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Abstract Introduction Diagnosing infected joint replacements relies heavily on assessing the neutrophil response to bacteria. Bacteria form biofilms on joint replacements. Biofilms are sessile bacterial communities encased in a protective extracellular matrix, making them notoriously difficult to culture, remarkably tolerant to antibiotics, and able to evade phagocytosis. Phagocytized bacteria dramatically alter cytokine production and compromise macrophage antigen presentation. We hypothesize that a subset of joint replacements have a dormant infection that suppresses the neutrophil response to bacteria but can be distinguished from uninfected joint replacements by the response of the mononuclear phagocyte system (MPS) within periarticular tissue, synovial fluid, and circulating plasma. Methods Single cell RNASeq transcriptomic and OLink proteomic profiling was performed on matched whole blood, synovial fluid, and periarticular tissue samples collected from 4 joint replacements with an active infection and 3 joint replacements without infection as well as 6 joint replacements with a prior infection deemed “infection-free” by the 2018 Musculoskeletal Infection Society criteria (follow-up of 26 ± 3 months). Results The MPS and neutrophil responses differ by infected state; the cellular distribution of the MPS response in the subset of joints with dormant infections resembled actively infected joints (p = 0.843, Chi-square test) but was significantly different from uninfected joints (p

Abstract In the realm of epigenetic regulation, Protein arginine deiminase 2 (PAD2) stands out as a therapeutic target due to its significant role in neurological disorders, rheumatoid arthritis (RA), multiple sclerosis (MS), and various cancers. To date, no in silico studies have focused on PAD2 for lead compound identification. Therefore, we conducted structure-based pharmacophore modeling, virtual screening, molecular docking, molecular dynamics (MD) simulations, and essential dynamics studies using PCA and free energy landscape analyses to identify repurposed drugs and selective inhibitors against PAD2. The best pharmacophore model, ‘Pharm_01,’ had a selectivity score of 10.485 and an excellent ROC curve quality of 0.972. Pharm1 consisted of three hydrogen bond donors (HBD) and two hydrophobic (Hy) features (DDDHH). A virtual screening of about 9.2 million compounds yielded 2575 hits using a fit value threshold of 2.5 and drug-likeness criteria. Molecular docking identified the top ten molecules, which were verified using MD simulations. Stability was verified using MM-PBSA studies, whereas conformational differences were investigated using PCA and free energy landscape analyses. Two hits (Leads 1 and 2) from the DrugBank dataset showed promise for repurposing as PAD2 inhibitors, while one hit compound (Lead 8) from the ZINC database emerged as a novel PAD2 inhibitor. These findings indicate that the discovered compounds may be potent PAD2 inhibitors, necessitating additional preclinical and clinical research to produce viable treatments for cancer and neurological disorders.

Abstract Studies have used extensive clinical information to predict time-to-heart failure (HF) in patients with and without diabetes mellitus (DM). We aimed to determine a screening method using only computed tomography calcium scoring (CTCS) to assess HF risk. We analyzed CTCS scans from 1,998 patients (336 with type 2 diabetes) from a no-charge coronary artery calcium score registry (CLARIFY Study, Clinicaltrials.gov NCT04075162). We used deep learning to segment epicardial adipose tissue (EAT) and engineered radiomic features of calcifications (“calcium-omics”) and EAT (“fat-omics”). We developed models incorporating radiomics to predict risk of incident HF in patients with and without type 2 diabetes. At a median follow-up of 1.7 years, 5% had incident HF. In the overall cohort, fat-omics (C-index: 77.3) outperformed models using clinical factors, EAT volume, Agatston score, calcium-omics, and calcium-and-fat-omics to predict HF. For DM patients, the calcium-omics model (C-index: 81.8) outperformed other models. In conclusion, CTCS-based models combining calcium and fat-omics can predict incident HF, outperforming prediction scores based on clinical factors.Please check article title if captured correctly.YesPlease check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary.Yes

Introduction The Gonds tribe, indigenous to the Sonbhadra region in Uttar Pradesh, India, faces unique challenges and disparities in women’s health, particularly in the domains of menstrual health, pregnancy, and postpregnancy care. This study aims to shed light on the demographic patterns of these critical aspects of women’s health among the Gonds tribe, providing valuable insights for healthcare interventions and policy development. Aim This study explores the demographic and socioeconomic factors affecting Gond women’s health, focusing on menstrual hygiene and life stages before, during, and after pregnancy. Methodology We collected data on menstruation wellness behaviors, pregnancy experiences, and postpregnancy care by conducting an extensive survey among Gonds women in the Sonbhadra area. In addition, focus groups and qualitative interviews were used to acquire greater knowledge of the socioeconomic and social factors impacting these health-distinctive characteristics. Result The Chi-square test shows no significant link between age group and menstrual hygiene product use. Young women (under 18) mostly use cotton cloth (56%). Women aged 18–49 prefer cotton cloth (53.2%). Women 50+ use cotton cloth (43.2%), cotton (29.7%), and sanitary napkins (27%). Marital status affects product use and cycle regularity. Cultural beliefs and education influence healthcare decisions. Menstrual hygiene mainly involves cotton cloth (45%) and cotton (26.1%). Conclusion In conclusion, our analysis uncovers key insights: Marital status, healthcare access, education, cultural beliefs, and reproductive health practices influence community healthcare decisions. These findings inform tailored interventions to enhance health outcomes and equity.

Background: Didactic teaching being teacher centric usually does not generate sense of responsibility for learning among the students. The Jigsaw method is a form of cooperative learning that improves not only the cognitive but also the affective and psychomotor skills, which are required by a student to become an Indian Medical Graduate. Thus, this study was aimed at assessing the effectiveness of Jigsaw strategy in comparison to didactic teaching and to understand the perception of the students. Methodology: This was a quasi-experimental study conducted among second year MBBS students. They were randomly assigned to lecture and Jigsaw groups. A topic on general toxicology was chosen. Handouts were prepared which were given to all the students. The lecture group was taught using audio visual aids. The topic was sub divided into five subtopics for Jigsaw group. A post test consisting of MCQs was used to assess the effectiveness of the method. A validated questionnaire was used to gather feedback from the students belonging to Jigsaw Group. Descriptive statistics were used to analyze responses to the Likert scale questions. Results: The present study included a total of 65 II year MBBS students, out of which 30 students were in Jigsaw group. A total of 94% students agreed to participate actively in the Jigsaw session. Most of the students (93%) students listened to and respected the ideas of their peers. A total of 72% students found this method of learning useful in Forensic Medicine and Toxicology. Only 53% of the students felt that the time for preparation and presentation of the topic was sufficient. Conclusions: The present study advocates this cooperating learning method to be an effective tool in better understanding of the subject, to improve communication skills and to inculcate lifelong learning attitude among the medical graduates. The jigsaw method, however, requires more time for planning and execution, to yield positive outcomes.

Background: The new competency-based curriculum incorporates the social sciences and humanism to the basic and clinical sciences, thus giving an integrated approach to medical education. Comparing the empathy score with the motivation level across the two curricula was thus planned to assess the current status. Method: A cross-sectional qualitative study using an Internet-based electronic survey containing both an academic motivation scale to assess the motivation level and Jefferson’s scale of empathy was used to assess empathy score. Result: From the above study, we concluded that males have a higher empathy score across both the curricula. >95% of students of both categories belonged to the High Intrinsic High Control motivational category. The empathy scores were slightly higher among the CBME (Competency Based Medical Education) group compared to the non-CBME group, but it was not statistically significant. In subgroup analysis, Phase 3 was found to have a significant association. Conclusion: The majority of the students fall in the High Intrinsic High Control category, where they have the next highest level of empathy. Phase 2 was found to have a significant association; it could be because of the positive effects of AETCOM classes on the ready-to-enter clinical exposure batch. The study also revealed that while motivation and empathy are generally linked, outliers existed, particularly among participants with low initial motivation but high empathy. This suggests a potential association between extrinsic motivation and empathy, possibly influenced by external factors.

