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Abstract In this paper, we study a non-minimal gauged U 1 L μ − L τ $$ \textrm{U}{(1)}_{L_{\mu }-{L}_{\tau }} $$ model, where we add two complex singlet scalars, three right-handed Majorana neutrinos (RHN), and a vector-like dark fermion to the Standard Model (SM), all non-trivially charged under the extra gauge symmetry. The model offers an easy resolution to the muon (g – 2) anomaly, which fixes the scale of spontaneous symmetry breaking. Furthermore, the two-zero minor structure in the RHN mass matrix provides successful predictions for neutrino oscillation parameters, including the Dirac phase. The extended scalar sector can easily induce first-order phase transitions. We identify all possible phase transition patterns in the three-dimensional field space. We quantify the associated gravitational waves from the sound wave source and demonstrate that the signatures can be observed in future space-based experiments. We find that strong first-order phase transitions require large values of scalar quartic couplings which constrain the scalar dark matter (DM) relic density to a maximum of 10−2 and 10−5 when we consider the DM direct detection bound. Nonetheless, the model successfully explains the DM relic density via contribution from the vector-like dark fermion. We show the allowed range of the model parameters that can address all the beyond SM issues targeted in this study.

Abstract This study provides an analysis of atmospheric neutrino oscillations at the ESSnuSB far detector facility. The prospects of the two cylindrical Water Cherenkov detectors with a total fiducial mass of 540 kt are investigated over 10 years of data taking in the standard three-flavor oscillation scenario. We present the confidence intervals for the determination of mass ordering, θ 23 octant as well as for the precisions on sin2 θ 23 and Δ m 31 2 $$ \left|\Delta {m}_{31}^2\right| $$ . It is shown that mass ordering can be resolved by 3σ CL (5σ CL) after 4 years (10 years) regardless of the true neutrino mass ordering. Correspondingly, the wrong θ 23 octant could be excluded by 3σ CL after 4 years (8 years) in the case where the true neutrino mass ordering is normal ordering (inverted ordering). The results presented in this work are complementary to the accelerator neutrino program in the ESSnuSB project.

Category: Ankle; Midfoot/Forefoot Introduction/Purpose: Wound complications, whether superficial or deep, can be challenging to manage after orthopaedic foot and ankle surgery. Intra-operative application of topical vancomycin powder within surgical wounds has shown promise in reducing surgical site infections (SSI) among patients with diabetes, lower extremity trauma, and following spine surgery. However, there are few studies with large patient populations that examine its use in orthopaedic foot and ankle surgery. The purpose of this study is to retrospectively evaluate and compare postoperative wound complications following foot and ankle surgery with and without intra-operative application of topical vancomycin powder within the surgical wound(s). We hypothesize that patients who received topical vancomycin within their surgical wound(s) will have lower rates of wound complications than those without. Methods: 367 patients that received foot and ankle surgery were retrospectively included in this study, with 93 and 274 patients with and without the use of topical vancomycin within surgical wounds during surgery, respectively. All surgeries were performed by a single fellowship-trained orthopaedic foot/ankle surgeon from February 2019 - October 2023. Exclusion criteria were patients that were minors, with wounds too small for usage of topical vancomycin, or receiving surgery for treatment of an infectious condition. Retrospective chart review was performed to identify patient demographics, comorbidities, and post-operative outcomes including the incidence and nature of superficial and deep wound complications. Chi-squared and independent samples t-tests were performed to determine statistically significant differences in patient characteristics and post-operative wound problems between these two groups. Results: There were no statistically significant differences in patient demographics between both study groups. The only statistically significant difference in medical comorbidities between both study groups was that more patients that did not receive intra-operative topical vancomycin were nicotine users (P=0.013). 13 of 93 (14%) and 27 of 274 (10%) patients that did and did not receive intra-operative topical vancomycin at their wound(s) respectively developed post-surgical superficial wound complications without SSI (P=0.270). 5 of 93 (5%) and 8 of 274 (3%) patients that did and did not receive intra-operative topical vancomycin at their wound(s) respectively developed post-surgical deep wound complications with SSI (P=0.268). There was no statistically significant difference in hospital readmission rates between the two study groups. Conclusion: This study demonstrates that the intra-operative use of topical vancomycin powder at surgical wounds does not significantly decrease the incidence of superficial or deep wound complications in foot and ankle surgery. Despite its reported value in preventing wound complications and/or surgical site infection in prior literature, this study showed no such benefit in the patient populations examined. Studies that are prospective with a larger patient population may be needed to further confirm this reported lack of difference when using topical vancomycin intra-operatively to minimize post-surgical wound complications.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Total ankle arthroplasty (TAA) has become a viable option for the treatment of end-stage ankle arthritis. Initiation of weightbearing after a TAA has traditionally been conservative with anywhere from 6 to 12 weeks of non-weight bearing recommended by surgeons. To date, there has been a paucity of literature examining the impact of early weightbearing after TAA on postoperative outcomes. The objective of this study was to compare weightbearing at 3 weeks versus 6 weeks on functional recovery after primary TAA. We hypothesized that patients allowed to weight bear at 3 weeks would exhibit greater improvements in range of motion (ROM) without any increase in postoperative complications. Methods: In this retrospective cohort study, we analyzed patients who underwent a primary TAA by a single surgeon from January 2018 to March 2023 using the INBONE 2 prosthesis. These patients were separated into 2 groups – those who began initiation of weightbearing at 3 (n=50) weeks and those at 6 (n=27) weeks. Basic demographic data and postoperative complications was collected for both groups. Ankle ROM was collected and measured from both pre- and postoperative ankle dorsi-flexion and plantar-flexion radiographs at routine postoperative visits. Postoperative complications were additionally subcategorized into major or minor. Comparisons between groups were performed with Student T-test for independent variables, paired T-test for in-group comparisons, and Chi-square test for categorical variables with P < 0.05 considered to be statistically significant. Kaplan-Meier survival plots were created for overall, minor, and major complication rates. Results: Sex, smoking status, diabetes, obesity, and arthritis etiology did not statistically differ between groups. The 3-week weightbearing group was significantly older than the 6-week group (67.8 years vs 61.1 years, respectively, P=0.013). Patients in the 3-week group had statistically greater improvements in their postoperative ankle ROM at 6 weeks, 6 months, 1 year, and 2 years compared to their preoperative ankle ROM. Furthermore, patients in the 3-week group had statistically greater increases in postoperative ankle ROM at 6 weeks, 6 months, and 1 year compared to their 6-week counterparts. Total number of overall, minor, or major complications did not differ significantly between groups. The time to first overall, minor, or major complication also did not differ significantly between groups. Conclusion: The initiation of early weightbearing at 3 weeks postoperative after a primary TAA appears to bring about greater improvements in postoperative ankle ROM compared to preoperative ROM that is sustained even out to 2 years postoperative. Furthermore, the early weightbearing group demonstrated increased ankle ROM compared to the delayed weightbearing group at medium-term follow-up without any increase in complications. These findings suggest earlier initiation of weightbearing after a primary TAA is safe and even beneficial in terms of motion.

