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The demand for advanced materials with exceptional mechanical and thermal properties has increased significantly in various aerospace, automotive, and power generation industries in recent years. Inconel 718 superalloy is preferred due to its exceptional strength, corrosion resistance, and elevated temperature stability. However, machining Inconel 718 poses substantial challenges due to its inherent toughness, low thermal conductivity, and high work hardening rate. This study investigated the drilling performance of Yttrium Stabilized Zirconia (YSZ)-coated Inconel 718 superalloy using Abrasive Water Jet machining. The objective of this study is to comprehensively examine the effects of process parameters, such as water pressure (WP), abrasive flow rate (AFR), and stand-off distance (SOD), on the quality and efficiency of drilling YSZ-coated Inconel 718. Experimental investigations are conducted using a specially designed AWJ setup. Further, the dragon-fly optimization algorithm is proposed to identify optimal drilling process parameters to simultaneously minimize output responses like entry, exit, and erosion diameters. Comparing the proposed algorithm's performance against that of the Harmony Search and Jaya algorithms demonstrates its effectiveness.

Purpose: The purpose of this study was to compare the efficacy of various suturing methods used in deep third molar extraction procedures. Methods: A total of four suturing method groups—simple interrupted, horizontal mattress, vertical mattress, and figure-of-eight—were randomly allocated to 100 patients having deep third molar surgery. Assessments were conducted on wound healing, operation time, intraoperative problems, postoperative pain scores, swelling measures, and patient satisfaction questionnaires. Appropriate tests were used for statistical analysis, with P < 0.05 being regarded as significant. Results: Compared to other procedures, the figure-of-eight technique showed better results in terms of postoperative pain scores, swelling measures, wound healing percentages, and patient satisfaction (P < 0.05). There was no discernible difference in the operating time or intraoperative problems between the groups. Conclusion: In conclusion, there seems to be a benefit to using the figure-of-eight suturing approach for deep third molar surgery in terms of improved postoperative results and patient satisfaction. It is recommended that clinicians give this strategy some thought to improve patient care and surgical results.

Objective: The purpose of this research is to estimate the effectiveness of non-laser surgery and laser surgery in the management of periodontitis. Methods: One hundred participants with a chronic periodontitis diagnosis participated in a randomized controlled experiment. Two cohorts of patients were created: Cohort B underwent non-laser surgery and Cohort A underwent laser surgery. Pre- and postoperative assessments were conducted at 3, 6, and 12 months for clinical criteria such as “pocket depth (PD), gingival index (GI), and clinical attachment level (CAL)”. Results: There was a noticeable improvement in clinical parameters following both laser and non-laser operations. However, laser surgery showed superior results in terms of decreased PD and raised CAL. Conclusion: In conclusion, compared to non-laser surgery, laser surgery seems to be a more successful treatment option for periodontitis. Larger sample sizes and longstanding follow-up are required for future research in order to validate these results and evaluate the longstanding sustainability of the treatment effects.

Oxygen supplementation is a widely used treatment for ICU patients. However, it can lead to hyperoxia, which in turn can result in oxidative stress, cardiac remodeling, and even mortality. This paper expands upon previous research conducted by our lab to establish time-dependent cardiac changes under hyperoxia. In this study, both young and aged mice (male and female) underwent 72 h of hyperoxia exposure and were monitored at 24-hour intervals for cardiac electrophysiological and functional parameters using ECG and electrocardiogram data. Our analysis showed that young male mice experienced significant weight loss as well as significant lung edema by 48 h. Although young male mice were highly susceptible to physical changes, they were resistant to early cardiac functional and electrophysiological changes compared to the other groups. Both young and aged female and aged males developed functional impairments by 24 h of hyperoxia exposure. Furthermore, sex and age differences were noted in the onset of electrophysiological changes. While some groups could resist early cardiac remodeling, our data suggests that 72 h of hyperoxia exposure is sufficient to induce significant cardiac remodeling across all age and sex groups. Our data establishes that time-dependent cardiac changes due to oxygen supplementation can have devastating consequences even with short exposure periods. These findings can aid in developing clinical practices for individuals admitted to the ICU by elucidating the impact of aging, sex, and length of stay under mechanical ventilation to limit hyperoxia-induced cardiac remodeling.

Zoonotic diseases are one of the primary public health concerns. Both developing and developed nations have experienced the resurgence of infectious diseases with zoonotic potential, leading to significant economic and human losses. This raises the question of how well the public is informed about zoonotic illnesses in the state, where several outbreaks have occurred in recent years. This study attempts to understand the awareness level of individuals in Wayanad district, Kerala, and their relation with gender and education. A cross-sectional study was conducted among 122 individuals belonging to different sectors and ages selected using power analysis and a well-structured questionnaire was propagated among individuals. The collected data were analyzed using simple mathematical percentages and hypothesis testing using the Chi-square test. According to the research, the majority of the people are uninformed of zoonotic illnesses, particularly Kyasanur Forest Disease, Japanese Encephalitis, West Nile Fever, Rabies, Avian Influenza, and Swine Influenza, which have the lowest awareness. The news media, which comprises print, television, and the internet, is the main information source for most people about these illnesses. Similarly, the study found a significant association between overall awareness and educational level. The study put forward the existence of low awareness regarding many zoonoses in the study area. It advises that the government should be more involved in raising public awareness by collaborating with veterinarians and healthcare professionals.

Abstract High-performance lead-free Barium Zirconium Titanate (BZT) based ceramics have emerged as a potential candidate for applications in energy storage, catalysis for electro chemical energy conversion and energy harvesting devices as presented in this work. In the present study hybrid microwave sintered BZT are studied for dielectric, ferroelectric and phase transition properties. BZT ceramic exhibits tetragonal structure as confirmed by the Retvield refinement studies. XPS studies confirms the elemental composition of BZT and presence of Zr. Polarization versus electric field hysteresis loops confirms the ferroelectric behaviour of BZT ceramic. Encouragingly, the BZT showed a moderate energy storage efficiency of 30.7 % and relatively good electro chemical energy conversion (HER). Excellent catalytic activity observed for BZT electrode in acid medium with low Tafel slope 77 mV dec-1. Furthermore, electrospun nanofibers made of PVDF-HFP and BZT are used to make flexible piezoelectric nano generators (PENGs). FTIR studies show that the 16 wt% BZT composite ink exhibits a higher electroactive beta phase. The optimized open-circuit voltage and short circuit current of the flexible PENG exhibits 7Vpp and 750 nA under an applied force of 3N. Thus, flexible and self-powered BZT PENGs are alternative source of energy due to its reliability, affordability and environmental-friendly nature.

Background and Objectives: Dental caries continues to be a major health concern for populations worldwide. In India, the prevalence is increasing at an alarming rate among child population. Assessing caries risk in children is more beneficial than treating the disease in terms of economic as well as public health outcomes. Hence, a study was conducted to assess caries risk in 13–15-year-old government and private schoolchildren in Guntur city using Cariogram model and to identify the particular risk factors that were most frequent among schoolchildren. Materials and Methods: A comparative cross-sectional study was conducted among government and private high schoolchildren in Guntur city. A total of 100 children aged 13–15 years were selected randomly. Data were obtained by means of questionnaire, intraoral examination, and salivary analysis. The information obtained was entered into Cariogram model to calculate the “percentage chance to avoid caries.” Results: Of the total 100 schoolchildren, 43 were boys and 57 were girls. The government schoolchildren had a higher mean decayed, missing, and filled teeth (1.50 ± 1.669) compared to the private schoolchildren (0.40 ± 0.833), which was significant. The mean chance to avoid caries was significantly higher in private schoolchildren (70.56%) compared to government schoolchildren (57.32%). Conclusion: Diet incorporates a major role in assessing caries risk in the present study including its content and frequency. The Cariogram model could find out the factors contributing to the development of caries in the individual and help to plan targeted preventive actions.

