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Abstract Background SARS-CoV-2 was reported to induce cell fusions to form multinuclear syncytia that might facilitate viral replication, dissemination, immune evasion, and inflammatory responses. In this study, we have reported the types of cells involved in syncytia formation at different stages of COVID-19 disease through electron microscopy. Methods Bronchoalveolar fluids from the mild (n = 8, SpO2 > 95%, no hypoxia, within 2–8 days of infection), moderate (n = 8, SpO2 90% to ≤ 93% on room air, respiratory rate ≥ 24/min, breathlessness, within 9–16 days of infection), and severe (n = 8, SpO2 30/min, external oxygen support, after 17th days of infection) COVID-19 patients were examined by PAP (cell type identification), immunofluorescence (for the level of viral infection), scanning (SEM), and transmission (TEM) electron microscopy to identify the syncytia. Results Immunofluorescence studies (S protein-specific antibodies) from each syncytium indicate a very high infection level. We could not find any syncytial cells in mildly infected patients. However, identical (neutrophils or type 2 pneumocytes) and heterotypic (neutrophils-monocytes) plasma membrane initial fusion (indicating initiation of fusion) was observed under TEM in moderately infected patients. Fully matured large-size (20–100 μm) syncytial cells were found in severe acute respiratory distress syndrome (ARDS-like) patients of neutrophils, monocytes, and macrophage origin under SEM. Conclusions This ultrastructural study on the syncytial cells from COVID-19 patients sheds light on the disease’s stages and types of cells involved in the syncytia formations. Syncytia formation was first induced in type II pneumocytes by homotypic fusion and later with haematopoetic cells (monocyte and neutrophils) by heterotypic fusion in the moderate stage (9–16 days) of the disease. Matured syncytia were reported in the late phase of the disease and formed large giant cells of 20 to 100 μm.

Transducin mediates signal transduction in a classical G protein-coupled receptor (GPCR) phototransduction cascade. Interactions of transducin with the receptor and the effector molecules had been extensively investigated and are currently defined at the atomic level. However, partners and functions of rod transducin α (Gαt1) and βγ (Gβ1γ1) outside the visual pathway are not well-understood. In particular, light-induced redistribution of rod transducin from the outer segment to the inner segment and synaptic terminal (IS/ST) allows Gαt1 and/or Gβ1γ1 to modulate synaptic transmission from rods to rod bipolar cells (RBCs). Protein-protein interactions underlying this modulation are largely unknown. We discuss known interactors of transducin in the rod IS/ST compartment and potential pathways leading to the synaptic effects of light-dispersed Gαt1 and Gβ1γ1. Furthermore, we show that a prominent non-GPCR guanine nucleotide exchange factor (GEF) and a chaperone of Gα subunits, resistance to inhibitors of cholinesterase 8A (Ric-8A) protein, is expressed throughout the retina including photoreceptor cells. Recent structures of Ric-8A alone and in complexes with Gα subunits have illuminated the structural underpinnings of the Ric-8A activities. We generated a mouse model with conditional knockout of Ric-8A in rods in order to begin defining the functional roles of the protein in rod photoreceptors and the retina. Our analysis suggests that Ric-8A is not an obligate chaperone of Gαt1. Further research is needed to investigate probable roles of Ric-8A as a GEF, trafficking chaperone, or a mediator of the synaptic effects of Gαt1.

Microbial electrochemical cells (MxCs) offer a sustainable approach for wastewater treatment and energy recovery by harnessing the electroactive properties of microorganisms. This study explores the enrichment of Geobacter species on anode biofilms in single-(S-MxCs) and double-chambered (D-MxCs) MxCs, using domestic wastewater without an external anode potential. Stable current densities were achieved within 10 days for S-MxCs (9.52 ± 0.8 A/m2) and 14 days for D-MxCs (4.28 ± 0.9 A/m2), with S-MxCs showing a superior electrochemical performance. Hydrogen production rates were higher in D-MxCs (14.93 ± 0.66 mmol H2/L/day) compared to S-MxCs (9.46 ± 0.8 mmol H2/L/day), with cumulative production rates of 12.9 ± 1.3 mmol H2/g COD and 6.48 ± 1.4 mmol H2/g COD, respectively. Cyclic voltammetry confirmed enhanced bioelectrocatalytic activity in S-MxCs, while SEM imaging showed denser biofilms on S-MxC anodes. The novelty of this study lies in its demonstration of efficient biofilm development and microbial community resilience under non-potentialized conditions, providing insights that advance the practical application of MxCs in environmental biotechnology.

