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Abstract Regulatory elements controlling gene expression fine-tune bacterial responses to environmental cues, including antimicrobials, to optimize survival. Acinetobacter baumannii, a pathogen notorious for antimicrobial resistance, relies on efficient efflux systems. Though the role of efflux systems in antibiotic expulsion are well recognized, the regulatory mechanisms controlling their expression remain understudied. This review explores the current understanding of these regulators, aiming to inspire strategies to combat bacterial resistance and improve therapeutic outcomes.

Introduction: Fallopian tube blockage is an important factor for female infertility. Fallopian tubes can be correlated with the Artavavaha Srotas and the block is compared with the Sanga Srotodushti (obstruction in channels). This article discusses a 28-year-old female patient with a history of 10 years of infertility. Main Clinical Finding: In this case study, the patient was anxious to conceive after 10 years of a regular and satisfactory marital relationship. Diagnosis: The patient was diagnosed with primary infertility due to bilateral tubal blockage after allopathic consultation and was advised for in vitro fertilization. However, she was indisposed to do so because of her low socioeconomic condition. Hence, she approached the Outpatient Department of Prasuti Tantra, Sir Sunderlal Hospital, IMS, BHU. Interventions: After appropriate analysis based on Ayurvedic and modern parameters, the patient was treated with Kshar Taila Uttar Basti (UB) along with oral medications. The management was to remove the blockage in the fallopian tubes. Outcome: Two cycles of treatment were given and the patient came with positive urine pregnancy test with the complaint of 2-month amenorrhea. Then, she took regular antenatal care and delivered a baby boy after 9 months of pregnancy through cesarean delivery (C-section). Conclusions: Hence, here, management with Kshar Taila UB has been proved to be a very effective treatment modality to treat tubal blockage.

IntroductionHypertrophic cardiomyopathy (HCM) is a common genetic heart disorder. It is characterized by left ventricular hypertrophy and impaired cardiac function, with forms categorized into obstructive (oHCM) and nonobstructive (nHCM). Traditional treatments address symptoms but not the underlying disease mechanism, highlighting the need for novel therapies. Cardiac myosin inhibitors such as mavacamten and aficamten present potential new treatment options.MethodsA meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Studies comparing cardiac myosin inhibitors with placebo were reviewed, and outcomes related to NYHA functional class, Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS), LVOT gradients, and left ventricular ejection fraction (LVEF) were analyzed.ResultsSix RCTs involving 826 participants demonstrated that mavacamten and aficamten significantly improved NYHA functional class and KCCQ-CSS scores. The incidence of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) was similar between the treatment and control groups, indicating a comparable safety profile.ConclusionCardiac myosin inhibitors are effective in improving cardiac function and reducing LVOT obstruction in HCM patients. They offer a promising alternative to current treatments, with a safety profile comparable to placebo. Further research is needed to confirm long-term benefits.

IntroductionAtopic dermatitis (AD) is a chronic inflammatory skin disorder that affects millions worldwide, presenting challenges in managing symptoms and quality of life. Current treatments include topical corticosteroids (TCS), but novel approaches, such as Janus kinase (JAK) inhibitors, show promise. Baricitinib, a selective JAK1 and JAK2 inhibitor, targets cytokines involved in AD and offers potential benefits beyond traditional therapies.MethodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the efficacy and safety of baricitinib in treating moderate-to-severe AD. We followed PRISMA guidelines and assessed data from PubMed, Cochrane Central, ScienceDirect, and ClinicalTrials.gov up to August 2024. The analysis included trials comparing baricitinib to placebo, with or without TCS, evaluating outcomes such as Investigator's Global Assessment (IGA) scores, Eczema Area and Severity Index (EASI) scores, and safety profiles.ResultsSix RCTs involving 2,595 participants met the inclusion criteria. Baricitinib demonstrated significant improvements in IGA scores, EASI scores, Dermatology Life Quality Index (DLQI), and other outcome measures compared to placebo. The efficacy was consistent across different dosages (1 mg, 2 mg, 4 mg) and whether baricitinib was used with or without TCS. Safety analyses revealed a significant increase in treatment-emergent adverse events (TEAEs), particularly with the 2 mg and 4 mg dosages and with TCS.ConclusionBaricitinib, both alone and in combination with TCS, significantly improves symptoms and quality of life in patients with moderate-to-severe AD, with efficacy consistent across dosages. The safety profile is overall acceptable, though a significant increase in TEAEs was observed, particularly with higher dosages and when used with TCS. Ongoing monitoring of TEAEs is recommended, and future trials with longer follow-up periods are suggested to better understand long-term outcomes.