Background: Chronic inflammation of the tooth’s supporting tissues is known as periodontal disease. It causes pockets to develop, attachments to break, and eventually the loss of teeth. Because of their well-known anti-inflammatory qualities, omega-3 fatty acids have been recommended as an additional therapy for periodontal inflammation. Materials and Methods: A randomized controlled study of 60 individuals suffering from persistent periodontitis was carried out. Two groups of participants were randomly assigned: The test group (n = 30) got conventional periodontal treatment with omega-3 fatty acid supplementation (1000 mg/day), while the control group (n = 30) received normal periodontal therapy alone. Measurements of periodontal parameters were made at baseline, 3 months, and 6 months after therapy, including bleeding on probing (BOP) and pocket depth. Paired t-tests and analysis of variance were used in the statistical analysis to determine the significance of the group differences. Results: Participants in the test group showed a greater reduction in probing pocket depth (PPD) and BOP at both 3 and 6 months. Specifically, the mean PPD decreased from 5.4 ± 0.7 mm to 3.0 ± 0.4 mm, and BOP reduced from 71.2 ± 14.5% to 28.3 ± 9.2% in the test group, with both outcomes showing statistically significant differences compared to the control group (P < 0.01). Conclusion: In individuals with chronic periodontitis, omega-3 fatty acid supplementation dramatically improves the decrease of periodontal pocket depth and inflammation when administered as an adjuvant to regular periodontal treatment.

Background: Tobacco use is a leading cause of preventable diseases, including oral cancer and periodontal disease. Dental settings offer a unique opportunity for tobacco cessation interventions due to the frequent patient–dentist interactions. Materials and Methods: A randomized controlled trial was conducted across 20 dental clinics. Participants included 400 adult tobacco users who were randomly assigned to either an intervention group (n = 200) or a control group (n = 200). The intervention group received a comprehensive tobacco cessation program consisting of behavioral counseling, nicotine replacement therapy, and follow-up sessions over 6 months. The control group received standard care, which included general advice on quitting tobacco. Data on tobacco use, quit rates, and oral health status were collected at baseline, 3 months, and 6 months. Statistical analysis was performed using SPSS 24.0, and significance was set at P < 0.05. Results: At 6 months, the intervention group showed a significantly higher quit rate (45%) compared to the control group (20%) (P < 0.001). Additionally, participants in the intervention group exhibited significant improvements in oral health parameters, including reductions in periodontal pocket depths (a mean reduction of 2.5 mm) and improvements in gingival health scores. Satisfaction with the program was high among participants in the intervention group, with 85% reporting they would recommend the program to others. Conclusion: The tobacco cessation program implemented in dental settings significantly increased quit rates and improved oral health outcomes compared to standard care. These findings suggest that integrating tobacco cessation programs into routine dental practice can effectively reduce tobacco use and enhance oral health.