BackgroundDischarge date prediction plays a crucial role in healthcare management, enabling efficient resource allocation and patient care planning. Accurate estimation of the discharge date can optimize hospital operations and facilitate better patient outcomes.Materials and methodsIn this study, we employed a systematic approach to develop a discharge date prediction model. We collaborated closely with clinical experts to identify relevant data elements that contribute to the prediction accuracy. Feature engineering was used to extract predictive features from both structured and unstructured data sources. XGBoost, a powerful machine learning algorithm, was employed for the prediction task. Furthermore, the developed model was seamlessly integrated into a widely used Electronic Medical Record (EMR) system, ensuring practical usability.ResultsThe model achieved a performance surpassing baseline estimates by up to 35.68% in the F1-score. Post-deployment, the model demonstrated operational value by aligning with MS GMLOS and contributing to an 18.96% reduction in excess hospital days.ConclusionsOur findings highlight the effectiveness and potential value of the developed discharge date prediction model in clinical practice. By improving the accuracy of discharge date estimations, the model has the potential to enhance healthcare resource management and patient care planning. Additional research endeavors should prioritize the evaluation of the model's long-term applicability across diverse scenarios and the comprehensive analysis of its influence on patient outcomes.

Abstract Green walls are gaining attention for greywater management in the imminent terrestrial space and land constraint scenario. They have been tested primarily with greywater from a single source such as showers, hand or wash basins, laundry, and kitchen or a mix of a couple of these sources but barely with mixed greywater from all these household activities. Here, a green wall system coupled with a slow sand filter (SSF) was tested for managing household greywater. It consisted of a set of five serial hydraulic flow-connected reactors and an SSF unit. Each reactor housed an Epipremnum aureum sapling embedded in the support bed matrix, consisting of cocopeat and granular activated charcoal. The system operated at 150 cm d−1 hydraulic loading rate (HLR) achieved 90 ± 0.7%, 85 ± 4.5%, 72.9 ± 4.4%, and 60.6 ± 5.1% removal efficiencies for turbidity, chemical oxygen demand (COD), total nitrogen (TN), and total phosphorous (TP), respectively. The system maintained similar treatment performance with varying greywater strength when COD and TN were below ~400 and ~15 mg L−1, respectively. The polished effluent produced by SSF operated at 187 cm d−1 HLR, with characteristics

This study attempts to overcome the challenges associated with the degradation of complex organic substances like corn straw hydrolysate in hydrogen recovery by strategically enriching functional microbial communities in single-chamber cubic microbial electrolysis cells (MECs). We applied negative pressure, using acetate or xylose as electron donors, to mitigate the hydrogen sink issues caused by methanogens. This innovative method significantly enhanced MEC performance. MECs enriched with xylose demonstrated superior performance, achieving a hydrogen production rate 3.5 times higher than that achieved by those enriched with acetate. Under negative pressure, hydrogen production in N-XyHy10 reached 0.912 ± 0.08 LH2/L MEC/D, which was 6.7 times higher than in the passive-pressure MECs (XyHy10). This advancement also resulted in substantial increases in current density (73%), energy efficiency (800%), and overall energy efficiency (540%) compared with MECs operated under passive pressure with 10% hydrolysate feed. The enrichment of polysaccharide-degrading bacteria such as Citrobacter and Pseudomonas under negative pressure underscores the potential for their industrial application in harnessing complex organic substrates for bioenergy production in single-chamber MECs. This is a promising approach to scaling up bioenergy recovery processes. The findings of this research study contribute significantly to the field by demonstrating the efficacy of negative pressure in enhancing microbial activity and energy recovery, thereby offering a promising strategy for improving bioenergy production efficiency in industries.

