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Elisabetta Bugianesi,1 Luca Miele,2,3 Giovanna Donnarumma,4 Katrine Grau,5 Mariarosaria Mancuso,4 Preethy Prasad,5 Andrea Leith,6 Victoria Higgins6 1Division of Gastroenterology, Department of Medical Sciences, University of Torino, AOU Città della Salute e della Scienza, Torino, Italy; 2Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; 3Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy; 4Novo Nordisk SpA, Rome, Italy; 5Novo Nordisk A/S, Søborg, Denmark; 6Adelphi Real World, Bollington, Cheshire, UKCorrespondence: Elisabetta Bugianesi, Email elisabetta.bugianesi@unito.itBackground: Although the estimated prevalence of non-alcoholic steatohepatitis (NASH) in Italy is 4– 6%, little is known about patient characteristics and care pathways.Aim: To describe patient characteristics and management approaches for patients with NASH or suspected NASH in Italy.Methods: Data were drawn from the Adelphi Real World NASH Disease Specific Programme™, a cross-sectional survey of endocrinologists and gastroenterologists in Italy from January to March 2018. Physicians completed questionnaires for their next five consecutively consulting patients with NASH or suspected NASH. Analyses were descriptive.Results: Seventy-six physicians provided data on 380 patients. The mean age was 58.5 ± 11.1 years and the mean body mass index was 31.8 ± 5.5 kg/m2. A total of 231 patients (61%) had no/non-advanced fibrosis as evaluated by liver biopsy or non-invasive tests. Common diagnostic assessments were cholesterol, hemoglobin A1c, absence of viral hepatitis, and alcohol assessment. At diagnosis, 87% (n=322/372) and 45% (n=169/372) of patients received an ultrasound and liver biopsy, respectively. Overall, 88% of patients were referred from primary to secondary care. Obesity (81%) and type 2 diabetes (62%) were the most commonly recorded comorbidities, with 70% of patients having ≥ 3 comorbidities. Vitamin E (13%) and GLP-1 receptor agonists (13%) were the most prescribed guideline-recommended treatments for all patients.Conclusion: Patients with NASH in Italy had high levels of obesity and comorbidities, while diagnosis and treatment frequently were not according to guidelines. Our data show an unmet need for more targeted diagnosis and treatment in Italian patients with NASH, in order to optimize outcomes.Plain language summary: Fat buildup in the liver, known as fatty liver disease, affects around 4-6% of people in Italy, and can lead to complications if left untreated. However, little is known about how doctors manage people with this disease. Fatty liver disease can only be diagnosed by a liver biopsy, but we found this is only performed in 45% of people, making accurate diagnosis difficult. We also found that 28% of people receive a recommended medication. Overall, increasing doctor awareness of fatty liver medical guidelines may help improve the diagnosis and treatment for people living with fatty liver disease in Italy.Keywords: NASH diagnosis, NASH treatment, NASH resource utilization

Introduction: In the backdrop of escalating healthcare costs and an increasing focus on resource optimization, this audit study delves into the realm of anesthesia management, specifically exploring the application of low-flow anesthesia (LFA). The primary objective was to assess adherence to hospital standards and evaluate the economic implications of LFA (

Abstract Background Blood-based transcriptional gene signatures for tuberculosis (TB) have been developed with potential use to diagnose disease. However, an unresolved issue is whether gene set enrichment analysis of the signature transcripts alone is sufficient for prediction and differentiation or whether it is necessary to use the original model created when the signature was derived. Intra-method comparison is complicated by the unavailability of original training data and missing details about the original trained model. To facilitate the utilization of these signatures in TB research, comparisons between gene set scoring methods cross-data validation of original model implementations are needed. Methods We compared the performance of 19 TB gene signatures across 24 transcriptomic datasets using both rrebuilt original models and gene set scoring methods. Existing gene set scoring methods, including ssGSEA, GSVA, PLAGE, Singscore, and Zscore, were used as alternative approaches to obtain the profile scores. The area under the ROC curve (AUC) value was computed to measure performance. Correlation analysis and Wilcoxon paired tests were used to compare the performance of enrichment methods with the original models. Results For many signatures, the predictions from gene set scoring methods were highly correlated and statistically equivalent to the results given by the original models. In some cases, PLAGE outperformed the original models when considering signatures’ weighted mean AUC values and the AUC results within individual studies. Conclusion Gene set enrichment scoring of existing gene sets can distinguish patients with active TB disease from other clinical conditions with equivalent or improved accuracy compared to the original methods and models. These data justify using gene set scoring methods of published TB gene signatures for predicting TB risk and treatment outcomes, especially when original models are difficult to apply or implement.

Abstract Elastic turbulence is the chaotic fluid motion resulting from elastic instabilities due to the addition of polymers in small concentrations at very small Reynolds ( $${{{{{{{\rm{Re}}}}}}}}$$ Re ) numbers. Our direct numerical simulations show that elastic turbulence, though a low $${{{{{{{\rm{Re}}}}}}}}$$ Re phenomenon, has more in common with classical, Newtonian turbulence than previously thought. In particular, we find power-law spectra for kinetic energy E(k) ~ k −4 and polymeric energy E p(k) ~ k −3/2, independent of the Deborah (De) number. This is further supported by calculation of scale-by-scale energy budget which shows a balance between the viscous term and the polymeric term in the momentum equation. In real space, as expected, the velocity field is smooth, i.e., the velocity difference across a length scale r, δ u ~ r but, crucially, with a non-trivial sub-leading contribution r 3/2 which we extract by using the second difference of velocity. The structure functions of second difference of velocity up to order 6 show clear evidence of intermittency/multifractality. We provide additional evidence in support of this intermittent nature by calculating moments of rate of dissipation of kinetic energy averaged over a ball of radius r, ε r , from which we compute the multifractal spectrum.

Abstract Typical plant membranes and storage lipids are comprised of five common fatty acids yet over 450 unusual fatty acids accumulate in seed oils of various plant species. Plant oils are important human and animal nutrients, while some unusual fatty acids such as hydroxylated fatty acids (HFA) are used in the chemical industry (lubricants, paints, polymers, cosmetics, etc.). Most unusual fatty acids are extracted from non-agronomic crops leading to high production costs. Attempts to engineer HFA into crops are unsuccessful due to bottlenecks in the overlapping pathways of oil and membrane lipid synthesis where HFA are not compatible. Physaria fendleri naturally overcomes these bottlenecks through a triacylglycerol (TAG) remodeling mechanism where HFA are incorporated into TAG after initial synthesis. TAG remodeling involves a unique TAG lipase and two diacylglycerol acyltransferases (DGAT) that are selective for different stereochemical and acyl-containing species of diacylglycerol within a synthesis, partial degradation, and resynthesis cycle. The TAG lipase interacts with DGAT1, localizes to the endoplasmic reticulum (with the DGATs) and to puncta around the lipid droplet, likely forming a TAG remodeling metabolon near the lipid droplet-ER junction. Each characterized DGAT and TAG lipase can increase HFA accumulation in engineered seed oils.

