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Abstract Bio-transformations refer to the chemical modifications made by an organism on a chemical compound that often involves the interaction of plants with microbes to alter the chemical composition of soil or plant. Integrating bio-transformations and entomopathogenic fungi into litchi cultivation can enhance symbiotic relationships, microbial enzymatic activity in rhizosphere, disease suppression and promote overall plant health. The integration of biological formulations and entomopathogenic fungi can significantly influence growth, nutrient dynamics, physiology, and rhizosphere microbiome of air-layered litchi (Litchi chinensis Sonn.) saplings. Biological modifications included, K-mobilizers, AM fungi, Pseudomonas florescence and Azotobacter chroococcum along with Metarhizium, entomopathogenic fungi have been used. The treatments included, T1-Litchi orchard soil + sand (1:1); T2-Sand + AM fungi + Azotobacter chroococcum (1:2:1); T3-Sand + Pseudomonas florecence + K-mobilizer (1:1:1); T4- AM fungi + K-mobilizers (1:1); T5, P. Florecence + A. chroococcum + K-mobilizer (1:1:1); T6-Sand + P. florecence (1:2) and T7-Uninoculated control for field performance. Treatments T4-T6 were further uniformly amended with drenching of Metarrhizium in rhizosphere. T2 application significantly increased resident microbe survival, total chlorophyll content and root soil ratio in seedlings. A. chroococcum, Pseudomonas, K-mobilizers and AM fungi increased in microbial biomass of 2.59, 3.39, 2.42 and 2.77 times, respectively. Acidic phosphatases, dehydrogenases and alkaline phosphatases were increased in rhizosphere. Leaf nutrients reflected through DOP were considerably altered by T2 treatment. Based on Eigen value, PCA-induced changes at biological modifications showed maximum total variance. The study inferred that the bio-transformations through microbial inoculants and entomopathogenic fungi could be an encouraging strategy to enhance the growth of plants, health and productivity. Such practices align well with the goals of sustainable agriculture through biological means by reducing dependency on chemical inputs. By delving into these aspects, the research gaps including microbial processes, competitive and symbiotic relationships, resistance in microbes and how complex interactions among bio-transformations, entomopathogenic fungi and microbes can significantly impact the health and productivity of litchi. Understanding and harnessing these interactions can lead to more effective and sustainable farming practices.

Abstract Cotton seeds have poorer germination than other crops because of their high sensitivity towards insect pests and other biotic and abiotic stresses during the germination process. In the present study, inorganic bulk and nano nutrients of zinc oxide (ZnO) and titanium oxide (TiO2) nanoparticles were synthesized using the chemical reduction method and invigourated with cotton seeds. The characterization of nanoparticles was done by FESEM, HRTEM, UV/Vis analysis and FTIR. The delinted and fuzzy seeds of two American cotton varieties (H 1300 and H 1098-i) were nano-primed for 10 h with zinc oxide nanoparticles (ZnONPs) @ 400 ppm and titanium dioxide nanoparticles (TiO2NPs) @ 100 ppm. After nanoparticle invigouration, the seeds were analyzed for various parameters at different intervals (0 months, 3 months, 6 months, 9 months and 12 months) such as germination percentage, seedling length, seedling dry weight, electrical conductivity, dehydrogenase activity, antioxidant enzyme activity. The results indicated that that different storage periods and nanopriming treatments had significant effects on all seed quality parameters except the effect of nanopriming treatments on germination percentage (excluding delinted seeds of H 1098-i). It is also revealed that the interaction effect of nanopriming treatment and storage period was non-significant on all parameters except EC. Maximum reduction in seed quality parameters was observed in control treatment and minimum was found when seeds were nanoprimed with ZnONPs @ 400 ppm. The differences in the response for both NPs can be attributed to their surface charge, and concentration used. Overall, ZnONPs and TiO2NPs could hold seed quality and vigour during the storage of cotton seeds of American varieties (H 1300 and H 1098-i).

Abstract To address the pressing need for reducing building energy consumption and combating climate change, thermoelectric glazing (TEGZ) presents a promising solution. This technology harnesses waste heat from buildings and converts it into electricity, while maintaining comfortable indoor temperatures. Here, we developed a TEGZ using cost-effective materials, specifically aluminium-doped zinc oxide (AZO) and copper iodide (CuI). Both AZO and CuI exhibit a high figure of merit (ZT), a key indicator of thermoelectric efficiency, with values of 1.37 and 0.72, respectively, at 340 K, demonstrating their strong potential for efficient heat-to-electricity conversion. Additionally, we fabricated an AZO-CuI based TEGZ prototype (5 × 5 cm²), incorporating eight nanogenerators, each producing 32 nW at 340 K. Early testing of the prototype showed a notable temperature differential of 22.5 °C between the outer and inner surfaces of the window glazing. These results suggest TEGZ could advance building energy efficiency, offering a futuristic approach to sustainable build environment.

Background: The data on Leydig cell hypoplasia (LCH) resulting from biallelic Luteinizing hormone/chorionic gonadotropin receptor (LHCGR) inactivating variants is limited to case series. Methods: We aim to describe our patients and perform systematic review of the patients with LHCGR inactivating variants in the literature. Detailed phenotype and genotype data of three patients from our centre and 85 (46,XY: 67; 46,XX: 18) patients from 59 families with LHCGR-inactivating variants from literature were described. Results: Three 46,XY patients (age 6–18 years) from our center, with two reared as females, had two novel variants in LHCGR. Systematic review (including our patients) revealed 72 variants in 88 patients. 46,XY patients (n = 70, 56 raised as females) presented with pubertal delay (n = 41) or atypical genitalia (n = 17). Sinnecker score ≥3 (suggesting antenatal human chorionic gonadotropin (hCG) inaction) was seen in 80% (56/70), and hCG-stimulated testosterone was low (

This review article discusses the most common benign biliary disorders and the various radiological findings on multiple modalities. A broad spectrum of diseases including various congenital disorders, infective and parasitic etiologies, immunological pathologies such as primary sclerosing cholangitis, and immunoglobulin G4-related sclerosing cholangitis are discussed along with obstructive diseases and ischemic cholangitis.

Introduction: Scabies affects 200–300 million individuals annually around the globe and it is a serious public health issue causing social stigmatisation in patients. With this background and its substantial impact on morbidity, this study was undertaken with the objective to find the demographic profile, clinical morphology and quality of life in patients suffering from scabies in urban slums of Ludhiana. MATERIALS AND METHODS: A cross-sectional, time-bound hospital-based study was carried out for a period of 2 months. A total of 173 patients with a diagnosis of scabies comprising all adults and children >5 years of age attending skin outpatient department were included in the study. The collected information was entered in Microsoft Excel sheet and analysed using SPSS. Results: The mean age of the study population was 34.85 ± 17.48 years. The most affected age groups were 18–40 years (46.9%), followed by 41–60 years (26.0%) and 17.9% in children. The majority of patients had difficulty in working and feelings of embarrassment, and in three-fifths of patients, their sexual relationship was affected due to scabies. In children, more than half experienced teasing and feeling of embarrassment and their routine activities such as playing were affected. Conclusion: In the present study, scabies moderately affected the quality of life of the patients in the form of embarrassment and stigma associated with disease. As it is a contagious disease, early diagnosis and prompt treatment can be helpful in the prevention and control of disease.

