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Background: Tobacco use poses severe health risks globally, affecting both young people and adults. It is highly addictive and a major contributor to various diseases, including cancer. This research at Teerthanker Mahaveer Dental College and Research Centre (TMDC and RC), Moradabad, focused on participants aged 35–44, highlighting the urgent need to address tobacco-related issues for public health and economic well-being. Aim: This study assesses the occurrence of smokers and smokeless tobacco and analyzes its correlation with the oral health-related quality of life (OHRQoL) among participants. Materials and Methods: A prevalence study was substantiated at TMDC and RC, Moradabad, involving 640 participants aged between 35 and 44 years. Informed assent was obtained from all participants. Sociodemographic information was collected, and their oral mucous lesions were assessed using the World Health Organization form. In addition, participants completed a validated Hindi version of the Oral Health Impact Profile-14 questionnaire to evaluate their OHRQoL. Results: The study revealed a higher prevalence of tobacco usage among males compared to females. Furthermore, the prevalence of smoking was established to be greater than that of smokeless tobacco. Consequently, a statistically apparent association was recognized between smokers and their OHRQoL, as well as between users of smokeless tobacco and their OHRQoL. However, no association was established between smokers, smokeless tobacco users, and OHRQoL when considering the significance value. Conclusion: The study indicates that individuals aged 35–44 years who use either smoked or smokeless tobacco experience similar impacts on their OHRQoL. Encouraging regular dental examinations, facilitating access to tobacco cessation programs, and extending support for individuals to sustain tobacco-free lifestyles are indispensable strategies for amplifying oral health outcomes besides the overall quality of life among individuals aged 35–44.

Background: The attitudes of dental students to study a particular specialty of dentistry in post-graduation are of great importance as these facilitate workforce planning in the dental sector. Aim and Objective: To assess the attitude of dental students towards choosing periodontology as their future career and to explore demographic variables that affect their choice. Materials and Methods: A cross-sectional survey based on a questionnaire was conducted, including students of the third and fourth years and interns of the dental college. Twenty-seven questions, graded on a Likert scale (5-point) were included in the questionnaire, and the responses were categorised via three attitudes: negative (score 0–21), neutral (score 22–44) and positive (score 45–64). The Chi-square test for proportions was used to examine the differences between groups. Results: Among 114 participants, 53 (46.5%) were males and 61 (53.5%) were females. One-third of the respondents had a positive attitude towards selecting periodontology as their future career, and the majority had a neutral perspective, with a few students having a negative attitude (20.2%). Out of the total, 34.2% of respondents had a positive attitude, and 45.6% showed a neutral attitude or perspective. Conclusion: Efforts should be intensified, and undergraduate (UG) students should be motivated by broadening the scope of the field in the UG curriculum by the dental council so that the students show considerable interest in pursuing the field as their future career.

Abstract Background Preeclampsia, a condition very frequently linked to maternal and fetal deaths worldwide, remains a pressing concern due to delays in recognition and response. Effective screening tests for early detection of high-risk cases and appropriate preventive measures are currently lacking. Well planned prenatal care, timely detection, monitoring, and appropriate management are vital to prevent preeclampsia-related fatalities. Methods This prospective study evaluated the use of shear wave elastography (SWE) in identifying placental structural issues caused by preeclampsia in high-risk pregnancies. A total of 143 high-risk pregnant women with singleton pregnancies and an anterior placental position were included in the study. Results Women with preeclampsia exhibited significantly elevated SWE values in both center (27.98 ± 16.12 vs. 4.57 ± 6.57 kPa) and peripheral areas of the placenta (29.14 ± 16.12 vs. 4.80 ± 7.70 kPa) when compared to non-preeclampsia women (p = 0.000). Cutoff values of 8.70 kPa and 8.15 kPa at the Center and edge of the placenta respectively, accurately predicted preeclampsia in second-trimester pregnancies, with 84.62% sensitivity and 94% specificity. However no significant difference was observed between elastography values obtained from the center and edge of the placenta. Conclusions In conclusion, shear wave elastography can help diagnose preeclampsia early by assessing placental stiffness.

Based on the signum function (sign of magnitudes) of transient energy, this paper proposes a fault classification approach and algorithm for a monopolar HVDC system. The analytical study here shows that the signum function of variation in transient energy has a zero value individually at both ends on no-fault conditions. Moreover, the summation of the signum functions computed for internal DC faults is zero, whereas the same has a non-zero value for external AC faults. The performance of the proposed algorithm has been extensively evaluated by simulating faults on a CIGRE benchmark system for HVDC monopolar configuration using EMTDC/PSCAD software. Three locations of DC line fault, and AC fault at the two ends of the system have been considered for this evaluation. Five fault resistance values (0, 10, 100, 1000, and 2000 ohms) have been simulated for each fault location. The results conform with the theoretical analysis, and the fault classification by the algorithm is 100% accurate. The time taken to detect and classify a DC fault at the mid-point of the 800-km line is 1.5 ms, and that for line-end faults on the DC line is 3 ms for all values of fault resistance. These results show a marked improvement over those reported earlier in the literature using other techniques. A comparison table is given in the last section to corroborate it.

Air pollution is known to be one of the major risk factors for premature morbidity and mortality globally, which are preventable. Therefore, the public is informed about air pollution through the Air Quality Index (AQI). The AQI represents integrated data of selected pollutants and produces a combined overall index for specific locations and time. The AQI algorithm generates a range of numbers and categories of colors that indicate likely health risks from air pollutants and the public's actions to minimize the risks. However, it lacks emerging evidence on chemical toxicity or composition. Hence, policymakers may also consider addinga toxicity matrix of fine particles to refine the algorithm, such as oxidative potential. Further, the risk is commonly communicated in numbers and not in color as dictated by the AQI. The AQI values and categories vary significantly between countries for the same pollution concentration, leading to confusion. Hence, we recommend developing a universal AQI (UAQI) with a consistent relationship between colors, concentrations, and toxicity to communicate air pollution risks to the public. Further, communication media should be encouraged to use universal color-coding rather than AQI values, i.e., numbers. Therefore, a global policy framework for regulatory authorities and policymakers is needed to communicate air pollution risk information consistently and to minimize public health exposure.

Background: Evaluation of type, nature, and prevalence of common oral pathology lesions involving periodontium and implant in patients of tertiary level dental hospital in Hazaribagh City, Jharkhand. Materials and Methods: A total of 2467 people were requested to take part in the oral examination. The current study cohort was made up of the 62.4% of the initial subgroup who participated in the clinical oral examination and granted their agreement for the use of the data. Between January 2023 and June 2023, the clinical oral examination was completed. Results: No changes were observed in 89.6% of study participants. 88.2% males had no changes while 90.4% females had no changes. Normal variations were observed in 3.4% of study participants. 4.3% males had normal variations while 2.7% females had normal variations. Infectious oral pathology was observed in 3.3% of study participants. 2.4% males had infectious oral pathology while 3.2% females had infectious oral pathology Ulcerative lesions were observed in 4.1% of study participants. 3.6% males had ulcerative lesions while 2.4% females had ulcerative lesions. White lesions were observed in 6.7% of study participants. 8.2% males had white lesions while 5.6% females had white lesions. Conclusion: This study provided a detailed evaluation of type, nature, and prevalence of different oral pathology lesions focusing on periodontium and implant.

Study purpose. The COVID-19 pandemic has a considerable impact on social and financial factors in addition to health outcomes. There is, however, still little information available as to how Covid-19 actually impacted housewives. Consequently, this paper aims to provide a new dimension to the study of how vinyasa could support mothers’ fitness throughout the pandemic. This study sought to determine whether an online vinyasa programme for 8 weeks during Covid-19 pandemic could significantly influence housewives’ upper and lower body muscle endurance. Materials and methods. 24 housewives (between the ages of 26 and 36) from the NCR region of Delhi participated in the study. The participants were divided at random and put either into the experimental group (vinyasa) or the control group. Both upper and lower body muscular endurance was found to be the health-related variable. The longest-lasting bent knee push-ups were used to gauge upper body muscular endurance, while the longest-lasting bodyweight squat holds over a 90-degree angle were used to gauge lower body muscle endurance. Results. To analyse the findings, tests were run both prior to and following the training. A substantial difference between the experimental group and control group was found using ANCOVA to compare them to the baseline after 8 weeks. Conclusions. Thus, it was determined that the online/virtual vinyasa training programme was a successful way for housewives to increase their body muscular endurance (health-related fitness).

