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This research reports on the production of copper oxide nanoparticles (CuO NPs) through the green synthesis method using Azadirachta indica (Ai) flower extract. Synthesized Ai-CuO NPs are characterized by Zeta Potential, TGA, SEM and TEM analysis. The Ai-CuO NPs gave a maximum peak at 270 nm. As per XRD studies, the Ai-CuO NPs obtained were crystalline. FTIR spectrum Ai-CuO NPs showed the presence of functional groups like the O-H group, aromatic group, etc. TEM and SEM assist in investigating the size and morphology of the Ai-CuO NPs, which were spherical and varied in size between 10.11 nm and 17.54 nm. EDAX showed that Ai-CuO NPs were pure with no impurities. The synthesized Ai-CuO NPs were then analyzed for their cytotoxicity at various concentrations (5, 10, 20, 30, 40 and 50 μg/mL) against H9c2 cardiomyocyte cells using MTT assay. DOX-induced H9c2 cell damage of apoptosis and ROS. The nanoparticle formed by Ai-CuO was cured with different concentrations (5, 10 and 20 μg/mL). In zebrafish, 48 hpf and 72 hpf were measured at 75 μM to reduce dysfunction and mortality during organ development. These results can have a beneficial impact on eco-toxicological effects., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Baseline assessments of marine microbial studies are very limited around ecologically sensitive areas of the Nuclear Power Plant (NPP) site with respect to their occurrence, distribution, role in adaptation, and their potential remediation process. The distribution and diversity of marine microbes are largely dependent on the physicochemical parameters relating to a specific area, especially spore-producing marine actinobacteria are a source for indigenous bioremediation agents. Marine actinobacterial diversity with conventional and 16 S rRNA gene analysis was done with different pre-treatment conditions and selective media. Totally, 170 different strains are identified in genera level and it belongs to 18 genera with dominant by Streptomyces sp. (75species) followed by Nocardiposis sp, (18species) Rhodococcus sp. (14species). Multiple k-dominance plots simplified the perception of marine actinobacteria according to genera level influence to standard stock. This is the first kind of study in India and the results could act as baseline inventory in terms of microbial diversity around NPP sites. Further, a potential strain of Actinomadura sp. (T5S13) produced 243.7 mg/L of EPS and remediate the Uranium radionuclides. The functional group shifting and adsorption nature were also confirmed by SEM with EDS analysis., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to prepare a polyherbal mouthwash and evaluate its antimicrobial and anti-inflammatory efficacy against commercially available herbal mouthwash. The objective was to signify whether the novel herbal combination (extracts of Zingiber officinale [ginger], Curcuma longa [turmeric], and Syzygium aromaticum [clove] 5% v/w) could be a better alternative to commercially available herbal mouthwashes., Materials and Methods: An in vitro study was undertaken in which extracts of Z. officinale (ginger), C. longa (turmeric), and S. aromaticum (clove) 5% v/w were used. Seven different concentrations were prepared and tested against Streptococcus mutans, Enterococcus faecalis, Candida albicans , and Staphylococcus aureus in Mueller-Hinton agar medium. Plates were incubated aerobically at 37° C for 48 h, and the zone of inhibition was measured using a vernier caliper. Commercially available herbal mouthwash (Hiora) was used as a control group. The data were analyzed by descriptive analytics., Results: Results showed that the efficacy of novel polyherbal mouthwash had comparatively less significant antimicrobial properties against the microorganisms as compared to the commercially available herbal mouthwash. The minimum inhibitory concentration was also found to be very high, that is, 100 μg/mL., Conclusion: There was no significant antimicrobial and anti-inflammatory effects for the polyherbal mouthwash as compared to commercially available herbal mouthwash (Hiora). Because this combination is readily available, it can be a cost-effective alternative to commercially available herbal mouthwashes.

Background: Atherosclerotic risk starts at an early stage in adolescents and interventions on adolescents' lifestyles are most important. The pandemic of obesity-related morbidities like atherosclerosis among young adults and atherosclerotic risk factors for middle-aged adolescents in India is known. Yet, there is a lack of cost-effective and integrated intervention programs to treat this important health problem., Objective: The main objective of this study is to evaluate the effect of a 12-week structured interventional strategy program, containing integrated education and supervised physical activity interventions for middle-aged adolescents., Methods/design: This will be a school-based pre-experimental one-group pre-post time-series research design. The sample size is estimated to include 154 adolescents of 10th to 12th grade; aged 15-17 years will be grouped as a single arm. Data will be collected from July 2021 to January 2022. The intervention duration will be 3 months. The following measures will be evaluated before, during, and after intervention: knowledge, body mass index, level of physical activity, dietary habits, and sedentary activity., Discussion: We believe that the structured interventional strategy approach which includes education related to atherosclerosis, physical activity, dietary habits, and sedentary activity, and cost-effective physical activity training will be more effective in preventing atherosclerotic-related changes among middle-aged adolescents. Further, this kind of approach may be applied in similar study areas elsewhere in India., Trial Registration: Clinical Trials Registry-India (Registered Number: CTRI/2021/03/032271)., Competing Interests: The authors have declared that no competing interests exist.

Chagas Disease (CD) is a neglected zoonotic disease of the Americas. It can be fatal if not diagnosed and treated in its early stages. Using geospatial and sensitivity analysis, this study focuses on understanding how to better allocate resources and educational information to areas in the United States, specifically Texas, that have the potential for increased risk of CD cases and the associated costs of addressing the disease. ICD-9 and 10 inpatient hospital diagnostic codes were used to illustrate the salience of potentially missed CD diagnoses (e.g., cardiomyopathic diagnoses) and where these are occurring with more frequency. Coding software along with GIS and Microsoft Excel 3D mapping were used to generate maps to illustrate where there may be a need for increased statewide surveillance and screening of populations at greater risk for CD. The CD cases reported to the Texas Department of State Healthcare Services (TxDSHS) are not homogenously dispersed throughout the state but rather, reveal that the incidences are in clusters and primarily in urban areas, where there is increased access to physician care, CD research and diagnostic capabilities., (© 2022. The Author(s).)

The current study assesses the prospect of using R. Communis seed oil as a substitute fuel for diesel engines. Biodiesel is prepared from the R. Communis plant seed oil by a single-step base catalytic transesterification procedure. The investigation deals with the Physico-chemical characteristics of R. Communis biodiesel and has been associated with the base diesel. It has been perceived that the characteristics of biodiesel are well-matched with the base diesel under the ASTM D6751 limits correspondingly. R. Communis biodiesel is blended in different proportions with base diesel such as D10, D20, D30, D40, D50 and D100 and is tested in a Kirloskar TV1 single-cylinder, 4 blows DI engine under altered loading conditions. Outcomes demonstrate that BTE and BSFC for D10 as well as D20 are similar to base diesel. BSFC indicates that the precise BSFC of base diesel, D10, D20, D30, D40 and D50 was 0.87, 1.70, 2.60, 3.0, 3.4, and 3.5 kg/kW-hr, respectively. The extreme BTE at full load condition for base diesel, D10, D20, D30, D40, D50 and D100 are 28.2%, 28.1%, 27.9%, 25.5%, 24.1%, and 23.6% , respectively. In the case of engine emissions, R. Communis biodiesel blends provided an average decrease in hydrocarbon (HC), Carbon-monoxide (CO) and carbon dioxide (CO2) associated with base diesel. Nevertheless, R. Communis biodiesel blends discharged high stages of nitrogen oxide (NOx) compares to base diesel. Base diesel, D10, D20, D30, D40, D50, and D100 had UBHC emissions of 45 ppm, 40 ppm, 44 ppm, 46 ppm, 41 ppm, and 43 ppm, respectively. The reduction in CO emissions for D10, D20, D30, D40, D50 and D100 are 0.13%, 0.14%, 0.17%, 0.18% and 0.21% respectively. The dissimilarity in NOx attentiveness within brake powers for D10, D20, D30, D40, and D50 and base diesel are 50-ppm, 100 ppm, 150 ppm, 250 ppm, 350 ppm, and 500 ppm, respectively. The dissimilarity of CO 2 emanation with reverence to break powers for the base-diesel, D10, D20, D30, D40, D50, and D100 are 4.8%, 4.9%, 4.8%, 4.56%, 4.9% and 5.1%, respectively. The present research provides a way for renewable petrol blends to substitute diesel for powering diesel engines in that way dropping the reliance on fossil fuels., (© 2022. The Author(s).)