This study explored the genetic diversity within a collection of 94 economically important pearl millet inbreds, encompassing 45 maintainers and 49 restorer lines, using DNA-based markers. A set of 30 polymorphic SSR primer pairs were utilized, yielding 84 alleles, with alleles per locus ranging from 2 to 4 with an average of 2.8 alleles. Employing DARwin’s tree and Neighbor Joining method for cluster analysis, all cultivars were effectively categorized into two major groups (restorer and maintainer), further subdivided into subgroups. Noteworthy variations in Polymorphism Information Content (PIC) values were observed among the markers, indicating varying degrees of genetic diversity. Notably, some markers exhibited substantial diversity, whereas others were highly conserved. Genetic similarity estimates ranged from 0.05 to 0.67, averaging 0.28, underscoring ample diversity among maintainer and restorer inbreds for productive breeding efforts. Intriguingly, the study also detected contamination in three analyzed lines, adding an intriguing facet to the investigation.

Sr0.2Zn0.8TiO3 (SZT) ternary nanopowders of perovskite structure samples were prepared by conventional solid state reaction technique using ultra-pure metal oxide powders. SrCO3, ZnO and TiO2 powders were used as a source of Strontium, Zinc, and Titanium. The calcination temperature of the samples is 820 °C and sintered at different temperatures ranging from 850 °C to 1000 °C in conventional and microwave furnaces for 2 hours and 30 min., respectively. The synthesized nano-powders were characterized using XRD, SEM, XPS and their dielectric properties were studied by temperature dependent LCR meter. The dielectric constant increases with an increase in sintering temperature until 950 °C and it decreases with a further increase of frequency.

Introduction: A recent study has demonstrated that social factors have an impact on the condition of dental implants. The present investigation investigated how varied alcohol intake quantities might alter the condition of dental implants and related peri-implant inflammation. Materials and Methods: This retrospective research was piloted in a tertiary care center, and implants inserted between 2010 and 2022 were evaluated through a retrospective cohort analysis. Within 3 months following implant implantation, information on alcohol intake was gathered from the health maintenance records and employed as the predictor variable. The implant results as well as peri-implantitis were examined at follow-up visits. Using the logistic regression model, the Wald test analysis analyzed the statistical consequences of each parameter. The findings were translated using an odds ratio that was determined with a 95% confidence level. The data were generated and analyzed using descriptive statistics, with statistical significance defined as P < 0.05. Results: At the time of implant placement, the enrolled patients were 59 ± 11.3 years old on average. The median time before peri-implantitis occurred was 31.3 ± 22.2 months. Within the first 2 years following implant implantation, the majority of people experienced peri-implantitis. The incidence of peri-implantitis was the lowest among light and moderate alcoholics (11.5%) and the highest among heavy alcoholics (46.2%). Moderate alcohol use was associated with a 79.1% decrease in peri-implantitis when compared to not drinking (P = 0.0365), whereas light alcohol consumption was connected to a 51.3% decrease (P = 0.026). The incidence of peri-implantitis among heavy drinkers was significantly significant (P = 0.0001). Conclusion: According to the findings of the current retrospective cohort analysis, drinking alcohol at mild-to-moderate levels is connected to a reduction in the incidence rate of peri-implantitis compared to heavy drinkers. In contrast, high alcohol consumption was found to be associated with an increase in the prevalence of peri-implantitis among the participants who had dental implants.

Recent breakthroughs in component downsizing and miniaturization emphasise the requirement for deep-hole drilling with an increased aspect ratio, especially in the automobile sector for fuel injectors and the medical sector for manufacturing bone screws or surgical equipment. In this research, deep hole drilling on stainless steel AISI 316L has been conducted using an Abrasive Waterjet Machine (AWJM), and the influence of drilling variables on the material removal rate, roundness deviation of drilled holes have been evaluated to assess the machining and hole characteristics. In addition, machining parameters' statistical relevance has been investigated using a multi-parametric analysis of variance. Quadratic mathematical models for material removal rate and roundness deviation have been established by correlating drilling parameters. The Grey Wolf Optimization (GWO) algorithm has been applied in this research to identify the optimal combination of deep hole drilling parameters for maximizing material removal rate and minimizing the roundness deviation. The results have been compared with Derivative-free optimization, Whale optimization, and Harmony search algorithms. The comparison revealed that the GWO algorithm performed better than other algorithms. In addition, a validation test has been carried out to confirm the accuracy of the results produced by the GWO. The images obtained from the scanning electron microscope showed that the surfaces of the deep holes are smooth. Additionally, the ploughing action was shown to be the principal mechanism responsible for removing the material.

Background: Lumbar Disc Herniation (LDH) is the most frequent entity affecting the spine resulting in low back pain and sciatica. Many minimally invasive procedures have been proposed for the treatment of LDH. Percutaneous Endoscopic Discectomy (PELD) is gaining popularity in recent years for the treatment of LDH and its supremacy over the well-established gold standard Microsurgical Lumbar Discectomy (MLD) is yet to be proven. Aim and Objectives: To compare pain relief using Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI), duration of surgery and incision length between MLD and PELD; To evaluate systemic cytokine response (CPK-CK, hs-CRP, IL-6) between MLD and PELD. Material and Methods: This was a prospective comparative analysis between MLD and PELD in patients undergoing surgery for single-level lumbar disc prolapse from January 2022 to October 2022 at a single institute. Results: The study included 64 patients, divided equally into two groups: 32 patients underwent conventional MLD, and 32 patients underwent PELD. Groups had similar demographic profiles and preoperative clinical features. Postoperatively, both groups showed significant improvements in pain (VAS) scores and functional disability (ODI), with no significant difference between the two groups. However, there were differences in certain biochemical markers: CPK and IL-6 levels were lower in the PELD group compared to the MLD group, and hs-CRP levels were also lower in the PELD group, though statistically significant only on the 3rd postoperative day. The surgery duration and incision length were shorter in the PELD group. Complication rates were low, with two complications in the MLD group and one in the PELD group. Conclusion: Both MLD and PELD demonstrated positive outcomes in terms of pain and functional disability reduction, but PELD showed advantages in terms of shorter surgery duration, smaller incision length, and lower levels of certain inflammatory markers. No significant difference was noted in clinical outcomes between MLD and PELD. Postoperative systemic cytokine response is significantly lower in the PELD group than in the MLD group.

It is essential for a dental student about to graduate to possess robust fundamentals in both basic and clinical dental science. There should be a perfect harmony and blend of basic and clinical science integration and application among final year graduating students. They should also demonstrate readiness and competence in performing various clinical skills independently, after correctly interpreting and diagnosing a dental disorder. Besides the clinical aspects of dentistry, the newly graduating dental student should understand the principles of professionalism and ethos. The main aim and objective were to conduct a study to assess the impact of COVID-19 on practice readiness among the fifth-year dental students at Oman Dental College (ODC). A study was conducted to measure self-preparedness among graduating students, especially during the challenging times of the COVID-19 pandemic when education was significantly impacted. This study used a validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS). The DU-PAS consists of 50 items, including 24 items related to clinical skills (part A) and 26 items related to scientific knowledge and affective skills (part B). Each item in part A was scored on a three-point scale ranging from no experience (0), with verbal and/or practical input from a colleague (1), to independently (2). Items in part B of the DU-PAS are scored on a three-point scale: no experience (0), mostly (1), and always (2). The maximum score for the 50 items on the DU-PAS is 100. Interestingly, the current study showed that the ODC final-year students were confident in performing several clinical procedures and had a good understanding of various professional aspects of clinical dentistry. The didactic online classes and preclinical sessions conducted while adhering to social distancing and other safety norms during the COVID-19 pandemic, were positively received by the students.

