer risk than a negative Pap test.

Abstract In a prospective cohort of subjects who subsequently developed preeclampsia (PE, n = 14) versus remaining healthy (NORM, n = 12), early gestation circulating extracellular vesicles (EVs) containing a panel of microRNA signatures were characterized and their biological networks of targets deciphered. Multiple microRNAs of which some arose from the placenta (19MC and 14MC) demonstrated changes in association with advancing gestation, while others expressed were pathognomonic of the subsequent development of characteristic clinical features of PE which set in as a late-onset subtype. This panel of miRNAs demonstrated a predictability with an area under the curve of 0.96 using leave-one-out cross-validation training in a logistic regression model with elastic-net regularization and precautions against overfitting. In addition, this panel of miRNAs, some of which were previously detected in either placental tissue or as maternal cell-free non-coding transcripts, lent further validation to our EV studies and the observed association with PE. Further, the identified biological networks of targets of these detected miRNAs revealed biological functions related to vascular remodeling, cellular proliferation, growth, VEGF, EGF and the PIP3/Akt signaling pathways, all mediating key cellular functions. We conclude that we have demonstrated a proof-of-principle by detecting a panel of EV packaged miRNAs in the maternal circulation early in gestation with possibilities of biological function in the placenta and other maternal tissues, along with the probability of predicting the subsequent clinical appearance of PE, particularly the late-onset subtype.

Abstract Type-2 diabetes (T2D) is a rapidly growing multifactorial metabolic disorder that induces the onset of various diseases in the human body. The compositional and metabolic shift of the gut microbiota is a crucial factor behind T2D. Hence, gaining insight into the metabolic profile of the gut microbiota is essential for revealing their role in regulating the metabolism of T2D patients. Here, we have focused on the genome-scale community metabolic model reconstruction of crucial T2D-associated gut microbes. The model-based analysis of biochemical flux in T2D and healthy gut conditions showed distinct biochemical signatures and diverse metabolic interactions in the microbial community. The metabolic interactions encompass cross-feeding of short-chain fatty acids, amino acids, and vitamins among individual microbes within the community. In T2D conditions, a reduction in the metabolic flux of acetate, butyrate, vitamin B5, and bicarbonate was observed in the microbial community model, which can impact carbohydrate metabolism. The decline in butyrate levels is correlated with both insulin resistance and diminished glucose metabolism in T2D patients. Compared to the healthy gut, an overall reduction in glucose consumption and SCFA production flux was estimated in the T2D gut environment. Moreover, the decreased consumption profiles of branch chain amino acids (BCAAs) and aromatic amino acids (AAAs) in the T2D gut microbiota can be a distinct biomarker for T2D. Hence, the flux-level analysis of the microbial community model can provide insights into the metabolic reprogramming in diabetic gut microbiomes, which may be helpful in personalized therapeutics and diet design against T2D.

Abstract Manufacturing regenerative medicine requires continuous monitoring of pluripotent cell culture and quality assessment while eliminating cell destruction and contaminants. In this study, we employed a novel method to monitor the pluripotency of stem cells through image analysis, avoiding the traditionally used invasive procedures. This approach employs machine learning algorithms to analyze stem cell images to predict the expression of pluripotency markers, such as OCT4 and NANOG, without physically interacting with or harming cells. We cultured induced pluripotent stem cells under various conditions to induce different pluripotent states and imaged the cells using bright-field microscopy. Pluripotency states of induced pluripotent stem cells were assessed using invasive methods, including qPCR, immunostaining, flow cytometry, and RNA sequencing. Unsupervised and semi-supervised learning models were applied to evaluate the results and accurately predict the pluripotency of the cells using only image analysis. Our approach directly links images to invasive assessment results, making the analysis of cell labeling and annotation of cells in images by experts dispensable. This core achievement not only contributes for safer and more reliable stem cell research but also opens new avenues for real-time monitoring and quality control in regenerative medicine manufacturing. Our research fills an important gap in the field by providing a viable, noninvasive alternative to traditional invasive methods for assessing pluripotency. This innovation is expected to make a significant contribution to improving regenerative medicine manufacturing because it will enable a more detailed and feasible understanding of cellular status during the manufacturing process.

