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Luckni Sellahewa,1,2 Craig Simpson,2 Prema Maharajan,2 John Duffy,2 Iskandar Idris3 1Diabetic Medicine Department, Nottingham University Hospitals, 2North Nottinghamshire Eye Screening Service, Sherwood Forest Hospitals Foundation Trust, 3Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK Background: Digital retinal photography with mydriasis is the preferred modality for diabetes eye screening. The purpose of this study was to evaluate agreement in grading levels between primary and secondary graders and to calculate their sensitivity and specificity for identifying sight-threatening disease in an optometry-based retinopathy screening program.Methods: This was a retrospective study using data from 8,977 patients registered in the North Nottinghamshire retinal screening program. In all cases, the ophthalmology diagnosis was used as the arbitrator and considered to be the gold standard. Kappa statistics were used to evaluate the level of agreement between graders.Results: Agreement between primary and secondary graders was 51.4% and 79.7% for detecting no retinopathy (R0) and background retinopathy (R1), respectively. For preproliferative (R2) and proliferative retinopathy (R3) at primary grading, agreement between the primary and secondary grader was 100%. Where there was disagreement between the primary and secondary grader for R1, only 2.6% (n=41) were upgraded by an ophthalmologist. The sensitivity and specificity for detecting R3 was 78.2% and 98.1%, respectively. None of the patients upgraded from any level of retinopathy to R3 required photocoagulation therapy. The observed kappa between the primary and secondary grader was 0.3223 (95% confidence interval 0.2937–0.3509), ie, fair agreement, and between the primary grader and ophthalmology for R3 was 0.5667 (95% confidence interval 0.4557–0.6123), ie, moderate agreement. Conclusion: These data provide information on the safety of a community optometry-based retinal screening program for screening as a primary and as a secondary grader. The level of agreement between the primary and secondary grader at a higher level of retinopathy (R2 and R3) was 100%. Sensitivity and specificity for R3 were 78.2% and 98.1%, respectively. None of the false-negative results required photocoagulation therapy. Keywords: retinopathy, screening, public health, community, optometry, diabetes

Endometrioma is the localization of endometriosis in ovary which often develops as cyst. The condition can be complicated with infection, torsion and rupture leading to significant hemoperitoneum and ascites. We present here a 28-year female P2 L1 presented with the features of acute abdomen and severe anemia referred from other hospital where pain management was done. She had raised Ca-125 level, negative Urine Beta HCG and USG findings of left endometrioma with degenerating subserosal fibroid. The improvement of her general condition with analgesics was misleading however a static hematocrit level despite blood transfusion raised suspicion of ongoing pathology leading to blood loss and diagnostic paracentesis confirmed the hemoperitoneum while awaiting of CT report. She underwent Emergency Laparotomy which revealed hemoperitoneum of 2000ml and right ruptured ovarian endometrioma measuring and left ovarian cyst measuring 6x6 cm was noted. The postoperative period was uneventful. Keywords: Acute abdomen; case report; endometriosis; hemoperitoneum; ruptured endometrioma.

A steady deterioration in kidney function over months or years is known as chronic kidney disease (CKD). Through a range of techniques, such as pharmacological intervention in moderate cases and hemodialysis and renal transport in severe cases, early identification of CKD is crucial and has a substantial influence on reducing the patient's health development. The outcomes show the patient's kidneys' present state. It is suggested to develop a system for detecting chronic renal disease using machine learning. Finding the best feature sets typically involves using metaheuristic algorithms since feature selection is an NP-hard issue with amorphous polynomials. Semi-crystalline tabu search (TS) is frequently used for both local and global searches. In this study, we employ a brand-new hybrid TS with stochastic diffusion search (SDX)-based feature selection. The adaptive backpropagation neural network (ABPNN-ANFIS) is then classified using fuzzy logic. Fuzzy logic may be used to combine the ABPNN findings. Consequently, these techniques can aid experts in determining the stage of chronic renal disease. The Adaptive Neuron Clearing Inference System (ABPNN-ANFIS) was utilised to develop adaptive inverse neural networks using the MATLAB programme. The outcomes demonstrate that the suggested ABPNN-ANFIS is 98 % accurate in terms of efficiency.

