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Electrical discharge machining (EDM) is mainly utilized for the die manufacturing and also used to machine the hard materials. Pure Copper, Copper based alloys, brass, graphite, steel are the conventional electrode materials for EDM process. While machining with the conventional electrode materials, tool wear becomes the main bottleneck which led to increased machining cost. In the present work, the composite tool tip comprises 80% Copper and 20% silicon carbide was used for the machining of hardened D2 steel. The powder metallurgy route was used to fabricate the composite tool tip. Electrode wear rate and surface roughness were assessed with respect to the different process parameters like input current, gap voltage, pulse on time, pulse off time and dielectric flushing pressure. During the analysis it was found that Input current (I p ), Pulse on time (T on ) and Pulse off time (T off ) were the significant parameters which were affecting the tool wear rate (TWR) while the I p , T on and flushing pressure affected more the surface roughness (SR). SEM micrograph reveals that increase in I p leads to increase in the wear rate of the tool. The data obtained from experiments were used to develop machine learning based surrogate models. Three machine learning (ML) models are random forest, polynomial regression and gradient boosted tree. The predictive capability of ML based surrogate models was assessed by contrasting the R 2 and mean square error (MSE) of prediction of responses. The best surrogate model was used to develop a complex objective function for use in firefly algorithm-based optimization of input machining parameters for minimization of the output responses.

Abstract Background Scleral buckling has been the standard for rhegmatogenous retinal detachment repair in young patients given the typical lack of posterior vitreous detachment, phakic status, and lower risk of proliferative vitreoretinopathy. In older patients, pars plana vitrectomy alone is typically used for rhegmatogenous retinal detachment repair. We report the outcomes and complications of pars plana vitrectomy for rhegmatogenous retinal detachment in young eyes. Methods Retrospective, single-center cohort study. Medical records of patients between 15 to 45 years of age undergoing primary pars plana vitrectomy for rhegmatogenous retinal detachment repair between 2010 and 2020 were carefully reviewed. All analyses were performed using the Kruskal–Wallis tests for numeric covariates between age groups. Results Eyes were stratified by age: 15–24 (group 1, n = 10), 25–34 (group 2, n = 14), and 35–45 (group 3, n = 38). The average number of surgeries were 1.9, 1.4, and 1.1 in groups 1, 2, and 3, respectively (p = 0.004). Single surgery success rates were 50%, 64%, and 92% in groups 1, 2 and 3, respectively (p = 0.005). Final reattachment rates were 80%, 93%, 100% in groups 1, 2, and 3, respectively (p = 0.568). Proliferative vitreoretinopathy developed in 50%, 7%, and 8% of eyes in groups 1, 2, and 3, respectively (p

Abstract Background This study aimed to explore the perception of doctors regarding telemedicine consultations and the level of patient satisfaction with the services received through teleconsultations. Methods This cross-sectional study was conducted on clinicians who provided teleconsultations and patients who received teleconsultations in an Apex healthcare institution in Western India. Semi-structured interview schedules were used to record the quantitative and qualitative information. Clinicians’ perceptions and patients’ satisfaction were assessed using two different 5-point Likert scales. Data were analyzed using SPSS v.23 using non-parametric tests (Kruskal Wallis and Mann-Whitney U). Results A total of 52 clinicians who delivered teleconsultations and 134 patients who received teleconsultations from those doctors were interviewed in this study. For 69% of doctors, telemedicine was feasible to implement, and for the rest, it was challenging. Doctors believe telemedicine is convenient for patients (77%) and prevents the transmission of infection (94.2%). Difficulty in clinical evaluation (73%), communication (55.7%), network connectivity (34%), diagnosis and investigations (32%), and patients’ e-illiteracy (32%) were the most common challenges faced by clinicians. Patients’ experiences were positive in terms of ease of registration (82.1%), audio quality (100%), freedom to discuss medicine (94.8%), and comprehension of the diagnoses (88.1%). Patients expressed satisfaction with the length of the teleconsultation (81.4%), the advice and care they received (78.4%), and the manner and communication of the clinicians (78.4%). Conclusions Though there were some challenges in the implementation of telemedicine, the clinicians perceived it quite helpful. The majority of the patients were satisfied with teleconsultation services. Difficulty in registration, lack of communication, and a deep-rooted mindset of physical consultations were the primary concerns from the patient side.

Background: Achalasia cardia is a neuromuscular disorder of unknown etiology characterized by aperistalsis of the body of the esophagus and failure of relaxation of the lower esophageal sphincter. The diagnosis of achalasia cardia is delayed due to the rarity and the ability to mimic other common conditions in children. Hence, a study was conducted to evaluate the clinical presentation and the management of achalasia cardia in children. Materials and Methods: A retrospective observational study was conducted in the department of pediatric surgery at a tertiary center. The children with achalasia cardia who presented between January 2014 and December 2021 were included. Results: A total of 12 patients were treated for achalasia cardia during the study period. All children presented with recurrent episodes of vomiting, whereas dysphagia was seen in six (50%) children. Eighty-three percent of the children presented with a history of weight loss, whereas failure to thrive was seen in nine (75%) children. Five (42%) children were managed as gastroesophageal reflux disease (GERD) for more than a year before presenting to us. Three (25%) children underwent open cardiomyotomy with Thal fundoplication and the rest nine (75%) underwent laparoscopic cardiomyotomy. All are thriving well. Conclusion: Achalasia is an important differential diagnosis in children with suspected GERD. The most common symptom of achalasia cardia is vomiting followed by dysphagia. Weight loss and failure to thrive are important presenting features in children with achalasia which are uncommon in adults. Cardiomyotomy without fundoplication is safe and effective to treat achalasia cardia in children without having any extra complications.

Aim: To find out the normal mean oral temperature in the Indian population as per a longitudinal study. Background: 98.6°F is generally accepted as normal body temperature as defined by Wunderlich (1868) and later challenged by Mackowiak (1992) and Protsiv (2020) who concluded it as 98.2°F based on cross-sectional studies. Hence, the normal body temperature at present needs quantification as per a longitudinal study in Indians. Patients and Methods: A longitudinal study on the healthy population of Northern India was followed-up over 1 year. Participants were advised for self-monitoring of oral temperature with a standard digital thermometer in either left or right sublingual pocket and record it in the thermometry diary. The study was considered complete if the participant had all three phases of the study (i.e., non-febrile, febrile and post-febrile phases) or completed the duration of the study. Results: The mean oral temperature of the participants (n = 144) during the non-febrile and post-febrile phases (temperature readings = 6543) were 98.0°F (standard deviation [SD], 0.61) and 98.01°F (SD, 0.60), respectively (P < 0.001). With the diurnal variability, the morning (am), noon (an) and afternoon (pm) mean temperatures were 97.91°F, 98.08°F and 98.27°F (P < 0.001), respectively, during the non-febrile phase. Similar trends were observed in variability among men and women, seasons and across post-febrile phase. Conclusions: The mean oral temperature was 98.0°F (SD, 0.61). The temperature was as low as 96.9°F and as high as 99.1°F. The temperature during the post-febrile phase was found to be higher than the non-febrile phase temperature such as pm over an and am, women over men, summer over other seasons in the non-febrile phase and spring over others in the post-febrile phase.

