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Tenofovir disoproxil fumarate (TDF) is increasingly used in the highly active antiretroviral therapy (HAART) regimens of pregnant women, but limited data exist on the pregnancy pharmacokinetics of chronically dosed TDF. This study described tenofovir pharmacokinetics during pregnancy and postpartum. Methods: International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) P1026s is a prospective, nonblinded pharmacokinetic study of HIV-infected pregnant women that included a cohort receiving 300mg TDF once daily. Steady-state 24-hour pharmacokinetic profiles were measured at the second and third trimesters, postpartum, and in maternal and umbilical cord samples collected at delivery. Tenofovir was measured by liquid chromatography-mass spectrometry (LC-MS). The target area under the concentration versus time curve from time 0 to 24h post dose (AUC) was ≥1.99μg h/mL (nonpregnant historical control 10th percentile). Results: The median tenofovir AUC was decreased during the second (1.9μg h/mL) and third (2.4μg h/mL; P=0.005) trimesters versus postpartum (3.0μg h/mL). Tenofovir AUC exceeded the target for two of four women (50%) in the second trimester, 27 of 37 women [73%; 95% confidence interval (CI) 56%, 86%] in the third trimester, and 27 of 32 women (84%; 95% CI 67%, 95%) postpartum (P>0.05). Median second/third-trimester troughs were lower (39/54ng/mL) than postpartum (61ng/mL). Median third-trimester weight was greater for subjects below the target AUC versus those above the target (97.9 versus 74.2kg, respectively; P=0.006). The median ratio of cord blood to maternal concentrations was 0.88. No infants were HIV infected. Conclusions: This study found lower tenofovir AUC and troughs during pregnancy. Transplacental passage with chronic TDF use during pregnancy was high. Standard TDF doses appear to be appropriate for most HIV-infected pregnant women but therapeutic drug monitoring with dose adjustment should be considered in pregnant women with high weight (>90kg) or inadequate HIV RNA response.

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.Setting Prospective, international, multicentre, observational cohort study.Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration number NCT04323644

Objective: Humans have a limited ability to accurately and continuously analyse large amount of data. In recent times, there has been a rapid growth in patient monitoring and medical data analysis using smart monitoring systems. Fuzzy logic-based expert systems, which can mimic human thought processes in complex circumstances, have indicated potential to improve clinicians' performance and accurately execute repetitive tasks to which humans are ill-suited. The main goal of this study is to develop a clinically useful diagnostic alarm system based on fuzzy logic for detecting critical events during anaesthesia administration.Method: The proposed diagnostic alarm system called fuzzy logic monitoring system (FLMS) is presented. New diagnostic rules and membership functions (MFs) are developed. In addition, fuzzy inference system (FIS), adaptive neuro fuzzy inference system (ANFIS), and clustering techniques are explored for developing the FLMS' diagnostic modules. The performance of FLMS which is based on fuzzy logic expert diagnostic systems is validated through a series of off-line tests. The training and testing data set are selected randomly from 30 sets of patients' data.Results: The accuracy of diagnoses generated by the FLMS was validated by comparing the diagnostic information with the one provided by an anaesthetist for each patient. Kappa-analysis was used for measuring the level of agreement between the anaesthetist's and FLMS's diagnoses. When detecting hypovolaemia, a substantial level of agreement was observed between FLMS and the human expert (the anaesthetist) during surgical procedures.Conclusion: The diagnostic alarm system FLMS demonstrated that evidence-based expert diagnostic systems can diagnose hypovolaemia, with a substantial degree of accuracy, in anaesthetized patients and could be useful in delivering decision support to anaesthetists. [ABSTRACT FROM AUTHOR]

Objective: This research was conducted to assess the therapeutic advantage of combined letrozole and clomiphene citrate versus monotherapy for polycystic ovarian syndrome (PCOS) patients., Study Design: Five databases were searched using the search string: (letrozole and clomiphene) AND (clomiphene OR clomiphene citrate OR CC) AND (letrozole OR LE) AND (ovulation induc* OR fertility induc* OR fertility preserv*) AND (polycystic ovarian syndrome OR PCOS). All statistical analyses were conducted in Review Manager 5.4.1. Random effect-effect model was used to pool risk ratio (RR), mean difference (MD), and odds ratio (OR) and their corresponding 95% confidence interval (CI). Moreover, qualitative analysis was conducted to qualitatively analyze ovulation, secondary outcomes, and cycle characteristics., Results: One clinical trial and three randomized clinical trials (RCTs) were used in the study. Two studies were used in a quantitative analysis showing that combination was superior for ovulation induction (RR = 1.86 [1.37, 2.53]; p  < 0.0001; I  = 0%), but the number of follicles ≥15 mm was significantly associated with the combination (MD = 0.40[0.14, 0.66]; 2  = 0%), but the number of follicles ≥15 mm was significantly associated with the combination (MD = 0.40[0.14, 0.66]; p  = 0.002; I 2  = 0%). On subgroup analysis, only hot flushes were significantly associated with the combination (RR = 2.67[1.12, 6.36]; p  = 0.03; I 2  = 0%). The meta-analysis of two studies reported a significantly higher ovulation rate and number of dominant follicles in the combination therapy group compared with the LE alone arm but no significant difference in pregnancy rate, endometrial thickness, and adverse events., Conclusion: Our study demonstrates a significant effect of the combination on ovulation induction. The combination yielded a better chance of conception and viable pregnancy. Further studies are needed to determine the live birth rate. HighlightsCombined Letrozole and Clomiphene is superior to either of these drugs alone for ovulation induction in PCOS.Our results conclude that the combination results in better ovulation, cycle characteristics, and secondary changes.Only the incidence of hot flushes as an adverse effect is increasingly reported in combination.