Abstract Cloud computing is the most widely adapted computing model to process scientific workloads in remote servers accessed through the internet. In the IaaS cloud, the virtual machine (VM) is the execution unit that processes the user workloads. Virtualization enables the execution of multiple virtual machines (VMs) on a single physical machine (PM). Virtual machine placement (VMP) strategically assigns VMs to suitable physical devices within a data center. From the cloud provider's perspective, the virtual machine must be placed optimally to reduce resource wastage to aid economic revenue and develop green data centres. Cloud providers need an efficient methodology to minimize resource wastage, power consumption, and network transmission delay. This paper uses NSGA-III, a multi-objective evolutionary algorithm, to simultaneously reduce the mentioned objectives to obtain a non-dominated solution. The performance metrics (Overall Nondominated Vector Generation and Spacing) of the proposed NSGA-III algorithm is compared with other multi-objective algorithms, namely VEGA, MOGA, SPEA, and NSGA-II. It is observed that the proposed algorithm performs 7% better that the existing algorithm in terms of ONVG and 12% better results in terms of spacing. ANOVA and DMRT statistical tests are used to cross-validate the results.

Abstract Quantifiable decline in the maternal body temperature during the pre-calving offers the possibilities for predicting the calving that can improve the calving management. As infrared thermography (IRT) is a simple non-contact tool for precise measurement of surface temperature, we investigated the use of IRT to establish thermal signatures around calving in the Murrah buffalo. The IRT of eye, right lateral, left lateral and rear side of udder skin surface temperature (USST) were recorded at 6 h interval from 96 h before the expected date of calving, at the time of calving and 24 h post-calving in Murrah buffaloes (n = 28). In parallel, blood samples were collected for progesterone (P4) assay. The results revealed that the IRT of the eye, right and left lateral and rear side of USST showed a significant decrease in the temperature from 48 h pre-calving till the onset of calving with a ΔT (°C) of 0.56, 0.91, 0.70, and 0.90, respectively. Mean USST significantly declined from 48 h pre-calving with a ΔT of 0.85 °C. The residual temperature of both eye and various ROI of the udder also followed a similar and significant declining trend from 48 to 0 h of calving indicating that circadian influence on the USST was minimum. Plasma P4 concentration significantly decreased from 72 h pre-calving till calving. It is concluded that a marked reduction in the IRT of the USST at 6–12 h pre-calving would be useful in predicting the onset of calving in the Murrah buffalo.

Background: In the current trend, following a code of ethics and upgrading the knowledge to match the recent updates has become an essential factor in any healthcare professional to maintain professionalism. Physiotherapy is no exception where the treatment outcome depends majorly on professionalism and evidence-based practice (EBP) on par with current trends. Objective: This study aimed to find out the interest toward the upgradation of their professional and ethical knowledge on par with current trends. Materials and methods: A cross-sectional study was carried out through self-administered online questionnaire among practicing physiotherapists. Results: There is a higher rate of interest in improving the skills (4.1 ± 0.99) and increased awareness of currently accepted standards of practice (4.11 ± 0.89). Conclusion: Physiotherapists show a positive attitude in upgrading their professional and ethical knowledge. Core competency: Practice-based learning and improvement.

The critical aspect in advancing global trade lies in ensuring security across marine trading systems. This research significantly contributes to monitoring ships by assessing operational performance parameters. These parameters are sensed through ship-attached sensors, and further transmitted to the cloud via an Internet of Things (IoT) Module. To optimize the efficiency of this data transfer to the cloud, the proposed work employs a Whale Optimization Algorithm-based Radial Basis Function Neural Network (WOA-RBFNN). The utilization of this algorithm enhances the overall effectiveness of the system. Furthermore, to address security concerns, a 128-bit Two Fish Algorithm-based key management is introduced, providing enhanced data protection. This dual-focus approach not only optimizes the efficiency of data transmission but also fortifies the system against potential cyber threats. These enhancements collectively contribute to the successful and secure transmission of information to the cloud advancing the security and efficiency of marine trading systems.

The Brushless Direct Current (BLDC) motor has many benefits due to characteristics like its small size and precise speed regulation. Uncertainty problems are presented by the system’s slow Proportional-Integral (PI) controller response time as well as some BLDC motor operating circumstances. The proposed Fractional-Order Proportional-Integral-Derivative (FOPID) controller and Difference of Orientation Offset Gaussian (DOOG) Grasshopper Optimization Algorithm (GOA) (DGOA) function are used to mitigate torque ripples in BLDC motors and overcome these drawbacks. An adaptive parameter has been introduced to enhance the performance of the conventional GOA method, and the performance of the suggested DGOA is compared to the benchmark functions. The simulation of the driver with the suggested DGOA-FOPID results in an improvement in Torque Ripple Reduction and speed control is obtained that better torque ripple reduction and speed regulation have been achieved.

