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Aluminium-reinforced composites play a vital role in the engineering industry because of their better strength and stiffness. The properties are directly related to the solidification phenomenon of the cast alloy. The design engineer should understand the importance of the solidification behavior of base alloy and its reinforcement. Composites’ solidification study is rare, and the reviews are limited. The solidification process is analyzed using the finite element method (FEM), and this would fetch a lot of information about the cooling rate of the composites and also helps to reduce the time in experimentation. This paper reports and plots the cooling curves of Al/SiCp composites using simulation software. Cylindrical-shaped composites were developed using the squeeze casting method, and the experimental cooling curves were plotted using a K-type thermocouple. Composites samples were prepared at the following squeeze pressures: 0, 30, 50, 70, 100, and 130 MPa; melt and die temperature was kept constant at 800 and 400°C, respectively. The experimental and FEA cooling curves were compared, and it was agreed that the increase in the squeeze pressure increases the cooling rate of the developed composite. Furthermore, the effect of temperature distribution from the inner region of the melt and die material which causes the radial and tangential stress of components has also been examined.

Abstract Hinduism is otherwise known as Sanatana dharma, the oldest of all religions in the world. Its scriptures allow absolute freedom to the rational mind of human to choose the choice as per individual’s choice wherein individual freewill is exercised. The present review article aims at how a Hindu is educated and guided by the scriptures to lead a harmonious life in the society in general and in particular the sexual functions as prescribed. The main focus of this article are the roles of individuals, families, community, the religious, and educational institutions, and the government to create awareness in the areas such sex, sexual functions and sexual problems among men and women. They are essentially important and needed for the healthy practices of sex in our Indian culture. To strengthen it further, some practical measures are suggested to bring in a change, especially adolescent period is a very exciting phase and they are facing lot of difficulties and challenges in the area of sex. Therefore, the educational institutions should conduct training and workshop for teachers, parents and students on reproductive health and healthy sexual function and the state and central should encourage to undertake the scientific research studies in different areas and groups, for different groups.

Abstract Background Tuberculosis (TB) lymphadenitis is the most common form of extra-pulmonary TB, and the treatment duration is six months. This non-inferiority based randomized clinical trial in South India evaluated the efficacy and safety of a four-month ofloxacin containing regimen in tuberculosis lymphadenitis (TBL) patients. Methods New, adult, HIV-negative, microbiologically and or histopathologically confirmed superficial lymph node TB patients were randomized to either four-month oflaxacin containing test regimen [ofloxacin (O), isoniazid (H), rifampicin (R), pyrazinamide (Z) -2RHZO daily/ 2RHO thrice-weekly] or a six-month thrice-weekly control regimen (2HRZ, ethambutol/4RH). The treatment was directly observed. Clinical progress was monitored monthly during and up to 12 months post-treatment, and thereafter every three months up to 24 months. The primary outcome was determined by response at the end of treatment and TB recurrence during the 24 months post-treatment. Results Of the 302 patients randomized, 298 (98.7%) were eligible for modified intention-to-treat (ITT) analysis and 294 (97%) for per-protocol (PP) analysis. The TB recurrence-free favourable response in the PP analysis was 94.0% (95% CI: 90.1–97.8) and 94.5% (95% CI: 90.8–98.2) in the test and control regimen respectively, while in the ITT analysis, it was 92.7% and 93.2%. The TB recurrence-free favourable response in the test regimen was non-inferior to the control regimen 0.5% (95% CI: -4.8-5.9) in the PP analysis based on the 6% non-inferiority margin. Treatment was modified for drug toxicity in two patients in the test regimen, while one patient had a paradoxical reaction. Conclusion The 4-month ofloxacin containing regimen was found to be non-inferior and as safe as the 6-month thrice-weekly control regimen.

Abstract Objectives International guidelines recommend resection of suspected localised renal cell carcinoma (RCC), with surgical series showing benign pathology in 30%. Non‐invasive diagnostic tests to differentiate benign from malignant tumours are an unmet need. Our objective was to determine diagnostic accuracy of imaging modalities for detecting cancer in T1 renal tumours. Methods A systematic review was performed for reports of diagnostic accuracy of any imaging test compared to a reference standard of histopathology for T1 renal masses, from inception until January 2023. Twenty‐seven publications (including 2277 tumours in 2044 participants) were included in the systematic review, and nine in the meta‐analysis. Results Forest plots of sensitivity and specificity were produced for CT (seven records, 1118 participants), contrast‐enhanced ultrasound (seven records, 197 participants), [99mTc]Tc‐sestamibi SPECT/CT (five records, 263 participants), MRI (three records, 220 participants), [18F]FDG PET (four records, 43 participants), [68Ga]Ga‐PSMA‐11 PET (one record, 27 participants) and [111In]In‐girentuximab SPECT/CT (one record, eight participants). Meta‐analysis returned summary estimates of sensitivity and specificity for [99mTc]Tc‐sestamibi SPECT/CT of 88.6% (95% CI 82.7%–92.6%) and 77.0% (95% CI 63.0%–86.9%) and for [18F]FDG PET 53.5% (95% CI 1.6%–98.8%) and 62.5% (95% CI 14.0%–94.5%), respectively. A comparison hierarchical summary receiver operating characteristic (HSROC) model did not converge. Meta‐analysis was not performed for other imaging due to different thresholds for test positivity. Conclusion The optimal imaging strategy for T1 renal masses is not clear. [99mTc]Tc‐sestamibi SPECT/CT is an emerging tool, but further studies are required to inform its role in clinical practice. The field would benefit from standardisation of diagnostic thresholds for CT, MRI and contrast‐enhanced ultrasound to facilitate future meta‐analyses.