A stable aerobic consortium was enriched to degrade crystalline cellulose (Whatman filter paper 1). The degradation efficiency of the consortium after 7 days of incubation was 91% compared to the control. One bacterial isolate, C7, capable of degrading various cellulosic substrates, was obtained from the consortium under aerobic conditions. The sequencing of 16s rDNA revealed that it was related to Paenibacillus sp. It degraded 83% of cotton after 3 days of incubation. The degradation efficiency of Paenibacillus sp. C7 for filter paper, cotton, and avicel was 90%, 90%, and 92% after 5 days of incubation compared to the control. It also degraded non-pretreated agricultural residues efficiently by 70% for rice straw and 46% for wheat bran in 10 days. Scanning electron micrographs (SEMs) of degraded filter paper after 2 days of incubation indicated smoother and thinner fabrics in its structure. It is a potential cheaper candidate for the degradation of lignocellulosic biomass without any pretreatment.

This work accounts for the green synthesis of iron oxide nanoparticles using Moringa oleifera leaf extract as a stabilizing and reducing agent. The preliminary confirmation of synthesized Fe3O4NPs was done by UV–visible spectroscopy in the wavelength range of 190–900 nm. The crystalline nature of Fe3O4 NPs was established via X-ray diffraction analysis. FT-IR studies reveal the bioactive phytochemicals present in the Moringa leaf extract based Fe3O4 NPs. A DLS particle size analyser was used to determine the size of green synthesized Fe3O4 NPs and its spherical morphology was determined by using SEM and TEM techniques. The growth of Brassica oleracea var. italica seedlings was measured by analysing biophysical and biochemical parameters in two concentrations of Fe3O4 NPs i.e. 15 mg/L and 30 mg/L alone and in combination with cadmium. Treatments were designated as control C, NP1, NP2, Cd+NP1, Cd+NP2, and Cd. Fe3O4 NPs treated broccoli seedlings showed noteworthy improvement in shoot length, root length, plant biomass, total chlorophyll content, carotenoid content, total soluble sugars, protein content, and nitrate reductase activity, while decline in electrolyte leakage, lipid peroxidation, proline content, superoxide dismutase activity and catalase activity was reported as compared to control. Exposure of iron oxide nano-treatments was found efficacious in reducing cadmium accumulation at a concentration of 30 mg/L. The seedlings exposed to NP2 (30 mg/L) concentration of green synthesized nano iron oxide increased nutrient uptake and thus stimulating plant growth, and also improved morphological and physiological characteristics of Brassica oleracea seedlings. Therefore, the present study reported that bio-based iron oxide nanoparticles were significantly useful for plant growth, by enhancing the plant defense mechanism in response to cadmium induced toxicity.

Highly aligned multi-wall carbon nanotubes were investigated with scanning electron microscopy (SEM), Raman spectroscopy and X-ray photoelectron spectroscopy (XPS) before and after bombardment performed using noble gas ions of different masses (argon, neon and helium), in an ultra-high-vacuum (UHV) environment. Ion irradiation leads to change in morphology, deformation of the carbon (C) honeycomb lattice and different structural defects in multi-wall carbon nanotubes. One of the major effects is the production of bond distortions, as determined by micro-Raman and micro-X-ray photoelectron spectroscopy. We observe an increase in sp3 distorted bonds at higher binding energy with respect to the expected sp2 associated signal of the carbon 1s core level, and increase in dangling bonds. Furthermore, the surface damage as determined by the X-ray photoelectron spectroscopy carbon 1s core level is equivalent upon bombarding with ions of different masses, while the impact and density of defects in the lattice of the MWCNTs as determined by micro-Raman are dependent on the bombarding ion mass; heavier for helium ions, lighter for argon ions. These results on the controlled increase in sp3 distorted bonds, as created on the multi-wall carbon nanotubes, open new functionalization prospects to improve and increase atomic hydrogen uptake on ion-bombarded multi-wall carbon nanotubes.