The average global temperature is rising due to anthropogenic emissions. Hence, a systematic approach was used to examine the projected impacts of rising global temperatures on heatwaves in India and provide insights into mitigation and adaptation strategies. With over 24,000 deaths attributed to heatwaves from 1992 to 2015, there is an urgent need to understand India's vulnerabilities and prepare adaptive strategies under various emission scenarios.This situation is predicted to worsen as heatwaves become more frequent, intense, and long-lasting. Severe heatwaves can exacerbate chronic health conditions, vector-borne diseases, air pollution, droughts and other socio-economic pressures causing higher mortality and morbidity. Heatwaves with severe consequences have increased and are expected to become more frequent in Indian climatic and geographical conditions. As per the future projection studies, the temperature could rise ±1.2° C to ±3.5° C and will start reducing by the end of 2050. The study also provides data from the research that employs climatic models and statistical approaches for a more precise characterization of heat extremes and improved projections. Also, the study appraises the past, present and future heatwave trend projections. Most of these studies compute future projections using the Coupled Model Intercomparison Project (CMIP5) models and Representative Concentration Pathway (RCP). Limited systematic reports have been found using CMIP6, whereas the best-suited and widely used method was the RCP8.5. The study findings will aid in identifying the zones most susceptible to heatwave risk and provide actionable projections for policymakers to examine the existing evidence for developing proper planning and policy formulation, considering the future climate and temperature projections.

Abstract Background To study incidence of sinonasal mucormycosis in active and post COVID-19 patients in a district-level hospital in India and develop a simplified screening and referral protocol for use at peripheral centres to aid rapid diagnosis/treatment. Methods Study design: A prospective, interventional cohort study conducted from April 2021 to January 2022. Setting: Secondary level hospital in North India. Inclusion criteria: COVID-19 positive patients with diabetes mellitus as co-morbidity and with at least one of the following: received steroid therapy and/or on high flow oxygen therapy and/or had prolonged hospital stay (> 7 days). Exclusion criteria: Patients already immunocompromised/having malignancy/organ transplant recipients. Clinical workup: History, examination, imaging (CECT/MRI nose and paranasal sinuses if indicated), diagnostic nasal endoscopy + Nasal scrapings for KOH mount to detect fungal elements. STROBE guidelines were followed in the study. Results Fourteen out of 250 patients tested positive for mucormycosis (incidence 5.6%). Thirteen were symptomatic, one patient was asymptomatic and detected on screening. No significant difference was found in mucormycosis versus non-mucormycosis group with respect to HbA1c status, vaccination status or steroid + oxygen treatment (p > 0.05 in all scenarios). Patients were treated with intravenous liposomal amphotericin B and surgical debridement when indicated. Two succumbed to disease (survival 85.7%). A clinical screening protocol was thus developed which can be used as an effective tool even at far-flung and remote healthcare facilities for diagnosis and timely referral of patients. Conclusions Mucormycosis is a potentially lethal disease which needs rapid diagnosis and timely action to decrease morbidity and mortality.

Abstract Background Both Alzheimer’s disease (AD) genetic risk factors and indices of cognitive reserve (CR) influence risk of cognitive decline, but it remains unclear whether they interact. This study examined whether a CR index score modifies the relationship between AD genetic risk factors and long-term cognitive trajectories in a large sample of individuals with normal cognition. Methods Analyses used data from the Preclinical AD Consortium, including harmonized data from 5 longitudinal cohort studies. Participants were cognitively normal at baseline (M baseline age = 64 years, 59% female) and underwent 10 years of follow-up, on average. AD genetic risk was measured by (i) apolipoprotein-E (APOE) genetic status (APOE-ε2 and APOE-ε4 vs. APOE-ε3; N = 1819) and (ii) AD polygenic risk scores (AD-PRS; N = 1175). A CR index was calculated by combining years of education and literacy scores. Longitudinal cognitive performance was measured by harmonized factor scores for global cognition, episodic memory, and executive function. Results In mixed-effects models, higher CR index scores were associated with better baseline cognitive performance for all cognitive outcomes. APOE-ε4 genotype and AD-PRS that included the APOE region (AD-PRSAPOE) were associated with declines in all cognitive domains, whereas AD-PRS that excluded the APOE region (AD-PRSw/oAPOE) was associated with declines in executive function and global cognition, but not memory. There were significant 3-way CR index score × APOE-ε4 × time interactions for the global (p = 0.04, effect size = 0.16) and memory scores (p = 0.01, effect size = 0.22), indicating the negative effect of APOE-ε4 genotype on global and episodic memory score change was attenuated among individuals with higher CR index scores. In contrast, levels of CR did not attenuate APOE-ε4-related declines in executive function or declines associated with higher AD-PRS. APOE-ε2 genotype was unrelated to cognition. Conclusions These results suggest that APOE-ε4 and non-APOE-ε4 AD polygenic risk are independently associated with global cognitive and executive function declines among individuals with normal cognition at baseline, but only APOE-ε4 is associated with declines in episodic memory. Importantly, higher levels of CR may mitigate APOE-ε4-related declines in some cognitive domains. Future research is needed to address study limitations, including generalizability due to cohort demographic characteristics.

Epilepsy is one of the most prevalent and serious brain disorders and affects over 70 million people globally. Antiseizure medications (ASMs) relieve symptoms and prevent the occurrence of future seizures in epileptic patients but have a limited effect on epileptogenesis. Addressing the multifaceted nature of epileptogenesis and its association with the Nod-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediated neuroinflammation requires a comprehensive understanding of the underlying mechanisms of these medications for the development of targeted therapeutic strategies beyond conventional antiseizure treatments. Several types of NLRP3 inhibitors have been developed and their effect has been validated both in in vitro and in vivo models of epileptogenesis. In this review, we discuss the advances in understanding the regulatory mechanisms of NLRP3 activation as well as progress made, and challenges faced in the development of NLRP3 inhibitors for the treatment of epilepsy.

Objective: To compare and evaluate the clinical efficacy of diode laser and cryosurgery for treating melanin pigmentation of gingiva. Material and Methods: A total of twenty-five subjects with physiological gingival pigmentation on the facial aspect of both maxillary and mandibular anterior arches (50 sites), both male and female, with an average age ranging from 18-35 years, participated in the study. The sites were randomly divided into Group I: depigmentation by Laser and Group II: depigmentation by Cryosurgery. The following parameters were assessed for the evaluation of treatment results: Melanin Oral Pigmentation Index (PI), Visual Analogue Scale (VAS) for pain evaluation and Healing index (HI). The data collected was statistically evaluated. Results: On intergroup comparison, there was no statistical difference in the score from baseline (p>0.05); however, a statistically significant difference was seen at the end of 1 year (p

Objective: The objective of this study was to assess current practices and usage patterns of antihypertensive medications in managing hypertension (HTN) in India. Materials and Methods: A cross-sectional, observational digital study was conducted among health-care practitioners (HCPs) across India (November 2022–March 2023). Results: A total of 792 HCPs (cardiologists, consulting, and general physicians) participated in this study. According to 63.38% of HCPs, 20–50 essential HTN patients seek consultation weekly. The majority of patients were in the age range of 40–60 years (84.09%). A total of 67.55% of HCPs mentioned that systolic blood pressure (BP) ranged between 140 and 160 mmHg. Type 2 diabetes mellitus was the most common comorbidity among hypertensive patients (84.09%). In total, 53.79% and 37.37% of HCPs preferred angiotensin receptor blockers (ARBs)/angiotensin-converting enzyme and calcium channel blockers (CCBs) as the first choice of antihypertensive agents. The majority of HCPs (>69%) preferred prescribing a triple-drug fixed-dose combination (FDC) of CCBs + ARB + diuretics in hypertensive patients with coronary artery disease (CAD) and resistant HTN. The majority (89.90%) of HCPs preferred prescribing FDC of CCBs over monotherapy. Amlodipine (>55%) followed by cilnidipine (>32%) were preferred CCBs for young and older hypertensive patients. In patients with essential HTN without any CVD, amlodipine (72.85%) was the preferred CCB. Vascular selectivity (59.09%) and longer half-life (54.55%) were important factors for prescribing CCBs. Resistant HTN, inadequate BP control with monotherapy, and the presence of CAD were all (62.63%) important considerations for FDC with CCBs. The underutilization of CCBs in managing HTN (63.88%) was highlighted. Conclusion: Overall responses provide a comprehensive overview of the prevailing perception and the usage patterns of antihypertensive agents employed by HCPs in India.

