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Abstract The Gd-doped ZnO/SnO2 nanocomposites with various atomic percentages (0, 0.5, 0.8, and 1.2 at%) of gadolinium (coded as GdZS0, GdZS1, GdZS2, and GdZS3) was synthesis via the sol–gel method and explored for photodegradation against dye solutions exposing solar light irradiation. The synthesized nanocomposites were characterized employing the XRD, FTIR, FE-SEM, Raman spectroscopy, BET analysis and UV–Vis spectrophotometer. The FE-SEM results indicated that the formation of nanoparticles to nanoflowers covered with Gd ions was observed with an increased doping concentration of Gd. The optical bandgap was evaluated and found in the range of 3.21–3.27 eV for GdZS nanocomposites. The GdZS nano-photocatalysts were investigated against the degradation of different organic dyes and GdZS3 shows the highest degradation efficiencies of 99.3%, 98.3% and 99.4% towards MO, MB and RhB dyes, respectively at neutral pH in aqueous media. Before and after photodegradation. Biological oxygen demand and chemical oxygen demand tests to make estimations of mineralization. The investigations are very promising for the degradation process in rare earth doped metal oxide nanocomposites. A plausible photodegradation mechanism of synthesized nanocomposites under investigation has also been proposed.

Recycled coarse aggregate concrete enables the creation of environmentally friendly and cost-effective mixes. It helps address the disposal problem of demolition concrete waste, meeting demand while improving product functionality and reusability. The abundance of obsolete buildings in cemeteries contributes to Construction and Demolition waste. Recycled Concrete Aggregate (RCA) from demolished structures can be utilized as aggregates, albeit with concerns about its impact on compressive strength due to absorption issues. This review aimed to study and develop the different Artificial Intelligence (AI) model for the prediction of the compressive strength of concrete with varying RCA content and natural coarse aggregate content as input parameters while compressive strength as output parameter. The range of the input parameters is 0 % to 100 % while the range output parameter is 28 MPa to 70.3 MPa. Experimental data from literature articles used to train and validate the model development. Engineers and researchers can utilize these models to predict compressive strength by changing the input parameters. XGBoost Regression Model performed well with R2 0.93594 followed by Random Forest Model with R2 0.92766, and Gradient Boosting Model with R2 0.90616 respectively. Ridge Regression, Lasso Regression, and Linear Regression Models were not performed well in predicting the compressive strength of RCA concrete with R2 0.57657, 0.57558, 0.57675 respectively. ANN also performed significant in prediction of RCAC compressive strength with R2 0.8039. Future research could focus on optimizing the mechanical properties of concrete containing RCA using AI models. Furthermore, the study extends its analysis to explore the application of AI in predicting the strength of various types of concrete, highlighting the versatility and potential of AI-driven approaches in enhancing concrete mix design.

Testicular compartment syndrome (TCS) impedes the microcirculation in the testicle, resulting from increased venous resistance or an extraluminal compression that might lead to a cascade of hypoxia, ischemia, and gangrene. We report a case of fulminant necrotizing orchitis occurring in a 45-year-old immunocompetent patient in the form of TCS. The patient underwent imaging, which suggested extensive localized right testicular abscess formation, for which the patient underwent guided drainage from the abscess. Subsequently, the patient was started on culture-sensitive intravenous antibiotics. Due to the failure of conservative treatment and symptomatic deterioration, we planned scrotal exploration. Intraoperatively, we found that the testicular tissue was necrotic and completely replaced by frank pus, with an already ruptured tunica, due to higher compartmental pressure. The patient underwent a right orchidectomy. The postoperative course in the hospital was uneventful. We report that this case as TCS is rare, and all surgeons should be aware of such possibility of occurrence.

Neuromyelitis optica spectrum disorder also known as Devic's disease is an autoimmune condition where the body produces antibodies against Aquaporin-4 in the astrocytes. This affects the brain and spinal cord leading to numerous manifestations like paralysis, transverse myelitis, and optic neuritis. MRI and aquaporin-4 antibody (AQP4-IgG) are crucial for its diagnosis. Treatment of the acute stage involves plasma exchange and intravenous steroids. Steroids and immune modulators can do long-term management. This case highlights a 40-year-old woman who manifested a wide range of neurological symptoms, including paralysis and eyesight loss. She had blood testing, radiology, and a clinical evaluation to diagnose her condition. Neuromyelitis optica spectrum disorder was diagnosed in light of the investigations. This instance emphasizes the need for careful examination and consideration of any paralysis. To prevent patients from experiencing psychological, financial, or physical challenges, treating physicians should be vigilant for any findings related to conditions like neuromyelitis optica spectrum disorder.

Key Clinical Message Antinuclear antibody‐negative full‐house lupus nephritis though previously reported, is fairly uncommon. Some patients go on to develop antibodies later in the disease course. The presence of RO‐52 antibody in this case suggests an underlying immunological cause. Swift management based on strong clinical suspicion can be life‐saving to the patient. Abstract Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) and is more likely to progress to end‐stage renal disease (ESRD). With the recent EULAR/ACR criteria mandating antinuclear antibody (ANA) positivity as an entry criterion, clinicians are faced with a diagnostic dilemma in diagnosing cases of seronegative SLE. We present the case of a 25‐year‐old female who presented with photosensitive malar rash, hair loss, oral ulcers, menorrhagia, and kidney dysfunction, suggestive of SLE. Her ANA tests were negative, raising doubts about the diagnosis. Biopsy was delayed owing to anemia and thrombocytopenia, and clinical judgment led to the patient being diagnosed with LN, with prompt treatment resulting in significant improvement. Renal biopsy subsequently confirmed the case as diffuse class IV LN with full‐house nephropathy. This case highlights the limitations of relying solely on ANA positivity in diagnosing LN and underscores the need for a comprehensive diagnostic approach for SLE that incorporates clinical features, immunological markers, and patient demographics. ANA‐negative SLE patients demand heightened clinical suspicion, especially when other diagnostic parameters align with the disease. Swift intervention with immunosuppressive therapy, as seen in this case, can be life‐saving.