abstract: In the present study, the leaves of Vernonia cinerea were utilized as an efficacious bio-reductant, stabilizing, and capping agent for biological/green synthesis of zinc oxide nanoparticles (ZnO NPs). The nanoparticle (NPs) characteristics show that phytocapped ZnO NPs are in the nano-size range (1–100 nm). Fourier transforms infrared studies reveal the outline of the synthesis mechanism for ZnO NPs whereas X-ray diffraction analysis approved the crystalline structure of ZnO-NPs. Energy-dispersive X-ray analysis defined the pureness and chemical constituent of ZnO-NPs. The microscopic analysis of ZnO NPs confirmed the spherical and non-agglomeration attributes of nano-particles. The commenced study reveals the outcome of phytocapped ZnO NPs on the growth of tomato seedlings. Results showed ZnO-NPs boost the morphological as well as physiological characteristics as compared to the bulk Zn. At lower doses, ZnO NPs give better results as compared to higher doses. The higher doses showed obstruction in the growth and development thereby recommending the 50 mg/L−1of ZnO NPs exposed to tomato seedlings is beneficial.

abstract: Zinc oxide nanoparticles are synthesized through an eco-friendly route by using Vernonia cinerea (L.) leaf extract. The extract obtained from leaf functions acts as a reducing, stabilizing, and capping agent. The bio-synthesized ZnO NPs were characterized by viz. Ultraviolet-visible spectrum, Fourier transforms infrared spectrum, X-ray diffraction analysis, and Field emission scanning electron microscope. The present study explored the plausible role of bio-synthesized ZnO NPs in the mitigation of lead induced oxidative stress by investigating the growth parameters, photosynthetic pigments, protein content, nitrate reductase activity, antioxidant enzymes, etc in the tomato (Solanum lycopersicum L.) seedlings. The seedlings of Solanum lycopersicum were treated with single dose (50 mg L−1) of bio-synthesized ZnO NPs and/or in combination with lead. The bio-synthesized ZnO NPs remarkably increased germination rate, seedling vigor index, relative water content, chlorophyll content, protein, sugars, nitrate reductase activity alone, and in the combination with lead in tomato seedlings. Furthermore, the bio-synthesized ZnO NPs mitigated the deleterious impact of Pb-induced stress by up-regulation of photosynthetic machinery and stimulating the antioxidant stress markers such as superoxide dismutase, catalase, and ascorbate peroxidase in lead-induced stress. The present study concluded that the bio-synthesized ZnO NPs boost the growth performance and ameliorate the lead stress in tomato seedlings.

Background: The COVID-19 pandemic is badly affecting more than 2 million population of 213 countries and has caused 1,952,976 deaths till January 12, 2020. India has also suffered a great loss in terms of economy and people. Furthermore, owing to the complete lockdown enforced in India, restricting humanitarian movement also affected day-to-day life of Indians with a huge impact. Objectives: The present clinical trial was carried out to evaluate the impact of the COVID-19 pandemic on private practitioners. Furthermore, changes in their practice pattern were evaluated along with the perspective of their health, role, and response to the pandemic. Materials and Methods: The study includes a total of 120 health-care professionals of either gender. The stress and mental health of the participants was assessed using Depression Anxiety Stress Scale-21 in English format, also included the questions related to the demographic characteristics, use of technologies for providing virtual health care, changes in the working during the pandemic, and an opinion of their experiences during that period. The data collected were subjected to the analysis and were kept confidential and anonymous. Results: 16.6% of participants preferred virtual consultation before the pandemic in contrast to 83.3% during the pandemic. The most preferred method remained the phone call by 15.8% (n = 19) patients. Depression was seen severely in 35% of study participants (n = 42) and 13.3% of participants extremely severe depression was seen (n = 16). Severe and extremely severe anxiety was noticed in 31.66% (=38) and 15% (18) study participants respectively, whereas severe and extremely severe stress was found in 30% (n = 36), and 12.5% (n = 15) private practitioners. The most common factor that can be considered responsible for compromised mental health in private practitioners was the possibility of infecting the society seen in 59.1% (n = 71) participants. Conclusion: During the pandemic breakout, private practitioners suffered a great challenge both financially and mentally, especially during the lockdown. Furthermore, a significant increase was seen in the virtual consultation methods during the pandemic breakout.