Background: Due to the staggering number of tobacco users in India, it is important to determine the exact mortality and morbidity rates due to tobacco use. This study aimed to estimate deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) attributable to cigarettes, bidis, and smokeless tobacco (SLT) in India. Methods: Data pooling and meta-analysis were done using case-control studies available on the three types of tobacco products. Health burden was estimated by applying the population attributable fraction (PAF) value to the total disease burden. Findings: A total of 33 studies were included. PAF was calculated for oral and lung cancer as well as ischemic heart disease (IHD) due to cigarettes, oral and lung cancer, IHD, and chronic obstructive pulmonary disease due to bidi, and oral and stomach cancer and IHD due to SLT. Cigarettes resulted in 8.4 million DALYs, 8.26 million YLLs, and 341 deaths; bidis led to 11.7 million DALYs, 10.7 million YLLs, and 478 thousand deaths, and SLTs accounted for 4.38 million DALYs, 4.3 million YLLs, and 171 thousand deaths annually. Conclusion: Evidence of measurable health burden and methodology for calculation for individual states was provided in the study. The generated evidence could be utilized for policy recommendations and revision of the existing taxation norms.

Background: The National Program for the HealthCare of the Elderly (NPHCE) was adopted by the Ministry of Health and Family Welfare in 2010 to provide promotional, preventive, curative, and rehabilitative health-care services for the fast-growing older population in India. As literature about the assessment of NPHCE is lacking, the present study was conducted to perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the program. Methods: The SWOT of the NPHCE program is analyzed using available literature and relevant documents. Results: Although this program embraces strategies to provide specialized training and services at primary health center, community health center, and district levels, including dedicated bedded wards, equipment, consumables, and pharmaceuticals but home-based care for the elderly, and the role of caregivers is overlooked in this program. NPHCE program can utilize the framework and take support of various ongoing healthy aging initiatives of international agencies to augment the health-care strategies for the elderly in India. Integrating schemes developed by the government for the upliftment of the elderly and the inclusion of traditional medicine systems in the program can serve as an opportunity for meeting unmet needs and improving the quality of life and well-being of the elderly. However, the growing elderly population, rise in nuclear families, and dual disease burden are significant threats to the program's implementation. Conclusion: This program can be more effective in providing comprehensive health care to the elderly if more emphasis is given to community participation, home-based care, and integrating digital health technologies and other existing welfare schemes.

Background: High blood pressure (BP) in adolescents and young adults is a rising concern in today's world. Behavioral factors largely contribute toward the development of hypertension. Once these are established, they often persist throughout life, and if identified timely, might play a significant role in prevalence reduction. This study was conducted to assess the prevalence and association of hypertension and its risk factors in college students of Jodhpur district. Methodology: A cross-sectional study was conducted in ten colleges across five zones of Jodhpur district using modified WHO STEPS questionnaire and by taking physical measurements of BP, height, and weight. Descriptive analysis was done using means and percentages, and statistical significance was established using prevalence odds ratio (POR). Results: Of the 421 study participants, 251 (59.60%) were males and 170 (40.20%) were females, with a mean age of 20.12. The prevalence of risk factors and significant association were observed between gender and educational level with behavioral habits. Further, hypertension prevalence (16.15%) was found to be associated with smoking (POR = 2.72), high salt intake (POR = 3.21), physical activity (POR = 0.30), overweight (POR = 2.34), and obese body mass index (POR = 4.02). Conclusion: The study provided evidence of high prevalence of hypertension and its associated behavioral risk factors such as tobacco, salt, and physical inactivity. Such evidences may be utilized for health promotion programs for the specific age group and region.

Introduction: Despite all the advances, the mortality rate of congenital diaphragmatic hernia (CDH) ranges from 30% to 60% for isolated CDH and as high as 89% when they are associated with additional structural or chromosomal anomalies. Hence, a study was conducted to evaluate the factors contributing to the mortality of neonates treated for CDH or the eventration of diaphragm. Materials and Methods: A retrospective study was conducted in the department of paediatric surgery at a tertiary centre. The neonates admitted with a diagnosis of CDH or eventration requiring surgery, between March 2013 and March 2021, were included in the study. Results: A total of 123 neonates were included in the study. The variables, earlier median age at presentation (1 [1–23] vs. 3 [1–28]; P < 0.001; Mann–Whitney U-test), preterm birth (10/79 vs. 0/44; P = 0.01; Fischer's exact test), inborn (68/79 vs. 27/44; P = 0.002; Chi-square test), weight ≤2 kg (18/79 vs. 1/44; P = 0.003; Chi-square test), central cyanosis at presentation (21/79 vs. 1/44; P < 0.001; Chi-square test), antenatal detection (47/79 vs. 14/44; P = 0.003; Chi-square test) and earlier mean age at surgery (3.66 ± 1.47 vs. 7.66 ± 6.88; P < 0.001; Independent sample t-test) were associated with increased mortality. On multinominal logistic regression analysis, the factors preterm (odd's Ratio [OR] =4.735; P = 0.03), weight ≤2 kg (OR = 5.081; P = 0.02), central cyanosis at presentation (OR = 6.969; P = 0.008) and antenatal detection (OR = 7.471; P = 0.006) were found to be independently associated with increased mortality in CDH/eventration. Conclusion: The factors: prematurity, weight

Objective: To assess the utilization of reproductive health services in urban slum of Jodhpur city, India. Methods: A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021. Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care (ANC) services, delivery and post-partum services. Results: The majority of females were aged less than 25 years (n=195; 65.0%), married after 18 years (n=240; 80%), living in extended families (n=265; 88.3%) and with monthly family income less than 10000 rupees (n=182; 60.7%). Statistically significant associations were found between ≥4 ANC visits and educational level of secondary and above (OR 2.47, 95% CI 1.03-6.28; P=0.04), older age (OR 15.70, 95% CI 14.87–16.54 for women aged 26–35 years, OR 16.14, 95% CI 12.12–20.01 for women aged ≥36 years; P

India is among the largest producers of sugarcane in the world. Sugarcane bagasse (SCB) has been used in different applications in the area of sugar and its products, biomedical sciences, biotechnology, textile industry, etc., and its utilization as a source of cellulose is also gaining rapid popularity in construction and health sector. The aim of the study is to analyze the surface morphology, structure, elemental composition of sugarcane bagasse as agro-waste cellulose nano fibrils (CNFs) extracted by alkali treatment, followed by steam explosion and acid treatment. It was observed that the properties are dissimilar for each of the samples tested at each of the four different stages of chemical treatment of sugarcane fibers studied by Scanning electron microscopy (SEM), structural spectroscopy (FTIR), X-ray diffraction (XRD), and elemental analysis (energy dispersive x-ray diffraction (EDX). Based on the characterization some probable applications in fiber reinforced composites have been discussed.

Microgrids are facing several operational and control issues while integrating with the grid. To deal with it, STATCOM, as one of the emerging power converter circuits, is connected with such microgrids. STATCOM with microgrid introduces current harmonic, inherent resonance, and active power losses related to high switching frequency. Filter design can help attenuate these effects and maintain the predefined standards as in IEEE 519-1992 and IEEE P1547.2-2003. There are also some more points of concern about filter design. Inappropriate filter types and parameters may cause worse filtering, reactive power surplus production, and low power factor. Therefore, this paper suggests that the reactive power compensation capability, as a local area problem, must be attended through the proper designing of LCL filtered grid-tied STATCOM. The parameters are estimated through transient analysis, power quality, and power balance studies for proposed Micro-grid and the results obtained are compared using nature-inspired algorithms such as GA, PSO, and FA over conventional mathematical formulation. The main contributions of this work are; (i) study of system with the inclusion of voltage and frequency-dependent load, (ii) modified STATCOM model clubbing reactive power control feedback and LCL filter with damping resistance, (iii) real and reactive power tracking system using dynamic compensator capabilities, and (iv) suppression of total harmonic distortions along with real and reactive power tracking using advanced tuning for filter parameters with GA, PSO, and FA based algorithms.