The idea of delay-dependent states of neutral-type uncertain descriptor neural networks with mixed delays in time-varying sense (i.e. discrete & distributed) and leakage delays is implemented in this study. By building a modern LKF (Lyapunov–Krasovskii functional) and enlisting some analysis techniques, new stability conditions for the designated neural networks are derived in terms of linear matrix inequalities (LMIs), which can be easily verified by the MATLAB LMI toolbox. To do that, the research that is being offered here is more advanced and less constrained than the previous one that has been published in the literature. Two numerical examples with simulations and some novel comparative statements are carried out to demonstrate the benefit and validity of our theoretical conclusions.

Millets are small-seeded cereals belonging to the family Poaceae. They are considered to be climate-resilient and future nutritional food cereals for humans. Millets are resistant to biotic and abiotic stressors compared to other major cereals and thrive in low-quality soils with little maintenance and less rainfall. The importance of millets is still not well known to many people due to the lack of popularity and cultivation in semi-arid tropics of Asia and Africa. The United Nations has declared 2023 as the International Year of Millets (IYM 2023) to promote millet cultivation and popularize their health benefits globally. A few years ago, the application of molecular biology was in its infancy in millets due to the unavailability of genome sequences. Genome sequences are available for most of the millets on NCBI and Phytozome databases. In this review, we discuss the details of genome sequences for millets, candidate genes identified from the native genome of millets. The current status of quantitative trait loci and genome-wide association studies in millets are also discussed. The utilization of millet genome sequences in functional genomics research and translating the information for crop improvement will help millet and non-millet cereals survive harsh environments in the future. Such efforts will help strengthen food security and reduce malnutrition worldwide in 2050.

Fetal alcohol spectrum disorders (FASD) are a group of preventable and nongenetic birth defects caused by prenatal alcohol exposure that can result in a range of cognitive, behavioral, emotional, and functioning deficits, as well as craniofacial dysmorphology and other congenital defects. During embryonic development, neural crest cells (NCCs) play a critical role in giving rise to many cell types in the developing embryos, including those in the peripheral nervous system and craniofacial structures. Ethanol exposure during this critical period can have detrimental effects on NCC induction, migration, differentiation, and survival, leading to a broad range of structural and functional abnormalities observed in individuals with FASD. This review article provides an overview of the current knowledge on the detrimental effects of ethanol on NCC induction, migration, differentiation, and survival. The article also examines the molecular mechanisms involved in ethanol-induced NCC dysfunction, such as oxidative stress, altered gene expression, apoptosis, epigenetic modifications, and other signaling pathways. Furthermore, the review highlights potential therapeutic strategies for preventing or mitigating the detrimental effects of ethanol on NCCs and reducing the risk of FASD. Overall, this article offers a comprehensive overview of the current understanding of the impact of ethanol on NCCs and its role in FASD, shedding light on potential avenues for future research and intervention.

In Malaysia, heart disease is a major non-communicable disease and a leading cause of morbidity and mortality. Individuals need to understand the risk factors of heart disease, including health-related behaviors. This study was done to determine the perceived risks of heart disease and to estimate the willingness to pay (WTP) for its diagnosis. One-way analysis of variance was used to determine the significance of mean differences among the other demographic variables, followed by Tukey’s post hoc test to determine the differences between groups. The Spearman Rho test was employed to determine the correlations between participants’ perceived heart disease risk and their WTP for its diagnosis. The Perception of Risk of Heart Disease Scale (PRHDS) mean score of participants with a family history of heart diseases (25.32 ± 2.81; n = 556) was significantly higher than those who did not have such a family history (22.14 ± 3.42; n = 761; p = 0.04). The participants with a family history of heart disease showed a greater WTP for diagnostic tests compared with those without a family history. The participants who were ready to spend within the range of Ringgit Malaysia (RM) 1-RM1000 were willing to pay for diagnostic testing of heart diseases based on their family history and socioeconomic background. This study demonstrated a higher perception of the risk of heart disease in people with a family history of heart disease, who also demonstrated a greater WTP for diagnostic tests. Individuals ready to spend up to RM 1000 were willing to pay for diagnostic testing for heart diseases. The individuals with a family history of heart disease perceived a higher risk of heart disease and were willing to pay to improve life expectancy per year. Hence, the information on family history can be used as a tool for the holistic approach to educate individuals on their risk factors for heart disease and encourage them to do early screening for cardiovascular diseases.