Background: Vaccine hesitancy has been inching up and its root cause lies in the factors that influence the vaccination. The present study was conducted to find out the proportion and factors contributing to vaccine hesitancy for routine childhood vaccinations in the slum population. Methods: A community-based cross-sectional study was carried out among 210 children between the age group of 0 and 59 months residing in the urban slums of Ranchi in 2021. Data were collected during the household visit by interviewing the parents using a predesigned pretested interview schedule which was developed based on the validated version of the vaccine hesitancy survey questionnaire originally developed by the World Health Organization Strategic Advisory Group of Experts’ working group on vaccine hesitancy. Associations between variables were analyzed using logistic regression. Results: A total of 210 children whose parents had given consent were included in our study. The majority of the families, 188 (89.5%), were not hesitant while only 22 (10.5%) were vaccine hesitant. Tribal children and unreserved category children had adjusted odds ratio of 4.41 (95% CI, 1.61–45.46) and 7.75 (95% CI, 1.07–56.08) for the delay as against their reference category. Conclusions: Most of the children were vaccinated in our study area and the families have shown confidence in vaccines. Although there were delays in vaccination and the reasons for the delays must be addressed to prevent these vaccine-hesitant populations from turning into vaccine-refusal population. Uniformity in vaccination days in different health facilities in slum areas, appropriate antenatal information, and counseling regarding childhood vaccinations, widespread awareness, and improving mother’s education can help address the issue of vaccine hesitancy.

Abstract Bionanofertilizers are promising eco-friendly alternative to chemical fertilizers, leveraging nanotechnology and biotechnology to enhance nutrient uptake by plants and improve soil health. They consist of nanoscale materials and beneficial microorganisms, offering benefits such as enhanced seed germination, improved soil quality, increased nutrient use efficiency, and pesticide residue degradation, ultimately leading to improved crop productivity. Bionanofertilizers are designed for targeted delivery of nutrients, controlled release, and minimizing environmental pollutants, making them a sustainable option for agriculture. These fertilizers also have the potential to enhance plant growth, provide disease resistance, and contribute to sustainable farming practices. The development of bionanofertilizers addresses the adverse environmental impact of chemical fertilizers, offering a safer and productive means of fertilization for agricultural practices. This review provides substantial evidence supporting the potential of bionanofertilizers in revolutionizing agricultural practices, offering eco-friendly and sustainable solutions for crop management and soil health.

This study analyzed the water quality of the Yamuna river in Prayagraj across nine locations where the sampling was done upstream, downstream and middle stream from May 2019 to April 2020 using fourteen water quality parameters. Quarterly samples showed good Water Quality Index (WQI) values for summer (95.19), monsoon (77.28), and winter (90.77), but a decline in spring (102.11) due to religious activities was observed. Inductively coupled plasma mass spectroscopy suggested high concentration of Ca2+, Mg2+, K, and P in the river. Principal Component Analysis revealed 9 significant factors (eigen value >0.5) covering 25.13 – 93.89 % variance. Strong correlations included TDS-EC (0.853) and Ca2+ – Mg2+ (1.00) was observed. The correlation between water quality parameters generated by principal component analysis showed that the main parameters affecting the water quality vary in all the seasons. Based on the water quality indicators, anthropogenic activities are accountable to deteriorate the quality of river water. Therefore, the pollution status of the river need to be made publicly.

Satellite images serve a crucial role in weather prediction, particularly in assessing the strength of tropical storms such as cyclones. Tropical cyclones are commonly observed in regions of open oceans where conventional meteorological stations are scarce or absent, posing difficulties in accurately measuring their precise intensity in those areas. Meteorologists utilise high-resolution satellite imagery to address this challenge by accurately perceiving the complexities of storm genesis and structure. This research presents a novel method for forecasting the strength of tropical storms using the You Only Look Once-Neural Architecture Search (YOLO-NAS) algorithm, leveraging real-time satellite imagery from the INSAT-3D platform. YOLO-NAS, a state-of-the-art object detection model, is used to detect and analyse key features in multispectral infrared satellite images, which are vital for assessing cyclone strength. The model is trained on an extensive dataset covering cyclone events in the Indian Ocean region. The experimental findings indicate an accuracy rate of 81 %, a retrieval rate of 83 %, mean Average Precision (mAP) of 85.19 %, and a Mean Square Error (MSE) of 0.10. The study demonstrates that accurate estimation of tropical cyclone strength can be obtained, leading to improved real-time capabilities. Extensive experimentation illustrates that the proposed model achieves superior performance on various metrics such as accuracy, precision, recall, F1-Score, mAP rates, MSE and inference time as compared to other similar cutting-edge algorithms. The meteorological significance of this work lies in its ability to offer a reliable, real-time tool for cyclone intensity prediction, which could be integrated into operational weather forecasting systems. The finding shows that there is potential for practical use of this method.

Tissue on a chip or organ-on-chip (OOC) is a technology that's dignified to form a transformation in drug discovery through the use of advanced platforms. These are 3D in-vitro cell culture models that mimic micro-environment of human organs or tissues on artificial microstructures built on a portable microfluidic chip without involving sacrificial humans or animals.This review article aims to offer readers a thorough and insightful understanding of technology. It begins with an in-depth understanding of chip design and instrumentation, underlining its pivotal role and the imperative need for its development in the modern scientific landscape. The review article explores into the myriad applications of OOC technology, showcasing its transformative impact on fields such as radiobiology, drug discovery and screening, and its pioneering use in space research. In addition to highlighting these diverse applications, the article provides a critical analysis of the current challenges that OOC technology faces. It examines both the biological and technical limitations that hinder its progress and efficacy and discusses the potential advancements and innovations that could drive the OOC technology forward. Through this comprehensive review, readers will gain a deep appreciation of the significance, capabilities, and evolving landscape of OOC technology.

Context: A geographic information system (GIS) is a framework for gathering, managing, and analyzing data. Department of Community Medicine was tasked with SARS-CoV2-IgG antibody serosurvey by Pimpri Chinchwad Municipal Corporation, sampling 5000 people spread over an area of 181 sq. km. There were no real-time mapping apps available for field surveys. Aims: Our aim was to develop an easy-to-use GIS system with a shallow learning curve and real-time mapping for field surveys which could be easily deployed. Materials and Methods: The program was developed using PHP hosted on a virtual private server and using Google Maps Application Programming Interface (API). The field investigator shares location through telegram to a bot which parses message, decodes geo-coordinates, team information, and time stamp. The program then passes the information for further processing, viewing, or analyzing. The map is generated using Google Maps API at user request. The teams are segregated using color coding. Results: The data can be accessed at http://test.techlabel.in/. Over 638 households from which samples were taken were plotted by the data from ten teams over ten days. Real-time feedbacks were possible as the study progressed. Households plotted on the maps were verified by the respective field investigators after the study had completed and showed good accuracy. Conclusion: The introduction of GIS software such as ours could bring about a positive impact on small- and medium-scale field researches. The quality and internal validity of small-scale field researches could certainly be improved by using GIS programs.

