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Our aim in this study was to determine the test characteristics of algorithms using hospitalization and physician claims data to predict gestational diabetes (GDM).Using population-level health-care administrative data, we identified all pregnant women in Ontario in 2019. The presence of GDM was determined based on glucose screening laboratory results. Algorithms using hospitalization records and/or physician claims were tested against this "gold standard." The selected algorithm was applied to administrative data records from 1999 to 2019 to determine GDM prevalence in each year.Identifying GDM based on either a diabetes mellitus code on the delivery hospitalization record, OR at least 1 physician claim with a diabetes diagnosis code with a 90-day lookback before delivery yielded a sensitivity of 95.9%, a specificity of 99.2% and a positive predictive value of 87.6%. The prevalence of GDM increased from 4.2% of pregnancies in 1999 to 12.0% in 2019.Algorithms using hospitalization or physician claims administrative data can accurately identify GDM.

The ISCHEMIA trial showed similar cardiovascular outcomes of an initial conservative strategy as compared with invasive management in patients with stable ischemic heart disease without left main stenosis. We aim to assess the feasibility of predicting significant left main stenosis using extensive clinical, laboratory and non-invasive tests data.All adult patients who had stress testing prior to undergoing an elective coronary angiography for stable ischemic heart disease in Ontario, Canada, between April 2010 and March 2019, were included. Candidate predictors included comprehensive demographics, comorbidities, laboratory tests, and cardiac stress test data. The outcome was stenosis of 50% or greater in the left main coronary artery. A traditional model (logistic regression) and a machine learning algorithm (boosted trees) were used to build prediction models.Among 150,423 patients included (mean age: 64.2 ± 10.6 years; 64.1% males), there were 9,225 (6.1%) with left main stenosis. The final logistic regression model included 24 predictors and 3 interactions, had an optimism-adjusted c-statistic of 0.72 and adequate calibration (optimism-adjusted Integrated Calibration Index 0.0044). These results were consistent in subgroups of males and females, diabetes and non-diabetes, and extent of ischemia. The boosted tree algorithm had similar accuracy, also resulting in a c-statistic of 0.72 and adequate calibration (Integrated Calibration Index 0.0054).In this large population-based study of patients with stable ischemic heart disease using extensive clinical data, only modest prediction of left main coronary artery disease was possible with traditional and machine learning modelling techniques.

OBJECTIVE Cardiovascular risk reduction is an important focus in the management of people with diabetes. Although event rates have been declining over the long term, they have been observed to plateau or reverse in recent years. Furthermore, the impact of income-related disparities in cardiovascular events is unknown. The objective of this study is to evaluate age-, sex-, and income-related trends in cardiovascular hospitalization rates among people with diagnosed diabetes. RESEARCH DESIGN AND METHODS We calculated rates of hospitalization for acute myocardial infarction, stroke, heart failure, and lower-extremity amputation in annual cohorts of the entire population of Ontario, Canada, with diagnosed diabetes, from 1995 to 2019. Event rates were stratified by age, sex, and income level. RESULTS We studied nearly 1.7 million people with diabetes. The rate of acute myocardial infarction declined throughout the 25-year study period (P < 0.0001), such that the rate in 2019 was less than half the rate in 1995. Rates of stroke (P < 0.0001), heart failure (P < 0.0001), and amputation (P < 0.0001) also changed over time, but hospitalization rates stabilized through the 2010s. This apparent stabilization concealed a growing income-related disparity: wealthier patients showed continued declines in rates of these outcomes during the decade, whereas rates for lower-income patients increased (P for interaction < 0.0001 for all four outcomes). CONCLUSIONS During a quarter-century of follow-up, cardiovascular hospitalization rates among people with diabetes fell. However, the apparent stabilization in rates of stroke, heart failure, and amputation in recent years masks the fact that rates have risen for lower-income individuals.

Background: Premature rupture of membranes is the rupture of the fetal membranes in the absence of uterine contraction or before the onset of labor. When this occurs before 37 weeks of gestation, it is termed as preterm premature rupture of membranes. Management depends upon gestational age and the presence of complicating factors. An accurate assessment of gestational age and knowledge of the maternal, fetal and neonatal risks are essential to appropriate evaluation, counselling, and care of patients with PROM. The purpose of the study is timely diagnosis and appropriate management of the cases of PROM and PPROM to improve maternal and neonatal outcomes. Methods: A Prospective study was performed at the department of obstetrics and gynecology, at a tertiary care center from August 2020 to December 2021. A clinical data sheet was made for recording all information about the pregnant women after taking their consent. And their maternal and neonatal outcomes were recorded. Results: a total of 150 cases of PROM and PPROM were taken during our study out of which 53.33% belong to the younger age group, 43.33% were primi gravida, 66.66% belonged to the lower socioeconomic class, 25.33% had a previous history of abortion followed by dilatation and evacuation, rate of cesarean delivery was 34.66% and rate of NICU admission of neonates was 15.78% and 57.87% babies had low birth weight and rate of stillbirth was 1.97%. whereas 34.66% of cases had various complications related to PROM. Conclusions: Individualized management of PROM cases depending on the gestational age and risk of complications and antibiotic coverage is the best way to achieve a good fetomaternal outcome.