ABSTRACT Acinetobacter calcoaceticus-baumannii (ACB) complex has been identified as a group of emerging opportunistic pathogens that cause nosocomial infections. The current study investigates the prevalence, distribution, and diversity of pathogenic ACB complex in various aquatic systems with different uses. Of the total 157 agricultural, raw drinking water intake, recreational beach, and wastewater treatment plant (WWTP) effluent samples, acinetobacters were isolated, quantified, and confirmed by genus- and ACB complex-specific PCR assays. Of all agricultural surface water samples, A. calcoaceticus (65%) was more frequently detected than A. pittii (14%), A. nosocomialis (9%), and A. baumannii (3%). In WWTP effluent samples, A. baumannii was more prevalent in de-chlorinated (60%) samples compared to both A. pittii and A. nosocomialis (40%). Interestingly, A. nosocomialis (43%), A. calcoaceticus (29%), and A. baumannii (14%) were detected in raw drinking water intake samples, whereas A. pittii (50%) and A. nosocomialis (25%) were detected in beach samples. Although no sampling location-specific differences were recorded, significant (P < 0.05) seasonal differences were observed when agricultural surface water samples collected in spring were compared with the summer and fall. Whereas effluent chlorination significantly impacted the degree of prevalence of Acinetobacter in WWTP effluent samples, overall, the prevalence of ACB complex in all sampling locations and seasons indicates that these water sources, containing human-associated ACB complex, may pose potential health risks as community-acquired opportunistic infections.IMPORTANCEAcinetobacter calcoaceticus-baumannii (ACB) complex is a group of organisms known to cause problematic nosocomial opportunistic infections. A member of the species complex, A. baumannii, is becoming a global threat to infection treatment as strains are increasingly develop resistance to antibiotics. The prevalence and distribution of potentially pathogenic Acinetobacter calcoaceticus-baumannii complex species remain poorly understood, and there is a need to better understand the occurrence of A. baumannii in non-nosocomial environments. Our research details the spatial-temporal distribution of ACB complex species in a regional watershed and highlights the presence of ACB complex in wastewater effluent that is discharged into a river. These findings deepen our understanding of this group of species in non-nosocomial environments and encourage the development of monitoring programs for these species in regional waters.

Background: Dental implant treatment has gained widespread acceptance as a reliable method for replacing lost teeth. Nevertheless, the favorable outcome of implant therapy hinges on having adequate bone quality and quantity. Individuals with restricted bone height or density pose a unique challenge for implant placement. Short and ultra-short dental implants offer an alternative solution for such patients, as they necessitate less vertical bone height and can mitigate the necessity for supplementary bone augmentation procedures. Aim: This narrative review was conducted to understand the different types of short and ultra-short implants, their indications and contraindications, and their prosthetic considerations, summarizing the current literature on the clinical outcomes, success rates, and potential complications. Methods: Research publications were searched on search engines such as EBSCO, EMBASE, PubMed, Web of Science, and Cochrane library databases, and the articles published from January 1988 to December 2022 with terms such as “short implants, ultra-short implants, atrophic ridge, and alveolar ridge augmentation” were collected. Results: A total of 10 articles were collected, and they were further used to formulate this review. Despite their constraints, short and ultra-short implants have demonstrated comparable clinical results to conventional implants in specific scenarios and provide several advantages, such as reduced surgical time, lower costs, and decreased risk of anatomical complications. Discussion: Short and ultra-short dental implants are used when regular ones are not feasible. They increase stability by enhancing bone contact. They work well for various dental prostheses, especially for those who cannot use removable options. While not recommended for everyone, they can be successful in many cases. Factors such as implant shape, surgical technique, and prosthetic considerations play a key role in their success. Studies show high survival rates for short implants, making them a reliable choice for specific situations. They offer a less invasive and cost-effective alternative in challenging cases. Conclusion: As technology and designs continue to advance, the adoption of short and ultra-short implants is expected to see a rise in implant dentistry. It is imperative to exercise careful patient selection, comprehensive treatment planning, and precise execution of both surgical and prosthetic techniques for the successful implementation of implant therapy with short and ultra-short implants.

Purpose: Fever serves as the most frequent cause of visits to emergency/outpatient pediatric departments among children under the age of five. Very frequently, the youngster is given antibiotics on an arbitrary basis without receiving the proper examination for a urinary tract infection (UTI). This study’s goals were to assess the prevalence of UTIs in febrile children between 6 months and 5 years of age. To study the proportion of UTIs in children between 6 months and 5 years presenting with fever. To study the association of various risk factors with UTI. Methodology: This Cross-sectional Descriptive observational research was done in the Pediatric department of tertiary care hospital from August 2020 to December 2022, in febrile kids between 6 months and 5 years age group using different variables. Association between two qualitative variables was seen by using Chi-square/Fischer’s exact test. A P < 0.05 was considered statistically significant whereas a P < 0.001 was considered highly significant. Results: Among the total study population, it was found that 5.58% of the patients with fever without focus had a UTI, while the majority of patients, 94.42% did not have a UTI but had fever without a specific focus. In UTI cases, urine culture growth patterns showed the presence of different isolates, including Escherichia coli (30.43%), Klebsiella (56.52%), Pseudomonas aeruginosa (8.7%), and Candida (4.34%). Conclusion: In the present research, the overall occurrence of UTI in children

