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Priya Battu,1,* Kaushal Sharma,1,* Rajarathna Thangavel,2 Ramandeep Singh,3 Suresh Sharma,4 Vinod Srivastava,5 Akshay Anand1 1Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; 2Department of Ophthalmology, Vasan Eye Care, Chennai, India; 3Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India; 4Department of Statistics, Panjab University, Chandigarh, India; 5College of Health and Behavioral Sciences, Fort Hays State University, Hays, KS, USA*These authors contributed equally to this workCorrespondence: Akshay Anand, Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India, Tel +911722756094, Email akshay1anand@rediffmail.comBackground: Optical coherence tomography (OCT) parameters like subretinal fluid (SRF), intra retinal fluid (IRF) and retinal detachment (RPED) etc are routinely accessed by ophthalmologists in patients with retinal complaints. Correlation of OCT findings with genotype and phenotype of AMD patients is relatively unexplored. Here, we have investigated the association of OCT parameters’ with genetic variants along with protein expressions and examined their clinical relevance with AREDS (Age-Related Eye Disease Study) criteria in AMD patients.Methods: For this study, samples were recruited from Advanced Eye Centre, PGIMER, Chandigarh, India. Case-only analysis of anonymous imaging data (OCT/Fundus) acquired during the routine clinical evaluation of patients was done to examine the OCT findings in the AMD patients. TaqMan genotyping assays were used to analyze the single nucleotide polymorphisms in these patients. ELISA (enzyme linked immunosorbent assay) was used to estimate the protein levels of these genes in serum. Information pertaining to lifestyle/habits was also collected by administering a standard questionnaire at the time of recruitment of the patients.Results: Intra-retinal fluid (IRF) was associated significantly with the LIPC genotype (p=0.04). Similarly, smoking status and early AMD were also associated with the APOE genotype (p=0.03). Additionally, variants of IER-3 and SLC16A8 were also found to be associated with co-morbidities (p=0.02) and males (p=0.02), respectively. RPED has shown a significant association with AREDS criteria, which demonstrated an area under AUROC around 72%.Conclusion: Results of genotype–phenotype association can give a precise impression of AMD severity and can be beneficial for the early diagnosis of AMD cases.Keywords: age-related macular degeneration, RPE detachment, OCT parameters, TIMP-3, HTRA1, IPC, APOE, anti-VEGF therapy, AREDS

Complex multi-element alloys are gaining prominence for structural applications, supplementing steels, and superalloys. Understanding the impact of each element on alloy surfaces due to oxidation is vital in maintaining material integrity. This study investigates oxidation mechanisms in these alloys using a model five-element equiatomic CoCrFeNiMn alloy, in a controlled oxygen environment. The oxidation-induced surface changes correlate with each element's interactive tendencies with the environment, guided by thermodynamics. Initial oxidation stages follow atomic size and redox potential, with the latter becoming dominant over time, causing composition inversion. The study employs in-situ atom probe tomography, transmission electron microscopy, and X-ray absorption near-edge structure techniques to elucidate the oxidation process and surface oxide structure evolution. Our findings deconvolute the mechanism for compositional and structural changes in the oxide film and will pave the way for a predictive design of complex alloys with improved resistance to oxidation under extreme conditions.

Abstract Background Microsponges are one of the advanced drug delivery systems that facilitates precise and controlled release of active ingredients that are suitable for topical and oral use. These porous microspheres are typically sized between 5 and 300 μm, offer benefits including controlled release, stability, and minimized side effects. Manufacturing techniques like quasi-emulsion solvent diffusion and liquid–liquid suspension polymerization are usually employed to prepare microsponges, although various challenges arise from the use of potentially hazardous organic solvents. Main body Microsponges possess distinct traits such as extended drug release, formulation flexibility, and high drug loading capacity. Entrapment of drugs requires considerations of solubility, stability, and miscibility, while evaluation methods encompass production yield and particle size analysis. Their applications range from dermatological to biopharmaceutical delivery, with diverse products utilizing this technology. Ongoing innovations about microsponges are evident in patents concerning medical dressings and hyaluronic acid delivery systems. Conclusion Microsponges present a promising avenue in drug delivery, despite many challenges. Current review addresses on limitations and diverse products highlighting commercial viability. Patent activity signifies continued interest, suggesting significant potential for enhancing patient care.

