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Abstract Background In Nepal, despite the escalating burden of non-communicable diseases (NCDs), there is a gap in the continuum of care for prevention, diagnosis, treatment, and care services for NCDs. The study aimed at assessing the changes in availability and readiness scores of health facilities between two consecutive health facility surveys. Methods We compared NCD readiness scores between 2015 and 2021, using data from two nationally representative cross-sectional Nepal Health Facility Surveys (NHFS). Both consecutive surveys used globally validated standard tools of Demographic and Health Surveys (DHS)’s service provision assessment. Both surveys were undertaken using World Health Organization’s (WHO) service availability and readiness assessment (SARA) tools. Data were collected using the Census and Survey Processing System on tablets, with validation performed through field check tables. Trained enumerators with a medical background collected data for the surveys, and we analyzed the information from a de-identified dataset downloaded from the DHS website upon request. Both the NHFS protocols were reviewed and approved by the Nepal Health Research Council and the institutional review board of ICF. We calculated the readiness scores based on WHO SARA indicators for diabetes, cardiovascular disease (CVD), and chronic respiratory disease (CRD) using a additive procedure. Multivariate linear regression analysis was undertaken to assess associated factors, with complex sampling design accounting for both surveys. Results The overall availability of all three services has improved between 2015 and 2021 NHFS. Although the availability of diabetes-related services increased significantly between 2015 and 2021, this does not correspond to the increase in the readiness score. The readiness score increased by 10% points for CVDs related services and 9% points for CRDs. Compared to public hospitals, primary healthcare facilities experienced greater increase in readiness scores (11.5% versus 20.9%). Interestingly, those health facilities without quality assurance systems experienced a lower increase or even decrease in readiness scores than those with quality assurance systems. For the factors associated with readiness scores, health facilities charging additional or separate fees to the patients had a higher readiness score than those not charging any user fee for all three services. Compared to 2015, the readiness scores in 2021 improved for diabetes [β = 11.01 (95% CI 9.02 to 12.96)], CVD [β = 10.70 (95% CI 9.61 to 11.80)], and CRD [β = 8.41 (95% CI 7.20 to 9.62)]. Conclusion The improvement in NCD service availability does not correspond to the proportional increase in readiness scores, which is crucial for delivering quality care. Regular staff meetings and feedback systems are crucial for improving all services including NCD-related service readiness and should be prioritized by local and provincial governments.

Background and Objectives: Cardiovascular magnetic resonance imaging (CMRI) is the noninvasive technique of choice for early detection of cardiac involvement in Duchenne and Becker muscular dystrophy (DMD and BMD, respectively), but is seldom used in routine clinical practice in the Indian context. We sought to determine the prevalence of CMRI abnormalities in patients with DMD and BMD and to compare the CMRI parameters with the phenotypic and genotypic characteristics. Methods: A prospective, observational study was conducted on patients genetically diagnosed with DMD and BMD who could complete CMRI between March 2020 and March 2022. Abnormal CMRI was the presence of any late gadolinium enhancement (LGE) that signifies myocardial fibrosis (LGE positivity), regional wall motion abnormality, or reduced left ventricular ejection fraction (LVEF

Background: Development of video laryngoscope has made management of airway easier. 0ur study was aimed to compare the efficacy of Macintosh laryngoscope and King Vision video laryngoscope for endotracheal intubation in adult patients under general anesthesia. Objectives: The primary objective of the study was to compare the glottic view obtained , the need for external manipulation, endotracheal tube insertion time and attempts taken for successful intubation with Macintosh laryngoscope and King Vision video laryngoscope. The secondary objective was to estimate the changes in hemodynamic parameters and to evaluate the occurrence of complications during intubation. Materials and Methods: The study included 136 patients posted for surgery under general anesthesia. Patients were randomly allocated in group C (N=68) and group V (N=68 ).Endotracheal intubation was done in group C by Macintosh and in group V by King Vision video laryngoscope. Laryngoscopy was assessed by Cormack Lehane grading and the need for any manipulation. The intubation time was calculated with each blade. Hemodynamic parameters were recorded and any complication during laryngoscopy and intubation were noted. The observations were analysed statistically by SPSS Program for windows version 28. Results: In group C, 61.8% of patients had Cormack and Lehane score I while in group V 76.5 % of patients had score I . Mean time of successful intubation was 34.90±8.35 sec in group C while in group V it was 32.82± 5.20 second . There was no statistical difference in distribution of patients according to number of attempts of intubation. In group C, 64.7% of patients needed external laryngeal pressure while in group V 97.1 % patients were intubated without external laryngeal pressure. Both the groups were comparable in relation to changes in hemodynamic parameters and any complications associated with laryngoscopy and intubation. Conclusion: We conclude that glottic view is better obtained with King Vision Video laryngoscope whereas optimisation of position and external laryngeal manipulation is often required with Macintosh laryngoscope to get similar glottic view. Introduction of King Vision video laryngoscope into the oral cavity takes time but intubation is easier with it. Hemodynamic variables and complications during the procedure are equally distributed between the two devices.

Lumbar spine surgeries are complex procedures often associated with challenges in maintaining hemodynamic stability and controlling intraoperative bleeding, which are crucial for optimizing patient outcomes. Clonidine and dexmedetomidine both are α2-adrenergic agonists with sedative and analgesic properties, known for their potential to attenuate sympathetic responses and stabilize hemodynamics. However, their comparative efficacy in lumbar spine surgeries remains underexplored. METHODOLOGY This study was carried out in 40 patients, ASA grade1 and 2, undergoing lumbar spinal instrumentation requiring laminectomy. The patients were randomly allocated into two groups (20 each) using the computer generated random number table. Group C received 2 µg/kg of clonidine diluted in 10 ml of normal saline, given slowly intravenous infusion over 10 min before induction of general anaesthesia. Group D received 1 µg/kg of dexmedetomidine diluted in 10 ml normal saline, given slow intravenous infusion over 10 minutes before induction of general anaesthesia. Heart rate, systolic, diastolic, and mean arterial pressure were monitored before intubation as the baseline and after intubation, 15, 30, and 60 minutes after starting the surgery, and after extubation. The amount of intraoperative blood loss was estimated based on the volume of blood in the suction bottle and the number of the blood-soaked gauze pads (20 mL for a completely blood-soaked gauze and 50 mL for a completely blood-soaked long gauze). OBSERVATION No statistically significant difference was found on comparing the two drugs in terms of Baseline characteristics, Mean Arterial Pressure and the amount of blood loss. However Dexmedetomidine group had a higher reduction in Heart Rate as compared to the Clonidine Group. CONCLUSION In conclusion, both the alpha2 agonist drugs; intravenous clonidine and dexmedetomidine represent valuable options for achieving stable hemodynamics as well as decreases the intraoperative surgical bleeding in lumbar spine surgeries. Total opioid requirements for intraoperative and rescue analgesia in postoperative period were decreased in both the groups.