This paper presents a comparative analysis of single, double, and three-diode models for commercial and industrial photovoltaic (PV) cells. The efficiency of a PV system depends on various factors, including fill factor, material effect, temperature coefficient, interconnections, module degradation, solar irradiation, module temperature, soiling, potential induced degradation, PV module tilt angle, parasitic resistance, and shading effect. The results show that adding diodes decreases the maximum allowable power taken from a PV cell, resulting in the single-diode model with the highest efficiency of 99.9% at STC. As the temperature increases, the voltage decreases and the maximum power decreases to 4.044 watts/°C, while with the rise in irradiation, the maximum power value increases to 80.04 watts/100w/m2. A rise in temperature affects voltage and current values, while irradiation affects current values. An increase in series resistance decreases maximum power values by 216.785 watts/0.1-ohm, while shunt resistance increases maximum power by 0.0725 watts/100 ohm without significant change in current value. $P_{max}$ , $V_{max}$ , and $I_{max}$ values increase with a decrease in shading value. Two and three-diodes respond more effectively than single diodes at the lowest and maximum shading values. Total-Cross-Tied configurations perform more efficiently in various connections, while HC and BL connections have comparable I-V performance. However, BL and HC have low maximum power. MATLAB software is used for modeling and simulation, assisting researchers in understanding factors affecting solar PV system efficiency and diode models.

Aim: This study aims to compare audio-visual and verbal education on the Oral Health status of Diabetes Mellitus (DM) Patients attending a Hospital in Moradabad. Materials and Methods: The current longitudinal interventional study was conducted to check the efficiency of audio-visual and verbal education on the Oral Health status of DM Patients attending a Hospital in Moradabad, U. P., India. The World Health Organization Oral Health Pro forma 1997 was used to collect information regarding the Oral Health Status and Treatment Needs of the DM patients. After collecting the initial baseline data, the sample was divided into two groups verbal education group (n = 1030) and audio-visual education group (n = 1030). Then, oral health education (OHE) was provided verbally to Group I patients and OHE with audio-visual aids was given to Group II patients visiting Teerthanker Mahaveer Hospital. OHE was repeated after each 2 months. At every 6, 12, and 18 months, clinical examination was repeated to evaluate the effectiveness of OHE. Inspection will be conducted under natural daylight on Hospital premises. Results: A total of 1926 patients attended all the follow-up and review examination. Subject dropout for Group I was 2% with 1009 at 6th month; 3% with 978 at 12th month; and 1% with 967 at 18th month. The subject dropout rate for Group II was 3% with 999 at 6th month; 0% with 999 at 12th month; and 4% with 959 at 18th month. The difference in subject dropout among the groups was not statistically significant (P = 0.23). After 18 months, the number of Type I and Type II DM patients with bleeding, calculus, and pockets was further reduced to 115, 114, and 29, respectively in verbal education group while it reduced to 96, 89, and 16, respectively, in audio-visual education group. The result was found to be statistically significant. At the end of 18 months, the number of Type I and Type II DM patients with decayed teeth were reduced to 486 in verbal education group while it was reduced to 421 in audio-visual education group. The result was found to be statistically significant. Conclusion: A main part of oral disease prevention is done by use of personal oral hygiene measures and maintaining oral hygiene. It is the duty of dental professionals to motivate, demonstrate and instruct patients to maintain appropriate oral health and oral hygiene.

Most of world’s electrical energy demand is fulfilled by natural resources (Oil, Coal, Gas, etc.) and there is a huge gap between demand and supply. Therefore, utilities are facing the problem of peak load burden. Broadly speaking, to sustain future electricity demand renewable/alternate sources (solar, wind etc.) of energy must be integrated with smart grid (SG) to cope with energy demand. These sources are freely available, inexhaustible and can be used as an alternate source of energy. For smart utilization of electrical energy, a balance between supply and demand is required at all instants of time. In the SG environment, the most promising solution to reduce the peak load burden on utility is demand side management (DSM) which is possible because of the property of smart grid inertia. DSM permits all types of consumers to alter their energy consumption pattern to reduce the cost of energy and it helps the utility to reduce peak load burden and reshape load profile. In this study, DSM has been formulated as a single objective minimization problem to reduce peak load burden on utility. Although several optimization techniques has been listed in the literature which reduces the peak load and cost of energy, but integration of renewable energy is limited to residential consumers only. In this paper, a robust optimization algorithm inspired by the lifestyle of grey wolves, popularly known as grey wolf optimization (GWO) algorithm is utilized to solve the proposed DSM minimization problem. The DSM minimization problem optimization using GWO is demonstrated on three different cases-residential, commercial, and industrial loads in time of use (TOU) pricing scheme with and without solar PV energy (SPVE). Validation of GWO displays remarkable reductions in peak load on utility and cost of energy of consumers with and without SPVE. Also, GWO optimization results are compared with existing research papers having identical data sets.

Mast cells are important components of the immune system, and they perform pro-inflammatory as well as anti-inflammatory roles in the complex process of immune regulation in health and disease. Because of their strategic perivascular localization, sensitivity and adaptability to the microenvironment, and ability to release a variety of preformed and newly synthesized effector molecules, mast cells perform unique functions in almost all organs. Additionally, Mast cells express a wide range of surface and cytoplasmic receptors which enable them to respond to a variety of cytokines, chemicals, and pathogens. The mast cell’s role as a cellular interface between external and internal environments as well as between vasculature and tissues is critical for protection and repair. Mast cell interactions with different immune and nonimmune cells through secreted inflammatory mediators may also turn in favor of disease promoting agents. First and forefront, mast cells are well recognized for their multifaceted functions in allergic diseases. Reciprocal communication between mast cells and endothelial cells in the presence of bacterial toxins in chronic/sub-clinical infections induce persistent vascular inflammation. We have shown that mast cell proteases and histamine induce endothelial inflammatory responses that are synergistically amplified by bacterial toxins. Mast cells have been shown to exacerbate vascular changes in normal states as well as in chronic or subclinical infections, particularly among cigarette smokers. Furthermore, a potential role of mast cells in SARS-CoV-2-induced dysfunction of the capillary-alveolar interface adds to the growing understanding of mast cells in viral infections. The interaction between mast cells and microglial cells in the brain further highlights their significance in neuroinflammation. This review highlights the significant role of mast cells as the interface that acts as sensor and early responder through interactions with cells in systemic organs and the nervous system.

Abstract Quantum flatland i.e., the family of two dimensional (2D) quantum materials has become increscent and has already encompassed elemental atomic sheets (Xenes), 2D transition metal dichalcogenides (TMDCs), 2D metal nitrides/carbides/carbonitrides (MXenes), 2D metal oxides, 2D metal phosphides, 2D metal halides, 2D mixed oxides, etc. and still new members are being explored. Owing to the occurrence of various structural phases of each 2D material and each exhibiting a unique electronic structure; bestows distinct physical and chemical properties. In the early years, world record electronic mobility and fractional quantum Hall effect of graphene attracted attention. Thanks to excellent electronic mobility, and extreme sensitivity of their electronic structures towards the adjacent environment, 2D materials have been employed as various ultrafast precision sensors such as gas/fire/light/strain sensors and in trace-level molecular detectors and disease diagnosis. 2D materials, their doped versions, and their hetero layers and hybrids have been successfully employed in electronic/photonic/optoelectronic/spintronic and straintronic chips. In recent times, quantum behavior such as the existence of a superconducting phase in moiré hetero layers, the feasibility of hyperbolic photonic metamaterials, mechanical metamaterials with negative Poisson ratio, and potential usage in second/third harmonic generation and electromagnetic shields, etc. have raised the expectations further. High surface area, excellent young’s moduli, and anchoring/coupling capability bolster hopes for their usage as nanofillers in polymers, glass, and soft metals. Even though lab-scale demonstrations have been showcased, large-scale applications such as solar cells, LEDs, flat panel displays, hybrid energy storage, catalysis (including water splitting and CO2 reduction), etc. will catch up. While new members of the flatland family will be invented, new methods of large-scale synthesis of defect-free crystals will be explored and novel applications will emerge, it is expected. Achieving a high level of in-plane doping in 2D materials without adding defects is a challenge to work on. Development of understanding of inter-layer coupling and its effects on electron injection/excited state electron transfer at the 2D-2D interfaces will lead to future generation heterolayer devices and sensors.