Abstract Complex multi-element alloys are gaining prominence for structural applications, supplementing steels, and superalloys. Understanding the impact of each element on alloy surfaces due to oxidation is vital in maintaining material integrity. This study investigates oxidation mechanisms in these alloys using a model five-element equiatomic CoCrFeNiMn alloy, in a controlled oxygen environment. The oxidation-induced surface changes correlate with each element’s interactive tendencies with the environment, guided by thermodynamics. Initial oxidation stages follow atomic size and redox potential, with the latter becoming dominant over time, causing composition inversion. The study employs in-situ atom probe tomography, transmission electron microscopy, and X-ray absorption near-edge structure techniques to elucidate the oxidation process and surface oxide structure evolution. Our findings deconvolute the mechanism for compositional and structural changes in the oxide film and will pave the way for a predictive design of complex alloys with improved resistance to oxidation under extreme conditions.

Abstract As robots become increasingly integrated into social economic interactions, it becomes crucial to understand how people perceive a robot’s mind. It has been argued that minds are perceived along two dimensions: experience, i.e., the ability to feel, and agency, i.e., the ability to act and take responsibility for one’s actions. However, the influence of these perceived dimensions on human–machine interactions, particularly those involving altruism and trust, remains unknown. We hypothesize that the perception of experience influences altruism, while the perception of agency influences trust. To test these hypotheses, we pair participants with bot partners in a dictator game (to measure altruism) and a trust game (to measure trust) while varying the bots’ perceived experience and agency, either by manipulating the degree to which the bot resembles humans, or by manipulating the description of the bots’ ability to feel and exercise self-control. The results demonstrate that the money transferred in the dictator game is influenced by the perceived experience, while the money transferred in the trust game is influenced by the perceived agency, thereby confirming our hypotheses. More broadly, our findings support the specificity of the mind hypothesis: Perceptions of different dimensions of the mind lead to different kinds of social behavior.

In medical schools, the foundational subject of human anatomy usually requires the medical students to procure a set of human bones, either real or artificial, for comprehensive understanding of the human body. The proper maintenance and disposal of these human remains is the responsibility of the students and the institutions possessing the remains. Improper disposal of human remains can have far-reaching implications, including ethical, legal, public health, environmental, social, and psychological consequences. We present a case of a human skull used for medical studies found dumped in a garbage, leading to unnecessary investigation by the law authorities. The case brings to light the need for including ethical disposal of academic human skeletons at the beginning of the medical curriculum. The authors also discuss in detail the various legal provisions and cultural practices of disposal of human remains in the Indian scenario.

Understanding the early stages of interactions between oxygen and material surfaces—especially at very high spatial resolutions—is highly beneficial for fields ranging from materials degradation, corrosion, geological sciences, forensics, and catalysis. The ability of in situ atom probe tomography (APT) is demonstrated to track the diffusion of oxygen and metal ions at nanoscale spatial resolution during the early stages of oxidation of a model Fe–Cr–Ni alloy. Using 18O isotope tracers in these in situ APT experiments and complementary ex situ multimodal microscopy, spectroscopy, and computational simulations allows to precisely analyze the kinetics of oxidation and determine that outward cation diffusion to oxide/air interface is the primary mechanism for intragranular oxide growth in this alloy at 300 °C. This unique in situ isotopic tracer APT approach and the insights gained can be highly beneficial for studying early stages of gas–surface reactions in a broad array of materials.