Origanum vulgare essential oil (EO) is traditionally well-known for its aromatic properties and biomedical applications, including anticancer. This was the first report where oregano essential oil-based nano emulsion (OENE) was synthesized for studying its effects on prostate cancer cell lines (PC3). At first, we have synthesized OENE and characterized using various spectroscopic analyses. The toxicity and inhibitory concentration (IC 50 ) of OENE toward prostate cancer by MTT analysis were performed. The lipid biogenesis mediated, molecular target pathway analyses were performed using fluorescence cellular staining techniques, real-time RT-PCR, or western blotting analysis. OENE showed IC 50 at 13.82  µ g/mL and significantly induced distinct morphological changes, including cell shrinkage, cell density, and cell shape reduction. In addition, OENE could also significantly decreased lipid droplet accumulation which was confirmed by studying mRNA transcripts of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) (0.31-fold), fatty acid synthase (FASN) (0.18-fold), and sterol regulatory element-binding protein (SREPB1) (0.11-fold), respectively. Furthermore, there is a significant upregulation BAX (BCL2 associated X) and caspase 3 expressions. Nevertheless, OENE decreased the transcript level of BCL2 (B-cell lymphoma 2), thus resulting in apoptosis. Overall, our present work demonstrated that OENE could be a therapeutic target for the treatment of prostate cancer and warrants in vivo studies., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2022 Haribalan Perumalsamy et al.)

Chitosan being non-toxic, biocompatible, and biodegradable gained considerable interest among agriculturists. Our research review discusses about the role of Cs, chitosan nanoparticles (CsNPs), and modified chitosan biomaterials (CsBMs) under salt stress to improve growth parameters such as plant height, weight, stem width, fruit yield, pigments such as chlorophyll a, b, total chlorophyll, and carotenoid contents, as well as antioxidant and non-antioxidative enzymes. Upon Cs treatment and salt stress, total aminoacids (TAA), glutamic acids, and gamma-aminobutyric acid (GABA) were increased. Furthermore, Cs activated SOS1 pathway and increased various gene transcripts involved in sodium compartmentalization, proton motive force, energy production, and phenol metabolism. On the other hand, CsNPs and modified CsBMs treated plants under salinity stress increased indole terpene alkaloid metabolism, defense related genes, decreased ROS production by enhancing JA signaling, increased essential oil, anthocyanins, membrane stability, alkaloids, and diterpene glycosides. This is the first review that specifically brings insights about the physiological and biochemical parameters of the plants by comparing Cs/CsNPs/modified CsBMs treatment options under salt stress and encourages the use of CsNPs and modified CsBMs compared to Cs for better plant function under salinity stress., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Silymarin, a blend of flavonolignans isolated from plant Silybum marianum L., has long been used as an herbal medicine. Biogenic routes especially the plant-based synthesis of selenium nanoparticles (SeNPs) is safe, eco-friendly, nontoxic and being considered as one of the best strategies for treatment of cancer., Purpose: Silymarin-mediated green synthesis of SeNPs and their possibility as an anticancer agent have not been reported to date. Therefore, our present study was aimed to synthesize and characterize the selenium mediated silymarin nanoparticles (Si-SeNPs) from silymarin and investigate their possibility as an anticancer agent., Methods: The physicochemical characteristics of Si-SeNPs were analyzed using various analytical techniques, such as HPLC, field emission-transmission electron microscope, energy-dispersive X-ray spectrometer, and thermogravimetric analysis. The underlying molecular mechanism were evaluated using AGS gastric cancer cells., Results: Compared with silymarin, the Si-SeNPs exhibited significantly increased cytotoxic effect of AGS cells without exhibiting toxicity on normal cells. Real time PCR and western blotting analysis indicated that Si-SeNPs induced expression of Bax/Bcl-2, cytochrome c, and cleavage of caspase proteins, which is associated with mitochondria-mediated apoptosis signaling in AGS cells. Moreover, agonist assay using PI3K activator indicated that Si-SeNPs-inhibited PI3K/AKT/mTOR pathways were significantly associated as an autophagy and apoptosis signaling in AGS cells., Conclusion: Our study demonstrated the improved anticancer efficacy of Si-SeNPs- induced apoptosis and autophagy pathways, and therefore recommended Si-SeNPs as a novel anticancer agent after in vivo studies., (Copyright © 2022. Published by Elsevier GmbH.)

Background: India has the highest number of preterm births and maximum number of deaths due to prematurity. Chengalpattu Government Medical College had 11 593 deliveries annually in 2020, of which 2252 of neonates were low birth weight. 2016 Cochrane review concluded that Kangaroo Mother Care (KMC) reduces the morbidity and mortality in low birthweight infants. The average duration of KMC in our unit was around 4.6 hours/baby/day., Objective: To improve the duration of KMC in stable low birthweight babies from short duration to continuous duration (>12 hours) over 8 weeks., Methods: The implementation phase was conducted during January 2021 and February 2021. All babies with birth weight <2 kg and who were haemodynamically stable were enrolled. QI (Qualitympovement) team included staff nurses, nursing in charge, resident doctors and consultants. Potential barriers were listed using fishbone analysis. Various possible interventions were identified and a priority matrix was formed to decide the sequence of introduction of changes. The following measures were subsequently tested by multiple PDSA (Plan Do Study Act) cycles: ensuring the availability of KMC charts, combining KMC chart with individualised weight chart, documentation of KMC duration in case sheets, increasing number of KMC chairs, opening of mother-neonatal ICU (M-NICU), KMC slings for mothers, education videos in local language and rewards for mothers., Outcome Indicator: Duration of KMC, recorded by bedside nurses on daily basis., Results: A total of 86 newborns were enrolled. At the end of 8 weeks, average duration of KMC increased to 16.6 hours/baby/day. The intervention which was most useful in increasing KMC duration was opening of M-NICU. We were able to sustain the improvement at the end of 6 months., Conclusion: Sequential measures taken as a part of QI initiative, helped to increase the average duration of KMC from 4.6 hours/day to 16.6 hours/day, without much additional resources., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

"Thamira parpam" (TP), a copper-based herbometallic oxide (copper (II) oxide) nanodrug has been used in Siddha medicine for centuries because of its anti-ulcerogenic property. However, the physicochemical properties and in vivo toxicity of TP still remain elusive. Rigorous clinical translation requires deciphering these vital properties. We have synthesized TP following a gold standard protocol in the traditional Siddha methodology. We assessed the size, phase, elemental constituents, and thermal stability of TP by SEM and TEM, XRD, EPR, and EDAX analyses, respectively. The results depicted the conversion of metallic copper into copper (II) oxide in the final stages of TP preparation and exhibited nanodimensions ranging between 10 and 50 nm. The XPS spectra revealed the presence of oxygen-deficient state and a carbonaceous coating was found on the surface of TP using TEM analysis. In vivo safety was studied in rat toxicity models by adopting OECD guidelines. Body weight changes, feed, and water intake were unaltered upon TP administration. Hematological, biochemical profiling, and histopathological findings also suggested its nontoxic nature with no abnormalities in major organs and its functions. Interestingly, we found that the metal toxicity could have been subdued because of the carbonaceous coating around the nanoparticle copper (II) oxide, confirming that the drug is safe at a low dose. Overall, our study has enlightened the safety of TP supporting the use of Siddha formulations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Royapuram Parthasarathy, Manikandamathavan, Chandronitha, Vasanthi, Mohan, Vijayakumar, Shanmugam, Sekaran, Unni Nair, Chamundeeswari and Thyagarajan.)

