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Abstract Methylation at 5' cytosine of DNA molecule is an important epigenetic mark. It is known to play critical role in adaptation of organisms under different biotic and abiotic stressors via modulating gene expression and/or chromatin architecture. Plant populations evolved under variable climatic conditions may have evolved different epigenetic marks including DNA methylation. Here we, describe the genome-wide DNA methylation pattern under native field, F1 and F6 generation followed by their association with phenotypes, climate and global gene expression in the three Arabidopsis thaliana populations originated at different elevation ranges of Indian West Himalaya. We show that the global methyl cytosine (mC) content is more or less similar in the three populations but differ in their distribution across genome. There was an increase in differential methylation between the populations as elevation increased. The methylation divergence was the highest between the low and the high elevation populations. The high elevation populations were hypo-methylated than the low elevation population. The methylation in the genes was associated with population specific phenotypes and climate of the region. The genes which were differentially methylated as well as differentially expressed between the low and high elevation populations were mostly related to abiotic stresses. When grown under controlled condition, there was gain of differential methylation over native condition and the maximum percent changes was observed in CHH-sequence context. Further ~ 99.8% methylated cytosines were stably passed on from F1 to F6 generation. Overall, our data suggest that high elevation population is epigenetically more plastic under changing environmental condition. Background Arabidopsis thaliana is the model plant species and has been extensively studied to understand plants life processes. There are numerous reports on its origin, demography, evolution, epigenomes and adaptation etc. however, Indian populations of Arabidopsis thaliana evolved along wide elevation ranging from ~ 700 m amsl to ~ 3400 m amsl not explored yet. Here we, describe the genome-wide DNA methylation pattern under native field, F1 and F6 generation followed by their association with phenotypes, climate and global gene expression in the three Arabidopsis thaliana populations originated at different elevation ranges of Indian West Himalaya. Results In our study we found that total mCs percent was more or less similar in the three populations but differ in their distribution across genome. The proportion of CG-mCs was the highest, followed by CHH-mCs and CHG-mCs in all the three populations. Under native field condition the methylation divergence was more prominent between low and high elevation populations and the high elevation populations were hypo-methylated than the low elevation population. The methylation in the genes was linked to population-specific phenotypes and the regional climate. The genes that showed differential methylation and expression between low and high elevation populations were primarily associated with abiotic stress responses. When grown under controlled condition, there was gain of differential methylation compared to the native condition and the maximum percent changes was observed in CHH-sequence context. Further 99.8% methylated cytosines were stably passed on from F1 to F6 generation. Conclusions The populations of A. thaliana adapted at different climatic conditions were significantly differentially methylated both under native and controlled condition. However, the magnitude and extent of gain or loss of methylation were most significant between the low and the high elevation populations. Overall, our data suggest that high elevation population is epigenetically more plastic under changing environmental condition.

Purpose: Rhino-orbital-cerebral mucormycosis (ROCM) is the most common presentation of mucormycosis. Sinonasal–orbital debridement with exenteration is a life-saving procedure in ROCM patients in view of severe involvement of sinuses and the eyeball. Following the second wave of coronavirus disease 2019 (COVID-19), there was a massive surge in mucormycosis cases in India in post-COVID-19 patients. Of over 300 cases of mucormycosis admitted in our hospital, many underwent exenteration and these specimens were evaluated histopathologically, where fat necrosis was found to be a prominent finding. The spectrum of fat necrosis in ROCM in orbital fat has not been described in literature. Hence, we sought to evaluate the significance and spectrum of orbital fat necrosis in ROCM. Methods: This 3-month retrospective study included 15 cases of ROCM which underwent exenteration. Clinical data, radiologic details, and histopathologic findings were tabulated. Sections were also subjected to Periodic acid Schiff (PAS) and Gomori’s methenamine silver (GMS) stains for confirming the fungus. Results: All 15 cases showed fat stranding on computed tomography (CT) scan. On histopathologic examination, various tissue reaction patterns observed included acute/chronic inflammatory infiltrate, suppurative granulomas with giant cells, coagulative and fat necrosis, broad aseptate fungal hyphae with or without angioinvasion, and neural invasion. Fungal hyphae were confirmed with PAS and GMS stains. The spectrum of fat necrosis observed in all the cases included 1) acute necrotizing fat necrosis, 2) ghost adipocytes with or without saponification, and 3) crystalline/gouty fat necrosis. Conclusion: Fat necrosis is a significant finding in ROCM, both on CT scan and histopathology. All three patterns of fat necrosis may be observed simultaneously in a case of ROCM.

Background: Peri-implant biofilm formation due to local bacterial colonization is one of the important factors for the instability of temporary anchorage devices (TADs). Aim: The aim of this study was to quantify and compare the colonization of Streptococcus sanguinis on ultraviolet (UV) treated and untreated titanium TADs. Materials and Methods: This prospective, in vivo study included 20 subjects requiring orthodontic treatment with first premolar extraction, followed by retraction of the anterior teeth with absolute anchorage using TADs. TADs were placed interdentally, in the keratinized tissue between the upper second premolar and the first molar on the buccal side, at the mucogingival junction. It was a split-mouth study where one side of TAD was UV-treated for 15 min, and the other side was kept untreated as a control. TADs were removed after 6 months for S. sanguinis quantification on both sides and were compared for biofilm reduction. Statistical Analysis: Statistical software was used to perform unpaired t-tests for the individual samples as well as for comparing total UV-treated and untreated samples. P

Fibromyalgia is an idiopathic chronic widespread pain syndrome marked with specified tender points. There is no permanent cure of the disease. A 50-year-old man and his 49-year-old wife suffered from widespread pain, morning stiffness, sleep problems, and fatigue with complaints of brain fogging and forgetfulness from the past 13 and 26 years, respectively. Blood examinations were negative for rheumatic diseases; they were diagnosed with fibromyalgia. Supervised yogic intervention was administered to the couple for 4 weeks and assessed pain, flexibility, and cortical excitability before and after the intervention. Pain was assessed both objectively using quantitative sensory testing and subjectively using questionnaires. Flexibility and range of motion were assessed using the sit and reach test, Schober’s test, and goniometry. Corticomotor excitability was recorded using transcranial magnetic stimulation figure of 8 coils. Reduction in pain on the numerical rating scale and descriptors’ score was observed after yoga. There was an elevation in pressure pain thresholds, specifically at the painful areas using a digital algometer. Flexibility parameters showed an improvement in both the cases. The resting motor threshold was reduced by 2% of the maximum stimulus output; other corticomotor excitability parameters also showed some changes indicating the beneficial effect of yoga. At least 4 weeks of regular and supervised yogic intervention can harness pain relief, flexibility, and range of motion and improve corticomotor excitability in fibromyalgia patients.

Due to the anticipated increase in loads, the power grid will encounter the issue of system peak loads in the future, which is typically addressed through grid reinforcement. However, implementing a flexibility service option can prevent the need for grid development. As the overall load continues to rise, the distribution transformer becomes overloaded. The presented work focuses on enhancing one of the parameters that define the insulation life of the transformer, known as the Loss-of-Life (LOL). Transactive approach involves the rescheduling of the battery and photovoltaic generation. Dominated Group Search Optimization (DGSO) algorithm is utilized to optimize the objective function of reducing the peak transformer load under the power flow and voltage constraints of the network. Experimental validation of the proposed method is conducted using MATLAB 2018 software. Modified IEEE 34-bus system is used to implement the proposed methodology. Numerical results obtained from various cases elucidate that the proposed model reduces the LOL of the transformer from 0.0103 to 0.0017 p.u.Comparative analysis of the proposed method with the already used methods of voltage-control and Volt-Var control have been presented.

