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Objectives: The objectives of the study were to obtain the current estimates of cataract surgical coverage (CSC) at varying thresholds of vision and gender variations across districts in diverse Indian populations aged ≥50 years. Methods: Data collected from the national blindness survey from 31 Indian districts between 2015 and 2019 were analyzed. CSC at varying thresholds of presenting visual acuity

Tickborne infections are challenging to diagnose, particularly among solid organ transplant recipients. We report a US case of donor-derived ehrlichiosis from a living kidney donation that highlights how screening for living donors may miss tickborne infections. Clinicians should consider the epidemiology of the donor when screening donations and evaluating recipients for donor-derived infection.

Abstract The Immunoglobulin superfamily (IgSF) is a heterogeneous and conserved family of adhesion proteins crucial during the development of the central nervous system including neuronal migration and synaptogenesis. The Immunoglobulin superfamily member 3 (IGSF3) is expressed in the developing brain and has been suggested to play a role during morphological development of the granule cells neurites in the cerebellum. In addition, a role for IGSF3 in supporting glioma progression has been recently demonstrated. Remaining unexplored is the physiological role of IGSF3 in regulating brain development, including neocortical development. We generated an Igsf3 knockout (KO) mouse using a CRISPR/Cas9-based approach and explored the function of Igsf3 in regulating cortical development. We found that Igsf3 largely co-localizes with other IgSF proteins during cortical development and despite its expression being developmentally regulated in neuronal progenitors and in postmitotic neurons, Igsf3 is not essential for brain development, neuronal migration, or neuronal maturation.

Abstract Sequence evolution of protein complexes (PCs) is constrained by protein-protein interactions (PPIs). PPI-interfaces are predominantly conserved and hotspots for disease-related mutations. How do lipid-protein interactions (LPIs) constrain sequence evolution of membrane-PCs? We explore Respiratory Complexes (RCs) as a case study as these allow to compare sequence evolution in subunits exposed to both lipids in inner-mitochondrial membrane (IMM) and lipid-free aqueous matrix. We find that lipid-exposed surfaces of the IMM-subunits but not of the matrix subunits are populated with non-PPI disease-causing mutations signifying LPIs in stabilizing RCs. Further, IMM-subunits including their exposed surfaces show high intra-kingdom sequence conservation but remarkably diverge beyond. Molecular Dynamics simulation suggests contrasting LPIs of structurally superimposable but sequence-wise diverged IMM-exposed helices of Complex I (CI) subunit Ndufa1 from human and Arabidopsis depending on kingdom-specific unsaturation of cardiolipin fatty acyl chains. in cellulo assays consolidate inter-kingdom incompatibility of Ndufa1-helices due to the lipid-exposed amino acids. Plant-specific unsaturated fatty acids in human cells also trigger CI-instability. Taken together, we posit that altered LPIs calibrate sequence evolution at the IMM-arms of eukaryotic RCs.

Abstract This paper introduces a novel design and development of a compact circularly polarized antenna operating at two distinct frequency bands, 2.5 GHz and 6 GHz. The innovation lies in using a modified circular patch and a uniquely designed feeding element, which optimize circular polarization performance while maintaining a low-profile form factor. Fabricated on an FR4 substrate with an overall thickness of 1.6 mm and dimensions of 62 mm × 62 mm × 1.6 mm, corresponding to approximately 0.5167λ × 0.5167λ × 0.0133λ at 2.5 GHz, the antenna achieves a compact configuration well-suited for space-constrained applications. Extensive simulations and measurements show close agreement, with axial ratios below 3 dB across both operational bands, ensuring effective circular polarization. The antenna achieves peak gains of 1.8 dBi at 2.5 GHz and 3.8 dBi at 6 GHz, highlighting its ability to combine compactness, dual-band functionality, and strong radiation characteristics. This proposed design provides a groundbreaking solution for Industrial, Scientific, and Medical (ISM) and Vehicle-to-Everything (V2X) communication systems, addressing the increasing demand for efficient, dual-band, and space-saving wireless communication solutions.

Abstract Recent advances in stem cell-derived embryo models have transformed developmental biology, offering insights into embryogenesis without the constraints of natural embryos. However, variability in their development challenges research standardization. To address this, we use deep learning to enhance the reproducibility of selecting stem cell-derived embryo models. Through live imaging and AI-based models, we classify 900 mouse post-implantation stem cell-derived embryo-like structures (ETiX-embryos) into normal and abnormal categories. Our best-performing model achieves 88% accuracy at 90 h post-cell seeding and 65% accuracy at the initial cell-seeding stage, forecasting developmental trajectories. Our analysis reveals that normally developed ETiX-embryos have higher cell counts and distinct morphological features such as larger size and more compact shape. Perturbation experiments increasing initial cell numbers further supported this finding by improving normal development outcomes. This study demonstrates deep learning’s utility in improving embryo model selection and reveals critical features of ETiX-embryo self-organization, advancing consistency in this evolving field.

Abstract The diagnosis of schizophrenia (SCZ) primarily relies on clinical history and mental status assessments by trained professionals. There has been a search for biomarkers to facilitate laboratory diagnosis. Since extracellular vesicles (EVs) communicate with brain cells and can easily cross blood-brain barrier, there is increased interest among experts to explore them as potential molecular signals for disease detection. A scoping review was conducted to provide a comprehensive summary of the existing literature to identify the differentially expressed molecular signals in EVs isolated from SCZ patients. The methodological framework outline provided by Arksey and O’Malley was employed to conduct this scoping review. A systematic search was conducted using a search string across four databases, ultimately leading to selection of 24 relevant studies. Over 1122 differentially expressed biomolecules were identified in EVs extracted from biological fluids and tissues that can be primarily categorized as RNAs, proteins, and metabolites. Among them, 83 biomolecules were identified as validated differentially expressed molecular signals, which included metabolites, circRNAs, lncRNAs, miRNAs, and proteins. These biomolecules were found to affect cellular receptors and intracellular pathways, neurotransmitters, mitochondrial functions, immune-related functions, and metabolic pathways, which could serve as potential biomarkers for SCZ diagnosis.

