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Background: Twin pregnancies are found to be associated with greater risks to the mother and the babies. The normal length of gestation for an average pregnancy is around 40 weeks however in multiple pregnancies (twins, triplets, quadruplets, etc) it is usually shorter. Methods: A prospective observational study of women with twin pregnancy was carried out in a tertiary care hospital, in Maharashtra, from October 2020 to October 2022 with the purpose to assess the maternal and neonatal outcomes. 100 women with twin pregnancies who were registered to the hospital were selected for the study as per the inclusion and exclusion criteria. Results: 64% of women with twin pregnancies were in the age group of 21-30 years. Most of them had pregnancy as a result of the spontaneous type of conception. It was found that the vaginally delivered twins (20%) were at gestational age above 37 weeks and 8% at less than 32 weeks. 38% of twins were delivered by LSCS (elective LSCS 6% and emergency LSCS 38%). The gestational age at the time of delivery was found as 35-37 weeks (Mean ±SD 36 ± 1.2). 46% of neonates were shifted to NICU. The incidence of low birth weight and respiratory distress was more in babies born at 37 weeks and below. It was also observed that the as gestational age increased the perinatal deaths decreased. Conclusions: Regular follow-up of women with twin pregnancies is necessary for attainment of positive outcomes.

Background: Anaemia during pregnancy is considered to be a serious health concern. Whilst oral supplementation is most prevalent, it is also possible to provide iron parentally to replace the deficit. Methods: An observational study was conducted in the department of obstetrics and gynaecology of a tertiary care hospital, in Maharashtra. Total 110 women with iron deficiency anaemia were randomly divided into two groups using computer generated random numbers. Group A received oral iron therapy and group B received intravenous sucrose therapy. The haemoglobin and serum ferritin were assessed before and after treatment. Results: In the oral iron therapy group the age ranged between 19.3 to 27.1 years and in intravenous iron therapy group from 19.2 and 26.5 years. Baseline (0 day) haemoglobin in oral iron therapy group was 8.21±1.12 gm/dl and 8.36±1.14 gm/dl in intravenous iron group. The mean difference of 3.38 gm/dl was seen in the intravenous therapy group at 8th weeks against the mean difference of 1.63 gm/dl in oral iron therapy group. The mean difference of serum ferritin 18.92 µg/l was found in the oral iron therapy at the 8th week while the mean difference of 63.79 µg/l was seen in the intravenous therapy group. Conclusions: The intravenous sucrose therapy is found to be safe and effective alternative treatment for iron deficiency anaemia in pregnancy though the cost of treatment is significantly higher than the oral therapy.

Van der Waals magnetic materials are building blocks for novel kinds of spintronic devices and playgrounds for exploring collective magnetic phenomena down to the two-dimensional limit. Chromium-tellurium compounds are relevant in this perspective. In particular, the 1$T$ phase of CrTe$_2$ has been argued to have a Curie temperature above 300~K, a rare and desirable property in the class of lamellar materials, making it a candidate for practical applications. However, recent literature reveals a strong variability in the reported properties, including magnetic ones. Using electron microscopy, diffraction and spectroscopy techniques, together with local and macroscopic magnetometry approaches, our work sheds new light on the structural, chemical and magnetic properties of bulk 1$T$-CrTe$_2$ exfoliated in the form of flakes having a thickness ranging from few to several tens of nanometers. We unambiguously establish that 1$T$-CrTe$_2$ flakes are ferromagnetic above room temperature, have an in-plane easy axis of magnetization, low coercivity, and we confirm that their Raman spectroscopy signatures are two modes, $E_{2\text{g}}$ (103.5~cm$^{-1}$) and $A_{1\text{g}}$ (136.5~cm$^{-1}$). We also prove that thermal annealing causes a phase transformation to monoclinic Cr$_5$Te$_8$ and, to a lesser extent, to trigonal Cr$_5$Te$_8$. In sharp contrast with 1$T$-CrTe$_2$, none of these compounds have a Curie temperature above room temperature, and they both have perpendicular magnetic anisotropy. Our findings reconcile the apparently conflicting reports in the literature and open opportunities for phase-engineered magnetic properties.

Suicide is the 2nd leading cause of death in the world, for those aged 15-24 and about 800,000 victims of suicide yearly (all age), which is about 40 per second. Behavioural health disorder, explicitly depression, are the type of health concerns, not many are aware of. There is no way one can get treatment of something they are not aware of. So, classifying potential health disordered person is the first step towards prevention. Lifestyle is something which defines individual the best. Lifestyle including Income, age group, martial status, child, property owned, alcohol or tobacco consumption, medical expenditure, insurance or other type of investment and many more. Using 76 such kind of attributes, model will predict if the individual is victim of depression or not. The proposed model has used eight mainstream ML calculation methods, namely (Decision tree (DT), Random Forest(RF), Support Vector Machine(SVM), Naive Bayes(NB), Logistic Regression(LR), XGBoost(XGB), Gradient Boosting Classifier(GBC) and Artificial Neural Network(ANN) to build up the expectation models utilizing a huge dataset (1429 individual's survey), bringing about precise and productive dynamics. By using various strategies and different model, this research work has attempted to get a clear and precise picture. The reason to follow various approaches is that, precise the information, work in a better way and reduce the number of suicide case. The final outcome received was 87.38 percent, which was using Support Vector Machine (SVM).