Abstract The co-evolution of conditional cooperation and social norms has garnered significant attention, yet the underlying mechanisms remain elusive. Social norms result from empirical expectations, individual expectations of group behavior, and normative expectations, the population's expectations of individual behavior. Aligning these expectations aids in norm formation, but diverse individual reactions to observed behavior and their sensitivity to norm conformity can be challenging. In our study, the agents are initially endowed with diverse conditional expectations, which mirror their anticipations regarding group behavior and their inherent inclination to conform to social norms, indicative of their sensitivity to psychic costs. These agents engage in a repeated public goods game, where their decisions to cooperate are shaped by their conditional expectations and the observed levels of cooperation within their group. Concurrently, free riders experience psychic costs determined by the overall level of cooperation, contribution costs, and the individual’s inclination to adhere to social norms. Remarkably, our simulations unveil that agents commencing with random conditional expectations and a propensity to conform to norms can adapt to lower conditional expectations and moderate their propensity to conform to norms when initial cooperation levels are high and the contribution cost is reduced. Interestingly, increasing contribution costs intensify the population’s response to norm enforcement, but this doesn’t always result in a corresponding increase in cooperation. By incorporating population diversity and accounting for empirical and normative expectations within our model, we gain valuable insights into the intricate relationship between conditional cooperation and the emergence of social norms.

Abstract The emergence of large language models has led to the development of powerful tools such as ChatGPT that can produce text indistinguishable from human-generated work. With the increasing accessibility of such technology, students across the globe may utilize it to help with their school work—a possibility that has sparked ample discussion on the integrity of student evaluation processes in the age of artificial intelligence (AI). To date, it is unclear how such tools perform compared to students on university-level courses across various disciplines. Further, students’ perspectives regarding the use of such tools in school work, and educators’ perspectives on treating their use as plagiarism, remain unknown. Here, we compare the performance of the state-of-the-art tool, ChatGPT, against that of students on 32 university-level courses. We also assess the degree to which its use can be detected by two classifiers designed specifically for this purpose. Additionally, we conduct a global survey across five countries, as well as a more in-depth survey at the authors’ institution, to discern students’ and educators’ perceptions of ChatGPT’s use in school work. We find that ChatGPT’s performance is comparable, if not superior, to that of students in a multitude of courses. Moreover, current AI-text classifiers cannot reliably detect ChatGPT’s use in school work, due to both their propensity to classify human-written answers as AI-generated, as well as the relative ease with which AI-generated text can be edited to evade detection. Finally, there seems to be an emerging consensus among students to use the tool, and among educators to treat its use as plagiarism. Our findings offer insights that could guide policy discussions addressing the integration of artificial intelligence into educational frameworks.

Abstract Background Insect pests are a major cause for losses in agricultural systems, and it is reported that they alone cause up to 45% loss in annual food production. Alleviating the destructive upheaval caused by these six-legged mortals in the agroecosystems falls within the expansive docket of the scientific coterie. Hence, insects are a subject to many experiments in the laboratories and on fields to understand and evaluate their interactions with their biology, physiology, and behavior so as to develop effective managerial strategies against them. Conventional methods include rearing the insects in the laboratory for experimenting on them, which is a very tiring as well as time-consuming process. How convenient it would be, if there is a way to conduct experiments which are directed specifically toward the tissues of insects, particularly cells. Main body The present review presents the immense potential of insect cell cultures in screening the toxicity and mode of action of novel insecticides, physiological studies apart from their ability to produce recombinant proteins through baculovirus expression vector system (BEVS) which includes a broad range of molecules ranging from the antibiotics to the vaccines. Also, we bring together the concept of culturing insect cells in vitro and how revolutionary they could be in changing the future of research in burgeoning strategies to tackle the menace of insect pests in agricultural production systems. Conclusion A deeper grasp of biology and physiological processes will enable us to create techniques that will improve our arsenal in the fight against food crop insect pests. The advancement in culturing insect cells and their potential in entomological research aimed at developing pest control strategies and also for manufacturing vaccines.