Abstract Purpose The prevalence of cancer among patients accessing primary care in federally qualified health centers (FQHCs) is poorly characterized. A patient’s history of cancer in addition to common chronic conditions makes providing comprehensive primary care more complex, especially for patients accessing care at FQHCs who often face additional social and economic barriers to care. Methods Trained auditors conducted a comprehensive electronic medical record audit using a standardized abstraction form to identify cancer history in patients aged ≥ 40 years with two common chronic conditions (diabetes and/or hypertension) and who had at least one visit to an FQHC between January 1 and December 31, 2019. Descriptive statistics were performed. Results Among 712 adult patients with diabetes and/or hypertension, 46 (6.46%) had a documented history of cancer. For the majority of cancer patients (67.4%), cancer information was documented in the “Problem List” section of their medical record. Conclusion Our study revealed a higher prevalence of cancer in FQHC primary care records than previously reported. Future research should examine whether readily accessible cancer history information in primary care records could enhance comprehensive care delivery for all chronic conditions, including cancer.

Abstract ER/PR+HER2- breast tumours are the most predominant subtype of breast cancer worldwide, including India. Unlike TNBCs, these tumours can be treated with anti-estrogens or aromatase inhibitors. Despite the success of endocrine therapy, a fraction of patients with ER/PR+ breast tumours do not respond to hormone-receptor-specific treatment and encounter disease recurrence contributing to their poor survival. The genomic underpinnings of therapy resistance in ER/PR+HER2- breast tumours are incompletely understood. We have performed whole genome sequencing (WGS) from tumour and normal tissue samples from endocrine-therapy resistant ER/PR+HER2- breast cancer patients who have relapsed on endocrine therapy and have conducted a comparative analysis of WGS data generated from tissues of endocrine therapy sensitive patients who remained free of disease during a minimum 5-year follow-up. Our analysis shows (a) a three-gene (PIK3CA-ESR1-TP53) resistance signature, and (b) impaired DNA double-strand break repair and homologous recombination pathways, were significantly associated with endocrine-therapy resistance and disease recurrence in ER/PR+HER2- tumours. Genome instability, contributing to high burden of copy-number, structural alterations and telomere-shortening identified as major markers of endocrine treatment resistance. Early prediction of endocrine-therapy resistance from the genomic landscape of breast tumours will aid therapeutics. Our finding also opens up the possibility of repurposing PARP inhibitors in treating endocrine therapy-resistant breast cancer patients.

Abstract Research on composite materials has increasingly replaced traditional materials and alloys in an effort to create effective and lightweight solutions for a range of applications. Metal Matrix Composites (MMCs) offer several advantages over other composites, including reduced density, improved strength-to-weight ratio, enhanced resistance to wear and abrasion, and lower thermal expansion coefficient. This review focuses on MMCs based on aluminum, copper, magnesium, titanium, and zinc including their alloys. It examines their physical and mechanical properties, fabrication techniques (e.g., liquid-phase, solid-phase, and In-situ processing), and recent advancements. MMCs have shown remarkable improvements in their properties. This makes them suitable for critical applications in aerospace, automotive, and electronics. Key findings highlight their ability to overcome the weaknesses of traditional materials by enhancing various mechanical properties. They achieve improvements in tensile strength, density, thermal expansion coefficient, elasticity modulus, toughness and fracture resistance, fatigue resistance, creep resistance, and electrical conductivity through reinforcement techniques. The article also highlights the importance of selecting suitable fabrication methods to achieve desired characteristics while minimizing costs and defects. This review serves as a comprehensive guide for researchers and industry professionals. It highlights current trends, challenges, and the significant potential of MMCs as materials for the future. Graphical Abstract

Graves’ disease, a common autoimmune disorder, characteristically presents with upper eyelid retraction, causing significant functional and cosmetic concerns for affected individuals. The management of Graves’ upper eyelid retraction has evolved significantly over recent years, with various surgical and non-surgical interventions. An ideal procedure is predictable and easily repeatable. This review provides a comprehensive overview of the contemporary approaches to managing Graves’ upper eyelid retraction, encompassing both traditional and emerging techniques. It critically evaluates the surgical options for correcting Graves’ upper eyelid retraction to achieve the desired eyelid contour, eyelid crease, tarsal platform show, and brow fat span. Their comparative effectiveness is meticulously explored, offering clinicians valuable insights into treatment selection. Moreover, this review also underscores combined orbital decompression with levator recession. Additionally, advancements in non-invasive modalities, including botulinum toxin, triamcinolone acetate injections, and hyaluronic acid fillers are discussed in detail. This review aims to facilitate informed decision-making and improve the overall outcomes for individuals affected by Graves’ disease-associated upper eyelid retraction.

Esophageal cancer is one of the common cancers. Risk factors are well recognized and lead most commonly to two distinct histological subtypes (squamous cell carcinoma and adenocarcinoma). The diagnosis is based on endoscopic evaluation. The most challenging aspect of management is accurate staging as it guides appropriate management. Endoscopic ultrasound, computed tomography (CT), positron emission tomography-CT, and magnetic resonance imaging are the imaging tests employed for the staging. Each imaging test has its own merits and demerits. Imaging is also critical to evaluate posttreatment complication and for response assessment. In this review article, we discuss in detail the risk factors, anatomical aspects, and role of imaging test in staging and evaluation of complications and response after treatment.

Amyotrophic lateral sclerosis (ALS) is a motor neuron disease characterized by the progressive degeneration of the upper and lower motor neurons. This disease is mostly observed in patients of the 6th decade or above, and it is extremely rare to observe this pathology in patients less than 50 years of age. This manuscript depicts the magnetic resonance imaging findings of ALS showing a wine glass sign in a 31-year-old female from a rural area with complaints of progressive limb weakness and muscle wasting.

Abstract Nanomedicine, the most promising approach for regulated and targeted drug delivery, is frequently applied in cancer treatment. Essentially, accumulating evidence indicates that nanomedicine has positive results in the treatment of breast cancer (BC), with many BC patients benefiting from nanomedicine-related treatments. Currently, nanodrug delivery systems based on stimulus responses are gaining popularity because of their additional ability to manage drug release depending on the interior environment of the cancer. This review includes a synopsis of several types of internal (pH, redox, enzyme, reactive oxygen species, and hypoxia) stimuli-responsive nanoparticle drug delivery systems as well as perspectives for forthcoming times. Stimulus-responsive nanoparticles can remain stable under physiological conditions while being rapidly activated to release drugs in response to specific stimuli, prolonging blood circulation and increasing cancer cellular uptake, resulting in excellent therapeutic performance and improved biosafety. In this paper, we discuss tumor microenvironment responsive Nanoformulation for breast cancer treatment.