Potential evapotranspiration (PET) is a crucial component of the hydrological cycle and energy balance. Although the Penman-Monteith (PM) model is the most widely used method to estimate daily PET, it requires temperature, relative humidity, solar radiation, and wind speed. In Thailand, the number of potential weather stations to provide the required data is limited, which resulted in the absence of some input variables in many locations. The objective of this study is to develop the revised potential evapotranspiration (RPET) model to estimate daily PET using Global Navigation Satellite System-derived Precipitable Water Vapor (GNSS-PWV) and temperature data. The multiple linear regression analysis was used to develop and validate the RPET model. The performance of the RPET model along with the Global Land Evaporation Amsterdam Model (GLEAM v3.2 b) and the European Centre for Medium-Range Weather Forecasts Reanalysis-5 (ERA5-Land) products was investigated using the PM model. The results revealed that the RPET model showed a strong correlation with the PM model (r = 0.85, RMSE = 0.97 mm day−1, RSR = 0.53, NSE = 0.72) under limited meteorological inputs. The RPET model performance was superior when compared to GLEAM and ERA5-Land (r = 0.80, RMSE = 1.06 mm day−1). Therefore, the proposed model is greatly suitable for daily PET estimation with only required GNSS-PWV and temperature data, and this can be implemented for drought assessment and water resources management.

To plan therapies for Hepatocellular Carcinoma (HCC), staging methods are necessary. The most often employed HCC management recommendation is the Barcelona Clinic Liver Cancer (BCLC) staging system. Transarterial Chemoembolisation (TACE) is the go- to therapy for BCLC stage B (intermediate HCC). Numerous studies back the use of TACE in individuals with early and advanced HCC. TACE may be an option for individuals who are not candidates for Radiofrequency Ablation (RFA) or Hepatic Resection (HR) for BCLC stage 0 (very early HCC). TACE with RFA offers superior local tumour suppression than RFA alone in BCLC stage. Patients awaiting liver transplants may benefit from TACE as a bridging treatment. When compared to supportive care approaches, TACE improves survival for BCLC-B patients. Patients with BCLC-C stage HCC are treated in the first instance with sorafenib. The combination of sorafenib and TACE has demonstrated efficacy in slowing the development of tumours. Patients with HCC and portal venous thrombosis have superior survival results with TACE combined with radiation. Taking all of these facts into account, it is obvious that TACE, either alone or in conjunction with other therapies, plays a crucial part in the treatment of HCC at every stage. Patients with HCC should get a variety of treatments, and the best TACE candidates should be chosen using a more accurate patient classification approach.

Background: Fluoride is a noxious element known to destroy gastrointestinal mucosa, leading to erythrocytes' destruction and causing anaemia. The birth weight of newborn babies is a significant indicator of a child's vulnerability to the risk of childhood diseases and chances of existence. Methods: This prospective cohort study was planned to find linkages between fluorosis and the low-birth weight of newborn babies with anaemic mothers. Antenatal mothers until the 20th week of gestation were followed up till delivery in the Antenatal Clinic of a District Hospital in one of the known fluoride-endemic districts (Nagaur) and the other not-so-endemic district (Jodhpur) of Western Rajasthan. Results: Around 19% of the newborn in Jodhpur and around 22% in Nagaur had low birth weight. Mean fluoride values in water samples were measured to be 0.57 (range from 0.0 to 2.7 PPM) in Jodhpur and 0.7 (range from 0.0 to 3.4 PPM) in Nagaur. Conclusions: Thus, in fluoride endemic areas, other factors should be included besides iron and folic acid supplementation for improving anaemia in pregnant women. This calls for assessing the effectiveness of de-fluoridation activities along with the area's most common indigenous food practices.

The global statistics of bone disorders, skeletal defects, and fractures are frightening. Several therapeutic strategies are being used to fix them; however, RNAi-based siRNA therapy is starting to prove to be a promising approach for the prevention of bone disorders because of its advanced capabilities to deliver siRNA or siRNA drug conjugate to the target tissue. Despite its ‘bench-to-bedside’ usefulness and approval by food and drug administration for five siRNA-based therapeutic medicines: Patisiran, Vutrisiran, Inclisiran, Lumasiran, and Givosiran, its use for the other diseases still remains to be resolved. By correcting the complications and complexities involved in siRNA delivery for its sustained release, better absorption, and toxicity-free activity, siRNA therapy can be harnessed as an experimental tool for the prevention of complex and undruggable diseases with a personalized medicine approach. The present review summarizes the findings of notable research to address the implications of siRNA in bone health for the restoration of bone mass, recovery of bone loss, and recuperation of bone fractures.

Abstract Background Astronauts have a higher risk of cervical intervertebral disc herniation. Several mechanisms have been attributed as causative factors for this increased risk. However, most of the previous studies have examined potential causal factors for lumbar intervertebral disc herniation only. Hence, we aim to conduct a study to identify the various changes in the cervical spine that lead to an increased risk of cervical disc herniation after spaceflight. Methods A cohort study with astronauts will be conducted. The data collection will involve four main components: a) Magnetic resonance imaging (MRI); b) cervical 3D kinematics; c) an Integrated Protocol consisting of maximal and submaximal voluntary contractions of the neck muscles, endurance testing of the neck muscles, neck muscle fatigue testing and questionnaires; and d) dual energy X-ray absorptiometry (DXA) examination. Measurements will be conducted at several time points before and after astronauts visit the International Space Station. The main outcomes of interest are adaptations in the cervical discs, muscles and bones. Discussion Astronauts are at higher risk of cervical disc herniation, but contributing factors remain unclear. The results of this study will inform future preventive measures for astronauts and will also contribute to the understanding of intervertebral disc herniation risk in the cervical spine for people on Earth. In addition, we anticipate deeper insight into the aetiology of neck pain with this research project. Trial registration German Clinical Trials Register, DRKS00026777. Registered on 08 October 2021.

Abstract Background Recent studies have provided insights into the persistence and succession of microbes aboard the International Space Station (ISS), notably the dominance of Klebsiella pneumoniae. However, the interactions between the various microbes aboard the ISS and how they shape the microbiome remain to be clearly understood. In this study, we apply a computational approach to predict possible metabolic interactions in the ISS microbiome and shed further light on its organization. Results Through a combination of a systems-based graph-theoretical approach, and a constraint-based community metabolic modeling approach, we demonstrated several key interactions in the ISS microbiome. These complementary approaches provided insights into the metabolic interactions and dependencies present amongst various microbes in a community, highlighting key interactions and keystone species. Our results showed that the presence of K. pneumoniae is beneficial to many other microorganisms it coexists with, notably those from the Pantoea genus. Species belonging to the Enterobacteriaceae family were often found to be the most beneficial for the survival of other microorganisms in the ISS microbiome. However, K. pneumoniae was found to exhibit parasitic and amensalistic interactions with Aspergillus and Penicillium species, respectively. To prove this metabolic prediction, K. pneumoniae and Aspergillus fumigatus were co-cultured under normal and simulated microgravity, where K. pneumoniae cells showed parasitic characteristics to the fungus. The electron micrography revealed that the presence of K. pneumoniae compromised the morphology of fungal conidia and degenerated its biofilm-forming structures. Conclusion Our study underscores the importance of K. pneumoniae in the ISS, and its potential positive and negative interactions with other microbes, including potential pathogens. This integrated modeling approach, combined with experiments, demonstrates the potential for understanding the organization of other such microbiomes, unravelling key organisms and their interdependencies. Video Abstract

Here, Forster et al. compare 1354 cultured commensal strains (540 species) to 45,403 pathogen strains (12 species), identifying 64,188 MGE-mediated antibiotic resistance gene transfer events between the two groups, and show that 15 broad host range MGEs are able to transfer between phyla.