Abstract The distorted Born iterative (DBI) method is considered to obtain images with high-contrast and resolution. Besides satisfying the Born approximation condition, the frequency-hopping (FH) technique is necessary to gradually update the sound contrast from the first iteration and progress to the actual sound contrast of the imaged object in subsequent iterations. Inspired by the fact that the higher the frequency, the higher the resolution. Because low-frequency allows for low-resolution object imaging, hence for high-resolution imaging requirements, using low-frequency to possess a high-resolution image from the first iteration will be less efficient. For an effective reconstruction, the object’s resolution at low frequencies should be small. And similarly, with high frequencies, the object resolution should be larger. Therefore, in this paper, the FH, and the resolution-turning (RT) technique are proposed to obtain object images with high-contrast and -resolution. The convergence speed in the initial iterations is rapidly achieved by utilizing low frequency in the frequency-turning technique and low image resolution in the resolution-turning technique. It is crucial to ensure accurate object reconstruction for subsequent iterations. The desired spatial resolution is attained by employing high frequency and large image resolution. The resolution-turning distorted Born iterative (RT-DBI) and frequency-hopping distorted Born iterative (FH-DBI) solutions are thoroughly investigated to exploit their best performance. This makes sense because if it is not good to choose the number of iterations for the frequency f 1 in FH-DBI and for the resolution of N 1 × N 1 in RT-DBI, then these solutions give even worse quality than traditional DBI. After that, the RT-FH-DBI integration was investigated in two sub-solutions. We found that the lower frequency f 1 used both before and after the RT would get the best performance. Consequently, compared to the traditional DBI approaches, the normalized error and total runtime for the reconstruction process were dramatically decreased, at 83.6% and 18.6%, respectively. Besides fast and quality imaging, the proposed solution RT-FH-DBI is promised to produce high-contrast and high-resolution object images, aiming at object reconstruction at the biological tissue. The development of 3D imaging and experimental verification will be studied further.

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Abstract Reproductive tract infections (RTIs) are a persistent public health threat worldwide, particularly among women in low-income countries of Africa, including Ethiopia, where drug resistance is also a growing problem. It is crucial to address this problem to ensure women's health and well-being. A cross-sectional study was carried out among a cohort of 398 women of reproductive age who sought medical attention at the Gynecology Department of the Arba Minch General Hospital, southern Ethiopia, from January to June 2020. They were chosen through systematic random sampling, and a pre-tested structured questionnaire was used to collect the data. The collection of vaginal and/or cervical swabs were done to diagnose bacterial vaginosis (BV) and aerobic vaginitis (AV) using Nugent and AV score analyses, respectively. The swabs were subjected to standard microbiological culture techniques to detect the isolates causing AV and vaginal candidiasis (VC). The susceptibility profiles of the causative agents of AV were checked by the Kirby-Bauer disc diffusion technique. Descriptive and inferential statistical analyses were also done. Aerobic vaginitis was the predominantly diagnosed RTI (n = 122, 30.7%), followed by BV (n = 117, 29.4%) and VC (n = 111, 27.9%). The prominent bacteria of AV were Escherichia coli (n = 36, 34.2%) and Klebsiella pneumoniae (n = 30, 28.5%). The overall rate of multidrug-resistant (MDR) bacteria was 65.71% (n = 69). History of abortion (p = 0.01; AOR = 4.0, 95% CI = 2.1, 7.7) and the habit of using vaginal pH-altering contraceptives (p = 0.01; AOR = 4.7, 95% CI = 2.5, 8.8) have the greatest odds of RTI. The high prevalence of RTIs in our study warrants an urgent intervention to minimize the associated morbidities and complications. The overall rate of MDR bacterial isolates necessitates the implementation of an effective surveillance program in the study setting.

