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Abstract Background CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis. Methods The major electronic databases (PubMed, Google Scholar, and Scopus) were searched for the literature review by using distinct keywords: "CNS" or "intracranial" or "brain abscess" or "meningitis" OR "spinal" OR "epidural abscess" and "actinomycosis." All cases with CNS actinomycosis reported between January 1988 to March 2022 were included. Results A total of 118 cases of CNS disease were included in the final analysis. The mean age of patients was 44 years, and a significant proportion was male (57%). Actinomycosis israelii was the most prevalent species (41.5%), followed by Actinomyces meyeri (22.6%). Disseminated disease was found in 19.5% of cases. Most commonly involved extra-CNS organs are lung (10.2%) and abdomen (5.1%). Brain abscess (55%) followed by leptomeningeal enhancement (22%) were the most common neuroimaging findings. Culture positivity was found in nearly half of the cases (53.4%). The overall case-fatality rate was 11%. Neurological sequelae were present in 22% of the patients. On multivariate analysis, patients who underwent surgery with antimicrobials had better survival (adjusted OR 0.14, 95% CI 0.04–0.28, p value 0.039) compared to those treated with antimicrobials alone. Conclusion CNS actinomycosis carries significant morbidity and mortality despite its indolent nature. Early aggressive surgery, along with prolonged antimicrobial treatment is vital to improve outcomes.

Background: During the COVID-19 pandemic lockdown, the normal daily routine activities of children were restricted as a result of the need to stay indoors. Consequently, children were forced to attend online classes provided by their educational institutions at their homes. Due to the subsequent increased screen exposure, children have started complaining of blurred vision, headache, and symptoms related to computer vision syndrome (CVS), predisposing them to myopia. Objective: To determine the prevalence of CVS symptoms, such as blurring of vision, headache, and watery eyes in children, due to increased screen time during the lockdown period of the COVID-19 pandemic. Methods: This was a non-randomized, questionnaire-based study conducted at the ophthalmology department of a tertiary care pediatric hospital. The participants were parents of children aged between 6 and 16 years attending regular school. Enrolled parents were interviewed through a Google Form after completing the online consent in English. Eligible participants were recruited by a circulation of this form through multiple groups on social media, namely, WhatsApp and email. Results: A total of 145 parents participated in the study. The children were classified according to the duration of exposure to digital devices ranging from less than 2 h to less than 6 h daily. There was a significant association between the increase in the number of activities and the development of CVS symptoms in children (r = 0.15; P = 0.036). Conclusion: COVID-19 lockdown has largely affected the lifestyle of school-going children by significantly decreasing their outdoor activities and increased online exposure to screen, thus predisposing them to myopia, ocular ill health, and increased dry eye symptoms. Increased exposure to online screen was detected during this lockdown period of the COVID-19 pandemic; this strongly supports the recommendation to decrease the number of hours of online screen exposure and encourages students to regularly get engaged in outdoor activities.

Risk administration has increased due to increased online orders to avoid sales invoices. Failure to pay a bill within 90 days of receipt constitutes overdue payment. The credit rating is used to determine the probability that consumers will fail. The CR has been thoroughly studied and several learning algorithms have been proposed. The main goal is to create a CR model for the role of Risk Solution Services (RSS), an industry standard for predicting the parameters of customer default in e-commerce risk assessment. The risk assessment included a general concept, exclusion criteria, and details of the ordering process. The most recent design should operate both independently and in conjunction with the NRC Primary Risk Audit as it is intended to replace the overall screening risk assessment. This article is about a CR implementation of Genetic Programming (GP) with Artificial Intelligence (AI). The dataset includes RSS-enabled purchase requisitions. The results show that the GP pre-risk control model goes beyond the generic CR model in terms of classification accuracy. A system with more discriminatory capacity is produced by combining GP models with the NRC's major risk assessment.

Vertical vibration tests were conducted using model footings of different size and mass, resting on the surface of a finite sand layer with different height-to-width ratios, which was underlain either by a rigid concrete base or a natural red-earth base. Using the results of resonant frequency, the equivalent stiffness was obtained using the empirical equations available in the literature. The results of the experimental study showed that the rigidity of the finite base has significant influence on the equivalent stiffness of the soil-foundation system. The equivalent stiffness obtained for model footings resting on a finite sand stratum underlain by a rigid concrete base is higher than those obtained under the influence of the natural red-earth base. The increase in dynamic force rating decreases the stiffness of the soil. At a constant height to width () ratio, for a footing with higher mass ratio when compared with a footing with lower mass ratio, the equivalent stiffness does not decrease significantly with increase in the mass ratio of the model footing, indicating the significant influence of the contact area of the footing. When a layer having significantly larger value of stiffness compared to the upper layer is present at shallow depth, it can be treated to act as a finite sand stratum. [ABSTRACT FROM AUTHOR]

Lacrimal fistula can occur due to trauma, iatrogenic or congenital. The most common presentation in patients with congenital lacrimal fistula is epiphora or purulent discharge due to cystic dilatation from secondary infection.

INTRODUCTION: cette étude a pour objectif de décrire la pratique anesthésique dans un pays à faible revenu et où le plateau technique anesthésique est moins équipé. METHODES: une étude descriptive transversale a été menée durant l'année 2013. L'enquête a concerné les pratiques anesthésiques, les indications chirurgicales et les caractéristiques des malades. L'encodage et l'analyse des données ont été réalisées grâce aux logiciels Epi Info 3.5.3 et Excel 2010. RESULTATS: nous avons enregistré 2358 patients dont l'âge médian était de 29 + 15 ans, avec 81,5% âgés de 11 à 50 ans.Parmi eux, 67,3% des malades étaient du sexe féminin. Dans ensemble, 62,5% de ces patients étaient pris en charge pour les interventions programmées. L'évaluation du risque anesthésique a montré que 91,9% des patients étaient de la classe ASA I et II. La chirurgie la plus pratiquée était viscérale (46,7%) suivie de la chirurgie gynéco-obstétricale (29,2%). Les différents types d'anesthésie étaient les suivants: anesthésie générale (87,6%), locorégionale (11,8%) et combinée (0,6%). CONCLUSION: la pratique anesthésique dans la population d'étude était dominée par l'anesthésie générale. Les malades étaient au trois quart de sexe féminin et de la classe ASA I et II. Les résultats de cette étude indiquent la nécessité d'évaluer l'issue de cette pratique. La pratique anesthésique à Lubumbashi est tributaire du plateau technique, des compétences du personnel et de l'acceptabilité du type d'anesthésie par les patients.

The urgent need to mitigate water pollution and achieve Sustainable Development Goal 14 (SDG 14)-Life below water, necessitates developing efficient and eco-friendly wastewater treatment technologies. This research addresses this challenge by photocatalytic degradation of terephthalic acid, a precursor for PET bottles using environment-friendly and biocompatible photocatalysts. The 1D/2D nanocomposite comprising zinc oxide (ZnO) nanorods and functionalized graphitic carbon nitride (Zn-TG) nanosheets were synthesized and thoroughly characterized. The nanocomposite effectively mitigated the individual drawbacks of Zn-TG agglomeration and the wide band gap of ZnO as confirmed through zeta potential and Tauc's plot studies, respectively. The synthesized nanocomposite achieved ~100 % degradation within 60 minutes, exhibiting superior kinetics (~2.5 times) compared to pristine samples. The enhanced degradation efficiency was elucidated by efficient charge carrier transfer (~5 times faster) and separation (~2 times improved) as confirmed through electrochemical impedance spectroscopy and time-resolved photoluminescence studies. The proposed Z-scheme pathway provides mechanistic insights. This proposed mechanism is supported by extensive electron paramagnetic resonance (EPR) and scavenger studies. The liquid chromatography-mass spectrometry (LC-MS) analysis confirms the formation of less toxic byproducts for ensuring that the wastewater treatment process is efficient and environmentally friendly. This research helps in developing a highly effective and sustainable wastewater treatment technology., (© 2024 Wiley-VCH GmbH.)

Human papillomavirus (HPV) vaccine is an underutilized tool in cancer prevention. HPV vaccine completion rates in adolescents age 13 to 15 years remain low at 59%. The HPV vaccine can prevent more than 90% of cases of cancer caused by HPV, including cervical, oropharyngeal, anal, penile, vulvar, and vaginal. HPV vaccine is very safe and effective, as demonstrated by numerous large-scale studies. Practice-based strategies can improve vaccination rates, such as having providers give a strong presumptive recommendation for the vaccine, using motivational interviewing for hesitant families, and using electronic health record reminders to prompt providers to offer it, among other interventions. Offering HPV vaccine starting at age 9 years is another evidence-based strategy to improve HPV vaccine completion rates, which has been shown to be acceptable to both providers and parents. [ Pediatr Ann . 2024;53(10):e372-e377.] .