The aim of the study is to evaluate the stability and longevity of the paper-based screening test for the sickle cell disease in relation to different temperatures and storage time. Blood stain patterns were interpreted after spotting the blood-buffer mixture (phosphate buffer, saponin and sodium metabisulfite) on chromatographic paper (Whatman no. 3). The stability of the buffer was tested after keeping the buffer at different temperature for 24 h. Longevity of the buffer was tested post storage for various time intervals. Test indicated reproducibility with the buffer stored at 4°C. The 15% metabisulfite buffer was found to be stable up to 180 days at 4°C and showed accurate identification of all genotypes. The tests revealed 100% sensitivity and 100% specificity in identification of HbS. However, the sensitivity of differentiation between sickle cell trait (AS) with disease (SS) was found to be 97.7% with 100% specificity. The paper-based screening test may be used as a method of choice for the screening of sickle cell anemia in community-based screening programs. The low-cost, rapid, and accurate point of care testing tools offer an avenue for effective screening in developing nations., (© Association of Clinical Biochemists of India 2021.)

Bisphosphonates improve orthodontic anchorage. More targeted action of this drug can be achieved through its conjugation with gold nanoparticles. Asparagus racemosus is a green edible medicinal plant used in Ayurvedic preparations to treat aging, vigor, immunity, longevity, and skeletal issues. Therefore, it is of interest to report the green synthesized Bisphosphonate conjugated gold nanoparticles with Asparagus racemosus extract and to characterize them., Competing Interests: There are no conflicts of interest., (© 2022 Biomedical Informatics.)

The human gastrointestinal tract (GIT) is a well-recognized hub of microbial activities. The microbiota harboring the mucus layer of the GIT act as a defense against noxious substances, and pathogens including Clostridium difficile , Enterococcus faecium , Escherichia coli , Salmonella Typhimurium. Toxins, pathogens, and antibiotics perturb the commensal floral composition within the GIT. Imbalanced gut microbiota leads to dysbiosis, manifested as diseases ranging from obesity, diabetes, and cancer to reduced lifespan. Among the bacteria present in the gut microbiome, the most beneficial are those representing Firmicutes and Bacteroidetes. Recent studies have revealed the emergence of a novel biotherapeutic agent, Akkermansia , which is instrumental in regaining eubiosis and conferring various health benefits., (© Association of Microbiologists of India 2021.)

Sickle cell disease (SCD) poses considerable public health problems in India. This study was undertaken to understand the clinical course of SCD among children identified during newborn screening programmes in Gujarat and Madhya Pradesh where the frequency of the HbS gene is high. A total of 8,916 newborn babies 8,411 from Gujarat and 505 from Madhya Pradesh were screened over 6 years (2010-2016) using HPLC and the diagnosis was confirmed by molecular analysis in a subset. A total of 128 babies (122 Gujarat, 6 Madhya Pradesh) were identified with sickle cell disease, of whom 87 (69 HbSS, 18 HbS-β thalassemia) from Gujarat were followed for 0.5-6.6 years. Acute painful events, severe anemia and fever with infections were the major complications and 23 babies required hospitalization. Severe to moderate clinical presentation was found in 13.8% babies with SCD whereas, 86.2% babies had a milder presentation. Presence of ameliorating factors (α-thalassemia and Xmn 1 polymorphism) did not have a discernible effect on the clinical severity. Parents of babies with SCD were educated and counseled for home care. Distribution of mobile phones to 44 families having babies with SCD was beneficial as it allowed regular contact with patients and their families. Genetic counseling to the affected families has increased the awareness and acceptance for prenatal diagnosis and 18 couples opted for prenatal diagnosis in subsequent pregnancies. SCD is not always mild among tribal groups in India. Therefore, facilities for early diagnosis and prophylactic treatment in the tertiary care centers should be made available. The difficulties in regular follow up of the babies in remote rural areas have also been highlighted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Thaker, Colah, Patel, Raicha, Mistry, Mehta, Italia, Desai, Dave, Shanmugam, Ghosh and Mukherjee.)

In this study, we developed a portable electrochemical sensor for realizing the pesticide residue in biological, environmental, and vegetable samples. A lower concentration of carbendazim pesticide (CBZ) was electrochemically exposed by newly developed gadolinium oxide/functionalized carbon nanosphere modified glassy carbon electrode (Gd 2 O 3 /f-CNS/GCE). The Gd 2 O 3 /f-CNS composite was prepared by two-pot ultrasonic-assisted co-precipitation method and characterized by various physicochemical analytical techniques. In addition, the electrocatalytic activity of the composite was investigated by cyclic voltammetry (CV) towards the detection of CBZ. Besides, the Gd 2 O 3 /f-CNS/GCE exhibited excellent electrocatalytic capability and sensitivity towards the oxidation of CBZ due to its high electrochemical active surface area, good conductivity, and fast electron transfer ability. A wide linear range of CBZ (0.5-552 μM) was attained with a low level of detection (LOD) of 0.009 μM L -1 and exceptional stability of 93.41%. The proposed sensor exemplifies practical feasibility in blood serum, water, and vegetable samples with an remarkable recovery range of 96.27-99.44% and primary current response of ∼91% after 15 days., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Cancer-specific hTERT promoter mutations reported in 19% of cancers result in enhanced telomerase activity. Understanding the distinctions between transcriptional regulation of wild-type (WT) and mutant (Mut) hTERT promoters may open up avenues for development of inhibitors which specially block hTERT expression in cancer cells. To comprehensively identify physiological regulators of WT- or Mut- hTERT promoters, we generated several isogenic reporter cells driven by endogenous hTERT loci. Genome-wide CRISPR-Cas9 and small interfering RNA screens using these isogenic reporter lines identified specific regulators of Mut- hTERT promoters. We validate and characterize one of these hits, namely, MED12, a kinase subunit of mediator complex. We demonstrate that MED12 specifically drives expression of hTERT from the Mut- hTERT promoter by mediating long-range chromatin interaction between the proximal Mut- hTERT promoter and T-INT1 distal regulatory region 260 kb upstream. Several hits identified in our screens could serve as potential therapeutic targets, inhibition of which may specifically block Mut- hTERT promoter driven telomerase reactivation in cancers., Competing Interests: The authors declare no competing interest., (Copyright © 2022 the Author(s). Published by PNAS.)