Background: Clinical teaching and educational activities are of the utmost importance in nursing education for overcoming the theory–practice gap. There is a significant paucity of knowledge on nursing students’ experiences in the clinical learning setting and how supervision is carried out. AIM: The intent of this research is to determine the perception of undergraduate nursing student towards clinical learning environment and supervision. Methods: An institution-based, cross-sectional, descriptive-exploratory study comprising 476 nursing students selected through stratified sampling, conducted in the selected Institutes of National Importance (INI) using Google Form. The study instrument used includes self-structured demographic section and rating scale to assess the students’ perception towards the clinical learning environment and supervision. Descriptive and inferential statistics were used for data analysis using IBM SPSS (version 23). Results: A study of 476 nursing students from across INI, majority were aged 21–24 years (74.8%), found significant differences in their perceptions of the clinical learning environment and supervision. In terms of the clinical learning environment, almost all of first-year students (94.1%) considered nursing officers in the unit were learning sources, and 92.4% said that they learned something new every day in clinical settings. The majority of third-year students (89.1%) stated that increasing exposure to patients was the primary source of their clinical learning. First-year students had positive perceptions of supervision, although their expectations differed from those of higher-year students. Conclusion: According to the study, the majority of students feel that effective clinical learning environment necessitates excellent communication skills, a positive attitude, motivation and effective problem-solving strategies. Regarding supervision, students respect good communication skills, confidence in the supervisory relationship, constructive criticism and trust.

Background: Cervical cancer is a leading cause of cancer mortality among women in India. Screening can help in early detection and improve outcomes. However, uptake remains low, especially in rural areas. Understanding multidimensional factors influencing screening in local contexts is essential to promote equitable access. This study examined knowledge, attitudes, practices, and sociocultural factors associated with cervical cancer screening and vaccination in rural India. Methods: A mixed methods study was conducted among 400 women aged 18–60 years in rural Maharashtra. Quantitative data were collected on knowledge, attitudes, and screening practices by using a structured questionnaire. Qualitative data were gathered through in-depth interviews with 30 participants on perspectives influencing screening. Quantitative data were analyzed using descriptive statistics and logistic regression. Thematic analysis was done for qualitative data. The integration provided complementary insights. Results: Quantitative results showed poor knowledge (17% had good knowledge) and positive attitudes (64%) but low screening uptake (9%). Qualitative findings revealed limited awareness, stigma around gynecological exams, gender inequities, fear, fatalism, and low prioritization of self-care as screening barriers. Conclusion: Multifaceted strategies addressing knowledge gaps, gender roles, stigma, and access are required to improve cervical cancer screening in marginalized rural communities. Mixed methods provide comprehensive evidence for designing context-specific interventions.

Introduction: Video-assisted teaching (VAT) is an effective means of intervention in motivating toward a particular medico-social goal. We evaluated the efficacy of a VAT intervention in caregivers of patients at a polyclinic in Haryana, India. Objectives: To asses efficacy of VAT in changing attitude towards organ donation. Method: One hundred and fifty participants each from rural and urban backgrounds were chosen randomly. A standard set of questions consisting of 9 positively framed and 11 negatively framed questions was prepared. The participants were subjected to an initial evaluation with the questionnaire, followed by VAT, after which the same questionnaire was repeated. Results: An increase in favorable responses was noted post-VAT, both in urban and rural populations. In particular, the favorable response to negatively framed questions improved significantly after the VAT, as seen after a Z-test for paired proportions before and after VAT. Conclusion: The findings of the present study suggest that VAT might be a useful adjunct in motivational sessions for organ donation, especially in removing negative prejudice toward organ donation.

Abstract A study was conducted at Punjab Agricultural University, Ludhiana, Punjab, with the aim of monitoring soil loss and infiltration rate in loamy sand soil. The study focused on the effects of applying polyvinyl alcohol (PVA) and mulch under simulated rainfall conditions. The experimental setup involved testing three levels of PVA (0.5%, 0.75%, and 1.0%), one level of wheat-straw mulch (600 g/m2), and a Control treatment (untreated soil). Each of these treatments was replicated four times. The lowest soil loss (20.9 g/m2) was recorded under the 1.0% PVA treatment, while the highest (120.1 g/m2) was seen under the 0.5% PVA treatment. The 1.0% PVA treatment showed a significant reduction in soil loss compared to the 0.5% PVA, 0.75% PVA, mulch, and Control treatments, with reductions of approximately 82.6%, 45.1%, 81.2%, and 89.6%, respectively. Regarding infiltration rates, the Control treatment exhibited the lowest rate (2.4 cm/h), while the 1.0% PVA treatment displayed the highest rate (9.6 cm/h). Additionally, the use of mulch led to a 44.7% reduction in soil loss compared to the treatment without mulch, likely due to the mitigated impact of raindrops. The infiltration rate was significantly higher (4.8 cm/h) under the mulched treatment compared to the unmulched treatment (2.4 cm/h). Overall, the application of PVA and mulch resulted in a drastic reduction in soil loss, likely attributable to the enhanced stability of soil aggregates, improved infiltration rate, and reduced runoff.

Introduction: Undifferentiated round cell tumours (URCTs) are rare and less researched Ewing-like mesenchymal tumours that primarily affect bones and soft tissues. Therapeutic options for advanced URCT are limited. Pazopanib, a multi-tyrosine kinase and angiogenesis inhibitor, is currently used for managing advanced soft-tissue sarcoma. However, its efficacy in the treatment of URCT remains uncertain and has not been established. In this study, we have cultured and characterised a patient-derived URCT cell line to understand the in vitro growth properties and anti-cancer agent sensitivity. Materials and Methods: Primary cell culture was performed by mechanical and enzymatic dissociation of URCT tissue specimens to derive a cell line. Morphology, growth properties and immunological features characterised the cells. Further, the in vitro sensitivity for clinically used anti-cancer drugs was evaluated. Results: The URCT cell line was established from a high-grade round-cell tumour patient. The cells had mesenchymal morphology and showed cyclin B3 (CCNB3) positivity, which was confirmed in the tissue from the patient. The cells exhibited an anchorage-independent growth property and aggregated to form spheroids in a non-adherent in vitro system. Anti-cancer agents vincristine, doxorubicin, etoposide and pazopanib inhibited URCT cell proliferation. Pazopanib exhibited cytotoxic action in URCT cells, leading to cell death. Conclusions: This is an early report of cultured URCT cells expressing CCNB3, studied in vitro. The patient-derived model suggests the efficacy of pazopanib in URCT cells. The characterised line will be helpful to advance sarcoma studies.

Background and Aims: Precise airway management is vital in thoracic surgeries to ensure patient safety and optimal outcomes. Choosing the correct double-lumen tube (DLT) size is challenging, as it typically relies on height, gender and subjective experience. This study investigates using ultrasonography (USG) and computed tomography (CT) to measure cricoid cartilage diameter for objective DLT sizing. Methods: In a randomised study, 120 adult patients undergoing elective thoracic surgery were randomised to three groups: Group A (DLT size determined by USG), Group B (DLT size determined by CT) and Group C (DLT size determined by conventional methods based on height and gender). The primary outcome variable was the appropriateness of DLT size. Secondary outcome variables were the degree of lung collapse and sore throat. Student’s t-test and ꭓ2 test were used to analyse continuous and dichotomous variables, respectively. Results: DLT sizing based on cricoid cartilage diameter improved the accuracy, with inappropriate sizes found in 25% in the conventional group, 5% in the USG group and 2.5% in the CT group (P < 0.05). Lung collapse was better in the USG (excellent in 92.5%) and CT (95%) groups compared to the conventional group (70%) (P < 0.05). Moderate sore throat was higher in the conventional group (37.5%) compared to the USG (5%) and CT groups (7.5%). Conclusion: The study demonstrates that USG- and CT-guided measurements of cricoid cartilage diameter are reliable and effective methods for determining DLT size in thoracic surgery compared to conventional methods.