Abstract Protocells are believed to have existed on early Earth prior to the emergence of prokaryotes. Due to their rudimentary nature, it is widely accepted that these protocells lacked intracellular mechanisms to regulate their reproduction, thereby relying heavily on environmental conditions. To understand protocell reproduction, we adopted a top–down approach of transforming a Gram-positive bacterium into a lipid-vesicle-like state. In this state, cells lacked intrinsic mechanisms to regulate their morphology or reproduction, resembling theoretical propositions on protocells. Subsequently, we grew these proxy-protocells under the environmental conditions of early Earth to understand their impact on protocell reproduction. Despite the lack of molecular biological coordination, cells in our study underwent reproduction in an organized manner. The method and the efficiency of their reproduction can be explained by an interplay between the physicochemical properties of cell constituents and environmental conditions. While the overall reproductive efficiency in these top-down modified cells was lower than their counterparts with a cell wall, the process always resulted in viable daughter cells. Given the simplicity and suitability of this reproduction method to early Earth environmental conditions, we propose that primitive protocells likely reproduced by a process like the one we described below.

Abstract Background Currently, there are more than two million people in prisons or jails, with nearly two-thirds meeting the criteria for a substance use disorder. Following these patterns, overdose is the leading cause of death following release from prison and the third leading cause of death during periods of incarceration in jails. Traditional quantitative methods analyzing the factors associated with overdose following incarceration may fail to capture structural and environmental factors present in specific communities. People with lived experiences in the criminal legal system and with substance use disorder hold unique perspectives and must be involved in the research process. Objective To identify perceived factors that impact overdose following release from incarceration among people with direct criminal legal involvement and experience with substance use. Methods Within a community-engaged approach to research, we used concept mapping to center the perspectives of people with personal experience with the carceral system. The following prompt guided our study: “What do you think are some of the main things that make people who have been in jail or prison more and less likely to overdose?” Individuals participated in three rounds of focus groups, which included brainstorming, sorting and rating, and community interpretation. We used the Concept Systems Inc. platform groupwisdom for our analyses and constructed cluster maps. Results Eight individuals (ages 33 to 53) from four states participated. The brainstorming process resulted in 83 unique factors that impact overdose. The concept mapping process resulted in five clusters: (1) Community-Based Prevention, (2) Drug Use and Incarceration, (3) Resources for Treatment for Substance Use, (4) Carceral Factors, and (5) Stigma and Structural Barriers. Conclusions Our study provides critical insight into community-identified factors associated with overdose following incarceration. These factors should be accounted for during resource planning and decision-making.

Immune dysregulation is a pivotal factor in the onset and progression of various diseases. In cancer, the immune system's inability to discern and eliminate abnormal cells leads to uncontrolled tumor growth. When faced with resilient pathogens or harmful toxins, the immune system encounters challenges in clearance and neutralization. Achieving a delicate balance of pro‐inflammatory and anti‐inflammatory signals is essential in managing a range of disorders and diseases. Like in other biomedical research domains, nanotechnology has provided innovative approaches for rebalancing host immunity. Among the plethora of nanotechnology‐based interventions, the concept of cell membrane‐coated nanoparticles holds significant potential for immunomodulatory applications owing to their biomimetic properties that allow for precise interaction with the compromised immune system. This review thoroughly examines the potential of novel nanosystems for immune modulation. The exploration covers crucial elements, including the origins and characteristics of cell membranes, the methods employed for their procurement and coating, physicochemical/biological characterization techniques, and enhancement of their therapeutic efficacy via functionalization. Subsequently, case studies‐based analysis of utilizing these bioinspired nanosystems in tackling different conditions caused by immune disturbance has been comprehensively discussed.

Separation and quantification of highly polar metformin (MTF) alone or in combination with dipeptidyl peptidase-4 inhibitors, such as evogliptin (EVG), sitagliptin, saxagliptin, vildagliptin, linagliptin and teneligliptin, specifically from human plasma and pharmaceutical products is still difficult in mostly preferred ODS based RP-HPLC techniques. Since, owing to weak retention of MTF in ODS, it elutes together with the biological fluid components and drug excipients. Therefore, in this study, alternative to ODS based RP-HPLC, comparatively less known analytical techniques like strong cation exchange chromatography (SCX-3), hydrophilic interaction liquid chromatography (HILIC) and mix-mode chromatography (MMC) were comprehensively evaluated for their potentials and limitations in simultaneous quantification of newly approved EVG and MTF combination (Valera-M). In results, prolonged application of SCX-3, exhibits irreproducible and irreversible retention of MTF and EVG. While in HILIC with Cyano column, excessive acetonitrile as eluent developed the precipitation of MTF and column back pressure. Comparatively, the Acclaimed® mix-mode HILIC-1, demonstrated much promising and reproducible results for MTF and EVG separation and importantly, it can be used either reverse phase or HILIC mode. Considering the overall benefits of Acclaimed® mix-mode HILIC-1, it was used in estimation of MTF and EVG from human plasma and pharmaceutical formulations.

IntroductionUsing a validated translational model that quantitatively predicts opioid-induced respiratory depression and cardiac arrest, we compared cardiac arrest events caused by synthetic opioids (fentanyl, carfentanil) following rescue by intranasal (IN) administration of the μ-opioid receptor antagonists naloxone and nalmefene.MethodsThis translational model was originally developed by Mann et al. (Clin Pharmacol Ther 2022) to evaluate the effectiveness of intramuscular (IM) naloxone. We initially implemented this model using published codes, reproducing the effects reported by Mann et al. on the incidence of cardiac arrest events following intravenous doses of fentanyl and carfentanil as well as the reduction in cardiac arrest events following a standard 2 mg IM dose of naloxone. We then expanded the model in terms of pharmacokinetic and µ-opioid receptor binding parameters to simulate effects of 4 mg naloxone hydrochloride IN and 3 mg nalmefene hydrochloride IN, both FDA-approved for the treatment of opioid overdose. Model simulations were conducted to quantify the percentage of cardiac arrest in 2000 virtual patients in both the presence and absence of IN antagonist treatment.ResultsFollowing simulated overdoses with both fentanyl and carfentanil in chronic opioid users, IN nalmefene produced a substantially greater reduction in the incidence of cardiac arrest compared to IN naloxone. For example, following a dose of fentanyl (1.63 mg) producing cardiac arrest in 52.1% (95% confidence interval, 47.3-56.8) of simulated patients, IN nalmefene reduced this rate to 2.2% (1.0-3.8) compared to 19.2% (15.5-23.3) for IN naloxone. Nalmefene also produced large and clinically meaningful reductions in the incidence of cardiac arrests in opioid naïve subjects. Across dosing scenarios, simultaneous administration of four doses of IN naloxone were needed to reduce the percentage of cardiac arrest events to levels that approached those produced by a single dose of IN nalmefene.ConclusionSimulations using this validated translational model of opioid overdose demonstrate that a single dose of IN nalmefene produces clinically meaningful reductions in the incidence of cardiac arrest compared to IN naloxone following a synthetic opioid overdose. These findings are especially impactful in an era when >90% of all opioid overdose deaths are linked to synthetic opioids such as fentanyl.

