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The aim of this study was to understand the variability in the fronts and water masses, and the effect of melt water on the concentration of chlorophyll (Chla) in the Indian Ocean sector of the Southern Ocean using hydrographic data collected during the austral summer (February 2010 and 2011). The Southern Subtropical Front (SSTF) and Northern Sub Antarctic Front (SAF1) were found to be further south at 57°30′E than at 47–48°E. This southward shift of the fronts was consistent with the southward meandering (c. 2°) of the Antarctic Circumpolar Current (ACC) core from the western section to the eastern section, which could have been caused by the bottom topography. The intrusion of water masses also differed between the western and eastern transects of the study region as a result of the meandering of the ACC core. Fresh water layer thickness relative to the winter water in 2011 was more compared to that during 2010. This could have been due to the larger amount of sea ice that was present in the winter of 2010, which subsequently melted, resulting in the advection of melt water from the south and west of the study region. In situ observations and satellite data detected a high Chlaconcentration (c. 0.38 mg m−3) south of the Northern Polar Front (PF1) in 2011, which was caused by this melt water. [ABSTRACT FROM AUTHOR]

Background: To study effect of pregnancy on obese women's maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications., Methods: This cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured., Results: We enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration., Conclusion: This study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by Tawam Human Research Ethics Committee, with approval number THREC-627. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Exposures to ambient ultrafine particle (UFP) air pollution (AP) during the early postnatal period in mice (equivalent to human third trimester brain development) produce male-biased changes in brain structure, including ventriculomegaly, reduced brain myelination, alterations in neurotransmitters and glial activation, as well as impulsive-like behavioral characteristics, all of which are also features characteristic of male-biased neurodevelopmental disorders (NDDs). The purpose of this study was to ascertain the extent to which inhaled Cu, a common contaminant of AP that is also dysregulated across multiple NDDs, might contribute to these phenotypes. For this purpose, C57BL/6J mice were exposed from postnatal days 4-7 and 10-13 for 4 hr/day to inhaled copper oxide (Cu x O y ) nanoparticles at an environmentally relevant concentration averaging 171.9 ng/m 3 . Changes in brain metal homeostasis and neurotransmitter levels were determined following termination of exposure (postnatal day 14), while behavioral changes were assessed in adulthood. Cu x O y inhalation modified cortical metal homeostasis and produced male-biased disruption of striatal neurotransmitters, with marked increases in dopaminergic function, as well as excitatory/inhibitory imbalance and reductions in serotonergic function. Impulsive-like behaviors in a fixed ratio (FR) waiting-for-reward schedule and a fixed interval (FI) schedule of food reward occurred in both sexes, but more prominently in males, effects which could not be attributed to altered locomotor activity or short-term memory. Inhaled Cu as from AP exposures, at environmentally relevant levels experienced during development, may contribute to impaired brain function, as shown by its ability to disrupt brain metal homeostasis and striatal neurotransmission. In addition, its ability to evoke impulsive-like behavior, particularly in male offspring, may be related to striatal dopaminergic dysfunction that is known to mediate such behaviors. As such, regulation of air Cu levels may be protective of public health., 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 © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Acute respiratory distress syndrome is an important clinical presentation of respiratory complications caused by severe acute respiratory syndrome coronavirus 2, a novel coronavirus responsible for the ongoing pandemic. The disease is poorly understood, and immunopathogenesis is constantly evolving. Cytokine release syndrome remains central to pathology of coronavirus disease 2019. Antivirals, anticytokine treatment, and other pharmacological approaches have failed to treat it. CytoSorb, an extracorporeal cytokine adsorber that reduces the cytokine storm and other inflammatory mediators in the blood, seems promising in treating severely ill patients with coronavirus disease 2019., Case Presentation: This article presents three cases of Asian ethnicity of severely ill adult patients with coronavirus disease 2019 admitted to intensive care unit who were treated with CytoSorb therapy. All patients used single CytoSorb device. During their clinical course, all patients were prescribed tocilizumab (an interleukin-6 receptor blocker), antivirals, hydroxychloroquine, azithromycin, and other antibiotics and general antipyretic drugs. No vasopressor treatment was required. The patients' average duration of stay in intensive care unit was 30 days; the average duration of stay in hospital was 31 days. All three patients showed significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy. C-reactive protein levels decreased by 91.5%, 97.4%, and 55.75 %, and mean arterial pressure improved by 18%, 23%, and 17 % in patient 1, 2, and 3, respectively, on day 7 post-therapy., Conclusions: All three patients improved clinically and survived., (© 2021. The Author(s).)

