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Background: Understanding pathways to dual diagnosis (DD) care will help organize DD services and facilitate training and referral across healthcare sectors. Aim: The aim of our study was to characterize the stepwise healthcare and other contacts among patients with DD, compare the characteristics of the first contact persons with common mental disorder (CMD) versus severe mental illness (SMI), and estimate the likelihood of receiving appropriate DD treatment across levels of contacts. Methods: This cross-sectional, descriptive study in eight Indian centers included newly enrolled patients with DD between April 2022 and February 2023. The research spans varied geographic regions, tapping into regional variations in disease burden, health practices, and demographics. The study categorized healthcare contacts by using the WHO Pathways Encounter Form. Results: The sample (n = 589) had a median age of 32 years, mostly males (96%). Alcohol was the most common substance; SMI (50.8%) and CMD were equally represented. Traditional healers were a common first contact choice (18.5%); however, integrated DD care dominated subsequent contacts. Assistance likelihood increased from the first to the second contact (23.1% to 62.1%) but declined in subsequent contacts, except for a significant rise in the fifth contact (97.4%). In the initial contact, patients with CMD sought help from public-general hospitals and private practitioners for SUD symptoms; individuals with SMI leaned on relatives and sought out traditional healers for psychiatric symptoms. Conclusion: Recognizing the cultural nuances, advocating for integrated care, and addressing systemic challenges pave the way to bridge the gap in DD treatment.

Abstract In the realm of cloud computing, ensuring the dependability and robustness of software systems is paramount. The intricate and evolving nature of cloud infrastructures, however, presents substantial obstacles in the pre-emptive identification and rectification of software anomalies. This study introduces an innovative methodology that amalgamates hybrid optimization algorithms with Neural Networks (NN) to refine the prediction of software malfunctions. The core objective is to augment the purity metric of our method across diverse operational conditions. This is accomplished through the utilization of two distinct optimization algorithms: the Yellow Saddle Goat Fish Algorithm (YSGA), which is instrumental in the discernment of pivotal features linked to software failures, and the Grasshopper Optimization Algorithm (GOA), which further polishes the feature compilation. These features are then processed by Neural Networks (NN), capitalizing on their proficiency in deciphering intricate data patterns and interconnections. The NNs are integral to the classification of instances predicated on the ascertained features. Our evaluation, conducted using the Failure-Dataset-OpenStack database and MATLAB Software, demonstrates that the hybrid optimization strategy employed for feature selection significantly curtails complexity and expedites processing

Background: Substance use disorders (SUDs) are among the leading causes of morbidity in the population. In low- and medium-income countries like India, there is a wide treatment gap for SUD. A multicentric study on the care pathways for SUD in India can help to understand service provision, service utilization, and challenges to improve existing SUD care in India. Aim: We aimed to map pathways to care in SUD. We compared the clinical and demographic characteristics of patients who first consulted specialized services versus other medical services. Methods: This was a cross-sectional study of consecutive, consenting adults (18–65 years) with SUD registered to each of the nine participating addiction treatment services distributed across five Indian regions. We adapted the World Health Organization’s pathway encounter form. Results: Of the 998 participants, 98% were males, 49.4% were rural, and 20% were indigenous population. Addiction services dominated initial (50%) and subsequent (60%) healthcare contacts. One in five contacted private for-profit healthcare. Primary care contact was rare (5/998). Diverse approaches included traditional healers (4–6%) and self-medication (2–8%). There was a 3-year delay in first contact; younger, educated individuals with opioid dependence preferred specialized services. Conclusion: There is a need to strengthen public healthcare infrastructure and delivery systems and integrate SUD treatment into public healthcare.

Abstract In bread wheat, a literature search gave 228 QTLs for six traits, including resistance against spot blotch and the following five other related traits: (i) stay green; (ii) flag leaf senescence; (iii) green leaf area duration; (iv) green leaf area of the main stem; and (v) black point resistance. These QTLs were used for metaQTL (MQTL) analysis. For this purpose, a consensus map with 72,788 markers was prepared; 69 of the above 228 QTLs, which were suitable for MQTL analysis, were projected on the consensus map. This exercise resulted in the identification of 16 meta-QTLs (MQTLs) located on 11 chromosomes, with the PVE ranging from 5.4% (MQTL7) to 21.8% (MQTL5), and the confidence intervals ranging from 1.5 to 20.7 cM (except five MQTLs with a range of 36.1–57.8 cM). The number of QTLs associated with individual MQTLs ranged from a maximum of 17 in MQTL3 to 8 each in MQTL5 and MQTL8 and 5 each in MQTL7 and MQTL14. The 16 MQTLs, included 12 multi-trait MQTLs; one of the MQTL also overlapped a genomic region carrying the major spot blotch resistance gene Sb1. Of the total 16 MQTLs, 12 MQTLs were also validated through marker-trait associations that were available from earlier genome-wide association studies. The genomic regions associated with MQTLs were also used for the identification of candidate genes (CGs) and led to the identification of 516 CGs encoding 508 proteins; 411 of these proteins are known to be associated with resistance against several biotic stresses. In silico expression analysis of CGs using transcriptome data allowed the identification of 71 differentially expressed CGs, which were examined for further possible studies. The findings of the present study should facilitate fine-mapping and cloning of genes, enabling Marker Assisted Selection.

Background: Rapidity and reliability are the major advantages of cytopathology in tumor diagnosis. The need for minimal turnaround time for assessing cytological smears has encouraged innovations in staining techniques that require lesser staining time with unequivocal cell morphology. Rapid Pap staining was introduced as a hybrid to conventional Pap stain. It improves staining quality, gets over the staining time in restriction, and is a more efficient technique financially. In the present study, a modified staining technique was adopted where phloxine is added as one of the cytoplasmic stain components in rapid Pap stain kits. Objective: The aim of this study was to assess whether the modification of the existing procedure by adding phloxine as one of the components of the cytoplasmic stain intensifies the cytoplasmic differentiation and cytoplasmic staining in gynecological smears. Materials and Methods: This was a prospective study done on 50 cases of gynecological smears. Two smears were collected from each patient and fixed in 100% propanol and stained with the rapid Pap stain kit procedure and modified rapid Pap stain with phloxine. Slides were then analyzed by two pathologists blinded to the staining method used. Five parameters were considered and scored (background, cell morphology, nuclear staining, cytoplasmic differentiation, and cytoplasmic staining). The quality index for each method was calculated by finding out the ratio of the actual score obtained to the maximum score possible. Results: Both the staining methods had comparable results. For both pathologists, the quality index calculated for modified Pap stain was found to be marginally higher than the quality index for rapid Pap. The mean quality index was comparable for modified Pap (0.91) and rapid Pap (0.89). Conclusions: The efficacy of modified Pap stain with phloxine to distinctly stain the cytoplasm is comparable with that of rapid Pap stain. In addition, the intensity of staining can be enhanced with little cost outlay, and this can be especially beneficial in low-resource settings.

