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Introduction: Clostridioides difficile (C. difficile), once considered a nosocomial pathogen, is now increasingly being observed in the community. The organism is known to cause Antibiotic-associated Diarrhoea (AAD), Pseudomembranous Colitis (PMC), megacolon, and even death. Aim: To determine the prevalence of C. difficile in stool samples and to associate the findings with the clinical presentation and risk factors of the patients. Materials and Methods: This retrospective cross-sectional study analysed 208 stool samples received for C. difficile detection at Father Muller Medical College Hospital, Mangaluru, Karnataka, India from January 2021 to January 2023 using the CerTest C. difficile Glutamate dehydrogenase (GDH)+ Toxin A+B onestep combo card test. The results were then associated with the clinical profiles of the patients retrieved from the hospital software, Backbone. Statistical analysis was performed using frequency, percentage, the Chi-square test, and the z-test. Results: Out of the 208 samples analysed from patients belonging to all ages, 20 samples (9.62%) harboured toxigenic C. difficile, while 22 samples (10.58%) contained non toxigenic C. difficile. Proton Pump Inhibitor (PPI) use and underlying diseases/conditions were identified as highly significant risk factors (χ2=32.28, p-value

Background: Recent technological evolutions allow for the identification of hearing level (HL) in infants soon after birth. The goal of early hearing detection and intervention is to maximize linguistic and communication skills and literacy development for children who are deaf or hard of hearing. Infants whose HL has been confirmed before 6 months of age must be provided early intervention. Aims and Objectives: The aim of the study was to observe the changes in the otoacoustic emissions (OAE) and brainstem auditory evoked potential (BAEP) in infants with birth asphyxia (BA). Materials and Methods: The present study was a case–control study. A total of 50 cases of infants with BA and 50 normal-term infants were part of the study after obtaining informed consent as per the ICMR guidelines. A through clinical examination and otoscopy examination were done to rule out any conductive hearing loss. Then, OAE and BAEP were recorded to estimate the hearing loss and hearing threshold of infants. Results: BAEP waveform I, III, and V absolute latencies were significantly prolonged among BA infants than normal infants. The interpeak latency (IPL) of the right ear III-V was significantly increased in BA infants. However, III-V and I-V latencies though prolonged in BA infants, they are not statistically significant. No significant interaural difference was noted in absolute and IPLs of both BA and normal infants. No significant relationship existed between the mode of delivery and the degree of hearing loss in both ears. Significant association was observed between the degree of hearing loss and severity of BA (hypoxic-ischemic encephalopathy) in both ears. Conclusion: BAEP recording in BA infants is useful to identify the hearing impairment at the earliest. The implication of this research work will help in early detection of hearing impairment, so that speech and language developmental delay in the child can be prevented.

Background: The thyroid hormone is so essential that it is involved in the functioning of all the body systems, especially in the development of the brain in fetal life. The World Health Organization has estimated that around 2 billion individuals are suffering from thyroid disorders. Hence, it is essential to identify and diagnose hypothyroid patients so that the treatment strategy can be started at the earliest. Aims and Objectives: The present study aimed to find out the peripheral nerve conduction velocity, range, and degree of movement of joints in newly diagnosed hypothyroid women and compare them with those of normal euthyroid women. Materials and Methods: The present study was a case–control study conducted from July 2015 to March 2016. A total of 50 cases of newly diagnosed hypothyroid women and 50 age-matched euthyroid women were part of the study after obtaining written and informed consent. Thyroid estimation was performed in the Clinical Biochemistry Department by the ELISA method, and nerve conduction studies were performed in the Neurology Department. Results: The age and height of the participants were not statistically significant. Weight and body mass index were significantly higher in the cases when compared to the control group. Sensory and motor conduction velocities of the right median nerve are significantly less in these cases when compared to control group participants. Sensory and motor conduction velocities of the right ulnar nerve are significantly less in these cases when compared to control group participants. Sensory and motor conduction velocities of the left median nerve are significantly less in these cases when compared to control group participants. Sensory and motor conduction velocities of the left ulnar nerve are significantly less in these cases when compared to control group participants. The goniometric parameters (right and left sides) of the cases and control group participants were not significantly different. Conclusion: Hypothyroid women have a delay in peripheral nerve conduction velocities, including sensory and motor components, and the degree and range of movements of limb joints were not affected. A nerve conduction study may be utilized as a routine screening test for hypothyroid individuals so that hormone replacement therapy can be instituted at the earliest.

