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Purpose: This study describes the epidemiology, clinical extent at diagnosis, and treatment modalities for prostate cancer in India. Methodology: This study is a secondary analysis of primary prostate cancer data sourced from the National Cancer Registry Programme. Data from population-based cancer registry for the period 2012–2016 were used to estimate the incidence rates, including crude incidence rate (CR), age-adjusted incidence rate (AAR), age-specific rate, and cumulative risk. Trends in the AAR were assessed using join-point regression. Hospital-Based Cancer Registry data from 2012 to 2019 were used to describe the clinical extent of the cancer at diagnosis and the treatment modalities. Results: The incidence of prostate cancers was higher in urban registries such as Delhi, Kamrup Urban, and Mumbai (AAR of 11.8 per 100,000, 10.9 per 100,000, and 9.7 per 100,000, respectively). Prostate cancer incidence showed a rise after the age of 50, with a notable acceleration after age 64. The overall annual percentage change for prostate cancer incidence from 1982 to 2016 was 2.6. Around 43.0% of all prostate cancers were diagnosed at the distant metastatic stage. Surgery and radiotherapy, either as standalone treatments or in combination with other modalities, contributed to the treatment of 78.5% of localized cancer, 74.2% of locoregional cancer, and 57.2% of distant metastatic stage of prostate cancer. Conclusion: There is heterogeneity in the incidence of prostate cancer, as evidenced by urban registries. Additionally, there is a need for downstaging the disease, without risking overdiagnosis.

Summary: The rearrangement and expression of the immunoglobulin μ heavy chain (Igh) gene require communication of the intragenic Eμ and 3′ regulatory region (RR) enhancers with the variable (VH) gene promoter. Eμ binding of the transcription factor YY1 has been implicated in enhancer-promoter communication, but the YY1 protein network remains obscure. By analyzing the comprehensive proteome of the 1-kb Eμ wild-type enhancer and that of Eμ lacking the YY1 binding site, we identified the male-specific lethal (MSL)/MOF complex as a component of the YY1 protein network. We found that MSL2 recruitment depends on YY1 and that gene knockout of Msl2 in primary pre-B cells reduces μ gene expression and chromatin looping of Eμ to the 3′ RR enhancer and VH promoter. Moreover, Mof heterozygosity in mice impaired μ expression and early B cell differentiation. Together, these data suggest that the MSL/MOF complex regulates Igh gene expression by augmenting YY1-mediated enhancer-promoter communication.

Breast cancer (BC) is the leading cause of female cancer mortality and is a type of cancer that is a major threat to women's health. Deep learning methods have been used extensively in many medical domains recently, especially in detection and classification applications. Studying histological images for the automatic diagnosis of BC is important for patients and their prognosis. Owing to the complication and variety of histology images, manual examination can be difficult and susceptible to errors and thus needs the services of experienced pathologists. Therefore, publicly accessible datasets called BreakHis and invasive ductal carcinoma (IDC) are used in this study to analyze histopathological images of BC. Next, using super-resolution generative adversarial networks (SRGANs), which create high-resolution images from low-quality images, the gathered images from BreakHis and IDC are pre-processed to provide useful results in the prediction stage. The components of conventional generative adversarial network (GAN) loss functions and effective sub-pixel nets were combined to create the concept of SRGAN. Next, the high-quality images are sent to the data augmentation stage, where new data points are created by making small adjustments to the dataset using rotation, random cropping, mirroring, and color-shifting. Next, patch-based feature extraction using Inception V3 and Resnet-50 (PFE-INC-RES) is employed to extract the features from the augmentation. After the features have been extracted, the next step involves processing them and applying transductive long short-term memory (TLSTM) to improve classification accuracy by decreasing the number of false positives. The results of suggested PFE-INC-RES is evaluated using existing methods on the BreakHis dataset, with respect to accuracy (99.84%), specificity (99.71%), sensitivity (99.78%), and F1-score (99.80%), while the suggested PFE-INC-RES performed better in the IDC dataset based on F1-score (99.08%), accuracy (99.79%), specificity (98.97%), and sensitivity (99.17%).

The demand for digital platforms in managing heart failure (HF) is expected to increase with promising effects on readmission and health expenditure. The study aims to explore current post-discharge management strategies and identify the need and acceptance of digital platforms, to ensure the development of a user-friendly mobile application for HF patients. Using a cross-sectional analytical research design, 90 consecutive patients diagnosed with HF who were discharged from a Tertiary Care Center were enrolled. Tele-interview was conducted using a self-developed and validated tool. The mean age of participants was 55.54 ± 10.33 years. The participants’ adherence to HF management strategies was low in terms of physical exercise and weight monitoring. More than one-third were willing to self-record their measurements and use a mobile application. The common mobile application features requested were medication information/reminder (88.6%), health education (84.3%), chat with nurses (84.3%), physical activity (81.4%), symptoms (78.6%), diet (78.6%) and weight management (72.9%). The findings from this initial phase of mobile development are expected to help leverage better development of digital interventions for HF patients.