Aim: The study’s objective was to evaluate the stress distribution in tooth-implant, implant-implant, and tooth-tooth supported prostheses under parafunctional loading in axial and oblique directions employing a 3D finite element analysis in the mandibular posterior region which had D3 bone (porous cortical bone and fine trabecular bone). Setting and Design: In vitro study, Finite element analysis. Meterials and Methods: Cone-beam computed tomography data was used by Mimics software (Materialize Mimics 19) to create a three-dimensional finite element simulation of the jaw. Solid Works 2018 (Dassault Systems) was used to produce a geometric 3D model of the three systems. Each model consisted of a bone, an implant, and teeth (Model I tooth-tooth supported, Model II tooth-implant supported and Model III implant-implant supported). The three models’ geometrical models were transferred to Ansys Workbench (19.2 software) for the analysis portion. A load that mimicked masticatory force was delivered in both axial and oblique directions. Statistical Analysis Used: In the present study, statistical analysis was not required because 3D finite element analysis uses deterministic numerical methods to simulate physical behavior and stress distribution patterns. Result: The results demonstrated that under the parafunctional combined loading process, the implant- implant supported prosthesis showed significantly higher stress concentrations in the bone. It was found that the cortical bone around the crestal region had the highest stresses. Conclusion: Within the constraints of this investigation, we could draw the following conclusion: Of the three models, the tooth-tooth supported prosthesis exhibited the least amount of stress distribution, which was also least when functional loading was applied in the axial direction.

Abstract SARS-CoV-2 variants of concern (VOC) have been associated with increased viral transmission and disease severity. We investigated the mechanisms of pathogenesis caused by variants using a host blood transcriptome profiling approach. We analysed transcriptional signatures of COVID-19 patients comparing those infected with wildtype (wt), alpha, delta or omicron strains seeking insights into infection in Asymptomatic cases. Comparison of transcriptional profiles of Symptomatic and Asymptomatic COVID-19 cases showed increased differentially regulated gene (DEGs) of inflammatory, apoptosis and blood coagulation pathways, with decreased T cell and Interferon stimulated genes (ISG) activation. Between SARS-CoV-2 strains, an increasing number of DEGs occurred in comparisons between wt and alpha (196), delta (1425) or, omicron (2313) infections. COVID-19 cases with alpha or, delta variants demonstrated suppression transcripts of innate immune pathways. EGR1 and CXCL8 were highly upregulated in those infected with VOC; heme biosynthetic pathway genes (ALAS2, HBB, HBG1, HBD9) and ISGs were downregulated. Delta and omicron infections upregulated ribosomal pathways, reflecting increased viral RNA translation. Asymptomatic COVID-19 cases infected with delta infections showed increased cytokines and ISGs expression. Overall, increased inflammation, with reduced host heme synthesis was associated with infections caused by VOC infections, with raised type I interferon in cases with less severe disease.

Congenital anomalies of the biliary tree are rare and present challenges for endoscopists performing interventions such as endoscopic retrograde cholangiopancreatography (ERCP). The reported incidence of ectopic biliary drainage ranges from 2% to 20%, and the condition is often associated with pancreatobiliary complications, including choledocholithiasis (56%), cholangitis (39%), and acute pancreatitis (18.2%). These developmental abnormalities originate during embryogenesis. Uncommon sites for the ampullary opening include the third or fourth part of the duodenum, the stomach, and the pancreatic duct. We report a rare case of ectopic ampulla opening into the pylorus, which presented with cholangitis and was successfully managed with a modified ERCP technique.

Abstract An integrated approach using geophysical and geospatial techniques was employed to model the surface and subsurface water-bearing strata and assess aquifer vulnerability in the Sehnsa town, Kotli district, State of Azad Kashmir, Pakistan. The inadequate scientific studies in the hilly terrain with such complex geological conditions has led to the failure of the boreholes for groundwater extraction. For the evaluation of groundwater potential and subsurface lithology, 30 vertical electrical soundings (VES) stations utilizing the Schlumberger electrode configuration were completed, modeled and analyzed spatially. Numerous geoelectrical parameters like true resistivity, thickness of subsurface layers and Dar-Zarrouk parameters were evaluated. The subsurface lithology delineated comprised topsoil, clayey sand, sandstone, and boulder clays which closely resemble to the borehole lithologs available in the study area. The inversion model confirms the presence of patches of high-resistivity sandstone in the southwestern part of the study area with the maximum thickness of the aquifer up to 140 m. Most aquifers were classified as unconfined with Q–type resistivity curves. The protective overburden capacity of the aquifers is rated as poor at VES 1, 3–5, 8, 10–16, 18, 19, 22–25, 27 and 30 whereas the moderate category was found at VES 2, 9 and 20 and excellent at VES 7 and 28, respectively. Therefore, the VES stations with poor and moderate ratings of overburden protective capacity are vulnerable for surface contaminants. The aquifer recharge was associated with rainfall and partly from the Poonch River. The effective integration of geophysical and geospatial techniques in this study provides sufficient information about the regional water resources and gives a preliminary model that can facilitate efficient water resource management in the area. These approaches can be successfully applied to diverse geographical and hydrogeological sites due to their versatility and reliability.

Abstract In urban areas with dense populations and high water demands, effective management of water resources is crucial for sustainable development. It includes optimizing water usage and recycling wastewater to balance supply and demand. Urban rivers, which now carry sewage year-round due to increased urban water consumption, are increasingly used for irrigation in peri-urban regions. This study aims to assess the suitability of an urban stream for irrigation compared to catchment groundwater, using hydrochemical parameters to evaluate water quality indices. Analysis of major ion distribution from upstream to downstream reveals a significant increase of TDS (r2 = 0.65; p

Abstract Background Newborn screening programmes offer an opportunity to obtain dried blood spots (DBS) cards that contain a wealth of biological information that can be stored for long periods and have potential benefits for research and quality assurance. However, the storage and secondary uses of DBS cards pose numerous ethical, clinical, and social challenges. Empirical research exploring public attitudes is central to public policy planning as it can indicate whether or not there is broad public support, define public concerns, and ascertain the circumstances required to alleviate concerns and ensure support. This study aims to describe the clinical experience and attitudes towards newborn screening and investigate the perceptions and expectations of Hong Kong parents and healthcare providers regarding the retention of DBS cards and their usage for research. Methods We conducted semi-structured in-person interviews with 20 parents and healthcare providers in Hong Kong. Thematic analysis was conducted. Results Awareness of the significant research value of secondary uses of dried blood spot cards is low. Parents and healthcare providers support the storage and secondary uses of DBS cards with some concerns, including privacy and confidentiality breaches, the risk of discrimination or stigmatisation based on genetic information, and their inability to oversee the use of their child’s biospecimen. Parents, however, prioritise their child’s health over privacy concerns and support identifiable storage using pseudonymity to gain more information about their children's health. Conclusion Child information takes precedence over potential concerns over privacy, underscoring the significance of engaging patients and the public in shaping public policy related to biobanking and healthcare research, in line with cultural and social values.