Introduction: In hospitalized patients, candidemia accounts for considerable morbidity and mortality. Knowledge of local species epidemiology and antifungal susceptibility is important when considering therapy. This study was performed to speciate Candida isolates from inpatients admitted with blood stream infections in our hospital and to assess their risk factors. Materials and Methods: This present study of 2 years' duration was performed from April 2022 to March 2024. BacT/Alert aerobic culture bottle (bioMérieux, France) was used for all routine blood cultures and incubated for 5 days at 37°C. Any blood culture growing yeast was identified by Gram stain and MALDI-TOF MS (Bruker Daltonics). Disk diffusion method was used for antifungal susceptibility testing and test was performed according to clinical laboratory standard institute (CLSI) guidelines. Results: About 132 Candida isolates from blood were isolated in 2 years. Predominance of males (59%) was noted with the median age of 52 years. Majority were non- albicans Candida (81.06 %) with C. tropicalis (31.81%) and C. auris (13.63%). Susceptibility to fluconazole and voriconazole was 100% for both C. albicans and C. tropicalis isolates. Fluconazole resistance of 11.77% and 100% was observed in C. parapsilosis and C. auris isolates respectively. Conclusion: The predominance of non-albicans Candida with increasing fluconazole resistance and isolation of C. auris as the third most common non-albicans Candida species in this study is of concern. Accurate identification of non-albicans Candida specially C. auris and strict infection control policies should be in place to combat the spread of C. auris in the hospital.

Introduction: Enterococci are major cause of health care associated infections and are resistant to commonly used antibiotics like cephalosporins. The study aims to find the proportion and characteristics of Enterococcus faecium isolates among the enterococcal infections at a tertiary care hospital. Methods and Material: A prospective cohort study was conducted in a tertiary care hospital in Mangalore, Karnataka for a period of 6 months from June to November 2023. The enterococci were isolated and identified and tested for antibiotic susceptibility by the standard methods. Results: Among the 132 enterococcal strains isolated from the clinical samples, 68 (51.51%) were E. faecalis and 61(46.21%) were E. faecium. E. faecium was significantly isolated more from the urine samples and from the inpatients. Also, the resistance to ampicillin (57.4% vs 14.7%), high level gentamicin (54.1% vs 36.8%), nitrofurantoin (37.7% vs 8.8%) and vancomycin (11.5% vs 1.5%) was significantly more among the E. faecium isolates, compared to the E. faecalis isolates. Resistance to linezolid was not found in the current study. Conclusion: In the present study, E. faecium strains were isolated in higher proportion compared to other studies. Therefore, there is an emergent need to combat this increase in E. faecium infections and the associated antibiotic resistance by scrutinising and encouraging appropriate antibiotic use in the hospitals and community.

Background: Infection prevention surveillance revealed that patients admitted from two specific long term care facilities comprised the majority of multi-drug resistant organisms (MDRO) and scabies cases at our institution. Current practices include performing active surveillance for Candida auris and methicillin-resistant Staphylococcus aureus (MRSA) for specific high-risk patients, as surveillance for all MDROs and scabies is impractical. We therefore sought to create an admission screening process to efficiently identify patients from high-risk facilities (HRFs) and place them in pre-emptive contact precautions upon admission. Methods: Patients admitted from HRFs were identified on admission as part of the initial nursing assessment. For any positive responses, nursing received a Best Practice Advisory to place the patient in contact precautions and patient placement received an alert that the patient would require a private room. Infection Preventionists reviewed a report of all patients who screened positive and added a “High Risk Facility” banner to the chart. This banner remained for the duration of hospitalization and for every subsequent readmission and outpatient visit. We reviewed the electronic medical records of all patients with a HRF banner placed from March 8, 2023 to September 15, 2023 and abstracted data regarding the presence of scabies or any of the following MDROs before and after placement of the banner: C. auris, carbapenem-resistant enterobacterales (CRE), MRSA, vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Acinetobacter, and MDR Pseudomonas. Results: Of the 93 patients who had a HRF banner added during the study period, 31 (33.33%) were already known to have MDRO colonization at the time of admission to our facility. Thirty-three of the remaining 62 patients (53.22%) without known MDRO colonization were subsequently found to have MDRO colonization/infection or scabies infestation that may have required contact precautions during their index admission or a subsequent admission. This included 14 patients with C. auris, 2 with CRE, 3 with MDR Pseudomonas, 12 with MRSA, 12 with carbapenem-resistant Acinetobacter, and 2 with VRE. Patients were admitted for a median of 9 days before their diagnosis, and 36 of the 93 patients (38.71%) were re-admitted to our hospital during the study period. Conclusion: We found that empiric contact precautions based solely on exposure to specific HRFs facilitated earlier isolation by a median of 9 days. This approach should be considered in acute care hospitals with a high proportion of admissions from HRFs, especially when active and passive surveillance for MDROs is limited.