Erbium-doped materials can serve as spin-photon interfaces with optical transitions in the telecom C band, making them an exciting class of materials for long-distance quantum communication. However, the spin and optical coherence times of Er3+ ions are limited by currently available host materials, motivating the development of new Er3+-containing materials. Here we demonstrate the use of ion implantation to efficiently screen prospective host candidates, and show that disorder introduced by ion implantation can be mitigated through post-implantation thermal processing to achieve inhomogeneous linewidths comparable to bulk linewidths in as-grown samples. We present optical spectroscopy data for each host material, which allows us to determine the level structure of each site, allowing us to compare the environments of Er3+ introduced via implantation and via doping during growth. We demonstrate that implantation can generate a range of local environments for Er3+, including those observed in bulk-doped materials, and that the populations of these sites can be controlled with thermal processing.

The existence of long-range magnetic order in low-dimensional magnetic systems, such as the quasi-two-dimensional van der Waals (vdW) magnets, has attracted intensive studies of new physical phenomena. The vdW Fe_{N}GeTe_{2} (N=3, 4, 5; FGT) family is exceptional, owing to its vast tunability of magnetic properties. In particular, a ferromagnetic ordering temperature (T_{C}) above room temperature at N=5 (F5GT) is observed. Here, our study shows that, by nickel (Ni) substitution of iron in F5GT, a record high T_{C}=478(6)  K is achieved. Importantly, pervasive, beyond room-temperature ferromagnetism exists in almost the entire doping range of the phase diagram of Ni-F5GT. We argue that this striking observation in Ni-F5GT can be possibly due to several contributing factors, including increased 3D magnetic couplings due to the structural alterations.

Order–disorder transitions are widely explored in various vortex structures in condensed matter physics, that is, in the type-II superconductors and Bose–Einstein condensates. In this study, the ordering of the polar vortex phase in [Pb(Zr0.4Ti0.6)O3]n/(SrTiO3)n (PZT/STO) superlattices is investigated through phase-field simulations. With a large tensile substrate strain, an antiorder vortex state (where the rotation direction of the vortex arrays in the neighboring ferroelectric layers are flipped) is discovered for short-period PZT/STO superlattice. The driving force is the induced in-plane polarization in the STO layers due to the large tensile epitaxial strain. Increasing the periodicity leads to antiorder to disorder transition, resulting from the high energy of the head-to-head/tail-to-tail domain structure in the STO layer. On the other hand, when the periodicity is kept constant in short-period superlattices, the order–disorder–antiorder transition can be engineered by mediating the substrate strain, due to the competition between the induction of out-of-plane (due to interfacial depolarization effect) and in-plane (due to strain) polarization in the STO layer. The 3D ordering of such polar vortices is still a topic of significant current interest and it is envisioned that this study will spur further interest toward the understanding of order–disorder transitions in ferroelectric topological structures.

BackgroundAlthough there is extensive literature on robotic total intracorporeal anastomosis (TICA) for right colon resection, left total ICA using the da Vinci Xi robotic platform has only been described in short case series previously. In this study, we report on the largest cohort of robotic left total ICA, provide a description of our institution's techniques, and compare outcomes to robotic left partial extracorporeal anastomosis (PECA).MethodsPatients who underwent robotic left colectomy for any underlying pathology from July 1, 2016 through April 30, 2020 were identified by procedure code. A technical description is provided for two unique techniques performed at our institution. Outcomes included operative time, length of stay, supply cost, post-operative ileus, post-operative morbidity and mortality and need for complete mobilization of the splenic flexure.ResultsFrom a review of our institution's data, 83 robotic TICA cases were identified and 76 robotic PECA cases were identified. Common procedures included low anterior resection, sigmoidectomy, left hemicolectomy, and rectopexy with resection. TICA was associated with significantly shorter intraoperative time compared to PECA.ConclusionsOur series shows that TICA is a safe and feasible technique that does not increase the risk of adverse outcomes. Using either the anvil-forward or anvil-backward technique, we were able to reliably reproduce this method in a total of 83 patients undergoing left colon resection for either benign or malignant diseases.