Today's child is the future of the country. God resides in children. If we think like this, the place of children should be in playground or school. Despite the Child Labor Prohibition and Regulation Act, 1986, child labor under the age of 14 years should be regarded as a shameful incident for any country. According to the 2011 census in India, a large number of children under the age of 14 are involved in child labour, particularly in the unorganized sector. It is a reality that child laborers are engaged in child labor in various unorganized sectors in Ahmedabad city. This research has been done by collecting primary data through questionnaire to know the attitude of employers towards child labour. Abstract in Gujarati Language: આજનું બાળક દેશનું ભવિષ્ય છે. બાળકોમાં ભગવાનનો વાસ હોય છે. આ રીતે વિચારીએ તો બાળકોનું સ્થાન રમતના મેદાનમાં કે શાળામાં હોવું જોઈએ. બાળમજુરી પ્રતિબંધ અને નિયંત્રણ ધારો ૧૯૮૬ અમલમાં હોવા છતાં ૧૪ વર્ષથી નાની ઉમરના બાળકો મજુરી કરે તે કોઈપણ દેશ માટે લાંછનરૂપ ઘટના ગણાવી જોઈએ. ભારતમાં ૨૦૧૧ની વસ્તી ગણતરી અનુસાર ૧૪ વર્ષથી નીચેની ઉમરના સંખ્યાબંધ બાળકો બાળમજુરી કરે છે, તેમાય ખાસ કરીને અસંગઠિત ક્ષેત્રોમાં બાળમજુરી વ્યાપક પ્રમાણમાં જોવા મળે છે. અમદાવાદ શહેરમા વિવિધ અસંગઠિત ક્ષેત્રોમાં બાળમજૂરો બાળમજુરી કરે છે તે એક વાસત્વિકતા છે. બાળમજૂરો પ્રત્યે કામ કરાવનાર માલિકો અથવા કામ આપનારા કેવું વલણ રાખે છે તે જાણવાના હેતુથી પ્રશ્નાવલી દ્વારા પ્રાથામિક માહિતીને એકત્ર કરી આ સંશોધન કરવામાં આવેલ છે. Keywords: બાળ મજૂર, અસંગઠિત ક્ષેત્ર, વલણ, કામ આપનારા

The location of electrical substations is one of the factors affecting the improvement of electrical energy distribution, as well as the management and control of this energy source. Less cost and manpower will be spent through automating the process of detection and segmentation of these features with the help of deep neural networks and the potential of existing high spatial resolution satellite images. In this study, a deep encoder-decoder neural network was used. This network is one of the most updated deep learning methods in image processing and segmentation. This network has been trained in three RGB bands with the help of high-resolution satellite images (∼1m) and eventually segmented the areas related to electrical substations with relatively high accuracy. As the results of this convolutional neural network, the IOU and Precision parameters were obtained, and their values were 88.2 and 93.7%, respectively, indicating the efficiency of the proposed deep learning method in the segmentation of existing satellite images.

Change Detection (CD) is one of the most crucial applications in remote sensing which identifies meaningful changes from bitemporal images taken from the same location. Enhancing the temporal efficiency and accuracy of this task is of great importance and one way to achieve this is through transfer learning. In this study, we investigate the influence of transferring pre-trained weights on the performance of a Siamese CD network using a benchmark dataset. For this purpose, an autoencoder with the same encoder architecture as in the Siamese model is trained on the whole dataset. Then, the encoder weights are transferred from the autoencoder and the Siamese model is trained in two modes. In the first mode, the transferred weights are frozen and only the decoder section of the Siamese models is trained while the second mode trains the whole model without freezing any part of the model. Moreover, the Siamese model is also trained without using the pre-trained weights to set the basis for comparisons. The results indicate that freezing the encoder results in a relatively lower performance but offers a considerable amount of temporal efficiency in the training phase. On the other hand, training the whole model after the weight transfer acquires the best result with an improvement of 12.43% in the Intersection over Union (IoU) metric.

