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Introduction: Men who have Sex with Men (MSM) are at high-risk for acquiring Sexually Transmitted Infections (STIs). The high prevalence of STIs, such as syphilis, Human Immunodeficiency Virus (HIV), genital herpes, genital warts, gonorrhea, and hepatitis B, necessitates regular screening in the MSM group. Furthermore, the presence of these STIs increases the transmission of HIV. Unfortunately, limited data are available regarding STI prevalence among MSM in India. Understanding the prevalence in this high-risk group aids in rapid diagnosis and effective control of infections, thereby reducing their transmission. Aim: To analyse the prevalence of STIs in the MSM group in Venereology Outpatient Department (OPD) in a Tertiary care centre, Chennai, Tamil Nadu, India. Materials and Methods: A record-based cross-sectional study was conducted at a tertiary care centre in Chennai, Tamil Nadu, India over a period of one year (January 2023 - December 2023). The study included 110 men who were brought in by voluntary organisations or who walked in directly to the Venereology department and identified themselves as homosexuals. Their socio-demographic data, detailed contact history, chief complaints, relevant investigations, and treatments provided were recorded and analysed. All data were analysed using Statistical Package for the Social Sciences (SPSS) software. Results: Out of the 110 men enrolled in this study, most were in the 18 to 29 years age group, and a predominant 58 (52.72%) reported engaging in unprotected sexual practices. Specifically, 67 (60.91%) of the men identified themselves as strictly homosexuals, while 43 (39.1%) identified as bisexuals. Further inquiry about their partners revealed that 24 (21.82%) had contact with known partners, while 86 (78.18%) had contact with unknown partners, primarily through dating apps and social media platforms. Among the 42 patients diagnosed with STIs, syphilis was the most common, affecting 15 (13.63%) individuals. The second most common STI was HIV, seen in 10 (9.09%) of which 4 had co-infection with syphilis. The next most common STIs diagnosed were genital herpes in 7 (6.36%), gonorrhea in 6 (5.45%), genital warts in 3 (2.73%), hepatitis B in 3 (2.73%), and genital scabies in 2 (1.81%). Conclusion: The prevalence of STIs in this study was found to be 38.18%. This study underscores the importance of understanding the prevalence of STIs, which may aid in targeted interventions to address STI transmission, particularly among young adults and MSM populations. Efforts should focus on promoting safer sexual practices, increasing access to testing and treatment, and providing education and support to both individuals and their partners.

Objectives. To evaluate the informativeness of the N-terminal brain-promoting natriuretic peptide (NT-proBNP) for the diagnosis of chronic heart failure (CHF), depending on the presence of senile asthenia syndrome (SSA) in patients with arterial hypertension (AH) 80 years and older.Materials and Methods. 320 patients with hypertension, depending on the presence of CHF and SSA, were divided into groups: group 1A — patients with hypertension, SSA and CHF (n=84), group 1B — patients with hypertension, SSA without CHF (n=77), group 2A — patients with hypertension, CHF without SSA (n=84), group 2B — patients with hypertension without CHF and without SSA (n=75). The CSA was identified by the questionnaire “Age is not a hindrance”. The level of NT-proBNP was determined in blood serum by enzyme immunoassay. ROC analysis was used to determine the threshold value of markers.Results. In patients with hypertension and SSA without CHF, the concentration of NT-proBNP in the blood is 2.3 times higher (p=0.003) compared with patients with hypertension without SSA and without CHF, which indicates the effect of SSA on the level of NT-proBNP. In patients with hypertension and CHF without SSA, the level of NT-proBNP is 4.3 times higher compared with patients with hypertension without SSA and without CHF (p

Introduction: Fall is a common complication of stroke. People must use both their higher cognitive abilities and their motor skills simultaneously in everyday situations. Falling is much more likely to occur when performing multiple tasks requires continuous attention. Implementing a Cognitive Motor Dual Task (CMDT) might give more accurate information regarding how stroke survivors function throughout daily activities. Aim: To identify the walking speed in stroke patients using CMDT and to determine the impact of walking speed on risk of fall. Materials and Methods: In this cross-sectional study, 23 Middle Cerebral Artery (MCA) stroke patients with and without the risk of fall according to morse fall scale were included from Justice KS Hedge Charitable Hospital, Mangaluru, Karnataka, India from March 2023 to March 2024. After which the selected participants performed CMDT, the step count and time taken to complete the test was recorded using a pedometer and stop watch, the total and correct number of cognitive responses was recorded manually. The walking speed was calculated in m/sec. Based on the outcome measures of the present study; the statistical analysis was performed. Data collected was analysed by using the Statistical Package for the Social Sciences (SPSS) software version 29.0. To compare the data Independent sample t-test, One-way Analysis of Variance (ANOVA) was used. Results: The study participants consisted of an average age of 54.6±14.8 years. Individuals categorised as low-risk exhibited a mean walking speed of 0.238±0.014 m/sec, while those in the moderate risk group had a mean walking speed of around 0.211±0.024 m/sec and individuals at high-risk showed a lower mean walking speed of approximately 0.177±0.020 m/sec. The statistical analysis revealed a significant difference in walking speeds among the risk groups, with an F-value of 15.486 and a p-value less than 0.001. Conclusion: The study showed that walking speed will impact the risk of fall in stroke patients while performing CMDT. The time and step count are more in patients with high fall risk compared to patients with low fall risk therefore, walking speed is reduced in patients with high-risk of fall.

Introduction: Estimating age is becoming more and more important in forensic science and dentistry. Identifying criminals, child labor problems, birth certificates, job openings, illegal immigrants, or a body whose identity is unknown are just some of the situations where estimating age is necessary. This study’s goal is to find out how to figure out a child’s chronological age between the ages of 12 and 14 by looking at panoramic X-rays and measuring how big their open tooth root tips are. Things Used and Methods: The left mandibular canine, premolars, and molars from 83 dental panoramic X-rays of patients aged 12 to 14 years were used to study tooth development. The individual tooth-root ratio (A/L) was measured using Sirona software-XG machine (Made by Dentsply Sirona, Germany) in a straight line. An estimated age was made and then matched to the real age. Results: A regression equation was used in statistical analysis to guess the age of the people. To figure out the age, 15.9973-8.465(x7) +1.650(x3) was turned into a linear regression model. Conclusion: The equation that was found in this study can be used to accurately guess the dental age of young teens in South India.

Introduction: Globally, Non communicable diseases (NCD) are the leading cause of death accounting for 63% of annual deaths. More than 40% of NCD deaths are premature deaths which is mainly due to the complication arising as a result of non- adherence to treatment. Moreover, non-adherence to treatment is a growing challenge in India which blocks the clinical outcomes and paves way for complications. Objectives: To Assess the treatment adherence among Diabetic and Hypertensive patients and to determine the factors influencing adherence. Method: Community based, Cross sectional study was conducted among 112 patients of diabetes and hypertension diagnosed for more than 1 year attending NCD clinic of Puliyanthope UHC during Oct-Nov 2020. Data was collected using semi structured questionnaire with socio demographic details, treatment details by interviewer. Adherence was assessed using Morisky Adherence Scale (MAS 4). Results: Among patients, 57% were female and mean age was 54 years with Standard Deviation of 4.5 years. About 39% had diabetes, 27% had hypertension and 34% suffered with both. Total of 34% patients were highly adherent and 66% were non adherent to prescribed drugs. About 64% patients monitored their blood sugar once in three months. Female patients had better adherence (51%) to medications than male (38%) but not statistically significant. About 34% of patients at least once missed their drugs due to high cost. Adherence was high among those who were aware about complications of drug discontinuation. (p = 0.023). Literacy, Socioeconomic status, number of medicines were not significant with treatment adherence (P>0.05). Conclusion: This study indicates high proportion (66%) of non-adherence to treatment among patients with hypertension and/or diabetes. Awareness of impact of discontinuation of drugs had a major impact on adherence to treatment. Common reasons behind low adherence were fear of side effects of drugs, forgetfulness and carelessness.