This paper presents the analysis of water supply behavior within an educational campus, serving as a use-case to demonstrate the broader applicability of an innovative IoT-based framework integrated with deep learning techniques. By retrofitting analog water meters with IoT devices, the study captures images of meter dials, which are then locally processed using a deep learning-based digit detection algorithm. This process converts the images into digits and transmits the data to the cloud for real-time analysis, thereby enhancing the accuracy and reliability of water usage data. Focusing on two key regions within the campus—student hostels and faculty/staff quarters—the analysis thoroughly examines the impact of water supply patterns on both a monthly and weekly basis. It reveals how the distinct characteristics of each month, such as holidays, exams, and class schedules, significantly influence water consumption in these areas. The study particularly highlights the variations in water usage in student hostels, driven by the academic calendar and student lifestyle, in contrast to the more stable water demand observed in faculty/staff quarters. The integration of the data refinement algorithm uncovers the underlying consumption patterns within these campus residence. The findings from this detailed investigation are instrumental in understanding the water distribution patterns, particularly within Integrated Water Systems (IWS), and set a precedent for the potential scalability and adaptability of the framework. This study not only sheds light on the specific water management needs of an educational campus but also suggests that the successful application of this system in such a dynamic and varied setting indicates its potential for broader application, thereby contributing to more informed decision-making and promoting sustainable water management practices in various contexts.

The commercial success of online retailing platforms relies on sophisticated technological advancements of recommender systems. As online marketplaces gain popularity it becomes crucial to provide accurate product suggestions to make personalized shopping experience more exciting for the online customer. The evolution of recommendation systems from using collaborative and content-based approaches to more advanced deep learning-based approaches provide motivation as well the necessity to leverage more advanced tools for creating recommendation systems more powerful. Among variety of e-commerce products, this work concentrates on the apparels section, specifically coming under men’s shirt category. In this work, we introduce a Hybrid Recommender System that combines content based and item-based collaborative filtering strategies. To implement the content-based filtering approach we employ text-representation techniques. These methods carefully analyze how users interact with product specifications to understand their nuanced preferences. We also propose a cascading transformer mechanism for generating contextually aware representations using sentence transformers derived from Large Language Models (LLMs) T5 and BERT. To gauge the emotional tone and sentiment associated with product reviews, we make use of rule-based and embedding based sentiment analysis models. A weighted score mechanism has been used to determine the final recommendations by the proposed system. Finally, we discuss the efficiency of the proposed filtering technique and compare various text representation methods along with popular baseline transformer models. The introduced hybrid recommendation system with the proposed cascaded model was evaluated and found to give recommendations with 94.76% similarity score while FastText achieved 66.90%. Doc2Vec and Word2Vec resulted in recommendations with 46.62% and 47.70% similarity respectively.

This study evaluated the long-term effects of mesophilic (MAD) and thermophilic (TAD) anaerobic digestion on the fate and evolution of antimicrobial resistance genes (ARGs) and mobile genetic elements (MGEs) in cattle manure following a metagenomic approach. The results indicated that MAD and TAD lowered ARG levels in fresh cattle manure by over 50 % and MGEs by over 65 %. However, no statistically significant difference was observed between the MAD and TAD processes in terms of their ability to reduce ARG and MGE. Co-occurrence analysis suggested facultative anaerobic species belonging to the Bacillota and Actinomycetota phyla as the primary potential hosts of ARGs and MGEs. Analyses of co-assembled contigs revealed the presence of transposon and toxin-antitoxin systems in close proximity to ARGs typically found in anaerobic digesters. The identification of these systems near ARGs is particularly significant, as it highlights a potential mechanism for the persistence and spread of ARGs in such environments. Overall, the results indicated that digested cattle manure (whether under mesophilic or thermophilic conditions) would pose a much lower risk of dissemination of antimicrobial resistance than untreated manures. Since TAD did not outperform MAD at reducing ARGs and MGEs, thermophilic temperatures may not be necessary to improve ARG reduction rates in cattle manure AD. These valuable insights could help develop strategies to reduce the dissemination of antibiotic resistance due to manure treatment and disposal.

ABSTRACTThe microbiological content of water is an ongoing concern in First Nations communities in Canada. Many communities lack water treatment plants and continue to be under drinking water advisories. However, lack of access to treatment plants is only a part of the problem as poor water distribution systems also contribute to the failure to provide safe drinking water. Here, we studied the microbial diversity and antibiotic resistome from water stored in cisterns from two First Nations communities in Manitoba, Canada. We found that the cistern water contained a high number of bacteria and showed the presence of diverse antimicrobial resistance genes. Interestingly, the bacterial diversity and antimicrobial resistance genes varied considerably from that of the untreated source water, indicating that the origin of contamination in the cistern water came from within the treatment plant or along the delivery route to the homes. Our study highlights the importance of proper maintenance of the water distribution system in addition to access to water treatment facilities to ensure a supply of safe water to First Nations communities in Canada.IMPORTANCEThe work described addresses a critical issue in First Nations communities in Canada—the microbiological content of water. Many of these communities lack access to water treatment plants and frequently experience drinking water advisories. This study focused on the microbial diversity and antibiotic resistome in water stored in cisterns within two First Nations communities in Manitoba, Canada. These findings reveal that cistern water, a common source of drinking water in these communities, contains a high number of bacteria and a wide range of antimicrobial resistance genes. This highlights a serious health risk as exposure to such water can lead to the spread of drug-resistant infections, posing a threat to the well-being of the residents.