Numerous large graphs may be constructed from smaller ones, and graph operations are important in many graph theory applications. Here, we investigate the double and the strong double graphs as two graph-theoretical procedures. Alkanes, which simply contain hydrogen (H) and carbon (C) molecules and no additional functional groups, are the most basic and simplest hydrocarbons found in organic molecules. Topological indices come in a variety. There are several degree-based topological indices, including the Banhatti, Zagreb, Randi, and Revan indices (RI). In this paper, we compute a generic formula the first, second, and third Revan topological indices on the double graph and strong double graph of alkanes.

The current research examines the effectiveness of cryogenically treated (CT) tungsten carbide cutting inserts on Custom450 stainless steel using multi-objective soft computing approaches. The Taguchi-based L27 orthogonal array was employed in the experiments. During milling operations, cutting force, surface roughness, and cutting temperature were measured at different spindle speeds (rpm), feed rates (mm/min), and constant depths of cut (mm). The surface roughness and chip morphology of the Custom 450 stainless steel machined by cryo-treated (CT) and untreated (UT) cutting tool inserts were compared across various responses to cutting temperature and force. This paper also carried out multi-objective optimization, employing algorithm techniques such as Grasshopper Optimization Algorithm (GHO), Grey Wolf Optimization(GWO), Harmony Search Algorithm(HAS), and Ant line Optimization (ALO). The Multi-objective Taguchi approach and TOPSIS were first used to optimize the machining process parameters (spindle speed, feed rate, and cryogenic treatment) with different performance characteristics. Second, to relate the machining process parameters with the performance characteristics (cutting force, cutting temperature, and surface roughness), a mathematical model was developed using response surface analysis. The created mathematical response model was validated using ANOVA. The results showed that in IGD values of GHO, GWO, HSA and ALO module had 2.5765, 2.4706, 2.3647 and 2.5882 respectively, ALO has the best performance indicator. A Friedman’s test was also conducted, revealing higher resolution with the ALO method than with the HSA, GWO, and GHO methods. The results of the scanning test show that the ALO approach is workable.

Diabetic renal injury is a microvascular complication associated with inflammation and oxidative stress, culminating in renal dysfunction. Conventionally, it is treated with hypoglycemic agents to address metabolic perturbations. However, the way to mitigate immunological, inflammation, and oxidative stress have seldom been studied. Hence, in the present study, the nephroprotective role of immunosuppressive and anti-inflammatory drugs, mycophenolate mofetil (MMF) in combination with the oral hypoglycemic agent glibenclamide, on streptozotocin (STZ)- induced diabetic renal damage was studied. Bodyweight, fasting blood glucose, and glycosylated hemoglobin levels were altered in the diabetic rats. Furthermore, renal injury was indicated by abnormal levels of urinary protein and creatinine and serum markers of renal function in diabetic rats. Hyperglycemia-induced oxidative stress and inflammation were also observed in the diabetic rats. The combination of MMF and glibenclamide treatment significantly attenuated the abnormal effects of hyperglycemia, oxidative stress, and inflammation-induced renal injury in diabetic rats. Histopathological studies confirmed the nephroprotective role of MMF and glibenclamide by reversing renal injury in diabetic rats. The present study suggests that MMF and glibenclamide have a protective role in STZ-induced diabetic renal damage.

Crop digital twin is redefining traditional farming practices, offering unprecedented opportunities for real-time monitoring, predictive and simulation analysis, and optimization. This research embarks on an exploration of the synergy between precision agriculture, crop modeling, and regression algorithms to create a digital twin for farmers to augment the concentration and composition prediction-based crop nutrient recovery. This captures the holistic representation of crop characteristics, considering the intricate relationships between environmental factors, nutrient concentrations, and crop compositions. However, the complexity arising from diverse soil and environmental conditions makes nutrient content analysis expensive and time-consuming. This paper presents two approaches, namely, (i) single-nutrient concentration prediction and (ii) nutrient composition concentration prediction, which is the result of a predictive digital twin case study that employs six regression algorithms, namely, Elastic Net, Polynomial, Stepwise, Ridge, Lasso, and Linear Regression, to predict rice nutrient content efficiently, particularly considering the coexistence and composition of multiple nutrients. Our research findings highlight the superiority of the Polynomial Regression model in predicting nutrient content, with a specific focus on accurate nitrogen percentage prediction. This insight can be used for nutrient recovery intervention by knowing the precise amount of nutrient to be added into the crop medium. The adoption of the Polynomial Regression model offers a valuable tool for nutrient management practices in the crop digital twin, potentially resulting in higher-quality rice production and a reduced environmental impact. The proposed method can be replicable in other low-resourced crop digital twin system.

IntroductionPaprika (Capsicum annuum L.) is prone to chilling injury (CI) during low-temperature storage. Although recent findings suggest that CO2 treatment may protect against CI, the effects of short-term CO2 treatment on CI and the underlying molecular mechanisms in paprika remain unknown. Therefore, this study aimed to examine the effect of short-term CO2 treatment on CI and postharvest quality in paprika during storage at cold storage and retail condition at physio-biochemical-molecular level.MethodsPaprika was treated with 20 and 30% CO2 for 3 h and stored at 4°C for 14 days, followed by additional storage for 2 days at 20°C (retail condition). Fruit quality parameters, including weight loss, firmness, color, and pitting were assessed, and the molecular mechanism of the treatment was elucidated using transcriptomic and metabolomic analyses.ResultsShort-term treatment with 20 and 30% CO2 effectively maintained paprika quality during cold storage and retailer conditions, with reduced surface pitting, a common symptom of CI. Additionally, transcriptomic and metabolomic analyses revealed that 20% CO2 treatment induced genes associated with biosynthesis of phosphatidic acid (PA), diacylglycerol, triacylglycerol, and stress response, metabolites associated with phasphatidyl inositol signaling, inositol phosphate metabolism, and starch and sucrose metabolism.ConclusionCO2 treatment activates PA biosynthesis through PLD and PLC-DGK pathways, and induces inositol phosphate, starch, and sucrose metabolism, thereby regulating chilling stress response via the ICE-CBF pathway. These findings suggest that short-term CO2 treatment enhances resistance to cold-induced injury and preserves postharvest quality in non-climacteric fruits, such as paprika, through activation of PA signaling, which improves membrane stability during cold storage and distribution.