Background. Degenerative-dystrophic diseases of the joints are chronic progressive pathological conditions, accompanied by such features as presence of pain syndrome, impaired functional capacity, muscle weakness, deformation and instability of the joints. The high prevalence of degenerative-dystrophic diseases of the hip joint necessitates the search for optimal non-invasive treatment methods. Objectives. This study aims to analyze the clinical results of intra-articular injections of hyaluronic acid solution (Diart) in the treatment of patients with II–III stages of degenerative-dystrophic diseases of the hip joint. Materials and methods. The clinical results of 30 patients with II–III stages of degenerative-dystrophic diseases of the hip joint were analyzed. The group included 11 (36.67%) males and 19 (63.33%) females. The mean age of group was 61.43±7.98 years. All patients underwent a course of drug therapy using hyaluronic acid solution (Diart), which included 3 intra-articular injections of the drug, which were performed with the 7-day interval. Clinical results were evaluated at the initial visit, at 7, 14, 30 and 90 days after the first injection of Diart by objective examination of patients and analysis of subjective data using the WOMAC questionnaire. Statistical analysis was performed using Statistica 13 software package. Results. The high effectiveness of intra-articular injections of hyaluronic acid (Diart) in the treatment of patients with II-III stages of degenerative-dystrophic diseases of the hip joint and the absence of complications associated with intra-articular injection of the drug have been established. Signs of post-injection sy- novitis, discomfort, swelling or other unpleasant sensations weren’t observed in any of the examined patients. Comparing the results established during remote period, on the 90th day of observation, and indicators determined at the initial visit, we proved a decrease in the intensity of the pain syndrome in the hip joint by 30.35%, in stiffness — by 29.57%, an improvement in the indicators characterizing the functional capacity by 21.34 % and the total values of the WOMAC index — by 27.37%, after a treatment course using Diart. Conclusion. The high efficiency of using intra-articular injections of hyaluronic acid solution (Diart) in the treatment of patients with II–III stages of degen- erative-dystrophic diseases of the hip joint has been proven.

Aims: To investigate the sociodemographic profile of donors from four large Brazilian blood collection organizations (BCOs) from 2007 to 2016, providing key information to understand the characteristics of the blood donor population, and to support strategies to maintain and improve the sufficiency of the blood supply. Material and methods: Data were collected from BCOs participating in the REDS Brazil Study in São Paulo, Minas Gerais, and Pernambuco between 2007 and 2016, and in Rio de Janeiro from 2012 to 2016. We included all eligible blood donation candidates who passed through clinical and laboratory routine screenings. Results are presented in terms of frequencies and percentages, analyzed by demographic characteristics, donor type: first time (FTD) and repeat donors (RD), and donation type (community or replacement). Results: During the study period, 3,246,516 whole blood and 61,169 platelet apheresis donations were collected. The percentage of men (67%) was twice as high as the number of women but varied by BCO, and the predominant age group was 26-35 years (34%). In the assessment of self-reported race/skin color, we found a predominance of mixed race (44%), followed by white (43%). For education level, most donors reported having finished high school (50%). Among the donors, 67% were RD and 33% were FTD. Over the 10-year period, the overall demographic profile of blood donors remained relatively stable with a predominance of males (62-69% range by site), whites (40-47%) and/or mixed race (35-46%), donors with a higher level of education (39-54%) with high school-level), aged between 26-35 years (32-35%), community donors (60-66%) and RD (63-69%).Male donors between 26-35 years old with ≥high school education were most common in all BCOs. In São Paulo and Pernambuco, replacement donations were 57% and 55%, respectively. In Belo Horizonte and Rio de Janeiro, community donations were 86% and 71%, respectively. Discussion: Our results describe a predominance of male and young blood donors, as well as a predominance of community and RD. Campaigns conducted by the blood centers have increased the relative percentages of donations from female donors, but the efforts to attract community donors have seen limited success, with an overall increase of 5% in the percentage of female donors and an overall increase of 2% in community donors between 2007 and 2016. The greatest increase in the percentage of female donors was observed in São Paulo (10%) and Pernambuco (10%); the greatest increase in the percentage of community donors was observed in Minas Gerais (10%). The modest increases in female and community donors suggest that targeted strategies are needed to align with WHO recommendations, which emphasize that an adequate and reliable supply of safe blood is best assured by a stable base of regular and voluntary blood donors. Conclusion: This analysis provides information to understand the sociodemographic characteristics of Brazilian blood donors over time. With this analysis, we intend to support the Ministry of Health and other responsible bodies in creating effective strategies to increase blood donations. We are currently analyzing data up to 2023 to further assess these trends during and after the COVID pandemic.

Background: A concerning increase in syphilis has been observed worldwide. Traditional surveillance is limited by the scarce routine testing of asymptomatic infections. Blood donation screening is an opportunity to monitor resolved and active syphilis infections, providing public health insights into transmission. Aims: To define syphilis prevalence, incidence and factors associated with active infection among blood donors in five Brazilian blood centers. Material and methods: Donations from Jan. 2020 through Feb. 2022 were screened with treponemal or nontreponemal tests according to the local routine assessment at each blood center, followed by a confirmatory step with an alternate Enzyme-Linked Immunosorbent Assay (ELISA) and rapid plasma reagin (RPR) testing. Samples with positive or indeterminate results in the alternate ELISA were categorized as active (if RPR reactive) or resolved syphilis (nonreactive RPR). Active cases were further categorized according to RPR titers (< 1:8 or ≥ 1:8). We report the prevalence of syphilis in first-time donations (FTD) and repeat donations (RD), incidence in RD, and use regression models to assess factors associated with active syphilis. Results: Of 862,146 donations, 10,771 (1.3%) were reactive or indeterminate on screening; 7,541 available samples underwent additional testing. Of those, 5,876 (77.9%) tested positive on the alternate ELISA; 907 (12.0%) were resolved infections, 2,980 (39.5%) were active syphilis with RPR < 1:8, and 1,989 (26.4%) were active syphilis with RPR ≥ 1:8. Overall syphilis prevalence (including resolved and active cases) was 2.5% in FTD and 0.6% in RD. The prevalence of active syphilis was 1211 and 238 per 105 donations among FTD and RD, respectively. Among FTD, the prevalence rates of active syphilis with high and low RPR titers were 466 and 745/105 donations; these rates were 4.4 and 5.6 times higher than those observed in RD. Subgroups with the highest prevalence of active syphilis were black donors (946/105 donations), donors with ≤primary education (788/105 donations) and replacement donors (822/105 donations). In the multivariable model, age, gender, race, education, donor type, and type of donation were significantly associated with active syphilis. The incidence of syphilis in RD was 90/105 person-years, with age (25-34 and ≥ 55 relative to ≤ 24 years), male gender, Black and Mixed race (relative to White), lower education, and replacement donation significantly associated with incident syphilis in RD. Discussion: We observed that both the prevalence and incidence of active syphilis are associated with male sex, black and mixed race, lower schooling, and replacement donation; compared to donors ≤ 24 years old, older donors had higher prevalence of active syphilis, whereas those aged 25-34 years old had higher incidence of syphilis. Conclusion: The prevalence of syphilis was below 3% among FTD and below 1% among RD including resolved and active cases. We found wide variation according to demographic characteristics, with age, gender, race, education, donor type, and type of donation associated with higher prevalence of active syphilis in the adjusted models. The results indicate sociodemographic subgroups that can be targeted in efforts to promote sexual health education and surveillance, prevention and control of sexually transmitted infections.

