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Abstract Motivated by the pivotal role of routing in Wireless Sensor Networks (WSNs) and the prevalent security vulnerabilities arising from existing protocols, this research tackles the inherent challenges of securing WSNs. Many current WSN routing protocols prioritize computational efficiency but lack robust security measures, making them susceptible to exploitation by malicious actors. The prevalence of reactive protocols, chosen for their lower bandwidth consumption, exacerbates security concerns, as proactive alternatives require more resources for maintaining network routes. Additionally, the ad hoc nature and energy constraints of WSNs render conventional security models designed for wired and wireless networks unsuitable. In response to these limitations, this paper introduces the Secured Energy-Efficient Opportunistic Routing Scheme for Sustainable WSNs (EDSSR). EDSSR is designed to enhance security in WSNs by continuously updating neighbor information and validating the legitimacy of standard routing parameters. Critically, the protocol is power-aware, recognizing the vital importance of energy considerations in the constrained environment of WSNs. To assess the efficacy of EDSSR in mitigating WSN vulnerabilities, simulation experiments were conducted, evaluating the protocol’s performance on key metrics such as throughput, average End-to-End delay ( $$E^2$$ delay), energy consumption (EC), network lifetime (alive nodes), and malware detection rate. The results demonstrate that the EDSSR protocol significantly improves performance. It shows substantial gains in sum goodput relative to throughput, average $$E^2$$ delay, EC, and alive nodes. Specifically, the EDSSR protocol is 2–3% faster than DLAMD and 10–13% faster than EEFCR. Additionally, the malware detection rate increases by 23%.

Introduction: There are significant chances of maturation failure in arteriovenous fistulas (AVFs) made for vascular access for hemodialysis. AVFs are usually assessed for maturation 6 weeks after the operation. Significant time is lost for performing a salvage radiological procedure or making an alternative AVF, in case the AVF fails to mature. Materials and Methods: This prospective observational study was conducted to predict the chances of maturation of AVF by Doppler ultrasound (USG) study. One hundred and thirty-seven patients in whom native AVF was made as a vascular access procedure for hemodialysis were included in the study. In five patients, palpable thrill was absent after 48 h of operation and were excluded from the study. The velocity of the blood, diameter of the vessel, and depth of the vessel from the skin were assessed by USG Doppler 3 weeks after the operation and were correlated with AVF maturation. Results: Successful maturation occurred in 114 (86.3%) AVF. The flow rate of the blood and depth of the vein were statistically different in successful and unsuccessful AVF maturation for both the groups of radial artery (RA) and brachial artery (BA) based AVF. For RA AVF, successful maturation was predicted by the flow rate of 539 mL/min (sensitivity 95% and specificity 83%) and 4.2 mm diameter of the vein (sensitivity 93% and specificity 100%). For BA AVF, successful maturation was predicted by the flow rate of 456 mL/min (sensitivity 93% and specificity 100%) and 5.7 mm diameter of the vein (sensitivity 77% and specificity 100%). The measurement of flow and depth at 3 weeks after AVF may predict the maturation of AVF. Conclusion: It will be beneficial to do a USG Doppler study 3 weeks after making AVF, as the measurement of flow may predict the maturation of AVF.

Background Fingertip injuries with amputation are one of the common hand injury problems. Several reconstructive options are available for fingertip injury. V-Y advancement flap is one of the common flaps. In some cases, their advancement capacities are not sufficient to cover the whole defect, resulting in flexion deformity of the distal interphalangeal (DIP) joint, loss of finger pulp shape, or hooked deformity. The double V-Y flap consists of harvesting two cutaneous flaps on the same neurovascular digital palmar bundle. The first V-Y flap is raised as a neurovascular flap and the second flap is an advancement V-Y plasty.

Background: The current study investigates the switching behaviour and patterns among patients in India, particularly in the context of various ailments such as Non-Communicable Diseases (NCDs), Communicable Diseases (CDs), and other health issues. To evaluate people's behaviour towards accessing healthcare facilities in public and private healthcare providers separately for CDs, NCDs, and other ailments. Material and methods: The study design is observational and cross-sectional. The study included data from NSS 71st, NSS 75th, and LASI wave-1 datasets, which provide information on the incidence of switching behaviour among patients with different types of ailments. Statistical analysis used: The Binary logistic regression analysis has been used to examine the determinants of switching behaviour in usage of healthcare facilities. Prevalence estimates were exhibited using weighted % and 95 % confidence intervals (CI). P values

Abstract Background Tension-type headache (TTH) is prevalent among collegiate students due to academic stress. Manual therapies like suboccipital inhibition and soft tissue manipulation have shown efficacy in TTH management. However, comparative studies between these interventions in collegiate populations are scarce. Understanding their relative effectiveness can enhance treatment strategies and improve outcomes, shedding light on optimal manual therapy approaches for TTH among collegiate students. This study aimed to investigate the effects of suboccipital inhibition and soft tissue manipulation on pain intensity and disability in tension-type headache (TTH) among undergraduate physiotherapy students. Methods Forty undergraduate physiotherapy students diagnosed with TTH were randomly assigned to the suboccipital inhibition group (group A, n = 20) and the soft tissue manipulation group (group B, n = 20). The suboccipital inhibition group received manual therapy targeting the suboccipital muscles, while the soft tissue manipulation group received manipulation techniques focusing on the cervical and shoulder girdle muscles. Pain intensity and disability were assessed using Visual Analogue Scale (VAS) and Headache Disability Index (HDI) Questionnaire at baseline and after 6 weeks of intervention. The data were collected and analysed using independent t test. Results Both interventions demonstrated significant reductions in pain intensity and disability after 6 weeks, with the t value − 4.3150 and − 3.3106 at p