Introduction: Aortobifemoral bypass is the standard recommended procedure for aortoiliac occlusive disease (AIOD). Patients of AIOD presenting with claudication pain and tissue loss require revascularization of lower limbs, with few requiring mesenteric and/or renal revascularization. Aim: The aim of this study was to assess the outcomes of patients undergoing aortobifemoral bypass with mesenteric/renal revascularization in patients of AIOD with mesenteric/renal occlusion. Objective: The objectives of this study were as follows: (1) restoration of normal renal function in terms of urine output and renal function test in patients who underwent mesenteric revascularization and (2) resolution of abdominal angina in patients who underwent mesenteric revascularization. Methods: A total of 13 patients with a mean age of 45.8 years, presenting with critical limb ischemia with renal/mesenteric occlusion due to AIOD of Trans-Atlantic Inter-Society Consensus D type, underwent aortobifemoral bypass with renal/mesenteric revascularization. The demographics of patients, Rutherford stage and WIFI stage, pre- and postoperative ABI, probable etiology, any renovisceral interventions done, duration of procedure, type of renal ischemia (warm/cold), duration of renal ischemia, postoperative complications, duration of stay, patency of graft, wound infection, amputation rates, and mortality were documented on a structured pro forma. Five (38.46%) patients presented with severe claudication, 3 (23.07%) patients with rest pain, and the remaining 5 (38.46%) patients with minor tissue loss. Along with AIOD, 3 (23.07%) patients had concomitant bilateral femoropopliteal disease and tibial vessel disease, 3 (23.07%) patients had unilateral femoropopliteal disease, and 2 (15.38%) patients had bilateral tibial vessel disease. Three (23.07%) patients had infrarenal aortoiliac occlusion and 10 (76.9%) patients had juxtarenal aortoiliac occlusion (managed using Liddicoat/Madiba–Robbs technique). Outcomes were assessed in terms of graft patency, need of dialysis in postoperative period, wound infection, limb survival, amputations, and mortality. Results: Aortic clamp was placed suprarenal (38.46%), infrarenal (53.84%), and interrenal (7.69%) of patients. Cold renal perfusion solution was used in 15.38% of patients with an ischemia time of 38.5 min. The average duration of warm renal ischemia was 5 min 24 s. Revascularization of superior mesenteric artery (SMA) was done in 15.38%, and inferior mesenteric artery in 38.46%. Renal revascularization by Madiba–Robbs technique was done in 30.76% of patients. In 92.3% of patients, bifurcated Dacron synthetic graft was used, and in 7.69%, femoral vein with bovine pericardial patch was used for revascularization. In postoperative period, 7.69% developed acute limb ischemia, 30.07% had severe metabolic acidosis, and 15.38% of patients had respiratory complications with good renal function and no bowel ischemia. Conclusion: Renal and mesenteric revascularization in addition to aortobifemoral bypass is a safe, effective, and durable procedure with acceptable postoperative complications. The effective surgical technique of renal and mesenteric revascularization including the usage of renal perfusion solution was found to be of paramount importance in our study. All patients who underwent SMA revascularization were free from abdominal angina. All patients who underwent renal revascularization were free from dialysis and also there was a decrease in the use of antihypertensive drugs in these patients.

Background: Mycotic aortic aneurysm of the abdominal aorta is a rare entity. Repair of infected aneurysms is challenging because of the deleterious consequences of the usage of prosthetic material as an arterial conduit with limited availability of autogenous grafts. Aortic graft infection is one of the most morbid complications in vascular surgery. The main objective in treating aortic graft infection is to remove the infected graft material, thoroughly debride, and re-establish the vascular continuity. Neo-Aortoiliac system operation utilizes the femoropopliteal vein in various configurations, depending on the extent of infection and the availability of the conduit. Aim: This article aims to report our experience of various configurations of Neo aortoiliac system operation and various conduits used along with femoropopliteal vein, when the femoropoliteal vein is inadequate. Materials and Methods: The study was performed in a single tertiary care center. Between January 2022 and June 2023, 4 cases of Neo aortoiliac system operation were performed. The demographics, clinical presentation, operative data, and postoperative outcomes were subsequently collected and analysed. Results: 3 out 4 patients of Neo-Aortoiliac system operation survived, one patient had Major Adverse Limb Event and one patient succumbed to death due to sepsis.

Due to its heterogeneity, cloud services providers’ (CSPs) rapid expansion presents several challenges, such as optimal service selection and privacy preservation. Multiple users using the cloud service at once increases the delay for service selection and request. Service interruptions result from centralized provisioning and insecurity. Existing work constraints include access control loss, service disruptions, security issues, trust management issues, and delays. Blockchain-based request scheduling and optimal CSP selection in edge-assisted clouds were presented in this research. Five phases—Data User (DS) authentication, sensitivity-aware request scheduling, policy verification, trust management, and optimal CSP selection—are proposed. In the first phase, DU authentication detects and eliminates authorized users. We suggested a chaotic map-based camellia encryption algorithm (CMCE) to boost security. The gateway schedules service requests using Johnson’s rule-based Stochastic Gradient Descent method, considering delay, throughput, and priority, in the second phase. This schedules the request into sensitive and non-sensitive services. Policy verification is done in the third phase utilizing Dynamic Policy-based Access control, which allows only sensitive requests. In phase four, we calculate the CSP trust value to boost security. Based on CSP behavior, we introduced the Multi Behavior Analysis-based Nomadic People Optimizer method. Every CSP’s trust value is modified based on user feedback over time. Finally, the best CSP is chosen for data user service, and suggested Dynamic and non-cooperative Game Theory is to choose the best CSP from a list. CloudSim is used to simulate and assess.

The goal of this study is to find a cure for the masticatory muscle disease known as hemimasticatory spasm (HMS). This retrospective investigation intends to find a more efficient therapeutic approach for HMS patients by examining the clinical effectiveness of masseteric nerve avulsion performed on HMS using a temporomandibular arthroscope. A clinical study was piloted where the subjects were treated for masseter nerve avulsion by TMJ arthroscopy. The follow-up was done till 2 years, and the subjects were evaluated for the various characteristics like difficulties, masticatory abilities, and various sounds at the joint for the various functions of the joint. The diagnosis was done using the electrophysiological electromyogram (EMG) at the designated time intervals. There was a complete remission in all the subjects. The masseter nerve avulsion was effective since the scores lowered. Within 3 years of the operation, electrophysiological EMG depicted no discharge potential with a high frequency, and the total efficiency when paired with the clinical effectiveness was deemed acceptable. The maximal masseter power between the treated and nontreated sides was comparable. The mastication, on comparing, was also as effective as the normal side; however, lower mastication was noted in the first year. The avulsed nerve tissues lacked any apparent demyelination. Masseteric nerve avulsion with temporomandibular arthroscope assistance provided acceptable and stable total effectiveness for the intervention of the hemimasticatory spasm. While the strength of the muscle of the afflicted side was only marginally reduced, its masticatory effectiveness was optimally preserved.

Abstract In this paper, a Pareto multiobjective and grasshopper optimization algorithm (GOA) based optimum proportional–integral–derivative (P–I–D) controller design is proposed for improving the vehicle active suspension system dynamics under road disturbance conditions. The Pareto objectives considered are minimization of sprung mass suspension deflection, tyre deflection, sprung mass acceleration minimization and eigenvalue-based objective function. State space model for quarter vehicle active suspension system with P–I–D controller is developed for analyzing the stability and dynamic performance of the system. The sinusoidal-based bump road disturbances are used for testing the robustness of the proposed control technique. Simulation results have been presented to show the advantage of the proposed Pareto multiobjective and GOA-based P–I–D controller over the weighted multiobjective and genetic algorithm-based P–I–D controller in terms of stability and dynamics of the active suspension system.