Graphene holds promises for exploring exotic superconductivity with Dirac-like fermions. Making graphene a superconductor at large scales is however a long-lasting challenge. A possible solution relies on epitaxially-grown graphene, using a superconducting substrate. Such substrates are scarce, and usually destroy the Dirac character of the electronic band structure. Using electron diffraction (reflection high-energy, and low-energy), scanning tunneling microscopy and spectroscopy, atomic force microscopy, angle-resolved photoemission spectroscopy, Raman spectroscopy, and density functional theory calculations, we introduce a strategy to induce superconductivity in epitaxial graphene $via$ a remote proximity effect, from the rhenium substrate through an intercalated gold layer. Weak graphene-Au interaction, contrasting with the strong undesired graphene-Re interaction, is demonstrated by a reduced graphene corrugation, an increased distance between graphene and the underlying metal, a linear electronic dispersion and a characteristic vibrational signature, both latter features revealing also a slight $p$ doping of graphene. We also reveal that the main shortcoming of the intercalation approach to proximity superconductivity is the creation of a high density of point defects in graphene (10$^{14}$~cm$^{-2}$). Finally, we demonstrate remote proximity superconductivity in graphene/Au/Re(0001), at low temperature., Comment: 13 pages, 6 figures, to appear in 2D Materials

One of the key challenges of fuel cell technology is to find solid electrolytes which are cheap and environmentally friendly with high proton (H+) conductivities. In this context, designing new materials based on organic cocrystals/salts appears very promising to expand the scope of H+ ion conductors. In our approach, we have synthesized a quaternary organic salt consisting of gallic acid, isoniazid, sulfate (SO42–) ion, and water by a slow evaporation method which exhibits high proton conductivity of 0.2 mS cm–1 at 293 K to serve as a model system. The proton conductivity value observed in our system is comparable and in some cases better than recently published coordination polymers, metal organic frameworks, and covalent organic frameworks. The system crystallizes as monoclinic with space group P21/c (Z′ = 3; Z = 12), which depicts a layered structure with extensive O–H···O and N–H···O hydrogen bonding networks. Further, it exhibits interesting order–disorder phase transitions at both high and low temp...

Educational Data Mining (EDM) is a current trending multidisciplinary research area that explores the data and develops the methods in educational environments. The challenges in the EDM includes predicting and improving the student's performance which helps both instructors and students, identifying the key factors that affect the performance of students, understanding the learning process of the students, providing the best suggestions to students for their future development. The accurate prediction of student's performance helps the instructors to take proactive measures, improve teaching methodologies and guide the students in a right way. This also helps the student's to be active and encourage them to put extra effort on their studies. In this work, to achieve the goals of EDM various statistical and data mining techniques are used. The raw datasets obtained through various resources are first explored and the goals are identified. Afterwards, the data mining techniques are used to identify the hidden relationships and extracting the knowledge from these datasets.

Biomimetic antibacterial polymers, the functional mimics of antimicrobial peptides (AMPs), targeting the bacterial cell membrane have been developed to combat the problem of antibiotic resistance. Amphiphilicity, a balance of cationic charge and hydrophobicity, in these polymers has been shown to be pivotal for their selective interactions with anionic lipid membranes of bacteria instead of zwitterionic mammalian (human erythrocyte) membranes. However, it is unclear if and to what extent hydrogen bonding in amphiphilic antibacterial polymers contributes to this membrane binding specificity. To address this, we employ isosteric substitution of ester with amide moieties that differ in their potency for hydrogen bonding in the side chains of N-alkyl maleimide based amphiphilic polymers. Our studies reveal that amide polymer (AC3P) is a potent antibacterial agent with high membrane-disrupting properties compared to its ester counterpart (EC3P). To understand these differences we performed bio-physical experiments and molecular dynamics (MD) simulations which showed strong interactions of AC3P including hydrogen bonding with lipid head groups of bacterial model lipid bilayers, that are absent in EC3P, make them selective for bacterial membranes. Mechanistic investigations of these polymers in bacteria revealed specific membrane disruptive activity leading to the delocalization of cell division related proteins. This unprecedented and unique concept provides an understanding of bacterial membrane interactions highlighting the role of hydrogen bonding. Thus, these findings will have significant implications in efficient design of potent membrane-active agents.

