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Abstract The development and progression of chronic lymphocytic leukemia (CLL) depend on genetic abnormalities and on the immunosuppressive microenvironment. We have explored the possibility that genetic drivers might be responsible for the immune cell dysregulation that shapes the protumor microenvironment. We performed a transcriptome analysis of coding and non-coding RNAs (ncRNAs) during leukemia progression in the Rag2−/−γc −/− MEC1-based xenotransplantation model. The DLEU2/miR-16 locus was found downmodulated in monocytes/macrophages of leukemic mice. To validate the role of this cluster in the tumor immune microenvironment, we generated a mouse model that simultaneously mimics the overexpression of hTCL1 and the germline deletion of the minimal deleted region (MDR) encoding the DLEU2/miR-15a/miR-16-1 cluster. This model provides an innovative and faster CLL system where monocyte differentiation and macrophage polarization are exacerbated, and T-cells are dysfunctional. MDR deletion inversely correlates with the levels of predicted target proteins including BCL2 and PD1/PD-L1 on murine CLL cells and immune cells. The inverse correlation of miR-15a/miR-16-1 with target proteins has been confirmed on patient-derived immune cells. Forced expression of miR-16-1 interferes with monocyte differentiation into tumor-associated macrophages, indicating that selected ncRNAs drive the protumor phenotype of non-malignant immune cells.

Abstract Recycled manure solids (RMS) are dried cow dung processed using a manure dewatering machine and subsequently sun-dried to ~ 20% moisture. Benefits of RMS include abundant availability, low cost, and eco-friendliness, but its use as bedding material for cows is hindered by a moisture content that promotes microbial growth. This in vitro study evaluated impacts of calcium hydroxide (CH; 5 and 7.5%) and sodium hydrosulphate (SHS; 6 and 8%), independently and in combinations, at various depths of RMS, on physicochemical and microbial properties. The CH-treated groups had increased pH and reduced moisture on Day 0. Incorporating 7.5% CH + 6% SHS at 15–20 cm, and 7.5% CH + 8% SHS at all depths, effectively suppressed Escherichia coli and Klebsiella spp. Furthermore, a combination of 7.5% CH + 8% SHS at 20 cm inhibited coliform growth, whereas 7.5% CH with 6% SHS inhibited Streptococcus spp. In conclusion, a combination of 7.5% CH with either 6 or 8% SHS at a depth of 15 cm in RMS was particularly effective in controlling environmental mastitis-causing pathogens, specifically E. coli and Klebsiella spp. Graphical Abstract

Abstract Liquid-like protein condensates are ubiquitous in cellular system and are increasingly recognized for their roles in physiological processes. Condensed phase harbors distinctive chemical microenvironment, markedly different than dilute aqueous phase. Herein, we demonstrate chemoselective modification pattern of nucleophilic canonical amino acid sidechains (namely – cysteine, tyrosine and lysine) of the protein towards 4-chloro-7-nitrobenzofurazan in the dilute and condensed phase. We also delineate how the effect of nucleotides and their in situ enzymatic dissociation temporally modulate the protein condensate’s pH and the protein’s corresponding chemoselective modification. We have shown that the pH of the condensate decreases in the presence of nucleoside triphosphate, whereas it increases in the presence of nucleoside monophosphates or phosphate ion. For instance, we find lysine-specific modification gets inhibited in the presence of adenosine triphosphate (ATP), but significantly enhanced in the presence of monophosphates. This feature enables us to gain temporal control over dynamic change in protein functionalization via enzymatic ATP hydrolysis. Overall, this work substantiates the alteration in pH-responsiveness of Brønsted basicity of a protein’s ε-amine in the condensed phase. Furthermore, this environment sensitivity in chemoselective protein functionalization in condensed phase will be important in adaptable protein engineering to the chemical biology of protein phase separation.

Abstract Understanding the navigation through semi-dense crowds at intersections poses a significant challenge in pedestrian dynamics, with implications for facility design and insights into emergent collective behavior. To tackle this problem, a system of cognitive active agents at a crowded three-way intersection is studied using Langevin simulations of intelligent active Brownian particles (iABPs) with directed visual perception (resulting in non-reciprocal interactions) and self-steering avoidance—without volume exclusion. We find that the emergent self-organization depends on agent maneuverability, goal fixation, and vision angle, and identify several forms of collective behavior, including localized flocking, jamming and percolation, and self-organized rotational flows. Additionally, we demonstrate that the motion of individual agents can be characterized by fractional Brownian motion and Lévy walk models across different parameter regimes. Moreover, despite the rich variety of collective behavior, the fundamental flow diagram shows a universal curve for different vision angles. Our research highlights the impact of collision avoidance, goal following, and vision angle on the individual and collective dynamics of interacting pedestrians.

Abstract Patients with rare diseases often experience prolonged diagnostic delays. Ordering appropriate genetic tests is crucial yet challenging, especially for general pediatricians without genetic expertise. Recent American College of Medical Genetics (ACMG) guidelines embrace early use of exome sequencing (ES) or genome sequencing (GS) for conditions like congenital anomalies or developmental delays while still recommend gene panels for patients exhibiting strong manifestations of a specific disease. Recognizing the difficulty in navigating these options, we developed a machine learning model trained on 1005 patient records from Columbia University Irving Medical Center to recommend appropriate genetic tests based on the phenotype information. The model achieved a remarkable performance with an AUROC of 0.823 and AUPRC of 0.918, aligning closely with decisions made by genetic specialists, and demonstrated strong generalizability (AUROC:0.77, AUPRC: 0.816) in an external cohort, indicating its potential value for general pediatricians to expedite rare disease diagnosis by enhancing genetic test ordering.

Abstract Background Globally, digital transformation has been sweeping through healthcare in recent years. Reflecting this global change, Australia’s health and social care sector is also undergoing rapid digitalisation. Digital approaches can enhance care planning and coordination activities, as well as improve efficiencies in documentation and coordination of care. As the aged care environment continues to become digitalised into the future, there is an expectation that nurses practise the delicate art and science of compassionate caregiving in a technology-proliferated environment where care planning, provisioning, and documenting require digital knowledge and skills. Aim To explore the perspectives and expectations of nurses working in residential aged care setting regarding the utilisation of technology to enhance care at the end-of-life. Methods A qualitative descriptive research study design based on the secondary analysis of data collected as part of a larger study. Data collection was conducted using six semi-structured interviews and 11 focus group discussions with care workers, nurses, and nursing managers working in Australian residential aged care setting. Results A total of 64 participants took part in this study. Overall, four themes were generated from the data as following: engagement with various digital systems and platforms; 2) ambivalence toward technology; 3) challenges and concerns in technology use; and 4) anticipated technology roles in end-of-life care. This study found that, nurses in Australian RAC are open to engage with technologies for end-of-life provision, despite some ambivalence and challenges encountered in the process. Conclusion Nurses in residential aged care have an important role in end-of-life care of many older Australians. Digital approaches offer care and coordination opportunities however require the aged care sector and nurses to take up these opportunities. While nurses demonstrate openness to technology, focus needs to be placed on technology use support. This presents an opportunity for nurses to actively shape the future of digital innovations in aged care, ensuring high-quality, compassionate care for residents in their final stages of life.