Background: Healthcare outcomes are influenced by both the effectiveness of healthcare delivery and the health literacy of patients. Patient education materials (PEMs) play a crucial role in disseminating health information to the patients. PEMs need to be at the level of grade six for optimal comprehension across diverse populations. However, that has not been the case in prior studies in healthcare-related fields. We aimed to evaluate the readability status of online PEMs of active adult and pediatric liver transplant institutions. Methods: We used standardized tools to calculate indices, namely Flesch Reading Ease (FRE), Flesch–Kincaid Grade Level (FKGL), Gunning–Fog Score (GFS), Coleman–Liau Index (CLI), and Simple Measure of Gobbledygook for readability assessment. These indices use various measures, like average sentence length, average syllable per word, polysyllable count, and/or average number of letters per 100 words, to determine grade level. Results: The mean reading level of the PEMs was grade 10.73 ± 3.07, corresponding to grade 7 to 14. One-way ANOVA showed no statistically significant difference between these indices (p-value < 0.05). Conclusions: The readability of liver transplant centers’ PEMs exceeded the recommended level, hindering their generalizability to the broader population. This highlights the importance of optimizing the readability of PEMs to improve outcomes for equitable healthcare services.

Abstract Multimodal therapy for peritoneal metastasis (PM) including cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) provides long-term survival in highly selected colorectal cancer patients. Mechanisms behind HIPEC are unknown and may include induction of adaptive immunity. We therefore analyzed human PM samples and explored the impact of HIPEC in experimental models. Human samples from colorectal primary tumors (n = 19) and PM lesions (n = 37) were examined for the presence of CD8 + T-cells and their association with disease free (DFS) and overall survival (OS). CD8 + T cell response after HIPEC was assessed using an in-vivo PM mouse model, tumor cell lines and patient-derived tumor organoids. Patients with high intraepithelial CD8 + T cell counts showed longer DFS and OS. In the mouse model, HIPEC controlled growth of PM and increased numbers of functional granzyme positive CD8 + T cells within tumors. Cell lines and human organoids that were treated with heated chemotherapies showed immunogenic changes, reflected by significantly higher levels of MHC-class I molecules and expression of Cancer Testis Antigens Cyclin A1 and SSX-4. Using in-vitro co-culture assays, we noticed that cancer cells treated with heated chemotherapy primed dendritic cells, which subsequently enhanced effector functions of CD8 + T cells. The presence of CD8 + T-cells within PM lesions is associated with prolonged survival of patients with PM. Data from PM mouse model and in-vitro assay show that heated chemotherapies induce immunogenic changes on cancer cells leading to induction of CD8 + T-cells mediated immunity, which seems to control growth of PM lesions in mice after HIPEC.

Designing an ash pond for High Concentrated Slurry Disposal (HCSD) in hilly terrains poses a unique set of challenges. In such regions, the availability of barren land adjacent to the project sites is limited, making it difficult to locate suitable sites for ash pond construction. Furthermore, the hilly terrain and complex topography demand careful planning and design to ensure the long-term stability and safety of the ash pond and associated infrastructure. This paper discusses the design considerations for the construction of an ash pond dykes in a hilly region of Vietnam for HCSD disposal. The case study highlights detailed geotechnical design investigations such as soil type, slope stability and groundwater conditions. In addition, geotechnical instrumentation to monitor the performance of ash pond dykes and the subsoil supporting it during and after construction is also discussed. The paper also examines the environmental and hydrological design aspects of the ash pond, including development of drainage and channelization concept along the hilly terrain to manage storm water and prevent the mixing of rain water with ash slurry, which could otherwise create an environmental hazard.

Abstract The main challenges for utilizing daily evapotranspiration (ET) estimation in the study area revolve around the need for accurate and reliable data inputs, as well as the interpretation of ET dynamics within the context of local agricultural practices and environmental conditions. Factors such as cloud cover, atmospheric aerosols, and variations in land cover pose challenges to the precise estimation of ET from remote sensing data. This research aimed to utilize Landsat 8 and 9 datasets from the 2022–23 period in the Udham Singh Nagar district to apply the modified Priestley-Taylor (MPT) model for estimating ET. An average ET was estimated 1.33, 1.57, 1.70, 2.99, and 3.20 mm day−1 with 0.29, 0.33, 0.41, 0.69, and 1.03 standard deviation for December, January, February, March, and April month, respectively. In the validation phase, a strong correlation was found between the evaporative fraction derived from MPT and that observed by lysimeter, with R2 = 0.71, mean biased error = 0.04 mm day−1, root mean squared error = 0.62 mm day-1 and agreement index of 0.914. These results collectively support the effectiveness of the MPT model in accurately estimating ET across Udham Singh Nagar district. In essence, this research not only confirms the MPT model’s capability in ET estimation but also offers detailed insights into the spatial and temporal fluctuations of energy fluxes and daily ET rates.

Abstract The rapid advancement of machine learning (ML) technology across diverse domains has provided a framework for discovering and rationalising materials and photovoltaic devices. This study introduces a five-step methodology for implementing ML models in fabricating hole transport layer (HTL) free carbon-based PSCs (C-PSC). Our approach leverages various prevalent ML models, and we curated a comprehensive dataset of 700 data points using SCAPS-1D simulation, encompassing variations in the thickness of the electron transport layer (ETL) and perovskite layers, along with bandgap characteristics. Our results indicate that the ANN-based ML model exhibits superior predictive accuracy for C-PSC device parameters, achieving a low root mean square error (RMSE) of 0.028 and a high R-squared value of 0.954. The novelty of this work lies in its systematic use of ML to streamline the optimisation process, reducing the reliance on traditional trial-and-error methods and providing a deeper understanding of the interdependence of key device parameters.

Abstract Introduction Decompressive craniectomy [DC] is one of the leading armaments to lower refractory intracranial pressure. Post-DC hydrocephalus [PDCH] occurs in 11.9–36% of patients undergoing DCs for TBIs. Various theories have been given regarding pathophysiological mechanism of PDCH but remain dubious. Risk factors predicting PDCH still under research. Exact timeline regarding developmental process of PDCH remains undefined. Method This retrospective study was conducted on 422 patients who underwent DCs in our tertiary care trauma center over the period of one year. 60 patients out of 422 who developed PDCH were analyzed with respect to demographic variables and preoperative and postoperative risk factors. A total of 20 randomly selected patients, who underwent DCs but did not develop hydrocephalus, were selected and compared with patients who developed PDCH. Outcome analysis was done by dichotomizing the groups into independent and dependent groups. Results Among 422 patients undergoing DC, 14.21%[n = 60] developed PDCH. Younger [34.2 y vs 43.3 y, p = 0.0004] male age group was predominant in our study. Age [p = 0.021, multivariate analysis] and midline shift [p = 0.008, multivariate analysis] were significant preoperative predicting risk factors for PDCH. Interhemispheric hygroma [p = 0.031], brain bulge [ p = 0.008], and blood in postoperative scan [p = 0.029] were significant postoperative risk factors. Lower GCS score at admission [p = 0.0003], postoperative day 10 and at the time of establishment of PDCH were significantly predicted surgery to hydrocephalus time. Midline shift [p = 0.007] and thickness of interhemispheric hygroma [p = 0.021] were associated with poor outcome in patients with PDCH. Conclusion Younger age group and presence of midline shift are significant preoperative predictors of PDCH. Blood in postoperative scan, interhemispheric hygroma and brain bulge in postoperative period are significant predictors for PDCH. Deterioration in GCS score in postoperative period following DC should be taken as high index of suspicion for developing PDCH.