Abstract NF-κB has been reported to both promote and inhibit bone formation. To explore its role in osteolineage cells, we conditionally deleted IKKα, an upstream kinase required for non-canonical NF-κB activation, using Osterix (Osx)-Cre. Surprisingly, we found no effect on either cancellous or cortical bone, even following mechanical loading. However, we noted that IKKα conditional knockout (cKO) mice began to lose body weight after 6 months of age with severe reductions in fat mass and lower adipocyte size in geriatric animals. qPCR analysis of adipogenic markers in fat pads of cKO mice indicated no difference in early differentiation, but instead markedly lower leptin with age. We challenged young mice with a high fat diet finding that cKO mice gained less weight and showed improved glucose metabolism. Low levels of recombination at the IKKα locus were detected in fat pads isolated from old cKO mice. To determine whether recombination occurs in adipocytes, we examined fat pads in Osx-Cre;TdT reporter mice; these showed increasing Osx-Cre-mediated expression in peripheral adipocytes from 6 weeks to 18 months. Since Osx-Cre drives recombination in peripheral adipocytes with age, we conclude that fat loss in cKO mice is most likely caused by progressive deficits of IKKα in adipocytes.

Abstract While many studies suggested the isolated effects of plyometric and whole-body vibration exercises on physical performance variables, only few studies have compared the acute effects of plyometric and whole-body vibration on the occurrence of post-activation potentiation and the resultant improvements in performance. Therefore, we aimed to compare the acute effects of plyometric exercises and whole-body vibration training on physical performance in collegiate basketball players. Twenty-four collegiate male basketball players (age 20.8 ± 2.02 years, height 1.79 ± 0.7 m, and weight 71.2 ± 7.6 kg) participated in this randomized crossover study. Subjects were received both plyometric and whole-body vibration exercises after a 48-h washed-out period. Countermovement Jump height, sprint, and agility time were measured at baseline, 4- and 12-min post-plyometric, and whole-body vibration exercises. The result suggests a positive effect of both the plyometric and whole-body vibration exercises on countermovement jump and agility time (p = 0.001). While the countermovement jump height and agility were higher in the plyometric group (mean difference 1.60 cm and 0.16 s, respectively), the sprint performance was higher in the whole-body vibration group. However, these differences were statistically non-significant between the two groups (p > 0.05). This study suggests that both plyometric and whole-body vibration exercises may improve post-activation potentiation, which leads to better physical performance. Trial registration CTRI/2019/05/019059. Registered with the Clinical trials registry, India on 10/05/2019. http://ctri.nic.in/Clinicaltrials/advsearch.php .

This paper aims to enhance the capacitance of electroactive polymer (EAP)-based strain sensors. The enhancement in capacitance was achieved by using a free-standing stretchable polymer film while introducing conducting polymer to fabricate a hybrid dielectric film with controlled conductivity. In this work, styrene-ethylene-butylene-styrene (SEBS) rubber was used as the base material, and dodecyl benzene sulfonate anion (DBSA)-doped polyaniline (PANI) was used as filler to fabricate a hybrid composite conducting film. The maleic anhydride group of the SEBS Rubber and DBSA, the anion of the polyaniline dopant, make a very stable dispersion in Toluene and form a free-standing stretchable film by solution casting. DBSA-doped polyaniline increased the conductivity and dielectric constant of the dielectric film, resulting in a significant enhancement in the capacitance of the EAP-based strain sensor. The sensor presented in this article exhibits capacitance values ranging from 24.7 to 100 µF for strain levels ranging from 0 to 100%, and sensitivity was measured 3 at 100% strain level.

Background: Diabetic neuropathy is a debilitating manifestation of long-term diabetes mellitus. The present study explored the effects of the roots of Rubia cordifolia L. (R. cordifolia L.) in the Wistar rat model for diabetic neuropathy and possible neuroprotective, antidiabetic, and analgesic mechanisms underlying this effect. Materials and Methods: Rats were divided into five experimental groups. An amount of 0.25% carboxy methyl cellulose (CMC) in saline and streptozotocin (STZ) (60 mg/kg) was given to group 1 and group 2, respectively. Group 3 was treated with STZ and glibenclamide simultaneously while groups 4 and 5 were simultaneously treated with STZ and hydroalcoholic extract of the root of R. cordifolia, respectively. Hot plate and cold allodynias were used to evaluate the pain threshold. The antioxidant effects of R. cordifolia were assessed by measuring Thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD). At the end of the study, sciatic nerve and brain tissues were collected for histopathological study. Bcl-2 proteins, cleaved caspase-3, and Bax were assessed through the Western blot method. Results: R. cordifolia significantly attenuated paw withdrawal and tail flick latency in diabetic neuropathic rats. R. cordifolia significantly (p < 0.01) improved the levels of oxidative stress. It was found to decrease blood glucose levels and to increase animal weight in R. cordifolia-treated groups. Treatment with R. cordifolia suppressed the cleaved caspase-3 and reduced the Bax:Bcl2 ratio in sciatic nerve and brain tissue compared to the diabetic group. Histopathological analysis also revealed a marked improvement in architecture and loss of axons in brain and sciatic nerve tissues at a higher dose of R. cordifolia (400 mg/kg). Conclusion: R. cordifolia attenuated diabetic neuropathy through its antidiabetic and analgesic properties by ameliorating apoptosis and oxidative stress.

Avascular necrosis of the femoral head (ANFH) is a painful disorder characterized by the cessation of blood supply to the femoral head, leading to its death and subsequent joint collapse. Influenced by several risk factors, including corticosteroid use, excessive alcohol intake, hypercholesterolemia, smoking and some inflammatory disorders, along with cancer, its clinical consequences are thrombus formation due to underlying inflammation and endothelial dysfunction, which collaborates with coagulopathy and impaired angiogenesis. Nonetheless, angiogenesis resolves the obstructed free flow of the blood by providing alternative routes. Clinical manifestations of early stage of ANFH mimic cysts or lesions in subchondral bone, vasculitis and transient osteoporosis of the hip, rendering it difficult to diagnose, complex to understand and complicated to cure. To date, the treatment methods for ANFH are controversial as no foolproof curative strategy is available, and these depend upon different severity levels of the ANFH. From an in-depth understanding of the pathological determinants of ANFH, it is clear that impaired angiogenesis, coagulopathy and endothelial dysfunction contribute significantly. The present review has set two aims, firstly to examine the role and relevance of this molecular triad (impaired angiogenesis, coagulopathy and endothelial dysfunction) in ANFH pathology and secondly to propose some putative therapeutic strategies, delineating the fact that, for the better management of ANFH, a combined strategy to curtail this molecular triangle must be composed rather than focusing on individual contributions.

Sepsis is a critical disease caused by the abrupt increase of bacteria in human blood, which subsequently causes a cytokine storm. Early identification of bacteria is critical to treating a patient with proper antibiotics to avoid sepsis. However, conventional culture-based identification takes a long time. Polymerase chain reaction (PCR) is not so successful because of the complexity and similarity in the genome sequence of some bacterial species, making it difficult to design primers and thus less suitable for rapid bacterial identification. To address these issues, several new technologies have been developed. Recent advances in nanotechnology have shown great potential for fast and accurate bacterial identification. The most promising strategy in nanotechnology involves the use of nanoparticles, which has led to the advancement of highly specific and sensitive biosensors capable of detecting and identifying bacteria even at low concentrations in very little time. The primary drawback of conventional antibiotics is the potential for antimicrobial resistance, which can lead to the development of superbacteria, making them difficult to treat. The incorporation of diverse nanomaterials and designs of nanomaterials has been utilized to kill bacteria efficiently. Nanomaterials with distinct physicochemical properties, such as optical and magnetic properties, including plasmonic and magnetic nanoparticles, have been extensively studied for their potential to efficiently kill bacteria. In this review, we are emphasizing the recent advances in nano-biotechnologies for bacterial identification and anti-bacterial properties. The basic principles of new technologies, as well as their future challenges, have been discussed.