Abstract In Finland, the frequency of isolated cleft palate (CP) is higher than that of isolated cleft lip with or without cleft palate (CL/P). This trend contrasts to that in other European countries but its genetic underpinnings are unknown. We conducted a genome-wide association study in the Finnish population and identified rs570516915, a single nucleotide polymorphism highly enriched in Finns, as strongly associated with CP (P = 5.25 × 10−34, OR = 8.65, 95% CI 6.11–12.25), but not with CL/P (P = 7.2 × 10−5), with genome-wide significance. The risk allele frequency of rs570516915 parallels the regional variation of CP prevalence in Finland, and the association was replicated in independent cohorts of CP cases from Finland (P = 8.82 × 10−28) and Estonia (P = 1.25 × 10−5). The risk allele of rs570516915 alters a conserved binding site for the transcription factor IRF6 within an enhancer (MCS-9.7) upstream of the IRF6 gene and diminishes the enhancer activity. Oral epithelial cells derived from CRISPR-Cas9 edited induced pluripotent stem cells demonstrate that the CP-associated allele of rs570516915 concomitantly decreases the binding of IRF6 and the expression level of IRF6, suggesting impaired IRF6 autoregulation as a molecular mechanism underlying the risk for CP.

Abstract Hydrogen bonding is a central concept in chemistry and biochemistry, and so it continues to attract intense study. Here, we examine hydrogen bonding in the H2S dimer, in comparison with the well-studied water dimer, in unprecedented detail. We record a mass-selected IR spectrum of the H2S dimer in superfluid helium nanodroplets. We are able to resolve a rotational substructure in each of the three distinct bands and, based on it, assign these to vibration-rotation-tunneling transitions of a single intramolecular vibration. With the use of high-level potential and dipole-moment surfaces we compute the vibration-rotation-tunneling dynamics and far-infrared spectrum with rigorous quantum methods. Intramolecular mode Vibrational Self-Consistent-Field and Configuration-Interaction calculations provide the frequencies and intensities of the four SH-stretch modes, with a focus on the most intense, the donor bound SH mode which yields the experimentally observed bands. We show that the intermolecular modes in the H2S dimer are substantially more delocalized and more strongly mixed than in the water dimer. The less directional nature of the hydrogen bonding can be quantified in terms of weaker electrostatic and more important dispersion interactions. The present study reconciles all previous spectroscopic data, and serves as a sensitive test for the potential and dipole-moment surfaces.

Priyanka,1,2 Somdutt Mujwar,3 Ram Bharti,1,2 Thakur Gurjeet Singh,3 Neeraj Khatri1,2 1IMTech Centre for Animal Resources & Experimentation (iCARE), CSIR-Institute of Microbial Technology (CSIR-IMTECH), Chandigarh, 160036, India; 2Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India; 3Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, 140401, IndiaCorrespondence: Neeraj Khatri, Email neeraj@imtech.res.inPurpose: To elucidate the therapeutic potential of 2,2’-bipyridine derivatives [NPS (1– 6)] on hepatocellular carcinoma HepG2 cells.Methods: The effects on cell survival, colony formation, cellular and nuclear morphology, generation of reactive oxygen species (ROS), change in the integrity of mitochondrial membrane potential (MMP), and apoptosis were investigated. Additionally, docking studies were conducted to analyze and elucidate the interactions between the derivatives and AKT and BRAF proteins.Results: NPS derivatives (1, 2, 5 and 6) significantly impaired cell viability of HepG2 cell lines at nanogram range concentrations - 72.11 ng/mL, 154.42 ng/mL, 71.78 ng/mL, and 71.43 ng/mL, while other derivatives were also effective at concentrations below 1 μg/mL. These compounds reduced the colony formation capacity of HepG2 cells in a dose-dependent manner following treatment. Mechanistic studies revealed that these derivatives induce reactive oxygen species (ROS) accumulation and cause mitochondrial membrane depolarization, ultimately triggering apoptosis in HepG2 cells. In the presence of these derivatives, cells demonstrated that 75% of cells underwent apoptosis, compared to 25% in the control group. Additionally, there was a marked increase in mitochondrial depolarization (95% cells) and a threefold rise in ROS levels compared to the controls. Docking studies revealed interactions between the derivatives and the signaling proteins AKT (PDB ID: 6HHF) and BRAF (PDB ID: 8C7Y) with binding affinities ranging from − 7.10 to − 9.91, highlighting their pivotal role in targeting key players in hepatocellular carcinoma progression.Conclusion: The findings of this study underscore the therapeutic potential of these derivatives against HepG2 cells and offer valuable insights for further experimental validation of their efficacy as inhibitors targeting AKT or BRAF signaling pathways. Keywords: hepatocellular carcinoma, ROS, MMP, apoptosis, AKT, BRAF

Abstract Chili fruits are a potential source of phytochemicals and nutrients for food and reconstituted products. Due to its high nutritional and bioactive components, the current study focused on developing chili instant food products employing hot-air drying method. The effect of the hot-air drying method on physicochemical properties, microbiological quality, retention of bioactive components, phytochemicals, antioxidant properties, and sensory quality of green and red chilies reconstitution products were investigated. HPLC quantification unveiled that fresh red chili product had retained the highest capsaicin (2703.14 µg/g) and dihydrocapsaicin (1518 µg/g) content on the 0th day. Furthermore, UPLC-MS confirmed the presence of eleven phenolic compounds such as gallic acid, chlorogenic acid, caffeic acid, syringic acid, p-coumaric acid, protocatechuic acid, trans-cinnamic acid, ferulic acid, catechin, rutin, and quercetin. Among all, ferulic acid (382.91 µg/g) was the most abundant phenolic compound in fresh green chili products, followed by trans-cinnamic acid (73.19 µg/g) in green chili reconstituted and catechin (65.66 µg/g) in green and red chili reconstituted products. The chili products retained reasonable amounts of bioactive components and antioxidants during storage without microbial growth. The correlation analysis revealed a significant correlation between capsaicinoids, phenolic compounds, and antioxidant properties, which are linearly related in green chili products. This study offers manufacturers a cost-effective technology for producing high-quality chili-reconstituted products rich in essential nutrients and health benefits. Graphical Abstract

Background: Research suggests that self-compassion is important for understanding different life outcomes. This study explored how certain demographic factors and self-compassion affect the positive mental health of married Hindu couples. Methods: Utilizing a correlational design, 300 married Hindu couples (age range=26-50 years, Mean±SD, 38.42±7.89) from Sagar City, Madhya Pradesh, India, were recruited through snowball sampling, in which existing participants provided referrals to other potential participants. The self-compassion scale, the socioeconomic status scale and the mental health continuum-short form were used as study measures. Mean±SD, correlation and regression analysis were computed. The significance level was ≤0.05. Results: The results revealed that age (r=0.188, P=0.01) marriage length (r=0.110, P=0.01), self-kindness (r=0.332, P=0.01), common humanity (r=0.284, P=0.01), and mindfulness (r=0.250, P=0.01) were positively correlated with well-being. Conversely, self-judgment (r=-0.099, P=NS), isolation (r=0.019, P=NS) and over-identification (r=0.005, P=NS) displayed weak or negative correlations. Demographic factors (education, gender, age, domicile, occupation and marriage length) (R2=12.6%, P