Overactivated NLRP3 inflammasome has been shown to associate with an increasing number of disease conditions. Activation of the NLRP3 inflammasome results in caspase-1-catalyzed formation of active pro-inflammatory cytokines (IL-1β and IL-18) resulting in pyroptosis. The multi-protein composition of the NLRP3 inflammasome and its sensitivity to several damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) make this extensively studied inflammasome an attractive target to treat chronic conditions. However, none of the known NLRP3 inhibitors has been approved for clinical use. Sulfonylurea and covalent inhibitors with electrophilic warhead (Michael acceptor) are among the prominent classes of compounds explored for their NLRP3 inhibitory effects. Chalcone, a small molecule with α, β unsaturated carbonyl group (Michael acceptor), has also been studied as a promising scaffold for the development of NLRP3 inhibitors. Low molecular weight, easy to manipulate lipophilicity and cost-effectiveness have attracted many to use chalcone scaffold for drug development. In this review, we highlight chalcone derivatives with NLRP3 inflammasome inhibitory activities. Recent developments and potential new directions summarized here will, hopefully, serve as valuable perspectives for investigators including medicinal chemists and drug discovery researchers to utilize chalcone as a scaffold for developing novel NLRP3 inflammasome inhibitors.

Background. Body balance is among the most important aspects for achieving athletic excellence in competitive sports. Body balance helps in the development of proper body posture control, which supports high performance and skill demonstration across all sports. Body balance is known to be positively correlated to competitive athletic performance. In sports, good balance implies moving more efficiently and with better body control. Yoga is one of the means of improving body balance, and it has also been linked to enhancing athletic performance. Vinyasa yoga is a powerful method that targets the entire body. Navigate challenging poses to improve your strength, flexibility, and balance, especially if you want to target muscle groups that aren’t used in your preferred sport. The focus of this study. To analyse the efficacy of a 6-week Vinyasa Yoga Training Programme (VYTP) in improving dynamic body balance of male national level yoga players. Materials and methods. Twenty male national level yoga players (18-25 years) from the Lakshmibai National Institute of Physical Education, Gwalior, India, participated in the study. The participants were then randomly allocated into two groups, one experimental (Vinyasa) and the other control. The Sensbalance machine was used to measure the dynamic body balance. Results. ANCOVA indicates a significant difference in the selected variable of dynamic body balance in the experimental group compared to the control group. When compared to the control group which did not receive any training, the post-test found that the experimental yoga group significantly improved in dynamic body balance. Conclusions. VTYP was found to be helpful in enhancing dynamic body balance. In the current study after six weeks of vinyasa training it was observed that the male national yoga players had a substantial difference in dynamic body balance compared to the control group.

Introduction: Burn patients are vulnerable for opportunistic colonization by organisms of endogenous and exogenous origin. Hence, it is necessary to evaluate the flora obtained from wounds of burn patients to determine the most effective treatment. The aim of this study was to determine the incidence of various bacteria isolated from burn patients and to determine their antimicrobial susceptibility and resistance pattern spanning 7 years. Materials and Methods: The retrospective study included all the culture reports obtained over a period of 7 years (2012–2018). Results: Out of the total 1474 positive samples analyzed, the most common sample reported was pus (n = 816), followed by blood culture (n = 314), tissue (n = 188), and urine (n = 156). The most common organism cultured was Pseudomonas aeruginosa (n = 377), followed by Klebsiella pneumoniae (n = 309). Other commonly isolated organisms were Acinetobacter baumannii (n = 206), Escherichia coli (n = 89), coagulase-negative staphylococci (n = 88), Proteus mirabilis (n = 55), Burkholderia cepacia (n = 54), Staphylococcus aureus (n = 42), Candida spp. (n = 39), and Enterococci spp. (n = 36). Pseudomonas was seen to be sensitive to only colistin with resistance to all other major antibiotic classes. Klebsiella was sensitive to colistin, tigecycline, and cefoperazone/sulbactam. A. baumannii was observed to be sensitive only to colistin and tigecycline by the end of 2018 and E. coli was sensitive to amikacin, colistin, meropenem, and tigecycline. Conclusion: Antibiotic resistance is rampant, rapidly progressing and devouring down all the antibiotic classes one after other. The high antimicrobial resistance may be ascribed to the inappropriate use of broad-spectrum antibiotics and lack of a definite antibiotic policy in hospitals. Treating surgeons should frequently evaluate the burn patient and run regular tests to localize the most common organisms causing the infections with their antibiotic sensitivity profiles.

Context: Periodontal diseases negatively influence people's oral health-related quality of life (OHRQoL) and despite advancements; still disparity exists among urban and rural dwellers. OHRQoL helps in a better understanding of subjective perception ensuring a better treatment plan that fits the patient's needs and concerns. Aims and Objectives: (1) To record the periodontal status of urban and rural populations of Moradabad using WHO pro forma 2013. (2) To assess and compare the OHRQoL using the oral health impact profile-14 (OHIP-14). Subjects and Methods: A cross-sectional study was conducted among the rural (350) and urban (350) population of Moradabad aged 35–44 years, chosen from the outpatient department of Teerthanker Mahaveer Dental College and Hospital. The WHO oral health assessment form for adults (2013) was used to assess the periodontal status and OHIP-14 was used for assessing OHRQoL. Statistical Analysis Used: SPSS version 19.0 was used for statistical analysis. Chi-square, Student's t-test, and multiple logistic regression analysis were employed for statistical analysis. Results: The prevalence of loss of attachment (LOA) (93.20%), presence of pocket (76.0%), and bleeding on probing (BOP) (74.0%) was significantly higher among the rural population. The mean OHIP scores were significantly higher for the rural population as compared to urban counterparts. Among the study population, OHIP 14 was significantly (P ≤ 0.05) associated with age, gender, socioeconomic status, location, and periodontal parameters (LOA, Pocket, and BOP). Conclusions: The study shows that there is a significant association between periodontal status and OHRQoL. Rural individuals had a greater impact on OHRQoL than their urban counterpart. Strategies should be planned and implemented to minimize the disparity.

Objective: To assess the effects of Manuka honey, Ocimum sanctum, Curcuma longa, and 0.2% chlorhexidine mouthwash on Streptococcus mutans and Lactobacillus acidophilus levels. Material and Methods: A randomized controlled trial will be conducted on dental students of Teerthanker Mahaveer Dental College and Research Centre, Moradabad. The study participants will be divided into four groups. Each group will have a total of 20 individuals. By using a lottery system, Group A (Manuka honey mouthrinse), Group B (Ocimum sanctum mouthrinse), Group C (Curcuma longa mouthrinse), and Group D (0.2% chlorhexidine mouthrinse) will be chosen. To match the circadian cycle, saliva will be collected at baseline and again after 2 weeks between 10 and 10.30 a.m. The sterile container will subsequently be delivered to the microbiological laboratory and processed as soon as possible to measure Streptococcus mutans and Lactobacillus acidophilus count. For 2 weeks, participants were told to use 10 mL of mouthrinse twice daily. Results: The mean oral hygiene index-simplified (OHI-S) score of all the four groups showed reduction in their scores from baseline to after the study period. For both S. mutans and L. acidophilus, there was a substantial Percentage Reduction (PR) between the prerinse and postrinse samples in all four groups. Discussion: Because quantitative actions play a crucial part in the caries disease process, the changes in microbial activity before and after administration of experimental mouthwashes were examined. Conclusion: Essential oil aqueous extracts were as efficient antibacterial mouthwashes as chlorhexidine and iodine mouthwashes.