Advancing understanding of the diverse properties of essential oils has spurred a significant increase in both their production and application. The current research aimed to study the chemical, physical, and antifungal characteristics of Vinca rosea leaves’ essential oil compared to its extract. The leaf’s essential oil and extract composition were examined using GC-MS and further tested for antifungal activity against Fusarium graminearum and Bipolaris sorokiniana by poisoned food technique. 34 compounds were identified in leaves essential oil predominantly composed of butylated hydroxytoluene (32.74%). The methanolic extract showed the presence of alkaloids, mainly vindoline, and the non-polar extract showed the presence of cholesterol as the primary compound. The methanolic extract demonstrated stronger antifungal activity against F. graminearum, with ED50 and ED90 of 80 and 240 µg/mL, compared to the essential oil, which had higher ED50 and ED90 of 98 and 865 µg/mL, respectively. In the case of B. sorokiniana, ED50 values of methanol extract, essential oil, and hexane extract were 76, 100, and >1000 µg/ml, respectively, and ED90 were observed to be 290, 875, and >1000 µg/ml. Vinca rosea essential oil can potentially be used to develop natural antifungal agents. For the first time, the chemical composition of the essential oil of V. rosea cultivated in the Northern Indian region is being reported.

Five derived forms of 2-oxo-2-H-chromene clubbed guanine, thiazole and imidazoline derivatives 10 (i–v), 11 (i–v), and 12 (i–v) were synthesized, characterized, and biologically tested for in vitro antimicrobial activity against two types of bacteria viz. Staphylococcus aureus (MTCC 87) and Escherichia coli (MTCC 40). The synthesized compounds demonstrated mild to moderate antibacterial activity against Escherichia coli and Staphylococcus aureus at all concentrations (100 μg/ml, 250 μg/ml, and 500 μg/ml) in comparison to standard drug ciprofloxacin. It was observed that the compounds 10i, 10v, 11i, 11v, 12i, 12ii, 12iv and 12v have noticeable activity at higher dose in comparison to standard drug. Zone of inhibition values indicated higher antimicrobial activity at 500 μg/ml against Escherichia coli and Staphylococcus aureus in case of imidazoline and thiazole clubbed coumarin derivatives in comparison to guanine derivatives. The guanine derivatives have been found to be potent at lower dose (100 μg/ml) in comparison to thiazole and imidazoline derivatives having negligible activity at 100 μg/ml. This suggests a differential efficacy profile among the synthesized compounds, with guanine derivatives showing promising activity at lower doses while thiazole and imidazole derivatives manifesting increased potency at higher concentrations. These findings underscore the potential of these novel compounds as antimicrobial agents, warranting further investigation into their mechanisms of action and therapeutic applications.

The Transforming Growth Factor beta (TGF-β) family consists of numerous secreted peptide growth factors that play significant roles in cell function, tissue patterning, and organismal homeostasis, including wound repair and immunity. Typically studied as homodimers, these ligands have the potential to diversify their functions through ligand interactions that may enhance, repress, or generate novel functions. In the nematode Caenorhabditis elegans, there are only five TGF-β ligands, providing an opportunity to dissect ligand interactions in fewer combinations than in vertebrates. As in vertebrates, these ligands can be divided into bone morphogenetic protein (BMP) and TGF-β/Activin subfamilies that predominantly signal through discrete signaling pathways. The BMP subfamily ligand DBL-1 has been well studied for its role in the innate immune response in C. elegans. Here we show that all five TGF-β ligands play a role in survival on bacterial pathogens. We also demonstrate that multiple TGF-β ligand pairs act nonredundantly as part of this response. We show that the two BMP-like ligands-DBL-1 and TIG-2-function independently of each other in the immune response, while TIG-2/BMP and the TGF-β/Activin-like ligand TIG-3 function together. Structural modeling supports the potential for TIG-2 and TIG-3 to form heterodimers. Additionally, we identify TIG-2 and TIG-3 as members of a rare subset of TGF-β ligands lacking the conserved cysteine responsible for disulfide linking mature dimers. Finally, we show that canonical DBL-1/BMP receptor and Smad signal transducers function in the response to bacterial pathogens, while components of the DAF-7 TGF-β/Activin signaling pathway do not play a major role in survival. These results demonstrate a novel potential for BMP and TGF-β/Activin subfamily ligands to interact and may provide a mechanism for distinguishing the developmental and homeostatic functions of these ligands from an acute response such as the innate immune response to bacterial pathogens.

Introduction: The most crucial factor in improving animal reproduction efficiency is early pregnancy diagnosis. Early diagnosis not only reduces the time interval between two calvings but also aids farmers in identifying open animals, thereby preventing significant milk production losses. Therefore, the objective of this study was to discover circulatory miRNAs that would be useful for early pregnancy diagnosis in buffalo.Material and methods: Blood samples were taken on 0, 6th, 12th, and 18th day after artificial insemination from pregnant animals (n = 30) and non-pregnant animals (n = 20). During these stages of pregnancy, total RNA was extracted, and a small RNA library was subsequently generated and sequenced on the Illumina platform. Subsequently, Real-time PCR was used to validate the findings.Results and discussion: There were 4,022 miRNAs found during the pregnancy, with 15 of those lacking sequences and 4,007 having sequences already in the database. From the beginning of pregnancy until the 18th day, 25 of these miRNAs showed a substantial shift in expression levels in the maternal blood, with a change more than two logs. Furthermore, based on qPCR results, 19 miRNAs were found to be more abundant in pregnant animals than in non-pregnant animals. We used target prediction analysis to learn how maternally expressed miRNAs relate to fetal-maternal communication. In conclusion, miRNA based biomarkers that could be associated with the diagnosis of pregnancy were identified including miR-181a and miR-486 highly upregulated on the 18th day of pregnancy. This study also provides a comprehensive profile of the entire miRNA population in maternal buffalo blood during the early stages of pregnancy.

Children who learn two languages differ in their language learning experience in comparison to the monolinguals. In order to investigate lexical semantic knowledge, picture naming method is primarily used. Kohnert, 2002 reported increasing name agreement for pictures as proficiency in each language increased. Age and language factors seem to have a positive effect on the naming task in both mixed and single language conditions, although the processing of single language is faster than mixed language (Kohnert, Bates, Hernandez, 1999; Naranowicz et al, 2022). In Indian context, Cherian (2008) investigated verb processing of Malayalam-English bilinguals, in high and low competition conditions. She implied a different verb processing in L1 and L2 languages which varies according to years of exposure with L2. The present study focuses on identifying the patterns of lexical development within heterogeneous groups of school going Kannada-English bilingual children using noun processing and thus determines the effect of dual-language control in these bilinguals. The results indicated improved accuracy improved with increased age and language experience for processing of nouns. In 5 to 7 age group, the performance in blocked condition is better than that in the mixed condition. Overall results signify superior Noun processing in low competition when compared to the high competition condition for Kannada-English bilingual children. Apart from this, the study also implies that age and language experiences play an important role in processing of nouns. Thereby, bilingual children respond better for L1 (Kannada) in younger age groups, though the language dominance becomes parallel for both the languages, with language experience and age. The noun processing in bilingual children is different in L1 and L2 languages and varies according to years of exposure with L2 language. This is an important aspect which needs to be considered while assessing the lexical processing of a bilingual child.