Abstract Background Many studies have been conducted on under-five mortality in India and most of them focused on the associations between individual-level factors and under-five mortality risks. On the contrary, only a scarce number of literatures talked about contextual level effect on under-five mortality. Hence, it is very important to have thorough study of under-five mortality at various levels. This can be done by applying multilevel analysis, a method that assesses both fixed and random effects in a single model. The multilevel analysis allows extracting the influence of individual and community characteristics on under-five mortality. Hence, this study would contribute substantially in understanding the under-five mortality from a different perspective. Method The study used data from the Demographic and Health Survey (DHS) acquired in India, i.e., the fourth round of National Family and Health Survey (2015–16). It is a nationally representative repeated cross-sectional data. Multilevel Parametric Survival Model (MPSM) was employed to assess the influence of contextual correlates on the outcome. The assumption behind this study is that ‘individuals’ (i.e., level-1) are nested within ‘districts’ (i.e., level-2), and districts are enclosed within ‘states’ (i.e., level-3). This suggests that people have varying health conditions, residing in dissimilar communities with different characteristics. Results Highest under-five mortality i.e., 3.85% are happening among those women whose birth interval is less than two years. In case of parity, around 4% under-five mortality is among women with Third and above order parity. Further, findings from the full model is that ICC values of 1.17 and 0.65% are the correlation of the likelihood of having under-five mortality risk among people residing in the state and district communities, respectively. Besides, the risk of dying was increased alarmingly in the first year of life and slowly to aged 3 years and then it remains steady. Conclusion This study has revealed that both aspects viz. individual and contextual effect of the community are necessary to address the importance variations in under-five mortality in India. In order to ensure substantial reduction in under-five mortality, findings of the study support some policy initiatives that involves the need to think beyond individual level effects and considering contextual characteristics.

Thumb tip injuries constitute one of the most common hand injuries. There are various reconstructive options for thumb tip injuries. We present our series of thumb tip injuries reconstructed using Elliot's modification of the Moberg flap, which provides like-for-like tissue. We also present our flap improvisation, which can be useful in the armamentarium of plastic surgeons.

Key Clinical Message Amelogenesis imperfecta (AI) is a rare developmental anomaly characterized by poorly developed or absent tooth enamel, which complicates orthodontic treatment due to weak enamel‐bracket bond strength. This case report presents a successful management of AI using fixed orthodontic appliances and prosthodontic rehabilitation. Abstract Amelogenesis imperfecta (AI) causes enamel defects, complicating oral hygiene, reducing masticatory function and lowering self‐esteem. This case report details an 18‐year‐old female with AI who underwent fixed orthodontic treatment followed by prosthodontic rehabilitation. The multidisciplinary approach restored function and aesthetics, significantly improving her quality of life.

A study was conducted to investigate the performance of biojarosite as a catalyst in Fenton oxidation with and without the presence of the chelating agent ethylene diamine tetra acetic acid (EDTA). The addition of EDTA resulted in increased iron dissolution, confirming the role of EDTA as a chelating agent. The heterogeneous catalytic properties of jarosite were confirmed by the removal efficiencies of 93.5 and 83.4%, with and without EDTA, respectively. The Box–Behnken method was employed as a Design of Experiments tool to identify suitable experimental runs. Both Fenton oxidation and EDTA-based Fenton oxidation were examined separately, with PCP removal being the response variable. In the case of Fenton oxidation, the optimization process resulted in the selection of 0.1–1 g/L of iron catalyst, 100–1,000 mg/L of H2O2, and a pH range of 2.5–3.5. On the other hand, for EDTA-based Fenton oxidation, the optimal conditions were determined to be 0.1–1 g/L of iron catalyst, 100–1,000 mg/L of H2O2, and a pH range of 6.5–7.5. ANOVA was conducted to analyze the results, and the model fit was examined. HIGHLIGHTS Application of Box–Behnken design procedure for Fenton's oxidation of pentachlorophenol.; Use of biojarosite-based catalyst for Fenton's oxidation.; EDTA-based Fenton's oxidation at near neutral pH.; Comparison of the efficiency of the process with or without EDTA as a chelating agent.;

Dorsal metacarpal artery perforator flap (DMAP), first described by Quaba and Davison, is a useful tool in the armamentarium of plastic surgeons. It provides like for like tissue for the reconstruction of dorsal finger defects. It is a simple and relatively easy flap to harvest with minimal donor site morbidity. In this case series, we present our experience, applications, and surgical technique of flap harvesting.