Accurate parameter identification plays an integral role in the modeling of an optimized solar module which in turn helps in the error-free prediction of its output. Five important parameters: the photoelectric current (Iph), ideality factor(α), saturation current (Io), series resistance (Rs), and shunt resistance (Rsh) are required for the accurate modeling of the PV cells/modules and need to be extracted as these parameters are not provided by the manufacturer in the datasheet. This paper proposes a new metaheuristic jellyfish optimization (JFO) algorithm for the parameter extraction of a solar module. The JFO algorithm achieves the optimal solution without being trapped in local solutions in less time. The parameter extraction using the JFO algorithm is done on two different solar modules i.e., Soltech-1STH-215P and PWP-201. The results are compared in terms of extracted parameters (Iph, α, Io, Rs, and Rsh) with the well-known optimization techniques like PSO, GA, and others available in the literature and with the manufacturer I–V and P–V characteristics. The proposed technique I–V and P–V characteristics are validated at different environmental conditions and are found to be similar to that of PSO and GA. It is also observed that the extracted parameters obtained using JFO are comparable with the other twenty-two techniques, and the proposed technique is one of the highly efficient techniques that can be utilized for parameter extraction of PV modules and to predict solar cell characteristics for all commercial modules without setting up any experimental measurements. MATLAB/simulation software is used for implementation and performance validation.

Having psychological advantage that enables athletes to perform at their best regardless of challenges and adversity is what is meant by having mental toughness (MT). In order to better understand the mental toughness of elite Indian standing and sitting para-thrower athletes, this study looked at a variety of mental sub-scales. Elite para-throwers who competed at the international level, consider making up the sample of the current study; which includes a total of nine elite para-throwers [5 Standing Para-throwers (StPT) and 4 Seated Para-throwers (SePT)]. The researcher used the Psychological Performance Inventory (PPI), designed by Loehr, and the Personal Demographic Information form to gather data in order to ascertain the participants’ attitudes of mental toughness. An independent T-test with 0.05 significance level was performed for the research’s findings, there are no statistical significant difference between the two groups’ levels of motivation, self-confidence, ability to control negative energy, attention, visualisation, ability to control positive energy, and attitude control factors of MT. Elite Indian para-thrower athletes’ mental toughness is similar in both groups, with no discernible differences.

Few studies have looked at the psychological mechanisms that govern soccer officials’ performance to this point. The main goal of the study is to identify age-related changes in mental toughness among officials. Sixty active national officials were chosen at random from the All-India Football Federation’s national officials’ roster (AIFF). Group A is 25-30 years old, with a mean and SD of 27.4±3.39 (lower age group); Group B is 31-35 years old, with a mean and SD of 31.8±1.28 (middle age group); and Group C is 36-40 years old, with a mean and SD of 37.6±1.98 (higher age group). The Psychological Performance Inventory (PPI), developed by James E. Loehr in 1982, was chosen as the research’s test item. This instrument evaluates seven aspects of mental toughness, including self-confidence, negative energy control, attention control, visualisation and imagery control, motivation, positive energy control, and attitude control. One-way analysis of variance (ANOVA), with a significance threshold of 0.05, was used as the statistical approach to assess the study’s hypothesis. The finding of the research paper shows no significant difference among various groups.

When tracking the peak power point in PV systems, incremental conductance is the most common technique used. This approach preserves the first trap in the local peak power point, but it is unable to quickly keep up with the ever-changing peak power point under varying irradiance and temperature conditions. In this paper, the authors propose a hybrid algorithm, combining an artificial ecosystem optimizer and an incremental-conductance-based MPPT to solve these issues of traditional MPPT under varying irradiance and temperature conditions. The proposed hybrid algorithm has been applied to three scenarios, namely the constant irradiance condition, the varying irradiance condition, and the varying temperature condition. Under the constant irradiance condition, the PV array is maintained at a temperature of 25 °C and an irradiance of 1000 W/m2. The voltage of the DC link of the neutral-pointed-clamped inverter is maintained at 1000 V. Under the varying irradiance condition, the irradiance of the PV array is increased from 400 W/m2 to 1000 W/m2with a step size of 0.2 s. The same step size is maintained while decreasing the irradiance level from 1000 W/m2 to 400 W/m2, with a step change of 0.2 s. However, the temperature is maintained at 25 °C. Under the varying temperature condition, the temperature of the PV array varies from 35 °C, 25 °C, 15 °C, 10 °C, 15 °C, 25 °C, and 35 °C with a step size of 0.2 s, and the irradiance is maintained at 1000 W/m2. The DC link voltage in all three conditions is maintained at 1000 V, which confirms that the hybrid algorithm has been able to vary the duty cycle of the pulse wave modulation generator in such a manner that the variable DC voltage produced by the PV array has been changed by the flyback converter into a stable DC voltage. The simulation results show that the total harmonic distortion (THD) under all the simulated scenarios is within 5%, which agrees with IEEE standards. In the future, this algorithm may be compared with other types of available MPPTs under partial shading.

Inspection data can be used to comprehend and plan effective maintenance of bridges. In particular, the year of initial construction is one of the most important criteria for formulating maintenance plans, making budget allocations, and estimating soundness. In an initial survey of bridges in Cambodia, it was concluded that the year of construction of only 54% of 2439 bridges surveyed is known, with the remaining 46% remaining unknown. In this research, Landsat satellite data is used to estimate the year of construction of these bridges. Landsat provides spatial spectral reflectance information covering more than 30 years, and for longer bridges this can be used to estimate the year of construction by visual judgement. However, limited image resolution means this is not possible for shorter bridges. Instead, a method using the Landsat Normalized Difference Water Index (NDWI) is used to estimate the year of construction. Three pixels are selected from Landsat image data in such a way that one lies on the current location of a bridge and two other reference pixels are placed on similar terrain at a certain distance perpendicular to the bridge axis. NDWI values are plotted over time for the three pixels and the difference in value between the bridge pixel and the two reference pixels is then compared. Before the bridge is constructed, all three pixels should have similar NDWI values, but after construction the value of the target bridge pixel should differ from the other two because the NDWI value of a bridge surface is different from that of the surrounding vegetation. By looking for this change, the year of construction of a bridge can be estimated. All the bridges in the Cambodian database are classified into three categories based on length (which affects their visibility in Landsat images) and year of construction is estimated. The results show that estimated year of construction has the same accuracy in all three categories.

The efficiency of the low-cost renewable energy source i.e. solar is very poor due to inadequate extraction of maximum power. By employing the proper maximum power point tracking algorithm, the efficiency can be increased. An innovative adaptive backstepping neural network controller is proposed in this paper to extract the maximum power from the solar panels by tracking the desired photovoltaic array voltage in real-time. The maximum power is extracted indirectly by tuning the PV voltage to the desired PV voltage where the maximum power is attained at the desired PV voltage point. The desired photovoltaic array voltage is obtained from the linear regression method. The change in photovoltaic current caused by varying irradiance and temperature is approximated using the Chebyshev polynomials. The quicker steady-state and transient responses are accomplished and the computational burden of the photovoltaic system control law is reduced because of the orthogonal property of Chebyshev polynomials. The asymptotically stable system is obtained by tuning the weights of the neurons in accordance with the Lyapunov stability analysis. Also, Lyapunov control function of the backstepping control design procedure finds a control law by an innovative cubic equation interpretation, instead of resolving the first derivative of the control law, that diminishes the ripples in the duty cycle to make its appropriateness in real-time. A prototype is developed to validate the robustness of this controller in maximum power extraction at a faster time and the results confirm that adaptive backstepping neural network controller surpasses the performances of conventional backstepping controller and constant voltage PID controller.