Bioelectronics, a field pivotal in monitoring and stimulating biological processes, demands innovative nanomaterials as detection platforms. Two-dimensional (2D) materials, with their thin structures and exceptional physicochemical properties, have emerged as critical substances in this research. However, these materials face challenges in biomedical applications due to issues related to their biological compatibility, adaptability, functionality, and nano-bio surface characteristics. This review examines surface modifications using covalent and non-covalent-based polymer-functionalization strategies to overcome these limitations by enhancing the biological compatibility, adaptability, and functionality of 2D nanomaterials. These surface modifications aim to create stable and long-lasting therapeutic effects, significantly paving the way for the practical application of polymer-functionalized 2D materials in biosensors and bioelectronics. The review paper critically summarizes the surface functionalization of 2D nanomaterials with biocompatible polymers, including g-C 3 N 4 , graphene family, MXene, BP, MOF, and TMDCs, highlighting their current state, physicochemical structures, synthesis methods, material characteristics, and applications in biosensors and bioelectronics. The paper concludes with a discussion of prospects, challenges, and numerous opportunities in the evolving field of bioelectronics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Micro-supercapacitors (MSCs) have attracted significant attention for potential applications in miniaturized electronics due to their high power density, rapid charge/discharge rates, and extended lifespan. Despite the unique properties of low-dimensional nanomaterials, which hold tremendous potential for revolutionary applications, effectively integrating these attributes into MSCs presents several challenges. 3D printing is rapidly emerging as a key player in the fabrication of advanced energy storage devices. Its ability to design, prototype, and produce functional devices incorporating low-dimensional nanomaterials positions it as an influential technology. In this review, we delve into recent advancements and innovations in micro-supercapacitor manufacturing, with a specific focus on the incorporation of low-dimensional nanomaterials using direct ink writing (DIW) 3D printing techniques. We highlight the distinct advantages offered by low-dimensional nanomaterials, from quantum effects in 0D nanoparticles that result in high capacitance values to rapid electron and ion transport in 1D nanowires, as well as the extensive surface area and mechanical flexibility of 2D nanosheets. Additionally, we address the challenges encountered during the fabrication process, such as material viscosity, printing resolution, and seamless integration of active materials with current collectors. This review highlights the remarkable progress in the energy storage sector, demonstrating how the synergistic use of low-dimensional nanomaterials and 3D printing technologies not only overcomes existing limitations but also opens new avenues for the development and production of advanced micro-supercapacitors. The convergence of low-dimensional nanomaterials and DIW 3D printing heralds the advent of the next generation of energy storage devices, making a significant contribution to the field and laying the groundwork for future innovations.

Given India's goal of eliminating malaria by 2030, this study aimed to investigate community perspectives on malaria in highly endemic areas of Odisha, a region historically prone to malaria. The research explores self-reported malaria events, community knowledge, attitudes, practices, health-seeking behaviors, and access to healthcare services. A community-based cross-sectional survey conducted among 387 households between November 2022 and May 2023 served as an extension of our recent project, monitoring malaria elimination efforts in remote and challenging-to-reach communities in Odisha. The participants, who had a mean (SD) age of 41.7 (13.17) years, were predominantly male (88.4%). Self-reported malaria in the last 12 months prior to the survey was 6.2%, with half of the patients opting for primary health centers for treatment, averaging a 5-day recovery per episode. The median cost per malaria treatment episode was U.S. dollars 20.17. A significant majority (79.8%) demonstrated a strong awareness of malaria symptoms and transmission, with 83.3% expressing a favorable attitude toward disease prevention. Notably, 65.1% reported consistent use of long-lasting insecticidal nets. However, nearly half of the participants reported inadequate larval source management and indoor residual spraying services. Although there were slight variations in knowledge, attitude, and practice scores among demographic groups, the overall understanding of and approach to malaria were consistent in the study population, with no statistically significant differences (P >0.05). The study findings offer hope, suggesting that with sustained dedication and focused surveillance, malaria could become a thing of the past.

According to an estimate, 30% to 40%, of global fruit are wasted, leading to post harvest losses and contributing to economic losses ranging from $10 to $100 billion worldwide. Among, all fruits the discarded portion of oranges is around 20%. A novel and value addition approach to utilize the orange peels is in nanoscience. In the present study, a synthesis approach was conducted to prepare the metallic nanoparticles (copper and silver); by utilizing food waste (Citrus plant peels) as bioactive reductants. In addition, the Citrus sinensis extracts showed the reducing activity against metallic salts copper chloride and silver nitrate to form Cu-NPs (copper nanoparticles) and Ag-NPs (Silver nanoparticles). The in vitro potential of both types of prepared nanoparticles was examined against plant pathogenic bacteria Erwinia carotovora (Pectobacterium carotovorum) and pathogens effect on human health Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). Moreover, the in vivo antagonistic potential of both types of prepared nanoparticles was examined by their interaction with against plant (potato slices). Furthermore, additional antipathogenic (antiviral and antifungal) properties were also examined. The statistical analysis was done to explain the level of significance and antipathogenic effectiveness among synthesized Ag-NPs and Cu-NPs. The surface morphology, elemental description and size of particles were analyzed by scanning electron microscopy, transmission electron microscopy, energy-dispersive spectroscopy and zeta sizer (in addition polydispersity index and zeta potential). The justification for the preparation of particles was done by UV-Vis Spectroscopy (excitation peaks at 339 nm for copper and 415 nm for silver) and crystalline nature was observed by X-ray diffraction. Hence, the prepared particles are quite effective against soft rot pathogens in plants and can also be used effectively in some other multifunctional applications such as bioactive sport wear, surgical gowns, bioactive bandages and wrist or knee compression bandages, etc., (© 2024. The Author(s).)

Objective: Endometrial carcinoma is the most widespread gynecological cancer, with increasing morbidity and mortality. Pembrolizumab, a monoclonal antibody that targets PD1 receptor tumors, is approved for patients with microsatellite instability-high (MSI-H) solid tumors. Many clinical trials and observational studies have been conducted to assess the safety and efficacy of Lenvatinib and Pembrolizumab combination therapy in the setting of endometrial cancer. However, results have been inconsistent, and current data is based on a heterogeneous population. The primary objective was to assess the safety and efficacy of Lenvatinib plus Pembrolizumab for endometrial cancer., Data Sources: The search was conducted from inception from four databases; PubMed, Google Scholar, the Cochrane Library, and ClinicalTrials.gov. The electronic database search was conducted from inception to August 20, 2023., Study Eligibility Criteria: We considered randomized controlled trials and single-arm observational studies, i.e. cohort, case-control and cross-sectional studies., Methodology: We performed a single-arm meta-analysis, involving 7 studies having a total of 495 patients with endometrial cancer were eventually included which had the following outcomes: Complete response, Partial response, Progression-free survival, stable disease, progressive disease, safety outcomes, Adverse events, and the total number of deaths., Results: Our results showed that 88.6 % of the patients were positive for non-MSI-H/pMMR tumors (95 % CI = 0.825-0.927) whereas 6.5 % (95 % CI = 3.8-9.8 %) of the patients for MSI-H/dMMR tumors. The pooled objective response of endometrial cancer patients treated with Lenvatinib and Pembrolizumab was 36.5 % (95 % CI = 0.258-0.471), the pooled estimate of complete and partial response was 47 % (95 % CI = 0.024-0.070) and 31.3 % (95 % CI = 0.230-0.396). 38.2 % patients had stable disease (95 % CI = 0.329-0.435) and 24.0 % patients had progressive disease (95 % CI = 0.103-0.378). The pooled median progression-free survival was 5.97 (95 % CI 5.43-7.63) months and, whereas the median overall survival was 17.19 months (95 % CI 15.34-19.31). All grade adverse events occurred in 85 % and Grade 3 or worse adverse events occurred in 39 % of patients during the therapy whereas death occurred in 23.8 % during the treatment., Conclusion: The results of this meta-analysis concludes that although the combined treatment of a Lenvatinib and Pembrolizumab had a PFS and OS that was inferior to the standard therapy used to treat advanced and recurrent endometrial cancer, it is still a novel treatment and shows potential for further research with a greater sample size., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

An outbreak of dengue fever struck Tikarapada village, Rayagada district (April 2020). Among 117 fever cases, 49 tested positive for the dengue NS1 antigen. To identify mosquito-related factors in the outbreak, a survey of 101 houses found Aedes breeding sites in 11.6% of containers. Aedes aegypti (79%) and Aedes albopictus (21%) emerged from collected pupae. The village exhibited high (house index = 24.8), (container index = 11.6), (pupal index = 32.7), and (Breteau index = 40.6) indices. The findings confirmed the presence of Aedes and ample breeding sites, suggesting their role in the outbreak. A report recommending integrated vector control measures was submitted to district and state health authorities., (Copyright © 2024 Copyright: © 2024 Indian Journal of Public Health.)

