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Abstract Background Asthma, allergic rhinitis and eczema have been identified as the most prevalent childhood allergic diseases. However, the prevalence of these allergic diseases can vary in different regions within a country and in the world. Methods The objective of the study was to estimate the prevalence of asthma, allergic rhinitis and eczema in schoolchildren in the Kandy and Anuradhapura districts of Sri Lanka. This was a multicentre cross sectional study carried out among children of age 6–7 years and 13–14 years attending state schools fulfilling the entry criteria of the Global Asthma Network Phase 1 study methodology. Results A total of 3673 children of 6–7 years and 4658 children of 13–14 years were recruited. The prevalence of current asthma, allergic rhinitis and eczema were 12% (CI 10.44–13.75), 15.7% (CI 13.94–17.64) and 9.7% (CI 8.30–11.31) among 6–7 years age group and 15.3% (CI 13.66–17.09), 30.5% (CI 28.86–32.74) and 7.3% (CI 6.15–8.65) respectively among the 13–14 age group in Kandy district. The reported prevalence rates of the disease conditions were 9.9% (CI 8.72–11.22), 10.1% (CI 8.90–11.44) and 5.9% (CI 4.98–6.98) among 6–7 years age group and 14.9% (CI 13.67–16.22), 22.5% (CI 21.04–24.03) and 1.8% (CI 1.38–2.34) in the 13–14 years age group in Anuradhapura district. When comparing these prevalence rates, there is relatively a higher prevalence of childhood allergic diseases in Kandy district. This difference is statistically significant in all three allergic disease conditions (P

There has been a lot of focus in recent years on finding ways to incorporate renewable energy systems, especially solar photovoltaic (PV) systems, into the existing electrical grid. Power conversion technologies that are both efficient and reliable are in high demand due to the expanding popularity of solar photovoltaic (PV) systems. Micro-inverters, which are module-based inverters placed on individual PV modules, have grown in popularity in recent years due to their decentralized design. However, the integration of solar micro-inverter into the electrical grid presents power quality challenges. This research article presents an experimental investigation and power quality analysis of a solar micro-inverter under various operating conditions such as dust and shade.

Here, we present a lithiated molybdate‐sulfur battery with practical energy density greater than 300 Wh kg−1. Electrochemically pre‐lithiated α‐MoO3 is prepared to form lithium molybdate anode which was tested against mesoporous titania coated sulfur cathode. A pouch cell with a capacity of 5 mAh made using pre‐lithiated lithium molybdate nanowires as anode and mesoporous TiO2 (titania) coated carbon‐sulfur cathode exhibited 1.4 V operating voltage and exhibited 620 Wh kg−1 capacity in the first cycle, dropped to ∼400 Wh kg−1 in 2nd cycle and 300 Wh kg−1 at 100th cycle. Various prelithiation studies indicate that electrochemical lithiation of MoO3 nanomaterials is crucial to make Li2MoO3 material suitable as anode. In situ electrochemical lithiation of MoO3 anode is introduced as a method to fabricate lithium molybdate (Li2MoO3)‐sulfur pouch cells in one step. [ABSTRACT FROM AUTHOR]

Abstract: Multi-walled carbon nanotubes synthesized using fluidized bed chemical vapor deposition technique were fluorinated sequentially to prepare a series of CF x battery electrodes. Primary battery performance was tested using CF x as a cathode against Li. Fully fluorinated MWNTs showed capacity exceeding 815 mAh g−1 while partially fluorinated samples showed systematically lowered capacity with decreasing x (in CF x ). However, fully fluorinated MWCNTs showed distinctly low rechargeable capacity compared to the subfluorinated samples when used as an anode against Li. Mildly fluorinated MWNTs show high capacity and better stability during charge–discharge cycles. High concentrations of fluorine seem to affect capacity retention due to the increased defect densities and reduced electronic conduction. These defects of nanotubes will provide additional pathways for lithium ions to diffuse within the core of the fluorinated structure and to access the electrochemically active C–F sites. XRD, XPS, and Raman spectroscopy were utilized to characterize the samples. Finally the electrochemical performance of fluorinated MWNTs was compared with that of Natural Chinese Graphite (NCG). [Copyright &y& Elsevier]

Epithelial tissue forms a barrier around the human body and visceral organs, providing protection, permeation, sensation, and secretion. It is vital for our sustenance as it protects the tissue from harm and injury by restricting the entry of foreign bodies inside. Furthermore, it is a strong barrier to drugs, nutrients, and other essential deliverables. This layer also houses a large consortium of microbes, which thrive in tandem with human tissue, providing several health benefits. Moreover, the complex interplay of the microbiome with the barrier tissue is poorly understood. Therefore, replicating these barrier tissues on microdevices to generate physiological and pathophysiological models has been a huge interest for researchers over the last few decades. The artificially engineered reconstruction of these epithelial cellular barriers on microdevices could help underpin the host-microbe interaction, generating a physiological understanding of the tissue, tissue remodeling, receptor-based selective diffusion, drug testing, and others. In addition, these devices could reduce the burden of animal sacrifices for similar research and minimize the failure rate in drug discovery due to the use of primary human cells and others. This review discusses the nature of the epithelial barrier at different tissue sites, the recent developments in creating engineered barrier models, and their applications in pathophysiology, host-microbe interactions, drug discovery, and cytotoxicity. The review aims to provide know-how and knowledge behind engineered epithelial barrier tissue to bioengineers, biotechnologists, and scientists in allied fields.

