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Abstract 3D bioprinting has excellent potential in tissue engineering, regenerative medicine, and drug delivery systems due to the ability to fabricate intricate structures that are challenging to make with conventional manufacturing methods. However, the complexity of parametric combinations and lack of product quality control have restricted soft hydrogel bioprinting from practical applications. Here we show an in-situ ultrasound monitoring system that reveals the alginate-gelatin hydrogel’s additive manufacturing process. We use this technique to understand the parameters that influenced transient printing behaviors and material properties in approximately real-time. This unique monitoring process can facilitate the detection of minor errors/flaws during the printing. By analyzing the ultrasonic reflected signals in both time and frequency domains, transient printing information can be obtained from 3D printed soft hydrogels during the processes with a depth subwavelength resolution approaching 0.78 $$\lambda$$ λ . This in-situ technique monitors the printing behaviors regarding the constructed film, interlayer bonding, transient effective elastic constant, layer-wise surface roughness (elastic or plastic), nozzle indentation/scratching, and gravitational spreading. The simulation-verified experimental methods monitored fully infilled printing and gridded pattern printing conditions. Furthermore, the proposed ultrasound system also experimentally monitored the post-crosslinking process of alginate-gelatin hydrogel in CaCl2 solution. The results can optimize crosslinking time by balancing the hydrogel’s stiffness enhancement and geometrical distortion.

Abstract The Staphylococcus aureus (S. aureus) one of the important food borne pathogen from milk, which was investigated in this study. The isolates were screened for antimicrobial resistance, enterotoxin genes, biofilm formation, spa typing, coagulase gene polymorphism and accessory gene regulator types. The prevalence of S. aureus in milk samples was 34.4% (89/259). Methicillin resistant S. aureus (MRSA) was found at 27% (24/89) of the isolates, were classified as community acquired based on SCCmec typing. The 24.71% (22/89) isolates demonstrated multiple antimicrobial resistance (MAR) pattern. However, none of the isolates carried vancomycin and mupirocin resistance genes. The isolates were positive for sea and sed enterotoxin genes and exhibited high frequency of biofilm formation. The High-Resolution Melting and conventional spa typing revealed that the isolates had both animal and community-associated S. aureus clustered origins. Coagulase gene polymorphism and agr typing demonstrated variable genotypic patterns. The finding of this study establishes the prevalence of community associated, enterotoxigenic, biofilm forming and antimicrobial resistance among S. aureus from milk in Chennai city. This emphasizing a potential threat to public health which needs a continuous monitoring system and strategies to mitigate their spread across the food chain and achieve food safety.

Abstract Brainstem cerebral cavernous malformations (CCM) are clinically more aggressive compared to superficial CCMs. Due to their location, resection can be challenging, making stereotactic radiosurgery (SRS) an attractive alternative for symptomatic patient. Brainstem CCM patients (n = 170) were treated with Gamma Knife SRS at 11 radiosurgical centers. Hemorrhagic risk reduction, risk factors of post-SRS hemorrhage, and clinical outcomes were retrospectively analyzed. Most patients had a single (165/170 patients) brainstem CCMs treated; the majority of CCMs (165/181) presented with bleeding. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM (HR: 0.17, p 13 Gy (HR = 2.57, p = 0.044). Adverse radiation effect (ARE) occurred in 9 patients (5.3%) and was symptomatic in four (2.4%). At a median follow-up of 3.4 years (Inter-quartile range: 5.4), 13 patients (8.0%) had a worsened clinical status, with the treated CCM being the cause in 5.6% (10) of the patients. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM and conveyed this benefit with a low risk of advrse radiation effects (ARE) and worsening clinical status.

Abstract A novel method for discovery of adulteration in edible oil is proposed based on concept of refractive index and electronic sensors. The research work focusses on two distinct methodologies like employing datasets and implementing a fumigation technique that integrates real-time hardware for testing Edible oil Impurities. In the first method, the dataset taken into consideration contains spectral data collected using Advanced ATR-MIR Spectroscopy for pure oil and various levels of adulteration with Vegetable oil. Each and every edible oil has a certain value of refractive index. When such oils are contemned in a change adding adulterants, the value of its refractive indices also changes. This value of refractive index serves as a feature for testing the oil and helps us in detecting the adulteration. If Oil is adulterated with vegetable oils, the refractive index will be lower and with animal fats, the refractive index will be higher than that of pure Oil. While in Fumigation Method a hardware module is develop in which adulterated & pure oil samples are heated at 40–50 °C for 4.66 min and the volatiles that are generated by varying gas concentrations are forcefully passed through to the MEMS Gas Sensor-MISC-2714 and Multichannel Gas sensor. The conductance of the sensors changes according to the gases sensed by the sensors contributes to features extraction. The conductance value serves as a feature for the classifier to determine whether the sample is highly, moderately, or lowly contaminated. Thus, in proposed methods we use different algorithms based on machine learning like KNN, Random Forest, CATBOOST and XGBOOST to accurately reveal the adulteration. Amongst all the applied algorithm Random Forest (RF) Classifier & XGBOOST algorithm outperform well and gives 100% accuracy. The proposed work is used for identifying food adulteration in edible food products which helps us to feed Society with high-quality food.

Background/Objectives: Left ventricular diastolic dysfunction (LVDD) and elevated left ventricular filling pressure (LVFP) are strong predictors of clinical outcomes across various populations. However, their diagnostic utility in embolic stroke of undetermined source (ESUS) remains unclear. We hypothesized that LVDD with elevated LVFP (based on echocardiography) was more likely to be prevalent in ESUS compared to non-cardioembolic stroke (NCE) and to be associated with atrial fibrillation (AF) on follow-up monitoring. Methods: This is a single-center retrospective study that included adult patients with a diagnosis of acute ischemic stroke between January 2016 and June 2017. LV function was assessed by inpatient transthoracic echocardiogram (TTE), and stroke etiology was adjudicated by the neurologist per the consensus criteria. Patients with cardioembolic stroke and those with indeterminate diastolic function on TTE were excluded. Baseline patient characteristics and clinical variables were compared among patients with and without LVDD and elevated LVFP. Multivariable regression models were used to assess the associations between diastolic dysfunction, ESUS, and AF detection in ESUS patients. Results: We identified 509 patients with ESUS and NCE stroke who had reported diastolic function. The mean age was 64.19 years, 45.19% were female, and 146 had LVDD with available LVFP data. LVDD was not associated with ESUS (adjusted OR: 1.43, 95% CI: 0.90–2.27, p = 0.130) or atrial fibrillation (AF) detection on cardiac monitoring (adjusted OR: 1.88, 95% CI: 0.75–4.72, p = 0.179). However, LVDD with elevated LVFP was borderline associated with ESUS (adjusted OR: 2.17, 95% CI: 0.99–4.77, p = 0.054) and significantly associated with AF detection (adjusted OR: 3.59, 95% CI: 1.07–12.06, p = 0.038). Conclusions: Our data suggest that LVDD with elevated LVFP is borderline associated with ESUS and significantly associated with AF detection on follow-up cardiac monitoring. Therefore, the presence of LVDD with an increased probability of elevated LVFP may help identify a subset of stroke patients more likely to have ESUS, potentially due to atrial cardiopathy with underlying occult AF. Further studies are needed to confirm our findings and to evaluate the safety and efficacy of anticoagulation in patients with ESUS and LVDD with elevated LVFP.