Abstract We explored the challenges and solutions for managing data within the Whole Health System (WHS), which operates as a Learning Health System and a patient‐centered healthcare approach that combines conventional and complementary approaches. Addressing these challenges is critical for enhancing patient care and improving outcomes within WHS. The proposed solutions include prioritizing interoperability for seamless data exchange, incorporating patient‐centered comparative clinical effectiveness research and real‐world data to personalize treatment plans and validate integrative approaches, and leveraging advanced data analytics tools to incorporate patient‐reported outcomes, objective metrics, robust data platforms. Implementing these measures will enable WHS to fulfill its mission as a holistic and patient‐centered healthcare model, promoting greater collaboration among providers, boosting the well‐being of patients and providers, and improving patient outcomes.

The oral health/systemic health connection has been an area of research interest that increased dramatically during the 1990s. Periodontal disease has been associated with a number of systemic conditions, including cardiovascular disease, diabetes, pre-term low-birth-weight infants, respiratory conditions, rheumatoid arthritis, cancer, and Alzheimer’s disease. Inflammation is the obvious link that connects periodontal disease with these conditions, but is this association casual or causal? We will address the biologic plausibility, evidence from human studies, evidence from animal studies, and therapeutic interventions as we review the current understanding of the link between periodontitis and Alzheimer’s disease.

Artificial Intelligence (AI) has shown remarkable potential to revolutionise healthcare by enhancing diagnostics, improving treatment outcomes, and streamlining administrative processes. In the global regulatory landscape, several countries are working on regulating AI in healthcare. There are five key regulatory issues that need to be addressed: (i) data security and protection—measures to cover the “digital health footprints” left unknowingly by patients when they access AI in health services; (ii) data quality—availability of safe and secure data and more open database sources for AI, algorithms, and datasets to ensure equity and prevent demographic bias; (iii) validation of algorithms—mapping of the explainability and causability of the AI system; (iv) accountability—whether this lies with the healthcare professional, healthcare organisation, or the personified AI algorithm; (v) ethics and equitable access—whether fundamental rights of people are met in an ethical manner. Policymakers may need to consider the entire life cycle of AI in healthcare services and the databases that were used for the training of the AI system, along with requirements for their risk assessments to be publicly accessible for effective regulatory oversight. AI services that enhance their functionality over time need to undergo repeated algorithmic impact assessment and must also demonstrate real-time performance. Harmonising regulatory frameworks at the international level would help to resolve cross-border issues of AI in healthcare services.

Abstract Background The isolation of Ribonucleic Acid (RNA) from leaves and storage roots of cassava (Manihot esculenta Crantz) is a challenging one, due to the presence of large amounts of polyphenolic compounds, polysaccharides, and tuber proteins. RNA with high quality and intact integrity is vital for gene expression studies. We hereby report a precise, reproducible, and less cumbersome technique for isolating high-quality RNA from leaves and storage roots of cassava with minimal contamination from polyphenols, polysaccharides, and other secondary metabolites, using affordable reagents. This protocol functions without guanidinium salts in the extraction buffer. The presence of guanidinium salts usually leads to the formation of agglomerates during the extraction of RNA from plant tissues with high starch contents. Results The isolated RNA from leaves and storage roots of the ten cassava genotypes yielded between 1576.1 and 2861.9 µg/ml for RNA isolated from the leaf tissues and 2761.2–3873.5 µg/ml for RNA isolated from the storage roots. The A260:A280 ratios of the total RNA were more than 2.0 for both leaf and storage root samples, indicating minimal contamination from polysaccharides and polyphenols. The RNA samples recorded intact integrity, as demonstrated by clear 28 S and 18 S rRNA bands observed on agarose gel electrophoresis. The RNA integrity number (RIN) values ranged between 7.2 and 8.0. Also, the RNA samples were successfully used for transcriptome sequencing. Conclusion The present method which yielded high-quality and transcriptionally competent RNA samples is suitable for use in gene expression studies and downstream applications in the molecular breeding of cassava and related root/tuber crops.

Inequity in health has been documented all across the world, with higher risks recorded amongst minorities, indigenous populations and socially disadvantaged populations. The United States mirrors this pattern in Blacks, Hispanics, Native Americans and immigrant populations, all of whom experience worse health than White Americans. These inequities, exacerbated in emergency situations such as national disasters, pandemics and other emergencies, natural or man-made, have emerged again during the COVID-19 pandemic.