Abstract Nebraska is the number‐one producer of food‐grade white corn (Zea mays L.) in the United States. Food‐grade white corn has not been genetically engineered; therefore, non‐selective herbicides such as glyphosate or glufosinate cannot be used. Multiple herbicide‐resistant (MHR) Palmer amaranth (Amaranthus palmeri S. Watson) populations have been reported in multiple counties in Nebraska, and their management is a challenge, particularly for white corn producers. The objectives of this study were to evaluate the residual activity of pre‐emergence (PRE) herbicides for acetolactate synthase inhibitor (halosulfuron‐methyl)/atrazine/glyphosate‐resistant Palmer amaranth control, density, biomass, seed production, and grain yield in food‐grade white corn. Field experiments were conducted during summer 2020 and 2021 in a grower's field infested with MHR Palmer amaranth near Carleton, NE. All the PRE herbicides resulted in similar control (>90%) 30 days after PRE application (DAPRE) apart from atrazine (64%). At 45 DAPRE, acetochlor/mesotrione, atrazine/bicyclopyrone/mesotrione/S‐metolachlor, and acetochlor/clopyralid/mesotrione controlled 90%–95% Palmer amaranth. Acetochlor/clopyralid/mesotrione and atrazine/bicyclopyrone/mesotrione/S‐metolachlor provided 96%–99% MHR Palmer amaranth control and reduced Palmer amaranth density and biomass to 2–4 plants m−2 and 5–12 g m−2 60 DAPRE. The highest corn yields of 12,139 kg ha−1 and 12,093 kg ha−1 in 2020 and 2021, respectively, were obtained with acetochlor/clopyralid/mesotrione. Palmer amaranth seed production was least with acetochlor/clopyralid/mesotrione (32,894 seeds m−2). Tested residual PRE herbicides did not show corn injury and were safe to use in food‐grade white corn. It is concluded that acetochlor/clopyralid/mesotrione and atrazine/bicyclopyone/mesotrione/S‐metolachlor are the best options for early season control of MHR Palmer amaranth in food‐grade white corn.

Background/Aims The inflammatory bowel disease (IBD)-disk is a validated, visual, 10-item, self-administered questionnaire used to evaluate IBD-related disability. The present study aimed to evaluate IBD-disk in assessment of IBD daily life burden and its relation with disease activity. Methods A cross-sectional study was conducted between June 2021 and December 2021. Patients with IBD were asked to complete the IBD-disk and a visual analogue scale of IBD daily-life burden (scored from 0–10, score >5 indicative of high burden). The internal consistency of IBD-disk, correlation with IBD daily life burden and disease activity (assessed by partial Mayo score and Harvey Bradshaw Index in patients with ulcerative colitis [UC] and Crohn’s disease [CD], respectively) and diagnostic performance of IBD-disk to detect high burden were analyzed. Results Out of the 546 patients (mean age 40.33±13.74 years, 282 [51.6%] males) who completed the IBD-disk, 464 (84.98%) had UC and the remaining (n=82, 15.02%) had CD. A total of 311 patients (291 UC and 20 CD; 56.95%) had active disease. The mean IBD-disk total score and IBD daily life burden were 18.39±15.23 and 2.45±2.02, respectively. The IBD-disk total score correlated strongly with the IBD daily life burden (ρ=0.94, P30 predicted high IBD daily-life burden. Conclusions The IBD-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD and can be applied in clinical practice. (Intest Res, Published online )

Background: Extubation failure occurs in 5%–20% of patients and is associated with poor clinical outcomes. The primary aim of this project was to determine the predictive ability of the Respiratory Insufficiency (RI) index, Respiratory Oxygenation (ROX) index and Modified Early Warning Score (MEWS) in identifying extubation failure. Methods: This was a secondary analysis of a prior cross-sectional retrospective study conducted from February 2018 through December 2018 among adult subjects who received mechanical ventilation for more than 24 h. Extubation failure was defined as the need for reintubation or rescue non-invasive ventilation (NIV) within 48 h after planned extubation. Univariate analysis and logistic regression were used to identify the predictors and final model was validated using 10-fold cross validation. Nomogram was constructed based on the final model. Results: Of 216 enrolled subjects, 46 (21.3%) experienced extubation failure. The median RI index 1-h post extubation was 20 [interquartile range [IQR] 16.33–24.24] for success group and 27.02 [IQR 22.42–33.83] for the failure group (P60 years [OR 3.89 (95% CI 1.56–9.73); P=0.004], MEWS >4 [OR 4.01 (95% CI (1.59–10.14); P=0.003] and, RI index >20 [OR 4.50 (95% CI 1.43–14.21); P=0.010] were independently associated with extubation failure. Conclusion: In the present study, RI index and MEWS were independently associated with predicting extubation failure within 1 h of extubation. A prospective validation study is warranted to establish the role of these indices in predicting extubation outcome.

Multiple herbicide-resistant (MHR) Palmer amaranth is a troublesome weed in several crops across the USA, including corn. Due to unavoidable weather conditions, it is sometimes not possible for growers to apply pre-emergence herbicide; therefore, post-emergence (POST) herbicide is needed for effective control of MHR Palmer amaranth. The objectives of this study were to evaluate the effect of POST herbicides applied at two heights (10-15 cm and 20-30 cm) for MHR Palmer amaranth control and their effect on Palmer amaranth biomass, density, and seed production as well as yield of glufosinate/glyphosate-resistant corn. Field experiments were conducted at a grower’s field near Carleton, Nebraska, USA in 2020 and 2021. Control of MHR Palmer amaranth was affected by the plant height when herbicides were applied. Glufosinate, dicamba, dicamba/diflufenzopyr, and dicamba/tembotrione applied to 10-15 cm tall Palmer amaranth provided ≥ 94% control 30 d after EPOST (DAEPOST), whereas atrazine/bicyclopyone/mesotrione/S-metolachlor applied to 20-30 cm tall MHR Palmer amaranth provided 85% control in 2021. Glufosinate provided 85% to 90% control when applied to 20-30 cm tall Palmer amaranth in both years. At 90 DALPOST, dicamba, dicamba/diflufenzopyr, and dicamba/tembotrione applied to 10-15 cm tall Palmer amaranth provided ≥ 88% control. Dicamba/tembotrione, atrazine/bicyclopyone/mesotrione/S–metolachlor, and dicamba applied to 20-30 cm tall Palmer amaranth provided 85% to 92% control. Glufosinate, dicamba, and atrazine/bicyclopyone/mesotrione/S–metolachlor were the most effective for reducing Palmer amaranth density 2 to 19 plants m−2 when applied to 10-15 cm Palmer amaranth 30 DAEPOST compared with the nontreated control (137 plants m−2) in 2021; however, when applied to 20-30 cm Palmer amaranth, glufosinate, and atrazine/bicyclopyone/mesotrione/S–metolachlor reduced density 5 to 19 plants m−2. At 30 DAEPOST, glufosinate and atrazine/bicyclopyone/mesotrione/S–metolachlor had the lowest Palmer amaranth biomass (3-17 g m−2). Corn yield in 2020 was higher than 2021 due to more rain in 2020. All herbicides resulted in a similar yield in 2020. Lower seed production of 6,269 and 1,953 seeds plant-1 for 10-15 cm and 20-30 cm MHR Palmer amaranth were recorded with dicamba and atrazine/bicyclopyone/mesotrione/S–metolachlor.