Corn and Soybean are important crops for the world’s people. Agricultural planning relies heavily on monitoring and mapping corn and soybean fields. With the development of remote sensing technology and deep learning algorithms, corn and soybean fields are being managed more intelligently nowadays. By using Landsat-8 images with multi-temporal maps of NDVI index, we intend to compare deep learning models such as 1-D CNN, 1-D CNN-LSTM, and 2-D U-net for separating corn and soybean fields from other crops (because soybean and corn fields have similar NDVI curves) in the United States in 2020. It was found that the 2-D U-net model performed the most accurately for corn and soybean classes with Kappa coefficients of 88.48 and 88.89, respectively. This can be explained by the identification of complex features using NDVI multi-temporal indexes of March to November in the United States.

Weed management is of crucial importance in precision agriculture to improve productivity and reduce herbicide pollution. In this regard, showing promising results, deep learning algorithms have increasingly gained attention for crop and weed segmentation in agricultural fields. In this paper, the U-Net++ network, a state-of-the-art convolutional neural network (CNN) algorithm, which has rarely been used in precision agriculture, was implemented for the semantic segmentation of weed images. Then, we compared the model performance to that of the U-Net algorithm based on various criteria.The results show that the U-Net++ outperforms traditional U-Net in terms of overall accuracy, intersection over union (IoU), recall, and F1-Score metrics. Furthermore, the U-Net++ model provided weed IoU of 65%, whereas the U-Net gave weed IoU of 56%. In addition, the results indicate that the U-Net++ is quite capable of detecting small weeds, suggesting that this architecture is more desirable for identifying weeds in the early growing season.

Floods are one of the most dangerous crises that cause a lot of damage in various fields, including economic and human lives. Therefore, preparation for prevention and damage assessment in order to manage this crisis is essential. In the meantime, providing methods with high speed and accuracy together can be helpful. In this study, using the Google Earth engine system and various sources of remote sensing data, the flooded areas of 2019 in Khuzestan province of Iran were extracted and the area of damaged agricultural lands was estimated. The general method was to first use the Sentinel 1 images, which are independent of the cloud, and the JRC global surface water mapping data to obtain flooded areas. After that, with the help of Sentinel 2 images and extracting various features from its bands and implementing an automated method, a map of damaged agricultural lands was also prepared. In order to approximate the affected population, WorldPop Global Project Population data has been used to take advantage of the maximum capacity of various remote sensing sources. The resulting flood map was evaluated by a ground truth map to prove the efficiency of the method. The overall accuracy of the map was 96.30 and its kappa coefficient was 80.03, which is quantitatively appropriate. The proposed method and the system used, due to their simplicity, can be generalized at high speed to other areas.

This paper presents a deep learning approach for swift detection of COVID-19 in chest CT scan images in order to facilitate treatment planning and reduce the burden on hospital resources and staff workload. The detection procedure starts with a pre-processing step, which involves noise removal and resizing, and the pre-processed images are fed to VGG16, which is a powerful deep learning network for image classification applications. All algorithms have been implemented in Python and the deep learning network has been implemented in Tesorflow using the Keras library. Using VGG16, we have achieved 99% and 92% accuracy for the training and test data, respectively. Considering the accuracy of the method, it can be used for swift clinical detection of COVID-19, which could be of useful and magnificent help to treatment personnel. Also, this method is really helpful for detecting patient and starting treatment as soon as possible and reduces the cost of treatments.

The construction of a λ-shaped three side substituted alkoxy based molecular system (E1-E8) with azo-ester group was carried out and studied for liquid crystalline applications. The mesogenic behaviour and thermal stability of synthesized derivatives were checked and analyzed by POM, DSC and TGA analysis. These azo-ester based compounds show smectic C and nematic type mesomorphic properties. The observed texture patterns of the synthesized compounds are fan, broken fan, schlieren and threaded types. All derivatives shows broad temperature range of mesophase and further stabilized upto the room temperature. The structure-property relationship has been further studied to understand the effect of variable side-chain on liquid crystalline properties.