Bile acid transporters (BATs) are integral membrane proteins belonging to various families, such as solute carriers, organic anion transporters, and ATP-binding cassette families. These transporters play a crucial role in bile acid transportation within the portal and systemic circulations, with expression observed in tissues, including the liver, kidney, and small intestine. Bile acids serve as signaling molecules facilitating the absorption and reabsorption of fats and lipids. Dysregulation of bile acid concentration has been implicated in tumorigenesis, yet the role of BATs in this process remains underexplored. Emerging evidence suggests that BATs may modulate various stages of cancer progression, including initiation, development, proliferation, metastasis, and tumor microenvironment regulation. Targeting BATs using siRNAs, miRNAs, and small compound inhibitors in preclinical models and their polymorphisms are well-studied for transporters like BSEP, MDR1, MRP2, OATP1A2, etc., and have shed light on their involvement in tumorigenesis, particularly in cancers such as those affecting the liver and gastrointestinal tract. While BATs' role in diseases like Alagille syndrome, biliary atresia, and cirrhosis have been extensively studied, their implications in cancer warrant further investigation. This review highlights the expression and function of BATs in cancer development and emphasizes the potential of targeting these transporters as a novel therapeutic strategy for various malignancies., Competing Interests: Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ☐ The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal name] and was not involved in the editorial review or the decision to publish this article. ☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2024 Elsevier B.V. All rights reserved.)

Aims: Islet antibody-negative type 1 diabetes mellitus (T1DM) has not been well characterised. We determined the frequency of antibody-negative T1DM and compared it with antibody-positive T1DM in a cohort of north Indian children., Methods: In a multi-centre, prospective, observational study, 176 Indian children (age 1-18 years) were assessed within 2 weeks of diagnosis of T1DM. Antibodies against GAD65 (GADA), islet antigen-2 (IA-2A) and zinc transporter 8 (ZnT8A), were estimated using validated ELISA. HLA-DRB1, DQA1 and DQB1 alleles were studied by Luminex-based typing. Monogenic diabetes was determined by targeted next-generation sequencing using the Illumina platform., Results: After excluding 12 children with monogenic diabetes, GADA, IA-2A and ZnT8A were present in 124 (76%), 60 (37%) and 62 (38%) o children, respectively, while 24 (15%) were negative for all antibodies. A single antibody (most frequently GADA) was present in 68 (41%) of children, while all three antibodies were found in 34 (21%). Islet antibody-negative T1DM (n = 24, 15%) did not differ from antibody-positive children in their clinical features, HbA1c or plasma C-peptide, both at onset or after 1 year follow-up (available in 62 children). The frequency of other organ-specific antibodies or high-risk HLA-DR and DQ alleles were also similar. Children with a single islet antibody did not differ from those with multiple antibodies., Conclusions: The frequency of various islet-antibodies, in isolation and combination, differed considerably from studies among children of European descent with T1DM. Children with T1DM who were islet antibody-negative were indistinguishable from those who were antibody-positive., (© 2024 Diabetes UK.)

Over eight million surgical procedures are conducted annually in the United Stats to address organ failure or tissue losses. In response to this pressing need, recent medical advancements have significantly improved patient outcomes, primarily through innovative reconstructive surgeries utilizing tissue grafting techniques. Despite tremendous efforts, repairing damaged tissues remains a major clinical challenge for bioengineers and clinicians. 3D bioprinting is an additive manufacturing technique that holds significant promise for creating intricately detailed constructs of tissues, thereby bridging the gap between engineered and actual tissue constructs. In contrast to non-biological printing, 3D bioprinting introduces added intricacies, including considerations for material selection, cell types, growth, and differentiation factors. However, technical challenges arise, particularly concerning the delicate nature of living cells in bioink for tissue construction and limited knowledge about the cell fate processes in such a complex biomechanical environment. A bioink must have appropriate viscoelastic and rheological properties to mimic the native tissue microenvironment and attain desired biomechanical properties. Hence, the properties of bioink play a vital role in the success of 3D bioprinted substitutes. This review comprehensively delves into the scientific aspects of tissue-centric or tissue-specific bioinks and sheds light on the current challenges of the translation of bioinks and bioprinting.