The present study was undertaken with the objective to reconnoiter the role of Zat12-related biochemical activities in temperature stress tolerance in wheat transgenic lines Z-8-12 1A, Z-8-12 1B, Z-8-19, and Z-15-10, which were produced by transforming wheat-cultivar PBW 621. Zat12 transgenics (ZT) along with non-transgenic (NT) wheat cultivars (PBW 621, PBW, 550, and HD 3086) were assessed at the three-weeks seedling stage under chilling (−2 °C and −4 °C) and heat (30 °C and 32 °C) stress. Specific activities of superoxide dismutase (SOD), peroxidase (POD), ascorbate peroxidase (APX), glutathione-S-transferase (GST), glutathione reductase (GR), and antioxidants (proline and ascorbate) were profoundly increased under temperature stress in ZT related to NT. However, under −4 °C and 32 °C, a significantly higher increase was reported. In contrast, H2O2 and MDA were found to be much lower in ZT than in NT. Similarly, lesser decreases in length, fresh weight, and dry weight of seedlings were reported in ZT at 30 °C and 32 °C. RT-PCR studies revealed the enhanced expression of Zat12 in the roots of seedlings at the 5, 10, and 14 days after germination (DAG) stages in ZT under the stress conditions. Upregulation of the antioxidant defense system in ZT and their better tolerance depict an alternative for wheat cultivation under temperature stress-prone areas.

Rhododendron is a highly perishable and nutritious flower abundant in phytocompounds. However, due to its availability for a short span, it is not much exploited by food researchers. Therefore, the aim of the current study was to optimize the pre-treatments for drying of Rhododendron with maximum phytochemical retention. The effect of different variables was evaluated on the physico-chemical parameters (such as moisture, ash, protein, total sugars and reducing sugars) and phytocompounds (such as ascorbic acid, carotenoids, anthocyanin, total phenols, flavonoids, antioxidant activity and tannins). All the quality attributes were significantly (p ≤ 0.05) affected by blanching treatment and dipping time. Among the chemical pre-treatments, KMS had a significant (p ≤ 0.05) effect on the retention of all phytochemicals, whereas, citric acid could not possess a significant (p ≤ 0.05) effect on the phytochemicals. The optimum process conditions for Rhododendron flowers were found to be 3 min blanching time, 2000 ppm KMS, 0% citric acid, and 26.28 min dipping time along with 0.917 desirability. In the nutshell, it is concluded that KMS in combination with blanching, prior to drying has been proven beneficial in the preservation of the phytocompounds and has the potential to utilize as a new ingredient in various food products.

In recent years, saponins are gaining extensive attention due to their occurrence in several plants. Saponins and their derivatives are versatile glycosidic compounds, which play an important role in food, agriculture and pharmaceutical industries, ranging from as a natural additive in food and having their role in traditional medicines to various applications in the pharmaceutical sector. They possess immense therapeutic potential as hypolipidemic, hypoglycaemic, anti-asthmatic, antioxidant, anti-hypertensive, and anti-microbial activity along with few adverse effects such as cytotoxicity, etc. These emerging properties led to increased demand for saponins and therefore to meet the requirements, the researchers emphasize the synthetic production of saponins apart from the natural ones. The composition and bioavailability of saponins in food are significantly influenced by processing technologies because of the alterations between the linkages of aglycones and sugar chains. Therefore, an attempt has been made to make the consumer aware of the potential health benefits upon consumption of this magical compound. This review provides a concise and updated overview of saponins, the effect of different processing methods, health implications along various remedial effects and industrial uses of saponins.

# Background There is a lack of data assessing the influence of respiratory therapist (RT) education on clinical outcomes. The primary objective of this study was to evaluate the impact of RTs holding advanced degrees or completing adult critical care competencies on discharge outcomes of patients with COVID-19 pneumonia. # Study Design and Methods This retrospective, cross-sectional study included adults with confirmed COVID-19 admitted to the hospital for at least three days between March-May 2020. The academic degree held by each RT was considered advanced (baccalaureate or higher) or associate degree. Discharge outcomes were considered good, compromised, or poor when subjects' hospital discharge was directly to home, long-term care facility/rehabilitation center, or hospice/died, respectively. A time-to-event multi-state regression model was used to determine the impact of RT academic degree and adult critical care competencies on discharge outcomes using α=0.05. # Results A total of 260 subjects (median age 59 y; 166 males) received clinical care from 132 RTs. RT median professional experience was six y (IQR 3-11), 70.8% had an advanced degree, and 70.8% completed adult critical care competencies. The time-to-event multi-state regression model showed that patients with \>85% exposure to RTs with advanced degrees transitioned 3.72 times more frequently to good outcomes than RTs without advanced degrees (*p*=.001). Similarly, patients with \>85% exposure to RTs with adult critical care competencies transitioned 5.10 times more frequently to good outcomes than RTs without adult critical care competencies (*p*\

Background: Nonadherence to treatment is a recognized problem and the most challenging aspect of treatment, particularly in first-episode schizophrenia (FES). We aimed to identify a set of individuals in the social milieu of patients as opinion makers who play significant role in influencing treatment-seeking behavior in patients with FES. Materials and Methods: Patients with a diagnosis of schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fifth edition), first episode, were administered with a 20 items semi-structured questionnaire to identify the individuals and their role in treatment-seeking behavior of patients with FES. Results: A total of 72 patients were enrolled in the study. The mean age of the sample was 29 years (standard deviation [SD] ±7.35), and the mean duration of illness was 9.2 (SD ± 0.58) months. Our study shows that apart from treating psychiatrists, patient's family members and relatives play a crucial role in influencing treatment-seeking behavior such as treatment commencement, drug dose, formulation, place of treatment, etc., A large number of patients went to faith healers on the advice of family members (34.7%) and also followed the advice of family members regarding the duration of treatment (63.3%) as well as discontinuing treatment (63.3%). Conclusion: The index study concludes the role of family members/relatives as opinion makers in the social milieu of patients with FES in influencing treatment-related decisions and affecting adherence to treatment.

