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Introduction Adolescents represent 16% of the world’s population and around 21% of the Indian population. A study was done to assess the double burden of malnutrition, the proportion of inadequate intake of some important macronutrients and micronutrients, and the impact of COVID-19 pandemic on nutrient intakes among adolescents. Methodology Retrospective data analysis of the adolescents presented at the Adolescent Health Clinic at a teaching hospital (tertiary care level) in Andhra Pradesh, India, between September 2022 and December 2022 was done in the current study. Results A total of 800 adolescents were studied with the mean age of the participants as 15.8 (±2.38) years of age. Among the participants, the majority (59%) were immunized with Td vaccination at 10 years and/or 16 years, 21% were not immunized, and the rest 20% did not remember the status. Only 17 participants had a history of COVID-19 infection in the past. The majority (62.75%) of the participants belong to normal nutrition status as per BMI for age WHO growth charts. There is a significant difference in the nutrition status between males and females belonging to overweight and obese subgroups. There is no significant difference in the intake with respect to past COVID-19 status. Almost all the participants take inadequate amounts of carbohydrates (calories), pyridoxine, folate, iron, calcium, vitamin D3, and retinol. Protein intake is inadequate in 63% of participants, and the deficient intake rises with the age with respect to both EAR and RDA guidelines. Conclusion A large proportion of adolescents suffer from the double burden of malnutrition in South India, and almost all the adolescents do not get the recommended intake of most of the macro- and micronutrients in their diet following the lockdown and online schooling due to the COVID-19 pandemic.

In order to protect the environment, manufacturing sectors have begun implementing a green supply chain (GSC) strategy. Governments are enacting increasingly stringent environmental regulations; consequently, industries must reduce the environmental impact of their supply chains. Our research investigates the barriers to implementing a GSC in the agriculture equipment manufacturing industries (AEMI). This research aims to discover and prioritize the barriers that impede the implementation of sustainable supply chain strategies in the AEMI. Through an in-depth literature review, contributions from experts, and empirical analysis, seventy-one barriers are identified across ten categories. The top barrier in each category is determined using the Delphi approach. The Fuzzy Technique for Order of Preference by Similarity to the Ideal Solution (F-TOPSIS) method creates an exhaustive framework that evaluates and ranks these barriers. The top five barriers are the lack of an environmental partnership with buyers and suppliers, the design complexity when reusing or recycling old goods or products, carbon emissions, paint shop emissions, lack of environmental education and training professionals that lack the necessary skills and less manpower available for the greening supply chain. This framework facilitates decision-makers to organize resources and create effective strategies for overcoming identified barriers. In addition, we proposed a blockchain IoT integrated architecture and strategies. This integrated architecture and strategies will help to mitigate all GSC barriers. It also increases the supply chain's transparency, traceability and effectiveness, fostering sustainability practices and reducing environmental impacts. Blockchain and IoT facilitate real-time data collaboration, computerized transactions and the implementation of smart contracts, thereby enhancing cooperation, trust and collaboration among stakeholders. Implementing GSC practices enables manufacturers to reduce waste and increase productivity, thereby saving funds. In addition, adopting sustainable practices improves these industries' reputation and brand image among environmentally conscious customers, investors and other stakeholders.

The integration of network slicing into a Device-to-Device (D2D) network is a promising technological approach for efficiently accommodating Enhanced Mobile Broadband (eMBB) and Ultra Reliable Low Latency Communication (URLLC) services. In this work, we aim to optimize energy efficiency and resource allocation in a D2D underlay cellular network by jointly optimizing beamforming and Resource Sharing Unit (RSU) selection. The problem of our investigation involves a Mixed-Integer Nonlinear Program (MINLP). To solve the problem effectively, we utilize the concept of the Dinkelbach method, the iterative weighted ℓ1-norm technique, and the principles of Difference of Convex (DC) programming. To simplify the solution, we merge these methods into a two-step process using Semi-Definite Relaxation (SDR) and Successive Convex Approximation (SCA). The integration of network slicing and the optimization of short packet transmission are the proposed strategies to enhance spectral efficiency and satisfy the demand for low-latency and high-data-rate requirement applications. The Simulation results validate that the proposed method outperforms the benchmark schemes, demonstrating higher throughput ranging from 11.79% to 28.67% for URLLC users, and 13.67% to 35.89% for eMBB users, respectively.

Highlights Nonflammable gel polymer electrolyte (SGPE) is developed by in situ polymerizing trifluoroethyl methacrylate (TFMA) monomers with flame-retardant triethyl phosphate (TEP) solvents and LiTFSI–LiDFOB dual lithium salts. Molecular polarity interaction between TEP and PTFMA mitigates interfacial reactions and changes the solvation of Li+. SGPE forms stable inorganic-rich solid electrolyte interface/cathode electrolyte interface layer, exhibiting well compatibility with Li anode and LiCoO2-type high-voltage cathode.

Abstract Safe and effective brain tumor surgery aims to remove tumor tissue, not non-tumoral brain. This is a challenge since tumor cells are often not visually distinguishable from peritumoral brain during surgery. To address this, we conducted a multicenter study testing whether the Sentry System could distinguish the three most common types of brain tumors from brain tissue in a label-free manner. The Sentry System is a new real time, in situ brain tumor detection device that merges Raman spectroscopy with machine learning tissue classifiers. Nine hundred and seventy-six in situ spectroscopy measurements and colocalized tissue specimens were acquired from 67 patients undergoing surgery for glioblastoma, brain metastases, or meningioma to assess tumor classification. The device achieved diagnostic accuracies of 91% for glioblastoma, 97% for brain metastases, and 96% for meningiomas. These data show that the Sentry System discriminated tumor containing tissue from non-tumoral brain in real time and prior to resection.

Introduction Central venous catheterization is a common tool widely used in medical treatment for long-term intravenous administration of medication (e.g. chemotherapy or antibiotics) or parenteral nutrition. Here, we present a case of a missing peripherally inserted central catheter (PICC) which was detected on computed tomography (CT) scan thorax.

Abstract Adult T cell leukaemia (ATL), caused by infection with human T‐ lymphotropic virus type 1 (HTLV‐1), is often complicated by hypercalcemia and osteolytic lesions. Therefore, we studied the communication between patient‐derived ATL cells (ATL‐PDX) and HTLV‐1 immortalized CD4+ T cell lines (HTLV/T) with osteoclasts and their effects on bone mass in mice. Intratibial inoculation of some HTLV/T leads to a profound local decrease in bone mass similar to marrow‐replacing ATL‐PDX, despite the fact that few HTLV/T cells persisted in the bone. To study the direct effect of HTLV/T and ATL‐PDX on osteoclasts, supernatants were added to murine and human osteoclast precursors. ATL‐PDX supernatants from hypercalcemic patients promoted the formation of mature osteoclasts, while those from HTLV/T were variably stimulatory, but had largely consistent effects between human and murine cultures. Interestingly, this osteoclastic activity did not correlate with expression of osteoclastogenic cytokine receptor activator of nuclear factor kappa‐B ligand (RANKL), suggesting an alternative mechanism. HTLV/T and ATL‐PDX produce small extracellular vesicles (sEV), known to facilitate HTLV‐1 infection. We hypothesized that these sEV also mediate bone loss by targeting osteoclasts. We isolated sEV from both HTLV/T and ATL‐PDX, and found they carried most of the activity found in supernatants. In contrast, sEV from uninfected activated T cells had little effect. Analysis of sEV (both active and inactive) by mass spectrometry and electron microscopy confirmed absence of RANKL and intact virus. Viral proteins Tax and Env were only present in sEV from the active, osteoclast‐stimulatory group, along with increased representation of proteins involved in osteoclastogenesis and bone resorption. sEV from osteoclast‐active HTLV/T injected over mouse calvaria in the presence of low‐dose RANKL caused more osteolysis than osteoclast‐inactive sEV or RANKL alone. Thus, HTLV‐1 infection of T cells can cause release of sEV with strong osteolytic potential, providing a mechanism beyond RANKL production that modifies the bone microenvironment, even in the absence of overt leukaemia.