The present work was conducted to isolate, screen and identify polyhydroxybutyrate (PHB)-producing bacteria from municipal wastes. Samples were collected from dumping sites of Maiduguri Borno State and were checked for their bacterial population using nutrient agar and PHB Detection agar (PDA). A total of 20 PHB-producing bacteria were isolated and identified. Of the total, four of the isolates were found to be from Paenibacillus spp. while the remaining 16 were Bacillus spp. Isolates from Ngomari Custin denoted as NC 5, 2; NC 7, and NC 5A were suspected to be Paenibacillus favisporus, Bacillus lentus, and Bacillus firmus respectively while others of NC 7A X, NC 6A and NC 7A Y of the same site were all found to be Bacillus smithii. Isolates from Old Maiduguri Graveyard denoted as OMG 5X, OMG 7, OMG 6 and OMG 5A were all found to be Bacillus smithii. The isolates from Flour Mill Area denoted as FMA 5A, FMA 6A, FMA Y, and FMA7B were found to be Bacillus smithii, Paenibacillus nanensis, Bacillus acidiceler and Paenibacillus septentrionalis respectively. On the other hand, isolates from Ramat Square site denoted as RS 6,2; RS 6A, RS 5, RS 7,2 were registered as Bacillus nealsonii, Paenibacillus cookie, Bacillus firmus and Bacillus megaterium respectively. Those of RS 5B and RS 7A of the same sample site were both Bacillus acidiceler and their granules were stained by Nile Blue A staining and observed under the fluorescence microscope and were classified for the extent of their PHB production based on the intensity of fluorescence emitted under the microscopy. NC 7 produced the highest PHB yield compared to all other isolates. Hence, municipal wastes are a rich reservoir of PHB-producing bacteria and can readily produce (PHB), which has enormous advantages over petroleum-based polymers by means of cost effectiveness and eco-friendliness

Calcium determination is normally done by conventional titrimetric methods (complexometric titration). In this study, a simple, precise, accurate, rapid and sensitive method has been developed for calcium (Ca) determination in Maxcal-C Tablet (herbo-mineral formulation) and its raw materials by Atomic Absorption Spectrophotometer (AAS). For complete digestion of the sample, closed vessel wet digestion technique was used with 69% HNO3 and 30% H2O2 (7:1) as digestive solvents. Analysis was performed on AAS (AA-6300) at λmax 422.7 nm. Calcium nitrate Ca(NO3)2 was used as a standard for Calcium and the linearity of the standard was excellent over a concentration range of 0.5 to 20 μgmL-1. The regression coefficient (r2) was 0.999. For intraday and interday precision % RSD was obtained between 0.48%-1.95% and 3.48%-5.01%, respectively which complied with the standard range for AAS. Recovery was achieved at 93.24%, 99.73%, 101.75% for 3 levels of spikes (80%, 100%, 120%) respectively, which complied with the standard range 75- 125% for AAS. However, the AAS method produced accurate and reproducible results and also overcame the colour and other ions interference, which are common problems with the titrimetric method. The results of both techniques (the AAS method and the titrimetric method) were compared, which showed good estimation by AAS.

Goat (Capra hircus) is important meat animal of the country. Fattening performance of different breeds of goats with common mid hill fodder trees was conducted in Completely Randomized Design with 4×5 factorial arrangements at Goat Research Station, Tanahun. The first factor was breed of goats and second factor was species of fodder trees. The main parameters monitored included dry matter (DM) intake, fattening performance and average daily gain (ADG) of goats with respect to different fodders. Results showed that DM intake by breeds of goats and species of fodder trees were highly significant (p

Child labour is unacceptable because we don't like children to be labourers. Among the poor people of underdeveloped countries including India, children work with their elders as family members, especially in agriculture, animal husbandry and traditional occupations. Child labour is prevalent in the unorganized sector. It is a reality that child labourers are engaged in child labour in various unorganized sectors in Ahmedabad city. Child labourers use their income earned from child labour differently. The present research has been conducted by obtaining primary data through questionnaire to find out whether the child labourers have the habit of saving from their earned income or not. Abstract in Gujarati Language: બાળમજુરી ન સ્વીકારી શકાય એવી બાબત છે કારણ કે બાળકો મજુર બને એ બાબત જ આપણને ગમતિ હોતી નથી .ભારત સહીત અલ્પવિકસિત દેશોની ગરીબ પ્રજાઓમાં ખાસ કરીને ખેતી, પશુપાલન અને પરંપરાગત વ્યવસાયોમાં બાળકો કુટુંબનાં સભ્ય તરીકે તેમના વડીલો સાથે કામ કરતા હોય છે અસંગઠિત ક્ષેત્રોમાં બાળમજુરી વ્યાપક પ્રમાણમાં જોવા મળે છે. અમદાવાદ શહેરમા વિવિધ અસંગઠિત ક્ષેત્રોમાં બાળમજૂરો બાળમજુરી કરે છે તે એક વાસત્વિકતા છે. બાળમજુરો પોતાની બાળમજુરીથી કમાયેલી આવકનો જુદો-જુદો ઉપયોગ કરતા હોય છે. બાળમજૂરો પોતે કમાયેલી આવકમાંથી બચત કરવાની ટેવ ધરાવે છે કે નહી તે જાણવાનાં હેતુથી પ્રશ્નાવલી દ્વારા પ્રાથમિક માહિતી મેળવી પ્રસ્તુત સંશોધન હાથ ધરવામાં આવ્યો છે. Keywords: અસંગઠિત ક્ષેત્ર, કુટુંબ, બાળમજુર, આવક, બચત