Abstract This paper examines the impact of COVID-19 on the mental health of people from different socioeconomic classes. This has been done by creating an anxiety score, based on responses to a set of questions that were asked as part of a two-round telephonic survey done by Young Lives Data for India. Using this index, anxiety levels have been classified as high, medium, and low. As the dependent variable has an ordered nature, an ordered logit model has been used for regression. According to the results, job loss, death of the family’s earning member or mishap in the family, and price increases all contributed to increased anxiety. The analysis indicates that anxiety levels among women were higher than among men because of the increased burden of household chores and childcare responsibilities. Also, anxiety levels were higher among those who perceived themselves as rich or poor as opposed to those who were comfortable in their income group. There was a higher anxiety level among the rich due to income loss and increased household responsibilities. A high percentage of children and elders reported feeling anxious; school closures and a lack of social interaction caused stress. Isolation also plagued the elderly. Furthermore, many students couldn’t avail online learning opportunities due to a lack of resources. The government implemented many policies to mitigate these issues, which included those to mitigate the immediate hunger problem.

Background: Respiratory therapists (RTs) faced many unpredicted challenges and higher stress levels while managing critically ill patients with the coronavirus disease (COVID-19). This study’s primary objective was to evaluate the compassion satisfaction and compassion fatigue among RTs in the United States during the COVID-19 pandemic. Methods: This cross-sectional, descriptive, survey-based study conducted from July 2020 to August 2020 was administered to all active members of the American Association of Respiratory Care via AARConnect. RTs’ characteristics including personal, job-specific, and organizational factors were collected. Professional Quality of Life Scale (ProQOL, version 5) was used to measure compassion satisfaction and fatigue. Results: A total of 218 participants fully completed the survey, 143 (65.6%) were female, 107 (49.1%) were between 35 and 54 years of age and 72 (33%) were above 55 years of age. Compassion satisfaction was moderate in 123 (56.4%) and high in 93 (42.7%) RTs. Higher compassion satisfaction was found in RTs who have a higher salary (P = 0.003), work overtime (P = 0.01), hold leadership positions (P < 0.001), work in research/education (P < 0.001) and work for departments that provide help in managing burnout and stress (P = 0.007) and that promote a positive work environment (P < 0.001). Burnout score was low in 90 (41.3%) and moderate in 127 (58.3%) RTs. Higher burnout was found among younger RTs (P = 0.019), those with fewer years of experience (P = 0.013) and those with less than a year at their current job (P = 0.045). Secondary traumatic stress (STS) was low in 106 (48.6%) and moderate in 112 (51.4%) RTs. Higher STS levels were noted among younger RTs (P = 0.02) and RTs with lower education levels (P = 0.016). Conclusion: This survey study identified various personal, job and organizational-related factors associated with increased compassion satisfaction as well as compassion fatigue among RTs.

Powdery mildew (PM), caused by the fungal pathogen Blumeria graminis f. sp. tritici (Bgt), significantly threatens global bread wheat production. Although the use of resistant cultivars is an effective strategy for managing PM, currently available wheat cultivars lack sufficient levels of resistance. To tackle this challenge, we conducted a comprehensive genome-wide association study (GWAS) using a diverse panel of 286 bread wheat genotypes. Over three consecutive years (2020–2021, 2021–2022, and 2022–2023), these genotypes were extensively evaluated for PM severity under field conditions following inoculation with virulent Bgt isolates. The panel was previously genotyped using the Illumina 90K Infinium iSelect assay to obtain genome-wide single-nucleotide polymorphism (SNP) marker coverage. By applying FarmCPU, a multilocus mixed model, we identified a total of 113 marker–trait associations (MTAs) located on chromosomes 1A, 1B, 2B, 3A, 3B, 4A, 4B, 5A, 5B, 6B, 7A, and 7B at a significance level of p ≤ 0.001. Notably, four novel MTAs on chromosome 6B were consistently detected in 2020–2021 and 2021–2022. Furthermore, within the confidence intervals of the identified SNPs, we identified 96 candidate genes belonging to different proteins including 12 disease resistance/host–pathogen interaction-related protein families. Among these, protein kinases, leucine-rich repeats, and zinc finger proteins were of particular interest due to their potential roles in PM resistance. These identified loci can serve as targets for breeding programs aimed at developing disease-resistant wheat cultivars.

Background: Compassionate extubation (CE) refers to withdrawing mechanical ventilation and allowing a patient to die peacefully at the end of life. The primary objective of this pilot study was to quantify the emotional impact of CE on Respiratory Therapists (RT) and Registered Nurses (RNs). Methods: This pilot survey was conducted between March and April 2021 at an academic medical center among RTs and RNs. It included questions on participants’ demographics, work characteristics, and Impact of Events (IES) scale to assess the subjective stress caused by CE. Data were analyzed using descriptive and χ2 statistics. Results: Among 20 participants, 18 (90%) were females, 12 (60%) were in the 20–40-year age group, 12 (60%) were RTs, and 8 (40%) RNs. Around 15 (75%) participants worked day shifts with a weekly average of 3–4 shifts, and 14 (70%) performed/observed CE within 1 month before taking this survey. CE performed/observed in a month was ≤2 among 15 (75%) and 3–5 among 4 (20%) participants. Mean total IES score was 16.7 (12.3) among all participants representing 7 (35%) having low, 6 (30%) moderate, and 7 (35%) high emotional impact when performing CE. Risk of developing post-traumatic stress disorder (PTSD) was present in 6 (30%) participants. A significantly higher number of participants in the low impact group were satisfied with the institutional CE process (p = 0.043) than those in the medium/high impact group. Conclusion: This pilot study findings reveal that RTs and RNs experience moderate to high levels of subjective stress when performing CE. One-third of the survey participants were at risk of developing PTSD.

Abstract Background Awake prone positioning (APP) reduces the intubation rate in COVID-19 patients treated by high-flow nasal cannula (HFNC). However, the lung aeration response to APP has not been addressed. We aimed to explore the lung aeration response to APP by lung ultrasound (LUS). Methods This two-center, prospective, observational study enrolled patients with COVID-19-induced acute hypoxemic respiratory failure treated by HFNC and APP. LUS score was recorded 5–10 min before, 1 h after APP, and 5–10 min after supine in the first APP session within the first three days. The primary outcome was LUS score changes in the first three days. Secondary outcomes included changes in SpO2/FiO2 ratio, respiratory rate and ROX index (SpO2/FiO2/respiratory rate) related to APP, and the rate of treatment success (patients who avoided intubation). Results Seventy-one patients were enrolled. LUS score decreased from 20 (interquartile range [IQR] 19–24) to 19 (18–21) (p 1 after the first APP session was associated with decreased risk for intubation (Relative risk 0.25 [0.09–0.69]). APP daily duration was correlated with LUS score reduction in patients with treatment success, especially in dorsal lung zones (r = − 0.76; p

Abstract Within the growing family of strained carbon nanohoops and nanobelts, [10]CPP arguably offers the best compromise between synthetic accessibility and strong binding affinity for C60. In this work, we report the synthesis of two nitrogen-containing analogues of [10]CPP and we systematically compare the structure, optoelectronic properties and C60 binding affinities of this small set of structurally similar macrocycles. While Aza[10]CPP outcompetes the parent compound by approximately one order of magnitude with respect to C60 binding, we found that the reverse was true for the methylaza analogue. Transient absorption studies showed that photo-induced electron transfer occurred readily from [10]CPP and its aza-analogue to an encapsulated C60 guest. Formation of a charge-separated complex was not observed however for the N-methylated derivative. These insights will prove useful for further applications of strained nanohoops in supramolecular chemistry and organic electronics.

