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Radicular cysts are the most often documented inflammatory cysts in the adult population, although their incidence in children is regarded as unusual. This study presents a 12-year-old female patient, who had an asymptomatic radicular cyst along with a retained and decayed deciduous tooth in the left posterior mandibular area, the cyst. The patient underwent cystic enucleation after a clinical and radiographic evaluation which led to a provisional diagnosis that was corroborated by the histological findings. In this article, the differential diagnosis and treatment of a radicular cyst in a pediatric patient is discussed.

Background: Little information is available on response to electroconvulsive therapy (ECT) in patients with bipolar disorder (BD) from India. Aim: This exploratory study aims to evaluate and compare the sociodemographic and clinical profiles, treatment outcomes of BD patients with depression and mania/mixed episode who received ECT and to evaluate the predictors of response to ECT. Results: Data of 278 BD patients who received 325 ECT courses were extracted from the ECT register. The number courses of ECT for bipolar depression (n = 202) exceeded those for mania/mixed episodes (n = 123). In terms of response to ECT, >75% response was achieved in 63.3% cases and >50% response was seen in about 90% of the patients. No significant difference was seen in response to ECTs between bipolar depression and mania/mixed episodes. Conclusion: The present study suggests that about two-thirds of the BD patients show more than 75% response to ECT, and more than 90% of the BD patients show more than 50% response to ECT.

Abstract Background High-risk strains of HPV are known to cause cervical cancer. Multiple clinical studies have emphasized that smoking and drinking are critical risk factors for cervical cancer and its high-grade precursors. In this study, we investigated if smoking and/or drinking augment the molecular mechanisms of cervical carcinogenesis and defined a potential therapeutic approach for their attenuation. Methods The impact of benzo[a]pyrene (B[a]P) and/or ethanol (EtOH) exposure on cervical cancer cells was assessed by measuring changes in their cell migration and invasion characteristics. Expression of HPV16 E6/E7, NF-κB, cytokines, and inflammation mediators was determined using qRT-PCR, immunoblotting, ELISA, luciferase reporter assay, and confocal microscopy. Herein, we used curcumin (Cur), and PLGA nanoparticle formulation of curcumin (PLGA-Cur) and determined effectiveness of free Cur and PLGA-Cur formulation on smoking and drinking activated NF-κB/IL-6 mediated inflammatory signaling pathways using in vitro cervical cancer models. Results Treatments with B[a]P and/or EtOH altered the expression of HPV16 E6/E7 oncogenes and EMT markers in cervical cancer cells; it also enhanced migration and invasion. In addition, B[a]P and/or EtOH exposure promoted inflammation pathways through TNF-α and NF-κB signaling, leading to IL-6 upregulation and activation of VEGF. The molecular effects caused by B[a]P and/or EtOH exposure were effectively attenuated by curcumin (Cur)/PLGA-Cur treatment. Conclusions These data suggest a molecular link between smoking, drinking, and HPV infectivity in cervical carcinogenesis. In addition, attenuation of these effects by treatment with Cur/PLGA-Cur treatment, implies the role of curcumin in cervical cancer prevention and treatment.

Vascularity plays a pivotal role in the progression of breast lesions and may be associated with their aggressiveness and likelihood of being malignant. Contrast-enhanced imaging techniques are necessary to evaluate vascularity due to the limited sensitivity of conventional color Doppler techniques, in which motion artifacts are eliminated using wall filters. However, in this process, low-flow signals from small vessels also get removed unintentionally. Advancements in technology have revolutionized the way ultrasound images are generated, resulting in tremendous improvements in Doppler imaging techniques. The new, ultrasound-based noncontrast microvascular imaging techniques overcome the limitations of conventional Doppler, and are highly sensitive for detecting microvessels and low flow. The resultant high Doppler sensitivity leads to detection of vascularity in more breast lesions. It is important for radiologists to understand the imaging principles and the clinical implications of the new techniques, to optimally utilize them and aid correct diagnosis. Angio-PLUS is one such recent advancement, which uses unfocused or plane waves and three-dimensional wall filtering to analyze tissue motion in time, space, and amplitude domains that effectively distinguish between blood flow and tissue. The information is beneficial for assessing the lesion vascularity without using contrast. This article aims to explain the Doppler imaging techniques, their clinical applications, scanning methods, and review the common Doppler-based diagnostic criteria used in the evaluation of breast lesions.

Purpose: The purpose of this study was to assess the impact of oral health status (OHS) and sociodemographic indicators on oral health-related quality of life (OHRQoL) among children with type 1 diabetes mellitus (T1DM) aged 11–14 years and compare it with age-matched nondiabetic children. MATERIALS AND METHODS: This cross-sectional study included 80 children aged between 11 and 14 years with T1DM and 80 age-matched nondiabetic children. The OHRQoL was measured using a validated structured Hindi version of the child perception questionnaire (CPQ11-14) questionnaire. The clinical OHS was assessed using the decayed, missing, or filled teeth index, plaque index (PI), and gingival index (GI). Associations between OHRQoL and independent predictors were analyzed with the log-linear Poisson model regression method. Results: CPQ11-14 scores were significantly lower in nondiabetic children than diabetic children, indicating better OHRQoL among nondiabetic children than diabetic children (P ≤ 0.05). The GI score exhibited a significantly lower value in nondiabetic children than in diabetic children (P = 0.014). In contrast, the mean decayed, missing, and filled teeth score showed a significantly higher value in nondiabetic children than in diabetic children (P ≤ 0.001). There was no difference in the mean PI of diabetic and nondiabetic children (P = 0.096). Conclusion: The result of the present study highlighted the detrimental effect of T1DM on OHRQoL in children.

Abstract Wastewater is a geospatially- and temporally-linked microbial fingerprint of a given population, making it a potentially valuable tool for tracking public health across locales and time. Here, we integrate targeted and bulk RNA sequencing (N = 2238 samples) to track the viral, bacterial, and functional content over geospatially distinct areas within Miami Dade County, USA, from 2020-2022. We used targeted amplicon sequencing to track diverse SARS-CoV-2 variants across space and time, and we found a tight correspondence with positive PCR tests from University students and Miami-Dade hospital patients. Additionally, in bulk metatranscriptomic data, we demonstrate that the bacterial content of different wastewater sampling locations serving small population sizes can be used to detect putative, host-derived microorganisms that themselves have known associations with human health and diet. We also detect multiple enteric pathogens (e.g., Norovirus) and characterize viral diversity across sites. Moreover, we observed an enrichment of antimicrobial resistance genes (ARGs) in hospital wastewater; antibiotic-specific ARGs correlated to total prescriptions of those same antibiotics (e.g Ampicillin, Gentamicin). Overall, this effort lays the groundwork for systematic characterization of wastewater that can potentially influence public health decision-making.

Abstract Information on the effects of changing agricultural management on crop and livestock performance is critical for developing evidence-based policies, investments, and programs. Evidence for Resilient Agriculture (ERA) v1.0.1 presents a dataset that harmonizes and aggregates 112,859 observations from 2,011 agricultural studies taken place in Africa between 1934 and 2018. The dataset includes information on the effect of 364 combinations of management practices and technologies on 87 environmental, social, and economic indicators of outcomes. Observations are geolocated and temporally tagged and thus can be linked to other datasets such as historical weather, soil properties, and road networks. ERA offers a new resource for understanding the impacts of changing farming practices under diverse environmental contexts, providing data to support strategic interventions aimed to enhance productivity, resilience, and sustainability of African agriculture.