Abstract Cd(II) is a potentially toxic heavy metal having carcinogenic activity. It is becoming widespread in the soil and groundwater by various natural and anthropological activities. This is inviting its immediate removal. The present study is aimed at developing a Cd(II) resistant strain isolated from contaminated water body and testing its potency in biological remediation of Cd(II) from aqueous environment. The developed resistant strain was characterized by SEM, FESEM, TEM, EDAX, FT-IR, Raman Spectral, XRD and XPS analysis. The results depict considerable morphological changes had taken place on the cell surface and interaction of Cd(II) with the surface exposed functional groups along with intracellular accumulation. Molecular contribution of critical cell wall component has been evaluated. The developed resistant strain had undergone Cd(II) biosorption study by employing adsorption isotherms and kinetic modeling. Langmuir model best fitted the Cd(II) biosorption data compared to the Freundlich one. Cd(II) biosorption by the strain followed a pseudo second order kinetics. The physical parameters affecting biosorption were also optimized by employing response surface methodology using central composite design. The results depict remarkable removal capacity 75.682 ± 0.002% of Cd(II) by the developed resistant strain from contaminated aqueous medium using 500 ppm of Cd(II). Quantitatively, biosorption for Cd(II) by the newly developed resistant strain has been increased significantly (p

Background: Urolithiasis is a common condition in daily urological practice. Medical Expulsive Therapy (MET) is non-invasive approach for removal of ureteric stone. In MET, alpha-blocker Tamsulosin is commonly used in treating urolithiasis but it does not address the pathology of inflammation presents in such condition. With addition of low dose Deflazacort as anti-inflammatory agent, there may have a potential to improve the pathology and outcome of the treatment. Aims and Objectives: This study aims to find the efficacy of low-dose deflazacort combined with tamsulosin in the MET for distal ureterolithiasis. Materials and Methods: This prospective randomized controlled trial was conducted from December 2022 to December 2023 in Rampurhat Government Medical College and Hospital. A total of 130 patients with ureteric stone ≤10 mm were randomized into two groups. Tamsulosin group received tamsulosin (0.4 mg once daily for 28 days). Deflazacort group received tamsulosin (0.4 mg once daily for 28 days) with deflazacort (12 mg once daily for 10 days). All subjects were reviewed on 14 days and 28 days. Stone expulsion rate, time to stone expulsion, analgesic use, number of colic episodes, and hospitalization were recorded. Adverse effects of drugs were noted. Results: Among 130 patients randomized, 4 patients were lost to follow-up and 8 patients required early intervention. Deflazacort group had similar rate of stone expulsion (88% vs. 80%, P=0.548). There were significantly shorter expulsion time (10.15 days vs. 14.28 days, P

Living with a chronic condition like psoriasis can significantly affect the individual involved. Psoriasis patients have difficulties with their physical, psychological, occupational, and social functioning. These impairments can result in psychiatric morbidity depression and anxiety disorders. This systematic review (SR) assessed the impact of psychological factors in life of psoriasis patients. The literature search comprised Medline through PubMed, Web of Science, the Cochrane Library, Wiley Online Library, and additional sources such as Google Scholar, spanning the period from 2014 to 2023. Thorough examination of the most important electronic databases was conducted. Various study designs, including observational studies, trials, and commentaries, were incorporated to ensure a comprehensive examination of the research topic. The risk of bias was evaluated using established methodology. This SR comprised 13 studies, with the Cochrane Risk of Bias Tool employed to assess biases in randomized trials across five domains. The majority of the studies demonstrated a low risk (57.69%), indicating their reliability while those categorized as unclear (37.17%) exhibited some ambiguity without compromising the validity of results. Studies categorized as high risk (5.12%) suggested significant bias and potential errors. The findings indicate an association between psoriasis and various psychological factors, including depression, anxiety, suicidal ideation, impaired emotional functioning, negative body image, and self-perception. The significant impact of depression and anxiety on individuals with psoriasis underscores the need for greater awareness of its psychological aspects. Incorporating psychological interventions into care and management strategies is crucial for addressing this chronic condition and enhancing overall well-being, thus improving quality of life.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure and, hence, is distressing for awake patients, requiring an adequate level of anesthesia. Recent advancements have encouraged the use of monitored anesthesia care, that allows the patient to tolerate unpleasant experiences during procedures while maintaining cardio-respiratory function. Usually, propofol-based anesthesia is given in ERCP. The main aim of this study is to compare the effect of propofol alone and propofol with ketamine and dexmedetomidine on the hemodynamics during ERCP, recovery profile, and side effects (if any). Aims and Objectives: (1) To compare efficacy in terms of hemodynamic stability and desaturation events. (2) Recovery and quality of recovery. (3) Pain score. (4) Incidence of post-operative nausea and vomiting. Materials and Methods: This is a comparative double-blinded study. Adult patients from the age group of 18–70 years belonging to the American Society of Anesthesiologists (ASA-I) and ASA-II who had undergone ERCP under total intravenous anesthesia were taken and randomly assigned to either of the two groups. Both groups received 0.01 mg/kg glycopyrrolate, 0.1 mg/kg ondansetron, 0.05 mg/kg midazolam, 50 mcg fentanyl, and 40 mg hyoscine. Group A patients received 30 mg propofol as a bolus dose and then repeated according to requirements. Group B patients received 0.5 mcg/kg dexmedetomidine as a loading dose and 0.3 mcg/kg/h as a maintenance infusion dose. 30 mg propofol was given before negotiating scope and then 1 mL (1:1) mixture of propofol and ketamine was repeated according to requirements. Total propofol consumption, hemodynamics, quality of recovery, and side effects (if any) were recorded at regular intervals. Results: The study showed significant cases in Group A had episodes of hypotension and apneic events, whereas there were very few hemodynamic instability and almost no apneic events in Group B patients. The requirement of propofol was much higher in Group A patients. Conclusion: Dexmedetomidine when used along with propofol and ketamine in ERCP patients reduced the dose requirement of propofol and maintained hemodynamic stability without causing any apneic events.