Background: The integration of large language models (LLMs) like ChatGPT in diagnostic medicine, with a focus on digital pathology, has garnered significant attention. However, understanding the challenges and barriers associated with the use of LLMs in this context is crucial for their successful implementation., Methods: A scoping review was conducted to explore the challenges and barriers of using LLMs, in diagnostic medicine with a focus on digital pathology. A comprehensive search was conducted using electronic databases, including PubMed and Google Scholar, for relevant articles published within the past four years. The selected articles were critically analyzed to identify and summarize the challenges and barriers reported in the literature., Results: The scoping review identified several challenges and barriers associated with the use of LLMs in diagnostic medicine. These included limitations in contextual understanding and interpretability, biases in training data, ethical considerations, impact on healthcare professionals, and regulatory concerns. Contextual understanding and interpretability challenges arise due to the lack of true understanding of medical concepts and lack of these models being explicitly trained on medical records selected by trained professionals, and the black-box nature of LLMs. Biases in training data pose a risk of perpetuating disparities and inaccuracies in diagnoses. Ethical considerations include patient privacy, data security, and responsible AI use. The integration of LLMs may impact healthcare professionals' autonomy and decision-making abilities. Regulatory concerns surround the need for guidelines and frameworks to ensure safe and ethical implementation., Conclusion: The scoping review highlights the challenges and barriers of using LLMs in diagnostic medicine with a focus on digital pathology. Understanding these challenges is essential for addressing the limitations and developing strategies to overcome barriers. It is critical for health professionals to be involved in the selection of data and fine tuning of the models. Further research, validation, and collaboration between AI developers, healthcare professionals, and regulatory bodies are necessary to ensure the responsible and effective integration of LLMs in diagnostic medicine., (© 2024. The Author(s).)

Objective: Using cone beam computed tomography (CBCT), this study compared three rotary file systems-XP Endoshaper, Hyflex CM, and K3 XF-for centering, canal transportation, and root canal area growth., Materials and Methods: The rotating file system randomly separated 60 removed human mandibular molars into three groups ( n = 20). Manufacturer-recommended root canal instrumentation was done. Specialized software examined pre- and post-instrumentation CBCT scans. Centering ability was measured by canal transportation and root canal area expansion at different levels from the apex., Results: The Hyflex CM file system had the best centering and the least canal transit at all levels ( P < 0.05). XP Endoshaper increased the root canal area the most ( P < 0.05). The K3 XF file system had average centering and canal transfer results., Conclusion: The Hyflex CM system centered well, whereas the XP Endoshaper system increased the root canal area the most. The clinical context and therapeutic goals should determine the rotating file system., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Aim: The aim of the current study was to evaluate the dimensional accuracy of three various interocclusal recording materials., Materials and Methods: A total of 90 disc-shaped samples were prepared using polyether paste, wax, and polyvinyl siloxane material with the support of stainless steel die. For the purposes of this investigation, three frequently utilized interocclusal recording materials were chosen, and 30 samples from each material were prepared. Group I: Bite registration using polyether paste; Group II: Bite registration using wax; Group III: Bite registration using polyvinyl siloxane material. No samples were exposed to direct sunlight during storage and were kept at room temperature. Using a 10x universal measuring microscope, each sample disc was examined for the presence of horizontal and vertical lines inscripted in the die. For each of the samples, readings were taken at different time periods of 24, 48, and 72 hours., Results: After 24 hours, the less dimensional changes were found in polyether paste group (0.11 ± 0.07) followed by polyvinyl siloxane material group (0.19 ± 0.04) and wax group (0.25 ± 0.12). After 48 hours, the less dimensional changes were found in polyether paste group (0.34 ± 0.02) followed by polyvinyl siloxane material group (0.42 ± 0.01) and wax group (0.94 ± 0.12). After 72 hours, the least dimensional changes were found in polyether paste group (0.46 ± 0.14) followed by polyvinyl siloxane material group (0.92 ± 0.03) and wax group (1.14 ± 0.09)., Conclusion: The present study concluded that both the material and time factors had an impact on dimensional stability. The most dimensionally stable group was the polyether paste group, which was followed by the polyvinyl siloxane and wax material groups., Clinical Significance: Interocclusal recording material records the occlusal connection between real or artificial teeth for occlusal rehabilitation planning and for creating removable and fixed dentures. The creation of a clinically acceptable prosthesis is dependent upon the accuracy of the patient's diagnostic or working casts and the interocclusal record. How to cite this article: Sonkesriya S, Subramanian D, Saha P, et al . In Vitro Assessment of Dimensional Accuracy of Three Different Types of Interocclusal Recording Materials. J Contemp Dent Pract 2023;24(12):936-939.

In many electronic applications, the dielectric and structural properties of reinforced composites are vital. In this research work, the influence of fiber proportion on the properties of a silica fiber/epoxy (SFE) composite was investigated. The structure, morphology, dielectric constant and loss factor, mechanical properties, and thermal stability were determined. The increase of wt.% of silica fiber (SiO 2 (f) ) x = 30 to 90, reduced the dielectric constant (εr) and dielectric loss (δ) of the SFE composite from their original values to 18.9% and 48.5%, lowering local charge displacement towards the applied electric field. The SFE composite showed higher mechanical properties with the increase in SiO 2 (f) , x = 30 to 80, the tensile strength (UTS) was raised from 91.6 MPa to 155.7 MPa, the compression strength (UCS) was increased from 261.1 MPa to 409.6 MPa and the flexural strength was enhanced from 192.3 MPa to 311.9 MPa. Upon further addition of SiO 2 (f) to the composite, i.e., x = 90, the mechanical properties were reduced a little, but the dielectric properties were not changed. Increasing SiO 2 (f) improved the thermal stability as weight loss was found to be 69% (x = 30) and 24% (x = 90), and average moisture absorption was found to be 1.1 to 1.8%. A silica fiber/epoxy composite, for microelectronics, can be made from a low-cost fiber, and its dielectric properties as well as its mechanical and thermal stability can be tuned or improved by varying fiber fractions.