Introduction: Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will guide in the differentiation of similar-looking lesions. To date, there are only a few studies on mucoscopy of genital dermatoses especially from India. Aim and Objectives: The study aims to describe mucoscopic features and correlate histopathologically in various genital mucosal diseases. Materials and Methods: The study was conducted in a tertiary care center in Central India after IHEC approval between October 2020 and April 2022, and the sampling technique was based on a convenience purposive method. Any genital mucosal diseases were included in patients above 18 years of age. Sexually transmitted diseases in general were excluded, however, warts and molluscum contagiosum were included. All patients fulfilling the inclusion criteria were examined after proper informed consent, and the clinical images were photographed using iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermoscope in polarized mode at 10X magnification. Results: A total of 206 patients were recruited, and mucoscopy features were analyzed. Dermoscopic findings of physiological conditions such as vestibular papillomatosis, pearly penile papules, and Fordyce spots were evaluated. Inflammatory conditions such as lichen planus, pemphigus, and psoriasis were analyzed. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%), as well as dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), coalescing pustules in annular and polycyclic patterns (90%). Squamous cell carcinoma of the penis showed ulceration, serpentine, looped vessels, white structureless area, and yellow-brown crust in a pink background. Limitations: In our study, because of the inclusion of various diseases, sample size was inadequate, biopsies were not performed in all cases, and variations in mucoscopic features in patients who are already on therapy could not be assessed. Haziness while capturing pictures because of mist formation was hindering the quality of pictures. As patients with premalignant and malignant cases were less, the predicting features for malignant transformation or pathognomoniic signs could not be assessed. Conclusion: Various dermoscopies have been studied extensively, but the mucoscopy is still a gray area. The results of this study revealed the dermoscopic features of various genital disorders and histopathological correlation in few cases. However, biopsy was not performed in all mucosal disorders; hence, conclusive correlation could not be extrapolated.

Background The present study aimed to compare the efficacy, safety, and cost-effectiveness of quick penetrating solution (QPS) heparin, QPS diclofenac, and heparin gel in the prevention of superficial thrombophlebitis (ST). Materials and Methods This randomized controlled trial was conducted after approval from the Institutional Ethics Committee and registration to Clinical Trial Registry of India. Patients of 18–60 years age, American Society of Anesthesiologists I/II, and who needed venous cannulation for at least 72 h were included in the study. Patients were randomly divided into three groups receiving study drugs (heparin gel, QPS heparin, and QPS diclofenac) every 8 hourly for a period of 72 h. Venous cannulation site was graded using the Visual Infusion Phlebitis Scale. Patients developing no ST, mean time to reach ST Grade 1 and 2, prevention of ST probability, and cost-effectiveness of interventions during the study period were assessed. Results Out of 219 included patients, development of no ST in the study groups at 72 h of treatment were heparin gel (11%), QPS heparin (9.6%), and QPS diclofenac (2.7%). The mean time (hours) to develop any grade ST in the study arms was heparin gel (36.2 [11.9]), QPS heparin (40.0 [13.4]), and QPS diclofenac (37.0 [13.2]). The Kaplan–Meier analysis did not reveal significant differences for the prevention of any grade ST or severe ST in three treatment arms. The average cost-effectiveness ratio for preventing thrombophlebitis was 14.2 in heparin gel-, 13.2 in QPS heparin-, and 95.6 in QPS diclofenac-treated patients. Conclusion Based on efficacy, safety, and cost-effectiveness, heparin gel or QPS heparin can be used to prevent ST due to intravenous cannulation in surgical patients. QPS diclofenac is not a cost-effective option to prevent ST.

Background There is little information available regarding knowledge and attitudes towards the human papillomavirus (HPV) and its vaccines among the students in mainland India. Furthermore, there has not been much information accessible on how to increase their understanding of and readiness to receive HPV and associated vaccines, which could be crucial for the future success of vaccination campaigns. This study aims to assess the knowledge and attitude of middle- and high-school students towards HPV infection, HPV vaccine and cervical cancer prevention. Method The present study was an observational study conducted from July 2023 to December 2023 in the Gwalior District of Northern India among the 490 students aged 11–16 years. A self-administered questionnaire was used to collect information from the students. The collected data was entered into an Microsoft Excel spreadsheet for easy calculation. Frequency and percentage were calculated and significance in proportion was tested using the chi-square test. P value was judged at a 5% level of significance. Results The average age of the student was 13.67 ± 1.95 years range between 11 years and 16 years with a 0.52:1 sex ratio. Out of the 490 enrolled participants, 41.0% of subjects had previously heard about cervical cancer. About 64.7% of students heard it from the mass media. A total of 181 (36.9%) knew that cervical cancer was caused by HPV infection. Only 168 (34.3%) participants knew the fact that men were also infected by HPV infection. Only 12.4% knew that a healthy-looking person could have an HPV infection. Only 11.6% had shown their willingness for the HPV vaccination. There was a significant difference observed among the males and females regarding knowledge questions. Males (54.76%) heard more about cervical cancer than females (33.85%). Males had more knowledge (60.1%) regarding cervical cancer caused by HPV infection as compared with females (24.8%). Conclusion Students’ awareness of HPV and the HPV vaccine was low. Training that focusses on HPV information in addition to sex education is needed to promote HPV vaccine coverage.

Introduction Forensic odontology plays a pivotal role in identifying individuals in legal contexts. This study analyses the efficacy of lip prints, tongue prints and mandibular canine width in determining gender, aiming to contribute to the evolving field of forensic dentistry. Methods A cross-sectional study was conducted involving 100 participants, analysing lip prints based on Tsuchihashi’s classification, recording tongue shapes and features through the use of alginate impressions and measuring mandibular canine width using a vernier calliper. The findings were reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Results In lip prints, Tsuchihashi’s Type I lip print was predominantly found in females, whereas Tsuchihashi’s Type III prevailed in males. Tongue shapes revealed a predominance of pentagonal shapes in males and ovoid shapes in females. The lingual apex was blunt in males and sharp in females. Mandibular canine width was higher in males than females on both the left and right sides. Conclusion The findings of this study support the use of lip prints, tongue prints and canine width in determining gender as ancillary and supporting methods.