Introduction: Iodine deficiency disorders (IDD) have remained an unresolved public health problem in India. In this survey, we have estimated the prevalence of IDD among 6–12 years of school children in rural areas of north Karnataka, India and estimated the prevalence of low iodine content (

ObjectivesPeriodontitis disproportionately affects different racial and ethnic populations. We have previously reported the higher levels of Porphyromonas gingivalis and lower ratios of Streptococcus cristatus to P. gingivalis may contribute to periodontal health disparities. This prospective cohort study was designed to investigate if ethnic/racial groups responded differently to non-surgical periodontal treatment and if the treatment outcomes correlated to the bacterial distribution in patients with periodontitis before treatment.MethodsThis prospective cohort pilot study was carried out in an academic setting, at the School of Dentistry, University of Texas Health Science Center at Houston. Dental plaque was collected from a total of 75 African Americans, Caucasians and Hispanics periodontitis patients in a 3-year period. Quantitation of P. gingivalis and S. cristatus was carried out using qPCR. Clinical parameters including probing depths and clinical attachment levels were determined before and after nonsurgical treatment. Data were analyzed using one-way ANOVA, the Kruskal–Wallis test, the paired samples t-test and the chi-square test.ResultsThe gains in clinical attachment levels after treatment significantly differed amongst the 3 groups–Caucasians responded most favorably, followed by African-Americans, lastly Hispanics, while numbers of P. gingivalis were highest in Hispanics, followed by African-Americans, and lowest in Caucasians (p = 0.015). However, no statistical differences were found in the numbers of S. cristatus amongst the 3 groups.ConclusionDifferential response to nonsurgical periodontal treatment and distribution of P. gingivalis are present in different ethnic/racial groups with periodontitis.

The healthcare sector is faced with challenges due to a shrinking healthcare workforce and a rise in chronic diseases that are worsening with demographic and epidemiological shifts. Digital health interventions that include artificial intelligence (AI) are being identified as some of the potential solutions to these challenges. The ultimate aim of these AI systems is to improve the patient’s health outcomes and satisfaction, the overall population’s health, and the well-being of healthcare professionals. The applications of AI in healthcare services are vast and are expected to assist, automate, and augment several healthcare services. Like any other emerging innovation, AI in healthcare also comes with its own risks and requires regulatory controls. A review of the literature was undertaken to study the existing regulatory landscape for AI in the healthcare services sector in developed nations. In the global regulatory landscape, most of the regulations for AI revolve around Software as a Medical Device (SaMD) and are regulated under digital health products. However, it is necessary to note that the current regulations may not suffice as AI-based technologies are capable of working autonomously, adapting their algorithms, and improving their performance over time based on the new real-world data that they have encountered. Hence, a global regulatory convergence for AI in healthcare, similar to the voluntary AI code of conduct that is being developed by the US-EU Trade and Technology Council, would be beneficial to all nations, be it developing or developed.

Abstract Pile foundations are adopted if a soil of low bearing capacity extends to a considerable depth or if the structure is heavy or the settlement due to the structure is large. It transfers the load to a strong, stable stratum of soil. The behaviour of soil in slope and piles embedded in it is an elaborated soil-structure interaction problem. This paper presents the results of experimental investigations on a single pile subjected to lateral load by varying relative density of soil in the horizontal and sloping ground with three different slopes of 1V: 2H, 1V: 2.5H and 1V: 3H. The lateral load carrying capacity of the pile is considerably decreased when the lateral load is applied in the direction of the slope. It is found that the lateral load carrying capacity of the pile is increased for higher relative density of sand and the lateral capacity of the pile is greater in flatter slope than in steeper slope. The effect of different slopes on normalized lateral load versus displacement for the lateral load applied in the direction along and against slope is quantified. A set of empirical equations are formulated to determine the deflection, fixity depth and moment for the pile in sloping ground.

Melatonin (MT), a naturally occurring compound, is found in various species worldwide. In 1958, it was first identified in the pineal gland of dairy cows. MT is an “old friend” but a “new compound” for plant biology. It brings experts and research minds from the broad field of plant sciences due to its considerable influence on plant systems. The MT production process in plants and animals is distinct, where it has been expressed explicitly in chloroplasts and mitochondria in plants. Tryptophan acts as the precursor for the formation of phyto-melatonin, along with intermediates including tryptamine, serotonin, N-acetyl serotonin, and 5-methoxy tryptamine. It plays a vital role in growth phases such as the seed germination and seedling growth of crop plants. MT significantly impacts the gas exchange, thereby improving physio-chemical functions in plant systems. During stress, the excessive generation and accumulation of reactive oxygen species (ROS) causes protein oxidation, lipid peroxidation, nucleic acid damage, and enzyme inhibition. Because it directly acts as an antioxidant compound, it awakens the plant antioxidant defense system during stress and reduces the production of ROS, which results in decreasing cellular oxidative damage. MT can enhance plant growth and development in response to various abiotic stresses such as drought, salinity, high temperature, flooding, and heavy metals by regulating the antioxidant mechanism of plants. However, these reactions differ significantly from crop to crop and are based on the level and kind of stress. The role of MT in the physiological functions of plants towards plant growth and development, tolerance towards various abiotic stresses, and approaches for enhancing the endogenous MT in plant systems are broadly reviewed and it is suggested that MT is a steering compound in directing major physiological functions of plants under the changing climate in future.