Abstract Spindle epithelial tumor with thymus-like elements (SETTLE) is a rare malignant neoplasm of the thyroid gland which is believed to arise from intrathyroidal thymic tissue. It predominantly affects young adults and children presenting with a thyroid mass of variable duration and rarely occurs in adults. It has a high overall survival with a tendency for delayed metastasis. SETTLE is a biphasic lobulated tumor composed of spindle shaped cells along with glandular formations seen on histopathological examination. Despite its typical morphology it is commonly misdiagnosed on histopathology due to its rarity and overlapping morphology with other close mimics such as a carcinoma, synovial sarcoma and thymoma. Herein we report such a case occurring in a middle aged female presenting with a neck mass. She had an initial diagnosis of metastatic poorly differentiated squamous cell carcinoma possibly with an orophayngeal primary in view of co expression of CK, p40 and p16 on immunohistochemistry. The patient underwent surgical resection with modified neck dissection. On review at our hospital it was diagnosed as SETTLE and she remains disease free after a follow-up period of 1 year. Diligent histopathological examination espoused with a judicious panel of IHC markers in conjunction with clinicoradiological findings forms the mainstay of diagnosis. Diffuse and strong p16 immunoexpression has not been documented or evaluated in literature so far, and needs to be explored for its diagnostic utility in this rare entity.

Abstract Doped ceria has been extensively explored as an efficient electrolyte material for intermediate to low temperature solid oxide fuel cell. Among other ceria electrolytes, gadolinia doped ceria (GDC) is one of the most extensively studied electrolyte materials for low temperature SOFC applications. Here, co-precipitation method is employed to synthesize GDC nanoparticles with stoichiometric ratio of GdxCe1−xO2−δ (with 0 $$\le$$ ≤ x $$\le$$ ≤ 0.20). In this process, the molecular water of the precursors has been utilized during the co-precipitation to avoid possible agglomeration caused by hydrogen bonding. The cubic phase formation was examined using X-ray diffraction (XRD) and Raman profile ascribing absence of other phases. XRD along with Reitveld refinement confirm the presence of cubic phase of ceria and Raman profile confirms the oxygen vacancies due to the non-stoichiometry created in CeO2 lattice. The granularity of the sample was observed using field emission scanning electron microscopy (FESEM) with elemental mapping by EDS. It is observed from FESEM that the grains are compact in nature and the density observed was around 98% of the theoretical density. The electrochemical behavior was investigated using electrochemical impedance spectroscopy (EIS), which was taken between the temperature ranges of 350–700 °C. It is observed from the EIS study that ceria doped with 15 mol % Gd3+ (Gd0.15Ce0.85O2−δ) is having highest grain boundary ionic conductivity of about 0.104 S cm−1 at 700 °C with an activation energy of 0.81 eV. This work demonstrates the correlation between oxygen vacancy generation and the enhancement of ionic conductivity with Gd3+ doping in ceria.

Abstract The diagnosis of prostate cancer using histopathology is reliant on the accurate interpretation of prostate tissue sections. Current standards rely on the assessment of Haematoxylin and Eosin (H&E) staining, which can be difficult to interpret and introduce inter-observer variability. Here, we present a digital pathology atlas and online resource of prostate cancer tissue micrographs for both H&E and the reinterpretation of samples using a novel set of three biomarkers as an interactive tool, where clinicians and scientists can explore high resolution histopathology from various case studies. The digital pathology prostate cancer atlas when used in conjunction with the biomarkers, will assist pathologists to accurately grade prostate cancer tissue samples.

Abstract Background The mechanisms enabling dynamic shifts between drug-resistant and drug-sensitive states in cancer cells are still underexplored. This study investigated the role of targeted autophagic protein degradation in regulating ovarian cancer stem cell (CSC) fate decisions and chemo-resistance. Methods Autophagy levels were compared between CSC-enriched side population (SP) and non-SP cells (NSP) in multiple ovarian cancer cell lines using immunoblotting, immunofluorescence, and transmission electron microscopy. The impact of autophagy modulation on CSC markers and differentiation was assessed by flow cytometry, immunoblotting and qRT-PCR. In silico modeling and co-immunoprecipitation identified ID1 interacting proteins. Pharmacological and genetic approaches along with Annexin-PI assay, ChIP assay, western blotting, qRT-PCR and ICP-MS were used to evaluate effects on cisplatin sensitivity, apoptosis, SLC31A1 expression, promoter binding, and intracellular platinum accumulation in ID1 depleted backdrop. Patient-derived tumor spheroids were analyzed for autophagy and SLC31A1 levels. Results Ovarian CSCs exhibited increased basal autophagy compared to non-CSCs. Further autophagy stimulation by serum-starvation and chemical modes triggered proteolysis of the stemness regulator ID1, driving the differentiation of chemo-resistant CSCs into chemo-sensitive non-CSCs. In silico modeling predicted TCF12 as a potent ID1 interactor, which was validated by co-immunoprecipitation. ID1 depletion freed TCF12 to transactivate the cisplatin influx transporter SLC31A1, increasing intracellular cisplatin levels and cytotoxicity. Patient-derived tumor spheroids exhibited a functional association between autophagy, ID1, SLC31A1, and platinum sensitivity. Conclusions This study reveals a novel autophagy-ID1-TCF12-SLC31A1 axis where targeted autophagic degradation of ID1 enables rapid remodeling of CSCs to reverse chemo-resistance. Modulating this pathway could counter drug resistance in ovarian cancer.

Abstract Background Patient-reported outcome measures quantify outcomes from patients’ perspective with validated instruments. QuickDASH (Quick Disability of Arm, Shoulder and Hand, an upper extremity PROM) scores improve after completing instrument tasks, suggesting patient-reported outcome results can be modified. We hypothesized that performing lower extremity tasks on the knee injury and osteoarthritis outcome score for joint reconstruction (KOOS-JR) and hip disability and osteoarthritis outcome score for joint reconstruction (HOOS-JR) instruments would similarly improve the scores. Methods Forty seven hip and 62 knee osteoarthritis patients presenting to a suburban academic center outpatient osteoarthritis and joint replacement clinic were enrolled and randomized to an intervention or a control group. Inclusion criteria were age over 18 years and English competency. Patients completed a HOOS-JR or KOOS-JR instrument, completed tasks similar to those of the instrument (intervention) or the QuickDASH (control), and then repeated instruments again. Paired and unpaired t-tests were used to compare the intervention and control group scores before and after tasks. Results There was no significant difference in total or individual scores after task completion compared to baseline in either the HOOS-JR or the KOOS-JR groups. There was no significant difference in the scores between the intervention or control groups. Conclusions Disability may be less modifiable in the lower extremity than in the upper extremity, perhaps because upper extremity activities are more easily compensated by the contralateral limb, or because lower extremity activities are more frequent. Thorough evaluation of factors influencing patient-reported outcome measures is necessary before their extensive application to quality control and reimbursement models.