Abstract Background Penile cancer is a rare male genital malignancy. Surgical excision of the primary tumour is followed by radical inguinal lymphadenectomy if there is metastatic disease detected by biopsy, fine needle aspiration cytology (FNAC) or following sentinel lymph node biopsy in patients with impalpable disease. However, radical inguinal lymphadenectomy is associated with a high morbidity rate, and there is increasing usage of a videoendoscopic approach as an alternative. Methods A pragmatic, UK-wide multicentre feasibility randomised controlled trial (RCT), comparing videoendoscopic radical inguinal lymphadenectomy versus open radical inguinal lymphadenectomy. Patients will be identified and recruited from supraregional multi-disciplinary team meetings (sMDT) and must be aged 18 or over requiring inguinal lymphadenectomy, with no contraindications to surgical intervention for their cancer. Participants will be followed up for 6 months following randomisation. The primary outcome is the ability to recruit patients for randomisation across all selected sites and the rate of loss to follow-up. Other outcomes include acceptability of the trial and intervention to patients and healthcare professionals assessed by qualitative research and obtaining resource utilisation information for health economic analysis. Discussion There are currently no other published RCTs comparing videoendoscopic versus open radical inguinal lymphadenectomy. Ongoing study is required to determine whether randomising patients to either procedure is feasible and acceptable to patients. The results of this study may determine the design of a subsequent trial. Trial registration Clinicaltrials.gov PRS registry, registration number NCT05592639. Date of registration: 13th October 2022, retrospectively registered

Integrating values in managing a school is crucial to balance the role of school leaders as leaders and managers under one roof. This study highlights the practice of ethical leadership (branch of value-based leadership) based on seven dimensions. Using a mixed method (QUAN-qual) approach, this study: (1) identifies the level of principal's ethical leadership practices and trust in leader as perceived by primary and secondary school teachers of Malaysia; (2) explores the relationship between both variables and classifies accordingly the subconstructs of ethical leadership practices that significantly contribute to developing trust in their leaders; and (3) ascertains the understanding and practices of ethical leadership style among the principals as perceived by the principals themselves. The quantitative data were collected via Ethical Leadership at Workplace (ELW) and Trust in Leader (TL) questionnaire. A total of 438 public school teachers nationwide responded to the questionnaire. Data were analyzed using descriptive and inferential statistical method. The findings show that principals throughout the country practiced high ethical leadership. The level of teacher's trust in principals was also high. The inference analysis found very strong significant relationship between ethical leadership and teachers' trust on their principals. A semi-structured interview with three school principals was conducted to collect the qualitative data revealed that the Malaysian principals lacked the understanding of ethical leadership style, nevertheless practiced several dimensions of ethical leadership in their school administration. The study suggests ethical leadership to be integrated into current school leadership practices to further understand its impact.

BackgroundHigh sequence identity between segmental duplications (SDs) can facilitate copy number variants (CNVs) via non-allelic homologous recombination (NAHR). These CNVs are one of the fundamental causes of genomic disorders such as the 3q29 deletion syndrome (del3q29S). There are 21 protein-coding genes lost or gained as a result of such recurrent 1.6-Mbp deletions or duplications, respectively, in the 3q29 locus. While NAHR plays a role in CNV occurrence, the factors that increase the risk of NAHR at this particular locus are not well understood.MethodsWe employed an optical genome mapping technique to characterize the 3q29 locus in 161 unaffected individuals, 16 probands with del3q29S and their parents, and 2 probands with the 3q29 duplication syndrome (dup3q29S). Long-read sequencing-based haplotype resolved de novo assemblies from 44 unaffected individuals, and 1 trio was used for orthogonal validation of haplotypes and deletion breakpoints.ResultsIn total, we discovered 34 haplotypes, of which 19 were novel haplotypes. Among these 19 novel haplotypes, 18 were detected in unaffected individuals, while 1 novel haplotype was detected on the parent-of-origin chromosome of a proband with the del3q29S. Phased assemblies from 44 unaffected individuals enabled the orthogonal validation of 20 haplotypes. In 89% (16/18) of the probands, breakpoints were confined to paralogous copies of a 20-kbp segment within the 3q29 SDs. In one del3q29S proband, the breakpoint was confined to a 374-bp region using long-read sequencing. Furthermore, we categorized del3q29S cases into three classes and dup3q29S cases into two classes based on breakpoints. Finally, we found no evidence of inversions in parent-of-origin chromosomes.ConclusionsWe have generated the most comprehensive haplotype map for the 3q29 locus using unaffected individuals, probands with del3q29S or dup3q29S, and available parents, and also determined the deletion breakpoint to be within a 374-bp region in one proband with del3q29S. These results should provide a better understanding of the underlying genetic architecture that contributes to the etiology of del3q29S and dup3q29S.