Abstract The primary objective of Sustainable Development Goal target 2.5 established by the United Nations is to ensure the preservation of genetic diversity in domesticated animals. The ICAR-National Bureau of Animal Genetic Resources in India has been actively engaged in the conservation of cattle and buffalo bull semen for long-term storage. This present study aimed to assess the genetic diversity present in the conserved cattle bull semen, which would aid in determining the most suitable strategy for future conservation management. A total of 192 bull semen belonging to 19 cattle breeds were selected to evaluate genetic diversity using 17 pairs of FAO recommended microsatellite primers. Total 267 alleles were detected across all the samples which indicates substantial amount of allelic variation is being maintained in conserved bulls. Further, all cattle bulls semen conserved showed higher observed heterozygosity than expected heterozygosity which indicates excess genetic diversity in all the populations. The FST, F IT and FIS value across the loci and population is 0.146 ± 0.009, 0.054 ± 0.038, and − 0.105 ± 0.035, respectively, which suggests lack of inbreeding in conserved cattle bull semen. This study has established genetic diversity in conserved cattle semen samples to achieve sustainable development goals. In addition, it provides compelling evidence that the current approach for conserving cattle bull semen is heading in the correct direction.

Abstract Background The objective of this study was to describe real-world adjuvant therapy (AT) use by disease substage and assess determinants of treatment choice among patients with stage III melanoma. Methods This non-interventional retrospective study included survey responses and data from patient records provided by US medical oncologists. Survey responses, patient demographic/clinical characteristics, treatment utilization, and reasons for treatment were reported descriptively. The association between patient and disease characteristics and AT selection was assessed using logistic and multinomial regression models, overall and stratified by AJCC8 substage (IIIA vs. IIIB/C/D) and type of AT received (anti-PD1 monotherapy, BRAF/MEK, no AT), respectively. Results In total 152 medical oncologists completed the survey and reviewed the charts of 507 patients (168 stage IIIA; 339 stages IIIB/IIIC/IIID); 405 (79.9%) patients received AT (360/405 (88.9%) received anti-PD1 therapy; 45/405 (11.1%) received BRAF/MEK therapy). Physicians reported clinical guidelines (61.2%), treatment efficacy (37.5%), and ECOG performance status (31.6%) as drivers of AT prescription. Patient-level data confirmed that improving patient outcomes (79%) was the main reason for anti-PD1 prescription; expected limited treatment benefit (37%), patient refusal (36%), and toxicity concerns (30%) were reasons for not prescribing AT. In multivariable analyses stage IIIB/IIIC/IIID disease significantly increased the probability of receiving AT (odds ratio [OR] 1.74) and anti-PD1 therapy (OR 1.82); ECOG 2/3 and Medicaid/no insurance decreased the probability of AT receipt (OR 0.37 and 0.42, respectively) and anti-PD1 therapy (OR 0.41 and 0.42, respectively) among all patients and patients with stage IIIA disease. Conclusion Most patients were given AT with a vast majority treated with an anti-PD1 therapy. Physician- and patient-level evidence confirmed the impact of disease substage on AT use, with stage IIIA patients, patients without adequate insurance coverage, and worse ECOG status having a lower probability of receiving AT.

The Internet of Things (IoT) is expected to have a positive impact on various sectors, such as manufacturing, users, and operators. Due to the capabilities of smart objects to share their contents and interact with their social networks, the combined Social Internet of Educational Things (SIoET) for smart education is expected to provide users with more efficient services. The primary objective of this paper is to provide an efficient resource management by adopting edge intelligence technique for higher education system workloads on next-generation networks. As the number of tasks handled by these interconnected devices continues to rise, there is an escalating concern regarding resource competition and power consumption within the network. To mitigate these challenges, we propose an innovative edge intelligence-based resource allocation approach to intelligently allocate resources while minimizing latency and optimizing power consumption with increasing task volumes. The problem is dissected into two core sub-problems: computation resource optimization and power optimization. Leveraging the concept of Lagrangian and Bisection methods, our proposed algorithm, implemented within a Device-to-Device (D2D) -assisted edge intelligence network, demonstrates remarkable performance improvements. Network latency and energy consumption is reduced by up to 57.9 % and 82.3 % compared to the benchmark schemes. These findings hold promising implications for the integration of this work into higher education systems driven by SIoET. Furthermore, simulations indicate that the system maintains robust performance even in dynamic urban environments characterized by random device movement.

Abstract Transition metal oxides (TMO) are the preferred materials for metal ion battery cathodes because of their high redox potentials and good metal-ion intercalation capacity, which serve as an outstanding replacement for layered sulphide. In this work, using first-principles calculations based on Density functional theory approach, we explored the structural and electronic properties which comprise of adsorption and diffusion behaviour along with the analysis of voltage profile and storage capacity of Ru doped two-dimensional transition metal oxide $$MnO_{2}$$ M n O 2 , $$CoO_{2}$$ C o O 2 , and $$NiO_{2}$$ N i O 2 monolayers. The adsorption of alkali ions (Li, Na) to the surface of TMOs is strengthened by Ru-atom doping. Ru doping enhanced the adsorption energy of Li/Na-ion by 25%/11% for $$MnO_{2}$$ M n O 2 , 8%/13% for $$CoO_{2}$$ C o O 2 , and 10%/11% $$NiO_{2}$$ N i O 2 respectively. The open circuit voltage (OCV) also increases due to the high adsorption capacity of doped Monolayers. Ru doping makes the semiconducting TMOs conduct, which is suitable for battery application. As alkali ion moves closer to the dopant site, the adsorption energy increases. When alkali ions are close to the vicinity of doping site, their diffusion barrier decrease and rises as they go further away. Our current findings will be useful in finding ways to improve the storage performance of 2D oxide materials for application in energy harvesting and green energy architecture.

Background: Serratia has emerged as an important nosocomial opportunistic pathogen, often associated with serious infections. We investigated the antimicrobial resistance trends, predisposing factors, and infection outcomes associated with Serratia species isolated in a secondary-care hospital in Oman. Materials and Methods: A retrospective study was conducted at a secondary-care hospital in the northern region of Oman after receiving approval from the research ethics and approval committee of Oman. The relevant data of patients diagnosed with Serratia infection during 2017–2021 was extracted from the Sohar Hospital health records. We statistically analyzed the data using the statistical software STATA version 14. Results: A total of 257 non-duplicate Serratia strains were studied. S. marcescens was the predominant (79.4%) isolated species. Serratia strains were more frequently isolated from males (51.4%). The most affected were older people aged > 60 years (29.4%), infants (28%), and patients treated at critical care units. Serratia has demonstrated high resistance to beta-lactams. The susceptibility rates of Serratia strains to tigecycline, ciprofloxacin, trimethoprim-sulfamethoxazole, gentamicin, amikacin, piperacillin-tazobactam, imipenem, and meropenem was high. Septicemia, pneumonia, mechanical ventilation, and hemodialysis were the independent risk factors for increased mortality among studied subjects (P < 0.05). Conclusions: Our study results recommend empirical therapy with trimethoprim-sulfamethoxazole, piperacillin-tazobactam, aminoglycosides, and ciprofloxacin as first-line drugs for Serratia infection. The emergence of ESBL producers and carbapenem-resistant strains is worrisome. Regular updating of physicians’ knowledge about antimicrobial profiles, antibiotic prescription policies, and infection control measures is necessary to combat antimicrobial resistance and improve outcomes.

Objective: Milk production during lactation places a high demand for calcium that is fulfilled both from maternal bone resorption and diet. While it is known that mammary gland-derived PTHrP drives bone resorption during lactation, the impact of postpartum estrogen loss on bone has been unclear. Methods: We used a case-control study design to test the effect of estrogen loss in lactating mice. Results: In the present study, we show for the first time that estrogen loss during lactation activates memory T-cells (TM) to produce TNFα and IL-17A to aid in bone resorption and calcium release. Our studies reveal a new mechanism for the release of calcium from bone postpartum. The findings provide several new insights. First, the immune system plays a critical role in milk production postpartum. Second, evolutionarily, the pathway serves the physiological purpose of increasing bone resorption to release calcium for breastmilk production postpartum but becomes maladaptive postmenopause, leading to osteoporosis. Finally, these results highlight the crosstalk between the brain–bone–breast–endocrine axis and the immune system during lactation.