Objective: To identify the clinical, laboratory, and radiological markers that could predict a positive GeneXpert result in patients suspected of tuberculous meningitis. Methods: In this prospective, observational study, patients with tuberculous meningitis were systematically evaluated. Various clinical, laboratory [including cerebrospinal fluid (CSF) microscopy, culture, and GeneXpert], and neuroimaging factors were examined. All participants were administered anti-tuberculous treatment and corticosteroids. A six-month follow-up was done to evaluate the outcome. Results: Of the 116 patients studied, 54 (46.6%) tested positive for GeneXpert, while 62 (53.4%) were negative. Third cranial nerve involvement (OR 3.71, 95% CI 1.052-13.09, P=0.04) and the presence of basal exudates on neuroimaging (OR 5.22, 95% CI 2.03-13.42, P=0.001) emerged as independent predictive factors for a positive GeneXpert result. A positive CSF GeneXpert result (P=0.002) and drug resistance (P=0.004) were significantly linked to adverse outcomes. Additionally, a high score on the Medical Research Council stage III (OR 5.64, 95% CI 1.18-26.87, P=0.03) and elevated CSF cell counts (OR 1.002, 95% CI 1.00-1.001, P=0.03) were identified as independent predictors of poor prognosis. Conclusions: Third cranial nerve involvement and the presence of basal exudates were significant indicators of a positive GeneXpert result. MRC stage III disability and elevated CSF cell counts predicted poor outcomes.

Background: The Pathological Concern Questionnaire (PCQ) measures thoughts, emotions, and actions based on attitudes, including repression of personal needs and overinvestment in satisfaction of others’ needs. The PCQ is widely used in the literature, but its psychometric properties are not well-established in the Indian population. Aim: The current study aimed to examine the reliability and validity of PCQ among emerging adults in India. Materials and Methods: The data were collected from 252 emerging adults, aged between 18 and 29 years using PCQ. Confirmatory factor analysis was conducted to analyse the data. Internal reliability was computed using Cronbach’s alpha and correlational analysis was conducted to examine the convergent and discriminant validity. Results: The statistical findings supported an acceptable goodness of fit for PCQ in India. PCQ showed an adequate internal consistency (α = 0.903). In addition, correlational analyses supported the convergent and discriminant validity of the PCQ. Conclusion: Our findings suggest that the PCQ is a valid and reliable instrument to measure pathological concern among Indian emerging adults.

Aim: The precise estimation and replication of skin color are crucial for maxillofacial prosthesis. The study aimed to evaluate facial skin color with a colorimeter and suggest a skin shade guide and formula for color estimation. Settings and Design: An observational study conducted in the department of prosthodontics. Materials and Methods: Study was conducted on 368 individuals of Indian origin in age range of 20–45 years. The facial skin color was assessed in malar regions using SkinColorCatch colorimetric device and individual topography angle (ITA) and CIELAB L*a*b* values were noted. Statistical Analysis Used: K-means clustering was utilized to propose a shade guide for maxillofacial prosthesis with 24 skin shades. Logistic regression analysis was conducted to propose a formula to estimate skin shade of the individuals. Results: Based on cluster analysis, 368 subjects were divided into three clusters with similar characteristic as Cluster 1 with dark skin color in 88 (23.91%) subjects, Cluster 2 with medium skin color in 224 (60.87%) subjects, and Cluster 3 with light skin color in 56 (15.22%) subjects. The mean ITA and L*a*b* values for cluster 1 were −47.04° ±14.77°, 34.53 ± 4.31, 8.55 ± 2, 11.42 ± 3.7033, respectively. The mean ITA angle and L*a*b* values for Cluster 2 were 4.29° ±11.34° 51.67 ± 3.42, 8.79 ± 3.13, 21.36 ± 2.38, respectively. The mean ITA and L*a*b* values for Cluster 3 were 34.65 ± 4.29°, 62.66 ± 3.08, 6.53 ± 1.79, 17.73 ± 2.39, respectively. The proposed shade guide comprised a total of 24 different shades that were categorized into three primary colors according to three distinct clusters, each of which was further broken down into eight subclusters containing various shades within each cluster. Logistic regression analysis gave an equation as follows: Y =12.43 + 0.186X (Y = Predicted skin color, X = ITA angle). Conclusions: Twenty-four facial skin shade tabs have been proposed based on ITA angle and CIELAB values. This comprehensive approach to categorize the shades will ensure a detailed and organized system for selecting and matching colors in maxillofacial prosthesis.

Abstract This article is devoted to the synthesis of a new magnetic palladium catalyst that has been immobilized on A-TT-Pd coated-magnetic Fe3O4 nanoparticles. Such surface functionalization of magnetic particles is a promising method to bridge the gap between heterogeneous and homogeneous catalysis approaches. The structure, morphology, and physicochemical properties of the particles were characterized through different analytical techniques, including TEM, FT-IR, XRD, SEM, EDS, TGA-DTG, ICP, and VSM techniques. The obtained Fe3O4@SiO2@A-TT-Pd performance can show excellent catalytic activity for the synthesis of diaryl ethers and oxidation of sulfides, and the corresponding products were obtained with high yields. The advantages of this catalyst include a simple test method, green reaction conditions, no use of dangerous solvents, short reaction time, low catalyst loading, and reusability. Also, the nanocatalyst was easily separated from the reaction mixture with the help of a bar magnet and recovered and reused several times without loss of stability and activity.

Abstract Background India bears the highest global burden of oral cancer, despite having an operational tobacco cessation framework. Occupational groups like solid waste management personnel face significant health challenges due to prevalent tobacco use, leading to oral potentially malignant lesions and oral cancer. Enhanced tobacco control strategies are essential for these groups. Methods A pre-post interventional, community-based study enrolled 1200 municipal workers in Varanasi, India, from July 2022 to August 2023. 858 tobacco users underwent screening and were randomly assigned to one of three interventions: Very Brief Advice, Individual Behavioral Counseling, or Group Behavioral Therapy. Follow-up was conducted one year after the baseline interventions Effectiveness was measured by nicotine dependence reduction using the Fagerstrom Test for Nicotine Dependence (FTND) scores and cessation rates defined as at least 6-month abstinence. Appropriate statistical tests assessed the burden of tobacco use, oral potentially malignant lesions, and pre-post differences in FTND scores within and between groups. A p-value of

Abstract The recently discovered interaction between presenilin 1 (PS1), a subunit of γ-secretase involved in amyloid-β (Aβ) peptide production, and GLT-1, the major brain glutamate transporter (EAAT2 in the human), may link two pathological aspects of Alzheimer’s disease: abnormal Aβ occurrence and neuronal network hyperactivity. In the current study, we employed a FRET-based fluorescence lifetime imaging microscopy (FLIM) to characterize the PS1/GLT-1 interaction in brain tissue from sporadic AD (sAD) patients. sAD brains showed significantly less PS1/GLT-1 interaction than those with frontotemporal lobar degeneration or non-demented controls. Familial AD (fAD) PS1 mutations, inducing a “closed” PS1 conformation similar to that in sAD brain, and gamma-secretase modulators (GSMs), inducing a “relaxed” conformation, respectively reduced and increased the interaction. Furthermore, PS1 influences GLT-1 cell surface expression and homomultimer formation, acting as a chaperone but not affecting GLT-1 stability. The diminished PS1/GLT-1 interaction suggests that these functions may not work properly in AD.