Abstract Objective To report initial results from the Amyotrophic Lateral Sclerosis (ALS) Identified genetic testing (GT) program on characteristics of individuals tested and frequency of reported disease‐causing variants. Methods ALS Identified used the Invitae Amyotrophic Lateral Sclerosis panel (Invitae, San Francisco, CA, USA) to assay 22 ALS‐associated genes. Sponsored by Biogen (Cambridge, MA, USA), the program was launched in June 2021 and was available at no charge to individuals ≥18 years in the United States and Puerto Rico with an ALS diagnosis or a known family history of ALS. Deidentified data were available to Biogen. Results As of 26 October 2023, 998 healthcare professionals ordered the panel at 681 unique care sites. Of 8054 individuals examined, 7483 (92.9%) were reported to have a clinical diagnosis of ALS, while 571 (7.1%) were asymptomatic relatives. Of the individuals with a clinical ALS diagnosis, 57.7% were male (n = 4319) and 42.3% female (n = 3164). Mean (SD) age at diagnosis is 62 (13) years. Out of the 7483 clinically diagnosed individuals, 1810 (24.2%) showed genetic variations in ALS‐associated genes. Among these, 865 individuals (47.8%) carried pathogenic variants, and 44 (2.4%) had likely pathogenic variants, totaling 12.1% of the clinically diagnosed population. Interpretation Since 2021 there has been robust uptake and sustained use of the ALS Identified program, one of the largest samples of people with ALS to date across the United States, demonstrating the interest and need for genetic ALS testing.

Abstract Multistate memory systems have the ability to store and process more data in the same physical space as binary memory systems, making them a potential alternative to existing binary memory systems. In the past, it has been demonstrated that voltage-controlled magnetic anisotropy (VCMA) based writing is highly energy-efficient compared to other writing methods used in non-volatile nano-magnetic binary memory systems. In this study, we introduce a new, VCMA-based and skyrmion-mediated non-volatile ternary memory system using a perpendicular magnetic tunnel junction (p-MTJ) in the presence of room temperature thermal perturbation. We have also shown that ternary states {− 1, 0, + 1} can be implemented with three magnetoresistance values obtained from a p-MTJ corresponding to ferromagnetic up, down, and skyrmion state, with 99% switching probability in the presence of room temperature thermal noise in an energy-efficient way, requiring ~ 2 fJ energy on an average for each switching operation. Additionally, we show that our proposed ternary memory demonstrates an improvement in area and energy by at least 2X and ~ 104X respectively, compared to state-of-the-art spin-transfer torque (STT)-based non-volatile magnetic multistate memories. Furthermore, these three states can be potentially utilized for energy-efficient, high-density in-memory quantized deep neural network implementation.

Abstract Background Microbes in the cold polar and alpine environments play a critical role in feedbacks that amplify the effects of climate change. Defining the cold adapted ecotype is one of the prerequisites for understanding the response of polar and alpine microbes to climate change. Results Here, we analysed 85 high-quality, de-duplicated genomes of Deinococcus, which can survive in a variety of harsh environments. By leveraging genomic and phenotypic traits with reverse ecology, we defined a cold adapted clade from eight Deinococcus strains isolated from Arctic, Antarctic and high alpine environments. Genome-wide optimization in amino acid composition and regulation and signalling enable the cold adapted clade to produce CO2 from organic matter and boost the bioavailability of mineral nitrogen. Conclusions Based primarily on in silico genomic analysis, we defined a potential cold adapted clade in Deinococcus and provided an updated view of the genomic traits and metabolic potential of Deinococcus. Our study would facilitate the understanding of microbial processes in the cold polar and alpine environments.

Introduction: Overweight and obesity have become complex public health issues affecting all age, gender, and socioeconomic groups. It is a significant risk factor for various noncommunicable diseases such as hypertension, liver and kidney disease, diabetes, cardiovascular diseases, and depression. Despite this, obesity screening, prevention, and treatment are insufficiently focused in the health systems in low- and middle-income countries. There is a need for targeted interventions that are more realistic, applicable to all population groups, and have the potential for higher success rates. With this idea in mind, the current review has focused on systematically gathering evidence on the effect of weight management interventions compared to the standard of care among adults with overweight and obesity from low- and middle-income countries. Methodology: We will systematically search four electronic databases – PubMed, Google Scholar, Embase, and the Cochrane Library from their inception until July 2023 for relevant studies. A combination of medical subject headings and free text terms will be used for carrying out literature searches. All the experimental studies randomized controlled trials or nonrandomized trials conducted in a clinic-, hospital-, or community-based setting will be included in our review. Studies conducted among adults aged 18 years and above with overweight or obesity with nonpharmacological weight management given as intervention and standard of care given as comparator will be looked for. The outcome measures include the standardized mean difference of weight, body mass index, waist or hip circumference, or odds ratio of obesity or overweight between the treatment groups. Meta-regression or subgroup analyses will be performed to explore the heterogeneity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines will be used to report the review. Study Design: Systematic review and meta-analysis. Ethics and Dissemination: There are no ethical concerns about the conduct of this review. Evidence will be disseminated at relevant conferences and by submitting scientific articles to academic peer-reviewed journals. Conclusion: Findings from this systematic review will significantly contribute to enhancing knowledge about evidence of the effectiveness of various obesity management strategies. This evidence-based approach will guide informed decision-making processes and support the development of effective interventions or programs to address the obesity epidemic in low- and middle-income countries. Prospero Registration: CRD42022352118.

Abstract Background Hereditary transient neonatal hyperparathyroidism (TNHP) is a rare autosomal-recessive condition caused by variants in TRPV6 gene which encodes for a transient maternal–fetal calcium transport channel. This is characterized by interference with placental maternal–fetal calcium transport causing fetal calcium deficiency. It primarily manifests as defective bone mineralization, narrow and bell-shaped thorax, bone fractures and short bones at birth. The current study aimed to describe a novel TRPV6 variant linked with TNHP in an Indian family and the review of literature. Case presentation The proband is a term female neonate with fetal growth restriction born to a third-degree consanguineous couple. She was noted to have diffuse defective bone mineralization, narrow and bell-shaped thoracic cavity, short bones and curved ribs without any bone fractures. The first pregnancy was affected with similar features in the fetus and had been terminated. Parental whole-exome sequencing suggested heterozygous missense variant in exon 12 of the TRPV6 gene (c.1585G > A, p.Asp529Asn) in both the parents. The proband required non-invasive respiratory support for ten days in neonatal intensive care unit. She had low calcium and high parathyroid hormone (PTH) and alkaline phosphatase (ALP) levels. She received calcium, phosphorus and vitamin D supplements for three months leading to normalization of serum PTH and ALP levels. Whole-exome sequencing of the proband suggested a homozygous missense variant in exon 12 of the TRPV6 gene (p.Asp529Asn; ENST00000359396.9) that results in the amino acid substitution of asparagine for aspartic acid at codon 529. To the best of author’s knowledge, this is the twelfth case of TNHP reported in literature. The novel variant of TRPV6 gene present in this family has not been reported earlier. Conclusion Our finding broadens the genotypic spectrum of TNHP.