Abstract With the rapid growth of the agricultural information and the need for data analysis, how to accurately extract useful information from massive data has become an urgent first step in agricultural data mining and application. In this study, an agricultural question-answering information extraction method based on the BE-BILSTM (Improved Bidirectional Long Short-Term Memory) algorithm is designed. Firstly, it uses Python’s Scrapy crawler framework to obtain the information of soil types, crop diseases and pests, and agricultural trade information, and remove abnormal values. Secondly, the information extraction converts the semi-structured data by using entity extraction methods. Thirdly, the BERT (Bidirectional Encoder Representations from Transformers) algorithm is introduced to improve the performance of the BILSTM algorithm. After comparing with the BERT-CRF (Conditional Random Field) and BILSTM algorithm, the result shows that the BE-BILSTM algorithm has better information extraction performance than the other two algorithms. This study improves the accuracy of the agricultural information recommendation system from the perspective of information extraction. Compared with other work that is done from the perspective of recommendation algorithm optimization, it is more innovative; it helps to understand the semantics and contextual relationships in agricultural question and answer, which improves the accuracy of agricultural information recommendation systems. By gaining a deeper understanding of farmers’ needs and interests, the system can better recommend relevant and practical information.

Abstract Orbital tuberculosis is a rare form of extra pulmonary TB and may arise either by hematogenous route or spread directly from the paranasal sinus. We herein report two cases of orbital TB with a vision threatening complication. Case-1 is a 31-year-old female with a headache, a diminution of vision in the right eye, and pain in ocular movement. On examination, there was no proptosis with RAPD present in right eye and tenderness on palpation. CEMRI revealed a diffuse infiltrating lesion at the orbital apex, suggesting of inflammatory pathology. Case-2 is a 40-year-old male with similar complaints in the left eye, CECT showed edema and swelling in the optic nerve and extraocular muscle of the left eye. A detailed investigation was done, and a diagnosis of orbital tuberculosis was made in both patients. They were started on ATT and oral steroids but lost follow-up initially and due to delayed treatment, it led to irreversible vision loss. A long-term follow-up showed resolution of ocular symptoms with occasional headaches.

Background: Renal artery stenosis (RAS) is a significant cause of resistant hypertension, especially in patients presenting with comorbidities. Revascularization has been initially recommended to treat resistant hypertension due to RAS. However, recent studies have shown modest benefits for blood pressure control over medical therapy only. There is limited data on revascularization in patients with resistant hypertension and RAS, particularly in patients with a high cardiovascular risk profile. Materials and Methods: A systematic review of case reports was conducted to summarize the outcomes of revascularization in patients with resistant hypertension and RAS. The search was conducted through the Medline database (2013–2023) and was able to identify nine relevant reports documenting ten cases. Data on patient characteristics, blood pressure (BP), renal function, and antihypertensive medications before and after revascularization were extracted and analyzed descriptively. Results: The average age of patients was 60.4 years, with an equal distribution of male and female cases. Following revascularization, systolic BP decreased from 170 mmHg (± 29.69) to 126 mmHg (± 3.53), and diastolic BP from 96 mmHg (± 16.97) to 74 mmHg (± 7.07). The average number of antihypertensive medications reduced from four to two. Renal function also improved in all cases where creatinine and eGFR data were reported. Conclusions: Revascularization in RAS showed its benefit in lowering BP and medication burden, along with improving renal function in select cases. Decision for revascularization should be tailored to each patient while considering its potential risks and benefits.

Background: The transversus abdominis plane (TAP) block and local anesthetic wound infiltration have been used to relieve pain after laparoscopic cholecystectomy. This study investigated whether the subcostal transversus abdominis block was superior to traditional port-site infiltration of local anesthetic in reducing post-operative pain, opioid consumption, and time for recovery. Aim and Objectives: To investigated whether the subcostal transversus abdominis block is superior to traditional port-site infiltration of local anesthetic in reducing post-operative pain, opioid consumption, and time for recovery. Materials and Methods: All patients were randomly assigned to two equal groups (n=30) using computer-generated randomization. Patients in Group 1 (TAP group) received a TAP block by administration of 10 mL of 0.5% bupivacaine on each side just before completion of surgery, and patients in Group 2 (local wound infiltration [LWI] group) received 10 mL of 0.5% bupivacaine as a local infiltrate at the local site just before completion of surgery. The pain was measured using a Visual Analog Scale (VAS) at intervals of 30 min to 24 h after the procedure. Results: The mean VAS score was significantly lower in group 1 as compared to group 2 at 2 h and 4 h. Whereas the VAS score was not significantly different post-operative 30 min, 6 h, 12 h, and 24 h. The mean first rescue analgesia was significantly more in Group 1 than in Group 2 (P

Traction Energy Asia 2020 reported that 3 million kilolitres of WCO were collected in Indonesia in 2019, 1.6 million kilolitres from urban households. WCO poses risks due to common reuse or disposal. Repurposing for MES surfactant is vital. Hence, this study aims to produce an MES surfactant from WCO feedstock using NaHSO3 as a microwave-assisted reactant by observing the influence of variables such as reactant mole ratio, catalyst concentration, sulfonation reaction time, and microwave power. The adsorption method involves vacuum filtration of WCO to remove impurities, mixing with activated carbon, and settling before a second filtration. Transesterification transforms WCO into methyl ester through mixing with methoxide solution with a molar ratio of methanol to WCO of 1:9 and a 1 wet% NaOH catalyst based on WCO, followed by washing and drying. Sulfonation involves reacting methyl ester with NaHSO3 (1:1, 1:2, 1:3, 1:4) and CaO catalyst (1%, 1.5%, 2%, 2.5%). The reaction occurs in a microwave at power variations of 300, 450, 600, and 750 Watts, as well as with variations in time of 20, 30, 40, 50, and 60 minutes. After that, it ends with purifying and neutralizing to produce MES. The optimal conditions for MES production are a 1:2 molar ratio of reactants, 1.5% CaO catalyst concentration, 20 minutes, and 450 W, yielding 48.06%. MES characteristics: pale yellow color, density of 0.859 g/cm3, viscosity of 1.780 cSt, and surface tension of 32.62 dyne/cm. FTIR analysis confirms sulfonic acid groups at 1195.27 cm−1 and 1169.1 cm−1 wavelengths.

Abstract Objective Carotid artery web is a possible cause of ischemic stroke, especially in young patients who lack conventional risk factors. The immediate and long‐term outcomes are not well studied. We aimed to determine the association between an ipsilateral carotid web and in‐hospital stroke recurrence. Methods We analyzed data from adult patients admitted with an acute anterior circulation large vessel occlusion at a Comprehensive Stroke Center between July 2015 and March 2023. The primary outcome was in‐hospital stroke recurrence and secondary outcome was in‐hospital recurrent LVO. Multivariable logistic regression was performed to examine the association between ipsilateral carotid web and recurrent ischemic stroke and recurrent LVO. Results Of the 1463 patients with anterior circulation large vessel occlusion, 27 (1.8%) had an ipsilateral carotid artery web. Patients with carotid web were younger (median age (IQR), 60 years (53–67 years) versus 74 years (62–84 years), P

Microplastics (MPs) have emerged as one of the global principal marine environmental problems in many countries, including Indonesia. However, fewer studies have been conducted on the MP impact on aquatic organisms. Thus, the present case study aimed to investigate the presence of MPs in mangrove sediments and coral reef fish in Biawak Island, West Java, Indonesia.