BackgroundAdolescent and adult obesity continues to be a public health epidemic in the United States. Despite the popularity of mHealth apps with gamification among adolescents, there are insufficient studies to evaluate the efficacy of gamified mHealth apps and financial incentives to motivate sustained health behavior change in adolescents or their adult caregivers. ObjectiveThis study aims to evaluate the effectiveness of gamification techniques and financial incentives used in the novel “CommitFit” mHealth app to motivate health behavior change and improve various mental and physical health metrics in adolescents and their caregivers. MethodsThis study is a 3-month randomized controlled trial (RCT) with 30 adolescents (aged 13-15 years) and their adult caregivers (N=60). It evaluates “CommitFit,” which uses gamification including points and leaderboards to motivate logging and achievement of self-selected health behavior goals (eg, more water, sleep, physical activity, fruits, or vegetables or fewer sugary beverages). The RCT had three arms, each with 10 dyads: (1) CommitFit-only users; (2) CommitFit$, where adolescents were paid US $0.05 for each point they earned; and (3) waitlist control. Intervention dyads used the app for 3 months and had the option to use it for the fourth month without prompts or extra financial incentives. User analytic software was used to evaluate the frequency of user logs and goal achievement. Monthly surveys evaluated self-reported change in the 5 CommitFit health behaviors. Changes in BMI and blood pressure were evaluated for all participants at 3 clinical visits. Mental health, gamification, and behavior economics surveys were completed during the clinical visits. ResultsRecruitment began in August 2023 and was completed in 10 weeks. The research team successfully recruited and enrolled 30 dyads. Researchers emailed and called 89 caregivers on a physician-approved adolescent patient list, a 33% recruitment rate. Data collection and analysis will be conducted in the spring and summer of 2024. The results of this study are anticipated to be published between late 2024 and early 2025. ConclusionsThis RCT will expand knowledge of the effectiveness of gamification techniques, financial incentives, and mHealth apps to motivate sustained health behavior change among adolescents and caregivers. These results may offer new opportunities to caregivers, health insurers, health care systems, and clinicians to motivate health behavior change in adolescents and caregivers, with the ultimate goal of preventing or reducing obesity and obesity-related diseases. Additional gamification, mental health surveys, and app user analytics included in the study may provide further insight into the characteristics of adolescents or caregivers who would benefit the most from using a gamified mHealth app like CommitFit. International Registered Report Identifier (IRRID)DERR1-10.2196/63505

One of the most fulminant and quickly spreading types of fungal infection, mucormycosis typically starts in the nose and paranasal sinuses after inhaling spores. Orbital and intracranial structures may become infected either directly or through blood vessels, leading to life-threatening complications. This infection most commonly manifests in the rhinomaxillary area, particularly in individuals with immunocompromised conditions like diabetes. Even with appropriate treatment, the disease’s mortality rate can exceed 40%, and it is challenging to detect. The standard treatment plan involves surgical debridement combined with systemically active antifungal medications, depending on the site of infection and risk factors. As a first-line treatment, lipid-based amphotericin B is recommended; however, posaconazole also shows promise. Hereby, the authors present a case report of a 15-year-old male patient with juvenile diabetes mellitus who had been experiencing pain and diffuse swelling in his left malar area for the previous two months. Following a histological analysis and clinical and radiographic evaluation by a multidisciplinary team, the patient was diagnosed with maxillary mucormycosis. Because of the abundant blood supply in the maxillofacial regions; however, more virulent fungi like Mucor can get past this obstacle. The purpose of present article is to show how early detection and treatment of mucormycosis in a young patient could prevent major morbidity and mortality from this potentially fatal illness . Additionally, it aimed to contribute to the local epidemiology of mucormycosis and raise awareness among stakeholders attention to the difficulties in treating this serious condition.

An epididymal cyst (EC) is a benign lesion. It arises due to cystic degeneration of the epididymis. The torsion of it is extremely rare. The usual presentation of the cyst is asymptomatic scrotal swelling. The swelling has a lobulated surface and feels like a bunch of grapes. The huge EC is rare and moreover, it is associated with torsion-rarest presentation.