Histone H2B monoubiquitination in budding yeast is a highly conserved post-translational modification. It is involved in normal functions of the cells like DNA Repair, RNA Pol II activation, trans-histone H3K and H79K methylation, meiosis, vesicle budding, etc. Deregulation of H2BK123ub can lead to the activation of proto-oncogenes and is also linked to neurodegenerative and heart diseases. Recent discoveries have enhanced the mechanistic underpinnings of H2BK123ub. For the first time, the Rad6's acidic tail has been implicated in histone recognition and interaction with Bre1's RBD domain. The non-canonical backside of Rad6 showed inhibition in polyubiquitination activity. Bre1 domains RBD and RING play a role in site-specific ubiquitination. The role of single Alaline residue in Rad6 activity. Understanding the mechanism of ubiquitination before moving to therapeutic applications is important. Current advancements in this field indicate the creation of novel therapeutic approaches and a foundation for further study., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Tuberculosis (TB) is the leading cause of mortality among infectious diseases globally. Effectively managing TB requires early identification of individuals with TB disease. Resource-constrained settings often lack skilled professionals for interpreting chest X-rays (CXRs) used in TB diagnosis. To address this challenge, we developed "DecXpert" a novel Computer-Aided Detection (CAD) software solution based on deep neural networks for early TB diagnosis from CXRs, aiming to detect subtle abnormalities that may be overlooked by human interpretation alone. This study was conducted on the largest cohort size to date, where the performance of a CAD software (DecXpert version 1.4) was validated against the gold standard molecular diagnostic technique, GeneXpert MTB/RIF, analyzing data from 4363 individuals across 12 primary health care centers and one tertiary hospital in North India. DecXpert demonstrated 88% sensitivity (95% CI 0.85-0.93) and 85% specificity (95% CI 0.82-0.91) for active TB detection. Incorporating demographics, DecXpert achieved an area under the curve of 0.91 (95% CI 0.88-0.94), indicating robust diagnostic performance. Our findings establish DecXpert's potential as an accurate, efficient AI solution for early identification of active TB cases. Deployed as a screening tool in resource-limited settings, DecXpert could enable early identification of individuals with TB disease and facilitate effective TB management where skilled radiological interpretation is limited., (© 2024. The Author(s).)

Multiple transcription factors in the budding yeast Saccharomyces cerevisiae are required for the switch from fermentative growth to respiratory growth. The Hap2/3/4/5 complex is a transcriptional activator that binds to CCAAT sequence elements in the promoters of many genes involved in the tricarboxylic acid cycle and oxidative phosphorylation and activates gene expression. Adr1 and Cat8 are required to activate the expression of genes involved in the glyoxylate cycle, gluconeogenesis, and utilization of nonfermentable carbon sources. Here, we characterize the regulation and function of the zinc cluster transcription factor Gsm1 using Western blotting and lacZ reporter-gene analysis. GSM1 is subject to glucose repression, and it requires a CCAAT sequence element for Hap2/3/4/5-dependent expression under glucose-derepression conditions. Genome-wide CHIP analyses revealed many potential targets. We analyzed 29 of them and found that FBP1 , LPX1 , PCK1 , SFC1 , and YAT1 require both Gsm1 and Hap4 for optimal expression. FBP1 , PCK1 , SFC1 , and YAT1 play important roles in gluconeogenesis and utilization of two-carbon compounds, and they are known to be regulated by Cat8. GSM1 overexpression in cat8 Δ mutant cells increases the expression of these target genes and suppresses growth defects in cat8 Δ mutants on lactate medium. We propose that Gsm1 and Cat8 have shared functions in gluconeogenesis and utilization of nonfermentable carbon sources and that Cat8 is the primary regulator., Competing Interests: The authors declare no conflicts of interest.

Bioethanol fermentation from lignocellulosic hydrolysates is negatively affected by the presence of acetic acid. The budding yeast S. cerevisiae adapts to acetic acid stress partly by activating the transcription factor, Haa1. Haa1 induces the expression of many genes, which are responsible for increased fitness in the presence of acetic acid. Here, we show that protein kinase A (PKA) is a negative regulator of Haa1-dependent gene expression under both basal and acetic acid stress conditions. Deletions of RAS2 , encoding a positive regulator of PKA, and PDE2 , encoding a negative regulator of PKA, lead to an increased and decreased expression of Haa1-regulated genes, respectively. Importantly, the deletion of HAA1 largely reverses the effects of ras2 ∆. Additionally, the expression of a dominant, hyperactive RAS2 A18V19 mutant allele also reduces the expression of Haa1-regulated genes. We found that both pde2 Δ and RAS2 A18V19 reduce cell fitness in response to acetic acid stress, while ras2 Δ increases cellular adaptation. There are three PKA catalytic subunits in yeast, encoded by TPK1 , TPK2 , and TPK3 . We show that single mutations in TPK1 and TPK3 lead to the increased expression of Haa1-regulated genes, while tpk2 Δ reduces their expression. Among tpk double mutations, tpk1 Δ tpk3 Δ greatly increases the expression of Haa1-regulated genes. We found that acetic acid stress in a tpk1 Δ tpk3 Δ double mutant induces a flocculation phenotype, which is reversed by haa1 Δ. Our findings reveal PKA to be a negative regulator of the acetic acid stress response and may help engineer yeast strains with increased efficiency of bioethanol fermentation.

Newborns and young infants are at risk for severe respiratory syncytial virus (RSV) lower respiratory tract infection. Passive immunity is the mainstay of infection prevention in this cohort. Transplacental transfer of maternal antibodies provides the newborn with immediate protection from life-threatening infections, however, is dependent upon gestational age, birth weight, mother's age, recent maternal vaccination, maternal nutritional status, maternal immunocompetence and medical conditions, and placental integrity. Efficient transplacental transfer of RSV-neutralizing antibodies have led to the development and approval of maternal RSV immunization for the protection of the newborn. Additionally, administration of RSV-specific antibodies to infants leads to high serum titers of RSV-neutralizing antibodies and further protection from severe disease., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: EMPOWER-Lung 3 part 2 (NCT03409614), a double-blind, placebo-controlled phase 3 study, assessed cemiplimab (anti-programmed cell death protein 1) plus chemotherapy versus chemotherapy alone in patients with advanced non-small cell lung cancer (NSCLC) without EGFR, ALK, or ROS1 aberrations, regardless of histology or PD-L1 expression levels. We report results from subgroup analysis of patients with PD-L1 expression ≥ 1 %., Materials and Methods: Patients were randomized to receive cemiplimab 350 mg or placebo with chemotherapy every 3 weeks for up to 108 weeks. Overall survival (OS), progression-free survival (PFS), overall response rates (ORRs), patient-reported outcomes (PROs), and safety were assessed., Results: Of the 327 patients with PD-L1 ≥ 1 % (466 in the overall study), 217 received cemiplimab plus chemotherapy and 110 received chemotherapy alone. After median follow-up of 28.0 months, median OS for cemiplimab plus chemotherapy was 23.5 months (95 % confidence interval [CI]: 20.9-27.2) vs. 12.1 months (95 % CI: 10.1-15.7) for chemotherapy alone (hazard ratio [HR] = 0.51, 95 % CI: 0.38-0.69, P < 0.0001); median PFS was 8.3 months (95 % CI: 6.7-10.8) versus 5.5 months (95 % CI: 4.3-6.2; HR = 0.48; 95 % CI: 0.37-0.62, P < 0.0001), and ORR was 47.9 % versus 22.7 %, respectively. PRO results favored cemiplimab plus chemotherapy over chemotherapy alone. Improved efficacy over chemotherapy alone was observed in both squamous and non-squamous histology. Safety was consistent with previous reports., Conclusion: In this subgroup analysis from EMPOWER-Lung 3 part 2, cemiplimab plus chemotherapy demonstrated clinical benefit over chemotherapy alone in patients with advanced squamous or non-squamous NSCLC with PD-L1 ≥ 1 %., Competing Interests: Declaration of competing interest A. Baramidze, M. Gogishvili, T. Melkadze, D. Giorgadze, K. Laktionov, G. Nemsadze, M. Nechaeva, and I. Rozhkova report no conflicts of interest.T. Makharadze reports travel support from Regeneron Pharmaceuticals, Inc.K. Penkov reports honoraria from AstraZeneca, Merck Sharp & Dohme, Nektar, Pfizer, Regeneron Pharmaceuticals, Inc. and Roche.E. Kalinka reports honoraria from: BMS, Merck Sharpe & Dohme, Roche, AstraZeneca, Regeneron Pharmaceuticals, Inc., Nektar, Pfizer, and Amgen; travel support from Regeneron Pharmaceuticals, Inc., Gilead, Merck Sharpe & Dohme, and BMS.D. McIntyre, J. Perez, M. Kaul, R. Quek, F. Seebach, P. Rietschel, and J-F. Pouliot are employees and shareholders of Regeneron Pharmaceuticals, Inc., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: This article aims to evaluate the intrareader and interreader agreement of ultrasound (US) gallbladder reporting and data system (GB-RADS) and validate the risk of malignancy in each GB-RADS category., Materials and Methods: This retrospective study comprised consecutive patients with nonacute gallbladder wall thickening who underwent US evaluation between January 2019 and December 2022. Three radiologists independently read the static US images and cine-loops for GB-RADS findings and assigned GB-RADS categories. The intraobserver (static images) and interobserver (static images and cine-loops) agreement was calculated using kappa statistics and Krippendorff's alpha. Another radiologist assigned a consensus GB-RADS category. The percentage of malignancy in each GB-RADS category was calculated., Results: Static US images of 414 patients (median age, 56 years; 288 women, benign = 45.6% and malignant = 54.4%) and cine-loops of 50 patients were read. There was weak to moderate intrareader agreement for most GB-RADS findings and moderate intrareader agreement for the GB-RADS category for all readers. On static images, the interreader agreement was acceptable for GB-RADS categories. On cine-loops, the interreader agreement for GB-RADS findings and categories was better than static images. The percentage of malignancy was 1.2%, 37%, 71.1%, and 89.1% in GB-RADS 2, 3, 4, and 5 categories., Conclusion: GB-RADS has moderate intrareader for GB-RADS categories. As originally proposed, the risk of malignancy is negligible in GB-RADS 2 category and highest in GB-RADS 5 category. However, the discriminatory performance of GB-RADS 3 and 4 categories is low. Larger multicenter studies with more readers must assess the reader agreement and validate the GB-RADS systems for wider clinical utilization., (© 2024 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: (1) supply locally available ingredients for processing; (2) establish two fish drying sites; (3) initiate a community-based production site; and (4) distribute fish chutney to PLW for one year by six women nutrition field facilitators. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30 g of fish chutney daily for 12 months. Differences in mean MUAC and Hb levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30 g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