Anaemia is a well-known global health concern in the South Asian countries, and it is estimated that India has the utmost prevalence of anaemia and maternal deaths due to iron deficiency anaemia. This study aims to assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) in antenatal women with anaemia in the second and third trimesters of pregnancy. Methods: A single-arm prospective cohort (before–after) study among 60 antenatal women with moderate to severe anaemia in the second and third trimesters was conducted from December 2020 to December 2022, and the eligible women were given 1000 mg of intravenous FCM injection. Efficacy was assessed by rate of improvement in haemoglobin and ferritin at 2 weeks post infusion. Safety analysis was done by assessing adverse drug reactions and foetal heart monitoring during the infusion. Results: A total 60 antenatal women with a median gestational age of 32.5 weeks at presentation received 1000 mg of intravenous FCM. There was a rise in mean haemoglobin from 8.05 gm% pre-infusion to 10.93 gm% 2 weeks post infusion, showing a mean rise of 2.88 gm%. Similar improvement was noted in mean serum ferritin levels from 25.92 pre-infusion to 253.96 post FCM infusion. There were no reports of drug-related major adverse effects in the mother or the foetus. Conclusions: FCM is found to be safe and effective treatment with rapid replenishment of haemoglobin and ferritin levels in a single dose, which makes it suitable and compels consideration as the first choice for treatment of iron-deficiency anaemia.

Abstract As spaceflight becomes more common with commercial crews, blood-based measures of crew health can guide both astronaut biomedicine and countermeasures. By profiling plasma proteins, metabolites, and extracellular vesicles/particles (EVPs) from the SpaceX Inspiration4 crew, we generated “spaceflight secretome profiles,” which showed significant differences in coagulation, oxidative stress, and brain-enriched proteins. While >93% of differentially abundant proteins (DAPs) in vesicles and metabolites recovered within six months, the majority (73%) of plasma DAPs were still perturbed post-flight. Moreover, these proteomic alterations correlated better with peripheral blood mononuclear cells than whole blood, suggesting that immune cells contribute more DAPs than erythrocytes. Finally, to discern possible mechanisms leading to brain-enriched protein detection and blood-brain barrier (BBB) disruption, we examined protein changes in dissected brains of spaceflight mice, which showed increases in PECAM-1, a marker of BBB integrity. These data highlight how even short-duration spaceflight can disrupt human and murine physiology and identify spaceflight biomarkers that can guide countermeasure development.

Abstract The advent of civilian spaceflight challenges scientists to precisely describe the effects of spaceflight on human physiology, particularly at the molecular and cellular level. Newer, nanopore-based sequencing technologies can quantitatively map changes in chemical structure and expression at single molecule resolution across entire isoforms. We perform long-read, direct RNA nanopore sequencing, as well as Ultima high-coverage RNA-sequencing, of whole blood sampled longitudinally from four SpaceX Inspiration4 astronauts at seven timepoints, spanning pre-flight, day of return, and post-flight recovery. We report key genetic pathways, including changes in erythrocyte regulation, stress induction, and immune changes affected by spaceflight. We also present the first m6A methylation profiles for a human space mission, suggesting a significant spike in m6A levels immediately post-flight. These data and results represent the first longitudinal long-read RNA profiles and RNA modification maps for each gene for astronauts, improving our understanding of the human transcriptome’s dynamic response to spaceflight.

Abstract Spaceflight can change metabolic, immunological, and biological homeostasis and cause skin rashes and irritation, yet the molecular basis remains unclear. To investigate the impact of short-duration spaceflight on the skin, we conducted skin biopsies on the Inspiration4 crew members before (L-44) and after (R + 1) flight. Leveraging multi-omics assays including GeoMx™ Digital Spatial Profiler, single-cell RNA/ATAC-seq, and metagenomics/metatranscriptomics, we assessed spatial gene expressions and associated microbial and immune changes across 95 skin regions in four compartments: outer epidermis, inner epidermis, outer dermis, and vasculature. Post-flight samples showed significant up-regulation of genes related to inflammation and KRAS signaling across all skin regions. These spaceflight-associated changes mapped to specific cellular responses, including altered interferon responses, DNA damage, epithelial barrier disruptions, T-cell migration, and hindered regeneration were located primarily in outer tissue compartments. We also linked epithelial disruption to microbial shifts in skin swab and immune cell activity to PBMC single-cell data from the same crew and timepoints. Our findings present the inaugural collection and examination of astronaut skin, offering insights for future space missions and response countermeasures.

Abstract It is now widely recognised that the environment in space activates a diverse set of genes involved in regulating fundamental cellular pathways. This includes the activation of genes associated with blood homeostasis and erythropoiesis, with a particular emphasis on those involved in globin chain production. Haemoglobin biology provides an intriguing model for studying space omics, as it has been extensively explored at multiple -omic levels, spanning DNA, RNA, and protein analyses, in both experimental and clinical contexts. In this study, we examined the developmental expression of haemoglobin over time and space using a unique suite of multi-omic datasets available on NASA GeneLab, from the NASA Twins Study, the JAXA CFE study, and the Inspiration4 mission. Our findings reveal significant variations in globin gene expression corresponding to the distinct spatiotemporal characteristics of the collected samples. This study sheds light on the dynamic nature of globin gene regulation in response to the space environment and provides valuable insights into the broader implications of space omics research.

Abstract Spaceflight induces an immune response in astronauts. To better characterize this effect, we generated single-cell, multi-ome, cell-free RNA (cfRNA), biochemical, and hematology data for the SpaceX Inspiration4 (I4) mission crew. We found that 18 cytokines/chemokines related to inflammation, aging, and muscle homeostasis changed after spaceflight. In I4 single-cell multi-omics data, we identified a “spaceflight signature” of gene expression characterized by enrichment in oxidative phosphorylation, UV response, immune function, and TCF21 pathways. We confirmed the presence of this signature in independent datasets, including the NASA Twins Study, the I4 skin spatial transcriptomics, and 817 NASA GeneLab mouse transcriptomes. Finally, we observed that (1) T cells showed an up-regulation of FOXP3, (2) MHC class I genes exhibited long-term suppression, and (3) infection-related immune pathways were associated with microbiome shifts. In summary, this study reveals conserved and distinct immune disruptions occurring and details a roadmap for potential countermeasures to preserve astronaut health.

Abstract The SpaceX Inspiration4 mission provided a unique opportunity to study the impact of spaceflight on the human body. Biospecimen samples were collected from four crew members longitudinally before (Launch: L-92, L-44, L-3 days), during (Flight Day: FD1, FD2, FD3), and after (Return: R + 1, R + 45, R + 82, R + 194 days) spaceflight, spanning a total of 289 days across 2021-2022. The collection process included venous whole blood, capillary dried blood spot cards, saliva, urine, stool, body swabs, capsule swabs, SpaceX Dragon capsule HEPA filter, and skin biopsies. Venous whole blood was further processed to obtain aliquots of serum, plasma, extracellular vesicles and particles, and peripheral blood mononuclear cells. In total, 2,911 sample aliquots were shipped to our central lab at Weill Cornell Medicine for downstream assays and biobanking. This paper provides an overview of the extensive biospecimen collection and highlights their processing procedures and long-term biobanking techniques, facilitating future molecular tests and evaluations.As such, this study details a robust framework for obtaining and preserving high-quality human, microbial, and environmental samples for aerospace medicine in the Space Omics and Medical Atlas (SOMA) initiative, which can aid future human spaceflight and space biology experiments.

