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Introduction: Establishment of strong emergency medical services (EMS) systems plays a pivotal role in reducing morbidity and mortality, especially in low and middle-income countries. We aimed to study the EMS utilization and resources available in the ambulances to deliver prehospital care among patients presenting to the Emergency Medicine Department in a tertiary care hospital in south India. Methods: Data regarding prehospital transport practices such as mode of arrival, utilization of EMS, resources available in the ambulance, presenting complaints, triage category, and demographic details were collected and analyzed. Subgroup analysis for time-sensitive complaints was done. Variables were subjected to univariate and multivariate analysis to find the predictors of ambulance usage. Results: The study included 3935 patients. The most common time-sensitive complaints were trauma (17%) and chest pain (11.5%). The most preferred mode of transport was the personal vehicle (45.6%). 29.8% of patients arrived in the ambulance. 97.7% of ambulances were not Advanced Cardiac Life Support equipped and 87.1% did not have an accompanying health care provider. 64.5% inter-hospital patient transfers were through ambulance, 83.8% transfers were unaccompanied. Among patients with time-sensitive complaints, EMS utilization was inadequate (46.8% in acute coronary syndrome, 34% in trauma, and 56.5% in early acute ischemic stroke). Conclusion: There was underutilization of the EMS services. Majority of the ambulances were not adequately equipped/staffed to deliver prehospital interventions. Policies at national level are required to encourage EMS utilization by the public and urgent measures are needed to improve services provided by them. [ABSTRACT FROM AUTHOR]

Summary: Background: In 2022 and 2023, novel reassortant H3N8 influenza viruses infected three people, marking the first human infections with viruses of this subtype. Methods: Here, we generated one of these viruses (A/Henan/4-10CNIC/2022; hereafter called A/Henan/2022 virus) by using reverse genetics and characterized it. Findings: In intranasally infected mice, reverse genetics-generated A/Henan/2022 virus caused weight loss in all five animals (one of which had to be euthanized) and replicated efficiently in the respiratory tract. Intranasal infection of ferrets resulted in minor weight loss and moderate fever but no mortality. Reverse genetics-generated A/Henan/2022 virus replicated efficiently in the upper respiratory tract of ferrets but was not detected in the lungs. Virus transmission via respiratory droplets occurred in one of four pairs of ferrets. Deep-sequencing of nasal swab samples from inoculated and exposed ferrets revealed sequence polymorphisms in the haemagglutinin protein that may affect receptor-binding specificity. We also tested 90 human sera for neutralizing antibodies against reverse genetics-generated A/Henan/2022 virus and found that some of them possessed neutralizing antibody titres, especially sera from older donors with likely exposure to earlier human H3N2 viruses. Interpretation: Our data demonstrate that reverse genetics-generated A/Henan/2022 virus is a low pathogenic influenza virus (of avian influenza virus descent) with some antigenic resemblance to older human H3N2 viruses and limited respiratory droplet transmissibility in ferrets. Funding: This work was supported by the Japan Program for Infectious Diseases Research and Infrastructure (JP23wm0125002), and the Japan Initiative for World-leading Vaccine Research and Development Centers (JP233fa627001) from the Japan Agency for Medical Research and Development (AMED).

Summary: Background: Influenza viruses continually acquire mutations in the antigenic epitopes of their major viral antigen, the surface glycoprotein haemagglutinin (HA), allowing evasion from immunity in humans induced upon prior influenza virus infections or vaccinations. Consequently, the influenza strains used for vaccine production must be updated frequently. Methods: To better understand the antigenic evolution of influenza viruses, we introduced random mutations into the HA head region (where the immunodominant epitopes are located) of a pandemic H1N1 (H1N1pdm) virus from 2015 and incubated it with various human sera collected in 2015–2016. Mutants not neutralized by the human sera were sequenced and further characterized for their haemagglutination inhibition (HI) titers with human sera and with ferret sera raised to H1N1pdm viruses from 2009 to 2015. Findings: The largest antigenic changes were conferred by mutations at HA amino acid position 187; interestingly, these antigenic changes were recognized by human, but not by ferret serum. H1N1pdm viruses with amino acid changes at position 187 were very rare until the end of 2018, but have become more frequent since; in fact, the D187A amino acid change is one of the defining changes of clade 6B.1A.5a.1 viruses, which emerged in 2019. Interpretation: Our findings indicate that amino acid substitutions in H1N1pdm epitopes may be recognized by human sera, but not by homologous ferret sera. Funding: This project was supported by funding from the NIAID-funded Center for Research on Influenza Pathogenesis (CRIP, HHSN272201400008C).