Giant Hydronephrosis (GH) is rare due to improved diagnostic modalities and the ready availability of abdominal imaging. Pelviureteric junction obstruction is the most common aetiology of GH, with abdominal mass or distension being the most common presentation. If GH is not detected early, it can lead to various complications. Authors report three cases of GH in adults who presented to the emergency department with complications. One patient had abdominal distension, while the other two presented with painful abdominal swelling and fever. Two of them were admitted with sepsis, and one had haematuria. Percutaneous Nephrostomy (PCN) catheters were placed in all three cases to decompress the calyceal system, and subsequently, nephrectomy was performed on all of them as the kidneys were not salvageable.

Background: Pelvic floor disorders are often complex due to symptoms ranging from vague low back pain to major faecal incontinence and urinary incontinence. It is important to perform a dynamic study because certain abnormalities can be identified only during the straining or defaecation phase; for example, rectal prolapse or intussusception. Methods: This observational and descriptive study conducted over 18 months had included 50 patients (34 females). Cystocele was graded as mild, moderate and severe based on descent of urinary bladder below the pubococcygeal line (PCL). All of them underwent dynamic magnetic resonance imaging (MRI) of the pelvic floor. Uterine and vaginal vault prolapse was graded as mild, moderate and severe based on uterus, cervix and vaginal vault prolapse below the PCL line. Results: Their mean age was 52.4 (range 11-86) years. Cystocele was present in 59% of females and 19% of males. Urethral hypermobility seen in 6% females and 9% males. Conclusions: Dynamic MRI can be used as an important investigation before surgery to plan an appropriate surgical procedure based on grading of the pelvic organ prolapsed and involved compartment.

Abstract Adam’s Bridge is a submerged ridge connecting India and Sri Lanka, generally regarded as a chain of shoals extending for ~ 29 km from Dhanushkodi on the Indian side to Talaimannar Island of Sri Lanka. A high-resolution digital bathymetric elevation model generated using the seafloor returned photons of ICESat-2 was used to understand the intricate details of Adam’s Bridge structure. Photons emanating from ICESat-2’s green laser have the potential to detect the seafloor up to a depth of ~ 40 m; taking a cue from this potentiality, in our research, we have accrued ~ 0.2 million photons representing the depth information and generated a 10 m resolution bathymetric data for the extent of Adam’s Bridge. Visual interpretations made from this bathymetric data through 3D perspectives with multi-directional lighting effects, and also with the derived parameters like contours, slope, and volumetric analysis, enabled us to recognize the current form of Adam’s Bridge’s physical features. The results from our research confirm that, in its entirety, Adam’s Bridge is a submarine continuation of Dhanushkodi and Talaimannar Island. Throughout the crest line of Adam’s Bridge, approximately 1.5 km on either side is highly undulating within the super-shallow water with occurrences of sudden depths. There is an asymmetry of transverse slopes to the base on both sides of Adam’s Bridge, indicating dominant transgression of material energy from the waters of the Gulf of Mannar compared to the Palk Strait. The volume of Adam’s Bridge computed in our research yielded a value of ~ 1 km3; interestingly, only 0.02 percent of this volume is above the mean sea level, and in general, the same is visible in optical satellite imagery—in total ~ 99.98 percent of the Adam’s Bridge is submerged in shallow and super-shallow waters.

Abstract Background Sebelipase alfa (Kanuma®) is approved for patients with Wolman disease (WD) at a dosage of 3–5 mg/kg once weekly. Survival rates in the second of two clinical trials was greater, despite recruiting more severely ill patients, probably related to higher initial and maximal doses. We aimed to evaluate the effective pharmacokinetics and pharmacodynamics of Sebelipase alfa when administered to patients with severe WD at 5 mg/kg twice weekly, an intensive regimen which was not assessed in the trials. Methods We recruited 3 patients receiving Sebelipase alfa 5 mg/kg twice weekly. We measured LAL activity in leukocytes and plasma oxysterol concentration in two patients and LAL activity in fibroblasts in one patient. Clinical follow up was also assessed. Results Analyses of LAL activity and oxysterols demonstrate that there is short-lived enzyme activity post-dosing which is associated with the release of stored lipids. Clinical data demonstrate that 5 mg/kg twice weekly dosing is well tolerated and effective. Conclusion 5 mg/kg twice weekly dosing with Sebelipase alfa rescues severely ill infants with WD by increasing substrate clearance. There is biologically relevant lipid accumulation in the ‘trough’ periods before the next dosing, even with this intensive regimen.

