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Age-related macular diseases (AMD) are common reason for visual impairment in humans. These anomalies can result from a variety of illnesses and disorders. Currently, skilled medical professionals make this diagnosis by visually inspecting the pictures. The study of ophthalmology is moving towards the creation of a computer-aided diagnosis (CAD) system for the identification of ocular disorders and diseases. It is crucial to classify these illnesses as accurately and without any false-negatives as possible. However, a person’s retina could be impacted by a number of fundus problems. So, for the purpose of classifying these diseases and pathologies into multiple categories, we study a case with 40 possible class labels. Random Forest was found to be 72.57% accurate based on global features extracted from the dataset and an analysis of the performance of several machine learning models. The dataset was then trained using a few user-defined and pretrained models, and it was found that EfficientNet B1 outperformed all other deep learning models in terms of test accuracy (90.2%), precision (0.993), recall (0.992), F1 score (0.8737), and (=0.2) score. All the models were trained on a set of 1166 images, validated on 250 images, and tested on 250 images

Cerebral palsy (CP) is a group of disorders that alters patients’ muscle coordination, posture, and movement, resulting in a wide range of deformities. Cerebral palsy can be caused by various factors, both prenatal and postnatal, such as infections or injuries that damage different parts of the brain. As brain plasticity is more prevalent during childhood, early detection can help take the necessary course of management and treatments that would significantly benefit patients by improving their quality of life. Currently, cerebral palsy patients receive regular physiotherapies, occupational therapies, speech therapies, and medications to deal with secondary abnormalities arising due to CP. Advancements in artificial intelligence (AI) and machine learning (ML) over the years have demonstrated the potential to improve the diagnosis, prognosis, and management of CP. This review article synthesizes existing research on AI and ML techniques applied to CP. It provides a comprehensive overview of the role of AI-ML in cerebral palsy, focusing on its applications, benefits, challenges, and future prospects. Through an extensive examination of existing literature, we explore various AI-ML approaches, including but not limited to assessment, diagnosis, treatment planning, and outcome prediction for cerebral palsy. Additionally, we address the ethical considerations, technical limitations, and barriers to the widespread adoption of AI-ML for CP patient care. By synthesizing current knowledge and identifying gaps in research, this review aims to guide future endeavors in harnessing AI-ML for optimizing outcomes and transforming care delivery in cerebral palsy rehabilitation.

Objective: To characterize changes in the retinal microvasculature in eyes with birdshot chorioretinopathy (BCR) using OCT angiography (OCTA). Design: Retrospective, observational, single center. Subjects: Twenty-eight patients (53 eyes) with BCR and 59 age-matched controls (110 eyes). Methods: En face OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of each eye were assessed for the presence of microvascular abnormalities and used to measure the vessel and foveal avascular zone (FAZ) areas. A longitudinal analysis was performed with a representative cohort of 23 BCR eyes (16 patients) at baseline and at a 2-year time point. Main Outcome Measures: Whole-image vessel density (VD, %), extrafoveal avascular zone (extra-FAZ) VD (%), and FAZ area (%) were calculated and compared between control and BCR eyes. The frequency of microvascular abnormalities in BCR eyes was recorded. Results: In the SCP, increased intercapillary space and capillary loops were common features present on OCTA images. Whole-image and extra-FAZ VD were lower in the BCR group compared with controls (P < 0.0001 [SCP and DCP]). Foveal avascular zone area was enlarged in BCR eyes (P = 0.0008 [DCP]). Worsening best-corrected visual acuity was associated with a decrease in whole-image and extra-FAZ VD in the SCP (P

We study a one-loop induced neutrino mass model with an inert isospin triplet scalar field of Y=0 and heavier isospin doublet vector-like leptons and singlet Majorana right-handed fermions. In addition to the neutrino mass matrix, we explain sizable scale of muon anomalous magnetic dipole moment 10−9 by introducing a singly-charged boson S±. We show numerical analysis of neutrino oscillation, lepton flavor violations, Z boson decays, and demonstrate our allowed regions in cases of normal and inverted hierarchies. We find the sizable scale of muon anomalous magnetic dipole moment for both cases. Then, we move on to the discussion of dark matter candidates to satisfy the relic density where we have two candidates; fermionic dark matter and bosonic one. And, we classify four cases fermionic dark matter with normal and inverted hierarchies, bosonic one with normal and inverted hierarchies and search for each of the allowed points in the model.

The emergence of the clade 1b variant of mpox has transformed the virus into a global health threat, prompting the World Health Organization to declare it a public health emergency. Clade 1b is characterized by enhanced transmissibility, particularly through human-to-human contact, including sexual transmission. This variant has spread rapidly from its epicenter in the Democratic Republic of Congo to neighboring African countries and beyond, with confirmed cases in Europe and Asia. The global response has focused on enhancing surveillance, improving diagnostics, and increasing access to the Jynneos vaccine and antiviral treatments, such as tecovirimat. However, several challenges remain, particularly in resource-limited settings. This review emphasizes the need for robust public health infrastructure, international collaboration, and ongoing research to mitigate the impact of mpox and prepare for future outbreaks.

The present study was carried out during rainy (kharif) seasons of 2020 and 2021 at Regional Horticulture Research Station (Sher-e-Kashmir University of Agricultural Sciences and Technology, Jammu, Jammu and Kashmir), Bhaderwah, Doda, Jammu, Jammu and Kashmir to evaluate genetic variability for quantitative and biochemical traits of local landraces of rajmash (Phaseolus vulgaris L.) of north-western Himalayas. Twenty-two induced mutant lines of rajmash generated with gamma rays and ethyl methane sulphonate were screened for quantitative, qualitative and anthracnose reactions under natural and artificial conditions in the field during kharif 2020 (M3) and 2021 (M4). The highly significant differences imply that induced mutant lines for different traits exhibited substantial amount of genetic diversity. Zinc content (55.38) and grain yield/plant (33.24) both had high phenotypic coefficients of variation, while 1000-seed weight (10.14) and protein content had low values (9.83). Zinc content had highest genetic advance, measured as a percentage of the mean, and the highest heritability, followed by grain yield/plant, iron content, number of pods/plant, number of clusters/plant, days to flowering and number of seeds/pod, whereas days to maturity and 1000-seed weight were moderate. The number of pods/plant (0.774), number of seeds/pod (0.556), number of clusters/plant (0.729), length of pod (0.648) and 1000-seed weight (0.620) all exposed a highly significant relationship with grain yield/plant but the days to flowering (-0.636) and days to maturity showed negative correlation (-0.602). It is obvious that the 9 induced mutant lines of Bhaderwah local and Poonch local i.e. R-BL-M3-1, R-BL-M3-9, R-BL-M3-10, R-BL-M3-12, R-BL-M3-13, R-BL-M3-14, R-PL-M3-18, R-PL-M3-20 and R-PL-M3-22 showed the minimum anthracnose disease incidence along with early emergence and superiority in grain yield/plant compared to controls. These mutant lines may be carried forward for the development of mutant genetic stocks and varietal development programmes of rajmash for north-western Himalayan region.