Background: Syphilis is a public health problem with traditional surveillance limited to clinical monitoring data; asymptomatic and low-risk populations rarely undergo diagnostic testing. Globally, the syphilis prevalence has consistently increased over the last years, worldwide. Blood donation screening can provide valuable information on syphilis trends over time and on the occurrence of undetected cases in the community. Aims: To evaluate the rates and the relationship between syphilis positivity in blood donors when compared against the notifications of sexually acquired syphilis, syphilis in pregnant persons, and congenital syphilis reported by the Brazilian surveillance system between 2012 and 2022. Material and methods: Data was compared directly to evaluate the correlations between deferral rates due to syphilis in first-time donors within the REDS-IV-P blood centers (per 100,000 donations); annual rates of syphilis reactivity among Brazilian blood donors obtained from the Hemotherapy Bulletin (HEMOPROD; per 100,000 donations); and rates of congenital syphilis (per 1,000 live births), sexually acquired syphilis (per 100,000 population), and syphilis in pregnant persons (per 1,000 live births) in Brazil extracted from official reports published by the Ministry of Health. The deferral rates in blood donations were based on the results of screening tests. Results: We observed an increase in syphilis detection over time by all definitions between 2012 and 2022, with a more pronounced increase in syphilis in pregnant persons (5.7x) and sexually acquired syphilis (7.0x), except for 2020, likely due to underreporting secondary to the COVID-19 pandemic. The increase in deferral rates for syphilis in blood donors in Brazil and in REDS was less sharp (1.6x and 1.4x respectively) when compared to the rates for sexually acquired syphilis and gestational syphilis. REDS-IV-P data reflected the country's deferral pattern, approximately correlating with the increase in congenital syphilis detection rates (2.5x) in the period. Discussion: There is a close correlation between syphilis rates in first-time blood donors and congenital syphilis rates recorded by the surveillance system between 2012 and 2022. Donors have lower syphilis rates than the overall adult population and a less pronounced increase in rates over time, probably due to sociodemographic and behavioral characteristics of the blood donor population.

Background: Medical students' social media addiction disrupts and lowers sleep quality, hurting their everyday life and academic performance, stressing the need for effective ways to promote their well-being and achievement. The study aims to estimate the prevalence of social media addiction and to find out the association with sleep quality among medical students in private medical college. Methodology: A cross-sectional study involving 792 MBBS students from a private medical college in Chengalpattu district, Tamil Nadu, utilized the Bergen Social Media Addiction Scale (BSMAS) to assess social media addiction and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Data were collected through a pre-tested semi-structured questionnaire and analysed using SPSS version 25. Results: The study revealed a 17.7% prevalence of social media addiction among medical students, significantly associated with poor sleep quality, female gender, and morning social media use. Other factors included dependence on social media for updates, more than three hours of daily use, eye discomfort, Snapchat use, compulsion to post at least six photos and subjective sleep quality, sleep latency, duration, disturbances, use of sleeping medication, and Daytime dysfunction. Conclusions: Research demonstrates a significant correlation between social media addiction and poor sleep quality among medical students, highlighting the need for focused interventions and awareness activities to counteract its harmful influence.

Hilar Cholangiocarcinoma (CCA) is a very complex disease that requires the best multidisciplinary decisions. Improved outcomes are reported only in high-volume centres with good expertise and the latest technology in radiology for imaging and intervention, endoscopy, and surgery. However, in India, only very few centres have very good infrastructure for the same. Additionally, protocol-driven treatment is also not uniform in India. To fulfil this gap, authors believe that a strict, disciplined work-up of these complex cases is the only way to achieve optimal treatment. Authors propose a protocolised checklist involving multidisciplinary decisions for hilar CCA patients that could be used. This case series aims to assess the oncological outcome of hilar CCA using our checklist and, secondarily, to assess the immediate postoperative outcome and complications in these patients. Out of 20 patients, 13 underwent successful hepatectomy based on the decisions made. No mortality was noted in this case series. Two cases had a postoperative liver failure (Clavien Dindo 3A). All 13 patients had an R0 resection. The mean length of the tumour-free margin was 8.46 mm. Doing two-dimensional surgical simulation preoperatively and adhering to the special plane of transection helped in attaining R0 resection. Here, a small series of hilar CCA is presented which was managed successfully, signifying the importance of a protocol-based approach which can be easily adapted and reproduced.

In this article, the structural, electronic, and optical properties of lead-free cubic halide perovskite RbSrI3 are investigated by the first principles method that employs the density functional theory (DFT). This study implements the full potential linearized augmented plane wave (FP-LAPW) method with the generalized gradient approximation of Perdew-Burke-Ernzerhof (PBE-GGA) as the exchange-correlation potential. The structural stability of the compound is calculated using the Murnaghan equation of state, and the band structure calculations show the presence of a wide indirect bandgap of 3.32 eV. The optical response of the compound over the energy spectrum of 0–12 eV is studied and the compound exhibits good reflectance of 30.73 % at 7.66 eV and absorption of 112.45 × 104 cm−1 at 11.74 eV in the ultraviolet region. The values of reflectivity R(ω) and absorption coefficient α(ω) indicate that the compound shows potential in the fabrication of UV-related optoelectronic devices.

During current COVID Pandemic era, quantum of influence of employees' involvement towards the strategic implementation of the Total Quality Management (TQM) in Indian Telecom Industry Limited, India was the main aim of the study. The study was carried out in Indian Telecom industry Limited spread across India. The method for scrutiny was structural Equation model (SEM). The indicators for Employees involvement and strategic implementation of total quality management in the organisation were TMCL-top management commitment/Leadership, ET-Employees training, CI-continual improvement, CIS-communication and information system, WEC-Work environment and culture, EDT-Education and training. From the measurement of fit it was evident that employees’ involvement had no significant influence towards the strategic implementation of Total Quality Management in Indian Telecom Industry Limited, India.

A detailed description of the Limbus and the pupil.Anatomy of limbus which is a cardinal structure in ocular surgeries and its importance in maintaining corneal integrity is discussed .Also provided is a clinical algorithm on assessment of pupil.

Rickettsial infections are emerging and/or re-emerging disease that poses a serious global threat to humans and animals. Transmission to humans and animals is through the bite of the ectoparasites including ticks, fleas and chigger mites. Most of the rickettsial diseases are endemic in India, but underdiagnosed. This review is aimed at analyzing the prevalence of rickettsiosis in India and the advancement of rickettsial diagnosis. We have conducted a systematic review on the prevalence of rickettsial disease in India ranging from 1.3% to 46.6% for spotted fever, 2.4% to 77.8% for scrub typhus and 1% to 46.4% for Q fever, based on the literature published with the evidence of isolation, serological, and molecular diagnostics. Search engines Medline/PubMed, Science Direct, ProQuest, and EBSCO were used to retrieve the articles from electronic databases by using appropriate keywords to track the emergence of these rickettsial diseases in India for the period of 1865 to till date. We retrieved 153 published rickettsial articles on hospital-based studies from India that were purely made on the basis of prevalence and the laboratory parameters viz., Weil-Felix test (WF) and Rapid Immunochromatographic tests (RICT) with reference to the gold standard IFA and ELISA. More epidemiological studies are required for epidemic typhus to know the exact prevalence status of this louse-borne rickettsiosis in India. Currently, there is no confirmed specific inflammatory marker for rickettsial diseases. Moreover, serological cross-reactivity is an important aspect, and it should be investigated in endemic areas, there is also a need to include molecular diagnostic techniques for further confirmation in healthcare settings.