In the present work, Mg 1- x Zn x Fe 2 O 4 (MZFO) nanoparticles with x = 0.0, 0.2, 0.35, and 0.5 were synthesized via a chemical coprecipitation method. The study aimed to explore the effect of substituting Mg with Zn in MZFO on its structural, dielectric, and gas-sensing properties. The spinel phase formation was confirmed using X-ray diffraction, and the morphology of the prepared nanoparticles was revealed using scanning electron microscopy. Fourier transform infrared spectroscopy (FTIR) analysis confirmed the band ranges of 500-600 cm -1 for tetrahedral and 390-450 cm -1 for octahedral lattice sites. The dielectric data showed that Zn substitution in MZFO decreased both the dielectric constant and loss with increasing frequencies and attained a stagnant value at higher frequencies. Furthermore, the gas-sensing characteristics of Zn-substituted spinel ferrites at room temperature for CO 2 , O 2 , and N 2 were studied. The nanostructured MZFO exhibited high sensitivity in the order of CO 2 > O 2 ≫ N 2 and showed a good response time of (∼1 min) for CO 2 , demonstrating that MZFO can be a good potential candidate for gas-sensing applications., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Aim: The purpose of this study is to assess the efficacy of various disinfection and hemostasis procedures in providing postoperative pain relief following pulpotomy in cases of symptomatic irreversible pulpitis., Materials and Methods: The data from a cohort of 50 patients who received treatment with sodium hypochlorite (NaOCl) and another cohort of 50 patients who received treatment with potassium titanyl phosphate (KTP) laser were subjected to analysis. The patients were provided a questionnaire to evaluate pain levels before and after surgery. The patients documented their levels of postoperative pain at specific time intervals, including the sixth hour, first day, second day, third day, and eighth day. This was done using a 100 mm visual analog pain scale, where a marking of 0 mm indicated no pain and a marking of 100 mm indicated the highest level of pain, reflecting the severity of the pain experienced., Results: The pain score of group B was significantly lower than that of group A on the first day. While no notable disparity was detected among the groups during the remaining postoperative periods, it is worth noting that the KTP laser exhibited comparatively lower pain scores. In both groups, the initial pain score before surgery was found to be significantly higher than the pain scores recorded at all subsequent time intervals after surgery. Within group A, it was observed that the pain score during the sixth hour after the surgical procedure was notably greater compared to the pain scores recorded during all other time intervals following the operation. In group B, the pain score at the sixth hour exhibited a statistically significant increase compared to the pain scores observed on the third day and eighth day., Conclusion: The KTP laser group exhibited a lower postoperative pain score in comparison to the NaOCl group. The utilization of KTP laser-assisted pulpotomy demonstrated enhanced efficacy in alleviating pain among individuals diagnosed with symptomatic irreversible pulpitis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Dronamraju et al.)

Aim: The purpose of the present study was to compare the efficacy of three different file systems in removing gutta-percha during endodontic retreatment with or without solvents., Materials and Methods: The current study used 120 freshly extracted, single-rooted human mandibular premolars extracted for orthodontic procedures. The canal was prepared utilizing the step-back technique and obturation was done. The samples were allocated into three experimental groups at random, group I: Hedstrom Files, group II: D-RaCe rotary system, and group III: Mtwo retreatment files system. The three groups were again split into two subgroups of 20 samples each, i.e., with solvent and without solvent. Then, a stereomicroscope with a magnification of × 20 was used to examine the samples. The amount of GP and sealer left was measured in three sections: At apical third (1 mm above the apex), middle third (8 mm from the apex), and coronal third (2 mm below the cementoenamel junction). The obtained data were analyzed using parametric Analysis of Variance (ANOVA). p -values less than 0.05 were considered significant., Results: The overall least debris on the dentinal surface was found in the middle third with/without solvent. The D-RaCe rotary system was 1.24 ± 0.11 and 1.44 ± 0.14, Mtwo retreatment files system was 1.38 ± 0.17 and 1.72 ± 0.09 and Hedstrom files was 2.08 ± 0.21 and 2.18 ± 0.16 respectively and A significant difference was found between the three different file system groups ( p < 0.001)., Conclusion: The current study concluded that, when combined with a solvent, the D-RaCe rotary retreatment system is more effective than the Mtwo rotary retreatment system and Hedstrom Files in removing gutta-percha and sealant from root canal walls., Clinical Significance: When it comes to treating chronic infections, non-surgical retreatment is a more cautious method than periapical surgery. Retreatment should be performed efficiently and with appropriate instruments to ensure effective treatment.

Background & Aims: Evidence shows that CT-derived sarcopenia can predict adverse outcomes in COVID-19 patients. However, discrepancies exist as to which vertebral level can be used to calculate sarcopenia which can effectively serve as a prognostic tool. Thus, we aim to investigate the difference in sarcopenia calculated at the Thoracic and Lumbar vertebral levels., Methods: An online literature search was conducted on Electronic databases such as PubMed, Cochrane CENTRAL, and Google scholar. Meta-analysis was performed by using Revman 5.3 software., Results: A total of 14 articles were selected for meta-analysis. The prevalence of sarcopenia calculated at the Thoracic level was 31% (95%CI 24%-37%; p < 0.00001; I 2  = 86%), while sarcopenia calculated at the Lumbar vertebral level was 63% (95%CI 51%-75%; p < 0.00001; I 2  = 88%). Meanwhile, sarcopenia calculated at the Upper thoracic level was a significant predictor of mortality OR 3.47 (95%CI 1.74-6.91; p = 0.0004; I 2  = 56%)as compared to sarcopenia calculated at the lower thoracic OR 1.74 (95%Cl 0.91-3.33; p = 0.10; I 2  = 60%)or lumbar level OR 2.49 (95%CI 0.45-13.72; p = 0.30; I 2  = 57%). In addition to this sarcopenia calculated at the Upper thoracic level was also a significant predictor of severe illness OR 3.92 (95%CI 2.33-6.58; p < 0.00001; I 2  = 0%) as compared to lower thoracic OR 1.40 (95%CI 0.78-2.53; p = 0.26; I 2  = 67%) or lumbar level OR 1.64 (95%CI 0.26-10.50; p = 0.60; I 2  = 81%) CONCLUSIONS: Sarcopenia calculated at the thoracic vertebrae and lumber level has different prognostic values. Sarcopenia is prevalent at the lumbar level. Sarcopenia at the thoracic level has a higher mortality and severity rate., Competing Interests: Declaration of competing interest None of the authors have any conflict of interest., (Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study was to analyse the current use, identify challenges and barriers and propose a way forward for the use of the pager devices in the in-hospital communications., Methods: Initially, 447 studies were identified through database searching. After checking against the eligibility, 39 studies were included. Full-text records were retrieved and reviewed by two authors. After excluding unrelated studies and duplicate records, a total of 12 articles were selected for the final review., Results: The use of pagers often lacks standardisation, content, format, urgency level, and clarity within the message. Some studies reported that medical staff preferred in-person interactions with consults instead of communicating over the phone or pagers. Productive communication can reduce the turnaround time by up to 50%. The key challenges are; (1) data security and privacy, (2) timely acknowledgement of received communication, (3) lack of two-way communications causing issues in critical care situations and (4) there is no standard process for the in-hospital communications., Conclusion: We found that the clinicians' age, experience, speciality and preferences greatly matter and influence the selection of tools and technology in healthcare. With revolutionary advances in technology, smartphones have inevitably become beneficial to healthcare, owing to multiple instant messaging applications (apps) that can streamline encrypted clinical communication between medical teams and could be safely used for in-hospital communications., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