Background: Anemia during pregnancy may be associated with poor infant outcomes, although its consequences may vary based on etiology and timing. Objectives: We examined the associations between anemia and anemia-related biomarkers during pregnancy and infant outcomes [birthweight, gestational age at birth, birthweight-for-gestational age percentile, and infant hemoglobin (Hb) at 6 wk of age] in Nagpur, Eastern Maharashtra, India. Methods: We conducted a prospective cohort study of 200 pregnant women. In the first trimester, venous blood was collected to assess Hb via cyanmethemoglobin analysis, micronutrient status (ferritin, vitamin B12, and folate), and inflammation (C-reactive protein). Hb was also assessed in capillary samples using a hemoglobinometer in the first and third trimesters for mothers and at 6 wk for infants. Associations were assessed using generalized linear models controlling for background characteristics. Results: In the first trimester, high (compared with normal) venous Hb was significantly associated with lower gestational age at birth [β: −1.0 wk, 95% confidence interval (CI): −1.9, −0.2] and higher birthweight-for-gestational age percentile (β: 20.1, 95% CI: 9.0, 31.2). Mild anemia, moderate anemia, and high (compared with normal) capillary Hb were significantly associated with lower birthweight (β: −147.7 g, 95% CI: −243.4, −51.7; β: −77.7 g, 95% CI: −123.9, −31.4; and β: −236.0 g, 95% CI: −478.0, −48.1) and birthweight-for-gestational age percentile (β: −7.3, 95% CI: −13.7, −0.9; β: −8.4, 95% CI: −14.1, −2.8; and β: −8.9, 95% CI: −15.9, −1.9). Higher serum ferritin was significantly associated with higher birthweight (β: 2.0 g, 95% CI: 0.1, 3.9) and gestational age at birth (β: 0.01 wk, 95% CI: 0.00, 0.01). In the third trimester, mild anemia was significantly associated with lower gestational age at birth (β: −0.5 wk, 95% CI: −0.7, −0.3). Conclusions: Associations between maternal anemia during pregnancy and infant outcomes were mixed indicating further studies are needed to better understand these relationships.

Abstract Catalytic asymmetric synthesis of polysubstituted chiral cyclopropane presents a significant challenge in organic synthesis due to the difficulty in enantioselective control. Here we report a rhodium-catalyzed highly chemo-, regio- and enantioselective hydroformylation of trisubstituted cyclopropenes affording chiral quaternary cyclopropanes. Importantly, the easy made sterically bulky ligand L1 can effectively suppress hydrogenation and decomposition reactions and give quaternary cyclopropanes with high regio- and enantioselectivities for both aryl and alkyl functionalized substrates. Control experiments and computational studies reveal the sterically hindered well-defined chiral pocket instead of the substrates bearing electron-withdrawing diester groups is important for controlling the enantioselectivity and regioselectivity. Scale-up reaction and follow-up diverse transformations are also presented. Density Functional theory (DFT) computations suggest that the regio- and enantio-selectivities originate from the cyclopropene insertion to the Rh-H bond. The high regioselectivity is found to benefit from the presence of more efficient noncovalent interactions (NCIs) manifesting in the form of C–H···Cl, C–H···N, and l.p(Cl)···π contacts.

Background: Diabetes mellitus presents significant public health challenges worldwide. While its prevalence and management in the general population have been extensively studied, comprehensive research on diabetes among incarcerated individuals is lacking. This study aims to conduct a systematic review and meta-analysis to determine the prevalence of diabetes within the prison population. Methods: The systematic review included studies reporting on the prevalence of diabetes in prison populations. Searches were conducted in PubMed, Web of Science, and EMBASE from 2000 to November 4, 2023, with an update on December 15, 2023. Nested Knowledge web software was utilized for screening and data extraction. Quality assessment was conducted using the JBI tool. A meta-analysis was performed using a random-effects model in R software version 4.3. Results: Thirty-three studies were included, encompassing 807,617 participants, with 67,291 reported as patients with diabetes. The pooled prevalence of diabetes in prison populations was found to be 7.1% (95% CI: 4.9% to 10.1%), exhibiting high heterogeneity (I2 = 100%). Subgroup analysis revealed significant geographical variability: the United States had a prevalence of 9% (95% CI: 4 %to 17 %), Italy 5% (95% CI: 0% to 40 %), Iran 10% (95% CI: 7 % to 15 %), and Egypt 21% (95% CI: 14% to 28 %). Notable variations in prevalence were also observed in countries like France, Australia, Taiwan, India, the UK, Spain, Brazil, and Sub-Saharan Africa. An LFK index of −3.3 indicated the presence of publication bias. Conclusion: The study reveals that diabetes mellitus is a significant health concern in prisons, with a prevalence of 7.1%, comparable to that in the general population. The marked variability across studies indicates the challenges of diabetes management in correctional settings. These findings highlight the need for tailored healthcare strategies, considering prisons’ unique challenges and risk factors.

Background and objective: Lyme disease, caused by Borrelia burgdorferi, presents major health challenges worldwide, leading to serious neurological and musculoskeletal issues that impact patients' lives and healthcare systems. This systematic review and meta-analysis aim to determine the prevalence and link between Lyme disease and these complications, aiming to enhance clinical and public health approaches. Methods: We systematically searched PubMed, EMBASE, and Web of Science up until April 01, 2024, to find studies reporting the prevalence and severity of neurological and musculoskeletal complications associated with Lyme disease. Screening and data extraction were conducted using Nested Knowledge software. Two independent reviewers performed the quality assessment using the Newcastle-Ottawa Scale. Meta-analyses were performed using R software v4.3, employing a random-effects model. Results: Out of 3576 records, 17 studies were included, involving 3932 participants. These studies revealed significant prevalence of musculoskeletal symptoms (21.1%) and neurological disabilities (18%) among Lyme disease patients. The analysis showed a notable increase in risk for both complications in individuals with Lyme disease, with pooled Risk Ratios (RR) of 1.82 for musculoskeletal symptoms and 1.64 for neurological disabilities, indicating a significantly higher risk compared to control groups. Although heterogeneity across the studies was high, sensitivity analysis confirmed the consistency of our findings. Additionally, there was evidence of publication bias. Conclusion: The study reveals significant neurological and musculoskeletal complications in Lyme disease patients, emphasizing the importance of early diagnosis, comprehensive treatment, and supportive care. The noted heterogeneity and potential publication bias highlight the need for transparent research and further study on long-term outcomes.

Eosinophilia can be due to both infectious and non-infectious causes, many of which may be clinically indistinguishable. Filariasis, a tropical and subtropical infection, is caused by Wuchereria bancrofti, Brugia timori (B. timori), and Brugia malayi. Filariasis is conventionally diagnosed by demonstration of microfilaria in the peripheral blood smear. The disease may be missed if one is not aware of the possibility. We report two cases in two individuals with eosinophilia due to filaria resulting in tropical pulmonary eosinophilia and deep vein thrombosis (DVT). They had complete symptomatic improvement after a 3-week course of diethylcarbamazine (DEC) +/- ivermectin.

Pleural tumours represent a small yet significant subset of thoracic malignancies. Solitary Fibrous Tumours of the Pleura (SFTPs) are typically benign and account for 5% of all pleural tumours. Authors report a case of SFTPs excision with a postoperative diagnosis of Doege Potter Syndrome (DPS) in a 63-year-old male patient who was referred with complaints of chronic productive cough and breathlessness. Upon clinical and radiological evaluation, he was diagnosed with SFTPs. The patient experienced preoperative and intraoperative hypoglycaemic episodes, which were diagnosed as DPS during postoperative evaluation. This syndrome is a paraneoplastic condition associated with the secretion of Insulin-like growth factor-2 (IGF-II), observed in less than 5% of patients with SFTPs, with hypoglycaemia being a major symptom. Awake intubation and other procedures were performed with the patient in a propped-up position as he was unable to lie supine, which caused dyspnoea.