Introduction: Sports offer numerous health benefits, contributing to growth, development, physical fitness, and mental well-being. However, injuries are an inevitable part of sports, affecting both professional athletes and casual participants. The incidence of sports-related injuries has risen significantly due to increased participation, heightened competitiveness, inadequate injury prevention techniques, improper sporting gear, insufficient training, and overuse. Method: ology: A comprehensive literature search was performed in multiple databases such as PUBMED and SCOPUS. Relevant studies on therapeutic uses of platelet-rich plasma (PRP) in sports injuries were included. The findings provide a comprehensive overview of the topic. Results: Platelet-Rich Plasma (PRP) is a regenerative, minimally invasive, non-surgical procedure that accelerates healing by utilizing concentrated bioactive factors from the body. PRP has shown promising results in treating conditions such as patellar tendonitis, Achilles tendonitis, tennis elbow, partial rotator cuff tears, ligament tears, and mild to moderate arthritis. Following a PRP injection, athletes typically undergo a short period of rest from sports activities while attending rehabilitation therapy. This approach helps optimize healing and ensures an optimal outcome. Conclusion: PRP has shown great promise as a treatment modality for sports injuries. While further research is needed to optimize PRP protocols and understand its mechanisms of action in sports injuries, it holds significant potential for enhancing the recovery and rehabilitation of athletes, ultimately contributing to improved outcomes in the field of sports medicine.

Fossil fuels, such as coal and hydrocarbons, are major drivers of global warming and are primarily responsible for worldwide greenhouse gas emissions, including carbon dioxide CO2. The storage of CO2 in deep saline reservoirs is acknowledged as one of the top practical and promising methods to reduce CO2 emissions and meet climate goals. The North Dakota Industrial Commission (NDIC) recently approved the fourth Class VI permit for a carbon capture and storage project in the Williston basin of North Dakota for the geological CO2 storage in the Broom Creek formation. The current research aimed to conduct a comprehensive petrophysical characterization and rock physics modeling of the Broom Creek deep saline reservoir to unravel the mineralogical distribution and to understand the variations in petrophysical and elastic properties across the formation. This study utilized geophysical well logs, routine core analysis, and advanced core analysis to evaluate the Broom Creek formation. Multimineral petrophysical analysis calibrated with X-ray diffraction results reveals that this formation primarily comprises highly porous clean sandstone intervals with low-porosity interspersed with dolomite, anhydrite, and silt/clay layers. The formation exhibits varying porosities up to 0.3 and Klinkenberg air permeabilities up to ∼2600 mD. The formation water resistivity using Archie’s equation is approximately 0.055 ohm-m at 150 °F, corresponding to around 63,000 ppm NaCl salinity, which is consistent with prior data. The pore throat distribution in the samples from clean sandstone intervals is primarily situated in the macro-mega scales. However, the presence of anhydrite and dolomite impedes both porosity and pore throat sizes. The accurate prediction of effective elastic properties was achieved by developing a rock physics template. Dry rock moduli were modeled using Hill’s average, while Berryman’s self-consistent scheme was employed for modeling saturated moduli.

Abstract Background An increasing number of adults are over the age of 65, and there is concern about the increasing prevalence of age-associated cognitive decline and poor mental health status in older adults in the United States. Several nutrients are known to have important biological roles in brain health and neurological function, but many individuals fall short of recommended intake levels. The objective of this study was to examine the association between nutrient intake and cognitive function. We also explored whether nutrient intake was associated with depression. Methods This cross-sectional study was based on data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 and included participants ≥ 60 years of age who had reliable day 1 dietary recall data and either valid cognitive function data (n = 2713) or valid depression score data (n = 2943). The sample was stratified by gender, and cognitive functioning test (CFT) composite z-scores were analyzed by quartiles. Depression status was assessed using the Patient Health Questionnaire (PHQ-9). Results Higher intake and adequacy of a number of different nutrients from food were associated with higher cognitive function in both males and females. Nutrients that showed the most consistent associations with cognitive function across intake and adequacy analyses for food in both males and females were vitamin A, vitamin E, thiamin, riboflavin, vitamin B6, folate, magnesium, potassium, zinc, vitamin K, and lutein and zeaxanthin (p

This comprehensive review offers a thorough examination of fetal heart rate (fHR) monitoring methods, which are an essential component of prenatal care for assessing fetal health and identifying possible problems early on. It examines the clinical uses, accuracy, and limitations of both modern and traditional monitoring techniques, such as electrocardiography (ECG), ballistocardiography (BCG), phonocardiography (PCG), and cardiotocography (CTG), in a variety of obstetric scenarios. A particular focus is on the most recent developments in textile-based wearables for fHR monitoring. These innovative devices mark a substantial advancement in the field and are noteworthy for their continuous data collection capability and ergonomic design. The review delves into the obstacles that arise when incorporating these wearables into clinical practice. These challenges include problems with signal quality, user compliance, and data interpretation. Additionally, it looks at how these technologies could improve fetal health surveillance by providing expectant mothers with more individualized and non-intrusive options, which could change the prenatal monitoring landscape.

The net-effective stress is a fundamental physical property that undergoes dynamic changes in response to variations in pore pressure during production and injection activities. Petrophysical properties, including porosity, permeability, and wave velocities, play a critical role and exhibit strong dependence on the mechanical stress state of the formation. The Williston basin’s Bakken Formation represents a significant reservoir of hydrocarbons within the United States. To investigate this formation, we extracted core plugs from three distinct Bakken members, namely Upper Bakken, Middle Bakken, and Lower Bakken. Subsequently, we conducted a series of measurements of ultrasonic compressional and shear wave velocities, as well as pulse decay permeabilities using nitrogen, under various confining pressures employing the Autolab-1500 apparatus. Our experimental observations revealed that the ultrasonic wave velocities and permeability display a significant sensitivity to stress changes. We investigated existing empirical relationships on velocity-effective stress, compressional-shear wave velocities, and permeability-effective stress, and proposed the best models and associated fitting parameters applicable to the current datasets. In conjunction with the acquired datasets, these models have considerable potential for use in time-lapse seismic monitoring and the study of production decline behavior. The best fitting models can be used to forecast the petrophysical and geomechanical property changes as the reservoir pore pressure is depleted due to the production, which is critical to the production forecast for unconventional reservoirs.