Antecedentes: Las metástasis óseas son una manifestación común de muchas neoplasias malignas. La radioterapia de haz externo (EBRT) proporciona una paliación exitosa de las metástasis óseas dolorosas. En el presente estudio, comparamos tres esquemas de EBRT paliativo en metástasis óseas dolorosas. Objetivo: Evaluar el alivio del dolor y la mejora del estado funcional en estos pacientes. Método: Este estudio prospectivo se realizó en pacientes con metástasis óseas dolorosas de cualquier primario. Los pacientes se dividieron aleatoriamente en tres grupos para recibir EBRT paliativa, ya sea 6Gy en una sola sesión (grupo I), 8Gy en una sola sesión (grupo II) o 10 Gy/2 fracciones/1 semana de diferencia (grupo III) hasta el sitio involucrado. El objetivo principal fue valorar la respuesta general al dolor, evaluada mediante la escala de dolor de Glasgow y la mejora en el estado funcional, mediante la puntuación del estado funcional del Eastern Cooperative Oncology Group (ECOG). Los objetivos secundarios medidos fueron el alivio completo del dolor, la duración de la respuesta general al dolor, la necesidad de analgésicos y reirradiación. Resultados: Un total de 60 pacientes fueron igualmente asignados azar en 3 grupos. Conclusión: El alivio del dolor se observó máximo en el grupo III. En los tres grupos, la puntuación media inicial del dolor se redujo significativamente y el estado funcional ECOG medio mejoró 1 mes después de la EBRT.

With the climate continuing to change, specialty crop growers are particularly at risk for economic loss caused by erratic weather conditions, excess heat and rain, and frost damage. Although tolerant to cold, lettuce (Lactuca sativa) is a major horticultural crop at risk for exposure to freezing temperatures in late fall or early spring in the Midwest. Exogenous applications of salicylic acid, ascorbic acid, and calcium chloride have been shown to improve abiotic stress in plants, particularly with freezing tolerance. This research investigated the effects of the exogenous application of salicylic acid, ascorbic acid, and calcium chloride, in varying concentrations, on field-grown lettuce. The study was conducted at the Iowa State University Horticulture Research Station, Ames, IA, USA. Weekly applications of salicylic acid (0.5 and 1.0 mM), ascorbic acid (0.5 and 1.0 mM), and calcium chloride (10 and 20 mM) were applied until plants were a marketable size. A control treatment (no spray) was also included. Data regarding plant size, yield, leaf area, leaf number, plant dry weight, plant nutrient analysis, and freeze tolerance were collected. Freeze tolerance assessments were conducted through laboratory-simulated freeze events and the evaluation of natural in-field freeze events. Freeze injury was quantified through the electrolyte leakage method. Marketable weights in 2020 and 2021 were statistically similar, except for 1.0 mM salicylic acid in 2020, which showed a significantly lower marketable weight and head diameter. Trends during both years showed that stress protectant applications had the most effective freeze protection at −12 °C in laboratory-simulated freeze events. Calcium chloride at 20 mM had the highest protection at −12 °C, with 13.3% and 24.0% less injury compared with the control in 2020 and 2021, respectively. Salicylic acid 1.0 mM at −12 °C had 4.7% and 23.7% less injury compared with control during these two years, respectively. Ascorbic acid 1.0 mM at −12 °C also showed 6.8% and 9.5% less injury than the control in 2020 and 2021, respectively. Similar trends were observed after in-field freezing events, with 20 mM calcium chloride providing the highest protection against frost in 2020 and 2021. These findings advance the understanding of the capabilities of stress protectants on lettuce as chemical primers after freezing events. This research highlights the benefits of ascorbic acid, salicylic acid, and calcium chloride as stress protectants and encourages future research and further exploration of concentrations, methods of application, and timing of application of products.

Abstract Background Tardive dyskinesia (TD) has a multidimensional impact on patients with TD and, as importantly, their caregivers. An online survey was developed and administered to assess patient and caregiver burden of TD. Survey participants were unpaid caregivers for patients with diagnoses of TD and schizophrenia, bipolar disorder, and/or major depressive disorder. Overall, 162 caregivers rated the 7-day impact of TD on the physical, psychological, and social functioning of patients and the impact of TD on these domains in their own lives and in their professional lives. Results Across physical, psychological, and social domains, most caregivers (82.7%) reported that TD had severe impact on the cared-for patients, and 23.5% reported severe impact of TD in their own lives. Caregivers experienced 46.4% activity impairment, and caregivers who were employed (n = 136) experienced 49.5% overall work impairment because of TD-related caregiving. Conclusions These results suggest that TD imposes substantial burden for both caregivers and patients.

Abstract Investigating superconductivity represents one of the most significant phenomena in the field of condensed matter physics. Our simulations aim to elucidate the structures in the metallic state of Mg1−xMoxB2, which is essential for predicting their superconducting properties. By employing a first-principle cluster expansion and particle-swarm optimization, we have predicted the structures of Mg1−xMoxB2 ternary alloys, including Mg0.667Mo0.333B2, Mg0.5Mo0.5B2, and Mg0.333Mo0.667B2, and have determined their thermodynamically stable configurations under both atmospheric and high-pressure conditions. To investigate the potential for superconductivity in these structures, we have conducted a detailed examination of electronic properties that are pertinent to determining the superconducting state. Regarding superconducting properties, Mg0.333Mo0.667B2 exhibits superconductivity with a critical temperature (Tc) of 7.4 K at ambient pressure. These findings suggest that the theoretically predicted structures in Mg/Mo-substituted metal borides could play a significant role in synthesis and offer valuable insights into superconducting materials.

Introduction: Chronic gastritis is one of the most prevalent disorders affecting individuals, which affects hundreds of millions of people in different ways around the world. The significant incidence of poor dietary quality and diet-related illnesses may be addressed by orienting customers toward healthier food options. The objective of the study was to estimate the knowledge of front-of-package labels (FoPLs) and food group-based dietary intake of nutrients among patients with chronic gastritis. Materials and Methods: The study design was a hospital-based cross-sectional study that was done in Guntur district of Andhra Pradesh. The study population included 208 chronic gastritis patients between 20 to 60 years of age selected by systematic sampling. Detailed information on sociodemographic and lifestyle factors was collected using a questionnaire and 24-h dietary recall was done. The objective assessment of Knowledge of FoPLs was assessed mock package images representing a fictional brand to prevent other factors from interfering with product evaluation. Results: A total of 208 patients were studied with a near-equal proportion of males and females. Among participants, more than half (57.2%) can interpret FoPL, more than three-fourths (77.4%) have a belief that they eat a healthy diet mostly and only half (52.4%) of participants are somewhat knowledgeable about nutrition, and finally almost half (46.6%) of participants are not seeing the FoP label during food purchase. The mean score of knowledge of FoP labeling was 0.92 ± 1.135. Knowledge of FOPL was positively associated with the age of study participants OR 0.178 (95% CI: 0.178 to 0.856) with P value = 0.02. Grains have the maximum intake among all the food groups with a mean intake of 123.21 g/day. Conclusion: The majority of participants do not know the food labeling, thus methods of education that focus on dietary interventions are urgently needed to raise awareness among the people.

Objectives: The presentation and outcomes of acute decompensated heart failure (ADHF) during COVID times (June 2020 to Dec 2020) were compared with the historical control during the same period in 2019. Methods: Data of 4806 consecutive patients of acute HF admitted in 22 centres in the country were collected during this period. The admission patterns, aetiology, outcomes, prescription of guideline-directed medical therapy (GDMT) and interventions were analysed in this retrospective study. Results: Admissions for acute heart failure during the pandemic period in 2020 decreased by 20% compared to the corresponding six-month period in 2019, with numbers dropping from 2675 to 2131. However, no difference in the epidemiology was seen. The mean age of presentation in 2019 was 61.75 (±13.7) years, and 59.97 (±14.6) years in 2020. There was a significant decrease in the mean age of presentation (p = 0.001). Also. the proportion of male patients decreased significantly from 68.67% to 65.84% (p = 0.037). The in-hospital mortality for acute heart failure did not differ significantly between 2019 and 2020 (4.19% and 4.,97%) respectively (p = 0.19). The proportion of patients with HFrEF did not change in 2020 compared to 2019 (76.82% vs 75.74%, respectively). The average duration of hospital stay was 6.5 days. Conclusion: The outcomes of ADHF patients admitted during the Covid pandemic did not differ significantly. The length of hospital stay remained the same. The study highlighted the sub-optimal use of GDMT, though slightly improving over the last few years.