Abstract Telomeres are repetitive nucleoprotein complexes at chromosomal termini essential for maintaining genome stability. Telomeric RNA, or TERRA, is a previously presumed long noncoding RNA of heterogeneous lengths that contributes to end-capping structure and function, and facilitates telomeric recombination in tumors that maintain telomere length via the telomerase-independent Alternative Lengthening of Telomeres (ALT) pathway. Here, we investigated TERRA in the radiation-induced DNA damage response (DDR) across astronauts, high-altitude climbers, healthy donors, and cellular models. Similar to astronauts in the space radiation environment and climbers of Mt. Everest, in vitro radiation exposure prompted increased transcription of TERRA, while simulated microgravity did not. Data suggest a specific TERRA DDR to telomeric double-strand breaks (DSBs), and provide direct demonstration of hybridized TERRA at telomere-specific DSB sites, indicative of protective TERRA:telomeric DNA hybrid formation. Targeted telomeric DSBs also resulted in accumulation of TERRA foci in G2-phase, supportive of TERRA’s role in facilitating recombination-mediated telomere elongation. Results have important implications for scenarios involving persistent telomeric DNA damage, such as those associated with chronic oxidative stress (e.g., aging, systemic inflammation, environmental and occupational radiation exposures), which can trigger transient ALT in normal human cells, as well as for targeting TERRA as a therapeutic strategy against ALT-positive tumors.

Abstract Background Maternal dietary diversity is a key to improving the birth and child health outcomes. Besides socio-economic factors, the nutrition specific program- Social and Behavioural Change Communication (SBCC) interventions aimed to improve maternal dietary diversity has varied levels of impact on the socio-economic groups in poor resource setups. Objective To measure the factors associated with the minimum dietary diversity (MDD) among pregnant women in selected districts of Rajasthan with special emphasis on the SBCC components. Additionally, it measures the socio-economic gaps in the behaviour of consumption of diversified diet during pregnancy. Methods Data from a cross sectional survey of 6848 pregnant women, who have received a continuous SBCC counselling and registered under a state introduced conditional cash transfer program, during May to June, 2023, in five intervention districts -Banswara, Baran, Dunagrpur, Pratapgarh and Udaipur in Rajasthan was used. A 24 h recall based food consumption behaviour has been gathered to measure the MDD of pregnant women. Study has used descriptive statistics, multivariate regressions, and multivariate decomposition analysis to address the research objectives. Results Study finds that only 55.2% of pregnant women are consuming diverse diet in the study duration with mean dietary diversity score is 4.8 (+/- 1.5). Logistic regression finds that SBCC components such as frontline workers (aOR = 1.3, CI: 1.1–1.4), community motivators (aOR = 1.9, CI: 1.7–2.1), and participation in MCHND (aOR = 1.0, CI: 0.9-1.2) have significant and higher likelihood on consumption of MDD food on previous day. A higher education and belonging from richer wealth quintile also show higher association for consumption of MDD. Multivariate decomposition shows, among richest and poorest wealth categories there is 19% point difference (58% difference due to coefficient vs. 42% difference due to composition) in MDD consumption. This is positively contributed by the caste and educational categories of women. Conclusion Despite a predominant vegetarian diet consuming population, better maternal dietary diversity was observed among those exposed to higher dose of SBCC intervention package. Educational status and caste of the respondent were significantly associated with minimum dietary diversity and contributed to the socio-economic inequality highlighting the importance of tailored and sustained SBCC interventions.

The World Health Organization started the Expanded Program on Immunization in 1974, including 6 antigens with up to 8 vaccine doses for childhood vaccination. The number of antigens has now increased to 11 antigens in 21 vaccines. The expansion of vaccination programs to include more antigens and doses has led to concerns about the burden of multiple injections on infants and children, as well as factors such as fear of adverse reactions, pain, and overall acceptability of vaccines. To address these challenges, there's a call for research to focus on developing combined vaccines that can be administered through more acceptable routes, such as oral, nasal, or needleless administration. This approach could potentially reduce the number of injections required and increase the willingness of individuals to receive vaccines. We highlight the importance of ongoing research and innovation in vaccine development and delivery methods to ensure that vaccination programs remain effective, efficient, and acceptable to the communities they serve, particularly in resource-limited settings.

Polyglutamine (PolyQ) diseases including Huntington’s disease are devastating neurodegenerative disorders characterized by progressive neuronal loss and motor dysfunction. PolyQ pathology involves multiple cellular events and phytochemicals with multi-target mechanisms hold promise to treat these diseases with least side effects. One such promising phytochemical is Eugenol, which possesses antioxidant and anti-inflammatory properties, potentially targeting disrupted cellular pathways in PolyQ diseases. The present study investigated the effects of Eugenol on neurodegeneration and motor dysfunction in transgenic Drosophila models of PolyQ diseases. In this study, the robust pseudopupil assay was performed to analyze adult photoreceptor neuron degeneration, a marker of widespread degenerative events. Furthermore, the well-established crawling and climbing assays were conducted to evaluate progressive motor dysfunction in the PolyQ larvae and flies. This study found that Eugenol administration at disease onset or after progression reduced PolyQ disease phenotypes, particularly, neurodegeneration and motor dysfunction in a dose-dependent manner and with no side effects. Thus, this study suggests that Eugenol could be a viable candidate for developing treatments for PolyQ diseases, offering a multi-target approach with the potential for minimal or no side effects compared to conventional therapies.

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Introduction: Pneumonia vaccination rates have increased to >60% over the last 20 years. At the Long Island, New York, Northport VA Hospital, pneumonia vaccination data from 2021 showed a vaccination rate of 68.55%. The goal is a pneumonia vaccination rate of 85%. Pneumonia vaccines prevent invasive pneumococcal disease and pneumococcal pneumonia. The authors aimed to increase vaccination rates at Northport. Methods: The authors established a weekly vaccine and prevention clinic aiming to vaccinate as many veterans as possible. Preventive medicine residents performed outreach, scheduling, vaccine administration, and Brief Action Planning. Motivational interviewing techniques were used in outreach calls and clinic visits to encourage behavioral change. Results: From an outreach list >7,000 patients, 506 patients were contacted and counseled on pneumonia vaccination. A total of 130 patients were scheduled for clinic visits. Of these 130, 91 kept their appointments and were seen in the clinic, and 87 vaccines were administered, of which 56 were pneumonia vaccines. Data were collected and analyzed in 2022. Conclusions: Implementing a dedicated vaccine and prevention clinic using motivational interviewing techniques in outreach and clinical visits allows for optimized patient vaccinations, enhanced information sharing, increased primary care retention, and increasing visibility of preventive medicine among patients and colleagues within the Veterans Affairs medical system.

Post-transcriptional regulation has emerged as a key mechanism for regulating stem cell renewal and differentiation, which is essential for understanding tissue regeneration and homeostasis. Poly(A)-binding proteins are a family of RNA-binding proteins that play a vital role in post-transcriptional regulation by controlling mRNA stability and protein synthesis. The involvement of poly(A) binding proteins in a wide range of cellular functions is increasingly being investigated. In this study, we used the regenerative model planarian organism Schmidtea mediterranea to demonstrate the critical role of poly(A)-binding protein 2 (PABP2) in regulating neoblast maintenance and differentiation. A deficit in PABP2 blocks the transition of neoblasts toward immediate early progenitors, leading to an enhanced pool of non-committed neoblasts and a decreased progenitor population. This is reflected in variations in the transcriptome profile, providing evidence of downregulation in multiple lineages. Thus, an insufficiency of PABP2 resulted in defective formation and organization of tissue, leading to abnormal regeneration. Our study reveals the essential role of PABP2 in regulating genes that mediate stem cell commitment to early progenitors during tissue regeneration.