ABSTRACTAcinetobacter baumannii is a Gram-negative, opportunistic pathogen that causes infections in the immunocompromised. With a high incidence of muti-drug resistance, carbapenem-resistant A. baumannii is designated as a priority 1 pathogen by the WHO. The current literature has expertly characterized clinical isolates of A. baumannii. As the challenge of these infections has recently been classified as a One Health issue, we set out to explore the diversity of isolates from human and non-clinical sources, such as agricultural surface water, urban streams, various effluents from wastewater treatment plants, and food (tank milk); and, importantly, these isolates came from a wide geographic distribution. Phylogenomic analysis considering almost 200 isolates showed that our diverse set is well-differentiated from the main international clones of A. baumannii. We discovered novel sequence types in both hospital and non-clinical settings and five strains that overexpress the resistance-nodulation-division efflux pump adeIJK without changes in susceptibility reflected by this overexpression. Furthermore, we detected a bla ADC-79 in a non-human isolate despite its sensitivity to all antibiotics. There was no significant differentiation between the virulence profiles of clinical and non-clinical isolates in the Galleria mellonella insect model of virulence, suggesting that virulence is neither dependent on geographic origin nor isolation source. The detection of antibiotic resistance and virulence genes in non-human strains suggests that these isolates may act as a genetic reservoir for clinical strains. This endorses the notion that in order to combat multi-drug-resistant infection caused by A. baumannii, a One Health approach is required, and a deeper understanding of non-clinical strains must be achieved.IMPORTANCEThe global crisis of antibiotic resistance is a silent one. More and more bacteria are becoming resistant to all antibiotics available for treatment, leaving no options remaining. This includes Acinetobacter baumannii. This Gram-negative, opportunistic pathogen shows a high frequency of multi-drug resistance, and many strains are resistant to the last-resort drugs carbapenem and colistin. Research has focused on strains of clinical origin, but there is a knowledge gap regarding virulence traits, particularly how A. baumannii became the notorious pathogen of today. Antibiotic resistance and virulence genes have been detected in strains from animals and environmental locations such as grass and soil. As such, A. baumannii is a One Health concern, which includes the health of humans, animals, and the environment. Thus, in order to truly combat the antibiotic resistance crisis, we need to understand the antibiotic resistance and virulence gene reservoirs of this pathogen under the One Health continuum.

Particulate matter (PM) is considered the primary contributor to air pollution and has severe implications for general health. PM concentration has high spatial variability and thus needs to be monitored locally. Traditional PM monitoring setups are bulky, expensive, and cannot be scaled for dense deployments. This paper argues for a densely deployed network of IoT-enabled PM monitoring devices using low-cost sensors, specifically focusing on PM10 and PM2.5, the most health-impacting particulates. In this work, 49 devices were deployed in a region of the Indian metropolitan city of Hyderabad, of which 43 devices were developed as part of this work, and six devices were taken off the shelf. The low-cost sensors were calibrated for seasonal variations using a precise reference sensor and were particularly adjusted to accurately measure PM10 and PM2.5 levels. A thorough analysis of data collected for 7 months has been presented to establish the need for dense deployment of PM monitoring devices. Different analyses such as mean, variance, spatial interpolation, and correlation have been employed to generate interesting insights about temporal and seasonal variations of PM10 and PM2.5. In addition, event-driven spatio-temporal analysis is done for PM2.5 and PM10 values to understand the impact of the bursting of firecrackers on the evening of the Diwali festival. A web-based dashboard is designed for real-time data visualization.

Introduction: The burden of hearing impairment in India is substantially high, largely preventable, and avoidable. The present study aimed to estimate the prevalence of hearing impairment using a smartphone-based tool among medical students and to study the factors associated, including personal audio device usage in a medical college hospital in Delhi, India. Material and Methods: We conducted a cross-sectional study among undergraduate medical students. The study participants were enrolled via. Stratified random sampling. We assessed hearing impairment via—HearWHO application with scores ranging from a minimum of 0 to a maximum of 100 with categorization into i) above 75 ii) 50-75 iii) below 50. A p-value less than 0.05 was considered statistically significant. Results: A total of 96 study participants were included, with the mean age of study participants as 20.3±1.4 years. On assessment with HearWHO, 36 (37.5%) were in the category of score above 75, 51 (53.1%) in score category 50-75, and 9 (9.4%) in score below 50. The overall mean score of the hearing assessment was 68.9±13.4 (Range: 12 to 94). Among the earphone device users, 27.1% do not comply with volume alerts on user devices. Conclusion: Among the study population, 9.4% of the study participants were likely to be having hearing loss and 53.1% should be screened regularly for hearing impairment. Addressing hearing loss remains crucial among the young population, especially the medical professionals, which is feasible and imperative in the current scenario.