Abstract Soil contamination with heavy metals presents a substantial environmental peril, necessitating the exploration of innovative remediation approaches. This research aimed to investigate the efficiency of nano-silica in stabilizing heavy metals in a calcareous heavy metal-contaminated soil. The soil was treated with five nano-silica levels of 0, 100, 200, 500, and 1000 mg/kg and incubated for two months. The results showed that nano-silica had a specific surface area of 179.68 $${\text{m}}^{2}/\text{g}$$ m 2 / g . At 1000 mg/kg, the DTPA-extractable concentrations of Pb, Zn, Cu, Ni, and Cr decreased by 12%, 11%, 11.6%, 10%, and 9.5% compared to the controls, respectively. Additionally, as the nano-silica application rate increased, both soil pH and specific surface area increased. The augmentation of nano-silica adsorbent in the soil led to a decline in the exchangeable (EX) and carbonate-bound fractions of Pb, Cu, Zn, Ni, and Cr, while the distribution of heavy metals in fractions bonded with Fe–Mn oxides, organic matter, and residue increased. The use of 1000 mg/kg nano-silica resulted in an 8.0% reduction in EX Pb, 4.5% in EX Cu, 7.3% in EX Zn, 7.1% in EX Ni, and 7.9% in EX Cr compared to the control treatment. Overall, our study highlights the potential of nano silica as a promising remediation strategy for addressing heavy metal pollution in contaminated soils, offering sustainable solutions for environmental restoration and ecosystem protection.

Abstract The internal microenvironment of a living cell is heterogeneous and comprises a multitude of organelles with distinct biochemistry. Amongst them are biomolecular condensates, which are membrane-less, phase-separated compartments enriched in system-specific proteins and nucleic acids. The heterogeneity of the cell engenders the presence of multiple spatiotemporal gradients in chemistry, charge, concentration, temperature, and pressure. Such thermodynamic gradients can lead to non-equilibrium driving forces for the formation and transport of biomolecular condensates. Here, we report how ion gradients impact the transport processes of biomolecular condensates on the mesoscale and biomolecules on the microscale. Utilizing a microfluidic platform, we demonstrate that the presence of ion concentration gradients can accelerate the transport of biomolecules, including nucleic acids and proteins, via diffusiophoresis. This hydrodynamic transport process allows localized enrichment of biomolecules, thereby promoting the location-specific formation of biomolecular condensates via phase separation. The ion gradients further impart directional motility of condensates, allowing them to exhibit enhanced diffusion along the gradient. Coupled with a reentrant phase behavior, the gradient-induced enhanced motility leads to a dynamical redistribution of condensates that ultimately extends their lifetime. Together, our results demonstrate diffusiophoresis as a non-equilibrium thermodynamic force that governs the formation and transport of biomolecular condensates.

This study analyzed the water quality of the Yamuna river in Prayagraj across nine locations where the sampling was done upstream, downstream and middle stream from May 2019 to April 2020 using fourteen water quality parameters. Quarterly samples showed good Water Quality Index (WQI) values for summer (95.19), monsoon (77.28), and winter (90.77), but a decline in spring (102.11) due to religious activities was observed. Inductively coupled plasma mass spectroscopy suggested high concentration of Ca2+, Mg2+, K, and P in the river. Principal Component Analysis revealed 9 significant factors (eigen value >0.5) covering 25.13 – 93.89 % variance. Strong correlations included TDS-EC (0.853) and Ca2+ – Mg2+ (1.00) was observed. The correlation between water quality parameters generated by principal component analysis showed that the main parameters affecting the water quality vary in all the seasons. Based on the water quality indicators, anthropogenic activities are accountable to deteriorate the quality of river water. Therefore, the pollution status of the river need to be made publicly.

Abstract Background Myocardial bridging (MB) is a known congenital anomaly in which a segment of the coronary artery transverses from the epicardium through the myocardium. MB may clinically manifest as recurrent angina, acute coronary syndrome, ventricular dysrhythmia, and even sudden cardiac death. On electrocardiogram (EKG), MB can present with findings consistent with significant ST-segment changes. The AngelMed Guardian System (the Guardian device) was developed in an effort to optimize the time from the onset of myocardial ischemia to intervention. The device analyzes myocardial electrical changes and alerts the patient to seek emergent medical evaluation if an acute ST-segment deviation is detected. We describe the first documented case of the Guardian device detecting acute ST-segment changes secondary to myocardial bridging. Case Presentation A 50-year-old male, with a history of percutaneous coronary intervention of the proximal left anterior descending (LAD) artery, presented to his cardiologist’s office with reports of recurrent, atypical chest pain. The Guardian device was implanted. One month after implantation, the patient experienced chest pain and was alerted by the Guardian device to seek emergent medical evaluation. Initial EKG and high-sensitivity troponins were negative for acute ischemia. Guardian device interrogation revealed significant ST depressions, encouraging further ischemic evaluation. The exercise myocardial perfusion imaging revealed an apical reversible defect. Left heart catheterization revealed a large segment of mid-LAD MB with the patient’s previous LAD stent noted to be widely patent along with no evidence of new obstructive coronary disease. Following the identification of the MB, medication regimen adjusted and the patient denied recurrence of chest pain or Guardian alerts. Conclusions We describe the first documented case of the Guardian device detecting acute ST-segment changes that were secondary to myocardial bridging. The Guardian device appropriately documented an ischemic event not appreciated with initial EKG or troponin testing. With the assistance of the Guardian device, we were able to rapidly identify MB as the cause for the ischemic EKG changes and subsequent abnormal stress test, optimize medical management, and prevent recurrent atypical chest pain along with office and hospital visits.

Systemic sclerosis or scleroderma is an uncommon autoimmune condition with a global incidence of 8 to 56 new cases per million per year, which commences from skin and progresses to affect multiple systems in the body. It is marked by abnormalities in blood vessels, sclerosis of connective tissues and atrophy of skin and internal organs. The systemic sclerosis treatment depends on the disease manifestation and are usually treated with vasodilators (for vasculopathy improvement and prevention of Raynaud’s phenomenon), prostacyclin analogues (for the prevention of Raynaud’s phenomenon refractory to oral vasodilators), immunosuppressants like methotrexate, cyclophosphamide, mycophenolate mofetil, low dose corticosteroids (for the treatment of skin hardening, interstitial lung disease and inflammatory arthritis) and antifibrotics like endothelin receptor antagonists (for the treatment of pulmonary artery hypertension). Avascular necrosis in systemic sclerosis can arise as a result of the macrovascular and microvascular effects of vasculitis and corticosteroid therapy. The multisystem involvement of systemic sclerosis can impact every aspect of anaesthetic care especially airway management. During perioperative management, numerous systemic manifestations like pulmonary artery hypertension, interstitial lung disease and cardiac arrhythmia should be considered. The regional anaesthesia serves as a safe alternative to general anaesthesia and useful adjunct in the management of postoperative pain, but can be technically challenging. This case report described a 61-year-old female patient who had a history of systemic sclerosis for past 25 years and was scheduled for a total hip replacement due to avascular necrosis and secondary osteoarthritis of the left hip. The patient was having difficult cannulation, interstitial lung disease and anticipated difficult airway because of microstomia, limited mouth opening and limited flexion and extension at atlantooccipital joint. But the patient was successfully managed with combined spinal epidural anaesthesia, which provided effective pain control and minimised the perioperative risk associated with general anaesthesia.