OBJECTIVE Type 2 diabetes (T2D) increases dementia risk, but clear evidence to recommend interventions that can mitigate that risk remains lacking. This population-based retrospective cohort study aimed to determine whether new use of sodium–glucose cotransporter 2 (SGLT2) inhibitors compared with dipeptidyl peptidase 4 (DPP-4) inhibitors was associated with lower dementia risk. RESEARCH DESIGN AND METHODS Ontario residents aged ≥66 years who were new users of an SGLT2 inhibitor or a DPP-4 inhibitor from 1 July 2016 to 31 March 2021 entered the cohort. Incident dementia was identified using a validated algorithm for Alzheimer’s disease and related dementias. Propensity score–weighted Cox proportional hazards models were used to obtain adjusted hazard ratios (aHR) and CIs for time to incident dementia. To address reverse causality and disease latency, the observation window started at 1-year lag time from cohort entry. The primary analysis followed intention-to-treat exposure definition, and a secondary as-treated analysis was performed. RESULTS Among 106,903 individuals, SGLT2 inhibitors compared with DPP-4 inhibitors were associated with lower risk of dementia (14.2/1,000 person-years; aHR 0.80 [95% CI 0.71–0.89]) over a mean follow-up of 2.80 years from cohort entry. When stratified by different SGLT2 inhibitors, dapagliflozin exhibited the lowest risk (aHR 0.67 [95% CI 0.53–0.84]), followed by empagliflozin (aHR 0.78 [95% CI 0.69–0.89]), whereas canagliflozin showed no association (aHR 0.96 [95% CI 0.80–1.16]). The as-treated analysis observed a larger association (aHR 0.66 [95% CI 0.57–0.76]) than the intention-to-treat analysis. CONCLUSIONS SGLT2 inhibitors showed an association with lower dementia risk in older people with T2D. Randomized controlled trials are warranted.

The United States Food and Drug Administration (US FDA) is a department of health and human services federal agency. If the FDA notices major violations of federal regulations, it sends warning letters to pharmaceutical makers, distributors, and clinical investigators. The nature of the infractions discovered, as well as the FDA's proposed corrective activities, are detailed in these warning letters. Following the completion of the corrective activities, the recipient may request a follow-up inspection. This review article examines the current state of warning letters issued by the US Food and Drug Administration (FDA) from 2019 to 2021. The main goal of this study is to examine warning letters related to drug and determine what the significant violations.

The bromodomain and extra terminal (BET) family of proteins are an integral part of human epigenome regulation, the dysregulation of which is implicated in multiple oncology and inflammatory diseases. Disrupting the BET family bromodomain acetyl-lysine (KAc) histone protein-protein interaction with small-molecule KAc mimetics has proven to be a disease-relevant mechanism of action, and multiple molecules are currently undergoing oncology clinical trials. This work describes an efficiency analysis of published GSK pan-BET bromodomain inhibitors, which drove a strategic choice to focus on the identification of a ligand-efficient KAc mimetic with the hypothesis that lipophilic efficiency could be drastically improved during optimization. This focus drove the discovery of the highly ligand-efficient and structurally distinct benzoazepinone KAc mimetic. Following crystallography to identify suitable growth vectors, the benzoazepinone core was optimized through an explore-exploit structure-activity relationship (SAR) approach while carefully monitoring lipophilic efficiency to deliver I-BET432 (