For curing of fiber-reinforced epoxy composites, an alternative to thermal heating is the use of microwave energy, which cures quickly and consumes less energy. Employing thermal curing (TC) and microwave (MC) curing methods, we present a comparative study on the functional characteristics of fiber-reinforced composite for microelectronics. The composite prepregs, prepared from commercial silica fiber fabric/epoxy resin, were separately cured via thermal and microwave energy under curing conditions (temperature/time). The dielectric, structural, morphological, thermal, and mechanical properties of composite materials were investigated. Microwave cured composite showed a 1% lower dielectric constant, 21.5% lower dielectric loss factor, and 2.6% lower weight loss, than thermally cured one. Furthermore, the dynamic mechanical analysis (DMA) revealed a 20% increase in the storage and loss modulus along with a 15.5% increase in the glass transition temperature (Tg) of microwave-cured compared to thermally cured composite. The fourier transformation infrared spectroscopy (FTIR) showed similar spectra of both the composites; however, the microwave-cured composite exhibited higher tensile (15.4%), and compression strength (4.3%) than the thermally cured composite. These results illustrate that microwave-cured silica-fiber-reinforced composite exhibit superior electrical performance, thermal stability, and mechanical properties compared to thermally cured silica fiber/epoxy composite in a shorter time and the expense of less energy.

Background: There is limited evidence exploring the relationship between mental health disorders and the readmissions following total joint arthroplasty (TJA). Therefore, we conducted a meta-analysis to evaluate the relationship between mental health disorders and the risk of readmission following TJA., Methods: We searched PubMed, Cochrane, and Google Scholar from their inception till April 19, 2022. Studies exploring the association of mental health disorders and readmission risk following TJA were selected. The outcomes were divided into 30-day readmission, 90-day readmission, and readmission after 90 days. We also performed subgroup analyses based on the type of arthroplasty: total hip arthroplasty (THA) and total knee arthroplasty (TKA). A total of 12 studies were selected, of which 11 were included in quantitative analysis. A total of 1,345,893 patients were evaluated, of which 73,953 patients suffered from mental health disorders., Results: The risk of 30-day readmission (odds ratio = 1.43, 95% CI 1.14-1.80, P = .002, I 2  = 87%) and 90-day readmission (OR = 1.35, 95% CI 1.22-1.49, P < .00001, I 2  = 89%) was significantly associated with mental health disorders. On subgroup analyses, 30-day readmission was significantly associated with THA (OR = 1.29, 95% CI 1.04-1.60, P = .02), but not with TKA (OR = 1.44, 95% CI 0.51-4.06, P = .50). Similarly, 90-day readmission was significantly associated with both THA (OR = 1.21, 95% CI 1.14-1.29, P < .00001) and TKA (OR = 1.33, 95% CI 1.17-1.51, P < .0001)., Conclusion: Mental health disorders are significantly associated with increased 30-day and 90-day readmissions. Increasing awareness regarding mental health disorders and readmission in arthroplasty will help in efficient preoperative risk stratification and better postoperative management in these patients., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aim: The aim of the current in vitro research was to evaluate the sealing capacity of three different agents employed for the repair of perforations at the furcation area., Materials and Methods: Recently 60 extracted human mandibular permanent molars having well apart plus fully formed roots, and intact furcation were chosen. The 60 samples were allocated at random to three groups of 20 samples: Group I: Furcation perforation repair by means of mineral trioxide aggregate (MTA)-Angelus, Group II: Furcal perforation repair using Biodentine, Group III: Furcal perforation repair by EndoSequence. The specimens were subjected to sectioning with a hard tissue microtome and the sectioned parts of the samples were then examined. The specimens were subjected to gold sputtering and visualizing beneath scanning electron microscope (SEM) at 2000× magnification for assessing the sealing capacity of the agents., Results: The highest sealing capacity was noted with the use of Biodentine at 0.96 ± 0.10, in pursuit by EndoSequence use at 1.18 ± 0.14 and MTA-Angelus use at 1.74 ± 0.08. The disparity amid the three groups was statistically significant with p < 0.001., Conclusion: In conclusion, it may be inferred that Biodentine exhibited the finest sealing capacity than EndoSequence and MTA- Angelus. It may thus be given consideration as a substance of preference for the repair of furcal perforation., Clinical Significance: Using biologically compatible substances may be suggested to amend perforations thereby decreasing the occurrence of inflammatory response in the neighboring tissues. The sealing capacity is a significant feature in supporting the result of a root canal treatment of a tooth.

Aims and Objectives: This study investigated clinical staff perceptions of learning about current monitoring practices and the planned introduction of an electronic system for patient monitoring. The aim of this research was to evaluate the perceptions of clinical staff (nurses and doctors) about the perceived strengths and weaknesses of the current state of the rapid response system (RRS) and how those strengths and weakness would be affected by introducing an electronic RRS., Methods: This research applied a descriptive study methodology. Two detailed sessions on demonstration on the electronic RRS for measuring and recording vital signs and the electronic Early Warning System (EWS) were followed by two structured surveys administered through an online portal (SurveyMonkey) for nurses and doctors working at Taranaki District Health Board. The study was planned and conducted between October 2020 and May 2021 at Taranaki Base Hospital, New Plymouth, New Zealand., Results: We found that the perceptions of clinical staff were a combination of key practice issues with current manual monitoring, expectations of improved visibility of vital sign charts, better communication between staff and thus improved patient care with the introduction of an electronic system. A majority (24, 60%) of nurses reported that, when called to assess deteriorating patients, the responders arrive at bedside within 5-30 min and an additional 11 (27%) said the responders arrive within 5 min. That is a collective 87% responder arrival within 30 min., Conclusion: Staff believe that an electronic RRS could improve communication, speed up decision making and have a positive impact on patient outcomes., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors.)

Socio-economic and racial/ethnic disparities in healthcare quality have been the point of huge discussion and debate. There is currently a public debate over healthcare legislation in the United States to eliminate the disparities in healthcare. We reviewed the literature and critically examined standard socio-economic and racial/ethnic measurement approaches. As a result of the literature review, we identified and discussed the limitations in existing quality assessment for identifying and addressing these disparities. The aim of this research was to investigate the difference between health outcomes based on patients' ability to pay and ethnic status during a single emergency admission . We conducted a multifactorial analysis using the 11-year admissions data from a single hospital to test the bias in short-term health outcomes for length of stay and death rate, based on 'payment type' and 'race', for emergency hospital admissions. Inconclusive findings for racial bias in outcomes may be influenced by different insurance and demographic profiles by race. As a result, we found that the Self-Pay (no insurance) category has the shortest statistically significant length of stay. While the differences between Medicare, Private and Government are not significant, Self-Pay was significantly shorter. That 'Whites' have more Medicare (older) patients than 'Blacks' might possibly lead to a longer length of stay and higher death rate for the group.