Introduction: Herpes Zoster (HZ) is a very painful and debilitating condition caused by the reactivation of the Varicella Zoster Virus (VZV). HZ is characterised by a maculopapular or vesicular rash, usually accompanied by pain that is unilateral and restricted to dermatomes. Post-herpetic Neuralgia (PHN) is defined as pain that persists for more than 90 days after the onset of the HZ rash. Aim: To evaluate the analgesic efficacy of a lidocaine patch in PHN. Materials and Methods: This prospective interventional study conducted at the Department of Anaesthesiology and Critical Care, Pt. BD Sharma, PGIMS, Rohtak, Haryana, India, from February 2020 to March 2021. The study included a total of 24 patients (single group), with a male-to-female ratio of 11:13, aged between 18 and 75 years, all with a Visual Analogue Scale (VAS) score greater than 4. An evaluation of patient pain scores using the VAS and the total number of lidocaine patches used per week for four weeks or until the VAS declined to four was conducted. After obtaining informed and written consent, a medicated 5% lidocaine patch was applied to cover the appropriate area for a minimum period of 12 hours, followed by removal for the next 12 hours. This application continued until the VAS declined to four or up to a maximum of four weeks. The level of significance was set at p≤0.05. Results: In the present study, a total of 24 patients were included. The mean age was 59.5±12.85 years, with 54.2% being female and 45.8% male. The VAS scores at baseline were 8.71±0.999, which reduced to 7.08±1.349 at the end of one week, 5.67±0.007 at the end of two weeks, 4.25±0.442 at the end of three weeks and 3.58±0.830 at the end of four weeks. The VAS scores were significantly lower in all patients over the four weeks (p=0.001). The total number of patches used was 1.88±0.338 at one week, 1.46±0.509 at two weeks, 1.04±0.204 at three weeks and 1.00 at four weeks. The total amount of patches used was significantly reduced over the four weeks (p=0.001). No side-effects related to the lidocaine patch were noted. Conclusion: The 5% lidocaine patch demonstrated good tolerability with a minimal risk of systemic adverse drug reactions and is an effective modality for relieving moderate to severe pain. It is concluded that the 5% lidocaine patch is very effective in the treatment of PHN.

In a biostatistics course on clinical trials, one important topic is human research ethics. In this study, an E-Learning module (e-module) was developed to train students in human research ethics. This interactive e-module provides an overview of the ethical perspectives of conducting clinical research, historical events, Nuremberg Code, three principles of the Belmont Report, and eight ethical requirements to conduct clinical research. Students in a clinical trials course were randomized to the e-module or traditional online lecture and then took a knowledge-based quiz and an optional satisfaction survey. Students indicated that they preferred learning from an e-module and would like additional e-modules added to the course. We found students randomized to the e-module did not perform as well on the knowledge-based quiz compared to those assigned to the traditional online format, however, e-module students were not given a copy of the slides. When the study was repeated in a second cohort, and both groups were given a copy of the slides, the two groups performed similarly on the knowledge-based quiz. This indicates that additional resources, such as the slides, are helpful when implementing an e-module as part of a biostatistics course.

Abstract Protein kinases are critical components of a myriad biological processes and strongly associated with various diseases. While kinase research has been a point of focus in biomedical research for several decades, a large portion of the kinome is still considered understudied or “dark,” because prior research is targeted towards a subset of kinases with well-established roles in cellular processes. We present an empirical and in-silico hybrid workflow to extend the functional knowledge of understudied kinases. Utilizing multiplex peptide activity arrays and robust in-silico analyses, we extended the functional knowledge of five dark tyrosine kinases (AATK, EPHA6, INSRR, LTK, TNK1) and explored their roles in schizophrenia, Alzheimer’s dementia (AD), and major depressive disorder (MDD). Using this hybrid approach, we identified 195 novel kinase-substrate interactions with variable degrees of affinity and linked extended functional networks for these kinases to biological processes that are impaired in psychiatric and neurological disorders. Biochemical assays and mass spectrometry were used to confirm a putative substrate of EPHA6, an understudied dark tyrosine kinase. We examined the EPHA6 network and knowledgebase in schizophrenia using reporter peptides identified and validated from the multi-plex array with high affinity for phosphorylation by EPHA6. Identification and confirmation of putative substrates for understudied kinases provides a wealth of actionable information for the development of new drug treatments as well as exploration of the pathophysiology of disease states using signaling network approaches.

Abstract Purpose This study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs). Methods A retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed. Results Idiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups. Conclusions Secondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management.

Abstract Atopic dermatitis (AD) is a common chronic inflammatory skin disorder characterized by disrupted epidermal barrier function and aberrant immune responses. Despite recent developments in new therapeutics for AD, there is still a large unmet medical need for disease management due to the complex and multifactorial nature of AD. Recent genome-wide association studies (GWAS) have identified NLRP10 as a susceptible gene for AD but the physiological role of NLRP10 in skin homeostasis and AD remains unknown. Here we show that NLRP10 is downregulated in AD skin samples. Using an air-lift human skin equivalent culture, we demonstrate that NLRP10 promotes keratinocyte survival and is required for epidermal differentiation and barrier function. Mechanistically, NLRP10 limits cell death by preventing the recruitment of caspase-8 to the death inducing signaling complex (DISC) and by inhibiting its subsequent activation. NLRP10 also stabilizes p63, the master regulator of keratinocyte differentiation, to drive proper keratinocyte differentiation and to reinforce the barrier function. Our findings underscore NLRP10 as a key player in atopic dermatitis pathogenesis, highlighting NLRP10 as a potential target for therapeutic intervention to restore skin barrier function and homeostasis in AD.

Abstract Lignocellulosic biomass (LB) represents a sustainable and abundant feedstock with diverse applications, particularly in microbial fermentation processes for the production of biofuels and biochemical. This biomass serves as a promising alternative to conventional fossil fuels. Extensive research on the decomposition of wood has elucidated various microbial enzymatic and non-enzymatic mechanisms that facilitate the utilization of this resource. This review systematically examines the chemical and structural factors contributing to biomass recalcitrance, emphasizing recent advancements in analytical tools for their assessment. Furthermore, we explore innovative predictive models for hydrolysis, which are crucial for optimizing the conversion of LB into biofuels and bio-based chemicals. A comprehensive cost analysis of hydrolysis processes is also presented, offering insights into the economic feasibility of these conversion methods. The findings underscore the potential of lignocellulosic biomass as a key player in sustainable energy and material production.