Background: Type 2 Diabetes mellitus(T2DM) is the most common endocrine disorder, affecting millions of people, leading to morbidity and mortality. Metformin is most widely used antidiabetic drug due to various reasons. Long-term metformin treatment in type 2 diabetes mellitus patients can cause vitamin B12 insufficiency. Severe deficits, if untreated, may lead to life-threatening neurological issues, which are often overlooked and undertreated. Objective: To analyze the correlation between the duration and dosage of metformin treatment of more than one year in T2DM Patient and their combined impact on serum B12 levels among T2DM patients. Materials and Methods: Hospital-based Cross-Sectional observational study evaluated 42 diabetic subjects, encompassing both sexes aged 18 to 70 years, who had been on metformin medication for more than one year. Assessment involved a comprehensive questionnaire and measurements of FBS, HbA1c, and serum B12 levels. Additionally, data on Metformin Dosage and Duration of its use were collected. B12 deficiency was defined as serum B12 levels ≤ 200 pg/ml. Data analysis was conducted by statistically comparing the mean vitamin B12 levels in each group using the One-Way ANOVA test through SPSS version 23 software. Results: Increase in the duration of metformin drug usage correlates with a significant decrease in serum vitamin B12 levels, as confirmed by ANOVA test results (p < 0.05). Conclusions: This study finding indicate that vitamin B12 deficiency is linked to a higher risk of worsening diabetic neuropathy. Therefore, individuals with diabetes who take higher doses of metformin (over 1000mg) for extended periods (≥ 8 years) should undergo regular monitoring of their vitamin B12 levels. Proactive use of vitamin B12 supplementation, whether for prevention or treatment, can help mitigate this concern.

Abstract Phages are gaining attention for their ability to target drug-resistant bacteria, disrupt biofilms, and reach intracellular pathogens, offering promising alternatives to traditional antibiotics. The Collection discusses advances in phage therapy, including their application in vaccine development, cancer immunotherapy, and gene delivery systems. Key research gaps are identified, such as challenges related to phage stability, immune response, and regulatory hurdles. Despite the progress, phage therapy faces obstacles in maintaining phage viability, evading immune detection, and navigating complex regulatory frameworks. The articles collectively address these challenges and propose potential solutions to enhance the effectiveness and acceptance of phage-based treatments. By overcoming these barriers, bacteriophage research has the potential to revolutionize medical therapies, providing innovative approaches to some of the most pressing healthcare challenges today.

Abstract Background Oral Submucous Fibrosis (OSMF) is an oral potentially malignant disorder (OPMD) that commonly occurs in the South Asian population as there is high usage of areca nut. There has been extensive research on the pathogenesis and treatment of this condition. It is well-established in the scientific literature that mast cells (MC) have a definitive role in several inflammatory disorders. OSMF being a chronic inflammatory disorder, is also expected to have increased MCs. Hence, this review aims to evaluate the role of MCs in the pathogenesis of OSMF. Methods A systematic search of articles was performed by two of the authors independently in PubMed, Scopus, Embase, Web of Science, and Google Scholar using the appropriate keywords and Boolean terms. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. The meta-analysis was performed with R studio software (Version: 4.4.0, Year: 2024, Company: The R foundation for statistical computing). Results The search retrieved 36 studies, of which 16 were suitable for the review. There is evidence for a marked increase in the number of MCs in OSMF than the normal mucosa upon analyzing the retrieved articles. However, when comparing the grades of OSMF, there are variations in the reports. As all the retrieved articles were case-control studies, the risk of bias was analyzed using the Modified New Castle Ottawa Scale. All the studies scored in the good category (Score 6–9). The pooled effect size shows the Standard Mean Deviation (SMD) to be 0.09, 95% confidence interval (CI) [-0.18;0.37] to lie on either side of no effect. Hence the role of MCs in OSMF has not been established because of homogeneity and consistent sampling error. Conclusion Our systematic review does suggest a definitive role of mast cells in the progression of OSMF. However, there is a lack of methodological rigor in the included studies. This may contribute to diluting the results.

Abstract Background Indoor lighting, exposure to outdoor daylight, physical activity and sleep interact to influence functioning, mood and cicadian rhythm. Older adults (≥ 65 years), who often spend more time at home, are less physically active and experience more sleep problems, could benefit from strategies to support behavioural change and self-managed modifications in the home. The study’s primary objective was to assess the usability and feasibility of the ‘Light, activity and sleep in my daily life’ intervention, delivered as a web-based course. Methods This 9-week intervention was delivered in a municipality in Sweden (55.70° N). Participants were eight healthy women (age 71–84), community-living in one-person households. We recruited through municipal staff and posters at senior citizen meeting points. Both qualitative and quantitative data were collected before and after the intervention. The outcome measures were intervention usability (ease of use, usefulness) and study feasibility (e.g., recruitment procedure, online engagement). Measures also included changes to routines and self-managed home adjustments to determine whether the participants applied what they had learnt. Results All participants completed the intervention. Time logged in varied between 25 min and 3 h (M = 1 h 50 min) per week. Seven participants’ system usability scores were between 90 and 100 (‘Excellent’) out of 100. When interviewed, participants reported overall high satisfaction with what they had learnt. Six participants were particularly satisfied with the modules targeting light. Seven participants made changes to their lighting or darkness conditions, such as replaced bulbs with either 3-step dimming or higher colour temperature LEDs (samples were included in the intervention test kit). One suggestion to improve the online delivery was to enable participants to add text comments to the weekly evaluation form. Conclusions The web-based intervention was feasible to deliver but time for recruitment should be extended and advertisement in the local newspaper should be considered. Participants’ computer proficiency and access to the internet at home will be critical in a future study with a larger sample. Only minor changes to the online content of the intervention are needed based on participants’ feedback. The intervention will be possible to evaluate in a future pilot study.

Wind energy's significance lies in its contribution to electricity production. Accurate wind speed prediction is crucial for precisely forecasting electricity generation, enhancing its overall importance. For the wind speed prediction two methods are developed in this paper that are the Linear Regression Method and Convolutional Neural Networks (CNNs). Linear regression makes a linear relation between input and output which are used to predict continuous outcomes. The second proposed leverage hierarchical feature extraction through convolutional layers, enabling them to excel at tasks like pattern recognition by capturing spatial patterns and hierarchies of information. Hyperparameter tuning is applied on both the models to minimize the errors. Then both the model’s performances are compared under different error matrices including MAE, RMSE, MSE and MAPE. The observations indicate that both the Linear Regression Model and CNN models are capable of forecasting wind speed However, the Linear Regression Model after Hyperparameter tuning performs better in terms of the calculated errors.

We describe a new plexippine genus, Tenkana gen. nov., supported by phylogenomic data from ultraconserved elements (UCEs), Sanger sequences of four genes, and morphological evidence. The type species, Tenkana manu (Caleb, Christudhas, Laltanpuii & Chitra, 2014), comb. nov. is transferred from Colopsus, as is Tenkana arkavathi (Caleb, 2022), comb. nov. The phylogenomic data places Tenkana among the plexippines near Hyllus C.L. Koch, 1846 and Telamonia Thorell, 1887, while the constrained four-gene phylogeny indicates that Tenkana is distinct from Colopsus. Additionally, we describe a new species, Tenkana jayamangali sp. nov.