Introduction Thrombosis of fistula occurs most frequently in end-stage kidney disease (ESKD) patients receiving hemodialysis. However, the role of thrombophilia in arteriovenous fistula (AVF) failure has not been well established. Hence, this study was aimed at assessing the roles of hereditary and acquired thrombophilic factors in association with AVF failure among patients with ESKD undergoing hemodialysis. Methods A cross-sectional study was conducted on 100 ESKD patients, of whom 50 patients with well-functioning AVFs with no fistula failures earlier were enrolled as Group 1, and 50 patients who have had AVF failure were enrolled as Group 2. The hereditary factors as factor V Leiden, factor XIII, prothrombin, and methylene tetrahydrofolate reductase and the acquired factors as lipoprotein (a), fibrinogen, homocysteine, and anticardiolipin antibodies IgG and IgM were studied. Results Among the hereditary factors, no statistically significant difference was observed in relation to factor V Leiden and Prothrombin (p > 0.05). However, for factor XIII and methylene tetrahydrofolate reductase, a statistically significant difference was observed between patients with well-functioning AVFs and patients who have had AVF failure (p 0.05). Conclusion Thus, our study suggests significant role of acquired factors in causing AVF failure.

IntroductionEthylene response factors (ERFs) play a critical role in regulating hormone interactions that affect the shelf life of tomatoes. Understanding their regulation during storage and distribution can be highly beneficial.MethodsThis study examined the effects of treatment with ethylene (ET), brassinosteroid (BR), auxin (AUX), and gibberellin (GA) on fruit ripening and the expression of 18 ripening-associated ERFs in tomato stored at 20°C (room temperature) for 10 d or 4°C (cold storage) for 14 d followed by 2 d at 20°C (retailer conditions). ResultsThe results showed that ripening was accelerated by ET and BR but was delayed by AUX and GA at room temperature. Cold storage delayed ripening in all groups, with ET and GA treatments showing the highest and lowest a* values, respectively. The effects of hormone treatment were consistent with room temperature when the fruits were transferred from cold storage to retail conditions. At room temperature, ERFs responsive to ET (ERF.B1, B2, B6, E2, and F1) and BR (ERF.E5, F2, and F3) were inhibited by AUX. ET-induced genes (ERF.C1, E1, F4, and H7) could be co-regulated by other hormones at cold storage. When the fruits were transferred from cold storage to retailer conditions, ERFs responsive to ET and BR were inhibited by GA. Additionally, ET-responsive ERFs could be inhibited by BR at room temperature, whereas ET could inhibit BR-responsive ERFs at retailer conditions. The same ERFs that were regulated by ET at room temperature were instead regulated by BR under retailer conditions, and vice versa. DiscussionThese findings can help provide a better understanding of the complex hormone interactions regulating the postharvest physiology of tomato and in maintaining its quality and shelf life during storage and distribution.

Violent attacks have been one of the hot issues in recent years. In the presence of closed-circuit televisions (CCTVs) in smart cities, there is an emerging challenge in apprehending criminals, leading to a need for innovative solutions. In this paper, the propose a model aimed at enhancing real-time emergency response capabilities and swiftly identifying criminals. This initiative aims to foster a safer environment and better manage criminal activity within smart cities. The proposed architecture combines an image-to-image stable diffusion model with violence detection and pose estimation approaches. The diffusion model generates synthetic data while the object detection approach uses YOLO v7 to identify violent objects like baseball bats, knives, and pistols, complemented by MediaPipe for action detection. Further, a long short-term memory (LSTM) network classifies the action attacks involving violent objects. Subsequently, an ensemble consisting of an edge device and the entire proposed model is deployed onto the edge device for real-time data testing using a dash camera. Thus, this study can handle violent attacks and send alerts in emergencies. As a result, our proposed YOLO model achieves a mean average precision (MAP) of 89.5% for violent attack detection, and the LSTM classifier model achieves an accuracy of 88.33% for violent action classification. The results highlight the model’s enhanced capability to accurately detect violent objects, particularly in effectively identifying violence through the implemented artificial intelligence system.

Background: Head and neck cancers account for about 30% of all cancers in India. Studies showed that there is an increased primary DNA damage even before the commencement of any modality of treatment in cancer patients which is further increased by the treatment. Chemo-radiation induced DNA damage is not repaired so effectively in patients with carcinoma which might pave way for secondary carcinoma. Aims and Objectives: The aim of this study was to assess the degree of DNA damage by comet assay technique in patients with head and neck carcinoma receiving radiotherapy. The degree of DNA damage was compared according to the age, gender, and associated risk factors of the patients. Materials and Methods: 35 patients with Stages II, III, and IVA, histopathologically confirmed Squamous cell carcinoma of head and neck with Karnofsky Performance Status >70 attending radiotherapy OPD for treatment were included in this study.1 ml of heparinized blood was collected from the study participants during various doses of radiation treatment. All the samples were processed immediately and analyzed for DNA damage by single cell gel electrophoresis assay - Comet assay technique. Results: The comet length parameter, head diameter, and tail length were found to be increased when compared to baseline sample. The percentage of DNA in head parameter of post-RT sample was decreased when compared to baseline sample All these findings are indicative of DNA damage following radiotherapy. Conclusion: Patients with locally advanced head and neck carcinoma following radiotherapy showed a sequential increase in the DNA damage. The co-existing risk factors and old age may increase the baseline DNA damage in the patients with head and neck cancers.

Chronic kidney disease (CKD) is a low-grade inflammatory state which is accom–panied by elevated markers of oxidative stress, inflammatory, and endothelial dysfunction in patients on peritoneal dialysis (PD). These represent a key triad for the development and progression of atherosclerosis. The present study assessed the markers of oxidative stress, inflammatory and endothelial dysfunction in diabetic and non-diabetic CKD patients on PD. A cross-sectional study was undertaken on 100 CKD patients on PD, of whom 52 patients were nondiabetic and 48 were diabetic patients. Blood samples were estimated for malondialdehyde (MDA) and ferric reducing ability of plasma (FRAP) as markers of oxidative stress; interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP), and fibrinogen as inflammatory markers; and markers of endothelial dysfunction such as nitric oxide (NO), carotid wall intimal medial thickness (CIMT), and number of plaques, among others. The MDA levels increased and FRAP levels decreased in both diabetic and nondiabetic CKD patients on PD. The levels of IL-6, hs-CRP, fibrinogen, NO, CIMT, and the number of plaques were significantly higher in diabetic patients than in nondiabetic CKD patients on PD. The lipid profile was significantly atherogenic in diabetic patients compared with nondiabetics CKD patients. The results showed increased oxidative stress, inflammation, and endothelial dysfunction in diabetic patients compared with nondiabetics CKD patients on PD.

Introduction: In this modern era, a significant group of people is living in isolated hilly areas far away from civilization with their custom and beliefs. They are known as “tribes.” “Kodhu” tribe is one of the major Indian tribes present in the remote areas of Visakhapatnam. The objective is to assess the oral health status and oral health-related quality of life and education level in Kodhu Tribe in residing in Araku and Paderu regions of Visakhapatnam. Material and Methods: A descriptive cross-sectional study was conducted among the Kodhu tribal population situated in the Araku and Paderu areas Visakhapatnam, Andhra Pradesh. The study comprised of 800 participants selected using a simple random sampling technique. Chi-square test was used to assess the oral health status of the tribal population, while, independent t-test was used for multiple comparison of OHIP-14 and oral health status. A p-value ≤ 0.05 was considered statistically significant. Results: Among 800 participants, 458 were illiterate, and 342 were literate. The prevalence of dental caries was 49% among the illiterates while literates had 50.4% prevalence and the difference was statistically significant (P < 0.03). The periodontal status prevalence was found to be higher in illiterates (56.4%). The domains that are present in OHIP were found to be significantly associated with dental caries, periodontal status, and oral mucosal lesions (P < 0.001). Conclusion: The oral health status of Kodhu tribe was found to have high prevalence of the periodontal disease and dental caries. Regular oral examination by dental professionals, dental health education, and motivation to maintain oral hygiene should be insisted to improve the oral health status of this tribal community.

