Search

The rising instances of drug resistance in Mycobacterium tuberculosis strains pose a significant global health challenge. Conventional tuberculosis (TB) treatments, which typically involve multiple antibiotics, face hurdles like drug resistance, reduced effectiveness, and heightened toxicity. Consequently, there is a pressing need for innovative anti-TB agents with new modes of action. Decaprenyl-phosphoryl-β-d-ribose 2′-epimerase 1(DprE1), a crucial enzyme in Mycobacterium tuberculosis, plays a vital role in cell wall biosynthesis – a critical aspect for the bacterium’s survival. Building on the success of diarylquinolines like bedaquiline, targeting DprE1 presents a promising avenue for developing anti-TB drugs, especially against drug-resistant strains. Our research focused on discovering novel DprE1 inhibitors using a ligand-based drug design strategy, starting with the established non-covalent inhibitor Ty38c. We assembled a library of 16 molecules, modifying them based on factors like drug-like properties, chemical accessibility, and synthetic feasibility. Molecular docking analyses of this library identified three molecules with binding affinities comparable to Ty38c. Among these, KS_QD_05 and KS_QD_04 are promising candidates, which were further validated through molecular dynamics simulation studies where root-mean-square deviation (RMSD) values of all three complexes reached a plateau, measuring around 0.3 nm, indicating that the apoprotein and all complexes stabilized during the simulation. The ligands KS_QD_04 and KS_QD_05 displayed significantly stable deviation. KS_QD_05 reached about 0.1 nm equilibrium value. However, the ligand KS_QD_04 reached an RMSD value of 0.17 nm and showed distress at 70 nm. KS_QD_04 and KS_QD_05 showed an average value of 1-3 H-bond interaction and regarding the RMSF values, both the compounds showed fluctuations less than 0.5 nm in the case of Mtb. DprE1 enzyme. This indicates the potential of both compounds to become lead compounds in the pursuit of DprE1 inhibitors for TB treatment.

Parth J Rana,1 Himanshu Deshmukh,2 Urmil Shah,3 Vinod Kumar,4 Sanghamitra Kanungo,5 Deepika Singhal,6 Santosh Kumar Mahapatra,7 Ira Vakharia,8 Mukesh Jaiswal,9 Ajitkumar Gondane,10 Pooja Vaidya,10 Vinayaka Shahavi,9 Harish Shandilya,11 Dattatray Pawar,10 Akhilesh Sharma12 1Department of Retina and Trauma Surgery, Netralaya Superspeciallity Hospital, Ahmedabad, Gujarat, India; 2Department of Retina; ‘Daulat’ Deshmukh Eye Hospital, Khaparde Gardens, Amravati, Maharashtra, India; 3Department of Retina, P.N. Desai Eye Hospital, Ahmedabad, Gujarat, 380052, India; 4Department of Ophthalmology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India; 5Department of Retina, Kar Vision Eye Hospital, Bhubaneswar, Odisha, 751007, India; 6Department of Ophthalmology, GMERS Medical College and Civil Hospital, Ahmedabad, Gujarat, India; 7Department of Retina, JPM Rotary Club of Cuttack Eye Hospital and Research Institute, Cuttak, Odisha, 753014, India; 8Department of Retina, Nirmal Hospital Pvt Ltd, Surat, Gujarat, 395002, India; 9Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, India; 10Medical Affairs Department, Alkem Laboratories Ltd., Lower parel, Mumbai, India; 11Global Product Development, IPM & Regulatory Affairs, Enzene Biosciences Ltd., Pune, India; 12Medical Affairs and Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, IndiaCorrespondence: Ajitkumar Gondane, Medical Affairs, ALKEM Laboratories Ltd., ALKEM HOUSE, “Devashish”, Adjacent to Matulya Centre, Senapati Bapat Marg, Lower Parel, Mumbai, 400 013, India, Tel +8983375722, Email ajitkumar.gondane@alkem.comObjective: This study aimed to compare efficacy, safety, and immunogenicity of the biosimilar ranibizumab in comparison with the Innovator Ranibizumab in treatment-naive patients with neovascular (wet) age-related macular degeneration (nAMD or wAMD).Materials and Methods: This comparative, double blind, multicentre, Phase III clinical study randomized eligible patients in a 3:1 ratio to receive either OPTIMAB® (Alkem Laboratories Ltd./ Enzene Biosciences Ltd.) or Innovator Ranibizumab. Intravitreal injections of Innovator Ranibizumab (0.5 mg in 0.05 mL) and OPTIMAB® (0.5 mg in 0.05 mL) were administered every four weeks for 12 weeks (three doses). Primary efficacy endpoints included loss of < 15 letters from baseline, gain of ≥ 15 letters from baseline in visual acuity, mean change in best corrected visual acuity (BCVA) from baseline, and change in central subfoveal thickness (CSFT) from baseline at week 12. Safety was assessed through monitoring of adverse events (AEs) and serious adverse events (SAEs) throughout the study.Results: Overall, of the 152 patients randomized, 141 (92.8%) patients (mean age, 66.6 ± 9.37 years) completed the study. Percentage of patients who lost < 15 letters in BCVA at week 12 from baseline was comparable in both the groups (100.0%, each). On secondary end point analysis, the two groups had comparable mean changes in BCVA (OPTIMAB®, 11.8 ± 9.18; innovator ranibizumab, 12.9 ± 10.29; P = 0.5509); proportion of patients who gained ≥ 15 letters in visual acuity (OPTIMAB®, 32.18%; innovator ranibizumab, 25.74%; P = 0.4785) and mean change in CSFT (OPTIMAB®, − 76.6 ± 89.03; Innovator ranibizumab, − 73.1 ± 92.23 μm; P = 0.8422) at week 12 as compared to baseline. OPTIMAB® and innovator ranibizumab demonstrated comparable safety over the 12-week treatment period and no patient expressed anti-ranibizumab antibody in either group patient.Conclusion: Biosimilar ranibizumab (OPTIMAB®) was non-inferior to innovator ranibizumab in terms of efficacy, safety, and immunogenicity in the patients of nAMD.Keywords: biosimilar ranibizumab, best corrected visual acuity, central subfoveal thickness, nAMD

The rich phytochemical profile of Perilla frutescens leaf extract (PLE) makes it a compelling bioreducing agent for the green synthesis of silver nanoparticles (AgNPs), offering diverse biomedical applications. In this study, the PLE-mediated phytosynthesis of AgNPs was confirmed by UV-vis spectra with maximum absorbance at 440 nm. The spherical PLE-AgNPs of

Background: Coronavirus disease 19 (COVID-19) has become a global pandemic; its unparalleled speed of spread has left us all in a worldwide alarming situation. Aims: The aim was to study the prevalence of COVID-19 infection in asymptomatic antenatal patients at term and its maternal and fetal outcomes and neonates being followed up till 18 months for developmental assessment. This was a prospective observational study carried out from September 1, 2020, to March 31, 2023. Materials and Methods: This prospective observational study was conducted on 250 pregnant women attending the antenatal care outpatient department in a Zonal Hospital in Northeastern India expected to undergo delivery in the next 5 days, and all suspected COVID-19 pregnant women were included in the study. Asymptomatic pregnant women not expecting delivery in the next 5 days were excluded. All neonates born to these 250 mothers were followed till 18 months of age and were then assessed for the impact of COVID-19 on the developmental milestones. The prevalence of COVID-19 was calculated in the study population. The Chi-square test was used to compare categorical variables in COVID-19-positive and -negative groups. P

May–Thurner syndrome (MTS) is an anatomical condition of external luminal compression of common iliac vein due to a partial obstruction of the common iliac vein between common iliac artery and lumbar vertebra causes deep-vein thrombosis, venous hypertension, and chronic venous insufficiencies. In this article, we review present evidence of the clinical diagnosis and management of MTS. Here, we conducted a literature review of studies on MTS. We also reviewed different clinical features, presentation, diagnostic methods, and therapeutic procedure for this condition. Most studies mentioned the diagnosis of this condition is performed by color Doppler, computed tomographic angiography, venography, and problem-solving cases by intravascular ultrasound technique. Nonsurgical methods of management are first line, and vascular surgery is reserved for refractory cases. Multiple modalities are required to reach the diagnosis of MTS, and noninvasive intervention radiology methods are the first line of management. This review highlights the presentations of MTS and outlines diagnostic procedure and management.