Abstract Nicotine is a highly addictive alkaloid and a neurostimulator found in tobacco that causes addiction in humans and makes tobacco a high-demand commercial product. It is popularly used for recreational purposes and is a harmful substance (Oral LD50 value for rat is 50 mg/kg) and causes addiction. The metabolites of nicotine such as the Tobacco-specific Nitrosamines (TSNAs) are hazardous substances whose metabolites are highly electrophilic and form DNA adducts, which will initiate the process of carcinogenesis. TSNAs are formed during curing, storage and fermentation due to the nitrosation of nicotine and other tobacco alkaloids. TSNAs are used as biomarkers for cancer risk assessment in humans exposed to tobacco and its products. To determine the occasional formation of TSNAs in tobacco-feeding insects, 5th instar larvae of Spodoptera litura and their faeces were analyzed for the presence of N′-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) along with the stored tobacco leaves (PT-76) using an Agilent 6470B LC–MS/MS system following ISO/DIS 19290:2015 protocol. The larvae are extracted in a buffered acetonitrile–water extraction and the amount of TSNAs are quantified in multiple reaction monitoring (MRM) mode. 20 $$\upmu$$ μ l of each extracted and cleaned up sample was injected into the LC–MS/MS system for quantification. The Limit of Detection (LOD) and Limit of Quantification (LOQ) were 0.001 mg/kg and 0.005 mg/kg for all the tested nitrosamines. NNN was found to be 0.361 mg/kg, 0.340 mg/kg, and 5.66 mg/kg in insect whole-body samples, faeces, and tobacco leaves, respectively. NNK was found to be 0.060 mg/kg, 0.035 mg/kg and 0.93 mg/kg in insect whole body samples, faeces and tobacco leaves, respectively. However, NNAL was not detected in both the insect’s whole body and faeces. Recoveries ranged between 95 and 98% for all compounds when spiked at LOD and LOQ. The presence of TSNAs is a biomarker for cancer risk and their presence in insects would point to cancer risk assessment in tobacco feeding insects and any possible TSNA-detoxifying pathways in insects that might prevent mutagenesis caused these compounds.

Background: Regional anesthesia avoids airway instrumentation, preserves conscious level and provide rapid recovery with significant postoperative analgesia. There has always been a search for adjuvants to the regional nerve block with drugs that prolong the duration of analgesia but with lesser adverse effects. The search for the ideal additive still continues, and therefore in this study, we investigated the effects of addition of dexamethasone versus clonidine to levobupivacaine for supraclavicular brachial plexus block. The primary outcome of this study was the onset and duration of sensory block, motor block, and the secondary outcome was postoperative analgesia. Aims and Objectives: The aim of the study was to compare the effect of dexamethasone and clonidine on onset and duration of anesthesia, when used as an adjuvant to levobupivacaine in supraclavicular brachial plexus block. 7. Materials and Methods: In this prospective, double-blind, randomized controlled trial, 60 patients with American Society of Anaesthesiologists physical status I/II scheduled to undergo upper limb surgeries below shoulder were enrolled. The patients were randomly divided into two groups: Group I (n=30): 20 mL of 0.5% isobaric levobupivacaine with 2 mL of dexamethasone. Group II (n=30): 20 mL of 0.5% isobaric levobupivacaine and 30 mcg clonidine (diluted in normal saline, making volume of 2 mL). Results: Clonidine when added to levobupivacaine provide early onset of sensory and motor block but less duration of analgesia and motor blockade as compared to dexamethasone. Conclusion: Dexamethasone should be preferred as compared to clonidine as an adjuvant whenever longer duration of post-operative analgesia is required.

Control of organ morphology is a fundamental feature of living organisms. There is, however, observable variation in organ size and shape within a given genotype. Taking the sepal of Arabidopsis as a model, we investigated whether we can use variability of gene expression alongside variability of organ morphology to identify gene regulatory networks potentially involved in organ size and shape determination. We produced a dataset composed of morphological parameters and genome-wide transcriptome obtained from 27 individual sepals from wild-type plants with nearly identical genetic backgrounds, environment, and developmental stage. Sepals exhibited appreciable variability in both morphology and transcriptome, with response to stimulus genes and cell-wall related genes displaying high variability in expression. We additionally identified five modules of co-expressed genes which correlated significantly with morphology, revealing biologically relevant gene regulatory networks. Interestingly, cell-wall related genes were overrepresented in two of the top three modules. Overall, our work highlights the benefit of using coupled variation in gene expression and phenotype in wild-type plants to shed light on the mechanisms underlying organ size and shape determination. Although causality between gene expression and sepal morphology has not been established, our approach opens the way to informed analysis for mutant characterization and functional studies.