Background: Airports pose a possible threat in facilitating global disease transmission within the community which may be prevented by rigorous systematic entry-exit screening. This study captures the perception of stakeholders on barriers and facilitators of coronavirus disease 2019 (COVID-19) screening. Further, key outcomes viz. total passengers screened, suspected cases, and confirmed cases were assessed. Methods: An inductive-deductive mix-method thematic analysis was conducted to capture qualitative data of key stakeholders on COVID-19 disease screening at Jaipur International Airport. Additionally, secondary data retrieved from Rajasthan Medical & Health Department team deployed for COVID-19 airport screening were analyzed. Results: Jaipur International Airport screened 4565 passengers (Males = 4073 and Females = 492) with 23 suspected cases during an outlined period of declaration of Pandemic to Lockdown in India (11 to 24 March 2020). Total 65 passengers had travel history from China (3 from Wuhan). The mean average age of passengers was 40.95 ± 7.8 years. The average screening time per passenger was 2-3 min with a load of 25-90 passengers per team per flight. Fishbone analysis of screening challenges revealed poor cooperation of passengers, masking symptoms, apprehension, and stigma related to quarantine. Moreover, inadequate human resources and changing guidelines overburdened healthcare providers. But, perception of risk, and social responsibility of travelers together with supportive organization behavior act as facilitators. Overall, groundwork on airport screening was insightful to propose key action areas for screening. Conclusions: Globally, COVID-19 has an impact on health infrastructure and international travel. International coordination with streamlined screening will go an extended way in virus containment.

Background: The old definitions of fever are based on cross-sectional surveys of the population without analyzing the associated symptomatology as fever is a sign, not symptom. Therefore, a longitudinal follow-up study is the need of hour to analyze associated symptoms with fever. Methods: In a longitudinal study over one year, 196 participants recorded three temperature readings daily, one after waking up, one between 12 and 3 PM, one before sleeping, and filled the symptomatology questionnaire in a thermometry diary. Results: Per protocol analysis was done for febrile participants (n = 144). Fatigue (50.3%), warmth (47.3%), headache/head heaviness (47.0%), feeling malaise/general weakness (46.7%), loss of appetite (46.5%), muscle cramps/muscle aches (45.6%), chills/shivering (44.6%), increased sweating (43.0%), nausea (42.5%), irritability (38.9%), increased breathing rate (37.1%), and restlessness/anxiety/palpitations (36.5%) were the symptoms maximally seen during the febrile phase. A higher number of associated symptoms are associated with higher temperature readings. Dehydration suggested the numerically highest temperature values (100.86 ± 1.70°F) but seen in few febrile patients. Conclusions: Incorporation of symptom analysis in febrile patients is the need of the hour. Fatigue and warmth are found to be the most prevalent symptoms during febrile phase. Associated symptoms can help in predicting the intensity of fever also.

Aim: This study aims to determine the sequelae of corrosive ingestion in children. Methods: A retrospective study was conducted in the Department of Pediatric Surgery at a Tertiary Center. The children presenting between January 2015 and December 2020 with a history of ingestion of caustic agents were included in the study. Results: A total of 26 children were included in the study. The children with suicidal attempts were significantly older than those who ingested the corrosive agents accidentally (14.2 ± 1.9 years vs. 6 ± 3.3 years; P < 0.01; Student's t-test). Sixteen (62%) children had esophageal strictures, 8 (31%) had pyloric strictures, and a child (4%) had both esophageal and gastric strictures. Eight (31%) children required an initial feeding jejunostomy and 6 (23%) required a feeding gastrostomy as they had significant weight loss on presentation. Eleven (65%) esophageal strictures responded to the dilatation regimen and are symptom-free on follow-up. Three (18%) children with esophageal stricture underwent esophageal replacement. Eight (31%) children had a pyloric stricture and all of them were treated with a modified Billroth I gastro-duodenostomy. The children who presented after 2 months were found to have a significantly increased need for esophageal replacement (3/9 vs. 0/17; P = 0.03; Fischer's exact test). Conclusion: The corrosive ingestion in children is associated with higher morbidity. The sequelae include esophageal and antro-pyloric strictures. A feeding gastrostomy or jejunostomy was required in more than half of the patients. The children presenting after 2 months of ingestion were associated with an increased need for esophageal replacement.

Objective: To investigate the contraceptive effect of intratesticular injection of chlorhexidine gluconate in dogs and compare it with that of zinc gluconate neutralized with arginine. Methods: Twenty-four sexually mature male mongrel dogs were randomly divided by replicate into four groups (n=6 per group). Group I received intra-testicular injection of 2 mL zinc gluconate (10 mg/mL) neutralized with arginine. Group II received intratesticular injection of 2 mL chlorhexidine gluconate (5% w/v). Group Ⅲ received intratesticular injection of 2 mL chlorhexidine gluconate (4% w/v). Group Ⅳ did not receive any treatment and served as the control group. Testicular morphometry was conducted on day 0, 7, 15 and 30 after treatment. Semen was collected and evaluated on day 0 and 30. Data were analyzed using repeated measures analysis of variance. Results: There was no difference in the mean values of various parameters between dogs treated with zinc gluconate and those treated with chlorhexidine gluconate at any of the time points. In dogs treated with zinc gluconate or chlorhexidine gluconate, there was a significant increase in the testicular morphometric parameters on day 7 followed by a significant reduction thereafter (day 15 and 30). In contrast, there was no change in any of the parameters in the control untreated dogs during the course of the study. Compared to the pre-treatment values, the mean scrotal circumference and the mean paired testicular volume and testicular weight on day 30 were significantly lower in the treated dogs. Semen samples collected on day 30 from treated dogs were found to be azoospermic, whereas no change in semen quality was observed in the control untreated dogs. Conclusions: Intratesticular injection of chlorhexidine gluconate (5% w/v and 4% w/v) is equally as effective as zinc gluconate neutralized with arginine for chemical contraception in dogs.

Telemedicine and remote patient monitoring (RPM) systems have been gaining interest and received adaptation in healthcare sectors since the COVID-19 pandemic due to their efficiency and capability to deliver timely healthcare services while containing COVID-19 transmission. These systems were developed using the latest technology in wireless sensors, medical devices, cloud computing, mobile computing, telecommunications, and machine learning technologies. In this article, a real-time remote patient monitoring system is proposed with an accessible, compact, accurate, and low-cost design. The implemented system is designed to an end-to-end communication interface between medical practitioners and patients. The objective of this study is to provide remote healthcare services to patients who need ongoing care or those who have been discharged from the hospital without affecting their daily routines. The developed monitoring system was then evaluated on 1177 records from MIMIC-III clinical dataset (aged between 19 and 99 years). The performance analysis of the proposed system achieved 88.7% accuracy in generating alerts with logistic regression classification algorithm. This result reflects positively on the quality and robustness of the proposed study. Since the processing time of the proposed system is less than 2 minutes, it can be stated that the system has a high computational speed and is convenient to use in real-time monitoring. Furthermore, the proposed system will fulfil to cover the lower doctor-to-patient ratio by monitoring patients from remote locations and aged people who reside in their residences.