BackgroundIn contrast to the standard shoulder arthroscopy, current radio-diagnostic techniques like magnetic resonance arthrography (MRA), and magnetic resonance imaging (MRI) provide less invasive intricate structural detail of shoulder anatomy. ObjectivesComparison of efficacy of MRA and MRI for diagnosing suspected rotator cuff injury. Materials and MethodsOver the course of 4 years (from June 2017 to June 2021), a comparative study, including 100 individuals with suspected rotator cuff pathology, was conducted. For the evaluation of shoulder injuries, the assessment and comparison of MRA and MRI were done in terms of sensitivity (Sn), positive predictive value (PPV), and diagnostic accuracy (DA). ResultsMRI and MRA were positive in 76 (76%) and 98 (98%) patients, respectively. The Sn and PPV of MRI for diagnosing the shoulder injury were 76% and 100%, respectively, whereas the Sn and PPV of MRA were 98% and 100%, respectively. MRA was better than MRI in terms of diagnostic accuracy (98% vs. 76%, P = 0.03). ConclusionMRA is a nonsurgical effective method in evaluating and diagnosing rotator cuff injuries in comparison to MRI.

Sushmita Negi,1,2,&ast; Nikunj Tandel,3,&ast; Neeraj K Garg,4 Prakriti Sharma,1 Rajinder Kumar,1 Praveen Sharma,1 Reetesh Kumar,5 Sheetal Saini,1 Aman Sharma,6 Rajeev K Tyagi1,2 1Biomedical Parasitology and Translational-Immunology Lab, Division of Cell Biology and Immunology, CSIR-Institute of Microbial Technology (IMTECH), Chandigarh, 160036, India; 2Academy of Scientific and Innovation Research (Acsir), Ghaziabad, 201002, India; 3Institute of Science, Nirma University, Ahmedabad, Gujarat, India; 4University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, 160014, India; 5Faculty of Agricultural Sciences, Institute of Applied Sciences and Humanities, GLA University, Mathura, Uttar Pradesh, India; 6Clinical Immunology and Rheumatology Wing, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India&ast;These authors contributed equally to this workCorrespondence: Rajeev K Tyagi, Biomedical Parasitology and Translational-immunology Lab, Division of Cell Biology and Immunology, CSIR-Institute of Microbial Technology (IMTECH), Sec-39a, Chandigarh, 160036, India, Tel +91-172-6665278; +91-172-6665279, Email rajeevtyagi@imtech.res.in; rajeev.gru@gmail.comBackground: Rheumatoid arthritis (RA) is a common acute inflammatory autoimmune connective tissue arthropathy. The genetic studies, tissue analyses, experimental animal models, and clinical investigations have confirmed that stromal tissue damage and pathology driven by RA mounts the chronic inflammation and dysregulated immune events.Methods: We developed methotrexate (MTX)-loaded lipid-polymer hybrid nanoparticles (MTX-LPHNPs) and aceclofenac (ACE)-loaded nanostructured lipid carriers (ACE-NLCs) for the efficient co-delivery of MTX and ACE via intravenous and transdermal routes, respectively. Bio-assays were performed using ex-vivo skin permeation and transport, macrophage model of inflammation (MMI) (LPS-stimulated THP-1 macrophages), Wistar rats with experimental RA (induction of arthritis with Complete Freund’s adjuvant; CFA and BCG), and programmed death of RA affected cells. In addition, gene transcription profiling and serum estimation of inflammatory, signaling, and cell death markers were performed on the blood samples collected from patients with RA.Results: Higher permeation of ACE-NLCs/CE across skin layers confirming the greater “therapeutic index” of ACE. The systemic delivery of MTX-loaded LPHNPs via the parenteral (intravenous) route is shown to modulate the RA-induced inflammation and other immune events. The regulated immunological and signaling pathway(s) influence the immunological axis to program the death of inflamed cells in the MMI and the animals with the experimental RA. Our data suggested the CD40-mediated and Akt1 controlled cell death along with the inhibited autophagy in vitro. Moreover, the ex vivo gene transcription profiling in drug-treated PBMCs and serum analysis of immune/signalling markers confirmed the therapeutic role co-delivery of drug nanoparticles to treat RA. The animals with experimental RA receiving drug treatment were shown to regain the structure of paw bones and joints similar to the control and were comparable with the market formulations.Conclusion: Our findings confirmed the use of co-delivery of drug nanoformulations as the “combination drug regimen” to treat RA.Keywords: methotrexate, aceclofenac, lipid polymer hybrid nanoparticles, nanostructured lipid nanocarriers, rheumatoid arthritis, MMP-1

A challenge in optical phased arrays (OPAs) is to achieve single-lobe emission using densely spaced emitters without incurring inter-waveguide optical crosstalk. Here, we propose to heuristically optimize the amplitude and phase of each grating antenna in an OPA to correct for optical non-idealities, including fabrication variations and inter-waveguide crosstalk. This method was applied to a silicon photonic integrated circuit with 1 mm-long gratings at 775 nm spacing for operation in a wavelength range of 1450–1650 nm. We achieved a wide two-dimensional beam-steering range of 110° × 28°, evaluated over a 127° × 47° field-of-view (FOV). Within this FOV, we measured an average sidelobe suppression of 8.2 dB and focused on average, 34.5 % of the emitted power into the main lobe. We achieved a peak sidelobe suppression of 14.5 dB and 50 % of the power concentrated in the main lobe. The approach is suitable for applications that require alias-free out-of-plane emission.

This review paper provides an overview of recent research on landslide susceptibility. Landslides are a natural phenomenon that can cause significant damage to infrastructure and endanger human lives. The paper presents an in-depth analysis of the factors that contribute to landslide susceptibility, including geological, hydrological and anthropogenic factors. It also discusses various methods and techniques used to assess landslide susceptibility, including statistical models, geographic information systems (GIS) and remote sensing. The paper examines the advantages and limitations of these methods and highlights the need for an integrated approach that combines multiple techniques to improve accuracy and reliability. Additionally, the paper discusses the challenges associated with developing landslide susceptibility maps and emphasises the importance of considering uncertainties and risk assessments. The review paper concludes by identifying the gaps in current research and suggesting potential directions for future studies. Overall, this review paper provides a comprehensive analysis of landslide susceptibility, which can serve as a valuable resource for researchers, practitioners and policymakers working in this field.

This article systematically reviews research on noise pollution monitoring conducted over the past 23 years at various bus transit terminals located worldwide. About 18 articles were identified using PRISMA method and were evaluated to provide summary of prior research work to examine accuracy, authenticity, and reliability of noise monitoring results with respect to chosen methodology and extent of noise pollution at bus transit terminals. It examines important indicators of noise pollution and the analysis parameters such as noise sampling, noise descriptors, processing of acquired data, noise mapping, etc., and compares it with the regulations and standard guidelines notably ISO 1996-2:2017 and American National Standards Institute/ASA S12.18-1994 (R2009) and their prior versions aiming to identify research gaps. The studies have primarily focused on noise monitoring, revealing widespread excessive noise pollution exceeding permissible levels at bus terminals globally. This article underscores significant research deficiencies in noise pollution monitoring at bus terminals, emphasizing the challenge of conducting quantitative meta-analyses and statistical comparisons due to variations in parameters and qualities. Noise pollution standards are breached in all terminals covered in the identified literature; hence, noise mitigation measures must be implemented at these bus terminals. The study suggests that noise monitoring must be carefully devised with respect to individual site operations and noise sources and in compliance with standard guidelines to improve the accuracy of the results. There is a need for uniform guidelines that can be followed globally for environmental noise monitoring as there are only a few countries that have guidelines for noise monitoring. The outcomes of this research will be helpful in guiding noise monitoring, mapping, and mitigation strategies as well as designing transit terminals to improve overall acoustical ambiance for more passenger footfall for sustainable transportation.