Trbhuvan international Airport (TIA) is only one International Airport in Kathamandu. It has one domestic and one international terminal. The road intersection at the access road of the TIA and the Ring Road is one of the important intersections of traffic network of Kathmandu city. The probable impact on the Ring Road and road to multi level car park was investigated. SIDRA INTERSECTION 5.1 was used to analyze the delay and queue lengths at the intersection. The traffic count, vehicle dimensions, movement data and geometric data of the site were used as input for analysis. Four parameters consisting of average delay, level of service degree of saturation and queue length were considered for the analysis of the probable intersection layouts. The intersection was analyzed as of existing intersection layout and other six alternative options. The operational performance of intersection at ring road due to multi level car park without any improvement was found to cause more average delay and queue lengths under the existing layout. The analysis of probable intersection layouts show that right turn movements were main cause of traffic disturbance resulting into increased delay and queue length.

The accumulation of oxidative stress is one of the important factors causing cellular senescence. Oxymatrine (OM) is a natural quinolizidine alkaloid compound known for its antioxidant effects. This study aimed to investigate the anti-senescence potential of OM through oxidative stress-induced in vitro and in vivo models. By treating 600 μM of H2O2 to the HT22 mouse hippocampal neuronal cell line and by administering 150 mg/kg D-galactose to mice, we generated oxidative stress-induced senescence models. After providing 1, 2, and 4 μg/mL of OM to the HT22 mouse cell line and by administering 50 mg/kg OM to mice, we evaluated the enhancing effects. We evaluated different senescence markers, AMPK activity, and autophagy, along with DCFH-DA detection reaction and behavioral tests. In HT22 cells, OM showed a protective effect. OM, by reducing ROS and increasing p-AMPK expression, could potentially reduce oxidative stress-induced senescence. In the D-Gal-induced senescence mouse model, both the brain and heart tissues recovered AMPK activity, resulting in reduced levels of senescence. In neural tissue, to assess neurological recovery, including anxiety symptoms and exploration, we used a behavioral test. We also found that OM decreased the expression level of receptors for advanced glycation end products (RAGE). In heart tissue, we could observe the restoration of AMPK activity, which also increased the activity of autophagy. The results of our study suggest that OM ameliorates oxidative stress-induced senescence through its antioxidant action by restoring AMPK activity.

Introduction The Global prevalence of lumbar pain during pregnancy is reported a range from 24% to 90% where pregnant women experience lumbar pain as the pregnancy advances (from a later stage of the second trimester). Only limited studies have emphasized the importance of pelvic tilt exercises for lumbar pain during pregnancy. Thereby our aim is to find the immediate and short-term effect of sitting and standing pelvic tilt exercise on lumbar pain during pregnancy. Methods An experimental study of pre and post type done on 40 pregnant women selected according to the inclusion and exclusion criteria and randomly divided into an experimental group (group A) and the control group (group B). Each group consists of 20 subjects. The experimental group was treated with sitting and standing pelvic tilt exercise along with Kinesiotaping, whereas the Control group with Kinesiotaping alone. Results Immediate effect and short-term effect on lumbar pain were statistically significant in the experimental group ( p ≤ 0.01) than the control group. Immediate effect and short term effect on functional disability were not statistically significant between the experimental group (24.28%) and the control group (20.81%) at ( p > 0.05). Conclusions It is concluded that pelvic tilt exercise in sitting and standing positions proved to be an effective treatment for lumbar pain during pregnancy.

Introduction: This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia. Methods: The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis. Results: A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents’ ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (OR=16.60, 95% CI=2.54–108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (OR=0.13, 95% CI=0.08–0.24). Conclusion: Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.

Societal Impact Statement Strengthening food and nutrient security is crucial to feeding the ever‐growing world population. Millets provide energy and nutrients for millions of poor people in low‐ and middle‐income countries of Asia and Africa. Millets require less fertilizer and pesticide, unlike mainstream cereals, for cultivation. Millets supply superior nutrients and possess excellent climate resilience properties. Therefore, promotion of millets could help attain the sustainable developmental goals (SDGs) of the United Nations (UN).

