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Introduction: Non-small cell lung cancer (NSCLC) is the leading cause of mortality globally. Early imaging detection modalities are associated with high false-positive rates and radiation exposure. A non-invasive biomarker can serve as an improvised method for early detection. MicroRNAs can serve as a potential non-invasive biomarker as they are stable in circulation, tissue or biological process-specific, easy to detect, cost-effective, and not associated with radiation hazards. This study validates circulating microRNA in NSCLC of the Indian population and studies its correlation with clinicopathological parameters. Materials and Methods: Circulating microRNA (-miR-193b, miR-301a, miR-7, and miR-25) was evaluated in 101 cases of tissue-proven NSCLC and 28 controls in serum samples. Results: There were 67 male and 34 female patients (Male: Female = 1.97:1). The age range was 25 to 86 years with a median age of 60 years. There was a significant upregulation in the expression of miR-193b in the NSCLC group as compared to controls (P = 0.034). MiR-7 was also upregulated while miR-25 and miR-301a were downregulated in NSCLC as compared to controls; however, a level of significance was not achieved. ROC curve analysis for miR-193b showed an AUC of 0.636 (95% CI, 0.522-0.750; P-value = 0.036) between NSCLC cases and controls. Conclusion: The present study showed variable expression of the above-studied miRNAs. MiR-193b showed a significant upregulation in cancer patients; however, the other three miRNAs were not conclusive. This suggests that profiling of microRNA in each population is essential to search for a valid non-invasive biomarker in that population.

The swift and pervasive rise of artificial intelligence (AI), particularly Generative AI (GenAI), is reshaping the educational landscape globally. As we navigate a future shaped by developments in AI, the need for critical engagement, ethical frameworks, and innovative learning designs becomes paramount. This special issue of AJIMS, titled Moving Artificial Intelligence Scholarship, emerges at a crucial juncture. Employers today expect graduates to embody an entrepreneurial mindset, possess higher-order literacies, and demonstrate global relevance beyond discipline-specific expertise. This issue interrogates how AI intersects with these expectations, advancing conversations about the future of higher education and professional practice development, particularly navigating the perspectives from China and South Africa. The eight papers in this issue reflect the complexities of integrating AI into education, offering perspectives that span disciplinary, institutional, and cultural contexts. They collectively underscore the transformative potential of AI while highlighting the ethical, relational, and pedagogical challenges it introduces. In this editorial, we synthesise the contributions of these works and their implications for academia.

Intracranial aneurysms (IAs) represent a critical health concern due to their potential to rupture, leading to severe morbidity and mortality. Small molecule inhibitors (SMIs) have emerged as promising therapeutic candidates for managing IA progression and rupture risk. The current landscape of SMIs targets various molecular pathways implicated in IA pathogenesis, including inflammation, endothelial dysfunction, and extracellular matrix (ECM) degradation. Among the prominent therapeutic candidates discussed are statins, recognized for their multifaceted effects, anti-inflammatory properties, and enhancement of endothelial stability, which may mitigate IA progression. Matrix metalloproteinase inhibitors are also highlighted for their role in preserving ECM structural integrity, essential for preventing IA wall weakening and rupture. Furthermore, the review evaluates the efficacy of anti-inflammatory agents such as corticosteroids and cytokine inhibitors in attenuating IA growth driven by inflammatory processes. Our findings highlight the possibility of several pharmaceutical therapies that target matrix remodeling, inflammation, and other underlying processes to manage cerebral aneurysms. By precisely delivering therapeutic chemicals, such as antioxidants, gene therapy vectors, or anti-inflammatory medicines, to the aneurysm site, these SMI technologies treat the underlying pathophysiological causes while sparing healthy brain tissue. This review underscores the potential of SMIs as adjunctive or primary therapies in the comprehensive management of IAs, emphasizing the need for further clinical research to optimize their efficacy and safety in clinical practice.

Abstract Background Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding “How” to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs. Methods Using purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants’ experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration. Results Context and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership’s influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish “central management units” for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency. Conclusion This study offers multiple solutions to enhance local implementers’ engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.

Abstract Background Resveratrol has demonstrated its ability to regulate BRCA1 gene expression in breast cancer cells, and previous studies have established the binding of MBD proteins to BRCA1 gene promoter regions. However, the molecular mechanism underlying these interactions remains to be elucidated. The aimed to evaluate the impact of MBD proteins on the regulation of BRCA1, BRCA2, and p16 genes and their consequential effects on breast cancer cells. Methods Efficacy of resveratrol was assessed using the MTT assay. Binding interactions were investigated through EMSA, ChIP, & MeIP assay. Expression analyses of MBD genes and proteins were conducted using qRT-PCR and western blotting, respectively. Functional assays, including clonogenic, migratory, and sphere formation assays were used to assess cancer cells’ colony-forming, metastatic, and tumor-forming abilities. The cytotoxicity of resveratrol on cancer cells was also tested using an apoptosis assay. Results The study determined an IC50 of 30µM for resveratrol. MBD proteins were found to bind to the BRCA1 gene promoter. Resveratrol exhibited regulatory effects on MBD gene expression, subsequently impacting BRCA1 gene expression and protein levels. Higher concentrations of resveratrol resulted in reduced colony and sphere formation, decreases migration of cancer cells, and an increases number of apoptotic cells in breast cancer cells. Impact Identification of MBD2-BRCA1 axis indicates their significant role in the induction of apoptosis and reduction of metastasis and proliferation in breast cancer cells. Further therapy can be designed to target these MBD proteins and resveratrol could be used along with other anticancer drugs to target breast cancer. Conclusions In conclusion MBD2 protein interact to the BRCA1 gene promoter, and resveratrol modulates MBD2 gene expression, which in turn regulates BRCA1 gene expression, and inhibits cell proliferation, migration, and induces apoptosis in ER+, PR+ & Triple negative breast cancer cells.