Objectives Although COVID-19 vaccines offer protection against infection and severe disease, there is limited information on the effect of vaccination on prolonged symptoms following COVID-19. Our objective was to determine differences in prevalence of prolonged symptoms 6 weeks after onset of COVID-19 among healthcare personnel (HCP) by vaccination status, and to assess differences in timing of return to work.Design Cohort analysis of HCP with COVID-19 enrolled in a multicentre vaccine effectiveness study. HCP with COVID-19 between December 2020 and August 2021 were followed up 6 weeks after illness onset.Setting Health systems in 12 US states.Participants HCP participating in a vaccine effectiveness study were eligible for inclusion if they had laboratory-confirmed symptomatic SARS-CoV-2 with mRNA vaccination (symptom onset ≥14 days after two doses) or no prior vaccination. Among 681 eligible participants, 419 (61%) completed a follow-up survey to assess symptoms reported 6 weeks after illness onset.Exposures Two doses of a COVID-19 mRNA vaccine compared with no COVID-19 vaccine.Main outcome measures Prevalence of symptoms 6 weeks after onset of COVID-19 illness and days to return to work.Results Among 419 HCP with COVID-19, 298 (71%) reported one or more COVID-like symptoms 6 weeks after illness onset, with a lower prevalence among vaccinated participants compared with unvaccinated participants (60.6% vs 79.1%; adjusted risk ratio 0.70, 95% CI 0.58 to 0.84). Following their illness, vaccinated HCP returned to work a median 2.0 days (95% CI 1.0 to 3.0) sooner than unvaccinated HCP (adjusted HR 1.37, 95% CI 1.04 to 1.79).Conclusions Receipt of two doses of a COVID-19 mRNA vaccine among HCP with COVID-19 illness was associated with decreased prevalence of COVID-like symptoms at 6 weeks and earlier return to work.

Due to the obvious minimal doses of drugs in biological matrices as well as the societal difficulties caused by methamphetamine usage, methamphetamine identification is critical in clinical and forensic laboratories. Because of their simple and inexpensive production procedure, as well as their excellent selectivity and sensitivity, polymeric carbon-based nanocomposites are strong contenders for the diffusive solid-phase extraction approach. The diffusive solid-phase extraction absorbent nanographene oxide polypyrrole composite was produced and used to recover methamphetamine from a complicated urine substrate. The generated NGPPC was fully characterized, and the significant extracting parameters have been explored using the one-parameter-at-a-time strategy. NGOPC is being used to extract methamphetamine using a urine medium with high efficiency. The NGPPC synthesizing procedure was easy, and the extraction method will demonstrate good repeatability. Moreover, the practical and efficient synthesis process stimulates the use of carbon-based compounds in various extraction procedures. As for detecting and quantifying equipment, HPLC monitors are being used. 300 mL methanol, 7 min extracting and desorption duration, 5000 mixing frequency, urinary pH value of 20, 40 mg adsorption, and 5 mL amount of urine were the optimal extraction variables. Following tracing the calibration graph, the method’s linear ranges were determined to be 40-600 ng/ml. The detection limits (LOD) and quantitation limits (LOQ), correspondingly, were 10 and 35.80 ng/mL. The proposed methodology seemed to have a detection range of 9 ng/mL. The suggested approach’s applicability in numerous characterization and medical facilities was proven by the examination of addicted subjects using the proposed technique. For successful extraction of methamphetamine using biological urine samples, the carbon-based adsorbent was being used as diffusive solid-phase extraction adsorption.