Although some serum biomarkers are elevated in both Kawasaki disease (KD) and infections, these conditions have not been compared by individual or combined biomarkers. The aim of this study, undertaken between January 2016 and May 2018 in a large teaching hospital, was to compare the serum concentration of cytokines, metalloproteinases (MMP) and heat shock protein (HSP) between cases defined as children with Kawasaki disease (KD) and those with febrile infections (controls) . Serum concentrations of tumour necrosis factor-alpha (TNF-alpha), interleukins (IL 1beta, 6, and 8), heat shock proteins (HSP 60 and 70) and matrix metalloproteinase (MMP 9) were measured on admission in 17 children under six years of age with a temperature >38.5 °C for ≥five days, and compared between the two groups. The median age was 25 months and the median duration of fever eight days. Seven children were diagnosed with KD and ten had a febrile infection. Only the serum concentrations of IL-6 and TNF-alpha were significantly higher in the former than in the latter group ( P  = 0.01 and 0.04 respectively). To differentiate between the two groups with the best sensitivity and specificity, the optimal cut-off value for IL-6 was 12.6 pg/mL, and for TNF-alpha 47.9 pg/mL. Their combined increase, however, outperformed their individual concentrations. The characteristic diagnostic "signature" of the combined elevation of IL-6 and TNF-alpha serum levels has the potential, in febrile children, to differentiate early KD from febrile infections, allowing the institution of appropriate therapy., 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., (© 2020 The Authors.)

Objectives: Few studies have investigated pharyngeal colonisation in the United Arab Emirates (UAE). This study aims to identify the pharyngeal organisms present in a cohort of medical students with and without symptomatic pharyngitis., Methods: This study was conducted between September 2016 and June 2018 at the College of Medicine and Health Sciences, UAE University, Al-Ain. Nasopharyngeal swabs were collected from preclinical and clinical medical students attending the college during the study period. The specimens were tested for 16 viral and nine bacterial pathogens using a real-time polymerase chain reaction assay., Results: A total of 352 nasopharyngeal swabs were collected from 287 students; of these, 22 (7.7%) had pharyngitis symptoms. Overall, the most common isolates were human rhinovirus, Streptococcus pneumoniae and Haemophilus influenzae , with no significant differences in terms of gender, year of study or stage of study. The prevalence of S. pyogenes in asymptomatic and symptomatic students was 1.1% and 0%, respectively. A Centor score of ≥2 was not associated with S. pyogenes -positive samples. Six pathogens were isolated from symptomatic students including H. influenzae . Fusobacterium necrophorum was not detected in any of the samples., Conclusion: The diagnosis and management of pharyngitis should be tailored to common pathogens in the region. This study found that S. pyogenes and F. necrophorum were not detected among students with symptoms of pharyngitis; moreover, Centor scores of ≥2 were not associated with the presence of S. pyogenes . This cut-off score therefore should not be employed as an empirical measure to initiate penicillin therapy in this population., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest., (© Copyright 2020, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Sea surface temperature (SST) is a fundamental driver of tropical weather systems such as monsoon rainfall and tropical cyclones. However, understanding of the factors that control SST variability is lacking, especially during the monsoons when in situ observations are sparse. Here we use a ground-breaking observational approach to determine the controls on the SST variability in the southern Bay of Bengal. We achieve this through the first full closure of the ocean mixed layer energy budget derived entirely from in situ observations during the Bay of Bengal Boundary Layer Experiment (BoBBLE). Locally measured horizontal advection and entrainment contribute more significantly than expected to SST evolution and thus oceanic variability during the observation period. These processes are poorly resolved by state-of-the-art climate models, which may contribute to poor representation of monsoon rainfall variability. The novel techniques presented here provide a blueprint for future observational experiments to quantify the mixed layer heat budget on longer time scales and to evaluate these processes in models.