Children are the greatest gift to humanity and childhood is an important and influential stage of human development as it holds the potential for the future development of any society. However, it is a fact that in many countries including India, children are found working in factories or unorganized sectors at a tender age. Despite the Child Labor Prohibition and Regulation Act, 1986, there are 10.1 million child laborers in India, of which 5.6 million are boys and 4.5 million are girls. Although the rate of child labor has decreased in the last few years, children are still used in some serious forms of child labor such as bonded labor and trafficking. The present study has been conducted by collecting primary level data to find out the difficulties faced by child laborers engaged in boot polishing and garbage picking in self-employment sectors. Abstract in Gujarat Language: બાળકો એ માનવતા માટે સૌથી મોટી ભેટ છે અને બાળપણ એ માનવ વિકાસનો એક મહત્વપૂર્ણ અને પ્રભાવશાળી તબક્કો છે કારણ કે તે કોઈપણ સમાજના ભાવિ વિકાસની ક્ષમતા ધરાવે છે. આમ છતાં ભારત સહીત ઘણા દેશોમાં બાળકો કુમળી વયે કારખાનાઓમાં કે અસંગઠિત ક્ષેત્રોમાં કરતા જોવા મળે છે તે એક સત્ય હકીકત છે. ભારતમાં બાળમજુરી પ્રતિબંધ અને નિયંત્રણ ધારો ૧૯૮૬ હોવા છતાં ૧૦.૧ મિલિયન બાળમજૂરો છે, જે પૈકી ૫.૬ મિલિયન છોકરાઓ અને ૪.૫ મિલિયન છોકરીઓ છે. છેલ્લા કેટલાક વર્ષોમાં બાળ મજૂરીના દરમાં ઘટાડો થયો હોવા છતાં બાળકોનો હજુ પણ બાળ મજૂરીના કેટલાક ગંભીર સ્વરૂપો જેમ કે બંધુઆ મજૂરી અને હેરફેરમાં ઉપયોગ કરવામાં આવે છે. સ્વરોજગારીના ક્ષેત્રોમાં બુટ પોલીશ કરવાનું કામ અને કચરો વીણવાનું કામ કરનારા બાળમજુરોની મુશ્કેલીઓ જાણવાના હેતુથી પ્રાથમિક કક્ષાની માહિતી એકત્ર કરી પ્રસ્તુત અભ્યાસ કરેલ છે. Keywords: અસંગઠિત ક્ષેત્ર, સ્વરોજગારી, કચરો વિણનારા અને બૂટપોશિ કરનારા

Birt-Hogg-Dubé syndrome is an uncommon autosomal dominant systemic disorder with cutaneous findings notable for fibrofolliculomas or trichodiscomas on the scalp, face, neck, and trunk. These cutaneous signs are associated with bilateral renal cell carcinoma, benign renal cysts, pulmonary cysts, and spontaneous pneumothorax. Given its autosomal dominant inheritance pattern, the successful diagnosis of Birt-Hogg-Dubé syndrome (BHDS) may elucidate a diagnosis in family members. BHDS results from a mutation in the FLCN gene encoding the folliculin protein, a transcriptional regulator of the mammalian target of rapamycin signaling pathway. Like tuberous sclerosis, BHDS's clinical features may subside with the use of oral rapamycin for mammalian target of rapamycin inhibition, a theoretical concept meriting exploration. Although its prevalence in the general population has been estimated at 2 cases per million, BHDS has been detected in a few patients from the nearby Portuguese-lineage quarter of the city of Newark, a disproportionate prevalence possibly explained by the founder effect.

Increasing incidence of hepatocellular carcinoma (HCC) in India is a matter of concern and need for adequate profiling and streamlining management strategies cannot be over-emphasized.This is a prospective multi-centric observational cohort study comprising of an oncology center, one university tertiary hospital with specialized hepatology service, one public hospital with gastroenterology service, and a private liver transplant center located within a 3-km radius. The demographic and clinical parameters were recorded on a prospectively maintained database. The clinical profile, demographics, characteristics of HCC and the allocated treatment were noted and compared among the four centers.In total, 672 patients were enrolled from June 2016 till January 2020. Abdominal pain (64.3%) and weight loss (47.3%) were the most common symptoms. Most common identified etiology was hepatitis B (39%). The cancer center received lesser patients with hepatitis C and those with advanced stage of HCC. The private transplant center reported the highest proportion of NASH, which was also significantly higher in those belonging to higher socioeconomic strata, and lowest proportion of alcoholic cirrhosis. Metastasis was seen in almost one-fifth (19%) cases at diagnosis. Portal vein thrombosis was evident in 40%. Adherence to treatment guidelines was seen in three-fourth cases (76%).Hepatitis B is the most common underlying cause for HCC, whereas other causes like NASH are on the rise. Etiologic profile may vary with selective specialization of centers catering to patients with HCC. Adherence to guideline while allocating treatment was high among all centers with highest non-adherence in BCLC A.

The natural radioactivity in our living environment is mainly due to radionuclides of 40K, 232Th and 238U. We studied the distribution of these radionuclides in the sediment of different rivers and streams throughout the Kathmandu valley. The activity concentrations were determined by using digiBase NaI(TI) gamma-ray spectrometer, and further they were used to calculate radiological hazard indices to estimate the risk associated with the use of these sediments. The average activity concentrations for 40K, 232Th and 238U were found to be 378.54 ± 109.06, 45.95 ± 18.47 and 26.90 ± 9.61 Bq per kg, respectively. The average concentrations and calculated hazard indices have been compared with the respective reported activity concentration in different countries. This study reveals that there is no radiological threat using these local sediments as building materials and for other purposes.