Abstract Background People living with HIV (PLHIV) demonstrate accelerated aging and immunosenescence in spite of immune-restoration following long-term antiretroviral treatment (ART). Low level inflammation leading to inflammaging plays an important role in mediating premature immunosenescence. Ongoing viral replication, antiretrovirals and subclinical infections with the common viruses like Cytomegalovirus (CMV) are known to induce inflammaging. However such data is scarce in India where persistent low level inflammation is common in general population due to various subclinical infections. Hence we conducted a study to determine the extent of immunosenescence in asymptomatic PLHIV on long term ART in comparison with their age-matched controls. Results The study was conducted in asymptomatic virally suppressed PLHIV on ART for more than 5 years [n = 70, M: F = 36:34] and HIV uninfected controls [n = 68, M: F = 31:37] belonging to the age-group of 40–55 years. Blood samples were collected for assessing levels of immunosenescence markers on CD4 T cells by flow cytometry and anti-CMV antibodies as well as soluble CD14 (sCD14) levels by ELISA. The levels were compared between cases and controls and correlated with the levels of anti-CMV antibody and sCD14. PLHIV had significantly lower levels of naïve T cells and higher levels of activated and immunosenescent T cells than controls as indicated by CD38, CD57, CD28 expressing CD4 and CD8 T cells. PLHIV had higher levels of anti-CMV antibodies, but lower levels of sCD14 levels and HLADR + CD8 T cells than those in controls. Immunosenescent T cells correlated positively with anti-CMV antibody levels and negatively with sCD14 levels. Duration of dolutegravir based therapy correlated negatively with sCD14 levels. Conclusions Thus, higher levels of immune activation and immunosenescence in the cases possibly indicate their compromised immune status predisposing PLHIV to infections and cancers. The study indicated a need for CMV treatment regimens even in asymptomatic individuals for preventing immunosenescence. The study also indicated a role of dolutegravir induced loss of sCD14 levels in predisposing PLHIV to immunosenescence.

Abstract A network created in places inaccessible to humans is known as the wireless sensor network. A sensor must detect data/information before it sends this data to a base station. Data can be routed between just one node to a base station using a variety of routing protocols. The hierarchical routing method is one of the routing protocols that hierarchically distributes sensed data. Using clustering to arrange the network into an interconnected hierarchy has shown to be a successful strategy. Bio‐inspired particle swarm optimisation is combined with the Enhanced LEACH protocol to overcome the shortcomings of conventional protocol like overall consumption of energy, the total number of survival nodes, and packets being delivered during the network's life. Metaheuristic approach of particle swarm optimisation which explores alternative paths during optimisation, leading to more adaptive and efficient energy dissipation. Enhanced LEACH with the bioinspired protocol makes it more efficient for real‐time applications. Simulation results show that the proposed protocol has a greater advantage over the conventional and Enhanced LEACH.

Abstract Objective A key component of determining that a patient-reported outcome (PRO) measure is fit-for-purpose is to ensure that respondents understand its instructions and items. Any modification to a measure should be evaluated for relevance and understandability. The objective of the study was to assess comprehension of the adapted Urticaria Activity Score (UAS) questionnaire among adolescents aged populations with chronic spontaneous urticaria (CSU) and the modification to UAS question 2 to include patient-friendly terminology “wheals (hives).” A patient guidance document for completing the adapted UAS was also examined. Methods A non-interventional, cross-sectional, qualitative study involving hybrid concept elicitation and cognitive interviews was conducted among adults and adolescents with CSU. Eligibility included clinician confirmation of CSU and experience of itch and hives for ≥ 6 weeks. Study participants were recruited from US clinical sites and online CSU patient communities. Telephone interviews were conducted using a semi-structured interview guide. Participants reviewed the UAS and provided their input on the UAS guidance document. Results Twenty-two interviews were conducted (seven adolescents and 15 adults; mean age 34 ± 18 years, 64% female, 77% White, 77% non-Hispanic, and 59% moderate to severe CSU symptoms). All participants (n = 22/22, 100%) stated that the adapted UAS was clear and “easy” to understand. For the adapted UAS “wheals (hives)” item, several participants were unfamiliar with the term “wheals,” but the term “hives” was well understood by US participants. Most participants reported that it was “easy” or “not difficult” to count and recall the number of hives they had over the past 24 h. Participants found the adapted UAS guidance document “helpful” and “easy to understand” for determining and counting hives in a 24-hour period. Suggestions for improving the guide included adding a picture to aid in counting hives. Conclusions Itch and hives are important symptoms of CSU. Results support the content validity of an adapted UAS as a daily measure of severity of itch and hives and provided valuable suggestions for improving its patient guidance, which can be used in future clinical trials involving adults and adolescents ≥ 12 years old with CSU to assess the severity of itch and hives.

Abstract Background Despite the increasing integration of competency-based education in medicine, there remains a significant gap in effectively assessing educational outcomes, underscoring the urgent need for designed assessment blueprints that accurately reflect both curriculum content and competency standards in Community Medicine for undergraduate students. This study, conducted across the All-India Institute of Medical Sciences (AIIMS) network, develops a summative assessment blueprint aimed at standardizing evaluations in medical education across diverse geographic locations in India. Methods Twenty-five experts from 10 All India Institutes of Medical Science were invited via email and contributed for summative assessment for a theory paper. Each week, the study lead team sent an online form containing 25 topics. A total of 269 topics were selected to be included in the blueprint development. An Impact and Frequency score was obtained for each topic, with a score between 1 and 3 for both its “Impact (I)” and “Frequency” (F). Results The overall response rate was 71%. “Principle of epidemiology” (14.7%) had the most weight, followed by “Epidemiology of communicable disease” (13.4%) and “National Health Program” (10%). These three chapters constituted more than one-third of the total weight of the summative assessment (theory). 20 out of 24 (83%) chapters have moderate-to-good interrater reliability. Conclusions The blueprint developed in this study is intended to serve as a guideline for setting question papers and aims to enhance objectivity, uniformity, and validity in assessment construction. While it provides a structured approach within the AIIMS network, its broader applicability may be limited, suggesting that its effectiveness in other educational contexts remains to be validated. Continued research is encouraged to explore its utility across diverse educational settings.