Summary: Understanding the cell biological mechanisms that enable tumor cells to persist after therapy is necessary to improve the treatment of recurrent disease. Here, we demonstrate that transient receptor potential channel 6 (TRPC6), a channel that mediates calcium entry, contributes to the properties of breast cancer stem cells, including resistance to chemotherapy, and that tumor cells that persist after therapy are dependent on TRPC6. The mechanism involves the ability of TRPC6 to regulate integrin α6 mRNA splicing. Specifically, TRPC6-mediated calcium entry represses the epithelial splicing factor ESRP1 (epithelial splicing regulatory protein 1), which enables expression of the integrin α6B splice variant. TRPC6 and α6B function in tandem to facilitate stemness and persistence by activating TAZ and, consequently, repressing Myc. Therapeutic inhibition of TRPC6 sensitizes triple-negative breast cancer (TNBC) cells and tumors to chemotherapy by targeting the splicing of α6 integrin mRNA and inducing Myc. These data reveal a Ca2+-dependent mechanism of chemotherapy-induced persistence, which is amenable to therapy, that involves integrin mRNA splicing.

Two major future challenges are an increase in global earth temperature and a growing world population, which threaten agricultural productivity and nutritional food security. Underutilized crops have the potential to become future climate crops due to their high climate-resilience and nutritional quality. In this context, C4 pseudocereals such as grain amaranths are very important as C4 crops are more heat tolerant than C3 crops. However, the thermal sensitivity of grain amaranths remains unexplored. Here, Amaranthus hypochondriacus was exposed to heat stress at the vegetative and reproductive stages to capture heat stress and recovery responses. Heat Shock Factors (Hsfs) form the central module to impart heat tolerance, thus we sought to identify and characterize Hsf genes. Chlorophyll content and chlorophyll fluorescence (Fv/Fm) reduced significantly during heat stress, while malondialdehyde (MDA) content increased, suggesting that heat exposure caused stress in the plants. The genome-wide analysis led to the identification of thirteen AhHsfs, which were classified into A, B and C classes. Gene expression profiling at the tissue and developmental scales resolution under heat stress revealed the transient upregulation of most of the Hsfs in the leaf and inflorescence tissues, which reverted back to control levels at the recovery time point. However, a few Hsfs somewhat sustained their upregulation during recovery phase. The study reported the identification, physical location, gene/motif structure, promoter analysis and phylogenetic relationships of Hsfs in Amaranthus hypochondriacus. Also, the genes identified may be crucial for future gene functional studies and develop thermotolerant cultivars.

Introduction: Urinary tract infection during pregnancy and postpartum is a common obstetric complication. The term Mutrakruchhacomes under the disorders of MutravahaSrotas, and mainly deals with shool (pain) and krucchrata (dysuria). This article discusses a female patient with a history of 6 months 24 days of pregnancy seen in the OPD of Prasuti Tantra, Sir SundarlalHospital, IMS, BHU. Main Clinical Finding: Her chief complaints were painful, difficult urination with burning along with pain in the suprapubic region for 8 days. Diagnosis: In this case, the patient has an urge to micturate, but she passes urine with pain. The painful voiding of urine is diagnosed as Mutrakruchha. Interventions: After appropriate analysis based on ayurvedic and modern parameters, the patient was treated with Trinapanchmulakwath. Outcome: Before treatment, her scoring of subjective parameters was 13 and after treatment, her score decreased to 2. Thus, the treatment module showed significant relief in the symptoms by 84.62%. Laboratory investigation showed marked improvement as pus cells were reduced to 0–1/high power field (HPF) from 10 to 12/HPF and epithelial cells were reduced to 1–2/HPF from 9 to 10/HPF. Conclusions: All the symptoms and investigations showed highly significant results, hence it can be concluded that this medicine is very effective in patients of garbhinimutrakruchha.

Background: Healthcare workers have dealt with a range of psychological problems during the COVID 19 epidemic, including sadness, mental discomfort, anxiety, and poor sleep. Burnout is a state of prolonged work stress-related psychological, emotional, and physical stress brought on by emotional weariness, depersonalization, and decreasing professional success. The goal of this study was to find out how many healthcare workers burned out during the Omicron wave of the COVID-19 pandemic and to find out what factors put them at risk for this psychological effect. Methods: This cross-sectional research was performed in Syria during the current Omicron wave of COVID-19 pandemic to evaluate the Burnout experienced by Syrian physicians who treat COVID-19 patients. The inclusion criteria were all Syrian healthcare workers who treated COVID-19 patients the current Omicron wave of COVID-19. The data was collected between April 3 and March 20, 2022. We investigated whether the questionnaire used was valid and understandable to the participants. Results: A total of (729) healthcare providers inquired in our study; however, 30 participants were disqualified because their answers were not fully completed. The overall age of the participants was 31±9, and the ratio of males to females was almost equal. The majority (47.5%) of the sample study's participants are residents, and 72.8% of the participants carried for COVID19 patients. The prevalence of high level of burnout among the sample study was 41.6%. Compared to men (22.3%), women were much more likely (27.9%) to report experiencing a high degree of emotional exhaustion, also the participants who carried for COVID19 patients were much more likely (30.1%%) to report experiencing a high degree of emotional exhaustion compared to others, which individuals who carried for COVID19 patients were 1.76 times more likely than participants who did not carry for COVID19 patients to experience severe burnout (OR:1.766, 95%CI:1.2-2.4, P-value