Abstract Background District Residency Programme (DRP) was introduced by National Medical Commission as mandatory three-months training program for postgraduate residents. The program was for the first time implemented in April 2023 in Rajasthan. However, it ran into several teething problems, especially for residents. With a lack of any precedence, this study was planned to explore experiences and challenges of residents posted in DRP. Methods Cross-sectional study was conducted at 12 DRP sites attached to SMS Medical College, Jaipur between August-October 2023. A self-administered questionnaire was used to collect information from residents who had completed DRP. Questions were scored on a five-point Likert scale. Mann-Whitney U test and Kruskal-Wallis H test was used to show association. Results Only around 17% residents felt that the learning objectives of DRP were fulfilled and nearly 60% residents felt isolated from academic activities and parent department. Over half of the residents were never posted with their concerned specialty services. Around four-fifth residents felt concerned about safety at least sometimes and more than three-fourth residents were dissatisfied with basic amenities. Kruskal-Wallis and Mann-Whitney tests showed significant association of gender and specialisation strata with multiple outcome variables. Conclusion The study finds high degree of dissatisfaction among residents towards learning objectives, academic learning, and basic amenities during DRP. There was also a clear lack of specialty-exposure and high concerns of safety, especially for female residents. The study findings should alarm and inform policymakers and administrators to improve DRP implementation so as to better achieve laid objectives.

Abstract Background Poor intrapartum care in India contributes to high maternal and newborn mortality. India’s Labor Room Quality Improvement Initiative (LaQshya) launched in 2017, aims to improve intrapartum care by minimizing complications, enforcing protocols, and promoting respectful maternity care (RMC). However, limited studies pose a challenge to fully examine its potential to assess quality of maternal and newborn care. This study aims to bridge this knowledge gap and reviews LaQshya’s ability to assess maternal and newborn care quality. Findings will guide modifications for enhancing LaQshya’s effectiveness. Methods We reviewed LaQshya’s ability to assess the quality of care through a two-step approach: a comprehensive descriptive analysis using document reviews to highlight program attributes, enablers, and challenges affecting LaQshya’s quality assessment capability, and a comparison of its measurement parameters with the 352 quality measures outlined in the WHO Standards for Maternal and Newborn Care. Comparing LaQshya with WHO standards offers insights into how its measurement criteria align with global standards for assessing maternity and newborn care quality. Results LaQshya utilizes several proven catalysts to enhance and measure quality- institutional structures, empirical measures, external validation, certification, and performance incentives for high-quality care. The program also embodies contemporary methods like quality circles, rapid improvement cycles, ongoing facility training, and plan-do-check, and act (PDCA) strategies for sustained quality enhancement. Key drivers of LaQshya’s assessment are- leadership, staff mentoring, digital infrastructure and stakeholder engagement from certified facilities. However, governance issues, understaffing, unclear directives, competency gaps, staff reluctance towards new quality improvement approaches inhibit the program, and its capacity to enhance quality of care. LaQshya addresses 76% of WHO’s 352 quality measures for maternal and newborn care but lacks comprehensive assessment of crucial elements: harmful labor practices, mistreatment of mothers or newborns, childbirth support, and effective clinical leadership and supervision. Conclusion LaQshya is a powerful model for evaluating quality of care, surpassing other global assessment tools. To achieve its maximum potential, we suggest strengthening district governance structures and offering tailored training programs for RMC and other new quality processes. Furthermore, expanding its quality measurement metrics to effectively assess provider accountability, patient outcomes, rights, staff supervision, and health facility leadership will increase its ability to assess quality improvements.

HIV self-testing (HIVST) plays a significant role in addressing the health care needs of high-risk populations, particularly men who have sex with men (MSM). The present systematic review and meta-analysis provide an assessment of the prevalence of HIVST among MSM within the last 5 years. Seven databases (PubMed, Web of Science, Cochrane, Scopus, EMBASE, ProQuest, and EBSCOhost) were searched systematically from January 1, 2018 to March 10, 2023. After an independent search and quality assessment, the pooled prevalence was calculated using a random-effects model. Eight relevant studies were finally included in our study from an initial pool of 288 articles identified through a systematic search. Our meta-analysis revealed that the pooled prevalence of HIVST among MSM is 8% (95% CI: 5%–14%). Significant heterogeneity was noticed among the studies, with an I 2 value of 99% and a 95% prediction interval of 3% to 11%. Geography emerged as a significant moderator of this heterogeneity ( p < .001). Specifically, studies from China reported a notably higher prevalence of 20% (15%–26%), while other countries reported a lower prevalence of 5% (3%–6%). A symmetrical Doi plot with a Luis–Furuya–Kanamori (LFK) index of −0.57 indicated no publication bias. HIVST has a low take-up among MSM globally. Factors leading to variation in HIVST need to be studied. The coordinated efforts of policymakers, health care providers, and affected communities are required in HIVST promotion.

Introduction: In traditional Chinese medicine (TCM), Benincasa hispida (B. Hispida) has a long history of use as a medicinal herb. Benincasa hispida contains a wide range of phytochemical elements, with the five most notable bioactive substances being Flavonoids, alkaloids, Tannins, Saponins and Phenols were also present. Numerous pharmacological activities, such as antioxidant, anti-cancer, and antiviral properties, have been established by these substances. Furthermore, B. Hispida has been studied for its ability to treat a variety of illnesses, including cancer, heart problems, and neurological issues. This review aims to provide an updated overview of the phytochemical constituents and pharmacological attributes B. Hispida.Method: A thorough search of scientific databases, such as Web of Science, PubMed, and Scopus, was done in order to find pertinent research up to 2002 to 2023. There have more than 90 review and research papers from scientific sources collected with inclusion criteria of ethno pharmacological uses of selected herb and exclusion criteria of herbs including botanical description's, morphological patterns of selected herb etc.Result: Benincasa hispida highlights the continued need for scientific research and clinical evaluation by offering a compelling path for potential medicinal development.Conclusion: Different parts of Benincasa Hispida have yielded a variety of phytochemicals that might be used to cure illnesses and open up new research avenues in the future.

Objective: This research is meant to evaluate the effectiveness of different bonding agents in minimally invasive cavity preparations at a tertiary care center. Materials and Methods: A prospective research was conducted involving patients requiring minimally invasive cavity preparations. Patients were randomly assigned to groups based on the bonding agent used. Standardized cavity preparations were performed, and bonding agent application followed manufacturer instructions. Outcome measures included bond strength and marginal adaptation. Data were analyzed using appropriate statistical methods. Results: Bonding Agent A exhibited the highest mean bond strength (25.6 MPa) and superior marginal adaptation (mean score: 4.2) compared to Bonding Agents B and C. These differences were statistically significant (P < 0.001 for bond strength, P < 0.05 for marginal adaptation). Conclusion: Bonding Agent A demonstrated superior performance in achieving durable and esthetically pleasing restorations in minimally invasive cavity preparations. These findings underscore the importance of selecting appropriate bonding agents for conservative dental treatments to optimize treatment outcomes and patient satisfaction.