Suicide in young children is rare; the incidence increases towards the end of adolescence. Skin disorders confer a high prevalence of psychiatric and psycho­logical comorbidities. However, published research on suicidal behaviour in adolescents and children with skin disorders is sparse. The aim of this study was to identify the prevalence of suicidal behaviour in children and adolescents under 18 years of age with chronic skin disorders and associated contributing risk factors. MEDLINE, PsycINFO, EMBASE, CINAHL and Cochrane databases were searched from inception to October 2020 for suicide or suicide attempts in patients under 18 years old with chronic skin disorders. The study protocol was logged on PROSPERO (CRD42020083528). Returned texts were reviewed independently by 2 authors. Bias was assessed according to Joanna Briggs Institute criteria. Five studies met the inclusion criteria; 4 cross-sectional surveys and 1 retrospective matched-cohort study. A total of 31,641 patients with acne, atopic dermatitis, body dysmorphic disorder or psoriasis were identified. Prevalence of suicidal ideation was 0.45% (psoriasis) to 67% (body dysmorphic disorder). The prevalence of suicidal attempts ranged from 0.08% (psoriasis) to 21.9% (acne). Patients with acne or atopic dermatitis had significantly increased odds ratio for suicidal attempts. Meta-analysis could not be performed owing to the heterogeneity and sparsity of data. Suicidal risk in skin disorders amongst adolescents and children under the age of 18 years old is broad and complex. The suicidal risk remained after adjusting for depression, suggestive of an alternative mechanism.

The present study was conducted to investigate the effect of selenium supplementation on the oxidative status of hepatic tissue during heat stress in broilers. The study was conducted in two phases, one during autumn and the other during summer with a total of 300 birds. During the first phase, 60 chicks were divided into six replicates with 10 birds in each and during the second phase, 240 chicks were divided into four groups with six replicates containing 10 birds in each. The experimental rations given to different groups were control (Basal ration), HS I (Basal ration), HS II (Basal ration + 0.3 ppm Se, HS III (Basal ration + 0.6 ppm Se) and HS IV (Basal ration + 0.9 ppm Se). Hepatic tissues collected at 21 and 42d were analyzed for oxidative status. HS-induced oxidative stress was revealed by the significant elevation in lipid hydroperoxides, MDA and protein carbonyl levels which in turn triggered the activities of anti-oxidant enzymes, i.e GPx, GST, SOD and G6PD in the hepatic cytosol. The total antioxidant capacity and glutathione concentration were significantly altered due to HS. Selenium at 0.3 ppm was effective in counteracting the oxidative stress at 21d while 0.6 ppm of Se was more effective at 42d. Se supplementation at 0.6 ppm improved the activities of antioxidant enzymes and G6PD. The total antioxidant capacity and GSH concentrations were better improved with 0.6 ppm of Se compared to other treatments.

Introduction: Hepatitis B Virus (HBV) infection remains a significant global health concern that may cause acute or chronic hepatitis. Chronically infected patients are at risk for cirrhosis and hepatocellular carcinoma. The disease causes a problem in the tribal communities. There are lack of studies on the prevalence of HBV among the tribal population. Aim: To assess the seroprevalence of HBV infection among the tribal population of Attapady, Kerala. Materials and Methods: This was a community based crosssectional study conducted on serum samples collected from 269 subjects among the tribal population of Attapady. Serum samples were tested for quantitative antibody to HBsAg (anti-HBs), Hepatitis B surface antigen (HBsAg) and Hepatitis B envelope antigen (HBeAg) Enzyme Linked Immunosorbent Assay (ELISA). Total hepatitis B core antibody (anti-HBc) and IgM antibody to hepatitis B core antigen (anti HBc IgM), frequencies were obtained using proportion and 95% Confidence Interval (CI). Results: The seroprevalence of HBsAg was 10.4%. HBeAg was detected in 7.1% of HBsAg positive patients. A 21.2% had protective anti-HBs titre. Anti-HBe was detected in five patients. Anti-HBc total and anti-HBc IgM were positive for 26.7% and 2.6%, respectively. Anti-HBc IgM alone and isolated anti-HBc were detected in 1.5% and 5.9%, respectively. Anti-HBs and anti-HBc total both became positive in 8.6% cases. Conclusion: The HBV infection poses a huge burden on tribal health. All HBsAg positive patients should be tested further to determine the stage of the disease. There is need to explore high HBV prevalence areas with studies on associated risk factors to bring out the ongoing transmission process and focus on preventive measures. HBV vaccination, antenatal screening, and health awareness should be given priority to tackle the burden.

Background: phosphaturic mesenchymal tumor (PMT) is a rare neoplasm in which the tumor cells produce fibroblast growth factor 23 (FGF23), leading to oncogenic osteomalacia and thus a distinct clinical presentation. Case presentation: A 39-year-old male patient presented with 6 months history of progressive weakness in the legs and feet, which was later accompanied by upper extremity pain and left-sided nose blockade. On examination, was found to have a left-sided nasal cavity mass. Histopathologic examination was suggestive of PMT.