Abstract Healthcare-associated infections (HAIs) are an important global issue, leading to poor patient outcomes. A potential route of transmission of HAIs is through contact with hospital privacy curtains. The aim of this study is to evaluate cleaning on reduction of curtain bacterial burden. In this pilot cluster randomized controlled trial we compared the bacterial burden between three groups of 24 curtains on a regional burn/plastic surgery ward. A control group was not cleaned. Two groups were cleaned at 3–4 day intervals with either disinfectant spray or wipe. The primary outcome was the difference in mean CFU/cm2 between day 0 to day 21. The secondary outcome was the proportion of curtains contaminated with Methicillin-resistant Staphylococcus aureus (MRSA). By day 21, the control group was statistically higher (2.2 CFU/cm2) than spray (1.3 CFU/cm2) or wipe (1.5 CFU/cm2) (p

The study aims to fabricate and characterize polyester-nanoclay nanocomposites using different weight percentages of nanoclay. Nanoclay is mixed into polyester resin using a mechanical stirrer and a sonicator. The mixture is molded into specimens that meet ASTM standards. The nanoclay addition improved mechanical properties, thus lowering the water uptake of polyester-nanoclay nanocomposites. The causes of specimen failure are discovered using scanning electron microscopy images. A wear test on a pin-on-disc apparatus involves 4 factors, viz., nanoclay wt.%, speed, load, and time at 3 levels. Response surface methodology (RSM)'s ''central composite face-centered design'' is used to investigate individual factor's influence on the wear property of a polyester-nanoclay nanocomposite. The addition of nanoclay increased the wear resistance of polyester, according to the results.

Many bacteria use the second messenger cyclic diguanylate (c-di-GMP) to control motility, biofilm production and virulence. Here, the authors identify a thermosensitive enzyme that synthesizes c-di-GMP and modulates temperature-dependent motility, biofilm development and virulence in the opportunistic pathogen Pseudomonas aeruginosa.

Abstract Background To establish the normal reference range of fetal thorax by two-dimensional (2D) and three-dimensional (3D) ultrasound VOCAL technique and evaluate the application in diagnosing fetal thoracic malformations. Methods A prospective cross-sectional study was undertaken involving 1077 women who have a normal singleton pregnancy at 13–40 weeks gestational age (GA). 2D ultrasound and 3D ultrasound VOCAL technique were utilized to assess fetal thoracic transverse diameter, thoracic anteroposterior diameter, thoracic circumference, thoracic area, lung volume, thoracic volume and lung-to-thoracic volume ratio. The nomograms of 2D and 3D fetal thoracic measurements were created to GA. 50 cases were randomly selected to calculate intra- and inter-observer reliability and agreement. In addition, the case groups including congenital skeletal dysplasia (SD) (15), congenital diaphragmatic hernia (CDH) (30), pulmonary sequestration (PS) (25) and congenital cystic adenomatoid malformation (CCAM) (36) were assessed by the nomograms and followed up subsequently. Results Both 2D and 3D fetal thoracic parameters increased with GA using a quadratic regression equation. The intra- and inter-observer reliability and agreement of each thoracic parameter were excellent. 2D fetal thoracic parameters could initially evaluate the fetal thoracic development and diagnose the skeletal thoracic deformity, and lung volume, thoracic volume and lung-to-thorax volume ratio were practical to diagnose and differentiate CDH, PS and CCAM. Conclusion We have established the normal fetal thoracic reference range at 13–40 weeks, which has a high value in diagnosing congenital thoracic malformations.

Objective: The objective of this study is to provide an overview of the effects of pesticide exposure during pregnancy and to newly born baby with its possible management and preconceptional care through Ayurveda. Data Source: We visited Hisar, Sirsa, Faridabad, and Bhivani cities of Haryana state and interviewed some pregnant ladies and farmers who were in direct contact with pesticide in agriculture or pesticide industries; collected information and assessed its effect on their body. Data were collected from the related websites, conference proceedings, scientific or technical reports, and other documents from the Government of India to identify the relevant information. The detoxification methodology was adopted from the classical text books of Ayurveda and research articles. Review Methods: It is a descriptive literature review-related study. Results: The detail analysis suggests that the pregnant women have greater vulnerability to chemicals, however, may include toxic elements in diet poses health risks to both mother and child. Exposure to pesticides during pregnancy impairs growth and neurodevelopment of growing fetus. There are lot of opportunities can be explored through Panchkarma and medicinal plants described in Ayurveda for preconceptional detoxication Vishghna plants (antitoxic herbs) can prove to be a mile stone for detoxification. Conclusion: This study provides the advantages of detoxification before conception. It will be helpful in causing awareness among the masses about the harmful effects of pesticides exposure and the benefits of Ayurveda for detoxification.

Understanding and predicting cyber malfeasance is an emerging area of research with the increase in cybercrimes and heightened awareness about cybersecurity in recent years. The nature of cybercrimes is also becoming increasingly complex as hackers are more proficient and well-financed than earlier. Thus, our understanding of the various types of hackers and their motivations needs to be consistently updated. We identified and reviewed 11 classifications and typologies of hackers and their motivations published over three decades to consolidate our understanding in this area and summarize the state of the art. Following that, we present a unified framework of 13 hacker types and 7 unique motivations. In addition, we detail the strategies each hacker type typically employs. This framework, applicable to various domains, allows readers to map various motivations to each hacker type and understand that hackers often hold multiple motivations at once. It also allows for the identification of specific hacker types based on the strategies used during a cyberattack.