Background: Cytokines and inflammatory mediators are the hallmarks of sepsis. Extracorporeal cytokine hemoadsorption devices are the newer clinical support system to overcome the cytokine storm during sepsis., Aim: To retrospectively evaluate the clinical outcomes of patients admitted in intensive care unit with septic shock with different etiologies., Methods: The laboratory parameters including biomarkers such as procalcitonin, serum lactate and C-reactive protein; and the hemodynamic parameters; mean arterial pressure, vasopressor doses, sepsis scores, cytokine levels and other vital parameters were evaluated. We evaluated these outcomes among survivors and non-survivors., Results: Of 100 patients evaluated, 40 patients survived. Post treatment, the vasopressors dosage remarkably decreased though it was not statistically different; 34.15% ( P = 0.0816) for epinephrine, 20.5 % for norepinephrine ( P = 0.3099) and 51% ( P = 0.0678) for vasopressin. In the survivor group, a remarkable reduction of biomarkers levels; procalcitonin (65%, P = 0.5859), C-reactive protein (27%, P = 0.659), serum lactate (27%, P = 0.0159) and bilirubin (43.11%; P = 0.0565) were observed from baseline after CytoSorb ® therapy. A significant reduction in inflammatory markers; interleukin 6 and interleukin 10; (87% and 92%, P < 0.0001) and in tumour necrosis factor (24%, P = 0.0003) was also seen. Overall, 28 (28%) patients who were given CytoSorb ® therapy less than 48 h after onset of septic shock survived and the maximum duration of stay for 70% of these patients in intensive care unit was less than 15 d., Conclusion: CytoSorb ® is a safe and well tolerated rescue therapy option in patients with septic shock. However, early (preferably within < 48 h after onset of septic shock) initiation could result in better clinical outcomes. Further randomized trials are needed to define the potential benefits of this new treatment modality., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare., (©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.)

The COVID-19 pandemic is imposing enormous global challenges in managing the spread of the virus. A key pillar to mitigation is contact tracing, which complements testing and isolation. Digital apps for contact tracing using Bluetooth technology available in smartphones have gained prevalence globally. In this article, we discuss various capabilities of such digital contact tracing, and its implication on community safety and individual privacy, among others. We further describe the GoCoronaGo institutional contact tracing app that we have developed, and the conscious and sometimes contrarian design choices we have made. We offer a detailed overview of the app, backend platform and analytics, and our early experiences with deploying the app to over 1000 users within the Indian Institute of Science campus in Bangalore. We also highlight research opportunities and open challenges for digital contact tracing and analytics over temporal networks constructed from them., (© Indian Institute of Science 2020.)

Background: Pressure ulcers (PU) usually occur over bony prominences in hospitalized patients. But they may occur due to medical devices referred also as Medical device related pressure ulcers (MDRPU). The United States National advisory panel (NPUAP) recognizes it as an important entity. MDRPU is one of the key quality indicators of hospital care, so far no data is available on MDRPU from the Indian Sub-continent., Aim: The primary objective of the study was to examine prevalence and Risk factors of MDRPU in critically sick patients., Design: A Cross-sectional point prevalence study., Methods: All patients above 18 years of age admitted in Intensive care units (ICU) on the date of the survey were included in the study. It was conducted in medical, cardiothoracic and neurosurgical ICUs. Demographic and MDRPU data were recorded. MDRPU was staged as per National Pressure ulcer advisory panel staging system. Ethics Committee approval was obtained prior to the start of the study., Results: One hundred and forty-six patients were included. The prevalence of PU was 26.0%. The prevalence of MDRPU was found to be 19.2%. MDRPUs most commonly occurred with non-invasive ventilation mask (NIV) and nasogastric tube (NGT) (20% and 12.3% respectively). MDRPUs were associated with a longer ICU Stay., Conclusions: MDRPUs pose a significant burden on healthcare. Our study showed significant prevalence rate of MDRPU which is comparable to those seen internationally. There is a compelling need to have continuous audits and structured training programs among healthcare professionals to prevent MDRPUs in critically sick patients., (Copyright © 2018. Published by Elsevier Ltd.)