IntroductionContextually responsive implementation support strategies are needed to enhance the integration of mental health services into primary health care. Technical assistance is widely used as a core “capacity building” strategy, primarily for increasing the motivation and capacity of individuals (e.g., frontline workers) to adopt evidence-based interventions in healthcare settings. This article documents the systematic design of a technical assistance strategy for supporting primary care staff (e.g., nurses) in integrating depression care, from screening to treatment, aligned with a non-communicable disease program across seven health facilities in the Sehore District of Madhya Pradesh, India.MethodsWe conducted a mapping exercise of local health facilities with dedicated staff and a literature review to inform the development of the technical assistance strategy.ResultsReporting guidelines guided the structure of the strategy protocol. The evidence-supported strategy, called Remote Coaching Support, is tailored to the local setting. It uses quality improvement methods like the Plan-Do-Act-Study cycle and training materials to help coaches deliver support remotely via video/phone-based calls and WhatsApp messaging with the overall goal of increasing uptake and fidelity of depression screening and referral among primary care staff in alignment with an existing non-communicable diseases program.ConclusionThe development of Remote Coaching Support involved iterative improvements through team meetings and practice-training feedback, though limitations exist due to a lack of systematic implementation standards, especially in this setting. This strategy will be tested in increasing scales to refine its application, with effectiveness and acceptability results to be evaluated in a randomized control trial.

This work examines shrimp shell waste as a promising raw material for biodiesel production. Prawn shells, comprising 30–40 % protein, 20–30 % chitin, and 20–30 % calcium carbonate, also contain lipids that can be efficiently converted into biodiesel, with solvent extraction yielding 90 % of lipids. The use of ZnO nanoparticles as a catalyst boosts biodiesel production from 80 % to 95 %, increasing catalytic activity by 20 %. Recent advancements in ZnO synthesis have reduced production costs by 15–20 %, making ZnO an attractive catalyst due to its reusability and stability over multiple cycles. Additionally, converting chitin from shrimp shells into chitosan has economic potential, reducing waste by 50,000 tons annually and generating $10–15 million in revenue. However, challenges remain, including the scalability of lipid extraction and the durability of ZnO nanoparticles, which can decline by 10–15 % over time. Further research is required to enhance ZnO stability and improve large-scale lipid extraction methods. This work underscores biodiesel's environmental and economic benefits, supporting global sustainability efforts through waste reduction and renewable energy expansion.

This article introduces a novel method for designing a fast chaotic oscillator using a CCTA (Current Conveyor Transconductance Amplifier) based on Chua's circuit. The proposed method uses innovative configurations and advanced simulation techniques to overcome challenges in high-speed operation, nonlinear dynamics, and Analog Building Block (ABB) selection. The design begins with nonlinear negative resistance, essential for Chua's diode characteristics, including two negative resistances, NR1 and NR2. The circuit integrates one CCTA block, two grounded capacitors, two fixed resistors, one inductor, and one potentiometer. It is simulated using PSPICE with IC (Integrated Circuit) macro-models and 180nm CMOS (Complementary Metal Oxide Semiconductor) technology. Various chaotic waveforms and attractors are produced, validating the theoretical and mathematical predictions. By varying the resistance values (1450Ω, 1650Ω, 1800Ω, 1950Ω), the circuit exhibits different chaotic behaviors, such as large limit cycles, double-scroll attractors, Rossler-type attractors, and I-periodic attractors. FFT (Fast Fourier Transform) analysis confirms the highest dominant operating frequency of 37.5MHz. A Monte Carlo simulation with 100 runs shows maximum voltage variations in the chaotic waveforms of 5.21 % and 4.61 % across the capacitors, demonstrating robustness and reliability. This design offers significant advancements in implementing high-frequency chaotic oscillators, with potential applications in various fields requiring chaotic signal generation. • A novel design of Chua's diode and Chua's chaotic oscillator using only one CCTA block is presented in this paper. • The proposed chaotic oscillator achieves the highest operating frequency of 37.5MHz. • The proposed circuit is simulated using commercially available ICs (MAX435 and AD844) and CMOS 180nm technology in PSPICE to confirm its workability.