Abstract Background Diffuse invasion of glioblastoma cells through normal brain tissue is a key contributor to tumor aggressiveness, resistance to conventional therapies, and dismal prognosis in patients. A deeper understanding of how components of the tumor microenvironment (TME) contribute to overall tumor organization and to programs of invasion may reveal opportunities for improved therapeutic strategies. Results Towards this goal, we apply a novel computational workflow to a spatiotemporally profiled GBM xenograft cohort, leveraging the ability to distinguish human tumor from mouse TME to overcome previous limitations in the analysis of diffuse invasion. Our analytic approach, based on unsupervised deconvolution, performs reference-free discovery of cell types and cell activities within the complete GBM ecosystem. We present a comprehensive catalogue of 15 tumor cell programs set within the spatiotemporal context of 90 mouse brain and TME cell types, cell activities, and anatomic structures. Distinct tumor programs related to invasion align with routes of perivascular, white matter, and parenchymal invasion. Furthermore, sub-modules of genes serving as program network hubs are highly prognostic in GBM patients. Conclusion The compendium of programs presented here provides a basis for rational targeting of tumor and/or TME components. We anticipate that our approach will facilitate an ecosystem-level understanding of the immediate and long-term consequences of such perturbations, including the identification of compensatory programs that will inform improved combinatorial therapies.

Abstract Background Periodontitis, a prevalent inflammatory disease affecting tooth-supporting structures, leads to significant oral health and systemic complications if untreated. While traditional smoking is a well-known risk factor for periodontitis, the impact of electronic cigarettes (e-cigarettes) on periodontal health remains unclear. This systematic review and meta-analysis aim to synthesize existing evidence on the effects of e-cigarette use on periodontitis and other periodontal outcomes. Methods A literature search was conducted across PubMed, EMBASE, and Web of Science from their inception up to June 15 2024. Eligible studies included those assessing the impact of e-cigarette use on periodontal outcomes such as bleeding on probing (BOP), plaque index, probing depth, clinical attachment loss, and marginal bone loss. Data were extracted and analyzed using random-effect models to calculate pooled mean differences. R statistical software was used to perform meta-analyses. Results Twelve studies were included in the meta-analysis. E-cigarette users showed a significantly lower mean BOP score compared to non-users (pooled mean difference: -14.233; 95% CI: -20.424 to -8.043; I² = 99%). For other periodontal outcomes, the findings were as follows: Plaque Index (MD: -0.160; 95% CI: -0.680 to 0.360; I² = 95%), Clinical Attachment Loss (MD: 0.120; 95% CI: -0.045 to 0.285; I² = 90%), Probing Depth (MD: 0.056; 95% CI: -0.070 to 0.182; I² = 85%), and Marginal Bone Loss (MD: -0.052; 95% CI: -0.168 to 0.064; I² = 88%). Conclusion Present studies have not identified a significant link between e-cigarette use and adverse effects on periodontal health, but the available research is limited. Further longitudinal research is necessary to evaluate the long-term effects of e-cigarette use on periodontal health and to clarify any associated risks.

Abstract Introduction While research has examined the connections between sleep quality, smartphone addiction, and depressive symptoms in general, no studies focused on undergraduate medical students in Nepal have specifically tested the complex relationship between these factors. Therefore, this study aimed to investigate the interaction between smartphone addiction, sleep quality, and depressive symptoms among undergraduate medical students of Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Methods A cross-sectional study was conducted among 212 undergraduate medical students at Maharajgunj Medical Campus, Tribhuvan University, Nepal. Sleep quality, smartphone addiction, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index, Smartphone Addiction Scale Short Version, and Patient Health Questionnaire-9. Data were analyzed using IBM SPSS version 26 via the bootstrap model approach. Results Out of the total participants, 67.9% were male. Males showed higher scores in smartphone addiction and depressive symptoms than females (b = 5.3, Bca 95% CI:1.2, 9.1, p

Abstract Rice (Oryza sativa L.) is a vital crop with enormous economic and nutritional importance in Nepal and worldwide. The yellow stem borer (YSB), Scirpophaga incertulas (Walker) (Lepidoptera: Crambidae), is a monophagous severe pest that poses a substantial threat to rice crops, causing significant yield losses by its larva feeding on stems and tillers. This review covers the life cycle, distribution, damage, and management and control strategies of YSB. YSB primarily targets rice plants, causing symptoms like dead hearts and whiteheads. Integrated pest management (IPM) strategies are crucial for effective YSB control. Cultural practices include selecting resistant rice varieties, using Bacillus thuringiensis (Bt) incorporated transgenic rice plants, synchronizing planting to reduce generations, and promoting natural enemies by conserving their habitats. Mechanical methods involve pheromone and light traps to disrupt mating and reduce adult populations. Biological control methods utilize natural predators like beetles and spiders and parasitoids such as Cotesia flavipes and Trichogramma spp. In contrast, chemical control involves targeted insecticide application when pest populations reach economic threshold levels that is when 5–10% dead hearts are seen. The article emphasizes the importance of IPM techniques in reducing YSB infestation and fostering sustainable rice production. These approaches not only help to lower the YSB population but also contribute to environmental preservation and long-term agricultural viability. As rice is a staple food for millions, effective management of YSB becomes crucial for guaranteeing food security and livelihoods across the globe.

Background: Allergic conjunctivitis is increasing with the rise in the levels of allergens. Drug therapy is usually needed in addition to avoidance of general allergens to treat this condition. Both bepotastine besilate and olopatadine hydrochloride ophthalmic solutions are newer additions in the treatment of allergic conjunctivitis having dual properties of second-generation antihistaminics along with mast cell stabilizing activity. Aims and Objectives: The aim of the study was to compare the efficacy and tolerability of bepotastine besilate (1.5%) and olopatadine hydrochloride (0.1%) eye drops in patients presenting with allergic conjunctivitis in a tertiary care hospital of Southern part of India. Materials and Methods: Sixty patients who were clinically diagnosed to be suffering from allergic conjunctivitis were selected as participants for the study. They were randomly distributed into two groups consisting of 30 patients each. One group received eye drop bepotastine (1.5%) and the other group received eye drop olopatadine (0.1%), with each patient receiving the medication twice daily for a duration of 2 weeks. During the first visit, all the patients were assessed for the signs and symptoms and subsequently re-assessed at weekly intervals for a period of 2 weeks. They were also advised to report occurrence of any unwanted drug reaction during the weekly follow-up visits. Results: The above study showed the effectiveness of both bepotastine and olopatadine eye drops in decreasing the signs and symptoms of allergic conjunctivitis. Significant clinical improvement was found in all participants, whereas deterioration was found in none of them. Statistically significant improvement of itching and redness of eyes was observed with use of both the study drugs mentioned beforehand. Both the drugs were well tolerated by the patients. Statistically significant reduction of itching and foreign body sensation was found to be more in patients using bepotastine eye drops compared to those using olopatadine eye drops. Only two patients using bepotastine eye drops complained of having a mild burning sensation in eyes. Conclusion: From this study, bepotastine and olopatadine eye drops have been observed to be safe and efficacious in allergic conjunctivitis. Bepotastine eye drop was found to be more efficacious to relieve itching and foreign body sensation compared to that of olopatadine eye drops.