Pain is one of the most common reasons why patients seek medical attention. When experiencing discomfort in the orofacial region, a dentist is usually the first medical professional consulted. While odontogenic factors are the most common causes of acute pain in the maxillofacial region, it can also be non odontogenic, making it challenging to differentiate between the two. However, with a thorough examination, taking a complete history, and ordering necessary diagnostic tests, a dentist can make an accurate diagnosis and evaluate the entire stomatognathic system and other relevant anatomical regions. Misdiagnosis can lead to unnecessary dental procedures and cause trauma to the patients. Case 1 (50-year-old female) and case 3 (63-year-old female) were finally diagnosed as Trigeminal Neuralgia (TN), which were initially misdiagnosed as odontogenic pain and were treated with unnecessary irreversible dental treatments like Randomised Controlled Clinical Trials (RCT). Case 2 ( 28-year-old female) was eventually diagnosed as a case of myofascial pain with loss of muscle tone, for which the patient required palliative physical therapy. Instead, the splint, which was worn day and night by the patient, and soft diet resulted in muscle atrophy. The present case series emphasises the importance of accurate diagnosis to prevent irreversible dental treatment and protect patients from harm.

Background: Considering the concerns of obesity problems, Mumbai Police authorities had launched full-day residential “Healthy Living Training Program” in February 2019 for obese policemen. We studied the effectiveness of the program by assessing health profile of the participants, and change in anthropometric measurements and blood pressure readings. Methods and Materials: Permission from the concerned authorities and approval from the Institutional Ethics Committee (IEC) were taken. Health profiles of 143 policemen were assessed. Anthropometric measurements and blood pressure recordings were done on the first and the last day of the 28-day program. The data were coded and entered in password-protected Microsoft Excel. Paired t-test was applied to test statistically significant differences. The association of some of the variables with weight change was assessed by the Chi-square test for categorical variables. Results: The mean age of participants was 49.6 ± 5 years. The proportion of hypertensive, diabetics, vision problems, and bone and joint problems were 48.2%, 23.2%, 57.1%, and 46.4%, respectively. Only 70% of them had home-cooked food in the lunch. Daily, 50% of the participants do physical activity. There was statistically significant weight reduction (105.6 ± 12.1s vs. 103.3 ± 12 kg), body mass index (BMI) (36.3 ± 3.4 vs. 35.5 ± 3.3), waist circumference (110.8 ± 7.9 vs. 109.5 ± 7.9), and hip circumference (115.6 ± 8.1 vs. 106.8 ± 15.0) of the participants after 28 days of training program. Conclusion: “Healthy Living Training Program” was effective in reducing weight, blood pressure, BMI, and waist and hip circumference. The program benefitted the participants by inculcating healthy lifestyles and raising awareness of health issues.

Abstract Birdshot chorioretinopathy is an inflammatory eye condition strongly associated with MHC-I allele HLA-A29. The striking association with MHC-I suggests involvement of T cells, whereas natural killer (NK) cell involvement remains largely unstudied. Here we show that HLA-A29-positive birdshot chorioretinopathy patients have a skewed NK cell pool containing expanded CD16 positive NK cells which produce more proinflammatory cytokines. These NK cells contain populations that express CD8A which is involved in MHC-I recognition on target cells, display gene signatures indicative of high cytotoxic activity (GZMB, PRF1 and ISG15), and signaling through NK cell receptor CD244 (SH2D1B). Long-term monitoring of a cohort of birdshot chorioretinopathy patients with active disease identifies a population of CD8bright CD244bright NK cells, which rapidly declines to normal levels upon clinical remission following successful treatment. Collectively, these studies implicate CD8bright CD244bright NK cells in birdshot chorioretinopathy.

Background: Stunting or chronic malnutrition has been one of the major challenges to mankind for ages. The trends from the National Family Health surveys are more or less stagnant with a huge failure of the public health systems to tackle the problem of malnutrition. Innovative approaches are needed to tackle malnutrition. Objective: This pragmatic cluster randomized controlled trial (CTRI registration no. Trial REF/2023/08/071521) is planned to assess the effectiveness of a multifaceted antenatal and postnatal health educational intervention package implemented from the first trimester of pregnancy up to one year of infant age in reducing the rates of Low Birth Weight and improving the maternal-infant growth and developmental indicators in a cohort of rural pregnant women as compared to existing standards of care. Implication - The study emphasizes the importance of an ongoing continuum of care during the first 1000 days for effective birth weight, preventing malnutrition, and fostering infant growth and development as its programmatic pathway to impact. Results: We anticipate that the intervention will complement the existing health programs and will be implemented through the grassroot-level workers along with a community peer named “Safalta Tai” enabling community ownership of the intervention. Discussion: It also has a robust inbuilt monitoring and evaluation system through participatory action research for making it scalable and sustainable beyond the implementation period. Conclusion: The program leverages on the existing goverment programs like the poshan abhiyaan and the digital health mission. It has the potential to be incorporated in the exsiting health infrastructure without any additional resources and scaled up if found effective in reduction of low birth weight which is an important determinant of stunting in under five children.

Background and Aims: Of late, there are many legal representations from select quarters to halt all medical interventions in children with differences of sex development (DSD). In this survey on management decisions in DSD, we distil the views of Indian stakeholders: parents, physicians, and grown-up patients with DSD on their management decisions to identify decisional satisfaction or gender dysphoria. Methods: The survey domains included the patient demographics, final diagnosis, decision on the sex of rearing, surgical interventions, opinion of the stakeholders on the preferred age of sex assignment, final sex of rearing, and agreement/disagreement about sex assignment (gender dysphoria). Results: A total of 106 responses were recorded (66% parents, 34% grown-up patients aged 12–50 years). Among parents, 65/70 (95%) preferred the sex to be assigned soon after birth. All grown-up patients preferred sex to be assigned soon after birth. Regarding decisions on surgery, 74% of physicians and 75% of the grown-up patients felt parents should be allowed to decide interventions. Among Indian parents, 90% felt they should have the right to decide surgery in the best interest of their child for a safe social upbringing. Overall, gender dysphoria among Indian DSD patients was

Preimplantation genetic testing for aneuploidy (PGT-A) has become a useful approach for embryo selection following IVF and ICSI. However, the biopsy process associated with PGT-A is expensive, prone to errors in embryo ploidy determination, and potentially damaging, impacting competence and implantation potential. Therefore, a less invasive method of PGT-A would be desirable and more cost-effective. Noninvasive methods for PGT-A (ni-PGT-A) have been well-studied but present limitations in terms of cf-DNA origin and diagnostic accuracy. Minimally invasive pre-implantation genetic testing (mi-PGT-A) for frozen-thawed embryo transfer is a promising, less studied approach that utilizes a combination of spent culture media (SCM) and blastocoelic fluid (BF)-derived cell-free (CF)-DNA for genetic testing. This study aimed to optimize the effectiveness of mi-PGT-A for aneuploidy diagnosis by investigating the optimal temporal sequence for this protocol. SCM+BF was collected at either 48 or 72 h of culture after thawing day 3 preimplantation embryos. cf-DNA in the SCM+BF was amplified, analyzed by next-generation sequencing (NGS) and compared with results from the corresponding whole embryos (WEs) obtained from human embryos donated for research. Fifty-three (42 expanded blastocysts, 9 early blastocysts, and 2 morula) WE and SCM+BF samples were analyzed and compared. The overall concordance rate between SCM+BF and WE was 60%. Gender and ploidy concordance improved with extended culture time from 48 h (73% and 45%) to 72 h (100% and 64%), respectively. These results demonstrate that SCM+BF-derived cf-DNA can be successfully used for mi-PGT-A. Our findings indicate that longer embryo culture time prior to SCM+BF-derived cf-DNA analysis improves DNA detection rate and concordance with WEs and decreases the proportion of false positive results.