Abstract Background People living with HIV (PLWH), even when viral replication is controlled through antiretroviral therapy (ART), experience persistent inflammation. This inflammation is partly attributed to intestinal microbial dysbiosis and translocation, which may lead to non-AIDS-related aging-associated comorbidities. The extent to which living with HIV — influenced by the infection itself, ART usage, sexual orientation, or other associated factors — affects the biological age of the intestines is unclear. Furthermore, the role of microbial dysbiosis and translocation in the biological aging of PLWH remains to be elucidated. To investigate these uncertainties, we used a systems biology approach, analyzing colon and ileal biopsies, blood samples, and stool specimens from PLWH on ART and people living without HIV (PLWoH) as controls. Results PLWH exhibit accelerated biological aging in the colon, ileum, and blood, as measured by various epigenetic aging clocks, compared to PLWoH. Investigating the relationship between microbial translocation and biological aging, PLWH had decreased levels of tight junction proteins in the intestines, along with increased microbial translocation. This intestinal permeability correlated with faster biological aging and increased inflammation. When investigating the relationship between microbial dysbiosis and biological aging, the intestines of PLWH had higher abundance of specific pro-inflammatory bacteria, such as Catenibacterium and Prevotella. These bacteria correlated with accelerated biological aging. Conversely, the intestines of PLWH had lower abundance of bacteria known for producing the anti-inflammatory short-chain fatty acids, such as Subdoligranulum and Erysipelotrichaceae, and these bacteria were associated with slower biological aging. Correlation networks revealed significant links between specific microbial genera in the colon and ileum (but not in feces), increased aging, a rise in pro-inflammatory microbe-related metabolites (e.g., those in the tryptophan metabolism pathway), and a decrease in anti-inflammatory metabolites like hippuric acid. Conclusions We identified specific microbial compositions and microbiota-related metabolic pathways that are intertwined with intestinal and systemic biological aging. This microbial signature of biological aging is likely reflecting various factors including the HIV infection itself, ART usage, sexual orientation, and other aspects associated with living with HIV. A deeper understanding of the mechanisms underlying these connections could offer potential strategies to mitigate accelerated aging and its associated health complications. Video Abstract

Context: This study adds to the existing body of literature on the role of optical coherence tomography (OCT) parameters in active thyroid eye disease (TED) among the Indian population. Purpose: Comparison of choroidal vascularity index (CVI) and subfoveal choroidal thickness (SFCT) in active and inactive TED. Settings and Design: An observational, cross-sectional analytical study conducted at a tertiary eye care hospital in North India that included patients with active and inactive TED. Methods: Demographic details and clinical evaluation were performed for all TED patients. SFCT was determined with OCT by using the Cirrus linear measurement tool. CVI was calculated using Image J software. The SFCT and CVI measurements were compared between both groups. Statistical Analysis Used: Comparison between active and inactive TED groups was done using Mann–Whitney U test for non-parametric data and Student t test for parametric data. Multivariate regression analysis was performed with SFCT and CVI as dependent variables. Results: Sixty-two eyes of 31 patients were included. Thirteen eyes had active TED, and 49 eyes had inactive TED. SFCT was significantly lower in eyes with higher clinical activity score (CAS) and older age. No significant difference was found in CVI between active and inactive TED eyes. Conclusion: SFCT was lower in eyes with higher CAS and older age. Our findings differ from previous studies, which showed a positive correlation between SFCT and CAS. There was no significant difference in CVI between active and inactive TED eyes.

Abstract Background Several reports discussed a connection between CD36 genotypes associated with obesity, influencing the development of Type 2 diabetes mellitus (T2DM). Therefore, this study examines the prognostic value of CD36 polymorphism rs1761667 (G/A) in individuals with obese T2DM. The investigation also explores the correlation between this genetic variation and the clinical/biochemical parameters of the subjects. Methods Blood samples of a total of 475 subjects from north India were collected from the outpatient unit (OPD), Department of Medicine, KGMU, Lucknow as per inclusion/exclusion criteria. Anthropometric details of study subjects were recorded and biochemical parameters were estimated in 250 T2DM cases, 75 obese T2DM cases, and 150 controls. The CD36 gene variant rs1761667 (G/A) was subject to genotypic analysis using the polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) method, utilizing specific primers and HhaI enzyme. All statistical analysis was done using SPSS (ver. 21.0) and Prism (5.01) software. Results Fasting plasma glucose (FPG), systolic blood pressure (SBP), post-prandial glucose (PPG) were significant in T2DM subjects. Lipid profile such as Total Cholesterol (TC), Low-Density Lipoprotein (LDL) and Very Low-Density Lipoprotein (VLDL) were also found significantly associated with obese T2DM cases. GA and AA genotypes of rs1761667 (G/A) showed significant associations in obese T2DM cases. The GA genotype demonstrated a considerable association (P

Among all non-communicable diseases, Cardiovascular Diseases (CVDs) stand as the leading global cause of mortality. Within this spectrum, Myocardial Infarction (MI) strikingly accounts for over 15 % of all deaths. The intricate web of risk factors for MI, comprising family history, tobacco use, oral health, hypertension, nutritional pattern, and microbial infections, is firmly influenced by the human gut and oral microbiota, their diversity, richness, and dysbiosis, along with their respective metabolites. Host genetic factors, especially allelic variations in signaling and inflammatory markers, greatly affect the progression or severity of the disease. Despite the established significance of the human microbiome-nutrient-metabolite interplay in associations with CVDs, the unexplored terrain of the gut-heart-oral axis has risen as a critical knowledge gap. Moreover, the pivotal role of the microbiome and the complex interplay with host genetics, compounded by age-related changes, emerges as an area of vital importance in the development of MI. In addition, a distinctive disease susceptibility and severity influenced by gender-based or ancestral differences, adds a crucial insights to the association with increased mortality. Here, we aimed to provide an overview on interactions of microbiome (oral and gut) with major risk factors (tobacco use, alcohol consumption, diet, hypertension host genetics, gender, and aging) in the development of MI and therapeutic regulation.