The Covid-19 pandemic left millions to suffer its impact in the forms of unemployment, displacement, acute food shortage, and more. It kept migrants and urban poor to remain more vulnerable to food. This study examined the impact of coronavirus on the food security of the urban poor through the lens of Aahar Yojana, one of the government-led subsidised meal programs in Odisha, India. It combined the interview data obtained from the Aahar centres with structured observations and evaluated interlinked elements of the institutional services and pandemic: Hunger satisfaction level, Food hygiene, Sanitation, Quality, and Quantity. Results emphasised integrating such initiatives with robust governmental interventions to shift focus from cash transfers and subsidies. The originality of this paper is that it revealed that the scope of formerly established meal programs could mitigate food insecurity as reflected from the practical benefits during the pandemic.

Background: Despite its six-hour half-life, Hesperidin, a bioflavonoid with therapeutic benefits, has low water solubility and bioavailability. This limits treatment. This study improved hesperidin solubility and dissolution by making solid dispersions using appropriate carriers. Methodology: Solid dispersions of hesperidin were prepared using two methods: kneading and solvent evaporation. The carriers utilized in the study were polyvinylpyrrolidone K30 (PVP K30) and mannitol. The formulations were evaluated based on various parameters, including yield, solubility, dissolution rate, drug content, and structural analysis using techniques such as X-ray diffraction (XRD), differential scanning calorimetry (DSC), and infrared (IR) spectroscopy. Results: Solid dispersions yielded 81.2% to 97.5% by weight and included 93.7% to 98.4% drug content. Hesperidin's solubility increased 3.72- to 24.05-fold, with a maximum drug release of 64.06% within 30 minutes. Comparatively, formulations with mannitol as the carrier demonstrated higher solubility (24.05 times) and dissolution (54.06%) than those containing PVP K30 (20.16 times and 34.36%). Discussion: Different carriers alter hesperidin solubility and dissolution. Mannitol improved drug release more than PVP K30. XRD and DSC experiments showed hesperidin's crystalline character changed in solid dispersions, possibly explaining its improved dissolving. IR spectroscopy showed physical dispersion because medication and carriers did not interact chemically. Conclusion: The study showed that solid dispersing hesperidin improves its solubility and dissolution. Drug release was greater with mannitol than with PVP K30. Solid dispersion formulations may improve the bioavailability of poorly soluble medicines like hesperidin.

Background and Aims: Clinical laboratories are essential for disease screening, diagnosis and management, and they play a crucial role in patient care services. Thus, laboratory personnel’s primary responsibility is to issue high-quality reports that fulfil clinicians’ and patients’ expectations. Quality control (QC), including internal and external QC (IQC and EQC), is vital for the reliability of laboratory reports. QC encompasses the procedures used to determine whether laboratory results are reliable for clinical use, whereas IQC ensures daily consistency in the laboratory results. The aim of the study was to find out the knowledge of quality control both internal and external among laboratory personnel working in the Department of Biochemistry in a tertiary care centre. Materials and Methods: This study assessed the knowledge of QC among laboratory personnel working in the department of biochemistry in a tertiary care centre. A structured questionnaire was used to evaluate both IQC and EQC. Results: It was observed that 32% of laboratory personnel attained an average score, whereas 68% achieved a good score. Conclusions: The primary responsibility of laboratory personnel is to ensure accurate laboratory test results. Thus, the knowledge and practice of QC procedures improve medical laboratories’ quality and prepare laboratory personnel for various accreditation procedures.

Background: The choice of sealing material is a crucial factor that influences the outcome of endodontic treatment. Aim: The purpose of this study was to compare the sealing ability of mineral trioxide aggregate (MTA) Angelus, Endocem MTA, and NeoPutty MTA when used as furcal perforation repair materials. Materials and Methods: A total of 45 mandibular molars were used. Root canal treatment was carried out following which standardized furcal perforations were made. The specimens were randomly divided into three groups of 15 teeth each. Group A-Furcal perforation repair by means of MTA Angelus, Group B-Furcal perforation repair using Endocem MTA, and Group C-Furcal perforation repair by NeoPutty MTA. Following the repair procedure, the pulp chambers and access openings were filled with temporary restorative material and immersed in 1% basic fuchsin dye for 24 h. The teeth were sectioned longitudinally and the linear dye penetration was measured using a stereo-microscope. Results: The one-way analysis of variance (ANOVA) revealed a statistically significant difference among the groups (F = 16.15, P < 0.001). On calculating the depth of leakage to the total length of the perforation, it was observed that the mean leakage was 32.83% in Group I, 52.92% in Group II and the lowest, 16.35% in Group III. The ANOVA test reveals a statistically significant difference among the groups (F = 15.92, P < 0.001). Comparing the depth of dye penetration of dye, 33.3% of the Group I samples showed ≥50%, 49%–25%, and

Immunoglobulin G4-related disease of the ocular adnexa is a systemic fibroinflammatory process of unknown etiology characterized by tissue infiltration by Immunoglobulin G4 plasma cells. In this case report, we present a case of Immunoglobulin G4-related disease involving extraocular muscles and lacrimal gland in a young female with initial and follow-up magnetic resonance imaging findings.

Background: Personality traits have not only been identified as risk factors for the onset and maintenance of alcohol use disorders but also as a significant predictor of alcohol-related dysfunction and comorbidity when tested with multifactorial models. The five-factor model of personality is popular as it explains a good deal of the variance in the personality profiles of different individuals. The study aimed to assess the personality traits of patients with alcohol dependence using neuroticism, extraversion, and openness five-factor inventory (NEO-FFI) and to determine its association with various alcohol-related variables, dysfunction, and comorbidities. Methodology: Fifty patients with alcohol dependence, aged 18–65 years, in a hospital outpatient and inpatient settings, were evaluated using a semi-structured sociodemographic pro forma and the 60-item NEO-FFI-3. Results: Patients with alcohol dependence had high scores on neuroticism and low scores on agreeableness and conscientiousness. High scores on neuroticism and extraversion and low scores on agreeableness and conscientiousness were associated with higher alcohol variable scores, dysfunction, and comorbidities. Conclusion: Higher neuroticism and extraversion and lower agreeableness and conscientiousness scores are associated with parameters associated with higher severity of alcohol dependence and its complications.