Lung cancer is a leading cause of cancer-related death worldwide that needs updated therapies to contrast both the serious side effects and the occurrence of drug resistance. A panel of non-small cell lung cancer (NSCLC) cells were herein employed as cancer models. Eight structurally related gold(I) and gold(III) complexes with NHC and halides or triphenylphosphane ligands were investigated as lung cancer cell growth inhibitors. As expected, gold compounds with PPh3 were found to be more cytotoxic than homoleptic [(NHC)2-Au(I)]X or heteroleptic NHC-Au(I)X or NHC-Au(III)X3 complexes. Mixed ligand gold(I) compounds exhibiting the linear NHC-AuPPh3 (compound 7) or the trigonal NHC-Au(Cl)PPh3 (compound 8) arrangements at the central metal were found to be the best lung cancer cytotoxic compounds. Analysis of the TrxR residual activity of the treated cells revealed that these compounds efficiently inhibit the most accredited molecular target for gold compounds, the TrxR, with compound 8 reaching more than 80% activity reduction in lung cells. Some of the current cancer lung therapy protocols consist of specific lung cancer cell cytotoxic agents combined with antifolate drugs; interestingly, the herein gold compounds are both TrxR and antifolate inhibitors. The human DHFR was inhibited with IC50 ranging between 10–21 µM, depending on substrate concentrations, proceeding by a likely allosteric mechanism only for compound 8.

A validated marker system is crucial to running an effective genomics-assisted breeding program. We used 36 Kompetitive Allele-Specific PCR (KASP) markers to genotype 376 clones from the biofortified cassava pipeline, and fingerprinted 93 of these clones with DArTseq markers to characterize breeding materials and evaluate their relationships. The discriminating ability of the 36-quality control (QC) KASP and 6602 DArTseq markers was assessed using 92 clones genotyped in both assays. In addition, trait-specific markers were used to determine the presence or absence of target genomic regions. Hierarchical clustering identified two major groups, and the clusters were consistent with the breeding program origins. There was moderate genetic differentiation and a low degree of variation between the identified groups. The general structure of the population was similar using both assays. Nevertheless, KASP markers had poor resolution when it came to differentiating the genotypes by seed sources and overestimated the prevalence of duplicates. The trait-linked markers did not achieve optimal performance as all markers displayed variable levels of false positive and/or false negative. These findings represent the initial step in the application of genomics-assisted breeding for the biofortified cassava pipeline, and will guide the use of genomic selection in the future.

Fracture porosity is crucial for storage and production efficiency in fractured tight reservoirs. Geophysical image logs using resistivity measurements have traditionally been used for fracture characterization. This study aims to develop a novel, hybrid machine-learning method to predict fracture porosity using conventional well logs in the Ahnet field, Algeria. Initially, we explored an Artificial Neural Network (ANN) model for regression analysis. To overcome the limitations of ANN, we proposed a hybrid model combining Support Vector Machine (SVM) classification and ANN regression, resulting in improved fracture porosity predictions. The models were tested against logging data by combining the Machine Learning approach with advanced logging tools recorded in two wells. In this context, we used electrical image logs and the dipole acoustic tool, which allowed us to identify 404 open fractures and 231 closed fractures and, consequently, to assess the fracture porosity. The results were then fed into two machine-learning algorithms. Pure Artificial Neural Networks and hybrid models were used to obtain comprehensive results, which were subsequently tested to check the accuracy of the models. The outputs obtained from the two methods demonstrate that the hybridized model has a lower Root Mean Square Error (RMSE) than pure ANN. The results of our approach strongly suggest that incorporating hybridized machine learning algorithms into fracture porosity estimations can contribute to the development of more trustworthy static reservoir models in simulation programs. Finally, the combination of Machine Learning (ML) and well log analysis made it possible to reliably estimate fracture porosity in the Ahnet field in Algeria, where, in many places, advanced logging data are absent or expensive.

The Patient Protection and Affordable Care Act, more commonly known as the ACA, was legislation passed in the United States in 2010 to expand access to health insurance coverage for millions of Americans with a key emphasis on preventive care. Nutrition plays a critical role in overall wellness, disease prevention and resilience to chronic illness but prior to the ACA many Americans did not have adequate health insurance coverage to ensure proper nutrition. With passage of the ACA, more individuals received access to nutritional counseling through their primary care physicians as well as prescription vitamins and supplements free of charge. The objective of this study was to evaluate the impact of a national health insurance reform on nutrient intake among general population, including more vulnerable low-income individuals and patients with chronic conditions. Using data from the National Health and Nutrition Examination Survey (NHANES), we identified 8,443 adults aged 21 years and older who participated in the survey before (2011–2012) and after the ACA (2015–2016) implementation and conducted a subgroup analysis of 952 respondents who identified as Medicaid beneficiaries and 719 patients with a history of cancer. Using pre-post study design and bivariate and multivariable logistic analyses, we compared nutrient intake from food and supplementation before and after the ACA and identified risk factors for inadequate intake. Our results suggest that intake of micronutrients found in nutrient-dense foods, mainly fruit and vegetables, has not changed significantly after the ACA. However, overall use of nutritional supplements increased after the ACA (p = 0.05), particularly magnesium (OR = 1.02), potassium (OR = 0.76), vitamin D (both D2, and D3, OR = 1.34), vitamin K (OR = 1.15) and zinc (OR = 0.83), for the general population as well as those in our subgroup analysis Cancer Survivors and Medicaid Recipients. Given the association of increased use of nutritional supplements and expansion of insurance access, particularly in our subgroup analysis, more research is necessary to understand the effect of increasing access to nutritional supplements on the overall intake of micro- and macronutrients to meet daily nutritional recommended allowances.