Introduction: Tobacco exposure during pregnancy has a negative influence on fetal growth. Maternal smoking causes placental vaso­constriction and fetal growth restriction (FGR). In India, the tobacco industry employs women to hand roll cigarettes called bidis. A bidi roller handles 120 g of tobacco and therefore 3 g of nicotine per day. Aim: To evaluate the effect of occupational tobacco handling by pregnant women on fetal growth and wellbeing. Methods: In this cohort study, 177 pregnant bidi rollers (exposed cohort) and 354 pregnant non-rollers (unexposed cohort) were followed up from 18-22 weeks of pregnancy until delivery with fetal sonogram and Doppler. Fetal surveillance data (including fetal biometry, Doppler indices, amniotic fluid index, biophysical profile and placentation) were recorded and compared. Maternal nicotine absorption was quantified by serum cotinine. Intergroup differences and relative risk (RR) were determined by Chi-square test (or Fisher exact when the count was ≤ 5), and adjusted odds ratio (OR) by binary logistic regression. Intrauterine growth trend was plotted. Results: Fetal surveillance results were ab­normal in 37.9% of the tobacco-exposed group, with a RR of 1.6 (p = 0.001) and adjusted OR of 1.8 (p = 0.005) in comparison with the unex­posed group. Nicotine absorption was evident in 28.4% of the bidi rollers that had abnormal fetal surveillance results. The mean estimated fetal weight and head circumference demonstrated a sustained deceleration, starting at 28-30 weeks of gestation, in the exposed group. Doppler data suggested fetal adaptation to maintain cerebral circulation. We found a higher frequency of oligohydramnios (statistically significant), pla­cental abruption (not statistically significant), and placenta previa (not statistically significant) in the tobacco-exposed group. Conclusions: Occupational tobacco handling in bidi rollers resulted in early-onset symmetric FGR and compromised wellbeing. Pregnant women with any form of tobacco exposure require vigilant fetal surveillance.

Cilj članka je opredeliti tranzicije, do katerih prihaja na makro ravni globalnih politik, in sicer prehod od izobraževanja odraslih do vseživljenjskega učenja ter posledično prehod od izobraževalnega sektorja do ekosistemov vseživljenjskega učenja. Za analizo dokumentov mednarodnih organizacij smo uporabili Ehlersov model in politične okvire ter tako izpostavili dva premika: prvi je prehod iz izobraževalnega sektorja v ekosisteme vseživljenjskega učenja, drugi pa prehod sektorja izobraževanja odraslih v učenje in izobraževanje odraslih znotraj okvira vseživljenjskega učenja. Oba prehoda sta zaradi pogojev za dodeljevanje sredstev neizogibna in učečim se ponujata ogromno priložnosti, a se to skozi njihovo nesodelovanje ne potrjuje. Zainteresirani akterji v izobraževanju odraslih lahko torej ta prehoda spodbudijo s pozitivnim pristopom do novih priložnosti ter hkrati izrazijo pomisleke neslišanih učečih se ali pa se spremembam uprejo in tako dolgoročno izginejo zaradi pomanjkanja relevantnosti in posledične izgube sredstev za delovanje.

This paper discusses the role of Individual Learning Accounts (ILAs) as policy instruments in challenging the Matthew Effect and promoting self-directed learning among the non-participant but potential adult learners. The paper builds upon the Integrated Implementation Model of Winter (2012) explaining policy implementation and the typology for classifying systems of lifelong learning according to their governance by Green (2000). The paper banks upon data from Denmark, France and the EU, and proposes a learner-centric model for the implementation of education policies along with revisions in Green’s typology.

Objective: Using cone beam computed tomography (CBCT), this study compared three rotary file systems—XP Endoshaper, Hyflex CM, and K3 XF—for centering, canal transportation, and root canal area growth. Materials and Methods: The rotating file system randomly separated 60 removed human mandibular molars into three groups (n = 20). Manufacturer-recommended root canal instrumentation was done. Specialized software examined pre- and post-instrumentation CBCT scans. Centering ability was measured by canal transportation and root canal area expansion at different levels from the apex. Results: The Hyflex CM file system had the best centering and the least canal transit at all levels (P < 0.05). XP Endoshaper increased the root canal area the most (P < 0.05). The K3 XF file system had average centering and canal transfer results. Conclusion: The Hyflex CM system centered well, whereas the XP Endoshaper system increased the root canal area the most. The clinical context and therapeutic goals should determine the rotating file system.

Abstract Background Endometrial pathology is a recognized contributor to infertility and recurrent implantation failure, but its detection during hysteroscopy, particularly in the absence of visible lesions, is challenging. Chromohysteroscopy, involving the use of methylene blue dye, has shown promise in improving diagnostic accuracy. Methods This interventional cross-sectional study compared the diagnostic accuracy of chromohysteroscopy and conventional hysteroscopy, using histopathology as the gold standard. A total of 100 consenting infertility patients were included, in a sequential step, hysteroscopy followed by chromohysteroscopy using methylene blue dye was performed to enhance the detection of subtle endometrial pathologies. Results Among the 100 women who underwent diagnostic hysteroscopy, 76 exhibited normal findings, while 24 had abnormal findings. During chromohysteroscopy, 62 cases displayed a light staining pattern, and 38 cases exhibited dark staining. Histopathological analysis of biopsy tissue from the dark-stained areas revealed endometrial pathology in 84.2% (32/38) and normal endometrium in 15.8% (6/38) cases. In contrast, biopsies from the light-stained areas indicated abnormal endometrium in only 3.23% (2/62) cases, with the remaining 96.77% having a normal histology. Chromohysteroscopy demonstrated a significantly higher diagnostic accuracy (92%) for endometrial pathology compared to conventional hysteroscopy (58%). Notably, chromohysteroscopy’s sensitivity was 94.12%, and its specificity was 90.9%. The staining patterns observed during chromohysteroscopy correlated well with histological findings, highlighting its effectiveness in identifying structurally damaged endometrium. Conclusion Chromohysteroscopy emerges as a valuable diagnostic tool for assessing endometrial pathology, especially in infertility cases. This technique offers superior accuracy compared to conventional hysteroscopy, providing clinicians with a more precise means of diagnosis and potential targeted treatments.