Background Class II malocclusions represent anteroposterior dysplasia usually resulting from mandibular retrusion. Along with a retropositioned mandible, it can be associated with either upward or backward jaw rotation. High angle cases are often associated with a short ramal height, steeper mandibular plane, and large gonial angle. Twin block is a commonly used myofunctional appliance that incorporates bite planes that direct the occlusal forces in a more favorable direction for correction of the retrognathic mandible. We aimed to evaluate skeletal, dental, and soft tissue changes following modified twin block appliance therapy in high-angle cases. Methods A cephalometric study was performed on 15 growing (10-14 years) high angle (Frankfort mandibular angle 28-35°) Class II Division I malocclusion patients undergoing twin block therapy. Skeletal, dental, and soft tissue changes were evaluated by cephalometric analysis using Dolphin software. Results Pre- and post-treatment changes in cephalograms were assessed by analysis of variance and paired t-test. Significant changes in the position of the mandible (angle between Sella-Nasion-Point B [SNB] increased by 3.9 degrees, P=0.02), Wits appraisal (decreased by 1.54 mm, P=0.04), maxillo-mandibular relationship (angle between Point A-Nasion-Point B [ANB] decreased by 3.74 degrees, P=0.02) were observed. Soft tissue changes like the nasolabial angle were also significant, increasing by 3.8 degrees (P=0.04) and lower lip relation to E-line (reduction in lower lip protrusion) by 2 mm (P=0.04). Vertical parameters showed non-significant changes, like the Frankfort mandibular angle (FMA) increased by 0.07 degrees, (P=0.67), the angle between Sella-Nasion and Gonion-Gnathion (SN-Go-Gn) increased by 0.33 degrees, (P=0.67), Y-axis increased by 0.2 degrees, (P=0.32). The upper incisor inclination decreased non-significantly from 115.27±1.33 to 113.42±1.65 degrees, (P=0.12) and lower incisor increased non-significantly from 100.13±2.23 to 101.80 ±1.37 degrees, (P=0.08). Conclusions Modified twin block appliance can be used to successfully treat Class II Division I high angle cases with good vertical control.

Objectives: Tobacco and smoke associated with tobacco comprises of a mixture of more than 9500 chemical compounds, most of which have been identified as harmful. Two of the most potent carcinogens found in cigarette smoke are N′-nitrosonornicotine (NNN) and polycyclic aromatic hydrocarbons (PAHs). The most commonly used method to detect and monitor nicotine addiction is via serum cotinine levels. Though considered the gold standard, there is a decline in preventive screening and diagnostic testing due to the fear of pain from invasive testing. Data sources and study selection: A structured literature search was performed using the search engines PubMed and Google scholar following the PRISMA guidelines for systematic reviews. The titles and abstracts were retrieved and analysed, followed by full-text relevant data extraction in addition to a risk-of-bias analysis. Data extraction and synthesis: A total of 37 studies were included in the systematic review. Salivary cotinine levels were compared between smokers and non-smokers, cigarette smokers and water pipe smokers, water pipe smokers and non-smokers. Lactate dehydrogenase salivary levels were compared between smokers and non-smokers, and salivary thiocyanate were compared between smokers and non-smokers. Conclusions: Identifying biomarkers with high performance in terms of sensitivity and specificity will contribute to accelerating future research in this domain.

Abstract Background Despite therapeutic advances, the prognosis of pancreatic ductal adenocarcinoma (PDAC) remains extremely poor. Metabolic reprogramming is increasingly recognized as a key contributor to tumor progression and therapy resistance in PDAC. One of the main metabolic changes essential for tumor growth is altered cholesterol flux. Targeting cholesterol flux appears an attractive therapeutic approach, however, the complex regulation of cholesterol balance in PDAC cells remains poorly understood. Methods The lipid content in human pancreatic duct epithelial (HPDE) cells and human PDAC cell lines (BxPC-3, MIA PaCa-2, and PANC-1) was determined. Cells exposed to eight different inhibitors targeting different regulators of lipid flux, in the presence or absence of oleic acid (OA) stimulation were assessed for changes in viability, proliferation, migration, and invasion. Intracellular content and distribution of cholesterol was assessed. Lastly, proteome profiling of PANC-1 exposed to the sterol O-acyltransferase 1 (SOAT1) inhibitor avasimibe, in presence or absence of OA, was performed. Results PDAC cells contain more free cholesterol but less cholesteryl esters and lipid droplets than HPDE cells. Exposure to different lipid flux inhibitors increased cell death and suppressed proliferation, with different efficiency in the tested PDAC cell lines. Avasimibe had the strongest ability to suppress proliferation across the three PDAC cell lines. All inhibitors showing cell suppressive effect disturbed intracellular cholesterol flux and increased cholesterol aggregation. OA improved overall cholesterol balance, reduced free cholesterol aggregation, and reversed cell death induced by the inhibitors. Treatment with avasimibe changed the cellular proteome substantially, mainly for proteins related to biosynthesis and metabolism of lipids and fatty acids, apoptosis, and cell adhesion. Most of these changes were restored by OA. Conclusions The study reveals that disturbing the cholesterol flux by inhibiting the actions of its key regulators can yield growth suppressive effects on PDAC cells. The presence of fatty acids restores intracellular cholesterol balance and abrogates the alternations induced by cholesterol flux inhibitors. Taken together, targeting cholesterol flux might be an attractive strategy to develop new therapeutics against PDAC. However, the impact of fatty acids in the tumor microenvironment must be taken into consideration.