Background: Orbital cellulitis is an acute inflammatory disorder of the orbit. It results from an acute infection spread from the blood, adjacent sinuses and facial skin. Cavernous sinus thrombosis (CST) typically occurs due to an infection originating from regions such as the face, sphenoid and ethmoid sinuses, or the oral cavity. Case report: An eleven-year-old girl was brought by her parents to our hospital with a complaint of right nasal discharge and fever for the last 10 days. She developed right-sided periorbital oedema for the past six days. She was under treatment at a local hospital. After that her parents noticed an increase in swelling associated with redness in her right peri-orbital region, so she came to our hospital. MRI brain showed changes of cavernous sinus thrombosis. A functional endoscopic sinus surgery (FESS) was performed for right nasal blockage on the second day of admission and about 10 ml of pus was drained. Fragmented fibrovascular tissue bits received from the frontal sinus and maxillary sinus revealed numerous pus cells with Gram-positive bacterial cocci on the third day. She responded to treatment as she was without fever by the day fourth on admission. The aerobic culture of the pus swab was positive and the organism detected was staphylococcus aureus on the eighth day after admission. Conclusion: Cavernous sinus thrombosis is a serious complication of orbital cellulitis with high morbidity and mortality. Unusually, orbital cellulitis occurs as sequelae of cavernous sinus thrombosis. Gram-positive bacteria noted on the nasal lesion's histopathology helped in starting antibiotics in the patient before the culture report was positive.

Abstract Silver nanoparticles (AgNPs) have been successfully synthesized using leaf extract of Neem (Azadirachta Indica), Mint (Mentha Piperita), Tulsi (Ocimum Tenuiflorum), Bermuda grass (Cynodon Dactylon) and silver salt. As plant extracts produce best capping material for the stabilization of nanoparticles. AgNPs were characterized by UV–Vis spectroscopy in range of 200–800 nm and transmission electron microscopy TEM, XRD and FTIR. The nanoparticles synthesized were mainly in sizes between 25 and 100 nm. They appeared to be spherical, nanotriangles and irregular in shape. Catalytic application was observed for all the aqueous solution of leaves, quantity taken was 1 ml, 2 ml, 3 ml, 4 ml and 5 ml. Furthermore, prepared Ag nanoparticles are also used for seed germination.

Abstract Background The healthcare system in India is tiered and has primary, secondary and tertiary levels of facilities depending on the complexity and severity of health challenges at these facilities. Evidence suggests that emergency services in the country is fragmented. This study aims to identify the barriers and facilitators of emergency care delivery for patients with time-sensitive conditions, and develop and implement a contextually relevant model, and measure its impact using implementation research outcomes. Methods We will study 85 healthcare facilities across five zones of the country and focus on emergency care delivery for 11 time-sensitive conditions. This implementation research will include seven phases: the preparatory phase, formative assessment, co-design of Model “Zero”, co-implementation, model optimization, end-line evaluation and consolidation phase. The “preparatory phase” will involve stakeholder meetings, approval from health authorities and the establishment of a research ecosystem. The “formative assessment” will include quantitative and qualitative evaluations of the existing healthcare facilities and personnel to identify gaps, barriers and facilitators of emergency care services for time-sensitive conditions. On the basis of the results of the formative assessment, context-specific implementation strategies will be developed through meetings with stakeholders, providers and experts. The “co-design of Model ‘Zero’” phase will help develop the initial Model “Zero”, which will be pilot tested on a small scale (co-implementation). In the “model optimization” phase, iterative feedback loops of meetings and testing various strategies will help develop and implement the final context-specific model. End-line evaluation will assess implementation research outcomes such as acceptability, adoption, fidelity and penetration. The consolidation phase will include planning for the sustenance of the interventions. Discussion In a country such as India, where resources are scarce, this study will identify the barriers and facilitators to delivering emergency care services for time-sensitive conditions across five varied zones of the country. Stakeholder and provider participation in developing consensus-based implementation strategies, along with iterative cycles of meetings and testing, will help adapt these strategies to local needs. This approach will ensure that the developed models are practical, feasible and tailored to the specific challenges and requirements of each region.

Bioremediation, an advanced and environmentally sustainable technology, utilizes biological microorganisms to mitigate pollution. This review combines insights from two perspectives: one focusing on the mechanisms, applications, and types of bioremediation, and the other examining the transformative potential of integrating Internet of Things (IoT), Artificial Intelligence (AI), and biosensors in pollution management. The first perspective delves into the effectiveness of bioremediation in decomposing and detoxifying hazardous substances, emphasizing its cost-effectiveness and eco-friendliness compared to conventional methods. In-situ and ex-situ bioremediation methods are analyzed, along with intrinsic and engineered techniques, and phytoremediation strategies for heavy metal removal. The review underscores the growing importance of bioremediation in addressing industrial effluents, contaminated soils, and groundwater, with future advancements expected to enhance its efficiency and applicability. From the second perspective, recent advancements in IoT, AI, and biosensors are explored for their potential to revolutionize bioremediation and waste management. IoT facilitates real-time monitoring and remote management, AI enhances data analysis and predictive modelling, and biosensors contribute to precise pollutant detection and environmental monitoring. The review highlights the synergistic integration of these technologies, presenting smart bioremediation systems with real-time feedback loops and adaptive capabilities. Together, these technologies offer scalable solutions for environmental pollution mitigation, marking a significant stride towards sustainable environmental management.

Recurrent pulmonary infections starting from childhood often prompt evaluation for primary immunodeficiency disorders (PIDs). Hyper IgE syndrome (HIES) is a less common PID characterised by recurrent skin and pulmonary infections associated with elevated IgE levels. Staphylococcal infections are more commonly seen in these individuals, resulting in structural lung abnormalities such as pneumatoceles and bronchiectasis. The associated non-immunologic features (characteristic facies, retained primary dentition, scoliosis, osteopenia, and hyperextensible joints) should raise suspicion of this syndrome. We present four cases of HIES and review the pulmonary manifestations in this disease as reported in the Indian literature.

Context: Internet addiction (IA) is a rising issue, particularly among university students. The presence of comorbid psychiatric distress can worsen the impact of IA on academic and social functioning. Alexithymia, difficulty recognizing and expressing emotions may play a role in this relationship. Aims: This study aimed to assess the severity and association of IA, psychological distress, and alexithymia among undergraduate medical students in India. Settings and Design: This was a cross-sectional study of 380 undergraduate medical students following convenience sampling, studying in Mysore Medical College and Research Institute (MMCRI), Mysuru. Subjects and Methods: Sociodemographic details were collected, and participants completed the Young's Internet Addiction Test (IAT-20), Depression, Anxiety, and Stress Scale-21 (DASS-21), and Toronto Alexithymia Scale-20 (TAS-20). Statistical Analysis: Statistical analysis was performed using SPSS-20. Descriptive statistics expressed as frequencies, means, and percentages. Qualitative data were analyzed using the Chi-square test to find out the association between two categorical variables. Spearman's rank correlation test was used to find the correlation involving ordinal variables. Statistical significance was set at p