Abstract T Cell Receptor (TCR) antigen binding underlies a key mechanism of the adaptive immune response yet the vast diversity of TCRs and the complexity of protein interactions limits our ability to build useful low dimensional representations of TCRs. To address the current limitations in TCR analysis we develop a capacity-controlled disentangling variational autoencoder trained using a dataset of approximately 100 million TCR sequences, that we name TCR-VALID. We design TCR-VALID such that the model representations are low-dimensional, continuous, disentangled, and sufficiently informative to provide high-quality TCR sequence de novo generation. We thoroughly quantify these properties of the representations, providing a framework for future protein representation learning in low dimensions. The continuity of TCR-VALID representations allows fast and accurate TCR clustering and is benchmarked against other state-of-the-art TCR clustering tools and pre-trained language models.

The emergence of combination antiretroviral therapy (cART) has greatly transformed the life expectancy of people living with HIV (PWH). Today, over 76% of the individuals with HIV have access to this life-saving therapy. However, this progress has come with a new challenge: an increase in age-related non-AIDS conditions among patients with HIV. These conditions manifest earlier in PWH than in uninfected individuals, accelerating the aging process. Like PWH, the uninfected aging population experiences immunosenescence marked by an increased proinflammatory environment. This phenomenon is linked to chronic inflammation, driven in part by cellular structures called inflammasomes. Inflammatory signaling pathways activated by HIV-1 infection play a key role in inflammasome formation, suggesting a crucial link between HIV and a chronic inflammatory state. This review outlines the inflammatory processes triggered by HIV-1 infection and aging, with a focus on the inflammasomes. This review also explores current research regarding inflammasomes and potential strategies for targeting inflammasomes to mitigate inflammation. Further research on inflammasome signaling presents a unique opportunity to develop targeted interventions and innovative therapeutic modalities for combating HIV and aging-associated inflammatory processes.

Diabetic retinopathy (DR) is a significant cause of vision impairment globally, emphasizing the importance of timely and precise detection to prevent severe consequences. This study presents an optimized Vision Transformer (ViT) model that incorporates Harris Hawk Optimization (HHO) to improve the automated detection of diabetic retinopathy (DR). The ViT architecture utilizes self-attention mechanisms to capture local and global features in retinal images. Additionally, HHO optimizes key hyperparameters to maximize the performance of the model. The proposed ViT-HHO model achieved exceptional performance on the APTOS-2019 and IDRiD datasets. Specifically, it achieved 99.83 % accuracy, 99.78 % sensitivity, 99.85 % specificity, and 99.80 % AUC-ROC on the APTOS-2019 dataset, surpassing traditional CNNs and alternative optimization techniques. The model exhibited strong generalization on the IDRiID dataset, achieving an accuracy of 99.11 % and an AUC-ROC of 99.12 %. The ViT-HHO model demonstrates the potential for enhancing the clinical detection of diabetic retinopathy (DR), providing high precision and reliability. • An optimized Vision Transformer (ViT) model was developed using HHO for improved detection of Diabetic Retinopathy (DR). • The model was validated on the APTOS-2019 and IDRiID datasets, demonstrating superior accuracy and AUC-ROC metrics. • The model's generalization and robustness were demonstrated through comprehensive performance evaluations.

The jigsaw method which utilises peer-teaching in small-group settings permits a facilitator to incorporate active learning strategies into their educational toolbox. In November 2022, we evaluated the impact of the jigsaw method with groups stratified by post-graduate year (PGY) level. We assessed pre and post learner confidence and medical knowledge during a facilitator-led workshop. Participants were stratified into three groups who presented on the following subtopics about osteoporosis in men: (1) history and physical examination (PGY1s), (2) lab work and imaging studies (PGY2s) and (3) management and interventions (PGY3s). We evaluated if stratifying by PGY level impacted learner medical knowledge and confidence in November 2022. We had an 80% response rate from 16 actual participants from a total of 20 possible participants. Authors found a statistically significant increases in residents’ confidence and medical knowledge after the training for all questions, but broad application across a variety of learners is still needed. The jigsaw method showed improvement in learner confidence about osteoporosis in men and may be implemented in teams distributed by PGY levels. Distribution by PGY level allows each team to building on their current training level to educate their peers.

Abstract Sepsis impacts 1.7 million Americans annually. It is a life‐threatening disruption of organ function because of the body's host response to infection. Sepsis remains a condition frequently encountered in emergency departments (ED) with an estimated 850,000 annual visits affected by sepsis each year in the United States. The pillars of managing sepsis remain timely identification, initiation of antimicrobials while aiming for source control and resuscitation with a goal of restoring tissue perfusion. The focus herein is current evidence and best practice recommendations for state‐of‐the‐art sepsis care that begins in the ED.

The existing biclustering algorithms often depend on assumptions like monotonicity or linearity of feature relations for finding biclusters. Though a few algorithms overcome this problem using density-based methods, they tend to miss out many biclusters because they use global criteria for identifying dense regions. The proposed method, PF-RelDenBi, uses local variations in marginal and joint densities for each pair of features to find the subset of observations, forming the basis of the relation between them. It then finds the set of features connected by a common set of observations using a non-linear feature relation index, resulting in a bicluster. This approach allows us to find biclusters based on feature relations, even if the relations are non-linear or non-monotonous. Additionally, the proposed method does not require the user to provide any parameters, allowing its application to datasets from different domains.To study the behaviour of PF-RelDenBi on datasets with different properties, experiments were carried out on sixteen simulated datasets and the performance has been compared with eleven state-of-the-art algorithms. The proposed method is seen to produce better results for most of the simulated datasets. Experiments were conducted with five benchmark datasets and biclusters were detected using PF-RelDenBi. For the first two datasets, the detected biclusters were used to generate additional features that improved classification performance. For the other three datasets, the performance of PF-RelDenBi was compared with the eleven state-of-the-art methods in terms of accuracy, NMI and ARI. The proposed method is seen to detect biclusters with greater accuracy. The proposed technique has also been applied to the COVID-19 dataset to identify some demographic features that are likely to affect the spread of COVID-19.

Background: Wilms’ tumor is the most common renal malignancy in children, with a peak incidence between 1 and 4 years of age. The prevalence of antenatal renal tumors is scarce, around 7 in 100,000 live births. We report a case of an antenatally diagnosed Wilms tumor. Case Presentation: A 2-month-old infant presented with a right renal lump since birth. The antenatal USG done at 35 weeks of gestation, showed an ill-defined heteroechoic area of size 57.3X29.9 mm at the upper pole of the right kidney, with few cystic areas with increased echogenicity. A right nephroureterectomy was done. It was WT1 and Vimentin positive and focally positive for Cyclin D1, whereas negative for Desmin, SMA, and PAX8, thus confirming the histopathological diagnosis of Wilms’ tumor. Conclusion: Antenatal Wilms’ tumor is rarely detected. A high degree of suspicion and active investigations should be conducted in antenatal and immediate neonatal periods for prompt decision-making and better outcomes.