Abstract Indoor air quality (IAQ) describes the air quality within buildings and other structures, particularly concerning how it affects the health and comfort of building inhabitants. Your likelihood of experiencing indoor health issues can be decreased by being aware of and controlling common indoor contaminants. In addition to maintaining indoor relative humidity at or below 65%, The American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) recommends temperatures between 21 and 26 °C in the summer and 20–24 °C in the winter. The EPA advises using humidity levels between 30 and 60% to stop mold from growing. Silica gel, lithium chloride, and molecular sieves 5A are excellent for dehumidification due to their strong moisture adsorption capability and potential for regeneration. Choosing the right desiccant depends on factors like adsorption capacity, pore size, and chemical compatibility, which are crucial for dehumidification applications and environments. This study compares the performance of silica gel desiccant wheels with three additional composite materials for air dehumidification, which is unusual in this work because very few studies of these combinations have been provided. For all desiccant wheels, the various operating parameters of the needed dehumidification process have been investigated and compared. For adsorption and regeneration rate, the performance of three different composite desiccant wheels was examined and compared experimentally. This experimental evaluation reveals that the composite desiccant wheel (silica gel-lithium chloride-molecular sieve 5A) has a higher adsorption and regeneration rate than others. When a composite desiccant wheel made from silica gel-lithium chloride, silica gel-molecular sieve 5A, and silica gel-lithium chloride-molecular sieve 5A was compared to the performance of a silica gel desiccant wheel, the percentage improvements in adsorption rate were 34.99%, 43.58%, and 85.5%, and the percentage increases in regeneration rate were 5.65%, 7.08%, and 14%.

Background Palmaris longus (PL) is a short-bellied muscle with a long tendon that merges with the palmar aponeurosis. It is supplied by the median nerve and acts as a tensor of the palmar aponeurosis and flexes the wrist. This tendon is commonly used for tendon transfers and as a donor for tendon graft. There are numerous clinical tests to detect the presence of PL like Schaeffer's test, Thompson's test, Mishra's test I, Mishra's test II, Pushpakumar's “two-finger sign” method, and AIIMS test. The principle of all these tests is to make the tendon prominent by eliciting its flexor action and then its identification by inspection and palpation.

Depression is a neuropsychiatric disorder characterized by altered emotion and cognition. Alpha lipoic acid (ALA) is a potent natural antioxidant and exhibits neuroprotective effects. However, its antidepressant activity and its mechanism of action in rats exposed to chronic unpredictable mild stress (CUMS) need to be evaluated. The rats were divided into six groups. Group, I vehicle control (without stress), II- CUMS, III- fluoxetine (FLX) (50 mg/kg p.o.), IV, V, and VI were treated with ALA (50, 100, 200 mg/kg, p.o.), respectively. All the groups, except I, were subjected to CUMS + treatments from day 1 to day 42. Body weight and behavioral parameters like sucrose preference test (SPT), Morris water maze (MWM), resident intruder test (RIT), and marble-burying test (MBT) were performed on day 0, day 21, and day 42, and forced swim test (FST) on last day 42 and 43 only. The rats were further sacrificed for biochemical and histopathological evaluation. ALA significantly improved behavioral function, increased antioxidant strength, reduced lipid peroxidation, restored monoamines, and protected CA3 neurons. Further, docking studies revealed strong binding of ALA on the 5HT3 receptor. The study demonstrates that ALA might be exhibiting antidepressant effects in part by restoring monoamines and modulating the 5HT3 receptor.

Key Clinical Message Impacted maxillary central incisors represent a relatively infrequent occurrence. This condition significantly impacts the patient's self‐esteem and aesthetic concerns. Effective resolution is achievable through a combined strategy involving surgical exposure, bracket attachment, and subsequent orthodontic extrusion. The Surgical orthodontic approach is the optimal strategy for addressing impacted maxillary central incisors. Abstract Central incisor is rarely impacted teeth often associated with supernumerary teeth. This case series includes three cases of central incisor impaction presented with complaints of missing teeth, unesthetic appearance, and unclear speech. All the cases were managed with surgical exposure followed by traction by orthodontic force, restoring smile aesthetics.

Key Clinical Message Skin ulcerations are a significant cause of morbidity and can be challenging to manage. Among the various causes of chronic non‐healing ulcers, lymphedema is also considered a possible diagnosis in countries such as Nepal. Lymphatic filariasis has been a significant public health issue in endemic areas. Wuchereria bancrofti is a common nematode parasite that causes lymphatic filariasis. Excessive retention of lymphatic fluid in the interstitial compartment can cause localized tissue swelling, known as lymphedema, which is caused by impaired lymphatic drainage. Microfilariae can be detected in peripheral blood, body fluids, and needle aspirates. Microfilaria is not commonly found in ulcers on elephantiasis legs. We discuss here a case of 73‐year‐old women with elephantiasis legs with pus discharging ulcers in the thighs. Microscopic examination of pus discharge revealed microfilaria which highlights the importance of pus examination as diagnostic modality in endemic countries.