Background: Over the last decade, the rate of cesarean sections has steadily increased owing to various reasons, and along with it the incidence of wound sepsis. Different risk factors identified are maternal age, socioeconomic status, educational status, antenatal visits, pregestational diabetes, obesity, recurrent pregnancy losses, duration of surgery, preterm rupture of membranes, etc. Hence, assessing infections and their management is an integral part of health care, as it helps develop strategies for prevention, better management of infection, reducing the hospital stay, and cost of healthcare. Aims and Objectives: The aim of the study was to assess and note the variability of social and demographic profiles of patients undergoing cesarean sections and developing wound infection, along with its various presentations and categories. Materials and Methods: A prospective observational study was conducted on patients who developed wound sepsis after undergoing cesarean section at a tertiary center in India. Results: Among the patients enrolled, 35.83% were illiterate and 45.83% were educated up to the tenth standard. About 74% of patients were not registered during the antenatal period. Furthermore, the majority of patients were overweight and obese (74%) and were from lower socioeconomic strata. About 85% of the patients who developed wound infection had their surgery lasting for more than 60 minutes. About 87.50% developed a superficial category of infection, and 68.33% presented within the first 5 days of surgery. Patients with deep infected wounds had significantly bigger wounds and longer hospitalization. Conclusion: Illiteracy and lower socioeconomic conditions predispose women to wound sepsis. A longer duration of surgery was associated with a higher risk of infection. Superficial wounds are the most common type of infection encountered. Deep and organ space categories of wound infection are associated with increased morbidity and longer hospitalization warranting aggressive management. Reducing the incidence of wound sepsis can help to reduce morbidity by identifying risk factors before pregnancy and supporting the implementation of preconception counseling centers and prenatal programs to educate and raise awareness among patients.

Background: Tethered cord syndrome (TCS) is a stretch-induced functional disorder of the spinal cord in which the caudal part is anchored by an inelastic structure. It is believed that, if the viscoelasticity of the filum is lost or compromised by either fatty infiltration or abnormal thickening, caudal tension and traction may cause undue stress upon the conus, resulting in TCS. It typically occurs in children, and it is rare in adults. Aims and Objectives: The study was conducted to know the clinicoradiological, pathological, and surgical outcomes in patients with TCS. Materials and Methods: This is a prospective observational study done in the premier institute of central India from May 2022 to April 2024. This study included patients who exhibited clinical and/or radiological features of congenital tethered cords. This encompassed both patients with tethered cord and those with TCS. Patients who failed to give consent and refused to participate in the study were excluded from the study. Results: A total of 30 patients were recruited for the study. The median age of the patients was 6–12 months (range). The gender distribution M:F was 63.3:36.6. Based on 30 cases studied, most of the patients (75%) had improvement in urinary symptoms, 57.1% of patients had improvement in bowel symptoms, 80% of patients had improvement in pain symptoms, 75% had improvement in motor deficit, and 83.3% had improvement in sensory deficit. Conclusion: Our prospective, cross-sectional study aimed at complete detethering of the spinal cord and the nerve roots along with excision of filum terminale and dural reconstruction to maintain adequate cerebrospinal fluid space around the spinal cord to prevent retethering.

Summary: SARS-CoV-2 has had a significant worldwide impact, leading to widespread illness and mortality. With the lack of specific antiviral treatments, there is a growing interest in exploring the potential therapeutic effects of various nutritional supplements, including vitamin D. Vitamin D plays an essential role in health, has been implicated in modulating the immune response and reducing inflammation, which may have implications in the prevention and management of coronavirus disease 2019 (COVID-19). Patients having low level of vitamin D are predisposed to severe consequences. Vitamin D and COVID-19 have shown an inverse relationship. This review is an understanding of the remedial effects of vitamin D in COVID-19, including its potential mechanism of action, evidence from clinical studies, and recommendations for supplementation of vitamin D in patients suffering from COVID-19. Material and Methods: Google scholar, Sci-Hub, pubmed.

Introduction: Dyslipidemia comprises disorders of lipoprotein metabolism, which is usually characterized by increased plasma levels of total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL), or reduced plasma level of high-density lipoprotein (HDL). Dyslipidemia is commonly found in Type 2 Diabetes Mellitus (T2DM) patients causing an increased risk of atherosclerosis and cardiovascular disease. Many studies done previously show variable prevalence of dyslipidemia (68 to 85 %) in known diagnosed patients of T2DM (with unknown history of onset), however, only limited studies have been done for finding prevalence of dyslipidemia in newly detected T2DM patients. AIM: This study is a cross-sectional observational study done in a tertiary care hospital in Mumbai (India), aiming to study prevalence and pattern in newly detected T2DM patients. The secondary objective is to compare the prevalence and pattern of dyslipidemia in newly detected T2DM patients with non-diabetic controls. Material and Method: For this, 100 newly detected T2DM patients were chosen along with 100 cases of age & gender-matched non-diabetic controls. Their clinical profile and lipid profile of both groups were observed and compared. Result: Results showed higher prevalence of dyslipidemia in newly detected T2DM patients (64%) which was significantly more than the control group (32%). Moreover, the pattern of dyslipidemia showed greater mean levels of TC, TG, and LDL and low mean levels of HDL in T2DM patients compared to the control group. Conclusion: These findings show that there is an increased risk of Dyslipidemia in new onset T2DM patients.

AIM: To investigate clinical outcomes in adults with type 2 diabetes (T2D) after insulin degludec/insulin aspart (IDegAsp) treatment in a real-world setting. Methods: The 26 weeks study involved 1102 adults with T2D who were either initiated with or switched to IDegAsp according to local practice in six countries. It was an open-label, non-interventional study. The primary endpoint was the change in glycosylated haemoglobin (HbA1c) levels from baseline to the end of study (EOS). Results: From India, 185 adults participated in this study with mean age of 58.1 (10.3) years and 14.4 (8.1) years of mean duration of T2D. Mean HbA1c decreased from 9.8% (1.8) at baseline to 8.2% (0.1) at the EOS; change in HbA1c from baseline [95% CI]: -1.6% (0.1) [-1.8; -1.4], P < 0.0001. There was a significant reduction in mean fasting plasma glucose (FPG) level from 190.0 (65.8) mg/dl at baseline to 141.9 (4.3) mg/dl at EOS; change in FPG from baseline [95% CI]: -52.2 (4.3) mg/dl [-60.7; -43.7], P < 0.0001. There was a numerical reduction in resource utilization related to diabetes and its complications and hypoglycaemic episodes. From baseline to EOS, the participants with outpatient visits (72 to 32) and workdays missed (2 to 0) decreased. Additionally, the number of patient-reported non-severe hypoglycaemic (47 to 8) and severe hypoglycaemic (4 to 1) episodes decreased as well. Conclusion: Initiation or switching to IDegAsp led to improvement in glycaemic control in real-world population of Indian adults with T2D. This was accompanied by a numerical reduction in resource utilization and patient-reported hypoglycaemia. Clinical trial registration: NCT04042441