Purpose: CLN3 Batten disease (also known as juvenile neuronal ceroid lipofuscinosis) is a lysosomal storage disorder that typically initiates with retinal degeneration but is followed by seizure onset, motor decline and premature death. Patient-derived CLN3 disease induced pluripotent stem cell-RPE cells show defective phagocytosis of photoreceptor outer segment (POS). Because modifier genes are implicated in CLN3 disease, our goal here was to investigate a direct link between CLN3 mutation and POS phagocytosis defect., Methods: Isogenic control and CLN3 mutant stem cell lines were generated by CRISPR-Cas9-mediated biallelic deletion of exons 7 and 8. A transgenic CLN3Δ7-8/Δ7-8 (CLN3) Yucatan miniswine was also used to study the impact of CLN3Δ7-8/Δ7-8 mutation on POS phagocytosis. POS phagocytosis by cultured RPE cells was analyzed by Western blotting and immunohistochemistry. Electroretinogram, optical coherence tomography and histological analysis of CLN3Δ7-8/Δ7-8 and wild-type miniswine eyes were carried out at 6, 36, or 48 months of age., Results: CLN3Δ7-8/Δ7-8 RPE (CLN3 RPE) displayed decreased POS binding and consequently decreased uptake of POS compared with isogenic control RPE cells. Furthermore, wild-type miniswine RPE cells phagocytosed CLN3Δ7-8/Δ7-8 POS less efficiently than wild-type POS. Consistent with decreased POS phagocytosis, lipofuscin/autofluorescence was decreased in CLN3 miniswine RPE at 36 months of age and was followed by almost complete loss of photoreceptors at 48 months of age., Conclusions: CLN3Δ7-8/Δ7-8 mutation (which affects ≤85% of patients) affects both RPE and POS and leads to photoreceptor cell loss in CLN3 disease. Furthermore, both primary RPE dysfunction and mutant POS independently contribute to impaired POS phagocytosis in CLN3 disease.

Pregnancy with history of peripartum cardiomyopathy, residual left ventricular dysfunction is associated with high maternal and neonatal morbidity and mortality. Remote monitoring of pulmonary artery pressure and vital signs have been utilized in clinical settings to manage select patients with heart failure. However, data of using these systems to aid clinical management in pregnancy remains unexplored. To our knowledge, this case report is the first to describe successful management of a 31-year-old pregnant patient with history of peripartum cardiomyopathy, severe left ventricular dysfunction and pulmonary embolism using the CardioMEMS device throughout pregnancy. CardioMEMS system provided continuous remote hemodynamic monitoring during pregnancy, aiding in the management of this high-risk patient. The device's ability to provide real-time data allowed for correlation between symptoms and hemodynamics, allowing for prompt adjustments in treatment, ensuring stability throughout the pregnancy. This patient was able to avoid hospital admissions and successfully deliver a healthy baby via vaginal delivery. This report highlights the potential benefits of utilizing CardioMEMS in clinical management of such patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Oxytocin receptor (Oxtr) signaling influences complex social behaviors in diverse species, including social monogamy in prairie voles. How Oxtr regulates specific components of social attachment behaviors and the neural mechanisms mediating them remains unknown. Here, we examine prairie voles lacking Oxtr and demonstrate that pair bonding comprises distinct behavioral modules: the preference for a bonded partner, and the rejection of novel potential mates. Our longitudinal study of social attachment shows that Oxtr sex-specifically influences early interactions between novel partners facilitating the formation of partner preference. Additionally, Oxtr suppresses promiscuity towards novel potential mates following pair bonding, contributing to rejection. Oxtr function regulates coordinated patterns of gene expression in regions implicated in attachment behaviors and regulates the expression of oxytocin in the paraventricular nucleus of the hypothalamus, a principal source of oxytocin. Thus, Oxtr controls genetically separable components of pair bonding behaviors and coordinates development of the neural substrates of attachment.

Cystic fibrosis (CF) is a genetic disorder that profoundly affects the respiratory and digestive systems, particularly in pediatric patients. This comprehensive review aims to conduct a comparative analysis of various treatment modalities employed in the management of CF in children. We systematically evaluated current literature focusing on pharmacological interventions, airway clearance techniques, nutritional management, and emerging therapies, including gene therapy and personalized medicine. Our analysis highlights the efficacy, safety, and accessibility of these treatments through a comparative lens, examining performance across diverse patient populations. Key comparisons include standard therapies, such as CF transmembrane conductance regulator (CFTR) modulators, versus traditional treatments and the effectiveness of airway clearance techniques in relation to lung function outcomes. We explore variations in treatment adherence and outcomes based on socioeconomic factors and healthcare systems. The review underscores the importance of individualized care plans tailored to the unique needs of pediatric patients. By synthesizing findings from clinical studies, meta-analyses, and expert guidelines, this review serves as a valuable resource for healthcare providers and researchers. Our goal is to optimize therapeutic strategies for pediatric patients with CF and ultimately improve their clinical outcomes., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Lakhani et al.)