Abstract This work reports the measurement of two-dimensional electron properties over a nanosecond scale integration time across a femtosecond laser-induced plasma filament in atmospheric pressure argon. Radial electron properties across the $$\sim 100$$ ∼ 100 $$\upmu$$ μ m diameter filament are obtained at discrete axial locations at 2.5 mm steps by one-dimensional high-resolution laser Thomson scattering with a spatial resolution of 10 $$\upmu$$ μ m. These measurements reveal plasma structural information in the filament. The Thomson spectral lineshapes exhibit clear spectral sidebands with an $$\alpha$$ α parameter $$\sim 1$$ ∼ 1 , enabling the measurement of both electron temperature and density profiles. These measurements yield electron densities on the order of $$10^{22}$$ 10 22 /m $$^{3}$$ 3 and electron temperatures of $$\sim 2$$ ∼ 2 eV. Heating from the probe laser due to inverse bremsstrahlung is taken into account to correct the Thomson scattering electron temperature measurements. Under these conditions, electron-neutral collision induced bremsstrahlung becomes the dominant laser-induced plasma heating process associated with the probe laser. The measurements reveal structural features of the filament, including an asymmetrically skewed density structure in the axial direction and reversed radial distributions of electron density and temperature.

Abstract Labor shortages in the United States are impacting a number of industries including the meat processing sector. Collaborative technologies that work alongside humans while increasing production abilities may support the industry by enhancing automation and improving job quality. However, existing automation technologies used in the meat industry have limited collaboration potential, low flexibility, and high cost. The objective of this work was to explore the use of a robot arm to collaboratively work alongside a human and complete tasks performed in a meat processing facility. Toward this objective, we demonstrated proof-of-concept approaches to ensure human safety while exploring the capacity of the robot arm to perform example meat processing tasks. In support of human safety, we developed a knife instrumentation system to detect when the cutting implement comes into contact with meat within the collaborative space. To demonstrate the capability of the system to flexibly conduct a variety of basic meat processing tasks, we developed vision and control protocols to execute slicing, trimming, and cubing of pork loins. We also collected a subjective evaluation of the actions from experts within the U.S. meat processing industry. On average the experts rated the robot’s performance as adequate. Moreover, the experts generally preferred the cuts performed in collaboration with a human worker to cuts completed autonomously, highlighting the benefits of robotic technologies that assist human workers rather than replace them. Video demonstrations of our proposed framework can be found here: https://youtu.be/56mdHjjYMVc .

The prevalence and burden of diabetes are on the rise in India, making it 'the diabetes capital of the world'. Comorbidities such as obesity, cardiovascular (CV) complications, chronic kidney disease (CKD), non-alcoholic fatty liver disease (NAFLD), and neurodegenerative diseases are common in patients with diabetes. Recent breakthroughs in diabetes medications and continuous glucose monitoring have resulted in a paradigm shift in diabetes care. Hence, a review in the Indian context is warranted. This review focuses on the existing evidence (gathered by a systematic literature search utilising online databases such as PubMed) on the metabolic, cardio-renoprotective, and hepatoprotective effects of sodium-glucose co-transporter 2 (SGLT2) inhibition, particularly in the Indian setting. The study revealed that the SGLT2 inhibitors (SGLT2i), with their numerous pleiotropic benefits, have received considerable attention recently as a novel class of antihyperglycaemic agents (AHAs) for the management of diabetes. SGLT2i play a crucial role in the transition from glycaemic control to metabolic care, particularly in the context of obesity, CV disease and renal disease. In addition to improving glycaemic control, SGLT2i have been shown to promote weight loss, reduce blood pressure and improve lipid profiles, which are key components of metabolic health. Moreover, SGLT2i have demonstrated renal protective effects, including a reduction in albuminuria and a slower decline in the estimated glomerular filtration rate (eGFR), suggesting a potential role in the management of renal dysfunction.

Abstract Co-occurrence and spatial and temporal overlap of sympatric jungle and leopard cats are influenced by habitat preferences, and interspecific competition. Understanding these factors influence is crucial for developing effective conservation strategies. We conducted a camera survey in Parsa‒Koshi Complex (PKC), Nepal during December 2022–March 2023 to investigate factors influencing occupancy and spatial and temporal overlap between jungle cats (Felis chaus) and leopard cats (Prionailurus bengalensis). The mean detection probability (t = 0.664, p = 0.507) did not differ between jungle cats (p = 0.500 ± 0.289) and leopard cats (p = 0.501 ± 0.288); however, occupancy (t = 31.008, p

IntroductionSepsis remains a major cause of death in Intensive Care Units. Sepsis is a life-threatening multi-organ dysfunction caused by a dysregulated systemic inflammatory response. Pattern recognition receptors, such as TLRs and NLRs contribute to innate immune responses. Upon activation, some NLRs form multimeric protein complexes in the cytoplasm termed “inflammasomes” which induce gasdermin d-mediated pyroptotic cell death and the release of mature forms of IL-1β and IL-18. The NLRP6 inflammasome is documented to be both a positive and a negative regulator of host defense in distinct infectious diseases. However, the role of NLRP6 in polymicrobial sepsis remains elusive.MethodsWe have used NLRP6 KO mice and human septic spleen samples to examine the role of NLRP6 in host defense in sepsis.ResultsNLRP6 KO mice display enhanced survival, reduced bacterial burden in the organs, and reduced cytokine/chemokine production. Co-housed WT and KO mice following sepsis show decreased bacterial burden in the KO mice as observed in singly housed groups. NLRP6 is upregulated in CD3, CD4, and CD8 cells of septic patients and septic mice. The KO mice showed a higher number of CD3, CD4, and CD8 positive T cell subsets and reduced T cell death in the spleen following sepsis. Furthermore, administration of recombinant IL-18, but not IL-1β, elicited excessive inflammation and reversed the survival advantages observed in NLRP6 KO mice.ConclusionThese results unveil NLRP6 as a negative regulator of host defense during sepsis and offer novel insights for the development of new treatment strategies for sepsis.

Background: Suicide is an emerging public health problem accounting for over 700,000 annual deaths globally. It is also the fourth leading cause of death among the age group 15-29 years in the world. In Nepal, on average 14 people commit suicide every day. Our study explores the factors associated with suicidal and self-harm behaviours among young adults in the Kathmandu district, Nepal. Methods: A descriptive cross-sectional study was conducted among a total of 242 young adults of the Kathmandu district. Data were collected through interview using a developed semi-structured questionnaire. Descriptive statistics and odds ratios were used for data analysis. Results: The mean age for initial suicidal and self-harm behaviour was found to be 14 and 15 years respectively, with 28.51% reporting suicidal behaviours including making a plan or suicidal ideation or attempts, and 18.5% with self-harm behaviours. Avoidance and emotional discharge were found as common coping strategies adopted by participants. Belief, family functioning, depression status and self-harm behaviour were found statistically associated with suicidal behaviour. Conclusions: Various factors including belief, family functioning, and depression were found to influence individual suicidal behaviour. Hence, an integrated approach addressing these factors is crucial for the prevention and control of suicide among young adults at risk. Keywords: Self-harm behaviour; suicidal behaviour; suicidal ideation; young adults.