The influence of bath temperature on nano-manufactured PbSe (lead selenide) films was successfully generated by utilizing CBD on the acid solution's metal surface tool. Pb (NO 3 ) 2 was employed as a lead ion source as a precursor, while Na 2 O 4 Se was used as a selenide ion source. The XRD characterization revealed that the prepared samples are the property of crystalline structure (111), (101), (100), and (110) Miller indices. The scanning electron microscope indicated that the particles have a rock-like shape. There was a decrement of energy bandgap that is from 2.4 eV to 1.2 eV with increasing temperature 20°C-85°C. Thin films prepared at 85°C revealed the best polycrystal structure as well as homogeneously dispersed on the substrate at superior particle scales. The photoluminescence spectrophotometer witnessed that as the temperature of the solution bath increases from 20°C to 85°C, the average strength of PL emission of the film decreases. The maximum photoluminescence strength predominantly exists at high temperatures because of self-trapped exciton recombination, formed from O 2 vacancy and particle size what we call defect centres, for the deposited thin films at 45°C and 85°C. Therefore, the finest solution temperature is 85°C., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Saka Abel et al.)

Nanotechnology explores a variety of promising approaches in the field of biomedical sciences. For biogenesis of selenium (Se) nanoparticles different parts of a plant are used as they contain metabolites such as alkaloids, flavonoids, phenols, proteins, and other phytochemicals which act as reducing agent to produce and stabilize nanoparticles. Nanotechnology is also widely practiced in medicine, agriculture, and many other technologies. This review is focused on green synthesis and its latest developments for the fabrication of Se nanoparticles. This research article also summarizes Se nanoparticles and different plants individually and combined along with their characterizations, using techniques such as ultraviolet-visible spectroscopy, transmission electron microscopy, and scanning electron microscopy, which specified the range, shape, size, and other specifications to easily identify and explore the studies further.

This article provides a thorough explanation of methods and theoretical concepts to detect infectivity of COVID-19. The concept of heterogeneity is discussed and its impacts on COVID-19 pandemics are explored. Observable heterogeneity is distinguished from non-observable heterogeneity. The data support the concepts of heterogeneity and the methods to extract and interpret the data evidence for the conclusions in this paper. Heterogeneity among the vulnerable to COVID-19 is a significant factor in the contagion of COVID-19, as demonstrated with incidence rates using data of a Diamond Princess cruise ship. Given the nature of the pandemic, its heterogeneity with different social norms, pre- and post-voyage quick testing procedures ought to become the new standard for cruise ship passengers and crew. With quick testing, identification of those infected and thus, not allowing to embark on a cruise or quarantine those disembarking, and other mitigation strategies, the popular cruise adventure could become norm for safe voyage. The novel method used in this article adds valuable insight in the modeling of disease and specifically, the COVID-19 virus., Competing Interests: The authors report no conflicts of interest for this work., (© 2022 Shanmugam et al.)

Competing Interests: Conflict of interestThe authors declare no conflict of interest.

Background: Because of its diverse range of use in several ethics of diagnosis and care of multiple diseases, nanotechnology has seen remarkable growth and has become a key component of medical sciences. In recent years, there has been rapid advancement in medicine and biomaterials. Nanomedicine aids in illness prevention, diagnosis, monitoring, and treatment., Aim: The purpose of this work is to evaluate the antibacterial, anti-inflammatory, and cytotoxic capabilities of green produced silver nanoparticle with the addition of curcumin-assisted chitosan nanocomposite (SCCN) against wound pathogenic as reducing agents., Materials and Methods: The plant extract of Pongamia pinnata , silver nanoparticles, and its based curcumin nanoformulations was studied in this study utilizing UV visible spectrophotometer, selected area electron diffraction (SAED), and TEM. Anti-inflammatory, antimicrobial, and cytotoxic tests were performed on silver nanoparticles with the addition of curcumin-assisted chitosan nanocomposite (SCCN). Furthermore, these produced nanocomposites were coated on clinical silk and tested for antibacterial activity., Results: The produced silver nanoparticle with the addition of curcumin-assisted chitosan nanocomposite (SCCN) has significant antibacterial activities against Pseudomonas aeruginosa and staphylococcus aureus . They are as well as possess anti-inflammatory activity and furthermore prove to be biocompatible., Conclusion: This advancement in the field of biomaterials, which means nanocomposite, not only helps to reduce the harmful effects of pathogenic organisms while representing an environmentally benign material but it also shows to be a material with zero danger to humans and the environment., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Rajeshkumar Shanmugam et al.)

Background/purpose: The purpose of this research is to determine if the tradeoffs that Kissick proposed among cost containment, quality, and access remain as rigidly interconnected as originally conceived in the contemporary health care context. Although many have relied on the Kissick model to advocate for health policy decisions, to our knowledge the model has never been empirically tested. Some have called for policy makers to come to terms with the premise of the Kissick model tradeoffs, while others have questioned the model, given the proliferation of quality-enhancing initiatives, automation, and information technology in the health care industry. One wonders whether these evolutionary changes alter or disrupt the originality of the Kissick paradigms themselves., Methods: Structural equation modeling (SEM) was used to evaluate the Kissick hypothetical relationships among the unobserved constructs of cost, quality, and access in hospitals for the year 2018. Hospital data were obtained from Definitive Healthcare, a subscription site that contains Medicare data as well as non-Medicare data for networks, hospitals, and clinics (final n = 2766)., Results: Reporting significant net effects as defined by our chosen study variables, we find that as quality increases, costs increase, as access increases, quality increases, and as access increases, costs increase. Policy and Practice Implications: Our findings lend continued relevance to a balanced approach to health care policy reform efforts. Simultaneously bending the health care cost curve, increasing access to care, and advancing quality of care is as challenging now as it was when the Kissick model was originally conceived.

Harmful effects on living organisms and the environment are on the rise due to a significant increase in greenhouse gas (GHG) emissions through human activities. Therefore, various research initiatives have been carried out in several directions in relation to the utilization of GHGs via physicochemical or biological routes. An environmentally friendly approach to reduce the burden of significant emissions and their harmful effects is the bioconversion of GHGs, including methane (CH 4 ) and carbon dioxide (CO 2 ), into value-added products. Methanotrophs have enormous potential for the efficient biotransformation of CH 4 to various bioactive molecules, including biofuels, polyhydroxyalkanoates, and fatty acids. This review highlights the recent developments in methanotroph-based systems for methanol production from GHGs and proposes future perspectives to improve process sustainability via biorefinery approaches., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© Association of Microbiologists of India 2021.)

Background: Neonatal sepsis is a global public health problem. There is no consensus regarding the optimum duration of antibiotics for culture-proven neonatal sepsis. Published randomized controlled trials (RCTs) comparing shorter versus longer courses of antibiotics provide low-quality evidence with serious risk of bias. We hypothesized that among neonates with uncomplicated culture-proven sepsis, antibiotic duration of 7 days is not inferior to 14 days., Methods: This is a multi-centric, parallel-group, stratified, block-randomized, active-controlled, non-inferiority trial with outcome assessment blinded. Stratification is by center and birth weight. Neonates weighing ≥1000 g at birth, with blood-culture-proven sepsis (barring Staphylococcus aureus and fungi), without conditions warranting > 14 days antibiotics, and who clinically remit, are enrolled in the RCT on day 7 of administration of sensitive antibiotics. They are randomly allocated to no further antibiotics (intervention arm: total 7 days) or 7 more days of the same antibiotics (control arm: total 14 days). Allocation is concealed by opaque, sealed envelopes. The primary outcome is "definite or probable relapse" within 21 days after antibiotic completion. Secondary outcomes include definite and probable relapses at various timepoints until day 35 post-randomization, secondary infections, and adverse events. The neonatologist adjudicating probable relapses and lab personnel are blinded. Three hundred fifty subjects will be recruited in each arm, assuming a non-inferiority margin of 7%, one-sided alpha error 5%, and power of 90%. Analysis will be per protocol and by intention-to-treat. An independent Data Safety Monitoring Board monitors adverse events and will perform one interim analysis when 50% of expected primary outcomes have occurred or 50% of subjects have completed follow-up, whichever is earlier. O'Brien-Fleming criteria will be used to stop for mid-term benefit and Pocock's to stop for mid-term harm. A priori subgroup analyses are planned by birth weight categories, gram-stain status of pathogens, and radiological pneumonia., Discussion: This trial will provide evidence to guide practice regarding optimum duration of antibiotics for culture-proven neonatal bacterial sepsis. If a 7-day regime is proved to be non-inferior to a 14-day regime, it is likely to reduce hospital stay, costs, adverse effects of drugs, and nosocomial infections., Trial Registration: Clinical Trials Registry India CTRI/2017/09/009743 . Registered on 13 September 2017., (© 2021. The Author(s).)