The intricate architecture of the intestinal epithelium, crucial for nutrient absorption, is constantly threatened by environmental factors. The epithelium undergoes rapid turnover, which is essential for maintaining homeostasis, under the control of intestinal stem cells (ISCs). The central regulator, Wnt/β-catenin signaling plays a key role in intestinal integrity and turnover. Despite its significance, the impact of environmental factors on this pathway has been largely overlooked. This study, for the first time, investigates the influence of Cd on the intestinal Wnt signaling pathway using a mouse model. In this study, male BALB/c mice were administered an environmentally relevant Cd dose (0.98 mg/kg) through oral gavage to investigate the intestinal disruption and Wnt signaling pathway. Various studies, including histopathology, immunohistochemistry, RT-PCR, western blotting, ELISA, intestinal permeability assay, and flow cytometry, were conducted to study Cd-induced changes in the intestine. The canonical Wnt signaling pathway experienced significant downregulation as a result of sub-chronic Cd exposure, which caused extensive damage throughout the small intestine. Increased intestinal permeability and a skewed immune response were also observed. To confirm that Wnt signaling downregulation is the key driver of Cd-induced gastrointestinal toxicity, mice were co-exposed to LiCl (a recognized Wnt activator) and Cd. The results clearly showed that the harmful effects of Cd could be reversed, which is strong evidence that Cd mostly damages the intestine through the Wnt/β-catenin signalling axis. In conclusion, this research advances the current understanding of the role of Wnt/β catenin signaling in gastrointestinal toxicity caused by diverse environmental pollutants., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background Syphilis remains a significant public health concern in India. Ensuring the accuracy of diagnostic tests is crucial for effectively managing this disease. Objectives This study aims to assess the detectability of syphilis using commercially available non-treponemal and treponemal tests due to observed discrepancies in test results, which can lead to confusion and anxiety among healthcare providers and patients. Materials and methods We analyzed 2312 serum samples using the rapid plasma reagin (RPR), Treponema pallidum hemagglutination assay (TPHA), enzyme-linked immunosorbent assay (ELISA), and modified TPHA rapid test, interpreting the results according to the manufacturers' instructions. We evaluated the diagnostic accuracy of all four tests. Concordance between the traditional and reverse algorithms was determined by calculating the percentage of agreement and the kappa (κ) coefficient. Results Of the 2312 samples tested, 34 (1.5%) were positive, and 2098 (90.7%) were negative across all four tests. Comparing the test results with clinical diagnosis, TPHA and TP-ELISA showed the highest sensitivity at 96.08%, while RPR demonstrated the highest specificity at 100%. The agreement between the traditional and reverse algorithms was moderate, with a 97.3% agreement and a κ value of 0.53. Conclusion Reliance on a single serological test for syphilis screening presents limitations. A combined approach using both RPR and TPHA tests can more accurately diagnose and confirm syphilis. This combination strategy is cost-effective and relatively simple to implement., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Lyngdoh et al.)

The two-dimensional (2D) WSe 2 nanostructure was successfully synthesized via the hydrothermal method and subjected to comprehensive characterization using various spectroscopic techniques. X-ray diffraction (XRD) analysis confirmed the formation of nanosheets with a hexagonal crystal structure having a space symmetry of P 63/ mmc . Scanning electron microscopy (SEM) images showed irregular and nonuniform morphology. The size of the 2D nanosheets was determined using transmission electron microscopy (TEM) providing insights intotheir physical characteristics. The optical spectrum analysis yielded a discernible band gap value of 2.1 eV, as determined by the Tauc equation. Photoluminescence (PL) spectra display an emission at a wavelength of 610 nm, showing a broad emission associated with self-trapped excitons. Under excitation at λ exc = 360 nm, PL emission spectra displayed a distinct peak at 610 nm, demonstrating the ability of the nanostructure to emit vivid red light. Photometric analysis underscored the potential of this nanostructure as a prominent red-light source for diverse display applications. The optimized photodetection performance of a device showcases a photoresponsivity of approximately 1.25 × 10 -3 AW -1 and a detectivity of around 5.19 × 10 8 Jones at a wavelength of 390 nm. Additionally, the quantum efficiency is reported to be approximately 6.99 × 10 -3 at a wavelength of 635 nm. These findings highlight the capability of the device for efficient photoconversion at specified wavelengths, indicating potential applications in sensing, imaging, and optical communication. The combination of structural, morphological, and optical characterizations highlights the suitability of 2D WSe 2 nanostructure for practical optoelectronic applications, particularly in display technologies.

Aim: The purpose of the present study was to compare the clinical efficacy of GC Gold Label IX, GC Gold Label IX Extra, and GC Gold Label Hybrid in occlusal surface cavities in primary molars prepared by hand instrumentation technique., Materials and Methods: Ninety primary molars were selected from the children according to the inclusion and exclusion criteria. The selected teeth were randomly allocated into the following three groups, with 30 teeth in each group, according to the restorative material used: group I: GC Gold Label IX, group II: GC Gold Label IX Extra, and group III: GC Gold Label Hybrid. Occlusal cavities were prepared using hand instruments. Caries removal efficacy was verified using caries detector dye. The restorative materials were mixed and condensed into the prepared cavities. The restorations were assessed using modified United States Public Health Service (USPHS) evaluation criteria at 1, 3, and 6 months., Results: The results were tabulated and statistically analyzed using the Chi-squared test. No significant difference was found in terms of color match, marginal discoloration, marginal integrity, surface roughness, and secondary caries, but a significant difference was observed in terms of retention and anatomic form between group I and group III., Conclusion: GC Gold Label Hybrid exhibited better clinical performance with respect to GC Gold Label IX and comparable clinical performance with respect to GC Gold Label IX Extra., Clinical Significance: GC Gold Label Hybrid is a newly developed glass ionomer cement (GIC), and its clinical performance needs to be studied., How to Cite This Article: Mittal M, Bajaj N, Bhola M, et al. Comparative Evaluation of GC Gold Label IX with GC Gold Label IX Extra and GC Gold Label Hybrid in Cavitated Lesions Prepared by Hand Instrumentation Technique in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(5):570-575., Competing Interests: Source of support: Nil Conflict of interest: NoneConflict of interest: None, (Copyright © 2024; The Author(s).)