Aim: The aim of this study was to compare audio-visual and verbal education on oral health related quality of life, dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad. Materials and Method: The current longitudinal interventional study was conducted to check the efficiency of audio-visual and verbal education on OHRQoL, Dental anxiety and dental neglect, on diabetes mellitus patients attending Teerthanker Mahaveer Hospital, Moradabad, U.P., India. A 14-item questionnaire, OHIP-14, with emphasis on seven proportions of impact was used to collect information on OHRQoL. Corah Dental Anxiety Scale (DAS) will be used to collect data on Dental Anxiety. A prevalidated revised proforma of Dental Neglect Scale (DNS) was used to gather information on Dental Neglect. The questionnaire was a six-question instrument related to dental problems. After collecting the initial baseline data, the sample was divided into two groups: verbal education group (n = 1030) and audio-visual education group (n = 1030). Then oral health education (OHE) was provided verbally to Group I patients and OHE with audio-visual aids was given to Group II patients visiting Teerthanker Mahaveer Hospital. OHE was repeated every 2 months. At every 6, 12 and 18 months, questionnaire was repeated to evaluate the effectiveness of OHE. Inspection will be conducted under natural daylight in hospital premises. To avoid the disruption while conducting the examination, adequate supply of instruments was taken. Instruments were sterilized by autoclaving in the college. Results: A total of 1926 patients attended all the follow-up and review examinations. Subject dropout for Group I was 2% with 1009 at 6th month; 3% with 978 at 12th month and 1% with 967 at 18th month. Subject dropout rate for Group II was 3% with 999 at 6th month; 0% with 999 at 12th month and 4% with 959 at 18th month. The difference of subject dropout among the groups was not statistically significant (P = 0.23). Group mean total OHIP-14 score after 18 months was recorded as 15.36 ± 8.61, whereas in Audio-visual education group mean total OHIP-14 score after 18 months was recorded as 14.42 ± 7.59. At the end of study mean DAS score for DAS ≥15 (severe anxiety) was found to be 1.95 ± 2.18 in verbal education group, whereas in audio-visual education group mean DAS score for DAS ≥15 (severe anxiety) was found to be 2.24 ± 1.98. At the end of the study mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 3.54 ± 2.63 in verbal education group, whereas audiovisual education group mean DN score for DNS ≥15 (severe Dental Neglect) was found to be 2.59 ± 2.75. Conclusion: The quality of life is a factor that can be considerably affected by oral health, which in turn reflects the general health of an individual. The main part of oral disease prevention is done by use of personal oral hygiene measures and maintaining oral hygiene. It is the duty of dental professionals to motivate, show and instruct patients to maintain appropriate oral health and oral hygiene. The study concludes that the program of this kind may be beneficial in improving many dimensions of dental health of an individual that includes physical health, emotional well-being, OHRQoL, inter-personal relationship and the fear related to dental treatment.

Intraoperative imaging has become one of the most important adjuncts in neurosurgery, especially in the surgical treatment of intra-axial tumors. Navigation and intraoperative magnetic resonance imaging have limitations, and intraoperative ultrasonography (IOUS) has emerged as a versatile and multifaceted alternative. With technological advances in ultrasound scanners and newer multifunctional probes, the potential of IOUS is increasingly being utilized in the resection of tumors. The addition of image guidance to IOUS has exponentially increased the power of this technique. Navigated ultrasonography (nUS) can now overcome many of the limitations of conventional standalone two-dimensional ultrasonography. In this pictorial essay, we outline our nUS technique (both two- and three-dimensional) for the resection of intra-axial tumors with illustrated examples highlighting the various steps and corresponding benefits of the technique.

Introduction: It is a standard practice to cover the burn wounds with skin grafts at the earliest. Deficiency of donor skin seriously limits timely cover of extensive burns. Studies have shown that these autologous cells enhance the wound-healing process by reducing the time needed for the host cells to invade the wound tissue and by early synthesis of new skin this technique of enzymatically digesting small skin grafts, centrifuging the suspended cells and spraying the epidermal cells over burn raw areas may allow early healing. Aims and Objective: The aim of this study is to assess feasibility and role of epidermal cell suspension as wound cover in burns. Materials and Methods: This study was conducted at the burn center of a tertiary Hospital in India over a period of 1 year. Patients with postburn raw areas were included. Similar size two sites were identified in the patients. On one site cell suspension was applied, while other areas were managed with conventional dressings. Small piece of split-skin graft (SSG) was used to make cell suspension. Under anesthesia, required size of SSG was harvested from healthy donor site. Trypsinization of graft was done; epidermis was separated from the dermis. The epidermis was cut into tiny pieces, and patient's serum was added and centrifuged. Epidermal cell suspension was made, and viability of cells is confirmed using an inverted microscope. Meanwhile, the wound is thoroughly cleaned by soda bicarbonate solution. The freshly prepared keratinocytes suspension was applied on day 1, 3, and 5. Similar standard dressing protocol was followed on the control side. Wound assessment was done based on the percentage of reepithelization on the 7th and 14th day. Results: Twenty-eight patients (18 males and 10 females with a mean age of 34 years) were included the study. Cell suspension was sprayed on 4735 cm2 area. Wound size reduced to 2247 cm2 and 923 cm2 on the 10th and 14th day, respectively. While, at control site wound reduced to 3882 cm2 and 2134 cm2 on the 7th and 14th day, respectively. The difference in cell suspension and control treated area was found to be significant. Conclusion: Keratinocytes cell suspension is feasible in burns and improves the healing of wounds. However, larger studies are required to standardize and validate its use in major burns.

This case report describes glomus tumor of the stomach, a rare entity, which is a mesenchymal origin tumor. They are generally benign and account for nearly 1% of all gastrointestinal (GI) soft-tissue tumors. They are almost impossible to diagnose preoperatively because of the lack of specific characteristics and are often mistaken for GI stromal tumors (GISTs). In our hospital setup, a female aged 24 years, presented with right lumbar abdominal pain which after a thorough workup leads to the preoperative diagnosis of GIST, and distal gastrectomy with Roux-en-y anastomosis was done. However, pathological and immunohistochemical findings done after the surgery were found consistent with the diagnosis of gastric glomus tumor. Discovered on GIST-1 (DOG-1) nonreactivity is considered for the diagnosis of glomus tumor which helps in excluding the diagnosis of GIST, which is positive for DOG-1. Hence, it was concluded that differential diagnosis on the basis of immunohistochemical findings can lead to an accurate preoperative diagnosis and further targeted surgical intervention.

This article investigates the performance of serial-parallel (SP) configuration of photovoltaic (PV) array under artificial arrangement for partial shading conditions (PSCs). The concept of bypass diode (BPD) is a very attractive solution to reduce the shading effect on the PV module and therefore gives better performance in such shading environment types. Various bypass diode integration (BPD) placement topologies with the solar photovoltaic (PV) modules are being investigated to demonstrate the improved performance under PSCs in the current work. The sixteen PV modules arranged in SP configuration are associated with the BPD Topologies such as (a) Without bypass diode (W–BPD) (b), Single string- single bypass diode (SS–SBPD) (c) Single string- double bypass diode (SS–DBPD) (d) Series group- bypass diode (G–BPD) (e) Staggered group- bypass diode (SG–BPD) (f) Multi level-octal bypass diode (ML–OBPD) for performance investigation. The performance assessment for all PV array supported by BPD topologies has been investigated using current–voltage (I–V) and power–voltage (P–V) characteristics and comparing to show better power and voltage results at global maximum power point (GMPP), improved fill factor and minimized power losses etc. The results presented may be recommended for the appropriate PV array configuration interconnection of BPD. Overall, this article reports that the ML–OBPD based SP configured PV array is superior among the BPD topologies under the considered PSTCs.