Background: Many academic institutions have been cheering lecturers to execute flipped learning methodologies. The present study determined perceived competency of dental interns toward dental practice among various dental colleges. Materials and Methods: A total of 138 interns of dental college were provided with self-administered questionnaire with close-ended questions. All were instructed to read it and submit it. Results: Out of 138 subjects, there were 78 males and 60 females. The mean value for general patient management was 3.12 and 3.0 in males and females, periodontology and dental public health was 2.54 and 2.65, conservative dentistry was 2.70 and 2.82, oral rehabilitation was 2.32 and 2.30, orthodontics was 2.10 and 2.28, management of children and special needs patients was 2.52 and 2.64, oral and maxillofacial surgery was 2.49 and 2.42, and drug and emergency management was 2.62 and 2.60, respectively. Conclusion: Dental interns were well prepared toward dental practice.

Objectives: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality around the world. Preliminary studies have evaluated the association between innate immunity including Toll-like receptors (TLRs) and airway samples of patients with COPD. The role of TLRs in peripheral blood neutrophils is poorly understood. Hence, this study aimed to investigate the role of TLR2 and TLR4 in peripheral blood neutrophils of COPD patients. Methods: A total of 101 COPD cases and an equal number of healthy controls participated in this case-control study. Peripheral blood neutrophils were isolated from all participants and cultured for 24 hours through lipopolysaccharide (LPS) stimulation. The gene expressions of TLR2 and TLR4 were assessed by real-time polymerase chain reaction. The protein levels of interleukin (IL)-8 and matrix metalloproteinase (MMP)-9 were measured in neutrophils cell culture supernatants using enzyme-linked immunosorbent assay (ELISA). Results: The levels of IL-8 and MMP-9 were significantly higher in patients with COPD compared to healthy controls. Similarly, the gene expression of TLR2 and TLR4 were increased in LPS stimulated peripheral blood neutrophils of patients with COPD. Smoke pack years was positively correlated with IL-8 levels and negatively correlated with forced expiratory volume in the first second % (r = -0.33; p = 0.023) and FEV1/forced vital capacity (FVC) (r = -0.27; p = 0.011). Conclusions: The increased expression of TLR2 and TLR4 suggests its role in disease pathogenesis of COPD. Smoke pack years was negatively associated with spirometric parameters in COPD patients. This may help to predict the smokers without COPD who risk developing the condition in the future.

Background: Multiple studies have suggested that subjects with glutathione S-transferase P1 (GSTP1)-mutations are at high risk for urinary bladder cancer (UBC). Methods: In the present study, we evaluated the mutations in GSTP1 and mitochondrial D-loop genes in two unrelated familial bladder cancer patients belonging to Karbi Anglong Assam tribe. Mitochondrial D-loop and nuclear GSTP1 polymorphic region were amplified and sequenced for all the family members and patients. Two SNPs in the GSTP1 gene for amino acid substitutions at codons 105 (Ile→Val) and 114 (Val→Ala) were genotyped by PCR-RFLP-based methods. Results: mtDNA D-loop sequence variations were found and there were A and C insertions common at positions 235 and 309, respectively for both the families. Two sequence differences were identified in urinary bladder cancer samples in GSTP1 gene. These two heteroplasmic mutations were found at positions 11qG3037G/A and 11qC3038C/A in patient, father, mother, brother and son, but not in the sister and wife samples in family 2. The GSTP1, 105Ile > Val is most susceptible to inherited UBC risk for these ethnic families. The samples from families 1 and 2, including healthy subjects were placed in macrohaplogroup L3e, except the wife (macrohaplogroup F1c1a) of patient in family 1, and the wife and son (haplogroup M) of the patient in family-2. Conclusion: A strong familial nuclear GSTP1 sequence variation and mitochondrial control region was observed in this study for familial urinary bladder cancer. This could afford early recognition of patients at risk of developing micro- or macroscopic, pathological lesions as well as the introduction of preventive measures for familial bladder cancer.