Background: Artificial intelligence (AI) based models are explored increasingly in the medical field. The highly contagious pandemic of coronavirus disease 2019 (COVID-19) affected the world and availability of diagnostic tools high resolution computed tomography (HRCT) and/or real-time reverse transcriptase-polymerase chain reaction (RTPCR) was very limited, costly and time consuming. Therefore, the use of AI in COVID-19 for diagnosis using cough sounds can be efficacious and cost effective for screening in clinic or hospital and help in early diagnosis and further management of patients., Objectives: To develop an accurate and fast voice-processing AI software to determine voice-based signatures in discriminating COVID-19 and non-COVID-19 cough sounds for screening of COVID-19., Methodology: A prospective study involving 117 patients was performed based on online and/or offline voice data collection of cough sounds of COVID-19 patients in isolation ward of a tertiary care teaching hospital and non-COVID-19 participants using a smart phone. A website-based AI software was developed to identify the cough sounds as COVID-19 or non-COVID-19. The data were divided into three segments including training set, validation set and test set. A pre-processing algorithm was utilized and combined with Short Time Fourier Transform feature representation and Logistic regression model. A precise software was used to identify vocal signatures and K-fold cross validation was carried out., Result: A total of 117 audio recordings of cough sounds were collected through the developed website after inclusion-exclusion criteria out of which 52 have been marked belonging to COVID-19 positive, while 65 were marked as COVID-19 negative/unsure /never had COVID-19, which were assumed to be COVID-19 negative based on RT-PCR test results. The mean and standard error values for the accuracies attained at the end of each experiment in training, validation and testing set were found to be 67.34%±0.22, 58.57%±1.11 and 64.60%±1.79 respectively. The weight values were found to be positive which were contributing towards predicting the samples as COVID-19 positive with large spikes around 7.5 kHz, 7.8 kHz, 8.6 kHz and 11 kHz which can be used for classification., Conclusion: The proposed AI based approach can be a helpful screening tool for COVID-19 using vocal sounds of cough. It can help the health system by reducing the cost burden and improving overall diagnosis and management of the disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Modi et al.)

Objective: To describe the radiopathological characteristics of a new morphological "combined type" of gallbladder cancer (GBC) and compare it with the mass replacing gallbladder and thickening types of GBC., Materials and Methods: The imaging and pathological details of consecutive patients with GBC between August 2020 and December 2022 were retrospectively reviewed. Two radiologists reviewed computed tomography/magnetic resonance imaging in consensus for the morphological type of GBC. The radiologists classified GBC as mass replacing gallbladder, wall thickening, and combined type. The combined type was defined as a mass arising from the thickened wall of an adequately distended gallbladder that extended exophytically into the adjacent liver parenchyma. The presence of calculi, site, and size of lesion, biliary/portal vein involvement, liver, lymph node, and omental metastases was compared among the various types. The pathological characteristics were also compared., Results: Of the 481 patients (median age 55 years, 63.2% females) included in the study, mass replacing gallbladder, wall thickening, and combined-type GBC were seen in 42.8% (206/481), 40.5% (195/481), and 16.6% (80/481) of patients, respectively. In the combined type of GBC, biliary/portal vein involvement was seen in 63.7% (51/80) and 7.5% (6/80) of patients. Liver, lymph node, and omental metastases were seen in 67.5% (54/80), 40% (32/80), and 41.2% (33/80) patients, respectively. Liver metastases were significantly more common in the combined type (p = 0.002). There were no significant differences in pathological characteristics among the various types., Conclusion: Combined-type GBC is less common than the mass replacing gallbladder and thickening types and is associated with a higher risk of liver metastases., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This pilot study assessed the acceptability and pre-post intervention effects of a cognitive dissonance-based body image intervention, Free Being Me, delivered by Guide leaders to adolescent girls in India. Girls aged 11-14 years (Mage = 12.6, N = 117), who were members of the national scouting and guiding association of India, received the intervention across five weekly 1-hour group sessions. The primary outcome (body esteem) and secondary outcomes (self-esteem, internalisation of appearance ideals, negative and positive affect, and life disengagement) were measured pre-intervention and immediately post-intervention. The intervention was acceptable. Adolescent girls reported high levels of comfort (89%), enjoyment (90%), and perceived importance (92%) with suggestions for improvement including more interactive activities. Facilitator adherence and competence delivering Free Being Me was rated good. Significant within-groups pre-post intervention improvements in body esteem (Cohen's d = 0.28) and reductions in internalisation of appearance ideals (Cohen's d = 0.49) were identified. No changes to self-esteem, negative or positive affect, or life disengagement were observed. This study suggests that Free Being Me is acceptable for community-based delivery and Guide leader format with promising pre-post intervention effects. Going forward, a randomised controlled trial is necessary to make confident interpretations on the effectiveness of Free Being Me., Competing Interests: Declaration of Competing Interest Phillippa Diedrichs is an independent consultant to the Dove Self-Esteem Project. The authors declare no other conflicts of interest in relation to this work., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Ketamine is one of the most commonly abused drugs globally, posing a severe risk to social stability and human health, not only it is being used for recreational purposes, but this tasteless, odourless, and colourless drug also facilitates sexual assaults when it is mixed with drinks. Ketamine abuse is a threat for safety, and this misuse is one of the main uses of the drug. The crucial role of ketamine detection is evident in its contributions to forensic investigations, law enforcement, drug control, workplace integrity, and public health. Electrochemical sensors have gained considerable interest among researchers due to their various advantages, such as low cost and specificity, and particularly screen-printed paper-based electrode (SPBE) biosensors have gained attention. Here, we reported an ePAD (electrochemical paper-based analytical device) for detecting the recreational drug ketamine. The advantages of using a paper-based electrode are that it reduces the electrode's production costs and is disposable and environmentally friendly. At the same time, nanographite sheets (NGSs) assisted in amplifying the signals generated in the cyclic voltammetry system when ketamine was present. This ePAD was developed by immobilizing a ketamine aptamer on NGS electrodes. The characterization of proper synthesized NGSs was performed by Scanning Electron Microscopy (SEM), XRD (X-ray Diffraction), Fourier-transform infrared spectroscopy (FTIR), and UV-Vis spectroscopy. Electrochemical techniques, including cyclic voltammetry (CV) and linear sweep voltammetry (LSV), were employed to validate the results and confirm each attachment. Furthermore, the versatility of the proposed sensor was explored in both alcoholic and non-alcoholic beverages. The developed sensor showed a low LOD of about 0.01 μg/mL, and the linear range was between 0.01 and 5 μg/mL. This approach offers a valid diagnostic technique for onsite service with minimal resources. This cost effective and portable platform offers desirable characteristics like sensitivity and selectivity and can also be used for POC (point of care) testing to help in the quick identification of suspicious samples and for testing at trafficking sites, amusement parks, and by the side of the road.

As climate change exacerbates drought stress in many parts of the world, understanding plant physiological mechanisms for drought survival is critical to predicting ecosystem responses. Stem net photosynthesis, which is common in arid environments, may be a drought survival trait, but whether the additional carbon fixed by stems contributes to plant hydraulic function and drought survival in arid land plants is untested. We conducted a stem light-exclusion experiment on saplings of a widespread North American desert tree species, Parkinsonia florida L., and after shading acclimation, we then subjected half of the plants to a drought treatment to test the interaction between light exclusion and water limitation on growth, leaf and stem photosynthetic gas exchange, xylem embolism assessed with micro-computed tomography and gravimetric techniques, and survival. Growth, stem photosynthetic gas exchange, hydraulic function and survival all showed expected reductions in response to light exclusion. However, stem photosynthesis mitigated the drought-induced reductions in gas exchange, xylem embolism (percent loss of conductivity, PLC) and mortality. The highest mortality was in the combined light exclusion and drought treatment, and was related to stem PLC and native sapwood-specific hydraulic conductivity. This research highlights the integration of carbon economy and water transport. Our results show that additional carbon income by photosynthetic stems has an important role in the growth and survival of a widespread desert tree species during drought. This shift in function under conditions of increasing stress underscores the importance of considering stem photosynthesis for predicting drought-induced mortality not only for the additional supply of carbon, but also for its extended benefits for hydraulic function., (© The Author(s) 2024. Published by Oxford University Press.)

To evaluate the anatomical and functional success rates of palisade cartilage tympanoplasty in chronic otitis media. Thirty patients with chronic otitis media with subtotal perforation underwent palisade cartilage tympanoplasty and were assessed prospectively. The outcomes evaluated were graft uptake and hearing gain. Overall graft uptake was 90% with failure in 3 cases. The preoperative mean air conduction threshold was 22.087 ± 6.120 dB which was improved to 13.387 ± 5.253 dB postoperatively at 12 weeks which was statistically significant. The mean postoperative ABG closure was 8.700 dB with a p value of 0.001 which was statistically significant. Palisade cartilage tympanoplasty demonstrates that subtotal perforations, which are at high risk for graft failure, can be treated efficiently and a durable and resistant reconstruction of the tympanic membrane with reasonable hearing can be achieved., Competing Interests: Conflict of interestThe authors have no conflict of interest., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Pancreatic fistula is a highly morbid complication of pancreatitis. External pancreatic fistulas result when pancreatic secretions leak externally into the percutaneous drains or external wound (following surgery) due to the communication of the peripancreatic collection with the main pancreatic duct (MPD). Internal pancreatic fistulas include communication of the pancreatic duct (directly or via intervening collection) with the pleura, pericardium, mediastinum, peritoneal cavity, or gastrointestinal tract. Cross-sectional imaging plays an essential role in the management of pancreatic fistulas. With the help of multiplanar imaging, fistulous tracts can be delineated clearly. Thin computed tomography sections and magnetic resonance cholangiopancreatography images may demonstrate the communication between MPD and pancreatic fluid collections or body cavities. Endoscopic retrograde cholangiography (ERCP) is diagnostic as well as therapeutic. In this review, we discuss the imaging diagnosis and management of various types of pancreatic fistulas with the aim to sensitize radiologists to timely diagnosis of this critical complication of pancreatitis., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