Aim: Aim of this research was to assess the microbial leakage of restorative materials with/without antibacterial primer as an intracoronal barrier., Materials and Methods: Fifty-five extracted single-rooted teeth were included in this study. The canals were cleaned, shaped, and obturated with gutta-percha and AH plus sealer at the established working length. After removing 2 mm of coronal gutta-percha, the teeth were incubated for 24 hours. The teeth were divided into groups according to the materials used as intracoronary orifice barriers as follows: • Group I: Clearfil Protect Bond/Clearfil AP-X • Group II: Xeno IV/Clearfil AP-X • Group III: Chemflex (glass ionomer) • Group IV: Positive control (no barrier) • Group V: Negative control (no barrier and inoculated with sterile broth) Sterile 2 chambers bacterial technique was used to assess the microleakage and Enterococcus faecalis was considered as a microbial marker. The percentage of samples leaked, the time taken for leakage, and the number of colony-forming units (CFUs) in the leaked samples were calculated and analyzed statistically., Results: There was no statistically significant difference found in bacterial penetration among the three investigated materials after 120 days of use as an intracoronal orifice barrier. This study can also infer that the leaked sample from the Clearfil Protect Bond showed the least mean number of CFUs (43 CFUs) followed by Xeno IV (61 CFUs) and glass ionomer cement (GIC) (63 CFUs)., Conclusion: This study concluded that all three experimental antibacterial primers performed better as intracoronal barrier. However, Clearfil Protect Bond with an antibacterial primer showed promising results as an intracoronal orifice barrier in reducing the number of bacterial leakages., Clinical Significance: The significance of intracoronal orifice barriers in the success of endodontic treatment depends on the ability of the materials to prevent microleakage. This helps clinicians to provide successful antibacterial therapy against endodontic anaerobes.

Pioglitazone (PGZ) is utilized as a therapeutic agent in the management of (type 2) diabetes to control blood glucose levels. The existing research work was intended to make and optimize PGZ-containing NLCs (nanostructured lipid carriers). The fabricated nanostructured lipid carrier preparation was optimized by using different concentrations of the surfactants (Tween 80 and Span 80) and solid lipid (Compritol ® 888 ATO) and liquid lipid (Labrasol ® ) while keeping the concentration of drug (PGZ), and co-surfactants (poloxamer 188) the same. The optimized NLC formulation (PGZ-NLCs) was further assessed for physical and chemical characterization, in vitro PGZ release, and stability studies. The optimized PGZ-NLCs have shown an average diameter of 150.4 nm, EE of 92.53%, PDI value of 0.076, and zeta-potential of -29.1 mV, correspondingly. The DSC thermal analysis and XRD diffractograms had not presented the spectrum of PGZ, confirming the comprehensive encapsulation of PGZ in the lipid core. PGZ-NLCs showed significantly extended release (51% in 24 h) compared to the unformulated PGZ. Our study findings confirmed that PGZ-NLCs can be a promising drug delivery system for the treatment of type 2 diabetes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ilyas, Asif, Wang, Altaf, Zafar, Faran Ashraf Baig, Paiva-Santos and Abbas.)

Introduction: To highlight predictors of mortality in acute mesenteric ischemia (AMI) by conducting a meta-analysis of all relevant published studies., Methods: PubMed, Cochrane, and Google Scholar were searched from their inception till October 31, 2021. Studies evaluating predictors of mortality were selected. Only those factors were selected for meta-analysis that was reported by at least four studies. Meta-analysis was performed on selected factors using the random-effects model by using Revman 5.3 software., Results: Fifty-one studies were included evaluating 10,425 patients of AMI. Studies selected had a low risk of bias (Median = 7). Thirty-three factors were evaluated in our review. Age (OR 1.17, 95% CI 1.08-1.27), chronic renal disease (OR 2.47, 95% CI 1.37-4.45), patient dependency (OR 3.01, 95% CI 1.95-4.65), arrhythmias (OR 1.93, 95% CI 1.38-2.69), cardiac failure (OR 2.28, 95% CI 1.57-3.31), hypotension (OR 3.44, 95% CI 1.81-6.54), large bowel involvement (OR 2.98, 95% CI 1.44-6.17), small and large bowel involvement (OR 1.86, 95% CI 1.23-2.81), creatinine (OR 1.67, 95% CI 1.27-2.20), lactate (OR 1.43, 95% CI 1.26-1.62), delay to surgery (OR 2.51, 95% CI 1.58-3.99) and inotropes (OR 3.79, 95% CI 1.47-9.77) were significantly associated with mortality. On the contrary bowel wall thickening (OR 0.53, 95% CI 0.38-0.88), anticoagulation (OR 0.27, 95% CI 0.10-0.74), and revascularization (OR 0.30, 95% CI 0.13-0.69) were significantly associated with survival., Conclusions: In conclusion, Age, chronic renal disease, diabetes, patient dependency, arrhythmias, cardiac failure, hypotension, large bowel involvement, small & large bowel involvement, creatinine, lactate, delay to surgery, and inotropes were significantly associated with mortality while anticoagulants, revascularization and bowel thickening on CT was associated with decreased mortality., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Cancer is a disease that seriously threatens human health. Based on the improvement of traditional treatment methods and the development of new treatment modes, the pattern of cancer treatment is constantly being optimized. Nanomedicine plays an important role in these evolving tumor treatment modalities. In this article, we outline the applications of nanomedicine in three important tumor-related fields: chemotherapy, gene therapy, and immunotherapy. According to the current common problems, such as poor targeting of first-line chemotherapy drugs, easy destruction of nucleic acid drugs, and common immune-related adverse events in immunotherapy, we discuss how nanomedicine can be combined with these treatment modalities, provide typical examples, and summarize the advantages brought by the application of nanomedicine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hou, Hasnat, Chen, Liu, Faran Ashraf Baig, Liu and Chen.)

This study aims to assess the role of vitamin D on systemic lupus erythematosus (SLE) patients and its effects on systemic lupus erythematosus disease activity index (SLEDAI), anti-double-stranded DNA (anti-dsDNA), C3, C4, and fatigue in patients with SLE. A systemic search was conducted using three electronic databases, i.e., PubMed/Medline, Cochrane Library, and Google Scholar. Review Manager 5.4.1 (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) was employed for statistical analysis. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the result was reported in the standard mean difference (SMD) with its corresponding 95% confidence interval. Six randomized controlled trials were selected. Five outcomes were assessed (SLEDAI, anti-dsDNA, C3, C4, and fatigue) to evaluate the role of vitamin D in SLE patients. A significant decrease in SLEDAI (SMD = -0.85 (-1.12, -0.58); p < 0.00001; I 2   = 42%) and a non-significant decrease in anti-dsDNA (SMD = -0.09 (-0.03, 0.12); p = 0.42; I 2   = 0%) was noted. A significant increase in levels of C3 (SMD = 0.30 (0.09, 0.51); p = 0.006; I 2  = 0%) and fatigue (SMD = -1.27 (-2.38, -0.16); p = 0.02; I 2  = 56%) was noted when vitamin D was used. Insignificant difference was observed in C4 (SMD = 0.20 (-0.02, 0.41); p = 0.07; I 2   = 0%). Vitamin D in SLE patients showed a significant decrease in SLEDAI scores and a significant increase in C3 levels. The effect of vitamin D on fatigue was inconclusive. No significant difference in anti-dsDNA and C4 levels was noted., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Irfan et al.)