Background: The clinicopathological characterization of biomarkers to identify microsatellite instability in patients with colon cancers has not been fully studied. This study aims to evaluate the spectrum of histopathology of MLH1, MSH2, MSH6, and PMS2 markers to identify microsatellite instability in patients with colon cancers. Methods: The study analyzed the association between clinicopathological features and immunohistochemistry MLH-1, MSH-2, PMS-2, & MSH-6 expressions in 36 resected colorectal cancer samples. Patients' data were collected retrospectively, including tumor localization, size, the origin of polyp, mucinous differentiation, tumor stage, lymphovascular and perineural invasion, surgical boundary, and lymph node metastases. The primary antibodies, such as MLH-1, MSH-2, PMS-2, & MSH-6, were tested immunohistochemically. Results: The number of male cases was higher than female cases, 63.89% vs. 36.11%. The highest incidence (27.78%) of colorectal cancer was seen in the age group of 51-60 years. Tumors were predominantly adenocarcinoma NOS (69.44%). Moderately differentiated tumors (55.56%) were higher in number than poorly differentiated and well-differentiated ones. The highest stage seen was stage III in 50%. 80.56% of cases showed perineural invasion, 27.78% showed lymphovascular invasion, and 52.78% showed nodal metastasis. Right colon placement was associated with mucinous adenocarcinoma and a mucinous component. The ulcerous tumors were quite small, and their pathological tumor stage was higher. Tumors developing from polyps were large in size and had a lower pathological tumor stage. The study found that deletion of MSH-2 & MSH-6 expressions was substantially associated with right-colon placement and poor differentiation. In poorly differentiated adenocarcinomas, mucinous, lymphovascular, and perineural invasions were common. Tumors with mucinous differentiation showed less lymphovascular invasion and lymph node metastases. Perineural invasion was not noted in the pT1 or pT2 tumor stages. Conclusion: A strong correlation was found between immunohistochemical markers and clinical characteristics of tumors with microsatellite instability. However, these conclusions should be supported by large-scale investigations involving molecular PCR and other approaches.

This paper introduces a novel computational approach utilizing the quartic B-spline method on a uniform mesh for the numerical solution of non-linear singularly perturbed delay differential equations (NSP-DDE) of second-order with a small negative shift. These types of equations are encountered in various scientific and engineering disciplines, including biology, physics, and control theory. We are using quartic B-spline methods to solve NSP-DDE without linearizing the equation. Thus, the set of equations generated by the quartic B-spline technique is non-linear and the obtained equations are solved by Newton-Raphson method. The success of the approach is assessed by applying it to a numerical example for different values of perturbation and delay parameter parameters, the maximum absolute error (MAE) is obtained via the double mesh principle. The convergence rate of the proposed method is four. Obtained numerical results are compared with existing numerical techniques in literature and observe that the proposed method is superior with other numerical techniques. The quartic B-spline method provides the numerical solution at any point of the given interval. It is easy to implement on a computer and more efficient for handling second-order NSP-DDE.

Abstract Aims Among persons with prevalent heart failure (HF), iron deficiency has been linked to HF admissions, and intravenous iron replacement improves HF outcomes. Recent studies in persons with chronic kidney disease (CKD) demonstrate that iron deficiency is associated with incident HF. This study aimed to determine the relationship of iron status with incident HF in community‐dwelling older adults irrespective of their kidney function. Methods In this case‐cohort study, 1,006 Cardiovascular Health Study participants (785 from the random sub‐cohort [including 193 HF cases] and 221 additional HF cases [N = 414 total HF cases]) aged ≥ 65 years without HF (41% with CKD), we used weighted Cox models to evaluate associations of iron status with incident HF. Participants were categorized based on quartiles of transferrin saturation and ferritin as “iron replete” (27.3%), “functional iron deficiency” (7.7%), “iron deficiency” (11.8%), “mixed iron deficiency” (5.6%), “high iron” (9.3%) and “non‐classified” (38.1%), consistent with prior studies. Results Compared to older persons who were iron replete, those with iron deficiency were at higher risk of incident HF (HR 1.47; 1.02–2.11) in models adjusting for demographics, HF risk factors, and estimated glomerular filtration rate. Other iron categories did not associate with incident HF. The relationship of iron deficiency with incident HF did not differ by CKD status (interaction P value 0.2). Conclusions Among community‐dwelling elders, iron deficiency is independently associated with incident HF, an association that was similar irrespective of CKD status. Our findings support conduct of clinical trials of iron replacement for prevention of HF in older adults with iron deficiency.

Background and objective: The integration of machine learning (ML) in health care has garnered significant attention because of its unprecedented opportunities to enhance patient care and outcomes. In this study, we trained ML algorithms for automated prediction of outcomes of ureteroscopic laser lithotripsy (URSL) on the basis of preoperative characteristics. Methods: Data were retrieved for patients treated with ureteroscopy for urolithiasis by a single experienced surgeon over a 7-yr period. Sixteen ML classification algorithms were trained to investigate correlation between preoperative characteristics and postoperative outcomes. The outcomes assessed were primary stone-free status (SFS, defined as the presence of only stone fragments 90% for prediction of SFS and complications, and represents a basis for the development of an accessible predictive model for endourologists and patients in the URSL setting. Patient summary: We tested the ability of artificial intelligence to predict treatment outcomes for patients with kidney stones. We trained 16 different machine learning tools with data before surgery, such as patient age and the stone characteristics. Our final model was >90% accurate in predicting stone-free status after surgery and the occurrence of complications.

Hepatitis C virus infection is one of the main causes of liver disease that can lead to liver cirrhosis and finally to the chronic development of Hepatocellular Carcinoma (HCC). With 8 different HCV genotypes circulating, it becomes necessary to characterize the pathogenesis caused by each one of the HCV genotypes infecting population of a particular setting. Present study aims to identify the circulating Hepatitis C virus (HCV) genotypes in the different areas of State of Uttar Pradesh, India and understand their clinical etiology and related co-morbidities. The patients reporting to Sharda Hospital, Uttar Pradesh, India who were diagnosed positive for HCV were included in the study. The informed consent was obtained and then blood was drawn. In-house primers, for all the 8 genotypes were prepared and RT-PCR was performed. The amplified product was subjected to Agarose gel electrophoresis to identify the genotypes present in individual samples. Total 30 serum samples were taken. Of these, 21 (70%) showed presence of multiple genotypes, while 7 (23.33%) showed positivity for single genotype and two did not show any bands. Presence of multiple genotypes in individual patient has been reported for the first time. The pathological consequences of multiple genotypes within one host need to be studied further in terms of increased risk of developing a chronic liver disease. Further studies are being undertaken to study association of specific HCV genotype and multiple genotypes, Core, NS3 and NS5 viral proteins with the disease progression to develop predictors of liver cirrhosis and HCC.

Abstract Bioethanol is a sustainable energy alternative and can contribute to global greenhouse-gas emission reductions by over 60%. Its industrial production faces various bottlenecks, including sub-optimal efficiency resulting from bacteria. Broad-spectrum removal of these contaminants results in negligible gains, suggesting that the process is shaped by ecological interactions within the microbial community. Here, we survey the microbiome across all process steps at two biorefineries, over three timepoints in a production season. Leveraging shotgun metagenomics and cultivation-based approaches, we identify beneficial bacteria and find improved outcome when yeast-to-bacteria ratios increase during fermentation. We provide a microbial gene catalogue which reveals bacteria-specific pathways associated with performance. We also show that Limosilactobacillus fermentum overgrowth lowers production, with one strain reducing yield by ~5% in laboratory fermentations, potentially due to its metabolite profile. Temperature is found to be a major driver for strain-level dynamics. Improved microbial management strategies could unlock environmental and economic gains in this US $ 60 billion industry enabling its wider adoption.