A sensitive and selective LC-MS/MS method to quantify Lamivudine and Nevirapine in K3EDTA human plasma over the concentration range of 25.0240 to 3997.1740 ng/mL and 37.5080 to 5991.0460 ng/mL, respectively were developed and validated. Lamivudine and Nevirapine and its internal standard (Lamivudine 13C 15N2 and Nevirapine D5) were selectively extracted from 300 µL plasma by direct elution using solid phase extraction technique. Elution was achieved by reverse phase liquid chromatography on Hypurity C18 (100 mm × 4.6 mm, 5.0 µm) column was done. LLOQ of 25.0240 ng/mL and 37.5080 ng/mL were resolute for this technique for Lamivudine and Nevirapine respectively. Accuracy and precision values for Lamivudine were 99.55 & 1.50 and for Nevirapine the accuracy and precision values are 99.33 & 1.03%, respectively. [ABSTRACT FROM AUTHOR]

The aim of the stability studies is to perform to meet the quality, safety and efficacy. This type of study is used to know the changes in physical, chemical or microbiological properties of the drug with respect to time. Based on our study, noticed that Lamivudine and Nevirapine were stable to thermal stress. Percentage stability of all the stock solutions met the acceptance criteria. Working Solution percentage Stability values for Lamivudine and Nevirapine at LQC & HQC levels were 104.35 & 99.73% and 100.82 & 99.49%, respectively. Working Solution percentage Stability values for Lamivudine 13C 15N2 and Nevirapine D5 at LQC & HQC levels were 99.66 & 99.85% and 101.41 & 101.93, respectively. The stability studies were determined by calculating the Low Quality Control and High Quality Control samples percentage nominal beside freshly pointed, prepared calibration curve standards and compared with freshly spiked and prepared comparison samples at Low Quality Control and High Quality Control level.. [ABSTRACT FROM AUTHOR]

India is a developing country in world now a days. In future there will be a need of high strength and high performance concrete required for the construction of work. Fiber concrete is concrete containing fibrous material which increases its structural integrity. The character of fiber concrete changes with varying concretes fiber materials, geometries, distribution, orientation, and densities. Polypropylene fiber is a light weight synthetic fiber. It prevents crack formation and provides reinforcement to the concrete structure. In this project we are adding the different percentage values of the polypropylene fibers such as 0%,0.5%, 1%, 1.5%, 2% values and replacement of the cement by 10% of fly ash and rice husk each are added in concrete. Tests on workability, compressive strength, split tensile strength and flexural resistance were conducted on specimens. [ABSTRACT FROM AUTHOR]

This paper explores some design parameters of an interior permanent magnet synchronous motor that contribute to enhancing motor performance. Various geometry parameters such as magnet dimension, machine diameter, stator teeth height, and number of poles are analyzed to compare overall torque, power, and torque ripples in order to select the best design parameters and their ranges. Pyleecan, an open-source software, is used to design and optimize the motor for electric vehicle applications. Following optimization with Non-dominated Sorting Genetic Algorithm (NSGA-II), two designs A and B were obtained for two objective functions and the corresponding torque ripples values of the design A and B were later reduced by 32% and 77%. Additionally, the impact of different magnet grades on the output performances is analyzed.