Abstract Background The additive model of inheritance assumes that heterozygotes (Aa) are exactly intermediate in respect to homozygotes (AA and aa). While this model is commonly used in single-locus genetic association studies, significant deviations from additivity are well-documented and contribute to phenotypic variance across many traits and systems. This assumption can introduce type I and type II errors by overestimating or underestimating the effects of variants that deviate from additivity. Alternative genotype encoding strategies have been explored to account for different inheritance patterns, but they often incur significant computational or methodological costs. To address these challenges, we introduce PAGER (Phenotype Adjusted Genotype Encoding and Ranking), an efficient pre-processing method that encodes each genetic variant based on normalized mean phenotypic differences between diallelic genotype classes (AA, Aa, and aa). This approach more accurately reflects each variant’s true inheritance model, improving model precision while minimizing the costs associated with alternative encoding strategies. Results Through extensive benchmarking on SNPs simulated with both binary and continuous phenotypes, we demonstrate that PAGER accurately represents various inheritance patterns (including additive, dominant, recessive, and heterosis), achieves levels of statistical power that meet or exceed other encoding strategies, and attains computation speeds up to 55 times faster than a similar method, EDGE. We also apply PAGER to publicly available real-world data and identify a novel, relevant putative QTL associated with body mass index in rats (Rattus norvegicus) that is not detected with the additive model. Conclusions Overall, we show that PAGER is an efficient genotype encoding approach that can uncover sources of missing heritability and reveal novel insights in the study of complex traits while incurring minimal costs.

Abstract Open nanoshells such as nanobowls or nanocups collectively described as ‘semi shells’ have unique plasmonic properties due to their lack of symmetry. So far, their fabrication was based on multistep and laborious methods such as solid state sputter coating or selective deposition/etching using sacrificial templates. In this work, we report a rapid one step colloidal synthetic protocol for PEGylated semi-shell (SS) fabrication by simultaneous facet specific anisotropic chemical etching of rhombic dodecahedral ZIF-8 and heterogenous nucleation & growth of gold. The SS possesses a strong localized surface plasmon resonance in the near-infrared region, which is retained after surface passivation with polyethylene glycol and subsequent cryopreservation for extended shelf-life. Freshly reconstituted PEGylated SS was found to be safe & non-toxic in healthy C57BL/6 mice post intravenous administration. The PEGylated SS displayed significant photothermal efficiency of ~37% with 808 nm laser irradiation. Preclinical assessment of intra-tumoral photothermal efficacy indicated complete remission of primary breast tumor mass with insignificant metastasis to vital organs in 4T1 FL2 tumor bearing CD1 nude mice. Further, PEGylated SS mediated photothermal therapy also yielded morbidity free survivael of 75% for up to 90 days, indicating their potential to significantly improve outcomes in advanced breast tumors.

Abstract Diffusion-weighted imaging (DWI) is a technique used to probe the random microscopic motion of water protons in living tissue, represented by a parameter measurement of apparent diffusion coefficient (ADC) values. This study aimed to measure the ADC values of various fetal organs and placenta using 3T at various gestational ages. This was a prospective observational study. A total of 103 singleton pregnancies from 20 to 38 weeks of gestational age were included. Diffusion-weighted imaging was performed in the axial plane from the fetal head to the trunk with the following parameters: TR: 2000–2500 ms; TE: 88 ms; FOV: 250 mm; 256 matrix; slice thickness: 4 mm with a 0 mm gap; acquisition time: 1 min, 18 s. Diffusion gradient values were b = 0 and b = 700 s/mm2. ADC was measured in fetal brain regions (frontal white matter, occipital white matter, centrum semiovale, pons, thalamus, cerebellum, and fetal organs (lungs, kidney, and placenta). ANOVA was used to calculate the mean ADC values. Karl Pearson’s coefficient of correlation was used to evaluate the correlation between ADC values and increasing gestational age. The mean ADC values of brain regions were: frontal white matter (1.64 ± 0.08 × 10− 3 mm2 /s, F-39.10,p-

Abstract The work report on architecture of integrated frequency selective meta-surface (IFSMS) absorbers for aerospace stealth applications. Fabricated IFSMS comprised of a pattern metasurface integrated with dielectric interlayer and conducting ground. Initially, a supercell (2 × 2-unit cell: 24 × 24 mm2) was designed with a fourfold topological symmetry. Supercell produces impedances (R), inductances (L), and capacitances (C) in tune with design on its interaction with microwave. RC performance was tested at variable incident transverse electric/magnetic (TE/TM) modes over, Θ, 0°–60° and at the normal incidence (TE), against a planer, clockwise rotation over, Φ, 0°–90°. The mode stability and rotational invariance was analyzed for displacement current- and power-density distributions. The impedance behavior and phase reversal S11 reflection coefficient studies revealed the emergence of mid-band Fabry–Perot mode distinguishing LC behavior of the circuit. The meta-pattern was manufactured by mask lithography using a customized resistive micro-carbon ink and imprinted onto dielectric/ground tile (dimension: 30 × 30 cm2). Structure–property relationship of the ink material was investigated using SEM, XRD, FTIR, UV–visible spectroscopy to reveled surface properties of imprinted material. The absorber was subjected to the free space measurements over C (4–8), X (8–12), and Ku (12–18 GHz) bands, including pristine interlayer dielectrics. The simulated and experimental RC data was found to be in excellent agreement. The proposed IFSMS design is a potential candidate for the stealth application.

Objective: Public spitting attributable to Smokeless Tobacco (SLT) use not only causes a threat to public cleanliness but also to the people exposed around them. An electronic search on various anti-spitting laws and ban in India was done using Google search engine for duration of three months (November 2018 to January 2019). Material and Methods: The original state gazettes were reviewed to extract the data on spit ban and penalty. Renewals of Acts were also thoroughly checked for recent updates of penalty or severity of the act. The law implementing bodies were broadly classified as National, State, Municipal, Village councils (Gram Panchayat), Airports, Metro Railway, and Company Law Tribunal. Results: A total of 42 Anti-spitting laws were identified in this search and 16 states had anti spitting law under different sectors. Discussion: Under these laws, sign boards and warnings are placed commonly at Airports, Railway stations, and metro stations. States with high rates of SLT users like Tripura, Arunachal Pradesh and Mizoram did not have any policy on spitting. Conclusion: Strong enforcement of anti-spitting laws in India will not only reduce spread of communicable diseases but also indirectly will reduce the act of using SLT also.

Introduction: In modern times, endodontic intervention is preferred and tooth extraction is becoming increasingly rare. Root Canal Therapy (RCT) is well-established, with success rates exceeding 90%. A key contributor to post-endodontic pain is the extrusion of debris into the periapical region, which causes inflammation and nerve compression. The amount of debris extruded varies with instrumentation techniques and no current technology completely prevents it. Rotary and reciprocating Nickel-Titanium (NiTi) instruments, each with distinct designs and kinematics, play a critical role in managing this complication. Aim: To evaluate postoperative pain using rotary and reciprocating file systems in single visit endodontics. Materials and Methods: This prospective, parallel-group, single-centre, double-blinded, equivalence, randomised clinical study was conducted at the Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed To be University), Karad, Maharashtra, India, from October 2023 to March 2024, with the aim of comparing postoperative pain following endodontic therapy using two reciprocating systems, WaveOne Gold (WOG) and E-Flex Rec, versus two rotary systems, Mtwo and XP Endo Shaper (XPES). A total of 80 patients with symptomatic irreversible pulpitis were enrolled and randomly assigned to four groups, each treated with one of the four endodontic file systems. Patients were randomised into four groups: 1A-Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland); 1B-XP Endo Shaper (XPS; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland); 2A-Eighteeth E-Flex Rec File; and 2B-WOG (Dentsply Sirona, York, PA). Postoperative pain scores were measured using the Visual Analogue Scale (VAS) at 24, 48 and 72 hours and seven days post-treatment. Statistical analysis was conducted using One-way Analysis of Variance (ANOVA) with Tukey’s post-hoc test and Chi-square tests for categorical data using Statistical Package for Social Sciences (SPSS) software version 21.0, with p-values