Antiretroviral drugs have made significant progress in treating HIV-1 and improving the quality of HIV-1-infected individuals. However, due to their limited permeability into the brain HIV-1 replication persists in brain reservoirs such as perivascular macrophages and microglia, which cause HIV-1-associated neurocognitive disorders. Therefore, it is highly desirable to find a novel therapy that can cross the blood-brain barrier (BBB) and target HIV-1 pathogenesis in brain reservoirs. A recently developed 2-amino-3-methylpentanoic acid [2-morpholin-4-yl-ethyl]-amide (LM11A-31), which is a p75 neutrotrophin receptor (p75NTR) modulator, can cross the BBB. In this study, we examined whether LM11A-31 treatment can suppress HIV-1 replication, oxidative stress, cytotoxicity, and inflammatory response in macrophages. Our results showed that LM11A-31 (100 nM) alone and/or in combination with positive control darunavir (5.5 µM) significantly suppresses viral replication and reduces cytotoxicity. Moreover, the HIV-1 suppression by LM11A-31 was comparable to the HIV-1 suppression by darunavir. Although p75NTR was upregulated in HIV-1-infected macrophages compared to uninfected macrophages, LM11A-31 did not significantly reduce the p75NTR expression in macrophages. Furthermore, our study illustrated that LM11A-31 alone and/or in combination with darunavir significantly suppress pro-inflammatory cytokines including IL-1β, IL-8, IL-18, and TNF-α and chemokines MCP-1 in HIV-induced macrophages. The suppression of these cytokines and chemokines by LM11A-31 was comparable to darunavir. In contrast, LM11A-31 did not significantly alter oxidative stress, expression of antioxidant enzymes, or autophagy marker proteins in U1 macrophages. The results suggest that LM11A-31, which can cross the BBB, has therapeutic potential in suppressing HIV-1 and inflammatory response in brain reservoirs, especially in macrophages.

Inter-appointment pain (IAP) is a subtype of postoperative pain which occurs between endodontic appointments. It may begin within a few hours after the first appointment and may continue for several days. Apart from mechanical instrumentation and thorough irrigation, intracanal medicaments play a central role in the disinfection of root canals and thus decreasing IAP. The aim of this study was to evaluate the effect of Curcuma Longa as an intracanal medicament on IAP in patients with symptomatic irreversible pulpitis (SIP). One hundred healthy adult patients having SIP in one of their single-rooted maxillary or mandibular teeth participated in this randomized, parallel, single-blinded clinical trial. After thorough biomechanical preparation, the root canals were randomly medicated with one of the following medicaments, Control (no medicament), Calcium Hydroxide, triple antibiotic paste (TAP), and Curcuma Longa. The pain was recorded using Visual analog scale at 4 h, 24 h, and every day until the seventh day. Data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-rank tests. No statistical difference in pain scores was observed between Calcium Hydroxide, TAP or Curcuma Longa groups. It can be concluded that Curcuma Longa, Calcium hydroxide, and TAP are equally effective in controlling IAP.

Present study was carried out during 2021–23 at ICAR-Indian Agricultural Research Institute, New Delhi to investigate the efficacy of active edible coatings, incorporated with extracts from rose leaves and marigold petals in preserving the quality of mature green guava (Psidium guajava L.) cv. Allahabad Safeda during storage at both ambient (25±2°C) and cold (10±1°C) conditions. The coatings, particularly carboxy methyl cellulose combined with rose leaf extract (CMC+RL) demonstrated the highest effectiveness in minimizing per cent firmness reduction (PFR; 77.02% and 84.71%) compared to the control (89.95% and 89.73%) after 4 and 18 days of ambient and cold storage, respectively. Additionally, the coatings significantly influenced total soluble solids (TSS), total sugar content (TSC) and yellowness index (YI) showing potential in slowing down the fruit ripening. Moreover, the coatings demonstrated notable antioxidant activity with CMC+RL coating exhibited the highest activity. Furthermore, the coatings exhibited a substantial inhibitory effect on polygalactouronase (PG) activity, indicating a potential to mitigate cell wall degradation. Overall, the results highlight the promise of these biodegradable coatings as an alternative to synthetic preservatives in preserving postharvest quality and enhancing the shelf-life of guava fruits.

With the rapid advancement of health delivery, there has been a renewed interest in conducting research among healthcare professionals in Nepal. However, concern is there regarding availability of funds and mechanisms of awarding. The purpose of this scoping review is to map the available evidence regarding the evolution and current status of health research funding in Nepal and to highlight gaps and areas for future research. We searched three databases for empirical papers and several gray literature. Our search, conducted between March and April 2024 yielded 76 documents of which 30 that met the selection criteria were included in the scoping review. Almost all studies identified lack of funding as a deterrent to research. We found a paucity of research focusing on the role of researchers in funding decision-making. Our findings revealed that there are 12 national and four international organizations providing funds for research. University Grant Commission is the largest funder from Nepal whereas the Research Council of Norway is the biggest international funder. There were certain barriers and facilitators for obtaining funds identified by this scoping review. Further efforts are needed to increase the amount and availability of funds in Nepal to enable high-quality research.

Abstract Bibliometric analysis explores large volume of scientific data, revealing trends and insights in a specific research field. Consistently, a bibliometric analysis of 30 years (1990–2020) was performed within the US corn (Zea mays L.) production using the Scopus database and VOSviewer. Search query was performed within the article title, abstract, and keywords indicative of management practices in corn. Exclusion criterion based on subject area and journals generated a total of 7468 publications. The data analysis revealed contributions from 7327 authors and 47 organizations documented in 69 journals. The top five organizations leading the investigation were United States Department of Agriculture – Agricultural Research Service, Iowa State University, University of Nebraska, University of Illinois, and Purdue University. The most prolific authors were Dr. Rattan Lal (Ohio State University, Columbus, OH), Dr. Douglas L. Karlen (USDA‐ARS, Ames, IA), Dr. Kenneth G. Cassman (University of Nebraska, Lincoln, NE), Dr. Lajpat Rai Ahuja (USDA‐ARS, Ft. Collins, CO), and Dr. John Walsh Doran (USDA‐ARS, Lincoln, NE). Journals with most publications were Agronomy Journal; Soil Science Society of America Journal; Soil and Tillage Research; Crop Science; and Agriculture, Ecosystems & Environment. Furthermore, author keywords differed from queried keywords, and no‐till, nitrogen, cover crop, soybean, irrigation, phosphorus, conservation tillage, yield, and water quality were most prominent. Moreover, there was an evident shift in keywords and an observed trend between 1998 and 2020. Overall, these findings allow researchers to explore network maps via the hyperlinks present in papers, identifying research gaps and advancing original studies to bridge gaps in the literature.

Abstract Endophytes are microorganisms that inhabit various plant parts and cause no damage to the host plants. During the last few years, a number of novel endophytic fungi have been isolated and identified from medicinal plants and were found to be utilized as bio-stimulants and bio fertilizers. In lieu of this, the present study aims to isolate and identify endophytic fungi associated with the leaves of Anisomeles indica L. an important medicinal plant of the Terai-Duars region of West Bengal. A total of ten endophytic fungi were isolated from the leaves of A. indica and five were identified using ITS1/ITS4 sequencing based on their ability for plant growth promotion, secondary metabolite production, and extracellular enzyme production. Endophytic fungal isolates were identified as Colletotrichum yulongense Ai1, Colletotrichum cobbittiense Ai2, Colletotrichum alienum Ai2.1, Colletotrichum cobbittiense Ai3, and Fusarium equiseti. Five isolates tested positive for their plant growth promotion potential, while isolates Ai4. Ai1, Ai2, and Ai2.1 showed significant production of secondary metabolites viz. alkaloids, phenolics, flavonoids, saponins, etc. Isolate Ai2 showed maximum total phenolic concentration (25.98 mg g−1), while isolate Ai4 showed maximum total flavonoid concentration (20.10 mg g−1). Significant results were observed for the production of extracellular enzymes such as cellulases, amylases, laccases, lipases, etc. The isolates significantly influenced the seed germination percentage of tomato seedlings and augmented their growth and development under in vitro assay. The present work comprehensively tested these isolates and ascertained their huge application for the commercial utilization of these isolates both in the agricultural and industrial sectors.