The Chronic Kidney Disease (CKD) Prognosis Consortium is a collaborative author of the above-mentioned article. The CKD Prognosis Consortium investigators/collaborators are as follows: • African American Study of Kidney Disease and Hypertension (AASK): Brad Astor, Lawrence J. Appel; Canadian Study of Prediction of Death, Dialysis and Interim Cardiovascular Events (CanPREDDICT): Adeera Levin, Mila Tang, Ognjenka Djurdjev; Cleveland Clinic CKD Registry Study (CCF): Sankar D. Navaneethan, Stacey E. Jolly, Jesse D. Schold, Joseph V. Nally Jr.; Chronic Renal Impairment in Birmingham (CRIB): David C. Wheeler, Jonathan Emberson, John Townend, Martin Landray; Chronic Renal Insufficiency Cohort Study (CRIC): Harold I. Feldman, Chi-yuan Hsu, James P. Lash, Lawrence J. Appel; Chronic Renal Insufficiency Standards Implementation Study (CRISIS): Philip A. Kalra, James P. Ritchie, Raman Maharajan, Rachel J. Middleton, Donal J. O'Donoghue; German Chronic Kidney Disease Study (GCKD): Kai-Uwe Eckardt, Markus P. Schneider, Anna Köttgen, Florian Kronenberg, Barbara Bärthlein; Geisinger Health System: Alex R. Chang, Jamie A. Green, H. Lester Kirchner, Kevin Ho; Grampian Laboratory Outcomes, Morbidity and Mortality Studies – 2 (GLOMMS2): Angharad Marks, Corri Black, Gordon J. Prescott, Nick Fluck; Gonryo Study: Masaaki Nakayama, Mariko Miyazaki, Tae Yamamoto, Gen Yamada; Hong Kong CKD Studies: Angela Yee-Moon Wang, Sharon Cheung, Sharon Wong, Jessie Chu, Henry Wu; Ontario Institute for Clinical Evaluative Sciences, Provincial Kidney, Dialysis and Transplantation program (ICES KDT): Amit X. Garg, Eric McArthur, Danielle M. Nash; Maccabi Health System: Varda Shalev, Gabriel Chodick; Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of a Nurse Practitioner (MASTERPLAN): Peter J. Blankestijn, Jack F.M. Wetzels, Arjan D. van Zuilen, Jan A. van den Brand; Modification of Diet in Renal Disease Study (MDRD): Andrew S. Levey, Lesley A. Inker, Mark J. Sarnak, Hocine Tighiouart; Nanjing CKD Network Cohort Study (Nanjing CKD): Haitao Zhang; NephroTest Study (NephroTest): Benedicte Stengel, Marie Metzger, Martin Flamant, Pascal Houillier, Jean-Philippe Haymann; National Renal Healthcare Program – Uruguay (NRHP-URU): Pablo G. Rios, Nelson Mazzuchi, Liliana Gadola, Verónica Lamadrid, Laura Sola; New Zealand Diabetes Cohort Study (NZDCS): John F. Collins, C. Raina Elley, Timothy Kenealy; Parcours de Soins des Personnes Agées (PSPA): Olivier Moranne, Cecile Couchoud, Cecile Vigneau; Primary-Secondary Care Partnership to Prevent Adverse Outcomes in Chronic Kidney Disease (PSP CKD): Nigel J. Brunskill, Rupert W. Major, David Shepherd, James F. Medcalf; Racial and Cardiovascular Risk Anomalies in CKD Cohort (RCAV): Csaba P. Kovesdy, Kamyar Kalantar-Zadeh, Miklos Z. Molnar, Keiichi Sumida, Praveen K. Potukuchi; Reduction of Endpoints in Non-insulin Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan (RENAAL): Hiddo J.L. Heerspink, Dick de Zeeuw, Barry Brenner; Stockholm CREAtinine Measurements Cohort (SCREAM): Juan Jesus Carrero, Alessandro Gasparini, Abdul Rashid Qureshi, Carl-Gustaf Elinder; Second Manifestations of ARTerial Disease Study (SMART): Frank L.J. Visseren, Yolanda van der Graaf; Swedish Renal Registry CKD Cohort (SRR CKD): Marie Evans, Maria Stendahl, Staffan Schön, Mårten Segelmark, Karl-Göran Prütz; Sunnybrook Cohort: David M. Naimark, Navdeep Tangri; West of Scotland CKD Study: Patrick B. Mark, Jamie P. Traynor, Colin C. Geddes, Peter C. Thomson.• CKD Prognosis Consortium Steering Committee: Alex R. Chang, Josef Coresh (Chair), Ron T. Gansevoort, Morgan E. Grams, Anna Köttgen, Andrew S. Levey, Kunihiro Matsushita, Mark Woodward, Luxia Zhang.• CKD Prognosis Consortium Data Coordinating Center: Shoshana H. Ballew (Assistant Project Director), Jingsha Chen (Programmer), Josef Coresh (Principal Investigator), Morgan E. Grams (Director of Nephrology Initiatives), Lucia Kwak (Programmer), Kunihiro Matsushita (Director), Yingying Sang (Lead Programmer), Aditya Surapaneni (Programmer), Mark Woodward (Senior Statistician).• Kidney Disease Improving Global Outcomes (KDIGO) Controversies Conference on Prognosis and Optimal Management of Patients with Advanced CKD: Kai-Uwe Eckardt (Conference Co-Chair), Brenda R. Hemmelgarn (Conference Co-Chair), David C. Wheeler (KDIGO Co-Chair), Wolfgang C. Winkelmayer (KDIGO Co-Chair), John Davis (CEO), Danielle Green (Managing Director), Michael Cheung (Chief Scientific Officer), Tanya Green (Communications Director), Melissa McMahan (Programs Director).