Introduction: When there is significant furcation involvement, mechanical debridement without surgery can cause the disease to progressively worsen. To halt the disease process, surgery allows for odontoplasty, root debridement, osseous recontouring, and periodontal regeneration while preserving periodontal attachment. Need of the Study: In cases of furcation deficiencies, periodontal regeneration with different bone grafts is an effective method to both replace lost bone tissue and slow down the progression of the disease. In osseous abnormalities, the additive actions and features of Cissus Quadrangularis (CQ) demonstrate improved healing. Thus, the purpose of present clinical trial is to determine whether the combination of CQ, when utilised locally and systemically, is efficacious for the management of Class II furcation defects. Aim: To evaluate and compare the efficacy of CQ (Hadjod) used locally, systemically, and in combination as an adjunct to osteon II with Platelet Rich Fibrin (PRF) for the management of Class II furcation defects. Methodology: A randomised clinical trial will be conducted in the Department of Periodontics at Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, Maharashtra, India from April 2024 to March 2026. A total 60 systemically healthy individuals with Class II furcation invasions, either buccal or lingual, and moderate to severe chronic periodontitis will be selected. The study population will be categorised into three interventional groups and one control group as follows: Group A: Control group (n=15) will be treated with osteon II + PRF membrane + antibiotic coverage for Class II furcation defects, Group B: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) for Class II furcation defects + antibiotic coverage, Group C: (n=15) will be treated with osteon II + PRF membrane + systemic dosage of CQ for Class II furcation defects + antibiotic coverage, Group D: (n=15) will be treated with osteon II + PRF membrane + CQ graft (locally) + systemic dosage of CQ for Class II furcation defects + antibiotic coverage. The data will be analysed and calculated using the Student’s t-test, with a significance level of less than 0.05.

Abstract Introduction Primary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India’s Chhattisgarh state. Methods We conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care. Results On an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population’s health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure. Conclusion HWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population’s acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

Abstract Background Provision of essential newborn care at home, rapid identification of illness, and care-seeking by caregivers can prevent neonatal mortality. Mobile technology can connect caregivers with information and healthcare worker advice more rapidly and frequently than healthcare visits. Community health workers (CHWs) are well-suited to deliver such interventions. We developed an interactive short message service (SMS) intervention for neonatal health in Kenya, named CHV-NEO. CHV-NEO sends automated, theory-based, actionable, messages throughout the peripartum period that guide mothers to evaluate maternal and neonatal danger signs and facilitate real-time dialogue with a CHW via SMS. We integrated this intervention into Kenya’s national electronic community health information system (eCHIS), which is currently used at scale to support CHW workflow. Methods The effect of CHV-NEO on clinical and implementation outcomes will be evaluated through a non-blinded cluster randomized controlled trial. Twenty sites across Kisumu County in Western Kenya were randomized 1:1 to provide either the national eCHIS with integrated CHV-NEO messaging (intervention) or standard of care using eCHIS without CHV-NEO (control). We will compare neonatal mortality between arms based on abstracted eCHIS data from 7200 pregnant women. Secondary outcomes include self-reported provision of essential newborn care (appropriate cord care, thermal care, and timely initiation of breastfeeding), knowledge of neonatal danger signs, and care-seeking for neonatal illness, compared between arms based on questionnaires with a subgroup of 2000 women attending study visits at enrollment in pregnancy and 6 weeks postpartum. We will also determine CHV-NEO’s effect on CHW workflows and evaluate determinants of intervention acceptability, adoption, and fidelity of use through questionnaires, individual interviews, and messaging data. Discussion We hypothesize that the CHV-NEO direct-to-client communication strategy can be successfully integrated within existing CHW workflows and infrastructure, improve the provision of at-home essential newborn care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. The intervention’s integration into the national eCHIS tool will facilitate rapid scale-up if it is clinically effective and successfully implemented. Trial registration ClinicalTrials.gov, NCT05187897 . The CHV-NEO study was registered on January 12, 2022.

Abstract Due to climate and human activity, water supply in Jharkhand, India, fluctuates. This study measured AWS and AWA in Jharkhand, India. MODIS NDVI and Terra Climate data processed by Google Earth Engine (GEE) are used in the analysis. Based on mean annual values for NDWI, run-off, precipitation, and ET, AWS and AWA are categorised. Results show significant regional differences in ET, precipitation, runoff, AWS, and AWA in Jharkhand. Purbi Singhbhum has far higher ET rates than Garhwa, Palamu, and Chatra. High AWS levels in Sahibganj, Godda, Pakur, Garhwa, and Kodarma indicate serious water scarcity. Therefore, these locations need focused water management approaches. Different districts including Giridih, Chatra, Jamtara, Latehar, Simdega, and Hazaribagh have different levels of AWS, highlighting the need for individualised treatments. The AWA index helps resource managers make educated decisions by detecting water-scarce places. Climate variability affects temperatures and precipitation, worsening AWS in high-AWS areas. Water scarcity mitigation requires local infrastructure development and water management measures. To verify remote sensing data accuracy, future study should improve data resolution and include in-situ measurements. These findings can help policymakers and stakeholders in Jharkhand create efficient water resource management strategies to reduce water stress and assure water supply.

Objective: Mastalgia, a common complaint among women, denotes breast discomfort that can manifest as cyclical or non-cyclical. Reassurance, mechanical support and various non-pharmacological treatments, like flaxseeds, have been seen to have a good effect in treating mastalgia. Thus, the aim of this study was to investigates the efficacy of flaxseed in alleviating pain associated with mastalgia and its impact on the overall health-related quality of life among female patients. Materials and Methods: Conducted at a tertiary care center in Northern India over 18 months, it employed a single-arm interventional design. The participants included females aged 18 years and older presenting with breast pain at the Department of General Surgery. The intervention involved daily consumption of 30 g of milled flaxseed for each participant, administered over a period of six months. Pain severity was assessed using the visual analogue scale (VAS) before supplementation and at follow-up intervals up to six months. Concurrently, the Short Form-12 (SF-12) items Health Survey measured health-related quality of life, encompassing both physical and mental health domains. Statistical analysis employed parametric (paired t-test) and non-parametric tests (chi-square, McNemar) where appropriate, with statistical significance set at p

Introduction The effect of the second wave of COVID-19 was immense in India, specifically in the form of vicious COVID-19-associated mucormycosis. A higher number of radical debridements are required for disease control in combination with antifungal drugs in cases of COVID-19-associated mucormycosis, which results in complex maxillofacial defects. We aimed to evaluate the clinical outcomes in patients with rhino-orbito-maxillary defects due to COVID-19-associated mucormycosis undergoing a single stage delayed free flap reconstruction.