Introduction: Cancer related fatigue, a problem often less understood and under-diagnosed. It is imperative to find non-invasive and non-pharmacological solutions for managing it. The aim of the study was to assess the effect of pranayama on reducing the level of Fatigue during External Radiation Therapy (ERT) among the patients in a selected cancer hospital of Guwahati, Assam. Materials and methods: The study adopted Quantitative evaluative approach; randomized pre-test post-test control group design. Simple random sampling technique without replacement was used and 84 cancer patients were equally divided in control group (42) and experimental group (42). The pre-test level of fatigue was assessed from both the groups and pranayama as intervention was given to experimental group. Result: Pranayama was found to be effective in patients receiving ERT. It was found that following pranayama, majority in experimental group 41 (97.6%) had mild level of fatigue whereas in control group 27 (64.3%) experienced severe level of fatigue. There is significant mean difference in the experimental group as compared to control group after the intervention of pranayama (t=17.99, df=41, p-value=

Cypermethrin insecticide is widely used to prevent and control pest and crop diseases though, its residues have caused significant damage to the environment and living organisms. Microbial remediation becomes a popular approach to counter the toxicity of cypermethrin in both aquatic as well as terrestrial life. Cypermethrin can be effectively degraded to nontoxic compounds by bacterial and fungal strains. Various bacterial and fungal strains such as Ochrobactrum lupini DG-S-01, Bacillus sp. strain SG2, Azoarcus indigens strain HZ5, Streptomyces aureus strain HP-S-01, and Aspergillus oryzae M-4 are used for the cypermethrin degradation. Extensive usage of cypermethrin has caused problems such as surface water contamination, reduced fertility of the soil, detrimental effects on soil microbiota and non-targeted species. Due to environmental concerns associated with the cypermethrin in groundwater and food products, there is a crucial need to develop economical, rapid, and reliable techniques that can be used for field applications. An in-depth understanding of cypermethrin is explored in this review paper and possible solutions to mitigate its environmental toxicity are suggested.

Generation mean analysis of brinjal lines, GL 401 × BR 104 (CROSS I), GL 401 × W 230 (CROSS II) and W 230 × RMO 1142 (CROSS III) six generation of three crosses viz. highlighted the involvement of epistatic interactions (duplicate) for most of the qualitative traits. However, the number of fruits per plant in CROSS I & III and fruit girth, calyx length, and yield per plant in CROSS II confirmed the occurrence of complementary epistasis. Mainly, additive effect for fruit girth, non-additive effect for calyx length, calyx width, peduncle girth, fruit weight, and fruit length, and both types for peduncle length, number of fruits /cluster, number of fruits/ plant, and yield/ plant were experienced. Additive × dominance or dominance × dominance type of interactions were more prevalent than additive × additive type of interactions for different traits. Cluster bearing was monogenic dominant and green color of calyx as well as peduncle was dominant over purple with the duplicate type of epistasis. Fruit shape was dgenic with incomplete dominance. Fruit color displayed digenic control in CROSS I & II and tri-genic ratio in CROSS III with incomplete dominance of purple and green pigmentations producing variable color intensity in homozygous or heterozygous conditions.

Introduction: Sedation with propofol during interventional gastrointestinal endoscopy is usually accomplished with two main modes-intermittent manually controlled using a syringe, and continuous infusion using an infusion device. Aim: To compare the effect of bolus administration and infusion of propofol on recovery profile during sedation in patients undergoing interventional endoscopy procedures. Materials and Methods: The present study was a single-blinded randomised study in which 120 patients, belonging to American Society of Anaesthesiologists (ASA) grade I and II, of either gender, and age 18-70 years, were randomly assigned to receive intermittent bolus (Bolus Group, BG) or continuous infusion (Infusion Group, IG) of propofol sedation after induction with 2 mg Midazolam for deep sedation. BG patients received an initial dose of propofol, 1%, according to body weight (60 kg: 60 mg), followed by boluses of 10-20 mg adjusted to maintain a Modified Observer’s Assessment of Alertness /Sedation Scale (MOAA/S) of 0 or 1. In the IG, continuous propofol infusion (4-6 mg/kg/hr) via Graseby 2000 (Smiths Medical) was administered after a bolus of 1 mg/kg of propofol. Vital signs, recovery time, quality of recovery, total dose of propofol, side-effects as well as patient and endoscopist satisfaction score were evaluated. The data was compiled systematically and analysed using unpaired Student’s t-test and Chi-square test. The p-value

BackgroundNutcracker syndrome (NS) is an uncommon condition resulting from the compression of the left renal vein (LRV) between the aorta and superior mesenteric artery (SMA), resulting in symptoms such as flank pain and hematuria.Case presentationWe present the case of a 30-year-old woman complaining of abdominal pain who was found to have nutcracker syndrome and treated with endovascular stenting of the left renal vein.DiscussionWe review the literature related to endovascular treatment of NS with focus on the distribution of the sizes of stents and rates of stent migration.ConclusionNC is a rare condition requiring a high index of suspicion for diagnosis. Endovascular treatment is a reasonable option, but its limitations must be considered.

Mulberry (Morus alba L.) is having numerous natural phytocompounds, which possess nutritional and pharmaceutical value. Due to its perishable nature and limited availability, it is not yet much explored except for its value addition. However, the wholesomeness in terms of shape has been always ignored. Therefore, the aim of present study was to optimize the processing conditions for production of osmo-dehydrated (OD) mulberry and retaining the shape of the fruit. The effect of three process variables i.e., blanching time (0 to 180 s), syrup concentration (45 to 75 obrix) and drying temperature (45–60 °C) was evaluated on the quality attributes of OD mulberry. All the phytochemicals were significantly (p ≤ 0.05) affected during processing conditions. The optimized conditions for the development of OD mulberry were 170 s blanching time, 66.52°brix syrup concentration and 53.48 °C drying temperature with 0.84 desirability. All the variables possess an important role in the quality of mulberry as revealed during cluster analysis. The optimized sample had more nutritional and phytochemical potential as confirmed during the qualitative analysis. In a nutshell, it is concluded that optimized conditions can be used to produce OD mulberry along with maintenance of original shape and to make it available at off places and during off seasons.