Orthognathic surgery is a procedure used to correct facial deformities and jaw bone misalignment. The use of technology, specifically virtual surgical planning (VSP), has become increasingly prevalent in preoperative planning for orthognathic surgery. High-resolution computed tomography (CT) imaging has enabled computer-aided modelling. Artificial intelligence (AI) implementation has transformed orthognathic surgery methodology. This article highlights the latest market trends and modern-day advancements in the field, including the conventional and surgery first approach for orthognathic surgery. The use of computer-aided surgical simulation (CASS) in VSP for orthognathic surgery was studied. The different software used for orthognathic surgical planning and the detailed protocol followed during the surgery, including the preoperative procedure were discussed along with utilisation of 3-dimension cone-beam computed tomography (3D CBCT) images for surgical planning. The implementation of VSP with CASS had significantly enhanced the accuracy and efficiency of orthognathic surgery for dentofacial deformity correction. The use of technology allowed improved preoperative planning, resulting in better outcomes for patients. The study of different software for orthognathic surgical planning and the protocol followed during surgery has provided valuable insight into the surgery. The continued advancement of technology in orthognathic surgery is promising for the field and for the patients.

Christina Mueller,1 Ayushe A Sharma,2 Jerzy P Szaflarski3 1Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; 3Departments of Neurology, Neurobiology, and Neurosurgery, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Christina Mueller, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, 1719 6th Ave S, Birmingham, AL, 35222, USA, Tel +1 205-975-4219, Fax +1 205-996-4802, Email cm1@uab.eduPurpose: Inflammation may link trauma to clinical symptoms in functional seizures (FS). We compared brain temperature and metabolites in FS, psychiatric (PCs) and healthy controls (HCs) and quantified their associations with serum biomarkers of inflammation and clinical symptoms.Patients and Methods: Brain temperature and metabolites were measured with whole-brain magnetic resonance spectroscopic imaging (MRSI) and compared between groups in regions of interest and the whole brain. Relationships with inflammatory biomarkers and symptoms were assessed with Pearson correlations.Results: Brain temperature was higher in FS than HCs in the orbitofrontal cortex (OFC) and anterior cingulate gyrus (ACG) and lower in the occipital cortex and frontal lobe. PCs showed lower temperatures than HCs in the frontal lobe including precentral gyrus and in the cerebellum. Myo-inositol (MINO) was higher in FS than HCs in the precentral gyrus, posterior temporal gyrus, ACG and OFC, and choline (CHO) was higher in the occipital lobe. CHO was higher in PCs than HCs in the ACG and OFC, and N-acetylaspartate (NAA) was higher in the ACG. There were no significant correlations with the serum inflammatory biomarkers. In FS, brain temperature correlated with depression, quality of life, psychological symptoms, and disability, CHO correlated with disability, and MINO correlated with hostility, disability, and quality of life.Conclusion: Some of the previously identified neuroimaging abnormalities in FS may be related to comorbid psychiatric symptoms, while others, such as abnormalities in sensorimotor cortex, occipital regions, and the temporo-parietal junction may be specific to FS. Overlapping MINO and temperature increases in the ACG and OFC in FS suggest neuroinflammation.Keywords: brain temperature, magnetic resonance spectroscopy, functional seizures, inflammatory biomarkers, metabolites

Agriculture encompasses the study, practice, and discipline of plant cultivation. Agriculture has an extensive history dating back thousands of years. Depending on climate and terrain, it began independently in various locations on the planet. In comparison to what could be sustained by foraging and gathering, agriculture has the potential to significantly increase the human population. Throughout the twenty-first century, precision farming (PF) has increased the agricultural output. precision agriculture (PA) is a technology-enabled method of agriculture that assesses, monitors, and evaluates the needs of specific fields and commodities. The primary objective of this farming method, as opposed to conventional farming, is to increase crop yields and profitability through the precise application of inputs. This work describes in depth the development and function of artificial intelligence (AI) and the internet of things (IoT) in contemporary agriculture. Modern day-to-day applications rely extensively on AI and the IoT. Modern agriculture leverages AI and IoT for technological advancement. This improves the accuracy and profitability of modern agriculture. The use of AI and IoT in modern smart precision agricultural applications is highlighted in this work and the method proposed incorporates specific steps in PF and demonstrates superior performance compared to existing classification methods. It achieves a remarkable accuracy of 98.65%, precision of 98.32%, and recall rate of 97.65% while retaining competitive execution time of 0.23 s, when analysing PF using the FAOSTAT benchmark dataset. Additionally, crucial equipment and methods used in PF are described and the vital advantages and real-time tools utilised in PA are covered in detail.

James Kenneth Walters,1 Anurag Sharma,2 Jamie Boyce,1 Reema Harrison3 1HealthShare NSW, NSW Health, St Leonards, NSW, Australia; 2School of Population Health, UNSW, Sydney, NSW, Australia; 3Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, AustraliaCorrespondence: James Kenneth Walters, Email james.walters@health.nsw.gov.auAim: Analysis of centralized efficiency improvement practices in Australian public health systems.Introduction: Public health systems seek to maximize outcomes generated for resources used through efficiency improvement (EI) in response to funding and demand pressures. Despite this focus, evidence for EI approaches at the whole-of-system level is lacking in the literature. There is an urgent need for evidence-based approaches to centralized EI to address these pressures. This study aims to address this gap by answering the research question “How is EI conceptualized and managed by central public health system management entities in Australia?”.Material and Methods: Document analysis was selected due to its suitability for systematically searching and appraising health system documentation, with this study following Altheide’s approach focusing on whole-of-system strategic plan and management framework documents originating from Australian public health organizations.Results: Conceptualization of efficiency varied substantially with no consistent definition identified, however common attributes included resource use, management, service and delivery. Forty-two of 43 documents contained approaches associated with improving efficiency at the whole of system level.Discussion: While no comprehensive framework for centralized EI was evident, we identified nine core approaches which together characterize centralized EI. Together these approaches represent a comprehensive evidence-based approach to EI at the whole of system level.Conclusion: The approaches to whole-of-system EI identified in this study are likely to be highly transferable across health systems internationally with approaches including strategic priority setting, incentivization, performance support, use of EI evidence, digital enablement and workforce capability development.Keywords: efficiency, public health, health management

Ankita Sharma, Srikant Natarajan, Nidhi Manaktala, Karen Boaz, Nandita KP, Amitha Lewis, Shweta Yellapurkar Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaCorrespondence: Karen Boaz, Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India, Email karen.boaz@manipal.eduIntroduction: Nomograms are proven in “individualized risk prediction” in sarcomas and breast and prostate cancers. Incorporating immunohistochemical markers and histopathological parameters can enhance accuracy of these graphical representations of statistical predictive models concerning metastasis. D2-40, a monoclonal antibody to podoplanin (regulator of motility expressed in malignant epithelial cells), dually predicts metastatic potential of tumour by estimating the motile tumour phenotype and by detecting lymphatic vessels/density, both essential to metastasis in OSCC. Thus, we propose a model that incorporates D2-40 immunostaining of individual tumour cells (ITC) too with other variables (seen in H+E staining) as a predictive nomogram.Methods: Sixty cases of OSCC were selected with equal number of cases (n=30) of pN0 and pN+ status. Bryne’s grading of invasive front of tumour (ITF) was done on H+E-stained slides followed by D2-40 immunostaining for ITCs at ITF and lymphatic vessels. Multivariate regression analysis was used to generate the nomogram of LNM where the predictive contribution of each covariate, namely depth of invasion, D2-40-stained ITCs, gender, histological grade, and worst pattern of invasion (WPOI), was plotted on a scale of 1– 100 points.Results: The nomogram showed that the strongest variable in OSCC was the WPOI in H+E-stained section followed by D2-40-positive ITCs and gender.Discussion: Our predictive nomogram for LNM in OSCC surprisingly showed that a tumour with lower score of WPOI (islands vs ITC) showed numerous D2-40-positive ITCs, drastically increasing the probability of metastasis. The concept of “individualized risk prediction” can be used to predict lymph node metastasis using a variety of histopathological criteria that can be visualized in routine and immunohistochemical staining in OSCC with the aid of a nomogram.Keywords: nomogram, individualized risk prediction, D2-40, lymph node metastasis in OSCC, podoplanin