This global study, which has been coordinated by the World Meteorological Organization Global Atmospheric Watch (WMO/GAW) programme, aims to understand the behaviour of key air pollutant species during the COVID-19 pandemic period of exceptionally low emissions across the globe. We investigated the effects of the differences in both emissions and regional and local meteorology in 2020 compared with the period 2015–2019. By adopting a globally consistent approach, this comprehensive observational analysis focuses on changes in air quality in and around cities across the globe for the following air pollutants PM2.5, PM10, PMC (coarse fraction of PM), NO2, SO2, NOx, CO, O3 and the total gaseous oxidant (OX = NO2 + O3) during the pre-lockdown, partial lockdown, full lockdown and two relaxation periods spanning from January to September 2020. The analysis is based on in situ ground-based air quality observations at over 540 traffic, background and rural stations, from 63 cities and covering 25 countries over seven geographical regions of the world. Anomalies in the air pollutant concentrations (increases or decreases during 2020 periods compared to equivalent 2015–2019 periods) were calculated and the possible effects of meteorological conditions were analysed by computing anomalies from ERA5 reanalyses and local observations for these periods. We observed a positive correlation between the reductions in NO2 and NOx concentrations and peoples’ mobility for most cities. A correlation between PMC and mobility changes was also seen for some Asian and South American cities. A clear signal was not observed for other pollutants, suggesting that sources besides vehicular emissions also substantially contributed to the change in air quality.As a global and regional overview of the changes in ambient concentrations of key air quality species, we observed decreases of up to about 70% in mean NO2 and between 30% and 40% in mean PM2.5 concentrations over 2020 full lockdown compared to the same period in 2015–2019. However, PM2.5 exhibited complex signals, even within the same region, with increases in some Spanish cities, attributed mainly to the long-range transport of African dust and/or biomass burning (corroborated with the analysis of NO2/CO ratio). Some Chinese cities showed similar increases in PM2.5 during the lockdown periods, but in this case, it was likely due to secondary PM formation. Changes in O3 concentrations were highly heterogeneous, with no overall change or small increases (as in the case of Europe), and positive anomalies of 25% and 30% in East Asia and South America, respectively, with Colombia showing the largest positive anomaly of ~70%. The SO2 anomalies were negative for 2020 compared to 2015–2019 (between ~25 to 60%) for all regions. For CO, negative anomalies were observed for all regions with the largest decrease for South America of up to ~40%. The NO2/CO ratio indicated that specific sites (such as those in Spanish cities) were affected by biomass burning plumes, which outweighed the NO2 decrease due to the general reduction in mobility (ratio of ~60%). Analysis of the total oxidant (OX = NO2 + O3) showed that primary NO2 emissions at urban locations were greater than the O3 production, whereas at background sites, OX was mostly driven by the regional contributions rather than local NO2 and O3 concentrations. The present study clearly highlights the importance of meteorology and episodic contributions (e.g., from dust, domestic, agricultural biomass burning and crop fertilizing) when analysing air quality in and around cities even during large emissions reductions. There is still the need to better understand how the chemical responses of secondary pollutants to emission change under complex meteorological conditions, along with climate change and socio-economic drivers may affect future air quality. The implications for regional and global policies are also significant, as our study clearly indicates that PM2.5 concentrations would not likely meet the World Health Organization guidelines in many parts of the world, despite the drastic reductions in mobility. Consequently, revisions of air quality regulation (e.g., the Gothenburg Protocol) with more ambitious targets that are specific to the different regions of the world may well be required.

Pre-operative optimization of cardiovascular conditions in patients awaiting renal transplantation significantly improves post-transplantation cardiac complications. We describe a case of symptomatic coronary fistula treated with percutaneous coil embolization in a young adult awaiting renal transplantation. (Level of Difficulty: Advanced.)

Nutritionally rich cucumber seeds remain in demand in the agricultural, health and cosmetic sectors as they are essential for a successful crop stand establishment and seed-based products. However, the production of cucumber seeds is impeded by source limitation and nutrient deficiency. The foliar application of micronutrients can supplement this deficiency and overcome the physiological setback. An experiment was undertaken to compare the impacts of the foliar application of Fe and Zn, as nanoparticles and fertilizers, on the yield and seed quality of cucumber under open and protected environments. A foliar spray of nano-ZnO (ZnNPs) and nano-Fe3O4 (FeNPs) at 100, 200 and 300 mg L−1, as well as ZnSO4 and FeSO4 as fertilizer (0.5%), was conducted at the vegetative stage and pre- and post-flowering stages. The NPs had a greater efficacy in an open field than in the protected (naturally ventilated poly house) environment. The application of both NPs increased seed yield (51.7–52.2%), total chlorophyll content (15.9–17.3%) and concentration of Zn and Fe in the fruit and the seed, by 2.0–58.5% and 5.0–30.5%, respectively. A significant increase in starch, soluble proteins, soluble sugars and oil content was observed in the seeds from the NP treated plants. NP treatment also enhanced the germination-related parameters, such as percent germination (16.8–17.0%), rate of germination (18.0–22.2%) and seedling vigor (59.8–72.6%). The biochemical characterization showed a significant improvement in the seed water uptake and the activity of hydrolytic enzymes (amylase and protease) in the germinating seed. The involvement of reactive oxygen species (superoxide anion and hydrogen peroxide) and antioxidant enzymes (Superoxide dismutase, Catalase and Peroxidase) in the germination process was indicated by an increase in their activities in the seeds from NP treated plants. Hence, the study proposes the potential benefit of the foliar application of 300 mg L−1 ZnNPs and 200 mg L−1 FeNPs at crucial stages of plant growth to improve the yield and seed quality in cucumbers.

Purpose The purpose of this study was to evaluate the relative utility and benefits of free-hand 2-dimensional intraoperative ultrasound (FUS) and navigated 3-dimensional intraoperative ultrasound (NUS) as ultrasound-guided biopsy (USGB) techniques for supratentorial lesions. Methods All patients who underwent USGB for suspected supratentorial tumours from January 2008 to December 2017 were retrospectively analyzed. The charts and electronic medical records of these patients were studied. Demographic, surgical, and pathological variables were collected and analyzed. The study group consisted of patients who underwent either FUS or NUS for biopsy. Results A total of 125 patients (112 adults and 13 children) underwent USGB during the study period (89 FUS and 36 NUS). NUS was used more often for deep-seated lesions (58% vs. 18% for FUS, P

Furosemide (FSM) is commonly used in the treatment of edema associated with congestive cardiac failure, cirrhosis of the liver, renal disease, including the nephrotic syndrome and hypertension. However, in ascites, it is clinically limited due to its frequent dosing and short biological half-life and its prolonged-release preparations are not available. Therefore, the main objective behind the present research work is to develop chitosan coated and conjugated poly (lactic-co-glycolic acid) (PLGA) nanocarriers, to sustain the delivery of FSM with improved systemic circulation. Emulsion-solvent evaporation technique was used for the preparation of nanoparticles. In-vivo pharmacokinetic study showed 2.6, 3.10, and 4.30 folds enhancement in relative availability of FSM for FSM-PLGA, FSM-chitosan-coated-PLGA and FSM-chitosan-conjugated- PLGA nanoparticles, respectively than FSM. The present research work concluded that FSM loaded chitosan conjugated PLGA nanoparticles could enhance the systemic circulation of FSM with improved pharmacokinetics parameters.

Objective: Transaxillary approach for the surgical management of thoracic outlet syndrome (TOS) has the advantage of minimal manipulation of brachial plexus and lesser perioperative and postoperative complications. We studied the clinical presentation and transaxillary surgical excision of the first rib in TOS at our center. Materials and Methods: All patients with TOS were reviewed for their clinical presentation and outcomes of transaxillary approach for thoracic outlet decompression over a period of 10 years. We evaluated the clinical presentation, surgical details, and postoperative course of all patients who underwent surgery. Results: Sixty-three patients of TOS were studied who underwent decompression through transaxillary approach over a period of 10 years. Nearly 79.4% of the patients had neurological symptoms, whereas 20.6% had arterial symptoms. Almost all patients (98.4%) had a cervical rib. One-fourth of the study population had bilateral cervical ribs. Around 17.46% of the patients presented with acute thromboembolism of the brachial artery and were managed with emergency thromboembolectomy. Postoperative complications encountered were pleural breach (11.11%), wound infection (7.94%), and re-thrombosis (1.59%). Conclusions: Transaxillary resection of the cervical/ first rib has excellent results, with less morbidity. It is efficient in relieving symptoms and gives cosmetically acceptable scar. It is proposed that whenever any patient presents with acute upper-limb ischemia, he/she must be evaluated for cervical rib as a cause of TOS.

The World Health Organization has declared the COVID-19 pandemic a global public health emergency. Many countries of the world, including India, closed their borders and imposed a nationwide lockdown. In India, the lockdown was declared on March 24 for 21 days (March 25–April 14, 2020) and was later extended until May 3, 2020. During the lockdown, all major anthropogenic activities, which contribute to atmospheric pollution (such as industries, vehicles, and businesses), were restricted. The current study examines the impact of the lockdown on tropospheric NO2 concentrations. Satellite-based ozone monitoring instrument sensor data were analyzed in order to investigate the variations in tropospheric NO2 concentrations. The results showed that from March 1 to 21, 2020, the average tropospheric NO2 concentration was 214.4 ×1013 molecule cm−2 over India, and it subsequently decreased by 12.1% over the next four weeks. An increase of 0.8% in tropospheric NO2 concentrations was observed for the same period in 2019 and hence, the reduced tropospheric NO2 concentrations can be attributed to restricted anthropogenic activities during the lockdown. In the absence of significant activities, the contribution of various sources was estimated, and the emissions from biomass burning were identified as a major source of tropospheric NO2 during the lockdown. The findings of this study provide an opportunity to understand the mechanism of tropospheric NO2 emissions over India, in order to improve air quality modeling and management strategies.