Abstract Background Awake prone positioning (APP) is widely used in the management of patients with coronavirus disease (COVID-19). The primary objective of this study was to compare the outcome of COVID-19 patients who received early versus late APP. Methods Post hoc analysis of data collected for a randomized controlled trial (ClinicalTrials.gov NCT04325906). Adult patients with acute hypoxemic respiratory failure secondary to COVID-19 who received APP for at least one hour were included. Early prone positioning was defined as APP initiated within 24 h of high-flow nasal cannula (HFNC) start. Primary outcomes were 28-day mortality and intubation rate. Results We included 125 patients (79 male) with a mean age of 62 years. Of them, 92 (73.6%) received early APP and 33 (26.4%) received late APP. Median time from HFNC initiation to APP was 2.25 (0.8–12.82) vs 36.35 (30.2–75.23) hours in the early and late APP group (p

The spotted bollworm Earias vittella (Lepidoptera: Nolidae) is a polyphagous pest with enormous economic significance, primarily affecting cotton and okra. However, the lack of gene sequence information on this pest has a significant constraint on molecular investigations and the formulation of superior pest management strategies. An RNA-seq-based transcriptome study was conducted to alleviate such limitations, and de novo assembly was performed to obtain transcript sequences of this pest. Reference gene identification across E. vittella developmental stages and RNAi treatments were conducted using its sequence information, which resulted in identifying transcription elongation factor (TEF), V-type proton ATPase (V-ATPase), and Glyceraldehyde -3-phosphate dehydrogenase (GAPDH) as the most suitable reference genes for normalization in RT-qPCR-based gene expression studies. The present study also identified important developmental, RNAi pathway, and RNAi target genes and performed life-stage developmental expression analysis using RT-qPCR to select the optimal targets for RNAi. We found that naked dsRNA degradation in the E. vittella hemolymph is the primary reason for poor RNAi. A total of six genes including Juvenile hormone methyl transferase (JHAMT), Chitin synthase (CHS), Aminopeptidase (AMN), Cadherin (CAD), Alpha-amylase (AMY), and V-type proton ATPase (V-ATPase) were selected and knocked down significantly with three different nanoparticles encapsulated dsRNA conjugates, i.e., Chitosan-dsRNA, carbon quantum dots-dsRNA (CQD-dsRNA), and Lipofectamine-dsRNA conjugate. These results demonstrate that feeding nanoparticle-shielded dsRNA silences target genes and suggests that nanoparticle-based RNAi can efficiently manage this pest.

Religion is an abstract concept encompassing specific set of organized beliefs and practices, usually shared by a community or group, whereas spirituality is more of an individual practice dealing with having a sense of peace and purpose. Religion and psychiatric illness too share a complex relationship and intent for religious conversions pose a diagnostic dilemma in many cases. This relationship is further being influenced by easy access to social media and excessive smartphone use in the contemporary world. Here, we discuss two cases of young males who presented to us with intense desire to change their religion (interest generated after watching YouTube videos and listening to speeches on the smartphone), consequently leading to interpersonal problems and psychopathology. The management approach highlights the need to identify the intent and knowledge for religious change, differentiate individual preferences from that of the family/society, avoiding misdiagnosis and focusing on symptom resolution and improving functionality.

Background: Child sexual abuse occurs in a variety of settings and the POCSO Act, 2012 came into force with effect from November 14, 2012. Objectives: A community-based cross-sectional study to assess the knowledge regarding the POCSO Act among adults in the rural community of Chandigarh was carried out in full compliance with ethical standards provided by the institutional research and ethical committee. Materials and Methods: A nonprobability sampling technique was used to select 190 subjects from Sector 56, Palsora, Chandigarh. Results: This study found that 55.8% have an adequate level of knowledge and 44.2% have an inadequate level of knowledge. Conclusions: The variables heard or seen by a victim of child abuse have only significant associations with the level of knowledge.

Shikonin and its derivatives, isolated from traditional medicinal plant species of the genus Lithospermum, Alkanna, Arnebia, Anchusa, Onosma, and Echium belonging to the Boraginaceae family, have numerous applications in foods, cosmetics, and textiles. Shikonin, a potent bioactive red pigment, has been used in traditional medicinal systems to cure various ailments and is well known for its diverse pharmacological potential such as anticancer, antithrombotic, neuroprotective, antidiabetic, antiviral, anti-inflammatory, anti-gonadotropic, antioxidants, antimicrobial and insecticidal. Herein, updated research on the natural sources, pharmacology, toxicity studies, and various patents filed worldwide related to shikonin and approaches to shikonin’s biogenic and chemical synthesis are reviewed. Furthermore, recent studies to establish reliable production systems to meet market demand, functional identification, and future clinical development of shikonin and its derivatives against various diseases are presented.

Background: Medications studied for therapeutic benefits in coronavirus disease 2019 (COVID-19) have produced inconclusive efficacy results except for steroids. Objective: A prospective randomized open-label, parallel-arm Phase I/II clinical trial was planned to compare essential oil (EO) blend versus placebo nebulization in mild COVID-19. Methods: A Phase I safety evaluation was carried out in a single ascending and multiple ascending dose study designs. We assessed Phase II therapeutic efficacy on COVID-19 and general respiratory symptoms on days 0, 3, 5, 7, 10, and 14 on the predesigned case record form. Viremia was evaluated on day 0, day 5, and day 10. Results: Dose-limiting toxicities were not reached with the doses, frequencies, and duration studied, thus confirming the formulation's preliminary safety. General respiratory symptoms (p

Essential oils possessing antimicrobial characteristics have acquired considerable interest as an alternative to chemical preservatives in food products. This research hypothesizes that mānuka (MO) and kānuka (KO) oils may possess antimicrobial characteristics and have the potential to be used as natural preservatives for food applications. Initial experimentation was conducted to characterize MOs (with 5, 25, and 40% triketone contents), rosemary oil (RO) along with kanuka oil (KO) for their antibacterial efficacy against selected Gram-negative (Salmonella spp. and Escherichia coli), and Gram-positive (Listeria monocytogenes and Staphylococcus aureus) bacteria through disc diffusion and broth dilution assays. All MOs showed a higher antimicrobial effect against L. monocytogenes and S. aureus with a minimum inhibitory concentration below 0.04%, compared with KO (0.63%) and RO (2.5%). In chemical composition, α-pinene in KO, 1, 8 cineole in RO, calamenene, and leptospermone in MO were the major compounds, confirmed through Gas-chromatography-mass spectrometry analysis. Further, the antimicrobial effect of MO and RO in vacuum-packed beef pastes prepared from New Zealand commercial breed (3% fat) and wagyu (12% fat) beef tenderloins during 16 days of refrigerated storage was compared with sodium nitrate (SN) and control (without added oil). In both meat types, compared with the SN-treated and control samples, lower growth of L. monocytogenes and S. aureus in MO- and RO- treated samples was observed. However, for Salmonella and E. coli, RO treatment inhibited microbial growth most effectively. The results suggest the potential use of MO as a partial replacement for synthetic preservatives like sodium nitrate in meats, especially against L. monocytogenes and S. aureus.