Anam Herekar, Dhanush Shimoga, Asad Jehangir, Dariush Shahsavari, Yun Yan, Tennekoon Buddhika Karunaratne, Amol Sharma Department of Medicine, Augusta University, Augusta, GA, USACorrespondence: Amol Sharma, Medical College of Georgia, Augusta University, 1120 15th Street, AD 2226, Augusta, GA, 30912, USA, Email amosharma@augusta.eduAbstract: Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction (DGBI). IBS significantly impacts the quality of life of patients. Since its pathogenesis is unclear and can be multifactorial, it highlights the need for new and improved pharmaceutical drugs that not only improve bowel symptoms, but also address global IBS symptoms, such as abdominal pain. Tenapanor, a recently Food & Drug Administration (FDA)-approved medication for IBS with constipation (IBS-C), is a small molecule inhibitor of the sodium/hydrogen exchanger isoform 3 (NHE3) that inhibits the absorption of sodium and phosphate in the gastrointestinal tract, resulting in fluid retention and softer stool. Furthermore, tenapanor reduces intestinal permeability to improve visceral hypersensitivity and abdominal pain. Due to its recent approval, tenapanor was not included in the recent IBS guidelines, however, it may be considered for IBS-C patients failing first-line treatment of soluble fiber. In this review article, we aim to provide in-depth information to the reader regarding the design of tenapanor, its development through Phase I, II and III randomized clinical trials, and its role in the treatment of IBS-C.Keywords: irritable bowel syndrome, irritable bowel syndrome with constipation, IBS, IBS-C, constipation, tenapanor

Layered composite materials are widely used across a variety of sectors, including the automotive industry, aerospace engineering, offshore, and various mechanical domains, because of their strong yet lightweight structures. Therefore, various emergent theories are available on the deformation of layered beams. The previous research studies are insufficient as they are based on deformation of layered composite and sandwich arches with simply supported (SS) end conditions. Therefore, it is a good opportunity for researchers to investigate the arches using exponential shear deformation and normal deformation theory. The leading hypothesis mainly adds to the research of bending for sandwich and layered composite arches adopting the exponential theory. The present theory does not require any shear correction factor to satisfy zero transverse shear stress condition at the bottom and top fibers of arches. Governing equations and associated end conditions are derived through principle of virtual work. Navier’s techniques used for sandwich and layered composite arches are SS boundary conditions subjected to uniformly distributed load. The results of the current study showed that the exponential normal and shear deformation theories may be used to evaluate static responses for layered composite and sandwich arches. The obtained results from the present theory are validated through the results available in published literature.

Ashok Sharma,1 Namrata Sharma,2 Sayan Basu,3 Rajan Sharma,1 Shruti Aggarwal,4 Parul Chawla Gupta,5 Jagat Ram,6 Verinder S Nirankari7 1Dr Ashok Sharma Cornea Centre, Chandigarh, UT, India; 2Cornea Service, Dr. R. P. Centre, AIIMS, New Delhi, India; 3LVPEI Banjara Hills, Hyderabad, Telangana, India; 4Anterior Segment Cataract Surgery, Katzen Eye Group, Baltimore, MD, USA; 5Advanced Eye Centre, PGIMER, Chandigarh, UT, India; 6Advanced Eye Centre PGIMER, Chandigarh, UT, India; 7University of Maryland, Baltimore, MD, USACorrespondence: Ashok Sharma, SCO 2463-2464, Sector 22C, Cornea Service, Dr Ashok Sharma’s Cornea Centre, Chandigarh, 160022, India, Email asharmapgius@yahoo.comAbstract: Corneal perforations are ophthalmological emergencies which can have serious and detrimental consequences, if not managed timely and appropriately. These are a significant cause of ocular morbidity and can result in decreased vision, blindness, and even loss of the eye. Corneal perforations can be managed using a range of treatment approaches, including temporary solutions such as the application of corneal glue and bandage contact lens, as well as definitive treatment such as corneal transplantation. Tissue glues/adhesives were developed as substitutes for sutures in ophthalmic surgery. Unlike sutures, these glues are associated with shorter overall surgical times and reduced inflammation, thus improving postoperative comfort without compromising wound strength. The available tissue adhesives can be broadly classified into two types: synthetic (eg, cyanoacrylate derivatives) and biological (eg, fibrin glue). Cyanoacrylate glue is chiefly used as a corneal patch to manage acute corneal perforations and improve visual outcomes. Fibrin glue can be used instead of cyanoacrylate glue in many conditions with the benefits of reduced conjunctival and corneal inflammation and reaction. Apart from this, each type of adhesive is distinct in terms of its benefits as well as limitations and is accordingly used for different indications. The present review focuses on the two main types of tissue adhesives, their applications in the management of corneal perforations, the associated complications, safety and efficacy data related to their use available in the literature and the need for newer adhesives in this field.Keywords: corneal perforation, tissue adhesives, cyanoacrylate, fibrin glue, corneal patch

Background: Stress is defined by American Psychological Association is “Any uncomfortable emotional experience accompanied by predictable biochemical, physiological and behavioral changes.” It is a feeling of being overwhelmed, worried or run-down. Stress affects people of all ages, gender and circumstances and can lead to both physical and psychological health issues. Social contexts and family structures are particularly impacted by stress in women. This study aims to assess the levels of stress and associated factors of stress among working women in Mangalore. Methodology: This cross-sectional study was conducted among 298 working women, who were managerial staff/Clerical staff recruited from 2 Banks, 2 shopping malls, health care workers from 2 hospitals and doctors/ clerical staff from Medical College, Mangalore. Data was collected using a semi- structured questionnaire including sociodemographic characteristics and perceived stress scale and analyzed using SPSS version 24. Results were expressed in mean (standard deviation) and proportion. For comparison across the groups chi-square test was used. A ‘p’ value of less than 0.05 was considered statistically significant. Results: Out of 298 women surveyed, 3.4% were found to be highly stressed, 83.9% were moderately stressed. Significant stress determinants were found to be associated with age, education, occupation, years of work experience and marital status- where the association is statistically significant. Working women prefer to go for leisure activities like outing with friends and family to reduce stress while other activities like smoking and alcohol consumption were least popular among the study participants. Conclusion: The study emphasizes the critical elements—age, education, employment, job experience, and years since marriage—that significantly influence women’s stress levels. Furthermore, it highlights that for working women, entertainment is the main way to decompress, and employers need to take note of this to help staff members maintain a healthy work-life balance.

Background: During the surge of COVID-19 pandemic, the mechanism of reporting and documentation of deaths was inadequate. It is crucial to establish the mechanism for measuring the actual events of COVID-19 and associated mortalities as well during this pandemic situation. This is the first instance of application of different rapid methods for death estimation during the pandemic situation. If found to be valid, these methods may be useful for other countries with limited resources and less developed death registration system. Objective: To find out the feasibility, acceptability of different rapid method for estimating the cause of deaths among the general population & healthcare workers and also to estimate the number of deaths among allopathic doctors. Methodology: The study was conducted from September 2022 to October 2023. Target population being adult deceased person between 1st April 2020 to 30th November 2022 among general population, health care worker and allopathic doctor. For the general population, the study was conducted in one urban municipal area and two sub-centres of Habra Block I under North 24 Parganas district with WHO Verbal Autopsy (VA) tool for adult. Complete enumeration with snowballing, compartmental and capture-recapture method was adopted for general population, health care worker and allopathic doctor respectively. Results: Overall, 300 VA could be performed (121 urban & 179 rural) among general population. There were challenges related to both feasibility & acceptability in terms of data access, permission and cooperation. Research team employed a combination of persistence, local collaboration, and strategic decision-making to successfully collect data. Acceptability was more in rural area. Total number of deceased doctors was estimated to be 246 from two different lists. Conclusion: Rapid methods may be employed as a part of response systems during pandemic or any future disasters if adequate governmental support and assistance is obtained along with aid from the local people.