Introduction: Coronavirus Disease-2019 (COVID-19) is a highly contagious viral illness caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Serological surveys help in understanding the burden of past infections. The World Health Organisation (WHO) suggests the need for populationbased sero-epidemiological investigations to acquire data for implementing containment measures. The tribal population, being the most marginalised and vulnerable section, is at a higher risk for COVID-19. However, there is limited literature regarding the seroprevalence of COVID-19 among the tribal population in our country. Aim: To assess the COVID-19 seropositivity, associated factors, and knowledge among adults of tribal origin attending a primary care centre in Wayanad, Kerala. Materials and Methods: A cross-sectional study was conducted among 279 adults of tribal origin, aged between 18 and 95 years, attending a primary tribal healthcare centre at Amrita Institute of Medical Sciences, Kochi, Kerala, India, from August 2021 to October 2021. A semistructured questionnaire was used to collect socio-demographic details, history of COVID-19 infection, vaccination status, and participants’ knowledge and awareness about COVID-19. Antibody presence was tested using the WANTAI test kit. Data analysis was performed using Statistical Package for Social Sciences(SPSS) version 21.0 A multivariable logistic regression was conducted following univariate analysis to identify independent factors associated with COVID-19 seropositivity. Results: The mean age of the study population was 45.34±15.86 years. Among the 279 participants, the proportion of seropositivity to COVID-19 antibodies was found to be 245 (87.8%) with a 95% confidence interval (CI) of 83.98 to 91.62. Regarding knowledge and awareness related to COVID-19, 186 (66.7%) participants were not aware of the common symptoms of COVID19. Individuals aged above 60 years had a five times higher probability of having COVID-19 antibodies compared to those aged 30 years or younger (adjusted odds ratio (aOR) 4.71, 95% CI 0.111 to 20.025). Those who had received atleast one dose of the vaccine were nine times more likely to have seropositivity (aOR 8.58, 95% CI 1.390 to 53.028). Conclusion: The seropositivity of COVID-19 was high at 87.8%. Older people and vaccinated individuals were more likely to be seropositive. Therefore, it is necessary to strengthen vaccination efforts among all age groups. Continued sero-surveillance and vaccination surveys need to be conducted to gain more insights into the antibody kinetics of this novel pathogen.

Introduction: The clinical features of sepsis in neonates are subtle and non specific, requiring a high index of suspicion for early diagnosis. Blood culture is the gold standard for diagnosis, but it is time consuming. Therefore, there is a need for a costeffective and reliable screening tool. The Leukocyte Alkaline Phosphatase (LAP) activity of neutrophils is known to increase during bacterial infections in adults. Aim: To determine the activity of LAP in Neonatal Sepsis (NS) and compare the results with blood culture. Materials and Methods: This is a prospective cohort study conducted from January 2018 to June 2019 at Mandya Institute of Medical Sciences, Karnataka, India. Total of 200 neonates by their haematological profile were clinically suspected of having sepsis. A peripheral smear was prepared from a drop of blood and stained to assess the LAP activity. In each smear, a total of 100 consecutive segmented neutrophils were examined and were rated from 0 to 4 according to the red granular precipitate intensity within their cytoplasm. The possible range of 0-400. The blood culture report was obtained from the case sheet. The neonates were divided into two groups: Group 1 consisted of culture-proven sepsis cases, and Group 2 consisted of neonates with clinical suspicion of sepsis but negative blood culture results. Descriptive analysis was performed using mean and standard deviation for quantitative variables, and frequency and proportion for categorical variables. Chi-square test was conducted, and a p-value

Background & aim: Ticks, as external parasites, biological carriers and reservoirs of various diseases, play a role in the transmission of various disease agents to humans and animals. The aim of the present study was to identify hard ticks (Acari: Ixodidae) in the southern villages of Ahvaz-Khorramshahr road in southwest Iran. Methods: In this descriptive cross-sectional study which was conducted in 5 selected southern villages of the Ahvaz-Khorramshahr road in the summer and autumn of 2019, 156 heads of livestock were investigated, ticks in the two seasons of summer and autumn from different parts of the body of cattle, sheep and goats. were collected and identified according to Chegini's diagnostic key. The sample collection method was manual, the collected data were analyzed using descriptive statistical tests and Vines analysis. Results: In the present study, 156 animals were examined and 234 ticks were caught. A total of 3 species of ticks from 2 genera (Ripcephalus, Hyaloma) were identified. In total, Hyaluma marginatum was the most common species and Rhipicephalus sanguinus was the least abundant. The abundance of Rhipicephalus sanguinus was 16.4%, Hyaluma anatolicum was 36.2% and Hyaluma marginatum was 47.4% in this area. The highest abundance of Hyaloma marginatum and Ripicephalus sanguinus ticks was observed in Umm al-Tir village with 56% and 29%, respectively. The highest abundance of Hyaluma anatolicum species was observed in Krishan village with 50%. Tick infestation was observed in 6% of cattle, 13% of sheep and 10% of goats. The frequency of tick infection based on the body regions in cattle was in the head and neck (59%), under the tail and around the anus (27%), groin (14%), which statistically indicated a significant difference (02.02). p = 0). Conclusion: The distribution of the collected ticks revealed that the studied areas were suitable for the activity of ticks due to the weather conditions, so health planners need to consider the possibility of the spread of tick-borne diseases in these areas.

Bargur, the hill cattle of Tamil Nadu, India is reared mostly inside the forests and is surviving under zero-input conditions. Their home tract is restricted to a narrow geographical area in and around Bargur hills at an elevation of about 1000 m above the MSL. The distinguishing morphological features of these cattle include its typical brown colour with white patches and being compact in size. The average body length, height at withers and heart girth were 99.7-2.0 cm, 10836+0.8 cm and 139, 92+0.9 cm in cows and 109.18-32 cm, 117.59-1.5 cm and 152.7+3.2 cm for adult males respectively. Cows are poor milkers and produce about 0.5 to 3.0 litres milk per day after suckling by calf. However, bullocks are famous for their endurance and speed in trotting. Animal are mostly maintained for dung and draft in the breeding tract. In the last three decades, the population of these animals has declined drastically by about 90% (to less than 10,000) due to various reasons. There is a strong and urgent need to make efforts for conservation so that the extinction of this valuable germplasm may be avoided.