Abstract Observational health research often relies on accurate and complete race and ethnicity (RE) patient information, such as characterizing cohorts, assessing quality/performance metrics of hospitals and health systems, and identifying health disparities. While the electronic health record contains structured data such as accessible patient-level RE data, it is often missing, inaccurate, or lacking granular details. Natural language processing models can be trained to identify RE in clinical text which can supplement missing RE data in clinical data repositories. Here we describe the Contextualized Race and Ethnicity Annotations for Clinical Text (C-REACT) Dataset, which comprises 12,000 patients and 17,281 sentences from their clinical notes in the MIMIC-III dataset. Using these sentences, two sets of reference standard annotations for RE data are made available with annotation guidelines. The first set of annotations comprise highly granular information related to RE, such as preferred language and country of origin, while the second set contains RE labels annotated by physicians. This dataset can support health systems’ ability to use RE data to serve health equity goals.

Abstract Background Gangliocapsular stroke is a specific type of hemorrhagic stroke that primarily affects the basal ganglia and internal capsule due to rupture of the lenticulostriate perforating arteries. Patients afflicted with this condition often present with contralateral motor deficits, particularly affecting the upper extremity. Additionally, these individuals may experience challenges in coordination and stability, largely due to the involvement of the shoulder and scapular girdle. The stability of proximal joint is essential to increase the limited functions and distal movement of the upper extremities. Malalignment of scapula further complicates the execution of daily activities, profoundly affecting patients’ overall well-being and reducing engagement in society. Therefore, restoring upper limb function is imperative for a successful return to daily routines, with a focus on improving arm function being a crucial aspect of stroke therapy. Many methods have been explored for enhancing the function of upper limb in stroke, but the emphasis is more toward developing independence in grasp and improving scapular stability is often neglected. This case reports aim to examine the effect of targeted scapular proprioceptive neuromuscular facilitation on upper limb function in a patient who suffered a gangliocapsular stroke. Case presentation A 54-year-old South Asian man was presented with left-sided hemiplegia following a right gangliocapsular stroke. He reported challenges in using his left upper limb and weakness of the left side of the body, which severely impaired his ability to perform activities of daily living. Radiological findings indicated a right gangliocapsular hemorrhage. The patient underwent a 4-week physiotherapy rehabilitation program, with outcome measures including the palpation meter, Fugl–Meyer assessment of upper extremity, and functional independence measure. Following the treatment period, significant improvements were observed in scapular alignment and upper limb functions, underscoring the effectiveness of rehabilitation strategies for optimal outcomes and recovery. Conclusions The study underscores the beneficial outcomes of targeted scapular muscles through facilitatory movement patterns to improve upper extremity function in gangliocapsular stroke. Implementing scapular proprioceptive neuromuscular facilitation techniques led to a beneficial change in scapular positioning, consequently improving upper limb function, and quality of life significantly.

Background: Dentin hypersensitivity (DH) is one of the most common conditions clinicians encounter in clinical practice. New techniques are continuously being set forth to treat this condition. In recent times, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has garnered attention owing to its ability to improve remineralization and prevent enamel demineralization. Consequently, it has been indicated as an advanced treatment for DH. Purpose: This clinical trial aims to assess the efficacy of a CPP-ACP varnish in the management of non-carious cervical hypersensitivity and compare it with that of a dentin desensitizer. Methods: Patients between the ages of 20 and 65 years who reported to our institute with complaints of DH were selected for this study. Forty teeth were chosen for this study and randomly assigned to two groups. The test group was treated with a CPP-ACP varnish (MI Varnish®, GC Corporation, Japan), while the control group was treated with a dentin desensitizer (Gluma®, Heraeus-Kulzer, Germany). Dentin hypersensitivity assessments were conducted during pre-treatment, immediately following treatment, and 2 and 4 weeks after treatment. Statistical analysis was performed after data collection. Results: An intragroup comparison showed both the CPP-ACP varnish and the dentin desensitizer achieved a maximum decrease in sensitivity in the time interval from baseline to post-op, and these desensitizing effects were sustained through the second and fourth week following treatment. An intergroup comparison revealed no statistically significant difference in sensitivity between the two groups at different time intervals. Conclusion: It could be concluded that CPP-ACP varnish and dentin desensitizer possess similar efficacy in the treatment of DH.

Bartonella quintana infection can cause severe disease that includes clinical manifestations such as endocarditis, chronic bacteremia, and vasoproliferative lesions of the skin and viscera. B. quintana bacteria is transmitted by the human body louse (Pediculus humanus corporis) and is associated with homelessness and limited access to hygienic services. We report B. quintana infection in 2 kidney transplant recipients in the United States from an organ donor who was experiencing homelessness. One infection manifested atypically, and the other was minimally symptomatic; with rapid detection, both recipients received timely treatment and recovered. B. quintana was identified retrospectively in an archived donor hematoma specimen, confirming the transmission link. Information about the organ donor’s housing status was critical to this investigation. Evaluation for B. quintana infection should be considered for solid organ transplant recipients who receive organs from donors with a history of homelessness or of body lice infestation.

In patients with cirrhosis of the liver, acute variceal bleeding can be fatal. Bleeding colonic varices is a very rare cause of lower gastrointestinal bleeding that can result in massive hemorrhage in patients with cirrhosis. Here we present the case of a 50-year-old gentleman, having cirrhosis of the liver with chronic portal vein occlusion, who presented with massive bleeding per rectum. Contrast computed tomography (CT) revealed a large shunt arising from the superior mesenteric vein forming submucosal colonic varices and joining the right renal vein. He underwent successful obliteration of the varix by antegrade endovascular embolization via the trans-splenic access. Endovascular embolization could be an effective and life-saving treatment option for colonic variceal bleeding.

This study investigated the hydrogeological characteristics and groundwater dynamics in the shallow aquifer zones of inner Guwahati city, Assam, India. Sixteen dug wells spread across the city, specifically used for domestic purposes, were selected for this study. Additionally, ten wells were selected for trend analysis. The borehole lithology reveals predominant compositions of clay, sand, and granules, with thin clay cappings indicating significant groundwater potential. Depth-to-water level analysis revealed varying water levels across the study area, with shallow levels in the northern and western regions and gradual deepening toward the eastern and southern parts. The groundwater flow directions show nonuniform patterns and reflect the influence of topography and domestic pumping in urban residential zones. The general groundwater flow direction is toward the Brahmaputra River. Trends in groundwater level, assessed using the Mann–Kendall test and Sen’s slope, suggest both falling and rising trends across different locations, indicating complex groundwater dynamics influenced by factors such as recharge, extraction, and topography. However, the long-term rainfall data indicate no significant trend over the studied period, suggesting limited natural influence on groundwater level trends. These findings may contribute to a comprehensive understanding of groundwater dynamics in the study area and are essential for sustainable water resource management and mitigation of groundwater depletion risks.