Abstract The heat shock response (HSR) is a universal mechanism of cellular adaptation to elevated temperatures and is regulated by heat shock transcription factor 1 (HSF1) or HSF3 in vertebrate endotherms, such as humans, mice, and chickens. We here showed that HSF1 and HSF3 from egg-laying mammals (monotremes), with a low homeothermic capacity, equally possess a potential to maximally induce the HSR, whereas either HSF1 or HSF3 from birds have this potential. Therefore, we focused on cellular adaptation to daily temperature fluctuations and found that HSF1 was required for the proliferation and survival of human cells under daily temperature fluctuations. The ectopic expression of vertebrate HSF1 proteins, but not HSF3 proteins, restored the resistance in HSF1-null cells, regardless of the induction of heat shock proteins. This function was associated with the up-regulation of specific HSF1-target genes. These results indicate the distinct role of HSF1 in adaptation to thermally fluctuating environments and suggest association of homeothermic capacity with functional diversification of vertebrate HSF genes.

Abstract Breast cancer is one of the leading causes of death among women globally, making its diagnosis and treatment challenging. The use of nanotechnology for cancer diagnosis and treatment is an emerging area of research. To address this issue, multiwalled carbon nanotubes (MWCNTs) were ligand exchanged with butyric acid (BA) to gain hydrophilic character. The successful functionalization was confirmed by FTIR spectroscopy. Surface morphology changes were observed using SEM, while TEM confirmed the structural integrity of the MWCNTs after functionalization. Particle size, zeta potential, and UV spectroscopy were also performed to further characterize the nanoparticles. The breast cancer aptamer specific to Mucin-1 (MUC-1) was then conjugated with the functionalized MWCNTs. These MWCNTs successfully targeted breast cancer cells (MDA-MB-231) as examined by cellular uptake studies and exhibited a reduction in cancer-induced inflammation, as evidenced by gene transcription (qPCR) and protein expression (immunoblotting) levels. Immunoblot and confocal-based immunofluorescence assay (IFA) indicated the ability of CNTs to induce photothermal cell death of MDA-MB-231 cells. Upon imaging, cancer cells were effectively visualized due to the MWCNTs’ ability to act as magnetic resonance imaging (MRI) contrast agents. Additionally, MWCNTs demonstrated photothermal capabilities to eliminate bound cancer cells. Collectively, our findings pave the way for developing aptamer-labeled MWCNTs as viable “theranostic alternatives” for breast cancer treatment. Graphical abstract

Introduction: Selecting a correct shade is the key to success of any prosthesis, especially in the aesthetic zone. Variations of shade in a single tooth or the polychromatic nature of a tooth can impose greater challenges in shade matching. Therefore, it would be best if it is taught during the undergraduate course in dental schools. Aim: To evaluate the knowledge and shade matching skills among dental undergraduate students with and without training in three different clinical conditions. Materials and Methods: This post-test only quasi-experimental study was conducted with 377 undergraduate students of Indian origin studying in a dental teaching institute. The students were divided into two groups based upon their clinical training in shade matching: Group I (trained, n=197) and Group II (untrained, n=180). Three different patients, in terms of their shade complexity, were presented to both the groups and their shade matching ability was assessed. The results were subjected to statistical analysis using the Chi-square test and one-way Analysis of Variance (ANOVA). Results: Statistical analysis showed that the mean correct scores of the trained students were significantly higher than those of the untrained students (p=0.0001) in all three patients. There was a statistically significant difference (p=0.0001), as the trained group was better able to identify the correct or clinically acceptable shade compared to the untrained group in all three cases. Conclusion: The study concluded that training significantly improved the shade matching ability of dental undergraduate students in clinical conditions presenting varied complexities.

Abstract Background Dysregulated splicing events are a common phenomenon in cancer with the Serine-arginine-rich splicing factor (SRSF) family emerging as pivotal regulators of gene expression, exerting influence over constitutive and alternative splicing processes. Although aberrations in a few SRSF family members have been implicated in various cancers, the comprehensive roles of other family constituents remain underexplored. Methods This study delves into the expression profile of the entire SRSF family (SRSF1-SRSF12) in 23 cancerous cell lines originating from diverse tissues using quantitative Real-Time PCR. Further, the transcript levels of the SRSF family were examined in oral cancer patient samples stratified into Pre-cancer (n = 15), Early cancer (n = 11), Late cancer (n = 14), and adjacent non-tumor tissues (n = 26) as controls. The results were corroborated by a parallel investigation utilizing the transcriptomics data of oral squamous cell carcinoma (OSCC) patients (n = 319) and controls (n = 35) available in The Cancer Genome Atlas (TCGA) database. Results Our investigation reveals a notable upregulation in the expression levels of key splicing factors, namely SRSF3, SRSF9, and SRSF10 in all oral cancer cell lines (SCC-4, UM-SCC-84, CAL33, SAS-H1). Conversely, no significant associations between SRSF family members and other cancer cell lines were discerned. Further, the expression profile of the SRSF family in oral cancer patient samples revealed significant upregulation of SRSF1, SRSF3, SRSF7, SRSF9, SRSF10, and SRSF11 in patients with late-stage oral cancer compared to controls. Transcriptomics data from TCGA database demonstrated remarkable upregulation of SRSF1, SRSF4, SRSF9, SRSF10, and SRSF11 in OSCC patients. Conclusion Collectively our results underscore the critical involvement of SRSF family members in the context of oral cancer, highlighting their potential as key players in the altered splicing dynamics associated with cancer progression. Graphical abstract

Introduction: Mental health-related problems among medical students were well-researched before the era of competency-based curricula. These problems were revealed to be widespread among college students who experienced greater effort-reward imbalance and over-commitment. Such research is insufficient in the Indian context. Aims: The present study aims to assess the prevalence of mental health problems (stress, anxiety, and depression), and their covariates among female medical undergraduate students. Methodology: A cross-sectional exploratory study was conducted from March 2022 to May 2022 on 364 female medical undergraduate students in a rural institution located in Northern India. A stratified random sampling technique was used. The study included a semi-structured sociodemographic with personal and psychological domains proforma along with a Perceived Stress Scale-10, Generalized Anxiety Disorder-7 questionnaire, Becks Depression Inventory-II, Medical Students Stressor Questionnaire, and brief-coping orientation to problems experienced to assess perceived stress, anxiety, depression, stressors, and coping mechanisms, respectively. The Chi-square test and backward multivariable logistic regression analyses were used to investigate the correlates of dependent variables. Results: Of 364, around 40.7%, 36.5%, and 17.9% of students were highly stressed, anxious, and moderate to severely depressed, respectively, with a mean age of 20.44 ± 1.88 years. The results indicate that poor sleep and irregular exercise patterns were significant covariates of mental health problems. Respondents with interpersonal- and intrapersonal-related stressors were found to have two times (adjusted odds ratio [AOR] = 2.632; confidence interval [CI] = 1.216–5.698; P < 0.05) and four times (AOR = 4.230; CI = 1.832–9.763; P < 0.001) higher odds of perceived stress and anxiety symptoms, respectively. A personal history and family history of psychiatric illness among participants influenced perceived stress by 211%–226% while drive- and desire-related stressors influenced depressive symptoms by more than three times (AOR = 3.719; 95% CI = 1.702–8.124; P < 0.001). Conclusions: Findings from the present study suggest that a large number of students are suffering from mental health issues. Modifiable factors such as poor sleep and irregular exercise patterns can be addressed through various wellness programs and group sessions. Various supportive and preventive measures along with scheduled psychological interventions can be adopted by the institution to address various stressors faced by the students.