Background: According to the American Psychological Association, anxiety and depression are both emotional responses that cause symptoms that are very similar, such as difculty sleeping, fatigue, muscle tension, and irritability. Whereas stress is usually caused by an external factor and is temporary, anxiety is persistent even in the absence of a stressor. Psychosocial factors are determinants, risk factors, and prognostic factors for neck pain. Aim: To nd the effect of the 5 Pranayamas versus Sudarshan Kriya on Neck Pain, Stress and Anxiety Methods and Material: Participants fullling the inclusion criteria were selected for the study. Informed and signed consent was taken from participants prior to commencing the study. Pre-readings were taken. Participants were randomly allocated in 2 groups, 15 in Group A and 15 in Group B respectively. Group A was given Sudarshan kriya and Group B was given 5 types of Pranayamas for 4 weeks 5 days a week for 30 minutes each day. Results: Paired and unpaired t test was used for within and between group analysis where p

Background: Extracorporeal membrane oxygenation (ECMO) is widely utilized for severe cardiopulmonary insufficiency, but its application to the oncologic population has been debated given concern for increased risk of infection. This study aims to analyze the implications of infections acquired during ECMO runs in patients with malignancy. Methods: The Extracorporeal Life Support Organization (ELSO) database was queried for patients with an International Classification of Diseases code of neoplasms over the last two decades (2000–2019). Culture-proven infections during ECMO runs were analyzed and compared to previously reported data for all ECMO runs. Results: Two thousand, seven hundred and fifty-seven patients met inclusion criteria. Infection acquired during ECMO run was found in 687 patients, a significantly greater proportion compared to all ECMO runs (24.9% vs 11.7%; P = .001). Adult patients had a significantly higher rate of infection (27.0%; P

Objectives Health education may improve health in geriatric patients. To evaluate differences between remote and in-person education, the DREAMS ( Developing a Research Participation Enhancement and Advocacy Training Program for Diverse Seniors) health seminar series compared in-person and remote learning groups to assess feasibility, satisfaction, adherence, health literacy, and cognitive outcomes. Research Design Nonrandomized two-arm interventions occurred remotely or in-person. About 130 diverse, older adults ( M age: 70.8 ± 9.2 years; in-person n = 95; remote, n = 35) enrolled. Data from 115 completers (In-person n = 80; Remote n = 35) were analyzed for performance outcomes. Feasibility, adherence, and satisfaction benchmarks were evaluated at baseline, immediately post intervention, and 8 weeks post intervention. Adjusting for baseline performances, outcomes on health literacy and cognitive measures were compared between groups after intervention (at posttest and at 8-week follow-up) using adjusted mean differences (β coefficients). Results Eighty in-person and all remote participants completed at least six modules. Both programs had high satisfaction, feasibility, and strong adherence. After adjusting for demographic covariates and baseline values, cognitive and motor cognitive measures between groups were domain specific (e.g., global cognition, executive function, spatial memory, mental tracking capacity, and cognitive integration). Discussion and Implications This work explores feasible measures of knowledge acquisition and its link to health literacy and cognitive outcomes. Identifying effective delivery methods may increase involvement in clinical research. Future studies may encourage remote learning for increased accessibility.

This study evaluated initial information about psychosocial differences of 130 diverse, older adults ( M age: 70.8 ± 9.2 years) who received a “low-tech” remote (independent reading with telephone support) or in-person education through DREAMS ( Developing a Research Participation Enhancement and Advocacy Training Program for Diverse Seniors) health seminar series. Outcomes on measures of depression, quality of life, and spatial extent of lifestyle of 115 completers were analyzed at baseline, immediately post-intervention, and 8-week follow-up. Adjusted at baseline, psychosocial outcomes were compared between groups at post-test and 8-week follow-up using adjusted mean differences. Post-participation, compared to remote participants, in-person participants had significantly lower depression on Beck Depression Inventory-II, Geriatric Depression Scale, and significantly higher mental quality of life on Short Form-12. This study links knowledge acquisition via in-person learning with decreased stress, depression, and increased quality of life among seniors. Identifying effective educational delivery methods may increase clinical research involvement for aging communities.