IntroductionThe mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France.Materials and methodsThe Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS

Introduction: Antimicrobial resistance is on the rise, posing a global threat to the success of modern surgical procedures. A common and notorious superbug causing community and hospital-acquired infections is Methicillin-resistant Staphylococcus aureus (MRSA). Its potential for easy and rapid spread leads to increased mortality in hospitals. Clindamycin, a relatively inexpensive and effective drug, is empirically prescribed for the treatment of MRSA infections. Due to the risk of misidentifying clindamycin resistance as susceptibility, leading to treatment failure, its judicious use after D-test is advocated. Aim: To isolate Staphylococcus aureus (S.aureus) from various clinical specimens and to identify MRSA using cefoxitin disc (30 μg), further determining the incidence of inducible clindamycin resistance among MRSA by the disc diffusion method (D-test). Materials and Methods: The present cross-sectional study was conducted in the Department of Microbiology, Government Mohan Kumaramangalam Medical College Hospital (GMKMCH), Salem, Tamil Nadu, India, from June 2023 to August 2023. Study was conducted using 185 S.aureus isolates collected from samples received from patients of all genders treated at the present study hospital. Various clinical samples such as pus, sputum, blood, urine and fluids collected from patients treated at the study Institute Salem during the study period were included. A cefoxitin disc (30 μg) was used to detect MRSA among the 185 S.aureus isolates by disc diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines, which were further tested for clindamycin resistance using clindamycin (2 μg) with erythromycin (15 μg) discs by the D-test. The data of the study were analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Further descriptive statistics and a chi-square test with a level of significance, p-value ≤0.005 (statistically significant), were used. Results: Among 185 S.aureus isolates, 130 (70.27%) were Methicillin-sensitive S.aureus (MSSA) and 55 (29.7%) were MRSA. Inducible clindamycin resistance was observed in 22 (40%) isolates, while 17 (30.9%) isolates showed constitutive resistance, 9 (16.36%) showed the MS phenotype, and the remaining 7 (12.72%) showed the susceptible phenotype. Among the clindamycin resistance patterns in MRSA, inducible clindamycin resistance was reported predominantly. Conclusion: The majority of S.aureus was isolated from pus samples, highlighting its importance as a pyogenic microorganism. The current study records a high rate of MRSA resistance among S.aureus isolates. The present study reports a higher rate of inducible clindamycin resistance among MRSA isolates when compared to other phenotypes of clindamycin resistance. Therefore, routine D-testing must be implemented to identify inducible resistance to clindamycin in MRSA to avoid treatment failure.

The fruit-bearing medicinal tree, Garcinia morella, grows in the tropical rain forests of India’s Western Ghats, Indo-Chinese Himalayan regions and Sri Lanka. Its fruit rinds are used as a garnish and in seasoning during food preparation. In order to genetically exploit it and assess diversity, development of microsatellite markers was attempted. We partially sequenced genomic DNA using the Illumina Hiseq 2000 platform and examined sequence data for microsatellite loci. We obtained high-quality 10653 Mbp data and was assembled into 1613263 contigs. A total of 121199 SSRs were discovered, Di nucleotide repeats were predominant (42.5%), followed by mono and tri nucleotide repeats (30.4 and 7.9%, respectively). We were able to design primers for 52901 microsatellites. Genetic analysis of 48 SSR loci, showed PIC values ranging from 0.067 to 0.939 with a mean value of 0.7547. The allele per locus ranged from 2 to 24 with a mean of 13. These microsatellite markers can be employed for genetic diversity analysis, molecular characterization and mapping different traits.

The research is focused on a comprehensive analysis of digitalization as a prerequisite for higher education modernization. The authors of this article consider the digital divide as a component of information inequality, which has a technological nature and presupposes unequal opportunities for access, use, and production of information and knowledge or new technologies for their effective use in practice. The authors determined the digital divide is intensifying under pandemic and quarantine restrictions when the preference is given to blended learning technologies, collaborative learning, integrated learning, flipped classroom technology, storytelling, inquiry based learning (IBL), and project based learning (PBL). The research result is a unified information and communication ecosystem developed, which unites the scientific, technological, and educational potential of the network educational digital environment. The ecosystem also provides for the transformation from a lineal to a cluster model of competence cultivation, the formation of digital skills, growth in the volume of information, and creation of digital products.

Abstract Background Quality of life is decreased in bipolar disorders (BD) and contributes to poor prognosis. However, little is known about the causal pathways that may affect it. This study aimed to explore health-related QoL (HRQoL) in BD and investigate its relationship with cognition and psychosocial functioning. Methods This multicenter cross-sectional study used a neuropsychological battery to assess five cognition domains. Functioning was evaluated using global and domain-based tools, and health-related HRQoL was assessed using the EQ-5D-3L. Structural equation modeling was used to test whether the association between cognition and HRQoL would be mediated by functioning in BD while controlling for covariates such as residual depression, anxiety, antipsychotic medication, and psychotic features. Results We included 1 190 adults with euthymic BD. The model provided a good fit for the data. In this model, the direct effect of cognition on HRQoL was not significant (β = − 0.03, z = −0.78, p = 0.433). The total effect of cognition on HRQoL was weak, albeit significant (β = 0.05, z = 3.6, p

When purebred laying hen chicks hatch, they remain at a rearing farm until approximately 17 weeks of age, after which they are transferred to a laying farm. Chicks or pullets are removed from the flocks during these 17 weeks if they display any rearing abnormality. The aim of this study was to investigate associations between single nucleotide polymorphisms (SNPs) and rearing success of 4 purebred White Leghorns layer lines by implementing a Bayesian network approach. Phenotypic traits and SNPs of four purebred genetic White Leghorn layer lines were available for 23,000 rearing batches obtained between 2010 and 2020. Associations between incubation traits (clutch size, embryo mortality), rearing traits (genetic line, first week mortality, rearing abnormalities, natural death, rearing success, pullet flock age, and season) and SNPs were analyzed, using a two-step Bayesian Network (BN) approach. Furthermore, the SNPs were connected to their corresponding genes, which were further explored in bioinformatics databases. BN analysis revealed a total of 28 SNPs associated with some of the traits: ten SNPs were associated with clutch size, another 10 with rearing abnormalities, a single SNP with natural death, and seven SNPs with first week mortality. Exploration via bioinformatics databases showed that one of the SNPs (ENAH) had a protein predicted network composed of 11 other proteins. The major hub of this SNP was CDC42 protein, which has a role in egg production and reproduction. The results highlight the power of BNs in knowledge discovery and how their application in complex biological systems can help getting a deeper understanding of functionality underlying genetic variation of rearing success in laying hens. Improved welfare and production might result from the identified SNPs. Selecting for these SNPs through breeding could reduce stress and increase livability during rearing.

Antibacterial resistance (ABR) is a major public health threat. An important accelerating factor is treatment-seeking behaviour, including inappropriate antibiotic (AB) use. In many low- and middle-income countries (LMICs) this includes taking ABs with and without prescription sourced from various providers, including health facilities and community drug sellers. However, investigations of complex treatment-seeking, AB use and drug resistance in LMICs are scarce. The Holistic Approach to Unravel Antibacterial Resistance in East Africa (HATUA) Consortium collected questionnaire and microbiological data from adult outpatients with urinary tract infection (UTI)-like symptoms presenting at healthcare facilities in Kenya, Tanzania and Uganda. Using data from 6,388 patients, we analysed patterns of self-reported treatment seeking behaviours ('patient pathways') using process mining and single-channel sequence analysis. Among those with microbiologically confirmed UTI (n = 1,946), we used logistic regression to assess the relationship between treatment seeking behaviour, AB use, and the likelihood of having a multi-drug resistant (MDR) UTI. The most common treatment pathway for UTI-like symptoms in this sample involved attending health facilities, rather than other providers like drug sellers. Patients from sites in Tanzania and Uganda, where over 50% of patients had an MDR UTI, were more likely to report treatment failures, and have repeat visits to providers than those from Kenyan sites, where MDR UTI proportions were lower (33%). There was no strong or consistent relationship between individual AB use and likelihood of MDR UTI, after accounting for country context. The results highlight the hurdles East African patients face in accessing effective UTI care. These challenges are exacerbated by high rates of MDR UTI, suggesting a vicious cycle of failed treatment attempts and sustained selection for drug resistance. Whilst individual AB use may contribute to the risk of MDR UTI, our data show that factors related to context are stronger drivers of variations in ABR.