Metastatic renal cell carcinoma of the head and neck is extremely rare. Metastasis to the nasopharynx is extremely unusual and can be misdiagnosed as primary of the specific site hindering further management. The present case report of an 82-year-old male presenting with epistaxis was found to have a nasopharyngeal mass on radiology. Microscopic evaluation of the nasopharyngeal mass revealed a highly vascular clear cell tumour with cells arranged in alveolar and trabecular pattern. Immunohistochemical assessment revealed positive PAX 8, CD10 and vimentin which are highly specific for metastatic renal cell carcinoma. Retrospective computed tomography scan revealed a renal mass; however, the patient succumbed before any biopsy could be performed.

Background: The effect of positive end-expiratory pressure (PEEP) has been studied in detail after induction of general anesthesia especially in obese individuals. However, sparse information can be gathered from the literature regarding its effect when applied at the time of induction and the time of onset of its effect. Thus, this study was planned to assess the effect of PEEP when applied for a single minute in morbidly obese patients. Materials and Methods: This was a randomized prospective study comprising seven morbidly obese patients (body mass index ≥40 kg/m2). Control group included 30 patients who received no PEEP at the time of induction. The study group consisted of thirty patients who were given a PEEP of 10 cmH2O. Serial arterial blood gas samples were taken preoperatively, at the time of intubation, 5 min after intubation and 10 min after intubation. Results: PaO2 was significantly higher in test group (242.0 ± 116.0 mmHg) than in control group (183.0 ± 107.0 mmHg) just after intubation. PaCO2 was comparable in control group (43.73 ± 6.32 mmHg) and test group (44.52 ± 6.33 mmHg) just after intubation but was significantly less in test group than in control group at 5 and 10 min thereafter. Hemodynamic parameters were comparable in both groups at all time intervals. Conclusion: Application of even a single minute of PEEP at the time of induction improves oxygenation without any adverse effects on hemodynamics, in morbidly obese patients undergoing laparoscopic Bariatric surgery.

Partial replacement of Ti4+ by Te4+ ions in calcium copper titanate lattice improved its dielectric behaviour mostly due to cubic-to-tetragonal structural transformation and associated distortion in TiO6 octahedra. The relative permittivity values (23–30 x 103) of Te4+ doped ceramics is more than thrice that of un-doped ceramics (8 x 103) at 1 kHz. A decreasing trend in relative permittivity with increasing temperature (50–300 K) is observed for all the samples. Barrett’s formula, as a signature of incipient ferroelectricity, is invoked to rationalize the relative permittivity variation as a function of temperature. A systematic investigation supported by temperature dependent Raman studies reveal a possible ferroelectric transition in Te4+ doped ceramic samples below 120 K. The possible ferroelectric transition is attributed to the interactions between quasi-local vibrations associated with the micro-clusters comprising TiO6 and TeO6 structural units and indirect dipole-dipole interactions of off-center B–cations (Ti4+ and Te4+) in double perovskite lattice.

Background: Positive end-expiratory pressure (PEEP) at the time of induction increases oxygenation by preventing lung atelectasis. However, PEEP may not prove beneficial in all cases. Factors affecting the action of PEEP have not been elucidated well and remain controversial. Pulmonary vasculature has direct bearing on the action of PEEP as has been proven in the previous studies. Thus, this prospective study was planned to evaluate the action of PEEP on the basis of pulmonary artery systolic pressure (PASP) which is noninvasive and easily measured by transthoracic echocardiography. Materials and Methods: Seventy morbidly obese patients, the American Society of Anesthesiologists Grade II, or III, aged 20–65 years with body mass index >40 kg/m2 , scheduled for elective laparoscopic bariatric surgery were included. Patients who denied consent, those undergoing emergency and/or open surgery and those requiring >2 attempts for intubation were excluded from the study. Ten patients had to be excluded. Thus, a total of sixty patients participated in the study. Thirty patients received no PEEP at the time of induction while other thirty patients were given a PEEP of 10 cm of H2O. Serial ABG samples were taken preoperatively, at the time of intubation, 5 min after intubation, and 10 min after intubation. Patients were then divided into four groups on the basis of PASP value of ≤30 mm Hg with and without PEEP or >30 mm Hg with and without PEEP. Primary Outcome: The primary outcome was the effect of PEEP of 10 cm of H2 O on ABG and hemodynamics in morbidly obese patients. Secondary Outcome: The secondary outcome was the effect of PASP on the action of PEEP in morbidly obese patients undergoing laparoscopic surgery. Results: Patients having PASP of >30 mm Hg had significant improvement in oxygenation on PEEP application (270.11 ± 119.26 mm Hg) as compared to those without PEEP (157.57 ± 109.29 mm Hg) just after intubation. The increase in oxygenation remained significant at all time intervals. Patients with PASP ≤30 mm Hg did not show significant improvement in oxygenation with PEEP application (177.09 ± 85.85 mm Hg as compared to 226.27 ± 92.42 mm Hg without PEEP). Hemodynamic parameters did not show statistically significant alterations. Conclusion: Morbidly obese patients who have PASP >30 mm Hg benefit most from the PEEP. Thus, PASP which is an easily measurable noninvasive parameter can be used as a criterion for selecting patients who benefit from PEEP application.