Phosphorus is one of the essential nutrients for plant growth, but it may be relatively unavailable to plants because of its chemistry. In soil, the majority of phosphorus is present in the form of a phosphate, usually as metal complexes making it bound to minerals or organic matter. Therefore, inorganic phosphate solubilization is an important process of plant growth promotion by plant associated bacteria and fungi. Non-nodulating plant species have been shown to thrive in low-nutrient environments, in some instances by relying on plant associated microorganisms called endophytes. These microorganisms live within the plant and help supply nutrients for the plant. Despite their potential enormous environmental importance, there are a limited number of studies looking at the direct molecular impact of phosphate solubilizing endophytic bacteria on the host plant. In this work, we studied the impact of two endophyte strains of wild poplar (Populus trichocarpa) that solubilize phosphate. Using a combination of x-ray imaging, spectroscopy methods, and proteomics, we report direct evidence of endophyte-promoted phosphorus uptake in poplar. We found that the solubilized phosphate may react and become insoluble once inside plant tissue, suggesting that endophytes may aid in the re-release of phosphate. Using synchrotron x-ray fluorescence spectromicroscopy, we visualized the nutrient phosphorus inside poplar roots inoculated by the selected endophytes and found the phosphorus in both forms of organic and inorganic phosphates inside the root. Tomography-based root imaging revealed a markedly different root biomass and root architecture for poplar samples inoculated with the phosphate solubilizing bacteria strains. Proteomics characterization on poplar roots coupled with protein network analysis revealed novel proteins and metabolic pathways with possible involvement in endophyte enriched phosphorus uptake. These findings suggest an important role of endophytes for phosphorus acquisition and provide a deeper understanding of the critical symbiotic associations between poplar and the endophytic bacteria.

Abstract A fundamental question in social and biological sciences is whether self-governance is possible when individual and collective interests are in conflict. Free riding poses a major challenge to self-governance, and a prominent solution to this challenge has been altruistic punishment. However, this solution is ineffective when counter-punishments are possible and when social interactions are noisy. We set out to address these shortcomings, motivated by the fact that most people behave like conditional cooperators—individuals willing to cooperate if a critical number of others do so. In our evolutionary model, the population contains heterogeneous conditional cooperators whose decisions depend on past cooperation levels. The population plays a repeated public goods game in a moderately noisy environment where individuals can occasionally commit mistakes in their cooperative decisions and in their imitation of the role models’ strategies. We show that, under moderate levels of noise, injecting a few altruists into the population triggers positive reciprocity among conditional cooperators, thereby providing a novel mechanism to establish stable cooperation. More broadly, our findings indicate that self-governance is possible while avoiding the detrimental effects of punishment, and suggest that society should focus on creating a critical amount of trust to harness the conditional nature of its members.

In recent years, we have witnessed a surge in mobile devices such as smartphones, tablets, smart watches, etc., most of which are based on the Android operating system. However, because these Android-based mobile devices are becoming increasingly popular, they are now the primary target of mobile malware, which could lead to both privacy leakage and property loss. To address the rapidly deteriorating security issues caused by mobile malware, various research efforts have been made to develop novel and effective detection mechanisms to identify and combat them. Nevertheless, in order to avoid being caught by these malware detection mechanisms, malware authors are inclined to initiate adversarial example attacks by tampering with mobile applications. In this paper, several types of adversarial example attacks are investigated and a feasible approach is proposed to fight against them. First, we look at adversarial example attacks on the Android system and prior solutions that have been proposed to address these attacks. Then, we specifically focus on the data poisoning attack and evasion attack models, which may mutate various application features, such as API calls, permissions and the class label, to produce adversarial examples. Then, we propose and design a malware detection approach that is resistant to adversarial examples. To observe and investigate how the malware detection system is influenced by the adversarial example attacks, we conduct experiments on some real Android application datasets which are composed of both malware and benign applications. Experimental results clearly indicate that the performance of Android malware detection is severely degraded when facing adversarial example attacks.