Introduction: During the last two decades, the evaluation and management of renal and upper ureteric stones has vastly altered. The era of endoscopic surgery replaced open pyelolithotomy or nephrolithotomy which caused a significant morbidity. During this decade we saw evolution of endoscopic surgery where Mini PCNL (Mini Perc), Ultra Mini and Micro Perc have further achieved stone clearance with better outcomes pertaining to reduced morbidity because of reduction in caliber of tract dilatation, even avoiding a nephrostomy post rocedure in select cases. Aim of this study summarizes the outcome of patients undergoing Mini Perc. The primary objective of the study was to get post-Operative evaluation of complications associated with Mini Perc by Modified Clavien Dindo Grading and secondary objectives were to see Post-Operative pain assessment by Visual Analogue scale and to see Stone clearance rate of the surgical procedure. Materials and Methods: Research was carried out in the form of a Hospital-based prospective observational study as per the guidelines shared by the Prospective Observational Clinical Studies Good Research Practices Task Force (formed May 16, 2010). Hospital-based prospective observational study of 78 consecutive patients who underwent Mini Perc between Aug 2018 and May 2020 at tertiary care centre were vetted against the criteria for inclusion and exclusion. The management policy for pelvicalyceal calculi at the study centre has closely followed those of the American Urological Association (AUA) guidelines for managing renal stones. Results: The mean age of the group was 43.3 years (range 16-84) with 47 males and 38 females. Mean stone size was 20.11 mm (range 11-38 mm) and mean operative time was 44.5 min (range 29-98 min). Double J (DJ) stent was placed in all patients as a prophylaxis to prevent obstructive uropathy / post op urinary leak. Postoperatively, the most commonly noted complication was fever recorded in 12 (15.38%) patients followed by bleeding at the surgical site in 03 (3.84%) patients. Sepsis was noted in 02 (2.56%) patients, pleural injury in 01(1.28) patient. Haemorrhage requiring intervention was recorded in 01 (1.28%) of patients. Pain assessment done at specified interval showed progressive decreasing trend in intensity as evaluated by visual analogue scale. The stone clearance rate in our study was 96.15% at the end of one month following post op period. Conclusion: The study shows that Mini Perc remains standard of care for management of Renal and upper ureteric stone. The technique beyond doubt is safe, efficient, feasible and economical in achieving excellent stone clearance rates. The Modified Clavien-Dindo system of grading for perioperative complications is easy to use and reproducible. It can be used as an objective and reliable method for describing the complications of the surgical procedure.

Abstract Background Profound resistance to chemotherapy remains a major challenge in achieving better clinical outcomes for patients with pancreatic ductal adenocarcinoma (PDAC). Recent studies indicate that gemcitabine (GEM) resistance is promoted both by pancreatic stellate cells (PSCs) and through increased glycolysis. However, it remains unknown whether PSCs affect GEM sensitivity via glycolytic regulation. Methods Human pancreatic cancer cell (PCC) lines (BxPC-3, Capan-2, HPAF-II, Mia PaCa-2, Panc-1, SW-1990) were exposed to three different PSC-conditioned media (PSC-CM; PSC-1, PSC-2, HPaSteC), following either pre-treatment with glycolysis inhibitor NV-5440 or transfection for transient silencing of key glycolytic regulators (LDHA and MCT4). Proliferation, glucose transport, extracellular lactate, and GEM sensitivity were assessed. Protein expression was determined by Western blot and immunostaining. Moreover, secreted proteins in PSC-CMs were profiled by mass spectrometry (MS). Results While exposure to PSC-CMs did not affect glucose transport in PCCs, it increased their lactate release and proliferation, and reduced the sensitivity for GEM. Both NV-5440 treatment and transient silencing of LDHA and MCT4 inhibited these PSC-induced changes in PCCs. MS analysis identified 688 unique proteins with differential expression, of which only 87 were common to the three PSC-CMs. Most PSC-secreted proteins were extracellular matrix-related, including SPARC, fibronectin, and collagens. Moreover, exposure to PSC-CMs increased the phosphorylation of ERK in PCCs, but the treatment of PCCs with the MEK/ERK inhibitor PD98059 resulted in a reduction of PSC-CM-induced glycolysis and improved GEM sensitivity. Conclusions The study findings suggest that PSC-secreted factors promote both glycolysis and GEM resistance in PCCs, and that glycolysis inhibition by NV-5440 and blocking of ERK phosphorylation by PD98059 protect PCCs from PSC-CM-induced loss of GEM sensitivity. Taken together, PSCs appear to promote GEM resistance in PDAC via glycolysis. Thus, targeting glycolysis may improve the effect of chemotherapy in PDAC.