The MV X-Press Pearl accident near Sri Lanka in May 2021 released several pollutants into the ocean, including 1843.3 t of urea, raising concerns about the impact on the region. This study uses a coupled ocean (NEMO)-biogeochemistry (ERSEM) model to simulate urea dispersion under various scenarios. While it doesn't directly reflect the real accident, it provides insights into the potential impact of similar chemical spills. By adjusting tracer release rates and timing, we assessed their impact on the distribution of the chemical plume. Findings show slower release rates prolong higher urea concentrations, potentially causing phytoplankton blooms, while monsoon conditions significantly affect dispersal patterns. Due to a lack of publicly available urea observations, we used particle tracking experiments validated with data on plastic nurdle beaching. This research shows how a simpler, affordable scenario approach could inform the management of chemical spills without a fully developed operational oceanographic system., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The immune system and cancer cells interact intricately during the growth of tumors, and the dynamic interplay between immune activation and suppression greatly influences the cancer outcome. Natural killer cells (NK), cytotoxic T lymphocytes (CTLs) and Dendritic cells (DC), employ diverse mechanisms, to combat cancer. However, the challenges posed by factors such as chronic inflammation and the immunosuppressive tumor microenvironment (TME) often hinder immune cells' ability to detect and eliminate tumors accurately. Immunotherapy offers a promising approach, reprogramming the immune system to target and eliminating cancer cells while minimizing side effects, enhancing immune memory, and lowering the risk of metastasis and relapse compared to traditional treatments like radiation and surgery. Nanotechnology presents a potential solution by enabling safer, more efficient drug delivery through nanoparticles. These nanoengineered drugs can be tailored for controlled activation and release. Improving TME characters holds potential for enhancing personalized immunotherapy and addressing T cell availability issues within tumor sites, particularly when combined with existing therapies. This review discusses TMEs and the strategies to overcome immunosuppression in TME, and various immune cell-based strategies to improve antitumor response. It also focuses on the strategies for constructing microenvironment responsive nanoplatforms based upon the factors present at higher levels in TME like acidic pH, hypoxia facilitated by poor oxygen supply, higher expression of certain enzymes, and other factors such light, ultrasound and magnetic field. Combination immune therapies combined with immunotherapy include photodynamic therapy, photothermal therapy, chemotherapy, gene therapy and radiotherapy, revealing a high level of anticancer activity in comparison to a single therapy, enhancing immunogenicity, promoting therapeutic efficacy, and lowering metastasis. In conclusion, cancer immunotherapy is a potential technique to combat cancer cells and boost the immune system, hindering their growth and recurrence. In order to prevent cancer, it helps the immune system target cancer cells selectively and strengthens its long-term memory. Clinical trials are extending the application of immunotherapy and identifying strategies to improve the immune system tumor-fighting capabilities. Immunotherapy has enormous promise and gives hope for more successful cancer treatment., (© 2024 The Author(s). Published by IMR Press.)

Objective: The objective of this study is to evaluate the quality of mobile health (mHealth) applications that promote cervical cancer awareness and provide screening assistance, with an emphasis on apps available on the Google Play Store and iOS., Methods: From December 2023 to February 2024, we assessed mobile applications focused on cervical cancer screening that are available on Google Play and Apple iTunes. The "Cervical Cancer," "Mobile Application," "Pap Test," "Cervical Cancer Guide," "Human Papillomavirus," plus "Cervical Screening are the keywords used to search the applications." Data collection includes features such as application name, pricing, download metrics, invention date, last update, affiliation, online access, login requirements, and notification functionality, which were gathered in Excel. Interrater reliability based on four reviewers' independent judgments, varied from 0.75 to 0.83., Result: In our research, we found 25 apps (16 on the Google Play Store and 9 on iOS). After a thorough review, only 14 relevant apps were included. According to the MARS rating, Rise Against Cancer received the highest score (3.9), followed by FightHPV and Cervical Cancer Forum (3.8). Rise Against Cancer (29), HPV Vaccine (28), and CDC STI Tx Guidelines (28) scored highest in the APPLICATIONS rating system. Hope 4 All and OCI Cervibreast closely matched the statements, meeting seven of the thirteen requirements each., Conclusion: Future app developers should produce user-friendly, often updated mHealth applications that include high-quality cervical cancer awareness and screening content. These apps should provide validated information and pleasant graphic effects.

Organophosphorus and carbamate Insectiside is common in Asia-Pacific region consisting of 63% of the Global death. Organophosphorus and Carbamate poisoning can lead into different complications in the respiratory,digestive,neurological aspects and maybe fatal in certain cases.Besides medical management of the same,early rehabilitation is also required to manage different kinds of neurological aspects caused due to Organophosphorus and carbamate poisoning. The study was done to introspect the early intervention in swallowing and speech therapy in organophosphorus and carbamate poisoning individual,as a part of management besides medical intervention. A 19 years old female reported to the hospital with history of consuming organophos and carbamate insecticide with the intention of self harming causing cardiac arrest and as diagnosed as Flaccid Dysarthria with Oro-Pharyngeal Dysphagia when assessed with diagnostic tools respectively. Early speech and swallowing intervention was provided and introspected using MASA which showed improvement in scores during the therapeutic intervention and was statistically analysed using linear regression analysis. The result showed the improvement in MASA scores (the slope of the best fit) and proved that MASA scores improved significantly (slope = 14.3, p  < 0.05) over time as the therapy sessions proceeded. The regression model was also significant ( p  < 0.05). The motor-speech therapeutic intervention provided improvement in the kinematics of oro-motor skills along with improvement in intelligibility of speech. This study concludes that early intervention in managing speech and swallowing abilities in Dysarthria and Dysphagia is helpful besides medical intervention in such cases., Competing Interests: Conflict of interestNone., (© Association of Otolaryngologists of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

We have described the hyperreflective ganglion cell layer band (HGCB) in a series of cases of gyrate atrophy. Clinical fundus examination and multimodal imaging which included optical coherence tomography (OCT) was done in all cases. Four patients (one male, three female) were studied. In all four cases, a hyperreflective band was noted in the ganglion cell layer. In three patients, the band was continuous, and in one patient, the band was patchy. To conclude, HGCB is a novel OCT sign in gyrate atrophy and can be valuable in prognostication of disease. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:598-602.] .