BACKGROUND: This study aims to evaluate how well bingo game-based activities serve as instructional tools to enhance student learning. MATERIALS AND METHODS: This prospective cross-sectional study was approved by the Institutional Ethics Committee. The study sample size was 145 MD3 year college of medicine students for the academic year 2023–2024. The evaluation instruments included the participants’ exam grades, pre-test scores, post-test scores, and feedback. The study employed a mixed-methods approach combining quantitative and qualitative research methods to investigate how students perceived and interacted with the bingo game-based activity. The data were analyzed by Statistical Package for Social Sciences (SPSS) version 26. The association between exam and post-test scores was examined using the correlation coefficient and a straightforward regression analysis. The P value of less than 0.05 was deemed significant. RESULTS: The study comprised 145 students in total who completed all the tasks. The post-test scores (10.62 ± 1.73) showed a statistically significant improvement (P < 0.01) over the pre-test scores (6.3 ± 1.99). Most students (85–90%) thought that activities centered around bingo games were great tools for learning. Nine out of ten students said the game-based activity was engaging and enjoyable, that it inspired them to engage in group discussions, that it assisted them in identifying and concentrating on important topics, and that it improved their knowledge and helped them get ready for the final exam. Almost all the participants (>90%) suggested adding this exercise to the list of future topics. Overall, exam scores achieved by students for topics covered in the bingo-based activity (92.7 ± 4.96) were significantly higher (P < 0.01) than exam scores for topics not covered in the activity (83.75 ± 7.74). CONCLUSION: Bingo game is an effective learning strategy to promote students’ learning in the immunology course. Furthermore, utilizing bingo games as a formative assessment technique can significantly improve students’ learning and help them achieve higher scores on summative assessments.

BACKGROUND: Hepatitis C virus (HCV) infection, predominantly transmitted by exposure to infected blood, remains one of the major public health problems worldwide. This study aims to identify the risk factors of HCV transmission and its chronic complications among the study group. MATERIALS AND METHODS: This retrospective study was approved by the Research and Ethical Review and Approve Committee (RERAC) of Oman and conducted at a secondary-care hospital situated in the North Batinah region of Oman. The study population included all HCV cases confirmed by positive serology and reverse-transcription polymerase chain reaction tests during their presence at the hospital between January 2017 and December 2022. The relevant data of the study population were retrieved from the hospital electronic health record system. The data were analyzed using the Statistical Package for the Social Sciences (SPSS), Version 26.0. RESULTS: A total of 177 HCV confirmed cases were included in the study. HCV infection was predominant among males (74%) and individuals of the age group of 21–60 years (74.6%). Genotyping was possible only in 107 cases. Among HCV genotypes, genotype 3 (58.9%) was the most frequently identified, followed by genotype 1 (34.6%). Hemodialysis (21.5%), history of blood transfusion (16.4%), and injection drug use (11.9%) were the major risk factors for HCV infection, while cirrhosis (7.3%) and fatty liver disease (4%) were the most frequently observed chronic HCV complications. HCV infection in the spouse/partner (21.5%), alcohol use (7.3%), and co-infection with hepatitis B virus (2.3%) and human immunodeficiency virus (1.7%) were the other significant factors detected in our study population. CONCLUSIONS: HCV is a multi-factorial disease leading to severe chronic complications, thus representing a public health threat. This clearly emphasizes the cruciality of HCV community awareness campaigns and enhancement of Omani national guidelines for early screening of high-risk groups as well as effective management of HCV-infected cases to reduce the substantial burden of the disease on patients as well as the healthcare system.

The exceptional photophysical and electronic properties of 2D hybrid perovskites possess potential applications in the field of solar energy harvesting. The present work focuses on the two systems, exhibiting the Dion–Jacobson phase of 2D perovskite consisting of methylammonium (MA) and formamidinium (FA) cations at A‐site and 3‐(aminomethyl)pyridinium (3AMPY) as ring‐shaped organic spacer. Altering A‐site cations creates a distortion of inorganic layers and hydrogen bond interactions. It has been noted that the angles of Pb–I–Pb and I–Pb–I are more symmetric (close to 180°) for (3AMPY)(MA)Pb2I7 compared to (3AMPY)(FA)Pb2I7 and result in increase of bandgap from 1.51 to 1.58 eV. This further leads to a significant difference in Rashba splitting energy under the influence of spin‐orbit coupling effects, where the highest splitting (36 meV) is calculated for conduction band edge of the (3AMPY)(FA)Pb2I7, suggesting the promising applications toward spintronics. The calculated absorption spectra cover the range from 300 to 450 nm, indicating significant optical activity of 2D (3AMPY)(MA)Pb2I7 and (3AMPY)(FA)Pb2I7 in the visible and ultraviolet regions, which bodes well for their application in advanced optoelectronic devices. The bandgap and high absorption coefficients present more than 30% of theoretical power conversion efficiency for both systems, as calculated from the spectroscopic‐limited maximum efficiency.

The base station installed on the unmanned aerial vehicle, referred to as the UAV-mounted base station (UBS), is considered an innovative paradigm for restoring cellular connectivity in areas where a terrestrial network does not exist, has been demolished, or is overcrowded. The challenging issue in this context is how to acquire the position information of user equipment (UE), characterize the air-to-ground (A2G) channel, and identify the optimal locations for quality-of-service (QoS)-aware 3D UBS deployment. To tackle these issues, we proposed a framework for 3D UBS deployment with the goal of maximizing the number of UEs covered. First, unlike the existing UBS deployment schemes, which ignore the UEs' localization, we propose a received signal strength indicator (RSSI)-based localization (RBL) approach to localize the randomly distributed UEs. Then, the 3D UBS deployment problem is divided into horizontal position optimization to meet the QoS requirements of individual UEs’ and vertical position optimization for path loss minimization. We propose a K-means initialized grey wolf optimization (KIGWO) approach in which UBSs are deployed to maximize the covered UEs percentage while taking the QoS requirements of individual UEs’ and UBS’ total capacity into account. Finally, the effectiveness of the proposed approach is demonstrated through Monte Carlo simulations conducted in four different environmental scenarios.

Introduction: Assessing and improving infection prevention and control (IPC) knowledge and practicing skills among medical students who are the future medical practitioners is crucial for reducing the burden of healthcare-associated infections (HAIs). In this study, we assessed the IPC knowledge of undergraduate clinical-year medical students before and after interventional IPC modular training and evaluated the effectiveness and students’perception on structured modular IPC training presented to them.Methods: This cross-sectional interventional study was conducted on single medical cohort comprising of 145 final-yearundergraduate medical students of the academic year 2022-23 at COMHS. Pre-test, post-test, and feedback questionnaire were used as the assessing tools. The data were collected, entered into Excel sheet, and analyzed using SPSS software version 22. McNemar and Paired-T tests were carried out, and a P-value90%) perceived IPC training as an excellent tool to improve IPC knowledge and practicing skills.Conclusion: IPC training had a significant impact in gaining adequate IPC knowledge and practicing skills among ourparticipants. Therefore, it is recommended that IPC training should be implemented in the undergraduate medical curriculum with greater emphasis on practicing skills.

Abstract Amorphous alloys exhibit useful properties such as the excellent soft magnetic behaviour of Fe-based metallic glasses. The detailed structure of amorphous $$\text {Fe}_{(1-x)}\text {Zr}_x$$ Fe ( 1 - x ) Zr x with x = 0.07, 0.10, and 0.20 is in this work explored through a synergetic combination of atomistic simulations and experimental characterisation. Thin-film samples were investigated using X-ray diffraction and extended X-ray absorption fine structure (EXAFS), while the corresponding atomic structures were simulated using an efficient first-principles-based method called stochastic quenching (SQ). The simulated local atomic arrangements are investigated by constructing the radial- and angular-distribution functions, as well as by Voronoi tesselation. The radial distribution functions are then used to construct a model to fit simultaneously the experimental EXAFS data of multiple samples with different compositions, creating a simple yet accurate description of the atomic structures valid for any composition in the range x = 0.07 to 0.20, using a minimal number of free parameters. This approach significantly improves the accuracy of the fitted parameters and allows us to relate the compositional dependence of the amorphous structures with the magnetic properties. The proposed EXAFS fitting process can be generalised to other amorphous systems, contributing to the understanding of structure-property relationships and the development of amorphous alloys with tailored functional properties.