Chronic kidney disease (CKD) which is characterized by progressive loss of renal function and renal fibrosis is a worldwide public health problem. Hepatocyte growth factor (HGF) is a polypeptide that exhibits multiple functions including antifibrotic effects on kidneys. The present study was aimed at evaluating HGF levels and studying its association with markers of inflammation and oxidative stress in patients of predialysis and dialysis CKD. A total of 80 subjects including 20 healthy controls, 40 patients of CKD stage 1 to stage 5 (predialysis), and 20 CKD patients with end-stage renal disease on hemodialysis were recruited. HGF, high-sensitivity C-reactive protein (hsCRP), malondialdehyde (MDA), and ferric reducing ability of plasma (FRAP) were measured in all the subjects. HGF levels were significantly higher in all patients with CKD compared to controls. The levels were found to be lower in patients on dialysis than in the predialysis group; however, the difference was not statistically significant. hsCRP, MDA, and FRAP were significantly higher in all patients with CKD than in controls. HGF levels did not show a significant correlation with the markers studied. HGF levels were increased in response to renal injury in CKD patients. The levels were higher in predialysis patients of CKD than in CKD patients on dialysis. HGF levels may be used as an indicator of renal fibrosis in patients with CKD.

Background: In India, improper access to health services, particularly oral health care, is the main concern. As a result, teledentistry is a novel technique of practicing that ensures an exponential increase in clinical practice and public health-care delivery. Aim: The aim of the study was to assess the knowledge, attitude, and perception regarding teledentistry among dental students of Andhra Pradesh, India. Materials and Methodology: A descriptive cross-sectional study was conducted. Two hundred and fifty dental students are selected through a random sampling technique, including 3rd year Bachelor of Dental Surgery (BDS), 4th year Bachelor of Dental Surgery, interns, and Master of Dental Surgery (MDS) students studying in Andhra Pradesh. Dental students' knowledge, attitude, and perception regarding teledentistry was recorded using a self-administered, structured, pretested, and validated questionnaire administered through Google Forms, and the completed questionnaires were statistically analyzed using Statistical software (SPSS 25). Descriptive statistics included the computation of percentages and inferential statistics; the Chi-square test was used for intergroup comparisons. Statistical significance was set at P ≤ 0.05. Results: A total of 250 (100%) participants participated in the study. Sociodemographic data indicates that most respondents were between 20 and 23 years of age [n = 153 (61.2%)]. Most of the respondents accounted are females [n = 184 (73.6%)], and the remaining were males [n = 66 (26.4%)]. Majority of the participants were BDS [n = 193 (77.2%)] and the remaining were MDS [n = 57 (22.8%)]. The majority of postgraduate students, 77.2% (P = 0.022), were found to be familiar with the definition of teledentistry. It was observed that the majority of postgraduate students, 78.9% (P = 0.02) had knowledge about teledentistry and how to improve the health education of the masses. It shows that 61.4% (P = 0.002) of postgraduates believe that teledentistry can save time in dental practice. The overall study results uncovered that the postgraduates had a greater mean knowledge score than undergraduates. Conclusion: Most dental students were aware of teledentistry, its benefits, drawbacks, and how to use it. As teledentistry is still a nascent technology, this topic should be included in dental education.

The epidemic of Coronavirus disease 2019 (COVID-19), originated in Wuhan, China, has become a major public health challenge not only for China but also countries around the world. The repercussions of the current rapid spread of COVID-19, which has affected millions of people worldwide, ranging from being isolated and quarantined to fatality have resulted in considerable psychological stress and fear. Aim: The aim of the study is to assess the knowledge, attitude and perception of practicing dentists toward COVID-19 in Visakhapatnam. Materials and Methods: A self-administered, pretested, and validated questionnaire was designed and mailed to the dental professionals assessing information regarding sociodemographic details, knowledge, attitude, and perception toward COVID-19 among dental practitioners in Visakhapatnam. Convenience sampling was used and a total of 264 participants were included in the study based on inclusion and exclusion criteria. Results: The correct incubation period of the virus was recognized by 43% of participants. Participants in age groups 50–60, 40–50, were more likely to perceive COVID-19 as a very dangerous disease compared to 30–40 and 23–30 years of age groups. Study participants with 15–20 and 20–25 years of practice were more likely to treat those patients and ask them to go to the hospital (74%, 67%, respectively). On the other hand, dentists with 1–5, 5–10, years of practice were more likely to refuse to treat and ask him/her to leave clinic (75%, 63%, of participants, respectively). The study participants showed satisfactory knowledge and a positive attitude toward COVID-19. Conclusion: Although we had faced the prospect of a second wave of virus transmission, we must take certain measures and make changes to minimize the effects of next coming waves of the COVID-19 outbreak on dental practice. This is the time for change and there should be support and enthusiasm for providing valid solutions to reduce this disruption which can be achieved through increasing their accessibility to materials provided by dental health-care authorities, which specifies the best and safest approaches for dealing with patients during and after the outbreak.

Background: Shortening of the dental roots denoted by a decrease in root-crown ratio is a common manifestation of root resorption. Several natural conditions place roots at risk of resorption without any pathology. To date, information regarding root resorption in sagittal malocclusions is deplete in the literature. Aims: To measure and associate the root-crown ratio of maxillary incisors in different malocclusions. Methods: About 85 patients were allocated to three groups, Skeletal and Angle's Class I, Class II and Class III. Panoramic radiographs and periapical radiographs for maxillary incisors (340 teeth) using paralleling technique were taken and traced. Length of the root and crown were assessed and root-crown ratios were calculated. Results: The root-crown ratio was significantly lower in Skeletal and Angle's Class III group (P < 0.05) compared to Classes I and II groups. Gender predilection was found to be absent. Conclusion: Root resorption of maxillary incisors was observed in Skeletal and Angle's Class III patients. Maxillary central incisors were observed to have decreased root-crown ratios compared to maxillary lateral incisors irrespective of malocclusion.

Background: Cyberchondria has been used to describe an increase in anxiety about one's health status as a result of excessive online searches. These online health research studies were associated with a small but reliable increase in depression and anxiety which may decrease concentration of a student on academics. Methods: The questionnaire was distributed among 302 undergraduate dental students (second year, third year, fourth year, and interns) of Kamineni Institute of Dental Sciences and Hospital. The survey tool comprised Cyberchondria Severity Scale–Short form (CSS-15) questionnaire and percentage of marks obtained in the previous University examination. Statistically significance was set at P < 0.05. Results: A significant difference was observed for subscale Compulsion (p = 0.05*), Distress (p = 0.001*) with a higher mean score among 24-26 years old dental students. Females had significant higher mean score subscales Distress (4.63 ± 2.93; P = 0.02*) and Reassurance (5.99 ± 2.90; P = 0.001*) than males. Regarding overall CSS, significant higher mean scores were observed among the students who scored less than 65% (7.90 ± 2.01) in their last year university academic examination (0.000*). Conclusion: Scheduling educational programs and strengthening easily accessible health services for the students has a particular importance in solving the health problems of young people.