The most common kind of developing odontogenic cysts are dentigerous cysts. They frequently push impacted teeth into ectopic locations by encircling the crown of the tooth. The mandibular third molar, maxillary canine, mandibular premolar, and maxillary third molar are the teeth that are most commonly afflicted, in decreasing order. Although these cysts are more prevalent in men, they can also occur in children and teenagers, especially in the second and third decades of life. Dentigerous cyst-related teeth in the maxilla frequently cause root dilatation in the mandibular area, permanent tooth bud displacement close to the sinus, and cortical bone enlargement, sometimes, even up to the level of the orbit or floor of the nose. Clinically, these cysts do not cause any symptoms and are frequently found by chance during radiographs done to look into cases of primary teeth that are retained, teeth that are missing, teeth that erupt slowly, or orthodontic issues. Cone-beam computed tomography’s advent has just made it possible to shed fresh, extensively documented light on diagnostic and treatment approaches. Protocol for management: Surgery is typically used to treat dentigerous cysts. In this instance, the affected tooth underwent endodontic therapy, after which the cyst was curettaged, a further apicoectomy was performed, and canine impaction was completed. In the end, a bone graft and platelet-rich fibrin were implanted for rehabilitation.

Introduction: The standard approaches to ultrasound-guided central line insertion by Short Axis (SAX) and Long Axis (LAX) have limitations. The Medial Oblique Axis (M-OAX) approach allows visualisation of the length of the needle in real-time along with both the artery and vein. Aim: To compare the three approaches for ultrasound-guided right Internal Jugular Vein (IJV) cannulation with respect to ease of access and complications. Materials and Methods: A total of 171 patients scheduled to undergo right IJV cannulation were divided equally into three groups-SAX (Group-1), LAX (Group-2), and M-OAX (Group-3). They were compared with respect to first pass success, Venous Access Time (VAT), guide wire insertion time, catheterisation time, and complications. Continuous variables were compared with Analysis of Variance (ANOVA) test. Categorical variables were analysed using the Chi-square test. The p-value 0.05). Conclusion: The medial oblique approach to IJV cannulation combines the advantages of both LAX and SAX and is a safer alternative with easier and faster venous access.

Introduction: Lectures as a method of teaching are very common and also under increasing criticism due to passive recipients of information with no development of thinking skills or change in attitude. Objectives: To Compare traditional lecture method with interactive teaching methods in large groups and to assess the perceptions of students towards these methods. Material and Methods: A Quasi-Experimental Study was taken up at the Department of Community Medicine among 7th semester students of MBBS course of our Medical College located at Hyderabad for a period of 4 months. Four different teaching-learning methods such as traditional, case-based, Jigsaw, and Quiz were conducted for 4 topics of Non-communicable diseases which were evaluated through objective structured questions and subjective by perceptions rated on a Likert scale(1-5). Results: Out of 100 students, 92 students regularly attended all the teaching methods of 4 topics-Hypertension, Diabetes Mellitus, Stroke, and Coronary artery disease. The highest objective structured mean score of 6.34+2.367 was obtained for case based teaching in hypertension topic, Diabetes Mellitus (6.63+1.827) for the jigsaw method, Coronary artery disease (6.95+1.561) and stroke (6.11+1.941). Subjective rating was excellent for jigsaw method in context with the topic related to Hypertension and stroke. Quiz was rated as excellent for the topics related to Diabetes mellitus and Coronary artery disease. For the overall perceptions consisting of positive and negative questions, highest score was rated for the jigsaw method of teaching. Conclusions: Objective evaluation has revealed higher scores with interactive teaching methods compared to traditional method and on students feedback about their perceptions and most preferable method, the jigsaw scored the highest.

Abstract Dendranthema grandiflora is an important cut flower with high economic importance in the floriculture industry. Identification of stable and high yielding genotypes of Dendranthema grandiflora, hence becomes paramount for ensuring its year-round production. In this context, the genotype by environment interaction effects on 22 chrysanthemum hybrids across six test environments were investigated. The experiment was conducted using Randomized Complete Block Design with three replications for 6 years and data on various agro-morphological and yield-contributing traits were evaluated. Our analysis revealed significant mean sum of squares due to environmental, genotypic and genotype by environment interaction variations for all examined traits. A 2D GGE biplot constructed using first two principal components computed as 59.2% and 23.3% of the differences in genotype by environment interaction for flower yield per plant. The GGE biplot identified two top-performing genotypes, G2 and G5, while the AMMI model highlighted genotypes G17, G15, G6, G5, and G2 as the best performers. Genotype G17 ranked highest for multiple traits, while G2 displayed high mean flower yield as well as stability across all environments. According to AEC line, genotypes G2 and G5 exhibited exceptional stability, whereas genotypes G4, G18 and G19 demonstrated lower stability but maintained high average flower yields. Hence, our findings provide valuable insights into chrysanthemum hybrids that were not only best performing but also hold promise to meet the growers demand of the cut flower industry and can be recommended for large scale commercial cultivation.

Artificial intelligence is an ever-growing modality revolutionizing the field of medical science. It utilizes various computational models and algorithms and helps out in different sectors of healthcare. Here, in this scoping review, we are trying to evaluate the use of Artificial intelligence (AI) in the field of pediatric anesthesia, specifically in the more challenging domain, the pediatric airway. Different components within the domain of AI include machine learning, neural networks, deep learning, robotics, and computer vision. Electronic databases like Google Scholar, Cochrane databases, and Pubmed were searched. Different studies had heterogeneity of age groups, so all studies with children under 18 years of age were included and assessed. The use of AI was reviewed in the preoperative, intraoperative, and postoperative domains of pediatric anesthesia. The applicability of AI needs to be supplemented by clinical judgment for the final anticipation in various fields of medicine.

Background : Patients with chronic kidney disease (CKD) who undergo hemodialysis are predisposed to interstitial cerebral edema. Robotic-assisted laparoscopic surgery can increase optic nerve sheath diameter (ONSD) and intracranial pressure. The impact of robotic-assisted kidney transplant (RAKT) on ONSD is complicated by the presence of CKD, the administration of furosemide and mannitol, and the manipulation of hemodynamics. We examined ONSD variations in patients undergoing RAKT over a 1-year period at our institution. Furthermore, we attempted to identify any perioperative hemodynamic factors influencing these changes. Methods : This prospective study included 20 patients undergoing RAKT. ONSD, heart rate, central venous pressure, systolic blood pressure, diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured following intubation (T1), after assuming the steep Trendelenburg position (T2), 1 hour after docking (T3), upon reperfusion (T4), after transition to the supine position (T5), and 3 hours postextubation (T6). Repeated measures analysis of variance with post hoc Bonferroni correction was employed to compare variables at each time point. Pearson correlation analysis was utilized to assess relationships between variables. P-values ≤0.05 were considered to indicate statistical significance. Results : ONSD (in mm) increased from T1 (3.60±0.44) to T3 (4.06±0.45, P=0.002) and T4 (3.99±0.62, P=0.046), before falling to its lowest value at T6 (3.42±0.64, P=0.002). Pearson correlation analysis revealed significant correlations (P

Abstract. The study aimed to investigate the effects of Ficus religiosa (L.) leaf compost on the germination and plant growth parameters of tomato seedlings. Physical parameters of the leaf compost and soil, such as color, texture, appearance, electric conductivity, pH were recorded. Various concentrations of the leaf compost ranging from 10% - 40% were used in the study. The total carbon, nitrogen, potassium and phosphorus levels in soil and leaf compost before sowing and after sowing were also measured. The results revealed that the seedling growth parameters such as Mean Germination Time, Initiation of Germination, Mean Daily Germination, Speed of Germination, Completion of Germination, Peak Value, Germination Value were maximum at 40% Leaf compost. The results of plant growth parameters of tomato plants revealed that the 40% LC showed maximum increase in shoot length, number of leaves, diameter of leaves, length of leaves, root length, number of leaflets, total plant length, fresh weight and dry weight. The average percentage of carbon, nitrogen, potassium, phosphorus content significantly increased with a higher dose of leaf compost compared to the control. The results indicated that leaf compost of F. religiosa at 40% improved plant growth minimizing the need of chemical fertilizers.