Summary: Extracellular matrices contain fibril-like polymers often organized in parallel arrays. Although their role in morphogenesis has been long recognized, it remains unclear how the subcellular control of fibril synthesis translates into organ shape. We address this question using the Arabidopsis sepal as a model organ. In plants, cell growth is restrained by the cell wall (extracellular matrix). Cellulose microfibrils are the main load-bearing wall component, thought to channel growth perpendicularly to their main orientation. Given the key function of CELLULOSE SYNTHASE INTERACTIVE1 (CSI1) in guidance of cellulose synthesis, we investigate the role of CSI1 in sepal morphogenesis. We observe that sepals from csi1 mutants are shorter, although their newest cellulose microfibrils are more aligned compared to wild-type. Surprisingly, cell growth anisotropy is similar in csi1 and wild-type plants. We resolve this apparent paradox by showing that CSI1 is required for spatial consistency of growth direction across the sepal.

Abstract There is an increasing need to develop biological anti‐inflammatory agents that are more targeted, effective, and with lesser side effects as compared to conventional chemical drugs. In the present study, we found that Mycobacterium tuberculosis protein PPE2 and a synthetic derivative peptide can suppress the mast cell population and inhibit several vasoactive and fibrogenic mediators and pro‐inflammatory cytokines induced by mast cells in formalin‐induced tissue injury. PPE2 was found to inhibit transcription from the promoter of stem cell factor, important for mast cell maintenance and migration. Thus, PPE2/peptide can be used as a potent nonsteroidal therapeutic agent for the treatment of inflammation and tissue injury.

While significant progress has been made in understanding global carbon (C) cycling, the mechanisms regulating belowground C fluxes and storage are still uncertain. New molecular technologies have the power to elucidate these processes, yet we have no widespread standardized implementation of molecular techniques. To address this gap, we introduce the Molecular Observation Network (MONet), a decadal vision from the Environmental Molecular Sciences Laboratory (EMSL), to develop a national network for understanding the molecular composition, physical structure, and hydraulic and biological properties of soil and water. These data are essential for advancing the next generation of multiscale Earth systems models. In this paper, we discuss the 1000 Soils Pilot for MONet, including a description of standardized sampling materials and protocols and a use case to highlight the utility of molecular-level and microstructural measurements for assessing the impacts of wildfire on soil. While the 1000 Soils Pilot generated a plethora of data, we focus on assessments of soil organic matter (SOM) chemistry via Fourier-transform ion cyclotron resonance-mass spectrometry and microstructural properties via X-ray computed tomography to highlight the effects of recent fire history in forested ecosystems on belowground C cycling. We observed decreases in soil respiration, microbial biomass, and potential enzyme activity in soils with high frequency burns. Additionally, the nominal oxidation state of carbon in SOM increased with burn frequency in surface soils. This results in a quantifiable shift in the molecular signature of SOM and shows that wildfire may result in oxidation of SOM and structural changes to soil pore networks that persist into deeper soils.

As a key partner of Ministry of Health (MOH) Ethiopia, The Clinton Health Access Initiative (CHAI) had been implementing the Child Survival Project (CSP) since October 2015. Strengthening DTC was one of its focuses to improve overall supply chain management (SCM). The objective of this study are to review the evolution of DTCs in Ethiopia from their early years to current practice and identify the major driving and hindering factors for their functionality. A descriptive mixed study design was employed. The study made use of qualitative data supplemented with quantitative data, generated from both primary and secondary sources through key informant interviews and desk review methods. DTCs were introduced in Ethiopia in the early 1980s. The mandate of DTCs has been given to four different government organizations during that time. As a result, due to a lack of coordination among these organizations, its implementation was lagging. Recently, the government and its partners have given attention to DTCs. More than 5847 professionals underwent DTC training from 2016 onwards. DTC establishment in health facilities improved from 85% to 98% between 2015 and 2019 during baseline and end-line assessments carried out by CHAI/CSP. Similarly, DTC functionality in HFs improved from 20% to 63%. The CHAI/CSP regular supervision data analysis revealed that DTC establishment improved from 83% to 100% of HFs, while its functionality improved from 5% to 72% between 2016 and 2019, respectively. A chi-square test of independence examining the relationship between facility and pharmacy head training on DTCs and functionality of DTC in the same facility revealed a significant association between the two variables at p