INTRODUCTION: : Sepsis is a global healthcare challenge, and accurate scores are required to identify and stratify patients' risk. The current study aimed to compare the prognostic accuracy of quick SOFA (qSOFA) with comparison to SOFA and MEWS scores in order to identify the length of hospital stay and outcomes among patients with sepsis who presented to emergency department (EMD). MATERIAL AND METHODS: Between July and November 2018, 77 adult patients with sepsis were treated at EMD. The area under the receiver operating characteristic curve (AUROC) of quick SOFA (qSOFA), SOFA, and MEWS scores was used to compare prognostic accuracy for the outcome of hospital mortality and length of stay. RESULTS: The majority of patients (68%) were over the age of 50. Systemic Hypertension is the most common comorbid condition, accounting for 38.9% (n=30). Pneumonia is the most common diagnosis in 27.3 percent of cases (n=21). Patients required vasoactive support in 45.5 percent (n=35) of cases, and ventilator support in 50.6 percent (n=39) of cases. Mortality was observed in 34.1 percent (n=27) of the cases. Patients on vasopressor and ventilator support have a higher mortality rate [8(19%) vs. 21(50%)]. The mortality rate in patients with a qSOFA score of 3 is 71.4 percent. Patients with a SOFA score of >15 had higher mortality rate. The mortality rate in patients with MEWS score > 5 is 48.9%. A qSOFA score of 3 is associated with an increased risk of death, and the majority died in less than three days. Because of increased mortality, most patients with a SOFA score of 7 have a length of stay of 3 days. Most patients with a Mews score of 5 or higher have a length of stay of 3 days due to mortality. The AUC value for qSOFA is 0.721, the AUC value for SOFA is 0.714, and the AUC value for MEWS is 0.693, indicating that qSOFA is more sensitive in predicting the outcome than SOFA and MEWS. CONCLUSIONS: In all prediction scores, qSOFA outperformed than SOFA and MEWS in terms of hospital mortality and length of hospital stay. qSOFA is a simple, rapid bedside tool that does not require laboratory parameters and can be used to predict the prognosis of patients with sepsis in the EMD.

Abstract Oxygen supplementation, although a cornerstone of emergency and cardiovascular medicine, often results in hyperoxia, a condition characterized by excessive tissue oxygen which results in adverse cardiac remodeling and subsequent injurious effects to physiological function. Cardiac remodeling is further influenced by various risk factors, including pre-existing conditions and sex. Thus, the purpose of this experiment was to investigate cardiac remodeling in Type I Diabetic (Akita) mice subjected to hyperoxic treatment. Overall, we demonstrated that Akita mice experience distinct challenges from wild type (WT) mice. Specifically, Akita males at both normoxia and hyperoxia showed significant decreases in body and heart weights, prolonged PR, QRS, and QTc intervals, and reduced %EF and %FS at normoxia compared to WT controls. Moreover, Akita males largely resemble female mice (both WT and Akita) with regards to the parameters studied. Finally, statistical analysis revealed hyperoxia to have the greatest influence on cardiac pathophysiology, followed by sex, and finally genotype. Taken together, our data suggest that Type I diabetic patients may have distinct cardiac pathophysiology under hyperoxia compared to uncomplicated patients, with males being at high risk. These findings can be used to enhance provision of care in ICU patients with Type I diabetes as a comorbid condition.

The addition of natural gas (NG) with diesel fuel is an attempt to increase the combustion efficiency of the diesel engine and to reduce nitrogen-based emissions in this investigation. A three-dimensional computational study has been carried out on the combustion chamber of a NG–dieseldual fuel engine. Standard k-ɛ turbulence model was used to incorporate the turbulence inside the combustion chamber. The spray angle inside the combustion chamber was varied from 100° to 150°. The flow characteristics such as pressure, temperature, and velocity distributions, combustion characteristic of apparent heat release rate, and emission characteristic of NO emission of dual fuel engine were investigated at different spray and crank angles. The results show that the maximum pressure inside the cylinder increased from 129 to 131 bar when the spray angle was varied from 100° to 150° at a crank angle of 360°. The maximum temperature was found to be 1602 K at a spray angle of 150° and at crank angle of 360°. The range of velocity inside the cylinder was from 5 m/s to 15.6 m/s. At the spray angle of 150°, the mass fraction of NO emission was 1.15 × 10−09 and was the least among the different spray angles. The optimized spray angle was chosen such that the combustion can take place properly with the least emission and was found to be 150°. The results of the present study were compared with the existing literature and are found to be in good agreement.

Fruit ripening involves the dynamic interaction of phytohormones. Ethylene (ET) and gibberellin (GA) antagonistically affect fruit ripening. However, the mechanism of GA and its potential interaction with ET during fruit ripening remain unknown. To identify the potential molecular mechanism of ET and GA interplay in tomato (Solanum lycopersicum L.) fruit ripening, transcriptome and metabolomic profiling was carried out in tomato fruit treated with GA, ET or the combination of the two hormones (GA+ET). ET accelerated fruit ripening with the simultaneous repression of auxin signaling. In contrast, gibberellin delayed ripening by the upregulation of auxin signaling. ET signaling and response was inhibited by GA or combined with ET. At the metabolite level, while GA treatment inhibited metabolite shift during ripening, ET treatment promoted. In the combined hormone treatment, ET reduced or recovered GA inhibitory effect on specific metabolites. This study provided insight into ET and GA interaction, highlighting the importance of auxin signaling in metabolic shifts during tomato ripening progression.

The selection of an appropriate number of features and their combinations will play a major role in improving the learning accuracy, computation cost, and understanding of machine learning models. In this present work, 22 gray-level co-occurrence matrix features extracted from magnetic flux leakage images captured in steam generator tubes’ cracks are considered for developing a machine learning model to predict and analyze crack dimensions in terms of their length, depth, and width. The performance of the models is examined by considering R2 and RMSE values calculated using both training and testing data sets. The F Score and Mutual Information Score methods have been applied to prioritize the features. To analyze the effect of different machine learning models, their number of features, and their selection methods, a Taguchi experimental design has been implemented and an analysis of variance test has been conducted. The dynamic population gray wolf algorithm (DPGWO) has been adopted to select the best features and their combinations. Due to the two contradictory natures of performance metrics, Pareto optimal solutions are considered, and the best one is obtained using Deng’s method. The effectiveness of DPGWO is proved by comparing its performance with Grey Wolf Optimization and Moth Flame Optimization algorithms using the Friedman test and performance indicators, namely inverted generational distance and spacing.

Custom 450 stainless steel is the most desirable material across industries due to its widespread application in the aerospace, defense and marine industries. Stainless-steel materials are challenging to deal with and fall into the list of hard-to-process materials due to their low heat conduction coefficient and high mechanical properties. In this research work, end milling was carried out on Custom 450 stainless steel machined using TiAlN coated with tungsten carbide inserts that have been cryo-treated (CT) for 24 h (24 h) and 36 h (36 h), as well as untreated (UT) inserts. The inserts were evaluated in terms of feed force, feed rate and consistent depth of cut (ap) at various spindle speeds (S). Also examined were the tool morphology, chip anatomy and surface morphology of cryo-treated material compared to untreated inserts at various responses to cutting force (Fx, Fy, Fz), cutting temperature (Tc), vibration and surface abrasion. For inserts that have been cryo-treated for 36 h, the feed force (Fx) value was 44% and 5% less compared to inserts treated for 24 h and in UT inserts, respectively. Furthermore, for 24-h and 36-h CT inserts, feed force (Fx) was 12% and 20% less compared to a UT insert. Using 24-h cryo-treated inserts as opposed to UT inserts significantly reduced the surface roughness by 20%. Cutting inserts that have undergone cryogenic treatment have been observed to exhibit longer cutting tool life due to less wear and friction on the cutting edges.