Background: With the advent of spectral domain optical coherence tomography (SDOCT), there has been a renewed interest in macular region for detection of glaucoma. However, most macular SDOCT parameters currently are thickness parameters which evaluate thinning of the macular layers but do not quantify the extent of area over which the thinning has occurred. We therefore calculated a new macular parameter, "ganglion cell complex surface abnormality ratio (GCC SAR)" that represented the surface area over which the macular thickness was decreased. Purpose: To evaluate the ability of SAR in detecting perimetric and preperimetric glaucoma. Design: Retrospective image analysis. Materials and Methods: 68 eyes with perimetric glaucoma, 62 eyes with preperimetric glaucoma and 165 control eyes underwent GCC imaging with SDOCT. SAR was calculated as the ratio of the abnormal to total area on the GCC significance map. Statistical Analysis: Diagnostic ability of SAR in glaucoma was compared against that of the standard parameters generated by the SDOCT software using area under receiver operating characteristic curves (AUC) and sensitivities at fixed specificities. Results: AUC of SAR (0.91) was statistically significantly better than that of GCC average thickness (0.86, P = 0.001) and GCC global loss volume (GLV; 0.88, P = 0.01) in differentiating perimetric glaucoma from control eyes. In differentiating preperimetric glaucoma from control eyes, AUC of SAR (0.72) was comparable to that of GCC average thickness (0.70, P > 0.05) and GLV (0.72, P > 0.05). Sensitivities at specificities of 80% and 95% of SAR were comparable (P > 0.05 for all comparisons) to that of GCC average thickness and GLV in diagnosing perimetric and preperimetric glaucoma. Conclusion: GCC SAR had a better ability to diagnose perimetric glaucoma compared to the SDOCT software provided global GCC parameters. However, in diagnosing preperimetric glaucoma, the ability of SAR was similar to that of software provided global GCC parameters.

Mixed hardwood chips were treated with lignin-degrading fungi to study the effect of fungal pretreatment on bleaching characteristics of kraft pulp. Pretreated wood chips were subjected to reduced active alkali doses in comparison to untreated chips. Comparable results were obtained for pretreated chips with reduced alkali dose as was obtained with higher dose of alkali in case of untreated chips. Fungal treatment made the process more energy-efficient, and 4.8% less chlorine was consumed in comparison to the control process. Pretreatment with Ceriporiopsis subvermispora was responsible for reduction of 4.7% in lignin contents, 14.3% permanganate number, and overall reduction of 15.5 kg/T of Cl2 consumption. The pollution load in terms of COD and BOD at the CD stage was reduced by 32.6% and 41.5% respectively, whereas 12% reduction in AOX compounds was observed in effluent of pretreated pulp.

To evaluate the ability of normative database classification (color-coded maps) of spectral domain optical coherence tomograph (SDOCT) in detecting wedge shaped retinal nerve fiber layer (RNFL) defects identified on photographs and the factors affecting the ability of SDOCT in detecting these RNFL defects.In a cross-sectional study, 238 eyes (476 RNFL quadrants) of 172 normal subjects and 85 eyes (103 RNFL quadrants with wedge shaped RNFL defects) of 66 glaucoma patients underwent RNFL imaging with SDOCT. Logistic regression models were used to evaluate the factors associated with false positive and false negative RNFL classifications of the color-coded maps of SDOCT.False positive classification at a p value of

To compare the abilities of peripapillary retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting preperimetric glaucoma.In a cross-sectional study, 35 preperimetric glaucoma eyes (32 subjects) and 94 control eyes (74 subjects) underwent digital optic disc photography and RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT and GDx ECC to discriminate preperimetric glaucoma eyes from control eyes was compared using area under receiver operating characteristic curves (AUC), sensitivities at fixed specificities and likelihood ratios (LR).AUC of the global average RNFL thickness of SDOCT (0.786) was significantly greater (p