Introduction: Achenbach syndrome is a rare, benign condition characterized by painful discoloration of a finger. Recognition of this syndrome prevents unnecessary costly workup and risky interventions. Case Report: A healthy, 54-year-old female was transferred to our emergency department (ED) from a community ED for vascular evaluation of discoloration and numbness to her finger. After extensive workup, medical intervention, and consultation with multiple specialists, she was diagnosed with Achenbach syndrome. Conclusion: Emergency physicians may practice good healthcare stewardship and limit invasive, potentially harmful, and expensive workup by reassuring patients of the benign nature of this condition.

Background: It is very well known that the supraclavicular nerve (SCN) which occupies the inferior part of the superficial cervical plexus basically originates from the ventral rami of C2–C4, then travels caudally into the investing layer of the deep cervical fascia (IL-DCF) alternatively termed the “prevertebral fascia.” Methods: This cadaveric study (a total of 6 soft-embalmed cadavers and bilateral dissections, i.e. 12 specimens) intended to ascertain the location of SCN within the layers of the IL-DCF. We hypothesized that ultrasonography identification of SCN within the IL-DCF and needle tip positioned between the layers of IL-DCF provide an alternative site for the blockade of the SCN. Results: After dissection, we described a compact double-layered IL-DCF hosting the SCNs and a specific topographic arrangement at the C4 root with SCN lateral and C4 branches of the phrenic nerve medial to the C4. Conclusion: We recommend another alternative site for the SCN block at a site in the compact double layer of IL-DCF. We conclude that a caudal site at the exit of SCN from the IL-DCF would be appropriate to perform the intervention.

Introduction: Diabetic foot is one of the most devastating complications of diabetes and is the leading cause of lower limb amputations. Patients with a long-standing history of diabetes mellitus often experience symptoms of pain, burning sensation, numbness, and paraesthesia in the heel and feet. These symptoms may be due to compression of the medial plantar nerve, a branch of the tibial nerve, within the tarsal tunnel. Aim: To evaluate the incidence of Tarsal Tunnel Syndrome (TTS) in patients suffering from Type 2 Diabetes Mellitus (T2DM). Materials and Methods: This study was a cross-sectional analysis conducted at the Army Hospital (Research and Referral) in New Delhi, India, from October 2019 to April 2021. A total of 30 consecutive diabetic patients presenting with pain, burning, numbness, and paraesthesia in the heel or feet, with or without ulcers, were included. All patients were clinically evaluated using three-point sensory testing, Tinel’s sign at the tarsal tunnel, and assessment for the presence of ulcers on the foot. All patients underwent Nerve Conduction Velocity (NCV) studies. Imaging studies in the form of Magnetic Resonance Imaging (MRI) were performed for a complete work-up of these patients and further diagnosis of TTS. The incidence of TTS was evaluated using clinical, radiological and electrodiagnostic studies. Results: Of the 30 patients enrolled, 20 were males (66.7%) and 10 were females (33.3%). The incidence of TTS among diabetic patients was found to be 14 (46.7%) based on electrodiagnostic criteria, 22 (73.3%) based on clinical evaluation, and 25 (83.3%) based on radiological findings. The mean HbA1c level was 8.5±1.04%. The most common imaging finding was oedema, observed in 83.3% of patients. Inflammation and ganglion cysts were seen in 13.3% and 10% of patients, respectively. Conclusion: TTS is difficult to diagnose. MRI is a useful imaging modality to support the diagnosis. Electrodiagnostic studies can help confirm the diagnosis.

Background Encapsulated pancreatic fluid collection (PFC) is a requisite for endoscopic drainage procedures. The 4-week threshold for defining walled-off necrosis does not capture the dynamic process of encapsulation. We aim to investigate the changes in the wall characteristics of PFC in acute necrotizing pancreatitis (ANP) by comparing baseline contrast-enhanced computed tomography (CECT) with follow-up CT scans.

Introduction: Early Childhood Caries (ECC) is a major public health issue that negatively affects children’s physical and mental health. Silver Diamine Fluoride (SDF) is a novel material that has the potential to improve dentin hypersensitivity and enhance enamel remineralisation. This alkaline solution is known to be more resistant to acidic environments than hydroxyapatite. Aim: To measure the pH (Potential of Hydrogen) in saliva at three different intervals after the application of 38% SDF in children with ECC. Materials and Methods: This pre-post single-group quasi-experimental study was conducted in the Department of Paediatric and Preventive Dentistry at Rajarajeswari Dental College and Hospital in Bengaluru, Karnataka, India from September 2021 to February 2022. A total of 15 patients with ECC, aged 3-6 years, were selected for the application of 38% SDF. Saliva samples were collected before the application, immediately after the application, and one hour after the application of 38% SDF. pH analysis was then conducted. The data obtained were subjected to statistical analysis. Repeated measures of Analysis of Variance (ANOVA) and Bonferroni’s post-hoc test were used for multiple comparisons of salivary pH levels at different time intervals. Age and gender-wise comparisons of mean salivary pH levels at different time intervals were conducted using an independent Student’s t-test. Results: Among the 15 participants included in the study, the average age of the subjects was 4.60±1.06 years. Among the study participants, 9 (60.0%) were males and 6 (40.0%) were females. A comparison of mean salivary pH levels at different time intervals showed that the mean salivary pH levels before the SDF application were 6.45±0.22, immediately after the application were 6.95±0.18, and one hour after the application were 7.30±0.27. In the gender-wise comparison, a higher mean pH was recorded in males than in females. Conclusion: The change in mean pH was found to be statistically significant before and after the application of SDF, as well as at the one-hour time interval, showing an increasing trend. This indicates that the changes in salivary pH that occur after applying 38% SDF are clinically significant and can be used as an effective caries control and preventive strategy.