Background: The incidence of PCOS among females is increasing. Awareness among women about PCOS can help in early diagnosis and prevention by making lifestyle modifications. Lifestyle modifications not only help in prevention of disease but also in managing the symptoms and complications. Objectives: 1. To find out the perception regarding PCOS among students of different courses. 2. To assess the knowledge about PCOS among students Methodology: A cross-sectional study on Undergraduate medical, dental and allied health sciences students enrolled in KMC, Mangalore and MCODS, Mangalore Results: 12.6% of the students had a family history of PCOS. 85% of the students have heard about PCOS. Out of the people who have heard about PCOS 20% have been diagnosed with it. Out of the people who have heard about PCOS, most of the students knew that PCOS is associated with irregular periods, infertility, mood swings and hormonal disturbances. Conclusion: Awareness about PCOS is maximum among MBBS students followed by AHS and then BDS students.

Background: Chronic viral infection results in impaired immune responses rendering viral persistence. Here, we compared the quality of T-cell responses among chronic hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV)-infected individuals by examining the levels of expression of selected immune activation and exhaustion molecules on circulating MAIT cells and Tfh cells. Methods: Cytokines were measured using a commercial Bio-plex Pro Human Cytokine Grp I Panel 17-plex kit (BioRad, Hercules, CA, USA). Inflammation was assessed by measuring an array of plasma cytokines, and phenotypic alterations in CD4+ T cells including circulating Tfh cells, CD8+ T cells, and TCR iVα7.2+ MAIT cells in chronic HBV, HCV, and HIV-infected patients and healthy controls. The cells were characterized based on markers pertaining to immune activation (CD69, ICOS, and CD27) proliferation (Ki67), cytokine production (TNF-α, IFN-γ) and exhaustion (PD-1). The cytokine levels and T cell phenotypes together with cell markers were correlated with surrogate markers of disease progression. Results: The activation marker CD69 was significantly increased in CD4+hi T cells, while CD8+ MAIT cells producing IFN-γ were significantly increased in chronic HBV, HCV and HIV infections. Six cell phenotypes, viz., TNF-α+CD4+lo T cells, CD69+CD8+ T cells, CD69+CD4+ MAIT cells, PD-1+CD4+hi T cells, PD-1+CD8+ T cells, and Ki67+CD4+ MAIT cells, were independently associated with decelerating the plasma viral load (PVL). TNF-α levels showed a positive correlation with increase in cytokine levels and decrease in PVL. Conclusion: Chronic viral infection negatively impacts the quality of peripheral MAIT cells and Tfh cells via differential expression of both activating and inhibitory receptors.

Objective: Pseudomonas aeruginosa is a common cause of nosocomial infections worldwide. Increasing in the emergence and spread of multidrug-resistant (MDR) strains is a serious health concern. The aim of the present study was to determine the antibiotic resistance pattern of P. aeruginosa isolated from clinical samples. Materials and Methods: The current retrospective cross-sectional study was conducted at a tertiary-care hospital in Oman. The data of P. aeruginosa isolates identified during 2015–2019 at Sohar Hospital were retrieved from Al-Shifa computerized data system. The data were systematically analyzed using SPSS 22 software system, IBM Chicago. Descriptive statistics were applied to find frequencies and percentages. Trends were analyzed using a one-sample Chi-square test. Results: A total of 5865 P. aeruginosa strains identified in clinical samples of 4024 patients were studied. The frequency of isolation of P. aeruginosa was more among people aged >60 years (33%). The rate of isolation was significantly high (47%) in pus/wound swabs. The overall resistance of P. aeruginosa was low to moderate (10%–30%) to commonly used anti-pseudomonal drugs. Among, 10% were MDR strains. The lowest resistance (10%) was observed to piperacillin-tazobactam (TAZP), while significantly high resistance (29%–30%) was exhibited by carbapenems. Furthermore, strains isolated from respiratory secretions and urine samples have shown a significantly high percentage of resistance compared to others. Conclusions: Piperacillin-tazobactam is recommended as the drug of choice for treating especially severe Pseudomonas infections. Moderate resistance to carbapenems is an alarming sign. This pattern of resistance suggests the probable overuse of drugs. Therefore, it emphasizes strict antibiotic policy, rapid detection, and continuous monitoring of drug-resistant strains, and timely dissemination of the resistant report to clinicians.

Background: Enterococci are recognized as an important nosocomial opportunistic pathogens in recent times and are difficult to treat due to their intrinsic and acquired resistance to many antibiotics. In this study, we analyzed the clinical profile and antibiotic susceptibility pattern with an emphasis on vancomycin resistance among Enterococcus faecalis and Enterococcus faecium isolated from various clinical samples. Methods: This retrospective study was carried out in Sohar Hospital, Oman, after obtaining an ethical approval from the Ministry of Health, Oman. Enterococci isolates identified as E. faecalis and E. faecium from the positive bacterial culture in patients' suspicion of bacterial infection during the study period from January 2017 to December 2021 were analyzed. Details of the study population such as demography, clinical samples, and antibiotic susceptibility pattern of the enterococci isolates were extracted from the hospital electronic health record system. The data were entered into Microsoft Excel sheet, cleaned for errors, and statistically analyzed using Statistical Package for the Social Sciences (SPSS) version 26. The quantitative variables were expressed as mean ± standard deviation while qualitative variables presented as frequencies. Results: In total, 132 nonduplicate E. faecalis and E. faecium were studied. E. faecalis (68.9%) was the predominantly isolated species followed by E. faecium (31.1%). The frequency of isolation was more among females (54.5%) and elderly (47.7%) aged more than 60 years. Majority of enterococci were isolated from urine (49.6%), followed by blood (29.1%) and pus/wound swab (11.8%). All isolates were susceptible to linezolid, while all isolates showed resistance to clindamycin. None of the E. faecalis isolates exhibited resistance to vancomycin, while 13.5% of E. faecium isolates were resistant to vancomycin. E. faecium showed higher resistance to beta lactams, ciprofloxacin, and nitrofurantoin (>80%), while E. faecalis demonstrated low resistance to beta-lactams and nitrofurantoin (

Background: Immunization against severe acute respiratory syndrome coronavirus 2 became necessary to control the menace of COVID-19. However, the safety of COVID-19 vaccines must be monitored continuously. The present study aims at comparing the effectiveness and adverse effects of Pfizer and AstraZeneca vaccines among the cohort of medical students. Methods: It was a single-cohort comparative study, and the data were collected using an online survey from participants who took at least two doses of AstraZeneca or Pfizer vaccines. The data included demography, breakthrough infections, and adverse effects following vaccination. Bivariate and logistic regression models were used to find associations between effectiveness and independent variables. Statistical significance was considered at P < 0.05. Results: In total, 115 students who had received Pfizer or AstraZeneca vaccines were included in the study. The mean age of the participants was 21.52. Female (n = 90) participants were more compared to males (n = 25). The majority of them received Pfizer vaccine (95), while AstraZeneca was received by only 20 participants. Overall effectiveness of both AstraZeneca and Pfizer was nearly 85%, while almost 100% protection was observed among those who were vaccinated after contracting the disease. Logistic regression revealed an independent effect of COVID-19 before any vaccination dose offered 66% protection against any subsequent breakthroughs (odds ratio 0.44, 95% confidence interval [CI]: 0.095–2.08). At least one adverse effect was reported by 96 (83.5%) participants (95% CI: 75.4%–89.75%). Pain at the site of injection, fever, generalized weakness, and headache were the most common adverse effects. Fever (P < 0.001), body ache (P < 0.001), generalized weakness (P = 0.002), and joint pain (P = 0.014) were significantly more common in AstraZeneca as compared to Pfizer. Conclusion: Coronavirus vaccines were well tolerated, safe, and induced protection in most participants. Most postvaccine adverse events were mild to moderate, mainly due to induction of immune response by the body for protection. Furthermore, these mild to moderate adverse effects should not be hindrance to vaccination.