Congenital pulmonary airway malformation (CPAM) is a rare congenital dysplastic malformation characterized by failure of bronchial development and localized glandular overgrowth. Previously known as Congenital Cystic Adenoid Malformation (CCAM), CPAM is classified into 5 types, from type 0 to type IV, depending upon the origin of pulmonary areas of the lung, cyst size, and cyst appearance. CPAM is a rare congenital anomaly typically diagnosed prenatally in ultrasound. However, few cases are diagnosed in childhood and even fewer in adulthood. CPAM can be differentiated from pulmonary sequestration based on the origin of the arterial supply; the former has its arterial supply from the pulmonary artery, whereas pulmonary sequestration has its arterial supply from the systemic circulation. Another differential diagnosis of CPAM includes congenital bronchogenic cyst, congenital lobar emphysema, pleuropulmonary blastoma, congenital cystic bronchiectasis, and congenital diaphragmatic hernia. The most common presentation is recurrent chest infection and chest pain, whereas other presentation includes pneumothorax and hemoptysis. Here, we present a case of a 6-year-old child with recurrent episodes of fever and cough diagnosed as a type II CPAM based on computed tomography findings.

Inflammation of the bile ducts and surrounding tissues can impede bile flow from the liver into the intestines. If this occurs, a plastic or self-expanding metal (SEM) stent is placed to restore bile drainage. United States (US) Food and Drug Administration (FDA)-approved plastic biliary stents are less expensive than SEMs but have limited patency and can occlude bile flow if placed spanning a duct juncture. Recently, we investigated the effects of variations to post-processing and autoclaving on a commercially available stereolithography (SLA) resin in an effort to produce a suitable material for use in a biliary stent, an FDA Class II medical device. We tested six variations from the manufacturer’s recommended post-processing and found that tripling the isopropanol (IPA) wash time to 60 min and reducing the time and temperature of the UV cure to 10 min at 40 °C, followed by a 30 min gravity autoclave cycle, yielded a polymer that was flexible and non-cytotoxic. In turn, we designed and fabricated customizable, SLA 3D-printed polymeric biliary stents that permit bile flow at a duct juncture and can be deployed via catheter. Next, we generated an in silico stent 3-point bend test to predict displacements and peak stresses in the stent designs. We confirmed our simulation accuracy with experimental data from 3-point bend tests on SLA 3D-printed stents. Unfortunately, our 3-point bend test simulation indicates that, when bent to the degree needed for placement via catheter (~30°), the peak stress the stents are predicted to experience would exceed the yield stress of the polymer. Thus, the risk of permanent deformation or damage during placement via catheter to a stent printed and post-processed as we have described would be significant. Moving forward, we will test alternative resins and post-processing parameters that have increased elasticity but would still be compatible with use in a Class II medical device.

In the present research, the open-source WRF-SFIRE model has been used to carry out surface forest fire spread forecasting in the North Sikkim region of the Indian Himalayas. Global forecast system (GFS)-based hourly forecasted weather model data obtained through the National Centers for Environmental Prediction (NCEP) at 0.25 degree resolution were used to provide the initial conditions for running WRF-SFIRE. A landuse–landcover map at 1:10,000 scale was used to define fuel parameters for different vegetation types. The fuel parameters, i.e., fuel depth and fuel load, were collected from 23 sample plots (0.1 ha each) laid down in the study area. Samples of different categories of forest fuels were measured for their wet and dry weights to obtain the fuel load. The vegetation specific surface area-to-volume ratio was referenced from the literature. The atmospheric data were downscaled using nested domains in the WRF model to capture fire–atmosphere interactions at a finer resolution (40 m). VIIRS satellite sensor-based fire alert (375 m spatial resolution) was used as ignition initiation point for the fire spread forecasting, whereas the forecasted hourly weather data (time synchronized with the fire alert) were used for dynamic forest-fire spread forecasting. The forecasted burnt area (1.72 km2) was validated against the satellite-based burnt area (1.07 km2) obtained through Sentinel 2 satellite data. The shapes of the original and forecasted burnt areas matched well. Based on the various simulation studies conducted, an operational fire spread forecasting system, i.e., Sikkim Wildfire Forecasting and Monitoring System (SWFMS), has been developed to facilitate firefighting agencies to issue early warnings and carry out strategic firefighting.

Abstract Background Development of valid and feasible quality indicators (QIs) is needed to track quality initiatives for osteoarthritis pain management in primary care settings. Methods Literature search identified published guidelines that were reviewed for QI extraction. A panel of 14 experts was assembled, including primary care physicians, rheumatologists, orthopedic surgeons, pain specialists, and outcomes research pharmacists. A screening survey excluded QIs that cannot be reliably extracted from the electronic health record or that are irrelevant for osteoarthritis in primary care settings. A validity screening survey used a 9-point Likert scale to rate the validity of each QI based on predefined criteria. During expert panel discussions, stakeholders revised QI wording, added new QIs, and voted to include or exclude each QI. A priority survey used a 9-point Likert scale to prioritize the included QIs. Results Literature search identified 520 references published from January 2015 to March 2021 and 4 additional guidelines from professional/governmental websites. The study included 41 guidelines. Extraction of 741 recommendations yielded 115 candidate QIs. Feasibility screening excluded 28 QIs. Validity screening and expert panel discussion excluded 73 QIs and added 1 QI. The final set of 15 prioritized QIs focused on pain management safety, education, weight-management, psychological wellbeing, optimizing first-line medications, referral, and imaging. Conclusion This multi-disciplinary expert panel established consensus on QIs for osteoarthritis pain management in primary care settings by combining scientific evidence with expert opinion. The resulting list of 15 prioritized, valid, and feasible QIs can be used to track quality initiatives for osteoarthritis pain management.