The modest clinical benefits of neoadjuvant chemotherapy (NAT) in pancreatic ductal adenocarcinoma (PDAC) are associated with a lack of robust data on treatment‐induced changes in the tumor. To this end, comparative proteomic profiling of tumor tissue samples from treatment‐naïve (TN, n = 20) and NAT‐treated (n = 22) PDACs was performed. Differentially expressed proteins were identified and correlation with overall survival (OS) was performed. Tumors were also examined for histopathological changes and expression of cancer stem cell (CSC) markers. Serum from 33 matched patients was analyzed for metabolic markers. Cytotoxicity, proliferation, and expression of CSC markers were assessed in chemoresistant Panc‐1 and Mia PaCa‐2 cells. Of the 2265 proteins identified, 227 and 144 proteins showed significantly altered expression and differential phosphorylation, respectively, in NAT compared with TN samples. The majority of these were metabolism‐related proteins, and 14 of these correlated moderately with OS. NAT‐treated tumors and chemoresistant cancer cells showed increased expression of CSC markers. Serum ALDH1A1 was higher in NAT compared with TN. Differentially phosphorylated proteins were mainly involved in cytoskeleton organization, cell locomotion, motility, and migration, and 17 of these showed a strong positive correlation with OS. This study provides evidence of the effects of NAT on PDAC metabolism at both the tumor and the systemic levels. NAT‐treated tumors showed significantly lower expression of metabolic proteins, and patients who underwent NAT showed reduced serum lactate and high‐density lipoprotein‐cholesterol. Lastly, cancer cells that survived cytotoxic treatment expressed higher CSC markers, both in vivo and in vitro.

Present study examines friction and wear characteristics for Ni-P-SiC coated SS 304 steel sample and It is used in conveyors in terms of increment in life cycle of conveyors under dry condition with cost effective manner. It is one of the most commonly produced and used stainless steel grades. So, this research is focused on SS304. The surface of SS 304 steel is finished by Ni-P-SiC electroless coating, and its characteristics have been studied through different analyses. FESEM with EDAX has been used to identify the elemental distribution of samples. Taguchi L16 orthogonal array, ANOVA, and regression analysis have been used to obtain experiment layout, significant process parameters, and linear relationship between input and output variables, respectively, under the experiment of design and validate with confirmatory test. Combination of operating parameters which minimize both coefficient of friction and wear is generated using multi-objective optimization. Experiments are carried out according to L16 orthogonal array and the significant parameters among the chosen, which influence wear and coefficient of friction of Ni-P-SiC electroless coated SS 304 under dry conditions are determined. Relations between the output variable and input variable is established by linear regression equations of the friction coefficient between interacting components and wear under the dry condition in terms of load, speed, and temperature. 10 N, 100 rpm, and 90°C are found to be an optimum set of operating parameters among selected levels which minimize both wear and coefficient of friction of sample.

Abstract Four years of Indian Institute of Tropical Meteorology lightning location network lightning observation data are used to determine the seasonal and spatial (over different geographical locations) distribution of the ratio of intra‐cloud (IC) lightning to cloud‐to‐ground (CG) lightning in thunderstorms over the Indian subcontinent. The ratio is high (6–10) in the northwestern parts and low (0.5–3.5) in the northeastern parts. No prominent latitudinal variation of the IC to CG ratio exists, but a climatological seasonal variability exists over all regions. In the pre‐monsoon season (March–May), the mean ratio is observed to be 3.81 with a standard deviation of 0.79, and during the monsoon season (June–September), a value of 3.04 with a standard deviation of 0.50. Although convective available potential energy is the regulating factor, little dependency has been found between the ratio of IC to CG lightning (IC:CG ratio) and the total flash rate (f), as well as with cold cloud depths. The ratio is observed to be proportional to the total flash rate as f0.61. The cold cloud depth is most prominently linked with the regional and seasonal IC:CG ratio. The implication of these observed results has the importance of separating CG lightning flash from total and can be used in numerical models to give a proper prediction of CG lightning in hazard mitigation.

In the last decade, despite rapid advancements in artificial intelligence (AI) transforming many industry practices, construction largely lags in adoption. Recently, the emergence and rapid adoption of advanced large language models (LLMs) like OpenAI’s GPT, Google’s PaLM, and Meta’s Llama have shown great potential and sparked considerable global interest. However, the current surge lacks a study investigating the opportunities and challenges of implementing Generative AI (GenAI) in the construction sector, creating a critical knowledge gap for researchers and practitioners. This underlines the necessity to explore the prospects and complexities of GenAI integration. Bridging this gap is fundamental to optimizing GenAI’s early stage adoption within the construction sector. Given GenAI’s unprecedented capabilities to generate human-like content based on learning from existing content, we reflect on two guiding questions: What will the future bring for GenAI in the construction industry? What are the potential opportunities and challenges in implementing GenAI in the construction industry? This study delves into reflected perception in literature, analyzes the industry perception using programming-based word cloud and frequency analysis, and integrates authors’ opinions to answer these questions. This paper recommends a conceptual GenAI implementation framework, provides practical recommendations, summarizes future research questions, and builds foundational literature to foster subsequent research expansion in GenAI within the construction and its allied architecture and engineering domains.