ABSTRACTIn the Himalaya, availability of fresh water is a need of mankind, but due to numerous unsustainable developments, hill peoplesare witnessing scarcity of potable water. Hence, there is an imperative need for continuous monitoring of different water sources of Himalaya along with sustainable groundwater management practices in the highlands. The present study is based on extensive field visits investigating natural and other anthropogenic influences on mountain springs, locally known as “boweris”. In the undertaken study, eleven boweris were identified in the Salol region of Kangra, out of which two were exclusively selected as representative boweris, for their detailed studies and revival during the year 2021–2022. The physio-chemical characteristics (pH, TDS, and Electrical Conductivity) of the collected water samples from the boweris and hand pumps were found to be within the acceptable limits as prescribed by Bureau of Indian standards. The correlation between the pairs of TDS-EC depicted a strong positive relationship in both post-monsoon and pre-monsoon seasons and was found to be 0.94 and 0.99, respectively. Results of the t-test show a statistically significant difference in the mean concentrations of TDS (p = 0.02) and EC (p = 0.01) compared to pH (p = 0.39) with no significant difference at 5% significance level during both the seasons in the studied area. It was evident from the field investigations that the recharge structures constructed are facilitating the local boweris in maintaining the water level during the dry seasons. In the Bhatlahru region, the water level in the boweris rose from 127 to 159 cm, whereas in the Salol region, a rise from 119 to 142 cm was observed. The obtained results support the effectiveness and suitability of the proposed structures for the sustainable water resource management in the lower Himalaya. However, regular and long-term hydrological monitoring of the existing groundwater sources of the Himalaya is required for a better understanding of groundwater dynamics.

Variant peptides resulting from single nucleotide polymorphisms (SNPs) can lead to aberrant protein functions and have translational potential for disease diagnosis and personalized therapy. Variant peptides detected by proteogenomics are fraught with high number of false positives, but there is no uniform and comprehensive approach to assess variant quality across analysis pipelines. Despite class-specific FDR along with ad-hoc filters, the problem is far from solved. These protocols are typically manual and tedious, and thus not uniform across labs. We demonstrate that variant peptide rescoring, integrated with intensity, variant event information and search result features, allows better discrimination of correct variant peptides. Implemented into PgxSAVy – a tool for quality control of variant peptides, this method can tackle the high rate of false positives. PgxSAVy provides a rigorous framework for quality control and annotations of variant peptides on the basis of (i) variant quality, (ii) isobaric masses, and (iii) disease annotation. PgxSAVy demonstrated high accuracy by identifying true variants with 98.43% accuracy on simulated data. Large-scale proteogenomic reanalysis of ∼2.8 million spectra (PXD004010 and PXD001468) resulted in 12,705 variant peptide spectrum matches (PSMs), of which PgxSAVy evaluated 3028 (23.8%), 1409 (11.1%) and 8268 (65.1%) as confident, semi-confident and doubtful respectively. PgxSAVy also annotates the variants based on their pathogenicity and provides support for assisted manual validation. The analysis of proteins carrying variants can provide fine granularity in discovering important pathways. PgxSAVy will advance personalized medicine by providing a comprehensive framework for quality control and prioritization of proteogenomics variants. PgxSAVy is freely available at https://pgxsavy.igib.res.in/ as a webserver and https://github.com/anuragraj/PgxSAVy as a stand-alone tool.

In the present scenario, emerging topologies in the area of Asymmetrical Multilevel Inverter (AMLI) with fewer power switches and voltage sources have been received greater attention to achieve higher levels with low THD and voltage stress. The present work proposes a novel modular AMLI topology to generate 7-level and 15-level in the output voltage. This topology needs minimal components in comparison of topologies reported in literature. Simulation of the 7-level and 15-level AMLI is performed using MATLAB to generate all the desired levels in the output voltage for different operating frequencies and different modulation indexes. Further, a comparison of the suggested topology with other similar multilevel inverter (MLI) topologies has also been performed on the basis of number of drivers, number of DC sources, levels in the output voltage and power switches. Furthermore, efficiency, losses and total harmonic analysis of 7-level and 15-level AMLI have been calculated and compared with other studies. Finally, simulation results are validated on a hardware set up of the proposed inverter using Opal-RT 4510 controller.

Imaging is essential for managing COVID-19 pneumonia. In resource-limited settings, chest radiography is the only practicable imaging modality. The Brixia radiographic scoring system, an objective method of assessing pulmonary involvement, is yet to be studied in India. (a) To study the association between the clinical severity of COVID-19 patients with their Brixia scores and, (b) to evaluate the utility of the score as a predictor for invasive ventilation. Peripheral rural hospital by Indian Armed Forces; Cross-sectional study. A thousand patients diagnosed with COVID-19 and hospitalized were classified as having a mild, moderate, and severe disease based on their least oxygen saturation (SpO2 >94: mild, between 90-94: moderate, and

Radiation therapists, also known as radiotherapy technologists, are allied health professionals who specialise in providing high doses of radiation to patients with malignant growths. High-energy radiation damages cells’ genetic material {Deoxyribonucleic Acid (DNA)}, stopping them from replicating and multiplying further. Radiation can be used to treat cancer or as a highly effective palliative therapy to alleviate cancer-related pain in patients. Radiation therapy can be used in conjunction with other treatments, including surgery, chemotherapy, and immunotherapy. Because radiation harms both healthy tissues and malignant cells, the primary objective of radiation therapy is to optimise radiation exposure to abnormal cancer cells while avoiding irradiation of healthy tissues adjacent to or in the path of radiation. Remarkable precision is required to provide ionising radiation to patients and target specific cells for consistent, accurate, and successful radiation treatment. A team consisting of radiation oncologists, medical physicists, radiation therapists, medical dosimetrists, and nurses work together to achieve this goal. Radiation therapists are responsible for delivering radiation treatment, as well as maintaining and testing the equipment used to monitor and administer the treatment. The radiation therapist administers the patient’s treatment dose according to the prescription plan made by the radiation oncologists and medical physicists. Radiation therapists must communicate with patients and their families, respond to their inquiries, and clarify the radiation treatment plan. They must also track the patient’s progress and report any changes to their seniors. Radiation therapists must maintain high levels of precision while administering therapy, think critically, and exercise autonomous, professional, and ethical judgment in all aspects of their work. The field of radiotherapy is continuously evolving with new advancements in technology and treatment delivery techniques that maximise patient satisfaction and treatment delivery efficacy. Radiation therapists undergo continuing education and training to broaden their knowledge of the field and stay current with standard practice. This review addresses the critical role of radiation therapists in clinical radiation therapy practices. It highlights their significance in delivering safe and effective treatment to radiotherapy patients. The review covers various aspects, including the responsibilities of technologists in treatment planning, equipment operation, patient care and safety, quality assurance, and research. This present review provides a comprehensive understanding of the importance of well-trained and skilled radiation therapists in ensuring the success of radiation therapy treatments.