The escalating impact and remarkable progress of nanotechnology have shifted the paradigms of medicine and the healthcare system. Nanosystems have emerged, extensively holding the potential to advance disease diagnosis and treatment specificity. The extraordinary attributes imparted by nano-systems have helped in overcoming the limitations of conventional interventions to an extent and led to targeted therapy, to name one. The role of nanotechnology in diagnosis is another breakthrough in its appellation. This article aims to address the current characterization and sample preparation techniques for the analysis of nanosystems and provide insights into novel methodologies and in situ instrumentation that have eased sampling procedures.

Abstract The major driver oncogenes MYC, mutant KRAS, and mutant TP53 often coexist and cooperate to promote human neoplasia, which results in anticancer therapeutic opportunities within their downstream molecular programs. However, little research has been conducted on whether redundancy and competition among oncogenes affect their programs and ability to drive neoplasia. By CRISPR‒Cas9-mediated downregulation we evaluated the downstream proteomics and transcriptomics programs of MYC, mutant KRAS, and mutant TP53 in a panel of cell lines with either one or three of these oncogenes activated, in cancers of the lung, colon and pancreas. Using RNAi screening of the commonly activated molecular programs, we found a signature of three proteins - RUVBL1, HSPA9, and XPO1, which could be efficiently targeted by novel drug combinations in the studied cancer types. Interestingly, the signature was controlled by the oncoproteins in a redundant or competitive manner rather than by cooperation. Each oncoprotein individually upregulated the target genes, while upon oncogene co-expression each target was controlled preferably by a dominant oncoprotein which reduced the influence of the others. This interplay was mediated by redundant routes of target gene activation - as in the case of mutant KRAS signaling to c-Jun/GLI2 transcription factors bypassing c-Myc activation, and by competition - as in the case of mutant p53 and c-Myc competing for binding to target promoters. The global transcriptomics data from the cell lines and patient samples indicate that the redundancy and competition of oncogenic programs are broad phenomena, that may constitute even a majority of the genes dependent on oncoproteins, as shown for mutant p53 in colon and lung cancer cell lines. Nevertheless, we demonstrated that redundant oncogene programs harbor targets for efficient anticancer drug combinations, bypassing the limitations for direct oncoprotein inhibition.

Abstract Previous work has shown that binding of target proteins to a sparse, unbiased sample of all possible peptide sequences is sufficient to train a machine learning model that can then predict, with statistically high accuracy, target binding to any possible peptide sequence of similar length. Here, highly sequence-specific molecular recognition is explored by measuring binding of 8 monoclonal antibodies (mAbs) with specific linear cognate epitopes to an array containing 121,715 near-random sequences about 10 residues in length. Network models trained on resulting sequence-binding values are used to predict the binding of each mAb to its cognate sequence and to an in silico generated one million random sequences. The model always ranks the binding of the cognate sequence in the top 100 sequences, and for 6 of the 8 mAbs, the cognate sequence ranks in the top ten. Practically, this approach has potential utility in selecting highly specific mAbs for therapeutics or diagnostics. More fundamentally, this demonstrates that very sparse random sampling of a large amino acid sequence spaces is sufficient to generate comprehensive models predictive of highly specific molecular recognition.

Central Giant Cell Granuloma (CGCG) is a reactive, benign bony lesion primarily affecting the jaw bones of unknown etiology. Its widespread clinical manifestations can make diagnosis challenging. It is usually seen in mandible but can also involve the maxilla and hence should be considered as a differential diagnosis. Both surgical and non-surgical method can be considered but conservative surgical excision is the widely used treatment approach for management of CGCG.

The ProteinPaint Hi-C tool (ppHiC) facilitates web-based visualization and collaborative exploration of Hi-C data, a vital resource for understanding three-dimensional genomic structures. ppHiC allows researchers to easily analyze large Hi-C datasets on a web browser without requiring the computational expertise that has heretofore limited access to this complex genomic data. The platform is compatible with multiple Hi-C data versions and boasts a highly customizable interface, including a configuration panel for the precise adjustment of key visualization parameters. The tool’s interactive features offer a broad range of views, from whole-genome landscapes to detailed interactions between pairs of loci, that are accessible within a single, integrated environment. Here, we demonstrate how using ppHiC to visualize an altered chromatin conformational landscape in neuroblastoma can inform understanding of the genomic rearrangements in this cancer.

Microglia are poorly understood immune cells of the central nervous system that play a determining role in the progression of multiple sclerosis. With the advent of genomic techniques such as single-cell RNA sequencing and single-nucleus RNA sequencing, a more comprehensive understanding of microglia at the transcriptomic level has uncovered various disease-specific clusters, context-dependent heterogeneity, and region-specific microglia, unlocking the recondite secrets embedded within these glial cells. These techniques have raised questions regarding the conventional and widely accepted categorization of microglia as M1 and M2 phenotypes. The neuroimmune component of multiple sclerosis, which is the microglia, makes it a complex and challenging disease. This review aims to demystify the complexities of microglia in multiple sclerosis, providing a vivid map of different clusters and subclusters of microglia found in multiple sclerosis and outlining the current knowledge of the distinctive roles of microglia. Also, this review highlights the neuroimmune interaction with microglia as the epicenter and how they act as sabotaging agents. Moreover, this will provide a more comprehensive direction toward a treatment approach focusing on local, region-specific microglia.

Background: Snakebites are a common medical emergency and occupational hazard for children in India, particularly in rural areas where poverty is prevalent. However, there is limited data on the epidemiology of snakebites on the Indian subcontinent. Objective: This cross-sectional, observational study aims to investigate the epidemiology, major clinical manifestations, and outcomes of snakebites in children under the age of 15 who were admitted to a tertiary care center in Bihar, a state in East India, and draw attention to this public health concern. Methods: A cross-sectional observational study was conducted at the Department of Paediatrics, Patna Medical College and Hospital, Patna. The study included all cases of snakebites with features of envenomation involving patients less than 15 years of age who were brought to the department over a 2-year period. Data were collected using a data collection form and analyzed using the Statistical Package for the Social Sciences, version 11.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 59 cases were recorded, with 62.71% (n = 37) being male and 37.28% (n = 22) being female. Kraits were responsible for 38.9% (n = 23) of cases, vipers for 42.3% (n = 25), and cobras for 5% (n = 3). Fang marks were present in 67.7% (n = 40) of cases, and the majority of bites (84.7%, n = 50) occurred on a lower limb during the day. The age distribution showed that 16.9% (n = 10) were below 5 years old, 44% (n = 26) were between 5 and 10 years old, and 22% (n = 13) were above 10 years old. Traditional treatment was used in 44.7% (n = 22) of cases, with the most common treatments being local incision + tourniquet (22%, n = 13) and no traditional treatment (55.9%, n = 33). The highest number of cases occurred during July–September (35.5%, n = 21). Conclusion: Snakebites are a significant public health issue in Bihar, India, with the majority of cases occurring in rural areas. The study highlights the importance of increased awareness and preparedness among healthcare providers and the general public, particularly during the monsoon season. Early hospital transfer, prehospital management, and prevention should be promoted through regular public health initiatives.