Over the past few decades, there has been a significant rise in wearable healthcare technologies that have been playing a major role all over the world in monitoring health, alerting individuals during deviations from their normal health conditions and assisting them to stay fit and healthy. Due to the modern lifestyle and consumption of unhealthy food products, there has been an adverse effect on digestive health standards. In this work, a wearable device with textile electrodes is designed and developed to analyze the digestive conditions, namely, pre-prandial and post-prandial, using Electrogastrogram (EGG) signals. Further, the proposed device is comprised of textile electrodes as a sensor, an Analog-to-Digital Converter (ADC) with a Programmable Gain Amplifier (PGA), a Microcontroller with an inbuilt WirelessFidelity (WiFi) module, and an Internet of Things (IoT) cloud platform. Also, the EGG signals are acquired under two different conditions, namely, pre-prandial and post-prandial conditions, and then the Long Short Term Memory (LSTM) deep learning model is utilized to classify pre-prandial and post-prandial EGG signals to identify the eating habits of normal individuals. Results demonstrate that the proposed approach is capable of classifying the pre-prandial and post-prandial EGG signals, which, in turn, identify the fasting or ingestion state of normal individuals.

Operational applications for Synthetic Aperture Radar (SAR) are under development around the world, driven by the free-and-open access of SAR C-band observations that Sentinel-1 of Copernicus has provided since 2014. Radiometric Terrain Correction (RTC) data are key entry-level products for multiple applications ranging from ecosystem to hazard monitoring. Various open-source software packages exist to create RTC products from Single Look Complex (SLC) or Ground Range Detected (GRD) level SAR data, including the Interferometric SAR Computing Environment (ISCE), and the Sentinel-1 Toolbox from the European Space Agency (SNAP 8). Despite the growing availability of RTC software solutions, little work has been performed to identify differences between RTC products generated using different software packages. This work evaluates several Sentinel-1 RTC products and two other Sentinel-1 Analysis Ready Data (ARD) to address the following questions: (1) Which software provides the most accurate RTC product? and (2) how appropriate for analysis are other non-RTC products that are readily available? The RTCs are produced with GAMMA, ISCE-2, and SNAP 8. The other two ARD products evaluated consisted of an angular-based radiometric slope correction produced in Google Earth Engine (GEE) following Vollrath et al., and the Sentinel-1 GRD product. Products are evaluated across 10 sites in a single image approach for (1) radiometric calibration, (2) geometric corrections, and for (3) geolocation quality. In addition, time-series stacks over two sites representing varied terrain and ecosystems are evaluated. The GAMMA-derived RTC product implemented by the Alaska Satellite Facility (ASF) is used as a reference for some of the time-series metrics. The results provide direct guidance and recommendations about the quality of the RTC and ARD products obtained from open source methods. The results indicate that it is not recommended to use the GRD product with no radiometric or geometric corrections for any applications given low performance in multiple metrics. The radiometric calibration and geometric corrections have overall good performance for all open-source solutions, only the non-RTC products (Vollrath et al. and GRD) portray some significant variances in steep terrain. The geolocation assessment indicated that the GRD product has the most significant displacement errors, followed by SNAP 8 with Digital Elevation Model (DEM) matching, and ISCE-2. RTCs created without DEM-matching performed better for both GAMMA and SNAP 8. The time-series results indicate that SNAP 8 products align more closely to GAMMA products than other open-source software in terms of radiometric and geometric quality. This understanding of software performance for SAR image processing is key to designing the affordable and scalable solutions needed for the operational application of SAR Sentinel-1 data.

Abstract Osteoarthritis is a joint disease characterized by a poorly-defined inflammatory response that does not encompass a massive immune cell infiltration yet contributes to cartilage degradation and loss of joint mobility, suggesting a chondrocyte intrinsic inflammatory response. Using primary chondrocytes from joints of osteoarthritic mice and patients, we first show that these cells express ample pro-inflammatory markers and RANKL in an NF-κB dependent manner. The inflammatory phenotype of chondrocytes was recapitulated by exposure of chondrocytes to IL-1β and bone particles, which were used to model bone matrix breakdown products revealed to be present in synovial fluid of OA patients, albeit their role was not defined. We further show that bone particles and IL-1β can promote senescent and apoptotic changes in primary chondrocytes due to oxidative stress from various cellular sources such as the mitochondria. Finally, we provide evidence that inflammation, oxidative stress and senescence converge upon IκB-ζ, the principal mediator downstream of NF-κB, which regulates expression of RANKL, inflammatory, catabolic, and SASP genes. Overall, this work highlights the capacity and mechanisms by which inflammatory cues, primarily joint degradation products, i.e., bone matrix particles in concert with IL-1β in the joint microenvironment, program chondrocytes into an “inflammatory phenotype” which inflects local tissue damage.

The grid-tied converters are always susceptible to abnormal grid disturbances, which are countered with the advanced current controllers. This paper presents an adaptive multi-resonant current controller (MRCC) in a current loop to maintain the converter synchronization with the grid under grid disturbance. The most critical disturbance like dc-offset, frequency variation, and harmonics in the grid voltage leads to current tracking performance degradation due to their non-adaptive nature. The modified second-order generalized integrator (MSOGI) based phase-locked loop (PLL) is proposed with grid frequency adaptability. The detailed analysis of the adaptive MRCC is presented with the dc-offset, frequency deviation, and harmonics in the grid voltage. The proposed MSOGI-PLL with an adaptive MRCC is tested under non-ideal grid conditions indicating the enhanced dynamic response over the non-adaptive methods. The efficacy of the frequency adaptive MRCC is tested on the laboratory prototype model of the single-phase GTC.