Abstract We compute tree level scattering amplitudes involving more than one highly excited states and tachyons in bosonic string theory. We use these amplitudes to understand the chaotic and thermal aspects of the excited string states lending support to the Susskind-Horowitz-Polchinski correspondence principle. The unaveraged amplitudes exhibit chaos in the resonance distribution as a function of the kinematic parameters, which can be described by random matrix theory. Upon coarse-graining, these amplitudes are shown to exponentiate, and capture various thermal features, including features of a stringy version of the eigenstate thermalization hypothesis as well as notions of typicality. Further, we compute the effective string form factor corresponding to the highly excited states, and argue for the random walk behaviour of the long strings.

Abstract Cisplatin-induced nephrotoxicity restricts its clinical use against solid tumors. The present study elucidated the pharmacological effects of Renogrit, a plant-derived prescription medicine, using cisplatin-induced human renal proximal tubular (HK-2) cells and Caenorhabditis elegans. Quantification of phytochemicals in Renogrit was performed on HPTLC and UHPLC platforms. Renogrit was assessed in vitro in HK-2 cells post-exposure to clinically relevant concentration of cisplatin. It was observed that renoprotective properties of Renogrit against cisplatin-induced injury stem from its ability to regulate renal injury markers (KIM-1, NAG levels; NGAL mRNA expression), redox imbalance (ROS generation; GST levels), and mitochondrial dysfunction (mitochondrial membrane potential; SKN-1, HSP-60 expression). Renogrit was also found to modulate apoptosis (EGL-1 mRNA expression; protein levels of p-ERK, p-JNK, p-p38, c-PARP1), necroptosis (intracellular calcium accumulation; RIPK1, RIPK3, MLKL mRNA expression), mitophagy (lysosome population; mRNA expression of PINK1, PDR1; protein levels of p-PINK1, LC3B), and inflammation (IL-1β activity; protein levels of LXR-α). More importantly, Renogrit treatment did not hamper normal anti-proliferative effects of cisplatin as observed from cytotoxicity analysis on MCF-7, A549, SiHa, and T24 human cancer cells. Taken together, Renogrit could be a potential clinical candidate to mitigate cisplatin-induced nephrotoxicity without compromising the anti-neoplastic properties of cisplatin.

Abstract The presence of defects at the interface between the perovskite film and the carrier transport layer poses significant challenges to the performance and stability of perovskite solar cells (PSCs). Addressing this issue, we introduce a dual host-guest (DHG) complexation strategy to modulate both the bulk and interfacial properties of FAPbI3-rich PSCs. Through NMR spectroscopy, a synergistic effect of the dual treatment is observed. Additionally, electro-optical characterizations demonstrate that the DHG strategy not only passivates defects but also enhances carrier extraction and transport. Remarkably, employing the DHG strategy yields PSCs with power conversion efficiencies (PCE) of 25.89% (certified at 25.53%). Furthermore, these DHG-modified PSCs exhibit enhanced operational stability, retaining over 96.6% of their initial PCE of 25.55% after 1050 hours of continuous operation under one-sun illumination, which was the highest initial value in the recently reported articles. This work establishes a promising pathway for stabilizing high-efficiency perovskite photovoltaics through supramolecular engineering, marking a significant advancement in the field.

Abstract Background Germline genetic testing is recommended for an increasing number of conditions with underlying genetic etiologies, the results of which impact medical management. However, genetic testing is underutilized in clinics due to system, clinician, and patient level barriers. Behavioral economics provides a framework to create implementation strategies, such as nudges, to address these multi-level barriers and increase the uptake of genetic testing for conditions where the results impact medical management. Methods Patients meeting eligibility for germline genetic testing for a group of conditions will be identified using electronic phenotyping algorithms. A pragmatic, type 3 hybrid cluster randomization study will test nudges to patients and/or clinicians, or neither. Clinicians who receive nudges will be prompted to either refer their patient to genetics or order genetic testing themselves. We will use rapid cycle approaches informed by clinician and patient experiences, health equity, and behavioral economics to optimize these nudges before trial initiation. The primary implementation outcome is uptake of germline genetic testing for the pre-selected health conditions. Patient data collected through the electronic health record (e.g. demographics, geocoded address) will be examined as moderators of the effect of nudges. Discussion This study will be one of the first randomized trials to examine the effects of patient- and clinician-directed nudges informed by behavioral economics on uptake of genetic testing. The pragmatic design will facilitate a large and diverse patient sample, allow for the assessment of genetic testing uptake, and provide comparison of the effect of different nudge combinations. This trial also involves optimization of patient identification, test selection, ordering, and result reporting in an electronic health record-based infrastructure to further address clinician-level barriers to utilizing genomic medicine. The findings may help determine the impact of low-cost, sustainable implementation strategies that can be integrated into health care systems to improve the use of genomic medicine. Trial registration ClinicalTrials.gov. NCT06377033. Registered on March 31, 2024. https://clinicaltrials.gov/study/NCT06377033?term=NCT06377033&rank=1

Abstract Spindle epithelial tumor with thymus-like elements (SETTLE) is a rare malignant neoplasm of the thyroid gland which is believed to arise from intrathyroidal thymic tissue. It predominantly affects young adults and children presenting with a thyroid mass of variable duration and rarely occurs in adults. It has a high overall survival with a tendency for delayed metastasis. SETTLE is a biphasic lobulated tumor composed of spindle shaped cells along with glandular formations seen on histopathological examination. Despite its typical morphology it is commonly misdiagnosed on histopathology due to its rarity and overlapping morphology with other close mimics such as a carcinoma, synovial sarcoma and thymoma. Herein we report such a case occurring in a middle aged female presenting with a neck mass. She had an initial diagnosis of metastatic poorly differentiated squamous cell carcinoma possibly with an orophayngeal primary in view of co expression of CK, p40 and p16 on immunohistochemistry. The patient underwent surgical resection with modified neck dissection. On review at our hospital it was diagnosed as SETTLE and she remains disease free after a follow-up period of 1 year. Diligent histopathological examination espoused with a judicious panel of IHC markers in conjunction with clinicoradiological findings forms the mainstay of diagnosis. Diffuse and strong p16 immunoexpression has not been documented or evaluated in literature so far, and needs to be explored for its diagnostic utility in this rare entity.

Abstract Diamond-like Carbon (DLC) has been used as a coating material of choice for a variety of technological applications owing to its favorable bio-tribo-thermo-mechanical characteristics. Here, the possibility of bringing DLC into orthopedic joint implants is examined. With ever increasing number of patients suffering from osteoarthritis as well as with the ingress of the osteoarthritic joints’ malaise into younger and more active demographics, there is a pressing need to augment the performance and integrity of conventional total joint replacements (TJRs). Contemporary joint replacement devices use metal-on-polymer articulations to restore function to worn, damaged or diseased cartilage. The wear of polymeric components has been addressed using crosslinking and antioxidants; however, in the context of the metallic components, complications pertaining to corrosion and metal ion release inside the body still persist. Through this review article, we explore the use of DLC coatings on metallic bearing surfaces and elucidate why this technology might be a viable solution for ongoing electrochemical challenges in orthopedics. The different characteristics of DLC coatings and their feasibility in TJRs are examined through assessment of tribo-material characterization methods. A holistic characterization of the coating-substrate interface and the wear performance of such systems are discussed. As with all biomaterials used in TJRs, we need mindful consideration of potential in-vivo challenges. We present a few caveats for DLC coatings including delamination, hydrophobicity, and other conflicting as well as outdating findings in the literature. We recommend prudently exploring DLC films as potential coatings on metallic TJR components to solve the problems pertaining to wear, metal ion release, and corrosion. Ultimately, we advise bringing DLC into clinical use only after addressing all challenges and concerns outlined in this article. Graphical Abstract