[This corrects the article DOI: 10.1016/j.ekir.2018.01.002.].

Gastric ulcer (GU) is one of the most prevalent digestive system diseases in humans, and it has been linked to inflammation. Previous studies have demonstrated the anti-inflammatory potential of isoalantolactone (IAL), a sesquiterpene lactone isolated from Radix Inulae. However, the pharmacological effects of IAL on GU and its mechanism of action are still unclear. Hence, the present study is aimed to investigate the anti-inflammatory potential of IAL on GU. Firstly, we assessed the effect of IAL on ethanol-induced injury of human gastric epithelial cells and the levels of inflammatory cytokines in cell culture supernatants. Then, the anti-inflammatory effects of IAL were confirmed in vivo using zebrafish inflammation models. Furthermore, the mechanism of IAL against GU was preliminarily discussed through network pharmacology and molecular docking studies. Quantitative real-time PCR assays were also used to confirm the mechanism of IAL action. ALB, EGFR, SRC, HSP90AA1, and CASP3 were found for the first time as the key targets of the IAL anti-GU. PI3K-Akt signaling pathway and Th17 cell differentiation were identified to play a crucial role in the anti-GU effects of IAL. In conclusion, we found that IAL has anti-inflammatory effects both in vitro and in vivo, and showed potential protective effects against ethanol-induced GU.

Introduction: Family planning services can bring a wide range of benefits to women, their families and society as a whole. Many women of reproductive age have little or incorrect information about family planning methods. Even when they know some methods of contraceptives, they don’t know the availability or how to use them properly. The aim of this study is to find out the prevalence of contraception use among women visiting the outpatient department of gynaecology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among women visiting the gynaecological outpatient department from 10 April 2021 to 10 April 2022 after taking ethical approval from the Institutional review committee (Reference number: 2079/80-03). Women aged 18 to 49 years visiting during the study period were included and pregnant, postmenopausal and unmarried women were excluded from the study. Data was collected from one-to-one interviews. A convenience sampling method was used. Point estimate and 95% confidence interval were calculated. Results: Out of 208 patients, 146 (70.19%) (63.97-76.41, 95% Confidence Interval) women were currently using contraceptives. Short-acting reversible contraception was used by 97 (66.44%) and long-acting reversible contraception was used by 23 (15.75%). A total of 21 (14.38%) women used permanent sterilisation. The most commonly used contraceptive device was Depo Provera, 43 (29.45%) followed by condoms, 29 (19.86%). Conclusions: The prevalence of contraception use is lower than the other studies done in similar settings. Therefore, contraception promotion programs have to be encouraged to promote the efficient use of contraception.