Background: Breast cancer (BC) is currently the fifth largest cause of mortality worldwide and has become the most frequent type of cancer. Fatty acid transport proteins (FATPs) assist cancer cells in meeting their higher metabolic needs by increasing fatty acid uptake, which is a significant source of energy for cancer cells. The phosphoinositide 3-kinase/protein kinase B/mammalian target of the rapamycin (PI3K/Akt/mTOR) pathway is an important signaling pathway that coordinates the uptake and utilization of various nutrients, including fatty acids. The current study aimed to correlate the FATPs with the PI3K/Akt/mTOR pathway in BC. Methods: Eighty serum samples were collected from BC and control subjects after obtaining an informed consent form. Total ribonucleic acid (RNA) was isolated, and the relative messenger RNA (mRNA) expression of PI3K, Akt, and mTOR was analyzed by a reverse transcriptase-quantitative polymerase chain reaction. Serum FATPs were estimated using commercially available enzyme-linked immunoassay kits. P < 0.05 was indicated as statistically significant. Results: The serum FATPs in subjects with BC differed significantly compared to the control. Relative mRNA expression of PI3K, Akt, and mTOR differed significantly between the groups. Further, on correlating the serum FATPs with PI3K-related signaling molecules showed a significant positive correlation within BC subjects. Conclusion: Significant positive correlation between FATPs and the PI3K, Akt, and mTOR pathway suggests a crucial role of FATPs in promoting BC.

Background: A desired target for cancer therapy is a cancer-specific metabolism which is associated with innate or acquired therapeutic resistance, malignancies, and aggressive cancer growth. Nevertheless, these cells utilize manifold metabolic routes to prolong their mass explosion. Human hexokinase 2 (HK2), phosphofructokinase, muscle (PFKM), pyruvate kinase M2 (PKM2), and lactate dehydrogenase A (LDHA) are fundamental signature players of cancer glycolysis playing a role in cancer cell regulation. Reflecting their metabolic roles may be possible with a better grasp of the metabolism transition in the early onset and spread of cancer. This study was designed to assess the serum protein levels of HK2, PFKM, PKM2, and LDHA in women with breast carcinoma and its correlation with phosphatidylinositol-3-kinase (PI3K)/Akt and the mammalian target of rapamycin (mTOR) pathway. Methods: In the current research, case–control investigation was undertaken with breast cancer women (n = 30) and compatible healthy women (n = 30) visiting Justice K. S. Hegde Charitable Hospital, Deralakatte, Mangaluru, who were selected on the basis of inclusion and exclusion criteria. Baseline characteristics for the study population were marked down. The HK2, PFKM, PKM2, and LDHA levels within serum were estimated by means of sandwich enzyme-linked immunosorbent assay. Results: We observed a difference that was significant among the two groups with regard to age and postmenopausal status and also a difference in first-degree family history. The levels of PKM2 and key glycolytic enzymes in serum varied between the case and control groups. There was a positive correlation that was observed in breast carcinoma subjects with glycolytic proteins and signaling pathway (PI3K/Akt/mTOR). Conclusions: Nevertheless, assured processes that persuade the target enzymes remain vague and require further in-depth exploration. Overall, discovering anticancer therapeutics that target glycolytic enzymes involved in glucose metabolism remains a dilemma.

Abstract The genus Clostridium is a large and diverse group within the Bacillota (formerly Firmicutes), whose members can encode useful complex traits such as solvent production, gas-fermentation, and lignocellulose breakdown. We describe 270 genome sequences of solventogenic clostridia from a comprehensive industrial strain collection assembled by Professor David Jones that includes 194 C. beijerinckii, 57 C. saccharobutylicum, 4 C. saccharoperbutylacetonicum, 5 C. butyricum, 7 C. acetobutylicum, and 3 C. tetanomorphum genomes. We report methods, analyses and characterization for phylogeny, key attributes, core biosynthetic genes, secondary metabolites, plasmids, prophage/CRISPR diversity, cellulosomes and quorum sensing for the 6 species. The expanded genomic data described here will facilitate engineering of solvent-producing clostridia as well as non-model microorganisms with innately desirable traits. Sequences could be applied in conventional platform biocatalysts such as yeast or Escherichia coli for enhanced chemical production. Recently, gene sequences from this collection were used to engineer Clostridium autoethanogenum, a gas-fermenting autotrophic acetogen, for continuous acetone or isopropanol production, as well as butanol, butanoic acid, hexanol and hexanoic acid production.

Abstract Background Chronic headache disorders are disabling. The CHESS trial studied the effects of a short non-pharmacological intervention of education with self-management support for people affected by migraine and/or tension type headache for at least 15 days per month for at least three months. There were no statistically significant effects on the Headache Impact Test-6 (HIT-6) at 12-months. However, we observed improvement in pain self-efficacy questionnaire (PSEQ) and short-term HIT-6. We explored the impact of the CHESS intervention on PSEQ, and subsequently, on the HIT-6 and chronic headache quality of life questionnaire (CH-QLQ) at four, eighth and 12 months. Methods We included all 736 participants from the CHESS trial. We used simple linear regression models to explore the change of HIT-6 and CH-QLQ with treatment and PSEQ at baseline (predictor analysis), and the interaction between treatment and baseline PSEQ (moderator analysis). We considered the change of PSEQ from baseline to four months as a mediator in the mediation analysis. Results Baseline PSEQ neither predicted nor moderated outcomes. The prediction effect on change of HIT-6 from baseline to 12 months was 0.01 (95% CI, -0.03 to 0.04) and the interaction (moderation) effect was −0.07 (95% CI, -0.15 to 0.002). However, the change of PSEQ from baseline to 4-month mediated the HIT-6 (baseline to 8-, and 12-month) and all components of CH-QLQ (baseline to 8-, and 12-month). The CHESS intervention improved the mediated variable, PSEQ, by 2.34 (95% CI, 0.484 to 4.187) units and this corresponds to an increase of 0.21 (95% CI, 0.03 to 0.45) units in HIT-6 at 12-months. The largest mediated effect was observed on the CH-QLQ Emotional Function, an increase of 1.12 (95% CI, 0.22 to 2.20). Conclusions PSEQ was not an effective predictor of outcome. However, change of short-term PSEQ mediated all outcomes, albeit minimally. Future behavioural therapy for chronic headache may need to consider how to achieve larger, and more sustained increases level of self-efficacy than that achieved within the CHESS trial. Trial registration ISRCTN79708100.

Abstract A small number of cancer patients respond exceptionally well to therapies and survive significantly longer than patients with similar diagnoses. Profiling the germline genetic backgrounds of exceptional responder (ER) patients, with extreme survival times, can yield insights into the germline polymorphisms that influence response to therapy. As ERs showed a high incidence in autoimmune diseases, we hypothesized the differences in autoimmune disease risk could reflect the immune background of ERs and contribute to better cancer treatment responses. We analyzed the germline variants of 51 ERs using polygenic risk score (PRS) analysis. Compared to typical cancer patients, the ERs had significantly elevated PRSs for several autoimmune-related diseases: type 1 diabetes, hypothyroidism, and psoriasis. This indicates that an increased genetic predisposition towards these autoimmune diseases is more prevalent among the ERs. In contrast, ERs had significantly lower PRSs for developing inflammatory bowel disease. The left-skew of type 1 diabetes score was significant for exceptional responders. Variants on genes involved in the T1D PRS model associated with cancer drug response are more likely to co-occur with other variants among ERs. In conclusion, ERs exhibited different risks for autoimmune diseases compared to typical cancer patients, which suggests that changes in a patient’s immune set point or immune surveillance specificity could be a potential mechanistic link to their exceptional response. These findings expand upon previous research on immune checkpoint inhibitor-treated patients to include those who received chemotherapy or radiotherapy.