Abstract Breast cancer (BC) has emerged as the most common malignancy among females. The genomic profile of BC is diverse in nature and complex due to heterogeneity among various geographically different ethnic groups. The primary objective of this study was to carry out a comprehensive mutational analysis of Indian BC cases by performing whole exome sequencing. The cohort included patients with a median age of 48 years. TTN, TP53, MUC16, SYNE1, and OBSCN were the frequently altered genes found in our cohort. The PIK3CA and KLC3 genes are driver genes implicated in various cellular functions and cargo transportation through microtubules, respectively. Except for CCDC168 and PIK3CA, several gene pairings were found to be significantly linked with co-occurrence. Irrespective of their hormonal receptor status, RTK/RAS was observed with frequently altered signaling pathways. Further analysis of the mutational signature revealed that SBS13, SBS6, and SBS29 were mainly observed in our cohort. This study supplements the discovery of diagnostic biomarkers and provides new therapeutic options for the improved management of BC.

Abstract Background Asthma is a heterogeneous, inflammatory disease with several phenotypes and endotypes. Severe asthmatics often exhibit mixed granulocytosis with reduced corticosteroid sensitivity. Bronchom is a newly developed Ayurvedic prescription medicine, indicated for the treatment of obstructive airway disorders. The purpose of the present study was to evaluate the in-vivo efficacy of Bronchom in mouse model of mixed granulocytic asthma with steroidal recalcitrance. Methods High-performance thin layer chromatography (HPTLC) and Ultra-high performance liquid chromatography (UHPLC) were employed to identify and quantitate the phytometabolites present in Bronchom. The preclinical effectiveness of Bronchom was assessed in house dust mite (HDM) and Complete Freund’s adjuvant (CFA)-induced mixed granulocytic asthma model in mice. High dose of dexamethasone was tested parallelly. Specific-pathogen-free C57BL/6 mice were immunized with HDM and CFA and nineteen days later, they were intranasally challenged with HDM for four consecutive days. Then the mice were challenged with nebulized methacholine to evaluate airway hyperresponsiveness (AHR). Inflammatory cell influx was enumerated in the bronchoalveolar lavage fluid (BALF) followed by lung histology. Additionally, the concentrations of Th2 and pro-inflammatory cytokines was assessed in the BALF by multiplexed immune assay. The mRNA expression of pro-inflammatory cytokines and Mucin 5AC (MUC5AC) was also evaluated in the lung. Results HPTLC fingerprinting and UHPLC quantification of Bronchom revealed the presence of bioactive phytometabolites, namely, rosmarinic acid, gallic acid, methyl gallate, piperine, eugenol and glycyrrhizin. Bronchom effectively reduced AHR driven by HDM-CFA and the influx of total leukocytes, eosinophils and neutrophils in the BALF. In addition, Bronchom inhibited the infiltration of inflammatory cells in the lung as well as goblet cell metaplasia. Further, it also suppressed the elevated levels of Th2 cytokines and pro-inflammatory cytokines in the BALF. Similarly, Bronchom also regulated the mRNA expression of pro-inflammatory cytokines as well as MUC5AC in mice lungs. Reduced effectiveness of a high dose of the steroid, dexamethasone was observed in the model. Conclusions We have demonstrated for the first time the robust pharmacological effects of an herbo-mineral medicine in an animal model of mixed granulocytic asthma induced by HDM and CFA. The outcomes suggest the potential utility of Bronchom in severe asthmatics with a mixed granulocytic phenotype.

Abstract Novel therapeutic agents in clinical trials offer a paradigm shift in the approach to battling this prevalent and destructive disease, and the area of cancer therapy is on the precipice of a trans formative revolution. Despite the importance of tried-and-true cancer treatments like surgery, radiation, and chemotherapy, the disease continues to evolve and adapt, making new, more potent methods necessary. The field of cancer therapy is currently witnessing the emergence of a wide range of innovative approaches. Immunotherapy, including checkpoint inhibitors, CAR-T cell treatment, and cancer vaccines, utilizes the host’s immune system to selectively target and eradicate malignant cells while minimizing harm to normal tissue. The development of targeted medicines like kinase inhibitors and monoclonal antibodies has allowed for more targeted and less harmful approaches to treating cancer. With the help of genomics and molecular profiling, “precision medicine” customizes therapies to each patient’s unique genetic makeup to maximize therapeutic efficacy while minimizing unwanted side effects. Epigenetic therapies, metabolic interventions, radio-pharmaceuticals, and an increasing emphasis on combination therapy with synergistic effects further broaden the therapeutic landscape. Multiple-stage clinical trials are essential for determining the safety and efficacy of these novel drugs, allowing patients to gain access to novel treatments while also furthering scientific understanding. The future of cancer therapy is rife with promise, as the integration of artificial intelligence and big data has the potential to revolutionize early detection and prevention. Collaboration among researchers, and healthcare providers, and the active involvement of patients remain the bedrock of the ongoing battle against cancer. In conclusion, the dynamic and evolving landscape of cancer therapy provides hope for improved treatment outcomes, emphasizing a patient-centered, data-driven, and ethically grounded approach as we collectively strive towards a cancer-free world.

Benign cardiac tumors are rare, and cardiac lipomas constitute a small proportion. Since the majority of these lipomas vary in morphology, size, clinical presentation, and diagnosis, it is difficult to diagnose them until they become symptomatic. Management of large adherent cardiac lipomas presenting with obstructive symptoms can be challenging. It can be arduous to excise them completely, as they may involve vital structures and may sometimes need debulking only, leading to the possibility of recurring tumors. We report a case of a 60-year-old male with complaints of chest pain and dyspnea on exertion, diagnosed with a large right atrial mass, extensive involvement of the right atrial wall, and impingement on the tricuspid valve and was managed by surgical resection with a positive clinical result. This case highlights that obstructive or symptomatic cardiac lipomas can be effectively resected with favorable outcomes.

The coronavirus disease 2019 (COVID-19) pandemic has significantly altered the lives and lifestyles of several older populations in the United Kingdom. It was important to note how it has affected their physical, mental, and social health and well-being during the first wave of the Covid-19 pandemic. To study the impact of the Covid-19 pandemic and the imposed restrictions on the day-to-day lives of the elderly population in the United Kingdom. A review of the published literature on the first wave of the Covid-19 pandemic and its consequences on the older population in the United Kingdom is done. Search engines used for medical databases were Pubmed, Google Scholar, and Internet Explorer. It was found that physical as well as mental well-being was affected in the elderly citizens of the United Kingdom. Mental health studies noted an obvious increase in anxiety and depressive symptoms. Social isolation and reduced access to healthcare services had a deteriorating impact on their social health. Covid-19-related lockdown and pandemic-associated physical, mental, and social well-being effects have been evident in the elderly population in the United Kingdom. The reasons identified for such findings are lack of physical activity, poor social interactions, social isolation, the perceived threat of a pandemic, and poor access to healthcare facilities.