Due to increasing last-mile logistics complexity, the e-commerce business's last-mile delivery has emerged as an imperative issue that impedes the advancement of contemporary last-mile logistics practices. The paper attempts to identify last-mile logistics associated risk hurdles from e-commerce literature and prioritize them on their significantly affecting logistics operations. The factors were identified by reflecting on the recent literature and internet resources coupled with in-depth brainstorming with experts in the field of Logistics Company including, practitioners, and employers. Two ranking methods namely TODIM (TOmada de Decisao Interativa Multicriterio in Portuguese “interactive and multicriteria decision making” in English) and ARAS (Additive Ratio ASsessment method) are used together to rank order the major risk hurdles and criteria. The results of this study present that lack of visibility (LV), low-efficiency levels (LEL), and unpredictable elements (UE) are ranked as the top three major risk hurdles whereas real-time information on a package’s location (LV1), putting a GPS tracking system to track last- mile journey (OT3) and users wants on time location of their package (LV2) are ranked as top three most significant criteria affecting the practices of modern last-mile logistics in e-commerce businesses. The findings can be used by logistics firms, organizations, and policymakers to better understand the issues and develop strategies to address them, making last-mile delivery a more efficient also better form of awareness for practitioners who are engaged in third-party logistics firms. The novelty of this study is to identify the primary risk hurdles affecting the practices of last-mile logistics and to prioritize them using ranking methods such as TODIM and ARAS. This offers advice for managers and researchers to consider how to handle the logistical uncertainty in e-commerce enterprises.

[This corrects the article DOI: 10.1371/journal.pone.0264956.].

Purpose – E-tourism is instilling in the tourism industry with the advancement in the technological infrastructure all over the world and fetching tremendous tourists’ attention. The dynamic changes in the technological aspects unveil varied developments in the tourism industry. This paper attempts to reveal the developments in the field of e-tourism by a systematic review of the literature using bibliometric analysis. Design/methodology/approach – In total,146 research articles were retrieved from the Web of Science data during the period of 2004 – 2020, for further analysis using VOSviewer and Biblioshiny package of R Studio. Findings – Useful insights resulted in the form of most cited papers, contribution in e-tourism research by different authors, countries, institutions, journals and so on, co-occurrence analysis and cluster analysis for major trends or themes of e-tourism. This study solicits an elaborated review of e-tourism research and unveils the future directions for the researchers. Originality/value – This study adds substantial value to the research of e-tourism by analysing the bibliometric data of the last 16 years, that is, from 2004 – 2020, procured from the Scopus by analysing the significant trends developed in the e-tourism research. It also adds value by indicating the emerging areas of e-tourism.

Abstract Objectives The present study aimed to examine the association of multimorbidity status with food insecurity among disadvantaged groups such as Scheduled Castes (SCs), Scheduled Tribes (STs), and Other Backward Class (OBCs) in India. Method The data for this study was derived from the first wave of the Longitudinal Ageing Study in India (LASI),2017–18, focusing on 46,953 individuals aged 45 years and over who belong to SCs, STs, and OBCs groups. Food insecurity was measured based on the set of five questions developed by the Food and Nutrition Technical Assistance Program (FANTA). Bivariate analysis was performed to examine the prevalence of food insecurity by multimorbidity status along with socio-demographic and health-related factors. Multivariable logistic regression analysis and interaction models were used. Results The overall prevalence of multimorbidity was about 16% of the study sample. The prevalence of food insecurity was higher among people with multimorbidity compared to those without multimorbidity. Unadjusted and adjusted models suggested that people with multimorbidity were more likely to be food insecure than people without multimorbidity. While middle-aged adults with multimorbidity and men with multimorbidity had a higher risk of food insecurity. Conclusion The findings of this study suggest an association between multimorbidity and food insecurity among socially disadvantaged people in India. Middle-aged adults experiencing food insecurity tend to reduce the quality of their diet and consume a few low-cost, nutritionally deficient meals to maintain caloric intake, putting them again at risk for several negative health outcomes. Therefore, strengthening disease management could reduce food insecurity in those facing multimorbidity.

Objective Tobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22% of tobacco smokers and 81% of smokeless tobacco (SLT) users reside.Methods Data from the nationally representative Global Adult Tobacco Surveys in India, Bangladesh and Pakistan were analysed to examine patterns of initiation among smokers and smokeless tobacco users.Results Data on 94 651 individuals were analysed, of which 13 396 reported were ever daily smokers and 17 684 were ever SLT users. The proportion of individuals initiating tobacco use before the age of 15 years has increased over time. The rates of SLT initiation among those aged 15–24 years increased markedly in Bangladesh (by 7.8%) and Pakistan (by 37.7%) between 1983 and 1999–2000. Among males, the increase in SLT initiation was higher in individuals aged below 15 years compared with other age groups in India and Bangladesh. Smoking initiation among females aged below 15 years has also significantly increased in India over time. Compared with the initiation of tobacco smoking before the age of 15 years, a greater increase in the proportion of SLT users was observed in urban areas.Conclusion Our findings indicate that the proportion of youth initiating tobacco (both smoking and smokeless) before the age of 15 years has increased over time in all three countries. Moreover, variations in age at initiation for different types of tobacco products across countries, and by rurality, were noticeable. Younger youths (aged up to 15 years) should therefore be a priority population for tobacco control interventions. Strategies such as raising the legal age of tobacco sale and use to 21 years, and, other measures under WHO Framework Convention on Tobacco Control (FCTC), may prevent underage use and avert lifelong addiction to tobacco products.

Long-term use of asbestos-contaminated talcum power has been reported to be the main causative agent for carcinogenesis in many research studies. In recent developments Johnson & Johnson has lost multimillion-dollar lawsuits for being associated with the development of mesothelioma and ovarian cancer by its talc-based baby powder. In May 2020, the company announced, the end of the sale of its baby powder in the USA and Canada and in August 2022, announced the global discontinuation by 2023. However, in India vast proportions of people are using talc-based baby powder and the products are readily available in the market. The purpose of this communication is to create awareness and draw attention of authorities for effective regulation, including prohibition of sale and retraction of the contaminated talc-based products from the Indian market at the earliest.