Background Unique identifiers are not universal in low- and middle-income countries. Biometric solutions have the potential to augment existing name-based searches used for identification in these settings. This paper describes a comparison of the searching accuracy of a palm-based biometric solution with a name-based database. Objective To compare the identification of individuals between a palm-based biometric solution to a name-based District Health Information Software 2 (DHIS2) Android application, in a low-resource setting. Methods The study was conducted in Chandpur district, Bangladesh. Trained data collectors enrolled 150 women of reproductive age into two android applications – i) a name-based DHIS2 application, and ii) a palm-based biometric solution – both run on tablets. One week after enrollment, a different research team member attempted to re-identify each enrolled woman using both systems. A single image or text-based name was used for searching at the time of re-identification. We interviewed data collectors at the end of the study. Results Significantly more women were successfully identified on the first attempt with a palm-based biometric application (84%) compared with the name-based DHIS2 application (61%). The proportion of identifications that required three or more attempts was similar between name-based (7%, CI 3.7–12.3) and palm-based biometric system (5%, CI: 1.9–9.4). However, the total number of attempts needed was significantly lower with the palm-based solution (mean 1.2 vs. 1.5, p

Background: Pericardial effusion (PE) is one of the common pericardial diseases in our population with its associated morbidity and mortality. Our study aims to evaluate the clinical characteristics of patients with PE from eastern region of Nepal. Materials and Methods: A descriptive cross-sectional study carried out in tertiary care center in eastern region of Nepal from March 2019 to February 2020. A total of 45 cases of PE were enrolled by convenient sampling method. Diagnosis was made based on clinical history, examination, and relevant laboratory investigations. Data was entered in Microsoft excel 2007 and converted into IBM SPSS data editor, version 20. Results: Forty five patients were included with mean age of 55.36 ± 16.38 years. Twenty seven patients (60%) were male and 18 (40%) were female. Hypertension was present in 12 (26.7%) and diabetes mellitus in 13 (28.9%). Mean serum hemoglobin was 10.85 ± 2.09 gm/dl. Chronic kidney disease (Uremia), tuberculosis and hypothyroidism were the common causes of PE. Common clinical symptoms were dyspnea, fever, and cough and chest pain. Moderate to large pericardial effusion was noted in 21 (46.7%) of patients. Cardiac tamponade was present in 6 (13.3%). Twenty seven patients (60%) patients underwent pericardiocentesis. Conclusion: Chronic kidney disease, tuberculosis and hypothyroidism were the common causes of PE with male predominance. Dyspnea was the most common presenting symptom. Cardiac tamponade was relatively less common.

The aim of this study is to evaluate the usability of new cement (NC) made by the burning of quinary by-product to make commercial binders. Chemical analysis of the by-products and NC as well as X-ray diffraction (XRD) analysis of NC, fineness, density, consistency, and setting time of NC paste, and slump in addition to compressive strength (CS) and splitting tensile strength (STS) of NC concrete (NCC) were conducted. The results suggested that chemical composition of by-products is suitable to make NC binder. The NC contains Ca3SiO5, Ca2SiO5, Ca3Al2O6, and Ca3Al2FeO10. The particles passing through the 200 um Sieve were 56% compared with 52% for Portland cement (PC). The density of the of NC was similar to that of PC. The NC needed 48% more water than PC for normal consistency. The initial and final setting-time of NC was 105 min and 225 min respectively which is much higher than that of PC (15 and 45 min). The slump, compressive strength and splitting tensile strength were slightly lower for concrete containing NC compared with that pf PC concrete. Although the CS and STS of NCC are the lowest, the rate of the CS and STS gain of NCC is greater than that of PCC. It was concluded that NC is a viable alternative to PC for the production of greener concrete.

High performance colloid flake of carbon is gaining interest due importance in meeting the challenges of the globe. To make novel superior materials, the pulverized fuel ash-green adhesive based construction materials modified with the flake of carbon and the colloid flake of carbon were evaluated in view of synthesis, physico-mechanical properties, and material processing and models. For better understanding, such experimental samples as green adhesive plaster and green adhesive grout were made of the pulverized fuel ash of class C, the common adhesive, the flake of carbon, the colloid flake of carbon, fine sand, and the distilled water to compare with the structural material properties each other. The results of the adsorption spectra of optical atomic spectroscopy of the colloid flake carbon, the thickening-period of plaster, the spread and the consolidating level, the apparent unit volume mass, the apparent porosity, the apparent compacity, and the compressive stress of green grouts were reported in the research. It was concluded that the flake of carbon and the colloid flake of carbon led to important progress in the novel superior materials, e.g., accelerating of the thickening-period of plasters and increasing of the compressive stress of grouts.

Sukhvir Wright et al. present a NMDAR antibody-induced model of encephalitis in rats and use in vitro, in vivo, and in silico electrophysiology to examine alterations in neural circuit behavior. Their results suggest that reduction of NMDARs leads to increased excitability and seizure activity, and highlights the potential use of receptor-specific treatments in antibody-mediated seizures and epilepsy.