Infertility has a remarkable global impact affecting approximately about 48 million couples worldwide. One of the most contended concerns in reproductive biology is the prospective influence of psychological stress on pregnancy rates. Individuals struggling to conceive face a stupendous amount of emotional turbulence and have a greater risk for psychological vulnerability. Both stress and infertility reinforce the impact of each other; hence, there exists a reciprocal relationship. Stress may be the major contributor to subsequent infertility. Infertility treatments may enhance stress levels as well as reduce treatment outcomes. The biological mechanisms that interlink stress and infertility are the outcome of the hormonal actions at the brain level, where they stimulate or suppress the hypothalamic-pituitary-adrenal axis (HPA) and have a potential influence on the secretion of the respective hormone by the reproductive organs and the pregnancy outcomes. Sex hormones play an essential role in reproductive biology as well as in general physiology where they generate the cycle and provide a potential environment for pregnancy. This article reviews the impact of stress on reproductive rates and the implications of sex hormones on infertility. Additionally, it suggests strategies to overcome the stress conditions and the scenarios that may lead to stress.

Background: Hypertension is one of the diseases of occupational origin. It is ranked 5th among the 10 most important categories of occupational illness. Police personnel constitute a special occupational group with exposure to violence at work, which directly and indirectly affects their health. Various studies have reported significantly high prevalence of stress-related disorders such as hypertension, diabetes, and coronary heart disease among the policemen and found police occupation as a prominent risk factor for coronary heart disease. Aims and Objectives: This study aims to estimate the prevalence of hypertension among police personnel of a metropolitan city. Materials and Methods: A cross-sectional study was conducted among the police personal of a metropolitan city for a period of 1 year. Three hundred and fifty police personnel were contacted and interviewed using pre-designed, pre-tested, semi-structured pro forma. Police personnel were screened by taking two B.P. readings. Data analysis was done using SPSS 20.0 Statistical software. Chi-square/Fisher’s exact test was used to find the association. Statistical significance was considered at P

Background: A training program for Management of Animal-bite as per NRCP (National Rabies Control Program) guidelines & Snakebite of Medical Officer was conducted in the Tertiary Healthcare Centre. Evaluation of such training has been rarely reported. Objective: The objective of this study was to reflect on the quality of this training program regarding knowledge assessment and feedback. Methodology: A pre-test and post-test cross-sectional assessment of knowledge of medical officers working at health facilities of Bhopal district of Madhya Pradesh government, who attended one-day training program at AIIMS Bhopal in 2023, were conducted through the same questionnaire having 18 single-answer multiple choice questions. Anonymous feedback was also taken through a semi-structured questionnaire. Data were analyzed using R statistical software. The Chi-square test and Wilcoxon signed-rank test was used to compare the pre-and post-test proportions of correct responses and scores, respectively. Results: Out of a total of 54 participants, 64.8% were males. The median (IQR) age was 41 (31,52) years. The majority of the participants (68.5%) had the qualification of MBBS, 14.8% had PG degree, and the rest, 16.6%, had BAMS degree. Median (IQR) pre and post-test scores were9.0 (9.0, 12.0) and 15 (12, 16.0) respectively. All participants agreed that the training was very useful for the patient care and gave positive feedback related to the management of training. Conclusion: This training was very useful in terms of improvement of knowledge is concerned. More Tertiary Healthcare institutions should take the initiative to conduct such training programs for capacity building of Medical Officers working at community level.

Background: Warranting adequate sexual and reproductive health (SRH) among the youth population in India is challenging. While the Government has undertaken several measures to improve SRH services, gaps exist in terms of availability of these services at the health centre. Objective: To assess utilization of SRH services and explore the associated factors among youth population in rural area of Central India. Methodology: An explanatory sequential mixed method study was conducted which included collection and analysis of quantitative data pertaining to the utilization of SRH services from 236 youth (aged 15-24 years) selected through multistage cluster sampling. This was followed by 29 in-depth interviews conducted among the various stakeholders. Quantitative data was entered using MS Excel and analyzed using R v-4.1.0. The notes and audio recordings from the interviews were transcribed manually and thematic analysis was done. Results: Out of 236 youths, only 90 (38.1%) had ever availed SRH services, of whom 85.5% had visited the SRH clinic in the past 12 months. The most common reason to visit a government health facility was cited as a pregnancy test while in the case of private health facility the reasons were STD treatment, pregnancy tests, and abortions. Except the request for contraceptive services and adequate response to questions by clients, the services provided by the facilities were reported to be inadequate. Further exploration summarized the barriers and facilitators of the health care services under the themes of training, logistics, ARSH clinic, adolescent health days, and community awareness. Conclusion: Among the various influences of SRH, the healthcare system is a fundamental aspect; which seems to address inadequately the varied needs of the rural youth. Future efforts must focus on community awareness and involvement of all stakeholders to uplift SRH services, so as to have positive impact on their sexual health.

No abstract available. Article truncated after 150 words. A 72-year-old woman was referred to our practice from an outside hospital with a history of tracheal mass with impending airway compromise. She originally presented with several days of dyspnea, stridor, and an increasingly muffled voice. She also provided a history of severe shortness of breath, but only when eating. Interestingly, she had no trouble swallowing. CXR findings at the outside hospital (Figure 1) prompted a CT (Figure 2A), which further prompted transfer of patient to our facility. The patient had a history of hypertension, hyperlipidemia, type 2 diabetes and obstructive sleep apnea. Her past surgical history included C-section and hysterectomy. The patient was a never-smoker with no significant drinking or drug usage history. The patient had no recent travel or exposure history. Review of symptoms otherwise negative. Although the patient had no formal diagnosis of asthma, she was on Mometasone/formoterol, 2 puffs bid and also had an albuterol rescue …

No abstract available. Article truncated after 150 words. An 85-year-old man presented to our institution for a second opinion and for management of a recurrent left-sided pleural effusion. The patient has a history of CLL, which was diagnosed with a chest wall biopsy 4 years prior to presentation. Since that time, he has undergone chemotherapy and had a good response. In the past 18 months, the patient has had their left-sided pleural effusion drained 24 times. The patient also has a history of hypothyroidism and has had a cholecystectomy. The patient brought multiple outside imaging studies with him for review. An image capture from a recent ultrasound-guided left thoracentesis (Figure 1A) demonstrated, in retrospect, a pedunculated left lower lobe mass. An outside PET-CT (Figure 1B) was also available, confirming the presence of this mass, which had relatively uniform, low level FDG uptake such that it evade notice on first interpretation. A CT angiogram (Figure 2) demonstrated a large …