Background: Despite advancements in treatment, patients with Parkinson’s disease (PD) experience a range of symptoms that affect their quality of life. There is a need to integrate neuropalliative care into standard care. The aim of the study is to understand the psychosocial functioning in persons with PD and explore their caregivers’ burden. Methods: The study utilizes a mixed-methods design where 50 patient–caregiver dyads attending the outpatient services of the movement disorder clinic at a tertiary care hospital were measured on psychosocial functioning and caregiver burden and palliative care outcomes for a period of 6 months. Focus group discussions were conducted with 18 patient–caregiver dyads to understand the needs of palliative care. Results: It was found that caregiver burden was positively correlated with palliative care outcomes scores of patients (r = 0.586) and caregivers (r = 0.675) and psychosocial functioning was positively correlated with palliative care outcomes of patients (r = 0.708). The psychosocial functioning score was higher among female patients (indicating worse functioning) than males, and female caregivers experienced significantly higher caregiver burden. The qualitative findings reveal that there is a substantial gap in awareness about palliative care, lack of information, presence of stigmatizing beliefs, and lack of adequate accessibility to palliative facilities. Conclusion: The study lays the foundation for future PD neuropalliative care research, guiding interventions, and exploration of regional variations in PD experiences in India. There is a need to address caregiver burden in PD in India.

Abstract Background Both length of hospital stay and discharge to a skilled nursing facility are key drivers of total knee arthroplasty (TKA)-associated spending. Identifying patients who require increased postoperative care may improve expectation setting, discharge planning, and cost reduction. Balance deficits affect patients undergoing TKA and are critical to recovery. We aimed to assess whether a device that measures preoperative balance predicts patients’ rehabilitation needs and outcomes after TKA. Methods 40 patients indicated for primary TKA were prospectively enrolled and followed for 12 months. Demographics, KOOS-JR, and PROMIS data were collected at baseline, 3-months, and 12-months. Single-leg balance and sway velocity were assessed preoperatively with a force plate (Sparta Science, Menlo Park, CA). The primary outcome was patients’ discharge facility (home versus skilled nursing facility). Secondary outcomes included length of hospital stay, KOOS-JR scores, and PROMIS scores. Results The mean preoperative sway velocity for the operative leg was 5.7 ± 2.7 cm/s, which did not differ from that of the non-operative leg (5.7 ± 2.6 cm/s, p = 1.00). Five patients (13%) were discharged to a skilled nursing facility and the mean length of hospital stay was 2.8 ± 1.5 days. Sway velocity was not associated with discharge to a skilled nursing facility (odds ratio, OR = 0.82, 95% CI = 0.27–2.11, p = 0.690) or longer length of hospital stay (b = -0.03, SE = 0.10, p = 0.738). An increased sway velocity was associated with change in PROMIS items from baseline to 3 months for global07 (“How would you rate your pain on average?” b = 1.17, SE = 0.46, p = 0.015) and pain21 (“What is your level of pain right now?” b = 0.39, SE = 0.17, p = 0.025) at 3-months. Conclusion Preoperative balance deficits were associated with postoperative improvements in pain and function after TKA, but a balance focused biometric that measured single-leg sway preoperatively did not predict discharge to a skilled nursing facility or length of hospital stay after TKA making their routine measurement cost-ineffective.

Background: Anxiety, depression and stress (ADS) are prevalent mental health disorders among university students due to the demanding nature of their academic pursuits. Pranayama yogic breathing (PYB), a controlled breathing technique has been suggested as a potential intervention to alleviate these psychological maladies. Aim: This study aimed to investigate the effect of PYB practices on ADS levels of post-graduate students (PGSs) while exploring the potential relationships with serum cortisol (SC) and hemoglobin (Hb) levels. Methods: 60 university students aged between 21 to 24 years were randomly assigned into two groups: an experimental group participant (n=30) who practiced PYB for 45 minutes daily for three months and a control group participant (n=30) who did not receive any intervention. ADS levels were assessed using a standardized questionnaire ADSS, while SC levels and Hb were measured using laboratory tests. Data were collected at three states pre (before intervention), mid (after 45 days of intervention) and post (after 90 days of intervention). Data were analyzed using SPSS version 2.5.11 (110) Results: The results demonstrated that PGSs who underwent the PYB intervention exhibited significantly reduced anxiety, depression and stress compared to the control group. Furthermore, the experimental group showed a significant decrease in SC levels and a significant increase in Hb levels after the intervention. Conclusion: PYB practice has been shown to significantly reduced ADS and positively influenced SC and Hb levels in PGSs. Further research is warranted to explore the long-term effects and broader applicability of PYB on diverse populations.

Abstract Background Neuroblastoma is the most common extra-cranial pediatric solid tumor. 131I-metaiodobenzylguanidine (MIBG) is a targeted radiopharmaceutical highly specific for neuroblastoma tumors, providing potent radiotherapy to widely metastatic disease. Aurora kinase A (AURKA) plays a role in mitosis and stabilization of the MYCN protein in neuroblastoma. We aimed to study the impact of AURKA inhibitors on DNA damage and tumor cell death in combination with 131I-MIBG therapy in a pre-clinical model of high-risk neuroblastoma. Results Using an in vivo model of high-risk neuroblastoma, we demonstrated a marked combinatorial effect of 131I-MIBG and alisertib on tumor growth. In MYCN amplified cell lines, the combination of radiation and an AURKA A inhibitor increased DNA damage and apoptosis and decreased MYCN protein levels. Conclusion The combination of AURKA inhibition with 131I-MIBG treatment is active in resistant neuroblastoma models.

One of the best ways to remove organic dyes based contaminant from water resources and industrial waste water is the sunlight driven photo-catalytic degradation method. The theme of the present investigation is the photocatalytic degradation of methylene blue (MB) dye using economically produced Cu2-XSe nanoparticles (NPs) catalyst under solar radiations. The Cu2-XSe NPs crystallized in the cubic structural phase with an average crystallite size around 19 nm. The direct band gap was found to be 2.1 eV. The PL spectra and corresponding CIE diagram show the Cu2-xSe NPs emitted yellow color. The SEM micrographs show that the small grains staked over others to form large grains or patches. The FTIR and EDX spectra confirmed the formation of Cu2-XSe NPs. The obtained optimum photocatalytic degradation efficiency for Cu2-XSe NPs is 90.3 %. For first cycle analysis. The pseudo-first order and second order models were used to analyze the kinetic data of Cu2-XSe NPs for varying concentrations. The multiple-cycle degradation analysis by catalyst of MB dye in one day spam for continuous four cycles were also analysed and discussed. The sun light driven multi-cycle catalytic degradation confirms the re-usability of Cu2-xSe NPs for the treatment of industrial waste water and other contaminated water bodies for the survival of aquatic life and for saving environment.

Background: Periprosthetic femur fractures (PPFFs) following total hip arthroplasty (THA) have increased in the past decade as the demand for primary surgery continues to grow. Although there is now more evidence to describe the treatment of Vancouver B fractures, there is still limited knowledge regarding factors that cause surgeons to perform either an open reduction and internal fixation (ORIF) or revision THA (rTHA). The purpose of this study was to determine what type of surgeons treat Vancouver B PPFFs at 11 major academic institutions and if there are trends in treatment decision-making regarding the use of ORIF or rTHA based on surgical training or patient factors. Methods: This multicenter retrospective study evaluated patients surgically treated for Vancouver B PPFF after THA between 2014 and 2019. Patients from 11 academic centers located in the United States were included in this study. Surgical outcomes and patient demographics were evaluated based on surgeon training, surgical treatment type, and institution. Results: Presence of Vancouver B2 (odds ratio [OR]: 0.02, P < .001) or B3 (OR: 0.04, P < .001) fractures were independent risk factors for treatment with rTHA. Treatment by a trauma (OR: 12.49, P < .001) or other-specified surgeon (OR: 13.63, P < .001) were independent risk factors for ORIF repair of Vancouver B fractures. There were no differences in outcomes based on surgeon subspecialty training. Conclusions: This study showed the trends in surgeons who surgically manage Vancouver B fractures at 11 major academic institutions and highlighted that regardless of surgical training or surgical treatment type, postoperative outcomes following management of PPFF were similar.