Abstract Globally, biodiversity is declining due to habitat loss and degradation, over‐exploitation, climate change, invasive species, pollution, and infrastructure development. These threats affect the populations of large waterbird species, such as Sarus crane (Grus antigone), which inhabits agricultural–wetland ecosystems. Despite the burgeoning built‐up areas and diminishing agricultural and wetland spaces, scant research investigates the impact of these changing land uses on the globally vulnerable Sarus crane in Nepal. During the pre‐breeding season from April to June 2023, our comprehensive study meticulously scrutinized Sarus crane population status and factors associated with the occurrences and conservation challenges across 10 specific districts of Nepal. Our study documented a total of 690 individuals of Sarus cranes in five districts. The Lumbini Province has 685 individuals, occupying 11 roosting sites. Conversely, the remaining five districts have no Sarus cranes presence during this period. Wetland, farmland and built‐up areas exhibited a significantly positive influence on Sarus crane occurrences in the Lumbini Province. Additionally, we recorded 47 fatalities of Sarus cranes over the past 13 years in the Lumbini Province due to electrocution and collisions. Our study provides a baseline dataset crucial for developing conservation policies, particularly during the dry season when Sarus crane populations tend to congregate in larger flocks. The adaptation of the Sarus crane to urbanized landscapes exposes them to several anthropogenic threats in the coming days. Therefore, protecting wetlands and farmland areas and adopting transboundary conservation approaches are imperative for the long‐term conservation of the Sarus crane and its habitat.

Complex metacarpophalangeal dislocation is an uncommon injury where the index is the most commonly involved finger. The most common mechanism involves hyperextension of digits at the metacarpophalangeal joint. Such dislocation needs open reduction as the volar plate becomes entrapped between the metacarpal head and proximal phalanx making close reduction difficult. Approaches for open reduction can be dorsal, volar, and lateral. In our patient, we commenced a dorsal approach for reduction and additional stabilization done with K-wire. An early range of movement was initiated and resulted in good functional recovery. Keywords: Dislocation; metacarpophalangeal; plate; volar.

Geopolymerization in concrete production is a sustainable approach that utilizes industrial waste materials in conjunction with alkaline activators, such as sodium hydroxide and sodium silicate. Geopolymer concrete (GPC) has emerged as an environmentally friendly alternative, addressing the pressing concern of CO2 emissions associated with conventional cement manufacturing. However, GPC often exhibits suboptimal ambient-cured strength, necessitating the incorporation of nanomaterials to enhance its mechanical properties. This study delves into the investigation of diverse nanomaterial ratios and their profound impact on GPC properties. The research explores the application of engineering-favored additives, including nano-silica, aluminum oxide, titanium oxide, graphene, and carbon nanotubes, to bolster GPC attributes on a global scale. Notably, nanomaterial-modified GPC surpasses the strength of conventionally heat-cured GPC. In-depth microstructural and X-ray diffraction (XRD) analyses shed light on the intricate nature of nanomaterial-infused GPC, offering a comprehensive understanding of this pioneering composite. This paper serves as an extensive analysis of nanomaterial integration in GPC, unraveling its effects on the material’s characteristics and presenting valuable insights for future application. Incorporating nanomaterials in GPC yields impressive strength gains even under ambient curing conditions, overcoming the limitations of heat curing. Nano material infusion leads to improved concrete densification, reducing sorptivity and water absorption (%) of GPC. Durability against acidic conditions is enhanced by approximately 2–2.5% after the incorporation of nanomaterials in GPC.

Clinical trials have demonstrated that combining fimasartan potassium trihydrate and atorvastatin calcium produces better results for essential hypertension and dyslipidemia with fewer side effects than individual drugs. However, no analytical method is available to accurately determine both drugs' qualitative and quantitative amounts when used together. Therefore, we are interested in developing and validating three analytical methods for simultaneously estimating fimasartan potassium trihydrate and atorvastatin calcium in laboratory-prepared tablets. These methods include a novel, simple, precise, sensitive, robust HPLC technique, and two UV spectrophotometric methods. The HPLC method used a reversed-phase Shimpack ODS C18 column as a stationary phase with an isocratic procedure. A mobile phase consisting of a mixture of acetonitrile and 0.01 M ammonium acetate buffer, (pH adjusted to 3.7 using formic acid) at a ratio of 70:30 v/v, at a constant flow rate of 1 mL/min and chromatograms were recorded at 234 nm for the two analytes. Vierordt's simultaneous equation method used two wavelengths (247 nm and 263 nm) to estimate the drugs' amounts and derive a simultaneous equation for FIMA and ATOR. Meanwhile, the first-order derivative method used zero-crossing points of 224nm and 261nm to estimate the concentrations of ATOR and FIMA. A statistical analysis using an analysis of variance test revealed no significant differences among the three methods regarding accuracy and precision. Moreover, the three developed methods underwent rigorous statistical validation by the ICH Q2R1 guidelines, demonstrating their successful application in the concurrent analysis of the two drugs in bulk and tablets prepared within the laboratory. To assess the ecological impact of the new UV spectrophotometric technique and HPLC method, the greenness profile was evaluated utilizing Analytical eco scale (AES), National environmental method index (NEMI), the Green analytical procedure index (GAPI), and the software-based Analytical greenness metric (AGREE) tools. This evaluation substantiated the method's environmental friendliness regarding solvent usage, chemical substances, energy consumption, and waste generation.

Abstract The study focused on identifying autochthonous bacteria from the indigenous catfish intestine and evaluating their impacts on survival, growth and against Aeromonas veronii infection in Clarias batrachus and Heteropneustes fossilis under laboratory conditions. Candidate bacteria were isolated using Nutrient Agar (NA) and de Man, Rogosa and Sharpe (MRS) agar in duplicate. An immersion technique was employed to determine the biosafety of these isolates in both catfish species at a dose of 107 CFU/mL. Three experimental diets: D1 (basal diet + putative Bacillus sp., 108–109 CFU/g), D2 (basal diet + 3% BioFav Aqua) and D3 (basal diet + putative Lactobacillus sp., 108–109 CFU/g) were prepared to conduct a 4‐week long feeding trial, whereas the control diet received no probiotic supplementation. The probiotic performance was analysed by comparing the growth performance and survival of C. batrachus and H. fossilis. Resistance against Aeromonas veronii infection was determined by a challenge test of catfish. Initially, 16 autochthonous isolates were collected, and among them, an isolate from C. batrachus intestine and another from the gut of H. fossilis were selected for further studies. A series of biochemical analyses identified that the putative bacteria were Bacillus sp. and Lactobacillus sp., respectively. The biosafety test showed no clinical signs of infection or mortality among experimental catfishes. All probiotic‐treated fish showed higher growth increments than control. Incorporation of Bacillus sp. and Lactobacillus sp. in the basal diet significantly (p