Background and Aims: None of the clinical difficult airway predictors are 100% sensitive and specific. Ultrasound is being used for airway assessment, but there is still no established parameters or model to predict difficult laryngoscopy. This observational study was planned to determine the predictive ability of clinical and sonography-based airway assessment parameters for difficult laryngoscopy and intubation. Material and Methods: A total of 130 patients of 18–60 years of age undergoing elective intubation were included. The distribution of Cormack–Lehane (CL) grade and intubation difficulty scale (IDS) was correlated with the clinical and sonographic screening parameters for difficult airways. Results: The prevalence of difficult laryngoscopy and difficult intubation in our study was 17.6% and 11.5%, respectively. Mallampati grade (MMG), upper lip bite test (ULBT), neck circumference, hyomental distance ratio (HMDR), tongue thickness (TT), skin to epiglottis/epiglottis to vocal cord distance (SED/E-VC), and mandibular condylar mobility (MCM) had significant association with the difficult laryngoscopy and MMG, neck circumference, SED, SED/E-VC; MCM had significant association with the difficult intubation. The combination of these predictors showed better diagnostic ability for difficult airways. Model 1 based on ultrasound parameters showed an area under the curve (AUC) of 0.848 (CI- 0.748-0.947, P value < 0.0001) and model 2 based on combined clinical and ultrasound parameters showed an AUC of 0.755 (95% CI- 0.631-0.879, P value < 0.0001). Conclusions: Ultrasound-based airway predictors can help in predicting difficult laryngoscopy and intubation along with the clinical parameters. Individual sonographic predictors have moderately satisfactory diagnostic profiles. The models based on combined tests have better diagnostic value.

Recent advancements in residential solar electricity have revolutionized sustainable development. This paper introduces a methodology leveraging machine learning to forecast solar panels’ power output based on weather and air pollution parameters, along with an automated model for fault detection. Innovations in high-efficiency solar panels and advanced energy storage systems ensure reliable electricity supply. Smart inverters and grid-tied systems enhance energy management. Government incentives and decreasing installation costs have increased solar power accessibility. The proposed methodology, utilizing machine learning techniques, achieved an R-squared value of 0.95 and a Mean Squared Error of 0.02 in forecasting solar panel power output, demonstrating high accuracy in predicting energy production under varying environmental conditions. By improving operational efficiency and anticipating power output, this approach not only reduces carbon footprints but also promotes energy independence, contributing to the global transition towards sustainability.

Abstract Introduction Reducing childhood mortality by curtailing the incidence of vaccine preventable diseases is contingent upon a robust and high-performing routine immunization system. According to the available data, the full immunization coverage (FIC) in the state of Bihar (India) has reached ~ 71%. While the government aspires to reach 90% FIC, a systematic evidence-based investigation of the reasons behind underimmunization as well as the identification of drivers and enablers to reach and sustain 90% FIC is critical. This study aimed to review the factors leading to underimmunized children in the state of Bihar and develop a forward-looking roadmap to reach and sustain 90% FIC by adopting a system strengthening approach. Method We conducted a desk review, followed by extensive stakeholder interviews and field visits to document and analyze the data and evidence relevant to routine immunization system performance in the state of Bihar. The stakeholders included the State Immunization Officer, District Immunization Officers, Block-level health officials, representatives from development agencies, healthcare workers, and caregivers. A total of eighty-six structured interviews were conducted, which included qualitative and quantitative parameters. Result While positive results were observed from the assessment of Bihar’s immunization system, the implementation of targeted strategies for supply, service delivery and demand can provide a means to achieve FIC of 90%. The roadmap developed by the Government of Bihar enlists 40 + interventions across key thematic areas and has been prioritized over a 5-year time horizon as short, medium, and long-term milestones to achieve 90% FIC. These interventions include strengthening the data availability and quality, improving the governance and review mechanism, augmenting the capacity of health workers involve with immunization programme, and initiatives to increase demand for immunization services. Conclusion The Bihar’s Immunization Roadmap development project work follows a methodical approach to assess and identify intervention to improve immunization coverage and can provide information and reference to other states and countries that are aiming to formulate similar action plans.

Abstract Remarkable advances are being made in developing interventions for eliciting long-term remission of HIV-1 infection. The success of these interventions will obviate the need for lifelong antiretroviral therapy, the current standard-of-care, and benefit the millions living today with HIV-1. Mathematical modelling has made significant contributions to these efforts. It has helped elucidate the possible mechanistic origins of natural and post-treatment control, deduced potential pathways of the loss of such control, quantified the effects of interventions, and developed frameworks for their rational optimization. Yet, several important questions remain, posing challenges to the translation of these promising interventions. Here, we survey the recent advances in the mathematical modelling of HIV-1 control and remission, highlight their contributions, and discuss potential avenues for future developments.

Introduction: Non-small cell lung cancer (NSCLC) is the leading cause of mortality globally. Early imaging detection modalities are associated with high false-positive rates and radiation exposure. A non-invasive biomarker can serve as an improvised method for early detection. MicroRNAs can serve as a potential non-invasive biomarker as they are stable in circulation, tissue or biological process-specific, easy to detect, cost-effective, and not associated with radiation hazards. This study validates circulating microRNA in NSCLC of the Indian population and studies its correlation with clinicopathological parameters. Materials and Methods: Circulating microRNA (-miR-193b, miR-301a, miR-7, and miR-25) was evaluated in 101 cases of tissue-proven NSCLC and 28 controls in serum samples. Results: There were 67 male and 34 female patients (Male: Female = 1.97:1). The age range was 25 to 86 years with a median age of 60 years. There was a significant upregulation in the expression of miR-193b in the NSCLC group as compared to controls (P = 0.034). MiR-7 was also upregulated while miR-25 and miR-301a were downregulated in NSCLC as compared to controls; however, a level of significance was not achieved. ROC curve analysis for miR-193b showed an AUC of 0.636 (95% CI, 0.522-0.750; P-value = 0.036) between NSCLC cases and controls. Conclusion: The present study showed variable expression of the above-studied miRNAs. MiR-193b showed a significant upregulation in cancer patients; however, the other three miRNAs were not conclusive. This suggests that profiling of microRNA in each population is essential to search for a valid non-invasive biomarker in that population.

Abstract Background Mild hypoxic ischemic encephalopathy is associated with sub optimal cognition and learning difficulties at school age. Although whole-body hypothermia reduces death and disability after moderate or severe encephalopathy in high-income countries, the safety and efficacy of hypothermia in mild encephalopathy is not known. The cooling in mild encephalopathy (COMET) trial will examine if whole-body hypothermia improves cognitive development of neonates with mild encephalopathy. Methods The COMET trial is a phase III multicentre open label two-arm randomised controlled trial with masked outcome assessments. A total of 426 neonates with mild encephalopathy will be recruited from 50 to 60 NHS hospitals over 2 ½ years following parental consent. The neonates will be randomised to 72 h of whole-body hypothermia (33.5 ± 0.5 C) or normothermia (37.0 ± 0.5 C) within six hours or age. Prior to the recruitment front line clinical staff will be trained and certified on expanded modified Sarnat staging for encephalopathy. The neurological assessment of all screened and recruited cases will be video recorded and centrally assessed for quality assurance. If recruitment occurs at a non-cooling centre, neonates in both arms will be transferred to a cooling centre for continued care, after randomisation. All neonates will have continuous amplitude integrated electroencephalography (aEEG) at least for the first 48 h to monitor for seizures. Predefined safety outcomes will be documented, and data collected to assess resource utilization of health care. A central team masked to trial group allocation will assess neurodevelopmental outcomes at 2 years of age. The primary outcome is mean difference in composite cognitive scores on Bayley scales of Infant and Toddler development 4th Edition. Discussion The COMET trial will establish the safety and efficacy of whole-body hypothermia for mild hypoxic ischaemic encephalopathy and inform national and international guidelines in high income countries. It will also provide an economic assessment of whole-body hypothermia therapy for mild encephalopathy in the NHS on cost-effectiveness grounds. Trial registration number NCT05889507 June 5, 2023.