Fabrication of temperature-influenced nanoparticles over the superficial region of glassy carbon electrode (GCE) stimulates the electrocatalytic activity owing to their morphology, defective sites, and higher active surface area, etc. In this regard, we have fabricated annealed magnesium stannate nanoparticles (Mg 2 SnO 4 NPs) on GCE for nanomolar level detection of hazardous flavoring and pharmaceutical compound Rutin (RT). To analyze the impact of temperature, we have compared annealed Mg 2 SnO 4 NPs with unannealed magnesium stannate hydrate (MgSnO 3 ·3H 2 O) particles. The physicochemical properties of synthesized materials were characterized with different microscopic and spectroscopic techniques. From these studies, annealed Mg 2 SnO 4 NPs formed purely without any flith and existence of water molecules as compared to unannealed MgSnO 3 ·3H 2 O. Moreover as fabricated, Mg 2 SnO 4 NPs/GCE outcomes with higher redox behavior compared to other electrodes in presence of RT at optimized working buffer (pH = 7.0). Interestingly, the electrode successfully established a dual wider linear response (0.062-34.8 & 34.8-346.8 µM) with a nanomolar detection limit (1 nM) and higher sensitivity. The practicability analysis of the proposed sensor also affords excellent selectivity, reproducibility, repeatability, reversibility, and storage stability. Furthermore, the real sample analysis was carried out in blood and orange samples fallout with better recovery results., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Melioidosis, the infection caused by Burkholderia pseudomallei, is associated with a high case fatality rate, due in part to difficulties in clinical recognition and diagnostic confirmation of the disease. Although head and neck involvement is common in children, specific disease manifestations differ between geographic regions. The aim of this study was to provide a detailed description of melioidosis of the head and neck among children in Sarawak, Malaysia, and determine if fine-needle aspiration of suspected head or neck lesions could improve melioidosis diagnosis., Methods: We conducted a retrospective descriptive study of all children aged < 12 years with culture-confirmed melioidosis presenting with head and neck manifestations and admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2011 until December 2020. Fine-needle aspiration of head and neck lesions suspected to be due to melioidosis with inoculation in blood culture bottles (FNA + BCB) was used from the beginning of 2016., Results: Of 34 children with culture-confirmed melioidosis, 20 (59%) had an infection involving one or more sites in the head and neck. Of these, 17 (85%) were diagnosed in or after 2016. Cervical lymph nodes were the most common organ or site affected, involved in 19 (95%) children. Clinical presentations of B. pseudomallei lymph node infections were highly variable. Five (25%) children had salivary gland involvement. Lacrimal gland involvement (dacryocystitis) and skin or soft tissue infection (scalp abscess) were less frequent. B. pseudomallei was isolated from the head or neck using FNA + BCB in 15 (75%) children and by standard culture methods of direct plating of pus on agar following incision and drainage in only 2 (10%) children. B. pseudomallei was isolated from non-head or neck specimens or blood in 3 (15%) children., Conclusions: Manifestations of pediatric head and neck melioidosis in Sarawak, Malaysia, differ from those of other regions. Fine-needle aspiration, mainly of affected cervical lymph nodes, facilitates B. pseudomallei detection and enables confirmation of melioidosis infections., (© 2021. The Author(s).)

Sickle cell disease is a major public health problem in India. Lack of rapid and reliable diagnostic methods result in many avoidable deaths in affected population. Current diagnostic tools are laboratory based, expensive and need trained manpower. Here, we evaluated the performance of a microchip-based cellulose acetate electrophoresis test, "Gazelle" in the tribal-dominated Indian states of Chhattisgarh and Madhya Pradesh. A total of 1,050 patients were screened by sickle cell solubility, hemoglobin (cellulose acetate) electrophoresis, high-performance liquid chromatography (HPLC) and Gazelle. Of the total 1,027 test results obtained, 960 tests were "Valid" (93.5%) and included in the analysis. Gazelle identified all patients with disease (HbSS and Thalassemia Major) with 100% accuracy. Gazelle demonstrated 100% sensitivity when comparing sickle cell disease (SCD) vs. sickle cell trait and SCD vs. normal. Specificity was 98.9% and 99.5% when comparing SCD vs. trait and trait vs. normal, respectively. Specificity was 99.8% when comparing SCD vs. normal and sensitivity was 99.3% when comparing trait vs. normal. Overall, Gazelle yielded a high accuracy (99.0%) compared to reference standard tests (hemoglobin electrophoresis and HPLC). Gazelle is a low-cost, rapid diagnostic test with high accuracy for detecting SCD both quantitatively and qualitatively. Gazelle can be a potential screening tool for the rapid diagnosis in resource limited settings and developing countries with high burden of hemoglobin disorders., Competing Interests: RS reports grants and non-financial support from Hemex Health, USA. PT is an employee of Hemex Health USA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer SSM declared a shared affiliation with several of the authors SS, MP, RK, AG, RU, ST, AV, AD, PB, and RS to the handling editor at time of review., (Copyright © 2021 Shrivas, Patel, Kumar, Gwal, Uikey, Tiwari, Verma, Thota, Das, Bharti and Shanmugam.)

Conjugated chromophores possessing π-twisted functionality such as tetracyanobutadiene (TCBD) have emerged as promising active layer materials for organic photovoltaics (OPVs). In this study, we disclose the synthesis of two azulenyl chromophores containing one and two TCBD groups. The symmetrical and unsymmetrical structural characteristics of these molecules inflict dissimilar optoelectronic and electrochemical properties. Based on molar absorptivity, aggregation behavior, HOMO-LUMO energies and other quantum chemical parameters, the symmetrical molecule (TATC2) appears to be a better non-fullerene acceptor (NFA) compared to its unsymmetrical counterpart (TATC1). For instance, higher absorptivity and deeper HOMO-LUMO levels for TATC2 (23950 M -1  cm -1 ; -6.01 eV/-3.86 eV) over TATC1 (12200 M 1  cm -1 ; -5.46 eV/-3.64 eV) was observed. Validating this structure-property relationship on solar cell prototypes exhibited higher photovoltaic parameters (V OC =0.54 V, FF=0.48, J SC =6.42 mA/cm 2 ) for TATC2 than TATC1 (V OC =0.47 V, FF=0.38, J SC =5.77 mA/cm 2 ). Though the device parameters are not high, this work uncovers the intrinsic properties of azulene-tethered twisted chromophores as potential π-semiconductor choice for NFA solar cells. In particular, this report explores the utility of azulene-based π-twisted semiconductors as acceptor material for OPVs with cell efficiencies of 1.70 and 1.04 % for TATC2 and TATC1 respectively., (© 2021 Wiley-VCH GmbH.)

COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the preventive efforts have reduced COVID-19 deaths in the United States. To address this question, we analyze data pertaining to COVID-19 deaths drawn from the Centers for Disease Control and Prevention (CDC). For this purpose, we employ incidence rate restricted Poisson (IRRP) as an underlying analysis methodology and evaluate all preventive efforts utilized to attempt to reduce COVID-19 deaths. Interpretations of analytic results and graphical visualizations are used to emphasize our various findings. Much needed modifications of the public health policies with respect to dealing with any future pandemics are compiled, critically assessed, and discussed.

In this study, the medium requirements to increase the production of xylitol by using Candida tropicalis (CT) have been investigated. The technique of single addition or omission of medium components was applied to determine the nutritional requirements. The addition of amino acids such as Asp, Glu, Gln, Asn, Thr, and Gly had no significant effect on CT growth. However, in the absence of other metal ions, there was a higher concentration of cell growth and xylitol production when only Zn 2+ was present in the medium. The analysis of various vitamins unveiled that biotin and thiamine were the only vitamins required for the growth of CT. Surprisingly, when only biotin was present in the medium as a vitamin, there was less growth of CT than when the medium was complete, but the amount of xylitol released was significantly higher. Overall, this study will increase the xylitol production using the single omission or addtion technique., (© Association of Microbiologists of India 2021.)

This study estimated the effects of Medicaid Expansion, demographics, socioeconomic status (SES), and health status on disease management of diabetes over time. The hypothesis was that the introduction of the ACA and particularly Medicaid Expansion would increase the following dependent variables (all proportions): (1) provider checks of HbA1c, (2) provider checks of feet, (3) provider checks of eyes, (4) patient education, (5) annual physician checks for diabetes, (6) patient self-checks of blood sugar. Data were available from the Behavioral Risk Factor Surveillance System for 2011 to 2019. We filtered the data to include only patients with diagnosed non-gestational diabetes of age 45 or older ( n = 510,991 cases prior to weighting). Linear splines modeled Medicaid Expansion based on state of residence as well as implementation status. Descriptive time series plots showed no major changes in proportions of the dependent variables over time. Quasibinomial analysis showed that implementation of Medicaid Expansion had a statistically negative effect on patient self-checks of blood sugar (odds ratio = 0.971, p < 0.001), a statistically positive effect on physician checks of HbA1c (odds ratio = 1.048, p < 0.001), a statistically positive effect on feet checks (odds ratio = 1.021, p < 0.001), and no other significant effects. Evidence of demographic, SES, and health status disparities existed for most of the dependent variables. This finding was especially significant for HbA1c checks by providers. Barriers to achieving better diabetic care remain and require innovative policy interventions.

We present a restricted infection rate inverse binomial-based approach to better predict COVID-19 cases after a family gathering. The traditional inverse binomial (IB) model is inappropriate to match the reality of COVID-19, because the collected data contradicts the model's requirement that variance should be larger than the expected value. Our version of an IB model is more appropriate, as it can accommodate all potential data scenarios in which the variance is smaller, equal, or larger than the mean. This is unlike the usual IB, which accommodates only the scenario in which the variance is more than the mean. Therefore, we propose a refined version of an IB model to be able to accommodate all potential data scenarios. The application of the approach is based on a restricted infectivity rate and methodology on COVID-19 data, which exhibit two clusters of infectivity. Cluster 1 has a smaller number of primary cases and exhibits larger variance than the expected cases with a negative correlation of 28%, implying that the number of secondary cases is lesser when the number of primary cases increases and vice versa. The traditional IB model is appropriate for Cluster 1. The probability of contracting COVID-19 is estimated to be 0.13 among the primary, but is 0.75 among the secondary in Cluster 1, with a wider gap. Cluster 2, with a larger number of primary cases, exhibits smaller variance than the expected cases with a correlation of 79%, implying that the number of primary and secondary cases do increase or decrease together. Cluster 2 disqualifies the traditional IB model and requires its refined version. The probability of contracting COVID-19 is estimated to be 0.74 among the primary, but is 0.72 among the secondary in Cluster 2, with a narrower gap. The advantages of the proposed approach include the model's ability to estimate the community's health system memory, as future policies might reduce COVID's spread. In our approach, the current hazard level to be infected with COVID-19 and the odds of not contracting COVID-19 among the primary in comparison to the secondary groups are estimable and interpretable., Competing Interests: The authors have declared that no competing interests exist.

The relationship between healthcare organizational accreditation and their leaders' professional certification in healthcare management is of specific interest to institutions of higher education and individuals in the healthcare management field. Since academic program accreditation is one piece of evidence of high-quality education, and since professional certification is an attestation to the knowledge, skills, and abilities of those who are certified, we expect alumni who graduated from accredited programs and obtained professional certification to have a positive impact on the organizations that they lead, compared with alumni who did not graduate from accredited programs and who did not obtain professional certification. The authors' analysis examined the impact of hiring graduates from higher education programs that held external accreditation from the Commission on Accreditation of Healthcare Management Education (CAHME). Graduates' affiliation with the American College of Healthcare Executives (ACHE) professional healthcare leadership organization was also assessed as an independent variable. Study outcomes focused on these graduates' respective healthcare organization's performance measures (cost, quality, and access) to assess the researchers' inquiry into the perceived value of a CAHME-accredited graduate degree in healthcare administration and a professional ACHE affiliation. The results from this study found no effect of CAHME accreditation or ACHE affiliation on healthcare organization performance outcomes. The study findings support the need for future research surrounding healthcare administration professional graduate degree program characteristics and leader development affiliations, as perceived by various industry stakeholders.

Enhanced covalent immobilization of xylanase from Chaetomium globosum (XylCg) onto SiO 2 nanoparticles was achieved by the modification of surface residues. The mutation of surface residues to lysine by site-directed mutagenesis increased the immobilization efficiency (IE) and immobilization yield (IY). The immobilized mutant XylCg (N172K-H173K-S176K-K133A-K148A) exhibited an IY of 99.5% and IE of 135%, which were 1.8- and 4.3-fold higher than immobilized wildtype (WT). Regarding the catalytic properties, the k cat and k cat /K m values were 1850 s -1 and 2030 mL mg -1 s -1 for the immobilized mutant, and 331 s -1 and 404 mL mg -1 s -1 for the immobilized WT, respectively. Additionally, the immobilized mutant exhibited four times higher thermal stability than the immobilized WT at 60 °C. These results suggest that surface-mutated lysine residues confer good stability and orientation on the support matrix, thus improving the overall performance of xylanase., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Challenges to manage, mitigate, or prevent the COVID-19's pandemics are felt by medical, healthcare professionals and governing agencies. Health researchers conduct survey among the citizens to capture their opinion on COVID-19. In such surveys like in Hanafiah and Wan (2020), structural-zero (different from sampling zero) category occurs as they question about perception, knowledge, and communication regarding COVID-19., Materials: The data were collected in a survey conducted among Malaysians by Hanafiah and Wan regarding COVID-19. The survey focused on people's response about the public communication, knowledge, and perception., Methods: One of the four question categories in the survey is mutually exclusive with the other three questions. Consequently, there will be no entry in that category. Such group is called structurally zero category in the literature. The literature never probed the migrative split to other categories of the unknown proportion belonging to the structural zero category. In this article, the probability-based new and innovative method configures what proportion in that mutually exclusive category and it is the essence of our method., Results: The mutually exclusive nature of subquestions manufactured structural zero in their data. A careful analysis of the data has created so far unknown probability concepts in the literature, which we named as "Exodus probabilities" in this article. Its discovery and utility are illustrated and elaborated with application in COVID-19. This methodology is also useful in applications in engineering, epidemiology, marketing, communication networking, etc., Conclusion: What is quite novel about the discovery of the exodus probability in this article is the evolution of the concepts from the structural-zero category. In such situation, when a category is eliminated, the proportions of the sample might have uncommunicatively transited to other viable categories and our research question is all about configuring their proportions. This is an innovative approach., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Shanmugam and Singh.)