Chronic obstructive pulmonary disease (COPD) presents as a multifaceted clinical landscape with various hematological manifestations. Among these, polycythemia and anemia pose distinct challenges. While the prevalence of polycythemia has decreased in recent years, anemia remains a prevalent concern, impacting patient outcomes. This study investigated the incidence and clinical characteristics of polycythemia in COPD patients, focusing on a diverse cohort in India. Methodological approaches included comprehensive evaluations of clinical parameters, pulmonary function, and hematological profiles. Results revealed significant variations in COPD severity, pulmonary function, and respiratory symptoms among patients with different hemoglobin levels. The findings shed light on the complex interplay between hematological variations and clinical manifestations in COPD, providing valuable insights for disease management strategies.

Summary: Helicobacter-induced gastric cancer progresses very slowly, even in animal models, making it difficult to study. Here, we present a protocol to establish an accelerated murine model for Helicobacter-induced gastric cancer. We describe steps for infecting mice with Helicobacter felis, harvesting gastric tissue, assessing disease severity by histopathologic scoring, and performing gene expression studies with RT-qPCR and RNA sequencing. The accelerated model shows rapid progression of the disease, with gastric precancerous lesions developing within 6 months post-infection with Helicobacter.For complete details on the use and execution of this protocol, please refer to Bali et al.1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Background: The basic product information, health, safety, and nutritional details, as well as food marketing, advertising, and promotion, are all provided on a packed food label. This study was carried out to assess the knowledge, attitude, and practices of the shoppers regarding food labels as there are few studies done in India and none in Pune. Methodology: A cross-sectional study was carried out among 226 participants using a validated semi-structured questionnaire, which consisted of sociodemographic details and questions on their knowledge, attitude, and practice regarding food labels while purchasing a packed food item. Quantitative data are presented in the form of mean, standard deviation, 95% confidence interval (CI) of mean, median, and interquartile range (IQR). Qualitative data are in terms of number (N), percentages (%), and 95% CI of percentage. Results: Of the 226 participants, 163 (72.12) were aware of the label on packaged foods. One hundred seventy-seven (78.32%) participants in all read the label on the packaged food. The maximum retail price (MRP) and expiration date were the most frequent labels sought. Although 17.7% of consumers did not consider nutrient composition when making a purchase, energy and protein were the most often considered nutrients. The majority (70.35%) falsely believed that juice was healthy. The packed food label’s tiny font made it difficult to read for 30.38% of the customers. Conclusion: Despite the increased awareness about packed food labeling, a fraction of shoppers were not concerned about nutritional information. In contrast to the prevailing knowledge, the majority believes packed food has a positive effect on health.

Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving.

Purpose: Untreated stress, anxiety, and depression during the perinatal period can lead to adverse maternal and infant outcomes. Yoga, the practice of body–mind–spirit techniques has been shown to reduce stress, anxiety, and depression. Aims: The aim of the study was to examine the feasibility and limited efficacy of the 4-week practice of pregnancy tele-yoga module (PTYM) delivered and monitored through an online platform. Methodology: A multicentric, open-label, exploratory study was conducted in the antenatal clinics (ANCs) of three tertiary care hospitals in India. Pregnant women between 13 and 32 weeks of gestation were invited to participate. PTYM was taught by the trained research staff. A YouTube link demonstrating the PTYM developed by the researchers was shared with consenting participants. Using the Yoga Performance Assessment (YPA), research staff monitored the online performance of the PTYM. Pre- and postintervention, women were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Results: Preintervention, among 162 consented pregnant women, anxiety (62.34%) was the most common mental health condition, followed by stress (55.55%) and depression (45.67%). YPA at the end of week 1, week 2, week 3, and week 4 was 19.45, 21.35, 24.15, and 28.45, respectively. Postintervention anxiety, stress, and depression persisted in 19.78%, 11.44%, and 10.41% of women. Pregnant women with stress (DASS-21 ≥15; n = 90), anxiety (DASS-21 ≥8; n = 101), and depressive (DASS-21 ≥10; n = 74) symptoms after undergoing 4 weeks of PTYM reported significant reduction in the scores. Conclusion: The current study demonstrated the feasibility and limited efficacy of PTYM in ANCs of a tertiary care hospital in India.

Shift work, long work hours, and operational tasks contribute to sleep and circadian disruption in defence personnel, with profound impacts on cognition. To address this, a digital technology, the SleepSync app, was designed for use in defence. A pre-post design study was undertaken to examine whether four weeks app use improved sleep and cognitive fitness (high performance neurocognition) in a cohort of shift workers from the Royal Australian Air Force. In total, 13 of approximately 20 shift-working personnel from one base volunteered for the study. Sleep outcomes were assessed using the Insomnia Severity Index (ISI), the Patient-Reported Outcomes Measurement Information System (PROMIS), Sleep Disturbance and Sleep-Related Impairment Scales, the Glasgow Sleep Effort Scale, the Sleep Hygiene Index, and mental health was assessed using the Depression, Anxiety, and Stress Scale-21. Sustained attention was measured using the 3-min Psychomotor Vigilance Task (PVT) and controlled response using the NBack. Results showed significant improvements in insomnia (ISI scores 10.31 at baseline and 7.50 after app use), sleep-related impairments (SRI T-scores 53.03 at baseline to 46.75 post-app use), and healthy sleep practices (SHI scores 21.61 at baseline to 18.83 post-app use; all p < 0.001). Trends for improvement were recorded for depression. NBack incorrect responses reduced significantly (9.36 at baseline; reduced by −3.87 at last week of app use, p < 0.001), but no other objective measures improved. These findings suggest that SleepSync may improve sleep and positively enhance cognitive fitness but warrants further investigation in large samples. Randomised control trials with other cohorts of defence personnel are needed to confirm the utility of this intervention in defence settings.

Abstract ARID1B haploinsufficiency in humans causes Coffin-Siris syndrome, associated with developmental delay, facial dysmorphism, and intellectual disability. The role of ARID1B has been widely studied in neuronal development, but whether it also regulates stem cells remains unknown. Here, we employ scRNA-seq and scATAC-seq to dissect the regulatory functions and mechanisms of ARID1B within mesenchymal stem cells (MSCs) using the mouse incisor model. We reveal that loss of Arid1b in the GLI1+ MSC lineage disturbs MSCs’ quiescence and leads to their proliferation due to the ectopic activation of non-canonical Activin signaling via p-ERK. Furthermore, loss of Arid1b upregulates Bcl11b, which encodes a BAF complex subunit that modulates non-canonical Activin signaling by directly regulating the expression of activin A subunit, Inhba. Reduction of Bcl11b or non-canonical Activin signaling restores the MSC population in Arid1b mutant mice. Notably, we have identified that ARID1B suppresses Bcl11b expression via specific binding to its third intron, unveiling the direct inter-regulatory interactions among BAF subunits in MSCs. Our results demonstrate the vital role of ARID1B as an epigenetic modifier in maintaining MSC homeostasis and reveal its intricate mechanistic regulatory network in vivo, providing novel insights into the linkage between chromatin remodeling and stem cell fate determination.