We evaluated the impact of a low intensity web-based and intensive nurse-administered intervention to reduce systolic blood pressure (SBP) among patients with prior MI.Secondary Prevention Risk Interventions via Telemedicine and Tailored Patient Education (SPRITE) was a three-arm trial. Patients were randomized to 1) post-MI education-only; 2) nurse-administered telephone program; or 3) web-based interactive tool. The study was conducted 2009-2013.Participants (n = 415) had a mean age of 61 years (standard deviation [SD], 11). Relative to the education-only group, the 12-month differential improvement in SBP was - 3.97 and - 3.27 mmHg for nurse-administered telephone and web-based groups, respectively. Neither were statistically significant. Post hoc exploratory subgroup analyses found participants who received a higher dose (12 encounters) in the nurse-administered telephone intervention (n = 60; 46%) had an 8.8 mmHg (95% CI, 0.69, 16.89; p = 0.03) differential SBP improvement versus low dose (11 encounters; n = 71; 54%). For the web-based intervention, those who had higher dose (n = 73; 53%;1 web encounter) experienced a 2.3 mmHg (95% CI, -10.74, 6.14; p = 0.59) differential SBP improvement versus low dose (n = 65; 47%).The main effects were not statistically significant.Completing the full dose of the intervention may be essential to experience the intervention effect.The unique identifier is NCT00901277 (http://www.gov/ct2/show/NCT00901277?term=NCT00901277rank=1).

Liquid Chromatography- Mass Spectrometry is a powerful analytical technique having high Sensitivity and Specificity. LC-MS combines the separation capabilities of Liquid Chromatography with the mass analysis capabilities of Mass Spectrometry. Liquid Chromatography separates the mixture, which is having multiple components, and then Mass Spectrometry provides the Spectral information which is used to identify each separated component. Interfaces are used in LC-MS system to transfer the maximum amount of analyte, remove a significant portion of the mobile phase, and preserves the chemical identity. Different types of Interfaces are used which include Atmospheric-Pressure Ionization, Electrospray Ionization, Atmospheric Pressure Chemical Ionization, Thermospray and Plasma Spray Ionization, Particle Beam Ionization, Continuous Flow Fast Atom Bombardment. LC-MS having a wide range of application in various field which include Pharmaceutical, Drug Development, Forensic Science, Cosmetic, Petrochemistry, Environment, Food Analysis, Biochemical Application. In this article Principle, Instrument and Application are discussed briefly.

This study evaluated the in vivo therapeutic efficacy of oncolytic serotype 5 adenovirus TAV255 in CAR-deficient tumors. In vitro experiments were performed with cell lines that expressed different levels of CAR (HEK293, A549, CT26, 4T1, and MCF-7). Low CAR cells, such as CT26, were poorly transduced by Ad in vitro unless the adenovirus was encapsulated in liposomes. However, the CT26 tumor in an immune-competent mouse model responded to the unencapsulated TAV255; 33% of the tumors were induced into complete remission, and mice with complete remission rejected the rechallenge with cancer cell injection. Encapsulation of TAV255 improves its therapeutic efficacy by transducing more CT26 cells, as expected from in vitro results. In a bilateral tumor model, nonencapsulated TAV255 reduced the growth rate of the locally treated tumors but had no effect on the growth rate of the distant tumor site. Conversely, encapsulated TAV255-infected CT26 induced a delayed growth rate of both the primary injected tumor and the distant tumor, consistent with a robust immune response. In vivo, intratumorally injected unencapsulated adenoviruses infect CAR-negative cells with only limited efficiency. However, unencapsulated adenoviruses robustly inhibit the growth of CAR-deficient tumors, an effect that constitutes an ‘in situ vaccination’ by stimulating cytotoxic T cells.

Background Healthcare inequity drives high costs, worse outcomes and is heavily influenced by social determinants of health (SDOH). Addressing health behaviors and SDOH through a culturally competent community-based exposure may be effective in improving value for Medicaid enrollees. This study aims to evaluate whether such an exposure lowers costs at equal or improved quality. Methods A retrospective cohort study leveraging claims data was conducted in Detroit, Michigan from April 2021 to April 2022 to examine the impact of a community-based peer support program on clinical, utilization and financial outcomes. A one-to-one propensity matching of 738 pairs of African American Medicaid enrollees was generated, and compared the difference of differences between inpatient, emergency department, prescription and outpatient paid amounts, utilization, and available claims-based quality metrics. Results Compared to controls, peer support recipients generated significantly lower per member per month costs ($115, (95% CI $20.2 to $210)). Recipients showed a significant increase in the Adult Access to Preventative/Ambulatory Health Services 20–44 year old quality metric (8.31% (95% CI 0.35–16.3%)). Member retention in the health insurance plan was significantly higher for peer support recipients vs. the control group by 3.62% (p Conclusions Among a population of African American Medicaid enrollees, a culturally competent community-based intervention was associated with lower cost and better member retention with preserved or improved quality.