Objectives: Mutations in Tissue Inhibitor of Metalloproteinases 3 (TIMP3) cause Sorsby's Fundus Dystrophy (SFD), a dominantly inherited, rare form of macular degeneration that results in vision loss. TIMP3 is synthesized primarily by retinal pigment epithelial (RPE) cells, which constitute the outer blood-retinal barrier. One major function of RPE is the synthesis and transport of vital nutrients, such as glucose, to the retina. Recently, metabolic dysfunction in RPE cells has emerged as an important contributing factor in retinal degenerations. We set out to determine if RPE metabolic dysfunction was contributing to SFD pathogenesis., Methods: Quantitative proteomics was conducted on RPE of mice expressing the S179C variant of TIMP3, known to be causative of SFD in humans. Proteins found to be differentially expressed (P < 0.05) were analyzed using statistical overrepresentation analysis to determine enriched pathways, processes, and protein classes using g:profiler and PANTHER Gene Ontology. We examined the effects of mutant TIMP3 on RPE metabolism using human ARPE-19 cells expressing mutant S179C TIMP3 and patient-derived induced pluripotent stem cell-derived RPE (iRPE) carrying the S204C TIMP3 mutation. RPE metabolism was directly probed using isotopic tracing coupled with GC/MS analysis. Steady state [U- 13 C 6 ] glucose isotopic tracing was preliminarily conducted on S179C ARPE-19 followed by [U- 13 C 6 ] glucose and [U- 13 C 5 ] glutamine isotopic tracing in SFD iRPE cells., Results: Quantitative proteomics and enrichment analysis conducted on RPE of mice expressing mutant S179C TIMP3 identified differentially expressed proteins that were enriched for metabolism-related pathways and processes. Notably these results highlighted dysregulated glycolysis and glucose metabolism. Stable isotope tracing experiments with [U- 13 C 6 ] glucose demonstrated enhanced glucose utilization and glycolytic activity in S179C TIMP3 APRE-19 cells. Similarly, [U- 13 C 6 ] glucose tracing in SFD iRPE revealed increased glucose contribution to glycolysis and the TCA cycle. Additionally, [U- 13 C 5 ] glutamine tracing found evidence of altered malic enzyme activity., Conclusions: This study provides important information on the dysregulation of RPE glucose metabolism in SFD and implicates a potential commonality with other retinal degenerative diseases, emphasizing RPE cellular metabolism as a therapeutic target., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier GmbH.. All rights reserved.)

Age-related macular degeneration (AMD) and related macular dystrophies (MDs) primarily affect the retinal pigment epithelium (RPE) in the eye. A hallmark of AMD/MDs that drives later-stage pathologies is drusen. Drusen are sub-RPE lipid-protein-rich extracellular deposits, but how drusen forms and accumulates is not known. We utilized human induced pluripotent stem cell (iPSC)-derived RPE from patients with AMD and three distinct MDs to demonstrate that reduced activity of RPE-secreted matrix metalloproteinase 2 (MMP2) contributes to drusen in multiple maculopathies in a genotype-agnostic manner by instigating sterile inflammation and impaired lipid homeostasis via damage-associated molecular pattern molecule (DAMP)-mediated activation of receptor for advanced glycation end-products (RAGE) and increased secretory phospholipase 2-IIA (sPLA2-IIA) levels. Therapeutically, RPE-specific MMP2 supplementation, RAGE-antagonistic peptide, and a small molecule inhibitor of sPLA2-IIA ameliorated drusen accumulation in AMD/MD iPSC-RPE. Ultimately, this study defines a causal role of the MMP2-DAMP-RAGE-sPLA2-IIA axis in AMD/MDs., Competing Interests: Declaration of interests University of Rochester has filed a provisional US patent application: U.S. Provisional Patent Application No. 63/632,123, filed April 10, 2024, title: “Drug Treatment for Macular Degeneration.”, (Published by Elsevier Inc.)