Background Context: Both Transforaminal (TF) and Interlaminar (IL) endoscopic approaches are established techniques of decompression for lumbar compressive radiculopathy. In the absence of adequate literature, there is always some dilemma in selecting the approach for endoscopic decompression leading to long learning curves and high chances of inadequate decompression, iatrogenic instability, dural tear, or dysesthesia. Hence authors propose a new surgical nomenclature and algorithm for selection of endoscopic approach. Methods: This retrospective study included 396 of 626 consecutive patients who met the inclusion criteria, who underwent either TF (n=302) or IL (n=202) full endoscopic spine surgery. MRI findings of every patient were classified as per FAPDIS (Facet angle, Anterior pathology, Posterior pathology, Dorsal, Inferior, and Superior migration) algorithm. Inter-observer variations were calculated. The targeted nomenclature was used to define the selection of endoscopic TF or IL approach for symptomatic nerve root decompression. All patients were followed up for preop and postop 6 months VAS and Oswestry Disability Index score for validation of FAPDIS algorithm. Results: Median age: 46.8 years; Sides and levels operated 330 single-level ipsilateral, 54 multiple-level ipsilateral, 6 single-level bilateral, and 6 multiple-level bilateral. Interobserver agreement in the selection of TF approach was 0.873 and IL approach was 0.882. Interobserver variability was also calculated for each FAPDIS factor, selection of P3 and P4 pathology was the main reason for disagreement. All other FAPDIS factors show good to excellent correlation. The overall VAS score decreased from a preoperative value of 9 to 1 at 6 months follow-up (p-value < 0.001), and the overall Oswestry Disability Index score improved from 89 to 12 (p-value

The technology-supported education systems seamlessly integrated throughout the globe in response to the demands of post COVID-19 pandemic. The swift developments of the digital tools with Artificial Intelligence (AI) support are also readily diffused among the educational communities. This research paper investigates the synergistic impact of digital literacy, the incorporation of AI tools, and Peer Supported Collaborative Learning (PSCL) on the learning perceptions of university students. The research aims to discern the implications of these technological and social facets on students' attitudes towards AI assisted learning process. Structured questionnaire-based survey among the University students were done for this descriptive research. 409 responses collected were analysed with SPSS, Excel and Process Macro. It is found that the students' Digital Literacy, Use of AI tools and PSCL on AI assisted learning were positively correlated. The partial mediatory path through the PSCL and AI tool usage has a significant positive influence on students learning process. The insights gathered from this study can inform educators, policymakers, and institutions on optimizing the amalgamation of digital literacy, AI tools and PSCL to enhance the contemporary learning environment. As universities navigate the digital age, this research provides a nuanced understanding of the dynamics shaping students' perceptions, offering valuable insights into the multifaceted aspects of AI influencing the educational landscape.

Abstract Background The SARS-CoV-2/COVID-19 pandemic has inflicted medical and socioeconomic havoc, and despite the current availability of vaccines and broad implementation of vaccination programs, more easily accessible and cost-effective acute treatment options preventing morbidity and mortality are urgently needed. Herbal teas have historically and recurrently been applied as self-medication for prophylaxis, therapy, and symptom alleviation in diverse diseases, including those caused by respiratory viruses, and have provided sources of natural products as basis for the development of therapeutic agents. To identify affordable, ubiquitously available, and effective treatments, we tested herbs consumed worldwide as herbal teas regarding their antiviral activity against SARS-CoV-2. Results Aqueous infusions prepared by boiling leaves of the Lamiaceae perilla and sage elicit potent and sustained antiviral activity against SARS-CoV-2 when applied after infection as well as prior to infection of cells. The herbal infusions exerted in vitro antiviral effects comparable to interferon-β and remdesivir but outperformed convalescent sera and interferon-α2 upon short-term treatment early after infection. Based on protein fractionation analyses, we identified caffeic acid, perilla aldehyde, and perillyl alcohol as antiviral compounds. Global mass spectrometry (MS) analyses performed comparatively in two different cell culture infection models revealed changes of the proteome upon treatment with herbal infusions and provided insights into the mode of action. As inferred by the MS data, induction of heme oxygenase 1 (HMOX-1) was confirmed as effector mechanism by the antiviral activity of the HMOX-1-inducing compounds sulforaphane and fraxetin. Conclusions In conclusion, herbal teas based on perilla and sage exhibit antiviral activity against SARS-CoV-2 including variants of concern such as Alpha, Beta, Delta, and Omicron, and we identified HMOX-1 as potential therapeutic target. Given that perilla and sage have been suggested as treatment options for various diseases, our dataset may constitute a valuable resource also for future research beyond virology.

Transition-metal-doped semiconductor nanocrystals have received significant attention because of their attractive features deeming them invaluable in various technological fields including optoelectronics, bio-photonics, and energy conversion, to name a few. Of particular, these interests are two-dimensional materials with useful optical and magnetic properties combined with their large surface areas opening up new applications in biotechnology. These applications range from multimodal optical and magnetic bioimaging and sensing to measuring the weak magnetic field due to brain waves using their magneto-optic properties stemming from the exchange interaction between the transition metal dopants and the carrier spins. These magnetic 2D materials could also significantly advance the field of spintronics. In this work, we report on a study of the magnetic and magneto-optic properties of colloidal two-dimensional (2D) copper-doped CdSe nanoplatelets (NPLs) that are synthesized using a high-temperature colloidal technique. We carried out optical and circularly polarized magneto-photoluminescence spectrometry to investigate the magnetism in our solution-processed nanostructures doped with copper ion impurities. At cryogenic temperatures, two excitonic features are observed for doped NPLs, which are more prominent compared to the undoped NPLs. Furthermore, the excitonic circular polarization (CP) is recorded as a function of the applied magnetic field (B) and temperature (T). The detailed analysis provides a picture of the magneto-optical behavior of the doped 2D NPLs in the presence of paramagnetic copper ions. This work paves the way for significant advances in bio/nanophotonics where tunable optical and magnetic properties of doped nanoplatelets can be leveraged to make more efficient, flexible, and low-cost devices.

Pathogenic bacteria proliferating inside mammalian host cells need to rapidly adapt to the intracellular environment. How they achieve this and scavenge essential nutrients from the host has been an open question due to the difficulties in distinguishing between bacterial and host metabolites in situ. Here, we capitalized on the inability of mammalian cells to metabolize mannitol to develop a stable isotopic labeling approach to track Salmonella enterica metabolites during intracellular proliferation in host macrophage and epithelial cells. By measuring label incorporation into Salmonella metabolites with liquid chromatography-mass spectrometry (LC-MS), and combining it with metabolic modeling, we identify relevant carbon sources used by Salmonella, uncover routes of their metabolization, and quantify relative reaction rates in central carbon metabolism. Our results underline the importance of the Entner-Doudoroff pathway (EDP) and the phosphoenolpyruvate carboxylase for intracellularly proliferating Salmonella. More broadly, our metabolic labeling strategy opens novel avenues for understanding the metabolism of pathogens inside host cells.