There is currently a lot of interest in the construction of point-of-care devices stemming from paper-based origami biosensors. These devices demonstrate how paper's foldability permits the construction of sensitive, selective, user-friendly, intelligent, and maintainable analytical devices for the detection of several ailments. Herein, the first example of the electrochemical aptasensor-based polyvalent dengue viral antigen detection using the origami paper-folding method is presented. Coupling it with an aptamer leads to the development of a new notation known as OBAs, or origami-based aptasensor, that presents a multitude of advantages to the developed platform, such as assisting in safeguarding the sample from air-dust particles, providing confidentiality, and providing a closed chamber to the electrodes. In this paper, gold-decorated nanocomposites of zinc and graphene oxide (Au/ZnO/GO) were synthesized via the chemical method, and characterization was conducted by Scanning Electron Microscope, Transmission Electron Microscope, UV-Vis, and XRD which reveals the successful formation of nanocomposites, mainly helping to enhance the signal and specificity of the sensor by employing aptamers, since isolation and purification procedures are not required. The biosensor that is being demonstrated here is affordable, simple, and efficient. The reported biosensor is an OBA detection of polyvalent antigens of the dengue virus in human serum, presenting a good range from 0.0001 to 0.1 mg/mL with a limit of detection of 0.0001 mg/mL. The reported single-folding ori-aptasensor demonstrates exceptional sensitivity, specificity, and performance in human serum assays, and can also be used for the POC testing of various viral infections in remote areas and underdeveloped countries, as well as being potentially effective during outbreaks. Highlights: (1) First report on origami-based aptasensors for the detection of polyvalent antigens of DENV; (2) In-house construction of low-cost origami-based setup; (3) Gold-decorated zinc/graphene nanocomposite characterization was confirmed via FESEM/UV-Vis/FTIR; (4) Cross-reactivity of dengue-aptamer has been deduced; (5) Electrochemical validation was conducted through CV.

The Medical Termination of Pregnancy (MTP) Amendment Act, 2021, contains some progressive changes. However, survivors of rape will continue to go through mental as well as physical trauma to secure an abortion. We argue that the MTP Amendment Act, 2021, fails to address the rights of rape survivors adequately.

Community-wide vaccine uptake remains sub-optimal. Healthcare provider (HCP) vaccine recommendations influence patient vaccination; however, provider vaccine recommendation behavior is highly influenced by one's own vaccine attitudes and/or knowledge. We aim to describe vaccine knowledge, attitudes, and recommendation practices (KAP) among New York State HCPs. A survey to assess HCP KAP was developed and electronically distributed to NYS members of national medical organizations via their local chapter administrators. Descriptive statistical methods were used to define provider KAP. A total of 864 surveys were included, 500 (60%) and 336 (40%) primary and specialty care providers, respectively. Eighty-one percent (402/499) of primary care providers (PCPs) report encountering vaccine hesitant patients daily or weekly. Of the 500 PCPs who responded, only 204 (41%) stated strong agreement with confidence in their communications with vaccine hesitant patients. HCPs who correctly answered all four knowledge questions were more likely to self-report routine recommendations of standard vaccines to all patients when compared to those who correctly answered fewer questions (489/588 (83%) vs 135/241 (56%), p  < .05). HCPs were more likely to routinely recommend standard vaccines to all patients if they also report initiating vaccine discussion (476/485 (98%) vs 148/344 (43%), p  < .05) and reviewing and recommending vaccinations at each encounter (315/320 (98%) vs 308/508 (61%), p  < .05). Vaccine hesitancy exists across healthcare specialties and provider roles. Focused interventions should include reaching all HCPs to promote vaccinations for disease prevention, tailoring messages to reduce HCP vaccine misperceptions, and increasing awareness of evidence-based office strategies known to facilitate immunizations.

CRISPR/Cas9 gene editing system is recently developed robust genome editing technology for accelerating plant breeding. Various modifications of this editing system have been established for adaptability in plant varieties as well as for its improved efficiency and portability. This review provides an in-depth look at the various strategies for synthesizing gRNAs for efficient delivery in plant cells, including chemical synthesis and in vitro transcription. It also covers traditional analytical tools and emerging developments in detection methods to analyze CRISPR/Cas9 mediated mutation in plant breeding. Additionally, the review outlines the various analytical tools which are used to detect and analyze CRISPR/Cas9 mediated mutations, such as next-generation sequencing, restriction enzyme analysis, and southern blotting. Finally, the review discusses emerging detection methods, including digital PCR and qPCR. Hence, CRISPR/Cas9 has great potential for transforming agriculture and opening avenues for new advancements in the system for gene editing in plants.

Dietary sodium intake is high among adults in India. Use of low sodium iodized salt (LSIS) can help reduce sodium intake. However, contextually relevant and culturally appropriate interventions to promote LSIS uptake in India have not been developed and implemented. We carried out formative research to inform an intervention to promote uptake of LSIS among rural and urban households in north (Sonipat district) and south (Visakhapatnam and Anakapalli districts) India. Sixty-two in-depth interviews of six focus groups were held with a range of stakeholders-consumers, retailers and influencers. Participant views on availability, affordability, taste and safety of LSIS, along with views on hypertension, its risk factors and potential intervention design and delivery strategies were elicited. Thematic analysis of the data was carried out. While the awareness of hypertension and its risk factors was high among the participants, awareness of LSIS was low. There was also low demand for, and availability of, LSIS. Since cost of LSIS was higher than regular salt, participants preferred that a subsidy be provided to offset the cost. Based on these findings, an intervention to promote the uptake of LSIS was implemented by project staff using various educational materials such as posters, pamphlets and short videos.

Hypertensive disorders of pregnancy affect 5% to 10% of all pregnancies globally. The aim of treatment is to bring down blood pressure (BP) quickly and smoothly, which is safe for the mother and baby. The aim of our study was to study the efficacy and safety of intravenous labetalol and oral nifedipine in severe pregnancy-induced hypertension., Materials and Methods: It is a retrospective observational study, intravenous labetalol 20 mg was given initially in escalating doses of 40 mg, 80 mg, 80 mg, and 80 mg every 15 mins up to a maximum dose of 5 or until the goal BP ≤150/100 mmHg was reached. Some women with severe pregnancy-induced hypertension were given oral nifedipine to control their BP according to the choice of the attending consultant. Nifedipine 10 mg tablet was given initially in repeated doses of 10 mg every 15 mins up to a maximum of five doses or until the goal of BP ≤150/100 mmHg was reached., Results: In our study, we found that there was a strong statistical significance in stabilizing the BP with oral nifedipine than with intravenous labetalol drug used. The majority of the patients in the oral nifedipine group got to normal BP quicker when compared to intravenous labetalol group patients., Conclusion: From this study, both drugs were found to be safe and effective in the reduction in BP. The use of nifedipine may be recommended in low-resource settings since it has an oral regimen and dosage is simple when compared to incremental intravenous dosing of labetalol., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

Background: Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of hospitalizations among infants in the United States. Unpredictability in RSV seasonality has occurred following the onset of the coronavirus disease 2019 (COVID-19) pandemic. Local surveillance networks can enhance the ability to appropriately time prophylaxis when exposure risk is highest., Methods: A retrospective, cohort study was conducted to describe the epidemiologic patterns of RSV disease among outpatient, emergency department and inpatient encounters in children <5 years in Central New York before and after the onset of the COVID-19 pandemic. Local data were collected from October 2015 to January 2023 and compared to state-level data. Linear regression models were used to identify clinical and sociodemographic differences before and after the pandemic., Results: Local variation in RSV seasonality was noted prior to the COVID-19 pandemic, however highly atypical circulation patterns appeared in the post-COVID-19 era. Since March 2020, patterns for local and state-defined RSV seasons have remained atypical (local season onset in 2021: week 27 and 2022: week 27; state season onset in 2021: week 31 and 2022: week 38). After adjusting for increases in testing, RSV bronchiolitis cases were not significantly different during pre- and post-pandemic eras. In comparison to the 2021 bronchiolitis season, the 2022 season had a higher proportion of RSV cases despite decreased testing., Conclusions: Temporal patterns for RSV have shifted during the COVID-19 pandemic. Local surveillance networks may be advantageous in trending community-level RSV activity to optimize prophylaxis administration. Changes in RSV testing patterns occurred throughout the study period and should be accounted for when describing infant and childhood RSV disease., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