Background: Reducing the maternal and neonatal mortality rate are the predominant goals of achieving sustainable development for which it is important to ensure adequate health workforce, especially pediatric professionals at all levels of health care. Recent trends reveal a significant decline in the number of doctors opting for pediatrics specialization., Objective: This study was carried out to explore the career preferences of the undergraduate medical students and factors influencing career choice., Methods: This cross sectional study was carried out among 362 undergraduate medical students studying in prefinal and final year during a period of three months. A self administered questionnaire was used to obtain information regarding the career preferences and factors influencing the decision making. Attitudes regarding career choice was assessed using Likert scale and later recoded into binomial variables. Statistical analysis was carried out using SPSS software., Results: Majority of the participants were females (61.8%). The individual choice of specialty revealed that 12.2% of the males and 18.5% of the females wanted to take up pediatrics as their first career choice while 5.5% of the males and 7.7% of the females had pediatrics as their second choice. Overall, more females preferred pediatrics as a career choice compared to the males. The observed difference was statistically significant (p<0.0001)., Conclusion: Adequate motivation, driven with passion for patient care can be inculcated at the young age and will go a long way in not only addressing the pediatric needs of the society, but also improve health indicators and sustainable development of the country., Competing Interests: There are no conflicts of interest., (© 2021 Arun Sriram Amudhan, Anitha Palaniyandi, Mahalakshmi Rajan, Premkumar Parthiban, Sasitharan Rajendraprasath, Thulasiraj Saminathan, Reshma Shanmugam, Vinoth Ponnurangam Nagarajan.)

The physical demands on U.S. service members have increased significantly over the past several decades as the number of military operations requiring overseas deployment have expanded in frequency, duration, and intensity. These elevated demands from military operations placed upon a small subset of the population may be resulting in a group of individuals more at-risk for a variety of debilitating health conditions. To better understand how the U.S Veterans health outcomes compared to non-Veterans, this study utilized the U.S. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) dataset to examine 10 different self-reported morbidities. Yearly age-adjusted, population estimates from 2003 to 2019 were used for Veteran vs. non-Veteran. Complex weights were used to evaluate the panel series for each morbidity overweight/obesity, heart disease, stroke, skin cancer, cancer, COPD, arthritis, mental health, kidney disease, and diabetes. General linear models (GLM's) were created using 2019 data only to investigate any possible explanatory variables associated with these morbidities. The time series analysis showed that Veterans have disproportionately higher self-reported rates of each morbidity with the exception of mental health issues and heart disease. The GLM showed that when taking into account all the variables, Veterans disproportionately self-reported a higher amount of every morbidity with the exception of mental health. These data present an overall poor state of the health of the average U.S. Veteran. Our study findings suggest that when taken as a whole, these morbidities among Veterans could prompt the U.S. Department of Veteran Affairs (VA) to help develop more effective health interventions aimed at improving the overall health of the Veterans.

Background: Electronic health records (EHRs) are a central feature of care delivery in acute care hospitals; however, the financial and quality outcomes associated with system performance remain unclear., Objective: In this study, we aimed to evaluate the association between the top 3 EHR vendors and measures of hospital financial and quality performance., Methods: This study evaluated 2667 hospitals with Cerner, Epic, or Meditech as their primary EHR and considered their performance with regard to net income, Hospital Value-Based Purchasing Total Performance Score (TPS), and the unweighted subdomains of efficiency and cost reduction; clinical care; patient- and caregiver-centered experience; and patient safety. We hypothesized that there would be a difference among the 3 vendors for each measure., Results: None of the EHR systems were associated with a statistically significant financial relationship in our study. Epic was positively associated with TPS outcomes (R 2 =23.6%; β=.0159, SE 0.0079; P=.04) and higher patient perceptions of quality (R 2 =29.3%; β=.0292, SE 0.0099; P=.003) but was negatively associated with patient safety quality scores (R 2 =24.3%; β=-.0221, SE 0.0102; P=.03). Cerner and Epic were positively associated with improved efficiency (R 2 =31.9%; Cerner: β=.0330, SE 0.0135, P=.01; Epic: β=.0465, SE 0.0133, P<.001). Finally, all 3 vendors were associated with positive performance in the clinical care domain (Epic: β=.0388, SE 0.0122, P=.002; Cerner: β=.0283, SE 0.0124, P=.02; Meditech: β=.0273, SE 0.0123, P=.03) but with low explanatory power (R 2 =4.2%)., Conclusions: The results of this study provide evidence of a difference in clinical outcome performance among the top 3 EHR vendors and may serve as supportive evidence for health care leaders to target future capital investments to improve health care delivery., (©Bradley Beauvais, Clemens Scott Kruse, Lawrence Fulton, Ramalingam Shanmugam, Zo Ramamonjiarivelo, Matthew Brooks. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.04.2021.)

Plastics are an integral part of most of the daily requirements. Indiscriminate usage and disposal have led to the accumulation of massive quantities of waste. Their non-biodegradable nature makes it increasingly difficult to manage and dispose them. To counter this impending disaster, biodegradable polymers, especially polyhydroxy-alkanoates (PHAs), have been envisaged as potential alternatives. Owing to their unique physicochemical characteristics, PHAs are gaining importance for versatile applications in the agricultural and medical sectors. Applications in the medical sector are more promising because of their commercial viability and sustainability. Despite such potential, their production and commercialization are significant challenges. The major limitations are their poor mechanical strength, production in small quantities, costly feed, and lack of facilities for industrial production. This article provides an overview of the contemporary progress in the field, to attract researchers and stakeholders to further exploit these renewable resources to produce biodegradable plastics on a commercial scale., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The present research work was conducted on a compression ignition engine to assess the engine characteristics fueled with the blend of diesel and high-oxygenated additives such as ethanol. Ethanol does not easily blend with diesel. In order to attain a homogeneous mixture, a small amount of additive is added to the blend. Different additives were added to the blend to form a homogeneous mixture. Stability test was conducted on the blend to ensure prolonged homogeneity. The additives used for the test purpose were isopropanol, oleic acid, and ethylene acetate. From the stability results, it was found that oleic acid was the best additive which produces a better homogenous mixture for the blend of ethanol and diesel. One percentage of oleic acid is used as an additive to blend ethanol and diesel. The different combinations of blend ratios used for the test purpose were D90E10, D80E20, and D70E30. All the aforementioned blends have low cetane number because of ethanol, which was compensated by adding 1% DEE (diethyl ether) to all the blends. Experimental results exhibit that there is an improvement in the performance characteristics, such as brake thermal efficiency (BTE) and specific energy consumption (SEC), with the enrichment of DEE in ethanol-diesel blend. It is also noticed that the blend without DEE exhibited lower magnitude. This is mainly due to higher energy content and cetane number of DEE. Emission characteristics, like hydrocarbon (HC) and carbon monoxide (CO), were found to drastically increase with the increase in the ethanol concentration in the diesel blend. This is attributed to higher latent heat of vaporization (LHV) of ethanol present in the blend. Combustion pressure and heat release rate of the DEE-enriched ethanol blends were higher by 2.2 % and 2.4 %, respectively, when compared with their corresponding blends without DEE. This is a result of higher volatility of DEE which leads to better combustion. Graphical abstract.