Abstract Breeding high yielding groundnut cultivars with 2–3 weeks of fresh seed dormancy, particularly in Spanish-type cultivars, enhances the sustainability of agriculture in groundnuts. In this context, we conducted a comprehensive phenotypic and genotypic evaluation of advanced breeding lines developed in the genetic background of Spanish types. By employing multi-phenotyping and marker data, we identified PBS 15044, 16004, 16013, 16015, 16016, 16017, 16020, 16021, 16026, 16031, 16035, 16037, 16038, 16039, 16041, and 16042 with 2–3 weeks dormancy (> 90%).The various parametric and non-parametric estimates identified the stable fresh dormant genotypes with one or more superior economic trait. PBS 16021, 15044, 16038, and 16039 identified with high hundred pod weight (HPW) were also reported having high intensity of dormancy (> 90% for up to 3 weeks); PBS 15044, 16016, PBS 16038 and PBS 16039 with high hundred kernel weight (HKW) also reported with up to 3 weeks fresh seed dormancy; and PBS 16013, 16031, and 16038 with up to 3 weeks fresh seed dormancy had high shelling percentage (SP). They can be used to develop lines with the desired level of dormancy, and high yields, by designing appropriate breeding strategies.

Abstract Background The high prevalence of osteoporosis has increased the economic burden on the health system globally. The burden of osteoporosis and its associated factors have not been adequately assessed in community settings in the Nepalese context thus far. Therefore, this study aimed to assess the prevalence of osteoporosis and its associated factors, lifestyle behaviors, and dietary calcium intake. Methods A community-based cross-sectional study was conducted among 395 people aged 50 years and older in the Madhesh Province of Nepal between July 2022 and August 2023. The Osteoporosis Self-assessment Tools for Asians (OSTA) index was used to measure osteoporosis. A structured questionnaire was used to collect sociodemographic information, anthropometric data, lifestyle behavior, daily dietary calcium intake, and frequency of calcium-rich food consumption. A food frequency questionnaire and 24-hour recall methods were used to assess dietary intake. The chi-square test, binary logistic regression and Mann‒Whitney U test were applied to measure the association between predictors and the outcome of interest. Results The prevalence of no risk, moderate risk and high risk of osteoporosis were 38.7%, 39%, and 22.3% respectively. The risk of osteoporosis was higher in females (aOR = 5.18, CI: 2.10-12.75, p

Abstract Despite progress in reducing the infant mortality in India, the neonatal mortality decline has been slower, necessitating concerted efforts to achieve Sustainable Development Goal-3. A promising strategy aiming to prevent neonatal sepsis in high-risk, vulnerable, low birth weight neonates through an innovative intervention includes probiotic supplementation. This article communicates the decision by the ProSPoNS trial investigators to establish a Central Endpoint Adjudication Committee (CEAC) as an addendum to the protocol published in Trials in 2021 for the purpose of clarifying the primary outcome. In the published protocol, the study hypothesis and primary objective are based on “sepsis,” the primary outcome has been specified as sepsis/PSBI, whereas the sample size estimation was performed based on the “physician diagnosed sepsis.” To align all the three above, the investigators meeting, held on 17th–18th August 2023, at MGIMS Sevagram, Wardha, deliberated and unanimously agreed that “physician diagnosed sepsis” is the primary study outcome which includes sepsis/PSBI. The CEAC, chaired by an external subject expert and members including trial statistician, a microbiologist, and all site principal investigators will employ four criteria to determine “physician diagnosed sepsis”: (1) blood culture status, (2) sepsis screen status, (3) PSBI/non-PSBI signs and symptoms, and (4) the clinical course for each sickness event. Importantly, this clarification maintains consistency with the approved study protocol (Protocol No. 5/7/915/2012 version 3.1 dated 14 Feb 2020), emphasizing the commitment to methodological transparency and adherence to predefined standards. The decision to utilize the guidance of a CEAC is recommended as the gold standard in multicentric complex clinical trials to achieve consistency and accuracy in assessment of outcomes. Trial registration Clinical Trial Registry of India (CTRI) CTRI/2019/05/019197. Registered on 16 May 2019.

Background Various graft materials have been used for closure of small tympanic membrane perforations with varying success rates. This study was done to compare the success rates of endoscopic fat plug myringoplasty (EFPM) and chemical cauterization for managing small TM perforations. Methodology This was a prospective study conducted in ENT Department of a teaching hospital of western Gujarat from November 2020 to December 2022. 50 patients with small central dry perforation were randomly divided into 2 groups. 25 patients in Group A underwent endoscopic fat plug myringoplasty (EFPM) and 25 in Group B underwent trichloroacetic acid (TCA) application (chemical cauterization). At the end of 3 months (last follow-up) the perforation closure rates and hearing improvement were compared between the two groups. Results Out of 50 participants, 20 (40%) were males and 30 (60%) females. 36% participants belonged to 31-40 years of age group. The perforation closure with EFPM was significantly higher than chemical cauterization (92% vs 64%, p=0.0168) measured at 3 months follow-up. Similarly, the post operative hearing improvement was significantly better with EFPM that with chemical cauterization (p=0.0168). Conclusions EFPM is an effective method for managing small central tympanic membrane perforations. It is a day-care procedure and success rate is equal or even better than other modalities of managing small TM perforations. This method should be used more often.

Introduction Pneumococcal diseases pose a significant public health concern in India, with substantial morbidity and mortality, with the elderly and those with coexisting medical conditions being most at risk. Pneumococcus was also seen to be one of the main reasons for co-infection, pneumonia and complications in COVID. Current guidelines recommend vaccination for specific adult populations, but there is a lack of uniformity and guidance on risk stratification, prioritisation and optimal timing. Methods Nation Against Pneumococcal Infections – Expert Panel Opinion (NAP-EXPO) is a panel convened to review and update recommendations for adult pneumococcal vaccination in India. The panel of 23 experts from various medical specialties engaged in discussions and evidence-based reviews, discussed appropriate age for vaccination, risk stratification for COPD and asthma patients, vaccination strategies for post-COVID patients, smokers and diabetics, as well as methods to improve vaccine awareness and uptake. Outcome The NAP-EXPO recommends the following for adults: All healthy individuals 60 years of age and above should receive the pneumococcal vaccine; all COPD patients, regardless of severity, high-risk asthma patients, post-COVID cases with lung fibrosis or significant lung damage, should be vaccinated with the pneumococcal vaccine; all current smokers and passive smokers should be educated and offered the pneumococcal vaccine, regardless of their age or health condition; all diabetic individuals should receive the pneumococcal vaccine, irrespective of their diabetes control. Strategies to improve vaccine awareness and uptake should involve general practitioners (GPs), primary health physicians (PHPs) and physicians treating patients at high risk of pneumococcal disease. Advocacy campaigns should involve media, including social media platforms. Conclusion These recommendations aim to enhance pneumococcal vaccination coverage among high-risk populations in India in order to ensure a reduction in the burden of pneumococcal diseases, in the post-COVID era. There is a need to create more evidence and data to support the recommendations that the vaccine will be useful to a wider range of populations, as suggested in our consensus.