Background and Aims: Deep venous thrombosis (DVT) prophylaxis is underutilized, and there is a paucity of data reflecting the incidence of DVT in Indian Intensive Care Unit (ICU) population. We sought to evaluate the incidence and risk factors for DVT in medical and surgical ICU patients with DVT prophylaxis., Material and Methods: The ICU patients more than 18 years old, expected to be in the ICU for more than 48 h were enrolled and DVT prophylaxis were given as per risk and were observed for clinical signs of DVT along with duplex ultrasound until in ICU. The patients receiving anticoagulant for some other reasons were excluded along with those with pregnancy, congenital coagulation disorders and terminal illness., Results: The incidence of DVT was 0.8% (95% confidence interval: 0.78-0.81) in mixed populations (1.6% in medical and 0.5% in surgical). The higher DVT score (DVT (+) 10.75 ± 2.06/DVT (-) 8.75 ± 1.7 P = 0. 0264), Acute physiology and chronic health evaluation (APACHE) IV score (DVT positive patient - DVT (+) 59.25 ± 15.06/DVT negative patients - DVT (-) 44.01 ± 13.74) P = 0. 0292), length of ICU stay ([DVT (+) 26.75 ± 12.87 days/DVT (-) 5.19 ± 6.18] P < 0.010), and inotropes (DVT (+) 50%/DVT (-) 12.3% P = 0. 023) were associated with DVT., Conclusion: The incidence of DVT was 0.8% with prophylaxis. High DVT and APACHE IV score were associated with DVT. Prolonged ICU stay and vasopressors were the risk factors., Competing Interests: None.

Background and Objectives: The aim of the study was to determine the effect of two access cavity designs on the peri-cervical dentin thickness before and after instrumentation using cone beam computed tomography (CBCT)., Materials and Methods: Sixty mandibular anterior teeth were divided into two groups of thirty teeth each: Group I: conventional access cavity preparation, where access was prepared just above the cingulum and Group II: incisal access cavity preparation, where access was prepared in proximity to the incisal edge. CBCT scans were taken preoperatively, following access cavity preparation and post instrumentation. 200 μm thick slices were obtained 4mm apical and coronal to the cemento-enamel junction. The peri-cervical dentin thickness was calculated on the facial, lingual, mesial, and distal for all the three obtained scans., Results: The analysis showed that access cavity preparation and instrumentation resulted in a significant loss of tooth structure in Group I on all surfaces, but in Group II, there was a significant loss of tooth structure only in the mesial, lingual, and distal surfaces (P < 0.05)., Conclusion: Incisal access cavity preparation resulted in lesser loss of dentin in the peri-cervical region.

Background: Alleviating pain is of utmost importance when treating patients with endodontic pain., Aim: To compare and evaluate the efficacy of two modes of delivery of pretreatment Piroxicam (Dolonex(®), Pfizer) for the management of postendodontic pain., Materials and Methods: Sixty-six patients with symptomatic irreversible pulpitis were randomly divided into three groups of 22 subjects Group I - control group, no pharmacological intervention, Group II - patients received pretreatment oral Piroxicam (40 mg), Group III - patients received pretreatment intraligamentary injections totaling 0.4 mL of Piroxicam. Single visit endodontic therapy was performed by a single endodontist. Visual analogue scale was used to record pain before treatment and 4, 8, 12, 24, and 48 h postoperatively. Mann-Whitney U-test and Kruskal-Wallis tests were used to analyze the data., Results: The patients in Groups II and III perceived less postendodontic pain as compared to Group I (P < 0.05), at all the time intervals. At 12, 24, and 48 h, pain experience in patients of Group III was significantly less., Conclusions: Intraligamentary mode of delivery of Piroxicam was more efficacious.