Objective: Bullous pemphigoid is a rare autoimmune skin disorder characterized by blistering, urticarial lesions, which are sometimes associated with adverse drug reactions. Vildagliptin is an oral anti-diabetic agent that selectively inhibits the dipeptidyl peptidase-4 (DPP-4) enzyme. Materials and Methods: A 75-year-old female with a known case of type 2 Diabetes Mellitus, hypertension, and hypothyroidism for the last 10 years presented with pruriginous tense bullous skin lesions over her both palms and soles. There was no mucosal involvement. Further interrogation revealed that she started taking Vildagliptin 5 days ago which was prescribed due to high levels of post-prandial blood sugar level despite already intake of Glimepiride-4 mg and Metformin-3 gm. Results: Vildagliptin was immediately advised to be stopped. She was treated with antihistamines, steroids, and conservative management which led to remission of the blisters. Conclusion: Vildagliptin is the probable causative drug for developing bullous pemphigoid skin lesion which shows temporal association in this case as other concomitant drugs has no direct correlation. Therefore physicians must be aware of this rare life-threatening side effect of this medicine and advice patients to visit the hospital even the slightest cutaneous manifestation. Bullous pemphigoid can result in fatal life-threatening conditions if not treated early.

Introduction: During the 2 years and 9 months from March 2020 to December 2022, the SARS-CoV-2 virus raged across the country. Cases occurred in three particular time clusters recognised by World Health Organisation as coronavirus disease 2019 (COVID-19) waves. In this study, we compare the clinical parameters of adult non-obstetric COVID-19 patients admitted to our rural tertiary care hospital during the three distinct waves of the pandemic. Materials and Methods: Retrospective chart analysis of 272, 853 and 97 patients admitted with SARS-CoV-2 infection to the only rural medical tertiary care centre in the Sunderbans of West Bengal in the first, second and third waves, respectively, was done after obtaining ethical and scientific clearance. Clinical [vital parameters, oxygen requirement, mental status, risk factor assessment, duration of hospital stay, modified-emergency warning score (m-EWS), quick Sequential Organ Failure Assessment (qSOFA), confusion, uraemia, respiratory rate, blood pressure, age ≥ 65 years (CURB65)], epidemiological variables (age, gender, and vaccination status), laboratory parameters and in-hospital outcome were recorded and analysed statistically. Results: Statistically significant (P < 0.05) m-EWS and qSOFA scores were recorded during the second wave of the pandemic. The second wave also recorded the highest mortality (14.89%) compared to the first (12.87%) and third (11.96%) waves, though this was not statistically significant. The highest duration of hospital stay was recorded in the first wave of the pandemic (mean = 9.99 days, P < 0.01). The difference in mortality rates between patients with and without co-morbidity (P < 0.05) was observed during Wave-1, across any pandemic wave, and overall but not in Wave-2 and Wave-3. Conclusion: The second wave of the COVID-19 pandemic was the most severe in comparison with the other two waves, while the outcome was poorer in those with co-morbidities, especially in the first wave.

Abstract Tumor-derived extracellular vesicles (EVs) show great potential as biomarkers for several diseases, including pancreatic cancer, due to their roles in cancer development and progression. However, the challenge of utilizing EVs as biomarkers lies in their inherent heterogeneity in terms of size and concentration, making accurate quantification difficult, which is highly dependent on the isolation and quantification methods used. In our study, we compared three EV isolation techniques and two EV quantification methods. We observed variations in EV concentration, with approximately 1.5-fold differences depending on the quantification method used. Interestingly, all EV isolation techniques consistently yielded similar EV quantities, overall size distribution, and modal sizes. In contrast, we found a notable increase in total EV amounts in samples from pancreatic cancer cell lines, mouse models, and patient plasma, compared to non-cancerous conditions. Moreover, individual tumor-derived EVs exhibited at least a 3-fold increase in several EV biomarkers. Our data, obtained from EVs isolated using various techniques and quantified through different methods, as well as originating from various pancreatic cancer models, suggests that EV profiling holds promise for the identification of unique and cancer-specific biomarkers in pancreatic cancer.

Introduction: While placing the Proseal-laryngeal Mask Airway (PLMA) using the digital technique, there may be failed insertion or inadequate ventilation. Therefore, a placement technique using the Gum Elastic Bougie (GEB)-aided placement was employed. Aim: To compare the clinical efficacy of Proseal Laryngeal Mask Airway (PLMA) insertion by two different techniques viz. Digital and Gum elastic bougie-aided, in mastoid surgery in adult patients done under General Anaesthesia. Materials and Methods: In this randomised clinical study conducted at the Department of Anaesthesiology, R.G. Kar Medical College, Kolkata, West Bengal, India from November 2016 to December 2022. A total of 88 patients of American Society of Anaesthesiologists (ASA) class I and II of either sex undergoing mastoid surgery using the PLMA as an airway management device were allocated to Digital (Group D) and gum elastic Bougie (Group B) techniques. Parameters studied included the percentage of successful insertion of PLMA on the first attempt, number of attempts required and time taken for successful insertion of PLMA and postoperative complications if any. The t-test was used to compare the groups regarding PLMA insertion time, while categorical data such as airway trauma was compared using Chi-square test or Fischer’s-exact test (whichever applicable). Results: In the present study 88 patients were included, with 44 patients in each of the two groups. The difference in Mallampati scoring of both groups was statistically insignificant. In the present study 68.18% patients in Gum elastic bougie group and 70.45% patients in Digital group were of ASA Grade I, showing no statistical significance between these two groups regarding ASA status. In Group B (GEB), PLMA was successfully inserted in 95.45% of cases on the first attempt, and in group D (digital) the corresponding figure was 77.27% and 22.72% of cases required a 2nd attempt, this difference was statistically significant (p-value

Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young population has begun to rise. There is not enough data regarding the characteristics of young patients with ACS. Aim: To evaluate risk factors, clinical and angiographic profile of young patients with ACS. Materials and Methods: A prospective observational study was conducted from December 2017 to December 2020 at SSWH, Burdwan Medical College and Hospital, Burdwan, West Bengal, Kolkata, India among 100 patients. Patients with ACS and aged ≤45 years were enrolled in the study. Patients were divided into two groups: patients with and without obstructive Coronary Artery Disease (CAD). Clinical parameters and coronary angiography data were collected and analysed. The p-value

Abstract After obtaining an exact regular-AdS black hole resulting from the coupling of general relativity with nonlinear electrodynamics (NED), we explore the thermodynamics of the extended phase space, treating the cosmological constant ( $$\Lambda$$ Λ ) as the pressure (P) of the black holes and its conjugate as thermodynamic volume (V). Considering the NED parameter (g), we investigate the Hawking temperature, entropy, Gibb’s free energy and specific heat at the horizon radius. Due to the presence of NED charge, the black hole exhibits van der Waals-like phase transition instead of Hawking-Page phase transition, which could be observed through the $$G-T$$ G - T plots, which display a swallowtail pattern below the critical pressure, and it gives rise to second-order phase transitions when pressure attains its critical value. The first-order phase transition shares similarities with the liquid-gas phase transition. We determine the exact critical points and explore the influence of NED on $$P-V$$ P - V criticality, revealing that the isotherms undergo a liquid-gas-like phase transition for temperatures below its critical value $$T_C$$ T C , especially at lower $$T_C$$ T C . The identical critical exponent to that of the van der Waals fluid suggests that the NED does not alter the critical exponents, as observed in other arbitrary AdS black holes.

Abstract This study introduces a novel Hybrid Ensemble Machine-Learning (HEML) algorithm to merge long-term satellite-based reanalysis precipitation products (SRPPs), enabling the estimation of super drought events in the Lake Victoria Basin (LVB) during the period of 1984 to 2019. This study considers three widely used Machine learning (ML) models, including RF (Random Forest), GBM (Gradient Boosting Machine), and KNN (k-nearest Neighbors), for the emerging HEML approach. The three SRPPs, including CHIRPS (Climate Hazards Group Infra-Red Precipitation with Station), ERA5-Land, and PERSIANN-CDR (Precipitation Estimation from Remotely Sensed Information using Artificial Neural Network-Climate Data Record), were used to merge for developing new precipitation estimates from HEML model. Additionally, classification and regression models were employed as base learners in developing this algorithm. The newly developed HEML datasets were compared with other ML and SRPP products for super-drought monitoring. The Standardized precipitation evapotranspiration index (SPEI) was used to estimate super drought characteristics, including Drought frequency (DF), Drought Duration (DD), and Drought Intensity (DI) from machine learning and SRPPs products in LVB and compared with RG observation. The results revealed that the HEML algorithm shows excellent performance (CC = 0.93) compared to the single ML merging method and SRPPs against observation. Furthermore, the HEML merging product adeptly captures the spatiotemporal patterns of super drought characteristics during both training (1984–2009) and testing (2010–2019) periods. This research offers crucial insights for near-real-time drought monitoring, water resource management, and informed policy decisions.

Abstract To date, degraded mangrove ecosystem restoration accomplished worldwide primarily aligns towards rehabilitation with monotypic plantations, while ecological restoration principles are rarely followed in these interventions. However, researchers admit that most of these initiatives' success rate is not appreciable often. An integrative framework of ecological restoration for degraded mangroves where site-specific observations could be scientifically rationalized, with co-located reference pristine mangroves as the target ecosystem to achieve is currently distinctively lacking. Through this experimental scale study, we studied the suitability of site-specific strategies to ecologically restore degraded mangrove patches vis-à-vis the conventional mono-species plantations in a highly vulnerable mangrove ecosystem in Indian Sundarbans. This comprehensive restoration framework was trialed in small discrete degraded mangrove patches spanning ~ 65 ha. Site-specific key restoration components applied are statistically validated through RDA analyses and Bayesian t-tests. 25 quantifiable metrics evaluate the restoration success of a ~ 3 ha degraded mangrove patch with Ridgeline distribution, Kolmogorov–Smirnov (K-S) tests, and Mahalanobis Distance (D2) measure to prove the site’s near-equivalence to pristine reference in multiple ecosystem attributes. This restoration intervention irrevocably establishes the greater potential of this framework in the recovery of ecosystem functions and self-sustenance compared to that of predominant monoculture practices for vulnerable mangroves.