The evaluation of different mango varieties was conducted during 2019-20 and 2020-21. The experiment was laid out in a randomized block design (RBD) with four varieties, namely, Ambika, Pusa Arunima, Kesar, and Dashehari-51, each replicated three times. The plants were spaced at 4x4 m intervals. The results obtained demonstrated significant variations in various parameters, ranging from minimum to maximum values. The canopy spread ranged from 1.77 to 7.49 m, stem girth from 16.67 to 40 cm, number of fruits per plant from 21 to 118, fruit length from 92.04 to 123.28 mm, fruit width from 56.02 to 77.41 mm, and fruit weight from 202 to 591 g. However, the number of primary branches (2-3) and plant height (1.54-4.35 m) were found to be nonsignificant. Based on the morpho-economic traits, Pusa Arunima appeared to be a superior variety in terms of tree morpho-economic traits, while others were considered moderate. Considering the average number of fruits per plant and fruit weight (g) over a two-year period, Pusa Arunima clearly outperformed the other three varieties in terms of yield. Furthermore, Pusa Arunima, Kesar, and Ambika exhibited more marketable fruit traits. These findings emphasize the significant diversity among the examined mango cultivars. Therefore, it is crucial to protect and preserve these valuable genetic resources for future breeding programs aimed at developing novel and commercially viable cultivars.

The SARS-CoV-2 omicron variants keep accumulating a large number of mutations in the spike (S) protein, which contributes to greater transmissibility and a rapid rise to dominance within populations. The identification of mutations and their affinity to the cellular angiotensin-converting enzyme-2 (ACE-2) receptor and immune evasion in the Delhi NCR region was under-acknowledged. The study identifies some mutations (Y505 reversion, G339H, and R346T/N) in genomes from Delhi, India, and their probable implications for altering the immune response and binding affinity for ACE-2. The spike mutations have influenced the neutralizing activity of antibodies against the omicron variant, which shows partial immune escape. However, researchers are currently exploring various mitigation strategies to tackle the potential decline in efficacy or effectiveness against existing and future variants of SARS-CoV-2. These strategies include modifying vaccines to target specific variants, such as the omicron variant, developing multivalent vaccine formulations, and exploring alternative delivery methods. To address this, it is also necessary to understand the impact of these mutations from a different perspective, especially in terms of alterations in antigenic determinants. In this study, we have done whole genome sequencing (WGS) of SARS-CoV-2 in COVID-19 samples from Delhi, NCR, and analyzed the spike’s mutation with an emphasis on antigenic alterations. The impact of mutation in terms of epitope formation, loss/gain of efficiency, and interaction of epitopes with antibodies has been studied. Some of the mutations or variant genomes seem to be the progenitors of the upcoming variants in India. Our analyses suggested that weakening interactions with antibodies may lead to immune resistance in the circulating genomes.

Culture plays a significant buying role in shaping different aspects of consumer behavior such as rational, impulse, and compulsive buying behavior. Impulse buying is one of the prevalent phenomena that significantly affect the sales revenue of companies. This study focuses on unveiling the interaction between cultural factors and impulse buying behavior. For this systematic literature review, 112 significant articles were examined to understand the relationship between various aspects of culture and impulse buying behavior in both online and offline contexts. Further investigation of impulse buying in cross-cultural context helps to understand and classify different theoretical perspectives to study impulse buying behavior and cultural factors. This study offers practical implications for retail professionals and e-commerce strategists to design and implement viable cross-cultural marketing campaigns. Academic researchers may also understand research gaps and contribute further to understanding cross-cultural impulse buying.

Abstract Objective: Tobacco consumption among low- and middle-income countries where food insecurity remains a challenge poses several concerns. This review examines the available global evidence linking smokeless tobacco (SLT) use with public health nutrition and its implications. Design: Systematic review of articles extracted from PubMed and Scopus from January 2000 to December 2020. Setting: Included studies that demonstrated the relationship between SLT and nutrition-related factors, that is, BMI, malnutrition, anaemia, poor birth outcomes and metabolic disorders. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines have been followed to conduct the systematic evidence review. Participants: A total of thirty-four studies were finally used in the systematic review, which included cross-sectional (thirty-one) and cohort (three). Results: SLT use has a huge impact on body weight, alteration in taste, poor oral health, and consumption of fruits and vegetables leading to malnutrition. Maternal use of SLT not only leads to anaemia but also hampers birth outcomes. Increased risk of metabolic syndrome and gallstone disease among SLT users are also well documented in the studies. Conclusion: The review highlights the linkages between SLT usage and poor nutritional outcomes. Tobacco control efforts should be convergent with public health nutrition to achieve overall health benefits. Attention is also required to explore suitable mechanisms for SLT cessation combined with enhancing food and nutrition security at the community level in sync with investments in public health nutrition intervention.

Background: Alcohol use disorders (AUD) contribute substantially to the global disease and disability burden. The Indian Disability Evaluation and Assessment Scale (IDEAS) has seldom been used to measure disability in those with AUDs. Objectives: To assess the validity of IDEAS to quantify disability among persons with AUDs by measuring the level of agreement between IDEAS and World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0). Materials and Methods: A cross-sectional measurement of disability and quality of life (QoL) measures was carried out among those seeking treatment for AUDs. Correlational analyses and Bland–Altman plot analysis were done to measure the level of agreement between IDEAS and WHODAS2.0. Results: The scores on the WHODAS and IDEAS show statistically significant positive correlation (Rho: 0.435, P = 0.0001) indicating convergent validity. There was a significant level of agreement of disability scores using both tools. The IDEAS score had significant negative correlation with the brief version (WHOQoL BREF-Hindi) measures (Rho: ‒0.301, P = 0.003) indicating divergent validity. Those with greater severity of AUD had higher IDEAS scores (β = 1.9, P = 0.046). Conclusions: IDEAS scores correlate with disability scores measured with WHODAS 2.0 and QoL assessment using WHOQOL-BREF Hindi in those with AUDs. This instrument can be used to quantify disability and provide socioeconomic compensations to these individuals.