Adoption of Industry 4.0 (I4.0) and sustainable manufacturing practices plays an important role for manufacturing industries to sustain their globe market reputation. However, the adoption of I4.0 technologies in manufacturing practices is more concern for manufacturing industries. Volatile customer demands, changing manufacturing trends and market scenario has forced manufacturing organization to revisit their production system and incorporate sustainability practices. Blockchain enabled practices helps to maintain transparency and traceability in supply chain as well as manufacturing activities. But lack of framework related to blockchain enabled sustainable manufacturing has become a serious concern for policymakers and practitioners. Similarly, due to changing market scenario it is important to identify the solutions to overcome the blockchain enabled sustainable manufacturing issues through circular economy and I4.0 solution measures. The present study identifies the 28 critical challenges and 22 I4.0 and circular economy based solution measures to overcome the issues of blockchain enabled sustainable manufacturing. Further, a case study in electronics manufacturing industries is used to test the developed framework using hybrid multi-criteria decision making approach. The case study findings that organizational and managerial challenges are critical to blockchain enabled sustainable manufacturing adoption. In the end of study, we have proposed an integrated framework for blockchain enabled sustainable manufacturing practices for energy, waste, resource, quality and life cycle management. It is expected that present study will be helpful for the researchers, practitioners and policymakers to understand the complications in the adoption of blockchain enabled sustainable manufacturing practices.

Climate change poses a real risk, as does a shortage of resources to accommodate the world's rising population. Every nation is trying to produce maximum without caring for the environment. As a result, the circular economy (CE) is critical to the long-term sustainability of society, business and the environment. Government and policymakers are forcing industries and organizations to adopt or establish CE in their businesses to protect the environment. However, the concept of CE is unclear, and there are various hurdles and barriers to adopting a CE in industries and organizations. For a sustainable environment, CE barrier management plays a crucial role. This paper aims to explore and prioritize barriers to establishing a CE. A detailed methodological literature review is carried out to explore the twenty-nine barriers in CE. The various barriers to CE are prioritized using the Multi-criteria decision-making methods Order of Preference by Similarity to Ideal Solution (TOPSIS). Based on the TOPSIS barrier of increased emission and pollution while recycling was found to be a top rank and the barrier of tedious environmental regulations and lack of government support was found to be at the lowest rank. The top priorities are the barriers to increasing emission and pollution while recycling, radically changing production, and lack of public participation in using recycled products. The Blockchain-IoT architecture and strategies are developed to mitigate all these barriers. As in CE, resources are not ending as these are recyclables since products are made to last several life cycles. Product's lifespans are extended by maintaining, repairing and re-manufacture to reduce carbon footprints in the environment. This barrier ranking will help supply chain professionals and business executives analyze the failure to implement CE in industries. Strategies and architecture based on blockchain-IoT will also help in mitigating the barrier in CE. This study will give new dimensions for the adaption of CE in industries. CE will create sustainable ecosystems for soil, air and water. These sustainable ecosystems provide a long and healthy life for all living things on this planet.

Abstract The lncRNA GAS5 acts as a tumor suppressor and is downregulated in gastric cancer (GC). In contrast, E2F1, an important transcription factor and tumor promoter, directly inhibits miR-34c expression in GC cell lines. Furthermore, in the corresponding GC cell lines, lncRNA GAS5 directly targets E2F1. However, lncRNA GAS5 and miR-34c remain to be studied in conjunction with GC. Here, we present a dynamic Boolean network to classify gene regulation between these two non-coding RNAs (ncRNAs) in GC. This is the first study to show that lncRNA GAS5 can positively regulate miR-34c in GC through a previously unknown molecular pathway coupling lncRNA/miRNA. We compared our network to several in-vivo/in-vitro experiments and obtained an excellent agreement. We revealed that lncRNA GAS5 regulates miR-34c by targeting E2F1. Additionally, we found that lncRNA GAS5, independently of p53, inhibits GC proliferation through the ATM/p38 MAPK signaling pathway. Accordingly, our results support that E2F1 is an engaging target of drug development in tumor growth and aggressive proliferation of GC, and favorable results can be achieved through tumor suppressor lncRNA GAS5/miR-34c axis in GC. Thus, our findings unlock a new avenue for GC treatment in response to DNA damage by these ncRNAs.

Abstract Janus nanosystems enable one to achieve complementary properties in a single entity. In the current study, the fundamental properties like structural, electronic, and dynamical of Janus hexagonal boron nitride (h‐BN) by selectively hydrogenating and fluorinating a h‐BN surface are systematically examined, using density functional theory. Functionalization of h‐BN introduces partial sp3 (buckled) character in the predicted materials as compared to planar sp2 h‐BNs. Fully fluorinated and hydrogenated h‐BN have a direct bandgap of 3.42 and 3.37 eV, respectively. All the investigated configurations are predicted to be dynamically stable. Furthermore, optical properties including dielectric function, absorption spectra, refractive index, and reflectivity are evaluated to realize the optical and photocatalytic behavior of considered systems. The dielectric function ɛ2(ω) shows fundamental absorption edge arising at 3.2, 3.9, 2.8, and 3.4 eV for hydrogen on boron and nitrogen, hydrogen on boron and fluorine on nitrogen, fluorine on boron and hydrogen on nitrogen (FBNH) and fluorine on boron and nitrogen which is comparable to the bandgap of respective monolayers. Solar cell parameters of all considered BN structures are calculated using the Shockley–Queisser (SQ) limit. The highest short‐circuit current density (Jsc ) for FBNH is found to be 2.1 mA cm−2 providing the efficiency of 8.27% making FBNH a potential candidate for absorber layer in solar cells.

The adhesion of a 2D material to a substrate is facilitated by the van der Waals (vdW) interactions, which is significantly influenced by the roughness and wettability of the substrate. It is challenging to achieve good as well as conformal adhesion of mechanically exfoliated 2D materials to a hydrophobic soft substrate like polydimethylsiloxane (PDMS). In addition, the mechanical folding instabilities are inevitably observed in 2D elastic nanosheets over a smooth PDMS substrate under higher compressions in a prestretch-release process. However, the manipulation of the soft substrate’s surface roughness may provide an essential degree of freedom for tailoring the conformation level and topography of the 2D elastic nanosheets. Herein, we propose a technique to improve the interfacial adhesion of the graphene membrane to a periodically trenched PDMS substrate by suppressing the mechanical folding instabilities in a prestretch-release process. The conformal wrinkling of the graphene membrane, as confirmed through atomic force microscopy (AFM) imaging, is found to result from its pinning into the trenches via snap-through transition. We also show the impact of the substrate’s topography on the buckling behavior of the graphene membrane under the stress loading-unloading cycle by surface-engineering of the PDMS substrate using ion beam irradiation. This study offers fundamental as well as practical insights into the adhesion mechanics of the 2D elastic nanosheets over the corrugated soft substrates under the prestretch-release process. The wrinkled topography of the membrane could be harnessed for flexible, conformal, and tunable electronic devices.

Abstract Localization in underwater wireless sensor network (UWSN) faces an imminent threat when the triangulating anchor node starts to malfunction. Traditional geometric approaches are insufficient to cope with the survivability of UWSN topology. To address these issues, this paper presents a symplectic geometry for identification of the malicious anchor node. Consequently, a geodesic search algorithm (GSA) based Target localization is proposed which reduces the positioning error by exploiting the phase-space constancy of the underwater acoustic sensor network topology to effectively triangulate the target node despite its mobility. First, a malicious anchor node model is presented. The node movement is expressed in the form of “ripple region”. GSA is then proposed which effectively frees the node metastasis from anchor node geometry, thereby making the underwater system more survivable and resilient. Simulation results evaluate the survivability of the geodesic formalism in terms of the reduced penalty incurred by node movement, as well as the reduced impact of anchor node malfunction. An improvement of 13.46% and 9.26% reveals the utility of the geodesic technique in aquamarine sensor deployments, which would be beneficial in underwater resource exploration and defense planning.