With the growth of IoT, a vast number of devices are connected to the web. Consequently, both users and devices are susceptible to deception by intruders through malicious links leading to the disclosure of personal information. Hence, it is essential to identify suspicious URLs before accessing them. While numerous researchers have proposed several URL detection approaches, the machine learning-based technique stands out as particularly effective because of its ability to detect zero-day attacks; however, its success depends on the type and dimension of features utilized. In earlier research, only the lexical features of URLs were employed for classification to attain high detection speeds. However, this approach does not allow for the retrieval of comprehensive information about a website. Hence, to enhance the security of IoT devices, both lexical and page content-based features of URLs must be considered. To improve the performance of the model, the researchers extract informative features using different Feature Selection Techniques (FSTs), including filter and wrapper methods. However, challenges such as the demand for more resources, time, and handling of high-dimensional datasets encountered by individual FSTs have driven the development of hybrid FSTs. Nevertheless, the combination of a filter-based FST and a wrapper search-based Genetic Algorithm (GA) is used in the identification of malicious URLs as well as the detection of malicious links in the IoT devices research studies. Therefore, the proposed approach leverages the advantages of a variety of features and explores a hybrid FST to produce the optimal feature subset to evaluate the boosting estimators with specific hyperparameter configurations. Our proposed approach effectively fills the research gap associated with previous methodologies research 99% while keeping the computational costs minimal, making it suitable for resource-constrained devices in detecting malignant URLs.

Context: In wound management, traditional use of plants has received attention by the scientific community, as traditional medicines are a valuable source of affordable, comprehensive medical care. Azadirachta indica A. Juss (Neem) and Nigella sativa Linn (Black cumin) are well-known versatile medicinal plants with wide spectrum of biological activity. Methods: This study was undertaken to evaluate the wound healing activity of neem oil (NO) and black cumin oil (BCO) in rats. The oils were standardized using standard procedures. Gas chromatography mass spectrometry analysis and high-performance thin-layer chromatography fingerprinting of oils were carried out to identify major phytoconstituents present in the oils. The oils were suitably incorporated in carbopol-based emulgel formulation, evaluated for physicochemical parameters and stability. Results: The wound healing potential assessed by the measurement of wound contraction and histopathology studies in excision and burn wound models, demonstrated comparable efficacy with standard nano-crystalline silver gel (0.002% w/w). This may be attributed to the presence of phytoconstituents such as nimbidin and thymoquinone present in selected oils. Polyunsaturated fatty acid profile of BCO may be responsible for stimulating the release of vascular endothelial growth factor, which plays a significant role in accelerating wound healing process. Conclusion: Topical carbopol-934 base emulgel containing natural oils such as BCO and NO have been successfully prepared for wound management. However, further studies to establish the mechanistic aspects of wound healing needs to be undertaken.

Abstract Introduction While multiple treatments are available for moderate to severe psoriasis, patient preferences are rarely systematically studied. This study aims to identify factors associated with choice of a new once-daily oral psoriasis treatment, elicit patient views on treatment characteristics, and rank treatment characteristics by importance. Methods This noninterventional, cross-sectional survey study, conducted from December 2021 to June 2022, recruited US adults with moderate to severe psoriasis. Demographics, clinical characteristics, and perspectives on psoriasis treatment were collected. Factors associated with the choice of a new oral treatment were identified using multivariable logistic regression analysis. Treatment characteristics and reasons for treatment choice were ranked using bivariate comparisons. Results The study included 882 participants [mean (standard deviation; SD) age, 45.7 (12.8) years; female, 67.7%; White, 74.9%]; 92.7% were currently receiving treatment [mean (SD) duration, 2.9 (4.8) years]. Half of participants rated their psoriasis symptoms over the past week as mild, very mild, or nonexistent; 36.5% as moderate; and 12.7% as severe or very severe. Most (66.5%) indicated willingness to start a new oral treatment; 65.0% indicated that the new oral treatment would cause less anxiety than injections/infusions. Participants were significantly more likely to start the new oral treatment if they were currently receiving a tumor necrosis factor inhibitor [odds ratio (OR): 2.1, 95% confidence interval (CI): 1.4–3.1] or ustekinumab (OR: 2.7, 95% CI: 1.6–5.0) versus apremilast (P

Background: Globally, Breast cancer is the commonest malignancy among women. Neoadjuvant chemotherapy (NACT) is the treatment of choice for patients with locally advanced breast cancer. Pathological evaluation of tumor size remains the gold standard for evaluation of residual tumor after chemotherapy.1, 2 The aim of study was to evaluate histomorphological changes in the post-NACT MRM biopsies and to assess the response to chemotherapy. Method: The study was carried out over a period of one year in 30 patients of breast cancer who received neoadjuvant chemotherapy and underwent MRM. The pathological tumor response was evaluated. Observations: Mean age of presentation was 50.13 years and mean clinical size was 3.86 cm. Post MRM, residual tumor was found in 22 cases. The mean residual tumor size was 2.53 cm. Complete Pathological Response (pCR) was observed in 8 patients, partial response (pPR) developed in 19 patients and 3 patients elicited no response (pNR). The major observation was overall decrease in cellularity along with significant nuclear and stromal alterations. The common stromal changes observed was necrosis (n=24), fibrosis (n=22), desmoplasia (n=20), hyalinization of vessels (n=18) and chronic inflammatory infiltrates. Nuclear changes (n=14) and cytoplasmic vacuolations (n=11) were also observed. Presence of older age group, larger tumor size, DCIS, LVI and necrosis prior to chemotherapy indicated a poor response to treatment. Conclusion: Each patient responds differently to the NACT based on numerous factors like age, tumor size and tumor morphology. Hence, the pathologists must be aware of the vast array of histomorphological changes seen in breast post-NACT. Keywords: Breast cancer, Neo­Adjuvant Chemotherapy (NACT), Pathological response, Histomorphology, Modified radical mastectomy (MRM)

Background/Objectives: The aim of this study was to estimate the effect of a 6 months’ treatment course of the innate immune modulator NP001 (a pH-adjusted intravenous formulation of purified sodium chlorite), on disease progression, as measured by overall survival (OS) in patients with amyotrophic lateral sclerosis. Methods: Blinded survival data were retrospectively collected for 268 of the 273 patients who had participated in two phase 2 placebo-controlled clinical trials of NP001 (ClinicalTrials.gov: NCT01281631 and NCT02794857) and received at least one dose of either 1 mg/kg or 2 mg/kg of NP001 as chlorite based on actual body weight, or placebo. Kaplan–Meier methods were used on the intent-to-treat population to estimate survival probabilities. Results: In the overall population, the median OS was 4.8 months (2.7 years [95% CI: 2.3, 3.5] in the 2 mg/kg NP001group and 2.3 years [95% CI: 1.8, 2.9] in the placebo group). Hazard ratio (HR): 0.77 (95% CI: 0.57, 1.03), p = 0.073. Among patients aged ≤ 65 years, the median OS for the 2 mg/kg NP001 group was 10.8 months (3.3 years [95% CI: 2.4, 3.8] in the 2 mg/kg NP001 group and 2.4 years [95% CI: 1.7, 3.3] in the placebo group). HR: 0.69 (95% CI: 0.50, 0.95). No differences were observed in the 1 mg/kg NP001 group or in patients aged > 65 years. Conclusions: The findings from this study suggest that a 6 months’ treatment course of NP001 resulted in a 4.8-month increase in overall survival in patients with ALS. The findings from this study indicate that targeting inflammation associated with the innate immune system may provide a pathway for new therapeutic options for the treatment of ALS.