Background: Soul of India lives in its villages with >65% population living in rural settings. Saturation of all services especially Health services is at core of “leave no one behind” in line with principle of ‘Antyodaya’ reaching out at all. To build momentum with Pradhan Mantri Jan Arogya Yojana Ayushman Health Camps were organised by IGMC Shimla at secondary level facilities under flagship campaign Ayushman Bhavah Objective: Evaluation of health care services delivered by IGMC Shimla in Ayushmann Health Melas at secondary level facilities of 03 districts of Himachal Pradesh. Methodology: Ayushman Melas organised by IGMC Shimla at secondary level facilities from September 2023 to December 2023 in 03 districts Shimla (25); Solan (12) and Bilaspur (13) for providing clinical services to beneficiaries. Real time portal based reporting and analysis of same alongwith specialitywise footfallbifurcation is core. Results: As per Real time-based portal report analysis a footfall of 10379 registered out of which 9055 (87.24%) availed specialists services and 1324(12.74%) general physician services. A net of 2672 (29.5%) beneficiaries availed internal medicine specialist services, 458 (5.05%) surgical, 1619 (17.87%) orthopaedics, 772 (8.52%) obstetrics and gynaecology, 1460 (16.12%) Opthalmology, 698 (7.7%) Otorhinolaryngology, 152 (1.67%) psychiatry, 493 (5.44%) dermatology and 731 (8.07%) paediatric services respectively. 1012(9.75%) new diagnosed Hypertensives and 945 (9.10%) new diagnosed Diabetics, 1492 14.37%) beneficiaries screened for Oral Cancers, 804 (7.75%) for breast cancers and 468 (4.5%) for cervical Cancers. 299 (2.88%) new diagnosed cataract cases. 10379 beneficiaries were tested for 11102 tests (106.96%). Conclusion: Comprehensive health care service delivery by camps to unreachable for screening, diagnosis, one stop multi-speciality consultancy, referral and digitalisation of health vitals.

Despite the availability of factor replacement therapy, including prophylaxis, to treat and prevent bleeding, haemophilic arthropathy continues to be the most common complication of haemophilia and significantly impairs the quality of life in people with haemophilia (PwH). Regular periodic assessment of joint status in PwH is essential to identify early arthropathic changes and prevent the development or progression of haemophilic arthropathy. Kinematic and kinetic assessment are preferable and MRI is the gold standard for diagnosing haemophilic arthropathy, but availability is limited in developing countries. HJHS and ultrasound in conjunction with HEAD-US have been shown to effective in assessing changes indicating arthropathy.

Avijit Sharma,1 Feng Dai,2 Lanya Tseng,1 Philip R Effraim,1 Bin Zhou,2 Robert B Schonberger,1 Jinlei Li1 1Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA; 2Yale Center for Analytical Sciences, Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USACorrespondence: Jinlei Li, Department of Anesthesiology, Yale University School of Medicine, 20 York Street, New Haven, CT, 06510, USA, Tel +1 917 601 6828, Fax +1 203 785 6664, Email jinlei.li@yale.eduPurpose: Glucocorticoids are commonly used as regional anesthesia adjuvants to improve blockade quality and duration. There are limited data in the literature regarding the potential systemic effects and safety of perineural glucocorticoids. This study examines the effects of perineural glucocorticoids on serum glucose, potassium, and white blood cell count (WBC) in the immediate postoperative period after primary total hip arthroplasty (THA).Patients and Methods: A retrospective cohort study was carried out at a tertiary academic medical center utilizing electronic health records of 210 patients who underwent THA, for which patients received either a periarticular local anesthetic injection alone (PAI, N=132) or additional peripheral nerve blocks (PNB, N=78) containing 10 mg dexamethasone and 80 mg methylprednisolone acetate (PAI+PNB). The primary outcome was change in serum glucose from a preoperative baseline on postoperative days (POD) 1, 2, and 3. Secondary outcomes included changes in WBC and serum potassium.Results: The change in serum glucose from baseline was found to be significantly higher in the PAI+PNB group compared to the PAI group on POD 1 (mean difference 19.87 mg/dL, 95% CI [12.42, 27.32]; P< 0.001) and POD 2 (mean difference 17.5 mg/dL, 95% CI [9.66, 25.44], P< 0.001). No significant difference was found on POD 3 (mean difference − 8.18 mg/dL, 95% CI [− 19.07, 2.70], P=0.14). Statistically significant but clinically insignificant differences were detected in serum potassium in the PAI+PNB group compared to the PAI group on POD1 (mean difference 0.16 mEq/L, 95% CI [0.02, 0.30], P=0.03) and WBC on POD 2 (mean difference 3.18 × 1000/mm3, 95% CI [2.14, 4.22], P< 0.001).Conclusion: Patients who underwent THA and received PAI+PNB with glucocorticoid adjuvants demonstrated higher elevations in serum glucose for the first two PODs compared to patients who received PAI alone. These differences resolved by a third POD and are likely to be of no clinical significance.Keywords: perineural glucocorticoid, perineural dexamethasone, perineural methylprednisolone acetate, total Hip arthroplasty, fascia plane block, serum glucose

Conjoined twins are a rare congenital anomaly. The extent of organ sharing and cross circulation between twins determine the possibility and prognosis of a separation procedure. In this case anaesthetic management for successful separation of omphalopagus conjoined twins at day three of life is presented. Authors emphasise the importance of an integrated approach, thorough preoperative evaluation and planning, vigilant intraoperative monitoring and anticipation and management of complications like hypothermia, hypotension, hypokalaemia, hypocalcaemia and postoperative concerns and care.

The most important and core technology of the Internet of things (IoT) is still the internet, and it also includes many other technical fields and is applied to many fields. The various processes of IoT data are the guarantee that the IoT can meet the management and management requirements in a certain application field, so that each application field can better meet the requirements of people’s lives. In order to study the nonlinear analysis and processing of software development data under the IoT monitoring system, this work uses QT software and socket programming to build the detection, control, and transmission module of the system, and uses multiple processes to classify and process the data. The user interface technology is used to display the data in real time. The system can control the type of transmitted data through interface operation. The classified transmission of data is realized, and the transmission speed is guaranteed to be about 50 MB/s. The experimental results show that after the functional design of each module is completed, the whole system is finally tested to determine whether the system can meet the requirements of data transmission, control, and processing. Since these data are simulated data, video playback is used to simulate the occurrence of a real accident. When an abnormal situation occurs, the whole system starts to work. If an accident occurs, a signal is sent after the accident. The system not only ensures the intellectualization of control, but also ensures the rapidity of data transmission.

The research suggests an approach that prioritizes customer needs and aims to reduce energy expenses while safeguarding customer privacy. Furthermore, it is recommended that smart homes incorporate a home energy management system to optimize appliance energy consumption. Conversely, the introduction of demand-side management addresses the energy management challenges faced by smart households. The main goal of this approach is to decrease energy usage and electricity costs for customers. Moreover, it enhances user satisfaction while waiting at common intervals. The primary emphasis of this study is on a smart residence furnished with energy management technology and smart home gadgets capable of supplying electricity to the grid. These objectives are considered distinct aspects in the multi-objective optimization issue stemming from this approach. The study utilizes the grasshopper optimization algorithm (GOA) to optimize battery and home appliance scheduling in smart homes with flexible devices. The goal is to reduce the overall cost of microgrid systems through demand-side management implementation. This comparison highlights the superiority of the proposed method in optimizing energy consumption and reducing carbon emissions in a variety of scenarios. By achieving lower energy costs and carbon emissions while maintaining a comfortable indoor environment, the proposed method proves to be a highly effective and sustainable solution for energy management in buildings. These simulation results provide strong evidence of the method’s potential to significantly impact energy efficiency and environmental sustainability in real-world applications. Furthermore, the consistent minimization of the discomfort index showcases the method’s ability to prioritize occupant comfort while still achieving significant energy savings and emissions reductions. Overall, the comparison with other algorithms solidifies the effectiveness and practicality of the proposed method in addressing the complex challenges of energy management and sustainability in smart homes.

The student exchange programs are venues for learning opportunities by offering multicultural contexts. This study reports on the experiences of ten prospective English language teachers in a virtual student exchange program to investigate likely skill development in a multicultural and open and distance learning setting. This descriptive study used the qualitative method. The textual data were elicited through eighty reflective essays written by the participants. Virtual classroom observations and WhatsApp chat data ensured data triangulation. The results revealed the themes as developed learning and life skills and enhanced internal gains. It was found that internal outcomes, such as self-confidence, empathy, and self-reliance, were enhanced rather than external gains. One of the limitations of this study was the brevity of the exchange program, which lasted only eight days. Additionally, the current study is a small-scale study, which limits the generalizability of the results. Last but not least, only two participants placed in the researcher's class were observed. The study poses a few implications for education policymakers, curriculum developers, and teachers. In light of the results, it is posed that adding a multicultural aspect to the teacher training curriculum is imperative for teacher empowerment. Though the literature on student exchange reports findings on the gains and challenges, there is a scarcity of studies delving into what skills students develop and how with vivid examples. In this respect, this study adds to the relevant literature.

