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A Pd-catalysed 100% atom-economical method has been developed for the synthesis of 1,3-disubstituted indolizine derivatives in good yields through a regiospecific formal [3 + 2]-annulation from 2-pyridinyl-substituted p-quinone methides and terminal alkynes.

The COVID-19 pandemic created significant challenges for academic health systems (AHSs) across their tripartite mission of providing clinical care, conducting research, and educating learners. Despite these challenges, AHSs played an invaluable role in responding to the pandemic. Clinicians worked tirelessly to care for patients, and institutions quickly reoriented their care delivery systems. Furthermore, AHSs played an important role in advancing science, launching studies and clinical trials to examine new vaccines and treatments for COVID-19. However, there is room for improvement; AHSs can use lessons learned from the COVID-19 pandemic to reshape their operations for the future. To prepare for the next pandemic, AHSs must modernize, adapt, and transform their clinical operations, research infrastructure, and educational programs to include public health and to build surveillance capacity for detecting, monitoring, and managing emerging outbreaks. In this Invited Commentary, the authors describe the opportunities AHSs have to build on their experiences during the COVID-19 pandemic and the ways they can take advantage of their unique strengths in each of their 3 mission areas. Within clinical care, AHSs can reach patients outside traditional clinical settings, build national and regional networks, advance data-driven insights, engage with the community, and support and protect the workforce. Within research, they can leverage data science and artificial intelligence, perform pandemic forecasting, leverage the social and behavioral sciences, conduct clinical trials, and build a research and development preparedness and operational plan. Within education, AHSs can promote remote learning, make interprofessional learning the norm, and build a system of continuing education.

A detailed experimental programme was conducted to evaluate the liquefaction susceptibility of non-plastic and low-plasticity soils subjected to cyclic loading under undrained triaxial loading conditions. The study mainly focused on examining the influence of the amount of fines and plasticity indices on the liquefaction resistance of sands. After mixing silt and clay fractions into fine sand, 16 soil combinations were prepared. The silty sands contained up to 40% non-plastic fines and the low-plasticity soils contained a clay fraction of 5–40%. Each cylindrical soil specimen was constituted to a medium relative density and saturated specimens were subjected to a confinement pressure of 100 kPa. The consolidated specimens were then subjected to various levels of cyclic stress amplitudes using a sinusoidal wave load form at a frequency of 1 Hz. The results showed that both the non-plastic and low-plasticity clay soils were less resistant to liquefaction than the fine sand. The soils belonging to categories SM and SC (silty sand and clayey sand, respectively, as per Indian standard soil classifications) were susceptible to liquefaction if the fines passing through a 75 μm sieve were ≤ 40%, the liquid limit was ≤ 40%, the plasticity index was

To analyse the patients with foreign body oesophagus in relation to the clinico-radiological and socio-economic profile. The present prospective study was conducted on 100 consecutive patients of all age groups who underwent oesophagoscopy for suspected foreign body ingestion in a tertiary care hospital. The most common age group affected was 0-5 years. The median age was 5 ± 14.37 years. There was preponderance in males as compared to females, male to female ratio was 2.23:1. Majority (70%) of the patients, both males and females, belonged to rural areas. Lower socio-economic group was more commonly affected (54%). The most commonly reported symptom was foreign body sensation (55%) followed by vomiting (54%) and difficulty in swallowing (51%). Foreign body ingestion was witnessed in only 19% cases by the family members. The mean time between ingestion of the foreign body and admission to the hospital was found to be 4.5 h. The majority (97%) of foreign bodies were radio-opaque. The most common site of lodgement was just below the cricopharynx (89%). The most common foreign body retrieved in our series were coins (65%). The majority of foreign bodies (68%) were retrieved in 20-40 min after induction of general anaesthesia. In 99% of the patients we did not encounter any complications. The majority (93%) of the patient's parents/relatives had curiosity to have a glimpse of the foreign body till they actually saw the retrieved foreign body. Foreign body lodgement is more common among children of lower socio-economic strata more so in rural areas. Rigid oesophagoscopy is a safe and effective procedure for removal of the foreign body. Early intervention makes it easier to extract the foreign body without complications.

Nasal foreign bodies is common pediatric emergency in otorhinolaryngology. Sometimes these may get dislodged in the airways which may prove catastrophic. Aim: To analyzed the age, sex, side of nose, nature of foreign bodies and complications in pediatric population in India. Material & Methods: 1156 cases of nasal foreign bodies removed endoscopically in age group of 1-14 years in the years 2001 to 2014 were evaluated according to the parameter related above. Two self-fabricated simple and atraumatic nasal foreign body hooks were used for removal of foreign bodies. Results: We observed higher incidence of foreign bodies in 1-4 years age group, inorganic foreign bodies (601) being more common than organic foreign bodies (555). Minor complications like momentary nasal bleeding due to laceration of nasal mucosa were observed in very few cases. Conclusion: Nasal endoscopy is best technique for removal of foreign bodies which is very quick, safe, less traumatic and site is well visualized. Foreign body hooks used by us are economical and atraumatic. Any Otorhinolaryngologist can make these hooks in his/ her clinic

Background: The present study was undertaken to compare the efficacy of otoendoscopic removal with conventional techniques in aural myiasis patients. Methods: The three hundred and thirty eight, aural myiasis patients in study group were treated using Hopkine rigid otoendoscope, the visible crawling caudal end of maggots was grasped with forceps & removed. Rests were identified from crawling movements or the visible caudal end buried in EAC and middle ear cavity and removed. Complete maggots clearance of ear cavity from EAC to middle ear cavity was done and same was repeated on other side if needed. Equal number of patients were treated using head light. Results: The mean age in two groups was 55.5 years (range 02-68) in aural myiasis patients. There were 56.5% males and 43.5% females. Mean duration of aural symptom in both groups was 2 days. Endoscopically mean number of 42 maggots (range-10- 62) were removed in first sitting as compared to conventional technique where mean of 28 (range 10-48) maggots were removed (p

Background Cognitive training has been demonstrated to improve cognitive performance in older adults. To date, no study has explored personalized training that targets the brain activity of each individual. Objective This is the first large-scale trial that examines the usefulness of personalized neurofeedback cognitive training. Methods We conducted a randomized-controlled trial with participants who were 60-80 years old, with Clinical Dementia Rating (CDR) score of 0-0.5, Mini-Mental State Examination (MMSE) score of 24 and above, and with no neuropsychiatric diagnosis. Participants were randomly assigned to the Intervention or Waitlist-Control group. The training system, BRAINMEM, has attention, working memory, and delayed recall game components. The intervention schedule comprised 24 sessions over eight weeks and three monthly booster sessions. The primary outcome was the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total score after the 24-session training. Results There were no significant between-subjects differences in overall cognitive performance post-intervention. However, a sex moderation effect (p = 0.014) was present. Men in the intervention group performed better than those in the waitlist group (mean difference, +4.03 (95% CI 0.1 to 8.0), p = 0.046. Among females, however, both waitlist-control and intervention participants improved from baseline, although the between-group difference in improvement did not reach significance. BRAINMEM also received positive appraisal and intervention adherence from the participants. Conclusion A personalized neurofeedback intervention is potentially feasible for use in cognitive training for older males. The sex moderation effect warrants further investigation and highlights the importance of taking sex into account during cognitive training.