Abstract Background Vitamin A deficiency (VAD) is a major public health problem in India, where approximately 62% of children under five have low retinol levels (

Abstract Background Human papillomavirus (HPV) is increasingly recognized as a significant risk factor in the development of head and neck cancers (HNCs), with varying prevalence and impact. This study aims to systematically review and analyze the prevalence of HPV in HNCs in India, providing insights into regional variations. Methods A comprehensive literature search was carried out using PubMed, Embase, and Web of Science up to November 10, 2023. Inclusion criteria focused on original research reporting HPV-positive cases among HNC patients in India. We used Nested-Knowledge software, for screening, and data extraction. The modified Newcastle-Ottawa Scale was used for quality assessment of included studies. We pooled the prevalence of HPV among HNC patients and performed a random-effects model meta-analysis using R software (version 4.3). Results The search yielded 33 studies, encompassing 4654 HNC patients. The pooled prevalence of HPV infection was found to be 33% (95% CI: 25.8–42.6), with notable heterogeneity (I² = 95%). Analysis of subgroups according to geographical location indicated varying prevalence rates. Specifically, the prevalence was 47% (95% CI: 32.2–62.4) in the eastern regions and 19.8% (95% CI: 10.8–33.4) in the western regions. No evidence of publication bias was detected. Conclusion The observed considerable regional disparities on the prevalence of HPV in HNC patients in India emphasizes the need for integrated HPV vaccination and screening programs in public health strategies. The findings underline the necessity for further research to explore regional variations and treatment responses in HPV-associated HNCs, considering the impact of factors such as tobacco use and the potential benefits of HPV vaccination.

Abstract Smokeless tobacco (SLT) poses many negative health impacts. Despite its longstanding presence in societies across the world, the health implications of SLT have only been rigorously studied in recent decades. This systematic review and meta-analysis aimed to consolidate existing research to provide a comprehensive understanding of the global prevalence of SLT use among women of reproductive age. Relevant articles were extracted from databases such as PubMed, EMBASE, Web of Science, and Scopus from their inception until November 11, 2023. Observational studies reporting the number of SLT users among women of reproductive age were included. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) tool. The meta-analysis used a random-effects model to determine SLT prevalence, supported by statistical tools like forest plots, I2 statistics, and sensitivity analyses to ensure the accuracy and comprehensiveness of the results. All statistical analyses were performed in R version 4.3. From 10 studies involving 2,053,667 participants, a pooled prevalence for SLT use among women of reproductive age was found to be 9.3% (95% CI: 0.038 to 0.21), with significant heterogeneity among studies (I2 = 100%). Publication bias was suspected among the studies. Sensitivity analysis and subgroup analysis couldn’t resolve the heterogeneity. Our analysis shows a significant prevalence of SLT use in women of reproductive age, especially in low socioeconomic and developing countries like India, Pakistan, and Nepal. For women of reproductive age, the use of smokeless tobacco (SLT) can lead to infertility, pregnancy complications, and adverse fetal outcomes, including low birth weight and preterm birth. The results highlight the necessity for specific public health measures and policy changes to decrease SLT consumption among reproductive-age women. Further studies are needed to investigate the reasons behind SLT usage in this group and to assess the impact of intervention strategies, to guide more effective public health initiatives and policies.

Abstract Background In recent years, there has been an increase in cases of heart failure, ultimately leading to an increase in hospitalization for heart failure (HF) and cardiovascular mortality. The aim of our study was to evaluate ivabradine combined with beta-blocker versus beta-blocker alone in addition to standard care for chronic heart failure, followed for a period of 6 months for the rate of hospitalization and major adverse cardiovascular event (MACE) in patients with reduced left ventricular ejection fraction (LVEF

Introduction: Prakriti (body constitution) is the essential fundamental of Ayurveda. In female physiology, it plays a crucial role in determining the age of menarche and menopause. Recent research has shown that early menopause occurs in tribal women. Vagbhata states that a kapha dosha pradhan prakriti female has a longer menstrual life [i.e., reproductive period] compared to the vata and pitta prakriti females. This study was done to estimate prakriti in females who attain early and premature menopause in the tribal population to provide optimal care for tribal women through primary and whole health systems. Materials and Methods: This cross-sectional questionnaire survey study was carried out in four villages of Nagpur district territory of Eastern Maharashtra, the central zone of India after seeking permission from IEC. A multistage sampling technique was used to select the 80%, and above tribal people, 169 married women who attained early or premature menopause were included. Post-menopausal women were selected for the study, and females with hysterectomy, secondary amenorrhea, and other major illnesses were excluded from the study. Data were collected by survey method with the help of a pre-validated questionnaire. Observation and Result: Out of 169 females 57.98% of females were of vata prakriti, 24.85% of females were of pitta prakriti, and 17.15% of females were of kapha prakriti. The prevalence of early or premature menopause of vata prakriti females is 57.98. Discussion: Vata dosha characteristics such as ruksha, laghu, sheeta, and khara in vata prakriti females lead to early or premature menopause. To avoid early or premature menopause in tribal females, ghee (ghrit) and milk can be included in dietary habits, lifestyle modification, and awareness counseling may prove beneficial. Conclusion: Early or premature menopause is observed largely in vata prakriti females of Nagpur district, Eastern Maharashtra, tribal zone of Central Inda.

Renal vascular complications constitute a clinically significant cause of morbidity following renal transplantation. Transplant renal artery stenosis (TRAS) is a well-recognized complication accounting for ~75% of posttransplant vascular complications. Early recognition and prompt correction of TRAS can prevent adverse outcomes, including graft loss. This series is a summary of four renal transplant recipients who developed TRAS at varied time periods and with varied clinical presentations. A 23-year-old male who presented after 1½ months of renal transplantation with accelerated hypertension was diagnosed with TRAS and was treated successfully with percutaneous transluminal angioplasty with stenting. A 26-year-old male with acute allograft dysfunction after 1 month of transplantation without worsening hypertension was diagnosed with TRAS, which was treated successfully with angioplasty and stenting. A 49-year-old male who presented to the emergency with pulmonary edema secondary to accelerated hypertension (Pickering syndrome) after 2 months of transplantation was diagnosed to have TRAS, which was treated successfully with angioplasty with stenting. A 44-year-old male with an incidentally detected TRAS-like clinical picture secondary to kinking in the transplant renal artery in the immediate posttransplant period was successfully treated with re-exploration and repair. All the patients were screened with Doppler ultrasonogram and computed tomogram-angiography supported the diagnosis in three of the cases. None of the cases developed procedure-related complications including contrast-associated nephropathy. All the patients on follow-up after 6 months of the intervention are normotensive with normal renal function. A high index of suspicion is required in the early identification of TRAS, which is a reversible cause of hypertension and graft dysfunction. The risk of contrast-associated nephropathy cannot hinder or delay the diagnosis especially, in emerging transplant centers. The endovascular procedures used today for the treatment of TRAS are safe with high technical success rates.