Abstract As per the Global Burden of Disease survey, in India, developmental disabilities are projected to affect more than 11 million children in the age group of less than 5 years. The highest percentage of persons with disability is in the age group of 10–19 years, amounting to 17% of the disabled population, and around 1.2% are disabled in the age group of 0–6 years. Research based evidence has reported that intervention provided at the early stages of development has been proven to be highly effective in addressing developmental challenges of children with special needs and improving their quality of life. This perspective has been written to highlight the importance of mental health professionals at a multidisciplinary integrated early intervention and rehabilitation centre for children with special needs in the country.

Abstract The ongoing evolution of SARS-CoV-2 to evade vaccines and therapeutics underlines the need for innovative therapies with high genetic barriers to resistance. Therefore, there is pronounced interest in identifying new pharmacological targets in the SARS-CoV-2 viral life cycle. The small molecule PAV-104, identified through a cell-free protein synthesis and assembly screen, was recently shown to target host protein assembly machinery in a manner specific to viral assembly. In this study, we investigate the capacity of PAV-104 to inhibit SARS-CoV-2 replication in human airway epithelial cells (AECs). We show that PAV-104 inhibits >99% of infection with diverse SARS-CoV-2 variants in immortalized AECs, and in primary human AECs cultured at the air-liquid interface (ALI) to represent the lung microenvironment in vivo. Our data demonstrate that PAV-104 inhibits SARS-CoV-2 production without affecting viral entry, mRNA transcription, or protein synthesis. PAV-104 interacts with SARS-CoV-2 nucleocapsid (N) and interferes with its oligomerization, blocking particle assembly. Transcriptomic analysis reveals that PAV-104 reverses SARS-CoV-2 induction of the type-I interferon response and the maturation of nucleoprotein signaling pathway known to support coronavirus replication. Our findings suggest that PAV-104 is a promising therapeutic candidate for COVID-19 with a mechanism of action that is distinct from existing clinical management approaches.

Purpose: The Hospital Corneal Retrieval Program (HCRP) aims to counsel and encourage the family of a critically ill or deceased person in the hospital for eye donation. Adequately sensitized health-care workers (HCWs) may play a pivotal role in boosting HCRP. Study Design: Multicentric, cross-sectional, descriptive study. Methods: Study participants included all HCWs of three medical colleges, including one with eye bank and corneal transplant services. A pretested, structured questionnaire was used to record the awareness, knowledge, and attitude about eye donation among HCWs. The expected outcome was to seek differences in awareness, if any, among medical and paramedical workers of medical colleges with (group A) or without (group B) eye bank and corneal transplant facilities. Results: Of the 4060 study participants, 2100 HCWs were in group A and the rest (1960) were in group B. For eight out of 13 questions assessing awareness and perception, a statistically insignificant difference in responses was observed between the two groups. Regarding questions related to attitude, although the majority of HCWs in both groups were comfortable talking about eye donation, they did feel that counseling relatives of a terminally ill patient about eye donation was insensitive. Less than half of HCWs showed a willingness to donate eyes, and about half of the participants wanted to acquire more knowledge about eye donation. Conclusion: Awareness regarding eye donation among HCWs was mostly found to be at dismal levels, irrespective of whether they worked in an institute with or without eye bank and corneal transplant services. This warrants an accelerated effort at sensitizing HCWs as a strengthening measure for HCRP.

Purpose: Human ocular tissue banking plays an important part in the advancement of translational research for identifying the molecular processes involved in disease etiology and pathogenesis. Timely obtaining a good-quality ocular tissue from a cadaveric donor is exceedingly difficult, especially in remote areas, with a variable transportation time (within 12–24 h), raising concerns about RNA quality and its subsequent applications. Therefore, we assessed the utility of retinal tissues from cadaver donor and enucleated eyes based on the RNA quality and gene expression by real-time polymerase chain reaction (PCR). Settings and Design: Prospective study. Methods: Retina tissues were separated from the donor/enucleated eyes received in the eye bank within 24 h of death (n = 15) and within an hour from OR (n = 3), respectively, and stored immediately at -80 degree. RNA was isolated using trizol, and the quantity and quality were assessed using Qubit and agarose gel electrophoresis, respectively. QPCR was performed for measuring the expression of different retinal-specific genes. The cellular viability of the retina was assessed by establishing explant primary cell cultures. Statistical Analysis: The data were calculated as an average of normalised Ct values ± standard error of the mean. Results: RNA obtained from cadaveric tissues despite being partially degraded showed a uniform strong gene expression of several retinal-specific genes such as PAX6, RHO, TUBB3, CRX, and ALDH1L1. The primary cultures established from cadaveric tissues showed viable cells. Conclusion: The cadaver donor tissues collected within 24 hours of death can be effectively utilized for gene expression profiling.

Oral cancer can result from mutations in cells located in the lips or mouth. Diagnosing oral cavity squamous cell carcinoma (OCSCC) is particularly challenging, often occurring at advanced stages. To address this, computer-aided diagnosis methods are increasingly being used. In this work, a deep learning-based approach utilizing models such as VGG16, ResNet50, LeNet-5, MobileNetV2, and Inception V3 is presented. NEOR and OCSCC datasets were used for feature extraction, with virtual slide images divided into tiles and classified as normal or squamous cell cancer. Performance metrics like accuracy, F1-score, AUC, precision, and recall were analyzed to determine the prerequisites for optimal CNN performance. The proposed CNN approaches were effective for classifying OCSCC and oral dysplasia, with the highest accuracy of 95.41 % achieved using MobileNetV2. Key findings: Deep learning models, particularly MobileNetV2, achieved high classification accuracy (95.41 %) for OCSCC.CNN-based methods show promise for early-stage OCSCC and oral dysplasia diagnosis. Performance parameters like precision, recall, and F1-score help optimize CNN model selection for this task.

AbstractToll-like receptor (TLR) innate immunity signalling protects against pathogens, but excessive or prolonged signalling contributes to a range of inflammatory conditions. Structural information on the TLR cytoplasmic TIR (Toll/interleukin-1 receptor) domains and the downstream adaptor proteins can help us develop inhibitors targeting this pathway. The small molecule o-vanillin has previously been reported as an inhibitor of TLR2 signalling. To study its mechanism of action, we tested its binding to the TIR domain of the TLR adaptor MAL/TIRAP (MALTIR). We show that o-vanillin binds to MALTIR and inhibits its higher-order assembly in vitro. Using NMR approaches, we show that o-vanillin forms a covalent bond with lysine 210 of MAL. We confirm in mouse and human cells that o-vanillin inhibits TLR2 but not TLR4 signalling, independently of MAL, suggesting it may covalently modify TLR2 signalling complexes directly. Reactive aldehyde-containing small molecules such as o-vanillin may target multiple proteins in the cell.

Aim: To compare the efficacy of virtual reality (VR) glasses and on-screen distraction techniques in managing anxiety and behavior in children receiving dental treatments. Materials and Methods: Forty patients aged 4–8 years requiring restoration were divided into two groups: group I with 20 members using audio-visual distraction aid in the form of VR glasses and group II with 20 participants utilizing on-screen distraction techniques. Each child underwent two appointments one week apart; their anxiety and behavior levels were assessed at each visit using the Facial Image Scale and Frankel’s Behavior rating scale. Result: The Wilcoxon signed-rank and Chi-squared test were utilized to assess the correlation between two categorical variables, with VR demonstrating a notable divergence from on-screen distraction. Conclusions: Both on-screen distraction and VR applications decreased anxiety levels and improved behavior. However, VR was substantially more effective in managing these areas.