Organic Farming is a system designed and maintained to produce agricultural products using methods and substances that preserve the integrity of organic agricultural products. Organic agriculture is a more sustainable alternative to the dominant agricultural model. Organic Farming reduces the risk of adverse environmental effects compared to conventional farming methods; in terms of soil fertility and nutrient management, organic Farming is suited to significantly improve soil fertility and nutrient management on the farm level; and comparative studies on biodiversity demonstrate that organic farming has a greater impact on biodiversity preservation. Furthermore, when comparing organic farming systems to conventional farming systems, the lower crop yields attained by organic systems may outweigh the benefits of using more environmentally friendly practices when calculating the environmental impact per product unit. Modern agriculture, which involves the use of pesticides and fertilizers, harms the environment by affecting soil fertility, water hardness, the development of insect resistance, and an increase in toxic residue through the food chain and animal feed, resulting in increased health problems, and many other serious health concerns and environmental degradation. Organic Farming is one of the most widely used methods, and it is widely regarded as the best alternative to avoiding the negative effects of chemical farming. It also has far more benefits than conventional and other modern agricultural practices. This study demonstrated that organic farming systems could be a viable method of reducing greenhouse gas emissions in the agricultural sector. Also, organic farming is not only the model for sustainable agriculture and food security, but creative hybridizations of organic and conventional farming methods could assist to increase agricultural productivity globally.

This paper embodies the design and development of a compact Coplanar Waveguide (CPW) fed connected ground Multiple- Input-Multiple-Output (MIMO) antennas operating in the sub-millimeter-wave 5G New Radio (NR) n257/n258/n261 bands. The planar geometry leads to a small and compact structure while achieving a wide operating bandwidth, high gain, and better radiation efficiency. The top surface of the antenna comprises a modified CPW in the form of two circular structures that feeds the centrally slotted circular patch. The single antenna structure is arranged in a rotational orthogonal manner forming a 4-port structure. The ground plane on the bottom of a 4-port structure is connected using a circular ring which is carefully optimized for achieving isolation levels>20 dB across the band of interest. The sub-mm-wave resonating 4-port antenna achieves a compact size of 24 × 24 mm2, a wide bandwidth of 24.8–44.45 GHz (79.35%), the maximum gain of 8.6dBi, and minimum efficiency of 85% across the bands of interest. The proposed antenna element is fabricated over Rogers 5880 substrate and experimental tests are carried out, where a good correlation between the scattering parameters, transmission parameters, gain, and MIMO diversity performance is achieved that makes the antenna a potential candidate for its application in sub-millimeter wave 5G applications.

ABSTRACT Changes to gut environmental factors such as pH and osmolality due to disease or drugs correlate with major shifts in microbiome composition; however, we currently cannot predict which species can tolerate such changes or how the community will be affected. Here, we assessed the growth of 92 representative human gut bacterial strains spanning 28 families across multiple pH values and osmolalities in vitro. The ability to grow in extreme pH or osmolality conditions correlated with the availability of known stress response genes in many cases, but not all, indicating that novel pathways may participate in protecting against acid or osmotic stresses. Machine learning analysis uncovered genes or subsystems that are predictive of differential tolerance in either acid or osmotic stress. For osmotic stress, we corroborated the increased abundance of these genes in vivo during osmotic perturbation. The growth of specific taxa in limiting conditions in isolation in vitro correlated with survival in complex communities in vitro and in an in vivo mouse model of diet-induced intestinal acidification. Our data show that in vitro stress tolerance results are generalizable and that physical parameters may supersede interspecies interactions in determining the relative abundance of community members. This study provides insight into the ability of the microbiota to respond to common perturbations that may be encountered in the gut and provides a list of genes that correlate with increased ability to survive in these conditions. IMPORTANCE To achieve greater predictability in microbiota studies, it is crucial to consider physical environmental factors such as pH and particle concentration, as they play a pivotal role in influencing bacterial function and survival. For example, pH is significantly altered in various diseases, including cancers, inflammatory bowel disease, as well in the case of over-the-counter drug use. Additionally, conditions like malabsorption can affect particle concentration. In our study, we investigate how changes in environmental pH and osmolality can serve as predictive indicators of bacterial growth and abundance. Our research provides a comprehensive resource for anticipating shifts in microbial composition and gene abundance during complex perturbations. Moreover, our findings underscore the significance of the physical environment as a major driver of bacterial composition. Finally, this work emphasizes the necessity of incorporating physical measurements into animal and clinical studies to better understand the factors influencing shifts in microbiota abundance.

‘Chambourcin’ is a French-American interspecific hybrid grape grown in the eastern and midwestern United States and used for making wine. Few genomic resources are available for hybrid grapevines like ‘Chambourcin’. Here, we assembled the genome of ‘Chambourcin’ using PacBio HiFi long-read, Bionano optical map, and Illumina short-read sequencing technologies. We generated an assembly for ‘Chambourcin’ with 26 scaffolds, with an N50 length of 23.3 Mb and an estimated BUSCO completeness of 97.9%. We predicted 33,791 gene models and identified 16,056 common orthologs between ‘Chambourcin’, V. vinifera ‘PN40024’ 12X.v2, VCOST.v3, Shine Muscat and V. riparia Gloire. We found 1,606 plant transcription factors from 58 gene families. Finally, we identified 304,571 simple sequence repeats (up to six base pairs long). Our work provides the genome assembly, annotation and the protein and coding sequences of ‘Chambourcin’. Our genome assembly is a valuable resource for genome comparisons, functional genomic analyses and genome-assisted breeding research.

Though the European Commission classifies eggshell as a hazardous material, using eggshell powder in place of cement can aid in waste reduction and contribute to sustainability initiatives. Eggshell powder replaces cement in concrete manufacturing due to its high calcium content. Eggshell is impermeable in nature, so it helps in reducing the permeability of concrete. Eggshell powder fastens the process of hydration of cement by the formation of monocarboaluminate during the mixing of material at the time of casting. This paper includes a detailed study of the process production of eggshell powder, the properties of eggshell powder concrete, and the relationship between different properties has been determined. In addition, Artifical Neural Network approach has been used to predict the strength of eggshell powder concrete to reduce the labour cost and experimental time. In the end, microstructure of eggshell powder and its application in various engineering products have been reviewed. After analyzing the qualities of eggshell powder concrete, it was determined that replacing up to 20% of the cement in concrete with eggshell powder increases the material's strength. The ANN model's results also demonstrate its effectiveness in forecasting the strength of eggshell powder concrete, with an R2 value of 0.96. So, it clearly shows that eggshell powder can be used to replace cement to improve the properties of concrete and reduce the percentage of cement usage. Finally, the conclusions and discussion of this study addressed the eco-friendly utilization of eggshell powder in construction applications.