Molecular docking (Mol.Doc) techniques were employed to ascertain the binding affinity and energetics of hydroxy derivatives of benzoic and cinnamic acids extract from Psidium guajava L. with Human Serum Albumin (HSA). Caffeic acid (CA), Ferullic acid (FA), Sinapic acid (SA), Syringic acid (SyA) and Vanillic acid (VA) are the derivatives phenolic acids (DPA) employed in docking studies which acts as the guest molecule. Docking of various feasible conformers of DPA with HSA (host) was explored and these conformers were categorized based on the docking score which is correlated to the binding energy (BE) and the stability depends upon the molecular interactions. Among the phenolic acids, SA-HSA complex was energetically more favorable and feasible based on BE and the order of binding stability upon complex formation of various DPA-HSA follows the order SA > FA = CA > VA > SyA, though SA and SyA are structurally similar to each other, likewise FA and VA exhibit a similar structure. The stability upon complex formation is correlated to the docking of the guest molecule in the binding domains of HSA and several molecular interactions. Hydrogen-bonding (HB) interaction governs the stability of host-guest complex is established. Interestingly, the presence of multiple hydrophobic interactions (pi-pi, pi-alkyl, pi-cation or anion, pi-sigma and pi-amide) competes over HB interaction in several conformers resulting in a decrease in BE. We report that SA acts as an excellent site selective and site-specific ligand that prefers to dock in Sudlow binding site II comprising of sub domains IIIA and IIIB respectively. However, all other phenolic acids do not behave neither as site selective nor site specific ligand such that they prefer to reside both in site II and site III (non-Sudlow binding site) of HSA. We authenticate that all the DPA as well as the amino acid moieties in HSA act as HB donor as well as acceptor sites apart from several hydrophobic interactions. We further establish that all the DPA has the least probable affinity to reside in binding site I (warfarin binding site), whereas sub domain IIIA of site II is the most preferred site which is energetically most favoured among all the sub domains.

In the current paper we research the consolidated impact of Corridor flows, turn, compound response and dissemination on non-Darcy convective warmth and mass exchange stream of nanofluids through a permeable medium past an exponentially extending sheet. By utilizing Runge Kutta shooting technique the overseeing conditions have been assessed for various varieties. It is discovered that the direct and rotational speeds, nanoparticle volume part improve with Corridor pall boundary and diminishes with pivot boundary while the temperature lessens with m and increments with R. [ABSTRACT FROM AUTHOR]

Avian influenza viruses of the H6 subtype are prevalent in wild ducks and likely play an important role in the ecology of influenza viruses through reassortment with other avian influenza viruses. Yet, only 152 Vietnamese H6 virus sequences were available in GISAID (Global Initiative on Sharing All Influenza Data) prior to this study with the most recent sequences being from 2018. Through surveillance in Vietnamese live bird markets from 2018 to 2021, we identified 287 samples containing one or several H6 viruses and other influenza A virus subtypes, demonstrating a high rate of co-infections among birds in Vietnamese live bird markets. For the 132 H6 samples with unique influenza virus sequences, we conducted phylogenetic and genetic analyses. Most of the H6 viruses were similar to each other and closely related to other H6 viruses; however, signs of reassortment with other avian influenza viruses were evident. At the genetic level, the Vietnamese H6 viruses characterized in our study encode a single basic amino acid at the HA cleavage site, consistent with low pathogenicity in poultry. The Vietnamese H6 viruses analyzed here possess an amino acid motif in HA that confers binding to both avian- and human-type receptors on host cells, consistent with their ability to infect mammals. The frequent detection of H6 viruses in Vietnamese live bird markets, the high rate of co-infections of birds with different influenza viruses, and the dual receptor-binding specificity of these viruses warrant their close monitoring for potential infection and spread among mammals.