Introduction: Concept maps are graphical representations of knowledge that connect concepts, ideas, and relationships. The present study aims at assessing the perception of medical students in utilization of concept maps as a tool to foster their lifelong learning skills in immunology.Methods: The current study was approved by Institutional Ethics and Review Committee. Third-year undergraduate (MD3) medical students of the academic year 2021-22 were sensitized about the concept map study and included after obtaining their informed consent. The students worked in teams to find answers and link the different words or phrases of the concept maps. At the end of the immunology course, students’ perception on concept map-based learning strategy was assessed. A pre-designed, selfadministered questionnaire, pre-validated by subject experts for relevance and feasibility, was used for the study. The questionnaire included some quantitative questions assessed by using 3-pointLikert Scale and an open-ended question to receive students’ comments on concept map-based learning strategy. The responses were collected and analyzed using SPSS version 22. Descriptive statistics was used for the quantitative variables, tabulated as numbers and percentages while the qualitative data was analyzed by thematic analysis. The quantitative data results were prioritized but supported by students’ comments on open ended question.Results: Out of 133 eligible participants, 109 students who volunteered and completed the study were included. Majority of our participants (>80%) welcomed the concept map-based learning strategy. Almost 4 out of 5 expressed that concept maps are interesting and enjoyable, encourage active participation, peer discussion, and enhance critical thinking and problem-solving skills. More than 80% of the students agreed that concept maps promoted deep understanding of the topic and lifelong learning. Nearly 3 out of 4 students suggested including concept maps in many immunology topics in future. Majority of students penned down positive comments indicating concept map tool facilitates metacognitive skills.Conclusion: From the study, it can be concluded that concept maps are effective active learning strategies to improve themetacognitive domain of medical students in immunology course, thus assisting them to become better lifelong learners.

Immune cells play an important functional role in bone fracture healing. Fracture repair is a well-choreographed process that takes approximately 21 days in healthy mice. While the process is complex, conceptually it can be divided into four overlapping stages: inflammation, cartilaginous callus formation, bony callus formation, and remodeling. T cells play a key role in both the cartilaginous and bony callus phases by producing IL-17A. In this issue of the JCI, Dar et al. showed that T cells were recruited from the gut, where the gut microbiota determined the pool of T cells that expressed IL-17A. Treatment with antibiotics and dysbiosis reduced the expansion of IL-17–expressing CD4+ T cells (Th17) and impaired callus formation. These findings demonstrate crosstalk among the gut microbiota, the adaptive immune system, and bone that has clinical implications for fracture healing.

The goal of present study is to explore how the size and functionalization of graphene quantum dots (GQDs) affect their sensing capabilities. Specifically, we investigated the adsorption of SO2, SOF2, SO2F2, and SF6 on GQDs that were functionalized with –CH3, –COCH3, and –NH2. We used density functional theory to analyse the electronic properties of these functionalized GQDs and found that the functionalization significantly altered their electronic properties. For example, the B3LYP H-L gap of pristine triangulene was 3.9eV, while the H-L gap of functionalized triangulene ranged from 2.8 eV to 3.6 eV (using the B3LYP functional). Our results indicate that –NH2 functionalized phenalenyl and triangulene provide strong interaction with SO2, with adsorption energies of −0.429 eV and −0.427 eV, respectively. These adsorption properties exhibit physisorption, leading to high gas sensitivity and superior recovery time. The findings of this study provide new insights into the potential use of GQDs for detecting the decomposed constituents of sulfur hexafluoride, which can be beneficial for assessing the operation status of SF6 insulated devices. Overall, our calculations suggest that functionalized GQDs can be employed in gas insulated systems for partial discharge detection.

Abstract Background Fremanezumab, a fully humanized monoclonal antibody (mAb; IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), is approved for the preventive treatment of migraine in adults. The efficacy and safety of fremanezumab for migraine prevention have been demonstrated in randomized, double-blind, placebo-controlled trials. Real-world effectiveness data are needed to complement clinical trial data. This study assessed the effectiveness of fremanezumab across different subgroups of adult patients with episodic migraine (EM), chronic migraine (CM), or difficult-to-treat (DTT) migraine in real-world clinical settings. Methods This retrospective, panel-based online chart review used electronic case report forms. Patient inclusion criteria were a physician diagnosis of EM or CM; age ≥ 18 years at the time of first fremanezumab initiation; ≥ 1 dose of fremanezumab treatment; ≥ 1 follow-up visit since first initiation; and ≥ 2 measurements of monthly migraine days (MMD; with 1 within a month before or at first initiation and ≥ 1 after first initiation). Changes in MMD and monthly headache days were assessed during the follow-up period. These endpoints were evaluated in subgroups of patients by migraine type (EM/CM) and in subgroups with DTT migraine (diagnosis of medication overuse [MO], major depressive disorder [MDD], generalized anxiety disorder [GAD], or prior exposure to a different CGRP pathway–targeted mAb [CGRP mAb]). Results Data were collected from 421 clinicians and 1003 patients. Mean (percent) reductions from baseline in MMD at Month 6 were − 7.7 (77.0%) in EM patients, − 10.1 (68.7%) in CM patients, − 10.8 (80.6%) in the MO subgroup, − 9.9 (68.3%) in the MDD subgroup, − 9.5 (66.4%) in the GAD subgroup, and − 9.0 (68.7%) in the prior CGRP mAb exposure subgroup. Improvements in MDD or GAD severity were reported by 45.5% and 45.8% of patients with comorbid MDD or GAD, respectively. Conclusions In this real-world study, fremanezumab demonstrated effectiveness for migraine regardless of migraine type or the presence of factors contributing to DTT migraine (MO, GAD, MDD, or prior exposure to a different CGRP mAb).

Abstract Background The efficacy and tolerability of fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP) and is approved for the preventive treatment of migraine in adults, have been demonstrated in randomized, double-blind, placebo-controlled trials. Real-world data can further support those clinical trial data and demonstrate the full clinical benefits of fremanezumab. This chart review assessed the effectiveness of fremanezumab for improving clinical outcomes in adult patients with migraine treated according to real-world clinical practice. Methods This retrospective, panel-based, online physician chart review study used electronic case report forms with US physicians. Patient inclusion criteria were a physician diagnosis of migraine, fremanezumab treatment initiation at ≥ 18 years of age after US Food and Drug Administration approval, ≥ 1 dose of fremanezumab treatment, and ≥ 2 assessments of monthly migraine days (MMD; 1 within 30 days before treatment initiation and ≥ 1 after initiation). Changes from baseline in MMD, monthly headache days (MHD), and Migraine Disability Assessment (MIDAS) and 6-item Headache Impact Test (HIT-6) scores were assessed over 6 months. These endpoints were evaluated in the overall population and subgroups divided by dosing schedule and number of prior migraine preventive treatment failures. Results This study included data from 421 clinicians and 1003 patients. Mean age at fremanezumab initiation was 39.7 years, and most patients were female (75.8%). In the overall population, mean baseline MMD and MHD were 12.7 and 14.0, respectively. Mean (percent) reductions from baseline in MMD and MHD, respectively, were − 4.6 (36.2%) and − 4.7 (33.6%) at Month 1, − 6.7 (52.8%) and − 6.8 (48.6%) at Month 3, and − 9.2 (72.4%) and − 9.8 (70.0%) at Month 6. Mean (percent) reductions from baseline in MIDAS and HIT-6 scores also increased over the 6-month study period, from − 6.2 (21.6%) and − 8.4 (14.0%) at Month 1 to − 18.1 (63.1%) and − 16.2 (27.0%) at Month 6, respectively. Improvements in these outcomes over 6 months were observed across all evaluated subgroups. Conclusions This real-world study demonstrated effectiveness of fremanezumab treatment for up to 6 months, irrespective of dosing regimen or number of prior migraine preventive treatment failures, reflecting ongoing, clinically meaningful improvements in patient outcomes.