IntroductionIntersecting vulnerabilities of disability, low socio-economic status, marginalization, and age indicate that adolescents with disabilities in low-and middle-income countries were uniquely affected by the COVID-19 pandemic. Yet, there has been limited research about their experience. We conducted participatory research with adolescents with disabilities in rural, hilly Nepal to explore their experience of the pandemic and inform understanding about how they can be supported in future pandemics and humanitarian emergencies.MethodsWe used qualitative methods, purposively sampling adolescents with different severe impairments from two rural, hilly areas of Nepal. We collected data through semi-structured interviews with five girls and seven boys between the age of 11 and 17 years old. Interviews used inclusive, participatory, and arts-based methods to engage adolescents, support discussions and enable them to choose what they would like to discuss. We also conducted semi-structured interviews with 11 caregivers.ResultsWe found that adolescents with disabilities and their families experienced social exclusion and social isolation because of COVID-19 mitigation measures, and some experienced social stigma due to misconceptions about transmission of COVID-19 and perceived increased vulnerability of adolescents with disabilities to COVID-19. Adolescents who remained connected with their peers throughout lockdown had a more positive experience of the pandemic than those who were isolated from friends. They became disconnected because they moved away from those they could communicate with, or they had moved to live with relatives who lived in a remote, rural area. We found that caregivers were particularly fearful and anxious about accessing health care if the adolescent they cared for became ill. Caregivers also worried about protecting adolescents from COVID-19 if they themselves got ill, and about the likelihood that the adolescent would be neglected if the caregiver died.ConclusionContextually specific research with adolescents with disabilities to explore their experience of the pandemic is necessary to capture how intersecting vulnerabilities can adversely affect particular groups, such as those with disabilities. The participation of adolescents with disabilities and their caregivers in the development of stigma mitigation initiatives and strategies to meet their needs in future emergencies is necessary to enable an informed and inclusive response.

Background: Despite being an uncommon tumor, sacrococcygeal teratoma (SCT) is the most prevalent among newborns. SCT comprises tissue generated from many germ layers. It develops from Hensen's node's totipotent cells. The objective of our study was to determine the epidemiology and management of neonatal sacrococcygeal teratoma in the tertiary care center of Nepal in a resource-limited setting. Methods: It is a retrospective cross-sectional study that includes all cases of neonatal SCT admitted and treated in the department of Pediatrics and Neurosurgery, B. P. Koirala Institute of Health Sciences, over the period from July 2017 to December 2021. The primary endpoint was to determine the epidemiological profile of neonates with SCT, their surgical management, and their complications. Results: Our investigation included a total of 15 patients. Nine of the fifteen cases were female (60%) and six were male (40%). Six newborns (40%) were diagnosed with SCT antenatally and were referred to our tertiary care institution for delivery. The size of the SCT varied ranging from less than 8 cm to greater than 11 cm. Surgical excision was performed. Only 1 case (6.6 %) expired due to complications. Conclusions: In our context, SCT is the most prevalent tumor in babies. Even with limited resources, great surgical results with a high level of satisfaction in patients and caregivers may be accomplished with sound clinical judgment and competency of the surgeons and clinicians. Prenatal diagnosis should be encouraged.

Excellent characteristics of Nitinol shape memory alloys (SMAs) makes them favourable for use in industrial applications. Precision machining of such advanced alloys becomes a key requirement for industrial applications. Conventional machining processes imposes many difficulties for nitinol SMAs. Electrical discharge machining (EDM) process is appropriate for fabricating intricate and complex profile geometries and also provides a better alternative for difficult-to-cut materials. Addition of nano-particles in an appropriate amount in the dielectric fluid improves the machining by producing good dimensional accuracy, higher productivity, and good surface finish for machining of newly developed advanced alloys. The current study investigated the performance of powder-mixed EDM of nitinol SMA with the considerations of design variables of current, pulse-on-time (Ton), nano-graphene powder concentration (PC), and pulse-off-time (Toff) on surface roughness, dimensional deviation (DD), and material removal rate (MRR). Taguchi's L9 (3ˆ4) design was employed to perform the experiments and Minitab 17 software was used for statistical analysis of design variables using ANOVA, residual plots, and main effect plots. ANOVA results depicted that PC, Ton, and Toff were identified to be the highest contributing parameters with 75.18%, 29.37%, and 45.72% to affect MRR, SR, and DD, respectively. Obtained results has depicted a preferred combined positive trend of increase in MRR with a simultaneous drop in SR and DD after the addition of nano-graphene PC. HST algorithm was used to optimize single and multiple responses. Validation trials were also conducted to reveal the ability and suitability of the HTS technique. Field emission scanning electron microscopy revealed the minor occurrence of resolidified debris particles, globules, micro-pores, and micro-cracks after the addition of nano-graphene PC at 2 g/L.

Acmella paniculata (Wall. Ex DC.) R. K. Jansen, also known as Akkalkadha or toothache plant is an important medicinal herb of the Asteraceae family that grows in the tropics and subtropics of the world. The present phytochemical investigation aimed at evaluating the impact of different solvents on extraction yields, ash analysis, fluorescence analysis and phytochemical compounds from flower drug of A. paniculata plant. The results indicate that solvents have a significant impact in the yield of extraction. Resulting in the higher extraction yield in solvent distilled water and ethanol. Flavonoids, alkaloids, tannins, saponins, cardiac glycosides, and terpenoids are found in the crude flower drug of the plant. The present study is useful in drug standardization, identifying the adulteration in the Ayurvedic medicines from this plant.

Introduction: Congenital pouch colon (CPC) is a congenital malformation of the large bowel in which the entire large bowel or segments of varying lengths of the large bowel exhibit enormous dilatations in the form of a pouch communicating distally through a fistula with the urogenital system. CPC shows male predominance and is mainly present in the early neonatal period with the absence of anus and intestinal obstruction. We report a case of Type 2 CPC in a 16-day-old male child presenting with abdominal distension and non-passing of stool. Presentation of the case: A 16-day-old male presented with his parents with abdominal distension and an imperforate anus. A plain abdominal X-ray revealed multiple dilated bowel loops. Exploratory laparotomy revealed a Type 2 CPC. The patient was treated via 2 staged surgery and his clinical condition was stable after surgery and is being followed in 3 monthly-basis. Clinical discussion: CPC is a rare condition with male predominance and is suspected in a patient with abdominal distension and an imperforate anus. Surgical management of CPC and the outcome, as well as overall prognosis, mainly depend on the type of CPC, the length of the affected colon, type of perineum, and anorectal muscle complexity, as well as other congenital associations. Conclusion: Though being a rare syndrome, CPC must be kept as a differential diagnosis for abdominal distension and must be taken into consideration when anorectal malformation is present.