Background: Cardiovascular magnetic resonance (CMR) is used to diagnose myocarditis in adults and children based on the original Lake Louise Criteria (LLC) and more recently the revised LLC. The major change included in the revised LLC was the incorporation of parametric mapping, which significantly increases the sensitivity and specificity of diagnosis. Subsequently, scientific statements have recommended the use of parametric mapping in the diagnosis of myocarditis in children. However, there are some challenges to parametric mapping that are unique to the pediatric population. Our goal is to characterize clinical CMR and parametric mapping practice patterns for diagnosis of myocarditis in pediatric centers., Methods: The Cardiovascular Magnetic Resonance Evaluation in Return to Athletes for Myocarditis in COVID-19 and Immunization Consortium created a REDCap survey to evaluate clinical practice patterns for diagnosis of myocarditis in pediatrics. This survey was distributed to the Society for Cardiovascular Magnetic Resonance community., Results: 59 responses from 51 centers were received, with only one response from each center being utilized. Only 35% of centers (37% of North America, 31% of international) reported using CMR routinely in all patients with a suspicion for myocarditis. Diagnostic uncertainty was noted as the most important reason for CMR, while cost was noted as the least important consideration. The majority of centers reported using the revised LLC (37/51, 72%) compared to original LLC (7/51, 14%) or a hybrid criteria (6/51, 12%). When looking at the use of parametric mapping, only 5/47 (11%) for T1 mapping and 11/49 (22%) for T2 mapping reported having scanner-specific pediatric normative data., Conclusion: Routine CMR imaging for diagnosis of myocarditis in pediatrics is infrequently performed at surveyed centers despite the focus on a group of non-invasive cardiac imagers. While the majority reported using parametric mapping, few centers reporting having pediatric scanner-specific normative data. This highlights an important gap in the utilization of CMR that may aid in the diagnosis of myocardial disease., Competing Interests: Competing interests Dr. M. Jay Campbell is a Subject Matter Expert for the Center for Disease Control Clinical Immunization Safety Assessment. Michael P. DiLorenzo has grant support from GE Healthcare and Genentech, Inc (completed 2021). There are no relevant competing interests for the rest of the authors., (Copyright © 2024. Published by Elsevier Inc.)

Competing Interests: There are no conflicts of interest.

Carotenoids are fat-soluble bio pigments often responsible for red, orange, pink and yellow coloration of fruits and vegetables. They are commonly referred as nutraceutical which is an alternative to pharmaceutical drugs claiming to have numerous physiological benefits. However their activity often get disoriented by photonic exposure, temperature and aeration rate thus leading to low bioavailability and bio accessibility. Most of the market value for carotenoids revolves around food and cosmetic industries as supplement where they have been continuously exposed to rigorous physico-chemical treatment. Though several encapsulation techniques are now in practice to improve stability of carotenoids, the factors like shelf life during storage and controlled release from the delivery vehicle always appeared to be a bottleneck in this field. In this situation, different technologies in nanoscale is showing promising result for carotenoid encapsulation and delivery as they provide greater mass per surface area and protects most of their bioactivities. However, safety concerns related to carrier material and process must be evaluated crucially. Thus, the aim of this review was to collect and correlate technical information concerning the parameters playing pivotal role in characterization and stabilization of designed vehicles for carotenoids delivery. This comprehensive study predominantly focused on experiments carried out in past decade explaining how researchers have fabricated bioprocess engineering in amalgamation with nano techniques to improve the bioavailability for carotenoids. Furthermore, it will help the readers to understand the cognisance of carotenoids in nutraceutical market for their trendy application in food, feed and cosmeceutical industries in contemporary era.

Objective: The aim of the present study is to determine similarities between patients with type 2 diabetes not on metformin therapy compared to patients on metformin therapy at a resident-led primary care clinic. Methods: An exploratory, single-center retrospective chart review was performed on patients 18 years and older with a documented diagnosis of type 2 diabetes seen at the University of Arkansas for Medical Sciences Family Medicine Clinic in Little Rock, Arkansas. Of the 2452 patients who met criteria for the study, 1085 patients did not have a documented metformin allergy. A subset of 216 patients who were not currently prescribed metformin and had no documented metformin allergy were further examined and compared to the 869 patients who were prescribed metformin. We sought to determine reasons for nonuse by evaluating their EPIC electronic health record. Information on these patients such as race, gender, hemoglobin A1c (A1c), kidney function, stated metformin intolerance, and comorbid disease states such as neuropathy, chronic kidney disease (CKD), ulcerative colitis, and irritable bowel syndrome were collected. Further examination was performed to determine why patients were not on metformin therapy and potential similarities between metformin intolerant patients. Results: The results of the study indicated a significant difference between metformin users and non-users in relation to body mass index (BMI) and diagnosis of CKD. Metformin non-users were found to have significantly lower mean BMI (30.87 vs. 35.43; p-value <0.0001), and significantly higher rates of CKD (25.93% vs 14.73%; p-value <0.0001) as compared to metformin users. BMI value of patients (coefficient: 0.2033, p value: <0.0001) was found to be significantly and positively correlated with metformin use, and CKD (coefficient: - 0.1191, p-value: <0.0001) was found to be significantly and negatively correlated with metformin use. A1c levels for patients not on metformin therapy were evaluated. Most non-metformin patients fell in prediabetic A1c levels ranging from 5-6.4% (84 patients; 38.89%), and 31 patients (14.35%) should be on insulin therapy according to guidelines. Conclusion: The results demonstrated that patients with lower BMI, CKD, or A1c in the prediabetic range were less likely to be prescribed metformin., (© Individual authors.)