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

Background: Peripheral arterial disease (PAD) is characterized by stenosis or occlusion in the arteries of the limb causing limitation in the distal blood flow. Out of the various risk factors identified, diabetes and cigarette smoking are the strongest predictors of PAD. PAD results from atherosclerosis of the vessel wall. Patients with lower extremity PAD have clinical presentation of intermittent claudication and atypical leg pain. In patients with arterial stenosis, there is a drop in pressure and flow across stenosis. Asymptomatic PAD approximately 20%–50% of total patients diagnosed with PAD. Ankle brachial index (ABI) is clinically widely used modality which helps to identify the disease. ABI test is the ratio of systolic ankle blood pressure and highest systolic brachial blood pressure. Population at risk with normal resting ABI may still have PAD. For such population, postexercise ABI is recommended. This study evaluated and compared ABI postexercise in normal healthy individuals without risk of PAD, at risk of PAD. Materials and Methods: This study is an observational study. Population with age more than 35 years were selected. Framingham Risk Score was taken for normal and at-risk population. Subjects were recruited in three groups: A, B, and C. ABI at rest was assessed. Individuals performed exercise treadmill test. Immediately, after completing the exercise, postexercise ABI was taken. Absolute systolic blood pressure values and postexercise ABI values were obtained in all three groups and then were compared. Data were analyzed using the SPSS software version 26. Results: The results of this study showed that for all the three groups, there was a significant difference in ABI at rest, postexercise ABI, and difference in systolic ankle pressure as P value was 0.05. Conclusion: On comparison with at risk and normal individuals, no significant difference was found in terms of postexercise ABI and change in systolic ankle pressure.

Background: Nomophobia or no-mobile-phone phobia, defined as the fear of being unable to use or being unreachable via one’s mobile phone. The pervasive concern has varied bio-psychosocial and clinical implications in an individual’s life. Nomophobia is currently in an exploratory phase. Methods: A scoping review was conducted to systematically map the relevant evidence and literature on nomophobia. The review of scholarly literature spanning from January 2010 to May 2023 employed a narrative synthesis methodology to succinctly encapsulate the research findings. Additionally, it encompassed a meticulous examination and visual representation of studies, detailing both the frequency of investigation into specific variables and the instances in which said variables exhibited a statistically significant association with nomophobia. Results: A thorough examination of 92 studies revealed a total of 133 variables spanning demographic, lifestyle-related, academic, smartphone-related, psychosocial, and clinical domains. Notably, 42.86% of these variables have only been investigated in a single research study, underscoring the imperative for replication to enhance the generalizability, validity, and applicability of research findings. Moreover, the review identifies Nomophobia Questionnaire (NMP-Q) by Yildirim and Correia as the most widely used tool for measuring the severity of nomophobia. Conclusion: There is a crucial need for homogeneity and consistency in reporting nomophobia scores and establishing corresponding gradations indicative of functional ramifications or clinical severity of nomophobia. The findings elucidate significant research gaps in existing literature on nomophobia, hold implications for further synthesis of data, and contribute to a comprehensive understanding of nomophobia; ensuring superior diagnostic accuracy and precision, and facilitating successful delivery of targeted interventions.

Abstract This study introduces a novel Graph Neural Network (GNN) architecture that leverages infrared and collinear (IRC) safety and equivariance to enhance the analysis of collider data for Beyond the Standard Model (BSM) discoveries. By integrating equivariance in the rapidity-azimuth plane with IRC-safe principles, our model significantly reduces computational overhead while ensuring theoretical consistency in identifying BSM scenarios amidst Quantum Chromodynamics backgrounds. The proposed GNN architecture demonstrates superior performance in tagging semi-visible jets, highlighting its potential as a robust tool for advancing BSM search strategies at high-energy colliders.

Abstract Globally, millions of diabetic patients require daily life-saving insulin injections. Insulin heat-lability and fibrillation pose significant challenges, especially in parts of the world without ready access to uninterrupted refrigeration. Here, we have synthesized four human insulin analogs by conjugating ε-amine of B29 lysine of insulin with acetic acid, phenylacetic acid, alanine, and phenylalanine residues. Of these, phenylalanine-conjugated insulin, termed FHI, was the most stable under high temperature (65 °C), elevated salt stress (25 mM NaCl), and varying pH levels (ranging from highly acidic pH 1.6 to physiological pH 7.4). It resists fibrillation for a significantly longer duration with sustained biological activity in in vitro, ex vivo, and in vivo and displays prolonged stability over its native counterpart. We further unravel the critical interactions, such as additional aromatic π-π interactions and hydrogen bonding in FHI, that are notably absent in native insulin. These interactions confer enhanced structural stability of FHI and offer a promising solution to the challenges associated with insulin heat sensitivity.

Abstract Background Normal saline (NS) infusion in large volumes may result in hyperchloremic metabolic acidosis and renal compromise. Balanced crystalloid (BC) with physiochemical composition akin to that of plasma may avoid these problems associated with NS. The present study aimed to evaluate effects of NS versus BC on acid–base balance and renal functions in patients undergoing intracranial tumor resection surgeries. Methods Fifty adult patients scheduled to undergo elective neurosurgery for intracranial tumor resection were randomized to receive either NS or BC as intraoperative or maintenance fluid. Metabolic and renal parameters were estimated prior to induction (baseline), at 1 h and 2 h after induction, at the end of surgery and 4 h after extubation. Serum neutrophil gelatinase-associated lipocalin (NGAL) was measured postoperatively. Brain relaxation score was assessed by the operating surgeon. Results Baseline values of variables were similar between the groups. At rest of the observed time-points, pH was significantly lower, while blood urea, serum creatinine, sodium, chloride, NGAL and plasma osmolality were significantly higher in the NS group as compared to the BC group. Brain relaxation score, serum bicarbonate and base excess were comparable between the two groups. Conclusion Use of balanced crystalloid (plasmalyte) resulted in better metabolic and renal profile as compared to normal saline in neurosurgical patients.

Dental caries is the most common unmet dental need of children with special health-care needs (SHCNs), and their treatment is challenging in routine dental settings. Based on surplus evidence, silver diamine fluoride (SDF) is a simple, safe, cost-effective, and efficient topical solution for treating dental caries. It is a clear, colorless, odorless fluoride-containing solution, does not require an extensive armamentarium for its application, and can be used in any setting. However, even with worldwide acceptance, there occurs limited research regarding SDF use in children with special needs. This review aims to update the possibilities and acceptability of SDF usage in patients with special needs with dental caries as a promising option for managing dental caries and improving their quality of life.

Background: Ventilator-associated pneumonia (VAP) in acute respiratory distress syndrome patients is expected in the setting of prolonged mechanical ventilation due to abridged immunity and dysregulation of the microorganisms inhabiting the oral cavity. We conducted this study to identify the spectrum of microorganisms causing VAP in patients admitted to the medicine intensive care unit (MICU) and their antibiotic susceptibility patterns. Materials and Methods: We conducted a retrospective cross-sectional laboratory-based study from January 2021 to April 2021. Our cohort included patients with respiratory distress who were admitted to the MICU. We observed the incidence of VAP and the risk factors responsible for multidrug resistance (MDR) microorganisms in the MICU, along with 250-day survival in the existence of specific comorbidities along with VAP. Results: Clinical charts of patients (n = 366) admitted to the MICU between January 2021 and April 2021 were used. The mean age of patients admitted to MICU was 57.3 ± 18.7 years with a male predominance (n = 252, 68.8%). VAP was diagnosed in 69.1% (n = 253) of patients, and the most common microorganism in our cohort was Klebsiella pneumoniae (n = 78, 30.8%), followed by Acinetobacter spp. (n = 77, 30.4%). None of the K. pneumoniae isolates (n = 0/78) and only a minority of Acinetobacter spp. (n = 4/77, 5.2%) and Pseudomonas aeruginosa isolates (n = 8/54, 14.8%) were susceptible to fluoroquinolones. A higher proportion of K. pneumoniae (n = 1/78, 1.3%), Acinetobacter spp. (n = 2/77, 2.6%), and P. aeruginosa isolates (n = 9/54, 16.7%) were susceptible to aminoglycosides. The incidence rate of MDR microorganisms among the 253 patients diagnosed with VAP was 92.8% (n = 219/253). Conclusion: There is a high prevalence of multidrug resistance (MDR) isolates among those causing VAP in the MICU setting. Knowing the broad spectrum of causative pathogens and their susceptibility to various antibiotics may guide the physician in judicious and appropriate use of antibiotics for treatment.