Background: The safety and efficacy of fixed-dose combination (FDC) of glycopyrronium bromide 12.5 μg/formoterol fumarate 12 μg (GB/FF) twice daily as dry powder inhalers (DPIs) compared to glycopyrronium 50 μg monotherapy (GLY) once daily as DPI in subjects with moderate-to-severe chronic obstructive pulmonary disease (COPD) were evaluated. Methods: This was a phase-3, randomized, double-blind, active-controlled, parallel-group, superiority study conducted in India. COPD patients aged ≥40 to ≤65 years, current or ex-smokers with FEV1/FVC

Paying regard to the increasing concern of consumers towards nutrients-loaded food products and agriculture sustainability, the main aim of this paper is to assess the consumers’ willingness to pay the price premium for organic vegetables and to know their perception of the organic vegetables in Budhanilkantha-8 municipality, Kathmandu. A total of 100 respondents were randomly surveyed using a questionnaire. The first part of the questionnaire included the demographic section, while in the second part, consumers were asked about their perception of organic vegetable consumption. The consumers’ survey revealed that 28% of the respondents were willing to pay a 0-10% price premium compared to inorganic vegetables. Similarly, 24% were willing to pay a 20-30% price premium. Some (22%) were willing to pay a 10-20% price premium, 9% liked to pay a 30-40% price premium, 1% liked to pay a 40-50% price premium, and 8% were willing to pay greater than 50% price premium, while 8% of surveyed consumers denied paying price premium even in case of product availability. The consumers’ willingness to pay was health properties, followed by freshness and taste. Few factors, such as low availability, low trust, lack of information, and high price, were considered barriers to purchasing organic vegetables. The survey also suggested that the consumption of organic vegetables is increasing; however, to stimulate further demand for its consumption, huge production and timely availability, credible certification, processing, and packaging are needed to be promoted.

Dedicated fifth generation (5G) positioning networks are envisaged as a key technology to complement Global Navigation Satellite Systems (GNSS) in challenging situations, such as safety-critical automotive and aerial applications. These 5G networks are explicitly designed to fulfil the positioning needs in a specific environment, by using dedicated pilot signals and locating the base stations (BSs) in favorable conditions for user reception. To prove this concept, the Hybrid Overlay Positioning with 5G and GNSS (HOP-5G) testbed demonstrates the enhanced positioning capabilities resulting from the deployment of ground and aerial BSs. This paper presents a preliminary assessment of the first real-time ranging measurements obtained with a flying BS in a dedicated 5G positioning network. Under hovering and optimal conditions, field results obtained over an 80 MHz downlink bandwidth indicate a ranging precision below 1 m in 95% of cases.

Durable concrete significantly reduces the spalling caused by chemical damage. The objective of current research is to substitute cement with supplementary such as fly ash (FA), ground granulated blast furnace slag (GGBS), and alccofine (AF). Additionally, the impact of nano-silica (NS) and silica fumes (SF) on the GPC durability when cured at various temperatures has been attempted. In order to perform this, GPC samples were produced by combining NS and SF at proportions of 0.5% NS + 5% SF, 1% NS + 10% SF, and 1.5% NS + 15% SF, and then cured at temperatures of 27 °C, 60 °C, 90 °C, and 120 °C, respectively. In this research, all concrete specimens were continuously immersed for twelve weeks under four different chemicals, i.e., HCl (2%), H2SO4 (2%), NaCl (6%), and Na2SO4 (6%). The influence of chemical attack on the qualities of concrete was examined by evaluating the water absorption, sorptivity, loss of mass, and loss of GPC strength. The durability aspect is also studied by visual appearance and mass loss under harmful chemical attack. The combination of GPC with integrated NS and SF affords great resistance against chemical attacks. The percentages of these two components are 1.5% and 15%. For GPC specimens, when cured at 90 °C, the resultant strength is found at its maximum.

Background: There is a need to improve their nutritional status of under-five children through specific targeted interventions. The present study discusses the impact of intervention on nutritional status among under-five children in Palghar district from Maharashtra. Objective: The objective is to improve the nutritional status of under-five children by implementing multi-component health and nutrition education intervention, focusing on dietary counseling and modification keeping in view the cultural and socio-economic status of population. Methods: A prospective pre- and post-intervention study was conducted in two tribal blocks. Total 480 under-five children were included in pre- and post-intervention survey each. Results: Exclusive breastfeeding rates improved from 48.9% to 50.5% and initiation of complementary feeding at 6 months improved from 48.3% to 72.5% in post intervention survey as compared to preintervention survey. Among other Infant and Young Child Feeding indicators, Minimum Meal Frequency increased significantly to 67.03% from 5.91% and minimum acceptable diet improved from 5.37% to 47.2% in post intervention survey. The prevalence of Severe Acute Malnutrition (SAM) reduced from 5.4% to nil whereas severe stunting and underweight significantly decreased by 17% and 8% respectively in post intervention survey. Severe anemia decreased from 16.24% to nil post intervention. Conclusion: The study reveals a substantial improvement in timely initiation of complementary feeds, nil cases of SAM, stunting, and underweight along with severe anemia in postintervention phase. This highlights the impact of multicomponent health and nutrition education interventions which may be adapted at a programmatic level to reduce child mortality and morbidity in India.

5G NR has gained importance in academic and industrial research communities in recent times as its millimetre wave (mmWave) band operations offer a promising alternative for next-generation wireless communications. However, the susceptibility of mmWave signals to severe path loss and shadowing requires the use of highly directional antennas. Since the narrow beams are vulnerable to blockages, the interference behaviour becomes the key factor in building the network. In this paper, we propose a blockage model by considering the distribution of buildings in the cell as a Poisson point process. We analytically derive the blockage probability using the queuing theory. Subsequently, we derive the interference statistics using the blockage model considering the spatial randomness of the locations of blockages and User Equipments (UEs). We define and derive the coverage probability of a UE depending on the interference statistics. We calculate the success probability of a preamble transmission of a UE subjected its coverage. The effect of mobility on blockage, coverage and preamble success probability has been presented through extensive simulations.