Abstract Background Pneumonia is the leading infectious cause of death in children worldwide, accounting for 15% of all deaths in children under the age of five. Hypoxemia is a major cause of death in patients suffering from pneumonia. There is strong evidence that using pulse oximetry and having reliable oxygen sources in health care facilities can reduce deaths due to pneumonia by one-third. Despite its importance, hypoxemia is frequently overlooked in resource-constrained settings. Aside from the limited availability of pulse oximetry, evidence showed that healthcare workers did not use it as frequently to generate evidence-based decisions on the need for oxygen therapy. As a result, the goal of this study was to assess the availability of medical oxygen devices, operating manuals, guidelines, healthcare workers’ knowledge, and skills in the practice of hypoxemia diagnosis and oxygen therapy in piloted health centers of Ethiopia. Methods A pre-post non-experimental study design was employed. An interviewer-administered questionnaire was used to collect primary data and review medical record charts. A chi-square test with a statistical significance level of P

Inherited retinal diseases (IRD) are genotypically and phenotypically varied disorders that lead to progressive degeneration of the outer retina and the retinal pigment epithelium (RPE) eventually resulting in severe vision loss. Recent research and developments in gene therapy and cell therapy have shown therapeutic promise in these hitherto incurable diseases. In gene therapy, copies of a healthy gene are introduced into the host cells via a viral vector. Clinical trials for several genes are underway while treatment for RPE65 called voretigene neparvovec, is already approved and commercially available. Cell therapy involves the introduction of stem cells that can replace degenerated cells. These therapies are delivered to the target tissues, namely the photoreceptors (PR) and RPE via subretinal, intravitreal, or suprachoroidal delivery systems. Although there are several limitations to these therapies, they are expected to slow the disease progression and restore some visual functions. Further advances such as gene editing technologies are likely to result in more precise and personalized treatments. Currently, several IRDs such as retinitis pigmentosa, Stargardt disease, Leber congenital amaurosis, choroideremia, achromatopsia, and Usher syndrome are being evaluated for possible gene therapy or cell therapy. It is important to encourage patients to undergo gene testing and maintain a nationwide registry of IRDs. This article provides an overview of the basics of these therapies and their current status.

BackgroundAntenatal care (ANC) is one of the most important ways to reduce maternal and neonatal morbidity and mortality. According to data from poor countries, the majority of pregnant women attend ANC when they are in their later stages of pregnancy. In this regard, limited information is currently known about the factors that determine ANC scheduling and the type of care for pregnant women in the town of Mizan-Aman in southwestern Ethiopia. Therefore, the purpose of this study was to determine late antenatal care booking and associated factors among pregnant women in the Town.MethodThe institutional-based cross-sectional study design was conducted in Mizan-Aman town using a systematic random sampling method through structured questions from February 15 to March 25, 2021. The collected data was entered into EPI info-7 which later on, was exported to SPSS version 20 for statistical analysis. Binary and multiple logistic regressions were used to identify associated factors and p-value ResultsA total of 425 female pregnant women participated, making a 100% response rate. The prevalence of delayed first ANC bookings in this study was 70.0% [95.0%, CI = 65.65-74.35]. Multivariate analysis revealed that unplanned pregnancy [AOR = 2.63, 95% CI: 1.18, 5.85], inappropriate perception of ANC starting time [AOR = 4.1, 95% CI: 1.9, 8.83], pregnant women who were unaware of pregnancy-related danger signs [AOR = 6.76, 95% CI: 2.83, 16.1], and pregnant women who were unaware of service delivery during working hours in the institution [AOR = 0.44, 95% CI: 0.19, 0.98].ConclusionThe current study showed a greater prevalence of delayed ANC beginnings, and the factors for this were having an unplanned pregnancy, lack of awareness about pregnancy danger signs, inappropriate perception of ANC starting time, and pregnant women who were unaware of service delivery during working hours at the institution. Responsible bodies working in maternal and child health care better create awareness of the benefits of early ANC booking and appropriate ANC starting times. Further, each health institution's MCH clinic should deliver the service through working hours.