In this article, we report the synthesis, characterization of novel biofriendly 2D/2D heterostructure WS 2 /ZnIn 2 S 4 material in which 2D WS 2 nanosheets are uniformly distributed spatially onto the spherically arranged 2D leaves of ZnIn 2 S 4 . We then studied the in-depth photocatalytic degradation activity of this novel nanocomposite and its pristine component materials on cationic dye: malachite green, anionic dye: congo red and reduction of heavy metal: chromium(VI) and the degradation efficiency of composite material was also tested on rhodamine-B, methylene blue, methyl orange dyes and acetaminophen/paracetamol drug. Form factor, structure factor and shape factor analysis has been carried out using X-ray diffractometry (XRD). Bond vibrations, functional groups and phonon vibration mode analysis has been done based on Fourier transform infrared (FTIR) spectroscopy and Raman spectroscopy. Morphological and compositional analysis has been done using field emission scanning electron microscopy (FE-SEM), energy dispersive X-ray spectroscopy (EDAX) and X-ray photoelectron spectroscopy (XPS), high-resolution transmission electron microscopy (HR-TEM). Surface area and pore size/distribution was characterized using Brunauer-Emmett-Teller (BET) method and Barrett-Joyner-Halenda Model. Degradation pathways and intermediate products are proposed using the high-performance liquid chromatography (HPLC). Photocatalytic activity of the nanocomposite WS 2 /ZnIn 2 S 4 is compared with pristine ZnIn 2 S 4 and pristine WS 2 , which shows more than 50% enhancement in both efficiency and rate of degradation/reduction for all the pollutants. A scavenger study was carried out to get insight of primary and secondary reactive oxygen species (ROS) taking part in degradation. Exciton lifetime, surface charge and stability, and flat band positions were studied based on time-correlated single photon counting (TCSPC) also known as time-resolved photoluminescence (TRPL), zeta potential, and Mott-Schottky respectively. Rate kinetics study was performed to analyze the physical and chemical behaviour of the nanocomposite with pollutants in consideration. Results show ∼100%, ∼90%, and ∼95% degradation efficiency by the heterostructure for malachite green (MG), congo red (CR), and reduction of heavy metal chromium (Cr(VI)) respectively within 5 min, which is a huge improvement as compared to pristine WS 2 and pristine ZnIn 2 S 4 , both of which show the efficiencies of only ∼25% to∼75% in all the cases., Competing Interests: Declaration of competing interest We declare that we have no conflict of interest that could inappropriately influence, or appear to influence, the content of our research. We have not received any financial or non-financial incentives that could be perceived as influencing the content of our research., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The differentiation of benign and malignant gallbladder wall thickening is challenging. The purpose of this study is to evaluate a new sonographic sign, "cervix sign" for differentiation of benign and malignant gallbladder neck thickening., Methods: This retrospective study comprised consecutive patients with gallbladder neck thickening who underwent sonography between August 2019 and December 2021. The presence of "cervix sign" was assessed by two radiologists independently., Results: Sixty-five patients had gallbladder neck thickening (28 malignant and 37 benign). The sonographic "cervix sign" was present in 18 (64%) patients with malignant thickening and in only one (2.7%) patient with benign thickening ( P  = 0.0001). The mean wall thickness was greater, and symmetric wall thickening and liver metastases were more common in malignant thickening with "cervix sign" (without reaching statistical significance). There was substantial agreement (kappa = 0.78) between the two observers for the cervix sign., Conclusion: Sonographic "cervix sign" is a useful ancillary feature of gallbladder neck cancer., (© 2023 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Illicit drug misuse has become a widespread issue that requires continuous drug monitoring and diagnosis. Wearable electrochemical drug detection devices possess the potential to function as potent screening instruments in the possession of law enforcement personnel, aiding in the fight against drug trafficking and facilitating forensic investigations conducted on site. These wearable sensors are promising alternatives to traditional detection methods. In this study, we present a novel wearable electrochemical glove-based analytical device (eGAD) designed especially for detecting the club drug, methamphetamine. To develop this sensor, we immobilized meth aptamer onto silver nanoparticle (AgNPs)-modified electrodes that were printed onto latex gloves. The characteristics of AgNPs, including their shape, size and purity were analysed using FTIR, SEM and UV vis spectrometry, confirming the successful synthesis. The developed sensor shows a 0.1 µg/mL limit of detection and 0.3 µg/mL limit of quantification with a linear concentration range of about 0.01-5 µg/mL and recovery percentages of approximately 102 and 103%, respectively. To demonstrate its applicability, we tested the developed wearable sensor by spiking various alcoholic and non-alcoholic drink samples. We found that the sensor remains effective for 60 days, making it a practical option with a reasonable shelf-life. The developed sensor offers several advantages, including its affordability, ease of handling and high sensitivity and selectivity. Its portable nature makes it an ideal tool for rapid detection of METH in beverages too.

Purpose: To evaluate renal cortical and medullary stiffness using 2D Shear-wave elastography (SWE) in healthy children., Methods: In this IRB approved prospective study, we measured the stiffness of cortex and medulla of children (4 months-17 years) at the upper pole, mid pole, and lower pole in bilateral kidneys., Results: The median (IQR) values of renal cortex in <1 year age group was 8.7 (5.7-11.7) kPa for right and 8.7 (4.2-14.1) kPa for the left side. For 1-5 years age group, it was 7.3 (5.3-10) kPa for the right and 8.9 (6-12.3) kPa for the left side. For >5 years, it was 7.4 (5.3-11.2) kPa for the right and 9.6 (6.2-12.7) kPa for the left side. The median (IQR) values of renal medulla in <1 year age group was 7.1 (5.1-12.5) kPa for right and 6.8 (4-10.6) kPa for the left side. For 1-5 years age group, it was 7.2 (4.9-9.7) kPa for the right and 6.9 (5.6-9.9) kPa for the left side. For >5 years, it was 6.8 (5.1-9.6) kPa for the right and 7 (5-10.2) kPa for the left side. The differences in the elasticity values amongst these groups were statistically insignificant (p>0.05). There was a significant correlation between SWE values of cortex and medulla of right kidney (ρ=0.64) and of left kidney (ρ=0.61), respectively., Conclusion: SWE values of renal cortical and medullary stiffness in healthy children do not correlate with age. There is a significant correlation between SWE values of cortex and medulla of the kidneys in healthy children., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: There is relatively scarce data on the computed tomography (CT) detection of gastrointestinal (GI) involvement in gallbladder cancer (GBC). We aim to assess the GI involvement in GBC on CT and propose a CT-based classification., Methods: This retrospective study comprized consecutive patients with GBC who underwent contrast-enhanced computed tomography (CECT) for staging between January 2019 and April 2022. Two radiologists evaluated the CT images independently for the morphological type of GBC and the presence of GI involvement. GI involvement was classified into probable involvement, definite involvement and GI fistulization. The incidence of GI involvement and the association of GI involvement with the morphological type of GBC was evaluated. In addition, the inter-observer agreement for GI involvement was assessed., Results: Over the study period, 260 patients with GBC were evaluated. Forty-three (16.5%) patients had GI involvement. Probable GI involvement, definite GI involvement and GI fistulization were seen in 18 (41.9%), 19 (44.2%) and six (13.9%) patients, respectively. Duodenum was the most common site of involvement (55.8%), followed by hepatic flexure (23.3%), antropyloric region (9.3%) and transverse colon (2.3%). There was no association between GI involvement and morphological type of GBC. There was substantial to near-perfect agreement between the two radiologists for the overall GI involvement (k = 0.790), definite GI involvement (k = 0.815) and GI fistulization (k = 0.943). There was moderate agreement (k = 0.567) for probable GI involvement., Conclusion: GBC frequently involves the GI tract and CT can be used to categorize the GI involvement. However, the proposed CT classification needs validation., (© 2023. Indian Society of Gastroenterology.)