Medical gas production, supply and distribution is a closely regulated process with its intrinsic safety designs and procedure along with this anaesthesia work station designed with utmost safety for delivering anaesthetic gases to patients during the peri-operative period. The ingress of condensed water into anaesthesia machine from central medical gas pipeline can lead to catastrophic incidents.

ABSTRACT Current knowledge on resistance-conferring determinants in Mycobacterium tuberculosis is biased toward globally dominant lineages 2 and 4. In contrast, lineages 1 and 3 are predominant in India. In this study, we performed whole-genome sequencing of 498 MDR M. tuberculosis isolates from India to determine the prevalence of drug resistance mutations and to understand the genomic diversity. A retrospective collection of 498 M. tuberculosis isolates submitted to the National Institute for Research in Tuberculosis for phenotypic susceptibility testing between 2014 to 2016 were sequenced. Genotypic resistance prediction was performed using known resistance-conferring determinants. Genotypic and phenotypic results for 12 antituberculosis drugs were compared, and sequence data were explored to characterize lineages and their association with drug resistance. Four lineages were identified although lineage 1 predominated (43%). The sensitivity of prediction for isoniazid and rifampicin was 92% and 98%, respectively. We observed lineage-specific variations in the proportion of isolates with resistance-conferring mutations, with drug resistance more common in lineages 2 and 3. Disputed mutations (codons 430, 435, 445, and 452) in the rpoB gene were more common in isolates other than lineage 2. Phylogenetic analysis and pairwise SNP difference revealed high genetic relatedness of lineage 2 isolates. WGS based resistance prediction has huge potential, but knowledge of regional and national diversity is essential to achieve high accuracy for resistance prediction. IMPORTANCE Current knowledge on resistance-conferring determinants in Mycobacterium tuberculosis is biased toward globally dominant lineages 2 and 4. In contrast, lineages 1 and 3 are predominant in India. We performed whole-genome sequencing of 498 MDR M. tuberculosis isolates from India to determine the prevalence of drug resistance mutations and to understand genomic diversity. Four lineages were identified although lineage 1 predominated (43%). The sensitivity of prediction for isoniazid and rifampicin was 92% and 98%, respectively. We observed lineage-specific variations in the proportion of isolates with resistance-conferring mutations, with drug resistance more common in lineages 2 and 3. Disputed mutations (codons 430, 435, 445, and 452) in the rpoB gene were more common in isolates other than lineage 2. Phylogenetic analysis and pairwise SNP difference revealed high genetic relatedness of lineage 2 isolates. WGS based resistance prediction has huge potential, but knowledge of regional and national diversity is essential to achieve high accuracy for resistance prediction.

Mechanical ventilation often results in hyperoxia, a condition characterized by excess SpO2 levels (>96%). Hyperoxia results in changes in the physiological parameters, severe cardiac remodeling, arrhythmia development, and alteration of cardiac ion channels, all of which can point toward a gradual increase in the risk of developing cardiovascular disease (CVD). This study extends the analysis of our prior work in young Akita mice, which demonstrated that exposure to hyperoxia worsens cardiac outcomes in a type 1 diabetic murine model as compared to wild-type (WT) mice. Age is an independent risk factor, and when present with a major comorbidity, such as type 1 diabetes (T1D), it can further exacerbate cardiac outcomes. Thus, this research subjected aged T1D Akita mice to clinical hyperoxia and analyzed the cardiac outcomes. Overall, aged Akita mice (60 to 68 weeks) had preexisting cardiac challenges compared to young Akita mice. Aged mice were overweight, had an increased cardiac cross-sectional area, and showed prolonged QTc and JT intervals, which are proposed as major risk factors for CVD like intraventricular arrhythmias. Additionally, exposure to hyperoxia resulted in severe cardiac remodeling and a decrease in Kv 4.2 and KChIP2 cardiac potassium channels in these rodents. Based on sex-specific differences, aged male Akita mice had a higher risk of poor cardiac outcomes than aged females. Aged male Akita mice had prolonged RR, QTc, and JT intervals even at baseline normoxic exposure. Moreover, they were not protected against hyperoxic stress through adaptive cardiac hypertrophy, which, at least to some extent, is due to reduced cardiac androgen receptors. This study in aged Akita mice aims to draw attention to the clinically important yet understudied subject of the effect of hyperoxia on cardiac parameters in the presence of preexisting comorbidities. The findings would help revise the provision of care for older T1D patients admitted to ICUs.

An efficient and cost-effective power converter is a pre-requisite for the modern power applications. With the evolvement of matured medium power self-commutated switching devices, multilevel inverters (MLIs) are emerged as a promising solution for high-power medium-voltage applications. Though, MLIs are performing a promising role in industrial applications, their high device count, size, cost and control complexities have restricted their market penetration. To address the disadvantages of MLIs, researchers are continuously contributing to new generation topologies under the name of reduced switch count (RSC) MLIs. From the past decade, numerous RSC-MLIs topologies have been reported for various applications. Therefore, this paper presents a comprehensive review and classification of RSC-MLI topologies, in terms of their structure, features, limitations, suitability and selection for specific applications.

Background: The scientific journal is a periodical publication intended to further the progress of science, usually by reporting new research, bibliometric methods are used to evaluate the standard of journal. Objective: The objective of the study is to analyze the publication trends of articles in the Journal of Indian Association of Public Health Dentistry (JIAPHD) over a period of 7 years from 2014 to 2020 (till Vol 18, Issue 2) and describe quantitatively the number of articles published in each issue, type of articles, and place of the institution and to assess the quality of the journal and compare that with bibliometric analysis of JIAPHD from 2002 to 2013. Methodology: A retrospective observational study was conducted, and all issues of JIAPHD were electronically searched for the parameters: study design, area of interest of research, state/college where research was conducted, authorship pattern, source of articles published each year, changing study trends, and publication bias and compared with bibliometric analysis of JIAPHD from 2002 to 2013. Results: Total 411 articles were retrieved and compared to 676 articles of previous bibliometric analysis, of which 430 articles from 2002-2013 issues and 344 from 2014 to 2020 issues were descriptive studies,341 and 352 articles were questionnaire studies, 420 and 340 articles were from South zone respectively. Conclusion: Fields such as descriptive, analytical, experimental, laboratory research studies, letter to editor dominated the publications; participation from East zone was also visible; studies with non-significant results were also improved in the present analysis.

Introduction: The viral infection COVID-19 is highly infectious and has claimed many lives till date and is still continuing to consume lives. In the COVID-19, along with pulmonary symptoms, cardiovascular (CV) events were also recorded that have known to significantly contribute to the mortality. In our study, we designed and validated a new risk score that can predict CV events, and also evaluated the effect of these complications on the prognosis in COVID-19 patients. Materials and Methods: A retrospective, multicenter, observational study was done among 1000 laboratory-confirmed COVID-19 patients between June 2020 and December 2020. All the data of the clinical and laboratory parameters were collected. Patients were randomly divided into two groups for testing and validating the hypothesis. The identification of the independent risk factors was done by the logistic regression analysis method. Results: Of all the types of the clinical and laboratory parameters, ten “independent risk factors” were identified associated with CV events in Group A: male gender, older age, chronic heart disease, cough, lymphocyte count 7 mmol/L at admission, estimated glomerular filtration rate 37 S, D-dimer, and procalcitonin >0.5 mg/L. In our study, we found that CV events were significantly related with inferior prognosis (P < 0.001). Conclusions: A new risk scoring system was designed in our study, which may be used as a predictive tool for CV complications among the patients with COVID-19 infection.