Context: The 5-year survival rate in patients with cervical lymph node metastasis is reported to be 20–36% post surgery as compared to 63–86% in patients without nodal involvement. This necessitates assessing the metastatic potential of OSCC patients. Objectives: To evaluate the role of Pancytokeratin immunostained tumour buds and cytoplasmic pseudofragments with other histopathological and immunohistochemical variables in predicting metastatic risk of Oral Squamous Cell Carcinoma (OSCC). Settings and Design: Retrospective study on archival tissues of OSCC available from the Department of Oral Pathology and Microbiology. Methodology: Totally, 40 samples of 117 histopathologically diagnosed OSCC samples were selected that displayed metastatic risk variables like invasive tumour front pattern, lymphovascular invasion, tumour buds and cytoplasmic pseudofragmentation and were grouped into 20 each of metastatic and non-metastatic OSCC. 5 normal oral mucosa samples were included in the control group. The 45 tissues were stained with congo red to assess tumour - associated tissue eosinophilia (TATE) and immunohistochemically evaluated for tumour budding and cytoplasmic pseudofragmentation using pancytokeratin, proliferation (Ki-67), microvessel density (MVD)(CD31) and lymphatic vessel density (LVD)( LYVE-1). Statistical Analysis: Pearson's Chi square test and Man Whitney U test were used and analysed by Statistical Package for the Social Sciences (SPSS) software version 20.0. Results: Metastatic OSCC showed significantly high number of tumour buds (p = 0.001), cytoplasmic pseudofragments (p = 0.008), higher tumour grade (p = 0.038), lymphovascular invasion (p = 0.008) and LVD (p = 0.013), aggressive invasive tumour front pattern (p = 0.001) compared to non-metastatic OSCC. Conclusion: Pancytokeratin immunostained tumour buds, cytoplasmic pseudofragments and higher LYVE-1 expression may be used as independent predictors for OSCC metastasis. This study highlights the importance of recognizing the early metastatic risk variables that navigates the surgeon in planning appropriate therapy for OSCC.

Hundreds of resumes are received, processed, and managed by large companies and recruitment agencies. Furthermore, many people post their resumes on the internet. Organizations all across the world, on the other hand, are battling to locate the greatest resource. To complete this work, these organisations rely on industry expertise. Manual interaction is required in the resume screening process. Most of the current technologies search for keywords but do not consider semantics, resulting in many superfluous resumes being shortlisted. The goal of the proposed study is to create a smart resume screening algorithm that can automatically retrieve and process resumes. Name, phone / cell numbers, e-mail addresses, qualification, experience, skill sets, and other fields are mapped to the retrieved data. The proposed model uses AI and ML techniques to do so. The gathered data can be utilised to develop applicant profiles that meet the organization’s recruitment needs. By applying multiple filters to the data, an efficient man-less screening process can be achieved. The model is applied to the resumes that the company receives. The model has performed with an average accuracy of more than 90%. The model can be enhanced to apply on the resumes written in languages other than English.

Tinospora cordifolia is a medically valuable plant widely used in Ayurveda and has been attributed with immunomodulatory properties. We compared the immunomodulation of repeated doses of the purified polysaccharide G1-4A and polysaccharide-rich extract (PRE) of T. cordifolia in BALB/c mice. Since both had comparable effects, we further compared the repeated dose effects of 50 and 500 mg/kg b.w PRE per dose with particular emphasis on histological changes in different organs, splenic cell death and DNA damage and immunomodulation. In mice treated with both concentrations of PRE, no gross changes were observed in any organ by histopathological analyses along with normal biochemical parameters similar to control. There was no increase in splenic lymphocyte cell death or DNA damage. A significant increase in the number of splenic macrophages with no increase in phagocytosis was observed. Increased expression of phenotypic maturation markers was observed in splenic dendritic cells and not in bone marrow-derived dendritic cells of PRE-treated mice. Increased activation of B cells in response to mitogen with no change in such a response by T cells was also observed. These results from repeated dose experiments indicate that PRE treatment has no associated organ toxicity and activates antigen-presenting cells and thus can be used instead of G1-4A as a promising immunotherapeutic adjuvant.

Infertility is a major concern for couples wanting to have progeny. Despite recent advances in the field of IVF, success rates still need improvement. Understanding the patient’s variability and addressing it with personalized interventions may improve the success rate of fertilization and live births. This study examined the impact of a personalized pharmacogenomic approach on LH supplementation on the pregnancy and live birth rate outcomes in comparison with the traditional approaches. 193 patients undergoing a second IVF cycle in Krishna IVF Clinic received LH supplementation either as per the conventional methods or based on N312S (rs2293275) LHCGR gene polymorphism. Results showed a significant increase in pregnancy rate (P-value: 0.049) and a trend showing improvement in live birth rates (P-value: 0.082) when r-hLH supplementation protocol was decided as per the genotypes A/A, A/G, and G/G of the N312S variant in the respective patients. This stimulation regimen helped in providing optimum levels of r-hLH supplementation to patients with impaired hormone-receptor interacting activity, to achieve higher success in pregnancy and live birth rates.