Changing climate and rising temperatures are predicted to affect millions of workers due to heat stress risks, especially in tropical settings. We used a cross-sectional study design to profile the heat exposures of ~1500 workers from eight-industrial sectors using a QuesTemp wet bulb globe temperature (WBGT) monitor, quantified the heat-strain indicators viz., rise in Core Body Temperature (CBT), Sweat Rate (SwR), and Urine Specific Gravity (USG) by standard methods and evaluated the health impacts of heat stress using a structured questionnaire. Heat exposures (Avg.WBGT: 28.4 ± 2.6 °C) exceeded the Threshold Limit Value (TLV) for 70% of workers and was significantly associated with the rise in CBT >1 °C in 11.3% and elevated USG >1.020 in 10.5% of the workers. The heat-exposed workers had 2.3 times higher odds of reporting adverse health outcomes (84%) compared to the unexposed workers (95% CI: 1.74-3.19; p value ≤ 0.0001). Mild reduction in kidney function observed in 49% of salt - pan workers, and a high prevalence of kidney stones (33%) among the 91 steelworkers subjected to kidney ultrasound had a significant association with chronic high WBGT exposure above the TLV (p value < 0.034). Further, in-depth assessments are warranted to develop strategies for interventions and protective labor policies to avert adverse occupational health and productivity consequences for millions of workers globally, especially in the rising temperature scenario.

Isradipine is a dihydropyridine calcium channel blocker (CCB) commonly used as vasodilator with antihypertensive properties. A remote-controlled release formulation for isradipine would substantially improve the clinical outcomes of the patients requiring chronic long-term treatment. In this work, sustained release (SR) tablets of isradipine, composed of hydroxypropylmethyl cellulose (HPMC), have been produced by wet granulation and their in vitro and in vivo characterization was compared to a conventional tablet dosage form of immediate release (IR) as preliminary assessment. Tablets composed of 15.0% (wt/wt) HPMC exhibited a SR profile over a period of 24 hours. The release of isradipine followed a Fickian diffusion pattern obeying to the first order kinetics and the extent of absorption was even higher in comparison to the developed conventional tablets, which showed immediate drug release. In vivo studies were carried out in rabbits, showing that the extent of isradipine absorption from the developed tablets was higher in comparison to IR tablets due to the modified release profile obtained for the former ( p  < 0.05). Our results suggest that SR tablets of isradipine are an efficient solid dosage form to overcome the limitations encountered in conventional IR tablets.

Background: By dividing the burden of one's weight between the shins and the buttocks in the sitting position on an office or saddle chair, a person can avoid back pain. In this 21st century, sitting on a chair for long hours in workplace on office chair is unavoidable necessity and hence, millions in different countries undergo a risk for backpain. Is there a right sitting position?, Objective: The aim of this article is to find out how much a correlation exists between the angle of sitting and the length of spinal curvature which is the source of backpain. An experiment can be designed and carried out to measure various angles in sitting and the changing length of the person's spinal cord curvature., Method: The usual statistical methodology requires a pair of values namely x and y to quantify the correlation. The data on sitting angles and the length of spinal curvature do not have such pairing, and hence, the traditional approach to find the correlation between the sitting angle and length of spinal curvature is not applicable. Yet, an approach is necessary. This article constructs an innovative statistical approach to fulfil this need., Results: Our approach yields a correlation of 0.998 for sitting on office chair and an increased correlation of 0.999 on saddle chair, according to the Truszczyńska-Baszaka et al.'s data., Conclusions: An adjustment is made in various angles of sitting on office chair to transform the comfortable sitting on a saddle chair. In consequence, the proportional effect on the spinal curvature is estimable with the data and it is phenomenal (that is significantly more than one). No wonder people prefer saddle chair over office chair when it comes to avoid back pain and this article proves the convenience statistically.

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human erythroenzymopathy affecting around 10% of the world population. India is endemic for malaria and antimalarial drugs are known to induce haemolysis in G6PD deficient individuals. Here we report the prevalence as well as the molecular diversity of G6PD deficiency in geographical regions of India., Methods and Results: A total of 20,896 individuals (11,838 males and 9058 females) were screened by DPIP dye decolorisation method followed by quantitation of G6PD enzyme activity on the suspected samples. Molecular analysis was undertaken in a total of 350 G6PD deficient individuals by PCR-RFLP and DNA sequencing. A structural characteristic of the novel variant was deduced by using DynaMut web-server. The prevalence rate of G6PD deficiency varied between 0.8 and 6.3% with an overall prevalence of 1.9%. A total of twelve mutations were identified. Of the total deleterious alleles detected G6PD Orissa (56.5%) was found to be the most predominant variant followed by G6PD Mediterranean (23.6%). G6PD Mediterranean, G6PD Kaiping and G6PD Mahidol were found to be severely deficient variant and 14.1% of them showed undetectable activity. A novel mutation c.544C➔G (R182G) in exon 6 was identified in one tribal male where substitution of arginine by glycine, likely causes the alteration in the alpha helix leading to disruption of secondary structure of the protein., Conclusion: There are large differences in the distribution of G6PD causal variants between Indian states, and this may have implications for the treatment in the malaria endemic areas., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Emergence of novel pandemic viral disease CoVid-19 and its mutational behaviour are alarming. The potential use of nano-biotechnology in combating CoVid-19 is promising. We glean available data to explore such possibility in this short note., (© 2020 Biomedical Informatics.)

Despite estimated high prevalence of inherited hemoglobin (Hb) disorders among tribal populations in Madhya Pradesh State, India, the burden of disease is unknown, leading to high morbidity and associated mortality. Our aim was to screen tribal populations in designated tribal districts of Madhya Pradesh State for various hemoglobinopathies and to estimate the prevalence and plausible cause of anemia. The present study screened a total of 3992 tribal individuals comprised of students of Tribal schools, ashrams of Dindori, Mandla, and Chhindwara districts of Madhya Pradesh State. Screening of hemoglobinopathies was done using Hb electrophoresis and or high performance liquid chromatography (HPLC), α-thalassemia (α-thal) was detected using polymerase chain reaction (PCR). The median age of the studied cohort was 15 years (interquartile range 13-16 years). High prevalence (76.7%) of anemia was observed among the studied cohort. The prevalence of sickle cell trait and sickle cell disease varies from 10.7 to 15.6% and 0.4 to 0.8%, respectively. The allele frequency of sickle cell gene was highest in the Pradhan tribe followed by the Panika tribe. Dindori district had the highest prevalence of sickle cell trait. β-Thalassemia (β-thal) trait was observed in only 1.4% of the screened population. α Gene deletions were observed in 84.7% individuals. Significant association of α gene deletion mutations with mean Hb, mean corpuscular volume (MCV), and mean corpuscular Hb (MCH) was observed. The Bharia tribe showed the highest prevalence for α-thal. For comprehensive health care, effective intervention programs are needed to reduce the high prevalence of anemia and hemoglobinopathies among tribes.