Abstract In this paper, we investigate how market concentration and efficiency impact banks’ performance and stability during the SAR-COV-2 pandemic. There is a research gap in the empirical literature in understanding the specific impact of market concentration and efficiency on the profitability and risk-taking behavior of banks, particularly in the developing context of the Middle East and North Africa (MENA) region. To address this gap, we examine the relationship between market concentration, efficiency, and bank performance using a comprehensive dataset encompassing 575 banks across 20 MENA countries from 2006 to 2021. Specifically, we examine the market dynamics and performance of different banking systems co-existing in the MENA region. Our findings indicate that prior to the pandemic, both conventional and Islamic banks benefited from enhanced financial stability as a result of the increased market concentration and efficiency. However, during the pandemic, the positive effects of efficiency and concentration were primarily observed within the group of Islamic banks. Furthermore, we provide new evidence for the moderating effect of market concentration, with a significant negative impact suggesting that increased market competition reinforces the efficiency effect during the pandemic. Our findings are important for policymakers and regulatory authorities in the MENA region as they indicate the need for new policies that assign a more significant role to Islamic banking in the post-SAR-COV-2 recovery.

Background: Sufficient literature is available regarding Functional Electrical stimulation (FES) for its effects on the function of both the upper limb and lower limb. However, there is still a lack of literature that describes accurate frequency and time duration of FES in improving lower limb functions. Therefore, this review aimed to report the effects of FES regarding its various frequencies, duration, and intensity in improving lower limb muscle strength, gait, posture, and quality of life in patients with stroke. Methods: We included all those individuals with stroke (Hemiplegia) both acute and chronic irrespective of its type ischemic and hemorrhagic. All patients were well-oriented without cognitive impairments aged between 45 and 80 years old. Randomized controlled trials in which patients were provided FES either four channels or bi-channels on various muscles of the lower limb only were selected. In addition, we only included those RCTs, where FES was applied with specific frequencies and durations on the lower limb only. Results: The participants in the included studies ranged from 16 to 61 years of age. The majority of the studies were conducted with a population with post-stroke duration of ≥ 6 months. It was evident that functional electrical stimulation with low frequencies is effective in improving various outcomes related to function in the stroke population (P < 0.05). Conclusion: Functional electrical stimulation with low frequency improves activities of daily living, balance, gait, mobility, postural control, and range of motion, and reduces spasticity and foot drop. For rehabilitation, it would be important to replicate the findings by conducting highly randomized control trials with high quality and a larger number of samples.

Representations of human trafficking in film and media have widely missed the mark by misinforming the public and funders and harming those with lived experience. This has real implications for the anti-trafficking movement, including a lack of sufficient financial support for victim services and the failure to implement long-term systemic change. To change this, this article argues that we must invest in narrative change around human trafficking, under the leadership of those with lived experience. If done well, this could potentially bring additional funding for services by reaching the wider public, and even move the needle on trafficking prevention.

Objective: To determine the prevalence of cheiloscopic patterns in Pakistani population. Study Design: Cross-sectional study. Place and Duration of Study: The study was conducted at Post Graduate Medical Institute (PGMI), Lahore, Capital diagnostic Centre CDC Islamabad, HITEC Taxilla for a duration of 12 months from 1 September 2021 to 31 August 2022. Materials and Methods: The lip prints of 320 males and females were taken by applying lip shades and then cellophane tapes (2 inches). They were transferred to an A4 sheet (white A4 ROCO Premium 80g copy papers) and then observed with magnifying hand lenses Deluxe magnifier (70mm diameter). The data was analyzed by IBM SPSS statistics 27.0. Chi square test was applied and a p value of ≤ 0.05 was considered statistically significant. Results: The results showed differences in all individuals in both lip prints. The predominant lip pattern was type III, observed in 159 (99.4%) male participants while it was observed in all the female participants. Type I' observed in 37 (23.1%) female participants and IV are greater in females 160(100%) than males. Type II (was) greater in males 152 (95.0%) than females. Conclusion: Lip prints are useful tool that can be used as biometric markers in dentistry and forensic odontology.

Highlights Ultra-transparent vanadium-doped indium zinc oxide mesh (mIZVO) electrodes are fabricated using a self-cracking template. Fabricated electrodes are employed to realize flexible organic solar cell (OSC), organic light-emitting diode (OLED), and memristor devices. OSC exhibits 14.38% power conversion efficiency and OLED achieves 18.06% external quantum efficiency with mIZVO electrode. Flexible-transparent memristor based on mIZVO mimics various synaptic functions.

Abstract Temporomandibular joint dislocation is a common challenge in dental care, but it can be promptly addressed through manual realignment, making it standard procedure in the realm of oral health. Nonetheless, effectively preventing and treating chronic protracted mandibular dislocation (CPMD), characterized by prolonged dislocation, remains a significant challenge. Hence, a retrospective analysis was conducted on the clinical data of 10 patients diagnosed with chronic protracted mandibular dislocation (CPMD), encompassing diagnosis, treatment, and prognosis details. CPMD tends to be more prevalent among the elderly population, with an average age of 67.2±11.9 years and a male-to-female ratio of 1:9. All diagnosed patients presented with bilateral anterior dislocation, each requiring diverse pre-treatment approaches. The most significant risk factor contributing to CPMD was unconsciousness resulting from nervous system injury, which delayed the perception of symptoms associated with temporomandibular joint dislocation. 90% of CPMD patients experienced successful treatment through manual reduction, while a refractory CPMD cohort, resistant to manual reduction, necessitated surgical intervention for resolution. All patients underwent treatment involving elastic intermaxillary traction, which served as the primary means of achieving reduction. Subsequent analysis of CT data revealed that condylar displacement beyond the zygomatic arch served as an indication for surgical reduction. Consequently, manual reduction under general anesthesia combined with elastic intermaxillary traction proved effective for managing CPMD cases. However, cases displaying excessive vertical displacement beyond the zygomatic arch should be considered for surgical intervention based on CT findings.

Abstract Background Pakistan reported 1.57 million COVID-19 cases between 2020 and 2022, based on approximately 30.6 million SARS-CoV-2 RT-PCR (reverse-transcription polymerase chain reaction) tests conducted. This study utilized data from one of the largest in-country testing facilities, Aga Khan University Hospital (AKUH) in Karachi, Pakistan, to explore gender and age-related in RT-PCR testing patterns. Methods We conducted a retrospective review of SARS-CoV-2 RT-PCR test data extracted from AKUH clinical laboratory records between February 2020 and February 2022. Gender and age distributions were examined in the context of testing patterns across the period. Multivariate regression models assessed independent associations between COVID-19 positivity and key variables. Results We reviewed 470,249 RT-PCR tests, finding that most tests were in those aged 21–40 years (48.1%). Overall, COVID-19 test positivity was 20.6%. In all, 57.7% were performed for males, predominant amongst those tested across all age groups and waves. Females had significantly lower odds of testing positive for COVID-19 (OR: 0.9; 95% CI: 0.9-1.0). However, when adjusted for gender, age and pandemic phases, the positivity rates between males and females were the same. The odds of a positive result increased significantly with age; individuals aged > 80 years had 2.5 times higher odds of testing positive than those aged 0–10 years (aOR 2.5, 95% CI 2.3–2.7). Conclusions The analysis indicates a consistent male dominance in COVID-19 testing, with higher positivity rates in older age groups. Our study highlight the importance of examining demographic characteristics in disease associated data especially, representation of females amongst cohorts.