Abstract Background Nuclear medicine has made enormous progress in the past decades. However, there are still significant inequalities in patient access among different countries, which could be mitigated by improving access to and availability of radiopharmaceuticals. Main body This paper summarises major considerations for a suitable pharmaceutical regulatory framework to facilitate patient access to radiopharmaceuticals. These include the distinct characteristics of radiopharmaceuticals which require dedicated regulations, considering the impact of the variable complexity of radiopharmaceutical preparation, personnel requirements, manufacturing practices and quality assurance, regulatory authority interfaces, communication and training, as well as marketing authorisation procedures to ensure availability of radiopharmaceuticals. Finally, domestic and regional supply to ensure patient access via alternative regulatory pathways, including in-house production of radiopharmaceuticals, is described, and an outlook on regulatory challenges faced by new developments, such as the use of alpha emitters, is provided. Conclusions All these considerations are an outcome of a dedicated Technical Meeting organised by the IAEA in 2023 and represent the views and opinions of experts in the field, not those of any regulatory authorities.

Abstract Bismuth ferrite has garnered considerable attention as a promising candidate for magnetoelectric spin-orbit coupled logic-in-memory. As model systems, epitaxial BiFeO3 thin films have typically been deposited at relatively high temperatures (650–800 °C), higher than allowed for direct integration with silicon-CMOS platforms. Here, we circumvent this problem by growing lanthanum-substituted BiFeO3 at 450 °C (which is reasonably compatible with silicon-CMOS integration) on epitaxial BaPb0.75Bi0.25O3 electrodes. Notwithstanding the large lattice mismatch between the La-BiFeO3, BaPb0.75Bi0.25O3, and SrTiO3 (001) substrates, all the layers in the heterostructures are well ordered with a [001] texture. Polarization mapping using atomic resolution STEM imaging and vector mapping established the short-range polarization ordering in the low temperature grown La-BiFeO3. Current-voltage, pulsed-switching, fatigue, and retention measurements follow the characteristic behavior of high-temperature grown La-BiFeO3, where SrRuO3 typically serves as the metallic electrode. These results provide a possible route for realizing epitaxial multiferroics on complex-oxide buffer layers at low temperatures and opens the door for potential silicon-CMOS integration.

Introduction: Endotracheal intubation and mechanical ventilation are the most frequently used life-sustaining interventions in critical care. Prolonged intubation can lead to post-extubation dysphagia, affecting the individual’s nutritional level and communication ability. Thereupon, this study aims to assess the effectiveness of swallowing and oral care interventions in resuming oral intake and increasing salivary flow in post-extubation patients. Methods: A randomized controlled trial was conducted in critical care units of a tertiary care setting, where 92 post-extubation patients who had undergone intubation for≥48 hours were enrolled. The intervention group received swallowing and oral interventions, including safe swallowing education (SSE), toothbrushing, salivary gland massage, oral cavity, and swallowing exercises. In contrast, the control group received standard oral care every 8th hour. Oral intake was assessed daily with the Functional Oral Intake Scale, and the salivary flow measurement was assessed with oral Schirmer’s test on the 1st, 3rd, and 7th day after extubation. Results: The baseline demographic and clinical characteristics showed that the groups were homogenous. The intervention group achieved total oral intake two days earlier than the control group. Findings also showed that the participants in the intervention group had a significant increase in salivary flow than in the control group on the 3rd and 7th days of the intervention. Conclusion: Swallowing and oral care interventions help post-extubation patients resume early oral intake and increase salivary flow after prolonged intubation. Hence, it improves the patient’s outcome toward a healthy life.

Lignocellulosic biomass extracted from plants that contain rich amounts of cellulose, hemicellulose, and lignin content can replace synthetic fibers in many engineering applications and is biodegradable. However, e-waste is rapidly evolving into one of the most serious environmental issues in the world owing to the presence of several toxic compounds that can contaminate the environment and pose a threat to human health. Printed circuit boards (PCBs) are one of the major components available in e-waste. In this research work, waste PCB (WPCB) powder is mixed in suitable proportions of 5%, 10%, 15%, and 20% with a lignocellulosic sisal woven fabric fiber mat, and blended with epoxy resin using the vacuum-assisted hand lay-up method. To determine the effect of particle size on the fabricated composites, mechanical, thermal, water absorption, surface roughness, and wear tests were conducted. It was found that the composition that contains 15% nanofiller composites gave better results in mechanical testing than the composition that contains 10% microfiller composites. Pin-on disc wear test and differential scanning calorimetric thermal test results show that 10% microfiller composites show better outcome results than 15% nanofiller composites. Testing values indicate that lignocellulosic sisal fiber composites with WPCB nano- and microfillers can be substituted for many engineering applications instead of being disposed of in landfills.