Background: Health-care workers (HCWs) in India have been heavily impacted by the COVID-19 pandemic, facing significant psychological distress due to their challenging work, exposure to the virus, and isolation. This study examines the emotional states and coping strategies of HCWs and the potential effects of religious coping mechanisms on their mental health. Aim: To explore the emotional state, coping strategies, and impact of religious beliefs on the mental health of junior doctors in a COVID-19-designated tertiary care hospital in Mysore. Methods: The cross-sectional survey-based observational study included residents and house surgeons working in COVID-19 wards. Sociodemographic data along with their emotional state and coping strategies were assessed using Depression, Anxiety, and Stress Scale-21 (DASS-21), Brief COPE Inventory, and the Brief Religion COPE. Chi-square test and Pearson’s correlation were used to evaluate the relationship between variables. Results: Majority (57.2%) of the participants were between 21 and 25 years and of male gender (61.6%), with Hinduism being the most prevalent religious affiliation (88.4%). Most (71.7%) tested positive for COVID-19. A significant prevalence of stress, anxiety, and depression among HCWs. Significant associations were found between stress, anxiety, and factors such as living alone, working in emergency care, substance use, and associations between religious coping and emotional status. Conclusion: The study highlighted the psychological distress faced by HCWs during the COVID-19 pandemic and proposes that religious coping techniques may help their mental health amid emergencies. Promoting an integrated strategy that incorporates psychological and religious coping mechanisms may improve health-care personnel’s overall resilience and mental well-being in the face of future challenges.

Introduction: Traumatic hemothorax is accounted for about 20% of traumatic chest injuries. Although majority can be managed with the timely placement of intercostal tube (ICT) drainage, the remaining pose a challenge owing to high complication rates associated with retained hemothorax. Although various treatment modalities including intrapleural instillation of fibrinolytics, radioimage guided drainage, VATS guided evacuation and thoractomy do exist to address the retained hemothorax, but indications along with timing to employ a specific treatment option is still unclear and ambiguous. Methods: Patient with residual hemothorax (>200 mL) on ultrasonography after 48 h of indwelling ICT was randomized into either early video-assisted thoracic surgery (VATS) or conventional approach cohort. Early VATS cohort was subjected to video-assisted thoracoscopic evacuation of undrained blood along with normal saline irrigation and ICT placement. The conventional cohort underwent intrapleural thrombolytic instillation for 3 consecutive days. The outcome measures were the duration of indwelling ICT, removal rate of tube thoracostomy, length of hospital stay, duration of intensive care unit (ICU) monitoring, need for mechanical ventilation, incidence of pulmonary and pleural complications, and requirement of additional intervention to address undrained hemothorax and mortality rate. Results: The early VATS cohort had shorter length of hospital stay (7.50 ± 0.85 vs. 9.50 ± 3.03, P = 0.060), reduced duration of indwelling ICT (6.70 ± 1.25 vs. 8.30 ± 2.91, P = 0.127) with higher rate of tube thoracostomy removal (70% vs. 30%, P = 0.003) and lesser need of additional interventions (0% vs. 30%, P = 0.105). Thoracotomy (3 patients) and image-guided drainage (4 patients) were additional interventions to address retained hemothorax in the conventional cohort. However, similar length of ventilator assistance (0.7 ± 0.48 vs. 0.60 ± 1.08, P = 0.791) and prolonged ICU monitoring (1.30 ± 1.06 vs. 0.90 ± 1.45, P = 0.490) was observed in early VATS cohort. Both the cohorts had no mortality. Conclusion: VATS-guided early evacuation of traumatic hemothorax is associated with shorter length of hospital stay along with abbreviated indwelling ICT duration, reduced incidence of complications, lesser readmissions, and improved rate of tube thoracostomy removal. However, the duration of ventilator requirement, ICU stay, and mortality remain unchanged.

We studied human casualties in the buffer zone of Koshi Tappu Wildlife Reserve to gain insights into the factors responsible for elephant attacks on humans. We interviewed victims' families for those that got killed and victims that got injured, over the past six years. Human behaviour was responsible for more casualties than elephant behaviour. Casualties were mainly caused by people's negligence of threats and confrontation of elephants. Providing awareness about elephant ecology and training people about deterrents and methods for avoiding conflict, along with regular patrolling and maintenance of electric fences is required to ensure the safety of both people and elephants.

Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences. Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia. Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I–II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron. Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0–2 h. After 2–6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B. Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe.

Abstract Perovskite solar cells (PSCs) with evaporated gold (Au) electrodes have shown great efficiencies, but the maturity of the technology demands low-cost and scalable alternatives to progress towards commercialisation. Carbon electrode-based PSCs (C-PSCs) represent a promising alternative, however, optimising the interface between the hole transport layer (HTL) and the carbon electrode without damaging the underlying functional layers is a persistent challenge. Here, we describe a lamination technique using an isostatic press that can apply exceedingly high pressure to physically form an HTL/carbon interface on par with vacuum-evaporated electrodes, without damaging the device. Research-scale C-PSCs with a power conversion efficiency (PCE) of up to 20.8% are demonstrated along with large-area C-PSCs with PCEs of 19.8% and 16.9% for cell areas of 0.95 cm2 and 5.5 cm2, respectively. The unencapsulated C-PSCs significantly outperform the Au-electrode devices in accelerated operational stability testing (ISOS-L-1), retaining 84% of the initial PCE after 1000 h. Additionally, this versatile technique is also used to fabricate flexible, roll-to-roll printed C-PSCs with efficiencies of up to 15.8%.

Schwannomas are common benign tumours arising from the myelin sheath of peripheral nerves. These tumours are usually located in the intradural and extramedullary regions. The common sites are cervical (58%) and thoracic region (32%), followed by the lumbar region (10%). Intramedullary location is rare and if present, is usually associated with neurofibromatosis 1 and 2 (NF-1 and 2). Intramedullary brainstem schwannomas without NF are uncommon, and to the best of the authors’ knowledge, only 19 cases have been reported to date. It was first described by James Watson Kernohan, an Irish-American pathologist, in 1931. The rarity of these tumours in this location is due to the absence of Schwann cells in this area. There are several hypotheses postulating the presence of these tumours in this location. The exact cause is not yet known. The authors here present a case of intramedullary brainstem ancient schwannoma with an unusual clinicoradiological presentation, which raised suspicion of Glioma with the possibility of Astrocytoma. The patient presented with right-sided neck stiffness and shoulder pain for a period of four months. Total excision of the tumour was performed, and the postoperative period was uneventful with clinical improvement in the patient. Histomorphology raised the suspicion of a tumour of glial origin with the possibility of Astrocytoma; Immunohistochemistry (IHC) helped in reaching the definitive diagnosis of Ancient Schwannoma. Thus, a combined approach of clinicoradiological, as well as histomorphology and IHC, is essential for a definitive diagnosis of these tumours. Future multicentric studies are required to elucidate the pathogenesis of the location of these tumours.