Background: Statin therapy is commonly used on the long term in hypertensive patients with dyslipidemia and can interfere with vitamin D metabolism. Overweight/obesity and type 2 diabetes mellitus (DM) are frequently associated with hypertension.

Automatic bokeh is one of the smartphone’s essential photography effects. This effect enhances the quality of the image where the subject background gets out of focus by providing a soft (i.e., diverse) background. Most smartphones have a single rear camera that is lacking to provide which effects need to be applied to which kind of images. To do the same, smartphones depend on different software to generate the bokeh effect on images. Blur, Color-point, Zoom, Spin, Big Bokeh, Color Picker, Low-key, High-Key, and Silhouette are the popular bokeh effects. With this wide range of bokeh types available, it is difficult for the user to choose a suitable effect for their images. Deep Learning (DL) models (i.e., MobileNetV2, InceptionV3, and VGG16) are used in this work to recommend high-quality bokeh effects for images. Four thousand five hundred images are collected from online resources such as Google images, Unsplash, and Kaggle to examine the model performance. 85% accuracy has been achieved for recommending different bokeh effects using the proposed model MobileNetV2, which exceeds many of the existing models.

In a number of malignancies, new immuno-oncology therapies that focus on the programmed cell death 1 (PD-1) have improvised the patient condition along with a positive aftereffect. Monoclonal antibodies (mAbs) directed against PD-1 and its ligand (PD-L1), have been widely used to treat a variety of malignancies, including melanoma, renal cancer, and non-small cell lung cancer (NSCLC). Dostarlimab, a therapeutic anti-PD-1 antibody, was authorised by the United States Food and Drug Administration (FDA) in April 2021 under the trade name JEMPERLI. It is a humanised contrary PD-1 immunoglobulin G 4 (IgG4) mAb, which successfully blocks interaction with PD-L1 and PD-L2 by binding tightly to the PD-1 receptor. This article summarizes the different aspects associated with the dostarlimab, including currently available anti-PD-1/PD-L1 antibodies, pharmacokinetics (PK), pharmacodynamics, adverse reaction, and mechanism of action of dostarlimab, as well as various reported clinical trials.

Akeatit Trirattanapikul,1 Sawinee Kongpetch,2,3 Eakalak Lukkanalikitkul,2,3 Anucha Ahooja,4 Patamapon Seesuk,3 Amod Sharma,5 Sirirat Anutrakulchai2,5 1Department of Medicine, Mahidol University, Bangkok, Thailand; 2Deparment of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3Center of Excellence in Kidney Diseases, Khon Kaen University, Khon Kaen, Thailand; 4Department of Radiology, Khon Kaen University, Khon Kaen, Thailand; 5Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET) Project, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Sirirat Anutrakulchai, Division of Nephrology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand, Email sirirt_a@kku.ac.th; siriratrj@gmail.comIntroduction: Lung ultrasound (LUS) is used for dry weight guidance by assessment of pulmonary congestion in hemodialysis (HD) patients. The aim of this study was to estimate amounts of accumulated fluid by total LUS scores (TLUSS), which were scarcely reported in HD patients who were normal or had a mild functional abnormality. In addition, the correlations between the LUS score of each area and TLUSS were determined to suggest fewer specific areas valuable to shorten the examination time of LUS.Methods: This cohort study was conducted in adult HD patients who have New York Heart Association Classes I–II. LUS and multifrequency bioimpedance (BIA) were performed at baseline and the individual prescribed dry weight was set. Then each LUS was conducted at 28 areas of bilateral intercostal spaces and calculated as TLUSS weekly for eight weeks in which dry weight was adjusted. The second BIA was also measured at week eight. The difference of pre-HD weight and target weight (weight gain; WG) represented the amount of fluid accumulation.Results: Twenty patients with a mean age of 62.2± 14.0 years were enrolled. One hundred and sixty-six LUS were performed in which forty episodes of them were simultaneously measured with BIA. Optimum dry weight adjusted by TLUSS which benefited in mean reductions of blood pressure, and cardiothoracic ratios. WG amounts were significantly correlated with TLUSS (r=0.38), and with extracellular fluid (r=0.35) and overhydration fluid (r=0.39) assessed by BIA. Estimations of mean fluid overload were 2.18 (TLUSS ≤ 15), 2.72 (TLUSS 16– 24), 3.17 (TLUSS 25– 33), 3.65 (TLUSS 34– 38) and 5.03 (TLUSS ≥ 39) in liters. The cut-off points of sum scores of 12 specific lung areas represented the none-mild were < 8, moderate at 8– 16, and severe pulmonary congestions were > 16.Conclusion: TLUSS estimated accumulated fluid useful for volume and blood pressure controls. Performance of LUS in 12 specific lung areas may reduce spending time and support routine uses of LUS in clinical practice.Keywords: lung ultrasonography, bioelectrical impedance analysis, volume status, hemodialysis

Ali Hassan,1,2,&ast; Shafi Balal,1,2,&ast; Erica Cook,3 Hakim-Moulay Dehbi,4 Shahina Pardhan,5 Rupert Bourne,6 Sajjad Ahmad,1,2 Anant Sharma1,2 1Department of External Eye Diseases, Moorfields Eye Hospital, London, UK; 2Department of Ophthalmology, UCL Institute of Ophthalmology, London, UK; 3Department of Healthcare, University of Bedfordshire, Luton, UK; 4Trials department, Comprehensive Clinical Trials Unit, London, UK; 5Department of Eye Research, Vision and Eye Research Institute (VERI) Anglia Ruskin University, Cambridge, UK; 6Department of Ophthalmology, Addenbrookes Hospital, Cambridge, UK&ast;These authors contributed equally to this workCorrespondence: Shafi Balal, Moorfields Eye Hospital, 162 City Road, London, United Kingdom, Email Shafi.balal@nhs.netPurpose: To investigate the quantitative and qualitative efficacy of finger-prick autologous blood (FAB) eye drops versus conventional medical therapy for the treatment of severe dry eye disease (DED).Methods: Two centre, single masked, randomised controlled trial. Sixty patients in total were recruited with thirty patients (sixty eyes) treated with FAB eye drops four times per day in addition to their conventional DED treatment, and thirty patients (fifty-eight eyes) served as control subjects on conventional treatment alone. Ocular surface disease index (OSDI), Schirmer’s test, fluorescein ocular staining grade (OCSG) Oxford schema and fluorescein tear film break-up time (TBUT), were performed at baseline, at 4 and 8 weeks.Results: OSDI scores significantly decreased in the FAB arm by greater than − 17.68 (− 37.67 to − 2.96, p=0.02) compared to the control arm. There were greater improvements in OCSG and TBUT in the FAB arm but these were non-significant (p> 0.05).Conclusion: This feasibility study demonstrates adding FAB eye drops to conventional medical therapy for DED improves mean OSDI symptom score compared to conventional medical therapy alone. It may have particular use in settings where serum is unobtainable. An adequately powered and well-designed randomised trial is needed to further evaluate the long-term clinical benefit of FAB.Keywords: finger-prick, dry eye, serum, autologous

Rice is one of the most widely consumed foods all over the world. Various diseases and deficiency disorders impact the rice crop’s growth, thereby hampering the rice yield. Therefore, proper crop monitoring is very important for the early diagnosis of diseases or deficiency disorders. Diagnosis of diseases and disorders requires specialized manpower, which is not scalable and accessible to all farmers. To address this issue, machine learning and deep learning (DL)-driven automated systems are designed, which may help the farmers in diagnosing disease/deficiency disorders in crops so that proper care can be taken on time. Various studies have used transfer learning (TL) models in the recent past. In recent studies, further improvement in rice disease and deficiency disorder diagnosis system performance is achieved by performing the ensemble of various TL models. However, in all these DL-based studies, the segmentation of the region of interest is not done beforehand and the infected-region extraction is left for the DL model to handle automatically. Therefore, this article proposes a novel framework for the diagnosis of rice-infected leaves based on DL-based segmentation with bitwise logical AND operation and DL-based classification. The rice diseases covered in this study are bacterial leaf blight, brown spot, and leaf smut. The rice nutrient deficiencies like nitrogen (N), phosphorous (P), and potassium (K) were also included. The results of the experiment conducted on these datasets showed that the performance of DeepBatch was significantly improved as compared to the conventional technique.