Background: Early diagnosis of neonatal osteomyelitis is often challenging due to the rarity of such cases and here we are presenting 2 case reports to add to the existing deficient literature. Case 1: A 15-day-old male infant presented with swelling and pus discharge from the anterior region of the mandible. Repeated culture and sensitivity tests revealed a transition from disseminated methicillin-sensitive S. aureus sepsis to methicillin-resistant sepsis. Moreover, there was swelling of the left elbow and right thigh. The Clinical diagnosis made was acute osteomyelitis of mandible associated with disseminated neonatal sepsis (LONS). A multidisciplinary approach was taken for the management by surgical debridement of the lesion alongwith removal of associated primary tooth buds, under specific antibiotic coverage. Case 2: A 20-day old male infant reported with pus discharge from upper lateral region of mouth past 10days. Personal history revealed, abscess in mother's right breast. A soft fluctuant pus pocket with draining sinus was present w.r.t.alveolar region of 54. CT revealed an osteolytic lesion of labial cortex of alveolar ridge in maxillary right first molar region. Pus specimen culture and sensitivity revealed growth of Staphylococcus aureus (MSSA). The clinical diagnosis of acute osteomyelitis of maxillawas made. Initially, antibiotics were prescribed which did not help and finally, surgical debridement accompanied by extraction of 54 tooth bud was done. Conclusion: Acute osteomyelitis should always be considered as one of the differentials in infants with clinical signs of sepsis and Multidisciplinary management should be assured for the successful management of such cases.

Abstract The escalating global cancer burden underscores the urgent need for more effective therapeutic strategies. Phytochemicals, naturally occurring compounds in plants, have garnered attention for their potential in cancer chemoprevention and chemotherapy. Their ability to modulate molecular mechanisms and influence cell signaling pathways offers a promising avenue for cancer management. This review aims to synthesize current knowledge on phytochemicals’ chemopreventive and chemotherapeutic potential, focusing on their molecular mechanisms of action and impacts on cell signaling pathways involved in cancer. A systematic literature search was conducted across major databases, including PubMed/Medline, Web of Science, Scopus, and Google Scholar. The search strategy uses Medical Subject Headings (MeSH) and free‐text terms using Boolean operators to capture relevant studies. Inclusion criteria targeted original research and reviews on the effects of phytochemicals in cancer, with a specific focus on molecular mechanisms. Phytochemicals, including flavonoids, polyphenols, and terpenoids, demonstrated significant anticancer properties by inducing cell cycle arrest, apoptosis, and autophagy. They modulate critical cell signaling pathways, such as cyclooxygenase‐2, nuclear factor kappa B, and various growth factor‐related pathways, and rectify epigenetic alterations, contributing to their chemopreventive and therapeutic effects. Phytochemicals represent a valuable resource for developing novel cancer prevention and treatment strategies; their actions on molecular mechanisms and cell signaling pathways underscore their potential in cancer prevention and combat. Further research is warranted to translate these findings into clinical applications, optimizing phytochemical‐based interventions for cancer management.

Pulmonary tuberculosis (TB) is a leading cause of mortality and morbidity in India, presenting with diverse clinical and radiological manifestations such as consolidation, cavitation, lymphadenopathy, pleural effusion, miliary TB, and endobronchial TB. While acute miliary TB presenting as Acute respiratory distress syndrome (ARDS) is documented, the association with a skin rash mimicking viral exanthematous fever is not. This case report describes the case of a 41-year-old male patient with acute dyspnea, a maculopapular rash, and lung infiltrates on chest radiograph, initially diagnosed with acute hypoxic respiratory failure and later confirmed as ARDS. High-resolution computed tomography (HRCT) thorax revealed consolidation with nodules and a characteristic butterfly pattern sparing the apices and bases. Bronchoscopy confirmed TB etiology through MTB genome in BAL samples. The patient improved significantly with intravenous antibiotics, steroids, and HFNC, leading to a documented cure after 6 months of anti-tuberculosis treatment. This report highlights the importance of considering TB in cases with nodular consolidation and positive limiting signs and recommends ICU bronchoscopy as a reliable diagnostic tool. The Kigali modification for ARDS definition was instrumental in managing this case. Use of Kigali modification for defining ARDS in resource limited setting guided management in our case.

Abstract Introduction International guidelines recommend definitive combination antibiotic therapy for the management of serious infections involving carbapenem-resistant Acinetobacter (CRAB) species. The commonly available combination options include high-dose sulbactam, polymyxins, tetracyclines, and cefiderocol. Scanty prospective data exist to support this approach. Methods Patients with CRAB bacteraemia, ventilator-associated pneumonia (VAP), or both were categorized based on whether they received combination therapy or monotherapy. The 30-day mortality was compared between the two groups. Inverse probability treatment weighting (IPTW) was done using propensity score (PS) for a balanced comparison between groups. Results Between January 2021 and May 2023, of the 161 patients with CRAB bacteraemia (n = 55, 34.2%), VAP (n = 46, 28.6%), or both (n = 60, 37.3%) who received appropriate intravenous antibiotic therapy, 70% (112/161) received monotherapy, and the rest received combination therapy. The overall 30-day mortality was 62% (99/161) and not different (p = 0.76) between the combination therapy (31/49, 63.3%) and monotherapy (68/112, 60.7%) groups. The propensity score matching using IPTW did not show a statistical difference (p = 0.47) in 30-day mortality for receiving combination therapy with an adjusted odds ratio (OR) P of 1.29 (0.64, 2.58). Conclusion Combination therapy for CRAB infections needs further study in a randomised controlled trial, as this observational study showed no difference in 30-day mortality between monotherapy and combination therapy.

A numerical study of 𝐹𝑒3𝑂4−TiO2−𝑁𝑖/C2H6O2 modified nanofluid's flow through a stretched surface is presented in the current work with an applied angled magnetic field. In the subsequent form of hybrid nanofluid, known as modified nanofluid, three distinct suspended nanoparticles in a base fluid are taken into consideration. Iron Oxide, Nical, and Titanium Dioxide nanoparticles are suspended in ethanol glycol, which is used as a base liquid. One way to improve heat transfer rates in MHD flow over a stretched surface with variable viscosity is to utilize modified nanofluids. This is useful in a number of sectors, including energy systems, thermal management in aircraft, and cooling electronic systems. By applying the proper similarity transformations, the Runga-Kutta fourth order technique encounters the mathematical framework of the flow. One important finding is that, in contrast to nanofluids and hybrid nanofluids, the modified nanofluid has a larger capacity for heat transmission. The modified nanofluid's heat transfer capabilities exhibit intriguing behavior that calls for more research on it. There are numerical solutions that are displayed graphically. Increases in the volume fraction parameter and the inclination angle parameter of the magnetic field have been found to cause a drop in the velocity field of the modified nanofluid.