Let G be a graph with p vertices and q edges. Define a bijection f : V (G) → {1, 8, ..., p(3p - 2)} by f(vi) = i(3i - 2) for every i from 1 to p and define a 1 - 1 mapping fopgl ∗ : E(G) → set of natural number N such that f∗(uv) = |f(u) - f(v)| for all edges (uv) ∈ E(G).The induced function f is said to be octagonal prime graceful labeling if the gcin of each vertex of degree atleast 2 is one.

A novel sol-gel auto-combustion technique is utilized to prepare nano-sized, perovskite-structured LaFeO3 powders. The nanoparticles were synthesized for three distinct precursor concentrations (0.5, 1 and 1.5 M) maintaining pH, annealing temperature and time. The synthesized nanoparticles were characterized by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy, high-resolution scanning electron microscopy (HRSEM), high-resolution transmission electron microscopy (HRTEM), energy dispersive X-ray absorption spectroscopy (EDAX), diffuse reflectance spectroscopy (DRS), photoluminescence (PL) study and vibrating sample magnetometer (VSM). XRD revealed that all the prepared samples have shown an orthorhombic phase with space group Pnma. DRS suggested a marginal increase in bandgap and the average band gap was found to be 2.2 eV VSM analysis has shown that all the prepared samples exhibit weak ferromagnetic behaviour due to uncompensated canted spins. All the studies performed revealed a significant modification of structural, optical and magnetic properties with the variation of precursor concentration.

Agricultural waste materials are increasingly being used as partial replacements for cement in concrete. Several experimental studies are available to evaluate the mechanical properties of plastic waste reinforced concrete but there are limited evaluations on agricultural waste material. In this study, an attempt is made to investigate the compressive strength of Corn Cob Ash (CCA) concrete at different replacement levels by implementing an Artificial Neural Network (ANN). As the percentage of CCA increases, workability, density and compressive strength decreases, hence the developed ANN model consists of 3 input parameters (cement content, CCA content, and curing ages) in the input layer, 4 hidden neurons in the hidden layer and 3 output parameters (slump, density, and compressive strength) in the output layer. Training is done by adopting Levenberg-Marquardt back-propagation algorithm by considering 80% of experimental data with log-sigmoid activation function for both hidden and output layers. The developed model has a high correlation coefficient of 0.999 for both the training and testing data sets. It has low MSE and MAPE values of 2.2768x10-5 and 1.25 for training data respectively and 3.0463x10-5 and 1.37 for testing data respectively. Hence, it is concluded that the developed model predicts the output at an average rate of 98% accuracy. The predicted 2.5% replaced CCA concrete shows the best performance at all curing ages. Therefore, this percentage level is considered as an optimum replacement level which does not much affect the hardened properties of concrete.

Background and Objective: Correction of vertical maxillary excess (VME) via superior surgical repositioning of the maxilla can lead to counterclockwise rotation of the mandible along with alteration of jaw relationship and dental occlusion. The aim of this study was to determine the interrelationship between surgical superior repositioning of the maxilla and lower incisors inclination change after mandibular autorotation. Methods: In this correlational study, 13 patients with Class II malocclusion, mandibular plane angle greater than 27 degrees, and fully-erupted lower second molars were examined. Superior maxillary repositioning of 4mm was simulated on lateral cephalometric radiographs and maxillary dental models. Degree of mandibular autorotation was then predicted on lateral cephalograms, considering radiographic center of the condyle as the center of rotation, and on semi-adjustable articulator, measuring the articulator’s upper arm inclination change in degrees by digital inclinometer. As lower incisors rotate on the same arc of rotation as the mandible, measuring mandibular autorotation also indicates the amount of change in lower incisors’ inclination. Findings: Mean (standard deviation) values of mandibular autorotation and lower incisors’ inclination change after 4mm superior repositioning of the maxilla were 3.38±0.93 and 2.63±0.83 degrees based on Prediction Planning and Model Planning techniques, respectively. The difference between two methods was statistically significant (p

Background and Objective: Stability is one of the major issues in orthodontics. The purpose of this study is to investigate the effect of Low-Level Laser Therapy on the rate of relapse of mandibular incisors. Methods: This Single-blinded Randomized Controlled Trial consisted of twenty patients (aged 12-18 years) seeking orthodontic treatment. The subjects were divided into two groups with randomly permuted blocks (n=10): experimental and control groups. The Little’s irregularity index was measured on plaster models prior to treatment using American Board of Orthodontic Measuring Gauge. After unraveling of initial crowding, archwires on mandibular anterior segments of both groups were removed. The experimental group received Low-Level Diode Laser at 808 nm wavelength, 250 mW power, 4J energy and continuous wave mode, on coronal third of lower central and lateral incisors and canines’ roots for sixteen seconds three times a week, within a four-week period. The relapse rate was quantified on each plaster model using Little’s irregularity index at the end of first (T1), second (T2), third (T3), and fourth (T4) weeks. Findings: The study population consisted of twenty patients aged 12-18 years who had 5-9 mm crowding and proper oral hygiene. At T1, the relapse rate was 0 mm and 0.05±0.15 mm in experimental and control group, respectively, which was not statistically significant (p=0.343). Over the following weeks, however, there was statistically significant difference between the relapse rate of the two groups (p=0.003). The mean rate of relapse percentage was 4.48±4.31 mm in experimental and 12.06±5.52 mm in control group, which was significantly lower in Low-Level Laser Therapy group. Conclusion: The application of Low-Level Laser Therapy at 808 nm wavelength on mandibular incisors during orthodontic retention phase may slow down the relapse rate. Therefore, it could be considered as an effective adjunct to reduce immediate relapse.

Background: Fine-needle aspiration (FNA) has been challenged about its role in the management of patients with clinical suspicion of infective or neoplastic etiology but cytological picture showing features of acute suppuration. This study emphasizes the need to perform repeat FNA cytology (FNAC), especially if the mass lesion is indicating suppuration and has not responded to the initial course of antibiotics. Materials and Methods: All patients with a previously diagnosed suppurative lesion on cytology smears who have undergone repeat FNA were included in the study. Insufficient material on FNA and the nonavailability of slides were excluded from this study. Results: Repeat FNA assisted in the detection of malignant lesions (3), tubercular lesions (20), fungal lesions (9), and benign lesions (9) out of the 123 cases of previously diagnosed acute suppurative lesions. Comparison of FNAC findings with histopathological specimens was available for 52 cases, following which repeat FNA had a sensitivity of 66.67% (95% confidence interval 34.89%-90.08%) in detecting neoplastic, specificity was 100%, positive predictive value was 100%, negative predictive value was 90.91%, and the total diagnostic accuracy was 92.31%. Conclusion: Patients with acute suppurative lesions should be followed by repeat FNA, especially if the lesion is not responded to initial antibiotic therapy. Repeat FNA will enhance the diagnostic accuracy of malignant lesions and many other lesions, such as fungal or tubercular infections. It will reduce the need for surgical interventions and molecular detection of infectious diseases.