Current research underscores that there are only a few evidence-based programs that teach STEM (science, technology, engineering, and mathematics) as part of their curriculum, especially for autistic students. Even fewer programs focus on engineering and design learning. Hence, we developed an informal afterschool maker program to develop autistic and non-autistic students' interests in engineering to understand their experiences learning STEM concepts and values while applying the engineering mindset to develop projects. This qualitative study aimed to explore and understand students' experiences participating in STEM activities in the maker club. We interviewed twenty-six students (seventeen autistic and nine non-autistic), nine teachers, and thirteen parents representing diverse cultural and socio-economic backgrounds across three public middle schools in a large urban metropolitan city between 2018 and 2019. Our thematic analysis yielded four themes: (1) "active participation in STEM"; (2) "curiosity about STEM topics, concepts, and practices"; (3) "capacity-building to engage in STEM learning"; and (4) "understanding of the importance of STEM education in daily life." The results of this study enabled us to understand that students were deeply engaged with the content and curriculum of our program, expanded their knowledge base about scientific concepts, used engineering-specific scientific terminologies, and engaged with the engineering design process to conceptualize, test, improvise, and problem-solve. Furthermore, this afterschool engineering education program created a safe, nurturing, and stimulating environment for students to build engineering readiness skills.

Experiment on genetic variability parameters viz., phenotypic coefficient of variation (PCV), genotypic coefficient of variation (GCV), broad sense heritability (h2) and genetic advance as per cent of mean (GAM) for yield and yield attributing traits such as days to 50% flowering, plant height (cm), number of clusters per plant, number of branches per plant, number of pods per plant, pod length (cm), number of seeds per pod, hundred seeds weight (g) and seed yield per plant (g)in nine F2 populations were studied. The results revealed that high h2 and high GAM were recorded for plant height (cm), pod length, seeds per pod, hundred seeds weight (g) and single plant yield (g). High level of PCV and GCV were observed for number of branches per plant, number of clusters per plant, number of pods per plant and single plant yield (g).Low level of PCV and GCV were obtained for all the crosses except for cross IV (CO4 × VCP-09-024). Results suggest that quantitative traits like number of branches per plant, number of clusters per plant, number of pods per plant and single plant yield (g) can be used as selection criteria for yield improvement in F2population of cowpea.

In this study, the protective effect of curcumin on sodium nitrite (NaNO2) induced hepatotoxicity was assessed in male Wistar rats. Wistar rats were administered orally daily with 20 mg/kg of curcumin for 28 days and NaNO2 was administered as a single dose of 60 mg/kg on day 28. Lipid profile, liver function biomarkers and C-reactive protein were assessed in the serum; lipid peroxidation, non-enzymatic and enzymatic antioxidants were assessed in the liver. Alanine amino transferases (94.67 U/L), aspartate amino transferases (194.33 U/L), alkaline phosphatases, C-reactive proteins (19.56 ng/L) and lipid peroxidation (8.03 × 10−6 μmol/mg protein) were significantly elevated (P

Modification of lignin in feedstocks via genetic engineering aims to reduce biomass recalcitrance to facilitate efficient conversion processes. These improvements can be achieved by expressing exogenous enzymes that interfere with native biosynthetic pathways responsible for the production of the lignin precursors. In planta expression of a bacterial 3-dehydroshikimate dehydratase in poplar trees reduced lignin content and altered the monomer composition, which enabled higher yields of sugars after cell wall polysaccharide hydrolysis. Understanding how plants respond to such genetic modifications at the transcriptional and metabolic levels is needed to facilitate further improvement and field deployment. In this work, we acquired fundamental knowledge on lignin-modified poplar expressing 3-dehydroshikimate dehydratase using RNA-seq and metabolomics. The data clearly demonstrate that changes in gene expression and metabolite abundance can occur in a strict spatiotemporal fashion, revealing tissue-specific responses in the xylem, phloem, or periderm. In the poplar line that exhibited the strongest reduction in lignin, we found that 3% of the transcripts had altered expression levels and ~19% of the detected metabolites had differential abundance in the xylem from older stems. The changes affected predominantly the shikimate and phenylpropanoid pathways as well as secondary cell wall metabolism, and resulted in significant accumulation of hydroxybenzoates derived from protocatechuate and salicylate.

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.