Context: Gambling disorder is a significant public health problem. Despite the significant negative consequences of problem gambling, a relatively small proportion actively seek help for their issues. Aims: This study was conducted to understand the reasons why people did not seek help for gambling disorders. Settings and Design: The study was conducted at a public-funded tertiary care centre (National Drug Dependence Treatment Centre [NDDTC], Ghaziabad). The study was a cross sectional and observational design. Materials and Methods: A total of 486 subjects visiting outpatient as well as inpatient settings were screened for gambling. Fifty participants were diagnosed with gambling disorder and were included in the study. Data were collected using a structured sociodemographic pro forma, Gambling Readiness to Change Scale, Attitude toward Gambling Scale, Gambling Perceived Stigma Scale, Gambling Experiences Stigma Scale, and Barriers to Treatment Inventory. Statistical Analysis: Pearson’s product-moment coefficient and Kendall’s Tau correlation coefficients were computed. Independent sample t-test, ANOVA, Mann–Whitney U, and Kruskal–Wallis H-test were used for comparisons. Results: The study identified denial of the problem, perceived and experienced stigma, time conflict, and limited availability and accessibility of treatment facilities as significant barriers to treatment for problem gamblers. Conclusion: There exists a pressing necessity to impart comprehensive awareness, education, and training to various community stakeholders, including family members, friends, and health-care professionals. It is vital for treatment centers to proactively communicate their broader focus, encompassing not only substance and alcohol use challenges but also problems related to gambling.

Background: Despite advancements in treatment, patients with Parkinson’s disease (PD) experience a range of symptoms that affect their quality of life. There is a need to integrate neuropalliative care into standard care. The aim of the study is to understand the psychosocial functioning in persons with PD and explore their caregivers’ burden. Methods: The study utilizes a mixed-methods design where 50 patient–caregiver dyads attending the outpatient services of the movement disorder clinic at a tertiary care hospital were measured on psychosocial functioning and caregiver burden and palliative care outcomes for a period of 6 months. Focus group discussions were conducted with 18 patient–caregiver dyads to understand the needs of palliative care. Results: It was found that caregiver burden was positively correlated with palliative care outcomes scores of patients (r = 0.586) and caregivers (r = 0.675) and psychosocial functioning was positively correlated with palliative care outcomes of patients (r = 0.708). The psychosocial functioning score was higher among female patients (indicating worse functioning) than males, and female caregivers experienced significantly higher caregiver burden. The qualitative findings reveal that there is a substantial gap in awareness about palliative care, lack of information, presence of stigmatizing beliefs, and lack of adequate accessibility to palliative facilities. Conclusion: The study lays the foundation for future PD neuropalliative care research, guiding interventions, and exploration of regional variations in PD experiences in India. There is a need to address caregiver burden in PD in India.

Hypervalent iodine catalysis has been widely utilized in olefin functionalization reactions. Intermolecularly, the regioselective addition of two distinct nucleophiles across the olefin is a challenging process in hypervalent iodine catalysis. We introduce here a unique strategy using simple lithium salts for hypervalent iodine catalyst activation. The activated hypervalent iodine catalyst allows the intermolecular coupling of soft nucleophiles such as amides onto electronically activated olefins with high regioselectivity.

Abstract Inflammation acts as a dual role in disease initiation and progression, while Cannabis sativa L. (hemp) seeds, known for their abundance of anti-inflammatory phytochemicals, present a promising food source. Additionally, fermentation may optimize the food matrix, thereby augmenting its developmental prospects. This study explores the anti-inflammatory potential of hemp seeds fermented with 10 different probiotic strains. Among these, Lactiplantibacillus plantarum fermented hemp seeds (FHS) demonstrated a significant anti-inflammatory ability, accompanied by a reduction in the expression of critical inflammatory markers such as TLR4, NF-κBp65, and iNOS. Moreover, there is a noteworthy dose-dependent inhibition of inflammatory cytokines TNF-α, IL-6, IL-1β, and NO within a concentration range of 50 to 500 µg/mL. Subsequently, metabolomics analysis using UHPLC-QTOF-MS highlighted significant metabolic alterations in FHS compared to raw hemp seeds (RHS). Through multivariate, univariate, and correlation analyses, indolelactic acid (IA) and homovanillic acid (HVA) emerged as the main anti-inflammatory metabolites in FHS. Validation via HPLC confirmed the concentration of IA and HVA in RHS and FHS and both organic acids demonstrated lower IC50 values for TNF-α, IL-1β, IL-6, IL-18, and NO inhibition, showcasing their potent anti-inflammatory abilities. Furthermore, in vitro gastro-intestinal digestion coupled with the Caco-2 cell monolayer model validates the uptake and bioaccessibility of FHS, further affirming IA and HVA as major anti-inflammatory compounds. Overall, this research sets the stage for the development of novel hemp seed-based products targeting inflammation-associated disorders.

The increasing commercial, industrial, and medical applications of plastics cannot be halted during the coming years. Microplastics are a new class of plastic pollutants which have emerged as escalating environmental threats. The persistence, effects, and removal of MPs present in soil, water, and numerous organisms have become an important research field. However, atmospheric microplastics (AMPs), which are subcategorized into deposited and suspended, remain largely unexplored. This review presents the recent developments and challenges involved in fully understanding suspended and deposited AMPs. The evaluation of indoor suspended MP fibers needs to be critically investigated to understand their implications for human health. Furthermore, the transportation of AMPs to isolated locations, such as cryospheric regions, requires immediate attention. The major challenges associated with AMPs, which have hindered advancement in this field, are inconsistency in the available data, limited knowledge, and the lack of standardized methodologies for the sampling and characterization techniques of AMPs.

Abstract A composite of Zinc oxide loaded with 5-weight % silver decorated on carbon nanotubes (Ag-loaded ZnO: CNT) was synthesized using a simple refluxed chemical method. The influence of deviation in the weight % of carbon nanotube loading on photocatalytic dye degradation (methylene blue and rose bengal) and antibiotic (antimicrobial and antifungal) performance was investigated in this study. The light capture ability of Ag-loaded ZnO:CNT in the visible region was higher in photocatalytic activity than that of Ag-loaded ZnO and ZnO:CNT. The bandgap of the Ag-loaded ZnO: CNT was tuned owing to the surface plasmon resonance effect. The photocatalytic degradation investigations were optimized by varying the wt% in CNTs, pH of dye solution, concentration of the dye solution, and amount of catalytic dose. Around 100% photocatalytic efficiency in 2 min against MB dye was observed for Ag doped ZnO with 10 wt% CNT composite at pH 9, at a rate constant 1.48 min−1. Bipolaris sorokiniana fungus was first time tested against a composite material, which demonstrated optimum fungal inhibition efficiency of 48%. They were also tested against the bacterial strains Staphylococcus aureus, Bacillus cerius, Proteus vulgaris, and Salmonella typhimurium, which showed promising antibacterial activity compared to commercially available drugs. The composite of Ag doped ZnO with 5 wt% CNT has shown competitive zone inhibition efficacy of 21.66 ± 0.57, 15.66 ± 0.57, 13.66 ± 0.57 against bacterial strains Bacillus cerius, Proteus vulgaris, and Salmonella typhimurium which were tested for the first time against Ag-loaded ZnO:CNT.