Background: Community pharmacists face challenges in job retention due to compensation, work–life balance, and career growth concerns. With pharmacists’ evolving roles in healthcare, retaining them becomes crucial for maintaining quality service. Addressing their needs is vital for a skilled healthcare workforce. This study evaluates job retention among community pharmacists, considering various workforce management domains and demographic characteristics. Materials and Methods: A cross-sectional study was employed with a self-administered questionnaire among community pharmacists in Kuala Lumpur and Selangor, Malaysia. Spearman’s correlations and ordinal logistic regression analysed job retention relationships with workforce domains and predicted the demographic characteristics. Results: A total of 414 participants attempted the survey, of which 311 completed the study. Strong correlations linked job retention with value, trust, and work–life balance. Female pharmacists had higher retention odds, while younger pharmacists had lower retention odds. Pharmacists with over 10 years of experience showed higher retention odds. Discussion: ‘Value and trust’ and ‘work–life balance’ were pivotal for the job retention of community pharmacists. Strategies boosting value, trust, and work–life balance was vital. Gender, age, and experience also predicted job retention. Conclusions: Cultivating trust, valuing contributions, and providing a work–life balance can enhance job retention and commitment.

Deficiencies of either phosphorus (P) or zinc (Zn) or both are one of the major abiotic constraints influencing agricultural production. Research on the effects of individual or combined P and Zn deficiency is limited in cereals. This study reports the effects of the individual or combined deficiency of inorganic phosphate (Pi) and Zn on the phenotypic, root hair modification, nutrient uptake, and molecular responses of finger millet (Eleusine coracana), a nutri-rich cereal crop. Finger millet seedlings were grown hydroponically under control (+Pi+Zn), individual Pi deficiency (−Pi), individual Zn deficiency (−Zn), and combined Pi and Zn deficiency (−Pi−Zn) conditions for 30 days to find the phenotypic, root hair modification, nutrient uptake, and molecular responses. Compared to the individual −Zn condition, the individual −Pi condition had more of an effect in terms of biomass reduction. The combined −Pi−Zn condition increased the root hair length and density compared to the other three conditions. The individual −Zn condition increased the Pi uptake, while the individual −Pi condition favored the Zn uptake. EcZIP2 was highly upregulated in shoot tissues under the individual −Zn condition, and EcPHT1;2 was highly expressed in root tissues under the individual −Pi condition. This is the first study to report the effects of the individual or combined deficiency of Pi and Zn in finger millet and may lead to future studies to better manage P and Zn deficiency.

Acute lymphoblastic leukemia (ALL) is a disorder caused by the abnormal proliferation of immature lymphocytes. Of the varied ocular manifestations seen in ALL, infiltration of the optic nerve is a rare and serious complication that heralds a relapse of the disease. It requires a high index of suspicion for diagnosis. Urgent intervention may prove to be lifesaving. We describe a case of optic neuropathy in a 12-year-old boy with ALL and wish to emphasize the need to maintain a low threshold for diagnosing optic nerve infiltration in patients with a prior history of leukemia.

BackgroundTaxation on sugar-sweetened beverages (SSBs) has been adopted in more than 40 countries but remained under discussion in Vietnam. This study aimed to estimate the health impacts of different SSBs tax plans currently under discussion to provide an evidence base to inform decision-making about a SSBs tax policy in Vietnam.Method & findingsFive tax scenarios were modelled, representing three levels of price increase: 5%, 11% and 19-20%. Scenarios of the highest price increase were assessed across three different tax designs: ad valorem, volume-based specific tax & sugar-based specific tax. We modelled SSBs consumption in each tax scenario; how this reduction in consumption translates to a reduction in total energy intake and how this relationship in turn translates to an average change in body weight and obesity status among adults by applying the calorie-to weight conversion factor. Changes in type 2 diabetes burden were then calculated based on the change in average BMI of the modelled cohort. A Monte Carlo simulation approach was applied on the conversion factor of weight change and diabetes risk reduction for the sensitivity analysis. We found that the taxation that involved a 5% price increase gave relatively small impacts while increasing SSBs' price up to 20% appeared to impact substantially on overweight and obesity rates (reduction of 12.7% and 12.4% respectively) saving 27 million USD for direct medical cost. The greatest reduction was observed for overweight and obesity class I. The decline in overweight and obesity rates was slightly higher for women than men.ConclusionThis study supports the SSB tax policy in pursuit of public health benefits, especially where the tax increase involves around a 20% price increase. The health benefit and revenue gains were evident across all three tax designs with the specific tax based on sugar density achieving greatest effects.