ABSTRACT Herpesviruses are ubiquitous double-stranded DNA viruses that cause lifelong infections and are associated with a variety of diseases. While they have evolved multiple mechanisms to evade the immune system, they are all recognized by the innate immune system, which can lead to both localized and systemic inflammation. A more recently appreciated mechanism of herpesvirus innate immune activation is through inflammasome signaling. The inflammasome is an intracellular multiprotein complex that, when activated, leads to the release of proinflammatory cytokines, including IL-1β and IL-18, and activation of the inflammatory programed cell death pathway known as pyroptosis. Despite the herpesviruses sharing a similar structure, their mechanisms of inflammasome activation and the consequences of inflammasome activation in cases of virus-associated disease are not uniform. This review will highlight the similarities and differences among herpesviruses with regard to their mechanisms of inflammasome activation and impacts on diseases caused by herpesviruses. Furthermore, it will identify areas where additional studies are warranted to better understand the impact of this important innate immune signaling program on the pathogenesis of these common viruses.

While animal aggregations can benefit the fitness of group members, the behaviour may also lead to higher risks of parasite infection as group density increases. Some animals are known to moderate their investment in immunity relative to the risk of infection. These animals exhibit density-dependent prophylaxis (DDP) by increasing their immune investment as group density increases. Despite being documented in many taxa, the mechanisms of DDP remain largely unexplored. Snails are known to aggregate and experience large fluctuations in density and serve as required hosts for many parasites. Further, they are known to use chemical cues to aggregate. To test whether freshwater snails exhibit DDP and investigate the role that chemical signaling compounds may play in triggering this phenomenon, we performed four experiments on the freshwater snail Stagnicola elodes, which is a common host for many trematode parasite species. First, we tested if DDP occurred in snails in laboratory-controlled conditions (control vs snail-conditioned water) and whether differences in exposure to chemical cues affected immune function. Second, we used gas chromatography to characterize fatty acids expressed in snail-conditioned water to determine if precursors for particular signaling molecules, such as oxylipins, were being produced by snails. Third, we characterized the oxylipins released by infected and uninfected field-collected snails, to better understand how differences in oxylipin cocktails may play a role in inducing DDP. Finally, we tested the immune response of snails exposed to four oxylipins to test the ability of specific oxylipins to affect DDP. We found that snails exposed to water with higher densities of snails and raised in snail-conditioned water had higher counts of haemocytes. Additionally, lipid analysis demonstrated that fatty acid molecules that are also precursors for oxylipins were present in snail-conditioned water. Trematode-infected snails emitted 50 oxylipins in higher amounts, with 24 of these oxylipins only detected in this group. Finally, oxylipins that were higher in infected snails induced naïve snails to increase their immune responses compared to sham-exposed snails. Our results provide evidence that snails exhibit DDP, and the changes in oxylipins emitted by infected hosts may be one of the molecular mechanisms driving this phenomenon.

Recently reported peptidomimetics with increased resistance to trypsin were shown to sensitize priority multidrug-resistant (MDR) Gram-negative bacteria to novobiocin and rifampicin. To further optimize proteolytic stability, β-amino acid-containing derivatives of these compounds were prepared, resulting in three dioctanoyl ultrashort tetrabasic β-peptides (dUSTBβPs). The nonhemolytic dUSTBβP 3, comprised of three β3-homoarginine residues and two fatty acyl tails eight carbons long, enhanced the antibacterial activity of various antibiotics from different classes. Notably, compound 3 retained the ability to potentiate novobiocin and rifampicin in wild-type Gram-negative bacteria against MDR clinical isolates of Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae. dUSTBβP 3 reduced the minimum inhibitory concentration of novobiocin and rifampicin below their interpretative susceptibility breakpoints. Furthermore, compound 3 exhibited improved in vitro stability (86.8 ± 3.7% remaining) relative to its α-amino acid-based counterpart (39.5 ± 7.4% remaining) after a 2 h incubation in human plasma.

Fungi produce numerous secondary metabolites with intriguing biological properties for the health, industrial, and agricultural sectors. Herein, we report the high-yield isolation of phenolic natural products, N-formyl-4-hydroxyphenyl-acetamide 1 (~117 mg/L) and atraric acid 2 (~18 mg/L), from the ethyl acetate extract of the soil-derived fungus, Aspergillus fumigatus. The structures of compounds 1 and 2 were elucidated through the detailed spectroscopic analysis of NMR and LCMS data. These compounds were assayed for their antimicrobial activities. It was observed that compounds 1 and 2 exhibited strong inhibition against a series of fungal strains but only weak antibacterial properties against multi-drug-resistant strains. More significantly, this is the first known instance of the isolation of atraric acid 2 from a non-lichen fungal strain. We suggest the optimization of this fungal strain may exhibit elevated production of compounds 1 and 2, potentially rendering it a valuable source for the industrial-scale production of these natural antimicrobial compounds. Further investigation is necessary to establish the veracity of this hypothesis.