Background: Right ventricular function (RVF) is an independent predictor of prognosis for patients undergoing aortic valve replacement: transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). The effect of transfemoral aortic valve replacement (TF-TAVR) on RVF is uncertain. We aimed to perform a meta-analysis of the effect of TF-TAVR on RVF in patients with aortic stenosis (AS) and compare the effect of TF-TAVR with SAVR. Methods: We searched relevant studies from PubMed, Embase, Cochrane Library databases, and Web of Science. Furthermore, two reviewers (Wang AQ and Cao YS) extracted all relevant data, which were then double checked by another two reviewers (Zhang M and Qi GM). We used the forest plot to present results. Tricuspid annular plane systolic excursion (TAPSE) was the primary outcome. Results: This meta-analysis included 11 studies. There were 353 patients who underwent TF-TAVR, and 358 patients who were subjected to SAVR. There was no significant difference in TAPSE at 1 week and 6 months as well as right ventricular ejection fraction (RVEF) at

Background: Suicide rates are on the rise globally. Many suicide completers are previous attempters. Risk identification of attempters will provide an opportunity for prompt and targeted intervention towards suicide prevention. The aim of this study was to determine the incidence of suicide attempt and self-inflicted injury (SASI), and its associations with deployment-related PTSD and/or TBI and attempted suicide among a large national cohort of Veterans deployed pre and post-9/11 2001 who received care from the Veterans Health Administration (VHA) between 1998 - 2014. Methods: Clinical data from over 1,400 VHA establishments provided by the Veterans Administrations Informatics and Computing Infrastructure (VINCI) were used for descriptive and Cox regression analyses. Results: There were 1,327,604 patients in the study - PTSD only (1,121,818), TBI only (100,033), both PTSD and TBI (105,753). The incidence of SASI in the entire cohort was 351 per 100,000 person years; PTSD only (323), TBI only (181), both PTSD and TBI (835). Compared to TBI only group, the adjusted risk for SASI was higher in the PTSD only group (HR=1.129; 95% CI =1.063 - 1.200) and much higher in those with both PTSD and TBI (HR=2.283; 95% CI =2.136 - 2.441). The risk of SASI was higher if they were younger than 50 years, divorced or separated, non-Hispanic females, homeless, suffered adult abuse and neglect, had substance use, generalized anxiety and antisocial personality disorders, and if they were in the Pre-9/11 service period. Proportion of people attempting suicide increased every year post-diagnosis of PTSD and/or TBI. Conclusion: We recommend prioritizing resources to prevent suicide among at risk groups.

Hyperfiltration is an important underlying cause of glomerular dysfunction associated with several systemic and intrinsic glomerular conditions leading to chronic kidney disease (CKD). These include obesity, diabetes, hypertension, focal segmental glomerulosclerosis (FSGS), congenital abnormalities and reduced renal mass (low nephron number). Hyperfiltration-associated biomechanical forces directly impact the cell membrane, generating tensile and fluid flow shear stresses in multiple segments of the nephron. Ongoing research suggests these biomechanical forces as the initial mediators of hyperfiltration-induced deterioration of podocyte structure and function leading to their detachment and irreplaceable loss from the glomerular filtration barrier. Membrane lipid-derived polyunsaturated fatty acids (PUFA) and their metabolites are potent transducers of biomechanical stress from the cell surface to intracellular compartments. Omega-6 and ω-3 long-chain PUFA from membrane phospholipids generate many versatile and autacoid oxylipins that modulate pro-inflammatory as well as anti-inflammatory autocrine and paracrine signaling. We advance the idea that lipid signaling molecules, related enzymes, metabolites and receptors are not just mediators of cellular stress but also potential targets for developing novel interventions. With the growing emphasis on lifestyle changes for wellness, dietary fatty acids are potential adjunct-therapeutics to minimize/treat hyperfiltration-induced progressive glomerular damage and CKD.

Plants have evolved several adaptive strategies through physiological changes in response to herbivore attacks. Plant secondary metabolites (PSMs) are synthesized to provide defensive functions and regulate defense signaling pathways to safeguard plants against herbivores. Herbivore injury initiates complex reactions which ultimately lead to synthesis and accumulation of PSMs. The biosynthesis of these metabolites is regulated by the interplay of signaling molecules comprising phytohormones. Plant volatile metabolites are released upon herbivore attack and are capable of directly inducing or priming hormonal defense signaling pathways. Secondary metabolites enable plants to quickly detect herbivore attacks and respond in a timely way in a rapidly changing scenario of pest and environment. Several studies have suggested that the potential for adaptation and/or resistance by insect herbivores to secondary metabolites is limited. These metabolites cause direct toxicity to insect pests, stimulate antixenosis mechanisms in plants to insect herbivores, and, by recruiting herbivore natural enemies, indirectly protect the plants. Herbivores adapt to secondary metabolites by the up/down regulation of sensory genes, and sequestration or detoxification of toxic metabolites. PSMs modulate multi-trophic interactions involving host plants, herbivores, natural enemies and pollinators. Although the role of secondary metabolites in plant-pollinator interplay has been little explored, several reports suggest that both plants and pollinators are mutually benefited. Molecular insights into the regulatory proteins and genes involved in the biosynthesis of secondary metabolites will pave the way for the metabolic engineering of biosynthetic pathway intermediates for improving plant tolerance to herbivores. This review throws light on the role of PSMs in modulating multi-trophic interactions, contributing to the knowledge of plant-herbivore interactions to enable their management in an eco-friendly and sustainable manner.

Transcatheter aortic valve replacement (TAVR) initially emerged as a therapeutic option for high-risk patients with severe aortic stenosis. Advancement in technologies since the first era of TAVRs, experience from previous obstacles, and lessons learned from complications have allowed the evolution of this procedure to the current state. This review focuses on the updates on the most current devices, complications, and outcomes of TAVR. Keywords: Aortic stenosis, Transcatheter aortic valve implantation, Transcatheter aortic valve replacement

Introduction: We present a rare case of severe penile torsion of 180° along with giant congenital anterior urethral diverticula. Presentation of these two rare anomalies together is extremely rare and has not been reported yet. The extreme rarity of the case and its management warrants this presentation. Observation: A 5 years old boy presented to us as a case of epispadias with post-void dribbling and wetting of the underwears. On examination, he was found to be a case of severe congenital penile torsion with diversion and rotation of median raphae in a counterclockwise fashion upto the midline dorsally confirming 180° torsion. During voiding, there was appearance of a swelling in distal penile region with passage of urinary drops while compressing it. Micturating cystourethrogram showed diverticula in penile and bulbar urethra. Torsion was completely corrected by penile de-gloving in a plane between two layers of buck fascia and mobilization of the urethra along with spongiosum proximally upto the penoscrotal junction and distally upto the glans. Diverticula was laid open and underwent urethroplasty along with double breasting of thickened diverticular tissue. Torsion was completely corrected after surgery. Post-operative recovery was uneventful. Urine culture was sterile and uroflowmetry showed maximal urinary flow of 12 ml/s at 3 months postoperatively. Conclusions: Penile de-gloving and adequate urethral mobilization corrects the severe penile torsion of 180°. Correction of severe torsion and urethroplasty is feasible in a single stage with good results. Keywords: Penile torsion, Urethral diverticula, Congenital anomalies, Mobilization of urethra, Urethroplasty, Double Breasting, Correction of penile torsion

Contrast-induced acute kidney injury is a common iatrogenic complication associated with increased health resource utilization and adverse outcomes, including short- and long-term mortality and accelerated progression of preexisting renal insufficiency. The incidence of contrast-induced nephropathy (CIN) has been reported to range from 0% to 24%. This wide range reported by the studies is due to differences in definition, background risk factors, type and dose of contrast medium used, and the frequency of other coexisting potential causes of acute renal failure. CIN is usually transient, with serum creatinine levels peaking at 2–3 days after administration of contrast medium and returning to baseline within 7–10 days after administration. Multiple studies have been conducted using variety of therapeutic interventions in an attempt to prevent CIN. Of these, careful selection of patients, using newer radiocontrast agents, maintenance of hydration status, and avoiding nephrotoxic agents pre- and post-procedure are the most effective interventions to protect against CIN. This review focuses on the basic concepts of CIN and summarizes our recent understanding of its pathophysiology. In addition, this article provides practical recommendations with respect to CIN prevention and management.