Background: This research focuses on the positive impacts of the COVID-19 lockdown on society and the environment, despite acknowledging the widespread negative effects of the pandemic and lockdown measures. The research was aimed at pinpointing and evaluating the beneficial results stemming from these measures., Method: Data for the study was collected through an online survey distributed via Google forms to adults over the age of 18 across the country. A total of 1230 participants completed the survey, mostly from rural areas (61.7%), providing valuable insights for analysis. The questionnaire encompassed personal, family, and cohesive social data, along with information on the environment and biodiversity. The study utilized structural equation modeling (SEM) and confirmatory factor analysis (CFA) to analyze the data and examine correlations between variables., Results: The findings indicated that the COVID-19 lockdown had positive implications for individuals and society, leading to increased health consciousness, improved family relationships, and constructive social attitudes. Moreover, restrictions on access to natural tourist destinations and parks during the lockdown contributed to positive changes in biodiversity. These results highlight the importance of adopting appropriate measures during pandemics to foster personal and social well-being, as well as the preservation of natural environments and biodiversity., Conclusion: This study emphasizes the need for further research to promote sustainable living in similar situations. By understanding the data appropriately, individuals can play a constructive role in future pandemics, leading to positive outcomes for both society and the environment., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

In this study, a facile and scalable method for synthesizing MoSe 2 nanomaterial via a sonication-assisted liquid-phase exfoliation method is proposed. This study shows the successful synthesis of few-layered MoSe 2 in various solvents including DI water, ethanol, N-Methyl-2-pyrrolidone (NMP), Dimethylformamide (DMF) and Dimethylsulfoxide (DMSO). The exfoliated nanosheets have remarkably different properties than bulk MoSe 2 which were studied using Field emission scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction and UV-Vis spectroscopy to investigate their morphology, functional groups, structure and optical properties, respectively. The mean values of the number of layers from an optical extinction spectrum based on the effect of edge and quantum confinement were also calculated. Moreover, the exfoliated material using this method has potential application in energy storage as demonstrated by the electrochemical performance of the bulk and exfoliated materials.•Successful synthesis of the few-layer MoSe 2 from bulk MoSe 2 using liquid phase exfoliation method in various solvents•The investigation of the effect of solvent on the number of layers and optical properties of MoSe 2 ., (© 2023 The Author(s).)

Tight unconventional rocks are characterized by the presence of laminations, preferentially oriented cracks, and an interconnected network of compliant minerals. Such anisotropic features can mechanically deform due to pressure depletion during production, leading to a human-induced change of elastic and fluid transport properties. Rock physics models allow us to better predict and assess stress- and direction-dependent elastic moduli of the rock, useful for horizontal stress estimates. However, elastic anisotropy can be challenging to measure and interpret. We have developed an anisotropy template that can be used to assess stress-dependent changes in elastic moduli and investigate rock textures. We present here the template construction using an effective medium model consisting of stiff and compliant layers and crack inclusions and evaluate the origin of stress-dependent stiffness changes in acoustic data from Berea, Bakken, Three Forks, and Mancos formations., (© 2023. Springer Nature Limited.)

Background: Malnutrition is a major global public health issue, especially for under five children and their mothers. Objective: This study examined the relationships between socio-economic and demographic characteristics and under- and over-nutrition in mothers and children of Bangladesh. Method: Using the Nationally representative Bangladesh Demographic and Health Survey (2017-18) data, we performed the multiple logistic regression analysis to assess the relationships between key outcome variables and predictors. The analysis included 8321 children aged 0-59 months and 7800 mothers aged 15-49 years. Findings: The prevalence of stunting, wasting, and overweight among children under five was 30.72%, 8.44%, and 2.21% respectively. About 2.74% of the children were both stunted and wasted, while 0.56% of the children were both stunted and overweight. The prevalence of underweight and overweight among mother was 14.09% and 26.35% respectively. Children who are stunted are significantly associated with the mother's BMI status, mothers' education, fathers' education, and wealth index, while children who are wasted are significantly associated with the mother's BMI status and the child's sex. A child's sex and birth order are significantly associated with children being overweight. Mother's age, mother's education, father's education, place of residence and wealth index are significant determinants for mothers being underweight, whereas mother's age, mother's occupation, father's education, father's occupation, place of residence and wealth index are significant determinants for mothers being overweight. Conclusion: In addition to essential nutrition interventions, it is vital to address the basic social-economic and demographic determinants.

Background: Gallbladder cancer (GBC) is highly aggressive. Diagnosis of GBC is challenging as benign gallbladder lesions can have similar imaging features. We aim to develop and validate a deep learning (DL) model for the automatic detection of GBC at abdominal ultrasound (US) and compare its diagnostic performance with that of radiologists., Methods: In this prospective study, a multiscale, second-order pooling-based DL classifier model was trained (training and validation cohorts) using the US data of patients with gallbladder lesions acquired between August 2019 and June 2021 at the Postgraduate Institute of Medical Education and research, a tertiary care hospital in North India. The performance of the DL model to detect GBC was evaluated in a temporally independent test cohort (July 2021-September 2022) and was compared with that of two radiologists., Findings: The study included 233 patients in the training set (mean age, 48 ± (2SD) 23 years; 142 women), 59 patients in the validation set (mean age, 51.4 ± 19.2 years; 38 women), and 273 patients in the test set (mean age, 50.4 ± 22.1 years; 177 women). In the test set, the DL model had sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of 92.3% (95% CI, 88.1-95.6), 74.4% (95% CI, 65.3-79.9), and 0.887 (95% CI, 0.844-0.930), respectively for detecting GBC which was comparable to both the radiologists. The DL-based approach showed high sensitivity (89.8-93%) and AUC (0.810-0.890) for detecting GBC in the presence of stones, contracted gallbladders, lesion size <10 mm, and neck lesions, which was comparable to both the radiologists (p = 0.052-0.738 for sensitivity and p = 0.061-0.745 for AUC). The sensitivity for DL-based detection of mural thickening type of GBC was significantly greater than one of the radiologists (87.8% vs. 72.8%, p = 0.012), despite a reduced specificity., Interpretation: The DL-based approach demonstrated diagnostic performance comparable to experienced radiologists in detecting GBC using US. However, multicentre studies are warranted to explore the potential of DL-based diagnosis of GBC fully., Funding: None., Competing Interests: None., (© 2023 The Author(s).)

In this study, 105 bacterial colonies were isolated from the feces of newborn healthy Bos indicus calves and 37 isolates were confirmed using morphological, biochemical tests, and genus-specific PCR as lactobacilli. 11 isolates were then short-listed for in vitro probiotic testing based on their ability to dwell under acid and bile stress. Species-level identification using 16S rRNA gene sequencing revealed that they were Ligilactobacillus salivarius. These isolates flourished in 0.4% phenol, depicting resistance in adverse conditions encountered in the gastrointestinal tract. The results of cell surface hydrophobicity were found to be 74.50% for RBL12 and 62.62% for RBL09 in hexadecane and xylene, respectively, and that of auto-aggregation was highest in RBL26 (58.92%). These isolates also produced digestive enzymes like amylase, protease, and β-galactosidase. Further assays reiterated their antimicrobial and coaggregation potential against diarrhea-causing pathogens like Escherichia coli ATCC-25922 and Salmonella arizonae ATCC-13314. Biosafety assessment revealed that none of the tested isolates were hemolytic and mucinolytic in nature. Furthermore, the antioxidant potential of the isolates was also confirmed using 1,1‑diphenyl‑2‑picrylhydrazyl (DPPH) and ferric ion-reducing antioxidant power (FRAP) assay. Along with efficient utilization of inulin, isolates showed promising adhesion ability to the HT-29 cell line. The current findings hence conclude that these Lactobacillus isolates can be exploited as animal probiotics for potential application in young calves to foster gut health and immunity., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Salt plays a critical role in India's past as well as its present, from Dandi March to its role as a vehicle for micronutrient fortification. However, excess salt intake is a risk factor for high blood pressure and cardiovascular diseases (CVDs). Indians consume double the World Health Organization recommended daily salt (<5 g). India has committed to a 30 per cent reduction in sodium intake by 2025. Evidence based strategies for population sodium intake reduction require a moderate reduction in salt in - home cooked foods, packaged foods and outside-home foods. Reducing the sodium content in packaged food includes policy driven interventions such as front-of-package warning labels, food reformulation, marketing restrictions and taxation on high sodium foods. For foods outside of the home, setting standards for foods purchased and served by schemes like mid-day meals can have a moderate impact. For home cooked foods (the major source of sodium), strategies include advocacy for reducing salt intake. In addition to mass media campaigns for awareness generation, substituting regular salt with low sodium salt (LSS) has the potential to reduce salt intake even in the absence of a major shift in consumer behaviour. LSS substitution effectively lowers blood pressure and thus reduces the risk of CVDs. Further research is required on the effect of LSS substitutes on patients with chronic kidney disease. India needs an integrated approach to sodium reduction that uses evidence based strategies and can be implemented sustainably at scale. This will be possible only through scientific research, governmental leadership and a responsive evidence-to-action approach through a multi-stakeholder coalition.