Fungus-growing termites, like Odontotermes obesus, cultivate Termitomyces as their sole food source on fungus combs which are continuously maintained with foraged plant materials. This necessary augmentation also increases the threat of introducing non-specific fungi capable of displacing Termitomyces. The magnitude of this threat and how termites prevent the invasion of such fungi remain largely unknown. This study identifies these non-specific fungi by establishing the pan-mycobiota of O. obesus from the fungus comb and termite castes. Furthermore, to maximize the identification of such fungi, the mycobiota of the decaying stages of the unattended fungus comb were also assessed. The simultaneous assessment of the microbiota and the mycobiota of these stages identified possible interactions between the fungal and bacterial members of this community. Based on these findings, we propose possible interactions among the crop fungus Termitomyces, the weedy fungus Pseudoxylaria and some bacterial symbiotes. These possibilities were then tested with in vitro interaction assays which suggest that Termitomyces, Pseudoxylaria and certain potential bacterial symbiotes possess anti-fungal capabilities. We propose a multifactorial interaction model of these microbes, under the care of the termites, to explain how their interactions can maintain a predominantly Termitomyces monoculture., (© 2024. The Author(s).)

Fusarium stalk rot (FSR), caused by the Fusarium species complex, is an economic threat to maize cultivation all over the world. We investigated the population structure and genetic diversity of Fusarium species obtained from five major maize-growing regions in India. The Tef-1α locus was used for phylogenetic analysis of geographically distinct isolates of Fusarium verticillioides , F. andiyazi , F. proliferatum , F. nygamai , and F. acutatum causing FSR. A phylogenetic tree showed monophyletic, polyphyletic, and paraphyletic groupings reflecting the complex evolutionary history and genetic diversity within the genus. Monophyletic groupings depicting strong bootstrap support were shown to have a single common ancestor and genetic coherence with limited genetic divergence among sequences. Polyphyletic groupings also presented significant genetic differentiation within the F. verticillioides sequences from diverse ecological niches. Nucleotide diversity of moderate level 0.02471 reflected genetic variations within populations that were attributed to factors such as mutation, genetic drift, or varying selection pressures. The Fst value of 0.98205 is particularly indicative of high genetic differentiation, implying that most of the genetic variance is due to differences between populations rather than within them. F. verticillioides , with 57 sequences, showed low genetic diversity with three segregating sites and a low haplotype diversity of 0.19486, suggesting the founder effect, where a reduced population expands from a limited genetic pool. The total data estimates across all populations for haplotype analysis showed 72 sequences, 44 segregating sites, and 9 haplotypes with a haplotype diversity of 0.48513. The evolutionary dynamics showed genetic differentiations among Fusarium species causing FSR. AMOVA indicated high within-population variations, depicting a substantial genetic diversity within individual populations. The results offer a comprehensive framework for discussing the implications of genetic diversity in pathogen management and the evolutionary dynamics of the Fusarium species causing FSR in maize in the Indian subcontinent.