Introduction People with diabetes are at risk of developing chronic kidney disease. However, limited data are available to quantify their risk of kidney function decline in South Asia. This study evaluates the rate and predictors of kidney function decline among people with type 2 diabetes in South Asia.Research design and methods We analyzed data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) Trial to quantify the rate of decline in estimated glomerular filtration rate (eGFR) in people with type 2 diabetes (n=1146) over 2.5 years of follow-up. The CARRS Trial evaluated a multicomponent intervention of decision-supported electronic health records and non-physician care coordinator to improve diabetes management at 10 diabetes clinics in India and Pakistan. We used linear mixed models to estimate eGFR slope among all participants and tested the association of eGFR slope with demographic, disease-related, and self-care parameters, accounting for randomization and site.Results The mean age of participants was 54.2 years, with a median duration of diabetes of 7.0 years (IQR: 3.0 - 12.0) and median CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) eGFR of 83.6 (IQR: 67.7 to 97.9) mL/min/1.73 m2. The overall mean eGFR slope was −1.33/mL/min/1.73 m2/year. There were no differences in the eGFR slope by treatment assignment to intervention versus usual care. In the adjusted regression model, pre-existing diabetic retinopathy (slope difference: −2.11; 95% CI: −3.45 to –0.77), previous cardiovascular disease (−1.93; 95% CI: −3.45 to –0.40), and statins use (−0.87; 95% CI: −1.65 to –0.10) were associated with faster eGFR decline.Conclusions People with diabetes receiving care at urban diabetes clinics in South Asia experienced annual eGFR decline at two times higher rate than that reported from other contemporary international diabetes cohorts. Risk factors for faster decline were similar to those previously established, and thus care delivery models must put an additional emphasis on kidney protective therapies among subgroups with microvascular and macrovascular diabetes complications.Trial registration number NCT01212328.

Recently, a plethora of advancements have been made in the area of polysaccharide research to improve their properties for human health care. The present research is an attempt to develop hydrogels from through grafting of methacrylamide (MAAm) and vinyl sulphonic acid (VSA) co monomers onto psyllium for use in drug delivery (DD) applications. Copolymer hydrogels were characterized by scanning electron micrographs (SEM), Atomic force microscopy (AFM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), 13C nuclear magnetic resonance (13C NMR), thermogravimetric analysis (TGA) and differential thermal analysis (DTG). SEM, AFM and XRD revealed heterogeneous morphology of the copolymer hydrogels with surface roughness and amorphous state of polymer chains in copolymer hydrogels due to graft-copolymerization reactions. The appearance of the FTIR bands at 1636.87 (amide-I), 1618.11 cm−1 (amide- II), 1469.58 cm−1 (amide- III) indicated presence of amide and bands at 1167.12 cm−1, 1112.06 cm−1 band (symmetric vibrations of SO3H groups and anti-symmetric & symmetric stretching modes of C–S) presence of VSA. The appearance of bands at 181.801 ppm and 62.053 ppm indicated presence of CO carbon of functional groups poly (MAAm) and −CH2–SO3H of poly (VSA) in copolymer hydrogels. Diffusion of the antibiotic drug vancomycin occurred in sustained manner with a non-Fickian diffusion mechanism. The release profile was best described by Korsmeyar-Peppas kinetic model. The copolymers exhibited biocompatible nature and revealed haemolytic index less than 5 % during polymer-blood interactions. The hydrogel demonstrated mucoadhesive character and required 0.135 ± 0.01 N force to detach from mucous membrane. These properties demonstrated the suitability of copolymer hydrogels for drug delivery applications.

The accelerated rise in antimicrobial resistance (AMR) poses a significant global health risk, necessitating the exploration of alternative strategies to combat pathogenic infections. Biofilm-related infections that are unresponsive to standard antibiotics often require the use of higher-order antimicrobials with toxic side effects and the potential to disrupt the microbiome. Probiotic therapy, with its diverse benefits and inherent safety, is emerging as a promising approach to prevent and treat various infections, and as an alternative to antibiotic therapy. In this study, we isolated novel probiotic bacteria from the gut of domestic goats (Capra hircus) and evaluated their antimicrobial and anti-biofilm activities against the ‘ESKAPE’ group of pathogens. We performed comprehensive microbiological, biochemical, and molecular characterizations, including analysis of the 16S-rRNA gene V1-V3 region and the 16S-23S ISR region, on 20 caprine gut-derived lactic acid bacteria (LAB). Among these, six selected Lactobacillus isolates demonstrated substantial biofilm formation under anaerobic conditions and exhibited robust cell surface hydrophobicity and autoaggregation, and epithelial cell adhesion properties highlighting their superior enteric colonization capability. Notably, these Lactobacillus isolates exhibited broad-spectrum growth inhibitory and anti-biofilm properties against ‘ESKAPE’ pathogens. Additionally, the Lactobacillus isolates were susceptible to antibiotics listed by the European Food Safety Authority (EFSA) within the prescribed Minimum Inhibitory Concentration limits, suggesting their safety as feed additives. The remarkable probiotic characteristics exhibited by the caprine gut-derived Lactobacillus isolates in this study strongly endorse their potential as compelling alternatives to antibiotics and direct-fed microbial (DFM) feed supplements in the livestock industry, addressing the escalating need for antibiotic-free animal products.

Aims To ensure smooth running of Multidisciplinary team (MDT) in Community mental health team (CMHT) and reviewing MDT structure for better functioning at Parkview Mental health Resource centre. On a Friday two Multidisciplinary teams (MDTs) were running online on Microsoft teams simultaneously. The same staff was running the two MDTs, so staff input could be limited at times and staff would dip in and out of MDTs. Discussion around ways of improving this so that both MDTs run smoothly. Also, there was no formal structure to MDT meetings. It was decided that improvement in Quality of MDT needs to be addressed. Methods Initially numerous discussions held online with Parkview team, nursing colleagues. CMHT Quality improvement group was set up and a meeting was arranged where everyone's ideas were considered. A pilot project was first introduced in March 2022 and audited in July 2022. Plan, do, study, act (PDSA) cycle was carried out. Plan Two nursing teams to be setup which will feed back into the two MDTs on alternate weeks. This will reduce nursing teams having to come in and out of one MDT to join other MDT, hence increasing the efficacy of the MDT. Devise a new template to provide formal structure for the MDT presentation. Do Trial the new setup of two nursing teams. Study Ask all MDT staff members for feedback on the working of MDT. Act Reformat the Structured template and distribute to all staff members. Results 100% staff felt that new structure of MDT was useful. 84% staff satisfied with the new way of running of MDT. 84% staff satisfied with having designated teams for MDT. Conclusion Having Designated MDT teams and a structured format helped in robust functioning of the MDT in the CMHT.

Background During adolescence, behaviours are initiated that will have substantial impacts on the individual’s short-term and long-term health and well-being. However, adolescents rarely have regular contact with health services, and available services are not always appropriate for their needs. We co-developed with adolescents a health and well-being check-up programme (Y-Check). This paper describes the methods to evaluate the feasibility, acceptability, short-term effects and cost-effectiveness of Y-Check in three African cities.Method This is a multi-country prospective intervention study, with a mixed-method process evaluation. The intervention involves screening, on-the-spot care and referral of adolescents through health and well-being check-up visits. In each city, 2000 adolescents will be recruited in schools or community venues. Adolescents will be followed-up at 4 months. The study will assess the effects of Y-Check on knowledge and behaviours, as well as clinical outcomes and costs. Process and economic evaluations will investigate acceptability, feasibility, uptake, fidelity and cost effectiveness.Ethics and dissemination Approval has been received from the WHO (WHO/ERC Protocol ID Number ERC.0003778); Ghana Health Service (Protocol ID Number GHS-ERC: 027/07/22), the United Republic of Tanzania National Institute for Medical Research (Clearance No. NIMR/HQ/R.8a/Vol.IX/4199), the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2766) and the LSHTM (Approval Numbers 26 395 and 28312). Consent and disclosure are addressed in the paper. Results will be published in three country-specific peer-reviewed journal publications, and one multicountry publication; and disseminated through videos, briefs and webinars. Data will be placed into an open access repository. Data will be deidentified and anonymised.Trial registration number NCT06090006.