Dear Editor, Sepsis, a potentially fatal outcome, carries an extremely high risk of mortality. Coagulation abnormalities are often considered in association with sepsis. Changes that are significant clinically in terms of signs, symptoms or lab parameters affect up to 70% of septic patients of which 35% meet the criteria for disseminated intravascular coagulation [1]. Septic patients may develop thromboembolic sequela due to coagulopathies, and certain microvascular clots may not be clinically apparent but contribute to multiorgan dysfunction [2]. The risk of requiring intensive care and mortality increases with the severity of sepsis-induced coagulopathy (SIC). Lyon PG et al. reported in their study that hospital-based mortality doubled in patients with SIC from 25.4% in patients without SIC to 56.1% with severe SIC. Moreover, the length of ICU stays increased with the severity of SIC [3]. Despite recent advances in the management of sepsis that have resulted in an increase in the rate of survival, the coagulopathies caused by sepsis have received less attention. In order to prevent an increase in SIC-related mortality, we must address a number of issues, including patient delays in seeking care and hospital delays in acquiring proper health care services. As observed in our clinical practice the delay in treating patients with suitable antibiotics to treat the underlying infection is one of the most common issues noticed. In addition, there is no gold standard investigation for measuring coagulopathy. To monitor anticoagulant therapy, traditional coagulation testing designed as plasma-based tests are insufficient [4]. Sepsis-induced coagulopathy has shown high prevalence but is the least understood clinical issue in critical diseases and actions should be taken to reduce mortality from SIC. It is critical to manage SIC quickly and effectively, as any delay in therapy can increase the chances of negative outcomes [5]. In patients with sepsis who develop thrombocytopenia, the existence of SIC should be thoroughly investigated. The use of specific scoring frameworks, such as thrombocytopenia, delayed prothrombin time, and organ failure as measured by the Sequential Organ Failure Assessment score, should be used to determine the existence of coagulopathy in sepsis. Moreover, there are numerous different conditions that clinically mimic SIC. For instance, in clinical practice, it is frequently confused for heparininduced thrombocytopenia, especially when it occurs in conjunction with organ dysfunction. Given that coagulopathy in sepsis is a dynamic process with multiple manifestations, work should be done to develop an exact, precise, and ideal method to detect this dynamic alteration in sepsis so that patients are not delayed in receiving treatment. Furthermore, proper SIC management guidelines should be defined and implemented globally [6]

Acinetobacter baumannii is classified as a top priority pathogen by the World Health Organization (WHO) because of its widespread resistance to all classes of antibiotics. This makes the need for understanding the mechanisms of resistance and virulence critical. Therefore, tools that allow genetic manipulations are vital to unravel the mechanisms of multidrug resistance (MDR) and virulence in A. baumannii. A host of current strategies are available for genetic manipulations of A. baumannii laboratory-strains, including ATCC® 17978TM and ATCC® 19606T, but depending on susceptibility profiles, these strategies may not be sufficient when targeting strains newly obtained from clinic, primarily due to the latter’s high resistance to antibiotics that are commonly used for selection during genetic manipulations. This review highlights the most recent methods for genetic manipulation of A. baumannii including CRISPR based approaches, transposon mutagenesis, homologous recombination strategies, reporter systems and complementation techniques with the spotlight on those that can be applied to MDR clinical isolates.

Covaxin and Covishield have been granted approval for emergency medical use in India due to the severity of COVID-19. Both vaccines are safe and effective and have a good immunogenic response. There is no difference between Covaxin and Covishield in terms of dosages and both can be administered as 0.5 mL (containing 6 mg of virus antigen for Covaxin and 5×1010 virus particles for Covishield) in the upper arm region. Covaxin and Covishield are designed for a two dose schedule, and it is advised that the second dose of Covaxin be administered 4-6 weeks after the first dose while 12-16 weeks after the first dose for Covishield. These vaccines may have several side effects such as swelling and itching at the injection site, joint pain, dizziness, headache, allergic reaction, increased heartbeat, and fever. Appropriate counselling and suggestion should be provided for any symptoms associated with vaccination so that post-vaccinated issues can be managed. Physician and community pharmacists may play a vital role in the management of adverse drug event associated with vaccines.

Dactyloctenium aegyptium (L.) Willd. and D. aristatum Link. are common grass weeds of cultivated fields in many crops. The two grass weed species growing under same habitat showed characteristic morphological differences of caryopses and seedlings. The identification of weeds at seedling stage may be useful in weed and environment management. Under the light microscopy, features like colour, base, surface, scutellum and hilum of caryopses showed differences between the studied species. D. aegyptium had dark brown caryopses colour, while D. aristatum had grey colour. The base of D. aegyptium was truncate, while D. aristatumhad obtuse base. Both species had rugose surface but in D. aegyptium surface undulations were closely spaced whereas in D. Aristatum it was widely spaced. Similarly seedlings were found distinct with respect to coleoptile shape and size, first leaf sheath surface and first leaf blade shape and surface. D. aegyptium had oblong coleoptile whereas it was obovate in D. aristatum. The leaf sheath and leaf blade were recorded glabrous and hairy in D. aegyptium and in D. aristatum respectively. Both species studied hereby, showed remarkable differentiations in their characters, thus indicating that the morphological attributes of caryopses and seedling can be exploited taxonomically and for crop and weed management.