Abstract Rapid urban development and population outbursts in India have led to a tremendous increase in pollutant emissions and their transboundary dispersion. Hence, the increase in tropospheric ozone (O3) formation is further amplified depending on the meteorology of the area. This review attempts to compile the studies reporting tropospheric O3-induced loss of yield and biomass in the vegetation of the Indian sub-continent from 2012 to 2023, with a mechanistic approach. The response of vegetation (agricultural, horticultural, perennial, medicinal and grassland) to O3 have been collated and their order of sensitivity has been established. The vegetation displayed two significant strategies to cope with the O3 induced stress- stomatal flux regulation and shifting the photoassimilates towards either defense or reproduction (trade-off), which decides the plant's ability to respond towards O3. Considering the varying responses of plants, it was observed that plants that adopted both stomatal regulation and trade-off strategies to endure the stress were least sensitive to O3 than those focusing on one of them.

Abstract Aims Graft dysfunction (GD) after heart transplantation (HTx) can develop without evidence of cell‐ or antibody‐mediated rejection. Cardiac magnetic resonance imaging (CMR) has an evolving role in detecting rejection; however, its role in biopsy‐negative GD has not been described. This study examines CMR findings, evaluates outcomes based on CMR results, and seeks to identify the possibility of rejection missed through endomyocardial biopsy by using CMR in HTx recipients with biopsy‐negative GD. Methods and results HTx recipients with GD [defined as a decrease in left ventricular ejection fraction (LVEF) by >5% and LVEF

Cesarean scar ectopic pregnancy is a leading cause of life-threatening complications in the first trimester. It poses a diagnostic and management challenge; if not diagnosed and adequately treated in early pregnancy, it may lead to considerable maternal morbidity and mortality. We report a case series of cesarean scar ectopic pregnancies managed successfully by laparoscopy. Laparoscopic excision is the gold standard management approach for cesarean scar ectopic pregnancy.

Background: Malnourishment is a risk factor for persistent pneumonia among under-five children with severe pneumonia. This study aims to determine the prevalence of persistent pneumonia and the association between nutritional status and pneumonia severity in children under 5 years of age. Methodology: A prospective observational hospital-based study was conducted in the Department of Paediatrics, King George’s Medical University (KGMU) from May 2019 to April 2020 among children aged 1 month to 5 years admitted with a diagnosis of severe pneumonia. An anthropometric assessment along with general and systemic examination was conducted. Weight for age, height for age and weight for height were calculated to assess the nutritional status. Children with severe pneumonia were followed for 4–6 weeks to assess the prevalence of persistent pneumonia. Results: The prevalence of persistent pneumonia was 6.8%, while 32 (31.1%) and 64 (62.1%) patients had recurrent and severe pneumonia, respectively. No statistically significant distribution was observed in age, sex, residential area, parent’s education or occupation of the child. The statistically significant distribution was seen on assessing nutritional status based on weight for age, height for age and weight for height (P value- 0.001, 0.001, 0.0001). Those with weight for age ≤ 3SD were anaemics and up to 1 year of age had 5.21, 3.52 and 2.83 times more odds of having persistent pneumonia, respectively. Conclusion: The prevalence of persistent pneumonia among children less than 5 years of age was 6.8%. Malnutrition can be considered a major determinant of persistent pneumonia among children under 5 years of age.

Harnessing solar energy by employing chemical photoswitches in molecular solar thermal (MOST) energy storage systems is a topic of appealing research interest. However, incorporating all the features desired for an ideal MOST system in a single photoswitching couple is challenging. Inspired by experimental synthesis, herein we report our attempt to enhance both the thermochemical and photophysical properties in a single-bridged bicyclic diene (BBD)-based photoswitch by elongating the unsaturated bridge with different heteroatomic units. To elucidate the best elongation unit, the energy storage capacity and the TBR barriers were accounted using the DLPNO-CCSD(T) and (8,8)-CASPT2 methods, respectively. The photophysical properties including the absorption onset, excitation wavelengths, and the absorption intensities were extensively investigated with the time-dependent calculations. The result provides information on the most versatile solvent to exhibit the best photoswitching behaviour which is beneficial for real-life energy storage applications. Additionally, the stability and reversibility of the photoswitching system with elongated unsaturated bridges have also been assessed. By means of the studied modification, the storage energy of 158.57 kJ/mol, energy storage density of 1.48 MJ/kg, TBR barrier of 136.36 kJ/mol, and the absorption onset of 305.00 nm is achieved in acetonitrile. These values are substantially higher when compared with the storage energy (96.06 kJ/mol), energy storage density (1.04 MJ/kg), and TBR barrier (121.76 kJ/mol) of prototype NBD/QC in the gas phase. The outcomes render useful insights into the stability and properties of bicyclic diene-based photoswitches having elongated unsaturated bridges and indeed paves the way for the rational design of practical MOST systems.

Introduction: Sepsis continues to be a leading cause of mortality and prolonged hospitalisation. The conventional method of blood culture, while considered the gold standard, has limitations such as contamination and delayed reporting. The examination of peripheral smears has uncovered signs suggestive of septicaemia; however, these findings suffer from inter-observer variability and reliance on staining quality. Aim: To investigate the variation of neutrophil and monocyte parameters, including Volume, Conductivity, and Scatter (VCS), in sepsis compared to healthy controls. Materials and Methods: A cross-sectional analytical study was conducted at the Himalayan Institute of Medical Sciences, Swami Rama Himalayan University in Dehradun, Uttarakhand, over the course of one year, from January 2021 to December 2021, involving patients over 18 years of age categorised into sepsis group based on clinical suspicion, sepsis screen, blood culture, and Sequential Organ Failure Assessment (SOFA) score (n=117). A group of healthy controls was also included (n=140). Haematological investigations were performed using the DXH 800 Haematology Analyser (Beckman Coulter, CA, USA) with VCS Technology. Categorical variables were analysed using the Chi-square test, while non parametric data was compared using the Mann-Whitney U test. Results: The average age in the sepsis group was 50.17±13.17 years, while in the control group, it was 38.14±8.78 years. The results revealed higher White Blood Cell (WBC) counts (16.76±7.39)×103/cumm in the sepsis group compared to healthy controls (6.68±1.42)×103, absolute neutrophil counts (13.74±7.280)×103 in sepsis patients, and eosinopenia in the sepsis group (0.0114±0.0104)×103 compared to controls (0.23±0.116)×103. Moreover, mean neutrophilic volumes (158.00±14.840) and monocytic volumes (182.58±18.64) were higher in the sepsis group, while they were lower in healthy controls, which were (149.52±5.23 and 171.17±6.28), respectively. Axial light loss for neutrophil and monocyte was 142.40±11.78 and 121.50±17.93, respectively, while it was lower in healthy controls showing a value of 135.51±7.63 and 119.45±8.25, respectively. Furthermore, mean neutrophilic and monocytic conductivity and scatter were decreased in sepsis. The observed higher WBC counts and absolute neutrophil counts in sepsis patients suggest a premature release of neutrophils from the bone marrow. The alterations in cell volume reflect an immune response. Additionally, the overall scatter of neutrophils and monocytes was reduced, accompanied by increased cellular transparency. Conclusion: The present study contributes valuable insights into the pathophysiological mechanisms underlying sepsis, emphasising the dynamic interplay between immune cells and their functional characteristics. Understanding these variations in cellular parameters could potentially aid in the development of more targeted diagnostic and therapeutic approaches for sepsis, ultimately improving patient outcomes. Further research is warranted to delve deeper into the specific mechanisms driving these observed changes and to explore their clinical implications in the context of sepsis management.