A biodegradable polymer electrolyte comprising poly (caprolactone) (PCL) and guar gum (GG) doped with lithium perchlorate (LiClO _4 ) was investigated for its application in supercapacitors. The films’ thermal properties, surface morphology, and tensile strength were determined to understand the interaction between the blend system and the salt. Scanning electron microscopic images showed a network of GG channels across the polymer matrix. A unique combo of THF/water as solvent was used for this study as they bring out relaxation in GG segments and compatibility between GG and PCL. The blend polymer electrolyte (BPE) was characterized using conductivity, dielectric, and biodegradation studies. Supercapacitors were fabricated, and electrochemical studies were performed. The optimized BPE was used to fabricate supercapacitors, producing a specific capacitance of 125 F g ^−1 . The time constant was measured at 0.8 s, and a consistent cyclic pattern was observed during galvanostatic charge/discharge studies with 96% Coulombic efficiency. This novel amalgamation of polymeric films holds immense promise for supercapacitor applications.

Cassava breeding faces obstacles due to late flowering and poor flower and seed set. The acceleration of breeding processes and the reduction in each cycle’s duration hinge upon efficiently conducting crosses to yield ample progeny for subsequent cycles. Our primary objective was to identify methods that provide tools for cassava breeding programs, enabling them to consistently and rapidly generate offspring from a wide array of genotypes. In greenhouse trials, we examined the effects of the anti-ethylene silver thiosulfate (STS) and the cytokinin benzyladenine (BA). STS, administered via petiole infusion, and BA, applied as an apical spray, combined with the pruning of young branches, significantly augmented the number of flowers. Controls produced no flowers, whereas treatments with pruning plus either BA or STS alone produced an average maximum of 86 flowers per plant, and the combination of pruning, BA and STS yielded 168 flowers per plant. While STS had its primary effect on flower numbers, BA increased the fraction of female flowers from less than 20% to ≥87%, thus increasing the number of progeny from desired parents. Through field studies, we devised an optimal protocol that maintained acceptable levels of phytodamage ratings while substantially increasing seed production per plant compared to untreated plants. This protocol involves adjusting the dosage and timing of treatments to accommodate genotypic variations. As a result, cassava breeding programs can effectively leverage a diverse range of germplasm to develop cultivars with the desired traits.

The primary prevention, early detection, and treatment of cardiovascular disease (CVD) have been long-standing scientific research goals worldwide. In the past decades, traditional blood lipid profiles have been routinely used in clinical practice to estimate the risk of CVDs such as atherosclerotic cardiovascular disease (ASCVD) and as treatment targets for the primary prevention of adverse cardiac events. These blood lipid panel tests often fail to fully predict all CVD risks and thus need to be improved. A comprehensive analysis of molecular species of lipids and metabolites (defined as lipidomics and metabolomics, respectively) can provide molecular insights into the pathophysiology of the disease and could serve as diagnostic and prognostic indicators of disease. Mass spectrometry (MS) and nuclear magnetic resonance (NMR)-based lipidomics and metabolomics analysis have been increasingly used to study the metabolic changes that occur during CVD pathogenesis. In this review, we provide an overview of various MS-based platforms and approaches that are commonly used in lipidomics and metabolomics workflows. This review summarizes the lipids and metabolites in human plasma/serum that have recently (from 2018 to December 2022) been identified as promising CVD biomarkers. In addition, this review describes the potential pathophysiological mechanisms associated with candidate CVD biomarkers. Future studies focused on these potential biomarkers and pathways will provide mechanistic clues of CVD pathogenesis and thus help with the risk assessment, diagnosis, and treatment of CVD.

No abstract available. Article truncated after 150 words. A 66-year-old man presented to our emergency department with fever and lethargy. A CBC demonstrated profound neutropenia with an absolute neutrophil count of

We present direct numerical simulations (DNS) study of confined buoyancy-driven bubbly flows in a Hele-Shaw setup. We investigate the spectral properties of the flow and make comparisons with experiments. The energy spectrum obtained from the gap-averaged velocity field shows E(k) ∼ k for k < kd, E(k) ∼ k−5 for k > kd, and an intermediate scaling range with E(k) ∼ k−3 around k ∼ kd. We perform an energy budget analysis to understand the dominant balances and explain the observed scaling behavior. For k < kd, energy injection balances dissipation due to drag, whereas for k > kd, the net injection balances net dissipation. We also show that the Navier-Stokes equation with a linear drag can be used to approximate large scale flow properties of bubbly Hele-Shaw flow.

The process of unconventional machining is widely used to produce detailed, complex and accurate forms in materials such as titanium, stainless steel, high power temperature resistant alloys. It is used to remove materials using devices that are harder than the content itself. In the modern manufacturing system, to enhance the productivity of textile industries extensively using nontraditional machining system. Laser beam machining is one of them. The present paper is an attempt to review the usage of nontraditional machining especially laser beam machining.

The influence of individual macro- and micronutrients on absenteeism in the United States is largely unknown. The objective of this study was to determine whether nutritional status or nutrient intake were associated with absenteeism from school and work due to illness or injury. Data from NHANES 2003–2008 were used to assess nutrient intake from food and food plus supplements, nutritional biomarker levels, and school and work absenteeism per year in children and adults. Negative binomial regression models were used to predict mean days of missed work per year and to estimate incidence rate ratios (IRRs) of absenteeism by nutrient biomarker status. Of 7429 children, 77% reported missing school days (mean 4.0 days). Of 8252 adults, 51% reported missing work days (mean 4.9 days). Children and adults who reported more absent days had a significantly lower intake of protein and several essential micronutrients from the diet. When nutrients from supplements were included, this negative association was retained for protein, selenium, choline, and DHA in children and for protein, selenium, vitamin K, choline, potassium, fiber, octadecatrienoic acid, and lycopene in adults. Future studies are needed to ascertain whether dietary interventions, such as access to healthier food options and/or dietary supplements, can reduce absenteeism.

Abstract An isophorone‐based quaternary compound with two positively charged polymer chains has been synthesized to modify charge‐neutral graphene without affecting its unique intrinsic properties. A highly scalable dip and dry coating method is employed to coat the textile‐based substrates without subsequent post‐treatment. The resultant electronic textiles exhibit remarkably low sheet resistance ≈140 Ω sq−1) after 10 washing cycles, which is considerably better compared to any reported graphene‐based e‐textiles without post‐treatment. Graphene‐based nonwoven piezoresistive sensors developed for wearable e‐textiles use this approach to exhibit an impressive piezoresistive sensitivity in the low‐pressure range of 0 to 40 Pa and display good repeatability after washing cycles. Hence this novel modification strategy is envisaged to have strong potential for multifunctional applications in next‐generation graphene‐based wearable e‐textiles.