Elucidation of structure and dynamics of alternative higher-order structures of DNA such as in branched form could be targeted for therapeutics designing. Herein, we are reporting the intrinsically dynamic and folds transitions of an unusual DNA junction with sequence d(CGGCGGCCGC)4 which self-assembles into a four-way DNA junction form with sticky ends using long interval molecular simulations under various artificial physiological conditions. The original crystal structure coordinates (PDB ID: 3Q5C) for the selected DNA junction was considered for a total of 1.1 μs molecular dynamics simulation interval, including different temperature and pH, under OPLS-2005 force field using DESMOND suite. Following, post-dynamics structure parameters for the DNA junction were calculated and analyzed by comparison to the crystal structure. We show here that the self-assembly dynamics of DNA junction is mitigated by the temperature and pH sensitivities, and discloses peculiar structural properties as function of time. From this study it can be concluded on account of temperature sensitive and pH dependent behaviours, DNA junction periodic arrangements can willingly be synthesized and redeveloped for multiple uses like genetic biomarkers, DNA biosensor, DNA nanotechnology, DNA Zipper, etc. Furthermore, the pH dis-regulation behaviour may be used to trigger the functionality of DNA made drug-releasing nanomachines.

Abstract For maintaining the healthy metabolic status, vitamin D is a beneficial metabolite stored majorly in its pre-activated form, 25-hydroxyvitamin D3 (25(OH)D3). Due to its important role in bone strengthening, the study was planned to quantify 25(OH)D3 levels in our blood. Quantification techniques for 25(OH)D3 are costly thus requiring a need for a low cost, and sensitive detection methods. In this work, an economic, and sensitive sensor for the detection of 25(OH)D3 was developed using aptamer and graphene oxide (GO). Aptamer is an oligonucleotide, sensitive towards its target, whereas, GO with 2D nanosheets provides excellent quenching surface. Aptamer labeled with fluorescein (5’, 6-FAM) is adsorbed by π–π interaction on the GO sheets leading to quenching of the fluorescence due to Förster resonance energy transfer (FRET). However, in the presence of 25(OH)D3, a major portion of aptamer fluorescence remains unaltered, due to its association with 25(OH)D3. However, in the absence, aptamer fluorescence gets fully quenched. Fluorescence intensity quenching was monitored using fluorescence spectrophotometer and agarose gel based system. The limit of detection of 25(OH)D3 by this method was found to be 0.15 µg/mL whereas when GO-COOH was used, limit of detection was improved to 0.075 µg/mL. Therefore, this method could come up as a new sensing method in the field of vitamin D detection.

Introduction: FIFA 11+, has already shown a positive response to the various physical parameters and reduced injury rates in football players, similar studies were not performed on badminton players. With this background, the present study was conducted. Aim: To compare the effects of FIFA 11+, dynamic warm-up, and regular badminton warm-up on speed, agility, and lower limb explosive power. Materials and Methods: A quasi-experimental study was conducted in different badminton academies located in Faridabad, Haryana, India, from September 2017 to March 2019 with the implementation of the programme for four weeks with a sample size of 48 players (both male and female) aged between 14-18 years participated in the study. The participants were divided randomly into group A; following FIFA 11+ protocol (11+ is a multifaceted warm-up program with four components- sprinting, strength, plyometric and balance), group B followed dynamic warm-up and group C followed their regular warm-up. The players followed the protocols for four weeks (12 sessions with FIFA11+ for 15-20 minutes and dynamic warm-up of 15 minutes). A pre and postassessment was done for agility using a T-test, speed was assessed by a 10 m sprint, and Lower limb explosive power was assessed using the vertical jump test. The statistical tests used for analysis was the Post-Hoc Tukey test for between-group analysis and Analysis of Variance (ANOVA) paired t-test for within-group analysis using Statistical Package for Social Sciences (SPSS) version 21.0 software. Results: There was no statistical difference between the three groups when the Post-Hoc Tukey test was done. However, when within the group analysis was done using paired t-test there was statistically significant difference for agility in group A (p-value=0.030) and speed in group B (p-value=0.021). Conclusion: This study concludes that none of the three groups out performed the other for all the parameters.

Introduction The Rashtriya Bal Swasthya Karyakram of the Government of India subsumes the existing school health program to provide care and treatment to children below 18 years through screening and early interventions. Benefitting an estimated 270 million children for 30 preidentified conditions is a step toward “health for all.” Although the program is running since 2013, due to paucity of studies particularly in Thar desert region and its associated challenges, this study was planned to assess challenges and good practices in the implementation of RBSK in Jodhpur. Objectives To assess the challenges, barriers, and good practices in the implementation of RBSK among the mobile health team (MHT) in Jodhpur, Rajasthan. Methods A community based descriptive cross-sectional study in all 11 medical blocks of Jodhpur district, with purposive sampling to invite all members of MHT to participate in the study as grassroot workers was planned. A pretested, semistructured questionnaire was processed using SPSS for quantitative component and in-depth interviews were reported using qualifiers for qualitative observations. Results As much as 74.1% (n = 40) of the staff perceived the trainings to be sufficient for daily work needs but needed more sessions for birth defects (33.3%) and development delays (29.6%). As much as 96.3% (n = 52) of the staff considered salaries to be low and 55.5% were dissatisfied with the jobs. However, 70.4% found targets to be achievable and 76% found the work environment helpful. Taboos and superstitions in community, harsh climate, dual workload on pharmacists as data operators, and noninclusion of AYUSH medicines for AYUSH medical officers (MOs) were few of the challenges, while good practices such as fully equipped MHTs, readily available vehicles, information education communication (IEC) materials, and treatment coverage under Bhamashah Bima Yojana (BSBY) were also observed. Conclusion Many good practices were observed during the study which can be adopted by other states for better implementations elsewhere. Certain challenges such as belief in quackery, superstitions and taboos could be minimized by conducting rapport-building meetings with community stakeholders. Feedback and regular trainings of MHT staff can further increase the success manifold.

Introduction: Lower Respiratory Tract Infection (LRTI) is one of the commonest health problems which is not a single disease but a group of specific infections with varying aetiology and symptomatology. These infections are the leading cause of illness and mortality in children and adults across the world because of different epidemiology, pathogenesis, clinical presentation, and outcomes. Aim: To find out the prevalence, bacteriological profile and antimicrobial susceptibility pattern of clinical isolates causing LRTI. Materials and Methods: This was a laboratory based observational study which was carried out between June 2019 to May 2020. All the lower respiratory tract samples (sputum, Endotracheal (ET) aspirate, Bronchoalveolar Lavage (BAL) etc.,) were collected and sample processing was done for isolation and identification by standard methods and antimicrobial susceptibility testing was done using Kirby Bauer disc diffusion method. The data was analysed in Microsoft Office excel worksheet. Results: A total number of 1364 samples were processed in which 615 were culture positive. ET aspirates 65.04% (n=400) showed higher positivity rate than sputum 32.03% (n=197). In this study, gram positive and gram negative bacteria (GNB) were 4.23% (n=26) and 92.19% (n=567) respectively with yeast recovered in only 3.58% (n=22) of the specimens. Among the isolates, Klebsiella pneumoniae 171 (30.15%) was the most common organism. The overall susceptibility of GNB was highest towards tigecycline (51.85%) followed by gentamicin (38.62%). Conclusion: Specific antibiotic utilisation strategies like antibiotic restriction, combination therapy may help to decrease or prevent the emergence of resistance. There is a need for further community based studies to identify the best treatment protocol for individual patients.