Abstract The nematode Caenorhabditis elegans is widely employed as a model organism to study basic biological mechanisms. However, transgenic C. elegans are generated by manual injection, which remains low-throughput and labor-intensive, limiting the scope of approaches benefitting from large-scale transgenesis. Here, we report a robotic microinjection system, integrating a microfluidic device capable of reliable worm immobilization, transfer, and rotation, for high-speed injection of C. elegans. The robotic system provides an injection speed 2-3 times faster than that of experts with 7–22 years of experience while maintaining comparable injection quality and only limited trials needed by users to become proficient. We further employ our system in a large-scale reverse genetic screen using multiplexed alternative splicing reporters, and find that the TDP-1 RNA-binding protein regulates alternative splicing of zoo-1 mRNA, which encodes variants of the zonula occludens tight junction proteins. With its high speed, high accuracy, and high efficiency in worm injection, this robotic system shows great potential for high-throughput transgenic studies of C. elegans.

Abstract Background People’s wider culture plays a vital role in both dementia care and policy. This study aims to explore the cultural practice and policy influence around caring for People Living with Dementia (PLWD) in Nepal. Methods An exploratory qualitative study was designed to investigate dementia care in Nepal. The study comprised four in-depth interviews and four focus group discussions with 29 participants, including family members, health care professionals, and other stakeholders. Data were analysed using thematic analysis. Result Four major themes (each with several sub-themes) were identified: (1) Cultural practice in dementia care; (2) Impact of policy on the dementia care; (3) Service provision; and (4) Education and training. Conclusion There is a need for community-based awareness raising on dementia and its care, to sensitise all relevant stakeholders to meet the needs of PLWD. In addition, capacity building of health workforce is needed to enhance their knowledge of and skills in providing culturally appropriate dementia care.

Abstract Roots play a crucial role in plant development, serving to absorb water and nutrients from the soil while also providing structural stability. However, the impacts of global warming can impede root growth by altering soil conditions that hinder overall plant growth. To address this challenge, there is a need to screen and identify plant genotypes with superior Root System Architecture traits (RSA), that can be used for future breeding efforts in enhancing their resilience to these environmental changes. In this project, 500 mid to late-maturity soybean accessions were grown on blue blotting papers hydroponically with six replicates and assessed seven RSA traits. Genome-Wide Association Studies (GWAS) were carried out with root phenotypic data and SNP data from the SoySNP50K iSelect SNP BeadChip, using both the TASSEL 5.0 and FarmCPU techniques. A total of 26 significant SNP-trait correlations were discovered, with 11 SNPs on chromosome 13. After SNP selection, we identified 14 candidate genes within 100-kb regions flanking the SNPs, which are related to root architecture. Notably, Glyma.17G258700, which exhibited substantial differential expression in root tips and its Arabidopsis homolog, AT4G24190 (GRP94) is involved in the regulation of meristem size and organization. Other candidate genes includes Glyma.03G023000 and Glyma.13G273500 that are also play a key role in lateral root initiation and root meristem growth, respectively. These findings significantly contribute to the discovery of key genes associated with root system architecture, facilitating the breeding of resilient cultivars adaptable to changing climates.

Abstract Background To compare the diagnostic utility of computed tomography (CT) and ultrasonography (USG) for preoperative determination of metastatic lymph nodes. Methods Head and neck squamous cell carcinoma (HNSCC) cases planned for neck dissection were included. All underwent preoperative neck USG and CT followed by histopathological evaluation after surgery. Sensitivity, specificity, positive and negative predictive value along with accuracy was calculated for each outcome variable. Efficacy was calculated by comparing these to postoperative histopathology. Both imaging modalities were compared with lymph nodal volume. Results Eighty-seven lymph nodes were selected from 30 patients. Median volume on CT was 5412.15 mm3 for metastatic and 237.7 mm3 for benign nodes and on ultrasound, 4168.92 mm3 for metastatic and 233.1 mm3 for benign nodes (p

The disorder known as hyperdontia is characterized by an excess of teeth or teeth that appear to be added to the normal amount of teeth. With a frequency ranging from 0.1% to 3.9% in permanent dentition and from 0.3% to 1.8% in deciduous dentition, it affects males more often than women. Since children’s cognitive abilities are still developing in comparison to adults’, children freely communicate their worry and anxiety and frequently exhibit uncooperative behavior patterns while undergoing treatment. A 7-year-old child who was emotionally immature reported with a principal complaint of missing tooth in his left upper front tooth area for 2 years. Cone-beam computed tomography was advised to verify location and structural interaction with neighboring structures. Due to his lack of emotional sensitivity and cooperation with others, we planned the surgical extraction under general anesthesia. In the present case, it was deemed preferable to wait for a spontaneous eruption, and the patient was observed for a month on a regular basis.

Ixoberogene soroparvovec (ixo-vec), formerly ADVM-022, is an adeno-associated virus (AAV) gene therapy using the AAV.7m8 capsid for intravitreal delivery (IVT) to transduce retinal tissue and produce sustained intraocular aflibercept for treating neovascular age-related macular degeneration (nAMD). Non-clinical studies show that aflibercept production by ixo-vec is less than dose proportional, while intraocular inflammation (IOI) increases with dose, suggesting that lower doses could yield effective aflibercept levels with reduced IOI risk. Our evaluation confirmed that doses as low as 3E10 vg (vector genome)/eye (6E10 vg/eye human equivalent) maintained effective aflibercept production. The concept behind ADVM-022 is supported by clinical studies OPTIC (NCT03748784) and LUNA (NCT05536973), where a single IVT administration eliminated or significantly reduced the need for additional anti-VEGF injections in patients. Moreover, LUNA confirmed the clinical efficacy of a 6E10-vg/eye dose, demonstrating robust and sustained aflibercept levels. Additionally, we evaluated staggered dosing in contralateral eyes to treat asynchronous disease development. Staggered dosing, administered 2 months apart, did not exacerbate IOI, and both eyes maintained therapeutic aflibercept levels. These findings support the tolerability and efficacy of staggered dosing, indicating the potential for bilaterally relevant aflibercept levels with ixo-vec, due to immune response confinement to the dosed eye.