The need for ending plastic waste and creating a circular economy has prompted significant interest in developing a new family of composite materials through recycling and recovery of waste resources (including bio-sourced materials). In this work, a family of natural fiber-reinforced plastic composites has been developed from paint pail waste recycled polypropylene (rPP) and waste wool fibers of different diameter and aspect ratio. Composites were fabricated by melt processing using polypropylene-graft-maleic anhydride as a compatibilizer. The internal morphology, interfacial and thermal characteristics, viscoelastic behavior, water sorption/wettability, and mechanical properties of composites were studied using electron microscopy, high-resolution synchrotron Fourier transform infrared microspectroscopy, thermal analysis, rheology, immersion test, contact angle measurement, tensile test and flexural test. The composite matrix exhibited an internal morphology of coalescent micro-droplets due to the presence of polyethylene and dry paint in the rPP phase. In general, the rheological and mechanical properties of the composites comprising higher-aspect-ratio (lower diameter) fibers exhibited relatively superior performance. About an 18% increase in tensile strength and a 39% increase in flexural strength were measured for composites with an optimal fiber loading of 10 wt.%. Interfacial debonding and fiber pull-out were observed as the main failure mechanism of the composites. The developed composites have potential for applications in automotive, decking, and building industries.

In the early postpartum period, acute life-threatening problems can occur and cause maternal morbidity and mortality. In the present case report, a 19-year-old primipara had undergone caesarean delivery following which she developed breathlessness, tachycardia and fall in oxygen saturation after 14 hours of surgery. Her Chest X-Ray (CXR) report confirmed a complete collapse of the left lung. Contrast-enhanced Computed Tomography (CECT) of the thorax showed a complete collapse of the left lung due to obstruction at the level of the proximal main stem bronchus. Medical management with mucolytics was administered. The patient showed improvement clinically and a repeat CXR after 24 hours showed normal lung findings with complete resolution of collapse and medical management was continued. The patient recovered progressively and follow-up of the patient was uneventful. This is a rare case of development of respiratory distress and atelectasis, hence proper diagnosis is essential.

Objective: To assess and analyse the pattern of dental treatment services and their characteristics provided to children by evaluating the clinical use of materials and prevalence in material research in a major postgraduate paediatric tertiary care hospital in India over three years. Material and Methods: Institutionally approved retrospective analysis was conducted by auditing the clinical records of 2644 patients who visited and had treatment in the Outpatient and Inpatient Department of Paedodontics and Preventive Dentistry from January 2017 to December 2019. Clinical logbooks of postgraduate students were analysed by crosschecking with the department's data warehouse. Results: Out of the 2644 children who had treatment, more than two-thirds of them were in the age group of 4-7 years old. Around 5.6% of the patients were specially-abled children. Extraction (33.5%) was the most common treatment, followed by restorative treatment (29.1%). Endodontic treatment had a prevalence of 19.8%, with a reduced prevalence of preventive treatment care (0.5%). Patients who had traumatic tooth management included 2.8% of the study population. The prevalence of preventive care was found to be 2.1%. The teaching curriculum with theoretical and clinical skill practices was under the country's assigned authority. Conclusion: Despite advancements in paediatric dentistry, more children had extraction treatment with less observed utilization of preventive care. The widening of the training prospectus includes comprehensive care and an amplified focus on preventive care in the academic curriculum of paediatric postgraduates, which is the need of the hour.

A field experiment was conducted during the rainy (kharif) and winter (rabi) seasons of 2019–20 and 2020–21 at research farm of ICAR-Indian Agricultural Research Institute, New Delhi to study the effect of various crop establishment methods and microbial consortia (Pusa decomposer) mediated in situ rice straw management options on zinc (Zn) concentration and uptake in rice (Oryza sativa L.) (cv. Pusa Basmati 1509) and wheat (Triticum aestivum L.) (cv. HD 2967). The experiment was laid out in split-plot design (SPD) with 3 replications having 2 main plot (main factor) treatments, viz. aerobic rice (AR); and conventional transplanted (CT) rice in wet season; and 7 sub- plot (sub-factor) treatments, viz. Clean cultivation (removal of paddy straw); Paddy straw incorporation (PSI); Paddy straw mulching (PSM); PSI + Pusa decomposer (PD); PSM + PD; PSI + urea @20 kg/ha; and PSI + PD + urea @10 kg/ha in dry season. Findings showed that, in rice the zinc concentration (18.51 and 20.30 mg/kg in grain; 57.02 and 57.81 mg/kg in straw) and uptake (78.38 and 89.81 g/ha in grain; 427.1 and 434.6 g/ha in straw) were significantly superior in CT rice than AR in main plots during both the years of experiments. However, sub-plot treatments were non-significant in the zinc concentration and uptake. In wheat, among in situ rice straw management options (sub- plots), paddy straw incorporation + Pusa decomposer + Urea @10 kg/ha treatment significantly resulted in higher Zn concentration (38.08 and 39.03 mg/kg in grain; 28.24 and 29.01 mg/kg in straw) and uptake (185.0 and 191.9 g/ha in grain; 234.2 and 242.6 g/ha in straw) compared to other treatments and control (clean cultivation). The principal component analysis revealed that Zn uptake positively correlated with straw and grain yields in rice and wheat. Thus, the same treatment was found to be a better option for higher Zn concentration and uptake in the rice-wheat cropping system.

Background: By increasing fluidity and conversion, pre-heated composites enhance adaptability and strength, while soft-start polymerization decreases internal stresses. Aim: Over a period of a year, this split-mouth design, randomized controlled clinical trial (RCT) compared pre-heated composites with soft-start polymerization to conventional composites in class-I lesions, with the goal of improving restoration outcomes. Methods: and Findings: Immediately following ethical approval and registration with CTRI, 37 patients with in-formed permission who met specified inclusion and exclusion criteria for class-I lesions were chosen for enrollment. Using a 1:1 ratio, teeth were randomly assigned to Group-A (pre-heated composite with soft-start polymerization) or Group-B (traditional composite restoration). At three-time intervals, the evaluation was blinded and calibrated using Modified United States Public Health Service (USPHS) criteria: baseline, six-month, and one-year marks. Statistical analysis was performed using SPSS 21.0 and the Mann-Whitney U test for inter-group comparisons and the Friedman test for intra-group comparisons. Interpretation: Pre-heated composites with soft-start polymerization performed better in terms of marginal adaptation with a statistically significant difference (p = 0.019) and in terms of color match they performed better clinically (p = 0.062) at 12 months. Other variables like marginal discolouration, sec-ondary caries, anatomic form, post-operative sensitivity, surface texture and retention showed no statistically significant difference (p