Abstract Forest biomass estimation at large scale is challenging and generally entails large uncertainty in tropical regions. With their wall‐to‐wall coverage ability, passive remote sensing signals are frequently used to extrapolate field estimates of forest aboveground biomass (AGB). However, studies often use limited reference data and/or flawed validation schemes and thus report unreliable extrapolation error estimates. Here, we compared the ability of three medium‐ to high‐resolution passive satellite sensors, Landsat‐8 (L8), Sentinel‐2B (S2) and Worldview‐3 (WV3), to map AGB in a forest landscape of Thailand. We used a large airborne LiDAR‐derived AGB dataset as a reference to train and validate a random forest algorithm and conducted robust error assessments and variable selection using spatialized cross‐validations. Our results indicate that the selected predictors strongly varied among the three sensors and between analyses restricted to low (≤200 Mg ha−1) and high (>200 Mg ha−1) AGB areas. WV3 and S2 data outperformed L8 data to extrapolate AGB (RMSE of 68 and 72 against 84 Mg ha−1, respectively) due to the inclusion of the red‐edge band and, probably, to their higher spatial and spectral resolution. Sensitivity to large AGB values was higher for WV3 than for S2 and L8 with saturation point of 247 Mg ha−1 against 204 and 192 Mg ha−1. AGB values above these saturation points remained poorly predictable, especially for L8, indicating that several tropical forest AGB maps should be interpreted with extreme caution. However, predicted gradients of lower AGB values (≤200 Mg ha−1), i.e., in early forest successional stages, were fairly consistent among sensors (r > 0.70), even if the mean absolute difference between estimates was large when AGB predictions were extrapolated out of the calibration area at regional level (34%). We finally showed that calibrating the model only within the sensitivity AGB domain (e.g.,

Introduction: The age-old definition of fever was derived using cross-sectional population surveying utilising old techniques without considering symptomatology. However, the diagnosis of fever must be made only in the presence of associated symptoms that can distinguish it from the mere asymptomatic physiologic rise of temperature. Aim: Analysis of symptoms to re-define the cut-off of fever based on symptomatology. Materials and Methods: A longitudinal study on the healthy population of Uttarakhand, India was conducted and the population was followed up from July 2019 to September 2020. Healthy staff and students of All India Institute of Medical Sciences (AIIMS), and their family members between 4-100 years of age were chosen. Participants were advised to self-monitor oral temperature with a standard digital thermometer in either left or right sublingual pocket and record it in the thermometry diary. The study was considered complete if the participant had all the three phases of the study (i.e., prefebrile, febrile, and postfebrile phases) or completed the duration of the study. The febrile phase was defined when the participants subjectively ‘felt feverish’. Associated symptoms like fatigue, warmth, headache, and feeling malaise were also recorded. Results: Mean age of the participants was 24.24±5.92 years, and 52.1% (75) were males. Per protocol analysis was done for febrile participants (n=144, temperature recordings=6544). The mean febrile phase temperature was 100.25±1.440F. A temperature of 99.10F had maximum diagnostic accuracy for feeling feverish (98.2%), along with one (98.3%) or two (99%) associated symptoms. Summer and spring months showed higher temperatures (100.38±1.44 v/s 99.80±1.49, p-value

Water scarcity is a significant environmental limitation to plant productivity as drought-induced crop output losses are likely to outnumber losses from all other factors. In this context, triazole compounds have recently been discovered to act as plant growth regulators and multi-stress protectants such as heat, chilling, drought, waterlogging, heavy metals, etc. Paclobutrazol (PBZ) [(2RS, 3RS)-1-(4-chlorophenyl)- 4, 4-dimethyl-2-(1H-1, 2, 4-trizol-1-yl)-pentan-3-ol)] disrupts the isoprenoid pathway by blocking ent-kaurene synthesis, affecting gibberellic acid (GA) and abscisic acid (ABA) hormone levels. PBZ affects the level of ethylene and cytokinin by interfering with their biosynthesis pathways. Through a variety of physiological responses, PBZ improves plant survival under drought. Some of the documented responses include a decrease in transpiration rate (due to reduced leaf area), higher diffusive resistance, relieving reduction in water potential, greater relative water content, less water use, and increased antioxidant activity. We examined and discussed current findings as well as the prospective application of PBZ in regulating crop growth and ameliorating abiotic stresses in this review. Furthermore, the influence of PBZ on numerous biochemical, physiological, and molecular processes is thoroughly investigated, resulting in increased crop yield.

ObjectivesBlau syndrome (BS) is a rare autoinflammatory disease characterized by arthritis, dermatitis, and granulomatous uveitis in early childhood. The study presents the clinical experience of patients with BS at a tertiary care centre in Chandigarh, North India.MethodsAnalysis of the clinical profile of patients of BS with NOD2 gene mutations under follow-up was carried out.ResultsDiagnosis of BS was genetically confirmed in 11 patients (10 children and one adult; six male and five female patients) from 10 families. The median age of onset of symptoms was 12 months (range, 4 months–4 years), while the age at diagnosis ranged from 2.3 to 26 years. The classic triad of arthritis, dermatitis, and uveitis was present in 6/11 (54.5%) patients. The frequency of arthritis, dermatitis, and uveitis was 100%, 81.8%, and 72.7%, respectively. The median age at diagnosis of ocular symptoms was 4 years (range, 2–26 years). Family history was noted in six families. Renal involvement was observed in two children. All patients in our cohort had the R334W variant in NOD2 gene. An asymptomatic carrier sibling with R334W mutation was identified in one family. Methotrexate was used as a first-line agent in all children. Adalimumab, which was commenced in five patients with uveitis, resulted in significant improvement in four patients. The total follow-up duration of the present cohort is 1,063.8 patient-months.ConclusionsThe possibility of BS should always be considered in patients with arthritis and early ocular involvement. Uveitis is often progressive and refractory to currently available therapies. Systemic involvement appears to remain a significant cause of morbidity and mortality.

This paper aims to develop a machine-learning model based on a gradient-boosting algorithm to predict the energy-saving awareness of households using a questionnaire survey and 11-month energy data collected from more than 200 smart houses in Kitakyushu, Japan. We utilize the LightGBM (light gradient boosting machine) classifier to perform feature selection for the prediction. By using this approach, we demonstrate that the key features are the standard deviations of electricity purchased between 8 a.m. and 9 a.m. and electricity consumed between 7 p.m. and 9 p.m. Next, by using k-means clustering we split the households based on the obtained features into three groups. Finally, by using statistical hypothesis testing, we prove that these three groups have statistically distinct levels of energy-saving awareness. This model enables us to detect eco-friendly households from their energy data, which may support energy policymaking.

Traditional freshwater sources have been over-abstracted in the worldwide crisis of water scarcity. Effluents have extremely high amounts of Zn2+ and Pb2+, according to an investigation of wastewater samples taken from several industrial zones. However, these heavy metals are among the most harmful to both humans and wildlife that are currently known. Streptomyces sp. is utilized in this study as a biosorbent to biosorb Zn2+ and Pb2+ from single and binary aqueous solutions. Several factors, such as biomass concentration (0.25–4 g), metal solution concentration (5–50 mg L−1), solution pH (2–5), and contact time were standardized. Streptomyces sp. biomass was able to extract 93% Pb2+ and 91% Zn2+ from a single and 95% Pb2+ and 97% Zn2+ from a binary metal aqueous solution containing 25 mg L−1 and pH 4. The highest adsorption capacity in both single and binary sorption experiments was determined to be shared by Zn2+ and Pb2+. The biosorbent’s metal adsorption increased from 0.48 to 4.56 mg g−1 for Pb2+ and from 0.21 mg g−1 to 4.65 mg g−1 for Zn2+ when the metals were present singly, and from 0.44 to 4.18 mg g−1 for Pb2+ and from 0.41 mg g−1 to 5.67 mg g−1 for Zn2+ when the metals were present in binary form. The amount of metal ions was raised from 5 to 50 mg L−1. Correlation coefficient (R2) values indicate that the adsorption pattern for Zn2+ and Pb2+ followed Freundlich isotherm R2 > 0.9543 for single and 0.9582 for binary sorption system. In order to remove Zn2+ and Pb2+ from an aqueous solution, Streptomyces sp. is a potential and different source of adsorbents.