Background and Aims: Multiple laboratory methods are used to screen patients with colorectal cancer (CRC) for mismatch repair (MMR) protein deficiency to identify possible Lynch syndrome patients. The goal of this study was to compare the agreement between ready-to-use immunohistochemistry (IHC) assays for MLH-1, PMS-2, MSH-2, MSH-6, and mutated BRAF at V600E and molecular methods in CRC cases. The inclusion of the BRAF V600E mutation testing is important for the identification of patients with sporadic CRC, as the BRAF V600E mutation is very rarely observed in patients with Lynch syndrome tumors. Methods: CRC cases were analyzed by ColoSeqTM tumor sequencing assay and VENTANA MMR IHC Panel that included anti-MLH1, anti-PMS2, anti-MSH2, anti-MSH6, and anti-BRAF V600E antibodies. Additionally, CRC cases with MLH1 IHC loss were evaluated for MLH1 promoter hypermethylation. Results: One hundred and eighteen cases were analyzed. The overall percent agreement (OPA) for each evaluated marker status compared to next-generation sequencing (NGS) exceeded 96%. Twenty-three cases were positive for the BRAF V600E mutation by IHC and NGS, and twenty cases showed loss of MLH1 protein and were positive for MLH1 hypermethylation. Samples with loss of MMR protein expression by IHC demonstrated genetic and/or epigenetic alterations that were consistent with the observed protein expression patterns. Conclusions: The results of this study indicate that ready-to-use IHC assays can correctly identify the loss of MMR proteins and the presence of mutated BRAF V600E protein, supporting the utility of the VENTANA MMR IHC Panel as an aid to stratify patients with sporadic CRC vs. potential Lynch syndrome.

Femoral atherosclerotic plaques are less inflammatory than carotid plaques histologically, but limited cell-level data exist regarding comparative immune landscapes and polarization at these sites. We investigated intraplaque leukocyte phenotypes and transcriptional polarization in 49 patients undergoing femoral (n = 23) or carotid (n = 26) endarterectomy using single-cell RNA-Seq (scRNA-Seq; n = 13), flow cytometry (n = 24), and IHC (n = 12). Comparative scRNA-Seq of CD45+-selected leukocytes from femoral (n = 9; 35,265 cells) and carotid (n = 4; 30,655 cells) plaque revealed distinct transcriptional profiles. Inflammatory foam cell–like macrophages and monocytes comprised higher proportions of myeloid cells in carotid plaques, whereas noninflammatory foam cell–like macrophages and LYVE1-overexpressing macrophages comprised higher proportions of myeloid cells in femoral plaque (P < 0.001 for all). A significant comparative excess of CCR2+ macrophages in carotid versus plaque was observed by flow cytometry in a separate validation cohort. B cells were more prevalent and exhibited a comparatively antiinflammatory profile in femoral plaque, whereas cytotoxic CD8+ T cells were more prevalent in carotid plaque. In conclusion, human femoral plaques exhibit distinct macrophage phenotypic and transcriptional profiles as well as diminished CD8+ T cell populations compared with human carotid plaques

The emergence of digitalisation and the Fourth Industrial Revolution has resulted in a significant shift in practices, resulting in a disconnection among organisations, employees, and technology, particularly affecting developing nations like the BRICS group which have faced disproportionate challenges due to the COVID-19 pandemic. The aim of this paper is to explore the role of quality in the context of intelligent and automated systems operating in a technologically advanced environment. The study employs a systematic literature review methodology, which encompassed a rigorous process of identifying and selecting 38 articles, followed by a comprehensive thematic analysis. The findings highlight that organisations need to adapt their quality systems to effectively operate in a world dominated by intelligent and automated systems. The implication is that by leveraging digital technologies, organisations can embrace the integration of quality with machine learning, programmable logic controllers, adaptive feedback loops, automated information collection, and blockchain technology to develop a value-based, transparent, and secure quality system. The proposed roadmap and model derived from this study affords organisations the opportunity to establish an intelligent quality ecosystem that aptly aligns with the requisites of the technologically advanced era, thereby ensuring the attainment of excellence in quality during the digital era.

Introduction: Endometrial cancer is the seventh most common cancer in women worldwide with Age Standardised Incidence Rate (ASIR) of 8.4 per lac. In Indian subcontinent, the incidence is lesser and the ASIR is 2.1/100,000 women. However, its incidence is on the steady rise in developing part of the world including India. Surgery is the primary treatment and adjuvant radiotherapy is given in patients with high-risk of recurrence and significant change has happened in the management in the last 20 years. From India limited literature is available for management practices for endometrial cancer. Aim: To assess the referral patterns, demography, staging, surgical practices, adjuvant treatment and follow-up policies for endometrial cancer in a tertiary care hospital in northern India. Materials and Methods: A retrospective cross-sectional study was done for patients having endometrial cancer treated between January 2000- December 2015 in a tertiary care hospital in northern India in January 2022. A total of 93 patients having endometrial cancer were referred for radiotherapy. For these patients, their referral patterns, demography, staging, surgical practices, adjuvant treatment and follow-up policies were analysed, retrospectively. Disease Free Survival (DFS) and Overall Survival (OS) were computed by Kaplan-Meier method. Results: The median age at presentation was 55 years. Postmenopausal vaginal bleeding was the commonest symptom 78 (83.87%). Ultrasonography 23 (24.73%) was the preferred first imaging modality. Type 1 endometroid carcinoma was 75 (80.64%) and total abdominal hysterectomy with bilateral salpingo-oophrectomy was done in 82 (88.17%). Adjuvant External Beam Radiotherapy (EBRT) with Brachytherapy (BT) was given in 61 (65.59%), EBRT alone in 7(7.52%) and BT alone given in 11 (11.83%). Median EBRT dose was 50.4 Gy. Vaginal cylinder applicator was used in 69 (95.83%) out of 72 patients receiving BT. A 6.0 Gy/# to a total of 2 fractions were given in 57 (79.16%). Median treated length of vagina was 3 cm (range 2-8 cm). Five year DFS and OS was 25% and 25% and 64% and 62% respectively in worst and best case scenario. Ten (10.75%) patients, all having high-risk had multiple visceral and local recurrence. Conclusion: In patients with endometrial cancer, total abdominal hysterectomy with bilateral salpingo-oophrectomy is commonest surgical practice with adjuvant radiotherapy in high-risk patients. In a developing country like India, assuring uniformity of treatment protocols is a challenging task.