The potential effects of combining biochar with hyperaccumulator plants on heavy metal stabilization and uptake in Cd and Pb-contaminated soils have received limited attention. This study used biochar (BC) at levels ranging from 0 to 40 t ha-1 as soil amendments in Cd and Pb contaminated rice paddy soil. Biochar significantly decreased soil bioavailable Cd and Pb concentrations 6.7 to 16.6% and 10.6 to 39.7%, respectively, compared to the control. The shoot and root Cd concentrations in Arabidopsis helleri increased significantly by 33.5% and 133.1%, respectively, in the C3 treatment compared to the control. Similarly, shoot Pb concentrations showed a 57.5% increase compared to the control, but no significant changes were observed in root Pb concentrations. The Arabidopsis helleri bioconcentration factor (BCF) saw an increase of up to 40.5% for Cd and 57.8% for Pb with the C3 treatment. Conversely, the Cd translocation factor (TF) decreased 42.8 to 49.1%, while the Pb TF increased 32.8 to 96.6% with biochar application. The majority of Arabidopsis helleri-biochar Cd and Pb was found in the B3 fraction (organic fraction), constituting over 50%, and even over 80% for Cd. The Arabidopsis helleri-biochar primarily contained organic char binding Cd and exhibited slow-release characteristics.

Introduction: Anaemia is the most common Extraintestinal Manifestation (EIM) associated with Ulcerative Colitis (UC) and has been linked to increased mortality in UC patients, with iron deficiency having the most pronounced effect. Moreover, iron deficiency in UC can occur with or without anaemia. Aim: To assess anaemia and iron deficiency, with or without anaemia, in UC patients. Materials and Methods: The present cross-sectional study was conducted in the Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India, from August 2020 to December 2021. Study included 75 patients with UC and varying levels of disease activity. A complete haemogram, Red Blood Cell (RBC) indices, and serum iron studies {serum iron levels, Total Iron Binding Capacity (TIBC), Transferrin Saturation (TfS), and serum ferritin} were conducted. Patients were classified as having Iron Deficiency Anaemia (IDA), Anaemia of Chronic Disease (ACD), or mixed anaemia based on the results of the iron studies. Disease activity was assessed using the Mayo score. Patients were divided into group I (mild disease activity) and group II (moderate to severe disease activity). Haemoglobin (Hb), RBC indices and iron levels were compared between the two groups. Independent t-tests and Chi-square tests were employed for statistical analysis. Results: The mean±Standard Deviation (SD) age of the patients was 34.8±14 years, with a male-to-female ratio of 1.7:1. The mean±SD duration of the disease was 28.8±33.8 months (median: 12 months). Fifteen patients had mild disease activity, 52 had moderate activity, and eight had severe activity. The mean±SD Hb level among the patients was 11.1±2.0 g/dL. The mean±SD values for Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), and Mean Corpuscular Haemoglobin Concentration (MCHC) were 80.4±7.7 fL, 26.4±4.0 pg, and 32.1±2.5 g/dL, respectively. The mean±SD serum iron level and ferritin levels were 59.3±29.1 mcg/dL and 27.2±27.9 ng/mL, respectively. The mean±SD TfS was 14.3±10.8%, while the mean±SD TIBC was 337.1±80.5 mcg/dL. A total of 45 (60%) patients had anaemia, and 16 (21.3%) patients had iron deficiency without anaemia. Among those with anaemia, 32 (42.7%) had IDA and 13 (17.3%) had mixed anaemia; none of the patients had ACD. In total, 61 (81.3%) patients had iron deficiency, with or without anaemia. Hb, RBC indices and iron studies were comparable between both groups. Conclusion: Iron deficiency anaemia is common in UC patients, affecting 60% of the cohort; however, iron deficiency without anaemia was also observed in 21.3% of patients. Changes in Hb, RBC indices and iron studies were independent of disease activity.

The current investigation assessed the capability of a well-adapted and enriched bacterial strain known as Bacillus brevis for the biodegradation of phenanthrene. To enhance the removal efficiency of phenanthrene, employed Response Surface Methodology (RSM) in conjunction with a Box-Behnken design (BBD) model. The experiments were designed to explore the impact of pH (6.0 to 9.0), temperature (20 to 40°C), initial phenanthrene concentration (50 and 100 ppm), and incubation time (7 to 21 days) on biodegradation of phenanthrene. The highest level of phenanthrene biodegradation, approximately 55.0%, was achieved by Bacillus brevis when the optimal conditions were met as pH of 7.0, temperature 30oC, and initial phenanthrene concentration (70 ppm) after 21 days of incubation time. This study underscores the significance of employing statistical tools like RSM to enhance the microbial degradation of contaminants.

Abstract Background Community health workers (CHWs) remain an underutilized resource in social risk diagnostics in the primary care setting. This process evaluation study seeks to assess the role of CHWs in social risk screening, referral, and follow-up through process mapping to identify barriers to the process for future quality improvement efforts. Methods Researchers at the Arizona Prevention Research Center (AzPRC) engaged with two Federally Qualified Health Centers (FQHCs) in two of Arizona’s major urban areas to evaluate their internal processes for social risk screening and intervention. The Consolidated Framework for Implementation Research (CFIR) was used to direct a process mapping exercise to visually describe the workflow, gaps, and barriers to identifying and addressing social risk. Results The process unveiled key areas for health system improvements in the community setting, the organizational setting, and in the implementation of social risk screening, referral, and follow-up. Further, process maps highlight the potential resources needed for effective CHW integration to address social risk in the primary care setting. Conclusions Our findings demonstrate the importance of organizational tools, such as process mapping, to assist primary care settings in evaluating internal processes for quality improvement in addressing social risk and in effectively integrating the CHW workforce. Subsequent research will evaluate rates of social risk screening, referral, and follow-up within all of Arizona’s FQHCs and propose models for CHW integration to address social risk in primary care and strengthen social risk screening reach and effectiveness.

AbstractSocial prescribing (SP) embodies a comprehensive approach to addressing the social determinants of health. Access to Resources in the Community (ARC) is an innovative SP program offering bilingual services that involves a single point of entry for health and social needs and introduces practice changes to assist primary care providers in engaging patients, along with a nonclinical lay navigator who supports patients in accessing relevant community resources. The ARC team has created a SP toolkit offering practical guidance for setting up, implementing, monitoring the progress of and evaluating SP programs. The four ARC guides can be easily customized for application in diverse practice and research settings.