Aim: To evaluate and compare the translucency of various commercially available zirconium oxide ceramic systems, i.e., Ceramill® Zolid Classic, Ceramill® Zi, and DD Bio ZX²71 by using a dual beam UV-visible spectrophotometer., Materials and Methods: The present study comprised of 21 disk-shaped samples of zirconia for every group, i.e., group I-Ceramill® Zolid Classic, group II-Ceramill Zi®, and group III-DD Bio ZX²71. Furthermore, each group was split into three subgroups and every subgroup had seven samples each one of 0.7, 0.8, and 0.9 mm thickness. The samples were prepared by computer-aided design/computer-aided manufacturing (CAD/CAM) system devised by Amann Girrbach AG in accord with the steps provided by the manufacturer. The entire sample was designed having 10 mm in diameter with 0.7, 0.8, and 0.9 mm thickness for every group. The UV-visible dual beam spectrophotometer equipped with D2 lamp and W lamp was used for the measurement of absorbance and transmittance in order to assess the translucency of the fabricated zirconia samples., Results: The mean value of transmittance % for Ceramill® Zi at 0.8 mm came out to be 0.849 ± 0.024, i.e., the least among all, whereas the mean value of Ceramill® Zolid Classic was 1.408 ± 0.033, being the highest for the same thickness. DD Bio ZX²71 had an intermediate value of 1.274 ± 0.012. The mean value of absorbance for Ceramill® Zi at 0.8 mm came out to be 2.086 ± 0.013, i.e., the maximum among all, whereas the mean value of Ceramill® Zolid Classic was, being the lowest for the same thickness. DD Bio ZX²71 had an intermediate value of 1.902 ± 0.004., Conclusion: The present study data suggest that all the materials subjected to evaluation exhibited a substantial translucency. We attempted to study few of the desirable properties, these materials should possess when used for prosthetic rehabilitation with esthetic contentment a clinical setup. There has been an ambiguous distinction that Ceramill® Zi Zirconia supersedes the Ceramill® Zolid Classic and DD Bio ZX²71. Furthermore, 0.8 mm thickness substantiates to be the most ideal among 0.7, 0.8, and 0.9 mm., Clinical Significance: The desired outcome of the procedure becomes dependent solely on the clinician's judgment to opt for the material whose properties are most fitting as per the demands of the esthetics. While a clinician should always be ambitious, but a good clinician should also bear in mind that the success of any treatment procedure not only depends on the assortment of properties of these materials but also the host response and satisfaction evoked by these materials.

A growing body of research documents the persistence of physical and neuropsychiatric symptoms following the resolution of acute COVID-19 infection. To the best of our knowledge, no published study has examined the interaction between insomnia and mental health. Accordingly, we proposed to examine new diagnoses of insomnia, and referrals to pulmonary and sleep medicine clinics for treatment of sleep disorders, in patients presenting to one post-acute COVID-19 recovery clinic. Additionally, we aimed to examine the relationship between poor sleep quality, depression, anxiety, and post-traumatic stress. Patients presented to the clinic on average 2 months following COVID-19 infection; 51.9% ( n = 41) were hospitalized, 11.4% ( n = 9) were in the intensive care unit, 2.5% ( n = 2) were on a mechanical ventilator, and 38.0% ( n = 30) were discharged on oxygen. The most commonly reported symptom was fatigue (88%, n = 70), with worse sleep following a COVID-19 infection reported in 50.6% ( n = 40). The mean PSQI score was 9.7 (82.3%, n = 65 with poor sleep quality). The mean GAD-7 score was 8.3 (22.8%, n = 14 with severe depression). The mean PHQ-9 was 10.1 (17.8%, n = 18 with severe anxiety). The mean IES-6 was 2.1 (54.4%, n = 43 with post-traumatic stress). Poor sleep quality was significantly associated with increased severity of depression, anxiety, and post-traumatic stress. Future work should follow patients longitudinally to examine if sleep, fatigue, and mental health symptoms improve over time.

Background: Iron deficiency is the most common nutritional deficiency worldwide. Common causes of IDA in children are excessive consumption of cow's milk and prolonged breast feeding with delayed and poor weaning. Oral iron is the first line of treatment in children with IDA but occasionally there is inadequate response due to poor compliance. The objective of this study is to assess the effectiveness and safety of intravenous iron in children with IDA, poorly compliant to oral iron therapy., Methods: This study consisted of 90 children from 12-60 months with IDA who were not responding adequately to oral iron therapy. Total iron requirement was calculated and given intravenously (IV) in two divided doses over two consecutive days. Participants were followed up at 2 and 4 weeks to assess the rise in haemoglobin level. Any adverse event was also noted. SPSS version 25 was used for statistical analysis., Results: Of the 90 enrolled children the mean age was 23.1±10.7 months, 47 (52.2%) were males and 43(47.8%) were females. The mean ferritin level before IV iron therapy was 3.75±2.53 ng/ml and mean haemoglobin was 5.9±1.3 g/dL. After IV iron therapy the haemoglobin level was raised to 8.38±1.09 g/dl and 9.74±0.88 g/dl at 2 and 4 weeks respectively which was statistically significant (p<0.05). The adverse events were fever in 3 (3.3%) and urticaria in 2 (2.2%) patients., Conclusions: Intravenous iron therapy is effective and safe to raise the haemoglobin levels in children with IDA who are poorly compliant to oral iron therapy.

The prevalence, incidence, and characteristics of bacterial infections in patients infected with severe acute respiratory syndrome coronavirus 2 are not well understood and have been raised as an important knowledge gap. Therefore, our study focused on the most common opportunistic infections/secondary infections/superinfections in coronavirus disease 2019 (COVID-19) patients. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible studies were identified using PubMed/Medline since inception to June 25, 2021. Studies meeting the inclusion criteria were selected. Statistical analysis was conducted in Review Manager 5.4.1. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported as inverse variance and the corresponding 95% confidence interval. We screened 701 articles comprising 22 cohort studies which were included for analysis. The pooled prevalence of opportunistic infections/secondary infections/superinfections was 16% in COVID-19 patients. The highest prevalence of secondary infections was observed among viruses at 33%, followed by bacteria at 16%, fungi at 6%, and 25% among the miscellaneous group/wrong outcome. Opportunistic infections are more prevalent in critically ill patients. The isolated pathogens included Epstein-Barr virus, Pseudomonas aeruginosa , Escherichia coli , Acinetobacter baumannii , Hemophilus influenza , and invasive pulmonary aspergillosis. Large-scale studies are required to better identify opportunistic/secondary/superinfections in COVID-19 patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Kurra et al.)