Owing to unpredicted power demand, integration of distributed generators and parametric disparity in the system cause the power system more intricacy which in turn affects the frequency and power fluctuation critically. To mitigate these phenomena, an intelligent and efficient automatic generation control (AGC) is indispensable. Therefore, in this paper, an intelligent and robust controller named fuzzy sliding mode controller (FSMC) has been recommended to tackle the AGC problem in a deregulated power system in the presence of distributed generators effectively. Again, to manifest its dominance over SMC, fuzzy-PID and PID controllers, dynamic response of the deregulated system under Poolco, Bilateral and Contract violation conditions has been evaluated and compared. Further, to support the FSMC controller’s ability, another test model has been taken for the AGC study. The gains of these controllers have been enumerated by Gannet Optimization Algorithm (GOA) subjecting to a minimization problem. Exploration phase of GOA involves two steps, namely U- & V-shaped diving patterns of Gannets and exploitation phase again involves two steps namely sudden rotation and random walk of Gannets. These four steps ensures quick convergence of the objective function to its optimal value. Apart from transient response under different power transaction conditions, parametric uncertainties of the system, solar and wind power variation and abrupt load change have been considered to support the robustness & credibility of FSMC controller. In addition to this, the stability of the proposed model has been analyzed in the frequency domain. Finally, the MATLAB/SIMULINK based transient response has been validated by a real-time simulator using OPAL-RT-4510, Xilinx Kintex-7 FPGA software.

Introduction: The burden of chronic liver disease (CLD) is on the rise and liver transplantation remains the best treatment modality for the end stage liver disease (ESLD). Tribhuvan University Teaching Hospital has started doing living donor liver transplantation (LDLT) and we aim to report our experience and early postoperative outcomes of the first 10 living donor liver transplants performed in our institute. Methods: This is a retrospective review and included all patients who were operated for LDLT from the year 2019 to 2023 for various indications. Demographic data, Model for End-Stage Liver Disease score, Child score, etiology of CLD, liver graft type, graft-to-recipient weight ratio, operative time, blood transfusion and complications were analysed. Results: From 2019 to 2023, in total, 10 patients underwent LDLT, including one paediatric transplant. The most common etiology was alcohol (50%) and right lobe was the preferred graft. The average operative time was 7.9 ± 2.56 hours. There were no re exploration or re transplantation. The mean duration of hospital stay was around 21.37 ± 6.43 days. All patients were followed for one to five years. Four recipients had Clavien Dindo Grade II and above complications, including bile leak and post-operative bleeding. One mortality occurred on 27th post-operative day due to covid infection. Conclusions: Living donor liver transplantation is a feasible option for patients with end stage liver disease and is safe to be performed in low volume centre with the help of expertise and good team work.

Optimum soil moisture and high crop residue return (RR) can increase the active pool of soil organic carbon and nitrogen, thus modulating the magnitude of greenhouse gas (GHG) fluxes. To determine the effect of soil moisture on the threshold level of RR for the wheat production system, we analyzed the relationship between GHG fluxes and RR at four levels, namely 0, 5, 10, and 15 Mg ha−1 (R0, R5, R10, and R15) under two soil moisture content (80% FC and 100% FC) and three levels of nutrient management (NS0: no nutrient; NS1, NS2= 3x NS1). Nutrient input (N and P) in NS1 balanced the residue C/nutrient stoichiometry to achieve 30% stabilization of the residue C input in RR (R5). All RR treatments (cf. R0) were found to significantly reduce N2O emission in moderate soil moisture content (80% FC) by 22–56% across nutrient management due to enhanced soil C mineralization, microbial biomass carbon, and N immobilization. However, averaged across nutrient management, a linear increase in N2O emission was observed with increasing RR under 100% FC soil moisture. A significant decrease in CH4 emission by ca. 46% in most RR treatments was observed in 100% FC compared with the R0. The N2O emission was negatively correlated (p = 0.8) to management variables (RR rate, nitrogen (N) input rate, soil moisture, and nutrient stoichiometry of C: N) and post-incubation soil properties (SMBC and NO3-N) in Alfisols. This study demonstrated that the mechanisms responsible for RR effects on soil N2O, CH4 fluxes, and carbon mineralization depend on soil moisture and nutrient management, shifting the nutrient stoichiometry of residue C: N: P.

Developing successful mitigation strategies for greenhouse gases (GHGs) from crop residue returned to the soil can be difficult due to an incomplete understanding of factors controlling their magnitude and direction. Therefore, this study investigates the effects of varying levels of wheat residue (WR) and nutrient management on GHGs emissions (CO2, N2O, and CH4) across three soil types: Alfisol, Vertisol, and Inceptisol. A combination of laboratory-based measurements and a variety of data analysis techniques was used to assess the GHG responses under four levels of WR inputs (0, 5, 10, and 15 Mg/ha; WR0, WR5, WR10, and WR15) and three levels of nutrient (NP0: no nutrient, NP1: nutrients (N and P) were added to balance the residue C/nutrient stoichiometry of C/N/P= 100: 8.3: 2.0 to achieve 30% stabilization of added residue C input at 5 Mg/ha (R5), and NP2: 3 × NP1). The results of this study clearly showed that averaged across residue and nutrient input, Inceptisol showed negative N2O flux, suggesting consumption which was supported by its high legacy phosphorus (19.7 mg kg⁻1), elevated pH (8.49), and lower clay content (13%), which reduced microbial activity, as indicated by lower microbial biomass carbon (MBC) and alkaline phosphatase (Alk-P) levels. N2O emissions were more responsive to nutrient inputs, particularly in Vertisol under high WR (15 Mg/ha) input, while CH4 fluxes were significantly reduced under high residue inputs, especially in Vertisol and Inceptisol. Alfisol exhibited the highest total carbon mineralization and GWP, with cumulative GWP being 1.2 times higher than Vertisol and 1.4 times higher than Inceptisol across residue and nutrient input. The partial least square (PLS) regression revealed that anthropogenic factors significantly influenced CO2 and N2O fluxes more than CH4. The anthropogenic drivers contributed 62% and 44% of the variance explained for N2O and CH4 responses. Our study proves that different biogeochemical mechanisms operate simultaneously depending on the stoichiometry of residue C and nutrients influencing soil GHG responses. Our findings provide insight into the relative contribution of anthropogenic and natural drivers to agricultural GHG emissions, which are relevant for developing process-based models and addressing the broader challenge of climate change mitigation through crop residue management.

This study investigated the pH of four popular Nepalese tea brands such as Tokla, Ridhisidhi, Suman, and Muna, under different conditions to assess their acidity and potential health implications. The teas were prepared using standardized brewing methods, and pH measurements were taken at room temperature and after chilling to observe any temperature-related variations. Freshly brewed teas tended to be more alkaline, while those with added sugar and lemon were more acidic. Temperature changes had minimal impact on pH, indicating that acidity remains stable whether the tea is consumed hot or cold. While the pH range of these teas is generally safe for consumption, it may cause discomfort for those with acid sensitivity. These findings provide insights into the acidity of Nepalese teas and its potential effects on sensory and health attributes.