Background: Obesity is one of the leading public health problems, emerging and evolving across the ages from childhood, adolescence, young adults, and middle age to the geriatric sphere of life. The young adult age group also includes the special population of medical students with possible unique stressors and risk factors requiring special attention. Aims and Objectives: The current study was planned with the objectives of studying obesity among medical students with a focus on determining the prevalence of obesity problem and associated socioeconomic level and lifestyle variables; dietary calorie intake and physical activity. Materials and Methods: The current study is a cross-sectional survey conducted using a pre-tested, semi-structured questionnaire among MBBS students of central India. A total of 400 students were interviewed. Body mass index (BMI) was used to identify and the World Health Organization classification (WHO) was used to categorize the students in nutritional levels. Physical activity level was assessed using the General Practice Physical Activity Questionnaire. Socioeconomic status (SES) was assessed using the Modified Prasad Classification and All India Consumer Price Index. Dietary calorie intake was assessed using 24-h oral questionnaire method. Results: The current study finds a prevalence of 7.5% obesity among medical students with another 10% in the pre-obese category as per the WHO classification. It was also found that Male gender, inactivity, and upper SES were significantly associated with the obesity prevailing in this special population of medical students. Conclusion: The current study concludes that obesity/pre-obesity is an important problem prevalent among medical students with association with sedentary lifestyle and high SES; thus, recommends screening students for lifestyle disease, dietary modification, change in sedentary lifestyle, and recreational activities to reduce stress.

In the field of tissue engineering, synthetic and degradable polyesters like poly(ε-caprolactone) (PCL) and poly(ε-caprolactone-co-p-dioxanone) (PCLDX) are widely used as scaffolds. Our previous research revealed that thermal storage conditions could alter the surface texture of PCL and PCLDX scaffolds, which might influence cell-scaffold interactions in tissue engineering applications. These findings highlighted the importance of multi-scale characterization techniques to identify the scales most sensitive to external changes and the need for personalized surface texture analysis. Sterilization techniques, such as ethylene oxide and gamma radiation, are essential for ensuring the sterility of polymeric medical devices. However, these processes can significantly impact the bulk polymer properties and/or surface texture of the scaffolds, potentially affecting their biocompatibility, safety, and overall performance. Therefore, the influence of sterilization processes on the surface texture of PCLDX films and electrospun nanofibers and to correlate these findings with the thermal and physical properties of the polymer are essential and have been assessed. Our results demonstrated that ethylene oxide maintained the structural integrity and surface texture of PCLDX scaffolds, while gamma irradiation caused a significant reduction in molar mass and increased the number of hills (Shn) and dales (Sdn) on PCLDX samples. Despite these changes, both sterilization methods showed minimal effects on the thermal properties, such as melting temperature and degree of crystallinity, and surface wettability of the scaffolds. This comprehensive surface texture analysis highlights the importance of evaluating feature parameters such as Shn and Sdn for optimizing the performance and biocompatibility of polymeric scaffolds in tissue engineering.

Summary: Background: There are limited data on the effectiveness of differentiated service delivery (DSD) for HIV care during sociopolitical turmoil. We assessed outcomes with a DSD model of care that includes patient choice between community-based antiretroviral therapy (ART) centres, home-based ART dispensing, or facility-based care at GHESKIO clinic during a period of severe civil unrest in Port-au-Prince, Haiti. Methods: This retrospective analysis included data on patients with at least one HIV visit at GHESKIO between May 1, 2019, and December 31, 2021. Multivariable logistic regression models were used to assess predictors of attending ≥1 community visit during the study period, and failure to attend timely visits. HIV-1 RNA test results were reported among patients who had been ART for ≥3 months at last visit. Findings: Of the 18,625 patients included in the analysis, 9659 (51.9%) attended at least one community visit. The proportion of community visits ranged from 0.3% (2019) to 44.1% (2021). Predictors of ≥1 community visit included male sex (aOR: 1.13; 95% CI: 1.06, 1.20), secondary education (aOR: 1.07; 95% CI: 1.01, 1.14), income > $USD 1.00/day (aOR: 1.24; 95% CI: 1.14, 1.35), longer duration on ART (aOR: 1.08 per additional year; 95% CI: 1.07, 1.09), and residence in Carrefour/Gressier (p

Introduction: Curcuma isolates from different agroclimatic zones in Chhattisgarh have been found to possess a varied spectrum of Curcumin, we set out to learn more about their genetic diversity by molecular fingerprinting in the present study. Methods: Using SSR primers, the genetic variability of 25 Curcuma genotypes has been analyzed. These included the fingerprints of Curcuma longa, Curcuma aromatica, and Curcuma caesia. 13 inter simple sequence repeat (ISSR) primers amplified 107 unique fragments across all kinds, whereas 11 simple sequence repeat (SSR) primers amplified 51 unique fragments across all varieties, with 97 % and 86 % showing polymorphism, respectively. Results: A total of 1080 ISSR and 567 SSR loci were amplified across all genotypes; among these, 5 monomorphic and 102 polymorphic alleles were produced in ISSR primers. However, SSR data showed 47 polymorphic and 4 monomorphic alleles. A panel of ISSR and SSR markers calculated DNA fingerprinting, genetic similarity, and distance estimates between Curcuma genotypes. In order to examine the diversity in different Curcuma genotypes, UPGMA data scoring methods were used. Discussion: Curcuma species demonstrate significant genetic variability, which is essential for breeding initiatives focused on creating better cultivars with desirable characteristics such as increased productivity, resistance to diseases, and improved medicinal capabilities.

Background Women’s underage marriage (

ABSTRACT: Purpose: The impact of the COVID-19 pandemic on antimicrobial resistance (AMR) is largely studied in healthcare settings. There is a need to understand the fluctuations in AMR during pandemic at the community level. With urinary tract infection (UTI) being one of the most common infections in the community, the AMR profile of community-acquired UTI (CA-UTI) is considered representative AMR at the community level. Methods: The study was taken in a cohort of patients with a clinical diagnosis of CA-UTI. The four study sites represented different community health centres in India. Escherichia coli isolates were analysed phenotypically and genotypically for AMR pre-COVID (October 2019–February 2020) and in the first (March 2020–February 2021) and second waves of COVID-19 (March 2021–December 2021). Results: E. coli was the predominant uropathogen (229, 82%). Increased susceptibility to nitrofurantoin was observed during the pandemic. Reduced susceptibility to first-line oral antibiotics and carbapenems was seen during the second wave, and an increased minimum inhibitory concentration (MIC50) to beta-lactams and fluoroquinolones was seen during the pandemic. Genomic analysis of E. coli isolates showed some AMR genes (aacC1, aacC4, SHV, QepA) only during the second wave. Conclusion: One good outcome of the pandemic was increased susceptibility to nitrofurantoin, while drawback was a significant decrease in susceptibility to oral antibiotics during the second wave and increased MIC50 of some antibiotics. Decreased susceptibility to last-resort carbapenems and the occurrence of various AMR genes during the second wave of the pandemic are of great concern.