RésuméLa prescription sociale est une approche globale qui agit sur les déterminants sociaux de la santé. « Accès aux ressources communautaires » (ARC) est un programme de prescription sociale novateur aux services bilingues qui offre un point d’entrée unique pour les besoins en matière de santé et de services sociaux et qui permet d’apporter des changements dans les lieux de pratique dans le but d’aider les fournisseurs de soins primaires à mobiliser leurs patients, grâce à un intervenant-pivot non clinicien qui aide les patients à accéder aux ressources communautaires pertinentes. L’équipe du programme ARC a créé une trousse d’outils de prescription sociale qui contient des conseils pratiques sur l’établissement, la mise en oeuvre et l’évaluation de programmes de prescription sociale ainsi que sur le suivi des progrès. Les quatre guides du programme ARC sont facilement adaptables à divers milieux de pratique et de recherche.

Objectives This study aims to evaluate whether stent removal through endoscopic retrograde cholangiopancreatography (ERCP) with balloon sweeps is necessary or whether stent removal by forward-viewing gastroscope without cholangiogram is sufficient.

Lightweight materials with better resistance to sliding wear are prominent candidates for automobile brake drums, clutch pads and cylinder block applications to facilitate fuel economy. This attempt is reserved to cater to materials with higher tribological quality needs. Less dense foamy pumice stone particles were involved in three different percentages (5, 10, and 15 wt%) to reinforce lightweight AZ31 Mg alloy. A stir-assisted squeeze casting technique was pursued to process the composite and refine the grain structure. A phase detection, elemental mapping and microstructure study were done through X-ray diffraction (XRD), energy dispersive spectroscopy (EDS), and scanning electron microscopy (SEM), respectively. An experimental dry sliding wear scrutiny was administered using a pin-on-disc apparatus by considering: (i) ambient and elevated temperature environments and (ii) three different levels of loads. The results reveal a significant drop in wear loss and a frictional coefficient for 15% pumice-loaded composite than the base alloy. Post-wear examination acknowledges the fact that the ambient temperature wear is governed by adhesive-abrasive wear and high temperature is by abrasive wear mechanisms. Worn-out scrutiny authenticates the presence of oxide layers and their role in lubrication. A comparative study with previous works upholds the novel magnesium composite is the right candidate for the mentioned automobile applications.

Introduction Difficult biliary cannulation leads to prolonged papillary manipulation and repeated attempts at cannulation are known to increase the risk of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. This study aims to compare the efficacy and complications of three rescue methods, transpancreatic biliary sphincterotomy (TP), double guidewire technique (DGW), and precut sphincterotomy (precut) in difficult common bile duct (CBD) cannulations.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rarely described in the pregnant population, and knowledge of their impact on the mother/fetus is limited. Objective: To describe SJS/TEN in pregnant women and to investigate the risk factors for developing SJS/TEN in pregnancy. Methods: We utilized hospitalization data from the 2009–2020 National Inpatient Sample. Pregnancy hospitalizations and SJS/TEN involvement were identified by ICD-9/10 codes and analyzed by chi-square and logistic regression. Results: We identified 650 pregnancies complicated by SJS/TEN requiring hospitalization. The median age was 28 years, and most were non-Hispanic White (55.2%). There were ≤10 cases associated with mortality. Most SJS/TEN cases (73.9%) occurred during the third trimester. HIV infection (OR = 9.49; P = .030), herpes simplex virus infection (OR = 2.49; P = .021), genitourinary tract infections (OR = 3.80; P

Objectives: To measure the Body Mass Index (BMI) and Blood pressure (BP) of newly enrolled undergraduate students in a medical university in Karachi, Pakistan, and to assess any association between BMI and BP levels among them. Methods: A cross-sectional study was conducted on pre-existing three-year data of 1403 students. The age, gender, BMI, and BP were recorded. The BMI of students was classified according to the Asian cutoff and BP was categorized using the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) classification. Data was analyzed using SPSS version 24. Descriptive statistics were used to present quantitative and qualitative variables. The association was measured using the Chi-square test of significance. A p-value of < 0.05 was taken as significant. Results: Total 1403 students with a mean age of 19 + 1.4 years students were enrolled including 397 (28.3%) males and 1006 (71.7%) females. A total of 667 (47.5%) students had a normal weight while 216 (15.4%) students were underweight, and 512 (36.5%) were either overweight or obese. Mean systolic BP was 111.42 + 10.7 mmHg and mean diastolic BP was 73.45 + 7.96 mmHg. Most students had normal systolic BP 901 (64.2%) while 501 (35.7%) had prehypertension or stage- I or II hypertension (HTN). The majority of the students had normal diastolic BP 1357 (96.7%) and 45 (3.3%) had stage- I or II HTN. There was a significant association between BMI and BP (p

This study addresses the gap in the comprehensive literature on the intersection of readiness technology and changes in the manufacturing sector. This study employs a hybrid review (bibliometric analysis and conceptual framework) to offer a panoramic overview of the field. We scrutinised 77 publications from peer-reviewed journals, from 2005 to 2023, using methodological lenses such as keyword co-occurrence networks and thematic maps. The review reveals the major contributors (publication trends, themes, and topics) to integrating 3D printing, additive manufacturing, Tech Competition and Lifecycle Assessment in Manufacturing, and Smart Manufacturing Strategies. Based on these insights, we advocate a focused research agenda to expand scholarly contributions to this field. We introduce a framework that offers a theoretically robust tool for scholars and practitioners studying the impact of technology readiness in the manufacturing sector. Consequently, this study not only distils the existing literature, but also sets the stage for future research. This study places significant emphasis on the implementation of technological solutions as a means to improve production operations. Additionally, this research emphasises the significance of ensuring that investment strategies follow the organisation’s technological preparedness. An additional crucial implication concerns the cybersecurity protocols. This is consistent with the research’s emphasis on investigating cybersecurity concerns in the manufacturing industry.

Canine parvovirus type 2 (CPV-2) infection in dogs is considered as one of the most common cause of morbidity and mortality in young dogs and continues to occur with high incidence worldwide. Despite a single-stranded DNA virus, CPV-2 possesses a high mutation rate which has led to the development of new variants from time to time. These variants are classically classified based on the amino acid markers present in the VP2 gene. In this study, we examined 20 different cases of CPV-2 infection from seven different states of the North East region (NER) of India. The near-complete genome sequences of all these isolates were subjected to phylodynamic and phylogeographic analysis to evaluate the genetic diversity and geographical spread of CPV-2 variants. Analysis of the deduced amino acid sequences revealed residues characteristic of the ‘Asian CPV-2c lineage’ in all the 20 sequences confirming it as the dominant strain circulating in NER, India. The phylogenetic analysis based on the whole genome showed that all 20 sequences formed a monophyletic clade together with other Asian CPV-2c sequences. Furthermore, phylogeographic analysis based on the VP2 gene showed the likely introduction of Asian CPV-2c strain to India from China. This study marks the first comprehensive report elucidating the molecular epidemiology of CPV-2 in India.

Introduction ORAI-1 is a plasma membrane calcium release-activated calcium channel that plays a crucial role in the excitation–contraction of skeletal muscles. Loss-of-function mutations of ORAI-1 cause severe combined immunodeficiency, nonprogressive muscle hypotonia, and anhidrotic ectodermal dysplasia. Autosomal dominant gain-of-function mutation causes Stormorken's syndrome, which includes tubular aggregate myopathy along with bleeding diathesis.