Personalized medicine, leveraging patient-specific genomic data, is revolutionizing treatment paradigms by enabling tailored therapies to individual needs, thus mitigating adverse effects and enhancing clinical outcomes. One innovative application in this field is the use of 3D bioprinting technology to design, develop and screen patient-customized medicines. This technology meticulously designs and develops therapeutic drugs by depositing active pharmaceutical ingredients layer by layer, culminating in a drug delivery structure optimized for the patient's unique dosage requirements. 3D bioprinting represents an emerging confluence of biological sciences and additive manufacturing, meeting the clinical demand for functional biological tissues through the integration of printing technologies, regenerative medicine principles, and advanced material science. This review provides an overview of the current state of 3D bioprinting applications and explores the transformative potential of 3D bioprinting in personalizing medicine. Moreover, the review elucidates the capabilities of 3D bioprinting in drug design, facilitating the production of complex therapeutic regimens in specific dosage forms, such as drugs with tailored dose concentrations, controlled release kinetics, and the capacity to combine multiple therapeutic regimens into a single, easy-to-administer format. This paper also addresses the challenges and obstacles faced in integrating 3D bioprinting techniques into pharmaceutical practice, ranging from technical and regulatory hurdles to scalability. Further, the efficacy of 3D bioprinting as a tool for advancing personalized medicine helps to utilize the full potential of this technology to enhance patient healthcare regimes.

This case report details the unusual presentation of a 6-year-old male child who had an asymptomatic, well-defined, brown raised lesion over the vertex area of the scalp since birth. His parents noticed a new growth with finger-like projections over existing old lesions for 1 year. With an initial diagnosis of growth of verruca over nevus sebaceous (NS), a sample for histopathology study was sent which revealed findings consistent with squamous papilloma occurring on NS. This is reported to emphasize that any growth over NS should be confirmed histopathologically due to the rarity of this association and to reduce the possibility of its malignant potential. The article emphasizes how crucial histological analysis is to clarifying mistaken cutaneous lesions and refining an accurate diagnosis.

Introduction: Increased Pulse Pressure (PP) and arterial stiffness are both associated with an elevated risk of Cardiovascular Disease (CVD). Raised PP is an independent prognostic marker for CVD not only in adults but also in young normotensive subjects. Normotensive Offspring of Hypertensive Parents (OHP) are more likely to develop future hypertension. Visceral obesity, closely tied to endocrine activity, magnifies susceptibility to hypertension and CVD development in young adults. Thus, understanding the association between visceral fat and PP assumes paramount importance in young adults. Aim: To study the correlation between visceral fat and PP in young offspring of hypertensive and normotensive parents. Materials and Methods: The cross-sectional study was conducted in the Department of Physiology, Government Medical College, Datia, Madhya Pradesh, India for eight months from June 2023 to January 2024 among 140 healthy young participants aged 18-25 years. The subjects were divided into two groups: Group-1 {Offspring of Normotensive Parents (ONP)} and Group-2 offsprings of Hypertensive Parents (OHPs). Body composition parameters and visceral fat levels were measured using a calibrated Karada scan. Detailed information regarding the history of hypertension in the family, alcohol intake, etc., was collected in a pre-defined proforma. Blood pressure measurements of subjects were taken using a standard electronic sphygmomanometer. Statistical analysis of the data was conducted using Statistical Package for Social Sciences (SPSS) Version 28.0 software. For correlational analysis, Pearson correlation test was used and a p-value

The options trader’s decisions are expected to be rational decisions but an element of irrationality is observed in decision making. The Disposition effect is the behavioral aspect of an investor which explains his irrational decision-making. The disposition effect is the tendency to keep losing positions too long and selling winning positions too early. The present research work studies the disposition effect in options trading. Options are derivatives of underlying assets which give the holder the right to exercise them at a given date and price. In this research work, elements of disposition effect namely,Herding (HE), Mental accounting (MA), Risk Aversion (RA) are studied along with Trade enablers (TE) and Cost consciousness (CC). The data was collected from 250 respondents’ trading options on the National Stock Exchange, India. The collected data was analyzed using Structured Equation Modeling (SEM). The results reflected that the disposition effect existed in decision-making by options traders. Trade Enabler consisting of Time decay and Open Interest, and Herding emerged as significant elements of disposition effect for options trading. Mental accounting, risk aversion, and cost-consciousness emerged as less significant elements affecting the disposition effect in options trading.

Hypoplastic left heart syndrome (HLHS) is a complex congenital heart defect (CHD) characterized by a spectrum of underdeveloped left-sided cardiac structures. It is a serious defect and warrants either 3-staged surgical palliation or a heart transplant. Despite numerous surgical advancements, long-term outcomes remain challenging and still have significant morbidity and mortality. There have been notable advancements in stem cell therapy for HLHS, including developments in diverse stem cell origins and methods of administration. Clinical trials have shown safety and potential benefits, including improved ventricular function, reduced heart failure, and fewer adverse events. Younger myocardium seems particularly receptive to stem cell signals, suggesting the importance of early intervention. This review explores the potential of emerging stem cell-based therapies as an adjunctive approach to improve the outcomes for HLHS patients.