Background and Aims: Tracheostomy is a commonly performed procedure in critically ill patients because patients requiring chronic mechanical ventilation (MV) are rising by as much as 5.5% per year. The controversy on likely benefits of early versus late tracheostomy is ongoing. We aimed to study the impact of early versus late tracheostomy on patient outcomes. Material and Methods: A retrospective observational study was performed in intensive care unit (ICU) patients who underwent tracheostomy in a 31-bedded multispeciality ICU of a 350-bedded tertiary care hospital, over a period of 1 year. Data collected included the age, sex, APACHE II score, indication for tracheostomy, timing of procedure, whether surgical or percutaneous, any complication, MV days, ICU stay, and patient outcome. Patients were divided into two groups for statistical comparison: early ≤7 days and late >7 days of MV. Results: A total of 102 patients underwent tracheostomy over the study period, of which 19 were excluded because of inadequate data and exclusion criteria. Of the 83 study patients, 60 had percutaneous, while 23 had surgical tracheostomy. About 51 (61.45%) had early, while 32 (38.55%) had late tracheostomy. On statistical analysis, there was a significant difference in MV days (5 vs 12.5 days, P = 0.002), ICU stay (10 vs 16 days, P = 0.004), mortality (21.6% vs 43.8%, P = 0.032), and decannulation rate (29.41% vs 6.25%, P = 0.009). No difference was observed in hospital stay or complication rates. Conclusion: Early tracheostomy is associated with both morbidity and mortality benefits. Patients requiring MV should be given an option of early tracheostomy.

Abstract Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.

Hypoxemia is defined as the decrease in arterial partial pressure of oxygen (PaO2) below 80 mmHg. One of the ways to alleviate this condition is through oxygen therapy, which consists of administering oxygen at a concentration higher than atmospheric. This therapy is indicated in various pathologies and is aimed to treat hypoxemia and reduce the patient's myocardial demand and respiratory effort. Classically, this treatment has been carried out using low-flow systems, in which the inspiratory fraction of oxygen (FiO2) cannot be regulated. However, an increase in the use of high-flow oxygen therapy (HFO) has been observed in recent years. These systems allow for greater patient comfort as well as more precise regulation of the FiO2. The purpose of this article is to review respiratory physiology to understand respiratory failure from a clinical and pathophysiological point of view. Likewise, the different oxygen therapy systems most widely used are discussed, as well as their indications for acute and chronic pathologies, both in the pediatric and adult populations.

Primary care services provide an entry point into the health system which directly impact's people well-being and their use of other health care resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organization (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, majority of the work has been focussed on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. The present paper focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.

The objective of the present investigation was to study the shelf-life of green chilli (Capsicum annuum L.) hybrid CH-52 and checks (CH-27 and Veerji) under cold storage and ambient conditions. The study was carried out at Punjab Horticultural Postharvest Technology Centre, Punjab Agricultural University during 2019–20. All the cultivars were packed in LDPE (Low Density Polyethylene) bags of 25 gauge thickness and were stored under cold store (4–7°C ± 1°C) and ambient (25–30°C) conditions. Significant differences were observed among genotypes for various physicochemical characteristics under both the storage conditions. CH-52 recorded lowest weight loss and minimum spoilage. Higher antioxidant potential, chlorophyll and capsaicin were also retained in CH-52 at the end of storage period. Among other two genotypes CH-27 showed better shelf life than Veerji. Therefore, CH-52 could be recommended for commercial cultivation owing to its lowest spoilage index and higher shelf life as compared to checks.

In this study, main focus has been drawn on the utilization of agricultural waste sources to synthesize nanomaterials. Graphene oxide and nanocellulose were prepared using rice husk ash and sugarcane bagasse, respectively. Further, their nanocomposites were also prepared in (1:1) ratio of graphene oxide and nanocellulose. The synthesized nanomaterials from agricultural waste were compared with those prepared from conventional sources through varied characterizations. Scanning electron microscopy, transmission electron microscopy, fourier transform infrared spectroscopy and N _2 adsorption-desorption analysis was performed to examine the structural, functional and surface properties of the prepared nanomaterials from different precursors. High resolution imaging revealed better structural characteristics of the nanomaterials fabricated from agri-waste precursors. SEM images showed well exfoliated structure of GO and porous nature of NC. The folded layers of GO represent the presence of hydroxyl groups in the TEM images of GO @ graphite powder. TEM images of nanocellulose showed circular shaped nanoparticles of NC @ cellulose powder. Fourier transform infrared spectroscopy confirmed the presence of all the essential functional groups in the structure of prepared nanomaterials. The nanocomposites prepared using agricultural waste sources and conventional sources were inspected by N _2 adsorption-desorption analysis, which demonstrated that the nanocomposites prepared from agri-waste sources exhibits much higher specific surface area than that of prepared from conventional precursors. R _2 possess specific surface area of 82.832 m ^2 g ^−1 while, R _1 possess only 6.721 m ^2 g ^−1 . N _2 adsorption-desorption analysis revealed the pore volume, pore diameter, micropore volume, micropore area and surface area of the prepared nanocomposites. The nanomaterials prepared using agricultural waste products shows desirable characteristics in all aspects which makes them equally applicable in energy storage devices, food packaging, drug delivery systems, nanosensors and water filtration systems.

A newly isolated alkaline protease-producing myxobacterium was isolated from soil. The strain was identified as Pyxidicoccus sp. S252 on the basis of 16S rRNA sequence analysis. The extracellular alkaline proteases produced by isolate S252 (PyCP) was optimally active in the pH range of 11.0–12.0 and temperature range of 40–50°C The zymogram of PyCP showed six caseinolytic protease bands. The proteases were stable in the pH range of 8.0–10.0 and temperature range of 40–50°C. The activity of PyCP was enhanced in the presence of Na+, Mg2+, Cu2+, Tween-20, and hydrogen peroxide (H2O2) (hydrogen peroxide), whereas in Triton X-100, glycerol, ethylenediaminetetraacetic acid (EDTA), and Co2+, it was stable. PyCP showed a potential in various applications. The addition of PyCP in the commercial detergent enhanced the wash performance of the detergent by efficiently removing the stains of tomato ketchup and coffee. PyCP efficiently hydrolyzed the gelatin layer on X-ray film to release the embedded silver. PyCP also showed potent dehairing of goat skin and also efficiently deproteinized sea shell waste indicating its application in chitin extraction. Thus, the results of the present study indicate that Pyxidicoccus sp. S252 proteases have the potential to be used as an ecofriendly replacement of chemicals in several industrial processes.