IntroductionThis study aimed to identify and characterize novel siderophore-producing organisms capable of secreting high quantities of the iron-binding compounds. In the course of this, two not yet reported halophilic strains designated ATCHAT and ATCH28T were isolated from hypersaline, alkaline surface waters of Salar de Llamará and Laguna Lejía, respectively. The alkaline environment limits iron bioavailability, suggesting that native organisms produce abundant siderophores to sequester iron.MethodsBoth strains were characterized by polyphasic approach. Comparative analysis of the 16S rRNA gene sequences revealed their affiliation with the genus Halomonas. ATCHAT showed close similarity to Halomonas salicampi and Halomonas vilamensis, while ATCH28T was related closest to Halomonas ventosae and Halomonas salina. The ability of both strains to secrete siderophores was initially assessed using the chromeazurol S (CAS) liquid assay and subsequently further investigated through genomic analysis and NMR. Furthermore, the effect of various media components on the siderophore secretion by strain ATCH28T was explored.ResultsThe CAS assay confirmed the ability of both strains to produce iron-binding compounds. Genomic analysis of strain ATCHAT revealed the presence of a not yet reported NRPS-dependant gene cluster responsible for the secretion of siderophore. However, as only small amounts of siderophore were secreted, further investigations did not lie within the scope of this study. Via NMR and genomic analysis, strain ATCH28T has been determined to produce desferrioxamine E (DFOE). Although this siderophore is common in various terrestrial microorganisms, it has not yet been reported to occur within Halomonas, making strain ATCH28T the first member of the genus to produce a non-amphiphilic siderophore. By means of media optimization, the produced quantity of DFOE could be increased to more than 1000 µM.DiscussionPhenotypic and genotypic characteristics clearly differentiated both strains from other members of the genus Halomonas. Average nucleotide identity (ANI) values and DNA–DNA relatedness indicated that the strains represented two novel species. Therefore, both species should be added as new representatives of the genus Halomonas, for which the designations Halomonas llamarensis sp. nov. (type strain ATCHAT = DSM 114476 = LMG 32709) and Halomonas gemina sp. nov. (type strain ATCH28T = DSM 114418 = LMG 32708) are proposed.

There has been extensive research on improving and innovating current treatments for irritable-bowel-syndrome using nanotechnology. However, there are growing challenges to progress these drugs to clinical trials and commercialisation. This study sought to develop a framework to manage key features, overlooked in current studies, to improve the development of drugs. An integrative literature review was used to extract themes by using a summative content analysis to interrogate information. Validity was established when saturation of information was achieved. Reliability focussed on the repeatability of key information. Absorption, distribution, metabolism, excretion and toxicity, quality by design attributes, metrology, and standardisation of practice emerged as important themes. These themes together among others, were used to develop the framework to manage the drug development process: Knowledge-based society, Foresight planning, Multidisciplinary approach, Unified definition, Adapt to existing standards and guidelines, Precautionary principle, Case-by-case approach, Quality-by-design, Scale-up and Training. The framework provided reflections that no study has considered. The framework will ensure that drug development will be approached strategically to avoid duplication of research-designs, including risk mitigation, quality at the source and supplier-chain management to progress drug development to clinical trials and beyond.

Introduction Across a variety of settings, women in tenuous financial circumstances are drawn to community health work as a way to advance themselves in the context of limited employment options. Female Community Health Workers (CHWs) are often preferred because they can more easily access mothers and children; at the same time, gender norms are at the heart of many of the challenges and inequities that these workers encounter. Here, we explore how these gender roles and a lack of formal worker protections leave CHWs vulnerable to violence and sexual harassment, common occurrences that are frequently downplayed or silenced.Methods We are a group of researchers who work on CHW programmes in a variety of contexts globally. The examples here are drawn from our ethnographic research (participant observation and in-depth interviews).Results CHW work creates job opportunities for women in contexts where such opportunities are extremely rare. These jobs can be a lifeline for women with few other options. Yet the threat of violence can be very real: women may face violence from the community, and some experience harassment from supervisors within health programmes.Conclusion Taking gendered harassment and violence seriously in CHW programmes is critical for research and practice. Fulfilling CHWs’ vision of health programmes that value them, support them and give them opportunities may be a way for CHW programmes to lead the way in gender-transformative labour practices.

Background: The World Health Organization declared the coronavirus disease 2019 (COVID-19) a global pandemic on 11 March 2020. Identifying the infected people and isolating them was the only measure that was available to control the viral spread, as there were no standardized treatment interventions available. Various public health measures, including vaccination, have been implemented to control the spread of the virus worldwide. India, being a densely populated country, required laboratories in different zones of the country with the capacity to test a large number of samples and report test results at the earliest. The Indian Council of Medical Research (ICMR) took the lead role in developing policies, generating advisories, formulating guidelines, and establishing and approving testing centers for COVID-19 testing. With advisories of ICMR, the National Institute of Cancer Prevention and Research (NICPR) established a high-throughput viral diagnostic laboratory (HTVDL) for RT-PCR-based diagnosis of SARS-CoV-2 in April 2020. HTVDL was established during the first lockdown to serve the nation in developing and adopting rapid testing procedures and to expand the testing capacity using “Real-Time PCR.” The HTVDL provided its testing support to the national capital territory of Delhi and western Uttar Pradesh, with a testing capacity of 6000 tests per day. The experience of establishing a high-throughput laboratory with all standard operating procedures against varied challenges in a developing country such as India is explained in the current manuscript which will be useful globally to enhance the knowledge on establishing an HTVDL in pandemic or non-pandemic times.

Objective To assess the psychological impact of suspension/postponement of various fertility treatments on infertile women during the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a cross-sectional study conducted as an online survey among infertile women consulting either through teleconsultation or physical consultation at a fertility clinic of a tertiary care referral unit. A validated questionnaire was given as a WhatsApp link to the women who were consulting for the resumption of services. Questions asked were based on their socio-demographic parameters, fertility treatment at the time of suspension, anxiety (self-reported) and stress (perceived stress scale-4, PSS-4) due to delay in treatment, psychosocial effect of pandemic, and wishes regarding the resumption of fertility services. Results Of 430 patients who received the questionnaire, 250 completed the survey (response rate: 58%). The mean age of participants was 29.26±4.18 years and the majority (70.4%) had lower socioeconomic status. The average PSS-4 score was 7.8±0.71, and the prevalence of self-reported anxiety was 72%. Those who suffered migration during the pandemic had significantly higher PSS-4 scores, and increasing age was associated with increased self-reported anxiety due to the suspension of fertility services. The top three priorities reported were infertility and treatment delay (48.4%), job loss (19.2%), and the risk of contracting COVID-19 infection (16%). The degree of spousal support was significantly correlated with lower PSS-4 scores (r=−0.30, P