Background: Cemiplimab provided significant survival benefit to patients with advanced non-small-cell lung cancer with PD-L1 tumour expression of at least 50% and no actionable biomarkers at 1-year follow-up. In this exploratory analysis, we provide outcomes after 35 months' follow-up and the effect of adding chemotherapy to cemiplimab at the time of disease progression., Methods: EMPOWER-Lung 1 was a multicentre, open-label, randomised, phase 3 trial. We enrolled patients (aged ≥18 years) with histologically confirmed squamous or non-squamous advanced non-small-cell lung cancer with PD-L1 tumour expression of 50% or more. We randomly assigned (1:1) patients to intravenous cemiplimab 350 mg every 3 weeks for up to 108 weeks, or until disease progression, or investigator's choice of chemotherapy. Central randomisation scheme generated by an interactive web response system governed the randomisation process that was stratified by histology and geographical region. Primary endpoints were overall survival and progression free survival, as assessed by a blinded independent central review (BICR) per Response Evaluation Criteria in Solid Tumours version 1.1. Patients with disease progression on cemiplimab could continue cemiplimab with the addition of up to four cycles of chemotherapy. We assessed response in these patients by BICR against a new baseline, defined as the last scan before chemotherapy initiation. The primary endpoints were assessed in all randomly assigned participants (ie, intention-to-treat population) and in those with a PD-L1 expression of at least 50%. We assessed adverse events in all patients who received at least one dose of their assigned treatment. This trial is registered with ClinicalTrials.gov, NCT03088540., Findings: Between May 29, 2017, and March 4, 2020, we recruited 712 patients (607 [85%] were male and 105 [15%] were female). We randomly assigned 357 (50%) to cemiplimab and 355 (50%) to chemotherapy. 284 (50%) patients assigned to cemiplimab and 281 (50%) assigned to chemotherapy had verified PD-L1 expression of at least 50%. At 35 months' follow-up, among those with a verified PD-L1 expression of at least 50% median overall survival in the cemiplimab group was 26·1 months (95% CI 22·1-31·8; 149 [52%] of 284 died) versus 13·3 months (10·5-16·2; 188 [67%] of 281 died) in the chemotherapy group (hazard ratio [HR] 0·57, 95% CI 0·46-0·71; p<0·0001), median progression-free survival was 8·1 months (95% CI 6·2-8·8; 214 events occurred) in the cemiplimab group versus 5·3 months (4·3-6·1; 236 events occurred) in the chemotherapy group (HR 0·51, 95% CI 0·42-0·62; p<0·0001). Continued cemiplimab plus chemotherapy as second-line therapy (n=64) resulted in a median progression-free survival of 6·6 months (6·1-9·3) and overall survival of 15·1 months (11·3-18·7). The most common grade 3-4 treatment-emergent adverse events were anaemia (15 [4%] of 356 patients in the cemiplimab group vs 60 [17%] of 343 in the control group), neutropenia (three [1%] vs 35 [10%]), and pneumonia (18 [5%] vs 13 [4%]). Treatment-related deaths occurred in ten (3%) of 356 patients treated with cemiplimab (due to autoimmune myocarditis, cardiac failure, cardio-respiratory arrest, cardiopulmonary failure, septic shock, tumour hyperprogression, nephritis, respiratory failure, [n=1 each] and general disorders or unknown [n=2]) and in seven (2%) of 343 patients treated with chemotherapy (due to pneumonia and pulmonary embolism [n=2 each], and cardiac arrest, lung abscess, and myocardial infarction [n=1 each]). The safety profile of cemiplimab at 35 months, and of continued cemiplimab plus chemotherapy, was generally consistent with that previously observed for these treatments, with no new safety signals INTERPRETATION: At 35 months' follow-up, the survival benefit of cemiplimab for patients with advanced non-small-cell lung cancer was at least as pronounced as at 1 year, affirming its use as first-line monotherapy for this population. Adding chemotherapy to cemiplimab at progression might provide a new second-line treatment for patients with advanced non-small-cell lung cancer., Funding: Regeneron Pharmaceuticals and Sanofi., Competing Interests: Declaration of interests MÖ reports consulting fees, support for attending meetings, and participation in an advisory board from Regeneron Pharmaceuticals. AS reports support for attending meeting from Regeneron Pharmaceuticals. MS reports research grants from Regeneron Pharmaceuticals, Bristol Myers Squibb, MSD, Roche, Merck Serono, AstraZeneca, Eli Lilly, Astellas, Amgen, BeiGene, Bayer, Eisai, Pfizer, GSK, AbbVie, Bioven, Novartis, Clovis, Daichii Sankyo, PharmaMar, Tesaro, and FivePrime. IC reports personal fees (paid to institution) from Pfizer, MSD Oncology, Roche, Novartis–Ipsen, Eli Lilly, Bristol Myers Squibb, SERVIER, Abdi Ibrahim, Nobelpharma, AbbVie, Teva, and Janssen Oncology; and speakers' bureau fees (paid to institution) from Novartis, Roche, Bristol Myers Squibb, Pfizer, and Abdi Ibrahim, all outside the submitted work. GFH reports research grants from EliLily, Regeneron Pharmaceuticals, MSD, AB Science, Astellas, Tessa Therapeutics, Roche, Arcus Bioscience, AstraZeneca, Pfizer, and Janssen Research & Development; payment or honoraria from MSD, Novartis, Roche, AstraZeneca, Boehringer Ingelheim, and Pfizer; support for attending meetings or travel from Ipsen, AstraZeneca, Bristol Myers Squibb, MSD, and Regeneron Pharmaceuticals; DSMB or advisory board fees from MSD, Novartis, Roche, AstraZeneca, Boehringer Ingelheim, and Pfizer; and receipt of equipment, materials, drugs, medical writing, gifts or other services from Pfizer, Novartis, Janssen Pharmaceuticals, Taiho, and EliLily. MCG reports personal financial interests in the form of consulting fees, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, and participation on a DSMB or advisory board from AstraZeneca, MSD, BMS, Boehringer Ingelheim Italia, Celgene, Eli Lilly, Ignyta, Incyte, Inivata, MedImmune, Novartis, Pfizer, Roche, Takeda, Seattle Genetics, Mirati, Daiichi Sankyo, Regerenon, and Merck; institutional financial interests in the form of consulting fees, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, participation on a DSMB or advisory board from Eli Lilly, MSD, Pfizer (MISP), AstraZeneca, MSD International, BMS, Boehringer Ingelheim Italia, Celgene, Eli Lilly, Ignyta, Incyte, MedImmune, Novartis, Pfizer, Roche, Takeda, Tiziana, Foundation Medicine, GSK, and Spectrum pharmaceuticals, Italian Association for Cancer Research, Italian Medicines Agency, Italian Moh, and TRANSCAN; research funding, support for attending meetings, and travel from Merck; and having a leadership or fiduciary role in European Society for Medical Oncology, American Society of Clinical Oncology, and International Association for the Study of Lung Cancer. XH, MK, EO, YL, SL, J-FP, and FS employees and shareholders of Regeneron Pharmaceuticals. GG is a former employee and shareholder of Regeneron Pharmaceuticals. IL and PR are employees of, have a patent pending (PCT/US2018/018747), and are shareholders of Regeneron Pharmaceuticals. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Histone deacetylases (HDACs) play a vital role in the epigenetic regulation of transcription and expression. HDAC1 overexpression is seen in many cancers. Methodology: The authors synthesized and evaluated 27 novel coumarin-based amide derivatives for HDAC1 inhibitory activity. The compounds were screened at the US National Cancer Institute, and 5k and 5u were selected for five-dose assays. Compound 5k showed GI 50 values of 0.294 and 0.264 μM against MOLT-4 and LOX-IMVI, respectively; whereas 5u had GI 50 values of 0.189 and 0.263 μM, respectively. Both derivatives showed better activity than entinostat and suberoylanilide hydroxamic acid. Compound 5k exhibited an IC 50 value of 1.00 μM on ACHN cells. Conclusion: Coumarin derivatives exhibited promising HDAC1 inhibitory potential and warrant future development as anticancer agents.

Healthcare provider vaccine knowledge and attitudes influence delivery of a strong vaccine recommendation. We aim to describe HPV vaccine knowledge, attitudes, and recommendation or discussion practices (KAP) among New York State medical providers, dentists, and pharmacists. A survey to assess providers' KAP was distributed electronically to NYS members of medical organizations. Descriptive and inferential statistical methods were used to characterize provider KAP. Responses from 1637 surveys were included, from 864 (53%) medical providers, 737 (45%) dentists, and 36 (2%) pharmacists. 59% (509/864) of medical providers responded that they recommend HPV vaccine to patients, with 390/509 (77%) strongly recommending vaccine at 11-12 years. Medical providers were more likely to report recommending HPV vaccine for children ages 11-12 years if they strongly agreed that HPV vaccine prevents cancer 326/391 (83%) vs 64/117 (55%) and responded that HPV vaccination does not increase the risk of unprotected sex (386/494 (78%) vs 4/15 (25%)) ( p  < .05). Less than 1/3 of dentists reported discussing HPV vaccine with 11-26-year-old females (230/737, 31%) and males (205/737, 28%) at least "sometimes." Dentists were more likely to answer that they routinely discuss HPV vaccine with children ages 11-12 years if they responded that HPV vaccination does not increase sexual activity (70/73 (96%) vs 528/662 (80%), p  < .001). Few pharmacists reported discussing HPV vaccine with 11-26-year-old females (6/36 (17%)) and males (5/36 (14%)) at least "sometimes." Gaps in HPV vaccine knowledge among providers still exist and may influence vaccine attitudes and recommendation or discussion practices.