Malignant and potentially malignant epithelial lesions are often associated with various abnormalities such as epithelial dysplasia, abnormal DNA content, loss of heterozygosity, and chromosomal number aberrations. Screening and early detection of such abnormalities facilitates proper care and also helps to prevent further progression of potentially malignant lesions to malignancy. In such way, the presence of DNA aneuploidy in oral potentially malignant disorders (OPMDs) may serve as an indicator for the malignant transforming potential. Various assessment methods have been proposed to find the DNA ploidy status of cells. This current systematic review is mainly designed to assess the importance of ploidy status in OPMD while measuring the feasibility of using this biomarker for evaluating the hazard of malignant transformation. As an upshot of this systematic review, we can conclude that use of DNA ploidy status can serve as an independent bio-marker for predicting the malignant transformation of lesions. Furthermore, as a future scope the use of DNA ploidy analysis in normal mucosa of smokers will help to assess the malignancy risk and this technique might also help to predict the genetic predisposition of patients with malignancy.

Background: Oral candidiasis is an opportunistic fungal infection of the mucus membrane, where Candida albicans (C. albicans) is commonly responsible for the infection, especially in immune-compromised patients. Resistance of Candida species to antifungal drugs has led clinicians to pay more attention to alternative therapy. Punicalagin, isolated from pomegranate peel, was reported to be effective against C. albicans. This study compares the efficacy of Punica granatum peel extract gel 0.2% with topical clotrimazole in oral candidiasis. Materials and Methods: Forty-four oral candidiasis patients aged 20–67 years of either sex were enrolled. The swab samples from the oral lesion were collected for periodic acid Schiff (PAS) staining, and a quantitative analysis of Candida species was carried out. They were randomly divided into two groups. Group I subjects were administered a topical application of P. granatum gel 0.2%. Group II subjects were administered clotrimazole 1%. Both medicaments were administered in the form of a topical gel thrice a day for 14 days. Follow-up was done on the 7th and 14th days. Results: Reduction in burning sensation measured with the mean visual analog scale (VAS) score was from 2.0238 to 1.3095 in group I and from 1.4783 to 0.8913 in group II. Reduction in the lesion size from baseline to post-treatment was from 1.652 to 0.781 in group I and from 0.939 to 0.439 in group II. Also, a reduction in candidal colony count from baseline to post-treatment was observed in both groups. The taste and tolerability of punicalagin were acceptable. Conclusion: P. granatum 0.2% is safe, well tolerated, and effective for oral candidiasis.

Background and Aim: Medical emergencies can happen habitually in dental setting. It is ultimately a dentist's responsibility to foresee the situation and manage it effectively. The aim was to assess the knowledge, attitude, and practice of dental interns and postgraduates regarding managing medical emergencies in dental chair. Materials and Methods: A cross-sectional study was conducted for a period of 6 months from June 2021 to November 2021 on postgraduates and dental interns studying in dental colleges in and around the Chennai city. A pre-validated questionnaire consisting of 20 close-ended questions was circulated through Google forms. It consisted of questions on experience of medical emergencies encountered by interns during their graduation, knowledge about the essential drugs and equipment, amount of medical emergency training undertaken by participants, and preparedness of interns in handling of medical emergencies. Extracted data were statistically analysed by the Chi square test. Results: Of 217 participants, only 50.63% of interns and 49.37% of postgraduates had good knowledge about drugs used in medical emergencies; 71.65% of interns and 28.35% of postgraduates had come across medical emergencies and were confident enough in handling them during their practice. Also, 64.79% of interns and 35.21% of postgraduates were well informed about treating patients with airway obstruction, haemophilia, diabetes, epilepsy, spontaneous bleeding after extraction, acute asthmatic attack, and adrenal crisis. Conclusion: The majority of postgraduates had a good knowledge about management of medical emergencies in dental chair while the interns lacked confidence in handling some of the medical emergencies.

Climate change impacts on vertebrates have many implications. The thermal conditions of vertebrates during incubation are known to influence morphological, physiological, and behavioral traits. Thus, incubation temperatures have consequences for ecological and evolutionary processes, and for certain reptiles can determine sex. For oviparous reptiles, information on the thermal environment of nests is often used to estimate sex ratio, metabolic heat, and their effects on hatching success. This critical baseline information is not always available for all species in all regions, hampering our ability to design analyses that could direct future management and conservation actions. Such is the case for green turtles in the Mediterranean, which nest at many different sites but few of which have had their thermal environment documented in detail. We recorded temperature in 225 green turtle nests (between 2009 and 2013) and 12 control sites in the sand (15, 30, and 45 m distance from high tide line between 2010 and 2013) at 75 cm depth at Akyatan beach, Turkey. The mean temperature of the nests ranged from 28.4 to 33.5°C, and those experiencing high temperatures exhibited low hatching success. The observed thermal environment within the nests exhibited a narrow range relative to the control sites, with daily temperature fluctuations in nests ranging from 0.1°C up to 4.5°C. The nest temperature was strongly negatively correlated with incubation duration, while metabolic heating was highest in the last third of the incubation duration, and was significantly correlated to clutch size.

Abstract Background Small vessel childhood primary angiitis of the central nervous system (SV-cPACNS) is a rare disease characterized by inflammation within small vessels such as arterioles or capillaries. Case presentation We report a case of SV-cPACNS in an 8-year-old boy confirmed by brain biopsy. This patient was also incidentally found to have anti-glial fibrillary acidic protein (GFAP) antibodies in the cerebrospinal fluid (CSF) but had no evidence of antibody-mediated disease on brain biopsy. A literature review highlighted the rarity of SV-cPACNS and found no prior reports of CSF GFAP-associated SV-cPACNS in the pediatric age group. Conclusion We present the first case of biopsy proven SV-cPACNS vasculitis associated with an incidental finding of CSF GFAP antibodies. The GFAP antibodies are likely a clinically insignificant bystander in this case and possibly in other diseases with CNS inflammation. Further research is needed to determine the clinical significance of newer CSF autoantibodies such as anti-GFAP before they are used for medical decision-making in pediatrics.

Context: Schizophrenia is mostly treated with atypical antipsycotics, which may be required for lifetime. Olanzapine is commonly used in this condition, whereas levosulpiride is approved in India for the same. Knowing the effect of these drugs on psychomotor function helps in choosing a suitable drug to a particular patient based on his daily activities. Aims: The aim is to compare the effect of levosulpiride and olanzapine on psychomotor performance, efficacy, and adherence in patients with schizophrenia. Settings and Design: This was open-label, parallel arm, prospective observational study carried out in a tertiary care hospital of central India from December 2019 to December 2021. Subjects and Methods: Thirty-six patients visiting psychiatry OPD, diagnosed by treating psychiatrist as schizophrenia were assessed by CFFT, hand steadiness test (HST), arithmetic ability test, and reaction time (RT) for psychomotor function, and symptoms were scored on positive and negative syndrome scale (PANSS) and brief negative symptom scale (BNSS) rating scales at the first visit, end of 4 and 8 weeks. Adherence was assessed by the Medication adherence rating scale at 8 weeks. Results: Statistically significant increase in RT was seen in both levosulpiride (P = 0.04) and olanzapine (P = 0.0065) groups, whereas only the olanzapine group had a significant change in CFFT (P = 0.04) and HST (P = 0.01) at 8 weeks. On head-to-head comparison, a statistically significant worsening in HST score (P = 0.01) was seen in olanzapine group. Both the groups had significant decreases in all PANSS (P < 0.001) and BNSS (P < 0.001) scores. When change in PANSS and BNSS scores were compared with each other, the levosulpiride group had a significantly more decrease in scores on PANSS negative scale (P = 0.03). Patients in both groups were adherent to treatment. Conclusions: Our study concluded that levosulpiride is better than olanzapine on its fine motor control. Both the drugs increase RT while only olanzapine worsened fine motor control and CFF. Both the drugs were effective for schizophrenia with 8 weeks treatment, while levosulpiride is superior to olanzapine in improving negative symptoms of schizophrenia.