The aim of the present study was to develop antibacterial cellulose (cotton) nanocomposite fabrics (CNCFs) with in situ generated silver nanoparticles using medicinal plant Vitex leaf extract. The developed CNCFs were characterized by scanning electron microscope (SEM), Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD) and antibacterial tests. Further, these CNCFs possessed good antibacterial activities. These CNCFs prepared using simple and environmentally friendly method can be considered for medical applications in, such as, surgical aprons, wound cleaning, wound dressing, and hospital bed materials.

Climate change in Arctic landscapes may increase freeze–thaw frequency within the active layer as well as newly thawed permafrost. Freeze-thaw is a highly disruptive process that can deform soil pores and alter the architecture of the soil pore network with varied impacts to water transport and retention, redox conditions, and microbial activity. Our objective was to investigate how freeze–thaw cycles impacted the pore network of newly thawed permafrost aggregates to improve understanding of what type of transformations can be expected from warming Arctic landscapes. We measured the impact of freeze–thaw on pore morphology, pore throat diameter distribution, and pore connectivity with X-ray computed tomography (XCT) using six permafrost aggregates with sizes of 2.5 cm3 from a mineral soil horizon (Bw; 28–50 cm depths) in Toolik, Alaska. Freeze-thaw cycles were performed using a laboratory incubation consisting of five freeze–thaw cycles (−10 °C to 20 °C) over five weeks. Our findings indicated decreasing spatial connectivity of the pore network across all aggregates with higher frequencies of singly connected pores following freeze–thaw. Water-filled pores that were connected to the pore network decreased in volume while the overall connected pore volumetric fraction was not affected. Shifts in the pore throat diameter distribution were mostly observed in pore throats ranges of 100 µm or less with no corresponding changes to the pore shape factor of pore throats. Responses of the pore network to freeze–thaw varied by aggregate, suggesting that initial pore morphology may play a role in driving freeze–thaw response. Our research suggests that freeze–thaw alters the microenvironment of permafrost aggregates during the incipient stage of deformation following permafrost thaw, impacting soil properties and function in Arctic landscapes undergoing transition.

Abstract Background Hypoxemia is a severe condition associated with high rates of mortality, particularly in low- and middle-income countries (LMICs) with poor access to oxygen therapy. Despite its clinical significance, there have been few studies to describe the burden of hypoxemia. Thus, the primary objective of this study is to systematically describe the prevalence of hypoxemia among pediatric and adult patients in low- and middle-income countries. Methods/design Standard systematic review methods will be used. Bibliographic databases (MEDLINE, EMBASE, CINAHL) will be searched from 1998 onwards. The search strategy aims to identify studies that have measured peripheral blood oxygen saturation (SpO2) in children and adults presenting to health facilities in LMICs. Studies will be included if oxygen saturation measurements by pulse oximetry were measured. No studies will be excluded based on study design though patients recruited from intensive care units and post-operative care will be excluded. The primary outcome is the prevalence of hypoxemia on presentation to the healthcare facility. We define hypoxemia on the basis of SpO2 measurements, and use a threshold of SpO2 less than 90% at sea level though allow for a lower threshold for studies conducted at higher altitude and where justified. Standardized tools will be used to extract data on number of patients with SpO2 measurements, number of patients with hypoxemia, patient population characteristics, and study characteristics. Quality of the included studies will be assessed using the “Checklist for Prevalence Studies” developed by the Joanna Briggs Institute. If there are enough studies to do so, we will conduct meta-analysis using a random effects model to estimate prevalence of hypoxemia and conduct subgroup analyses by age and disease groups. Discussion Hypoxemia is a critical condition and understanding the burden of hypoxemia may support decision-making in LMICs to deploy pulse oximeters and oxygen treatments more efficiently to address diseases and patient populations with the highest burden. Previous studies on hypoxemia prevalence have focused too narrowly on a few diseases or specific patient populations (e.g., pneumonia in children under five) whereas any effort to improve access to oxygen requires understanding of the potential demand for oxygen for all diseases and population groups. Governments, UN agencies, donors, and NGOs are investing strongly to improve oxygen systems in LMICs. Effective oxygen system planning requires estimation of oxygen need, informed by robust data on hypoxemia prevalence and admission patterns at all the levels of the health system. This study aims to fill that gap by providing comprehensive estimates of hypoxemia prevalence. Systematic review registration PROSPERO CRD42019136622 .