ABSTRACTMango is an important tropical edible fruit having economic importance, which is cultivated mainly in India (36.6%). It contains various macronutrients, micronutrients, antioxidants, and other bioactive compounds. It is consumed in fresh form or processed into different products namely pulp, juice, puree, pickle, jam, and nectar. It has been predicted mango processing will increase considerably reaching USD 1.8 billion in 2029.] The by-products generated during the processing of mangoes are peel, pomace, seed, and kernel which constitute 25–40% of fresh fruit. This review article describes the nutritional composition of mango peels and also provides detailed insights into different extraction methodologies for value-added compounds. This review also explores the available literature reports that prove mango peels are an excellent source of carotenoids, pectin, phenolic compounds, and volatile aroma compounds. Mango peels contain significantly higher amounts of minerals compared to pulp. It possesses antioxidant, antimicrobial, cardioprotective, anti-diabetic, and anti-cancer properties. This article emphasizes the advantages of green extraction methodologies like ultrasound or microwave-assisted deep eutectic solvents compared to conventional extraction methods. The sustainable valorization of mango peels generated during processing can be economical as well as environmentally feasible.

Abstract In the US, racial disparities in hospital outcomes are well documented. We explored whether race was associated with all-cause in-hospital mortality and intensive care unit (ICU) admission among COVID-19 patients in California. This was a retrospective analysis of California State Inpatient Database during 2020. Hospitalizations ≥ 18 years of age for COVID-19 were included. Cox proportional hazards with mixed effects were used for associations between race and in-hospital mortality. Logistic regression was used for the association between race and ICU admission. Among 87,934 COVID-19 hospitalizations, majority were Hispanics (56.5%), followed by White (27.3%), Asian, Pacific Islander, Native American (9.9%), and Black (6.3%). Cox regression showed higher mortality risk among Hispanics, compared to Whites (hazard ratio, 0.91; 95% CI 0.87–0.96), Blacks (hazard ratio, 0.87; 95% CI 0.79–0.94), and Asian, Pacific Islander, Native American (hazard ratio, 0.89; 95% CI 0.83–0.95). Logistic regression showed that the odds of ICU admission were significantly higher among Hispanics, compared to Whites (OR, 1.70; 95% CI 1.67–1.74), Blacks (OR, 1.70; 95% CI 1.64–1.78), and Asian, Pacific Islander, Native American (OR, 1.82; 95% CI 1.76–1.89). We found significant disparities in mortality among COVID-19 hospitalizations in California. Hispanics were the worst affected with the highest mortality and ICU admission rates.

Abstract Predicting and understanding the behavior of dynamic systems have driven advancements in various approaches, including physics-based models and data-driven techniques like deep neural networks. Chaotic systems, with their stochastic nature and unpredictable behavior, pose challenges for accurate modeling and forecasting, especially during extreme events. In this paper, we propose a novel deep learning framework called Attractor-Inspired Deep Learning (AiDL), which seamlessly integrates actual statistics and mathematical models of system kinetics. AiDL combines the strengths of physics-informed machine learning and data-driven methods, offering a promising solution for modeling nonlinear systems. By leveraging the intricate dynamics of attractors, AiDL bridges the gap between physics-based models and deep neural networks. We demonstrate the effectiveness of AiDL using real-world data from various domains, including catastrophic weather mechanics, El Niño cycles, and disease transmission. Our empirical results showcase AiDL’s ability to substantially enhance the modeling of extreme events. The proposed AiDL paradigm holds promise for advancing research in Time Series Prediction of Extreme Events and has applications in real-world chaotic system transformations.

Background Mechanical ventilation (MV) is a necessary life-saving measure for critically ill patients. Ventilator-associated events (VAEs) are potentially avoidable complications associated with MV that can double the rate of death. Oral care and oropharyngeal suctioning, although neglected procedures, play a vital role in the prevention of VAE. Methods A randomized controlled trial was conducted in the intensive care units to compare the effect of fourth hourly oropharyngeal suctioning with the standard oral care protocol on VAE among patients on MV. One hundred twenty mechanically ventilated patients who were freshly intubated and expected to be on ventilator support for the next 72 hours were randomly allocated to the control or intervention groups. The intervention was fourth hourly oropharyngeal suctioning along with the standard oral care procedure. The control group received standard oral care (i.e., thrice a day) and on-demand oral suctioning. On the 3rd and 7th days following the intervention, endotracheal aspirates were sent to rule out ventilator-associated pneumonia. Results Both groups were homogenous at baseline with respect to their clinical characteristics. The intervention group had fewer VAEs (56.7%) than the control group (78.3%) which was significant at P