Abstract We explored the phase stability of ternary pentahydride $$\hbox {CaCH}_{{5}}$$ CaCH 5 based on the first principles evolutionary algorithm. Here, we successfully search for a candidate structure up to 500 GPa. As a consequence, the possible stable structure of $$\hbox {CaCH}_{{5}}$$ CaCH 5 is found be to a monoclinic structure with space group Pm at a pressure of 50 GPa. Moreover, the orthorhombic structure with a space group of Cmcm is found to be thermodynamically stable above 316 GPa. With this, the Kohn-Sham equation plays a crucial role in determining the structural stability and the electronic structure. Therefore, its structural stability is discussed in term of electronic band structure, Fermi surface topology, and dynamic stability. With these results, we propose that the superconducting transition temperature ( $$\hbox {T}_{{c}}$$ T c ) of Cmcm structure is estimated to be 50 K at 450 GPa. This could be implied that the proposed Cmcm structure may be emerging as a new class of superconductive ternary metal pentahydride. Our findings pave the way for further studies on an experimental observation that can be synthesized at high pressure.

Abstract Transfection of tumor suppressor miRNAs such as miR-34a, miR-449a, and miR-16 with DNA damage can regulate apoptosis and senescence in cancer cells. miR-16 has been shown to influence autophagy in cervical cancer. However, the function of miR-34a and miR-449a in autophagy remains unknown. The functional and persistent G1/S checkpoint signaling pathways in HeLa cells via these three miRNAs, either synergistically or separately, remain a mystery. As a result, we present a synthetic Boolean network of the functional G1/S checkpoint regulation, illustrating the regulatory effects of these three miRNAs. To our knowledge, this is the first synthetic Boolean network that demonstrates the advanced role of these miRNAs in cervical cancer signaling pathways reliant on or independent of p53, such as MAPK or AMPK. We compared our estimated probability to the experimental data and found reasonable agreement. Our findings indicate that miR-34a or miR-16 may control senescence, autophagy, apoptosis, and the functional G1/S checkpoint. Additionally, miR-449a can regulate just senescence and apoptosis on an individual basis. MiR-449a can coordinate autophagy in HeLa cells in a synergistic manner with miR-16 and/or miR-34a.

Abstract Device‐to‐device (D2D) communication plays a vital role in communication technologies with resource management and power control, which are the major issues for researchers in the era of 2020. In 5G networks, machine learning algorithms play a crucial role to manage these issues. In the proposed work, the problem is formulated for the uplink underlaid model of D2D communication. The Lyapunov optimization technique is utilized with a combination of machine learning techniques for resource allocation in D2D communication. First, the maximization of uplink and overall system capacity is formulated with resource management, which guarantees the signal to interference noise ratio for the D2D users. The optimization is a mixed integer non‐linear problem which uses the Lyapunov optimization method to optimize the bit error rate value and iterative algorithm to optimize the power value with different constraints. After attaining the optimized value, the support vector machine technique is utilized to ensure the spectral efficiency of an overall system in autonomous mode. Simulation results show that the proposed method provides higher reliability and power efficiency with higher system capacity in comparison to prevailing technologies.

The paper examines how new age pedagogies and neoliberal policies consciously work towards "naturalizing" English language's hegemony in institutions of Higher Education (IHE) in India. An ethnographic study the paper foregrounds the precarious positioning of non-English Indian languages "vis-à-vis" the pervading discourses of internationalization and education as job/skill oriented. Hegemony of English in the present is coupled with a restructuring of language departments as well as fleeting market demands for human capital. The paper also brings into question the role of the Internet and related technologies in reorganizing the linguistic dynamics of HE. Instead of democratizing, the Internet produces new monopolies in knowledge production, controls knowledge traffic from global North to South and further legitimizes the language hegemony. The paper argues that, in the last two decades, the neoliberal rupture has been leading HE institutions to a death of vernaculars within their physical, cultural and academic spaces.

Abstract Strain-mediated magnetism in 2D materials and dilute magnetic semiconductors hold multi-functional applications for future nano-electronics. Herein, First principles calculations are employed to study the influence of biaxial strain on the magnetic properties of Co-doped monolayer $$WS_2$$ W S 2 . The non-magnetic $$WS_2$$ W S 2 shows ferromagnetic signature upon Co doping due to spin polarization, which is further improved at low compressive (-2 %) and tensile (+2 %) strains. From the PDOS and spin density analysis, the opposite magnetic ordering is found to be favourable under the application of compressive and tensile strains. The double exchange interaction and p-d hybridization mechanisms make Co-doped $$WS_2$$ W S 2 a potential host for magnetism. More importantly, the competition between exchange and crystal field splittings, i.e. ( $$\Delta _{ex}>\Delta _{cfs}$$ Δ ex > Δ cfs ), of the Co-atom play pivotal roles in deciding the values of the magnetic moments under applied strain. Micromagnetic simulation reveals, the ferromagnetic behavior calculated from DFT exhibits low-field magnetic reversal (190 Oe). Moreover, the spins of Co-doped $$WS_2$$ W S 2 are slightly tilted from the easy axis orientations showing slanted ferromagnetic hysteresis loop. The ferromagnetic nature of Co-doped $$WS_2$$ W S 2 suppresses beyond $$\pm 2~\%$$ ± 2 % strain, which is reflected in terms of decrease in the coercivity in the micromagnetic simulation. The understanding of low-field magnetic reversal and spin orientations in Co-doped $$WS_2$$ W S 2 may pave the way for next-generation spintronics and straintronics applications.

Abstract We studied the physical, electronic transport and optical properties of a unique pentagonal PdQ2 (Q = S, Se) monolayers. The dynamic stability of 2Dwrinkle like-PdQ2 is proven by positive phonon frequencies in the phonon dispersion curve. The optimized structural parameters of wrinkled pentagonal PdQ2 are in good agreement with the available experimental results. The ultimate tensile strength (UTHS) was calculated and found that, penta-PdS2 monolayer can withstand up to 16% (18%) strain along x (y) direction with 3.44 GPa (3.43 GPa). While, penta-PdSe2 monolayer can withstand up to 17% (19%) strain along x (y) dirrection with 3.46 GPa (3.40 GPa). It is found that, the penta-PdQ2 monolayers has the semiconducting behavior with indirect band gap of 0.94 and 1.26 eV for 2D-PdS2 and 2D-PdSe2, respectively. More interestingly, at room temperacture, the hole mobilty (electron mobility) obtained for 2D-PdS2 and PdSe2 are 67.43 (258.06) cm2 V−1 s−1 and 1518.81 (442.49) cm2 V−1 s−1, respectively. In addition, I-V characteristics of PdSe2 monolayer show strong negative differential conductance (NDC) region near the 3.57 V. The Shockly-Queisser (SQ) effeciency prameters of PdQ2 monolayers are also explored and the highest SQ efficeinciy obtained for PdS2 is 33.93% at −5% strain and for PdSe2 is 33.94% at −2% strain. The penta-PdQ2 exhibits high optical absorption intensity in the UV region, up to 4.04 × 105 (for PdS2) and 5.28 × 105 (for PdSe2), which is suitable for applications in optoelectronic devices. Thus, the ultrathin PdQ2 monolayers could be potential material for next-generation solar-cell applications and high performance nanodevices.

Introduction: Anemia is a major public health problem in India, especially among tribal women. The study was done to estimate the prevalence of iron intake below the estimated average requirement in the diet and to study the effectiveness of weekly local mothers' kitchen recipe talks. Methodology: A total of 340 women from scheduled tribes participated in a prospective cohort study over 10 months in 10 clusters in the Guntur district of Andhra Pradesh, India. A questionnaire, a 24-hour dietary recall, and an assessment of hemoglobin were done to gather information at baseline and after three months of weekly local recipe talks in mothers' kitchens. Results: A total of 340 women were studied. The mean age of the mothers was 23.5 ± 3.6 years. At baseline prevalence, the mean intake of daily iron in diet among mothers was 9.04 ± 3.18 (SD) mg/day. The prevalence of anemia among mothers at the baseline was 63.8%. The mean intake of daily iron in the diet at the end line was significantly higher with a P value of 0.019 among mothers who attended 10 or more weekly local mothers' kitchen recipe talks and did not take iron folic acid (IFA). Mothers who attended 10 or more weekly local mothers' kitchen recipe talks without IFA intake have a significant drop in the prevalence of severe anemia. Conclusion: The integration of weekly local mothers' kitchen recipe talks in the ongoing Integrated Child Development Service Scheme can be a boon for early-aged, less-literate, inexperienced, and financially poor mothers.