This research examines the application of Particle Swarm Optimization (PSO) to optimize energy storage optimizations with the objectives of improving energy generation, cost-efficiency, system dependability, and environmental sustainability. The optimisation of solar panel and energy storage capacities was conducted using empirical data from various microgrid locations: Site 1, which had a capacity of 90 kW solar and 40 kW wind, Site 2, which had a capacity of 50 kW wind and 80 kW solar, Site 3, which had a capacity of 60 kW wind and 110 kW solar, and Site 4, which had a capacity of 45 kW wind and 85 kW solar. The findings suggest that energy generation increased significantly by 15% to 25% across all sites following optimization. Furthermore, significant decreases in the levelized cost of energy (LCOE) between 10% and 14% were noted, providing confirmation of the economic feasibility. Increased grid stability of 17% to 24% during periods when microgrids were operating under stable conditions demonstrates that PSO-optimized configurations are dependable. The positive environmental effects of solutions derived from PSO were apparent, as evidenced by the conservation of carbon emissions and ecological footprints, which decreased by 7% to 15%. The sensitivity analysis validated the optimized configurations' robustness, establishing their ability to withstand changes in parameters. In summary, the utilization of PSO to optimize energy storage optimizations showcases its capacity to enhance the efficiency, dependability, cost-effectiveness, and environmental impact of these systems. This advances the possibility of constructing microgrids that exclusively utilize sustainable renewable energy sources.

Biochar, a sustainable green technology product, is essential for promoting plant development and growth. Nano biochar emerges as a promising solution for environmental sustainability. Despite its potential, the intricate dynamics between plants and nano-biochar, particularly in finger millet (Eleusine coracana), remain largely unexplored, necessitating a deeper understanding of their interaction. This study investigates the effects of carbon nitride (C3N4) nano-biochar, derived from melamine, on finger millet. A screening setup was employed with varied concentrations of C3N4: 0 µM (control), 500 µM, 1000 µM, 1500 µM, and 2000 µM. Morphological parameters of plants includes root-shoot length, fresh and dry weights, were analysed to determine the optimal dosage. Results reveal that the most effective concentration of C3N4 for enhancing finger millet growth was found to be 1000 µM. Beyond this threshold, higher doses proved to be toxic, impeding plant growth and development. This research sheds light on the unexplored relationship between nano-biochar and plant physiology, offering insights crucial for sustainable agricultural practices.

As population growth accelerates, agriculture’s significance in our lives remains paramount. However, this surge in population has led to land degradation and increased food scarcity. The impact of silicon (Si) on plants has garnered significant attention in agricultural research. This study was aimed at examining the impact of Si on barley (Hordeum vulgare) plants by administering varying concentrations (5µM, 10µM, 20µM, 50µM, 100µM, 200µM, 500µM, 1000µM) and assessing their effects on plant growth parameters, particularly root and shoot lengths, and root fresh weight. Our study employed a controlled experimental setup to observe how barley plants respond to varying concentrations of Si. The data indicates that Si concentrations up to 10µM offer advantageous effects on barley compared to the control group, suggesting its potential in bolstering agricultural productivity. Similarly, concentrations of 20µM, 50µM, and 100µM were identified as safe for plant growth, opening avenues for their agricultural utilization. However, concentrations of 500µM and 1000µM resulted in complete inhibition of plant growth, emphasizing the necessity for cautious Si application in agriculture to prevent adverse impacts on crop yields. These findings underscore the importance of fine-tuning Si concentrations in agricultural practices to optimize benefits while mitigating potential risks to plants.

Biochar, a byproduct of biomass pyrolysis, has gained interest for its wideranging uses in agriculture and environmental remediation. Nano-biochar, in particular, holds promise for enhancing crop productivity and addressing environmental challenges faced by the plants. Its ability to improve soil properties and biological functions underscores its potential in sustainable agriculture. This study investigates the influence of a carbon-based nanobiocharcarbon nitride (C3N4, derived from melamine) on rice (Oryza sativa) growth. Despite the promise of nanostructured biochar materials in bolstering crop yields, their interaction with varying concentrations of C3N4 remains poorly understood. In this study, we studied the impact of five concentrations (0µM, 500µM, 1000µM, 1500µM, and 2000µM) of C3N4 on rice growth. Our results reveal a concentration-dependent response, with 1500µM and 2000µM concentrations exhibiting toxic effects on rice plants, while 500µM and 1000µM concentrations demonstrate positive effects on rice growth parameters (root-shoot length, fresh-dry biomass) with maximum values obtained in case of the latter. This research sheds light on the potential of C3N4 nanobiochars to influence the growth of crop plants, emphasizing the importance of optimizing concentrations for sustainable agricultural practices. Further exploration in this area could lead to finding of solutions for enhancing agricultural productivity in a sustainable manner.

Plants require nitrogen (N) in various forms to facilitate essential physiological functions. Nitrate (NO3-) is one of the most readily absorbed N forms by plants and is preferred in well-aerated soils because it can be easily transported within the plant. Ammonium (NH4+), on the other hand, is utilized especially in waterlogged or acidic soils, where it is directly absorbed by the roots and incorporated into amino acids. Urea (CH4N2O) is another significant N source found in many fertilizers; it is transformed into NH4+ and nitrate in the soil through microbial processes. These diverse forms of N are crucial for supporting photosynthesis, protein synthesis, and energy production in plants. The escalating use of ammonium sulphate (NH4)2SO4) as a N source in agriculture prompts a thorough examination of its impact on crop health and productivity. This study aimed to investigate the NH4+ toxicity on rice (Oryza sativa) plants by administering various dosages (0 mM, 5 mM, 7 mM, 10 mM, 12 mM, and 15 mM) and assessing their effects on plant growth parameters, particularly root-shoot lengths, root-shoot fresh biomass along with dry weight. Our research utilized a controlled experimental setup to monitor the growth responses of rice plants to these NH4+ concentrations. Results indicated a clear threshold of tolerance, with adverse effects becoming significant at concentrations starting from 7 mM. At this concentration and higher, there was a noticeable decline in root-shoot lengths, root-shoot biomass and dry biomass, marking the onset of toxicity symptoms in rice plants. These findings suggest a critical need for regulated application of (NH4)2SO4 in rice cultivation to avoid detrimental effects on plant health and yield. The study underscores the importance of establishing safe usage guidelines for (NH4)2SO4 in agriculture, ensuring sustainable farming practices while maintaining crop productivity.

Advanced materials play a crucial role in the development of next-generation electronics and photonics due to their unique physical and chemical properties. This review highlights recent advances in the processing of advanced materials, including two-dimensional materials, organic semiconductors, and perovskites, for their integration into electronic and photonic devices. Specifically, we discuss the methods of material synthesis, characterization, and device fabrication, as well as their applications in transistors, photovoltaics, light-emitting diodes, and sensors. We also address the challenges and opportunities associated with the development of advanced materials for the future of electronics and photonics.