Background and Aim: In India, among adolescent girls, the problem associated with menstrual hygiene management (MHM) has a deep impact on health-related quality of life (HRQoL). Improvement in knowledge and menstrual hygiene practices may lead to enhancement in HRQoL. Therefore, the aim of the study was to enhance the HRQoL of adolescent school girls by improvement in menstrual hygiene knowledge and practices. Materials and Methods: The present study was an interventional, cross-sectional, questionnaire study conducted among adolescent school-going girls. The study was conducted among randomly selected five government secondary schools in Ajmer city and was conducted among adolescent girls of 7th–10th Class with the age group of 14–16 years. A total of 538 adolescent girls were surveyed in the pretest, and 503 was the sample size in the posttest with an attrition of 6.5%. Moreover, after the pretest, a workshop was conducted to educate adolescent girls about MHM. Results: A majority of the study participants (328 [61%]) had poor HRQoL after the pretest, which was improved to 195 (39%) of the study participants with good HRQoL after 3 months of the workshop during the posttest. The mean general health scores ([15.35 ± 0.38]) after 3 months of the workshop were significantly (P = 0.01*) higher among the study participants compared to the pretest scores ([10.93 ± 1.63]). Conclusion: From the above results, it has been concluded that there has been a significant improvement in knowledge, practice, and HRQoL among adolescent school-going girls of age 14–16 years when assessed after 3 months of the workshop on MHM.

The sun serves as the primary energy source, providing our planet with the essential energy for sustaining life. To efficiently harness this energy, photovoltaic cells, commonly known as PV cells, are employed. These cells convert the solar energy they receive into electrical energy. The operational point of the solar cell, delivering maximum output power, is referred to as the maximum power point (MPP). However, as light availability and temperature fluctuate throughout the day, the MPP also varies accordingly. To maintain constant operation at the MPP, Maximum Power Point Tracking (MPPT) algorithms are employed to trace the MPP during module operation. These algorithms can be categorized into four groups: classical, intelligent, optimization, and hybrid, based on the tracking algorithm utilized. Each MPPT algorithm, existing in these categories, comes with its own set of advantages and limitations. This paper extensively reviews fifteen algorithms categorized under different groups. The review concludes with a comparative analysis of these algorithms, considering various parameters such as cost, complexity, tracking accuracy, and sensed parameters in a succinct manner. The paper focuses on elucidating the necessity of MPPT algorithms, their classification as per existing literature, and a comparative assessment of the studied MPPT algorithms. This comprehensive review aims to address advancements in this field, paving the way for further research.

Background: Respiratory infections are common infections reported among human beings. Infections involving the respiratory tract can be mild and transient and people tend to neglect them. The chief cause of lower respiratory tract infections (LRTIs) can be attributed to hospitalization. Materials and Methods: We conducted a retrospective, cross-sectional study from January 2021 to April 2021. The clinical, demographic, and microbiological characteristics of the patients admitted to adult respiratory ward (ARW), pediatric ward (PW), and medicine intensive care unit (MICU) were extracted from the electronic records and laboratory registers for this study. Results: We included 788 patients in this study from January 2021 to April 2021. The mean age of patients was 52.67 ± 20.15 years with a male predominance in ARW (248/383, 64.75%) and MICU (252/369, 68.29%) and a female predominance in PW (28/36, 77.78%). Most patients were admitted to the ARW (383/788, 48.60%) followed by the MICU (369/788, 46.83%). Bacterial growth was seen in 358 (358/788, 38.89%) respiratory samples. Blood culture was positive in 188 (188/788, 23.86%) samples. The most common microorganism causing LRTI and bloodstream infection was Klebsiella pneumoniae with an infection rate of 32.68% (117/358, 32.68%) and 25.53% (48/188, 25.53%), respectively. Total leukocyte count (P < 0.0001) and procalcitonin (P = 0.0113) were statistically significant diagnostic parameters associated with MDR isolates. Conclusion: This study establishes the range of bacteria obtained from the respiratory samples of LRTI patients and guides the clinicians in the administration of appropriate antibiotics according to the antibiotic susceptibility pattern to eliminate MDR.

Background: Pseudomonas aeruginosa is a major cause of multidrug resistant (MDR) nosocomial pathogen isolated from clinical samples of patients admitted to the intensive care unit. Treating the ever-increasing antimicrobial resistance in P. aeruginosa isolates has turned into a challenge. Materials and Methods: All data were extracted from the hospital information system on P. aeruginosa pneumonia from July 2017 to July 2022. All isolates were identified by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and routine biochemicals. A comparison between the consequences of antibiotic susceptibility testing, demographics, and risk factors between the patients with community-acquired and nosocomial-acquired pneumonia due to either P. aeruginosa or multidrug-resistant P. aeruginosa was performed. Results: In this study, 576 (576/19224, 2.99%) patients developed P. aeruginosa pneumonia over 6 years. There were 114 (19.79%) cases of community-acquired pneumonia and 462 (80.21%) cases of nosocomially acquired pneumonia in this study. P. aeruginosa showed high resistance to cefoperazone-sulbactam and imipenem, which was statistically significant in cases of patients suffering from nosocomially acquired pneumonia compared to community-acquired pneumonia. High susceptibility to colistin was statistically significant in cases of community-acquired pneumonia compared to nosocomially acquired pneumonia. A total of 182 (182/576, 31.59%) deaths occurred among cases of P. aeruginosa pneumonia. Conclusion: This study explains the emergence of resistance among the P. aeruginosa isolates causing community-acquired pneumonia or nosocomially acquired pneumonia over 6 years.

Introduction Soft-tissue origin joint contractures are a common orthopedic problem. It could be due to various etiologies. Treatment options are available from conservative to surgical methods. These joint contractures slowly become irreversible causing impairment in activities of daily routine. The Ilizarov method is a well established and time-tested method used for management of bone pathologies, but its use in the management of soft-tissue origin contractures is also possible. It has an established role in neoosteogenesis and histogenesis. Fixator assisted soft-tissue stretching done at sustained slow pace leads to histoneogenesis that avoids stretching of neurovascular structures and reduces the possibility of recurrence. Aims To determine usefulness of the Ilizarov method in management of joint contractures of soft tissue origin; to meet functional requirements of patients; to study complications of Ilizarov method in management joint contractures due to soft tissue origin. Material and methods A total of 6 cases of soft-tissue origin joint contractures due to tuberculosis, post‑traumatic stiffness, post-burn contracture, deformity due to a snake bite in the age group from 3 to 55 years were treated with gradual distraction of joint with the Ilizarov method from January 22 to October 23. Two cases were of triple knee deformity, two were post-traumatic elbow stiffness, one was post-burn great toe contracture and one was post snake bite valgus foot contracture. All cases were operated with transarticular Ilizarov frame application and gradual distraction of joints and soft tissue with the help of hinge- and rod distractor assembly done. All cases completed follow up of 1 year. Aggressive physiotherapy was given postoperatively. Results All cases obtained a reasonable functional outcome, with no recurrence of deformity. All patients walk independently. Conclusion The Ilizarov method can be used for treating joint contractures due to traumatic and non‑traumatic pathologies.

Abstract Rheumatoid arthritis (RA) is an autoimmune disorder with a varying range of organs involved leading to adverse outcomes. However, very little is known, with conflicting results about the association between RA and atrial fibrillation (AF). We aim to evaluate the association between RA and AF, and other clinical outcomes. We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until September 10, 2023. Primary clinical outcomes were AF. Secondary outcomes were acute coronary syndrome (ACS), stroke, and all‐cause mortality (ACM). A total of 4 679 930 patients were included in the analysis, with 81 677 patients in the RA group and 4 493 993 patients in the nonrheumatoid arthritis (NRA) group. The mean age of the patients was 57.2 years. Pooled analysis of primary outcomes shows that RA groups of patients had a significantly higher risk of AF (odds ratios [OR], 1.53; 95% confidence interval [CI]: [1.16–2.03], p