Abstract Non-melanoma skin cancer (NMSC), encompassing basal and squamous cell carcinoma, is the most prevalent cancer in the United States. While surgical removal remains the conventional therapy with a 95% 5-year cure rate, there is a growing interest in exploring alternative treatment strategies. In this study, we investigated the role of Bortezomib (BTZ), a proteasome inhibitor, in NMSC. Using two NMSC cell lines (A431 and A388), we examined the effects of BTZ treatment. Our results demonstrated that 48 h of BTZ treatment led to downregulating Skp2 expression in both A431 and A388 cells while upregulating p53 expression, specifically in A388 cells. These alterations resulted in impaired cellular growth and caspase-dependent cell death. Silencing Skp2 in A388 cells with siRNA confirmed the upregulation of p53 as a direct target. Furthermore, BTZ treatment increased the Bax to Bcl-2 ratio, promoting mitochondrial permeability and the subsequent release of cytochrome C, thereby activating caspases. We also found that BTZ exerted its antitumor effects by generating reactive oxygen species (ROS), as blocking ROS production significantly reduced BTZ-induced apoptotic cell death. Interestingly, BTZ treatment induced autophagy, which is evident from the increased expression of microtubule-associated proteins nucleoporin p62 and LC-3A/B. In addition to cell lines, we assessed the impact of BTZ in an in vivo setting using Caenorhabditis elegans (C. elegans). Our findings demonstrated that BTZ induced germline apoptosis in worms even at low concentrations. Notably, this increased apoptosis was mediated through the activity of CEP-1, the worm’s counterpart to mammalian p53. In summary, our study elucidated the molecular mechanism underlying BTZ-induced apoptosis in NMSC cell lines and C. elegans. By targeting the skp2/p53 axis, inducing mitochondrial permeability, generating ROS, and promoting autophagy, BTZ demonstrates promising anti-cancer activity in NMSC. These findings provide novel insights into potential therapeutic strategies for controlling the unregulated growth of NMSC.

Convergent and divergent channels have practical uses in the manufacture of fibres and glass, for the production of plastic sheets, the control of molten metal flows, and casting of metals. Also, hybrid nanofluids are being explored as possible working fluids for solar collectors and other high heat flux systems because of their outstanding heat transfer abilities. The present study focuses on exploring the effect of quadratic thermal radiation on the hybrid nanoliquid stream via a convergent/divergent channel, considering the impact of homogeneous-heterogeneous chemical reactions with the suspension of tantalum and alumina nanoparticles on the liquid stream. The governing partial differential equations of the present problem are transformed into dimensionless ordinary differential equations with the help of similarity variables. Further, the resultant equations are solved using the finite element approach. Also, the Laguerre Polynomial-based Physics Informed Neural Network (L-PINN) model is adopted to analyze the fluid flow, heat, and mass transfer characteristics. The significance of pertinent physical parameters on the field variables is depicted with graphical representations. Turbulence, caused by chaotic fluid motion, increases energy dissipation, which can limit the channel's effective flow velocity in stretching convergent channels. A rise in the Reynolds number in a divergent stretchable and shrinkable channel raises the temperature due to improved convective heat transfer.

Background: Heart failure (HF) is a complex syndrome. Despite availability of multiple treatment options, the mortality remains high and the quality of life poor. Better understanding of the underlying pathophysiological processes can lead to development of novel therapies. Multiple comparative transcriptomics studies, which revealed gene level changes in the key pathophysiological pathways in failing hearts, point towards heterogeneity from interplay of disease stage, etiologies and ethnicity. Transcriptomic characterization of HF in patients from different ethnicities can potentially help in understanding the heterogeneity imparted by various factors and the core elements in heart failure. Methods & results: An integrated analysis of bulk transcriptome and microRNA sequencing from the cardiac tissues of 30 South Asian (SA) patients having HF with reduced ejection fraction (HFrEF) and 19 control subjects was conducted. Plasma miRNAs from a subset of HFrEF and control patients were also sequenced to understand their biomarker potential. The altered transcriptome from the myocardium of SA HFrEF patients reflected cardiac muscle contraction, cellular energetics, altered immune signaling and extracellular matrix remodelling as predominant pathophysiological mechanisms. The SA HFrEF patients also showed dysregulation of multiple microRNAs in cardiac tissue like miR-216, miR-217, miR-184 and miR-9983. Many of these miRNAs, such as miR184 and few others, showed altered levels in both the plasma and cardiac tissue of HFrEF patients suggesting their biomarker potential. The diversity in the HFrEF transcriptomes from published studies led us to examine the core HF genes in our cohort. A gene signature generated using machine learning (ML) from the top dysregulated genes in SA HFrEF cohort stratified HF from controls in other cohorts. The sensitivity of the HF gene signature was further improved when union of two cohorts was used as a training set. Our ML analyses developed a core HF gene signature consisting of 21 genes that can stratify HF patients from controls with 98 % sensitivity in all the tested cohorts. Conclusions: This study reveals molecular changes underlying the pathophysiology as reflected by coding and regulatory non-coding components of transcriptome from South Asian patients and uncovers a conserved gene signature for HF.

Sustainable land management targets climate change by mitigating greenhouse gas emissions, bolstering resilience against climate-related disasters and advocating sustainable practices. India has significantly contributed to shaping the UN Sustainable Development Agenda 2030, in which agroforestry has emerged as a critical component. The tree-based intercropping practices implemented in agroforestry reduce competitive associations between woody and non-woody components, at the same time obtaining advantage of interactions that are beneficial. The present investigation was accomplished during the year 2019–20. The research trial was structured using a split-plot design to explore the possibilities of successfully cultivating Phaseolus vulgaris as an intercrop under Morus alba. The study incorporated 4 different levels of tree lopping (T0: 0%; T1: 25%; T2: 50%; T3: 75%) and 5 dosages of manure (S0: No manure; S1; FYM, S2: Jeevamrutha 5%; S3: Jeevamrutha 10%; S4: RDF+FYM). The results revealed that maximum values for above and below-ground growth parameters were recorded in treatment T3 (75% lopping intensity) and treatment S4 (RDF + FYM). The treatments S1 (FYM) and S4 also significantly influenced soil parameters. Based on this investigation, it was inference that the integration of Phaseolus vulgaris with Morus alba provides the best possibility for diversity and enhanced profitability compared to a single species, if lopping is performed scientifically and a combination of manures are applied appropriately, besides offering numerous additional environmental gains.

Background: Pregnancy and HIV affect CD4+ T lymphocytes and impact performance of QuantiFERON-TB Gold (QFT). We compared the results of QFT with QuantiFERON-TB Gold Plus (QFT-Plus), which also measures CD8+ responses to TB antigens, during pregnancy and postpartum. Methods: We screened 516 pregnant women for TB infection (TBI) with IGRA. From 165 IGRA + pregnant women, QFT vs QFT-Plus results were compared at delivery and postpartum. Longitudinal changes in QFT-Plus were assessed in 74 pregnant women who received QFT-Plus testing at pregnancy, delivery, and postpartum. Results: Through cross-sectional analysis of the IGRA + cohort, QFT-Plus showed higher positivity than QFT (80 % vs 65 %, p = 0.04) at delivery but no difference postpartum. Among 35 women with HIV, QFT-Plus returned more positive results than QFT at delivery and postpartum (76 % vs 47 %, p = 0.08; 90 % vs 80 %, p = 0.54), though not statistically significant. Longitudinally, QFT-Plus positivity by TB1 or TB2 was highest antepartum vs. delivery and postpartum (74 % vs. 58 % vs. 62 %; p = 0.09) and performed better than TB1 alone (100 % vs 90 %, p = 0.04) in women without HIV but not in women with HIV. Conclusions: Performance of QFT-Plus was consistent across pregnancy, including at delivery when QFT positivity is lower. QFT-Plus may enhance antenatal TBI detection among pregnant women.