Introduction: Among all face masks, N95 masks have been recommended for medical professionals involved mainly in patients with severe respiratory illnesses. Studies showing a decrease in peripheral oxygen saturation (SpO2 ) and an increase in heart rate after N95 mask usage have already created panic/ concern among medical professionals. On the contrary, a few studies have shown no such negative impact of N95 mask usage, thereby urging scientific communities to investigate/ explore these contrasting results. Aim: To study the effect of wearing an N95 mask continuously for three hours on SpO2 and heart rate specifically in Indian medical professionals. Materials and Methods: This was a quasi-experimental study conducted for a period of 2 months from June 15, 2022, to August 15, 2022, at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India, with a total of 105 healthy Indian medical professionals aged 18-40 years (55 males, 50 females) (12 study participants dropped from the study midway). In each participant, SpO2 and heart rate were recorded first without a mask (M0) and then with a mask (M3) after three hours of routine work in the hospital. Using Mystat statistical software (version 12.0), results were expressed as mean±Standard Deviation (SD), and Student’s paired t-test was used to compare the pairs of means. Results: Among the 105 eligible participants, 93 successfully completed the study, whereas 12 participants were excluded (dropout rate=11.42%). The study included 55 males (52.38%) and 50 females (47.61%) with an age range of 18-40 years and a mean age of 30.2±6.4 years. The SpO2 levels statistically showed a highly significant decrease after three hours of wearing an N95 mask (96.5±0.83% in M0 vs. 93.98±0.6% in M3). Similarly, the heart rate statistically showed a highly significant increase after three hours of using an N95 mask (73.45±3.6 in M0 vs. 89.6±6.1 beats/min in M3). Conclusion: The authors highlighted lower SpO2 levels and an increase in heart rate after three hours of N95 mask usage specifically in Indian medical professionals and thereby appeal to develop/upgrade the N95 mask by lowering its humidity, thermal stress, and breathing resistance.

BackgroundSepsis is a life-threatening condition caused by a dysregulated response to infection, affecting millions of people worldwide. Early diagnosis and treatment are critical for managing sepsis and reducing morbidity and mortality rates.Materials and methodsA systematic design approach was employed to build a model that predicts sepsis, incorporating clinical feedback to identify relevant data elements. XGBoost was utilized for prediction, and interpretability was achieved through the application of Shapley values. The model was successfully deployed within a widely used Electronic Medical Record (EMR) system.ResultsThe developed model demonstrated robust performance pre-operations, with a sensitivity of 92%, specificity of 93%, and a false positive rate of 7%. Following deployment, the model maintained comparable performance, with a sensitivity of 91% and specificity of 94%. Notably, the post-deployment false positive rate of 6% represents a substantial reduction compared to the currently deployed commercial model in the same health system, which exhibits a false positive rate of 30%.DiscussionThese findings underscore the effectiveness and potential value of the developed model in improving timely sepsis detection and reducing unnecessary alerts in clinical practice. Further investigations should focus on its long-term generalizability and impact on patient outcomes.

Abstract Gastric cancer has emerged as a key challenge in oncology research as a malignant tumour with advanced stage detection. Apart from surgical management, a pharmacotherapeutic approach to stomach cancer treatment is an appealing option to consider. Andrographolide has been shown to have anticancer and chemosensitizer properties in a variety of solid tumors, including stomach cancer but the exact molecular mechanism is skeptical. In this study, we identified and validated pharmacological mechanism involved in the treatment of GC with integrated approach of network pharmacology and molecular docking. The targets of andrographolide and GC were obtained from databases. The intersected targets between andrographolide and GC-related genes were used to construct protein–protein interaction (PPI) network. Furthermore, mechanism of action of the targets was predicted by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Finally, these results were validated by molecular docking experiments, mRNA and protein expression level. A total of 197 targets were obtained for andrographolide treating GC. Functional enrichment analysis revealed that the target genes were exerted promising therapeutic effects on GC by HIF-1 and PI3K-Akt signaling pathway. The possible mechanism of action is by inactivation of HIF-1 signaling pathway which is dependent on the inhibition of upstream PI3K-AKT pathway. The PPI network identified SRC, AKT1, TP53, STAT3, PIK3CA, MAPK1, MAPK3, VEGFA, JUN and HSP90AA1 as potential hub targets. In addition, these results were further validated with molecular docking experiments. Survival analysis indicated that the expression levels of the hub genes were significantly associated with the clinical prognosis of GC. This study provided a novel approach to reveal the therapeutic mechanisms of andrographolide on GC, making future clinical application of andrographolide in the treatment of GC.