Abstract Pili are bacterial surface structures important for surface adhesion. In the alphaproteobacterium Caulobacter crescentus, the global regulator CtrA activates transcription of roughly 100 genes, including pilA which codes for the pilin monomer that makes up the pilus filament. While most CtrA-activated promoters have a single CtrA-binding site at the − 35 position and are induced at the early to mid-predivisional cell stage, the pilA promoter has 3 additional upstream CtrA-binding sites and it is induced at the late predivisional cell stage. Reporter constructs where these additional sites were disrupted by deletion or mutation led to increased activity compared to the WT promoter. In synchronized cultures, these mutations caused pilA transcription to occur approximately 20 min earlier than WT. The results suggested that the site overlapping the − 35 position drives pilA gene expression while the other upstream CtrA-binding sites serve to reduce and delay expression. EMSA experiments showed that the − 35 Site has lower affinity for CtrA∼P compared to the other sites, suggesting binding site affinity may be involved in the delay mechanism. Mutating the upstream inhibitory CtrA-binding sites in the pilA promoter caused significantly higher numbers of pre-divisional cells to express pili, and phage survival assays showed this strain to be significantly more sensitive to pilitropic phage. These results suggest that pilA regulation evolved in C. crescentus to provide an ecological advantage within the context of phage infection.

Abstract Scattering amplitudes involving multiple partons are plagued with infrared singularities. The soft singularities of the amplitude are captured by the soft function which is defined as the vacuum expectation value of Wilson line correlators. Renormalization properties of soft function allows us to write it as an exponential of the finite soft anomalous dimension. An efficient way to study the soft function is through a set of Feynman diagrams known as Cwebs (webs). We present the mixing matrices and exponentiated colour factors (ECFs) for the Cwebs at five loops that connect six Wilson lines, except those that are related by relabeling of Wilson lines. Further, we express these ECFs in terms of 29 basis colour factors. We also find that this basis can be categorized into two colour structures. Our results are the first key ingredients for the calculation of the soft anomalous dimension at five loops.

Abstract Background The National Comprehensive Cancer Network (NCCN) guideline recommends consideration of weekly cisplatin as an alternative option for patients with head and neck cancer undergoing definitive chemoradiation. However, in a recent phase III trial (ConCERT), 20% of patients treated with weekly cisplatin could not receive a total of 200 mg/m2, and the association of low adherence to weekly cisplatin and cancer control outcomes remains unclear. To fill this knowledge gap, we performed an observational cohort study of patients with head and neck cancer undergoing definitive chemoradiation with weekly cisplatin. Methods Our institutional database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation with weekly cisplatin (40 mg/m2) between November 2007 and April 2023. Adherence to weekly cisplatin was defined as receiving at least 5 cycles with a total cumulative dose of 200 mg/m2. Survival outcomes were evaluated using Kaplan–Meier method, log-rank tests, Cox proportional hazard multivariable (MVA) analyses. Logistic MVA was performed to identify variables associated with low adherence to weekly cisplatin. Fine-Gray MVA was performed to analyze failure outcomes with death as a competing event. Results Among 119 patients who met our criteria, 51 patients (42.9%) had low adherence to weekly cisplatin. Median follow up was 19.8 months (interquartile range 8.8–65.6). Low adherence to weekly cisplatin was associated with worse overall survival (adjusted hazards ratio [aHR] 2.94, 95% confidence interval [CI] 1.58–5.47, p

Abstract The sole treatment for snakebite envenomation (SBE), the anti-snake venom (ASV), suffers from considerable drawbacks, including side effects and limited species specificity. Additionally, despite its existence for more than a century, uniform availability of good quality ASV does not yet exist. The present review describes the journey of a SBE victim and highlights the global crisis of SBE management. A detailed analysis of the current ASV market has also been presented along with the worldwide snake distribution. The current production of country specific licensed ASV throughout the globe along with their manufacturers has been examined at the snake species level. Furthermore, a detailed analysis of on-ground situation of SBE management in antivenom manufacturing countries has been done using the most recent literature. Additionally, the export and import of different ASVs have been discussed in terms of procurement policies of individual countries, their shortcomings, along with the possible solution at the species level. It is interesting to note that in most countries, the existence of ASV is really either neglected or overstated, implying that it is there but unsuitable for use, or that it is not present but can be obtained from other countries. This highlights the urgent need of significant reassessment and international collaborations not just for development and production, but also for procurement, distribution, availability, and awareness. A PROMISE (Practical ROutes for Managing Indigenous Snakebite Envenoming) approach has also been introduced, offering simple, economical, and easy to adopt steps to efficiently alleviate the worldwide SBE burden.

Context: Worldwide malnutrition is identified as a major health and nutrition problem. Undernutrition contributes to an estimated 45% of child deaths globally. The prevalence of underweight among children in India is among the highest in the world. Our children also bear a tremendous double burden of malnutrition. Aims: To find out the prevalence and determinants of malnutrition among six months to three-year-old children in the rural community of Northern India. Settings and Design: A community-based cross-sectional study conducted among children aged six months to three years in a rural area of Ludhiana district, Methods and Material: A total of 662 children in the age group of six months to three years from a population of 30,000 were identified and included in the study. All the relevant information regarding these children was collected from family folders. Socioeconomic status was assessed using the modified Udai Pareek scale (MUP). Statistical analysis used: The data collected was entered in MS Excel and was analyzed using SPSS version 26 and WHO Anthro Survey Analyzer. Results: Out of 662 children, 16% were underweight. Almost 50% of the children in the two—three years category were underweight. The prevalence of stunting in the study population was 20.7% and that of overweight was 4.8%. The prevalence of underweight was higher in children of low socioeconomic status than in children from upper socioeconomic status (P = 0.000). There was a significant association between birth order and increasing cases of underweight (P = 0.000). Conclusions: The causes of malnutrition in children are complex and involve multiple factors. There is a need for vigorous monitoring for early detection of malnutrition for children aged two—three years. The improvement of maternal education will improve the nutritional status of the child.

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. It causes alteration in the cardiac performance that can be recorded by electrocardiogram (ECG) and echocardiography noninvasively. Methods: In this observational study, we studied ECG changes and their relation with the disease severity and disease duration amongst 100 COPD patients. Results: Their mean age was 58.1 ± 12.0 years, and the mean disease duration was 7.9 ± 4.1 years. ECG was found normal in 31% and abnormal in 69% of subjects. Right axis deviation (RAD), right ventricular hypertrophy, right bundle branch block and P-pulmonale were noted in 38%, 28%, 20% and 17% of study subjects, respectively. Left bundle branch block, ventricular premature contractions (VPC) and second and third-degree block were seen in none of the subjects. ECG was found abnormal in 78% of patients with Stage 4 COPD, whereas only 17% of patients with Stage 1 COPD had their ECGs abnormal (P < 0.01). ECG was abnormal in 91% of patients with a disease duration of more than 10 years and 39% of patients with a disease duration of

Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country. The current clinical practice recommendations focused on peri-implant care to bridge the gap between academic theory and clinical practice by compiling evidence-based suggestions for preventing and treating peri-implant diseases. Twenty-eight subject experts across the country prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three sections covering peri-implant health and maintenance, peri-implant mucositis, and peri-implantitis. It will be a quick and concise reference for oral implant practitioners in patient management. The guidelines provide distinct definitions, signs, and symptoms, treatment required; recall visit specifications for plausible clinical case situations, and home-care recommendations regarding maintaining peri-implant health. The document advocates combined efforts of oral implant practitioners and the population at large with evidence-based, integrated, and comprehensive peri-implant care. By providing accessible, applicable guidance, these guidelines would empower dental professionals to uphold the well-being of implant patients and ensure the long-term success of implant therapy.