Cardiac amyloidosis (CA), a significant condition resulting in infiltrative cardiomyopathy and heart failure with preserved ejection fraction (HFpEF), is caused by extracellular deposition of amyloid fibrils in the heart. Even though this has been known for an extended period, its prevalence in elderly patients with heart failure is increasingly being recognized. Recent advances in diagnosis with non-invasive methods like technetium pyrophosphate-labeled cardiac scintigraphy (i.e., Tc-PYP scan) and treatment options with tafamidis have played a pivotal role in awareness of the burden of this disease. Management of cardiac complications like heart failure, atrial arrhythmias, conduction block, ventricular arrhythmias, coronary artery disease, and aortic stenosis is now more critical than ever. We aim to review and outline the recent advances in diagnoses of CA. We also review management strategies for cardiac complications of CA with a brief summary of disease-modifying therapies.

The pathogen SARS-CoV-2 has emerged and taken the shape of a global pandemic by causing COVID-19. SARS-CoV-2 has a very novel and unique set of genetic makeup that has created a puzzle in biological research. Therefore, the scientific community has not yet discovered a very effective new treatment or preventive solution. By using various bioinformatics techniques and tools, the decoding of the genomic structure of the virus has been possible. In COVID-19 research methodologies, next-gene sequencing and computer-aided drug design have been implemented to decode this new structure of the SARS-CoV-2. Implementing in silico studies for COVID-19 has analyzed various evolutionary relationships, sequencing errors, and for determining potential candidates against the SARS-CoV-2 genes, and that too in a short span. The information derived using various bioinformatics techniques would fast forward the research speed on the SARS-CoV-2 and provide essential information for vaccine development, which is essential to ensure the overall betterment of public health. The application of artificial intelligence (AI) and Machine learning (ML) has provided an attractive niche for the bio-therapeutics development for COVID-19. This review article describes the application of AI and ML for the therapeutic management of COVID-19.

Background The COVID-19 pandemic and other humanitarian emergencies exacerbate pre-existing inequalities faced by people with disabilities. They experience worse access to health, education, and social services, and increased violence in comparison with people without disabilities. Adolescents with disabilities are amongst those most severely affected in these situations. Using participatory research methods with adolescents can be more effective than other methods but may be challenging in such emergency contexts. Objectives We conducted a scoping review to: 1) describe the literature and methods used in peer-reviewed and grey literature on adolescents (aged ten to nineteen) with disabilities’ experience of COVID-19 and other humanitarian emergencies in low- and middle-income countries, and 2) identify research gaps and make recommendations for future research. Methods The review followed a protocol developed using PRISMA guidelines and the Arksey and O’Malley framework. We searched grey and peer-reviewed literature between 2011 and 2021. Results Thirty studies were included. Twelve were peer-reviewed, and of those seven used participatory methods. Humanitarian emergencies had adverse effects on adolescents with disabilities across health, education, livelihoods, social protection, and community participation domains. Surprisingly few studies collected data directly with adolescents with disabilities. Twenty-three studies combined data from non-disabled children, caregivers, and disabled adults which made it challenging to understand adolescents with disabilities’ unique experience. Conclusions Our review highlights both the scarcity of literature and the importance of conducting research with adolescents with disabilities in humanitarian contexts. Despite challenges, our review shows that it has been possible to conduct research with adolescents with disabilities to explore their experiences of humanitarian emergencies, and that these experiences were different from those of non-disabled adolescents. There is a need to disaggregate findings and support the implementation and reporting of rigorous research methods. Capacity development through partnerships between non-governmental organisations and researchers may improve reporting of methods.

Excellent characteristics of multi-walled carbon nanotubes (MWCNTs), such as higher toughness and stiffness, enlarged strength, and high thermal conductivity, make them an attractive choice to improve surface characteristics and machining performance. In the current study, MWCNTs mixed with dielectric fluid in the wire electrical discharge machining (WEDM) process was used to enhance the machining performance of Nitinol shape memory alloy (SMA). Significance of WEDM machining variables such as current, pulse-on time (Ton), pulse-off time (Toff), and variation in powder concentration of MWCNTs are studied on material removal rate (MRR) and surface roughness (SR). The addition of MWCNTs substantially improves the machining performance by increasing MRR and simultaneously reducing the SR. Improvement in the MRR of 75.42% and SR of 19.15% is achieved with the use of MWCNTs at 1 g/L in comparison to the conventional WEDM process. An advanced parameterless TLBO algorithm is used for simultaneous optimization of multiple responses. An advanced parameterless TLBO algorithm is used to find the optimal solution of multiple responses. Single objective optimization result has yielded maximum MRR of 0.5262 g/min at a current of 5 A, Ton 110 μs, Toff 1 μs and MWCNTs amount of 1 g/L while minimum SR of 1.27 μm at a current of 1 A, Ton 1 μs, Toff 24 μs and MWCNTs amount of 1 g/L. MOTLBO algorithm is used for simultaneous optimization of MRR and SR. Lastly, the surface integrity of machined surfaces using a field emission scanning electron microscope (FESEM) is also studied to evaluate the effect of MWCNTs on recast layer thickness (RLT) and other surface defects. The incorporation of MWCNTs has shown a substantial reduction in RLT and other surface defects such as reduction in globules of debris, melted material deposition, micro-crack-free, and micro-pores-free surfaces.

Abstract Purpose: To highlight diagnostic challenges in patients with acquired vitelliform macular degeneration (AVMD) with subretinal fluid (SRF) and to examine the characteristics of image findings in patients with AVMD. Methods: In this retrospective review, the electronic medical record of 22 eyes of 16 patients with AVMD was studied. The rates of SRF, drusen, pigment epithelial detachment (PED), and patient clinical information such as age, length of follow-up, and best-corrected visual acuity (BCVA) were assessed. Results: The mean age at diagnosis with AVMD was 72 years with a mean follow-up time of 29 months. Median BCVA 20/33 at presentation and 20/33 at final follow-up. Drusen was found in 13 of 22 eyes (59.1%), PEDs in 4 of 22 eyes (18.2%), and SRF in 10 of 22 eyes (45.5%) at some point during their follow-up. Of the 10 eyes with SRF, 70% were center involving, and recurrence occurred in 40%, all in the same location as the initial presentation of SRF. Three eyes received an anti-vascular endothelial growth factor injection for SRF. In 66% of cases receiving an injection, the fluid later relapsed and remitted without further injections during the course of follow-up. Conclusion: AVMD occurs in the same demographic as age-related macular degeneration (AMD) and has many common features. SRF in AVMD tends to be center involving and recurs usually in the same location as its origin. The use of anti-VEGF injections did not seem to improve SRF in contrast to the SRF seen in wet AMD. Proper differentiation of AVMD may prevent unnecessary long-term treatment with intravitreal anti-VEGF injections.