Aim: To compare the fracture resistance of maxillary central incisor fragments having two different fracture patterns and re-attached using two different posts - fibre post and Ribbond., Materials and Methods: Sixty extracted human maxillary central incisors were randomly divided into two groups of thirty samples each. Group A consisted of samples with 'labio-palatal' fracture pattern and Group B with a 'palato-labial' fracture pattern. The crowns of all the samples were sectioned using safe-sided diamond discs. Following cleaning and shaping and sectional obturation, the samples were randomly subdivided into two subgroups of 15 samples each. Prefabricated fibre post (Reforpost, Angelus, Londrina, PR, Brazil) was placed in all samples of Subgroup I, and Ribbond (Ribbond Inc., Seattle, WA, USA) was placed in all samples of Subgroup II. The fragments were re-attached, fracture resistance was tested using Instron Universal Testing Machine, and the failure modes were assessed using a stereomicroscope., Results: Group A with a labio-palatal fracture pattern exhibited higher fracture resistance as compared to Group B (palato-labial) in both subgroups. The fibre post (Subgroup I) exhibited higher fracture resistance as compared to Ribbond (Subgroup II). The Ribbond group exhibited significantly more number of repairable failures as compared to fibre post group., Conclusion: The labio-palatal pattern of fracture is a favourable type of fracture on palatal load application. The fragments re-attached using the fibre post (Reforpost) had a higher resistance to fracture. However, teeth restored with Ribbond posts exhibited 100% repairable failures upon load application. The fracture pattern had no influence on the failure modes., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Pressure ulcers is a frequent problem in hospitalized patients. Several prevalence studies have been conducted across the globe. Little information is available regarding prevalence of pressure ulcers in India., Purpose: The aim was to identify the prevalence of pressure ulcers in one of the tertiary hospital in northern India and the factors associated with its development., Design: A cross sectional point prevalence study., Instruments: European Pressure Ulcer Advisory Panel (EPUAP) data collection form., Methods: Ethics approval was obtained prior to start of the study. Total of 358 patients were enrolled in the study. All patients above 18 years of age admitted in intensive care units and wards were included in the study. Patients admitted in emergency, day care, coronary care unit were excluded because of their short duration of hospital stay (varies from 24 to 72 h usually). All patients admitted before midnight on the predetermined day were included. The Braden scale was used to identify the risk of developing pressure ulcers. European Pressure ulcer advisory panel (EPUAP) minimum data set was used to collect prevalence data., Results: The overall prevalence rate was 7.8%.The sacrum and heel were more commonly affected. Grade III pressure ulcers were the most common (42.8%)., Conclusion: The pressure ulcer prevalence rate in our hospital was lower than that published in international studies. Severe forms of pressure ulcers were commonly encountered This data provides background information that may help us in developing protocols for applying effective practices for prevention of pressure ulcers., (Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.)

Dental procedures done in the vicinity of dermal fillers may result in complications of the dermal fillers such as infections which may mimic a dental infection. These infections of dermal fillers must be differentiated from facial cellulitis or from dental infection as treatment for infection from dermal fillers may be prolonged with repeated use of antibiotics, incision and drainage or removal of the filler material itself. Dental surgeons need to be aware of this potential risk in order to recognize and manage it appropriately.

The spatial variation of chlorophyll a (Chl a) and factors influencing the high Chl a were studied during austral summer based on the physical and biogeochemical parameters collected near the coastal waters of Antarctica in 2010 and a zonal section along 60°S in 2011. In the coastal waters, high Chl a (>3 mg m(-3)) was observed near the upper layers (∼15 m) between 53°30'E and 54°30'E. A comparatively higher mesozooplankton biomass (53.33 ml 100 m(-3)) was also observed concordant with the elevated Chl a. Low saline water formed by melting of glacial ice and snow, as well as deep mixed-layer depth (60 m) due to strong wind (>11 ms(-1)) could be the dominant factors for this biological response. In the open ocean, moderately high surface Chl a was observed (>0.6 mg m(-3)) between 47°E and 50°E along with a Deep Chlorophyll Maximum of ∼1 mg m(-3) present at 30-40 m depth. Melt water advected from the Antarctic continent could be the prime reason for this high Chl a. The mesozooplankton biomass (22.76 ml 100 m(-3)) observed in the open ocean was comparatively lower than that in the coastal waters. Physical factors such as melting, advection of melt water from Antarctic continent, water masses and wind-induced vertical mixing may be the possible reasons that led to the increase in phytoplankton biomass (Chl a).

Background: In restorative treatment dental unit water is used while irrigating the cavity and also in the use of composite restorations to flush away the etchant to place bonding agent. These antimicrobials may influence the bond strength of the dentine bonding agent to the dentine., Aim and Objective: To evaluate the effect of three different dental units waterline antimicrobials on the shear bond strength of dentin., Materials and Methods: Sixty freshly extracted human teeth were taken and the occlusal surfaces were sectioned to obtain a flat dentin surface. Then the teeth were randomized into 4 groups depending on the antimicrobial used: Group 1(Distilled water), Group 2 (Alpron), Group 3 (CitriSil), and Group 4 (Chlorhexidine). The dentine surface was prepared for bonding and composite resin was placed in two increments of 2 mm each. The specimens were stored in distilled water, thermo cycled after 7 days shear test was performed by using the universal testing machine., Result: No significant difference between Group 1 and Group 2 with regard to shear bond strength. There was a significant difference in the SBS of Group 1 and Group 3 and Group 4. The SBS of group 2 was higher than Group 3 and Group 4 and the difference was statistically significant., Conclusion: Citrisil and Chlorhexidine groups showed affected bond strength whereas Alpron did not vary with bond strength.