Abstract Background Human-to-human transmission of symbiotic, anaerobic bacteria is a fundamental evolutionary adaptation essential for membership of the human gut microbiota. However, despite its importance, the genomic and biological adaptations underpinning symbiont transmission remain poorly understood. The Firmicutes are a dominant phylum within the intestinal microbiota that are capable of producing resistant endospores that maintain viability within the environment and germinate within the intestine to facilitate transmission. However, the impact of host transmission on the evolutionary and adaptive processes within the intestinal microbiota remains unknown. Results We analyze 1358 genomes of Firmicutes bacteria derived from host and environment-associated habitats. Characterization of genomes as spore-forming based on the presence of sporulation-predictive genes reveals multiple losses of sporulation in many distinct lineages. Loss of sporulation in gut Firmicutes is associated with features of host-adaptation such as genome reduction and specialized metabolic capabilities. Consistent with these data, analysis of 9966 gut metagenomes from adults around the world demonstrates that bacteria now incapable of sporulation are more abundant within individuals but less prevalent in the human population compared to spore-forming bacteria. Conclusions Our results suggest host adaptation in gut Firmicutes is an evolutionary trade-off between transmission range and colonization abundance. We reveal host transmission as an underappreciated process that shapes the evolution, assembly, and functions of gut Firmicutes.

BackgroundDuring the second wave of the COVID-19 pandemic in India, the Ministry of Ayush conducted a community study to provide therapeutic care to patients with asymptomatic, mild, and moderate COVID-19 in home isolation based on the empirical evidence generated on the efficacy of AYUSH-64 in COVID-19.ObjectiveTo document disease characteristics, care-seeking behavior, and outcomes in patients with asymptomatic, mild, or moderate COVID-19 in home isolation who used AYUSH-64 for COVID-19.MethodsCross-sectional analysis of the data generated through a community study conducted in India from 08 May to 31 August 2021 was performed to study the disease characteristics, care-seeking behavior during home isolation, clinical outcomes, adverse events, and the association between various risk factors and clinical recovery during the study period. The data were collected through semi-structured questionnaires, available in electronic data collection format at the baseline, 7, 14, and 21 days. A logistic regression was performed to explore the relationship between relevant variables and clinical recovery.ResultsData from 64,642 participants were analyzed for baseline assessment, and final analysis was done for 49,770 participants. The mean age of the enrolled participants was 38.8 ± 11.7 years, and 8.4% had co-morbidities. AYUSH-64 was utilized as an add-on to the standard care by 58.3% of participants. Comparable clinical outcomes were observed in participants utilizing AYUSH-64 either as a standalone or as an add-on to standard care, in terms of clinical recovery, disease progression, the requirement for oxygen supplementation, hospitalization, ICU admission, and need for ventilator support. Younger age, having no co-morbidities or substance abuse, and having been vaccinated were associated with early clinical recovery than those who were older and not vaccinated.ConclusionsThe study findings suggest that AYUSH-64 use, either standalone or as an adjunct to standard care, in asymptomatic, mild, or moderate COVID-19 is associated with good clinical outcomes. Ayush services and interventions can be effectively integrated into the mainstream public health architecture to serve public health goals.

Abstract Sirtuin 2 (Sirt2) nicotinamide adenine dinucleotide-dependent deacetylase enzyme has been reported to alter diverse biological functions in the cells and onset of diseases, including cancer, aging, and neurodegenerative diseases, which implicate the regulation of Sirt2 function as a potential drug target. Available Sirt2 inhibitors or modulators exhibit insufficient specificity and potency, and even partially contradictory Sirt2 effects were described for the available inhibitors. Herein, we applied computational screening and evaluation of FDA-approved drugs for highly selective modulation of Sirt2 activity via a unique inhibitory mechanism as reported earlier for SirReal2 inhibitor. Application of stringent molecular docking results in the identification of 48 FDA-approved drugs as selective putative inhibitors of Sirt2, but only top 10 drugs with docking scores > − 11 kcal/mol were considered in reference to SirReal2 inhibitor for computational analysis. The molecular dynamics simulations and post-simulation analysis of Sirt2-drug complexes revealed substantial stability for Fluphenazine and Nintedanib with Sirt2. Additionally, developed 3D-QSAR-models also support the inhibitory potential of drugs, which exclusively revealed highest activities for Nintedanib (pIC50 ≥ 5.90 µM). Conclusively, screened FDA-approved drugs were advocated as promising agents for Sirt2 inhibition and required in vitro investigation for Sirt2 targeted drug development.

The current study relates to RADAR (RAdio Detection and Ranging) application for level measurement of vitrified radioactive liquid nuclear waste. The vitrification of radioactive liquid waste is carried out in special equipment called ‘Melters’. The study is directed towards the design and frequency modulation used in the level measurement of vitrified waste. More specifically, the RADAR design and frequency used for level measurement in a melter. This level measurement technique can also be used for dynamic vitrification process and can be used to measure the level variations without using any external medium/material and using only electromagnetic waves. Also, this technique is durable and accurate even under the high radioactive environment present inside the melter.

Abstract Campylobacter hyointestinalis is an emerging pathogen currently divided in two subspecies: C. hyointestinalis subsp. lawsonii which is predominantly recovered from pigs, and C. hyointestinalis subsp. hyointestinalis which can be found in a much wider range of mammalian hosts. Despite C. hyointestinalis being reported as an emerging pathogen, its evolutionary and host-associated diversification patterns are still vastly unexplored. For this reason, we generated whole-genome sequences of 13 C. hyointestinalis subsp. hyointestinalis strains and performed a comprehensive comparative analysis including publicly available C. hyointestinalis subsp. hyointestinalis and C. hyointestinalis subsp. lawsonii genomes, to gain insight into the genomic variation of these differentially-adapted subspecies. Both subspecies are distinct phylogenetic lineages which present an apparent barrier to homologous recombination, suggesting genetic isolation. This is further supported by accessory gene patterns that recapitulate the core genome phylogeny. Additionally, C. hyointestinalis subsp. hyointestinalis presents a bigger and more diverse accessory genome, which probably reflects its capacity to colonize different mammalian hosts unlike C. hyointestinalis subsp. lawsonii that is presumably host-restricted. This greater plasticity in the accessory genome of C. hyointestinalis subsp. hyointestinalis correlates to a higher incidence of genome-wide recombination events, that may be the underlying mechanism driving its diversification. Concordantly, both subspecies present distinct patterns of gene families involved in genome plasticity and DNA repair like CRISPR-associated proteins and restriction-modification systems. Together, our results provide an overview of the genetic mechanisms shaping the genomes of C. hyointestinalis subspecies, contributing to understand the biology of Campylobacter species that are increasingly recognized as emerging pathogens.

Context: With the increasing trend of adopting e-Health technologies, the need for evidence for assessing e-Health technologies has become crucial. The appraisal of the e-Health program is important as this could provide guidance on further e-Health investment and adoption. Aims: The aim of the study was to provide an articulated body of literature on the current state of knowledge about the assessment of e-Health interventions. Settings and Design: Scoping review was conducted based on the framework provided by Arksey and O'Malley (2005) and considering enhancements proposed by Peters et al. (2015). Subjects and Methods: We searched the electronic databases and available gray literature from inception until the last week of October 2019. PRISMA flowchart for the study selection process was used to guide reporting. Data extraction included information on study design, authors, year of study, country, and key findings in terms of approaches used for assessment of e-Health programs. Data were compiled and summarized narratively. Results: Searches were performed between October and December 2019. Seventy-one relevant papers published between the years until the last week of October 2019 were reviewed and analyzed. After considering all the eligibility criteria, 15 papers were included. We identified 15 approaches for assessing e-Health programs, which were summarized and tabulated. Conclusions: This review showed that available literature on the assessment of e-Health programs is heterogeneous in terms of the methodology used. e-Health interventions are highly contextual; therefore; the phase of maturity and objective of the assessment should be considered while carrying out the assessment of e-Health programs.