Combination of Congenital Adrenal Hyperplasia (CAH) with Turner Syndrome (TS) is rare. We report a 20-days old new born, born from second degree consanguineous marriage presented with refusal of feeds, vomiting and loose stools. On examination, ambiguous genitalia with presence of a 2.6 cm phallus, incomplete labial fusion, gonads not palpable and hyperpigmentation were noted. Laboratory findings revealed a classical type of CAH caused by 21-hydroxylase deficiency. Karyotyping showed a 45 X0[4] / 46 XX[16] pattern concluding mosaic TS. She was given hydrocortisone at a dose of 5 mg/m2/day, fludrocortisone acetate in dose of 0.1mg/day, along with oral salt of 1 gm/day. At 8 months follow-up, the patient appeared to be in good health; her height was 69.3 cm [> 50th percentile] and her weight was 8.3 kg (> 50th percentile). System examinations turned out to be normal. The patient’s electrolyte levels were normal and she was in good metabolic control. The findings of this particular patient show that routine karyotyping during investigation of patients with disorders of sexual differentiation (DSD) can help us to reveal TS. Additionally, signs of virilism have to be investigated at the time of diagnosis or during physical examinations for proper follow-up of TS cases.

Background: Dengue fever is a viral illness commonly caused by Flavivirus. Dengue becomes the most common public health issues in India because the incidence of dengue fever is high all over the world. In Tamil Nadu, the existence of all the four serotypes of the dengue virus was proved during the several outbreaks of dengue fever earlier and the reported seasonal changes especially Rainfall influencing the several crucial issues of people. Objectives: Assess the knowledge regarding dengue fever, and associate the level of knowledge with selected demographic variables. Method: A quantitative approach and a descriptive research design for 100 samples by non-probability convenient sampling technique were used. Results: The results revealed that 10.0% of people were with inadequate knowledge of dengue fever, 58.0% of people have moderately adequate knowledge, and 32.0% of people had adequate knowledge. Conclusion: Only a moderate level of people has adequate knowledge about dengue fever and seeks prevention. [ABSTRACT FROM AUTHOR]

In India, 65% of the people have adopted agriculture for their primary source of income. Several vital factors that affect the farmers are natural calamities and disasters such as unpredicted rain, floods, storm, drought, etc. Added to these one of the major issues faced in agriculture domain is in plant pathology. The identification and verification of plant diseases is a serious concern which needs to be treated well for increasing the yield, plant growth and quality. Many researchers, scientists and scholars have greatly contributed towards plant disease identification. However, still we see many drawbacks such as accuracy in the end results, false acceptance and false rejection problems. The main purpose of this work is to provide a detailed analysis and comparison on existing techniques versus the current trend techniques. This review will help the researchers to choose the adequate technique or method for future use. In this paper, the results of several methods used to identify diseases in leaves have been reviewed strenuously. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a disease that has both medical as well as social dimensions. Stigma and associated discrimination experienced by persons affected by TB is a barrier to the interventions towards TB elimination. A better understanding of stigma will improve the effectiveness of the interventions aimed to alleviate the effects of TB stigma. The objectives were to measure the prevalence of self, anticipated, experienced stigma and its associated factors and to explore the impact of tuberculosis related stigma among TB patients. Methodology: A cross-sectional study was conducted in Puducherry district, Southern India among 420 adult drug sensitive non-HIV TB patients registered under NTEP. Data was collected by face-to-face interview using standardised questionnaire. Results: The mean(±SD) age of the study participants was 44.5 (±15.03) years. Majority were males (267, 63.6%) and were married (330, 78.6%). The prevalence of stigma among TB patients was found to be 69.3%. Perceived stigma was noted in 47.1%, 33.6% had self- stigma and 26.0% had experienced stigma. On measuring the impact of stigma, 52.6% reported participation restriction. Illiteracy and lower-socio economic status were found to be significantly associated with TB stigma. Conclusions: Stigma among TB patients was high. Tailored patient-centric interventions to address stigma and discrimination using culturally appropriate and locally available resources are necessary.