Background: For effective policy making, it is important to understand out of pocket costs incurred in neonatal admissions in public hospitals. This cross sectional study was conducted with an objective to estimate out of pocket expenses expended on neonates and attenders during neonatal hospitalizations in a tertiary care referral hospital. Material and Methods: The data were collected using a pretested and semi structured questionnaire in 298 neonates during July'2022. Expenditures were reported as median values with interquartile range (IQR) and compared using the Kruskal Wallis test. Result: On analyzing the results, there were no direct medical costs. The median cost spent on food per day, transport during the stay, non medical expenses per day, and total expenses per day were Rs. 300 (IQR 200, 500), Rs. 1000 (500, 1500), Rs. 500 (333, 896), and Rs. 1080 (800, 1533), respectively. Higher expenses were associated with preterm, low birth weight, neonatal seizures, and longer stay (P values

Introduction: The bleaching of the teeth is known to reduce the bonding of the orthodontic brackets. Hence, this in vitro study was piloted to analyze if there was any variance between the teeth that were and were not bleached when the adhesive boosters were used and for its effect on the shear bond strength. Materials and Procedures: Hundred premolars (maxillary) that had been excised were randomly split into two groups: bleached teeth and unbleached teeth. The bleaching agent was gel composed of 22% carbamide peroxide. Maxillary premolar brackets were bonded, and each group was subdivided as control and adhesive booster Enhance LC groups. A universal testing device was used for debonding. The SBS thus recorded was compared for the subgroups and groups. Results: Significant variance was obtained for between the groups and between the subgroups. Higher bond strength was for the non-bleached teeth than the bleached teeth and was seen in the adhesive booster subgroup than the control group. Conclusion: In summary, adhesive boosters dramatically raised the shear bond strength of teeth irrespective of the bleaching. Further in vivo studies are suggested.

The challenge of creating reliable technology-based resources for science learning is a perennial challenge in Philippine education, with limited learning materials accessible to all learners. This study is about the development of a videocast embedded with physics education technology (PhET) simulation that served as supplementary learning material for grade 9 science in response to the scarcity of dependable visualization materials. The study employed the developmental research design with analysisdesign-development-implementation-evaluation (ADDIE) model as the developmental framework. The vodcast evaluation tool, achievement test questionnaire, and vodcast perception survey questionnaire for students and teachers were used in the data collection, while the Kendall's W statistic, mean, percentage, and gain score were used in the data interpretation. The teacher respondents (N=64) have moderate agreement on the ranking of topic difficulty, with Kendall's W of 0.45. The researcher-made vodcast attained an overall rating of 4.78 from experts, which implies that the vodcast can be very good material for classroom implementation. The developed achievement test has acceptable difficulty and discrimination indices. The implementation stage yielded a low normalized gain, which can be accounted for by unfocused attention during the pandemic. Nevertheless, the voicecasts were found very useful in learning projectile motion, as perceived by both students and teacher-observers.

This article highlights the nascent efforts between College Unbound, Brown University, and Providence College--three very different types of institutions in Providence, Rhode Island--to foster cross-institutional capacity for place-based community engagement. By collectively engaging our institutions, we experimented with what collaboration around community engagement might look like within our local context. In this article, we share our approach and reflections in working to cultivate a place-based collaboration that is community-centric and grounded in students' lived experiences, along with limitations, lessons learned, and next steps related to our collaborative work. Through our efforts, we situate cross-institutional collaborations as an opportunity for more sustained and transformative work within higher education community engagement.

The technology-supported education systems seamlessly integrated throughout the globe in response to the demands of post COVID-19 pandemic. The swift developments of the digital tools with Artificial Intelligence (AI) support are also readily diffused among the educational communities. This research paper investigates the synergistic impact of digital literacy, the incorporation of AI tools, and Peer Supported Collaborative Learning (PSCL) on the learning perceptions of university students. The research aims to discern the implications of these technological and social facets on students' attitudes towards AI assisted learning process. Structured questionnaire-based survey among the University students were done for this descriptive research. 409 responses collected were analysed with SPSS, Excel and Process Macro. It is found that the students' Digital Literacy, Use of AI tools and PSCL on AI assisted learning were positively correlated. The partial mediatory path through the PSCL and AI tool usage has a significant positive influence on students learning process. The insights gathered from this study can inform educators, policymakers, and institutions on optimizing the amalgamation of digital literacy, AI tools and PSCL to enhance the contemporary learning environment. As universities navigate the digital age, this research provides a nuanced understanding of the dynamics shaping students' perceptions, offering valuable insights into the multifaceted aspects of AI influencing the educational landscape.

We theoretically study the generation of attosecond XUV pulses via high-order frequency mixing (HFM) of two intense generating fields, and compare this process with the more common high-order harmonic generation (HHG) process. We calculate the macroscopic XUV signal by numerically integrating the 1D propagation equation coupled with the 3D time-dependent Schrödinger equation. We analytically find the length scales which limit the quadratic growth of the HFM macroscopic signal with propagation length. Compared to HHG these length scales are much longer for a group of HFM components, with orders defined by the frequencies of the generating fields. This results in a higher HFM macroscopic signal despite the microscopic response being lower than for HHG. In our numerical simulations in a gas target, the intensity of the HFM signal is several times higher than that for HHG, while for a plasma target the HFM generation efficiency is up to three orders of magnitude higher than for HHG. The HFM with relatively long generating pulses provides very narrow XUV lines ( $\delta \omega / \omega = 4.6 \times 10^{-4}$ ) with well-defined frequencies, thus allowing for a simple extension of optical frequency standards to the XUV range. Finally, we show that the group of HFM components effectively generated due to macroscopic effects provides a train of attosecond pulses such that the carrier-envelope phase of an individual attosecond pulse can be easily controlled by tuning the phase of one of the generating fields.

Composite materials are supposed to be used extensively as an alternate Al structure in aircraft, aerospace, and automobile applications. The main objective of this work is to carry out a finite element analysis (FEA) of Hemp Fiber Reinforced Cellulose Filled Epoxy Composites (HFRCFEC) was analyzed in the ANSYS multiphysics simulation software. In this analysis, the 3D models were designed using Creo, and it is incorporated in the Ansys for predicting the behavior of HFRCFEC and AA 6061. A plate is considered heterogeneous, and also effective moduli and strength properties differentiate the maximum stress and strain. It is found that HFRCFEC reinforced doors have withstood the maximum tensile strength of 53 MPa, the flexural strength of 153 GPa, the impact strength of 0.85 KJ/mm, and the compressive strength of 215 MPa, which were more superior when compared to conventional doors. The buckling load was carried out in Ansys to check the safe area and found that HFRCFEC has high buckling torque of 31153 (Nm) than the standard aluminum door buckling torque of 4403 (Nm). From the FE Simulation carried out in various conditions, it is found out that HFRCFEC composite exhibits superior properties to aluminum doors.