The traditional method of detecting crop nutrients is based on the direct chemical detection method in the laboratory, which causes great damage to crops. In order to solve the above problems, the main goal of this study is to design a precise fertilization method for greenhouse vegetables based on the improved back-propagation neural network (IM-BPNN) algorithm to increase fertilizer utilization efficiency, reduce production costs, and improve the economic viability of agriculture. First, soil samples from the farm in china are selected. With the laboratory treatment, available phosphorus, available potassium, and alkaline nitrogen are extracted. These data are preprocessed by the z-score (zero-mean normalization) standardization method. Then, the BPNN (backpropagation neural network) algorithm is improved by being trained and combined with the characteristics of the dual particle swarm optimization algorithm. After that, the soil sample data are divided into training and test sets, and the model is established by setting parameters, weights, and network hierarchy. Finally, the NBTY (nutrient balance target yield),BPNN (backpropagation neural network) and IM-BPNN algorithm are used to calculate the amount of fertilizer. Compared with the BPNN and NBTY algorithm, it shows that the IM-BPNN algorithm can more accurately determine the amount of fertilizer required by vegetables and avoid over-application, which can improve fertilizer utilization efficiency, reduce production costs, and improve the economic feasibility of agriculture.

The increasing use of unmanned aerial vehicles (UAVs) in both military and civilian applications, such as infrastructure inspection, package delivery, and recreational activities, underscores the importance of enhancing their autonomous functionalities. Artificial intelligence (AI), particularly deep learning-based computer vision (DL-based CV), plays a crucial role in this enhancement. This paper aims to provide a systematic literature review (SLR) of Scopus-indexed research studies published from 2019 to 2024, focusing on DL-based CV approaches for autonomous UAV applications. By analyzing 173 studies, we categorize the research into four domains: sensing and inspection, landing, surveillance and tracking, and search and rescue. Our review reveals a significant increase in research utilizing computer vision for UAV applications, with over 39.5 % of studies employing the You Only Look Once (YOLO) framework. We discuss the key findings, including the dominant trends, challenges, and opportunities in the field, and highlight emerging technologies such as in-sensor computing. This review provides valuable insights into the current state and future directions of DL-based CV for autonomous UAVs, emphasizing its growing significance as legislative frameworks evolve to support these technologies.

Background: Benign Prostatic Hyperplasia (BPH) commonly affects older men, leading to lower urinary tract symptoms (LUTS) that affect sleep and quality of life. This study evaluates the effect of Pranic Healing (PH) as a complementary therapy for bothersome LUTS by normalising biofield energy centres called Chakras. Methodology: A single blind trial involving 76 men with LUTS was conducted, randomised into Medication-only (MED) and Medication-plus-Pranic Healing (MEDPH) groups. The MEDPH received PH sessions twice weekly for 5 weeks. Results: The study compared MED (n = 30) and MEDPH (n = 36) participants, finding significant improvements in IPSS scores (p ≤ .001) in both groups. The MEDPH group showed a greater reduction in incomplete bladder emptying and intermittency. The post void residual volume increased significantly in the MED group (Wilcoxon Z = −2.335, p = .02), while the MEDPH group reduced non-significantly. Sleep quality index improved significantly (McNemar=.013) in the MEDPH group, while the MED group showed no significant change. Subjective sleep quality, duration, and latency improved significantly in the MEDPH group. Healers reported improved energy balance in chakras of MEDPH group. Perceived energy by healers in lower chakra relates to urinary parameters. Conclusion: PH could alleviate LUTS, enhancing quality of life due to urination, and improved sleep, among moderate BPH patients. Trial registration: This study has been registered under the Clinical Trial Registry of India. (CTRI No: CTRI/2023/01/049004)

FeCrAl alloys exhibit outstanding high-temperature oxidation resistance and impressive mechanical strength, rendering them as forefront materials with broad applicability across various engineering domains, notably in the nuclear field. In addition to their unique properties, they are likely to continue to hold important place in these applications due to tremendous potential in their fabrication through versatile additive manufacturing techniques. In light of this, current review article conducts an exhaustive examination of recent research, providing a comprehensive overview of the progress made in the additive manufacturing of FeCrAl alloys. The exploration entails a thorough analysis of the challenges encountered in fusion-based fabrication, a detailed scrutiny of their microstructural characteristics, assessments of their mechanical and oxidation properties, and an exploration of their potential utility in applications related to irradiation. Some of the recent results on performance of AM based FeCrAl alloys increase the confidence on deploying AM for fabrication of these challenging materials. For instance, the laser welded FeCrAl alloy, irradiated at 560 °C up to 1.9 dpa showed no degradation of the mechanical performance and exhibited mechanical properties comparable to the wrought alloys.

Ischemia-reperfusion (IR) injury remains a pivotal contributor to myocardial damage following acute coronary events and revascularization procedures. Phosphoinositide 3-kinase (PI3K), a key mediator of cell survival signaling, plays a central role in regulating inflammatory responses and cell death mechanisms. Trans-chalcone (Tch), a natural compound known for its anti-inflammatory activities, has shown promise in various disease models. The aim of the current study was to investigate the potential protective effects of Tch against myocardial injury induced by ischemia and reperfusion challenges by targeting the PI3K-inflammasome interaction. Experimental models utilizing male rats subjected to an in vivo model of IR injury and myocardial infarction were employed. Administration of Tch (100 μg/kg, intraperitoneally) significantly reduced myocardial injury, as indicated by limited infarct size and decreased levels of the myocardial enzyme troponin. Mechanistically, Tch upregulated PI3K expression, thereby inhibiting the activity of the NOD-like receptor protein 3 inflammasome followed by the activation of pro-inflammatory cytokines interleukin-1β (IL-1β) and IL-18. Moreover, it mitigated oxidative stress and suppressed vascular-intercellular adhesion molecules, contributing to its cardioprotective effects. The PI3K/Akt pathway inhibitor LY294002 considerably attenuated the beneficial effects of Tch. These findings highlight the therapeutic potential of Tch in ameliorating myocardial injury associated with IR insults through its modulation of the PI3K/Akt-inflammasome axis. The multifaceted mechanisms underlying its protective effects signify Tch as a promising candidate for further exploration in developing targeted therapies aimed at mitigating ischemic heart injury and improving clinical outcomes in cardiovascular diseases characterized by IR injury.

Introduction: India launched a national initiative named Health and Wellness Centres (HWCs) in 2018 to provide population-based primary care including for the non-communicable diseases (NCDs) in rural areas. The current study assesses whether operationalization of HWCs improved the detection of NCDs and increased the share of public sector facilities in providing NCD services. Methods: Two rounds of household surveys were conducted in rural Chhattisgarh in 2019 and 2022. With a focus on NCDs, the household survey covered a representative sample of individuals above the age of 30 years – 2760 individuals in 2019 and 2638 in 2022. Multi-variate regression analysis was carried out to determine effects of HWCs on identification of NCDs and utilization of public sector services. Results: The population covered by HWCs had 25% greater chance of being identified with NCDs as compared to the population without HWCs (AOR = 1.25, P = 0.03). The NCD patients living in areas covered by HWCs had 70% greater chance of utilizing the public healthcare facilities (AOR = 1.70, P = 0.01). In the population covered by HWCs, the share of the public sector in NCD care increased from 41.2% in 2019 to 62.1% in 2022, whereas the share of informal private providers dropped from 23.5% in 2019 to 8.4% in 2022. Conclusion: The HWCs showed effectiveness in increasing detection of NCDs at the population level and bringing a larger share of NCD patients to utilize public sector services. They can prove to be a crucial architectural correction for improving primary care service delivery for NCDs and other population health needs in India.