Abstract This review study highlights the importance of loquat (Eriobotrya japonica Lindl.) in terms of its nutritional, pharmaceutical, and nutraceutical value. The entire plant, including its seeds, leaves, flowers, fruits, and peel, contains a wide range of bioactive compounds, such as phenolics, carotenoids, triterpenic acids, and organic acids. These compounds exhibit a wide range of beneficial properties such as fighting cancer, reducing inflammation, managing diabetes, combating viruses, preventing mutations, inhibiting nitrosamine formation, killing harmful microorganisms, lowering blood sugar levels, inducing cell death, and protecting the liver. The extraction and separation of such compounds will greatly enhance and expand its potential. Furthermore, the waste generated from the seeds and peel can be effectively used for submerged and solid state biomass production.

Lowering the dependency of receivers and sensors on energy supplies is a requirement for a realistic Internet of Things. This is certainly achieved when sensor nodes are powered wirelessly. Local oscillators (LOs), required to receive and transmit modern radio frequency (RF) waveforms, consume a considerable amount of the power budget. We propose a Wireless Local Oscillator (WiLO) concept to move the LO from the sensor to an external location and transmit it wirelessly to the sensor. This WiLO is modeled as a constant tone transmission. As is well known, the sensor can backscatter the constant tone, which enables uplink transmission. Our system approach allows the downconversion of any RF waveform without LO and mixer while simultaneously utilizing the same signal for power transfer. In this work, we demonstrate our approach to different types of OFDM signals, which can be considered as a general complex RF signal example to be received. Our WiLO-based technique to receive any modern communication signal without LO, in combination with harvesting energy from the tone and backscattering on that tone, results in a promising energy-efficient IoT solution. We present the performance model with design requirements for WiLO tone and amplitudes of OFDM tones for feasible reception of WiLO-OFDM. Simultaneous Wireless Information and Power Transfer (SWIPT) applications typically operate in a high SNR regime, and both energy harvesting and information transfer are equally important. The cost of 12 dB performance with an AWGN noisy channel can be acceptable by saving a significant amount of power by removing the LO.

Abstract Background Infection risk was significant for front-line nurses during the Covid-19 outbreak. The pandemic presented several ethical difficulties and sapped nurses’ drive to labor harder for longer periods. This study evaluates registered nurses’ perceptions of Covid-19 infection risk, ethical dilemmas, and motivating factors. Materials and methods During March and April 2022, 400 registered nurses from a newly established tertiary care hospital participated in this cross-sectional exploratory survey. The risk assessment scale, motivation to work scale, and ethical dilemma scale were used to assess the perceived risk of infection, motivational factors and ethical challenges experienced by the nurses. Appropriate descriptive and inferential statistics were applied to compute the results. Results 76.4% of nurses feared working as a nurse put them at higher risk of infection. Besides the fear of contracting infection, nurses believed they were the source of infection to family members (70.8%) and people around (67.5%). 63.3% of nurses agree that they do not have the right to refuse treatment and every patient has the right to receive optimal care, regardless of age, gender, and medical conditions. Professional obligation to treat patients (72.3%) and sound professional knowledge and experience (83.5%) are important motivating factors to work during the pandemic. Multilinear regression analysis revealed that professional education (95% CI, 3.845 − 0.694, p = 0.005), Covid-19 positive status (95% CI,0.455-2.756, p = 0.006), and post-Covid-19 hospitalization (95% CI, 1.395–6.978, p = 0.003) and duration of hospitalization (95% CI, 0.754-0.058, p = 0.022) are independent predictors of higher perceived risk of infection among nurses. Conclusions During the pandemic, nurses were afraid to work and faced personal and family risks of contracting the virus. Despite these challenges, they still feel a strong sense of commitment and dedication to providing the best possible care. Nurse administrators need to create a supportive environment that follows ethical principles and meets the needs of nurses to boost their motivation and encourage them to continue working for longer periods.

Background: Adverse childhood experiences include exposure of children to physical abuse, physical neglect, emotional neglect, emotional abuse, and sexual abuse. Children exposed to severe maltreatment and trauma during their early childhood are at a higher risk of early onset of psychiatric disorders. Aim: To find the prevalence of childhood adverse experiences in psychiatric patients and its association with perceived social support and suicidal attempts. Materials and Methods: A cross-sectional observational study was conducted in the psychiatry outpatient department at a tertiary care hospital in Kerala. Patients with a diagnosis of substance use disorders, psychotic disorders, mood disorders, and neurotic disorders according to ICD-10 (F10-F45) and in remission were included in the study. Institutional Ethical Committee approval and informed consent from the participants were obtained. Socio-demographic and clinical details were obtained. Childhood Trauma Questionnaire-Short Form and Multidimensional scale of Perceived Social Support were administered. Descriptive statistics and Chi-square test were employed for data analysis. Results: Eighty-five per cent of the subjects had a history of at least one type of childhood trauma. Emotional abuse was the most commonly reported type of trauma. Among patients with childhood trauma, 47.2% reported high levels of perceived social support, whereas 18.5% individuals reported a history of at least one suicide attempt. Conclusions: A significant proportion of patients with psychiatric disorders in an Indian setting have experienced childhood trauma. Childhood trauma in psychiatric disorders is associated with a higher risk of attempting suicide.

Purpose: There has been a sudden increase in the number of rhino-orbital mucormycosis cases, primarily affecting patients recovering from COVID-19 infection. The local health authorities have declared the current situation an epidemic. In this study, we assess the role of exenteration in preventing disease progression and improving survival in patients with rhino-orbital mucormycosis. Methods: The patients undergoing exenteration were grouped into the exenteration arm and those denying exenteration were grouped into the nonexenteration arm. The patients were followed at 1 month and 3 months. The 6-month survival data were collected telephonically. Continuous data were presented as Mean ± SD/Median (IQR) depending on the normality distribution of data, whereas the frequency with percentages was used to present the categorical variables. Kaplan–Meier survival curves were created to estimate the difference in survival of patients with exenteration in rhino-orbital mucormycosis versus those without exenteration. Results: A total of 14 patients were recruited for our study based on the inclusion and exclusion criteria. All the patients were qualified for exenteration; however, only eight patients underwent exenteration and six patients did not consent to exenteration. At the end of 3 months in the exenteration group, four (50%) patients died. Two patients died within a week of exenteration, whereas two patients died after 2 weeks of exenteration. The deaths in the first week were attributed to septic shock and the deaths happening beyond 2 weeks were attributed to severe meningitis. The Kaplan–Meier survival analysis showed the cumulative probability of being alive at 1 month in the exenteration arm to be 85%, and it decreased to 67% by 53 days and subsequently remained stable until the end of 3 months. Conclusion: The Kaplan–Meier survival analysis did not show a survival benefit of exenteration at 3 months and 6 months in COVID-associated rhino-orbital mucormycosis.