Abstract Background Liver transplantation (LT) is offered as a cure for Hepatocellular carcinoma (HCC), however 15–20% develop recurrence post-transplant which tends to be aggressive. In this study, we examined the transcriptome profiles of patients with recurrent HCC to identify differentially expressed genes (DEGs), the involved pathways, biological functions, and potential gene signatures of recurrent HCC post-transplant using deep machine learning (ML) methodology. Materials and methods We analyzed the transcriptomic profiles of primary and recurrent tumor samples from 7 pairs of patients who underwent LT. Following differential gene expression analysis, we performed pathway enrichment, gene ontology (GO) analyses and protein-protein interactions (PPIs) with top 10 hub gene networks. We also predicted the landscape of infiltrating immune cells using Cibersortx. We next develop pathway and GO term-based deep learning models leveraging primary tissue gene expression data from The Cancer Genome Atlas (TCGA) to identify gene signatures in recurrent HCC. Results The PI3K/Akt signaling pathway and cytokine-mediated signaling pathway were particularly activated in HCC recurrence. The recurrent tumors exhibited upregulation of an immune-escape related gene, CD274, in the top 10 hub gene analysis. Significantly higher infiltration of monocytes and lower M1 macrophages were found in recurrent HCC tumors. Our deep learning approach identified a 20-gene signature in recurrent HCC. Amongst the 20 genes, through multiple analysis, IL6 was found to be significantly associated with HCC recurrence. Conclusion Our deep learning approach identified PI3K/Akt signaling as potentially regulating cytokine-mediated functions and the expression of immune escape genes, leading to alterations in the pattern of immune cell infiltration. In conclusion, IL6 was identified to play an important role in HCC recurrence.

Background: The application of the Six Sigma (σ) metric in biochemical laboratories is a powerful tool for reducing the occurrence of errors and prioritizing important improvements in laboratory quality control. The National Accreditation Board for Testing and Calibration Laboratories (NABL) is an accreditation body with an accreditation system established in accordance with ISO/IEC 17011, providing specialty- or scope-based certification based on the conformance of quality indices to medical laboratories. In this context, a study has been designed that considers the quality guidelines set by NABL as well as the sigma metric rule in the assessment of analytical performance. Aims and Objectives: The aims of this study were to identify the gaps and need for strategy modification for quality improvement by assessing the performance of two NABL-accredited medical testing laboratories on a Sigma metric scale. Materials and Methods: A retrospective analytical study was conducted over 6 months (January–June 2021). Internal quality control (IQC) and EQAS data were obtained from third-party QC providers (Bio-Rad, India) and analyzed by calculating sigma (σ) values based on the coefficient of variation, bias, and total error allowable in two NABL-accredited medical testing laboratories. To identify potential problems for analytes with poor sigma values, a quality goal index (QGI) analysis was performed. Results: By analyzing the sigma values obtained by both NABL-accredited laboratories, we can see that laboratory 2 performed better than laboratory 1. After calculating the QGI, there was a problem of inaccuracy and imprecision in laboratory 1, and laboratory 2 had QGI values that indicated only imprecision. Conclusion: Diagnostic laboratories should incorporate Six Sigma metrics to identify gaps in their performance to ensure better quality control and patient safety.

Background: Early childhood development (ECD) is the foundation of future life starting from conception and depends on biological and environmental factors. Seventy-four percent of these children reside in villages; many are underserved and marginalized. Enabling young children to achieve their full developmental potential is a requisite for sustainable development, but globally, 43% of children are still at risk to do so. The problem of ECD is grave for underprivileged rural population in India. Objectives: The objective of the present study was to identify the key risk factors that are prevalent in a marginalized rural community in West Bengal and to observe the impact of these impeding factors on ECD, thereby helping in priority setting in service delivery to optimize ECD promotion. Methods: In this community-based cross-sectional observational study, a random sample survey of 609 households with children 0–6 years was conducted in Purulia district, West Bengal, India, using a Multiple Indicator Cluster Survey III-based questionnaire followed by data analysis. Results: Lack of stimulatory home environment, poor learning opportunities, and inadequate responsive parental care were major hindrances. The cumulative effect of multiple other health and hygiene factors was also hindering ECD. Most factors were strongly influenced by poor maternal education. Conclusion: Education of caregivers, especially parents by dedicated health workers on early learning opportunities, showed the path of applied sciences in pediatric clinical practice. To modulate socioeconomic adversities with responsive parental care, ECD can be fostered.