Biofuel, a sustainable fuel source, is crucial in the modern day as it reduces reliance on non-renewable energy sources and helps to reduce CO2 emissions. The manufacture of biofuels on a wide scale is a difficult process due to the numerous limitations in current technology and the subsequent rise in expenses. Moreover, the processes employed to transform diverse raw materials into the desired biofuel may differ depending on the particular methodologies and substances utilized. The global demand for bioethanol is growing as countries throughout the world enforce legislation requiring the blending of bioethanol with gasoline. Second-generation bioethanol derived from lignocellulosic biomass is rapidly gaining prominence. The biochemical conversion process has various technical, practical, and economic challenges such as pre-treatment, hydrolysis, and fermentation. Nanoparticles (NPs) offer a highly efficient solution for overcoming current challenges in utilizing biomass, thanks to their selectivity, energy efficiency, and time management capabilities, all while reducing prices. Also, the biotechnological significant advancement in revolutionized the sorghum varieties or strains to enhance the yield of ethanol. This article offers a succinct summary of bioethanol from sweet sorghum feedstock and the progress made in using nanotechnology to produce them, with a specific focus on the enzyme immobilization approach. The text offers an in-depth exploration of how nanotechnology is utilized across ethanol production, with a specific focus on comprehending the process by which enzymes immobilized on nanoparticles interact with lignocellulose to enhance the output of ethanol.

Aneuploidy typically poses challenges for cell survival and growth. However, recent studies have identified exceptions where aneuploidy is beneficial for cells with mutations in certain regulatory genes. Our research reveals that cells lacking the spindle checkpoint gene BUB3 exhibit aneuploidy of select chromosomes. While the spindle checkpoint is not essential in budding yeast, the loss of BUB3 and BUB1 increases the probability of chromosome missegregation compared to wildtype cells. Contrary to the prevailing assumption that the aneuploid cells would be outcompeted due to growth defects, our findings demonstrate that bub3Δ cells consistently maintained aneuploidy of specific chromosomes over many generations. We investigated whether the persistence of these additional chromosomes in bub3Δ cells resulted from the beneficial elevated expression of certain genes, or mere tolerance. We identified several genes involved in chromosome segregation and cell cycle regulation that confer an advantage to Bub3-depleted cells. Overall, our results suggest that the gain of specific genes through aneuploidy may provide a survival advantage to strains with poor chromosome segregation fidelity.

Objectives To identify burnout constructs from descriptions of staff experiences of health inequalities operating across paediatric specialist hospitals and to categorise the constructs according to Leiter and Maslach’s six Areas of Worklife (AWL) model of burnout.Design A secondary data analysis of a qualitative study using semi-structured interviews and focus groups.Setting The interviews and focus groups were conducted within nine children’s hospitals in England.Participants The dataset included responses from 217 individual staff members occupying various roles: leadership, clinical, professional and support. All staff who volunteered to participate were included in the study.Results The results of this exploratory analysis showed that psychological burnout constructs were frequently embedded in hospital staff’s descriptions of their experiences of health inequalities in hospitals, and relevant excerpts were found for all six domains of the AWL model. Staff described a work environment where socioeconomic disparities increased workload pressures, but efforts to improve services were frustrated by a perceived lack of control in decision making or professional recognition. There was ambiguity of role-based responsibilities for tackling health inequalities and an imbalance between organisational practices and personal and professional values of social justice.Conclusions There is a reciprocal relationship between health inequalities and burnout experienced by healthcare professionals operating within specialist children’s hospital settings. The extant knowledge and approaches to health inequalities and occupational burnout should be considered in tandem, integrated into quality improvement and operationalised within paediatric healthcare organisations to improve safety and quality of care.

Neurologic disorders currently affect approximately 100 million people worldwide. Neurologic disorders most often occur due to inherent genetic mutations, which lead to numerous types of functional disruptions in nervous system development. Neurologic disease-related events, such as genetic and epigenetic changes, cause inflammatory processes in the area which may enhance the disease cycle. Gene therapy has progressed to a compelling therapeutic approach for various neurodegenerative disorders. Several efforts to enhance gene therapy rely on discovering novel vectors, recent curative targets, and the dependability of transgenic delivery paths. These viral and non-viral vectors techniques are carefully screened through preclinical and clinical levels and eventually render patients with effective therapies. This review addresses gene therapy developments and obstacles for neurodegenerative diseases and discusses emerging strategies, goals, and prospects.

Follicular lymphoma (FL) is an indolent B cell lymphoma with a heterogenous disease course, and patients may not require immediate treatment upon diagnosis. Scrutiny of its microenvironment may provide key insights into lymphomagenesis and enhancement of therapeutic options. We analyzed the T-cell composition of a large, well-annotated follicular hyperplasia (FH; n=43) cohort utilizing standardized high dimensionality flow cytometry (>150,000 cells analyzed/sample) and a novel reproducible analytical pipeline leading to identification of even minor T-cell subsets. This baseline reference set was compared to prospectively collected FL samples (n=91) from untreated patients (FL-UT) and patients with relapsed/refractory disease (FL-RR). Compared to FH, both FL-UT and FL-RR specimens exhibited depletion of CD4+ and CD8+ naive subsets and were characterized by an immune suppressive microenvironment enriched in specific inhibitory T-cells, along with exhausted memory T-cells overexpressing varying combinations of immune checkpoint receptors. FL specimens showed enrichment of T follicular regulatory cells (TFR) and two highly suppressive regulatory T-cell (Treg) populations expressing TIGIT and CTLA4 (TC) and PD1, TIGIT, CTLA4, and TIM3 (PTCTi). FL-UT cases with either increased T-reg TC or increased T follicular helper cells (TFH) showed reduced time to first treatment (

[This corrects the article DOI: 10.1371/journal.pbio.3001427.].

Wafer-level packaging (WLP) is a pivotal semiconductor packaging technology that enables heterogeneously integrated advanced semiconductor packages with high-density electrical interconnections through its efficient and highly reliable manufacturing processes. Within this domain, fan-out wafer-level packaging has gained prominence due to its potential for high integration capacity, scalability, and performance on a smaller footprint. This review examines FOWLP technology and its associated challenges, primarily warpage. As semiconductor companies strive to develop cutting-edge packages, wafer warpage remains an intrinsic and persistent issue affecting yield and reliability at both the wafer and package levels. Warpage characterization techniques and modeling approaches, including theoretical, numerical, and emerging artificial intelligence and machine learning (AI/ML) methods, have been analyzed. The structural parameters and properties of the constituent materials of the reconstituted wafer and the FOWLP process have been considered to evaluate the effectiveness of these methods in predicting and analyzing warpage. Potential directions and limitations in warpage prediction and mitigation have been outlined for future research for more reliable and high-performance FOWLP solutions.