The aim of the present work was to synthesize magnetite (Fe3O4) nano hollow spheres (NHS) via simple, one-pot, template-free, hydrothermal method. The structural, morphological, and surface analysis of Fe3O4 NHS were studied by scanning electron microscopy (SEM), x-ray diffraction technique (XRD), Fourier transform infrared spectroscopy FTIR and burner-Emmett-teller (BET). The as obtained magnetic (Fe3O4) NHS were used as an adsorbent for treating industrial trinitrotoluene (TNT) wastewater to reduce its Chemical Oxygen Demand (COD) values. Adsorption capacity (Qe) of the NHS obtained is 70 mg/g, confirming the attractive forces present between adsorbent (Fe3O4 NHS) and adsorbate (TNT wastewater). COD value of TNT wastewater was reduced to >92% in 2 h at room temperature. The adsorption capacity of Fe3O4 NHS was observed as a function of time, initial concentration, pH, and temperature. The applied Fe3O4 NHS was recovered for reuse by simply manipulating its magnetic properties with slight shift in pH of the solution. A modest decrease in Qe (5.0−15.1%) was observed after each cycle. The novel Fe3O4 NHS could be an excellent candidate for treating wastewater generated by the intermediate processes during cyclonite, cyclotetramethylene-tetranitramine (HMX), nitroglycerin (NG) production and other various environmental pollutants/species.

We performed FMEA on the existing RRS with the help of routine users of the RRS who acted as subject matter experts and evaluated the failures for their criticality using the Risk Priority Number approach based on their experience of the RRS. The FMEA found 35 potential failure modes and 101 failure mode effects across 13 process steps of the RRS. The afferent limb of RRS was found to be more prone to these failures (62, 61.4%) than the efferent limb of the RRS (39, 38.6%). Modification of calling criteria (12, 11.9%) and calculation of New Zealand Early Warning Scores (NZEWS) calculation (11, 10.9%) steps were found to potentially give rise to the highest number of these failures. Causes of these failures include human error and related factors (35, 34.7%), staff workload/staffing levels (30, 29.7%) and limitations due to paper-based charts and organisational factors (n = 30, 29.7%). The demonstrated electronic system was found to potentially eliminate or reduce the likelihood of 71 (70.2%) failures. The failures not eliminated by the electronic RRS require targeted corrective measures including scenario-based training and education, and revised calling criteria to include triggers for hypothermia and high systolic blood pressure., Competing Interests: The authors declare no conflict of interest., (© 2022 Published by Elsevier Ltd.)

Due to rapid technological advancements, the demand for lightweight materials with improved tribo-mechanical properties is continuously growing. The development of composite materials is one of the routes taken by researchers to meet these target properties. Aluminum (Al) is one of the most suitable materials used for developing composites for a wide range of applications because of its light weight, high conductivity, and high specific strength. In this study, aluminum hybrid nanocomposites with alumina (10 Vol% Al 2 O 3 ) and varying loadings of graphene oxide (0.25, 0.5 and 1 wt% GO) were fabricated using the spark plasma sintering technique. The tribological properties of the developed hybrid composites were evaluated by conducting ball-on-disk wear tests at a normal load of 3N, with a sliding speed of 0.1 m/s, and for a sliding distance of 100 m. A 440C hardened stainless steel ball with a diameter of 6.3 mm and a hardness of 62 RC was used as a counterface. Scanning electron microscopy (SEM), elemental X-ray dispersive analysis (EDS), and optical profilometry were used to ascertain the involved wear mechanisms. The results revealed that Al-10 Vol%Vol% Al 2 O 3 -0.25 wt% GO hybrid nanocomposite showed an increase of 48% in the hardness, a reduction of 55% in the specific wear rate, and a reduction of 5% in COF compared with pure aluminum.

Lansoprazole (LPZ) show poor bioavailability because of first pass effect and absorption factors. The floating delivery systems could reduce fluctuations in plasma drug concentration through maintaining desirable plasma drug concentration. The objective of present study was to enhance bioavailability despite first pass effect through continuous availability of drug from floating system. Gum tragacanth (GT) and itaconic acid (IA) based floating hydrogels (FH) were synthesized. Parameters optimized were; microwave radiation exposure time, pH, GT:IA ratio and concentration of the glutaraldehyde. Optimized FH were evaluated for entrapment efficiency (% EE), in-vitro release, FTIR, SEM, and in- vitro and in-vivo floating study. Finally, pharmacokinetic was evaluated in ulcer-induced SD rats. Grafting percentage, swelling ratio and %EE of LPZ was 115%, ̴250% and 90%, respectively. Microwave radiation exposure time, pH of reaction medium, GT:IA ratios and cross linker concentration were 2 min, pH 5, ratios 2:1 and 0.02%, respectively. The optimized FH showed acceptable floating behavior. The X-ray images revealed that hydrogels remained floated over gastric contents up to 24 hours. The in-vitro release and pharmacokinetics revealed availability of LPZ upto to 24h in-vitro and in ulcer-induced SD rats, respectively. The present hydrogels based floating system of lansoprazole is capable to extend the gastric residence time upto 24 hours.

Background: Idiopathic nodular mesangial sclerosis, also called idiopathic nodular glomerulosclerosis (ING), is a rare clinical entity with an unclear pathogenesis. The hallmark of this disease is the presence of nodular mesangial sclerosis on histology without clinical evidence of diabetes mellitus or other predisposing diagnoses. To achieve insights into its pathogenesis, we queried the clinical, histopathologic and transcriptomic features of ING and nodular diabetic nephropathy (DN)., Methods: All renal biopsy reports accessioned at Indiana University Health from 2001 to 2016 were reviewed to identify 48 ING cases. Clinical and histopathologic features were compared between individuals with ING and DN (n = 751). Glomeruli of ING (n = 5), DN (n = 18) and reference (REF) nephrectomy (n = 9) samples were isolated by laser microdissection and RNA was sequenced. Immunohistochemistry of proline-rich 36 (PRR36) protein was performed., Results: ING subjects were frequently hypertensive (95.8%) with a smoking history (66.7%). ING subjects were older, had lower proteinuria and had less hyaline arteriolosclerosis than DN subjects. Butanoate metabolism was an enriched pathway in ING samples compared with either REF or DN samples. The top differentially expressed gene, PRR36, had increased expression in glomeruli 248-fold [false discovery rate (FDR) P = 5.93 × 10-6] compared with the REF and increased 109-fold (FDR P = 1.85 × 10-6) compared with DN samples. Immunohistochemistry revealed a reduced proportion of cells with perinuclear reaction in ING samples as compared to DN., Conclusions: Despite similar clinical and histopathologic characteristics in ING and DN, the uncovered transcriptomic signature suggests that ING has distinct molecular features from nodular DN. Further study is warranted to understand these relationships., (© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)