James Kenneth Walters,1 Anurag Sharma,2 Reema Harrison3 1Patient Experience and System Performance Division, NSW Health, St Leonards, NSW, Australia; 2School of Population Health, UNSW, Kensington, NSW, Australia; 3Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie Park, NSW, AustraliaCorrespondence: James Kenneth Walters, NSW Health, Level 9, 1 Reserve Road, St Leonards, NSW, Australia, Email james.walters@health.nsw.gov.auIntroduction: Public healthcare systems face rising demand coupled with reducing funding growth rates, necessitating ongoing approaches to efficiency improvement (EI). Centrally coordinated EI approaches l may support EI leaders, yet few such approaches exist internationally. This study provides evidence to inform system-wide EI by harnessing understanding of the perceptions, role demands and support requirements of key EI stakeholders in the centralised EI model implemented in New South Wales.Methods: A purposive sample of key informants within NSW Health with responsibility for EI in their organisation were invited to participate. Semi-structured interviews were conducted, recorded and transcribed. A thematic analysis was undertaken using a theoretical deductive approach.Results: Seventeen respondents participated who occupied EI leadership roles in metro (8) and rural (6) health services as well as non-clinical support (3) services. Four primary themes emerged on the perceptions and experiences of participants in 1. holding a unique skillset which enables them to undertake EI; 2. inheriting EI accountabilities as additional duties rather than holding dedicated EI roles; 3. the importance of senior support for EI success; and 4. feelings of isolation in undertaking EI. An additional underpinning theme that EI is not well conceptualized in public health systems also emerged, whereby EI planners felt that frontline staff generally do not consider efficiency as a component of their duties.Conclusion: EI leaders provide points of authority, experience and influence across organisations within public health systems. This study finds that EI planners possess a unique skillset, can feel isolated both within their health organisation and within the broader public health system and believe that EI is poorly conceptualized amongst health staff. Centralised support for EI stakeholders across a public health system can promote knowledge sharing and capability development. Addressing the role and support requirements of key EI stakeholders is essential.Keywords: public health, health management, efficiency improvement, stakeholder engagement

Internet of Things (IoT) gadgets are very attractive globally, and IoT facilities are universal. Their progress has not been ignored, and the number of invaders and outbreaks on IoT and facilities is growing. Because cyber-assaults are zero-trust to the IoT, and the IoT is deeply ingrained in our lives and culture, we must embrace a comprehensive Zero-Trust strategy for cyber defense. As a result, the new model is no longer vulnerable to fear and outbreak on the IoT structure. In this article, an effort is made to categorize threat types and analyze and explain invaders and assaults on IoT gadgets and facilities.

A detailed research on deep learning in renewable energy forecasting shows how sophisticated algorithms may improve prediction accuracy. The research explores deep learning models and finds intriguing aspects that improve predictions. Long Short-Term Memory (LSTM) networks can capture temporal relationships in energy data, making them successful in predicting short-term variations with a prediction accuracy boost of 18.18% over ARIMA. Convolutional Neural Networks (CNNs) capture spatial correlations in huge datasets with up to 13% accuracy. With its capacity to analyze sequential data, Recurrent Neural Networks (RNNs) can capture long-term patterns and improve forecasting accuracy by 29.41% over Support Vector Machines. In addition, LSTM’s better handling of non-linear connections in wind energy data has improved prediction accuracy by 14.29% over feedforward networks. These results demonstrate how deep learning approaches improve renewable energy forecasting with unparalleled precision and dependability. As shown in diverse applications, LSTM, CNN, and RNN models improve renewable energy forecasting efficiency and efficacy, boosting sustainable energy solution innovation.

Because of their superior fatigue resistance and high strength-to-weight ratio, composite materials are essential to the construction of modern airplanes. The joints that interconnect the various parts of these structures play a critical role in their integrity and functionality. In aerospace applications, bonded, riveted, and hybrid joints are among the many types of joints that are frequently used. A thorough finite element analysis (FEA) of hybrid, bonded, and riveted joints in glass fiber epoxy composite laminates for airplane structures is presented in this work. The literature review addresses earlier studies on bonded, riveted, and hybrid joints and emphasizes the importance of joints in composite constructions. There are gaps in our knowledge of these joints' performance under various stress scenarios, despite the fact that previous research offer insightful information about the mechanical behavior and failure processes of these joints. The mechanical behavior of composite materials and the fundamentals of FEA are explained by the theoretical basis. Additionally covered are basic principles that control the behavior of bonded, riveted, and hybrid joints; they set the foundation for further investigation. The manufacturing procedure, experimental setup, and specimen preparation for testing bonded, riveted, and hybrid joints are all described in the methodology. With parameters changed to examine their influence on joint performance, finite element models are created to mimic how joints behave under different loading scenarios. Experiments on mechanical testing of joints yield useful information about failure mechanisms, stiffness, and strength. To verify the accuracy of the numerical models, these outcomes are contrasted with FEA predictions. An analysis of the variables affecting the functionality of various joint types reveals the benefits and drawbacks of each. The stress distribution, deformation, and load-carrying capability of bonded, riveted, and hybrid joints are presented by the results of finite element analysis. The results show how various joint configurations impact structural behavior, offering important information for structural integrity and design optimization. Results from FEA and experimental investigations are interpreted in the discussion, with special attention to the implications for structural applications in airplanes. The comparative study of joint types provides direction for choosing the best joint designs to satisfy particular design specifications. To sum up, this research advances our knowledge of hybrid, bonded, and riveted connections in glass fiber epoxy composite laminates used in aircraft construction. The results provide important information for creating joints that satisfy demanding aerospace performance standards, thereby improving the dependability and safety of aircraft structures.

Considering the disruptive potential of electric cars in the automotive industry, this studyaims to analyze the factors influencing electric car adoption behavior among Indian car usersMethodology:The research adopts both exploratory and descriptive approaches, conducted in two phases. Phase oneinvolves engaging with 200 prospective electric car buyers to identify critical adoption factors. Phase twoemploys conjoint analysis, involving 300 consumers and assessing nine attribute combinations (price,recharge time, and driving range) derived from literature review and interactions with potentialbuyers. Findings: The study reveals the three most valued attribute combinations for Indian consumers whenselecting electric cars. Practical Implications: Decision-makers and electric vehicle manufacturers can leveragethese results to introduce advanced technology into the Indian market. The conjoint analysis findings assistmanufacturers in understanding the relative importance of features influencing consumer utility. Originality: This study contributes to the existing literature by focusing on consumer behavior in developing markets,particularly India, which has been less explored compared to the asymmetry in research on electric caradoption behavior in developed markets.

The digital age is reshaping student reading habits, especially in management education, focusing on accessibility, affordability, technology, and mindset. This study examines how digital learning resources affect management students' reading habits, challenging the notion that students should only read textbooks. Despite the widespread availability of online reading materials, only some studies have explored how management students' reading habits are changing. This study used a mixed research design, starting with qualitative interviews with 20 management students to identify themes, which were then used to develop and validate a questionnaire with 20 experts. The questionnaire was then administered to 200 management students from public and private universities in Punjab, India. The findings identified four key factors influencing management students' changing textbook reading habits: convenience, price, technology, and attitude. Regression analysis indicated that attitude was the most significant predictor of changed reading habits, suggesting that promoting a positive attitude towards textbook reading could help counter the impact of digitalization. The study concludes with recommendations for publishers to update content regularly, offer online resources, and consider a hybrid publishing model combining free and premium content to adapt to the digital age and promote inclusive education, aligning with Sustainable Development Goal 4.

There are two distinct forms of Newton’s second law of motion (1686) i.e. original or Principia’s form of (change in motion is proportional to impressed force, F = KdV) and textbook form (rate of change of momentum is proportional to impressed force, F =ma). Newton neither gave acceleration nor F =ma, it is mentioned by IOP England, publications of the American Institute of Physics, etc. Truesdell has inconsistently pointed out in 1960 that Euler had given F =ma in 1752, but the truth is that Euler had given F=2ma in the said paper. Euler had also given various equations such as F =ma/n, F =2ma, F =ma/2g, F =ma etc.; but these are ignored by Truesdell. The exceptionally useful equation F =ma was given by Euler in 1775, and then succeeding scientists inconsistently tried to show that F =ma follows from the original form of the law. Consequently, some arbitrary assumptions are made, original form, F =KdV; and the fact that Euler gave F =ma are not mentioned in the standard textbooks. For comparison, Newton’s first law and third law (Reaction =-Action) are the same in the Principia and textbooks. In the existing literature, F =ma is obtained from Principia’s definition of NSLM, by replacing ‘change in motion’ equal to ‘rate of change of momentum’, but motion is not ascribed to any units and dimensions. If the original definition of Newton’s law is changed in a postulatory way i.e. ‘change in motion’ is replaced by ‘rate of change in momentum’ and ‘proportionality’ by ‘equality’; then F=ma is obtained from a modified equation without any arbitrary assumption. In 1893, Rouse Ball randomly altered Newton’s second law as a change in momentum [per unit time] is always proportional to the impressed force.