Background: Human activities are driving climate, land cover, and population change (global change), and shifting the baseline geographical distribution of snakebite. The interacting effects of global change on snakes and communities at risk of snakebite are poorly understood, limiting capacity to anticipate and manage future changes in snakebite risk., Methods: In this modelling study, we projected how global change will affect snakebite envenoming incidence in Sri Lanka, as a model system that has a high incidence of snakebite. We used the shared socioeconomic pathway (SSP) scenario analysis framework to integrate forecasts across the domains of: climate change (historical trend from WorldClim plus three underlying regional circulation models [RCMs] in the Coordinated Regional Downscaling Experiment-South Asia repository, with two emissions pathways [representative concentration pathways RCP4.5 and RCP8.5]); land cover change (Dyna-CLUE model); and human population density change (based on Gridded Population of the World data) from Jan 1, 2010 to Dec 31, 2050. Forecasts were integrated under three different development scenarios: a sustainability pathway (SSP1 and no further emissions), a middle-of-the-road pathway (SSP2 and RCP4.5), and a fossil-fuelled pathway (SSP5 and RCP8.5). For SSP2 and SSP5, we nested three different RCMs (CNRM-CM5, GFDL-CCM3, and MPI-ESM-LR; mean averaged to represent consensus) to account for variability in climate predictions. Data were used as inputs to a mechanistic model that predicted snakebite envenoming incidence based on human-snake contact patterns., Findings: From 2010 to 2050, at the national level, envenoming incidence in Sri Lanka was projected to decrease by 12·0-23·0%, depending on the scenario. The rate of decrease in envenoming incidence was higher in SSP5-RCP8.5 than in SSP1 and SSP2-RCP4.5. Change in envenoming incidence was heterogenous across the country. In SSP1, incidence decreased in urban areas expected to have population growth, and with land cover changes towards anthropised classes. In SSP2-RCP4.5 and SSP5-RCP8.5, most areas were projected to have decreases in incidence (SSP5-RCP8.5 showing the largest area with incidence reductions), while areas such as the central highlands and the north of the country showed localised increases. In the model, decreases occurred with human population growth, land use change towards anthropised classes (potentially shifting occupational risk factors), and decreasing abundance of some snake species, potentially due to global warming and reduced climatic and habitat suitability, with displacement of some snake species., Interpretation: Snakebite envenoming incidence was projected to decrease overall in the coming decades in Sri Lanka, but with an apparent emerging conflict with sustainability objectives. Therefore, efforts to mitigate snakebite envenoming incidence will need to consider the potential impacts of sustainability interventions, particularly related to climate and land use change and in areas where increases in incidence are projected. In view of global change, neglected tropical diseases and public health issues related to biodiversity, such as snakebite, should be managed collaboratively by both environment and health stakeholders., Funding: UK Medical Research Council., Competing Interests: Declaration of interests GM and JJE received salary from the UK Medical Research Council (grant number MP/P024513/1) in 2018–19. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Purpose: To report occurrence of central serous chorioretinopathy(CSCR) which mimicked recurrence of ODP maculopathy in a young adult in whom surgery for the same had been done., Methods: Clinical fundus examination and multimodal imaging which included optical coherence tomography(OCT) and fundus autofluorescence(FFA) was done., Results: Patient had undergone surgery for ODP maculopathy. At 1 year follow up, there was recurrence of subretinal fluid at the macula. Fundus fluorescein angiography was done and the presence of ink blot pattern leakage clinched the diagnosis of CSCR, ruling out ODP maculopathy., Conclusion: CSCR is a great masquerade and correct diagnosis is very important to prevent permanent visual impairment. Subretinal fluid(SRF) associated with ODP must be examined carefully to rule out other pathologies like CSCR. Serous macular detachment after surgery for ODP maculopathy has been done, does not necessarily mean recurrence of the maculopathy. Other pathologies like CSCR should be ruled out. This case highlights the importance of multimodal imaging along with clinical signs in correct diagnosis and treatment of conditions with overlapping features like CSCR and ODP maculopathy., Competing Interests: Conflicts of interests: None

Management of severe traumatic brain injury (sTBI) typically involves the use of sedation, which inherently results in benefits and risks. The cytochrome P450 enzyme CYP2B6 is involved in the biotransformation of particular drug classes, including many intravenous sedatives. Variants of the CYP2B6 gene can lead to decreased systemic clearance of some sedatives, including propofol. This study aimed to investigate the relationship of CYP2B6 gene variation and patient outcomes after TBI while also considering propofol administration. Patients who sustained a non-penetrating sTBI and admitted to a single-center Level 1 trauma hospital were included in this study ( n = 440). The *6 functional allele of CYP2B6 that leads to reduced enzyme expression and activity required genotyping two single nucleotide polymorphisms, rs3745274 and rs2279343. Patient outcomes were evaluated using the Glasgow Outcome Scale (GOS) and Disability Rating Scale (DRS) at 3 and 6 months post-injury. Data on sedative administration were abstracted from medical records. Individuals homozygous for the alleles coding for the reduced enzyme expression and activity were more likely to have worse outcomes. A relationship between propofol administration and 3-month GOS and 6-month DRS was noted when controlling for CYP2B6 genotype. These findings suggest that genetic variation in CYP2B6 may influence the impact of intravenous sedation on patient outcomes after TBI and warrants further investigation., (© O’Meara et al., 2024; Published by Mary Ann Liebert, Inc.)

Background The National Medical Commission (NMC), the regulatory body for medical education in India introduced competency-based medical education (CBME) in 2019. It is an outcome-based learner-centric approach. To implement it, active and innovative learning strategies are being introduced. A flipped classroom (FC) is one such teaching method in which learners are provided learning materials before class with active discussion during teaching sessions. This promotes critical thinking, better retention, and future clinical applicability. This study aimed to compare FC and traditional teaching methods for first-phase medical learners for the anatomy curriculum. The objectives of this study were to evaluate the effectiveness of FC viz-a viz traditional lecture method for certain topics of clinical relevance from the anatomy curriculum and assess students' perception of the FC method.  Methodology The study was conducted on 96 phase-one medical learners after obtaining approval from the Institutional Ethics Committee. After obtaining informed consent, a simple random sampling method was used to group the students into two groups. For the same topic, one group was taught with the FC method, while the other group was taught using the didactic lecture (DL) method. A crossover was done for another topic. Students were assessed by pre- and post-tests. Students' perceptions' were recorded by a pre-validated questionnaire quantified on a Likert scale. Results The difference in posttest scores for the topics taught between the two groups was found to be statistically significant. Perception regarding various aspects of the FC method was affirmative. Conclusions The results of this study indicated that FC is advantageous for students. It improves learner engagement and performance, and students' perception of the method was positive. Effective execution of this method requires detailed planning, constant motivation, and consistent efforts. Therefore, this method should be used more often for the benefit of students., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Netaji Subhas Medical College and Hospital, Amhara, Bihta, Patna Clinical Research Ethics Committee (Human Studies) issued approval CREC/2023/42, January 4, 2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jha et al.)