Tetralogy Of Fallot (TOF), one of the most prevalent cyanotic congenital heart diseases in children. Single step corrective surgery, early on in life, provides a fair expectation of favourable outcome in these individuals. However, complex, and skilled anaesthetic management is required by experienced team of healthcare providers. Preoperative surgical preparation, intraoperative key anaesthesia principles and postoperative care intensive care unit are all perioperative considerations in these patients. This article reports challenges faced in the perioperative anaesthesic management of a 3-year-old child having uncorrected TOF, who underwent Waterston shunt and later Intracardiac Repair (ICR). He presented with postoperative complication like cyanotic spell, gastrointenstinal bleeding, sepsis; but later recovered successfully.

Introduction The incidence of renal tumours is increasing and anatomic imaging cannot reliably distinguish benign tumours from renal cell carcinoma. Up to 30% of renal tumours are benign, with oncocytomas the most common type. Biopsy has not been routinely adopted in many centres due to concerns surrounding non-diagnostic rate, bleeding and tumour seeding. As a result, benign masses are often unnecessarily surgically resected. 99mTc-sestamibi SPECT/CT has shown high diagnostic accuracy for benign renal oncocytomas and other oncocytic renal neoplasms of low malignant potential in single-centre studies. The primary aim of MULTI-MIBI is to assess feasibility of a multicentre study of 99mTc-sestamibi SPECT/CT against a reference standard of histopathology from surgical resection or biopsy. Secondary aims of the study include obtaining estimates of 99mTc-sestamibi SPECT/CT sensitivity and specificity and to inform the design and conduct of a future definitive trial.Methods and analysis A feasibility prospective multicentre study of participants with indeterminate, clinical T1 renal tumours to undergo 99mTc-sestamibi SPECT/CT (index test) compared with histopathology from biopsy or surgical resection (reference test). Interpretation of the index and reference tests will be blinded to the results of the other. Recruitment rate as well as estimates of sensitivity, specificity, positive and negative predictive value will be reported. Semistructured interviews with patients and clinicians will provide qualitative data to inform onward trial design and delivery. Training materials for 99mTc-sestamibi SPECT/CT interpretation will be developed, assessed and optimised. Early health economic modelling using a decision analytic approach for different diagnostic strategies will be performed to understand the potential cost-effectiveness of 99mTc-sestamibi SPECT/CT.Ethics and dissemination Ethical approval has been granted (UK HRA REC 20/YH/0279) protocol V.5.0 dated 21/6/2022. Study outputs will be presented and published nationally and internationally.Trial registration number ISRCTN12572202.

No abstract available. Article truncated after 150 words. A 70-year-old man presented with persistent cough productive of clear sputum which had persisted approximately 12 months after COVID-19 infection. The patient reported a more recent history of night sweats and had also recently developed what he described as “blisters” on his chest wall and right shoulder starting 4 weeks prior to presentation that “opened up” giving off a bloody discharge. The patient had been treated with Bactrim and Doxycycline without improvement and reported a 10-pound weight loss over the past several months. The patient was a never-smoker with no significant travel history and a past medical history of asthma, GERD, gout, and chronic rhinitis. Vital signs and physical exam were normal, except for a 1 cm open wound in the center of the patient’s chest [Figure 2A]. A chest CT performed as part of the patient’s workup demonstrated a spiculated mass in the left upper lobe with adjacent mediastinal …

Abstract The lockdown measures that were taken to combat the COVID-19 pandemic minimized anthropogenic activities and created natural laboratory conditions for studying air quality. Both observations and WRF-Chem simulations show a 20–50% reduction (compared to pre-lockdown and same period of previous year) in the concentrations of most aerosols and trace gases over Northwest India, the Indo Gangetic Plain (IGP), and the Northeast Indian regions. It is shown that this was mainly due to a 70–80% increase in the height of the boundary layer and the low emissions during lockdown. However, a 60–70% increase in the pollutants levels was observed over Central and South India including the Arabian sea and Bay of Bengal during this period, which is attributed to natural processes. Elevated (dust) aerosol layers are transported from the Middle East and Africa via long-range transport, and a decrease in the wind speed (20–40%) caused these aerosols to stagnate, enhancing the aerosol levels over Central and Southern India. A 40–60% increase in relative humidity further amplified aerosol concentrations. The results of this study suggest that besides emissions, natural processes including background meteorology and dynamics, play a crucial role in the pollution concentrations over the Indian sub-continent.

Background: India is among countries with a high maternal mortality rate. Every pregnant woman is at risk of developing pregnancy-related complication. It is not understood if and how the information and education on danger signals of pregnancy; translates into appropriate actions when a woman experiences a danger signal. Knowledge and recognition of danger signals during pregnancy would result in timely emergency obstetric care. Aims and Objectives: This study aims to determine the knowledge of key danger signals of pregnancy and its associated factors among the clients of maternal health services in tertiary care teaching hospital, Pune. Materials and Methods: This was a cross-sectional study conducted in obs. and gyne. dept. of tertiary care hospital for a period of 1 month that enrolled 55 eligible women who attended ANC and PNC clinic within study period. Ethical approval for the study was obtained from the IEC. The women were interviewed using a pre-tested questionnaire. All the women attending ANC and PNC clinic with a minimum of four ANC visits qualified the women for the inclusion in the study. Data analysis was performed using SPSS Version 20. The analyzed data were presented in suitable tabular format. Results: Out of 55 mothers, 43.6% know about four or more danger signals whereas 56.4% have knowledge of

Abstract The current transition towards electric mobility implies that a significant portion of electricity is drawn by and stored in the electric vehicle’s (EV) batteries. Vehicle-to-grid (V2G) technologies can potentially give distribution system operators access to such energy to provide ancillary services, while remunerating the vehicle owners for their availability to participate. Although the benefits of stabilization and grid efficiency improvements are clear, is it appealing and lucrative for the vehicle owners to participate in such services? In this work, we answer this question by modelling the V2G system and performing economic projections of the possible benefits for EV owners. In particular, we present a novel way of parametrizing the electric vehicle driving profile and the V2G energy transfer to compute battery degradation costs. A profit model is developed to evaluate the profit earned by the vehicle owners offering their batteries. The profit is estimated on the basis of the owner’s inclination to buy and sell energy from the grid based on the electricity price. Using data of the German electricity market, we estimate a profit of 662 €/EV/Year for a vehicle with 100 kWh capacity, 95% battery round trip efficiency and driving 52 km per day. The remuneration is meaningful and can have the potential to encourage EV owners to participate in V2G service.