Background: The role of caregivers in grooming the neuro-developmental outcome of high-risk newborns and developmental challenges in children needs to be explored. Objectives: To find the knowledge and perception among parents regarding the neuro-developmental outcome of high-risk newborns, methods adopted to address these problems, and to identify areas on which awareness generation needs to focus. Materials and Methods: A questionnaire-based awareness survey was conducted to understand the knowledge, attitude, and practices of families of children with developmental challenges. Results: The study revealed that more than 70 percent of families lack information about child development, developmental challenges, and means to deal with them. They are unaware of the available health care services and other resources. One in three families has misconceptions on developmental disabilities; consider them as curse or jinx and consequently neglected. Female children with developmental problems are further ostracized due to gender inequity in families. About 10 percent of families have shown great openness toward acquiring new skills and knowledge for handling their children with developmental delays. Conclusions: This study is based on the précis research findings of our grass-root level fieldwork conducted in remote rural Bengal areas. The observation will be of interest and learning materials for general primary care practitioners, family physicians, and stakeholders to initiate appropriate intervention strategies for properly rehabilitating children with developmental delay at grass-root levels of primary health care.

Context: With the ageing of Indian society, providing a healthy life among older people is a public health precedence. Therefore, beforehand discovery and possible forestalment of frailty may help promote healthy ageing and dwindle the social, mental and financial burden of their families and caregivers. Aims: The study aimed to assess the proportion of frailty and its associated factors among the elderly aged 65 years and above in a rural community of West Bengal. Settings and Design: A community-based cross-sectional study was conducted among 270 elderlies selected from 15 villages out of a total 64 villages of Singur under the Hooghly District of West Bengal from January 2019 to February 2020. Materials and Methods: Cluster sampling technique was used. Data was collected using a pre-designed, pre-tested structured schedule including Fried frailty phenotype (FFP), geriatric depression scale short form (GDS 15) and mini nutritional assessment (MNA) tool. Statistical Analysis Used: Associated factors of frailty were assessed by univariate and multivariable logistic regression using SPSS version 16 software and MS Excel 2019. Results: The proportion of frailty was observed to be 23.7% and that of prefrailty 40.7%. Frailty was significantly associated with increasing age [AOR(CI) 1.2(1.1-1.3)], decreasing years of schooling [AOR(CI) 1.3(1.1-1.5)], loss of spouse [AOR(CI) 4.2(1.2-15.2)], financial dependency [AOR(CI) 19.3(2.7-139.0)], staying at home [AOR(CI) 16.3(2.7-98.2)], presence of anaemia [AOR(CI) 3.6(1.3-9.5)], at risk of malnutrition [AOR(CI) 6.5(1.9-22.3)], increasing number of falls in the last 1 year [AOR(CI) 4.3(1.2-15.6)], presence of 3 or more chronic diseases [AOR(CI) 154.7(12.1-1981.9)] and depression [AOR(CI) 8.3(2.5-27.0)]. Conclusion: The burden of frailty among the study population is relatively high. It’s an intimidating situation that needs bettered screening provisions for early discovery with special stress on nutritive upliftment. Screening for depression should also be done regularly.

Introduction: The Sunderban area of West Bengal is home to tribal and religious minorities inhabiting various islands. There is a high prevalence of thalassemia among poverty-stricken residents of this region living with meagre health care facilities. This work was planned to determine the proportion of four viral transfusion-transmitted infections (TTIs): HIV-1, HIV-2, hepatitis B virus (HBV) and hepatitis C virus (HCV) among thalassemia patients attending the sole rural medical college in the region. Materials and Methods: Thalassemia patients (n = 359, age ranging from 1 year to 60 years) attending the thalassemia clinic or being admitted to the indoor facilities for better management were included in the study. Only patients diagnosed with high-performance liquid chromatography (HPLC) and with classical clinical features were included in the study. Blood samples of these patients were tested for HIV as per NACO protocol. For HBV and HCV, samples were first tested serologically; reactive samples were collected and sent in the cold chain to a higher centre for nucleic acid amplification testing (NAAT) for qualitative and quantitative estimation. Clinical and laboratory data was collected, patients were followed up for complications and hospitalisation during the study period, and statistical analysis was performed. Results: Majority of our patients had E-beta-thalassemia (245, 59.81%), followed by beta-thalassemia major (102, 28.30%). NAAT-confirmed HCV infection (14.21%) infection was the most common, followed by HBV (2.51%), and lastly by HIV-1 (0.58%) infection. Among infected thalassemia patients, the mean HCV RNA was 741063 ± 438514.67 IU/ml while the mean HBV DNA level was 4082863 ± 7298514 IU/ml. Co-infections of HIV-1 and HCV and that of HBV and HCV were noted in one patient each (0.28%). HCV-related liver disease (14.21%) and growth retardation (10.31%) were the most typical complication noted, and death occurred in five patients (1.39%) during the study period. Conclusion: Primary care physicians should know HCV infection is the most common TTI among thalassemia patients in rural eastern India.